Waist circumference as a predictor of cardiovascular and metabolic risk factors in obese girls.

OBJECTIVES: (a). to explore the relationship between waist circumference and certain cardiovascular risk factors in a group of girls; and (b). to assess the clinical relevance of waist circumference in identifying girls with higher cardiovascular risk across puberty. SUBJECTS AND METHODS: One-hundred and fifty-five overweight or obese girls aged 5-16 y were recruited. Overweight and obesity were defined on the basis of BMI, according to Cole. RESULTS: : Waist circumference was significantly correlated with plasma insulin (r=0.43; P<0.001), systolic blood pressure (r=0.22; P=0.007) and IR(HOMA) (r=0.40; P<0.001). A multivariate linear correlation analysis showed that, when adjusted for age and Tanner stage, waist circumference was significantly associated with plasma insulin (r(2)=0.23; P<0.01), IR(HOMA) (r(2)=0.17; P<0.02), systolic and diastolic blood pressure (r(2)=0.20; P=0.006 and r(2)=0.32; P<0.001, respectively). A logistic regression analysis, using IR(HOMA) as the dependent variable, showed that waist circumference was a significant independent risk factor of insulin resistance (IR(HOMA)>or=2.6) in this group of girls (OR 1.10; 95% CI 1.03-1.18; P=0.003), independently of their age and Tanner stage. CONCLUSIONS: Waist circumference of these girls was independently associated with certain cardiovascular risk factors, in particular insulin resistance and diastolic blood pressure, independently of age and Tanner stage. Thus suggesting that waist circumference may be reasonably included in clinical practice as a simple tool that may help to identify sub-groups of obese girls at higher metabolic risk across puberty.

[Neonatal hemorrhagic syndrome with unfavorable prognosis]. / Sindrome emorragica neonatale ad evoluzione rapidamente sfavorevole.

The Authors describe a case of neonatal hemorrhagic syndrome associated with a large hemangioma on the left lower limb with an unfavourable prognosis. The clinical, biohumoral and anatomicopathological characteristics indicate a Kasabach-Merrit syndrome (SKM) with massive platelet sequestration in the large hemangioma. The pathogenetical mechanisms of SKM and the medical surgical and radiant therapy are mentioned. The Authors also discuss the various diagnostic problems imposed by the presence of serious hemorrhagic pathology at neonatal age.

[A case of CHARGE with fibrocystic disease of the pancreas]. / Un caso di associazione CHARGE e fibrosi cistica del pancreas.

The Authors describe a case of CHARGE association (CA) with fibrocystic disease of the pancreas (FCP). The CA is characterized by seven mayor defects (colobomatous malformation, heart defect, atresia choanae, growth and mental deficiency, genital hypoplasia, ear anomalies and/or deafness). Four of this seven defects are necessary for the diagnosis. Other diseases and anomalies associated with CA are examined. The peculiarity of contemporaneous presence of FCP and the seriousness of the prognosis is pointed out.

[A case of growth retardation of rare occurrence]. / Un caso di ritardo dell'accrescimento staturale di non comune riscontro.

The Authors describe an uncommon case of growth retardation; the clinical and radiological elements that the Authors to a diagnosis of spondyloepiphyseal dysplasia (SED) are noted; they compare this to other diagnosis of different types of growth retardation, they underline the necessity of taking these rare types into consideration before undergoing diagnostic procedures that would be costly both to the patient and society.