COVID-19 and Type 1 Diabetes: Concerns and Challenges

Due to the current COVID-19 pandemic, worldwide population's lifestyle has changed dramatically, causing psychosocialconsequences. Patients presenting a preexisting chronic condition, as Type 1 Diabetes (T1D), are the ones suffering the most from this situation. Moreover, people affected by diabetes are the ones with the worst prognosis, if infected by SARS-CoV-2. We analyzed why patients with T1D were poorly represented between the subjects hospitalized for COVID-19 and why the cases of diabetic ketoacidosis (DKA) were fewerand more severe compared with the past years. Furthermore, literature has showed howpatients of all ages with T1D did not experience a deterioration in their glucose control throughout the lockdown. Among other causes, this is also due tothe surging use of telemedicine. Finally, we tried to understand how the coronavirus tropism for endocrine tissues could influence the future epidemiology of T1D, focusing on the effects they have on pancreatic beta-cells

dispositivo collegabile ad una macchina per il trattamento extracorporeo del sangue di un paziente

L’invenzione concerne un apparato per trattare il sangue20 di un paziente al di fuori del corpo umano,particolarmente un apparato per la circolazioneextracorporea, ossia un apparato che consente ditrattare il sangue di un paziente al di fuori del corpodel paziente stesso esercitando temporaneamente la25 funzione di propulsione circolatoria normalmenteesercitata dal cuore e la funzione di ossigenazionenormalmente esercitata dai polmoni

Probiotics ingestion does not directly affect thyroid hormonal parameters in hypothyroid patients on levothyroxine treatment

Purpose: The relationship between probiotics and levothyroxine (LT4) requirement has not yet been investigated. The aim of this study was to assess whether a mixture of highly charged Lactobacilli and Bifidobacteria (VSL#3\uc2\uae) is able to influence LT4metabolism acting on the gut microbiota. Methods: A prospective, randomized, single-blind, controlled, investigator-started clinical trial was carried out. Patients with primary hypothyroidism were randomly assigned to the study (VSL#3\uc2\uae + LT4) and the control group (LT4). A 2-month treatment phase was followed by 2 months of follow-up. Clinical examination, blood tests for thyroid function and for peripheral tissue markers of thyroid hormones (PTM) were performed monthly. LT4dose adjustments were performed when necessary. Results: Thirty-nine patients were enrolled in the study group and 41 in the control group. No difference in thyroid function [thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4)] and PTM was found between groups and among visits. FT3/fT4ratio was directly correlated to TSH at each visit in both groups, with the exception of the first evaluation of probiotics-treated subjects (rho = 0.287, p = 0.076). LT4daily dose adjustments occurred more frequently in the control than in the study group (p = 0.007), despite no differences in the mean LT4daily dose. In particular, LT4doses were increased six times in the control group and decreased four times in the study group. Conclusion: VSL#3\uc2\uae does not directly alter thyroid functional compensation. A probiotics-mediated influence on thyroid hormones homeostasis is suggested since probiotics supplementation could be able to prevent serum hormonal fluctuations

DEVICE CONNECTABLE TO A MACHINE FOR EXTRACORPOREAL TREATMENT OF THE BLOOD OF A PATIENT

A device connected to a machine (29) for extracorporeal treatment of blood of a patient comprises a sensor element (17) positionable on the patient's body for detecting the electrical potential (VI) of the blood in the patient's body and varying means (18) for modifying the electrical potential of blood treated by said machine (29), the varying means (18) being so programmed as to make the difference between the electrical potential (V2) of the blood exiting said machine (29) and the electrical potential (VI) measured by the sensor element (!7) lower than present value

CASO CLINICO: QUANDO LA RISPOSTA ALLA DIETA IPOLIPIDEMIZZANTE DETERMINA LA DIAGNOSI

PRESENTAZIONE DEL CASO, STORIA CLINICA E SINTOMATOLOGIA G.M., maschio di 7.8 anni, è stato condotto presso il centro di Dislipidemie in età evolutiva per il riscontro occasionale di ipercolesterolemia [colesterolo totale (CT) 524 mg/dl, LDL-colesterolo (LDL-C) 412 mg/dl, HDL-colesterolo (HDL-C) 52 mg/dl, trigliceridi (TG) 55 mg/dl, Apolipoproteina A (ApoA) 104 mg/dl, ApoB100 253 mg/dl]. Obiettivamente: altezza -2.02 SDS e BMI -1.40 SDS; non riscontro clinico di xantomi e/o xantelasmi, arco corneale o splenomegalia. Anamnesi patologica remota: muta. Anamnesi familiare: positiva per moderata ipercolesterolemia paterna (CT 242 mg/dl), obesità ed ipertensione. IPOTESI DIAGNOSTICHE E INDAGINI DI I E II LIVELLO Previa esclusione di una forma di ipercolesterolemia secondaria (glicemia, funzionalità tiroidea ed epato-renale nella norma), nel sospetto di ipercolesterolemia familiare omozigote abbiamo eseguito l’analisi genetica dei geni LDL-R ed ARH, risultata negativa per mutazioni. L’ecocardiografi a non documentava alterazioni. DIAGNOSI ED EVENTUALE TERAPIA In considerazione dell’iniziale assetto lipidico, abbiamo posto immediata indicazione di seguire una dieta ipolipidemizzante come da National Cholesterol Education Program ATP III - STEP II (apporto di grassi totali pari al 30% delle kcal quotidiane, grassi saturi < 7% e colesterolo < 200 mg/die). La rivalutazione dell’assetto lipidico, eseguita a distanza di 6 mesi dall’inizio della dietoterapia esclusiva, ha documentato un importante e rapido miglioramento dei valori di CT (203 mg/dl; -39%) e LDL-C (141 mg/dl; -34%). Per questo motivo abbiamo posto il sospetto diagnostico di sitosterolemia. La sitosterolemia rappresenta un disordine raro (circa 80-100 casi descritti nel mondo) a trasmissione autosomica recessiva caratterizzato da iperassorbimento intestinale e ridotta escrezione biliare di steroli vegetali. Nel nostro paziente abbiamo, quindi, dosato le concentrazioni di steroli vegetali plasmatici (mg/L) che sono risultate elevate (betasitosterolo 228, campesterolo 77.9 e desmosterolo 2.13) ed eseguito l’analisi genetica del gene ABCG8 che ha confermato il sospetto diagnostico, identifi cando la presenza di 2 mutazioni non-senso (esone 3: c.320C>G, p.Ser107*; esone 7: c.1083 G>A, p.Trp361*) come da eterozigosi composta. In considerazione della diagnosi di sitosterolemia confermata geneticamente, abbiamo posto indicazione a seguire un approccio dietetico con restrizione di cibi ad alto contenuto di steroli (olii vegetali, margarina, frutta secca, avocado, cioccolato…) associato ad un’appropriata supplementazione vitaminica

CONCERTO POUR CLAVECIN EN DO MINEUR / Jean-Chrétien BACH ; Antonio BALLISTA, clavecin ; avec l'Orchestra dell'Angelicum di Milano dir. Umberto CATTINI. CONCERTO POUR CLAVECIN EN SOL MAJEUR / Jean-Chrétien BACH ; Luigi Ferdinando TAGLIAVINI, clavecin ; avec l'Orchestra dell'Angelicum di Milano dir. Umberto CATTINI

BnF-Partenariats, Collection sonore - BelieveContient une table des matière

Effects of probiotics assumption on serum thyroid hormone and TSH levels in hypothyroid patients on levothyroxine treatment.

Background. Probiotics are live microorganisms able to confer a health benefit to the host, when administered in adequate amounts. Despite the widespread use of probiotics, their pharmacological interference remains unclear. The relationship between probiotics and levothyroxine (LT4) requirement has not yet been investigated. Objective. To assess whether a mixture of highly charged Lactobacilli and Bifidobacteria (VSL#3®) is able to influence LT4 metabolism acting on the gut microbiota. Methods. A prospective, randomized, single-blind, controlled, investigator-started clinical trial was carried out. Patients with primary hypothyroidism were randomly assigned to the study (VSL#3®+ LT4) and the control group (LT4). A two months treatment phase was followed by two months of follow-up. Clinical examination, blood tests for thyroid function and for peripheral tissue markers of thyroid hormones effect were performed monthly for 4 months. LT4 dose adjustments were performed during the study when necessary. Results. Thirty-nine patients were enrolled in the study group and 41 in the control group. No difference in thyroid function (thyroid-stimulating hormone (TSH), free triiodothyronine (fT3) and free thyroxine (fT4)) and peripheral tissue markers was found between groups and among visits. FT3/fT4 ratio was directly correlated to TSH at each visit in the control and in the study group, with the exception of the first evaluation of subjects treated with probiotics. LT4 daily dose adjustments occurred 10 times in 8 patients, more frequently in the control than in the study group, despite no differences in the mean LT4 daily dose. Conclusions. VSL#3® does not directly alter thyroid functional compensation. A probiotics- mediated influence on thyroid hormones homeostasis is suggested since probiotics supplementation could be able to prevent serum hormonal fluctuations

Probiotics Ingestion Does Not Directly Affect Thyroid Hormonal Parameters in Hypothyroid Patients on Levothyroxine Treatment

PurposeThe relationship between probiotics and levothyroxine (LT4) requirement has not yet been investigated. The aim of this study was to assess whether a mixture of highly charged Lactobacilli and Bifidobacteria (VSL#3®) is able to influence LT4 metabolism acting on the gut microbiota.MethodsA prospective, randomized, single-blind, controlled, investigator-started clinical trial was carried out. Patients with primary hypothyroidism were randomly assigned to the study (VSL#3® + LT4) and the control group (LT4). A 2-month treatment phase was followed by 2 months of follow-up. Clinical examination, blood tests for thyroid function and for peripheral tissue markers of thyroid hormones (PTM) were performed monthly. LT4 dose adjustments were performed when necessary.ResultsThirty-nine patients were enrolled in the study group and 41 in the control group. No difference in thyroid function [thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4)] and PTM was found between groups and among visits. FT3/fT4 ratio was directly correlated to TSH at each visit in both groups, with the exception of the first evaluation of probiotics-treated subjects (rho = 0.287, p = 0.076). LT4 daily dose adjustments occurred more frequently in the control than in the study group (p = 0.007), despite no differences in the mean LT4 daily dose. In particular, LT4 doses were increased six times in the control group and decreased four times in the study group.ConclusionVSL#3® does not directly alter thyroid functional compensation. A probiotics-mediated influence on thyroid hormones homeostasis is suggested since probiotics supplementation could be able to prevent serum hormonal fluctuations.ClinicalTrials.gov IDRegistration number NCT03095963