Analysis of risk factors for atrial fibrillation in elderly Chinese patients with severe valvular heart disease / 中华老年医学杂志

Objective:To explore the risk factors for atrial fibrillation(AF)in elderly Chinese patients with severe valvular heart disease(VHD).Methods:This was a cross-sectional study and consecutively enrolled 978 elderly patients with severe VHD diagnosed in 18 Class A tertiary hospitals across the country from September 2021 to March 2022, including 322(32.9%)patients with concurrent AF.Clinical and echocardiographic data were collected to analyze the risk factors for AF.Results:Among VHD patients, compared with the non-AF group, the AF group was older, had a higher female ratio, higher diastolic blood pressure, higher proportions with cerebrovascular disease and chronic kidney disease, lower serum low density lipoprotein cholesterol and higher serum creatinine, amino-terminal A-type natriuretion peptide and glycosylated hemoglobin.As for echocardiographic parameters, the left atrial diameter was larger, the left ventricular end-diastolic diameter, interventricular septum thickness, and left ventricular posterior wall thickness were smaller in the AF group than in the non-AF group.All of the differences were statistically significant(all P<0.05). The results of multivariate Logistic regression analysis showed that the left atrial anteroposterior diameter increased( OR=1.166, P<0.01), the left ventricular end-diastolic diameter decreased( OR=0.929, P<0.01), and advanced age( OR=1.051, P<0.05)was an independent risk factor for elderly VHD patients with concurrent AF. Conclusions:In elderly patients with severe VHD, advanced age, an increased left atrial anteroposterior diameter, and a decreased left ventricular end-diastolic diameter were independently associated with AF.Therefore, evaluation of cardiac structure and regular follow-up should be performed in elderly patients with severe VHD for early intervention to reduce the incidence of AF.

Association of cardiac structure and function with frailty in elderly inpatients / 中华老年医学杂志

Objective:To assess whether cardiac structure and function are associated with frailty in elderly inpatients.Methods:This was a cross-sectional study.Inpatients aged 65 years or over, admitted to Beijing Hospital, Chinese PLA General Hospital and Beijing Tsinghua Changgeng Hospital, were consecutively recruited from September 2018 to April 2019.A total of 925 elderly inpatients were enrolled in the study, including 285 frailty patients and 640 non-frailty patients.Frailty was assessed with the Fried frailty phenotype.Clinical and echocardiographic data were collected.The association of cardiac structure and function with frailty was analyzed.Results:Compared with the non-frailty group, the frailty group was older, had lower body mass index, and had higher rates of heart failure, atrial fibrillation/atrial flutter, history of stroke/transient ischemic attack, renal insufficiency, and history of falls.N-terminal B-type natriuretic peptide(NT-proBNP)levels were higher while creatinine clearance and hemoglobin levels were lower(all P<0.05); The frailty group had a larger anterior-posterior left atrial diameter[(37.8±7.1)mm vs.(36.3±5.1)mm, t=-3.134, P=0.002]and a higher proportion with the left atrial anterior posterior diameter ≥45 mm[15.8%(45/285) vs.6.1%(39/640), χ2=22.452, P<0.001], a lower left ventricular ejection fraction[(60.1±9.5)% vs.(61.9±7.5)%, t=2.817, P=0.005]and a faster peak mitral inflow velocity[(0.8±0.3)cm/s vs.(0.7±0.2)cm/s, t=-2.675, P=0.003]. Multivariate logistic regression analysis showed that the left atrial anterior posterior diameter ≥45 mm was an independent correlation factor for frailty( OR=2.249, P=0.015). Increased age( OR=1.099, P<0.001), heart failure( OR=1.786, P=0.049), history of stroke/transient ischemic attack( OR=1.960, P=0.001)and decreased hemoglobin( OR=0.984, P=0.008)were independently associated with frailty. Conclusions:The left atrial anterior posterior diameter ≥45 mm and heart failure were independently associated with frailty.Assessing cardiac structure and function and screening for cardiovascular diseases in frailty patients should be emphasized.

Study Of Radiological Evaluation Of Cervical Spine In Marathwada Region

Background:Cervical vertebraeare the most crucially located and play a dynamic role in the mobility and protection of the vital parts of the central nervous system, they are prone to undergo degenerative diseases like spinal stenosis, cervical spondylosis etc.Hence it is important to know the exact dimensions of cervical vertebralbody and spinal canal in the diagnosis, prognosis and treatment of diseasesrelated tocervical spine and spinal cord.Material And Methods:Normal plain radiographs of cervical spine of two hundred adult subjects of known sex (one hundred males and one hundred females) and of known age group (between 18 to 50 years) studied for Antero-posterior diameter of vertebral body (AP-VB), Height of vertebral body (HT-VB)and Canal body ratio (CBR) in C3 to C7 cervical vertebrae. Data tabulated and analysed by using software statistical Package for Social Sciences(SPSS).Result:Higher mean AP –VB diameter andmean Ht -VB valuesare recorded in males as compared to females.Highermean Canal body ratio (CBR) was recorded in femalesascompared to males.Conclusion:Present study showed,higher mean value of(AP-VB),(HT-VB) in males as compared to females and found to be statistically significant indicating sexual dimorphism. Canal body ratio(CBR) showed slightly higher values in females as compared to malesand found statistically significant at C6 and C7 Levels.

Anatomical Evaluation Of Lumbar Vertebral Canal In Indian Population

Introduction: Low backache is one of the most common symptoms of lumbar canal stenosis and it developed aninterest among anatomists to do osteological analysis of lumbar canal. The aim of the current study was tocreate the morphometric database of lumbar canal dimensions in context of its applied clinical implications.Materials and Methods: A dry bone study was carried out on 47 adult human lumbar vertebral sets obtained fromvarious medical colleges in Pune District of Maharashtra. Anteroposterior (LCAP) and transverse (LCT) diametersof lumbar canal were measured by ‘Digital Vernier Caliper with 0.01 mm precision’. The data analysis was donein SPSS Version 20 and ‘ANOVA’ test was applied to evaluate statistical differences.Results: Lumbar canal antero-posterior (LCAP) diameters decreased from L1 to L5 vertebrae whereas there wasgradual increase in Lumbar canal transverse (LCT) diameter from first to fifth lumbar vertebra.Conclusion: The present study reported statistically significant differences in the dimensions of lumbar canal ofL1 to L5 in Indian population. This morphometric baseline data can be utilized in surgical management of lowback pain as a result of lumbar canal stenosis.

Application of ROM technique in rotational alignment of tibial prosthesis during knee arthroplasty / 中国组织工程研究

BACKGROUND: The ROM technique has been widely used to determine the rotational alignment of tibial prosthesis in total knee arthroplasty, but the accuracy of this technique remains controversial. However, there is no report on the influencing factors of ROM technique. OBJECTIVE: To explore the influencing factors of ROM technique in determining the rotational alignment of tibial prosthesis in total knee arthroplasty. METHODS: Totally 61 patients underwent unilateral knee arthroplasty, including 18 males and 43 females, aged between 55 and 78 years. All patients were diagnosed as knee osteoarthritis before operation. All operations were performed with the posterior cruciate-stabilizing total knee prostheses. All patients signed the informed consent. This study was approved by the Hospital Ethics Committee. The rotational orientation of the tibial prosthesis was determined by the ROM technique with closed and unclosed medial retinaculum. A line from the center of the posterior cruciate ligament to the medial border of the patellar tendon was used as the anteroposterior axis of tibia (Akagi line). The angles between the anteroposterior axis of tibia and lines determined by the ROM technique were measured to identify the classification of patellar track so as to decide whether the classification of patellar track, closing and unclosing medial retinaculum are the influencing factors of ROM technology. RESULTS AND CONCLUSION: (1) The angles between the Akagi line and lines determined by the ROM technique respectively were (0.5±2.5)°, (-0.9±2.6)°, and (-3.9±3.4)° for the unclosed medial retinaculum and (0.6±2.3)°, (-0.3±2.2)°, and (-1.5±2.9)° for the closed medial retinaculum. (2) For type III patellar track, the angle between line determined by the ROM and Akagi line was significantly internal rotation compared with type I and type II patellar track (P 0.05). For type III patellar track, closing the medial retinaculum could significantly reduce the difference between Akagi line and the line determined by ROM technology (P < 0.05). (4) These results indicate that for type I and type II patellar track, ROM technique can accurately locate the rotational alignment of tibial prosthesis in total knee arthroplasty, and closing or unclosing the medial retinaculum will not affect the accuracy of the results. As to type III patellar track, whether or not the medial retinaculum is closed may lead to failure in determining the rotation alignment of the tibial prosthesis.

The Relationship between Oesophageal Varices, Portal Vein Diameter And Splenic Length (Antero-Posterior)

Objective: In this study our main objective is to evaluate therelationship between Oesophageal varices, Portal veindiameter and splenic length (antero-posterior).Methodology: This Cross-sectional comparative studyconducted at the Department of Hepatology, BangabandhuSheikh Mujib Medical University (BSMMU) from Jan 2010 toDec 2011 where 50 Patients with cirrhosis of liver attending thedepartment of Hepatology, BSMMU were included as apopulation in this study.All the data was checked and edited after collection. It wasexpressed as Mean and SD. Data has been analyzed byANOVA. p value of less than 0.05 was considered statisticallysignificant. Statistical analysis was done by using SPSS-15(Statistical package for social sciences) win version 15software programme.Results: During the study, the mean age was43.12±15.68years. The highest frequency of cirrhosis patientswas found in 41-50 years age groups (Frequency 12). Leadingcause was HBV (68%) followed by HCV (12%), NBNC (12%),Wilson’s disease (6%) and both HVB& HCV (2%). Also,grade-3 mean portal Vein diameter was found 12.67±2.47 mmwhereas; mean splenic length (antero-post.) was 13.82±2.12cm.Conclusion: Splenic antero-posterior measurement is not areliable predictor for sizes of oesophageal varices. Furtherstudy is needed for better outcome.

Prevalence of impacted third molars among orthodontic patients in different malocclusions

Objectives: The aim of this retrospective study was to investigate the prevalence and pattern of third molar impaction and missing third molars in patients over 18 years in different anteroposterior skeletal patterns among central Indian populations. Materials and Methods: The study reviewed 357 orthopantomograms of patients attending the Government College of Dentistry, Indore, Madhya Pradesh. Patients were evaluated to determine the prevalence of third molar impaction, angulation, and level of eruption in Class I, Class II, and Class III patients using Winter's classification to determine angulation of third molars and Pell and Gregory classification for level of impaction. Results: Out of 357 patients, 187 (52.3%) were present with at least one impacted teeth. The third molar impaction was most commonly present in Class II malocclusion (60.65%). Overall, the most common angulation of impaction in both genders was the mesioangular (39%), and the most common level of impaction in both arches was Level B. In Class I, Class II and Class III malocclusion vertical angulation was the most common finding in the maxillary arch and mesioangular angulation in the mandibular arch. No significant association was observed between different types of malocclusion and third molar impaction (P > 0.4648). Conclusion: This study found that almost half of the adult patients above 18 years had at least one impacted third molar. The anteroposterior relationship does not have any significant role for the third molar impaction.

Predictive factors of outcome and observation period in children with unilateral hydronephrosis which caused by ureteropelvic junction obstruction / 中华泌尿外科杂志

Objective To evaluate the observation period and association between the initial visit data including initial APD measured by ultrasonography (USG) and outcome of unilateral hydronephrosis caused by ureteropelvic junction obstruction (UPJO) in children.Methods One hundred and ninety-three children with UPJO,who underwent the USG at the initial visit time.There were 155 boys and 38.166 cases in left side and other 27 cases in right side.All cases were divided by initial visit time and initial APD respectively.There were 109 infancy(≤ 12 months),36 toddler(12-36 months),19 preschooler(36-60 months),29 school-age children(＞ 60 months)and 11 cases in normal group (APD ＜ 0.5 cm),47 in mild (0.5 cm≤APD ＜ 1.0 cm),54 in moderate(1.0 cm≤ APD≤ 1.5 cm),81 in sever(APD ＞ 1.5 cm).All the patients were follow up for at least 24 months and divided into two groups depended on whether the patients received the surgery.Results Areas under the receiver operating characteristic plots were 0.924 (95％ CI 0.870-0.977,P ＜ 0.01);sensitivity,specificity,positive predictive value,and negative predictive value were 87.2％,88.9％,87.5％,and 95.5％,respectively,for the cut of APD is ≥ 1.85 cm.Infancy and initial APD ＞ 1.5 cm was the risk factors predicting operation with the hazard ratio of 2.991 (95％ CI 1.328-6.734,P =0.008) and 16.593 (95％ CI 5.893-46.719,P ＜ 0.01),respectively.Operation rate at one year of UPJO,for initial APD ＞ 1.5 cm,initial APD ≤ 1.5 cm,infancy and after infancy,were 43.20％(35/81),2.67％ (3/112),30.27％ (33/109),5.95％ (5/84),respectively.Conclusions Initial USG is an efficient diagnostic tool to detect pathologic hydronephrosis.Initial APD predicts the clinical outcome of UPJO in pediatrics accurately.Further investigation is recommended when initial APD ＞ 1.5 cm.Close observation is needed during the one year after initial visit to detect the deterioration of UPJO,especially in infancy.

A comparative study of the reproducibility of landmark identification on posteroanterior and anteroposterior cephalograms generated from cone-beam computed tomography scans / 대한치과교정학회지

OBJECTIVE: This in-vivo study aimed to compare landmark identification errors in anteroposterior (AP) and posteroanterior (PA) cephalograms generated from cone-beam computed tomography (CBCT) scan data in order to examine the feasibility of using AP cephalograms in clinical settings. METHODS: AP and PA cephalograms were generated from CBCT scans obtained from 25 adults. Four experienced and four inexperienced examiners were selected depending on their experience levels in analyzing frontal cephalograms. They identified six cephalometric landmarks on AP and PA cephalograms. The errors incurred in positioning the cephalometric landmarks on the AP and PA cephalograms were calculated by using the straight-line distance and the horizontal and vertical components as parameters. RESULTS: Comparison of the landmark identification errors in CBCT-generated frontal cephalograms revealed that landmark-dependent differences were greater than experience- or projection-dependent differences. Comparisons of landmark identification errors in the horizontal and vertical directions revealed larger errors in identification of the crista galli and anterior nasal spine in the vertical direction and the menton in the horizontal direction, in comparison with the other landmarks. Comparison of landmark identification errors between the AP and PA projections in CBCT-generated images revealed a slightly higher error rate in the AP projections, with no inter-examiner differences. Statistical testing of the differences in landmark identification errors between AP and PA cephalograms showed no statistically significant differences for all landmarks. CONCLUSIONS: The reproducibility of CBCT-generated AP cephalograms is comparable to that of PA cephalograms; therefore, AP cephalograms can be generated reliably from CBCT scan data in clinical settings.

Evaluation Of The Stability Of Post Treatment Sagittal Skeletal Changes After Twin Block Therapy On Class Ii Division 1 Subjects

Twin Block appliances are largely used for the correction of skeletal class II malocclusions due to mandibular retrognathism. Due to its patient comfort and ease, this appliance became the major tool for class II skeletal correction. Literature review on this appliance shows mixed responses, some claiming that the results are good and stable while others just put this as an appliance giving temporal acceleration in growth. Hence a study was designed to investigate the stability attained in antero posterior skeletal correction attained with Twin Block appliance. 30 subjects who were treated for mandibular retrognathism were identified. Average age group was 12.9[T1], 14.8 [T2] and 16.5 years [T3]. Pre-treatment, post treatment and a minimum of one year post treatment cephalograms were collected and analyzed. Results obtained from the present study showed that the treatment outcomes that were achieved immediately after twin block therapy was stable and that twin block appliance could be recommended in patients with sufficient growth with mandibular retrognathism.

Morphometric Analysis Of Foramen Magnum In Adult Human Dry Skull Of Gujarat Region

Background: Morphometric analysis of the foramen magnum of dry human skulls in Gujarat region was carriedout to demonstrate the anatomical variations in morphology. The measurements of the foramen magnum areclinically important because vital structures passing through it. There are certain diseases associated withcompression of structure present in foramen magnum like arnold chiari malformation (tonsillar herniation),achondroplasia, stenosis of foramen magnum, meningioma and atlanto-occipital fusion.Objectives: The aim of this study was to measure anteroposterior & transverse diameter of foramen magnum,surface area and index of foramen magnum and to observe its various shapes.Materials and methods: 326 dry skulls of adult human being were studied. Antero-posterior and TransverseDiameter were measured by using a digital vernier caliper. The surface area and foramen magnum index werecalculated. The cranial base was visually assessed for the shape of foramen magnum.Results: The mean antero-posterior and transverse diameter of the foramen magnum were 34.18 ± 2.74 mm and28.49 ± 2.13 mm respectively. The mean surface area and the foramen magnum index were 766.86 ± 104.76 mm2and 83.60 ± 6.21 mm respectively. The percentages of different shapes of foramen magnum were: Oval (42.33%),Round (32.82%), Tetragonal (8.59%), Hexagonal (7.67%), Pentagonal (4.60%), and irregular (3.99%).Conclusion: The knowledge of various dimensions & shape of the foramen magnum help to determine somemalformations like arnold chiari syndrome in which the transverse diameter is increased. The antero-posteriordiameter of foramen magnum was more than the transverse diameter and most common shape of foramenmagnum was found to be Oval.

Enmascaramiento en las mesioclusiones / Camouflage in mesiocclusions

Se analiza la difícil tarea de decidir, por parte del especialista, un camuflaje ortodóncico en aquellos pacientes con mesioclusiones verdaderas que no aceptan un tratamiento donde se realice cirugía ortognática. Cuál debe ser el límite que nos impone el caso clínico para poder tomar la decisión de realizar el tratamiento y qué debe esperar el paciente y el profesional en los resultados finales, una vez concluido. Somos los ortodoncistas los que tenemos el deber de decidir qué pacientes podrían ser tratados con camuflaje y cuáles, con cirugía ortognática, pero será el paciente el que tome la decisión final con nuestro asesoramiento (AU)

We discuss the difficult task of deciding, on the part of the specialist, an orthodontic camouflage in those patients with true mesioclusions who do not accept a treatment where orthognathic surgery is performed. What should be the limit imposed by the clinical case in order to make the decision to carry out the treatment and what the patient and the professional should expect in the final results, once concluded. We orthodontists have the duty to decide which patients could be treated with camouflage and which, with orthognathic surgery, but it will be the patient who makes the final decision with our advice (AU)

Pelvis peristalsis of hydronephrosis in children and its correlation with prognosis / 中华实用儿科临床杂志

Objective To analyze the frequency of pelvis peristalsis in children with hydronephrosis and its correlation with postoperative percentage of improvement in anteroposterior diameter (PI－APD).Methods From Oc-tober 2015 to September 2017,the data of the children with unilateral ureteropelvic junction obstruction (UPJO)hydro-nephrosis who underwent laparoscopic pyeloplasty were collected,and their pelvis peristalsis frequencies of 2 min were recorded after exposing the pelvis,while the APD and PI－APD were followed 1 year posto-peratively.The degrees of hydronephrosis were divided into mild,moderate and severe according to the Society of Fetal Urology(SFU)classifica-tion system.ANOVA was used to compare the pelvis peristalsis frequency and postoperative PI－APD between different degrees of hydronephrosis.Spearman analysis was used to analyze the correlation between pelvis peristalsis frequency and degree of hydronephrosis.Meanwhile,Pearson test was used to analyze the correlation between pelvis peristalsis fre-quency,hydronephrosis degree and PI－APD.Results A total of 50 children were included,of which 36 patients got follow－up for 1 year postoperatively.Pelvis 2 min peristalsis frequency between different degrees of hydronephrosis [mild:(8.1 ± 3. 3)times;moderate:(6.3 ± 3.5)times;severe:(7.8 ± 3.9)times]had no significant difference (F＝0.65,P＝0. 527);no statistical correlation was observed between pelvis peristalsis frequency and degree of hydro-nephrosis or PI－APD (all P ＞0.05).Preoperative hydronephrosis degree was positively correlated with PI －APD (r＝0.54,P＝0. 001).PI－APD in severe hydronephrosis (0.48 ± 0.29)was significantly higher than that of mild hydronephrosis (0.21 ± 0.20)(P ＝0.001 ). Conclusions For children with different degrees of hydronephrosis caused by UPJO,there was no significant difference in the pelvis peristalsis frequency recorded during laparoscopic pyeloplasty.Pelvis peristalsis frequency recorded during surgery was not correlated with PI －APD,but preoperative hydronephrosis degree was positively correlated with postoperative PI－APD.

Prospective value of early postoperative PI-APD in children with ureteropelvic junction obstruction / 上海交通大学学报（医学版）

Objective· To investigate the prospective value of early postoperative PI-APD in children with hydronephrosis.Methods· Data of children with hydronephrosis who underwent pyeloplasty in Xinhua Hospital,Shanghai Jiao Tong University School of Medicine between Jan 2012 to Nov 2015 was collected.PI-APD was divided into 3 categories (≤ 19％,19％＜PI-APD＜40％ and ≥ 40％).The relationship between PI-APD value and the degree of renal function (DRF) and dilation recovery after surgery was analyzed.Results· There were 360 children with hydronephrosis.The median follow-up was 20 months.The PI-APD value (3 months after pyeloplasty) was positively correlated with the degree of DRF recovery (r=0.631,P=0.000).Five patients received redo-pyeloplasty.PI-APD of all these patients was ＜19％.Conclusion· PI-APD is a new feasible ultrasound parameter in pyeloplasty followup.PI-APD ≥ 40％ at the first post-operative visit predicts pyeloplasty success.PI-APD ≤ 19％ indicates close follow-up after operation.PI-APD can also help select children at high risk for repeat intervention after pyeloplasty.

Estimation of Sex Using Antero-posterior Dimension of Talus in North Eastern Nigerians.

Aim: To evaluate sexual differences using demarking point and index of sexual dimorphism from the length of talus in relation to age among male and female north-eastern Nigerians. Study Design: Retrospective Study. Place and Duration of Study: Departments of Human Anatomy and Radiology, University of Maiduguri and University of Maiduguri Teaching Hospital (UMTH) respectively, Borno State, Nigeria between October 2010 to March 2012. Methodology: Three hundred and twelve (312) radiographs of adult north-eastern Nigerians (156 males and 156 females) with ages ranged from 20 to 69 years were measured. Radiographs used for this study were obtained from the collection of records unit of Radiology Department of UMTH in Borno State, Nigeria. Radiographic viewing box, erasable maker, meter rule were used for the measurements. Both female and male samples were grouped into two separate subsamples (right and left talus). Samples were classified into five (5) age groups which spanned ten years interval. The lateral views of the plain radiographs of the ankle were mounted on viewing box connected to a light source which gave good illumination. Antero-posterior length (APL) of the talus was measured as a linear distance between the most anterior point on the head of talus and the most posterior point on the body of the talus) using a calibrated meter rule. Results: The means of APL for males are all significantly greater than their female counterparts of the same age group. The results also show statistically significant (p<0.001) differences between the lengths of talus in males and females. The values of demarking points (DP) in males were higher than in females. The Index of sexual dimorphisms (ISDs) are greater than 100 which suggest that males have higher value over female counterparts. The result also show age related variation with male APL range from 5.82 cm at 60-69 years age group to 6.21 cm at 30-39 years age group; while female APL range from 5.27 cm at 60-69 years age group to 5.56 cm at 30-39 years age group. Conclusion: It was observed that the APLs of talus are sexually dimorphic; the DPs of male are all higher than those of female Counterparts. ISD also shows that, male APLs are greater than those of the female counterparts: because the ISDs were all greater than 100 at all age groups. However more studies are required in other part of Nigeria, so as to capture the racial variation of Nigeria.

Occurrence of vertebral fracture more closely associated with decreased anteroposterior than lateral lumbar bone mineral density

OBJECTIVES: While it has been pointed out that an anteroposterior (AP) view of the lumbar spine may lead to overestimation of the bone mineral density (BMD), a lateral view is expected lead to the early detection of BMD loss on scanning cancellous bone. Vertebral fracture is often seen in aged osteoporotic patients, and it is important to prevent this fracture. Therefore, we aimed to identify the optimal site for BMD measurement to assess the risk of vertebral fracture. METHODS: Forty-seven female patients with fresh osteoporotic vertebral fracture and BMD measurements were included in this study (Fracture group). As a non-fractured control group, 218 female patients with BMD measurements were enrolled (Control group). We compared BMD values based on AP and lateral views of the lumbar spine from L2 to L4 and the femoral neck. With a lateral view of the lumbar spine, we measured both the total vertebral body and vertebral body center, mainly composed of cancellous bone. RESULTS: BMD of the AP lumbar spine in the Fracture group was significantly lower than in the Control group (P < 0.05). In the subanalyses for comparisons between age-matched fracture and control groups, BMD of only the AP lumbar spine in the Fracture group was significantly lower than in the Control group (P < 0.01). CONCLUSIONS: AP lumbar spine BMD is optimal for assessing vertebral fracture occurrence.

Epistaxis severas. Nuestra experiencia y revisión de literatura / Severe epistaxis. Our experience and review of literature / Epistaxe grave. A nossa experiência e revisão da literatura

La epistaxis posterior es una de las urgencias más frecuente en la Otorrinolaringología. A pesar de esto no hay lineamientos claros entre los especialistas para su manejo. En este trabajo revisamos nuestra experiencia en 67 pacientes con diagnóstico de epistaxis severa que ingresaron por la guardia del Hospital Universitario ¨José de San Martín¨, entre el período de enero - septiembre de 2014 y comparándola con la literatura mundial con el objetivo de postular un algoritmo de tratamiento de esta enfermedad. A 66 de los 67 pacientes se les realizó taponaje anteroposterior (TAP) con diferentes métodos y 1 de los 67 fue directamente a cirugía endoscó- pica rinosinusal (CERS)...

Posterior epistaxis is one of the most common otolaryngology emergencies. Despite this, there are no clear guidelines among specialists for its management. In this paper, we review our experience in 67 patients with diagnosis of severe epistaxis who were evaluated on the emergency room of the University Hospital Jose de San Martin between January to September 2014. We compared our experience with the world literature in order to apply an algorithm treatment of this disease. 66 of 67 patients underwent posterior nasal packing (PNP)...

A epistaxe posterior é uma das emergências otorrinolaringológicas mais comuns. Apesar disso, não há um claro consenso entre os especialistas sobre seu procedimento. Neste artigo, apresentamos nossa experiência com 67 pacientes com diagnóstico de epistaxe grave atendidos pelo plantão do Hospital Universitário Jose de San Martin entre o período de janeiro a setembro de 2014 e comparamos com a literatura mundial, a fim de determinar um algoritmo de tratamento desta doença. 66 dos 67 casos foram submetidos a tamponamento ântero-posterior (TAP) com diferentes métodos e 1 foi diretamente encaminhado para cirurgia endoscópica rinossinusal (CERS). Destes 67 pacientes, 31 tiveram inicialmente escolhido o TAP como tratamento definitivo e, para os 36 restantes, CERS...

The Study of the Changes of Chest Wall Shape and Chest Compression Site According to Increasing Age

PURPOSE: The objective of this study is to investigate changes of chest wall shape and chest compression site according to increasing age. METHODS: This study is based on 99 patients who underwent chest computed tomography (CT) scans, and classified them into six groups according to age, from 30's to 80's. Using images of sagittal and coronal sections of chest CT scans, we found the chest compression site, which is in the lower half point of the sternal body. We calculated the vertical length to the left ventricular outflow tract and to the center of the left ventricle from the lower half point of the sternal body. We also estimated the antero-posterior (AP) diameters of the lower half region of the chest to determine how the shape of the chest changes according to increasing age. In addition, we calculated the horizontal length between the surface of the chest and center of the left ventricle. Data are classified and estimated according to age group. RESULTS: The AP diameter at the compression site was not significantly changed according to increasing age. The vertical length from the compression site to the center of the left ventricle and left ventricular outflow tract was significantly changed according to increasing age. The depth between surface of body and center of left ventricle was not significantly changed according to increasing age. CONCLUSION: There is a tendency where the position of the left ventricular outflow tract and center of the left ventricle show lower positioning according to increasing age. AP diameter at the compression point was not significantly changed according to increasing age.

Normal Glenoid Size of the Korean in 7th and 8th Decades

PURPOSE: We wanted to evaluate the normal glenoid size of Koreans in their 7th and 8th decades by conducting Computed tomographic (CT) studies. MATERIALS AND METHODS: The CT images were obtained from the normal scapulae of the patients (mean age: 68.8) who had humeral fracture. A display workstation version 2.0.73.315 was used to measure the scans to determine the maximal superoinferior (SI) and anteroposterior (AP) diameters of the glenoid vault. RESULTS: The average diameters of curvature of the glenoid were 31.2 mm (range: 27 to 34 mm) in the superior-inferior direction and 26.1mm (range: 22 to 31mm) in the anterior-posterior direction. CONCLUSION: This study showed the normal glenoid size of Koreans and it is different from the size that the international literature reported. It should be an important factor for the treatment of fracture or in designing arthroplasty implants.

Estudo antropométrico do crânio de recém-nascidos normais em Sergipe / Anthropometric cranial measurements of normal newborn in Sergipe - Northeast of Brazil

O estudo antropométrico do crânio é fundamental para a avaliação do recém-nascido. As medidas antropométricas usadas na atualidade são baseadas em resultados obtidos há mais de cinco décadas, os quais não são capazes de determinar um padrão nacional em decorrência de possíveis influências de algumas etnias. Realizamos estudo descritivo analítico em uma Maternidade em Aracaju-SE, com medidas de perímetro cefálico, distancia biauricular e anteroposterior, índice cefálico e medida da fontanela; foram examinadas 450 recém-nascidos com idade gestacional entre 37 e 42 semanas; 49,3 por cento era do gênero masculino e 50,6 por cento do feminino. O perímetro cefálico variou entre 30,0 cm e 39,8 cm com média de 34,14±2,48 com P50 34 cm. O índice cefálico variou entre 0,69 e 1,13 com média de 0,98±0,06 com P50 1. Foi feito uma comparação entre os estudos estrangeiros e brasileiros; o recém-nascido sergipano aproxima-se mais dos resultados obtidos nos estudos da região sudeste do que dos resultados da região nordeste, geograficamente semelhante. A possibilidade de influencias étnicas foi levantada, como também a necessidade de realizar um estudo multicêntrico para criar um perfil antropométrico do recém-nascido brasileiro.

The anthropometric mesureaments of the skull is essential for the evaluation of the newborn. The anthropometrics measureaments utilized at the present time are based in the results obtained for more than five decades, which are not able to determine a national pattern mostly likely due to some ethnic influences. We carried out an analytical descriptive study in a maternity hospital in Aracaju-Sergipe, Northeast of Brazil. Measurements of cephalic perimeter, biauricular and anteroposterior distances, cephalic index and fontanels were obtained from 450 newborns with gestacional age from 37 and 42 weeks; 49.3 percent were male and 50.6 percent female. The cephalic perimeter ranged from 30.0 cm to 39.8 cm with mean value of 34.14±2.48 P50 34 cm, and cephalic index ranged from 0.69 and 1.13 with mean value of 0.98±0.06 P50 1. A comparison was made between brazilian and foreign studies; the results of the newborn from Sergipe were closer to results obtained in the southeast region than the ones obtained in the northeast region itself. The possibility of ethnical influences was raised as well as the need to design a multicentric study in order to define an anthropometric profile of the brazilian newborn.