O objetivo deste estudo foi mostrar os efeitos da dieta ad libitum sobre a saúde dos animais de experimentação comparando-se os parâmetros bioquímicos em ratos alimentados com diferentes tipos de dieta e diferentes formas de alimentação. Três grupos de oito animais foram alimentados com ração padrão em quantidade controlada (30 g/dia)-grupo1, ração padrão ad libitum - grupo 2 e o grupo 3 ração hipercalórica ad libitum. Amostras de sangue foram coletadas antes e depois do experimento, para análise dos seguintes parâmetros bioquímicos: colesterol total (CT), lipoproteína de alta densidade (HDL-c), triglicérides(TG) e glicemia (G). Os resultados mostraram que os grupos 2 e 3, que receberam dieta ad libitum,apresentaram níveis mais elevados de CT, HDL-c e TG. Este estudo mostrou que a dieta padrão ad libitumaltera os parâmetros bioquímicos da mesma forma, que uma dieta hipercalórica, colocando em risco a saúde dos animais de experimentação.

Introduction Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders characterized by impaired cortisol synthesis with an incidence of 1:15 000 births. The most common form is attributable to mutations in CYP21A2, the gene encoding the adrenal steroid 21-hydroxilase enzyme (P450c21). Because of that, cortisol synthesis is impaired which leads to a corticotropin stimulation of the adrenal cortex, with accumulation of cortisol precursors that are derived to sex hormone biosynthesis. Aldosterone production may also be decreased (salt wasting forms). The final height of children with these disorders seems to be compromised. That can happen because of the disease itself or because an excessive dose of corticoids used during treatment. This work evaluates the final stature SDS of a group of patients with CAH and correlates it with 17-hydroxyprogesterone levels (17OHP) and corticoid dose at 10 years of age and at puberty onset. References Conclusion In this group of children the final height SDS was inferior to their target familial stature, because of the poor growth after puberty onset: their height SDS when they were 10 years old and on their puberty onset were better than the final one. There wasn't any correlation with 17OHP and corticoid dose used during treatment. When the growth after puberty onset was analysed, it was positively correlated with corticoid dose and negatively correlated with 17OHP levels on puberty onset. There are many studies reporting that high doses of corticoids used in these children may impair their growth. But, in this study, to achieve better levels of 17OHP, higher doses of corticoids were used. So, maybe that could have helped to achieve a better growth before puberty and could have prejudiced the growth after puberty onset.

Premature Pubarche (PP), or the development of pubic hair before the age of 8 years in girls or 9 years in boys, is most commonly caused by Idiopathic Premature Adrenarche (IPA). There is an increased production of Dehydroepiandrosterone (DHEA) and DHEA Sulfate (DHEAS) by the adrenal zona reticularis without a concomitant rise in Cortisol. IPA is a diagnosis of exclusion and differential diagnosis must include milder and nonclassic variants of Congenital Adrenal Hyperplasia (CAH), that can account for 0 to 40% of cases of PP. Early morning basal 17-Hydroxyprogesterone (17OHP) above 200 ng/dL is 100% sensitive and 99% specific for CAH.

Streptococcus pyogenes causes a wide spectrum of diseases in children. However, meningitis due to this pathogen is highly uncommon. Although rare, it is associated with a high case fatality rate and can result in severe neurological sequelae. We report a case of Streptococcus pyogenes meningitis in a previously healthy 3-year-old boy. The purpose of this case report is to emphasize that this agent should be considered a cause of meningitis in previously healthy infants because of its frequent association with complications, sequelae, and high mortality rates.

Case Discussion Though MIS-C is rare, with an incidence of 0.14% among children with SARS CoV-2 infection according to one Systematic Review (Hoang Et al. 2020), it is an important new differential which must be borne in mind in cases of fever with no clear source. Both of these cases had a negative PCR test for SARS CoV-2 and no history of Covid 19 disease. No serological testing for SARS CoV-2 was available in our hospital setting. But in accordance with RCPCH guidelines this does not exclude the diagnosis of MIS-CIn previous studies as many as 71% of cases of MIS-C required PICU admission (Ahmed Et al., 2020), however not all are severely unwell and may be stable enough to be managed on a ward setting as described above.

The authors reveal a clinical report of a 9-day-old newborn girl admitted to the emergency department with generalized erythematous blisters and desquamation without systemic symptoms. A purulent drainage was observed in the left groin area. Staphylococcal scalded skin syndrome (SSSS) was suspected and the newborn was transferred to a pediatric intensive care unit where she started intravenous antibiotics and supportive care. During her stay in the intensive care unit, Staphylococcus aureus (SA) was isolated from the culture obtained from the left groin lesion. A culture from the mother's milk, that did not show any signs of mastitis, was performed which yielded a pure growth of SA. The child improved after empirical treatment with antibiotic. SSSS is potentially life-threatening and thus its early recognition and prompt treatment are crucial to improve patients' outcomes. Further studies are required to better understand the role of breast milk in the transmission of SA.