Abstracts 2013

Canadian Journal of Anesthesia/Journal canadien d'anesthésie -     

Assistentenbefragung 2013

The 2013 residents’ survey was conducted electronically and aimed to provide an overview of the current situation and to disclose differences in comparison to the results of previous surveys. Although cardiac surgery does not suffer from an obvious lack of residents, it can still record a loss of attractiveness. This is largely due to the unstructured and nontransparent training. In addition, there is an increase in the average working hours and in colleagues being offered only fixed-term contracts. This goes along with a rising number of unmarried and childless residents. At the same time, the sex ratio is getting more balanced. An unfavorable work-life balance and a lack of perspectives are further important aspects within this context. Additional titles and certificates become increasingly interesting for residents and may provide further career options. Establishing new model regulations on postgraduate medical training and launching a modular education program should modernize and thus improve residents’ training in cardiac surgery.     

PSA-Screening 2013

In the healthcare political discussions on treatment measures, the controversy over prostate-specific antigen (PSA) screening has taken a leading role in comparison to, for example the relatively undisputed role of breast and colon screening. This has fortunately led to an in-depth critical analysis of the available data. One advantage is the benefit on survival which increases with longer follow-up observation times. When carrying out studies the quantitative extent of this benefit can become obscured by prescreening, prevalent screening, lack of compliance, contamination and healthy screen bias. Nevertheless, the European randomized screening study of prostate cancer (ERSPC) study, for example, showed sufficient statistical power to confirm a screening benefit after 9 or 11 years (evidence level A). However, even for prostate cancer the internal problems of preventive medicine of overdiagnosis and overtherapy are also partially dependent on the age range of the screening population and the screening frequency (28–52?%). Unnecessary deficits in the quality of life reduce the benefit of survival in these patients. By using a PSA fine tuning and risk stratification, approximately one third of diagnoses and therapies can be avoided. Additionally, the active surveillance of tumors unsuitable for treatment together with an improved quality of therapy should become of greater importance.