lanreotide 60 mg a new long acting formulation effectiveness in the chronic treatment of acromegaly

Lanreotide (LAN) 60 mg (LAN60), a new long-acting formulation of LAN alleged to suppress GH/IGF-I hypersecretion for 28 d in acromegalic patients, was administered in a prospective open multicenter study to 92 patients with active acromegaly (61 women and 31 men, aged 20–79 yr). LAN60 was given as adjuvant treatment (AT) in 62 patients; the other 30 patients [primary treatment (PT)] were de novo (n = 20) or previously treated only by pharmacotherapy (n = 10). After wash-out from previous treatments, LAN60 was started im every 28 d for 3 injections; the dose was then individually tailored, aiming at lowering GH to less than 2.5 μg/liter and IGF-I to the normal range. After a median follow-up of 24 months (range, 6–48 months), IGF-I normalized in 65% of patients, decreasing from 199 ± 8% (expressed as a percentage of the upper limit of normal range; mean ± se) to 87 ± 4% (P < 0.0001). GH fell to less than 2.5 μg/liter in 63% of patients and to less than 1 μg/liter in 25%, decreasing from 20 ± 3 to 3 ± 0.4 μ..

USEFULNESS OF AN AD HOC QUESTIONNAIRE (ACRO-CQ) FOR THE SYSTEMATIC ASSESSMENT OF ACROMEGALY COMORBIDITIES AT DIAGNOSIS AND THEIR MANAGEMENT AT FOLLOW-UP

Purpose: To determine the validity of a self-administered questionnaire (Acro-CQ) developed to systematically assess the presence, type and time of onset of acromegaly comorbidities. Methods: This is a cross-sectional study; 105 acromegaly patients and 147 controls with other types of pituitary adenoma, referred to a specialized Italian Center, autonomously compiled Acro-CQ in an outpatient clinical setting. To test its reliability in a different setting, Acro-CQ was administered via mail to 78 patients with acromegaly and 100 with other pituitary adenomas, referred to a specialized US Center. Data obtained from questionnaires in both settings were compared with medical records (gold standard). Results: Demographics of patients and controls from both countries were similar. In both settings, >95 % of the questionnaires were completely filled; only one item was missed in the others. Concordance with medical record was excellent (k > 0.85) for most of the items, independently from the way of administration, patient age, gender and nationality, pituitary adenoma type and disease activity. Conclusions: Acro-CQ is an inexpensive, highly accepted from patients and reliable tool recommended to expedite systematic collection of relevant clinical data in acromegaly at diagnosis, to be replicated at follow-ups. This tool may guide a targeted, cost-effective management of complications. Moreover, it could be applied to retrieve data for survey studies in both acromegaly and other pituitary adenomas, as information is easily and rapidly accessible for statistical analysis

Psychiatric disorders and anger in patients with controlled acromegaly

Background: Acromegaly (ACRO) is a chronic rare disease caused by a pathological increase in growth hormone (GH) secretion. In ACRO an increased prevalence of psychiatric disorders has been demonstrated, in particular depressive disorders, associated to a significant deterioration of the quality of life, independently from disease control. In addition, anger feelings, often detected in subjects affected by chronic disease, have not yet been investigated, in pituitary patients. Aim of the study was to evaluate in ACRO patients with a controlled disease, compared to patients suffering for non-functioning pituitary adenoma (NFPA) 1) prevalence of depressive and anxiety disorders, and 2) expression and control of anger feelings. The second purpose was to evaluate the correlation between psychiatric disorders, anger feelings and the "activity of disease," that is active ACRO that needs medical treatment versus cured ACRO. Methods: This is a cross-sectional, observational study, which included 53 patients enrolled at the Neuroendocrinology Outpatient Clinic of "Città della Salute e della Scienza di Torino". Of the 53 enrolled patients (24 male and 29 female), 34 had ACRO, while 19 had NFPA, as control group. All subjects went through the following self-administered, validated psychological tools: SF-36 (Short-Form 36 Item); STAXI - 2; BDI-II (Beck Depression Inventory -II); STAI (State-Trait Anxiety Inventory). Only in ACRO group, patients completed PASQ (Patient-Assessed Acromegaly Symptom Questionnaire) and ACROQoL (Acromegaly Quality of Life Questionnaire) questionnaires. In addition 45 patients underwent the International Neuropsychiatric Short Interview to assess the presence of a psychiatric disorder. For each patient, anthropometric, clinical and biochemical information was collected. Results: A higher frequency of psychiatric anxiety and mood disorders (not reported in the medical history) was observed in patients with controlled ACRO. In the SF-36 questionnaire, a lower score was found in the "emotional well-being" items in ACRO compared to NFPA, particularly in those with cured ACRO. Cured acromegalic patients had a worse score in "emotional well-being," "energy/fatigue" and "general health" items. Finally, subjects in ACRO group obtained a lower score in the ability to control anger and a higher score in the physical expression of it, demonstrating a tendency to more aggressive behaviors. Conclusions: This study showed that psychiatric illness is often hidden in patient suffering from ACRO, despite normal IGF-I levels. Recovery from the disease do not necessarily improve QoL scores, in fact in cured patients the quality of life can be even worse

Cecal volatilome and microbiota profile of organic chickens supplemented with black soldier fly live larvae

Insects have shown to be a potential nutritional replacement in poultry nutrition as substitute of traditional protein sources, with positive effects on gut microbiota. However, only few studies have investigated the effects of live black soldier fly (BSF) live larvae provision on short-chain fatty acids (SCFAs) and microbiota composition in chicken’s gut. Label naked neck (LNN, n. 240) chickens were reared in an organic production system from 21 to 82 days of age and randomly allocated into four experimental groups (10 birds/pen, 6 replicates/treatment) according to bird gender and larvae provision. Experimental groups were fed with 10% supplementation of BSF live larvae, based on the expected daily feed intake (DFI). At slaughter, samples of cecal digesta were collected from 60 animals (15 birds/treatment), frozen and stored at -80°C until to be analyzed by SPME-CG-MS and DNA sequencing techniques, respectively. Results showed that seven SCFAs were identified, with butyrate as the most abundant. Even if no significant differences were found between treatments, the cecal SCFAs concentration in insect-fed animals were noticed to be less variable than control group. Cecal microbiota analyses of birds fed with BSF live larvae, showed a higher incidence of Coprobacillus, Synergistaceae and Christensenellaceae, with the latter to having the potential to degrade chitin’s insect meal, a compound with immunoregulatory properties. In conclusion, results showed that even a dietary 10% supplementation of BSF live larvae can slightly improve microbiota profile and potentially, SCFAs production in LNN chickens. These results confirm what observed in recent studies on broilers, but with lower (5% of DFI) live larvae inclusion levels. Financial support for Poultrynsect project was provided by transnational funding bodies under the Joint SUSFOOD2/CORE Organic Call 2019