Morphological Variations and Normal Parameters of the Cross-Sectional Anatomy of the Tibiofibular Syndesmotic

2021 ◽  
pp. 193864002110552
Author(s):  
Seyed Ali Hashemi ◽  
Soheil Nosrati ◽  
Zahra Shayan ◽  
Amir Reza Vosoughi
Keyword(s):  
Tibiofibular Syndesmosis ◽  
Normal Range ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Morphological Variations ◽  
Upper Limit ◽  
Significant Difference ◽  
P 16 ◽  
Axial Ct ◽  
The Cross

Background: The aim of this study was to determine morphological variations and normal parameters of the cross-sectional tibiofibular syndesmotic anatomy. Methods: Configurations of syndesmosis, anterior syndesmotic width (ASW), posterior syndesmotic width (PSW), and overlap distance, defined as the overlap of medial fibula with a drawn line from tip of anterior tubercle of incisura fibularis to the posterior tip, were measured on normal computed tomography (CT) scans of 110 cases. Results: Seventy seven male (70%) and 33 female (30%) (left: 50 and right: 60) were assessed. Mean age of the cases was 33 ± 13 (range: 15-80) years. Three different syndesmotic configurations were crescent (55.5%), rectangular (39.1 %), and semicircle (5.4 %). Overall, mean ASW, PSW, and overlap distance were 2.72, 3.98, and 1.02 mm, respectively. Upper limit of normal ASW in crescent, rectangular, and semicircle was 4.80, 4.85, and 3.89 mm, respectively. The maximum of PSW in crescent, rectangular, and semicircle was 6.25, 6.50, and 4.97 mm, respectively. There was not significant difference between syndesmotic configurations based on age (P = .69) and sex (P = .16). Conclusions: During interpreting axial CT scan to diagnose syndesmotic injuries, the normal range of parameters according to the different configurations of the tibiofibular syndesmosis should be carefully considered. Level of Evidence: Level 4

scholarly journals Prevalence of Morphological Variations Associated With Femoroacetabular Impingement According to Age and Sex: A Study of 1878 Asymptomatic Hips in Nonprofessional Athletes

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712097789
Author(s):  
Rodolfo Morales-Avalos ◽  
Adriana Tapia-Náñez ◽  
Mario Simental-Mendía ◽  
Guillermo Elizondo-Riojas ◽  
Michelle Morcos-Sandino ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Alpha Angle ◽  
Cross Sectional Study ◽  
Level Of Evidence ◽  
Crossover Sign ◽  
Cross Sectional ◽  
Radiographic Findings ◽  
Morphological Variations ◽  
Pelvic Radiographs ◽  
Center Edge

Background: Radiographic findings related to the cam and pincer variants of femoroacetabular impingement (FAI) include measurements of the alpha angle and lateral center-edge angle (LCEA). The function of these radiographic findings has been put into question because of high heterogeneity in reported studies. Purpose: The aim of this study was 3-fold: (1) to determine the prevalence of cam and pincer variants according to sex and age on anteroposterior (AP) pelvic radiographs from an asymptomatic nonathletic population, (2) to identify the most common radiographic signs of cam- and pincer-type variants, and (3) to determine if there are variations in the prevalence of these radiographic signs according to sex and age. Study Design: Cross-sectional study; Level of evidence, 3. Methods: There were 3 independent observers who retrospectively analyzed the 939 AP pelvic radiographs (1878 hips) of patients aged 18 to 50 years who did not have hip symptoms and who were not professional athletes. The prevalence of the cam and pincer variants according to the alpha angle and LCEA, respectively, and the presence of other radiographic signs commonly associated with these variables were determined in the overall population and by subgroup according to sex and age group (18-30, 31-40, and 41-50 years). Descriptive and inferential statistics were used to analyze the study sample. Results: The mean age of the included population was 31.0 ± 9.2 years, and 68.2% were male. The prevalence of the cam-type variant was 29.7% (558/1878), and that of the pincer-type variant was 24.3% (456/1878). The radiographic signs that were most associated with the cam and pincer variants were a pistol-grip deformity and the crossover sign, respectively. Significant differences ( P < .001) in the prevalence of these variants were identified between men and women in both variants. No differences were observed in the alpha angle or LCEA according to sex or age. Conclusion: Radiographic findings suggestive of FAI had significant variations with respect to sex and age in this study sample. This study provides information to determine the prevalence of these anatomic variants in the general population.

scholarly journals perbandingan kadar HDL dan LDL akseptor Depo Medroksi Progesteron Asetat dengan IUD

2019 ◽  
Vol 7 (2) ◽  
pp. 47-51
Author(s):  
Suci Syahril ◽  
Meldafia Idaman ◽  
Dewi Fransisca
Keyword(s):  
Weight Gain ◽  
Lipid Profile ◽  
Medroxyprogesterone Acetate ◽  
Colorimetric Method ◽  
Cross Sectional Study ◽  
First Year ◽  
Sectional Study ◽  
Normal Range ◽  
Cross Sectional ◽  
Significant Difference

Abstract The use of contraceptive depot medroxyprogesterone acetate (DMPA) increasing lately, but some studies suggest has the side effects of weight gain and contraceptives that have side effect in lipid metabolism. Therefore, about 35% of acceptors of DMPA in the first year to stop the use of DMPA. The objective of this study was to determine the differences of lipid profile between acceptors DMPA with acceptors IUD. This was a obcervational study with cross sectional study. The study wasdone at health center Lubuk Buaya in Padang and at laboratory of Biochemistry Departement in Medical Faculty of Andalas University from Januari until September 2016. The subjects were consisted of two groups, each group had 26 subjects. The examination for LDL and HDL used an enzymatic colorimetric method CHOD-PAP.  Data was analyzed using analysis of t-test with p < 0.05 was considered to be significantly different. HDL levels average in Depo Medroxyprogesterone Acetate was 87,54±14,28 mg/dl and IUD was 75,90±8,67 mg/dl with p < 0.05 (significantly difference). Levels of  LDL means there is no significantly difference between DMPA and IUD acceptors (p> 0.05). This research concluded that there isa significant difference on average levels of HDL in the Depo Medroxyprogesterone Acetate and IUD but levels of LDL there is no significantly difference. The clinically lipid profile in the two groups is in normal range.  

scholarly journals COMPARISON OF EPOC AND RECOVERY ENERGY EXPENDITURE BETWEEN HIIT AND CONTINUOUS AEROBIC EXERCISE TRAINING

2019 ◽  
Vol 25 (1) ◽  
pp. 20-23 ◽  
Author(s):  
Mateus Ahlert ◽  
Fernando Matzenbacher ◽  
José Carlos dos Santos Albarello ◽  
Gustavo Henrique Halmenschlager
Keyword(s):  
Oxygen Consumption ◽  
Energy Expenditure ◽  
Aerobic Exercise ◽  
Maximal Oxygen Consumption ◽  
Aerobic Exercise Training ◽  
Fat Percentage ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Significant Difference ◽  
High Intensity Interval

ABSTRACT Objectives: The objective of this study was to compare EPOC - excess post-exercise oxygen consumption and recovery energy expenditure between high intensity interval aerobic exercise (HIIT) and continuous aerobic exercise in adult amateur runners. Methods: The study included 10 runners, with a mean age of 35.7 ± 5.87 years, height 1.69 ± 0.11 m; body mass 74.13 ± 11.26 kg; fat percentage 19.31 ± 4.27% and maximal oxygen consumption (VO2max) of 3.50 ± 0.64 l/kg/min-1. The continuous aerobic exercise protocol consisted of 20 minutes of running with intensity of 70-75% HRmax. Two 20-second cycles of 8 sprints were performed for HIIT at the highest possible speed, with 10 seconds of rest and a 3-minute interval between cycles. The sample group performed the two protocols at least 48 hours and at most one week apart. EPOC was observed using ergospirometry after the running protocols, and mean consumption was analyzed between 25-30 minutes after exercise. Oxygen consumption at 9-10 minutes was used for resting consumption. The study has a cross-sectional experimental design. Results: Oxygen consumption of 0.57 ± 0.29l/kg/min1 and energy expenditure of 2.84 ± 1.44 kcal/min were observed for continuous aerobic exercise, with values of 0.61 ± 0.62 l/kg/min−1 and 3.06 ± 1.10 kcal/min respectively (p <0.05) for HIIT. Conclusion: The protocols performed did not show a statistically significant difference in terms of EPOC and energy expenditure, but the performance of HIIT increased lipid metabolism for exercise recovery, which may favor the weight loss process. Moreover, this activity model takes up less time. Level of evidence I, randomized clinical trial.

Hard, soft and off-the-shelf foot orthoses and their effect on the angle of the medial longitudinal arch: A biplane fluoroscopy study

2019 ◽  
Vol 43 (3) ◽  
pp. 331-338 ◽  
Author(s):  
Megan Balsdon ◽  
Colin Dombroski ◽  
Kristen Bushey ◽  
Thomas R Jenkyn
Keyword(s):  
Study Design ◽  
Foot Orthoses ◽  
Medial Longitudinal Arch ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Longitudinal Arch ◽  
Significant Difference ◽  
Skeletal Kinematics ◽  
Dynamic Gait ◽  
Foot Orthosis

Background: Foot orthoses have proven to be effective for conservative management of various pathologies. Pathologies of the lower limb can be caused by abnormal biomechanics such as irregular foot structure and alignment, leading to inadequate support. Objectives: To compare biomechanical effects of different foot orthoses on the medial longitudinal arch during dynamic gait using skeletal kinematics. Study design: This study follows a prospective, cross-sectional study design. Methods: The medial longitudinal arch angle was measured for 12 participants among three groups: pes planus, pes cavus and normal arch. Five conditions were compared: three orthotic devices (hard custom foot orthosis, soft custom foot orthosis and off-the-shelf Barefoot Science©), barefoot and shod. An innovative method, markerless fluoroscopic radiostereometric analysis, was used to measure the medial longitudinal arch angle. Results: Mean medial longitudinal arch angles for both custom foot orthosis conditions were significantly different from the barefoot and shod conditions ( p < 0.05). There was no significant difference between the off-the-shelf device and the barefoot or shod conditions ( p > 0.05). In addition, the differences between hard and soft custom foot orthoses were not statistically significant. All foot types showed a medial longitudinal arch angle decrease with both the hard and soft custom foot orthoses. Conclusion: These results suggest that custom foot orthoses can reduce motion of the medial longitudinal arch for a range of foot types during dynamic gait. Level of evidence: Therapeutic study, Level 2. Clinical relevance Custom foot orthoses support and alter the position of the foot during weightbearing. The goal is to eliminate compensation of the foot for a structural deformity or malalignment and redistribute abnormal plantar pressures. By optimizing the position of the foot, the medial longitudinal arch (MLA) will also change and quantifying this change is of interest to clinicians.

Measurement of Glenohumeral Internal Rotation in Asymptomatic Tennis Players and Swimmers

2009 ◽  
Vol 37 (5) ◽  
pp. 1017-1023 ◽  
Author(s):  
Renato Rangel Torres ◽  
João Luiz Ellera Gomes
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Control Group ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Tennis Players ◽  
Glenohumeral Internal Rotation Deficit ◽  
Significant Difference ◽  
Overhead Sports ◽  
The Difference

Background Glenohumeral internal rotation deficit, often diagnosed in players of overhead sports, has been associated with the development of secondary shoulder lesions. Hypothesis Asymptomatic players of different overhead sports will exhibit variable degrees of glenohumeral internal rotation deficit. Study Design Cross-sectional study; Level of evidence, 3. Methods Fifty-four asymptomatic male volunteers (108 shoulders) divided into 3 groups (tennis players, swimmers, control group) underwent measurements of glenohumeral internal and external rotation using clinical examination with scapular stabilization. Measurements of dominant and nondominant shoulders were compared within and between groups. Glenohumeral internal rotation deficit (GIRD) was defined as the difference in internal rotation between the nondominant and dominant shoulders. Results In tennis players, mean GIRD was 23.9° ± 8.4° (P < .001); in swimmers, 12° ± 6.8° (P < .001); and in the control group, 4.9° ± 7.4° (P = .035). Dominant shoulders showed significant difference between all groups, and the difference in internal rotation of the dominant shoulder between the group of tennis players in comparison with the control group (27.6°, P < .001) was greater than the difference in internal rotation of the dominant shoulder found in the group of swimmers compared with the control group (17.9°, P < .001). Between tennis players and swimmers, the difference in internal rotation of the dominant shoulder was 9.7° (P = .002). Conclusion Dominant limbs showed less glenohumeral internal rotation than the nondominant limbs in all groups, with the deficit in the group of tennis players about twice the deficit found for swimmers. Mean difference between limbs in the control group was less than 5°, which is within normal parameters according to most studies. There were statistically significant differences between all groups when dominant shoulders were compared with each other, differences that were not compensated by external rotation gain. Tennis players had the least range of motion, followed by swimmers.

Evaluation of Reduction Accuracy of Suture-Button and Screw Fixation Techniques for Syndesmotic Injuries

2016 ◽  
Vol 37 (12) ◽  
pp. 1317-1325 ◽  
Author(s):  
Onur Kocadal ◽  
Mehmet Yucel ◽  
Murad Pepe ◽  
Ertugrul Aksahin ◽  
Cem Nuri Aktekin
Keyword(s):  
Screw Fixation ◽  
Ct Scans ◽  
Functional Evaluation ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Suture Button ◽  
Fixation Group ◽  
Significant Difference ◽  
The Mean

Background: Among the most important predictors of functional results of treatment of syndesmotic injuries is the accurate restoration of the syndesmotic space. The purpose of this study was to investigate the reduction performance of screw fixation and suture-button techniques using images obtained from computed tomography (CT) scans. Methods: Patients at or below 65 years who were treated with screw or suture-button fixation for syndesmotic injuries accompanying ankle fractures between January 2012 and March 2015 were retrospectively reviewed in our regional trauma unit. A total of 52 patients were included in the present study. Fixation was performed with syndesmotic screws in 26 patients and suture-button fixation in 26 patients. The patients were divided into 2 groups according to the fixation methods. Postoperative CT scans were used for radiologic evaluation. Four parameters (anteroposterior reduction, rotational reduction, the cross-sectional syndesmotic area, and the distal tibiofibular volumes) were taken into consideration for the radiologic assessment. Functional evaluation of patients was done using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale at the final follow-up. The mean follow-up period was 16.7 ± 11.0 months, and the mean age was 44.1 ± 13.2. Results: There was a statistically significant decrease in the degree of fibular rotation ( P = .03) and an increase in the upper syndesmotic area ( P = .006) compared with the contralateral limb in the screw fixation group. In the suture-button fixation group, there was a statistically significant increase in the lower syndesmotic area ( P = .02) and distal tibiofibular volumes ( P = .04) compared with the contralateral limbs. The mean AOFAS scores were 88.4 ± 9.2 and 86.1 ± 14.0 in the suture-button fixation and screw fixation group, respectively. There was no statistically significant difference in the functional ankle joint scores between the groups. Conclusion: Although the functional outcomes were similar, the restoration of the fibular rotation in the treatment of syndesmotic injuries by screw fixation was troublesome and the volume of the distal tibiofibular space increased with the suture-button fixation technique. Level of Evidence: Level III, retrospective comparative study.

scholarly journals TOMOGRAPHIC MORPHOLOGICAL STUDY OF THE CRANIUM AND ITS CORRELATION WITH CRANIAL HALO USE IN ADULTS

2017 ◽  
Vol 25 (1) ◽  
pp. 11-14
Author(s):  
TIAGO FERREIRA DE ALMEIDA ◽  
HOMAR TOLEDO CHARAFEDDINE ◽  
FERNANDO FLORES DE ARAÚJO ◽  
ALEXANDRE FOGAÇA CRISTANTE ◽  
RAPHAEL MARTUS MARCON ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Morphological Study ◽  
Descriptive Analysis ◽  
Parietal Bone ◽  
Frontal Bone ◽  
Ct Scans ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Significant Difference ◽  
Parietal Bones

ABSTRACT Objective: To evaluate using tomographic study the thickness of the cranial board at the insertions points of the cranial halo pins in adults Methods: This is a retrospective, cross-sectional, descriptive analysis of Computed Tomography (CT) scans of adult patients' crania. The study included adults between 20 and 50 years without cranial abnormalities. We excluded any exam with cranial abnormalities Results: We analyzed 50 CT scans, including 27 men and 23 women, at the original insertion points and alternative points (1 and 2 cm above the frontal and parietal bones). The average values were 7.4333 mm in the frontal bone and 6.0290 mm in the parietal bone Conclusion: There was no statistically significant difference between the classical and alternative points, making room for alternative fixings and safer introduction of the pins, if necessary. Level of Evidence II, Retrospective Study.

scholarly journals Distribution of White-to-White Corneal Diameter and Anterior Chamber Depth in Chinese Myopic Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Guihua Xu ◽  
Guanrong Wu ◽  
Zijing Du ◽  
Shanqing Zhu ◽  
Yunxiang Guo ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Age Groups ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Distribution Patterns ◽  
Normal Range ◽  
Cross Sectional ◽  
Significant Difference ◽  
Study Population ◽  
Corneal Diameter

Purpose: To investigate the distribution of white-to-white (WTW) corneal diameter and anterior chamber depth (ACD) in Chinese myopia patients.Methods: This was a cross-sectional observational study conducted at five ophthalmic centers. Anterior segment biometry was performed in 7,893 eyes of the 7,893 myopic patients using Pentacam, and the WTW and ACD were recorded. The distribution patterns of WTW and ACD were evaluated and the correlation between WTW and ACD was analyzed statistically.Results: There were 4416 (55.95%) males and 3477 (44.05%) females. The age of the study population was 25.14 ± 5.41 years. Distribution of WTW was slightly positively skewed (Skewness = 0.0076, Kurtosis = 0.3944, KS P = 0.020) with a mean of 11.65 ± 0.38 mm and a 95% normal range of 10.91–12.39 mm. A significant difference in WTW was found among different myopia groups (P &lt; 0.001). The ACD was normally distributed (Skewness = 0.899, Kurtosis = 0.027, KS P = 0.086). The mean ACD was 3.25 ± 0.26 mm and the 95% normal range of was 2.74–3.75 mm. A significant difference in ACD was also found among different myopia groups (P = 0.030). There was a significant correlation between WTW and ACD (r = 0.460, P &lt; 0.001).Conclusions: In our study, 95% of the Chinese myopic patients had a WTW within 10.91–12.39 mm and an ACD within 2.74–3.75 mm. ACD and WTW were significantly different among different myopia, gender and age groups. WTW was positively correlated with ACD.

scholarly journals Dural tear repair surgery comparative analysis: a stitch in time saves nine

2021 ◽  
Author(s):  
Charles Taylor ◽  
Amad Khan ◽  
Emad Shenouda ◽  
Nicholas Brooke ◽  
Ali Nader-Sepahi
Keyword(s):  
Infection Rate ◽  
Primary Closure ◽  
Neurological Symptoms ◽  
Dural Tear ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Repair Method ◽  
Operative Outcomes ◽  
Significant Difference ◽  
Dural Tears

Abstract Purpose A dural tear is a common iatrogenic complication of spinal surgery associated with a several post-operative adverse events. Despite their common occurrence, guidelines on how best to repair the defect remain unclear. This study uses five post-operative outcomes to the compare repair methods used to treat 106 dural tears to determine which method is clinically favourable. Methods Data were retrospectively collected from Southampton General Hospital’s online databases. 106 tears were identified and grouped per repair method. MANOVA was used to compare the following five outcomes: Length of stay, numbers of further admissions or revision surgeries, length of additional admissions, post-operative infection rate and dural tear associated neurological symptoms. Sub-analysis was conducted on patient demographics, primary vs non-primary closure and type of patch. Minimal clinically important difference (MCID) was calculated via the Delphi procedure. Results Age had a significant impact on patient outcomes and BMI displayed positive correlation with three-fifth of the predefined outcome measures. No significant difference was observed between repair groups; however, primary closure ± a patch achieved an MCID percentage improvement with regards to length of original stay, rate of additional admissions/surgeries and post-operative infection rate. Artificial over autologous patches resulted in shorter hospital stays, fewer readmissions, infections and neurological symptoms. Conclusion This study reports primary closure ± dural patch as the most efficient repair method with regards to the five reported outcomes. This study provides limited evidence in favour of artificial over autologous patches and recommends that dural patches be used in conjunction with primary closure. Level of evidence I Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.

scholarly journals Role of inflammation in non-allergic rhinitis

2014 ◽  
Vol 52 (2) ◽  
pp. 142-149
Author(s):  
E. de Corso ◽  
M. Battista ◽  
M. Pandolfini ◽  
L. Liberati ◽  
S. Baroni ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Clinical Symptoms ◽  
Diagnostic Algorithm ◽  
Inflammatory Cell Infiltrate ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Significant Difference ◽  
Nasal Cytology ◽  
Non Allergic Rhinitis

Objective: To investigate the role of inflammation in non-allergic rhinitis (NAR) patients in a large series to establish the prevalence of different NAR-subtypes, clinical features and the role of nasal cytology in the diagnostic algorithm. Methodology: Patients were selected out of 3650 individuals who spontaneously presented at our institution. We consecutively enrolled 519 NAR-patients in an analytical cross-sectional study between November 2007 and June 2013 (level of evidence: 3b). All patients underwent rhinological evaluation including symptoms questionnaire, endoscopy, CT scan, allergy tests and nasal cytology. Results: The inflammatory cell infiltrate affects the severity of symptoms differently, allowing for identification of different phenotypes of NAR. We distinguished two groups: “NAR without inflammation”(NAR-) and “NAR with inflammation”(NAR+), in addition to different NAR-subtypes with inflammation. A significant difference was observed in terms of clinical symptoms and association with comorbidities (previously diagnosed asthma and aspirin intolerance) between NAR–, NAR+ and between different NAR+ subtypes. Conclusion: Our data suggest that NAR- and NAR with neutrophils behave similarly, showing lower symptom score values and a lower risk of association with comorbidities compared to NAR with eosinophils and mast cells (singularly or mixed). In our belief it is very important to establish the presence and type of inflammation in non-allergic rhinitis patients and nasal cytology is a very useful test in correct differential diagnosis.

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