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Burhan, Ahmad S., Fehmieh R. Nawaya, Yousef N. Issa, and Lama G. Massouh. "Assessment of the Pubertal Growth Period using the Open Apices of the Lower Teeth." Journal of Contemporary Dental Practice 18, no. 1 (January 2017): 16–22. http://dx.doi.org/10.5005/jp-journals-10024-1981.
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ABSTRACT Aim The purpose of this study was to evaluate whether the open apex measurements of the lower teeth can be used for prediction of the pubertal growth spurt. Materials and methods The study group consisted of 150 males and 142 females ranging in age from 10 to 16 years. A total of 292 panoramic and 292 hand-wrist radiographs were obtained and analyzed. The skeletal maturity was determined according to the skeletal maturity indicators (SMIs) developed by Fishman. The open apices measurements of the left lower teeth were made according to the method described by Cameriere. Results The Spearman rank order correlation coefficient revealed a relationship between the skeletal maturity stages and the open apex measurements. These correlations ranged from 0.577 for the lower second premolar to 0.830 for the lower canine. The measurement of the left lower canine showed the highest correlation, so its relationship with the SMIs was further investigated. The measurements of 6.07 (or greater) indicated to SMI4, and 2.485 (or lesser) indicated to SMI7. Conclusion The skeletal maturity well related to the measurements of the open apices of the lower teeth. Lower canine open apex measurements could be used as an indicator of the SMI4 and SMI7. Clinical significance The measurements of the open apices of the left lower canines from panoramic radiographs may be clinically useful as an indicator of the beginning and the ending of the pubertal growth period. How to cite this article Issa YN, Burhan AS, Nawaya FR, Massouh LG. Assessment of the Pubertal Growth Period using the Open Apices of the Lower Teeth. J Contemp Dent Pract 2017;18(1):16-22.
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Kavya, S., Pavithra Pugalendi, Rose Martina P. A., N. Sriraam, K. S. Babu, and Basavaraj Hiremath. "Bone Age Assessment." International Journal of Biomedical and Clinical Engineering 2, no. 2 (July 2013): 1–10. http://dx.doi.org/10.4018/ijbce.2013070101.
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Bone age assessment defined as the measure of skeletal development is most often used in pediatrics and forensics to estimate the true age of a person. It is usually done by comparing the left hand X-ray of a person with the hand radiographs in the standard atlas or based on local regions of interests (ROI) that include epiphyseal regions of the phalanges (14 ROI’s).Both these assessments were labour intensive, prone to discrepancies and can only be used to estimate the age till 18. Hence there is a need to develop automated method to assess the bone age by exploiting the appropriate features. This paper attempts to identify a procedure in recognizing the respective bone that belongs to male or female with its corresponding age. The automated procedure comprises of segmentation of metacarpals using area based statistics followed by typical feature extraction. Nine features are extracted for the experimental study. A back propagation neural network is then applied to classify whether the given sample refers to male or female bone. It is observed from the simulation results that the proposed procedure is found to be less computation burden and the results are found to be comparable with the existing work reported in the literature.
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Knapik, D. M., J. O. Sanders, A. Gilmore, D. R. Weber, D. R. Cooperman, and R. W. Liu. "A quantitative method for the radiological assessment of skeletal maturity using the distal femur." Bone & Joint Journal 100-B, no. 8 (August 2018): 1106–11. http://dx.doi.org/10.1302/0301-620x.100b8.bjj-2017-1489.r1.
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Aims Using 90% of final height as a benchmark, we sought to develop a quick, quantitative and reproducible method of estimating skeletal maturity based on topographical changes in the distal femoral physis. Patients and Methods Serial radiographs of the distal femoral physis three years prior to, during, and two years following the chronological age associated with 90% of final height were analyzed in 81 healthy children. The distance from the tip of the central peak of the distal femoral physis to a line drawn across the physis was normalized to the physeal width. Results A total of 389 radiographs of the distal femur with corresponding Greulich and Pyle bone ages and known chronological ages were measured. Children reached 90% of final height at a mean age of 11.3 years (sd 0.8) for girls and 13.2 years (sd 0.6) for boys. Linear regression analysis showed higher correlation coefficent in predicting the true age at 90% of final height using chronological age + gender + central peak value (R2 = 0.900) than chronological age + gender (R2 = 0.879) and Greulich and Pyle bone age + gender (R2 = 0.878). Conclusion Chronological age + gender + central peak value provides more accurate prediction of 90% of final height compared with chronological age + gender and Greulich and Pyle bone age + gender. Cite this article: Bone Joint J 2018;100-B:1106–11.
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Alshamrani, Khalaf. "The Application of Magnetic Resonance Imaging in Skeletal Age Assessment." Applied Bionics and Biomechanics 2022 (February 21, 2022): 1–5. http://dx.doi.org/10.1155/2022/9607237.
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Aim of the Study. To assess whether skeletal age can be determined from left-hand magnetic resonance imaging (MRI) using the Greulich & Pyle (G&P). Method. The study includes 80 patients identified from an endocrine clinic, two males and two females from each of 5 age groups (<5, 5 to 7, 8 to 10, 11 to 13, and 14 to 16 years). Skeletal age as determined from an open MRI scanner and radiographs performed on the same day was compared for each child. Two observers assess the skeletal age from radiographs and MRI images independently. After a period of at least three weeks, observers determined the skeletal age of all patients independently. All of the images were in different and random orders, on both of the assessment occasions. The agreement was assessed using the interclass correlation coefficient and Bland Altman plots. Problem Statement. The recurrent use of left-hand radiography in children with chronic conditions might result in the patient being exposed to the same image several times throughout the course of their lives. Use of radiation-free methods such as magnetic resonance imaging (MRI) may be able to assist in reducing the risks associated with radiation exposure, if done properly. Results. Patients’ age ranged from 3 to 16 years, in which the mean of the chronological age was 9.3 years (±2.9) and 9.8 years (±2.7) in girls and boys, respectively. The interrater agreement for skeletal age determination was 0.984 for radiographs and 0.976 for MRI scans. Using the G&P technique, for Observer 1, intraobserver agreement for radiographs and DXA was 0.993 and 0.983, respectively, and 0.995 and 0.994, respectively, for Observer 2. Plotting the rater readings against the line of equality shows no significant differences between readings acquired from radiographs and MRI scans. Conclusion. For the study contribution, it is possible to employ open compact MRI to determine the skeletal age of a person. Our results showed that left-hand MRI scans were of better quality than the radiographs.
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Hua, Dong, Dechang Chen, Fang Liu, and Abdou Youssef. "A Bayesian Approach to Multistage Fitting of the Variation of the Skeletal Age Features." Journal of Biomedicine and Biotechnology 2009 (2009): 1–7. http://dx.doi.org/10.1155/2009/623853.
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Accurate assessment of skeletal maturity is important clinically. Skeletal age assessment is usually based on features encoded in ossification centers. Therefore, it is critical to design a mechanism to capture as much as possible characteristics of features. We have observed that given a feature, there exist stages of the skeletal age such that the variation pattern of the feature differs in these stages. Based on this observation, we propose a Bayesian cut fitting to describe features in response to the skeletal age. With our approach, appropriate positions for stage separation are determined automatically by a Bayesian approach, and a model is used to fit the variation of a feature within each stage. Our experimental results show that the proposed method surpasses the traditional fitting using only one line or one curve not only in the efficiency and accuracy of fitting but also in global and local feature characterization.
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Chung, David D., and Sepand Ghanouni. "Comparison of abnormalities in the sequence of growth stages in the skeletal maturity index vs cervical vertebral maturation:." Angle Orthodontist 92, no. 3 (December 9, 2021): 353–57. http://dx.doi.org/10.2319/051821-393.1.
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ABSTRACT Objectives To evaluate the frequency of abnormal progression that could ultimately affect the reliability of the skeletal maturity index (SMI) and the cervical vertebral maturation (CVM) method that are most commonly used analyses for skeletal age assessment. Materials and Methods A retrospective design was used to compare 299 hand-wrist radiographs with 299 lateral skull radiographs regarding the number of abnormalities in the proposed sequence of maturation in the SMI and CVM methods. Results A significantly greater number of abnormalities occurred in the sequence of CVM progression compared with SMI (P < .001). Sex and age did not have an effect. Conclusions Skeletal age assessment based on SMI is more accurate than CVM regarding the progressive sequence of stages.
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Ambreen, Sadaf. "COMPARISION OF DENTAL SCORING SYSTEM WITH RADIOGRAPHIC SKELETAL SYSTEM IN AGE ESTIMATION." JKCD 9, no. 1 (2019): 9–11. http://dx.doi.org/10.33279/2307-3934.2019.9103.
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Objectives: To compare Demirjian Dental scoring method with Greulich-Pyle (GP) Skeletal method of age estimation in pubertal children. Materials and Methods: Sample of the study included 267 male healthy subjects of 11-16 years of age group.. Demirjian Scoring system was utilized to evaluate the orthopantomograms to assess their Dental age and the Hand-Wrist radiographs were analyzed to calculate the skeletal age by utilizing GP atlas. Chronological age was obtained from the date of birth of the subject .Both methods were compared with one another and with the chronological age. It was a cross-sectional study and only healthy male subjects without any clinical abnormalities were included in the study. Results: A total of 267 male subjects of 11-16 years of age group were assessed by Demirjian and Greulich Pyle Methods. Both were compared with Chronological Age. Data obtained was statistically analyzed and the Student “t” test was applied in the study population. The mean difference between Chronolgical age and dental age was 0.69years and that of chronological age and skeletal age was 0.87 years. It was observed from dental age assessment that it does not differ much from the skeletal age. Conclusion: It was concluded that Demirjian method of Age Estimation is more precise than Greulich Pyle method of Age Estimation. Furthermore both methods can be used selectively in Medicolegal cases to access bone age which can be easily correlated to chronological age.
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Breen, Anne Berg, Harald Steen, Are Pripp, Ragnhild Gunderson, Hilde Kristine Sandberg Mentzoni, Else Merckoll, Wajeeha Zaidi, Mikael Lambert, Ivan Hvid, and Joachim Horn. "A comparison of 3 different methods for assessment of skeletal age when treating leg-length discrepancies: an inter- and intra-observer study." Acta Orthopaedica 93 (January 11, 2022): 222–28. http://dx.doi.org/10.2340/17453674.2021.1133.
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Background and purpose — Skeletal maturity is a crucial parameter when calculating remaining growth in children. We compared 3 different methods, 2 manual and 1 automated, in the radiological assessment of bone age with respect to precision and systematic difference. Material and methods — 66 simultaneous examinations of the left hand and left elbow from children treated for leg-length discrepancies were randomly selected for skeletal age assessment. The radiographs were anonymized and assessed twice with at least 3 weeks’ interval according to the Greulich and Pyle (GP) and Sauvegrain (SG) methods by 5 radiologists with different levels of experience. The hand radiographs were also assessed for GP bone age by use of the automated BoneXpert (BX) method for comparison. Results — The inter-observer intraclass correlation coefficient (ICC) was 0.96 for the GP and 0.98 for the SG method. The inter- and intra-observer standard error of the measurement (SEm) was 0.41 and 0.32 years for the GP method and 0.27 and 0.21 years for the SG method with a significant difference (p < 0.001) between the methods and between the experienced and the less experienced radiologists for both methods (p = 0.003 and p < 0.001). In 25% of the assessments the discrepancy between the GP and the SG methodwas > 1 year. There was no systematic difference comparing either manual method with the automatic BX method. Interpretation — With respect to the precision of skeletal age determination, we recommend using the SG method or preferably the automated BX method based on GP assessments in the calculation of remaining growth.
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Yu, Dayeol, and Donghyun Kim. "Assessment of Midpalatal Suture Maturation by Skeletal Maturity on Hand Wrist Radiographs." JOURNAL OF THE KOREAN ACADEMY OF PEDTATRIC DENTISTRY 48, no. 1 (February 28, 2021): 31–41. http://dx.doi.org/10.5933/jkapd.2021.48.1.31.
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The aim of this retrospective study was to evaluate the correlation between the midpalatal suture maturation and skeletal maturation in growing children aged 7 - 15 years and predict the maturational stages of the midpalatal suture corresponding to skeletal maturity assessed by the skeletal maturation indicators (SMI) and middle phalanx of the third finger (MP3) stages. The group of this retrospective study was consisted of randomly selected 132 male and 135 female in age from 7 - 15 years. The maturation of the midpalatal suture was evaluated by using images from cone-beam computed tomography (CBCT) while the skeletal age was assessed by hand-wrist radiography. CBCT images and hand-wrist radiographs used in this study were obtained from all subjects for orthodontic diagnosis before orthodontic treatment. The maturational stages of the midpalatal suture showed strong correlations with both SMI and MP3 stages. The correlation between the midpalatal suture maturation and SMI (Spearman’s correlation coefficient, ϒ<sub>S</sub> = 0.905, <i>p</i> < 0.05) was slightly greater than that of MP3 stages (ϒ<sub>S</sub> = 0.830, <i>p</i> < 0.05). There was a positive significant correlation between the midpalatal suture maturation and chronological age (ϒ<sub>S</sub> = 0.868,<i>p</i> < 0.05). CBCT for evaluation of the midpalatal suture maturational stages may be unnecessary in every pediatric patients because SMI and MP3 stages were both replaceable useful methods for assessing maturation of the midpalatal suture before orthopedic treatment. In this retrospective study, the diagnostic reliability of the SMI method for estimating midpalatal suture maturation showed better reliability than the MP3 method.
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Navega, David, Ernesto Costa, and Eugénia Cunha. "Adult Skeletal Age-at-Death Estimation through Deep Random Neural Networks: A New Method and Its Computational Analysis." Biology 11, no. 4 (March 30, 2022): 532. http://dx.doi.org/10.3390/biology11040532.
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Age-at-death assessment is a crucial step in the identification process of skeletal human remains. Nonetheless, in adult individuals this task is particularly difficult to achieve with reasonable accuracy due to high variability in the senescence processes. To improve the accuracy of age-at-estimation, in this work we propose a new method based on a multifactorial macroscopic analysis and deep random neural network models. A sample of 500 identified skeletons was used to establish a reference dataset (age-at-death: 19–101 years old, 250 males and 250 females). A total of 64 skeletal traits are covered in the proposed macroscopic technique. Age-at-death estimation is tackled from a function approximation perspective and a regression approach is used to infer both point and prediction interval estimates. Based on cross-validation and computational experiments, our results demonstrate that age estimation from skeletal remains can be accurately (~6 years mean absolute error) inferred across the entire adult age span and informative estimates and prediction intervals can be obtained for the elderly population. A novel software tool, DRNNAGE, was made available to the community.
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Moca, Abel Emanuel, Luminița Ligia Vaida, Rahela Tabita Moca, Anamaria Violeta Țuțuianu, Călin Florin Bochiș, Sergiu Alin Bochiș, Diana Carina Iovanovici, and Bianca Maria Negruțiu. "Chronological Age in Different Bone Development Stages: A Retrospective Comparative Study." Children 8, no. 2 (February 13, 2021): 142. http://dx.doi.org/10.3390/children8020142.
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The assessment of an individual’s development by investigating the skeletal maturity is of much use in various medical fields. Skeletal maturity can be estimated by evaluating the morphology of the cervical vertebrae. The aim of this study was to conduct comparisons of the chronological age in different bone development stages. The retrospective study was conducted based on lateral cephalometric radiographs belonging to patients with ages between 6 and 15.9 years, from Romania. For the assessment of skeletal maturity, the Cervical Vertebral Maturation (CVM) method was used. In total, 356 radiographs were selected, but after applying the exclusion criteria, 252 radiographs remained in the study (178 girls and 74 boys). Different mean chronological age values were obtained for the general sample, as well as for the two genders. The chronological age started to be significantly different at the CS4 stage. Patients with CS4, CS5, and CS6 stages had a significantly higher chronological age compared to patients with CS1, CS2, and CS3 stages. It was noted that patients with CS1 and CS2 stages were more frequently boys, while patients with the CS5 stage were more frequently girls.
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Kamal, Adeel Tahir, Attiya Shaikh, and Mubassar Fida. "Assessment of skeletal maturity using the calcification stages of permanent mandibular teeth." Dental Press Journal of Orthodontics 23, no. 4 (August 2018): 44.e1–44.e8. http://dx.doi.org/10.1590/2177-6709.23.4.44.e1-8.onl.
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Abstract Introduction: Knowledge of the growth status of patients is essential to formulate and initiate a precise treatment plan. This study aimed at determining the role of calcification of permanent mandibular teeth for the assessment of skeletal maturity. Methods: A cross-sectional study was conducted using lateral cephalograms and dental panoramic radiographs of 360 patients (ages 7-18 years) equally divided into six groups according to cervical vertebral maturation stages. Skeletal age was determined using Baccetti et al. method and dental age was calculated using Nolla and Demirjian methods. Results: Mean chronological stage at CS5 revealed a significant difference between male and female subjects (p= 0.003), which showed that the latter achieved skeletal maturity one year earlier than the former. A significant difference (p= 0.007) was found for dental age using Nolla’s stages at CS3, which showed females demonstrated a dental age of 1.4 years less than males. Mandibular canine showed the highest correlation with Demirjian index (DI) in males (rho = 0.818) and females (rho = 0.833). Mandibular second premolar showed the highest correlation with Nolla’s stages in males (rho = 0.654) and females (rho = 0.664). Conclusion: Comparisons between sexes revealed that females are skeletally and dentally advanced. The DI indicated stage F and Nolla’s stages identified stages 9, 10 to be indicative of CS2-3 for the mandibular canine and stages F and G and 9-10 for CS2-3 for the first premolars, second premolars and second molars, respectively.
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Shen, Xiang, Feng Zhu, Zhi Sun, and Shuli Zhao. "Research on Bone Age Automatic Judgment Algorithm Based on Deep Learning and Hand X-ray Image." Journal of Medical Imaging and Health Informatics 11, no. 1 (January 1, 2021): 156–61. http://dx.doi.org/10.1166/jmihi.2021.3443.
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Objective: To learn the depth of paper using feature extraction, combined with critical areas of heat syndrome and related information, X-ray image of hand to analyze bone age children. Methods: The thesis of the X-ray image data preprocessing left hand, the use of depth of depth neural network learning methods, combined with clinical data skeletal age evaluation model to evaluate the effectiveness of the test model. Results: X-ray image of hand artificial feature extraction, combined SVM classification, automatic assessment of skeletal age. The method of automatic assessment of bone age SVM-based feature primarily artificial, SIFT features extracted image, LBP features, characteristics of GCLM, these features are combined, and then used to train the SVM, have some ability to automatically assess bone age assessment based on SVM. Conclusion: This topic X-ray image based on the hand bones, computer vision, machine learning to extract the relevant methods, pretreatment and segmentation of X-ray images of the hand bones, characterized by automatic assessment of bone age, lack the core image of the sample problem.
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Sachan, Kiran, Vijay Prakash Sharma, Pradeep Tandon, Sneh Lata Verma, and Kamna Srivastav. "To Establish the Validity of Dental Age Assessment using Nolla’s Method on Comparing with Skeletal Age assessed by Hand-Wrist Radiographs." Journal of Indian Orthodontic Society 47 (2013): 438–42. http://dx.doi.org/10.5005/jp-journals-10021-1202.
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Sachan, Kiran, Vijay Prakash Sharma, Pradeep Tandon, Sneh Lata Verma, and Kamna Srivastav. "To Establish the Validity of Dental Age Assessment using Nolla's Method on Comparing with Skeletal Age assessed by Hand-Wrist Radiographs." Journal of Indian Orthodontic Society 47, no. 4_suppl4 (December 2013): 438–42. http://dx.doi.org/10.1177/0974909820130804s.
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Gualdi-Russo, Emanuela, Ilaria Saguto, Paolo Frisoni, Margherita Neri, and Natascia Rinaldo. "Tooth Cementum Thickness as a Method of Age Estimation in the Forensic Context." Biology 11, no. 5 (May 21, 2022): 784. http://dx.doi.org/10.3390/biology11050784.
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Estimating age at death is a key element in the process of human identification of skeletal remains. The interest in dental cementum stems from its increase in thickness throughout life and, at the same time, from the fact it should not be affected by remodeling processes. Since the age assessment is particularly difficult in adults when using traditional anthropological methods on the skeleton, we tested a dental method based on maximum cementum thickness and developed new regression equations. We microscopically analyzed the histological sections of dental roots from a sample of 108 permanent teeth with known age and sex. Age at the time of dental extraction was in the range of 18–84 years. Our findings show that there were no differences in thickness between sexes, dental arch, and mono- and pluriradicular teeth. Separate regression equations were developed for individuals in the whole age range and individuals under 45 years. The equations were then tested on a hold-out sample from the same Mediterranean population demonstrating higher reliability for the equation developed for those under 45. Conversely, due to the increased error in age estimation in individuals over 45, this method should be used with caution in the forensic context when skeletal remains presumably belong to elderly individuals.
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Politzer, Cary S., James D. Bomar, Hakan C. Pehlivan, Pradyumna Gurusamy, Eric W. Edmonds, and Andrew T. Pennock. "Creation and Validation of a Shorthand Magnetic Resonance Imaging Bone Age Assessment Tool of the Knee as an Alternative Skeletal Maturity Assessment." American Journal of Sports Medicine 49, no. 11 (August 4, 2021): 2955–59. http://dx.doi.org/10.1177/03635465211032986.
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Background: In managing pediatric knee conditions, an accurate bone age assessment is often critical for diagnostic, prognostic, and treatment purposes. Historically, the Greulich and Pyle atlas (hand atlas) has been the gold standard bone age assessment tool. In 2013, a shorthand bone age assessment tool based on this atlas (hand shorthand) was devised as a simpler and more efficient alternative. Recently, a knee magnetic resonance imaging (MRI) bone age atlas (MRI atlas) was created to circumvent the need for a left-hand radiograph. Purpose: To create a shorthand version of the knee MRI atlas. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A shorthand bone age assessment method was created utilizing the previously published MRI atlas, which utilizes several criteria that are visualized across a series of images. The MRI shorthand draws on characteristic criteria for each age that are best observed on a single MRI scan. For validation, we performed a retrospective assessment of skeletally immature patients. One reader performed the bone age assessment using the MRI atlas and the MRI shorthand on 200 patients. Then, 4 readers performed the bone age assessment with the hand atlas, hand shorthand, MRI atlas, and MRI shorthand on a subset of 22 patients in a blinded fashion. All 22 patients had a knee MRI scan and a left-hand radiograph within 4 weeks of each other. Interobserver and intraobserver reliability, as well as variability among observers, were evaluated. Results: A total of 200 patients with a mean age of 13.5 years (range, 9.08-17.98 years) were included in this study. Also, 22 patients with a mean age of 13.3 years (range, 9.0-15.6 years) had a knee MRI scan and a left-hand radiograph within 4 weeks. The intraobserver and interobserver reliability of all 4 assessment tools were acceptable (intraclass correlation coefficient [ICC] ≥ 0.8; P < .001). When comparing the MRI shorthand with the MRI atlas, there was excellent agreement (ICC = 0.989), whereas the hand shorthand compared with the hand atlas had good agreement (ICC = 0.765). The MRI shorthand also had perfect agreement in 50% of readings among all 4 readers, and 95% of readings had agreement within 1 year, whereas the hand shorthand had perfect agreement in 32% of readings and 77% agreement within 1 year. Conclusion: The MRI shorthand is a simple and efficient means of assessing the skeletal maturity of adolescent patients with a knee MRI scan. This bone age assessment technique had interobserver and intraobserver reliability equivalent to or better than the standard method of utilizing a left-hand radiograph.
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Castriota-Scanderbeg, A., Michele C. Sacco, Leonardo Emberti-Gialloreti, and Lucio Fraracci. "Skeletal age assessment in children and young adults: comparison between a newly developed sonographic method and conventional methods." Skeletal Radiology 27, no. 5 (May 18, 1998): 271–77. http://dx.doi.org/10.1007/s002560050380.
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Kiran, Sachan, VijayPrakash Sharma, Kamna Srivastava, Pradeep Tandon, Tripti Tikku, and Snehlata Verma. "To establish the validity of dental age assessment using Nolla′s method on comparing with skeletal age assessed by hand-wrist radiographs." Journal of Orthodontic Research 1, no. 1 (2013): 11. http://dx.doi.org/10.4103/2321-3825.112250.
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Politzer, Cary, James Bomar, Hakan Pehlivan, Pradyumna Gurusamy, Eric Edmonds, and Andrew Pennock. "Creation and Validation of a Shorthand Knee MRI Bone Age Assessment Tool as an Alternative for Skeletal Maturity Assessment (203)." Orthopaedic Journal of Sports Medicine 9, no. 10_suppl5 (October 1, 2021): 2325967121S0031. http://dx.doi.org/10.1177/2325967121s00312.
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Objectives: In managing pediatric knee conditions, an accurate bone age assessment is often critical for diagnostic, prognostic, and treatment purposes. Historically, the Greulich and Pyle Atlas (hand atlas) has been the gold standard bone age assessment tool. In 2013, a shorthand bone age assessment tool based on this atlas (hand shorthand) was established as a simpler and more efficient alternative. Recently, a knee MRI bone age atlas (MRI atlas) was created potentially to circumvent the need for a left hand radiograph. Our objective is to create a shorthand version of the magnetic resonance imaging atlas. Methods: A shorthand bone age method (Figure 1) was created utilizing the previously published MRI atlas, which utilizes several criteria that are visualized across a series of images. The MRI shorthand draws on the most characteristic criteria for each age that is best observed on a single MR image. For validation, we performed a retrospective assessment of skeletally immature patients that had a knee MRI and left hand radiograph within four weeks. Four readers who were familiar with the hand atlas, hand shorthand, MRI atlas, and MRI shorthand read each of the images in a blinded fashion. Inter- and intra-observer reliability was evaluated using intraclass correlation coefficient (ICC), variability among observers was evaluated using percent agreement. Results: 26 patients with a mean age of 13.6 years (range 9.0-16.9) met the inclusion criteria. The intra- and inter-observer reliability of all four assessment tools was excellent (ICC ≥ 0.8, p<0.001) (Table 1). When comparing the MRI shorthand to the MRI atlas, there was excellent agreement (ICC = 0.974), whereas the hand shorthand compared to the hand atlas had good agreement (ICC = 0.765). The MRI shorthand also had perfect agreement in 58% of reads among all four readers and 96% of reads had agreement within 1 year, whereas the hand shorthand had perfect agreement in 32% of reads and 77% agreement within 1 year (Table 2). Conclusions: The MRI shorthand is a simple and efficient means of assessing skeletal maturity of adolescent patients with a knee MRI. This bone age assessment technique has inter-observer and intra-observer reliability equivalent or better than the standard means utilizing a left hand radiograph.
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Khalid, Asia, Faisal Rasheed, and Zubair H. Awaisi. "Assessment of Palatal Height Index and palatal form in different malocclusions in adult patients visiting Nishtar Institute of Dentistry, Multan." Orthodontic Journal of Nepal 11, no. 2 (December 31, 2021): 20–24. http://dx.doi.org/10.3126/ojn.v11i2.43271.
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Introduction: This study was conducted to evaluate the palatal height index in different malocclusion because of appearance of variable palatal heights & palatal forms Materials & Method: In this study 108 adult subjects (41 males, 67 females), age ranges from 13-28yrs, were randomly selected from Orthodontic Department In Nishtar Institute of Dentistry Multan. Their impressions were taken by the Alginate and dental casts were formed and lateral cephalograms were collected. One sample t test was used to calculate the results. Result: Descriptive statistics showed mean palatal index of 60.95% in skeletal class I, 48.31% in skeletal class II, whereas 61.26% in skeletal class III. Frequency distribution in different skeletal patterns showed 100% high palate in class I and class III whereas skeletal class II showed variety in palatal form with 82.3% high palate, 11.3% medium palate and remaining 6.3% was low palate. major portion of the sample had high palate. Conclusion: Mean index in Skeletal Class I is 60.95 %, 48.31% in skeletal class II, 61.26% in skeletal class III. Mean palatal height index in females is significantly higher than in males. Skeletal class II has variety of palatal form with high prevalence of high palate. Most common palatal form is high palate.
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Tschurl, Jędrzej Roman, Wojciech Napiontek, Łukasz Żytka, Karolina Sławatycka, and Tomasz Kotwicki. "The Sanders Maturity Scale for skeletal maturity assessment in idiopathic scoliosis." Chirurgia Narządów Ruchu i Ortopedia Polska 87, no. 3 (September 22, 2022): 91–98. http://dx.doi.org/10.31139/chnriop.2022.87.3.1.
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Introduction. Skeletal maturity assessment in Idiopathic Scoliosis (IS) is used for the evaluation of deformation progression risk, as well as selecting a method of treatment. The Sanders Maturity Scale (SMS) is based on the ossification of phalanges, metacarpal bones and radius rated on AP radiograms of the left hand. Aim. This retrospective study aimed to compare SMS to other skeletal maturity assessment methods used in daily practice. Materials and methods. We included 39 female patients with IS (50 series of radiograms) with a mean age of 13.4, ranging from 10.3 to 17.3. Each series of radiograms was evaluated by three observers with different experience. Skeletal maturity was assessed using the Sanders Maturity Scale (SMS), Risser sign, Greulich and Pyle (GP) atlas, as well as the closure of the triradiate cartilage. Results. The majority of patients, 17 out of 50 (34 %) were classified as type 3 (adolescent rapid – early). Intra-observer and inter-observer reliability for the SMS was very good (Krippendorff’s alpha >0.95). The GP and Risser method showed good reliability, whereas the triradiate cartilage closure assessment showed lower reliability. The Risser 0 grade corresponded with as many as four Sanders stages, 16 out of 20 (80 %) were rated Sanders 3. All radiograms with open triradiate cartilage (7/50, 14 %) were rated Sanders 2 or 3; they all received a Risser 0 grading. Conclusions. The SMS proved to have a very good intra-observer and inter-observer reliability, it is easy to be used by physicians and does not require an atlas. The SMS enhances the assessment of skeletal maturity of IS patients by providing additional stages in the early phase of growth (Risser 0).
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Schlégl, Ádám Tibor, Ian O’Sullivan, Péter Varga, Péter Than, and Csaba Vermes. "Alternative methods for skeletal maturity estimation with the EOS scanner—Experience from 934 patients." PLOS ONE 17, no. 5 (May 6, 2022): e0267668. http://dx.doi.org/10.1371/journal.pone.0267668.
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Background Hand-wrist bone age assessment methods are not possible on typical EOS 2D/3D images without body position modifications that may affect spinal position. We aimed to identify and assess lesser known bone age assessment alternatives that may be applied retrospectively and without the need for extra imaging. Materials and methods After review of 2857 articles, nine bone age methods were selected and applied retrospectively in pilot study (thirteen individuals), followed by evaluation of EOS images of 934 4-24-year-olds. Difficulty of assessment and time taken were recorded, and reliability calculated. Results Five methods proved promising after pilot study. Risser ‘plus’ could be applied with no difficulty in 89.5% of scans (836/934) followed by the Oxford hip method (78.6%, 734/934), cervical (79.0%, 738/934), calcaneus (70.8%, 669/934) and the knee (68.2%, 667/934). Calcaneus and cervical methods proved to be fastest at 17.7s (95% confidence interval, 16.0s to 19.38s & 26.5s (95% CI, 22.16s to 30.75s), respectively, with Oxford hip the slowest at 82.0 s (95% CI, 76.12 to 87.88s). Difficulties included: regions lying outside of the image—assessment was difficult or impossible in upper cervical vertebrae (46/934 images 4.9%) and calcaneus methods (144/934 images, 15.4%); position: lower step length was associated with difficult lateral knee assessment & head/hand position with cervical evaluation; and resolution: in the higher stages of the hip, calcaneal and knee methods. Conclusions Hip, iliac crest and cervical regions can be assessed on the majority of EOS scans and may be useful for retrospective application. Calcaneus evaluation is a simple and rapidly applicable method that may be appropriate if consideration is given to include full imaging of the foot.
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AGHIMIEN, Osaronse Anthony, Emmanuel Olubusayo AJAYI, and Idia Nibokun IZE-IYAMU. "Skeletal Maturation Pattern among Down Syndrome Individuals in Benin, City. Nigeria." Nigerian Journal of Dental Research 7, no. 1 (January 28, 2022): 1–9. http://dx.doi.org/10.4314/njdr.v7i1.1.
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Background: The assessment of skeletal maturity is important in the timing of orthodontic treatment especially in the modification of dento-facial growth. The use of cervical vertebrae as a method of assessment of skeletal maturity has rarely been used among Down Syndrome.
Objective: To assess skeletal maturity among individuals with Down Syndrome using the cervical vertebrae maturation stages.
Methods: The study was conducted among 21 Down Syndrome with mean ages of 11.70 ± 1.83 years (males) and 13.64 ± 1.75 years (female); and 21 control individuals with mean ages of 12.00 ± 2.00 years (male), and 13.50 ± 1.90 years (female). The independent t-test and chi-square test were used to determine significant differences among the continuous (age) and categorical variables (cervical vertebrae maturation stages) respectively when matched with gender and chronological age. Fischer exact test was used when an expected frequency presentation was <5. A p-value of < 0.05 was set as statistically significant.
Results: Down Syndrome males had delayed maturation at 11 years but accelerated at 12 with early attainment of maturity at 15 years. Down Syndrome female had a delay tendency in skeletal maturation from 11–15 years of age. Overall, Down Syndrome had a 1.242 probability of either having a delay or advancement in skeletal maturation which was not statistically significant. Conclusively, the skeletal maturation pattern between Down syndrome patients and normal individuals was not statistically different.
Conclusion: The average timing for commencement of orthodontic treatment especially growth modification for normal individuals can be applied for individuals with Down Syndrome as this present study did not show any statistically significant difference in their overall skeletal maturation.Down syndrome.
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Feeney, Robin N. M. "An investigation of ultrasound methods for the assessment of sex and age from intact human teeth." Dental Anthropology Journal 18, no. 1 (September 3, 2018): 2–11. http://dx.doi.org/10.26575/daj.v18i1.128.
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Determining sex and age in humanremains is necessary to achieve positive identificationof individuals in forensic settings, and to provide datarequired for demographic analyses in archaeologicalsamples. Due to their denser mineralization, teeth maybe better preserved than other skeletal elements, whichare often fragmentary and poorly preserved. This workis the first to investigate the use of ultrasound methodsto accurately, objectively, and non-destructively assesssex and estimate age of human skeletal remains fromintact teeth. An ultrasound imaging system usingpulse-echo technique and nominal frequency (3.5 MHz)longitudinal waves was developed for applicationon teeth. Mechanical and acoustic properties of teethwere examined to explore their relationship withthe interaction of ultrasound wave propagation.Experiments were conducted to determine differencesin wave propagation in teeth from individualsof different ages and sex, both permanent anddeciduous. Consistent differences in integral acousticresponse patterns in the different teeth were found.It is concluded that pulse-echo ultrasound is a viablenon-destructive technique to yield integral acousticcharacteristic properties of teeth, potentially usefulfor assessing sex and estimating age, and resolvingminimum numbers of individuals from commingledand scattered remains. Information developed fromthis study will be significant to future research insofaras it introduces a new potential method that is nondestructive,fast, and easy to administer in situ.
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Siemensma, Mark F., Christiaan van Bergen, Eline van Es, Joost W. Colaris, and Denise Eygendaal. "Indications and Timing of Guided Growth Techniques for Pediatric Upper Extremity Deformities: A Literature Review." Children 10, no. 2 (January 20, 2023): 195. http://dx.doi.org/10.3390/children10020195.
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Osseous deformities in children arise due to progressive angular growth or complete physeal arrest. Clinical and radiological alignment measurements help to provide an impression of the deformity, which can be corrected using guided growth techniques. However, little is known about timing and techniques for the upper extremity. Treatment options for deformity correction include monitoring of the deformity, (hemi-)epiphysiodesis, physeal bar resection, and correction osteotomy. Treatment is dependent on the extent and location of the deformity, physeal involvement, presence of a physeal bar, patient age, and predicted length inequality at skeletal maturity. An accurate estimation of the projected limb or bone length inequality is crucial for optimal timing of the intervention. The Paley multiplier method remains the most accurate and simple method for calculating limb growth. While the multiplier method is accurate for calculating growth prior to the growth spurt, measuring peak height velocity (PHV) is superior to chronological age after the onset of the growth spurt. PHV is closely related to skeletal age in children. The Sauvegrain method of skeletal age assessment using elbow radiographs is possibly a simpler and more reliable method than the method by Greulich and Pyle using hand radiographs. PHV-derived multipliers need to be developed for the Sauvegrain method for a more accurate calculation of limb growth during the growth spurt. This paper provides a review of the current literature on the clinical and radiological evaluation of normal upper extremity alignment and aims to provide state-of-the-art directions on deformity evaluation, treatment options, and optimal timing of these options during growth.
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Radovic, Marija. "Ageing in the Danube gorges population (9500-5500 BC): Tooth cementum annulation method." Starinar, no. 62 (2012): 9–18. http://dx.doi.org/10.2298/sta1262009r.
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Tooth cementum annulation, the microscopic method for the determination of an individual?s age, gives results that are highly correlated with the chronological age of an individual. Nevertheless, this method is still rarely used for age estimation in archaeological populations. In this study, using the tooth cementum annulation method, teeth of 21 individuals of the Djerdap anthropological series, dated to a period from the 10th to the 6th millennium BC, were analysed. The obtained data are important for overcoming some methodological issues in anthropology of the Danube Gorges, as well as with the precise age estimation of old individuals and with the assessment of age in cases where the skeletal material has been very poorly preserved. The only obstacle to the full application of the tooth cementum annulation method is the taphonomy changes of tooth cementum which were detected on several teeth in this study.
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Azarbakhsh, Golnoosh, Parastoo Iranparvar, Azita Tehranchi, and Mahkameh Moshfeghi. "Relationship of Vitamin D Deficiency with Cervical Vertebral Maturation and Dental Age in Adolescents: A Cross-Sectional Study." International Journal of Dentistry 2022 (November 22, 2022): 1–7. http://dx.doi.org/10.1155/2022/7762873.
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Background. Considering the high prevalence of vitamin D deficiency and its effect on growth and development, the assessment of the dental age and skeletal age with regard to vitamin D deficiency status could influence the treatment planning of growth modification treatment. This study aimed to assess the relationship between vitamin D deficiency, cervical vertebral maturation (CVM) as an indicator of skeletal age, and dental age in adolescent patients. Methods. In this cross-sectional study, the chronological age of 52 orthodontic patients aged between 10 and 14 years was recorded, and their serum level of vitamin D was determined using a radioimmunoassay test. The patients were then divided into three groups based on their serum vitamin D level: severe deficiency, moderate deficiency, and the control group with normal vitamin D. The panoramic radiographs of patients were assessed to determine their dental age using Demirjian’s method. CVM was determined on lateral cephalograms using Baccetti’s classification to specify the skeletal age. Data were analyzed using a t-test, linear regression, ordinal logistic regression, and Pearson’s correlation coefficient (at P < 0.05 , confidence interval = 95%). Results. Skeletal age showed a significant difference between the group with severe vitamin D deficiency and the control group ( P = 0.01 ); however, such difference was not observed between the group with moderate vitamin D deficiency and the control group ( P = 0.12 ). Dental age was not significantly different between the groups with vitamin D deficiency and the control group ( P = 0.26 for severe, and P = 0.39 for moderate deficiency). Conclusions. A less advanced skeletal maturation was observed in adolescents with severe vitamin D deficiency; however, dental development was not affected by this deficiency. Vitamin D status is better to be considered in decision-making for the initiation of growth modification orthodontic treatments.
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Huffman, Michaela, and Daniel Antoine. "Analysis of Cementum Layers in Archaeological Material." Dental Anthropology Journal 23, no. 3 (September 2, 2018): 67–73. http://dx.doi.org/10.26575/daj.v23i3.79.
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The aim of this study was to assess the utility of cementum layers for estimating age at death of remains from an archaeological site. Variability in cementum layer counts due to interobserver error and variation among dental regions were analyzed. Interobserver error was later incorporated into age ranges based on counts of cementum layers and compared with age estimates derived from the skeleton. The layers were counted, using 9 teeth from 3 individuals, and the eruption age of the tooth was summed with the average layer count to achieve an estimated age. The research indicates that the assessment of archaeological dental cementum layers has a relatively high interobserver error. The cementum layer aging method resulted in large age ranges and did not correspond with age ranges from skeletal techniques. Chemical diagenetic processes can affect the observation and count of cementum layers by obscuring bands and/or creating additional bands. The variables that affected observability of cementum layers were: high interobserver error, discrepancy of readability of root regions, and large age ranges using the cementum layer technique that exceeded age ranges derived from other, skeletal methods.
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Kirkham, Brooke M., Susan M. Schultz, Khalid Ashi, and Chandra M. Sehgal. "Assessment of Age-related Oxygenation Changes in Calf Skeletal Muscle by Photoacoustic Imaging: A Potential Tool for Peripheral Arterial Disease." Ultrasonic Imaging 41, no. 5 (July 19, 2019): 290–300. http://dx.doi.org/10.1177/0161734619862287.
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Peripheral artery disease is often asymptomatic, and various imaging and nonimaging techniques have been used for assessment and monitoring treatments. This study is designed to demonstrate the ability of photoacoustic imaging to noninvasively determine changes in tissue oxygenation that occur in mice’s hind limb skeletal muscle as they age. Mice from two age cohorts were scanned bilaterally with a pulsed laser. The photoacoustic signal was unmixed to generate a parametric map of estimated oxygen saturation and then overlaid on grayscale ultrasound images. Tissue oxygenation measured in young and old mice was compared. Photoacoustic imaging visually and quantitatively showed the decrease in skeletal muscle oxygenation that occurs with age. Percent tissue oxygenation decreased from 30.2% to 3.5% ( p < 0.05). This reduction corresponded to reduced fractional area of oxygenation, which decreased from 60.6% to 6.0% ( p < 0.05). The change in oxygenation capacity of the still active vascular regions was insignificant ( p > 0.05). Intrasubject, intra-, and interobserver comparisons showed low variability in measurements, exhibited by high regression and intraclass correlations exceeding 0.81 for all ages. The decrease in oxygenation detected by photoacoustic imaging paralleled the known oxygenation decrease observed in aging tissues, demonstrating that photoacoustic imaging can assess age-related changes in a mouse calf muscle. These intramuscular changes could potentially act as a strong diagnostic marker for peripheral artery disease. This study thus opens the doors for a novel, affordable, noninvasive method of evaluation free of radiation or exogenous material.
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Landau, Kurt, Regina Brauchler, Marianela Diaz-Meyer, Johannes Kiesel, Andreas Lenz, Herwig Meschke, and Angelika Presl. "Occupational stress factors and musculo-skeletal disease in patients at a rehabilitation center." Occupational Ergonomics 10, no. 4 (September 26, 2012): 139–53. http://dx.doi.org/10.3233/oer-2012-0198.
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Disorders of the musculo-skeletal system are one of the main occupational diseases occurring in industrial countries and the number of reported cases is rapidly increasing, especially among the older age groups. Musculo-skeletal diseases can be influenced by a number of stress factors arising during physical work. The aim of this study is to identify the physical work stress factors, to which persons already suffering from musculo-skeletal diseases (patients at a rehabilitation center) have been exposed in their work, and, firstly, to examine whether these data can be used to predict the probability of future musculo-skeletal disorders in workers occupying this type of job, secondly, to determine how these factors interact with each other in the development of these disorders. Trained specialists in occupational medicine using a program called Medical Job-oriented Rehabilitation (MJOR), collected data on 6668 patients by means of a standardized checklist called Bavaria Rehabilitation Assessment Method (BRA). Analysis of the recursive binary partitioning trees revealed that 19 predictor variables corresponding to age and gender, plus repetitive operations, rotation in sedentary position, degree of hand force used and forced head/neck postures were good predictors for the disorders of the hand-/arm system, the cervico-brachial syndrome and the impingement syndrome of shoulder.
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Kenis, V. M., A. V. Sapogovskiy, E. V. Melchenko, O. E. Agranovich, A. I. Shubina, and M. V. Zhurbitskaya. "Ultrasound elastography of muscles in cerebral palsy: systematic review." Neuromuscular Diseases 12, no. 1 (February 14, 2022): 10–20. http://dx.doi.org/10.17650/2222-8721-2022-12-1-10-20.
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Quantitative analysis of skeletal muscles in cerebral palsy is an important but unsolved problem. Ultrasound elastography is a group of diagnostic methods that allow visualizing tissue stiffness, measuring and displaying biomechanical properties of tissues. The aim of our study was to conduct a systematic analysis of literature on ultrasound elastography of skeletal muscles in children with cerebral palsy.A literary search for keywords in the databases PubMed, Google Scholar, eLIBRARY was carried out. The inclusion criteria were nosology (cerebral palsy), age (up to 18 years) and the study design (original study in ultrasound elastography of the skeletal muscler), as well as the availability of detailed information about the technical issues, demographic and clinical data.The final analysis included 20 publications. Patients with hemiplegic cerebral palsy were most often studied, with the healthy side used as a control, shear wave elastography was used more often, in which both share wave velocity and shear modulus were assessed, and linear probes were used more often. The most frequent anatomical objects were the calf muscles. Most often, elastography was used to assess the results of botulinum therapy, and demonstrated an increase in muscle elasticity after treatment.Ultrasound elastography as a method od assessment of the mechanical properties of skeletal muscles in children with cerebral palsy cannot be considered suitable as a routine study at the moment. But the method showed promising results for the research purposes: all the publications we analyzed demonstrated significant difference in elastography indicators both when comparing with unaffected limb or with healthy controls. Positive changes were also detected after various therapeutic interventions aimed to reducing muscle tone and retraction e. g. botulinum toxin injections.The absence of a unified approach to muscle elastography in children with cerebral palsy was demonstrated, both for data obtaining and interpretation. In general, ultrasound elastography of the skeletal muscles in children with cerebral palsy is a promising method for qualitative and quantitative assessment of muscle tissue that requires further development. Improvement of technology, standardization of technique and measurements will further expand the usage of this method.
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Chow, Simon Kwoon-Ho, Marloes van Mourik, Vivian Wing-Yin Hung, Ning Zhang, Michelle Meng-Chen Li, Ronald Man-Yeung Wong, Kwok-Sui Leung, and Wing-Hoi Cheung. "HR-pQCT for the Evaluation of Muscle Quality and Intramuscular Fat Infiltration in Ageing Skeletal Muscle." Journal of Personalized Medicine 12, no. 6 (June 20, 2022): 1016. http://dx.doi.org/10.3390/jpm12061016.
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Myosteatosis is the infiltration of fat in skeletal muscle during the onset of sarcopenia. The quantification of intramuscular adipose tissue (IMAT) can be a feasible imaging modality for the clinical assessment of myosteatosis, important for the early identification of sarcopenia patients and timely intervention decisions. There is currently no standardized method or consensus for such an application. The aim of this study was to develop a method for the detection and analysis of IMAT in clinical HR-pQCT images of the distal tibia to evaluate skeletal muscle during the ageing process, validated with animal and clinical experimentation. A pre-clinical model of ovariectomized (OVX) rats with known intramuscular fat infiltration was used, where gastrocnemii were scanned by micro-computed tomography (micro-CT) at an 8.4 μm isotropic voxel size, and the images were analyzed using our modified IMAT analysis protocol. IMAT, muscle density (MD), and muscle volume (MV) were compared with SHAM controls validated with Oil-red-O (ORO) staining. Furthermore, the segmentation and IMAT evaluation method was applied to 30 human subjects at ages from 18 to 81 (mean = 47.3 ± 19.2). Muscle-related parameters were analyzed with functional outcomes. In the animal model, the micro-CT adipose tissue-related parameter of IMAT% segmented at −600 HU to 100 HU was shown to strongly associate with the ORO-positively stained area (r = 0.898, p = 0.002). For the human subjects, at an adjusted threshold of −600 to −20 HU, moderate positive correlations were found between MV and MD (r = 0.642, p < 0.001), and between MV and IMAT volume (r = 0.618, p < 0.01). Moderate negative correlations were detected between MD and IMAT% (r = −0.640, p < 0.001). Strong and moderate associations were found between age and MD (r = −0.763, p < 0.01), and age and IMAT (r = 0.559, p < 0.01). There was also a strong correlation between IMAT% and chair rise time (r = 0.671, p < 0.01). The proposed HR-pQCT evaluation protocol for intramuscular adipose-tissue produced MD and IMAT results that were associated with age and physical performance measures, and were of good predictive value for the progression of myosteatosis or sarcopenia. The protocol was also validated on animal skeletal muscle samples that showed a good representation of histological lipid content with positive correlations, further supporting the clinical application for the rapid evaluation of muscle quality and objective quantification of skeletal muscle at the peripheral for sarcopenia assessment.
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Gutiérrez-Vilahú, Lourdes, Núria Massó-Ortigosa, Ferran Rey-Abella, Lluís Costa-Tutusaus, and Myriam Guerra-Balic. "Reliability and Validity of the Footprint Assessment Method Using Photoshop CS5 Software in Young People with Down Syndrome." Journal of the American Podiatric Medical Association 106, no. 3 (May 1, 2016): 207–13. http://dx.doi.org/10.7547/15-012.
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Background: People with Down syndrome present skeletal abnormalities in their feet that can be analyzed by commonly used gold standard indices (the Hernández-Corvo index, the Chippaux-Smirak index, the Staheli arch index, and the Clarke angle) based on footprint measurements. The use of Photoshop CS5 software (Adobe Systems Software Ireland Ltd, Dublin, Ireland) to measure footprints has been validated in the general population. The present study aimed to assess the reliability and validity of this footprint assessment technique in the population with Down syndrome. Methods: Using optical podography and photography, 44 footprints from 22 patients with Down syndrome (11 men [mean ± SD age, 23.82 ± 3.12 years] and 11 women [mean ± SD age, 24.82 ± 6.81 years]) were recorded in a static bipedal standing position. A blinded observer performed the measurements using a validated manual method three times during the 4-month study, with 2 months between measurements. Test-retest was used to check the reliability of the Photoshop CS5 software measurements. Validity and reliability were obtained by intraclass correlation coefficient (ICC). Results: The reliability test for all of the indices showed very good values for the Photoshop CS5 method (ICC, 0.982–0.995). Validity testing also found no differences between the techniques (ICC, 0.988–0.999). Conclusions: The Photoshop CS5 software method is reliable and valid for the study of footprints in young people with Down syndrome.
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Wanger, Lorena, Christina Gar, Michaela Rippl, Stefanie Kern-Matschilles, Anne Potzel, Stefanie Haschka, Jochen Seissler, Nina Hesse, and Andreas Lechner. "Function outperforms morphology in the assessment of muscular contribution to insulin sensitivity in premenopausal women." Diabetes and Vascular Disease Research 19, no. 1 (January 2022): 147916412110702. http://dx.doi.org/10.1177/14791641211070281.
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Introduction Skeletal muscle contributes significantly to insulin sensitivity in humans. However, which non-invasive measurement best reflects this contribution remains unknown. Consequently, this paper compares morphologic and functional measurements. Research methods and design We conducted a cross-sectional analysis of 144 premenopausal women enrolled in the “Prediction, Prevention, and Sub-classification of Type 2 Diabetes” (PPSDiab) cohort study. For the analysis, we quantified insulin sensitivity by oral glucose tolerance testing and, in a subgroup of 30 women, euglycemic clamp. To assess skeletal muscle, we measured volume by magnetic resonance imaging, intramyocellular lipid content by magnetic resonance spectroscopy, and physical fitness by cardiopulmonary exercise testing. Results The mean age of the cohort was 35.7 ± 4.1 years and 94 participants (65%) had a history of gestational diabetes mellitus. Of the morphologic and functional muscle parameters, the maximum workload achieved during cardiopulmonary exercise testing associated most closely with insulin sensitivity (standardized beta = 0.39; p < .001). Peak oxygen uptake also demonstrated significant associations, whereas muscle volume and intramyocellular lipid content displayed none. Conclusion Functional measurements provided a better assessment of the muscular contribution to insulin sensitivity than morphologic measurements in premenopausal women. In particular, exercise testing rendered an easy and cost-effective method applicable in clinical settings and other human studies.
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Cipriani, Cristiana, Salvatore Minisola, John P. Bilezikian, Davide Diacinti, Luciano Colangelo, Valentina Piazzolla, Maurizio Angelozzi, Luciano Nieddu, Jessica Pepe, and Daniele Diacinti. "Vertebral Fracture Assessment in Postmenopausal Women With Postsurgical Hypoparathyroidism." Journal of Clinical Endocrinology & Metabolism 106, no. 5 (February 10, 2021): 1303–11. http://dx.doi.org/10.1210/clinem/dgab076.
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Abstract Context Hypoparathyroidism is a rare endocrine disorder whose skeletal features include suppression of bone turnover and greater volume and width of the trabecular compartment. Few and inconsistent data are available on the prevalence of vertebral fractures (VF). Objective To evaluate the prevalence of VF assessed by vertebral fracture assessment (VFA) in postmenopausal women with chronic postsurgical hypoparathyroidism. Design Cross-sectional study Setting Ambulatory referral center. Patients or Other Participants Fifty postmenopausal women (mean age 65.4 ± 9 years) with chronic postsurgical hypoparathyroidism and 40 age-matched healthy postmenopausal women (mean age 64.2 ± 8.6). Main outcome measures Lumbar spine, femoral neck, and total hip bone mineral density were measured by dual X-ray absorptiometry (Hologic Inc., USA) in all subjects. Site-matched spine trabecular bone score was calculated by TBS iNsight (Medimaps, Switzerland). Assessment of VF was made by VFA (iDXA, Lunar GE, USA) using the semiquantitative method and the algorithm-based qualitative assessment. Results All-site BMD values were higher in the hypoparathyroid vs the control group. By VFA, we observed a 16% prevalence of VF in hypoparathyroid women vs 7.5% in control subjects. Among those with hypoparathyroidism who fractured, 5 (62.5%) had grade 1 wedge, 2 (25%) had grade 2 wedge, and 1 (12.5%) had grade 2 wedge and grade 2 biconcave VF. In the hypoparathyroid group, 57% with VFs and 32% without VFs had symptoms of hypoparathyroidism. Conclusion We demonstrate for the first time that in postmenopausal women with chronic postsurgical hypoparathyroidism, VFs are demonstrable by VFA despite normal BMD.
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Fagher, B., M. Monti, and I. Wadsö. "A microcalorimetric study of heat production in resting skeletal muscle from human subjects." Clinical Science 70, no. 1 (January 1, 1986): 63–72. http://dx.doi.org/10.1042/cs0700063.
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1. Different microcalorimetric techniques have been compared for the assessment in vitro of the total metabolic activity of resting skeletal muscle. Human fibre bundles were suspended in Krebs-Ringer-phosphate buffer containing glucose and insulin and the heat evolution was continuously monitored for 2–6 h. Palmitate as substrate was also tested. 2. The power signals declined rapidly when a static calorimetric method (A) was used. Two different perfusion methods (B, C) gave higher power values. Long-lasting steady states were observed with method C, where the sample was contained in a cage acting as a stirrer. 3. Significant differences were found for fibre bundles from different human muscles as well as age- and sex-related differences. The heat production in samples from the rectus abdominis muscle (method B), 0.73 mW/g muscle wet wt., was significantly higher than for the obliquus internus muscle, 0.44 mW/g, and the vastus lateralis muscle, 0.55 mW/g, but not different from the heat production value of vastus medialis, 0.66 mW/g. 4. In method C particularly, the fibre bundles are believed to be in adequate contact with the surrounding medium. With the use of a multichannel calorimeter it is possible to perform up to four experiments simultaneously, e.g. involving the calorigenic effects of pharmacological substances. The technique provides a new approach for detailed studies of muscle metabolism in physiological and pathological conditions.
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Singh, Harinder, Anjali Aggarwal, Tulika Gupta, Harjeet Kaur, Daisy Sahni, Lavina Sodhi, and Kunal Chawla. "Estimation of Age from Symphyseal Surface of Cadaveric Pubic Bones of Northwest Indian Male Adults." Journal of Postgraduate Medicine, Education and Research 50, no. 4 (2016): 176–80. http://dx.doi.org/10.5005/jp-journals-10028-1214.
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ABSTRACT Introduction Age estimation of dead persons of unknown age and identity from skeletal remains has an important role in legal and forensic investigations. Due to their relatively better ability to withstand the impact of physical forces and agents, the skeletal remains of human mortals provide us with wealth of information in the form of preserved morphological patterns or markings on bones. Out of all bones, morphological features on pubic bones are by far the best indicators. A large-scale study on pubic bones was conducted by a famous anatomist, Todd, in 1920, and since then his method is being followed for the assessment of age. Materials and methods Cadaveric pubic bones of 204 Northwest Indian adult males aged 18 to 61 years were taken for the study from the archive collection in museum of anatomy. Sixteen morphological features on the symphyseal surface of pubic bones were noted and arranged in 10 phases according to Todd's (1920) method. Frequency of these features present in each phase was calculated. Linear regression analysis was applied to obtain an equation for estimation of age from a pubic bone of an unknown deceased individual. Results It was seen that frequency of most morphological features of the pubic bones in the present study age groups (phases) was 100%, i.e., similar to those in Todd's study. There was a significant correlation (r = 0.9, p < 0.001) between the actual age of the pubic bone and age estimated by linear regression equation. Conclusion: Despite numerous improved methods, Todd's method remains the most useful method for determination of age. Appearance of morphological features on the symphyseal surface of pubic bones in the present study were similar to most phases of Todd's study. Thus, Todd's method can be successfully applied for the estimation of age in Northwest Indian adult male population. How to cite this article Sodhi L, Singh H, Sahni D, Gupta T, Aggarwal A, Chawla K, Kaur H. Estimation of Age from Symphyseal Surface of Cadaveric Pubic Bones of Northwest Indian Male Adults. J Postgrad Med Edu Res 2016;50(4):176-180.
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Jackes, Mary, and Christopher Meiklejohn. "Building a method for the study of the Mesolithic Neolithic transition in Portugal." Documenta Praehistorica 31 (December 31, 2004): 88–111. http://dx.doi.org/10.4312/dp.31.7.
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This paper focuses on the agricultural transition in Portugal and on demography across this transition, concentrating on two key skeletal samples, the Mesolithic shell midden of Cabeco da Arruda and the Neolithic burial cave of Casa da Moura. It extends our previous work on the demography of the transition and the methodology surrounding its determination. We explain our method for determination of the number of individuals in samples where whole skeletons cannot be used. We then concentrate on the estimation of fertility, placing it within limits of biological feasibility, sample inadequacies, and vagaries of age assessment. From our analysis, which includes an examination of historical issues with the sites, we argue for regional population continuity between 8000 and 6000 cal BP, and suggest that Neolithic life-ways slowly intensified, founded on important elements deriving from the late Mesolithic, with changes that included increased fertility through shortening of the birth interval
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Shahrestani, S., M. R. Makarov, C. H. Jo, and J. G. Birch. "Comparison of Moseley and Rotterdam straight-line graphs in predicting leg lengths and leg-length discrepancy at maturity." Journal of Children's Orthopaedics 13, no. 5 (October 1, 2019): 536–42. http://dx.doi.org/10.1302/1863-2548.13.190086.
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Purpose One method of predicting leg-length discrepancy at maturity is the Moseley straight-line graph. Beumer et al developed an alternative graph, using a more modern Dutch population. The purpose of this study was to compare the prediction accuracy of these two graphs in a cohort of patients treated at our institution using epiphysiodesis. Methods We identified 76 patients treated using epiphysiodesis for leg-length discrepancy who were followed to maturity and had adequate preoperative radiographic assessment for straight-line graph construction. We compared predicted long leg length (after epiphysiodesis), short leg length, and residual leg-length discrepancy to actual outcome for both methods, using both chronological and skeletal ages. Results Both methods were more accurate using skeletal age rather than chronological age. The Rotterdam graph showed modest improved accuracy compared to the Moseley graph in developmental aetiologies and in Hispanic patients. Using a difference of one centimetre in prediction error as clinically relevant (long leg [after epiphysiodesis], short leg, and leg-length discrepancy in each of the 76 patients, 228 predictions), we found comparable predictions in 171, more accurate prediction using the Rotterdam in 32, and using the Moseley in 25 predictions. Conclusions Straight-line graphs provide a generally more accurate prediction of leg lengths at maturity by virtue of multiple preoperative evaluations. The Rotterdam straight-line graph was equal to or superior to the Moseley graph in most patients in this cohort. Use of skeletal age resulted in more accurate predictions than chronological age. Clinicians should remain familiar with the concept and use of the straight-line graph. Level of evidence III, case-control study.
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Sapkota, B., S. Koju, S. K. Mahanta, and U. Rimal. "Assessment of Palatal Throat Form in Lateral Cephalogram and its Correlation with the Skeletal Base and Facial Divergence: An Institutional Based Study." Kathmandu University Medical Journal 19, no. 4 (December 31, 2021): 442–45. http://dx.doi.org/10.3126/kumj.v19i4.49758.
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Background Along with peripheral seal, palatal throat form also has significant value to achieve good retention and stability of maxillary complete denture. The palatal throat form also determines the posterior extention of maxillary dentures and affects the comfortability of the patients.
Objective To analyse the palatal throat form in a Nepalese population based on age, gender malocclusion and facial divergence.
Method This study consisted of 300 randomly selected radiographs with a mean age of 21.46±5.62 years. Skeletal malocclusion in lateral palatal throat form outlines. Patient were also categorized according to different Schudy’s facial divergence angle (SNMP). The obtained data was tabulated based on the age, gender, palatal throat form, type of malocclusion and facial divergence. The results obtained were subjected to a statistical analysis to find the relation between variants of the soft palate and types of malocclusion in different gender groups.
Result Proportion between palatal throat form and malocclusion found to be significant. There is no significant difference in proportion of different class of palatal throat form between genders. Whereas Class II palatal throat form found to be most common in all facial divergence.
Conclusion It was observed that Class II malocclusion was most common among three types. The relation between palatal throat form and malocclusion, was found to be statistically significant.
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Silva, Barbara C., and John P. Bilezikian. "Trabecular bone score: perspectives of an imaging technology coming of age." Arquivos Brasileiros de Endocrinologia & Metabologia 58, no. 5 (July 2014): 493–503. http://dx.doi.org/10.1590/0004-2730000003456.
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The trabecular bone score (TBS) is a new method to describe skeletal microarchitecture from the dual energy X-ray absorptiometry (DXA) image of the lumbar spine. While TBS is not a direct physical measurement of trabecular microarchitecture, it correlates with micro-computed tomography (µCT) measures of bone volume fraction, connectivity density, trabecular number, and trabecular separation, and with vertebral mechanical behavior in ex vivo studies. In human subjects, TBS has been shown to be associated with trabecular microarchitecture and bone strength by high resolution peripheral quantitative computed tomography (HRpQCT). Cross-sectional and prospective studies, involving a large number of subjects, have both shown that TBS is associated with vertebral, femoral neck, and other types of osteoporotic fractures in postmenopausal women. Data in men, while much less extensive, show similar findings. TBS is also associated with fragility fractures in subjects with secondary causes of osteoporosis, and preliminary data suggest that TBS might improve fracture prediction when incorporated in the fracture risk assessment system known as FRAX. In this article, we review recent advances that have helped to establish this new imaging technology.
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Zulkifley, Mohd Asyraf, Siti Raihanah Abdani, and Nuraisyah Hani Zulkifley. "Automated Bone Age Assessment with Image Registration Using Hand X-ray Images." Applied Sciences 10, no. 20 (October 16, 2020): 7233. http://dx.doi.org/10.3390/app10207233.
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One of the methods for identifying growth disorder is by assessing the skeletal bone age. A child with a healthy growth rate will have approximately the same chronological and bone ages. It is important to detect any growth disorder as early as possible, so that mitigation treatment can be administered with less negative consequences. Recently, the most popular approach in assessing the discrepancy between bone and chronological ages is through the subjective protocol of Tanner–Whitehouse that assesses selected regions in the hand X-ray images. This approach relies heavily on the medical personnel experience, which produces a high intra-observer bias. Therefore, an automated bone age prediction system with image registration using hand X-ray images is proposed in order to complement the inexperienced doctors by providing the second opinion. The system relies on an optimized regression network using a novel residual separable convolution model. The regressor network requires an input image to be 299 × 299 pixels, which will be mapped to the predicted bone age through three modules of the Xception network. Moreover, the images will be pre-processed or registered first to a standardized and normalized pose using separable convolutional neural networks. Three steps image registration are performed by segmenting the hand regions, which will be rotated using angle calculated from four keypoints of interest, before positional alignment is applied to ensure the region of interest is located in the middle. The hand segmentation is based on DeepLab V3 plus architecture, while keypoints regressor for angle alignment is based on MobileNet V1 architecture, where both of them use separable convolution as the core operators. To avoid the pitfall of underfitting, synthetic data are generated while using various rotation angles, zooming factors, and shearing images in order to augment the training dataset. The experimental results show that the proposed method returns the lowest mean absolute error and mean squared error of 8.200 months and 121.902 months2, respectively. Hence, an error of less than one year is acceptable in predicting the bone age, which can serve as a good supplement tool for providing the second expert opinion. This work does not consider gender information, which is crucial in making a better prediction, as the male and female bone structures are naturally different.
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Vasileva, V., L. Marchenkova, and V. Sergeev. "POS1282 VERIFICATION OF MANIFESTATIONS OF SARCOPENIA IN OBESE PATIENTS WITH THREE METHODS FOR BODY COMPOSITION ASSESSMENT." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 924.1–924. http://dx.doi.org/10.1136/annrheumdis-2021-eular.3629.
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Background:With new technologies for body composition assessment determining changes learn, muscle and fat mass. Prevention of sarcopenic obesity is timely detection of decrease.Objectives:Aim of the study was to compare the effectiveness of three methods of body composition assessment such as bioimpedans analysis (BIA), air-replacement bodyplatismography (BodPod) and Dual X-ray absorptiometry Total body program (DXA Total Body) in the verification of reducing of skeletal muscle mass as sign of sarcopenic obesity in obese patients.Methods:The study group included 95 patients aged 21-69 y.o. (average age 53,9±11,05 years) with BMI≥30.0 kg/m2. The control group included 37 patients aged 37-69 y.o (average age 50,73±10,6 years) of the same age without obesity with BMI 20.0-29.9 kg/m2. Body composition was tested using BIA, BodPod and DXA with calculating fat, lean and skeletal muscles mass (kg) and % in all the patients.Results:According to BIA the groups differ only in fat mass (FM) 42.75 (4.8;6.3) vs. 33.15 (28.4;35.5) kg; p=0.036 and did not differ (p>0.05) in lean (LM), skeletal muscle mass (SMM) and in % of FM and SMM. According to BodPod analyses groups differed in the FM 3.4 [36.81;69.94] vs 31.02 [23.22;38] kg, p=0.007, % FM 45.4 [42.1;53.8] vs 37.7 [28.6;41.1], p=0.003 and % LM - 54.6 [46.2;57.9] vs 62.3 [58.9;71.4], p=0.003, but had statistically equivalent values of LM 55 [49.48;67.77] vs 40.36 [33.12;49.06] kg, p=0.19. According to DXA Total Body analyses statistically significant differences (p<0.05) have been identified between the groups in FM and % FM of the hands, feet, trunk, total body (p>0.05), but not in LM and % LM (p>0.05) (Table 1).Table 1.Effectiveness of three methods for body composition assessmentINDICATORSSTUDY GROUPCONTROL GROUPpWeight (kg)106 [96;122]80 [77;81]0.00251BMI (kg/m2)37.6 [104;124]26.8 [24;30]0.000000Bod Pod% fat mass45.4 [42.1;53.8]37.7 [28.6;41.1]0.003424% lean mass54.6 [46.2;57.9]62.3 [58.9;71.4]0.003424fat mass (kg)43.4 [36.81;69.935]31.016 [23.223;38.004]0.006836lean mass (kg)55.002 [49.48;67.77]40.359 [33.122;49.058]0.185377BIAfat mass (kg)42.75 [4.8;6.3]33.150 [28.4;35.5]0.035771lean mass (kg)59.5 [53.95;71.05]54.850 [49.9;62.6]0.458312skeletal muscle mass (kg)27.9 [23.9;33.2]25.6 [22;29.3]0.701678skeletal muscle mass (%)45.3 [43.3;47.7]47.1 [42.3;48.1]0.415687DXA Total Bodytotal body lean mass (g)97276 [86062; 109154]62628 [57839; 85068]0.602523total body fat mass (g)47030 [39300; 56729]25652 [22164; 36396]0.009796total body muscle mass (g)49861 [42793; 57088]36426 [32273; 43341]0.973711Conclusion:From methods of body composition assessment, air-replacement bodyplatismography (BodPod) is the most sensitive in the verification of skeletal muscle mass reduction in obese patients. This method shows that patients with obesity have a significantly reduced muscle mass compared with normal weight or overweight subjects.References:[1]L. A. Marchenkova, V. A. Vasileva, Motor and balance function disorders and possibilities of their correction in patients with obesity and metabolic syndrome // Lechashchiy vrach. 2019. № 4. S. 68.[2]P. Corbeil, M. Simoheau, D. Rancourt, A. Tremblay, N. Teasdale, Increased risk for falling associated with obesity: mathematical modeling of postural control // IEEE Transactions on Neural Systems and Rechabilitation Enqineering. 2001; 9 (2): 126-136.Disclosure of Interests:None declared
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Kumar, Sandeep, Neeraj Agarwal, and Anil Mehrotra. "Evaluation of skeletal maturity in North Indian subjects using an objective method based on cervical vertebral bone age and assessment of its reliability as compared to hand wrist radiographic method." Journal of Indian Orthodontic Society 50, no. 1 (March 2016): 3–7. http://dx.doi.org/10.4103/0301-5742.175704.
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Kumar, Sandeep, Neeraj Agarwal, and Anil Mehrotra. "Evaluation of skeletal maturity in North Indian subjects using an objective method based on cervical vertebral bone age and assessment of its reliability as compared to hand wrist radiographic method." Journal of Indian Orthodontic Society 50, no. 1 (March 2016): 3–7. http://dx.doi.org/10.1177/0974909820160102.
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Lavrishcheva, I. V., A. Sh Rumyantsev, M. V. Zakharov, N. N. Kulaeva, and V. M. Somova. "Sarcopenia is an actual problem in chronic kidney disease of the 5d stage." Nephrology (Saint-Petersburg) 24, no. 1 (January 25, 2020): 60–66. http://dx.doi.org/10.36485/1561-6274-2020-24-1-60-66.
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BACKGROUND. The lack of data on the epidemiology of presarcopenia/sarcopenia leads to an underestimation of the role of this condition in the structure of morbidity and mortality of haemodialysis patients in theRussian Federation. THE AIM: to study the epidemiological aspects of presarcopenia /sarcopenia in patients with chronic kidney disease stage 5d. PATIENTS AND METHODS. This study comprised 317 patients receiving programmed bicarbonate haemodialysis for 8.2 ± 5.1 years, among them 171 women and 146 men, the average age was 57.1 ± 11.3 years. The assessment of the presence of sarcopenia was performed using the method recommended by the European Working Group on Sarcopenia in Older People. RESULTS. The prevalence of presarcopenia was 0.7 % and sarcopenia 29.6 %. The incidence of skeletal muscle mass deficiency according to muscle mass index (IMM) was 30.3 %, 48.7 % showed a decrease in muscle strength according to dynamometry, and low performance of skeletal muscles according to 6 minute walk test was determined in 42.8 %. Sarcopenia patients were significantly characterized by lower body mass index, as well as higher body fat mass values. The duration of haemodialysis (χ2 = 22.376, p = 0.0001) and the patient's age (χ2 = 10.545 p = 0.014) were an independent risk factors for the development of sarcopenia. CONCLUSION. Sarcopenia is recorded more frequently in hemodialysis patients than presarcopenia. Its prevalence increases among patients of older age groups and with a hemodialysis duration of more than 5 years. The age and experience of dialysis make their independent contribution to the development of this syndrome.
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Patil, Mithileshwari, Manisha Sardar, and Anuradha Sinha. "A substantiate comparative study of the mandibular canine index method of gender assessment using two decedent Maharashtra population." International Journal of Orofacial Research 6, no. 1 (July 9, 2022): 5–10. http://dx.doi.org/10.56501/intjorofacres.v6i1.143.
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Introduction: Mandibular Canine Index (MCI), indispensable tools of forensic odontology in gender determination of skeletal remains is a contributing part of anthropological, genetic, odontological, and forensic investigations as well as archaeological and medico-legal examinations. Aim & Objective: To compare the differences in odontometrics of mandibular canine between males and females of two different regions in Maharashtra. Method: Present study includes 60 individuals (15 male and 15 female subjects belonging to the Kolhapur region and 15 male and 15 female subjects belonging to the Mumbai region) having age group 21 to 28 years. The mesio-distal width of the right and left mandibular canine and intercanine distance were measured. Subsequently, standard MCI, intercanine distance, sexual dimorphism, and percentage accuracy in both regions were calculated. Result: Statistically highly significant variation was seen in mesio-distal width of mandibular canine in the left side of the population of both the regions as compared to the right side. Also, variation in intercanine distance was seen in females of both the population. There was no variation seen in MCI of both the population. The standard MCI was 0.24 for Mumbai and 0.25 for the Kolhapur population. Conclusion: As region, racial patterns, genetic and epigenetic factors indirectly affect MCI values, this technique can be used as one of the diagnostic adjuvant and reliable methods for gender determination in forensic dentistry.
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Agbley, Daniel, Henry Holdbrook-Smith, and Yao Ahonon. "A comparative evaluation of the efficacy between skeletal traction and skin traction in pre-operative management of femur shaft fractures in Korle Bu Teaching Hospital." Ghana Medical Journal 54, no. 3 (September 30, 2020): 146–50. http://dx.doi.org/10.4314/gmj.v54i3.4.
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Objectives: This study is to compare the outcomes of pre-operative skeletal and skin traction in adult femoral shaft fractures awaiting surgical fixation within two weeks of presentation to the Accident Center of Korle Bu Teaching Hospital.Methods: This study was a clinical trial on 86 recruited patients with closed femoral shaft fractures sustained within 24 hours of presentation grouped into 2 groups. Descriptive and inferential statistics comprising frequency, percentage, Chi-square, independent sample t-test and Mann-Whitney U test were used in analysing the data.Results: Of the total number of patients involved in the study, 74% (n=64) were males and 26% (n=22) were females with a mean age of 39.49 (SD ±15). There was no statistically significant difference in the mean visual analogue scale (VAS) pain assessment between the Skin traction group and Trans-tibia skeletal traction group after traction. With regards to complications, the difference between the Skin traction group and the Skeletal traction group was statistically significant (P=0.001). Moreover, the mean blood loss compared with the open type of reduction in the Transtibia skeletal traction group was significantly less than the Skin traction group (p=0.000).Conclusion: This study has shown that both Skeletal traction and Skin traction were equally effective in controlling pre-operative pain in adult patients with femoral shaft fractures and does not affect intra-operative blood loss and postoperative management. Therefore, pre-operative Skin traction can be considered a useful and cost-effective method of maintaining alignment and pain relief in adult femoral shaft fractures.Keywords: Skin traction, Trans-tibia skeletal, reamed Intramedullary nailing, Intra-operative blood loss, Visual Analogue ScaleFunding: Personal Funding
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Suslov, Vasiliy M., Alexander V. Pozdnyakov, Dmitry O. Ivanov, Dmitry I. Rudenko, Damir A. Malekov, Alexandra D. Suslova, and Daria I. Ulyanenko. "Correlation analysis of T2-weighted images and Medical Research Council scale in corticosteroid-naive patients with Duchenne muscular dystrophy." Pediatrician (St. Petersburg) 8, no. 6 (December 28, 2017): 72–79. http://dx.doi.org/10.17816/ped8672-79.
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Because of the necessity of objective instrumental methods for assessing the state of skeletal musculature in patients with Duchenne muscular dystrophy, the aim of our work was to evaluate the correlation between manual methods of assessment of the muscle strength and the results of magnetic resonance imaging (MRI) of the skeletal muscles of lower limbs. We have examined 15 corticosteroid-naive patients with Duchenne muscular dystrophy. Patients were divided into 2 groups: ambulant patients (average age 8.1 years) and non-ambulant patients (mean age 12.7 years). Muscle strength of lower extremities of all patients has been evaluated by Medical Research Council scale and MRI of skeletal muscles of the pelvic girdle, thighs and lower legs has been performed. The following results have been obtained: ambulant patients have been characterized by a high correlation of MRC scale and MRI of the lower extremities in the evaluation of the pelvic girdle and thighs muscles and the total score (pelvic girdle, thighs and lower legs) and salient correlation in the evaluation of the lower legs muscles. Non-ambulant patients have been characterized by moderate correlation in the evaluation of pelvic girdle and thighs muscles, as well as the total score of lower limbs. There was no correlation between MRC and MRI results in the muscles of the lower legs. Magnetic resonance tomography is able to reliably estimate the degree of fatty infiltration in Duchenne muscular dystrophy and is the method of choice in the diagnosis and evaluation of the severity of this disease.