Background: Vitamin D deficiency may increase predisposition to a number of pediatric orthopaedic conditions and the prevalence of vitamin D deficiency is increasing in children in developed countries. The aim of this study was to determine the epidemiology of vitamin D deficiency and insufficiency in children presenting to a regional pediatric orthopaedic service. We also examined the relationships between vitamin D status, social deprivation, and ethnicity.
Methods: Individuals of age 18 years and younger presenting to the regional pediatric orthopaedic service at Southampton, UK from 2008 to 2010 were investigated. Deprivation index scores were calculated from indices of deprivation.
Results: A total of 187 children (97 male, 90 female, mean age 7.1 y) underwent serum 25-hydroxyvitamin D level measurement. Of them 82% were white British and 11% were of Asian ethnicity. The calculation of the total depravation index for the whole cohort showed 34 patients (18%) were in quartile 1 (most deprived), 54 (29%) in quartile 2, 49 (26%) in quartile 3, and 50 (27%) in quartile 4 (least deprived). Sixty patients (32%) had vitamin D insufficiency with 25-(OH) levels <50 nmol/L and 15 patients (8%) had vitamin D deficiency. No relationship was identified between vitamin D level and social deprivation score.
Conclusions: There is a need for awareness of the prevalence of vitamin D deficiency in the pediatric orthopaedic population presenting with bone pain and lower limb deformity before commencing "observation or orthopaedic surgical treatment."
Level Of Evidence: 3.
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http://dx.doi.org/10.1097/BPO.0b013e31822f1af1 | DOI Listing |
J Neurol
January 2025
Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Background: Neurologic symptoms seen in patients receiving immune checkpoint inhibitors (ICI) may not be entirely caused by immunotoxicity. We aim to highlight these confounding conditions through clinical cases to encourage early recognition and management.
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GMS Ophthalmol Cases
December 2024
Department of Neuro-Ophthalmology, Aravind Eye Hospital and Postgraduate Institute, Coimbatore, India.
We present a case of a young woman who presented with blurring of vision in her right eye, worsening on near work. Detailed ophthalmic and neurological evaluation was done, which revealed light near dissociation, vermiform iris movements, constriction to diluted pilocarpine with absent deep tendon reflexes. Laboratory investigation indicated mild iron deficiency anemia and reduced vitamin D3 level.
View Article and Find Full Text PDFEJIFCC
December 2024
Clinical Analysis Department, Hospital Infanta Elena, Huelva, Spain.
A narrative review of the main guidelines and recommendations published from 2011 up to date about the status of vitamin D deficiency has been carried out. The objective of this review is to discuss the origin of the controversy about the status of this entity, as well as the evolution of the methodological aspects and clinical situations that require vitamin D screening. The results obtained indicate that the criteria defining vitamin D status, according to two studies published in 2011, the Institute of Medicine (IOM) recommendations and the Endocrine Society (ES) guidelines, regardless the affected population.
View Article and Find Full Text PDFOrthopadie (Heidelb)
January 2025
Sporthopaedicum Straubing und Regensburg, Regensburg, Deutschland.
Pre- and perioperative management of malnutrition is crucial for the success of hip and knee arthroplasties. Various studies indicate that malnutrition, particularly when associated with vitamin D deficiency, significantly increases the risk of postoperative complications such as periprosthetic fractures and infections, prolonged hospital stays, and higher mortality rates. Adequate preoperative nutritional intake, including vitamin D supplementation, can improve arthroplasty outcomes.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Internal Medicine, MS Ramaiah Medical College, Bengaluru, Karnataka, India.
Tumour-induced osteomalacia (TIO) is an uncommon, debilitating disorder often characterised by non-specific clinical manifestations, posing a significant diagnostic challenge. The tumours causing TIO can be minuscule and occur in unusual areas, further complicating diagnosis. This report details the case of a woman in her early 30s presenting with chronic pain who subsequently developed fragility fractures.
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