A Comparison Of Bone Mineral Density In Adolescent Swimmers, Pentathletes And Figure Skaters

Physical activity accounts for up to 17% of the variance in bone mineral density (BMD). Specifically, weight bearing exercises are of critical importance in increasing BMD. The aim of the present study was to evaluate the influence of three different sports with different mechanical loading properties on BMD of young athletes. This was an observational retrospective cohort study. All available medical records of adolescent athletes who have been followed at the Division of Adolescent Medicine at Hacettepe University were reviewed. Bone mineral content (BMC) and BMD of lumbar spine (L1-L4) and left femoral region were compared between young athletes participating in swimming (n=50), pentathlon (n=18), and figure skating (n=7). Femur total and lumbar spine (L1-L4) BMC values of figure skaters (29.1 +/- 8.1 g and 51.5 +/- 19.0 g, respectively) were found to be higher than swimmers (21.5 +/- 6.6 g and 36.1 +/- 11.7 g, respectively) and pentathletes (21.6 +/- 6.2 g and 41.7 +/- 19.4 g, respectively). However, there were no significant differences between any of the groups in lumbar spine and left proximal femur measurements. Regarding BMD, figure skaters (1.1 +/- 0.2 g/cm(2)) had significantly higher femur total BMD values than pentathletes (0.9 +/- 0.1 g/cm(2)) and swimmers (0.9 +/- 0.1 g/cm(2), p <0.05). The type of sport has an impact on BMD. Weight bearing and high impact loading activities seem to be associated with a better bone density in a region specific manner. Recommendation of high impact loading exercises may be considered to improve bone health in young athletes especially participating in low impact and non-weight bearing sports.WoSScopu

An Adolescent Boy With Comorbid Anorexia Nervosa And Hashimoto Thyroiditis

Low triiodothyronine syndrome is a physiological adaptation encountered in anorexia nervosa (AN) and generally improves with sufficient weight gain. However, when a primary thyroid pathology accompanies AN, both the evaluation of thyroid hormone levels and the management of the co-morbid disease become more challenging. Hashimoto thyroiditis could complicate the management of AN by causing hyper- or hypothyroidism. AN could also negatively affect the treatment of Hashimoto thyroiditis by altering body weight and metabolic rate, as well as by causing drug non-compliance. We present the case of a 15-year-old boy with comorbid AN restrictive sub-type and Hashimoto thyroiditis. In this case report, we aimed to draw attention to the challenges that could be encountered in the diagnosis, treatment, and follow-up of patients with AN when accompanied by Hashimoto thyroiditis.PubMedWoSScopu

Evaluation Of Serum Vitamin D Levels In Adolescents With Pubertal Gynecomastia

Background: Since vitamin D has an inhibitory function on ductal morphogenesis of the pubertal mammary gland, it may have a role in the development of gynecomastia. The aim of this study was to determine the effect of vitamin D deficiency on the development of pubertal gynecomastia. Methods: Serum 25-hydroxyvitamin D (25D) levels in 50 adolescents with pubertal gynecomastia and 54 healthy controls between the ages of 11 and 17 years were compared. Results: Mean 25D level was 14.03 +/- 6.38 (5.0-32.5) ng/ml in the pubertal gynecomastia group and 15.19 +/- 6.49 (5.0-33.2) ng/ml in the control group (p = 0.361). According to the vitamin D status classification of the American Academy of Pediatrics, 66% of the pubertal gynecomastia group was found to be deficient and 14% were insufficient. In the control group these values were 53.7% and 29.6%, respectively (p = 0.158). Conclusion: From our results we hypothesize that, rather than low serum levels of 25D, a dysregulation of the vitamin D signal pathway, vitamin D metabolism or vitamin D storage within the mammary tissue might be the contributing factors to the development of gynecomastia. (C) 2016 S. Karger GmbH, FreiburgWoSScopu

Is White Matter Affected in Adolescents with Anorexia Nervosa? A Study Using Magnetization Transfer Imaging

The aim of the study was to assess potential changes in structural integrity of the brain in adolescent patients with Anorexia Nervosa (AN) using the magnetization transfer imaging technique and re-evaluating after nutritional rehabilitation was accomplished. Magnetization transfer ratio (MTR) was used for the detection and quantification of histological changes to the white matter of 9 adolescents diagnosed with AN at diagnosis and after weight gain. Using the MTR technique 6 regions were measured: the pons, left cerebellar hemisphere, amygdala, thalamus, corona radiata and white matter adjacent to the left dorsolateral prefrontal cortex. Scans from the patients with AN were also compared with scans from an age-matched subset of 9 healthy controls. Compared with control subjects, the MTR of participants with AN was no different either at the early stages of diagnosis (p=0.62) or after weight recovery (p=0.81). Similarly, comparison of MTR between patients with AN at diagnoses compared with MTR after weight recovery yielded no statistically significant difference (P=0.33). We conclude that MTR was not able to detect any neuropathological alterations in adolescent patients with AN at either diagnosis or after nutritional recovery and the achievement of weight gain.WoSScopu

The Effect of Swimming and Type of Stroke on Bone Metabolism in Competitive Adolescent Swimmers: A Pilot Study

Background/aim: Physical activity plays a key role in increasing and preserving bone mineral density (BMD). Effects on bone development associated with various nonweight-bearing sporting activities, such as swimming, are controversial. Different strokes used in swimming may also present as another factor. The aim of this study was to evaluate the effect of swimming and type of stroke on BMD in competitive adolescent athletes. Materials and methods: Seventy-nine swimmers between the ages of 10 and 21 years participated in this study. BMD was measured with dual-energy X-ray absorptiometry at the lumbar vertebrae and left proximal femur. Daily calorie intake and calcium consumption, and measurements of calcium, phosphorus, alkaline phosphates, 25-hydroxyvitamin D (25(OH) D), and osteocalcin were evaluated. Results: Preliminary results revealed that the type of stroke had no effect on BMD (P = 0.79). Additionally competitive swimmers did not have augmented bone mineral accretion, and in 13.9% of athletes low BMD was confirmed. Sixty percent of swimmers had either deficient or insufficient 25(OH) D levels and a low mean calorie (P = 0.542) and calcium (P = 0.038) intake was observed. Conclusion: This was the first study to evaluate the effect of swimming stroke on BMD. Although no effect was statistically shown, further studies with a larger series may determine this effect.WoSScopu

Etiology Of Vaginal Discharge In Sexually Inactive Adolescents

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The Use Of The Midas Questionnaire To Assess Migraine And Tension Type Headache In Adolescents

Objective: Headache is the most common type of pain that children and adolescents complain as well as being the most common neurological symptom. Among all school-age children, 15-20% experience headache and 3-5% of these are migraine. To determine the grade of disability caused by migraine, a specific scale, the Migraine Disability Assessment (MIDAS) questionnaire has been developed. Our objective was to gain information about the evaluation of different types of headaches in adolescents by using the Turkish version of the MIDAS, and to investigate its reliability for differentiation of migraine and tension type headaches. Material and Methods: Eighty two adolescents between the ages of 10 and 16 years were asked questions about the characteristics of their headaches and then the MIDAS questionnaire was administered. The type of headache was then determined according to the International Classification of Headache Disorders Criteria-II (ICHD-II). Results: In 45 patients (54.9%) tension type, in 20 patients (24.4%) migraine, in 10 patients (12.2%) psychogenic type and in seven (8.5%) patients a mixed or nonspecific headache was found. It was found that patients with tension type headaches were more likely to have a grade 1score (48.9%) whereas migraine type headache was more common in grade 4 (45%). Conclusion: We believe that modification of the MIDAS questionnaire to meet the needs of adolescent patients will help in the differentiation between different types of headaches.WoSScopu

Type Of Setting For The Inpatient Adolescent With An Eating Disorder: Are Specialized Inpatient Clinics A Must Or Will The Pediatric Ward Do?

There are a range of different services for treating adolescent eating disorders (ED) but there is no clinical consensus and a paucity of research indicating which type of treatment setting is the best. Although it would be ideal to have a specialized ward for these patients what happens when this is not possible? The aim of this study was to evaluate patients with ED hospitalized on a general pediatric ward. A retrospective chart review for 37 patients hospitalized for an ED and followed by a team consisting of an adolescent medicine specialist, a child and adolescent psychiatrist and a dietician on a pediatric ward were re-evaluated. Twenty-four (64.9%) patients were diagnosed with anorexia nervosa (AN) restricting type, 8 (21.6%) with anorexia nervosa binging purging type, 3 (8.1%) with bulimia nervosa (BN) and 2 (5.4%) with eating disorder otherwise not specified. The mean age at admission was 14.79 +/- 1.75 years and 7 (20%) were males. A majority were hospitalized due to medical instability. Mean period of time from admittance to medical stabilization was 6.04 +/- 4.79 days. The mean period of admittance was 26.4 +/- 11.9 days for AN and 23.7 +/- 15.03 days for BN patients. The mean calorie intake of the AN group was 607 +/- 333 kcal and 2,358 +/- 605 kcal at hospitalization and discharge, respectively. Hypophosphatemia occurred in 2 patients during refeeding. Mean total weight gained during the whole hospitalization period was 3,950 +/- 3,524grs. This study shows that although not ideal, EDs can successfully be followed on general pediatric wards and could have implications at centers with no specialized wards.WoSScopu

Diastematomyelia: A Case With Familial Aggregation of Neural Tube Defects

Intrauterine neural tube defects, meningomyelocele, and diastematomyelia are developmental errors at different stages of the closure of the neural tube. The familial aggregation of these neural tube defects is not previously reported in the literature and should make one think about a common embryogenesis and a possible common mechanism of etiopathogenesis leading to anomalies at different stages of this embryogenesis. This paper presents a 12-year-old Turkish boy with diastematomyelia who was suspected with a demonstrative dermatologic finding without any neurologic sign and diagnosed with magnetic resonance imaging (MRI). He has a positive family history of a stillbirth with neural tube defect, an exitus with meningomyelocele, and an epileptic child in his female siblings.PubMedScopu