Policaptil Gel Retard significantly reduces body mass index and hyperinsulinism and may decrease the risk of type 2 diabetes mellitus (T2DM) in obese children and adolescents with family history of obesity and T2DM.

BACKGROUND: Treatments for childhood obesity are critically needed because of the risk of developing co-morbidities, although the interventions are frequently time-consuming, frustrating, difficult, and expensive. PATIENTS AND METHODS: We conducted a longitudinal, randomised, clinical study, based on a per protocol analysis, on 133 obese children and adolescents (n = 69 males and 64 females; median age, 11.3 years) with family history of obesity and type 2 diabetes mellitus (T2DM). The patients were divided into three arms: Arm A (n = 53 patients), Arm B (n = 45 patients), and Arm C (n = 35 patients) patients were treated with a low-glycaemic-index (LGI) diet and Policaptil Gel Retard®, only a LGI diet, or only an energy-restricted diet (ERD), respectively. The homeostasis model assessment of insulin resistance (HOMA-IR) and the Matsuda, insulinogenic and disposition indexes were calculated at T(0) and after 1 year (T(1)). RESULTS: At T(1), the BMI-SD scores were significantly reduced from 2.32 to 1.80 (p < 0.0001) in Arm A and from 2.23 to 1.99 (p < 0.05) in Arm B. Acanthosis nigricans was significantly reduced in Arm A (13.2% to 5.6%; p < 0.05), and glycosylated-haemoglobin levels were significantly reduced in Arms A (p < 0.005). The percentage of glucose-metabolism abnormalities was reduced, although not significantly. However, the HOMA-IR index was significantly reduced in Arms A (p < 0.0001) and B (p < 0.05), with Arm A showing a significant reduction in the insulinogenic index (p < 0.05). Finally, the disposition index was significantly improved in Arms A (p < 0.0001) and B (p < 0.05). CONCLUSIONS: A LGI diet, particularly associated with the use of Policaptil Gel Retard®, may reduce weight gain and ameliorate the metabolic syndrome and insulin-resistance parameters in obese children and adolescents with family history of obesity and T2DM

Osteomielite cronica ricorrente in et&#224; pediatrica

Le osteomieliti croniche non-batteriche (CNO, Chronic Non-bacterial Osteomyelitis) costituiscono un gruppo di patologie appartenenti alle sindromi autoinfiammatorie, caratterizzate dalla ricorrenza di focolai sterili di osteomielite. Il quadro clinico pu\uf2 associarsi a manifestazioni extra-ossee soprattutto a livello cutaneo e gastro-intestinale. L\u2019esordio avviene prevalentemente in et\ue0 pediatrica e il decorso spesso \ue8 cronico. Sebbene l\u2019eziopatogenesi nella maggior parte dei casi non sia ancora nota, sembra essere un difetto genetico a carico dei meccanismi dell\u2019immunit\ue0 innata a favorire una periodica attivazione della flogosi. Il trattamento di scelta \ue8 costituito dai FANS (farmaci anti-infiammatori non steroidei), soprattutto dal naprossene. I farmaci di seconda linea sono rappresentati dai biologici anti-TNF-alfa e anti-IL-1, dai bifosfonati, metotrexate e sulfasalazina. Nelle forme resistenti possono essere associati cicli di terapia steroidea.Non-bacterial Chronic Osteomyelitis (CNO) is an autoinflammatory disorder that mostly affects children, characterized by chronic recurrent multifocal osteomyelitis. Bone involvement is often associated with inflammation of the skin and/or the intestine. Although the etiopathogenesis in most cases is not yet known, it seems to be a genetic disorder of innate immunity mechanisms to induce a periodic activation of the inflammation. The first treatment option are non-steroidal anti-inflammatory drugs, especially naproxen. Second-line drugs include anti-TNF-alpha, anti-IL- 1, bisphosphonates, methotrexate, and sulfasalazine. In case of recurrences or prolonged disease course an association with steroids should be considered

Positive direct antiglobulin test in COVID-19 patients: Decision-making process.

In this unprecedented crisis of severe acute respiratory syndrome coronavirus 2 and its associated coronavirus disease 2019 (COVID-19), polymerase chain reaction and then serological testing platforms have been massively developed to face the important screening demand. Polymerase chain reaction and serological testing platforms are not the only actors impacted by the crisis, transfusion services are facing important difficulties. A positive direct antiglobulin test is frequently observed for patients encountering COVID-19. Patients with severe symptoms may develop anaemia and become good candidates for blood transfusions. The interpretation of a positive direct antiglobulin test for patients recently transfused and suffering from COVID-19 is complex. The differentiation between COVID-19 induced antibodies and possible associated transfusion alloantibodies is therefore crucial. In this context, the elution technique incorporated in an appropriate decision-making process plays its full role. This intricate topic is presented through a case report followed by literature review and finally decision-making process for COVID-19 patients necessitating red blood cells administration

Elevated carbohydrate antigen 19-9 following Helicobacter suis gastritis and nor- malisation after eradication: first case report and review of the literature

Carbohydrate antigen 19-9 (CA 19-9) is a biological marker used to diagnose and monitor the progression of various cancers. Elevated CA 19-9 has also been sporadically observed in Helicobacter pylori infected patients. Similar to H. pylori, animal-hosted non-H. pylori Helicobacter (NHPH) species can induce gastroduodenal lesions in humans. We report the first case of CA 19-9 elevation related to H. suis gastritis and its normalisation after eradication. A CA 19-9 screening prescribed as part of a regular check up by the general practitioner was found elevated in a 68-year-old man presenting chronic dyspeptic symptoms. Medical investigations were negative for presence of neoplasia or biliary obstruction. Upper gastrointestinal endoscopy confirmed the presence of chronic gastritis and H. suis was identified in gastric biopsies. The standard treatment for H. pylori successfully eradicated H. suis with normalisation of CA 19-9 levels. In addition to H. pylori, infection with NHPH species should be considered as an additional cause of elevated CA19-9. (Acta gastroenterol. belg., 2022, 85, 403-405)