LA TERAPIA CON LIRAGLUTIDE NELL’OBESITÀ: RISULTATI NELLA PRATICA CLINICA

La Liraglutide, un analogo dell’ormone increnitico intestinale Glucagon-like peptide 1 (GLP-1 (GLP-1), è stata approvata in Italia per il trattamento farmacologico dell’obesità nel 2015. Precedenti studi clinici controllati randomizzati hanno dimostrato che la Liraglutide associata a terapia dietetico-comportamentale determinava un calo ponderale, dose-dipendente, significativamente maggiore rispetto ai soli interventi dieta-comportamentali. Gli studi Real-Life potrebbero mostrare risultati differenti rispetto a quelli osservati nei trials clinici controllati randomizzati, a causa delle differenze nella selezione di pazienti, dei protocolli di incremento della dose del farmaco e di follow-up. Il nostro studio si propone di valutare l’effetto del trattamento con Liraglutide sul calo ponderale in una serie consecutiva di pazienti, in un singolo centro Obesità. A tal fine abbiamo condotto uno studio su una serie di 72 pazienti trattati con Liraglutide, afferenti al centro Obesità dell’U.O. di endocrinologia 1 dell’Azienda Ospedaliera Universitaria Pisana da ottobre 2016 a marzo 2019. È stato valutato il calo ponderale al termine del trattamento; il calo ponderale precoce dopo 12 ±2 settimane dall’inizio del trattamento; la ripresa ponderale dopo almeno 60 giorni dalla sospensione del trattamento; le modificazioni della pressione arteriosa sistolica (PAS) e diastolica (PAD) e della frequenza cardiaca (FC) al termine del trattamento.. Il trattamento in condizioni di Real-Life di pazienti afferenti a un singolo centro Obesità ha mostrato risultati compatibili con quelli riportati negli studi controllati randomizzati. La combinazione dei dati ottenuti in studi clinici controllati randomizzati con quelli ottenuti in studi Real-Life potrebbe incrementare la valenza dei risultati e superare i rispettivi limiti degli studi

Common Diagnostic Challenges and Pitfalls in Segmental Colitis Associated with Diverticulosis (SCAD)

Segmental colitis associated with diverticulosis (SCAD) is characterized by inflammation involving the sigmoid inter-diverticular mucosa, sparing the proximal colon and rectum. Due to the heterogeneity of clinical manifestations and endoscopic and histological findings, SCAD diagnosis might be challenging in clinical practice. This narrative review aimed to report the SCAD diagnostic criteria adopted in different studies, highlighting the current challenges and main pitfalls in its diagnosis. We analysed fourteen studies, mainly prospective observational studies. Haematochezia and rectal bleeding were the main complaints leading to diagnosis, followed by diarrhoea. An accurate endoscopic description was performed in 86% of studies, while a standardised biopsy sampling protocol (sigma, proximal colon and rectum) was scarcely adopted, being complete only in 28.5% of studies. The evaluation of concomitant drugs potentially inducing colitis was carried out in only 57% of studies. Great heterogeneity in sigmoid endoscopic (edema, erythema, erosions, ulcers, mucosal friability) and histological findings (chronic and/or acute inflammatory infiltrate) was observed. We showed that SCAD diagnosis is often based on not fully adequate macroscopic colonic description and scant biopsy protocol sampling. An accurate clinical and endoscopic evaluation, with an adequate sampling biopsy protocol, with attention to differential diagnosis, seemed to be crucial for a prompt SCAD diagnosis

Patients with Diverticular Disease Have Different Dietary Habits Compared to Control Subjects: Results from an Observational Italian Study

The role of dietary habits as risk factor for the development of diverticular complications has strongly emerged in the last years. We aimed to evaluate possible differences in dietary habits between patients with diverticular disease (DD) and matched controls without diverticula. Dietary habits were obtained from standardized food frequency questionnaires collected at entry to the Diverticular Disease Registry (REMAD). We compared controls (C) (n = 119) with asymptomatic diverticulosis (D) (n = 344), symptomatic uncomplicated diverticular disease (SUDD) (n = 154) and previous diverticulitis (PD) (n = 83) patients, in terms of daily calories, macro and micronutrients and dietary vitamins. Daily kcal intake and lipids, both saturated and unsaturated, were significantly lower in patients with DD than C. Total protein consumption was lower in PD than D, with differing consumption of unprocessed red meat, white meat and eggs between groups. Consumption of fibre, both soluble and insoluble, was lower in patients with PD compared to patients with SUDD, D and C, whereas dietary vitamins A, C, D and E and Oxygen Radical Adsorbance Capacity index were lower in all DD groups compared to C. This observational study showed that DD patients have different dietary habits, mainly in terms of caloric, fat, fibre and vitamin intake, compared to control subjects

Patients with Diverticular Disease Have Different Dietary Habits Compared to Control Subjects: Results from an Observational Italian Study

The role of dietary habits as risk factor for the development of diverticular complications has strongly emerged in the last years. We aimed to evaluate possible differences in dietary habits between patients with diverticular disease (DD) and matched controls without diverticula. Dietary habits were obtained from standardized food frequency questionnaires collected at entry to the Diverticular Disease Registry (REMAD). We compared controls (C) (n = 119) with asymptomatic diverticulosis (D) (n = 344), symptomatic uncomplicated diverticular disease (SUDD) (n = 154) and previous diverticulitis (PD) (n = 83) patients, in terms of daily calories, macro and micronutrients and dietary vitamins. Daily kcal intake and lipids, both saturated and unsaturated, were significantly lower in patients with DD than C. Total protein consumption was lower in PD than D, with differing consumption of unprocessed red meat, white meat and eggs between groups. Consumption of fibre, both soluble and insoluble, was lower in patients with PD compared to patients with SUDD, D and C, whereas dietary vitamins A, C, D and E and Oxygen Radical Adsorbance Capacity index were lower in all DD groups compared to C. This observational study showed that DD patients have different dietary habits, mainly in terms of caloric, fat, fibre and vitamin intake, compared to control subjects