Search

Obesity in childhood is associated with the presence of complications that can undermine health immediately or in the long term. Several conditions, such as pulmonary or orthopedic complications are strictly associated with the severity of overweight, since they are directly associated to the mechanic stress of fat tissue on the airways or on the bones. Other conditions, such as metabolic or liver complications, although increasing with the extent of overweight, are associated with insulin resistance, which can be modulated by different other factors (ethnicity, genetics, fat distribution) and can occur in overweight children as well. No less important are psychological correlates, such as depression and stigma, which can seriously affect the health related quality of life. Pediatric services for the care of childhood obesity need to be able to screen overweight and obese children for the presence of physical and psychological complications, which can be still reversed by weight loss. This article provides pediatricians a comprehensive update on the main complications in obese children and adolescents and their treatment.

The present study, performed in the Department of Internal Medicine and Gastroenterology of Policlinico of Modena, shows the results of the treatment with percutaneous ethanol injection of cirrhotic patients with hepatocellular carcinoma. In the period between June 1991-May 1998, 37 nodules of hepatocellular carcinoma, in 26 cirrhotic patients, were treated with ethanol injection under the ecographic guidance; the total number of sessions was 179. Ten lesions were recurrences (local or distant) in patients already treated. These patients were excluded from surgical treatment because of the high age, the high surgical risk or patient's choice. "Therapeutic success", defined as radiologic (TC or RM) demonstration of complete necrosis at the end of the first cycle of treatment, was achieved in 22/27 nodules after the first treatment (81.5%). Therapeutic success of the recurrence (second treatment) was achieved in 7/10 nodules (70%). In treated patients, survival probability (obtained with Kaplan Meier method) was 84.5%, 73.0%, 50.0%, 38.5%, 26.9%, respectively at 1st, 2nd, 3rd, 4th and 5th year. After a total number of 179 sessions, there were no relevant complications. The results obtained in our experience prove the efficacy and safety of this therapeutic technique in patients with cirrhosis and hepatocellular carcinoma.

A lactose-free soy and beef hydrolysate based formula ("Pregomin" Milupa) was studied in 12 infants affected with protracted enteritis and in 10 infants affected with atopic eczema. After 1 month of treatment with "Pregomin" an oral provocation test was performed using intact soy protein. The aim of this latter test was to evaluate if the hydrolysed soy formula could cause allergic sensitization to soy protein. We obtained the following results in the group of infants with enteritis: good catch-up growth, malnutrition laboratory test improvement, negative allergic tests, positive oral provocation test in only one infant who had been previously fed with intact soy protein. In the group with atopic eczema we found an improvement of the eczema, negative allergic tests, 3 out of 9 positive oral provocation tests (in infants previously fed with soy protein based formulas). Our data show that "Pregomin" formula was effective both from a gastroenterological point of view and from an allergological one. Furthermore we did not observe any positive oral provocation test with soy protein in infants who had never been exposed to this type of protein. The latter result seems to demonstrate that "Pregomin" formula does not possess any allergenic properties.