Relationship between coronary risk factors, c-reactive protein, bone mineral density and carotid circulation among frail elderly

Frailty may now be regarded as a geriatric syndrome of decreased reserve and resistance tostressors, resulting from cumulative declines across multiple physiologic systems, causing vulnerability toadverse health outcomes including falls, hospitalisation, institutionalisation and mortality. Theinflammatory mediators as C-reactive protein have been associated with the development of the geriatricfrailty. Several studies have pointed out increased level of homocystiene in frail elderly Increasing frailtywas associated with lower bone mineral density, as both bone mass and muscle strength decrease duringageing and this has also been associated with higher risk of osteoporotic fractures in frail elderly. To compare frail and non-frail elderly regarding Bone mineral density, carotid circulation andserum levels of Homocysteine, coronary risk factors and CRP. 104 elderly patients, who were assigned to 2 groups. Group A [52 frail participants]:diagnosed byFried's criteria as applied byAvila-Funes et al., 2008. Group B [52 non-frailparticipants].All participants were subjected to the following: through history, physical examination,ADL, IADL assessment, MMSE ,GDS, laboratory investigations including; CRP, homocystiene and totallipid profile, measurement of bone mineral density by DEXA and carotid intima-media thickness bycarotid duplex. There was no statistically significant difference in age, sex, among both groups.Frail participantshad higher ADL and IADL dependence, higher incidence of depression, cognitive impairment andosteoprosis.They also had higher levels of homocystiene, CRP, CIMT and lower levels of HDLcholesterol. Osteoporosis is more prevalent among frail elderly also frailty is associated with more ADL and IADL dependence, higher GDS scores and lower MMSE score in addition to higher mean level ofhomocystiene, CRP and triglycerides in addition to low serum HDL and higher CIMT

Bone density in survivors of childhood acute leukemia and malignant lymphomas

This study aimed to assess bone mineral density in survivors of childhood acute leukemia and malignant lymphomas to determine the prevalence of osteoporosis and identify the possible predisposing factors and patients at the greatest risk of reduced bone mineral density. The study included 41 survivors [27 patients had acute lymphoblastic leukemia and 14 patients had malignant lymphomas]. In conclusion, 60.9% of the survivors of childhood leukemias and lymphomas had decreased BMD, osteoporosis being especially severe in 17.1% of these patients. In view of the risk of fractures among patients with osteoporosis, the survivors of childhood malignancy were at an increasing risk of bone fractures later in life irrespective of the underlying cause of osteoporosis, thus the intervention should be considered for prevention and proper management

Value of abdominal ultrasonography and doppler in assessment of portal hypertension in children

This study was carried out to find a relation between ultrasonographic and Doppler findings of portal hypertension and grading of Esophageal varices as detected by upper GIT endoscopy. 24 children suffering from portal hypertension were subjected to full clinical examination laboratory investigations, liver biopsy, upper GIT endoscopy and abdominal US. Their ultrasonographic and Doppler data were compared to those of a control group consisting of 20 healthy children of matched age and sex. According to endoscopic grading of OV, patients were divided into two groups, mild and severe. The severe group was again subdivided into bleeders and non-bleeders for further analysis. Ultrasonographic parameters as MPV-d, sp-MPV, sp-RPV, sp-LPV, SV-d, long axis of the spleen and omental thickness were all significantly different from those of controls. Among patients of the severe group, bleeders were significantly different from non-bleeders as regards SV- d, OT and sp-splenorenal. To predict severity and onset of bleeding of OV in patients with PH, a score was developed. Accordingly, patients having scores above seven are at risk of hematemesis and might be considered for prophylactic regimens