Background Dysphagic patients are not always able to meet their energy, micro and macronutrients needs for various causes and therefore are at high risk of malnutrition. The aim of the present study was to evaluate the effectiveness on satisfaction of the meal (by a 10-cm visuo-analogical scale), food intake (by visual estimation of food waste), nutritional status (anthropometric measures, mini nutritional assessment [MNA], vitamin D, B12, folic acid), functional (handgrip) and blood chemistry metabolic parameters of a tailored texture-modified sous-vide cooking meals (TTMSVC), well balanced in macro and micronutrients, in elderly women suffering from oropharyngeal dysphagia at long-term care facilities. Methods A 12-week intervention study was conducted on female elderly subjects affected by oropharyngeal dysphagia of level 3-5. The treated group received TTMSVC with the consistencies standardized using viscosimeter (5000-10000 mP/s). The control group maintained pureed hospital diet. Results 50 subjects, 25 in treatment group and 25 in control group, with mean±SD age 89.12±4.18 and mini mental state examination (MMSE) 20.58±1.63 were enrolled. The treatment and control groups were similar at baseline. The changes over time between the two groups showed significant differences for food intake, meal appreciation, Body Mass Index (BMI), calf circumference, arm circumference, MNA, prealbumin, albumin, folic acid, vitamin D, ionized calcium, C-Reactive Protein (CRP), Tumor Necrosis Factor (TNF-α), handgrip. Significant positive correlations were observed in the treatment group between the meal appreciation and prealbumin and vitamin D. Conclusions This study demonstrated that elderly dysphagic women at long-term care facilities can eat better and increase nutritional status by eating 12-week tailored appealing TTMSVC.

BACKGROUND Despite the abundance of studies on the beneficial effects of a fiber rich diet as well as polyphenols deriving from Citrus fruits on postprandial serum glucose and insulin, clinical evidence on their synergic effects on healthy subjects have never been published. We aimed to investigate the feasibility of a new dietary approach in controlling glucose and insulin response at breakfast time by testing a brioche enriched with wheat bran and bergamot fiber. METHODS We enrolled 11 healthy volunteers in a cross-over study. Participants consumed a classic brioche at breakfast and our functional brioche, containing wheat bran and bergamot fiber, on another day. Vital functions, biochemical parameters (including glucose and insulin), anthropometric measurements as well as resting energy expenditure and fat oxidation were evaluated before and after the intake of both meals. RESULTS The mean age was ~25 years. The mean BMI was 23.5 kg/m2. The consumption of the functional brioche reduced the glucose C max(0-120 min) by ~6% and prevented the insulin increase over time by 30%, finally demonstrating insulin C max(0-120 min) and iAUC (0-120 min) values significantly lower compared to classic brioche (respectively P value =0.04 and 0.03). The stepwise multivariable analysis confirmed the association between the consumption of the functional brioche containing bran and bergamot fiber and glucose C max(0-120 min) (B=-0.45; P=0.034), and insulin iAUC (0-120 min) (B=-764 P=0.036). CONCLUSIONS The association of wheat bran and bergamot fiber significantly influences glucose metabolism and may exert insulin-like effects on healthy volunteers. If confirmed, berga-brioche would be a useful tool in preventing diabetes and controlling the glycometabolic status of type 2 diabetic patients.

Background Turner Syndrome (TS) is a chromosomal disorder with short stature as the most common feature. The aim of this paper was to show the characteristics of TS patients treated at our Clinic, with an emphasis on their age at diagnosis and the effect of growth hormone therapy on their final height and height gain. Methods This retrospective study is based on the medical records of 37 female pediatric patients aged 0-18 years treated at the Pediatric Department of the Sestre Milosrdnice University Hospital Center from 1997 to 2017. Results Mean age at diagnosis is 7.55±5.13 years. In the observed period a trend towards later diagnosis was shown (P=0.004). Most patients (26) were treated with rhGH. The average height of all patients who reached their final height (N.=30) was 151.49±6.49 cm (standard deviation score [SDS]: -1.73±1.11). The initial height SDS was significantly lower in the treated compared to the untreated patients (P=0.02). The final height was 151.59±7.21 cm (SDS: -1.72±1.3) in the treated and 151.12±5.85 cm (SDS: -1.77±0.94) in the untreated patients. The difference between the initial and final height was significantly greater in the treated patients compared to the untreated patients (30.46 and 16.28 cm, P=0.039). The same was true for the difference between the initial and final height SDS (0.78, or -0.3, P=0.042). Conclusions Based on the results of this research, TS is increasingly diagnosed at a later age. The effect of rhGH therapy was favorable and resulted in a greater height gain in the treated patients.

The world population is facing a health challenge never seen since the Spanish influenza of one hundred years ago. During the last months, the scientific community has been debating on the potential harmful effect of angiotensin-converting-enzyme inhibitors (ACEi) or angiotensin II receptor type 1 receptor blockers (AT1-receptor blockers, ARBs) during the COVID-19 pandemic. That is because the S spike protein of SARS-CoV viruses utilizes the angiotensin-converting enzyme 2 (ACE2) as a receptor to enter alveolar epithelial cells. Obesity, often associated to type 2 Diabetes, was shown to worsen the prognosis of SARS-CoV-2 infection. Herein we discuss the complex interaction between the renin-angiotensin-aldosterone system (RAAS), its receptors, and the interaction with the Kallikrein-Kinin-system (KKS) and the potential activation of the coagulation cascade. Alteration of the equilibrium between the RAAS system and the KKS cascade may explain the frequent thromboembolic complications of COVID-19 mainly seen in obese and diabetic-obese patients. In contrast, angiotensin (1-7) contributes to maintaining a correct balance between RAAS and KKS system. Our conclusion is that the higher mortality rate in patients with obesity is linked to the alteration of RAS and RAS-KKS interaction consequent to SARS-CoV-2-cell entrance. At present, no data support the necessity of modifying ACEi or ARBs treatment in hypertensive patients.

Ultrasonography (US) is the simplest method of evaluating thyroid volume (TV). The current normal TV in Liguria is not known. The aim of this study was to obtain normative data on TV in Liguria. From 3552 files of endocrine evaluations registered in a primary outpatient setting, we selected 483 files on euthyroid subjects (383 females and 100 males) with a normal echoic pattern on US. The inclusion criterion was the absence of thyroperoxidase autoantibodies and drugs known to interfere with thyroid hormone secretion or metabolism. TV was calculated by means of US. Anthropometric characteristics, smoking habits and the district where subjects lived were registered. Less than 50% of patients were not taking any drug. The percentage of obesity was similar in both sexes. TSH levels were similar in males and females. Median TV was 8.0 ml (IQR 6.7 - 9.8 ml) in females and 11.8 ml (9.3 - 15.6 ml) in males (P<0.0001). In females, TV was greater (P=0.01) in smokers than in non-smokers. In both sexes, the right lobe was significantly (P<0.0001) larger in volume than the left. Post-hoc analysis did not show any differences among age-groups in either females or males. In females, but not in males, TV differed significantly (P=0.0002) according to the district of residence. A significant positive correlation was found in both groups between TV and weight, height, BMI and BSA. Reference values of TV in the Ligurian population are now available. TV in the general population could be compared with these normative data.

The differential diagnosis of anovulatory disorders is actually based on serum gonadotrophin and estradiol levels. However, several other markers have been proposed. The purpose of this review was to underline the role of anti-Müllerian hormone (AMH) as a possible marker in differential diagnosis of the anovulatory diseases and its use as a predictive marker of prognosis. In this article we discuss clinical and experimental evidences actually existing in literature and we suggest new potential clinical application of AMH.

Neudesin is a protein that is secreted from adipose tissue and central nervous system and has a regulatory function on energy metabolism. Although the effect of this protein is shown in the experimental model of type-2 diabetes mellitus (Type-2DM), its effect in humans is not clearly known. In this study, we aimed to evaluate the relationship between serum neudesin level and metabolic, anthropometric and cardiovascular parameters in newly diagnosed Type-2 DM patients (Group 1). Forty patients in each were included in our study for Group 1 and for the control group (Group 2), which consisted of age and sex-matched healthy subjects. Serum neudesin, hs-CRP, carotid intima media thickness (CIMT), body mass index (BMI) and insulin resistance (HOMA-IR) levels were compared prospectively. Serum neudesin levels were significantly higher in diabetic patients than in the control group (Type 2 DM = 64.69 ± 3.06 ng / ml, Control = 55.52 ± 5.48 ng / ml, P = 0.004 *). There was an independent relationship between serum neudesin and HOMA-IR and BMI. Although there is a correlation between serum neudesin and CIMT ; this feature disappeared in the regression analysis. Serum neudesin increased in new diagnosis Type-2 DM patients. This increase seems to be related to obesity and insulin resistance. However, more extensive research is needed to clarify this issue.

It is well known that Diabetes Mellitus is one of the leading causes of morbidity and mortality arising from multiple etiologies and still is an incurable one. Besides modern medicines and technologies, science is looking at some nature made remedies to avoid toxic side effects and to invent a hassle-free treatment for it. While plant resources have turned into a chief target to search new drugs, Abelmoschus Esculentus is claimed to be an alternative approach to current medicines of diabetes but yet need to explore more. Review authors searched PubMed, Medline, Embase, CINAHL, Scopus database (last search July 30, 2020), with the MeSH terms and keywords of Abelmoschus Esculentus, lady's finger, and Diabetes mellitus to make a brief explanation regarding effects of Abelmoschus Esculentus on diabetes, along with summary of molecular evidence, nutritive and phytochemical components, illustrative evidence of human trial and mice demonstration. Selected articles are also screened in the reference list to find other relevant content. Finally, 21 studies were found suitable for consideration in writing this comprehensive evidence-based rapid review. Meta-analysis was not done because of clinical and methodological heterogeneity among the included studies. Therefore, the narrative summary approach was used for data synthesis. This review can highlight the current evidence of the particular topic, useful for a reader to gain knowledge, application in clinical practice in a community setting, or planning for new human experiment in depth.

This study aimed to determine the relationship between the expression of epidermal growth factor receptor (EGFR) and pathological indicators in papillary thyroid carcinoma (PTC). PubMed, Embase, Web of Science, MEDLINE, and Cochrane Library databases were searched for relevant clinical trials. The odds ratio (OR) and 95% confidence interval (CI) showed the effect magnitude of the expression of EGFR, age, gender, tumor size, lymph node metastasis (LNM), extrathyroid extension(ETE), and TNM(Tumor, Lymph node, Metastasis) stage. Stata 12.0 was used for statistical analysis of data. A total of 845 cases of PTC were included through the retrieval of 8 studies performed abroad. EGFR significantly correlated with extrathyroid extension (OR = 3.25; 95% CI: 1.25-8.43; Z = 2.42; P = 0.015), LNM (OR = 8.40; 95% CI: 5.44-12.97; Z = 9.61; P = 0.000), and TNM stage (OR = 2.30, 95% CI: 1.51-3.51; Z = 3.87; P= 0.000). EGFR had no correlation with age (OR =1.13; 95% CI: 0.83-1.53; Z = 0.77; P = 0.44], gender (OR = 0.93; 95% CI: 0.66-1.33; Z = 0.38; P = 0.70), and tumor size (OR = 1.68; 95% CI: 1.06-2.68; Z = 2.19; P = 0.03). Sensitivity analysis demonstrated that the studies by Cui Tang and Alfred King Yin Lam in LNM impacted the pooled OR. After removing these two studies, relatively stable results between the expression of EGFR and LNM were obtained. The results in the expression of EGFR is frequent and cancer-specific event in PTC. Besides, the expression of EGFR was involved in the progression and metastasis of PTC.