ABSTRACT
UNLABELLED: The aim of this study was to assess bone mineral density (BMD) and biochemical bone metabolism markers in patients with bone tumors after anti-cancer treatment. The study included 27 patients (median age 15 years) with malignant bone tumors and 27 healthy children. In all subjects, BMD and body composition were measured by dual-energy x-ray absorptiometry. Serum bone markers were determined by immunoenzymatic assays. After completion of treatment, patients with bone tumors had significantly decreased total and lumbar spine BMD. We observed lower calcium and vitamin D levels in patients and comparable values of bone turnover markers (carboxyterminal telopeptide of collagen type I - CTX, bone alkaline phosphatase - BALP and osteocalcin - OC) in both groups of children. However, the level of carboxylated osteocalcin (cOC) was significantly lower (p<0.01) and undercarboxylated OC (ucOC) was higher (p<0.05) in patients than in controls. Additionally, we observed similar values of anthropometric parameters in the subgroups of patients treated with methotrexate (MTX) or without MTX. In patients treated without MTX we found lower (p<0.05) ratio of cOC/ucOC, lower vitamin D level and higher CTX concentrations. Patients with bone tumors after anticancer treatment had decreased bone mineral density and alterations in bone metabolism markers with potential decrease in bone formation. KEYWORDS: bone cancer survivors, bone mineral density, bone formation markers, bone resorption markers, methotrexate.
ABSTRACT
The aim of the study was to evaluate how the hiatal hernia acts on the gastroesophageal reflux (GER). We observed 52 children (31 boys, and 21 girls) aged from 2 months to 12 years (mean age 14,3 months), who were diagnosed as having GER by clinical symptoms and 24-hr oesophageal pH monitoring. All patients underwent barium radiological examination. According to the absence or presence of hiatal hernia diagnosed by barium radiology, subjects were divided into two groups: I- without hernia, II-with hernia. In both groups 24-hr oesophageal pH monitoring was analyzed. We found that patients with sliding hiatal hernia had significantly higher median percent total time when oesophageal pH was below 4, significantly higher median total number of reflux episodes and higher median time of duration of oesophageal episodes. Median number of episodes greater than five minutes did not significantly differ in both groups. We conclude that hiatal hernia increases the GER.
Subject(s)
Diaphragm/physiopathology , Gastroesophageal Reflux/etiology , Hernia, Hiatal/complications , Child , Child, Preschool , Diaphragm/diagnostic imaging , Female , Gastroesophageal Reflux/physiopathology , Hernia, Hiatal/diagnostic imaging , Hernia, Hiatal/physiopathology , Humans , Hydrogen-Ion Concentration , Infant , Male , Monitoring, Physiologic , RadiographyABSTRACT
A case of triple mosaicism involving chromosome 18 is described in a girl with abnormal skin pigmentation similar to hypomelanosis of Ito. The karyotype is 46,XX, -18, + del(18)(p11.23-->pter)/46,XX, -18, + idic(18)(p11.23)/46,XX, -18, + r(18). The patient displays some clinical features of monosomy 18p and a few signs of trisomy 18q. Our case illustrates a non-random association of chromosomal mosaicism with abnormal skin pigmentation.
