Author/Editor		Jekovec-Vrhovšek, Maja
Title		Kostna gostota pri otrocih z najtežjo motnjo v razvoju
Translated title		Bone mineral density in severely disabled children
Type		monografija
Place		Ljubljana
Publisher		Univerza v Ljubljani, Medicinska fakulteta
Publication year		2004
Volume		str. 63
Language		slo
Abstract		Children and young people with the most severe developmental disability who are longterm bed-ridden and are being treated for epilepsy, frequently suffer from atraumatic fractures of long bones. Measuring bone density using dual X-ray absorptiometry (DEXA) is difficult to perform on the most severely developmentally disabled and is not undertaken in routine practice. Calcaneal ultrasound (US) provides reliable data on the bone stiffness of adults. Its implementation is simple and fast. Because of feet deformities we modified standard method by placing under them plastosote lamellas. It was therefore decided to look at the use of such a modified calcaneal US method for assessing bone substance and the risk of fracturing in most severely disabled children. The usefulness of modified calcaneal US was also desired for assessing changes during treatment with calcium and vitamin D. Of interest was whether or not the polymorphism of the gene for vitamin D receptor (VDR) was linked to the US determined bone density and to the effect of treatment. Methods The clinical trial comprised 85 patients with the most severe developmental disability. 47 of them were male and 38 female. 70 were being treated with various combinations of anti-epileptic drugs (AED), whereas 1 S were not. None of the patients had been given any other drug that could influence bone density. Other illnesses likely to affect bone density were excluded. The bone density in the heel bone area was measured on all the patients using US. At the start of the trial levels of calcium, phosphate, magnesium and albumin in the serum were measured along with the biochemical indicators of bone alteration-bone alkaline phosphatase, osteocalcine, intact parathormone and 25-OH vitamin D in serum and calcium/creatinine and deoxypyridinolinelcreatinine in the urine. Treatment with calcium and 1.25 dihydroxy vitamin D was commenced. (Abstract truncated at 2000 characters).
Descriptors		EPILEPSY CEREBRAL PALSY BONE DENSITY OSTEOPOROSIS CALCANEUS CHILD SPINE HIP DENSITOMETRY, X-RAY FRACTURES, SPONTANEOUS PROSPECTIVE STUDIES POLYMORPHISM (GENETICS) RECEPTORS, CALCITRIOL POLYMERASE CHAIN REACTION POLYMORPHISM, RESTRICTION FRAGMENT LENGTH