Jump Landing Kinematics: Establishing Normative Ranges For Male And Female Athletes.

CONTEXT: Lower extremity joint (LE) kinematics during landing tasks are important predictors of injury risk and performance outcomes in athletes. OBJECTIVE: To establish sex-related differences and normative ranges for LE kinematics during the jump-landing task in a large cohort of healthy military service academy cadets. DESIGN: Cross-Sectional Study. SETTING: US Air Force, Naval, and Military Academies. PARTICIPANTS: 5308 cadets (2062 females [38.8%]). MAIN OUTCOME MEASURE(S): Sex-related differences in LE kinematics were analyzed using independent samples t-tests. Mean differences (MD) and effect sizes (d) were reported for interpretability. Normative ranges for hip and knee joint angles were established separately for males and females at initial contact (IC) and 50% of the stance phase. RESULTS: Compared to males, moderate effect sizes (d ≥ .5) were observed for knee external rotation (negative value) where females displayed greater motion at IC and at 50% stance (MD: - 3.9˚ and -5.0˚, respectively, p < .001). The following findings were of small effect size (.2 ≥ d > .5). Females exhibited less knee and hip flexion at IC (MD: -1.8˚ and -0.5˚, respectively, p < .001) and at 50% stance (MD: -4.1˚ and -4.6˚, respectfully, p < .001). This was accompanied by females having greater knee valgus (negative value) and hip adduction at IC (MD: -2.2˚ and 1.06˚, respectively, p < .001) and at 50% stance (MD: -3.2˚ and 1.8˚, respectfully, p < .001). CONCLUSION: This study establishes normative ranges for LE kinematics during the jump-landing task in a large cohort of healthy military service academy cadets entering their first year. Sex- related differences in LE kinematics were observed, highlighting the importance of considering sex as a factor in the evaluation of lower extremity movement quality and management of injury risk.

Variation in normative values of major clinical biochemistry analytes in healthy reproductive-age women in India: A subset of data from a National Indian Council of Medical Research-Polycystic Ovary Syndrome task force study.

OBJECTIVES: Clinical biochemistry reference intervals (RIs) play a crucial role in interpreting patient test results and making informed clinical decisions. Using data from an ongoing Indian Council of Medical Research-National task force study on healthy women, normative ranges for commonly analyzed biochemical analytes were established. MATERIALS AND METHODS: A.total of 13,181 women of reproductive age (18-40 years) were recruited from different urban and rural regions of the country, of which 9898 women signed an informed consent were included. Among these, women having features of hyperandrogenism, menstrual cycle irregularities, and comorbidities were excluded. RIs of 22 analytes were computed in the remaining 938 women controls. To estimate the 95% range of the reference distribution, the limits of the 2.5th percentile and the 97.5th percentile were used in the study. RESULTS: Mean ± standard deviation of age and body mass index of participants was 30.12 ± 6.32 years and 22.8 ± 3.36 kg/m2 respectively. Centiles (2.5th-97.5th) of liver function parameters, lipid parameters, glycaemic parameters, and renal parameters are presented. No significant difference in analytes was observed in relation to the area of residence, and age groups except in albumin (P = 0.03). The distribution of most of the parameters was consistent with the various RI studies conducted in India as well as other countries. CONCLUSION: This is the first study generating biochemical RIs data among a large representative sample of healthy reproductive-age women recruited using a robust design across the country. The resource may serve as a reference range for common biochemical analytes for future in this age group.

Physiological variations in the sagittal spine alignment in an asymptomatic elderly population.

BACKGROUND CONTEXT: Sagittal plane alignment is of crucial importance for the treatment of spinal deformities. When planning corrective strategies, spine surgeons need to refer to normative parameters' ranges which characterize the alignment in the asymptomatic population. Changes are known to occur with age. For the Caucasian population, the reference ranges are extensively documented for the young and middle-aged adults. In contrast, only a few studies have evaluated individuals in advanced age (>60 years) and in groups of limited numbers of subjects (less than 50). PURPOSE: To describe the normative parameter ranges of sagittal spine alignment in a large population of asymptomatic elderly subjects. STUDY DESIGN/SETTING: Monocentric, prospective, cross-sectional study. PATIENT SAMPLE: One hundred sixty asymptomatic elderly volunteers (age>60 years, Caucasian heritage), consecutively enrolled. OUTCOME MEASURES: Sagittal parameters of spine and pelvis: thoracic kyphosis (TK); lumbar lordosis (LL); sacral slope (SS); pelvic incidence (PI); pelvic tilt (PT); sagittal vertical axis (SVA); T1 pelvic angle (TPA); mismatch between PI and LL (PI-LL); Roussouly classification of the lumbopelvic profile. METHODS: Each subject underwent one radiographic scan, performed in standing position with EOS low-dose system (EOS Imaging, Paris, France). The radiographic images were processed with sterEOS software allowing identification of the anatomical parameters and the presence of scoliosis. SVA, TPA, and the lumbopelvic profile were manually measured in the lateral images. The results were compared to previous studies describing younger adult populations. The study was supported by the Italian Ministry of Health in the amount of $15,000. The authors declare that there are no conflicts of interests. RESULTS: Overall, the average values of the spinopelvic parameters were the followings: TK, 55±14°; LL, 57±12°; PI, 55±11°; SS, 38±10°; PT, 16±7°. The average PI-LL, SVA, and TPA was -3±11°, 25±32 mm, and 14.6±7.4°, respectively. TK, TPA, and SVA were found increasing with age. As for classification of the lumbopelvic profile, 16% of subjects were excluded because they were considered not to belong to any of the Roussouly types. In the classified subjects, the distribution was similar to that of younger adults. Asymptomatic scoliosis (average Cobb angle, 22±7°) was identified in 27% of individuals. CONCLUSIONS: The ranges of values pointed out differences compared to younger adults and represent an important resource for spine surgeons in planning the surgical correction of spinal deformities. The characteristic changes occurring with age, as well as the observed presence of mild or moderate asymptomatic scoliosis, should be carefully taken into account. The classification of the lumbopelvic profile based on the Roussouly scheme revealed some limitations, although similar frequencies were identified compared to younger adults.

Activity of lysosomal exoglycosidases in the urine of healthy normotensive and pre-hypertensive children.

PURPOSE: We investigated the relationship between blood pressure (BP) and the activity of lysosomal exoglycosidases: N-acetyl-ß-hexosaminidase (HEX), its isoenzymes A (HEX A) and B (HEX B), α-fucosidase (FUC), ß-galactosidase (GAL), ß-glucuronidase (GLU) and α-mannosidase (MAN) in pre-hypertensive (high normal blood pressure - HNBP) and normal blood pressure (NBP) children. MATERIAL AND METHODS: The study was carried out with urine samples collected from 176 children, aged 6-17.9 years, divided into 2 groups: 42 HNBP and 134 NBP subjects. The children were stratified depending on systolic and diastolic BP (SBP; DBP): HNBP (SBP and/or DBP greater than or equal to the 90th percentile, but less than the 95th percentile) for sex, age, and height; and NBP (SBP and DBP less than the 90th centile). The activities of lysosomal exoglycosidases were determined by the colorimetric method, and expressed in pKat/mL and pKat/µgCr. RESULTS: The activity of urinary HEX A in HNBP group was significantly higher than in NBP (p < 0.05). The HNBP group showed significant positive correlation between HEX, HEX A (pKat/mL) and SBP. AUC for HEX A was 0.616, cut-off value -29.351 pKat/mL (sensitivity 51.2%, specificity 71.8%), and 0.589, cut-off value -0.054 pKat/µgCr (sensitivity 31.7%, specificity 86.3%). CONCLUSIONS: This is the first report of the relationship between BP and the activity of urinary lysosomal exoglycosidases: HEX, HEX A and HEX B, FUC, GAL, GLU, and MAN in healthy children and adolescents. It seems that HEX A (pKat/mL) can be used as a useful tool in identifying children with HNBP.

Pediatric reference data on activity of urinary N-acetyl-ß-D-hexosaminidase and its isoenzymes.

PURPOSE: The objective of the study was to establish age - dependent values of the urinary lysosomal exoglycosidases activities: N-acetyl-ß-D-hexosaminidase (HEX) and its isoenzyme A (HEX A) as well as isoenzyme B (HEX B) in healthy children and adolescents. MATERIAL AND METHODS: The study was performed using a random sample of 203 healthy children and adolescents (girls=99, boys=104), aged six months to 17.9 years. The activities of HEX, HEX A and HEX B were determined by a colorimetric method. The activities of the urinary HEX and its isoenzymes were expressed in pKat/µg of creatinine (pKat/µg Cr). RESULTS: Median concentrations of urinary HEX, and its HEX A, HEX B isoenzymes in particular age groups were analyzed using ANOVA. Urinary HEX, HEX A and HEX B activities (pKat/µg Cr) were the highest in children below 3 years, in comparison to remaining age groups. There were statistically significant negative correlations between urinary HEX, HEX A as well as HEX B and age (r=-0.24, p<0.001 (HEX); r=-0.20, p<0.01 (HEX A); r=-0.26, p<0.001 (HEX B), respectively. We constructed the reference values for urinary activity of HEX, HEX A and HEX B (pKat/µg Cr) in centiles according to age, in three-year intervals. CONCLUSIONS: Reported data present, for the first time, reference values for urinary activities of HEX and its isoenzymes HEX A and HEX B in children and adolescent.

Quantification of normative ranges and baseline predictors of aortoventricular interface dimensions using multi-detector computed tomographic imaging in patients without aortic valve disease.

BACKGROUND: Multidetector computed tomographic (MDCT) assessment of the aortoventricular interface has gained increased importance with the advent of minimally invasive treatment modalities for aortic and mitral valve disease. This has included a standardised technique of identifying a plane through the nadir of each coronary cusp, the basal plane, and taking further measurements in relation to this plane. Despite this there is no published data defining normal ranges for these aortoventricular metrics in a healthy cohort. This study seeks to quantify normative ranges for MDCT derived aortoventricular dimensions and evaluate baseline demographic and anthropomorphic associates of these measurements in a normal cohort. METHODS: 250 consecutive patients undergoing MDCT coronary angiography were included. Aortoventricular dimensions at multiple levels of the aortoventricular interface were assessed and normative ranges quantified. Multivariate linear regression was performed to identify baseline predictors of each metric. RESULTS: The mean age was 59±12 years. The basal plane was eccentric (EI=0.22±0.06) while the left ventricular outflow tract was more eccentric (EI=0.32±0.06), with no correlation to gender, age or hypertension. Male gender, height and body mass index were consistent independent predictors of larger aortoventricular dimensions at all anatomical levels, while age was predictive of supra-annular measurements. CONCLUSIONS: Male gender, height and BMI are independent predictors of all aortoventricular dimensions while age predicts only supra-annular dimensions. Use of defined metrics such as the basal plane and formation of normative ranges for these metrics allows reference for clinical reporting and for future research studies by using a standardised measurement technique.

Prevalence, clinical and biochemical profile of subclinical hypothyroidism in normal population in Mumbai.

BACKGROUND: Subclinical Hypothyroidism (ScHt) affects 3-15% of the adult population. It's clinical and biochemical profile is not well defined, especially in Indian scenario. Our study aimed at screening normal population to define normative ranges of thyroid hormones and Serum thyroid stimulating hormone (S.TSH) and prevalence of ScHt and thyroid autoimmunity. MATERIALS AND METHODS: Two-hundred thirty-seven normal subjects without family history of thyroid disease were evaluated for symptoms and laboratory tests for thyroid dysfunction and autoimmunity. RESULTS: The thyroid function tests were as follows: EUTHYROID GROUP: MEAN VALUES WERE: T3: 1.79 ± 0.42 ng/mL, T4: 10.23 ± 2.25 µg/dL, FT3: 1.88 ± 0.19 pg/mL, FT4: 1.12 ± 0.21 ng/dL, S.TSH: 2.22 ± 1.06 µlu/mL. 10.2% of euthyroid subjects had antimicrosomal antibodies (AMA) +ve (mean titer 1:918) and 23.6% were anti-thyroid peroxidase autoantibody (anti-TPO) +ve (mean titer 15.06 Au/mL). The euthyroid outlier range for S.TSH was 0.3-4.6 µlu/mL. The values were comparable in both the sexes. Those with S.TSH ≥ 5 µlu/mL were defined to have ScHt. SCHT GROUP: Prevalence of ScHt was 11.3% (M:F ratio 1:3.7). 74% belonged to 35-54 years age group and prevalence increased with age (post-menopausal females: prevalence 20%). S.TSH was 9.8 ± 7.22 µlu/mL, mean S.AMA was 1:5079 (40.7% positivity) and mean S.anti-TPO was 260 Au/mL (47.6% positivity). Majority were agoitrous (74%), and stage I goiter was seen in 26% of this population. Symptom score of 5-8 was seen in 55% ScHt subjects versus 35% normal subjects. CONCLUSION: Mean S.TSH in our population was 2.22 µlu/mL (euthyroid outliers: 0.3-4.6 µlu/mL); hence, S.TSH above 4.6 µlu/mL should be considered as abnormal. The prevalence of thyroid autoimmunity increases after age of 35 years. ScHt presents mainly in agoitrous form and with positive antibodies, suggesting autoimmunity as the cause.