Endothelial dysfunction, inflammation, and oxidative stress in obese children and adolescents: markers and effect of lifestyle intervention

With an increasing prevalence, pediatric obesity is often a prelude to adulthood obesity, and represents a major public health issue. Comorbidities are very common and severe in obese adults, justifying the search for earlier markers or risk factors for cardiovascular diseases in obese children. Endothelial dysfunction has been found to be present in the early stages of atherosclerosis, and can be non-invasively assessed with widely accepted and well-standardized techniques at the macrocirculation level. Endothelial dysfunction at the microcirculation level is less documented in obese children. Obesity in children has been repeatedly and independently correlated to endothelial dysfunction, inflammation and oxidative stress markers, although the relationship between these factors remains to be investigated. However, this would not only allow substantial improvements in risk stratification, but also provide essential data regarding the evolution of endothelial dysfunction in childhood obesity, especially during puberty when pro-inflammatory and pro-oxidative changes, with relative insulin resistance, occur. Therapeutic strategies such as lifestyle interventions in early childhood obesity appear all the more necessary, optimally including both exercise and diet because of their known effects on inflammatory and oxidative stress markers, potentially reversing endothelial dysfunction.

Social networking patterns/hazards among teenagers

Social Networking Sites (SNSs) have grown substantially, posing new hazards to teenagers. This study aimed to determine general patterns of Internet usage among Irish teenagers aged 11-16 years, and to identify potential hazards, including; bullying, inappropriate contact, overuse, addiction and invasion of users' privacy. A cross-sectional study design was employed to survey students at three Irish secondary schools, with a sample of 474 completing a questionnaire. 202 (44%) (n = 460) accessed the Internet using a shared home computer. Two hours or less were spent online daily by 285(62%), of whom 450 (98%) were unsupervised. 306 (72%) (n = 425) reported frequent usage of SNSs, 403 (95%) of whom were Facebook users. 42 (10%) males and 51 (12%) females experienced bullying online, while 114 (27%) reported inappropriate contact from others. Concerning overuse and the risk of addiction, 140 (33%) felt they accessed SNSs too often. These patterns among Irish teenagers suggest that SNS usage poses significant dangers, which are going largely unaddressed.

Correlation between body mass index and body composition in elite athletes

AIM

The body mass index (BMI) of an athlete is directly related to his/her weight, however, whether this parameter is actually related to specific anthropometric compartments is still in debate. The aim of this study was to determine the correlation between BMI and fat, muscle and bone percentages.

METHODS

To this end, body anthropometric parameters were determined in 3971 athletes according to International Society for Advancement of Kinanthropometry (ISAK) provided equations. Pearson's correlation coefficient was calculated to analyze the relation between BMI and the different anthropometric values. Intraclass correlation coefficient was calculated to validate if BMI is an adequate parameter to measure body composition.

RESULTS

The average values found in the different anthropometric parameters, with the exception of bone mass percentage, increased in association with the BMI. However, this positive increase, or decrease in the case of bone mass, is only maintained up to a certain BMI value that differs depending on the parameter analyzed. Athletes that present normal BMI values (18.5-25 kg/m(2) up until 27 kg/m(2)), as well as in several cases where the athletes presented higher values (30-33 kg/m(2)), displayed positive increases for fat percentage, but not for muscle and bone. Pearson's coefficient indicates that BMI has a high correlation with fat content, but not muscle percentage, in athletes.

CONCLUSIONS

As seen in the training programs, the data showed that well-trained athletes tend to display optimal muscle contents, being the fat content the only parameter that could influence BMI. However, intraclass correlation coefficient shows that BMI cannot be used as a direct measurement of body fat content in athletes.

[Sensitization to acrylates caused by artificial acrylic nails: review of 15 cases]

BACKGROUND

Allergic contact dermatitis due to acrylates present in the workplace is a disease frequently reported among dentists, printers, and fiberglass workers. Recently, the number of cases of contact allergic dermatitis among beauticians specialized in sculpting artificial nails has increased.

OBJECTIVE

Our objective was to study the clinical characteristics and allergens implicated in allergic contact dermatitis due to acrylates in beauticians and users of sculpted nails.

MATERIAL AND METHODS

This was an observational, retrospective study of patients diagnosed with allergic contact dermatitis due to acrylates used in sculpting artificial nails over the last 26 years in the Hospital General Universitario, Valencia, Spain.

RESULTS

In total, 15 patients were diagnosed: 14 beauticians and 1 client. Most cases were diagnosed in the past 2 years. All were women, their mean age was 32.2 years, and 26.7 % had a personal or family history of atopy. The sensitization time varied between 1 month and 15 years. The most frequently affected areas were the fleshy parts of the fingers and hands. Three patients - 2 beauticians and 1 client - presented allergic asthma due to acrylates. All patients underwent patch testing with a standard battery of allergens and a battery of acrylates. The most frequent allergens were ethylene glycol dimethacrylate (13/15, 86.7 %), hydroxyethyl methacrylate (13/15, 86.7 %), triethylene glycol dimethacrylate (7/15, 46.7 %), 2-hydroxypropyl methacrylate (5/15, 33.3 %), and methyl methacrylate (5/15, 33.3 %).

CONCLUSIONS

Acrylate monomers used for sculpting artificial nails are important sensitizers for contact and occupational dermatitis. The most important consideration is primary and secondary prevention.

[Two cases of eruptive pyoderma gangrenosum associated with cocaine use]

We present the cases of 2 regular cocaine users aged 30 and 37 years who developed a cutaneous condition with an identical presentation and a similar clinical course. The lesions first appeared as eruptions on the back and then spread to other parts of the body. They consisted of painful inflammatory nodules that developed into abscesses and ulcers that grew outwards. They had a granulomatous base and irregular violaceous edges. The results of histopathologic studies were compatible with the clinical diagnosis of pyoderma gangrenosum, and additional tests ruled out underlying diseases. After several therapeutic failures with usual treatments, the patients responded quickly to infliximab after interrupting their cocaine consumption. The association between pyoderma gangrenosum and cocaine use was clear as both suffered clinical relapses at the same time as they started using the drug again.

[Clinical follow-up and presence of visceral tumors in 12 patients with sebaceous gland tumors]

BACKGROUND

Sebaceous gland tumors are a rare type of neoplasm. In some cases they have been associated with visceral tumors in patients with Muir-Torre syndrome, a hereditary form of nonpolyposis colorectal cancer. The aim of this study was to review the diagnosis and follow-up of a series of patients with sebaceous gland tumors to assess how many met the criteria for Muir-Torre syndrome.

PATIENTS AND METHODS

A search was performed of records from 1990 to 2005 in the database of the Department of Dermatology of the Consorcio Hospital General Universitario de Valencia in Valencia, Spain, to identify patients with sebaceous gland tumors. The biopsy material was reviewed to confirm the diagnosis. We also searched the patient histories for information suggestive of a diagnosis of Muir-Torre syndrome; when the histories were incomplete, we contacted the patients by telephone.

RESULTS

We identified 20 patients diagnosed with sebaceous gland tumors, but after reviewing the biopsy material diagnosis was only confirmed in 12. Two patients belonged to a family with a history of visceral tumors that met the clinical criteria for hereditary nonpolyposis colorectal cancer syndrome. Follow-up was not uniform in all patients and not all underwent the same tests.

CONCLUSIONS

It is essential to rule out the presence of Muir-Torre syndrome in patients with sebaceous gland tumors. The use of new techniques such as immunohistochemistry or detection of microsatellite instability may help to identify families at increased risk of Muir-Torre syndrome.

Thyroid dysfunction in Down's syndrome and screening for hypothyroidism in children and adolescents using capillary TSH measurement

Thyroid dysfunction is more common in individuals with Down's syndrome (DS) than in the general population, whose clinical features can mask the presenting signs and symptoms of hypothyroidism. Biochemical screening is necessary; however, venepuncture may be difficult.

AIMS

To assess the prevalence of thyroid dysfunction in children and adolescents with DS and the feasibility of screening for hypothyroidism using capillary dried blood spot thyroid stimulating hormone (TSH) from infancy.

METHODS

394 children (217 boys, 177 girls) were clinically assessed for thyroid dysfunction and 305 children (aged 4 months to 18.9 years) were screened for hypothyroidism by capillary whole blood TSH sample.

RESULTS

Thyroid dysfunction was detected in 4.6%, with 50% unscreened since neonatal screening. Parents reported minimal distress by fingerprick screening.

CONCLUSION

DS is associated with an increased prevalence of thyroid dysfunction, particularly in preschool children. Biochemical screening is essential and capillary whole blood TSH sampling for hypothyroidism is feasible, less invasive and acceptable.