The Sardinian Hypertensive Adolescents Research Programme Study, which for the sake of simplicity we will describe as SHARP, was aimed at detecting the prevalence of hypertension in a number of Southern Italian students, using a process of longitudinal screening lasting 3 years, hoping to answer the question whether it is better to use tables charting values established in the United States of America, or to use charts specific for the Italian population.In all, we studied 839 children, of whom 52.6% were male. We defined hypertension as the average blood pressure exceeding the 95th percentile according to previous tables prepared by the United States Task Force, and previous Italian references. Use of the American tables identified very high proportions of hypertensive subjects if compared with the distribution curves from our own study (p less than 0.00001), albeit that our findings correlated well with previous Italian charts as reference (no statistical significance).In short, notwithstanding a little difference in millimetres of mercury about the same percentiles, the tables prepared in the United States of America overestimate the prevalence of hypertension, specific Italian material being more suitable for our needs. Our study emphasises the need to integrate these standards with more up-to-date and representative reports on Italian children, as is done periodically in the United States of America. Even using the Italian specific charts, nonetheless, hypertension was more common in Sardinian children than would be expected from international studies, with one-tenth of the sample being hypertensive.

In spite of its successful surgical cure, Cushing's syndrome results in a significantly decreased arterial distensibility when compared with the control group, which might explain these differences in blood pressure levels. It underlines a significantly higher cardiovascular risk, notwithstanding both the normalisation of cortisol secretion and the very early age of the patients.

We report on two Italian brothers with facial clefting, hypertelorism, urogenital anomalies including micropenis, shawl scrotum, hearing loss, caudal appendage, and umbilical hernia. We have evaluated the two cases as Malpuech syndrome. This is an extremely rare autosomal recessive syndrome.

BackgroundPrevious Italian paediatric blood pressure (BP) tables overestimated the prevalence of hypertension in adolescents of specific geographic areas, such as Sardinia, an island in the Mediterranean Sea. This is probably due to a not very homogeneous distribution of the subjects studied, most from Middle and Northern Italy, and the long period from the survey.MethodsBPs were repeatedly measured over a period of 3 years in 839 children (52.6% males. Age range: from 11 to 14 years during this period), using a standard mercury sphygmomanometer. For each gender, the specific percentile curves of systolic and diastolic BP were constructed.Results (corrected by the 50th percentile of height)Males (11-14 years)mean systolic BP (50th centile): from 111 to 115 mmHg. Hypertensive systolic BP (> 95th percentile): from 127 to 135 mmHg. Mean diastolic BP (50th centile): from 65 to 69 mmHg. Hypertensive diastolic BP (> 95th percentile): from 78 to 82 mmHg.Females(11-14 years)mean systolic BP (50th centile): from 110 to 112 mmHg. Hypertensive systolic BP (> 95th percentile): from 127 to 130 mmHg. Mean diastolic BP (50th centile): from 65 to 67. Hypertensive diastolic BP (> 95th percentile): from 78 to 80 mmHg.ConclusionsSardinian BP tables emphasizes the need to integrate the previous standards with more up-to-date and representative reports on Italian children, as periodically performed in the USA, in order to increase the number of subjects to be checked, and to obtain a national coverage better and more completely representative of every geographic area of our country.

Complications, such as recoarctation or secondary hypertension, probably related to the loss of arterial elasticity, frequently occur after aortic coarctation surgery. This study aimed to investigate arterial compliance as evaluated by automated recording of the QKd interval in patients who underwent repair of coarctation by construction of a subclavian flap compared with those who underwent resection of the narrowed aortic segment with end-to-end anastomosis. Thirty-nine children who underwent surgical repair of aortic coarctation by subclavian flap (n = 19) and by end-to-end anastomosis (n = 20) were enrolled. Arterial stiffness was measured by the noninvasive QKd 100-60 method. Twenty-four-hour ambulatory blood pressure monitoring and a transthoracic echocardiography were also performed. The group of patients who had an end-to-end anastomosis showed better results regarding 24-hour blood pressure profile and QKD 100-60 value compared with those underwent construction of a subclavian flap. Surgical repair of aortic obstruction by end-to-end anastomosis demonstrates better preservation of arterial distensibility than those repaired by subclavian flap. Therefore, it appears to be advantageous, whenever possible, to use the end-end anastomosis approach, which appears to lessen the incidence of the most common complications after aortic arch surgery.