Context On December 1, 2020, Drs. Wolfgang Wodarg and Micheal Yeadon petitioned to withhold emergency use authorization of the BNT162b2 messenger ribonucleic acid vaccine for coronavirus disease 2019 (COVID-19) manufactured by BioNTech and Pfizer, raising concern for female infertility risks but acknowledging the lack of evidence. The European Medicines Agency and the US Food and Drug Administration ultimately issued emergency use authorizations, but misinformation claiming that COVID-19 vaccines cause female infertility began circulating on social media, potentially influencing public perception and medical decision making among pregnant patients or those seeking to become pregnant. Objectives To determine the potential influence misinformation may have had on public interest in infertility related topics, as analyzed through internet search statistics in the US. Methods The Google Trends tool was used to analyze results for the search terms “infertility,” “infertility AND vaccine,” and “infertility AND COVID vaccine” in the US from February 4, 2020 to February 3, 2021. We applied autoregressive integrated moving average models to forecast expected values, comparing them with actual observed values. Results At peak interest (100), the forecasted relative search volumes interest for the search terms “infertility,” “infertility AND vaccine,” and “infertility AND COVID vaccine” were 45.47 (95% CI, 33.27–57.66; p<0.001), 0.88 (95% CI, 2.87–4.63; p<0.001), and 0.29 (95% CI, −2.25–2.82; p<0.001). The actual relative search volumes at peak searching represented 119.9, 11,251, and 34,900% increases, respectively, when compared with forecasted values. Conclusions COVID-19 vaccine misinformation corresponded with increased internet searches for topics related to infertility in the US. Dispelling misinformation and informing patients about the risks and benefits of COVID-19 vaccination may prevent unnecessary vaccine hesitancy or refusal, contributing to successful vaccination efforts.

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Background Involvement in scholarly activities is considered to be one of the foundational pillars of medical education. Objective This study aims to investigate publication rates before, during, and after residency to determine whether research productivity throughout medical training correlates with future academic success and research involvement. Methods We successfully identified a list of 296 graduates from 25 US dermatology residency programs from the years 2013-2015. The publication history for each graduate was compiled using Scopus, PubMed, and Google Scholar. The Pearson correlation test and linear regression were used to assess the relationship between research productivity and continued academic success after residency graduation. Results Before residency, graduates published a mean of 1.9 (SD 3.5) total publications and a mean of 0.88 (SD 1.5) first-author publications. During residency, graduates published a mean of 2.7 (SD 3.6) total publications and a mean of 1.39 (SD 2.0) first-author publications. Graduates who pursued a fellowship had more total publications (t294=−4.0; P<.001), more first-author publications (t294=−3.9; P<.001), and a higher h-index (t294=−3.8; P=.002). Graduates who chose to pursue careers in academic medicine had more mean total publications (t294=−7.5; P<.001), more first-author publications (t294=−5.9; P<.001), and a higher mean h-index (t294=−6.9; P<.001). Graduates with one or more first-author publications before residency were 1.3 times more likely to pursue a career in academic medicine (adjusted odds ratio 1.3, 95% CI 1.1-1.5). Graduates who pursued a fellowship were also 1.9 times more likely to pursue a career in academic medicine (adjusted odds ratio 1.9, 95% CI 1.2-3.2). Conclusions Our results suggest that research productivity before and during residency training are potential markers for continued academic success and research involvement after completing dermatology residency training.

Prosthetic joint replacement of the elbow is, with some delay in comparison with the shoulder, the finger joints and especially the hip and knee joint, becoming a routine operation at least in more specialised orthopedic and trauma centers. In the seventies and eighties, more than 80% of the indications were in patients affected by rheumatoid arthritis, in which both sides were typically affected, seriously jeopardising their independence in activities of daily living. In the last decade an increasing number of posttraumatic osteoarthritic cases were included in the indications. Among the numerous prosthetic devices, only a few have stood the test of time (> 10 years) ; a meta-analysis of the world literature shows an average follow-up of less than 5 years. Two main types of prostheses must be distinguished, linked and non-linked. The linked prostheses are, with few exceptions, so-called sloppy hinges with a clearance between both components, permitting movement in the sagittal plane and in the frontal plane and also some rotation. Using the normal anatomical stabilising structures, the stresses on the interface are reduced. This type of linked prostheses has a wider range of possible indications than the non-linked resurfacing prostheses, which require a largely preserved bone stock and intact ligaments in order to avoid instability with subluxations or even dislocations. Resurfacing prostheses can be more or less constrained according to the degree to which they mimic normal elbow anatomy. In order to reduce the stresses on the interface, the more constrained resurfacing prostheses make additional use of an intramedullary stem. The fixation of the device in the bone is achieved with bone cement in nearly all the linked and non-linked prostheses. Sloppy hinges with condylar configurations (as the GSB III elbow prosthesis) or an anterior flange (Coonrad-Morrey) further reduce the stresses on the interface and have better long-term results. Special instruments help to place the prosthesis in correspondence to the normal center of rotation and to minimise the bone resection needed and the risk of intra-operative complications (condyle fractures, shaft perforation). The results concerning pain relief and mobility are, for all properly placed prostheses, very satisfactory in the first years. A reliable account of long-term results (> 10 years of non-interrupted series of elbow prostheses) has so far been given only by a few authors. In cases with rheumatoid arthritis the survival rate at 10 years reaches 90% ; the complication rate however is still definitely larger than with hip, knee and shoulder prostheses. This is particularly true for posttraumatic OA cases. Aseptic loosening, infection, instability and ulnar nerve lesions are at the fore and about twice as frequent as in RA, especially in patients below 60 years of age. In order to keep a safe retreat possibility open, we insist on the best possible preservation or reconstruction of normal anatomy (e.g. condyle reconstruction) when implanting an elbow prosthes...

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