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Metabolic syndrome (MS) has been a condition involved in considerable controversy, starting with the terminology. Gerald Reaven himself, the author who proposed the term MS, advised against the use of this terminology because the definition implies in at least three metabolic alterations, and it is never clear to which group of alterations we are referring to when we say that a patient has MS. In children, the problem is even more complicated, since there are many different adaptations to the criteria used in adults. On the other hand, independent of the terminology, cardiovascular risks are well-established and it is very clear that even children may present metabolic disturbances which predict future metabolic problems. The role of the pediatric endocrinologist or the general pediatrician is to investigate, especially in overweight/obese children, conditions that if treated early, may prevent future complications that today, unfortunately, are being diagnosed only in adult life. In this review, we discuss problems on the definition, epidemiology, pathophysiology, and complications of MS in children and adolescents.

After the initial thyroid cancer treatment, the detection of likely recurrences and/or metastases is made through the measurement of serum markers determinations and diagnostic image procedures. These techniques may be negative in spite of biochemical evidence of metastatic disease. The positron emission tomography with fluorodeoxyglucose (FDG-PET) has been proposed as an accurate method to detect it. The aim of this study is to present a synthesis of the evidences obtained from a systematic review regarding FDG-PET accuracy in locating suspected metastases of previously treated thyroid cancer, when the conventional methods failed to do it. A bibliographic review of all studies related to FDG-PET and differentiated thyroid cancer was made on MEDLINE, indexed until September 2005. Two hundred and sixteen citations were collected and 17 studies included, 71% were published after 2000. FDG-PET sensibility was high, with only one study presenting a sensibility lower than 75%. The specificity, examined in 12 studies was lower than 75% in 3 studies. There was at least one test compared to FDG-PET in 41% of the studies. The results point to FDG-PET as a useful diagnostic test to detect and localize thyroid cancer metastases, with direct implications in the treatment of these patients.

Objective: To evaluate insulin sensitivity and the metabolic features in normal weight and overweight/obese patients with PCOS., Subjects and Methods: Forty-nine (49) patients from 18 to 45 years were retrospectively evaluated and divided into 2 groups, according to the body mass index (BMI): group 1 (18.5-24.9 kg/m(2)) and group 2 (25-40 kg/m(2)). Collected data: systolic and diastolic blood pressure; fasting and after OGTT glucose, insulin and glucose/insulin ratio; area under the curve for glucose and insulin; HOMA-IR and HOMA-beta; lipidic profile; free (FT) and total testosterone (T) levels., Results: Greater averages of pressoric levels, insulin resistance (IR) indices, triglycerides and the FT levels, in addition to lower HDL levels, were found in group 2. Neither correlation between the IMC with none of data nor of the FT and IR indices with the lipid profile were found., Conclusions: Obesity is associated with insulin resistance and diabetes mellitus in PCOS, independently on familiar history of DM. The absence of correlation between the IR indices and the FT with the lipidic profile suggests that other factors, such as the free fatty acids, can be involved in the pathogenesis of dyslipidemia in PCOS.