Screening For Dysplasia Research Articles

Barlow, Ortolani, and Hippy Dolls: Understanding child health nurses practice when screening for Developmental Dysplasia of the Hip

Objective: To identify Child Health Nurses, Registered Midwives, Registered Nurses, or General Practice Nurses' individual practices, understand their practice and any enablers or barriers to their practice when screening for Developmental Dysplasia of the Hip (DDH) in infants. Methods: Online focus groups were held via Zoom. The focus groups were semi-structured and utilised a pre-developed guide to ensure the research aims and objectives were covered. The three focus groups were recorded transcribed, and data from the 11 participants analysed using a structured thematic analysis. Results: Four themes were found to be important to practice when screening for DDH. Theoretical education and practical training of clinicians were viewed as essential and included consistency of training and ongoing education. Participants highlighted perceptions of practice and confidence in their own and others practice. Understanding screening, diagnosis and treatment was important, as was the role of other health care providers and best practice recommendations. Finally supporting families and the child was seen as an essential role especially during missed diagnoses. Conclusion: Barriers to confidently screening for DDH are many, with enablers few. Child Health Nurses require ongoing training and education to confidently screen infants for DDH. This training should be evidence based which will require further research into the current education available. To support an evidence-based approach to screening a study of accuracy should be explored.

Outcomes from the urgent assessment pathway in selective ultrasonographic screening for developmental dysplasia of the hip (DDH).

This study is a retrospective case series, as it involves a review of clinical outcomes from a defined group of patients over a specific time period. According to the criteria, this study would be classified as Level III evidence.

Dysplasia screening in inflammatory bowel disease patients: To whom, when and how

Dysplasia screening in inflammatory bowel disease patients: To whom, when and how

Morphometric Evaluation of the Hip Joint in Dogs

Abstract Hip dysplasia represents the most prevalent non-traumatic disease leading to lameness in dogs, which subsequently causes secondary joint pathologies such as arthrosis and arthritis. Diagnosis and selection for breeding use radiographic evaluation of the ventrodorsal projection of the hip joint. Early detection and treatment can halt or reverse the disease progression. In veterinary medicine, various radiological measurements are applied to evaluate such anatomical abnormalities. These measurements include the Norberg angle, percentage coverage of the femoral head, and various indices related to the acetabulum and proximal femur. The differences in measurements between breeds are significant and reflect differences in body conformation. Ventrodorsal radiographs are crucial for the diagnosis, screening and monitoring of hip dysplasia. Lack of reference values for morphometric measurements in dogs highlights the need for further research.

Acute Measurement of Developmental Dysplasia of the Hip: Comparing Two Approaches for Measuring the Alpha Angle Using the Graf Technique

Objective: The Graf method, in ultrasonography screening of developmental hip dysplasia, is based on angle measurements. Using different reference points may cause varied results. The aim of this study was to investigate to what extent the alpha angle obtained, varied at different reference points. Materials and Methods: There were 178 hips evaluated by two trained observers. Both measured the alpha angle with different reference points and these were labeled as methods A and B, for all the hips evaluated. The statistical analysis was performed with SPSS Version 21. Results: The average of observer 1, based on measurements with method A, were 65.63 (SD ±5.95) and based on method B were 73.39 (SD ±6.29). The average of the measurements of observer 2, utilizing method A were 64.39 (SD ±4.85) and based on method B were 69.92 (SD ±6.08). It was observed that method B showed higher mean and variability compared to method A. The agreement between observers was moderate in method A and poor in method B. The intraobserver correlation coefficient (ICC) was 0.69 for method A and 0.47 for method B. The ICC was considered good (e.g., 95%) for both observers in terms of using methods A and B. Conclusion: The use of ultrasonography still maintains its place in the diagnosis of developmental hip dysplasia. The Graf method is based on precise measurements, and the most decisive parameter is the alpha angle. Reference points in method A would be more useful in patient management and may increase the diagnostic accuracy.

Evaluation of Ultrasound Imaging in Developmental Hip Dysplasia with Artificial Intelligence

Objective: Developmental hip dysplasia is a common condition that starts in infancy. With the introduction of machine learning (artificial intelligence, AI) into medicine, the early diagnosis of disease and the success of treatment have increased significantly. This study aims to determine the accuracy of ultrasound images from ultrasound videos used in the developmental hip dysplasia screening program using machine learning techniques. Material and Method: The study involved the extraction of ultrasound image features using the Local Binary Pattern (LBP) method. The ultrasound image dataset was then prepared to evaluate the effectiveness of various machine learning approaches, including Decision Tree (DT), Random Forest (RF), K-Nearest Neighbour (KNN), Gradient Boosting (GB), Support Vector Machines (SVM), Naïve Bayes (NB), Logistic Regression (LR), and Multilayer Perceptron (MLP). Results: RF algorithm performed very well, recording the highest correct image rate. The study was generally considered successful and it is believed that the resulting model will be useful in the early diagnosis of developmental hip dysplasia. Conclusion: RF algorithm recorded the highest correct image rate, performing very well at 87.62% compared to other tested algorithms. The study was generally considered successful and the resulting model is believed to be useful in the early diagnosis of developmental hip dysplasia.

Virtual chromoendoscopy for the identification of colonic dysplasia in patients with inflammatory bowel disease. A systematic review.

to analyze the best evidence available on the usefulness of VCE versus DCE for dysplasia identification in patients with long-standing colonic IBD. a qualitative, PRISMA 2020-based systematic review of the literature was carried out in the PubMed, Science Direct, and Scielo databases until June 2023. Clinical trials, case-control studies, comparative studies, and crossover studies in English or Spanish were included that directly compared DCE versus VCE for the screening of colonic dysplasia in patients with IBD. The Quality Assessment of Diagnostic Accuracy studies (QUADAS) 2 was used for assessing study quality. The selected studies were evaluated by 2 independent researchers, who entered their abstracted results into a database. out of 141 identified studies 9 were selected that compared DCE with VCE (1131 patients included). Six studies are prospective, randomized, controlled trials; 2 are retrospective case-control studies; and 1 is a prospective comparative study. VCE showed a dysplasia detection ability similar to that of DCE, albeit with shorter examination times (8 studies; 985 patients). Factors associated with dysplasia identification included lesions in the right colon (3 studies; 581 patients); non-polypoid lesions (1 study; 210 patients) and/or lesions with Kudo's type III-V pit patterns (2 studies; 254 patients); and patient age (1 study; 129 patients). VCE may be an alternative to DCE for CRC screening in patients with long-standing IBD, with similar detection ability for colonic dysplasia and the benefit of shorter procedure times. Currently available evidence is limited in this regard given the small numbers of patients in the relevant studies, hence further research is necessary with greater numbers of included subjects.

Screening, diagnosis, treatment and outcomes of developmental dysplasia of the hip in Brazilian population: a scoping review

ObjectiveThis study aims to map the literature on screening, diagnosis, treatment and outcomes of developmental dysplasia of the hip (DDH) in the Brazilian population aged 0–18 years, to describe regional...

Age-optimized cut-off values for pubofemoral distances in screening for hip dysplasia.

To establish cut-off values for lateral pubofemoral distance (PFD) measurements for detecting hip dysplasia in early (four days) and standard care (six weeks) screening for developmental dysplasia of the hip (DDH). All newborns, during a one-year period (October 2021 to October 2022), were offered a PFD ultrasound (US) examination in addition to the existing screening programme for DDH. Newborns who were referred for standard care hip US, suspected for DDH, received a secondary PFD US examination in conjunction with the standard care Graf/Harcke hip US examination. Receiver operating characteristic curves and empirically optimal cut-off values were calculated with a true positive defined as a Graf type ≥ IIc hip. We included 2,735 newborns, of whom 758 received both early PFD hip US and standard care Graf/Harcke hip US. For early (four days) PFD screening, the optimal cut-off point was calculated to be 6.2 mm (95% CI 4.7 to 7.7) producing a sensitivity of 80% (95% CI 55% to 100%) and a specificity of 87% (86% to 89%). For PFD screening performed at standard care (six weeks) hip US, the optimal cut-off point was calculated to be 5.6 mm (95% CI 4.9 to 6.3) producing a sensitivity of 100% (95% CI 100% to 100%) and a specificity of 96% (95% CI 95% to 97%). PFD US screening produces a high degree of both sensitivity and specificity for detecting DDH. Age-specific cut-off values should be used to heighten the accuracy of PFD US screening.

Dysplasia screening in inflammatory bowel disease patients: to whom, when and how.

Dysplasia screening in inflammatory bowel disease patients: to whom, when and how.

Network Meta-Analysis: Comparison of Endoscopic Dysplasia Detection Technologies in Inflammatory Bowel Disease.

Novel colorectal cancer endoscopic surveillance techniques for inflammatory bowel disease (IBD) have recently been developed. Compare the efficacy of currently available techniques for dysplasia detection in colonic IBD. We conducted a systematic literature search from inception to March 2024 for randomized controlled trials (RCTs) or prospective cohort studies enrolling adults with IBD and having surveillance colonoscopy for dysplasia screening. Primary outcome was the number of dysplastic lesions (per-lesion analysis). Secondary outcome was the number of patients with dysplasia (per-patient analysis). We assessed endpoints using the frequentist NMA random effect model. We included 25 studies (22 RCTs). 4837 patients met eligibility criteria (850 total dysplastic lesions; 105 with advanced dysplasia). Nine different screening techniques were studied. In per-lesion analysis, dye-based chromoendoscopy (DCE) ranked the highest (83%) per SUCRA ranking. DCE was superior to HD-WLE (OR, 1.78; 95% CI, 1.06-3.00). There were no significant differences between NBI and DCE, HD-WLE with SR or CEM in head-to-head comparisons. In a sub-analysis confined to ulcerative colitis (UC), DCE ranked highest (98%) with per-lesion analysis, and was superior to NBI (OR, 1.69; 95% CI, 1.03-2.77). HD-WLE-SR, DCE and CEM demonstrated superiority over other techniques for detection of dysplasia in colonic IBD. DCE was superior for dysplasia detection in colonic IBD. DCE was superior to HD-WLE in colonic IBD. DCE was the best technique in UC. Further studies to compare HD-WLE-SR and NBI with DCE are warranted to ascertain performance equivalency and define the optimal surveillance technique.

Prevalence, Incidence and Predictors of Anal HPV Infection and HPV-Related Squamous Intraepithelial Lesions in a Cohort of People Living with HIV.

Background: Anal HPV infection can cause squamous intraepithelial lesions (SILs), which are precursors of anal squamous cell carcinoma (SCC). The early detection of HPV infections and improvement of effective screening programmes are, therefore, essential to prevent progression from pre-cancerous lesions to SCC, especially in people living with HIV (PLWH), who represent a population at higher risk of HPV infection and associated lesions. Among prevention strategies, HPV vaccination is relevant too, but its efficacy in persons already infected by HPV is still debated. Methods: This is a retrospective single-center study on a cohort of PLWH who performed longitudinal screening for anal dysplasia and HPV infection. The screening included cytological and molecular analyses. Results: A total of 110 PLWH performed at least one anal HPV screening, with an overall prevalence of HPV infection of 86.4% [23.6% low risk (LR)-HPV and 62.7% high risk (HR)-HPV genotypes]. Abnormal cytology was demonstrated in 39.1% of subjects, of whom ASCUS 6.4%, LSIL 30.9% and HSIL 1.8%. In total, 80 patients (72.7%) had an available longitudinal screening. No patient developed SCC during follow-up. However, a high incidence of new cytological abnormalities and new HPV infections was observed. On the other side, clearance of some HPV genotypes was also frequent, confirming that HPV infection is a dynamic process. A CD4 cell count > 500/mmc was an independent predictor of HPV clearance. HPV vaccination was performed on 30.9% of patients. A trend toward an increased clearance of HPV genotypes included in 9-valent vaccine was observed in vaccinated patients (40.6% versus 30.8% in unvaccinated, p = 0.079). Conclusions: A high prevalence of HPV infection and SILs was observed in our cohort of PLWH. A high incidence of new HPV infections and HPV-associated lesions was also observed in the longitudinal cohort, highlighting the need of strengthening immunization programs and continuous screening for anal HPV infection. Whether HPV vaccination may be efficacious in patients already infected by HPV remains to be determined.

Was the ultrasound examination for developmental dysplasia of the hip performed correctly? Introduction of a rapid training tool for nonexpert practitioners.

Pediatricians and general practitioners are involved in the newborn screening for developmental dysplasia of the hip. They often rely on the quality of the ultrasound (US) examination to make diagnostic and therapeutic decisions. Therefore, the professional must be able to assess its quality. The aim of our work is to present a new system to evaluate the quality of a neonatal hip US and to assess the effectiveness and reproducibility of this tool among professionals involved in the evaluation of the neonatal hip but not experts in the radiological examination of hip US. In a 15-min training session, 135 professionals involved in neonatal hip US screening with limited or no experience in evaluating the quality of hip US were taught to recognize the basic landmarks of hip US using evocative descriptions (Christmas ball) despite the technical terms. Before and after training, participants were given a test of 10 hip US images presented in random order and asked to identify incorrect images. One hundred thirty-five physicians participated in the study. In the first and second evaluation, participants answered 1.46 ± 2.49 and 8.64 ± 1.51 questions correctly on average (P < 0.05); analysis of the individual questions showed a significant improvement (P < 0.05) for all questions. A simple and relatively quick training tool can help professionals with little or no experience in interpreting neonatal hip US to understand when a hip US exam has been performed incorrectly and improve their diagnostic and therapeutic decisions. Level of evidence: III.

Impact of probe tilt on Graf ultrasonography accuracy for neonatal hip dysplasia screening.

Developmental Dysplasia of the Hip (DDH) is the most common congenital musculoskeletal disease of the infantile age. The gold standard for early diagnosis of the disease is the Graf ultrasound method. In our study, we examined the correlation between age of the examined infant and diagnostic errors due to the ultrasound probe tilt effect during examination. Forty-two newborns who underwent ultrasound examination with the Graf method, were included. We categorized the neonates into three age groups (Group#1: 0-1 weeks, Group#2: 3-4 weeks, Group#3: 5-6weeks). Two ultrasound examinations were performed in every group. In the first examination, images were obtained with the probe in vertical position. In the second examination, images were taken with a 10° caudocranial tilt of the probe. Our aim was to measure the α angle in both examination and to mention the possible Type changes according to the Graf classification. The α angle defines the osseous coverage of the femoral head from the acetabulum in the neonatal hip joint. In many cases, the classification changed from type I to type IIa or D and from type IIa to D, when instead of the vertical acquisition, the ultrasound probe was placed in a 10° caudocranial tilt at the hip joint of the examined infant. At Group#1 of the study we observed 60 Graf classification Type changes (90.91%), while in Group#2 and Group#3 we had 18 (33.33%) and 3 (7.96%) Type changes respectively. As the age of the examined newborns increases, measurement and classification errors due to the tilt effect are significantly reduced. Clinically, the examination will be even more accurate and the use of an incorrect therapeutic approach due to incorrect classification will be avoided. Finally, the optimal time for conducting an ultrasonographic examination is between the 5th and 6th week of life.

Clinical Evaluation of an Electronic Guidance System for Optimizing the Ultrasound Screening for Developmental Hip Dysplasia in Newborns.

Background: Graf ultrasound screening is considered an established method for early detection of developmental dysplasia of the hip (DDH). Although characterized by a high degree of standardization to allow for good reproducibility of results, examination-related factors may still affect sonographic measurements. The relative tilt angle between the hip and the probe is a potential pitfall as it significantly influences sonographic measurements and consequently classification of DDH according to Graf. Objectives: Evaluation of an electronic guidance system developed to reduce relative tilt angles and increase reliability and comparability in ultrasound screening of DDH. Materials and Methods: Twenty-five newborns were examined using a prototype guidance system, which tracks the position of the transducer and the pelvis to calculate the relative tilt angles. Two ultrasound images were obtained, one conventionally and the other one using the guidance system. Subsequently, relative roll and pitch angles and sonographic measurements were determined and analyzed. Results: The relative inclination angles in the conventional group ranged from -12.6° to 14.3° (frontal plane) and -23.8° to 32.5° (axial plane). vs. -3.7° to 3.0° and -3.2° to 4.5° in the guidance system group. The variances were significantly lower in the guidance system-assisted group for both planes (p < 0.001 and p < 0.001, respectively). The optimized transducer position showed significant effects and consequently significantly reduced alpha angles were observed (p = 0.001, and p = 0.003). Conclusions: The guidance system allowed a significant reduction in the relative tilt angles, supporting optimal positioning of the transducer, resulting in significant effects on Graf sonographic measurements. This technique shows great potential for enhancing the reproducibility and reliability of ultrasound screening for DDH.

Automated Assessment of Pelvic Longitudinal Rotation Using Computer Vision in Canine Hip Dysplasia Screening.

Canine hip dysplasia (CHD) screening relies on accurate positioning in the ventrodorsal hip extended (VDHE) view, as even mild pelvic rotation can affect CHD scoring and impact breeding decisions. This study aimed to assess the association between pelvic rotation and asymmetry in obturator foramina areas (AOFAs) and to develop a computer vision model for automated AOFA measurement. In the first part, 203 radiographs were analyzed to examine the relationship between pelvic rotation, assessed through asymmetry in iliac wing and obturator foramina widths (AOFWs), and AOFAs. A significant association was found between pelvic rotation and AOFA, with AOFW showing a stronger correlation (R2 = 0.92, p < 0.01). AOFW rotation values were categorized into minimal (n = 71), moderate (n = 41), marked (n = 37), and extreme (n = 54) groups, corresponding to mean AOFA ± standard deviation values of 33.28 ± 27.25, 54.73 ± 27.98, 85.85 ± 41.31, and 160.68 ± 64.20 mm2, respectively. ANOVA and post hoc testing confirmed significant differences in AOFA across these groups (p < 0.01). In part two, the dataset was expanded to 312 images to develop the automated AOFA model, with 80% allocated for training, 10% for validation, and 10% for testing. On the 32 test images, the model achieved high segmentation accuracy (Dice score = 0.96; Intersection over Union = 0.93), closely aligning with examiner measurements. Paired t-tests indicated no significant differences between the examiner and model's outputs (p > 0.05), though the Bland-Altman analysis identified occasional discrepancies. The model demonstrated excellent reliability (ICC = 0.99) with a standard error of 17.18 mm2. A threshold of 50.46 mm2 enabled effective differentiation between acceptable and excessive pelvic rotation. With additional training data, further improvements in precision are expected, enhancing the model's clinical utility.

Human papillomavirus associated vulval intraepithelial neoplasias: Screening for cervical dysplasia in this cohort.

Human papillomavirus associated vulval intraepithelial neoplasias: Screening for cervical dysplasia in this cohort.

The association of vaccine hesitancy with other public health practices in well child care: a cross-sectional study

Vaccination is one of the most successful public health initiatives in human history. Despite all the benefits of vaccination, it is noteworthy that the number of vaccine hesitant parents has increased in recent years. Individuals with vaccine hesitancy are known to have similar attitudes towards other scientific initiatives. In this study, we investigated the relationship between the attitudes of vaccine hesitant parents and other practices and interventions in well child care. The “Parental Attitudes Towards Childhood Vaccinations (PACV) scale was applied to parents of children aged 2-6 without chronic diseases. A PACV score of 50 or above was considered as vaccine hesitancy. Sociodemographic characteristics, economic status and practices in well child care were questioned. Parents' vaccine hesitancy and their approaches to other practices in well child follow-up were compared. A total of 329 parents were included in the study. The rate of parents with vaccine hesitancy was 22.8% (n=75). In both groups, most participants had an undergraduate/graduate level of education. Those with vaccine hesitancy were less likely to have received vitamin K at birth (81.3% vs. 97.6%, p&lt;0.01), and use of prophylactic vitamin D (72% vs. 88.2%, p&lt;0.01) and iron supplements in the first year of life (66.7% vs 78.3%, p=0.038) were lower. No difference was found for developmental hip dysplasia and hearing screening. The current attitudes of vaccine hesitant parents are not limited to vaccination, but also affect other health initiatives. In our study, we have shown that vaccine hesitant individuals are also opposed and/or reluctant to child health initiatives. Taking this into account when developing strategies to overcome vaccine hesitancy may lead to more effective results.

Screening, diagnosis, treatment and outcomes of developmental dysplasia of the hip in Brazilian population: a scoping review protocol

IntroductionDevelopmental dysplasia of the hip (DDH) includes a spectrum of clinical and imaging findings at birth or early infancy. The circumstances in which this condition is detected and managed may...

S1311 Need to Improve Awareness for Cervical Dysplasia Screening in Immunosuppressed Patients With Inflammatory Bowel Disease

S1311 Need to Improve Awareness for Cervical Dysplasia Screening in Immunosuppressed Patients With Inflammatory Bowel Disease