Abstract
Chronic fluoride intoxication in the form of dental and skeletal fluorosis was surveyed in five villages of the Palamau district, Jharkhand, India. Out of 238 sources of drinking water, mainly from groundwater, the majority had elevated fluoride concentrations capable of causing health risk to the community. In one water source a concentration of 12 mg F/L was observed. Dietary intake of fluoride through food, however, was much less significant compared with drinking water. Among the children, 83% were diagnosed with dental fluorosis, and 47% of adults were afflicted with various stages of skeletal fluorosis. A level of 2.5 mg F/L was found to be a critical threshold for manifestations of crippling skeletal fluorosis. Household defluoridation along with improved nutrition rich in calcium is recommended for amelioration of fluorosis in these villages.
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Increasing fluoride content deteriorates rat bone mechanical properties.
Highlights High fluoride increases indentation distances and lowers elastic modulus and ultimate stress. cRPI indentation distances were inversely related to elastic modulus and ultimate stress. In vitro NaF incubation detrimentally affects bone's mechanical behavior. Elevation of bone fluoride levels due to drinking beverages with high fluoride content or other means
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Painful periostitis in the setting of chronic voriconazole therapy
A 72-year-old woman on chronic voriconazole therapy for recurrent histoplasmosis developed a painful forearm mass. Laboratory and imaging findings were consistent with a diffuse periostitis. Her symptoms resolved after discontinuation of voriconazole. To our knowledge, this is the first case of voriconazole-induced periostitis to be reported in a patient with
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Endemic fluorosis in San Luis Potosi, Mexico. II Identification of risk factors associated with occupational exposure to fluoride.
SUMMARY: The city of San Luis Potosi (SLP), Mexico, is located in an area where drinking water contains excessive quantities of natural fluoride. Also in this city is located a small industry that produces hydrofluoric acid. In order to investigate both routes of exposure to fluoride (industrial air and drinking
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Downregulation of miR-4755-5p promotes fluoride-induced osteoblast activation via tageting Cyclin D1.
Background Endemic fluorosis remains a major public health issue in many countries. Fluoride can cause abnormalities in osteoblast proliferation and activation, leading to skeletal fluorosis. However, its detailed molecular mechanism remains unclear. Based on a previous study, the aim of this study is to explore the role of miRNA in osteoblast
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A Fluoride Zonation Map of the Karbianglong District, Assam, India
The Assam region has been recognized only recently as one of the endemic fluorosis areas in India. Surveys indicate that one-seventh of the 700,000 people in the Karbianglong district of Assam have dental and/or skeletal fluorosis. For this reason, the high concentrations of fluoride (F) in the water resources in
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Fluoride & Osteoarthritis
While the osteoarthritic effects that occurred from fluoride exposure were once considered to be limited to those with skeletal fluorosis, recent research shows that fluoride can cause osteoarthritis in the absence of traditionally defined fluorosis. Conventional methods used for detecting skeletal fluorosis, therefore, will fail to detect the full range of people suffering from fluoride-induced osteoarthritis.
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"Pre-Skeletal" Fluorosis
As demonstrated by the studies below, skeletal fluorosis may produce adverse symptoms, including arthritic pains, clinical osteoarthritis, gastrointestinal disturbances, and bone fragility, before the classic bone change of fluorosis (i.e., osteosclerosis in the spine and pelvis) is detectable by x-ray. Relying on x-rays, therefore, to diagnosis skeletal fluorosis will invariably fail to protect those individuals who are suffering from the pre-skeletal phase of the disease. Moreover, some individuals with clinical skeletal fluorosis will not develop an increase in bone density, let alone osteosclerosis, of the spine. Thus, relying on unusual increases in spinal bone density will under-detect the rate of skeletal fluoride poisoning in a population.
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Skeletal Fluorosis: The Misdiagnosis Problem
It is a virtual certainty that there are individuals in the general population unknowingly suffering from some form of skeletal fluorosis as a result of a doctor's failure to consider fluoride as a cause of their symptoms. Proof that this is the case can be found in the following case reports of skeletal fluorosis written by doctors in the U.S. and other western countries. As can be seen, a consistent feature of these reports is that fluorosis patients--even those with crippling skeletal fluorosis--are misdiagnosed for years by multiple teams of doctors who routinely fail to consider fluoride as a possible cause of their disease.
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Skeletal Fluorosis in the U.S.
Although there has been a notable absence of systematic studies on skeletal fluorosis in the U.S., the available evidence indicates that the consumption of artificially fluoridated water is likely to cause skeletal fluorosis and other forms of bone disease in people with kidney disease and other vulnerable populations.
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Variability in Radiographic Appearance of Skeletal Fluorosis
Osteosclerosis (dense bone) is the bone change typically associated with skeletal fluorosis, particularly in the axial skeleton (spine, pelvis, and ribs). Research shows, however, that skeletal fluorosis produces a spectrum of bone changes, including osteomalacia, osteoporosis, exostoses, changes resulting from secondary hyperparathyroidism, and combinations thereof. Although the reason for this radiographic variability is not yet fully understood, it is believed to relate to the dose of fluoride consumed, the individual's nutritional status, exposure to aluminum, genetic susceptibility, presence of kidney disease, and area of the skeleton examined.
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