Accuracy of transcranial ultrasound in the detection of mild white matter lesions in newborns.

Cranial Ultrasound (cUS) may not be sensitive enough to detect subtle white matter (WM) injuries. Our study compared serial cUS with MRI at term equivalent age (TEA) to determine if it is possible to identify an ultrasound representation of subtle diffuse WM injuries such as punctate lesions (PWMLs) and diffuse excessive high signal intensity (DEHSI). Fifty-six very preterm infants were scanned sequentially from birth to TEA, an MRI was performed at TEA. Each echodensity found on cUS was classified as absent, transient (≤7 days), or prolonged (>7 days). A transient periventricular echodensity was detected in seven infants (12.5%), and a prolonged echodensity in 15 (26.8%). MRI examinations were performed in all 56 infants. No altered signal intensity was found in 18 infants (32.1%). DEHSI was detected in 14 infants (25%), and PWMLs were detected in eight babies (14.3%). Both abnormalities were found in 16 infants (28.6%). The positive predictive values of the prolonged echodensity for DEHSI and PWMLs were 86.7% and 46.7% respectively. However, a significant statistical correspondence (p=0.002, Odds Ratio 11.9) was found comparing DEHSI with cUS abnormal echodensities. Serial cUS during the neonatal period in preterm infants is essential and cannot be replaced with MRI at TEA. MRI seems to be more reliable in detecting mild or moderate WM abnormalities. However, serial cUS performed by an experienced neonatologist can provide valuable information on early WM changes such as prolonged echodensities that could potentially lead to a diffuse injury.

[Hypertension in schoolchildren: research carried out in a secondary school in Rome and observations on dietary patterns]. / Ipertensione arteriosa in età scolare. Indagine in una scuola media romana con considerazioni anche sul comportamento alimentare dei ragazzi.

AIM: The aim of this research was to evaluate the incidence of hypertension in adolescents by assessing their anthropometric measurements and diet, since recent literature data suggest that 30% of obese adolescents are hypertensive. METHODS: The 293 schoolchildren engaged in the study were aged 11-14 years and 54% were male. They attended a Secondary School in Rome with a middle-high class background. Blood pressure, heart rate, weight, height, tricipital and subscapular skinfolds and body mass index (BMI) were measured and dietary patterns assessed through 24-h recall. The findings were then statistically evaluated. RESULTS: The incidence of hypertension was 6.5%, without distinction between sexes. On the basis of the statistical evaluation of the correlations between hypertension and obesity, familial hypertension, weaning with the addition of salt and bottle-feeding from birth, only obesity was found to be statistically significant (p<0.001). Even though the hypertensive adolescents had a high intake of snacks, salt, meat, sausages and cheese in their daily diet, only the excess of proteins was statistically significant (p<0.05). The incidence of obesity (calculated as being 20% over the ideal weight for a given height) was 17.3%. This finding was confirmed by the mean value of the both skinfolds, whereas BMI, for which obesity and overweight were considered together, showed a slight overestimation of this percentage. CONCLUSION: A high number of hypertensive adolescents was found, about 1/3 of the obese adolescents examined. This confirms the findings of an extensive study previously carried out by the Group of Hypertension of the Italian Society of Pediatrics. From a nutritional point of view, the excessive intake of proteins of the 19 hypertensive adolescents was found to be statistically significant. However, a more extensive study could probably provide further data on other nutrients which, in this case, were not quite statistically significant.

Age-related trend for blood pressure circadian rhythm in normotensive healthy subjects: estimates provided by the clinospectror method.

The present study investigates how blood pressure (BP) circadian rhythm (CR) changes in its rhythmic properties as a function of chronological age in normotensive healthy subjects (NHS). The age-related trend for BP CR was investigated via the Clinospectror method, a periodic-linear analysis of regression for rhythmic parameters. The study was performed on 437 NHS (219 males and 218 females, ranging in age from 1 year to 102 years), who were monitored in their 24-h BP via a noninvasive automated recorder. An age-related trend was detected for the three properties of BP CR, i.e., mesor (M), amplitude (A) and acrophase (cent). Such a trend was positive for M and A, and negative for cent. According to the clinospectrometric formula, the BP CR can be classified as a "dianaclinous rhythm", i.e., a rhythm which increases in its oscillatory level and extent with advancing years. The documented age-related trend for the rhythmic properties suggests that the biological clock which regulates the BP CR in human beings undergoes a resetting of its mechanisms of tonic, amplitude and phasic modulation as a function of chronological age. The readjustment of the pressure clock may be regarded as one of the physiological features which characterize the aging process in human beings.

24 hour monitoring of blood pressure in premature and full-term new born babies.

Using a 24 hour monitoring of the systo-diastolic blood pressure, 127 new born babies were studied in the first five days of life. 45 of these new born babies were premature (35 +/- 1 week) and 82 full-term. The results showed an overlap in the systo-diastolic blood pressure in the 2 groups of subjects with a rise and fall in pressure in the 24 hour period and no fall in pressure during the night typical to a healthy adult.

[Dietetic counseling of obese school child. Study in an elementary school]. / Suggerimenti dietetici per lo scolaro obeso. Indagine nella scuola elementare.

We controlled, after nine months, 29 obese children, who attended the primary school, and to whom it was advised a good balanced base diet of 1200 kcal. One child wasn't obese anymore, and in 13 cases there was a sensible reduction of overweight percentage. We consider these results positively, because our aim was to obtain a gradual resolution of the overweight, trying to avoid some very dangerous relapses for the young's future. Finally, we underline the necessity to begin some conferences about the young's and family's alimentary education, as soon as possible. These conferences have to be addressed to all the teachers, parents and pupils, from the primary school.

[Obesity and hypercholesterolemia in a primary school in Rome]. / Obesità ed ipercolesterolemia in una scuola elementare romana.

The research in particular the incidence of obesity, hypertension and hyperlipemia was evaluated involved 201 primary school children. The results show an obesity percentage equal to 28%; 23% of the young were hypercholesterolic and 21% had hypertriglyceridemia. Nobody was hypertensioned. The high percentage of obese and hjperlipemic subjects suggest the immediate needs of Courses of alimentary education in schools, as well as to resort to sound daily sporting activity.