Diagnostic performance of transvaginal ultrasound and magnetic resonance imaging for preoperative evaluation of low-grade endometrioid endometrial carcinoma: prospective comparative study.

OBJECTIVE: To compare the diagnostic performance of transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) in the prediction of deep myometrial invasion (DMI) and cervical stromal invasion (CSI) in patients with low-grade (Grade 1 or 2) endometrioid endometrial cancer (EEC). METHODS: This was a prospective study including all patients with low-grade EEC diagnosed between October 2013 and July 2018 at the Vall d'Hebron Hospital in Barcelona, Spain. Preoperative staging was performed using TVS and MRI, followed by surgical staging. Final histology was considered as the reference standard. Sensitivity, specificity, likelihood ratios and diagnostic accuracy were calculated for both imaging techniques in the prediction of DMI and CSI, and the agreement index was calculated for both techniques. The STARD 2015 guidelines were followed. RESULTS: A total of 131 patients with low-grade EEC were included consecutively. Sensitivity was higher for TVS than for MRI both for the prediction of DMI (69% (95% CI, 53-82%) vs 51% (95% CI, 36-66%), respectively) and CSI (43% (95% CI, 27-61%) vs 24% (95% CI, 12-41%), respectively). Specificity was similar for TVS and MRI in the prediction of DMI (87% (95% CI, 78-93%) vs 91% (95% CI, 82-96%)) and equal in the prediction of CSI (97% (95% CI, 91-99%) for both). The agreement index between TVS and MRI was 0.84 (95% CI, 0.76-0.90) for DMI and 0.92 (95% CI, 0.85-0.96) for CSI. CONCLUSIONS: The diagnostic performance of TVS is similar to that of MRI for the prediction of DMI and CSI in low-grade EEC, and TVS can play a role as a first-line imaging technique in the preoperative evaluation of low-grade EEC. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

[Who Stays Loyal to Orthopaedics and Trauma Surgery? Results of a Nationwide Survey]. / Wer bleibt nach einer Famulatur in Orthopädie und Unfallchirurgie dem Fachbereich treu? Ergebnisse einer bundesweiten Umfrage.

INTRODUCTION: The general shortage of medical doctors in Germany can also be felt in the area of trauma and orthopaedics. Medical elective placements, in Germany known as "Famulatur", are sensitive interfaces between the theoretical university studies and the practical medical workplace. In this research project, the aim was to study how medical students perceive these types of placements and if it alters their decision making when planning their further career. METHODS: During the summer term of 2012, 9079 medical students answered an online questionnaire. Of these, the subgroup was evaluated that had had a placement of at least 4 weeks in the field of trauma and orthopaedics. Overall, 37 test items about this placement and further career steps were included in this study. Groups were evaluated separately by the item "I am considering a career in trauma and orthopaedics" (PJ-Ja) versus "I am not considering a career in trauma and orthopaedics" (PJ-Nein). RESULTS: Overall 397 students were included in this study; 55 % were female. 267 (67.3 %) stated: "I am considering a career in trauma and orthopaedics"; 130 (32.7 %) were not. There was no significant difference in age or sex between these groups (sex: χ²= 2.50, p = 0.114; age: F[1.93]< 1, p = 0.764). Specific and statistically significant differences between those groups were found in the items team integration, ward climate, qualification of teaching, training for specific knowledge in the field, practical aspects of the tasks performed, general planning and structure of the elective achievement of the teaching goals. DISCUSSION: Knowledge of satisfaction during medical elective placements is essential if one aims to inspire students for a specific medical profession. Instructors who can identify weaknesses and deficits in their training regime can therefore in the future increase the number of medical doctors who choose their speciality. The foundation of personal development has to be laid very early in the career of medical students.

Lack of an association of miR-938 SNP in IDDM10 with human type 1 diabetes.

MicroRNAs (miRNAs) are a newly discovered type of small non-protein coding RNA that function in the inhibition of effective mRNA translation, and may serve as susceptibility genes for various disease developments. The SNP rs12416605, located in human type 1 diabetes IDDM10 locus, changes the seeding sequence (UGU[G/A]CCC) of miRNA miR-938 and potentially alters miR-938 targets, including IL-16 and IL-17A. In an attempt to test whether miR-938 may be a susceptibility gene for IDDM10, we assessed the possible association of the miR-938 SNP with T1D in an American Caucasian cohort of 622 patients and 723 healthy controls by TaqMan assay. Our current data do not support the association between the SNP in miR-938 and type 1 diabetes.

[Giant cell arteritis and polymyalgia rheumatica: influence of past pregnancies? The GRACG multicenter case control study]. / Maladie de Horton et pseudopolyarthrite rhizomélique: influence des antécédents de grossesse? Etude cas-témoins prospective GRACG.

BACKGROUND: The overprevalence of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) in women remains unexplained. Microchimerism pathogenicity has been discussed in some systemic diseases. We tested history of pregnancy as a risk factor for GCA. METHODS: Prospective, multicenter case-control study with multiple, age-matched, control groups. Patients have been included in 40 different centers. The first control group has been randomly selected in the general population, consecutive hospitalized patients in two geographically distant departments of internal medicine made up the second and third ones. RESULTS: Three hundred and fifteen patients (249 GCA and 66 PMR), 242 general population controls, 333 in the first hospitalized control group, and 355 in the second, have been included in the 1991-1998 period. Pregnancy has been constantly protective against GCA/PMR (Wilcoxon rank sum test: P = 0.0001, 0.0005, and 0.054, respectively, for the three control groups), more particularly for parity equal or greater than 4 (OR = 0.32, 95% CI: 0.18-0.57, P = 0.00003; OR = 0.44, 95% CI: 0.26-0.74; P = 0.0009, and OR = 0.42; 95% CI: 0.25-0.71, P = 0.0006, respectively). In multivariate analysis, risk for GCA on pre-existing degenerative, vascular disease is decreased by half for each pregnancy (OR = 0.49, 95% CI = 0.27-0.90, P = 0.022). CONCLUSION: Contrary to the initial hypothesis, multiparity is a protective factor against GCA. Mechanism is unknown.