The influence of gender and sport on popliteal angle and dorsiflexion in junior high school students.

BACKGROUND: The aim of the study was to assess factors affecting the popliteal angle and foot dorsiflexion, in particular gender. The subjects were 142 students from the 2nd and 3rd year of Poznan junior high schools. METHODS: The participants included 57 girls and 87 boys. Three raters examined each subject: a specialist in orthopaedics, a resident doctor and a physical therapy student. Foot dorsal flexion was tested in a supine position with lower limbs extended. Next, dorsal flexion was evaluated with the knee and hip in 90 degrees of flexion. Finally, a passive knee extension (PKE) test was carried out. The significance of the PKE test is that the lower the angle the more flexible the hamstrings. This is because the PKE measurement is the distance to the right angle, that is a full knee extension with the hip flexed. RESULTS: The non-parametric test (Mann-Whitney) and the Student's t-test showed differences between the female and male gender in the measurements of the popliteal angle (p < .05000). The correlation was negative, which means that the hamstrings are more flexible in girls. No differences were found between gender and passive foot dorsiflexion and dorsiflexion with a flexed hip and knee. No differences were found between the group with the extended PE curriculum and the group with the standard number of PE classes in the range of motion of foot dorsiflexion and the value of the popliteal angle. CONCLUSIONS: Girls between 13 and 15 years old have a significantly larger hamstring flexibility, which is confirmed by the tests of the popliteal angle. No differences were found in dorsiflexion between girls and boys who have not been trained using a training model.

Evaluation of PHASES Score for Predicting Rupture of Intracranial Aneurysms: Significance of Aneurysm Size.

BACKGROUND: Recent data have identified that certain risk factors for rupture differ between small and larger intracranial aneurysms (IAs). Such differing risk factors make up 5 out of the 6 predictor variables used in the PHASES score, which raises the question on whether IA size has a significant effect on the score's performance. METHODS: Patients who were diagnosed with an IA incidentally or due to a subarachnoid hemorrhage between 2015 and 2023 were selected for potential inclusion. The median IA size of the cohort was chosen as the cutoff point to categorize small and large (6 mm). The PHASES score was calculated for all patients, and a receiver operating characteristic curve analysis was performed to evaluate the classification accuracy of PHASES in predicting rupture for small and large IAs. RESULTS: A total of 677 IAs were included. Among the IAs, 400 (58.9%) presented as UIAs and 279 (41.0%) as subarachnoid hemorrhage. The average PHASES score was 2.9 and 6.5 for small (n = 322) and large (n = 355) IAs, respectively. The PHASES score performed significantly lower for predicting rupture in smaller IAs (area under the curve: 0.634) compared with the larger (area under the curve: 0.741) (P = 0.00083). CONCLUSIONS: PHASES was shown to underperform on small IAs. The decision to treat small unruptured IAs remains highly controversial, and the development of a new score to estimate the annual rupture rate while accounting for IA morphology is of great need. Our findings can help encourage future researchers to develop such a score.

The agreement and repeatability of measurements of ankle joint dorsiflexion and poplietal angle in healthy adolescents.

BACKGROUND: The intra-rater repeatability and inter-rater agreement of orthopaedics measurements are important for estimating injury risk and appropriate treatment. In clinical practice, it is often unavoidable to trust the measurements of other health professionals. METHODS: This study tested the agreement and repeatability of measurements of the dorsiflexion of the foot, dorsiflexion with 90-degrees knee flexion, and popliteal angle test in healthy adolescents performed twice by three raters differing in clinical experience. Three raters, i.e., an orthopaedics specialist (16 years of experience), a resident medical doctor in orthopaedics (4 years of experience), and a physiotherapy student (1 year of experience) measured the ankle joint dorsiflexion and the popliteal angle in 142 healthy adolescent subjects. RESULTS: The student outperformed more experienced raters by displaying good repeatability for all the evaluated parameters. The orthopaedics specialist failed to replicate the measurements of the left ankle joint passive dorsiflexion and the left popliteal angle. The medical resident in orthopaedics displayed a lack of repeatability in evaluating the right ankle joint dorsiflexion with the knee joint bent. Kendall's W value for all parameters ranged 0.66-0.78, indicating a good inter-rater agreement. CONCLUSIONS: The study highlights that measurements of the ankle joint dorsiflexion and popliteal angle test by different health professionals can generally be trusted. It indicates that novice health professionals could potentially evaluate such parameters in healthy subjects without a quality loss.

Flexibility does not affect the dorsiflexion of foot and the popliteal angle in young adults.

BACKGROUND: The aim of the study was to assess how flexibility affects the dorsiflexion of foot and the popliteal angle test results in junior high school students. METHODS: The subjects were 142 students from the 2nd, and 3rd year of Poznan junior high schools (age between 13 and 15). Each subject was examined 6 times: there were 3 raters, a specialist in orthopaedics, a resident doctor and a physical therapy student, and each of them performed 2 measurements. Flexibility was also measured using the Beighton scale (score from 0 to 9). RESULTS: Since the Beighton scale is ordinal in order to evaluate the relationship between flexibility and the range of motion Spearman's rank correlation coefficient was calculated. The statistical analysis showed no correlation between flexibility measured on the Beighton scale and the range of passive foot dorsiflexion and the popliteal angle. CONCLUSIONS: The degree of flexibility does not affect the dorsiflexion of the foot and the popliteal angle in junior high students. At this age the range of dorsiflexion is determined by the length of the triceps surae muscle while the popliteal angle depends on the length of the muscles on the back of the thigh.

Józef Brudzinski (1874-1917).

Józef Brudzinski's (1874-1917) contribution to the field of neurology is noteworthy and undeniable. His organizational efforts and research activity have earned him the name of the "father of the Polish paediatrics". He described the Brudzinski reflex and Brudzinski neck sign. He proved that the symptoms of these conditions were caused by nerve root irritation and elevated CSF pressure. He also described cheek phenomenon and symphyseal sign.

Jan Evangelista Purkynje (1787-1869): first to describe fingerprints.

Fingerprints have been used for years as the accepted tool in criminology and for identification. The first system of classification of fingerprints was introduced by Jan Evangelista Purkynje (1787-1869), a Czech physiologist, in 1823. He divided the papillary lines into nine types, based on their geometric arrangement. This work, however, was not recognized internationally for many years. In 1858, Sir William Herschel (1833-1917) registered fingerprints for those signing documents at the Indian magistrate's office in Jungipoor. Henry Faulds (1843-1930) in 1880 proposed using ink for fingerprint determination and people identification, and Francis Galton (1822-1911) collected 8000 fingerprints and developed their classification based on the spirals, loops, and arches. In 1892, Juan Vucetich (1858-1925) created his own fingerprint identification system and proved that a woman was responsible for killing two of her sons. In 1896, a London police officer Edward Henry (1850-1931) expanded on earlier systems of classification and used papillary lines to identify criminals; it was his system that was adopted by the forensic world. The work of Jan Evangelista Purkynje (1787-1869) (Figure 1), who in 1823 was the first to describe in detail fingerprints, is almost forgotten. He also established their classification. The year 2013 marked the 190th anniversary of the publication of his work on this topic. Our contribution is an attempt to introduce the reader to this scientist and his discoveries in the field of fingerprint identification.

Joint preserving surgery versus arthrodesis in operative treatment of patients with neuromuscular polyneuropathy: questionnaire assessment.

The purpose of the paper was to present the results of surgical treatment of foot deformities in peripheral neuropathies using bone procedures: both joint preserving and with joint arthrodesis. The study included 26 patients, 14 males and 12 females (43 feet). The age of the patients at surgery ranged from 5 to 55 years (average 23 years). The follow-up ranged from 0.5 to 15 years (average 4.3 years). Seventeen patients presented Charcot-Marie-Tooth disease, three Friedreich's ataxia and six peripheral motor and sensory neuropathies of undetermined nature. Sixteen patients had bilateral procedures. Four patients had to be re-operated during the follow-up. The patients were divided into four groups depending on the age and the surgical technique applied. The groups I and II (9 children, 17 feet) included patients with growth plate still present in the foot just before surgery. In the groups III and IV (17 adults, 26 feet), bone growth was completed. The assessment of all patients based on a modified AOFAS scale ranged from 44 to 105 points (mean 83.7; SD 17.5). The assessment on the subjective scale ranged from 3 to 10 points (mean 7.4; SD 2.1). The assessment of quality of life on the WOMAC scale ranged from 0 to 41 points (mean 15.7; SD 13.2). All patients stated that they would decide to undergo the treatment again. For groups I and II, joint preserving surgeries gave better results; however, the results could not be statistically confirmed. The results for the groups III and IV were inconclusive as to which surgical techniques should be preferred, arthrodesis or joint preserving. The results show that none of the surgical techniques used for correction of foot deformities in motor-sensory polyneuropathies seems to be preferable.

Robert Koch (1843-1910) and dermatology on his 171st birthday.

Robert Koch (1843-1910) received the Nobel Prize in Medicine in 1905 for his studies of tuberculosis. He contributed significantly to microbiology, isolating also cholera and anthrax pathogens, and introducing several postulates in this field. In addition, he developed staining methods, as well as culturing and microscopic techniques. Many of his achievements have also influenced dermatology. This contribution reviews his life and major achievements on the occasion of the 171st anniversary of his birth.

Robert Remak (1815-1865): discoverer of the fungal character of dermatophytoses.

Robert Remak was the first scientist to undertake successful research on fungal skin infections. A neurologist, physiologist, and embryologist, Remak was the first to observe the fungal changes causing the disease of favus; however, he gave credit for the discovery to Professor Johann Schönlein and denied all attempts by others to credit him with the discovery by calling them a mistake. He named the disease Achorion schönleinii; however, over time, the name was changed to Trichophyton schoenleinii. Remak also described axial fibers encased in a medullary sheath and was the first to recognize nonmyelated (sympathetic) nerve fibers, today called fibers of Remak. He demonstrated the existence of the medullary nerve sheath and its production in the process of structured cell division. Remak also was the first to demonstrate that the cerebral cortex consists of six layers and to assert that there are three germ layers in the early embryo and not four.

Patient-related outcome questionnaires in the assessment of the results of total hip replacement.

A variety of patient-related outcome questionnaires have been used for the assessment of results of total hip replacement. Generic core scales (SF-12, SF-36) and disease-specific scales like: Harris Hip Score, Western Ontario and McMaster University Osteoarthritis Index, Hip dysfunction and Osteoarthritis Outcome Score, Oxford Hip Score, American Academy of Orthopedic Surgeons hip and knee Questionnaire, Lower Extremity Functional Scale are used most frequently. Even though all of them were assessed in terms of construct and content validity, reproducibility and sensitivity, there are still some problems related to bias when total hip replacement evaluation is performed in the presence of comorbidities, contralateral hip disease and ceiling effect influencing the final score. As a result, there is a need for development of a new PRO questionnaire in order to improve total hip replacement assessment, enable early detection of postoperative complications or to evaluate the results of surgery in both hips separately. It is crucial that such measuring device has to be deprived of the influence of irrelevant factors on the final score.