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1.
Int J Legal Med ; 138(3): 983-995, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38279991

RESUMO

Age assessment of migrants is crucial, particularly for unaccompanied foreign minors, a population facing legal, social, and humanitarian challenges. Despite existing guidelines, there is no unified protocol in Europe for age assessment.The Forensic Anthropology Society of Europe (FASE) conducted a comprehensive questionnaire to understand age estimation practices in Europe. The questionnaire had sections focusing on the professional background of respondents, annual assessment numbers, requesting parties and reasons, types of examinations conducted (e.g., physical, radiological), followed protocols, age estimation methods, and questions on how age estimates are reported.The questionnaire's findings reveal extensive engagement of the forensic community in age assessment in the living, emphasizing multidisciplinary approaches. However, there seems to be an incomplete appreciation of AGFAD guidelines. Commonalities exist in examination methodologies and imaging tests. However, discrepancies emerged among respondents regarding sexual maturity assessment and reporting assessment results. Given the increasing importance of age assessment, especially for migrant child protection, the study stresses the need for a unified protocol across European countries. This can only be achieved if EU Member States wholeheartedly embrace the fundamental principles outlined in EU Directives and conduct medical age assessments aligned with recognized standards such as the AGFAD guidelines.


Assuntos
Refugiados , Migrantes , Criança , Humanos , Menores de Idade , Europa (Continente) , Antropologia Forense , Determinação da Idade pelo Esqueleto
2.
Forensic Sci Int ; 352: 111813, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37742459

RESUMO

Virtual Anthropology (VA) transposes the traditional methods of physical anthropology to virtual environments using imaging techniques and exploits imaging technologies to devise new methodological protocols. In this research, we investigate whether the measurements used in the Diagnose Sexuelle Probabiliste (DSP) and Ischio-Pubic Index (IPI) differ significantly when 3D models of a bone are generated using 3D surface scans (3DSS) and Multidetector Computed Tomography (MDCT) scans. Thirty pelvises were selected from the SIMON identified skeletal collection. An equal ratio of females to males was sought, as well as a good preservation of the bones. The pelvises were scanned using an MDCT scanner and a 3D surface scanner. The measurements of the DSP and IPI methods on the dry bones (referred to as macroscopic measurements here), and then to the 3D models. The intra- and interobserver, using the Technical Error of Measurement (TEM) and relative Technical Error of Measurement (rTEM) error was assessed, and we aimed to observe if the measurements made on the MDCT and 3DSS generated models were significantly different from those taken on the dry bones. Additionally, the normality of the data was tested (Shapiro-Wilk test) and the differences in measurements was evaluated using parametric (Student t-tests) and non-parametric (Wilcoxon) tests. The TEM and rTEM calculations show high intra and interobserver consistency in general. However, some measurements present insufficient inter- and intraobserver agreement. Student t and Wilcoxon tests indicate potentially significant differences of some measurements between the different environments. The results show that especially in the virtual environment, it is not easy to find the right angle for some of the DSP measurements, However, when comparing the measurement differences between dry and virtual bones, the results show that most of the differences are less than or equal to 2.5 mm. Considering the IPI, the landmarks are already difficult to determine on the dry bone, but they are even more difficult to locate in the virtual environment. Nevertheless, this study shows that quantitative methods may be better suited for application in the virtual environment, but further research using different methods is needed.


Assuntos
Imageamento Tridimensional , Tomografia Computadorizada Multidetectores , Masculino , Feminino , Humanos , Antropologia Forense/métodos , Osso Púbico , Osso e Ossos
3.
Forensic Sci Int ; 352: 111832, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37776598

RESUMO

Forensic authorities often request age estimation from forensic experts, particularly in cases related to sexual abuse, child pornography, illegal migration, marriage, etc. The most commonly used method in this regard is radiological methods. Because of the potential dangers of radiation exposure outside of clinical indications, new researches are focusing on non-ionizing and non-invasive technologies. This study aimed to demonstrate the applicability of age estimation in living individuals from ankle magnetic resonance images as a non-ionizing method, and to determine whether it is compatible with individuals' real ages and to establish a database. Ankle MRI images of patients aged between 7 and 26 years who applied to the Cukurova University Faculty of Medicine Balcali Hospital between January 2011 and December 2020 were retrospectively evaluated. A six-stage staging method proposed by Lu et al. was applied to the distal tibial and calcaneal epiphyseal ossification points by examining ankle MRI images of a total of 331 patients, 197 males and 134 females. In the study, images obtained from a sagittal section fast spin echo T1-weighted sequence, with a section thickness of 3-4 mm, were evaluated. As a result of the study, Stage 1 in both distal tibial and calcaneal epiphysis was observed only in patients under 18 years of age in both sex. In males, stage 2 in distal tibial epiphyseal ossification was observed under 18 years of age, except for one case, and stage 5 in both distal tibial and calcaneal epiphyseal ossification was observed in almost all cases over 18 years of age in males. According to the results of our study, magnetic resonance imaging was found to be a non-ionizing method that could be used in addition to other radiological methods aimed at determining the 18-year age limit in age estimation. Multicenter, comparative, and prospective studies conducted by experienced researchers are needed to enable the routine use of MRI in age estimation.


Assuntos
Determinação da Idade pelo Esqueleto , Tornozelo , Masculino , Criança , Feminino , Humanos , Adolescente , Adulto , Adulto Jovem , Estudos Retrospectivos , Estudos Prospectivos , Tornozelo/diagnóstico por imagem , Determinação da Idade pelo Esqueleto/métodos , Antropologia Forense , Imageamento por Ressonância Magnética/métodos , Epífises/diagnóstico por imagem , Osteogênese
4.
Forensic Sci Res ; 7(2): 97-105, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35784432

RESUMO

Sex estimation is considered one of the first steps in the forensic identification process. Morphological and morphometrical differences between males and females have been used as means for morphoscopic and metric methods on both cranial and postcranial skeletal elements. When dry skeletal elements are not available, virtual data can be used as a substitute. The present research explores 3-dimensional (3D) scans from a Turkish population to test a sex estimation method developed by Purkait (2005). Overall, 296 individuals were used in this study (158 males and 138 females). Purkait's triangle parameters were measured on computed tomography (CT) scans obtained from both right and left femora of each patient at the Bakirkoy Dr. Sadi Konuk Training Research Hospital (Istanbul, Turkey). Intra- and inter-observer errors were assessed for all variables through technical error of measurements analysis. Bilateral asymmetry and sex differences were evaluated using parametric and non-parametric statistical approaches. Univariate and multivariate discriminant function analyses were then conducted. Observer errors demonstrated an overall agreement within and between experts, as indicated by technical error of measurement (TEM) results. No bilateral asymmetries were reported, and all parameters demonstrated a statistically significant difference between males and females. Fourteen discriminant models were generated by applying single and combined parameters, producing a total correct sex classification ranging from 78.4% to 92.6%. In addition, over 67% of the total sample was accurately classified, with 95% or greater posterior probabilities. Our study demonstrates the feasibility of 3D sex estimation using Purkait's triangle on a Turkish population, with accuracy rates comparable to those reported in other populations. This is the first attempt to apply this method on virtual data and although further validation and standardisation are recommended for its application on dry bone, this research constitutes a significant contribution to the development of population-specific standards when only virtual data are available.Key pointsCT analysis using Purkait's triangle is a suitable tool for assessment of sex in unidentified individuals.The best overall estimation rate was achieved with the F11 model, with around 92% of accuracy.The results suggested 78.4% to 92.6% correct sex identification rates.More research is needed to expand the sample set and verify the results.

5.
Eur J Orthop Surg Traumatol ; 32(3): 413-418, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33939002

RESUMO

PURPOSE: The aim of this study was to compare knee awareness, based on the FJS-12 score, among three patient groups: Anterior cruciate ligament reconstruction (ACLR), ACLR + meniscus repair and ACLR + partial meniscectomy. The relationship between FJS-12 scores and scores on other instruments (Lysholm Knee Scoring Scale, Tegner Activity Level Scale, KOOS and WOMAC) was also evaluated. METHODS: Forty-three patients were divided into group A (isolated ACLR) group B (ACLR + meniscectomy) and group C (ACLR + meniscus repair). Graft thickness, femoral tunnel width, tibial tunnel width, tibial screw thickness and follow-up time were evaluated in all three groups. The subjective knee scores (KOOS, WOMAC, Lysholm Knee Scoring Scale, Tegner Activity Level Scale and FJS-12) of the groups were then compared. RESULTS: FJS-12 scores of 43 patients were evaluated. The mean age was 26.1 ± 6.5 years (range: 18-40 years). Group A: 23; group B: 9 and group C include 11 patients. The mean FJS-12 score of group B (median: 100 [range: 98-100]) was higher than that the others. Spearman's rho test showed that the FJS-12 is highly compatible with the other scores. CONCLUSION: According to this study, FJS-12 and the other scoring systems showed that ACLR with partial meniscectomy is the most effective surgical method to restore normal sensation in the knee.


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Articulação do Joelho , Menisco , Adolescente , Adulto , Lesões do Ligamento Cruzado Anterior/diagnóstico , Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/métodos , Humanos , Articulação do Joelho/cirurgia , Meniscectomia/métodos , Menisco/cirurgia , Sensação , Adulto Jovem
6.
Biology (Basel) ; 10(12)2021 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-34943218

RESUMO

Many cases encountered by forensic anthropologists involve commingled remains or isolated elements. Common methods for analysing these contexts are characterised by limitations such as high degrees of subjectivity, high cost of application, or low proven accuracy. This study sought to test mesh-to-mesh value comparison (MCV), a relatively new method for pair-matching skeletal elements, to validate the claims that the technique is unaffected by age, sex and pathology. The sample consisted of 160 three-dimensional clavicle models created from computed tomography (CT) scans of a contemporary Turkish population. Additionally, this research explored the application of MVC to match fragmented elements to their intact counterparts by creating a sample of 480 simulated fragments, consisting of three different types based on the region of the bone they originate from. For comparing whole clavicles, this resulted in a sensitivity value of 87.6% and specificity of 90.9% using ROC analysis comparing clavicles. For the fragment comparisons, each type was compared to the entire clavicles of the opposite side. The results included a range of sensitivity values from 81.3% to 87.6%. Overall results are promising and the MVC technique seems to be a useful technique for matching paired elements that can be accurately applied to a Modern Turkish sample.

7.
Forensic Sci Int ; 328: 110995, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34583243

RESUMO

Identified (documented) osteological collections represent an important resource in the development of forensic anthropology standards and methods as well as a precious tool for learning and training of practitioners. Even though the number of papers presenting identified collections worldwide increases, many of the collections have still not been divulged to the scientific community in sufficient detail to ascertain their exact number. The Forensic Anthropology Society of Europe (FASE) therefore developed a tool that goes beyond sporadic publications: the FASE Map of Identified Osteological Collections, which is freely accessible and continuously updated and revised. The online map is available at http://forensicanthropology.eu/osteological-collections/. The map of skeletal collections was created in 2017 and currently displays information on 153 identified osteological collections (43 of them categorized as contemporary) located in 41 different countries. This article offers a short analysis of the type, geographical location and content of the collections included in the map. The aim of this article and the map as such is to provide a useful resource to facilitate research planning and teaching in forensic anthropology and related disciplines.


Assuntos
Antropologia Forense , Osso e Ossos , Europa (Continente) , Sociedades
8.
Cureus ; 13(6): e15472, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34262810

RESUMO

AIM: The posterior tibial slope (PTS) is important in planning many orthopedic procedures. The aim of the study is to outline a PTS measurement method using multiplanar reconstruction (MPR) in knee computed tomography (CT) images. METHODS: MPR reconstruction was performed on pre-captured CT angio images of 124 patients. A standard tibial axis was created. Then, using reference points, the PTS was measured separately for the medial PTS (MPTS) and lateral PTS (LPTS). To identify an intra- and interobserver error, the technical error of measurement (TEM), relative TEM (rTEM), and coefficient of reliability (R) of the measurement were analyzed. RESULTS: The study enrolled 124 patients (88 males, 36 females) from 18 to 92 years old. The average MPTS 8.63 ± 2.7° and LPTS 7.77 ± 3.1° were significantly different (p < 0.05). However, there was no difference between the sexes (p = 0.52 for MPTS; p = 0.9 for LPTS). The R for intraobserver reliability was 0.942 for the MPTS and 0.943 for the LPTS, and that for interobserver reliability was 0.815 and 0.806, respectively. CONCLUSIONS: PTS measurement from CT images appears advantageous as it eliminates measurement limitations due to tibial rotation and has high intra- and interobserver consistency.

9.
Int J Legal Med ; 135(4): 1573-1580, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33611667

RESUMO

Since forensic age estimation is not a valid medical indication, research on the use of nonionizing methods is increasing. Ultrasonography is a radiological approach that protects patients from radiation exposure and offers special convenience to them. In this study, ultrasonography was used for age estimation by investigating the degree of ossification of the distal radial epiphysis. Its applicability on the Turkish population was investigated. The left wrist of 688 (322 males, 366 females) patients between the ages of 9 and 25 years was prospectively evaluated by ultrasonography. The intra- and interobserver reliabilities in evaluating the distal radial epiphysis and Cohen's kappa statistics show that the interobserver error was very low, and the kappa value was found to be 0.919. Stage 3 and 4 ossification of the distal radial epiphysis was first detected at age 14.3 and 15.3 years in males and 12.7 and 14.8 years in females, respectively. The data obtained may help determine legally critical age limits of 14 and 15. Although it does not seem useful for the age of 18, ultrasonography may be recommended in selected cases as a fast, inexpensive, frequently reproducible radiological method without concern about radiation and without a predictable health risk.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Osteogênese , Rádio (Anatomia)/diagnóstico por imagem , Punho/diagnóstico por imagem , Adolescente , Criança , Epífises/crescimento & desenvolvimento , Feminino , Humanos , Masculino , Estudos Prospectivos , Turquia , Ultrassonografia , Adulto Jovem
10.
Int J Legal Med ; 135(5): 1953-1964, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33544176

RESUMO

Sex estimation from skeletal remains is crucial for the estimation of the biological profile of an individual. Although the most commonly used bones for means of sex estimation are the pelvis and the skull, research has shown that acceptable accuracy rates might be achieved by using other skeletal elements such as vertebrae. This study aims to contribute to the development of sex estimation standards from a Turkish population through the examination of CT scans from the seven cervical vertebrae. A total of 294 individuals were included in this study. The CT scans were obtained from patients attending the Bakirkoy Training and Research Hospital (Turkey) and the data was collected retrospectively by virtually taking measurements from each cervical vertebrae. The full database was divided into a training set (N = 210) and a validation set (N = 84) to test the fit of the models. Observer error was assessed through technical error of measurement and sex differences were explored using parametric and non-parametric approaches. Logistic regression was applied in order to explore different combinations of vertebral parameters. The results showed low intra- and inter-observer errors. All parameters presented statistically significant differences between the sexes and a total of 15 univariate and multivariate models were generated producing accuracies ranging from a minimum of 83.30% to a maximum of 91.40% for a model including three parameters collected from four vertebrae. This study presents a virtual method using cervical vertebrae for sex estimation on the Turkish population providing error rates comparable to other metric studies conducted on the postcranial skeleton. The presented results contribute not only to the development of population-specific standards but also to the generation of virtual methods that can be tested, validated, and further examined in future forensic cases.


Assuntos
Vértebras Cervicais/anatomia & histologia , Determinação do Sexo pelo Esqueleto/métodos , Adolescente , Adulto , Vértebras Cervicais/diagnóstico por imagem , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Determinação do Sexo pelo Esqueleto/estatística & dados numéricos , Tomografia Computadorizada por Raios X , Turquia , Adulto Jovem
11.
Int J Legal Med ; 135(4): 1611-1616, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33506297

RESUMO

Radiation exposure is a crucial factor to consider in forensic age estimation. The various magnetic resonance imaging (MRI) modalities used in forensic age estimation avoid radiation exposure. This study examined the reliability of distal radius ossification using fast spin-echo proton density (FSE PD)-weighted MRI to estimate age. Left wrist MRI findings of 532 patients aged 10-29 years were evaluated retrospectively using the five-stage system of Dedouit et al. The intra- and interobserver reliability values were κ = 0.906 and 0.869, respectively. Based on the results, the respective minimum ages estimated for stages 4 and 5 were 13.4 and 16.1 years for females, and 15.1 and 17.3 years for males; the method could not estimate an age of 18 years in any case. FSE PD MRI analysis of the distal radius epiphysis provides supportive data and can be used when evaluating the distal radius for forensic age estimation.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Imageamento por Ressonância Magnética/métodos , Osteogênese , Rádio (Anatomia)/diagnóstico por imagem , Punho/diagnóstico por imagem , Adolescente , Adulto , Criança , Epífises/diagnóstico por imagem , Feminino , Humanos , Masculino , Estudos Retrospectivos , Adulto Jovem
12.
Int J Legal Med ; 135(2): 631-637, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32839871

RESUMO

The evaluation of epiphyseal areas by magnetic resonance imaging (MRI) for forensic age estimation is an important supportive diagnostic method to prevent repeated radiation exposure without a valid medical reason. There are still not enough individuals being analyzed with MRI for age estimation. The aim of this study was to investigate the utility of T1-weighted turbo spin echo (T1-TSE) MRI sequences in determining the degree of ossification of the distal femoral and proximal tibial epiphyses in a Turkish population. In this study, images from 649 patients (335 males and 314 females) aged 10-30 years were retrospectively evaluated with sagittal T1-weighted turbo spin echo (T1-TSE) MRI sequences of the knee. Proximal tibial and distal femoral epiphysis were scored by two different observers twice using the combined staging system described by Schmeling and Kellinghaus. Spearman's rank correlation analysis indicated a significant positive relationship between age and ossification stages of the distal femoral and proximal tibial epiphyses (p < 0.001). The intra- and inter-observer reliabilities in evaluating the femur and tibia were separately determined and gave promising results and Cohen's kappa statistics ranged from κ = 0.886 and κ = 0.961. The minimal ages of patients with stage 4 ossification were 15.1 years for females and 15.8 years for males for the distal tibial epiphysis and 15.4 years for females and 17 years for males for the distal femoral epiphysis. This study show that (T1-TSE) MRI and the applicability and Schmeling and Kellinghaus staging method of the knee can be performed for living 14- to 17-year-old individuals in need of a supportive noninvasive method for estimating forensic age.


Assuntos
Determinação da Idade pelo Esqueleto , Epífises/diagnóstico por imagem , Fêmur/diagnóstico por imagem , Joelho/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Osteogênese/fisiologia , Tíbia/diagnóstico por imagem , Adolescente , Adulto , Criança , Epífises/crescimento & desenvolvimento , Feminino , Fêmur/crescimento & desenvolvimento , Humanos , Masculino , Tíbia/crescimento & desenvolvimento , Turquia/epidemiologia , Adulto Jovem
13.
Am J Forensic Med Pathol ; 42(2): 147-154, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33148968

RESUMO

ABSTRACT: Age estimation in forensic medicine practice is of particular importance to the legal systems, and it is one of the current research topics in forensic medicine. Age determination is most frequently performed by radiological methods, but recently, nonionized methods are preferred for nonmedical indications. Therefore, we aimed to examine feasibility of MRI imaging, which provides nonionized, noninvasive, and detailed images, in forensic age estimation and to expand the database on this subject. The MRI images of the patients between the ages of 10 and 25 years, who visited Cukurova University Faculty of Medicine between January 2012 and April 2018 for any reason, were retrospectively analyzed according to the staging method described by Dedouit et al. The stage 5 ossification in distal femoral epiphysis indicated an age over 18 years in both sexes (except for 2 cases of 14 and 15 years). The stage 5 ossification in proximal tibial epiphysis indicated an age older than 18 years (except for 1 male case at the age of 15 years and 2 female cases at the age of 14 and 17 years, respectively). It was determined that stage 1 and stage 2 in both distal femur and proximal tibial epiphysis were last seen in younger than 18 years in both sexes. Our study data show that MRI imaging is a nonionized method that can be used in addition to other radiological methods in determining the age limit of 18 years.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Epífises/diagnóstico por imagem , Fêmur/diagnóstico por imagem , Imageamento por Ressonância Magnética , Osteogênese , Tíbia/diagnóstico por imagem , Adolescente , Adulto , Criança , Epífises/crescimento & desenvolvimento , Feminino , Fêmur/crescimento & desenvolvimento , Humanos , Masculino , Estudos Retrospectivos , Tíbia/crescimento & desenvolvimento , Adulto Jovem
14.
Int J Legal Med ; 134(6): 2229-2237, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32778923

RESUMO

With increases in migration across borders, age estimation in living individuals of not (reliably) documented identity becomes all the more important. Unfortunately, there are not many age indicators that can be used for this purpose, and human variation requires specific methodical approaches. In this paper, a recently proposed age marker to assess the age around the critical age limit of 18 completed years is tested. The method uses apophyseal development of cervical vertebrae 2, 3 and 4. Here CT scans of a large sample of Turkish individuals (n = 1276) were assessed, and likelihoods of being 18 years at a given stage were calculated. The likelihood of being at least 18 years for stages 0, 1 and 2 were zero or close to zero in both males and females. By the time that stage 4 was reached, the likelihood to be 18 years were between 65 and 70% (depending on the vertebra) in females and 81 and 90% in males. In comparison to South Africans, the Turkish individuals developed earlier, but the likelihoods of being 18 years were lower at stage 4 as some individuals were still judged to be in stage 3 well into their twenties. Although fairly variable, this method is a valuable new addition to the modalities that can be used for age assessment in the living. CT scans seemed to provide good visualization of the structures in question, although in actual forensic cases the high radiation dose may be problematic.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/crescimento & desenvolvimento , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Tomografia Computadorizada por Raios X , Turquia , Adulto Jovem
15.
Surg Radiol Anat ; 42(6): 673-679, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32052159

RESUMO

PURPOSE: Posterior tibial inclination of the knee joint should be considered during anterior cruciate ligament reconstruction and total knee replacement surgery. This inclination is called the posterior tibial slope (PTS) angle. The PTS differs among populations and the aim of this study was to determine the mean PTS in a Turkish population. METHODS: PTS was measured retrospectively on lateral knee X-rays (n = 1024). The angle between the line connecting the anterior and posterior points of the lateral tibial plateau and the tibial longitudinal axis was taken as the PTS angle. Intra- and inter-observer agreement regarding the measurements on 20 X-rays were checked. RESULTS: The mean PTS angle for the entire cohort was 8.36 ± 3.3° (range: 2.1-18.7°); it was 8.57 ± 3.4° (range: 2.3-17.4°) in men and 8.16 ± 3.2° (range: 2.1-18.7°) in women. Although no significant correlation was detected between PTS and age, PTS was higher in men than in women. CONCLUSION: The increasing number of total knee replacement surgeries has increased the need for studies on implant mismatch. In this study, reference PTS values were determined for a Turkish population. It may be beneficial to use patient-specific implants in some cases.


Assuntos
Reconstrução do Ligamento Cruzado Anterior/métodos , Artroplastia do Joelho/instrumentação , Osteoartrite do Joelho/cirurgia , Tíbia/anatomia & histologia , Adulto , Fatores Etários , Idoso , Artroplastia do Joelho/métodos , Fenômenos Biomecânicos , Feminino , Humanos , Articulação do Joelho/anatomia & histologia , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Prótese do Joelho , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Radiografia , Valores de Referência , Estudos Retrospectivos , Fatores Sexuais , Tíbia/diagnóstico por imagem , Tíbia/cirurgia , Turquia
16.
Int J Legal Med ; 134(1): 375-380, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31713678

RESUMO

Magnetic resonance imaging is currently being studied extensively, but it is still far from being the frequently recommended radiological method for age estimation. In this study, we used magnetic resonance imaging (MRI) of distal radius ossification to obtain data for age estimation. Wrist MRI scans from 338 individuals, aged 10-29 years, were examined retrospectively using the staging system of Schmidt et al. and the extension of the stages as described by Timme et al. The results revealed that the minimum ages for stage 4a ossification were 16.0 years in women and 17.7 years in men, whereas those for stage 4b ossification were 16.6 and 18.2 years in women and men, respectively. Stage 5 was not detected in any patient. These results were comparable with those of a previous study using the same methodology with distal radial epiphysis ossification. Our finding regarding stage 4b ossification may provide valuable information on legally important age thresholds relevant to the use of MRI in evaluating the distal radial epiphysis in males. Further research needs to be conducted with large series in different populations to evaluate the triple banding at the distal radial epiphysis.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Imageamento por Ressonância Magnética , Osteogênese , Rádio (Anatomia)/diagnóstico por imagem , Adolescente , Adulto , Distribuição por Idade , Criança , Epífises/diagnóstico por imagem , Feminino , Humanos , Masculino , Estudos Retrospectivos , Distribuição por Sexo , Estatísticas não Paramétricas , Punho/diagnóstico por imagem , Adulto Jovem
17.
Forensic Sci Int ; 299: 223-228, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31055136

RESUMO

Ancestry estimation from skeletal remains is a challenging task, but essential for the creation of a complete biological profile. As such, the study of human variation between populations is important for the fields of biological and forensic anthropology, as well as medicine. Cranial and dental morphological variation have traditionally been linked to geographic affinity resulting in several methods of ancestry estimation, while the postcranial skeleton has been systematically neglected. The current study explores metric variation of the tibia in six Mediterranean populations and its validity in estimating ancestry in the Mediterranean. The study sample includes 909 individuals (470 males and 439 females) from Cyprus, Greece, Italy, Spain, Portugal and Turkey. The sample was divided in two subsamples: a reference and a validation sample. Multinomial regression models were created based on the reference sample and then applied to validation sample. The first model used three variables and resulted in 57% and 56% accuracy for the two samples respectively, while the second model (6 variables) resulted in 80% and 74% respectively. Classification between groups ranged from 28% to 95% for the reference sample and from 15% to 91% for the validation sample. The highest classification accuracy was noted for the Greek sample (95% and 90% for the reference and validation sample respectively), followed by the Turkish sample (74% and 78% respectively). The Spanish, Portuguese and Italian samples presented greater morphological overlap which resulted in lower classification accuracies. The results indicate that although the tibia presents considerable variation amongst neighbour populations it is not suitable as a sole skeletal element to separate all groups successfully. A combination of different skeletal elements may be required in order to achieve the levels of reliability required for forensic applications.


Assuntos
Antropologia Forense/métodos , Tíbia/anatomia & histologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Modelos Logísticos , Masculino , Região do Mediterrâneo , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
18.
Int J Legal Med ; 133(1): 249-256, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30334085

RESUMO

The most commonly used radiological method for age estimation of living individuals is X-ray. Computed tomography is not commonly used due to high radiation exposure, which raises ethical concerns. This problem can be solved with the use of magnetic resonance imaging (MRI), which avoids the use of ionizing radiation. The purpose of the present study was to evaluate the utility of MRI analysis of the proximal humeral epiphyses for forensic age estimations of living individuals. In this study, 395 left proximal humeral epiphyses (patient age 12-30 years) were evaluated with fast-spin-echo proton density-weighted image (FSE PD) sequences in a coronal oblique orientation on shoulder MRI images. A five-stage scoring system was used following the method of Dedouit et al. The intra- and interobserver reliabilities assessed using Cohen's kappa statistic were κ = 0.818 and κ = 0.798, respectively. According to this study, stage five first appeared at 20 and 21 years of age in males and females, respectively. These results are not directly comparable to any other published study due to the lack of MRI data on proximal humeral head development. These findings may provide valuable information for legally important age thresholds using shoulder MRI. The current study demonstrates that MRI of the proximal humerus can support forensic age estimation. Further research is needed to establish a standardized protocol that can be applied worldwide.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Epífises/diagnóstico por imagem , Epífises/crescimento & desenvolvimento , Úmero/diagnóstico por imagem , Osteogênese , Adolescente , Adulto , Criança , Estudos Transversais , Feminino , Antropologia Forense , Humanos , Imageamento por Ressonância Magnética , Masculino , Reprodutibilidade dos Testes , Estudos Retrospectivos , Turquia , Adulto Jovem
19.
Int J Legal Med ; 133(1): 241-248, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29804276

RESUMO

This work investigates the value of magnetic resonance imaging analysis of proximal epiphyseal fusion in research examining the growth and development of the humerus and its potential utility in establishing forensic age estimation. In this study, 428 proximal humeral epiphyses (patient age, 12-30 years) were evaluated with T1-weighted turbo spin echo (T1 TSE) sequences in coronal oblique orientation on shoulder MRI images. A scoring system was created following a combination of the Schmeling and Kellinghaus methods. Spearman's rank correlation analysis revealed a significant positive relationship between age and ossification stage of the proximal humeral epiphysis (all subjects: rho = 0.664, p < 0.001; males: 0.631, p < 0.001; females: rho = 0.651, p < 0.001). The intra- and inter-observer reliability assessed using Cohen's kappa statistic was κ = 0.898 and κ = 0.828, respectively. The earliest age of epiphysis closure was 17 years for females and 18 years for males. MRI of the proximal humeral epiphysis can be considered advantageous for forensic age estimation of living individuals in a variety of situations, ranging from monitoring public health to estimating the age of illegal immigrants/asylum seekers, minors engaged in criminal activities, and illegal participants in competitive sports, without the danger of radiation exposure.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Epífises/diagnóstico por imagem , Epífises/crescimento & desenvolvimento , Cabeça do Úmero/diagnóstico por imagem , Osteogênese , Adolescente , Adulto , Criança , Feminino , Antropologia Forense , Humanos , Imageamento por Ressonância Magnética , Masculino , Reprodutibilidade dos Testes , Turquia , Adulto Jovem
20.
Forensic Sci Int ; 286: 265.e1-265.e8, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29576396

RESUMO

The estimation of ancestry is an essential benchmark for positive identification of heavily decomposed bodies that are recovered in a variety of death and crime scenes. This is especially true when reconstructing the biological profile of the deceased as most methods for sex, age and stature estimation are population-specific. Ancestry estimation methods vary from traditional morphological assessment of cranial features and biometric quantification to computer-aided shape analysis and classification with specialised software. The current paper aims to explore population differences between three neighbouring countries (Greece, Cyprus and Turkey) that have been in constant interaction through conflicts and population movements from the ancient past to the present day, through cranial measurements. The sample consists of 160 dry crania of Greek origin, 137 dry crania of Greek-Cypriot of origin Cyprus and 380 CT scans from Turks individuals. Twelve measurements were taken in both dry and virtual skulls. Data were submitted to principal component analysis and discriminant function analysis. Intra- and inter-observer error as well as the measurement error between virtual and physical measurements were quantified using TEM, rTEM and R. Measurement error was very low in all cases. Classification accuracy for cross-validated data ranged from 74.1 to 97.9%. The highest accuracy was obtained for the Turks sample both in males and females. The results are in accordance with genetic data on the three populations. These results create great confidence in the application of the produced functions in forensic cases requiring ancestry estimation in Cyprus, specifically to unidentified individuals from the 1974 conflict. In addition, these standards can be applied in other forensic situations where ethnicity is an issue but the geographic area of origin is limited to the area encompassing Turkey, Cyprus and Greece.


Assuntos
Cefalometria , Antropologia Forense/métodos , Crânio/anatomia & histologia , Crânio/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Chipre , Análise Discriminante , Feminino , Grécia , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Análise de Componente Principal , Turquia , Adulto Jovem
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