Software-assisted morphometry and volumetry of the lumbar spine

The aim of the study was to measure volumes of the lumbar vertebral bodies with use dedicated Computed Tomography (CT) workstation software to predict expected volume of PMMA for vertebroplasty and supplement calculations using computed tomography scanogram. Quantitative CT scans of 87 women's (mean age 69.4 years; SD 10.9) and 15 men's (mean age 64.3 years; SD 11.8) lumbar spines were analyzed; this made a total of 379 vertebrae. The population of patients was divided into three groups depending on measured BMD value, in accordance with American College of Radiology Practice Parameter for the Performance of Quantitative Computed Tomography (QCT) Bone Densitometry. With the use of the general linear model and least squares means groups were compared regarding vertebral volume, anterior, middle, and posterior vertebral heights. Morphometric parameters tended to be greater in males than in females, in a population of diversified bone mineral density. BMD result should be considered as the modifying factor for preoperative planning of the bone cement volume to be deposited inside the vertebra. Vertebral body volumetry might prove to be a useful tool in pre-operative planning as well as an alternative for treatment monitoring after minimally invasive spinal procedures

Polish Telemedicine and eHealth Society tribute to Ryszard Mężyk (1948-2021)

The Polish Society of Telemedicine and eHealth expresses last farewell to Ryszard Mężyk, a colleague and former longtime Treasurer. His cooperation with the Polish Society of Telemedicine and e-Health (formerly the Polish Telemedicine Society), a national member of ISfTeH - International Society for Telemedicine & eHealth, started in 2006. He was a modest and noble person and very valuable and devoted to promoting telemedicine, eHealth, and digital health in his region and throughout Poland. After joining the Association in 2010, he was twice elected and served as the Association's Treasurer. He was honoured successively with the Bronze, Silver, and Gold "Bene Meritus" Badge of the Polish Society of Telemedicine and eHealth. Despite having retired on November 1, 2018, he was still an active member of the Association.&nbsp

A Cross-Lingual Mobile Medical Communication System Prototype for Foreigners and Subjects with Speech, Hearing, and Mental Disabilities Based on Pictograms

People with speech, hearing, or mental impairment require special communication assistance, especially for medical purposes. Automatic solutions for speech recognition and voice synthesis from text are poor fits for communication in the medical domain because they are dependent on error-prone statistical models. Systems dependent on manual text input are insufficient. Recently introduced systems for automatic sign language recognition are dependent on statistical models as well as on image and gesture quality. Such systems remain in early development and are based mostly on minimal hand gestures unsuitable for medical purposes. Furthermore, solutions that rely on the Internet cannot be used after disasters that require humanitarian aid. We propose a high-speed, intuitive, Internet-free, voice-free, and text-free tool suited for emergency medical communication. Our solution is a pictogram-based application that provides easy communication for individuals who have speech or hearing impairment or mental health issues that impair communication, as well as foreigners who do not speak the local language. It provides support and clarification in communication by using intuitive icons and interactive symbols that are easy to use on a mobile device. Such pictogram-based communication can be quite effective and ultimately make people’s lives happier, easier, and safer

Posture and low back pain during pregnancy — 3D study

Objectives: Back pain is a common complaint of pregnant women. The posture, curvatures of the spine and the center of gravity changes are considered as the mechanisms leading to pain. The study aimed to assess spinal curvatures and static postural characteristics with three-dimensional surface topography and search for relationships with the occurrence of back pain complaints among pregnant women. Material and methods: The study was conducted from December 2012 to February 2014. Patients referred from University Clinic of Gynecology and Obstetrics were examined outpatient at the Posture Study Unit of Department of Orthopaedics and Traumatology. Sixty-five women at 4–39 weeks of pregnancy were assessed and surveyed with Oswestry Disability Index; posture was evaluated using surface topography. Results: The study confirmed that difficulties in sitting and standing are significant in the third trimester of the pregnancy. The overall tendency for significant lumbar curvature changes in pregnant women was not confirmed. Major changes in sagittal trunk inclination in relation to the plumb line were not observed in the study group. Conclusions: The issue regarding how the pregnancy causes changes in spinal curvature and posture remains open for further studies. Presented method of 3D surface topography can reveal postural changes, but that requires several exams of each subject and strict follow-up of the series of cases

Telerehabilititation in osteoarthitis

Telerehabilitacja jest definiowana jako świadczenie usług rehabilitacyjnych za pośrednictwem sieci telekomunikacyjnych i Internetu. Wykorzystuje najnowsze zdobycze technologii informacyjno-komunikacyjnych i pozwala na świadczenie usług rehabilitacyjnych pacjentom zdalnie. Pacjent we własnym domu, mieszkaniu, środowisku, które dla większości chorych może być najbardziej przyjazne, ma możliwość uczestniczenia w procesie rehabilitacyjnym. Telerehabilitacja ma możność dostarczania terapii do pacjenta, który nie posiada możliwości udania się do oddziału, zakładu lub gabinetu fizjoterapii. Obejmuje szeroki zakres usług. W zakres ten wchodzą zarówno zagadnienia komunikacji, zarządzania w ochronie zdrowia, edukacji, ochrony środowiska, oceny czynnościowej pacjenta, a także procesu leczenia klinicznego. Bezprzewodowa i stacjonarna komunikacja, wideokonferencje i Internet sprawiają, że telerehabilitacja stała się rzeczywistym i dostępnym sposobem postępowania.Telerehabilitation is defined as the provision of rehabilitation services through telecommunications networks and the Internet. It uses the latest achievements of information and communication technologies and allows for the provision of rehabilitation services to patients remotely. The patient has the opportunity to participate in the rehabilitation process in his / her own home, apartment, or environment that may be the most friendly for most patients. Telerehabilitation has the ability to deliver therapy to a patient who is unable to go to a physiotherapy ward, facility or office. It covers a wide range of services. This scope covers the issues of communication, management in health care, education, environmental protection, functional assessment of the patient, as well as the clinical treatment process. Wireless and fixed communication, videoconferencing and the Internet make telerehabilitation a real and accessible procedure

The Increase of Osteoporotic Hip Fractures and Associated One-Year Mortality in Poland: 2008–2015

Introduction: Hip fractures are a worldwide public health issue associated with significant mortality. Previous Polish studies reported an increasing trend in the number of hip fractures for both men and women, although lower than most other European countries. Materials and Methods: The Polish National Database was analyzed to examine osteoporotic hip fractures in the population aged 50 and over. Hip fracture incidence, rate, one-year mortality, and postoperative length of hospitalization were analyzed using the national health system data. Hospital discharge registry ICD-10 codes were reviewed from 2008 to 2015. Results: The incidence of hip fractures increased in both women and men by 19.4% and 14.2%, respectively. The female to male fracture ratio was 2.46. Mean postoperative hospitalization decreased from 13.6 to 11.2 days. The one-year mortality ranged between 30.45% to 32.8% for men and 26.2% to 28% for women. Of note, women aged 80–89 had the highest one-year mortality, 50.7%–55.4% after femoral neck fracture and 53%–58.5% after a pertrochanteric fracture. Conclusions: Hip fractures in Poland are increasingly more prevalent in the aging population. The unfavorable trends observed in this study indicate higher annual mortality after hip fracture, compared with other European countries

Combining 3D Structured Light Imaging and Spine X-ray Data Improves Visualization of the Spinous Lines in the Scoliotic Spine

Scoliosis is a three-dimensional trunk and spinal deformity. Patient evaluation is essential for the decision-making process and determines the selection of specific and adequate treatment. The diagnosis requires a radiological evaluation that exposes patients to radiation. This exposure reaches hazardous levels when numerous, repetitive radiographic studies are required for diagnostics, monitoring, and treatment. Technological improvements in radiographic devices have significantly reduced radiation exposure, but the risk for patients remains. Optical three-dimensional surface topography (3D ST) measurement systems that use surface topography (ST) to screen, diagnose, and monitor scoliosis are safer alternatives to radiography. The study aimed to show that the combination of plain X-ray and 3D ST scans allows for an approximate presentation of the vertebral column spinous processes line in space to determine the shape of the spine’s deformity in scoliosis patients. Twelve patients diagnosed with scoliosis, aged 13.1 ± 4.5 years (range: 9 to 20 years) (mean: Cobb angle 17.8°, SD: ±9.5°) were enrolled in the study. Patients were diagnosed using full-spine X-ray and whole torso 3D ST. The novel three-dimensional assessment of the spinous process lines by merging 3D ST and X-ray data in patients with scoliosis was implemented. The method’s expected uncertainty is less than 5 mm, which is better than the norm for a standard measurement tool. The presented accuracy level is considered adequate; the proposed solution is accurate enough to monitor the changes in the shape of scoliosis’s spinous processes line. The proposed method allows for a relatively precise calculation of the spinous process lines based on a three-dimensional point cloud obtained with a four-directional, three-dimensional structured light diagnostic system and a single X-ray image. The method may help reduce patients’ total radiation exposure and avoid one X-ray in the sagittal projection if biplanar radiograms are required for reconstructing the three-dimensional line of the spinous processes line

Association of sports and physical activity with obesity among teenagers in Poland

Objectives The purpose of the study was to assess the relationship between the body mass index and sports and physical activities in an unbiased, simple, random sample of teenagers from mid-northeastern Poland. Material and Methods Children and adolescents aged 10–19 years old were surveyed. The Internet-based survey was conducted to collect information on physical activity, leisure time, studying hours, weight, and height. Results Obesity was found to be low in the study population. The overall prevalence of overweight was not higher than 8%. Only 0.6% of participants were underweight. Overall, 68% of them confirmed participating in sports. Boys were frequently more active than girls (> 70% boys and > 60% girls). Participants mostly played soccer, volleyball, handball, or basketball (30.5%); 7% of them practiced martial arts and 16.5% of them participated in swimming. Sports activity significantly influenced body mass index. Obesity was not related to the lack of participation for physical activity in girls but a significant relationship was observed in boys (p < 0.02). The risk of obesity or overweight for inactive teenagers increased 2-fold (p < 0.01). Conclusions We report the overall participation of teenagers from 2 cities in mid-northeastern Poland in sports and physical activities and demonstrate that the lack of statistically significant differences in the body mass index and obesity and overweight is prevalent among boys and girls. Obesity was significantly related to less physical activity in boys, and the likelihood of obesity or overweight increased in inactive teenagers. Thus, we suggest that the importance of overweight and obesity prevention programs should be emphasized. Int J Occup Med Environ Health 2018;31(6):771–78

Osteoarthritis Changes Hip Geometry and Biomechanics Regardless of Bone Mineral Density—A Quantitative Computed Tomography Study

We aimed to compare proximal femur geometry and biomechanics in postmenopausal women with osteoarthritis (OA) and/or osteoporosis (OP), using quantitative computed tomography (QCT). A retrospective analysis of QCT scans of the proximal femur of 175 postmenopausal women was performed. Morphometric and densitometric data of the proximal femur were used to evaluate its biomechanics. We found, 21 had a normal bone mineral density (BMD), 72 had osteopenia, and 81 were diagnosed with OP. Radiographic findings of hip OA were seen in 43.8%, 52.8%, and 39.5% of the normal BMD, osteopenic, and OP groups, respectively (p &lt; 0.05). OA was significantly correlated with total hip volume (r = 0.21), intertrochanteric cortical volume (r = 0.25), and trochanteric trabecular volume (r = 0.20). In each densitometric group, significant differences in hip geometry and BMD were found between the OA and non-OA subgroups. Hip OA and OP often coexist. In postmenopausal women, these diseases coexist in 40% of cases. Both OA and OP affect hip geometry and biomechanics. OA does so regardless of densitometric status. Changes are mostly reflected in the cortical bone. OA leads to significant changes in buckling ratio (BR) in both OP and non-OP women