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Arterial hypertension is a major risk factor for atherosclerotic ischemic heart disease and cerebrovascular stroke. Blood pressure measurements were taken in the supine position in 6,282 healthy adolescents (3073 boys, 3209 girls) aged 13-17 years of both sexes. Forty-eight subjects were found to have hypertension: 35 idopathic and 13 secondary to reflux nephropathy, chronic glomerulonephritis, coarctation of the aorta, and hemolytic uremic syndrome. Systolic blood pressure was significantly higher among males than females at ages 15-17 years (p<0.001); diastolic blood pressure was higher among males at age 17 years only (p<0.05). Males with BMI>17 exhibited higher systolic blood pressure than females. Prevalence of hypertension, mostly primary, in a large cohort of students was 0.76%. Early screening is important for early interventions and reducing cardiovascular morbidity and mortality in adulthood.

The development of hypertension was examined several years after an episode of Henoch-Schönlein purpura (HSP) in children with or without urinary abnormalities or hypertension at diagnosis. Medical records of 155 children (mean age 6.8+/-2.3) with HSP from 1969 to 1997 were reviewed for a specific description of renal involvement, blood pressure, and urinary abnormalities. The study group consisted of 86 boys (55.47%) and 69 girls (44.53%); 30% had renal involvement, 5 among them presented with nephritic-nephrotic syndrome. Hypertension was found in 7 patients with HSP on long-term follow-up including the 5 who had nephritic-nephrotic syndrome at presentation, 1 who had macroscopic hematuria but normal blood pressure, and 1 with normal urine and normal blood pressure. These data emphasize the need for regular monitoring of children with HSP with or without renal findings.

Recent studies have indicated possible changes in the incidence of acute mastoiditis. A retrospective review of children discharged with a diagnosis of acute mastoiditis was undertaken to describe the epidemiology, clinical presentation, microbiology, and treatment of acute mastoiditis over past years. Demographic historic, clinical, and laboratory data were collected. Eighty-six children (88 episodes of acute mastoiditis) were identified (1 month-16 years) (median 3.3 years). Almost half had a history of middle ear disease; 8% recurrent episodes and 68.2% received antibiotics preadmission, 91.2% for acute otitis media. Bacterial etiology was established in 43 patients (68.2% isolation rate). Pseudomonas aeruginosa and Streptococcus pneumoniae were the most frequently isolated agents. This review showed a significant increase (150%) in the number of patients with acute mastoiditis.

To assess the feasibility of using telemedicine for the diagnosis of inflammation in a pediatric population. The degree of erythrocyte adhesiveness/aggregation and the number of white blood cells on peripheral blood slides were evaluated using an image analysis system and transferred to an operator in a remote location. A highly significant correlation was found between the degrees of erythrocyte adhesiveness/aggregation as well as estimated white blood cell count determined by a remote operator and the objective measurements of both erythrocyte sedimentation rate and white blood cell count. A reasonable estimate of both erythrocyte sedimentation rate and white blood cell count can be obtained by using telemedicine in a group of children with acute infection/inflammation.

We applied an erythrocyte adhesiveness/aggregation test (EAAT) to a model of plasma exchange in individuals with familial and primary hypercholesterolemia. The significant (p < 0.0001) reduction in the concentration of fibrinogen by 56%, globulins by 48%, and cholesterol by 53% corresponded to the expected significant (p < 0.0001) reduction in the degree of erythrocyte adhesiveness/aggregation in the peripheral venous blood. By virtue of its being a real-time, simple, very-low-cost, and essentially bedside technique, the EAAT might have the potential of disclosing information of rheological relevance immediately before, during, as well as following apheretical procedures administered to patients with an impaired rheological profile.

Aims: To determine whether increased red blood cell adhesiveness/aggregation in diabetic patients is related to the extent of their metabolic control., Methods: We measured erythrocyte adhesiveness/aggregation in a group of 85 adult patients with diabetes mellitus by using citrated venous whole blood and a simple slide test. The erythrocyte adhesiveness/aggregation was determined by measuring the size of the spaces that are formed between the aggregated erythrocytes. We divided the patients into those with either low or high erythrocyte adhesiveness/aggregation values., Results: The erythrocyte adhesiveness/aggregation values of the two groups differed significantly in terms of their fibrinogen concentration, erythrocyte sedimentation rate, high sensitive C-reactive protein (CRP), total cholesterol and triglyceride concentrations. There was no difference between the two groups regarding the concentrations of HbA(1c). Logistic regression was applied to construct a model to predict the belonging of a patient in the low or high erythrocyte adhesiveness/aggregation group. A linear regression was applied to construct a model to predict the erythrocyte adhesiveness/aggregation values. Both models turned out to include gender, age, fibrinogen, triglyceride, retinopathy, coronary artery disease and age and gender interaction. Neither HbA(1c) nor CRP entered the models., Conclusions: The degree of erythrocyte adhesiveness/aggregation and several variables of the acute-phase response in patients with diabetes mellitus are not directly related to the degree of metabolic control as evaluated by means of HbA(1c) concentration. Diabetic patients might benefit from rheological or anti-inflammatory interventions regardless of their metabolic control.