Two-dimensional digital photography for child body posture evaluation: standardized technique, reliable parameters and normative data for age 7-10 years.

BACKGROUND: Digital photogrammetry provides measurements of body angles or distances which allow for quantitative posture assessment with or without the use of external markers. It is becoming an increasingly popular tool for the assessment of the musculoskeletal system. The aim of this paper is to present a structured method for the analysis of posture and its changes using a standardized digital photography technique. MATERIAL AND METHODS: The purpose of the study was twofold. The first one comprised 91 children (44 girls and 47 boys) aged 7-10 (8.2 ± 1.0), i.e., students of primary school, and its aim was to develop the photographic method, choose the quantitative parameters, and determine the intraobserver reliability (repeatability) along with the interobserver reliability (reproducibility) measurements in sagittal plane using digital photography, as well as to compare the Rippstein plurimeter and digital photography measurements. The second one involved 7782 children (3804 girls, 3978 boys) aged 7-10 (8.4 ± 0.5), who underwent digital photography postural screening. The methods consisted in measuring and calculating selected parameters, establishing the normal ranges of photographic parameters, presenting percentile charts, as well as noticing common pitfalls and possible sources of errors in digital photography. RESULTS: A standardized procedure for the photographic evaluation of child body posture was presented. The photographic measurements revealed very good intra- and inter-rater reliability regarding the five sagittal parameters and good reliability performed against Rippstein plurimeter measurements. The parameters displayed insignificant variability over time. Normative data were calculated based on photographic assessment, while the percentile charts were provided to serve as reference values. The technical errors observed during photogrammetry are carefully discussed in this article. CONCLUSIONS: Technical developments are allowed for the regular use of digital photogrammetry in body posture assessment. Specific child positioning (described above) enables us to avoid incidentally modified posture. Image registration is simple, quick, harmless, and cost-effective. The semi-automatic image analysis, together with the normal values and percentile charts, makes the technique reliable in terms of child's posture documentation and corrective therapy effects' monitoring.

Treatment of children scoliosis by corrective brace with regulated force effect.

Rigid structural spine scoliosis of a child and even non progressive congenital scoliosis (e.g. isolated hemivertebra) can be treated by hypercorrective brace in full day regime. The article shows the new type of corrective brace with adjustable force effect. The brace consists of 3 stiff parts connected by joints and telescopes. The parts of brace are made from plastic according to plaster form of child trunk. The joints allow only mutual turning brace parts at frontal plane. The special telescopes were developed which operated with prescribed forces, it means the brace and trunk parts are mutually turned at prescribed moments. The article shows the algorithm for calculation of spine stress state, and spine curve correction for given brace with adjusted telescope forces. The second algorithm calculates the telescope forces for demanded spine curve correction. The computer program can be used for computer aid design of brace forces. The force effect of the new type of brace is demonstrated on a 14 months old boy with congenital scoliosis of lumbar spine (hemivertebra L1 and L3 on the right side). Curvature measured according to Coob was changed after application of this brace from 47.5° to 32.0°.

[Contact sensitization to pharmaceutic aids in dermatologic cosmetic and external use preparations]. / Kontaktní senzibilizace na pomocné látky v dermatologických externech a kosmetických prípravcích.

From April 2001 to December 2002, a group of 514 patients (178 men, 336 women, average age 42.8 years) suffering from chronic eczema were tested by means of epicutaneous tests for contact hypersensitivity to selected auxiliary substances of dermatological external and cosmetic preparations. In 194 patients, the principal diagnosis was atopic eczema. Of the preservatives, the most frequently sensitizing agents were Thiomersal in 13.6%, phenylmercuric acetate in 7.8%, formaldehyde in 5.6%, Bronopol in 5.1%, chlorohexidine in 3.3%, dibromodicyanobutane/phenoxyethanol in 2.9%, chloroacetamide in 2.1%, Kathon CG and parabenes in 1.9%, imidazolidinyl urea and diazolidinyl urea in 1.4%, glutaraldehyde in 1.2%, DMDM-hydantoin in 1.0%, dichlorophen in 0.8%, sorbic acid, phenoxyethanol and triclosan in 0.6%, benzalkonium chloride, Quaternium-15 and chlorocresol in 0.4% and chloroquinaldol in 0.2% of the group of patients. Of antioxidizing agents, it was dodecyl gallate in 2.3%, butylhydroxyanisol in 1.2%, propyl gallate in 0.6%, butylhydroxytoluen in 0.4% of the group o patients and of emulsifiers, alcohols lanae in 5.1%, triethanolamine in 1.6% and propylene glycol in 0.4% of the group of patients. A complete list of contained substances in drug information sheets of both pharmaceutical and cosmetic preparations seems necessary particularly for patients suffering from eczema. The results of the test can serve as feed-back information for the manufacturers of both pharmaceutical and cosmetic preparations.

[Experience with the dipyridamole test in the diagnosis of coronary insufficiency]. / Zkusenosti s dipyridamolovým testem v diagnostice koronární nedostatecnosti.

In 1980-86 263 dipyridamole tests were made before or after ergometry on account of the diagnosis of coronary insufficiency and possible indication for coronarography. The sensitivity and specificity was evaluated in a group of 101 subjects where both examinations had been made. As a reference method the authors used ergometry with more strict criteria of positivity of the two tests (deviations of segment ST 0.2 mV, incl. stenocardia) which are in good agreement with coronarography. The sensitivity was 58.2 and the specificity 96% (in men 61.4 and 100%). On combination of 98 dipyridamole tests with immediately following ergometry of 39 negative ergometries 23 (58.6%) changed to positive. Of 38 coronarographies the dipyridamole test was positive in 73% and in some patients with affections of the three main branches it was negative. There was also one serious complication: a new myocardial infarction. Because of lower sensitivity the dipyridamole test does not replace ergometry, except when the latter cannot be performed. The combination of the two tests sensitizes ergometry. On account of the high specificity ergometry can be omitted when the test is positive, in particular in men. For diagnostic purposes the stricter variant of criteria for evaluation of the test is more reliable and almost specific.

[Maximal dilatation of the coronary bed using dipyridamole in the diagnosis of coronary insufficiency]. / Maximální dilatace koronárního reciste dipyridamolem v diagnostice koronární nedostatecnosti.

The authors give an account of the mechanism of action of dipyridamole. Via adenosine it produces selective and maximal vasodilatation of resisting coronary vessels in the non-ischaemic area. Thus redistribution of the blood flow from the ischaemic to the non-ischaemic portion of the heart muscle occurs along with clinical and electrocardiographic manifestations of cardiac angina which can be used for its diagnosis. The pharmacological dipyridamole test makes detection of myocardial ischaemia possible in a fundamentally different way as compared with other loading tests. The authors mention pharmacodynamic, metabolic, haemodynamic and associated phenomena of the action of dipyridamole and the mechanism of the opposite effect of aminophylline and nitroglycerin.

Patency after femoral angioplasty: correlation of angiographic appearance with clinical findings.

Fifty-seven patients (34 men and 23 women) underwent percutaneous angioplasty (PTA) of the superficial femoral artery. Follow-up angiography revealed restenoses/reocclusions in 23 patients (relapsing group) and a patent, previously-dilated segment in 34 cases (patent group). These two groups were compared retrospectively regarding their clinical and angiographic state at the time of PTA. The lengths and types of the dilated arterial lesions were similar for both groups. However, the patients in the relapsing group were older as an average, showed significantly more advanced arteriosclerotic disease of their outflow tracts, and were predominantly female. For the relapsing group, a smaller lumen had been attained and a significantly higher brachiopedal pressure difference remained after PTA as opposed to the patients of the patent group. Of the patients with clinical signs of relapse, 28% still had patency of previously dilated segments at follow-up angiography. The true patency rate of dilated arterial segments presumably is higher than what is expected from follow-up examinations using clinical methods alone.