An Inexpensive and Easy Ultrasound Phantom

Ultrasound models, commonly referred to as “phantoms,” are simulation tools for ultrasound education. Commercially produced phantoms are available, but there are “homemade” alternatives such as raw poultry and gelatin molds. Precooked, processed meat, better known as SPAM (Hormel Foods Corporation, Austin, MN), can be used as an ultrasound phantom to teach several ultrasound applications. It is a versatile, hygienic, and easily manipulated medium that does not require refrigeration or preparatory work and can be easily discarded at the end of use.     

Rapid‐access cardiology services: can these reduce the burden of acute chest pain on Australian and New Zealand health services?

Chest pain is common and places a significant burden on hospital resources. Many patients with undifferentiated low‐ to intermediate‐risk chest pain are admitted to hospital. Rapid‐access cardiology (RAC) services are hospital co‐located, cardiologist‐led outpatient clinics that provide rapid assessment and immediate management but not long‐term management. This service model is described as part of chest pain management and the National Service Framework for coronary heart disease in the United Kingdom (UK). We review the evidence on the effectiveness, safety and acceptability of RAC services. Our review finds that early assessment in RAC outpatient services of patients with suspected angina, without high‐risk features suspicious of an acute coronary syndrome, is safe, can reduce hospitalisations, is cost effective and has good medical practitioner and patient acceptability. However, the literature is limited in that the evaluation of this model of care has been only in the UK. It is potentially suited to other settings and needs further evaluation in other settings to assess its utility.     

Dental case manager encounters: the association with retention in dental care and treatment plan completion

Little is known about dental case managers as few programs have been scientifically evaluated. The goal of this study was to explore the impact of dental case manager on retention in dental care and completion of treatment plans, while specifically exploring the number of dental case manager encounters. Fourteen programs enrolled people with HIV/AIDS (PLWHA) in dental care and a longitudinal study between 2007 and 2009. The 758 participants had a total of 2715 encounters with a dental case manager over twelve months: 29% had a single encounter; 21% had two; 27% had 3–4 and; 23% had 5–29 encounters. Adjusting for baseline characteristics, participants receiving more encounters were significantly more likely to complete their Phase 1 treatment plan, be retained in dental care, and experience improvements in overall oral health status. Organizations considering efforts to improve the oral health of vulnerable, hard‐to‐engage populations should consider these findings when planning interventions.     

The burden of predatory journal and congress requests in foot and ankle surgery

IntroductionIn recent years the proportion of predatory invitations by email of the total number of emails received has grown dramatically. The aim of the current study was to objectify the increase in predatory journal and congress requests per email over a 5.5-year period and their relatedness to the receivers’ speciality in Foot and Ankle surgery.Material and methodA comprehensive Microsoft Outlook^® analysis of 5.5 years’ worth of junk email from one surgical Foot & Ankle specialist working at a Level-1 trauma centre was evaluated. The topic of each email from the last year was scored according to the ‘degree-of-relatedness’.ResultsBetween July 1^st 2013 and December 31^th 2018 a total of 41,687 emails were collected in the junk email folder of Microsoft Outlook^®. A total of 17.0 percent was attributed to emails from predatory journals and congresses. Over the 5.5-year period the percentage of total emails that consisted of invitations from predatory journals and congresses rose from 4.5% to 40.8%. Only an insignificant amount (2.3%) was directly related to the authors medical sub-speciality of Foot and Ankle surgery.ConclusionThis is the first study showing the individual burden of unsolicited emails from predatory publishers and journals. The authors acknowledge the risk that this publication, like all others, will likely result in yet even more invitations from predatory journals and congress invitations. All should be warned of a huge increase in emails from predatory journals and congresses, which has likely not peaked yet. Appropriate action is needed, as we urge foot–ankle interested scientists to publish in indexed journals with proper peer review.     

Custom 3-Dimensional Printed Ultrasound-Compatible Vascular Access Models: Training Medical Students for Vascular Access

PurposeTo generate 3-dimensional (3D) printed ultrasound (US)-compatible vascular models (3DPVAM) and test them for noninferiority in training medical students in femoral artery access.Materials and MethodsA 3DPVAM of normal femoral artery (FA) anatomy was developed from an anonymized computerized tomography (CT) examination. Students were randomized to a 3DPVAM or a commercial model (CM) simulation experience (SE) for US-guided FA access. Students completed a pre-SE questionnaire ranking their self-confidence in accessing the artery on a 5-point Likert scale. A standardized SE was administered by interventional radiology faculty or trainees. Students completed a post-SE questionnaire ranking comfort with FA access on a Likert scale. Student questionnaire results from the 3DPVAM group were compared with those from the CM group by using chi-square, Wilcoxon signed-rank, and noninferiority analyses.ResultsTwenty-six and twenty-three students were randomized to 3DPVAM and commercial model training, respectively. A total of 76.9% of 3DPVAM trainees and 82.6% of CM trainees did not feel confident performing FA access prior to the SE. In both groups, training increased student confidence by 2 Likert points (3DPVAM: P < 0.001; CM P < 0.001). The confidence increase in 3DPVAM trainees was noninferior to that in CM trainees (P < 0.001).ConclusionsGeneration of a custom-made 3DPVAM is feasible, producing comparable subjective training outcomes to those of CM. Custom-made 3D-printed training models, including incorporation of more complex anatomical configurations, could be used to instruct medical students in procedural skills.