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CLOVES syndrome is a rare overgrowth disorder caused by gene mutations. This case study describes a 28-year-old woman with CLOVES syndrome who underwent multiple surgeries to achieve a positive outcome while preserving lymphovascular structures. The report underscores the importance of a multidisciplinary approach and tailored surgical interventions for managing CLOVES. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) is first diagnosed during pregnancy and it is the most frequent maternal hyperglycemia. Objective: To know fetal and maternal outcomes in an intensive control program in pregnant women with and without DMG at the Instituto Mexicano del Seguro Social (Mexican Institute for Social Security) Regional General Hospital No. 6, in Ciudad Madero, Tamaulipas. Material and methods: A descriptive and retrospective study, which included 800 outcomes of pregnant women between January 2009 and June 2020. Anthropometric data and pregnancy outcomes were collected. The intensive control program consisted of face-to-face consultations of 1 to 4 weeks, granted according to the degree of metabolic control, with which it was given nutritional counseling, recommendations for physical activity, and in some cases pharmacological treatment. Results: The prevalence of GDM was 36.2%. There were no statistically significant differences between the two groups, except for respiratory distress syndrome, which was more common in GDM (9.4%, p = 0.06). Patients with GDM had a lower prevalence of macrosomy (6.1%) compared to the control group (6.6%). All women admitted to the program in the first trimester had fewer fetal and maternal complications. Conclusions: This study demonstrates the effectiveness and efficiency of implementing an intensive control program in women with GDM, by reducing and equalizing maternal and fetal outcomes compared to a group of women without the disease. [ABSTRACT FROM AUTHOR]

Introduction. Progress of labor in multiparous women usually is not accompanied with risk of any kind of birth trauma. Case Outline. We report a very rare case of rib fracture in a neonate during vaginal delivery in the 39/40 week of gestation. The expulsion started spontaneously without any manipulation from the obstetrician. Live male newborn was delivered 4650 g. in weight, 55 cm long, with head circumference of 39 cm, Apgar score 9. The child was immediately examined by the neonatologist. Crepitations were palpable over the left hemithorax, and auscultatory on the left side inspiratory cracks. Finding was suspicious for rib fracture on the left side posteriorly and brachial plexus palsy, while other findings were normal. X­ray finding was inconclusive, but suspicious for fracture of the 4th, 5th, and 6th left rib posteriorly, without dislocation of bone fragments. There were no signs of pneumothorax. Dorsal position of the newborn was considered sufficient, accompanied with analgetics. X­ray was scheduled in a week because formation of the calus would be the only objective sign of previous rib fracture. On the control X­ray fracture lines were clearly visible on the 3rd, 4th, 5th, 6th and 7th rib posteriorly, without dislocation of bone fragments with initial calus formation. The child was discharged from hospital in good condition after two weeks, for further outpatient care. Conclusion. With timely diagnostics of this very rare intrapartal fracture, adequate treatment, dorsal position and close control of clinical condition of the newborn, serious and potentially life threatening complications can be avoided.

Objetivo: evaluar los factores de riesgo (FR) para diabetes mellitus gestacional en una población obstétrica en Colombia. Materiales y métodos: estudio de casos y controles retrospectivo. Población de mujeres gestantes atendidas en tres clínicas privadas de alta complejidad que atienden población del régimen contributivo de la ciudad de Medellín, en el periodo de junio de 2005 a mayo de 2007. Se excluyeron pacientes con diabetes pregestacional. Se definió como caso: pacientes gestantes o en posparto inmediato con diagnóstico de DMG. Los controles: pacientes en posparto sin DMG. Tamaño muestral: 215 casos y 430 controles. Con base en un OR estimado de 2,3. Relación 2 controles:1 caso, con proporción de exposición entre los controles de 7%, confianza de 95%, poder 80%. Resultados: se incluyeron 244 casos (36,6%) y 423 controles (63,4%). Se encontró asociación estadística con el antecedente personal de DMG (OR = 16,6; IC 95%: 4,9-55,7), el antecedente de macrosomía (OR = 7,3; IC 95%: 3,6-15,1), la edad ≥ 25 años (OR = 5,5; IC 95%: 3,6-8,5), multiparidad (OR = 2,6; IC 95%: 1,8-3,8), el IMC previo a la gestación ≥ 25 kg/m² (OR = 3,1; IC 95%: 2,2-4,4) e IMC al inicio del segundo trimestre ≥ 25 kg/m² (OR = 3,5; IC 95%: 2,1-5,7). Conclusión: además de los factores de riesgo re portados en la literatura, se encontró la macrosomía, la multiparidad, y la obesidad pregestacional y ges tacional como factores independientes para DMG.Objective: Evaluating risk factors (FR) for gestational diabetes mellitus (GDM) in an obstetric population in Colombia. Materials and methods: This was a retrospective case-control study. The population consisted of pregnant females being seen at three private high-complexity clinics, attending the contributory regimen population in the city of Medellín from June 2005 to May 2007. Patients suffering pregestational diabetes were excluded. A case was defined as being a pregnant patient or female in the immediate postpartum period diagnosed with GDM. Controls consisted of patients in the postpartum with no GDM. Results: Data regarding 244 cases (36.6%) and 423 controls (63.4%) were included. Statistical association was found with personal background of GDM (OR = 16.6; 4.9-55.7 95% CI), a background of macrosomy (OR = 7.3; 3.6-15.1 95% CI), being aged ≥ 25 years (OR = 5.5: 3.61-8.5 95% CI), multiparity (OR = 2.6; 1.8-3.8 95% CI), ≥ 25 kg/m² BMI prior to gestation (OR = 3.1; 2.2-4.4 95% CI) ≥ 25 kg/m² BMI at the start of the second trimester (OR 3.5; 2.1-5.7 95% CI). Conclusion: As well as the risk factors reported in the literature, macrosomy, multiparity, pregestational and gestational obesity were also found to be independent factors for GDM.

The Angelman syndrome (AS) (developmental delay, mental retardation, speech impairment, ataxia, outbursts of laughter, seizures) can result either from a 15q11-q13 deletion, or from paternal uniparental disomy (UPD), imprinting, or UBE3A mutations. We describe here the phenotypic and behavioral variability detected in eight UPD patients out of a group of 58 AS patients studied. All of them presented developmental delay, mental retardation, ataxia, speech impairment, and frequent drooling. Only one had microcephaly, whereas in two of them the OFC (head circumference) was above the 98th percentile. The weight of all patients was above the 50th percentile, and in three of them the height was above the 90th percentile. Three were able to say a few words and to communicate by gestures. Two patients presented hyperphagia, and three presented skin picking, common features in the Prader-Willi syndrome (PWS). Four patients (4/7) had wide-spaced teeth. Five presented seizures, and two others did not manifest frequent laughter. One patient was very different from the others, as he showed a better understanding and abilities to communicate, to play video games and to draw. We suggest here that there seems to be an extreme phenotypic and behavioral variability within the UPD group, and that both typical patients and those with mental retardation, language impairment, happy disposition, and hyperactivity should be tested for AS.

Background: Gestational diabetes mellitus (GDM) is first diagnosed during pregnancy and it is the most frequent maternal hyperglycemia., Objective: To know fetal and maternal outcomes in an intensive control program in pregnant women with and without DMG at the Instituto Mexicano del Seguro Social (Mexican Institute for Social Security) Regional General Hospital No. 6, in Ciudad Madero, Tamaulipas., Material and Methods: A descriptive and retrospective study, which included 800 outcomes of pregnant women between January 2009 and June 2020. Anthropometric data and pregnancy outcomes were collected. The intensive control program consisted of face-to-face consultations of 1 to 4 weeks, granted according to the degree of metabolic control, with which it was given nutritional counseling, recommendations for physical activity, and in some cases pharmacological treatment., Results: The prevalence of GDM was 36.2%. There were no statistically significant differences between the two groups, except for respiratory distress syndrome, which was more common in GDM (9.4%, p = 0.06). Patients with GDM had a lower prevalence of macrosomy (6.1%) compared to the control group (6.6%). All women admitted to the program in the first trimester had fewer fetal and maternal complications., Conclusions: This study demonstrates the effectiveness and efficiency of implementing an intensive control program in women with GDM, by reducing and equalizing maternal and fetal outcomes compared to a group of women without the disease., (© 2023 Revista Médica del Instituto Mexicano del Seguro Social.)

Objective: Evaluating risk factors (FR) for gestational diabetes mellitus (GDM) in an obstetric population in Colombia. Materials and methods: This was a retrospective case-control study. The population consisted of pregnant females being seen at three private high-complexity clinics, attending the contributory regimen population in the city of Medellín from June 2005 to May 2007. Patients suffering pregestational diabetes were excluded. A case was defined as being a pregnant patient or female in the immediate postpartum period diagnosed with GDM. Controls consisted of patients in the postpartum with no GDM. Results: Data regarding 244 cases (36.6%) and 423 controls (63.4%) were included. Statistical association was found with personal background of GDM (OR = 16.6; 4.9-55.7 95% CI), a background of macrosomy (OR = 7.3; 3.6-15.1 95% CI), being aged ≥ 25 years (OR = 5.5: 3.61-8.5 95% CI), multiparity (OR = 2.6; 1.8-3.8 95% CI), ≥ 25 kg/m2 BMI prior to gestation (OR = 3.1; 2.2-4.4 95% CI) ≥ 25 kg/m2 BMI at the start of the second trimester (OR 3.5; 2.1-5.7 95% CI). Conclusion: A s well as t he risk factors reported in the literature, macrosomy, multiparity, pregestational and gestational obesity were also found to be independent factors for GDM. [ABSTRACT FROM AUTHOR]

Background: Head growth rates are often accelerated in autism. This study is aimed at defining the clinical, morphological, and biochemical correlates of head circumference in autistic patients. Methods: Fronto-occipital head circumference was measured in 241 nonsyndromic autistic patients, 3 to 16 years old, diagnosed according to DSM-IV criteria. We assessed 1) clinical parameters using the Autism Diagnostic Observation Schedule, Autism Diagnostic Interview-Revised, Vineland Adaptive Behavioral Scales, intelligence quotient measures, and an ad hoc clinical history questionnaire; 2) height and weight; 3) serotonin (5-HT) blood levels and peptiduria. Results: The distribution of cranial circumference is significantly skewed toward larger head sizes (p < .00001). Macrocephaly (i.e., head circumference >97th percentile) is generally part of a broader macrosomic endophenotype, characterized by highly significant correlations between head circumference, weight, and height (p < .001). A head circumference >75th percentile is associated with more impaired adaptive behaviors and with less impairment in IQ measures and motor and verbal language development. Surprisingly, larger head sizes are significantly associated with a positive history of allergic/immune disorders both in the patient and in his/her first-degree relatives. Conclusions: Our study demonstrates the existence of a macrosomic endophenotype in autism and points toward pathogenetic links with immune dysfunctions that we speculate either lead to or are associated with increased cell cycle progression and/or decreased apoptosis. [Copyright &y& Elsevier]

La obesidad es una enfermedad crónica, multifactorial y compleja que se desarrolla por la interacción del genotipo y el medio ambiente, que tiene su raíz en factores sociales, culturales, de comportamiento, fisiológicos, metabólicos y genéticos. Con el fin de identificar la obesidad entre los factores de riesgo ateroscleróticos que pueden observarse desde la infancia, se realizó un estudio descriptivo con un diseño de tipo caso-control en niños nacidos entre enero de 1992 y diciembre de 1995 en la maternidad "Ramón González Coro". Se conformaron dos grupos, uno al que se le denominó "grupo macrosómico" integrado por 140 niños con alto peso al nacer (de 4 000 g o más) y otro llamado "grupo control" conformado por 100 niños con peso normal al nacer. Se caracterizó la muestra según sexo, edad. Se evaluó el estado nutricional actual del niño o niña por medio de la relación peso (en kgs)/talla (en cms). Se encontró que no existen diferencias significativas entre el índice de masa corporal en ambos grupos, sin embargo, el número de escolares mal nutridos por exceso (sobrepeso y obesidad) fue elevado en los dos grupos aunque no predominó. Puede concluirse que el alto peso al nacer no es un factor predictor para la obesidad.Obesity is a chronic, multifactoral and complex disease that develops from the interaction of the genotype and the environment, and is rooted in social, cultural, behavioral, physiological, histobiological and genetic factors. With the purpose of identifying obesity as one of the atherosclerotic risk factors that may be observed from the very childhood, a case-control descriptive study was carried out in children who were born from January 1992 to December 1995 in "Ramón Gonzales Coro" hospital. This research work was conducted in two groups, one called "the macrosomic group" composed of 140 children with high birth weight (4 000 grams or over) and the other called "the control group" made up of 100 normoweighted children at birth. The sample was characterized by sex and age. The current nutritional status of either a boy or a girl was evaluated based on weight-size ratio. It was found that highly significant differences between average weights of the study group and the control group at birth existed, but the same was not valid for the body mass indexes of both groups, according to the statistical data. However, in this study, the number of malnourished school children due to overfeeding was high in both groups, but not predominant. It may be concluded that high birthweight is not a predictive factor for obesity.

Poco se ha investigado en relación con el alto peso al nacer y los factores de riesgo aterosclerótico. Los hechos precursores de enfermedades como las cardiovasculares, específicamente la hipertensión arterial, se establecen desde la infancia, pero sus manifestaciones clínicas son difíciles de advertir en el niño porque no son tan notorias como en los adultos. Para identificar de forma temprana estas manifestaciones, se realizó esta investigación en dos grupos de niños, uno al que se le denominó "grupo macrosómico" integrado por 140 niños con alto peso al nacer (de 4 000 g o más) y otro llamado "grupo control" conformado por 100 niños con peso normal al nacer. Se caracterizó la muestra según sexo y edad. Se realizaron de forma sistemática tres mediciones de la tensión arterial en cada grupo con intervalo de una semana y se tomó como cifra definitiva el promedio de estas mediciones. No hubo diferencias estadísticamente significativas en las cifras de tensión arterial en ambos grupos, pero se encontró que el 27,14 % de los macrosómicos y el 25,00 % del grupo control eran hipertensos. A pesar de que es preocupante la prevalencia de hipertensión arterial en ambos grupos, el alto peso al nacer (macrosomía) no constituye un factor predictor de hipertensión arterial en las condiciones de este estudio.Little research has been made about the high birth weight and the atherosclerotic risk factors. The precursor events of diseases such as the cardiovascular illness, particularly blood hypertension, are set since the childhood, but it is difficult to confirm their clinical manifestations in the child because they are not as obvious as in adults. With the objective of early detecting these manifestations, this research work was conducted in two groups of children, one called "the macrosomic group" composed of 140 children with high birth weight (4 000 grams or over) and the other called "the control group" made up of 100 normoweighted children at birth. The sample was characterized by sex and age. Blood pressure was systematically measured three times at one week interval and averages values was analyzed. There was no a statistically significant difference in blood pressure figures in the two groups of children, although 27.14 % of the macrosomic group and 25 % of the control group were hypertensive. Despite the concerns about the prevalence of blood hypertension in both groups, the high birth weight (macrosomy) is not a predictive factor of hypertension under the conditions of this study.

Pituitary hyperplasia is generally associated with end-organ failure such as primary hypothyroidism, physiological changes such as puberty and pregnancy, or neoplasms secreting releasing factors. We present a full-term infant with an enlarged pituitary height of 8 mm at age 3 days despite a normal endocrinological evaluation. Repeat imaging at 5 months of age revealed a normal-size pituitary gland. To our knowledge, pituitary hyperplasia has not been described in a neonate with normal pituitary function. [ABSTRACT FROM AUTHOR]

Objectives: It is the prospective observational study aimed at early prediction of pregnancy complications in women with symptoms of MS., Material and Methods: 124 Caucasian women in singleton pregnancies 11th to the 13th wks 6 days of gestation with MS criteria compared to 30 healthy controls. Perinatal maternal and fetal results were analyzed., Results: Increased in the MS group were: age (32.9 y vs. 28.6 y; p = 0,00), weight 11 to 13 + 6 weeks of gestation (79.0 kg vs. 59.7 kg; p = 0.00), BMI (29 kg/m² vs. 21.6 kg/m²; p = 0.00), waist-hip ratio (WHR) (0.9 vs. 0.8; p = 0.00). Maternal serum parameters were higher in the MS group: LDL-cholesterol (124.1 vs. 109.6 mg/dL; p = 0.02), t-PA (2556.8 vs. 1949.5 pg/mL; p < 0.00), GGTP (16.8 vs. 13.3 IU/L; p = 0.02) and lower values for: adiponectin (6.4 vs. 7.5 μg/mL; p = 0.01), SHBG (273.4 vs. 338.4 nmol/L; p = 0.001). MS group neonates higher body weight (3594.4 vs. 3312.2 g; p = 0.01), significantly frequent macrosomic neo-nates (> 4000 g) (20.9% vs. 6.6%; p = 0.042), GDM (12% vs. 0; p = 0.019)., Conclusions: Higher E-selectin serum concentration, GGTP and lower SHBG in first trimester are additionally to fasting maternal glucose, higher BMI and maternal age predictive for GDM. Higher E-selectin, fasting glucose, increased BMI and lower adiponectin serum concentration in first trimester are significant predictors of fetal macrosomia. Maternal BMI > 24.5 kg/m² is the best predictor of increased risk of fetal macrosomia and gestational diabetes mellitus.