Nutrizione iodica globale nel 2020

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Safe Follow-Up after Endovascular Aortic Repair with Unenhanced MRI: The SAFEVAR Study

We aimed to investigate whether unenhanced magnetic resonance imaging (MRI) could represent a safe and highly sensitive tool for endoleak screening in patients treated with endovascular aneurysm repair (EVAR) using computed tomography angiography (CTA) as a reference standard. Patients who underwent CTA for EVAR follow-up at our institution were prospectively enrolled. All MRI examinations were performed with a 1.5 T unit. The true-FISP and HASTE sequences of the MRI scans were assessed for the presence of hyperintensity within the aneurysm sac outside the graft, whereas phase-contrast through-plane sequences were used for blood flow quantification. We included 45 patients, 5 (11%) of whom were female. The median age was 73 years (IQR 68–78 years). Among our patients, 19 (42%) were positive for endoleaks at CTA, of whom 13 (68%) had type II endoleaks and 6 (32%) had type I endoleaks. There were no significant differences in age, sex, aneurysm type, prosthesis type, or contrast-to-noise ratio between hyperintensity and thrombus between patients with and without endoleaks (p > 0.300). The combined evaluation of true-FISP and HASTE yielded 100% sensitivity (95% CI: 79–100%) and 19% specificity (95% CI: 7–40%). Patients with a positive CTA had a median thrombus flow of 0.06 L/min (IQR 0.03–0.23 L/min), significantly greater than that of patients with a negative CTA (p = 0.007). Setting a threshold at 0.01 L/min, our MRI protocol yielded 100% sensitivity, 56% specificity, and an AUC of 0.76 (95% CI 0.60–0.91). In conclusion, unenhanced MRI has perfect sensitivity for endoleak detection, although with subpar specificity that could be improved with phase-contrast flow analysis

Safe Follow-Up after Endovascular Aortic Repair with Unenhanced MRI: The SAFEVAR Study

We aimed to investigate whether unenhanced magnetic resonance imaging (MRI) could represent a safe and highly sensitive tool for endoleak screening in patients treated with endovascular aneurysm repair (EVAR) using computed tomography angiography (CTA) as a reference standard. Patients who underwent CTA for EVAR follow-up at our institution were prospectively enrolled. All MRI examinations were performed with a 1.5 T unit. The true-FISP and HASTE sequences of the MRI scans were assessed for the presence of hyperintensity within the aneurysm sac outside the graft, whereas phase-contrast through-plane sequences were used for blood flow quantification. We included 45 patients, 5 (11%) of whom were female. The median age was 73 years (IQR 68–78 years). Among our patients, 19 (42%) were positive for endoleaks at CTA, of whom 13 (68%) had type II endoleaks and 6 (32%) had type I endoleaks. There were no significant differences in age, sex, aneurysm type, prosthesis type, or contrast-to-noise ratio between hyperintensity and thrombus between patients with and without endoleaks (p > 0.300). The combined evaluation of true-FISP and HASTE yielded 100% sensitivity (95% CI: 79–100%) and 19% specificity (95% CI: 7–40%). Patients with a positive CTA had a median thrombus flow of 0.06 L/min (IQR 0.03–0.23 L/min), significantly greater than that of patients with a negative CTA (p = 0.007). Setting a threshold at 0.01 L/min, our MRI protocol yielded 100% sensitivity, 56% specificity, and an AUC of 0.76 (95% CI 0.60–0.91). In conclusion, unenhanced MRI has perfect sensitivity for endoleak detection, although with subpar specificity that could be improved with phase-contrast flow analysis

Prevalence of Sarcopenia in Older Patients in Rehabilitation Wards

The multidisciplinary assessment of hospitalized patients via validated scales and tools has become crucial in the early identification of sarcopenia. The objective of this study was to determine the prevalence of sarcopenia and its related factors in patients aged ≥65 years admitted to the neurological rehabilitation departments of cognitive motor disorders and functional motor rehabilitation at the IRCCS Hospital San Raffaele in Milan. Using the algorithm reported by the European Working Group on Sarcopenia in Older People (EWGSOP2), the prevalence of sarcopenia in patients was investigated from 2019–2020. Definite sarcopenia was detected in 161 of 336 recruited patients (47.9%). Age was significantly higher in sarcopenic patients than in those without sarcopenia (median 81 vs. 79 years, p p p p p < 0.005 for both). In conclusion, sarcopenic patients were more cognitively impaired and less autonomous in their daily life, but the majority presented with a negative malnutrition screening test

Knowledge, Propensity and Hesitancy among Pregnant Women in the Post-Pandemic Phase Regarding COVID-19 Vaccination: A Prevalence Survey in Southern Italy

The vaccination of pregnant women against influenza and COVID-19 may reduce the risk of severe illness in both the women of this population and their babies. Although the risks of non-vaccination are more serious than the side effects, maternal immunization is still the least-used method of prevention due to a lack of information leading to concerns about the safety and efficacy of vaccines, resulting in a low prevalence rate among pregnant individuals. Our study investigates vaccination coverage and the knowledge, attitudes and perceptions of COVID-19 in pregnant women at a university hospital. A questionnaire was created with the following three scores: a vaccination propensity score, a knowledge score and a hesitancy score. The first observation in the results was the very low number of immunized women (only 4.7% received their first dose). The main barrier towards vaccination was found to be fear of adverse events. We noticed a low percentage of influenza and diphtheria tetanus pertussis vaccination compared to other studies. Vaccination propensity was higher when healthcare workers educated their patients. As immunization is a crucial part of public health policy, measuring coverage to identify gaps and monitor trends, especially for individuals considered at high risk, and developing new strategies in order to increase awareness of vaccination during pregnancy is particularly timely and relevant

A national cohort study on pediatric Behçet’s disease: cross-sectional data from an Italian registry

Abstract Background Behçet’s disease is a rare multi-systemic inflammatory disease with unknown etiology which involves principally oral and genital mucosa, skin and eyes. Average age at onset of the disease is about 25-30 years, but it may be diagnosed before the age of 16. It is not very rare in Italy, even though there are limited data concerning epidemiology. Aim of this study is to describe the baseline data of an Italian cohort of patients with as having BD or probable BD. Methods We described the baseline data of the first national epidemiological study on children coming from 16 Italian Pediatric Rheumatologic Centers diagnosed by the treating physicians as having Behçet’s Disease. Data on demographic characteristics, clinical features and therapy were collected. We then compared our findings to those of international pediatric cohort studies and also retrospectively evaluated the ability to diagnose BD using ISG, ICBD and, for the first time, the new PEDBD criteria. Results The study included 110 patients (62 M, 48F). Average age at onset was 8.34±4.11 years. The frequencies of signs/symptoms were: recurrent oral aphtosis 94.5%, genital ulcers 33.6%, ocular 43.6%, gastrointestinal 42.7%, musculoskeletal 42.7%, neurological 30.9% and vascular involvement 10%. Thirty-two patients (29.1%) fulfilled ISG, 78 (70.9%) ICBD, 50 (45.5%) PEDBD criteria and 31 (28%) didn’t fulfill any of them. The most frequently used treatments were colchicine and corticosteroids followed by immunosuppressants. Four patients received biologic therapy (anti TNF-α and anti-IL-1) to treat severe organ involvement. Conclusions Recurrent oral aphtosis was the most frequent clinical manifestation, followed by ocular involvement. Gastrointestinal lesions were more frequent in Italy than in non-European countries as opposed to genital ulcers. Skin, ocular and vascular manifestations had a higher frequency in males and genital ulcers in females. Constitutional symptoms were present in 44.5% and recurrent fever in one third of our population

Global iodine nutrition 2020. Italy is an iodine sufficient country

Dear Editor, Every year, the Iodine Global Network (IGN), which is a non-profit, non-government organization for the sustainable elimination of iodine deficiency worldwide (www.ign.org), releases a global scorecard of iodine nutrition in populations based on median urinary iodine concentration (UIC) in school-age children as a proxy for the general population. Based on the most recent scorecard [1, 2], 115 countries are classified as having optimal iodine nutrition, while 23 countries are still classified as iodine deficient (in Europe: Finland, Germany, and Norway). It is worth to note that the iodine intake in several countries formerly classified as optimal has declined, including Cambodia, Nicaragua, Tajikistan, and Germany, which reflects the risk of program backsliding and the need for vigilance and continuous monitoring. The scorecard also indicates that the iodine intake is classified as excessive in 14 countries, which reinforces the need for measures to reduce the excessive iodine exposure in these countries. In 2020 IGN scorecard, for the first time, Italy is reported among iodine sufficient countries. This achievement results from a long-standing nationwide program of iodine prophylaxis on a voluntary basis approved by law in 2005 (law n.55/2005), and from an efficient monitoring system carried out by the Italian National Observatory for Monitoring Iodine Prophylaxis (OSNAMI). The first surveillance conducted by OSNAMI in the period 2007–2012 still showed iodine deficiency in most of the Italian regions [3]. On the basis of these data, the General Direction of Food Safety and Nutrition at the Ministry of Health together with a panel of OSNAMI experts at the National Institute of Health decided to intensify nationwide informative campaigns on the use of iodized salt promoting the slogan “less salt but iodized”, in agreement with the nationwide strategy of reducing sodium intake in the population. These efforts have finally led to iodine sufficiency, as demonstrated by results of the second survey conducted in the period 2015–2019 on 4000 schoolchildren aged 11–13 years and residing in nine regions representative of Northern, Central, and Southern Italy. The analysis of spot urine samples showed a median UIC of 125 μg/L, with no significant differences b Query ID="Q2" Text="Please check and confirm that the authors and their respective affiliations have been correctly identified and amend if necessary." between rural and urban areas (126 μg/L and 118 μg/L, respectively). The study also showed the disappearance of goiter among schoolchildren in all but one studied region. These results represent an undoubted success of public health in our country. Nevertheless, these are only the first steps of the nationwide iodine prophylaxis program. In fact, three further important goals need to be achieved: (i) to ensure optimal intake for the entire population, included subgroups still at risk of insufficient iodine intake like pregnant women, newborns, and young children; (ii) to reinforce the notion that strategies for both salt reduction and salt iodization are compatible, although requiring effective monitoring to ensure sufficient iodine intake; and (iii) to obtain political commitment to ensure the sustainability of the iodine prophylaxis program. Once these goals will be achieved, the fight against iodine deficiency will be definitely won in our country