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1.
Am J Orthod Dentofacial Orthop ; 156(3): 383-390, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474268

RESUMO

INTRODUCTION: The aim of this study was to evaluate the height growth of Class I and III orthodontic patients according to the Fishman skeletal maturation index (SMI) and to compare it with that of a general population. METHODS: The study sample included 81 Class I and 71 Class III adolescents who had height measurements and hand-wrist radiographs taken annually and categorized according to SMI. Height completion rate, residual height, height increase per sequential SMI stage, and height velocity were analyzed. Sex differences were evaluated and comparisons between Class I and Class III groups were made. In addition, the height of orthodontic patients was indirectly compared with that of the general population. RESULTS: In boys and girls, height completion rate was >90% at SMI 6, residual height was fewer than 10 cm at SMI 7, and height increase per sequential SMI stage was greatest from SMI 6 to SMI 7. Height velocity was greatest from SMI 5 to SMI 6 in boys and from SMI 4 to SMI 5 in girls. CONCLUSIONS: There was no significant difference in body height parameters for all SMI stages between Class I and Class III adolescents. Adolescents who had orthodontic treatment were not shorter in stature at growth completion compared with the general population.


Assuntos
Estatura , Má Oclusão de Angle Classe III/terapia , Má Oclusão de Angle Classe II/terapia , Ortodontia Corretiva , Adolescente , Determinação da Idade pelo Esqueleto , Desenvolvimento Ósseo , Criança , Feminino , Gráficos de Crescimento , Mãos/diagnóstico por imagem , Mãos/crescimento & desenvolvimento , Ossos da Mão/diagnóstico por imagem , Ossos da Mão/crescimento & desenvolvimento , Humanos , Estudos Longitudinais , Masculino , Radiografia , República da Coreia , Estudos Retrospectivos , Fatores Sexuais , Punho/diagnóstico por imagem , Punho/crescimento & desenvolvimento
2.
Anthropol Anz ; 76(2): 91-93, 2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-30816406

RESUMO

The relationship between the length of the second and fourth ring finger (2D:4D ratio) is a sexually dimorphic trait, higher in females than in males. It is established during early prenatal development under the influence of sex hormones, as demonstrated in numerous studies both in humans and in mice. The current study involves patients with congenital GH/IGF-1 deficiency, a population not yet investigated. The 2D:4D ratio was measured from hand x-rays and compared with normal hand x-rays taken from the Greulich & Pyle Atlas. The analyses of our results revealed that patients with congenital GH/IGF-1 deficiency show an identical 2D:4D ratio for both sexes, but a higher (more feminine) ratio than the normal population. These findings may be explained by a higher estrogen effect resulting from the absence of a functional GH-IGF-1 axis prenatally.


Assuntos
Fator de Crescimento Insulin-Like I , Caracteres Sexuais , Animais , Feminino , Dedos/crescimento & desenvolvimento , Mãos/crescimento & desenvolvimento , Humanos , Fator de Crescimento Insulin-Like I/deficiência , Masculino , Camundongos , Gravidez , Radiografia
3.
J Anat ; 233(6): 828-842, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30368800

RESUMO

Whether the 1st segment of the human autopod 1st ray is a 'true' metapodial with loss of the proximal or mid phalanx or the original basal phalanx with loss of the metacarpal has been a long-lasting discussion. The actual knowledge of the developmental pattern of upper autopod segments at a fetal age of 20-22 weeks, combined with X-ray morphometry of normal long bones of the hand in the growing ages, was used for analysis of the parameters, percentage length, position of epiphyseal ossification centers and proximal/distal growth rate. The symmetric growth pattern in the fetal anlagen changed to unidirectional in the postnatal development in relation to epiphyseal ossification formation. The percentage length assessment, the distribution of the epiphyseal ossification centers, and differential proximal/distal growth rate among the growing hand segments supported homology of most proximal segment of the thumb with the 2nd-5th proximal phalanges and that of the proximal phalanx of the thumb with the 2nd-5th mid phalanges in the same hand. Published case reports of either metanalysis of 'triphalangeal thumb' and 'proximal/distal epiphyseal ossification centers' were used to support the applied morphometric methodology; in particular, the latter did not give evidence of growth pattern inversion of the proximal segment of the thumb. The presented data support the hypothesis that during evolution, the lost segment of the autopod 1st ray is the metacarpal.


Assuntos
Mãos/embriologia , Mãos/crescimento & desenvolvimento , Ossos Metacarpais/embriologia , Ossos Metacarpais/crescimento & desenvolvimento , Adolescente , Criança , Pré-Escolar , Humanos , Lactente
4.
Pediatr Neurol ; 86: 52-56, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30057144

RESUMO

BACKGROUND: The aims of the study were (1) to assess hand sensibility in healthy young children using instruments validated for adults; (2) to identify which test tools are suitable; and (3) to compare the dominant and nondominant sides. METHODS: Twenty-five healthy children aged seven to 11 years (mean = 9.5 years) were investigated. Sensibility was assessed with the Semmes-Weinstein monofilament test, two-point discrimination, localization test, and stereognosis object recognition. RESULTS: The thinnest Semmes-Weinstein filament (D = 2.83 mm) was felt at 94% of examined points. A two-point discrimination at the smallest distance of 2 mm was found in the thumb in 84% of children and in the index finger in 94%. Only 60% felt this distance in the fifth digit. The difference between little finger and index finger was statistically significant. Near-maximum value on the localization test was scored in both hands. All children had a 100% score for both hands in the stereognosis object recognition. CONCLUSIONS: Most children can detect touch in the digits at low pressure. The majority are able to discern two points 2 mm apart in the first and second digits, but significantly less so in the fifth digit. Children are well able to localize on which side of a fingertip pressure is applied. Objects are recognized well. There appear to be no differences between the dominant and nondominant hands in either test. Adjustment of sensory test protocols routinely used in adults is necessary to optimize hand sensation testing in children, in view of the detection limits.


Assuntos
Mãos , Tato , Criança , Mãos/crescimento & desenvolvimento , Mãos/fisiologia , Humanos , Detecção de Sinal Psicológico , Tato/fisiologia
5.
Eur. j. anat ; 22(4): 317-322, jul. 2018. tab
Artigo em Inglês | IBECS | ID: ibc-179095

RESUMO

The length ratio of the second to the fourth finger (2D:4D) is a possible biomarker of prenatal sex hormone levels, which play a significant role in determining the sex-related body traits. The aim of this study was to assess the association between the 2D:4D ratio and morphological characteristics, related to sexual dimorphism. We analyzed a group of Russian males (N = 169) and females (N = 193) aged between 17 and 27 years (with mean ages of 18.6±1.50 and 18.9±1.85, respectively) for the association between the 2D:4D ratio and a wide range of morphological characteristics, some of which were considered in this aspect for the first time. The 2D:4D ratio in males was significantly lower than in females (p ˂ 0.000). A highly statistically significant correlation was found between 2D:4D and sexually dimorphic morphological traits in the total sample. The association of 2D:4D ratio with morphological signs of masculinity/femininity within male and female samples were revealed only as a trend, which was more distinct for the functional indicators (handgrip strength)


No disponible


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Dedos/anatomia & histologia , Caracteres Sexuais , Mãos/crescimento & desenvolvimento , Desenvolvimento Fetal/fisiologia , Testosterona , Federação Russa , Identidade de Gênero , Pesos e Medidas Corporais/métodos , Força da Mão
6.
Cereb Cortex ; 27(11): 5385-5397, 2017 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-28968653

RESUMO

Functional lateralization can be an indicator of brain maturation. We have consistently shown that, in the adult brain, proprioceptive processing of muscle spindle afferents generating illusory movement of the right hand activates inferior frontoparietal cortical regions in a right-side dominant manner in addition to the cerebrocerebellar motor network. Here we provide novel evidence regarding the development of the right-dominant use of the inferior frontoparietal cortical regions in humans using this task. We studied brain activity using functional magnetic resonance imaging while 60 right-handed blindfolded healthy children (8-11 years), adolescents (12-15 years), and young adults (18-23 years) (20 per group) experienced the illusion. Adult-like right-dominant use of the inferior parietal lobule (IPL) was observed in adolescents, while children used the IPL bilaterally. In contrast, adult-like lateralized cerebrocerebellar motor activation patterns were already observable in children. The right-side dominance progresses during adolescence along with the suppression of the left-sided IPL activity that emerges during childhood. Therefore, the neuronal processing implemented in the adult's right IPL during the proprioceptive illusion task is likely mediated bilaterally during childhood, and then becomes right-lateralized during adolescence at a substantially later time than the lateralized use of the cerebrocerebellar motor system for kinesthetic processing.


Assuntos
Lateralidade Funcional/fisiologia , Ilusões/fisiologia , Lobo Parietal/crescimento & desenvolvimento , Lobo Parietal/fisiologia , Propriocepção/fisiologia , Adolescente , Mapeamento Encefálico , Criança , Feminino , Mãos/crescimento & desenvolvimento , Mãos/fisiologia , Humanos , Imagem por Ressonância Magnética , Masculino , Movimento/fisiologia , Lobo Parietal/diagnóstico por imagem , Estimulação Física , Psicofísica , Vibração , Adulto Jovem
7.
Clin Plast Surg ; 44(4): 865-873, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28888311
8.
Handchir Mikrochir Plast Chir ; 49(1): 20-28, 2017 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-28423439

RESUMO

Congenital hand malformations are rare, but hand function and aesthetics cannot be improved by surgery in every affected child. However, whenever this is possible, it is important to create an individual surgical plan for each child. Growth has to be taken into account in the accurate planning of incisions and local flaps. Just because it is technically possible, not every flap should be used in the malformed child's hand. In the following article, we present a collection of reliable flaps in the surgery of the congenitally malformed hand.


Assuntos
Deformidades Congênitas da Mão/cirurgia , Retalhos Cirúrgicos/cirurgia , Criança , Estética , Mãos/crescimento & desenvolvimento , Mãos/cirurgia , Humanos , Comunicação Interdisciplinar , Colaboração Intersetorial , Destreza Motora , Planejamento de Assistência ao Paciente , Prognóstico , Ferida Cirúrgica
9.
Diagn Interv Radiol ; 23(3): 194-198, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28345523

RESUMO

PURPOSE: We aimed to establish a practical method to evaluate skeletal age using cervical vertebrae. METHODS: The study consisted of hand-wrist and cephalometric radiographs of 324 subjects (167 girls, 157 boys; age range, 7.3-17.2 years). Skeletal ages of the subjects were calculated from hand-wrist radiographs, and cervical vertebral bodies were measured using cephalometric radiographs. A single formula based on C3 and C4 vertebral body heights with different coefficients for each gender was derived using ridge regression analysis. RESULTS: The correlation coefficients for vertebral and hand-wrist bone age were 0.825 and 0.856 for girls and boys, respectively. The correlations among vertebral bone age and C3 and C4 vertebral body heights were also found to be significant. The intraclass correlation (ICC) score was found to be 0.914, which shows high consistency between the two measurements of the same investigator for each C3 and C4 vertebral body height result. CONCLUSION: The formula derived for evaluating skeletal age in cephalometric radiographs is reliable and can be applied to both girl and boy subjects for legal requirements or therapeutic needs of age estimation.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Cefalometria/instrumentação , Vértebras Cervicais/crescimento & desenvolvimento , Mãos/crescimento & desenvolvimento , Articulação do Punho/crescimento & desenvolvimento , Punho/crescimento & desenvolvimento , Adolescente , Cefalometria/métodos , Vértebras Cervicais/anatomia & histologia , Vértebras Cervicais/diagnóstico por imagem , Criança , Feminino , Mãos/diagnóstico por imagem , Humanos , Masculino , Reprodutibilidade dos Testes , Estudos Retrospectivos , Punho/diagnóstico por imagem , Articulação do Punho/diagnóstico por imagem
10.
J Electromyogr Kinesiol ; 30: 231-7, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27541386

RESUMO

Falling on the outstretched hands (FOOSH), a protective mechanism to arrest the body and avoid injury, requires upper limb and trunk motor control for effective body descent. The purpose of this study was to investigate muscle activity during three phases of an unexpected FOOSH in healthy older and younger women. Twenty young (mean age 22.9yrs, SD±3.7) and 20 older females (mean age 68.1yrs, SD±5.0) performed five trials of unexpected FOOSHs. Surface electromyography (EMG) determined muscle activations for left shoulder girdle, elbow and abdominal muscles during an unexpected FOOSH. Root mean squared EMG data were calculated during three phases: (1) baseline (BL; 500msprior to release), (2) the preparatory phase (PRE; time between release and impact) (mean 257±37ms) and post-impact (POST; 200msafter impact). A mixed MANOVA determined differences between phases and age groups. There was a significant multivariate interaction effect of age and time phase on muscle activity (p=0.001). Younger women had significantly higher internal oblique/transversus abdominus activity during PRE (p=0.006) as well as variations in muscle activity of shoulder girdle and elbow muscles. The age differences observed may lead to poorer preliminary trunk activation and greater arm bracing in older women, potentially increasing risk of fallrelated injury.


Assuntos
Acidentes por Quedas , Envelhecimento/fisiologia , Mãos/fisiologia , Músculo Esquelético/fisiologia , Tronco/fisiologia , Adolescente , Adulto , Idoso , Fenômenos Biomecânicos , Eletromiografia , Feminino , Mãos/crescimento & desenvolvimento , Humanos , Pessoa de Meia-Idade , Músculo Esquelético/crescimento & desenvolvimento , Equilíbrio Postural , Tronco/crescimento & desenvolvimento
11.
Pediatr Endocrinol Rev ; 13(1): 444-7, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26540759

RESUMO

Bone (skeletal) age determination is the simplest and most used index for the assessment of developmental and physiological age in healthy children and those with growth disorders. At present the test is done by manual or automated reading of the hand and wrist X-rays, necessitating two visits by the child: to the pediatrician and radiology departments. A newly developed simple quantitative ultrasound technique (QUST) using several hand and wrist bones, which can be performed in the pediatrician's office could combine the child's growth and biological age evaluation in one visit.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Determinação da Idade pelo Esqueleto/normas , Adolescente , Desenvolvimento Ósseo , Criança , Pré-Escolar , Grupos Étnicos , Feminino , Mãos/diagnóstico por imagem , Mãos/crescimento & desenvolvimento , Humanos , Lactente , Recém-Nascido , Masculino , Ultrassonografia , Punho/diagnóstico por imagem , Punho/crescimento & desenvolvimento , Adulto Jovem
12.
Actas dermo-sifiliogr. (Ed. impr.) ; 106(7): 533-544, sept. 2015. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-143899

RESUMO

El manejo del eczema de manos es complejo, ya que engloba eczemas de etiopatogenia, curso y pronóstico muy diferentes; la mayoría de tratamientos disponibles no cuentan con niveles de eficacia establecidos, y en sus formas graves la calidad de vida se afecta de forma importante. La educación del paciente, las medidas de protección y el uso de emolientes constituyen un pilar fundamental en el abordaje de estos pacientes. Los corticoides tópicos de alta potencia son el tratamiento de elección, seguidos de los inhibidores de la calcineurina para el mantenimiento de la enfermedad. En los casos refractarios a estos tratamientos deberíamos utilizar la fototerapia o tratamientos sistémicos, los cuales no deberían demorarse para evitar sensibilizaciones, bajas laborales y alteración en la calidad de vida. La alitretinoína es el único tratamiento oral disponible que ha sido aprobado para su utilización en el eczema crónico de manos


Management of hand eczema is complex because of the broad range of different pathogeneses, courses, and prognoses. Furthermore, the efficacy of most available treatments is not well established and the more severe forms can have a major impact on the patient's quality of life. Patient education, preventive measures, and the use of emollients are the mainstays in the management of hand eczema. High-potency topical corticosteroids are the treatment of choice, with calcineurin inhibitors used for maintenance. Phototherapy or systemic treatments are indicated in patients who do not respond to topical treatments. Switching from topical treatments should not be delayed to avoid sensitizations, time off work, and a negative impact on quality of life. Alitretinoin is the only oral treatment approved for use in chronic hand eczema


Assuntos
Feminino , Humanos , Masculino , Eczema/metabolismo , Eczema/patologia , Mãos/patologia , /normas , Calcineurina/provisão & distribução , Terapêutica/métodos , Qualidade de Vida/psicologia , Prevenção Primária/métodos , Prevenção Secundária/educação , Prevenção Terciária/métodos , Eczema/diagnóstico , Mãos/crescimento & desenvolvimento , Calcineurina/uso terapêutico , Terapêutica/tendências , Terapêutica , Qualidade de Vida/legislação & jurisprudência , Prevenção Primária , Prevenção Secundária/normas , Prevenção Terciária , Educação de Pacientes como Assunto/classificação
13.
Ann Hum Biol ; 42(4): 358-67, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26313328

RESUMO

BACKGROUND: Age estimation of individuals is important in human biology and has various medical and forensic applications. Recent interest in MR-based methods aims to investigate alternatives for established methods involving ionising radiation. Automatic, software-based methods additionally promise improved estimation objectivity. AIM: To investigate how informative automatically selected image features are regarding their ability to discriminate age, by exploring a recently proposed software-based age estimation method for MR images of the left hand and wrist. SUBJECTS AND METHODS: One hundred and two MR datasets of left hand images are used to evaluate age estimation performance, consisting of bone and epiphyseal gap volume localisation, computation of one age regression model per bone mapping image features to age and fusion of individual bone age predictions to a final age estimate. RESULTS: Quantitative results of the software-based method show an age estimation performance with a mean absolute difference of 0.85 years (SD = 0.58 years) to chronological age, as determined by a cross-validation experiment. Qualitatively, it is demonstrated how feature selection works and which image features of skeletal maturation are automatically chosen to model the non-linear regression function. CONCLUSION: Feasibility of automatic age estimation based on MRI data is shown and selected image features are found to be informative for describing anatomical changes during physical maturation in male adolescents.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Mãos/crescimento & desenvolvimento , Aprendizado de Máquina , Imagem por Ressonância Magnética , Punho/crescimento & desenvolvimento , Adolescente , Áustria , Humanos , Masculino , Software , Adulto Jovem
14.
Neuropsychologia ; 70: 429-41, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25486636

RESUMO

To act on the environment, organisms must perceive object locations in relation to their body. Several neuroscientific studies provide evidence of neural circuits that selectively represent space within reach (i.e., peripersonal) and space outside of reach (i.e., extrapersonal). However, the developmental emergence of these space representations remains largely unexplored. We investigated the development of space coding in infant macaques and found that they exhibit different motor strategies and hand configurations depending on the objects' size and location. Reaching-grasping improved from 2 to 4 weeks of age, suggesting a broadly defined perceptual body schema at birth, modified by the acquisition and refinement of motor skills through early sensorimotor experience, enabling the development of a mature capacity for coding space.


Assuntos
Imagem Corporal , Espaço Pessoal , Desempenho Psicomotor/fisiologia , Percepção Espacial/fisiologia , Fatores Etários , Animais , Animais Recém-Nascidos , Feminino , Mãos/crescimento & desenvolvimento , Força da Mão/fisiologia , Macaca mulatta , Masculino , Tempo de Reação/fisiologia
15.
Brain Dev ; 37(4): 370-5, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25027193

RESUMO

BACKGROUND: Diffusion tensor imaging (DTI) has expanded our knowledge of corticospinal tract (CST) anatomy and development. However, previous developmental DTI studies assessed the CST as a whole, overlooking potential differences in development of its components related to control of the upper and lower extremities. The present cross-sectional study investigated age-related changes, side and gender differences in streamline volume of the leg- and hand-related segments of the CST in children. SUBJECTS AND METHODS: DTI data of 31 children (1-14 years; mean age: 6±4 years; 17 girls) with normal conventional MRI were analyzed. Leg- and hand-related CST streamline volumes were quantified separately, using a recently validated novel tractography approach. CST streamline volumes on both sides were compared between genders and correlated with age. RESULTS: Higher absolute streamline volumes were found in the left leg-related CST compared to the right (p=0.001) without a gender effect (p=0.4), whereas no differences were found in the absolute hand-related CST volumes (p>0.4). CST leg-related streamline volumes, normalized to hemispheric white matter volumes, declined with age in the right hemisphere only (R=-.51; p=0.004). Absolute leg-related CST streamline volumes showed similar, but slightly weaker correlations. Hand-related absolute or normalized CST streamline volumes showed no age-related variations on either side. CONCLUSION: These results suggest differential development of CST segments controlling hand vs. leg movements. Asymmetric volume changes in the lower limb motor pathway may be secondary to gradually strengthening left hemispheric dominance and is consistent with previous data suggesting that footedness is a better predictor of hemispheric lateralization than handedness.


Assuntos
Imagem de Tensor de Difusão/métodos , Perna (Membro) , Atividade Motora , Tratos Piramidais/anatomia & histologia , Tratos Piramidais/crescimento & desenvolvimento , Adolescente , Criança , Desenvolvimento Infantil , Pré-Escolar , Feminino , Lateralidade Funcional , Mãos/crescimento & desenvolvimento , Mãos/fisiologia , Humanos , Lactente , Perna (Membro)/crescimento & desenvolvimento , Perna (Membro)/fisiologia , Imagem por Ressonância Magnética , Masculino , Atividade Motora/fisiologia , Tamanho do Órgão , Tratos Piramidais/fisiologia , Caracteres Sexuais , Substância Branca/anatomia & histologia , Substância Branca/crescimento & desenvolvimento , Substância Branca/fisiologia
16.
Ortodontia ; 47(6): 561-568, nov.-dez. 2014. ilus, tab, graf
Artigo em Português | LILACS, BBO - Odontologia | ID: lil-760094

RESUMO

Este estudo analisou a aplicabilidade da Fórmula de Regressão Múltipla de Mito, Sato e Mitani (2002) na avaliação da maturidade esquelética em 289 crianças brasileiras, naturais da cidade de Ourinhos, com a idade cronológica variando entre sete e 15 anos, sendo 153 do sexo feminino e 136 do sexo masculino. Na sequência, comparou-se a idade esquelética verificada na vértebra cervical com a identificada na radiografia carpal, empregando-se o método computadorizado de Eklõf e Ringertz (1967), e o método comparativo de Greulich e Pyle (1959). Com a aplicação do teste t e da análise de correlação, e considerando a metodologia adotada, concluiu-se que: 1) para o sexo feminino, observou-se uma maior correlação entre a idade ER e a idade GP; com relação à idade das vértebras, a correlação foi significante com a idade GP, ao passo que, no sexo masculino, verificou-se a diferença entre a idade vertebral e as demais; 2) o resultado das proporções mostrou-se semelhante ao de Mito, Sato e Mitani, para o sexo feminino; 3) a morfologia das vértebras apresentou maior correlação com o metacarpo do segundo dedo; 4) a fórmula de regressão não foi aplicável à amostra avaliada, devendo ser individualizada segundo a composição racial.


This study verified the applicability of the Multiple Regression Formula of Mito, Sato and Mitani (2002) in the assessment of skeletal maturity in 289 Brazilian children that were born in Ourinhos, with chronological ages ranging from 7-15 years, of which 153 were of the female gender and 136 of the male gender. Next, we compared the skeletal age checking the cervical vertebrae with the carpal index on radiographs, using the computerized method of the Eklõf Ringertz (1967), and the comparative method of Greulich and Pyle (1959). The application of the test t and correlation analysis, considering the methodology, it can be concluded that: 1) children of the female gender, showed a higher correlation between ER and GP age; with the vertebrae age, the correlation was significant, with the GP age; however in children of the male gender, it was verified a difference between the vertebral age with the others; 2) the result of the proportions was similar to the Mito, Sato and Mitani, for females; 3) the morphology of the vertebrae showed a higher correlation with the second finger metacarpal; 4) the regression formula was not applicable to the assessed sample and should be individualized according to racial composition.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Determinação da Idade pelo Esqueleto , Mãos/crescimento & desenvolvimento , Ossos do Carpo/crescimento & desenvolvimento , Vértebras Cervicais/crescimento & desenvolvimento , Ortodontia
17.
J Burn Care Res ; 35(5): e312-6, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25144813

RESUMO

Pediatric palmar hand burns are a difficult problem because of the serious hand deformity, with functional impairment resulting from rapid growth. In cases of severe pediatric palmar hand burns, a secondary full-thickness skin graft after a primary full-thickness skin graft offers a reliable way of obtaining the required functional and aesthetic outcomes.This study retrospectively evaluated 28 children who required palmar crease releases and secondary full-thickness skin grafts during the past 12 years. The case records were reviewed for sex and age distributions, injury mechanism, and time interval between the primary and secondary full-thickness skin grafts. Surgical procedures included secondary full-thickness skin grafts and incisional releases of grafted skin on the involved creases. There were 19 men and 9 women. The mean age at the time of the burn injury was 10.1 months (range, 5-19 months). The mean age at the time of the secondary full-thickness skin graft was 8.3 years (range, 3-17 years). The most common mechanism of burn injury was steam (n = 24). The median time interval from the primary to the secondary full-thickness skin graft was 67 months (range, 8-156 months). The number of released creases was 81. The number of palmar web contractures in 23 patients was 52. A secondary full-thickness skin graft was more frequently necessary in patients with a primary full-thickness skin graft in the proximal digital crease and palmar web areas. All patients achieved adequate digital length and palmar web contour after surgery. Our patients should be observed until the rapid pubertal growth period.


Assuntos
Queimaduras/complicações , Queimaduras/cirurgia , Contratura/etiologia , Contratura/cirurgia , Traumatismos da Mão/cirurgia , Mãos/crescimento & desenvolvimento , Transplante de Pele/métodos , Adolescente , Criança , Pré-Escolar , Estética , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , Resultado do Tratamento
18.
J Hand Surg Am ; 39(3): 488-92, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24559625

RESUMO

We present 2 siblings with multiple complete pseudoepiphyses in their hands and feet with associated symptomatic enhanced growth. Physical examination of the 6-year-old boy revealed long slender fingers and hyperplastic great toes. Radiography showed complete pseudoepiphyses in the first metacarpals, proximal and middle phalanges of the hands, and proximal phalanges of the feet. The patient's younger brother had a similar phenotype with slightly milder functional complaints. Genetic analysis did not reveal an underlying syndrome in these siblings.


Assuntos
Epífises/anormalidades , Pé/crescimento & desenvolvimento , Mãos/crescimento & desenvolvimento , Ossos Metacarpais/anormalidades , Ossos do Metatarso/anormalidades , Criança , Epífises/diagnóstico por imagem , Pé/diagnóstico por imagem , Mãos/diagnóstico por imagem , Humanos , Masculino , Ossos Metacarpais/diagnóstico por imagem , Ossos Metacarpais/cirurgia , Ossos do Metatarso/diagnóstico por imagem , Ossos do Metatarso/cirurgia , Radiografia , Irmãos
19.
J Child Neurol ; 29(2): 203-9, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23611885

RESUMO

The purpose of this retrospective study was to analyze the effect of peripheral nerve injury on the skeletal maturation process. The bone ages of the affected and unaffected hand-wrists of 42 children with obstetrical brachial palsy were determined according to the Greulich and Pyle atlas. In 23 patients, the bone ages of the both sides were identical (bone-age-symmetrical group), in 19 patients the bone age of the affected side was delayed (bone-age-delayed group). The mean bone age of the affected side was delayed 0.48 ± 0.25 years that of the unaffected side (P = .000), and the delay of bone age was inversely correlated with chronological age (R (2) = .45, P < .02) in the bone-age-delayed group. Skeletal retardation can be recognized after appearance of ossification centers by plain radiography, dating from the third month of life, in early infancy. Thus, bone age determination method might be helpful for predicting potential future limb shortness.


Assuntos
Traumatismos do Nascimento/complicações , Desenvolvimento Ósseo , Neuropatias do Plexo Braquial/diagnóstico por imagem , Neuropatias do Plexo Braquial/etiologia , Mãos/diagnóstico por imagem , Punho/diagnóstico por imagem , Determinação da Idade pelo Esqueleto , Fatores Etários , Pré-Escolar , Feminino , Lateralidade Funcional , Mãos/crescimento & desenvolvimento , Humanos , Masculino , Estudos Retrospectivos , Punho/crescimento & desenvolvimento
20.
Am J Orthod Dentofacial Orthop ; 144(6): 838-47, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24286907

RESUMO

INTRODUCTION: The aim of this study was to examine the agreement of skeletal age assessment based on hand-wrist radiographs with cephalogram-based cervical vertebrae evaluation. To circumvent bias and loss of information from staging, a quantitative approach was applied to determine morphologic changes. METHODS: We analyzed 730 sets of radiographs (cephalogram and hand-wrist) of untreated subjects (352 boys, 378 girls; age range, 6-18 years) from a growth study, each sex as a separate sample. Skeletal age was determined on the hand-wrist radiographs according to the method of Greulich and Pyle. Morphometric changes of the vertebral bodies C2 through C4 were measured (concavity, anterior height, and angle) and tested for correlations with the method of Greulich and Pyle. All correlating variables were included in a multiple linear regression to generate a calculated skeletal age. To establish the agreement between the method of Greulich and Pyle and calculated skeletal age, Bland-Altman plots were made, limits of agreement were identified, and cross-tables (before and after peak height velocity) were computed. Similarly, the agreement between the method of Greulich and Pyle and each subject's chronologic age was estimated for comparison. RESULTS: Concavity of C2, C3, and C4; anterior height of C3 and C4; and the angle of C3 correlated with skeletal age highly significantly (P <0.0001) in both sexes, and calculated skeletal age was established based on a linear regression. The agreement between the method of Greulich and Pyle and calculated skeletal age was modest (limits of agreement: boys, ±3.5 years; girls, ±3.3 years) and substantially weaker than the agreement between the method of Greulich and Pyle and chronologic age (limits of agreement: boys, +2.1 to -1.7 years; girls, +2.2 to -1.2 years). Similarly, calculated skeletal age resulted in considerably more false predictions of peak height velocity (boys, 18.9%; girls, 12.9%) than did chronologic age (boys, 7.1%; girls, 7.4%). CONCLUSIONS: Morphometric assessment of age-dependent changes in the cervical spine offers no advantage over chronologic age, in either assessing skeletal age or predicting the pubertal growth spurt.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Vértebras Cervicais/diagnóstico por imagem , Mãos/diagnóstico por imagem , Punho/diagnóstico por imagem , Adolescente , Fatores Etários , Análise de Variância , Pontos de Referência Anatômicos , Cefalometria/métodos , Vértebras Cervicais/anatomia & histologia , Vértebras Cervicais/crescimento & desenvolvimento , Criança , Estudos Transversais , Feminino , Mãos/anatomia & histologia , Mãos/crescimento & desenvolvimento , Humanos , Modelos Lineares , Masculino , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Fatores Sexuais , Punho/anatomia & histologia , Punho/crescimento & desenvolvimento
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