ITEMS IN AFP WITH MESH TERM:
ABSTRACT: Children and adolescents whose heights and growth velocities deviate from the normal percentiles on standard growth charts present a special challenge to physicians. Height that is less than the 3rd percentile or greater than the 97th percentile is deemed short or tall stature, respectively. A growth velocity outside the 25th to 75th percentile range may be considered abnormal. Serial height measurements over time documented on a growth chart are key in identifying abnormal growth. Short or tall stature is usually caused by variants of a normal growth pattern, although some patients may have serious underlying pathologies. A comprehensive history and physical examination can help differentiate abnormal growth patterns from normal variants and identify specific dysmorphic features of genetic syndromes. History and physical examination findings should guide laboratory testing.
Revised Growth Charts for Children - Practice Guidelines
Osteoporosis in Men - Article
ABSTRACT: Osteoporosis is an important and often overlooked problem in men. Although the lifetime risk of hip fracture is lower in men than in women, men are twice as likely to die after a hip fracture. Bone mineral density measurement with a T-score of -2.5 or less indicates osteoporosis. The American College of Physicians recommends beginning periodic osteoporosis risk assessment in men before 65 years of age and performing dual-energy x-ray absorptiometry for men at increased risk of osteoporosis who are candidates for drug therapy. All men diagnosed with osteoporosis should be evaluated for secondary causes of bone loss. The decision regarding treatment of osteoporosis should be based on clinical evaluation, diagnostic workup, fracture risk assessments, and bone mineral density measurements. Pharmacotherapy is recommended for men with osteoporosis and for high-risk men with low bone mass (osteopenia) with a T-score of -1 to -2.5. Bisphosphonates are the first-line agents for treating osteoporosis in men. Teriparatide (i.e., recombinant human parathyroid hormone) is an option for men with severe osteoporosis. Testosterone therapy is beneficial for men with osteoporosis and hypogonadism. Adequate intake of calcium and vitamin D should be encouraged in all men to maintain bone mass. Men should be educated regarding lifestyle measures, which include weight-bearing exercise, limiting alcohol consumption, and smoking cessation. Fall prevention strategies should be implemented in older men at risk of falls.
Assessment of Abnormal Growth Curves - Article
ABSTRACT: An important part of well-child care is the assessment of a child's growth. While growth in the vast majority of children falls within normal percentile ranges on standard growth curves, an occasional child demonstrates worrisome deviations in weight, height or head size. A single growth percentile value at any particular point in a child's life is only of limited usefulness to the physician. More important is the child's rate of growth. Children whose growth parameters are at the extremes of the growth curve but whose growth rates are normal are likely to be healthy. Conversely, accelerated or slowed growth rates are rarely normal and warrant further evaluation. This article addresses the initial steps to be taken when evaluating children with suspected growth abnormalities, the guiding principles that apply to all growth problems, and the most common growth curve deviations and approaches to their management.