Grip on recovery after paediatric forearm fractures

Paediatric forearm fractures often do not need to be aligned perfectly, since growing bones can still remodel. Whilst scarce studies advocate less invasive treatments, surgical intervention is becoming an upward trend. This development is worry some, considering the incidence is simultaneously increasing. Functional outcome is rarely examined prospectively, and there is no consensus regarding outcome measures. This thesis focuses on outcome measures of functional recovery. It provides interpersonal and intrapersonal reference values of grip strength. Intrapersonal data is easier to obtain and has a higher accuracy. Compared to other strength measurements, namely key grip and three-jaw chuck, grip strength is more sensitive to change. The extent as well as the duration of strength loss is more prominent the more invasive the treatment underwent. Grip strength is associated with fracture angulation whereas range of motion is not. Loss of mobility of elbow, forearm and wrist can be considered mild with an overall average below 20° for reduced and below 10° for non-reduced fractures 6 weeks post-injury. Measurements of pronation and palmar flexion are significantly impaired up to 3 months post-injury. Similarly to strength, an inverse relation was seen between extent of impairment and invasiveness of treatment. The recovery of pain, reduced sensitivity and hypertrichosis warrants further investigation. Although a trend was observed in relation to treatment invasiveness, the operative group was too small. Future research should focus on the consequences on functional recovery when moving the (arbitrary) lines between successive treatments in favor of the least invasive one

Christliche Religiosität und moralisches Handeln- Eine empirische Studie bei Kindern im Alter von zehn und elf Jahren.

In der Soziologie, speziell in der Religionssoziologie, nimmt christliche Religiosität eine wesentliche Rolle ein. Einige publizierte Arbeiten dieses Themengebiets haben die Wirkung von Religiosität auf verschiedene soziologische Bereiche wie psychische Gesundheit, soziale Integration, oder delinquentes Verhalten bei Jugendlichen behandelt. Wie sich christliche Religiosität auf moralisches Handeln bei Erwachsenen und Heranwachsenden auswirkt, wurde bislang wenig untersucht; bei Kindern bis zwölf Jahren fehlen Untersuchungen zu diesem Aspekt gänzlich. Umgekehrt werden als Faktoren, die Religiosität beeinflussen, soziostrukturelle Merkmale wie Geschlecht, Alter, Bildung und Einkommen oder die primäre und sekundäre Sozialisation diskutiert. Diese Faktoren wurden bezogen auf Deutschland bisher vor allem bei Erwachsenen und Jugendlichen untersucht, aber nur unzureichend bei Kindern unter 12 Jahren. In der vorliegenden Arbeit steht christliche Religiosität im Fokus und wird zum einen als unabhängige Variable für moralisches Verhalten untersucht: beeinflusst Religiosität moralisches Verhalten und falls ja, inwiefern? Zum anderen wird christliche Religiosität als abhängige Variable der Faktoren Geschlecht, Peergroup und Religiosität der Eltern analysiert: beeinflussen umgekehrt diese Faktoren die Religiosität? Das soziologische Makro-Mikro-Makro Erklärungsmodell dient einerseits als Abgrenzung zu Arbeiten von der Makroebene, andererseits wird ein Zusammenhang zwischen Moral und Religion bzw. zwischen moralischem Verhalten und Religiosität durch verschiedene Verknüpfungsaspekte (Gesellschaftsvergleich, Sozialisation und Gottesbeziehung (Gottesbilder)) hergestellt. Bei den hier präsentierten Daten handelt es sich um einen repräsentativen Querschnitt. 1.035 Kinder und je ein (überwiegend für die religiöse Erziehung verantwortlicher) Elternteil wurden mithilfe eines Fragebogens zur Messung von Religiosität untersucht. Die Kinder wurden zusätzlich anhand zweier Fragemodule zu moralischem Handeln und zur Religiosität enger Freunde befragt. Die zusätzlichen Fragemodule wurden zuvor mittels Pretest optimiert. Die Datenanalyse ausschließlich valider und reliabler Werte erfolgte mit Strukturgleichungsmodellen, welche sich insbesondere zur gleichzeitigen Betrachtung mehrerer Faktoren eignen. Aus der Auswertung ergeben sich folgende Aussagen: • Die Religiosität des Kindes wirkt sich positiv auf moralisches Handeln aus. • Das Geschlecht hat geringen Einfluss auf die Religiosität der Probanden. Mädchen tendieren eher zu fürsorglichem und verantwortungsvollem als zu gerechtem Handeln. Dabei sind Mädchen ein wenig religiöser als Jungen und haben ebenfalls religiösere Freunde. • Hingegen ist die Religiosität des Elternteils enorm wichtig für die Religiosität des Kindes. Auch der Freundeskreis hat Einfluss auf die Religiosität, dieser wirkt jedoch geringer als der der Eltern

Grip strength is strongly associated with height, weight and gender in childhood:a cross sectional study of 2241 children and adolescents providing reference values

QuestionWhat are reference values for grip strength in children and adolescents based on a large and heterogeneous study population? What is the association of grip strength with age, gender, weight, and height in this population?DesignCross-sectional study.ParticipantsParticipants were recruited from schools in the northern provinces of the Netherlands. The study included healthy children and adolescents ranging in age from 4 to 15 years.Outcome measuresAll children had their height (cm) and weight (kg) measured and were allowed a total of four attempts using the Jamar hand dynamometer: twice with each hand. Grip strength scores (kg) were recorded for the dominant and non-dominant hands.ResultsThe study population comprised 2241 children and adolescents. Reference values for both genders are provided according to age and dominance. Grip strength shows a linear and parallel progression for both genders until the age of 11 or 12, after which grip strength development shows an acceleration that is more prominent in boys.ConclusionThere is a significant difference in grip strength with each ascending year of age in favour of the older group, as well as a trend for boys to be stronger than girls in all age groups between 4 and 15 years. Weight and especially height have a strong association with grip strength in children

Interstitial lung disease of infancy caused by a new NKX2‐1 mutation

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/137254/1/ccr3901.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137254/2/ccr3901_am.pd

Recovery of strength after reduced pediatric fractures of the forearm, wrist or hand; A prospective study

INTRODUCTION: The way strength recovers after reduction of pediatric fractures of the upper extremity has not previously been the specific scope of research. This is remarkable, since strength measurements are often used as an outcome measure in studies on trauma of the upper extremity. The aim of this study was to evaluate how strength recovers after sustainment of fractures of the forearm, wrist or hand treated by closed or open reduction in children and adolescents in the first 6 months after trauma. How much strength is lost at 6 weeks, 3 months and 6 months after trauma, and is this loss significant? Are there differences in the pattern of recovery between children who underwent a different treatment? And finally, which of the following factors are associated with an increase in the ratio between affected grip strength and expected strength: type of fracture, cast immobilization, occurrence of complications, and degree of pain? DESIGN: Prospective observational study. PARTICIPANTS: Children and adolescents aged 4-18 years with a reduced fracture of the forearm, wrist or hand. METHODS: Grip strength, key grip and three-jaw chuck grip were measured twice in each hand 6 weeks, 3 months and 6 months after trauma. Details on fracture type and location, treatment received, cast immobilization and complications were obtained. Hand-dominance and pain were verbally confirmed. RESULTS: Loss of strength was more prominent and prolonged the more invasive the treatment, hence most extensive in the group receiving open reduction with internal fixation (ORIF), intermediate in the group receiving closed reduction with percutaneous pinning (CRIF), and least extensive in the group undergoing closed reduction without internal fixation (CR). Besides time passed, gender and age were of significant influence on strength, although there was no difference in pattern of recovery over time between children who received a different treatment. In the period of 6 weeks to 3 months after trauma, female gender, type of fracture sustained and occurrence of an unwanted event were associated with an increased ratio between affected and expected grip strength. For the later phase of recovery, between 3 and 6 months, this was only true for the occurrence of an unwanted event

Decreased Muscle Strength in Children With Repaired Tetralogy of Fallot:Relation With Exercise Capacity

Background: The aim of this study is to describe muscle strength in pediatric patients with repaired tetralogy of Fallot compared with healthy peers and to analyze the correlation between muscle strength and peak oxygen uptake, exercise capacity (mL/min).Methods and Results: A prospective, cross-sectional study was carried out in the University Medical Center Groningen between March 2016 and December 2019, which included 8 -to-19-year-old patients with repaired tetralogy of Fallot. Exclusion criteria comprised the following: Down syndrome, unstable pulmonary disease and severe scoliosis affecting pulmonary function, neuromuscular disease, and mental or physical limitations that prohibit the execution of the functional tests. Muscle strength was compared with 2 healthy pediatric cohorts from the Northern Netherlands. Handgrip strength, maximal voluntary isometric contraction, and dynamic muscle strength in correlation with peak oxygen uptake, exercise capacity (mL/min) were the main outcomes of the study. The 67 patients with repaired tetralogy of Fallot (42% female; aged 12.9 [interquartile range, 10.0-16.3] years old) were compared with healthy children. The patients showed reduced grip strength ( z-score [mean±SD] -1.5±1.2, P&lt;0.001), and total muscle strength ( z-score -0.9±1.3, P&lt;0.001). Dynamic strength (Bruininks-Oseretsky test) was significantly reduced ( z-score -0.3±0.8, P=0.001), but running, speed, and agility were normal ( z-score 0.1±0.7, P=0.4). Univariate correlation analyses showed strong correlations between absolute peak oxygen uptake, exercise capacity (mL/min), and muscle strength (grip strength r=0.83, total muscle strength r=0.88; P&lt;0.001). In multivariate analyses, including correction for age and sex, total muscle strength (B 0.3; P=0.009), and forced vital capacity (B 0.5; P=0.02) correlated with peak oxygen uptake, exercise capacity (mL/min), independent of conventional cardiovascular parameters.Conclusions: Children with repaired tetralogy of Fallot show reduced muscle strength, which strongly correlated with their exercise performance. </p

The Influence of Hand Preference on Grip Strength in Children and Adolescents; A Cross-Sectional Study of 2284 Children and Adolescents

Introduction In adults the preferred hand is often considered to be around 10% stronger than the non-preferred hand. Whether the same is true for children and adolescents remains unclear. The objective of this study is therefore to determine whether there is a difference in grip strength between the preferred and non-preferred hand in developing children, to establish whether this difference is similar for children of a different gender or hand preference, and whether there is a difference in grip strength of the preferred hand of left-preferent (LP) and right-preferent (RP) children. Design Cross-sectional study. Participants Participants were recruited from schools in the northern provinces of the Netherlands. The study included healthy children and adolescents in the age range of 4-17 years. Outcome Measures Each child was allowed a total of four attempts using the JAMAR hand dynamometer, two attempts with each hand. All individual attempts were scored. Hand preference was determined by asking which hand was used to write, or in the case of 4- and 5-year-olds, which hand was used to draw a shape. Results The study population comprised 2284 children and adolescents. RP boys and girls scored significantly higher with their preferred hand, the difference amounting to 9.5 and 10.1% respectively. LP girls scored significantly higher with their preferred hand, but this difference was only 3.0%. For LP boys no significant difference was found in favor of either hand. LP children score higher with the non-preferred hand and tie scores on both hands more often than RP children. Conclusion The 10% rule of hand preference is applicable to RP children ranging in age between 4 and 17 years, but not to LP children. In contrast to LP boys, LP girls are generally significantly stronger with their preferred hand

Alveolar Dynamics and Beyond – The Importance of Surfactant Protein C and Cholesterol in Lung Homeostasis and Fibrosis

Surfactant protein C (SP-C) is an important player in enhancing the interfacial adsorption of lung surfactant lipid films to the alveolar air-liquid interface. Doing so, surface tension drops down enough to stabilize alveoli and the lung, reducing the work of breathing. In addition, it has been shown that SP-C counteracts the deleterious effect of high amounts of cholesterol in the surfactant lipid films. On its side, cholesterol is a wellknown modulator of the biophysical properties of biological membranes and it has been proven that it activates the inflammasome pathways in the lung. Even though the molecular mechanism is not known, there are evidences suggesting that these two molecules may interplay with each other in order to keep the proper function of the lung. This review focuses in the role of SP-C and cholesterol in the development of lung fibrosis and the potential pathways in which impairment of both molecules leads to aberrant lung repair, and therefore impaired alveolar dynamics. From molecular to cellular mechanisms to evidences in animal models and human diseases. The evidences revised here highlight a potential SP-C/cholesterol axis as target for the treatment of lung fibrosis

Studies about the inhibitoric effects of the transcription factor C/EBPbeta on the activity of the interleukin 2 promoter

Untersuchungen über den inhibitorischen Effekt des Transkriptionsfaktors C/EBPß auf die Aktivität des Interleukin 2-PromotorsStudies about the inhibitoric effects of the transcription factor C/EBPbeta on the activity of the interleukin 2 promote