What is the message of a meeting? Analysis and comparison of the 2458 abstracts of the EANM/WCNMB congress in Berlin and the SNM meeting in Toronto in 1998. European Association of Nuclear Medicine/World Federation of Nuclear Medicine and Biology, and the Society of Nuclear Medicine

The abstracts of the joint congress of EANM/WCNMB in Berlin 1998 and of the 45th Annual Meeting of the Society of Nuclear Medicine in Toronto 1998 have been analysed and compared in terms of comprehensibility, composition, questions at issue, methods, patient/subject number, type of conclusion and duplication of information between the meetings. All 1362 and 1096 abstracts, respectively, were analysed from the abstract books with regard to ten "hard" and four "soft" variables. The dominant topics were new radiopharmaceuticals, methods of synthesis, examination methods, evaluation of examinations, investigation algorithms, technical devices and novel use of radiopharmaceuticals. In addition to these topics, there were numerous reports about established radiopharmaceuticals and techniques, often without a specific merit mentioned. There were also many abstracts with questions outside nuclear medicine, but using such techniques. Few papers reported negative findings or dealt with quality assurance, dosimetry, and cost-effectiveness. Many of the conclusions contained hyperbole. Some abstracts were very extensive and detailed. Sixty-seven contributions conveyed identical information at both meetings. Structured and/or paragraphed abstracts promote clarity and reduce the number of lines that need to be read in order to comprehend the background and aim of the abstract. Such contributions were more frequent at the EANM/WCNMB congress while the SNM meeting covered a wider field with a greater representation of radiophysics, instrumentation, and computer evaluations.     

Assessment of abstracts submitted for the 1998 BNMS annual meeting: concordance or lottery?

The selection of abstracts for presentation at the Annual Meeting of the British Nuclear Medicine Society is an arduous task for the assessors. It is only to be expected that assessors' appreciation of an abstract will be biased by their interests and knowledge. This study assessed the concordance between the marks awarded by specialist and general assessors for the 173 abstracts submitted to the 1998 Spring BNMS meeting. The results showed considerable agreement among the markers for most comparisons. We conclude that the current combination of specialist assessors evaluating specific sections and three generalists assessing all abstracts appears to be working well.     

What is the definition of a poisoning?

New insights in medicine and acceptable treatments necessitates an adjustment of the existing definition of clinical or forensic poisoning to: 'An individual's medical or social unacceptable condition as a consequence of being under influence of an exogenous substance in a dose too high for the person concerned'. For medical and legal purposes it is important to know how the victim became poisoned. In general, there are three ways of causing medical poisoning: accidental poisoning, including iatrogenic poisoning, experimental and intentional poisoning. Nowadays iatrogenic intoxication, poisoning caused by the Münchhausen's syndrome (by proxy) and experimental poisoning (designer drugs) have a major place in contemporary toxicology. Although some toxicologists use the word 'intoxication' only overdoses with central effects, in this article 'intoxication' and 'poisoning' are considered to be synonymous.     

What is the role of titin in active muscle?

Several properties of muscle defy explanation solely based on the sliding filament-swinging cross-bridge theory. Indeed, muscle behaves as though there is a dynamic "spring" within the sarcomeres. We propose a new "winding filament" mechanism for how titin acts, in conjunction with the cross-bridges, as a force-dependent spring. The addition of titin into active sarcomeres resolves many puzzling muscle characteristics.     

What is the significance of haemosiderin in the lungs of deceased infants?

In infants, pulmonary haemosiderin has been put forward as a marker of previous asphyxic abuse and possible grounds for suspicion of homicide. Review of the available literature does not provide a strong enough evidence base to support this claim. Further research is needed before instigation of criminal proceedings can be justified on this pathological finding.     

Debulking Atherectomy in the Peripheral Arteries: Is There a Role and What is the Evidence?

CardioVascular and Interventional Radiology - Traditional percutaneous balloon angioplasty and stent placement is based on mechanical plaque disruption and displacement within the arterial wall. On...     

Reflections on the role of consultant radiographers in the UK: What is a consultant radiographer?

ContextThis paper is the second paper from a two year in depth case study, exploring the role of consultant radiographers in the UK.MethodsA longitudinal case study approach was used to determine the role of consultant radiographers. Interviews were used to explore experiences of being a consultant, which were analysed using thematic analysis.Eight consultant radiographers participated (Note, two of the consultants withdrew after the first interview due to workload). Therefore two consultants were interviewed only once. The remaining six consultants were interviewed twice over a 12 month period.FindingsThe data presented in this paper explores the nature of the role, differences between roles, the four domains of practice, and how the role fits into local organisational structures.The study shows wide variation in the types of roles undertaken, reflecting that the creation of these roles were in response to local clinical need and often related to an individual practitioner's skills. The broad scope of the role was shown across all the consultants, with evidence of roles developing into new areas of service delivery.ConclusionsThe paper offers insight into the role(s) of consultant radiographers in the UK. The range and scope of their practice is extensive, with much variation. It is evident that the clinical aspect of the role dominates, with research being the least supported domain of practice. There remains a lack of clarity around the role, with concerns about remuneration and other limitations that may restrict the role developing further.     

What is the role of bone scintigraphy in the diagnosis of infected joint prostheses?

AIM: To analyse the role played by bone scintigraphy in the diagnosis of infected joint prostheses. METHODS: The study included 77 patients, aged 32-77 years, in whom infection of a joint prosthesis (48 hip, 29 knee) was suspected. In all patients the following examinations were performed consecutively: a two-phase Tc methylene diphosphonate (Tc-MDP) bone scan, a Tc hexamethylproplyene amine oxime (Tc-HMPAO) labelled white blood cell (WBC) scan, and a Tc microcolloid bone marrow (BM) scan. The minimum interval between examinations was 48 h. The diagnoses were based on data obtained from bacteriological cultures. RESULTS: The bone scan was positive in all patients and 28 of them had an infection (sensitivity 100%, specificity 0%). The WBC scan was positive in 61 patients but only 27 had an infection. The WBC scan was negative in 16 patients, and the possibility of infection was discarded in 15 of these cases (sensitivity 96%, specificity 30%). The results of the bone marrow scan were not compatible with those of the WBC scan (suggestive of infection) in 27 patients: 26 of them had prosthesis infection. The results of both examinations were compatible in the other 34 patients and the possibility of infection was discarded in 33 of these patients (sensitivity 92.8%, specificity 98%). The addition of a BM scan to a WBC scan decreased the sensitivity from 96% to 92.8% but increased specificity from 30% to 98%. The addition of a bone scan to this dual combination did not alter the results. CONCLUSIONS: When infection of a prosthesis is suspected the diagnostic procedure should start with a WBC scan followed, if positive, by a BM scan. This procedure reduces the cost, the time required for a diagnosis, and the dose of radiation received by the patient.     

What is the appropriate approach in sex determination of hyoid bones?

The hyoid bone is characterized by sexually dimorphic features, enabling it to occasionally be used in the sex determination aspect of establishing the biological profile in skeletal remains. Based on a sample of 298 fused and non-fused hyoid bones, the present paper compares several methodological approaches to sexing human hyoid bones in order to test the legitimacy of osteometrics-based linear discriminant equations and to explore the potentials of symbolic regression and methods of geometric morphometrics. In addition, two sets of published predictive models, one of which originated in an indigenous population, were validated on the studied sample. The results showed that the hyoid shape itself is a moderate sex predictor and a combination of linear measurements is a better representation of sex-related differences. The symbolic regression was shown to exceed the predictive powers of linear discriminant function analysis when two models based on a logistic and step regression reached 96% of correctly classified cases. There was a positive correlation between discriminant scores and an individual's age as the sex assessment was highly skewed in favour of males. This suggests that the human hyoid undergoes age-related modifications which facilitates determination of male bones and complicates determination of females in older individuals. The validation of discriminant equations by Komenda and ?erný (1990) and Kindschud et al. (2010) revealed that there are marked inter-population and inter-sample differences which lessened the power to correctly determine female hyoid bones.     

Injury prevention and the promotion of physical activity: What is the nexus?

The promotion of physical activity is a public health priority for Australia. The new "National Physical Activity Guidelines for Australians" include a statement on additional health benefits of vigorous sporting and fitness activities. However, injury associated with sport and physical activity can lead to significant health care costs and consequent disabilities and reduced mobility may result in inactivity, this increasing the risk of cardiovascular disease and other health problems. Consideration of injury prevention principles when promoting physical activity is therefore crucial. There are several areas of research needed in this new field. These include the importance of good quality population monitoring and the use of other data sources to determine the population-wide consequences and health costs of injury sustained during sport and physical activity. The goal is to have evidence based, educational, regulatory and other preventive strategies that can be systematically evaluated by drawing on well organised, representative population-based injury data.     

What is the role of calcium scoring in the age of coronary computed tomographic angiography?

Non-contrast-enhanced CT for coronary artery calcification (CAC) as a marker of coronary atherosclerosis has been studied extensively in the primary prevention setting. With rapidly evolving multidetector CT technology, contrast-enhanced coronary CT angiography (CCTA) has emerged as the non-invasive method of choice for detailed imaging of the coronary tree. In this review, we systematically evaluate the role of CAC testing in the age of CCTA in both asymptomatic and symptomatic patients, across varying levels of risk. Although the role of CAC testing is well established in asymptomatic subjects, its use in evaluating those with stable symptoms that represent possible obstructive coronary artery disease is controversial. Nevertheless, available data suggest that in low-to-intermediate risk symptomatic patients, CAC scanning may serve as an appropriate gatekeeper to further testing with either CCTA (if no or only mild CAC present) versus functional imaging or invasive coronary angiography (when moderate or severe CAC present). Given the strong short-term prognostic value of CAC?=?0, studies are needed to further evaluate the role of CAC scanning in low-risk patients with acute chest pain presenting to the emergency room.