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Background: In adults, both metabolic alterations related to syndrome X and lower plasma vitamin E levels have been associated with an increased risk of developing cardiovascular disease., Objectives: To study the presence of metabolic alterations related to syndrome X and to determine the plasma levels of vitamin E in obese children with acanthosis nigricans., Methods: We performed a prospective study in 42 obese children [15 with acanthosis nigricans (AN) and 27 without]. Thirteen healthy non-obese children were also studied. After a 12-hour fast, plasma levels of glucose, insulin, triglycerides, cholesterol, high-density lipoprotein (HDL)-cholesterol, and vitamin E were determined. The insulin resistance index was also calculated. Differences between groups were determined using ANOVA., Results: Obese children with AN showed higher plasma levels of insulin and triglycerides and lower plasma levels of HDL-cholesterol and vitamin E, as well as a higher insulin resistance index than non-obese children and obese children without AN., Conclusions: In obese children, the presence of acanthosis nigricans is linked to a group of metabolic alterations associated with a higher risk of developing cardiovascular disease and type 2 diabetes.

Problem: To examine the associative relationship among autoantibodies, C4 levels and intrauterine hematomas (IUH) in more detail than in the studies published earlier., Method of Study: We performed a retrospective study of 54 women with poor obstetric outcomes. Sera were screened for antinuclear antibodies (ANA), anti-DNA antibodies, antiphospholipid antibodies (aPL), and antithyroid antibodies. C4-complement and gammaglobulin levels were also monitored. We compared the main variables in IUH complicated pregnancy group with the risk pregnancy group without IUH. We also compared these variables in the IUH cases before and during IUH., Results: Eight IUH were detected. The average number of spontaneous losses for these eight women was 3.3 +/- 2.1 (range: 1-8). aPL was present in 100% of cases. ANAs and hypergammaglobulinemia were present in 50% of cases and low C4 in 87.5% of cases. After comparing these variables apart from C4 before and during IUH, we found no statistical differences. However, C4 was low in four patients before IUH and in seven patients during IUH (OR: 7.0; 95% CI: 0.57-86.33). When we compared autoantibodies apart from lupus anticoagulant (LAC) between the two groups, no differences were observed. However, seven of the eight (87.5%) patients with IUH were LAC positive whereas only 24 of the 46 patients (52.1%) were positive in the non-IUH group (OR: 6.42; 95% CI: 0.73-56.41). Rapid plasma reagin was present in 8/46 in the non-IUH group (16.7%) and 5/8 in the IUH group (62.5%) P < 0.015)., Conclusions: In women with poor obstetric histories, autoantibodies, especially antiphospholid antibodies, may play a role in the IUH development especially if low C4 and/or hypergammaglobulinemia are present.

Background: Changes in body configuration that may affect the physical activity may play a role in the caloric consumption and led to the development of obesity., Objectives: To determine the presence of genu valgum, an alteration that may decrease physical activity and caloric expenditure, in overweight children., Methods: Thirty-five overweight children without any endocrinological alterations that could lead to obesity were studied. Twenty-nine non-overweight children of a similar age were studied as a control group. In all children weight, height, and body mass index (BMI) were studied, and intermalleolar distance was used to measure the degree of genu valgum. The differences between groups were studied using ANOVA and the correlation between variables was determined using Pearson's correlation., Results: BMI was higher in overweight children than in the control group. Intermalleolar distance was greater in overweight children than in the non-overweight group (11.0 0.6 vs 2.90 0.43; p < 0.001). A positive correlation between the intermalleolar distance and the BMI was observed in the overweight group (p < 0.009). Fifty percent of the overweight children showed an intermalleolar distance of more than 10 cm, a value considered abnormal., Conclusions: The incidence of genu valgum is much higher in overweight children than in non-overweight children of the same age. This alteration may lead to decreased physical activity and lead to obesity.

A neonate with increased nuchal translucency and congenital adrenal hyperplasia is described. The possible interferences in hormone assays when values are much higher than the average assay range are also discussed.

We describe two girls who showed physical and biochemical features of insulin resistance and steatohepatitis. The possible pathophysiological mechanisms involved in fatty liver and hepatotoxicity are discussed.

A comparison of the behaviour of three different rigid composite matrices for the construction of amperometric tyrosinase biosensors, which are widely used for the detection of phenolic compounds, is reported. The composite electrode matrices were, graphite-Teflon; reticulated vitreous carbon (RVC)-epoxy resin; and graphite-ethylene/propylene/diene (EPD) terpolymer. After optimization of the experimental conditions, different aspects regarding the stability of the three composite tyrosinase electrode designs were considered and compared. A better reproducibility of the amperometric responses was found with the graphite-EPD electrodes, whereas a longer useful lifetime was observed for the graphite-Teflon electrodes. The kinetic parameters of the tyrosinase reaction were calculated for eight different phenolic compounds, as well as their corresponding calibration plots. The general trend in sensitivity was graphite-EPD>graphite-Teflon>>RVC-epoxy resin. A correlation between sensitivity and the catalytic efficiency of the enzyme reaction for each phenolic substrate was found. Furthermore, differences in the sensitivity order for the phenolic compounds were observed among the three biocomposite electrodes, which suggests that the nature of the electrode matrix influences the interactions in the tyrosinase catalytic cycle.

The case of an 9-year-old girl with precocious puberty and a non-functioning pituitary adenoma is described. A review of the literature on the incidence, evolution and therapeutic options of pituitary incidentalomas in children and adults is performed.

Surveillance of dengue fever is mainly based on specific laboratory tests. However non-specific systems, such as clinical surveillance, are also required. In French Guiana, we have tested a non-specific laboratory surveillance system where different biological examinations performed for other reasons than the diagnosis of dengue fever were analysed as methods for dengue fever surveillance. The number of negative malaria diagnoses in Cayenne and Kourou was found to be the best indicator of dengue fever infections in these towns. This surveillance system appears to be very simple and reliable, and a test which could serve as an indicator that is likely to be found everywhere.

A bienzyme amperometric graphite-Teflon composite biosensor, in which lactate oxidase (LOD) and peroxidase, together with the mediator ferrocene, are incorporated into the electrode matrix, was developed for the determination of L-lactate in food samples such as wine and yogurt by using both batch- and flow-injection modes. This bienzyme electrode was fabricated by simple physical inclusion of the enzymes and the mediator in the bulk of the graphite-Teflon matrix. A Teflon content of 70%, an applied potential of 0.00 V, and a pH of 7.4 were employed as working conditions. The composite bioelectrode exhibited long-term operation because of the renewability of its surface by polishing. Reproducible amperometric responses were achieved with different electrodes fabricated from different composite matrices, and no significant loss of the enzyme activity occurred after 6 months of storage at 4 degrees C. Detection limits for L-lactate of 1.4 and 0.9 microM were obtained by batch amperometry in stirred solutions and flow-injection with amperometric detection, respectively. An interferences study with different substances which may be present in wine and yogurt together with L-lactic acid demonstrated very good selectivity for the determination of this analyte. The bienzyme composite electrode was applied to the determination of L-lactic acid in red wine and shaken yogurt, and the methods were validated by comparing these results with those obtained by applying a recommended reference method.

A retrospective study was performed on children with hypercholesterolemia or hypertriglyceridemia referred to the Endocrine Clinic of the Niño Jesús University Hospital over a period of 5 years. One hundred twenty-seven children, from 2 to 16 years of age, were followed. The subjects were classified into the following groups: 90 with primary hyperlipidemia [55 polygenic hypercholesterolemia (PH), 23 familial hypercholesterolemia (FH) and 12 with familial combined hyperlipidemia (FCH)]; 2 with secondary hypercholesterolemia and 35 were found to have normal cholesterol and triglyceride values. All patients with primary hyperlipoproteinemia were instructed to carry out dietary intervention during a 6 month period, following the step I recommendations of the National Cholesterol Education Program (NCEP). The following results were obtained: In the group of children with PH and FH a decrease in total and LDL cholesterol was observed (p < 0.0001 for both groups). In the group of FH, a decrease in the LDL/HDL ratio was also observed (p < 0.01). In contrast, the group of children with FCH did not show any changes in the lipoprotein pattern after dietary intervention. In the three groups studied, no statistically significant differences were observed in the remaining parameters (HDL-C, VLDL, and apo A1) after dietary intervention. Lp(a) levels above 30 mg/dl were observed in 25%, 37% and 46% of the children with PH, FH and FCH, respectively. Nine patients with FH were treated with resins for 3 months. In these children a decrease in total and LDL cholesterol, apo B and in the LDL/HDL ratio was observed (p < 0.05). No changes in Lp(a) and HDL-C were observed in this group of children. In our experience, dietary intervention to reduce fat and cholesterol intake in children with primary hyperlipoproteinemia, a population at high risk of developing atherosclerosis, is safe and useful. The treatment with resins in children with FH improves their lipoprotein profile.