The long term predictive validity of four current risk assessment instruments was assessed in Germany on three different groups of subjects. The groups consisted of 73 sex offenders released from a prison-based special therapeutic unit (therapeutic sample), 15 individuals who did not complete this treatment (drop-outs), and another 46 subjects who were assessed in a psychiatric hospital having been accused of a sexual offence (assessment sample). The results of the three samples were then compared. The outcome was obtained by examining the national conviction registry. The mean follow-up time was 9 years (range: 1 -340 months). The highest rate of recidivism was observed in the dropout group, with only one individual not reoffending. The assessment group had slightly fewer reoffences compared to the treatment group, which had been selected as a high risk population. The treatment sample exceeded the assessment sample, especially concerning sexual reoffences, but less so concerning violent reoffences. Of all the assessment instruments and using the total sample, the Static-99 was the most efficient predictor of all, violent non-sexual and non-contact sexual recidivism. For the prediction of contact sexual recidivism the AUC of the HCR-20 and the SVR-20 was slightly better, but very similar to the Static-99. These differences between assessment instruments were, however, not statistically significant. The AUC for the Static-99 was smaller in the treatment group, but larger than for other assessment instruments. The Static-99 risk categories correlated significantly with the Kaplan -Meier survival functions.

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The anatomy of the ilioinguinal nerve makes it vulnerable to entrapment near its exit from the superficial inguinal ring, where it lies almost directly superior to the pubic tubercle. Ilioinguinal nerve entrapment is a documented complication of inguinal herniorrhaphy, inguinal lymph node dissection, appendectomy, Pfannenstiel incision and the needle suspension procedure. It has not previously been described as a complication of the tension-free vaginal tape (TVT) procedure, which is the most recent technique for the treatment of genuine urinary stress incontinence. This paper describes a clinical history to illustrate the diagnosis and management of ilioinguinal nerve entrapment occurring as a complication of tension-free vaginal tape procedure.

Background: In the general population, uterine sarcoma (US) is an uncommon tumor, which accounts for approximately 1–3% of all uterine neoplasms. Its biological behavior is characterized by hematogenous metastases and local recurrent growth including the pelvis and peritoneal cavity. In the management of US, surgery is the primary form of treatment. Up to now the role of adjuvant radiotherapy has not been clearly established. Patients and Methods: We report about 54 patients with US treated from 1954 to 1994 by surgical resection alone (22) or a combination of surgery and irradiation (32) and evaluate the influence of histology, stage and different treatment options on survival. Results and Conclusions: Our data indicate an increased disease-free survival for patients treated with adjuvant radiotherapy, especially if poor prognostic factors are present (advanced tumor stage, histopathological grade II or III of leiomyosarcoma and mixed mesodermal sarcoma). Postoperative irradiation using doses between 50 and 60 Gy is recommended, in selected cases brachytherapy should be added. Prospective multicentric trials including a statistically evaluable number of patients are necessary to further clarify the role of multimodality treatment programs for US.

In order to evaluate risk assessment instruments for sex offenders in Germany, we compared the predictive validity of the Static-99, HCR-20, SVR-20, and PCL-R scales for 134 sex offenders. The mean follow-up time was 9 years (range 1-340 months), using the first entry into the National Register of Criminal Convictions as endpoint variable. For the estimate of predictive power, the area under the curve (AUC) of receiver operating characteristic (ROC) analysis was calculated. The AUC plots accurately identified violent or sexual recidivists and "false positives" at all scale levels. Comparing the predictive validity of these four instruments, the results favored Static-99. As for the limited sample size, differences between the assessment instruments were, however, not statistically significant. The ROC analysis for Static-99 showed that including treatment dropouts does not improve predictive accuracy (including dropouts: AUC 0.710; excluding dropouts: AUC 0.721). Kaplan-Meier survival analyses yielded highly a significant correlation to recidivism time point for two Static-99 and SVR-20 risk categories. Higher-risk categories were related to earlier recidivism. However, relying on the Static-99 and SVR-20 alone showed false positive results: for up to two out of three sex offenders, they predicted recidivism which did not occur.