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Objective To evaluate the characteristics of obese girls with gonadotropin releasing hormone-dependent precocious puberty with and without polycystic-like ovaries. Methods Forty-seven overweight (>75th centile of the Italian reference data) girls with a diagnosis of isosexual precocious puberty underwent auxological analysis, hormonal assay and utero-ovarian sonographic and Doppler evaluation. On the basis of sonography the patients were subdivided into two groups, girls presenting normal ovaries (Group I; n = 31) and those with polycystic-like ovaries (Group II; n = 16). Results The mean body weight was significantly higher (P = 0.003) in Group II than it was in Group I. In addition, the patients with polycystic-like ovaries fell within our definition of superobese (≥97th centile of the Italian reference data) in 44% of cases. The uterine and ovarian volumes were significantly greater in Group II compared with Group I patients. The Doppler evaluation showed intraparenchymal ovarian vascularization and low down-stream impedance to flow in all patients in Group II. Conclusions Girls with precocious puberty and polycystic ovaries, compared with those without polycystic ovaries, have a higher incidence of body weight exceeding the 85th centile of the Italian reference data (obesity). [ABSTRACT FROM AUTHOR]

Objective To evaluate the effects of transdermal hormone replacement therapy (HRT) on plasma viscosity, serum levels of thromboxane B2 (TXB2) and vascular impedance in the uterine, bladder wall, internal carotid and ophthalmic arteries in normotensive and hypertensive postmenopausal patients. Methods Thirty postmenopausal patients underwent continuous estradiol transdermal supplementation at a dose of 50 μg/day and 12-day courses of medroxyprogesterone acetate 10 mg/day every 2 months. The women were divided into two groups according to their blood pressure: normotensive women (Group 1, n = 14) and hypertensive subjects (Group 2, n = 16). Before starting HRT and after 6 months of therapy, the patients underwent: transvaginal ultrasonographic examination of the pelvic organs; Doppler examination of the blood flow velocities in the uterine, bladder wall, internal carotid and ophthalmic arteries; and analysis of plasma viscosity and plasma TXB2. Results After 6 months of HRT plasma viscosity had decreased in both groups (mean reduction in Group 1, (14 ± 1)%, P = 0.005; mean reduction in Group 2, (10 ± 1)%, P = 0.005) as had the TXB2 levels (mean reduction in Group 1, (93 ± 2)%, P < 0.001; mean reduction in Group 2, (92 ± 3)%, P < 0.001). The mean percentage reduction in plasma viscosity was smaller in hypertensive women than in normotensive women (P < 0.05). There was also a significant reduction in vascular impedance in the uterine artery (mean reduction in Group 1, (16 ± 1)%, P = 0.005; mean reduction in Group 2, (19 ± 1)%, P = 0.005), the bladder wall arteries (mean reduction in Group 1, (23 ± 2)%, P = 0.005; mean reduction in Group 2, (18 ± 1)%, P = 0.005), the internal carotid artery (mean reduction in Group 1, (25 ± 1)%, P = 0.005; mean reduction in Group 2, (26 ± 1)%, P = 0.005) and the ophthalmic artery (mean reduction in Group 1, (24 ± 2)%, P = 0.005; mean reduction in Group 2, (16 ± 1)%, P = 0.005). The percentage reduction in vascular impedance did not differ significantly between the two groups. Conclusions Our results show that transdermal HRT is effective in reducing plasma viscosity, TXB2 levels and vascular impedance in the peripheral and central vessels both in normotensive and hypertensive postmenopausal patients. [ABSTRACT FROM AUTHOR]

Objective To evaluate the role of ultrasound and color Doppler analyses in improving the differential diagnosis of pubertal precocities. Methods Sixty-nine girls with premature (< 8 years old) breast development and/or pubic hair growth underwent: auxological (height, weight, body mass index, skeletal maturation), hormonal (basal, gonadotropin releasing hormone (GnRH)-test, adrenocorticotropic hormone test), and sonographic (uterine and ovarian volume and endometrial echo) including color Doppler (uterine arteries) evaluations. Results The uterine size was greater in girls with a pubertal response to the GnRH test (Group II, n = 16; 7.48 ± 4.18 mL) than in those with a prepubertal response to the GnRH test (Group I, n = 17; 3.02 ± 1.36 mL; P = 0.006), an isolated pubarche (Group III; n = 20; 2.58 ± 1.32 mL; P < 0.001) or an isolated thelarche (Group IV, n = 16; 1.82 ± 1.07 mL; P < 0.001). Endometrial echo was observed in 87.5%, 29.4% and 5% of girls, respectively, in Groups II, I and III. The Doppler analysis of the uterine arteries showed the lowest impedance to be in patients with a pubertal response to the GnRH test (Group II). Conclusions Sonographic and color Doppler parameters may improve the diagnosis of GnRH-dependent precocious puberty and may be useful to determine which girls need treatment. [ABSTRACT FROM AUTHOR]