Multidisciplinary Treatment for Childhood Obesity: A Two-Year Experience in the Province of Naples, Italy

Childhood obesity must be faced through an integrated multi-level preventive approach. This study was aimed at assessing the adherence and the outcomes of an outpatient service for childhood obesity treatment activated in the province of Naples, Italy, throughout a 2-year follow-up period. At first visit (T0), weight, height, waist circumference, and body composition of children were assessed, together with sociodemographic features and physical activity levels of children and parents. Anthropometric and body composition parameters of children were measured at 6 ± 3 months (T1) and 12 ± 3 months (T2). A total of 451 non-related children who accessed the service were analyzed: 220 (48.7%) of them returned at least once (attrition rate 51.3%). Returner outpatients showed higher age (p = 0.046) and father's educational level (p = 0.041) than non-returner ones. Adherence to the treatment was found to be related to father's (Rho = 0.140, p = 0.005) and mother's (Rho = 0.109, p = 0.026) educational level. All the outcomes improved between T0 and T1 (p < 0.001), while only body mass index (BMI) decreased significantly at T2. Changes in BMI-SDS were associated with baseline value (OR 0.158, 95%CI 0.017-0.298, p = 0.029). The multidisciplinary approach seems to be promising to treat childhood obesity in this geographic context. Lower parents' educational level should be considered as an attrition determinant

Geological criteria to the 3D delimitation of groundwater bodies (GWB) in the hydrographic district of Sardinia

The Water Framework Directive 2000/60/EC (WFD), establishing a framework for Community action in the field of water, has introduced for all Member States the obligations relating to the identification of surface and groundwater bodies and their monitoring, classification and definition of programs of measures to achieve a good status of all water bodies. In compliance with this statement, the River Basin Management Plan of Sardinia (Regione Sardegna, 2015) has identified and delimited 114 groundwater bodies (GWB). Main criteria were the identification of geological boundaries at the scale of 1:200,000, hydrogeological divides, analysis of pressures, and chemical status of groundwater. In order to have a better knowledge of groundwater bodies boundaries, a more detailed delineation and characterization is in progress. As a first step of delineation the geological map of Sardinia at the 1:25,000 scale was used. Considering that the aim of this map was not for hydrogeological purpose, its reinterpretation was mandatory. Every geological context needs in-depth knowledges to describe and model it properly. A further hydrogeological analysis can allow new interpretation of existing model according to the most recent methodologies developed. Each GWB required a different investigation specific approach. For example, incoherent recent deposits (gravels, sands, silts, clays, etc.) hosting groundwater bodies are characterized by porous aquifers types. Thus, necessary to consider the geometric relationships between stratigraphic units and the depositional environment provides important information on the lateral variation of hydrogeological features. Otherwise, the groundwater bodies hosted in crystalline rocks show continuous lithological characteristics for wide zone, but the primary relationships with neighboring units are often modified by tectonics (Feroni Cerrina et al., 2008). The geological, hydrogeological and hydrogeochemical knowledge of GWBs becomes necessary to understand the quantitative state (extension and thickness of the area, yield, specific storage) and qualitative state (chemical state) for the correct delimitation of the GWB

[Hyperuricaemia and Chronic Kidney Disease]

Hyperuricemia is defined as serum uric acid values greater than 6 mg/dl and could occur either due to hyperproduction or as a result of reduced renal excretion, which exceeds gut compensation. In Italy, prevalence is around 12% of the general population and increases in renal disease up to 60%. Recent experimental studies demonstrated a role of uric acid in the development of arterial hypertension and systemic arteriosclerosis, with an increase in cardiovascular risk. It also appears from observational studies that high uric acid is an independent risk factor associated with de novo onset of chronic kidney disease after adjustment of main confounding variables. Hyperuricemic subjects treated with febuxostat, a selective inhibitor of xantino-oxidase, showed in RCTs a better control of hyperuricaemia in comparison with those receiving allopurinol. Moreover, observational studies indicate that urate lowering treatment could be helpful in reducing cardiovascular events as well as in slowing the progression of chronic kidney disease; randomized controlled studies, designed to assess as primary outcome the nephroprotective effect of urate lowering treatment, are in progress

Pre-treatment neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as predictors of occult cervical metastasis in clinically negative neck supraglottic and glottic cancer

Background. Among patients with diagnosis of Laryngeal Squamous Cell Carcinoma (LSCC), up to 37.5% of cases may have occult metastasis (OM), and this feature is linked to poor prognosis and high rate of local recurrence. The role of elective neck dissection (END) in clinically negative neck (cN0) LSCC remains controversial. It is of great value to search for low-cost and easily detectable indicators to predict the risk of OM in laryngeal cancer. Recent reports have shown that high values of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) represent a negative prognostic factor in head and neck cancers. The aim of our study has been to investigate the value of pre-treatment NLR and PLR with regard to predicting occult cervical metastasis in cN0 supraglottic and glottic LSCC. Materials and methods. Data of patients affected by LSCC, who had been surgically treated by means of laryngectomy (total, horizontal partial and supracricoid) and END between January 2006 and January 2021, were retrospectively reviewed, using information retrieved from a database dedicated to such procedures in a single tertiary care referral institute. Results. A total of 387 patients were treated for LSCC at our Institute from 2006 to 2021, but only 108 of them met the inclusion criteria. The median age at the time of diagnosis was 64 years (range, 39–89 years). All the tumors were treated with a laryngectomy and an END. A total of 27.7% of patients were found positive for neck node metastasis (the pN+ group), while 78/108 (72.3%) patients were found to be negative for the presence of neck metastasis (the pN0 group). High values of NLR, but not PLR, significantly correlated with the probability of OM, and according to the iterative algorithm of Newton–Raphson, an NLR value of 2.26 corresponds to a probability of OM of 20%. Conclusion. Our analysis revealed a statistical correlation between high NLR pre-treatment values and positive neck OM in patients with LSCC