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Pintaudi B, Gironi I, Disoteo O, Meneghini E, Mion E, Massimiliano Epis O, Bertuzzi F. The effectiveness of a televisit service for people with type 1 diabetes: An observational, retrospective, single center, one year follow-up study. Diabetes Res Clin Pract 2022; 189:109960. [PMID: 35709912 DOI: 10.1016/j.diabres.2022.109960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/03/2022] [Accepted: 06/10/2022] [Indexed: 11/30/2022]
Abstract
The use of a televisit service complying with efficiency and safety regulatory parameters was effective in significantly improving HbA1c levels of people with T1D after a one-year follow-up period. No acute diabetes-related complications occurred. Patients were highly satisfied with the service. Televisit is a valid option for diabetes management.
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Affiliation(s)
| | - Ilaria Gironi
- Diabetes Unit, Niguarda Ca Granda Hospital, Milan, Italy
| | - Olga Disoteo
- Diabetes Unit, Niguarda Ca Granda Hospital, Milan, Italy
| | | | - Elen Mion
- Diabetes Unit, Niguarda Ca Granda Hospital, Milan, Italy
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Viano F, Terranova C, Ricciardi S, Mion E, Gianesini R, Faccin S, Giachetti M, Masciavè M, De Santis L. Thyroid surgery in an elderly population. BMC Geriatr 2010. [PMCID: PMC3290179 DOI: 10.1186/1471-2318-10-s1-a37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Antonelli G, Gianesini R, Mion E, Terranova C, De Santis L. Laparoscopic splenectomy in an elderly patient with splenic limphoma and splenomegaly. BMC Geriatr 2010. [PMCID: PMC3290160 DOI: 10.1186/1471-2318-10-s1-a2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Mion E, Viano F, Terranova C, Ricciardi S, Gianesini R, Faccin S, De Santis L. Intestinal preparation for elective laparoscopic colorectal surgery in elderly patients. BMC Geriatr 2010. [PMCID: PMC3290155 DOI: 10.1186/1471-2318-10-s1-a15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Ricciardi S, Terranova C, Gianesini R, Mion E, Viano F, Faccin L, De Santis L. Sentinel lymph node biopsy in elderly breast cancer. BMC Geriatr 2010. [PMCID: PMC3290170 DOI: 10.1186/1471-2318-10-s1-a29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Mainente P, Gianesini R, Faccin S, Ricciardi S, Mion E, Antonelli G, De Santis L. Melanoma in the elderly and sentinel lymph node biopsy: a single center experience of 124 consecutive patients. BMC Geriatr 2009. [PMCID: PMC4290855 DOI: 10.1186/1471-2318-9-s1-a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Ricciardi S, Gianesini R, Mion E, Mainente P, Faccin S, De Santis L. Giant paraesophageal hernia in an elderly woman: laparoscopic fundoplication and mesh in the hiatus. BMC Geriatr 2009. [PMCID: PMC4290870 DOI: 10.1186/1471-2318-9-s1-a37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Ricciardi S, Giansini R, Mion E, Mainente P, Faccin S, De Santis L. Laparoscopic treatment of giant solitary hepatic cyst in a geriatric patient. BMC Geriatr 2009. [PMCID: PMC4290884 DOI: 10.1186/1471-2318-9-s1-a45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lapolla A, Dalfrà MG, Bonomo M, Castiglioni MT, Di Cianni G, Masin M, Mion E, Paleari R, Schievano C, Songini M, Tocco G, Volpe L, Mosca A. Can plasma glucose and HbA1c predict fetal growth in mothers with different glucose tolerance levels? Diabetes Res Clin Pract 2007; 77:465-70. [PMID: 17350135 DOI: 10.1016/j.diabres.2007.01.022] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2006] [Accepted: 01/24/2007] [Indexed: 02/05/2023]
Abstract
To assess whether HbA1c and plasma glucose predicts abnormal fetal growth, 758 pregnant women attending 5 Diabetic Centers were screened for gestational diabetes mellitus (GDM). On glucose challenge (GCT) at 24-27 weeks of gestation (g.w.), negative cases formed the normal control group (N1). Positive cases took an oral glucose tolerance test (OGTT): those found negative were classed as false positives screening test (N2); if they had an OGTT result at least as high as their normal glucose levels, they were classed as having one abnormal glucose value (OAV) at OGTT; two values as GDM. HbA1c was assayed on the day of GCT. We considered fetal macrosomia, large for gestational age (LGA), ponderal index and mean growth percentile. Mean age, pre-pregnancy BMI, fasting plasma glucose (FPG) and HbA1c were progressively higher from N1 to GDM patients. The newborn of N2 mothers were heavier than those with N1 or GDM. The mean growth percentile was significantly higher in N2 than in N1. More LGA babies were born to OAV than to N1 or N2 women. Macrosomia and ponderal index did not differ significantly in the four groups. At logistic regression only plasma glucose at GCT could predict LGA babies and a ponderal index above 2.85. At risk analysis, GDM and OAV significantly predicted LGA babies, and GDM a ponderal index >2.85. In conclusion, FPG at GCT could predict fetal overgrowth and plasma glucose >85mg/dl doubles the risk of LGA infants. HbA1c at 24-27g.w. does not predict fetal overgrowth. Mild alterations in glucose tolerance correlate with fetal overgrowth and needs monitoring and treatment.
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Affiliation(s)
- A Lapolla
- Dipartimento di Scienze Mediche e Chirurgiche-Cattedra di Malattie del Metabolismo, Università di Padova, Via Giustinuani n. 2, 35100 Padua, Italy.
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Bonomo M, Corica D, Mion E, Gonçalves D, Motta G, Merati R, Ragusa A, Morabito A. Evaluating the therapeutic approach in pregnancies complicated by borderline glucose intolerance: a randomized clinical trial. Diabet Med 2005; 22:1536-41. [PMID: 16241919 DOI: 10.1111/j.1464-5491.2005.01690.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS Most studies relating minor gestational metabolic alterations to macrosomia refer to glucose intolerance classified on the basis of the National Diabetes Data Group or previous World Health Organization diagnostic thresholds. Our aim was to evaluate the consequences of very mild forms of gestational glucose intolerance, defined by an elevated 50-g glucose challenge test followed by a normal oral glucose tolerance test, using the more restrictive Carpenter and Coustan's criteria (Borderline Gestational Glucose Intolerance, BGGI). METHODS Three hundred BGGI women were randomly assigned to: Group A (standard management), Group B (dietary treatment and regular monitoring). A control group (C) was also considered. Newborns were classified as macrosomic, large (LGA), or small for gestational age (SGA). RESULTS The three groups were similar in age, body mass index and parity. Therapy in Group B significantly improved fasting (from 4.68 +/- 0.45 to 4.28 +/- 0.45 mmol/l) and 2-h postprandial glycaemia (from 6.01 +/- 0.57 to 5.13 +/- 0.68 mmol/l). Fasting glycaemia at delivery was significantly lower in B (4.20 +/- 0.38 mmol/l) than in A (4.84 +/- 0.45 mmol/l), and was also lower than in C (4.31 +/- 0.39 mmol/l). Significantly fewer LGA babies were born to Group B (6.0%) than Group A (14.0%) and Group C (9.1%). No difference was found in the SGA rate. The neonatal Ponderal Index was higher (P = 0.030) in group A (2.73 +/- 0.35) than in C (2.64 +/- 0.30) and B (2.64 +/- 0.24). CONCLUSIONS Even very mild alterations in glucose tolerance can result in excessive or disharmonious fetal growth, which may be prevented by simple, non-invasive therapeutic measures.
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Affiliation(s)
- M Bonomo
- Department of Obstetrics and Gynaecology, Niguarda Ca'Granda Hospital, Piazza Ospedale Maggiore 3, 201621 Milan, Italy.
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Bonomo M, Cetin I, Pisoni MP, Faden D, Mion E, Taricco E, Nobile de Santis M, Radaelli T, Motta G, Costa M, Solerte L, Morabito A. Flexible treatment of Gestational Diabetes modulated on ultrasound evaluation of intrauterine growth: a controlled randomized clinical trial. Diabetes & Metabolism 2004; 30:237-44. [PMID: 15223975 DOI: 10.1016/s1262-3636(07)70114-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES In order to prevent abnormalities of fetal growth still characterizing pregnancies complicated by Gestational Diabetes (GDM), in the present study we evaluated a therapeutic strategy for GDM based on ultrasound (US) measurement of fetal insulin-sensitive tissues. METHODS All GDM women diagnosed before 28th week immediately started diet and self-monitoring of blood glucose; after 2 weeks they were randomized to conventional (C) or modified (M) management. In C the glycemic target (GT) was fixed at 90 fasting/120 post-prandial mg/dl; in M GT varied, according to US measurement of the Abdominal Circumference (AC) centile performed every 2 weeks: 80/100 if AC > or =75th, 100/140 if AC<75th. Therapy was tailored to mean fasting (FG) and postprandial glycemia (PPG). RESULTS Globally, 229 women completed the study, 78 in C, 151 in M. Use of insulin was 16.7% in C, 30.4% in M (total groups), significantly more frequent in M than in C (59.7% vs 15.4%) when considering only women with AC > or =75th c. Mean metabolic data were similar in the 2 groups, but in M a tightly-optimized subgroup, resulting from the lowering of GT due to AC > or =75th, coexisted with a less-controlled one, whose higher GT was justified by AC<75th. Pregnancy outcome was better in M, with lower (p<0.05*) rate of LGA* (7.9% vs 17.9%), SGA (6.0% vs 9.0%) and Macrosomia* (3.3% vs 11.5%). CONCLUSIONS Our data show the value of a flexible US-based approach to the treatment of GDM. This model does not necessarily involve a generalized aggressive treatment, allowing to concentrate therapeutical efforts on a small subgroup of women showing indirect US evidence of fetal hyperinsulinization. Such a selective approach allowed to obtain a near-normalization of fetal growth, with clear advantages on global pregnancy outcome.
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Affiliation(s)
- M Bonomo
- Diabetes Unit, Interdisciplinary Diabetes and Pregnancy Center, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy.
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Ballotta E, Mion E, Bardini R. Right-sided aortic arch and aberrant left subclavian artery. J Cardiovasc Surg (Torino) 2003; 44:783-4. [PMID: 14994749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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Ballotta E, Da Giau G, Abbruzzese E, Mion E, Manara R, Baracchini C. Subclavian carotid transposition for symptomatic subclavian artery stenosis or occlusion. A comparison with the endovascular procedure. INT ANGIOL 2002; 21:138-44. [PMID: 12110774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND Although subclavian-carotid transposition (SCT), among all extrathoracic revascularization procedures, has emerged as the treatment of choice for symptomatic subclavian artery (SA) stenosis or occlusion, some authors advocate percutaneous transluminal angioplasty with stenting as the optimum primary therapy. AIM to assess safety, efficacy and durability of SCT in the treatment of symptomatic SA stenosis or occlusion. METHODS DESIGN review of a prospectively maintained vascular surgical registry. SETTING University vascular surgical service. PATIENTS 39 patients requiring surgery for symptomatic stenosis or occlusion of the proximal SA from September 1985 to August 1999. INTERVENTION SCT. MEASURES data were collected prospectively from hospital charts and office medical records to determine demographics, risk factors, presenting clinical manifestation, blood pressure differentials, location of the SA lesion and early postoperative outcome. Long-term follow-up was available in all patients. Patency of the revascularization was determined by physical examination and non-invasive laboratory studies. RESULTS The perioperative mortality and morbidity rates were 2.5% (1 of 39) and 2.5% (1 of 39), respectively. Immediate relief of symptoms was achieved in 100% of cases. Mean follow-up was 6.8 years. Revascularization neither failed during the follow-up period, nor did patients have recurrent symptoms. The overall survival rates at 1, 3, 5 and 10 years were 100%, 100%, 86% and 68%. Overall late mortality rate was 18.4%: no death was stroke related. CONCLUSIONS SCT is a very safe and effective surgical procedure for the treatment of symptomatic SA atherosclerotic disease, ensuring an excellent long-term patency.
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Affiliation(s)
- E Ballotta
- Service of Vascular Surgery, Department of Medical and Surgical Sciences, University of Padua, School of Medicine, Padua, Italy.
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Ballotta E, Merenda R, Mion E, Da Giau G. Abdominal aortic aneurysm in liver transplant recipients. Langenbecks Arch Surg 2001; 386:426-9. [PMID: 11735015 DOI: 10.1007/s004230100247] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2001] [Accepted: 01/26/2001] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND AIMS To analyze the incidence, clinical features, expansion rate of, and clinical approach to abdominal aortic aneurysm in patients who had undergone orthotopic liver transplantation. To our knowledge, this is the first report on this issue in liver transplant recipients. PATIENTS/METHODS Among 172 patients undergoing 185 liver transplantations at our institution over the last 10-year period, we identified three patients (1.7%) with infrarenal aortic aneurysm. They had all undergone routine pre-liver transplant ultrasonography screening for aortic aneurysm. RESULTS All three patients were symptom free at the time of the discovery of a mild infrarenal abdominal enlargement before ( n=2) and after liver transplantation ( n=1), and were closely monitored by ultrasonography in the follow-up period (3.1-4.3 years). The mean aneurysm expansion rate was 0.73 cm/year. All patients underwent aneurysm repair after their aneurysm expanded significantly under observation, with a mean diameter of 5.1 cm at the time of repair. All three patients are alive and well (median follow-up: 19 months). CONCLUSIONS Our data suggest that careful ultrasonographic surveillance is warranted in any liver transplant recipient, because of the apparent propensity for a more rapid aneurysm expansion and potentially aggressive course than in the untransplanted population. Early repair of the infrarenal aneurysm is recommended in transplant recipients, given that excellent perioperative and late outcomes can be achieved.
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Affiliation(s)
- E Ballotta
- Section of Vascular Surgery, Department of Medical and Surgical Sciences, University of Padua, School of Medicine, Policlinico Universitario,Via N. Giustiniani, 2, 35128, Padova, Italy.
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Bonomo M, Gandini ML, Farina A, Bonfadini E, Pisoni MP, Prudenziati A, Mion E, Greco P. Should we treat minor degrees of glucose intolerance in pregnancy? Ann Ist Super Sanita 1998; 33:393-7. [PMID: 9542269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We examined the pregnancy outcome of 112 women classified as minor degrees of glucose intolerance (MDGI) in pregnancy in a screening program based on Carpenter and Coustan's criteria. The MDGI group comprised 49 women with abnormal oral glucose challenge test (OGCT) followed by normal OGTT (group A), and 63 with "borderline" OGTT (1 abnormal value, group B). No treatment was offered to 88 MDGI women, while 26 received dietary advice and metabolic monitoring. A control group was constituted from 112 age- and BMI-matched negative screenees. Similar rates of cesarean sections and macrosomia, but higher rate of large for gestational age (LGA) babies (25.9% vs 14.3%) were found in MDGI, without difference between groups A and B. When comparing treated and untreated MDGI, lower LGA incidence (11.5% vs 30.2%) and no macrosomia were found in the former. In conclusion, untreated MDGI may present excessive fetal growth, which can be normalized by dietary treatment and metabolic monitoring.
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Affiliation(s)
- M Bonomo
- Centro di Diabetologia e Malattie Metaboliche, Ospedale Niguarda Ca' Granda, Milan, Italy
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