Orthorexia nervosa (ON) is an unspecified feeding or eating disorder (USFED) characterized by an exaggerated, unhealthy obsession with healthy eating. Τypical eating disorders (EDs) and USFEDs are common among patients with diabetes mellitus (DM), which complicates metabolic control and disease outcomes. The present systematic review summarizes the evidence on the prevalence of ON symptomatology among patients with DM. PubMed, Web of Science, Scopus, and grey literature were searched, and relevant observational studies were screened using the Rayyan software. The quality of the studies was assessed using the appraisal tool for cross-sectional studies (AXIS) and the Newcastle–Ottawa scale (NOS). Out of 4642 studies, 6 fulfilled the predefined criteria and were included in the qualitative synthesis. Most studies relied on the ORTO-15 or its adaptations to identify ON among patients with DM. No apparent sex or age differences exist regarding the prevalence of ON symptoms. None of the studies compared the prevalence of ON in patients with type 1 and type 2 DM. Most of the research was of average to good methodological quality. In conclusion, patients with DM often exhibit ON tendencies, although research is still limited regarding the etiology or mechanistic drivers behind ON and the characteristics of patients with a dual ON–DM diagnosis.

Introduction: Stigma concerning mental disorder is a widespread phenomenon concerning the beliefs and attitudes of the public toward mental patients with a significant negative impact on state policy and the outcome of the patients. Material and methods: The study included 1,363 students of the Aristotle University of Thessaloniki. The survey was based on an Internet-based electronic platform. The statistical analysis included analysis of variance (ANOVA) and Yates corrected chi-square test. Results: Approximately, 87% of students responded that they know what mental disorder is, 70% were informed from the Internet, 30% consider mental patients responsible for their condition, more than 95% blame the way they were raised and almost 60% consider mental disorder to be heritable. Only a minority feel negatively with a mental patient around and close to 80% would socialize with them. More than 80% accept the need for psychiatric medication treatment but the opinion is split concerning compulsory treatment, and one-third consider medication to be harmful. Discussion: The results of this study suggest that most students believe they know much about mental illness; however, overall their responses are contradictory. They reply with confidence although they are informed mainly by the media and the Internet in an unreliable way. A number of factors including gender, specific school or personal experience of mental disorder in the family seem to influence the result. A combined educational plus contact might be necessary to reduce stigma, since education alone seems to exert a weak effect.

Objective: Acromegaly is a rare disorder caused by a growth hormone-secreting pituitary adenoma. Clinical trial evidence for its management is limited. This study compared medical treatments for acromegaly through a network meta-analysis, assessing biochemical and radiological responses. Design: A systematic review and network meta-analysis were conducted following the preferred reporting items for systematic reviews and network meta-analyses guidelines and Cochrane Handbook recommendations (PROSPERO registration: CRD42023364373). Methods: PubMed, Scopus and Web of Science were searched up to June 2024. Included studies were randomized controlled trials and non-randomized studies evaluating the efficacy or safety of acromegaly treatments. Primary outcomes were the percentage of adjusted insulin-like growth factor 1 (IGF-1) normalization and tumor shrinkage. Results: Twenty-seven studies, involving 4131 patients and 11 treatments were included. Pegvisomant was the best treatment for IGF-1 normalization, followed by pasireotide LAR. Both outperformed first-generation somatostatin analogs (SRLs) combined with dopamine agonists (OR 1.83; 95% CIs 1.37-2.46 and OR 1.46; 95% CIs 1.02-2.08, respectively; I2=41%). Octreotide LAR was superior to oral octreotide capsules (OR 5.41; 95% CIs 1.89-15.52). For tumor shrinkage, pasireotide LAR was more effective than SRLs (n=1059; OR 11.47; 95% CIs 1.5-87.64; I2=0%). Methodological heterogeneity may have affected comparability. Conclusions: Our findings suggest pasireotide LAR and pegvisomant as the most effective treatments for IGF-1 normalization. Pasireotide LAR was the best treatment for tumor shrinkage, though the evidence base was limited, requiring cautious interpretation. Their potential role as first-line options after surgery requires further research. Clinical decisions should consider cost, safety and patient-specific parameters to optimize outcomes.

Purpose: Aggressive pituitary tumours (APT) and pituitary carcinomas (PC) are rare pituitary neoplasms and occur more frequently in men. Corticotroph and lactotroph tumours represent the most frequent secreting subtypes, showing different sex-related distribution, clinical features, and behaviour compared with benign disease. This review evaluates whether these sex-related differences persist in APT/PC and their clinical and therapeutic implications. Methods: A literature review of case reports, series, and clinical studies, published between 2000 and October 2025, reporting sex-related data on corticotroph and lactotroph APT/PC, was conducted. Clinical presentation, pathological features, and outcomes were extracted and analysed by sex. Results: 93 corticotroph APT/PC (38 W, 55 M) and 80 lactotroph APT/PC (29 W, 51 M) were included. Among corticotroph APT/PC, men more commonly had non-functioning lesions (36.5%, vs. 17.6%), showed loss of hormonal secretion (7.7%, n = 4/52), and had invasive disease (100%, vs. 73.3%, p: 0.03). Women more frequently harboured Crooke’s cell tumours (26.3% vs. 5.5%, p: 0.006) and showed complete radiological responses (22.2%, vs. 9.1%). In lactotroph APT/PC, men had giant tumours (27.3%, vs. 5.0%), invasive disease (83.3%, vs. 63.6%), higher prolactin levels, and dopamine agonist resistance. Complete tumour responses to temozolomide occurred exclusively in women (22.7%, n = 5/22, p: 0.02), whereas partial durable responses predominated in men (46.2%, n = 18/39). Conclusion: Male sex is associated with higher prevalence and more aggressive disease, whereas women achieve more profound tumour and hormonal responses. Sex-specific stratification may support personalized management of these rare pituitary tumours.