Yosra Hasni

Introduction: Dietary interventions are central to the management of obesity, insulin resistance, type 2 diabetes and related cardiometabolic disorders, yet clinical responses vary substantially between individuals exposed to apparently similar nutritional prescriptions. The gut microbiota may explain part of this variability because it transforms dietary substrates into bioactive metabolites and influences intestinal, immune and endocrine pathways. Methods: A narrative review informed by a structured literature search was conducted using PubMed, ScienceDirect and Google Scholar. Search terms combined concepts related to gut microbiota, intestinal microbiota, dietary intervention, nutrition, fiber, prebiotics, probiotics, metabolic response, obesity, insulin sensitivity and glycemic response. Forty records were initially identified, and 21 references were retained for qualitative synthesis after duplicate removal, screening and full-text eligibility assessment. Results: The reviewed literature indicates that baseline microbial diversity, community structure and functional capacity are associated with differential metabolic responses to calorie restriction, fiber-rich dietary patterns, probiotics, prebiotics and glycemia-oriented personalized nutrition. Key taxa and communities discussed in the evidence include Bacteroides, Prevotella, Akkermansia muciniphila, Bifidobacterium, Lactobacillus and Christensenella-associated communities. Mechanistic pathways include short-chain fatty acid generation, bile acid transformation, tryptophan-derived signaling, incretin-related pathways, epithelial barrier integrity and low-grade inflammation. Conclusion: The gut microbiota should be regarded as both a biomarker and a potential mediator of response to dietary interventions. Microbiota-informed nutrition is promising for precision diabetes and endocrinology care, but standardized prospective studies integrating microbiome profiling with robust metabolic outcomes remain necessary before routine clinical implementation.

Introduction: Treatment of Graves' disease (GD) is based on the triad of antithyroid drugs (ATD), radioactive iodine and surgery (total or subtotal thyroidectomy). ATD remains the first-line treatment. Aim: To determine predictors of GD remission after treatment with ATD. Methods: Cross-sectional study for analytical purposes including 105 patients followed for GD treated with ATD for 12 to 18 months. The collection of clinical and biological data was done through the consultation of medical records. Patients were divided to two groups according to their outcome. The "Remission" group included patients with durable euthyroidism after treatment withdrawal. The "Failure" group included patients who did not achieve euthyroidism at the end of treatment or who had relapsed after treatment withdrawal. Results were compared using Chi-Square test and t-test and logistic regression model with significance at p Results: Patients in the "Remission" group were 43 (40.95%) and patients in the "Failure" group were 62 (59.05%). Factors that were significantly associated with remission at univariate analysis were: a shorter duration of symptom progression, a shorter duration of treatment, a lower initial anti-TSH receptor antibodies level, methimazole use compared to Benzylthiouracil use and better therapeutic adherence. Multivariate analysis showed that only shorter treatment duration (p = 0.01, OR = 0.90, IC95% [0.87 0.97]), lower initial anti-TSH receptor antibodies level (p = 0.016; = 0.93, IC95% [0.87-0.98]) and methimazole use (p = 0.048, OR = 2.4, IC95% [1.00-5.74]) were significant predictors of remission. Conclusion: A lower initial level of anti-TSH receptor antibodies, the use of methimazole compared to Benzylthiouracil as well as a shorter duration of treatment are factors of better prognosis in the outcome of Graves’ disease after Antithyroid drug treatment.

Cushing's disease (CD) is a rare endocrine disorder primarily caused by a corticotroph pituitary microadenoma. The occurrence of double pituitary adenomas (DPA), particularly with two ACTH-secreting microadenomas, is exceptionally uncommon. Untreated or poorly managed CD can lead to severe complications, such as bilateral avascular necrosis of the femoral heads.