Molecular imaging in oncology: the acceptance of PET/CT and the emergence of MR/PET imaging

In the last decade, PET-only systems have been phased out and replaced with PET-CT systems. This merger of a functional and anatomical imaging modality turned out to be extremely useful in clinical practice. Currently, PET-CT is a major diagnostic tool in oncology. At the dawn of the merger of MRI and PET, another breakthrough in clinical imaging is expected. The combination of these imaging modalities is challenging, but has particular features such as imaging biological processes at the same time in specific body locations

General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multi-centre observational study

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients' (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16-22) and failed intubation in 1 in 312 (95%CI 1 in 169-667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%)

1,500-year cycle in the Arctic Oscillation identified in Holocene Arctic sea-ice drift

Weather and climate in the Northern Hemisphere is profoundly affected by the Arctic Oscillation, a quasi-periodic fluctuation in atmospheric pressure that occurs on interannual to interdecadal timescales. Reconstructions of the Arctic Oscillation over longer timescales have suggested additional centennial- to millennial-scale variations in the phase of the oscillation, but often with conflicting results. Here we assess patterns of sea-ice drift in the Arctic Ocean over the past 8,000 years by geochemically determining the source of ice-rafted iron grains in a sediment core off the coast of Alaska. We identify pulses of sediment carried by sea ice from the Kara Sea, which can reach the coast of Alaska only during a strongly positive Arctic Oscillation. On the basis of these observations, we construct a record of the Arctic Oscillation phase, and identify a 1,500-year periodicity similar to that found in Holocene records of ice-rafted debrisin the North Atlantic, distinct from a 1,000-year cycle that has been found in total solar irradiance. We conclude that the 1,500-year cycle in the Arctic Oscillation arises from either internal variability of the climate system or as an indirect response to low-latitude solar forcing.</p