National radiology on-call survey: a cross-sectional survey investigating diagnostic radiology on-call provision by trainees out of hours

AIMS

To investigate how diagnostic radiology on-call work is conducted by trainees out of hours, and to explore how this on-call experience may be improved from a trainee perspective.

MATERIALS AND METHODS

A nationwide online questionnaire was distributed to each radiology training scheme. A trainee on the diagnostic on-call rota completed the questionnaire on behalf of the scheme. Twenty-six questions spanning four domains were assessed exploring how radiology service provision is performed by trainees out of hours, and ways to improve it.

RESULTS

Forty schemes responded, representing the entire population size. Twenty-eight (70%) schemes formally assessed trainees prior to joining the on-call rota. Almost half (46%) of trainees start verifying reports independently at ST2. The most common combinations of imaging performed out of hours accounting for 32% each were: (1) computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and radiography; and (2) CT, ultrasound and radiography. A majority of schemes (54%) had a fixed number of trainees across all shift types.

CONCLUSION

Radiology on-call provision by trainees varies considerably. Common factors between schemes include all trainees providing an on-call service on weekend day shifts. The most sought-after recommendation to improve the on-call experience was to introduce a collaborative reporting on-call hub set-up where trainees cross-cover multiple sites remotely as a team. Further analytical studies are needed to assess if any relationships between on-call set-up and trainee satisfaction exist.

The Cheshire & Merseyside Collaborative trainee-led on-call service: a review of safety and efficiency

AIM

To assess safety and efficiency of the Cheshire & Merseyside Collaborative, the largest trainee led on-call service in the UK, based on discrepancy rates and time taken to issue reports.

MATERIALS & METHODS

All studies reported by the collaborative in a 4-week period were evaluated for discrepancy and the time taken to issue a report. These figures were compared against the Royal College of Radiologists (RCR) guidelines and a recent national audit of discrepancy rates. The time taken to report was measured against the National Institute of Health and Clinical Excellence (NICE) and Trauma Audit Research Network (TARN) guidelines.

RESULTS

The overall discrepancy rates for the collaborative were 2.5% for minor discrepancies and 2% for major discrepancies, which is within the RCR standard. The median time taken to issue a report was 30 min, which is within the NICE and TARN 1-h targets.

CONCLUSIONS

The Cheshire & Merseyside Collaborative can be deemed a safe and efficient way of delivering an out-of-hours radiology service.

Berberis lycium Royle. extracts attenuate inflammation and modulates hyperglycemia in alloxan induced diabetic rats

Berberis lycium Royle (Berberidaceae) is traditionally used for the treatment of diabetes mellitus. Present study was conducted to determine the antioxidant, antidiabetic and anti-inflammatory effects of aqueous and methanolic whole plant extracts. Total phenolic contents were determined by Folin-ciocalteu method whereas antioxidant activity was determined by 2,2-diphenyl-1-picryl hydrazyl (DPPH) method. In vitro anti-diabetic activity was determined using alpha amylase assay. Acute hypoglycemic activity was investigated on normoglycemic rats. Sub-acute anti-diabetic effects were investigated in alloxan induced diabetic rats for 14 days. Methanolic extract exhibited 183.5±1 mg/g Gallic acid equivalent (GAE) phenolic contents. The methanolic extract exhibited an IC50 of 242µg/mL and 37.26 mg/mL in antioxidant and alpha amylase inhibitory assays respectively. Administration of methanolic extract in normoglycemic rats exhibited significant anti-hyperglycemic effect at 90 and 120 min. Methanolic extract (500 mg/kg extract) significantly reduced blood glucose at day 14. Methanolic extract (500 mg/kg) significantly reduced the concentration of tumor necrosis factor (TNF-α) and interleukin (IL-6) along with reduction in total cholesterol and triglyceride levels in diabetic rats. Administration of methanol extract also improved the hepatic markers. The study suggested that the methanolic extract possessed antidiabetic effect that might be attributed to its alpha amylase, antioxidant and anti-inflammatory potential.

Prevalence of Anaplasma phagocytophilum in horses from Southern Punjab (Pakistan)

The present study was designed to optimize a PCR-RFLP protocol for the molecular detection of Anaplasma sp. and to compare its prevalence in blood samples of equines from Southern Punjab (Pakistan) and to find out the risk factors involved in the spread of anaplasmosis. A total of 210 blood samples were collected from equines from 2 sampling sites (Dera Ghazi Khan and Khanewal districts). Data on the animals' characteristics (age, species and gender) were collected through survey. PCR amplified the 577bp product specific for 16S rRNA gene of Anaplasma spp. in 9 blood samples (4.3% of total), [Dera Ghazi Khan (N = 3) and Khanewal (N = 6)]. These Anaplasma spp. positive blood samples were used for PCR amplification using A. phagocytophilum specific primers and parasite was detected in all of them. Also it was revealed that the characteristics of the animals i.e. age, gender, species had no significant association with the presence of Anaplasma sp. Hematological parameters remained unaffected while lymphocyte count was significantly lowered in A. phagocytophilum positive samples.

The development of cytomegalovirus-induced adrenal failure in a patient with AIDS while receiving corticosteroid therapy

We report a case of Addisonian crisis due to cytomegalovirus (CMV) adrenalitis occurring in a patient with AIDS while receiving supraphysiological doses of steroids for the treatment of Pneumocystis carinii pneumonia. The case highlights the importance of considering the diagnosis of adrenal failure in AIDS, even in patients receiving supraphysiological doses of steroids.