@article {10808, title = {Learning curve for the ultrasonographic diagnosis of deep endometriosis using a structured off-line training program.}, journal = {Ultrasound Obstet Gynecol}, year = {2018}, month = {2018 Nov 13}, abstract = {

OBJECTIVE: The aim of the present study was to assess the learning curves of trainees during a structured off-line/hands-on training program on the diagnosis of deep infiltrating endometriosis (DIE).

METHODS: A two-week training program was conducted. One day was devoted to theoretical issues and guided off-line analysis of 10 volumes of three-dimensional (3D) ultrasound. During the following days, five sessions of real-time sonographic examinations were performed in a DIE referral center Ultrasound unit. In between sessions, the trainees analyzed four off-line sets, containing twenty-five 3D volumes each. At the end of each set, misinterpreted volumes were assessed with the trainer. One trainer and 4 trainees (all post-graduated Ob/Gyn with at least 5 years of experience in ultrasonography in Obstetrics and Gynecology but with no experience in DIE sonographic examinations) participated in the study. Presence or absence of DIE at surgery was considered as gold standard for the trainees. Trainee{\textquoteright}s results were evaluated by learning curve cumulative summation (LC-CUSUM) and the deviations of the level of trainees{\textquoteright} performance at the control stage by CUSUM (standard CUSUM) for different locations of DIE.

RESULTS: The trainees reached competence on average after 17 evaluations (range 21-14) for bladder locations, after 39 evaluations (range 60-30) for rectosigmoid locations, after 25 evaluations (range 34-14) for forniceal locations, after 44 evaluations (range 66-25) for utero-sacral locations (USL), after 21 evaluations (range 43-14) for rectovaginal septum (RVS) locations respectively, and kept the process under control with error levels of less than 4.5\% until the end of the test. The overall accuracy for each trainee at the different locations ranged from 0.91 to 0.96 for bladder DIE, from 0.80 to 0.94 for recto-sigmoid DIE, from 0.90 to 0.94\% for forniceal DIE, from 0.79 to 0.82 for utero-sacral ligaments DIE and from 0.89 to 0.97 for recto-vaginal septum DIE.

CONCLUSIONS: The suggested two-weeks learning program based on a mix of off-line and live sessions is feasible and suggests a good performance in training for the diagnosis of DIE. This article is protected by copyright. All rights reserved.

}, issn = {1469-0705}, doi = {10.1002/uog.20176}, author = {Guerriero, Stefano and Pascual, M Angela and Ajossa, Silvia and Rodriguez, Ignacio and Zajicek, Michal and Rolla, Martino and Rams, Noelia Llop and Yulzari, Vered and Bardin, Ron and Buonomo, Francesca and Comparetto, Ornella and Perniciano, Maura and Saba, Luca and Mais, Valerio and Alcazar, Juan Luis} } @article {8063, title = {When Feeding Difficulties Are due to Genetics: The Case of Familial Partial 9q Duplication.}, journal = {J Investig Med High Impact Case Rep}, volume = {3}, year = {2015}, month = {2015 Jan-Mar}, pages = {2324709615574949}, abstract = {

Chromosomal abnormalities may cause growth failure before or since birth. 9q duplication is reported as a cause of intrauterine growth restriction, mild dysmporphism, and intellectual disabilities. We report a case of a maternally inherited 9q21.31q21.33 duplication causing prenatal and postnatal growth restriction with feeding refusal and mild facial dysmorphisms, prenatally diagnosed by single-nucleotide polymorphism array analysis. Hypothesis of the possible pathogenic mechanisms are discussed.

}, issn = {2324-7096}, doi = {10.1177/2324709615574949}, author = {Travan, Laura and Rocca, Maria Santa and Buonomo, Francesca and Cleva, Lisa and Pecile, Vanna and De Cunto, Angela} }