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Kim SM, Kim AS, Ko HJ, Moon H, Choi HI, Song J. Association between Bone Mineral Density and Serum Iron Indices in Premenopausal Women in South Korea. Korean J Fam Med 2020; 41:175-182. [PMID: 32456385 PMCID: PMC7272370 DOI: 10.4082/kjfm.18.0142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 01/09/2019] [Indexed: 01/11/2023] Open
Abstract
Background Osteoporosis is characterized by a decrease in bone mineral density (BMD) and increased risk of fragility fractures. Serum iron level may interact with bone health status. This study investigated the correlations of BMD with serum iron level, hemoglobin level, and total iron-binding capacity (TIBC). Methods We performed a retrospective analysis of data from the medical records of premenopausal women in South Korea. The women’s BMDs and the Z scores of the BMDs were verified using dual-energy X-ray absorption. The participants were stratified into quartiles for analyses of the associations of BMD with serum iron level, TIBC, and hemoglobin level. Results A simple linear regression analysis revealed associations of changes in BMD with iron level (β=-0.001, standard error [SE]=0.001, P<0.001), hemoglobin level (β=0.015, SE=0.003, P<0.001), and TIBC (β=0.001, SE=0.001, P<0.001). This pattern was also observed in a multiple linear regression analysis. A multivariate logistic regression analysis of iron level and TIBC for low BMD revealed odds ratios of 1.005 (P<0.001) and 0.995 (P<0.001), respectively. Conclusion This study demonstrated clear relationships of changes in BMD with serum iron level and TIBC, and thus confirms the usefulness of these markers in the clinical evaluation of iron storage and BMD in younger women.
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Affiliation(s)
- Sung-Min Kim
- Department of Family Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - A-Sol Kim
- Department of Family Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.,Department of Family Medicine, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Hae-Jin Ko
- Department of Family Medicine, Kyungpook National University Hospital, Daegu, Korea.,Department of Family Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hana Moon
- Department of Family Medicine, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Hye-In Choi
- Department of Family Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jieun Song
- Department of Family Medicine, Kyungpook National University Hospital, Daegu, Korea
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2
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D'Anna C, Diplomatico M, Tipo V. Facial palsy in a baby with acute otitis media. Arch Dis Child Educ Pract Ed 2018; 103:155-157. [PMID: 28363956 DOI: 10.1136/archdischild-2017-312743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 02/21/2017] [Indexed: 11/03/2022]
Affiliation(s)
- Carolina D'Anna
- Pediatric Emergency Department, Azienda Ospedaliera di Rilievo Nazionale Santobono-Pausilipon di Napoli, Napoli, Italy
| | - Mario Diplomatico
- Department of Woman, Child and of General and Specialized Surgery, Seconda Università degli Studi di Napoli, Napoli, Italy
| | - Vincenzo Tipo
- Pediatric Emergency Department, Azienda Ospedaliera di Rilievo Nazionale Santobono-Pausilipon di Napoli, Napoli, Italy
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3
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Park KH, Gu DR, Jin SH, Yoon CS, Ko W, Kim YC, Lee SH. Pueraria lobate Inhibits RANKL-Mediated Osteoclastogenesis Via Downregulation of CREB/PGC1β/c-Fos/NFATc1 Signaling. Am J Chin Med 2017; 45:1725-1744. [PMID: 29121799 DOI: 10.1142/s0192415x17500938] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Puerariae radix, the dried root of Pueraria lobate Ohwi, is known to prevent bone loss in ovariectomized mice; however, the precise molecular mechanisms are not understood. In this study, we investigated the effects and underlying mechanisms of action of Puerariae radix extract (PRE) on receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis. PRE dose-dependently inhibited osteoclast differentiation and formation, decreased the bone-resorbing activity of osteoclasts, and downregulated the expression of osteoclast differentiation marker genes. The expression of osteoclastogenic factors produced by PRE-treated osteoblasts such as RANKL, macrophage colony-stimulating factor (M-CSF), and osteoprotegerin (OPG) was comparable to that of untreated (control) cells. However, the formation of osteoclasts via bone marrow cell and calvaria-derived osteoblast co-cultures was suppressed by PRE treatment. Therefore, the inhibitory effects of PRE on osteoclastogenesis clearly targeted osteoclasts, but not osteoblasts. PRE treatment considerably reduced RANKL-induced mitogen-activated protein kinases (MAPKs) activity, especially c-Jun N-terminal kinase, in osteoclast precursor cells. In addition, PRE markedly suppressed cAMP response element-binding protein (CREB) activation and the induction of peroxisome proliferator-activated receptor gamma coactivator 1β (PGC1β), which stimulate osteoclastogenesis - an effect that was not observed for puerarin and 17-β estradiol. Finally, PRE treatment significantly repressed the expression of c-Fos and the nuclear factor of activated T-cells cytoplasmic 1 (NFATc1), which is a master transcription factor for osteoclastogenesis in vitro and in vivo. Overall, these results strongly suggest that PRE is an effective inhibitor of RANKL-induced osteoclastogenesis and may be a potent therapeutic agent for bone-related diseases such as osteoporosis, rheumatoid arthritis, and periodontitis.
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Affiliation(s)
- Keun Ha Park
- * Department of Oral Microbiology and Immunology, College of Dentistry, Wonkwang University, Iksan, Jeonbuk 54538, Republic of Korea
| | - Dong Ryun Gu
- * Department of Oral Microbiology and Immunology, College of Dentistry, Wonkwang University, Iksan, Jeonbuk 54538, Republic of Korea
- † Center for Metabolic Function Regulation (CMFR), School of Medicine, Wonkwang University, Iksan, Jeonbuk 54538, Republic of Korea
| | - Su Hyun Jin
- † Center for Metabolic Function Regulation (CMFR), School of Medicine, Wonkwang University, Iksan, Jeonbuk 54538, Republic of Korea
| | - Chi-Su Yoon
- ‡ Institute of Pharmaceutical Research and Development and Standardized Material Bank for New Botanical Drugs, College of Pharmacy, Wonkwang University, Iksan, Jeonbuk 54538, Republic of Korea
| | - Wonmin Ko
- ‡ Institute of Pharmaceutical Research and Development and Standardized Material Bank for New Botanical Drugs, College of Pharmacy, Wonkwang University, Iksan, Jeonbuk 54538, Republic of Korea
| | - Youn Chul Kim
- ‡ Institute of Pharmaceutical Research and Development and Standardized Material Bank for New Botanical Drugs, College of Pharmacy, Wonkwang University, Iksan, Jeonbuk 54538, Republic of Korea
| | - Seoung Hoon Lee
- * Department of Oral Microbiology and Immunology, College of Dentistry, Wonkwang University, Iksan, Jeonbuk 54538, Republic of Korea
- † Center for Metabolic Function Regulation (CMFR), School of Medicine, Wonkwang University, Iksan, Jeonbuk 54538, Republic of Korea
- § Institute of Biomaterials & Implant, Wonkwang University, Iksan, Jeonbuk 54538, Republic of Korea
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4
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Afinowi RA, Chaturvedi A, Cattermole HR. Diagnostic use of intramedullary reaming biopsy in metastatic long bone disease. Ann R Coll Surg Engl 2017; 99:452-455. [PMID: 28660831 PMCID: PMC5696972 DOI: 10.1308/rcsann.2017.0049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Bone is the third most common site of metastasis. A histological diagnosis is important in guiding therapy and prognosis. In up to 15% of cases of metastatic disease, the primary tumour remains unknown. This emphasises the importance of adequate, reliable and accurate sampling when performing any type of biopsy. Reaming biopsy is commonly performed during intramedullary nailing of metastatic long-bone disease but there is little published evidence on the diagnostic use and reliability of this technique. AIMS AND METHODS We reviewed 49 cases of confirmed metastatic bone disease to determine adequacy for analysis, diagnostic accuracy and factors affecting reliability. RESULTS Adequate tissue for histopathological analysis was obtained in 96% of cases but metastasis was confirmed in only 51% of cases. The presence of a pathological fracture had no effect on accuracy of the results but metastasis was more likely to be missed in the presence of tissue crushing and or necrosis (P = 0.015). DISCUSSION This study determines the use and accuracy of bone reaming biopsy in metastatic disease and, to the best of our knowledge, is the only study determining the effect of additional factors such as the presence of a pathological fracture and tissue necrosis or crushing on the diagnostic accuracy of this technique. CONCLUSIONS In spite of adequate tissue sampling, the diagnostic accuracy and, hence, reliability of intramedullary reaming biopsy in metastatic bone disease is less than optimal. A reaming histopathology report suggesting no evident metastasis should always be taken in clinical context.
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Affiliation(s)
- RA Afinowi
- Hull and East Yorkshire Hospitals NHS Trust, Department of Trauma and Orthopaedic Surgery, Hull, UK
| | - A Chaturvedi
- Hull and East Yorkshire Hospitals NHS Trust, Department of Trauma and Orthopaedic Surgery, Hull, UK
| | - HR Cattermole
- Hull and East Yorkshire Hospitals NHS Trust, Department of Trauma and Orthopaedic Surgery, Hull, UK
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5
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Affiliation(s)
- Julia Judd
- Department of Paediatric Orthopaedics, Southampton Children's Hospital, University Hospital Southampton, Southampton, Hampshire, UK
| | - Aexander Aarvold
- Department of Paediatric Orthopaedics, Southampton Children's Hospital, University Hospital Southampton, Southampton, Hampshire, UK
| | - Nicholas M P Clarke
- Department of Paediatric Orthopaedics, Southampton Children's Hospital, University Hospital Southampton, Southampton, Hampshire, UK
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6
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Affiliation(s)
- Nick Bishop
- Department of Human Metabolism, University of Sheffield, Sheffield, UK
| | - Craig F Munns
- Department ofEndocrinology, The Children's Hospital at Westmead, Westmead, New South Wales, Australia,Department of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University, Graduate School of Medicine, Suita, Osaka, Japan
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7
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Amin NL, James RM, Phillips R. QUESTION 1: Should we be using bisphosphonates for osteonecrosis complicating childhood acute lymphoblastic leukaemia? Arch Dis Child 2016; 101:287-90. [PMID: 26768828 DOI: 10.1136/archdischild-2015-309934] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 12/16/2015] [Indexed: 11/03/2022]
Affiliation(s)
- Nadia Laila Amin
- Department of Paediatric Endocrinology, Leeds General Infirmary, Leeds, West Yorkshire, UK Department of Paediatric Haematology and Oncology, Leeds Teaching Hospitals NHS Trust, York, UK
| | - Rebecca M James
- Department of Paediatric Haematology and Oncology, Leeds Teaching Hospitals NHS Trust, York, UK
| | - Robert Phillips
- Department of Paediatric Haematology and Oncology, Leeds Teaching Hospitals NHS Trust, York, UK Centre for Reviews and Dissemination, York, UK
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8
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Abstract
The classical clinical consequence of vitamin D deficiency is osteomalacia, presenting as rickets in children. This remains a common problem in parts of the Middle East and the Indian subcontinent, and occurs when serum 25-hydroxyvitamin D levels are <25 nmol/L. Osteomalacia remains the only problem that is unequivocally a consequence of vitamin D deficiency. Low levels of 25-hydroxyvitamin D are observed in a wide range of conditions, but consistent trial evidence of amelioration of these conditions with vitamin D is lacking. Monotherapy with vitamin D has not been found to be effective in meta-analyses of trials assessing its effects on bone density, fractures or falls. At present, supplements should be advised for individuals at risk of having serum 25-hydroxyvitamin D levels in the 25-40 nmol/L range, or below, with a view to prevention of osteomalacia.
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Affiliation(s)
- Ian R Reid
- University of Auckland, Auckland, New Zealand Department of Endocrinology, Auckland District Health Board, Auckland, New Zealand
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9
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Abstract
Vitamin D is vital for bone health and its deficiency deemed as a disease of the past has re-emerged as an important health concern. Exposure of the skin to solar ultraviolet B radiation is the major source of vitamin D and only a small proportion is derived from dietary intake. We review the various factors that influence the cutaneous synthesis of vitamin D and the recommendations regarding safe sun exposure and dietary supplementation to achieve adequate vitamin D levels proposed for optimal bone health.
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Affiliation(s)
- Vrinda Saraff
- Department of Endocrinology and Diabetes, Birmingham Children's Hospital, Birmingham, UK
| | - Nick Shaw
- Department of Endocrinology and Diabetes, Birmingham Children's Hospital, Birmingham, UK
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10
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Abstract
The term 'bone strength' is often used to explain why some children's bones fracture while others do not. Bone strength describes the general integrity of bone; a complex organ with multiple structural levels and an array of biomechanical properties. Key biomechanical properties of bone include stiffness, toughness, ductility and mechanical strength. When measured in bone tissue, these properties are known as the intrinsic biomechanical properties of bone, while the extrinsic biomechanical properties reflect the structural behaviour of a whole bone. The fine balance between various and often opposing intrinsic and extrinsic biomechanical properties of bone is crucial for fracture resistance. When clinically evaluating a child with a fracture, an understanding of basic bone biomechanics helps determine the likely mechanism of injury and whether underlying reduced fracture resistance exists.
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Affiliation(s)
- Lydia Forestier-Zhang
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK Oxford University Hospitals NHS Trust, Oxford, UK Academic Unit of Child Health, Department of Human Metabolism, University of Sheffield, Sheffield, UK
| | - Nick Bishop
- Academic Unit of Child Health, Department of Human Metabolism, University of Sheffield, Sheffield, UK Sheffield Children's Hospital, Sheffield, UK
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11
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Affiliation(s)
- Lucy Fullerton
- Department of Child Health, Royal Free Foundation Hospital NHS Trust, London, UK
| | - Lauren Huckerby
- Department of Child Health, Royal Free Foundation Hospital NHS Trust, London, UK
| | - Minal Gandhi
- Department of Child Health, Royal Free Foundation Hospital NHS Trust, London, UK
| | - Farrah Jabeen
- Department of Radiology, Royal Free Foundation Hospital NHS Trust, London, UK
| | - Santanu Maity
- Department of Child Health, Royal Free Foundation Hospital NHS Trust, London, UK
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12
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Piona C, Maines E, Morandi G, Gaudino R, Cavarzere P, Consolo U, Boner A. Painless bilateral swelling of the face: think about cherubism. Arch Dis Child 2015; 100:971-2. [PMID: 26245886 DOI: 10.1136/archdischild-2015-308914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2015] [Indexed: 11/03/2022]
Affiliation(s)
- Claudia Piona
- Department of Life and Reproduction Sciences, Pediatric Clinic, University of Verona, Verona, Italy
| | - Evelina Maines
- Department of Life and Reproduction Sciences, Pediatric Clinic, University of Verona, Verona, Italy
| | - Grazia Morandi
- Department of Life and Reproduction Sciences, Pediatric Clinic, University of Verona, Verona, Italy
| | - Rossella Gaudino
- Department of Life and Reproduction Sciences, Pediatric Clinic, University of Verona, Verona, Italy
| | - Paolo Cavarzere
- Department of Life and Reproduction Sciences, Pediatric Clinic, University of Verona, Verona, Italy
| | - Ugo Consolo
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | - Attilio Boner
- Department of Life and Reproduction Sciences, Pediatric Clinic, University of Verona, Verona, Italy
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13
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Fitzpatrick P, Leonard J, Twomey E, Malone A, Nademi Z, Jackson M, Abinun M, Leahy TR, Gavin PJ. Severe combined immunodeficiency syndrome presenting with disseminated BCG infection. Arch Dis Child 2015; 100:891. [PMID: 26130382 DOI: 10.1136/archdischild-2015-308598] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/22/2015] [Indexed: 11/03/2022]
Affiliation(s)
| | | | | | | | | | | | - Mario Abinun
- Newcastle upon Tyne Hospital Trust, Newcastle, UK
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14
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Affiliation(s)
- Ethan S Sen
- Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
| | - John P Moppett
- Department of Paediatric Haematology and Oncology, Bristol Royal Hospital for Children, Bristol, UK
| | - A V Ramanan
- Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
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15
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Aupiais C, Ilharreborde B, Doit C, Blachier A, Desmarest M, Job-Deslandre C, Mazda K, Faye A, Bonacorsi S, Alberti C, Lorrot M. Aetiology of arthritis in hospitalised children: an observational study. Arch Dis Child 2015; 100:742-7. [PMID: 25732253 DOI: 10.1136/archdischild-2014-307490] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [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] [Received: 09/05/2014] [Accepted: 02/09/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND AND OBJECTIVE Arthritis in children has many causes and includes septic and viral arthritis, reactive arthritis and juvenile idiopathic arthritis (JIA). We aimed to describe the different types of arthritis among children hospitalised for a first episode of arthritis. DESIGN Retrospective, descriptive case series study. SETTING A French tertiary care centre. PATIENTS Children under 16 years of age hospitalised for an arthritis episode between 1 January 2008 and 31 December 2009. MAIN OUTCOME MEASURES Demographic and clinical features were compared with χ(2) or Fisher's exact tests and non-parametric tests. RESULTS 173 children were hospitalised for a first episode of arthritis during the study period, with a male/female ratio of 1.14. The most frequent cause of hospitalisation was septic arthritis (43.4% of cases, 69.3% of which were due to Kingella kingae and 10.7% to Staphylococcus aureus). JIA was responsible for 8.1% of cases and arthritis without any definitive diagnosis for 40.4%. Median age at diagnosis was 2.7 years (IQR 0.3-14.6) and was lower in the septic arthritis group (1.5 years; 1.1-3.4) than in the JIA group (4.7 years; 2.5-10.9) (p<0.01). Septic arthritis involved a single joint in 97.3% of cases, while JIA involved four joints in 14.3% of cases and two to four joints in 28.6% of cases (p<0.01). CONCLUSIONS Septic arthritis was the most frequent cause of arthritis in hospitalised children. Despite the increasing application of microbiological molecular methods to synovial fluid analysis, further measures are required to improve the diagnosis of arthritis of unknown cause.
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Affiliation(s)
- Camille Aupiais
- Unité d'Epidémiologie clinique, AP-HP, Hôpital Robert Debré, Paris, France Inserm, U1123, Paris, France Univ Denis Diderot Paris 7, Sorbonne Paris Cité, Paris, France
| | - Brice Ilharreborde
- Univ Denis Diderot Paris 7, Sorbonne Paris Cité, Paris, France Service d'orthopédie pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France
| | - Catherine Doit
- Service de Microbiologie, AP-HP, Hôpital Robert Debré, Paris, France
| | - Audrey Blachier
- Département informatique médicale, AP-HP, Hôpital Robert Debré, Paris, France
| | - Marie Desmarest
- Service d'Accueil des Urgences pédiatriques, AP-HP, Hôpital Robert Debré, Paris, France
| | - Chantal Job-Deslandre
- Service de rhumatologie, AP-HP, Hôpital Cochin, Paris, France Université René Descartes Paris 5, Paris, France
| | - Keyvan Mazda
- Univ Denis Diderot Paris 7, Sorbonne Paris Cité, Paris, France Service d'orthopédie pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France
| | - Albert Faye
- Inserm, U1123, Paris, France Univ Denis Diderot Paris 7, Sorbonne Paris Cité, Paris, France Service de Pédiatrie générale, AP-HP, Hôpital Robert Debré, Paris, France
| | - Stéphane Bonacorsi
- Univ Denis Diderot Paris 7, Sorbonne Paris Cité, Paris, France Service de Microbiologie, AP-HP, Hôpital Robert Debré, Paris, France
| | - Corinne Alberti
- Unité d'Epidémiologie clinique, AP-HP, Hôpital Robert Debré, Paris, France Inserm, U1123, Paris, France Univ Denis Diderot Paris 7, Sorbonne Paris Cité, Paris, France
| | - Mathie Lorrot
- Inserm, U1123, Paris, France Univ Denis Diderot Paris 7, Sorbonne Paris Cité, Paris, France Service de Pédiatrie générale, AP-HP, Hôpital Robert Debré, Paris, France
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Abstract
UNLABELLED Back pain in childhood is relatively unusual, although as a child matures through adolescence it becomes much more common. At any age, potentially serious illnesses need to be excluded. There are some useful red flags to be aware of when taking a history and performing an examination. We outline a systematic approach when faced with this clinical presentation in a general paediatric setting, with suggestions for initial investigations and when to consider referral to a specialist. OBJECTIVE To provide a structured approach for the paediatrician to appropriately manage a child or adolescent who presents with back pain. METHOD Review of the literature and description of the approach commonly adopted in a paediatric setting. Extended matching case questions are used to help the reader test their understanding. CONCLUSIONS A focused history, specifically asking about red flags, and a careful examination are essential to reach an appropriate differential diagnosis and management plan. Onward referral to a specialist may be required.
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Affiliation(s)
- Mary Cruikshank
- Department of Paediatric Rheumatology, Royal Hospital for Sick Children, Edinburgh, UK
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17
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Affiliation(s)
- Jeremy Allgrove
- Consultant Paediatric Endocrinologist, Barts Health NHS Trust, Royal London Hospital, London, UK Honorary Consultant Paediatric Endocrinologist, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - M Zulf Mughal
- Consultant in Paediatric Bone Disorders & Honorary Professor of Child Health, Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
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18
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Nikolica G, Badnjar Z, Cadjenovic T, Raceta-Masic D. Primary extra nodal Hodgkin disease: Bone presentation. Pol J Radiol 2014; 79:91-3. [PMID: 24808935 PMCID: PMC4011671 DOI: 10.12659/pjr.884036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 02/11/2013] [Indexed: 11/16/2022] Open
Abstract
Background Extra nodal and extra lymphatic propagation of Hodgkin’s disease is a characteristic of the fourth stage of disease when the organs are affected. Primary appearances of the disease outside the lymph node is a rare event. Therefore, it makes diagnostic problem. Skeletal system is possible localization of primary extra nodal Hodgkin’s disease. Case Report Women, 42-years-old, was admitted to hospital because of swelling and pain in the right shoulder. After imaging and histological examination diagnosed Hodgkin’s nodular sclerosing histological subtype disease has been established. The patient starts to receive chemotherapy. Conclusions Primary extra nodal Hodgkin’s disease of bone is manifested with painful swelling in geared area. Imaging method shows destruction of the affected bone, with swelling of the soft tissues. Propagation in soft tissue is not accompanied by their destruction, but rather manifested swelling of the surrounding soft tissue.
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Affiliation(s)
- Goran Nikolica
- Department of Radiology, Montenegrin Academy of Sciences and Arts, Podgorica, Montenegro
| | - Zorka Badnjar
- Department of Radiology, Montenegrin Academy of Sciences and Arts, Podgorica, Montenegro
| | - Tanja Cadjenovic
- Department of Radiology, Montenegrin Academy of Sciences and Arts, Podgorica, Montenegro
| | - Dijana Raceta-Masic
- Department of Radiology, Montenegrin Academy of Sciences and Arts, Podgorica, Montenegro
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19
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Abstract
OBJECTIVE We examined the clinical and genetic features of hypophosphatasia (HPP) in Japanese patients. HPP is a rare metabolic bone disorder of bone mineralisation caused by mutations in the liver/bone/kidney alkaline phosphatase (ALPL) gene, which encodes tissue-non-specific alkaline phosphatase isoenzyme. METHODS We retrospectively investigate the incidence and clinical features of 52 patients with paediatric HPP who were born between 1999 and 2010. Mutations of the ALPL gene were analysed in 31 patients. RESULTS The annual incidence of perinatal lethal HPP (PLH) was estimated to be 2-3/1 000 000 births. The most frequent clinical type was PLH followed by prenatal benign. In addition to bone symptoms, cerebral manifestations were frequently observed including convulsion, mental retardation, deafness and short stature with growth hormone deficiency. Respiratory failure was the most significant predictor of a poor prognosis for PLH. The first and second most frequent mutations in the ALPL gene were c.1559delT and c.T979C (p.F327L), respectively. The c.1559delT homozygous mutation was lethal with respiratory failure. Patients with the p.F327L compound heterozygous mutation had the different non-lethal type with short stature and a gradual improvement in ALP level and bone mineralisation. CONCLUSIONS The most frequent clinical type was the PLH type with prognosis related to respiratory failure, biochemical/radiological changes and ALPL mutations. Cerebral manifestations frequently occurred. Genotype-phenotype correlations were associated with specific outcomes in the PLH type, whereas different clinical features were associated with the same genotype in the non-lethal type.
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Affiliation(s)
- Takeshi Taketani
- Division of Blood Transfusion, Shimane University Hospital, , Shimane, Japan
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20
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Duggan SN, Smyth ND, Murphy A, Macnaughton D, O'Keefe SJ, Conlon KC. High prevalence of osteoporosis in patients with chronic pancreatitis: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2014; 12:219-28. [PMID: 23856359 DOI: 10.1016/j.cgh.2013.06.016] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 06/19/2013] [Accepted: 06/19/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Patients with chronic pancreatitis may be at high risk for osteoporosis and osteopenia. We performed a systematic review and meta-analysis to determine the prevalence of osteoporosis and osteopenia in patients with chronic pancreatitis. METHODS Articles were identified from MEDLINE, EMBASE, and SCOPUS databases (through October 2012) and a manual search of the literature. The primary outcome measure was bone density, measured by dual-energy X-ray absorptiometry (T-score or Z-score). When available, data on the prevalence of osteopenia, bone mineral density, and bone mineral content also were recorded. RESULTS Ten studies including 513 patients were eligible for inclusion. Based on a random-effects model, the pooled prevalence rate for osteoporosis among patients with chronic pancreatitis was 23.4% (95% confidence interval, 16.6-32.0). The pooled prevalence for osteopenia was 39.8% (95% confidence interval, 29.1-51.6). The pooled prevalence rate for either osteoporosis or osteopenia was 65% (95% confidence interval, 54.7-74.0). CONCLUSIONS Based on meta-analysis, almost 1 of 4 patients with chronic pancreatitis have osteoporosis, and almost two-thirds of patients have either osteoporosis or osteopenia. Osteoporosis and osteopenia are underappreciated sources of morbidity in patients with chronic pancreatitis. Bone health management guidelines are urgently required in patients with chronic pancreatitis.
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Affiliation(s)
- Bharathi Pai
- Department of Paediatrics, George Eliot Hospital, Nuneaton, UK
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Mohd Daud K. Challenges in recognising significant back pain in a child with learning difficulties. Arch Dis Child 2013; 98:697. [PMID: 23645813 DOI: 10.1136/archdischild-2013-304097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Karina Mohd Daud
- Department of Paediatrics, Chase Farm Hospital, The Ridgeway, Enfield, Middlesex EN2 8JL, UK.
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