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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Periarticular calcifications containing giant pseudo-crystals of francolite in skeletal fluorosis from 1,1-difluoroethane 'huffing".
Highlights Diagnosing inhalant use disorder can be lifesaving. Chronic inhalation of F--containing vapors can cause skeletal fluorosis (SF). SF can elevate bone density and cause periostitis and ectopic calcification. Francolite is a carbonate-rich fluorapatite. Periarticular calcification in SF can comprise giant pseudo-crystals of francolite. Inhalant use disorder is a psychiatric
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Skeletal fluorosis from instant tea
INTRODUCTION: Skeletal fluorosis (SF) can result from prolonged consumption of well water with >4 ppm fluoride ion (F(-); i.e., >4 mg/liter). Black and green teas can contain significant amounts of F(-). In 2005, SF caused by drinking 1-2 gallons of double-strength instant tea daily throughout adult life was reported in
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Skeletal Fluorosis: An Unusual Manifestation of Computer Cleaner Inhalant Abuse.
Skeletal fluorosis is a metabolic bone disease caused by accumulation of fluoride and is generally associated with chronic exposure to fluoride-contaminated groundwater, a phenomenon endemic to developing countries. Whereas elevated water fluoride concentrations do not constitute a public health issue in the United States, emergence of skeletal fluorosis as a
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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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"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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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 & Individual Variability
One of the common fallacies in the research on skeletal fluorosis is the notion that there is a uniform level of fluoride that is safe for everyone in the population. These "safety thresholds" have been expressed in terms of (a) bone fluoride content, (b) daily dose, (c) water fluoride level, (d) urinary fluoride level, and (e) blood fluoride level. The central fallacy with each of these alleged safety thresholds, however, is that they ignore the wide range of individual susceptibility in how people respond to toxic substances, including fluoride.
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Similarities between Skeletal Fluorosis and Renal Osteodystrophy
It is quite possible, and indeed likely, that some kidney patients diagnosed with renal osteodystrophy are either suffering from skeletal fluorosis or their condition is being complicated/exacerbated by fluoride exposure.
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