Long-term Results for Expectant Management of Ultrasonographically Diagnosed Benign Ovarian Teratomas.

OBJECTIVE: To assess the natural history of ultrasonographically diagnosed benign ovarian teratomas in asymptomatic women. METHODS: We conducted a retrospective observational cohort study of 408 women (mean age 36.6 years, range 14-81 years) diagnosed as having an ovarian teratoma by transvaginal ultrasonography (except eight who only had a transabdominal study done) between January 2003 and December 2013 at a single tertiary care institution. Six hundred thirteen women were diagnosed with ovarian teratoma of whom 205 were promptly treated surgically, leaving 408 patients followed conservatively with follow-up scans at 3 and 6 months from diagnosis and then yearly. The ultrasonographic diagnosis of a benign ovarian teratoma required at least one of the following features: a cystic mass with mixed echogenicity, thick band-like echoes, a fat-fluid level, or echogenic tubercle with posterior shadowing. Clinical, ultrasonographic, and histologic data (in case of surgery) were retrieved for analysis. RESULTS: During follow-up, 130 of 408 (31.8%) women underwent surgery. The main reason for surgery was the physician's recommendation according to our protocol (n=115). One patient had adnexal torsion. Most surgeries (112/130 [86.2%]) were performed within the first 5 years after diagnosis. The remainder (278/408) is still being followed (median time 45.6 months, range 6-147 months). The vast majority of these lesions had no change and women remain asymptomatic. Histologic diagnosis of tumors removed surgically revealed a benign ovarian teratoma in 103 of 130 (79.2%) of the women. There were two borderline tumors, four endometriomas, three fibromas, seven serous cysts, two mucinous cysts, two stroma ovarii, seven other benign, and no case of malignant tumor. CONCLUSION: Our results demonstrate that expectant management might be a reasonable option for managing asymptomatic women who receive a ultrasonographic diagnosis of a benign ovarian teratoma. The risk of undergoing surgery for this lesion decreases significantly after 5 years to follow-up. With careful observation, the risk of missing a diagnosis of malignancy is low.

A Simple Method for Excluding Uterine Canalization Defects Using Two-Dimensional Ultrasound in Infertile Women.

Objective: To compare the uterine transverse diameter (UTD) in women with normal uteri and women with uterine canalization defects as well as to assess its performance for ruling out such defects. Study Design: Retrospective analysis of prospectively collected data in a series of selected women with primary or secondary infertility. Measurement of UTD and 3D volume acquisition for subsequent off-line analysis was performed in order to identify possible canalization defects. UTD of the normal uterus, measured by 2D ultrasound, was compared to that of arcuate, subseptate, and septate uteri. ROC curve was plotted to determine the best UTD cutoff for differentiating normal from abnormal uteri. Results: A total of 421 women were ultimately evaluated. UTD was significantly larger in women with arcuate (53.3 mm, SD 6.3, p<0.05), subseptate (55.0 mm, SD 6.7, p<0.05), and septate (56.0 mm, SD 4.8, p<0.05) uterus as compared with the normal uterus (45.9 mm, SD 7.1). ROC curve showed that the best UTD cutoff for ruling out the presence of a uterine canalization defect was 45 mm (AUC 0.809, 95% CI 0.768­0.849). Conclusion: Measurement of UTD may be a simple and practical method for ruling out a uterine canalization defect in infertile women.

Normal and abnormal images of intrauterine devices: Role of three-dimensional sonography.

The purpose of this pictorial essay is to describe the diagnostic value of two-dimensional ultrasound (2DUS) and the additional information that three-dimensional ultrasound (3DUS) provides in the assessment of location, type and complications of IUDs.

Aprendizaje-servicio: una nueva metodología para formar profesionales del equipo de enfermería / Service-learning: a new methodology to train nursing team professionals

Objetivos: demostrar que el Aprendizaje-Servicio (ApS) mejoraba la adquisiciónde conocimientos y habilidades instrumentales en estudiantes deTécnico en Cuidados Auxiliares de Enfermería frente a las metodologías clásicasy conocer qué percepción tenía éstos respecto al crecimiento personalrelacionado la metodología ApS.Material y métodos: estudio cuasiexperimental en 48 alumnos de la Escuelade Ciclos Formativos SOLC NOU (Barcelona), durante el curso 2007-08. Variables estudiadas: tipo de metodología de enseñanza/aprendizaje (variableindependiente): metodología ApS (grupo experimental) y metodologíaclásica (grupo control). Variables dependientes: conocimientos teóricos y habilidadesinstrumentales adquiridas, tanto a través del Aps como de metodologíasclásicas, contribución percibida por el estudiante del ApS para eldesarrollo de las capacidades clave y para su crecimiento personal. Se calcularoníndices de estadística descriptiva y se usaron pruebas no paramétricaspara el análisis bivariante.Resultados: se estudiaron 44 alumnos. En el grupo experimental (metodologíaApS) la media de la calificación para los conocimientos adquiridos fuede 7,27 (IC95%: 7,24-8,20) y de 7,91 (IC95%: 7,53-8,29) para las habilidadesinstrumentales adquiridas. En el grupo control (metodología clásica)la media de la calificación para los conocimientos adquiridos fue de mediantela metodología ApS fue de 6,75 (IC95%: 6,12-7,38) y de 7,44 (IC95%:7,10-7,78) para las habilidades instrumentales adquiridas (..) (AU)

Objectives: to demonstrate that Service-Learning (S-L) improved the acquisitionof knowledge and instrumental skills in students enrolled in the NursesAid Technician’s programme against traditional methods of teachingand to determine what the students’ perception were regarding personalgrowth as it relates to S-L methodology.Material y methods: a quasi-experimental study on 48 students enrolled atthe Vocational Professional SOLC NOU School (Barcelona) during the2007/2008 academic year. Studied variables included: type of teaching/learning methods (independent variable): S-L methodology (experimentalgroup) and traditional methods (control group). Dependent variables:acquired theoretical knowledge and instrumental skills, both throughS-L and traditional teaching methods, contribution as perceived by the SLstudent for the development of key skills and for his or her personal growth.Descriptive statistics indexes were calculated and non parametric tests usedfor bivariate analysis.Results: 44 students were assessed. In the experimental group the meanclassification score for acquired learning was 7,27 (CI 95%: 7,24-8,20)and 7,91 (CI 95%: 7,53-8,29) for acquired instrumental skills. In the controlgroup (traditional methodology) the mean classification score for acquiredknowledge by means of the S-L method was 6,75 (CI 95%: 6,12-7,38) and 7,44 (CI 95%: 7,10-7,78) for acquired instrumental skills.No students regard S-L methodology as having contributed “nothing to little”to the development of their key capacities. S-L contributed to the personalgrowth of the students in 98% of students.Conclusions: even though the results have not been statistically significant,the scores were higher with the S-L method, for the acquisition of knowledgeas well as for the acquisition of instrumental skills. The S-L “let’stake care of our elderly” has made a very positive contribution to the developmentof the pupils’ key capacities and their personal capacities (AU)