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Arch Dis Child Fetal Neonatal Ed 2004;89:F57-F60 Objective: To describe the immune response of preterm infants to a diphtheria/tetanus/three component acellular pertussis (DTaP) vaccine, under an accelerated schedule, and the [...]

A 13 year old girl presented with auricular chondritis and recurrent episodes of unexplained chest pain, arthritis, bronchitis, conjunctivitis, prolonged steroid resistant alopecia areata, and a history of recurrent tonsillitis. [...]

We read with interest the letters: 'Is parenteral methotrexate worth trying?' by Osman and Mulherin (1) and 'Intramuscular methotrexate in inflammatory rheumatic disease' by Burbage, Gupta, and Lim. (2) We [...]

Identification of the population at risk, minimalization of risk factors, adequate calcium and vitamin supply, and regular physical exercise are the best measures for preventing osteoporosis. Hormonal replacement, biphosphonates, and calcium are effective therapies. Coherence therapy is a promising therapeutic option.

Coined in French in the early 1820s as a mere description of a pathological state of the bone, the term ‘osteoporosis’ made its way into the English medical vocabulary only in the twentieth century. Unlike other medical concepts, which have not been substantially altered by progress in medical research, the definition of osteoporosis has constantly reflected the state of knowledge on the phenomenon itself. Over its 170 years of evolution, this definition has continuously sought to maintain a difficult balance between physiological and clinical criteria. Even at present, while the 1990 Consensus Conference definition (centering mainly on physiological deterioration) merely implies the clinical aspect through the notions of fragility and fracture risk, others advocate restriction of the term to the clinical consequences of osteopenia. How will the concept of osteoporosis develop in the future? This article, which deals with the origin of the term and its successive definitions, is offered as a basis for further discussion on this subject of high topicality.

Summary Progressive diaphyseal dysplasia is a rare osteosclerotic dysplasia of the bone which presents clinically with bone pain, muscle weakness and a waddling gait. Radiography, which shows progressive hyperostosis along the long bones forms the basis of the diagnosis. We present a young patient in whom pain and limitation of movement in the shoulder joint area, mimicking capsulitis, were the presenting symptoms of the disease. The diagnostic and the therapeutic approach to this unusual disorder are discussed.

Abstract: Calcium hydroxyapatite deposition [CHAD] of the hand and wrist, known also as acute calcific tendonitis, is an uncommon entity frequently misdiagnosed as infection, tumor or a tumor-like condition. We describe a series of seven patients in whom the clinical features, means of diagnosis, pathophysiology and modalities of conservative and surgical treatment are discussed. The proper diagnosis avoids unnecessary antibiotic treatment, surgery, potential anesthetic complications and hospitalization.

A patient with Crohn’s disease developed proximal muscle weakness, increased serum creatine phosphokinase activity and electromyographic abnormalities. A muscle biopsy was non-diagnostic. Although rare, myositis should be included in the differential diagnosis of muscle weakness in patients with inflammatory bowel disease.

Summary Spontaneous fractures of the sternum are rare but worth knowing as they may simulate acute cardiac and pulmonary emergencies. A case of an insufficiency sternal fracture mimicking myocardial infarction and subsequent anginal pain is presented. The risk factors of this condition, its clinical features and the diagnostic procedures are discussed. Spontaneous fractures of the sternum should be considered as a diagnostic possibility for unexplained chest pains in the elderly.

Four premature infants developed apnoeas severe enough to warrant resuscitation after immunisation with diphtheria, pertussis, and tetanus (DPT), and Haemophilus influenzae B (Hib). One required re-intubation and ventilation. Although apnoeas after immunisation are recognised, they are not well documented. It is time for further research to elucidate the best time to immunise such infants.