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Rickets at children and adults
Rickets is an illness which mainly develops at the person at children's and infantile age. This disease is known to mankind long ago. So, references of this illness were found in manuscripts of ancient physicians. For the first time accurate symptoms of rickets were described in the seventeenth century in England. By the way, the English physicians called this illness "a foggy illness" as rickets was most often shown at children of working people who constantly lived in the smog arising because of the smoking factories. But nevertheless the real reason of this disease was defined only in the 1980th years.
The term "rickets" comes from the Greek word "a backbone ". This illness rather often occurs among children. At rickets formation of bones is broken. It happens because of deficit in an organism of a calcium-phosphorus exchange. Symptoms of rickets are found in children worldwide. However most often rickets at babies develops in the northern countries where there is not enough sunlight. Some modern scientists claim that than a half of children has rickets of different severity more. More often this illness is diagnosed for babies who were born in the fall and in the winter.
In the countries where the medicine is well developed, accurate prevention of this disease is conducted, and children receive adequate treatment as soon as the first symptoms of rickets appear. However after carrying out X-ray inspection at children the hidden symptoms of rickets which are difficult for noticing at survey or on a photo can come to light.
If the person in infancy had rickets, then effects of a disease remain for the rest of life. The person who had rickets has disturbances of a bearing, flat-footedness, there is a deformation of pelvic bones, short-sightedness. Also at adult age diseases of teeth, in particular, caries develop. But if at the person in the childhood only easy degree of rickets was observed, then such effects are not observed.
Much vitamin D as without it the organism does not acquire calcium means in the course of bone tissue forming. Respectively, this mineral which is the main material for a structure of a bone tissue does not come to bones. Therefore, the lack of vitamin D of an organism was considered as the main reason of rickets. But recently there was an opportunity to define concentration of metabolites of vitamin D in blood. As a result, it became clear that deficit of vitamin D is only one of the reasons of development of rickets. Modern specialists say that the lack of phosphates and salts of calcium is a basic reason of rickets, at the same time the hypophosphatemia has first-priority value.
At babies and children at early age the variety of reasons on which in an organism the lack of salts of calcium and phosphates can be observed is defined. First of all, this birth of the baby premature as phosphorus and calcium most actively arrives to the child in the last trimester of pregnancy.
After the birth the lack of calcium and phosphorus of an organism can be observed in connection with the wrong feeding of the child. Because rickets is considered an illness of an organism which grows, higher need for minerals is when the period of intensive growth of the child is observed.
Disturbance of their transportation in kidneys, a liver, a gastrointestinal tract, bones becomes the reason of deficit of these minerals also sometimes. It happens owing to diseases of these bodies or because of immaturity of fermental systems. Besides, the bad ecological situation, disturbances in work of endocrine system and a genetic favor to a disease can become the reason of development of rickets. Rickets smuglokozhy children have more often, that who have a blood group of II (A), at boys rickets is diagnosed more often than for girls.
Rickets symptoms for the first time become noticeable at children at the age of two-three months. If parents attentively watch the kid, then the fact that the child began to show concern can disturb them, to be frightened bright light and loud sounds. Rickets at babies is shown by a sleep disorder: the kid sleeps is very disturbing and is restless. Constant perspiration is observed: at the child the head, a face sweats. At the same time sweat has the expressed acid smell. Rickets at children about one year is shown also by the fact that on a head the child gradually has a bald head as the kid constantly a nape rubs about a pillow. It is an important sign which can be determined at survey and even by a photo.
In development of an illness symptoms of rickets at babies become more various and expressed. At the kid the small appetite is observed, the tone of muscles decreases. Edges of a big fontanel which at newborns remains open become soft. On edges at the babies sick with rickets, thickenings are observed. It is important to parents not to miss this period and to consult with the doctor how to treat rickets. As a rule, the specialist appoints necessary drugs. Otherwise to six-month-old age the illness progresses to heavier degree. Then neuromuscular frustration are already noted, delay signs in physical and mental development are shown. Skull bones at the sick child are softened, and the nape is flattened.
Sometimes the bone tissue expands in a forehead and a darkness there are hillocks, and on wrists and edges there are noticeable thickenings. Hard cases of rickets at babies are expressed by changes in a thorax: it is deformed and pressed or stuck out. There is a curvature of legs, pelvic bones are narrowed.
Rickets at adults, as well as at children, has several periods. Also three severity of rickets – hidden, average degree, heavy degree are defined. On character of a course of a disease acute, subacute and recurrent rickets is allocated.
Diagnosis of rickets
The specialist can diagnose rickets after detailed acquaintance with a clinical picture of an illness. Besides, blood tests are carried out to determine the level of calcium, phosphorus and activity of an alkaline phosphatase. If the activity increased, then it is also the most precursory symptom of a disease. And, it can be found still before noticeable symptoms of an illness are shown. Also carrying out the analysis of urine for determination of concentration of calcium in it is sometimes appointed. In the course of research carrying out X-ray inspection of bones of the child is also appointed.
Treatment of rickets
Effectively to cure a disease, it is necessary to take measures at once after establishment of the diagnosis. The most important point is saturation of an organism of the sick child or adult fluorine, calcium and vitamin D. Beginning treatment of rickets at children, parents should know that one of important points of therapy is regular stay of the kid on the street when the sun is located highly. However it is necessary to consider that if there were symptoms of rickets at the child who was not one year old yet, then in the flying such kid cannot be under direct beams of the sun. Artificial radiation by an ultraviolet also contraindicated. And here the child after a year can acquire periodically a tan, but only a limited amount of time. During the summer period for receiving a sufficient dose of vitamin it is enough to child to walk on the street about 20 minutes in clothes with a short sleeve. And here during the autumn and winter period of babies it is possible to take out on the street for an unlimited span.
Parents who note symptoms of rickets at children have to treat the organization of a food allowance very carefully. The products rich in vitamin D, is cod liver, a halibut. Calcium contains in various dairy products, green vegetables.
Daily the child has to receive vitamin D in a dose 400 ME. Without enough this vitamin, calcium is not acquired in intestines. Therefore both treatment, and prevention of rickets provides its reception. In the course of treatment of an illness specialists recommend to accept the drugs containing D3 vitamin as D2 vitamin is acquired by an organism worse. Aqueous solution of D3 vitamin is a medicamentous drug "Akvadetrim". It is appointed to children who were 3-4 weeks old. To accept drug on 1-2 drops a day. However, having found rickets symptoms in children, parents should not make independently the decision on administration of drug with the content of vitamin D as overdose can have negative effects for an organism. To define how to treat rickets, in each case only the specialist after diagnosis and survey of the child can. Neither according to stories of parents, nor precisely it is impossible to determine features of disease by a photo.
Important part of therapy is nonspecific treatment. This, first of all, natural feeding of the baby, correct day regimen, massage sessions, gymnastics, hardening, etc. If treatment of rickets is begun timely and at the same time is carried out correctly, then gradually all symptoms disappear, and disease effects are not shown later.
Prevention of rickets
Future mother has to think that the child can get sick with rickets her during pregnancy. Therefore, prevention of rickets begins even during pre-natal development. The pregnant woman has to have the balanced diet. Every day it is necessary to use vegetables, meat, dairy products. The correct day regimen, gymnastics, treatment of toxicosis, anemia is important for the pregnant woman. Throughout the entire period of incubation of the child it is necessary to accept vitamin complexes which are selected by the doctor. Future mother has to make everything in order that the fruit developed harmoniously.
Young mother needs and to accept further vitamins, but it is possible to choose them only after consultation with the doctor. It is very important that, at least, to six-month-old age the child received breast milk as microelements which contain in it are well acquired. Natural feeding completely satisfies need of the child for microelements and vitamins. If necessary, the pediatrician can sometimes appoint reception of polyvitamins directly to the kid.
When feeding up time comes, in process of introduction of new products the child should give periodically dishes with products which contain a large amount of vitamin D. It eggs, fish, butter, green vegetables. Approximately from 7 months the child can give cottage cheese, meat. In a month it is possible to enter into a diet fish gradually. It is especially important to provide receipt of enough vitamin D and microelements to children who stay on the artificial and mixed feeding. It is necessary to show consideration very much for selection of mixes for feeding. It is important that they contained the delivery and balanced amount of calcium, phosphorus and vitamin D. At the correct approach to prevention of a disease it is possible to avoid.
Section: Pediatrics (Children's diseases)