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  1. Article ; Online: Metabolic Bone Disease of Infancy in the offspring of mothers with bariatric surgery: A series of 5 infants in contested cases of child abuse.

    Miller, Marvin / Ayoub, David

    Clinical nutrition ESPEN

    2022  Volume 48, Page(s) 227–233

    Abstract: Background and aims: Metabolic Bone Disease of Infancy is a multifactorial disorder of bone fragility in infants who typically present under 6 months of age with multiple unexplained fractures. Major risk factors for this disorder relate to the fetal ... ...

    Abstract Background and aims: Metabolic Bone Disease of Infancy is a multifactorial disorder of bone fragility in infants who typically present under 6 months of age with multiple unexplained fractures. Major risk factors for this disorder relate to the fetal time period and include decreased provision of the essential nutrients for bone formation during pregnancy (calcium, phosphate, vitamin D, and protein), prematurity, and decreased fetal bone loading.
    Methods: This study presents 5 infants with multiple unexplained fractures born to women who had prior bariatric surgery in which child abuse was alleged, and the alleged perpetrator denied wrong doing.
    Results: The radiographic findings showed poor bone mineralization and were consistent with Metabolic Bone Disease of Infancy.
    Conclusions: Using the Utah Paradigm to understand risk factors for MBDI, the authors believe the nutritional deficiencies that accompany bariatric surgery likely contribute to the bone fragility in these 5 infants. Other risk factors for MBDI were appreciated in 4 of the 5 cases. 1,25 dihydroxyvitamin D was elevated or high-normal suggesting calcium deficiency in 2 cases. We believe infants born to mothers who have had prior bariatric surgery are at increased risk for bone fragility and MBDI during the first 6 months of life.
    MeSH term(s) Bariatric Surgery/adverse effects ; Bone Diseases, Metabolic/diagnostic imaging ; Bone Diseases, Metabolic/etiology ; Bone and Bones/diagnostic imaging ; Child ; Child Abuse ; Female ; Humans ; Infant ; Mothers ; Pregnancy
    Language English
    Publishing date 2022-02-18
    Publishing country England
    Document type Journal Article
    ISSN 2405-4577
    ISSN (online) 2405-4577
    DOI 10.1016/j.clnesp.2022.02.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Metabolic Bone Disease of Infancy in the offspring of mothers with bariatric surgery: A series of 5 infants in contested cases of child abuse

    Miller, Marvin / Ayoub, David

    Clinical nutrition ESPEN. 2022 Apr., v. 48

    2022  

    Abstract: Metabolic Bone Disease of Infancy is a multifactorial disorder of bone fragility in infants who typically present under 6 months of age with multiple unexplained fractures. Major risk factors for this disorder relate to the fetal time period and include ... ...

    Abstract Metabolic Bone Disease of Infancy is a multifactorial disorder of bone fragility in infants who typically present under 6 months of age with multiple unexplained fractures. Major risk factors for this disorder relate to the fetal time period and include decreased provision of the essential nutrients for bone formation during pregnancy (calcium, phosphate, vitamin D, and protein), prematurity, and decreased fetal bone loading. This study presents 5 infants with multiple unexplained fractures born to women who had prior bariatric surgery in which child abuse was alleged, and the alleged perpetrator denied wrong doing. The radiographic findings showed poor bone mineralization and were consistent with Metabolic Bone Disease of Infancy. Using the Utah Paradigm to understand risk factors for MBDI, the authors believe the nutritional deficiencies that accompany bariatric surgery likely contribute to the bone fragility in these 5 infants. Other risk factors for MBDI were appreciated in 4 of the 5 cases. 1,25 dihydroxyvitamin D was elevated or high-normal suggesting calcium deficiency in 2 cases. We believe infants born to mothers who have had prior bariatric surgery are at increased risk for bone fragility and MBDI during the first 6 months of life.
    Keywords bariatric surgery ; bone mineralization ; calcium ; calcium deficiency ; child abuse ; clinical nutrition ; developmental orthopedic disease ; infancy ; phosphates ; pregnancy ; premature birth ; progeny ; radiography ; Utah
    Language English
    Dates of publication 2022-04
    Size p. 227-233.
    Publishing place Elsevier Ltd
    Document type Article
    ISSN 2405-4577
    DOI 10.1016/j.clnesp.2022.02.009
    Database NAL-Catalogue (AGRICOLA)

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  3. Article ; Online: Nutritional rickets and vitamin D deficiency: consequences and strategies for treatment and prevention.

    Charoenngam, Nipith / Ayoub, David / Holick, Michael F

    Expert review of endocrinology & metabolism

    2022  , Page(s) 1–14

    Abstract: Introduction: Rickets is typically characterized by bone deformities due to defective bone mineralization and chondrocyte maturation in growing bones. However, infantile rickets often goes unrecognized, because the skeletal abnormalities are more subtle ...

    Abstract Introduction: Rickets is typically characterized by bone deformities due to defective bone mineralization and chondrocyte maturation in growing bones. However, infantile rickets often goes unrecognized, because the skeletal abnormalities are more subtle and often can only be detected radiologically. Nutritional rickets is a major public health concern in several regions worldwide. It is most commonly caused by vitamin D and/or calcium deficiency.
    Area covered: We provide an overview of historical perspective, epidemiology, and pathophysiology of nutritional rickets. Additionally, we outline diagnostic approaches and highlight challenges in radiographic diagnosis of rickets. Finally, we present strategies for prevention and treatment of rickets.
    Expert opinion: Despite the evidence from clinical databases that rickets is a rare disease, it is likely that rickets is clinically underdiagnosed as studies designed to screen healthy children for radiographic evidence of rickets reported surprisingly much higher prevalence. It has been reported that some of the radiologic features of rickets can be misinterpreted as fractures. To prevent nutritional rickets, most if not all infants and young children, should receive vitamin D from formulas and foods that are fortified with vitamin D or supplementation to achieve a serum 25-hydroxyvitamin D of at least 20 ng/mL as recommended by the Institute of Medicine. It has been recommended by the Endocrine Society that to achieve maximum bone health for children and adults, a serum concentration of 25-hydroxyvitamin D should be at least 30 ng/mL and preferably 40-60 ng/mL. Pregnant women who are unable to obtain an adequate amount of vitamin D from sunlight exposure and natural and fortified diets should take a vitamin D supplement of 1500-2000 IUs daily as recommended by the Endocrine Society since it has been demonstrated that 600 IUs daily will not maintain a circulating 25-hydroxyvitamin D of at least 20 ng/mL and most pregnant women. If lactating women take approximately 6400 IUs of vitamin D daily, they provide enough vitamin D in their milk to satisfy their infant's requirement thereby preventing rickets.
    Language English
    Publishing date 2022-07-19
    Publishing country England
    Document type Journal Article
    ISSN 1744-8417
    ISSN (online) 1744-8417
    DOI 10.1080/17446651.2022.2099374
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Reply of Miller and Ayoub to Brown et al. Letter to the Editor.

    Miller, Marvin / Ayoub, David

    Journal of pediatric endocrinology & metabolism : JPEM

    2020  Volume 33, Issue 4, Page(s) 549–551

    MeSH term(s) Bone Diseases, Metabolic ; Child ; Child Abuse ; Fractures, Bone ; Humans ; Infant
    Language English
    Publishing date 2020-03-30
    Publishing country Germany
    Document type Letter ; Comment
    ZDB-ID 1231070-0
    ISSN 2191-0251 ; 0334-018X
    ISSN (online) 2191-0251
    ISSN 0334-018X
    DOI 10.1515/jpem-2020-0091
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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  5. Article: Limitations of radiology in rickets.

    Ayoub, David

    Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society

    2013  Volume 16, Issue 5, Page(s) 397

    MeSH term(s) Female ; Humans ; Male ; Sudden Infant Death/blood ; Vitamin D Deficiency/epidemiology
    Language English
    Publishing date 2013-09
    Publishing country United States
    Document type Comment ; Letter
    ZDB-ID 1463498-3
    ISSN 1615-5742 ; 1093-5266
    ISSN (online) 1615-5742
    ISSN 1093-5266
    DOI 10.2350/13-06-1344-LET.1
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  6. Article ; Online: Fractures: abuse or rickets?

    Ayoub, David

    Radiology

    2012  Volume 264, Issue 2, Page(s) 614–5; author reply 615–7

    MeSH term(s) Female ; Fractures, Bone/diagnostic imaging ; Fractures, Bone/etiology ; Humans ; Male ; Radiography ; Rickets/diagnostic imaging ; Rickets/etiology ; Vitamin D Deficiency/complications ; Vitamin D Deficiency/diagnostic imaging
    Language English
    Publishing date 2012-08
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 80324-8
    ISSN 1527-1315 ; 0033-8419
    ISSN (online) 1527-1315
    ISSN 0033-8419
    DOI 10.1148/radiol.12120120
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Findings of metabolic bone disease in infants with unexplained fractures in contested child abuse investigations: a case series of 75 infants.

    Miller, Marvin / Stolfi, Adrienne / Ayoub, David

    Journal of pediatric endocrinology & metabolism : JPEM

    2019  Volume 32, Issue 10, Page(s) 1103–1120

    Abstract: Background Infants who present with multiple unexplained fractures (MUF) are often diagnosed as victims of child abuse when parents deny wrongdoing and cannot provide a plausible alternative explanation. Herein we describe evidence of specific and ... ...

    Abstract Background Infants who present with multiple unexplained fractures (MUF) are often diagnosed as victims of child abuse when parents deny wrongdoing and cannot provide a plausible alternative explanation. Herein we describe evidence of specific and commonly overlooked radiographic abnormalities and risk factors that suggest a medical explanation in such cases. Methods We evaluated such infants in which we reviewed the radiographs for signs of poor bone mineralization. We reviewed medical, pregnancy and family histories. Results Seventy-five of 78 cases showed poor bone mineralization with findings of healing rickets indicating susceptibility to fragility fractures that could result from a wide variety of causes other than child abuse. We found risk factors that could explain the poor bone mineralization: maternal and infant vitamin D deficiency (VDD), decreased fetal bone loading, prematurity and others. Most infants had more than one risk factor indicating that this bone disorder is a multifactorial disorder that we term metabolic bone disease of infancy (MBDI). Maternal and infant VDD were common. When tested, 1,25-dihydroxyvitamin D levels were often elevated, indicating metabolic bone disease. Conclusions Child abuse is sometimes incorrectly diagnosed in infants with MUF. Appreciation of the radiographic signs of MBDI (healing rickets), risk factors for MBDI and appropriate laboratory testing will improve diagnostic accuracy in these cases.
    MeSH term(s) Bone Diseases, Metabolic/diagnosis ; Bone Diseases, Metabolic/etiology ; Calcification, Physiologic ; Child Abuse/statistics & numerical data ; Diabetes, Gestational/physiopathology ; Female ; Follow-Up Studies ; Fractures, Bone/diagnosis ; Fractures, Bone/etiology ; Gestational Age ; Humans ; Infant ; Male ; Pregnancy ; Prognosis ; Risk Factors ; Vitamin D Deficiency/complications
    Language English
    Publishing date 2019-10-10
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1231070-0
    ISSN 2191-0251 ; 0334-018X
    ISSN (online) 2191-0251
    ISSN 0334-018X
    DOI 10.1515/jpem-2019-0093
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2258: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  8. Article ; Online: Congenital rickets due to vitamin D deficiency in the mothers.

    Paterson, Colin R / Ayoub, David

    Clinical nutrition (Edinburgh, Scotland)

    2015  Volume 34, Issue 5, Page(s) 793–798

    Abstract: Background & aims: We wished to review all published reports of congenital rickets to identify the causes and characteristics.: Methods: 25 cases were identified in 19 published reports in which there was radiological and/or histological evidence of ... ...

    Abstract Background & aims: We wished to review all published reports of congenital rickets to identify the causes and characteristics.
    Methods: 25 cases were identified in 19 published reports in which there was radiological and/or histological evidence of rickets in the first two weeks after birth. Cases of rickets associated with maternal renal failure were excluded as were infants born at less than 32 weeks gestation.
    Results: There was evidence of maternal deficiency in 24 of these cases. In 16 cases the diagnosis of the rickets led to the identification of symptomatic osteomalacia in the mothers. Of the 12 mothers who had assays for serum 25-hydroxyvitamin D (25OHD) 11 had values less than 10 ng/mL. Presentations in the infants included craniotabes, wide skull sutures, rachitic rosaries, enlargement of the wrists, tetany and convulsions. In two cases rickets had been suspected from antenatal X-rays. In five cases fractures were found at the time of initial presentation. Of the 16 infants with serum calcium assays 15 had values lower than 8.8 mg/dL. Of 13 infants who had serum alkaline phosphatase assays 12 had abnormally high levels. Of the seven infants in whom serum 25OHD was measured before treatment, all had values less than 10 ng/mL.
    Conclusions: These reports provide strong support for the view that maternal deficiency leads to overt bone disease from before birth. Maternal deficiency probably also leads to impairment of bone quality in postnatal life. The importance of ensuring adequate vitamin D nutrition in pregnancy is emphasised.
    MeSH term(s) Congenital Abnormalities/blood ; Databases, Factual ; Female ; Humans ; Infant, Newborn ; Maternal Nutritional Physiological Phenomena ; Pregnancy ; Rickets/blood ; Rickets/diagnosis ; Vitamin D Deficiency/blood
    Language English
    Publishing date 2015-10
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 604812-2
    ISSN 1532-1983 ; 0261-5614
    ISSN (online) 1532-1983
    ISSN 0261-5614
    DOI 10.1016/j.clnu.2014.12.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1774: Show issues Location:
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  9. Article: Genome Mining and Comparative Analysis of <i>Streptococcus intermedius</i> Causing Brain Abscess in a Child

    Issa, Elio / Salloum, Tamara / Panossian, Balig / Ayoub, David / Abboud, Edmond / Tokajian, Sima

    Pathogens. 2019 Feb. 13, v. 8, no. 1

    2019  

    Abstract: Streptococcus intermedius (SI) is associated with prolonged hospitalization and low survival rates. The genetic mechanisms involved in brain abscess development and genome evolution in comparison to other members of the Streptococcus anginosus group are ... ...

    Abstract Streptococcus intermedius (SI) is associated with prolonged hospitalization and low survival rates. The genetic mechanisms involved in brain abscess development and genome evolution in comparison to other members of the Streptococcus anginosus group are understudied. We performed a whole-genome comparative analysis of an SI isolate, LAU_SINT, associated with brain abscess following sinusitis with all SI genomes in addition to S. constellatus and S. anginosus. Selective pressure on virulence factors, phages, pan-genome evolution and single-nucleotide polymorphism analysis were assessed. The structural details of the type seven secretion system (T7SS) was elucidated and compared with different organisms. ily and nanA were both abundant and conserved. Nisin resistance determinants were found in 47% of the isolates. Pan-genome and SNPs-based analysis didn’t reveal significant geo-patterns. Our results showed that two SC isolates were misidentified as SI. We propose the presence of four T7SS modules (I–IV) located on various genomic islands. We detected a variety of factors linked to metal ions binding on the GIs carrying T7SS. This is the first detailed report characterizing the T7SS and its link to nisin resistance and metal ions binding in SI. These and yet uncharacterized T7SS transmembrane proteins merit further studies and could represent potential therapeutic targets.
    Keywords Streptococcus anginosus ; Streptococcus constellatus ; Streptococcus intermedius ; abscess ; antibiotic resistance ; brain ; children ; evolution ; genome mining ; genomic islands ; metal ions ; nisin ; phages ; secretion ; single nucleotide polymorphism ; sinusitis ; survival rate ; therapeutics ; transmembrane proteins ; virulence
    Language English
    Dates of publication 2019-0213
    Publishing place Multidisciplinary Digital Publishing Institute
    Document type Article
    ZDB-ID 2695572-6
    ISSN 2076-0817
    ISSN 2076-0817
    DOI 10.3390/pathogens8010022
    Database NAL-Catalogue (AGRICOLA)

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  10. Article: Genome Mining and Comparative Analysis of

    Issa, Elio / Salloum, Tamara / Panossian, Balig / Ayoub, David / Abboud, Edmond / Tokajian, Sima

    Pathogens (Basel, Switzerland)

    2019  Volume 8, Issue 1

    Abstract: Streptococcus ... ...

    Abstract Streptococcus intermedius
    Language English
    Publishing date 2019-02-13
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2695572-6
    ISSN 2076-0817
    ISSN 2076-0817
    DOI 10.3390/pathogens8010022
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