Low bone mineral density is found in low weight female youth with avoidant/restrictive food intake disorder and associated with higher PYY levels

BACKGROUND: Avoidant/restrictive food intake disorder (ARFID) is a restrictive eating disorder commonly associated with medical complications of undernutrition and low weight. In adolescence, a critical time for bone accrual, the impact of ARFID on bone health is uncertain. We aimed to study bone health in low-weight females with ARFID, as well as the association between peptide YY (PYY), an anorexigenic hormone with a role in regulation of bone metabolism, and bone mineral density (BMD) in these individuals. We hypothesized that BMD would be lower in low-weight females with ARFID than healthy controls (HC), and that PYY levels would be negatively associated with BMD. METHODS: We performed a cross-sectional study in 14 adolescent low-weight females with ARFID and 20 HC 10–23 years old. We assessed BMD (total body, total body less head and lumbar spine) using dual x-ray absorptiometry (DXA) and assessed fasting total PYY concentration in blood. RESULTS: Total body BMD Z-scores were significantly lower in ARFID than in HC (− 1.41 ± 0.28 vs. − 0.50 ± 0.25, p = 0.021). Mean PYY levels trended higher in ARFID vs. HC (98.18 ± 13.55 pg/ml vs. 71.40 ± 5.61 pg/ml, p = 0.055). In multivariate analysis within the ARFID group, PYY was negatively associated with lumbar BMD adjusted for age (β = -0.481, p = 0.032). CONCLUSION: Our findings suggest that female adolescents with low-weight ARFID may have lower BMD than healthy controls and that higher PYY levels may be associated with lower BMD at some, but not all, sites in ARFID. Further research with larger samples will be important to investigate whether high PYY drives bone loss in ARFID

Long Term Therapy with Lenalidomide in a patient with POEMS Syndrome

Lenalidomide is an effective therapy against malignant plasma cells and a potent agent against proinflammatory and proangiogenic cytokines. The use of lenalidomide in POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein with plasma cells, skin changes) has been reported, but its benefit in long-term use is not well established. A 55-year-old man with POEMS and debilitating polyneuropathy was treated with lenalidomide and dexamethasone followed by maintenance lenalidomide. He remains in haematologic remission and in complete recovery of functional status 3.5 years after diagnosis. This case supports the long-term use of lenalidomide in patients with POEMS syndrome

The effects of concreteness on mathematical manipulative choice

There is mixed evidence as to whether concrete manipulatives (e.g., toy animals) are better than abstract manipulatives (e.g., counters) for teaching mathematical concepts to children. Concreteness is defined as the amount of extraneous information a manipulative provides, and in this study we aimed to unpick which dimensions of concreteness influence manipulative choice. Researchers, teachers, and parents completed a comparative judgement task comparing images of manipulatives varying in different dimensions of concreteness, selecting which they would choose to teach arithmetic to children. The findings indicated homogeneous, 3-dimensional manipulatives were the most preferred across all groups to teach arithmetic to children, regardless of more extraneous features. This contradicts research recommendations to minimise the use of concrete manipulatives due to their distractive qualities. Instead, it suggests that some concrete features may be preferred in more naturalistic contexts. More research is required to investigate how different dimensions of concreteness influence learning outcomes for children both in artificial research contexts and in practice.</p