Fog, Smoke, Sunlight
Sir Arthur Newsholme in The Story of Modern Preventive Medicine, 2015
This chapter considers the influence of smoke, fog and sunlight in the prevention and treatment of disease. The effect of fog and smoke in the air is due in part to its direct irritating effect, and in part to its shutting off the rays of the sun. The effect of a few days of smoky fog in increasing the death rate in the following week, especially from bronchitis and other respiratory affections, is well known. In 1889 Huntley and in 1900 Palm published articles lauding sunlight as a preventive of rickets. In 1819 Raczynski published the first experimental evidence of the physiological effect of the sun. The separate influence of the invisible ultra-violet part of the spectrum was stated by Huldschinsky in 1919, who showed that rickets could be prevented or cured either by irradiation with sunlight or by exposure to the quartz mercury lamp.
Common nutritional problems in preschool children
Judy More in Infant, Child and Adolescent Nutrition, 2021
The common nutritional problems seen in under-fives are dental caries, iron-deficiency anaemia, obesity, constipation, diarrhoea, gastro-oesophageal reflux disease, selective eating. Faltering growth and rickets are also seen but are not common. Dental caries are common in under-fives mainly due to: the frequent consumption of sugary foods and sugary acidic drinks and poor dental healthcare in the home. About 5 per cent of preschool children in the UK are iron deficient and anaemia is more common in this age group than other age groups except adolescent females. Toddler diarrhoea may occur in children who are otherwise healthy and growing well. Children with avoidant restrictive food intake disorder whose health is compromised by their eating behaviour may be referred to a feeding clinic if one exists in their NHS area. Such clinics provide a coordinated multidisciplinary approach to helping families decide how to change the way they manage mealtimes and feeding children with feeding difficulties.
Thyroid and parathyroid disease
Catherine Nelson-Piercy in Handbook of Obstetric Medicine, 2020
The most discriminatory features in pregnancy are weight loss, tremor, a persistent tachycardia, lid lag and exophthalmos. The latter feature indicates thyroid disease at some time rather than active thyrotoxicosis. Thyrotoxicosis may lead to sinus tachycardia, supraventricular tachycardia or atrial fibrillation. If poorly controlled, a thyroid crisis (storm) in the mother and heart failure may develop, particularly at the time of delivery. Carbimazole and propylthiouracil are the most commonly used anti-thyroid drugs in the United Kingdom. Most patients are initially treated with 15–40 mg carbimazole (150–400 mg PTU) for 4—6 weeks. Primary hyperparathyroidism is the third most common endocrine disorder after diabetes and thyroid disease, although it usually presents after the childbearing years. Untreated hypocalcaemia in the mother increases the risk of second-trimester miscarriage, fetal hypocalcaemia and secondary hyperparathyroidism, bone demineralization and neonatal rickets. Vitamin D deficiency is common in non-Caucasian ethnic groups in the United Kingdom.
Rickets in a 6-year-old girl resulting in extreme deformities
Published in Paediatrics and International Child Health, 2018
Rickets remains endemic in low- and middle-income countries (LMIC) and has re-emerged in high-income countries. Poverty, ignorance and poor healthcare in LMIC still contribute to development of the disease and, if untreated, its progression to severe forms. A 6-year-old girl from a poor background presented with malnutrition, anaemia, rachitic rosary and severe deformities of the upper and lower limbs owing to vitamin D deficiency. Although she responded well to treatment initially, some of the deformities required surgical intervention. Unfortunately, she was lost to follow-up.
Two cases of rickets presenting with poor growth, hypotonia, and respiratory problems
Published in Acta Clinica Belgica, 2015
E. Wouters, M. Wojciechowski, E. de Vries
Rickets is a rare disease in developed countries. In children, it is a disease which affects growing bone. Depending on the severity, it can present with a wide variety of symptoms. Because it is such a rare disease in developed countries, symptoms suggesting rickets are often not easily recognized. This can cause a delay in diagnosing and treating rickets. Often unnecessary and sometimes invasive investigations are performed. First leading clues to rickets on physical examination are poor growth, especially length, thickening of wrists, bow legs, and craniotabes. At further examination, special attention should be paid to osteopenia and cupping and fraying at the metaphyses on X-rays. Laboratory results suggestive for rickets are elevated alkaline phosphatase and disturbances in calcium and phosphate homeostasis. In this report, we present two cases presenting with poor growth, severe pain, and respiratory problems secondary to calcipenic rickets.
Rickets associated with ichthyosis
Published in Paediatrics and International Child Health, 2012
V Kumar, S Kalra, D Mutreja, A Arya
Nutritional rickets in disorders of keratinisation is very rare. A 12-year-old girl with autosomal dominant ichthyosis vulgaris is reported who presented with tetany and a waddling gait. She had the classic clinical, biochemical and radiological features of rickets. She was treated with vitamin D and calcium supplements together with keratolytic and emollient agents, which was followed by biochemical and clinical remission. This appears to be the first report of rickets associated with autosomal dominant ichthyosis vulgaris.
Related Knowledge Centers
- Metabolic Processes
- Osteomalacia
- Secondary Hyperparathyroidism
- Vitamin D Deficiency
- Bone Formation
- Dihydroxyvitamin
- Calcium Metabolism Disorders