Adolescent Growth Spurt Research Articles

EFFECTIVENESS OF PLYOMETRIC EXERCISE ON LOWER EXTREMITY FUNCTION AMONG CLASSICAL BHARATANATYAM DANCERS.

Background: Aramandi is the most basic position in Bharatanatyam which is like Demiplie position of ballet dancers in which both the legs were internally rotated. Gaining proficiency in Bharatanatyam requires rigorous training for prolonged periods of time while maintaining specific postures which begin at a very young age during the adolescent growth spurt. Objective. To find out the effectiveness of plyometric exercise on lower extremity function among classical Bharatanatyam dancers Methods. Totally 20 classical dancers were recruited in accordance with inclusion criteria. Classical dancers were given plyometric exercise. Post-test taken for 20 participants with regular follow up. The LEFS questionnaire is an outcome measure that is used before and after the treatment. Result. The obtained data were analyzed by using paired ‘t’ test comparison of pre and post-test value for LEFS questionnaire the p value is 0.001. Hence, it is concluded that the LEFS questionnaire has highly significant. Conclusion. This study concluded that plyometric exercise had beneficial effect to shows that there is an improvement on lower extremity function among classical Bharatanatyam dancers.

The estimation of pubertal growth spurt parameters using the superimposition by translation and rotation model in Korean children and adolescents: a longitudinal cohort study.

Understanding the characteristics of the pubertal growth spurt in Korean children and adolescents can serve as crucial foundational data for researching puberty and growth-related disorders. This study aims to estimate the key parameters of pubertal growth, specifically the age and magnitude of the pubertal growth spurt, utilizing longitudinal data from a cohort of Korean children and adolescents. This study used mixed longitudinal height data from a cohort of Korean elementary, middle, and high school students aged 7-18 years. The Superimposition by Translation and Rotation (SITAR) model, a shape-invariant growth curve model, was utilized to estimate a reference height velocity curve for the entire dataset and individual curves via random effects to evaluate pubertal growth parameters. Altogether, 3,339 height measurements (1,519 for boys and 1,820 for girls) from 270 individuals (123 boys and 147 girls) were analyzed. The average age of growth spurt onset in Korean boys was 10.17 ± 0.61 years (mean ± SE), with peak height velocity occurring at 12.46 ± 0.69 years of age (9.61 ± 1.26 cm/year). Korean girls, contrarily, experience their growth spurt at an earlier age (8.57 ± 0.68 years), with peak height velocity occurring at 10.99 ± 0.74 years of age (8.32 ± 1.09 cm/year). An earlier onset of puberty in both sexes is associated with a shorter growth spurt duration (0.63 years for boys and 0.58 years for girls) and a higher peak height velocity (1.82 cm/year for boys and 1.39 cm/year for girls). These associations were statistically significant for both sexes (all p < 0.0001). This study is the first to use the height velocity curve from the SITAR model to examine the pubertal growth spurt of Korean children and adolescents. The estimated timing and magnitude of the pubertal growth spurt, and their relationships can be useful data for clinicians and researchers.

Associations between growth, maturation and injury in youth athletes engaged in elite pathways: a scoping review

ObjectiveTo describe the evidence pertaining to associations between growth, maturation and injury in elite youth athletes.DesignScoping review.Data sourcesElectronic databases (SPORTDiscus, Embase, PubMed, MEDLINE and Web of Science) searched on 30...

Text-first virtual care: The key to virtual care sustainability

Virtual care is, and will continue to be, a ubiquitous front door to care as it evolves as a modality to better match the demands and lifestyles of consumers. As with any technology, success comes from learning, iterating, and evolving, and this is certainly true of virtual care as it comes of age. It’s been a complex journey as the modality gained acceptance, moving through the early adopter stage into its adolescent growth spurt propelled by COVID. Virtual care’s growth has been a mix of progress and pitfalls, manifested in policy changes, market shifts, sustainability issues, and the trials of big-name players. However, these challenges have also presented new opportunities for learning, partnering, and a runway for refined models to take hold. The legacy issues surrounding virtual care are now being resolved with the data-rich approach of on-demand, text-first virtual care. Fueled by artificial intelligence (AI) and poised to drive needed change, text-first virtual care is quality-oriented, data-based, and people-first, improving patient engagement and empowering clinicians. Helen Schnase, MD, MBA, shares her experience with on-demand, text-first virtual care and gives insight on how virtual care can continue to thrive and be the ubiquitous front door to care we all want it to be. She lays out why it must be an experience that people want to use and support the tenets of: high-quality comprehensive care delivery; improved access to care; increased engagement and affordability; as well as scalability and the ability to accommodate future innovation.

Novel signals and polygenic score for height are associated with pubertal growth traits in Southwestern American Indians.

Most genetic variants associated with adult height have been identified through large genome-wide association studies (GWASs) in European-ancestry cohorts. However, it is unclear how these variants influence linear growth during adolescence. This study uses anthropometric and genotypic data from a longitudinal study conducted in an American Indian community in Arizona between 1965-2007. Growth parameters (i.e. height, velocity, and timing of growth spurt) were derived from the Preece-Baines growth model, a parametric growth curve fitted to longitudinal height data, in 787 participants with height measurements spanning the whole period of growth. Heritability estimates suggested that genetic factors could explain 25% to 71% of the variance of pubertal growth traits. We performed a GWAS of growth parameters, testing their associations with 5 077 595 imputed or directly genotyped variants. Six variants associated with height at peak velocity (P < 5 × 10-8, adjusted for sex, birth year and principal components). Implicated genes include NUDT3, previously associated with adult height, and PACSIN1. Two novel variants associated with duration of growth spurt (P < 5 × 10-8) in LOC105375344, an uncharacterized gene with unknown function. We finally examined the association of growth parameters with a polygenic score for height derived from 9557 single nucleotide polymorphisms (SNPs) identified in the GIANT meta-analysis for which genotypic data were available for the American Indian study population. Height polygenic score was correlated with the magnitude and velocity of height growth that occurred before and at the peak of the adolescent growth spurt, indicating overlapping genetic architecture, with no influence on the timing of adolescent growth.

Are There Sensitive Periods for Skill Development in Male Adolescent Basketball Players?

Although spurts in physical capacities during adolescence are well known, little is known about the existence of such spurts in sport-specific skill development, especially during the period of rapid growth in stature. Our aims were to examine the timing, intensity, and sequence of basketball-specific skill spurts aligned with biological (years from peak height velocity (PHV)) rather than chronological age. We then defined putative sensitive periods (windows of optimal development) for each skill aligned to the adolescent growth spurt. Altogether, 160 adolescent male basketballers aged 11-15 yr were tested biannually over 3 consecutive years. The years from attainment of PHV was estimated, and six skill tests were aligned to each year from PHV in 3-month intervals. Skill velocities were estimated using a nonsmooth polynomial model. Maximal gains in slalom dribble occurred 12 months before PHV attainment (intensity, 0.18 m·s -1 ·yr -1 ), whereas in speed shot shooting (intensity, 9.91 pts·yr -1 ), passing (intensity, 19.13 pts·yr -1 ), and slalom sprint (intensity, 0.19 m·s -1 ·yr -1 ), these skill spurts were attained 6 months before PHV attainment. The mean gains in control dribble (intensity, 0.10 m·s -1 ·yr -1 ) and defensive movement (intensity, 0.12 m·s -1 ·yr -1 ) peaks coincided with attainment of PHV. We identified different sized windows for optimal development for each skill. Peak spurts in skill development, for most basketball skills, were attained at the same time as PHV. The multiple peaks observed within the defined windows of optimal development suggest that there is room for skill improvement even if gains might be greater earlier rather than later in practice. Our findings highlight the need to make coaches aware of where their players are relative to the attainment of PHV because different skills appear to develop differently relative to PHV. Such knowledge may help in designing more relevant training regimes that incorporate the athlete's current growth status so that skill development can be maximized.

Integrated transcriptomic analysis systematically reveals the heterogeneity and molecular characterization of cancer-associated fibroblasts in osteosarcoma

BackgroundOsteosarcoma (OS), with a peak incidence during the adolescent growth spurt, is correlated with poor prognosis for its high malignancy. The tumor microenvironment (TME) is highly complicated, with frequent interactions between tumor and stromal cells. The cancer-associated fibroblasts (CAFs) in the TME have been considered to actively involve in the progression, metastasis, and drug resistance of OS. This study aimed to characterize cellular heterogeneity and molecular characterization in CAFs subtypes and explore the potential targeting therapeutic strategies to improve the prognosis of OS patients. MethodsThe single-cell atlas of human OS tumor lesions were constructed from the GEO database. Then significant marker genes and potential biological functions for each CAFs subtype were identified and explored using the Seurat R package. Next, by performing the survival analyses and constructing the risk scores for CAFs subtypes, we aimed to identify and characterize the prognostic values of specific marker genes and different CAFs subtypes. Furthermore, we explored the therapeutic targets and innovative drugs targeting different CAFs subtypes based on the GDSC database. Finally, prognoses related CAFs subtypes were further validated through immunohistochemistry (IHC) on clinical OS specimens. ResultsOverall, nine main cell clusters and five subtypes of CAFs were identified. The differentially expressed marker genes for each CAFs clusters were then identified. Moreover, through Gene Ontology (GO) enrichment analysis, we defined the CAFs_2 (upregulated CXCL14 and C3), which was closely related to leukocyte migration and chemotaxis, as inflammatory CAFs (iCAFs). Likewise, we defined the CAFs_4 (upregulated CD74, HLA-DRA and HLA-DRB1), which was closely related to antigen process and presentation, as antigen-presenting CAFs (apCAFs). Furthermore, Kaplan-Meier analyses showed that CAFs_2 and CAFs_4 were correlated with poor clinical prognosis of OS patients. Meanwhile, therapeutic drugs targeting CAFs_2 and CAFs_4, such as 17-AAG/Docetaxel/Bleomycin and PHA-793887/NG-25/KIN001-102, were also explored, respectively. Finally, IHC assay confirmed the abundant CAFs_2 and CAFs_4 subtypes infiltration in the OS microenvironment compared with adjacent tissues. ConclusionOur study revealed the diversity, complexity, and heterogeneity of CAFs in OS, and complemented the single-cell atlas in OS TME.

Adaptation of Left Ventricular Twist Mechanics in Exercise-Trained Children Is Only Evident after the Adolescent Growth Spurt

The extent of structural cardiac remodeling in response to endurance training is maturity dependent. In adults, this structural adaptation is often associated with the adaptation of left ventricular (LV) twist mechanics. For example, an increase in LV twist often follows an expansion in end-diastolic volume, whereas a reduction in twist may follow a thickening of the LV walls. While structural cardiac remodeling has been shown to be more prominent post-peak height velocity (PHV), it remains to be determined how this maturation-dependent structural remodeling influences LV twist. Therefore, we aimed to (1) compare LV twist mechanics between trained and untrained children pre- and post-PHV and (2) investigate how LV structural variables relate to LV twist mechanics pre- and post-PHV. Left ventricular function and morphology were assessed (echocardiography) in endurance-trained and untrained boys (n=38 and n=28, respectively) and girls (n=39 and n=34, respectively). Participants were categorized as either pre- or post-PHV using maturity offset to estimate somatic maturation. Pre-PHV, there were no differences in LV twist or torsion between trained and untrained boys (twist: P=.630; torsion: P=.382) or girls (twist: P=.502; torsion: P=.316), and LV twist mechanics were not related with any LV structural variables (P>.05). Post-PHV, LV twist was lower in trained versus untrained boys (P=.004), with torsion lower in trained groups, irrespective of sex (boys: P<.001; girls: P=.017). Moreover, LV torsion was inversely related to LV mass (boys: r=-0.55, P=.001; girls: r=-0.46, P=.003) and end-diastolic volume (boys: r=-0.64, P<.001; girls: r=-0.36, P=.025) in both sexes. A difference in LV twist mechanics between endurance-trained and untrained cohorts is only apparent post-PHV, where structural and functional remodeling were related.

Parameters of pubertal growth spurt in children and adolescents living at high altitude in Peru

ObjectivesThe aim was to estimate the pubertal growth height of children and adolescents living in a high-altitude region of Peru using the Preece-Baines model 1 (1 PB). MethodsA cross-sectional study was conducted in schoolchildren from the department of Puno (Peru) between 3841 and 3874 masl. The age range was between 4 and 17 years. Standing height was evaluated. 1 PB was used to infer the mathematical and biological parameters of stature. ResultsMathematical parameters estimated by the 1 PB model reflected small residual standard error (RSE) values in both sexes (0.25 in boys and 0.27 in girls). In boys, the age at which peak velocity was reached (APHV) was estimated at 13.21 ± 0.33years. While in girls it was 9.96 ± 0.26years (p < 0.05). In general, girls reached APHV (y) 3.25 years earlier than boys. On the other hand, the growth velocity of maximum height [APHV (cm/y)] of boys was higher (6.33 ± 6.06 cm/y) relative to girls (6.06 ± 0.32 cm/y). Estimated final adult height (EFAH) in boys was reached at 166.020 ± 0.99 cm and height at maximum growth velocity (HPHV) was 153.07 ± 0.67 cm, while in girls they were significantly lower (EFAH; 153.74 ± 0.44 cm and HPHV: 139.73 ± 0.84 cm). ConclusionsThis study showed that girls living in Puno at a high altitude in Peru reached APHV 3 years earlier than boys and at the same time reflected slower PHV. These results suggest that pubertal growth at high altitudes is slower in both sexes and especially in girls. Thus, modeling physical growth may be an important step in understanding the onset of puberty at different latitudes.

Taste Neophobia, Latent Inhibition of Taste Aversion and Object Recognition Memory in Adolescent Rats.

Adolescence in mammals is a period marked by increased novelty-seeking and enhanced responsiveness to the stressful properties of novel stimuli. Despite the need to taste potentially toxic novel foods during the adolescent growth spurt, there has been little study of taste neophobia and its attenuation. Four experiments were carried out to compare taste neophobia and related memory processes in male and female adolescent (PND28) and adult (PND70) Wistar rats. Experiments 1 and 2 evaluated attenuation of taste neophobia to cider vinegar (3%) and sodium saccharin (0.1%) solutions were evaluated. Additionally, to test the role of memory in neophobia during adolescence, latent inhibition of taste aversion and object recognition memory were assessed in Experiment 3 and Experiment 4, respectively. Adolescent and adult rats exhibited taste neophobia to the saccharin solution but adolescent rats required more exposure trials than adults to recognize the vinegar solution as safe. Both groups exhibited similar latent inhibition of taste aversion and object recognition memory. No sex effect was significant. Contrary to the accepted view associating adolescence with reduced neophobia, adolescent rats exhibited taste neophobia which even increased when sour tastes were encountered.

O.4.3-1 Girls with low motor competence may be particularly at risk of insufficient skeletal loading; latent profiles analysis of a four-year follow-up of Finnish adolescents

Abstract Purpose Adequate skeletal loads during the adolescent growth spurt are elemental in building a robust skeleton. Adolescents with poorer motor competence are less active and develop a less robust skeleton compared to their peers with better develop motor competence. However, few longitudinal examinations of motor competence and skeletal loading through adolescence have been reported. Therefore, the purpose of the present study was to explore the association between motor competence and free-living bone-generating (osteogenic) skeletal load trajectories among adolescents. Methods A total of N = 562 5th graders (11 to 13 years-of-age) were initially included in the sample and were followed up annually for four years from 2017 to 2020 (N = 239 in 2020). The children were asked to wear a waist-worn accelerometer for 7 days and motor competence was assessed with 5-leap and side-to-side jumping tests once a year. Latent profiles were identified based on motor competence, and skeletal loading was estimated using an osteogenic index, which combines the number of loading peaks in particular intensity categories akin to counting steps but with accounting for the magnitude of the impact. Results Three motor competence groups arose from the data for both boys and girls and all groups exhibited persistent low, mid or high motor competence throughout the follow-up. The latent group with the low motor competence consistently exhibited the lowest skeletal loads (10 to 20% below the highest motor competence), and the highest motor competence group the highest with the mid-group in between. All latent groups declined in skeletal loads over the follow-up (from osteogenic index 420 SD[80] to 300[90]) with no difference in the steepness of the decline among boys. However, the lowest motor competence group among girls had a slightly steeper decline in skeletal loads than the other groups. Conclusions the finding that motor competence is associated with skeletal loading among adolescents was confirmed in this longitudinal study. Notably, girls with the lowest motor competence had the steepest decline in skeletal loading over the follow-up. Policies aiming to improve fundamental movement skills could be expected to improve skeletal development particularly among less motor competent girls.

Evidence for adolescent length growth spurts in bonobos and other primates highlights the importance of scaling laws

Adolescent growth spurts (GSs) in body length seem to be absent in non-human primates and are considered a distinct human trait. However, this distinction between present and absent length-GSs may reflect a mathematical artefact that makes it arbitrary. We first outline how scaling issues and inappropriate comparisons between length (linear) and weight (volume) growth rates result in misleading interpretations like the absence of length-GSs in non-human primates despite pronounced weight-GSs, or temporal delays between length- and weight-GSs. We then apply a scale-corrected approach to a comprehensive dataset on 258 zoo-housed bonobos that includes weight and length growth as well as several physiological markers related to growth and adolescence. We found pronounced GSs in body weight and length in both sexes. Weight and length growth trajectories corresponded with each other and with patterns of testosterone and insulin-like growth factor-binding protein 3 levels, resembling adolescent GSs in humans. We further re-interpreted published data of non-human primates, which showed that aligned GSs in weight and length exist not only in bonobos. Altogether, our results emphasize the importance of considering scaling laws when interpreting growth curves in general, and further show that pronounced, human-like adolescent length-GSs exist in bonobos and probably also many other non-human primates.

Evidence for adolescent length growth spurts in bonobos and other primates highlights the importance of scaling laws.

Adolescent growth spurts (GSs) in body length seem to be absent in non-human primates and are considered a distinct human trait. However, this distinction between present and absent length-GSs may reflect a mathematical artefact that makes it arbitrary. We first outline how scaling issues and inappropriate comparisons between length (linear) and weight (volume) growth rates result in misleading interpretations like the absence of length-GSs in non-human primates despite pronounced weight-GSs, or temporal delays between length- and weight-GSs. We then apply a scale-corrected approach to a comprehensive dataset on 258 zoo-housed bonobos that includes weight and length growth as well as several physiological markers related to growth and adolescence. We found pronounced GSs in body weight and length in both sexes. Weight and length growth trajectories corresponded with each other and with patterns of testosterone and insulin-like growth factor-binding protein 3 levels, resembling adolescent GSs in humans. We further re-interpreted published data of non-human primates, which showed that aligned GSs in weight and length exist not only in bonobos. Altogether, our results emphasize the importance of considering scaling laws when interpreting growth curves in general, and further show that pronounced, human-like adolescent length-GSs exist in bonobos and probably also many other non-human primates.

Radiographic assessment of the pubic symphysis in elite male adolescent football players: Development and reliability of the Maturing Adolescent Pubic Symphysis (MAPS) classification

IntroductionThe pubic symphysis is susceptible to growth related injuries long after the adolescent growth spurt. Our study describes the radiographic maturation of the pubic symphysis on pelvic radiographs in adolescent football players and introduces the Maturing Adolescent Pubic Symphysis classification (MAPS classification). MethodsAnteroposterior pelvic radiographs of 105 healthy adolescent male football players between 12 and 24 years old were used to develop the classification system. The radiological scoring of the symphyseal joint was developed over five rounds. The final MAPS classification items were scored in random order by two experienced readers, blinded to the age of the participant and to each other’s scoring. The inter- and intra-rater reliability were examined using weighted kappa (κ). ResultsWe developed a classification system with descriptive definitions and an accompanying pictorial atlas. The symphyseal joint was divided into three regions: the superior corners, and the upper and lower regions of the joint line. Inter-rater reliability was substantial to almost perfect: superior region: κ = 0.70 (95% CI 0.60–––0.79), upper region of the joint line: κ = 0.89 (95% CI 0.86–––0.92), lower region of the joint line: κ = 0.65 (95% CI 0.55–––0.75). The intra-observer reliability showed similar results. ConclusionThe Maturing Adolescent Pubic Symphysis classification (MAPS classification) is a reliable descriptive classification of the radiographic maturation of the pubic symphysis joint in athletic males. The stages can provide a basis for understanding in clinical practice and will allow future research in this field.

Palmar Shift of the Proximal Interphalangeal Joint in Different Grip Positions as a Potential Risk Factor for Periphyseal Injuries in Adolescent Climbers

The aim of this study was to evaluate different grip positions as a contributing factor for primary periphyseal stress injuries of the finger phalanges in climbing. Ultrasound imaging of the proximal interphalangeal joint was performed on 37 asymptomatic adolescent climbers. Longitudinal images were obtained of middle and ring fingers of both hands in different grip positions (open, half-open, and crimp), unloaded and loaded. The translation between the dorsal head of the proximal phalanx and the shaft of the middle phalanx was measured in an unloaded and loaded situation for all grip positions. The resulting difference was determined as the palmar shift. The mean age of the study population was 13 y. Results showed a palmar shift of 0.57 mm in a loaded crimp grip position compared to 0.13 mm in an open position and 0.20 mm in a half-open grip position. With a P value of <0.001, this shift was significantly higher in a crimp grip position compared to open or half-open grip positions. This leads to an increase in joint incongruity and much higher peak forces on the dorsal aspect of the epiphyseal-physeal-metaphyseal complex, which is particularly vulnerable during the adolescent growth spurt. Thus, climbing and training behavior should be adapted accordingly during this phase by avoiding the crimp grip position until epiphyseal fusion.

The rise and fall of SES gradients in heights around the world

We use data from a large sample of low- and middle-income countries to study the association (or “gradient”) between child height and maternal education. We show that the gap in height between high- and low-SES children is small at birth, rises throughout childhood, and declines in adolescence as girls and boys go through puberty. This inverted U-shaped pattern is consistent with a degree of catch-up in linear height among children of low- relative to high-SES families, in partial contrast to the argument that height deficits cannot be overcome after the early years of life. This finding appears to be explained by the association between SES and the timing of puberty and therefore of the adolescent growth spurt: low-SES children start their adolescent growth spurt later and stop growing at later ages as well.

1476-P: Genetic Relationships between Puberty Onset and Type 2 Diabetes

Early puberty onset is a risk factor for type 2 diabetes (T2D). In this study we aimed to determine whether these phenotypes are associated via genetic variation that contributes to both T2D and puberty onset. We, thus, investigated the associations of a polygenic score (PS) for T2D and a PS for age of menarche (AAM) with parameters of adolescent growth and T2D status in an Indigenous population from the Southwestern US with a high T2D prevalence. Genotypic and clinical data were obtained from a longitudinal study. Two key parameters of the adolescent growth spurt, including age at take-off (ATO) and age at peak velocity (APV), were derived from the Preece-Baines growth model, a parametric growth curve for longitudinal height data. PSs were constructed using imputed genotypes, where variants for the T2D-PS (n=289) and the AAM-PS (n= 275) were selected from genome-wide significant variants in European meta-analyses (DIAGRAM Consortium and Reprogen Consortium, respectively). Associations between PS and T2D status (N=7659) were adjusted for age, sex, birth year and the first 5 genetic PCs. Associations with ATO and APV (N=787) were adjusted for birth year, sex, maternal diabetes and the first 5 genetic principal components (PCs). Associations were calculated using linear mixed models, accounting for genetic relationships. The T2D-PS had a significant, positive association with T2D (OR=1.47 per SD [95% CI 1.38, 1.57]; p=4.05×10−30). We found no association of the T2D-PS with ATO (p=0.11) nor APV (p=0.20). Conversely, genetically-predicted later puberty onset (AAM-PS) had a significant, inverse association with T2D (OR=0.92 per SD [95% CI 0.86, 0.98]; p=0.0194). The AAM-PS also associated with ATO (r=0.11, p=0.0013) and APV (r=0.13, p=1.8×10−04). Our results suggest that many variants that associate with AAM and T2D in large European cohorts also affect these traits in this Indigenous population. They also support the notion that variants that associate with early puberty onset also confer susceptibility to T2D. Disclosure M.J.Ramirez-luzuriaga: None. S.Kobes: None. L.E.Wedekind: None. W.Hsueh: None. L.Baier: None. R.L.Hanson: None.

Decision-Making and Management of Tarsal Coalition in the Young Adult Patient: A Critical Analysis Review.

» Tarsal coalitions most commonly affect the calcaneonavicular and talocalcaneal joints in up to 13% of the general population. They alter the mechanics of the subtalar joint, limiting inversion and eversion, and place excessive stress on neighboring joints causing pain, recurrent ankle sprains, and/or progressive pes planus during the adolescent growth spurt.» While many coalitions are identified on radiographs, advanced imaging with computed tomography or magnetic resonance imaging is sometimes required. These advanced imaging modalities also serve an essential role for surgical planning to quantify coalition involvement, identify fibrous or cartilaginous coalitions, and aid in determining the degree of deformity within the foot.» Surgical treatment is reserved for feet with persistent activity-related pain not relieved by prolonged attempts at nonoperative management, which include nonsteroidal anti-inflammatory drugs, shoe orthotics, and periods of non-weight-bearing in a cast. These conservative modalities may be successful in up to 85% of cases.» For adolescent patients, recent surgical options attempt to avoid arthrodesis and focus on coalition resection and interposition grafting with or without deformity correction. The ultimate decision is based on the location of the pain, the size and histology of the coalition, the health of the posterior subtalar facet, the degree of flatfoot deformity, and the presence of degenerative changes in the subtalar and/or adjacent joints.» While many studies focus on subtalar motion and gait kinematics, the critical outcomes remain pain relief and future need for arthrodesis, which may be related not only to resection of the coalition but assessment of deformity, including after the resection has been performed.

Adolescent Growth Spurt and Type 2 Diabetes Risk in Southwestern American Indians.

Early puberty onset is associated with higher risk of diabetes, but most studies have not accounted for childhood factors that may confound the association. Using data from a study conducted in an Indigenous community in Arizona (1965-2007), we examined associations of timing and velocity of the adolescent growth spurt with type 2 diabetes, and whether these associations are mediated by childhood body mass index and insulinemia. Adolescent growth parameters were derived from the Preece-Baines growth model, a parametric growth curve fitted to longitudinal height data, for 861 participants with height measurements spanning the whole period of growth. In males, older age at take-off, age at peak velocity, and age at maturation were associated with decreased prevalence of diabetes (odds ratio (OR)= 0.43 per year, 95% confidence interval (CI): 0.27, 0.69; OR= 0.50, 95% CI: 0.35, 0.72; OR= 0.58, 95% CI: 0.41, 0.83, respectively), while higher velocity at take-off was associated with increased risk (OR= 3.47 per cm/year, 95% CI: 1.87, 6.42) adjusting for age, birth year, and maternal diabetes. Similar results were observed with incident diabetes. Our findings suggest that an early and accelerated adolescent growth spurt is a risk factor for diabetes, at least in males. These associations are only partially explained by measures of adiposity and insulinemia.

Serum osteocalcin – A biochemical marker for pubertal growth assessment

Objectives: Growth evaluation methods have made great strides in the shift from radiologic to non-radiologic biomarkers. Osteocalcin (OC), a bone protein, has been reportedly used as a biomarker for osteoblastic bone formation. The present study aimed at evaluation of serum OC in Class II skeletal patterns for accurate assessment of pubertal growth spurt to facilitate functional jaw orthopedics during the growth period. Material and Methods: Eighty subjects, comprising 38 males and 42 females with skeletal Class II malocclusion in the age range of 11–18 years, were recruited for the study. Human serum OC was quantitatively assessed with enzyme-linked immunosorbent assay. The cervical vertebral stages were assessed from lateral cephalograms. Statistical analysis for gender-wise comparison of mean serum levels of OC at each cervical stage (CS) and in the intervals of the CSs was carried out using Kruskal–Wallis test and for intergroup comparisons, Mann–Whitney U-test with Bonferroni’s correction was done. Results: Gender-wise comparison of mean serum OC levels revealed that it was highest in CS2 in both males (72.24 ng/mL) and females (74.71 ng/mL) with another discernible peak in CS5 in males (66.82 ng/mL) and in CS6 in females (63.78 ng/mL), exhibiting thereby a circadian rhythm in bone modeling during the entire adolescent growth spurt. Conclusion: Despite a pre-pubertal and a late pubertal spike in both the genders, the mean OC serum levels actually exhibited a circadian rhythmicity across all the CSs, exhorting thereby the importance of bone remodeling during the complete circumpubertal growth period.