Prevalence of hypovitaminosis D and predictors of vitamin D status in Italian healthy adolescents

Background: Vitamin D plays an important role in health promotion during adolescence. Vitamin D deficiency and insufficiency are common in adolescents worldwide. Few data on vitamin D status and risk factors for hypovitaminosis D in Italian adolescents are currently available. Methods. 25-hydroxyvitamin D (25-OH-D) and parathyroid hormone (PTH) levels were evaluated in 427 Italian healthy adolescents (10.0-21.0 years). We used the following cut-off of 25-OH-D to define vitamin D status: deficiency < 50 nmol/L; insufficiency 50-75 nmol/L; sufficiency ≥ 75 nmol/L. Hypovitaminosis D was defined as 25-OH-D levels < 75.0 nmol/L and severe vitamin D deficiency as 25-OH-D levels < 25.0 nmol/L. We evaluated gender, residence, season of blood withdrawal, ethnicity, weight status, sun exposure, use of sunscreens, outdoor physical activity, and history of fractures as predictors of vitamin D status. Results: Enrolled adolescents had a median serum 25-OH-D level of 50.0 nmol/L, range 8.1-174.7, with 82.2% having hypovitaminosis D. Vitamin D deficiency and insufficiency were detected in 49.9% and 32.3% of adolescents, respectively. Among those with deficiency, 38 subjects were severely deficient (38/427, 8.9% of the entire sample). Non-white adolescents had a higher prevalence of severe vitamin D deficiency than white subjects (6/17-35.3% vs 32/410-7.8% respectively, p = 0.002). Logistic regression showed increased risk of hypovitaminosis D as follows: blood withdrawal taken in winter-spring (Odds ratio (OR) 5.64) compared to summer-fall period; overweight-obese adolescents (OR 3.89) compared to subjects with normal body mass index (BMI); low sun exposure (OR 5.94) compared to moderate-good exposure and regular use of sunscreens (OR 5.89) compared to non regular use. Adolescents who performed < 3 hours/week of outdoor exercise had higher prevalence of hypovitaminosis D. Gender, residence, and history of fractures were not associated with vitamin D status. Serum 25-OH-D levels were inversely related to PTH (r = -0.387, p < 0.0001) and BMI-SDS (r = -0.141, p = 0.007). 44/427 (10.3%) adolescents showed secondary hyperparathyroidism. Conclusions: Italian adolescents have high prevalence of vitamin D deficiency and insufficiency. Pediatricians should tackle predictors of vitamin D status, favoring a healthier lifestyle and promoting supplementation in the groups at higher risk of hypovitaminosis D. © 2014 Vierucci et al.; licensee BioMed Central Ltd

Prescrizione elettronica della nutrizione parenterale per il neonato: dalla simulazione alla realtà clinica. Lavoro multidisciplinare medico-ingegneristico per la sicurezza e il miglioramento dell'outcome clinico-auxologico del neonato.

Presso la U.O. Neonatologia di Pisa è stato intrapreso uno studio multidisciplinare medico-ingegneristico con obiettivo primario, preclinico, quello di progettare e creare un programma computerizzato di interfaccia diretta con la farmacia, inserito all’interno della cartella clinica elettronica, per la prescrizione elettronica della nutrizione parenterale. Di pari passo sono stati creati e revisionati dei protocolli interni standardizzati per la prescrizione della nutrizione parenterale, basati sui fabbisogni dei neonati pretermine e a termine. Come secondo obiettivo ci siamo posti quello di verificare la funzionalità del sistema e contemporaneamente di formare il personale medico della U.O. Neonatologia di Pisa tramite sessioni di simulazione. Infine abbiamo fissato obiettivi per la parte della fase clinica dello studio, che sono: raggiungere in parenterale la quantità di macronutrienti necessaria, ridurre il tempo necessario al raggiungimento dell’obiettivo precedente, ridurre la frequenza di disturbi elettrolitici, ridurre il rischio di errori per una miglior sicurezza dei piccoli pazienti, ridurre l’incidenza degli interventi di aggiustamento alla composizione delle sacche in seguito a revisione delle prescrizioni da parte della farmacia e, infine, personalizzare le prescrizioni di nutrizione parenterale in neonati con rischio di EUGR o patologie particolari (es. insufficienza renale) per migliorarne l’outcome clinico-auxologico

Valutazione della densità minerale ossea e del metabolismo fosfo-calcico in un gruppo di giovani adulti nati pretermine e/o piccoli per l'età gestazionale

Valutazione della densità minerale ossea e del metabolismo fosfo-calcico al momento del picco di massa ossea in un gruppo di giovani adulti nati pretermine e/o piccoli per l'età gestazionale (SGA)

17q12 Microduplications: A Challenge for Clinicians

In the recent years, some cases of 17q12 deletions and duplications have been reported, but the clinical impact of these imbalances is still to be fully elucidated. In particular, 17q12 duplications elude syndrome classification, since they are associated with a wide phenotypic spectrum, ranging from very mild to quite severe phenotypes. Here, two unrelated patients with the same 1.2 Mb microduplication of 17q12 are reported. Comparing these patients' phenotype with those previously published, it emerges that the more patients reported, the more difficult is finding common characteristics, even in presence of exactly the same genetic anomaly. The role of the genes duplicated in this region and the impact of this chromosomal imbalance are discussed