Past and current drug use among Canadian correctional officers.

Current and past drug use was assessed in a sample of 77 Canadian correctional officers working in two medium-security penitentiaries. 58% of correctional officers indicated past illicit drug use. This compares with 20% of Canadians who indicate illicit drug use. Correctional officers were more likely than the general population to have used marijuana and cocaine.

A survey of drinking behaviors of Canadian correctional officers.

77 correctional officers from two Canadian medium security penitentiaries were surveyed concerning their use of alcohol. 94% reported drinking at least once during the preceding year. 45 men consumed alcohol more frequently than the 29 women, more often felt obligated to drink at social gatherings, and were more likely to believe that drinkers do not suffer health problems related to their drinking. Although other studies have indicated correctional officers have special problems with drinking, more similarities with the general population than differences were found in the present drinking patterns.

The General Electric-Association of University Radiologists Radiology Research Academic Fellowship (GERRAF). An industry-academic collaboration to improve clinical research in radiology.

The association of GE Medical Systems and the AUR represents a unique collaboration between academic radiology and industry that bears important potential for elevating the quality of clinical research in radiology and developing a cadre of high-quality radiologist researchers for the future. The establishment of the GERRAF is especially timely given the new imperatives of the rapidly changing health care environment, with its emphasis on expenditure reduction. The ultimate goals of GERRAF are to develop research leaders for radiology that will provide guidance for appropriate clinical practice, better train future researchers, and secure the role of radiologists in caring for patients.

Pathways to improved radiologic research. An NIH workshop.

In summary, the workshop recommended two years of research training as being essential for radiologists to acquire the skills and knowledge necessary to begin a successful research career in today's funding and academic environment. Many pathways can combine two years of research training and provide fulfillment of existing requirements to achieve specialty certification and subspecialty credentialing. Departments of radiology supporting the beginning qualified investigator should allow him or her approximately 75% research time for the first three years of the academic appointment. Departmental research time accorded faculty members may best be concentrated on a few individuals, providing them sufficient time to be competitive for peer-reviewed grants and enabling research advances to provide a solid foundation for the future of radiologic imaging.

Plasminogen activators: pharmacology and therapy.

Biochemical advances are providing new insights into coagulation and fibrinolysis. Integrating this biochemical knowledge into plasminogen activator therapy improves understanding of currently available enzymes. Basic components of the fibrinolytic system are discussed and the chemical structures, pharmacokinetics, dosages, and modes of delivery of current and future plasminogen activators are reviewed.

Limb salvage in high-risk patients with multisegmental disease.

Is percutaneous iliac angioplasty before distal bypass a logical limb salvage option in a high-risk patient? A retrospective review of 113 iliac angioplasty procedures identified 10 patients in this situation. Angioplasty preceded femoropopliteal bypass (five), femorotibial bypass (three) and, in one case each, femorofemoral bypass or profundoplasty. There were no interventional deaths or complications. Ankle/brachial pressure index improvement followed intervention: 0.28 + 0.2 vs. 0.92 + 0.08, (p less than 0.0005). Limb salvage was 90% at one month, 80% at six months and 70% at one to three years by Life-Table analysis. Two patients with a patent bypass lost limbs from uncontrolled infection within two months. One patient required an amputation 311 days after the only failure of angioplasty and distal bypass. During this study period, 56% of the patients died. This review supports an angioplasty/bypass combined intervention as a valuable treatment option in high-risk patients facing limb loss.

Economics of breast examination in the United States.

Screening mammography is expensive and will increasingly be challenged by professional health care economists. The cost of breast biopsies generated from screening mammography is also very significant. The breast imaging and surgical communities must accept this economic challenge and work to improve cost-effective breast health care delivery systems.

Variation of transducer frequency output and receiver band-pass characteristics for improved detection and image characterization of solid breast masses.

A new approach has been used for ultrasound detection of small benign and malignant breast masses, namely, control of scattering in such a manner that a small mass can be easily recognized because of the effect of the scattering on the contrast between the mass and the surrounding normal tissue. Maintenance of good resolution as scattering is varied is an essential aspect of this approach. Image contrast is dependent on a number of instrumentation parameters but, in a fundamental sense, it is related to differences in the amount of scattering between a solid breast mass and the surrounding normal tissue. In the subject studies, modification of image contrast is accomplished by varying either the center frequency output of the transducer or the band-pass of the receiver. These approaches take advantage of differences in the frequency dependence of scattering coefficients of solid breast masses and normal tissue. A unique technique for varying center frequency without switching transducers was developed, namely, use of a wide bandwidth, co-polymer PVDF transducer, in combination with certain instrumentation conditions which allow the center frequency output of a single ultrasound transducer to vary over a relatively wide frequency range. Using this technique, an automatic B-mode ultrasound imaging breast instrument which allows emission of 3.5, 4.5, 6.5 and 11 MHz ultrasound frequencies from the same co-polymer transducer was used to examine patients with solid breast masses. Both a wide band-pass receiver, similar to that commonly used in clinical ultrasound systems and a tunable receiver (which allows variation of the band-pass from wide to narrow) was used with this automated system. Using the standard receiver system, it was found that there are advantages to having a range of transducer frequencies immediately available for breast examination. These include: (1) improved detection of masses located in highly attenuating regions of breast (by decreasing frequency); (2) availability of diagnostically relevant information at some one frequency which may not be apparent at other frequencies. Using the multiple frequency system and the standard receiver, it was found that the most appropriate examination frequencies for detection and diagnosis of fibroadenomas are higher frequencies (8 to 11 MHz). This is particularly true in the case of fibroadenomas in fatty breasts.(ABSTRACT TRUNCATED AT 400 WORDS)

Interventional radiology for restoration of vascular patency in the postoperative patient--case reports.

The postoperative patient may present with one or more of a variety of problems amenable to management by interventional radiologic techniques, which may be curative by themselves or may, in addition, require or allow successful surgical intervention. To optimize patient care, a good working relationship between the vascular surgeon and the interventional radiologist is essential. Consideration should be given to the patient's presenting signs and symptoms, the surgical history with its alteration of anatomy, the results of available noninvasive studies, and knowledge of various therapeutic alternatives. Vascular radiologic interventions include angioplasty, thrombolytic therapy, a combination of both angioplasty and thrombolysis, and newer techniques such as percutaneous valvectomy. In this report, examples of some of the experience at Indiana University are presented. Emphasis is placed on the appropriate approach to the patient.

MR imaging of central pontine myelinolysis.

Central pontine myelinolysis is a demyelinating disorder with characteristic magnetic resonance features. Findings on T1-weighted scans include a symmetric region of low signal involving the basilar pons with sparing of the descending corticospinal tracts as well as the peripheral pontine tissues. The T2-weighted images show an area of high signal corresponding to the abnormal region identified on T1-weighted scans. Associated extrapontine demyelinating lesions are also demonstrated.

Detection of acute gastrointestinal bleeding by intra-arterial Tc-99m sulfur colloid scintigraphy in a canine model. Preliminary study.

The diagnostic sensitivities of arteriography, intravenous (IV) Tc-99m sulfur colloid scintigraphy, and intra-arterial (IA) Tc-99m sulfur colloid scintigraphy were evaluated in a canine model of gastrointestinal bleeding. Fifteen dogs were studied at bleeding rates ranging from .4 to 1.0 ml/minute. All three studies were obtained in six of the 15 dogs. Intravenous scintigraphy was superior to angiography in two cases, inferior in three, and equal in one. No significant difference could be shown between these two tests at these bleeding rates. Intra-arterial scintigraphy was superior to angiography in four cases and equal in two (P = .06). It was superior to IV scintigraphy in five cases and inferior in one (P = .10). In this small preliminary study, IA scintigraphy appears to be superior to the other two modalities and may prove useful in the detection of acute bleeding at the time of negative arteriography, and in serial studies in patients receiving Pitressin.

The dedicated breast clinic.

There is solid scientific data justifying the routine screening of women as proposed by the ACR and ACS. The review of the financial proforma of dedicated breast imaging clinic indicates routine screening can be accomplished at an affordable price to the patient and provide a reasonable profit for the radiologist. Dedicated mammography equipment, quality imaging, and professional interpretations should produce a profitable operation in both mobile and fixed instillations if one has an adequate market and works successfully at marketing the clinic.

Cerebrovascular disease: evaluation with transbrachial intraarterial digital subtraction angiography using a 4-F catheter.

Three hundred sixty-one patients underwent intraarterial digital subtraction angiography for definite or probable occlusive vascular disease of the carotid arteries. Examinations were performed with 65-cm-long, 4-F aortic catheters. A transbrachial approach was used. Images were good or excellent in nearly all cases. No postprocedural neurologic deficits or hematomas occurred. Permanent pulse deficit occurred in two patients, and temporary deficit occurred in three patients, an improvement over the frequency found in previous transbrachial series using 6-8-F catheters. While these results establish the efficacy of this technique, they also indicate a possible greater relative safety in men than in women.