BACKGROUND & AIMS: :A 43-year-old man developed a skin eruption characterized by 'macules with blisters' typical to Stevens-Johnson syndrome, as well as erosions of the lips and buccal mucosa, 2 weeks after he had started treatment with lamotrigine. He had a fever (39.6 degrees C), elevated liver enzymes and atypical lymphocytes in the peripheral blood. This undoubtedly reflects a case of Stevens-Johnson syndrome induced by lamotrigine, but it can also fulfill the criteria of anticonvulsant hypersensitivity syndrome or drug rash with eosinophilia and systemic signs. A case that precisely fits the definition of two syndromes that have different characteristics, different treatments and different prognoses indicates that there is a flaw in the classification.

背景与目标： : 一名43岁的男子在开始使用拉莫三嗪治疗2周后，出现了以史蒂文斯-约翰逊综合征典型的 “带水疱的斑疹” 以及嘴唇和颊粘膜糜烂为特征的皮肤喷发。发热 (39.6 ℃)，肝酶升高，外周血淋巴细胞不典型。这无疑反映了拉莫三嗪诱发的史蒂文斯-约翰逊综合征，但它也可以满足抗惊厥超敏反应综合征或伴有嗜酸性粒细胞增多和全身体征的药疹的标准。一个精确地符合具有不同特征，不同治疗方法和不同预后的两种综合征的定义的案例表明，分类存在缺陷。

BACKGROUND & AIMS: :Restless legs syndrome (RLS) is a common condition that is difficult to diagnose. However, once correctly diagnosed, its management is straightforward and evidence-based. The purpose of this article is to familiarise clinicians with both the symptoms and diagnostic criteria for RLS and to elucidate secondary and often curable causes of this prevalent condition. There is also a concise review of its pathophysiology and current management strategies. The authors hope this article will raise awareness of this condition among clinicians and in doing so improve the quality of life for the patients affected by it.

背景与目标： : 不宁腿综合征 (RLS) 是一种很难诊断的常见疾病。然而，一旦被正确诊断，它的管理是直接的和基于证据的。本文的目的是使临床医生熟悉RLS的症状和诊断标准，并阐明这种普遍情况的继发性和通常可治愈的原因。还简要回顾了其病理生理学和当前的管理策略。作者希望这篇文章能提高临床医生对这种疾病的认识，并以此改善受其影响的患者的生活质量。

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: OBJECTIVE:Patients with severe traumatic or burn injury and a mouse model of burn injury were studied early after injury to determine the relation of plasma endotoxin (lipopolysaccharide [LPS]) to the production of proinflammatory cytokines and subsequent resistance to infection.

SUMMARY BACKGROUND DATA:Elevated levels of plasma LPS have been reported in patients after serious injury. It has been suggested that circulating LPS may be a trigger for increased proinflammatory cytokine production and may play a role in the septic syndromes seen in a substantial portion of such patients. Yet, despite multiple reports of leakage of LPS from the gut and bacterial translocation after injury in animal models, there is little direct evidence linking circulating LPS with production of inflammatory mediators.

METHODS:The authors studied serial samples of peripheral blood from 10 patients with 25% to 50% surface area burns and 8 trauma patients (injury Severity Score, 25-57). Patients were compared with 18 healthy volunteers. The study was focused on the first 10 days after injury before the onset of sepsis or the systemic inflammatory response syndrome. Plasma samples were assayed for LPS, and adherent cells from the blood were studied for basal and LPS-stimulated production of tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), and interleukin-6 (IL-6). The correlation of increased plasma LPS with TNF-alpha production was studied as was the association of increased plasma LPS and increased TNF-alpha production with subsequent septic complications. We also studied a mouse model of 25% burn injury. Burn mice were compared with sham burn control subjects. Plasma samples were assayed at serial intervals for LPS, and adherent cells from the spleens were studied for basal- and LPS-stimulated production of TNF-alpha, IL-1 beta, and IL-6. Expression of the messenger RNAs for IL-1 beta and TNF-alpha also was measured. The relation of increased TNF-alpha production with mortality from a septic challenge, cecal ligation and puncture (CLP), was determined. Finally, the effect of administration of LPS to normal mice on subsequent mortality after CLP and on TNF-alpha production was studied.

RESULTS:Elevated plasma LPS (> 1 pg/mL) was seen in 11 of the 18 patients within 10 days of injury and in no normal control subjects. In this period, patients as compared with control subjects showed increased stimulated production of TNF-alpha, IL-1 beta, and IL-6. Increased TNF-alpha production was not correlated with elevated plasma LPS in the same patients. Neither increased plasma LPS nor increased TNF-alpha production early after injury was correlated with subsequent development of systemic inflammatory response syndrome or sepsis in the patients. Burn mice, as compared with sham burn control subjects, showed elevated plasma LPS levels chiefly in the first 3 days after injury. Increased stimulated production of proinflammatory cytokines by adherent splenocytes from the burn mice also was seen at multiple intervals after injury and did not correlate with mortality from CLP. Increased production of TNF-alpha and IL-1 beta was associated with increased expression of messenger RNAs for these cytokines. Finally, two doses of 1 ng LPS administered 24 hours apart to normal mice had no effect on mortality from CLP performed 7 days later nor on the production of TNF-alpha at the time of CLP.

CONCLUSIONS:These findings call into question the idea that circulating LPS is the trigger for increased proinflammatory cytokine production, systemic inflammatory response syndrome, and septic complications in injured patients.

背景与目标： 目标 : 严重创伤或烧伤患者和烧伤小鼠模型在损伤后早期进行了研究，以确定血浆内毒素 (脂多糖 [LPS]) 与促炎细胞因子的产生以及随后对感染的抵抗力之间的关系。
摘要背景数据 : 据报道，严重损伤后患者血浆LPS水平升高。已经提出，循环LPS可能是促炎性细胞因子产生增加的触发因素，并且可能在此类患者的大部分脓毒症综合征中起作用。然而，尽管有多份动物模型中LPS从肠道泄漏和细菌移位的报道，但几乎没有直接证据将循环LPS与炎症介质的产生联系起来。
方法 : 作者研究了10例25% 至50% 表面积烧伤患者和8例创伤患者的外周血系列样本 (损伤严重程度评分，25-57)。将患者与18名健康志愿者进行比较。该研究的重点是败血症或全身性炎症反应综合征发作前的受伤后10天。测定血浆样品中的LPS，并研究血液中的贴壁细胞的基础和LPS刺激的肿瘤坏死因子-α (TNF-α)，interleukin-1 β (IL-1 β) 和interleukin-6 (IL-6) 的产生。研究了血浆LPS增加与TNF-α 产生的相关性，以及血浆LPS增加和TNF-α 产生增加与随后的败血症并发症的关联。我们还研究了25% 烧伤的小鼠模型。将烧伤小鼠与假烧伤对照组进行比较。以连续间隔测定血浆样品中的LPS，并研究来自脾脏的贴壁细胞的基础和LPS刺激的TNF-α，IL-1 β 和IL-6的产生。还测量了IL-1 β 和TNF-α 的信使rna的表达。确定了TNF-α 产生增加与败血性攻击，盲肠结扎和穿刺 (CLP) 造成的死亡率之间的关系。最后，研究了向正常小鼠施用LPS对CLP后后续死亡率和TNF-α 产生的影响。
结果 : 18例患者中有11例在受伤后10天内发现血浆LPS升高 (> 1 pg/mL)，而没有正常对照。在此期间，与对照组相比，患者表现出TNF-α，IL-1 β 和IL-6的刺激产生增加。在同一患者中，TNF-α 产生的增加与血浆LPS升高无关。损伤后早期血浆LPS的增加和TNF-α 的产生均与患者全身炎症反应综合征或败血症的后续发展无关。与假烧伤对照组相比，烧伤小鼠的血浆LPS水平主要在受伤后的前3天升高。烧伤小鼠的粘附脾细胞刺激促炎细胞的产生也在受伤后的多个间隔内增加，并且与CLP的死亡率无关。TNF-α 和IL-1 β 的产生增加与这些细胞因子的信使rna的表达增加有关。最后，对正常小鼠相隔24小时施用两次1 ng LPS对7天后进行的CLP的死亡率没有影响，也没有对CLP时TNF-α 的产生影响。
结论 : 这些发现使人们质疑循环LPS是导致受伤患者促炎性细胞因子产生增加，全身性炎症反应综合征和败血症并发症的诱因。

BACKGROUND & AIMS: :The genotypic characteristics and drug susceptibility profiles of clinical isolates of Mycobacterium tuberculosis recovered from prison hospital patients in the Tula region (central Russia) during 2001 and 2002 are reported. The emergence of multi-drug-resistant tuberculosis (TB) poses a major health risk to the population, with economic implications for TB control. Prisons serve as a continuous source of TB transmission. The results showed that members of the LAM and Beijing families are major contributors to the epidemiological picture of TB in the population studied. The two families of strains accounted for most of the drug-resistant TB in the population. The genotypic characteristics of the M. tuberculosis predominant LAM strain that was responsible for 31 % of TB cases in this setting are presented.

背景与目标： : 报告了从图拉地区 (俄罗斯中部) 2001年和2002的监狱医院患者中回收的结核分枝杆菌临床分离株的基因型特征和药物敏感性。耐多药结核病 (TB) 的出现对人口构成重大健康风险，对结核病控制具有经济影响。监狱是结核病传播的持续来源。结果表明，LAM和北京家庭的成员是研究人群中结核病流行病学状况的主要贡献者。这两个菌株家族占人群中耐药性结核病的大部分。介绍了在这种情况下导致结核病病例31% 的结核分枝杆菌主要LAM菌株的基因型特征。

BACKGROUND & AIMS: :Sjögren's syndrome is an autoimmune disease of the exocrine glands characterized by the leading symptoms of keratoconjunctivitis and stomatitis sicca based on a complex pathogenesis. The prevalence is about 0.5-1%; primary Sjögren's syndrome is differentiated from secondary Sjögren's syndrome associated with other autoimmune disorders. The diagnosis is established by the presence of subjective complaints and objective evidence of sicca symptoms, anti-Ro(SSA)/La(SSB) antibodies, and/or focal lymphocytic infiltration of the glandular tissue. In addition to the typical sicca symptomatology, which is managed symptomatically by substitution and stimulation therapy, some patients exhibit extraglandular manifestations. Complaints involving the musculoskeletal system and inner ear dominate and are treated by the rheumatologist. The indication for base therapy is tailored to individual needs, but the efficacy of this approach has not been established in studies. About 5-10% of the patients with primary Sjögren's syndrome develop a B-cell non-Hodgkin's lymphoma. The disease requires interdisciplinary management including, among others, ophthalmologists, dentists, and otorhinolaryngologists, depending on the clinical picture.

背景与目标： : 干燥综合征是一种外分泌腺的自身免疫性疾病，其特征是角结膜炎和口炎的主要症状基于复杂的发病机理。患病率约为0.5-1%; 原发性干燥综合征与与其他自身免疫性疾病相关的继发性干燥综合征不同。诊断是通过主观主诉和sicca症状，抗Ro(SSA)/La(SSB) 抗体和/或腺组织的局灶性淋巴细胞浸润的客观证据来确定的。除了通过替代和刺激疗法对症治疗的典型sicca症状外，一些患者还表现出结肠外表现。涉及肌肉骨骼系统和内耳的主诉，由风湿病专家治疗。基础治疗的适应症是根据个人需求量身定制的，但是这种方法的疗效尚未在研究中确定。约5-10% 的原发性干燥综合征患者发展为b细胞非霍奇金淋巴瘤。该疾病需要跨学科的管理，其中包括眼科医生，牙医和耳鼻喉科医生，具体取决于临床情况。

BACKGROUND & AIMS: :We report a patient with a unique combination of features, including microcephaly; mental retardation; poorly developed frontal lobes; hypoplastic pituitary gland; hypothyroidism; alopecia universalis; single maxillary central incisor; taurodontism; median palatal ridge; longitudinally grooved nails; and scoliosis. His unbalanced karyotype was found to be 45,XY,der(15;18)(q10;q10). The constellation of anomalies appears to represent a contiguous gene syndrome caused, at least in part, by deletion of TGIF and the gene responsible for hereditary hypotrichosis simplex. The phenotype of our patient differs other reported patients with del(18p). Possible explanations include (1) the effects of a different deleted region, (2) a positional effect caused by a gene close by, or (3) by interruption of a different gene resulting from chromosomal translocation.

背景与目标： : 我们报告了一名具有独特特征组合的患者，包括小头畸形; 智力低下; 额叶发育不良; 垂体发育不良; 甲状腺功能减退; 普遍脱发; 单个上颌中切牙; 牛角牙症; 正中腭嵴; 纵向开槽的指甲; 和脊柱侧弯。发现他的不平衡核型为45，XY，der(15;18)(q10;q10)。异常星座似乎代表了一个连续的基因综合征，至少部分是由TGIF和负责遗传性低毛丝菌病的基因缺失引起的。我们患者的表型不同于其他报告的del患者 (18p)。可能的解释包括 (1) 不同缺失区域的影响，(2) 由接近的基因引起的位置效应，或 (3) 由染色体易位引起的不同基因的中断。

BACKGROUND & AIMS: PURPOSE OF REVIEW:Postthrombotic syndrome (PTS) is the most common complication of deep venous thrombosis (DVT). Identifying which patients are at high risk of developing PTS would help improve the management of patients with DVT and allow physicians to provide patients with individualized information on their expected prognosis. This review discusses the knowledge gained from key studies over the last decade on the incidence and determinants of PTS, with special emphasis on published studies from the last 2 years. RECENT FINDINGS:About a third to half of DVT patients will develop PTS, in most cases within 1-2 years of acute DVT. Important risk factors for PTS appear to be ipsilateral recurrence of DVT, poor quality of initial anticoagulation for the treatment of DVT and increased body mass index. SUMMARY:Preventing DVT recurrence by providing adequate intensity and duration of anticoagulation for the initial DVT and using effective thromboprophylaxis in high-risk settings is likely to reduce the frequency of PTS. Despite some advances in identifying risk factors for PTS, however, it is still not possible to reliably predict an individual patient's risk of developing PTS after an episode of DVT. Further studies of clinical determinants and biological markers of increased risk of PTS are needed to ultimately improve long-term prognosis after DVT.

背景与目标：

BACKGROUND & AIMS: :In 1969, the United States established its national rubella vaccination program. With the success of the program, 32 years later, reports of rubella reached record low numbers. To assess the achievement of elimination of rubella and congenital rubella syndrome (CRS) in the United States, 7 epidemiological criteria were used. Rubella cases reported to the National Notifiable Diseases Surveillance System from 1998 through 2004 and CRS cases reported to the National Congenital Rubella Syndrome Registry from 1998 through 2004 were analyzed. During 1998-2000, the median number of reported rubella cases was 272, whereas, during 2001-2004, the median number reported was 13. The incidence of rubella decreased significantly, from 0.1/100,000 population in 1998 to 0.005/100,000 population in 2004. Since 2001, 5 infants with CRS have been reported--3 were born in 2001, 1 was born in 2003, and 1 was born in 2004. The epidemiological evidence strongly supports the claim that rubella is no longer endemic in the United States. To prevent future rubella outbreaks and CRS cases, current strategies must be maintained.

背景与目标： : 1969年，美国建立了国家风疹疫苗接种计划。随着该计划的成功，32年后，风疹的报道达到了历史新低。为了评估在美国消除风疹和先天性风疹综合征 (CRS) 的成就，使用了7个流行病学标准。分析了向国家法定疾病监测系统报告的风疹病例1998年2004年和向国家先天性风疹综合征登记1998年2004年报告的CRS病例。在1998-2000年期间，报告的风疹病例的中位数为272，而在2001-2004年期间，报告的中位数为13。风疹的发病率从0.1/100,000人口1998年下降到0.005/100,000人口2004年。自2001年以来，已报告5例CRS婴儿-3例2001年出生，1例2003年出生，1例2004年出生。流行病学证据强烈支持风疹在美国不再流行的说法。为了防止未来的风疹暴发和CRS病例，必须维持当前的策略。

BACKGROUND & AIMS: BACKGROUND:The relationship between accessibility to the full range of subspecialty care available at freestanding pediatric hospitals and organ donor management and recovery rates has not been studied. OBJECTIVE:To examine current rates of recovery of organs from children for transplantation at free-standing pediatric hospitals versus all other hospitals. METHODS:Data from the hospitals served by Mid-America Transplant Services from January 2000 to July 2003 were reviewed. Organ recovery rates from freestanding children's hospitals were compared with the rates from other types of institutions. Patients were included if their organs were considered medically suitable at the time of referral for donation. RESULTS:Overall, 66% (210/318) of the potential organs were recovered. The type of institution in which the potential donor was managed did not influence the proportion of organs recovered: 67% (96/144) at freestanding children's hospitals versus 66% (114/174) at all other hospitals. A greater proportion of livers were recovered at other donor institutions than at children's hospitals (100% vs 85%, P< or =.01). CONCLUSION:The organ recovery rate from potential pediatric donors is low. In general, this rate does not appear to be affected by the type of managing pediatric institution except for liver recovery, which favors institutions that are not freestanding children's hospitals. The low rate of recovery suggests that although suitable donors are identified, appropriate referrals are made, and families provide consent for donation, major obstacles remain to the successful recovery of organs.

背景与目标：

BACKGROUND & AIMS: :There is strong evidence for an association between overgrowth disorders such as Beckwith-Wiedemann syndrome and the development of neoplasia. An increased cancer risk has also been observed in individuals with isolated hemihyperplasia. We critically review the evidence for tumour surveillance in Beckwith-Wiedemann syndrome and isolated hemihyperplasia and suggest local practice guidelines.

背景与目标： : 有强有力的证据表明，Beckwith-Wiedemann综合征等过度生长性疾病与肿瘤的发展之间存在关联。在孤立的半增生个体中也观察到癌症风险增加。我们严格审查了Beckwith-Wiedemann综合征和孤立性半增生中肿瘤监测的证据，并提出了当地实践指南。

BACKGROUND & AIMS: OBJECTIVE:To assess the prevalence of night eating syndrome (NES) and binge eating disorder (BED) and their related behavioral and psychological correlates in persons who sought bariatric surgery. RESEARCH METHODS AND PROCEDURES:A consecutive series of 215 persons with extreme obesity (82% women, 70% European American) completed the Weight and Lifestyle Inventory and a semistructured interview as part of a pre-surgery behavioral/psychological assessment. Diagnoses for NES and BED were based on graded diagnostic criteria. RESULTS:Percentages of participants who met diagnostic criteria for NES by interview were 1.9% for the strictest definition and 8.9% across all definitions of NES. After interview, full DSM-TR criteria for BED were met by 4.2%; an additional 1.4% reported binge eating at least once per week. Self-reported prevalence of NES and BED were higher. Those with NES or BED had significantly more symptoms of depression and a greater history of psychological complications than the remaining sample. DISCUSSION:The prevalence rates of NES and BED among this population of bariatric surgery candidates were lower than expected based on previous reports. Findings and hypotheses regarding lowered prevalence rates are discussed.

背景与目标：

BACKGROUND & AIMS: :Priority setting of health interventions is often ad-hoc and resources are not used to an optimal extent. Underlying problem is that multiple criteria play a role and decisions are complex. Interventions may be chosen to maximize general population health, to reduce health inequalities of disadvantaged or vulnerable groups, ad/or to respond to life-threatening situations, all with respect to practical and budgetary constraints. This is the type of problem that policy makers are typically bad at solving rationally, unaided. They tend to use heuristic or intuitive approaches to simplify complexity, and in the process, important information is ignored. Next, policy makers may select interventions for only political motives. This indicates the need for rational and transparent approaches to priority setting. Over the past decades, a number of approaches have been developed, including evidence-based medicine, burden of disease analyses, cost-effectiveness analyses, and equity analyses. However, these approaches concentrate on single criteria only, whereas in reality, policy makers need to make choices taking into account multiple criteria simultaneously. Moreover, they do not cover all criteria that are relevant to policy makers. Therefore, the development of a multi-criteria approach to priority setting is necessary, and this has indeed recently been identified as one of the most important issues in health system research. In other scientific disciplines, multi-criteria decision analysis is well developed, has gained widespread acceptance and is routinely used. This paper presents the main principles of multi-criteria decision analysis. There are only a very few applications to guide resource allocation decisions in health. We call for a shift away from present priority setting tools in health--that tend to focus on single criteria--towards transparent and systematic approaches that take into account all relevant criteria simultaneously.

背景与目标： : 卫生干预措施的优先级设定通常是临时性的，资源的使用没有达到最佳程度。潜在的问题是，多个标准发挥作用，决策很复杂。可以选择干预措施，以最大程度地提高总体人口健康水平，减少弱势或弱势群体的健康不平等，ad/或应对威胁生命的情况，所有这些都涉及实际和预算方面的限制。这是政策制定者通常不善于理性地、没有帮助地解决的问题。他们倾向于使用启发式或直观的方法来简化复杂性，在此过程中，重要的信息被忽略。接下来，政策制定者可能只出于政治动机选择干预措施。这表明需要合理和透明的方法来确定优先级。在过去的几十年中，已经开发了许多方法，包括循证医学，疾病负担分析，成本效益分析和公平性分析。但是，这些方法仅集中在单个标准上，而实际上，决策者需要同时考虑多个标准来做出选择。此外，它们并未涵盖与决策者相关的所有标准。因此，有必要开发一种多标准方法来确定优先级，并且最近确实已将其确定为卫生系统研究中最重要的问题之一。在其他科学学科中，多准则决策分析得到了很好的发展，得到了广泛的认可，并被常规使用。本文介绍了多准则决策分析的主要原理。只有很少的应用程序来指导健康中的资源分配决策。我们呼吁从目前的卫生优先事项设定工具 (往往侧重于单一标准) 转向透明和系统的方法，同时考虑到所有相关标准。

BACKGROUND & AIMS: :Obstructive sleep apnoea (OSA) is a complex disease entity strongly influenced by genetic factors, especially those that affect obesity and fat distribution, upper airway muscle tone, craniofacial morphology, ventilatory control and sleep, giving rise to the OSA phenotype. OSA can also be considered a metabolic syndrome which adversely affects multiple organ systems, especially the cardiovascular system and the brain. The most widely used clinical marker for the diagnosis of OSA is the apnoea-hypopnoea index, calculated by polysomnography. A percentage of 35 to 40% of its variance can be attributed to genetic factors. Therefore, the identification and elucidation of the genes implicated in the pathogenesis of OSA becomes a matter of extensive research and could lead to the development of therapeutic agents that can have a beneficial effect on the natural course of OSA.

背景与目标： 阻塞性睡眠呼吸暂停 (OSA) 是一种复杂的疾病，受到遗传因素的强烈影响，尤其是那些影响肥胖和脂肪分布，上呼吸道肌张力，颅面形态，通气控制和睡眠的因素，从而引起OSA表型。OSA也可以被认为是一种代谢综合征，它会对多个器官系统 (尤其是心血管系统和大脑) 产生不利影响。诊断OSA最广泛使用的临床标志物是通过多导睡眠图计算的呼吸暂停-低通气指数。其方差的35% 至40% 的百分比可归因于遗传因素。因此，鉴定和阐明与OSA发病机理有关的基因已成为广泛研究的问题，并可能导致开发可对OSA自然过程产生有益作用的治疗剂。

BACKGROUND & AIMS: STUDY DESIGN:A cross-sectional study of the spine in 40 young adults after solid organ transplantation in childhood. OBJECTIVE:To evaluate the impact of organ transplantation and long-term immunosuppressive treatment on growing spine using magnetic resonance imaging (MRI). SUMMARY OF BACKGROUND DATA:A review of the current literature reveals no systematic evaluation of the spine after transplantation in childhood. METHODS:A total of 40 adult patients (mean age 22.1 years, range, 16.0-27.0), who received either kidney, liver, or heart transplant as children, were evaluated. Mean follow-up after transplantation was 11.2 years (range 3.0-18.0). All patients filled in a questionnaire, underwent an interview and physical examination, as well as had MRI of the spine. Standing spinal radiographs were taken from patients with a rib hump > or = 6 degrees. RESULTS:There were 8 (20%) patients who had a history of vertebral fracture. Eleven (28%) patients reported frequent back pain at rest. There were 15 (38%) patients who had scoliosis > 10 degrees (range 10 degrees -69 degrees ). On MRI, narrowed disc spaces were noted in 32 (80%) patients, and irregular endplates were noted in 24 (60%). There were 14 (35%) patients who had at least 1 compressed or wedged vertebra (> 20%). Patients treated for acute rejection had wedged vertebrae, speckled or black disc spaces, and irregular endplates more often than patients without rejections. Males had wedged vertebrae more often than females (P = 0.0067). CONCLUSIONS:Back pain, scoliosis, wedged vertebrae, and narrowed, degenerated disc spaces are common after solid organ transplantation in childhood.

背景与目标：