المؤلفون: Piatti, A., Romeo, F., Manti, R., Doglio, M., Tartaglino, B., Nada, E., Giorda, C. B.

المصدر: Acta Diabetologica; Jan2024, Vol. 61 Issue 1, p63-68, 6p

مصطلحات موضوعية: DIABETIC retinopathy, MEDICAL screening, MACHINE learning, ARTIFICIAL intelligence, ELECTRONIC health records

مستخلص: Aims: Periodical screening for diabetic retinopathy (DR) by an ophthalmologist is expensive and demanding. Automated DR image evaluation with Artificial Intelligence tools may represent a clinical and cost-effective alternative for the detection of retinopathy. We aimed to evaluate the accuracy and reliability of a machine learning algorithm. Methods: This was an observational diagnostic precision study that compared human grader classification with that of DAIRET^®, an algorithm nested in an electronic medical record powered by Retmarker SA. Retinal images were taken from 637 consecutive patients attending a routine annual diabetic visit between June 2021 and February 2023. They were manually graded by an ophthalmologist following the International Clinical Diabetic Retinopathy Severity Scale and the results were compared with those of the AI responses. The main outcome measures were screening performance, such as sensitivity and specificity and diagnostic accuracy by 95% confidence intervals. Results: The rate of cases classified as ungradable was 1.2%, a figure consistent with the literature. DAIRET^® sensitivity in the detection of cases of referable DR (moderate and above, "sight-threatening" forms of retinopathy) was equal to 1 (100%). The specificity, that is the true negative rate of absence of DR, was 80 ± 0.04. Conclusions: DAIRET^® achieved excellent sensitivity for referable retinopathy compared with that of human graders. This is undoubtedly the key finding of the study and translates into the certainty that no patient in need of the ophthalmologist is misdiagnosed as negative. It also had sufficient specificity to represent a cost-effective alternative to manual grade alone. [ABSTRACT FROM AUTHOR]

: Copyright of Acta Diabetologica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Piatti, A., Romeo, F., Manti, R., Doglio, M., Tartaglino, B., Nada, E., Giorda, C. B.

المصدر: Acta Diabetologica ; volume 61, issue 1, page 63-68 ; ISSN 1432-5233

مصطلحات موضوعية: Endocrinology, General Medicine, Endocrinology, Diabetes and Metabolism, Internal Medicine

الإتاحة: https://doi.org/10.1007/s00592-023-02172-2Test

المؤلفون: Allione A., Pivetta E., Pizzolato E., Lorenzati B., Pomero F., Barutta L., Lauria G., Tartaglino B.

المساهمون: Allione A., Pivetta E., Pizzolato E., Lorenzati B., Pomero F., Barutta L., Lauria G., Tartaglino B.

مصطلحات موضوعية: Emergency department, Oligoanalgesia, Pain

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/29464223; info:eu-repo/semantics/altIdentifier/wos/WOS:000424190600011; volume:17; issue:4; firstpage:160; lastpage:164; numberofpages:5; journal:TURKISH JOURNAL OF EMERGENCY MEDICINE; http://hdl.handle.net/2318/1722569Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85035218556; http://www.trjemergmed.comTest/

الإتاحة: https://doi.org/10.1016/j.tjem.2017.08.001Test
http://hdl.handle.net/2318/1722569Test
http://www.trjemergmed.comTest/

المؤلفون: Giorda CB, Picariello R, Tartaglino B, Nada E, Linzalata C, Romeo F, Costa G, Gnavi R

المساهمون: Giorda CB, Picariello R, Tartaglino B, Nada E, Linzalata C, Romeo F, Costa G, Gnavi R

مصطلحات موضوعية: Insulin, risk, cancer

الوصف: Background and aims: Excess morbidity and mortality from chronic liver disease in type 2 diabetes (T2DM) is recognized; however, the clinical features associated with liver fibrosis (LF) of any origin are poorly known. Metabolic status and/or coexisting complications over time may play a role. Methods and results: We interrogated the database of the diabetes unit network of Piedmont (Italy) (71,285 T2DM patients) and calculated a fibrosis-4 score (FIB-4) from data recorded between 2006 and 2019. Comorbidities were obtained by linkage with hospital data. The study population was subdivided by aetiology of LF (alcoholic, viral, metabolic). Associations between upper level of FIB-4 and demographic and clinical variables were evaluated separately for each group using robust Poisson models and presented as prevalence ratios. Nearly one-quarter (24%) of T2DM patients had some form of LF: viral (0.4 4%) and alcoholic (0.53%) forms were far less frequent than metabolic ones (22.7%). Only 1 out of 5 of these patients had a history of known cirrhosis. Age, male sex, duration of diabetes, coronary disease, hyperuricemia, renal failure, and features of liver failure (e.g., lower body-mass index, lipid and HbA1c levels) were positively associated with metabolic LF. More intensive treatments with insulin and segretagogue emerged as a significant predictive indicators of LF of metabolic origin. Conclusion: A sizeable proportion of T2DM patients has some degree of LF, mainly of metabolic origin and often undiagnosed. There is a need to clarify whether the link between insulin therapy and advanced LF is causal or not. (c) 2021 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/34364773; info:eu-repo/semantics/altIdentifier/wos/WOS:000694742700016; volume:31(10); firstpage:2887; lastpage:2893; numberofpages:7; journal:NMCD. NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES; http://hdl.handle.net/2318/1833859Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85111903658

الإتاحة: https://doi.org/10.1016/j.numecd.2021.06.020Test
http://hdl.handle.net/2318/1833859Test

المؤلفون: Giorda CB, Picariello R, Tartaglino B, Nada E, Doglio M, Romeo F, Costa G, Gnavi R

المساهمون: Giorda CB, Picariello R, Tartaglino B, Nada E, Doglio M, Romeo F, Costa G, Gnavi R

مصطلحات موضوعية: Type 2 diabete, SARS COV-2, COVID 19

الوصف: Background: We aimed to study the impact of diabetes background on COVID-19 progression from swab testing to health outcomes in type 2 diabetes (T2DM). Methods: From the database of the diabetes units of Piedmont-Italy we extracted records of T2DM patients, which were linked with the swab-testing-database, and the database of hospital discharges. Five outcomes (PCR testing, PCR testing positivity, hospitalization, Intensive Care Unit (ICU), death) were evaluated using robust Poisson models. Results: Among 125,021 T2DM patients, 1882 had a positive PCR test. Of these patients, 49.4% were hospitalized within 30 days, 11.8% were admitted to an ICU, and 27.1% died. Greater probability of death was associated with age, male sex, liver and renal impairment, Hba1c above 8%, and former smoking. Hospitalization and ICU admission were mainly affected by age, male sex, hypertension, and metabolic control. Notably, ICU admissions were reduced in very elderly people. No outcomes were associated with educational level. Conclusions: Hospitalization and ICU admission are heavily affected by age and local triage policy. A key finding was that men who were > 75 years old and poorly compensated were highly vulnerable patients. Renal and/or hepatic impairment are additional factors. This information may be useful for addressing intervention priorities. (c) 2021 Elsevier B.V. All rights reserved.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/34437941; info:eu-repo/semantics/altIdentifier/wos/WOS:000701202100004; issue:109021; firstpage:1; lastpage:13; numberofpages:13; journal:DIABETES RESEARCH AND CLINICAL PRACTICE; http://hdl.handle.net/2318/1833888Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85114904483

الإتاحة: https://doi.org/10.1016/j.diabres.2021.109021Test
http://hdl.handle.net/2318/1833888Test

المؤلفون: Giorda CB, Picariello R, Tartaglino B, Nada E, Costa G, Gnavi R

المساهمون: Giorda CB, Picariello R, Tartaglino B, Nada E, Costa G, Gnavi R

مصطلحات موضوعية: incretin-based, cae-control study

الوصف: Background and aimsOne cohort and several basic science studies have raised suspicion about an association between incretin therapies and cholangiocarcinoma. Our aim was to verify the occurrence of CC in relation to incretin-based medication use versus any antidiabetic treatment in an unselected population of diabetic patients.MethodsA population-based matched case-control study was conducted using administrative data from the Region of Piedmont (4,400,000 inhabitants), Italy. From a database of 312,323 patients treated with antidiabetic drugs, we identified 744 cases hospitalized for cholangiocarcinoma from 2010 to 2016 and 2976 controls matched for gender, age and initiation of antidiabetic therapy; cases and controls were compared for exposure to incretin-based medications. All analyses were adjusted for risk factors for CC, as ascertained by hospital discharge records. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by fitting a conditional logistic model.ResultsThe mean age of the sampled population (cases and controls, 75 years) was very high, with no gender prevalence. Five per cent was treated with incretin-based medications. After adjusting for possible confounders, we found no increased risk of cholangiocarcinoma associated with the use of either DPP4i (OR 0.98, 95% CI 0.75-1.29: p=0.89) or GLP-1-RA (OR 1.09, 95% CI 0.63-1.89; p=0.76) in the 24 months before hospital admission. Neither the duration of the therapy nor the dose modified the risk of cholangiocarcinoma.ConclusionsOur findings suggest that, in an unselected population, the use of both classes of incretin-based medications is not associated with an increased risk of cholangiocarcinoma.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/31691043; info:eu-repo/semantics/altIdentifier/wos/WOS:000494397700001; volume:57(4); firstpage:401; lastpage:408; numberofpages:8; journal:ACTA DIABETOLOGICA; http://hdl.handle.net/2318/1735653Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85074712052

الإتاحة: https://doi.org/10.1007/S00592-019-01444-0Test
http://hdl.handle.net/2318/1735653Test

المؤلفون: Giorda, C. B., Picariello, R., Tartaglino, B., Marafetti, L., Di Noi, F., Alessiato, A., Costa, G., Gnavi, R.

المصدر: BMJ Open ; volume 5, issue 6, page e007959-e007959 ; ISSN 2044-6055

مصطلحات موضوعية: General Medicine

الإتاحة: https://doi.org/10.1136/bmjopen-2015-007959Test

المؤلفون: Giorda C, Picariello R, Nada E, Tartaglino B, Marafetti L, Gnavi R., COSTA, Giuseppe

المساهمون: Giorda C, Picariello R, Nada E, Tartaglino B, Marafetti L, Costa G, Gnavi R

الوصف: Despite the heightened awareness of diabetes as a major health problem, evidence on the impact of assistance and organizational factors, as well as of adherence to recommended care guidelines, on morbidity and mortality in diabetes is scanty. We identified diabetic residents in Torino, Italy, as of 1st January 2002, using multiple independent data sources. We collected data on several laboratory tests and specialist medical examinations to compare primary versus specialty care management of diabetes and the fulfillment of a quality-of-care indicator based on existing screening guidelines (GCI). Then, we performed regression analyses to identify associations of these factors with mortality and cardiovascular morbidity over a 4 year-follow-up. Patients with the lowest degree of quality of care (i.e. only cared for by primary care and with no fulfillment of GCI) had worse RRs for all-cause (1.72 [95% CI 1.57-1.89]), cardiovascular (1.74 [95% CI 1.50-2.01]) and cancer (1.35 [95% CI 1.14-1.61]) mortality, compared with those with the highest quality of care. They also showed increased RRs for incidence of major cardiovascular events up to 2.03 (95% CI 1.26-3.28) for lower extremity amputations. Receiving specialist care itself increased survival, but was far more effective when combined with the fulfillment of GCI. Throughout the whole set of analysis, implementation of guidelines emerged as a strong modifier of prognosis. We conclude that management of diabetic patients with a pathway based on both primary and specialist care is associated with a favorable impact on all-cause mortality and CV incidence, provided that guidelines are implemented.

وصف الملف: STAMPA

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/22509263; info:eu-repo/semantics/altIdentifier/wos/WOS:000304805900008; volume:7(4); firstpage:e33839; lastpage:e33839; numberofpages:1; journal:PLOS ONE; http://hdl.handle.net/2318/102766Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-84859256879

الإتاحة: https://doi.org/10.1371/journal.pone.0033839Test
http://hdl.handle.net/2318/102766Test

المؤلفون: Daniele Passerone A, Ugo Tartaglino B, Furio Ercolessi B, Erio Tosatti B

المساهمون: The Pennsylvania State University CiteSeerX Archives

المصدر: http://arxiv.org/pdf/cond-mat/0010389v1.pdfTest.

مصطلحات موضوعية: Molecular dynamics, Gold, Surface structure, morphology, roughness, and topography, Low index single crystal surfaces, Vicinal single crystal 1 surfaces, Surface relaxation and reconstruction

الوصف: Surface molecular dynamics simulation with two orthogonal surface steps: how to beat the particle conservation problem

وصف الملف: application/pdf

العلاقة: http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.310.9543Test; http://arxiv.org/pdf/cond-mat/0010389v1.pdfTest

الإتاحة: http://arxiv.org/pdf/cond-mat/0010389v1.pdfTest

المؤلفون: Pivetti, S, Aluffi, E, Bonino, L, Valpreda, S, Urbino, R, Tartaglino, B, Navone, F, Antro, C, Gai, V

المصدر: Critical Care ; volume 3, issue Suppl 1, page P242 ; ISSN 1364-8535

مصطلحات موضوعية: Critical Care and Intensive Care Medicine

الإتاحة: https://doi.org/10.1186/cc615Test