C Silva

Skeletal maturity and socio-economic status in Portuguese children and youths: the Madeira growth study

Background: Skeletal maturity is used to evaluate biological maturity status. Information about the association between socio-economic status (SES) and skeletal maturity is limited in Portugal. Aims: The aim of this study is to document the skeletal maturity of youths in Madeira and to evaluate variation in maturity associated with SES. Subjects and methods: The study involved 507 subjects (256 boys and 251 girls) from the Madeira Growth Study, a mixed-longitudinal study of five cohorts (8, 10, 12, 14 and 16 years of age) followed at yearly intervals over 3 years (1996–1998). A total of 1493 observations were made. Skeletal age was estimated from radiographs of the hand and wrist using the Tanner–Whitehouse 2 method (TW2). Social class rankings were based on Graffars (1956) method. Five social rankings were subsequently grouped into three SES categories: high, average and low. Results: Median for the radius, ulna and short finger bones (RUS scores) in the total sample of boys and girls increased curvilinearly across age whereas median for the 7 (without pisiform) carpal bones (Carpal scores) increased almost linearly. The 20-bone maturity scores demonstrated distinctive trends by gender: the medians for boys increased almost linearly while the medians for girls increased curvilinearly. SES differences were minimal. Only among children aged 10–11 years were high SES boys and girls advanced in skeletal maturity. Madeira adolescents were advanced in skeletal maturity compared with Belgian reference values. Conclusion: The data suggests population variation in TW2 estimates of skeletal maturation. Skeletal maturity was not related to SES in youths from Madeira.

Teleradiology based CT colonography to screen a population group of a remote island; at average risk for colorectal cancer

PURPOSE To prospectively assess the performance of teleradiology-based CT colonography to screen a population group of an island, at average risk for colorectal cancer. MATERIALS AND METHODS A cohort of 514 patients living in Madeira, Portugal, was enrolled in the study. Institutional review board approval was obtained and all patients signed an informed consent. All patients underwent both CT colonography and optical colonoscopy. CT colonography was interpreted by an experienced radiologist at a remote centre using tele-radiology. Per-patient sensitivity, specificity, positive (PPV) and negative (NPV) predictive values with 95% confidence intervals (95%CI) were calculated for colorectal adenomas and advanced neoplasia ≥6 mm. RESULTS 510 patients were included in the study. CT colonography obtained a per-patient sensitivity, specificity, PPV and, NPV for adenomas ≥6 mm of 98.11% (88.6-99.9% 95% CI), 90.97% (87.8-93.4% 95% CI), 56.52% (45.8-66.7% 95% CI), 99.75% (98.4-99.9% 95% CI). For advanced neoplasia ≥6 mm per-patient sensitivity, specificity, PPV and, NPV were 100% (86.7-100% 95% CI), 87.07% (83.6-89.9% 95% CI), 34.78% (25.3-45.5% 95% CI) and 100% (98.8-100% 95% CI), respectively. CONCLUSION In this prospective trial, teleradiology-based CT colonography was accurate to screen a patient cohort of a remote island, at average risk for colorectal cancer.