Changes in the market for diagnostic radiologists as measured through a help wanted index

OBJECTIVE: We sought to create and validate a help wanted index for tracking changes in the radiology job market. SUBJECTS AND METHODS: All jobs advertised in Radiology and the American Journal of Roentgenology from January 1991 through December 1998 were tracked according to three separate parameters: academic versus private practice, subspecialty, and region. Statistical comparison was made between the first and second 48-month subperiods to identify changes. RESULTS: Thirteen thousand seven hundred one advertised positions were coded. A dramatic decrease in job advertisements was noted after December 1991, with advertisements falling to one eighth of their late 1991 peak. A recovery has occurred, with advertising now approaching peak levels. Shifts were seen toward more private practice, midwestern location, vascular and interventional, and mammography positions. Declines occurred in the share of positions in California, the Southwest, and several radiology subspecialties. Other trends were noted but were statistically less significant. A strong correlation (R = 0.98) was found between the annual number of positions advertised and radiologists' median incomes relative to those of all physicians. CONCLUSION: The job market in radiology, much as in other fields, can be tracked in a coincident manner with the use of a help wanted index. Changes in the makeup of radiology practice are important and are identified in a well-constructed index. These findings have validity and can be useful as an adjunct to other information for policy and planning purposes.     

The role of lipopolysaccharides in endotoxin-induced thymocyte proliferation and chondrocyte collagenase synthesis

Crude endotoxin preparations from Haemophilus actinomycetemcomitans and Bacteroides gingivalis showed activity in the two principal bio-assays for interleukin 1--the lymphocyte activating factor assay and stimulation of chondrocyte collagenase synthesis. Lipopolysaccharides purified from the crude endotoxins had reduced activity in the chondrocyte collagenase assay. The activity of the endotoxins may be due to synergic interaction between their lipopolysaccharides and other, as yet unidentified, bacterial components.     

Idiopathic myelopathies with white matter vacuolation in non-acquired immunodeficiency syndrome patients

Postmortem examination of 21 patients showed a vacuolar myelopathy resembling that associated with the acquired immunodeficiency syndrome. Underlying diseases included six cases of leukemia or lymphoma, five of carcinoma, three of systemic lupus erythematosus, two of chronic lung disease, and one each of cadaveric renal transplant, cirrhosis, diabetes, hemophagocytic syndrome, and viral encephalitis. Fourteen patients were on long-term steroid therapy and 10 of these also had immunosuppressive chemotherapy. No patient had the acquired immunodeficiency syndrome, although one received blood transfusions in 1978. Signs and symptoms consistent with myelopathy included paraparesis in seven patients, ataxia in one, and bilateral extensor plantar reflexes in one. Microscopic examination showed vacuolation in spinal cord white matter primarily located in posterior and lateral columns. Lipid-laden macrophages and axonal changes were proportional to the severity of the vacuolation, which was severe in five patients, moderate in 10, and mild in six. Eight patients had coexistent viral diseases elsewhere in the central nervous system, but viral-associated antigens or genomic material was not found in regions of vacuolated spinal cord white matter. Although the etiology of these myelopathies is unknown, their association with immune suppression and coexistent viral infection of the central nervous system suggests that an opportunistic viral infection may be important.     

Assoziation von Mukoviszidose, Zöliakie und heterozygotem α-1-Antitrypsin-Mangel bei einem Kleinkind

Background. Cystic fibrosis associated diseases as coeliac disease or α-1-antitrypsin deficiency may remain undetected for a long time, as the leading symptoms may be explained by the underlying basic disorder CF. Case report. We report on a 4 year old caucasian cystic fibrosis patient with additional α-1-antitrypsin deficiency and coeliac disease. If a patient with cystic fibrosis fails to thrive despite intensive treatment, additional disorders, for example coeliac disease, must be excluded by means of serology and histology. An α-1-antitrysin deficiency syndrom in cystic fibrosis patients with hepatic manifestation may accelerate the progression of liver cirrhosis and increase the risk of acquiring pseudomonas aeruginosa.     

Sonographically detectable changes in placental structures in pregnancy. 5. Statistical comparison of the frequency distribution of placental stages 0-3 in newborn infants in a pregnancy of less than 37 weeks duration

The analysis of sonographically provable changes of placental structures in 97 pregnant women (202 examination) shows in cases with a duration of pregnancy less than 37 gestational weeks that stage 0 could be found statistically significant more frequent until the 32nd week of pregnancy, stage 1 in the whole pregnancy, stage 2 and 3 between the 29. and 36. gestational week. Stage 0 and 1 don't effect prematurity; however stages 2 and 3 could be proved before the 32nd or 34th week of pregnancy in 41 or 100% of examination respectively and effect a premature birth. Stage 2 could be proved 2,8 times more frequent and stage 3 4 times more frequent in premature babies than in newborns with a normal duration of pregnancy.     

Topiramate in the treatment of binge eating disorder associated with obesity: a randomized,placebo-controlled trial

OBJECTIVE: Binge eating disorder is associated with obesity. Topiramate is an antiepileptic agent associated with weight loss. The objective of this study was to evaluate topiramate in the treatment of binge eating disorder associated with obesity. METHOD: For this 14-week, double-blind, flexible-dose (25-600 mg/day) topiramate trial, 61 outpatients (53 women, eight men) with binge eating disorder who were obese (body mass index >/=30 kg/m(2)) were randomly assigned to receive topiramate (N=30) or placebo (N=31). The primary efficacy measure was binge frequency. The primary analysis of efficacy was a repeated-measures random regression with treatment-by-time as the effect measure. RESULTS: Compared with placebo, topiramate was associated with a significantly greater rate of reduction in binge frequency, binge day frequency, body mass index, weight, and scores on the Clinical Global Impression severity scale and the Yale-Brown Obsessive Compulsive Scale (modified for binge eating). Topiramate was also associated with significantly greater reductions in binge frequency (topiramate: 94%, placebo: 46%) and binge day frequency (topiramate: 93%, placebo: 46%) and with a significantly higher level of response than placebo. The mean weight loss for topiramate-treated subjects who completed the study was 5.9 kg. Median topiramate dose was 212 mg/day (range=50-600). Nine patients (three receiving placebo, six given topiramate) discontinued because of adverse events. The most common reasons for discontinuing topiramate were headache (N=3) and paresthesias (N=2). CONCLUSIONS: Topiramate was efficacious and relatively well tolerated in the short-term treatment of binge eating disorder associated with obesity.     

Slow saccadic eye movements in Wilson''s disease

This is the first reported case of Wilson's disease where a global defect of saccadic eye movements has been documented by electro-oculography. The defect of rapid eye movements is discussed in relation to current anatomical, pathological, and experimental work relating to the descending frontobulbar saccadic eye movement system. It is suggested that the caudate nucleus pathology in Wilson's disease might be responsible for the defect of saccadic movement by interrupting a descending polysynaptic pathway.