Endothelial progenitor cell levels in juvenile idiopathic arthritis patients: effects of anti-inflammatory therapies.

BACKGROUND: Juvenile idiopathic arthritis (JIA), similarly to other arthritides, can be associated with damage of endothelial layer of which structure and function is dependent on reparative properties of endothelial progenitor cells (EPC). To date, it remained unknown whether EPC numbers are altered in young JIA patients and whether on-going anti-inflammatory therapies could exert positive effects on these progenitor cells. METHODS: We performed a quantitative analysis of EPC numbers in 25 patients diagnosed with JIA according to International League of Associations for Rheumatism (ILAR) criteria [age 11.50 (7.50-15.00) years] in a broad context of inflammatory and cardiovascular parameters as well as different types of anti-inflammatory treatments. 11 healthy children [age 13.00 (11.00-14.00) years] were recruited as a control group. RESULTS: We demonstrated that EPC numbers were similar in JIA patients and control subjects (0.02% vs. 0.05%, respectively, p = 0.37). EPC levels in JIA patients were negatively correlated with index of insulin resistance (rho = -0.458, p = 0.021), endogenous insulin (rho = -0.472, p = 0.017), triglyceride (rho = -0.438, p = 0.029) and TNF-alpha levels (rho = -0.446, p = 0.026). Notably, glucocorticoid (GC) therapy, was associated with detection of decreased EPC levels in JIA patients (p = 0.023). In contrast, methothrexate (MTX) and etanercept therapy in JIA patients did not affect EPC levels (p = 0.92 and p = 0.08, respectively). CONCLUSIONS: We found that EPC numbers are maintained at normal levels in JIA patients and are not enhanced by disease-specific anti-inflammatory treatments.

Subclinical cardiovascular system changes in obese patients with juvenile idiopathic arthritis.

OBJECTIVE: We aimed to determine the prevalence of excess body mass in juvenile idiopathic arthritis (JIA) children and to investigate the influence of obesity into the early, subclinical changes in cardiovascular system in these patients. METHODS: Fifty-eight JIA patients, aged median 13 years, were compared to 36 healthy controls. Traditional cardiovascular risk factors and inflammatory markers (hsCRP, IL-6, TNF α, adiponectin) were studied together with IMT (intima-media thickness), FMD (flow mediated dilation), and LVMi (left ventricle mass index) as surrogate markers of subclinical atherosclerosis. RESULTS: Thirteen JIA children (22%) were obese and had increased systolic blood pressure, cholesterol, triglycerides, insulin, HOMA, hsCRP, and IL-6 compared to nonobese JIA and controls. FMD was decreased compared to nonobese JIA and controls, whereas IMT and LVMi were increased. In multivariate regression analysis, TNF α, SDS-BMI, and systolic blood pressure were independent predictors of early CV changes in JIA. CONCLUSIONS: Coincident obesity is common in JIA children and is associated with insulin resistance, dyslipidemia, and increased levels of inflammatory markers leading to early changes in cardiovascular system. Thus, medical care of children with JIA should include strategies preventing cardiovascular disease by maintenance of adequate body weight.

[Analysis of body composition with the use of bioimpedance in children with type 1 diabetes]. / Analiza skladu ciala z uzyciem metody bioimpedancji u dzieci z cukrzyca typu 1.

INTRODUCTION: Patients with diagnosed type 1 diabetes are a group particularly exposed to cardiovascular complications related to obesity. According to some previous data, one of the useful methods to analyze body composition may be a method of bioelectrical impedance. AIM OF THE STUDY: The aim of this research was to make an attempt of finding a correlation between anthropometric indicators and results of lipids profile and data obtained from bioelectrical impedance tests in children with diabetes. MATERIAL AND METHODS: The research sample comprised of 104 children with diabetes type 1 and 313 children without diabetes (a reference group). Anthropometric measurements were made in both groups. Furthermore data from lipids profile results was collected, as well as data from bioelectrical impedance analysis, such as: percentage and quantity (in kilograms) content of adipose tissue, fat-free body mass and total water content in the body. RESULTS: The tested and the reference groups were not different in respect of percentage content of adipose tissue, fat mass, fat-free body mass and total water content in the body. Substantially lower fat mass was noticed among children with overweight or obesity and diabetes than in the control children with overweight/obesity. In the whole sample a connection between percentage fat content and fat mass and standardized body mass index and waist circumference was noticed. The connection was stronger in the reference group, than among children with diabetes. Correlation between percentage content of adipose tissue with the fraction HLD-cholesterol and LDL-cholesterol and values of blood pressure were observed in the whole sample. CONCLUSIONS: The results of our research the confirm correlation between anthropometric parameters and the data collected from bioelectrical impedance. Those connections are, however, stronger in the group of children without diabetes than with diabetes, which questions the usefulness of this method in evaluation of adipose tissue among children treated with insulin.

Peripheral blood T lymphocyte subsets in children with congenital asplenia.

The aim of the current study was to examine whether a congenital lack of the spleen changes distribution, state of activation and function of peripheral lymphocyte T subsets. Seven children with congenital asplenia (CA) aged 1.5-17 years and seven age-matched controls were tested. By triple-color flow cytometry we examined: (1) the expression of CD3(+), CD4(+), CD8(+), CD19(+), and CD56(+) on lymphocytes; (2) the distribution of CD45RA(+) and CD45RO(+) in CD4(+) and CD8(+); (3) the expression of CD27(+) in the CD4(+) and CD8(+) T-cell-bearing CD45RA(+), CD45RO(+), or CD45RB(+). Lymphocyte proliferative responses and cytokines production (IFN-gamma, IL-6, TNF-alfa, and IL-10) in anti-CD3-induced peripheral blood mononuclear cells were tested. The results indicate (1) a normal distribution of the basic lymphocyte subsets, (2) low CD3(+)/CD8(+) percentage but expressing CD8(+high) and non-significantly elevated CD4(+)/CD8(+) ratio, (3) CD45RA(+high) and CD27(+high) in the CD4(+) and CD8(+) T cell, and (4) CD45RB(+high) in the CD4(+) and CD45RO(+high) in the CD8(+). The distribution of CD27(+) in the CD45RA(+) and CD45RO(+) CD4(+) T cells remained unchanged. However, the percentage of CD8(+)/CD45RO(+)/CD27(+) T cells tended to be elevated. Altogether, these data indicate that CA is connected with (1) the presence CD4(+) T cells expressing the "naive" phenotype (CD45RA(+high) RB(+high) and CD27(+high)), (2) high numbers of activated CD8(+) T cells shifted toward the memory phenotype (CD45RO(+high)) but still showing high CD27(+) expression, which may indicate failure in T CD8(+) cytotoxic effectors differentiation, and (3) a tendency to the rather pro-inflammatory status of cells, low IL-10 expression, and suboptimal lymphocytes responses to mitogenic stimulation.

Impact of lipophilic antioxidants and level of antibodies against oxidized low-density lipoprotein in Polish children with phenylketonuria.

The treatment of phenylketonuria (PKU) patients constitutes a phenylalanine (Phe) intake restriction in their diet, which is achieved by adding a special Phe-free amino acid mixture to the diet. It has been reported that this diet could have some micronutrient deficiency. Several authors have also reported an increased oxidative stress or impaired antioxidant status in human and experimental PKU. Our project assessed the concentrations of retinol, alpha-tocopherol, coenzyme Q10, and anti-oxidized low-density lipoprotein (ox-LDL) antibodies in PKU children's plasma. It was found that retinol concentration in PKU children remains within the norm despite a low intake. The lower plasma alpha-tocopherol concentration in PKU children compared with normal children was associated with the lower level of antibodies against ox-LDL. This raises the question whether higher than observed circulatory alpha-tocopherol is indeed beneficial to lower plasma ox-LDL levels. Further studies are needed to explain the genetic factor in PKU patients (e.g., CD36/FAT polymorphism gene). The open clinical question is whether daily supplementation of alpha-tocopherol changes the PKU patients' level of antibodies against ox-LDL.

Neutrophil phenotypic characteristics in children with congenital asplenia and splenectomized for hereditary spherocytosis.

The spleen plays an important role in the granulocyte homeostasis due to such mechanisms as pooling, elimination of senescent cells and regulatory effects on granulocyte renewal in the bone marrow. The expression profile of granulocyte receptors was tested in children with congenital asplenia, and splenectomized for spherocytosis. Receptors tested included those appearing with maturation (CD16, CD11b, CD11c, TREM-1), disappearing (CD54, CD49d, CD64) and maintained during maturation (CD11a, CD45). In general, we found that the circulating granulocyte pool in the asplenic patients had phenotypical features of highly matured but not apoptotic neutrophils with a significantly elevated expression of CD16 (CD16(high)), tendency to a lower expression of CD45 (CD45(low)) and an unchanged expression of CD64 (and other markers indicating systemic inflammatory reactions). The high fluorescence intensity of CD11b,c, and TREM-1 in the congenital asplenia may indicate a potentially elevated pro-inflammatory status of granulocytes, possibly due to the low activity of vagus nerve and spleen-dependent cholinergic anti-inflammatory pathway.

A potential pathogenic role of oxalate in autism.

BACKGROUND: Although autistic spectrum disorders (ASD) are a strongly genetic condition certain metabolic disturbances may contribute to clinical features. Metabolism of oxalate in children with ASD has not yet been studied. AIM: The objective was to determine oxalate levels in plasma and urine in autistic children in relation to other urinary parameters. METHOD: In this cross-sectional study, plasma oxalate (using enzymatic method with oxalate oxidase) and spontaneous urinary calcium oxalate (CaOx) crystallization (based on the Bonn-Risk-Index, BRI) were determined in 36 children and adolescents with ASD (26 boys, 10 girls) aged 2-18 years and compared with 60 healthy non-autistic children matched by age, gender and anthropometric traits. RESULTS: Children with ASD demonstrated 3-fold greater plasma oxalate levels [5.60 (5th-95th percentile: 3.47-7.51)] compared with reference [(1.84 (5th-95th percentile: 0.50-4.70) µmol/L (p < 0.05)] and 2.5-fold greater urinary oxalate concentrations (p < 0.05). No differences between the two groups were found in urinary pH, citraturia, calciuria or adjusted CaOx crystallization rates based on BRI. Despite significant hyperoxaluria no evidence of kidney stone disease or lithogenic risk was observed in these individuals. CONCLUSIONS: Hyperoxalemia and hyperoxaluria may be involved in the pathogenesis of ASD in children. Whether this is a result of impaired renal excretion or an extensive intestinal absorption, or both, or whether Ox may cross the blood brain barrier and disturb CNS function in the autistic children remains unclear. This appears to be the first report of plasma and urinary oxalate in childhood autism.

Thigh circumference as a useful predictor of body fat in adolescent girls with anorexia nervosa.

BACKGROUND/AIM: Girls with anorexia nervosa (AN) demonstrate severe depletion of body fat. The aim of this study was to determine an accurate anthropometric measurement for clinical assessment of fat depletion in girls with AN in connection with body composition measured by dual-energy X-ray absorptiometry (DXA). METHODS: In 64 female AN patients aged 12.8-23.1 years (mean 16.0 ± 1.8), body mass index (BMI), skinfold thickness (subscapular, abdominal and triceps), mid-upper arm and thigh circumference, fat mass (FM) and lean mass were determined and compared with the data of 71 controls. RESULTS: Girls with AN had lower anthropometric traits and were fat depleted compared to controls (14.9 ± 7.3 vs. 27.4 ± 6.4% of FM using DXA; all p < 0.001). BMI, thigh circumference and subscapular skinfold thickness demonstrated a very similar predictive value for DXA assessment of body fat. Based on the receiver-operating characteristic curve analysis and the determination of the positive predictive value, thigh circumference appeared the most specific and sensitive anthropometric predictor of fatness discriminating between AN and healthy girls, with the AUC value reaching 0.95 (95% CI = 0.92-0.97). Using a cutoff value of 49.6 cm, accuracy was 90.6%, sensitivity 93% and specificity 88.7%. CONCLUSIONS: Thigh circumference strongly correlates with DXA-FM and demonstrates a slight clinical advantage over BMI. This simple measurement might also serve as a useful predictor of body fatness in adolescent girls with AN and should therefore be further evaluated in independent cohort studies.

Vitamin D supplementation and status in infants: a prospective cohort observational study.

OBJECTIVE: Vitamin D status in infants depends on supplementation. We examined the vitamin D status in relation to supplementation dose and scheme in infants. PATIENTS AND METHODS: One hundred thirty-four infants age 6 months and 98 infants age 12 months (drop out 27%) were investigated. Vitamin D intake (diet, supplements), anthropometry, and 25-hydroxyvitamin D (25-OHD) serum concentration at the 6th and 12th months were assessed. RESULTS: Vitamin D intake of 1062 ± 694 IU at the 6th month was not different from that at the 12th month (937 ± 618 IU). Vitamin D intake expressed in international units per kilogram of body weight decreased from 141 ± 80 IU/kg at the 6th month to 93 ± 62 IU/kg at the 12th month (P < 0.0001), which was associated with a reduction in 25-OHD from 43 ± 20 ng/mL to 29 ± 12 ng/mL, respectively (P < 0.0001). In the subgroup of everyday supplemented infants (n = 43), vitamin D intake decreased from 143 ± 88 IU/kg at the 6th month to 118 ± 60 IU/kg at the 12th month (P < 0.05), which coincided with a reduction of 25-OHD from 40 ± 19 ng/mL to 32 ± 13 ng/mL (P < 0.01). In the subgroup with variable supplementation habits (n = 32), vitamin D intake decreased from 146 ± 79 IU/kg to 77 ± 56 IU/kg (P < 0.001), which was associated with a reduction of 25-OHD from 42 ± 21 ng/mL to 25 ± 8 ng/mL (P < 0.0001). 25-OHD concentration change between the 6th and the 12th months negatively correlated with the 25-OHD level assessed at the 6th month (r = -0.82; P < 0.0001). CONCLUSIONS: Vitamin D supplementation of infants should consider their rapid body weight increment. We postulate vitamin D daily dose close to 100 IU/kg body weight as favorable for infants up to age 12 months.

Chronic non-cholestatic liver disease is not associated with an increased fracture rate in children.

Chronic liver disease in adults is a risk factor of osteoporosis, but little is known about risk of fractures in children with non-cholestatic liver disease. The aim of this study was to investigate associations among the severity of liver fibrosis, bone mass and low-energy fractures in children. History of fractures, anthropometry, and bone mass and size were examined in 39 Caucasian children (25 boys, 14 girls) aged 7.1-18 years (mean 11.9 ± 3.1) with chronic hepatitis B and liver fibrosis evidenced by liver biopsy. Severity of liver fibrosis was based on histological classification according to the method of Batts and Ludwig (mild, 1-2 scores; advanced, 3 scores) and Ishak (1-3 and 4-5 scores, respectively). Bone mineral content (BMC), density (BMD) and body composition were determined in the total body and lumbar spine using dual energy X-ray absorptiometry. Seven subjects (4 girls, 3 boys; 18% of the sample) had low BMD in the total body and lumbar spine region (Z-scores below -2.0). No associations were found among BMC, BMD, bone size and the severity of liver fibrosis. Nine boys (36% of all boys) and one girl reported repeated fractures (forearm, wrist, tibia, ankle, humerus), showing trends similar to the prevalence in general population. Fractures were neither associated with lower BMD/BMC nor with scores of liver fibrosis. Deficits in BMD in children with chronic hepatitis B are not associated with the severity of liver fibrosis. This study suggests that non-cholestatic liver disease does not increase the risk of low-energy fractures during growth. From the practical perspective, however, children with chronic liver disease should be screened for history and clinical risk factors for fractures rather than referred to bone density testing.

Plasma levels of vitamins A and E, coenzyme Q10, and anti-ox-LDL antibody titer in children treated with an elimination diet due to food hypersensitivity.

AIM: Has elimination diet applied in children with food hypersensitivity in infancy any effect on plasma levels of anti-oxidative vitamins and antibodies to oxidized low-density lipoprotein (anti-ox-LDL antibody) titer in these children at their pre-school age?" MATERIAL: The study involved 92 children (3 to 7 years of age) with food hypersensitivity treated in their infancy and early childhood with soy formula or casein hydrolysate, as a milk substitute for at least 12 months. Control group comprised 62 children, who had never been treated with an elimination diet. METHODS: The status of the anti-oxidative system was evaluated by determination of retinol, alpha-tocopherol, and coenzyme Q10 plasma levels by high-performance liquid chromatography (HPLC). The titer of antibodies to oxidized LDL lipoproteins was specified by immunoenzymatic assay. On the basis of the RESULTS, the following CONCLUSIONS have been reached: 1. It was shown that alpha-tocopherol and retinol levels in pre-school children who had received dietary treatment in their infancy, were higher than in the control group. No deficiencies in anti-oxidative vitamins within the control group were found. 2. A type of milk-substitute formula applied in the elimination diet had no effect on the status of the anti-oxidative system in the children examined.

Dental malocclusion is associated with reduced systemic bone mineral density in adolescents.

There is no published data about associations between the state of dentition and bone mass in adolescents. The objective of this study was to investigate whether the prevalence of caries and dental malocclusion is associated with bone mass during growth. In 123 healthy Caucasian subjects (72 males, 51 females) aged 14-18 yr, DMFT figures (decayed teeth, missing teeth, filled teeth) and presence of malocclusion, according to Angle classification, were determined. Participants completed a questionnaire regarding dental hygiene, physical activity level, and consumption of sweets. Anthropometry and pubertal stages were examined. Bone mineral density (BMD) was examined using dual energy X-ray absorptiometry (DXA) in the total body, head, and lumbar spine. No association was found between DMFT (mean+/-SD: 8.33+/-3.9) and BMD or Z-scores for BMD. Malocclusion was found in 49 subjects (39.8%) and was more prevalent in females than males. Malocclusion was associated with lower total BMD independently of body size (p=0.001; Z-scores: -0.21+/-0.27 vs +0.33+/-0.17; p=0.1) in males (but not females), producing odds ratio 1.6 (95% confidence interval: 1.09-2.34%; p=0.02). Head BMD was also lower in the males with malocclusion than in those without (p=0.004). Neither caries nor the tooth loss appear to be associated with BMD during growth. Boys with malocclusion are at higher risk of reduced BMD. This suggests that inadequate bone mass accrual in males coexists with impaired growth of the masticatory system in childhood and adolescence, however, the causal pathway is unknown. Factors that produce malocclusion may also affect bone mass or size but further prospective studies are needed to evaluate the relationship.

HPLC method for simultaneous determination of retinol, alpha-tocopherol and coenzyme Q10 in human plasma.

A simple HPLC method with UV detection is proposed for the simultaneous determination of three lipophilic vitamins: all-trans-retinol, alpha-tocopherol and coenzyme Q(10) (ubiquinone) in human plasma. The following chromatographic conditions were used: RP-18 column, a mobile phase consisted of methanol -n-hexane 72:28 (v/v) and UV detector set at 324, 292 and 276 nm for all-trans-retinol, alpha-tocopherol and coenzyme Q(10), respectively. The linearity range was 0.35-70 microM for all-trans-retinol, 0.23-44 microM for alpha-tocopherol and 0.12-23 microM for coenzyme Q(10). Deproteinised plasma samples were extracted with n-hexane prior to the analysis. The within-day and between day reproducibilities were 1.5 and 3.7% for all-trans-retinol, 4.0 and 5.8% for alpha-tocopherol and 2.3 and 3.1% for coenzyme Q(10), respectively. Using the proposed method the following recoveries were achieved: 91% for all-trans-retinol, 86% for alpha-tocopherol and 88% for coenzyme Q(10). The method was applied to the determination of the levels of retinol, tocopherol and coenzyme Q(10) in plasma of healthy children and children treated by elimination diet.

Comparison of phalangeal ultrasound and dual energy X-ray absorptiometry in healthy male and female adolescents.

The aims of this study were to determine if there is a correlation between dual energy X-ray absorptiometry (DXA) and phalangeal quantitative ultrasound (QUS) in identifying children and adolescents with low bone density, and to assess if body size influences the results of the two techniques to the same degree. Measurements were performed in 67 girls and 83 boys aged 14 to 19 y using DBM Sonic 1200 (IGEA, Carpi, Italy) and the DXA equipment (LUNAR Radiation Corp., Madison, WI, USA). Twelve adolescents (eight males and four females) reported a past history of nonosteoporotic fractures. Lumbar spine bone mineral density (LS BMD), total body bone mineral density (TB BMD) and total body bone mineral content (TB BMC) correlated positively with age, height, BMI and weight, in both genders. Amplitude-dependent speed of sound (Ad-SOS) was positively correlated with age, height and Tanner stages in both genders and negatively correlated with BMI in females. TB BMD, TB BMC and LS BMD positively correlated with Ad-SOS only in males. In females, there were no significant correlations between Ad-SOS, TB BMD, TB BMC and LS BMD measurements. Twelve teenagers with previous fractures (high impact fractures) were found to have lower DXA and QUS values than age-matched teenagers without fractures but the statistical significance was found only in relation to TB BMD values (p = 0.02). In conclusion, we obtained results similar to those that have been reported by other authors using different QUS techniques. Furthermore, the Ad-SOS measurements taken at the distal metaphysis of the proximal phalanges correlate poorly with LS BMD and TB BMD measured by DXA in growing subjects.

Depression in anorexia nervosa: a risk factor for osteoporosis.

CONTEXT: Both anorexia nervosa (AN) and depression are associated with osteoporosis. We hypothesized that adolescent girls with AN and depression will have lower bone mineral density (BMD) than anorexic girls without depression. OBJECTIVE: The objective of this study was to investigate whether depression is an independent risk factor for osteoporosis in anorexic adolescent girls. DESIGN: This study was cross-sectional. SETTING: This study was conducted at the University Children's Hospital (Bialystok, Poland) from October 2002 through September 2003. PARTICIPANTS: Forty-five Caucasian anorexic girls aged 13-23 yr, matched by age, Tanner stage, weight, height, calcium intake, and duration of AN, were studied, including 14 with comorbid depression (based on Hamilton Depression Rating Scale and Montgomery-Asberg Depression Rating Scale) and 31 anorexic girls without depression. MAIN OUTCOME MEASURES: Total body and lumbar spine (LS) BMD, fat mass, and lean mass assessed using dual-energy x-ray absorptiometry were compared between AN girls with and without depression. RESULTS: BMD was reduced in both groups, relative to reference data, but girls with AN and depression had lower BMD than those with AN alone (LS Z-scores, -2.6 +/- 0.3 vs. -1.7 +/- 0.3; P = 0.02) (mean +/- sem). Quantitative assessment of depression correlated independently with total body BMD (r = -0.4; P < 0.05) and LS BMD (r = -0.6; P < 0.001). CONCLUSION: Anorexic girls with depression are at higher risk of osteoporosis than those without depression. The mechanisms responsible for decreased BMD in depression are not known. Independent treatment of the depressive disorder in AN may partly alleviate the bone fragility.

The characteristics of fractures in Polish adolescents aged 16-20 years.

The aim of the study was to identify associations between fractures in childhood and family, anthropometric and lifestyle factors. Among 1,246 subjects aged 16.3-20.6 years (539 boys, 707 girls), based on a questionnaire, 869 were fracture-free while 377 (30.26%) had fractures. Of those reporting fractures, 146 reported multiple fractures (12% of studied population, 39% of all fractures). More boys had fractures than girls (35.6% vs 24.9%, p < 0.001). Fracture sites included: forearm (37%), fingers (23%) wrist (16%), ankle (14%), humerus (10%), tibia (8%) clavicle (7%) and femoral shaft / neck (3%). Among adolescents with multiple fractures, 52% also reported fractures in at least one family member, compared with 29% of those without a fracture history. Fractures in siblings and mothers (but not fathers) accounted for 44% of the liability in adolescents' fractures. Subjects with multiple fractures reported more time at the computer than those without fractures and reported more time participating in team sports, and 18.6% avoided milk, whereas 12.4% of those without fractures reported milk-free diets. Using a logistic regression model, none of the lifestyle factors, except for computer use, were independently associated with fractures. Fractures, particularly multiple fractures, are common in childhood and adolescence. Familial clustering of fractures suggests shared genetic and environmental factors are responsible.

[Bone mineral density in children before and after completion of cancer treatment]. / Gestosc mineralna kosci u dzieci przed leczeniem choroby nowotworowej i po jego zakonczeniu.

This study was performed to determine the degree of osteopenia in children with malignancy before and after completion of treatment. Twenty six subjects (17 male, 9 female) treated for acute lymphoblastic leukemia (n=15), lymphogranulomatosis maligna (n=7) or solid tumor (n=4) at a mean age 9.34 (range 3-17.41 years) before and 15.85 (range 9.66-23) after treatment participated in this longitudinal study. Mean follow up period after discontinuation of therapy was 5.5 years (range 2.6-8.3 years). Interview (estimation of physical activity, other chronic disease, and fractures), anthropometric measurements of body mass and height, body mass index (BMI), bone mineral density total (BMD Total) and spine (BMD Spine) were obtained from every child. Gained findings were compared to the same parameters in the group of 473 healthy children, comparable in age and gender with examined group and showed as SD score. There were no differences in BMI and BMD Total and Spine between patients and controls. No correlation was found between the BMD values and the diagnosis, age at diagnosis, gender and cranial irradiation and duration of follow-up. BMD Spine SD score was significantly increased in a subgroup of patients in pubertal stage at diagnosis as compared to patients in prepubertal stage. Further studies are needed to evaluate the long-term effect on BMD in patients with cancer and how to prevent a decrease of BMD.

[Bone mineral density and markers of bone turnover in patients treated for malignant disease in childhood]. / Ocena gestosci kosci i wybranych wskazników kosciotworzenia i resorpcji u pacjentów leczonych w dziecinstwie z powodu choroby nowotworowej.

UNLABELLED: Development in diagnostic and therapeutic methods has led to increased survival rates in children with malignancies. The treatment with corticosteroids, methotrexate and irradiation may all cause reduction in bone mass. We assessed bone mineral density (BMD) and several parameters involved in bone formation in long-term survivors with a malignancy at completion of therapy. Total body and lumbar spine bone mineral densities (gram per cm2) were measured by dual energy x-ray absorptiometry in 40 patients (age 12-27 yr; median 17.5 yr; 21 with acute lymphoblastic leukemias, 19 with other malignancies) from 3 to 13.9 years (median 7 yr) after discontinuation of therapy. These results were compared with those from 473 healthy controls and expressed as a percentage of the age and sex-matched control values (mean and standard deviation). Serum levels of osteocalcin, bone specific alkaline phosphatase, parathormone, 1.25 dihydroxyvitamin D, urinary concentrations of deoxypyridinoline were determined as well as several specific markers of bone turnover. RESULTS: The total BMD and in the lumbar spine were not significantly reduced in survivors of childhood malignancies compared to the control population. No correlation was found between the BMD values and the cumulative doses and time of corticosteroids, administered Mtx, irradiation, duration of treatment, age at diagnosis. Duration of follow-up showed correlation with lumbar spine BMD. Serum markers of bone formation and resorption were in the normal range (expressed as standard deviation score relative to the age and sex-matched healthy population), bone turnover was not disturbed at the time of the study. CONCLUSION: We found no difference in bone mineralisation between our patients and the healthy population.

[Subjective perception of hypersensitivity to selected additives-containing foods in children and adolescents from schools in Bialystok]. / Subiektywne postrzeganie nadwrazliwosci na wybrane pokarmy zawierajace substancje dodatkowe wsród dzieci i mlodziezy ze szkól bialostockich.

The incidence of adverse reactions to food additives is difficult to establish and therefore not completely known. The aim of the present study is an attempt to determine the actual incidence of this problem in the population of school-age children and adolescents. The current work is the preliminary stage of this study and contains recapitulation of information obtained from parents and foster-parents of 5044 children aged 6-16 years from Bialystok. Analysis of data has revealed that 9.8% of children complain of undesired symptoms after consumption of additive-containing foods. The problem referred to younger children statistically significantly more frequently (p < 0.05), while no correlation was found with sex (47.9% boys, 52.1% girls). The foods most frequently associated with adverse symptoms appeared to be: sparkling drinks e.g. Coca-Cola, orangeade--9% and sweets products (e.g. chewing-gums, crisps, sweets, cakes)--6.4%. The most common symptoms related to the consumption of additive-rich foods were: abdominal pain--9.9%, cutaneous rash--8.8%, cough and rhinitis--5.5% and 5.6%, headache--4.9%. The preliminary findings should be verified using double-blind placebo-controlled food challenge tests in order to establish the actual incidence of food additive intolerance.

[Comparison of subjectively perceived hypersensitivity to selected additives-containing foods among children with and without food allergy/intolerance]. / Porównanie subiektywnie postrzeganej nadwrazliwosci na wybrane pokarmy zawierajace substancje dodatkowe w grupie dzieci z alergia/nietolerancja pokarmowa oraz w grupie dzieci bez tej patologii.

The incidence of adverse reactions to food additives is difficult to establish and therefore not completely known. The equally important problem is to what extent food additives induce ailments and to what degree they exacerbate symptoms of the already existing disease, e.g. urticaria, atopic dermatitis, asthma or rhinitis. The aim of the present study is to establish the actual incidence of this problem in the population of school-age children and adolescents. This work presents the preliminary evaluation. Analysis of the questionnaire data obtained from parents or foster-parents of 5044 children aged 6-16 years from Bialystok has revealed that 9.8% of children complain of subjective adverse symptoms after consumption of particular foods containing additives. The aim of this stage of the study is to determine and compare the incidence of adverse symptoms ascribed to food additives in the group of children with food allergy and/or intolerance and in unburdened children. The incidence of each of the evaluated features (i.e. type of food, clinical symptoms) was statistically significantly higher in children with symptoms of allergy or intolerance (p < 0.001).