Purpose: To examine the relationship between resident experience and fluoroscopy time for peripherally inserted central venous catheter (PICC) placement in a single program over a fouryear period. Materials: We conducted a retrospective analysis of the fluoroscopy times for PICC insertions by radiology residents and IR fellows from a single program, dual institution, over a four-year period. The date of procedure, resident operator and fluoroscopy time (in minutes) were compiled from technician logs. Resident schedules were cross-referenced to determine the level of operator experience at the time of each procedure, defined as weeks of training. Mixed regression models were then used to test the longitudinal relationship between fluoroscopy time and weeks of training. Results: The modeling dataset included 780 observations, with complete data for 735 observations. This included 40 residents with a maximum of 95 observations per resident. The overall model fit was significant (Null model likelihood ratio test chisquare ¼ 51.64), p o 0.0001. The solution for fixed effects noted a significant negative relationship between weeks of training and fluoroscopy time. This relationship was maintained until resident training level reached 20 weeks. Past 20 weeks, a further increase in weeks of experience was met with a plateau in fluoroscopy time. The average fluoroscopy time regardless of experience was 0.88 minutes, with a standard deviation of 1.06 minutes. Conclusions: Fluoroscopy time decreased as resident experience increased. This highlights the importance of early, frequent and hands-on resident participation in the interventional suite to achieve and maintain procedural competency. While technical skill as a function of experience is likely a significant contributor to this phenomenon, a focused orientation to fluoroscopy equipment and radiation reduction techniques may be useful in protecting patients and staff from unnecessary radiation exposure.Purpose: To evaluate the effects of a 10-week interventional radiology elective on pre-clinical medical student perceptions regarding the field of interventional radiology. Materials: A 10-week interventional radiology elective was created by two full-time IR faculty at the University of California, San Francisco Medical School. The elective was offered to first and second year medical students and conducted during the winter elective. At the conclusion of the elective, a survey was distributed to all first and second year students. Responses were collected anonymously via online survey. Results: A total of 53 responses were collected. This included 30 students who did not attend any portion of the elective (noexposure group), and 23 students who attended between 1 and 10 elective sessions (exposure group). Using Fisher's exact tests, the exposure group demonstrated statistically significant differences in knowledge of upcoming changes to the IR training pathway, as well as perceptions regarding inclusivity of female and minority physicians within the specialty. Non-stati...
To investigate the need for hormonal treatment in patients with functional ovarian cysts (FOC), the efficacy of this treatment was evaluated in a retrospective and also in a randomised prospective study. By retrospective analyses the resolution of FOC with a mean diameter larger than 2.0 cm at the beginning of a cycle was determined in 113 patients (31.6 +/- 4.6 years). Fifty-seven women received an oral contraceptive (ethinylestradiol 50 micrograms/d for 7 days, ethinylestradiol 50 micrograms and desogestrel 125 micrograms/d for 15 days), the others had no therapy. In a second study 59 patients (32.3 +/- 4.6 years) were randomised to receive a combination of ethinylestradiol 50 micrograms and levonorgestrel 250 micrograms/d for 21 days (Group 1, n = 24), or lynestrenol 10 mg/d continuously (Group 2, n = 14) or a third group (Group 3, n = 21) without treatment. In both studies no differences were found between those patients who had hormonal treatment and those who had not. The prospective study revealed that spontaneously appearing FOC and FOC evolving after ovulation induction during the cycle prior to study enrolment, resolved equally well within 12 weeks independent of contraceptive or gestagen treatment. FOC persisted in only one woman (group 2) who had a surgically proven endometrioma. In conclusion, hormonal treatment does not produce regression of FOC in women of reproductive age.
Die Zahl ambulanter Eingriffe nimmt in alien FÄchern zu, darunter auch in der Hals-Nasen-Ohren-Heilkunde. Aus anÄsthesiologischer Sicht steht dem nichts entgegen, jedoch mÜssen zur Sicherheit von Patient und Arzt hohe Anforderungen an Vorbereitung und Nachbetreuung gestellt werden. AnÄsthesietypische Komplikationen wie Maligne Hyperthermie oder Ateminsuffizienz bei Pseudocholinesterasemangel sind unabhÄngig vom Fachgebiet, auch deshalb muss eine StationÄrbehandlung jederzeit mÖglich sein. Die anÄsthesiebedingte Hospitalisationsrate liegt im Promillebereich. Besondere Sorgfalt ist wegen der hÖheren Komplikationsgefahren bei Eingriffen an den oberen Luftwegen geboten. Nicht alle Patienten sind fÜr ein ambulantes Vorgehen geeignet; psychologische Vorteile sind in erster Linie fÜr Kinder gegeben, bei Erwachsenen mÜssen die individuellen WÜnsche berÜcksichtigt werden.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.