Recurrence of abdominal distension due to fluid accumulation in a child: Ascites or a cyst?

Background: Abdominal distension in children can be caused by fluid accumulation due to ascites or large cysts. Case Presentation: A 25-month-old girl was brought to the pediatric gastroenterology clinic with the chief complaint of nontraumatic acute abdominal pain. She had undergone paracentesis last year with a diagnosis of suspected ascites in another medical clinic. Moreover, a CT scan following paracentesis was reported to be normal. After a few months, she gradually developed abdominal distension again. Diagnostic evaluations along with biochemical parameters and imaging strongly suggested the presence of a cyst. The large mesenteric cyst was totally removed by surgery. Conclusion: In conclusion, in the face of recurrence of abdominal fluid accumulation, mesenteric cysts should be considered despite the fact that abdominal CT scan is normal after paracentesis.

Relationship Between Visceral Adipose Tissue and Bone Mineral Density in Older People: Results from AHAP Study.

INTRODUCTION: Due to discrepancy of the relationship between visceral adipose tissue (VAT) and bone mineral density (BMD), this study was performed to determine the relationship between BMD and VAT in the elderly. METHODOLOGY: This cross-sectional study is part of the second wave of Amirkola Health and Ageing Project (AHAP), including 1,200 people aged 60 years and older. BMD and VAT were measured by dual-energy X-ray absorptiometry (DXA) in Hologic equipment. Based on the amount of VAT, individuals were divided into four quartiles. Then, the data were statistically analyzed by SPSS22 software using chi-square, ANOVA, Pearson correlation coefficient and logistic regression. RESULTS: The mean age of the participants was 69.6 ± 6.9 year and the mean VAT was 862.6 ± 337.8 gram. In this study, people with osteoporosis had less VAT (p<0.0001). Furthermore, with the increase in the amount of VAT, BMD increased in the femoral region and lumbar spine (p<0.0001). There was a positive and significant correlation between VAT and BMD in the femoral region (r = 0.267) and lumbar spine (r = 0.197) (p<0.0001). After performing multiple logistic regression analysis in the presence of factors such as age, gender, body mass index and especially lean mass, the protective role of VAT against osteoporosis was maintained (OR=0.510, CI95% (0.290-0.895)) (P = 0.019). CONCLUSIONS: This study has shown that VAT can independently have a positive association with BMD in the elderly.

Association between body fat and bone mineral density in non-obese post-menopausal women over 60 years old.

BACKGROUND: Loss of bone mineral density is one of the most important complications of menopause. The results of studies about the relation between body fat and bone mineral density are controversial. The aim of this study was to determine the association between fat mass and bone mineral density on non-obese post-menopausal elderly women. METHODS: This cross-sectional study is a part of the second phase of the Amirkola Health and Ageing Project (AHAP) that has been done on 356 elderly women with BMI of 18.5-30. Bone mineral density (BMD) and total body fat were measured using the Hologic Horizon-WI densitometer. Statistical tests were ANOVA, Pearson's correlation coefficient and multiple linear regression and a p- value less than 0.05 was considered significant. RESULTS: The mean age of the participants was 70.22±7.34 and the mean age of menopause was 47.68±5.05. Women with highest fat mass had a greater spine, femur and whole-body BMD (p<0.0001). In this study, we observed a direct and positive significant correlation between body fat mass and BMD at spine (r=0.308), femur (r=0.420) and whole body (r=0.312) (p<0.0001). Adjusted linear regression showed positive effect of fat mass on BMD on all three anatomical sites especially in total femur (ß=0.254, p<0.0001). CONCLUSION: This study showed a positive correlation between fat mass and bone mineral density at all sites in post-menopausal women.

Relationship between Helicobacter pylori infection (HP) and bone mineral density (BMD) in elderly people.

BACKGROUND: Low bone mass is a frequent complication of chronic inflammatory disease. The pathogenesis of osteoporosis in chronic inflammatory disease may be secondary to releases of cytokines such as TNF- and IL6. Chronic gastritis due to helicobacter pylori (HP) infection may lead to decreased bone mineral density (BMD) and predispose patients to osteoporosis. The objective of this study was to determine the BMD status in HP positive patients with gastritis versus HP negative cases. METHODS: In this cross-sectional study, we enrolled 967 participants aged 60 years old and more from Amirkola Health Study Ageing Project. Seven-hundred and fifty eight HP positive and 209 HP negative patients were analyzed. BMD was measured by dual-energy x-ray absorptiometry (DXA) method in the spine and femoral neck in all participants. RESULTS: The mean age in HP+ and HP- negative patients was 68.3±6.8 and 69.3±7.4 years, respectively. BMD g/cm2 in the spine and femoral neck did not differ between the two groups (P=0.19 and 0.22 respectively). The prevalence of osteoporosis did not also differ across the two groups as well. There was no relationship between the level of antibodies against HP and BMD. CONCLUSION: According to the findings of this study, H. pylori infection is not associated with BMD changes in the elderly population.

Dyshomeostasis of Serum Oxidant/Antioxidant Status and Copper, Zinc, and Selenium Levels in Elderly Physically Disabled Persons: an AHAP-Based Study.

The percentage of elderly persons is rapidly growing. Physical disability is one of the main age-related diseases which affect life quality. There are some studies that suggest the oxidative stress and trace elements are involved in physical disability in elderly persons, but the results are inconclusive. Therefore, the aim of this study was to investigate the status of aforementioned parameters in elderly physically disabled patients vs. healthy ones. According to the Katz questionnaire form, 44 subjects with physical disability and 66 age-gender-matched healthy subjects were selected from Amirkola Health and Aging Project (AHAP). The results indicated that patient group had lower serum Zn, Se, and total antioxidant levels than the control group (p < 0.001), whereas serum total oxidant level and Cu to Zn ratio (CZr) were higher in control group than in healthy one (p < 0.001). A positive correlation was found between Zn, Se, total antioxidant, and bone mineral density of femur (BMD.F) with activities of daily living (ADL) score (p < 0.01); meanwhile, a negative correlation between CZr and total oxidant with ADL score was observed (p < 0.01). Serum total oxidant level and CZr index had the highest area under the curve in receiver operating characteristic (ROC) analysis among the included parameters for discrimination of physically disabled patients than the normal ones. Decrease in serum Zn and Se levels, low BMD, and increase in CZr and oxidative stress were observed in physically disabled patients. It seems that CZr is more reliable parameter than the others to discriminate the physically disabled patients than the healthy persons.

Prevalence of osteoporosis and its association with serum vitamin D level in older people in Amirkola, North of Iran.

BACKGROUND: Ageing of population worldwide will be responsible for a major increase of the incidence of osteoporosis in elderly. For the individual, osteoporotic fractures result in great disability as well as loss of quality of life and also represent an enormous burden for healthcare systems. This study was conducted to determine the prevalence of osteoporosis and its association with serum vitamin D level in elderly people in Amirkola, North of Iran. METHODS: In this cross-sectional study, 193 subjects aged 60 years old and over were assessed in Amirkola. Using a standard questionnaire, individual characteristics and densitometry (with DXA) results were collected and the data were analyzed with SPSS, chi square tests and linear regression. RESULTS: The overall prevalence rate of osteoporosis was 32.1% in at least one measurement sites (28.5% in lumbar and 14.5% in femoral region), while 49.7% of elderly people suffering from decreased bone mass (osteopenia). Osteoporosis prevalence in women was 55.7% and this value in elderly men was 12.4%. Bone mineral density has negative association with age in femoral region (p<0.01, r-0.3), but no statistical relationships were seen between bone mineral density and serum 25-hydroxy vitamin D level in this study. CONCLUSION: Our findings revealed higher prevalence of osteoporosis in elderly people especially in women compared to other studies in Iran, and also showed high prevalence rate of vitamin D deficiency. No relationships were found between serum vitamin D and bone density in this study.