Objective To identify the incidence and risk factors of haemorrhoids and fissures during pregnancy and after childbirth.Design Prospective observational cohort study.Setting University hospital and outpatient clinics in Lithuania.Population A total of 280 pregnant women followed up until 1 month after delivery.Methods Women were examined four times through pregnancy and after delivery; those that developed peri-anal diseases were compared with those that did not.Main outcome measures Incidence, time and risk factors of haemorrhoids and fissures.Results In all, 123 (43.9%) women developed peri-anal disease: 1.6% in the first trimester, 61% during the third trimester, 34.1% after delivery and 3.3% 1 month after delivery; 114 (40.7%) women were diagnosed with haemorrhoids, seven (2.5%) with haemorrhoids and anal fissure and two (0.71%) with anal fissure. Ninety-nine (80.5%) women had vaginal delivery and 24 (19.5%) women had undergone caesarean section. Multivariate analysis identified personal history of peri-anal diseases (odds ratio [OR] 11.93; 95% confidence interval [95% CI] 2.18-65.30), constipation (OR 18.98; 95% CI 7.13-50.54), straining during delivery for more than 20 minutes (OR 29.75; 95% CI 4.00-221.23) and birthweight of newborn >3800 g (OR 17.99; 95% CI 3.29-98.49) as significant predictors of haemorrhoids and anal fissures during pregnancy and perinatal period.Conclusions Haemorrhoids and fissures are common during the last trimester of pregnancy and 1 month after delivery, with constipation, personal history of haemorrhoids or fissures, birthweight of newborn >3800 g, straining during delivery for more than 20 minutes being independently associated risk factors.

The age of the victim plays a crucial role for the legal implications concerning pornography. Judges therefore often call on forensic experts to verify the age of individuals depicted on photographs or videos. However, there is no scientifically established protocol available for forensic practice in such cases. The conventional methods such as the evaluation of secondary sexual characteristics provide unsatisfactory results particularly when the legally relevant ages for child pornography (i.e. 14 and 18 years) are concerned. To overcome these limits, a European research group has explored the applicability of facial proportions as an age indicator on images. In this pilot study, standardized facial images of 353 females and 20 males from four age groups (6, 10, 14 and 18 years) were randomly selected for the metric analysis from a large data set including German, Italian and Lithuanian subjects. In this sample, several indices extracted from the frontal and lateral photographs were closely correlated to their respective indices taken from the living individuals. Furthermore, age-related changes were identified for indices taken from the photographs. The discriminant analysis showed that for the pooled sample, 60.3% of the cases were correctly classified into the respective age group. The percentage of correctly classified cases increased in the respective country samples as follows: 69.9% for Germany, 69.4% for Lithuania and 80.5% for Italy. The present study suggests that the metric assessment of the face may be used for age estimation on images. Nonetheless, more work needs to be done in order to verify the reliability of these findings on a large sample.

The visual analysis of the face produces reasonably accurate age estimates up to the age of 18 years, which is the legally relevant age threshold for victims in cases of pedo-pornography. This approach can be applied in conjunction with the conventional methods for a preliminary age estimation of juveniles depicted on images.

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This study provided reference data and identified sex- and age-related growth patterns of the craniofacial complex of young European children, which may be used for detailed assessment of normal growth in paediatrics, maxillofacial reconstructive surgery and possibly for forensic age assessment.

Polycystic ovary syndrome (PCOS) is one of the most frequent endocrine and metabolic disorders in reproductive age women, and it is related to changes in body size, shape and composition. Anthropometric somatotype is a quantitative description of the individual's body shape and composition classified as endomorphy, mesomorphy or ectomorphy. Since PCOS somatotype has never previously been studied, here we evaluate body shape and composition phenomena in lean women with polycystic ovary syndrome and assess relationships with metabolic parameters. The study of 20-35 year-old women was carried out at the Department of Anatomy, Histology and Anthropology at Vilnius University. Standard anthropometric instruments and methods were used, and J. Matiegka's equations calculated skeletal mass, skin and subcutaneous adipose tissue and muscles and internal organs. In addition, Heath -Carter's somatotypes were computed, and the participants' glucose, insulin, testosterone, sex hormone-binding globulin and lipid levels were established. We analysed data from 120 women with a mean age of 27.30 ± 3.68 years. Lean women with PCOS had greater skeletal mass by 0.47 kg (p<0.05, Cohen's d=1.14), greater skin and subcutaneous adipose tissue mass by 2.79 kg (p<0.05, Cohen's d=6.07) and lower muscle mass by 1.47 kg (p<0.05, Cohen's d=2.84) compared to control women (p<0.05). The mean PCOS somatotype ratio was 4.96-4.38-3.00 (SD 1.50-1.26-1.11). This classified women with PCOS as mesomorphic endomorphs, in contrast to healthy women who were endomorphic mesomorphs. The PCOS subjects' skin and subcutaneous adipose tissue and endomorphy/mesomorphy somatotype positively correlated with insulin levels and the HOMA-IR. It was established that lean women with polycystic ovary syndrome had a mesomorphic endomorph somatotype and higher skin and subcutaneous adipose tissue mass, but less muscle mass than healthy lean women. In addition, skin and subcutaneous adipose tissue positively correlated with insulin level and HOMA-IR in lean PCOS women.

The analysis revitalizes the debate on clinically relevant and at the same time practicable but less demanding alternatives for constructing growth reference charts, and for economic reasons, strongly suggests replacing the traditional empirical methods by synthetic growth references.