ABSTRACT This study aimed to describe and compare the characteristics of runs performed by a cohort of male and female runners, with and without a history of knee surgery. Data on frequency, distance, pace and cadence were collected from 227 runners (45% females, 48% knee surgery) using smartwatches over 4 years (n = 114,324 runs). Generalised mixed models compared running characteristics between sex and knee surgery strata. Runners typically performed 2–5 runs per week between 3.5–20 km in length, 4–7 min/km pace, at 160–180 steps/min cadence. Comparing group averages, males ran faster (0.78 fewer min/km, 95% CI 0.55 to 1.0), and further distances (13% longer, [4% to 22%]). Average run frequency and cadence did not differ between males and females. Surgical group ran less frequently on average (66% longer gaps, [14% to 142%]), shorter distances (10% shorter, [17% to 2% shorter]), at slower pace (0.29 more min/km, [0.06 to 0.52]), with lower cadence (4.32 fewer steps/min, [0.73 to 7.91 fewer]). Despite group-level differences, sex and surgical history had limited ability to explain variations in running behaviours, with the majority of variance attributed to participant-level effects (29–53%). Runners within sex and knee surgery sub-groups should not be considered homogenous cohorts.

Acute lateral ankle sprain (ALAS) is responsible for short-term disability, increased risk for future acute ankle sprain, and chronic ankle instability. Several studies highlighted that manipulative therapy may reduce pain and increase the range of motion (ROM) of the injured ankle, but not all of them targeted acute injuries. Some studies focused their interest on a specific manipulative technique or utilized either physiotherapy or chiropractic techniques. The objectives of this study were to evaluate the effectiveness of osteopathic care in ALAS, to assess pain, edema, and functional stability of the injured ankle, and to assess and comparing mobility between the injured and noninjuredankle. We conducted an interventional randomized controlled trial (RCT) in the emergency department (ED) of a French University Hospital. Fifty patients were enrolled in this study. They had to be≥18years old, consulting in the ED for a single ALAS (<72 h) stage 1 or 2, and must have had preliminary consultation with an emergency physician. Patients with an ALAS stage 3 or fractured, or with history of homolateral ankle surgery, were excluded. Patients were randomized either in the medical treatment (MT) group or in the medical and osteopathic treatment (MOT) group and had a 3-week follow-up. In the MOT group, the intervention consisted of a single osteopathic treatment (manual intervention) at Day 0, depending on the tissue affected and on the intensity of the tissular tension found, and individualized advice provided at Days 0, 7, and 21. Comparisons between groups were investigated utilizing the chi-square or Fisher's exact test, or Student's t-test or Mann Whitney U-test, as appropriate. Forty-five patients completed the study. The patients' median age was 29.5years old (23-40 years). At Day 21, 95.7 % of patients in the MOT group had equivalent capacity of unloaded dorsal flexion between the injured and noninjured ankle, vs. 50.0 % of patients in the MT group (p=0.0005). Between Day 0 and Day 21, the pain with the injured ankle loaded and unloaded decreased more significantly in the MOT group (p=0.001 and p=0.0007, respectively), while the loaded and unloaded dorsal flexion, and the unloaded plantar flexion, increased (p=0.003, p<0.0001 and p=0.02, respectively). Between Day 0 and Day 0 postosteopathic treatment, all judgment criteria showed improvement in the MOT group. At Day 7, all the functional stability tests were performed better by patients in the MOTgroup. Early osteopathic treatment associated with usual MT, delivered to patients with an ALAS, may improve mobility and functional stability, and may reduce pain and edema, in the 3weeks postintervention. These promising findings require confirmation in a larger controlledtrial.

In total hip arthroplasty, stem alignment has been proposed to occur in the neutral and flexed positions. Nonetheless, there is a paucity of research on the relationship between the shape of the medullary cavity cross-section and its compatibility with the stem shape. A total of 216 female (Asian) patients with no history of fracture or surgery on the contralateral side with complete computed tomography (CT) data were included in the study. The plane of the medullary cavity in the neutral (N group) and flexion (F group) alignments was defined. The ratio of the plane of medullary cavity widths at 80mm and 130mm distal from the center of the femoral head in these two medullary cavity planes was defined as the modified canal flare index (mCFI). The mCFI was used to assess the compatibility between the configuration of the medullary canal plane and that of the stem. All patients in the N group formed a plane, whereas 58 patients in the F group (26.9%) lacked a clear calcar femorale. Fifteen patients in the F group (9.4%) were excluded because of the inability to insert the stem, leaving 143 patients in the F group. The mean mCFI was significantly lower in the F group (0.692 ± 0.128) than in the N group (0.807 ± 0.073). The mCFI values of frequently used stems were all close to the mCFI of flexion alignment. The medullary cavity shape differed in the neutral and flexion alignments. Preoperative three-dimensional planning is helpful because the flexion alignment may not allow for the insertion of an optimally sized stem.

BackgroundThis study aimed to evaluate dynamic thiol/disulfide homeostasis in the tear fluid of patients with type 2 diabetes and to investigate its relationship with the presence of diabetic retinopathy (DR), considering it as a potential biomarker of oxidative stress.MethodsA total of 96 individuals were included in the study. Participants were divided into three groups: 32 patients with diabetic retinopathy (Group 1, DR (+)), 31 patients with diabetes but without retinopathy (Group 2, DR (-)), and 33 healthy volunteers (Group 3). All participants underwent a comprehensive ophthalmological examination, including best-corrected visual acuity, slit-lamp biomicroscopy, and fundus evaluation. Tear samples were collected using Schirmer strips and stored in phosphate-buffered Eppendorf tubes at -80 °C until analysis. Total thiol, native thiol, and disulfide levels were analyzed using a spectrophotometric method. Patients with a history of intraocular surgery, trauma, glaucoma, or systemic diseases other than diabetes were excluded.ResultsThere were statistically significant differences between the groups in terms of total thiol, disulfide, disulfide/total thiol, and disulfide/native thiol ratios (p < 0.001). Total thiol levels were significantly lower, while disulfide levels and ratios were significantly higher in the DR (+) group. No significant difference was found in native thiol levels (p = 0.194). HbA1c and fasting blood glucose levels were significantly higher in the DR (+) group compared to the other groups (p < 0.001). Central macular thickness was also significantly greater in the DR (+) group (p < 0.001). Correlation analysis revealed a positive and significant relationship between HbA1c and fasting blood glucose (r = 0.551; p < 0.01), whereas no significant correlation was found between central macular thickness and glycemic parameters.ConclusionThe increased disulfide levels and disulfide ratios in the tear fluid of patients with diabetic retinopathy suggest a shift in thiol/disulfide homeostasis toward oxidative stress. These tear-based biomarkers may serve as valuable tools for the early diagnosis and monitoring of diabetic retinopathy.

Background Left ventricle-right atrium (LV-RA) connection may develop secondary to ventricular septal defect (VSD) repair, particularly when the membranous septum or tricuspid valve is affected, leading to a leaflet defect. While surgery remains the standard treatment, reports of transcatheter valve closure are limited. This highlights the importance of exploring the safety and feasibility of transcatheter approaches for LV-RA connection, especially in high-risk patients. Case presentation This is the first reported case of a retrograde Konar-MF closure of an LV-RA connection on a 6-year-old male patient with a history of VSD surgery. Pre-procedural transesophageal echocardiography (TEE) showed a 4 mm defect in the septal leaflet of the tricuspid valve. A residual membranous septal aneurysm (MSA) extending from the subaortic region to the septal annulus of the tricuspid valve without residual shunt, and a small atrial septal defect (ASD) were also identified. The cardiac team performed closure using Konar-MF VSD Occluder No. 6/8 mm via a retrograde right femoral arterial approach, advancing the catheter through the left ventricle and across the defect. A well-positioned device with minimal residual central shunt and without peripheral leakage were confirmed from the post-procedural TEE. Clinical evaluation immediately after procedure and at 3-month follow-up demonstrated good results. Conclusion Percutaneous transcatheter device closure of an LV-RA connection in pediatrics is a feasible alternative to surgery using a retrograde technique.

Pregnancy beyond the first trimester increases the risk of small bowel obstruction after Roux-en-Y gastric bypass, most often due to internal hernia. Surgical exploration can be challenging because of limited space and anatomical changes. Data on surgical and obstetrical outcomes are scarce. We identified 32 pregnant women who underwent surgery for small bowel obstruction following bariatric surgery at our institution between January 2014 and December 2024. Data were collected on bariatric surgery history, operative details, postoperative complications, and obstetric outcomes. All patients had a history of Roux-en-Y gastric bypass. Median gestational age at surgery was 23 weeks 0 days (IQR 17 + 3-29 + 6 weeks). The most common symptom was postprandial exacerbation of abdominal pain (74%, n = 29); vomiting occurred in 51% (n = 20). Intraoperative findings included chylous fluid (53%, n = 18) and venous small bowel congestion (26%, n = 9). Serosal tears occurred in 9% (n = 3), with one case requiring conversion to laparotomy. There were no ischemia-related bowel resections. No maternal or fetal deaths occurred. Median gestational age at delivery was 39weeks 0days (IQR 38 + 2-39 + 3weeks), with a mean interval from surgery to delivery of 13weeks 6days (IQR 8 + 1-19 + 2weeks). Laparoscopy is a suitable therapeutic approach for pregnant patients with suspected small bowel obstruction following bariatric surgery. Surgical intervention during pregnancy did not negatively impact outcomes. Early recognition of atypical presentations by clinicians, together with patient education on warning signs, is essential to prevent diagnostic delays and improve outcomes.

Predicting intraoperative transfusion volumes of blood products in cardiovascular surgery: a retrospective study.

Abstract Introduction: Dysphonia, a disorder characterized by impaired vocal quality, pitch, loudness, or vocal effort, significantly impacts individuals’ communication abilities and overall quality of life (QoL). Aim: The current study aimed to assess the level of handicap due to dysphonia among patients visiting the laryngology clinic and to evaluate the factors affecting the impact of dysphonia. Methodology: This study examined adult patients with dysphonia at King Abdullah Medical City’s laryngology clinic from January 2021 to June 2024. Using the voice handicap index and structured questionnaires, data were collected on demographics, smoking status, duration of dysphonia, gastroesophageal reflux disease symptoms, choking, shortness of breath, dysphagia, and history of laryngeal surgery. Results: The patients ranged in age from 18 to 73 years, with a mean age of 43.5 ± 10.6 years. There were 43 (55.8%) female cases. In terms of education, 28 (36.4%) had not completed high school, and 28 (36.4%) had earned a bachelor’s degree. A total of 33.8% of participants reported that their dysphonia had a minor-to-moderate physical impact on the nature of their voice; 31.2% reported an emotional impact; and 27.3% reported a mild-to-moderate functional impact on their everyday activities. In 71.4% of cases, there was no effect on overall QoL. Conclusions: The study found that dysphonia significantly impacts QoL, particularly among smokers and urban residents, due to difficulties in communication and understanding. No gender-based differences were observed.

The clinical relationship between cardiovascular disease and deleterious surgical outcomes has been extensively examined; however, the relationship between cardiovascular risk and the association with major surgical interventions has yet to be examined at the population level. Previous use of National Health and Nutrition Examination Survey (NHANES) data has investigated the relationship between cardiometabolic risk and a history of bariatric surgery, suggesting that NHANES population data may be a useful tool to uncover a primary association and provide insight into subgroup effects. This study attempts to quantify the relationships between cardiovascular risk factors and the history of open-chest or abdominal surgery. We analyzed de-identified NHANES data from January 2007 through March 2020 for US adults≥20years of age selected via stratified multistage sampling (participants with missing data were excluded; Institutional Review Board [IRB] not required). We extracted self-reported history of open-chest/abdominal surgery (binary), seven metabolic/cardiovascular biomarkers (hemoglobin A1c [HbA1c], low-density lipoprotein [LDL], triglycerides, total cholesterol, systolic/diastolic blood pressure [SBP/DBP], high-density lipoprotein [HDL]), and covariates (race/ethnicity, gender, education, insurance, income-to-poverty ratio). Associations were estimated as odds ratios (ORs) utilizing survey-weighted logistic regression in STATA 16 adjusted for all covariates (two-sided α=0.05), with subpopulation logistic models for subgroup analyses by HbA1c. The elevated HbA1c level was the only variable that was statistically significant, with an OR of 1.14 (95 % confidence interval [CI], 1.06-1.23). Secondary subgroup analyses demonstrated differential impacts: Non-Hispanic White, individuals without insurance, those with a lower income-to-poverty ratio, females, and individuals with less than a ninth-grade education or a high school/General Education Development (GED) equivalent were more likely to have a surgical history as HbA1c levels increased. A significant association exists between elevated HbA1c levels and a history of open-chest or abdominal surgery. Specific subgroups are at greater risk and may be disproportionately affected by the downstream consequences of higher HbA1c levels.

Postoperative complications (POC) following hepatic cystic echinococcosis (HCE) surgery remains a challenge. Frailty indices (FIs) as predictors of POC in this context has not been investigated. We aimed to evaluate the predictive value of three frailty assessment tools (mFI-11, FRAIL scale, and PRISMA-7 questionnaire), for POC in patients with HCE undergoing elective surgical treatment. Nested case-control study in a concurrent cohort. Consecutive patients who underwent elective open surgery for HCE between 2012 and 2020 with a minimum follow-up of 4 years were included. Cases were frail patients with mFI-11 ≥ 0.27, PRISMA-7 ≥ 3, or FRAIL ≥ 3. Cases and controls were matched in a 1:1 based on age, sex, cyst diameter, history of HCE surgery, ultrasonographic characteristics, and cyst location. Primary outcome was overall and severe POC. Sample size was based on overall POC of 28% for cases and 11% for controls, assuming 5% type I error and 80% statistical power. Descriptive and bivariate statistics were applied. Odds ratios (OR) and 95% confidence intervals were calculated, and predictive performance evaluated using area under the receiver operating characteristics curve (AUC), and its comparison applying DeLong test. 70 cases and 70 controls were included. mFI-11 ≥ 0.27 and PRISMA-7 ≥ 3 were identified as prognostic factors for overall and severe POC (p < 0.001 and p = 0.02; and p = 0.02 and p = 0.03, respectively); and FRAIL as an independent factor for overall POC (p = 0.005). Logistic regression adjusting for potential confounding variables confirmed mFI-11 ≥ 0.27 as an independent prognostic factor for overall POC (OR 4.8; p = 0.0001; AUC: 0.762) and severe POC (OR 10.7; p = 0.022; AUC: 0.763). The mFI-11 index showed the strongest predictive performance for both overall and severe POC in patients underwent HCE.

Objective This study aimed to evaluate the clinical efficacy of laparoscopic surgery for acute small bowel obstruction (SBO) in children. Methods The retrospective study included children with acute SBO who were treated at Shanghai Children's Hospital from June 2014 to December 2023. Patients were categorized into one of the following two groups based on the operative approach they underwent: the laparoscopic surgery group and the open surgery group. Perioperative variables, including operative time, fasting duration, hospital stay, and complication rates, were evaluated. The primary outcome was length of hospital stay. Categorical variables were compared using the χ 2 or Fisher's exact test, and continuous variables were analyzed using the t-test or Mann–Whitney U test, depending on the data distribution. A P -value &amp;lt; 0.05 was considered statistically significant. Results In total, 40 patients underwent laparoscopic surgery and 40 underwent open surgery. Laparoscopic procedures were completed in 29 patients (72.5%), while 11 required conversions to open surgery. Compared with open surgery, laparoscopy resulted in a shorter hospital stay (median, 7.0 vs. 9.5 days; P = 1.1 × 10 −5 ) and a shorter postoperative fasting period (median, 4.0 vs. 5.0 days; P = 0.011). A sensitivity analysis that excluded patients with a history of prior abdominal surgery still supported the overall findings and also showed a lower hospitalization cost in the laparoscopic group (median, 22,025.25 vs. 25,777.50 CNY; P = 0.013). The rates of intraoperative and postoperative complications were similar between the groups. Conclusion Laparoscopic surgery is a safe and effective option for pediatric acute SBO, offering faster recovery without increasing complication rates.

BackgroundThe integration of artificial intelligence (AI) and 12-lead ECGs is an essential topic for digital cardiology, and evidence is growing. In recent years, there has been a smattering of smartphone apps that capture 12-lead ECGs. The AI-based app "ECG Buddy™" extracts ECG rhythms and digital biomarkers from 12-lead ECGs.PurposeThe purpose of this study is to evaluate the effectiveness of this app using 12-lead ECG imaging in determining emergency intervention strategies for coronary artery disease.MethodsCross-sectional study of patients with suspected ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI)/unstable angina pectoris (UAP) who underwent emergency coronary angiography (eCAG) between 1/2024 and 12/2024 at St. Marianna University Hospital (Kawasaki, Japan). The application included ECG rhythm and 10 digital biomarkers, including "Critical Condition" score and "Acute Coronary Syndrome (ACS)" score (0–100 points each), which can estimate coronary artery occlusion and cardiac ischemic damage were extracted.Results158 of 207 patients met the inclusion criteria (exclusions: out-of-hospital cardiac arrest, congenital heart disease, history of cardiac surgery, pacemaker rhythm, ECG not taken 48 hours before CAG, heart rate >= 150/min or < 40/min). At the time of the pre-eCAG diagnosis, there were 58 and 100 STEMI and NSTEMI/UAP patients, respectively. The mean age was 73 ± 13 years and 61% were male. 102 patients underwent ad-hoc percutaneous coronary intervention (PCI) and 31 patients required mechanical circulatory support (MCS). The AUC-ROC (receiver operating characteristic) of the app-calculated "critical" score for MCS use was 0.772 (95% CI: 0.682-0.862, p < 0.001) (Figure 1). The AUC-ROC of the app-calculated "ACS" score for ad-hoc PCI was 0.759 (95% CI: 0.686-0.831, p < 0.001) (Figure 2).ConclusionThe app-calculated "critical" score and "ACS" score may be useful in determining the use of mechanical circulatory support and distinguishing the need for ad-hoc PCI.Figure 1and 2

Zero sheath exchange with VersaCross RF wire and FlexCath in cryoballoon AF ablation: A comparative study on procedural efficiency and safety.

Two female patients (74 and 80 years old) underwent revision total knee arthroplasty surgery due to aseptic loosening. Patient 1 was obese, while patient 2 had history of abdominal surgery, cerebrovascular and autoimmune disease. They were both under anti-depressive medication. Intravenous tranexamic acid was administrated according to institutional protocol. Knee mobilization and enoxaparin in prophylactic dose was initiated at day 1 postoperatively. Both patients had pulmonary thromboembolism within the first 30 days after surgery. Individual risk factors predispose to pulmonary thromboembolism, while tranexamic acid way of administration does not seem to be responsible for the risk increase. Individual risk factors predispose to pulmonary thromboembolism, while tranexamic acid way of administration does not seem to be responsible for the risk increase.

Background: Patients with end-stage renal failure (ESRF) are prone to vascular complications that may result in limb ischaemia and gangrene. While lower limb amputation (LLA) outcomes in this population are well-documented, data on upper limb involvement remain limited. This study aimed to characterise the types of hand conditions leading to hand specialist referrals amongst ESRF patients, identify risk factors associated with upper limb amputation (ULA) and assess post-amputation survival outcomes. Methods: ESRF patients referred to a single hand surgery unit were recruited over 5 years. Data on demographics, comorbidities, referral diagnosis and treatment were obtained. Univariate analysis and Kaplan-Meier survival analysis were performed using STATA. Results: Of the 76 included patients, 50% were referred for infection and the rest for trauma, digit ischaemia and gout in decreasing order of incidence. A total of 22 patients, accounting for 29% of the cohort, required ULA. All but one patient (96%) underwent a ULA due to an infection. Significant risk factors identified are having an ipsilateral arteriovenous fistula (p=0.024), peripheral neuropathy (p=0.031), peripheral arterial disease (PAD; p=0.00010), hyperlipidaemia (p=0.013), the history of previous surgery for a soft tissue infection (p<0.0001) and previous amputation in any limb (p=0.013). Survival rates at 1, 2 and 5 years post-ULA were 82%, 59% and 14%, respectively. The time to mortality after index amputation was 2.42 years. Conclusions: Infections were the most common referral diagnosis and the primary indication for ULA in ESRF patients. Identified risk factors - including PAD, previous soft tissue infection, prior LLA and the presence of an ipsilateral AV fistula - put patients at increased risk for ULA. Post-amputation survival was poor, with high mortality within 5 years. Level of Evidence: Level IV (Therapeutic).

Experience with isolated male epispadias repair: case report from Northern Tanzania

Temporal bone squamous cell carcinoma is a rare, aggressive malignancy often misdiagnosed due to its nonspecific symptoms resembling chronic ear infections. Malignant transformation from long-standing cholesteatoma, though rare, has been reported. Early diagnosis remains challenging due to the tumour’s deep location, histological heterogeneity, and biopsy limitations. A 61-year-old man with a history of childhood cholesteatoma surgery and chronic otorrhea presented with a postauricular ulcer and severe otalgia. Initial biopsy of an external auditory canal mass was inconclusive, delaying diagnosis. Imaging revealed extensive temporal bone destruction and a temporal lobe abscess. A repeat biopsy confirmed temporal bone squamous cell carcinoma, with metastatic spread to the lungs and liver. He received palliative chemotherapy but succumbed to the disease. Chronic inflammation from cholesteatoma may contribute to malignant transformation. Tumour-related inflammation, anatomical constraints, and histological heterogeneity complicate diagnosis. Multiple biopsies are often required, but false negatives are common due to sampling challenges. Advanced imaging techniques, such as apparent diffusion coefficient mapping, may improve lesion characterization and biopsy accuracy. This case highlights the difficulty of diagnosing temporal bone squamous cell carcinoma in patients with chronic ear disease. Persistent otorrhea and otalgia should prompt heightened clinical vigilance. Early intervention, multidisciplinary management, and integrating advanced imaging techniques could facilitate timely diagnosis and improve outcomes.

To report a case of non-hereditary bilateral foveomacular and peripheral retinoschisis in a young female, with electrophysiological abnormalities in the absence of high myopia. A 25-year-old female with recent-onset diminution of vision in the left eye (LE) underwent comprehensive ophthalmic evaluation including best-corrected visual acuity (BCVA), slit lamp biomicroscopy, indirect ophthalmoscopy, optical coherence tomography (OCT), full field electroretinography (ERG) and genetic evaluation. BCVA at presentation was 6/6, N6 in the right eye(RE) and 6/9, N8 in the LE. The patient had a prior history of laser refractive surgery for moderate myopia. Anterior segment examination was unremarkable. Fundus evaluation revealed bilateral foveoschisis and peripheral retinal schisis. OCT showed retinoschisis predominantly involving outer plexiform and outer nuclear layer, along with mild vitreoschisis. Foveal detachment was noted in the LE. ERG demonstrated rod and cone system dysfunction, severe rod bipolar cell dysfunction in both eyes, and a borderline electronegative waveform in the LE. There was no family history, and clinical exome sequencing did not reveal any pathogenic variants associated with the phenotype. Electrophysiological abnormalities with bipolar cell dysfunction, similar to those seen in hereditary retinoschisis, can also occur in non-hereditary retinoschisis. Genetic evaluation is recommended to differentiate between the two, as ERG may show abnormalities in both.

Introduction . Scoliosis is a multifactorial disease of the spine that has a high social significance at school age. There is a involvement in the process of the disease not only of the musculoskeletal system (MS), but also of other organs and systems, and therefore it is advisable to use the term «scoliotic disease» Analysis of the osteopathic status of children with scoliotic disease will potentially help to expand the understanding of its etiopathogenesis, as well as to develop comprehensive schemes of prevention, treatment and rehabilitation. The aim of the study : to study the osteopathic status of children with scoliosis. Materials and methods . Cross-sectional study was carried out at the Children′s Rehabilitation and Education Center № 76 (Moscow) from September 2023 to September 2024. Inclusion criteria: age 10–15 years; scoliosis of I–III degree (according to the Cobb method); incomplete skeletal growth according to the Risser criterion; pathologies of the cardiovascular and respiratory systems in the compensation stage; absence of diseases of the nervous system; absence of acute injuries and infectious diseases; informed consent of the patient′s parents to participate in the study. Criteria for non-inclusion: grade IV scoliosis; history of spinal surgery; epilepsy; spina bifida; vertebral abnormalities; cerebral palsy; osteomyelitis; limb paresis; malignant neoplasms. 100 children (62 girls and 38 boys) were selected. Age 10–15 years, median 13 years. The duration of the disease is 1–14 years, the median is 3 years. According to the results of measuring the Cobb′s angle, 25 people were determined to have grade I scoliosis, 65 people had grade II, and 10 people had grade III. All patients had their osteopathic status assessed according to clinical guidelines. Results. In the examined children with scoliosis, somatic dysfunctions (SD) of all three levels of manifestation were revealed. The most characteristic were dysfunctions at the regional level: pelvic structural and visceral components; thoracic structural and visceral components; neck visceral component; lumbar structural component. Global biomechanical disorders were diagnosed as dominant SDs in 6 % (all with grade III scoliosis), in the remaining patients, regional biomechanical SDs dominated, of which the most common were biomechanical SDs of the thoracic region structural component (37 %). Conclusion. From 1 to 3 biomechanical somatic dysfunction of the axial regions were revealed in all the examined, but only in the III degree of scoliosis there were the signs of a global biomechanical disorder.

The impact of previous head trauma and history of cranial surgery on clinical findings in acute pediatric head injury.