Long-term sequelae of sporadic cryptosporidiosis: a follow-up study.

To determine the frequency of occurrence of sequelae following cryptosporidiosis. A follow-up study was performed during a case-control study for sporadic cryptosporidiosis in the Netherlands (2013-2016). Cryptosporidiosis cases were invited to complete a follow-up questionnaire 4 months after diagnosis. Using a case-crossover study design, we compared the frequencies of reported symptoms 4 months after the acute phase to those reported 4 months before the onset of illness and during illness. Frequencies of symptoms in the pre- to post-infection phases were also compared with those of a population control group. Cryptosporidium species-specific effects were also studied. Logistic regression was used to calculate adjusted odds ratios (aOR) for symptoms occurrence. Of the 731 available cases, 443 (60%) responded and 308 (42%) could be included in the follow-up study. The median age was 26 years (range 1-80); 58% were female; 30% were infected with C. hominis and 70% with C. parvum. Compared to before illness, cases were significantly more likely to report dizziness (OR = 2.25), headache (OR = 2.15), fatigue (OR = 2.04), weight loss (OR = 1.82), diarrhoea (OR = 1.50), abdominal pain (OR = 1.38) or joint pain (OR = 1.84). However, symptoms of joint pain and headache occurred among cases after illness at a rate that was not significantly different from that observed in the general population. There were no significant differences in post-infection symptom occurrence between C. hominis and C. parvum. The disease burden of cryptosporidiosis extends beyond the acute phase of the infection, with cases reporting both intestinal and extra-intestinal symptoms up to 4 months following infection.

[Gender-specific evaluation of student's career planning during medical study in terms of orthopaedic trauma]. / Geschlechtsspezifische Wahrnehmung des orthopädisch-unfallchirurgischen Berufsbilds während des Medizinstudiums.

BACKGROUND: Due to recent changes in the medical licencing act as well as to the introduction of a new model-course programme for medical studies, careers in medicine have become increasingly more attractive. However, there is still a dramatic shortage in younger generation physicians, especially within the surgical fields. The goal of this cross-sectional study was the gender-specific assessment of the ideal career wishes of students during medical school, with a focus being placed in orthopaedic trauma surgery. MATERIALS AND METHODS: During the winter semester of 2010/2011 an online questionnaire (www.surveymonkey.com) was created for students enrolled in their 3rd to 12th semester (n=887). The questionnaire consisted of 50 questions [Likert scale (LS); 5 = agree, 1 = disagree] along with 10 free response questions. The scope of these questions ranged from personal career goals, within the context of their learning environment, to general life goals and planning. With regard to career choice, a differentiation was made between students' ideal career choices/subjects (IS), which were based solely on personal affinity, and so-called reality-based subjects (RS), which students considered more practical and to which they were more likely to apply in the future. RESULTS: The response rate was 36,4% (n=323, 23,4 years, 6.3 semesters, 226 [70.0%] female [f] and 97 [30.0%] male [m]). A total of 206 students (63.8%; m=55.7% vs. f=66.7%; p=0.047) were able to pinpoint an IS, this percentage increased with increasing semester number (p=0.048). Overall, 29.1% of students indicated that their IS lay in the field of orthopaedic trauma, while 20.0% of men and 19.1% of women saw it as a realistic career path (RS). Throughout the course of their studies, from the 3rd semester to their practical year, a declining tendency was observed regarding the agreement between ideal and realistic career paths. Particularly evident was a decreasing interest in the field of orthopaedic trauma, beginning around the 9th semester and during the practical year, especially among the female student population. The reason for this shift seems multifactorial, ranging from concerns about family planning as well as the work load in a male-dominated field. By the time students enter their practical year, 13.5% of women and 15.4% of men were still certain in their choice to pursue a career in orthopaedic trauma (RS). CONCLUSIONS: It seems that there is great interest in the fields of orthopaedic trauma among both female and male students in the middle portion of their studies. Women, especially, tend to prefer a specialisation in this operative field early in the course of their studies. However, this pool of potential successors decreases dramatically with time, due to personal experiences garnered on the wards, expectations regarding career paths (male-dominated, long hours) as well as concerns about family planning. The most dramatic shift seems to occur during the practical year.

[Undergraduate curricular training in musculoskeletal ultrasound: the impact of preexisting anatomic knowledge]. / Kurrikulare Ultraschallausbildung am Bewegungsapparat: Einfluss der anatomischen Vorbildung auf die Weitergabe von Basis-Skills an der Schulter.

OBJECTIVE: The aim of this study was to evaluate the impact of students preexisting anatomic proficiency to address the fundamental problems related to musculoskeletal ultrasound (MSUS) training by assessing the peer-assisted learning (PAL) system. METHODS: Students without anatomic knowledge (first semester, n = 38) and students in their fourth semester of medical school (n = 49) were randomly assigned to two groups: 1) The PAL group - teaching by a group of three minimally trained student-teachers and 2) the Staff group - students were taught by a group of three ultrasound-experienced operators. Sessions included both a theoretical and a praxis component (DEGUM/EULAR, Toshiba Nemio™ XG, 10 MHz). A multiple choice questionnaire (MCQ) and an objective structured clinical examination (OSCE) were performed. Qualitative differences were evaluated by the Likert scale. RESULTS: Exposure included three separate lessons (each 120 minutes, 65 minutes of active scanning). The results of the MCQ were better among the fourth semester students than among those without anatomic knowledge (p < 0.001). Among first semester students, the MCQ results were better for those who had been taught by medical staff than for those who had been instructed by means of PAL (4.3 vs. 3.1; p = 0.045). At no point during the practical evaluation did significant differences arise between students of fourth and first semesters after medical staff tutoring (19.6 vs. 19.7 points; p = 0.978). PAL did result in worse results with regard to practical MSUS competence levels in the students possessing no previous knowledge (OSCE score 16.1; p = 0.042). CONCLUSIONS: Although deficits in theoretical knowledge cannot be compensated for, basic MSUS content appears to be adequately transferable to students with limited anatomic knowledge. Thus, an early implementation of MSUS during medical school education would be prudent, provided that the training is performed by an experienced MSUS operator.