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Scavone M, Carboni E, Stefanelli E, Romano G, Vero A, Giancotti L, Miniero R, Talarico V. Prediction of Transient or Permanent Congenital Hypothyroidism from Initial Thyroid Stimulating Hormone Levels. Indian Pediatr 2018. [DOI: 10.1007/s13312-018-1442-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Scavone M, Carboni E, Stefanelli E, Romano G, Vero A, Giancotti L, Miniero R, Talarico V. Prediction of Transient or Permanent Congenital Hypothyroidism from Initial Thyroid Stimulating Hormone Levels. Indian Pediatr 2018; 55:1059-1061. [PMID: 30745478] [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: 06/09/2023]
Abstract
OBJECTIVE To identify factors that discriminate between transient and permanent congenital hypothyroidism. METHODS Retrospective evaluation of 58 children with congenital hypothyroidism and eutopic thyroid gland. Gender, gestational age, birth weight, TSH and serum thyroxine levels at diagnosis and L-thyroxine dose at 12 and 24 months of age were analyzed. RESULTS Median (IQR) initial TSH levels were 73.3 (276.5) µIU/mL in permanent hypothyroidism and 24.24 (52.7) µU/mL in transient hypothyroidism (P =0.0132). The optimum cut-off value of initial TSH to predict transient hypothyroidism was 90 µIU/mL. Mean (SD) L-thyroxine doses at 24 months of age were 2.64 (0.98) µg/kg/day in permanent hypothyroidism and 1.91 (0.65) µg/kg/day in transient hypothyroidism. Requirement of L-thyroxine dose at 24 months of ≤0.94 µg/kg/day had the highest sensitivity (100%) to predict transient hypothyroidism. CONCLUSIONS L-thyroxine doses at 24 months can predict transient hypothyroidism in patients with eutopic thyroid gland earlier than at 36 months.
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Affiliation(s)
- Maria Scavone
- Unit of Pediatrics, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Elena Carboni
- Unit of Pediatrics, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Ettore Stefanelli
- Unit of Pediatrics, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Giusy Romano
- Unit of Pediatrics, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Anna Vero
- Unit of Laboratory Medicine, Pugliese-Ciaccio Hospital; Catanzaro, Italy
| | - Laura Giancotti
- Unit of Pediatrics, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Roberto Miniero
- Unit of Pediatrics, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Valentina Talarico
- Unit of Pediatrics, Pugliese-Ciaccio Hospital; Catanzaro, Italy. Correspondence to: Valentina Talarico, Unit of Pediatrics, Pugliese-Ciaccio Hospital, Viale Pio X, 88100, Catanzaro, Italy.
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Chiefari E, Pastore I, Puccio L, Caroleo P, Oliverio R, Vero A, Foti DP, Vero R, Brunetti A. Impact of Seasonality on Gestational Diabetes Mellitus. Endocr Metab Immune Disord Drug Targets 2017; 17:246-252. [DOI: 10.2174/1871530317666170808155526] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 07/11/2017] [Accepted: 07/14/2017] [Indexed: 11/22/2022]
Affiliation(s)
- Eusebio Chiefari
- Department of Health Sciences, University Magna Graecia� of Catanzaro, Viale Europa (Localita Germaneto), 88100 Catanzaro, Italy
| | - Ida Pastore
- Department of Health Sciences, University Magna Graecia� of Catanzaro, Viale Europa (Localita Germaneto), 88100 Catanzaro, Italy
| | - Luigi Puccio
- Complex Operative Structure Endocrinology-Diabetology, Hospital Pugliese-Ciaccio, 88100 Catanzaro, Italy
| | - Patrizia Caroleo
- Complex Operative Structure Endocrinology-Diabetology, Hospital Pugliese-Ciaccio, 88100 Catanzaro, Italy
| | - Rosa Oliverio
- Complex Operative Structure Endocrinology-Diabetology, Hospital Pugliese-Ciaccio, 88100 Catanzaro, Italy
| | - Anna Vero
- Complex Operative Structure Endocrinology-Diabetology, Hospital Pugliese-Ciaccio, 88100 Catanzaro, Italy
| | - Daniela P. Foti
- Department of Health Sciences, University Magna Graecia� of Catanzaro, Viale Europa (Localita Germaneto), 88100 Catanzaro, Italy
| | - Raffaella Vero
- Complex Operative Structure Endocrinology-Diabetology, Hospital Pugliese-Ciaccio, 88100 Catanzaro, Italy
| | - Antonio Brunetti
- Department of Health Sciences, University Magna Graecia� of Catanzaro, Viale Europa (Localita Germaneto), 88100 Catanzaro, Italy
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Paleari R, Bonetti G, Callà C, Carta M, Ceriotti F, Di Gaetano N, Ferri M, Guerra E, Lavalle G, Cascio CL, Martino FG, Montagnana M, Moretti M, Santini G, Scribano D, Testa R, Vero A, Mosca A. Multicenter evaluation of an enzymatic method for glycated albumin. Clin Chim Acta 2017; 469:81-86. [PMID: 28365449 DOI: 10.1016/j.cca.2017.03.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 03/28/2017] [Indexed: 01/25/2023]
Abstract
BACKGROUND The use of glycated albumin (GA) has been proposed as an additional glycemic control marker particularly useful in intermediate-term monitoring and in situation when HbA1c test is not reliable. METHODS We have performed the first multicenter evaluation of the analytical performance of the enzymatic method quantILab Glycated Albumin assay implemented on the most widely used clinical chemistry analyzers (i.e. Abbott Architect C8000, Beckman Coulter AU 480 and 680, Roche Cobas C6000, Siemens ADVIA 2400 and 2400 XPT). RESULTS The repeatability of the GA measurement (expressed as CV, %) implemented in the participating centers ranged between 0.9% and 1.2%. The within-laboratory CVs ranged between 1.2% and 1.6%. A good alignment between laboratories was found, with correlation coefficients from 0.996 to 0.998. Linearity was confirmed in the range from 7.6 to 84.7%. CONCLUSION The new enzymatic method for glycated albumin evaluated by our investigation is suitable for clinical use.
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Affiliation(s)
- Renata Paleari
- Dip. di Fisiopatologia Medico-Chirurgica e dei Trapianti and Centro per la Riferibilità Metrologica in Medicina di Laboratorio (CIRME), Università degli Studi di Milano, Milano, Italy
| | - Graziella Bonetti
- Laboratorio Analisi Chimico Cliniche, ASST Spedali Civili, Brescia, Italy
| | - Cinzia Callà
- Polo Scienze delle Immagini, di Laboratorio ed Infettivologiche. Fondazione Policlinico Universitario A. Gemelli, Università Cattolica Sacro Cuore, Roma, Italy
| | | | - Ferruccio Ceriotti
- Central Laboratory, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Nicola Di Gaetano
- Instrumentation Laboratory - A Werfen Company, R&D Department, Milano, Italy
| | - Marilisa Ferri
- Laboratorio Analisi di Urbino, Azienda Sanitaria Unica Regione Marche Area Vasta 1, Fano, PU, Italy
| | - Elena Guerra
- Laboratorio di Standardizzazione, Servizio Medicina di Laboratorio, Ospedale S. Raffaele, Milano, Italy
| | | | - Claudia Lo Cascio
- UOC Laboratorio Analisi, Azienda Ospedaliera Universitaria Integrata Verona, Italy
| | | | - Martina Montagnana
- Sezione di Biochimica Clinica, Dip. di Neuroscienze, Biomedicina e Movimento, Università degli Studi di Verona, Verona, Italy
| | - Marco Moretti
- Patologia Clinica Azienda Ospedaliera Ospedali Riuniti Marche Nord Pesaro, Italy
| | - Gabriele Santini
- Instrumentation Laboratory - A Werfen Company, R&D Department, Milano, Italy
| | - Donata Scribano
- Polo Scienze delle Immagini, di Laboratorio ed Infettivologiche. Fondazione Policlinico Universitario A. Gemelli, Università Cattolica Sacro Cuore, Roma, Italy
| | - Roberto Testa
- Modelli di Integrazione Multidisciplinare in Patologia Clinica, INRCA-IRCCS, Ancona, Italy
| | - Anna Vero
- Laboratorio di Analisi Chimico-Clinica, Azienda Ospedaliera Pugliese Ciaccio, Catanzaro, Italy
| | - Andrea Mosca
- Dip. di Fisiopatologia Medico-Chirurgica e dei Trapianti and Centro per la Riferibilità Metrologica in Medicina di Laboratorio (CIRME), Università degli Studi di Milano, Milano, Italy.
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Capula C, Chiefari E, Borelli M, Oliverio R, Vero A, Foti D, Puccio L, Vero R, Brunetti A. A new predictive tool for the early risk assessment of gestational diabetes mellitus. Prim Care Diabetes 2016; 10:315-323. [PMID: 27268754 DOI: 10.1016/j.pcd.2016.05.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 02/08/2016] [Revised: 05/06/2016] [Accepted: 05/13/2016] [Indexed: 10/21/2022]
Abstract
AIMS The Italian National Institute of Health has recently introduced a selective screening based on the risk profile of pregnant women, which while recommending against screening of women at low risk (LR) for GDM, it recommends an early test for women at high risk (HR) for GDM. Herein, we assessed the accuracy and cost-effectiveness of this screening and developed a new index that improves these requirements. METHODS We retrospectively enrolled 3974 pregnant women. GDM was diagnosed with a 2h 75-g OGTT at 16-18 weeks (early test) or 24-28 weeks of gestation, according to the IADPSG guidelines. RESULTS 55.6% of HR women had GDM, although only 38.4% underwent early screening. Among 2654 women at medium risk, 20.9% had GDM; paradoxically, among 770 LR women, that would not have been screened, 26.6% received a GDM diagnosis. Based on these unsatisfactory results, we elaborated the Capula's index, that reduced both screening tests (p<0.001) and potentially undetected GDM cases (p<0.001), and corrected the paradoxical prevalence estimates of GDM obtained with the current Italian guidelines. Also, Capula's index improved correlation of GDM risk profile with obstetric and neonatal adverse events. CONCLUSIONS Capula's index improves accuracy of selective screening for GDM.
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Affiliation(s)
- Carmelo Capula
- Operative Unit of Endocrinology and Diabetes, Hospital Pugliese-Ciaccio, 88100 Catanzaro, Italy
| | - Eusebio Chiefari
- Department of Health Sciences, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy
| | - Massimo Borelli
- Department of Life Sciences, University of Trieste, 34127 Trieste, Italy
| | - Rosa Oliverio
- Operative Unit of Endocrinology and Diabetes, Hospital Pugliese-Ciaccio, 88100 Catanzaro, Italy
| | - Anna Vero
- Operative Unit of Endocrinology and Diabetes, Hospital Pugliese-Ciaccio, 88100 Catanzaro, Italy
| | - Daniela Foti
- Department of Health Sciences, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy
| | - Luigi Puccio
- Operative Unit of Endocrinology and Diabetes, Hospital Pugliese-Ciaccio, 88100 Catanzaro, Italy
| | - Raffaella Vero
- Operative Unit of Endocrinology and Diabetes, Hospital Pugliese-Ciaccio, 88100 Catanzaro, Italy
| | - Antonio Brunetti
- Department of Health Sciences, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy.
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Capula C, Chiefari E, Vero A, Foti DP, Brunetti A, Vero R. Prevalence and predictors of postpartum glucose intolerance in Italian women with gestational diabetes mellitus. Diabetes Res Clin Pract 2014; 105:223-30. [PMID: 24931701 DOI: 10.1016/j.diabres.2014.05.008] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [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: 10/24/2013] [Revised: 04/25/2014] [Accepted: 05/18/2014] [Indexed: 02/07/2023]
Abstract
AIMS To determine the prevalence of both prediabetes and type 2 diabetes mellitus (T2DM) by postpartum oral glucose tolerance test (ppOGTT) in Italian women diagnosed with gestational diabetes mellitus (GDM), and identify antepartum predictors of glucose intolerance. METHODS Retrospective study of 454 Caucasian women that underwent a 75g OGTT between 6 and 12 weeks postpartum in Calabria (Southern Italy) between 2004 and 2012. Prediabetes and T2DM were diagnosed according to the American Diabetes Association (ADA) criteria. Data were examined by univariate analysis and multiple regression analysis. RESULTS 290 women (63.9%) were normal, 146 (32.1%) had prediabetes (85 impaired fasting glycemia; 61 impaired glucose tolerance), and 18 (4.0%) had T2DM. Of the continuous variables, pre-pregnancy body mass index (BMI), age at pregnancy, fasting plasma glucose (FPG) at gravid OGTT, and week at diagnosis of GDM were associated with prediabetes and T2DM, whereas the parity was associated with T2DM only. For categorical traits, pre-pregnancy BMI ≥ 25 and previous diagnosis of polycystic ovary syndrome (PCOS) emerged as the strongest predictors of prediabetes whereas the strongest predictors of T2DM were FPG ≥ 100 mg/dl (5.6 mmol/l) at GDM diagnosis and pre-pregnancy BMI ≥ 25. Moreover, FPG at GDM screening was a good predictor of T2DM after receiver-operating-characteristic analysis. CONCLUSIONS Our findings confirm the high prevalence of glucose intolerance in the early postpartum period in women with previous GDM. PCOS emerges as a new strong antepartum predictor of prediabetes.
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Affiliation(s)
- Carmelo Capula
- Complex Operative Structure of Endocrinology-Diabetology, Pugliese-Ciaccio Hospital, 88100 Catanzaro, Italy
| | - Eusebio Chiefari
- Department of Health Sciences, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy
| | - Anna Vero
- Complex Operative Structure of Endocrinology-Diabetology, Pugliese-Ciaccio Hospital, 88100 Catanzaro, Italy
| | - Daniela P Foti
- Department of Health Sciences, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy
| | - Antonio Brunetti
- Department of Health Sciences, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy.
| | - Raffaella Vero
- Complex Operative Structure of Endocrinology-Diabetology, Pugliese-Ciaccio Hospital, 88100 Catanzaro, Italy
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Capula C, Chiefari E, Vero A, Arcidiacono B, Iiritano S, Puccio L, Pullano V, Foti DP, Brunetti A, Vero R. Gestational diabetes mellitus: screening and outcomes in southern italian pregnant women. ISRN Endocrinol 2013; 2013:387495. [PMID: 24093064 PMCID: PMC3777200 DOI: 10.1155/2013/387495] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 08/04/2013] [Indexed: 12/11/2022]
Abstract
Recent Italian guidelines exclude women <35 years old, without risk factors for gestational diabetes mellitus (GDM), from screening for GDM. To determine the effectiveness of these measures with respect to the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria, we evaluated 2,448 pregnant women retrospectively enrolled in Calabria, southern Italy. GDM was diagnosed following the IADPSG 2010 criteria. Among 538 women <35 years old, without risk factors, who would have not been tested according to the Italian guidelines, we diagnosed GDM in 171 (31.8%) pregnants (7.0% of total pregnants). Diagnosis was made at baseline (55.6%), 1 hour (39.8%), or 2 hours (4.7%) during OGTT. Despite of appropriate treatment, GDM represented a risk factor for cesarean section, polyhydramnios, increased birth weight, admission to neonatal intensive care units, and large for gestational age. These outcomes were similar to those observed in GDM women at high risk for GDM. In conclusion, Italian recommendations failed to identify 7.0% of women with GDM, when compared to IADPSG criteria. The risk for adverse hyperglycaemic-related outcomes is similar in low-risk and high-risk pregnants with GDM. To limit costs of GDM screening, our data suggest to restrict OGTT to two steps (baseline and 1 hour).
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Affiliation(s)
- Carmelo Capula
- Complex Operative Structure Endocrinology-Diabetology, Pugliese-Ciaccio Hospital, 88100 Catanzaro, Italy
| | - Eusebio Chiefari
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, Viale Europa (Località Germaneto), 88100 Catanzaro, Italy
| | - Anna Vero
- Complex Operative Structure Endocrinology-Diabetology, Pugliese-Ciaccio Hospital, 88100 Catanzaro, Italy
| | - Biagio Arcidiacono
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, Viale Europa (Località Germaneto), 88100 Catanzaro, Italy
| | - Stefania Iiritano
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, Viale Europa (Località Germaneto), 88100 Catanzaro, Italy
| | - Luigi Puccio
- Complex Operative Structure Endocrinology-Diabetology, Pugliese-Ciaccio Hospital, 88100 Catanzaro, Italy
| | - Vittorio Pullano
- Complex Operative Structure Endocrinology-Diabetology, Pugliese-Ciaccio Hospital, 88100 Catanzaro, Italy
| | - Daniela P. Foti
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, Viale Europa (Località Germaneto), 88100 Catanzaro, Italy
| | - Antonio Brunetti
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, Viale Europa (Località Germaneto), 88100 Catanzaro, Italy
| | - Raffaella Vero
- Complex Operative Structure Endocrinology-Diabetology, Pugliese-Ciaccio Hospital, 88100 Catanzaro, Italy
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Vero A, Bessonart L, Barbiel A, Ferla M, Margolis A. Health Information Systems Training for a Countrywide Implementation in Uruguay. Yearb Med Inform 2009. [DOI: 10.1055/s-0038-1638655] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Summary
Objectives Health Information systems training is one of the bottlenecks in clinical systems implementation. In this article, a strategy to massively create and train interdisciplinary coordinating teams is described for a project in Uruguay at FEMI, a non-academic setting which includes 23 health care institutions across the country and a tertiary referral center in Montevideo.
Methods A series of educational activities were designed for the local coordinating teams. They included both onsite and online formats, site visits, integrated with some of the project tasks.
Results In total, 128 professionals from all the Institutions participated in one or more of the training sessions (onsite and online) and 87 of them accomplished one of the forms of training.
Conclusions Massive basic health informatics training was possible in Uruguay through collaboration with academic institutions at the country and regional level. Next steps include an active involvement of nurses in the educational events and planning of massive training of end users.
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Margolis A, Vero A, Bessonart L, Barbiel A, Ferla M. Health information systems training for a countrywide implementation in Uruguay. Yearb Med Inform 2009:153-157. [PMID: 19855889] [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: 05/28/2023] Open
Abstract
OBJECTIVES Health Information systems training is one of the bottlenecks in clinical systems implementation. In this article, a strategy to massively create and train interdisciplinary coordinating teams is described for a project in Uruguay at FEMI, a non-academic setting which includes 23 health care institutions across the country and a tertiary referral center in Montevideo. METHODS A series of educational activities were designed for the local coordinating teams. They included both onsite and online formats, site visits, integrated with some of the project tasks. RESULTS In total, 128 professionals from all the Institutions participated in one or more of the training sessions (onsite and online) and 87 of them accomplished one of the forms of training. CONCLUSIONS Massive basic health informatics training was possible in Uruguay through collaboration with academic institutions at the country and regional level. Next steps include an active involvement of nurses in the educational events and planning of massive training of end users.
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Affiliation(s)
- A Margolis
- Federación Médica del Interior, Cufré 1781, Montevideo Uruguay CP 11200.
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