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Alcausin MB, Briody J, Pacey V, Ault J, McQuade M, Bridge C, Engelbert RHH, Sillence DO, Munns CF. Intravenous pamidronate treatment in children with moderate-to-severe osteogenesis imperfecta started under three years of age. Horm Res Paediatr 2014; 79:333-40. [PMID: 23735642 DOI: 10.1159/000351374] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 04/14/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Evaluate clinical outcome of early cyclic intravenous pamidronate treatment in children with moderate-to-severe osteogenesis imperfecta (OI), commenced before three years of age. METHODS A retrospective review of 17 patients with moderate-to-severe OI. Development, anthropometry, fracture history, bone mineral density (BMD) and biochemistry were collected at baseline, 12 and 24 months. RESULTS Four had OI type I, eleven had type III, one OI-FKBP10 type and one OI type V. Mean age at start of pamidronate was 14 ± 11 months. Pamidronate ranged from 6 to 12 mg/kg/year. No adverse reaction apart from fever and vomiting was noted. Long bone fracture decreased from a mean of 10.4/year to 1.2/year after 12 months and 1.4/year after 24 months (p = 0.02). Lumbar spine age- and height-matched BMD Z-scores increased (p < 0.005). Sixteen with vertebral compression fractures at baseline all showed improved vertebral shape (p < 0.001). Concavity index, likewise, improved (p < 0.005). Motor milestones compared to historical data show earlier attainment in rolling over, crawling, pulling to stand and walking independently but not sitting. CONCLUSION Cyclic intravenous pamidronate, started under 3 years of age in children with moderate-to-severe OI, was well tolerated and associated with an increase in lumbar spine BMD, reduced fracture frequency, vertebral remodelling and attainment of motor milestones at an earlier age.
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Affiliation(s)
- M B Alcausin
- Clinical Genetics, The Sydney Children's Hospital Network Westmead Campus, Westmead, N.S.W., Australia
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Ireland PJ, Ware RS, Donaghey S, McGill J, Zankl A, Pacey V, Ault J, Savarirayan R, Sillence D, Thompson E, Townshend S, Johnston LM. The effect of height, weight and head circumference on gross motor development in achondroplasia. J Paediatr Child Health 2013; 49:E122-7. [PMID: 23336715 DOI: 10.1111/jpc.12078] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/16/2012] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aimed to investigate whether height, weight, head circumference and/or relationships between these factors are associated with gross motor milestone acquisition in children with achondroplasia. METHOD Population-based data regarding timing of major gross motor milestones up to 5 years were correlated with height, weight and head circumference at birth and 12 months in 48 children with achondroplasia born in Australia and New Zealand between 2000 and 2009. RESULTS Although as a group children with achondroplasia showed delayed gross motor skill acquisition, within group differences in height, weight or head circumference did not appear to influence timing of gross motor skills before 5 years. The exception was lie to sit transitioning, which appears likely to occur earlier if the child is taller and heavier at 12 months, and later if the child has significant head-to-body disproportion. CONCLUSIONS This is the first study to investigate the relationship between common musculoskeletal impairments associated with achondroplasia and timing of gross motor achievement. Identification of the musculoskeletal factors that exacerbate delays in transitioning from lying to sitting will assist clinicians to provide more proactive assessment, advice and intervention regarding motor skill acquisition for this population.
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Affiliation(s)
- Penelope Jane Ireland
- Queensland Paediatric Rehabilitation Service, Royal Children's Hospital, Brisbane, Queensland, Australia.
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Ireland PJ, Donaghey S, McGill J, Zankl A, Ware RS, Pacey V, Ault J, Savarirayan R, Sillence D, Thompson E, Townshend S, Johnston LM. Development in children with achondroplasia: a prospective clinical cohort study. Dev Med Child Neurol 2012; 54:532-7. [PMID: 22409389 DOI: 10.1111/j.1469-8749.2012.04234.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM Achondroplasia is characterized by delays in the development of communication and motor skills. While previously reported developmental profiles exist across gross motor, fine motor, feeding, and communication skills, there has been no prospective study of development across multiple areas simultaneously. METHOD This Australasian population-based study utilized a prospective questionnaire to quantify developmental data for skills in children born from 2000 to 2009. Forty-eight families from Australia and New Zealand were asked to report every 3 months on their child's attainment of 41 milestones. Results include reference to previously available prospective information. RESULTS Information from questionnaires was used to develop an achondroplasia-specific developmental recording form. The 25th, 50th, 75th, and 90th centiles were plotted to offer clear guidelines for development across gross motor, fine motor, feeding, and communication skills in children with achondroplasia. INTERPRETATIONS Consistent with results from previous research, children with achondroplasia are delayed in development of gross motor and ambulatory skills. Young children with achondroplasia demonstrate a number of unique movement strategies that appear compensatory for the biomechanical changes. While delays were seen in development of later communication items, there were fewer delays seen across development of early communication, fine motor, and feeding skills.
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Affiliation(s)
- Penelope J Ireland
- Queensland Paediatric Rehabilitation Service, Royal Children's Hospital, Brisbane, Qld., Australia.
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Ireland PJ, Johnson S, Donaghey S, Johnston L, Ware RS, Zankl A, Pacey V, Ault J, Savarirayan R, Sillence D, Thompson E, Townshend S, McGill J. Medical management of children with achondroplasia: evaluation of an Australasian cohort aged 0-5 years. J Paediatr Child Health 2012; 48:443-9. [PMID: 22112170 DOI: 10.1111/j.1440-1754.2011.02255.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS Achondroplasia is the most common form of osteochondrodysplasia and is associated with a number of life-threatening complications. The complexity of the condition led to the development of Heath Supervision Guidelines published by the American Academy of Pediatrics in 1995 and revised in 2005. There remains limited population-based information on utilisation of medical and therapy services for children with achondroplasia. Increased information regarding use of these services will assist in future service development. METHODS Data regarding frequency and timing of medical and allied health consultations, investigations and interventions were collected from 53 Australasian families via questionnaire, based on recommendations of the Health Supervision Guidelines, an expert reference group and literature review. RESULTS Rates varied with age for medical consultations (geneticist, paediatric rehabilitation physician/paediatrician, respiratory physician, orthopaedic consultant, neurologist, neurosurgeon), medical investigations (sleep study, magnetic resonance imaging/computed tomography), operative procedures (brain-stem decompression, tonsillectomy/adenoidectomy, shunt insertion, shunt revision and insertion of grommets) and allied health consultations (physiotherapist, occupational therapist, speech pathologist, dietician and orthotist). CONCLUSIONS Access to geneticists and paediatricians within the first year is high as recommended by the 2005 American Academy of Pediatrics guidelines. Utilisation of craniocervical magnetic resonance imaging/computed tomography, polysomnography studies and formal speech review appears low, reflecting more emphasis on clinical monitoring for cervical cord compression and disordered sleep breathing as well as possible difficulties in accessing services for polysomnography and speech pathology. Grommet insertion, tonsillectomy/adenoidectomy and cervicomedullary decompression rates are similar to results reported previously. Over half of the children accessed physiotherapy and/or occupational therapy services, warranting consideration of these professionals in future guideline recommendations.
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Affiliation(s)
- Penelope J Ireland
- School of Health and Rehabilitation Sciences School of Population Health, The University of Queensland, Brisbane, Queensland, Australia.
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Ireland PJ, McGill J, Zankl A, Ware RS, Pacey V, Ault J, Savarirayan R, Sillence D, Thompson EM, Townshend S, Johnston LM. Functional performance in young Australian children with achondroplasia. Dev Med Child Neurol 2011; 53:944-50. [PMID: 21838822 DOI: 10.1111/j.1469-8749.2011.04050.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to determine population-specific developmental milestones for independence in self-care, mobility, and social cognitive skills in children with achondroplasia, the most common skeletal dysplasia. METHODS Population-based recruitment from October 2008 to October 2010 identified 44 Australian children with achondroplasia aged 3 to 7 years. Consenting parents of 35 children (16 males, 19 females 14 aged 3y; 12 aged 5y; nine aged 7y) reported their child's self-care, mobility, and social cognition function using the Functional Independence Measure for Children (WeeFIM-II) at the ages of 3 (n=14), 5 (n=12), or 7 (n=9) years. Children were excluded from the study if they had an additional neurological or musculoskeletal condition. RESULTS Functioning improved in children with achondroplasia between the ages of 3 and 5 years, but not subsequently. Milestones in the achondroplasia group were delayed across all ages and domains compared with normative reference data. Children with achondroplasia required greater caregiver assistance for self-care and mobility skills than typically developing children based on normative data. Social cognition appeared to be an area of relative strength. INTERPRETATION Children up to 7 years of age with achondroplasia show delayed milestone acquisition and a greater need for caregiver assistance for all domains. As functional delays are likely to be related to common musculoskeletal impairments associated with achondroplasia, access to physiotherapists, occupational therapists, and speech and language pathologists skilled in achondroplasia management may assist children and families to become more independent, particularly around the time of starting school.
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Affiliation(s)
- Penelope Jane Ireland
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.
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David-Vizcarra G, Briody J, Ault J, Fietz M, Fletcher J, Savarirayan R, Wilson M, McGill J, Edwards M, Munns C, Alcausin M, Cathey S, Sillence D. The natural history and osteodystrophy of mucolipidosis types II and III. J Paediatr Child Health 2010; 46:316-22. [PMID: 20367762 PMCID: PMC4188554 DOI: 10.1111/j.1440-1754.2010.01715.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To assess the natural history and impact of the secondary bone disease observed in patients with mucolipidosis (ML) II and III. METHODS Affected children and adults were ascertained from clinical genetics units around Australia and New Zealand. Diagnoses were confirmed by the National Referral Laboratory in Adelaide. The study encompassed all patients ascertained between 1975 and 2005. Data focussing on biochemical parameters at diagnosis, and longitudinal radiographic findings were sought for each patient. Where feasible, patients underwent clinical review and examination. Examinations included skeletal survey, bone densitometry, and measurement of serum and urine markers of bone metabolism. In a subset of patients, functional assessment using the Pediatric Evaluation and Disability Inventory (PEDI) and molecular analysis of GNPTAB were performed. RESULTS Twenty-five patients with mucolipidosis were ascertained over a 30-year period. Morbidity and functional outcomes on living patients were described. Serum calcium and phosphate were normal. All, but one patient, had normal alkaline phosphatase. Serum osteocalcin and urine deoxypyridinoline/creatinine were elevated. Two radiological patterns were observed (i) transient neonatal hyperparathyroidism in infants with ML II and (ii) progressive osteodystrophy in patients with ML intermediate and ML III. Molecular analyses of GNPTAB in nine subjects are reported. CONCLUSION ML is characterised by a progressive bone and mineral disorder which we describe as the 'osteodystrophy of mucolipidosis'. The clinical and radiographic features of this osteodystrophy are consistent with a syndrome of 'pseudohyperparathyroidism'. Much of the progressive skeletal and joint pathology is attributable to this bone disorder.
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Affiliation(s)
| | - Julie Briody
- Bone Densitometry, Department of Nuclear Medicine, The Children’s Hospital at estmead, NSW
| | - Jenny Ault
- Department of Rehabilitation, The Children’s Hospital at Westmead, NSW
| | - Michael Fietz
- Division of Genetic Medicine, Women’s and Children’s Hospital, North Adelaide, SA
| | - Janice Fletcher
- Division of Genetic Medicine, Women’s and Children’s Hospital, North Adelaide, SA
| | - Ravi Savarirayan
- Genetic Health Victoria, Royal Children’s Hospital, Parkville, Victoria
| | - Meredith Wilson
- Department of Clinical Genetics, The Children’s Hospital at Westmead, NSW
| | - Jim McGill
- Department of Metabolism, Royal Children’s Hospital, Brisbane, Qld
| | | | - Craig Munns
- Department of Endocrinology, The Children’s Hospital at Westmead, NSW
| | - Melanie Alcausin
- Department of Clinical Genetics, The Children’s Hospital at Westmead, NSW
| | | | - David Sillence
- Department of Clinical Genetics, The Children’s Hospital at Westmead, NSW,Discipline of Genetic Medicine, University of Sydney, Camperdown, NSW
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Abstract
The clinical and radiographic features and management of a young person with recently delineated Osteogenesis Imperfecta Type V is described. A female aged 9 years presented with a history of multiple fractures since 3 years of age and bilateral dislocation of the elbows from infancy. She was commenced on a low dose frequent regimen of cyclic intravenous pamidronate, which resulted in progressive improvement in bone density, reduced fracture frequency and remission of symptoms of osteoporosis.
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Affiliation(s)
- F Fleming
- Department of Clinical Genetics, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
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Tanner JT, Arnold D, Ault J, Collier D, Durst RA, Lattuada CP, Lawrence J, Newsome WH, Pope S, Sebranek J, Terry DL, Thiex N. Editorial Board. J AOAC Int 1997. [DOI: 10.1093/jaoac/80.1.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- James T Tanner
- U.S. Food and Drug Administration, HFS 451,200 C St, SW, Washington, DC 20204, USA
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Tanner JT, Arnold D, Ault J, Chamberlain IC, Collier RH, Durst RA, Gorham JR, Jain AV, Lattuada CP, Newsome WH, Sherma J, Terry DL. Editorial Board. J AOAC Int 1996. [DOI: 10.1093/jaoac/79.1.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- James T Tanner
- U.S. Food and Drug Administration, HFS 451, 200 C St, SW, Washington, DC 20204, USA
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McCully KA, Alvarez R, Ault J, Baldwin R, Chau ASY, Fishbeck R, Guira J, Lanier J, Luskin R, McNeal J, Meier E, Runser D, Sherken S, Smith K, Stijve T, Winter J. Committee on Laboratory Quality Assurance. J AOAC Int 1986. [DOI: 10.1093/jaoac/69.2.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Keith A McCully
- Health and Welfare Canada, Field Operations Directorate, Tunney’s Pasture, Ottawa, Ontario, Canada K1A 1B7
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Mccully KA, Alvarez R, Ault J, Chau ASY, Fishbeck RD, Garfield FM, Martin EE, McNeal JE, Sherken S, Smith K. Report of the Committee on Laboratory Quality Assurance. J AOAC Int 1984. [DOI: 10.1093/jaoac/67.2.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Keith A Mccully
- Health and Welfare Canada, Field Operations Directorate, Tunney's Pasture, Ottawa, Ontario, Canada K1A 1B7
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Abstract
The hemolytic plaque assay was adapted to the detection of antibodies to Newcastle disease virus (NDV) in an in vivo, an in vitro system, and a combined in vivo-in vitro system. Several conditions were tested for coupling of sheep erythrocytes to NDV and for the kinetics of plaque formation in the in vivo and in vitro systems. The one set of conditions which provided the best responses is presented. The effect of multiple injections of NDV into mice on plaque formation was optimized.
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