CTA in acute stroke: short intensive training intervention is highly effective in improving radiologists' performance.

AIM: To determine whether focussed radiology training in reporting stroke computed tomography angiography (CTA) improved diagnostic performance of general radiology specialty trainees staffing regional on call rotas. MATERIALS AND METHODS: A validated case archive (VCA) consisting of 50 hyperacute stroke CTA cases was developed for a full day course on CTA interpretation. Training days were organised ensuring all local trainees had a chance to attend. The rate of major and minor amendments by neuroradiology consultants were reviewed in 252 on-call radiology trainee reports. RESULTS: Before training, radiology trainees had a total discrepancy (reporting error) rate of 37%: 12% major, 25% minor. Following CTA training, the total discrepancy rate was not significantly reduced (34%) but there was a substantial reduction in major discrepancies to 4% (p=0.037; odds ratio=3.30, 95% confidence interval [CI]: 1.08 to 10.12). CONCLUSION: An intensive training course based on a hyperacute stroke VCA significantly reduced major discrepancies in stroke CTA interpretation for radiology trainees. The ability of radiology trainees to recognise large vessel occlusions and other significant findings improved.

Laparoscopic adjustable gastric banding: a 10-year single-centre experience of 575 cases with weight loss following surgery.

BACKGROUND: Laparoscopic adjustable gastric banding (LAGB) is one of the commonest bariatric procedures in the UK. This study reports our experience with this procedure over the last 10 years. METHODS: A prospectively maintained database of all the patients undergoing LAGB at our centre between March 2000 and August 2010 was analysed. RESULTS: Five hundred seventy-five patients underwent LAGB at our centre. There was no mortality in this series. Early (30-day) morbidity rate was 2.2 %. Late complications (20 %) comprised: 78 repositioning of the inflation port in 65 patients, repositioning of band in 24 patients (4 %), removal of band in 20 patients (3.4 %), conversion to bypass in 41 patients (7 %), diagnostic laparoscopy in 1 patient and subtotal gastrectomy in 1 patient. Median follow-up was 29 months. The median of percentage of weight loss (%WL) and excess body weight loss (EBWL) was 18.3 and 40 %, respectively, at ≥ 5 years post-LAGB. Patients with body mass index (BMI) over 50 kg/m(2) were compared to those with BMI ≤ 50 kg/m(2). No significant difference was noted in the weight loss between both of these groups. No significant difference was noted with regards to weight loss between patients <60 and >60 years of age. CONCLUSIONS: In this cohort of patients, %WL and EBWL were 18.3 and 40 % ≥ 5 years after LAGB, respectively, and early and late complication rates were 2.2 and 20 %, respectively. Majority of late complications were in the first 100 patients. Multifactorial causes included the surgical learning curve and patient selection process.