Browsing by Person "Randell, T. L."

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Girls with right thoracic adolescent idiopathic scoliosis (AIS): lower body mass index (BMI) and evidence suggesting an inverse relation between sympathoactivation and somatotropic (GH/1GF) secretions
(IOS Press, 2010-07-10) Burwell, R. G.; Aujla, R. K.; Grevitt, M. P.; Randell, T. L.; Dangerfield, P. H.; Cole, A. A.; Kirby, Alanah; Polak, F. J.; Pratt, R. K.; Moulton, A.; Webb, J. K.; Aubin, Carl-Eric; Labelle, Hubert; Moreau, Alain; Stokes, Ian A. F.
Introduction: Relatively lower but not higher BMI was associated with left-right skeletal asymmetries in 1)preoperative AIS girls, upper arm length asymmetry (UALA), 2) normal adolescent girls and boys, trunk asymmetry; and 3) normal juvenile girls, skeletal sizes for age associated withUALA. Objectives: In girls with right thoracic AIS to evaluate the effect of lower and higher BMI upon the relation of curve severity to UALA. Material and Methods: Data from girls with right thoracic AIS (n=110, preoperative n=77, screened n=33) including Cobb angle, apical vertebral rotation (AVR) and UALA (right minus left, mm), are evaluated by higher (n-57) and lower (n=53) BMI relative to median values (mean BMIs 21.8 and 17.3 respectively, p<0.001). Results: Mean Cobb angles and UALA are not significantly different between lower and higher BMI. Mean AVR in the lower BMI subset is significantly less than in the higher BMI subset. Cobbangle and AVR each correlate significantly with UALA in girls with lower but not higher BMI. Conclusion: In accordance with our double neuro-osseous theory for AIS pathogenesis in girls, we postulate that lower BMI girls with presumptively lower circulating leptin levels, have relatively more sympathoactivation causing the skeletal asymmetries and less somatotropic secretions. From previous findings of younger preoperative girls with higher BMI showing early skeletal overgrowth, such girls may have relatively more somatotropic secretions and less sympathoactivation. Significance: This putative inverse relation for AIS is in accordance with several medical conditions showingan inverse relationship between sympathoactivation and GH/1GF secretions.
Preoperative Girls with Adolescent Idiopathic Scoliosis (AIS): Systemic Skeletal Overgrowth Patterns Probably Hormonally-driven Revealed in Higher and Lower Body Mass Index (BMI) Subsets
(IOS Press, 2010-07-10) Burwell, R. G.; Aujla, R. K.; Grevitt, M. P.; Randell, T. L.; Dangerfield, P. H.; Cole, A. A.; Kirby, Alanah; Polak, F. J.; Pratt, R. K.; Moulton, A.; Webb, J. K.; Aubin, Carl-Eric; Labelle, Hubert; Moreau, Alain; Stokes, Ian A. F.
Introduction: Evidence suggests that extraspinal general skeletal overgrowth in AIS girls is associated with the relative anterior spinal overgrowth (RASO) giving such overgrowth pathogenetic significance. Objectives: To compare skeletal sizes for age of preoperative AIS/normal girls by higher and lower BMI subsets relative to median values in a cross-sectional study. Materials and Methods: Preoperative (n=122) and normal girls (n=274) age 11-18 years were measured using the Holtain equipment. BMI was weight in kg/stature in meters2 corrected for scoliosis. Skeletal sizes for each of stature, sitting height, subischial height, trunk widths (biacromial and biiliac) and limb segment lengths bilaterally (upper arm, forearm-with-hand, tibia, and foot) were compared within each BMI subset (ANOVA correcting for age). Spinal deformity was measured. Menarcheal age was recorded. Results: With relatively higher BMIs, preoperative girls from 11 years have larger skeletal segments than normals, decreasing to normal size by 16 years, in each of 11 skeletal segments, six in paired limb bones but not feet. BMIs and menarcheal ages are similar. With relatively lower BMIs, two growth phases are evident: early with skeletal sizes of preoperatives mostly similar to normals; and late, larger than normals. Menarche in preoperatives is later than normals but not statistically significant. Conclusion: Overall, preoperative girls show skeletal overgrowth patterns which are systemic, probably hormonally driven, for the relatively higher BMI subset somatotropic (growth hormone/IGF) axis, and the relatively lower BMI subset, estrogen. Significance: Circulating hormones in AIS girls by relatively higher and lower BMI need study, leading to possible medical therapy.
Upper arm lengths suggest transient asymmetry associated with right thoracic adolescent idiopathic scoliosis (RT-AIS) of girls with implications for pathogenesis and estimation of linear skeletal overgrowth
(IOS Press, 2012-07) Burwell, R. G.; Aujla, R. K.; Grevitt, M. P.; Randell, T. L.; Dangerfield, P. H.; Cole, A. A.; Kirby, Alanah; Polak, F. J.; Pratt, R. K.; Webb, J. K.; Moulton, A.; Grivas, T.; Kotwicki, T.
The International Research Society of Spinal Deformities (IRSSD) promotes a multidisciplinary approach to scoliosis and spinal problems, with a strong emphasis on research in the field of etiology, as well as the clinical effectiveness of a wide range of interventions. The society has been active in one form or another for three decades, encouraging open discussion in all areas related to spinal deformities. The International Research Society of Spinal Deformities (IRSSD) promotes a multidisciplinary approach to scoliosis and spinal problems, with a strong emphasis on research in the field of etiology, as well as the clinical effectiveness of a wide range of interventions. The society has been active in one form or another for three decades, encouraging open discussion in all areas related to spinal deformities. This current overview of topics related to spinal deformities provides the opportunity for readers to learn more about the latest developments in this field, and it contributes to the advancement of study and research into spinal deformities for the benefit of patients.