[Early Diagnosis of Osteoarthritis: Clinical Reality and Promising Experimental Techniques]. / Frühdiagnose der Arthrose: klinische Realität und experimentelle Pipeline.

It is considered that the structural damage in early osteoarthritis (OA) is potentially reversible. It is therefore particularly important for orthopaedic and trauma surgery to develop strategies and technologies for diagnosing early OA processes. This review presents 3 case reports to illustrate the current clinical diagnostic procedure for OA. Experimental techniques with translational character are discussed in the context of the detection of early degenerative processes relevant to OA. Non-invasive imaging methods such as quantitative MRI, ultrasound, optical coherence tomography (OCT), scintigraphy and diffraction-enhanced synchrotron imaging (DEI), as well as biochemical methods and proteomics, are considered. Early detection of OA is reviewed with minimally invasive techniques, such as arthroscopy, as well as the combination of arthroscopic techniques with indentation, spectrometry, and multiphoton microscopy. In addition, a brief summary of macroscopic and histologic scores is presented. Finally, the spatial organisation of joint surface chondrocytes as an image-based biomarker is used to illustrate an early OA detection strategy that focusses on early changes in tissue architecture potentially prior to damage. In summary, multiple translational techniques are able to detect early OA processes but we do not know whether they truly represent the initial events. Moreover, at this point it is difficult to judge the future clinical relevance of these procedures and to compare their efficacy, as there have been comparative studies. However, the expected gain in knowledge will hopefully help us top attain a more comprehensive understanding of early OA and to develop novel methods for its early diagnosis, therapy, and prevention. Overall, the clinical diagnosis of early OA remains one of the greatest challenges of our field. We still face uncharted territory.

[Is it Possible to Arouse Interest in a Career in Traumatology with a Curricular Course in Medical School?] / Kann mit praxisorientierter curricularer Lehre das Interesse am Fach Orthopädie und Unfallchirurgie geweckt werden?

Background: There is a serious lack of young doctors in trauma surgery, which has intensified in recent years. The reasons are complex. Studies have shown that the interest in starting a career in surgery significantly decreases during medical school. To counteract the lack of young talent in the clinic, interest in the subject should be aroused in medical school. The aim of the present study was to evaluate current teaching at our university, where trauma surgery is a curricular subject with mandatory attendance for all medical students. Material and Methods: The current curriculum is intended for medicine students in their fifth year. The curriculum comprises lectures, practical courses and observation modules held in small groups. Students are provided with an experienced surgeon as teacher and mentor for the whole week. A teaching and training centre is available for the practical courses. In an anonymised questionnaire, students were asked about their overall assessment and the training success of practical and theory-oriented modules, as well as their specific interest in traumatology. Results: The evaluated curriculum gave very good results, with an overall rating of 1.53 (average) on a 6-point Likert scale in the overall assessment. It could be shown that students previously not interested in starting a career in trauma surgery showed significantly more interest in the subject after the curriculum. The practical parts scored best in the individual assessment. Conclusion: We showed that intensive teaching can arouse interest in traumatology in students who had been indifferent to orthopaedics and traumatology.

[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.

Effects of hand-rearing on the behavioral development of infant and juvenile gorillas (Gorilla g. gorilla).

Nineteen hand-reared and seven mother-reared infant and juvenile gorillas were observed for a period of 3 years. Almost all hand-reared individuals developed stereotyped behaviors during the first months. In most cases these behaviors disappeared in the first or second year. Social behaviors, solitary play, nest building and grooming developed at about the same age in hand-reared and mother-reared infants. Hand-reared immatures showed significantly more solitary play, more aggression and less social play than mother-reared ones, especially when raised in pairs. When young gorillas were kept in groups, the frequencies of these behaviors came nearer to those of mother-reared immatures. No significant differences were noted in social play. When introduced to conspecifics, hand-reared infants sometimes reacted with indiscriminant aggression. Gorillas should thus preferably be reared in peer groups and be introduced to adults not later than one year of age.