Geburtshilfe Und Frauenheilkunde最新文献

{"title":"Adjuvant Targeted Treatment of Early Hormone Receptor-positive HER2-negative Breast Cancer: Olaparib, Abemaciclib or Ribociclib - Which One, How and For Whom?","authors":"Stefan Lukac, Kerstin Pfister, Henning Schäffler, Elena Leinert, Angelina Fink, Brigitte Rack, Visnja Fink, Wolfgang Janni, Sabine Heublein","doi":"10.1055/a-2562-8469","DOIUrl":"10.1055/a-2562-8469","url":null,"abstract":"<p><p>With around 70000 new cases every year, breast cancer (BC) continues to be the most prevalent form of cancer. Hormone receptor-positive, HER2-negative (HR+/HER2-) BC is the most common type and accounts for around 70% of cases of early BC (eBC). The development of new drugs in recent years has significantly improved the survival of patients with eBC. Alongside established endocrine therapy (ET) options such as tamoxifen, aromatase inhibitors (AI), and GnRH analogs, additional treatment options such as CDK 4/6 inhibitors (abemaciclib and ribociclib) and the PARP inhibitor (olaparib) are now also available. To facilitate their use in clinical practice, this article provides a summary of the current information on the use of these drugs in clinical practice. Abemaciclib was approved for the adjuvant treatment of HR+/HER2- eBC in cases with positive lymph node involvement in 2022. The MonarchE trial showed that the addition of abemaciclib to ET improved invasive disease-free survival (iDFS) after 5 years by around 7.6% in patients with a high risk of recurrence. Ribociclib, another CDK4/6 inhibitor, was recently approved based on the results of the NATALEE trial. When combined with non-steroidal AIs, ribociclib showed a significant iDFS benefit of 4.9% after 4 years in node-positive and node-negative patients with a high risk of recurrence. The PARP inhibitor olaparib may be used to treat patients with BRCA germline mutation and HR+/HER2- eBC and a high risk of recurrence (CPS-EG score ≥ 3). The OlympiA approval study showed an iDFS benefit of 7.3% after four years and a benefit of 3.4% for overall survival. In summary, targeted therapies are expanding the range of adjuvant treatment options for patients with HR+/HER2- eBC and a higher risk of recurrence. Treating physicians are increasingly facing the challenge of choosing the optimal therapy for their patients. To do so, it is essential to carefully weigh up potential side effects against the expected benefit of treatment on a case-by-case basis.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 6","pages":"590-598"},"PeriodicalIF":2.4,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COGNITION-GUIDE - Genomics-Guided Targeted Post-Neoadjuvant Therapy in Patients with Early Breast Cancer: Study Design of a Multicenter, Open-Label, Umbrella Phase II Study.","authors":"Constantin Pixberg, Christian Maurer, Katharina Smetanay, Luise Straßl, Mario Hlevnjak, Marc Zapatka, Celina V Wagner, Haniyeh Yazdanparast, Johanna Kurzawa, Vanessa Erben, Fangyoumin Feng, Chen Hong, Daniel Hübschmann, Lars Buschhorn, Jan Philip Suppelna, Laura Michel, Sabine Heublein, Carlo Fremd, Oliver Zivanovic, Peter Sinn, Albrecht Stenzinger, Renate Haidinger, Eva Schumacher-Wulf, Nina Ditsch, Sibylle Loibl, Stefan Fröhling, Theresa Link, Pauline Wimberger, Jens-Uwe Blohmer, Hanna Huebner, Peter A Fasching, Wolfgang Janni, Richard F Schlenk, Verena Thewes, Peter Lichter, Andreas Schneeweiss","doi":"10.1055/a-2557-1876","DOIUrl":"10.1055/a-2557-1876","url":null,"abstract":"<p><strong>Background: </strong>As part of the COGNITION diagnostic registry program, residual tumor material after neoadjuvant therapy (NAT) of patients with early breast cancer (eBC), who are still at high-risk for relapse after NAT, is analyzed by next generation sequencing to identify biomarkers and actionable alterations. This strategy aims to stratify patients for subsequent genomics-guided therapies to reduce the significant risk of metastatic dissemination and hence to improve disease-free survival.</p><p><strong>Patients and methods: </strong>COGNITION-GUIDE is a multicenter umbrella phase-II-trial to translate molecular biomarker profiles generated in the COGNITION platform into six molecular-guided post-neoadjuvant therapeutic options in addition to standard-of-care treatment. Patients can be allocated toimmune checkpoint inhibition (PD-L1-antibody),PI3K inhibition,AKT inhibition,PARP inhibition,anti-Trop-2 antibody-drug-conjugate,HER2 inhibition or, in case of missing biomarkers, to observation for 12 months.The primary endpoint is invasive disease-free survival (IDFS) four years after surgery. Secondary endpoints include IDFS in each study arm separately, distant disease-free survival, overall survival and safety. 240 patients will be enrolled within four years.</p><p><strong>Conclusions: </strong>The COGNITION-GUIDE trial, which was activated in June 2023 and will recruit in different centers in Germany, empowers a risk-adapted, biomarker-guided therapy escalation algorithm in eBC patients who are still at high risk of metastasis.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 6","pages":"611-619"},"PeriodicalIF":2.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indirect Treatment Comparison between Ribociclib Combined with Non-Steroidal Aromatase Inhibitors and Ovarian Function Suppression vs. Tamoxifen in Premenopausal Women with Early Breast Cancer.","authors":"Diana Lüftner, Maggie Banys-Paluchowski, Andreas D Hartkopf, Manuel Hörner, Wolfgang Janni, Dagmar Langanke, Volkmar Müller, Andreas Schneeweiss, Marcus Schmidt, Marc Thill, Michael Untch, Achim Wöckel, Lukas Höllrich, Julia Kreuzeder, Almuth Marx, Julia Meinzinger, Hanna Regus-Leidig, Christian Roos, Hien Wohlgemuth, Stephanie Sussmann, Peter A Fasching","doi":"10.1055/a-2561-6640","DOIUrl":"10.1055/a-2561-6640","url":null,"abstract":"<p><strong>Background: </strong>This study provides an indirect treatment comparison of ribociclib combined with non-steroidal aromatase inhibitors and ovarian function suppression (ribociclib + NSAI + OFS) vs. a frequently used treatment option in German clinical routine (tamoxifen ± OFS) in premenopausal patients with HR-positive (HR+), HER2-negative (HER2-) early breast cancer (BC).</p><p><strong>Material and methods: </strong>Data on premenopausal women treated with ribociclib and tamoxifen were derived from the NATALEE clinical trial (NCT03701334) and the retrospective German data collection CLEAR-B, respectively. NATALEE trial eligibility criteria were applied to the CLEAR-B dataset. Standardized mortality ratio weights were used for propensity score (PS) adjustment to balance study populations. All hazard ratios (HR) were calculated based on a 4-year-observation period for both treatment arms. Effectiveness endpoints comprised invasive and distant disease-free survival (iDFS, dDFS), recurrence-free survival (RFS), and overall survival (OS). Safety-related endpoints were treatment termination (TT) and toxicity-related TT (TTtox). For safety comparisons, the ribociclib arm was divided into groups that discontinued ribociclib + NSAI + OFS or ribociclib only.</p><p><strong>Results: </strong>Significant beneficial effects favoring ribociclib + NSAI + OFS (n = 1115) over tamoxifen ± OFS (n = 822) were observed for all effectiveness outcomes (iDFS [HR = 0.5 (95% CI 0.35; 0.71); p < 0.01]; dDFS [HR = 0.52 (95% CI 0.35; 0.77); p = 0.01], RFS [HR = 0.42 (95% CI 0.29; 0.62); p < 0.01], OS [HR = 0.34 (95% CI 0.18; 0.63); p = 0.01]) during the 4-year-observation period. The effect of early treatment discontinuation showed no significant differences between ribociclib + NSAI + OFS and tamoxifen ± OFS (TT-a: HR = 1.2 [95% CI: 0.71; 2.01], p = 0.48; TTtox-a: HR = 0.54 [95% CI 0.22; 1.30], p = 0.23).</p><p><strong>Conclusion: </strong>In this retrospective analysis, ribociclib + NSAI + OFS demonstrated advantages across all effectiveness endpoints, including OS, in premenopausal women with HR+, HER2- early BC, without increasing overall treatment discontinuation rates compared to tamoxifen ± OFS.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 6","pages":"599-610"},"PeriodicalIF":2.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcoma of the Uterus. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No. 015/074, June 2024).","authors":"Markus Wallwiener, Marco Johannes Battista, Eike-Christian Burandt, Wolfgang Cremer, Gerlinde Egerer, Mathias K Fehr, Markus Follmann, Paul Gass, Heidemarie Haase, Philipp Harter, Florian Heitz, Simone Hettmer, Lars-Christian Horn, Ingolf Juhasz-Böss, Karin Kast, Günther Köhler, Thomas Kröncke, Katja Lindel, Alexander Mustea, Jan Philipp Novotny, Edgar Petru, Peter Reichardt, Kerstin Rhiem, Hans-Georg Strauß, Clemens Tempfer, Falk C Thiel, Uwe Andreas Ulrich, Thomas Vogl, Dirk Vordermark, Dominik Denschlag","doi":"10.1055/a-2496-2591","DOIUrl":"10.1055/a-2496-2591","url":null,"abstract":"<p><p><b>Purpose</b> This is an official, recently updated guideline published and coordinated by the German Society of Gynecology and Obstetrics ( <i>Deutsche Gesellschaft für Gynäkologie und Geburtshilfe</i> , DGGG) together with the Austrian Society of Gynecology and Obstetrics ( <i>Österreichische Gesellschaft für Gynäkologie und Geburtshilfe</i> , OEGGG) and the Swiss Society of Gynecology and Obstetrics ( <i>Schweizerische Gesellschaft für Gynäkologie und Geburtshilfe</i> , SGGG) as part of the guidelines program. Because of their rarity and heterogeneous histopathology, uterine sarcomas are challenging in terms of their clinical management, and treatment requires a multidisciplinary approach. <b>Methods</b> This S2k guideline was first published in 2015. The update published here is again the result of a structured consensus of a representative interdisciplinary group of mandate holders and experts who carried out a selective search of the literature on uterine sarcomas. Members of the participating professional societies achieved a formal consensus on recommendations and statements after a structured consensus process. <b>Recommendations</b> Recommendations were made about the epidemiology, classification, staging of uterine sarcomas, symptoms, general diagnostic workup, general pathology and genetic predisposition for uterine sarcomas, leiomyosarcomas, endometrial stromal sarcomas (low-grade and high-grade), undifferentiated uterine sarcomas, adenosarcomas, and rhabdomyosarcoma of the uterus in children and adolescents. The guideline also discusses the follow-up of uterine sarcomas, the management of morcellated uterine sarcomas, and the information provided to patients.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 4","pages":"378-394"},"PeriodicalIF":2.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sentinel Lymphonodectomy in Early Vulvar Cancer in Daily Practice: a Multicenter Experience from Germany.","authors":"Philipp Soergel, Matthias Hempel, Julia Gallwas, Christian Dannecker, Linn Woelber, Ruediger Klapdor, Peer Hantschmann, Dirk M Forner, Paul Gass, Monika Hampl","doi":"10.1055/a-2541-2191","DOIUrl":"10.1055/a-2541-2191","url":null,"abstract":"<p><strong>Objective: </strong>Inguinal sentinel lymph node dissection has been shown to be safe in early vulvar cancer in several studies and is considered or even recommended in many guidelines. The prognosis of inguinal recurrence is often poor and associated with significant mortality. To ensure an acceptably low false-negative rate and recurrence, vulvar sentinel lymph node dissection should only be performed using high-quality standards. This retrospective study aims to investigate the incidence of isolated groin recurrence in daily practice in six large cancer centers in Germany.</p><p><strong>Methods: </strong>We identified all patients with early vulvar cancer in 2009-2015 who underwent inguinal sentinel lymphonodectomy and presented with node-negative final histologic results. Patient details regarding disease stage, sentinel procedure, and follow-up were examined using local cancer databases and patient registries.</p><p><strong>Results: </strong>A total of 414 patients with available follow-up data were found, with a mean follow-up time of 38.4 months. The mean tumor size, measured in the dermal plane before surgery, was 40.0 mm, with a median tumor size of 36 mm. Isolated groin recurrence was found in 13 of 414 cases, leading to an isolated groin recurrence rate of 3.1%. The mean time to isolated groin recurrence was 17.7 months. There was no statistically significant association of any of the different quality requirements (tumor size < 4 cm, unifocal tumor, histologic ultra-staging, and preoperative exclusion of suspicious groins) with isolated groin recurrence.</p><p><strong>Conclusion: </strong>Sentinel lymphadenectomy in vulvar cancer is a safe procedure in daily practice. The requirements of the cancer guidelines (unifocal tumor, ≤ 4 cm, histologic ultrastaging, and exclusion of suspicious groins preoperatively) should be followed to ensure a low isolated groin recurrence rate. However, in this study, we could not find any difference between the patients who fulfilled the guideline requirements and those who did not.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 5","pages":"533-540"},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Microcirculatory Dysfunction During Paclitaxel Treatment as a Critical Co-Factor for the Development of Chemotherapy-Induced Peripheral Neuropathy.","authors":"Susanne Reuter, Rika Bajorat, Fabian Müller-Graf, Amelie R Zitzmann, Volkmar Müller, Anna-Lena Pickhardt, Daniel A Reuter, Stephan H Böhm, Brigitte Vollmar","doi":"10.1055/a-2499-9856","DOIUrl":"10.1055/a-2499-9856","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy-induced peripheral neuropathy (CIPN) has a lasting impact on quality of life with a high prevalence and the lack of preventive and causal treatment options. In addition, they are often dose-limiting for curative and palliative oncological therapy. The aim of this study was to systematically investigate the occurrence of paclitaxel-induced peripheral microcirculatory dysfunction and its potential impact on peripheral neuropathy using an experimental <i>in vivo</i> approach.</p><p><strong>Methods: </strong>77 female 8-week-old mice were randomly assigned into three groups. Each group was exposed to the following intraperitoneal interventions in a blinded fashion: The therapy group was treated with six cycles of paclitaxel. In the control group, mice received six cycles of saline solution. In the vehicle group, animals received six cycles of cremophor. Various microscopic, neurological and biochemical analyses were performed to assess the effects on peripheral nerve function, microcirculation and inflammation.</p><p><strong>Results: </strong>Von Frey's neurological test showed a progressive peripheral neuropathy with a significant change in the sensitivity in the sense of hypesthesia of the hind paws in mice treated with paclitaxel. Beside signs of systemic inflammation, intravital microscopic analysis showed a significant reduction in functional capillary density, increased venular leukocyte adherence and endothelial permeability in the paclitaxel-treated mice compared to the control groups. In addition, serological tests and histopathological examinations underlined the paclitaxel-induced inflammation and nerve damage as well as the disturbance of the microcirculation.</p><p><strong>Conclusion: </strong>The presented findings suggest that paclitaxel-induced microcirculatory disturbances may contribute to the development and severity of CIPN, highlighting the importance of considering microvascular and inflammatory mechanisms in the pathogenesis and management of chemotherapy-induced neuropathy.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 7","pages":"710-723"},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Results for the Evaluation of the Cervical Cancer Screening Carried Out in 2021 and 2022 in the Context of the Organized Cancer Screening Program (oKFE): Part 1 - Primary Screening.","authors":"Juliane Hellfritsch, Marieluise Panzer, Sebastian Wagner, Kathleen Nieschke, Martin Grohmann","doi":"10.1055/a-2502-6915","DOIUrl":"10.1055/a-2502-6915","url":null,"abstract":"<p><p>Organized cancer screening programs (oKFE) aim to detect and treat various cancers in their early stages. The German oKFE Directive has set out the requirements for evaluating the efficacy, quality, and safety of such programs. The first evaluation report on the cervical cancer screening program in Germany was published in May 2024 and covers the years 2021 and 2022. Women with statutory health insurance who are above the age of 20 and live in Germany are entitled to be screened for cervical cancer. Between the ages of 20 and 34 years, women are offered an annual cytology-based examination. From the age of 35 years and above, screening consists of a cytology examination and an HPV test (co-testing). The current evaluable data consists of pseudonymized data obtained from statutory health insurance companies and service providers as defined by the specifications of the IQTIG. The evaluation shows that around three million women between 20 and 34 years of age undergo cervical cancer screening every year, which corresponds to a response rate of 45%. As regards the co-testing carried out in women aged 35 years and above, around 2.3 million women with statutory health insurance had cytological examinations and co-testing in 2021 and 1.3 million women were similarly examined in 2022. The participation rate for this cohort cannot yet be determined as the three-year interval for persons eligible for this type of screening cannot be depicted using only two years of data. 97% of cytology smears were unremarkable. Fewer than 0.1% of smears resulted in cytological findings indicating precancerous cervical lesions or cervical malignancies. The average positive rate for HPV tests carried out as part of co-testing was 8.56%. The high-risk human papilloma viruses 16/18 were identified in 30% of cases with positive HPV tests, and the presence of these high-risk viruses increased in parallel with an increase in the severity of cytological findings. More than 30% of insured women aged between 20 and 34 years have been fully vaccinated against HPV. The limitations of this evaluation are the short observation period, some data gaps, and the not yet implemented combination of screening data with data from the cancer registries of the German federal states. It is not yet possible to make valid statements about the acceptance of the screening program and the long-term impact of this program.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 4","pages":"417-433"},"PeriodicalIF":2.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy, Childbirth and Puerperium in Women with Spinal Cord Injury: Guideline of the DGGG and DMGP (S2k-Level, AWMF Registry No. 179/002, August 2024.","authors":"Markus Schmidt, Anke Jaekel, Sue Bertschy, Ute Lange, Simone Kues, Kai Fiebag, Gesa Cohrs, Ulrich Mehnert, Doris Knorr, Marlies Onken, Amke Baum, Barbara Schilcher, Ines Kurze","doi":"10.1055/a-2490-2876","DOIUrl":"10.1055/a-2490-2876","url":null,"abstract":"<p><p>This guideline on pregnancy, childbirth and puerperium for women with spinal cord injury (SCI) presents general issues relating to the wish to have children and pregnancy in the context of SCI. The guideline was developed by the German-speaking Medical Society for Paraplegia ( <i>Deutschsprachige Medizinische Gesellschaft für Paraplegiologie</i> , DMGP) and the German Society for Gynecology and Obstetrics ( <i>Deutsche Gesellschaft für Gynäkologie und Geburtshilfe</i> , DGGG). As there were no generally available evidence-based guidelines about this complex set of problems, this new guideline aims to standardize procedures using a structured consensus-of-experts approach. The aim is to establish general interdisciplinary standards and provide practical assistance for the care and counseling of women with SCI who wish to have children/are pregnant and thereby close the identified gaps in medical care, information, interdisciplinary cooperation and research.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 3","pages":"265-281"},"PeriodicalIF":2.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Technology-Supported Ultrasound Training in Prenatal Diagnosis through an Adaptive Image Recognition Training System (AdaptUS).","authors":"Talia Sachs, Stefan Michel, Katarina Koziol, Alex Kunz, Agnes Wittek, Ricarda Neubauer, Hannah Klinkhammer, Johannes Weimer, Brigitte Strizek, Florian Recker","doi":"10.1055/a-2510-7185","DOIUrl":"10.1055/a-2510-7185","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Prenatal diagnostics, particularly ultrasound examinations, are vital for monitoring fetal development and detecting potential complications. Traditional ultrasound training often lacks adequate focus on image recognition and interpretation, which are crucial for accurate diagnostics. This study evaluates the effectiveness of the AdaptUS module, a technology-supported, adaptive learning platform designed to enhance ultrasound diagnostic skills in prenatal medicine.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospective cross-sectional study was conducted with 76 medical students from the German University Hospital, divided into an intervention group (n = 37) and a control group (n = 39). The intervention group engaged with the AdaptUS module, which adjusts its content based on individual performance. More precisely, it is a learning program for ultrasound images that, while not directly adaptive to the user's skill level, can be considered adaptive in the sense that incorrectly answered images are presented again for re-interpretation. However, the images are currently shown at random and are not yet adjusted to the user's abilities, ensuring that the challenge is consistent but not tailored to skill level. It is important to note that this is not an ultrasound image software, but rather an image interpretation software designed to help users improve their diagnostic skills through repeated exposure to medical images. In contrast, the control group did not receive this training. Both groups were assessed on their ultrasound diagnostic skills at the beginning and end of the semester using a series of 16 questions, which involved interpreting images correctly rather than a standard multiple-choice format. Statistical analysis was performed to compare the pre- and post-test results within and between the groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The intervention group showed a significant improvement in their mean test scores, increasing from 70.9% to 86.0% (p &lt; 0.001), while the control group's scores decreased slightly from 62.0% to 59.0%, though this change was not statistically significant. The difference in score improvements between the intervention and control groups was statistically significant (p &lt; 0.001). The feedback from students in the intervention group was overwhelmingly positive, highlighting the system's flexibility in addressing individual learning needs and suggesting its potential for broader integration into medical curricula.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;The AdaptUS training module significantly enhances ultrasound diagnostic skills, particularly in prenatal medicine, by providing a personalized learning experience that addresses the gaps in traditional training methods. The success of AdaptUS underscores the importance of integrating adaptive learning technologies into medical education to bridge the gap between theoretical knowledge and practical application. Future research should explore the long","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 3","pages":"323-332"},"PeriodicalIF":2.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Undergraduate Medical Students' Perceptions and Career Choices in Obstetrics and Gynecology.","authors":"Lina Duhm, Agnes Wittek, Ruben Plöger, Nicolas Haverkamp, Milka Marinova, Brigitte Strizek, Florian Recker","doi":"10.1055/a-2500-0078","DOIUrl":"10.1055/a-2500-0078","url":null,"abstract":"<p><strong>Introduction: </strong>There is a global shortage of obstetricians and gynecologists (OB/GYN), raising concerns about patient care and workforce sustainability. Germany faces a particularly acute shortage, exacerbated by the impending retirement of many senior consultants. This study explores the career perceptions of graduate-entry medical students at the University of Bonn, focusing on their attitudes toward a career in OB/GYN.</p><p><strong>Methods: </strong>A cohort of fifth year medical students (n = 213) participated in this study. Surveys were administered directly via QR codes at two points in the 10th semester: pre-rotation (pre-clerkship) and post-rotation, at the time of the OSCE (OSCE = objective structured clinical examination) in OB/GYN. The questionnaires assessed multiple dimensions of students' career preferences, understanding of the specialty, and the impact of clinical exposure on their perceptions. Statistical analyses, including McNemar's test, were performed to evaluate changes in students' perspectives.</p><p><strong>Results: </strong>The findings revealed that prior to clinical exposure, only 32% of students expressed interest in a career in OB/GYN. After completing the rotation, this interest remained unchanged. Notably, concerns about night shifts increased significantly post-rotation, with 75% of students citing it as a key deterrent. Furthermore, financial considerations gained importance, with 54% of students highlighting future income as a critical factor post-rotation compared to 43% pre-rotation. Despite improved understanding of OB/GYN following hands-on experience, concerns about workload and stress persisted.</p><p><strong>Discussion: </strong>While clinical exposure increased students' knowledge of OB/GYN, it did not significantly affect their interest in the specialty, likely due to concerns about work-life balance and the demanding nature of the field. The study underscores the need for reforms in OB/GYN training and practice environments to address these deterrents and improve recruitment into this essential specialty.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 3","pages":"333-343"},"PeriodicalIF":2.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}