Survey among school-aged children with ultrasound-based motion analyzing system at two primary schools in szolnok

Aim: The use of ultrasound based motion analyzing systems is harmless and has no side effects. They are applicable among healthy people and children as well. Since 2007 we have been surveying children who suffer from spine and foot deformities and participate in adapted physical education. With three-year experience we decided to broaden the scope of the survey. In September last year we started a survey among primary school pupils aged 6-10 with the goal to follow up their state. At fi rst we examined the children’s initial state when their usual annual medical examination was made at school. The survey is planned to take at least three years. During the survey we pay special attention to reveal spine and foot vault deformities at an early stage, because these deformities are most common in the age group and after discovery conservative therapybased correction can be started without procrastination.Material and Method: After the orthopaedic examination, we performed a static posture examination and sole pressure distribution examination among 210 pupils from the two primary schools. By analysis with the Zebris CMS-HS ultrasound-based system and using Win Spine program we defi ned the degree of dorsal kyphosis and lumbar lordosis, the total trunk inclination in the sagittal and frontal planes and the degree of scoliosis.Results: Two children with innate locomotor disorders and a boy with neurological problems were excluded from the survey. Out of the remaining 207 children the orthopaedic examination found 75 healthy ones, 55 with bad back posture and 9 with flat back. 16 times the diagnosis was scoliosis, mostly functional but could be corrected properly. 53 children had no spine deformity but were positively fl at-footed. Following the recommendation of the GKE 2008 annual congress, we divided each group into subgroups according to the degree of curvatures in the sagittal plane. Dorsal kyphosis between 30 and 60 degrees and lumbar lordosis between 30 and 40 degrees were considered normal. Because of this consideration the healthy group was not homogeneous, either. 37.3% of them had fl at lumbar lordosis, 4% of them had fl at lumbar lordosis and thoracic kyphosis, too. Among children with bad back posture these ratios were 50.9% and 3%, respectively.Conclusion: Continuous control over different age groups makes it possible for us to search diagnosis- specifi csigns in the results of ultrasound-based motion analysis. The sign can be, for example, unbending of the curvature. The results of adapted physical education can be measured numerically. We can call the attention of teachers and parents for the need of posture correction built into physical education and everyday life. DOI: 10.17489/biohun/2010/1/3

Ultrasound-based motion analysing system in the assessment of children’s spinal curves in the sagittal plane

A gyermekkori tartásvizsgálat során gyakran felmerül az a kérdés, hogy indokolt-e röntgenvizsgálatot végezni. Szűrővizsgálatoknál és bármilyen ellenjavallat esetén a röntgenfelvétel készítése szóba sem jöhet, ekkor a fizikális vizsgálat mellett non-invasive, alternatív vizsgálati lehetőségek közül kell választani. A gyermekek gerincállapotának a felmérésére a Spinal Mouse és az ultrahang-alapú Zebris gerincvizsgáló eszköz egyaránt jól használható.A kutatás elsődleges célja, hogy az iskoláskorú gyermekek sagittalis síkú gerincgörbületeit alternatív, non-invasive sugárterheléssel nem járó vizsgáló módszerrel határozzuk meg: Az életkor és a testmagasság függvényében a háti kyphosis (TK), az ágyéki lordosis (LL), valamint a sagittalis síkú törzsdőlés (TTI) és a lateralis dőlés (LI) normáltartományát 530 helyes (fiziológiás) tartású és 394 hanyag testtartású 6-15 év közötti egészséges gyermek esetén adjuk meg.  Megállapítható, hogy a testmagasság szerinti (120 cm és 180 cm között 5 cm-enként) normálértékek megadása a célszerű. A kapott eredmények azt is mutatják, hogy mind a helyes-, mind a hanyag testtartású gyermekek esetén a fiúk és lányok gerincalakját jellemző paraméterek között a különbség szignifikáns, azaz a normáltartományok megadása a nemek szerinti bontásban indokolt. A vizsgálatok azt is bizonyítják, hogy a normál (fiziológiás) testtartású és a hanyag testtartású gyermekek összehasonlításakor a gerinc alakját leíró két szög (TK és LL) szignifikánsan eltérő. DOI: 10.17489/biohun/2015/2/05 In children’s posture examinations the question often arises whether an X-ray examination is necessary or appropriate. The use of X-ray is not an option in screenings or in case of any contraindication. In that case in addition to a physical examination a non-invasive, alternative examination method must be chosen. Both Spinal Mouse and Zebris ultrasound-based spine measuring instrument could be used to measure the shapes of the children’s spines. The main aim of the study is to determine the shape of the school-age children’s spines in the sagittal plane with an alternative, non-invasive, radiation-free measuring method. Normal ranges of kyphosis (TK), lordosis (LL) and thoracal and lateral inclination (TTI and LI) values are determined geared to age and height. The subjects were 530 healthy and 394 bad postured children between the ages of 6 and 15. In their case it can be stated that the normal values should be determined according to height (they were divided into groups according to their height between 120 and 180 cm with 5 cm long intervals). The results also showed that in both groups (in healthy children and in children with bad posture) there were a significant differences between the values of males and females, so normal values should be divided according to gender. The measurement results also indicated that comparing healthy children to bad postured children the two angels determining the shape of the spine (TK and LL) show significant differences.DOI: 10.17489/biohun/2015/2/0

The new processing of the results of examinations made with Zebris WIN-SPINE spine-measuring method and its validation

Aim: The Zebris spine-examination system and the associated measurement control program determine the spatial coordinates of processus spinosuses. Our processing program calculates kyphosis, lordosis and scoliosis values from the measurement data similarly to Cobb method. The aim of our research is to clarify whether the angle values determined from the X-ray results of young schoolchildren suffering from scoliosis by Cobb method differ from the values calculated from the spatial coordinates of processus spinosuses.Methods: In the case of 25 children suffering from scoliosis two-way full spine X-rays in standing position on 31 occasions were taken, in accordance with the professional standards. On the basis of the photographs the thoracic kyphosis, lumbar lordosis and scoliosis values were determined with Cobb method. While the children were in standing position, ultrasound-based spine examinations was performed with a WINSPINE measuring software developed specially for the Zebris CMS-HS measuring system.  From the spatial coordinates of processus spinosuses the same angle values with our self-developed Excel processing program according to the principles of Cobb method were calculated. The degree of scoliosis was evaluated in the dorsal and in the lumbar section separately. The relationship between the two measurements was indicated by the Pearson correlation.Results: From the comparison of the results of the two different measurement methods it was concluded that the correlation was strong between the values of the dorsal kyphosis and the lumbar lordosis (rkyphosis=0.80 rlordosis=0.94) while the correlation between the scoliosis values of the dorsal and lumbar sections was moderate (rthoracic scoliosis= 0.67 rlumbar scoliosis= 0.73). Conclusion: The sagittal curvatures calculated with our self-developed software from the spatial coordinates of processus spinosuses which were determined with the CMS-HS ultrasound-based motion analysing system, show a strong correlation with the values calculated from X-rays using Cobb technique. The accurate assessment of the degree of scoliosis can only be done with an X-ray. Values defined with motion analysing measurements without exposure to radiation in the terms between X-rays performed regularly as specified in the professional recommendations can give satisfactory information about the possible trend of changes.  DOI: 10.17489/biohun/2013/1/0

Successful treatment of late Salmonella infections in total hip replacement - report of two cases

Abstract Background Salmonella species can be rarely isolated from periprosthetic joint infections, however when present, are usually part of a severe septic clinical picture. Case presentations Two patients presented with late infected hip replacements to our institution. The first patient with multiple comorbidities had a confirmed Salmonella Enteridis infection with an abscess in the groin, with loosening of both components. He underwent a successful one stage cemented revision hip replacement, followed by 6 weeks of antibiotic therapy (ciprofloxacin). He had no recurrence or complications. The second patient was admitted in a septic condition with ARDS to the Intensive Care Unit 7 years following an uncemented total hip replacement. From an ultrasound guided hip aspirate Salmonella cholerae-suis was isolated. He underwent a successful a two-stage revision hip replacement. Conclusions Successful treatment of such potentially life threatening infections is achievable using modern orthopaedic techniques and close collaboration with the infectious diseases specialists.</p

Tailored immune responses: novel effector helper T cell subsets in protective immunity.

Differentiation of naïve CD4⁺ cells into functionally distinct effector helper T cell subsets, characterised by distinct "cytokine signatures," is a cardinal strategy employed by the mammalian immune system to efficiently deal with the rapidly evolving array of pathogenic microorganisms encountered by the host. Since the T(H)1/T(H)2 paradigm was first described by Mosmann and Coffman, research in the field of helper T cell biology has grown exponentially with seven functionally unique subsets having now been described. In this review, recent insights into the molecular mechanisms that govern differentiation and function of effector helper T cell subsets will be discussed in the context of microbial infections, with a focus on how these different helper T cell subsets orchestrate immune responses tailored to combat the nature of the pathogenic threat encountered