Abstract
Serum fluoride in relation to the prevalence of skeletal fluorosis was investigated in two villages in Jiangsu Province, China. In the high-fluoride village of Wamiao, 132 adults (average age 52.36 years; water fluoride 2.18±0.86mg/L; range 0.85–4.50mg/L) were surveyed. In the low-fluoride village of Xinhuai, 35 adults (average age 48.11 years; water fluoride 0.37±0.09 mg/L; range 0.21–0.55mg/L) were surveyed. Subjects were recruited by sampling according to the fluoride content of the drinking water in their household wells. When the subjects were divided into five subgroups according to their serum fluoride concentration, higher serum fluoride concentration was strongly associated with a higher prevalence of skeletal fluorosis in the form of a significant positive dose-response relationship (regression equation: Y = –27.29+890.42X–223.20X 2 ). In Wamiao village a significant difference was also found between serum fluoride concentrations in 41 subjects with X-ray detectable skeletal fluorosis and in 91 subjects without X-ray detectable skeletal fluorosis. Gender related differences in serum fluoride concentration, household well water fluoride, and the prevalence of skeletal fluorosis were not found in the subjects in Wamiao village. These findings indicate that serum fluoride concentrations have a significant positive dose-response relationship with the prevalence of skeletal fluorosis in an endemic fluorosis area associated with high-fluoride drinking water.
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[Relationship between fluoride exposure, orthopedic injuries and bone formation markers in patients with coal-burning fluorosis].
Chronic exposure to fluoride is a public health problem worldwide. We explored the relationship between fluoride exposure, orthopedic injuries and bone formation markers alkaline phosphatase (ALP), bone Gla protein (BGP) in participants with coal-burning fluorosis in Hehua Village (coal-burning fluorosis endemic area) in Zhijin County of Guizhou Province and Zhangguan
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Skeletal fluorosis in a resettled refugee from Kakuma refugee camp.
“I suspected some contamination of the water of the much-frequented street pump in Broad Street, near the end of Cambridge Street”, said John Snow, about the contaminated water pump of the cholera outbreak of 1854, in London, UK.1 In September, 2015, a Somalian man aged 46 years presented to a refugee
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Voriconazole-associated periostitis: Pathophysiology, risk factors, clinical manifestations, diagnosis, and management.
Voriconazole use has been associated with osteoarticular pain and periostitis, likely due to high fluoride content in the drug formulation. This phenomenon has been described primarily with high dosage or prolonged course of voriconazole therapy in immunocompromised and transplant patient populations. Patients typically present with diffuse bony pains associated with
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Skeletal fluorosis in Vavuniya District: an observational study.
Background: The WHO recommended safe upper limit for fluoride in drinking water is 1.5 mg/l. Groundwater sources in many parts of Sri Lanka often exceed this limit. The high fluoride content of groundwater and high environmental temperatures in Vavuniya District predispose to pre-skeletal fluorosis and skeletal fluorosis in adults. Objectives: To
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ESPEN micronutrient guideline
Background Trace elements and vitamins, named together micronutrients (MNs), are essential for human metabolism. Recent research has shown the importance of MNs in common pathologies, with significant deficiencies impacting the outcome. Objective This guideline aims to provide information for daily clinical nutrition practice regarding assessment of MN status, monitoring, and prescription. It proposes
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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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"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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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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Fluoride Reduces Bone Strength Prior to Onset of Skeletal Fluorosis
The majority of animal studies investigating fluoride's impact on bone strength have found that fluoride has either no effect, or a detrimental effect, on bone strength. Importantly, several of the animal studies that have found fluoride reductes bone strength have reported that this reduction in strength occurs before signs of skeletal fluorosis
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Fluoride Magnifies Impact of Repetitive Stress on Joints
Research has repeatedly found that fluoride's effect on the skeleton is most pronounced in the bones and joints that undergo the greatest strain. Indeed, both the symptoms of fluorosis (i.e., joint pain and stiffness) as well as the radiological findings (e.g., exostoses, interosseuous membrane calcification) have been found to occur earliest, and most severely, in the joints
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