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Background: The efficiency of traditional anthropometric measurements such as body mass index (BMI) or waist circumference (Waist C) used to replace biomedical imaging for assessing visceral adipose tissue (VAT) is still highly controversial in youth., Hypothesis and Objectives: We evaluated the most accurate model predicting VAT in overweight/obese youth, using various anthropometric measurements and their correlation with different body fat compartments, especially by testing, for the first time in youth, the hypothesis that subtracting the anthropometric measurement the most highly correlated with subcutaneous abdominal adipose tissue (SAAT) and less correlated possible with VAT from an anthropometric abdominal measurement highly correlated with visceral and total abdominal adipose tissue (TAAT), predicts VAT with higher accuracy., Subjects and Methods: VAT and SAAT data resulted from magnetic resonance imaging (MRI) analysis performed on 181 boys and girls (7-17 y) from Diabetes & Endocrinology Care Paediatrics Clinic in Luxembourg. Height, weight, abdominal diameters, waist, hip, and thigh circumferences were measured with a view to developing the anthropometric VAT predictive algorithms., Results: In girls, subtracting proximal thigh circumference (Proximal Thigh C), the most closely correlated anthropometric measurement with SAAT, from Waist C, the most closely correlated anthropometric measurement with VAT was instrumental in improving VAT prediction, in comparison with the most accurate single VAT anthropometric surrogate. [Formula: see text] Residual analysis showed a negligible estimation error (5 cm 2 ). In boys, Waist C was the best VAT predictor., Conclusions: Subtraction of abdominal subcutaneous fat is important to predict VAT in overweight/obese girls., (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Childhood obesity is associated with early cardiometabolic risk (CMR), increased risk of adulthood obesity, and worse health outcomes. Leg fat mass (LFM) is protective beyond total fat mass (TFM) in adults. However, the limited evidence in children remains controversial., Objective: We investigated the relationship between LFM and CMR factors in youth., Subjects: A total of 203 overweight/obese children, 7-17-yr-old, followed in the Pediatric Clinic, Luxembourg., Methods: TFM and LFM by dual energy x-ray absorptiometry and a detailed set of CMR markers were analyzed., Results: After TFM, age, sex, body mass index (BMI) Z-score, sexual maturity status, and physical activity adjustments, negative significant partial correlations were shown between LFM and homeostasis model assessment of insulin resistance (HOMA) (variance explained: 6.05% by LFM*; 7.18% by TFM**), fasting insulin (variance explained: 5.71% by LFM*; 6.97% by TFM**), triglycerides (variance explained: 3.96% by LFM*; 2.76% by TFM*), systolic blood pressure (variance explained: 2.68% by LFM*; 4.33% by TFM*), C-reactive protein (variance explained: 2.31% by LFM*; 4.28% by TFM*), and resistin (variance explained: 2.16% by LFM*; 3.57% by TFM*). Significant positive partial correlations were observed between LFM and high-density lipoprotein (HDL) cholesterol (variance explained: 4.16% by LFM*) and adiponectin (variance explained: 3.09% by LFM*) (*p-value < 0.05 and **p-value < 0.001). In order to adjust for multiple testing, Benjamini-Hochberg method was applied and the adjusted significance level was determined for each analysis. LFM remained significant in the aforementioned models predicting HOMA, fasting insulin, triglycerides, and HDL cholesterol (Benjamini and Hochberg corrected p-value < 0.01)., Conclusions: LFM is protective against CMR in children, at least in terms of insulin resistance and adverse blood lipid profiles., (© 2015 The Authors. Pediatric Diabetes published by John Wiley & Sons Ltd.)

Objectives: To report, to the best of our knowledge, the youngest patient with Lemierre syndrome., Design: Descriptive case report with review of the pediatric literature., Setting: Pediatric intensive care unit in a tertiary referral hospital., Data Source: Systemic review of the literature, including PubMed (English-only journals) and major textbooks., Patient: We report a 5-month-old boy who presented with fever and a perforated left-sided otitis media. He developed left-sided complicated otitis media with retroauricular fluid collection, mastoiditis, and temporomandibular joint effusion. The clinical picture was complicated by a left internal jugular vein and left lateral sinus thrombosis. Fusobacterium necrophorum grew in the pus culture., Interventions: Low molecular weight heparin., Measurements and Main Results: No immunodeficiency and no thrombophilia were identified as predisposing conditions for Lemierre syndrome. Surgical drainage, early and adequate antibiotic treatment, and anticoagulation were followed by complete recovery., Conclusions: This case report illustrates that Lemierre syndrome can occur in infants without underlying risk factors for severe infections or thrombotic complications.

Subcutaneus fat necrosis is an uncommon disease which may be complicated with potentially fatal hypercalcemia. The usual treatment of hypercalcemia includes hyperhydratation, corticosteroids and diet. This treatment is not always effective in normalizing plasma calcium concentration. A treatment with bisphosphonates has been effective in similar cases. We report on the case of a patient presenting with symptomatic hypercalcemia, complicated with nephrocalcinosis consecutive to subcutaneus fat necrosis after birth asphyxia at term. Oral etidronate has been used for 3 weeks, after failure of classical treatment. The evolution was favorable. After a short review of the complications of subcutaneus fat necrosis, we discuss the use of bisphophonates in this indication.

Background: The lack of a consensus in the literature on the imaging strategy in Langerhans cell histiocytosis (LCH) bone lesions in childhood., Objective: To evaluate the relative value of radionuclide bone scan (RBS) and radiographic skeletal survey (RSS) in the detection of LCH bone lesions, both in the initial work-up of the disease and during the follow-up period., Materials and Methods: Ten children with bone lesions evaluated by means of RSS and RBS in a retrospective study (1984-1993)., Results: Fifty radiologically and/or scintigraphically abnormal foci were detected: 27 anomalies in the initial work-up (12 by both RSS and RBS, 8 by RSS only and 7 by RBS only) and 23 additional anomalies during follow-up (10 by both RSS and RBS, 10 by RSS only and 3 by RBS only). RSS+/RBS- lesions (n = 18) are more frequently encountered in the skull (P = 0.038), and more frequently lack radiologic signs of osteoblastic activity (P = 0.020), than RSS+/RBS+ lesions (n = 22). RSS-/ RBS+ abnormalities (n = 10) were most frequently insignificant., Conclusion: In the initial work-up both RSS and RBS should be carried out, while in the follow-up only RSS should be performed.

Calcification within active post-transplantation lymphoproliferative disorders has, to our knowledge, never been described. We report the case of a 14-month-old boy who presented 4 months after orthotopic liver transplantation with a primary calcification in a lymphoproliferative nodule involving the hepatic graft. This calcification was detected by routine ultrasonography, visible on plain radiographs, and the post-transplantation lymphoproliferative disorder was histologically proved.

A 4-year-old child referred for acute jaundice following percutaneous needle biopsy of the liver underwent hepatobiliary scintigraphy. Although all conventional liver tests suggested preservation of hepatocyte function, the tracer uptake in the liver appeared dramatically reduced at scintigraphy and the blood pool activity did not decrease significantly until the end of the study. Visualization of the bile ducts indicated, however, that the tracer was taken up by the hepatocyte and further excreted into the biliary tree. There was no tracer pooling in the biliary tree although no bowel activity was observed, even on delayed images. The association of persistent blood pool activity, bile duct visualization without tracer pooling, and nonvisualization of the bowel was caused by a continuous recirculation of the tracer from the biliary tree into the bloodstream. The presence of a biliovenous fistula was further proven by percutaneous transhepatic cholangiography performed 24 h later. Since 1975, only 16 cases of bilhemia have been reported. To the best of our knowledge the scintigraphic pattern of this rare but life-threatening complication has not previously been reported.