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  • 1
    ISSN: 1432-0827
    Keywords: Key words: Broadband ultrasound attenuation — Contact ultrasound bone analyzer — Bone mineral density — Dual energy X-ray absorptiometry — Chronic rheumatic diseases.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract. Osteoporosis is a common complication in children with chronic rheumatic diseases (CRD). Although dual energy X-ray absorptiometry (DXA) is increasingly being used to determine bone mineral density (BMD) in children, it exposes the subject to ionizing radiation and does not provide a measure of true bone density; in fact, in growing bones the increase in BMD is mainly caused by the increase in bone size. In recent years, quantitative ultrasound techniques (QUS) have been used in radiation-free assessment of bone density and ``bone quality'' by measurement of the ultrasound waves attenuation by bone (BUA). In the present study we made a direct comparison of BUA in the calcaneum, determined by the pediatric contact ultrasound bone analyzer (CUBA) with lumbar BMD measured by DXA, in a group of 6–18-year-old patients with CRD. The study group consisted of 53 patients affected with juvenile rheumatoid arthritis (n = 29), systemic lupus erythematosus (n = 13), and juvenile dermatomyositis (n = 11). Mean age was 13.02 ± 2.69 years. In 22 patients (19 girls, 3 boys) both DXA and CUBA were repeated after 1 year in order to assess the mean percentage rate of BMD and BUA change over this time. Both lumbar spine BMD and calcaneal BUA measurements were lower in the CRD patients compared with a control group (P 〈 0.001). Calcaneal BUA was significantly correlated (r = 0.83, P 〈 0.001) with lumbar spine BMD. Age and sex correction (Z-score) did not change the relationship between BUA and BMD (r = 0.80, P 〈 0.001). A significant correlation between the mean percentage of variation (Δ%) of BMD and BUA (r = 0.76, P 〈 0.001) was also demonstrated in the 22 patients who were evaluated prospectively. Portability, ease of use, lower cost, and absence of radiation make CUBA a promising means of evaluating BMD in children.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric cardiology 21 (2000), S. 395-396 
    ISSN: 1432-1971
    Keywords: Key words: Idiopathic recurrent pericarditis — Colchicine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. A case of an adolescent patient with idiopathic recurrent pericarditis is reported. On several occasions during a period of 3.5 years he was shown to be dependent on corticosteroid therapy, and he became cushingoid. After corticosteroids were substituted with colchicine, no further relapses occurred during a period of 29 months. In accordance with the first published pediatric results, colchicine represents an effective and well-tolerated alternative therapy for recurrent idiopathic pericarditis and might replace prolonged administration of corticosteroids.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1433-2965
    Keywords: Key words:Bone mass – Bone mineral density – Children – Methotrexate – Rheumatoid arthritis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: Thirty-two children affected by juvenile rheumatoid arthritis (JRA) were studied with serial measurements of bone mass for an average of 18 months, to evaluate the effects of long-term methotrexate (MTX) treatment on bone. Bone mineral density (BMD) was measured on lumbar spine and total body. During MTX therapy some increase in BMD was observed, though this was smaller than in a control group of healthy children. Axial (spine and trunk) and appendicular (upper and lower limbs) BMD showed similar increases. BMD, either as an absolute value or as a percent variation from baseline, did not correlate with either MTX dose or length of therapy. In children treated also with corticosteroids, these drugs negatively influenced bone mass increase. The main determinant of absolute spine BMD value appeared to be weight, while height and lean mass seemed to be the determinants of total body BMD. Pubertal stage and disease activity significantly influenced the yearly change in BMD. In conclusion, our data suggest that long-term, low-dose therapy with MTX does not induce osteopenia in children with JRA.
    Type of Medium: Electronic Resource
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