Onset of Diabetes Pediatric Age and Comorbidly in the last 12 years and urgent Covid Vaccination in Sanitary Agency in Bergamo - Italy

Introduction Diabetes is a chronic disease as a result of absent or low intake in internal production of Insulin or glucose tolerance in a large diffusion population of 3.27 million people in Italy. 5,4 thousand of Italian people for ISTAT in a future prospective and there will be an increase in the next years for high increase risk of new cases every year until now. We have Diabetes typo II (T2DM, older in 90%), and Diabetes typo I (T1DM, younger in 10%), both are Prevent with Auxological Screening and early Intervention with Nutritional Applied Behavior Analysis (A.B.A.). An early diagnosis determines a survival of 5,000 patients for year. In our patients affects by T1DM, during pandemic of Coronavirus disease (SARS-CoV type 2 and variants), we have noted an increase of glycemia during respiratory infections with more comorbidities and complications for them. Clinical Study We study 181 patients who have accessed in Treviglio-Caravaggio Hospital in these years since 1/1/2009 to 1/6/2020. we have 181 records divided for sex: 104 males and 77 females. With follow-up for 55 patients with severe comorbidities and 4 were transferred to HUB Center for risk of coma in severe compliances and during Covid lock down 44 patients were suggested to take care in HUB center of Bergamo or Milan to prevent their hospitalizations in security environment. The children’s accesses affected by Diabetes type 1 was in our Emergency and Pediatric Department of Treviglio Hospital in the last 12 years, since 1 January 2009 to 1 June 2021, are 129 total patients and 52 new patients during Auxological-Nutritional Ambulatory for Pediatric T1DM outpatients before and during 2020-2021 controls of metabolic diet therapy in fellow-up, now, with cellphone and in Meet. Materials and Methods We have records data in excel and Pivot graphic and analysis in Anova Statics Program with follow-up of 181 patients divided in 2 period of age: preschooler 23, and scholar e adolescent 157. 125 patients are divided in 123 Diabetes Mellitus (with Italian code 775.1 e 250.1 national record), 2 MOBY cases and 57 patients with one or more comorbidly. From date of casehistory, we need now analysis 3 groups with outset of diabetes during 2 years of life of which 19.2% with comorbidity 21.6% with many comorbidities and cases of Insulin-dependent Diabetes after 2 years of life are 77,7%, with severe comorbidity in 24%. With comorbidity outset in the 39.2% and during follow-up in 42.4%. From report 21% patients have for the major part “Celiac Disease” and 6,4% other infections (Helicobacter Pylori and enteritis). Whereas 28% have metabolic-auxological endocrinological diseases (acute/chronic evolution during up-growth). Underweight young with T1DM (BMI < 15 Kg/m2) or obesity (BMI>35 Kg/m2) have a high risk to be infected and dead for COVID-19 owing to complications of their status of health. Conclusions Until 1/31/2018, we allow to do a distinction: the first since 2009-2014 within 20.6% early diagnosis and discovered in later age the second since 2014-2019 with more 38.4%. In the last years since 2019-2021 about, the early neonatal respect to mellitus DMT1 of last period, presents a predictive index of 55.5% with a better stature-ponderal development, neurological-behavior, and nutritional-compliance monitoring in 12 years of periodic controls. Since 11 March 2020 with WhatsApp, Hangouts and Meet or Skype, our data of SARS-CoV-19 infection in T1DM patients showed more than 65% positive patients by serological test after a period of suspect disease in 12 patients (6,6%) against a few symptoms in 107 patients (59,11%) with positive nasalpharyngeal test during quarantine or observation in a second lockdown, since September 2020 to May 2021.

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The nephropathy of non-insulin-dependent diabetes: predictors of outcome relative to diverse patterns of renal injury.

Journal of the American Society of Nephrology ◽

10.1681/asn.v9122336 ◽

1998 ◽

Vol 9 (12) ◽

pp. 2336-2343 ◽

Cited By ~ 2

Author(s):

P Ruggenenti ◽

V Gambara ◽

A Perna ◽

T Bertani ◽

G Remuzzi

Keyword(s):

Early Diagnosis ◽

Serum Creatinine ◽

Tissue Injury ◽

Excretion Rate ◽

Renal Tissue ◽

Urinary Protein Excretion ◽

Urinary Protein ◽

Protein Excretion ◽

Insulin Dependent

Nephropathy of non-insulin-dependent diabetes mellitus (NIDDM) is the most common cause of end-stage renal failure (ESRF) in Western countries. This study investigates the clinical and histologic putative predictors of disease progression, with the final goal to identify patients at risk who may benefit from early diagnosis and intervention. It examines by repeated measurements of BP, blood glucose, serum creatinine, and urinary protein excretion rate 65 consecutive NIDDM patients with clinical, persistent proteinuria and biopsy-documented typical diabetic glomerulopathy (class I; n = 30), predominant nephroangiosclerosis (class II; n = 23), or nondiabetic type glomerulopathy (class III; n = 12), whose severity of renal tissue involvement was precisely quantified by a global histologic score. Baseline parameters and progression to renal end points, i.e., doubling of baseline serum creatinine, dialysis, or transplantation, were univariately and multivariately correlated by proportional hazards regression models. The median kidney survival time in the overall study population was 3.07 yr. Thirty-seven percent of patients reached an end point during a median (range) follow-up of 1.8 yr (0.4 to 5.7 yr). By univariate and multivariate analysis, kidney survival significantly correlated with baseline urinary protein excretion rate (P = 0.04 and P = 0.04, respectively) and renal tissue injury score (P = 0.0001 and P = 0.02, respectively), but not with the histologic classes. Patients with a urinary protein excretion rate < or = 2 g/24 h, or > 2 g/24 h with a histologic score < 7, never reached an end point. All patients with urinary protein excretion > 2 g/24 h and a histologic score > 13 progressed to ESRF over a median of 1.6 yr. No differences in other baseline parameters or in BP and diabetes control during follow-up accounted for these different outcomes. In NIDDM as well as in nondiabetic chronic renal disease, quantification of urinary protein excretion rate--independent of the pattern of underlying glomerular involvement--reliably discriminates progressors from nonprogressors and, combined with precise quantification of renal tissue injury, reliably predicts risk of ESRF. This information may be used to set guidelines for early diagnosis and appropriate intervention to reduce the number of diabetic patients who will need renal replacement therapy in years to come.

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Postural Changes in Essential Hypertension under Treatment and their Effect on the Renogram

Nuklearmedizin ◽

10.1055/s-0038-1624732 ◽

1971 ◽

Vol 10 (01) ◽

pp. 39-46

Author(s):

C. Alexandrou ◽

E. Papadakis ◽

E. Gyftaki ◽

J. Darsinos

Keyword(s):

Renal Function ◽

Essential Hypertension ◽

Early Diagnosis ◽

Postural Hypotension ◽

Antihypertensive Treatment ◽

Normal Subjects ◽

Upright Position ◽

Postural Changes ◽

Significant Impairment

SummaryRadioisotope renograms were obtained in the upright and prone position in 9 normal subjects, in 5 patients with untreated essential hypertension and in 21 hypertensives under treatment, showing moderate postural hypotension.No significant renographic change were seen in the two positions in normal subjects and untreated hypertensives. Treated hypertensives with postural hypotension showed significant impairment of renal function in the upright position in 15 cases and no change in 6. Renal creatinine clearance was lower in the group that showed renographic changes. Renography in the upright position is suggested as a convenient test for early diagnosis and follow-up of the adverse effects of antihypertensive treatment.

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Follow-up Formula Consumption in 3- to 4-Year-Olds and Respiratory Infections: An RCT

PEDIATRICS ◽

10.1542/peds.2013-3598d ◽

2014 ◽

Vol 133 (6) ◽

pp. X19-X19

Keyword(s):

Respiratory Infections

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Macrolide-Resistant and Macrolide-Sensitive Mycoplasma pneumoniae Pneumonia in Children Treated Using Early Corticosteroids

Journal of Clinical Medicine ◽

10.3390/jcm10061309 ◽

2021 ◽

Vol 10 (6) ◽

pp. 1309

Author(s):

Hye Young Han ◽

Ki Cheol Park ◽

Eun-Ae Yang ◽

Kyung-Yil Lee

Keyword(s):

Mycoplasma Pneumoniae ◽

Serological Test ◽

Corticosteroid Treatment ◽

23S Rrna ◽

Laboratory Parameters ◽

The Mean ◽

Domain V ◽

Positive Results ◽

Mycoplasma Pneumoniae Pneumonia

We have found that early corticosteroid therapy was effective for reducing morbidity during five Korea-wide epidemics. We evaluated the clinical and laboratory parameters of 56 children who received early corticosteroid treatment for pneumonia that was caused by macrolide-resistant Mycoplasma pneumoniae (M. pneumoniae) or macrolide-sensitive M. pneumoniae between July 2019 and February 2020. All subjects had dual positive results from a PCR assay and serological test, and received corticosteroids within 24–36 h after admission. Point mutation of residues 2063, 2064, and 2067 was identified in domain V of 23S rRNA. The mean age was 6.8 years and the male:female ratio was 1.2:1 (31:25 patients). Most of the subjects had macrolide-resistant M. pneumoniae (73%), and all mutated strains had the A2063G transition. No significant differences in clinical and laboratory parameters were observed between macrolide-resistant and macrolide-sensitive M. pneumoniae groups that were treated with early dose-adjusted corticosteroids. Higher-dose steroid treatment may be needed for patients who have fever that persists for >48 h or increased biomarkers such as lactate dehydrogenase concentration at follow-up despite a usual dose of steroid therapy.

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The association between gastro-oesophageal reflux disease and subsequent rheumatoid arthritis occurrence: a nested case–control study from Taiwan

BMJ Open ◽

10.1136/bmjopen-2017-016667 ◽

2017 ◽

Vol 7 (11) ◽

pp. e016667 ◽

Cited By ~ 3

Author(s):

Herng-Ching Lin ◽

Sudha Xirasagar ◽

Cha-Ze Lee ◽

Chung-Chien Huang ◽

Chao-Hung Chen

Keyword(s):

Rheumatoid Arthritis ◽

Early Diagnosis ◽

Reflux Disease ◽

Treatment Guidelines ◽

Population Based ◽

Oesophageal Reflux ◽

Study Patient ◽

Oesophageal Reflux Disease ◽

Increased Risk

ObjectiveGastro-oesophageal reflux disease (GORD) is a common comorbidity among patients with rheumatoid arthritis (RA). While GORD has been attributed to the antirheumatic medications, no studies of human cohorts have investigated a link between GORD and RA. This study investigates whether GORD is associated with a subsequent RA diagnosis over a 5-year follow-up using a population-based dataset.SettingTaiwanParticipantsWe used data from the Taiwan Longitudinal Health Insurance Database. The study group consisted of 13 645 patients with an ambulatory claim showing a GORD diagnosis. We used propensity score matching to select 13 645 comparison patients (one per study patient with GORD).InterventionWe tracked each patient’s claims over a 5-year period to identify those who subsequently received a diagnosis of RA. Cox proportional hazard (PH) regression modelling was used for analysis.ResultsOver 5-year follow-up, RA incidence rate per 1000 person-years was 2.81 among patients with GORD and 0.84 among the comparison group. Cox PH modelling showed that GORD was independently associated with a 2.84-fold increased risk of RA (95% CI 2.09 to 3.85) over 5-year follow-up, after adjusting for the number of ambulatory care visits within the year following the index date (to mitigate surveillance bias).ConclusionsWe observed that GORD might associate with subsequent RA occurrence. Because current treatment guidelines for RA emphasise early diagnosis and prompt treatment, the observed association between GORD and RA may help acquaint clinicians to patients with GORD with higher RA risk and facilitate early diagnosis and treatment.

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Exposure to paternal tobacco smoking increased child hospitalization for lower respiratory infections but not for other diseases in Vietnam

Scientific Reports ◽

10.1038/srep45481 ◽

2017 ◽

Vol 7 (1) ◽

Cited By ~ 6

Author(s):

Reiko Miyahara ◽

Kensuke Takahashi ◽

Nguyen Thi Hien Anh ◽

Vu Dinh Thiem ◽

Motoi Suzuki ◽

...

Keyword(s):

Risk Factor ◽

Tobacco Smoking ◽

Respiratory Infections ◽

Disease Incidence ◽

Population Attributable Fraction ◽

Birth Cohort Study ◽

Effective Interventions ◽

Paternal Smoking ◽

Observation Period

Abstract Exposure to environmental tobacco smoke (ETS) is an important modifiable risk factor for child hospitalization, although its contribution is not well documented in countries where ETS due to maternal tobacco smoking is negligible. We conducted a birth cohort study of 1999 neonates between May 2009 and May 2010 in Nha Trang, Vietnam, to evaluate paternal tobacco smoking as a risk factor for infectious and non-infectious diseases. Hospitalizations during a 24-month observation period were identified using hospital records. The effect of paternal exposure during pregnancy and infancy on infectious disease incidence was evaluated using Poisson regression models. In total, 35.6% of 1624 children who attended follow-up visits required at least one hospitalization by 2 years of age, and the most common reason for hospitalization was lower respiratory tract infection (LRTI). Paternal tobacco smoking independently increased the risk of LRTI 1.76-fold (95% CI: 1.24–2.51) after adjusting for possible confounders but was not associated with any other cause of hospitalization. The population attributable fraction indicated that effective interventions to prevent paternal smoking in the presence of children would reduce LRTI-related hospitalizations by 14.8% in this epidemiological setting.

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Laryngeal cancer

InnovAiT Education and inspiration for general practice ◽

10.1177/17557380211010564 ◽

2021 ◽

pp. 175573802110105

Author(s):

Kelvin Miu

Keyword(s):

Head And Neck Cancer ◽

Early Diagnosis ◽

Head And Neck ◽

Patient Outcomes ◽

Laryngeal Cancer ◽

Neck Cancer ◽

Early Recognition ◽

Signs And Symptoms ◽

Diagnosis And Treatment

Laryngeal cancer is a common head and neck cancer and typically presents with voice hoarseness in patients older than 60 years. Early recognition of signs and symptoms of laryngeal cancer can lead to early diagnosis and treatment, therefore improving patient outcomes. This article aims to provide an overview of the anatomy of the larynx, presentation and management of laryngeal cancer, and common follow-up problems.

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ROHHAD(NET) Syndrome: Systematic Review of the Clinical Timeline and Recommendations for Diagnosis and Prognosis

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa247 ◽

2020 ◽

Vol 105 (7) ◽

pp. 2119-2131 ◽

Cited By ~ 1

Author(s):

Julie Harvengt ◽

Caroline Gernay ◽

Meriem Mastouri ◽

Nesrine Farhat ◽

Marie-Christine Lebrethon ◽

...

Keyword(s):

Systematic Review ◽

Early Diagnosis ◽

Individual Patient Data ◽

Psychiatric Symptoms ◽

Clinical Manifestations ◽

Rapid Onset ◽

Patient Data ◽

Autonomic Dysregulation ◽

Hypothalamic Dysfunction

Abstract Context Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, autonomic dysregulation and neural crest tumor (ROHHHAD[NET]) is a rare and potentially fatal disease. No specific diagnostic biomarker is currently available, making prompt diagnosis challenging. Since its first definition in 2007, a complete clinical analysis leading to specific diagnosis and follow-up recommendations is still missing. Objective The purpose of this work is to describe the clinical timeline of symptoms of ROHHAD(NET) and propose recommendations for diagnosis and follow-up. Design We conducted a systematic review of all ROHHAD(NET) case studies and report a new ROHHAD patient with early diagnosis and multidisciplinary care. Methods All the articles that meet the definition of ROHHAD(NET) and provide chronological clinical data were reviewed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis individual patient data guidelines. The data were grouped into 7 categories: hypothalamic dysfunction, autonomic dysregulation, hypoventilation, NET, psychiatric symptoms, other clinical manifestations, and outcome. Results Forty-three individual patient data descriptions were analyzed. The timeline of the disease shows rapid-onset obesity followed shortly by hypothalamic dysfunction. Dysautonomia was reported at a median age of 4.95 years and hypoventilation at 5.33 years, or 2.2 years after the initial obesity. A NET was reported in 56% of the patients, and 70% of these tumors were diagnosed within 2 years after initial weight gain. Conclusion Because early diagnosis improves the clinical management and the prognosis in ROHHAD(NET), this diagnosis should be considered for any child with rapid and early obesity. We propose guidance for systematic follow-up and advise multidisciplinary management with the aim of improving prognosis and life expectancy.

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