Identification of Novel Genetic Loci Associated with Thyroid Peroxidase Antibodies and Clinical Thyroid Disease

Peer reviewe

Disseminating Adamantinoma of the Tibia

Patient. This report describes a patient with a primary long bone adamantinoma. The lesion was initially wrongly diagnosed as fibrous dysplasia and the patient was treated by curettage. At second local recurrence, the tumour had progressed from an osteofibrous dysplasia-like to a full-blown classic adamantinoma, with metastatic potential to the lungs 19 years after the initial treatment. Lung metastasectomy by sternotomy was carried out twice in a period of over 312 years. The patient is currently alive without evidence of other metastatic disease

Poor Performance Among Trainees in a Dutch Postgraduate GP Training Program

BACKGROUND AND OBJECTIVES: Poor performance among trainees is an important issue, for patient safety and economic reasons. While early identification might enhance remediation measures, we explored the frequency, nature, and risk factors of poor performance in a Dutch postgraduate general practitioner (GP) training program. METHODS: All trainees who started the GP training between 2005 and 2007 were included. Multivariate logistic regression analysis was applied to examine associations between individual characteristics; early assessments of competencies and knowledge, training process characteristics (eg, illness, maternal leave), and the outcome poor performance; sub-analyses were performed for each year. RESULTS: A total of 215 trainees started the 3-year GP program, and 49 (22.8%) exhibited poor performance (in one or more years). In the first and second years, problem areas among poor performers were equally distributed across the roles of "medical expert," "communicator," and "professional." In the third year, shortcomings in "professionalism" were the most common problem. Increasing age was a risk factor for poor performance as were insufficient scores in communication and knowledge. Poor performance in the previous year was a risk factor for poor performance in the second and third years; OR=4.20 (CI=1.31--13.47) and OR=5.40 (CI=1.58--18.47), respectively. CONCLUSIONS: Poor performance is prevalent but primarily occurring within a single training year. This finding suggests that trainees are capable of solving trainee problems. Increasing age, insufficient assessment scores early in the training, and poor performance in a previous year constitute risk factors for poor performance

Selection for Dutch postgraduate GP training; time for improvement

Item does not contain fulltextBackground: In the Netherlands we select candidates for the postgraduate GP training by assessing personal qualities in interviews. Because of differences in the ratio of number of candidates and number of vacancies between the eight departments of GP training we questioned whether the risk of being rejected diverged amongst them. Objective: The research question of this study was to which degree department of choice, candidates' characteristics and qualities assessed during interviews explain admission into GP training. Methods: A nationwide observational study was conducted of all candidates who applied for postgraduate GP training in 2009/ 2010. Application ratio per department, candidates' characteristics (gender, age, region of medical school and times of application) and qualities (motivation, orientation on the job, personal attributes and learning needs) were collected. Outcome measures were admission to interview and admission to GP training. Results: The study population addressed 542 candidates. Sixty three candidates were rejected on application letter (11.6%). So 479 candidates were admitted to the interview, of which 340 were admitted to the GP training (71%). Gender and region of medical school outside North West Europe were associated with admission to the interview. Department of choice had a strong association with admission in both stages (RR: 0.30 to 0.74; 0.20 to 0.79 respectively), while candidates' qualities explained admission (RR: 1.09- 1.25) as well. Conclusion:The influence of department of choice yields doubts about fairness of the procedure. So advantages and disadvantages of a national procedure are discussed as well as those of a competency based procedure

Genetic risk score and the risk of TPOAb-positivity.

<p>GRS, genetic risk score (based on rs11675434, rs653178, rs10944479, rs1230666, rs2010099).</p>a<p>Adjusted for age and gender</p

Population characteristics and serum TPOAb, TSH, and FT4 level measurements specifications.

<p>Population characteristics and serum TPOAb, TSH, and FT4 level measurements specifications.</p

Newly identified loci associated with TPOAb-positivity and/or serum TPOAb levels reaching genome wide significance.

<p>Chr., chromosome</p>a<p>Risk allele frequency: Weighted mean frequency of the risk allele across all included cohorts.</p>b<p>Adjusted for age and gender</p>c<p>Expressed in sd of natural logarithm transformed serum TPOAb level, adjusted for age and gender</p