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It is well establish that posture deformities are a common problem among children that is often ignored by parent and teachers. Posture deformities in children could be related to their socio-economic status, lifestyle, culture, tradition, environmental factors, as well as activity levels and are associated with numerous adverse health effects, which include lung and heart defects, indigestion and back pain. Children who experience back pain are at increased risk of having back pain as adults. The economic impact of back pain affects the industry, were back problems are the most expensive type of injury claim. The increase in spinal problems, such as lower back pain in children and adolescents, points to the need for continued screening. It is suggested that early detection of postural deviation could provide an improve chance for corrective remedies and posture development. On investigating the relevant literature it becomes clear that attempts to define the prevalence of posture deformities among children have focused on reporting selected deformities only. Consequently the literature contains insufficient information on posture deformities involving the entire musculoskeletal system, as well as the prevalence of posture deformities among black African people. The purpose of this study was firstly to determine the incidence of posture deviations among black African children in the North West Province and secondly to determine the difference in the prevalence of posture deformities between boys and girls. In a longitudinal study posture deformities including the entire musculoskeletal system were assessed in 251 schoolchildren (136 girls and 115 boys). Posture screening was done according to the New York Posture test and a posture grid. Subjects were evaluated in a standing position from the rear and lateral side. Foot deformities (flat foot) were also measured with the use of white chalk and a black board. Thereafter the "Adam's test" (forward bending test) were used for further scoliosis evaluation. The prevalence of posture deformities was reported to be high among black African schoolchildren. The incidence of lordosis (84%) and protruding abdomen (67%) was the highest, while twisted head (8%) was reported as the lowest. Gender difference in the prevalence of posture deformities was also found, with a higher incidence of posture deformities reported in girls (54%) as in boys (46%). / Thesis (M.Sc. (Human Movement Science))--North-West University, Potchefstroom Campus, 2007.

Conjoined twinning has always been a phenomenon of great interest to the medical community because of its rarity and complexity. Each additional documented case bolsters our knowledge of embryologic development, anatomic anomalies, and strategic approaches to surgical challenges. Twins conjoined at the head, that is, craniopagi, are the rarest subtype of conjoined twins, and rates of survival to birth and through surgical separation are low. Those that do survive usually require multiple intensive procedures and often face lifelong developmental challenges due to shared brain tissue that must be parsed at time of separation. Here we present a case study of partial angular frontal craniopagus twin females with a soft-tissue-only conjuncture currently unrepresented in medical literature. Documentation of this case, in which a one-stage surgical separation occurred at day of life 1 without complication or any long-term disability, helps inform those that provide care for conjoined twins alongside their expectant parents of the wide possible range of clinical presentations and prognosis for craniopagi. A 28-year follow-up investigates how the anatomic configuration of the craniopagi and mechanical forces in utero impacted craniofacial development and their phenotypic characteristics as adults. Using clinical examination, CT imaging with 3D reconstruction, and Vectra® H1 stereophotogrammetry, overall symmetry and congenital deformities of both women’s external features and underlying craniofacial skeleton were characterized. Both twins exhibit near-identical skull deformities including right frontal bone flattening, ipsilateral parietal and occipital bossing, flattened malar eminence, and curvature of sagittal plane through the skull. Reported right anterolateral displacement of anterior fontanelles directly under the twins’ junctional area during infancy is reflected by asymmetry of the coronal suture withanterior displacement on the right side in both cases. In addition, Twin B has a persistent metopic suture that also shows lateral displacement toward site of junction. Soft tissue deformities include minor cosmetic asymmetries such as a sharp hairline irregularity below previous site of conjuncture, misaligned ears, sparse right eyebrow growth and weakened movement of this brow, and deviation of nasal tip in one twin. Both twins also sport a 5cm by 1.5-2cm surgical scar. Overall symmetry is good and most of these irregularities go unnoticed by laypeople; the women manage most of them with cosmetics and side-parting of the hair. Though some minor plastic surgery procedures could be offered to optimize symmetry, none are recommended or desired by the patients at this time. Through careful evaluation of their adult state, we conclude that minimally conjoined craniopagus twins sharing only soft tissue of the scalp at time of birth can still exhibit a number of lifelong cranial deformities and asymmetry of facial landmarks.

Foot problems are not only the most common but in general also the most severe of the diabetic complications. The age group 15-50 yrs in this study was chosen because these patients were considered to be at their most active age and were felt to require optimal foot function. 380 patients (96 %) participated, 78 % with Type 1, 20 % Type 2 and 1 % with secondary diabetes mellitus (DM) and 100 healthy controls. Only six patients had signs of peripheral ischaemia but half of the patients had deformities such as fallen forefoot arches and hammer toes. With sensory thresholds and clinical signs it was demonstrated that age, duration of DM and tall stature are major risk factors for diabetic neuropathy. Gender differences depend on differences in height. Dorsiflexion of the toes against resistance was used to test the function and volume of m.extensor digitorum brevis. When compared with measurements of sensory thresholds for vibration, perception and pain, it was found to be a valuable test for screening of distal motor neuropathy. To prevent worsening of foot deformities 266 patients with Type 1 DM were followed for 3 years. Those with the most pronounced deformities were fitted with custom-made insoles and had repeated examinations. Improvement was more common in patients with insoles compared to patients without insoles. Bone mineral density (BMD) was measured in nine patients with osteopathy in their feet and 18 controls. BMD was lower in L2-L3, but not in the proximal femur, implying osteopenia being a possible risk factor for distal osteopathy. Plaster cast treatment was used in 33 diabetic patients with severe foot ulcers who were selected because previous conservative treatment had been unsuccessful and they had been judged unsuitable for vascular surgery. The lesions healed in 19 patients. In conclusion, the main findings demonstrate the need for an increased awareness of early preventive foot care in young and middle-aged diabetic patients. / <p>S. 1-46: sammanfattning, s. 47-120: 6 uppsatser</p> / digitalisering@umu

Objetivo: elaborar diretrizes para o tratamento. Modelo: Análise retrospectiva dos históricos de 236 crianças, durante o período de julho de 2003 a julho de 2006 e análise descritiva dos resultados. Ambiente: Unidade de Cuidados Especiais (UCE) do HRAC-USP. Participantes: 236 crianças com disfagia orofaríngea, com idade de 3 dias a 8 anos, 204 (86,4%) apresentavam fissura labiopalatina. A Seqüência de Robin foi diagnosticada em 139 crianças (58,9%), sendo que 95 (68,3%) tinham SRI e 44 (31,7%) síndrome associada. Variáveis: incidência de disfagia, síndromes ou malformações associadas, grau da disfagia, presença de desconforto respiratório, uso de sondas alimentadoras (SNG e gastrostomia), DRGE, complicações relacionadas às gastrostomias e ao tratamento cirúrgico da DRGE, reinternações e o tempo total de hospitalização. Resultados: Das 236 crianças, 110 (46,6%) tinham disfagia leve, 47 (19,9%) moderada e 79 (33,5%) grave. A disfagia leve foi maior nas crianças com fissuras de lábio e/ou palato isoladas (88,5%), com malformações congênitas (81,3%) e com SRI (56,8%). A disfagia grave foi mais freqüente em crianças com síndrome (61,6%). Do universo estudado, 195 crianças (82,6%) necessitaram do uso da SNG. O tempo de uso variou de 1 dia a 750 dias, com média de 113 dias e mediana de 60 dias. A gastrostomia foi indicada em 67 (28,4%). Conclusões: A disfagia orofaríngea é um dos principais problemas apresentados pelas crianças com malformações craniofaciais. O diagnóstico de outras malformações ou síndromes associadas e a classificação do grau da disfagia orofaríngea são determinantes na orientação do tratamento. / Objective: To draw up guidelines for the treatment. Model: Retrospective analysis of historical of 236 children, during the period July 2003 to July 2006 and descriptive analysis of the results. Environment: Special Care Unit by HRAC-USP. Participants: 236 children with oropharyngeal dysphagia, aged 3 days to 8 years, 204 (86.4%) had cleft lip, and / or palate. The sequence of Robin was diagnosed in 139 children (58.9%), whereas 95 (68.3%) had SRI and 44 (31.7%) syndrome associated. Variables: incidence of dysphagia, syndromes or associated malformations, degree of dysphagia, presence of respiratory discomfort, use of probes feeding (nasogastric tube and gastrostomy), GERD, complications related to gastrostomies and the surgical treatment of GERD, readmissions and the total time of hospitalization. Results: Of the 236 children, 110 (46.6%) had mild dysphagia, 47 (19.9%) moderate and 79 (33.5%) serious. The mild dysphagia was higher for children with cleft lip, and / or palate alone (88.5%) with congenital malformations (81.3%) and with SRI (56.8%). The severe dysphagia was more frequent in children with syndrome (61.6%). Of the study, 195 children (82.6%) required the use of nasogastric tube . The time of use ranged from 1 day to 750 days, with an average of 113 days and a median of 60 days. The gastrostomy was indicated in 67 (28.4%). Conclusions: The oropharyngeal dysphagia is one of the main problems presented by children with craniofacial deformities. The diagnosis of malformations or other syndromes associated and classification the degree of oropharyngeal dysphagia are crucial in guiding treatment.

Source: Masters Abstracts International, Volume: 47-06, page: 3501. Advisers: Irwin B. Horwitz; Jacqueline T. Hecht. Includes bibliographical references.

Socio-economic status form a big part of each person's physical development. Socio-economic status is defined by house income, house standards, family size, physical activity level and parents education level and occupation. Socio-economic status influence posture as well as physical activity levels of adolescents. Adolescents living in low socio-economic areas show delayed growth with an influence on posture. Posture is mainly influenced by genetics as well as some socio-economic variables such as diet, malnutrition en obesity. Posture development is also related to physical activity. A sedentary lifestyle is more common under adolescence in low socio-economic areas than those in high socio-economic areas. This incidence can be due to the fact that a lack of equipment and safety are more common in low socio-economic areas, subsequently the lack of organised physical activity. The benefits of physical activity are endless and should be integrated as part of our daily living. Different studies of socio-economic status, physical activity and posture deformities were found although none compared all three valuables with each other. Literature is only used as a guideline and not for a comparison with this study. The goal of this study was firstly to determine the influence of socio-economic status on posture deformities on black African adolescence and secondly to determine the influence of socio-economic status on physical activity levels of black African adolescence. A total of 251 pupils participated in the study. Questionnaires were completed on socio-economic status as well as on physical activity levels. Posture screening was done according to the New York posture test and a posture grid. Pupils were evaluated from anterior, posterior and lateral sides together with evaluation of foot deformities and a more defined scoliosis screening by the Adams forward bending test. The prevalence of posture deformities and insufficient organised physical activity are high in black African adolescence. The most common posture deformity is lordosis (84%) and a protruding abdomen (67%). These deformities are closely correlated to socio-economic status especially diet because it influences growth and development of children. Physical activity levels are influenced by a lack of transport and organised physical activities. A total of 87,5% of pupils use walking as transport, based on which can conclude that little time is left for organised physical activity. Socio-economic status does have an influence on posture and participation in physical activity. / Thesis (M.Sc. (Human Movement Science))--North-West University, Potchefstroom Campus, 2009.

Socio-economic status form a big part of each person's physical development. Socio-economic status is defined by house income, house standards, family size, physical activity level and parents education level and occupation. Socio-economic status influence posture as well as physical activity levels of adolescents. Adolescents living in low socio-economic areas show delayed growth with an influence on posture. Posture is mainly influenced by genetics as well as some socio-economic variables such as diet, malnutrition en obesity. Posture development is also related to physical activity. A sedentary lifestyle is more common under adolescence in low socio-economic areas than those in high socio-economic areas. This incidence can be due to the fact that a lack of equipment and safety are more common in low socio-economic areas, subsequently the lack of organised physical activity. The benefits of physical activity are endless and should be integrated as part of our daily living. Different studies of socio-economic status, physical activity and posture deformities were found although none compared all three valuables with each other. Literature is only used as a guideline and not for a comparison with this study. The goal of this study was firstly to determine the influence of socio-economic status on posture deformities on black African adolescence and secondly to determine the influence of socio-economic status on physical activity levels of black African adolescence. A total of 251 pupils participated in the study. Questionnaires were completed on socio-economic status as well as on physical activity levels. Posture screening was done according to the New York posture test and a posture grid. Pupils were evaluated from anterior, posterior and lateral sides together with evaluation of foot deformities and a more defined scoliosis screening by the Adams forward bending test. The prevalence of posture deformities and insufficient organised physical activity are high in black African adolescence. The most common posture deformity is lordosis (84%) and a protruding abdomen (67%). These deformities are closely correlated to socio-economic status especially diet because it influences growth and development of children. Physical activity levels are influenced by a lack of transport and organised physical activities. A total of 87,5% of pupils use walking as transport, based on which can conclude that little time is left for organised physical activity. Socio-economic status does have an influence on posture and participation in physical activity. / Thesis (M.Sc. (Human Movement Science))--North-West University, Potchefstroom Campus, 2009.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.

Objetivo: elaborar diretrizes para o tratamento. Modelo: Análise retrospectiva dos históricos de 236 crianças, durante o período de julho de 2003 a julho de 2006 e análise descritiva dos resultados. Ambiente: Unidade de Cuidados Especiais (UCE) do HRAC-USP. Participantes: 236 crianças com disfagia orofaríngea, com idade de 3 dias a 8 anos, 204 (86,4%) apresentavam fissura labiopalatina. A Seqüência de Robin foi diagnosticada em 139 crianças (58,9%), sendo que 95 (68,3%) tinham SRI e 44 (31,7%) síndrome associada. Variáveis: incidência de disfagia, síndromes ou malformações associadas, grau da disfagia, presença de desconforto respiratório, uso de sondas alimentadoras (SNG e gastrostomia), DRGE, complicações relacionadas às gastrostomias e ao tratamento cirúrgico da DRGE, reinternações e o tempo total de hospitalização. Resultados: Das 236 crianças, 110 (46,6%) tinham disfagia leve, 47 (19,9%) moderada e 79 (33,5%) grave. A disfagia leve foi maior nas crianças com fissuras de lábio e/ou palato isoladas (88,5%), com malformações congênitas (81,3%) e com SRI (56,8%). A disfagia grave foi mais freqüente em crianças com síndrome (61,6%). Do universo estudado, 195 crianças (82,6%) necessitaram do uso da SNG. O tempo de uso variou de 1 dia a 750 dias, com média de 113 dias e mediana de 60 dias. A gastrostomia foi indicada em 67 (28,4%). Conclusões: A disfagia orofaríngea é um dos principais problemas apresentados pelas crianças com malformações craniofaciais. O diagnóstico de outras malformações ou síndromes associadas e a classificação do grau da disfagia orofaríngea são determinantes na orientação do tratamento. / Objective: To draw up guidelines for the treatment. Model: Retrospective analysis of historical of 236 children, during the period July 2003 to July 2006 and descriptive analysis of the results. Environment: Special Care Unit by HRAC-USP. Participants: 236 children with oropharyngeal dysphagia, aged 3 days to 8 years, 204 (86.4%) had cleft lip, and / or palate. The sequence of Robin was diagnosed in 139 children (58.9%), whereas 95 (68.3%) had SRI and 44 (31.7%) syndrome associated. Variables: incidence of dysphagia, syndromes or associated malformations, degree of dysphagia, presence of respiratory discomfort, use of probes feeding (nasogastric tube and gastrostomy), GERD, complications related to gastrostomies and the surgical treatment of GERD, readmissions and the total time of hospitalization. Results: Of the 236 children, 110 (46.6%) had mild dysphagia, 47 (19.9%) moderate and 79 (33.5%) serious. The mild dysphagia was higher for children with cleft lip, and / or palate alone (88.5%) with congenital malformations (81.3%) and with SRI (56.8%). The severe dysphagia was more frequent in children with syndrome (61.6%). Of the study, 195 children (82.6%) required the use of nasogastric tube . The time of use ranged from 1 day to 750 days, with an average of 113 days and a median of 60 days. The gastrostomy was indicated in 67 (28.4%). Conclusions: The oropharyngeal dysphagia is one of the main problems presented by children with craniofacial deformities. The diagnosis of malformations or other syndromes associated and classification the degree of oropharyngeal dysphagia are crucial in guiding treatment.