Pediatric obesity management strategies suffer from a high rate of dropout and persistence of weight excess, despite the use of new tools, such as the automated mobile technology (MT). We aimed to compare the efficacy of two personalized MT protocols with/without monthly in-presence recalls in terms of better adherence to follow-up, and improved anthropometric and lifestyle parameters. MT contacts consisted in three not automated messages per week, inserted between three-monthly in-presence regular visits with (PediaFit 1.2) or without (PediaFit 1.1) monthly in-presence recalls. The sample included 103 children (mean age 10 years, range 6-14) recruited in the Pediatric Obesity Clinic between January 2017 and February 2019, randomized in Intervention group (IG) (n=24 PediaFit 1.1; n=30 PediaFit 1.2) and Control group (CG) (total n=49). Both IGs achieved significantly better results than the CGs for all considered parameters. Comparison of the two IGs at the 6th month showed that IG 1.2 had a statistically significant lower drop-out rate (10% vs. 62%), along with improved body mass index z-score, systolic blood pressure, sleep duration and physical activity. The study suggests that the hybrid association of messaging through personalized/not automated MT plus monthly in-presence recalls may be considered for a favorable outcome of pediatric obesity programs.

Background: The increased vascular risk associated to Varicella- Zoster Virus (VZV) reactivation is extensively established in the general population. This retrospective cohort study investigates whether this observation holds true for People Living With HIV (PLWH), a group already con-fronting heightened cardiovascular risk. Methods: Among PLWH who initiated antiretroviral therapy (ART) at our center and have been under our care for > 24 months since January 1st, 2005, individuals with a history of Herpes Zoster (HZ) were identified and compared their features with those of PLWH with no history of HZ. The prevalence of ischemic events (Deep Venous Thrombosis, Stroke, Acute Myocardial Infarction) was calculated and compared using Chi Square. Odds Ratios (O.R.) with 95% Confidence Intervals (C.I.) for ischemic events following HZ were evaluated through univariate and multivariate logistic regression. Results: Overall, 45/581 PLWH reported HZ. Ischemic events followed HZ significantly more often than the other group (13% vs. 5%, p=0.01). Both positive serology for VZV and HZ correlated with increased ischemic risk (O.R. 4.01, 95% C.I. 1.38-11.6, p=0.01 and O.R. 3.14, 95% C.I. 1.12-7.68, p=0.02, respectively), though pre-existing heart disease demonstrated stronger predictive value in multivariate analysis(O.R. 8.68, 95% C.I. 2.49-29.50, p=0.001). Conclusions: VZV potentially exacerbates vascular risk for PLWH, particularly in the presence of other predisposing factors. Further research is needed to confirm our data.