Preoperative application of the Enzian classification for endometriosis (The cEnzian Study): A prospective international multicenter study.

OBJECTIVE: To assess the diagnostic performance of preoperative application of the Enzian classification (cEnzian) using surgical findings as reference standard. DESIGN: A prospective international non-interventional study. SETTING: Twelve endometriosis centres in four European countries (Austria, Germany, Switzerland and Czech Republic). POPULATION: 1062 women with endometriosis surgery. METHODS: Extent of endometriosis was preoperatively classified using the cEnzian classification based on gynaecological examination and/or transvaginal ultrasound (TVS) and/or magnetic resonance imaging (MRI). After subsequent surgery, the surgeon classified the intraoperative findings using the Enzian classification. MAIN OUTCOME MEASURES: Sensitivity, specificity, PPV, NPV, LR+ , LR- and accuracy were calculated. Conditional frequencies of intraoperative Enzian codings and the corresponding 95% confidence intervals were computed for each preoperative coding and visualised in plots. RESULTS: Although overall consistency of cEnzian and Enzian was poor (35.14%, 95% confidence interval 32.26-38.03), high specificities and negative predictive values (NPVs) of the cEnzian compartments could be demonstrated. Looking at the individual parts of the Enzian classification, the poorest diagnostic performance was detected for compartment B and the highest PPVs were found for category 3 lesions (>3 cm), independent of the compartment. CONCLUSIONS: Using the Enzian classification in a non-invasive setting is a useful tool providing us with an 'at a glance' summary of the diagnostic workup regarding deep endometriosis with high specificities and NPVs. An attempt to merge the two new endometriosis classification systems (#Enzian and AAGL 2021) seems reasonable taking into consideration the respective advantages of each other.

Gait analysis in patients after unilateral hip arthroplasty.

BACKGROUND: Osteoarthritis (OA) is the most common joint pathology and the main cause of disability in elderly persons. Arthroplasty still remains the most effective treatment of OA. Routine post-operative patient assessment does not include an objective functional examination leading to conclusions regarding the need of further rehabilitation. This role is played by gait analysis performed in patients after arthroplasty. The aim of the study was to conduct a quantitative and qualitative analysis of selected gait parameters in patients after unilateral cementless hip arthroplasty. MATERIAL AND METHODS: The study involved a group of 16 patients who were examined before and after hip arthroplasty. Gait analysis was conducted before surgery and at least 6 months after the procedure. The Smart DX BTS system for spatial gait analysis was used. RESULTS: The duration of the stance phase on the affected side was 63.8 [% gait cycle] and was significantly shorter (p<0.05) than the phase on the unaffected side, with a duration of 69.4 [% gait cycle]. After surgery, the duration of swing phase on the unaffected side increased (p<0.05) from 30.6 to 35.1 [% gait cycle]. A statistically significant change was also found in the double support phase (the arthrotic limb as the front limb), which was markedly shortened. The average length of a single and double step, cadence, average gait velocity, and the velocity of leg swing in the swing phase increased. The range of hip mobility increased in all planes, especially in the sagittal plane. CONCLUSION: The space and time gait parameters with regard to the operated leg after hip arthroplasty indicate an improvement as compared with the baseline results; however, they do not reach the values found in healthy persons.

Novel bioactive polyester scaffolds prepared from unsaturated resins based on isosorbide and succinic acid.

In this study new biodegradable materials obtained by crosslinking poly(3-allyloxy-1,2-propylene succinate) (PSAGE) with oligo(isosorbide maleate) (OMIS) and small amount of methyl methacrylate were investigated. The porous scaffolds were obtained in the presence of a foaming system consisted of calcium carbonate/carboxylic acid mixture, creating in situ porous structure during crosslinking of liquid formulations. The maximum crosslinking temperature and setting time, the cured porous materials morphology as well as the effect of their porosity on mechanical properties and hydrolytic degradation process were evaluated. It was found that the kind of carboxylic acid used in the foaming system influenced compressive strength and compressive modulus of porous scaffolds. The MTS cytotoxicity assay was carried out for OMIS using hFOB1.19 cell line. OMIS resin was found to be non-toxic in wide range of concentrations. On the ground of scanning electron microscopy (SEM) observations and energy X-ray dispersive analysis (EDX) it was found that hydroxyapatite (HA) formation at the scaffolds surfaces within short period of soaking in phosphate buffer solution occurs. After 3h immersion a compact layer of HA was observed at the surface of the samples. The obtained results suggest potential applicability of resulted new porous crosslinked polymeric materials as temporary bone void fillers.