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Tong Y, Udupa JK, McDonough JM, Xie L, Hao Y, Akhtar Y, Wu C, Rajapakse CS, Gogel S, Mayer OH, Anari JB, Torigian DA, Cahill PJ. Virtual Growing Child (VGC): A general normative comparative system via quantitative dynamic MRI for quantifying pediatric regional respiratory anomalies with application in thoracic insufficiency syndrome (TIS). BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.28.591554. [PMID: 38746219 PMCID: PMC11092456 DOI: 10.1101/2024.04.28.591554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Background A normative database of regional respiratory structure and function in healthy children does not exist. Methods VGC provides a database with four categories of regional respiratory measurement parameters including morphological, architectural, dynamic, and developmental. The database has 3,820 3D segmentations (around 100,000 2D slices with segmentations). Age and gender group analysis and comparisons for healthy children were performed using those parameters via two-sided t-testing to compare mean measurements, for left and right sides at end-inspiration (EI) and end-expiration (EE), for different age and gender specific groups. We also apply VGC measurements for comparison with TIS patients via an extrapolation approach to estimate the association between measurement and age via a linear model and to predict measurements for TIS patients. Furthermore, we check the Mahalanobis distance between TIS patients and healthy children of corresponding age. Findings The difference between male and female groups (10-12 years) behave differently from that in other age groups which is consistent with physiology/natural growth behavior related to adolescence with higher right lung and right diaphragm tidal volumes for females(p<0.05). The comparison of TIS patients before and after surgery show that the right and left components are not symmetrical, and the left side diaphragm height and tidal volume has been significantly improved after surgery (p <0.05). The left lung volume at EE, and left diaphragm height at EI of TIS patients after surgery are closer to the normal children with a significant smaller Mahalanobis distance (MD) after surgery (p<0.05). Interpretation The VGC system can serve as a reference standard to quantify regional respiratory abnormalities on dMRI in young patients with various respiratory conditions and facilitate treatment planning and response assessment. Funding The grant R01HL150147 from the National Institutes of Health (PI Udupa).
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Alsabri M, Street H, Sircy A, Labib B. Misdiagnosed metabolic bone abnormality: a case report. J Med Case Rep 2023; 17:436. [PMID: 37858137 PMCID: PMC10588102 DOI: 10.1186/s13256-023-04164-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 09/05/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Metabolic bone disease causes significant morbidity and mortality, especially when misdiagnosed. With genetic testing, multiple disease pathologies can be analyzed. CASE PRESENTATION A 5-year and 9-month-old otherwise healthy Yemeni girl presented to her Yemen physician for evaluation of inward bending of her right knee and short stature. After extensive medical testing, she was given a diagnosis of hypophosphatemic rickets and growth hormone deficiency and started on treatment. Despite appropriate treatment, however, her condition continued to progress, prompting her family to pursue additional workup including genetic testing outside of Yemen. Genetic testing ultimately revealed a variation of unknown significance associated with amelogenesis imperfecta. CONCLUSIONS Hypophosphatemic rickets secondary to renal tubular acidosis was the working diagnosis. However, the patient's condition did not improve. Further genetic testing revealed a variation of unknown significance associated with amelogenesis imperfecta. We aim to present this case, provide an overview of the causes, and diagnostic metabolic bone health evaluation.
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Affiliation(s)
- Mohammed Alsabri
- Pediatrics, 1 Brookdale University Hospital and Medical Center, 1Brookdale Plaza, Brooklyn, NY, 11212, USA.
- Emergency Medicine Department, Al Thawra Modern General Hospital (TMGH), Sana'a City, Yemen.
- College of Osteopathic Medicine, NYIT, Glen Head, NY, USA.
| | - Hannah Street
- NYU Langone Medical Center, 550 1st Avenue, New York, NY, 10016, USA
| | - Aaron Sircy
- CMEF Aultman Hospital, 2600 6th st. SW, Canton, OH, 44710, USA
| | - Bahaaeldin Labib
- Rutgers-Robert Wood Johnson University Hospital, 200 Somerset Street, New Brunswick, NJ, 08901, USA
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Al Ghali R, El-Mallah C, Obeid O, El-Saleh O, Smail L, Haroun D. Urinary minerals excretion among primary schoolchildren in Dubai-United Arab Emirates. PLoS One 2021; 16:e0255195. [PMID: 34351961 PMCID: PMC8341483 DOI: 10.1371/journal.pone.0255195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/10/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Urinary excretion of calcium (Ca), magnesium (Mg), phosphorus (P), iodine and fluoride is used to assess their statuses and/or the existence of metabolic abnormalities. In the United Arab Emirates (UAE), the urinary concentration of these minerals among children have not been documented. Materials and methods A cross-sectional study, including 593 subjects (232 boys and 361 girls), was conducted among healthy 6 to 11-year-old Emirati children living in Dubai. Non-fasting morning urine samples and anthropometrical measurements were collected and analyzed. Results were expressed as per mg of creatinine (Cr). Results On average, estimated Cr excretion was 17.88±3.12 mg/kg/d. Mean urinary Ca/Cr, Mg/Cr and P/Cr excretions were 0.08±0.07 mg/mg, 0.09±0.04 mg/mg, and 0.57±0.26 mg/mg respectively. Urinary excretion of Ca, Mg and P were found to decrease as age increased. Urinary excretion and predicted intake of fluoride were lower than 0.05 mg/kg body weight per day. Surprisingly, more than 50% of the children were found to have urinary iodine excretion level above adequate. Conclusion The Emirati schoolchildren had comparable levels of urinary Ca, Mg and P excretion to other countries. The 95% percentile allows the use of the current data as a reference value for the detection of mineral abnormalities. Fluoride excretion implies that Emirati children are at low risk of fluorosis. The level of urinary iodine excretion is slightly higher than recommended and requires close monitoring of the process of salt iodization to avoid the harmful impact of iodine overconsumption.
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Affiliation(s)
- Rola Al Ghali
- Department of Public Health and Nutrition, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - Carla El-Mallah
- Department of Nutrition and Food Science. Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Omar Obeid
- Department of Nutrition and Food Science. Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Ola El-Saleh
- Department of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Linda Smail
- Department of Mathematics and Statistics, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - Dalia Haroun
- Department of Public Health and Nutrition, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
- * E-mail:
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Sarigul N, Kurultak İ, Uslu Gökceoğlu A, Korkmaz F. Urine analysis using FTIR spectroscopy: A study on healthy adults and children. JOURNAL OF BIOPHOTONICS 2021; 14:e202100009. [PMID: 33768707 DOI: 10.1002/jbio.202100009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/23/2021] [Accepted: 03/23/2021] [Indexed: 06/12/2023]
Abstract
Urine spectra from 108 healthy volunteers are studied by attenuated total refraction-Fourier transform infrared (ATR-FTIR) spectroscopy. The spectral features are correlated with observable urine components. The variation of spectra within a healthy population is quantified and a library of reference spectra is constructed. Using the band assignments, these spectra are compared with both age-wise and gender-wise. Children show the least intensity variations compared to both adult groups. Young adults show the highest variation, particularly in the 1650 to 1400 cm-1 and 1200 to 900 cm-1 regions. These results indicate the importance of the size of the control group in comparative studies utilizing FTIR. Age-wise comparisons reveal that phosphate and sulfate excretion decreases with age, and that the variance of phosphate among individuals is higher with adults. As for gender-wise comparisons, females show a slightly higher citrate content at 1390 cm-1 regardless of the age and they show a higher variance in the 1200 to 1000 cm-1 region when compared to men.
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Affiliation(s)
- Neslihan Sarigul
- Institute of Nuclear Science, Hacettepe University, Ankara, Turkey
| | - İlhan Kurultak
- Department of Nephrology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Arife Uslu Gökceoğlu
- Ankara Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Filiz Korkmaz
- Biophysics Laboratory, Faculty of Engineering, Atilim University, Ankara, Turkey
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Heikkilä J, Jahnukainen T, Holmberg C, Taskinen S. Association of Renal Glomerular and Tubular Function With Renal Outcome in Patients With Posterior Urethral Valves. Urology 2020; 153:285-290. [PMID: 33296697 DOI: 10.1016/j.urology.2020.11.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/16/2020] [Accepted: 11/23/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To analyze renal glomerular and tubular function and their association in patients operated for posterior urethral valves and to prognosticate the risk for end-stage kidney disease (ESKD) METHODS: Sixty-three previously treated patients were evaluated for renal function during 1987-1991. The patients' age at evaluation was 11 years (range 2-24). Glomerular function was assessed by measuring glomerular filtration rate (GFR) and urine albumin excretion. Tubular function was determined by measuring urine concentration capacity and excretion of electrolytes (Na, K, Cl, Ca, P, Mg) and β-2-microglobulin. Additionally, the prevalence of hypertension and serum parathyroid hormone and aldosterone values were registered. Tubular function was compared with GFR and the risk of developing ESKD before November 2018. RESULTS Twenty of the study patients (32%) had decreased GFR. In addition, 19% had proteinuria and 56% were hypertensive. Those without proteinuria or hypertension had better GFR values (P < .01 for both). There was a significant correlation between GFR and all the tubular function (P < .05) variables (except excretion of chloride) measured. Compared to the patients with favorable renal outcome, the patients (n = 10) who later developed ESKD had significantly (P < .01) lower GFR and reduced urinary excretion of all measured electrolytes except calcium. Consistently, urine β-2 microglobulin and serum parathyroid hormone and aldosterone values were significantly higher in the patients who developed ESKD (P ≤ .01). CONCLUSION Both glomerular and tubular function decline was common and several parameters were likely to predict ESKD in posterior urethral valves patients.
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Affiliation(s)
- Jukka Heikkilä
- Department of Pediatric Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Timo Jahnukainen
- Department of Pediatric Nephrology, Transplantation New Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Christer Holmberg
- Department of Pediatric Nephrology, Transplantation New Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Seppo Taskinen
- Department of Pediatric Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
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Establishment and Verification of Sex- and Age-Specific Serum Electrolyte Reference Intervals in Healthy Han Children in Changchun, Northeastern China. BIOMED RESEARCH INTERNATIONAL 2020; 2019:8282910. [PMID: 31886255 PMCID: PMC6899288 DOI: 10.1155/2019/8282910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/19/2019] [Accepted: 09/28/2019] [Indexed: 11/17/2022]
Abstract
For lack of feasible interval values from population differences and potential analytical discrepancies, it is essential to ascertain potassium (K), sodium (Na), chlorine (Cl), calcium (Ca), and phosphorus (P) ions reference intervals within Chinese children to fill the gap. Healthy children (n = 1391, 2–<15 years old) were recruited from communities and schools to establish sex- and age-specific serum electrolyte reference intervals of Han children in Changchun, China. Levels of serum K, Na, Cl, Ca, and P were measured using a Hitachi 7600-210 automatic biochemical analyzer. Reference intervals were established according to Clinical and Laboratory Standards Institute EP28-A3c guidelines. Data from five representative hospitals located across Changchun were used to verify pediatric serum electrolyte reference intervals. Values were different from adult reference intervals in China. There were sex-specific differences in Na, Cl, Ca, and P reference intervals in 13-<14 children. Serum Na, Cl, and Ca reference intervals showed stable trends within early age groups but fluctuated in teens. Each serum electrolyte had ≤3 age-specific reference intervals. Five laboratories suggested reference intervals were applicable across Changchun.
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Population biomonitoring of micronutrient intakes in children using urinary spot samples. Eur J Nutr 2019; 59:3059-3068. [PMID: 31745727 DOI: 10.1007/s00394-019-02144-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 11/11/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Urinary spot samples are a promising method for the biomonitoring of micronutrient intake in children. Our aim was to assess whether urinary spot samples could be used to estimate the 24-h urinary excretion of potassium, phosphate, and iodine at the population level. METHODS A cross-sectional study of 101 children between 6 and 16 years of age was conducted. Each child collected a 24-h urine collection and three urinary spot samples (evening, overnight, and morning). Several equations were used to estimate 24-h excretion based on the urinary concentrations of each micronutrient in the three spot samples. Various equations and spot combinations were compared using several statistics and plots. RESULTS Ninety-four children were included in the analysis (mean age: 10.5 years). The mean measured 24-h urinary excretions of potassium, phosphate, and iodine were 1.76 g, 0.61 g, and 95 µg, respectively. For potassium, the best 24-h estimates were obtained with the Mage equation and morning spot (mean bias: 0.2 g, correlation: 0.27, precision: 56%, and misclassification: 10%). For phosphate, the best 24-h estimates were obtained with the Mage equation and overnight spot (mean bias: - 0.03 g, correlation: 0.54, precision: 72%, and misclassification: 10%). For iodine, the best 24-h estimates were obtained with the Remer equation and overnight spot (mean bias: - 8 µg, correlation: 0.58, precision: 86%, misclassification: 16%). CONCLUSIONS Urinary spot samples could be a good alternative to 24-h urine collection for the population biomonitoring of iodine and phosphate intakes in children. For potassium, spot samples were less reliable.
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