{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:57:24Z","timestamp":1788872244626,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,7,14]],"date-time":"2014-07-14T00:00:00Z","timestamp":1405296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Swiss National Foundation"},{"DOI":"10.13039\/501100006387","name":"Leenaards Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006387","id-type":"DOI","asserted-by":"crossref"}]},{"name":"FBM\/UniL, Lausanne, Switzerland"},{"name":"Fund for Scientific Research (FWO), Flanders, Belgium"},{"name":"Methusalem","award":["08\/01M01108"],"award-info":[{"award-number":["08\/01M01108"]}]},{"name":"Ghent University","award":["G.0171.05"],"award-info":[{"award-number":["G.0171.05"]}]},{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"crossref","award":["BMS 54\/6\/2009"],"award-info":[{"award-number":["BMS 54\/6\/2009"]}],"id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J of Med Genetics Pt A"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      We report on a series of 514 consecutive diagnoses of skeletal dysplasia made over an 8\u2010year period at a tertiary hospital in Kerala, India. The most common diagnostic groups were dysostosis multiplex group (n\u2009=\u200973) followed by\n                      <jats:italic>FGFR3<\/jats:italic>\n                      (n\u2009=\u200949) and osteogenesis imperfecta and decreased bone density group (n\u2009=\u200941). Molecular confirmation was obtained in 109 cases. Clinical and radiographic evaluation was obtained in close diagnostic collaboration with expert groups abroad through Internet communication for difficult cases. This has allowed for targeted biochemical and molecular studies leading to the correct identification of rare or novel conditions, which has not only helped affected families by allowing for improved genetic counseling and prenatal diagnosis but also resulted in several scientific contributions. We conclude that (1) the spectrum of genetic bone disease in Kerala, India, is similar to that of other parts of the world, but recessive entities may be more frequent because of widespread consanguinity; (2) prenatal detection of skeletal dysplasias remains relatively rare because of limited access to expert prenatal ultrasound facilities; (3) because of the low accessibility to molecular tests, precise clinical\u2010radiographic phenotyping remains the mainstay of diagnosis and counseling and of gatekeeping to efficient laboratory testing; (4) good phenotyping allows, a significant contribution to the recognition and characterization of novel entities. We suggest that the tight collaboration between a local reference center with dedicated personnel and expert diagnostic networks may be a proficient model to bring current diagnostics to developing countries. \u00a9 2014 Wiley Periodicals, Inc.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ajmg.a.36668","type":"journal-article","created":{"date-parts":[[2014,7,15]],"date-time":"2014-07-15T13:57:40Z","timestamp":1405432660000},"page":"2317-2323","source":"Crossref","is-referenced-by-count":19,"title":["Eight years experience from a skeletal dysplasia referral center in a tertiary hospital in Southern India: A model for the diagnosis and treatment of rare diseases in a developing country"],"prefix":"10.1002","volume":"164","author":[{"given":"Sheela","family":"Nampoothiri","sequence":"first","affiliation":[{"name":"Department of Pediatric Genetics Amrita Institute of Medical Sciences and Research Center Cochin Kerala 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