Blue prescription: A pilot study of health benefits for oncological patients of a short program of activities involving the sea

19 pages, 7 figures, 5 tables, 2 appendixes.-- Data availability statement: The data that has been used is confidentialPerforming outdoor activities in blue spaces can help improve human health and mental well-being by reducing stress and promoting social relationships. The number of people surviving cancer has increased globally to experience this disease as a life-changing and chronic condition with physical and psychosocial symptoms that have negative impacts on their quality of life. While there has been a growth of programs in green spaces to meet the needs of cancer patients, such as follow-up post-treatment care, support groups and physical activity programs, very few studies have examined the effects of activities involving the sea for the health and well-being of oncology patients. This is the first study to evaluate whether different outdoor activities in blue spaces can benefit oncological patients' physical and mental health using smartwatches, sphygmomanometers and Profile of Mood States (POMS) questionnaires. We assessed changes in blood pressure, heart rate, sleep quality and mental health of 16 patients after twelve sessions of three different activities (walking, beach and snorkelling) and four sessions of a control activity. While no significant differences between activities were observed in terms of the data gathered by the smartwatches, a gradient of positive results for human mental health was observed towards exposure to a blue space, assessed through POMS questionnaires. Results show that exposure to blue spaces contributes to tension and anger reduction and improves the vigour mood state of oncology patients. No significant increases in patients' heart rate were recorded after the beach and snorkelling activities, with results similar to the control activity, suggesting that the contribution may be to participants’ relaxationPeer reviewe

The Changing Landscape of Neonatal Diabetes Mellitus in Italy Between 2003 and 2022

Context In the last decade the Sanger method of DNA sequencing has been replaced by next-generation sequencing (NGS). NGS is valuable in conditions characterized by high genetic heterogeneity such as neonatal diabetes mellitus (NDM).Objective To compare results of genetic analysis of patients with NDM and congenital severe insulin resistance (c.SIR) identified in Italy in 2003-2012 (Sanger) vs 2013-2022 (NGS).Methods We reviewed clinical and genetic records of 104 cases with diabetes onset before 6 months of age (NDM + c.SIR) of the Italian dataset.Results Fifty-five patients (50 NDM + 5 c.SIR) were identified during 2003-2012 and 49 (46 NDM + 3 c.SIR) in 2013-2022. Twenty-year incidence was 1:103 340 (NDM) and 1:1 240 082 (c.SIR) live births. Frequent NDM/c.SIR genetic defects (KCNJ11, INS, ABCC8, 6q24, INSR) were detected in 41 and 34 probands during 2003-2012 and 2013-2022, respectively. We identified a pathogenic variant in rare genes in a single proband (GATA4) (1/42 or 2.4%) during 2003-2012 and in 8 infants (RFX6, PDX1, GATA6, HNF1B, FOXP3, IL2RA, LRBA, BSCL2) during 2013-2022 (8/42 or 19%, P = .034 vs 2003-2012). Notably, among rare genes 5 were recessive. Swift and accurate genetic diagnosis led to appropriate treatment: patients with autoimmune NDM (FOXP3, IL2RA, LRBA) were subjected to bone marrow transplant; patients with pancreas agenesis/hypoplasia (RFX6, PDX1) were supplemented with pancreatic enzymes, and the individual with lipodystrophy caused by BSCL2 was started on metreleptin.Conclusion NGS substantially improved diagnosis and precision therapy of monogenic forms of neonatal diabetes and c.SIR in Italy

The Silent Epidemic of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Children and Adolescents in Italy During the COVID-19 Pandemic in 2020

To compare the frequency of diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes in Italy during the COVID-19 pandemic in 2020 with the frequency of DKA during 2017-2019

Blue prescription : A pilot study of health benefits for oncological patients of a short program of activities involving the sea

Performing outdoor activities in blue spaces can help improve human health and mental well-being by reducing stress and promoting social relationships. The number of people surviving cancer has increased globally to experience this disease as a life-changing and chronic condition with physical and psychosocial symptoms that have negative impacts on their quality of life. While there has been a growth of programs in green spaces to meet the needs of cancer patients, such as follow-up post-treatment care, support groups and physical activity programs, very few studies have examined the effects of activities involving the sea for the health and well-being of oncology patients. This is the first study to evaluate whether different outdoor activities in blue spaces can benefit oncological patients' physical and mental health using smartwatches, sphygmomanometers and Profile of Mood States (POMS) questionnaires. We assessed changes in blood pressure, heart rate, sleep quality and mental health of 16 patients after twelve sessions of three different activities (walking, beach and snorkelling) and four sessions of a control activity. While no significant differences between activities were observed in terms of the data gathered by the smartwatches, a gradient of positive results for human mental health was observed towards exposure to a blue space, assessed through POMS questionnaires. Results show that exposure to blue spaces contributes to tension and anger reduction and improves the vigour mood state of oncology patients. No significant increases in patients' heart rate were recorded after the beach and snorkelling activities, with results similar to the control activity, suggesting that the contribution may be to participants' relaxation

Peroxisome proliferator-activated receptor-\u3b1 agonists modulate CXCL9 and CXCL11 chemokines in Graves\u2019 ophthalmopathy fibroblasts and preadipocytes

Peroxisome proliferator-activated receptors (PPAR)\u3b1 have been shown to exert immunomodulatory effects in autoimmune disorders; no study evaluated the effect of PPAR\u3b1 activation in Graves' ophthalmopathy (GO). We show the presence of PPAR\u3b1, \u3b4 and \u3b3 in GO fibroblasts and preadipocytes. PPAR\u3b1 activators have a potent inhibitory action on the secretion of CXCL9 and CXCL11 chemokines (induced by IFN\u3b3 and TNF\u3b1) in fibroblasts and preadipocytes. The potency of the used PPAR\u3b1 agonists was maximum on the secretion of CXCL11 (67% inhibition by fenofibrate) in fibroblasts. The relative potency of the compounds in GO fibroblasts was different with each chemokine. PPAR\u3b1 agonists were stronger inhibitors of CXCL9 and CXCL11 (in GO fibroblasts and preadipocytes) than PPAR\u3b3 activators. This study first shows that PPAR\u3b1 activators inhibit CXCL9 and CXCL11 chemokines in normal and GO fibroblasts and preadipocytes, suggesting that PPAR\u3b1 may be involved in the modulation of the immune response in GO

Sostenibilitat pesquera i salut humana

The oceans provide a number of essential goods and services, including much of the oxygen we breathe, climate regulation, mitigation of global warming and food supply. The benefits for the health of consumers derived from the consumption of fish in the Mediterranean diet, due to its content of omega-3 and other nutrients, and the benefits of this consumption for environmental sustainability are unquestionably helping to promote the appreciation of the quality of fish products, while highlighting the need to restore and conserve healthy marine ecosystems in order to preserve and ensure fishery stocks within a sustainable food system. Overexploitation, climate change and other factors such as marine pollution, the presence of pathogens and biotoxins, eutrophication (which causes deoxygenation), ocean acidification and the arrival of exotic species, endanger the omega-3 stocks necessary for human health. These are serious problems that affect marine habitats, marine biodiversity and, ultimately, fishery resources. For this reason, it is necessary to promote new sources of omega-3 and at the same time allow the recovery of the populations of overexploited species, as well as to support sustainable fishing systems such as artisanal fishing. The year 2022 has been declared the International Year of Sustainable Fisheries and Aquaculture by the Food and Agricultural Organization of the United Nations (FAO), with the aim of raising the awareness of their importance for food security and nutrition, poverty eradication and the sustainable use of natural resources. These small-scale production systems can contribute to the changes needed for a sustainable seafood system. Els oceans proporcionen una sèrie de béns i serveis fonamentals, entre els quals hi ha la producció de bona part de l’oxigen que respirem; la regulació del clima i la mitigació de l’escalfament del planeta, i l’aprovisionament d’aliments. La difusió dels beneficis del consum de peix dins de la dieta mediterrània, en relació amb la salut dels consumidors pel seu contingut en omega-3 i altres nutrients, i amb la sostenibilitat ambiental, contribueix sens dubte al fet que cada vegada més es valori millor la qualitat dels productes pesquers, i també emfatitza la necessitat de recuperar i conservar els ecosistemes marins per tal de preservar i garantir la salut dels estocs pesquers, en un sistema alimentari sostenible. La sobreexplotació pesquera, el canvi climàtic i altres factors com la contaminació marina, la presència de patògens i de biotoxines, l’eutrofització (que causa desoxigenació), l’acidificació de les aigües i les espècies exòtiques posen en risc l’obtenció dels omega-3 necessaris per a la salut humana. Són greus problemes que afecten els hàbitats marins i la biodiversitat marina i, finalment, els recursos pesquers. Per aquest motiu cal proposar fonts noves d’omega-3 i alhora permetre la recuperació de les poblacions d’espècies sobreexplotades, així com donar suport als sistemes de pesca més sostenibles com la pesca artesanal. El 2022 va ser declarat per l’Organització de les Nacions Unides per a l’Agricultura i l’Alimentació (FAO) l’Any Internacional de la Pesca i l’Aqüicultura Sostenible, amb l’objectiu de conscienciar de la importància que la pesca i l’aqüicultura a petita escala tenen per a la seguretat alimentària i la nutrició, l’erradicació de la pobresa i l’ús sostenible dels recursos naturals. Aquests sistemes productius a petita escala representen un exemple per promoure els canvis necessaris per assolir un sistema alimentari marí sostenible

Effects on glucose metabolism of high-dose octreotide LAR in patients with acromegaly inadequately controlled by conventional somatostatin analog therapy

The effects of conventional somatostatin analog (SSA) regimens on glucose homeostasis seem to have minor clinical impact in acromegaly. Recently, we performed a trial showing that high dose octreotide LAR significantly reduces IGF1 in acromegalic patients uncontrolled with conventional SSA doses. In this post-hoc analysis, we evaluated the effects of high doses versus high frequency octreotide LAR on glucose homeostasis (HbA1c, FPG, HOMA-R) in patients with acromegaly enrolled in this trial. After approval by ethical committee and informed consent, 26 patients (14 F, 12 M, median age 51 years, range: 27–78) with uncontrolled acromegaly were randomly treated with high-dose (11 patients: 60 mg/28 days) or high-frequency (15 patients: 30 mg/21 days) octreotide LAR for 6 months. At study entry, seven patients had diabetes mellitus and eight impaired fasting glucose (IFG). After 6-month treatment, glucose metabolism was impaired in six patients (23.1%), improved in two patients (7.7%) and unchanged in the remaining 18 patients (69.2%). Rate of impairment in glucose homeostasis was similar in high doses versus high frequency octreotide LAR (27.3 vs 20.0%; P=0.44). In all six patients with impaired glucose homeostasis, serum IGF1 and/or GH values remained high during treatment, whereas significant decrease (>20%) in serum IGF-I or GH values was observed in 75% of patients in whom glucose homeostasis did not impair (P=0.03). Impairment of glucose homeostasis occurred in 26.7% of patients with pre-existing diabetes mellitus or IFG and in 18.2% of patients with pre-existing normal glucose metabolism (P=0.35). In conclusion, the increase in octreotide LAR doses or frequency did not produce negative effects on glucose metabolism in the majority of patients. In the minority of patients who experienced impairment of glucose homeostasis, this event occurred more frequently in those with persistently uncontrolled acromegaly and it seems to be not dependent on the pre-existing abnormalities of glucose metabolism

High-dose octreotide LAR in patients with acromegaly inadequately controlled by conventional somatostatin analogue therapy: a randomized, controlled trial

Objective: In acromegaly, 25–50% of patients remain uncontrolled with conventional somatostatin analogue (SA) therapy. Evidence suggests that response may be improved by increasing the dose or frequency of administration of SAs. This study evaluated the efficacy and safety of octreotide LAR administered at a high dose or high frequency in patients with acromegaly. Methods: This was a 24-week prospective, multicenter, randomized, open-label trial in patients with active acromegaly despite ≥6 months’ conventional maximal-dose SA therapy. Patients had baseline GH>2.0 μg/l, elevated IGF-I for age/sex-matched controls and had a ≥50% reduction in GH during previous SA treatment. Patients were randomized to receive high-dose (60 mg/28 d; n=11) or high-frequency (30 mg/21 d; n=15) octreotide LAR for 24 weeks. The primary endpoint was change from baseline in GH and IGF-I at week 24. Secondary endpoints included IGF-I normalization, tumor shrinkage, safety and tolerability. Results: In the high-dose group only, a significant change from baseline was seen for mean GH (−28%; P=0.046) and IGF-I (−27%; P=0.023). In the high-frequency group, changes from baseline in mean GH (+6.4%) and IGF-I (−4.7%) were not statistically significant. Significantly more patients in the high-dose group achieved a reduction in IGF-I at week 24 than those in the high-frequency group (91 vs 53%; P<0.05). IGF-I normalization or GH<2 μg/l occurred with only the high-dose regimen (IGF-I 36 vs 0%, P=0.022; GH 27 vs 0%, P=0.06). The proportion of patients experiencing tumor shrinkage was similar in the high-frequency and high-dose groups (14 vs 11%). Both regimens were well tolerated. Conclusion: High-dose octreotide LAR (60 mg/28 d) is effective and well tolerated in patients with active acromegaly inadequately controlled with conventional SA therapy. These results suggest that in selected patients uncontrolled on conventional doses of SAs, high-dose octreotide LAR should be tried before switching to other treatment modalities

Blue prescription: A pilot study of health benefits for oncological patients of a short program of activities involving the sea

Performing outdoor activities in blue spaces can help improve human health and mental well-being by reducing stress and promoting social relationships. The number of people surviving cancer has increased globally to experience this disease as a life-changing and chronic condition with physical and psychosocial symptoms that have negative impacts on their quality of life. While there has been a growth of programs in green spaces to meet the needs of cancer patients, such as follow-up post-treatment care, support groups and physical activity programs, very few studies have examined the effects of activities involving the sea for the health and well-being of oncology patients. This is the first study to evaluate whether different outdoor activities in blue spaces can benefit oncological patients' physical and mental health using smartwatches, sphygmomanometers and Profile of Mood States (POMS) questionnaires. We assessed changes in blood pressure, heart rate, sleep quality and mental health of 16 patients after twelve sessions of three different activities (walking, beach and snorkelling) and four sessions of a control activity. While no significant differences between activities were observed in terms of the data gathered by the smartwatches, a gradient of positive results for human mental health was observed towards exposure to a blue space, assessed through POMS questionnaires. Results show that exposure to blue spaces contributes to tension and anger reduction and improves the vigour mood state of oncology patients. No significant increases in patients' heart rate were recorded after the beach and snorkelling activities, with results similar to the control activity, suggesting that the contribution may be to participants’ relaxation