Objective: To investigate whether there is an association of the triglyceride-to-HDL cholesterol (TG:HDL-C) ratio with cardiovascular risk factors and early signs of vascular damage in obese prepubertal children. Design and methods: In 50 obese (27 boys, 7.8G1.4 years) and 37 normal-weight (20 boys; 7.3G1.5 years) prepubertal children, anthropometric measurements, oxidative stress markers (urinary isoprostanes (PGF2a (prostaglandin F2a)), soluble receptor for advanced glycation end-products (sRAGE)) and insulin sensitivity (homeostasis model assessment of insulin resistance (HOMA-IR) and whole-body insulin sensitivity index (WBISI)) were evaluated. Lipids profile was assessed and the TG:HDL-C ratio was calculated. In addition, high-resolution ultrasound was performed to assess carotid intima-media thickness (cIMT). Results: Obese children showed significantly higher values of the TG:HDL-C ratio (1.9G1.1 vs 1.2G0.6, PZ0.002) compared with controls. After dividing the population in tertiles of the TG:HDL-C ratio (!1.04, 1.04-1.67, O1.67), cIMT (PZ0.0003), and HOMA-IR (PZ0.0001) progressively increased from the lower to the upper tertile, whereas WBISI (PZ0.0003) and sRAGE (PZ0.05) progressively decreased. In a regression model, the TG:HDL ratio was significantly and positively associated with cIMT (rZ0.493; PZ0.0005). A cutoff point for TG:HDL-C ratio of 1.12 had 81% sensitivity and 49% specificity in the identification of children with cIMT values in the upper quartile (Area under the curve values from receiver operating characteristic curvesZ0.633G0.065, PZ0.045). Conclusion: This study confirms the reliability of the TG:HDL-C ratio as a useful marker of cardiovascular risk. Interestingly, our results underline that the TG:HDL-C ratio is directly related with early signs of vascular damage already present in prepubertal children.

Aim: Perinatal factors seem to influence the onset of puberty, but there is limited information on the potential effect of large size at birth on pubertal growth. This study evaluated pubertal growth in children born large for gestational age (LGA) compared to children born appropriate for gestational age (AGA).Methods: Longitudinal growth data collected from 70 children -40 AGA and 30 LGAwere analysed. The ages at take-off, peak height velocity, final height and pubertal growth spurts were calculated using the Preece-Baines model I.Results: Large for gestational age children showed an earlier age at take-off compared to AGA children (10.1 AE 1.2 versus 11.0 AE 1.4 years, p = 0.007), whereas the age at peak height velocity and at final height was similar.LGA children showed a longer growth spurt duration (2.5 AE 1 versus 1.5 AE 1.2 years, p < 0.001) and total pubertal duration (5.3 AE 1.2 versus 4.6 AE 1.2 years, p = 0.036) than AGA children. Results were similar when stratified by sex. Conclusion: Being bornLGA was associated with an earlier pubertal take-off and longer growth duration. These unique findings, due to the lack of studies on pubertal growth patterns in LGA children, might lead the way to novel research and a different approach to LGA children at the onset of pubertal growth.

Obese children have increased markers of endothelial dysfunction and early signs of renal damage, similarly to children with T1D, confirming obesity to be a cardiovascular risk factor as T1D. The association between ICAM-1 with e-GFR and AER confirm the known the association between general endothelial and renal dysfunction.

(1) Background: Recurrent and/or metastatic patients with head and neck squamous cell carcinoma show a poor prognosis, which has not changed significantly in 30 years. Preserving quality of life is a primary goal for this subset of patients; (2) Methods: A group of 19 physicians working in South Italy and daily involved in head and neck cancer care took an anonymous online survey aimed at revealing the level of knowledge and the application of communication techniques in daily patient care; (3) Results: Several specialists, 18 out 19 (95%), considered that patient participation in therapeutic choices is mandatory. The main obstacles to complete and reciprocate communication still consist of lack of time and staff, but also in the need for greater organization, which goes beyond the multidisciplinary strategy already used; (4) Conclusions: A greater impulse to training and updating on issues related to counseling can improve communication between the different clinicians involved in the treatment plan.

Glioblastoma multiforme is one of the most frequent and aggressive primary tumors in the central nervous system, representing >60% of all brain tumors in adults. Despite treatment, prognosis remains poor with most if not all patients experiencing disease recurrence and a 2-year survival rate of 27%. At present, no confirmed standard treatment exists for recurrent glioblastoma. Regorafenib is one of the few options available, based on results from the REGOMA trial. In the present study, a real-life retrospective investigation on the role of regorafenib in patients with recurrent glioblastoma (>60 years old) from two