مجال
التميز
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تميز دراسي و بحثي
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البحوث المنشورة
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البحث (1):
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عنوان البحث:
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Estimating bone mass in children: can bone health index
replace dual energy x-ray absorptiometry?
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رابط إلى البحث:
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Click
here
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تاريخ النشر:
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24/11/2018
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موجز عن البحث:
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Background
Bisphosphonates
have been shown to increase metacarpal cortical width. Bone health index is
computed from hand radiographs by measuring cortical thickness, width and
length of the three middle metacarpals, and may potentially help predict
fracture risk in children.
Objective
To
compare bone health index with bone mineral density as measured from dual
energy X-ray absorptiometry scans in patients with and without bisphosphonate
treatment.
Materials
and methods
Two
hundred ninety-three Caucasian patients (mean age: 11.5±3.7 years) were
included. We documented absolute values and z-scores for whole-body less head
and lumbar spine bone mineral density then correlated these with the bone
health index, which were acquired on the same day, in different patient groups,
depending on their ethnicity and diagnosis.
Results
Bone
health index showed moderate to strong correlation with absolute values for
whole-body (r=0.52) and lumbar spine (r=0.70) bone mineral
density in those not treated with bisphosphonates and moderate correlation
absolute values for whole-body (r=0.54) and lumber spine (r=0.51)
bone mineral density for those treated with bisphosphonates. There was weak
correlation of z-scores, ranging from r=0.11 to r=0.35
in both groups.
Conclusion
The
lack of a strong correlation between dual energy X-ray absorptiometry and
bone health index suggests that they may be assessing different parameters.
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البحث (2):
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عنوان البحث:
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Is the Greulich and Pyle atlas applicable to all
ethnicities? A systematic review and meta-analysis
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رابط إلى البحث:
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Click
here
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تاريخ النشر:
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07/01/2019
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موجز عن البحث:
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Objective
To
determine whether the Greulich and Pyle (G&P) atlas is applicable when
applied to populations of different ethnicity.
Methods
A
systematic review of studies published between 1959 and 15th February 2017
identified from the Embase, MEDLINE and Cochrane databases was undertaken.
Quality of the studies was assessed using the National Institute for Health
and Care Excellence tool. Meta-analysis used mean differences and standard
deviations as summary statistics for the difference between bone age (BA) and
chronological age (CA).
Results
A total
of 49 studies were included of which 27 (55%) were related to Caucasian
populations. Of the 49 eligible studies, 35 were appropriate for further
meta-analysis. In African females, meta-analysis showed a significant mean
difference between BA and CA of 0.37 years (95% CI 0.04, 0.69). In Asian
males, meta-analysis showed significant differences between BA and CA of
-1.08, -1.35, -1.07, -0.80 and 0.50 years for chronological ages of 6,
7, 8, 9 and 17 years, respectively. Meta-analysis showed no significant
differences between BA and CA in African males, Asian females, Caucasians and
Hispanics.
Conclusions
The
G&P standard is imprecise and should be used with caution when applied to
Asian male and African female populations, particularly when aiming to determine
chronological age for forensic/legal purposes.
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المؤتمرات العلمية:
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المؤتمر (1):
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عنوان المؤتمر:
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The
8th International Conference on Children’s Bone Health (ICCBH)
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تاريخ الإنعقاد:
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10/06/2017
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مكان
الإنعقاد:
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Wurzburg, Germany
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طبيعة المشاركة:
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Poster presentation
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عنوان المشاركة:
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Bone
age assessment using Greulich and Pyle and Tanner-Whitehouse methods: a
systematic review
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ملخص المشاركة:
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Objectives: To have a better
understanding of the applicability of the Greulich and Pyle and Tanner
Whitehouse methods of bone age estimation in children who are of a different
ethnicity from those of the original standards.
Method: A systematic search of the
Medline database was conducted to include studies published between 1st January
1959 and 1st May 2016 (keywords ‘Greulich Pyle’; ‘Greulich and Pyle’) and 1st
January 2001 and 1st May 2016 (keywords ‘Tanner Whitehouse’; ‘TW3’). Each
study’s title and abstract were screened. The full text was retrieved when
the reviewer could not decide on the study’s eligibility from the title and
abstract alone. The following exclusion criteria were then applied,
participants with developmental disorders or subjected to nutritional
supplementation, studies which used modified methods of G&P or TW3 and/or
used other imaging modalities, full text not available within the resources
available to the reviewer, full text not in English and review articles.
Results: 376 studies were
identified, of which 40 were eligible for inclusion. Five additional studies
were identified from the reference lists. In relation to the use of the
G&P atlas in Caucasian children, of the 24 studies reviewed, 9 (38%) were
unequivocally in support, while 12 (50%) concluded that some modification was
required. 72% and 26% of the studies related to African and Asian populations
respectively, and concluded that new standards were required. In Hispanic
populations, 3 studies (50%) concluded that the standard is applicable, while
3 studies (50%) reported that some modification was required. Socio-economic
status was only reported in 8 studies (17.7%). Within these 8 studies,
children from lower socioeconomic status tend to be skeletally delayed and
show major deviations between bone age and chronological. Seven studies
identified were in relation to TW3, of which 1 study suggests poor
applicability of TW3 in Hispanics.
Conclusion: The G&P standard may be
used in Caucasians, but caution is required when applied to Asian and African
populations. There is a complex inter-relationship between the impacts of
socioeconomic status and ethnicity on bone age using the G&P atlas, which
no study to date has clearly set out to address.
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المؤتمر (2):
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عنوان المؤتمر:
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The
8th International Conference on Children’s Bone Health (ICCBH)
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تاريخ الإنعقاد:
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10/06/2017
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مكان
الإنعقاد:
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Wurzburg, Germany
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طبيعة المشاركة:
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Poster presentation
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عنوان المشاركة:
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Bone
age determination using dual-energy X-ray absorptiometry
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ملخص المشاركة:
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Objective:
To assess whether hand-wrist dual-energy x-ray absorptiometry (DXA) can
replace radiographs for bone age assessment using the Greulich & Pyle
(G&P) and/or Tanner & Whitehouse (TW3) methods.
Methodology:
Purposive sampling was used to include a total of 20 patients identified from
an Endocrine Clinic; two males and two females from each of 5 age groups
(<5; 5 to 7; 8 to 10; 11 to 13; 14 to 16 years). Bone age as determined
from DXA and radiographs performed on the same day were compared for each
child. Two observers independently assessed all radiographs and DXA scans on
two occasions. For each observer, there was a minimum interval of two weeks
between the two reads. Adequacy of hand positioning and image quality were
assessed using paired t tests. Interclass correlation coefficient and
Bland Altman plots were used to evaluate agreement between the observers and
correlation between the two imaging modalities.
Findings:
The mean chronological age was 9.04 (S.D.±3.8) and 9.8 (S.D.±3.2) years for
girls and boys respectively. A significant difference between DXA scans and
radiographs (P<0.001) was observed in terms of hand positioning.
The ulna was excluded from the scan field in 15% of the left hand DXAs. The
overall image quality assessment showed a significant difference (P<0.001)
between left hand DXA scans and left hand radiographs. Visibility of soft
tissue and fat planes was poor in all DXA scans compared to radiographs.
Despite the reduced image quality of DXA, inter-observer agreement for bone
age determination was 0.987 for radiographs and 0.980 for DXA using the
G&P technique. For Observer 1, intra-observer agreement for radiographs
and DXA was 0.993 and 0.983 respectively, and 0.995 and 0.994 respectively
for Observer 2. Poor DXA image quality did not allow bone age determination
using the TW3 method.
Conclusion:
Bone age can be determined from left hand/wrist DXA scans using G&P.
However, limited DXA image quality prohibits its use for bone age assessment
using the TW3 method.
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