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Objective: To determine bone mineral density (BMD) at axial and appendicular sites in patients with type 1 diabetes mellitus and evaluate its relationship with metabolic control and disease duration., Patients and Methods: BMD was measured by dual-energy X-ray absorptiometry (Hologic QDR-1000) in the lumbar spine (L1-L4) and at the distal third forearm in 246 healthy non-diabetic children and adolescents (111 boys, 135 girls, aged 2.8-20.8 years) and in 45 diabetic patients (18 boys, 27 girls, aged 5.2-19.4 years). The results were expressed as the mean and standard deviation. The differences were tested by analysis of variance or Students t-test, as appropriate. The relationship between BMD and the remaining variables was studied by simple Pearsons coefficient and partial correlation coefficient. Significance was defined as p < 0.05., Results: BMD Increased progressively from infancy to adulthood In both populations. Lumbar spine and forearm BMD were significantly lower in diabetic patients than in the healthy non-diabetic children, mainly during pubertal spurt. The greatest differences were found in males and in the trabecular bone. No relationship was found between metabolic control (mean glycosylated hemoglobin, insulin requirement) and duration of diabetes and the BMD in any region studied (p > 0.05)., Conclusions: Pediatric patients with type 1 diabetes mellitus appear to constitute a population at risk of osteoporosis in adult-hood. Diagnosis of osteopenia diagnosis should be established according to densitometric criteria. In this study, metabolic control parameters and duration of diabetes did not enable predetermination of diabetic patients at risk of osteoporosis in adulthood.

Objective: In order to establish the normal patterns of forearm bone mineral density (BMD), BMD in the cortical and trabecular parts of the distal forearm were studied in a normal pediatric population., Patients and Methods: BMD was measured by dual-energy X-ray absorptiometry (HOLOGIC QDR-1000) in the distal third forearm of 246 normal children and adolescents (111 boys and 135 girls) ranging from 2.8 to 20.8 years of age. BMD was correlated by multiple regression analysis with age, weight, body mass index (BMI), sex and pubertal Tanner stage., Results: Forearm BMD increased progressively with age, weight, height, BMI and maturity, with the maximal increase in all forearm bone sites occurring at the onset of puberty in girls and boys. A statistically significant correlation was found between forearm BMD and all of these variables (r = 0.65 to 0.92). Mean BMD was higher in boys than in girls in cortical, trabecular and cortical-trabecular sites of the distal forearm. Maximal differences in BMD between boys and girls occurred at 17-18 years of age, especially the trabecular-dominated (ultradistal) part of the distal forearm (0.446 vs 0.384 g/cm2)., Conclusions: Forearm BMD studies permit information of both cortical and trabecular bone mineralization to be obtained at the same time. This study reports normative data for forearm BMD in a healthy pediatric population. The values obtained may be used as a reference of normality when evaluating bone density in situations where skeletal mineralization may be compromised.

Objective: Our objective was to study children with familial short stature (FSS) to observe whether they develop bone mineralization similar to that seen in healthy children with an adequate height for their age and sex., Patients and Methods: The study included 70 FSS patients (39 boys and 31 girls) between 6 and 20 years of age and 246 control patients with the same mean age and sex of the study group. Bone mineral density was measured in the lumbar spine and forearm by performing dual energy X-ray absorptiometry using a Hologic ADR-1000., Results: The main difference between the FSS population and the control group was in the final adult bone mass, which was 20% less in the lumbar spine and 15% less in the forearm in the FSS group., Conclusions: A large difference in bone mineralization was observed among the FSS population compared to the control group during infancy and adolescence and this becomes accentuated with age or growth resulting in bone mineralization that is not optimum for facing the losses which occur during adulthood.

Objectives: The objective was to study hydronephrosis, the most common renal malformation during the neonatal period., Patients and Methods: We have studied 85 patients (119 renal units) with hydronephrosis. Prenatal and neonatal diagnosis were performed in 83% and 17%, respectively. Diagnosis was made by ultrasound, intravenous urography, voiding cystourethography and diuretic renogram., Results: The malformations were as follows: Ureteropelvic junction obstruction (UPJ; 40 cases), obstructive megaureter (OM; 16 cases), non-obstructive megaureter (NOM; 9 cases), multicystic kidney (MK; 8 cases), renoureteral duplication (RD; 8 cases) and posterior urethral valves (PUV; 4 cases). Surgical treatment was undergone in 39 cases (14 with UPJ, 10 with OM, 4 with NOM, 4 with MK, 3 with RD and 4 with PUV). Thirty-seven of these cases had prenatal diagnoses., Conclusions: Conservative therapy was followed in 46 patients (26 with UPJ, 6 with OM, 5 with NOM, 4 with MK and 5 with RD). Thirty of these were prenatally diagnosed. Postnatal mean follow-up was 36 months, using diagnostic methods described previously. Seven cases died (1 from sepsis and 6 others from associated malformations) and 78 patients have good evolution after surgical and conservative treatments.