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Luceri, Francesco, Davide Cucchi, Enrico Rosagrata, et al. "Novel Radiographic Indexes for Elbow Stability Assessment: Part B—Preliminary Clinical Study." Indian Journal of Orthopaedics 55, S2 (2021): 347–58. http://dx.doi.org/10.1007/s43465-021-00399-1.
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Abstract Introduction The coronoid process plays a key-role in preserving elbow stability. Currently, there are no radiographic indexes conceived to assess the intrinsic elbow stability and the joint congruency. The aim of this study is to present new radiological parameters, which will help assess the intrinsic stability of the ulnohumeral joint and to define normal values of these indexes in a normal, healthy population. Methods Four independent observers (two orthopaedic surgeons and two radiologists) selected lateral view X-rays of subjects with no history of upper limb disease or surgery. The following radiographic indexes were defined: trochlear depth index (TDI); anterior coverage index (ACI); posterior coverage index (PCI); olecranon–coronoid angle (OCA); radiographic coverage angle (RCA). Inter-observer and intra-observer reproducibility were assessed for each index. Results 126 subjects were included. Standardized lateral elbow radiographs (62 left and 64 right elbows) were obtained and analysed. The mean TDI was 0.46 ± 0.06 (0.3–1.6), the mean ACI was 2.0 ± 0.2 (1.6–3.1) and the mean PCI was 1.3 ± 0.1 (1.0–1.9). The mean RCA was 179.6 ± 8.3° (normalized RCA: 49.9 ± 2.3%) and the mean OCA was 24.6 ± 3.7°. The indexes had a high-grade of inter-observer and intra-observer reliability for each of the four observers. Significantly higher values were found for males for TDI, ACI, PCI and RCA. Conclusion The novel radiological parameters described are simple, reliable and easily reproducible. These features make them a promising tool for radiographic evaluation both for orthopaedic surgeons and for radiologists in the emergency department setting or during outpatient services. Level of evidence Basic Science Study (Case Series). Clinical relevance The novel radiological parameters described are reliable, easily reproducible and become handy for orthopaedic surgeons as well as radiologists in daily clinical practice.
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Luceri, Francesco, Davide Cucchi, Enrico Rosagrata, et al. "Novel Radiographic Indexes for Elbow Stability Assessment: Part A—Cadaveric Validation." Indian Journal of Orthopaedics 55, S2 (2021): 336–46. http://dx.doi.org/10.1007/s43465-021-00407-4.
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Abstract Introduction Elbow bony stability relies primarily on the high anatomic congruency between the humeral trochlea and the ulnar greater sigmoid notch. No practical tools are available to distinguish different morphotypes of the proximal ulna and herewith predict elbow stability. The aim of this study was to assess inter-observer reproducibility, evaluate diagnostic performance and determine responsiveness to change after simulated coronoid process fracture for three novel elbow radiographic indexes. Methods Ten fresh-frozen cadaver specimens of upper limbs from human donors were available for this study. Three primary indexes were defined, as well as two derived angles: Trochlear Depth Index (TDI); Posterior Coverage Index (PCI); Anterior Coverage Index (ACI); radiographic coverage angle (RCA); olecranon–diaphisary angle (ODA). Each index was first measured on standardized lateral radiographs and subsequently by direct measurement after open dissection. Finally, a type II coronoid fracture (Regan and Morrey classification) was created on each specimen and both radiographic and open measurements were repeated. All measurements were conducted by two orthopaedic surgeons and two dedicated musculoskeletal radiologists. Results All three indexes showed good or moderate inter-observer reliability and moderate accuracy and precision when compared to the gold standard (open measurement). A significant change between the radiographic TDI and ACI before and after simulated coronoid fracture was observed [TDI: decrease from 0.45 ± 0.03 to 0.39 ± 0.08 (p = 0.035); ACI: decrease from 1.90 ± 0.17 to 1.58 ± 0.21 (p = 0.001)]. As expected, no significant changes were documented for the PCI. Based on these data, a predictive model was generated, able to identify coronoid fractures with a sensitivity of 80% and a specificity of 100%. Conclusion New, simple and easily reproducible radiological indexes to describe the congruency of the greater sigmoid notch have been proposed. TDI and ACI change significantly after a simulated coronoid fracture, indicating a good responsiveness of these parameters to a pathological condition. Furthermore, combining TDI and ACI in a regression model equation allowed to identify simulated fractures with high sensitivity and specificity. The newly proposed indexes are, therefore, promising tools to improve diagnostic accuracy of coronoid fractures and show potential to enhance perioperative diagnostic also in cases of elbow instability and stiffness. Level of evidence Basic science study. Clinical relevance The newly proposed indexes are promising tools to improve diagnostic accuracy of coronoid fractures as well as to enhance perioperative diagnostic for elbow instability and stiffness.
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Ben Ali, K., M. Slouma, L. Kharrat, et al. "AB0071 RELATIONSHIP BETWEEN PRO-INFLAMMATORY CYTOKINE AND ATHEROGENIC INDEXES IN AXIAL RADIOGRAPHIC SPONDYLOARTHRITIS." Annals of the Rheumatic Diseases 80, Suppl 1 (2021): 1066.1–1066. http://dx.doi.org/10.1136/annrheumdis-2021-eular.1281.
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Background:The cardiovascular burden in inflammatory rheumatic diseases is well recognized. This burden has been reported in spondyloarthritis. Atherogenic indexes are known with their role of predicting cardiovascular risk.Objectives:The aim of our study was to determine the relation between pro-inflammatory cytokines and atherogenic indexes in spondyloarthritis.Methods:We performed a cross sectional study including 38 patients with spondyloarthritis according to ASAS criteria. For each patient we measured interleukin (IL)1, IL6, IL17, IL23 and tumor necrosis factor (TNF) alpha, total Cholesterol (CT), Triglycerides (TG), High density lipoprotein Cholesterol (HDLc) and Low density lipoprotein cholesterol (LDLc). We also calculated the following ratios: CT/HDLc, TG/HDLc, LDLc/HDLc, and LogTG/HDLc.Disease activity was measured using ASDAS (Ankylosing Spondylitis Disease Activity Score) and BASDAI (Bath Ankylosing Spondylitis Disease Activity Index).Statistical analysis was performed using IBM SPSS Statistics 25.Results:The mean age were 45.4±12.5 years. There were 33 Male (sex ratio were 6.6).The mean C-reactive protein(CRP) were 29.6 ±40.34mg/L, mean erythrocyte sedimentation rate(ESR) were 41±33.9mm.The mean ASDASCRP, BASDAI were 2.8±1.24, 3.7±2.12, respectively.Active disease were noted in 68 % of patients using ASDASCRP score.The mean IL1, IL6, IL17, IL23, TNF alpha were 11.6 ±25pg/ml, 15.4±45.9pg/ml, 84.6±77.9pg/ml, 15.3±15.26pg/ml, 25.3± 47.9pg/ml respectively.The mean CT,HDLc,LDLc, TG were 4.47±0.93mmol/l, 1.09±0.3mmol/L, 2.77±0.78mmol/L, 1.29±0.54mmol/L respectively.The mean CT/HDLc, TG/HDLc, LDL/HDLc, LogTG/HDLc were 4.28±1.26, 1.22±0.6, 2.7±1.06, 0.03±0.23, respectively.Correlations were found between TG/HDLC ratio and IL1 (p<0.01, r=0.515), IL6(p<0.05; r=0.407), Log TG/HDLc and IL1 (p< 0.05, r=0.369), and IL6(p<0.05; r=0.333)However, no correlations were noted between atherogenic indexes and IL7, IL17, IL23, TNFalpha.Conclusion:Our study showed a correlations between atherogenic indexes and both IL1 and IL6.These findings suggests that serum IL-6 and IL1 levels in spondyloarthritis contribute to the development of cardiovascular disease atherosclerosis.References:[1]Lau et al. Role of Adipokines in Cardiovascular Disease. Circ J. 2017; 81(7): 920-8.Disclosure of Interests:None declared
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Ammer, Luise Sophie, Esmeralda Oussoren, Nicole Maria Muschol, et al. "Hip Morphology in Mucolipidosis Type II." Journal of Clinical Medicine 9, no. 3 (2020): 728. http://dx.doi.org/10.3390/jcm9030728.
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Mucolipidosis type II (MLII) is a rare lysosomal storage disorder caused by defective trafficking of lysosomal enzymes. Severe skeletal manifestations are a hallmark of the disease including hip dysplasia. This study aims to describe hip morphology and the natural course of hip pathologies in MLII by systematic evaluation of plain radiographs, ultrasounds and magnetic resonance imaging (MRI). An international two-centered study was performed by retrospective chart review. All MLII patients with at least one pelvic radiograph were included. A total of 16 patients were followed over a mean of 3.5 years (range 0.2–10.7 years). Typical age-dependent radiographic signs identified were femoral cloaking (7/16), rickets/hyperparathyroidism-like changes (6/16) and constrictions of the supra-acetabular part of the os ilium (16/16) and the femoral neck (7/16). The course of acetabular and migration indexes (AI, MI) significantly increased in female patients. However, in the overall group, there was no relevant progression of acetabular dysplasia with a mean AI of 23.0 (range 5°–41°) and 23.7° (range 5°–40°) at the first and last assessments, respectively. Better knowledge on hip morphology in MLII could lead to earlier diagnosis, improved clinical management and enables assessment of effects of upcoming therapies on the skeletal system.
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McClincy, Michael, James Wylie, Yi-Meng Yen, and Eduardo Novais. "BORDERLINE DYSPLASIA: ARE THESE HIPS ONLY MILDLY UNCOVERED?" Orthopaedic Journal of Sports Medicine 7, no. 3_suppl (2019): 2325967119S0013. http://dx.doi.org/10.1177/2325967119s00138.
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Background: Controversy surrounds classification and treatment of hips with a lateral center-edge angle (LCEA) between 18° and 25°. It remains undetermined as to whether open or arthroscopic procedures are best used to treat patients with borderline dysplasia. We hypothesized that patients with hip pain and borderline acetabular dysplasia have different features of acetabular morphology as determined by other relevant radiographic measures beyond the LCEA. Methods: A retrospective review of patients undergoing hip preservation surgery between January 2010 and December 2015 with either periacetabular osteotomy(PAO) or hip arthroscopy with a LCEA between 18° and 25° was performed. Anteroposterior, Dunn lateral and false profile radiographs were used to measure LCEA, Tönnis Angle, anterior center edge angle (ACEA), anterior (AWI) and posterior (PWI) wall indexes, the femoral epiphyseal acetabular roof (FEAR) index, joint space width, crossover sign, posterior wall sign, P/A index, and femoral alpha angle. An agglomerative hierarchical clustering analysis was then performed on the continuous radiographic variables to identify different subtypes of hip pathomorphology among this patient cohort. There were sex-specific trends in hip morphology. Therefore, we proceeded to perform separate cluster analyses for each sex. Results: Ninety-nine patients underwent surgery in the study period, 77 (78%) were female, and 81 (82%) of these had complete radiographic images for cluster analysis. Mean age was 22.6 years. Hip arthroscopy was performed in 41% of patients and periacetabular osteotomy was performed in 59% of patients. The ACEA (45%), FEAR Index (34%), and AWI (30%) were the most commonly abnormal radiographic parameters among all patients. In female patients, the ACEA (55%), FEAR Index (42%), and AWI (34%) were the most commonly abnormal radiographic parameters. In male patients, an insufficient PWI (48%) was the most common radiographic abnormality. For females, we identified three clusters representing different patterns of hip morphology: impingement morphology; lateral acetabular deficiency, and anterolateral acetabular deficiency (Table 1A). For males, we identified three clusters: postero-lateral acetabular deficiency with global cam morphology, postero-lateral acetabular deficiency with focal cam morphology, and lateral acetabular deficiency without cam morphology (Table 1B). Conclusions: A comprehensive evaluation of radiographic parameters in patients with LCEA 18-25° identifies sex-specific trends in hip morphology and shows a large proportion of dysplastic features among these patients. A thorough evaluation of all pelvic morphology, not just lateral coverage, should be considered when indicating these patients for hip preservation surgeries. Further studies are needed to investigate the outcomes of patients within each of the identified clusters to determine optimal treatment options for each group. [Table: see text][Table: see text]
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Takatori, Yoshio, Kazuya Ito, Muroto Sofue, et al. "Analysis of interobserver reliability for radiographic staging of coxarthrosis and indexes of acetabular dysplasia: a preliminary study." Journal of Orthopaedic Science 15, no. 1 (2010): 14–19. http://dx.doi.org/10.1007/s00776-009-1412-1.
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Lajolo, Carlo, Michele Giuliani, Massimo Cordaro, et al. "Two new oro-cervical radiographic indexes for chronological age estimation: A pilot study on an Italian population." Journal of Forensic and Legal Medicine 20, no. 7 (2013): 861–66. http://dx.doi.org/10.1016/j.jflm.2013.06.021.
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Junior, Antonio Carlos Cunha Lacreta, Washington Luiz Assunção Pereira, José Augusto Pereira Carneiro Muniz, Mariana Avelino de Souza Santos, Thâmira Mota, and Luthesco Haddad Lima Chalfun. "Bone Radiographic Changes in Slaughter Buffalos with Low Body Condition Index." Acta Scientiae Veterinariae 45, no. 1 (2017): 8. http://dx.doi.org/10.22456/1679-9216.80472.
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Background: The largest buffalo herd in Brazil is located on the Island of Marajó, in the State of Pará, northern Brazil. The pastures of the Island of Marajó consist of low quality graminaceous plants, which are generally poor in protein and mineral content. Unbalanced diets associated with low quality pastures are responsible for latent, sub-clinical diseases and metabolic disorders in bovines which affect bone health, especially in periods such as pregnancy and lactation. The purpose of this study was to point out and to describe the radiographic bone changes of buffalos with low body index bred in extensive system and intended for slaughter on the Island of Marajó, Brazil.Materials, Methods & Results: Radiographic examinations of anatomical pieces were obtained from 34 animals of buffalo species, with no distinction of gender, age, or breed. The animals were selected among those that were in the stockyard waiting for slaughtering for the obtainment of the anatomical pieces. For this selection, low physical condition was considered, which mainly included individuals with body condition indexes (ICC) of 1 and 2, on a scale of 1 to 5. From this selection, 98 anatomical pieces were obtained, which included: 28 sets of ribs, 20 femurs, 26 metacarpus, 7 mandibles, 3 radius and ulnas, 4 sets of vertebrae, 4 sets of metacarpus and phalanges, 1 tarsus and 1 set of tarsus and metatarsus. All the pieces were separated, identified, packed in plastic bag and forwarded to the radiographic study. At least one radiographic projection was obtained of each anatomical piece. These were identified, manually processed and stored for subsequent assessment. A single observer, in order to identify and to describe the bone radiographic changes, subjectively performed the radiographic assessment.Discussion: Bone changes were remarkable and in animals of this study, reinforcing the nutritional aspect as being of great importance for the perfect mineral homeostasis and for the osteoarticular system maintenance. Consistent radiographic findings with osteopenia are most often related to nutritional disorders that affect bone metabolism, mainly involving the homeostasis of calcium (Ca) and phosphorus (P). The nutritional hyperparathyroidism, more commonly reported in dogs, cats and exotic animals is a common example of these affections, in which the bone radiopacity reduction is the most evident radiographic aspect. Copper (Cu) deficiency has been correlated with osteochondrosis, epiphyseal fracture of the femoral head and degenerative arthropathy of the hip joint, and erosion of the articular cartilage in a deer (Cervu selaphus). Degenerative arthropathy through radiographs was also found in this study. From the bone radiographic analysis, it is concluded that the osteodystrophic diseases of buffalos raised in pasture system on the Island of Marajó, Pará, Brazil, present a variety of pathological conditions and the most commonly found were: osteoporosis characterized at the radiographic examination for the bone decreased radiopacity, change in bone trabeculae (medullary expansion) and cortical thinning, followed by pathological fractures with high incidence in the ribs. The low body condition, the underdevelopment and cachexia states of the animals in this study indicate the lack of an appropriate prophylactic conduct and a proper feed management. Therefore, the low reserves of P and Cu in the organism may have contributed to the osteoporotic process and, possibly, also to the protein-energy deficit, leading to secondary bone changes and causing a lack of productivity in the herd.
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Lorenzin, M., A. Ortolan, S. Vio, et al. "Biomarkers, imaging and disease activity indices in patients with early axial spondyloarthritis: the Italian arm of the SpondyloArthritis-Caught-Early (SPACE) Study." Reumatismo 69, no. 2 (2017): 65. http://dx.doi.org/10.4081/reumatismo.2017.977.
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The study aimed to evaluate biomarkers facilitating early diagnosis of axial spondyloarthritis (axSpA) and correlations between them and disease activity parameters and imaging indexes. Patients with low back pain (LBP) (≥3 months, ≤2 years, onset ≤45 years) participating in the Italian arm of the SpondyloArthritis-Caught-Early SPACE study underwent a physical examination, questionnaires, laboratory tests, X-rays and MRI of the spine and sacroiliac joints (SIJ). An expert rheumatologist formulated axSpA diagnosis in accordance with Assessment of SpondyloArthritis International Society (ASAS) criteria. Disease activity and physical functioning were assessed using imaging, clinical and serological indices. Spine and SIJ MRI and X-rays were scored independently by 2 readers using the SPARCC, mSASSS and NY-criteria. Patients were classified as: subjects with signs of radiographic sacroiliitis (r-axSpA), subjects with signs of sacroiliitis on SIJ-MRI but not on X-rays (nr-axSpA MRI SIJ+) or subjects with no signs of sacroiliitis on MRI/X-rays but with &gt;2 SpA features and signs of bone oedema on MRI spine (nr-axSpA MRI SIJ-/undifferentiated SpA). Significant differences were found in the prevalence of radiographic sacroiliitis, active sacroiliitis on MRI and SPARCC SIJ scores. Biomarker levels were not significantly increased in any of the patient groups. The correlations between IL-17 and IL-23 and other indices were not significant; correlations were found between IL-22 and BASFI, BASG1, HAQ, VAS pain, between mSASSS and MMP3, and between the latter and hsCRP. Although not significantly higher in any of the three groups, IL-22, MMP3 and hsCRP values were correlated with some disease activity indexes and with mSASSS. Large observational studies are required to confirm these preliminary findings.
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Song, Jian, Hong-Li Wang, Xiao-Sheng Ma, et al. "The value of radiographic indexes in the diagnosis of discogenic low back pain: a retrospective analysis of imaging results." Oncotarget 8, no. 36 (2017): 60558–67. http://dx.doi.org/10.18632/oncotarget.18652.
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Felson, David T., Josef S. Smolen, George Wells, et al. "American College of Rheumatology/European League Against Rheumatism Provisional Definition of Remission in Rheumatoid Arthritis for Clinical Trials." Annals of the Rheumatic Diseases 70, no. 3 (2011): 404–13. http://dx.doi.org/10.1136/ard.2011.149765.
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ObjectiveRemission in rheumatoid arthritis (RA) is an increasingly attainable goal, but there is no widely used definition of remission that is stringent but achievable and could be applied uniformly as an outcome measure in clinical trials. This work was undertaken to develop such a definition.MethodsA committee consisting of members of the American College of Rheumatology, the European League Against Rheumatism, and the Outcome Measures in Rheumatology Initiative met to guide the process and review prespecified analyses from RA clinical trials. The committee requested a stringent definition (little, if any, active disease) and decided to use core set measures including, as a minimum, joint counts and levels of an acute-phase reactant to define remission. Members were surveyed to select the level of each core set measure that would be consistent with remission. Candidate definitions of remission were tested, including those that constituted a number of individual measures of remission (Boolean approach) as well as definitions using disease activity indexes. To select a definition of remission, trial data were analysed to examine the added contribution of patient-reported outcomes and the ability of candidate measures to predict later good radiographic and functional outcomes.ResultsSurvey results for the definition of remission suggested indexes at published thresholds and a count of core set measures, with each measure scored as 1 or less (eg, tender and swollen joint counts, C reactive protein (CRP) level, and global assessments on a 0–10 scale). Analyses suggested the need to include a patient-reported measure. Examination of 2-year follow-up data suggested that many candidate definitions performed comparably in terms of predicting later good radiographic and functional outcomes, although 28-joint Disease Activity Score–based measures of remission did not predict good radiographic outcomes as well as the other candidate definitions did. Given these and other considerations, we propose that a patient's RA can be defined as being in remission based on one of two definitions: (1) when scores on the tender joint count, swollen joint count, CRP (in mg/dl), and patient global assessment (0–10 scale) are all ≤1, or (2) when the score on the Simplified Disease Activity Index is ≤3.3.ConclusionWe propose two new definitions of remission, both of which can be uniformly applied and widely used in RA clinical trials. The authors recommend that one of these be selected as an outcome measure in each trial and that the results on both be reported for each trial.
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LaPrade, Robert F., Glenn C. Terry, Ronald D. Montgomery, David Curd, and David J. Simmons. "The Effects of Aggressive Notchplasty on the Normal Knee in Dogs." American Journal of Sports Medicine 26, no. 2 (1998): 193–200. http://dx.doi.org/10.1177/03635465980260020801.
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We assessed the possible association between an aggressive intercondylar notchplasty and histopathologic, radiographic, and gait changes to the knee. Three groups of six adult greyhounds were observed for 6 months. Group I dogs had a sham operation. Group II dogs had a 4-mm notchplasty of the lateral femoral condyle where it articulates with the lateral tibial spine. Group III dogs had a 7- to 8-mm notchplasty of the lateral femoral condyle to simulate the long-term effects of an overly aggressive notchplasty. Force plate gait analyses were not significantly different for any dogs at 3 and 6 months. Histopathologic studies (hematoxylin and eosin and safranin O stains) revealed notchplasty area remodeling with a thin layer of lamellar bone covered by fibrous connective tissue. Both Group II and III dogs had significant loss of lateral femoral condyle and trochlear groove articular surface proteoglycans. The radiographic notch width index remained unchanged throughout the study for Group I; the indexes increased immediately after surgery in Groups II and III because of the notchplasty, but after 6 months these values returned to near-preoperative measurements. An aggressive intercondylar notchplasty caused articular cartilage histopathologic changes at 6 months consistent with those found in knees with early degenerative arthritis. Significant refilling of a non-impinged notchplasty occurred by 6 months after surgery. Our results raise concern about the effects of aggressive intercondylar notch widening in humans.
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Ulian, Carla Maria V., Maria Lucia G. Lourenço, Leticia R. Inamassu, et al. "Echocardiographic parameters and vertebral heart size (VHS) in lambs during the neonatal period." Pesquisa Veterinária Brasileira 38, no. 9 (2018): 1869–77. http://dx.doi.org/10.1590/1678-5150-pvb-5678.
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ABSTRACT: Due to cardiac immaturity, newborns have a different morphology and cardiac output when compared with adults. The purpose of this study was to describe the cardiac changes in echocardiographic characteristics and vertebral heart size (VHS) in newborn lambs during the neonatal period. Twenty-eight healthy Ile de France lambs were evaluated from birth to 35 days old. With the assistance of echocardiography, this study evaluated, both in systole and diastole, indexes related to the right and left ventricles, the aorta (Ao), the left atrium (LA), the E point to septal separation (EPSS) and the thickness of the interventricular septum (VSd, VSs). The left atrium-to-aorta ratio (LA:Ao) was analyzed and both the shortening (SF%) and ejection fractions were calculated (EF%). The VHS was obtained by measuring the heart’s long and short axes and comparing it to the thoracic vertebrae. Throughout the first 35 days, the results obtained demonstrated an increased LV:RV ratio when compared to adult lambs. The calculated indexes and the LA:Ao ratio did not present statistically significant differences. The VHS values were normally distributed, presenting a mean of 9.67 vertebrae (v) during the entire period. Both radiographic and echocardiographic parameters showed significant differences between the analyzed moments. The VHS values ranged from 8.4v at the minimum end to 11.2v at the maximum. In order to prevent these changes from being misdiagnosed as heart diseases, this study contributed to take note of neonatal physiological anatomy peculiarities and in addition, it describes the parameters for this age in Ilê de France lambs.
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Borgonovo, Andrea Enrico, Rachele Censi, Virna Vavassori, Oscar Arnaboldi, Carlo Maiorana, and Dino Re. "Zirconia Implants in Esthetic Areas: 4-Year Follow-Up Evaluation Study." International Journal of Dentistry 2015 (2015): 1–8. http://dx.doi.org/10.1155/2015/415029.
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Objectives.The aim is to evaluate the survival and success rates, as well as the marginal bone loss (MBL) and periodontal indexes of zirconia implants positioned in the esthetic jaw areas.Materials and Method.13 patients were selected and 20 one-piece zirconia implants were used for the rehabilitation of single tooth or partially edentulous ridge in the esthetic jaw areas. Six months after surgery and then once a year, a clinical-radiographic evaluation was performed in order to estimate peri-implant tissue health and marginal bone loss.Results.The survival and success rates were 100%. The average marginal bone loss from baseline to 48 months after surgery was +2.1 mm. Four years after surgery, the median and the mode for visible Plaque Index and Bleeding On Probing resulted 1 whereas Probing Pocket Depth amounted to 3 mm (SD = ±0.49 mm).Conclusion.One-piece zirconia dental implants are characterized by high biocompatibility, low plaque adhesion, and absence of microgap that can be related to the clinical success of these implants even in the esthetic areas.
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Sevilla, Veronica, Xavier Inga, Felipe Castro, and Jose Aguilar. "Anatomical positions of the inferior dental canal and its relationship with impacted lower third molars in 18- to 29-year-old Ecuadorians." International Journal of Medical and Surgical Sciences 5, no. 2 (2018): 71–74. http://dx.doi.org/10.32457/ijmss.2018.018.
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Abstract: The third molars are the dental organs with the most variations in terms of their formation and time of eruption, which can cause several pathologies. The incidence of third molar impaction varies between 20% and 30%, with predominance in females. Through the inferior dental canal, goes the inferior dental nerve to innervate the molars and lower premolars. Recent studies on variations in the position of the lower dental canal have shown a low incidence of variations. Objective: To determine the prevalence of anatomical variations of the inferior dental canal in relation to impacted lower third molars, by means of digital image analysis in patients who attended the X-Ray Imaging Center in Azogues in 2016. Materials and Methods: A cross-sectional study was conducted on patients who attended the center X-Ray Imaging Center in Azogues in 2016. The following variables were analyzed: sex, age, variation of the position of the inferior dental canal in relation to the third impacted molar, the radiographic details according to the Monaco classification, and tooth position according to the Winter classification. In total, 64 radiographs were analyzed. Results: It was found that 5% of participants showed no relation of the inferior dental canal with the lower third molar, 72% had a relation of the dental canal with the third molar, and 23% presented with absence of the third molar. According to the Winter classification, the prevalence was 53% mesioangular, 18% horizontal, 19% vertical, 6% vestibuloversion, and 4% inverted. Conclusion: The third molars present high indexes of relation with the inferior dental canal in 18- to 29-year-old Ecuadorians.
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ALENCAR NETO, JONATAS BRITO DE, CLODOALDO JOSÉ DUARTE DE SOUZA, PEDRO RAFAEL REIS COELHO, PEDRO GOMES DE FREITAS JÚNIOR, MÁRCIO BEZERRA GADELHA LOPES, and FRANCISCO JOSÉ MAIA PINTO. "INTER- AND INTRA-OBSERVER RELIABILITY OF SCHATZKER, AO, AND LUO CLASSIFICATIONS FOR TIBIAL PLATEAU FRACTURES." Acta Ortopédica Brasileira 28, no. 5 (2020): 216–20. http://dx.doi.org/10.1590/1413-785220202805228092.
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ABSTRACT Objective: To verify inter- and intra-observer agreement of three classification systems for tibial plateau fractures - Schatzker, AO/ASIF, and Luo’s - among orthopedic surgery residents. Methods: This cross-sectional study was conducted with 29 observers. Radiographic and tomographic imaging of the knee of 15 patients presenting with fractures were evaluated. After six weeks, the test was reapplied. The level of agreement was calculated by the Kappa index. Results: In test 1, inter-observer agreement of all residents, according to the Kappa index, for Schatzker classification was 0.226, for AO 0.431, and Luo’s 0.319. In test 2, values were 0.316, 0.333, and 0.347, respectively (p < 0.001). Regarding intra-observer analysis, the mean Kappa indexes of 1st-year residents were: Schatzker, 0.20; AO, 0.32; and Luo’s, 0.3. For 2nd-year residents, means were: 0.51, 0.58, and 0.38, respectively. As for 3rd-year, results were 0.42, 0.42, and 0.41, respectively (p < 0.001). Conclusion: AO/ASIF showed a better reproducibility than other classifications, with substantial inter- and intra-observer agreement. We also found a stronger agreement among 2nd- and 3rd-year residents. Level of Evidence III, Diagnostic Studies - Investigating a Diagnostic Test.
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Ahmedullah, Abul Khair, Zinat Nasrin, Abu Shahin, Shamim Ahmed, Minhaj Rahim Choudhury, and Syed Atiqul Haq. "Does Clinical and Laboratory Markers are Predictive of Radiological Joint Damage in Rheumatoid Arthritis?" Bangladesh Journal of Medicine 26, no. 1 (2015): 13–17. http://dx.doi.org/10.3329/bjmed.v26i1.25648.
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Aims and objectives. To identify the association of following variables with radiographic findings in rheumatoid arthritis cases in Bangladesh: Age at onset, Duration of suffering, Sex, Clinical indexes of disease activity & Rheumatoid factorMethods. In this observational study, 100 consecutive rheumatoid arthritis patients who met ACR criteria 1987 were enrolled from rheumatology OPD of BSMMU from the period of August 2009- April 2010. Clinical evaluations and laboratory investigations were done in all cases. Final evaluation was done on 96 patients, because 4 patients were dropped out, due to inconclusive radiological report. Radiographs of hands and wrists were scored by Van der Heijde modification of Sharp scoring method.Results. Out of 96 patients 73 were female and 23 male with female male ratio of 3.1:1. Age of onset was 41.0±11.0 (mean ± SD) in male and 37.7±12.9 in female. 90 patients had severe RA among them 21 (23.3%) were male and 69 (76.6%) were female. Rose Waaler (RW) test was positive in 68 cases. Bony erosions were observed in 58 cases, out of them 15 (65.2%) were male and 43 (58.9%) female. Bony erosions were observed in 60.3% cases of positive Rose Waaler and 69.8% in patients whose age at onset was < 45 yrs. Hemoglobin level (gm/dl) was 12.2±1.6 in male and 10.9±1.5 in female. Platelet count was 312142±111233 in male and was 379114±115574 in females.Conclusion: Hemoglobin levels were significantly lower among the anemic women than anemic men. Thrombocytosis was also more in women than men. Higher percentage of bony erosions was observed among the cases of positive RW and whose age at onset was < 45 but it was not statistically significant.Bangladesh J Medicine Jan 2015; 26 (1) : 13-17
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Ceylan, Halil, Ozgur Selek, Murat Inanir, Omer Yonga, Bahar Odabas Ozgur, and Ahmet Y. Sarlak. "External Rotator Sparing with Posterior Acetabular Fracture Surgery: Does It Change Outcome?" Advances in Orthopedics 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/520196.
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This study analyses the results of the treatment with external rotator sparing approach in acetabular fractures to determine whether muscle sparing has a positive impact on functional outcome. 20 patients with a mean age of 45.9 years (range: 26–64) that had been treated for displaced acetabular fractures were included in this series. Short Musculoskeletal Function Assessment (SMFA) questionnaire and hip muscle strength measurement were done at the 24-month of follow-up period. The radiographic results at the final followup were excellent in 9 hips (45%), good in 6 hips (30%), fair in 4 hips (20%), and poor in one hip (5%) according to the criteria developed by Matta. The average SMFA score for all of the patients was 18.3 (range: 0–55.4). The mean dysfunctional and bother indexes were 17.2 and 20.6, respectively. The overall muscle strength deficit was 11.8%. The greatest loss of strength was in internal rotation. In patients with better postoperative reduction quality of acetabular fracture, peak torque, and maximum work of hip flexion, extension and also internal rotation maximum work deficit were significantly lower(P<0.05). Accurate initial reduction and longer postoperative muscle strengthening exercise programs seem critical to decrease postoperative hip muscle weakness after acetabular fractures.
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Cornish, Jillian, Karen E. Callon, Kathleen G. Mountjoy та ін. "α-Melanocyte-stimulating hormone is a novel regulator of bone". American Journal of Physiology-Endocrinology and Metabolism 284, № 6 (2003): E1181—E1190. http://dx.doi.org/10.1152/ajpendo.00412.2002.
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α-Melanocyte-stimulating hormone (α-MSH), a 13-amino acid peptide produced in the brain and pituitary gland, is a regulator of appetite and body weight, and its production is regulated by leptin, a factor that affects bone mass when administered centrally. α-MSH acts via melanocortin receptors. Humans deficient in melanocortin receptor 4 (MC4-R) have increased bone mass, and MC4-R has been identified in an osteoblast-like cell line. Thus α-MSH may act directly on the skeleton, a question addressed by the present studies. In primary cultures of osteoblasts and chondrocytes, α-MSH dose dependently (≥10−9 M) stimulated cell proliferation. In bone marrow cultures, α-MSH (>10−9 M) stimulated osteoclastogenesis. Systemic administration of α-MSH to mice (20 injections of 4.5 μg/day) decreased the trabecular bone volume in the proximal tibiae from 19.5 ± 1.8 to 15.2 ± 1.4% ( P = 0.03) and reduced trabecular number ( P = 0.001). Radiographic indexes of trabecular bone, assessed by phase-contrast X-ray imaging, confirmed the bone loss. It is concluded that α-MSH acts directly on bone, increasing bone turnover, and, when administered systemically, it decreases bone volume. The latter result may also be contributed to by α-MSH effects elsewhere, such as the adipocyte, pancreatic β-cell, or central nervous system.
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Kurniawati, Dartini, Ary. "Differences of Radiographic Quality and Exposure Index on Computed Radiography Using Imaging Plate with Different Reading Time Period." Journal of Medical Science And clinical Research 05, no. 06 (2017): 23664–69. http://dx.doi.org/10.18535/jmscr/v5i6.143.
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Seyfettinoğlu, Fırat, Özkan Köse, Hasan Ulaş Oğur, Ümit Tuhanioğlu, Hakan Çiçek, and Baver Acar. "Is There a Relationship between Patellofemoral Alignment and Osgood–Schlatter Disease? A Case-Control Study." Journal of Knee Surgery 33, no. 01 (2018): 067–72. http://dx.doi.org/10.1055/s-0038-1676523.
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AbstractThis study was aimed to investigate the role of anatomic variations in patellofemoral alignment in patients with or without Osgood-Schlatter disease (OSD) and to determine the potential anatomic risk factors that may play role in the etiology. This prospective observational case-control study was conducted on two groups of adolescent patients. Group 1 comprised patients who were diagnosed as having OSD and group 2 consisted of an equal number of age-matched patients who presented to the outpatient clinic with traumatic knee injury and underwent knee radiographic examination but without a diagnosis of OSD. Age, height, weight, body mass index (BMI), dominant side, and level of sporting activity were recorded. Quadriceps (Q) angles were measured using a long-arm goniometer with patients lying in the supine position with their knees in full extension and contracting the Q muscles. On anteroposterior, lateral knee, and tangential patella (Merchant and Laurin views) radiographs, the following measurements were performed: Insall–Salvati (IS), Caton–Deschamps (CD), and Blackburne–Peel (BP) indexes, congruence angles, lateral patellofemoral angles, sulcus angles, and patella type according to Grelsamer's morphology classification. Both groups were similar in respect of age (p = 0.160), sex (p = 0.311), height (p = 0.326), weight (p = 0.596), BMI (p = 0.153), and dominancy (p = 0.500). The rate of patients engaged in sports activities was significantly greater in the OSD group (p = 0.003). No significant difference was determined between the groups in respect to IS index, CD index, BP index, sulcus angle, lateral patellofemoral angle, and congruence angle (p–values: 0.358, 0.995, 0.912, 0.802, 1.000, and 0.907, respectively). The mean Q angle was measured as 15.6 ± 2.2 degrees in the OSD group and 14.3 ± 2.5 degrees in the control group (p = 0.014). Despite the difference being statistically significant, it was clinically insignificant because the difference was only 1.3 degrees. The principle etiologic factor seems to be increased physical activity rather than subtle variations is patellofemoral anatomy and alignment of extensor mechanism.
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Jiménez-Roldán, Luis, Jose F. Alén, Pedro A. Gómez, et al. "Volumetric analysis of subarachnoid hemorrhage: assessment of the reliability of two computerized methods and their comparison with other radiographic scales." Journal of Neurosurgery 118, no. 1 (2013): 84–93. http://dx.doi.org/10.3171/2012.8.jns12100.
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Object There were two main purposes to this study: first, to assess the feasibility and reliability of 2 quantitative methods to assess bleeding volume in patients who suffered spontaneous subarachnoid hemorrhage (SAH), and second, to compare these methods to other qualitative and semiquantitative scales in terms of reliability and accuracy in predicting delayed cerebral ischemia (DCI) and outcome. Methods A prospective series of 150 patients consecutively admitted to the Hospital 12 de Octubre over a 4-year period were included in the study. All of these patients had a diagnosis of SAH, and diagnostic CT was able to be performed in the first 24 hours after the onset of the symptoms. All CT scans were evaluated by 2 independent observers in a blinded fashion, using 2 different quantitative methods to estimate the aneurysmal bleeding volume: region of interest (ROI) volume and the Cavalieri method. The images were also graded using the Fisher scale, modified Fisher scale, Claasen scale, and the semiquantitative Hijdra scale. Weighted κ coefficients were calculated for assessing the interobserver reliability of qualitative scales and the Hijdra scores. For assessing the intermethod and interrater reliability of volumetric measurements, intraclass correlation coefficients (ICCs) were used as well as the methodology proposed by Bland and Altman. Finally, weighted κ coefficients were calculated for the different quartiles of the volumetric measurements to make comparison with qualitative scales easier. Patients surviving more than 48 hours were included in the analysis of DCI predisposing factors and analyzed using the chi-square or the Mann-Whitney U-tests. Logistic regression analysis was used for predicting DCI and outcome in the different quartiles of bleeding volume to obtain adjusted ORs. The diagnostic accuracy of each scale was obtained by calculating the area under the receiver operating characteristic curve (AUC). Results Qualitative scores showed a moderate interobserver reproducibility (weighted κ indexes were always < 0.65), whereas the semiquantitative and quantitative scores had a very strong interobserver reproducibility. Reliability was very high for all quantitative measures as expressed by the ICCs for intermethod and interobserver agreement. Poor outcome and DCI occurred in 49% and 31% of patients, respectively. Larger bleeding volumes were related to a poorer outcome and a higher risk of developing DCI, and the proportion of patients suffering DCI or a poor outcome increased with each quartile, maintaining this relationship after adjusting for the main clinical factors related to outcome. Quantitative analysis of total bleeding volume achieved the highest AUC, and had a greater discriminative ability than the qualitative scales for predicting the development of DCI and outcome. Conclusions The use of quantitative measures may reduce interobserver variability in comparison with categorical scales. These measures are feasible using dedicated software and show a better prognostic capability in relation to outcome and DCI than conventional categorical scales.
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Lai, Mingyao, Juan Li, Qingjun Hu, et al. "GCT-63. STEREOTACTIC RADIOSURGERY FOR RESIDUAL LESIONS OF PINEAL NON-GERMINOMATOUS GERM CELL TUMORS AFTER CONVENTIONAL RADIOTHERAPY: A RETROSPECTIVE STUDY." Neuro-Oncology 22, Supplement_3 (2020): iii341. http://dx.doi.org/10.1093/neuonc/noaa222.280.
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Abstract OBJECTIVE To explore the efficacy and safety of SRS for residual lesions of NGGCTs after conventional RT. METHODS The clinical data of patients with iGCT who were admitted to Department of Oncology, Guangdong Sanjiu Brain Hospital between January 1, 2008 and December 30, 2019 were gathered. Those who were pathologically or clinically diagnosed with NGGCTs, with lesions located at pineal region, limited stage and residual lesions (with a maximum diameter&gt;10mm) of pineal NGGCTs after RT with a total dose of 50-54Gy/25-30f, were eligible for the study. Several indexes such as local control rate, PFS, OS and treatment-related toxicity were analyzed. RESULTS A total of 27 patients were included; all were male, with a median age of 16 years (range 8–31 years). The patients were followed-up to December 30, 2019, but there were 2 cases lost to follow-up. The median follow-up time was 34 months (range 8–142 months). After a month of treatment with SRS, the ORR and DCR were 71.4% and 95.2%, respectively. During follow-up, 5 cases had radiographic progressions, including 3 cases combined with increased AFP which were diagnosed with local recurrence and 2 cases diagnosed with GTS；The 3y-PFS and OS were 85.2% and 88.0%.no acute radiation response was found after treatment with SRS, and only one patient had brain neurotoxicity. CONCLUSION SRS for residual lesions of NGGCTs after RT is proved to be safe and feasible, with well tolerance, which is beneficial for the improvement of local control and the prolongation of survival.
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Munhoz, Luciana, Lucas Morita, Aline Yukari Nagai, Julia Moreira, and Emiko Saito Arita. "Mandibular cortical index in the screening of postmenopausal at low mineral density risk: a systematic review." Dentomaxillofacial Radiology 50, no. 4 (2021): 20200514. http://dx.doi.org/10.1259/dmfr.20200514.
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Objectives: This systematic literature review addressed the use of mandibular cortical index (MCI), assessed by panoramic radiography, for the identification of postmenopausal women at risk of osteoporosis. Methods: Databases were searched for original research studies published from September 2010 to September 2020 using the following keywords: “postmenopausal osteoporosis” and synonyms combined with “panoramic radiography” and synonyms. Only English language manuscripts and studies pertaining to the MCI were selected. Results: A total of 24 studies were included. The publications were highly heterogeneous in terms of the subject of interest, i.e. the MCI, with some studies comparing the usefulness of the MCI using panoramic radiography and using cone beam computed tomography, and others comparing different radiomorphometric indexes developed for panoramic radiography. Conclusions: Based on the literature included in this systematic review, we conclude that the MCI is useful as an auxiliary tool for identifying postmenopausal females at risk of low bone mineral density (BMD), as it correlates with skeletal BMD measured by dual X-ray absorptiometry. Nevertheless, other radiomorphometric indexes obtained from panoramic radiographs, such as panoramic mandibular index, mental index, and mandibular cortical width, are also valuable as auxiliary tools in the identification of postmenopausal females at risk, as they also correlate with BMD. Thus, it is not possible to affirm which index is the most reliable for the identification of postmenopausal females considering the literature screened. PROSPERO registration systematic review CRD42020208152.
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Manish Kumar, Divya Sanghi, Jyoti Kataria, and Pratiksha Arya. "Association of flat foot with obesity in middle-aged individuals." International Journal of Research in Pharmaceutical Sciences 12, no. 2 (2021): 1102–7. http://dx.doi.org/10.26452/ijrps.v12i2.4639.
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Flat foot can be classified as a foot with collapsed or minimally developed longitudinal arches. Another term used for flat foot is pes planus in which the medial longitudinal arch of the foot has collapsed. The frequency of flat foot is not explained properly as there is a lack of comprehensive definition, better method to classify and proper radiographic criteria for defining a flat foot. Due to obesity, there is an increase in forces at weight-bearing areas of the lower limb and feet. Long term continuous loading effect, specifically related to the feet region due to obesity, has not been extensively evaluated. To find the association of flat foot with obesity in middle-aged Individuals. A total of 120 subjects in the age range of 30 to 50 years were recruited with 60 subjects in each two groups formed on the basis of BMI indexes as Group A (Normal with BMI score 17.5 – 22.99) and Group B (Obese with BMI score >28). Navicular Drop Test and Waist/Hip ratio were measured using Brody’s method and inch tape method, respectively and the correlation between Navicular drop and W/H ratio was evaluated thereafter in both the groups. The result of the study demonstrated that there is a statistically significant positive correlation between navicular drop test and W/H ratio in both the groups, with a stronger association in the obese group (r=0.7 at p=0.05). This study concluded that there is a strong correlation between flat foot and body weight in middle-aged individuals. Hence individuals should be physically active to maintain their body weight in order to avoid any biomechanical alteration in feet structures.
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Shesternya, P. A., O. D. Gritsenko, P. A. Astanin, A. Yu Stepanenko, and N. V. Popov. "Magnetic resonance tomography capabilities and limitations in managing the efficacy of treatment with biological disease modifying anti-rheumatic drugs in ankylosing spondylitis." Modern Rheumatology Journal 15, no. 2 (2021): 29–34. http://dx.doi.org/10.14412/1996-7012-2021-2-29-34.
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Extensive use of magnetic resonance imaging (MRI) in clinical practice revolutionized our understanding of the pathogenesis of axis spondyloarthritis (aSpA) and treatment approaches. The use of MRI to diagnose non-radiographic aSpA is well established. At the same time, the possibility of its use for follow-up and treatment assessment is actively discussed.Objective: To present comparative analysis of clinical and laboratory data, reflecting the activity of the disease, and analysis of MRI results in patients with ankylosing spondylitis (AS) receiving biological disease modifying anti-rheumatic drugs therapy (bDMARDs).Patients and methods. The study included 39 patients with AS, mainly men (74.3%), 24 patients (61.5%) had late and 15 (38.5%) – advanced stage of the disease. The average age was 41.0 [34.0; 48.0] years. All patients were administered bDNARDs; inhibitors of the tumor necrosis factor α or inhibitors of interleukin 17 were drug of choice. The median of treatment duration was 1.5 [1.0; 4,5] year. All patients had sacroiliac (SI) and spinal MRI. The activity of the disease was estimated using BASDAI and ASDAS-CRP/ESR indexes, functional disorders – using the BASFI questionnaire. Results and discussion. There was no significant difference in disease activity between patients with osteitis in the SI/spine or without it: BASDAI – 4.7 [2.7; 5,5] and 4.2 [2.9; 8,1], respectively (p=0.533); ASDAS-ESR – 2.6 [2.2; 3,0] and 2.6 [2.2; 3,2], respectively (p=0.725); ASDAS-CRP – 2.5 [2.1; 3,4] and 3.1 [2.8; 3.9], respectively (p=0.172). There was no significant difference in the number of osteitis foci between group of patients who have achieved the therapeutic target (ASDAS < 2.1) and those who have not (ASDAS ≥2.1) – 1.0 [0.0; 3.5] and 1.0 [1.0; 4.0], respectively, (p=0.376), and no difference in amount of inflammatory changes – 1.0 [0.2; 1.7] and 0.1 [0.0; 1,1] cm3, respectively (p=0.124). Conclusion. The data suggests a limited MRI informative value as a method for managing the efficacy of bDMARDs treatment in patients with the advanced / late stage of the AS.
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Meloti, Aparecida Fernanda, Renata de Cássia Gonçalves, Ertty Silva, Lídia Parsekian Martins, and Ary dos Santos-Pinto. "Lateral cephalometric diagnosis of asymmetry in Angle Class II subdivision compared to Class I and II." Dental Press Journal of Orthodontics 19, no. 4 (2014): 80–88. http://dx.doi.org/10.1590/2176-9451.19.4.080-088.oar.
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INTRODUCTION: Lateral cephalometric radiographs are traditionally required for orthodontic treatment, yet rarely used to assess asymmetries. OBJECTIVE: The objective of the present study was to use lateral cephalometric radiographs to identify existing skeletal and dentoalveolar morphological alterations in Class II subdivision and to compare them with the existing morphology in Class I and II relationship. MATERIAL AND METHODS: Ninety initial lateral cephalometric radiographs of male and female Brazilian children aged between 12 to 15 years old were randomly and proportionally divided into three groups: Group 1 (Class I), Group 2 (Class II) and Group 3 (Class II subdivision). Analysis of lateral cephalometric radiographs included angular measurements, horizontal linear measurements and two indexes of asymmetry that were prepared for this study. RESULTS: In accordance with an Index of Dental Asymmetry (IDA), greater mandibular dental asymmetry was identified in Group 3. An Index of Mandibular Asymmetry (IMA) revealed less skeletal and dental mandibular asymmetry in Group 2, greater skeletal mandibular asymmetry in Group 1, and greater mandibular dental asymmetry in Group 3. CONCLUSION: Both IDA and IMA revealed greater mandibular dental asymmetry for Group 3 in comparison to Groups 1 and 2. These results are in accordance with those found by other diagnostic methods, showing that lateral cephalometric radiography is an acceptable method to identify existing skeletal and dentoalveolar morphological alterations in malocclusions.
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Jansen, Nathalie W. D., Goris Roosendaal, Bjorn Lundin, et al. "Biomarkers of Cartilage and Bone Damage as a Measure of Joint Damage in Haemophilia." Blood 112, no. 11 (2008): 1214. http://dx.doi.org/10.1182/blood.v112.11.1214.1214.
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Abstract Purpose Biomarkers of bone and cartilage turnover have frequently been evaluated for joint diseases such as rheumatoid arthritis (RA) and osteoarthritis (OA). Results have thus fare not been very conclusive. Some biomarkers such as urinary CTXII and serum COMP appear to correlate with severity of joint degeneration, whereas other are less distinctive. Hemophilic arthropathy (HA) is a very progressive joint degeneration as a result of frequent joint bleeds. From clinical practice it is concluded that the rate of degeneration exceeds that of OA and RA joints. This degeneration has characteristics of both inflammation mediated (as seen in RA) and degenerative (as seen in OA) joint disease. Furthermore, the joint damage is largely restricted to 3 major joints (ankle, knees, and elbows). Therefore, it might be that this rapidly progressive, localized joint degeneration can be used for the evaluation and validation of biomarkers of cartilage and bone turnover. In the present study we therefore investigated whether commercially available biomarkers of cartilage and bone in blood and/or urine are associated with severity of joint damage in patients with haemophilic arthropathy. Methods Blood and urine were collected from 36 patients suffering from haemophilia. Urine samples were assessed for the amount of CTX-I and CTX-II. Serum samples were assessed for the amount of CTX-I, CTX-II, COMP, C1,2C, C2C, and CS846. Radiographs of ankles, knees and elbows were scored according to Pettersson, a radiographic joint score specific for haemophilic arthropathy based on cartilage and bone changes. Results U-CTX-II (R=0.39; p=0.01), C1,2C (R=0.31; p=0.04) and CS846 (R=0.31; p=0.03) showed (marginal) correlations with the Pettersson score. Slightly better correlations were obtained when only narrowing of joint space width (JSW) as one of the items in the Pettersson score was used. The other biomarkers showed no correlation with the Pettersson score. Also the bone biomarkers did not correlate with specific bone changes. Interestingly, combined indexes of different markers, based on linear stepwise regression analysis, increased the correlation significantly up to R=0.65; p≤0.001) for the combination of U-CTX-II, COMP and CS846. Conclusions The present results show that even despite this rapidly progressive degeneration of 6 large joints, from the individual biomarkers determined only U-CTX-II, C1,2C and CS846 show correlation with the severity of arthropathy. Importantly, a relation improved when the markers were related to the process they are supposed to describe (cartilage degeneration markers with JSW narrowing). Most important, combination of markers, significantly improve the relation with the radiographically determined joint degeneration. In general however, it may be concluded that these markers alone seem not of sufficient value for evaluation of joint damage yet.
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Park, Hyung Jun, Seung-Baik Kang, Moon Jong Chang, Chong Bum Chang, Woon Hwa Jung, and Heejin Jin. "Association of Gap Healing With Angle of Correction After Opening-Wedge High Tibial Osteotomy Without Bone Grafting." Orthopaedic Journal of Sports Medicine 9, no. 5 (2021): 232596712110022. http://dx.doi.org/10.1177/23259671211002289.
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Background: Studies have reported that opening wedge high tibial osteotomy (OWHTO) without bone grafting has outcomes that are similar to or even better than those of OWHTO with bone grafting, especially after use of a locking plate. However, a consensus on managing the gap after OWHTO has not been established. Purpose: To determine the degree of gap healing achieved without bone grafting, the factors associated with gap healing, and whether additional gap healing would be obtained after plate removal. Study Design: Cohort study; Level of evidence, 3. Methods: This retrospective study included 73 patients who underwent OWHTO without bone grafting between 2015 and 2018. Patients in the study were divided into 2 groups based on the correction angle: small correction group (<10°; SC group) and large correction group (≥10°; LC group). The locking plate used in OWHTO was removed at a mean of 13.5 months after surgery in 65 patients. Radiographic indexes were measured: gap filling height, gap vacancy ratio (GVR), and osteotomy filling index. The acceptable gap healing was defined as an osteotomy filling index ≥3. The factors related to gap healing around the osteotomy site were selected after multicollinearity analysis. Results: Although both groups achieved acceptable gap healing regardless of the correction angle, the SC group showed higher and earlier gap healing than did the LC group (gap healing rate 81.4% in the SC group vs 41.7% in the LC group at 3 months postoperatively). The GVR was 8.6% in the SC group and 15.3% in the LC group at 12 months after surgery ( P = .005). Both the amount of time that elapsed after surgery and the correction angle were associated with gap healing ( P < .05). Additional gap healing was observed after plate removal, as the GVR decreased 2.7% more in the patients with plate removal than in patients who did not have plate removal ( P = .012). Conclusion: All patients achieved acceptable gap healing without bone graft. The degree of gap healing was higher in the SC group and increased over time. Gap healing was promoted after plate removal. Considering the results of this study, a bone graft is not necessary in routine OWHTO in terms of gap healing.
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Gubar, E., E. Loginova, S. Glukhova, and T. Korotaeva. "FRI0341 RISK FACTORS FOR AXIAL INVOLVEMENT IN EARLY PSORIATIC ARTHRITIS." Annals of the Rheumatic Diseases 79, Suppl 1 (2020): 764–65. http://dx.doi.org/10.1136/annrheumdis-2020-eular.2029.
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Background:Axial Involvement in psoriatic arthritis (PsA) is quite common [1]. Predictors of axial involvement at early-stage of disease haven’t been sufficiently studied.Objectives:To identify predictors of axial involvement in PsA patients (pts) at early-stage of disease.Methods:95 patients (pts) (M/F–47/48) with early PsA fulfilling the CASPAR criteria were included. All pts had peripheral arthritis for≤2 years; no inflammatory back pain (IBP) pts were specifically selected. Mean (Me) age 36.5±10.7 yrs, disease duration 12.2±10.3 mo. Pts underwent standard clinical examination of PsA activity. Me disease activity indexes DAS=4.0±1.4, DAS28=4.2±1.1, BASDAI=4.5±1.6; Me pts global disease activity VAS 56.9±17.1. All patients were evaluated for the presence of IBP by ASAS criteria, underwent sacroiliac joints (SIJs) X-ray (pelvic radiographs) and HLA B27 antigen status study. MRI of SIJs was performed in 79 pts, regardless of IBP presence, on Signa Ovation 0.35T. Radiographic sacroiliitis (R-SI) was identified according to New York criteria (unilateral grade≥3 or bilateral grade≥2). Bone marrow edema/ osteitis on MRI (STIR) was considered active MRI sacroiliitis (MRI-SI). X-ray and MRI results were evaluated by an independent reader. IBP was observed in 63 (66.3%) cases, MRI-SI in 28 of 79 (35.4%) examined cases, R-SI in 29 (30.5%) cases. Skin lesion severity was evaluated as body surface area (BSA) affected: minor at <3%, mild at 3-10%, severe at >10%. Pts were split into 2 groups (gr.): those with axial involvement (axPsA), that is with IBP and/or R-SI and/or MRI-SI; and those without axial involvement (having only peripheral PsA [pPsA]).The axPsA gr. included 65 (68.4%) cases, the pPsA gr. 30 (31.6%) cases. Multi-dimensional step-by-step discriminant analysis was used to identify a group of features that are more typical for the axPsA patients.Results:The following features proved to be the most informative: male sex (р = 0.300), presence of HLA B27 (р = 0.107), mild or high DAS (р = 0.098), skin lesion severity BSA>3% (р = 0.118), and CRP > 5 mg/L (0.038).Sensitivity of model 79.0%, specificity of model 57.7%. Area under ROC curve 0.756; 95% CI (0.642-0.869).Conclusion:It is a combination of features – male sex, HLA-B27 positivity, mild or high activity of peripheral arthritis according to DAS, CRP > 5 mg/L, and BSA> 3% – that constitutes a clinical predictor for the development of axial involvement in early psoriatic arthritis.References:[1]V. Chandran et al. Curr Opin Rheumatol. 2019;31:329-34Disclosure of Interests:ELENA GUBAR: None declared, Elena Loginova Speakers bureau: Janssen, Svetlana Glukhova: None declared, Tatiana Korotaeva Grant/research support from: Pfizer, Consultant of: Abbvie, BIOCAD, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Novartis-Sandoz, Pfizer, UCB, Speakers bureau: Abbvie, BIOCAD, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Novartis-Sandoz, Pfizer, UCB
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Benavent, D., V. Navarro-Compán, C. Plasencia, D. Peiteado, A. Villalva, and A. Balsa. "AB0670 AXIAL MANIFESTATIONS IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS AND PSORIATIC ARTHRITIS: ARE THEY SIMILAR?" Annals of the Rheumatic Diseases 79, Suppl 1 (2020): 1630.1–1630. http://dx.doi.org/10.1136/annrheumdis-2020-eular.1703.
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Background:Spondyloarthritis (SpA) is a group of heterogeneous diseases that includes axial SpA (axSpA), such as ankylosing spondylitis and axial non-radiographic SpA, and Psoriatic Arthritis (PsA) with peripheral and/or axial involvement (axPsA). Currently, it is not well known if the characteristics and burden of the disease in patients with axPsA are similar to that of patients with axSpA.Objectives:To compare the demographic, clinical and structural features between patients with axSpA and axPsA.Methods:Data from an observational prospective cohort including all patients with SpA initiating biological therapy because of predominant axial manifestations from 2002-2019 in a university hospital were analyzed. AxSpA and axPsA were defined in clinical practice according to the prescribing rheumatologist, based on clinical features and complementary examinations. Demographic information, laboratory tests, disease presentation, sacroiliitis according to modified New York criteria in the pelvis X-ray, disease activity indexes (ASDAS and BASDAI) and concomitant treatment before starting biological drug were collected from the electronic medical record and biologic database. In the statistical analysis, chi square or the exact Fisher’s test was used for categorical and t-student or U-Mann Whitney for continuous variables, according to the distribution of the data. Then, the association between demographic and clinical features and each disease was analysed using univariable and multivariable logistic regression models.Results:Out of 352 included patients, 287 (81.5%) had axSpA, and 65 had axPsA (18.5%). Baseline characteristics are shown in Table 1. Mean baseline ASDAS was 3.3±0.9 and 3.1±1.0 for axSpA and axPsA, respectively. Biological therapies initiated can be seen in Figure 1. No significant differences at baseline were observed between axSpA and axPsA for most of the characteristics including: gender, age at diagnosis, age at starting biologic, disease duration before biologic, smoking habit, CRP, disease activity, enthesitis, dactylitis, inflammatory bowel disease (IBD), patient global assessment and sulfasalazine use. However, there were differences between diseases in some relevant characteristics. AxSpA patients had less peripheral involvement (41.5 vs. 78.5 %, p=0.004), more uveitis (15.3 vs. 3.1 %, p=0.03) and were more frequently HLA-B*27 positive (72.3 vs 34.1 %, p<0.001), in comparison to axPsA patients. They also had better physician global assessments (PhGA) (37.4 vs 44.4, p=0.02), and a higher grade of radiographic sacroiilitis. AxSpA patients used less global baseline concomitant therapy (p=0.001), methotrexate (p<0.001) and prednisone (p<0.01), whereas they used more sulfasalazine (p=0.003) than axPsA patients in our cohort. After running multivariate analyses, the absence of peripheral manifestations (OR=4.7; p<0.001) and the positivity of HLA-B27 (OR=5.4; p<0.001) were independently associated with axSpA.Table 1. Baseline stratified characteristics. Results are shown as absolute numbers (percentages) or mean ± standard deviation.Conclusion:Despite being spondyloartrithis with many common traits, axSpA and axPsA present some differences in clinical practice. Whereas axSpA patients are more frequently HLA-B27 positive, axPsA have more peripheral involvement. These differences in clinical presentation between both diseases may contribute to variances in therapeutic management, such as increased use of baseline concomitant therapy in axPsA patients who initiate biological therapy.Figure 1.Biological therapies initiated in axSpA and axPsADisclosure of Interests:Diego Benavent: None declared, Victoria Navarro-Compán Consultant of: Abbvie, Lilly, Novartis, Pfizer, UCB, Speakers bureau: AbbVie, MSD, Lilly, Novartis, Pfizer, UCB, Chamaida Plasencia: None declared, Diana Peiteado: None declared, Alejandro Villalva: None declared, Alejandro Balsa Grant/research support from: BMS, Roche, Consultant of: AbbVie, Gilead, Lilly, Pfizer, UCB, Sanofi, Sandoz, Speakers bureau: AbbVie, Lilly, Sanofi, Novartis, Pfizer, UCB, Roche, Nordic, Sandoz
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Kinalski, Mateus Azevedo, Noeli Boscato, and Melissa Feres Damian. "The accuracy of panoramic radiography as a screening of bone mineral density in women: a systematic review." Dentomaxillofacial Radiology 49, no. 2 (2020): 20190149. http://dx.doi.org/10.1259/dmfr.20190149.
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Objectives: A systematic review and meta-analysis of diagnostic test accuracy studies was conducted to assess if the radiomorphometric indexes observed in panoramic radiographies could estimate reduced bone mineral density (BMD) similarly to standard technique the bone densitometry (dual energy X-ray absorptiometry) in females older than 30 years. Methods: A systematic search in four databases was conducted until January 2019. Two evaluators performed data extraction and evaluation of risk of bias independently, and agreement was achieved by consensus. Data were synthesized on a subgroup meta-analysis with a random effect model and the hierarchical summary receiver-operating characteristic curve was used to calculate pooled estimates of studies. Results: Thirty three studies were included and 12 different radiomorphometric indexes identified, including Mandibular Cortical Index (MCI). The final number of cases pooled for the analysis was 5266 females.The MCI for BMD loss (osteopenia) presented values of sensitivity 0.81 [95% confidence interval (CI), 0.78–0.84] and specificity 0.48 (95% CI, 0.45–0.50), while for osteoporosis sensitivity 0.35 (95% CI, 0.30–0.40) and specificity 0.88 (95% CI, 0.86–0.90). The mandibular cortical width presented values of sensitivity 0.58 (95% CI, 0.40–0.73), specificity 0.73 (95% CI, 0.60–0.83) for osteopenia, while for osteoporosis sensitivity 0.57 (95% CI, 0.36–0.76) and specificity 0.83 (95% CI, 0.68–0.92). Due to the high sensitivity, MCI presented a potential value as a screening tool for initial BMD loss (osteopenia), once tests presenting high sensitivity are described as rarely missing subjects with the disease. To the other hand, MCI to osteoporosis and Mandibular Cortical Width for both conditions are not recommended because presented specificity higher than sensitivity. Conclusion: The MCI can be recommended as a feasible tool to screen initial BMD loss (osteopenia) in females above 30 years old using panoramic radiography exams.
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Ramires-Romito, Ana Cláudia Durante, Luciana Butini Oliveira, Giuseppe Alexandre Romito, Márcia Pinto Alves Mayer, and Célia Regina Martins Delgado Rodrigues. "Correlation study of plaque and gingival indexes of mothers and their children." Journal of Applied Oral Science 13, no. 3 (2005): 227–31. http://dx.doi.org/10.1590/s1678-77572005000300005.
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This study aimed to compare the periodontal condition between plaque and gingival indexes in 30 pairs of mother and child with mixed dentition, as well as to correlate the findings with some of their social and oral hygiene habits. Mother's and child's plaque and gingival indexes were recorded during clinical examination. Periapical and bitewing radiographs were taken in order to assess the presence of any pathologic bone loss. Questionnaires answered by the mothers were used to collect information regarding the mother's and the child's habits of tooth hygiene and the mother's job, instruction level and family income. The data collected from the mothers' group and from the children's group were statistically analyzed both separately and with the two groups together. From the statistical analyses (Pearson correlation test, student test and Covariance analysis), it was possible to conclude that there was a greater correlation between the plaque and gingival indexes in the mothers' group than in the children's group. No significant correlation between plaque and gingival indexes could be found between the pairs. Also, bone loss and plaque and gingival indexes in the children did not show any correlation. The mothers' plaque indexes increased with age and decreased when they flossed everyday and when they had a job. The children's plaque indexes were lower when they had their tooth hygiene done by their mothers, when the latter had declared that they flossed their children's teeth everyday, and also when the mothers had a job. Children's gingival indexes increased with age and decreased when they brushed their teeth more often, when their mothers had a job and when their mothers declared they are used to flossing every day.
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Shepard, SJ, and L. Goldman. "MO-A-L100F-01: Patient Dose in Digital Radiography: Exposure Indexes and Optimization Procedures." Medical Physics 34, no. 6Part15 (2007): 2509. http://dx.doi.org/10.1118/1.2761188.
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Göller Bulut, Duygu, Seval Bayrak, Ummügül Uyeturk, and Handan Ankarali. "Mandibular indexes and fractal properties on the panoramic radiographs of the patients using aromatase inhibitors." British Journal of Radiology 91, no. 1091 (2018): 20180442. http://dx.doi.org/10.1259/bjr.20180442.
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Nishii, T., T. Shiomi, T. Sakai, M. Takao, H. Yoshikawa, and N. Sugano. "417 ASSESSMENT OF MORPHOLOGICAL INDEXES OF HIPS WITH AND WITHOUT OSTEOARTHRITIS USING AUTOMATED IMAGE ANALYSIS ON PLAIN RADIOGRAPHS." Osteoarthritis and Cartilage 17 (September 2009): S222. http://dx.doi.org/10.1016/s1063-4584(09)60438-6.
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Morise, Y., T. Mori, Y. Koga, et al. "New evaluation indexes for estimated rotational knee angles in stading anteroposterior knee radiographs from Matsudai knee osteoarthritis survey." Osteoarthritis and Cartilage 28 (April 2020): S457—S458. http://dx.doi.org/10.1016/j.joca.2020.02.715.
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Bayrak, Seval, Duygu Göller Bulut, Kaan Orhan, et al. "Evaluation of osseous changes in dental panoramic radiography of thalassemia patients using mandibular indexes and fractal size analysis." Oral Radiology 36, no. 1 (2019): 18–24. http://dx.doi.org/10.1007/s11282-019-00372-7.
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Kilda, Artūras, Saulius Lukoševičius, Vidmantas Barauskas, Živilė Jankauskaitė, and Algidas Basevičius. "Radiological changes after Nuss operation for pectus excavatum." Medicina 45, no. 9 (2009): 699. http://dx.doi.org/10.3390/medicina45090091.
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The objective of this study was to evaluate sternovertebral distance and the chest wall deformation after Nuss procedure. Materials and methods. Anteroposterior and lateral chest radiographs were performed before Nuss procedure, 1, 6, and 12 months after operation and finally 1 month after bar removal. Sternovertebral distance and transversal chest dimension were measured on radiographs, as well as Haller and vertebral indexes were calculated. Results. A total of 84 children with funnel chest were operated on. Preoperative sternovertebral distance was 79.81±6.96 mm; 1 month after operation, 97.84±17.08 mm; 6 months, 110.55±13.85 mm; and 12 months, 113.6±14.61 mm. After removal of the bar, the distance was 105±11.95 mm. The mean increase in sternovertebral distance during the first month was 18 mm (P<0.0001); 1–6 months, 12.8 mm (P=0.0006); and 6-12 months, 3 mm (P=0.48). The mean decrease in sternovertebral distance after removal of the bar was 8.6 mm (P=0.47). The decrease in transversal chest dimension during the first month was significant (13.3±12.86 mm, P=0.012). Conclusions. The sternovertebral distance was significantly increased after Nuss operation. Restoration of deformation proceeds during all the first year after operation. The dynamics of deformation is better depicted by means of vertebral index rather than Haller index.
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Mulett Vasquez, Jackeline, and Hernán Parra Sánchez. "Ossification characteristics of the hand and the cervical vertebrae and correlation between the two techniques as indicators of somatic maturation in children from 8 to 17 years." Revista Estomatología 20, no. 2 (2017): 7–15. http://dx.doi.org/10.25100/re.v20i2.5736.
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Objective: To determine the characteristics of hand-wrist and cervical vertebral ossification and establish the correlation between these two techniques as indicators of somatic maturation in children between 8 and 17 years old.
 Materials and Methods: A cross sectional and correlational study was carried out in 200 children between 8 and 17 years old, born in the same city. Children should show no systemic diseases that affect the skeletal development or craniofacial syndromes. Lateral cephalometric radiographs and carpogram test were taken in the same day. The frequency of the variables such as gender, carpal and cervical vertebrae maturation indexes was established. A correlation matrix (Pearson’s coefficient) for the quantitative variables (height and weight) and the variables that explain the indexes, and the ordinal scale variables and Kendall’s Tau-b statistics were done. Regression models were developed to predict the skeletal maturation index (SMI).
 Results: According to the age and level of skeletal maturation (skeletal maturation assessment - SMA), the ossification stages begin earlier in women than in men (women SMI1: 8.4 +0.8 years and in men to 10.3 +1.5 years). Depending on the correlation model, there is a direct relation between height and shape of vertebrae with the SMI. The coefficient of determination (R2) indicated that 86% of SMI is explained by the two analyzed variables.
 Conclusions: There was a statistically significant correlation between height and shape of the vertebral body with stages of skeletal maturation index (SMI).
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Silva-Filho, Osmar F., Gerson T. Pessoa, Francisco C. A. Sousa, et al. "Assessment of the vertebral heart scale and cardiothoracic ratio to standardize the heart size of collared peccaries (Tayassu tajacu Linnaeus, 1758) restrained with ketamine and midazolam." Pesquisa Veterinária Brasileira 38, no. 8 (2018): 1705–11. http://dx.doi.org/10.1590/1678-5150-pvb-5434.
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ABSTRACT: Wild species, especially those threatened with extinction, are increasingly being investigated to obtain information that can be useful for their preservation. The objective of the present study was to standardize the vertebral heart scale (VHS) and cardiothoracic ratio (CTR) of the collared peccary (Tayassu tajacu Linnaeus, 1758) sedated with ketamine and midazolam. Fourteen clinically healthy collared peccaries were examined in the two-year age group weighing 15-22kg. The animals were submitted to digital radiography of the thorax in lateral and dorsal ventral projections to calculate the VHS and CTR. The VHS mean values for males and females was 8.88±0.51v for right recumbency and 8.84±0.39v for left decubitus, and there were no significant between-gender differences regarding recumbency (p>0.05). The CTR showed mean values of 0.50±0.05 (males) and 0.45±0.04 (females), but the gender-differences were not significant (p>0.05). A positive correlation was shown between VHS and CTR (r=0.98, right decubitus; r=0.96, left decubitus). Establishing reference values for heart measurements in collared peccaries using digital radiography of the thorax permitted standardization of the VHS and CTR values for this wild species. In the studied wild animal model, the VHS and CTR heart assessment indexes were shown to be essential diagnostic tools for investigations of alterations in the size of the cardiac silhouette.
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Vegter, Florine, and J. Joris Hage. "Facial Anthropometry in Cleft Patients: A Historical Appraisal." Cleft Palate-Craniofacial Journal 38, no. 6 (2001): 577–81. http://dx.doi.org/10.1597/1545-1569_2001_038_0577_faicpa_2.0.co_2.
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Objective: To present a historical appraisal of the use of anthropological and cephalometrical facial soft tissue measurements in cleft patients. Design: The McDowell Indexes and a Medline search were used to trace references up to 1999. Also, references listed with chapters and articles on facial clefts were searched for anthropometrical studies. Twenty-six retrieved articles and book chapters on soft tissue anthropometry and 12 cephalometric publications on soft tissue measurements on radiographs and plaster casts of cleft patients were reviewed. Results and Conclusions: Since 1931, the facial soft tissue appearance of cleft patients has been evaluated by means of anthropometric and cephalometric techniques. Not all of the older studies were performed in a statistically correct fashion. Many of the conclusions of the studies overlap despite differences in technique of assessment. Most studies demonstrate the deficient growth of the maxilla and the deformities of the facial profile in cleft patients.
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Roman-Torres, Caio V. G., José S. Neto, Marcio A. Souza, Humberto O. Schwartz-Filho, William C. Brandt, and Ricardo E. A. S. Diniz. "An Evaluation of Non-Surgical Periodontal Therapy in Patients with Rheumatoid Arthritis." Open Dentistry Journal 9, no. 1 (2015): 150–53. http://dx.doi.org/10.2174/1874210601509010150.
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aim of this study was to evaluate the efficacy of periodontal scaling and oral hygiene instruction for patients with mild chronic periodontitis and rheumatoid arthritis through clinical periodontal parameters and laboratory tests for CRP (C- reactive protein) and ESR (erythrocyte sedimentation rate). Twelve individuals with rheumatoid arthritis and 12 healthy individuals were evaluated, with a mean age of 45.38 and 46.75 respectively, all female and with mild, chronic periodontitis. The participants were evaluated clinically and periapical radiographs were taken (T1), after which periodontal treatment was instituted. After ninety days (T2), new clinical and laboratory data were obtained. Probing depth, bleeding index, and plaque indexes were observed in both groups, and the results demonstrated reductions but no statistical differences. Laboratory tests for CRP and ESR produced higher values for the rheumatoid arthritis group with T1- T2 reductions on the average, but the values were still higher than in the health group. We conclude that periodontal therapy in patients with rheumatoid arthritis and mild chronic periodontitis showed a improvement in the periodontal clinical parameters and laboratory tests that were evaluated.
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Miller, Andrew, Christopher Jones, Dennis Martin, et al. "Reliability of Metacarpal Subsidence Measurements after Thumb Carpometacarpal Joint Arthroplasty." Journal of Hand and Microsurgery 10, no. 01 (2018): 022–25. http://dx.doi.org/10.1055/s-0037-1618912.
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Abstract Background Thumb metacarpal subsidence after trapeziectomy can affect clinical function over time. Methods for measuring subsidence after trapeziectomy have been described, and they rely on an intact thumb metacarpal or proximal phalanx for measurement. The authors evaluated the reliability and reproducibility of measuring the trapezial space ratio, using previously described methods. In addition, the authors evaluated a new method that measures trapezial space on a posteroanterior (PA) hand/wrist radiograph that does not rely on an intact thumb metacarpal or proximal phalanx for measurement, which can often be altered by degenerative changes or in cases in which metacarpophalangeal arthrodesis is performed during carpometacarpal (CMC) joint arthroplasty to correct excessive hyperextension. The authors hypothesized that a new method of calculating trapezial space would have comparable reliability and reproducibility to previously proposed methods. Methods Thirty-seven PA hand/wrist radiographs from patients who had trapeziectomy with ligament reconstruction and tendon interposition were evaluated. Trapezial space was measured using PACS (Picture Archiving and Communication System) digital tools as the distance perpendicular to the tangents of the scaphoid and first metacarpal joint surfaces. All X-rays were evaluated individually by five fellowship-trained hand surgeons, twice, 4 weeks apart. The reviewers calculated trapezial space ratios, using three different methods, two previously described and a novel one: (1) trapezial space relative to first metacarpal length (classic 1); (2) trapezial space relative to proximal phalanx length (classic 2); and (3) trapezial space relative to capitate height (novel). Inter- and intraobserver reliabilities were measured using intraclass correlation coefficients (ICC) and limits of agreement for each method. Results The authors identified excellent agreement between the classic 1, classic 2, and novel methods with an ICC greater than 0.8, indicating excellent agreement. The average trapezial space ratios for the thumb proximal phalanx, thumb metacarpal, and capitate methods were measured as 0.19, 0.12, and 0.24, respectively. The upper and lower limits of the 95% confidence intervals for both the inter- and intraobserver agreements of the aforementioned trapezial space ratios were (0.17–0.26), (0.11–0.17), and (0.21–0.34) for the interobserver rates and (0.11–0.25), (0.06–0.16), and (0.12–0.33) for the intraobserver rates, respectively. Conclusion Measuring trapezial space is an important diagnostic tool to assess postoperative changes in thumb length. The trapezial space indexed to the capitate height method (novel) provides a simple and similarly reliable method for calculating the trapezial space ratio on a PA radiograph of the hand/wrist when other measurement techniques are unavailable and when the thumb metacarpal or proximal phalanx is not intact. The authors found a high degree of reproducibility and inter- and intraobserver reliability as measured by the ICC and the 95% limits of agreement that compare with previous agreements in the literature.
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Gonçalves, Berenice das Dores, Sonia Regina Lambert Passos, Maria Angelica Borges dos Santos, Carlos Augusto Ferreira de Andrade, Maria de Fátima Moreira Martins, and Fernanda Carvalho de Queiroz Mello. "Systematic Review With Meta-Analyses and Critical Appraisal of Clinical Prediction Rules for Pulmonary Tuberculosis in Hospitals." Infection Control & Hospital Epidemiology 36, no. 2 (2014): 204–13. http://dx.doi.org/10.1017/ice.2014.29.
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ObjectiveTo systematically review studies evaluating clinical prediction rules (CPRs) for adult inpatients suspected to have pulmonary tuberculosis.DesignSystematic review with meta-analyses.SettingHospitals.PatientsInpatients at least 15 years of age admitted to acute care.MethodsA search was conducted in 5 indexed electronic databases with no language or year of publication restrictions. We performed a meta-analysis for those CPRs with at least 2 validation studies. Results were reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses.ResultsOf the 461 abstracts selected, 36 articles were fully analyzed and 11 articles were included, yielding 8 CPRs derived in 4 countries. Broad validation studies were identified for 2 CPRs. The most frequent clinical predictors were fever and weight loss. All CPRs included chest imaging signs. Most CPRs were derived in countries with a low prevalence of pulmonary tuberculosis and included homeless, immigrants, and those who reacted to the purified protein derivative test. Both of the CPRs derived in countries with a high prevalence of pulmonary tuberculosis strongly relied on chest radiograph predictors. Accuracy of the different CPRs was high (area under receiver operating characteristic curve, 0.79–0.91). Meta-analysis of 4 validation studies for Wisnivesky´s CPR indicates optimistic pooled results: sensitivity, 94.1% (95% CI, 89.7%–96.7%); negative likelihood ratio, 0.22 (95% CI, 0.12–0.40).ConclusionOn the basis of a critical appraisal of the 2 best validated CPRs, the presence of weight loss and/or fever in inpatients warrants obtaining a chest radiograph, regardless of the presence of productive cough. If the chest radiograph is abnormal, the patient should be placed in isolation until more specific test results are available. Validation in different settings is required to maximize external generalization of existing CPRs.Infect Control Hosp Epidemiol 2014;00(0): 1–10
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Braga, Vagner, Lucas Morita, Luciana Munhoz, Silvia Lourenço, and Emiko Arita. "Periodontal disease defects and mandibular cortical index in lupus patients." Brazilian Dental Science 22, no. 4 (2019): 506–12. http://dx.doi.org/10.14295/bds.2019.v22i4.1808.
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Objective:Systemic lupus erythematosus is an autoimmune disease that affects multiple organs. It is well known that lupus patients have higher risk of osteoporosis, but if the disease affects mandibular cortical bone and alveolar bone is not fully established. The objective of this study was to evaluate periodontal disease defects and mandibular osteoporotic alterations in patients with lupus as compared to healthy patients using panoramic radiographs.Material and Methods:The panoramic radiographs of 72 patients with lupus and 360 healthy patients were evaluated for the presence of bone loss secondary to periodontal disease, classified as horizontal and vertical bone loss. We also assessed mandibular osteoporotic alterations by using the mandibular cortical index. Logistic regression analysis was applied to estimate the risk of mandibular osteoporotic alterations as well as horizontal and vertical bone loss in patients with lupus as compared to healthy patients.Results:There were no statistically significant differences between groups in the presence of horizontal bone defects and mandibular cortical indexes. However, patients with lupus demonstrated that patients with lupus were 2.17 more likely to present vertical bone loss than healthy patients.Conclusions:Patients with lupus might have higher risk of vertical bone loss than healthy patients due to pathophysiology of their disease. Further larger prospective studies should be performed to confirm our findings.
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CORDEIRO, FELIPPI GUIZARDI, PATRICIA MORENO GRANGEIRO, BRUNO SÉRGIO FERREIRA MASSA, NEI BOTTER MONTENEGRO, and ROBERTO GUARNIERO. "REPRODUCIBILITY OF MODIFIED WALDENSTRÖM CLASSIFICATION IN PERTHES DISEASE." Acta Ortopédica Brasileira 29, no. 2 (2021): 92–96. http://dx.doi.org/10.1590/1413-785220212902242018.
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ABSTRACT Objective: The purpose of our study is to evaluate intraobserver and interobserver reliability of modified Waldenström classification system for Legg-Calvé-Perthes disease and assess the influence of the professional’s area of expertise in the assessment. Methods: Twelve evaluators assessed 40 pairs of pelvic radiographs of patients with Legg-Calvé-Perthes disease. After two weeks, a new evaluation was performed by the same evaluators. Kappa and Kendall’s W indexes were used to evaluate both intraobserver and interobserver reliability and determine the influence of the evaluators’ experience and area of expertise. Results: The average intraobserver kappa value was 0.394, with a reasonable agreement level. The interobserver Kappa value was 0.243 in the first evaluation (95% CI, 0.227-0.259 and p < 0.0001) and 0.245 in the second evaluation (95% CI, 0.229-0.260 and p < 0.0001). The Kendall’s W values obtained for pediatric orthopedists, radiologists and resident physicians were 0.686, 0.630 and 0.529 (p < 0.0001), respectively. Conclusion: The modified Waldenström classification presented both moderate and reasonable levels of intraobserver agreement, and reasonable level of interobserver agreement. The evaluators’ degree of experience and area of expertise influenced the concordance level found. Level of Evidence II, Diagnostic Studies - Investigating a Diagnostic Test.
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de la Puerta, Benito, Matteo Rossanese, and Terry Emmerson. "Prevalence, Risk Factors and Outcome of Postoperative Tibial Tuberosity Fractures in Dogs Undergoing Triple Tibial Osteotomy Surgery." Veterinary and Comparative Orthopaedics and Traumatology 32, no. 04 (2019): 324–31. http://dx.doi.org/10.1055/s-0039-1685163.
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Objective The aim of this study was to report the prevalence and to identify the risk factors associated with postoperative tibial tuberosity fracture following a triple tibial osteotomy. This article also evaluates the outcome of these patients treated conservatively. Materials and Methods Medical records of 100 dogs (113 limbs) that underwent triple tibial osteotomy procedure were evaluated. Information obtained included signalment, preoperative, immediate postoperative and 6-week postoperative radiographic findings, intraoperative and postoperative complications. Long-term outcome was assessed using an owner questionnaire. Results Postoperative tibial tuberosity fracture was identified in 25/113 stifles. The only variable associated with the presence or absence of postoperative tibial tuberosity fracture within 6 weeks of surgery was postoperative cortical hinge width (CHW) or an indexed value of CHW to tibial width (TW). Using either a cut-off value of CHW of ≥ 5.5 mm or a cut-off value of CHW/TW of ≥ 0.21, only 1/27 stifle in our study developed tibial tuberosity fracture. Long-term owner evaluation of outcome was considered excellent or good in 65/70 stifles. Conclusion A narrow CHW at the distal cortical attachment of the tibial crest had a strong association with the development of postoperative tibial tuberosity fracture. No other patient or surgical variables were associated with tibial tuberosity fracture. Patients that developed tibial tuberosity fracture and were conservatively managed did not have a worse clinical outcome than patients that did not develop tibial tuberosity fracture.
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Bombonatti, Roberto, Arón Aliaga Del Castillo, Juliana Fraga Soares Bombonatti, Daniela Garib, Bryan Tompson, and Guilherme Janson. "Cephalometric and occlusal changes of Class III malocclusion treated with or without extractions." Dental Press Journal of Orthodontics 25, no. 4 (2020): 24–32. http://dx.doi.org/10.1590/2177-6709.25.4.024-032.oar.
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ABSTRACT Objective: The aim of this retrospective study was to evaluate the cephalometric and occlusal changes of orthodontically treated Class III malocclusion patients. Methods: The experimental groups comprised 37 Class III patients treated: G1) without (n=19) and G2) with extractions (n=18) . The control group (G3), matched by age and sex with the experimental groups, consisted of 18 subjects with untreated Class III malocclusion. Cephalometric (radiographs) and occlusal (study models) changes were assessed between the beginning (T1) and the end (T2) of treatment. Intergroup comparisons were performed with one-way ANOVA followed by Kruskal-Wallis tests (p< 0.05). Occlusal changes were evaluated by the peer assessment rating (PAR) index (ANOVA and Kruskal-Wallis tests), and the treatment outcomes were evaluated by the Objective Grading System (OGS) (t-tests). Results: The experimental groups showed a restrictive effect on mandibular anterior displacement and a discrete improvement in the maxillomandibular relationship. Extraction treatment resulted in a greater retrusive movement of the incisors and significant improvements in the overjet and molar relationship in both groups. The PAR indexes were significantly reduced with treatment, and the OGS scores were 25.6 (G1) and 28.6 (G2), with no significant intergroup difference. Conclusions: Orthodontic treatment of Class III malocclusion patients with fixed appliances improved the sagittal relationships, with greater incisor retrusion in the extraction group. Both the extraction and non-extraction treatments significantly decreased the initial malocclusion severity, with adequate and similar occlusal outcomes of treatment.
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Hassanzadeh, Nadia, Mohammadreza Majidi, and Mohammad Taghi Shakeri. "S262 – Effect of Etiology of Mouth Breathing on Facial Morphology." Otolaryngology–Head and Neck Surgery 139, no. 2_suppl (2008): P162—P163. http://dx.doi.org/10.1016/j.otohns.2008.05.438.
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Objectives Nasal septal deviation and hypertrophy of the adenoids and palatine tonsils are 2 common causes of nasopharyngeal obstruction and consequently mouth breathing in children. It is accepted that chronic mouth breathing influences craniofacial growth and development. The aim of this study was to evaluate the differences of craniofacial morphology in children with 2 different etiological factors of mouth breathing. Methods Study design:cross sectional. The research was conducted between 2005–2007 on 47 predominantly mouth-breathing patients aged 6–10 years. After otorhinolaryngologic examination and flexible nasofibroscopy, patients were divided into 2 groups based on the etiology of nasopharyngeal obstruction: group 1, with adenotonsillar hypertrophy, and group 2 with nasal septal deviation. Lateral cephalometric radiographs were obtained to assess craniofacial development. Data gained were statistically evaluated by Mann-Whitney and T-student tests. Results With respect to the inclination of the mandibular and palatal planes, anteroposterior relationship of maxilla and mandible to the cranial base, and indexes of facial height proportions, no significant differences were observed between two groups of children with mouth breathing. Only the angular ArGo. GoMe measurement was significantly larger in children with adenotonsillar hypertrophy (p<0.05). Conclusions The present study did not detect significant morphological differences between children with adenotonsillar hypertrophy and those with nasal septal deviation. Mouth breathing seems to have a similar effect on craniofacial morphology irrespective of its etiology. Prospective studies with larger samples including older children are suggested.