ABSTRACT
Fifty-nine children aged 18 to 47 months with normal and elevated blood lead levels had bone mineral density (BMD in gm/cm2) and bone mineral content (BMC in gm/cm) measured using the technique of single photon absorptiometry of the radius shaft. No normative data are available for black children of this age group. Moderate elevations of blood lead were not found to influence bone mineralization. The BMC of the study children was significantly higher than the published values for white children of the same age. We found no statistical difference between the bone mineral density of males and females in this age group.
Subject(s)
Black People , Bone Density/physiology , Absorptiometry, Photon , Body Height , Body Weight , Child, Preschool , Female , Humans , Infant , Lead/blood , Lead Poisoning/ethnology , Lead Poisoning/physiopathology , Male , Radius , Reference Values , Regression Analysis , White PeopleABSTRACT
Children with dystrophic forms of epidermolysis bullosa and oropharyngeal lesions often evidence the features of chronic malnutrition. Nutritional assessment plays a key role in the long-term management of these patients.
Subject(s)
Epidermolysis Bullosa/complications , Nutrition Disorders/diet therapy , Anthropometry , Child , Deficiency Diseases/etiology , Digestive System Diseases/etiology , Energy Intake , Epidermolysis Bullosa/diet therapy , Epidermolysis Bullosa/metabolism , Growth Disorders/etiology , Humans , Nutrition Disorders/etiology , Nutritional RequirementsABSTRACT
The clinical features of epidermolysis bullosa (EB) include oral, pharyngeal, gastrointestinal, and total-body blistering. This results in the potential for decreased oral intake, malabsorption, anemia, and depressed visceral protein stores, and a multifactorial etiology for the development of malnutrition and growth retardation. Thus, it was the purpose of this study to document the nutritional and metabolic profile of seven children with junctional or recessive dystrophic EB as compared to seven age- and sex-matched controls. Each child underwent a comprehensive nutritional assessment, including evaluation of anthropometric, dietary, and biochemical values and determination of resting energy expenditures. This study demonstrated that subjects with EB are statistically different for all anthropometric values studied and represent a population suffering from the effects of acute and chronic malnutrition. Nutrient deficiencies were reported for zinc, magnesium, calcium, potassium, and iron; vitamines A, D, E, B1, B12, and B6; protein, and calories. Comparison of laboratory values revealed significantly lower values for hemoglobin, hematocrit, and zinc. This research illustrates the magnitude of the growth deficits, and nutrient and biochemical deficiencies present in children with EB. The results provide a strong argument for the value of nutritional assessment and intervention and their potential impact in this population. Optimizing nutritional status may be one viable method of improving the morbidity and mortality associated with the disease and ultimately improving the overall quality of life.
