81. Dietary Deficiencies & Other Conditions :: Rickets In Chinese Children Medical Resources Common Diseases Dietary Deficiencies OtherConditions rickets in Chinese Children. rickets is a failure http://www.orphandoctor.com/medical/commondiseases/dietary/ricketschinese.html

Medical Resources :: Common Diseases :: :: Rickets in Chinese Children Rickets is a failure of the proper development (mineralization) of growing bone ( view photo ). It is probably present in 100% of all children adopted from China, even when it is not apparent to the observer. The predominant cause of rickets in orphanages abroad is nutritional deficiency of vitamin D due either to inadequate direct exposure to ultraviolet rays in sunlight or to inadequate intake of vitamin D, or both. Sunlight is necessary for the formation of vitamin D in the human body and vitamin D is necessary to make bone in the human body. Inadequate calcium and phosphorus in a child's diet also contributes to the development of rickets. When a child first arrives from China, rickets can be diagnosed by a skilled pediatrician who performs a thorough physical exam and orders a blood test called a "rickets screen". The rickets screen consists of alkaline phosphatase, calcium, and phosphorus. The calcium, phosphorus, and alkaline phosphatase levels in the blood may help support the diagnosis of rickets. The child with mild rickets may have no abnormalities in the rickets screen and a normal diet will effectively reverse any weakness in bones and muscles. If the child has bow legs, raised bony bumps along the ribs (rachitic rosaries), frontal bossing of the skull, and other deformities of the bones, rickets might be the cause. Some children have no obvious bony deformities, but still may have weak bones and muscles from a mild form of rickets.

82. Dietary Deficiencies & Other Conditions :: Rickets Medical Resources Common Diseases Dietary Deficiencies OtherConditions rickets. as published in the International Primer http://www.orphandoctor.com/medical/commondiseases/dietary/rickets.html

Medical Resources :: Common Diseases :: :: Rickets as published in the International Primer Rickets is a disease of the bones and muscles and is due to vitamin D and calcium deficiency ( view photo ). 1 It was first described in the 17th century 2 and causes delayed growth, weakening and bowing of weight-bearing bones, ineffective tooth enamel formation, and muscle weakness due to low levels of calcium. One of the classic physical manifestations of rickets is frontal bossing (enlarged forehead) and box-like shape of the head. Rickets is a prevalent health problem in children all over the world, not just for children living in orphanages. It is one of the top five medical issues in children living in China (malnutrition, rickets, anemia, lead poisoning, and asthma).3 Children living in orphanages do not get enough calcium and vitamin D in their diet and they lack exposure to sunlight, decreasing the skin's ability to produce adequate vitamin D.4, 5 The muscle weakness (hypotonia) due to the lack of calcium can cause the child to appear floppy. When the child arrives in the U.S., the child may appear developmentally delayed as a result of the decreased muscle tone and weakness of the bones due to rickets. Lack of stimulation and lack of exercise can also contribute to muscle weakness, especially muscles of the abdomen (belly). When a baby lies in the supine position (lying on the back) chronically, the abdominal (belly) muscles are weak and malnutrition can cause muscle wasting. Positioning on the belly improves this condition swiftly. Improved nutrition with vitamin D and calcium supplemented foods (formula, milk, milk products, green leafy vegetables, calcium supplemented juices) and vitamins, exposure to sunlight, and exercise rapidly improves the child's muscle tone and bone strength.

83. Rickets- Medcohealth.com rickets is a childhood disorder involving softening and weakening of the bones,primarily caused by lack of vitamin D, calcium, and/or phosphate. rickets. http://www.medcohealth.com/medco/consumer/ehealth/ehsarticle.jsp?ltSess=y&articl

84. RICKETS rickets, a constitutional disease of childhood characterized chiefly by a softenedcondition of the bones and by other evidences of perverted nutrition. http://91.1911encyclopedia.org/R/RI/RICKETS.htm

RICKETS RICKETS , a constitutional disease of childhood characterized chiefly by a softened condition of the bones and by other evidences of perverted nutrition. It was first described in 5649 by Arnold de Boot, a Frisian physician practising in Ireland. Its nature and causation are discussed under METABOLIC DISEASES. The name rickets is from the Old English wrickken, to twist; the more technical medical term, rachitis, which comes from Greek Mxts, the spine, was suggested by Francis Glisson in 165o, both from similarity of sound and from the part of the body which is one of the first to be affected. An acute form of rickets of rare occurrence (really a form of scurvy, q.v.) has been described by writers on diseases of children, in which all the symptoms are of more rapid development and progress, the result in many instances being fatal. When the disease is showing evidence of advancing, it is desirable to restrain the child from walking, as far as possible. But this precaution may be to some extent rendered unnecessary by the use of splints and other apparatus as supports for the limbs and body, enabling the child to move about without the risk of bending and deformity of the bones which otherwise would probably be the result. The condition formerly known as foetal rickets (achondroplasia or chondrodystrophia foetalis) is now classed as a separate disease. Its chief characteristics are dwarfism with shortening of the limbs and enormous enlargment of the articulations.

85. Rickets Pedigree Hypophosphatemic rickets. mates not indicated on the pedigree wereunaffected. The following summarizes the progeny of each mating http://www.people.virginia.edu/~rjh9u/hypophos.html

Hypophosphatemic Rickets mates not indicated on the pedigree were unaffected The following summarizes the progeny of each mating where one of the parents was affected. Gender of Progeny Generation I Generation II Generation III All Generations Affected Unaffected Affected Unaffected Affected Unaffected Affected Unaffected Male Female Note the following: the ratio of males to females is 18:17 (about 1:1) the ratio of affected to unaffected is 19:16 (also about 1:1) but the ratio of affected females to affected males is 12:7 (or about 2:1) and the ratio of unaffected females to unaffected males is 5:11 (or about 1:2) This type of segregation data is characteristic of an X-linked dominant pattern of inheritance. Web Page on Vitamin D and Rickets U. Iowa Med. School Page on Hypophosphatemic Rickets This document maintained by Robert J. Huskey Last updated on June 26, 1996.

86. EMJA: Seizures As The Presenting Feature Of Rickets In An Infant (Medical Journal of Australia) Seizures as the presenting feature of rickets inan infant. Letters. Seizures as the presenting feature of rickets in an infant. http://www.mja.com.au/public/issues/178_09_050503/letters_050503-1.html

Home Issues Classifieds Contact ... Search PubMed for related articles Letters Seizures as the presenting feature of rickets in an infant Graeme H Johnson and Francis Willis MJA To the Editor : An 8-month-old girl, born in Perth, Western Australia, who received only breast milk feeds for her first six months of life, was referred urgently to Princess Margaret Hospital for Children (the tertiary paediatric hospital in Western Australia) for investigations of seizures. Her parents described the seizures as episodic, involving all limbs, lasting less than five minutes and occurring over the 10 days before presentation. The infant responded to treatment with an infusion of 0.5 mg/kg of calcium gluconate and a 4-month oral course of 0.2 g calcitriol daily. After treatment commenced, she did not have any further seizures. Radiogaphy performed 4 months later showed increasing calcium deposition at the distal metaphyses of the radius and ulna. Seizures are described as a presenting feature of hypocalcaemia in vitamin D deficiency rickets. Ultraviolet radiation and/or dietary vitamin D are required to prevent rickets in children. Perth, Western Australia, located at latitude 32

87. EMJA: Comment: Seizures As The Presenting Feature Of Rickets In An Infant (Medical Journal of Australia) Comment Seizures as the presenting featureof rickets in an infant. Working In Australia. http://www.mja.com.au/public/issues/178_09_050503/letters_050503-2.html

Home Issues Classifieds Contact ... Pdf version of this article Letters Comment: Seizures as the presenting feature of rickets in an infant Christopher T Cowell MJA Comment: Nutritional rickets is highly prevalent in countries such as Mongolia, Tibet and China where winter sunlight is reduced and there is no universal vitamin D supplementation. Paradoxically, rickets is also prevalent in developing countries in the tropics and subtropics where sunlight is unlikely to be a limiting factor. Low calcium intakes (including vegetarian diets), prolonged breast feeding, and covering of the skin may all contribute. Published reports and clinical experience in Sydney suggest an increase in prevalence of rickets, especially in infants and mothers in immigrant populations The major source of vitamin D and its circulating form, 25-hydroxyvitamin D ), in children and adults is the skin. It is estimated that exposure to sunlight for 15 minutes three times per week normalises 25OHD levels. Dark skin, increasing age, sun protection agents, and the angle of the sun in winter will attenuate this increase in 25OHD Neonates acquire their vitamin D stores from their mothers via the placenta, with only a small amount transferred in breast milk.

88. Rickets rickets. rickets making comeback; kids not getting enough sunlight ByERIN MCCLAM The Associated Press. ATLANTA Childhood rickets http://www.cheef.com/buffaloskin/Answers/The_Pro___Con/Rickets/rickets.html

RICKETS Rickets making comeback; kids not getting enough sunlight By ERIN MCCLAM The Associated Press ATLANTA Childhood rickets a bone-softening disease that had become so rare the U.S. government stopped keeping statistics on it is making a comeback, in part because some youngsters are not getting enough sunlight, health officials say. Rickets, a vitamin D deficiency that causes bones to soften and bend and often results in bow legs, was once a major health problem. ~ The addition of vitamin D to milk in the 1930s virtually eliminated the disease. But health officials said Thursday that health departments across the United States are seeing a resurgence. The government attributes the comeback to the popularity of milk substitutes like soy that lack certain nutrients (Vitamin D) ; the failure to supplement breast milk with vitamin D; and a lack of childhood exposure to sunlight. ~ Sunlight stimulates the body to produce vitamin D. The resurgence has been seen particularly among children breastfed by black mothers. Dark-skinned people absorb less sunlight.

89. Vitamin D Processing And Familial Rickets Vitamin D Metabolism and rickets. This page last updated August 13, 2001 .All about Vitamin D. Vitamin D Sensitive rickets. Vitamin D Resistant rickets. http://www.xlhnetwork.org/larry/website/VitaminD/vitaminD.html

Vitamin D Metabolism and Rickets Welcome to these information and support pages provided as a public service as an online component of the XLH NETWORK These pages are mirrored at http://xlhnetwork.ncl.ac.uk/VitaminD/vitaminD.html which is a good site to bookmark in case this server goes down at any time. provided as a public service and is for educational purposes only. It does not neccesarily represent the opinions of other people or organizations with whom the author may be affiliated. Nothing herein should be construed as the prescription of medications or treatments, nor the provision of other medical services. The provider is not medically qualified, but holds a PhD in immunology , and a PGCE in secondary school science. Work on these pages is entirely supported by voluntary contribution of time and effort, from members of the F-HYPDRR mailing list , which is the main means of information dissemination amongst the members of the XLH NETWORK. These pages and information are presented on a Power Macintosh Performa 5200 belonging to the provider,

90. World Vision Canada - Make A Donation - Rickets Hurts rickets Hurts. Home Make A Donation rickets Hurts. rickets affectsone in three children in Mongolia but it s easily prevented. http://www.worldvision.ca/home/MakeADonation/rickets_hurts.cfm

Languages French HOME SPONSOR A CHILD TODAY! MAKE A DONATION GET INVOLVED ... 30 Hour Famine International Links Armenia Asia Pacific Australia Austria Brazil Canada Chile Costa Rica Colombia Finland France Germany Honduras Hong Kong Ireland Japan Korea LACRO Malaysia Mexico Netherlands New Zealand Romania Singapore South Africa Switzerland Taiwan Tanzania Thailand United Kingdom United States Vietnam International Office Rickets Hurts Home Make A Donation Rickets affects one in three children in Mongolia but it's easily prevented. Help the children of Mongolia now Caused by a lack of vitamin D, children suffering from this disease feel excruciating pain and struggle to walk...even a few steps. It affects one third of Mongolian children under the age of five. The solution is simple and effective...and ready to be shipped to Mongolia! 'Sprinkles' is a powdered mixture of micronutrients including vitamin D. Parents simply tear the package open and sprinkle it onto their children's food. SITE MAP CONTACT US

91. IPS-UAAP THE GROWING TIMES NEWSLETTER FOR May/June 2003. Sunlight Deficiencyand rickets The Utah Experience Gary M. Chan, MD. The American http://www.ips-uaap.org/news5.asp?articleId=107

92. Slide: Rickets, Clinical Features, Diagram rickets, clinical features, diagram Click picture to enlarge. Closewindow to return Diagram listing clinical features of rickets. http://www.kumc.edu/instruction/medicine/pathology/ed/ch_26/c26_s8.html

Rickets, clinical features, diagram Click picture to enlarge. Close window to return Diagram listing clinical features of rickets . In this condition, bone-bending and bone deformity results from inadequate mineralization of bone matrix, secondary to vitamin D deficiency.

93. Osteomalacia/Rickets CPS CPSP Vitamin D deficiency ricketsVitamin D deficiency rickets Principal investigator. The precise incidenceof vitamin D deficiency rickets in Canada is unknown. http://imc.gsm.com/integrated/msk/mspath/enneking/sect07/ricket.html

About Table of Contents Metabolic Bone Disease Help Osteomalacia/Rickets Introduction Causes Pathophysiology Clinical Presentation ... References Introduction Osteomalacia is the failure of bone and/or the epiphyseal cartilage to adequately mineralize. In children, this is called rickets while, in adults, it is called osteomalacia. Causes The underlying causes include: Dietary deficiency A deficiency of Vitamin D, calcium, or phosphate in the diet is a cause of osteomalacia or rickets. Gastrointestinal disorders Osteomalacia, or rickets, can be traced to gastric disease, hepatobiliary disease, enteric disorders, malabsorption syndromes, chronic diarrhea, post-surgical malabsorption, or any disorder which inhibits the absorption of adequate amounts of calcium in the gut. Vitamin D "resistance" Historically, this group of metabolic disorders, which result in rickets or osteomalacia, was so named because of their apparent resistance to treatment with Vitamin D. More importantly, these patients are now known to have an abnormality in the kidney and/or biochemical pathway(s) that results in systemic manifestations. There are four pathogenic mechanisms which account for the bone problems seen in these disorders: Phosphate wasting Hypophosphatemic rickets, or phosphate diabetes (still sometimes called Vitamin D resistant rickets), is a sex-linked dominant disorder of the renal tubule resulting in inability to resorb phosphate. The calcium, PTH, and Vitamin D levels are normal, but serum phosphate is low while urine phosphate is elevated. Treatment consists of phosphate replacement.

94. The Fall And Rise Of Rickets The fall and rise of rickets. Richard Goldbloom OC MD FRCPC. The conquestof rickets resulted from a remarkable sequence of lessons learned. http://www.pulsus.com/Paeds/07_07/gold_ed.htm

forgot your password? LESSONS LEARNED September 2002, Volume 7, Number 7 The fall and rise of rickets Richard Goldbloom OC MD FRCPC The near-disappearance of vitamin D-deficient rickets from much of the world’s population is a story of sequential victories for keen powers of observation, and for major initiatives in science and public health. In the early 20th century, rickets was one of the most disabling disorders of childhood, causing severe skeletal deformities of the spine and extremities, and growth failure. Pelvic involvement could cause dystocia, leading to neonatal and infant mortality. References 1. Palm TA. The geographic distribution and etiology of rickets. Practitioner 1890;15:321. 2. Huldschinsky K. Heilung von rachitis durch kunstliche hobensonne. Deutsch Med Wchnschr 1919;45:712.

95. Wheeless' Textbook Of Orthopaedics Main Menu Home Page rickets See - Osteomalacia problem; - HistologicChanges in rickets - Radiographic Findings - Treatment http://www.wheelessonline.com/o14/99.htm

Main Menu Home Page Rickets: - See: - Osteomalacia Vit D Abnormalities - Discussion: - rickets is an osteomalacic syndrome in which there is an inability to mineralize chondroid and osteoid; - lack of available calcium or phosphorus (or both) for mineralization of newly formed osteoid; - osseous changes in both adults and children reflect the fact that either ionized calcium or phosphate, or both, is insufficient in concentration to mineralize the skeleton fully; - there is less mineralized bone per unit volume of bone; - osseous changes in the rapidly growing skeleton of a young child w/ rickets may result in bowing deformities due to the decreased resistance of the skeleton to bending and shearing moments; - as consequence, stress frxs w/ resultant deformities occur; - note that the classic changes of rickets will typically occur in children younger than 6-7 years of age; - Causes of Rickets and Osteomalacia deficiency states gastrointestinal causes renal osteodystrophy hypophosphatemic vitamin d-resistant rickets ... vitamin-D deficiet rickets: - may see hypophosphatemia, low level of vitamin D, and normal level of PTH hormone; -

96. Rickets And Prematurity rickets and osteopenia of preemies, preterm infants, premature childrenand rickets. rickets and Osteopenia of Prematurity. By Helen Harrison. http://www.prematurity.org/research/helen-rickets.html

Rickets and Osteopenia of Prematurity By Helen Harrison Approximately 50% of very low birthweight infants develop "osteopenia of prematurity" (decreased bone density) with rickets (demineralized bones with a predominance of uncalcified bone matrix) which in turn may lead to traumatic or non-traumatic(i.e. spontaneous) fracture. Osteopenia may become quite serious and contribute to other medical problems. One of the most startling and haunting passages from the book, "The Long Dying of Baby Andrew" involved the note written in Baby Andrew's chart by the radiologist saying the only time he had seen more fractures was in an airforce crash victim! This was in a 26 week preemie who never left the NICU. One of the reasons the neonatologists cited for Andrew's inability to be successfully weaned from the ventilator was that with all his fractured ribs "it hurts like hell each time he takes a breath." Ricketsand/or osteopenia (which are not exactly the same, but usually go together in preemies) are characterized by low levels of calcium and phosphate and high levels of serum alkaline phosphotase. Low levels of Vitamin D or inability of preemies to properly metabolize Vitamin D contribute to bone abnormalities and fractures. Lack of trace elements, such as copper sulfate may play a role as well.

97. RICKETS AND OSTEOMALACIA rickets AND OSTEOMALACIA. Inadequate mineralization of bone. Skeletal deformitiesin the developing child (rickets); fractures in the adult (osteomalacia). http://pathophysiology.uams.edu/Spring01/bone/lect41s01/tsld041.htm

RICKETS AND OSTEOMALACIA Inadequate mineralization of bone Due to deficiency (dietary lack, defect in metabolism to the active form, or end-organ resistance) of Vitamin D and the exacerbating effects of a compensatory increase in PTH Skeletal deformities in the developing child (rickets); fractures in the adult (osteomalacia) Previous slide Next slide Back to first slide View graphic version

98. Karl May And Rickets life. Perhaps there was another reason, more in connection with the aftereffectsof childhood rickets. On It was the rickets. The first http://www.karl-may-stiftung.de/rickets1.html

Not only Karl May's eyesight was affected in his early childhood. His general health suffered as well: "... [I was] for full four years in bad health " . After treatment in Dresden he "returned, also for the rest recovered , home." May quite clearly states that his general health suffered apart from the eyesight. The only other remark about his childhood condition Karl May made in the following passage : "I was born as a sick, weak child, who even at the age of six years crawled on the ground, without being able to stand or even run ... I was blind three times ... ". This of course is a literary interpretation that nevertheless was based on Karl May's personal experience. There are no more clues left by Karl May, except perhaps in a book found in his library: "Der Saugling, Seine Ernaehrung in gesunden und Kranken Tagen", (The Toddler and its Nourishment in Health and Sickness) published in Hamburg in 1888 . It is quite understandable that Karl May might have tried to learn about his childhood illness from a contemporary text. We know that he did attempt to find out more about his mental state he was in when young from a textbook of psychiatry, also discovered in his library . Some leads to the childhood sickness of Karl May have been left by people who observed him. We also have photographs of Karl May that we can study. When May visited Komotau (the town of Chomutov presently in the Czech Republic) on the 13 July 1897, there is a record of his appearance at Hotel Scherber : " [The married couple entered the hall] ... She was an impressive womanly figure, as one would imagine a Wagner's Valkyrie, however the look of Karl May disappointed us. We imagined a hero's stature, instead of that in came a hardly middle sized man, with somewhat bow legs (from to much horse riding, as Fischer explained) and with upstanding, mostly uncombed hair, a gold pince-nez on his nose..."

99. NCPA - Daily Policy Digest - The Return Of Rickets CONTACT US The Return of rickets. As a result, rickets, a disease whichhad almost disappeared in the United States is on the rise. In 2000 http://www.ncpa.org/iss/hea/2004/pd010704e.html

Policy Issues NCPA Publications Both Sides Commentaries ... Audio/Visual NATIONAL CENTER FOR POLICY ANALYSIS HOME DONATE ONE LEVEL UP ABOUT NCPA ... CONTACT US The Return of Rickets Daily Policy Digest Health Issues / Public Health Issues Wednesday, January 07, 2004 In recent years, public health experts have been encouraging mothers to breast-feed infants and keep them from sun exposure in order to reduce the risk of skin cancer. However, these measures have reduced the intake of Vitamin D in children under 6 months. As a result, rickets, a disease which had almost disappeared in the United States is on the rise. In 2000, North Carolina doctors discovered an unusual number of cases of rickets, prompting the CDC to begin monitoring the disease. From 1990 to 1995, about 9 children per million in the United States were diagnosed with rickets. From 1996 to 2000, the number increased to 13 children per million; a smaller study indicated that from 1999 to 2000, the rate rose to 23 children per million. Researchers attribute the cause to Vitamin D deficiency which had been greatly reduced by the marketing of vitamin D-fortified milk since the 1930s.

100. .net - .opinions - Yo Landslide! What's Shaking, Rickets! yo landslide! what s shaking, rickets! drew internet superstar. acceptablesalutations are as follows yo landslide! what’s shaking, rickets! http://www.netmag.co.uk/opinion/default.asp?pagetypeid=2&articleid=19382&subsect

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