<p>Uvod: magnetno rezonantni imidžing (MR) je u &scaron;irokoj uporebi u dijagnostici patolo&scaron;kih poremećaja ekstremiteta. Postoji interes da se redukuje vreme trajanja snimanja tokom pregleda kako bi se povećao komfor pacijenata i redukovali problemi koji su u vezi sa klaustrofobijom i artefaktima koji nastaju pri pomeranju pacijenta tokom dugih snimanja. Trodimenzionalne (3D) izovoksel sekvence pokazale su značajne mogućnosti u redukciji vremena snimanja MR pregledom zgloba kolena bez smanjenja kvaliteta dijagnostičkih mogućnosti. Cilj: uporediti dijagnostičke mogućnosti rutinskog, 2D MR protokola, na 3.0 Tesla MR aparatu, sa 3D True fast imaging, TrueFISP, izovoksel sekvencom u detekciji hondralnih o&scaron;tećenja, ruptura prednjeg ukr&scaron;tenog ligamenta (LCA), ruptura meniskusa i abnormalnosti subhondralne kosti, u korelaciji sa artroskopijom, kao referentnim standardom. Materijal i metode: Studija je odobrena od institucionalnog etičkog odbora. Pacijenti su informisani o studiji i potpisali pristanak za uče&scaron;će u istraživanju. 76 zgloba kolena kod 76 pacijenata (34 ženskog pola; prosečne starosti 36 godina) uključeno je u prospektivnu studiju, snimljeno je standardnim 2D MR protokolom snimanja i 3D TrueFISP sekvencom u sagitalnoj ravni. Svim pacijentima je urađena artroskopija u periodu od maksimum 30 dana nakon snimanja. Dva radiologa, nezavisno jedan od drugog, su evaluirala dobijene snimke. Preciznost u detekciji hondralnih o&scaron;tećenja, ruptura LCA i meniskusa, i abnormalnosti subhondralne kostne srži je određena podudarno&scaron;ću radiolo&scaron;kih i artroskopskih nalaza kao i proverom podudaranja ove dve metode snimanja. Rezultati: prosečna senzitivnost i specifičnost 3DTrueFISP sekvence je bila 75%, 94% respektivno, u dijagnostici o&scaron;tećenja hrskavice, 97%, 97% u detekciji ruptura LCA, 65%, 89% u postavljanju dijagnoze ruptura meniskusa, a dobra podudarnost radiolo&scaron;kih nalaza je dobijena u interpretaciji o&scaron;tećenja subhondralne kosti. Standardnim 2D MR protokolom prosečna senzitivnost i specifičnost je bila 70%, 93%, respektivno, u postavljanju dijagnoze hondralnih o&scaron;tećenja, 94% i 100% u postavljanju dijagnoze rupture LCA, 65%, 88% u detekciji ruptura meniskusa. Zaključak: dijagnostičke mogućnosti upotrebom 3DTrueFISP sekvence su uporedive sa standardnim, 2D, MR protokolom u snimanju zgloba kolena.</p> / <p>Introduction: Magnetic resonance imaging (MR) is widely used to assess internal derangements of the extremities. There is an interest in decreasing examination times to improve patient comfort and reduce the problems related to claustrophobia and motion artifacts, which occur more commonly with long examinations. The three-dimensional (3D) isovoxel true FISP sequence facilitates a noticeable reduction in acquisition time for MR imaging of the knee without reducing diagnostic performance. Objective: To compare the diagnostic performance of conventional, 2D, MR protocol, at 3.0 Tesla MR, with 3D water-excitation true fast imaging with steady-state precession, TrueFISP, an isotropic resolution sequence for detecting articular cartilage defects, anterior crucial ligament tears, meniscal tears and subhondral bone changes of the knee joint, with arthroscopy as reference standard. Materials and methods: The study was institutional review board approved. Written informed consent was obtained from all patients. 76 knees of 76 patients (34 females; mean age 36 years) were prospectively examined by using a conventional 2D MR protocol and sagittal 3D TrueFISP sequence. All patients underwent arthroscopy within a maximum period of 30 days after imaging. Two blinded readers evaluated the MR images. Accuracy for detection of cartilage defects, anterior cruciate ligament and meniscal tears, and subchondral bone abnormalities interobserver agreement, and intermethod agreement were calculated. Results: Overall sensitivity and specificity of 3DTrueFISP sequence were, respectively, 75%, 94% for diagnosis cartilage defects, 97%, 97%, for a diagnosis ACL tears, 65%, 89% for diagnosis of meniscal tears and with good interobserver agreement in interpretation of subhondral bone abnormalities. The standard MR protocol had overall sensitivities and specificities 70%, 93%, respectively, for diagnosis of cartilage defects, 94% and 100% for diagnosis ACL tears and 65%, 88% for diagnosis meniscal tears. Conclusion: The diagnostic perfomance of knee MR imaging performed by using a 3DTrueFISP sequence is comparable to the diagnostic performance of the conventional, 2D, MR protocol.</p>

Introdução: O presente estudo comparou o desempenho de crianças brasileiras com distúrbio específico de linguagem (DEL), transtorno fonológico (TF) e desenvolvimento típico de linguagem (DTL) em memória de curto prazo e operacional nas modalidades verbal e visuoespacial. A hipótese central do estudo era de que o grupo com distúrbio específico de linguagem teria um desempenho aquém do observado nos demais grupos, nos dois tipos de memória e nas duas modalidades, enquanto o grupo com transtorno fonológico teria prejuízos apenas na modalidade verbal. Métodos: Participaram do estudo 60 crianças de ambos os gêneros e com faixa etária entre 5 anos e 6 anos e 11 meses, divididas igualmente em três grupos, com base em seu desenvolvimento de fala e linguagem. Todas apresentavam audição normal e rendimento intelectual não verbal adequado. Para a caracterização dos sujeitos, foram avaliados vocabulário expressivo, fonologia, discriminação auditiva para fonemas e nível socioeconômico. A avaliação experimental foi composta pelo teste de memória de curto prazo fonológica e por oito tarefas do Automated Working Memory Assessment, que avalia a combinação dos dois tipos de memória e suas duas modalidades (curto prazo verbal, operacional verbal, curto prazo visuoespacial e operacional visuoespacial). Resultados: A comparação entre os tipos e as modalidades de memória revelou que os três grupos apresentaram o mesmo padrão. Na modalidade verbal, o melhor desempenho ocorreu na memória de curto prazo, enquanto na modalidade visuoespacial, ocorreu na memória operacional. Já na memória de curto prazo, o melhor desempenho ocorreu nas tarefas verbais, enquanto na memória operacional, ocorreu nas tarefas visuoespaciais. A comparação entre os grupos revelou que os sujeitos com DEL tiveram desempenho inferior aos dois outros grupos em todas as combinações de tipos e modalidades de memória, com exceção da memória de curto prazo verbal e operacional visuoespacial, nas quais obtiveram desempenho similar ao grupo com TF. Já os sujeitos com TF tiveram desempenho inferior ao grupo com DTL apenas na modalidade verbal. A idade e o nível socioeconômico não demonstraram influenciar tal desempenho, porém, o rendimento intelectual não verbal, o vocabulário expressivo, a fonologia e a discriminação auditiva foram identificados como variáveis mediadoras. Por fim, a análise discriminante evidenciou que essas medidas foram capazes de discriminar corretamente 78,3% dos sujeitos, sendo que 75% foram corretamente classificados como DEL, 65% como TF e 95% como DTL. Conclusões: Ainda que os três grupos tenham demonstrado padrão semelhante de desempenho quanto ao tipo e modalidade de memória, o grupo com DEL apresentou um prejuízo que não se restringe à modalidade verbal, enquanto o grupo com TF demonstrou prejuízo exclusivamente na modalidade verbal. Tais achados confirmam a hipótese central formulada e contribuem para a compreensão da extensão e dos possíveis mediadores do comprometimento da memória de indivíduos com DEL. Descritores: memória; memória de curto prazo; linguagem infantil; linguagem; desenvolvimento da linguagem; transtornos do desenvolvimento da linguagem; transtornos da linguagem; fonoaudiologia; distúrbios da fala / Introduction: The present study compared the performances of Brazilian children with specific language impairment (SLI), speech sound disorder (SSD) and typical language development (TLD) on verbal and visuospatial measures of short-term (STM) and working memory (WM). The central hypothesis of the study was that children with SLI would present poorer performances on both types and domains of memory when compared to the other groups, while children with SSD would present deficits restricted to the verbal domain. Methods: Participants were sixty children aged 5- to 6-years of both genders. Participants were divided into three groups based on their speech and language development. All children presented hearing thresholds within normal limits and presented appropriate nonverbal intellectual performance. In order to characterize the children, we assessed expressive vocabulary, phonology, auditory phoneme discrimination and socioeconomic status. The experimental assessment was composed by a phonological short-term memory test and by eight tasks based on the Automated Working Memory Assessment. This battery assesses both types and domains of memory (verbal STM, verbal WM, visuospatial STM and visuospatial WM). Results: The comparison between types and domains of memory revealed that groups exhibited the same pattern: on verbal domain they performed better on STM while on visuospatial domain they performed better on WM; on STM they performed better on verbal tasks while on WM they performed better on visuospatial tasks. Intergroup comparison revealed that children with SLI performed worse than their peers on both types and domains of memory, except on verbal STM and visuospatial WM in which they performed similarly to children with SSD. In contrast, children with SSD performed worse than children with TLD only on verbal domain. Age and socioeconomic status showed no influence on children`s performance, but nonverbal intellectual performance, expressive vocabulary, phonology and auditory phoneme discrimination were identified as covariates. Finally, discriminant analysis indicated that these measures of memory were able to significantly discriminate between 79.3% of the all children, correctly classifying 75% of children with SLI, 65% of SSD and 95% of TLD. Conclusion: Although all groups presented a similar pattern in performance regarding types and memory domains, children with SLI exhibited deficits that were not restricted to the verbal domain, while children with SSD showed deficits restricted to this domain exclusively. These findings support the central hypothesis formulated for this study and contribute to the better understanding of comprehensiveness and of factors that might mediate memory impairment of children with SLI

Introdução: O presente estudo comparou o desempenho de crianças brasileiras com distúrbio específico de linguagem (DEL), transtorno fonológico (TF) e desenvolvimento típico de linguagem (DTL) em memória de curto prazo e operacional nas modalidades verbal e visuoespacial. A hipótese central do estudo era de que o grupo com distúrbio específico de linguagem teria um desempenho aquém do observado nos demais grupos, nos dois tipos de memória e nas duas modalidades, enquanto o grupo com transtorno fonológico teria prejuízos apenas na modalidade verbal. Métodos: Participaram do estudo 60 crianças de ambos os gêneros e com faixa etária entre 5 anos e 6 anos e 11 meses, divididas igualmente em três grupos, com base em seu desenvolvimento de fala e linguagem. Todas apresentavam audição normal e rendimento intelectual não verbal adequado. Para a caracterização dos sujeitos, foram avaliados vocabulário expressivo, fonologia, discriminação auditiva para fonemas e nível socioeconômico. A avaliação experimental foi composta pelo teste de memória de curto prazo fonológica e por oito tarefas do Automated Working Memory Assessment, que avalia a combinação dos dois tipos de memória e suas duas modalidades (curto prazo verbal, operacional verbal, curto prazo visuoespacial e operacional visuoespacial). Resultados: A comparação entre os tipos e as modalidades de memória revelou que os três grupos apresentaram o mesmo padrão. Na modalidade verbal, o melhor desempenho ocorreu na memória de curto prazo, enquanto na modalidade visuoespacial, ocorreu na memória operacional. Já na memória de curto prazo, o melhor desempenho ocorreu nas tarefas verbais, enquanto na memória operacional, ocorreu nas tarefas visuoespaciais. A comparação entre os grupos revelou que os sujeitos com DEL tiveram desempenho inferior aos dois outros grupos em todas as combinações de tipos e modalidades de memória, com exceção da memória de curto prazo verbal e operacional visuoespacial, nas quais obtiveram desempenho similar ao grupo com TF. Já os sujeitos com TF tiveram desempenho inferior ao grupo com DTL apenas na modalidade verbal. A idade e o nível socioeconômico não demonstraram influenciar tal desempenho, porém, o rendimento intelectual não verbal, o vocabulário expressivo, a fonologia e a discriminação auditiva foram identificados como variáveis mediadoras. Por fim, a análise discriminante evidenciou que essas medidas foram capazes de discriminar corretamente 78,3% dos sujeitos, sendo que 75% foram corretamente classificados como DEL, 65% como TF e 95% como DTL. Conclusões: Ainda que os três grupos tenham demonstrado padrão semelhante de desempenho quanto ao tipo e modalidade de memória, o grupo com DEL apresentou um prejuízo que não se restringe à modalidade verbal, enquanto o grupo com TF demonstrou prejuízo exclusivamente na modalidade verbal. Tais achados confirmam a hipótese central formulada e contribuem para a compreensão da extensão e dos possíveis mediadores do comprometimento da memória de indivíduos com DEL. Descritores: memória; memória de curto prazo; linguagem infantil; linguagem; desenvolvimento da linguagem; transtornos do desenvolvimento da linguagem; transtornos da linguagem; fonoaudiologia; distúrbios da fala / Introduction: The present study compared the performances of Brazilian children with specific language impairment (SLI), speech sound disorder (SSD) and typical language development (TLD) on verbal and visuospatial measures of short-term (STM) and working memory (WM). The central hypothesis of the study was that children with SLI would present poorer performances on both types and domains of memory when compared to the other groups, while children with SSD would present deficits restricted to the verbal domain. Methods: Participants were sixty children aged 5- to 6-years of both genders. Participants were divided into three groups based on their speech and language development. All children presented hearing thresholds within normal limits and presented appropriate nonverbal intellectual performance. In order to characterize the children, we assessed expressive vocabulary, phonology, auditory phoneme discrimination and socioeconomic status. The experimental assessment was composed by a phonological short-term memory test and by eight tasks based on the Automated Working Memory Assessment. This battery assesses both types and domains of memory (verbal STM, verbal WM, visuospatial STM and visuospatial WM). Results: The comparison between types and domains of memory revealed that groups exhibited the same pattern: on verbal domain they performed better on STM while on visuospatial domain they performed better on WM; on STM they performed better on verbal tasks while on WM they performed better on visuospatial tasks. Intergroup comparison revealed that children with SLI performed worse than their peers on both types and domains of memory, except on verbal STM and visuospatial WM in which they performed similarly to children with SSD. In contrast, children with SSD performed worse than children with TLD only on verbal domain. Age and socioeconomic status showed no influence on children`s performance, but nonverbal intellectual performance, expressive vocabulary, phonology and auditory phoneme discrimination were identified as covariates. Finally, discriminant analysis indicated that these measures of memory were able to significantly discriminate between 79.3% of the all children, correctly classifying 75% of children with SLI, 65% of SSD and 95% of TLD. Conclusion: Although all groups presented a similar pattern in performance regarding types and memory domains, children with SLI exhibited deficits that were not restricted to the verbal domain, while children with SSD showed deficits restricted to this domain exclusively. These findings support the central hypothesis formulated for this study and contribute to the better understanding of comprehensiveness and of factors that might mediate memory impairment of children with SLI

The skeletal material used in this thesis consists of 258 individuals, whereas 179 individuals had the requirements entailed for an analysis of health and lifestyles. In other words, their sex and age had been osteologically determined. In addition, they are either young adults, adults, or seniors, as infants and subadults usually die before skeletal changes. Males represent 63 percent (n=112) and females 37 percent (n=67) of the material. The material is collected from a Stone Age dwelling site in Ajvide, Gotland, and six Medieval churches in Visby, Gotland: St Hans, St Per, St Clemens, Ryska Kyrkan, St Gertrud and St Mikael. One of the most noticeable traits caused by a change in subsistence strategies is an increase in enamel hypoplasia, cribra orbitalia, degenerative joint diseases, and activity-related pathologies, as well as a decrease in oral health. Therefore, the population of Medieval Visby was exposed to more stressors in the shape of infections and malnutrition. Furthermore, the high amount of degenerative joint diseases also indicates a more physically strenuous life. / Skelettmaterialet som använts i denna uppsats består av 258 individer, varav 179 individer uppfyllde de krav som krävdes för en lyckad analys. Individerna måste alltså ha en känd ålder och kön, dessutom exkluderades spädbarn och juvenila, då de oftast avled innan skeletala förändringar. I materialet representerade männen 63 procent (n=112) och kvinnorna 37 procent (n=67) av den totala mängden skelett. Materialet hade blivit insamlad från stenåldersboplatsen Ajvide på Gotland samt sex medeltida kyrkor från Visby, Gotland: St Hans, St Per, St Clemens, Ryska Kyrkan, St Gertrud och St Mikael. Noterbara förändringar är en ökning i emaljhypoplasi, cribra orbitalia, degenerativa ledsjukdomar, aktivitet-relaterade patologier samt försämrad oral hälsa. Detta tyder på att den medeltida befolkningen utsattes för mer stress i form av infektioner och undernäring. Mängden degenerativa ledsjukdomar indikerar dessutom på ett mer fysiskt ansträngande liv.

Osteoarthritis (OA) is a degenerative pathological condition of the appendicular joints which affects the cartilage and underlying bone. OA is relatively common in both the archaeological and clinical context, and a significant amount of research has been conducted on this osteological condition. The purpose of this thesis is to assess the incidence, demographic prevalence, and general severity of hip and knee OA in a Roman-Christian period (50 A.D – 450 A.D) population sample from the Dakhleh Oasis, Egypt. The bioarchaeological sample originates from the Kellis 2 cemetery which is associated with the ancient town of Kellis. The town of Kellis is believed to have been a prosperous economic hub in Egypt, located in the Western Sahara Desert approximately 250 kilometers west of the Nile. The skeletal samples (n=135, 83 females and 51 males) was visually assessed for the osteological characteristics of OA in the hips and the knees. Joint surfaces of the hip include the acetabulum and femoral head. Joint surfaces of the knee include lateral/medial tibio-femoral compartments and the patellofemoral compartment. The ages of the individuals assessed in this study range from 19-72 years, and have been divided into five age categories which were then cross-tabulated with sex and OA incidence in order to determine demographic prevalence of OA. Findings indicate that age is a significant etiological factor of OA prevalence for both males and females. Males are afflicted by the disease significantly more than females in the hips (F: [L] 3.6%, [R] 5.9% and M: [L] 13.7%,[R] 13.7%) and also slightly more affected in the knees(F: [L] 17.5%,[R] 18.3% and M: [L] 22.9%,[R]21.3%). The acetabulum tends to be more arthritic than the femoral head for both males and females. Femoral condyles tend to be more arthritic than tibial condyles for both males and females. The patello-femoral compartment tends iv to be the most arthritic part of the knee while the medial condyles of both tibiae exhibit virtually no OA (with the exception of one individual). The joint surface observed with the highest OA prevalence is the femoral surface of the patella (F: [L] 17.5%,[R] 15.9% and M: [L] 21.3%,[R] 21.3%). The highest prevalence of OA by joint complex is observed on the left knee in males (22.9%), and the lowest prevalence of OA is observed on the left hip of females (3.6%). Both hip and knee joints have higher prevalence of unilateral OA manifestation than bilateral. Isotopic and archaeological evidence indicates that the individuals at Kellis maintained an agricultural subsistence regime, and that the males within the population may have been highly mobile migrating to and from the Dakhleh Oasis. Subsistence agriculture has its necessary physical demands which may have been a contributory factor to OA rates. Males show higher OA rates than females throughout the joints of the legs. Sexual dimorphism of OA for the hips is suggestive of sexual divisions of labor. OA of the knees lacks sexual dimorphism therefore the knee joint complex of males and females were likely subjected to similar levels of mechanical loading. It can be concluded based on the OA data that males and females exhibit similar activity, or biomechanical stress levels in the knee joint complexes. Males exhibit significantly higher pathological manifestation of OA in the hip joint complexes, indicative of higher levels of mechanical loading in the hip joint complex which can theoretically be attributed to sexual divisions of labor or perhaps terrestrial mobility