Utility of ApoB/ApoA1 Ratio for the Prediction of Cardiovascular Risk in Children with Metabolic Syndrome.

Objective To assess whether apoB/apoA1 ratio is associated or not with metabolic syndrome in obese children. Methods A 198 obese children and 41 healthy control subjects were enrolled in a cross-sectional study. The apoB/ apoA1 ratio and other metabolic sydrome components in obese children with/without metabolic syndrome were compared to healthy controls. Results The apoA1 level did not show significant difference (p=0.664) but apoB level (p=0.000) and apoB/apoA1 ratio (p=0.001) were significantly higher in obese group than in control group. Also, the apoB/apoA1 ratio was significantly higher in obese children with metabolic syndrome when compared to obese children without metabolic syndrome (p=0.007) and showed positive correlation with triglyceride (r=0.404, p=0.000) and negative correlation with high-density lipoprotein cholesterol (r=−0.593, p=0.000). Conclusions The apoB/apoA1 ratio is associated with metabolic syndrome in obese children. An elevated apoB/apoA1 ratio may constitute an important feature of the metabolic syndrome. There is a need for long term follow-up studies concerning cardiovascular risk in obese children with metabolic syndrome and high apoB/ apoA1 ratio.

Prolonged hungry bone syndrome in a 10-year-old child with parathyroid adenoma.

We report a case of primary hyperparathyroidism associated with prolonged hungry syndrome (HBS) after parathyroid adenomectomy in a 10-year-old girl. Bone mineral density (BMD) revealed severe loss of cancellous BMD. Overt bone disease, high alkaline phosphatase, decreased cancellous BMD and a large adenoma can be used as preoperative predictive risk factors of HBS in children.

Intravenous ketamine plus midazolam vs. intravenous ketamine for sedation in lumbar puncture: a randomized controlled trial.

OBJECTIVE: To compare a combined dose of ketamine and midazolam versus ketamine alone in the sedation of children requiring lumbar puncture. STUDY DESIGN: A randomized, controlled study, conducted between January 2004 and December 2006. SETTING: The Pediatric Emergency Department (PED) at Ankara Training and Research Hospital, Turkey. PARTICIPANTS: A random sample of 99 children (59 boys, 40 girls) aged 2-14 years (mean age 6.5+/-3.7) undergoing lumbar puncture. INTERVENTION: Participants were randomized to receive intravenous (IV) ketamine only (1 mg/kg; IVK) (n=51) or ketamine plus midazolam (1 mg/kg ketamine+0.1 mg/kg midazolam; IVKM) (n=48). MAIN OUTCOME MEASURES: The mean time to sedation and adverse events. RESULTS: The mean time to sedation was significantly shorter in the IVKM group than the IVK group (2.6+/-1.1 and 3.4+/-1.7 min, respectively; P=0.01). The parental satisfaction was significantly higher in the IVKM group (P=0.001). Also the fasting time and recovery time did not differ between groups, nor was there a significant difference in nausea/vomiting between groups. Nightmares or crying spells were more common in the IVK group than in the IVKM group (P=0.04). CONCLUSIONS: We conclude that adding midazolam to ketamine did not increase the frequency of adverse events and that the combined sedative was superior to ketamine alone in terms of speed of sedation and parental satisfaction.