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Sample records for juvenile hallux valgus

  1. Considering treatment of Hallux Valgus

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    Llontop Vite, Carlos S.; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú; Temple S., Roberto; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú

    2014-01-01

    Hallux valgus , common and unsightly foot deformation, apparent simplicity , is to present a complex etiopathogenic and therapeutic problem . The multiplicity of proposed techniques for correction and the diversity of etiological theories , undoubtedly pose a series of controversies uncertain solution . Hallux valgus , as any medical problem should be approached from a global point of view. It is extremely important then assess foot deformities therefore carry often personality disorders and ...

  2. The treatment of hallux valgus.

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    Wülker, Nikolaus; Mittag, Falk

    2012-12-01

    Hallux valgus is the commonest forefoot deformity, with an estimated prevalence of 23% to 35%. It causes symptoms on the medial edge of the foot, the sole, and the small toes. Non-operative treatment may alleviate symptoms but does not correct the deformity of the big toe. Surgery is indicated if the pain persists. The correct operation must be selected from a wide variety of available techniques. In this article, we selectively review the pertinent literature, including the recommendations of medical societies in Germany and abroad, in the light of our own clinical experience. There have been many clinical trials of various treatments for hallux valgus, but very few of these were randomized, and the case numbers were generally small. Mild deformities are best treated by distal first metatarsal osteotomies, e.g. the Chevron osteotomy. Severe deformities require a soft-tissue procedure at the first metatarsophalangeal joint and a proximal first metatarsal osteotomy. In case of osteoarthritis, and in elderly patients, a resection arthroplasty is preferred; arthrodesis is performed in physically active patients. After correction of hallux valgus, patients can usually bear their full weight on the treated foot while wearing a flat surgical shoe. Proper surgical treatment results in a good or very good outcome in 85% of patients and a satisfactory result in a further 10%. The clinical outcome of present treatments seems to be good in most cases, but large-scale randomized trials are still needed to verify the efficacy of the wide variety of operations and fixation techniques that are currently being offered.

  3. Involvement of valgus hindfoot deformity in hallux valgus deformity in rheumatoid arthritis.

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    Yamada, Shutaro; Hirao, Makoto; Tsuboi, Hideki; Akita, Shosuke; Matsushita, Masato; Ohshima, Shiro; Saeki, Yukihiko; Hashimoto, Jun

    2014-09-01

    The involvement of valgus hindfoot deformity in hallux valgus deformity was confirmed in a rheumatoid arthritis case with a destructive valgus hindfoot deformity. Correction of severe valgus, calcaneal lateral offset, and pronated foot deformity instantly normalized hallux valgus deformities postoperatively. Thus, careful hindfoot status evaluation is important when assessing forefoot deformity, including hallux valgus, in rheumatoid arthritis cases.

  4. Tendon shift in hallux valgus: observations at MR imaging

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    Eustace, S. [Department of Radiology, Boston University Medical Center Hospital, 88 East Newton Street, Atrium - 2, Boston, MA 02118 (United States); Williamson, D. [Department of Radiology, Brigham and Womens Hospital, Boston, Massachusetts (United States); Wilson, M. [Department of Orthopedics, Brigham and Womens Hospital, Boston, Massachusetts (United States); O`Byrne, J. [Department of Radiology, Boston University Medical Center Hospital, 88 East Newton Street, Atrium - 2, Boston, MA 02118 (United States); Bussolari, L. [Department of Radiology, Brigham and Womens Hospital, Boston, Massachusetts (United States); Thomas, M. [Department of Radiology, Brigham and Womens Hospital, Boston, Massachusetts (United States); Stephens, M. [Department of Radiology, Boston University Medical Center Hospital, 88 East Newton Street, Atrium - 2, Boston, MA 02118 (United States); Stack, J. [Department of Radiology, Boston University Medical Center Hospital, 88 East Newton Street, Atrium - 2, Boston, MA 02118 (United States); Weissman, B. [Department of Radiology, Brigham and Womens Hospital, Boston, Massachusetts (United States)

    1996-08-01

    Objective. This study was undertaken to demonstrate a shift in tendon alignment at the first metatarsophalangeal joint in patients with hallux valgus by means of magnetic resonance imaging. Design. Ten normal feet and 20 feet with the hallux valgus deformity conforming to conventional clinical and radiographic criteria were prospectively studied using magnetic resonance imaging. Correlation was made between tendon position at the first metatarsophalangeal joint and the severity of the hallux valgus deformity. Results. There is a significant shift in tendon position at the first metatarsophalangeal joint of patients with hallux valgus. The insertion of the abductor hallucis tendon is markedly plantarward and the flexor and extensor tendons bowstring at the first metatarsophalangeal joint compared with patients without the deformity. The severity of the tendon shift correlates with the hallux valgus angle and clinical severity of the hallux valgus deformity in each case. Conclusion. Patients with hallux valgus have a significant tendon shift at the first metatarsophalangeal joint which appears to contribute to development of the deformity. (orig.). With 4 figs., 1 tab.

  5. El Hallux Abductus Valgus en la bailaora de flamenco. Hallux Abductus Valgus in female flamenco dancer.

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    Joaquín Pérez Rendón

    2011-04-01

    Full Text Available El Hallux Abductus Valgus (HAV, comúnmente llamado juanete, se define como la desviación lateral del primer dedo del pie y su rotación en valgo. Su origen es multifactorial, existiendo etiología patomecánica de base: hiperpronación subastragalina, excesiva longitud del primer metatarsiano y/o del primer dedo, o la insuficiencia del músculo peroneo largo. Estadísticamente, afecta más al sexo femenino que al masculino, y, en relación al baile flamenco, hay dos factores que se han asociado con una alta incidencia: uso del calzado de tacón y puntera estrecha, y ciertas modalidades del gesto deportivo.Mediante estudio observacional transversal realizado en diferentes academias de flamenco de Andalucía, Área Clínica de Podología de la Universidad de Sevilla y centros privados de Investigación y Podología, sobre 32 bailaoras de flamenco, se determina que existe una muy alta prevalencia de hallux abductus valgus en la bailaora profesional de flamenco.The hallux abductus valgus (HAV, commonly known as bunion, is defined as first toe lateral curvature and its rotation in valgus. Its origin can be derived from multiple factors, such as the existence of pathomechanics etiology: subastragalina joint hiperpronation, excessive length of first metatarsal and/or first toe, or peroneus longus muscle failure. Statiscally, it affects more to females than males, and as regards flamenco dance there are two factors which are closely related to such high levels of deformity: high-heeled shoes and narrow toe cap use, and some sports gesture methods.

  6. Perisciatic infusion of ropivacaine and analgesia after hallux valgus repair

    DEFF Research Database (Denmark)

    Zaric, D; Jørgensen, B G; Laigaard, F;

    2010-01-01

    Moderate to severe pain after hallux valgus repair can be successfully treated with a continuous popliteal sciatic nerve block in ambulatory patients. Different anesthesiologists use various infusion rates for this purpose. The aim of this study was to compare the analgesic efficacy of two infusion...

  7. McBride's operation for hallux valgus can be used in patients older than 30 years

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Soelberg, M; Larsen, T

    1992-01-01

    Over a 10-year period, 46 feet with hallux valgus in 36 patients were treated with the McBride procedure. The median age was 35 years. At follow-up of 2 to 11 years after operation, a reduction in the hallux valgus angles, the intermetatarsal angles and the width of the forefeet was found. In pat...

  8. Double First Metatarsal and Akin Osteotomy for Severe Hallux Valgus.

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    Al-Nammari, Shafic Said; Christofi, Theodoros; Clark, Callum

    2015-10-01

    The technique of double first metatarsal osteotomies was first developed in response to the high frequency of recurrence noted in the treatment of severe adolescent congruent hallux valgus deformities. The concept behind the use of this technique is that it allows the individual correction of each component of the deformity. We have modified the technique for use in adult hallux valgus where the majority of deformities are incongruent deformities and the distal chevron osteotomy is used primarily for its additional translational properties rather than purely to correct the distal metatarsal articular angle (DMAA). We report on a series of double first metatarsal osteotomies (basal opening wedge and distal chevron osteotomy) with Akin osteotomy in the treatment of moderate to severe adult hallux valgus deformity. All patients presenting to our institution with a hallux valgus deformity and treated with this procedure between 2008 and 2013 with a minimum of 1 year of follow-up were identified. Data were obtained through review of case notes, electronic charts, and digital imaging. A total of 50 feet in 48 patients underwent double first metatarsal osteotomy with Akin osteotomy. Three patients were excluded due to loss to follow-up, leaving 47 feet in 45 patients with a mean follow-up of 45 months (range, 14-60 months). Of these 43 (96%) were female and the mean age was 56 years (range, 35-70 years). The mean preoperative hallux valgus angle (HVA), intermetatarsal angle (IMA), DMAA, sesamoid position, and lateral first metatarsotalar angle were 42 degrees (range, 32-52 degrees), 18 degrees (range, 6-26 degrees), 12 degrees (range, 4-26 degrees), stage 6 (range, 4-7), and 2 degrees of dorsiflexion (range, 20 degrees of dorsiflexion to 4 degrees of plantar flexion), respectively. The mean postoperative HVA, IMA, DMAA, sesamoid position, and lateral first metatarsotalar angle were 7 degrees (range, 2 to 24 degrees), 4 degrees (range, 4-14 degrees), 6 degrees (range, 10

  9. Effects of balance taping using kinesiology tape in a patient with moderate hallux valgus

    OpenAIRE

    Lee, Sun-Min; Lee, Jung-Hoon

    2016-01-01

    Abstract Background: Hallux valgus, an increased angle of lateral deviation in the big toe, can cause pain and difficulties in balancing and walking. This study aimed to investigate the effects of balance taping using elastic therapeutic tape on moderate hallux valgus. Methods: When she walked with shoes, she complained of pain over the medial eminence of the hallux metatarsophalangeal (MTP) joint. Balance taping using kinesiology tape was applied for 3 months (average, 16hours/d) to both big...

  10. Joint Manipulation Under Anesthesia for Arthrofibrosis After Hallux Valgus Surgery.

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    Feuerstein, Catherine; Weil, Lowell; Weil, Lowell Scott; Klein, Erin E; Argerakis, Nicholas; Fleischer, Adam E

    2016-01-01

    Arthrofibrosis is a known complication of hallux valgus surgery. Joint manipulation under anesthesia has been studied for adhesive capsulitis of the shoulder; however, a paucity of published data exists on the use of this modality in the foot and ankle. The purpose of the present study was to investigate the outcomes of first metatarsophalangeal joint manipulation for arthrofibrosis that occurred as a complication of bunion surgery. The study population consisted of patients attending a single foot and ankle specialty clinic who were evaluated for arthrofibrosis after bunion surgery. Patients who underwent joint manipulation under anesthesia were asked to complete a research visit in which a clinical examination was performed and the presence and severity of joint pain were assessed. A total of 38 patients (34 females, 4 males, 53 feet), with a mean age of 55.7 ± 11.8 (range 30 to 83) years, agreed to participate. The mean follow-up period was 6.5 ± 3.4 (range 1 to 17) years. The visual analog scale scores improved significantly from baseline to the final follow-up visit (baseline 6.5 ± 1.5, range 2 to 10; final follow-up visit 2.3 ± 1.5, range 0 to 6; p arthrofibrosis after surgical correction of hallux valgus. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Approach for measuring the angle of hallux valgus

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    Jin Zhou

    2013-01-01

    Materials and Methods: Fifteen age, body weight, and height matched male students were included and those with foot disorders, deformities, or injuries were excluded from the study. The dorsal protrusions of the first metatarsal and the hallux were marked by palpating from three experienced observers; then their barefoot model in standing was collected by a three dimensional laser scanning system. The AoH was defined in the X-Y plane by the angle between the line joining the marks of centre of head and centre of base of metatarsal shaft and the one connecting the marks of the centre of metatarsal head and the hallux. The same procedure was repeated a week later. Besides, other measures based on the footprint, outline, and the radiography were also available for comparisons. Paired t-test, linear regression, and reliability analysis were applied for statistical analysis with significant level of 0.05 and 95% confidence interval. Results: There were no significant differences recorded between the new method and the radiographic method ( P = 0.069. The AoH was superior to the methods of footprint and outline and it displayed a relative higher correlation with the radiographic method (r = 0.94, r2 = 0.89. Moreover both the inter and intraobserver reliabilities of this method were proved to be good. Conclusion: This new method can be used for hallux valgus inspection and evaluation.

  12. Open wedge metatarsal osteotomy versus crescentic osteotomy to correct severe hallux valgus deformity

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    Wester, Jens Ulrik; Hamborg-Petersen, Ellen; Herold, Niels

    2016-01-01

    BACKGROUND: Different techniques of proximal osteotomies have been introduced to correct severe hallux valgus. The open wedge osteotomy is a newly introduced method for proximal osteotomy. The aim of this prospective randomized study was to compare the radiological and clinical results after...... operation for severe hallux valgus, comparing the open wedge osteotomy to the crescentic osteotomy which is our traditional treatment. METHODS: Forty-five patients with severe hallux valgus (hallux valgus angle >35̊, and intermetatarsal angle >15̊) were included in this study. The treatment was proximal...... open wedge osteotomy and fixation with plate (Hemax), group 1, or operation with proximal crescentic osteotomy and fixation with a 3mm cannulated screw, group 2. The mean age was 52 years (19-71). Forty-one females and four males were included. Clinical and radiological follow-ups were performed 4...

  13. Shortening Scarf osteotomy for correction of severe hallux valgus. Does shortening affect the outcome?

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    Karpe, Prasad; Killen, Marie C; Pollock, Raymond D; Limaye, Rajiv

    2016-12-01

    Translation and shortening of Scarf osteotomy allows correction of severe hallux valgus deformity. Shortening may result in transfer metatarsalgia. To evaluate outcome of patients undergoing shortening Scarf osteotomy for severe hallux valgus deformities. Fifteen patients (20feet, mean age 58 years) underwent shortening Scarf osteotomy for severe hallux valgus deformities. Outcomes were pre and postoperative AOFAS scores, IM and HV angles, patient satisfaction. Mean follow-up was 25 months (range 22-30). The IM angle improved from a median of 18.60 (range 13.4-26.20) preoperatively to 9.70 (range 8.0-13.70) postoperatively (8.9; 95% CI=7.6-10.3; posteotomies united. Shortening Scarf osteotomy is a viable option for treating severe hallux valgus deformities with no transfer metatarsalgia. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Effects of balance taping using kinesiology tape in a patient with moderate hallux valgus

    Science.gov (United States)

    Lee, Sun-Min; Lee, Jung-Hoon

    2016-01-01

    Abstract Background: Hallux valgus, an increased angle of lateral deviation in the big toe, can cause pain and difficulties in balancing and walking. This study aimed to investigate the effects of balance taping using elastic therapeutic tape on moderate hallux valgus. Methods: When she walked with shoes, she complained of pain over the medial eminence of the hallux metatarsophalangeal (MTP) joint. Balance taping using kinesiology tape was applied for 3 months (average, 16hours/d) to both big toes of a 26-year-old woman with moderate hallux valgus. Results: On the right side, the hallux valgus angle (HVA) decreased from 21° to 14° and the intermetatarsal angle (IMA) decreased from 15° to 14.5°. On the left side, the HVA decreased from 22° to 11° and the IMA decreased from 15° to 12°. Furthermore, the patient was able to walk long distances in shoes without pain in the medial eminence of the hallux metatarsophalangeal joint. Conclusion: This study suggested that repeated balance taping with kinesiology tape could be used as a complementary treatment method for moderate hallux valgus. PMID:27861365

  15. Mitchell′s osteotomy in the management of hallux valgus: An Indian perspective

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    Baba Asif

    2009-01-01

    Full Text Available Background: Hallux valgus is a common condition that affects the forefoot. A large number of procedures are described for managing this condition. Mitchell′s osteotomy and its modifications are being widely used for treating hallux valgus. However, most of the studies describe the results from the developed world. We present results of the classic Mitchell′s osteotomy in hallux valgus in Indian subcontinent. Materials and Methods: Forty eight adult patients (including 12 bilateral ones in the age range of 18-60 years with hallux valgus were managed with the classic Mitchell′s osteotomy. Pain over the bunion was the reason for surgery in 53 of 60 feet and cosmesis in the remaining 7 feet. Patients with hallux valgus angle more than 20° degrees and not responding to a trial of conservative treatment were included. Patients having metatarsophalangeal (MTP joint osteoarthritis (Grade II and higher, hallux rigidus, rheumatoid arthritis, and with subluxation of MTP joint were excluded from the study. Further, patients with first metatarsal more than 3 mm shorter than second metatarsal were also excluded. Results: The average follow-up period is 3 yrs (range 18months - 6yrs. About 55 feet (83% were painless after surgery. Forty-two (70% patients were happy with the cosmetic results of the surgery. Metatarsalgia was the reason for dissatisfaction with the procedure in five patients. The average correction of hallux valgus and the intermetatarsal angles achieved was 19.7° and 6.9°, respectively. Using the Broughton and Winson scoring system, 37 (61.7% feet had excellent results, 18 (30% had good, and five (8.3% feet had a poor results. Conclusion: The classic Mitchell′s procedure is a simple procedure and gives good cosmetic and radiological results.

  16. Hallux valgus-a case for a physiotherapist or only for a surgeon? Literature review.

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    Mortka, Kamila; Lisiński, Przemysław

    2015-10-01

    [Purpose] Hallux valgus is one of the most common deformations of the human foot, and it causes great difficulties for the patients. The aim of this paper was to review available medical literature in search of evidence which would justify implementation of physiotherapy, based on its effectiveness for patients with hallux valgus. [Subjects and Methods] The following databases were searched for applicable papers: PubMed, Google Scholar, Clinical Key and UpToDate. Full-text articles from the last 15 years were subjected to a review, which ultimately selected seven papers about hallux valgus therapy published over the past 12 years. These studies were grouped according to their design and level of evidence and classified depending on whether they concerned physiotherapy as postoperative therapy or as the only treatment. [Results] The studies included in the present analysis used the following interventions for patients with hallux valgus: exercise, manual therapy, gait training, taping and orthosis. All the studies showed beneficial effects and the most frequently observed results were reductions in pain and improvements in function. [Conclusion] The evidence found in the reviewed materials clearly indicates that patients with hallux valgus should not only be subject to surgical procedures but also undergo physiotherapeutic treatment.

  17. Comparison of Designed Slippers Splints with the Splints Available on the Market in the Treatment of Hallux Valgus

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    Yadollah Pournia

    2012-02-01

    Full Text Available Hallux valgus or the lateral deviation of the great toe is a complex disease. If it is not treated, it will cause the deviation of other toes. Hallux valgus is three times more common in females and may cause uncomfortable deformity of the foot, problems in putting on unsuitable and narrow toe box shoes, and pain on the medial side of the first metatarsophalangeal joint; therefore, patients seek medical services. Untreated hallux valgus may cause the hammer toe deformity of the second toe. In this cohort study, 30 patients referring to the Orthopedic Clinic of Shohada Ashayer Hospital of Khorramabad, Iran, with a complaint of hallux valgus were randomly divided into two groups. The splints designed by the researches (slippers splints were given to the case group, and the splints on the market including night splints and interdigital pads were given to the control group. The patients were followed every three months for a year and every time the weight bearing anteroposterior radiography of both feet were taken and hallux valgus and inter-metatarsal angles were measured. The data was analyzed by the SPSS software using repeated measure tests. In the case group that used the designed splints regularly, hallux valgus angles decreased more dramatically than in the control group (P<0.001. This study showed that, despite controversies over the nonoperative treatment of hallux valgus, if hallux valgus angle in patient is mild to moderate, the splint can be used as a nonoperative treatment.

  18. McBride's operation for hallux valgus can be used in patients older than 30 years

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Soelberg, M; Larsen, T

    1992-01-01

    Over a 10-year period, 46 feet with hallux valgus in 36 patients were treated with the McBride procedure. The median age was 35 years. At follow-up of 2 to 11 years after operation, a reduction in the hallux valgus angles, the intermetatarsal angles and the width of the forefeet was found....... In patients older than 30 years there were significant reductions. In patients younger than 30 years, the reduction was not significant. The rate of problems with daily footwear was reduced from 36 of 46 feet to 13 of 38 feet. The authors noted few problems and a high rate of satisfied patients, despite...... the age. In 37 of 46 feet the overall result was found satisfactory by the patients. The authors find that McBride's operation can be used for hallux valgus, also in patients above 30 years, in spite of the generally accepted restriction to younger individuals....

  19. A geometric analysis of hallux valgus: correlation with clinical assessment of severity

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    Vila Joan

    2009-05-01

    Full Text Available Abstract Background Application of plane geometry to the study of bunion deformity may represent an interesting and novel approach in the research field of hallux valgus. For the purpose of contributing to development of a different perspective in the assessment of hallux valgus, this study was conducted with three objectives: a to determine the position on the intersection point of the perpendicular bisectors of the longitudinal axes of the first metatarsal and proximal phalanx (IP, b to correlate the location of this point with hallux valgus deformity according to angular measurements and according to visual assessment of the severity carried out by three independent observers, and c to assess whether this IP correlated with the radius of the first metatarsophalangeal arc circumference. Methods Measurements evaluated were intermetatarsal angle (IMA, hallux valgus angle (HVA, and proximal phalangeal articular angle (PPAA. The Autocad® program computed the location of the IP inside or outside of the foot. Three independent observers rated the severity of hallux valgus in photographs using a 100-mm visual analogue scale (VAS. Results Measurements of all angles except PPAA showed significantly lower values when the IP was located out of the foot more distantly and vice versa, significantly higher values for severe deformities in which the IP was found inside the foot (p p Conclusion The IP is a useful indicator of hallux valgus deformity because correlated significantly with IMA and HVA measurements, VAS scores obtained by visual inspection of the degree of deformity, and location of the center of the first metatarsophalangeal arc circumference.

  20. Radiological Characteristics and Anatomical Risk Factors in the Evaluation of Hallux Valgus in Chinese Adults

    Institute of Scientific and Technical Information of China (English)

    Hailin Xu; Kaiji Jin; Zhongguo Fu; Mingtai Ma; Zhongdi Liu; Shuai An; Baoguo Jiang

    2015-01-01

    Background:There are no unified theories as to the anatomical changes that occur with hallux valgus,we investigated the radiological characteristics and anatomical risk factors for hallux valgus deformity in Chinese adults.Methods:We reviewed 141 patients with hallux valgus (206 feet; 15 males,126 females; mean age,58.5 years).These patients attended Peking University People's Hospital from April 2008 to March 2014.All feet had intact radiological data,obtained using the Centricity RIS/PACS system.We measured hallux valgus angle (HVA),1-2 intermetatarsal angle (IMA),proximal articular set angle (PASA),distal articular set angle,hallux interphalangeal angle,metatarsocuneiform angle,size of the medial eminence of the distal first metatarsal,tibial sesamoid position,and joint congruity of the first metatarsophalangeal joint (MTPJ).Results:We found positive correlations between the HVA and IMA (r =0.279,P < 0.01) and HVA and PASA (r =0.358,P < 0.01),but not for IMA and PASA (P > 0.05).Feet were divided into three groups based on HVA severity.IMA (P < 0.05) and PASA (P < 0.05) in the mild group were significantly lower than that in the moderate and severe groups,with no significant difference determined for IMA or PASA between the moderate and severe groups (P > 0.05).Feet were then grouped based on the shape of the first metatarsal head.Using this grouping,HVA was significant higher in the rounded shape (19.92°) than in a flat shape (17.66°).The size of the medial eminence of the distal first metatarsal was positively correlated with HVA (r =0.185,P < 0.01).The medial eminence in the moderate and severe groups was significantly larger than that in the mild group; moderate and severe groups were not significantly different.Conclusions:PASA enlargement is an adaptive change during early hallux valgus formation,and decompensation leads to subdislocation in the first MTPJ.A rounded first metatarsal head would thus predispose a foot to hallux valgus

  1. Bipartite hallucal sesamoid bones: relationship with hallux valgus and metatarsal index

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    Munuera, Pedro V.; Dominguez, Gabriel [University of Seville, Department of Podiatrics, Seville (Spain); Centro Docente de Fisioterapia y Podologia, Departamento de Podologia, Seville (Spain); Reina, Maria; Trujillo, Piedad [Centro Docente de Fisioterapia y Podologia, Departamento de Podologia, Seville (Spain)

    2007-11-15

    The objective was to relate the incidence of the partition of the hallucal sesamoid bones to the size of the first metatarsal and the hallux valgus deformity. In a sample of 474 radiographs, the frequency of appearance of bipartite sesamoids was studied. The length and relative protrusion of the first metatarsal, and the hallux abductus angle, were measured and compared between the feet with and without sesamoid partition. The results showed that 14.6% of the feet studied had at least one partite sesamoid, that the sesamoid most frequently divided was the medial, and that unilateral partition was the most common. No difference was found in the incidence of partite sesamoids between men and women, or between left and right feet. Protrusion and length of the first metatarsal are greater in feet with partite sesamoids than in feet without this condition. A significantly higher incidence of bipartite medial sesamoid was obtained in feet with hallux valgus compared with normal feet. (orig.)

  2. Geometry of the Proximal Phalanx of Hallux and First Metatarsal Bone to Predict Hallux Abducto Valgus: A Radiological Study

    Science.gov (United States)

    Perez Boal, Eduardo; Becerro de Bengoa Vallejo, Ricardo; Fuentes Rodriguez, Miguel; Lopez Lopez, Daniel

    2016-01-01

    Background Hallux abducto valgus (HAV) is one of the most common forefoot deformities in adulthood with a variable prevalence but has been reported as high as 48%. The study proposed that HAV development involves a skeletal parameter of the first metatarsal bone and proximal phalanx hallux (PPH) to determine if the length measurements of the metatarsal and PPH can be used to infer adult HAV. Methods All consecutive patients over 21 years of age with HAV by roentgenographic evaluation were included in a cross-sectional study. The control group included patients without HAV. The study included 160 individuals. We identified and assessed the following radiographic measurements to evaluate HAV: the distances from the medial (LDM), central (LDC), and lateral (LDL) aspects of the base to the corresponding regions of the head of the PPH. The difference between the medial and lateral aspect of PPH was also calculated. Results The reliability of the variables measured in 40 radiographic films show perfect reliability ranging from 0.941 to 1 with a small error ranging from 0.762 to 0. Also, there were no systematic errors between the two measurements for any variable (P > 0.05). The LDM PPH showed the highest reliability and lowest error. Conclusion It is more suitable to measure the LDM PPH instead of the LDC PPH when calculating the hallux valgus angle based on our reliability results. When the differences of the medial and lateral PPH are greater, the risk for developing HAV increases. PMID:27861517

  3. Effects of balance taping using kinesiology tape in a patient with moderate hallux valgus: A case report.

    Science.gov (United States)

    Lee, Sun-Min; Lee, Jung-Hoon

    2016-11-01

    Hallux valgus, an increased angle of lateral deviation in the big toe, can cause pain and difficulties in balancing and walking. This study aimed to investigate the effects of balance taping using elastic therapeutic tape on moderate hallux valgus. When she walked with shoes, she complained of pain over the medial eminence of the hallux metatarsophalangeal (MTP) joint. Balance taping using kinesiology tape was applied for 3 months (average, 16hours/d) to both big toes of a 26-year-old woman with moderate hallux valgus. On the right side, the hallux valgus angle (HVA) decreased from 21° to 14° and the intermetatarsal angle (IMA) decreased from 15° to 14.5°. On the left side, the HVA decreased from 22° to 11° and the IMA decreased from 15° to 12°. Furthermore, the patient was able to walk long distances in shoes without pain in the medial eminence of the hallux metatarsophalangeal joint. This study suggested that repeated balance taping with kinesiology tape could be used as a complementary treatment method for moderate hallux valgus.

  4. Equivalent correction in scarf and chevron osteotomy in moderate and severe hallux valgus: a randomized controlled trial.

    NARCIS (Netherlands)

    Deenik, A.; Mameren, H van; Visser, E. de; Waal Malefijt, M.C. de; Draijer, F.; Bie, R. de

    2008-01-01

    BACKGROUND: Chevron osteotomy is a widely accepted osteotomy for correction of hallux valgus.(18) Algorithms were developed to overcome the limitations of distal osteotomies. Scarf osteotomy has become popular as a versatile procedure that should be able to correct most cases of acquired hallux valg

  5. Radiographic angles in hallux valgus: Comparison between protractor and iPhone measurements.

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    Meng, Hong-Zheng; Zhang, Wei-Lin; Li, Xiu-Cheng; Yang, Mao-Wei

    2015-08-01

    Radiographic angles are used to assess the severity of hallux valgus deformity, make preoperative plans, evaluate outcomes after surgery, and compare results between different methods. Traditionally, hallux valgus angle (HVA) has been measured by using a protractor and a marker pen with hardcopy radiographs. The main objective of this study is to compare HVA measurements performed using a smartphone and a traditional protractor. The secondary objective was to compare the time taken between those two methods. Six observers measured major HVA on 20 radiographs of hallux valgus deformity with both a standard protractor and an Apple iPhone. Four of the observers repeated the measurements at least a week after the original measurements. The mean absolute difference between pairs of protractor and smartphone measurements was 3.2°. The 95% confidence intervals for intra-observer variability were ±3.1° for the smartphone measurement and ±3.2° for the protractor method. The 95% confidence intervals for inter-observer variability were ±9.1° for the smartphone measurement and ±9.6° for the protractor measurement. We conclude that the smartphone is equivalent to the protractor for the accuracy of HVA measurement. But, the time taken in smartphone measurement was also reduced.

  6. [Metatarsus primus double osteotomy, a logical and non-disabling surgical technique for treatment of hallux valgus].

    Science.gov (United States)

    Osterwalder, A; Maestretti, G

    1993-09-01

    The procedure known as the Metatarsus Primus Double Osteotomy ("L'ostéotomie métatarsienne bipolaire" of Schnepp-Carret) for the treatment of the hallux valgus is a logical, efficient and non-mutilating procedure. The technique consists in reducing the hallux valgus deformity by a subcapital bone wedge resection of the metatarsus primus. The bone wedge is then pinched into a second proximal osteotomy of the metatarsus primus, correcting the varus deformity in a valgus direction. This procedure is little known and is not even mentioned in the classic orthopedic literature of German and English language.

  7. Surgical treatment of hallux valgus%(足母)外翻的手术治疗

    Institute of Scientific and Technical Information of China (English)

    盛锟琨; 王宸

    2009-01-01

    Hallux valgus is a frequent forefoot disease, which has the high incidence, more happened among females, hallux valgus becomes more serious along with the age increasing, it usually needed to be done with surgery treatment owing to deformity and pain. The surgery with regard to hallux valgus had emerged widespread at the end of the 18~(th) century, most of the operation styles had been eliminated due to their disadvantages along with the carried out and the follow up judgment of the operation styles , however, some operation styles had been certified effective, which have been modified and consummated endlessly, have been added in the contemporary therapeutic methods. Operation styles mostly consist of soft issue repairment, osteotomy, arthroplasty and arthrodesis , selecting the operation styles reasonably is the key point of guarantee the treatment effectiveness.%(足母)外翻是一种常见的前足疾病,发病率较高,多见于女性,常随年龄增长而呈加重趋势,由于畸形和疼痛,常需手术治疗.(足母)外翻的手术治疗早在18世纪末已广泛兴起,随着各种术式的广泛开展及对其效果的追踪评价,大多数手术方式由于弊大于利被淘汰,而一些术式被证实有效,且经过不断改良与完善,已融入现代治疗方法中,手术方式主要包括软组织修复手术、截骨术、关节成形术及关节融合术,手术方法的合理选择是保证治疗效果的关键.

  8. Treatment of moderate hallux valgus by percutaneous, extra-articular reverse-L Chevron (PERC) osteotomy.

    Science.gov (United States)

    Lucas y Hernandez, J; Golanó, P; Roshan-Zamir, S; Darcel, V; Chauveaux, D; Laffenêtre, O

    2016-03-01

    The aim of this study was to report a single surgeon series of consecutive patients with moderate hallux valgus managed with a percutaneous extra-articular reverse-L chevron (PERC) osteotomy. A total of 38 patients underwent 45 procedures. There were 35 women and three men. The mean age of the patients was 48 years (17 to 69). An additional percutaneous Akin osteotomy was performed in 37 feet and percutaneous lateral capsular release was performed in 22 feet. Clinical and radiological assessments included the type of forefoot, range of movement, the American Orthopedic Foot and Ankle (AOFAS) score, a subjective rating and radiological parameters. The mean follow-up was 59.1 months (45.9 to 75.2). No patients were lost to follow-up. The mean AOFAS score increased from 62.5 (30 to 80) pre-operatively to 97.1 (75 to 100) post-operatively. A total of 37 patients (97%) were satisfied. At the last follow up there was a statistically significant decrease in the hallux valgus angle, the intermetatarsal angle and the proximal articular set angle. The range of movement of the first metatarsophalangeal joint improved significantly.. There was more improvement in the range of movement in patients who had fixation of the osteotomy of the proximal phalanx. Preliminary results of this percutaneous approach are promising. This technique is reliable and reproducible. Its main asset is that it maintains an excellent range of movement. The PERC osteotomy procedure is an effective approach for surgical management of moderate hallux valgus which combines the benefits of percutaneous surgery with the versatility of the chevron osteotomy whilst maintaining excellent first MTPJ range of motion. ©2016 The British Editorial Society of Bone & Joint Surgery.

  9. First Metatarsophalangeal Contact Properties Following Proximal Opening Wedge and Scarf Osteotomies for Hallux Valgus Correction: A Biomechanical Study.

    Science.gov (United States)

    Kia, Cameron; Yoshida, Ryu; Cote, Mark; DiVenere, Jessica; Geaney, Lauren E

    2017-04-01

    Proximal opening wedge osteotomy (POWO) is an established procedure for moderate to severe hallux valgus. A common concern of this procedure is that it results in lengthening of the first metatarsal, which could cause increased intra-articular pressure of the first metatarsophalangeal joint (MTP) and may ultimately lead to arthritis because of these altered mechanics. The purpose of this study was to use a cadaveric model to compare intra-articular pressures and articulating contact properties of the MTP joint following either scarf osteotomy or POWO. Fresh-frozen cadaveric below-knee specimens with pre-existing hallux valgus (n = 12) and specimens without hallux valgus (n = 6, control group) were used. The hallux valgus specimens were stratified into 2 groups (n = 6 each): POWO or scarf osteotomy. The groups were matched based on the degree of deformity. Peak intra-articular pressure, force, and area were measured in all normal, preoperative, and postoperative specimens with a simulated weightbearing model. These measurements were made with a pressure transducer placed within the first MTP joint. Postoperatively POWO group had slightly higher contact forces and pressures compared to the scarf group and lower contact forces and pressures than those of the normal group but were not statistically significant ( P > .05). Normal specimens had higher intra-articular force, pressure, and area than postoperative specimens but the difference was not found to be significant. First metatarsal lengthening was found in both the scarf and POWO specimens; however, neither increase was found to be significant ( P > .05). The results from this study show that after operative correction, contact properties of the fist MTP joint among normal, POWO, and scarf osteotomy groups revealed no significant differences. First MTP joints in those with hallux valgus had significantly lower contact force and pressure compared to those without hallux valgus. With little long-term outcomes of

  10. Combined rotation scarf and Akin osteotomies for hallux valgus: a patient focussed 9 year follow up of 50 patients

    Directory of Open Access Journals (Sweden)

    Kilmartin Timothy E

    2010-02-01

    Full Text Available Abstract Background The Cochrane review of hallux valgus surgery has disputed the scientific validity of hallux valgus research. Scoring systems and surrogate measures such as x-ray angles are commonly reported at just one year post operatively but these are of dubious relevance to the patient. In this study we extended the follow up to a minimum of 8 years and sought to address patient specific concerns with hallux valgus surgery. The long term follow up also allowed a comprehensive review of the complications associated with the combined rotation scarf and Akin osteotomies. Methods Between 1996 and 1999, 101 patients underwent rotation scarf and Akin osteotomies for the treatment of hallux valgus. All patients were contacted and asked to participate in this study. 50 female participants were available allowing review of 73 procedures. The average follow up was over 9 years and the average age at the time of surgery was 57. The participants were physically examined and interviewed. Results Post-operatively, in 86% of the participants there were no footwear restrictions. Stiffness of the first metatarsophalangeal joint was reported in 8% (6 feet; 10% were unhappy with the cosmetic appearance of their feet, 3 feet had hallux varus, and 2 feet had recurrent hallux valgus. There were no foot-related activity restrictions in 92% of the group. Metatarsalgia occurred in 4% (3 feet. 96% were better than before surgery and 88% were completely satisfied with their post-operative result. Hallux varus was the greatest single cause of dissatisfaction. The most common adverse event in the study was internal fixation irritation. Hallux valgus surgery is not without risk and these findings could be useful in the informed consent process. Conclusions When combined the rotation scarf and Akin osteotomies are an effective treatment for hallux valgus that achieves good long-term correction with a low incidence of recurrence, footwear restriction or metatarsalgia

  11. Correlation between generalized joint hypermobility and hallux valgus

    Directory of Open Access Journals (Sweden)

    A. A. Kardanov

    2015-01-01

    Full Text Available Purpose: to evaluate correlation between generalized joint hypermobility, forefoot deformities and elasticity of the first ray of the foot. Material and methods. We examined 138 patients with complaints related with deformities at the forefoot level. During this study the medical history was obtained, the elasticity type of the feet was defined and the degree of motion of the medial metatarsal-cuneiform joint was evaluated. Forefoot elasticity was identified by bringing together the heads I and V metatarsal bones with fingers. If convergence occurred with little resistance, those feet were called hyperelastic. The convergence of the heads I and V metatarsal bones of the foot with an average type of elasticity occurred with resistance. It was impossible to converge the heads of I and V metatarsal bones. Due to the results of weight-bearing and non-weight bearing X-ray, analysis of the main radiographic angles of the foot was performed: between I and V metatarsal bones, between the first and second metatarsal bones and between the first metatarsal bone and proximal phalanx of the great toe. Calculation formula of the forefoot flatness index, showing the average ratios of basic radiographic angles of the foot on the x-ray images (weight-bearing and non-weight bearing was created. An assessment of total joint hypermobility using Beighton scale and evaluation of first ray deformity using DuPont scale were performed. Statistical analysis of obtained data was performed, as a result of which significantly strong correlation between total joint hypermobility, forefoot elasticity and valgus deviation of the great toe were revealed. Results. 11% of the feet were hyperelastic. Calculation of the index of forefoot flatness showed that forefoot flatness wasn’t significant for a rigid foot - 5.6 %, for the feet with an average degree of mobility it was 6.0% and it was expressed for hypemobile feet - 12.3 %. Strong correlation relation between the forefeet

  12. Radiographic Relevance of the Distal Medial Cuneiform Angle in Hallux Valgus Assessment.

    Science.gov (United States)

    Hatch, Daniel J; Smith, Abigail; Fowler, Troy

    2016-01-01

    The angle formed by the distal articular facet of the medial cuneiform has been evaluated and discussed by various investigators. However, no consistent method has been available to radiograph and measure this entity. The wide variability of the angle is not conducive to comparative analysis. Additionally, investigators have noted that the angles observed (obliquity) vary greatly because of changes in radiographic angle, foot position, rotation of the first ray, and declination of the first metatarsal. Recognizing that these variables exist, we propose a reproducible assessment using digital radiography and application of deformity of correction principles. Our results have indicated a mean distal medial cuneiform angle of 20.69° in normal feet, 23.51° with moderate hallux valgus, and 20.41° with severe hallux valgus deformity. The radiograph beam was kept at 15° from the coronal plane. An inverse relationship was found between the distal medial cuneiform angle and bunion severity. This was in contrast to our expected hypothesis. The overall angle of the first metatarsal-medial cuneiform did, however, correlate with the severity of the bunion deformity (p positioning, and soft tissue imbalances. Perhaps, 3-dimensional computed tomography imaging will provide better insight into this entity.

  13. [Hallux valgus and hypermobility of the first ray--causal treatment using tarso-metatarsal reorientation arthrodesis].

    Science.gov (United States)

    Klaue, K

    1991-12-01

    Today, bunion surgery is still very controversial. Considering that a bunion deformity is actually a result of multiple possible causes, the rationale of the currently applied techniques has not been conclusively demonstrated. Multiple techniques are still applied with uncertain outcome, as shown by the not insignificant recurrence rate. The tarsometatarsal reorientation arthrodesis addresses the deficient anteromedial buttress which is due to the most often concomittent hypermobile first ray. This is an important aspect of treating hallux valgus deformity and includes the sagittal alignment besides the horizontal reposition of the metatarsal over the sesamoid complex. Since in hallux valgus, the first metatarsal looses its position also by the insufficiency of the intrinsic musculature and the ligamento-capsular structures, the arthrodesis regulates the elasticity of the multiarticular first ray within the sagittal plane. Recurrences are less likely after this operation, even when performed on the adolescent hallux which is known as very difficult to be treated successfully.

  14. Can Double Osteotomy Be a Solution for Adult Hallux Valgus Deformity With an Increased Distal Metatarsal Articular Angle?

    Science.gov (United States)

    Park, Chul Hyun; Cho, Jae Ho; Moon, Jeong Jae; Lee, Woo Chun

    2016-01-01

    No previous study has reported the results of double metatarsal osteotomy for adult hallux valgus deformity with an increased distal metatarsal articular angle (DMAA). The purpose of the present study was to evaluate the results after double metatarsal osteotomy in adult patients with incongruent hallux valgus deformity. We retrospectively reviewed 16 cases of consecutive first metatarsal double metatarsal osteotomy without lateral soft tissue release in 14 patients with symptomatic hallux valgus associated with an increased DMAA (≥15° after proximal chevron osteotomy on intraoperative radiographs). Clinical results were assessed using the American Orthopaedic Foot and Ankle Society scale and the visual analog scale. The radiographic results were assessed over time, and changes in the DMAA and the relative length of the first metatarsal were assessed by measuring each value preoperatively and at the last follow-up visit. The American Orthopaedic Foot and Ankle Society and visual analog scale scores were significantly improved after surgery. The hallux valgus angle and intermetatarsal angle were stabilized >3 months after surgery. The sesamoid position did not increase significantly beyond the immediate postoperative period. The mean DMAA was corrected from 21.6° (range 15° to 29°) preoperatively to 11.1° (range -2° to 17°) at the last follow-up visit. The mean amount of shortening of the first metatarsal after surgery was 5.5 (range 4 to 7) mm. In conclusion, double metatarsal osteotomy without lateral soft tissue release in adult hallux valgus deformity results in high postoperative recurrence and complication rates. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  15. [Treatment of moderate and severe hallux valgus by performing percutaneous double osteotomy of the first metatarsal bone].

    Science.gov (United States)

    Díaz Fernández, R

    2015-01-01

    To evaluate the clinical and radiological results in the surgical treatment of moderate and severe hallux valgus by performing percutaneous double osteotomy. A retrospective study was conducted on 45 feet of 42 patients diagnosed with moderate-severe hallux valgus, operated on in a single centre and by the same surgeon from May 2009 to March 2013. Two patients were lost to follow-up. Clinical and radiological results were recorded. An improvement from 48.14 ± 4.79 points to 91.28 ± 8.73 points was registered using the American Orthopedic Foot and Ankle Society (AOFAS) scale. A radiological decrease from 16.88 ± 2.01 to 8.18 ± 3.23 was observed in the intermetatarsal angle, and from 40.02 ± 6.50 to 10.51 ± 6.55 in hallux valgus angle. There was one case of hallux varus, one case of non-union, a regional pain syndrome type I, an infection that resolved with antibiotics, and a case of loosening of the osteosynthesis that required an open surgical refixation. Percutaneous distal osteotomy of the first metatarsal when performed as an isolated procedure, show limitations when dealing with cases of moderate and severe hallux valgus. The described technique adds the advantages of minimally invasive surgery by expanding applications to severe deformities. Percutaneous double osteotomy is a reproducible technique for correcting severe deformities, with good clinical and radiological results with a complication rate similar to other techniques with the advantages of shorter surgical times and less soft tissue damage. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  16. Foot pain and functional limitation in healthy adults with hallux valgus: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Nix Sheree E

    2012-10-01

    Full Text Available Abstract Background Hallux valgus (HV is a very common deformity of the first metatarsophalangeal joint that often requires surgical correction. However, the association between structural HV deformity and related foot pain and disability is unclear. Furthermore, no previous studies have investigated concerns about appearance and difficulty with footwear in a population with HV not seeking surgical correction. The aim of this cross-sectional study was to investigate foot pain, functional limitation, concern about appearance and difficulty with footwear in otherwise healthy adults with HV compared to controls. Methods Thirty volunteers with HV (radiographic HV angle >15 degrees and 30 matched controls were recruited for this study (50 women, 10 men; mean age 44.4 years, range 20 to 76 years. Differences between groups were examined for self-reported foot pain and disability, satisfaction with appearance, footwear difficulty, and pressure-pain threshold at the first metatarsophalangeal joint. Functional measures included balance tests, walking performance, and hallux muscle strength (abduction and plantarflexion. Mean differences (MD and 95% confidence intervals (CI were calculated. Results All self-report measures showed that HV was associated with higher levels of foot pain and disability and significant concerns about appearance and footwear (p Conclusions These findings show that HV negatively impacts on self-reported foot pain and function, and concerns about foot appearance and footwear in otherwise healthy adults. There was also evidence of impaired hallux muscle strength and increased postural sway in HV subjects compared to controls, although general physical functioning and participation in physical activity were not adversely affected.

  17. Open wedge metatarsal osteotomy versus crescentic osteotomy to correct severe hallux valgus deformity - A prospective comparative study.

    Science.gov (United States)

    Wester, Jens Ulrik; Hamborg-Petersen, Ellen; Herold, Niels; Hansen, Palle Bo; Froekjaer, Johnny

    2016-03-01

    Different techniques of proximal osteotomies have been introduced to correct severe hallux valgus. The open wedge osteotomy is a newly introduced method for proximal osteotomy. The aim of this prospective randomized study was to compare the radiological and clinical results after operation for severe hallux valgus, comparing the open wedge osteotomy to the crescentic osteotomy which is our traditional treatment. Forty-five patients with severe hallux valgus (hallux valgus angle >35̊, and intermetatarsal angle >15̊) were included in this study. The treatment was proximal open wedge osteotomy and fixation with plate (Hemax), group 1, or operation with proximal crescentic osteotomy and fixation with a 3mm cannulated screw, group 2. The mean age was 52 years (19-71). Forty-one females and four males were included. Clinical and radiological follow-ups were performed 4 and 12 months after the operation. In group 1 the hallux valgus angle decreased from 39.0̊ to 24.1̊ after 4 months and 27.9̊ after 12 months. In group 2 the angle decreased from 38.3̊ to 21.4̊ after 4 months and 27.0̊ after 12 months. The intermetatarsal angle in group 1 was 19.0̊ preoperatively, 11.6̊ after 4 months and 12.6̊ after 12 months. In group 2 the mean intermetatarsal angle was 18.9̊ preoperatively, 12.0̊ after 4 months and 12.6̊ after 12 months. The AOFAS score improved from 59.3 to 81.5 in group 1 and from 61.8 to 84.8 in group 2 respectively measured 12 months postoperatively. The relative length of the 1 metatarsal compared to 2 metatarsal bone was 0.88 and 0.87 preoperatively and 0.88 and 0.86 for group 1 and 2 respectively measured after 12 months. Crescentic osteotomy and open wedge osteotomy improve AOFAS score and VAS scores on patients operated with severe hallux valgus. No significant difference was found in the two groups looking at the postoperative improvement of HVA and IMA measured 4 and 12 months postoperatively. The postoperative VAS score and AOFAS score were

  18. A comparative study of bone shortening and bone loss with use of saw blades versus burr in hallux valgus surgery.

    Science.gov (United States)

    Shahid, Muhammad Saleem; Lee, Paul; Evans, Sam; Thomas, Rhys

    2012-09-01

    The aim of this study was to assess bone loss and thickness of the cut with the use of a burr in percutaneous hallux valgus surgery. Twelve blocks of saw bone were used. Cuts of same depth were made in each block with two different saw blades and a burr. Each block was assessed for bone loss and thickness of the cut. There was statistically significant (ptwo different saw blades. The use of a burr resulted in threefold increased loss of bone material and fourfold increase in the thickness of the cut as compare to use of two different saw blades. The metatarsal shortening is a risk factor in percutaneous hallux valgus surgery with the use of a burr. Copyright © 2011 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  19. First metatarsal proximal opening wedge osteotomy for correction of hallux valgus deformity: comparison of straight versus oblique osteotomy.

    Science.gov (United States)

    Han, Seung Hwan; Park, Eui Hyun; Jo, Joon; Koh, Yong Gon; Lee, Jin Woo; Choi, Woo Jin; Kim, Yong Sang

    2015-05-01

    The aim of this study was to compare clinical and radiographic outcomes of proximal opening wedge osteotomy using a straight versus oblique osteotomy. We retrospectively reviewed 104 consecutive first metatarsal proximal opening wedge osteotomies performed in 95 patients with hallux valgus deformity. Twenty-six feet were treated using straight metatarsal osteotomy (group A), whereas 78 feet were treated using oblique metatarsal osteotomy (group B). The hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle, and distance from the first to the second metatarsal (distance) were measured for radiographic evaluation, whereas the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was used for clinical evaluation. Significant corrections in the HVA, IMA, and distance from the first to the second metatarsal were obtained in both groups at the last follow-up (posteotomy, an oblique first metatarsal osteotomy yielded better clinical and radiological outcomes.

  20. Correction of Hallux Valgus Interphalangeus With an Osteotomy of the Distal End of the Proximal Phalanx (Distal Akin Osteotomy).

    Science.gov (United States)

    Vander Griend, Robert

    2017-02-01

    Operative correction of a symptomatic hallux valgus interphalangeus (HVI) deformity is often achieved with an osteotomy at the proximal end of the proximal phalanx (Akin osteotomy). However, the apex of the typical HVI deformity (center of rotation angle) is at the interphalangeal joint of the hallux. This study was done to evaluate the results of performing a medial closing wedge osteotomy at the distal end of the proximal phalanx. Thirty-three patients (33 feet) underwent an osteotomy at the distal end of the proximal phalanx for correction of HVI. All of the patients had other forefoot deformities which were corrected at the same time. Eight of these were revision procedures of prior forefoot operations. The length of follow-up was determined by the associated procedures with a minimum follow-up of 4 months. The preoperative hallux valgus interphalangeus angle averaged 16 degrees of valgus (range 7-32 degrees) and was corrected to an average of 2 degrees of valgus (range 5 degrees valgus to 5 degrees varus). All of the patients were satisfied with the postoperative appearance and function of the first toe. Because of simultaneous correction of numerous other forefoot problems, it was not possible to specifically isolate or evaluate the effects and benefits of this osteotomy using outcomes measures. There was one intraoperative complication resulting in a fracture extending into the adjacent IP joint. Correction of an HVI deformity can be achieved with an osteotomy at the distal end of the proximal phalanx. This was a safe technique with few complications and with good results in terms of both correction and patient satisfaction. Level IV, retrospective case series.

  1. Radiographic features that enable assessment of first metatarsal rotation: the role of pronation in hallux valgus

    Energy Technology Data Exchange (ETDEWEB)

    Eustace, S. (Dept. of Radiology, Mater Misericordiae Hospital, Dublin (Ireland)); O' Byrne, J. (Dept. of Orthopaedics, Mater Misericordiae Hospital, Dublin (Ireland)); Stack, J. (Dept. of Radiology, Mater Misericordiae Hospital, Dublin (Ireland)); Stephens, M.M. (Dept. of Orthopaedics, Mater Misericordiae Hospital, Dublin (Ireland))

    1993-04-01

    This study describes a method of detecting first metatarsal pronation on the basis of the movement of the inferior tuberosity of the base of 20 cadaveric first metatarsals at 0 , 10 , 20 and 30 pronation. On pronation, the inferior tuberosity of the base of the first metatarsal moved lateral to the mid-line axis. At 10 , the tuberosity pointed to the junction of the inner third and outer two-thirds of a line between the midpoint and lateral tubercle of the base. At 20 , it pointed to the junction of the inner two-thirds and outer third of that line. At 30 , it pointed to the outer marting of the lateral third. Using these features, the amount of first metatarsal pronation in 100 consecutive weigth-bearing views of feet was recorded and plotted against the corresponding intermetatarsal angles in those feet. Four of 43 patients with an intermetatarsal angle of less than 9 had pronation greater than 10 , 48 of 57 patients with an intermetatarsal angle greater than 9 had pronation greater than 10 (P<0.001). As intermetatarsal angles increase, the amount of first metatarsal pronation increases (r=0.69). Pronation and varus deviation of the first metatarsal are linked; both alter the tendon balance maintaining proximal phalanx alignment and lead to the development of hallux valgus. (orig.)

  2. 如何治疗(足母)外翻%How to treat hallux valgus

    Institute of Scientific and Technical Information of China (English)

    陈宝兴

    2002-01-01

    @@ 本期有三篇分析(足母)外翻外科治疗效果的文 章.(足母)外翻(hallux abducto valgus,HAV)是足外科最常见的疾病,门诊患者几乎占2/3以上.HAV的治疗目的是矫正畸形,但曾有规定将(足母)外翻的治疗归为美容学范等,因而许多医院将(足母)外翻改称为(足母)囊炎(bunion,bursitis),实际上二者是并存的.(足母)外翻的病因有两种说法:遗传及鞋.北京足踝外科研究所的调查显示,20%的患者有家族史,但主要的原因还是"鞋".不穿鞋时,(足母)趾与跖骨在同一顺列,穿鞋后产生外翻角.

  3. Ultrasound evaluation of intrinsic plantar muscles and fascia in hallux valgus

    Science.gov (United States)

    Lobo, César Calvo; Marín, Alejandro Garrido; Sanz, David Rodríguez; López, Daniel López; López, Patricia Palomo; Morales, Carlos Romero; Corbalán, Irene Sanz

    2016-01-01

    Abstract A cross-sectional area (CSA) and thickness reduction of the abductor hallucis (AbH) is shown in subjects with hallux valgus (HV). To date, other soft-tissue structures have not been researched in relation with HV. The aim of this study was to compare the CSA and thickness of the intrinsic plantar muscles and fascia (PF) between feet with and without HV. Therefore, a cross-sectional and case-control study was performed using B-mode with an iU22 Philips ultrasound system and a 5 to 17-MHz transducer. The CSA and thickness were measured for the AbH, flexor digitorum brevis (FDB) and flexor hallucis brevis (FHB), and also the thickness for the anterior, middle, and posterior PF portions. A convenience sample of 40 feet, 20 with HV and 20 without HV, was recruited from a clinical and research center. A multivariate regression analysis using linear regression was performed to evaluate the ultrasound imaging measurements (α = 0.05). Consequently, statistically significant differences were observed between the groups (P fascia thickness increase in favor of the HV group. On the contrary, the FDB thickness and CSA did not show statistically significant differences (P ≥ 0.05). In conclusion, the CSA and thickness of the AbH and FHB intrinsic plantar muscles are reduced, whereas the thickness of the anterior, middle, and posterior PF portions are increased, in subjects with HV compared with those without HV. PMID:27828846

  4. CLINICAL CONCEPTION OF KELLER’S OPERATION FOR HALLUX VALGUS DEFORMITY——A SURVEY OF 112 CASES

    Institute of Scientific and Technical Information of China (English)

    葛茂之

    1993-01-01

    In a long-term follow-up study (average, 6.5 years) of 112 feet (90 pa-tients) subjected to Keller’s operation for hallux valgus deformity, the author observed arelationship between Keller’s operation and the metatarsalgia which was located beneaththe central metatarsal heads. The data showed that the metatarsalgia developed or was ag-gravated in 26 feet (23%), and was eliminated or alleviated in 23 feet (21%) afterKeller’s operation. When more than one-third of the proximal phalanx of the big toe wasresected, the incidence of the metatarsalgia obviously increased following surgery. Theautho rpreferred a "Z" lengthening of the extensor hallucis longus tendon instead ofresecting excessive proximal phalanx. The total incidence of the metatarsalgia was 36%(40 feet) preoperatively and 38% (43 feet) postoperatively. This result indicated thatthere was no obvious difference in the incidence of the preoperative and postoperativemetatarsalgia. No more than one-third of the proximal phalanx of the big toe should beremoved. This seems to reduce the incidence of the metatarsalgia after Keller’s operation.After operation, the three princepal symptoms of hallux valgus deformity, painful bunionand difficulty in shoe-wearing were improved for more than 95% in the 112 feet.Eighty one% of the patients were satisfied with the result of the operation. We considerthat this method is one of the effective operation for correcting the hallux valgusdeformity and it is also important to select suitable patients.

  5. Comparison of Postoperative Height Changes of the Second Metatarsal Among 3 Osteotomy Methods for Hallux Valgus Deformity Correction.

    Science.gov (United States)

    Choi, Jun Young; Suh, Yu Min; Yeom, Ji Woong; Suh, Jin Soo

    2017-01-01

    We aimed to compare the postoperative height of the second metatarsal head relative to the first metatarsal head using axial radiographs among 3 different commonly used osteotomy techniques: proximal chevron metatarsal osteotomy (PCMO), scarf osteotomy, and distal chevron metatarsal osteotomy (DCMO). We retrospectively reviewed the radiographs and clinical findings of the patients with painful callosities under the second metatarsal head, complicated by hallux valgus, who underwent isolated PCMO, scarf osteotomy, or DCMO from February 2005 to January 2015. Each osteotomy was performed with 20 degrees of plantar ward obliquity. Along with lateral translation and rotation of the distal fragment to correct the deformity, lowering of the first metatarsal head was made by virtue of the oblique metatarsal osteotomy. Significant postoperative change in the second metatarsal height was observed on axial radiographs in all groups; this value was greatest in the PCMO group (vs scarf: P = .013; vs DCMO: P = .008) but did not significantly differ between the scarf and DCMO groups ( P = .785). The power for second metatarsal height correction was significantly greater in the PCMO group (vs scarf: P = .0005; vs DCMO: P = .0005) but did not significantly differ between the scarf and DCMO groups ( P = .832). Among the 3 osteotomy techniques commonly used to correct hallux valgus deformity, we observed that PCMO yielded the most effective height change of the second metatarsal head. Level III, retrospective comparative series.

  6. Prevalence of hallux valgus in the general population: a systematic review and meta-analysis

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    Vicenzino Bill

    2010-09-01

    Full Text Available Abstract Background Hallux valgus (HV is a foot deformity commonly seen in medical practice, often accompanied by significant functional disability and foot pain. Despite frequent mention in a diverse body of literature, a precise estimate of the prevalence of HV is difficult to ascertain. The purpose of this systematic review was to investigate prevalence of HV in the overall population and evaluate the influence of age and gender. Methods Electronic databases (Medline, Embase, and CINAHL and reference lists of included papers were searched to June 2009 for papers on HV prevalence without language restriction. MeSH terms and keywords were used relating to HV or bunions, prevalence and various synonyms. Included studies were surveys reporting original data for prevalence of HV or bunions in healthy populations of any age group. Surveys reporting prevalence data grouped with other foot deformities and in specific disease groups (e.g. rheumatoid arthritis, diabetes were excluded. Two independent investigators quality rated all included papers on the Epidemiological Appraisal Instrument. Data on raw prevalence, population studied and methodology were extracted. Prevalence proportions and the standard error were calculated, and meta-analysis was performed using a random effects model. Results A total of 78 papers reporting results of 76 surveys (total 496,957 participants were included and grouped by study population for meta-analysis. Pooled prevalence estimates for HV were 23% in adults aged 18-65 years (CI: 16.3 to 29.6 and 35.7% in elderly people aged over 65 years (CI: 29.5 to 42.0. Prevalence increased with age and was higher in females [30% (CI: 22 to 38] compared to males [13% (CI: 9 to 17]. Potential sources of bias were sampling method, study quality and method of HV diagnosis. Conclusions Notwithstanding the wide variation in estimates, it is evident that HV is prevalent; more so in females and with increasing age. Methodological quality

  7. ARTHRODESIS OF THE FIRST METATARSOPHALANGEAL JOINT IN PATIENTS WITH RHEUMATOID ARTHRITIS AND HALLUX VALGUS: CHOICE OF TECHNIQUE OF ARTHRODESIS FIXATION, COMPLICATIONS AND LONG-TERM RESULTS

    Directory of Open Access Journals (Sweden)

    V. P. Pavlov

    2014-01-01

    Full Text Available Objective: to study results of arthrodesis of the first metatarsophalangeal joint (I MPT joint in patients with rheumatoidarthritis (RA and hallux valgus, assess methods of arthrodesis fixation, reveal complications and analyze longterm results.Subjects and methods. Authors observed 86 patients with RA, female : male ratio 3.2:1, mean age was 53.8±9.5 years (from 18 to 75 years; 80 from them had seropositive and 6 – seronegative RA. 72 patients had low, and 14 –moderate activity of the disease. II stage of RA was revealed in 31.4%, III – in 62.8%, IV – in 5.8%; 52.3% of  patients had I and 47.7% – II functional class. All patients  ad hallux valgus as a component of typical deformation of the forefoot – digitis V rheumaticus (DVR. Standard global reconstructive operation (SGRO and its modification (MGRO were used. Both techniques included arthrodesis of the I MTP joint where fusion of bones was fixed with Kirschner wire and compression clamps in groups A and B respectively. Results of surgical treatmentwere assessed separately for I and II–V toes. The present work provides solely the results of the I MTP joint arthrodesis.Results. Assessment of the I MTP joint with hallux valgus before and 2.3±1.5 years after operation based on AOFAS comprised 35.51±8.16/82.32±6.09 in the group A and 39.93±6.65/82.26±5,59 in the group B. Inefficiency of arthrodesis of the I MTP joint was observed in 3 patients from the group B (2.15%. Before operation, 3 from 141 feet had hallux valgus of the II stage (21–40°; III (41–60° and IV (>60° stages of hallux valgus were recorded in 90 and48 feet respectively. Following 2.3 years after arthrodesis normal I MTP joints (10–11° were observed in 131 feet whereas, that of the II stage of hallux valgus (12–20° – in 10 feet.Conclusion. High efficacy of arthrodesis of the I MTP joint in patients with RA and hallux valgus and, subsequently, low failure rate (2.15% were achieved as

  8. 手术治疗拇外翻218例的临床症状分析%Clinical Symptoms of 218 Patients with Hallux Valgus Undergoing Operation

    Institute of Scientific and Technical Information of China (English)

    黄加张; 马昕; 王旭; 张超; 顾湘杰; 陈立

    2011-01-01

    Objective To analyze presenting symptoms of hallux valgus and the relationship between presenting symptoms and hallvu valgus stage. Methods All of 218 patients (291 feet) with hallux valgus admitted to Huashan Hospital in 2004~2009 were analyzed. According to presenting symptoms: bunion, less toe deformity, forefoot planter pain. According to X-ray assessment: mild, moderate or severe hallux valgus. Results Many kinds of presenting symptoms were reported:27 feet with bunion, 47 feet with less toe deformity, 14 feet with forefoot planter pain, 205 feet with two or three presenting symptoms. Mild, moderate and severe hallux valgus were 58, 108 and 125 feet respectively. The magnitude of hallux valgus deformity was not related with bunion or fore planter pain (P ≥0.05). Severe hallux valgus was significantly related with less toe deformity (P <0.05). Two or three presenting symptoms were significantly related with moderate or severe hallux valgus (P<0.05). Presenting symptoms of moderate and severe hallux valgus were not significantly related (P ≥0.05). Conclusion There are many presenting symptoms of hallux valgus, each of them with its own particular pathogenesis and problems. Different procedures should depend on not only X-ray assessment but also presenting symptoms and other deformities.%目的 探讨拇外翻患者就诊手术原因及与分度的关系.方法 收集2004年1月~2009年8月复旦大学附属华山医院手术治疗拇外翻218例(291足)的临床资料,根据临床症状分为四类:单纯跖骨头内侧疼痛,单纯小趾畸形,单纯前足胼胝疼痛.根据X线测量拇外翻角、跖骨间角分为轻度、中度、重度.结果 拇外翻患者就诊原因多种多样,其中单纯拇囊炎疼痛27足,单纯小趾畸形疼痛45足,单纯前足疼痛14足,有两项或两项以上症状205足.根据X线分型:轻度拇外翻58足,中度拇外翻108足,重度拇外翻125足.单纯拇囊炎疼痛、单纯前足疼痛与拇外

  9. SURGICAL CORRECTION OF HALLUX VALGUS IN PATIENTS WITH TRANSVERSE FLATFOOT AND DEFORMING ARTHROSIS OF THE FIRST METATARSOPHALANGEAL JOINT

    Directory of Open Access Journals (Sweden)

    V. M. Mashkov

    2013-01-01

    Full Text Available Objective: to determine the opportunity of usage of Schede-Brandes procedure in the treatment of patients with hallux valgus. Material and methods. The results of Shede-Brandeis operation were studied in 119 patients (198 feet. The study included patients who were followed up long-term results of treatment for up to 10 years. The results of the surgical treatment were assessed by the AOFAS scale and total criteria proposed I.A. Pakhomov. According to these scales the following results were obtained: the good - in 59,59% of patients, satisfactory - in 22,73%, poor - in 17,68%. Conclusion. These results allow to recommend Schede-Brandes procedure for use in elderly patients with osteoporosis, concomitant vascular diseases of lower extremities and with rheumatoid arthritis.

  10. Quality of Life Impact Related to Foot Health in a Sample of Older People with Hallux Valgus

    Science.gov (United States)

    López, Daniel López; Callejo González, Lucía; Iglesias, Marta Elena Losa; Canosa, Jesús Luis Saleta; Sanz, David Rodríguez; Lobo, Cesar Calvo; de Bengoa Vallejo, Ricardo Becerro

    2016-01-01

    Hallux Valgus (HV) is a highly prevalent forefoot deformity in older people associated with progressive subluxation and osteoarthritis of the first metatarsophalangeal (MTP) joint and it is believed to be associated with varying degrees of HV effect on the quality of life related to foot health. The aim of this study is to compare the impact of varying degrees of HV on foot health in a sample of older people. The sample consisted of 115 participants, mean age 76.7 ± 9.1, who attended an outpatient center where self-report data were recorded. The degree of HV deformity was determined in both feet using the Manchester Scale (MS) from stage 1 (mild) to 4 (very severe). Scores obtained on the Foot Health Status Questionnaire (FHSQ) were compared. This has 13 questions that assess 4 health domains of the feet, namely pain, function, general health and footwear. The stage 4 of HV shown lower scores for the footwear domain (11.23 ± 15.6); general foot health (27.62 ± 19.1); foot pain (44.65 ± 24.5); foot function (53.04 ± 27.2); vigour (42.19 ± 16.8); social capacity (44.46 ± 28.1); and general health (41.15 ± 25.5) compared with stage 1 of HV (P<0.05) and there were no differences of physical activity (62.81 ± 24.6). Often, quality of life decreases in the elderly population based in large part on their foot health. There is a progressive reduction in health in general and foot health with increasing severity of hallux valgus deformity which appears to be associated with the presence of greater degree of HV, regardless of gender. PMID:26816663

  11. [Comparison of 3 combinations of 0.5% levobupivacaine and 1% mepivacaine in popliteal sciatic block in hallux valgus outpatient surgery].

    Science.gov (United States)

    Faulí, A; Anglada, M T; Gomar, C; Sala, X; López, A; Pons, M; Gambús, P; Fábregas, N

    2012-12-01

    To compare 3 combinations of 0.5% levobupivacaine (L) and 1% mepivacaine (M) for popliteal block for hallux valgus surgery. Prospective, double blind study of 120 patients undergoing unilateral hallux valgus outpatient surgery with posterior popliteal block with ultrasound-guided single injection. Patients were randomly allocated into three groups: G1: 20mL L+10mL M; G2: 10mL L+20mL M; and G3: 15mL L+15mL M. Recorded variables were: time of block, onset and reversal times for tibial and peroneal nerves block; postoperative pain until the 7(th) day by means of visual analogue scale (VAS), simple descriptive scale and the quality of nocturnal rest, complications, and patient satisfaction. ANOVA and chi2 were applied in the statistical analysis, with a Pmepivacaine 1% provide a good alternative for a lasting postoperative analgesia. Copyright © 2011 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  12. PROMIS Pain Interference and Physical Function Scores Correlate With the Foot and Ankle Ability Measure (FAAM) in Patients With Hallux Valgus.

    Science.gov (United States)

    Nixon, Devon C; McCormick, Jeremy J; Johnson, Jeffrey E; Klein, Sandra E

    2017-08-23

    Traditional patient-reported outcome instruments like the Foot and Ankle Ability Measure (FAAM) quantify patient disability but often are limited by responder burden and incomplete questionnaires. The Patient-Reported Outcome Measurement Information System (PROMIS) overcomes such obstacles through computer-adaptive technology and can capture outcome data from various domains including physical and psychosocial function. Prior work has compared the FAAM with PROMIS physical function; however, there is little evidence comparing the association between foot and ankle-specific tools like the FAAM with more general outcomes measures of PROMIS pain interference and depression in foot and ankle conditions. (1) We asked whether there was a relationship between FAAM Activities of Daily Living (ADL) scores with PROMIS physical function, pain interference, and depression in patients with hallux valgus. (2) Additionally, we asked if we could identify specific factors that are associated with variance in FAAM and PROMIS physical function scores in patients with hallux valgus. Eighty-five new patients with either a primary or secondary diagnosis of hallux valgus based on clinic billing codes from July 2015 to February 2016 were retrospectively identified. Patients completed FAAM ADL paper-based surveys and electronic PROMIS questionnaires for physical function, pain interference, and depression from new patient visits at a single time. Spearman rho correlations were performed between FAAM ADL and PROMIS scores. Analyses then were used to identify differences in FAAM ADL and PROMIS physical function measures based on demographic variables. Stepwise linear regressions then determined which demographic and/or outcome variable(s) accounted for the variance in FAAM ADL and PROMIS physical function scores. FAAM scores correlated strongly with PROMIS physical function (r = 0.70, p < 0.001), moderately with PROMIS pain interference (r = -0.65, p < 0.001), and weakly with PROMIS

  13. Efficacy of Arnica montana D4 for healing of wounds after Hallux valgus surgery compared to diclofenac.

    Science.gov (United States)

    Karow, Jens-Hagen; Abt, Hans-Peter; Fröhling, Markus; Ackermann, Hanns

    2008-01-01

    This study was undertaken to answer the question: "Is Arnica D4 as efficacious as diclofenac in relation to symptoms and wound healing after foot surgery?" In this randomized double-blinded, parallel-group study (GCP-standard), the efficacy of Arnica D4 10 pillules (taken orally, 3 times per day) and diclofenac sodium, 50 mg (taken orally, 3 times per day) were investigated for equivalence in 88 patients 4 days after hallux valgus surgery. Outcome parameters were (1) postoperative irritation, (2) patient mobility, (3) rated pain, and (4) use of analgesics. The hierarchic equivalence test based on one-sided Wilcoxon-Mann-Whitney-U confidence intervals (CIs) was used. Equivalence was perceived, when the lower margin of the 95% CI was > 0.36 corresponding to a range of equivalence of 1/2 standard deviation. Arnica D4 and diclofenac were equivalent for wound irritation (lower margin of the 95% CI on day 4: 0.4729 for rubor; 0.3674 for swelling; 0.4106 for calor) and patient mobility (0.4726). A descriptive analysis showed the superiority of Arnica D4 with respect to patient mobility (p = 0.045). With respect to pain, Arnica D4 was inferior to diclofenac (lower margin of the 95% CI 0.026). No significant differences were found regarding the use of additional analgesics during the 4 postoperative days (Dipidolor, Janssen-Cilag, Neuss, Germany; p = 0.54; Tramal, Grünenthal, Aachen, Germany; p = 0.1; and Novalgin, AVENTIS-Pharma, Bad Soden, Germany; p = 0.1). Arnica D4 was significantly better tolerated than diclofenac (p = 0.049). Nine (9) patients (20.45%) of the diclofenac group and 2 (4.5%) of the Arnica D4 group reported intolerance. There was no disturbance in wound healing in any of the patients. Arnica D4 is 60% cheaper than diclofenac. After foot operations, Arnica D4 can be used instead of diclofenac to reduce wound irritation.

  14. Scarf截骨治疗中重度(足母)外翻%Scarf osteotomy for moderate to severe hallux valgus

    Institute of Scientific and Technical Information of China (English)

    宋秀锋; 郑加法; 李宏志; 周锦明; 关盛溢; 赵鹏

    2015-01-01

    目的 探讨Scarf截骨治疗中重度(足母)外翻的手术技巧及疗效.方法 2008年9月至2014年4月,采用Scarf截骨结合其他手术方法治疗中重度(足母)外翻患者144例(195足),获得随访110例(168足),男12例(16足),女98例(152足);年龄19~71岁,平均51岁.所有病例均采用scarf截骨联合第1跖趾关节骨赘切除、软组织松解手术,多数患者加用(足母)趾近节趾骨Akin截骨.采用美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)Maryland(足母)跖趾关节评分系统进行疗效评估.术前、术后数据采用SPSS17.0软件进行统计学分析.结果 随访时间12~36个月,平均20.4个月.(足母)外翻角(hallux valgus angle,HVA)较术前平均矫正24.6°,第1、2跖骨间角(intermetatarsal angle,IMA)较术前平均矫正8.4°.AOFAS评分从术前(46.2±13.6)分改善为(86.1±4.1)分.结论 Scarf截骨术具有较好的自身稳定性,可以缩短、延长、旋转和降低第1跖骨头,矫形能力强,接触面积大,愈合快,螺钉内固定可使患者早期下地活动,并发症少,节约医疗费用等优点,结合其他手术方式是治疗中重度(足母)外翻的理想方法.

  15. Proximal oblique-domed osteotomy of the first metatarsal for the treatment of hallux valgus associate with flat foot: effect to the correction of the longitudinal arch of the foot.

    Science.gov (United States)

    Takao, Masato; Komatsu, Fumito; Oae, Kazunori; Miyamoto, Wataru; Uchio, Yuji; Ochi, Mitsuo; Matsushita, Takashi

    2007-10-01

    Flat foot and/or metatarsal primus varus are the major causes of hallux valgus, and it is important to correct these deformities in order to prevent the recurrence of this condition. We demonstrate the clinical and radiological assessment of the correction of hallux valgus, metatarsal primus varus, and flat foot after proximal oblique-domed osteotomy of the metatarsus with distal soft tissue reconstruction. Twenty-seven feet of 22 patients with moderate or severe hallux valgus who had undergone proximal oblique-domed osteotomy were studied. After the adductor hallucis tendon was cut at the attachment of the proximal phalanx and at the sesamoid bone, the osteotomy was performed 3 cm dorsal-distal to the metatarsocuneiform joint to transfer distal fragment approximately 5 mm in the plantar direction, and rotated laterally decreasing the first-second intermetatarsal angle to 5 degrees. The mean AOFAS score was 54.1 +/- 2.8 points at pre-operation and 92.8 +/- 4.8 points at the most recent follow-up (P surgery and at one year after surgery. The average improvement of the talar pitch and calcaneal plantar angle was 2.6 +/- 1.4 and 2.4 +/- 1.5 degrees, respectively. This study suggest that proximal oblique-domed osteotomy of the metatarsal as a surgical procedure for the treatment of moderate or severe hallux valgus with flat foot can be recommended to correct the longitudinal arch of the foot and the first-second intermetatarsal angle.

  16. Bunions (Hallux Abducto Valgus)

    Science.gov (United States)

    ... front part of the foot. The big toe leans toward the second toe, rather than pointing straight ... ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and ...

  17. Scarf截骨治疗(足母)外翻的短期疗效分析%Short-term curative effect of Scarf osteotomy for treatment of hallux valgus

    Institute of Scientific and Technical Information of China (English)

    宋秀锋; 李荣俊; 杨涛; 李宏志; 郑加法

    2012-01-01

    Background: Hallux valgus is a common disease in foot and ankle surgery. It is given priority to the surgical treatment at present. However, there are great differences in terms of clinical outcomes and recurrence for operative treatments. Objective: The purpose of the study is to evaluate the short-term results of Scarf osteotomy combined with other surgical procedures in the treatment of moderate or severe hallux valgus. Methods: From July 2008 to June 2010, 33 patients (41 feet) with moderate or severe hallux valgus were treated with Scarf osteotomy. There were 4 males (4 feet) and 29 females (37 feet) with an average age of 5L7 years (range, 24 to 69 years). The therapeutic effects were assessed by American Orthopedic Foot and Ankle Society (AOFAS) Maryland scoring, X-ray films were taken under enough weight loading during follow-up. Hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured before and after the treatment. Results: The average follow-up time was 20.4 months (range, 12 to 36 months). The mean HVA decreased from 32.78° to 10.18°, and the mean IMA decreased from 11.57° to 6.26°. According to AOFAS Maryland scoring, 28 feet (68.3%) were excellent, 11 feet (26.8%) good, 2 feet (4.9%) fair, and the rate of excellent or good was 95.1 % (39/41). Conclusions: Scarf osteotomy is a reliable method to treat hallux valgus. The osteotomy technique is simple, and could provide satisfactory short-term results with lower complication rate.%背景:(足母)外翻为足踝外科常见病、多发病,目前以各种手术治疗为主,术后效果及复发率有较大差异.目的:探讨Scarf截骨联合其他手术方式治疗中、重度(足母)外翻的短期疗效.方法:2008年7月至2010年6月,采用Scarf截骨治疗中、重度(足母)外翻患者33例(41足),男4例(4足),女29例(37足);年龄24~69岁,平均51.7岁.在Scarf截骨的基础上部分患者联合第一跖趾关节骨赘切除、软组织松解及(足母)趾近节趾

  18. A survey on the relationship between wedge heel of nurse shoes and hallux valgus%坡跟护士鞋与足拇外翻的相关性研究

    Institute of Scientific and Technical Information of China (English)

    胡婷

    2013-01-01

    Objective To investigate the relationship between the heel design of nurse shoes and the incidences of hallux valgus. The findings of this study will help clinical nurses to choose right shoes to keep the occupational safety. Methods To investigate 87 clinical nurses in different department through answering the questionnaire designed by the investigator. Results 63.2% clinical nurses felt squeezing wearing wedge heel of nurse shoes, 69% clinical nurses showed that wedge heel of nurse shoes could contribute the pain of the hallux joint. The working position and the extent of squeezing of shoes have positive relationship with the pain of po-darthrum (P<0.05), and the wedge heel has positive relationship with hallux valgus(P<0.01).Conclusion The result of the study demonstrated that the wedge heel of nurse shoes will cause hallux valgus. Therefore, wedge heel of the nurse shoes should not be de-signed for reducing the occurence of hallux valgus in clinical nurses.%目的研究护士鞋跟设计与诱发拇外翻的相关性,为临床护士选择合适的工作鞋从而改善护士职业安全提供依据。方法采用自行设计的调查问卷,对87例各科临床护士进行护士鞋跟设计对足部影响的调查。结果63.2%的护士认为坡跟护士鞋的鞋尖处感觉狭窄,认为工作时穿着坡跟护士鞋会感足趾关节疼痛的护士占69%,护士的工作状态、护士鞋对足趾挤压程度与坡跟鞋引起的足趾关节疼痛呈正相关(P<0.05),且坡跟鞋引起的足趾关节疼痛又与拇外翻发生呈正相关(P<0.01)。结论护士鞋坡跟设计增加了拇外翻病变的发生几率,针对护士群体,及护士特殊工作状态,应减少采取护士鞋坡跟设计,以改善临床护士的职业健康状况。

  19. Short term effect of Scarf osteotomy on moderate to severe hallux valgus%Scarf截骨治疗中重度外翻的短期疗效分析

    Institute of Scientific and Technical Information of China (English)

    徐子涵; 孙天胜; 汤宇; 戴鹤玲; 刘志杰; 程明

    2013-01-01

    背景:外翻是最常见的前足畸形,越来越受到矫形外科医生的重视,其治疗方式多种多样,如何选择适合的手术方式是治疗成功的关键。  目的:探讨Scarf截骨术治疗外翻的疗效。  方法:2010年7月至2012年6月,我院采用Scarf截骨术治疗中重度外翻患者47例(61足),男5例(7足),女42例(54足);年龄20~78岁,平均52.2岁。比较手术前后外翻角及第1、2跖骨间角纠正程度。采用AOFAS评分评估患者临床症状改善情况。  结果:所有患者均获得随访,随访时间4~8个月,平均6个月。外翻角由术前42.6°减小至12.9°,平均减小29.7°。第1、2跖骨间角由术前18.4°减小至8.9°,平均减小9.5°。AOFAS评分由术前49.9分增加至术后86.2分,平均增加26.5分。并发症发生率10%。  结论:Scarf截骨术治疗中重度外翻可以获得较好的短期临床结果,但需严格掌握手术适应证。%Background:Hallux valgus is the most common deformity in forefoot. There are many treatments for it. Therefore, it is very important to choose an appropriate surgical therapy for each patient. Objective:The purpose of the study is to explore the efficacy of Scarf osteotomy for the treatment of hallux valgus. Methods:From July 2010 to June 2012, 47 patients with 61 feet underwent Scarf osteotomy for the treatment of moderate to severe hallux valgus. There were 5 males (7 feet) and 42 females (54 feet) with an average age of 52.2 years (range, 20-78 years). The hallux valgus angle(HVA) and intermetatarsal angle (IMA) were compared before and after surgery. Clinical outcomes were assess by American Orthopedic Foot and Ankle Society (AOFAS) scoring. Results:The mean duration of follow-up was 6 months in all the patients (range, 4-8 months). HVA was decreased by 29.7° (from 42.6° preoperative to 12.9° postoperative). IMA was decreased by 9.5° (from 18.4° preoperative to 8.9° postopera

  20. Metatarsophalangeal joint medial collateral ligament reconstruction in the treatment of hallux valgus%跖趾关节内侧副韧带重建术治疗外翻

    Institute of Scientific and Technical Information of China (English)

    赵鸿声; 靖光武; 张建军; 黄吉利

    2012-01-01

    目的 探讨跖趾关节内侧副韧带重建加跖趾关节成形术治疗外翻疗效.方法 采用改良跖趾关节成形术治疗外翻23例(38足),并对趾畸形的矫正程度、疼痛症状的改善及行走功能的恢复等进行充分评估.结果 本组患者外翻角(HAV)及第一、二跖骨间夹角(IMA)术前、后比较,差异有统计学意义(P<0.05).术后随访(13.6±2.3)个月,疗效优28足,良8足,可1足,差1足,总优良率达94.7%.结论 跖趾关节内侧副韧带重建加跖趾关节成形术能够治疗多种中、重度外翻及合并趾跖关节炎患者,能有效改善足部外形及症状,恢复行走功能,并发症少.%Objective To investigate clinical effect of medial collateral ligament reconstruction and arthroplasty of metatarsophalangeal joint for the treatment of hallux valgus. Methods From 2006 to 2011,38 feet of 23 patients were treated with the modified operation. All patients were followed up and the degree of deformity correction, the improvement of pain and the recovery of walking function were fully e-valuated. Results After the surgery, there were significant differences in hallux valgus angle( HVA )and intermetatarsal angle( IMA )( P <0. 05 ). All the cases were followed up for( 13. 6 ± 2. 3 )months and an excellent outcome was found in 28 feet, good in 8, fair in 1 and poor in 1, the excellent and good rate was 94.7%. Conclusion The modified metatarsophalangeal joint arthroplasty is an effective method for patients with hallux valgus and extensor digitorum communis arthritis. It can markedly improve the appearance, release the symptoms, restore the function and reduce the complications.

  1. Hallux varus following scarf osteotomy.

    Science.gov (United States)

    Akhtar, Shahid; Malek, Sabur; Hariharan, Kartik

    2016-12-01

    Hallux varus is an uncommon condition and majority of the cases are iatrogenic. It can occur as a result of any type of hallux valgus correction surgery and in our cases scarf osteotomy is not an exception. Treatment of this complication can be challenging and it is important to understand the factors that cause this deformity before embarking on surgical correction. Four cases of hallux varus following Scarf osteotomy (1% of our total Scarf osteotomy cases) and discuss the salient features of these patients. The authors ascertained the factors that caused iatrogenic hallux varus and formulated a classification of the nature of the deformity. The management of iatrogenic hallux varus based on our experience and proposed classification system has also been outlined and discussed. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  2. Ludloff截骨治疗中重度拇外翻的临床疗效观察%Clinical results with the Ludloff osteotomy for correction of moderate-to-severe hallux valgus

    Institute of Scientific and Technical Information of China (English)

    杨波; 李强; 鲁英; 喻飞

    2011-01-01

    Objective To observe the outcomes of Ludloff proximal first metatarsal osteotomy. Methods Twentysix patients (34 feet) with a mean age of fifty-eight years underwent a modified Ludloff proximal first metatarsal osteotomy and a distal soft-tissue procedure at our hospital for the treatment of a moderate-to-severe hallux valgus deformity. The American Orthopaedic Foot and Ankle Society score and weight-bearing radiographs of the foot were assessed preoperatively and after a mean duration of follow-up of twenty-five months. Results The mean American Orthopaedic Foot and Ankle Society score improved significantly ( P < 0. 01 ) from 52 points preoperatively to 88 points at the time of the most recent follow-up. The average hallux valgus angle improved from 31° preoperatively to 10. 3° at follow-up. The average intermetatarsal angle improved from 17° to 7. 8°. No severe complication has found. Conclusion Our intermodiateterm results demonstrate that the procedure achieves significant correction of moderate-to-severe hallux valgus deformity, significant reduction in forefoot pain, and significant improvement in functional outcome. This technique is valuable in correction of moderate to severe hallux valgus deformities.%目的 研究Ludloff截骨术对中、重度拇外翻的治疗效果.方法 2007年9月至2008年10月对26例(34足)中、重度拇外翻患者使用Ludloff截骨配合远端软组织手术进行矫形手术治疗,截骨使用螺钉固定.男4例,女22例,年龄48~67岁,平均58岁.术后采用AOFAS评分对患足进行临床功能评价,同时拍负重位足的正侧位X线片进行影像学评价,比较术后AOFAS评分及跖拇角和第一二跖间角的变化,了解患者的满意程度.结果 平均随访时间25个月(19~36个月).在最后一次随访时,31足基本无痛,3足偶有疼痛或轻微疼痛.患者对拇外翻畸形纠正满意.AOFAS评分为从术前的51分(27~65分)提高到术后的88分(72~96分),HVA从术前的31°(21

  3. Hálux valgo: estudo comparativo entre duas técnicas cirúrgicas de osteotomia proximal de adição Hallux valgus: comparative study between two surgical techniques of proximal addition osteotomy

    Directory of Open Access Journals (Sweden)

    Luiz Carlos Ribeiro Lara

    2012-12-01

    Full Text Available OBJETIVO: Comparar clínica e radiograficamente os resultados da correção do hálux valgo, através de duas técnicas de osteotomia de adição: uma utilizando-se da exostose ressecada e outra, mediante a fixação com placa para cunha de adição. MÉTODOS: Avaliamos 24 pés em 19 pacientes, com média de idade de 51,3 anos, portadores de hálux valgo, com seguimento médio de 50,1 meses. Submeteram-se à técnica de osteotomia de adição com exostose óssea (OAEO 13 pés e à osteotomia de adição com placa para cunha de adição (OPCA 11 pés. Foram avaliados no pré e pós operatório o escore AOFAS, os ângulos intermetatársicos 1 e 2, e ângulo de valgismo do hálux. RESULTADOS: Na técnica OAEO a média no pré-operatório do AOFAS foi 46,6 pontos, AIM 14º e AVH 32º, enquanto no pós-operatório AOFAS 81,3 pontos, AIM 9º e AVH 25ºcom 92,3% de resultados satisfatórios. Na técnica OPCA a média no pré-operatório do AOFAS foi 42,1 pontos, AIM 15º e AVH 29º, enquanto no pós-operatório AOFAS 77,4 pontos, AIM 11º e AMF 23º com 81,8% de resultados satisfatórios. CONCLUSÕES: Ambas as técnicas cirúrgicas mostraram-se eficazes no tratamento do hálux valgo, clínica e radiograficamente, sem diferença estatística entre elas. Nível de evidência III, Estudo retrospectivo comparativo.OBJECTIVE: To clinically and radiographically compare the results of treatment of hallux valgus, by two addition osteotomy techniques: one using resected exostosis, and the other using a plate fixation for addition wedge. METHODS: We evaluated 24 feet of 19 patients, mean age 51.3 years, affected by hallux valgus, with a mean follow-up of 50.1 months. 13 feet underwent addition osteotomy with resected exostosis (AORE and 11 patients (11 feet underwent addition osteotomy with plate (AOP. The AOFAS score, intermetatarsal 1 and 2 angles, and hallux valgus angle were evaluated before and after surgery. RESULTS: In the AORE technique, the mean

  4. Hálux valgo e pés planos: as forças plantares são iguais? Hallux valgus and flat feet: are plantar forces equal?

    Directory of Open Access Journals (Sweden)

    Elaine Cristina Martinez Teodoro

    2007-01-01

    Full Text Available OBJETIVO: Este trabalho teve como objetivo estimar as forças plantares nos dedos dos pés de mulheres com hálux valgo e/ou pés planos. MÉTODOS: Trata-se de um estudo transversal envolvendo mulheres com hálux valgo e/ou pés planos confirmado através de análise radiográfica. Mediram-se as forças plantares, utilizando plataformas de forças. Coletaram-se estas forças com as mulheres descalças e em posição ereta, por três medidas sendo obtida uma média. Os dados foram adquiridos através da ponte amplificadora Spider 8 da HBM e analisados através do programa Catman®. Obtiveram-se as medidas de forças dos dedos de ambos os pés e as médias foram comparadas pelo teste t de Student segundo a presença de hálux valgo e pés planos; a associação entre essas deformidades foi estimada pelo teste exato de Fischer bicaudal, a significância estatística adotada foi alfa = 5%. RESULTADOS: Foram incluídas no estudo, vinte mulheres com presença ou não de hálux valgo. As forças médias encontradas mostraram-se maiores no 5º dedo em relação ao 1º dedo de ambos os pés (pOBJECTIVE: to measure the plantar forces above the toes of women with hallux valgus and/or flat feet. METHODS: This study involved women with hallux valgus and/or flat feet confirmed by X-ray images. The plantar forces were measured utilizing force plates. Force was measured three times, which were taken with the women on barefoot and at upright position, recording the average for the three measurements. Data were acquired from Spider 8 system (HBM and analyzed by using a Catman® software. The measurements for both feet's toes force were reported and the averages were compared by the Student's t-test according to the presence of hallux valgus and flat feet; the association between these deformities was estimated by using the two-tailed Fischer's exact test, the statistical significance adopted was alpha = 5%. RESULTS: For this study, 20 women with or without hallux

  5. 拇外翻患者术后门诊随访的依从性分析及应对策略%The analysis of clinic follow-up compliance of hallux valgus surgery patients and the strategies accordingly

    Institute of Scientific and Technical Information of China (English)

    余志勇; 温建民; 王林侠; 孙卫东; 蒋云峰; 张帅; 张明敏

    2011-01-01

    Objective It is to investigate the clinic follow-up compliance of patients with hallux valgus after surgery and puts forwards the corresponding strategies. Methods Through the form of questionnaire, the inquiry scale was filled by telephone interviews. Results 113 effective scales were hacked, there were 83 cases ( 73. 45% ) with good compliance and 30 cases ( 26.55% ) with poor compliance. The compliance was not correlated with age, education level, surgical procedure, limbs, hallux valgus severity , but related with residence. Conclusion Patient visits far as the main cause of poor compliance , followed by “ that there is no need to review” . It can be taken corresponding measures to improve compliance and ensure effective operation.%目的 调查拇外翻患者术后门诊随访依从性并提出应对策略.方法 通过问卷调查形式,采用电话访谈方法填写调查量表.结果 收回有效量表113份,其中依从性好83例(73.45%),依从性差30例(26.55%);依从性与患者年龄、文化程度、手术术肢、拇外翻严重程度无相关性,但受居住地影响.结论 患者就诊太远为依从性差的主因,其次为"认为没有必要复查".针对这些人群,可采取相应措施提高依从性,保证术后疗效.

  6. Long-term efficacy analysis of minimal incision osteotomy for treatment of hallux valgus%微创截骨治疗(足母)外翻的远期疗效分析

    Institute of Scientific and Technical Information of China (English)

    孙卫东; 吴夏勃; 戴鹤玲; 温建民; 胡海威; 孙永生; 桑志成; 蒋科卫; 梁朝; 程程; 林新晓

    2010-01-01

    Objective To evaluate the long-term results of minimal incision osteotomy for hallux valgus.Methods From February 1996 to May 1999,372 cases(705 feet)with hallux valgus were treated with minimal incision osteotomy.Seventy-nine cases after surgery were followed up for more than 5 years,including 6 males(10 feet)and 73 females(140 feet)with an average age of 47 years(range,13-75 years).The average follow-up time was 7.5 years(range,5.3-13.2 years).The preoperative and postoperative hallux valgus angles(HVA),intermetatarsal angles(IMA),the tibial sesamoid position(TSP),American orthopedic foot and ankle society(AOFAS)score,range of movement of the first metatarsophalangeal joint,and lateral metatarsalgia etc.were observed and measured.And the clinic outcome were studied and evaluated.Results Based on Wen Jian-min's clinic curative effect evaluation criterion(2001),56 feet(37.3%)were excellent,88 feet(58.7%)good ,6 feet(4.0%)fair.The rate of excellent or good was 96.0%(144/150).The postoperative mean AOFAS score was 84.20±4.32 points(range,60-100 points).The mean HVA decreased from 33.28 to 12.31 degrees,the mean IMA from 11.75 to 6.80 degrees.The TSP was corrected from an average preoperative grade of 4.29 to a grade of 3.07 at final follow-up.There are no nonunion or delayed union of osteotomy,avascular necrosis of the 1st metatarsal head,infection,hallux varus.Four feet(2.7%)had numbness in the medial of the big toe.The 1st metatarsophalangeal joint range of motion decreased from 70.20 to 69.53 degrees.There were 97 feet(64.7%)with the 2-5 metatarsalgia before operation,and 35 feet(23.3%)disappeared,54 feet(36.0%)improved,8 feet(5.3%)aggravated after operation.Conclusion Minimal incision osteotomy technique is sound and reliable method to treat hallux valgus.The osteotomy technique is simple,and could provide satisfactory long-term results with lower complication rate.%目的 评价微创截骨治疗(足母)外翻的远期疗效.方法 对1996年2月至1999年5月

  7. 第一跖骨双截骨矫正重度(足母)外翻畸形%Double wedge osteotomy of the first metatarsal for correction of severe hallux valgus

    Institute of Scientific and Technical Information of China (English)

    李昕宇; 林顺福; 王剑; 陈宇明; 王正义

    2013-01-01

    Objective To explore the curative effect of the operation of double wedge osteotomy of the first metatarsal for correction of severe hallux valgus.Methods The data of 62 patients (87 feet) with severe hallux valgus caused by enlarged distal metatarsal articular angle (DMAA) who were followed up after receiving the treatment of double wedge osteotomy of the first metatarsal from January 2008 to December 2011 were analyzed retrospectively.There are 9 males (14 feet),and 53 females (73 feet),with an average age of 56 years (range,28-70 years).Preoperative radiographs showed hallux valgus angle (HVA) was 48.6° in average,intermetatarsal angle (IMA) was 19.8° in average,and DMAA was 22.1° in avcragc.Thc opcration plan was made based on the preoperative deformity,and the osteotomy site,the angle,the capacity of osteotomy was all based on preoperative measurement.Compare the changes of HVA,IMA,DMAA before and after operation.The changes were also compared before and after the internal fixation extraction.The curative effect was observation based on American Orthopaedic Foot and Ankle Society (AOFAS) propodium score standard.Results Sixty-two patients (87 feet) were followed up for 10 to 57 months,with an average of 21 months.HVA (14.6°±1.2°),IMA (7.9°±0.7°),DMAA (7.7°±0.9°) were all satisfied 6 months after the operation.Stiff occurred in 2 patients after the operation.Cutaneous nerve injury occurred in 2 patients,and metastatic metatarsalgia occurred in 1 patient.No sever recurrence of deformity,bone nonunion and bone necrosis was found in all the patients.AOFAS score reached 91.8±1.8 one year after the operation,which was 28.4±9.1 preoperatively.Among them,49 feet were rated as excellent,31 as good,and 7 as fair.The excellent and good rate was 92% (80/87).Conclusion The first metatarsal double osteotomy can effectively correct the severe hallux valgus deformity with enlarged DMAA with few complications.It achieves good effect.Patients can bear part of

  8. 选择性跖骨远端截骨治疗中重度(足母)外翻%Selective distal osteotomy of the first metatarsal for treatment of moderate and severe hallux valgus

    Institute of Scientific and Technical Information of China (English)

    孙建峰; 申杨勇; 韩斌; 陈京峰; 吴长喜; 李治斌; 崇辉; 顾敏琪

    2012-01-01

    [Objective] To retrospectively study and discuss the indications, surgical techniques and outcomes of selective distal osteotomy of the first metatarsal [Methods] From March 2007 to January 2011, 60 patients (101 feet) with hallux val-gus received distal osteotomy of the first metatarsal in our hospital, including 57 females and 3 males, with the mean age of 62.6 years (range ,23~81 years) . [ Results ] The followed - up period varied from 6 months to 4 years, wilh an average of 22 months. AU patients were evaluated with the American Orthopaedic Foot and Ankle Society ( AOFAS) hallux metatarsophalange-al - interphalangeal scale for the clinical assessment The excellent result was abtained in 40 (66 feet), good in 16 (30 feet) , and fair in 4 (5 feet) . The hallux valgus angles decreased from 36° (30°~44°) to 15. 3° (10. 5°~21°) . The intermetatar-sal angles were 16° (13°~18°) before surgery, and decreased to 8.5° (6°~10°) after surgery. The hallux metatarsophalan-geal joint range of motion increased from 16° (0°~30°) to 35° (25°~50°) . The length of the first metatareals decreasedby 4.2 mm (3-6 mm) . [ Conclusion ] This technique is of a soft - tissue and bone surgery, which has the advantages of minimal invasion, stable fixation and sufficiently plastic metatarsal head. It should be widely used in the clinical practice. decreasedby 4.2%[目的]探讨选择性跖骨远端截骨治疗(足母)外翻的手术适应证、手术方法及疗效.[方法]对2007年3月~2011年1月本院60例(101足)中度及重度(足母)外翻进行回顾性分析.双足41例,单足19例.其中女性57例,男性3例;年龄23~81岁,平均62.6岁.[结果]本组60例(101足)均获随访,随访时间6~48个月,平均22个月.参照美国足踝外科协会Maryland(足母)跖趾关节百分评分系统,90~ 100分40例(66足);80~89分16例(30足);70~79分4例(5足);优良率95%.术前HVA 30°~44°,平均36°;术后10.5°~21°,平均15.3°.IMA 13

  9. 改良Mcbride术治疗轻中度拇外翻临床疗效分析%The analysis of curative effect of the modified McBride's procedure on correcting mild-moderate hallux val-gus

    Institute of Scientific and Technical Information of China (English)

    闫行超; 刘志刚; 潘月海; 贾晓燕; 刘鉴锋; 张亚楠; 邵江波; 刘彬

    2015-01-01

    Objective To explore the curative effect of clinical application of modified McBride's procedure on correcting mild-moderate hallux valgus.Methods We had retrospectively assessed 32 patients(52 feet)treated with the procedure of modified McBride's procedure.All patients were followed up,the follow -up period from 6 months to 6 years(3.1 years on average).There were 2 male(4 feet)patients and 30 female(48 feet)patients in this group.The average age at the time of surgery was 41.6 years old(from 21 to 59 years).Results According to the forefoot score of American Orthopedics Foot and Ankle Society(AOFAS),29 feet(55.8%)were excellent,17 feet (32.7%)were good,And the rate of excellent and good was 88.5%.The average correction of HVA and IMA was 13.68°and 3.24°respectively compared with the preoperative cases.Conclusion This procedure can not only effec-tively reduce the increased hallux valgus angle,but also narrow the angle between the 1st and 2nd metatarsal,relocate the sesamoid system,and effectively relieve patients'pain.This approach is of minor side effects to bone and joint structure,and of rapid recovery.It is a preferential choice to treat mild-to-moderate hallux valgus deformity.%目的:探讨改良Mcbride术治疗轻、中度拇外翻的临床疗效。方法选取采用改良Mcbride术治疗的拇外翻32例(52足),均获得随访,随访时间为6个月至6年,平均3.1年;男2例4足,女30例48足,手术年龄在21~59岁,平均41.6岁。结果参照美国足踝外科协会(AOFAS)前足评分系统对所有患者进行评定,优29足(55.8%),良17足(32.7%),优良率为88.5%;拇外翻角(HVA)较术前平均纠正了13.68°,第一、二跖骨间角(IMA)较术前平均纠正了3.24°。结论此术式能有效地减小增大的拇外翻角,同时也缩小第1、2跖骨间角,复位相对脱位的籽骨,有效地去除或减缓拇囊炎症状。此方法创伤小,恢复快,能较

  10. Clinical research of Silver operation combined with Akin osteotomy for therapy of elderly hallux valgus%Silver 手术联合 Akin 截骨术治疗老年足拇外翻临床研究

    Institute of Scientific and Technical Information of China (English)

    陈新宇

    2014-01-01

    目的:探讨 Silver 手术联合 Akin 截骨术治疗足拇外翻老年患者的临床疗效。方法选取2010年1月至2012年12月收治的足拇外翻老年患者40例。给予 Silver 手术联合 Akin 截骨术治疗,术后不采用外固定,尽早下床功能锻炼。随访并观察统计患者外翻角(HVA)、跖间角(IMA)和近侧关节固定角(PASA)的变化,疗效客观评价采用美国足踝外科协会(AOFAS)评分系统,采用自制调查表进行满意度调查。结果术前 HVA(29.65±4.79)°,术后矫正到(10.41±3.37)°,差异有统计学意义(t =27.47,P ﹤0.01),术前 IMA(9.47±2.48)°,术后矫正到(8.37±2.58)°,差异有统计学意义(t =3.21,P ﹤0.05)。术前 AOFAS 评分(28.37±5.81)术后提高到(82.74±10.76),具有统计学意义(t =35.71,P ﹤0.05)。结论 Silver 手术联合 Akin 截骨术治疗轻中度足拇外翻老年患者,矫正效果佳、复发率低,同时因不需要外固定,术后允许早期负重锻炼,可有效降低老年人围术期并发症发生率。%Objective To investigate the clinical curative effect of Silver operation combined with Akin osteotomy on elderly hallux valgus. Methods Forty cases of elderly hallux valgus patients from January 2010 to December 2012 were selected. All of the patients were given Silver operation com-bined with Akin osteotomy surgery treatment,with no external fixation after operation,and they all took functional exercise as soon as possible. The hallux valgus angle(HVA),intermetatarsal angle(IMA) and proximal articular set angle(PASA)were followed - up and observed. The curative effect was evalu-ated objectively by the American Orthopaedic Foot and Ankle Society(AOFAS)scoring system,and self-designed questionnaire was used for satisfaction survey. Results HVA was(29. 65 ± 4. 79)° before op-eration and it was corrected to the(10. 41 ± 3. 37)°after operation,there was significant

  11. Minimally invasive three-dimensional correction with limited fixed in the treatment of hallux valgus%微创三维矫正有限固定治疗(坶)外翻

    Institute of Scientific and Technical Information of China (English)

    孙洋; 吴俊; 马海东; 曲家富; 曹立海; 赵国志; 高建华; 彭义; 李绍光; 杜晓健; 王良

    2012-01-01

    背景:传统微创技术治疗(坶)外翻常出现第1、2趾骨间皮肤溃烂、行走不适、术后截骨端再移位、第1跖趾关节僵硬等并发症.目的:研究微创三维矫正有限固定治疗(坶)外翻的临床效果.方法:2005年7月至2010年10月采用微创技术、三维手法矫正加克氏针有限固定术治疗(坶)外翻151例281足,其中132例245足获得随访,男8例,女124例;年龄16 ~ 76岁,平均(50.2±10.3)岁;113例双侧226足,19例单侧19足.按Mann(坶)外翻分类:轻度98足,中度122足,重度25足.对比手术前后(坶)外翻角(HVA)、第1、2跖骨间角(IMA)、趾骨间角(IPA)、近侧关节固定角(PASA)、远侧关节固定角(DASA)、跖楔角(MCA)、美国足与踝关节协会足(坶)趾-跖趾关节-趾间关节功能评分标准(AOFAS)评分及前足底压力.结果:随访时间为2~6.25年,平均3.9年.236足(坶)外翻畸形完全矫正无复发,6足复发,3足第一跖趾关节炎行关节融合术.前足第2、3跖骨头底部胼胝体的疼痛早期均获得缓解,后期233足的胼胝体疼痛逐渐完全消失,12足未完全消失.(坶)囊炎疼痛完全消失;6足(坶)趾背内感觉麻木;15足第一跖趾关节活动受限4°~9°.伤口均Ⅰ期愈合,无一例出现感染、骨不愈合、跖骨头坏死和克氏针断裂.术后245足X线片均示HVA< 20°,IMA< 10°.手术前后各角度变化、AOFAS评分比较均有统计学差异(P< 0.001),前足底压力由术前第2、3、1、4、5跖骨头依次递减改善为术后第1~5跖骨头依次递减.结论:微创三维矫正有限固定治疗(坶)外翻是一种操作简单、损伤小痛苦少、下地早康复快、矫正彻底不易复发的治疗方法,疗效理想,但亦存在一定弊端如畸形纠正力度不强、转移性跖骨痛等,仍有待进一步解决.%Background: Traditional minimally invasive operation for hallux valgus may cause many complications, such as skin ulcer between the first and second toe

  12. 拇外翻发病危险因素与足底压力特征%The risk factors and plantar pressure characteristics of hallux valgus

    Institute of Scientific and Technical Information of China (English)

    黄萍; 钱念东; 齐进; 陈博; 邓廉夫

    2016-01-01

    BACKGROUND:Complex anatomic deformity of the foot due to hal ux valgus results in the changes of plantar biomechanics. OBJECTIVE:To analyze the risk factors of hal ux valgus and to detect the plantar pressure of hal ux valgus in natural walking. METHODS:The dynamic plantar pressures of 50 patients and 30 age-, height-and weight-matched normal persons were respectively tested by the Footscan USB2 system (RSscan International, Belgium). Al subjects were detected during barefoot walking over three times, to obtain the dynamic plantar pressure curves and characteristic parameters for further analysis. RESULTS AND CONCLUSION:Among patients with hal ux valgus, women accounted for 94%(al wearing pointed high-heeled shoes), men accounted for 6%(none wearing pointed high-heeled shoes), and 96%had a genetic history. During the natural walking, the first metatarsal pressure of hal ux valgus feet was increased significantly, which markedly differed from the normal people. The average peak pressure, average load, and average impulse of the first metatarsal in hal ux valgus patients were significantly increased compared with the normal controls (P  目的:分析拇外翻的发病危险因素,检测拇外翻患者平地自然行走下足底压力分布特征。  方法:采用比利时RSscan INTERNATIONAL公司生产的footscanUSB2平板式足底压力测试系统,检测50例拇外翻患者和年龄、身高、体质量匹配的30例正常人的动态足底压力。所有受试者测试时均脱鞋袜,以个人平常步态自然行走,每人测试3次以上,取得动态足底压力曲线及特征量参数,对曲线及各参数进行分析。  结果与结论:①测试的拇外翻患者中,女性占94%(均穿高跟尖头鞋),男性占6%(均不穿高跟尖头鞋),96%有遗传史;②在自然行走步态中,拇外翻患者双足第1跖骨区压力明显增高,与正常人足底压力图形明显不同;③拇外翻患者第1跖骨的平均

  13. Estudo retrospectivo da osteotomia de base do primeiro metatarso com tratamento do hálux valgo Retrospective study of first metatarsal base osteotomy as a treatment os hallux valgus

    Directory of Open Access Journals (Sweden)

    Helencar Ignácio

    2006-01-01

    Full Text Available Os autores avaliaram 33 pacientes (48 pés com hálux valgo moderado a grave tratados cirurgicamente com a técnica de osteotomia de base do I metatarso em cunha de adição associada a reparação de tecidos moles. Comparações correlacionando sexo, idade e parâmetros radiográficos, foram feitas pelo teste t para amostras independentes; o desvio do sesamóide foi comparado pelo teste não paramétrico de Kruskal-Wallis. Todos os pacientes responderam a um questionário no qual expressaram o grau de satisfação com o resultado final da cirurgia. 76% dos pacientes eram do sexo feminino, com idade entre 14 e 60 anos (média de 38,15 anos, com tempo médio de seguimento de 41 meses. Em relação ao sexo não houve diferença na variação radiográfica. Também não foram constatadas diferenças no pré e pós-operatório quando comparado os valores médios dos pés direito e esquerdo. A avaliação radiológica apresentou 73% de resultados excelentes e o grau de satisfação total foi de 60,7% . Não há evidência da idade média influenciar no grau de satisfação, porém acima de 60 anos todos os pacientes relataram satisfação parcial. Concluímos que o procedimento cirúrgico apresentado seja um método seguro e eficaz para o tratamento do halux valgo moderado e grave.The authors evaluated 33 patients (48 feet with moderate to severe hallux valgus, surgically treated by using a 1st metatarsal wedged base osteotomy technique associated to soft tissues repair. Comparisons correlating gender, age, and x-ray parameters were performed by using the t-test for independent samples; sesamoid deviation was compared by Kruskal-Wallis non-parametric test. All patients answered to a questionnaire in which they expressed their degree of satisfaction regarding the final results of the surgery. Seventy six per cent of patients were women between 14 and 60 years old (average 38.15 years old with an average follow-up time of 41 months. There was no

  14. Hallux Rigidus

    Science.gov (United States)

    ... Common causes of hallux rigidus are faulty function (biomechanics) and structural abnormalities of the foot that can ... by cold, damp weather Difficulty with certain activities (running, squatting) Swelling and inflammation around the joint As ...

  15. 拇外翻截骨矫形绷带外固定的疗效%Efficacy of the external bandage fixation for corrective osteotomy surgery of hallux valgus

    Institute of Scientific and Technical Information of China (English)

    高战鳌; 张云; 赵思桥; 马顺前

    2016-01-01

    目的:分析微创截骨矫形后绷带外固定拇外翻治疗的效果。方法对519例(961足)拇外翻患者微创截骨矫形术后采用“8”字绷带缠绕外固定。结果患者均获得随访,时间3~36个月。截骨均愈合,时间为12~20周。无骨折不愈合或假关节形成者。结论绷带外固定可以达到维持复位后的固定要求,使骨折愈合;与传统固定方法比较该方法具有方便、灵活、痛苦小且可早期功能锻炼等优点,值得在一些特殊部位骨折固定中应用。%Objective To analyze the efficacy of the external bandage fixation for corrective osteotomy surgery of hal-lux valgus. Methods All the 519 patients (961 feet) were carried out minimally invasive corrective osteotomy sur-gery, twining the incision with bandage as “8” shape for external fixation. Results All the patients had been fol-lowed-up from 3 months to 36 months and the fracture were healed within the time of 12~20 weeks, no fracture non-union or pseudoarthrosis was found. Conclusions The way of external bandage fixation can meet the requirements of maintaining restoration, make the fracture heal up. Comparing with the traditional way of fixation, the advantages of convenience, agility, less pain and early functional exercises are obvious in this way, so it′s worth to popularize and apply in fracture fixation of some special body parts.

  16. (踇)收肌与(踇)展肌移位吻接重建前足横弓矫治(踇)外翻畸形%PROCEDURE OF RECONSTRUCTING TRANSVERSE ARCH OF THE FOREFOOT BY TRANSFERING TENDONS FOR CORRECTING HALLUX VALGUS

    Institute of Scientific and Technical Information of China (English)

    闫行超; 刘鉴峰; 刘彬; 刘志刚; 潘月海; 贾晓燕; 张亚楠; 邵江波

    2015-01-01

    目的 探讨(踇)收肌与(踇)展肌移位吻接重建前足横弓矫治(踇)外翻畸形的疗效.方法 回顾分析2010年1月-2014年1月,采用(踇)收肌与(踇)展肌移位吻接重建前足横弓治疗并获随访的28例(40足)(踇)外翻畸形患者临床资料.其中男3例(6足),女25例(34足);年龄20~71岁,平均51.7岁.单足16例,双足12例.病程1~ 30年,平均8.9年.患者均有不同程度(踇)囊炎表现;22足有明显前足横弓塌陷并足底胼胝,8足合并锤状趾畸形.美国足踝外科协会(AOFAS)评分为(59.07±8.49)分.术前X线片示(踇)外翻角(hallux valgus angle,HVA)(33.68±8.10)°,跖间角(intermetatarsal angle,IMA)(15.60±4.07)°.根据Mann(踇)外翻分类标准,轻度9足,中度23足,重度8足.结果 术后1例(1足)切口感染,其余切口均Ⅰ期愈合.2例(3足)出现(踇)趾麻木.28例均获随访,随访时间6个月~4年,平均1.8年.末次随访时根据AOFAS评分量表评定疗效:获优24足,良9足,可4足,差3足;优良率为82.5%.末次随访时,HVA为(15.10±5.28)°,IMA为(9.05±2.42)°,AOFAS评分为(86.03±7.45)分,与术前比较差异均有统计学意义(P=0.00).伴前足横弓塌陷者横弓均有一定程度恢复,足底胼胝消失(14足)或变小(8足).2例(3足)分别于术后3个月和2个月时(踇)外翻复发,无(踇)内翻发生.结论 (踇)收肌与(踇)展肌移位吻接重建前足横弓矫治(踇)外翻畸形,能减小HVA及IMA,复位脱位籽骨,重建前足横弓,有效恢复前足生理解剖结构及功能.

  17. TREATMENT OF MILD OR MODERATE HALLUX VALGUS BY Austin OSTEOTOMY COMBINED WITH LATERAL SOFT TISSUE RELEASE THROUGH A SINGLE MEDIAL INCISION%经单一内侧切口Austin截骨联合外侧软组织松解治疗轻中度(母)外翻

    Institute of Scientific and Technical Information of China (English)

    俞光荣; 樊健; 周家钤; 李海丰; 杨云峰; 李兵

    2011-01-01

    目的 探讨经单一内侧切口Austin跖骨截骨联合(母)收肌、跖横韧带切断治疗轻中度(母)外翻的临床疗效.方法 2006年5月-2009年1月,收治41例45足轻中度(母)外翻.男9例10足,女32例35足;年龄23~71岁,平均45.3岁.左足22例,右足15例,双足4例.(母)外翻角(halluxvalgus angle,HVA)为(33.1±1.4)°,第1、2跖间角为(20.4±1.1)°.患足功能根据美国矫形足踝协会(AOFAS)踝与后足评分标准评分为(47.2±3.7)分.于第1趾跖关节内侧作纵形切口,同时完成Austin跖骨截骨及(母)收肌、跖横韧带等外侧软组织松解术.结果 术中1足腓浅神经足背支损伤,行显微缝合修复.术后患者切口均Ⅰ期愈合.41例均获随访,随访时间16~36个月,平均26个月.术后3 d 2足出现前足内侧麻木,6周内自行缓解.X线片检查示截骨处均于8周内达骨性愈合.末次随访时HVA为(10.7±1.7)°,与术前比较差异有统计学意义(t=22.32,P=0.00);第1、2跖间角为(12.1±1.7)°,与术前比较差异亦有统计学意义(t=21.17,P=0.03).AOFAS踝与后足评分为(84.9±4.5)分,与术前比较差异有统计学意义(t=20.75,P=0.01).随访期间无(母)内翻、(母)外翻及跖骨头坏死等并发症发生.结论 经单一内侧切口Austin跖骨截骨联合(母)收肌、跖横韧带等外侧软组织松解能有效矫正轻中度(母)外翻,手术创伤小,避免了外侧切口瘢痕及腓深神经分支损伤等并发症的发生.%Objective To evaluate the primary clinical effectiveness of Austin metatarsal osteotomy combined with transection of adductor muscle and transverse metatarsal ligament for treating mild or moderate hallux valgus through a single medial incision. Methods Between May 2006 and January 2009, 41 patients (45 feet) with mild or moderate hallux valgus were treated. There were 9 males (10 feet) and 32 females (35 feet) with an average age of 45.3 years (range, 23-71 years). The hallux valgus angle (HVA

  18. Osteotomia da base do I metatarsal no tratamento do hálux valgo moderado e grave: resultados após seguimento médio de oito anos Osteotomy of the 1st metatarsal base on the treatment of moderate to severe hallux valgus after mean follow-up time of 8 years

    Directory of Open Access Journals (Sweden)

    Marco Túlio Costa

    2009-06-01

    to severe hallux valgus with osteotomy of the first metatarsal base associated to distal release of soft parts and medial capsuloplasty. METHODS: 13 patients were assessed (15 feet submitted to surgical treatment of hallux valgus moderate to severe. The mean follow-up time was 102 months; there were 12 female and 1 male patients, with mean age at the time of surgery of 49 years. The patients enrolled were interviewed according to the questionnaire developed by our service, clinically examined according to the AOFAS scale and submitted to X-ray tests for comparing the results with baseline images. RESULTS: The mean score of the AOFAS scale obtained at the final assessment was 82 points. Nine of the 15 feet (60% showed some late complications, with four (27% varus deformities, three (20% recurrences; two patients (13% presenting with pain complaints with no associated deformity. In the hallux metatarsophalangeal joint, movement loss was 41º (57%; dorsiflexion movement was mostly affected, with a mean loss of 37º (60%. The range of motion on the contralateral intact side served as control group. Arthrosis progression was seen on the final X-ray evaluation. In all cases, shortening and lifting of the first metatarsal were noticed; however, we couldn't correlate the shortening and lifting with metatarsalgia, plant callosity or lower scoring on the AOFAS scale at the final evaluation. CONCLUSIONS: The osteotomy technique by the basis and with distal realignment of soft parts employed in the treatment of moderate to severe hallux valgus showed a high rate of late complications. Due to the high number of complications, we believe that adopting this technique for correcting hallux valgus deformities should be carefully considered.

  19. Mini double-thread hollow screw combined with osteotomy for the treatment of hallux valgus%迷你双螺纹空心钉结合截骨治疗拇外翻★

    Institute of Scientific and Technical Information of China (English)

    徐海栋; 陈勇; 赵建宁

    2013-01-01

    BACKGROUND: Treatments for hal ux valgus are diverse. Mini double thread hol ow screw combined with osteotomy surgery is a smal invasive surgery, which can meet the orthopedic purpose of hal ux valgus and can be considered as the new minimal y invasive biological fixation material in clinic. OBJECTIVE: To retrospectively analyze the curative effect of mini double-thread hol ow screw combined with osteotomy for the treatment of hal ux valgus. METHODS: Thirty patients with hal ux valgus (eight patients with bilateral orthopedic operation and 22 patients with unilateral orthopedic operation) were selected and treated with the first metatarsal osteotomy combined with mini double-thread hol ow screw internal fixation according to the wil ingness of the patients. The X-ray films were taken before and after operation to compare the hal ux valgus angle, intermetatarsal angle, sesamoides position and the American Orthopedic Foot and Ankle Society Ankle Hindfoot Scale score. And the shortening length of first metatarsal bone was calculated.RESULTS AND CONCLUSION: Hal ux valgus angle, intermetatarsal angle, sesamoides position and American Orthopaedic Foot and Ankle Society Ankle Hindfoot Scale score post-operation were improved obviously compared with those pre-operation. The shortening length of the first metatarsal bone was in orthopedic control able scope, thereby avoiding deformity recurrence and metatarsus pain.%  背景:拇外翻畸形矫正方式多样,采用迷你双螺纹空心钉材料结合截骨矫形的方式损伤小,能够满足拇外翻矫形的目的,是临床上新型的微创生物型内固定材料。目的:回顾性分析迷你双螺纹空心钉材料应用于截骨矫形拇外翻治疗中的临床疗效。方法:选择拇外翻畸形患者30例,其中双侧矫形患者8例,单侧矫形患者22例。根据自愿均采用第一跖骨截骨矫形迷你双螺纹空心钉内固定,治疗前后拍摄 X 射线片测量外翻角、跖间

  20. Finite element analysis of stability of the first metatarsal head and neck osteotomy in hallux valgus%拇外翻第1跖骨颈部不同截骨角度截骨端稳定性有限元分析

    Institute of Scientific and Technical Information of China (English)

    孙卫东; 温建民; 胡海威; 孙永生; 成永忠; 王庆雷

    2012-01-01

    Objective To analyze the relationship between the osteotomy stability and the different osteotomy angles on the first metatarsal neck of hallux valgus, and to explore the best osteotomy angle to maintain osteotomy stability. Methods Finite element osteotomy models of hallux valgus were established. Seven kinds of working conditions were simulated, which of the osteotomy line and the first metatarsal axis were angulated in 30°, 45°, 60°, 75°, 90°, 105°, 120° on the sagittal plane. The proximal osteotomy segment was set as fixed segment, the distal as the free segment. Between the two sides granulation tissue was set to fill with. A hallux valgus patient' s single foot with 62 kg body weight was bear about 310 N loads. The effects of flexor pollicis longus and flexor pollicis brevis muscle were considered to the osteotomy segment only when standing with hallux plantar flexion after osteotomy. Muscle strength was set parallel to the long axis of the first metatarsal and expressed load. The friction coefficient between the osteotomy segments was set to 0. 6. We calculated the maximum Von Mises stress and the total displacement V value of osteotomy segment edge node of 7 kinds of working conditions on the above constraints and loading conditions, and compared the calculations. Results The total displacement V value of osteotomy segment diminished gradually from 30° , reached to the minimum at 60° , and then increased significantly as osteotomy angle exceeded 90°. The Von Mises stress of osteotomy segment increased gradually from 30°, reached the first peak at 75° , and then flattened and reduced gradually. The stress increased rapidly at 105°. Conclusions Only keep the osteotomy direction of the first metatarsal on the sagittal plane from the distal dorsal to proximal plantar side, can the osteotomy segment maintain stability. It is at 60° or so that the osteotomy segment was the most stable. The best osteotomy angle needs adjustment according to different

  1. Radiologic Patterning of Hallux Deformity in Rheumatoid Arthritis and Its Relationship to Flatfoot.

    Science.gov (United States)

    Matsumoto, Takumi; Nakada, Izumi; Juji, Takuo; Nakamura, Ichiro; Ito, Katsumi

    2016-01-01

    Hallux deformities other than hallux valgus, especially those in the sagittal plane, have not yet been elucidated in the feet of patients with rheumatoid arthritis. The objectives of the present study were to classify rheumatoid arthritis hallux deformity in both the horizontal and the sagittal planes and investigate its relationship with flatfoot. Using a cross-sectional study design, we assessed patients with rheumatoid arthritis (527 feet in 274 patients) using radiographs and classified the deformity patterns of the great toes using cluster analysis. Of the 274 patients, the range of motion in the metatarsophalangeal joint was clinically investigated in 44 (16.1%) patients. The great toes could be divided into 5 clusters according to the characteristic configuration as follows: cluster I (normal type), cluster II (hallux valgus type), cluster III (boutonniere type), cluster IV (boutonniere with hallux valgus type), and cluster V (swan-neck type). Radiographic measurements revealed the characteristic deformities of each cluster, including splayed foot for cluster II; flat foot, metatarsal primus elevatus, and plantar displacement of the proximal phalanx for cluster III; and a mixture of these characteristics for cluster IV. Plantar displacement of the proximal phalanx, which was a specific characteristic of the boutonniere deformity, correlated significantly with the decreased dorsiflexion in the metatarsophalangeal joint. Our classification method revealed the relationship of hallux deformity in the sagittal plane to flatfoot and also demonstrated the usefulness of measuring basal phalanx displacement in predicting the range of motion of the metatarsophalangeal joint.

  2. The influence of hallux valgus on pelvis and lower extremity movement during gait [Vliv valgózní deformity palce na pohyb pánve a dolních končetin při chůzi

    Directory of Open Access Journals (Sweden)

    Miloslav Klugar

    2011-12-01

    Full Text Available BACKGROUND: The hallux and the first metatarsophalangeal joint play a major role in load transmission during walking. OBJECTIVE: The main aim of this study was to investigate differences in kinematics of the pelvis and lower extremities during gait by comparing people with hallux valgus (HV and a control group (CG. METHODS: We compared subjects with asymptomatic bilateral HV (n = 6, 57.8 ± 5.64 years with those who had CG (n = 11, 50.7 ± 4.41 years. Gait analysis was investigated using an optoelectronic system Vicon MX. The subjects walked at self-selected speeds. In total, five trials of each subject were analyzed. The statistical processing was performed by means of the Student t-test. The effect size was determined using the ω2 measure. RESULTS: In people with HV there was a significantly smaller maximum of dorsal flexion during the stance phase (p 0.06 and a greater maximum of plantar flexion at the beginning of the stance phase (p 0.06. The maximum of knee extension at the end of the swing phase was significantly greater (p 0.06 in subjects with HV. In the frontal plane, a significantly smaller maximum of hip abduction (p 0.06 during the gait cycle was observed in people with HV. The range of the pelvic obliquity (p 0.06 and the pelvic rotation (p 0.06 were significantly smaller in people with HV. CONCLUSION: This study demonstrated that HV does not exclusively concern the foot. The valgus deformity of the big toe can negatively influence function of the lower extremities and can cause overloading of those segments as well.[VÝCHODISKA: Palec a I. metatarzofalangeální kloub hrají klíčovou úlohu v přenosu zatížení při chůzi. CÍLE: Účelem této studie bylo analyzovat a interpretovat rozdíly v kinematických parametrech chůze u osob s hallux valgus v porovnání s kontrolní skupinou. METODIKA: Porovnávali jsme osoby s asymptomatickou oboustrannou valgózní deformitou palce (n = 6; 57,8 ± 5,64 let s kontrolní skupinou

  3. Radiographic measurements of hallux angles: a review of current techniques.

    Science.gov (United States)

    Srivastava, Subodh; Chockalingam, N; El Fakhri, Tarek

    2010-03-01

    Radiographic angles are commonly used in patients with hallux valgus deformity to assess the severity, plan surgery, assess outcome and compare results. Many different manual methods have been used, but are prone to error. More recently computer-assisted methods using software have become available. To review the different methods that have been used to measure radiographic angles in hallux valgus. A general literature search using relevant key words was undertaken using databases such as Medline, Embase, Cinahl and Cochrane Library. REVIEW FINDINGS AND DISCUSSION: The manual methods used are prone to errors. The reliability can be improved by using standardised radiographic technique and measurement technique using specific reference points. Computer-assisted methods using software, might improve reliability of measurements. Further studies are needed to assess if these methods are easy to use, and to compare different software's that are available. Specifically designed software for the foot might further improve the reliability of radiographic measurements in hallux valgus. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

  4. Estudio de casos y controles para la evaluación de la asociación de parametros morfológicos del pie y la presencia de Hallux Rigidus

    OpenAIRE

    Calvo de Cos, Alberto

    2005-01-01

    INTRODUCCIÓN La limitación en el plano sagital del movimiento y el dolor de la primera articulación metatarsofalángica fue denominada por primera vez "hallux flexus" en 1887 por Davies-Colley. En 1888 Cotterill fue el primero en utilizar el término "hallux rigidus" para describir esta patología. Después del hallux valgus, el hallux rigidus es la patología que más frecuentemente afecta a la primera articulación metatarsofalángica, pudiendo ser más imposibilitante para el paciente.Después ...

  5. Unilobed Rotational Flap for Plantar Hallux Interphalangeal Joint Ulceration Complicated by Osteomyelitis.

    Science.gov (United States)

    Boffeli, Troy J; Hyllengren, Shelby B

    2015-01-01

    Diabetes-related neuropathic ulcers located at the plantar aspect of the hallux interphalangeal joint are often chronic or recurrent and frequently become complicated by osteomyelitis. Once infected, treatment will typically involve hallux amputation. Although intended as a definitive procedure, amputation of the first toe is not desirable from a cosmetic or functional standpoint and often leads to transfer ulcers at adjacent locations of the foot. Reconstructive wound surgery, combined with limited bone resection, is possible if the infection is caught early before the local tissue and bone have become necrotic. In addition to neuropathy, biomechanical issues, including ankle equinus, hallux limitus, hallux extensus, and hallux valgus, predispose patients with diabetes mellitus to developing plantar hallux ulcers. We commonly employ a proximal based unilobed plantar rotational flap combined with hallux interphalangeal joint arthroplasty as an alternative to hallux amputation. We present a typical case with long-term follow-up to highlight our flap protocol, including patient selection criteria, flap design, surgical technique, bone resection and biopsy pearls, staging timeline, and a typical postoperative course. Periodic follow-up during the next 72 months for unrelated conditions allowed long-term monitoring with no recurrence of osteomyelitis or subsequent amputation. The foot remained ulcer free 6 years later. The benefits of this surgical approach include complete excision of the ulcer, adequate exposure for bone resection, early bone biopsy before the spread of infection or necrosis of local tissue, flap coverage with viable soft tissue, and partial offloading of mechanical pressure at the plantar interphalangeal joint.

  6. The hallux sesamoids revisited

    Energy Technology Data Exchange (ETDEWEB)

    Potter, H.G.; Pavlov, H. (Cornell Univ. Medical Coll., New York, NY (United States) Hospital for Special Surgery and New York Hospital, NY (United States)); Abrahams, T.G. (Univ. of Vermont School of Medicine and Maine Medical Center, Portland, ME (United States))

    1992-10-01

    The hallux sesamoids are vulnerable to significant injury and weight-bearing stress in both the athlete and the nonathlete. Unfortunately, they are often dismissed as inconsequential accessory bones. The historical significance, embryology, anatomy, and physiology of the sesamoids and the salient features of both traumatic and nontraumatic pathologic conditions affecting these structures are presented. Because the sesamoids can be responsible for prolonged disabling foot pain and discomfort, it is important for both clinician and radiologist to pay attention to these bones and recognize the early signs of abnormality. (orig.).

  7. Increased hallux angle in children and its association with insufficient length of footwear: A community based cross-sectional study

    Directory of Open Access Journals (Sweden)

    Kundi Michael

    2009-12-01

    Full Text Available Abstract Background Wearing shoes of insufficient length during childhood has often been cited as leading to deformities of the foot, particularly to the development of hallux valgus disorders. Until now, these assumptions have not been confirmed through scientific research. This study aims to investigate whether this association can be statistically proven, and if children who wear shoes of insufficient length actually do have a higher risk of a more pronounced lateral deviation of the hallux. Methods 858 pre-school children were included in the study. The study sample was stratified by sex, urban/rural areas and Austrian province. The hallux angle and the length of the feet were recorded. The inside length of the children's footwear (indoor shoes worn in pre-school and outdoor shoes were assessed. Personal data and different anthropometric measurements were taken. The risk of hallux valgus deviation was statistically tested by a stepwise logistic regression analysis and the relative risk (odds ratio for a hallux angle ≥ 4 degrees was calculated. Results Exact examinations of the hallux angle could be conducted on a total of 1,579 individual feet. Only 23.9% out of 1,579 feet presented a straight position of the great toe. The others were characterized by lateral deviations (valgus position at different degrees, equalling 10 degrees or greater in 14.2% of the children's feet. 88.8% of 808 children examined wore indoor footwear that was of insufficient length, and 69.4% of 812 children wore outdoor shoes that were too short. A significant relationship was observed between the lengthwise fit of the shoes and the hallux angle: the shorter the shoe, the higher the value of the hallux angle. The relative risk (odds ratio of a lateral hallux deviation of ≥ 4 degrees in children wearing shoes of insufficient length was significantly increased. Conclusions There is a significant relationship between the hallux angle in children and footwear that is

  8. Calcaneo-valgus deformity.

    Science.gov (United States)

    Evans, D

    1975-08-01

    A discussion of the essential deformity in calcaneo-valgus feet develops a theme originally put forward in 1961 on the relapsed club foot (Evans 1961). Whereas in the normal foot the medial and lateral columns are about equal in length, in talipes equino-varus the lateral column is longer and in calcaneo-valgus shorter than the medial column. The suggestion is that in the treatment of both deformities the length of the columns be made equal. A method is described of treating calcaneo-valgus deformity by inserting cortical bone grafts taken from the tibia to elongate the anterior end of the calcaneus.

  9. Hallux ulceration in diabetic patients.

    Science.gov (United States)

    ElMakki Ahmed, Mohamed; Tamimi, Abdulhakim O; Mahadi, Seif I; Widatalla, Abubakr H; Shawer, Mohamed A

    2010-01-01

    We undertook a prospective cohort study to assess risk factors associated with hallux ulceration, and to determine the incidence of healing or amputation, in consecutive patients with diabetes mellitus who were treated over the observation period extending from September 2004 to March 2005, at the Jabir Abu Eliz Diabetic Centre, Khartoum City, Sudan. There were 122 diabetic patients in the cohort (92 males and 30 females) with an overall mean age of 58 +/- 9 years. Fifty-three percent of patients had complete healing within 8 weeks and 43% healed within 20 weeks. The overall mean time to healing was 16 +/- 8 weeks. In 32 (26.2%) patients, osteomyelitic bone was removed, leaving a healed and boneless hallux. The hallux was amputated in 17 (13.9%) patients; in 2 (1.6%) patients it was followed by forefoot amputation and in 7 (5.7%) patients by below-the-knee amputation. In 90 (73.8%) patients the initial lesion was a blister. In conclusion, hallux ulceration is common in patients with diabetes mellitus and is usually preceded by a blister. Neuropathy, foot deformity, and wearing new shoes are common causative factors; and ischemia, osteomyelitis, any form of wound infection, and the size of the ulcer are main outcome determinants. Complete healing occurred in 103 (85%) of diabetic patients with a hallux ulcer. Vascular intervention is important relative to limb salvage when ischemia is the main cause of the ulcer.

  10. Therapeutic Management of the Hallux Rigidus

    Directory of Open Access Journals (Sweden)

    Anoop Aggarwal

    2012-01-01

    Full Text Available Background. Hallux rigidus is a chronic, disabling condition of foot characterized by reduced great toe extension. The manual therapy approaches are described theoretically however their practical published evidence has not been analyzed well. Objective. Aim of the present paper was to systematically review the literature available for therapeutic management of the hallux rigidus by identifying and evaluating the randomized controlled trials (RCTs and non-RCTs. Methods. To view the hallux rigidus and its rehabilitation, a webbased published literature search of Pubmed, Ovid Medline, Science direct, Cochrane Database, PEDro database, CINAHL was conducted for last 35 years in August 2010 using 4 specific keywords “hallux rigidus, physical therapy, chiropractic, and manual therapy” typed in exactly same manner in the search column of the databases. Result. the review finds that there is acute need of the quality studies and RCTs for the manual therapy, chiropractic, or physiotherapeutic management of the hallux rigidus. Conclusion. Review conclude that conservative programs for hallux rigidus consists of comprehensive intervention program that includes great toe mobilization, toe flexor strengthening, sesamoid bones mobilization and long MTP joint. The clinician should put an emphasis on the mobilization program with proper follow up along with comparative studies for rehabilitation of hallux rigidus.

  11. Saare Jazz toob valguse augustipimedusse

    Index Scriptorium Estoniae

    2009-01-01

    22. augustil Saaremaal Pidula Forelli puhkekülas toimuvast esimesest Saare Jazzist alapealkirjaga "Valgus pimeduses", peaesinejaks laulja Sofia Rubina koos ansambliga Club Eclectic, soojendusesinejaks laulja Teele Viira ja erikülaliseks Soome trompetist Kalevi Louhivuori, esinejatest

  12. Saare Jazz toob valguse augustipimedusse

    Index Scriptorium Estoniae

    2009-01-01

    22. augustil Saaremaal Pidula Forelli puhkekülas toimuvast esimesest Saare Jazzist alapealkirjaga "Valgus pimeduses", peaesinejaks laulja Sofia Rubina koos ansambliga Club Eclectic, soojendusesinejaks laulja Teele Viira ja erikülaliseks Soome trompetist Kalevi Louhivuori, esinejatest

  13. Influence of Hallux Rigidus on Reamputation in Patients With Diabetes Mellitus After Partial Hallux Amputation.

    Science.gov (United States)

    Oliver, Noah G; Attinger, Christopher E; Steinberg, John S; Evans, Karen K; Vieweger, David; Kim, Paul J

    2015-01-01

    Diabetic foot ulceration of the plantar hallux is a challenging condition and can require partial hallux amputation when complicated by infection. Lower extremity biomechanics play an important role in the development of hallux ulcers, and hallux rigidus (HR) could influence the outcomes after partial hallux amputation. We hypothesized that radiographic evidence of HR in patients with diabetes would be associated with greater ulcer recurrence and reamputation rates after partial hallux amputation. We performed a retrospective review of all patients with diabetes who had undergone a partial hallux amputation from January 2005 to December 2012. The subjects were divided into 2 cohorts according to the presence or absence of HR identified on preoperative radiographs. Baseline characteristics and outcomes were compared using a 2-sample Student's t test for continuous variables, and categorical variables were compared using the chi-square test for homogeneity and Fisher's exact test. A total of 52 patients were included, with 16 (31%) positive for radiographic evidence of HR at partial hallux amputation. Differences in the patient demographics and comorbidities were not significant between 2 cohorts with and without HR or reamputation. Reamputation was required in 5 subjects (31%) with HR and 2 (6%) without HR (p = .023). The average follow-up duration was 126 ± 89 weeks. Our results have demonstrated that the reamputation rate after partial hallux amputation is significantly greater in patients with than in those without radiographic evidence of HR. Surgeons should evaluate patients for HR when planning partial hallux amputation and use adjuvant methods of offloading when HR is evident to prevent recurrent ulceration and reamputation. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  14. [Treatment of hallux valgus (review of cases operated on from 1976 to 1978 )].

    Science.gov (United States)

    Bisognini, R; Governali, E

    1983-08-01

    The AA. reporton the long-term check-up (from 4 to 6 years) about 50 cases of big toe valgls treated with regularization of esostosus, correction of 1 metatarsus and plastic-capsule. The valuation of the results, executed on the ground parameters: pain, mobility, functionality, residual deformation, allows the Authors to confirm the validity of that therapeutical procedure.

  15. McBride's operation for hallux valgus can be used in patients older than 30 years

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Soelberg, M; Larsen, T;

    1992-01-01

    . In patients older than 30 years there were significant reductions. In patients younger than 30 years, the reduction was not significant. The rate of problems with daily footwear was reduced from 36 of 46 feet to 13 of 38 feet. The authors noted few problems and a high rate of satisfied patients, despite...

  16. Evaluation of Hallux Interphalangeal Joint Arthroplasty Compared With Nonoperative Treatment of Recalcitrant Hallux Ulceration.

    Science.gov (United States)

    Lew, Eric; Nicolosi, Nicole; McKee, Patrick

    2015-01-01

    Patients with chronic diabetes can develop plantar hallux ulcerations secondary to neuropathy, increased pressure, and deformity. The present retrospective study evaluated the efficacy of hallux interphalangeal joint (HIPJ) arthroplasty to address recalcitrant ulceration. Two groups of patients with diabetes were compared: a surgical group of 13 patients and a nonsurgical standard therapy group of 13 patients. The patients in the surgical group underwent HIPJ arthroplasty. All the patients in the standard therapy group received local wound care and offloading. The mean duration of follow-up was 19.5 (range 1.2 to 47.9) months, and the mean age was 55 ± 13.0 years. Statistical significance was found in the surgical group for faster time to healing (3.5 weeks [2.5, 4.25] vs 9 weeks [2, 17.29], p = .033) and lower incidence of ulcer recurrence (8% ± 7.69 vs 54% ± 53.85, p = .031). There were also fewer amputations in the surgical group (0% ± 0 vs 38% ± 38.6, p = .063). To our knowledge, only 1 other published study has evaluated HIPJ arthroplasty as a treatment of recalcitrant hallux ulceration. The present study adds comparison data from a nonoperative standard therapy group and found that HIPJ arthroplasty is an effective curative treatment option to address chronic plantar hallux ulcerations in diabetic patients with neuropathy.

  17. Valgus ümber kodu / Madis Tross

    Index Scriptorium Estoniae

    Tross, Madis

    2003-01-01

    Thorn Lighting Eesti filiaali juhataja Aivar Simmermann ja firma Moodne Valgustus projektijuht Ahto Kallas aia kujundamisest valguse abil. Soovitusi välisvalgustite valikuks ja ökonoomseks kasutamiseks

  18. Valgus ümber kodu / Madis Tross

    Index Scriptorium Estoniae

    Tross, Madis

    2003-01-01

    Thorn Lighting Eesti filiaali juhataja Aivar Simmermann ja firma Moodne Valgustus projektijuht Ahto Kallas aia kujundamisest valguse abil. Soovitusi välisvalgustite valikuks ja ökonoomseks kasutamiseks

  19. Valguse ja varjupooled Endla Teatrigaleriis / Rica Semjonova

    Index Scriptorium Estoniae

    Semjonova, Rica

    2004-01-01

    3. mail avati Pärnu Endla Teatrigaleriis Nerva näitus "Valguse varjus", peale näituse avamist oli kõigil võimalus Küüni saalis vaadata Priit Valkna dokumentaalfilmi "Hunt", mis valminud ETV sarjale "Eesti lood"

  20. Valguse ja varjupooled Endla Teatrigaleriis / Rica Semjonova

    Index Scriptorium Estoniae

    Semjonova, Rica

    2004-01-01

    3. mail avati Pärnu Endla Teatrigaleriis Nerva näitus "Valguse varjus", peale näituse avamist oli kõigil võimalus Küüni saalis vaadata Priit Valkna dokumentaalfilmi "Hunt", mis valminud ETV sarjale "Eesti lood"

  1. Weight-bearing passive dorsiflexion of the hallux in standing is not related to hallux dorsiflexion during walking.

    Science.gov (United States)

    Halstead, Jill; Redmond, Anthony C

    2006-08-01

    Case control study. To explore the validity of the assumptions underpinning the Hubscher maneuver of hallux dorsiflexion in relaxed standing, by comparing the relationship between static and dynamic first metatarsophalangeal (MTP) joint motions in groups differentiated by normal and abnormal clinical test findings. Limitation of motion at the first MTP joint during gait may be due to either structural or functional factors. Functional hallux limitus (FHL) has been proposed as a term to describe the situation in which the first MTP joint shows no limitation when non-weight bearing, but shows limited dorsiflexion during gait. One clinical test of first MTP joint limitation during standing (the Hubscher maneuver or Jack's test) has become widely used in physical therapy, orthopedic, and podiatric assessments, supposedly to assess for the presence of hallux limitations during gait. The utility of the test is based on an assumption that restriction during the static maneuver is predictive of functional limitation at this joint during gait. Despite a lack of evidence for the validity of such an assumption, the outcome of the static test is often used to infer risk of overuse injury or as an outcome for functional therapy. This paper examines the validity of the assumptions supporting this widely used static test. First-MTP-joint motion was assessed using an electromagnetic motion tracking system in cases (n = 15) demonstrating clinically limited passive hallux dorsiflexion in relaxed standing, and in 15 controls matched for age and gender and demonstrating a clinically normal Hubscher maneuver. Maximum hallux dorsiflexion was measured with the subject non-weight bearing (seated), during relaxed standing, and during normal walking. Hallux dorsiflexion was similar in cases and controls when motions were measured non-weight bearing (cases mean +/- SD, 55.0 degrees +/- 11.0 degrees; controls mean + SD, 55.0 degrees +/- 10.7 degrees), confirming the absence of structural

  2. Valgus Extension Overload in Baseball Players.

    Science.gov (United States)

    Paulino, Franklin E; Villacis, Diego C; Ahmad, Christopher S

    2016-01-01

    Repetitive throwing, such as in baseball pitching, applies massive stress on the elbow. This can often lead to a predictable constellation of elbow injuries, such as valgus extension overload syndrome (VEO). The following review of VEO provides an understanding of relevant anatomy, explanation of pathomechanics, key aspects to clinical evaluation, effective treatment options, and indications for surgery. In addition, we provide the senior author's (CSA) preferred arthroscopic technique for cases of VEO refractory to conservative management.

  3. Osteosarcoma: A rare cause of painful enlargement of the hallux.

    LENUS (Irish Health Repository)

    Sproule, J A

    2011-12-01

    Malignant osseous and soft-tissue tumors of the foot are rare. We report a case of osteosarcoma in the proximal phalanx of the hallux in a 45-year-old man. In patients with foot-related symptoms, a high index of suspicion for pedal osteosarcoma is required. Delayed or inappropriate diagnosis may compromise limb-sparing surgery and survivorship.

  4. Impacted valgus fractures of the proximal humerus☆

    Science.gov (United States)

    Ribeiro, Fabiano Rebouças; Takesian, Fernando Hovaguim; Bezerra, Luiz Eduardo Pimentel; Filho, Rômulo Brasil; Júnior, Antonio Carlos Tenor; da Costa, Miguel Pereira

    2016-01-01

    Impacted valgus fractures of the proximal humerus are considered to be a special type fracture, since impaction of the humeral head on the metaphysis with maintenance of the posteromedial periosteum improves the prognosis regarding occurrences of avascular necrosis. This characteristic can also facilitate the reduction maneuver and increase the consolidation rate of these fractures, even in more complex cases. The studies included were obtained by searching the Bireme, Medline, PubMed, Cochrane Library and Google Scholar databases for those published between 1991 and 2013. The objective of this study was to identify the most common definitions, classifications and treatment methods used for these fractures in the orthopedic medical literature. PMID:27069878

  5. Foot Pressure Comparison Between Hallux Rigidus Patients and Normal Asymptomatic Matched Individuals Using Pedobarograph

    Directory of Open Access Journals (Sweden)

    Hadi Mohammed

    2012-06-01

    Conclusion: This study has demonstrated an increased pressure transmitted through the outer aspect of the sole of the foot in the patients suffering from hallux rigidus. This is helpful in choosing treatment options and managing hallux rigidus patients particularly when using conservative and foot wear considerations.

  6. Juvenile angiofibroma

    Science.gov (United States)

    Nasal tumor; Angiofibroma - juvenile; Benign nasal tumor; Juvenile nasal angiofibroma; JNA ... Juvenile angiofibroma is not very common. It is most often found in adolescent boys. The tumor contains ...

  7. Lower-limb valgus deformity associated with developmental hip dysplasia

    Institute of Scientific and Technical Information of China (English)

    GUO Sheng-jie; ZHOU Yi-xin; YANG De-jin; YANG Xu-cheng

    2012-01-01

    Background Treating developmental dysplasia of the hip is often challenging.The difficulties include not only the hip surgery itself but also the treatment of the associated lower-limb valgus deformity However,there have been very few studies on such deformity in patients with developmental hip dysplasia.In this study,we investigated the prevalence and severity of lower-limb valgus deformity,along with the relationship between the severity ef valgus deformity and mechanical alterations of the hip or the ipsilateral knee.Methods Two hundred and six affected lower limbs of 116 adult patients with untreated developmental dysplasia of the hip were included in the study,grouped according to the severity of hip dysplasia.Each study participant's radiographs were measured to quantitatively evaluate the mechanical axis deviation of the lower limb,and further to evaluate the prevalence and severity of the lower-limb valgus deformity.Some mechanical alterations of the hip and the ipsilateral knee were also measured on the radiographs.Results Of the affected lower limbs,14.1% had valgus deformities.Study participants with Crowe typeⅢ?hip dysplasiahad the most severe deformity and the highest prevalence of deformity.Severity of valgus deformity had a strong positive correlation with the lateral migration of the femoral head but not with the superior migration.A decreased lateral distal femoral angle contributed to the lower-limb valgus deformity,and the lateral distal femoral angle had a strong negative correlation with the severity of valgus deformity.Conclusions Hip dysplasia is commonly associated with lower-limb valgus deformity,and the severity of the lower-limb valgus deformity is mostly affected by lateral migration but not superior migration of the femoral head.The valgus deformity may originate mainly in the distal femur,in addition to the hip joint itself.These findings can be taken into account when planning to treat the patients with hip dysplasia.

  8. Hip resurfacing femoral neck fracture influenced by valgus placement.

    Science.gov (United States)

    Anglin, Carolyn; Masri, Bassam A; Tonetti, Jérôme; Hodgson, Antony J; Greidanus, Nelson V

    2007-12-01

    Femoral neck fracture is the most common short-term concern after hip resurfacing arthroplasty. Currently, there is little basis to decide between neutral and valgus placement. We loaded 10 notched cadaveric femur pairs to failure; one side was implanted at 0 degrees relative to the femoral neck and the other at 10 degrees valgus. All 20 were dual-energy X-ray absorptiometry-scanned. Failure load correlated with bone mineral density. Valgus placement increased the fracture load by an average of 28% over neutral for specimens with normal bone mineral density but had no effect on fracture load in specimens with low bone mineral density. For specimens with normal bone mineral density (typical of patients undergoing resurfacing arthroplasty), neutral-valgus placement had a greater effect than bone mineral density, explaining 54% of the fracture load variance. Component placement greater than 10 degrees valgus is likely undesirable because this can lead to an increase in component size and a greater likelihood of notching. To reduce fracture risk, we recommend placing the femoral component in valgus and selecting patients with higher bone mineral density.

  9. Hallux Rigidus Grade Does Not Correlate With Foot and Ankle Ability Measure Score.

    Science.gov (United States)

    Nixon, Devon C; Lorbeer, Karly F; McCormick, Jeremy J; Klein, Sandra E; Johnson, Jeffrey E

    2017-09-01

    Classification systems for hallux rigidus imply that, as radiographic changes progress, symptoms will concurrently increase in severity. However, symptom intensity and radiographic severity can be discordant for many patients. We studied the correlation between hallux rigidus grades and the Foot and Ankle Ability Measure (FAAM) scores to better understand this relationship. We retrospectively reviewed weight-bearing radiographs of the foot and FAAM Activities of Daily Living (ADL) questionnaires for 84 patients with hallux rigidus. The Spearman rank coefficient was used to correlate clinical-radiographic hallux rigidus grade with FAAM ADL scores. In 84 patients, the clinical-radiographic grade for hallux rigidus showed no relationship with FAAM ADL score (r = -0.10; P = 0.36) but did show moderate correlation with patient age (r = 0.63; P < 0.001). Advancing radiographic changes in hallux rigidus did not correspond with patient symptoms as measured via FAAM ADL scores. The reliability and validity of current grading criteria for hallux rigidus may require further exploration. Level III.

  10. A new and simplified functional tendon transfer for a dropped hallux

    Directory of Open Access Journals (Sweden)

    Singh Sukhbir

    2010-01-01

    Full Text Available A case of fracture of the right tibia proximal 1/3rd extending up to diaphysis after a road traffic accident along with a dropped hallux is being reported. The extensor digitorum longus (EDL was intact. Patient was taken up for surgery for the fracture tibia with conservative management for his dropped hallux for initial six weeks. After six weeks when no improvement was seen surgical intervention was planned for the dropped hallux. The subsequent management of this patient is being described.

  11. Neuropathic foot ulcer prevention in diabetic American Indians with hallux limitus.

    Science.gov (United States)

    Dannels, E

    1989-09-01

    Infected neuropathic ulcerations are the leading cause of diabetes-related partial foot amputations at the Phoenix Indian Medical Center. Ten hallucal ulcerations in seven American Indian patients with hallux limitus were resolved by local wound care and partial first metatarsophalangeal joint resection. The average length of postsurgical follow-up care was 28.8 months. There have been no recurrences of the plantar hallux ulcerations in any of the patients.

  12. Varus instability of the hallux interphalangeal joint in a taekwondo athlete

    Science.gov (United States)

    Gong, Hyun Sik; Kim, Yeun Ho; Park, Moon Seok

    2009-01-01

    The hallux interphalangeal joint is stable in the transverse plane and there have been only a few reports of varus instability of this joint. A case is described of varus subluxation of the hallux interphalangeal joint in a taekwondo athlete and the surgical outcome after reconstruction of the collateral ligament. Taekwondo athletes, who require fast powerful kicks, should be warned about this type of forefoot injury. PMID:21686680

  13. Dermatomyositis (Juvenile)

    Science.gov (United States)

    ... Am A Patient / Caregiver Diseases & Conditions Dermatomyositis (Juvenile) Dermatomyositis (Juvenile) Fast Facts Patients with JDM have varying ... What are common signs and symptoms of juvenile dermatomyositis? The most common signs and symptoms of JDM ...

  14. Retinoschisis (Juvenile)

    Science.gov (United States)

    ... here Home › Eye Conditions Listen Retinoschisis What is Juvenile Retinoschisis? Juvenile retinoschisis is an inherited disease diagnosed in childhood ... degeneration of the retina. What are the symptoms? Juvenile retinoschisis, also known as X-linked retinoschisis, occurs ...

  15. Giant cell reparative granuloma of the hallux following enchondroma

    Science.gov (United States)

    Kamoun, Khaled; Sellami, Tarak; Jlailia, Zied; Abid, Layla; Jenzri, Mourad; Bouaziz, Mouna; Zouar, Omar

    2015-01-01

    Giant cell reparative granuloma (GCRG) is a rare, benign intra osseous lytic lesion occurring especially in gnathis bone but also seen in feet and hands. It has similar clinical and radiological presentations than giant cell tumor, chondroblastoma, aneurysmal bone cyst, and hyperparathyroidism brown tumors but with specific histological findings We report a case of a GCRG of hallux phalanx in 18 years old patient appearing many years after enchondroma curettage and grafting. Radiographs showed a multiloculated osteolytic lesions involving whole phalanx with cortical thinning and without fluid-fluid levels in CT view. Expected to be an enchondroma recurrence, second biopsy confirmed diagnosis of GCRG with specific histological findings. Although if aetiopathogeny remains unknown, GCRG is reported to be a local non neoplasic reaction to an intraosseous hemorrhage. Our exceptional case claims that this tumor can appear in reaction to cellular disturbance primary or secondary. PMID:26985281

  16. Disorders of the hallux sesamoid complex: MR features

    Energy Technology Data Exchange (ETDEWEB)

    Karasick, D.; Schweitzer, M.E. [Thomas Jefferson Univ., Philadelphia, PA (United States). Dept. of Radiology

    1998-08-01

    Numerous painful conditions can affect the first metatarsophalangeal-sesamoid joint complex. Symptoms can be of sudden or insidious onset, and be of acute or chronic duration. Although conventional radiography is recognized as the initial diagnostic procedure for these symptoms, there is often a need to proceed to MR imaging. MR imaging is sensitive and can be utilized in the investigation of the hallux sesamoid complex to differentiate soft tissue from osseous pathology. Synovitis, tendonitis, and bursitis can be distinguished from bony abnormalities such as sesamoid fracture, avascular necrosis, and osteomyelitis. An understanding of MR imaging features and techniques will result in the highest diagnostic yield. Early and accurate diagnosis of sesamoid complex disorders can guide the physician to the appropriate clinical management and prevent potentially harmful longstanding joint dysfunction. (orig.) With 11 figs., 30 refs.

  17. Total Knee Arthroplasty in Patients With Valgus Deformity

    Directory of Open Access Journals (Sweden)

    Mahmoud Jabalameli

    2016-05-01

    Full Text Available Background Valgus deformity (more than 10° valgus on anatomical measurement is seen in about 10% of patients undergoing total knee arthroplasty (TKA. Valgus deformity is a challenge for the surgeons both for gap balancing and constraint choice. Objectives The aim of this study was to describe a surgical technique to perform TKA in valgus knee. Patients and Methods We retrospectively reviewed 32 primary TKA in 27 patients (25 females and 2 males, with valgus knee deformity performed since 2006 to 2014. All procedures have been done by the senior author. In the balancing stage of each procedure, the iliotibial band has been released completely in the first step, and then step by step pie crusting of other lateral structures has been done as needed. Preoperative and postoperative data were obtained retrospectively through chart review and review of radiographs. All patients were clinically examined by the senior author. Preoperative and postoperative knee society scores (KSSs and functional knee society score (functional KSS were obtained accordingly. Results The patients had an average age of 68 years (range, 52 - 83 years with an average postoperative follow-up period of 47.5 months (range, 12 - 100 months. The average KSS improved significantly postoperatively from 42 (range, 20 - 69 to 90 (range, 67 - 99 (P < 0.0001. The average functional KSS improved significantly (P < 0.0001 from 51.4 (range, 35 - 70 to 85.5 (range, 45 - 100 during follow-up. An average preoperative range of motion also improved by 15.6 degrees during the last follow-up visit (P < 0.001. We had no complication in our patients. Conclusions The results of our study show that complete release of the iliotibial band and step by step pie-crusting of other lateral structures correct valgus deformities in a safe and simple manner with high success rate and less constrained prosthesis.

  18. Descriptive quantitative analysis of hallux abductovalgus transverse plane radiographic parameters.

    Science.gov (United States)

    Meyr, Andrew J; Myers, Adam; Pontious, Jane

    2014-01-01

    Although the transverse plane radiographic parameters of the first intermetatarsal angle (IMA), hallux abductus angle (HAA), and the metatarsal-sesamoid position (MSP) form the basis of preoperative procedure selection and postoperative surgical evaluation of the hallux abductovalgus deformity, the so-called normal values of these measurements have not been well established. The objectives of the present study were to (1) evaluate the descriptive statistics of the first IMA, HAA, and MSP from a large patient population and (2) to determine an objective basis for defining "normal" versus "abnormal" measurements. Anteroposterior foot radiographs from 373 consecutive patients without a history of previous foot and ankle surgery and/or trauma were evaluated for the measurements of the first IMA, HAA, and MSP. The results revealed a mean measurement of 9.93°, 17.59°, and position 3.63 for the first IMA, HAA, and MSP, respectively. An advanced descriptive analysis demonstrated data characteristics of both parametric and nonparametric distributions. Furthermore, clear differentiations in deformity progression were appreciated when the variables were graphically depicted against each other. This could represent a quantitative basis for defining "normal" versus "abnormal" values. From the results of the present study, we have concluded that these radiographic parameters can be more conservatively reported and analyzed using nonparametric descriptive and comparative statistics within medical studies and that the combination of a first IMA, HAA, and MSP at or greater than approximately 10°, 18°, and position 4, respectively, appears to be an objective "tipping point" in terms of deformity progression and might represent an upper limit of acceptable in terms of surgical deformity correction.

  19. Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism

    Science.gov (United States)

    Fujiwara, Yasuhiro; Hayashida, Tatsuro; Murakami, Koji; Makio, Satoshi; Shimizu, Yuichi; Oka, Yoshinobu; Kim, Wook-Choel; Ogura, Taku; Kubo, Toshikazu

    2017-01-01

    Slipped capital femoral epiphysis (SCFE) is a common disease of adolescent and the epiphysis is positioned more posteromedially in relation to the femoral neck shaft with varus SCFE; however, posterolateral displacement of the capital epiphysis, valgus SCFE, occurs less frequently. We report a case of valgus SCFE in a 17-year-old boy with hypopituitarism. After falling down, he experienced difficulty in walking. The radiographs were inconclusive; however three-dimensional computed tomography images showed lateral displacement of the epiphysis on the right femoral head. Valgus SCFE was diagnosed. The patient underwent in situ pinning of both sides. In situ pinning on the left side was performed as a prophylactic pinning because of endocrine abnormalities. At the 1-year follow-up, he could walk without any difficulty and there were no signs of pain. The epiphysis is commonly positioned more posteromedially in relation to the femoral neck shaft with most SCFE, but, in this case, the epiphysis slipped laterally. Differential diagnosis included femoral neck fracture (Delbet-Colonna type 1); however, this was less likely due to the absence of other clinical signs. Therefore, we diagnosed the patient as SCFE. When children complain of leg pain and limp, valgus SCFE that may not be visualized on anteroposterior radiographs needs to be considered. PMID:28154765

  20. Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism

    Directory of Open Access Journals (Sweden)

    Yoshihiro Kotoura

    2017-01-01

    Full Text Available Slipped capital femoral epiphysis (SCFE is a common disease of adolescent and the epiphysis is positioned more posteromedially in relation to the femoral neck shaft with varus SCFE; however, posterolateral displacement of the capital epiphysis, valgus SCFE, occurs less frequently. We report a case of valgus SCFE in a 17-year-old boy with hypopituitarism. After falling down, he experienced difficulty in walking. The radiographs were inconclusive; however three-dimensional computed tomography images showed lateral displacement of the epiphysis on the right femoral head. Valgus SCFE was diagnosed. The patient underwent in situ pinning of both sides. In situ pinning on the left side was performed as a prophylactic pinning because of endocrine abnormalities. At the 1-year follow-up, he could walk without any difficulty and there were no signs of pain. The epiphysis is commonly positioned more posteromedially in relation to the femoral neck shaft with most SCFE, but, in this case, the epiphysis slipped laterally. Differential diagnosis included femoral neck fracture (Delbet-Colonna type 1; however, this was less likely due to the absence of other clinical signs. Therefore, we diagnosed the patient as SCFE. When children complain of leg pain and limp, valgus SCFE that may not be visualized on anteroposterior radiographs needs to be considered.

  1. Juvenile Scleroderma

    Science.gov (United States)

    Juvenile Scleroderma INTRODUCTION Every parent will experience a moment of panic when told their child has scleroderma. ... in all their family members as well. CONCLUSION Juvenile scleroderma can be unsettling for the child and ...

  2. Lateral collateral ligament reconstruction for chronic varus instability of the hallux interphalangeal joint.

    Science.gov (United States)

    Cho, Jaeho

    2014-01-01

    Chronic varus instability of the hallux interphalangeal joint is a rare injury, and only a few reports of this injury have been published. In some studies, this injury has been related to taekwondo. Taekwondo is an essential martial art in the Korean military. We have described a case of varus instability of the hallux interphalangeal joint in a professional soldier who had practiced taekwondo for 5 years and the surgical outcome after reconstruction of the lateral collateral ligament with the fourth toe extensor tendon.

  3. Valgus osteotomy for nonunion and neglected neck of femur fractures.

    Science.gov (United States)

    Varghese, Viju Daniel; Livingston, Abel; Boopalan, P R; Jepegnanam, Thilak S

    2016-05-18

    Nonunion neck of femur can be a difficult problem to treat, particularly in the young, and is associated with high complication rates of avascular necrosis due to the precarious blood supply and poor biomechanics. The various treatment options that have been described can be broadly divided according to the aim of improving either biology or biomechanics. Surgeries aimed at improving the biology, such as vascularized fibula grafting, have good success rates but require high levels of expertise and substantial resources. A popular surgical treatment aimed at improving the biomechanics-valgus intertrochanteric osteotomy-optimizes conditions for fracture healing by converting shear forces across the fracture site into compressive forces. Numerous variations of this surgical procedure have been developed and successfully applied in clinical practice. As a result, the proximal femoral orientation for obtaining a good functional outcome has evolved over the years, and the present concept of altering the proximal femoral anatomy as little as possible has arisen. This technical objective supports attaining union as well as a good functional outcome, since excessive valgus can lead to increased joint reaction forces. This review summarizes the historical and current literature on valgus intertrochanteric osteotomy treatment of nonunion neck of femur, with a focus on factors predictive of good functional outcome and potential pitfalls to be avoided as well as controversies surrounding this procedure.

  4. Total knee arthroplasty for severe valgus knee deformity

    Institute of Scientific and Technical Information of China (English)

    Zhou Xinhua; Wang Min; Liu Chao; Zhang Liang; Zhou Yixin

    2014-01-01

    Background Primary total knee arthroplasty (TKA) in severe valgus knees may prove challenging,and choice of implant depends on the severity of the valgus deformity and the extent of soft-tissue release.The purpose of this study was to review 8 to 11 years (mean,10 years) follow-up results of primary TKA for varient-Ⅲ valgus knee deformity with use of different type implants.Methods Between January 2002 and January 2005,20 women and 12 men,aged 47 to 63 (mean,57.19±6.08) years old,with varient-Ⅲ valgus knees underwent primary TKA.Of the 32 patients,37 knees had varient-Ⅲ deformities.Pie crusting was carefully performed with small,multiple inside-out incisions,bone resection balanced the knee in lieu of soft tissue releases that were not used in the series.Cruciate-retaining knees (Gemini MKⅡ,Link Company,Germany) were used in 13 knees,Genesis Ⅱ (Simth & Nephew Company,USA) in 14 knees,and hinged knee (Endo-Model Company,Germany) in 10 knees.In five patients with bilateral variant-Ⅲll TKAs,three patients underwent 1-stage bilateral procedures,and two underwent 2-stage procedures.All implants were cemented and the patella was not resurfaced.The Hospital for Special Surgery (HSS) knee score was assessed.Patients were followed up from 8 to 11 years.Results The mean HSS knee score were improved from 50.33±11.60 to 90.06±3.07 (P <0.001).The mean tibiofemoral alignment were improved from valgus 32.72°±9.68° pre-operation to 4.89°±0.90° post-operation (P <0.001).The mean range of motion were improved from 93.72°±23.69° pre-operation to 116.61±16.29° post-operation (P <0.001).No patients underwent revision.One patient underwent open reduction and internal fixation using femoral condylar plates for supracondylar femoral fractures secondary to a fall at three years.Three patients developed transient peroneal nerve palsies,which resolved within nine months.Two patients developed symptomatic deep vein thrombosis that was managed with rivaroxaban

  5. Femoral neck non-union treatment by valgus intertrochanteric osteotomy

    Science.gov (United States)

    Schwartsmann, Carlos Roberto; Spinelli, Leandro de Freitas; Yépez, Anthony Kerbes; Boschin, Leonardo Carbonera; Silva, Marcelo Faria

    2015-01-01

    ABSTRACT OBJECTIVE : The purpose of this study was to evaluate the performance of valgus intertrochanteric osteotomy in femoral neck non-union. METHODS : Forty-two patients with femoral neck fractures with non-union treated using Pauwels' intertrochanteric osteotomy were reviewed. Demographics, time elapsed between fracture and surgery, follow--up, osteosynthesis used, Garden's classification, limb shortening, and x-rays were evaluated. RESULTS : Twenty-two men and 20 women were reviewed. The youngest patient was 18 years old and the oldest 65 years old, with a mean age of 42.4 years (±11.2). The minimum follow-up was 2 years, with a mean of 10.2 years. The average time elapsed between initial fracture and osteotomy was 6.5 months. Twel-ve cases were neglected femoral neck fractures. Nineteen patients were classified as Garden III, and 23 patients as Garden IV. After valgus osteotomy, non-union healing was observed in 38 patients (38/42; 90.4%). Healing of thirty-seven cases of pseudoarthrosis were obtained after the first-attempt osteotomy, and one case required two operations for healing. The osteotomy failed in four cases. Conside-ring the healed osteotomies, good to excellent functional results were achieved in 80.9% (34/42) of the patients. Total hip replacement was subsequently performed in 14.2% (6/42) of the patients for unfavoura-ble outcomes (two for cutting out, two for osteonecrosis, and two for osteoarthritis). CONCLUSIONS : Valgus intertrochanteric osteotomy has a high success rate in archiving healing in femoral neck non-union with good functional results. It is a biological and effective method. Level of Evidence IV, Therapeutic Study. PMID:27057146

  6. Juvenile Judge

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    SHANG Xiuyun was among the first sitting judges when the juvenile court was set up in Beijing 10 years ago. With enriched experience she has altered the way judges ask questions in court. She began the practice of inviting juvenile offenders, their parents, relatives, friends and teachers to the juvenile court to work hand in hand in dealing with cases: Facing their relatives and friends and hearing their heartfelt words, juvenile offenders would often be touched, thus bringing forth a positive attitude toward life.

  7. Juvenile Arthritis

    Science.gov (United States)

    Juvenile arthritis (JA) is arthritis that happens in children. It causes joint swelling, pain, stiffness, and loss of motion. It can affect any joint, but ... of JA that children get is juvenile idiopathic arthritis. There are several other forms of arthritis affecting ...

  8. Changing sidestep cutting technique reduces knee valgus loading.

    Science.gov (United States)

    Dempsey, Alasdair R; Lloyd, David G; Elliott, Bruce C; Steele, Julie R; Munro, Bridget J

    2009-11-01

    Common lower limb postures have been found when noncontact anterior cruciate ligament (ACL) injuries occur during sidestep cutting tasks. These same postures have been linked to knee loadings known to stress the ACL. Whole body technique modification would reduce knee loading. Controlled laboratory study. Experienced team sport athletes were recruited for whole body sidestep cutting technique modification. Before and after a 6-week technique modification training, participants performed sidestep cutting tasks while ground-reaction force and motion data were collected. A kinematic and inverse dynamics model was used to calculate 3-dimensional knee loading during sidestep cutting. At initial foot contact, the participants placed their stance foot closer to the body's midline and held their torso more upright, in line with the aims of the technique modification training. This was accompanied by significantly lower peak valgus moments in the weight acceptance phase of stance. Both postural changes were correlated with the change in peak valgus moment. Whole body sidestep cutting technique modification resulted in reduced knee loading. Implementation of whole body technique modification may produce effective ACL injury prevention programs in sports involving sidestep cutting.

  9. [Juvenile scleroderma].

    Science.gov (United States)

    de Mâcedo, Patrícia Andrade; Shinjo, Samuel Katsuyuki; Goldenstein-Schainberg, Cláudia

    2008-01-01

    Juvenile scleroderma is a rare childhood condition characterized by fibrosis of the skin and internal organs. Clinical manifestations of childhood scleroderma are different from adult disease and early recognition, correct classification and treatment can improve long-term outcome. This review explores the most recent actualizations on clinical manifestations, classification criteria, treatment options and prognosis of juvenile scleroderma. There are two main forms of the disease: localized scleroderma and systemic sclerosis. Localized scleroderma is the most common form in children and mostly restricted to the skin. Juvenile diffuse systemic sclerosis is related to visceral involvement and cardiac disease which is the main cause of death in these patients. The outcome of juvenile systemic sclerosis is better compared with the adult form. Treatment remains a medical challenge and the EULAR task force proposed an approach to juvenile scleroderma treatment based on expert's opinion and guidelines used for the treatment of adults. Larger studies on childhood scleroderma are warranted.

  10. Hallux amputation after a freshwater stingray injury in the Brazilian Amazon.

    Science.gov (United States)

    Monteiro, Wuelton Marcelo; Oliveira, Sâmella Silva de; Sachett, Jacqueline de Almeida Gonçalves; Silva, Iran Mendonça da; Ferreira, Luiz Carlos de Lima; Lacerda, Marcus Vinícius Guimarães

    2016-01-01

    Freshwater stingray injuries are a common problem in the Brazilian Amazon, affecting mostly riverine and indigenous populations. These injuries cause severe local and regional pain, swelling and erythema, as well as complications, such as local necrosis and bacterial infection. Herein, we report a case of bacterial infection and hallux necrosis, after a freshwater stingray injury in the Brazilian Amazon, which eventually required amputation. Different antimicrobial regimens were administered at different stages of the disease; however, avoiding amputation through effective treatment was not achieved.

  11. Congenital tibial dysplasia with lateral bowing and duplication of hallux: case presentations.

    Science.gov (United States)

    Beck, Jennifer J; Altiok, Haluk

    2013-05-01

    This article reports on two children with congenital unilateral tibial dysplasia with lateral bowing with no associated sagittal plane deformity. In both cases, it is associated with ipsilateral duplication of the hallux. Long-term follow-up of the patients showed spontaneous, almost complete resolution of the bowing without progressing into fracture or pseudoarthrosis. Leg length discrepancy appeared to be the only orthopedic sequela related to this phenomenon.

  12. Juvenile Prostitution.

    Science.gov (United States)

    Csapo, Marg

    1986-01-01

    Recent research and Canadian government committee reports concerning juvenile prostitution are reviewed. Proposals are made in the realms of law and social policy; and existing programs are described. (DB)

  13. Juvenile Prostitution.

    Science.gov (United States)

    Csapo, Marg

    1986-01-01

    Recent research and Canadian government committee reports concerning juvenile prostitution are reviewed. Proposals are made in the realms of law and social policy; and existing programs are described. (DB)

  14. Juvenile myasthenia

    Directory of Open Access Journals (Sweden)

    Knežević-Pogančev Marija

    2011-01-01

    Full Text Available Introduction. Juvenile myasthenia is a chronic autoimmune neuromuscular disease characterized by varying degrees of fluctuating, painless muscle weakness and rapid fatigue of any muscles under voluntary control. Juvenile myasthenia is a form of myasthenia appearing in adolescent age, representing 10% to 15% of all cases of myasthenia gravis. Juvenile myasthenia is presented by a defect in the transmission of nerve impulses to muscles, resulting from a breakdown in the normal communication between nerves and muscles. In myasthenia, antibodies produced by the body’s own immune system block, alter, or destroy the receptors for acetylcholine. Juvenile myasthenia is neither directly inherited nor is it contagious. Signs and Symptoms. The first noticeable symptoms may be eye muscle weakness, difficulty in swallowing, or slurred speech. Juvenile myasthenia usually affects muscles innervated by the cranial nerves (face, lips, tongue, neck and throat, but it can affect any muscle group. Symptoms vary in type and severity with typical periods of exacerbation interspersed with periods of remission. When the muscles necessary for breathing are affected, a patient is said to be in a myasthenic crisis, which is a life-threatening situation. Disease Outcome and Treatment. Juvenile myasthenia produces sporadic but progressive weakness and abnormal fatigability of striated (skeletal muscles, exacerbated by exercise and repeated movement, but improved by rest and anticholinesterase drugs. Juvenile myasthenia follows an unpredictable course of recurring exacerbations and periodic remissions. With current therapies, however, most cases of juvenile myasthenia are not as serious as the name implies. Although there is no known cure, drug treatment has improved prognosis and allows patients to lead relatively normal lives, except during exacerbations.

  15. Juvenile idiopathic arthritis

    Science.gov (United States)

    Juvenile rheumatoid arthritis (JRA); Juvenile chronic polyarthritis; Still disease; Juvenile spondyloarthritis ... The cause of juvenile idiopathic arthritis (JIA) is not known. It ... illness . This means the body attacks and destroys healthy body ...

  16. Juvenile Polyposis Syndrome

    Science.gov (United States)

    ... Types of Cancer > Juvenile Polyposis Syndrome Request Permissions Juvenile Polyposis Syndrome Approved by the Cancer.Net Editorial Board , 12/2015 What is juvenile polyposis syndrome? Juvenile polyposis syndrome (JPS) is a ...

  17. Finite element analysis of the valgus knee joint of an obese child.

    Science.gov (United States)

    Sun, Jun; Yan, Songhua; Jiang, Yan; Wong, Duo Wai-Chi; Zhang, Ming; Zeng, Jizhou; Zhang, Kuan

    2016-12-28

    Knee valgus and varus morbidity is at the second top place in children lower limb deformity diseases. It may cause abnormal stress distribution. The magnitude and location of contact forces on tibia plateau during gait cycle have been indicated as markers for risk of osteoarthritis. So far, few studies reported the contact stress and force distribution on tibial plateau of valgus knee of children. To estimate the contact stresses and forces on tibial plateau of an 8-year old obese boy with valgus knee and a 7-year old healthy boy, three-dimensional (3D) finite element (FE) models of their left knee joints were developed. The valgus knee model has 36,897 nodes and 1,65,106 elements, and the normal knee model has 78,278 nodes and 1,18,756 elements. Paired t test was used for the comparison between the results from the 3D FE analysis method and the results from traditional kinematic measurement methods. The p value of paired t test is 0.12. Maximum stresses shifted to lateral plateau in knee valgus children while maximum stresses were on medial plateau in normal knee child at the first peak of vertical GRF of stance phase. The locations of contact centers on medial plateau changed 3.38 mm more than that on lateral plateau, while the locations of contact centers on medial plateau changed 1.22 mm less than that on lateral plateau for healthy child from the first peak to second peak of vertical GRF of stance phase. The paired t test result shows that there is no significant difference between the two methods. The results of FE analysis method suggest that knee valgus malalignment could be the reason for abnormal knee load that may cause knee problems in obese children with valgus knee in the long-term. This study may help to understand biomechanical mechanism of valgus knees of obese children.

  18. The influence of valgus heel position on foot loading in a child's gait

    Directory of Open Access Journals (Sweden)

    Eliška Martinásková

    2012-12-01

    Full Text Available BACKGROUND: Flat foot is a typical clinical sign in childhood, expressed as valgus positioning of the heel during vertical foot loading. This may lead to medial deviation of the foot axis and cause overloading of some foot areas. OBJECTIVE: To determine the influence of valgus position of the heel (both bilateral and unilateral on foot loading during gait. METHODS: An experimental group consisting of children with bilateral heel valgus deformity (16 children, age 5.3 ± 1.3 years and children with unilateral heel valgus deformity (14 children, age 5.6 ± 1.6 years. The control group comprised of 14 children (age 4.5 ± 1.2 years. For measuring foot loading during gait, the Footscan (RSScan International, Olen, Belgium pressure plate was used. Each subject went through 8 trials of gait measurement. From each trial, 8 foot areas were evaluated. Data processing with mean values for each subject was performed by non-parametric tests (Mann-Whitney and Wilcoxon tests, Spearman correlation in the STATISTICA programme (StatSoft, Inc., Tulsa, USA. RESULTS: Pressure peak and pressure impulse in the first metatarsal was greater for the bilateral valgus group (p CONCLUSION: The results show that valgus positioning of the heel influences foot loading in children during gait. The findings of this study suggest the necessity of a complex solution to the problem of preventing further progression of pathological changes.

  19. The results of Grice Green subtalar arthrodesis of valgus foot in spina bifida

    Directory of Open Access Journals (Sweden)

    Fatih Küçükdurmaz

    2012-01-01

    Full Text Available Background: Valgus foot is a common foot deformity in spina bifida. The most popular operation for the valgus deformity has been the Grice talocalcaneal blocking. It has not been studied primarily in children with spina bifida. We report a prospective series, we present the results of hind foot valgus deformity of children with spina bifida, using Grice talocalcaneal arthrodesis with a tricortical iliac bone graft. Materials and Methods: Between May 2000 and December 2003, 21 patients with bilateral (42 feet valgus deformity of feet underwent surgery. There were 7 males and 14 females. The mean age of patients was 67.7 months (range 50-108 months. Results: The total number of feet that had nonunion was 11, in 7 of them the grafts were completely reabsorbed and the outcome of all these feet was unsatisfactory. Four feet had partial union of which three had unsatisfactory and one had satisfactory outcome. Sixteen feet had residual valgus deformity at the last followup visit, 10 patients had nonunion, and 6 had inadequate correction. Mean preoperative talocalcaneal and calcaneal pitch angles were 48.5΀ and 31.9΀, respectively, which decreased to 38.5΀ and 29.1΀, respectively, postoperatively. The decrease in talocalcaneal angle and calcaneal pitch was significant between preoperative and postoperative measurements (P<0.05. Conclusion: Grice subtalar arthrodesis technique is still a valuable option for valgus foot in patients with spina bifida. In this study, we found more encouraging results in older patients.

  20. The results of Grice Green subtalar arthrodesis of valgus foot in spina bifida.

    Science.gov (United States)

    Küçükdurmaz, Fatih; Ağır, Ismail; Saygı, Baransel; Bezer, Murat

    2012-05-01

    Valgus foot is a common foot deformity in spina bifida. The most popular operation for the valgus deformity has been the Grice talocalcaneal blocking. It has not been studied primarily in children with spina bifida. We report a prospective series, we present the results of hind foot valgus deformity of children with spina bifida, using Grice talocalcaneal arthrodesis with a tricortical iliac bone graft. Between May 2000 and December 2003, 21 patients with bilateral (42 feet) valgus deformity of feet underwent surgery. There were 7 males and 14 females. The mean age of patients was 67.7 months (range 50-108 months). The total number of feet that had nonunion was 11, in 7 of them the grafts were completely reabsorbed and the outcome of all these feet was unsatisfactory. Four feet had partial union of which three had unsatisfactory and one had satisfactory outcome. Sixteen feet had residual valgus deformity at the last followup visit, 10 patients had nonunion, and 6 had inadequate correction. Mean preoperative talocalcaneal and calcaneal pitch angles were 48.5° and 31.9°, respectively, which decreased to 38.5° and 29.1°, respectively, postoperatively. The decrease in talocalcaneal angle and calcaneal pitch was significant between preoperative and postoperative measurements (P<0.05). Grice subtalar arthrodesis technique is still a valuable option for valgus foot in patients with spina bifida. In this study, we found more encouraging results in older patients.

  1. SURGICAL TREATMENT OF HALLUX VALGLUS BY RECONSTRUCTION OF METATARSAL ARCH AND MODIFIED MCBRIDE OPERATION (40 CASES REPORT)

    Institute of Scientific and Technical Information of China (English)

    翁习生; 贺仁诚; 李柯; 廉清宇; 李秉璐

    1995-01-01

    72 feet with hallux valges among 40 patients treated by recoestruction of metatarsal arch and modified McBride operation are reported in this paper. After an average of 4. 5 years of postoperative follow-up , the results showed an overll 9° and 3° correction of the hallux abductes angle and the intermetatarsal angle, re-spectively. 95% of the cases of bunions disappeared, 66% calli under the heads of the first and second metatarsal disappeared, and 91% patients were satisfied with the changes of their feet appearance.

  2. Juvenile Spondyloarthritis

    Science.gov (United States)

    Gmuca, Sabrina; Weiss, Pamela F.

    2015-01-01

    Purpose of review To provide a comprehensive update of the pathogenesis, diagnostic imaging, treatments, and disease activity measurements of juvenile spondyloarthritis (JSpA). Recent findings Genetic and microbiome studies have provided new information regarding possible pathogenesis of JSpA. Recent work suggests that children with JSpA have decreased thresholds for pain in comparison to healthy children. Additionally, pain on physical examination and abnormalities on ultrasound of the entheses are not well correlated. Treatment guidelines for juvenile arthritis, including JSpA, were published by the American College of Rheumatology and are based on active joint count and presence of sacroiliitis. Recent studies have established the efficacy of tumor necrosis factor inhibitors in the symptomatic treatment of axial disease, though their efficacy for halting progression of structural damage is less clear. Newly developed disease activity measures for JSpA include the Juvenile Arthritis Disease Activity Score and the JSpA Disease Activity index. In comparison to other categories of juvenile arthritis, children with JSpA are less likely to attain and sustain inactive disease. Summary Further microbiome and genetic research may help elucidate JSpA pathogenesis. More randomized therapeutic trials are needed and the advent of new composite disease activity measurement tools will hopefully allow for the design of these greatly needed trials. PMID:26002028

  3. Traumatic Mallet Toe of the Hallux in a Paediatric Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    Jason Chow

    2013-06-01

    Full Text Available We describe a case of traumatic avulsion fracture of the distal phalanx of the hallux in a paediatric patient. The patient had a Salter Harris type III fracture of the distal phalanx with 40% of the articular cartilage involved and a clinical extension lag. We treated the injury non-operatively with applying a fibreglass dorsiflexion interphalangeal plaster for 6 weeks. An excellent outcome was achieved with normal range of interphalangeal motion and solid painless union of fracture at 12 weeks.

  4. Hallux amputation after a freshwater stingray injury in the Brazilian Amazon

    Directory of Open Access Journals (Sweden)

    Wuelton Marcelo Monteiro

    2016-06-01

    Full Text Available Abstract: Freshwater stingray injuries are a common problem in the Brazilian Amazon, affecting mostly riverine and indigenous populations. These injuries cause severe local and regional pain, swelling and erythema, as well as complications, such as local necrosis and bacterial infection. Herein, we report a case of bacterial infection and hallux necrosis, after a freshwater stingray injury in the Brazilian Amazon, which eventually required amputation. Different antimicrobial regimens were administered at different stages of the disease; however, avoiding amputation through effective treatment was not achieved.

  5. Varus distal femoral osteotomy in young adults with valgus knee

    Directory of Open Access Journals (Sweden)

    Mazlumi Mahdi

    2009-05-01

    Full Text Available Abstract Background Musculoskeletal disorders specially knee osteoarthritis are the most common causes of morbidity in old patients. Disturbance of the mechanical axis of the lower extremity is one of the most important causes in progression of knee osteoarthritis. The purpose of the present study was to analyze the surgical results of distal femoral varus osteotomy in patients with genu valgum. Methods In this study, after recording history and physical examination, appropriate radiographs were taken. We did varus distal femoral osteotomy by standard medial subvastus approach and 90-angle blade plate fixation then followed the patients clinically and radiographically. Results This study was done on 23 knees (16 patients age 23.3 years (range, 17 to 41 years. The mean duration of following up was 16.3 months (range, 8 to 25 months. Based on paired T test, there were statistically significant difference between pre- and postoperative tibiofemoral and congruence angles (p Conclusion Distal femoral varus osteotomy with blade plate fixation can be a reliable procedure for the treatment of valgus knee deformity. In this procedure, with more tibiofemoral angle correction, more congruence angle correction can be achieved. Therefore, along with genu valgum correction, the patella should be stabilized simultaneously.

  6. Total knee arthroplasty using computer assisted navigation in patients with severe valgus deformity of the knee

    Institute of Scientific and Technical Information of China (English)

    SHAO Jun-jie; ZHANG Xian-long; WANG Qi; CHEN Yun-su; SHEN Hao; JIANG Yao

    2010-01-01

    Background Severe valgus deformity often has bone defect and laxity of the medial ligamentous, and total knee arthroplasty in severe valgus knee is, in most cases, more challenging for surgeons. The usefulness of a computer assisted navigation system in reestablishing the mechanical axis has been well established. Hence, the interest for surgeons is how the navigation system makes the procedure of total knee arthroplasty with severe valgus knee easier.Methods From June 2006 to March 2008 in Department of Joint Surgery, Shanghai Sixth People's Hospital, 6 patients (7 knees) with severe valgus knee underwent total knee arthroplasty using the Stryker Navigation system, which is an active wireless and imageless system. All the patients were followed up for 12 to 18 months after surgery. The X-ray radiographs for whole limbs were obtained on all patients to determine preoperative and postoperative alignments.Results A primary, posterior stabilized prosthesis was utilized in all cases. The average preoperative overall mechanical axis of the seven knees was 19.6°±4.6° of valgus (range 16° to 29°), and the average postoperative mechanical axis was 0.4°±0.7° (range 0.8° varus to 1.4° valgus ).Conclusions The navigation system is a very effective and useful tool for accurate intraoperative restoration of alignment in the face of significant deformity with valgus knee. To prevent component malposition, we did not reduce the knee before solidification of bone cement but controlled alignment using the navigation system up to implantation of the final component.

  7. Effect of valgus knee alignment on gait biomechanics in healthy women.

    Science.gov (United States)

    Hoch, Matthew C; Weinhandl, Joshua T

    2017-08-01

    The purpose of this study was to compare lower extremity kinematics and kinetics between women with greater or lesser degrees of valgus knee alignment during gait. Nine women with greater valgus knee alignment (11.9±1.6°) were compared to nine women with lesser valgus knee alignment (6.6±2.4°). Participants completed a biomechanical assessment of overground walking for the right limb. Dependent variables included sagittal and frontal plane joint angles and moments for the hip, knee, and ankle at peak vertical ground reaction force, along with knee abduction angular impulse. Sagittal and frontal plane excursions for the hip, knee, and ankle were calculated from heel strike to the peak angle for each variable. The greater valgus alignment group demonstrated lower knee abduction moment (p=0.007), lower knee adduction angle (p0.05). Less knee adduction angle and excursion coupled with lower knee abduction moment and angular impulse in women with greater knee valgus indicates these individuals may be experiencing biomechanics which promote lateral tibiofemoral joint loading. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Quantifying varus and valgus thrust in individuals with severe knee osteoarthritis.

    Science.gov (United States)

    Sosdian, L; Hinman, R S; Wrigley, T V; Paterson, K L; Dowsey, M; Choong, P; Bennell, K

    2016-11-01

    Varus-valgus thrust is a biomechanical characteristic linked to knee osteoarthritis disease progression. This study aimed to determine: i) direction of thrust in individuals awaiting total knee arthroplasty versus controls, ii) whether thrust and related parameters differed between groups, iii) differences between osteoarthritis patients awaiting surgery with varus and valgus thrust. 44 patients scheduled for surgery and 40 asymptomatic participants were recruited. varus-valgus thrust excursion and absolute thrust magnitude, quantified by 3D gait analysis. Few differences were found between the osteoarthritis group and controls. The osteoarthritis group as a whole had a more varus knee angle during early- (pthrust osteoarthritis subgroup had a more varus knee angle in overall (p=0.012), early- (pthrust controls. No differences were found between the valgus thrust osteoarthritis and control groups. The varus thrust osteoarthritis group had a greater varus peak knee angle in overall (pthrust osteoarthritis group. Those with severe osteoarthritis and a varus thrust have poorer biomechanics, more varus static knee alignment, and lower quadriceps strength compared to those with osteoarthritis with a valgus thrust. Further work is needed to determine if these findings impact total knee arthroplasty outcome. Copyright © 2016. Published by Elsevier Ltd.

  9. Juvenile Justice in Milwaukee

    Science.gov (United States)

    Williams, Gary L.; Greer, Lanetta

    2010-01-01

    Historically, there have been several attempts made to address issues surrounding juvenile delinquency. The Wisconsin Legislature outlines the objectives of the juvenile justice system in the Juvenile Justice Code in s. 939.01, ?to promote a juvenile justice system capable of dealing with the problem of juvenile delinquency, a system which will…

  10. Isolated intraosseous gout in hallux sesamoid mimicking a bone tumor in a teenaged patient

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Shi-Zuo; Yeh, LeeRen; Chen, Clement Kuen-Huang; Pan, Huay-Ban [Department of Radiology, Kaohsiung Veterans General Hospital, 386 Ta-Chung first Rd., 813, Kaohsiung, Taiwan (Taiwan); Chou, Yi-Jiun [Department of Orthopedics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan (Taiwan)

    2003-11-01

    We are reporting an unusual case of isolated intraosseous tophus in medial hallux sesamoid presenting as tumor-like lesion in a teenage patient without prior history of gouty attack and underlying systemic disorders. The lesion manifested isointensity to surrounding muscles with internal low signal on spin echo (SE) T1-weighted images, and heterogeneous low signal intensity on fast spin echo (FSE) T2-weighted images. Computed tomography (CT) scan disclosed expansion and diffusely increased attenuation of the medial hallux sesamoid with focal cortical erosion and extraosseous extension of high attenuation content. The subsequent resection and pathology revealed intraosseous tophus deposition, which is particularly rare at this site and at this age. Imaging studies revealed some characteristic imaging features which can retrospectively be attributed to gouty tophus. When an expansile osteolytic lesion manifesting low signal intensity on T2-weighted image and internal calcifications on CT scan is encountered, the possibility of intraosseous tophus should be included in the list of differential diagnoses, even in a teenage patient without prior history of gout. (orig.)

  11. Juvenile xanthogranuloma.

    Science.gov (United States)

    Singh, R; Ghazali, W

    1992-05-01

    Juvenile xanthogranuloma is a benign cutaneous growth presenting as papules or nodules. It is characterized by an intradermal collection of lipid-laden macrophages and varying degrees of fibroblastic proliferation. We have recently observed two patients with xanthogranulomas: one was found to have a papular type and the second patient had multiple nodular growths. We present these cases, which should be considered in the differential diagnosis of skin nodules.

  12. Tolko poetom hotel bõt : Rastrogannost; Dozhdlivõi den; Jaanov ogon; Setumaa I-II; Tolko poetom. Haralskije zhizneopissanija : Aire Valgus; Aare Valgus; Peeter Petrov; Vaike Metsleht; Valdur Laiapea; Hillar Aruda, ekonomist; Pärja Lumendi; Valjo Z

    Index Scriptorium Estoniae

    Traat, Mats, 1936-

    1996-01-01

    Orig.: Heldimus; Sajupäev; Jaanituli; Setumaa I-II; Ainult poeet. Harala elulood: Aire Valgus; Aare Valgus; Peeter Petrov; Vaike Metsleht; Valdur Laiapea; Hillar Aruda, ökonomist; Pärja Lumendi; Valjo Zeiger; Pavlo Moskalenko; Johannes Iva; Viljar Laanemägi; Olga Kaljusaar; Aimi Vaimets; Einard Kalm (1923-1984); Sonetid vaikimisest I; Kui

  13. Tolko poetom hotel bõt : Rastrogannost; Dozhdlivõi den; Jaanov ogon; Setumaa I-II; Tolko poetom. Haralskije zhizneopissanija : Aire Valgus; Aare Valgus; Peeter Petrov; Vaike Metsleht; Valdur Laiapea; Hillar Aruda, ekonomist; Pärja Lumendi; Valjo Z

    Index Scriptorium Estoniae

    Traat, Mats, 1936-

    1996-01-01

    Orig.: Heldimus; Sajupäev; Jaanituli; Setumaa I-II; Ainult poeet. Harala elulood: Aire Valgus; Aare Valgus; Peeter Petrov; Vaike Metsleht; Valdur Laiapea; Hillar Aruda, ökonomist; Pärja Lumendi; Valjo Zeiger; Pavlo Moskalenko; Johannes Iva; Viljar Laanemägi; Olga Kaljusaar; Aimi Vaimets; Einard Kalm (1923-1984); Sonetid vaikimisest I; Kui

  14. Assessment of gait symmetry for Talus Valgus children based on experimental kinematic analysis

    Science.gov (United States)

    Toth-Tascau, Mirela; Pasca, Oana; Vigaru, Cosmina; Rusu, Lucian

    2013-10-01

    The general purpose of this study was to assess the gait symmetry for Talus Valgus deformity based on experimental kinematic analysis. As this foot condition generally occurs in children, the study is focused on two children having five years old, one being healthy, as control subject, and the second one having bilateral Talus Valgus deformity. Kinematic experimental analysis was conducted using Zebris CMS-HS Measuring System. The bilateral symmetry was analyzed using two methods: index of symmetry (SI) calculated for spatio-temporal parameters (stance phase, swing phase, and step length) and kinematic parameter (maximum value of dorsiflexion - plantar flexion angle in the ankle joint), and an unpaired t-test to compare the variation of means values of dorsiflexion - plantar flexion angle in ankle joint for both left and right side. The study evidenced a good bilateral symmetry in case of the control subject and quantified the asymmetry in case of subject with Talus Valgus deformity.

  15. Keblish's lateral surgical approach enhances patellar tilt in valgus knee arthroplasty

    Directory of Open Access Journals (Sweden)

    José Roberto Tonelli Filho

    Full Text Available ABSTRACT OBJECTIVE: To compare the clinical and radiological outcomes of conventional medial and lateral approaches for total knee replacement in the valgus osteoarthritic knee. METHODS: In this randomized controlled trial, 21 patients with valgus knee osteoarthritis were randomized to total knee replacement through medial or lateral approach. The primary outcome was radiographic patellar tilt. Secondary outcomes were visual analog scale of pain, postoperative levels of hemoglobin, and clinical aspect of the operative wound. RESULTS: There were no differences between the groups regarding other clinical variables. Mean lateral tilt of the patella was 3.1 degrees (SD ± 5.3 in the lateral approach group and 18 degrees (SD ± 10.2 in the medial approach group (p = 0.02. There were no differences regarding the secondary outcomes. CONCLUSION: Lateral approach provided better patellar tilt following total knee replacement in valgus osteoarthritic knee.

  16. Total knee arthroplasty in severe genu valgus. Five to 14 years followup.

    Directory of Open Access Journals (Sweden)

    César Angel Pesciallo

    2016-08-01

    Full Text Available Introduction: valgus malalignment is a complex, multiplanar deformity characterized by bone alterations and soft-tissue abnormalities. Several surgical techniques have been described for valgus knee, and the sequence of tight lateral structures release and necessity of constrained prosthesis were addressed. Total Knee Arthroplasty (TKA in valgus deformity remains a surgical challenge for orthopaedic surgeons. The objectives of the study were to evaluate our mid and long-term results in the surgical treatment of severe valgus disease, and describe the applied surgical technique.  Materials and Methods: a clinic-radiographic classification was developed, and patients treated for severe genu valgus were discriminated. We retrospectively evaluated 42 TKA in 39 patients, with an average follow-up of 9,2 years. Knee Society Score (KSS was used for clinical evolution, and the last control best quality radiography was considered for radiographic evaluation. Survivorship analysis contemplated need for revision for any reason and for mechanical failure. Results: postoperative average KSS was 83,3, with marked improvement in parameters pain and range of movement. Constrained implants were utilized in 16,7% of cases. Postoperative alignment was on average 5,9°. Two patients underwent revision surgery, having achieved a prosthetic survivorship for mechanical failure of 97,6%. We did not have any revision because of infection. Conclusion: a meticulous physical examination and proper preoperative radiographs are mandatory. The decision of using a constrained device is done intraoperative. Appropriate soft-tissue release is extremely significant. Despite the surgical technique, a constrained prosthesis utilization is limited. We recommend our technique as a low-demanding procedure, with encouraging mid and long-term results. Key words: valgus, deformity, severe, TKA, release, surgical technique.

  17. Dermatomiositis juvenil

    OpenAIRE

    Goldaracena, Pablo; Pérez, Federico

    2008-01-01

    La dermatomiositis juvenil (DMJ) es una enfermedad multi sistémica de etiología desconocida, caracterizada por una vasculitis que ocasiona una inflamación no supurativa del músculo estriado y lesiones cutáneas distintivas. La cobertura de los criterios de Bohan y Peter establece el diagnóstico: exantema patognomónico junto a debilidad muscular proximal simétrica, elevación sérica de enzimas musculares, s...

  18. Immediate effect of valgus bracing on knee joint moments in meniscectomised patients

    DEFF Research Database (Denmark)

    Thorning, Maria; Thorlund, Jonas Bloch; Roos, Ewa M

    2016-01-01

    OBJECTIVES: Patients undergoing medial arthroscopic partial meniscectomy are at increased risk of developing and/or progressing knee osteoarthritis, with increased medial compartment load being a potential contributor. The aim of this study was to evaluate the immediate effect of a valgus unloade...... tasks. Future research is required to explore the structural implications....

  19. [Underfoot pressure distribution of a patient after fracture of the calcaneal bone and bilateral hallux amputation--case report].

    Science.gov (United States)

    Lorkowski, Jacek; Trybus, Marek; Hładki, Waldemar; Brongel, Leszek

    2006-01-01

    The aim of our study was to estimate underfoot pressure distribution of a patient after bilateral hallux amputation and the unilateral calcaneal bone fracture on the left side at the end of orthopaedic end rehabilitation treatment. The pedobarographic examination during bipedal standing revealed localisation of maximal pressure at H region on the side of fracture and on MT1 and H foot regions on the other side. After the and of orthopaedic treatment underfoot pressure distribution changes persists in spite of pain regression.

  20. A descriptive study of foot problems in children with juvenile rheumatoid arthritis (JRA).

    Science.gov (United States)

    Spraul, G; Koenning, G

    1994-09-01

    In this study, we evaluated the feet of 144 consecutive children with juvenile rheumatoid arthritis (JRA) during a routine outpatient visit to discover patterns of foot problems. We found that all but nine subjects had at least 1 of 21 foot problems, categorized as inflammation, limitation of motion, and abnormal alignment. Overall, pronated rearfoot and midfoot were observed in 73% and 72% of JRA patients, respectively. Additionally, 36% had splayfoot, whereas 35% of subjects had ankle limitation of motion. Other common foot problems included pronated forefoot, rearfoot and forefoot synovitis, forefoot limitation of motion, and toe valgus. Significant differences in the occurrence of various foot problems were observed among JRA onset/course subgroups and were influenced by both age and disease duration. Specifically, subjects with polyarticular JRA had more forefoot limitation and toe valgus, whereas subjects with pauciarticular JRA had pronated forefoot more often. Ankle limitation of motion, although unrelated to the JRA sub-group, was related to the duration of JRA. Subjects with longer disease histories also had toe valgus more often. Conversely, forefoot limitation of motion seemed to be more a function of age than of disease duration. These results indicate that foot problems are common in the JRA population, and they underscore the need for thorough evaluation and physical therapy management.

  1. What Is Juvenile Arthritis?

    Science.gov (United States)

    ... Analgesics for Osteoarthritis (Report from AHRQ) Joint Replacement Surgery: Health Information Basics for You and Your Family NIH Pediatric Rheumatology Clinic Health Information Juvenile Arthritis Find a Clinical Trial Journal Articles Juvenile Arthritis PDF Version Size: 123 KB ...

  2. Juvenile Delinquency: An Introduction

    Science.gov (United States)

    Smith, Carolyn A.

    2008-01-01

    Juvenile Delinquency is a term which is often inaccurately used. This article clarifies definitions, looks at prevalence, and explores the relationship between juvenile delinquency and mental health. Throughout, differences between males and females are explored. (Contains 1 table.)

  3. Parenting and juvenile delinquency

    NARCIS (Netherlands)

    Hoeve, Machteld

    2008-01-01

    Juvenile delinquency is a noteworthy problem. This thesis addressed the association between parenting and juvenile delinquency by analyzing the concepts of parenting adopted in family research in relation to criminological concepts and measures of delinquent behavior. Four studies were conducted.

  4. Tibial condylar valgus osteotomy (TCVO) for osteoarthritis of the knee: 5-year clinical and radiological results.

    Science.gov (United States)

    Chiba, Ko; Yonekura, Akihiko; Miyamoto, Takashi; Osaki, Makoto; Chiba, Goji

    2017-03-01

    Tibial condylar valgus osteotomy (TCVO) is a type of opening-wedge high tibial osteotomy for advanced medial knee osteoarthritis (OA) with subluxated lateral joint. We report the concept, the current surgical technique with a locking plate, and the short-term clinical and radiological results of this procedure. 11 knees with medial OA and a widened lateral joint were treated by TCVO (KL stage III: 6, IV: 5). In this procedure, by the L-shaped osteotomy from the medial side of the proximal tibia to the intercondylar eminence and the valgus correction, lateralization of the mechanical axis and reduction of the subluxated lateral joint are obtained with early postoperative weight-bearing. Before, 6 months, 1, and 5 years after the operation, a visual analog scale (VAS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), alignment of the lower extremity, and congruency and stability of the femorotibial joint were investigated. The VAS improved from an average of 73 mm to 13 mm, and the total WOMAC score from 52 to 14 before to 5 years after the operation, respectively. The mechanical axis changed from 1 to 60%, and the FTA changed from 186° to 171°. The joint line convergence angle (JLCA) changed from 6° to 1°, and the angle difference of JLCA between varus and valgus stress improved from 8° to 4° after the procedure. Improvements in pain and activities of daily living were observed by TCVO along with valgus correction of the lower extremity and stabilization of the femorotibial joint.

  5. Minimal Invasive Percutaneous Osteosynthesis for Elderly Valgus Impacted Proximal Humeral Fractures with the PHILOS

    Directory of Open Access Journals (Sweden)

    Hang Chen

    2015-01-01

    Full Text Available There is a growing concern about elderly valgus impacted proximal humeral fractures. The aim of this study was to evaluate the treatment and clinical outcomes following minimal invasive percutaneous plate osteosynthesis (MIPPO with the proximal humeral internal locking system (PHILOS for the treatment of elderly valgus impacted proximal humeral fracture. Between May 2008 and May 2012, 27 patients (average age 67.3, range 61–74 with valgus impacted proximal humeral fractures were enrolled in the study. The patients were treated with MIPPO using PHILOS-plate through the anterolateral delta-splitting approach. Rehabilitation exercises were done gradually. The NEER score and Constant-Murley score were used to evaluate shoulder function. All the patients were followed up by routine radiological imaging and clinical examination. There were 15 cases of II-part greater tuberosity fractures, 10 cases of III-part greater tuberosity fractures, and 2 cases of IV-part fractures according to the NEER classification. The surgery was successful in all patients with an average follow-up of 20.8 (range: 11–34 months. The fractures united in an average of 7.2 (6–14 weeks without implant loosening. According to NEER score, there were 17 excellent, 7 satisfactory, 2 unsatisfactory, and 1 poor. The mean Constant-Murley score was 89.4±4.35. No complication including axillary nerve damage, postoperative nerve or vessel damage, infections, DVT, or death was observed. In conclusion, the MIPPO technique with the PHILOS through the anterolateral delta-splitting approach seems to be a safe and easy treatment for elderly valgus impacted proximal humeral fractures. A case-control study and longer follow-up time are needed.

  6. Minimal Invasive Percutaneous Osteosynthesis for Elderly Valgus Impacted Proximal Humeral Fractures with the PHILOS.

    Science.gov (United States)

    Chen, Hang; Hu, Xiaochuan; Tang, Haochen; Yang, Guoyong; Xiang, Ming

    2015-01-01

    There is a growing concern about elderly valgus impacted proximal humeral fractures. The aim of this study was to evaluate the treatment and clinical outcomes following minimal invasive percutaneous plate osteosynthesis (MIPPO) with the proximal humeral internal locking system (PHILOS) for the treatment of elderly valgus impacted proximal humeral fracture. Between May 2008 and May 2012, 27 patients (average age 67.3, range 61-74) with valgus impacted proximal humeral fractures were enrolled in the study. The patients were treated with MIPPO using PHILOS-plate through the anterolateral delta-splitting approach. Rehabilitation exercises were done gradually. The NEER score and Constant-Murley score were used to evaluate shoulder function. All the patients were followed up by routine radiological imaging and clinical examination. There were 15 cases of II-part greater tuberosity fractures, 10 cases of III-part greater tuberosity fractures, and 2 cases of IV-part fractures according to the NEER classification. The surgery was successful in all patients with an average follow-up of 20.8 (range: 11-34) months. The fractures united in an average of 7.2 (6-14) weeks without implant loosening. According to NEER score, there were 17 excellent, 7 satisfactory, 2 unsatisfactory, and 1 poor. The mean Constant-Murley score was 89.4 ± 4.35. No complication including axillary nerve damage, postoperative nerve or vessel damage, infections, DVT, or death was observed. In conclusion, the MIPPO technique with the PHILOS through the anterolateral delta-splitting approach seems to be a safe and easy treatment for elderly valgus impacted proximal humeral fractures. A case-control study and longer follow-up time are needed.

  7. Juvenile Arrests, 2007. Juvenile Justice Bulletin

    Science.gov (United States)

    Puzzanchera, Charles

    2009-01-01

    This Bulletin summarizes 2007 juvenile crime and arrest data reported by local law enforcement agencies across the country and cited in the FBI report, "Crime in the United States 2007." The Bulletin describes the extent and nature of juvenile crime that comes to the attention of the justice system. It serves as a baseline for comparison for…

  8. Juvenile polyposis syndrome

    NARCIS (Netherlands)

    L.A.A. Brosens; D. Langeveld; W.A. van Hattem; F.M. Giardiello; G.J.A. Offerhaus

    2011-01-01

    Juvenile polyposis syndrome is a rare autosomal dominant syndrome characterized by multiple distinct juvenile polyps in the gastrointestinal tract and an increased risk of colorectal cancer. The cumulative life-time risk of colorectal cancer is 39% and the relative risk is 34. Juvenile polyps have a

  9. Effect of shoes containing nanosilica particles on knee valgus in active females during landing

    Directory of Open Access Journals (Sweden)

    Zahra Bassiri

    2015-01-01

    Full Text Available Objective(s: The effect of silica nanoparticles (SNPs in sport shoes outsoles on the  parameters related to anterior cruciate ligament (ACL Injury has not been investigated. The aim of this study was to investigate the effect of shoes outsole containing a composite of thermoplastic elastomer based on styrene-butadiene and silica nanoparticles (TPEN shoe on Knee Valgus Angle (KVA as a risk factor of ACL injuries during landing Materials and Methods: Fourteen active healthy women without knee injuries and disorders performed bilateral drop jump (DJ and single leg drop landing (SLL tasks in barefoot, wearing shoes fabricated with polyvinyl chloride outsole (PVC shoe and TPEN shoes conditions , randomly. The knee valgus angle values of right and left legs were calculated in the landing conditions. Two factors repeated measures ANOVA were used to investigate the effect of landing and footwear conditions on KVA of right and left legs.  Results: For both left and right limbs, the KVA was at maximum and minimum values during landing with barefoot and TPEN shoes, respectively. PVC shoe significantly reduced the knee valgus by 3.84% in left and 4.18% in right knee (P

  10. Juveniles on trial.

    Science.gov (United States)

    Quinn, Kathleen M

    2002-10-01

    This article describes common forensic evaluations requested of juvenile court mental health evaluators. There has been a legal shift toward criminalization of juvenile court, with a greater emphasis on rights, abandonment of the rehabilitative model, and greater movement of adolescents into the adult criminal court. A resulting shift has been the redefinition of juvenile court forensic evaluations toward the specificity of adult forensic work. The challenge for evaluators is to refine their knowledge of the forensic standards and bring knowledge of development, assessment, and diagnosis in juveniles and interview techniques appropriate to juveniles to improve the evaluation and forensic reports.

  11. Asymmetric varus and valgus stability of the anatomic cadaver knee and the load sharing between collateral ligaments and bearing surfaces.

    Science.gov (United States)

    Wang, Xiaonan; Malik, Aamer; Bartel, Donald L; Wickiewicz, Thomas L; Wright, Timothy

    2014-08-01

    Knee joint stability is important in maintaining normal joint motion during activities of daily living. Joint instability not only disrupts normal motion but also plays a crucial role in the initiation and progression of osteoarthritis. Our goal was to examine knee joint coronal plane stability under varus or valgus loading and to understand the relative contributions of the mechanisms that act to stabilize the knee in response to varus-valgus moments, namely, load distribution between the medial and lateral condyles and the ligaments. A robot testing system was used to determine joint stability in human cadaveric knees as described by the moment versus angular rotation behavior under varus and valgus loads at extension and at 30 deg and 90 deg of flexion. The anatomic knee joint was more stable in response to valgus than varus moments, and stability decreased with flexion angle. The primary mechanism for providing varus-valgus stability was the redistribution of the contact force on the articular surfaces from both condyles to a single condyle. Stretching of the collateral ligaments provided a secondary stabilizing mechanism after the lift-off of a condyle occurred. Compressive loads applied across the knee joint, such as would occur with the application of muscle forces, enhanced the ability of the articular surface to provide varus-valgus moment, and thus, helped stabilize the joint in the coronal plane. Coupled internal/external rotations and anteroposterior and medial-lateral translations were variable and in the case of the rotations were often as large as the varus-valgus rotations created by the applied moment.

  12. Juvenile polyposis syndrome

    Institute of Scientific and Technical Information of China (English)

    Lodewijk AA Brosens; Danielle Langeveld; W Arnout van Hattem; Francis M Giardiello; G Johan A Offerhaus

    2011-01-01

    Juvenile polyposis syndrome is a rare autosomal dominant syndrome characterized by multiple distinct juvenile polyps in the gastrointestinal tract and an increased risk of colorectal cancer.The cumulative life-time risk of colorectal cancer is 39% and the relative risk is 34.Juvenile polyps have a distinctive histology characterized by an abundance of edematous lamina propria with inflammatory cells and cystically dilated glands lined by cuboidal to columnar epithelium with reactive changes.Clinically, juvenile polyposis syndrome is defined by the presence of 5 or more juvenile polyps in the colorectum,juvenile polyps throughout the gastrointestinal tract or any number of juvenile polyps and a positive family history of juvenile polyposis.In about 50%-60% of patients diagnosed with juvenile polyposis syndrome a germline mutation in the SMAD4 or BMPR1A gene is found.Both genes play a role in the BMP/TGF-beta signalling pathway.It has been suggested that cancer in juvenile polyposis may develop through the so-alled "landscaper mechanism" where an abnormal stromal environment leads to neoplastic transformation of the adjacent epithelium and in the end invasive carcinoma.Recognition of this rare disorder is important for patients and their families with regard to treatment,follow-up and screening of at risk individuals.Each clinician confronted with the diagnosis of a juvenile polyp should therefore consider the possibility of juvenile polyposis syndrome.In addition, juvenile polyposis syndrome provides a unique model to study colorectal cancer pathogenesis in general and gives insight in the molecular genetic basis of cancer. This review discusses clinical manifestations, genetics, pathogenesis and management of juvenile polyposis syndrome.

  13. Geometric pattern of the hominoid hallucal tarsometatarsal complex. Quantifying the degree of hallux abduction in early hominids

    Science.gov (United States)

    Berillon, Gilles

    1999-05-01

    The degree of hallux abduction in extant and fossil hominoids is analysed in terms of geometric relationships between the first metatarsal and the medial cuneiform and quantified by angular data, in relation to grasping ability and locomotor pattern. The 'australopithecine' pattern corresponds to an abducted first podal ray with some grasping abilities and seems to be derived from a ' Proconsul-like' pattern rather than a 'living African great ape-like' pattern. The Olduvai Hominid 8 condition closely resembles that of the modern human which corresponds to a full bipedalism.

  14. High knee valgus in female subjects does not yield higher knee translations during drop landings: a biplane fluoroscopic study.

    Science.gov (United States)

    Torry, Michael R; Shelburne, Kevin B; Myers, Casey; Giphart, J Erik; Pennington, W Wesley; Krong, Jacob P; Peterson, Daniel S; Steadman, J Richard; Woo, Savio L-Y

    2013-02-01

    The goal of this study was to determine the effects of peak knee valgus angle and peak knee abductor moment on the anterior, medial, and lateral tibial translations (ATT, MTT, LTT) in the "at risk" female knee during drop landing. Fifteen female subjects performed drop landings from 40 cm. Three-dimension knee motion was simultaneously recorded using a high speed, biplane fluoroscopy system, and a video-based motion analysis system. Valgus knee angles and knee abduction moments were stratified into low, intermediate, and high groups and peak ATT, MTT, and LTT were compared between these groups with ANOVA (α = 0.05). Significant differences were observed between stratified groups in peak knee valgus angle (p < 0.0001) and peak knee abduction moment (p < 0.0001). However, no corresponding differences in peak ATT, LTT, and MTT between groups exhibiting low to high-peak knee valgus angles (ATT: p = 0.80; LTT: p = 0.25; MTT: p = 0.72); or, in peak ATT (p = 0.61), LTT (p = 0.26) and MTT (p = 0.96) translations when stratified according to low to high knee abduction moments, were found. We conclude that the healthy female knee is tightly regulated with regard to translations even when motion analysis derived knee valgus angles and abduction moments are high.

  15. An evidence-based review of hip-focused neuromuscular exercise interventions to address dynamic lower extremity valgus

    Directory of Open Access Journals (Sweden)

    Ford KR

    2015-08-01

    Full Text Available Kevin R Ford,1 Anh-Dung Nguyen,2 Steven L Dischiavi,1 Eric J Hegedus,1 Emma F Zuk,2 Jeffrey B Taylor11Department of Physical Therapy, High Point University, High Point, NC, USA; 2Department of Athletic Training, School of Health Sciences, High Point University, High Point, NC, USAAbstract: Deficits in proximal hip strength or neuromuscular control may lead to dynamic lower extremity valgus. Measures of dynamic lower extremity valgus have been previously shown to relate to increased risk of several knee pathologies, specifically anterior cruciate ligament ruptures and patellofemoral pain. Therefore, hip-focused interventions have gained considerable attention and been successful in addressing these knee pathologies. The purpose of the review was to identify and discuss hip-focused exercise interventions that aim to address dynamic lower extremity valgus. Previous electromyography, kinematics, and kinetics research support the use of targeted hip exercises with non-weight-bearing, controlled weight-bearing, functional exercise, and, to a lesser extent, dynamic exercises in reducing dynamic lower extremity valgus. Further studies should be developed to identify and understand the mechanistic relationship between optimized biomechanics during sports and hip-focused neuromuscular exercise interventions.Keywords: dynamic lower extremity valgus, hip neuromuscular control, ACL injury rehabilitation, patellofemoral pain, hip muscular activation

  16. High Knee Valgus in Female Subjects Does Not Yield Higher Knee Translations During Drop Landings: A Biplane Fluoroscopic Study

    Science.gov (United States)

    Torry, Michael R.; Shelburne, Kevin B.; Myers, Casey; Giphart, J. Erik; Pennington, W. Wesley; Krong, Jacob P.; Peterson, Daniel S.; Steadman, J. Richard; Woo, Savio L-Y.

    2012-01-01

    The goal of this study was to determine the effects of peak knee valgus angle and peak knee abductor moment on the anterior, medial, and lateral tibial translations (ATT, MTT, LTT) in the ‘at risk’ female knee during drop landing. Fifteen female subjects performed drop landings from 40 cm. 3D knee motion was simultaneously recorded using a high speed, biplane fluoroscopy system and a video-based motion analysis system. Valgus knee angles and knee abduction moments were stratified into low, intermediate and high groups and peak ATT, MTT and LTT were compared between these groups with ANOVA (α = .05). Significant differences were observed between stratified groups in peak knee valgus angle (p knee abduction moment (p knee valgus angles (ATT: p = .80; LTT: p = .25; MTT: p = .72); or, in peak ATT (p = .61), LTT (p = .26) and MTT (p = .96) translations when stratified according to low to high knee abduction moments, were found. We conclude that the healthy female knee is tightly regulated with regard to translations even when motion analysis derived knee valgus angles and abduction moments are high. PMID:22968826

  17. Fixation of Intertrochanteric Valgus Osteotomy with T Plate in Treatment of Developmental Coxa Vara.

    Science.gov (United States)

    Elzohairy, Mohamed Mansour; Khairy, Hosam Mohamed

    2016-09-01

    Although the valgus subtrochanteric osteotomy is considered as a standard surgical treatment for coxa vara, there is no consensus on the optimal method of fixation and osteotomy technique. Fixation of the osteotomy has been achieved by various methods including external fixation and internal fixation with pins and cerclage and a variety of plates. The aim of this study is the evaluation of the results of developmental coxa treated by Y intertrochanteric valgus osteotomy fixed with a T-buttress plate compared with other methods of fixation in the literature. Eighteen corrective valgus intertrochanteric femoral osteotomies were performed in 18 patients (18 hips) for treatment of unilateral developmental coxa vara deformity and fixed with a T plate. There were 12 males and 6 females. The right hip was affected in 10 patients and the left hip in 8 patients. Clinically, patients were evaluated by Larson hip score. Radiographically, anteroposterior view of the pelvis and frog leg lateral views of the affected hip were taken preoperatively and compared with the findings at the final follow-up. The average follow-up was 29 months (range, 24 to 36 months). Clinical results showed improvement of the mean Larson hip score from 57.8 to 97.0 (p osteotomies were completely united in 2.4 months (range, 2 to 3 months) with the achievement of the planned correction angle. The average correction of Hilgenreiner's epiphyseal angle improved from 78.2° to 27.8° (p osteotomy of the proximal femur fixed with a T plate may be efficient for treatment of developmental coxa vara. With careful planning, it can result in a low complication rate and insignificant or minimal recurrence rate.

  18. Guided Growth With Temporary Hemiepiphysiodesis to Treat Ankle Valgus in a Skeletally Immature Individual: A Case Report.

    Science.gov (United States)

    LaPorta, Guido A; Susek, Mehgan M

    2016-01-01

    Guided growth is useful in correcting pediatric angular deformities. Ankle valgus is a coronal plane deformity and is often seen in skeletally immature patients with congenital or acquired lower extremity pathologic features. Temporary hemiepiphysiodesis with a percutaneous transphyseal medial malleolar screw is a surgical treatment capable of correcting the angular deformity and can offer effective correction. In the present case study, a 12-year-old male with dorsal-lateral peritalar subluxation and ankle valgus underwent a reconstructive procedure and temporary hemiepiphysiodesis with a percutaneous medial malleolar screw. After removal of the screw, reduction of his peritalar subluxation was achieved, improving his lateral-distal tibial angle from 81° preoperatively to 89° at the final follow-up examination. The patient returned to his preoperative sporting activities and ambulated comfortably and pain free in sneakers with orthotics. In conclusion, temporary hemiepiphysiodesis with a transphyseal medial malleolar screw is an effective treatment option for ankle valgus in a skeletally immature individual.

  19. Association between hip abductor function, rear-foot dynamic alignment, and dynamic knee valgus during single-leg squats and drop landings

    Directory of Open Access Journals (Sweden)

    Yoshinori Kagaya

    2015-06-01

    Conclusion: Dynamic hip mal-alignment might be associated with both greater KID and HOD, whereas rear-foot eversion is associated only with greater KID. Hip abductor and rear-foot dysfunction are important factors for dynamic knee valgus and thus evaluating DTT and HFT will help to prevent dynamic knee valgus.

  20. Use of Soft-Tissue Procedures for Managing Varus and Valgus Malalignment with Total Ankle Replacement.

    Science.gov (United States)

    Roukis, Thomas S; Elliott, Andrew D

    2015-10-01

    Achieving frontal plane alignment of the ankle joint during total ankle replacement is essential for long-term success. Tendon and ligament lengthening, ligament reinforcement, tendon transfer, nonanatomic tendon transfer ligament reconstruction, and periarticular osteotomies are safe, straightforward, minimally invasive, and reproducible procedures to correct varus and valgus deformities associated with end-stage degenerative joint disease. Using reproducible topographic anatomic landmarks is essential to these techniques properly and limit complications. The approach to frontal plane deformities is stepwise, with liberal use of tendon and ligament lengthening and reconstruction, a low threshold for nonanatomic tendon transfer ligament reconstructions, and tendon transfers and/or periarticular osteotomies.

  1. Techniques for managing varus and valgus malalignment during total ankle replacement.

    Science.gov (United States)

    Choi, Woo Jin; Yoon, Hang Seob; Lee, Jin Woo

    2013-01-01

    The ultimate goal of primary total ankle replacement is to provide a well-balanced soft-tissue envelope around a well-aligned, well-fixated implant. Some surgeons have emphasized that good outcomes in total ankle replacement are more dependent on ligament balancing, along with the procedure itself, than the extent of preoperative coronal deformity in the ankle. Thus, it is imperative that the surgeon be familiar with additional procedures to address the varus, valgus, and other associated deformities commonly encountered in primary total ankle replacement.

  2. "Viimne reliikvia" ja "Valgus koordis" : žanrifilmist žanrifilmini / Lauri Kärk

    Index Scriptorium Estoniae

    Kärk, Lauri, 1954-

    2010-01-01

    Žanrifilmi mõistmisest, 1960-ndate žanriuuendustest. Kahest eesti žanrifilmist: "Viimne reliikvia" (1969) ja "Valgus Koordis" (1951). Artikli järjes kõrvutatakse "Viimset reliikviat" Paul-Eerik Rummo "Tuhkatriinumänguga" (Vanemuises 1969., lavastaja E. Hermaküla). Sarnaseid jooni ka "Viimse reliikvia" ja teiste žanrifilmidega, pikemalt filmidest: Kaljo Kiisa "Hullumeelsus" (1968), Christian-Jaque'i "Tulp-Fanfanil" (Prantsusmaa, 1951), Tony Richardsoni "Tom Jones" (Inglismaa, 1963), Edmond Keosajani "Tabamatud tasujad" (Venemaa, 1966), Vytaytas Žalakeviciuse "Keegi ei tahtnud surra" (Leedu, 1965), Arthur Penni "Bonnie ja Clyde"

  3. Fixation of Intertrochanteric Valgus Osteotomy with T Plate in Treatment of Developmental Coxa Vara

    Science.gov (United States)

    Khairy, Hosam Mohamed

    2016-01-01

    Background Although the valgus subtrochanteric osteotomy is considered as a standard surgical treatment for coxa vara, there is no consensus on the optimal method of fixation and osteotomy technique. Fixation of the osteotomy has been achieved by various methods including external fixation and internal fixation with pins and cerclage and a variety of plates. The aim of this study is the evaluation of the results of developmental coxa treated by Y intertrochanteric valgus osteotomy fixed with a T-buttress plate compared with other methods of fixation in the literature. Methods Eighteen corrective valgus intertrochanteric femoral osteotomies were performed in 18 patients (18 hips) for treatment of unilateral developmental coxa vara deformity and fixed with a T plate. There were 12 males and 6 females. The right hip was affected in 10 patients and the left hip in 8 patients. Clinically, patients were evaluated by Larson hip score. Radiographically, anteroposterior view of the pelvis and frog leg lateral views of the affected hip were taken preoperatively and compared with the findings at the final follow-up. Results The average follow-up was 29 months (range, 24 to 36 months). Clinical results showed improvement of the mean Larson hip score from 57.8 to 97.0 (p < 0.001). Radiological results showed that all osteotomies were completely united in 2.4 months (range, 2 to 3 months) with the achievement of the planned correction angle. The average correction of Hilgenreiner's epiphyseal angle improved from 78.2° to 27.8° (p < 0.001) at the final follow-up. The femoral neck shaft angle was improved from 93.7° to 129.9° (p < 0.001) at the final follow-up. Shortening of the affected limb was corrected from 2.8 cm to 1.3 cm (p < 0.001) at the last follow-up. No major serious complications were recorded in the present study. Conclusions Intertrochanteric valgus osteotomy of the proximal femur fixed with a T plate may be efficient for treatment of developmental coxa vara

  4. Simultaneous surgical management of chronic grade-2 valgus instability of the knee and anterior cruciate ligament deficiency in athletes.

    Science.gov (United States)

    Osti, Leonardo; Papalia, Rocco; Del Buono, Angelo; Merlo, Franco; Denaro, Vincenzo; Maffulli, Nicola

    2010-03-01

    We report on 22 patients with chronic grade-2 valgus laxity of the knee combined with chronic anterior cruciate ligament (ACL) insufficiency, in whom the two lesions were addressed at the same surgical setting. At a minimum follow-up of 24 months, clinical and functional variables had improved significantly (P pre-injury level. There were no operative complications in this series. In selected athletes with chronic symptomatic valgus laxity of the knee combined with ACL insufficiency, surgical repair of the MCL in association with ACL reconstruction is a suitable and reliable option to restore knee stability and allow return to pre-injury activity level.

  5. Juvenile giant fibroadenoma

    Directory of Open Access Journals (Sweden)

    Vipul Yagnik

    2011-07-01

    Full Text Available Fibroadenomas are benign solid tumor associated with aberration of normal lobular development. Juvenile giant fibroadenoma is usually single and >5 cm in size /or >500 gms in weight. Important differential diagnoses are: phyllodes tumor and juvenile gigantomastia. Simple excision is the treatment of choice.

  6. Renewing Juvenile Justice

    Science.gov (United States)

    Macallair, Daniel; Males, Mike; Enty, Dinky Manek; Vinakor, Natasha

    2011-01-01

    The Center on Juvenile and Criminal Justice (CJCJ) was commissioned by Sierra Health Foundation to critically examine California's juvenile justice system and consider the potential role of foundations in promoting systemic reform. The information gathered by CJCJ researchers for this report suggests that foundations can perform a key leadership…

  7. Philanthropist in Juvenile Reformatory

    Institute of Scientific and Technical Information of China (English)

    HAN NIU

    2007-01-01

    @@ On the afternoon of February 1, 2007, Chen Guangbiao, a noted philanthropist, found himself in the Jiangsu Provincial Juvenile Reformatory in Jurong City for a ceremony to donate two buses, 100 computers, and 100 desks and 100 chairs for the juvenile offenders to use in their study.

  8. Parenting and juvenile delinquency

    NARCIS (Netherlands)

    Hoeve, Machteld

    2008-01-01

    Juvenile delinquency is a noteworthy problem. This thesis addressed the association between parenting and juvenile delinquency by analyzing the concepts of parenting adopted in family research in relation to criminological concepts and measures of delinquent behavior. Four studies were conducted. Th

  9. Juvenile Confinement in Context

    Science.gov (United States)

    Mendel, Richard A.

    2012-01-01

    For more than a century, the predominant strategy for the treatment and punishment of serious and sometimes not-so-serious juvenile offenders in the United States has been placement into large juvenile corrections institutions, alternatively known as training schools, reformatories, or youth corrections centers. America's heavy reliance on…

  10. Parenting and juvenile delinquency

    NARCIS (Netherlands)

    Hoeve, Machteld

    2008-01-01

    Juvenile delinquency is a noteworthy problem. This thesis addressed the association between parenting and juvenile delinquency by analyzing the concepts of parenting adopted in family research in relation to criminological concepts and measures of delinquent behavior. Four studies were conducted. Th

  11. Outcomes of Varus Valgus Constrained Versus Rotating-Hinge Implants in Total Knee Arthroplasty.

    Science.gov (United States)

    Malcolm, Tennison L; Bederman, S Samuel; Schwarzkopf, Ran

    2016-01-01

    The stability of a total knee arthroplasty is determined by the ability of the prosthesis components in concert with supportive bone and soft tissue structures to sufficiently resist deforming forces transmitted across the knee joint. Constrained prostheses are used in unstable knees due to their ability to resist varus and valgus transformative forces across the knee. Constraint requires inherent rigidity, which can facilitate early implant failure. The purpose of this study was to describe the comparative indications for surgery and postoperative outcomes of varus valgus constrained knee (VVK) and rotating-hinge knee (RHK) total knee arthroplasty prostheses. Seven retrospective observational studies describing 544 VVK and 254 RHK patients with an average follow-up of 66 months (range, 7-197 months) were evaluated. Patients in both groups experienced similar failure rates (P=.74), ranges of motion (P=.81), and Knee Society function scores (P=.29). Average Knee Society knee scores were 4.2 points higher in VVK patients compared with RHK patients, indicating minimal mid-term clinical differences may exist (P<.0001). Absent collateral ligament support is an almost universal indication for RHK implantation vs VVK. Constrained device implantation is routinely guided by inherent stability of the knee, and, when performed, similar postoperative outcomes can be achieved with VVK and RHK prostheses.

  12. Impaired varus-valgus proprioception and neuromuscular stabilization in medial knee osteoarthritis.

    Science.gov (United States)

    Chang, Alison H; Lee, Song Joo; Zhao, Heng; Ren, Yupeng; Zhang, Li-Qun

    2014-01-22

    Impaired proprioception and poor muscular stabilization in the frontal plane may lead to knee instability during functional activities, a common complaint in persons with knee osteoarthritis (KOA). Understanding these frontal plane neuromechanical properties in KOA will help elucidate the factors contributing to knee instability and aid in the development of targeted intervention strategies. The objectives of the study were to compare knee varus-valgus proprioception, isometric muscle strength, and active muscular contribution to stability between persons with medial KOA and healthy controls. We evaluated knee frontal plane neuromechanical parameters in 14 participants with medial KOA and 14 age- and gender-matched controls, using a joint driving device (JDD) with a customized motor and a 6-axis force sensor. Analysis of covariance with BMI as a covariate was used to test the differences in varus-valgus neuromechanical parameters between these two groups. The KOA group had impaired varus proprioception acuity (1.08±0.59° vs. 0.69±0.49°, pproprioceptive acuity) and muscular effectors (muscle strength and capacity to stabilize the joint).

  13. Secondary Subacromial Impingement after Valgus Closing-Wedge Osteotomy for Proximal Humerus Varus

    Directory of Open Access Journals (Sweden)

    Hirotaka Sano

    2015-01-01

    Full Text Available A 31-year-old construction worker had been suffering from both the motion pain and the restriction of elevation in his right shoulder due to severe varus deformity of humeral neck, which occurred after proximal humeral fracture. The angle for shoulder flexion and abduction was restricted to 50 and 80 degrees, respectively. Valgus closing-wedge osteotomy followed by the internal fixation using a locking plate was carried out at 12 months after injury. Postoperatively, the head-shaft angle of the humerus improved from 65 to 138 degrees. Active flexion and abduction angles improved from 80 to 135 degrees and from 50 to 135 degrees, respectively. However, the patient complained from a sharp pain with a clicking sound during shoulder abduction even after removal of the locking plate. Since subacromial steroid injection temporarily relieved his shoulder pain, we assumed that the secondary subacromial impingement was provoked after osteotomy. Thus, arthroscopic subacromial decompression was carried out at 27 months after the initial operation, which finally relieved his symptoms. In the valgus closing-wedge osteotomy, surgeons should pay attention to the condition of subacromial space to avoid causing the secondary subacromial impingement.

  14. Hindfoot Valgus following Interlocking Nail Treatment for Tibial Diaphysis Fractures: Can the Fibula Be Neglected?

    Directory of Open Access Journals (Sweden)

    Metin Uzun

    2014-01-01

    Full Text Available Purpose. We evaluated whether intramedullary nail fixation for tibial diaphysis fractures with concomitant fibula fractures (except at the distal one-third level managed conservatively with an associated fibula fracture resulted in ankle deformity and assessed the impact of the ankle deformity on lower extremity function. Methods. Sixty middle one-third tibial shaft fractures with associated fibular fractures, except the distal one-third level, were included in this study. All tibial shaft fractures were anatomically reduced and fixed with interlocking intramedullary nails. Fibular fractures were managed conservatively. Hindfoot alignment was assessed clinically. Tibia and fibular lengths were compared to contralateral measurements using radiographs. Functional results were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS and the Foot and Ankle Disability Index Score (FADI. Results. Anatomic union, defined as equal length in operative and contralateral tibias, was achieved in 60 fractures (100%. Fibular shortening was identified in 42 fractures (68%. Mean fibular shortening was 1.2 cm (range, 0.5–2 cm. Clinical exams showed increased hindfoot valgus in 42 fractures (68%. The mean KOOS was 88.4, and the mean FADI score was 90. Conclusion. Fibular fractures in the middle or proximal one-third may need to be stabilized at the time of tibial intramedullary nail fixation to prevent development of hindfoot valgus due to fibular shortening.

  15. Immediate effect of valgus bracing on knee joint moments in meniscectomised patients: An exploratory study.

    Science.gov (United States)

    Thorning, Maria; Thorlund, Jonas B; Roos, Ewa M; Wrigley, Tim V; Hall, Michelle

    2016-12-01

    Patients undergoing medial arthroscopic partial meniscectomy are at increased risk of developing and/or progressing knee osteoarthritis, with increased medial compartment load being a potential contributor. The aim of this study was to evaluate the immediate effect of a valgus unloader knee brace on knee joint moments in patients following medial arthroscopic partial meniscectomy. Within-participant design. Twenty-two patients (age 35-55 years) who had undergone medial arthroscopic partial meniscectomy within the previous 8-15 months completed three-dimensional analysis of gait, forward lunge and one-leg rise during two conditions: with and without a valgus unloader knee brace. Outcome measures included the peak and impulse of the knee adduction moment and the peak knee flexion moment. The peak knee flexion moment increased during brace condition for forward lunge (mean difference [95% CI]) 0.54 [0.27-0.82] (Nm/(BW×HT)%), pknee brace was detected in terms of an increase in peak knee flexion moment during the more demanding tasks such as forward lunge and one-leg rise. This increase implies enhanced stability of the knee provided by the brace, which may induce increased knee function and knee-related confidence during strenuous tasks. Future research is required to explore the structural implications. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  16. Valgus osteotomy of the tibia with a Puddu plate combined with anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Albuquerque Roberto Freire da Mota e

    2003-01-01

    Full Text Available Anterior knee instability associated with a varus deformity is a complex condition with several treatment possibilities. Among these, anterior cruciate ligament (ACL associated to a simultaneous valgus tibial osteotomy is a increasing indication. This simultaneous procedure adds technical issues to those related to the isolated surgeries. Thus, the osteotomy plane and location of fixation hardware shouldn?t conflict with tibial tunnel and ACL graft fixation. Authors analyze the relations between a opening tibial valgus osteotomy stabilized with a Puddu plate and ACL reconstruction with a patellar tendon graft fixated with interference screws in 10 human cadaver knees. A straight oblique tibial osteotomy starting on the medial tibial cortex and oriented laterally and proximally was performed on all knees with a 10mm opening medially and stabilized with a Puddu plate on the most posterior aspect of the medial tibia, and a tibial tunnel drilled 50° to tibial plateau. With this technique there was no intersection between tibial tunnel or interference screw and the osteotomy or the plate fixation screws.

  17. Juvenile mammary papillomatosis; Papilomatosis juvenil mamaria

    Energy Technology Data Exchange (ETDEWEB)

    Alvarez, M.; Jimenez, A. V. [Hospital Reina Sofia. Cordoba (Spain)

    2001-07-01

    Juvenile mammary papillomatosis is a benign proliferative disease of young patients, generally under 30 years of age. The most frequent clinical presentation is the existence of an elastic and mobile lymph node of the breast. Anatomopathologically, it is characterized because it presents ductal epithelial hyperplasia, sometimes with marked atypia, and there are numerous cysts having different sizes among the findings. It has been associated with an increase in the incidence of breast cancer, both in the patient herself as well as her family. We review the literature on the subject and present the mammographic and ultrasonographic findings of a 22 year old woman diagnosed of juvenile mammary papillomatosis. (Author) 12 refs.

  18. Valgus bracing in patients with medial compartment osteoarthritis of the knee. A gait analysis study of a new brace.

    NARCIS (Netherlands)

    Gaasbeek, R.D.A.; Groen, B.E.; Hampsink, B.; Heerwaarden, R.J. van; Duysens, J.E.J.

    2007-01-01

    A new valgus brace was evaluated in 15 patients with medial osteoarthritis of the knee and a varus leg axis. Significant improvement of pain and function were found after 6 weeks of brace treatment. Gait analysis showed that the brace had a tendency of lowering the peak varus moment about the knee.

  19. Long-term results of valgus osteotomy for terminal-stage osteoarthritis of the hip.

    Science.gov (United States)

    Ohsawa, Suguru

    2017-01-01

    Pauwels' femoral osteotomy is a classical and joint-preserving method for osteoarthritis of the hip caused by acetabular dysplasia and/or subluxation. However, its application for terminal-stage osteoarthritis of the hip, and the long-term results, have not yet been reported. We herein aim to investigate the long-term results of valgus osteotomy for terminal-stage osteoarthritis of the hip. Eighty-two hips of 75 patients (74 women and 1 man, mean age: 48.1 years) classified as having terminal-stage osteoarthritis by Kellgren and Laurence were indicated for valgus osteotomy from 1984 to 1993. Sixty-three hips of 57 patients were followed for more than 20 years (mean: 298 months). Follow-up rate was 77%. Preoperative mean hip score (Harris Hip Score) was 46.4 points. Thirty-two hips were later converted to total hip arthroplasty (THA) (mean: 185 months after surgery). Of the hips without conversion to THA, 31 hips scored 72.8 points on average, and 21 hips scored 70 or more points at the final follow-up. Kaplan-Meier survivorship analysis revealed that 40% of the hips, classified as non-atrophic type (according to Bombelli's classification) at the time of operation, maintained their joint space width for 20 years (endpoint: less than 1 mm at the weight-bearing segment, i.e., recurrence of osteoarthritis) and also revealed that 60% of the hips were not converted for 20 years after the initial operation (endpoint: conversion to THA). Cox's proportional hazard model revealed that those with the atrophic type had a hazard risk 24 times greater than those with the non-atrophic type of osteoarthritis. This is the first report of the long-term results of osteotomy for terminal-stage osteoarthritis of the hip showing satisfactory results with a lengthy follow-up period. Pauwels' valgus femoral osteotomy for terminal-stage osteoarthritis, excluding atrophic type, could be an acceptable alternative to THA.

  20. A comparison of the biomechanical effects of valgus knee braces and lateral wedged insoles in patients with knee osteoarthritis.

    Science.gov (United States)

    Jones, Richard K; Nester, Christopher J; Richards, Jim D; Kim, Winston Y; Johnson, David S; Jari, Sanjiv; Laxton, Philip; Tyson, Sarah F

    2013-03-01

    Increases in the external knee adduction moment (EKAM) have been associated with increased mechanical load at the knee and progression of knee osteoarthritis. Valgus knee braces and lateral wedged insoles are common approaches to reducing this loading; however no study has directly compared the biomechanical and clinical effects of these two treatments in patients with medial tibiofemoral osteoarthritis. A cross-over randomised design was used where each intervention was worn by 28 patients for a two week period. Pre- and post-intervention gait kinematic/kinetic data and clinical outcomes were collected to evaluate the biomechanical and clinical effects on the knee joint. The valgus knee brace and the lateral wedged insole significantly increased walking speed, reduced the early stance EKAM by 7% and 12%, and the knee adduction angular impulse by 8.6 and 16.1% respectively. The lateral wedged insole significantly reduced the early stance EKAM compared to the valgus knee brace (p=0.001). The valgus knee brace significantly reduced the knee varus angle compared to the baseline and lateral wedged insole. Improvements in pain and function subscales were comparable for the valgus knee brace and lateral wedged insole. There were no significant differences between the two treatments in any of the clinical outcomes; however the lateral wedged insoles demonstrated greater levels of acceptance by patients. This is the first study to biomechanically compare these two treatments, and demonstrates that given the potential role of knee loading in osteoarthritis progression, that both treatments reduce this but lateral wedge insoles appear to have a greater effect.

  1. Cryopyrin-Associated Autoinflammatory Syndromes (CAPS) - Juvenile

    Science.gov (United States)

    ... Cryopyrin-Associated Autoinflammatory Syndrome (CAPS) (Juvenile) Dermatomyositis (Juvenile) Familial Mediterranean Fever (Juvenile) Fibromyalgia Giant Cell Arteritis Glucocorticoid-induced Osteoperosis ...

  2. Juvenil idiopatisk arthritis

    DEFF Research Database (Denmark)

    Herlin, Troels

    2002-01-01

    The new classification of juvenile idiopathic arthritis (JIA) is described in this review. Clinical characteristics divide JIA in to subtypes: systemic, oligoarticular (persistent and extended type), RF-positive and--negative polyarticular, enthesitis-related arthritis and psoriatic arthritis...

  3. Juvenile Rockfish Recruitment Cruise

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — In 1983, the groundfish analysis project began a series of yearly cruises designed to assess the annual abundance of juvenile rockfish along the central California...

  4. Juvenile Idiopathic Arthritis

    Science.gov (United States)

    ... Physical Therapy Regular Exercise en español Artritis idiopática juvenil It may begin with a swollen knuckle, a ... may suddenly appear and disappear, developing in one area and then another. High fevers that tend to ...

  5. Juvenile Sex Offenders.

    Science.gov (United States)

    Ryan, Eileen P; Otonichar, Joseph M

    2016-07-01

    Sexual offending by juveniles accounts for a sizable percentage of sexual offenses, especially against young children. In this article, recent research on female juvenile sex offenders (JSOs), risk factors for offending in juveniles, treatment, and the ways in which these youth may differ from general delinquents will be reviewed. Most JSOs do not go on to develop paraphilic disorders or to commit sex offenses during adulthood, and as a group, they are more similar to nonsexual offending juvenile delinquents than to adult sex offenders. Recent research has elucidated some differences between youth who commit sex offenses and general delinquents in the areas of atypical sexual interests, the use of pornography, and early sexual victimization during childhood.

  6. Bilateral carpal valgus deformity in hand-reared cheetah cubs (Acinonyx jubatus).

    Science.gov (United States)

    Bell, Katherine M; van Zyl, Malan; Ugarte, Claudia E; Hartman, Angela

    2011-01-01

    Four hand-reared cheetah cubs (Acinonyx jubatus) exhibited progressively severe bilateral valgus deformity of the carpi (CV) during the weaning period. Radiographs of the thoracic limbs suggested normal bone ossification, and serum chemistry was unremarkable. All affected cubs developed CV shortly after the onset of gastroenteritis, which was treated medically, and included use of a prescription diet. A sudden decrease in growth rate was associated with gastrointestinal disease. Before gastroenteritis and CV, affected cubs had higher growth rates than unaffected cubs, despite similar mean daily energy intake. Return to normal thoracic limb conformation was consequent to dietary manipulation (including a reduction in energy intake and vitamin and mineral supplementation), as well as decreased growth rates and recovery from gastroenteritis. The cause of the CV is likely to have been multi-factorial with potentially complex physiological interactions involved. © 2010 Wiley-Liss, Inc.

  7. Juvenile Spondyloarthritis Treatment Recommendations

    OpenAIRE

    Tse, Shirley; Burgos-Vargas, Ruben; Colbert, Robert A

    2012-01-01

    No specific recommendations for the treatment of juvenile spondyloarthritis have been established. Important differences exist in how spondyloarthritis begins and progresses in children and adults, supporting the need for pediatric-specific recommendations. Recently published recommendations for the treatment of juvenile arthritis consider children with sacroiliitis in a separate group, and allow for more accelerated institution of a TNF inhibitor depending on disease activity and prognostic ...

  8. Parenting and juvenile delinquency

    OpenAIRE

    Hoeve, Machteld

    2008-01-01

    Juvenile delinquency is a noteworthy problem. This thesis addressed the association between parenting and juvenile delinquency by analyzing the concepts of parenting adopted in family research in relation to criminological concepts and measures of delinquent behavior. Four studies were conducted. The first study addressed a meta-analysis on parenting characteristics and styles in relation to delinquency. In this meta-analysis, previous manuscripts were systematically analyzed, computing mean ...

  9. Üksildased, patused ja vägivaldsed. Peategelasest Martin Scorsese loomingus, filmi "Aviaator - valguses ja varjus" põhjal / Allan Valge

    Index Scriptorium Estoniae

    Valge, Allan

    2006-01-01

    Howard Hughes - ameerika ärimees, kes teostas ennast jõuliselt lennunduses, produtsendina filmikunstis... Ta on prototüübiks Martin Scorsese mängufilmi "Aviaator - valguses ja varjus" ("The Aviator") peategelasele

  10. Vocational Teachers' Role in Serving Juvenile Offenders.

    Science.gov (United States)

    Meers, Gary D.

    1983-01-01

    Educators need to understand the juvenile justice system to understand what juvenile offenders go through while completing their sentences. This article reviews cases and juvenile charge classifications, and presents a model for alternative sentencing options for juveniles. (JOW)

  11. Trunk asymmetry in juveniles

    Directory of Open Access Journals (Sweden)

    Triantafyllopoulos Georgios

    2008-09-01

    Full Text Available Abstract Background Trunk asymmetry (TA is a common phenomenon in children, but its incidence in juveniles is not known. The present cross sectional study reports TA in normal juveniles and provides data which describe the evolution of TA from early childhood to adolescence. Materials and methods The scoliometer readings in both standing and sitting forward bending position (FBP of 3301 children, (1645 boys, and 1656 girls aged from 3 to 9 years old were studied. TA was quantified by measuring angle of trunk rotation (ATR and children were categorized as symmetric (ATR = 0°, mild asymmetric (ATR 1° – 6° and severely asymmetric (ATR ≥ 7°. The difference of TA between standing and sitting FBP as well as differences between boys and girls in frequency of TA were also calculated. The scoliometer readings were analyzed by age to reveal at which age the juvenile pattern of TA changes into the adolescent one. Results 74.2% of boys and 77% of girls were symmetric (ATR = 0° in the thoracic region in standing FBP, while 82.7% of boys and 84.1% of girls were symmetric in the thoracic region in sitting FBP. Juvenile girls are more symmetric than boys but severe TA was found almost the same between the two genders. A significant reduction in the frequency of mild TA from standing into sitting FBP, in all the examined regions in both boys and girls was found, but in severe TA this reduction is very small. Analysing scoliometer readings by age it appears that significant TA changes take place between 8–9 years of age for boys and between 6–7 and 8–9 years for girls. TA in boys is changing into the adolescent pattern at a later age than in girls. Conclusion Juveniles were found more symmetric than adolescents, who were studied previously in a different study. Furthermore, juvenile girls were found more symmetric than boys. Juvenile TA pattern seems to be in accordance with the higher incidence of juvenile idiopathic scoliosis in boys. Furthermore

  12. Juvenile Incarceration and Health.

    Science.gov (United States)

    Barnert, Elizabeth S; Perry, Raymond; Morris, Robert E

    2016-03-01

    Addressing the health status and needs of incarcerated youth represents an issue at the nexus of juvenile justice reform and health care reform. Incarcerated youth face disproportionately higher morbidity and higher mortality compared to the general adolescent population. Dental health, reproductive health, and mental health needs are particularly high, likely as a result of lower access to care, engagement in high-risk behaviors, and underlying health disparities. Violence exposure and injury also contribute to the health disparities seen in this population. Further, juvenile incarceration itself is an important determinant of health. Juvenile incarceration likely correlates with worse health and social functioning across the life course. Correctional health care facilities allow time for providers to address the unmet physical and mental health needs seen in this population. Yet substantial challenges to care delivery in detention facilities exist and quality of care in detention facilities varies widely. Community-based pediatricians can serve a vital role in ensuring continuity of care in the postdetention period and linking youth to services that can potentially prevent juvenile offending. Pediatricians who succeed in understanding and addressing the underlying social contexts of their patients' lives can have tremendous impact in improving the life trajectories of these vulnerable youth. Opportunities exist in clinical care, research, medical education, policy, and advocacy for pediatricians to lead change and improve the health status of youth involved in the juvenile justice system.

  13. Extending juvenility in grasses

    Energy Technology Data Exchange (ETDEWEB)

    Kaeppler, Shawn; de Leon Gatti, Natalia; Foerster, Jillian

    2017-04-11

    The present invention relates to compositions and methods for modulating the juvenile to adult developmental growth transition in plants, such as grasses (e.g. maize). In particular, the invention provides methods for enhancing agronomic properties in plants by modulating expression of GRMZM2G362718, GRMZM2G096016, or homologs thereof. Modulation of expression of one or more additional genes which affect juvenile to adult developmental growth transition such as Glossy15 or Cg1, in conjunction with such modulation of expression is also contemplated. Nucleic acid constructs for down-regulation of GRMZM2G362718 and/or GRMZM2G096016 are also contemplated, as are transgenic plants and products produced there from, that demonstrate altered, such as extended juvenile growth, and display associated phenotypes such as enhanced yield, improved digestibility, and increased disease resistance. Plants described herein may be used, for example, as improved forage or feed crops or in biofuel production.

  14. DERMATOMIOSITIS JUVENIL Y EMBARAZO

    OpenAIRE

    Evans M,Gregorio; Poulsen R,Ronald; Blanco R,Romiely; Luna V,Viviana

    2002-01-01

    La dermatomiositis juvenil es un desorden inflamatorio crónico multisistémico del tejido conectivo. Tiene una incidencia de 2-3/100.000/año. Con la disminución en la mortalidad experimentada en los últimos decenios, la atención está cifrada en la morbilidad a largo plazo y en las alteraciones funcionales. Con un tratamiento agresivo los niños con dermatomiositis juvenil generalmente tienen un futuro promisorio, sin incapacidad o con incapacidad mínima. La mortalidad actualmente se estima cerc...

  15. Juvenile idiopatiske inflammatoriske myopatier

    Directory of Open Access Journals (Sweden)

    Helga Sanner

    2009-10-01

    Full Text Available Juvenile idiopathic inflammatory myopathies (JIIM is a group of rare autoimmune systemic diseases in children and adolescents, characterized by chronic skeletal muscle inflammation. Unlike in adults, dermatomyositis (JDM is by far the most common of the idiopathic inflammatory myopathies in children and adolescents. The hallmark of JDM is calcinosis, lipodystrophy and vasculitis, findings that differs the juvenile form of dermatomyosits from the adult form. JDM is still diagnosed and classified by Bohan and Peter’s criteria from 1975. There are limited data on long time outcome of this disease

  16. Juvenile Battens Disease.

    Science.gov (United States)

    Gayton, Romayne

    1987-01-01

    Ten children diagnosed with juvenile Battens disease were tested over a three-year period in general intelligence, memory, listening and speech, motor skills, and general learning. Results showed that the patients followed a predetermined pattern but that the time span for development of memory, communication, and behavior problems varied greatly.…

  17. Juvenile Victimization and Delinquency.

    Science.gov (United States)

    Esbensen, Finn-Aage; Huizinga, David

    1991-01-01

    Demographic characteristics of juvenile victims of crime and a potential relationship between victimization and self-reported delinquency are examined for 877 adolescents from a large midwestern city. Lifetime victimization rates (LVRs) are higher for those involved in delinquency, and LVRs rise with age and higher levels of delinquent behavior.…

  18. Juvenile Battens Disease.

    Science.gov (United States)

    Gayton, Romayne

    1987-01-01

    Ten children diagnosed with juvenile Battens disease were tested over a three-year period in general intelligence, memory, listening and speech, motor skills, and general learning. Results showed that the patients followed a predetermined pattern but that the time span for development of memory, communication, and behavior problems varied greatly.…

  19. Juvenile idiopathic arthritis

    NARCIS (Netherlands)

    Prakken, Berent; Albani, Salvatore; Martini, Alberto

    2011-01-01

    Juvenile idiopathic arthritis is a heterogeneous group of diseases characterised by arthritis of unknown origin with onset before age of 16 years. Pivotal studies in the past 5 years have led to substantial progress in various areas, ranging from disease classification to new treatments. Gene expres

  20. MRI evaluation of abnormalities of subchondral bone after tibial condyle valgus osteotomy

    Energy Technology Data Exchange (ETDEWEB)

    Otsuka, Kazutaka; Mimura, Hiroshi; Yuge, Daishiro [Yamaguchi Central Hospital, Hofu (Japan); Teramoto, Tsukasa [Nagasaki Friendship Hospital, Sanwa (Japan); Taguchi, Katsuki [Goto Central Hospital, Fukue, Nagasaki (Japan)

    2002-03-01

    We evaluated subchondral low signal intence abnormality on T1-weighted MRI in the osteoarthritis (OA) and osteonecrosis (ON), of the knee after tibial condyle valgus osteotomy (TCVO). Subjects consisted of 11 OA patients, aged 71 on average (range: 66-79) and 3 ON patients, aged 59 on average (range:46-72). The MRI follow-up period was 18 months (range: 12-25) in the OA group and 17 months (range: 12-24) in the ON group. Clinical improvement was observed in all patients. Except for one patient in the OA group, T1-weighteed MRI showed low signal intense area in the medial compartment of the knee. At follow-up, the MRI evaluation revealed a decrease in the low signal intense areas in 9 of the 10 OA patients and in 2 of the 3 ON patients. These results suggest that bone remodelling of the subchondral lesion can be expected after decompression and stabilizing surgery, TCVO. (author)

  1. Late Onset Juvenile Xanthogranuloma

    Directory of Open Access Journals (Sweden)

    Punithwavathy K

    1999-01-01

    Full Text Available A 19 year old female was seen with multiple skin coloured and hyperpigmented macules, discrete as well as grouped papules and nodules of varying sizes distributed over the face, neck, extensor and flexor aspects of both upper and lower extremities including joints. The trunk was spared. Some of the lesions showed features of spontaneous regression. Investigations confirmed the diagnosis of juvenile xanthogranuloma. Lesions regressed satisfactorily with liquid nitrogen cryotherapy.

  2. Juvenile Incarceration and Health

    OpenAIRE

    Barnert, ES; R Perry; Morris, RE

    2015-01-01

    © 2015. Addressing the health status and needs of incarcerated youth represents an issue at the nexus of juvenile justice reform and health care reform. Incarcerated youth face disproportionately higher morbidity and higher mortality compared to the general adolescent population. Dental health, reproductive health, and mental health needs are particularly high, likely as a result of lower access to care, engagement in high-risk behaviors, and underlying health disparities. Violence exposure a...

  3. Juvenile Ultracool Dwarfs

    CERN Document Server

    Rice, Emily L; Cruz, Kelle; Barman, Travis; Looper, Dagny; Malo, Lison; Mamajek, Eric E; Metchev, Stanimir; Shkolnik, Evgenya L

    2011-01-01

    Juvenile ultracool dwarfs are late spectral type objects (later than ~M6) with ages between 10 Myr and several 100 Myr. Their age-related properties lie intermediate between very low mass objects in nearby star-forming regions (ages 1-5 Myr) and field stars and brown dwarfs that are members of the disk population (ages 1-5 Gyr). Kinematic associations of nearby young stars with ages from ~10-100 Myr provide sources for juvenile ultracool dwarfs. The lowest mass confirmed members of these groups are late-M dwarfs. Several apparently young L dwarfs and a few T dwarfs are known, but they have not been kinematically associated with any groups. Normalizing the field IMF to the high mass population of these groups suggests that more low mass (mainly late-M and possibly L dwarf) members have yet to be found. The lowest mass members of these groups, along with low mass companions to known young stars, provide benchmark objects with which spectroscopic age indicators for juvenile ultracool dwarfs can be calibrated and...

  4. Early proximal tibial valgus osteotomy as a very important prognostic factor in Thai children with infantile tibia vara.

    Science.gov (United States)

    Kaewpornsawan, Kamolporn; Tangsataporn, Suksan; Jatunarapit, Ratiporn

    2005-10-01

    To find the effectiveness of the early surgery (2-3 years of age)as a very important prognostic factor affecting the outcomes in Thai children with infantile tibia vara and all the prognostic factors including the usefulness of arthrographic study in correcting the deformity. From 1994 to 2004, sixteen children aged average 3.61 years old (2.08-7.0) were treated in Siriraj Hospital and diagnosed as infantile tibia vara by Langenskiold radiographic staging were included in the present study and retrospectively reviewed with an average of 6.4 years follow up (range 6 month - 11.1 years). All cases were initially treated by surgery because of low compliance for brace or brace failure. They consisted of 3 boys and 13 girls. There were 24 legs including the bilateral involvement in 8 cases (2 boy and 6 girls). After arihrography, the midshaft fibular osteotomy was performed then the proximal tibial dome-shaped valgus osteotomy was done and fixed with 2 pins. The desired position was 12 degree knee valgus . The patients were divided in two groups, 1)group A,the successful group with the knee becoming normal without any deformity after single osteotomy, 2)group B,the recurrent group with recurrence of the varus deformity required further corrective osteotomies to make normal axis of the knee. All variables were analyzed and compared between group A and group B. The general characteristics and radiographic findings were recorded in 1)age, 2)sex, 3)side, 4)weight in kilogram and in percentage of normal or overweight(obesity) compared with the standard Thai weight chart, 5)tibiofemoral angle (TFA) pre and postoperative treatment, 6) metaphyseal diaphyseal angle (MDA), 7)the medial physeal slope angle (MPS, 8)The preoperative arthrographic articulo-diaphyseal angle (ADA), 9.arthrographic articulo-medial physeal angle (AMPA). There were 14 legs in group A and the remaining 10 legs were in group B (average 2.4 operations). All cases healed in good alignment of the legs without

  5. Genetics Home Reference: juvenile idiopathic arthritis

    Science.gov (United States)

    ... Home Health Conditions juvenile idiopathic arthritis juvenile idiopathic arthritis Printable PDF Open All Close All Enable Javascript ... view the expand/collapse boxes. Description Juvenile idiopathic arthritis refers to a group of conditions involving joint ...

  6. Genetics Home Reference: juvenile primary osteoporosis

    Science.gov (United States)

    ... Home Health Conditions juvenile primary osteoporosis juvenile primary osteoporosis Enable Javascript to view the expand/collapse boxes. ... PDF Open All Close All Description Juvenile primary osteoporosis is a skeletal disorder characterized by thinning of ...

  7. Genetics Home Reference: juvenile myoclonic epilepsy

    Science.gov (United States)

    ... Home Health Conditions juvenile myoclonic epilepsy juvenile myoclonic epilepsy Enable Javascript to view the expand/collapse boxes. ... PDF Open All Close All Description Juvenile myoclonic epilepsy is a condition characterized by recurrent seizures (epilepsy). ...

  8. Juvenile Justice Bulletin: Aftercare Services. Juvenile Justice Practices Series.

    Science.gov (United States)

    Gies, Steve V.

    This bulletin examines aftercare services that provide youth with comprehensive health, education, family, and vocational services upon their release from the juvenile justice system. Aftercare can be defined as reintegrative services that prepare out-of-home placed juveniles for reentry into the community by reestablishing the necessary…

  9. Miastenia gravis juvenil Juvenile myasthenia gravis

    Directory of Open Access Journals (Sweden)

    Oscar Papazian

    2009-01-01

    Full Text Available La miastenia gravis juvenil (MGJ es un trastorno crónico auto inmune en el cual existen anticuerpos séricos que al unirse a los receptores de acetilcolin nicotínicos de la membrana muscular de la placa motora alteran la transmisión neuromuscular. El resultado es fatiga muscular precoz con progresión a la parálisis durante estados de contracción muscular iterativos (movimientos o sostenidos (posturas y más raramente parálisis permanente durante el reposo. Los músculos inervados por los nervios craneales, especialmente los extraoculares y elevadores de los párpados, tienen más tendencia a la debilidad muscular persistente que los inervados por otros pares craneales y las extremidades. Las formas clínicas de presentación son generalizadas, oculares y respiratorias. El diagnóstico se sospecha mediante la anamnesia, la fatiga anormal se comprueba mediante el examen físico y la estimulación eléctrica iterativa del nervio que inerva al músculo afectado pero no paralizado. Se corrobora mediante la administración de inhibidores de la acetilcolin esterasa (IACE que al aumentar la cantidad de acetilcolin en la hendidura sináptica, corrigen la fatiga o la debilidad muscular transitoriamente. Se hace el diagnóstico de certeza mediante la demostración sérica de anticuerpos contra los receptores de acetilcolin (ACRA. El tratamiento es a largo plazo sintomático con IACE y etiopatogénico con inmunosupresores, plasmaféresis, gamma globulina endovenosa y timectomía. El curso es crónico. La remisión espontánea o después de tratamiento sintomático o etiopatogénico ocurre entre 1-10 años respectivamente. La mortalidad es prácticamente nula aun durantes las crisis miastenias gracias a la educación de padres, pacientes y público en general sobre el tema, al desarrollo del sistema de respuesta rápida de auxilio domiciliario y las unidades de cuidados intensivos y el empleo de la ventilación asistida profiláctica, plasmaféresis y

  10. Juvenile Dermatomyositis in Pregnancy

    Directory of Open Access Journals (Sweden)

    Anthony Emeka Madu

    2013-01-01

    Full Text Available Juvenile dermatomyositis has variable clinical presentations both in and outside of pregnancy. A literature review indicated that optimal maternal and fetal outcomes can be anticipated when the pregnancy is undertaken while the disease is in remission. Poorer outcomes are associated with flare-up of the disease in early pregnancy compared with exacerbation in the second or third trimester, when fetal prognosis is usually good. We present a case of JDM in pregnancy with disease exacerbation late in pregnancy and review of the relevant literature.

  11. Juvenile dermatomyositis in pregnancy.

    Science.gov (United States)

    Madu, Anthony Emeka; Omih, Edwin; Baguley, Elaine; Lindow, Stephen W

    2013-01-01

    Juvenile dermatomyositis has variable clinical presentations both in and outside of pregnancy. A literature review indicated that optimal maternal and fetal outcomes can be anticipated when the pregnancy is undertaken while the disease is in remission. Poorer outcomes are associated with flare-up of the disease in early pregnancy compared with exacerbation in the second or third trimester, when fetal prognosis is usually good. We present a case of JDM in pregnancy with disease exacerbation late in pregnancy and review of the relevant literature.

  12. Juvenile hyaline fibromatosis.

    Science.gov (United States)

    Larralde, M; Santos-Muñoz, A; Calb, I; Magariños, C

    2001-01-01

    Juvenile hyaline fibromatosis (JHF) is a rare autosomal recessive disease with onset in infancy or early childhood. It is characterized by papulonodular skin lesions, soft tissue masses, gingival hypertrophy, and flexion contractures of the large joints. The light and electron microscopic features are very distinctive. Here we report an 8-month-old boy with characteristic stiffness of the knees and elbows and pink confluent papules on the paranasal folds, and periauricular and perianal regions. He also had hard nodules all over the scalp and around the mouth, and severe gingival hypertrophy. Histologic and ultrastructural features were typical of JHF. Clinical features, pathology, and physiology are discussed.

  13. Juvenile Justice in Rural America.

    Science.gov (United States)

    Jankovic, Joanne, Ed.; And Others

    Producing a much-needed organized body of literature about rural juvenile justice, 14 papers (largely from the 1979 National Symposium on Rural Justice) are organized to identify current issues, identify forces causing changes in current systems, review programs responding to rural juvenile justice problems, and provide planning models to aid…

  14. Intraoperative adjustment of alignment under valgus stress reduces outliers in patients undergoing medial opening-wedge high tibial osteotomy.

    Science.gov (United States)

    Kim, Man Soo; Son, Jong Min; Koh, In Jun; Bahk, Ji Hoon; In, Yong

    2017-08-01

    A considerable percentage of outliers with under- or over-correction continue to be reported despite precise preoperative planning and cautious intraoperative correction of lower limb alignment in medial opening-wedge high tibial osteotomy (MOWHTO). The purpose of this study was to determine whether our novel technique for the intraoperative adjustment of alignment under valgus stress reduces the number of outliers in patients undergoing MOWHTO compared to the conventional technique, which corrects alignment according to the cable method only. One hundred seventeen consecutive knees were enrolled in this case-control study. The first 52 knees (51 patients) were corrected in accordance with preoperative plans using the Dugdale method with modification with an intraoperative cable (group 1). In the other 65 knees (60 patients), the angle was corrected using the Dugdale method and limb alignment was adjusted using the intraoperative cable technique by applying valgus stress to the knee joint (group 2). The postoperative weight bearing line ratios and mechanical axis of the lower limb were compared at postoperative one year. Each knee was evaluated according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score preoperatively and at postoperative one year. A significant reduction in the number of outliers was seen in group 2 compared to group 1 (group 1 = 48.1%, group 2 = 9.2%, p outliers compared to a technique that corrected alignment using the cable method in patients undergoing MOWHTO. Level III, retrospective comparative study.

  15. Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function☆

    Science.gov (United States)

    Almeida, Gabriel Peixoto Leão; Silva, Ana Paula de Moura Campos Carvalho e; França, Fábio Jorge Renovato; Magalhães, Maurício Oliveira; Burke, Thomaz Nogueira; Marques, Amélia Pasqual

    2016-01-01

    Objective To investigate the relationship between the q-angle and anterior knee pain severity, functional capacity, dynamic knee valgus and hip abductor torque in women with patellofemoral pain syndrome (PFPS). Methods This study included 22 women with PFPS. The q-angle was assessed using goniometry: the participants were positioned in dorsal decubitus with the knee and hip extended, and the hip and foot in neutral rotation. Anterior knee pain severity was assessed using a visual analog scale, and functional capacity was assessed using the anterior knee pain scale. Dynamic valgus was evaluated using the frontal plane projection angle (FPPA) of the knee, which was recorded using a digital camera during step down, and hip abductor peak torque was recorded using a handheld dynamometer. Results The q-angle did not present any significant correlation with severity of knee pain (r = −0.29; p = 0.19), functional capacity (r = −0.08; p = 0.72), FPPA (r = −0.28; p = 0.19) or isometric peak torque of the abductor muscles (r = −0.21; p = 0.35). Conclusion The q-angle did not present any relationship with pain intensity, functional capacity, FPPA, or hip abductor peak torque in the patients with PFPS. PMID:27069887

  16. Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function

    Directory of Open Access Journals (Sweden)

    Gabriel Peixoto Leão Almeida

    2016-04-01

    Full Text Available OBJECTIVE: To investigate the relationship between the q-angle and anterior knee pain severity, functional capacity, dynamic knee valgus and hip abductor torque in women with patellofemoral pain syndrome (PFPS. METHODS: This study included 22 women with PFPS. The q-angle was assessed using goniometry: the participants were positioned in dorsal decubitus with the knee and hip extended, and the hip and foot in neutral rotation. Anterior knee pain severity was assessed using a visual analog scale, and functional capacity was assessed using the anterior knee pain scale. Dynamic valgus was evaluated using the frontal plane projection angle (FPPA of the knee, which was recorded using a digital camera during step down, and hip abductor peak torque was recorded using a handheld dynamometer. RESULTS: The q-angle did not present any significant correlation with severity of knee pain (r = -0.29; p = 0.19, functional capacity (r = -0.08; p = 0.72, FPPA (r = -0.28; p = 0.19 or isometric peak torque of the abductor muscles (r = -0.21; p = 0.35. CONCLUSION: The q-angle did not present any relationship with pain intensity, functional capacity, FPPA, or hip abductor peak torque in the patients with PFPS.

  17. Experience with a new technique for managing severely overcorrected valgus high tibial osteotomy at total knee arthroplasty.

    Science.gov (United States)

    Krackow, K A; Holtgrewe, J L

    1990-09-01

    Total knee arthroplasty (TKA) after valgus proximal tibial osteotomy poses no major difficulties in most cases. There is, however, a small subgroup of severely overcorrected patients in whom TKA is particularly difficult. These patients require special considerations. A complex ligament reconstruction has been developed to allow simultaneous implantation of a minimally constrained total knee prosthesis for patients with failed, severely overcorrected valgus high tibial osteotomies. The technique is described in five patients. The mean age of the group was 57 years and the average follow-up period was 34 months (range, 12-72 months). A 100-point knee-evaluation scale was used to rate the knees before and after TKA. The average pre- and postoperative scores were 50 and 94, respectively. None of the patients was noted to have any more than mild instability in any direction postoperatively. Despite this extensive reconstruction, the group functioned as well as most recipients of more standard primary TKAs and demonstrated it is possible to avoid highly constrained implants, custom prostheses, or major bone grafts.

  18. Juvenile arthritis and uveitis.

    Science.gov (United States)

    Kanski, J J

    1990-01-01

    The association between juvenile arthritis and uveitis is reviewed. Some children with the HLA-B27 related spondyloarthropathies develop anterior uveitis. About 20% of patients with juvenile rheumatoid arthritis (JRA) who are negative for IgM rheumatoid factor develop a frequently bilateral, nongranulomatous chronic anterior uveitis. Risk factors for uveitis in JRA patients are: female gender, pauciarticular onset of arthritis, presence of circulating antinuclear antibodies, and the antigens HLA-DW5 and HLA-DPw2. Uveitis is rare after seven years or more have elapsed from the onset of arthritis. The visual prognosis in patients with uveitis is good in 25% and fair in 50%. The remaining 25% develop visual impairment from complicated cataract and/or secondary inflammatory glaucoma. The potential benefit of cytotoxic agents in the treatment of intractable uveitis is outweighed by the risk of serious side effects. The management of secondary inflammatory glaucoma is unsatisfactory, but the results of treatment of complicated cataracts by lensectomy-vitrectomy are good.

  19. Aggressive juvenile mandibular fibromatosis.

    Science.gov (United States)

    Ivanov, Georgi P; Atanasov, Dimitar T; Anavi, Beniamin L

    2013-01-01

    Aggressive juvenile fibromatosis of the jawbones is a rare tumor presenting as infiltrative mass with unpredictable evolution. We report herein a 17-year-old student with a 6-month history of radiologically proven resorption of a part of the mandible, lingual displacement of tooth 34 and malocclusion. Alveolar ridge resorption and three dark-brown foci in the bone were seen after the tooth was extracted. Histological study showed the tumor tissue to have a bundle-like structure; immunohistochemically it was positive for vimentin, smooth muscle actin, beta-catenin, Ki-67 (5%), and negative for desmin and cytokeratin 34bE12. The golden standard in the diagnostics of desmoid fibromatoses is the nuclear or membrane expression of beta-catenin, which is found in 90% of the cases. Differential diagnosis include mandibular fibroma, well-differentiated fibrosarcoma, fibrosing histiocytoma, and infiltration from adjacent soft-tissue tumor. Aggressive juvenile fibromatosis should be managed by radical excision. Local recurrences are not rare, but metastases do not develop. In rare cases this type of fibromatosis has been known to regress spontaneously. Aggressive fibromatosis is a diagnostic challenge, since it remains in the grey zone between benign and malignant lesions of the oral cavity.

  20. Juvenile justice mental health services.

    Science.gov (United States)

    Thomas, Christopher R; Penn, Joseph V

    2002-10-01

    As the second century of partnership begins, child psychiatry and juvenile justice face continuing challenges in meeting the mental health needs of delinquents. The modern juvenile justice system is marked by a significantly higher volume of cases, with increasingly complicated multiproblem youths and families with comorbid medical, psychiatric, substance abuse disorders, multiple family and psychosocial adversities, and shrinking community resources and alternatives to confinement. The family court is faced with shrinking financial resources to support court-ordered placement and treatment programs in efforts to treat and rehabilitate youths. The recognition of high rates of mental disorders for incarcerated youth has prompted several recommendations for improvement and calls for reform [56,57]. In their 2000 annual report, the Coalition for Juvenile Justice advocated increased access to mental health services that provide a continuum of care tailored to the specific problems of incarcerated youth [58]. The specific recommendations of the report for mental health providers include the need for wraparound services, improved planning and coordination between agencies, and further research. The Department of Justice, Office of Juvenile Justice and Delinquency Prevention has set three priorities in dealing with the mental health needs of delinquents: further research on the prevalence of mental illness among juvenile offenders, development of mental health screening assessment protocols, and improved mental health services [59]. Other programs have called for earlier detection and diversion of troubled youth from juvenile justice to mental health systems [31,56]. Most recently, many juvenile and family courts have developed innovative programs to address specific problems such as truancy or substance use and diversionary or alternative sentencing programs to deal with first-time or nonviolent delinquents. All youths who come in contact with the juvenile justice system

  1. Combined intra-articular and varus opening wedge osteotomy for lateral depression and valgus malunion of the proximal part of the tibia. Surgical technique

    NARCIS (Netherlands)

    Kerkhoffs, G.M.M.J.; Rademakers, M.V.; Altena, M.; Marti, R.K.

    2009-01-01

    BACKGROUND: Reconstructive surgical measures for treatment of posttraumatic deformities of the lateral tibial plateau are seldom reported on in the literature. We report the long-term follow-up results of a consecutive series of reconstructive osteotomies performed to treat depression and valgus mal

  2. Miranda Rights: Implications for Juveniles with Disabilities

    Science.gov (United States)

    Katsiyannis, Antonis; Barrett, David E.; Losinski, Mickey L.

    2011-01-01

    Juvenile delinquency in the United States has been a persistent concern for decades. Consequently, because more juveniles have been referred to juvenile court and the arrest rate of preteen offenders has increased to almost three times that of older youth, the persistent and often controversial issue of the capacity of juvenile offenders to waive…

  3. Juvenile prison in parallel legislation

    Directory of Open Access Journals (Sweden)

    Lutovac Mitar

    2016-01-01

    Full Text Available The need for punishment of juveniles occurred from the time when there was no clear line separating them from the adult criminal population. At the same time, the evolution of the juvenile punishment is not in itself involve substantial changes to their criminal status. On the contrary, the status of minors in society did not show serious differences regarding the status of young adults, as well as the adult elderly. On the other hand, on the ground of their punishment is recorded deviations that go in the direction of application of mild corporal punishment. Closing the minor was performed in a physically separate parts of the general penal institutions with the use of a lower degree of restrictions while serving juvenile prison. Due to the different treatment of minors during the evolution of their criminal status leads to their different treatment in comparative law. That is why we are witnessing the existence of numerous differences in the juvenile punishment in some countries in the world. On the European continent there is a wide range of different legal solutions when it comes to punishing juveniles. There are considerable differences in the procedure pronouncing juvenile prison and in particular penal treatment of juveniles in penitentiary institutions. For these reasons, the author has decided to show the basic statutory provisions in the part that relates to the issue of punishment of minors in the legislation of individual countries.

  4. Update on juvenile myasthenia gravis.

    Science.gov (United States)

    Liew, Wendy K M; Kang, Peter B

    2013-12-01

    Juvenile myasthenia gravis is a relatively rare autoimmune neuromuscular disorder. The pathophysiology of juvenile myasthenia gravis is similar to that of adult myasthenia gravis, though there remain important differences regarding presentation and therapeutic options. We review the pathophysiology, clinical presentation, and treatment options for juvenile myasthenia gravis. Randomized clinical studies of myasthenia gravis have been carried out primarily in adult populations. As juvenile myasthenia gravis is rare, it has been difficult to collect prospective randomized controlled data to evaluate treatment outcomes and efficacy. A recent retrospective series suggests that, as in adult myasthenia gravis, thymectomy is a viable therapeutic option for selected cases of generalized juvenile myasthenia gravis. This is corroborated by the clinical experience of the authors in a referral center with a cohort of patients affected by juvenile myasthenia gravis over a number of years. Recent studies illustrate that some, but not all, adult research on myasthenia gravis is applicable to children and adolescents with juvenile myasthenia gravis. Adult research can inform pediatric studies, but should not be regarded as a substitute for dedicated research in those populations.

  5. Juvenile chronic arthritis.

    Science.gov (United States)

    Southwood, T R; Woo, P

    1995-05-01

    The nomenclature and classification criteria for arthritis in children should be dealt with initially as separate issues, although they are undoubtedly intertwined. The classification criteria should aim to delineate homogeneous patient populations, yet should be flexible enough to incorporate advances in disease knowledge. It should be recognized that arriving at an international consensus for classification criteria will merely provide a set of operational definitions to facilitate research, and not a set of diagnostic criteria. Indeed the only point to obtaining consensus is to begin a process of systematic ongoing review of the criteria. The labels attached to any of these diseases should facilitate accurate communication. In view of the heterogeneous nature of childhood arthritis, consideration should be given to using a broad umbrella term such as juvenile or childhood arthritis only for communicating with the lay public. Medical nomenclature should be formulated to reflect accurately homogeneous subgroups of arthritis, and should not artificially proscribe a relationship between paediatric and adult disease.

  6. [Juvenile idiopathic arthritis].

    Science.gov (United States)

    Herlin, Troels

    2002-08-19

    The new classification of juvenile idiopathic arthritis (JIA) is described in this review. Clinical characteristics divide JIA in to subtypes: systemic, oligoarticular (persistent and extended type), RF-positive and--negative polyarticular, enthesitis-related arthritis and psoriatic arthritis. In addition to the clinical characteristics, genetic and biochemical differences suggest that JIA could be regarded as a general term covering various diseases. Complications described are uveitis, temporomandibular joint affection and growth disturbances. The therapeutic strategy should be planned individually according to age, subtype and disease activity and carried out as teamwork with several specialties. Drugs showing significant effectiveness in controlled studies are primarily methotrexate and sulphasalazine. An immunomodulating agent, etanercept, a soluble TNF alpha-receptor fusion protein, has shown a promising effect in severe polyarticular JIA refractory to methotrexate treatment.

  7. Juvenile hyaline fibromatosis

    Directory of Open Access Journals (Sweden)

    Jayashree Krishnamurthy

    2011-01-01

    Full Text Available Juvenile hyaline fibromatosis is a rare, autosomal-recessive disease characterized by papular and nodular skin lesions, gingival hyperplasia, joint contractures and bone involvement in variable degrees. It is a connective tissue disorder with aberrant synthesis of glycosaminoglycans by fibroblasts. We report a 5-year-old female born of first-degree consanguineous marriage who presented with multiple, recurrent, painless, variable-sized nodules. Fine needle aspiration cytology smears and the subsequent histopathological examination from the nodules showed benign spindle cells in a Periodic acid Schiff-positive myxoid background. The disease has a relentlessly progressive course, with most patients surviving only up to the 4 th decade. As of now, there is no specific treatment for this disorder. Genetic counseling is essential to explain to parents about a 25% chance of having a diseased baby in any pregnancy. With the gene being mapped recently, techniques for antenatal diagnosis are likely to be established.

  8. [JUVENILE DERMATOMYOSITIS AND CALCINOSIS].

    Science.gov (United States)

    Zhvania, M

    2015-01-01

    Juvenile Dermatomiositis (JD) is autoimmune disease that progresses with time; JD's main differentiated syndromes are rash on the skin, poor function of muscles, and often developing invalidism. If the health practitioners manage to diagnose the JD on an early stage and prescribe the adequate treatment the disease will not progress aggressively. This approach is tangible for practical rheumatology and pediatric. The article aims to present the reasons of the development of the JD and calcinosis. The study based on the description of the patients with JD. There are distinguished the main symptoms of the disease in children: frequent and acute developments of muscles calcinosis, occasionally with diffuse character followed with hypotrophy of the muscles, contractures and invalidism. One of the patient cases that describe the article is the thirteen-year boy with JD indicating repeated sequence of the disease, with diffusive calcinosis, cellulitis followed with secondary infection and impaired vision.

  9. Juvenile idiopathic arthritis

    Directory of Open Access Journals (Sweden)

    Krupa H Bhatt

    2014-01-01

    Full Text Available Juvenile Idiopathic Arthritis (JIA is the most chronic musculoskeletal disease of pediatric population. The chronic course of disease has a great impact on oral health. Temporomandibular joint is involved in JIA causing limited mouth opening with progressive open bite, retrognathia, microgenia and bird like appearance. Joints of upper and lower extremities are also involved. Effect on upper limb function leads to difficulty with fine motor movements required for brushing and flossing. This increases incidence of caries and periodontal disease in children. The cause of JIA is still poorly understood and none of the available drugs for JIA can cure the disease. However, prognosis has improved as a result of progress in disease classification and management. The dental practitioner should be familiar with the symptoms and oral manifestations of JIA to help manage as multidisciplinary management is essential.

  10. Juvenile homosexual homicide.

    Science.gov (United States)

    Myers, Wade C; Chan, Heng Choon Oliver

    2012-01-01

    Limited information exists on juvenile homosexual homicide (JHH), that is, youths who perpetrate sexual homicides against same-sex victims. Only a handful of cases from the United States and internationally have been described in the literature. This study, the first of its kind, examines the epidemiology, victimology, victim-offender relationship, and weapon-use patterns in JHH offenders using a large U.S. database on homicide spanning three decades. The data for this study were derived from the Federal Bureau of Investigation's Supplementary Homicide Reports (SHRs) for the years 1976 through 2005. A total of 93 cases of JHH were identified. On average, three of these crimes occurred annually in the U.S., and there was a marked decline in its incidence over the study period. Ninety-five percent were male offender-male victim cases and 5% were female offender-female victim cases. JHH offenders were over-represented amongst all juvenile sexual murderers, similar to their adult counterparts. The majority of these boys were aged 16 or 17 and killed adult victims. They were significantly more likely to kill adult victims than other age groups, to be friends or acquaintances of the victims, and to use contact/edged weapons or firearms. Most offenders killed same-race victims, although Black offenders were significantly more likely than White offenders to kill interracially. A case report is provided to illustrate JHH. Further research is needed to promote our understanding of the pathogenesis, etiology, and associated risk factors for this aberrant form of murder by children.

  11. Frequency of varus and valgus thrust and factors associated with thrust presence in persons with or at higher risk of developing knee osteoarthritis.

    Science.gov (United States)

    Chang, Alison; Hochberg, Marc; Song, Jing; Dunlop, Dorothy; Chmiel, Joan S; Nevitt, Michael; Hayes, Karen; Eaton, Charles; Bathon, Joan; Jackson, Rebecca; Kwoh, C Kent; Sharma, Leena

    2010-05-01

    Varus thrust observed during gait has been shown to be associated with a 4-fold increase in the risk of medial knee osteoarthritis (OA) progression. Valgus thrust is believed to be less common than varus thrust; the prevalence of each is uncertain. Racial differences in risk factors may help explain variations in the natural history of knee OA. We undertook this study to determine the frequency of varus and valgus thrust in African Americans and Caucasians and to identify factors associated with thrust presence. The Osteoarthritis Initiative cohort includes men and women who have knee OA or are at increased risk of developing it. Trained examiners assessed thrust presence by gait observation. Logistic regression with generalized estimating equations was used to identify factors associated with thrust presence, and odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated. Compared with Caucasians, African Americans had lower odds of varus thrust, controlling for age, sex, body mass index (BMI), injury, surgery, disease severity, strength, pain, and alignment in persons without knee OA (adjusted OR 0.50 [95% CI 0.36, 0.72]) and in those with knee OA (adjusted OR 0.46 [95% CI 0.34, 0.61]). Also independently associated with varus thrust were age, sex, BMI, disease severity, strength, and alignment. The odds of valgus thrust were greater for African Americans than for Caucasians in persons without knee OA (adjusted OR 1.69 [95% CI 1.02, 2.80]) and in those with knee OA (adjusted OR 1.98 [95% CI 1.35, 2.91]). Also independently associated with valgus thrust were disease severity and malalignment. Compared with Caucasians, African Americans had lower odds of varus thrust and greater odds of valgus thrust. These findings may help explain the difference between these groups in the pattern of OA involvement at the knee.

  12. Frequency of Varus and Valgus Thrust and Factors Associated with Thrust Presence in Persons With or at Higher Risk for Knee Osteoarthritis

    Science.gov (United States)

    Chang, Alison; Hochberg, Marc; Song, Jing; Dunlop, Dorothy; Chmiel, Joan S.; Nevit, Michael; Hayes, Karen; Eaton, Charles; Bathon, Joan; Jackson, Rebecca; Kwoh, Kent; Sharma, Leena

    2010-01-01

    Varus thrust observed during gait has been shown to be associated with a 4-fold increase in the risk of medial knee osteoarthritis progression. Valgus thrust is believed less common than varus thrust; the prevalence of each is uncertain. Racial differences in risk factors may help explain variations in the natural history of knee osteoarthritis. Our objectives were: determine the frequency of varus and valgus thrust in African-Americans and Caucasians; identify factors associated with thrust presence. The Osteoarthritis Initiative cohort includes men and women with or at increased risk to develop knee osteoarthritis. Trained examiners assessed thrust presence by gait observation. Logistic regression with generalized estimating equations (GEE) was used to identify factors associated with thrust presence. African-Americans compared to Caucasians had lower odds of varus thrust, controlling for age, gender, BMI, injury, surgery, disease severity, strength, pain, and alignment in persons without (OR 0.50, 95% CI 0.36, 0.72) and with knee osteoarthritis (OR 0.46, 95% CI 0.34, 0.61). Also independently associated with varus thrust were age, gender, BMI, disease severity, strength, and alignment. The odds of valgus thrust were greater for African-Americans than Caucasians in persons without (OR 1.69, 95% CI 1.02, 2.80) and with knee osteoarthritis (OR 1.98, 95% CI 1.35, 2.91). Also independently associated with valgus thrust were disease severity and malalignment. African-Americans compared to Caucasians had lower odds of varus thrust and greater odds of valgus thrust, findings which may help explain the difference between these groups in the pattern of osteoarthritic involvement at the knee. PMID:20213800

  13. Do juvenile Amphiprion ocellaris (Pisces

    DEFF Research Database (Denmark)

    Brolund, Thea Marie; Nielsen, Lis Engdahl; Arvedlund, Michael

    2003-01-01

    . This is contrary to the settling mechanisms of the damselfish D. aruanus and D. reticulatus, and of the temperate herring Clupea harengus. Hence the results emphasize the variation of sensory abilities and behaviours in fish larvae and juveniles. It is not an area prone for generalizations.......Juvenile anemonefish Amphiprion ocellaris were tested in two behavioural laboratory set-ups for their ability to visually or chemically recognize conspecifics. Individuals of two other species of anemonefish, A. clarkii and Dascyllus aruanus, were also used as test specimens for recognition....... The results indicate that juvenile A. ocellaris recognize conspecifics visually rather than by olfaction. This is contrary to their finding mechanism of their host anemone. However, the results also indicate that the juvenile A ocellaris are neither attracted nor deterred by the presence of conspecifics...

  14. Bilateral, independent juvenile nasopharyngeal angiofibroma

    DEFF Research Database (Denmark)

    Mørkenborg, Marie-Louise; Frendø, M; Stavngaard, T;

    2015-01-01

    BACKGROUND: Juvenile nasopharyngeal angiofibroma is a benign, vascular tumour that primarily occurs in adolescent males. Despite its benign nature, aggressive growth patterns can cause potential life-threatening complications. Juvenile nasopharyngeal angiofibroma is normally unilateral, originating...... from the sphenopalatine artery, but bilateral symptoms can occur if a large tumour extends to the contralateral side of the nasopharynx. This paper presents the first reported case of true bilateral extensive juvenile nasopharyngeal angiofibroma involving clinically challenging pre-surgical planning...... embolisation. Radical removal performed as one-step, computer-assisted functional endoscopic sinus surgery was performed. The follow-up period was uncomplicated. CONCLUSION: This case illustrates the importance of suspecting bilateral juvenile nasopharyngeal angiofibroma in patients presenting with bilateral...

  15. Editor's Shelf: International Juvenile Titles.

    Science.gov (United States)

    Mitchell-Powell, Brenda

    1994-01-01

    Provides an annotated list of international juvenile picture books and notes those that emphasize text over pictures. The 49 titles present international perspectives for educators, librarians, and parents seeking materials with alternative cultural content. The majority are folk tales. (SLD)

  16. Reliability and concurrent validity between two-dimensional and three-dimensional evaluations of knee valgus during drop jumps

    Science.gov (United States)

    Ortiz, Alexis; Rosario-Canales, Martin; Rodríguez, Alejandro; Seda, Alexie; Figueroa, Carla; Venegas-Ríos, Heidi L

    2016-01-01

    Purpose The aim of this study was to establish the concurrent validity and reliability of four different two-dimensional (2D) video-based techniques for quantifying frontal plane knee kinematics during a 40 cm double-legged drop jump. Participants and methods A convenience sample of 16 healthy participants (nine males and seven females; age: [mean ± standard deviation] 25.5±2 years; body mass index: 24.33±2.98 kg/m2) participated in this investigation. A total of five trials during a 40 cm drop jump maneuver with a countermovement jump were used as the functional task. Four knee valgus measures, such as two different frontal plane projection angle measures, knee-to-ankle separation ratio (KASR), and knee separation distance (KSD), were measured using 2D and three-dimensional (3D) systems. To generalize to the greater population of possible evaluators, the testers performing the biomechanical analyses were three novice physical therapists. Intra- and intertester intraclass correlation coefficients (ICCs) were estimated for 2D analysis variables. ICCs were estimated for all measures between systems to determine concurrent validity of the 2D system. Results All four 2D measures showed good to excellent reliability (ICC: 0.89–0.99). KASR and KSD showed excellent correlation (ICC: 0.96; 95% CI: 0.82–0.98 and ICC: 0.94; 95% CI: 0.90–0.96, respectively) with the 3D system, while both methods of frontal plane projection angle showed poor to moderate correlation (ICC: 0–0.57) with the 3D system. Conclusion 2D KASR and KSD measures are cost effective, reliable, and highly correlated with the same measures using 3D techniques for the evaluation of knee valgus. PMID:27313480

  17. Salter-Harris type III and IV displaced fracture of the hallux in young gymnasts: A series of four cases at 1-year follow-up.

    Science.gov (United States)

    Perugia, Dario; Fabbri, Mattia; Guidi, Marco; Lepri, Marco; Masi, Vincenzo

    2014-12-01

    The purpose of this study was to describe four exceptional cases of Salter-Harris type III and IV fractures of the proximal phalanx of the hallux in young high-level gymnasts. All gymnasts underwent the same mechanism of injury of hyperadduction, which indicates a role of the abductor hallucis muscle in the genesis and displacement of these fractures. An open reduction and internal fixation was performed to achieve an anatomical reduction and avoid chronic disability. At 1-year follow-up, all patients had an excellent American Orthopaedic Foot and Ankle Society (AOFAS) score (100 points), and there was no shortening or angulation of the first ray and no evidence of degenerative joint disease on X-ray. Moreover, all the gymnasts had returned to pre-injury levels of sporting activity. To our knowledge, there are no previous studies that address these types of injuries and how they are handled in gymnasts.

  18. JUVENILE RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    I N Sartika

    2012-11-01

    Full Text Available Juvenile rheumatoid arthritis (JRA is the most common rheumatic condition in children. JRA is defined as persistent arthritis in 1 or more joints for at least 6 weeks, with the onset before age 16 years. The etiology of JRA is unknown. Antigen activated CD4+ T cell stimulate monocytes, macrophages, and synovial fibroblasts to produce the cytokines Interleukin-1 (IL-1, IL-6, and tumor necrosis factor ? (TNF-? and to secrete matrix metalloproteinases, which lead to chronic inflammation due to infiltration of inflammatory cell, angiogenesis, destruction of cartilage and bone with pannus formation. The 3 major subtypes of JRA are based on the symptoms at disease onset and are designated systemic onset, pauciarticular onset, and polyarticular onset. For all patients, the goals of therapy are to decrease chronic joint pain and suppress the inflammatory process. Poor prognostic have been observed in patients with polyarticular onset, rheumatoid factor, persistent morning stiffness, tenosynovitis, involvement of the small joints, rapid appearance of erosions, active late onset childhood, subcutaneous nodules, or antinuclear antibody.

  19. Juveniles tried as adults: the age of the juvenile matters.

    Science.gov (United States)

    Semple, Jaclyn K; Woody, William Douglas

    2011-08-01

    Serious juvenile crimes require evaluation of a child as a criminal defendant in adult court. In such cases, it is crucial to understand jurors' attitudes, biases, and ability to follow legal instructions and maintain fairness. 308 undergraduate psychology students served as mock jurors, were randomly separated into four groups, and each group read the same realistic summary of a trial with the defendant's age presented as 13, 15, 17, or 21 years. Participants were asked to render guilty or not guilty verdicts and, if guilty, to suggest sentences. Chi-squared analysis indicated 13- and 15-year-old defendants were convicted less often than 17- and 21-year-old defendants, showing that jurors distinguished between juvenile defendants of different ages, but not minors and adults as defined by law. Additional analysis showed that age did not affect sentencing recommendations. Decision processes jurors use for juveniles tried as adults are discussed.

  20. Forensic aspects of juvenile violence.

    Science.gov (United States)

    Haller, L H

    2000-10-01

    The juvenile justice system was created because it was recognized that youthful offenders needed to be managed differently from adults. They were to receive habilitation services instead of punishment. It is now more than a century since the creation of the first juvenile court. After 67 years, the US Supreme Court, in Kent v United States stated that the model was not working because juveniles in the criminal justice system received no treatment and they had no rights. Because the issue that had been appealed was the lack of rights (not lack of treatment), the Court mandated that juveniles, like adults, be given certain rights. The following year, in In re Gault, the Court expanded these rights. Subsequent Supreme Court cases have dealt with these kinds of issues--that is, whether juvenile offenders are entitled to the same rights as adults and subject to the same penalties. The Supreme Court has never heard a "right to treatment" case, which is the other part of the juvenile court system. Cases have been brought in lower courts (e.g., Nelson v. Heyne, 1972) alleging inadequate treatment services, but no national impact has resulted. Thus, in general, children in the juvenile court system do not have an enforceable right to treatment and can obtain only what services are available in their jurisdictions. The services often are woefully inadequate. Sentencing a youth to probation, with the requirement that he or she participate in counseling or mental health treatment, is meaningless if services are not available. Community-based, model programs that provide effective treatment do exist. They are, as yet, the rare exception rather than the norm and, therefore, are not available to most youthful offenders. Incarcerated juveniles, obviously, cannot avail themselves of community programs. Litigation to give these youth the same rights as adults in penal institutions is not the answer because incarcerated adults don't have a right to treatment, only a right to be free

  1. The Heterogeneity of Juvenile Myositis

    Science.gov (United States)

    Rider, Lisa G.

    2007-01-01

    Juvenile myositis is a heterogeneous group of systemic autoimmune diseases, in which clinical and serologic subgroups result in subsets of patients with distinct clinical manifestations, disease courses, immunogenetic associations, responses to therapy, and prognoses. A newly identified autoantibody of unknown specificity, anti-p155, is myositis-associated and seen in up to 20 – 30% of juvenile and adult DM patients. HLA DRB1*0301 and its linked allele DQA1*0501 have been identified as the major immunogenetic risk factor for juvenile and adult DM in both European- and African- American patients, and DQA1*0301 is an additional risk factor in European American patients. Several DQA1 alleles also are protective for juvenile DM. Environmental risk factors are poorly understood, but growing evidence suggests a role for infectious agents and ultraviolet radiation. The current therapy of juvenile DM consists of corticosteroids and other immunosuppressive agents, with the adjunctive treatment of cutaneous manifestations and rehabilitation. Therapeutic trials of biologic agents, including anti-TNFα and anti-CD20, may aid in developing promising new therapies for these disorders. PMID:17317616

  2. Juvenile Correctional Institutions Library Services: A Bibliography.

    Science.gov (United States)

    McAlister, Annette M.

    This bibliography lists citations for 14 articles, books, and reports concerned with library services in juvenile correctional institutions. A second section lists 21 additional materials on adult correctional libraries which also contain information relevant to the juvenile library. (KP)

  3. Juvenile technologies in foreign publications

    Directory of Open Access Journals (Sweden)

    Shpagina E.M.

    2012-09-01

    Full Text Available The article provides the review of foreign publications, concerning the juvenile technologies used in France, Canada, Germany and Switzerland. The paper presents legal, social and psychotherapeutic aspects of juvenile judiciary in foreign countries. The authors paid special attention to the complexity of approaches to young children and teenagers who found themselves in complicated life circumstances or got into trouble with the law. The article gives examples of using the following techniques: cognitive-behavioral intervention, mediation, family therapy (including family background and family history, relations theory, narrative practices, utilization of «emotional intelligence» resources.

  4. Evolution of Juvenile Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Ye.V. Prohorov

    2013-03-01

    Full Text Available Evolution of juvenile ankylosing spondylitis tend to follow a more frequent involvement in the pathological process of elbow and ankle joints, development of enthesiopathies, changes of intraarticular meniscal horns, forming of Baker’s cysts, cartilage flaps and systemic osteoporosis, and total value of all these signs 13 times exceeds thereof in patients with with the debut of disease in adulthood, but for juvenile ankylosing spondylitis vertebral lesion is less common. Age dimorphism of the use of certain groups of drugs and physiotherapy facilities is observed.

  5. Correction of static axial alignment in children with knee varus or valgus deformities through guided growth: Does it also correct dynamic frontal plane moments during walking?

    Science.gov (United States)

    Böhm, Harald; Stief, Felix; Sander, Klaus; Hösl, Matthias; Döderlein, Leonhard

    2015-09-01

    Malaligned knees are predisposed to the development and progression of unicompartmental degenerations because of the excessive load placed on one side of the knee. Therefore, guided growth in skeletally immature patients is recommended. Indication for correction of varus/valgus deformities are based on static weight bearing radiographs. However, the dynamic knee abduction moment during walking showed only a weak correlation to malalignment determined by static radiographs. Therefore, the aim of the study was to measure the effects of guided growth on the normalization of frontal plane knee joint moments during walking. 15 legs of 8 patients (11-15 years) with idiopathic axial varus or valgus malalignment were analyzed. 16 typically developed peers served as controls. Instrumented gait analysis and clinical assessment were performed the day before implantation and explantation of eight-plates. Correlation between static mechanical tibiofemoral axis angle (MAA) and dynamic frontal plane knee joint moments and their change by guided growth were performed. The changes in dynamic knee moment in the frontal plane following guided growth showed high and significant correlation to the changes in static MAA (R=0.97, pknee moment before treatment showed a more pathological one after treatment. In conclusion, the changes in the dynamic load situation during walking can be predicted from the changes in static alignment. If pre-surgical gait analysis reveals a natural load situation, despite a static varus or valgus deformity, the intervention must be critically discussed.

  6. On the Prevention of Juvenile Crime

    Science.gov (United States)

    Lelekov, V. A.; Kosheleva, E. V.

    2008-01-01

    Crimes committed by juveniles are among the most urgent social problems. Juvenile crime is as prevalent as crime itself is, and it has not been solved completely in any society and cannot be solved through law enforcement measures alone. In this article, the authors discuss the dynamics and structure of juvenile crime in Russia and present data…

  7. School-Related Characteristics of Male Juveniles.

    Science.gov (United States)

    Sapp, Gary L.; Abbott, Gypsy A.

    School-related characteristics of 256 male juveniles under the jurisdiction of a Family Court system were examined by perusing court records and conducting individual interviews with the juveniles. Results indicated that most juveniles last attended eighth grade, more than 81% had failed at least once, and more than half had fought frequently at…

  8. Intensive Reading Instruction in Juvenile Correctional Settings

    Science.gov (United States)

    Williams, Jacob L.; Wexler, Jade; Roberts, Greg; Carpenter, Clint

    2011-01-01

    Despite 60 years of evidence linking juvenile illiteracy and delinquency, practitioners and policymakers have been painfully slow in the implementation of evidence-based reading interventions for incarcerated juveniles. We will present the Texas Juvenile Justice Tiered Instructional Model, an evidence-based reading program model created…

  9. Sex Differences in Attributions of Juvenile Delinquency.

    Science.gov (United States)

    Sagatun, Inger J.

    This paper is an application of attribution theory to the processing of juvenile delinquents in an attempt to understand the differential treatment of female and male offenders within the juvenile justice system. The paper explores the attributions of juvenile delinquency both by male and female minors, by male and female parents, and by male and…

  10. Do Juveniles Bully More than Young Offenders?

    Science.gov (United States)

    Ireland, Jane L.

    2002-01-01

    Study compares bullying behavior among juvenile and young offenders. Ninety-five male juvenile and 196 male young offenders completed two questionnaires, measuring bullying directly and behaviors indicative of "being bullied" or of "bullying others". Juveniles perceived a higher extent of bullying and reported significantly…

  11. The Juvenile Court: Changes and Challenges.

    Science.gov (United States)

    Feld, Barry C.

    2000-01-01

    Explores the changes in the juvenile court system, in particular, the juvenile waiver and sentencing laws, as it transformed from a social welfare agency into a type of criminal court system for young offenders. Addresses whether states should create an integrated juvenile and criminal justice system. (CMK)

  12. Reforming Our Expectations about Juvenile Justice

    Science.gov (United States)

    Rodriguez, Pamela F.; Baille, Daphne M.

    2010-01-01

    Typing the term "juvenile justice reform" into a Google[TM] search will result in 60 pages of entries. But what is meant by juvenile justice reform? What does it look like? How will one know when it is achieved? This article defines juvenile justice reform, discusses the principles of effective reform, and describes the practice of juvenile…

  13. Least possible fixation techniques of 4-part valgus impacted fractures of the proximal humerus: a systematic review

    Directory of Open Access Journals (Sweden)

    Andreas Panagopoulos

    2016-03-01

    Full Text Available The valgus-impacted (VI 4-part fractures are a subset of fractures of the proximal humerus with a unique anatomic configuration characterized by a relatively lower incidence of avascular necrosis after operative intervention. We systematically reviewed clinical studies assessing the benefits and harms of least possible fixation techniques (LPFT for this unique fracture type. Such information would be potentially helpful in developing an evidence-based approach in the management of these complex injuries. We performed analytic searches of PubMed, Embase, Web of Science, Google Scholar and the Cochrane Library, restricting it to the years 1991-2014. Included studies had to describe outcomes and complications after primary osteosynthesis with any type of LPFT apart from plate-screws and intramedullary nailing. Eligibility criteria were also included English language, more than 5 cases, minimum follow up of one year and report of clinical outcome using at least one relevant score (Constant, Neer or ASES. Based on 292 database hits we identified 12 eligible studies including 190 four-part valgus impacted fractures in 188 patients. All eligible studies were case series composed of min 8 to max 45 patients per study. The gender distribution was 60% (112 female and 40% (76 male. The average age of the patients at the time of injury was 54.5 years. In 8/12 studies an open reduction was used for fracture fixation using different surgical techniques including KW, cerclage wires, cannulated screws and osteosutures. Closed reduction and percutaneous fixation was used in 4 studies. Mean follow-up time ranged from 24 to 69 months. A good functional outcome (constant score >80 was reported in 9/12 studies. The most common complication was avascular necrosis of the humeral head with an overall incidence of 11% (range, 0-26.3%. Total avascular necrosis (AVN was found in 15/188 patients (7.9% and was more common in percutaneous techniques and partial AVN in 6

  14. Mobilizing Communities To Prevent Juvenile Crime. Juvenile Justice Bulletin.

    Science.gov (United States)

    Bownes, Donna; Ingersoll, Sarah

    Through Title V Incentive Grants for Local Delinquency Prevention Programs (Community Prevention Grants), the Office of Juvenile Justice and Delinquency Prevention (OJJDP) allocated $20 million in fiscal year 1997 to states to complement law enforcement and justice system efforts by helping local communities foster strong families and nurture…

  15. Bilateral periprosthetic stress fractures in a juvenile chronic arthritis patient secondary to bilateral genu valgum.

    Science.gov (United States)

    Al-Khateeb, H; Meir, A; Singer, G C

    2007-01-01

    Lateral insufficiency fractures following total hip replacement have been reported with the femoral stems positioned in varus, together with osteopenia of the lateral femoral cortex. Any abnormal alignment of the lower limbs, such as genu valgum, will alter the load distribution across the femoral cortices, and repetitive loading during walking will predispose the bones to stress fractures at any stress riser point, such as the tip of a femoral component. Bilateral femoral stress fractures post total hip replacements have not been previously described. We present a 55-year-old woman, diagnosed with juvenile idiopathic arthritis, who had undergone bilateral total hip replacements and bilateral knee replacements. The knees 15 years postoperatively were in valgus and the left knee was extremely stiff, flexing to just 5. The patient presented with bilateral thigh pain, with plain radiographs confirming bilateral periprosthetic fractures of the femur at the tip of well-fixed femoral components. There was no history of injury and her hips were functioning well up to this time. The patient required revision of both hips to long-stem uncemented components, bypassing the fractures, and revision of both knees to stemmed semi-constrained implants, thereby correcting the alignment of both lower limbs. Both fractures healed and the patient is currently pain-free and mobile with walking aids. Surgeons must remain aware that when implants are in situ, abnormal alignments will lead to abnormal forces, and stress fractures are likely to occur at any stress riser around the implant. Avoiding malalignment will avoid this complication.

  16. Juvenile Justice and Substance Use

    Science.gov (United States)

    Chassin, Laurie

    2008-01-01

    Laurie Chassin focuses on the elevated prevalence of substance use disorders among young offenders in the juvenile justice system and on efforts by the justice system to provide treatment for these disorders. She emphasizes the importance of diagnosing and treating these disorders, which are linked both with continued offending and with a broad…

  17. Genetics in juvenile idiopathic arthritis

    NARCIS (Netherlands)

    Albers, Heleen Marion

    2015-01-01

    Juvenile idiopathic arthritis (JIA) is a non-common disease in children that can persist into adulthood. JIA is considered to be an auto-immune disease. Genetic factors play a role in the pathogenesis. In a new cohort of JIA patients from North-West European descent genetic candidate gene associatio

  18. Juvenile Courts. Creation and development

    Directory of Open Access Journals (Sweden)

    Montserrat GONZÁLEZ FERNÁNDEZ

    2013-11-01

    Full Text Available This paper studies the creation of Juvenile or Children's Courts in Spain, analysing their reasons and aims, as well as the ethical and political connotations present on their way of acting. Their history and the one of the institutions that complement them is built from the legislation, writings and ideas of their promoters.

  19. Juvenile Diabetes and Rehabilitation Counseling.

    Science.gov (United States)

    Stone, J. Blair; Gregg, Charles H.

    1981-01-01

    Severe complications of diabetes are more likely to occur with the juvenile diabetic and problems of psychosocial adjustment are recurring and difficult. Implications for the rehabilitation counselor are discussed in terms of employment considerations, the effects of complications, genetic counseling, and cooperation with other professionals.…

  20. Case Report: Juvenile Tophaceous Gout

    Directory of Open Access Journals (Sweden)

    Seyma Gunes

    2016-01-01

    Full Text Available Gout is a metabolic disease that manifests as recurrent arthritis. Its incidance increases with age. Clinical findings include recurrent acute arthritis, tophus at joints and tissues, uricacid stones and gouty nephropathy. Tophi is a late period complication of arthritis. In this casereport we presented  a patient with early-onset juvenile tophaceous gout.

  1. Do juvenile Amphiprion ocellaris (Pisces

    DEFF Research Database (Denmark)

    Brolund, Thea Marie; Nielsen, Lis Engdahl; Arvedlund, Michael

    2003-01-01

    . This is contrary to the settling mechanisms of the damselfish D. aruanus and D. reticulatus, and of the temperate herring Clupea harengus. Hence the results emphasize the variation of sensory abilities and behaviours in fish larvae and juveniles. It is not an area prone for generalizations....

  2. [Sex-linked juvenile retinoschisis].

    Science.gov (United States)

    François, P; Turut, P; Soltysik, C; Hache, J C

    1976-02-01

    About 13 observations of sexe linked juvenile retinoschisis, the authors describe the ophthalmoscopic, fluorographic and functional aspects of the disease whose caracteristics are:--its sexe linked recessive heredity; --its clinical characterestics associating: a microcystic macular degeneration, peripheral retinal lesions, vitreous body alterations, --an electroretinogram of the negative type.

  3. Subtalar Joint Distraction Arthrodesis to Correct Calcaneal Valgus in Pediatric Patients with Tarsal Coalition: A Case Series.

    Science.gov (United States)

    Schwartz, Jaclyn M; Kihm, Carl A; Camasta, Craig A

    2015-01-01

    Subtalar joint middle facet coalitions commonly present in children who have a painful, rigid, pes planovalgus foot type. The middle facet coalition allows rearfoot forces to be distributed medially through the coalition, and this can result in arthritis or lateral tarsal wedging. The senior author has used a wedged bone graft distraction subtalar joint arthrodesis to correct calcaneal valgus and restore the talar height in these patients. The tight, press-fit nature of the tricortical iliac crest allograft provides stability and can negate the need for internal fixation. We retrospectively reviewed 9 pediatric subtalar joint distraction arthrodesis procedures performed on 8 patients during a 6-year period. All patients began weightbearing at 6 weeks after surgery. All patients had osseous union, and no complications developed that required a second surgery. The clinical outcomes, assessed at a mean of 25.5 (range, 6.3 to 75.8) months postoperatively, were satisfactory. The mean American Orthopaedic Foot and Ankle Society score was 90.1 (range, 79 to 94), on a 94-point scale. The wedged distraction arthrodesis technique has not been previously described for correction of pediatric patients with lateral tarsal wedging, but it is an effective option and yields successful outcomes. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Juvenile Crime, Juvenile Justice. Panel on Juvenile Crime: Prevention, Treatment, and Control.

    Science.gov (United States)

    McCord, Joan, Ed.; Widom, Cathy Spatz, Ed.; Crowell, Nancy A., Ed.

    This book discusses patterns and trends in crimes committed by children and adolescents, analyzing youth crime as a subset of general crime and studying the impact of race and gender. It evaluates different approaches to forecasting future crime rates. Data come from a national panel that examined what is known about juvenile crime and its…

  5. A Practical Approach to Juvenile Dermatomyositis and Juvenile Scleroderma.

    Science.gov (United States)

    McCann, Liza J; Pain, Clare E

    2016-02-01

    Juvenile dermatomyositis and juvenile scleroderma are rare multisystem autoimmune disorders. Although they share some pathognomonic hallmarks with adult onset myositis or scleroderma, there are significant differences in presentation, characteristics and associated features when the diseases present in childhood. In view of this, and the rarity of the conditions, it is important for care to be led by teams with expertise in pediatric rheumatology conditions. Prognosis has improved significantly in the West; likely due to early diagnosis and aggressive treatment with immunosuppressive medications. However, this trend is not replicated in the developing world. Early recognition of these diseases is crucial to achieve rapid and sustained remission and prevent disease or medication associated complications. This article aims to provide a practical overview for recognition, diagnosis and treatment of these conditions.

  6. 8 CFR 236.3 - Detention and release of juveniles.

    Science.gov (United States)

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Detention and release of juveniles. 236.3... Aliens Prior to Order of Removal § 236.3 Detention and release of juveniles. (a) Juveniles. A juvenile is defined as an alien under the age of 18 years. (b) Release. Juveniles for whom bond has been posted,...

  7. MR findings in acute Lyme disease affecting the knee. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Cavallaro, A.; Harrer, T.; Richter, H.; Bautz, W.; Fellner, F.A. [Friedrich-Alexander-Univ., Erlangen-Nuernberg (Germany)

    2002-07-01

    In this paper we report a case with primarily unspecific arthralgia after surgical therapy of hallux valgus deformity and consecutive reflex sympathetic dystrophy in which MR led to the diagnosis of Lyme disease. (orig.)

  8. Uveitis in juvenile chronic arthritis.

    Science.gov (United States)

    Kanski, J J

    1990-01-01

    About 20% of patients with juvenile chronic arthritis develop uveitis which is frequently bilateral. Risk factors for uveitis are: female gender, pauciarticular onset of arthritis, presence of circulating antinuclear antibodies, and the antigens HLA-DW5 and HLA-DPw2. The visual prognosis in patients with uveitis is good in 25% and fair in 50%. The remaining 25% develop cataract and/or glaucoma. The management of glaucoma is unsatisfactory, but the results of cataract surgery by lensectomy are good.

  9. Juvenile morphology in baleen whale phylogeny.

    Science.gov (United States)

    Tsai, Cheng-Hsiu; Fordyce, R Ewan

    2014-09-01

    Phylogenetic reconstructions are sensitive to the influence of ontogeny on morphology. Here, we use foetal/neonatal specimens of known species of living baleen whales (Cetacea: Mysticeti) to show how juvenile morphology of extant species affects phylogenetic placement of the species. In one clade (sei whale, Balaenopteridae), the juvenile is distant from the usual phylogenetic position of adults, but in the other clade (pygmy right whale, Cetotheriidae), the juvenile is close to the adult. Different heterochronic processes at work in the studied species have different influences on juvenile morphology and on phylogenetic placement. This study helps to understand the relationship between evolutionary processes and phylogenetic patterns in baleen whale evolution and, more in general, between phylogeny and ontogeny; likewise, this study provides a proxy how to interpret the phylogeny when fossils that are immature individuals are included. Juvenile individuals in the peramorphic acceleration clades would produce misleading phylogenies, whereas juvenile individuals in the paedomorphic neoteny clades should still provide reliable phylogenetic signals.

  10. Juvenile morphology in baleen whale phylogeny

    Science.gov (United States)

    Tsai, Cheng-Hsiu; Fordyce, R. Ewan

    2014-09-01

    Phylogenetic reconstructions are sensitive to the influence of ontogeny on morphology. Here, we use foetal/neonatal specimens of known species of living baleen whales (Cetacea: Mysticeti) to show how juvenile morphology of extant species affects phylogenetic placement of the species. In one clade (sei whale, Balaenopteridae), the juvenile is distant from the usual phylogenetic position of adults, but in the other clade (pygmy right whale, Cetotheriidae), the juvenile is close to the adult. Different heterochronic processes at work in the studied species have different influences on juvenile morphology and on phylogenetic placement. This study helps to understand the relationship between evolutionary processes and phylogenetic patterns in baleen whale evolution and, more in general, between phylogeny and ontogeny; likewise, this study provides a proxy how to interpret the phylogeny when fossils that are immature individuals are included. Juvenile individuals in the peramorphic acceleration clades would produce misleading phylogenies, whereas juvenile individuals in the paedomorphic neoteny clades should still provide reliable phylogenetic signals.

  11. Juvenile psammomatoid ossifying fibroma. Case report

    OpenAIRE

    Vahtsevanos, Konstantinos; Persephone XIROU; Giorgos BALLIS; Tsekos, Antonis; Ntomouchtsis, Aris; Alexandros VALASIDIS; Doxa MAGGOUDI

    2012-01-01

    Ossifying fibroma (OS) represents a slow growing, benign neoplasm that belongs to the greater group of fibro-osseous lesions. Based on its histological features, ossifying fibroma is divided into: a) juvenile trabecular OS and b) juvenile psammomatoid OS which affects mainly the paranasal sinuses of children and teenagers aging from 5 to 15 years.A rare case of juvenile psammomatoid ossifying fibroma in a 30 year old male patient located in the left mandibular ramus is presented. Treatment pl...

  12. Distinct synovial immunopathologic characteristics of juvenile-onset spondylarthritis and other forms of juvenile idiopathic arthritis

    NARCIS (Netherlands)

    E. Kruithof; V. van den Bossche; L. de Rycke; B. Vandooren; R. Joos; J.D. Canete; P.P. Tak; A.M.H. Boots; E.M. Veys; D. Baeten

    2006-01-01

    Objective. To characterize the synovial immunopathologic features of juvenile-onset spondylarthritis (SpA) in relation to adult SpA and other forms of juvenile idiopathic arthritis (JIA). Methods. Synovial biopsy samples were obtained from 10 patients with juvenile-onset SpA, 23 with adult SpA, 19 w

  13. Justicia juvenil restaurativa como respuesta alternativa

    OpenAIRE

    Mariño Rojas, Cielo

    2016-01-01

    El artículo explora las posibilidades de la justicia juvenil restaurativa como respuesta alternativa en los sistemas de justicia juvenil en la región. Si bien la justicia restaurativa no aparece explícitamente en los instrumentos internacionales sobre justicia penal juvenil, estos dan la oportunidad para que aquella se desarrolle dentro de los sistemas de justicia juvenil. Inicialmente se aborda su evolución histórica para establecer el origen de sus principales características. A continuació...

  14. Juvenile hyaline fibromatosis. Radiological diagnosis. Fibromatosis hialina juvenil. Diagnostico radiologico

    Energy Technology Data Exchange (ETDEWEB)

    Fuentes, R.; Sar, V.; Cabrera, J.J.; Diaz, L.; Hernandez, B.; Valeron, P.; Baez, O.; Rodriguez, M.

    1993-10-01

    Juvenile hyaline fibromatosis (JHF) is a rare disorder of unknown etiology, very few cases of which have been reported in the literature. It presents similarities to other fibromatosys, but has its particular radiological features which differentiate it from them. The clinical findings consist of several, slow growing, subcutaneous nodules, flexion contractures of the joints which can lead to disability, gingival hypertrophy and muscular atrophy. The suspected radiological diagnosis is confirmed by electron microscopy study of the nodules, although light microscopy can also reveal suggestive images. Author (9 refs.)

  15. Juvenile ossifying fibroma: Psammamatoid variant

    Directory of Open Access Journals (Sweden)

    Shivani Aggarwal

    2012-01-01

    Full Text Available Juvenile ossifying fibroma is a rare fibro-osseous lesion containing variable amount of calcified masses, which resembles bone or cementum within a fibrocellular connective tissue stroma. It has variable clinical behavior, highly aggressive in nature including invasion and destruction of adjacent anatomic structures with a strong tendency to recur. We reported a 28-year-old female patient with a growth in the upper left vestibule region extending from canine to molar region with clinical, histopathological, and radiological features are presented. Surgical management was done, and regular follow-up was advised.

  16. [Juvenile monomelic amyotrophy: Hirayama disease].

    Science.gov (United States)

    Drozdowski, W; Baniukiewicz, E; Lewonowska, M

    1998-01-01

    We present three patients with unilateral upper limb weakness (with muscular atrophy)-two of them with distal and one with proximal localization. The disease onset was between 18th end 35-th year of life; the disease course was biphasic (i.e. progressive within first 1 to 3 years, and stabilized during following 4-24 years). The laboratory investigations permitted to diagnose juvenile monomelic amyotrophy, an entity that is very rare outside Japan. Electromyography revealed neurogenic involvement with spinal features also in clinically unaffected muscles. We suggest that these results may support the hypothesis of this disease being a benign variant of spinal muscular atrophy.

  17. Juvenile Competency to Stand Trial.

    Science.gov (United States)

    Stepanyan, Sofia T; Sidhu, Shawn S; Bath, Eraka

    2016-01-01

    Competency to stand trial is interpreted as a protected due process right for all defendants and is defined as a defendant's fundamental knowledge and understanding of the criminal charges being filed, roles and procedures within the courtroom, and a general ability to work with the defense counsel. Questions of competency are most often raised by the judge, defense, or the prosecution, and competency evaluations are most often completed by psychiatrists or psychologists with forensic training or work experience. Mental illness, intellectual disability, developmental disorders, and developmental immaturity are the 4 main factors considered in most juvenile competency evaluations.

  18. Glucocorticoids in juvenile idiopathic arthritis.

    Science.gov (United States)

    Malattia, Clara; Martini, Alberto

    2014-05-01

    Although the use of corticosteroids in juvenile idiopathic arthritis (JIA) is now much more limited owing to the availability of methotrexate and biological agents, there are clinical scenarios where it is still indicated. For example, corticosteroids may be indicated for intraarticular injections to prevent joint deformities, as a "bridge" drug to relieve symptoms in polyarticular disease while waiting for methotrexate and biologics to exert their full therapeutic effects, and in the treatment of chronic iridocyclitis, macrophage activation syndrome, and systemic JIA, although the advent of interleukin (IL)-1 and IL-6 blockers has greatly reduced the latter indication.

  19. Imaging of juvenile idiopathic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Karl [Birmingham Children' s Hospital, Radiology Department, Birmingham (United Kingdom)

    2006-08-15

    Over the past decade there have been considerable changes in the classification and imaging of juvenile idiopathic arthritis (JIA). Radiology now has a considerable role in the management of JIA, the differential diagnosis, monitoring disease progression and detecting complications. The different imaging modalities available, their role and limitations are discussed in this article and the various disease features that the radiologist should be aware of are described. An approach to the imaging of the child with joint disease and in the monitoring of disease complications are also discussed. (orig.)

  20. THE STUDY OF FEATURES OF GUILT OF JUVENILE OFFENDERS IN THE CONTEXT OF JUVENILE JUSTICE

    Directory of Open Access Journals (Sweden)

    Natalija Vladimirovna Galkina

    2015-08-01

    Full Text Available The article is devoted to the results of empirical studies of the experiences of guilt of juvenile offenders in the context of juvenile justice where a minor appears as the subject of legal relations. Restorative approach of juvenile justice is based on an admission of guilt to the victim. In connection with it, the research of features of the guilt of minors who have committed an offence and the conditions for the development of the subjectivity will enhance understanding of the possibilities of restorative juvenile justice system in the prevention of juvenile delinquency.Thus, the results of empirical research presented in the article are important for determining of the psychological bases of realization of rehabilitation programs in the context of juvenile justice. In particular, the results are important for the organization and conduct of psychological work to overcome the psychological barriers in the behavior of juveniles having inherently maladaptive guilt and destructive psychological defense mechanisms.

  1. Changes in Juvenile Justice in China.

    Science.gov (United States)

    Wong, Dennis S. W.

    2001-01-01

    Discusses rising juvenile and youth crime in China, highlighting the essence of Chinese Marxist criminological thought and changing conceptions of delinquency from the postrevolutionary period to the present; examining official responses to delinquency and the recent development of juvenile justice; and suggesting that current delinquency control…

  2. Juvenile Anorexia Nervosa: Family Therapy's Natural Niche

    Science.gov (United States)

    Fishman, H. Charles

    2006-01-01

    Juvenile Anorexia Nervosa (AN) is a severe problem both in terms of presenting symptomatology and its tendency toward chronicity. Researchers have consistently shown that family-based approaches are superior to individual approaches for the treatment of juvenile AN. This article addresses the capacity deficit of trained family therapists to treat…

  3. Sexually dimorphic body plumage in juvenile crossbills

    NARCIS (Netherlands)

    Edelaar, P; Phillips, RE; Knops, P

    2005-01-01

    Sexual dimorphism in color and pattern of contour feathers is rare in juvenile songbirds. We describe how captive-bred juvenile males of Scottish Crossbill (Loxia scotica) and nominate Red Crossbill (L. curvirostra curvirostra) can be differentiated from females prior to prebasic molt by an unstreak

  4. Juveniles' Motivations for Remaining in Prostitution

    Science.gov (United States)

    Hwang, Shu-Ling; Bedford, Olwen

    2004-01-01

    Qualitative data from in-depth interviews were collected in 1990-1991, 1992, and 2000 with 49 prostituted juveniles remanded to two rehabilitation centers in Taiwan. These data are analyzed to explore Taiwanese prostituted juveniles' feelings about themselves and their work, their motivations for remaining in prostitution, and their difficulties…

  5. Alternative sanctions for juveniles in the Netherlands

    NARCIS (Netherlands)

    Laan, P.H. van der

    1993-01-01

    In the Netherlands alternative sanctions for juveniles have become very popular. In less than ten years, the alternative sanction has surpassed the fine as the most frequently imposed penal sanction for juveniles. As a result of this popularity, some net widening has occured. In general, alternativl

  6. Psychiatric Disorder in a Juvenile Assessment Center

    Science.gov (United States)

    McReynolds, Larkin S.; Wasserman, Gail A.; DeComo, Robert E.; John, Reni; Keating, Joseph M.; Nolen, Scott

    2008-01-01

    Juvenile assessment centers (JACs) were developed to address service fragmentation and promote the sharing of information among agencies providing services to youth involved with the juvenile justice system. To date, there are no reports that describe the diagnostic profiles of the youth served by such centers. The authors hypothesize that the…

  7. Moral Development of Solo Juvenile Sex Offenders

    Science.gov (United States)

    Van Vugt, Eveline; Stams, Geert Jan; Dekovic, Maja; Brugman, Daan; Rutten, Esther; Hendriks, Jan

    2008-01-01

    This study compared the moral development of solo juvenile male sex offenders (n = 20) and juvenile male non-offenders (n = 76), aged 13-19 years, from lower socioeconomic and educational backgrounds. The Moral Orientation Measure (MOM) was used to assess punishment- and victim-based moral orientation in sexual and non-sexual situations. Moral…

  8. Juveniles' Motivations for Remaining in Prostitution

    Science.gov (United States)

    Hwang, Shu-Ling; Bedford, Olwen

    2004-01-01

    Qualitative data from in-depth interviews were collected in 1990-1991, 1992, and 2000 with 49 prostituted juveniles remanded to two rehabilitation centers in Taiwan. These data are analyzed to explore Taiwanese prostituted juveniles' feelings about themselves and their work, their motivations for remaining in prostitution, and their difficulties…

  9. Ethnic disparities in Dutch juvenile justice

    NARCIS (Netherlands)

    Komen, M.; van Schooten, E.

    2009-01-01

    In the Netherlands, ethnic minority boys are heavily overrepresented in prisons and secure judicial institutions for juveniles. In a sample of 324 juveniles of both native Dutch and ethnic minority origin who have come into contact with the Dutch criminal justice authorities, we compared the number

  10. Group sexual offending by juvenile females

    NARCIS (Netherlands)

    Wijkman, M.; Weerman, F.; Bijleveld, C.; Hendriks, J.

    2015-01-01

    This study examined all group sexual offending cases in the Netherlands between 1995 and 2009 (n = 26) in which at least one juvenile female offender (n = 35) had been adjudicated. Information from court files showed that the majority of juvenile female group sexual offenders have (inter)personal pr

  11. A social work study on juvenile delinquency

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Iravani

    2012-08-01

    Full Text Available We present an empirical study to study the effects of different factors on juvenile delinquency. The investigation distributes 100 questionnaires among people who are involved with crime and analyzes their feedbacks. There are five hypotheses in our survey and we look to see whether family conditions, religion, economical conditions, media and physical and psychological characteristics play important role on juvenile delinquency in Iranian society. The results shows that while family conditions, physical and psychological characteristics play important role on juvenile delinquency, other factors do not statistically have any impact on juvenile delinquency. The study suggests that a better family condition could help reduce juvenile delinquency and people could guide their children through better consultations.

  12. Family transitions and juvenile delinquency.

    Science.gov (United States)

    Schroeder, Ryan D; Osgood, Aurea K; Oghia, Michael J

    2010-01-01

    There is a large body of research that shows children from non-intact homes show higher rates of juvenile delinquency than children from intact homes, partially due to weaker parental control and supervision in non-intact homes. What has not been adequately addressed in the research is the influence of changes in family structure among individual adolescents over time on delinquent offending. Using the first and third waves of the National Youth Study, we assess the effect of family structure changes on changes in delinquent offending between waves through the intermediate process of changes in family time and parental attachment. Although prior research has documented adolescents in broken homes are more delinquent than youth in intact homes, the process of family dissolution is not associated with concurrent increases in offending. In contrast, family formation through marriage or cohabitation is associated with simultaneous increases in offending. Changes in family time and parental attachment account for a portion of the family formation effect on delinquency, and prior parental attachment and juvenile offending significantly condition the effect of family formation on offending.

  13. Atherosclerosis in Juvenile Idiopathic Arthritis

    Directory of Open Access Journals (Sweden)

    Ewa Jednacz

    2012-01-01

    Full Text Available Atherosclerosis is a chronic inflammatory disease of the arteries. Clinical consequences of the atherosclerotic process occur in the adult population, however atherosclerotic process begins in childhood. The classic risk factors for atherosclerosis include obesity, dyslipidaemia, age, gender or family history. In recent years, attention has been drawn to the similarity between atherosclerotic inflammatory processes and inflammatory changes in the course of systemic connective tissue disease, in particular systemic lupus etythematosus (SLE or rheumatoid arthritis (RA. There is also observed the similarity of the pathogenetic background of development of atherosclerosis and juvenile idiopathic arthritis (JIA. Elevated levels of pro-inflammatory cytokines are observed in the course of juvenile idiopathic arthritis. Also homocysteine concentrations, which may play a significant role in the development of atherosclerotic lesions, are observed higher in patients with JIA. Some studies revealed higher carotid intima-media thickness (IMT index values in children with JIA. In view of the fact that atherosclerotic process begins as early as in childhood, the introduction of appropriate preventive measures in children is a matter of utmost importance.

  14. Efficacy of intra-articular hyaluronan (Synvisc® for the treatment of osteoarthritis affecting the first metatarsophalangeal joint of the foot (hallux limitus: study protocol for a randomised placebo controlled trial

    Directory of Open Access Journals (Sweden)

    Landorf Karl B

    2009-01-01

    Full Text Available Abstract Background Osteoarthritis of the first metatarsophalangeal joint (MPJ of the foot, termed hallux limitus, is common and painful. Numerous non-surgical interventions have been proposed for this disorder, however there is limited evidence for their efficacy. Intra-articular injections of hyaluronan have shown beneficial effects in case-series and clinical trials for the treatment of osteoarthritis of the first metatarsophalangeal joint. However, no study has evaluated the efficacy of this form of treatment using a randomised placebo controlled trial. This article describes the design of a randomised placebo controlled trial to evaluate the efficacy of intra-articular hyaluronan (Synvisc® to reduce pain and improve function in people with hallux limitus. Methods One hundred and fifty community-dwelling men and women aged 18 years and over with hallux limitus (who satisfy inclusion and exclusion criteria will be recruited. Participants will be randomised, using a computer-generated random number sequence, to receive a single intra-articular injection of up to 1 ml hyaluronan (Synvisc® or sterile saline (placebo into the first MPJ. The injections will be performed by an interventional radiologist using fluoroscopy to ensure accurate deposition of the hyaluronan in the joint. Participants will be given the option of a second and final intra-articular injection (of Synvisc® or sterile saline according to the treatment group they are in either 1 or 3 months post-treatment if there is no improvement in pain and the participant has not experienced severe adverse effects after the first injection. The primary outcome measures will be the pain and function subscales of the Foot Health Status Questionnaire. The secondary outcome measures will be pain at the first MPJ (during walking and at rest, stiffness at the first MPJ, passive non-weightbearing dorsiflexion of the first MPJ, plantar flexion strength of the toe-flexors of the hallux, global

  15. Profile of Incarcerated Juveniles: Comparison of Male and Female Offenders

    Science.gov (United States)

    Martin, Don; Martin, Magy; Dell, Rex; Davis, Candice; Guerrieri, Karen

    2008-01-01

    Effective methods of identifying potential juvenile offenders are critical when developing prevention programs within both state and national juvenile justice systems. The characteristics of juvenile offenders in a large juvenile justice system are examined in this study. Participants live in a Midwestern city with a high rate of crime as…

  16. 8 CFR 1236.3 - Detention and release of juveniles.

    Science.gov (United States)

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Detention and release of juveniles. 1236.3... ORDERED REMOVED Detention of Aliens Prior to Order of Removal § 1236.3 Detention and release of juveniles. (a) Juveniles. A juvenile is defined as an alien under the age of 18 years. (b) Release....

  17. Saagu valgus / Karin Tarto

    Index Scriptorium Estoniae

    Paulus, Karin, 1975-

    1998-01-01

    Eesti valgustikujundajatest ja valgustitest. Kas eesti disaineritel on õnnestunud leida oma nišš lambiletil. Tootjatest : OÜ "Raunto", AS "Titanus" (disaineriks Eestis elav rootslane Renni Par)-, Norrast pärineva kontserni "Glamox" tehasest Keilas, "Estoplastist" (disainerid Martin Pärn, Raido Laasing), AS "Steel Line". Valgustikujundajatest Tarmo Luisust, Aleksander Jakovlevist, Raivo Pristolist, Mait Summatavetist, Tõnis Vellamast

  18. Saagu valgus / Karin Tarto

    Index Scriptorium Estoniae

    Paulus, Karin, 1975-

    1998-01-01

    Eesti valgustikujundajatest ja valgustitest. Kas eesti disaineritel on õnnestunud leida oma nišš lambiletil. Tootjatest : OÜ "Raunto", AS "Titanus" (disaineriks Eestis elav rootslane Renni Par)-, Norrast pärineva kontserni "Glamox" tehasest Keilas, "Estoplastist" (disainerid Martin Pärn, Raido Laasing), AS "Steel Line". Valgustikujundajatest Tarmo Luisust, Aleksander Jakovlevist, Raivo Pristolist, Mait Summatavetist, Tõnis Vellamast

  19. Habitat associations of juvenile versus adult butterflyfishes

    Science.gov (United States)

    Pratchett, M. S.; Berumen, M. L.; Marnane, M. J.; Eagle, J. V.; Pratchett, D. J.

    2008-09-01

    Many coral reef fishes exhibit distinct ontogenetic shifts in habitat use while some species settle directly in adult habitats, but there is not any general explanation to account for these differences in settlement strategies among coral reef fishes. This study compared distribution patterns and habitat associations of juvenile (young of the year) butterflyfishes to those of adult conspecifics. Three species, Chaetodon auriga, Chaetodon melannotus, and Chaetodon vagabundus, all of which have limited reliance on coral for food, exhibited marked differences in habitat association of juvenile versus adult individuals. Juveniles of these species were consistently found in shallow-water habitats, whereas adult conspecifics were widely distributed throughout a range of habitats. Juveniles of seven other species ( Chaetodon aureofasciatus, Chaetodon baronessa, Chaetodon citrinellus, Chaetodon lunulatus, Chaetodon plebeius, Chaetodon rainfordi, and Chaetodon trifascialis), all of which feed predominantly on live corals, settled directly into habitat occupied by adult conspecifics. Butterflyfishes with strong reliance on corals appear to be constrained to settle in habitats that provide access to essential prey resources, precluding their use of distinct juvenile habitats. More generalist butterflyfishes, however, appear to utilize distinct juvenile habitats and exhibit marked differences in the distribution of juveniles versus adults.

  20. Juvenile psammomatoid ossifying fibroma. Case report

    Directory of Open Access Journals (Sweden)

    Konstantinos VAHTSEVANOS

    2012-08-01

    Full Text Available Ossifying fibroma (OS represents a slow growing, benign neoplasm that belongs to the greater group of fibro-osseous lesions. Based on its histological features, ossifying fibroma is divided into: a juvenile trabecular OS and b juvenile psammomatoid OS which affects mainly the paranasal sinuses of children and teenagers aging from 5 to 15 years.A rare case of juvenile psammomatoid ossifying fibroma in a 30 year old male patient located in the left mandibular ramus is presented. Treatment plan included radical surgical excision of the lesion and restoration with autologous osteochondral graft from the 6th rib of the ipsilateral side.

  1. Juvenile eye growth, when completed?

    DEFF Research Database (Denmark)

    Fledelius, Hans C; Christensen, Anders S; Fledelius, Christian

    2014-01-01

    PURPOSE: To test Sorsby's classical statement of axial eye growth as completed at the age of 13 years, with a view also to differentiating between basic eye growth and juvenile elongation associated with eventual refractive change towards myopia. METHODS: (i) A total of 160 healthy eyes close...... was preferred for conventional ultrasound oculometry due to its extreme repeatability of measuring values, thus making it well fitted for evaluating very small differences. In particular, this had bearing for the decelerating end phase of growth in the longitudinal investigation. RESULTS: Sorby's statement...... about age 13 as general limit found support from the cross-sectional data, which suggested stable emmetropic eye size from about 11-12 years, with an average apparently outgrown male emmetropic value of 23.5 mm versus females' 22.9 mm. The longitudinal data, however, showed emmetropic growth also beyond...

  2. SUBTYPES OF JUVENILE SYSTEMIC SCLERODERMA

    Directory of Open Access Journals (Sweden)

    M N Slarovoitova

    2001-01-01

    Full Text Available Aim: to allot clinical forms of juvenile systemic scleroderma (JSSD. Material and methods: investigation and dynamic observation of 60 patients aged 14-54 (mean age 25.1 ±7.2 with onset of disease in child's and adolescent’s ages from 1 to 16 years old ( in average 11. 4±3.8 year old and disease duration from 1 to 39 years (in average 13.1 ±7.9. Results: 55% of patients demonstrated JSSD subtype with focal cutaneous lesion of different localization. The possibility of overlap-syndrome development in JSSD patients with onset in adolescent age typical for SSD-rheumatoid arthritis, SSD-polymvositis should be underlined. Conclusion: knowledge of different clinical forms and courses of the disease, modern diagnostics and early beginning of differential JSSD treatment will enable us to improve the prognosis and disease outcome.

  3. Juvenile Huntington disease in Argentina.

    Science.gov (United States)

    Gatto, Emilia Mabel; Parisi, Virginia; Etcheverry, José Luis; Sanguinetti, Ana; Cordi, Lorena; Binelli, Adrian; Persi, Gabriel; Squitieri, Ferdinando

    2016-01-01

    We analyzed demographic, clinical and genetic characteristics of juvenile Huntington disease (JHD) and it frequency in an Argentinean cohort. Age at onset was defined as the age at which behavioral, cognitive, psychiatric or motor abnormalities suggestive of JHD were first reported. Clinical and genetic data were similar to other international series, however, in this context we identified the highest JHD frequency reported so far (19.72%; 14/71). Age at onset of JHD is challenging and still under discussion. Our findings reinforce the hypothesis that clinical manifestations, other than the typical movement disorder, may anticipate age at onset of even many years. Analyses of JHD cohorts are required to explore it frequency in populations with different backgrounds to avoid an underestimation of this rare phenotype. Moreover, data from selected populations may open new pathways in therapeutic approaches and may explain new potential correlations between HD presentations and environmental or biological factors.

  4. [Physiotherapy for juvenile idiopathic arthritis].

    Science.gov (United States)

    Spamer, M; Georgi, M; Häfner, R; Händel, H; König, M; Haas, J-P

    2012-07-01

    Control of disease activity and recovery of function are major issues in the treatment of children and adolescents suffering from juvenile idiopathic arthritis (JIA). Functional therapies including physiotherapy are important components in the multidisciplinary teamwork and each phase of the disease requires different strategies. While in the active phase of the disease pain alleviation is the main focus, the inactive phase requires strategies for improving motility and function. During remission the aim is to regain general fitness by sports activities. These phase adapted strategies must be individually designed and usually require a combination of different measures including physiotherapy, occupational therapy, massage as well as other physical procedures and sport therapy. There are only few controlled studies investigating the effectiveness of physical therapies in JIA and many strategies are derived from long-standing experience. New results from physiology and sport sciences have contributed to the development in recent years. This report summarizes the basics and main strategies of physical therapy in JIA.

  5. Juvenile prison: Remarks on the specific characteristics of regular sentencing

    OpenAIRE

    Miladinović-Stefanović, Dušica

    2015-01-01

    The system of the juvenile criminal law in the Republic of Serbia includes different mechanisms of social response to juvenile delinquency, including corrective orders, corrective measures and juvenile prison. This paper deals with the issue of determining a relevant sentence for juvenile offenders in trial proceedings. The legislator has provided a number of guidelines for these proceedings: the specific range of the juvenile prison sentence, the purpose of punishment, the degree of maturity...

  6. Parenting Styles and Family Communication as Correlates of Juvenile Delinquency

    OpenAIRE

    1997-01-01

    The goal of this study was to examine parenting styles and family communication as correlates of juvenile delinquency. A review of the literature was completed in the areas of parenting styles, family communication, and juvenile delinquency. The literature that was reviewed for this study was examined mainly from juvenile perceptions. This study was approached from a general systems theory perspective. A sample of juveniles (N = 78) from Weber County, Utah, involved in the juvenile justice...

  7. Are antipredator behaviours of hatchery Salmo salar juveniles similar to wild juveniles?

    Science.gov (United States)

    Salvanes, A G V

    2017-01-27

    This study explores how antipredator behaviour of juvenile Atlantic salmon Salmo salar developed during conventional hatchery rearing of eggs from wild brood stock, compared with the behaviour of wild-caught juveniles from the same population. Juveniles aged 1+ years were tested in two unfamiliar environments; in one S. salar were presented with simulated predator attacks and in the other they were given the opportunity to explore an open-field arena. No difference was found in their spontaneous escape responses or ventilation rate (reflex responses) after simulated predator attacks. Hatchery-reared juveniles were more risk-prone in their behaviours than wild-caught individuals. Hatchery juveniles stayed less time in association with shelter. In the open-field arena, hatchery juveniles were more active than wild juveniles. Hatchery juveniles were also immobile for less time and spent a shorter amount of time than wild juveniles in the fringe of the open-field arena. Salmo salar size had no effect on the observed behaviour. Overall, this study provides empirical evidence that one generation of hatchery rearing does not change reflex responses associated with threats, whereas antipredator behaviour, typically associated with prior experience, was less developed in hatchery-reared than in wild individuals.

  8. Conceptualizing juvenile prostitution as child maltreatment: findings from the National Juvenile Prostitution Study.

    Science.gov (United States)

    Mitchell, Kimberly J; Finkelhor, David; Wolak, Janis

    2010-02-01

    Two studies were conducted to identify the incidence (Study 1) and characteristics (Study 2) of juvenile prostitution cases known to law enforcement agencies in the United States. Study 1 revealed a national estimate of 1,450 arrests or detentions (95% confidence interval [CI]: 1,287-1,614) in cases involving juvenile prostitution during a 1-year period. In Study 2, exploratory data were collected from a subsample of 138 cases from police records in 2005. The cases are broadly categorized into three main types: (a) third-party exploiters, (b) solo prostitution, and (c) conventional child sexual abuse (CSA) with payment. Cases were classified into three initial categories based on police orientation toward the juvenile: (a) juveniles as victims (53%), (b) juveniles as delinquents (31%), and (c) juvenile as both victims and delinquents (16%). When examining the status of the juveniles by case type, the authors found that all the juveniles in CSA with payment cases were treated as victims, 66% in third-party exploiters cases, and 11% in solo cases. Findings indicate law enforcement responses to juvenile prostitution are influential in determining whether such youth are viewed as victims of commercial sexual exploitation or as delinquents.

  9. The role of foot morphology on foot function in diabetic subjects with or without neuropathy.

    Science.gov (United States)

    Guiotto, Annamaria; Sawacha, Zimi; Guarneri, Gabriella; Cristoferi, Giuseppe; Avogaro, Angelo; Cobelli, Claudio

    2013-04-01

    The aim of this study was to investigate the role of foot morphology, related with respect to diabetes and peripheral neuropathy in altering foot kinematics and plantar pressure during gait. Healthy and diabetic subjects with or without neuropathy with different foot types were analyzed. Three dimensional multisegment foot kinematics and plantar pressures were assessed on 120 feet: 40 feet (24 cavus, 20 with valgus heel and 11 with hallux valgus) in the control group, 80 feet in the diabetic (25 cavus 13 with valgus heel and 13 with hallux valgus) and the neuropathic groups (28 cavus, 24 with valgus heel and 18 with hallux valgus). Subjects were classified according to their foot morphology allowing further comparisons among the subgroups with the same foot morphology. When comparing neuropathic subjects with cavus foot, valgus heel with controls with the same foot morphology, important differences were noticed: increased dorsiflexion and peak plantar pressure on the forefoot (Pfoot morphology in altering both kinematics and plantar pressure in diabetic subjects, diabetes appeared to further contribute in altering foot biomechanics. Surprisingly, all the diabetic subjects with normal foot arch or with valgus hallux were no more likely to display significant differences in biomechanics parameters than controls. This data could be considered a valuable support for future research on diabetic foot function, and in planning preventive interventions.

  10. Juvenile myoclonic epilepsy Epilepsia mioclônica juvenil

    Directory of Open Access Journals (Sweden)

    Isabel Alfradique

    2007-12-01

    Full Text Available Juvenile myoclonus epilepsy (JME is a common epileptic syndrome, the etiology of which is genetically determined. Its onset occurs from 6 through 22 years of age, and affected patients present with myoclonic jerks, often associated with generalized tonic-clonic seizures - the most common association - and absence seizures. JME is non-progressive, and there are no abnormalities on clinical examination or intellectual deficits. Psychiatric disorders may coexist. Generalized polyspike-and-waves are the most characteristic electroencephalographic pattern. Usual neuroimaging studies show no abnormalities. Atypical presentations should be entertained, as they are likely to induce misdiagnosis. Prevention of precipitating factors and therapy with valproic acid (VPA are able to control seizures in the great majority of patients. Whenever VPA is judged to be inappropriate, other antiepileptic drugs such as lamotrigine may be considered. Treatment should not be withdrawn, otherwise recurrences are frequent.A epilepsia mioclônica juvenil é uma síndrome epiléptica comum, cuja etiologia é fundamentada na genética. Inicia-se entre 6 e 22 anos e os indivíduos apresentam mioclonias, que podem ser acompanhadas por crises tônico-clônicas generalizadas - associação mais comum - e crises de ausência. A doença não é progressiva, e não há alterações detectáveis no exame físico ou déficits intelectuais. Distúrbios psiquiátricos podem coexistir. Polipontas-ondas lentas generalizadas constituem o padrão eletrencefalográfico ictal típico. Não há anormalidades em exames de imagem convencionais. Apresentações atípicas devem ser consideradas, pois predispõem a erros de diagnóstico. A prevenção de fatores desencadeantes e o uso de ácido valpróico (VPA controlam as crises epilépticas na grande maioria dos casos. Quando o VPA é inapropriado, outras drogas como a lamotrigina podem ser utilizadas. O tratamento não deve ser interrompido

  11. Juvenile idiopathic arthritis and the temporomandibular joint ...

    African Journals Online (AJOL)

    ... resonance imaging findings of temporomandibular joint inflammation among juvenile ... The mean total MRI score was significantly higher in patients with active ... Clinical signs of TMJ arthritis can be used as filter for MRI examination TMJ is ...

  12. Bilateral giant juvenile fibroadenoma of breasts

    Directory of Open Access Journals (Sweden)

    Mukhopadhyay Madhumita

    2009-01-01

    Full Text Available An 11-year-old girl with rapidly enlarging bilateral breast lumps is reported. It was diagnosed as a case of juvenile fibroadenoma following fine needle aspiration cytology and confirmed on histopathological examination of the excised specimens.

  13. Genetics Home Reference: juvenile Paget disease

    Science.gov (United States)

    ... Information & Resources MedlinePlus (1 link) Health Topic: Bone Diseases Genetic and Rare Diseases Information Center (1 link) Juvenile ... on PubMed Daroszewska A, Ralston SH. Mechanisms of disease: genetics of Paget's disease of bone and related disorders. ...

  14. Genetics Home Reference: juvenile hyaline fibromatosis

    Science.gov (United States)

    ... Antaya RJ, Cajaiba MM, Madri J, Lopez MA, Ramirez MC, Martignetti JA, Reyes-Múgica M. Juvenile hyaline ... 103. Citation on PubMed Dowling O, Difeo A, Ramirez MC, Tukel T, Narla G, Bonafe L, Kayserili ...

  15. Acute Lymphoblastic Leukaemia presenting as Juvenile Idiopathic ...

    African Journals Online (AJOL)

    Acute Lymphoblastic Leukaemia presenting as Juvenile Idiopathic Arthritis in a Nigerian boy. ... lead to delay in commencing appropriate treatment. ... of two months duration, had an elevated Rheumatoid factor and X-ray findings suggestive of ...

  16. Screening Incarcerated Juveniles Using the MAYSI-2.

    Science.gov (United States)

    Gilbert, Amy L; Grande, Todd L; Hallman, Janelle; Underwood, Lee A

    2015-01-01

    The high prevalence of mental health disorders among incarcerated juveniles is a matter of national and global concern. Juvenile justice personnel need accurate screening measures that identify youth requiring immediate mental health services. The purpose of this study was threefold: (a) to examine the utility of the Massachusetts Youth Screening Instrument, Version 2 (MAYSI-2) in identifying juveniles with mental health concerns in a large sample of juveniles (N = 4,009), (b) to provide data regarding rates of identified mental health needs in incarcerated youth, and (c) to provide descriptive comparisons to other studies using the MAYSI-2. Mean scores of subscales were compared with the MAYSI-2 normative samples and other recent studies. Results indicated that this population has a high occurrence of mental health symptoms and there is high variability in the severity of the symptoms. In addition, a multivariate analysis of variance test found significant differences in mental health problems across ethnic groups.

  17. SAB Juvenile Reef Fish (2002-2015)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Trawls were made during the summer months in shallow seagrass beds to monitor the number and species of juvenile snapper using the grass as a nursery.

  18. AFSC/ABL: Juvenile rockfish habitat utilization

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Juvenile rockfish were observed amongst coral, sponge, cobble, and gravel habitats. Rockfish utilized coral habitats more than any other, while gravel was the least...

  19. Total knee replacement in the fixed valgus deformity using a lateral approach: role of the automatic iliotibial band release for a successful balancing.

    Science.gov (United States)

    Boyer, P; Boublil, D; Magrino, B; Massin, P; Huten, D

    2009-12-01

    The purpose of this work was to document eleven years of experience in knee replacement for fixed knee valgus through a lateral approach with special emphasis on the balancing procedures. At a mean follow-up of seven years, only one revision for sepsis was required in this series of 63 knee replacements. The mean knee score improved from 37 (range 20-45) to 91 (range 65-100) at the last review (p iliotibial band was automatically released in the approach, only four of 63 knees required additional release for tightness in extension. These results underline the appeal of the lateral approach with the automatic release of the iliotibial band. If required, additional ligament release is recommended step-by-step after bone section to avoid postoperative instability.

  20. Differences in the Dominant and Non-Dominant Knee Valgus Angle in Junior Elite and Amateur Soccer Players after Unilateral Landing

    Directory of Open Access Journals (Sweden)

    Oliver Ludwig

    2017-02-01

    Full Text Available More than 70% of all knee injuries in soccer occur in non-contact situations. It is known that increased lower limb dynamic knee valgus is associated with such situations. Little has been found out about differences in knee kinematics of the dominant (kicking and non-dominant (supporting leg during a single leg landing. A total of 114 male adolescent soccer players (age 14.6 ± 1.1 years from elite (N = 66 and amateur soccer clubs (N = 48 performed a single leg drop landing down from a box. For each leg, the two-dimensional dynamic knee valgus angle (DKVA was calculated. Paired t-tests were used to statistically determine significant differences between dominant and non-dominant leg DKVA, and t-tests were calculated between the two performance groups. Statistically significant differences (p < 0.05 were identified for the DKVA between the dominant and non-dominant leg for both amateur and elite players, showing a greater DKVA for the dominant leg. Group differences for the DKVA between amateur and elite players were not found, neither for the dominant, nor for the non-dominant leg. It can be concluded that the non-dominant leg showed more stable dynamics than the dominant leg during unilateral landing regardless of the player’s performance level. This could be due to adaptions to sport-specific requirements. Therefore, it is recommended that programs to prevent knee injuries among soccer players consider the dynamics of each leg individually.

  1. A comparison between metatarsal head-resurfacing hemiarthroplasty and total metatarsophalangeal joint arthroplasty as surgical treatments for hallux rigidus: a retrospective study with short- to midterm follow-up

    Directory of Open Access Journals (Sweden)

    Mermerkaya MU

    2016-12-01

    Full Text Available Musa Ugur Mermerkaya,1 Houman Adli2 1Department of Orthopaedics and Traumatology, Medical School, Bozok University, 2Department of Orthopaedics and Traumatology, Yozgat State Hospital, Yozgat, Turkey Purpose: We evaluated the short- to midterm outcomes of metatarsal head-resurfacing hemiarthroplasty and total metatarsophalangeal joint arthroplasty (total joint replacement [TJR] as surgical treatments for advanced-stage hallux rigidus (HR.Patients and methods: From 2012 to 2014, all data from patients who underwent surgery for the treatment of grades 2–3 HR were retrospectively reviewed, and 45 patients were included in this study. Of these patients, 26 underwent metatarsal head-resurfacing hemiarthroplasty (Group I and 19 underwent TJR (Group II. All patients were clinically graded prior to surgery and at their final follow-up visits using the American Orthopedic Foot and Ankle Society’s (AOFAS hallux metatarsophalangeal–interphalangeal scale, a visual analog scale (VAS, and the “first metatarsophalangeal joint range of motion” (MTPJ ROM score.Results: Metatarsal head resurfacing was performed on 26 patients. Two patients underwent bilateral procedures, yielding a total of 28 cases in Group I. TJR was performed on 19 patients in Group II. Of the 26 Group I patients, 12 (46.2% were male and 14 (53.8% were female, with a mean age of 56.3±4.5 years (range: 47–63 years; the mean follow-up duration was 29.9±5.2 months. Of the 19 Group II patients, eight (42.1% were male and eleven (57.9% were female, with a mean age of 57.1±5.8 years (range: 45–66 years; the mean follow-up duration was 27.1±7.5 months. Significant improvements were evident in the AOFAS scores, and the VAS scores decreased, in both groups. No significant difference was evident between groups I and II.Conclusion: After failure of conservative treatment in patients with moderate-to-severe HR, both MTPJ hemiarthroplasty and TJR were associated with effective

  2. An Empirical Evaluation of Juvenile Awareness Programs in the United States: Can Juveniles Be "Scared Straight"?

    Science.gov (United States)

    Klenowski, Paul M.; Bell, Keith J.; Dodson, Kimberly D.

    2010-01-01

    Juvenile awareness programs like Scared Straight became popular crime prevention strategies during the 1970s. Juvenile offenders and at-risk youth who participate in these programs are taken to prisons where inmates use confrontational methods to recount stories about violence, sex, and abuse perpetrated by fellow inmates while living a life…

  3. Juvenile fibromyalgia: Guidance for management.

    Science.gov (United States)

    Yokota, Shumpei; Kikuchi, Masako; Miyamae, Takako

    2013-08-01

    Juvenile fibromyalgia (JFM) is a disease in which patients complain of acute and chronic severe pain, an overt primary cause for which cannot be found or surmised. Although patients with JFM mainly complain of systemic pain or allodynia in the medical interview and physical examination, the concept of the disease is the total sum of painful illness, chronic fatigue, hypothermia and many other autonomic symptoms and signs. Many issues are interacting including individual traits (personality, temperament, sensitivity, memory of pain; age: early adolescence), individual states (self-esteem, anxiety, developmental level), and external stressors (parent especially mother, school environment). JFM is diagnosed on the combination of disease history, physical examination to determine the 18 tender points and allodynia, pain from gently touching their hair, and negative results of blood tests (inflammatory markers, thyroid function, myogenic enzymes). The goals of treatment are the following: restoration of function and relief of pain. Psychological support is advocated. Although the exact number of patients with JFM is still to be elucidated, it seems to be growing because pediatric rheumatologists in Japan encounter children with a wide variety of musculoskeletal pains. This guideline describes how to diagnose JFM in children and how to treat them appropriately.

  4. Academic Achievement Among Juvenile Detainees.

    Science.gov (United States)

    Grigorenko, Elena L; Macomber, Donna; Hart, Lesley; Naples, Adam; Chapman, John; Geib, Catherine F; Chart, Hilary; Tan, Mei; Wolhendler, Baruch; Wagner, Richard

    2015-01-01

    The literature has long pointed to heightened frequencies of learning disabilities (LD) within the population of law offenders; however, a systematic appraisal of these observations, careful estimation of these frequencies, and investigation of their correlates and causes have been lacking. Here we present data collected from all youth (1,337 unique admissions, mean age 14.81, 20.3% females) placed in detention in Connecticut (January 1, 2010-July 1, 2011). All youth completed a computerized educational screener designed to test a range of performance in reading (word and text levels) and mathematics. A subsample (n = 410) received the Wide Range Achievement Test, in addition to the educational screener. Quantitative (scale-based) and qualitative (grade-equivalence-based) indicators were then analyzed for both assessments. Results established the range of LD in this sample from 13% to 40%, averaging 24.9%. This work provides a systematic exploration of the type and severity of word and text reading and mathematics skill deficiencies among juvenile detainees and builds the foundation for subsequent efforts that may link these deficiencies to both more formal, structured, and variable definitions and classifications of LD, and to other types of disabilities (e.g., intellectual disability) and developmental disorders (e.g., ADHD) that need to be conducted in future research.

  5. Pendidikan Agama Islam Sebagai Pencegah Juvenile Delinquency

    Directory of Open Access Journals (Sweden)

    Yuli Choirul Umah

    2016-09-01

    Full Text Available The challenges of Islamic education in the era of globalization are getting stronger now. It’s visible clearly changes happening so fast. The rapid of globalization is not only affect for adults, but also children, adolescents. A problem that often arises in the community revolves around the problems of Juvenile (teenagers, education and social community. Because adolescence is known as self-identity searching, so teens that can fulfill their role will have a positive impact, such as children understand their responsibilities better, and if they cannot, then there will emerge the exact opposite behavior that occurs an aberration or delinquency (juvenile delinquency. The existence of juvenile delinquency at this time also affect increasing in crime or criminal behavior in community. Juvenile delinquency can destroy moral values, the noble values ​​of religion, and the various aspects of the subject matter contained therein. Understanding, deepening, and adherence to the teachings of religion, especially Islamic education is required by the juvenile. Because Islamic education is a systematic effort by educators and adults to students both physical and spiritual by Islamic law to led the formation of personality according to the standard of Islam. Because in fact the children or adolescents who commit delinquency or crime mostly less understand the norms of Islam, perhaps they are negligent in fulfill the commandments of religion.

  6. PENDIDIKAN AGAMA ISLAM SEBAGAI PENCEGAH JUVENILE DELINQUENCY

    Directory of Open Access Journals (Sweden)

    Yuli Choirul Umah

    2016-09-01

    Full Text Available The challenges of Islamic education in the era of globalization are getting stronger now. It’s visible clearly changes happening so fast. The rapid of globalization is not only affect for adults, but also children, adolescents. A problem that often arises in the community revolves around the problems of Juvenile (teenagers, education and social community. Because adolescence is known as self-identity searching, so teens that can fulfill their role will have a positive impact, such as children understand their responsibilities better, and if they cannot, then there will emerge the exact opposite behavior that occurs an aberration or delinquency (juvenile delinquency. The existence of juvenile delinquency at this time also affect increasing in crime or criminal behavior in community. Juvenile delinquency can destroy moral values, the noble values of religion, and the various aspects of the subject matter contained therein. Understanding, deepening, and adherence to the teachings of religion, especially Islamic education is required by the juvenile. Because Islamic education is a systematic effort by educators and adults to students both physical and spiritual by Islamic law to led the formation of personality according to the standard of Islam. Because in fact the children or adolescents who commit delinquency or crime mostly less understand the norms of Islam, perhaps they are negligent in fulfill the commandments of religion.

  7. Psychiatric and Medical Health Care Policies in Juvenile Detention Facilities

    Science.gov (United States)

    Pajer, Kathleen A.; Kelleher, Kelly; Gupta, Ravindra A.; Rolls, Jennifer; Gardner, William

    2007-01-01

    A study aims to examine the existing health care policies in U.S. juvenile detention centres. The results conclude that juvenile detention facilities have many shortfalls in providing care for adolescents, particularly mental health care.

  8. AFSC/ABL: Juvenile rockfish DNA species identification

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Many pelagic juvenile rockfish (Sebastes) were collected in juvenile salmonid surveys in the Gulf of Alaska (GOA) from 1998 to 2002. Often species identification of...

  9. A case report of juvenile Huntington disease

    Directory of Open Access Journals (Sweden)

    Anita Choudhary

    2017-09-01

    Full Text Available Huntington disease (HD is a progressive neurodegenerative disorder, characterized by autosomal dominant inheritance, movement disorder, dementia, and behavioural disturbances. It is caused by a mutation in IT15 gene on chromosome 4p16.3, which leads to unstable CAG trinucleotide repeat expansion. The onset of juvenile HD occurs before the 2nd decade of life and comprises approximately 10% of total HD patients. Juvenile HD differs in symptomatology and is usually transmitted from paternal side with genetic anticipation phenomenon. Magnetic resonance imaging (MRI of the brain shows specific changes of early affection of caudate nucleus and putamen. Multidisciplinary approach with symptomatic treatment of specific symptoms is the current available management. Gene editing and gene silencing treatment are under trial. Hereby, we introduce a case of an 8-year-old boy, who presented with typical symptoms of juvenile HD, positive family history with genetic anticipation phenomenon and characteristic MRI findings.

  10. Corporal and capital punishment of juveniles.

    Science.gov (United States)

    Frazier, H C

    1990-01-01

    There is a previously unobserved connection between corporal punishment of public school children and capital punishment of juveniles. Both are barometers of acceptable levels of violent punishment and their elimination is a hallmark of a maturing and decent society. Within a majority of the eighteen states where school authorities most frequently strike children are housed 25 of the nation's 28 juvenile death row inmates. On average, the homicide rates of these jurisdictions are two and a half times greater than those that have abolished both state-sanctioned corporal and capital punishment or limit death sentences to those age eighteen and older at the time of their crime(s). Most of the eighteen state abolitions of corporal punishment occurred in the 1980's. The US Supreme Court has ruled both corporal and capital punishment of juveniles constitutional. Additional state legislative abolition of both is anticipated in the 1990s.

  11. Delincuencia y responsabilidad penal juvenil en Colombia

    Directory of Open Access Journals (Sweden)

    Cristina Montalvo Velásquez

    2011-01-01

    Full Text Available ResumenEl término «delincuencia juvenil» fue acuñado en Inglaterra en el año 1815, “Se entiende por delincuencia juvenil el conjunto de delitos, contravenciones o comportamientos socialmente reprochables, que cometen las personas consideradas como jóvenes por la ley”1 . Cada Estado está sujeto a su propio sistema jurídico, para algunos es delincuente juvenil el adolescente que comete acciones sancionadas por la ley sin importar su gravedad, otros Estados sólo consideran como delincuente juvenil al joven que comete un acto delictivo grave.El fenómeno de la delincuencia juvenil es algo que se inscribe en los espacios de una sociedad en la cual su estructura material, y su formación social consecuente, se halla en una profunda crisis. Que jóvenes conformen bandas de delincuencia organizada nos está indicando que son el resultado de la misma criminalidad general que se ha apoderado de la sociedad en la perspectiva de lograr sobrevivir materialmente. El capitalismo no es sólo acumulación de riqueza sino concentración de la misma en muy pocas manos; y todo el sistema institucional y legal tiende a favorecer ese fenómeno porque éste constituye la supra estructura del modo de producción capitalista. Así como los adultos se organizan para delinquir, lo hacen los niños y los jóvenes a partir de una edad en la cual pueden percibir que la sociedad no es sana y no tienen porvenir humano en ella. Abandonados y sujetos a la violencia que engendra el sistema, ellos simplemente responden en una manifestación de reflejos condicionados que sostienen la sobrevivencia en forma instintiva; “los niños no saben de normas legales sino de formas de sobrevivir a semejante situación; el instinto de sobrevivencia no tiene edades ni la normatividad puede incidir en él”.Palabras ClavesDelincuencia juvenil, Jóvenes, Criminalidad, Familia, Factores, Acto delictivo, Responsabilidad Penal.AbstractThe term “juvenile delinquency” was coined in

  12. Immunization Coverage Among Juvenile Justice Detainees.

    Science.gov (United States)

    Gaskin, Gregory L; Glanz, Jason M; Binswanger, Ingrid A; Anoshiravani, Arash

    2015-07-01

    This study sought to (1) quantify the baseline immunization coverage of adolescents entering the juvenile justice system and (2) assess the effect of detention-based care on immunization coverage in youth. A cross-sectional retrospective chart review was performed of 279 adolescents detained at a large juvenile detention facility. Only 3% of adolescents had received all study immunizations prior to detention. Before detention, immunization coverage was significantly lower than that for the general adolescent population for all vaccines except the first doses of hepatitis A and varicella-zoster virus vaccines. Subsequent to detention, most individual immunization coverage levels increased and were significantly higher than in the general adolescent population. The routine administration of immunizations in the juvenile justice setting can help detained youth achieve levels of immunization coverage similar to their nondetained peers.

  13. Effect of TBT on Ruditapes decussatus juveniles.

    Science.gov (United States)

    Coelho, M R; Langston, W J; Bebianno, M J

    2006-06-01

    The effects of sublethal concentrations of tributyltin (TBT) on growth of juvenile clams Ruditapes decussatus were determined during exposure to TBT concentrations of 50, 100 and 250 ng l(-1) (as Sn) for a period up to two years. Length and weight of clams increased continuously in all treatments throughout the experimental period, and, overall, rates were not significantly influenced by TBT exposure, although final length and weight were inversely related to increasing TBT concentration. Juvenile R. decussatus therefore appear to be less sensitive to TBT than larval stages. Some juveniles exposed to TBT developed abnormal shell growth, laterally, changing the typical flattened shape of clams into a more "rounded" form. This characteristic was more visible in the anterior margins of valves than posteriorly, and mainly observed in clams exposed to TBT at 50 ng l(-1) (as Sn).

  14. Juvenile Fibromyalgia: A Multidisciplinary Approach to Treatment.

    Science.gov (United States)

    Tesher, Melissa S

    2015-06-01

    A 14-year-old boy presented with months of severe widespread musculoskeletal pain. He was profoundly fatigued and unable to attend school. Laboratory evaluation, including complete blood count, comprehensive metabolic panel, inflammatory markers, and thyroid function, was unrevealing. Physical examination was also normal except for multiple tender points. The patient was diagnosed with juvenile primary fibromyalgia syndrome and referred for multidisciplinary treatment including physical therapy, exercise, and counseling, and his daily functioning gradually improves. Juvenile fibromyalgia is a complex syndrome that often severely limits patients' activities and can impede normal adolescent development. Effective treatment requires an understanding of the biologic, psychologic, and social factors contributing to the perpetuation of chronic pain. The author reviews the diagnostic criteria, pathophysiology, and treatment of juvenile fibromyalgia. Medications, particularly antidepressants and anticonvulsants, can be useful adjuncts to therapy. However, multimodal pain management including intensive physical therapy, exercise, counseling, and sleep hygiene is most effective in treating fibromyalgia.

  15. Osteotomia valgizante para pseudartrose do colo do fêmur: relato de 32 casos Valgusing intertrochanteric osteotomy for the treatment of femoral neck non-unions: report of 32 cases

    Directory of Open Access Journals (Sweden)

    Carlos Roberto Schwartsmann

    2009-04-01

    Full Text Available OBJETIVO: Avaliar a consolidação pós-osteotomia osteotomia valgizante do fêmur no tratamento do pseudartrose do colo femoral. MÉTODO: Durante 15 anos (1988-2003, 32 casos de pseudartrose do colo do fêmur foram tratados com osteotomia valgizante e fixação. O seguimento médio dos casos foi de 9,8 anos e a média de idade dos pacientes foi de 41,7 anos. RESULTADOS: Dos 32 casos quatro evoluíram para prótese total do quadril e 28 evoluíram para consolidação (87,4%. Oito casos evoluíram necrose parcial. CONCLUSÃO: A osteotomia valgizante é altamente eficaz para obtenção da consolidação na pseudartrose do colo do fêmur 87,4% (28/32 A recuperação integral da função do quadril só foi obtida em 56,2% (18/32PURPOSE: The purpose of the present study was to review the results of femoral neck non-unions treatment with valgusing intertrochanteric osteotomy. METHODS: Between 1988 and 2003 we treaded thirty two femoral neck non-unions with valgusing osteotomy and fixation. The mean follow-up time was 9.8 years and the mean age was 41.7 years. RESULTS: Twenty eight (87.4% of the thirty two valgusing osteotomies evolved to femoral neck union, while four cases (12.6% evolved to total hip arthroplasty. Eight cases evolved to partial osteonecrosis. CONCLUSIONS: The valgusing intertrochanteric osteotomy for treating femoral neck non-unions achieved consolidation in 87.4% (28/32. However, only 56.2% (18/32 achieved full recovery of hip function.

  16. Juvenile age estimation from facial images.

    Science.gov (United States)

    Ferguson, Eilidh; Wilkinson, Caroline

    2017-01-01

    Age determination from images can be of vital importance, particularly in cases involving suspected child sexual abuse (CSA). It is imperative to determine if an individual depicted in such an image is indeed a child, with a more concise age often sought, as this may affect the severity of offender sentencing. The aims of this study were to establish the accuracy of visual age estimation of the juvenile face in children aged between 0 and 16years and to determine if varying levels of exposure to children affected an individual's ability to assess age from the face. An online questionnaire consisting of 30 juvenile face images was created using SurveyMonkey®. The overall results suggested poor accuracy for visual age estimation of juvenile faces. The age, sex, occupation and number of children of the participants did not affect the ability to estimate age from facial images. Similarly, the sex and age of the juvenile faces did not appear to affect the accuracy of age estimation. When specific age groups are considered, sex may have an influence on age estimation, with female faces being aged more accurately in the younger age groups and male faces more accurate after the age of 11years, however this is based on a small sample. This study suggests that the accuracy of juvenile age estimation from the face alone is poor using simple visual assessment of images. Further research is required to determine exactly how age is assessed from a facial image, if there are indicators, or features in particular that lead to over- or under-estimation of juvenile age.

  17. 膝内外翻畸形时髋臼负重顶区的生物力学变化*★%Biomechanical changes in the acetabular dome region to knee joint varus and valgus

    Institute of Scientific and Technical Information of China (English)

    汤敏生; 白波; 谢诗涓; 龙浩; 刘琦; 陈艺

    2013-01-01

      背景:膝内、外翻畸形改变了膝关节的形态,除影响膝关节的功能外,还可能改变相邻关节髋关节的生物力学行为,也就是髋臼与股骨头之间的力学传导。  目的:评价不同程度膝内、外翻畸形对髋臼负重顶区的生物力学影响。  方法:取成年男性鲜尸体下肢标本3个,剔除附着的肌肉组织,保留骨膜、韧带及关节囊,通过胫骨高位截骨模拟不同程度的膝内外翻畸形。标本分为中立位组、膝内翻10°组、膝内翻20°组、膝外翻10°组和膝外翻20°组。实验中骨盆的位置选择单足站立中立位。标本通过生物力学试验机加载至50 kg,采用压敏片技术测量髋臼顶负重区的负重面积、平均应力及峰值应力。  结果与结论:髋臼顶区中立位时股胫关节面负重面积为(6.33±0.12) cm2,平均应力(3.62±0.33) MPa,峰值应力为(4.58±0.20) MPa。当膝内、外翻达10°时,髋臼顶区负重面积减少,平均应力及峰值应力有明显的增加,但差异无显著性意义(P>0.05);当膝内、外翻达20°时髋臼负重面积显著减少,平均应力峰值及应力显著增加,差异有非常显著性意义(P OBJECTIVE:To investigate the effect of different varus and valgus angle on the biomechanics of acetabular dome region. METHODS:Three lower limb specimens were col ected from adult male fresh cadaver. Al muscles and connective tissues were dissected while hip and knee periosteum, joint capsules and ligaments were preserved. The high tibial osteotomy was operated to simulate different degrees of knee varus and valgus. The specimens were divided into neutral position group, knee varus 10° group, knee varus 20° group, knee valgus 20° group and knee valgus 10° group. During the experiment, the pelves were in the single-leg standing neutral position. The specimens were loaded with 50 kg by biomechanical testing machine. The loading area, mean

  18. Juvenile dermatomyositis in a Nigerian girl

    Science.gov (United States)

    Adelowo, Olufemi; Nwankwo, Madu; Olaosebikan, Hakeem

    2014-01-01

    Juvenile dermatomyositis is an autoimmune connective tissue disease occurring in children less than 16 years old. It is part of a heterogeneous group of muscle diseases called idiopathic Iiflammatory myopathies. It had previously been reported in black Africans resident in UK. However, there is no documented case reported from Africa. The index sign of heliotrope rashes is often difficult to visualise in the black skin. An 11-year-old Nigerian girl presenting with clinical, laboratory and histopathological features of juvenile dermatomyositis is presented here. It is hoped that this case will heighten the index of suspicion of this condition among medical practitioners in Africa. PMID:24706700

  19. Posttraumatic stress among youths in juvenile detention.

    Science.gov (United States)

    Falk, Derek; Thompson, Sanna J; Sanford, Julia

    2014-01-01

    An estimated 1.8 million juveniles were arrested in the United States for delinquency in 2009. Previous studies indicate high rates of exposure to traumatic events and posttraumatic stress (PTS) symptoms for these youths. This study examined PTS in a sample of 170 youths in juvenile detention. The results of this study reveal higher rates of PTS symptoms (21%) compared to national rates (6%). The data also suggest youths suffering from more PTS symptoms also report higher depression, anxiety, anger, family relationship worries, thought problems, and attention problems. These factors provide a direction for continued practice targeting these youths.

  20. [HLA antigens in juvenile rheumatoid arthritis].

    Science.gov (United States)

    Rumba, I V; Sochnev, A M; Kukaĭne, E M; Burshteĭn, A M; Benevolenskaia, L I

    1990-01-01

    Antigens of I class HLA system (locus A and B) were investigated in 67 patients of Latvian nationality suffering from juvenile rheumatoid arthritis (JRA). Associations of HLA antigens with juvenile rheumatoid arthritis partially coincided with the ones revealed earlier. Typing established an increased incidence of antigen B27 (p less than 0.01) and gaplotype A2, B40 (p less than 0.01). Antigen B15 possessed a protective action with respect to JRA. Interlocus combinations demonstrated a closer association with the disease than a single antigen. The authors also revealed markers of various clinico-anatomical variants of JRA.

  1. Metabolic responses to hypoglycemia in juvenile diabetics

    DEFF Research Database (Denmark)

    Hilsted, J; Madsbad, S; Krarup, T;

    1980-01-01

    Glucagon and metabolic responses to insulin-induced hypoglycemia were studied in seven juvenile diabetics, age 31 +/- 2 years (mean and S.E.M.), duration of diabetes 17 +/- 3 years, with diabetic autonomic neuropathy (decreased beat-to-beat variation in heart rate during hyperventilation and...... in both patient groups. Metabolic responses to hypoglycemia were also similar in the two patient groups. In conclusion, diabetic autonomic neuropathy has no effect on glucagon and metabolic responses to hypoglycemia in juvenile, insulin-treated diabetics....

  2. Juvenil Pityriasis Rubra Pilaris: A Case Report

    Directory of Open Access Journals (Sweden)

    M. Emin YANIK et al.

    2010-05-01

    Full Text Available Juvenile pityriasis rubra pilaris (PRP is an uncommon skin disease characterized by follicularkeratotic papules, erythemato-squamous plaques and palmoplantar keratoderma. Etyology isunknown. A 8 years-old boy presented with a 15 days history of scaly patches and plaques withfollicular papules involving his scalp and face. However he had palmoplantar keratoderma onhis hands and feet. Based upon clinical and histopatological findings, he was diagnosed asJuvenile PRP. Acitretin was initiated for therapy. We presented our case because of its rarity.

  3. Acupuntura em adolescentes com fibromialgia juvenil

    OpenAIRE

    Dias,Marialda Höfling P.; Amaral,Elisabete; PAI, Hong Jin; Daniela Terumi Y. Tsai; LOTITO, Ana Paola N; Leone,Claudio; Silva, Clovis Artur

    2012-01-01

    OBJETIVO: Descrever a utilização da acupuntura em adolescentes com fibromialgia juvenil. MÉTODOS: Estudo retrospectivo realizado em pacientes com fibromialgia juvenil (critérios do Colégio Americano de Reumatologia) submetidos a, pelo menos, 11 sessões semanais de acupuntura. As avaliações antes e após acupuntura incluíram dados demográficos, características da dor musculoesquelética, número de pontos dolorosos (NPD), escala visual analógica (EVA) de dor, algiometria e índice miálgico (IM). D...

  4. Resiliency Scales for Children and Adolescents: Profiles of Juvenile Offenders

    Science.gov (United States)

    Mowder, Melissa H.; Cummings, Jack A.; McKinney, Robert

    2010-01-01

    An exploratory study of resiliency profiles of male and female juvenile offenders committed to a juvenile correctional facility was conducted. The goal of the present study was to examine juvenile offenders' positive characteristics (e.g., adaptability, optimism, self-efficacy, tolerance of differences). To assess positive characteristics and…

  5. Programa Shortstop: A Culturally Focused Juvenile Intervention for Hispanic Youth

    Science.gov (United States)

    Cervantes, Richard C.; Ruan, Karen; Duenas, Norma

    2004-01-01

    Culturally sensitive juvenile delinquency and substance abuse interventions are relatively limited and unavailable to many first-time Hispanic juvenile offenders. The purpose of this study was to test the effectiveness of a culturally focused juvenile and substance abuse intervention program for first time Hispanic youth offenders. The intent of…

  6. Increased Cyclooxygenase-2 Expression in Juvenile Polyposis Syndrome

    NARCIS (Netherlands)

    W.A. van Hattem; L.A.A. Brosens; S.Y. Marks; A.N.A. Milne; S. van Eeden; C.A. Iacobuzio-Donahue; A. Ristimäki; F.M. Giardiello; G.J.A. Offerhaus

    2009-01-01

    Background & Aims: Gastrointestinal juvenile polyps may occur in juvenile polyposis syndrome (JPS) or sporadically. JPS is an autosomal-dominant condition caused by a germline defect in SMAD4 or BMPR1A in 50% to 60% of cases, and is characterized by multiple juvenile polyps, predominantly in the col

  7. Chronic Juvenile Delinquency and the "Suppression Effect": An Exploratory Study.

    Science.gov (United States)

    Fraser, Mark; Norman, Michael

    1988-01-01

    Notes that fear of apprehension and punishment have been reported to suppress juvenile crime. Discusses suppression effect in regard to the correlates of chronic juvenile delinquency and exploratory evidence that youth who commit large volume of crime do not fear sanctions imposed by juvenile court any more than youth who commit only one offense…

  8. Juvenile rheumatoid arthritis: therapeutic perspectives.

    Science.gov (United States)

    Chikanza, Ian C

    2002-01-01

    Juvenile rheumatoid arthritis (JRA) is the most common childhood chronic systemic autoimmune inflammatory disease. The therapeutic approach to JRA has, to date, been casual and based on extensions of clinical experiences gained in the management of adult rheumatoid arthritis (RA). The physiology of inflammation has been systemically studied and this has led to the identification of specific therapeutic targets and the development of novel approaches to the management of JRA. The classical treatments of the disease such as methotrexate, sodium aurothiomalate and sulfasalazine, are not always effective in controlling RA and JRA. This has necessitated the development of novel agents for treating RA, most of which are biological in nature and are targeted at specific sites of the inflammatory cascades. These biological therapeutic strategies in RA have proved successful and are being applied in the management of JRA. These developments have been facilitated by the advances in molecular biology which have heralded the advent of biodrugs (recombinant proteins) and gene therapy, in which specific genes can be introduced locally to enhance in vivo gene expression or suppress gene(s) of interest with a view to down-regulating inflammation. Some of these biodrugs, such as anti-tumor necrosis factor alpha (anti-TNFalpha), monoclonal antibodies (infliximab, adalimumab), TNF soluble receptor constructs (etanercept) and interleukin-1 receptor antagonist (IL-1Ra) have been tested and shown to be effective in RA. Etanercept has now been licensed for JRA. Clinical trials of infliximab in JRA are planned. Studies show that the clinical effects are transient, necessitating repeated treatments and the risk of vaccination effects. Anti-inflammatory cytokines such as IL-4, IL-10, transforming growth factor-beta and interferon-beta (IFN-beta) are undergoing clinical trials. Many of these agents have to be administered parenterally and production costs are very high; thus, there is a need

  9. The challenges of the first migration: movement and behaviour of juvenile vs. adult white storks with insights regarding juvenile mortality.

    Science.gov (United States)

    Rotics, Shay; Kaatz, Michael; Resheff, Yehezkel S; Turjeman, Sondra Feldman; Zurell, Damaris; Sapir, Nir; Eggers, Ute; Flack, Andrea; Fiedler, Wolfgang; Jeltsch, Florian; Wikelski, Martin; Nathan, Ran

    2016-07-01

    Migration conveys an immense challenge, especially for juvenile birds coping with enduring and risky journeys shortly after fledging. Accordingly, juveniles exhibit considerably lower survival rates compared to adults, particularly during migration. Juvenile white storks (Ciconia ciconia), which are known to rely on adults during their first fall migration presumably for navigational purposes, also display much lower annual survival than adults. Using detailed GPS and body acceleration data, we examined the patterns and potential causes of age-related differences in fall migration properties of white storks by comparing first-year juveniles and adults. We compared juvenile and adult parameters of movement, behaviour and energy expenditure (estimated from overall dynamic body acceleration) and placed this in the context of the juveniles' lower survival rate. Juveniles used flapping flight vs. soaring flight 23% more than adults and were estimated to expend 14% more energy during flight. Juveniles did not compensate for their higher flight costs by increased refuelling or resting during migration. When juveniles and adults migrated together in the same flock, the juvenile flew mostly behind the adult and was left behind when they separated. Juveniles showed greater improvement in flight efficiency throughout migration compared to adults which appears crucial because juveniles exhibiting higher flight costs suffered increased mortality. Our findings demonstrate the conflict between the juveniles' inferior flight skills and their urge to keep up with mixed adult-juvenile flocks. We suggest that increased flight costs are an important proximate cause of juvenile mortality in white storks and likely in other soaring migrants and that natural selection is operating on juvenile variation in flight efficiency.

  10. Criminal Profiles of Violent Juvenile Sex and Violent Juvenile Non-Sex Offenders: An Explorative Longitudinal Study

    Science.gov (United States)

    van Wijk, Anton Ph.; Mali, Bas R. F.; Bullens, Ruud A. R.; Vermeiren, Robert R.

    2007-01-01

    Few studies have longitudinally investigated the criminal profiles of violent juvenile sex and violent juvenile non-sex offenders. To make up for this lack, this study used police records of juveniles to determine the nature of the criminal profiles of violent sex offenders (n = 226) and violent non-sex offenders (n = 4,130). All offenders…

  11. Juvenile Residential Facility Census, 2010: Selected Findings. Juvenile Offenders and Victims: National Report Series. Bulletin NCJ 241134

    Science.gov (United States)

    Hockenberry, Sarah; Sickmund, Melissa; Sladky, Anthony

    2013-01-01

    This bulletin is part of the "Juvenile Offenders and Victims National Report Series." The "National Report" offers a comprehensive statistical overview of the problems of juvenile crime, violence, and victimization and the response of the juvenile justice system. During each interim year, the bulletins in the "National…

  12. Juvenile penalty or leniency: Sentencing of juveniles in the criminal justice system.

    Science.gov (United States)

    Jordan, Kareem L; McNeal, Brittani A

    2016-08-01

    The purpose of this study is to examine the impact of being juvenile on sentencing in the criminal justice system. More specifically, youth transferred to criminal court are compared to adults in terms of likelihood of incarceration, jail length, and prison length. In this study, 2 national data sets are merged. The juvenile sample includes 3,381 convicted offenders, and the adult sample is comprised of 6,529 convicted offenders. The final sample is 9,910 offenders across 36 U.S. counties. The key independent variable is juvenile status, and the dependent variables are incarceration, jail length, and prison length. Because of the multilevel nature of the data, hierarchical linear modeling is used across all models. Juveniles are punished less severely in the jail incarceration decision. However, when youth are actually sentenced to incarceration (either jail or prison), they are given longer confinement time than adults. (PsycINFO Database Record

  13. Ethnic monitoring and social control: Descriptions from juveniles in juvenile care institutions

    OpenAIRE

    Basic, Goran

    2014-01-01

    Previous research has emphasized the institutional racism in total institutions. Researchers have highlighted the importance of narratives but have not focused on narratives about ethnic monitoring and social control. This article tries to fill this gap by analysing stories related to descriptions of ethnic monitoring and social control as told by juveniles of non-Swedish ethnicity in Swedish juvenile care institutions. A juvenile’s ethnicity was highlighted by drawing attention to the staff’...

  14. Biological agents in polyarticular juvenile idiopathic arthritis

    DEFF Research Database (Denmark)

    Amarilyo, Gil; Tarp, Simon; Foeldvari, Ivan

    2016-01-01

    BACKGROUND AND OBJECTIVE: Although various biological agents are in use for polyarticular juvenile idiopathic arthritis (pJIA), head-to-head trials comparing the efficacy and safety among them are lacking. We aimed to compare the efficacy and safety of biological agents in pJIA using all currently...

  15. Mineral Oil Aspiration Related Juvenile Idiopathic Arthritis

    OpenAIRE

    Nelson, Andrew D.; Fischer, Philip R.; Reed, Ann M.; Wylam, Mark E.

    2015-01-01

    We describe the development of rheumatoid factor-positive migratory polyarthritis in a 5-year-old male who had been administered bidaily oral mineral oil as a laxative since birth. Minor respiratory symptoms, radiographic and bronchoscopic findings were consistent with chronic lipoid pneumonia. We speculate that immune sensitization to mineral oil promoted the clinical syndrome of juvenile idiopathic arthritis.

  16. Retrocalcaneal bursitis in juvenile chronic arthritis.

    OpenAIRE

    Goldenstein-Schainberg, C; Homsi, C; Rodrigues Pereira, R M; W. Cossermelli

    1992-01-01

    Retrocalcaneal bursitis has been described in various adult rheumatic diseases and septic bursitis unrelated to previous bursal disease has been reported in children. The case is reported here of a girl with juvenile chronic arthritis who developed non-septic retrocalcaneal bursitis; the diagnosis was suggested by a combination of clinical and radiographic studies and was confirmed by ultrasonography.

  17. Family Disruption and Delinquency. Juvenile Justice Bulletin.

    Science.gov (United States)

    Thornberry, Terence P.; Smith, Carolyn A.; Rivera, Craig; Huizinga, David; Stouthamer-Loeber, Magda

    At study sites in Rochester (New York), Denver (Colorado) and Pittsburgh (Pennsylvania), three research teams studying the impact of family disruption on juvenile delinquency have interviewed approximately 4,000 participants at regular intervals for a decade, recording their lives in detail. Findings to date indicate that preventing delinquency…

  18. Childhood ovarian juvenile granulosa cell tumour

    African Journals Online (AJOL)

    Prof Ezechukwu

    2012-05-12

    May 12, 2012 ... years old of age. We describe a case ... Juvenile granulosa cell tumour a subtype of ovarian stro- mal cell ... A more serious estrogen effects can occur in various end ... usually behave in a benign manner despite having histo-.

  19. Antineutrophil cytoplasmic antibodies in juvenile chronic arthritis

    NARCIS (Netherlands)

    Mulder, L; Horst, G; Limburg, P; deGraeffMeeder, ER; Kuis, W; Kallenberg, C

    1997-01-01

    Objective, To evaluate the diagnostic significance of antineutrophil cytoplasmic antibodies (ANCA) by assessing the prevalence of ANCA in juvenile chronic arthritis (JCA) (n = 93) of either oligoarticular, polyarticular, or systemic onset. To investigate the prevalence of ANCA in other diseases of c

  20. Biologisk terapi ved juvenil idiopatisk artritis

    DEFF Research Database (Denmark)

    Herlin, Troels

    2008-01-01

    In recent years the treatment of juvenile idiopathic arthritis (JIA) has undergone marked changes. There is substantial evidence that inhibitors of tumor necrosis factor alpha (TNFalpha) like etanercept, infliximab and adalimumab show significant efficacy when standard therapy fails, and long-ter...

  1. Smerte og smertemestring ved juvenil idiopatisk artritis

    DEFF Research Database (Denmark)

    Herlin, Troels; Thastum, Mikael

    2008-01-01

    Pain is one of the primary symptoms of juvenile idiopathic arthritis (JIA). JIA patients have reduced pain tolerance and pain threshold compared to healthy controls. In children with JIA the greater use of coping strategies such as problem-solving, positive self-statements and distraction consist...

  2. Increasing Incidence of Juvenile Thyrotoxicosis in Denmark

    DEFF Research Database (Denmark)

    Kjær, R. H.; Andersen, M. S.; Hansen, D.

    2015-01-01

    . Additional data were collected on children diagnosed with GD in 2008-2012. Results: In total, 237 patients with juvenile thyrotoxicosis (JT) were identified. The overall IR in 1998-2012 was 1.58/100,000 person-years and has increased significantly from 0.79/100,000 person-years in 1982-1988 (p

  3. Predictors of juveniles' noncompliance with probation requirements.

    Science.gov (United States)

    NeMoyer, Amanda; Goldstein, Naomi E S; McKitten, Rhonda L; Prelic, Ana; Ebbecke, Jenna; Foster, Erika; Burkard, Casey

    2014-12-01

    Probation is the most common disposition for adjudicated youth, but little is known about which specific requirements are commonly imposed on juveniles, the requirements with which juveniles most often fail to comply, and how certain youth characteristics and/or imposed requirements might relate to probation noncompliance. An investigation of 120 archived files of youth represented by an urban public defender's office identified 29 probation requirements imposed on youth and 18 requirements with which youth commonly failed to comply. Results revealed that 52% of youth failed to comply with at least one probation requirement; prior probation noncompliance and race were both significantly associated with noncompliance in the examined probation disposition. In addition, the probability of probation noncompliance was significantly higher when youth received either of two substance-related probation requirements: drug tests or drug and alcohol counseling. Such results may prompt further investigation of juvenile probation-related predictors, identify areas of need for clinical service provision to foster successful completion of probation requirements, and help identify areas of potential biases among juvenile court personnel.

  4. Retrocalcaneal bursitis in juvenile chronic arthritis.

    Science.gov (United States)

    Goldenstein-Schainberg, C; Homsi, C; Rodrigues Pereira, R M; Cossermelli, W

    1992-01-01

    Retrocalcaneal bursitis has been described in various adult rheumatic diseases and septic bursitis unrelated to previous bursal disease has been reported in children. The case is reported here of a girl with juvenile chronic arthritis who developed non-septic retrocalcaneal bursitis; the diagnosis was suggested by a combination of clinical and radiographic studies and was confirmed by ultrasonography. Images PMID:1444631

  5. The human microbiome and juvenile idiopathic arthritis

    NARCIS (Netherlands)

    Verwoerd, Anouk; ter Haar, Nienke M.; de Roock, Sytze; Vastert, Sebastiaan J.; Bogaert, Debby

    2016-01-01

    Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood. The pathogenesis of JIA is thought to be the result of a combination of host genetic and environmental triggers. However, the precise factors that determine one's susceptibility to JIA remain to be unravelled. The

  6. Alteracioness cognitivas en familias con Parkinson juvenil

    Directory of Open Access Journals (Sweden)

    Francisco Javier Lopera Restrepo

    2005-03-01

    Full Text Available El Grupo de Neurociencias de la Universidad de Antioquia reportó por primera vez en Colombia cuatro familias afecatas por la Enfermedad de Parkinson Familiar Juvenil portadoras de la mutación G736A en el gen Parkin.

  7. Metamorphosis: How Missouri Rehabilitates Juvenile Offenders

    Science.gov (United States)

    Dubin, Jennifer

    2012-01-01

    Juveniles convicted of serious offenses usually end up in large correctional facilities that focus on punishment--not rehabilitation. The state of Missouri, however, has found a better way to help end the cycle of crime: by creating a network of small facilities that provide therapy and educational opportunities, it has dramatically reduced…

  8. The human microbiome and juvenile idiopathic arthritis

    NARCIS (Netherlands)

    Verwoerd, Anouk; ter Haar, Nienke M.; de Roock, Sytze; Vastert, Sebastiaan J.; Bogaert, Debby

    2016-01-01

    Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood. The pathogenesis of JIA is thought to be the result of a combination of host genetic and environmental triggers. However, the precise factors that determine one's susceptibility to JIA remain to be unravelled. The

  9. Autoimmune hepatitis and juvenile systemic lupus erythematosus

    NARCIS (Netherlands)

    Deen, M. E. J.; Porta, G.; Fiorot, F. J.; Campos, L. M. A.; Sallum, A. M. E.; Silva, C. A. A.

    2009-01-01

    Juvenile systemic lupus erythematosus (JSLE) and autoimmune hepatitis (AIH) are both autoimmune disorders that are rare in children and have a widespread clinical manifestation. A few case reports have shown a JSLE-AIH associated disorder. To our knowledge, this is the first study that simultaneousl

  10. JUVENILE RHEUMATOID ARTHRITIS (TERMINOLOGICALAND CLASSIFICATION ASPECTS

    Directory of Open Access Journals (Sweden)

    N N Kuzmina

    2000-01-01

    Full Text Available Basing on the data of home and foreign literature and on the long-term experience of pediatric rheumatologists, terminologic and classification aspects of Juvenile rheumatoid arthritis (JRA are presented. Approaches to developing of diagnostic and classification of JRA criteria in future are described.

  11. 全膝关节置换治疗膝关节外翻畸形%Total knee arthroplasty for treatment of valgus knee deformity

    Institute of Scientific and Technical Information of China (English)

    张锐; 柳海平; 谢兴文; 尤从新; 王承祥

    2014-01-01

    背景:膝关节外翻畸形临床相对较少,人工膝关节置换的治疗效果不如膝关节内翻畸形。对于置换入路、软组织松解方法步骤及假体选择目前均无统一看法。  目的:总结病例资料,观察全膝关节置换治疗膝关节外翻畸形的临床效果。  方法:回顾性分析甘肃省中医院关节骨一科同一组医师在2010年1月至2012年12月采用全膝关节置换治疗膝关节外翻畸形患者37例(42膝)的临床资料,其中男11例,13个膝关节;女26例,29个膝关节。年龄56-78岁,平均63.7岁。对比分析患者置换前后膝关节活动范围、股胫角及美国特种外科医院膝关节评分的差异,评估全膝关节置换治疗膝关节外翻畸形的临床效果。  结果与结论:置换后随访6-36个月。患者膝关节活动范围由置换前平均68.5°提高到置换后末次随访时平均108.5°,置换前股胫角平均16.82°减少到置换后末次随访时平均5.62°,置换前美国特种外科医院膝关节评分平均39分提高到置换后末次随访时88分,末次随访时与置换前比较差异有显著性意义(P OBJECTIVE:To summarize case data and to observe clinical effects of total knee arthroplasty for valgus knee deformity. METHODS:Clinical data of 37 cases of valgus knee deformity (42 knees) undergoing total knee arthroplasty, who were treated by the same group of physicians in the First Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine from January 2010 to December 2012 were retrospectively analyzed. There were 11 males (13 knees) and 26 females (29 knees), at the age from 56 to 78 years, with an average age of 63.7 years. The differences in range of motion, femorotibial angle and Hospital for Special Surgery knee score were compared before and after replacement. Clinical effects of total knee arthroplasty for valgus knee deformity were evaluated. RESULTS AND CONCLUSION

  12. Valgus and varus deformity after wide-local excision, brachytherapy and external beam irradiation in two children with lower extremity synovial cell sarcoma: case report

    Directory of Open Access Journals (Sweden)

    Merchant Thomas E

    2004-08-01

    Full Text Available Abstract Background Limb-salvage is a primary objective in the management of extremity soft-tissue sarcoma in adults and children. Wide-local excision combined with radiation therapy is effective in achieving local tumor control with acceptable morbidity and good functional outcomes for most patients. Case Presentation Two cases of deformity after wide-local excision, brachytherapy and external beam irradiation for lower-extremity synovial cell sarcoma are presented and discussed to highlight contributing factors, time course of radiation effects and orthopedic management. In an effort to spare normal tissues from the long-term effects of radiation therapy, more focal irradiation techniques have been applied to patients with musculoskeletal tumors including brachytherapy and conformal radiation therapy. As illustrated in this report, the use of these techniques results in the asymmetric irradiation of growth plates and contributes to the development of valgus or varus deformity and leg-length discrepancies. Conclusions Despite good functional outcomes, progressive deformity in both patients required epiphysiodesis more than 3 years after initial management. There is a dearth of information related to the effects of radiation therapy on the musculoskeletal system in children. Because limb-sparing approaches are to be highlighted in the next generation of cooperative group protocols for children with musculoskeletal tumors, documentation of the effects of surgery and radiation therapy will lead to improved decision making in the selection of the best treatment approach and in the follow-up of these patients.

  13. Evaluating juvenile detainees' Miranda misconceptions: The discriminant validity of the Juvenile Miranda Quiz.

    Science.gov (United States)

    Sharf, Allyson J; Rogers, Richard; Williams, Margot M; Drogin, Eric Y

    2017-05-01

    Most juvenile arrestees in custodial settings waive their Miranda rights almost immediately, and many then provide incriminating statements, if not outright confessions. Forensic practitioners are then asked to provide retrospective determinations regarding whether these waivers were effectuated knowingly, voluntarily, and intelligently. At present, the forensic assessment instrument for juvenile Miranda issues consists of the Miranda Rights Comprehension Instruments (MRCI)-which as its name implies-focuses mostly on Miranda comprehension with a de-emphasis of Miranda reasoning. In partially addressing this gap, the current study investigated the clinical utility of the Juvenile Miranda Quiz (JMQ) for evaluating key Miranda misconceptions, a critically important component of Miranda reasoning. Using data from 201 juvenile detainees, we evaluated the JMQ's discriminability with regards to cognitive variables and MRCI scales. Many moderate effect sizes in the predicted direction were found for the JMQ Primary Total and Juvenile Total scores. Finally, these detainees were tested using a mock crime scenario with a representative Miranda warning plus a brief interrogation to evaluate whether they would waive their rights, and if so, whether they would confess. Using Miranda measures to predict problematic outcomes (i.e., impaired waivers followed by confessions), the JMQ Juvenile Total proved the most successful. These findings are discussed within the context of the "intelligent" prong of Miranda waivers. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  14. 佩带膝外翻支具膝骨关节炎患者膝关节的生物力学变化%Biomechanical changes of the knee with the valgus bracing in people with medial knee osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    张旻; 江澜

    2011-01-01

    背景:佩带膝关节外翻矫形器已被证明是一种可以有效减轻内侧间室膝骨关节炎患者疼痛的方法,但是佩带矫形器后的膝关节所产生的运动学以及动力学变化至今尚不明确.目的:观察内侧间室膝骨关节炎患者佩带膝关节矫形器前后的膝关节运动学以及动力学参数变化,便于为将来设计新型膝关节矫形器提供依据.方法:纳入20例内侧间室膝骨关节炎患者,分别通过三维步态分析系统和测力板对其在佩带膝外翻矫形器及不佩带膝外翻矫形器两种情况步行中的运动学及动力学参数进行采集,并进行对比.结果与结论:相比未佩带膝关节外翻支具,佩带膝关节外翻支具后患者在步行过程中膝关节内收力矩明显减小,与此同时膝关节内翻角度明显减小,外翻角度明显增加(P均< 0.05),膝关节在步行过程中的最大屈曲角度以及时间空间参数差异无显著性意义.提示膝关节外翻矫形器可有效地通过增加内侧间室膝骨关节炎患者膝关节在步行过程中的外翻角度减小内翻角度从而降低膝内侧间室所承受的压力,与此同时纠正膝关节非正常对线.%BACKGROUND: Unloading valgus knee brace has been proved to be a very effective method which can help patients in medial knee osteoarthritis, but the kinematic and kinetic changes at knee joint after taking knee brace was not clear.OBJECTIVE: To investigate the kinematics and kinetics changes of the medial knee osteoarthritis at knee during walking with and without unloading valgus knee brace which is benefit for designing new type of knee brace in the future.METHODS: Totally 20 patients with medial knee osteoarthritis were included in this test kinematics changes were conducted with three dimensional gait analysis system and the kinetics changes were collected by the force platforms for medial knee osteoarthritis subjects with or without valgus knee brace.RESULTS AND CONCLUSION

  15. Musculoskeletal MRI findings of juvenile localized scleroderma

    Energy Technology Data Exchange (ETDEWEB)

    Eutsler, Eric P. [Nemours Children' s Health System/Alfred I. duPont Hospital for Children, Wilmington, DE (United States); Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Horton, Daniel B. [Nemours Children' s Health System/Alfred I. duPont Hospital for Children, Division of Rheumatology, Department of Pediatrics, Wilmington, DE (United States); Rutgers Robert Wood Johnson Medical School, Department of Pediatrics, New Brunswick, NJ (United States); Epelman, Monica [Nemours Children' s Health System/Nemours Children' s Hospital, Department of Medical Imaging, Orlando, FL (United States); Finkel, Terri [Nemours Children' s Health System/Nemours Children' s Hospital, Department of Pediatrics, Orlando, FL (United States); Averill, Lauren W. [Nemours Children' s Health System/Alfred I. duPont Hospital for Children, Wilmington, DE (United States)

    2017-04-15

    Juvenile localized scleroderma comprises a group of autoimmune conditions often characterized clinically by an area of skin hardening. In addition to superficial changes in the skin and subcutaneous tissues, juvenile localized scleroderma may involve the deep soft tissues, bones and joints, possibly resulting in functional impairment and pain in addition to cosmetic changes. There is literature documenting the spectrum of findings for deep involvement of localized scleroderma (fascia, muscles, tendons, bones and joints) in adults, but there is limited literature for the condition in children. We aimed to document the spectrum of musculoskeletal magnetic resonance imaging (MRI) findings of both superficial and deep juvenile localized scleroderma involvement in children and to evaluate the utility of various MRI sequences for detecting those findings. Two radiologists retrospectively evaluated 20 MRI studies of the extremities in 14 children with juvenile localized scleroderma. Each imaging sequence was also given a subjective score of 0 (not useful), 1 (somewhat useful) or 2 (most useful for detecting the findings). Deep tissue involvement was detected in 65% of the imaged extremities. Fascial thickening and enhancement were seen in 50% of imaged extremities. Axial T1, axial T1 fat-suppressed (FS) contrast-enhanced and axial fluid-sensitive sequences were rated most useful. Fascial thickening and enhancement were the most commonly encountered deep tissue findings in extremity MRIs of children with juvenile localized scleroderma. Because abnormalities of the skin, subcutaneous tissues and fascia tend to run longitudinally in an affected limb, axial T1, axial fluid-sensitive and axial T1-FS contrast-enhanced sequences should be included in the imaging protocol. (orig.)

  16. Orofacial pain, jaw function, and temporomandibular disorders in adult women with a history of juvenile chronic arthritis or persistent juvenile chronic arthritis

    DEFF Research Database (Denmark)

    Bakke, M.; Zak, M.; Jensen, B.L.;

    2001-01-01

    Orofacial pain, jaw function, temporomandibular disorders, adult women persistent juvenil chronic arthritis......Orofacial pain, jaw function, temporomandibular disorders, adult women persistent juvenil chronic arthritis...

  17. A comparison between metatarsal head-resurfacing hemiarthroplasty and total metatarsophalangeal joint arthroplasty as surgical treatments for hallux rigidus: a retrospective study with short- to midterm follow-up

    Science.gov (United States)

    Mermerkaya, Musa Ugur; Adli, Houman

    2016-01-01

    Purpose We evaluated the short- to midterm outcomes of metatarsal head-resurfacing hemiarthroplasty and total metatarsophalangeal joint arthroplasty (total joint replacement [TJR]) as surgical treatments for advanced-stage hallux rigidus (HR). Patients and methods From 2012 to 2014, all data from patients who underwent surgery for the treatment of grades 2–3 HR were retrospectively reviewed, and 45 patients were included in this study. Of these patients, 26 underwent metatarsal head-resurfacing hemiarthroplasty (Group I) and 19 underwent TJR (Group II). All patients were clinically graded prior to surgery and at their final follow-up visits using the American Orthopedic Foot and Ankle Society’s (AOFAS) hallux metatarsophalangeal–interphalangeal scale, a visual analog scale (VAS), and the “first metatarsophalangeal joint range of motion” (MTPJ ROM) score. Results Metatarsal head resurfacing was performed on 26 patients. Two patients underwent bilateral procedures, yielding a total of 28 cases in Group I. TJR was performed on 19 patients in Group II. Of the 26 Group I patients, 12 (46.2%) were male and 14 (53.8%) were female, with a mean age of 56.3±4.5 years (range: 47–63 years); the mean follow-up duration was 29.9±5.2 months. Of the 19 Group II patients, eight (42.1%) were male and eleven (57.9%) were female, with a mean age of 57.1±5.8 years (range: 45–66 years); the mean follow-up duration was 27.1±7.5 months. Significant improvements were evident in the AOFAS scores, and the VAS scores decreased, in both groups. No significant difference was evident between groups I and II. Conclusion After failure of conservative treatment in patients with moderate-to-severe HR, both MTPJ hemiarthroplasty and TJR were associated with effective recovery of toe function and MTPJ ROM, as well as good short- to midterm functional outcomes. PMID:28008240

  18. Acupuntura em adolescentes com fibromialgia juvenil Acupuntura en adolescentes con fibromialgia juvenil Acupuncture in adolescents with juvenile fibromyalgia

    Directory of Open Access Journals (Sweden)

    Marialda Höfling P. Dias

    2012-01-01

    Full Text Available OBJETIVO: Descrever a utilização da acupuntura em adolescentes com fibromialgia juvenil. MÉTODOS: Estudo retrospectivo realizado em pacientes com fibromialgia juvenil (critérios do Colégio Americano de Reumatologia submetidos a, pelo menos, 11 sessões semanais de acupuntura. As avaliações antes e após acupuntura incluíram dados demográficos, características da dor musculoesquelética, número de pontos dolorosos (NPD, escala visual analógica (EVA de dor, algiometria e índice miálgico (IM. Durante o estudo, os pacientes puderam usar analgésicos, amitriptilina e foram orientados a praticar atividade física aeróbica. Os resultados antes e após acupuntura foram comparados pelo teste não paramétrico de Wilcoxon. RESULTADOS: Dos 38 pacientes com fibromialgia juvenil acompanhados em oito anos consecutivos, 13 tinham todas as informações nos prontuários e nas fichas de acupuntura e foram avaliados. Destes 13, sete obtiveram melhora nos três parâmetros analisados (número de pontos dolorosos, EVA de dor e IM. As medianas do número de pontos dolorosos e da EVA de dor foram significativamente maiores antes do tratamento quando comparados ao final do tratamento com as sessões de acupuntura [14 (11-18 versus 10 (0-15, p=0,005; 6 (2-10 versus 3 (0-10, p=0,045; respectivamente]. Em contraste, a mediana do IM foi significativamente menor antes do tratamento [3,4 (2,49-4,39 versus 4,2 (2,71-5,99, p=0,02]. Nenhum dos pacientes com fibromialgia juvenil apresentou eventos adversos associados à acupuntura. CONCLUSÕES: Acupuntura é uma modalidade de Medicina Tradicional Chinesa que pode ser utilizada nos pacientes pediátricos com fibromialgia. Futuros estudos controlados serão necessários.OBJETIVO: Describir el uso de acupuntura en adolescentes con fibromialgia juvenil. MÉTODOS: Estudio retrospectivo realizado en pacientes con fibromialgia juvenil (criterios del Colegio Americano de Reumatología sometidos a al menos 11 sesiones

  19. The impact of schools on juvenile substance initiation and use.

    Science.gov (United States)

    Amuedo-Dorantes, Catalina; Mach, Traci; Clapp, John D

    2004-06-01

    We use data from the two rounds of the NLSY97 and the corresponding QED data to examine the effectiveness of school endowments and curricula in targeting juvenile use of tobacco, alcohol, and marijuana. Our results support the notion that schools matter in reducing juvenile involvement in substance use. Higher discretionary dollars per pupil are linked to reduced rates of juvenile initiation and repetitive use rates of cigarettes and marijuana. Additionally, school curricula, as indicated by the implementation of year round classes and some innovative and after-school programs--such as gifted and talented, attendance monitoring, homework hotline, international baccalaureate, extended-day, and mentoring, programs, affect both juvenile initiation to tobacco and alcohol use and juvenile repetitive use of tobacco and alcohol. In particular, we find that juvenile initiation to cigarette use is approximately between 2 percentage points and 3 percentage points lower among youths attending schools with gifted and talented and international baccalaureate programs. In addition, juvenile repetitive cigarette use is approximately 54%, 52%, and 48% lower among youths attending schools offering year round classes, international baccalaureate, and twenty-first century programs, respectively. Finally, juvenile initiation to alcohol use and juvenile repetitive use of alcohol are approximately 3% and 20% lower, respectively, among youths in schools offering gifted and talented programs. In sum, while these programs are not implemented to address substance use problems among the student body, we find that the implementation of these programs is often accompanied by a reduction in juvenile initiation and repetitive substance use.

  20. THE JUVENILE JUSTICE SYSTEM IN SPAIN

    Directory of Open Access Journals (Sweden)

    JosA Luis de la Cuesta

    2009-10-01

    Full Text Available 1. Relevant legal framework regulating criminal proceedings against juvenile offenders. 2. Age thresholds of criminal responsibility and liability to prosecution. 3. Specialized agencies. 3.1. Judges specialization. 3.2. Prosecutor\\'s specialization. 3.3. Specialization required for any, other figure acting in the proceedings. 3.4. Social services (or similar agencies involved in the proceedings. 4. Early definition of the proceedings. 5. Personality assessment procedures. 6. Mediation. 7. Personal liberty. 8. Safeguards for the protection of minors. 8.1. Affective and/or psychological assistance. 8.2. Preventing the disclosure of the juvenile offender\\'s identity. 8.3. Other measures. 9. Final remarks.

  1. The correlation of the first tarsometatarsal joint instability and transfer metatarsalgia after hallux valgus surgery A finite element study of distribution of pressure under forefoot metatarsal heads%第1跖楔关节失稳与(足母)外翻术后转移性跖骨痛相关性-前足跖骨头下压力的有限元研究

    Institute of Scientific and Technical Information of China (English)

    金立夫; 胡海威; 温建民; 荀淑英; 梁朝; 程桯; 蒋科卫; 孙卫东

    2013-01-01

    [目的] 建立(足母)外翻术后转移性跖骨痛足的有限元模型,探索足第1跖楔关节在矢状位的角度变化对前足跖骨头下的应力影响.[方法] 对(足母)外翻术后转移性跖骨痛患足进行CT扫描,利用VTK、Geomagic Studio 8.0、AN-SYS 13.0软件在计算机内构建右足三维有限元模型,静态直立加载人体重力,矢状位模拟第1跖楔关节角度分别在9°、12°、15°时,综合观察前足第1~5跖骨头下应力数值变化特点.[结果] 通过有限元方法对应力分析,第2、3、5跖骨头下Von Mises应力呈增大趋势,内侧籽骨应力逐渐减小,外侧籽骨应力先减小后增大,第4跖骨头下应力先增大后减小.[结论] 利用有限元分析方法研究第1跖楔关节对前足的应力影响,随着第1跖楔关节角度增加,前足外侧应力负荷有增大趋势.第1跖楔关节失稳可能是引起转移性跖骨痛发生的一个相关因素.临床医生对第1跖楔关节失稳应予以充分的重视,对于术前检查存在第1跖楔关节失稳,X线片有阳性表现的患者应向其交待术后出现转移性跖痛症的风险,并建议患者行跖楔关节融合术,以减少术后出现跖痛症的发生概率.

  2. Juvenile rheumatoid arthritis and lymphoedema: lymphangiographic aspects

    Energy Technology Data Exchange (ETDEWEB)

    Schmit, P.; Brunelle, F. [Service de Radiopediatrie, Groupe Hospitalier Necker-Enfants-Malades, Paris (France); Prieur, A.M. [Unite Fonctionnelle de Rhumatologie Infantile, Groupe Hospitalier Necker-Enfants-Malades, Paris (France)

    1999-05-01

    We report a 5{sup 1}/{sub 2}-year-old boy with juvenile rheumatoid arthritis (JRA) and lower-limb lymphoedema. US, MRI and lymphangiography were performed. Based on the lymphangiographic study, we propose a pathogenesis based on obstruction of normal superficial lymphatic vessels in the affected limb. This is discussed with other pathogenetic factors proposed in the 16 previously reported cases of lymphoedema complicating JRA. (orig.) With 3 figs., 5 refs.

  3. El rock como conformador de identidades juveniles

    Directory of Open Access Journals (Sweden)

    Adrián de Garay

    1996-04-01

    Full Text Available El autor analiza la relación entre el rock y las identidades juveniles, a partir del abordaje de cinco “estilos” que se pueden identificar como constitutivos de éstas identidades. Ellos son: la jerga, la estética, las producciones culturales, los no-lugares y el territorio. Finaliza el artículo señalando algunos hitos importantes de la culturarockera en la ciudad de México.

  4. Juvenile myoclonic epilepsy: clinical and EEG features

    DEFF Research Database (Denmark)

    Pedersen, S B; Petersen, K A

    1998-01-01

    We aimed to characterize the clinical profile and EEG features of 43 patients with juvenile myoclonic epilepsy. In a retrospective design we studied the records of, and re-interviewed, 43 patients diagnosed with JME from the epilepsy clinic data base. Furthermore, available EEGs were re-evaluated...... were sleep deprivation (84%), stress (70%), and alcohol consumption (51%). EEG findings included rapid spike-wave and polyspike-wave....

  5. De las bandas a las culturas juveniles

    Directory of Open Access Journals (Sweden)

    Carles Feixa

    1994-01-01

    Full Text Available This article is an exposition about the processes of elaboration oftheoretical concepts and methodological schemes of five ofthe princi-pal theoretical methodological paradigms thatstudygangsand juveni-le cultures in western contemporary societies. These processes oftheoretical methodological elaboration are derived from the resul-ting empirical data based on participatory observation, analysis andrellection about the conducts displayedby theadolescents as membersof a larger society.

  6. Juvenile ossifying fibroma: CT and MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Khoury, Nabil J.; Naffaa, Lena N.; Haddad, Maurice C. [Department of Diagnostic Radiology, American University of Beirut Medical Center, P.O. Box 113-6044, Beirut (Lebanon); Shabb, Nina S. [Department of Pathology, American University of Beirut - Medical Center, P.O. Box 113-6044, Beirut (Lebanon)

    2002-07-01

    We describe the CT findings in four patients and the MR imaging in one patient with juvenile ossifying fibroma. Three lesions involved the maxillary sinus and extended to the surrounding structures; one lesion was confined to the maxillary bone. CT scan revealed well-defined, expansile lesions with variable amount of calcifications. On MRI one lesion had intermediate signal intensity with significant contrast enhancement. (orig.)

  7. Solitary ulcerated congenital giant juvenile xanthogranuloma

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    Su Yuen Ng

    2015-01-01

    Full Text Available A 3-month-old female patient with a giant ulcerated nodule over the back since birth was diagnosed as congenital giant juvenile xanthogranuloma (JXG based on clinical and histopathological examination. Congenital giant JXG with ulceration at birth is a rare presentation of JXG and commonly misdiagnosed. This case emphasizes the importance of being aware of the myriad presentations of JXG in order to make a correct diagnosis and avoid unnecessary investigations or treatment.

  8. Do Juvenile Curfew Laws Reduce Underage Drinking?

    Science.gov (United States)

    Grossman, Elyse R.; Jernigan, David H.; Miller, Nancy A.

    2016-01-01

    Objective: Although not originally enacted to deter the problem of underage drinking in the United States, one set of laws that may influence this behavior is juvenile curfew laws. This research asked the following: (a) What is the effect of enacting a juvenile curfew law on youth drinking, and (b) do demographic variables moderate the relation between juvenile curfew law enactment and drinking? This study examined the effect of juvenile curfew laws on underage drinking, using data from 46 U.S. cities from 1991 to 2005. Method: In 2014, we compiled a data set containing alcohol and curfew law data by zip code. It included 63,081 minors (ages 12–17 years) from 1,081 zip codes. We used difference-in-difference regressions to analyze the data. Results: The effect of the enactment of a curfew law on the likelihood of consuming alcohol in the past year or past 30 days or of heavy episodic drinking in the past 2 weeks was not significant when compared with cities without curfew laws during the same periods. Although the likelihood of consuming alcohol over the past year differed depending on an individual’s characteristics (e.g., race/ethnicity, age, and gender), none of the interaction terms between these characteristics and curfew laws were significant. Conclusions: Curfew laws appear to have a non-significant effect on youth drinking, but these results are unclear without more knowledge as to where and when youth are drinking both before and after the enactment of curfew laws and how these laws are being enforced. PMID:27340963

  9. Worth replacing a loss of medial meniscal tissue with a polyurethane substitute (Actifit®) when performing a valgus tibial osteotomy addition

    Science.gov (United States)

    Gelber, Pablo E.; Isart, Anna; Erquicia, Juan I.; Tey, Marc; Pelfort, Xavier; Abat, Ferran; Monllau, Juan Carlos

    2015-01-01

    Introduction: The addition tibial valgus osteotomy (ovat) is a common treatment of symptomatic genu varus. This frequently is accompanied by considerable loss of medial meniscal tissue. The aim was to evaluate, in the context of performing a ovat, restoring the functional impact of this lack of medial meniscal tissue with Actifit® compared with the simple meniscectomy. Material and Methods: Sixty patients with symptomatic genu varo operated with ovat were studied prospectively. In 30 patients we have left a medial meniscal defect> 25 mm (M) and in 30 a medial Actifit® was implanted(A). The evaluations were performed using Womet, IKDC, Kujala, EVA and satisfaction (0-4). Results: Both groups were statistically comparable preoperatively, including follow-up time (31.2 months; range, 24-47.5; p = 0.35). 53.4 ± 8.4 Womet improved and 42.4 ± 17.2 points in M and A (p = 0.002), improved IKDC 56.7 ± 12 and 50.3 ± 15.6 points in M and A (p = 0.107), 50.4 ± 14.7 Kujala improved to 38.9 ± 21.6 points M and A (p = 0.02) and VAS decreased 6.9 ± 2.1 and 4.7 ± 2.8 points in M and A (p = 0.006). The satisfaction was 3.3 ± 0.8 and 3.3 ± 1 in M and A (p = 0.84). Conclusions: The symptomatic genu varus treated with OVAT associated to medial meniscectomy led, compared to when it was associated with the implantation of a medial Actifit®, to a marked improvement in most of the scales tested. There was no difference in the degree of satisfaction. Based on short-term results of this study, restitution replacement with polyurethane substitute can not be recommended to perform a ovat.

  10. Clinical presentation of juvenile Huntington disease

    Directory of Open Access Journals (Sweden)

    Ruocco Heloísa H.

    2006-01-01

    Full Text Available OBJECTIVE: To describe the clinical presentation a group of patients with juvenile onset of Huntington disease. METHOD: All patients were interviewed following a structured clinical questioner. Patients were genotyped for the trinucleotide cytosine-adenine-guanine (CAG repeat in the Huntington Disease gene. High resolution brain MRI was performed in all patients. RESULTS: We identified 4 patients with juvenile onset of disease among 50 patients with Huntington disease followed prospectively in our Neurogenetics clinic. Age at onset varied from 3 to 13 years, there were 2 boys, and 3 patients had a paternal inheritance of the disease. Expanded Huntington disease allele sizes varied from 41 to 69 trinucleotide repeats. The early onset patients presented with rigidity, bradykinesia, dystonia, dysarthria, seizures and ataxia. MRI showed severe volume loss of caudate and putamen nuclei (p=0.001 and reduced cerebral and cerebellum volumes (p=0.01. CONCLUSION: 8% of Huntington disease patients seen in our clinic had juvenile onset of the disease. They did not present with typical chorea as seen in adult onset Huntington disease. There was a predominance of rigidity and bradykinesia. Two other important clinical features were seizures and ataxia, which related with the imaging findings of early cortical atrophy and cerebellum volume loss.

  11. JUVENILE IDIOPATHIC ARTHRITIS – A CASE REPORT

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    Paresh H

    2012-11-01

    Full Text Available ABSTRACT: The prevalence of Juvenile idiopathic arthritis (JIA is 0.86 per 1000 children. Subcutaneous nodules have been reported in 5% to 10% of children with JIA. Approximately 90% of patients with RA and subc utaneous nodules test positive for rheumatoid factor (RF, and approximately 40% o f all RF-seropositive patients with RA have subcutaneous nodules, whereas only 6% in volvement is seen in seronegative cases. We hereby report a case of atypical Juvenile idiopathic arthritis (JIA in a 6 year old, female child with joint pain & myalgia along with subcutaneous nodules over the dorsum of feet, hands and elbows. Joint pain initial ly involving the left ankle, slowly progressed to involve the knee, shoulder, wrist, metacar pophalangeal and interphalangeal joints over a period of one year. Joint involvement was not symmetric. RF was Negative. Fundoscopy examination was normal. Histopathological examinat ion revealed a central zone of Fibrinoid necrosis surrounded by epithelioid h istiocytes and occasional lymphocytes. Differential diagnosis of Rheumatoid Nodule (R N or Subcutaneous Granuloma Annulare (SGA or Necrobiosis Lipoidica Diabeticorum was made. In light of clinicopathological findings, both SGA and NLD were ruled out a nd the diagnosis of Juvenile idiopathic arthritis presenting as RF-negative polyarthritis was made.

  12. Habitat selection by juvenile Mojave Desert tortoises

    Science.gov (United States)

    Todd, Brian D; Halstead, Brian J.; Chiquoine, Lindsay P.; Peaden, J. Mark; Buhlmann, Kurt A.; Tuberville, Tracey D.; Nafus, Melia G.

    2016-01-01

    Growing pressure to develop public lands for renewable energy production places several protected species at increased risk of habitat loss. One example is the Mojave desert tortoise (Gopherus agassizii), a species often at the center of conflicts over public land development. For this species and others on public lands, a better understanding of their habitat needs can help minimize negative impacts and facilitate protection or restoration of habitat. We used radio-telemetry to track 46 neonate and juvenile tortoises in the Eastern Mojave Desert, California, USA, to quantify habitat at tortoise locations and paired random points to assess habitat selection. Tortoise locations near burrows were more likely to be under canopy cover and had greater coverage of perennial plants (especially creosote [Larrea tridentata]), more coverage by washes, a greater number of small-mammal burrows, and fewer white bursage (Ambrosia dumosa) than random points. Active tortoise locations away from burrows were closer to washes and perennial plants than were random points. Our results can help planners locate juvenile tortoises and avoid impacts to habitat critical for this life stage. Additionally, our results provide targets for habitat protection and restoration and suggest that diverse and abundant small-mammal populations and the availability of creosote bush are vital for juvenile desert tortoises in the Eastern Mojave Desert.

  13. 重度膝关节外翻畸形的全膝关节置换术%Total knee arthroplasty for severe valgus knee deformity

    Institute of Scientific and Technical Information of China (English)

    任姜栋; 张晓岗; 曹力; 吾湖孜·吾拉木; 郭文涛; 彭理斌

    2014-01-01

    Objective To investigate the surgical methods and clinical effects of total knee arthroplasty (TKA) in patients with severe valgus knee deformity.Methods From January 2007 to December 2012,22 patients with 23 severe valgus knee deformity underwent TKA by means of medial parapatellar approach,standard osteotomy and only lateral soft tissue release with posterior stabilized implants were retrospectively analyzed.They were 7 males and 15 females,aged from 41 to 78 years,with an average age of 65 years.Tibiofemoral angle (angle between the femur and tibia anatomic axis) was 22°-50°,with an average of 34.6±2.4°.Among them,17 cases were osteoarthritis,5 cases were rheumatoid arthritis,3 cases complicated with patella dislocations,1 case complicated with medial instability,3 cases of 4 knees complicated with flexion contracture.Posterior stabilized prosthesis were used in 21 cases of 22 knees,constrained prosthesis were used in 1 case of 1 knee,5 cases accepted intraoperative patellar replacement.Clinical and radiographic evaluations including range of motion (ROM),the Hospital for Special Surgery (HSS)knee score and the tibial and femur angle (T-F angle) were performed at follow-up.Results The duration of follow-up averaged 30.5 months.The average HSS score improved from 19.6±4.7 points preoperatively to 89.7±3.6 points at the time of the last follow up.The average ROM improved from 43.7°-±5.8° preoperatively to 110.6°±7.5°.The average T-F angle was 8.6°±0.8°.We had 5 patella replacements,2 medial instability cured by using articular branches,2 palsies of nervus peroneus communis recovering after 3 months.No complications such as infection,DVT,or component loosening.Conclusion The techniques of medial parapatellar approach,standard osteotomy and only lateral soft tissue release with posterior stabilized implants can deal with a severe valgus knee deformity very successfully in patients undergoing primary total knee arthroplasty,and provide excellent

  14. Criminal profiles of violent juvenile sex and violent juvenile non sex offenders: an explorative longitudinal study.

    Science.gov (United States)

    van Wijk, Anton Ph; Mali, Bas R F; Bullens, Ruud A R; Vermeiren, Robert R

    2007-10-01

    Few studies have longitudinally investigated the criminal profiles of violent juvenile sex and violent juvenile non-sex offenders. To make up for this lack, this study used police records of juveniles to determine the nature of the criminal profiles of violent sex offenders (n = 226) and violent non-sex offenders (n = 4,130). All offenders committed their first offense in 1996 and were followed for 7 years. Results showed that violent sex offenders and violent non-sex offenders cannot be considered a homogeneous group because of different background characteristics and criminal profiles. Sex and violent offenses often constitute a small part of a broader criminal pattern. Further research is necessary to reveal in more detail the developmental and criminological patterns of violent and sexual delinquency. Treatment and intervention programs may benefit from this.

  15. Protection of juveniles: Victims of abuse and neglect in Serbia

    Directory of Open Access Journals (Sweden)

    Stevanović Ivana

    2005-01-01

    Full Text Available This paper is dedicated to analyses of the protection of juveniles - victims of abuse and neglect in criminal legal system of the Republic of Serbia. Particular attention is paid to of criminal acts against sexual integrity and family life of juveniles. The position of juveniles as witnesses in the criminal procedure has been viewed from the aspect of specify and vulnerability of the child, as well as through terms of secondary and tertiary victimization of minor as a victim.

  16. Giant Bilateral Juvenile Fibroadenoma of the Breast in Prepubescent Girl.

    Science.gov (United States)

    Khan, Salma; Khan, Momna; Rafique, Sadia

    2015-10-01

    Juvenile fibroadenoma accounts for 4% of the total fibroadenomas. Giant juvenile fibroadenoma is found in only 0.5% of all fibroadenomas. The authors report a 10-year girl presenting with progressive enlargement of both breasts for one year. Based on clinical findings and Fine Needle Aspiration Cytology (FNAC), a diagnosis of bilateral giant juvenile fibroadenomas of breast was made. She underwent bilateral lumpectomy with breast conservation and made uneventful postoperative recovery.

  17. New Ultrasound Biomicroscopy Iris Findings in Juvenile Xanthogranuloma.

    Science.gov (United States)

    Syed, Zeba A; Chen, Teresa C

    2016-08-01

    We report a case of juvenile xanthogranuloma in a 12-month-old girl presenting with heterochromia, hyphema, and elevated intraocular pressure. This case demonstrates new ultrasound biomicroscopy iris findings of a generalized bumpy iris contour, suggesting diffuse heterogeneous involvement. This imaging finding has not been previously described. Untreated, iris juvenile xanthogranuloma may lead to corneal blood staining, glaucoma, and amblyopia. An understanding of the full range of ultrasound features of juvenile xanthogranuloma expands our appreciation for the clinical findings in this condition.

  18. Penalty responsibility of juveniles in the Republic of Srpska

    Directory of Open Access Journals (Sweden)

    Grbić-Pavlović Nikolina

    2011-01-01

    Full Text Available The youngest members of organized society, more intensive than ever enter the circle of those whose behavior is deviant. Juvenile delinquency is a social problem, which recently experienced an expansion in all modern countries, including Bosnia and Herzegovina and the Republic of Srpska. Considering the fact that juvenile delinquency includes lighter criminal conducts, such as, for example misdemeanors, in this paper a position of juveniles when they are a perpetrators of misdemeanors will be analyzed. Also, the paper will statistically show the number of misdemeanors in the field of public peace and order that juveniles conducted in the Republic of Srpska in the period 2004-2009.

  19. Eliminating the Competency Presumption in Juvenile Delinquency Cases.

    Science.gov (United States)

    Katner, David R

    2015-01-01

    The legal presumption used in virtually all juvenile delinquency cases in the U.S. is that all juveniles are competent to stand trial. This Article calls for the elimination of that legal presumption, which is historically based on the Dusky v. United States decision and in the adult criminal justice system. The recent decisions of the U.S. Supreme Court recognize the developmental and organic brain differences between adults and juveniles. Current research demonstrates a higher frequency rate of incompetence based on intellectual deficiencies among children when compared with adults found to be not legally competent to stand trial. By eliminating the competency presumption for juveniles in both delinquency and adult criminal proceedings, the party seeking an adjudication would be responsible for establishing that the accused juvenile is in fact, competent to stand trial. Foreign jurisdictions in Europe, Asia, Africa, and South America have long required higher thresholds--at least fourteen years of age--for holding juveniles accountable for criminal misconduct, none of them presuming that juveniles are competent to go to trial. In the alternative, by expanding the factors currently in use for determination of juvenile competency by adding developmental immaturity and mental illness, juvenile justice systems could identify the reduction of recidivist offending as the primary systemic objective.

  20. Food resource utilization by juvenile Baltic cod Gadus morhua : a mechanism potentially influencing recruitment success at the demersal juvenile stage?

    DEFF Research Database (Denmark)

    Hüssy, Karin; St. John, Michael; Böttcher, U.

    1997-01-01

    those reported to be consumed by juveniles in other areas. The apparent overlap in food resource utilization among the different size groups of demersal juveniles observed in this study suggests that in years with low prey abundance, or high abundance of pelagic juveniles, strong intra......Pelagic and demersal juvenile Baltic cod Gadus morhua L. were collected during surveys in the Bornholm Basin (Baltic Sea) in autumn 1994. Stomach contents were examined for prey composition in order to evaluate the potential importance of the pelagic and demersal habitats for recruitment success....... Juvenile cod less than 40 mm fed exclusively on pelagic prey such as copepods and cladocerans. Between 40 and 50 mm the juveniles began to consume benthic prey such as mysids and amphipods; however, copepods were still the dominant food organisms. Between 50 and 70 mm the dominant prey items consumed were...

  1. Growth of juvenile shrimp Metapenaeus monoceros fed with squid and mussel

    Digital Repository Service at National Institute of Oceanography (India)

    Achuthankutty, C.T.; Nair, S.R.S.; Krishnakumari, L.

    Small juveniles of both sexes and females of large juveniles of Metapenaeus monoceros attained faster growth with squid diet. Males of large juveniles registered better growth with mussel diet. No significant difference was observed in moult weights...

  2. 78 FR 42109 - Agency Information Collection Activities; Proposed Collection; Comments Requested: Juvenile...

    Science.gov (United States)

    2013-07-15

    ...: Juvenile Justice Reform and Reinvestment Initiative Stakeholder Survey Under OMB's Partnership Fund ACTION: 60 Day Notice. The Department of Justice (DOJ), Office of Justice Programs, Office of Juvenile...-3649, Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs,...

  3. 77 FR 70473 - Office of Juvenile Justice and Delinquency Prevention; Agency Information Collection Activities...

    Science.gov (United States)

    2012-11-26

    ... of Juvenile Justice and Delinquency Prevention; Agency Information Collection Activities: Proposed Collection; Comments Requested; Census of Juveniles in Residential Placement (Revision of a Currently..., Office of Juvenile Justice and Delinquency Prevention, will be submitting the following...

  4. 78 FR 40189 - Agency Information Collection Activities; Proposed Collection; Comments Requested: Juvenile...

    Science.gov (United States)

    2013-07-03

    ... of Juvenile Justice and Delinquency Prevention Agency Information Collection Activities; Proposed Collection; Comments Requested: Juvenile Residential Facility Census (Extension, Without Change, of a... Programs, Office of Juvenile Justice and Delinquency Prevention, will be submitting the...

  5. 78 FR 66383 - Agency Information Collection Activities; Proposed Collection; Comments Requested: Juvenile...

    Science.gov (United States)

    2013-11-05

    ... of Justice Programs Office of Juvenile Justice and Delinquency Prevention Agency Information Collection Activities; Proposed Collection; Comments Requested: Juvenile Justice Reform and Reinvestment... (DOJ), Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention, will...

  6. The challenges of the first migration : movement and behaviour of juvenile vs. adult white storks with insights regarding juvenile mortality

    OpenAIRE

    Rotics, Shay; Kaatz, Michael; Resheff, Yehezkel S.; Turjeman, Sondra Feldman; Zurell, Damaris; Sapir, Nir; Fiedler, Wolfgang; Jeltsch, Florian; Wikelski, Martin; Nathan, Ran

    2016-01-01

    Migration conveys an immense challenge, especially for juvenile birds coping with enduring and risky journeys shortly after fledging. Accordingly, juveniles exhibit considerably lower survival rates compared to adults, particularly during migration. Juvenile white storks (Ciconia ciconia), which are known to rely on adults during their first fall migration presumably for navigational purposes, also display much lower annual survival than adults. Using detailed GPS and body acceleration data, ...

  7. Comparison of the localization of tetrodotoxin between wild pufferfish Takifugu rubripes juveniles and hatchery-reared juveniles with tetrodotoxin administration.

    Science.gov (United States)

    Okita, Kogen; Takatani, Tomohiro; Nakayasu, Junichi; Yamazaki, Hideki; Sakiyama, Kazutaka; Ikeda, Koichi; Arakawa, Osamu; Sakakura, Yoshitaka

    2013-09-01

    To reveal the accumulation profile of tetrodotoxin (TTX) in pufferfish Takifugu rubripes juveniles, we compared the localization of TTX in various tissues among wild juveniles and hatchery-reared juveniles with or without TTX administration using immunohistochemical technique with anti-TTX monoclonal antibody. Immuno-positive reaction was observed in hepatic tissue, basal cell of skin and olfactory, olfactory epithelium, optic nerve and brain (optic tectum, cerebellum, medulla oblongata) of wild juveniles (body length: BL, 4.7-9.4 cm). TTX was detected in the same tissues as wild juveniles and epithelial cell layer of intestine of hatchery-reared juveniles (BL, 5.0-5.3 cm) to which TTX was orally administrated. No positive reaction was observed from the tissues of hatchery-reared juveniles without TTX administration. These results suggest that orally administrated TTX to the non-toxic cultured juveniles is accumulated in the same manner of wild juveniles. In addition, our study revealed that pufferfish accumulates TTX in the central nervous system.

  8. Tropical tree rings reveal preferential survival of fast-growing juveniles and increased juvenile growth rates over time.

    Science.gov (United States)

    Rozendaal, Danaë M A; Brienen, Roel J W; Soliz-Gamboa, Claudia C; Zuidema, Pieter A

    2010-02-01

    Long-term juvenile growth patterns of tropical trees were studied to test two hypotheses: fast-growing juvenile trees have a higher chance of reaching the canopy ('juvenile selection effect'); and tree growth has increased over time ('historical growth increase'). Tree-ring analysis was applied to test these hypotheses for five tree species from three moist forest sites in Bolivia, using samples from 459 individuals. Basal area increment was calculated from ring widths, for trees rings formed by small juveniles. Thus, extant adult trees in these species have had higher juvenile growth rates than extant juvenile trees. By contrast, rings formed by somewhat larger juveniles in four species showed the opposite pattern: a historical growth increase. For most size classes of > 10 cm diameter none of the patterns was found. Fast juvenile growth may be essential to enable tropical trees to reach the forest canopy, especially for small juvenile trees in the dark forest understorey. The historical growth increase requires cautious interpretation, but may be partially attributable to CO(2) fertilization.

  9. Juvenile Justice in Australia 2009-10. Juvenile Justice Series. Number 8

    Science.gov (United States)

    Aalders, Rachel; Morgan, Kirsten

    2011-01-01

    In Australia, the state and territory governments are responsible for dealing with young people who are involved in crime. One major aspect of the juvenile justice system is the supervision of children and young people who have committed or are alleged to have committed an offence. This report presents information on the young people under…

  10. Predictors of Support for Juvenile Sex Offender Registration: Educated Individuals Recognize the Flaws of Juvenile Registration

    Science.gov (United States)

    Stevenson, Margaret C.; Smith, Amy C.; Sekely, Ady; Farnum, Katlyn S.

    2013-01-01

    We investigated demographic predictors of support for juvenile sex offender registration policies, including education level, gender, political orientation, and age. Participants were 168 individuals recruited from public places in a Midwest community (45% women; M age = 42). In line with hypotheses, as education level increased, support for…

  11. [What's new in forefoot surgery].

    Science.gov (United States)

    Ray, Adrien; Crevoisier, Xavier; Assal, Mathieu

    2010-12-22

    New implants and instruments have recently emerged in foot surgery. However, an additional and important development is the technique of minimally invasive surgery. As a result of new surgical approaches some common foot deformities can be corrected in a percutaneous manner. The benefits include improved wound healing, less pain, faster recovery, and less need for outpatient care. The main indications for such a technique are hallux valgus, correction of the lesser metatarsals, hallux rigidus, and some diabetic foot deformities.

  12. Gold nephropathy in juvenile rheumatoid arthritis.

    Science.gov (United States)

    Husserl, F E; Shuler, S E

    1979-01-01

    A 2-year-old girl was treated with gold salts for juvenile rheumatoid arthritis. Treatment had to be discontinued when persistent proteinuria was detected. As this case report indicates, close monitoring of the urine is mandatory during treatment with gold salts to detect early signs of toxicity: hematuria followed by casts and then proteinuria as therapy is continued. Histologic examination with electron microscopy will help to differentiate the different forms of gold toxicity. When the findings are consistent with gold-induced renal involvement, therapy should be discontinued. The gold nephropathy usually resolves in time, with no permanent renal damage.

  13. Juvenile idiopathic arthritis: the paediatric perspective

    Energy Technology Data Exchange (ETDEWEB)

    Jordan, Alison [Birmingham Children' s Hospital, Department of Adolescent Rheumatology, Birmingham (United Kingdom); McDonagh, Janet E. [Birmingham Children' s Hospital, Institute of Child Health, Birmingham (United Kingdom)

    2006-08-15

    Paediatric rheumatology is a relatively new specialty that has developed rapidly over the last 30 years. There have been major advances, which have included improvements in the classification and management of juvenile idiopathic arthritis (JIA). The former has led to enhanced international collaboration with disease registries, multicentre research and the development of new therapeutic agents. This has resulted in improved disease control and remission induction in many. There is, however, still significant morbidity associated with JIA during childhood, adolescence and adulthood, and challenges for the future include early identification of those with a poorer prognosis, appropriate administration of safe therapies and optimizing outcomes as young people move through adolescence into adulthood. (orig.)

  14. Massive juvenile angiomatosis of maxilla and mandible

    Directory of Open Access Journals (Sweden)

    Dinesh Singh Chauhan

    2014-01-01

    Full Text Available Angiomatosis is a complex vascular malformation of infancy and childhood consisting of proliferating blood vessels with accompanying mature fat, fibrous tissue, lymphatic′s and nerves, which may involve skin, subcutaneous tissue, skeletal muscle and occasionally bone. It is extremely rare and benign, but a clinically extensive vascular lesion of soft-tissue, which usually becomes symptomatic during childhood or adolescence. We report a rare case of massive juvenile angiomatosis of maxilla and mandible in a 15-year-old male patient.

  15. Juvenile hyaline fibromatosis: a case report.

    Science.gov (United States)

    Karaçal, Naci; Gülçelik, Nevzat; Yildiz, Kadriye; Mungan, Sevdegül; Kutlu, Necmettin

    2005-07-01

    Juvenile hyaline fibromatosis ( JHF ) is a rare autosomal recessive disease characterized by papulonodular skin lesions, gingival hyperplasia, joint contractures, and bone lesions. The skin lesions may consist of multiple large tumors, commonly on the scalp and around the neck, and small pearly, pink papules and plaques on the trunk, chin, ears, and around the nostrils. Here, we report a 2-year-old boy with characteristic stiffness of the knees and elbows and pink confluent papules on the paranasal folds, and periauricular and perianal regions. He also had hard nodules all over the scalp and around the mouth, and severe gingival hyperplasia. The lesions were totally excised and clinicopathological diagnosis was JHF.

  16. Managing juvenile Huntington’s disease

    OpenAIRE

    Quarrell, Oliver W. J.; Nance, Martha A.; Nopoulos, Peggy; Paulsen, Jane S.; Smith, Jonathan A.; Squitieri, Ferdinando

    2013-01-01

    Huntington’s disease (HD) is a well-recognized progressive neurodegenerative disorder that follows an autosomal dominant pattern of inheritance. Onset is insidious and can occur at almost any age, but most commonly the diagnosis is made between the ages of 35 and 55 years. Onset ≤20 years of age is classified as juvenile HD (JHD). This age-based definition is arbitrary but remains convenient. There is overlap between the clinical pathological and genetic features seen in JHD and more traditio...

  17. Cranial juvenile psammomatoid ossifying fibroma: case report.

    Science.gov (United States)

    Barrena López, Cristina; Bollar Zabala, Alicia; Úrculo Bareño, Enrique

    2016-03-01

    Juvenile psammomatoid ossifying fibroma (JPOF) is a fibroosseous tumor that arises in the craniofacial bones in young people. This lesion usually originates in the jaw, orbit, and ethmoid complex but can also be associated with the skull base and calvaria. Diagnosis must be made based on observing typical radiological and histopathological features. Although JPOF is a rare pathological entity, neurosurgeons must consider this odontogenic lesion in the differential diagnosis of skull masses given the lesion's aggressive behavior and locally invasive growth. Treatment must be gross-total resection. In the following article, the authors present a case of cranial JPOF and discuss various aspects of this entity.

  18. Juvenile idiopathic arthritis: a clinical overview

    Energy Technology Data Exchange (ETDEWEB)

    Davidson, J

    2000-02-01

    The chronic arthritides in childhood remain a poorly understood group of conditions. Their classification has been a source of much confusion over the years with differences in terminology between Europe and North America. A significant step forward in paediatric rheumatology has been the recent development of an internationally agreed classification system which uses the overall term juvenile idiopathic arthritis (JIA). The various subtypes of JIA and their clinical features are described, together with an overview of their differential diagnosis, complications and outcomes. An outline of current management strategies is given and potential future developments highlighted.

  19. CYCLOSPORIN A IN THERAPY FOR JUVENILE ARTHRITIS

    Directory of Open Access Journals (Sweden)

    E S Fedorov

    2010-01-01

    Full Text Available The paper describes approaches to using cyclosporin A (CsA in juvenile arthritis (JA. It shows the benefits of combination basic therapy with CsA and methotrexate included into a treatment regimen mainly for systemic JA and JA involving the eye (uveitis versus monotherapy with the above drugs. Attention is drawn to that the oral dose of glucocorticoids may be decreased when CsA is incorporated into the treatment regimen. CsA is shown to be of value as the drug of choice for the therapy of such a menacing complication of systemic JA as the macrophage activation syndrome

  20. Polipose juvenil: relato de 2 casos Juvenile polyposis: case two report

    Directory of Open Access Journals (Sweden)

    Juvenal da Rocha Torres Neto

    2010-06-01

    Full Text Available A Polipose Juvenil é uma afecção rara e faz parte do grupo das poliposes hamartomatosas familiares (PHF. É uma síndrome autossômica dominante que pode ser desencadeada por mutações no gene SMAD4/DPC4 (que codifica um sinalizador intermediário de TGF-b. Caracteriza-se pelo aparecimento de 10 ou mais pólipos hamartomatosos (juvenis no trato gastrintestinal, predominando no cólon. Costuma manifestar-se entre 4 e 14 anos de idade. Alguns pólipos adquirem focos adenomatosos apesar da natureza hamartomatosa das lesões e há chance de malignização. Relato de 2 casos de pacientes portadores de Polipose Juvenil colônica associada a focos de adenoma com displasia e revisão da literatura.Juvenile Polyposis Syndrome is a rare disease and is included in the Hamartomatous Familial Polyposis's (HFP group. It's an autosomal dominant syndrome which can be determinated by SMAD4/DPC4 germline mutations (which codifies an intermediary mediator of TGF-b. It's characterized by 10 or more hamartomatous polyps (juveniles throughout the gastrointestinal tract, especially in the colon. The symptoms usually appears between the ages of 4 and 14 years old. Some polyps can acquire adenomatous changes despite the lesion's hamartomatous nature and there's chance of colorectum malignization. Case report of two patients with Juvenile Polyposis coli associated to adenomatous changes with dysplasia and literature review.

  1. Dating Violence and Girls in the Juvenile Justice System

    Science.gov (United States)

    Kelly, Patricia J.; Cheng, An-Lin; Peralez-Dieckmann, Esther; Martinez, Elisabeth

    2009-01-01

    The purpose of this study is to explore the prevalence and associated behaviors of dating violence among a population of girls in the juvenile justice system. A sample of 590 girls from an urban juvenile justice system completed a questionnaire assessing attitudes and self-efficacy about and occurrence of dating violence. The analysis developed a…

  2. The Challenges in Providing Needed Transition Programming to Juvenile Offenders

    Science.gov (United States)

    Platt, John S.; Bohac, Paul D.; Wade, Wanda

    2015-01-01

    The transition to and from juvenile justice settings is a complex and challenging process. Effectively preparing juvenile justice personnel to address the transition needs of incarcerated students is an essential aspect of reducing the negative effects of the school-to-prison pipeline. This article examines program and professional development…

  3. Psychiatric Disorders of Youth in Detention. Juvenile Justice Bulletin

    Science.gov (United States)

    Teplin, Linda A.; Abram, Karen M.; McClelland, Gary M.; Mericle, Amy A.; Dulcan, Mina K.; Washburn, Jason J.

    2006-01-01

    This bulletin examines the prevalence of alcohol, drug, and mental disorders among youth at the Cook County (Illinois) Juvenile Temporary Detention Center, by gender, race/ethnicity, and age. Drawing on research conducted by the Northwestern Juvenile Project, this bulletin finds that nearly two-thirds of males and three-quarters of females studied…

  4. Treatment for Juveniles Who Sexually Offend in a Southwestern State

    Science.gov (United States)

    Ikomi, Philip A.; Harris-Wyatt, Georgetta; Doucet, Geraldine; Rodney, H. Elaine

    2009-01-01

    A 25-item questionnaire was mailed to sex offender treatment providers from counties with 60 or more reported juvenile sex offenders in a Southwestern state to determine the most effective treatment for juvenile sex offenders. Results indicated that cognitive behavioral therapy was the most successful reported approach to treatment with an average…

  5. Juvenile female sex offenders: Offender and offence characteristics

    NARCIS (Netherlands)

    Wijkman, M.; Bijleveld, C.; Hendriks, J.

    2014-01-01

    Almost all research on juvenile sex offending pertains to adolescent males. This study comprises all female juveniles convicted for sexual offences in the Netherlands between 1993 and 2008 (N = 66). From analysis of their court files and their criminal records, these female offenders are described i

  6. 28 CFR 0.57 - Criminal prosecutions against juveniles.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Criminal prosecutions against juveniles. 0.57 Section 0.57 Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE Criminal Division § 0.57 Criminal prosecutions against juveniles. The Assistant Attorney...

  7. Family and Community Perceptions of Quality in Juvenile Justice Programs

    Science.gov (United States)

    Selber, Katherine; Streeter, Calvin

    2004-01-01

    The conceptualization and empirical assessment of service quality in juvenile justice remains limited. There are few reports on programmatic attempts to assess satisfaction in juvenile justice programs or attempts to include what constitutes quality of service from multiple customer perspectives. This article describes a potential model, the Gap…

  8. The Effects of Computerized Information Systems on Juvenile Courts

    Science.gov (United States)

    Albrecht, Gary L.

    1976-01-01

    Organizational theorists alternatively hypothesized that computerized information systems (CIS) will produce no necessary changes, centralization, or decentralization in juvenile courts. This hypothesis is supported by the results of a four year study on the phenomenon. Suggestions are offered for improving the juvenile judicial system through…

  9. A Structural Equation Modeling Analysis of Influences on Juvenile Delinquency

    Science.gov (United States)

    Barrett, David E.; Katsiyannis, Antonis; Zhang, Dalun; Zhang, Dake

    2014-01-01

    This study examined influences on delinquency and recidivism using structural equation modeling. The sample comprised 199,204 individuals: 99,602 youth whose cases had been processed by the South Carolina Department of Juvenile Justice and a matched control group of 99,602 youth without juvenile records. Structural equation modeling for the…

  10. Social Skills Training for Juvenile Delinquents: Post-Treatment Changes

    NARCIS (Netherlands)

    van der Stouwe, Trudy; Asscher, J.J.; Stams, G.J.J.M.; Hoeve, M.; van der Laan, Peter H.

    2016-01-01

    Objectives: To examine the post-treatment effectiveness of an outpatient, individual social skills training for juvenile delinquents in the Netherlands and to conduct moderator tests for age, gender, ethnicity, and risk of reoffending. Methods: The sample consisted of juveniles who received Tools4U,

  11. Social skills training for juvenile delinquents : Post-treatment changes

    NARCIS (Netherlands)

    van der Stouwe, T.; Asscher, J.J.; Hoeve, M.; van der Laan, P.H.; Stams, G.J.J.M.

    2016-01-01

    Objectives To examine the post-treatment effectiveness of an outpatient, individual social skills training for juvenile delinquents in the Netherlands and to conduct moderator tests for age, gender, ethnicity, and risk of reoffending. Methods The sample consisted of juveniles who received Tools4U, a

  12. Office of Juvenile Justice and Delinquency Prevention, 1991 Annual Report.

    Science.gov (United States)

    Digital Systems Research Inc., Arlington, VA.

    This report fulfills the annual reporting requirements of the Juvenile Justice and Delinquency Prevention (JJDP) Act of 1974 as amended, and describes the Office of Juvenile Justice and Delinquency Prevention's (OJJDP) efforts to carry out the broad mandates of the JJDP Act during fiscal year 1991. The report begins with an explanation of the…

  13. Practitioner Views of Priorities, Policies, and Practices in Juvenile Justice

    Science.gov (United States)

    Mears, Daniel P.; Shollenberger, Tracey L.; Willison, Janeen B.; Owens, Colleen E.; Butts, Jeffrey A.

    2010-01-01

    Dramatic changes in juvenile justice have occurred in recent decades. One result has been the emergence of new policies and practices, many of which remain largely unexamined. One avenue for gaining insight into whether such policies and practices are needed or effective, as well as into how the juvenile justice system might be improved, is to tap…

  14. Spatial dynamics of juvenile anchovy in the Bay of Biscay

    KAUST Repository

    Boyra, Guillermo

    2016-07-08

    In autumn 2009, the implementation of two successive acoustic surveys targeting juvenile anchovy (Engraulis encrasicolus) in the Bay of Biscay allowed us to monitor the changes in the spatial distribution and aggregation patterns of juveniles of this species during 45 days under fairly stable meteorological conditions. Juvenile anchovy changed its biological condition and behavior in a different manner in two distinct areas. In the Spanish sector, the juveniles migrated 20 nautical miles (n.mi.) towards the coast, but they remained on the shelf and near the surface during the whole surveyed period. As the advance towards the shelf break progressed, their area of distribution decreased, their density increased and the juveniles spread in fewer but heavier shoals. In the French sector, the juveniles also migrated from slope waters towards the coast at a similar velocity, but they crossed the shelf break into the continental shelf, where they increased their mean depth significantly until gradually adopting the typical nyctemeral migrations of adult anchovy. The mean length of the juveniles that adopted the nyctemeral migrations was significantly higher than that of the juveniles remaining at the surface, suggesting that body size is relevant to accomplish this change. Besides, the stronger temperature gradients between the shelf and oceanic waters in the Spanish sector, favored by a narrow shelf, may have acted as a barrier influencing the distinct observed spatial patterns in the two areas. © 2016 John Wiley & Sons Ltd

  15. Juvenile Crime and Criminal Justice: Resolving Border Disputes

    Science.gov (United States)

    Fagan, Jeffrey

    2008-01-01

    Rising juvenile crime rates during the 1970s and 1980s spurred state legislatures across the country to exclude or transfer a significant share of offenders under the age of eighteen to the jurisdiction of the criminal court, essentially redrawing the boundary between the juvenile and adult justice systems. Jeffrey Fagan examines the legal…

  16. Extinguishing All Hope: Life-without-Parole for Juveniles

    Science.gov (United States)

    Butler, Frank

    2010-01-01

    Sentencing juveniles to life-without-parole (JLWOP) is a practice fraught with ethical dilemmas. Through in-depth interviews with 11 men living sentences of JLWOP, their narratives of their backgrounds and experiences as juveniles were studied. Common themes were identified, and 3 general categories of cases emerged from the narratives. Ethical…

  17. IDEA-Related Professional Development in Juvenile Corrections Schools

    Science.gov (United States)

    Gagnon, Joseph Calvin; Steinberg, Mary Anne; Crockett, Jean; Murphy, Kristin M.; Gaddis, Justin

    2013-01-01

    Incarcerated youth are among the least academically and behaviorally competent students in the United States. In spite of juvenile justice reform efforts, including state and federal guarantees of appropriate education, educational services in juvenile corrections (JC) schools, especially for youth with disabilities, are lacking (Houchins,…

  18. The Content Validity of Juvenile Psychopathy: An Empirical Examination

    Science.gov (United States)

    Lynam, Donald R.; Derefinko, Karen J.; Caspi, Avshalom; Loeber, Rolf; Stouthamer-Loeber, Magda

    2007-01-01

    This study examined the content validity of a juvenile psychopathy measure, the Childhood Psychopathy Scale (CPS; D. R. Lynam, 1997), based on a downward translation of an adult instrument, the Hare Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991). The CPS was compared with two other indices of juvenile psychopathy: (a) an index derived…

  19. Dating Violence and Girls in the Juvenile Justice System

    Science.gov (United States)

    Kelly, Patricia J.; Cheng, An-Lin; Peralez-Dieckmann, Esther; Martinez, Elisabeth

    2009-01-01

    The purpose of this study is to explore the prevalence and associated behaviors of dating violence among a population of girls in the juvenile justice system. A sample of 590 girls from an urban juvenile justice system completed a questionnaire assessing attitudes and self-efficacy about and occurrence of dating violence. The analysis developed a…

  20. The Juvenile Addiction Risk Rating: Development and Initial Psychometrics

    Science.gov (United States)

    Powell, Michael; Newgent, Rebecca A.

    2016-01-01

    This article describes the development and psychometrics of the Juvenile Addiction Risk Rating. The Juvenile Addiction Risk Rating is a brief screening of addiction potential based on 10 risk factors predictive of youth alcohol and drug-related problems that assists examiners in more accurate treatment planning when self-report information is…

  1. Serum neopterin is not increased in obese juveniles.

    Science.gov (United States)

    Mangge, Harald; Freytag, Florian; Almer, Gunter; Weghuber, Daniel; Bauer-Denk, Carmen; Fuchs, Dietmar

    2011-01-01

    Objective. Cardiovascular disease is associated with inflammation and immune activation, concentrations of immune activation markers like neopterin predict outcome in adults. Methods. Serum neopterin concentrations and early metabolic and pre-atherosclerotic symptoms were analyzed in 295 obese juveniles and 101 normal weight controls of similar age. Additionally, the influence of a 12 months weight reduction program on neopterin levels was investigated in 31 obese juveniles. Results. Intima-media thickness of common carotid arteries (IMT) and the concentrations of C-reactive protein (CRP) were increased in the obese juveniles (P juveniles (P juvenile obesity behaved considerably different from what was demonstrated in adults, levels did not correlate with metabolic and pre-atherosclerotic symptoms found in early phases although early vascular burden and chronic low grade inflammation was indicated by increased IMT and CRP. Neopterin concentrations increased after a 12 months intervention program.

  2. Factors influencing predation on juvenile ungulates and natural selection implications

    Directory of Open Access Journals (Sweden)

    S. M. Barber-Meyer

    2008-06-01

    Full Text Available Juvenile ungulates are generally more vulnerable to predation than are adult ungulates other than senescent individuals, not only because of their relative youth, fragility, and inexperience, but also because of congenital factors. Linnell et al.’s (Wildl. Biol. 1: 209-223 extensive review of predation on juvenile ungulates concluded that research was needed to determine the predisposition of these juveniles to predation. Since then, various characteristics that potentially predispose juvenile ungulates have emerged including blood characteristics, morphometric and other condition factors, and other factors such as birth period, the mother’s experience, and spatial and habitat aspects. To the extent that any of the physical or behavioral traits possessed by juvenile ungulates have a genetic or heritable and partly independent epigenetic component that predisposes them to predation, predators may play an important role in their natural selection. We review the possible influence of these characteristics on predisposing juvenile ungulates to predation and discuss natural selection implications and potential selection mechanisms. Although juvenile ungulates as a class are likely more vulnerable to predation than all but senescent adults, our review presents studies indicating that juveniles with certain tendencies or traits are killed more often than others. This finding suggests that successful predation on juveniles is more selective than is often assumed. Because we are unable to control for (or in some cases even measure the myriad of other possible vulnerabilities such as differences in sensory abilities, intelligence, hiding abilities, tendency to travel, etc., finding selective predation based on the relatively few differences we can measure is noteworthy and points to the significant role that predation on juveniles has in the natural selection of ungulates. Future research should compare characteristics, especially those known to

  3. [Lung is also involved in juvenile dermatomyositis].

    Science.gov (United States)

    Pouessel, G; Thumerelle, C; Nève, V; Santangelo, T; Flammarion, S; Pruvot, I; Tillie-Leblond, I; Deschildre, A

    2014-07-01

    Juvenile dermatomyositis is the leading cause of chronic idiopathic inflammatory myopathy of auto-immune origin in children. Lung involvement in inflammatory myopathies is well described in adults, involving mostly interstitial lung disease, aspiration pneumonia and alveolar hypoventilation. We propose to describe its specificities in children. Pulmonary involvement may be asymptomatic and therefore must be systematically screened for. In case of clinical or functional respiratory abnormality, a chest computed tomographic (CT) scan is necessary. In children, a decrease of respiratory muscle strength seems common and should be systematically and specifically searched for by non-invasive and reproducible tests (sniff test). Interstitial lung disease usually associates restrictive functional defect, impairment of carbon monoxide diffusion and interstitial lung disease on CT scan. As in adults, the first-line treatment of juvenile dermatomyositis is based on corticosteroids. Corticosteroid resistant forms require corticosteroid bolus or adjuvant immunosuppressive drugs (methotrexate or cyclosporine). There is no consensus in pediatrics for the treatment of diffuse interstitial lung disease. Complications of treatment, including prolonged steroid therapy, are frequent and therefore a careful assessment of the treatments risk-benefit ratio is necessary, especially in growing children.

  4. El desempleo juvenil: problema de efectos perpetuos

    Directory of Open Access Journals (Sweden)

    Fabio José De La Hoz

    2012-05-01

    Full Text Available El presente artículo evidencia avances teóricos y empíricos respecto al análisis deldesempleo juvenil, subrayando en materia teórica argumentos relacionados con las causas de estefenómeno, tales como la dinámica poblacional juvenil, el desempleo estructural y las condicionessocioeconómicas de los países; las consecuencias, como los bajos ingresos, la exclusión social yel desarrollo de actividades delictivas, efectos que pueden prolongarse por más de diez años. Y enmateria metodológica, diferencias conceptuales para definir a un individuo “joven”, que varían depaís a país, y dependen de instituciones nacionales encargadas de la información estadística, y enalgunos casos, de las mismas condiciones económicas de los países.

  5. Frontal Sinus Development and Juvenile Age Estimation.

    Science.gov (United States)

    Moore, Kaitlin; Ross, Ann

    2017-09-01

    Assessment of development is an important component of age estimation in juveniles. One area that has not been fully investigated as a possible aging method is the development of the frontal sinus. The frontal sinuses form when the ectocranial table of the frontal bone separates from the endocranial table forming an air pocket in the bone. The endocranial table ceases growth with the brain, while the ectocranial table is displaced anteriorly as the facial bones continue growth. In order to examine growth and the utility of the frontal sinuses for age estimation, 392 radiographs were examined (♀=159 and ♂=233) from the Juvenile Radiograph Database at North Carolina State University and the Patricia Database from Mercyhurst University. The sample included individuals who ranged in age from 0 to 18 years. Anterior view (or AP) radiographs were examined and were grouped based upon the presence or absence of the frontal sinus. Individuals were grouped into four age categories. A one-way ANOVA was performed to test whether developmental phase was related to age. Results from the ANOVA show that developmental phase is significantly related to age (P Anat Rec, 300:1609-1617, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  6. Heterogeneidad de trayectorias laborales y temporalidades juveniles

    Directory of Open Access Journals (Sweden)

    María Eugenia Longo

    2011-10-01

    Full Text Available Las trayectorias laborales de los jóvenes se diversifican en función de las duraciones, las etapas y las edades en las que ocurren los acontecimientos y se alcanzan ciertos roles. Sin embargo, factores clásicos asociados al origen social o al mundo del trabajo no alcanzan para comprender la diferenciación en los modos de inserción. Este artículo propone la inclusión de las temporalidades juveniles como factor clave para la comprensión de trayectorias laborales de jóvenes. Las temporalidades juveniles sirven para observar conjuntamente los marcos temporales dominantes de la inserción y la manera en la que los mismos son vividos por los sujetos. Las mismas discuten las tesis que señalan que en Argentina los jóvenes son prisioneros de un presentismo sin proyecto o que se someten inevitablemente a un contexto laboral incierto. Cuatro tipo des temporalidades han emergido en el análisis cualitativo y longitudinal de las trayectorias : los "planificadores", los "ejecutantes", los "latentes" y los "oportunistas"

  7. Systemic-onset juvenile idiopathic arthritis.

    Science.gov (United States)

    Cimaz, Rolando

    2016-09-01

    Systemic-onset juvenile idiopathic arthritis (SoJIA) is a systemic inflammatory disease which has up to now been classified as a category of juvenile idiopathic arthritis. However, in this context, systemic inflammation has been associated with dysregulation of the innate immune system, suggesting that it may rather be part of the spectrum of autoinflammatory disorders. The disease is in fact unique with regard to the other JIA categories, in terms of clinical manifestations, prognosis, and response to conventional immunosuppressant therapies. It is characterized clinically by fever, lymphadenopathy, arthritis, rash, and serositis. IL-1 and IL-6 play a major role in the pathogenesis of SoJIA, and treatment with IL-1 and IL-6 inhibitors has shown to be highly effective. However, complications of SoJIA, including macrophage activation syndrome, limitations in functional outcome by arthritis and long-term damage from chronic inflammation continue to be a major issue in patients' care. Recent advances on the pathogenesis and treatment have revolutionized the care and prognosis of this potentially life-threatening pediatric condition.

  8. Clinical outcome measures in juvenile idiopathic arthritis.

    Science.gov (United States)

    Consolaro, Alessandro; Giancane, Gabriella; Schiappapietra, Benedetta; Davì, Sergio; Calandra, Serena; Lanni, Stefano; Ravelli, Angelo

    2016-04-18

    Juvenile idiopathic arthritis (JIA), as a chronic condition, is associated with significant disease- and treatment-related morbidity, thus impacting children's quality of life. In order to optimize JIA management, the paediatric rheumatologist has begun to regularly use measurements of disease activity developed, validated and endorsed by international paediatric rheumatology professional societies in an effort to monitor the disease course over time and assess the efficacy of therapeutic interventions in JIA patients.A literature review was performed to describe the main outcome measures currently used in JIA patients to determine disease activity status.The Juvenile Disease Activity Score (JADAS), in its different versions (classic JADAS, JADAS-CRP and cJADAS) and the validated definitions of disease activity and response to treatment represent an important tool for the assessment of clinically relevant changes in disease activity, leading more and more to a treat-to-target strategy, based on a tight and thorough control of the patient condition. Moreover, in recent years, increasing attention on the incorporation of patient-reported or parent-reported outcomes (PRCOs), when measuring the health state of patients with paediatric rheumatic diseases has emerged.We think that the care of JIA patients cannot be possible without taking into account clinical outcome measures and, in this regard, further work is required.

  9. Managing juvenile idiopathic arthritis-associated uveitis.

    Science.gov (United States)

    Hawkins, Madeleine J; Dick, Andrew D; Lee, Richard J W; Ramanan, Athimalaipet V; Carreño, Ester; Guly, Catherine M; Ross, Adam H

    2016-01-01

    Bilateral chronic anterior uveitis is an extra-articular feature of juvenile idiopathic arthritis. Although figures vary, uveitis occurs in approximately 11%-13% of patients with this disease and is most commonly associated with the female gender, oligoarthritis, and presence of antinuclear antibodies. The disease has an insidious onset and is often asymptomatic. Managing patients with juvenile idiopathic arthritis-associated uveitis remains challenging as the disease may prove to be refractory to traditional treatment regimens. Stepwise immunomodulatory therapy is indicated, with new biologic drugs being used last in cases of refractory uveitis. Small scale studies and practice have provided the evidence to undertake randomized control trials to evaluate the efficacy, safety, and cost-effectiveness of anti-tumor necrosis factor-α therapies, such as infliximab and adalimumab. These have demonstrated promising results, with further data awaited from ongoing trials for adalimumab (as SYCAMORE and ADJUVITE trials). Lower grade evidence is supporting the use of newer biologics such as rituximab, daclizumab, tocilizumab, and abatacept in those cases refractory to anti-tumor necrosis factor-α therapy.

  10. Juvenile Delinquency and Teenage Pregnancy: A Comparison of Ecological Risk Profiles among Midwestern White and Black Female Juvenile Offenders

    Science.gov (United States)

    Khurana, Atika; Cooksey, Elizabeth C.; Gavazzi, Stephen M.

    2011-01-01

    The authors examined ecological risk factors associated with teen pregnancy with a sample of 1,190 court-involved female juvenile offenders between 11 and 18 years of age. Data were obtained from five Midwestern juvenile county courts using a recently developed youth risk assessment instrument called the global risk assessment device (GRAD). In…

  11. Juvenile Delinquency and Teenage Pregnancy: A Comparison of Ecological Risk Profiles among Midwestern White and Black Female Juvenile Offenders

    Science.gov (United States)

    Khurana, Atika; Cooksey, Elizabeth C.; Gavazzi, Stephen M.

    2011-01-01

    The authors examined ecological risk factors associated with teen pregnancy with a sample of 1,190 court-involved female juvenile offenders between 11 and 18 years of age. Data were obtained from five Midwestern juvenile county courts using a recently developed youth risk assessment instrument called the global risk assessment device (GRAD). In…

  12. Juvenile cellulitis in a puppy – case reportsCelulite juvenil canina – relato de casos

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Fonseca-Alves

    2012-08-01

    Full Text Available Juvenile cellulitis or juvenile sterile granulomatous lymphadenitis is a rare disorder that affects puppies between three weeks to six months years old. Clinical signs include alopecia, edema, papules, pustules and crusts especially on eyelids. Definitive diagnosis requires cytological and histological evaluation and early and aggressive therapy is recommended, once scars after recovery can be severe .The choice treatment is the high dose of corticosteroids use such as prednisone. Three animals of canine species were attended at the Veterinary Hospital Clinical Small Animal Service presenting different clinical signs. Hemogram, skin lesions and submandibular lymph nodes cytological examination was collected and analyzed. The treatment was instituted, using cephalexin (22mg/kg, twice daily up to control of secondary bacterial infection, and prednisone (2mg/kg, once a day until clinical resolution. Complete cure was obtained at the end of treatment. The aim of this work is to report three clinical cases of juvenile cellulitis in dogs. A celulite juvenil ou linfadenite granulomatosa estéril juvenil, é um distúrbio raro que acomete filhotes com idade entre três semanas a seis meses. Os sinais clínicos incluem alopecia, edema, pápulas, pústulas e crostas especialmente em pálpebras. O diagnóstico definitivo requer exames citológico e histopatológico e a terapia precoce e agressiva é preconizada, pois as cicatrizes após recuperação podem ser graves. O tratamento de escolha consiste no uso de altas doses dos glicocorticoides, como prednisona. Foram atendidos no Hospital Veterinário, três animais da espécie canina, apresentando sinais clínicos variados. Foram realizados hemograma, exame citológico das lesões de pele e dos linfonodos submandibulares. O tratamento foi instituído, utilizando-se cefalexina na dose de 22 mg/kg, duas vezes ao dia, até controle de infecção bacteriana secundária e prednisona na dose de 2mg/kg, uma vez

  13. Tants valguse laval / Aili Ermel

    Index Scriptorium Estoniae

    Ermel, Aili

    2013-01-01

    Valgustid Milanos toimunud messil "Euroluce 2013". Mihkel Masso ja Johan Tali paberlennukitest inspireeritud laevalgustid "Hetk". Tarmo Luisu valgusti "Spider" ja valgustisari "Toila", Tõnis Vellama valgusti "Aero", Tõnis Vellama ja Kalju Palo seinavalgusti "Retro", Triin Kõivupuu ja Eva Prüüsi valgustisari "Lill"

  14. Valgus pimeduse taga / Kai Stahl

    Index Scriptorium Estoniae

    Stahl, Kai

    2008-01-01

    Eesti Kunstimuuseumi näitus "Punaste lippude all" Turu Kunstimuuseumis kuni 31. VIII. Näituse kuraatorid Eha Komissarov (Kumu), Kari Immonen ja Susanna Luojus (Turu Kunstimuuseum). Vanim teos on 1943. aastast, uusim 1960. aastast

  15. From the Bench -- Juvenile Courts: How and Why They Have Changed.

    Science.gov (United States)

    Van Nuys, Heather; Blitzman, Jay; Hibbler, William; Wakefield, Dana

    2000-01-01

    Offers four judges' perspectives on the various changes in the juvenile court system focusing on the increased violence among juveniles as having the greatest effect on the courts; includes issues such as juveniles being tried in adult courts, the need to improve juvenile courts, and the role of public interest. (CMK)

  16. Critical Factors in Mental Health Programming for Juveniles in Corrections Facilities

    Science.gov (United States)

    Underwood, Lee A.; Phillips, Annie; von Dresner, Kara; Knight, Pamela D.

    2006-01-01

    Juveniles with mental health and other specialized needs are overrepresented in the juvenile justice system, and while juvenile corrections have not historically provided standardized and evidence-based mental health services for its incarcerated youth, the demand is evident. The reality is that juveniles with serious mental illness are committed…

  17. Setting a minimum age for juvenile justice jurisdiction in California.

    Science.gov (United States)

    S Barnert, Elizabeth; S Abrams, Laura; Maxson, Cheryl; Gase, Lauren; Soung, Patricia; Carroll, Paul; Bath, Eraka

    2017-03-13

    Purpose Despite the existence of minimum age laws for juvenile justice jurisdiction in 18 US states, California has no explicit law that protects children (i.e. youth less than 12 years old) from being processed in the juvenile justice system. In the absence of a minimum age law, California lags behind other states and international practice and standards. The paper aims to discuss these issues. Design/methodology/approach In this policy brief, academics across the University of California campuses examine current evidence, theory, and policy related to the minimum age of juvenile justice jurisdiction. Findings Existing evidence suggests that children lack the cognitive maturity to comprehend or benefit from formal juvenile justice processing, and diverting children from the system altogether is likely to be more beneficial for the child and for public safety. Research limitations/implications Based on current evidence and theory, the authors argue that minimum age legislation that protects children from contact with the juvenile justice system and treats them as children in need of services and support, rather than as delinquents or criminals, is an important policy goal for California and for other national and international jurisdictions lacking a minimum age law. Originality/value California has no law specifying a minimum age for juvenile justice jurisdiction, meaning that young children of any age can be processed in the juvenile justice system. This policy brief provides a rationale for a minimum age law in California and other states and jurisdictions without one.

  18. Maternal touch moderates sex differences in juvenile social play behavior.

    Directory of Open Access Journals (Sweden)

    Michelle N Edelmann

    Full Text Available Additional somatosensory contact of preterm human infants improves a variety of developmental assessment scores, but less is known about its lasting consequences. In rodents, maternal contact may influence the programming of juvenile social play behavior. Therefore, we used a paradigm where we can control the levels of somatosensory contact associated with maternal care. We find that additional somatosensory contact of offspring can have lasting consequences on juvenile social play behavior in a sex-dependent manner. Specifically, additional somatosensory stimuli reduced male social play behavior, but did not change female play behavior. We then examined if this additional infant contact altered some neurobiological substrates associated with play within the juvenile amygdala. Control males had lower levels of 5HT2a receptor mRNA levels contrasted to females; however, similar to its sex-dependent effect on juvenile social play, males that received additional somatosensory contact had higher serotonin 5HT2a receptor mRNA levels than control males. No difference was found in females. As serotonin signaling typically opposes juvenile play behavior, these data suggest that maternal touch can program lasting differences in juvenile social play and 5HT2a receptors mRNA levels within the juvenile amygdala.

  19. Maternal touch moderates sex differences in juvenile social play behavior.

    Science.gov (United States)

    Edelmann, Michelle N; Demers, Catherine H; Auger, Anthony P

    2013-01-01

    Additional somatosensory contact of preterm human infants improves a variety of developmental assessment scores, but less is known about its lasting consequences. In rodents, maternal contact may influence the programming of juvenile social play behavior. Therefore, we used a paradigm where we can control the levels of somatosensory contact associated with maternal care. We find that additional somatosensory contact of offspring can have lasting consequences on juvenile social play behavior in a sex-dependent manner. Specifically, additional somatosensory stimuli reduced male social play behavior, but did not change female play behavior. We then examined if this additional infant contact altered some neurobiological substrates associated with play within the juvenile amygdala. Control males had lower levels of 5HT2a receptor mRNA levels contrasted to females; however, similar to its sex-dependent effect on juvenile social play, males that received additional somatosensory contact had higher serotonin 5HT2a receptor mRNA levels than control males. No difference was found in females. As serotonin signaling typically opposes juvenile play behavior, these data suggest that maternal touch can program lasting differences in juvenile social play and 5HT2a receptors mRNA levels within the juvenile amygdala.

  20. Few juvenile auditory perceptual skills correlate with adult performance.

    Science.gov (United States)

    Sarro, Emma C; Sanes, Dan H

    2014-02-01

    Measures of human mental development suggest that behavioral skills displayed during early life can predict an individual's subsequent cognitive performance. Support for this draws from longitudinal studies that reveal compelling within-subject correlations during childhood. If this idea applies across the life span, then correlations in performance should persist into adulthood. Here, we address this prediction in juvenile and adult gerbils by evaluating within-subject measures of auditory learning and perception. Animals were trained and tested as juveniles on either an amplitude modulation (AM) or a frequency modulation (FM) detection task. Measures of learning and perception obtained from juveniles were then compared to similar measures obtained when each subject was tested in adulthood on either the same task or the untrained task. For animals trained and tested on the AM detection task as juveniles and adults, there was no correlation between juvenile and adult learning metrics, or perceptual sensitivity. For animals trained and tested on FM detection as juveniles, we observed a significant relationship to their adult performance. Juveniles that performed the best on FM detection were the poorest at AM detection, and the best at FM detection, when tested as adults. Thus, across-age correlations for sensory and cognitive measures, obtained during development and in adulthood, depend heavily on the specific type of developmental experience and the outcome measure.

  1. Offense related characteristics and psychosexual development of juvenile sex offenders

    Directory of Open Access Journals (Sweden)

    van Wijk Anton PH

    2009-07-01

    Full Text Available Abstract Objective: This article reports on offense related characteristics and the psychosexual development in subgroups of juvenile sex offenders as measured by the Global Assessment Instrument for Juvenile Sex Offenders (GAIJSO. The predictive validity of these characteristics for persistent (sexual offensive behavior in subgroups of juvenile sex offenders was investigated. Methods: One hundred seventy four sex offenders (mean age 14.9 SD 1.4 referred by the police to the Dutch Child Protection Board were examined. Offense related characteristics were assessed by means of the GAIJSO and the BARO (a global assessment tool for juvenile delinquents, and criminal careers of the subjects were ascertained from official judicial records. Results: Serious need for comprehensive diagnostics were found on the domains sexual offense and psychosexual development in juvenile sex offenders, especially in the group of child molesters. These youngsters displayed more internalizing and (psychosexual developmental problems and their sexual offense was more alarming as compared to the other juvenile sex offender subgroups. Although one third of the juveniles had already committed one or more sex offenses prior to the index offense, at follow up (mean follow up period: 36 months SD 18 months almost no sexual recidivism was found (0.6% of the entire sample. However, a substantial proportion of the entire sample of juvenile sex offenders showed non-sexual (55.6% and violent recidivism (32.1%. Several predictors for a history of multiple sex offending and non-sexual recidivism were identified. Conclusion: This study revealed numerous problems in juvenile sex offenders. Assessment using the GAIJSO is helpful in order to identify indicators for extensive diagnostic assessment. In order to investigate the predictive validity for sexual reoffending a longer follow up period is necessary.

  2. Offense related characteristics and psychosexual development of juvenile sex offenders

    Science.gov (United States)

    Hart-Kerkhoffs, Lisette 't A; Doreleijers, Theo AH; Jansen, Lucres MC; van Wijk, Anton PH; Bullens, Ruud AR

    2009-01-01

    Objective: This article reports on offense related characteristics and the psychosexual development in subgroups of juvenile sex offenders as measured by the Global Assessment Instrument for Juvenile Sex Offenders (GAIJSO). The predictive validity of these characteristics for persistent (sexual) offensive behavior in subgroups of juvenile sex offenders was investigated. Methods: One hundred seventy four sex offenders (mean age 14.9 SD 1.4) referred by the police to the Dutch Child Protection Board were examined. Offense related characteristics were assessed by means of the GAIJSO and the BARO (a global assessment tool for juvenile delinquents), and criminal careers of the subjects were ascertained from official judicial records. Results: Serious need for comprehensive diagnostics were found on the domains sexual offense and psychosexual development in juvenile sex offenders, especially in the group of child molesters. These youngsters displayed more internalizing and (psychosexual) developmental problems and their sexual offense was more alarming as compared to the other juvenile sex offender subgroups. Although one third of the juveniles had already committed one or more sex offenses prior to the index offense, at follow up (mean follow up period: 36 months SD 18 months) almost no sexual recidivism was found (0.6% of the entire sample). However, a substantial proportion of the entire sample of juvenile sex offenders showed non-sexual (55.6%) and violent recidivism (32.1%). Several predictors for a history of multiple sex offending and non-sexual recidivism were identified. Conclusion: This study revealed numerous problems in juvenile sex offenders. Assessment using the GAIJSO is helpful in order to identify indicators for extensive diagnostic assessment. In order to investigate the predictive validity for sexual reoffending a longer follow up period is necessary. PMID:19594889

  3. Prospective Prediction of Juvenile Homicide/Attempted Homicide among Early-Onset Juvenile Offenders

    Science.gov (United States)

    Baglivio, Michael T.; Wolff, Kevin T.

    2017-01-01

    While homicide perpetrated by juveniles is a relatively rare occurrence, between 2010 and 2014, approximately 7%–8% of all murders involved a juvenile offender. Unfortunately, few studies have prospectively examined the predictors of homicide offending, with none examining first-time murder among a sample of adjudicated male and female youth. The current study employed data on 5908 juvenile offenders (70% male, 45% Black) first arrested at the age of 12 or younger to prospectively examine predictors of an arrest for homicide/attempted homicide by the age of 18. Among these early-onset offenders, males, Black youth, those living in households with family members with a history of mental illness, those engaging in self-mutilation, and those with elevated levels of anger/aggression (all measured by age 13) were more likely to be arrested for homicide/attempted homicide by age 18. These findings add to the scant scientific literature on the predictors of homicide, and illustrate potential avenues for intervention. PMID:28212340

  4. Prospective Prediction of Juvenile Homicide/Attempted Homicide among Early-Onset Juvenile Offenders

    Directory of Open Access Journals (Sweden)

    Michael T. Baglivio

    2017-02-01

    Full Text Available While homicide perpetrated by juveniles is a relatively rare occurrence, between 2010 and 2014, approximately 7%–8% of all murders involved a juvenile offender. Unfortunately, few studies have prospectively examined the predictors of homicide offending, with none examining first-time murder among a sample of adjudicated male and female youth. The current study employed data on 5908 juvenile offenders (70% male, 45% Black first arrested at the age of 12 or younger to prospectively examine predictors of an arrest for homicide/attempted homicide by the age of 18. Among these early-onset offenders, males, Black youth, those living in households with family members with a history of mental illness, those engaging in self-mutilation, and those with elevated levels of anger/aggression (all measured by age 13 were more likely to be arrested for homicide/attempted homicide by age 18. These findings add to the scant scientific literature on the predictors of homicide, and illustrate potential avenues for intervention.

  5. Examining Antisocial Behavioral Antecedents of Juvenile Sexual Offenders and Juvenile Non-Sexual Offenders.

    Science.gov (United States)

    McCuish, Evan C; Lussier, Patrick; Corrado, Raymond R

    2015-08-01

    In prospective longitudinal studies of juvenile offenders, the presence of multiple developmental pathways of antisocial behaviors has consistently been identified. An "antisocial" type of juvenile sex offender (JSO) has also been identified; however, whether antisocial JSOs follow different antisocial pathways has not been examined. In the current study, differences in antisocial pathways within JSOs and between JSOs and juvenile non-sex offenders (JNSOs) were examined. Data on Canadian male incarcerated adolescent offenders were used to identify whether behavioral antecedents differed within JSOs and between JSOs (n = 51) and JNSOs (n = 94). Using latent class analysis (LCA), three behavioral groups were identified. For both JSOs and JNSOs, there was a Low Antisocial, Overt, and Covert group. Overall, there were important within-group differences in the behavioral patterns of JSOs, but these differences resembled differences in the behavioral patterns of their JNSO counterpart. Risk factors including offense history, abuse history, and family history were more strongly associated with the Overt and Covert groups compared with the Low Antisocial group. Implications for JSO assessment practices were discussed.

  6. FINES Y DETERMINACIÓN DE LAS SANCIONES PENALES JUVENILES

    OpenAIRE

    Tiffer Sotomayor, Carlos

    2013-01-01

    El artículo refiere los contenidos sobre los fines y la determinación de las sanciones penales juveniles. Se inicia con el elemento caracterizador del modelo de justicia responsabilizador penal juvenil. Presenta el dilema entre la prevención general y la prevención especial y el rol que desempeña el principio educativo, como finalidad primordial. Se presentan los principales criterios que debe considerar un juez al momento de determinar una sanción penal juvenil.

  7. Entre champetuos, pupys y harcoretos: Identidades juveniles en santa marta

    Directory of Open Access Journals (Sweden)

    Jorge Giraldo

    2004-01-01

    Full Text Available Este artículo describe las principales articulaciones de las identidades juveniles en la ciudad de Santa Marta, en el Caribe colombiano. Para ello, contrasta las más relevantes figuras en el espectro de las experiencias y subjetividades juveniles en sus estrechas relaciones con diferentes géneros musicales. Se evidencia, entonces, que en las identidades juveniles se pueden diferenciar unas figuras hegemónicas (champetuo, pupy, yuquero de unas alternativas (harcoreto,electrónico.

  8. The case of juvenile polygraphy as a clinical ethics dilemma.

    Science.gov (United States)

    Chaffin, Mark

    2011-09-01

    Polygraph interrogations are used by half of all surveyed juvenile sex offender (JSO) treatment programs in the United States. This is a distinctive and controversial practice that is rarely if ever used with other juvenile delinquent populations, and that is rarely used or is banned from JSO treatment programs in other countries. Clinical polygraphy is an ethically sensitive issue because it involves mental health therapists in involuntary coercive interrogations of minors. This article reviews core mental health professional ethics principles for juveniles. JSO polygraphy is used as an illustrative issue for applying human rights principles to a practice in light of its benefits, risks, and available alternatives.

  9. Hypoglycemia and hemostatic parameters in juvenile-onset diabetes

    DEFF Research Database (Denmark)

    Hilsted, J; Madsbad, S; Nielsen, J D;

    1980-01-01

    Hypoglycemia was induced by intravenous infusion of insulin in six juvenile-onset diabetic subjects. Hemostatic parameters were assessed before insulin infusion and 0, 1, and 2 h after discontinuation of insulin infusion. The onset of hypoglycemia coincided with an enhancement of ADP-induced plat......Hypoglycemia was induced by intravenous infusion of insulin in six juvenile-onset diabetic subjects. Hemostatic parameters were assessed before insulin infusion and 0, 1, and 2 h after discontinuation of insulin infusion. The onset of hypoglycemia coincided with an enhancement of ADP...... potentially lead to intravascular coagulation in juvenile-onset diabetic patients....

  10. Features of trust in other people in juvenile offenders

    OpenAIRE

    Astanina N.B.

    2013-01-01

    The paper describes the results of a comparative study of trust in other people in juvenile offender and law-abiding teens. The study involved 113 young offenders (from detention center for juvenile offenders, special closed schools, juvenile correctional facilities of Voronezh and Lipetsk regions) and 106 law-abiding teens, 13 to 18 years old. We identified the types of trust in other people in the two groups of adolescents. We analyzed the specifics of trust in other people in the group of ...

  11. Alteraciones de la afectividad en delincuentes juveniles privados de libertad

    OpenAIRE

    Herrero Remuzgo, Salvador

    2002-01-01

    La delincuencia juvenil ha interesado al saber científico desde siempre, y son muchos los autores y escuelas de todos los ámbitos del conocimiento que han intentado dar explicaciones sobre el origen de dicho comportamiento desadaptado, sin embargo, parece claro que esta tareas no parece fácil pues en la delincuencia juvenil están implicados una multitud de factores que ... hacen muy compleja su explicación. Esta complejidad se agrava cuando intentamos estudiar al delincuente juvenil sometido ...

  12. Juvenile myelomonocytic leukemia presenting as bilateral breast masses

    Energy Technology Data Exchange (ETDEWEB)

    Edison, Michele N.; Letter, Haley P. [Florida Hospital, Department of Radiology, Orlando, FL (United States); University of Central Florida, College of Medicine, Orlando, FL (United States); O' Dell, M.C. [University of Central Florida, College of Medicine, Orlando, FL (United States); Children' s Hospital of Philadelphia, Pediatric Radiology, Philadelphia, PA (United States); Scherer, Kurt; Williams, Jennifer L. [Florida Hospital, Department of Radiology, Orlando, FL (United States); University of Central Florida, College of Medicine, Orlando, FL (United States); Florida State University, College of Medicine, Tallahassee, FL (United States)

    2017-01-15

    An 8-year-old girl presented with bilateral breast masses and was subsequently diagnosed with juvenile myelomonocytic leukemia. Juvenile myelomonocytic leukemia is a rare myelodysplastic syndrome that typically presents in boys younger than 3 years of age with splenomegaly, lymphadenopathy and skin findings. Bilateral breast masses in a child are rare and, as such, present a diagnostic dilemma due to the relative paucity of cases in the literature. We present a case of granulocytic sarcoma of the breasts in a patient with juvenile myelomonocytic leukemia. The authors hope that increased reporting and research regarding pediatric breast masses will help create awareness for such cases. (orig.)

  13. Caring for juveniles with mental disorders in adult corrections facilities.

    Science.gov (United States)

    Wills, Cheryl D

    2017-02-01

    Although juveniles have developmental, educational, healthcare, and rehabilitation needs that differ from adults, thousands of them have been confined in adult corrections facilities in the past 30 years. This manuscript will review how and why juveniles end up in adult corrections facilities, who they are, their rehabilitative needs, and how they differ from adults in corrections facilities and youths in the juvenile justice system. The importance of providing developmentally-informed mental health services to youths in adult corrections facilities is examined, along with barriers to traditional adolescent psychiatric practice. Recommendations for future directions in adolescent psychiatric care are presented.

  14. Mediation involving a juvenile perpetrators of criminal acts

    Directory of Open Access Journals (Sweden)

    Małgorzata Cwalina

    2012-12-01

    Full Text Available The article describes issues concerning mediatory proceedings regarding juvenile court cases in Poland. It was based on original master’s dissertation entitled “Mediation as a form of protection of the juvenile against stigma”. Mediation is most often defined as a voluntary attempt to resolve the conflict and to reach an agreement as it regards the compensation, in presence of impartial and neutral mediator. By contrast with court cases, mediation’s aim is not to point out who is right, but to find a solution of conflict, satisfactory to all parties. Fundamental aim of mediation within juvenile cases is educational and reformatory influence.

  15. Landmark learning by juvenile salamanders (Ambystoma maculatum).

    Science.gov (United States)

    Heuring, Whitney L; Mathis, Alicia

    2014-10-01

    Learning to use a landmark as a beacon to locate resources is one of the simplest forms of spatial learning. We tested whether landmark learning occurs in a semifossorial salamander that migrates annually to breeding ponds as adults. Juvenile spotted salamanders (Ambystoma maculatum) were tested in square containers with a plastic feeding dish in each corner, and a piece of earthworm was placed in one randomly-chosen dish. For landmark-trained salamanders, a rock was placed beside the dish containing the prey. For control salamanders, the rock was placed beside a randomly selected feeding dish. Each salamander was trained once every 2 days for 30 days. Significantly more landmark-trained salamanders than control salamanders entered the landmark area first, and landmark-trained individuals had faster latencies to enter the landmark area and longer stay-times. These results suggest that spotted salamanders are able to locate resources by associating their positions with landmarks.

  16. IMPACTUL PRESEI ASUPRA DELICVENŢEI JUVENILE

    Directory of Open Access Journals (Sweden)

    Gheorghe CIOBANU

    2015-11-01

    Full Text Available Lucrarea în cauză e un rezultat al unui studiu asupra schimbărilor comportamentale ale adolescenţilor, influenţate de unele materiale publicistice. Departe de intenţia de a reveni la cenzura de altădată, autorul pledează pentru o auto-cenzură, pentru o autoexigenţă în procesul de creaţie, pentru o responsabilitate sporită pentru cuvântul scris sau rostit.THE IMPACT OF MEDIA ON THE JUVENILE DELINQUENCYThis writing is a result of a study of teenager’s behavior changes influenced by journalistic work. The author is not militating for the past censorship, but he pleads for an autocensorship, for an auto exigency during the creation process, for a high responsibility for written word or for the spoken one.

  17. Marcadores de inmunorrespuesta en la periodontitis juvenil

    Directory of Open Access Journals (Sweden)

    Amparo Pérez Borrego,

    2002-12-01

    Full Text Available La periodontitis juvenil es una enfermedad del periodonto propia de adolescentes y adultos jóvenes, afecta principalmente los primeros molares y los incisivos y se caracteriza por la pérdida severa del hueso alveolar alrededor de dientes permanentes sin correspondencia entre la rapidez y severidad de la destrucción con los factores locales. En la causa de la enfermedad se citan factores genéticos, infecciosos e inmunológicos. Estudiamos algunos marcadores de inmunorrespuesta en 6 adolescentes que acudieron a nuestro servicio con el diagnóstico de periodontitis juvenil, además de su valoración clínica y radiológica. Ambos sexos se afectaron por igual, la movilidad dentaria y el sangramiento al sondeo fueron los hallazgos clínicos más relevantes y el índice de higiene bucal fue adecuado en todos los casos. No encontramos homogeneidad en las alteraciones inmunológicas, pero todos los pacientes estuvieron afectados en más de un marcador. Predominaron las alteraciones funcionales de linfocitos T en los estudios celulares. La hipogammaglobulinemia y la IgM elevada fueron las alteraciones más frecuentes en la inmunidad de anticuerpos. Se señala la dificultad que aún existe para explicar la patogenia de la enfermedad basándose solamente en un único factor de riesgo, así como la importancia de la valoración individual de cada enfermo.Juvenile periodontitis is a disease of the periodontium inherent to adolescents and young adults, affecting mainly the first molars and incisives and characterized by the severe loss of the alveolar bone sorrounding the permanent teeth with no correspondance between the celerity and severity of the destruction and the local factors. Genetic, infectious and immunological factors are considereed as the causes of the disease. Some immunoresponse markers were studied in 6 adolescents that were seen at our service with the diagnosis of juvenile periodontitis in addition to their clinical and radiological

  18. Representaciones sociales juveniles sobre la democracia

    Directory of Open Access Journals (Sweden)

    Álvaro Díaz Gómez

    2005-01-01

    Full Text Available El presente artículo da cuenta de una parte de los resultados obtenidos en la investigación “representaciones sociales juveniles sobre la democracia y la multiculturalidad”. Se desarrolló desde la perspectiva metodológica de la Investigación Acción Participante, proceso dentro del cual, se aplicó un cuestionario conformado por nueve preguntas, divididas en tres bloques temáticos que permitieron conocer las representaciones sociales de un grupo de veinticinco jóvenes, sobre la democracia –aspecto que se reporta en este texto– la ciudadanía y la multiculturalidad a partir de tres dimensiones: significado, vivencias y condiciones de la democracia.

  19. Anterior uveitis in juvenile rheumatoid arthritis.

    Science.gov (United States)

    Kanski, J J

    1977-10-01

    The ocular and systemic characteristics of 160 patients with anterior uveitis and seronegative juvenile rheumatoid arthritis are reviewed. Chronic uveitis occurred in 131 patients, 76% of whom were girls. Both eyes were involved in 70% of the cases. Band keratopathy occurred in 41% of the eyes, cataract in 42%, and secondary glaucoma in 19%. Only 11 patients had uveitis before the onset of arthritis. Notable correlations included a pauciarticular onset of arthritis in 95% of the patients, and positive tests for antinuclear antibody in 82%. Of 29 patients with acute anterior uveitis, 27 were boys. The inflammation responded well to therapy, and serious complications did not occur. At follow-up 21 patients had typical ankylosing spondylitis, and five had sacroiliitis. The incidence of positive results of tests for HLA-B27 antigen was 94%.

  20. Screening for uveitis in juvenile chronic arthritis.

    Science.gov (United States)

    Kanski, J J

    1989-03-01

    Three hundred and fifteen patients with anterior uveitis associated with juvenile chronic arthritis (JCA) were studied in order to identify the various risk factors for uveitis. Girls were more susceptible to uveitis than boys by a ratio of 3:1. In 94% of cases the uveitis was diagnosed after the development of arthritis. The risk of uveitis was small after seven or more years had elapsed from the onset of arthritis. Patients with pauciarticular onset JCA had the highest risk of uveitis and systemic onset patients the least risk. The presence of circulating antinuclear antibody was also an important marker for an increased risk of uveitis. A regimen for routine screening of patients is suggested.