Background An ENDO-European Reference Network (ERN) initiative was launched that was endorsed by the European Society for Pediatric Endocrinology and the European Society for Endocrinology with 22 participants from the ENDO-ERN and the two societies. The aim was to update the practice guidelines for the diagnosis and management of congenital hypothyroidism (CH). A systematic literature search was conducted to identify key articles on neonatal screening, diagnosis, and management of primary and central CH. The evidence-based guidelines were graded with the Grading of Recommendations, Assessment, Development and Evaluation system, describing both the strength of recommendations and the quality of evidence. In the absence of sufficient evidence, conclusions were based on expert opinion. Summary The recommendations include the various neonatal screening approaches for CH as well as the etiology (also genetics), diagnostics, treatment, and prognosis of both primary and central CH. When CH is diagnosed, the expert on.

Constitutional varus in the coronal plane is formed based on the Hueter-Volkmann’s law. The varus deformity occurs at the proximal metaphysis of the tibia and the tibial condyle rotates medially. In the sagittal plane, we hypothesized that the posterior slope angle of the tibial articular surface may also occur at the proximal metaphysis and the tibial condyle rotates posteriorly. The purpose of this study was to verify the hypothesis.

A total of 208 patients who underwent TKA had lateral view proximal tibia digital radiograph on which seven parameters were analyzed. The posterior slope angle of the tibial articular surface relative to the anterior wall of the tibial condyle and that relative to the anterior cortex of the tibial shaft were assessed. Correlation between the position of the tibial condyle and the posterior slope angle of the articular surface were assessed.

The proximal tibial condyle itself did not have a posterior slope in the 86.5% of the participants. Posterior rotation of the tibial condyle created posterior slope of the tibial articular surface relative to the anterior cortex of the tibial shaft. The more tibial condyle was posteriorly rotated, the more the tibial articular surface shifted posteriorly.

Study findings showed that the posterior tibial slope occurs at the proximal metaphysis of the tibia, and the tibial condyle rotates posteriorly. The posterior tibial slope involves the posterior shift of the tibial articular surface. Captisol The posterior tibial slope is mainly created by the posterior rotation of the tibial condyle.

Study findings showed that the posterior tibial slope occurs at the proximal metaphysis of the tibia, and the tibial condyle rotates posteriorly. The posterior tibial slope involves the posterior shift of the tibial articular surface. The posterior tibial slope is mainly created by the posterior rotation of the tibial condyle.Background Epilepsy is a neurological disorder which is characterised by recurrent and involuntary seizures. Magnetoencephalography (MEG) is clinically used as a presurgical tool in locating the epileptogenic zone by localising either interictal epileptic discharges (IEDs) or ictal activities. The localisation of ictal onset provides reliable and more accurate seizure onset zones rather than localising the IEDs. Ictals or seizures are presently detected during MEG analysis by manually inspecting the recorded data. This is laborious when the duration of recordings is longer. Methods We propose a novel method which uses statistical features such as short-time permutation entropy (STPE), gradient of STPE (GSTPE), short-time energy (STE) and short-time mean (STM) extracted from the ictal and interictal MEG data of drug resistant epilepsy patients group. Since the data is heavily skewed, the RUSBoost algorithm with k-fold cross-validation is used to classify the data into ictal and interictal by using the four feature vectors. This method is further used for localising the epileptogenic region using region-specific classifications by means of the RUSBoost algorithm. Results The accuracy obtained for seizure detection is 93.4%. The specificity and sensitivity for the same are 93%. The localisation accuracies for each lobe are in the range of 88.1-99.1%. Discussion Through this ictus detection method, the current scenario of laborious inspection of the ictal MEG can be reduced. The proposed system, thus, can be implemented in real-time as a better and more efficient method for seizure detection and further it can prove to be highly beneficial for patients and health-care professionals during real-time MEG recording. Furthermore, the identification of the epileptogenic lobe can provide clinicians with useful insights, and a pre-cursor for source localisation.

Modern knee replacements aim to improve patient function in arthritis affecting different compartments of the knee. This study evaluates the Patient Reported Outcome Measure (PROM) and functional outcome of a modern total knee replacement (Attune, DePuy) in patients with isolated patellofemoral arthritis.

A total of 50 consecutive patients with isolated unilateral patellofemoral arthritis having had Attune total knee replacements at a single institution between 2010 and 2016 were prospectively studied. Five patients who developed symptoms on the opposite side during the study and two patients lost to follow-up were excluded. One patient needed early revision for loosening, leaving a total of 42 patients to be followed up over a period of 4 years. The Oxford Knee score (OKS) and Knee Injury and Osteoarthritis Outcome Score (KOOS) recorded pre-operatively and at follow-up was compared. A Functional assessment at around 8 months after operation was undertaken.

At average follow-up of 24 months the mean OKSThis unique study of a modern design total knee replacement (Attune) in patients with isolated unilateral patellofemoral arthritis shows good PROM scores at 2 years and good functional assessment results at 8 months. The PROM scores are marginally better than the published results with Attune’s predecessor, in a similar cohort of patients, but falls short of the published results of patellofemoral replacement implants. Large randomised comparative studies between traditional and the modern implant design is recommended to answer the question if design modification has influenced clinical outcome in patients with patellofemoral arthritis.