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

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.

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

Foot & Ankle International ◽

10.1177/1071100716661221 ◽

2016 ◽

Vol 37 (12) ◽

pp. 1317-1325 ◽

Cited By ~ 32

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.

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Jones Fractures Identified at the National Football League Scouting Combine: Assessment of Prognostic Factors, Computed Tomography Findings, and Initial Career Performance

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118790740 ◽

2018 ◽

Vol 6 (8) ◽

pp. 232596711879074 ◽

Cited By ~ 4

Author(s):

Robert C. Spang ◽

Daniel B. Haber ◽

Brendin R. Beaulieu-Jones ◽

Kristen L. Stupay ◽

George Sanchez ◽

...

Keyword(s):

Computed Tomography ◽

National Football League ◽

Treatment Method ◽

Level Of Evidence ◽

Significant Difference ◽

Specific Performance ◽

Incomplete Healing ◽

Bony Healing ◽

The Mean ◽

Career Performance

Background: Jones fractures result in subsequent dysfunction and remain an issue for athletes. Purpose: To (1) describe the epidemiology, treatment, and impact of Jones fractures identified at the National Football League (NFL) Scouting Combine on players’ early careers and (2) establish the value of computed tomography (CT) to determine bony healing after a fracture in prospective players. Study Design: Cohort study; Level of evidence, 3. Methods: All players who attended the combine between 2009 and 2015 were retrospectively reviewed to identify their history of Jones fractures. The playing position, treatment method, and number of missed collegiate games were recorded. The mean overall draft pick number, number of games started and played, snap percentage, and position-specific performance scores (fantasy score) over the first 2 years in the NFL were compared between players with fractures and controls. An imaging classification system was applied based on grading of each quadrant of the fifth metatarsal (plantar, dorsal, medial, lateral), with a score of 0 for not healed or 1 for healed. Results: Overall, the number of Jones fractures identified was 72 in 2285 athletes (3.2%), with all treated via intramedullary screw fixation. The mean overall draft pick number for players with fractures was 111.2 ± 67.9 compared with 99.0 ± 65.9 for controls ( P = .12). Performance scores for players with fractures were lower than those for controls across all positions, with a significant difference in running backs (2.6 vs 4.0, respectively; P < .001) and defensive linemen (1.4 vs 2.3, respectively; P = .02). The mean CT score was 2.5 ± 1.3. Of the 32 athletes who underwent imaging, 16 Jones fractures (50.0%) were healed or nearly healed, 12 (37.5%) were partially healed, and 4 (12.5%) showed little or no healing. The plantar cortex demonstrated the least healing (18/32; 56.3%), followed by the lateral cortex (15/32; 46.9%). Players with a mean score <1 were found to have fewer games started (2.7 ± 2.5) than those with 1 to 3 cortices healed (17.4 ± 10.4) or all cortices healed (8.7 ± 11.2). Conclusion: Based on CT, 50% of all players with a previous Jones fracture demonstrated incomplete healing. Moreover, position-specific performance scores over the first 2 years of a player’s career were lower across all positions for those with fractures compared with controls. Players with CT scores <1 were found to start fewer games and were drafted later than controls.

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The Prevalence of Nephrolithiasis in Patients with Primary Gout: A Cross-sectional Study Using Helical Computed Tomography

The Journal of Rheumatology ◽

10.3899/jrheum.081128 ◽

2009 ◽

Vol 36 (9) ◽

pp. 1958-1962 ◽

Cited By ~ 14

Author(s):

TORU SHIMIZU ◽

HIROSHI HORI

Keyword(s):

Computed Tomography ◽

Confidence Interval ◽

Laboratory Data ◽

Helical Computed Tomography ◽

Cross Sectional ◽

Patients Âgés ◽

Primary Gout ◽

Stone Formers ◽

Significant Difference ◽

History Of

Objective.To investigate the prevalence of nephrolithiasis in gouty patients by computed tomography (CT) imaging and to compare it with the “prevalence” of urolithiasis calculated from histories of urinary tract calculus.Methods.The kidneys of 383 male patients with primary gout were examined using an unenhanced 2-row helical CT detector, imaging at 2 mm collimation and a helical pitch of 3. The urolithiasis history of the 383 patients was investigated by inquiry. Patients’ ages, body mass index, and laboratory data from a 1-hour clearance test were determined.Results.CT scans confirmed nephrolithiasis in 103 (26.9%, 95% confidence interval 22.5%–31.6%) of the 383 gouty patients, and history of urinary calculus was positive in 65 (17.0%, 95% confidence interval 13.4%–21.1%) of the 383. However, 64 (62%) of the 103 stone-formers identified by CT had no history of urolithiasis. There was a significant difference between the ages of the 103 stone-formers identified by CT and the 65 stone-formers identified from the history.Conclusion.The prevalence of nephrolithiasis obtained using CT was 26.9% in the 383 patients with primary gout. Our results imply that we cannot determine an accurate prevalence of urolithiasis from a patient’s history. Most of the “prevalence” reported in the past may not correspond to a statistically justifiable one, but instead to the “cumulative incidence” during the contraction period of gout. Thus, the prevalence of nephrolithiasis confirmed by a cross-sectional method and the “prevalence” of urolithiasis calculated from patients’ calculus histories should be clearly distinguished.

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

Foot & Ankle Specialist ◽

10.1177/19386400211055274 ◽

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

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Is computed tomography of the brain necessary in patients with clinically suspected depressed skull fracture and no focal neurological deficit?

South African Journal of Radiology ◽

10.4102/sajr.v14i2.422 ◽

2010 ◽

Vol 14 (2) ◽

pp. 28

Author(s):

J A Rabie ◽

S Otto ◽

A J Le Roux

Keyword(s):

Computed Tomography ◽

Neurological Deficit ◽

Descriptive Analysis ◽

Skull Fracture ◽

Neurological Deficits ◽

Ct Scans ◽

Trauma Patients ◽

Focal Neurological Deficit ◽

Depressed Skull Fracture ◽

The Brain

Objective. The objective of the study was to determine whether computed tomography (CT) of the brain is necessary in all head trauma patients with clinically suspected depressed skull fractures, Glasgow Coma Scale (GCS) scores of 13 and above, and no focal neurological deficits. Design. A retrospective descriptive analysis was undertaken of patients of all ages who presented at the trauma unit of the Pelonomi Hospital Complex in Bloemfontein with GCS of 13 to 15, depressed skull fracture, no clinical focal neurological deficit, and who also underwent CT of the brain. Data were obtained from patients' files, and radiological reports and were analysed by the Department of Statistics, University of the Free State. Results. One hundred and thirty-one patients were included in the study, of whom 56 (42.7%) were found to have substantial intracranial pathology as determined by CT. Twenty-four (18.3%) of these patients had a GCS of 13, of whom 6 (25%) had normal CT scans and 18 (75%) intracranial pathology. Twenty-eight (21.37%) of the 56 patients with intracranial pathology had a GCS of 14, of whom 11 (39.3%) had normal CT scans and 17 (60.7%) intracranial pathology. A GCS of 15 was determined in 79 (60.3%) of the 131 patients, of whom 58 (73.4%) had normal CT scans and 21 (26.6%) intracranial pathology. Conclusion. Based on our findings, CT imaging of the brain in patients with a clinically suspected depressed skull fracture despite any clinical neurological deficit and a GCS of 13 or more is warranted in our setting. The likelihood of injury on CT correlated inversely with the GCS.

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A computed tomography study on two skulls of mistreated dogs from the Roman Age

Journal of Biological Research - Bollettino della Società Italiana di Biologia Sperimentale ◽

10.4081/jbr.2013.3668 ◽

2013 ◽

Vol 86 (1) ◽

Author(s):

V. Farina ◽

A. Mura ◽

V. Petruzzi ◽

G. Lepore ◽

E. Mura ◽

...

Keyword(s):

Computed Tomography ◽

Frontal Cortex ◽

Head Injuries ◽

Parietal Bone ◽

Frontal Bone ◽

Orbital Cavity ◽

Traumatic Lesion ◽

First Case ◽

Traumatic Lesions ◽

Roman Age

The study of ancient skeletons is of high interest, as the relationship between men and animals can be reconstructed. In dogs, head injuries frequently result from direct physical traumas. The excavation of a prehistoric well (Genomi, Sardinia) brought to light sixty canine bones of the Age Roman (2nd century AD), although this well was built during the Nuragic Age. (1st millennium BC). Two canine skulls showing three traumatic lesions underwent computed tomography in order to study the endocast of the brain cavity and indirectly locate possible brain lesions. In the first case, a traumatic lesion was found in the left parietal bone with depression of the outer surface. This lesion determined compression of the left frontal cortex and was compatible with life, as can be deduced by the inflammation of the periostenum. In the second case, two different traumatic lesions were found. The former was a wide fracture of the right frontal bone near the orbital cavity. The injured area showed clear signs of bone remodeling which took place many months before death. The latter was a severe comminuted fracture involving both the outer and inner surface of the left frontal bone, which provoked a deep wound in the left frontal cortex. The sharp outline of bone splinters with no signs of bone remodelling indicates that the trauma was not compatible with life. All lesions described were consequent to severe blows from humans and testify mistreatment of dogs in the Roman Age.

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

Revista Brasileira de Medicina do Esporte ◽

10.1590/1517-869220192501181346 ◽

2019 ◽

Vol 25 (1) ◽

pp. 20-23 ◽

Cited By ~ 1

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.

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The effect of curricula approaches to the development of the student’s clinical reasoning ability

Curationis ◽

10.4102/curationis.v28i2.955 ◽

2005 ◽

Vol 28 (2) ◽

Cited By ~ 3

Author(s):

T Khanyile ◽

F Mfidi

Keyword(s):

Nursing Students ◽

Clinical Reasoning ◽

Survey Design ◽

Traditional Approach ◽

Descriptive Analysis ◽

Problem Based Learning ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Jump Exercise ◽

Significant Difference

A comparative analysis was undertaken using descriptive and cross sectional survey design, to explore the effect of Problem Based Learning and Traditional approach on the development of clinical reasoning abilities of nursing students. Using quota sampling, a sample of 87 subjects was used from two University Nursing Departments, each using these curricula approaches. Students from their first, second and fourth year were interviewed, using the Triple Jump Exercise as an instrument to collect data. Data analysis using the SAS computer software package was employed to obtain both descriptive and statistical summarizations. Though descriptive analysis of the scores of clinical reasoning showed a slight difference between the two curricular approaches, this was not confirmed statistically as the two factor ANOVA and Tukey’s methods revealed no significant differences by approaches. The only significant difference was revealed between the students’ levels of study with senior levels (4th years) outperforming their juniors. These findings therefore conclude that, students using Problem Based Learning and Traditional approach perform on a similar level in clinical reasoning.

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

Prosthetics and Orthotics International ◽

10.1177/0309364619825607 ◽

2019 ◽

Vol 43 (3) ◽

pp. 331-338 ◽

Cited By ~ 1

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.

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Computed Tomography Description of the Uncinate Process Angulation in Patients With Cystic Fibrosis and Comparison With Primary Ciliary Dyskinesia, Nasal Polyposis, and Controls

Ear Nose & Throat Journal ◽

10.1177/0145561319828645 ◽

2019 ◽

Vol 98 (2) ◽

pp. 89-93 ◽

Cited By ~ 1

Author(s):

Rémi Hervochon ◽

Natacha Teissier ◽

Jean-Robert Blondeau ◽

Natacha Remus ◽

Laurence Bassinet ◽

...

Keyword(s):

Computed Tomography ◽

Cystic Fibrosis ◽

Primary Ciliary Dyskinesia ◽

Nasal Polyposis ◽

Uncinate Process ◽

Ct Scans ◽

Lateral Nasal Wall ◽

Average Value ◽

Significant Difference ◽

Ciliary Dyskinesia

Background: There is a medial bulging of the lateral nasal wall in patients with cystic fibrosis (CF). Aims: Uncinate process (UP) angulation measurements in patients and controls to objectify this bulging. Materials and Methods: Thirty CF, 17 primary ciliary dyskinesia (PCD), 13 chronic rhinosinusitis with polyps (CRSwp), and 30 controls were included. Angles were measured bilaterally on computed tomography (CT) scans: A, B, C on coronal sections, D and E on axial sections. Angle A was between the UP and the orbit inner wall, whereas the others were between UP and midline. Results: There was no significant difference between controls, PCD, and CRSwp. However, CF had 3 statistically different angles with controls, 5 with CRSwp, and 4 with PCD. Angle A average value was 126° (±16°) in patients with CF, 138° (±19°) in controls ( P = .007), 145° (±15°) in PCD ( P = .001), and 138° (±14°) in CRSwp ( P = .001). Angle E average value was 35° (±10°) in patients with CF, 20° (±6°) in controls ( P < .001), 21° (±4°) in PCD ( P < .001), and 22° (±6°) in CRSwp ( P < .001). Conclusion: Uncinate process’s anatomy is only modified in CF: Angle between UP and inner wall of orbit is closed, and angles between UP and midline are opened. Significance: These measures quantify the medial bulging of lateral nasal wall and support nasofibroscopic observations.

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