No abstract

Using 2010 McDonald criteria, 30% of the CIS patients could be diagnosed with MS using a single MRI scan. Inclusion of symptomatic lesions in the DIT criteria further increases this proportion to 33%.

ObjectiveThe objective of this paper is to evaluate potential dose-dependent adverse effects of gadolinium-based contrast agents (GBCAs) on MS progression.MethodsOutcomes from a cohort of 612 secondary progressive MS (SPMS) patients, enrolled in a two-year, placebo-controlled (negative) trial assessing the efficacy of MBP8298, were acquired. Patients received one to four (infrequent cohort; IFR) or 5–11 (frequent cohort; FR) GBCA injections between week 4 and week 104. The primary outcome was the change in Expanded Disability Status Scale (EDSS) and time to confirmed EDSS progression. Secondary outcomes included the changes in the Multiple Sclerosis Functional Composite (MSFC), Timed 25-Foot Walk (T25FW), 9-Hole-Peg Test (9HPT), and Paced Auditory Serial Addition Test (PASAT) from baseline to week 104.ResultsThe 512 IFR and 100 FR participants showed no differences in baseline demographics or disease history. The mean change from baseline to week 104 in EDSS was +0.21 (IFR) and +0.13 (FR); MSFC –0.38 (IFR) and –0.14 (FR); T25FW +1.28 (IFR) and +0.55 (FR); 9HPT –0.06 (IFR) and –0.08 (FR); and PASAT +0.22 (IFR) and +0.20 (FR). The FR to IFR progression hazard ratio equaled 0.68 (p = 0.09). There were no significant differences in any of the outcomes between the two cohorts.ConclusionThere were no differences in the disability progression measures between the two cohorts, indicating that gadolinium does not result in greater clinical worsening in SPMS after a two-year period.

Hyperintensity in deep brain structures from gadolinium deposition is related to the number of doses and the type of linear gadolinium-based contrast agent (nonionic greater than ionic) administration.

Purpose To determine medical students' and radiologists’ attitude toward radiology electives at a distributed medical school and identify specific areas for improvement. Methods During a single academic year, both students and faculty preceptors were surveyed anonymously following a senior radiology elective. The survey was based on an established theoretical framework for studying the educational environment which takes into account domains: (1) goal orientation, (2) organization/regulation, and (3) relationships. Mann-Whitney tests were performed to determine if there was any difference between the overall satisfaction of students and preceptors, responses from the different elective sites and students’ ratings of the domains. Statistical significance was set at P < .05. Thematic analysis was performed on the narrative comments to identify specific challenges. Results The response rate was 82.0% for students (95/116) and 19.5% (31/159) for radiologists. There was no difference in responses based on elective site. Overall, the elective was viewed positively by both groups however students rated their experience as significantly better than their preceptors ( P = .0012). Students viewed the relationships domain more positively than both the other two (goal orientation, P = .0001; organization/regulation, P = .0038). Thematic analysis identified that the student challenges were lack of autonomy, structured teaching, and preceptor continuity and the preceptor challenges were ambiguous learning objectives/expectations and insufficient resources. Conclusions The radiology elective challenges identified in this study provide educators with specific areas to target when updating radiology electives. A better elective experience may improve students' radiology knowledge and attitude towards the specialty as well as radiologists’ interest in teaching.