المؤلفون: Stefano Tumini, Laura Comegna, Elisabetta Fioretti, Paola Guidone, Gabriella Levantini, Daniele Panichi, Milena Catenaro, Ilaria Rossi, Flavia Amaro, Giusi Graziano, Maria Chiara Rossi, Paola Cipriano

المصدر: Pediatric Reports, Vol 12, Iss 1 (2020)

مصطلحات موضوعية: Type 1 diabetes, pediatric diabetes, diabetes camp, degludec, glargine, insulin analogues, continuous subcutaneous insulin infusion, Medicine, Pediatrics, RJ1-570

الوصف: Outcomes of insulin analogues in pediatric diabetes camps are poorly investigated; no data is available about insulin degludec (IDeg).Our aim was to assess impact of insulin therapy adopted by the participants to a 4-day diabetes camp held in 2017, hypothesizing a possible excess risk of hypoglycemia in patients treated with IDeg. Overall, 40 children with type 1 diabetes (mean age 13.4±3.0 years; 62.5% males) attended the camp (20.0% on continuous subcutaneous insulin infusion and 80.0% on multiple daily injections - MDI). Among children in MDI regimen, 71.9% were treated with IDeg as basal insulin and 28.1% with glargine U100 (IGlar). All patients used Lispro or Aspart as short-acting insulin. Daily plan of the camp included educational sessions, physical exercise, 3 main meals and 2 snacks. At the arrival, IGlar and short-acting insulin doses were revised according to existing guidelines, while IDeg dose was revised based on an empirical individualized approach. At the arrival, insulin doses were reduced in 22 participants (-19.4±10.5%), while doses were increased in 17 children (+17.8±12.7%), based on individual needs. No statistically significant between-group difference emerged in mean blood glucose and glucose variability. No excess risk of hypoglycemia was found in the IDeg group. The study suggests similar effectiveness and safety of different insulin schemes when associated with appropriate diabetes education and management, and flexible dose adjustments. Despite its longer halflife and the lack of a validated algorithm, IDeg was not associated with an excess risk of hypoglycemia.

وصف الملف: electronic resource

العلاقة: https://www.pagepress.org/journals/index.php/pr/article/view/8254Test; https://doaj.org/toc/2036-749XTest; https://doaj.org/toc/2036-7503Test

الوصول الحر: https://doaj.org/article/b726160fbb0043b88134dbd0f88837b9Test

المؤلفون: Stefano Tumini, Olimpia Iacono, Laura Comegna, Elisabetta Fioretti, Paola Guidone, Gabriella Levantini, Daniele Panichi, Milena Catenaro, Ilaria Rossi, Flavia Amaro, Giusi Graziano, Maria Chiara Rossi, Paola Cipriano

المصدر: Endocrinology, Diabetes & Metabolism, Vol 3, Iss 2, Pp n/a-n/a (2020)

مصطلحات موضوعية: carbohydrates, continuous subcutaneous insulin infusion, degludec, glargine, insulin analogues, paediatric diabetes, Diseases of the endocrine glands. Clinical endocrinology, RC648-665

الوصف: Abstract Background No data exist about the changes induced by the transition from first‐generation long‐acting insulins to second‐generation long‐acting analogues in the paediatric population. Objective To assess changes in insulin/carbohydrate ratio (I:CHO) after the first 6 months of degludec therapy in a paediatric population with type 1 diabetes previously treated with glargine U100. Subjects All patients treated with degludec under routine clinical practice conditions were retrospectively analysed. Methods Nonprofit observational retrospective study. Changes during the follow‐up in mean CHO/I ratio were assessed using longitudinal linear models for repeated measures. Rate of hypoglycaemia, ketoacidosis and adverse events was evaluated. Results Overall, 51 children (mean age 13.8 ± 4.6 years; mean diabetes duration 5.8 ± 3.9 years) started therapy with degludec in the period between April 2017 and April 2018. I:CHO ratio before starting degludec therapy significantly differed among the three meals, being the lowest at breakfast and the highest at dinner. After introducing degludec, I:CHO ratio at lunch (−1.29 95% CI −2.02;−0.57) and at dinner (−3.08 95% CI −4.35;−1.8) significantly decreased, while it slightly increased at breakfast (+1.37 95% CI 0.47;2.28). No episodes of severe hypoglycaemia, ketoacidosis and adverse event were recorded during 6 months. Conclusions Our data show that the use of degludec is associated with a significant change in the I:CHO ratio at the different meals compared to the previous glargine therapy. This could derive from the flat and prolonged pharmacokinetic profile of degludec. This has important clinical implications for daily insulin dose adjustments.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2398-9238Test

الوصول الحر: https://doaj.org/article/9163e7e66ae7473ea55778642c5f428fTest

المؤلفون: Gabriella Levantini, Maria Chiara Rossi, Ilaria Rossi, Milena Catenaro, Daniele Panichi, Flavia Amaro, Elisabetta Fioretti, Paola Guidone, Laura Comegna, Paola Cipriano, Olimpia Iacono, Giusi Graziano, Stefano Tumini

المصدر: Endocrinology, Diabetes & Metabolism, Vol 3, Iss 2, Pp n/a-n/a (2020)
Endocrinology, Diabetes & Metabolism

مصطلحات موضوعية: Insulin degludec, Pediatrics, medicine.medical_specialty, type 1 diabetes, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, insulin analogues, carbohydrates, paediatric diabetes, lcsh:Diseases of the endocrine glands. Clinical endocrinology, glargine, Medicine, Adverse effect, Type 1 diabetes, lcsh:RC648-665, continuous subcutaneous insulin infusion, business.industry, Insulin glargine, Insulin, Repeated measures design, Retrospective cohort study, Original Articles, medicine.disease, Ketoacidosis, Original Article, degludec, business, medicine.drug

الوصف: Background No data exist about the changes induced by the transition from first‐generation long‐acting insulins to second‐generation long‐acting analogues in the paediatric population. Objective To assess changes in insulin/carbohydrate ratio (I:CHO) after the first 6 months of degludec therapy in a paediatric population with type 1 diabetes previously treated with glargine U100. Subjects All patients treated with degludec under routine clinical practice conditions were retrospectively analysed. Methods Nonprofit observational retrospective study. Changes during the follow‐up in mean CHO/I ratio were assessed using longitudinal linear models for repeated measures. Rate of hypoglycaemia, ketoacidosis and adverse events was evaluated. Results Overall, 51 children (mean age 13.8 ± 4.6 years; mean diabetes duration 5.8 ± 3.9 years) started therapy with degludec in the period between April 2017 and April 2018. I:CHO ratio before starting degludec therapy significantly differed among the three meals, being the lowest at breakfast and the highest at dinner. After introducing degludec, I:CHO ratio at lunch (−1.29 95% CI −2.02;−0.57) and at dinner (−3.08 95% CI −4.35;−1.8) significantly decreased, while it slightly increased at breakfast (+1.37 95% CI 0.47;2.28). No episodes of severe hypoglycaemia, ketoacidosis and adverse event were recorded during 6 months. Conclusions Our data show that the use of degludec is associated with a significant change in the I:CHO ratio at the different meals compared to the previous glargine therapy. This could derive from the flat and prolonged pharmacokinetic profile of degludec. This has important clinical implications for daily insulin dose adjustments.
No data exist about the changes induced by the transition from first‐generation long‐acting insulins to second‐generation long‐acting analogues in the paediatric population. The study assessed changes in insulin/carbohydrate ratio (I:CHO) after the first 6 months of degludec therapy in a paediatric population with type 1 diabetes previously treated with glargine U100. Our data showed that the use of degludec is associated with a flattening in the I:CHO ratio at the different meals compared to the previous glargine therapy.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::224ff30f1fb79cb58b0f9b0021b96e31Test
https://doaj.org/article/9163e7e66ae7473ea55778642c5f428fTest

المؤلفون: Liborio Stuppia, Paola Guidone, Mirco Zucchelli, Gabriele Lisi, Sara Franchi, Stefano Tumini, Ilaria Cicalini, Damiana Pieragostino, Vincenzo De Laurenzi, Claudia Rossi, Pierluigi Lelli Chiesa

المصدر: Metabolites
Metabolites, Vol 9, Iss 12, p 284 (2019)

مصطلحات موضوعية: 0301 basic medicine, Screening test, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Confirmation test, lcsh:QR1-502, Physiology, Case Report, Steroid biosynthesis, urologic and male genital diseases, Biochemistry, lcsh:Microbiology, Steroid, 03 medical and health sciences, 0302 clinical medicine, LC–MS/MS, Liquid chromatography–mass spectrometry, medicine, congenital adrenal hyperplasia, Congenital adrenal hyperplasia, Molecular Biology, mass spectrometry, medicine.diagnostic_test, steroid profiling, business.industry, medicine.disease, metabolomics, 030104 developmental biology, 030220 oncology & carcinogenesis, Immunoassay, steroid profiling, Hypernatremia, business

الوصف: Congenital adrenal hyperplasia (CAH) describes a group of autosomal recessive disorders of steroid biosynthesis, in 95% of cases due to 21-hydroxylase deficiency. The resulting hormonal imbalances lead to increased 17-hydroxyprogesterone and androgens levels, at the expense of decreased concentrations of glucocorticoids and, in some cases, of mineralocorticoids. A variety of clinical presentations accompany a range of severities, which are described as different forms of CAH, and are the result of these hormonal imbalances. The incidence of CAH worldwide is approximately 1 in 15,000 live births, and is population-dependent; thus, its inclusion in neonatal screening tests is widely discussed. Diagnosis of CAH is based on the quantification of 17-hydroxyprogesterone, usually by immunoassay, which has low specificity and high false-positive rates, resulting in a relatively high demand for a second-tier confirmation test. We report a case of a newborn recognized as female at birth, but showing ambiguous genitalia and other CAH clinical features, including hypernatremia, in the first days of life. In addition to the classical assays, liquid chromatography–tandem mass spectrometry was used to determine the serum steroid profile, allowing for the accurate and simultaneous quantification of seven steroids in the same analysis. Such an application immediately revealed an alteration in the levels of specific steroids related to CAH, leading to an early intervention by hormone replacement therapy. Subsequently, the diagnosis of classic CAH due to 21-hydroxylase deficiency was further confirmed by molecular testing.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1197909622fc311eac6abd96e665436cTest
http://europepmc.org/articles/PMC6950672Test

المؤلفون: Ilaria Rossi, Paola Guidone, Gabriella Levantini, Laura Comegna, Maria Chiara Rossi, Elisabetta Fioretti, Milena Catenaro, Paola Cipriano, Giusi Graziano, Flavia Amaro, Daniele Panichi, Stefano Tumini

المصدر: Pediatric Reports
Pediatric Reports, Vol 12, Iss 1 (2020)
Pediatric Reports; Volume 12; Issue 1; Pages: 8254

مصطلحات موضوعية: Type 1 diabetes, pediatric diabetes, Insulin degludec, Pediatrics, medicine.medical_specialty, insulin analogues, medicine.medical_treatment, lcsh:Medicine, Physical exercise, Hypoglycemia, Article, diabetes camp, glargine, Diabetes mellitus, Medicine, pediatric diabetes, Type 1 diabetes, continuous subcutaneous insulin infusion, business.industry, Insulin, lcsh:R, type 1 diabetes, degludec, lcsh:RJ1-570, lcsh:Pediatrics, medicine.disease, Regimen, Basal (medicine), business

الوصف: Outcomes of insulin analogues in pediatric diabetes camps are poorly investigated; no data is available about insulin degludec (IDeg).Our aim was to assess impact of insulin therapy adopted by the participants to a 4-day diabetes camp held in 2017, hypothesizing a possible excess risk of hypoglycemia in patients treated with IDeg. Overall, 40 children with type 1 diabetes (mean age 13.4±3.0 years; 62.5% males) attended the camp (20.0% on continuous subcutaneous insulin infusion and 80.0% on multiple daily injections - MDI). Among children in MDI regimen, 71.9% were treated with IDeg as basal insulin and 28.1% with glargine U100 (IGlar). All patients used Lispro or Aspart as short-acting insulin. Daily plan of the camp included educational sessions, physical exercise, 3 main meals and 2 snacks. At the arrival, IGlar and short-acting insulin doses were revised according to existing guidelines, while IDeg dose was revised based on an empirical individualized approach. At the arrival, insulin doses were reduced in 22 participants (-19.4±10.5%), while doses were increased in 17 children (+17.8±12.7%), based on individual needs. No statistically significant between-group difference emerged in mean blood glucose and glucose variability. No excess risk of hypoglycemia was found in the IDeg group. The study suggests similar effectiveness and safety of different insulin schemes when associated with appropriate diabetes education and management, and flexible dose adjustments. Despite its longer halflife and the lack of a validated algorithm, IDeg was not associated with an excess risk of hypoglycemia.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f2ce8dd3fd9c4a0e351db857c0ac0057Test
https://doi.org/10.4081/pr.2020.8254Test

المؤلفون: Paola Guidone, Laura Comegna, Nadia Rossi, Simone Franchini, Giovanni Prezioso, Francesco Chiarelli, Paola Di Filippo, Angelika Mohn, Marianna Immacolata Petrosino

المصدر: Journal of Medical Case Reports

مصطلحات موضوعية: Male, Pathology, medicine.medical_specialty, Pyomyositis, Adolescent, Case Report, Disease, Malignancy, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, medicine, Humans, 030212 general & internal medicine, Abscess, Child, Muscle, Skeletal, Medicine(all), Teicoplanin, business.industry, Mortality rate, Ceftriaxone, General Medicine, Staphylococcal Infections, medicine.disease, Magnetic Resonance Imaging, Childhood, Anti-Bacterial Agents, Cephalosporins, Treatment Outcome, Tropical pathology, Female, Muscle infection, business, 030217 neurology & neurosurgery, medicine.drug, Pediatric population

الوصف: Background Pyomyositis is an acute bacterial infection of skeletal muscle that results in localized abscess formation. This infection was thought to be endemic to tropical countries, and is also known as “tropical pyomyositis”. However, pyomyositis is increasingly recognized in temperate climates and is frequently associated with an immunosuppressive condition, such as human immunodeficiency virus, malignancy, and diabetes mellitus. It is also found in healthy and athletic people after strenuous or vigorous exercise or following localized and possibly unnoticed trauma. It can be primary or secondary to neighboring or remote infection. Primary pyomyositis is a rare condition that can affect children and adolescents. Diagnosis can be delayed because the affected muscle is deeply situated and local signs are not apparent. This delay in diagnosis can result in increased morbidity and a significant mortality rate. The pediatric population, which comprises 35% of the reported pyomyositis cases, is an especially difficult subset of patients to diagnose. Case presentation In our series, we describe the cases of four previously healthy Caucasian children who were admitted to our Pediatric Department with different clinical presentations. Pyomyositis in our patients was related to factors affecting the muscle itself, including strenuous exercise and direct muscle trauma. Therapy was started with a cephalosporin antibiotic and teicoplanin was subsequently added. The minimum length of therapy was 3 weeks. Conclusions The diagnosis of pyomyositis in our patients, none of whom were immune-compromised, is confirmation that this disease is not an exclusive pathology of tropical countries and demonstrates that there is an increasing prevalence of pyomyositis in temperate climates.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0229661c8aa1066e024cb8f3d9240b6bTest
https://pubmed.ncbi.nlm.nih.gov/28003031Test

المؤلفون: Marianna Immacolata Petrosino, Marina Attanasi, Paola Guidone, Annalisa Blasetti, Nadia Rossi, Daniele Rapino, Laura Comegna, Francesco Chiarelli

المصدر: Archives of Medical Science : AMS

مصطلحات موضوعية: biology, business.industry, General Medicine, biology.organism_classification, medicine.disease_cause, medicine.disease, Virology, Epstein–Barr virus, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, 030220 oncology & carcinogenesis, medicine, Human herpesvirus 6, business, Rhabdomyolysis, Letter to the Editor, Co infection

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::38d758aab1800161eda4301915e52a16Test
https://pubmed.ncbi.nlm.nih.gov/29379557Test