Development, pathogenesis and complications of childhood obesity consist of complex mechanisms including numerous cytokines and hormones. New treatment modalities depend on understanding these complex mechanisms.

Sequential therapy seems highly effective for eradicating H pylori in children; however, the difference between 2 groups in resistant strains was the limitation of the study. Our country needs to reassess the effectiveness of standard triple therapy regimen for H pylori eradication.

Some children with congenital hypothyrodism may have mild to moderate neurodevelopmental retardation, despite the early diagnosis and treatment, and thus need to be under regular follow-up for neurodevelopmental status.

SUMMARY: This study aimed to determine the frequency of Helicobacter pylori infections in children with phenylketonuria (PKU). Sixty-six children with PKU (35 boys, 31 girls; mean age, 8.2 ± 6.7 years) and 32 outpatient controls (15 boys, 17 girls; mean age, 9.6 ± 4.7 years) were studied. Socioeconomic factors did not differ between the two groups. The frequency of H. pylori infections was higher in patients with PKU (28.1z) than in healthy controls (9.4z). In particular, a higher frequency of infection was detected in patients with PKU with poor metabolic control (51.8z). The frequency of H. pylori infection in patients with PKU with good metabolic control was only 10.2z. There was no difference in the mean total WISC-R score between the poor and good metabolic control groups. A high frequency of H. pylori infection in children with PKU with poor metabolic control could be related to many factors. Advanced and standardized clinical studies on H. pylori infections in children with PKU are required.

The absence of a spleen is a well-known risk factor for severe bacterial infections, especially due to encapsulated bacteria. Congenital asplenia can be part of multiple congenital abnormalities as in heterotaxy including Ivemark syndrome with congenital anomalies of the heart or great vessels, or it can be isolated, which is extremely rare. In these cases, asplenia is an important factor effecting mortality. In this report, the clinical courses of five children with asplenia and concomitant minor or complex cardiac anomalies are presented. The ages of the children ranged between 1.5 and 17 months at the time of diagnosis. All of the cases had had a history of hospitalisation for infectious diseases before the diagnosis. The patient who was diagnosed at 17 months old had a history pneumonia, urinary tract infection, and bacterial meningitis beginning at five months old. Three children had complex cardiac anomalies, one child had ventricular septal defect, and one child had atrial septal defect. Howell-Jolly bodies were determined in peripheral blood smear in all of the patients. The diagnoses of asplenia were confirmed with spleen scintigraphy. One of the patients with complex cardiac anomalies died a short time after diagnosis, because of cardiac failure. The rest of the four patients were vaccinated for encapsulated bacteria and were taken under antibiotic prophylaxis. These children did not need hospitalisation for infectious diseases during the follow-up period (5-40 months). In asplenic children, early diagnosis, antibiotic prophylaxis, and immunisation for encapsulated bacteria can decrease the risk of morbidity and mortality.

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Background and aims The adaptive changes of the fetal heart in fetal growth restriction (FGR) could persist into childhood and be responsible for the increased cardiovascular mortality rate in adulthood. The aim of the study was to assess cardiac morphology and function in newborns with FGR. Methods FGR was defined as a birth weight centile ≤ 10. Prospective study of 50 neonates, 25 with FGR and 25 with normal intrauterine growth and weight at birth (Table 1). Comprehensive echocardiographic study was performed assessing cardiac morphology, systolic and diastolic function. Results Compared with controls, neonates with FGR had more globular cardiac ventricles (Table 1), lower systolic excursions of the tricuspid and mitral valvular plane and lower values of the s' in the lateral and septal mitral annulus in the tissue Doppler imaging (TDI) study (p < 0,05). The e' at the tricuspid, lateral and septal mitral annulus together with the E wave of tricuspid inflow were significantly reduced in the FGR group; and tricuspid deceleration time showed a trend to increase without reaching statistical significance. Conclusions Newborns with FGR manifest cardiac shape changes, reduced systolic values of the TDI at the left heart and lower values of diastolic function more pronounced at the right heart compared with neonates with normal intrauterine growth. Background Evaluation of cardiac output in neonates might be difficult because of the complexity and risks of invasive classical procedures. New systems like electrical cardiometry (EC: Osypka Medical, Berlin, Germany and La Jolla, California, USA) have been proposed but few data are available in neonates. We investigated stroke volume (SV) using EC in term and preterm infants. Methods Eligible patients were neonates admitted to the NICU and undergoing echocardiography for any clinical reasons, without congenital heart disease. We measured SV with EC and echocardiography, within 10 min. Measurements were repeated 6 times by the same operator to calculate repeatability before and after echocardiography. Data have been compared with correlation and Bland-Altman analysis. Results 59 neonates were enrolled, allowing 150 paired measurements. Mean gestational age and birth weight were 33.9 ± 3.4 wks and 1988 ± 823 g, respectively. PS-021Results of Pearson correlation and Bland-Altman analysis for the whole population were (r = 0.611; p < 0.001) and (mean error [echo-EC] -1.35 mL [95% CI: -6.55 mL ± 3.85 ml]), respectively.Correlation is maintained even with PDA (r = 0.627; p < 0.001).Gestational age seems to do not influence the correlation between EC and echo (Partial correlation coefficient r = 0.36; p < 0.0001).Repeatability (coefficient of variation) was 46% for EC and 52% for echocardiography. There was no difference in SV measured by EC after 10 min (3.76 ± SD vs 3.78 ± SD; p = 0.56, Wilcoxon test). Conclusions EC is feasible, reproducible and quick. It could be an useful tool for continuous monitoring and haemodynamic evaluation in neonates. EC is particularly interesting ...