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Background and aims. The aim of this study is to assess the lipid profile pattern of pediatric overweight and/or obese patients with Non-Alcoholic Fatty Liver Disease (NAFLD) in relation to IDF Consensus Criteria for Metabolic Syndrome (MetS).

Background: Obesity prevalence is increasing in children. It is associated with various comorbidities including nonalcoholic fatty liver disease (NAFLD). Hsp90 isoforms were identified in previous proteomic studies as potential biomarkers for NAFLD. The aim of the study was to analyze circulating levels of Hsp90 α and Hsp90 β in overweight and obese children. In addition, Hsp90 α and Hsp90 β were evaluated as biomarkers for NAFLD in overweight and obese children., Methods: 68 overweight and obese children and ten age- and gender-matched controls were recruited. Hsp90 α and Hsp90 β levels were analyzed from serum in both controls and overweight and obese children by ELISA., Results: Serum Hsp90 β and total Hsp90 levels were statistically significantly higher in overweight and obese children compared to controls. On the contrary, there was no difference in Hsp90 α levels between overweight and obese children and healthy controls. Hsp90 isoforms had different expression in NAFLD patients. Hsp90 β levels were higher in overweight and obese NAFLD patients while Hsp90 α levels were lower. Hsp90 α to Hsp90 β ratio had better accuracy for NAFLD diagnosis in obese and overweight patients compared to individual biomarkers., Conclusion: Hsp90 isoforms were confirmed on an independent cohort as biomarkers for NAFLD in overweight and obese children. In these patients, it seems to be more useful to separately analyze Hsp90 isoforms rather than total Hsp90 as the isoforms have greater discriminative capacity., Competing Interests: The authors state that there is no conflict of interest., (Copyright © 2019 Anca Bălănescu et al.)

Cystic fibrosis ormucoviscidosis (CF) is the most frequent monogenic genetic disease with autosomal dominant transmision in caucasians. Currently, the typical approach is referring the CF patient to specialized centers with multidisciplinary teams. The inherent questions appear: which is then the role of the general practitioner (GP)? Should the GP be confined to the pasive role of exchanging medical letters with the specialist, or should he take active part in monitoring the disease? Is it ethicallyand professionally correct for the GP to simply copy the treatment of a patient that hedidn't actually see for years, or to assume the palliative care in final stages of a patient who was actually taken care of only by the specialist? What are the families' expectations and what is the level of competence they expect from the GP? These are some of the questions we will try to answer, considering the expertise we accumulated in the regional center in "Alfred Rusescu" lnstitute for Protection of Mother and Child, where 16.22% (60 out of 370) of CF patients in Romania are monitored, and based on a questionnaire addressed to the CF patient's families.