Almog Shalit

The early introduction of effective nutritional educational programs is pivotal for instilling sustainable healthy behaviors. The present work aims to present a best practice example of a nutrition and overall lifestyle school-based training program, the Nutritional Adventures (“Diatrofoperipeteies”). Conducted during 2020–2022 in Greek primary schools, this synchronous, online educational initiative included two 1-school-hour activities with a nutrition instructor. Additionally, schools were randomly assigned to supplementary “at-home” supported-by-parents or “in-class” supported-by-educators educational activities. In total, n = 12,451 students of 84 primary schools participated. Parent-completed questionnaires were selected in the recruitment and post-intervention phase (40% participation rate); overall, the working sample was n = 1487 students. In the post-intervention phase, a significant increase in Mediterranean diet adherence was observed (KIDMED score: mean increment = 0.25 units; p < 0.001), particularly fruit and vegetable consumption. Time spent on physical activity increased, while screen time decreased. Students’ total quality of life significantly improved (PedsQL; mean increment = 1.35 units; p < 0.001), including on all of its subscales (physical, emotional, social, and school function). Supplementary educational activities that were supported by educators rather than parents yielded a more favorable impact on students’ lifestyle and quality of life. The Nutritional Adventures program can be regarded as a successful initiative in primary schools, yielding immediate advantages that extend beyond promoting healthy dietary habits.

During the last decades, gestational diabetes mellitus (GDM) prevalence has been on the rise. While insulin remains the gold standard treatment for GDM, metformin use during pregnancy is controversial. This review aimed to comprehensively assess the available data on the efficacy and safety of metformin during pregnancy, both for the mother and the offspring. Metformin has been validated for maternal efficacy and safety, achieving comparable glycemic control with insulin. Additionally, it reduces maternal weight gain and possibly the occurrence of hypertensive disorders. During the early neonatal period, metformin administration does not increase the risk of congenital anomalies or other major adverse effects, including lower APGAR score at 5 min, neonatal intensive care unit admissions, and respiratory distress syndrome. Several studies have demonstrated a reduction in neonatal hypoglycemia. Metformin has been associated with an increase in preterm births and lower birth weight, although this effect is controversial and depends on the indication for which it was administered. Evidence indicates possible altered fetal programming and predisposition to childhood obesity and metabolic syndrome during adulthood after use of metformin in pregnancy. With critical questions still requiring a final verdict, ongoing research on the field must be conducted.

This retrospective cohort study compares the effectiveness of propylthiouracil (PTU) and methimazole (MMI) in thyroid storm management. A total of 1383 patients with thyroid storm from the Premier Healthcare Database that required thionamide and steroid treatment in intermediate or intensive care units were included. Of these, 656 (47.4%) were treated with PTU and 727 (52.6%) with MMI, based on the initially administered treatment. The study showed no statistically significant difference in in-hospital mortality or discharge to hospice, duration of organ support, total hospitalization cost, and rates of adverse events between the two groups. As opposed to the 2016 ATA guidelines, which recommend using PTU over MMI, this study suggests that both can be used interchangeably. Consequently, these findings should prompt further large-scale studies on the optimal treatment of thyroid storm.

In recent years, in the context of the increase in the life expectancy of cancer patients, special attention has been given to immunotherapy and, indeed, to immune checkpoint inhibitors. The use of immune checkpoint inhibitors has increased rapidly, and approximately 40% of cancer patients are eligible for this treatment. Although their impact is valuable on cancer treatment, immune checkpoint inhibitors come with side effects, known as immune-related adverse effects. These can affect many systems, including cutaneous, musculoskeletal, cardiovascular, gastrointestinal, endocrine, neural, and pulmonary systems. In this review, we focus on immune-related endocrinopathies that affect around 10% of all treated patients. Endocrine dysfunctions can manifest as hypophysitis, thyroid dysfunction, hypoparathyroidism, insulin-deficient diabetes mellitus, and primary adrenal insufficiency. Currently, there are multiple ongoing clinical trials that aim to identify possible predictive biomarkers for immune-related adverse effects. The design of those clinical trials relies on collecting a variety of biological specimens (tissue biopsy, blood, plasma, saliva, and stool) at baseline and regular intervals during treatment. In this review, we present the predictive biomarkers (such as antibodies, hormones, cytokines, human leukocyte antigens, and eosinophils) that could potentially be utilized in clinical practice in order to predict adverse effects and manage them appropriately.

Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors have emerged as novel treatment options in the management of advanced or metastatic breast cancer. MicroRNAs are endogenous non-coding 19–22-nucleotide-long RNAs that regulate gene expression in development and tumorigenesis. Herein, we systematically review all microRNAs associated with response to CDK4/6 inhibitors in solid tumors and hematological malignancies. Eligible articles were identified by a search of the MEDLINE and ClinicalTrials.gov databases for the period up to1 January 2021; the algorithm consisted of a predefined combination of the words “microRNAs”, “cancer” and “CDK 4/6 inhibitors”. Overall, 15 studies were retrieved. Six microRNAs (miR-126, miR-326, miR3613-3p, miR-29b-3p, miR-497 and miR-17-92) were associated with sensitivity to CDK4/6 inhibitors. Conversely, six microRNAs (miR-193b, miR-432-5p, miR-200a, miR-223, Let-7a and miR-21) conferred resistance to treatment with CDK4/6 inhibitors. An additional number of microRNAs (miR-124a, miR9, miR200b and miR-106b) were shown to mediate cellular response to CDK4/6 inhibitors without affecting sensitivity to treatment. Collectively, our review provides evidence that microRNAs could serve as predictive biomarkers for treatment with CDK4/6 inhibitors. Moreover, microRNA-targeted therapy could potentially maximize sensitivity to CDK4/6 inhibition.