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Sarcopenia is a progressive and generalized skeletal muscle disorder associated with poor outcomes and complications, including falls, fractures, physical disability, and death. The aim of this review is to assess the possible influence of sarcopenia on outcomes of sarcopenia in patients who underwent knee or hip replacement. A systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Medline, EMBASE, Scopus, CINAHL, and CENTRAL bibliographic databases were searched. General study characteristics extracted were: primary author and country, year of publication, type of study, level of evidence (LOE), sample size, mean age, gender, follow-up, type of surgery, diagnosis, and outcomes. At the final screening, five articles met the selection criteria and were included in the review. Sarcopenia influences the Barthel Index (BI), which is significantly lower compared to patients without sarcopenia, which indicates that the patient is subjected to a worsening of this condition that can influence their normal life since they will become dependent on someone else. No difference in mortality rate was found was found between the studies. This systematic review addressed the possible role of sarcopenia in patients undergoing joint replacement surgery. Despite the lack of high-quality literature on this topic, a general trend in considering sarcopenia as a negative factor for quality of life in joint replacement patients was reported. However, the lack of significant results means it is not possible to report useful conclusions.

Aims: To investigate if extra virgin olive oil (EVOO) or palm oil enriched chocolate spreads consumption leads to different results in terms of plasma ceramides concentration, glucose and lipid metabolism, inflammatory markers and appetite regulation in young healthy subjects. Methods: In a 2‐week, double‐blind, cross‐over, randomised controlled trial, 20 healthy, normal‐weight subjects with a mean age of 24.2 years (SD: 1.2), consumed chocolate spread snacks (73% of energy [%E] from fat, 20% from carbohydrates and 7% from proteins), providing 570 Kcal/day added to an isocaloric diet. The chocolate spreads were identical, except for the type of fat: EVOO oil, rich in monounsaturated fatty acids (MUFAs), or palm oil, rich in Saturated Fatty Acids (SFAs). Results: EVOO‐enriched chocolate spread consumption led to better circulating sphingolipids and glucose profile, with reduced plasma ceramide C16:0, ceramide C16:0/ceramide C22:0‐ceramide C24:0 ratio and sphingomyelin C18:0 (P = 0.030, P= 0.032 and P = 0.042, respectively) compared to the palm oil‐enriched chocolate spread diet. HOMA‐IR and plasma insulin were lower, while the Quicki and the McAuley Index were higher after the EVOO diet compared to the palm oil diet (P = 0.046, P = 0.045, P = 0.018 and P = 0.039 respectively). Subjects maintained a stable weight throughout the study. No major significant changes in total cholesterol, triglycerides, HDL, inflammatory markers, and appetite‐regulating hormones/visual analogue scale were observed between the groups. Conclusions: Partially replacing SFAs with MUFAs in a chocolate‐based snack as part of a short‐term isocaloric diet in healthy individuals may limit SFAs detrimental effects on insulin sensitivity and decrease circulating harmful sphingolipids in young adults. [ABSTRACT FROM AUTHOR]

Aims: Filipino people are one of the largest immigrant populations in Italy. Aim of this study was to assess differences in T2D, prediabetes and obesity between native Italians and Filipino immigrants living in Rome. Changes in metabolic characteristics and dietary habits between first-generation immigrants and their descendants were examined. Methods: A cross-sectional survey was carried out adopting principles of community-based participatory research. A total of 132 first-generation Filipinos aged 35-60 years resident in Rome for ≥ 5 years, 164 age and sex-matched native Italians and 27 descendants of the first-generation immigrants aged 10-18 years were studied. Diabetes history and dietary habits were investigated by standardized questionnaires; anthropometrics, blood pressure and fasting capillary blood glucose were measured. Results: T2D, impaired fasting glucose and obesity were all more prevalent among first-generation immigrants (13.5%, 35.4% and 41.7% respectively) than Italians (7.2%, 22.6% and 36.8%). Descendants showed higher prevalence of overweight and obesity (48.1%) than first-generation immigrants (p<0.05). First-generation immigrants consumed traditional food more days per week compared to their descendants, who preferred western food, with a large consumption (>4 times/week) of eggs (96%), processed meat (74%) and sweet foods or beverages (96%). Body Mass Index was directly related to years spent in Italy (r=0.19, p=0.03) and educational level (r=0.19, p=0.04). Size of household was directly related to weight gain in first-generation immigrant women (r=0.40, p<0.001). Conclusion: This survey reveals a higher prevalence of diabetes and its risk factors among the Filipino community resident in Rome. Obesity prevalence is higher in the second-generation, probably due to unhealthy changes in dietary pattern. These alarming data stress the need of appropriate health programs addressed to the minority groups immigrating in western countries. Disclosure: S. Pieralice: None. R. Del Toro: None. Y. Khazrai: None. E. Maddaloni: Speaker's Bureau; Self; Merck & Co., Inc., Pikdare. A. Maurizi: Consultant; Self; AstraZeneca. S. Manfrini: None. P. Pozzilli: None. [ABSTRACT FROM AUTHOR]

Compliance to diet in obese patients is hampered by repeated episodes of hypoglycaemia during fasting states associated with hyperinsulinemia and insulin resistance which in turn stimulate appetite, thus rendering diet compliance difficult to maintain. The avoidance of fasting hypoglycaemia may help to reduce insulin response which plays a major role in limiting body weight loss. The aim of this study was to find out whether the administration of small amounts of glucose through the Glucose RapidSpray device during fasting state may contribute to reduce body weight. This device consists of a 10 ml bottle containing 10g glucose solution with the addition of artificial flavours and excipients to facilitate buccal absorption delivering by spray puffing glucose in quantifies as small as 0.5 grams. We enrolled 20 obese subjects with BMI comprised between 30 and 46 (8 males, 12 females, mean age 52 yrs ±7) who followed a structured program aimed at understanding and managing their condition and a diet of 1300 Kcal (53% carbohydrates, 18% proteins, 29% lipids). Subjects were asked to exercise at least 150 minutes a week. Ten out of 20 subjects were randomly assigned to make use of Glucose RapidSpray in oral puffs releasing between 500 mg and 2 grams of glucose a day on the occasion of fasting state and early symptoms of hypoglycaemia. In separate experiments we found that the administration Glucose RapidSpray was able to increase blood glucose levels between 3 and 10 mg depending on the number of puffs. Subjects were followed-up for a period of 4 weeks. After two weeks the group randomised to Glucose RapidSpray lost 3.5 kg±2.3 kg vs.2.1 kg ± 2.5 in the control group. At 30 days, the group receiving Glucose RapidSpray lost 4.2 kg ± 2.3 vs.3.1 kg ± 2.4 in the control group. Overall 50% of subjects exposed to Glucose RapidSpray vs. 20% of the control group lost more than 5% of their initial body weight. (p<0.05). The results of this study indicate that the use of Glucose RapidSpray during fasting conditions associated with dietary restriction may help to lose body weight in obese subjects over a short period of time. [ABSTRACT FROM AUTHOR]

Group therapy is usually considered more effective in obtaining changes in patient nutritional behaviour. Members of the group can share experiences and common goals that strengthen relationships, help to be supportive of each other, thus increasing motivation to cope with the disease. The aim of this study was to evaluate in patients with type 2 diabetes the outcome in terms of metabolic control comparing Group versus Individual nutritional therapy. A total of 50 patients with type 2 diabetes were randomly assigned to either Group (n = 25) or Individual (n = 25) nutritional educational therapy. Four educational sessions took place every fortnight over a 2 month period; follow-up visits were scheduled every three months during one year follow-up. Fasting glucose, HbA1c, BMI and waist circumference were assessed during the first session and' at follow-up visits. Patients followed a structured program aimed at understanding and managing their disease, no written diet was provided but only information on the importance of a well-balanced diet, food composition, carbohydrate counting, and how to plan a healthy meal/snack. The importance of physical activity was also stressed encouraging subjects to exercise at least 150 minutes a week. No significant differences were observed between patients at entry. Patients enrolled in the Individual therapy underwent worsening of their anthropometric parameters, although these differences did not reach statistical significance compared to baseline values. A significant reduction in HbA[sub 1c] values was observed in the Group vs. Individual therapy (7.0% ± 1.1 at entry vs. 6.6% ± 0,9 at 1 year; 7.6% ± 1.3 at entry vs. 8.4% ± 1.8 at 1 year, respectively, p< 0.001), with a significant variation in delta SDS for Group vs. Individual therapy p< 0.5 ± 0.5 vs. + 0.8 ±1.6, respectively; p< 0,001). Group nutritional therapy was more effective than individual therapy in improving metabolic control in type 2 diabetes. We recommend its implementation in diabetes clinics. [ABSTRACT FROM AUTHOR]

Introduction: North Africa has become a key migratory hub where a large number of migrants attempt the journey by sea from the Libyan coastline to the south of Europe. In this humanitarian disaster scenario, the Mediterranean route has been one of the most used by illegal boats. Methodology: In this report, the state of physical and psychological health of a cluster of Eritrean migrants, escaped from Libya and rescued in the Mediterranean Sea after a shipwreck, was described by epidemiological, clinical and laboratory investigations. Results: Data suggest that despite the majority of the migrants being apparently in good health upon a syndromic surveillance approach, most of them suffered a decline in psychological status as well as severe malnutrition. The emergence of infectious diseases, related to poor living conditions during the journey, is not a rare event. Conclusion: The present report highlights the risks of failures of the syndromic medical approach in the setting of the extremely challenging migration route and underlines migrant frailties consequent to a prolonged journey and long period of detention. These stressors, which can degrade the initial health condition of traveling migrants, can lead to a premature "exhausted migrant effect" that should be carefully investigated in order to avoid the early emergence of diseases related to frailty. [ABSTRACT FROM AUTHOR]