Background and AimsComputed tomography, which uses ionizing radiation and expensive software packages for analysis of scans, can be used to quantify abdominal fat. The objective of this study is to measure abdominal fat with 3T MRI using free software for image analysis and to correlate these findings with anthropometric and laboratory parameters in adolescents.MethodsThis prospective observational study included 24 overweight/obese and 33 healthy adolescents (mean age 16.55 years). All participants underwent abdominal MRI exams. Visceral and subcutaneous fat area and percentage were correlated with anthropometric parameters, lipid profile, glucose metabolism, and insulin resistance. Student’s t test and Mann-Whitney’s test was applied. Pearson’s chi-square test was used to compare proportions. To determine associations Pearson’s linear correlation or Spearman’s correlation were used.ResultsIn both groups, waist circumference (WC) was associated with visceral fat area (P = 0.001 and P = 0.01 respectively), and triglycerides were associated with fat percentage (P = 0.046 and P = 0.071 respectively). In obese individuals, total cholesterol/HDL ratio was associated with visceral fat area (P = 0.03) and percentage (P = 0.09), and insulin and HOMA-IR were associated with visceral fat area (P = 0.001) and percentage (P = 0.005).Conclusions3T MRI can provide reliable and good quality images for quantification of visceral and subcutaneous fat by using a free software package. The results demonstrate that WC is a good predictor of visceral fat in obese adolescents and visceral fat area is associated with total cholesterol/HDL ratio, insulin and HOMA-IR.

ObjectiveWe evaluated the association between vitamin D levels and nutritional status, pulmonary function and pulmonary exacerbations in children and adolescents with cystic fibrosis.Methods25-hydroxyvitamin D (25(OH)D) levels of 37 children and adolescents were retrospectively evaluated. Pulmonary function, body mass index, height for age, and pulmonary exacerbations episodes were associated with vitamin D levels divided into two groups: sufficient (≥30ng/mL) and hypovitaminosis (<30ng/mL).ResultsHypovitaminosis D (25(OH)D <30ng/mL) was observed in 54% of subjects. The mean level of 25(OH)D was 30.53±12.14ng/mL. Pulmonary function and nutritional status were not associated with vitamin D levels. Pulmonary exacerbations over a 2-year period (p=0.007) and the period from measurement up to the end of the follow-up period (p=0.002) were significantly associated with vitamin D levels.ConclusionHypovitaminosis D was associated with higher rates of pulmonary exacerbations in this sample of children and adolescents with cystic fibrosis. Hypovitaminosis D should be further studied as a marker of disease severity in cystic fibrosis. Further prospective and randomized studies are necessary to investigate causality of this association.

A 6-year-old girl presented with severe abdominal pain, bilious vomiting, and fever for 15 hours. Nine months earlier, 2 inflammatory polyps had been removed at colonoscopy. On physical examination, the patient was lethargic and had abdominal tenderness and guarding in the hypogastrium and the right lower quadrant. Abdominal ultrasound showed a typical target lesion suggesting intussusception of the appendix into the cecum ( Fig. 1) that appeared to resolve with barium enema. The following day she continued with abdominal pain and developed diarrhea. Abdominal ultrasound was repeated and colonoscopy was performed. Both tests showed polypoid structure suggestive of everted appendix (Fig. 2). The patient underwent surgery for appendectomy (Fig. 3). Biopsy revealed an appendix with lymphoid hyperplasia.Appendiceal intussusception is a rare condition with an incidence of approximately 0.01% (1,2). It is usually diagnosed in the intraoperative period in patients with suspected acute appendicitis (1). Appendiceal intussusception should be considered in the differential diagnosis in children with abdominal pain. Colonoscopy may suggest a colon polyp, but the absence of the pedicle and the upper pole umbilication are more consistent with this diagnosis (3). Combined abdominal ultrasound and colonoscopy can lend support to this diagnosis that requires a surgical approach.

We found that superior mesenteric artery blood flow is significantly lower in children than in adolescents and is associated with body surface area.