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Introduction: This study explores the under-investigated area of obesity-related discrimination and stigmatization across different countries, specifically comparing Spain (Europe) and Egypt (Middle East)., Methods: We conducted a cross-sectional observational study involving 2,090 participants from both countries. Participants completed three well-validated questionnaires to assess their attitudes toward obesity, experiences of weight-related stigma, and internalization of weight bias: Antifat Attitudes Scale (AFA), Stigmatizing Situations Inventory (SSI), and Weight Bias Internalization Scale (WBIS). Participants were categorized into four groups based on body mass index (BMI) and history bariatric surgery., Results: Egyptian participants (BMI = 30.2 ± 6.7 kg/m2 [range: 18.5-69.0 kg/m2]) showed significantly higher aversion toward obesity, as indicated by higher AFA score, compared to their Spanish counterparts (BMI = 35.4 ± 10.1 kg/m2 [18.5-71.9 kg/m2]). In contrast, Spanish participants reported higher levels of weight bias internalization with increasing BMI, while in Egypt, this association was negative. The association of bariatric surgery on stigma reduction also differed between the countries. Multivariate analysis revealed that residing in Egypt was an independent risk factor for higher scores in AFA and WBIS (odds ratio 8.20 [95% confidence interval: 6.78-9.62], p < 0.001 and odds ratio (OR) 6.28 [95% CI: 4.78-7.78], p < 0.001, respectively). In contrast, Spaniards experienced more stigmatizing situations than Egyptians (OR -2.54 [95% CI: 6.78-9.62], p < 0.001)., Conclusion: Our study underscores the complex and diverse nature of obesity-related attitudes across cultures. Understanding these cultural differences is crucial for developing effective, culturally sensitive strategies to tackle weight stigma. This research opens avenues for further studies and interventions tailored to cultural contexts., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

Objective: Pituitary adenomas (PA) are rare in young patients, and additional studies are needed to fully understand their pathogenesis in this population. We describe the clinical and genetic characteristics of apparently sporadic PA in a cohort of young patients., Design: Clinical and molecular analysis of 235 patients (age ≤ 30 years) with PA. Clinicians from several Spanish and Chilean hospitals provided data., Methods: Genetic screening was performed via next-generation sequencing and comparative genomic hybridization array. Clinical variables were compared among paediatric, adolescent (<19 years) and young adults' (≥19-30 years) cohorts and types of adenomas. Phenotype-genotype associations were examined., Results: Among the total cohort, mean age was 17.3 years. Local mass effect symptoms were present in 22.0%, and prolactinomas were the most frequent (44.7%). Disease-causing germline variants were identified in 22 individuals (9.3%), more exactly in 13.1 and 4.7% of the populations aged between 0-19 and 19-30 years, respectively; genetically positive patients were younger at diagnosis and had larger tumour size. Healthy family carriers were also identified., Conclusions: Variants in genes associated with syndromic forms of PAs were detected in a large cohort of apparently sporadic pituitary tumours. We have identified novel variants in well-known genes and set the possibility of incomplete disease penetrance in carriers of MEN1 alterations or a limited clinical expression of the syndrome. Despite the low penetrance observed, screening of AIP and MEN1 variants in young patients and relatives is of clinical value.

Aim: The ACROPRAXIS program aims to describe the management of acromegaly in Spain and provide guidance., Methods: Ninety-three endocrinologists were organized into 13 panels to discuss the practical issues in managing acromegaly. Based on the key learnings, an online Delphi survey with 62 statements was performed, so those statements achieving consensus could be used as guidance. Statements were rated on a 9-point scale (9, full agreement; consensus > 66.6% of response in the same tertile)., Results: Ninety-two endocrinologists (98.8%) answered two rounds of the survey (mean age 47.6 years; 59.8% women; median 18.5 years of experience). Consensus was achieved for 49 (79%) statements., Diagnosis: The levels of insulin-like growth factor I (IGFI) is the preferred screening test. If IGFI levels 1-1.3 ULN, the test is repeated and growth hormone (GH) after oral glucose tolerance test (OGTT) is assessed. A pituitary magnetic resonance is performed after biochemical diagnosis., Treatment: Surgery is the first treatment choice for patients with microadenoma or macroadenoma with/without optical pathway compression. Pre-surgical somatostatin analogues (SSA) are indicated when surgery is delayed and/or to reduce anaesthesia-associated risks. After unsuccessful surgery, reintervention is performed if the residual tumor is resectable, while if non-resectable, SSA are administered. Follow-up First biochemical and clinical controls are performed 1-3 months after surgery. Disease remission is considered if random GH levels are < 1 µg/L or OGTT is < 1 or ≤ 0.4 µg/L, depending on the assay's sensitivity., Conclusion: Current clinical management for acromegaly is homogeneous across Spain and generally follows clinical guidelines.

The Mar Menor is a coastal lagoon threatened by the development of intensive agriculture in the surrounding areas. Large amounts of pesticides from these areas are discharged into El Albujón, a permanent watercourse flowing into the lagoon. We have used a multi-biomarker approach to assess the biological effects of agricultural pollution on a bivalve species. Biomarkers indicative of neurotoxicity (acetylcholinesterase, AChE), oxidative stress (catalase, CAT; glutathione reductase, GR and lipid peroxidation, LPO), phase II biotransformation of xenobiotics (glutathione S-transferase, GST) and physiological stress (scope for growth, SFG) were measured in clams transplanted to four sites of the lagoon (two reference sites and two sites affected by the dispersion of the effluent of the El Albujón), for exposure periods of 7 and 22 days. The hazards of this effluent were also examined by simultaneously measuring up to 83 contaminants (pesticides, PCBs, PAHs and others) in samples of fresh water from the watercourse mouth and seawater from the deployed sites, as well as the bioaccumulation of organochlorinated compounds and PAHs in the transplanted animals. Biomarker responses showed marked differences between reference and affected sites after 7 and 22 days. However it was only after 22 days that principal component analysis (PCA) of the biomarker responses distinguished between clams deployed in sites affected by the dispersion of the effluent of the watercourse and those from the reference sites. The chemical analysis of water showed high concentrations of pesticides close to El Albujón watercourse mouth, with the greatest input flux corresponding to the organophosphate chlorpyrifos, followed by pendimethalin and naphthalene, and at lower levels acenaphthene, terbuthylazine-desethyl and chlorpyrifos-methyl. In this regard, PCA analysis showed that the biological effects of the mixture of pesticides in caged clams after 22 days were reduced levels of AchE and SFG and increased levels of GR and phase II GST activity. An integrated biomarker response index was calculated from the combination of these biomarkers, proving useful for the assessment of the impact of agricultural pollution in caged clams., (Copyright © 2013 Elsevier B.V. All rights reserved.)