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- Munns, CF, et al.
(författare)
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Global Consensus Recommendations on Prevention and Management of Nutritional Rickets
- 2016
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Ingår i: Hormone research in paediatrics. - : S. Karger AG. - 1663-2826 .- 1663-2818. ; 85:2, s. 83-106
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background:</i></b> Vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a major impact on health, growth, and development of infants, children, and adolescents; the consequences can be lethal or can last into adulthood. The goals of this evidence-based consensus document are to provide health care professionals with guidance for prevention, diagnosis, and management of nutritional rickets and to provide policy makers with a framework to work toward its eradication. <b><i>Evidence:</i></b> A systematic literature search examining the definition, diagnosis, treatment, and prevention of nutritional rickets in children was conducted. Evidence-based recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system that describes the strength of the recommendation and the quality of supporting evidence. <b><i>Process:</i></b> Thirty-three nominated experts in pediatric endocrinology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus. <b><i>Results:</i></b> This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts. <b><i>Conclusion:</i></b> Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required.
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| 4. |
- Rushworth, RL, et al.
(författare)
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Hospital Admission Patterns in Children with CAH: Admission Rates and Adrenal Crises Decline with Age
- 2016
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Ingår i: International journal of endocrinology. - : Hindawi Limited. - 1687-8337 .- 1687-8345. ; 2016, s. 5748264-
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To examine patterns of hospitalisation for acute medical conditions in children with congenital adrenal hyperplasia (CAH).Design. A retrospective study of hospitalisation using administrative data.Setting. All hospitals in NSW, Australia.Patients. All patients admitted with CAH and a random sample of admissions in patients aged 0 to 18 years without adrenal insufficiency (AI).Main Outcome Measures. Admissions and comorbidities by age and sex.Results. Of 573 admissions for medical problems in CAH children, 286 (49.9%) were in males, and 236 (41.2%) had a principal diagnosis of CAH or had an adrenal crisis (AC). 37 (6.5%) ACs were recorded. An infection was found in 43.5% (n=249) of the CAH patient admissions and 51.7% (n=1613) of the non-AI group,p<0.001. Children aged up to one year had the highest number of admissions (n=149) and six ACs (four in males). There were 21 ACs recorded for children aged 1–5 years. Older CAH children had fewer admissions and fewer ACs. No in-hospital deaths were recorded.Conclusions. Admission for medical problems in CAH children declines with age. An AC was recorded in 6.5% of the admissions, with the majority of ACs occurring in the 1 to 5 years age group and there were no deaths.
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