Prevalencia de hipotiroidismo y su asociación con factores de riesgo cardiometabólicos en mujeres adultas argentinas

Introducción: El hipotiroidismo se asocia con factores de riesgo cardiometabólicos (FRC) además de la edad y del sexo femenino. El principal objetivo fue conocer la prevalencia de hipotiroidismo y su asociación con FRC en mujeres adultas concurrentes a un Centro de Endocrinología de la Ciudad Autónoma de Buenos Aires, Argentina. Material y Métodos: Diseño transversal y observacional en muestra no probabilística de 316 mujeres adultas (40 a 65 años), categorizadas en hipotiroideas controladas con tratamiento farmacológico y eutiroideas. Variables: Se estudiaron los siguientes FRC: Índice Masa Corporal (IMC), 88cm; etapa biológica (premenopausia y posmenopausia), tabaquismo, sedentarismo; perfil lipídico alterado (ColT>200mg/dl; LDL-c>130mg/dl; Tg>150mg/dl; HDL-c100mg/dl. Estadística con SPSS 15.0 estableciendo medidas de tendencia central, ANOVA y OR con intervalos de confianza 95% (IC) y diferencia de proporciones con valor p<0,05. Resultados: 46,2% hipotiroideas controladas y 53,8% eutiroideas; 64,2% posmenopáusicas; 68% con sobrepeso u obesidad y 45,2% con CC aumentada. La edad fue similar en ambos grupos: 53,3 (DS=6,4) años hipotiroideas y 53,9 (DS=6,6) años eutiroideas. Sedentarismo fue el FRC más prevalente en ambos grupos. Las hipotiroideas presentaron más riesgo de IMC aumentado (OR=0,36 IC95%=0,21-0,59; p=0,0001) y CC alterada (OR=0,53 IC95%=0,34-0,84; p=0,006) que las eutiroideas. Conclusiones: La prevalencia de hipotiroidismo se presentó aproximadamente en la mitad de la muestra. El estado nutricional alterado fue el único FRC asociado significativamente con el hipotiroidismo

Relación TG/HDL-C y resistencia a la insulina en mujeres adultas argentinas según su estado nutricional

Introduction: The ratio assessment TG/HDL-C is an indicator of LDL size, facilitating the detection of individuals with increased atherogenic risk. Estimating the size of the LDL becomes important, especially in patients with TG values near the upper limit of normal values of reference and HDL-C. The objective of the study is to estimate the association between TG/HDL-C and insulin resistance (IR) by nutritional status in adult women attending the Foundation for Endocrine Metabolic Diseases Research and Applied Clinical Research (FIEEM).Material and methods: Design Cross-sectional, non-pregnant adult women, apparently healthy, older than 30 years old, attending FIEEM in the Autonomous City of Buenos Aires. Dependent variable: TG/HDL-C ≥ 3.0 considered high value. Independent variables: IR by homeostatic model index HOMA-IR ≥ 2.5 categorizing the sample into two groups: with and without IR, and controlled by nutritional status using body mass index (BMI) and waist circumference (CC). SPSS Statistics 15.0, calculating X2 or Fisher exact test, OR with confidence intervals of 95% and establishing logistic regression p value &lt; 0.05.Results: We evaluated a purposive sample of 104 women (31.4% and 26% IR with TG/HDL-C high). 84.6% were overweight or obese and 88.5% increased CC. Women with BMI had significantly increased 0.15-fold increased risk (95% CI = 0.01 to 1.26) for TG/HDL-C high (p = 0.04) than the control women. There was no significance with increased CC. The ratio TG/HDL-C high IR was significantly correlated (r = 0.30 p = 0.002).Conclusions: Body weight was significantly associated with IR and the ratio TG/HDL-C increased. This ratio correlated significantly with IR in apparently healthy women.Introducción: la valoración del índice TG/HDL-C resulta un indicador del tamaño de las LDL, facilitando la detección de individuos con riesgo aterogénico aumentado. El objetivo del estudio fue estimar la asociación entre TG/HDL-C y resistencia a la insulina (RI) según el estado nutricional en mujeres adultas.Material y métodos: diseño descriptivo transversal, de mujeres adultas no embarazadas, y aparentemente sanas, mayores de 30 años de edad, concurrentes a la Fundación para Investigación de Enfermedades Endócrino Metabólicas e Investigación Clínica Aplicada (FIEEM) en la Ciudad Autónoma de Buenos Aires. Variable dependiente: relación TG/HDL-C considerando valor elevado ≥ 3,0. Variables independientes: RI por Índice modelo  homeostático HOMA-IR ≥ 2,5 categorizando a la muestra en dos grupos: con y sin RI, y controladas según el estado nutricional mediante índice de masa corporal (IMC) y circunferencia de la cintura (CC). Estadística con SPSS 15,0, calculando X2 o prueba exacta de Fisher, OR con intervalos de confianza del 95% y regresión logística estableciendo valor p &lt; 0,05.Resultados: se evaluó una muestra intencional de 104 mujeres (31,4% con RI y 26% con TG/HDL-C elevada). El 84,6% presentó sobrepeso u obesidad y el 88,5% CC aumentada. Las mujeres con IMC aumentado presentaron significativamente 0,15 veces (IC 95% = 0,01-1,26; p = 0,04) más riesgo de TG/HDL-C elevada que las mujeres normopeso. No hubo significación con la CC aumentada. La relación TG/HDL-C elevada se correlacionó significativamente con RI (r = 0,30 p= 0,002).Conclusiones: el peso corporal se asoció significativamente con RI y la relación TG/HDL-C aumentada. Esta relación se correlacionó con la RI en mujeres aparentemente sanas

Prevalencia de hipotiroidismo y su asociación con factores de riesgo cardiometabólicos en mujeres adultas argentinas

Introduction: It is known that hypothyroidism is associated with cardiometabolic risk factors (CRF) as well as age, female gender. The main objective was determine the prevalence of hypothyroidism and its association with cardiometabolic risk factors in adult women attending the Foundation for Endocrine Metabolic Diseases Research of the Autonomous City of Buenos Aires, Argentina.Material and Methods: Cross-sectional and observational design. Probabilistic sample of 316 adult women (40-65 years), randomized into two groups: hypothyroid controlled with pharmacological treatment and euthyroid. Variable: the following were studied CRF: body mass index (BMI), normal &lt;25kg/m2 and increased ≥25.0kg/m2; waist circumference (WC) normal ≤88cm and increased &gt;88cm; biological stage (premenopausal and postmenopausal), smoking, sedentary lifestyle; altered lipid profile (TC&gt;200mg/dl; LDL&gt;130mg/dl; Tg&gt;150mg/dl; HDL-c&lt;40mg/dl); HT≥120/80mmHg and increased fasting glucose &gt;100mg/dl. Statistics with SPSS 15.0 establishing measures of central tendency, ANOVA and OR with 95% confidence intervals (CI) and difference of proportions with p&lt;0.05.Results: The 46.2% of the sample were women controlled hypothyroid and euthyroid 53.8%. The 64.2% were postmenopausal, 68% overweight or obese and 45.2% with WC increased. Age was similar in both groups: 53.3 (SD=6.4) years the hypothyroid and 53.9 (SD=6.6) years theeuthyroid. The inactivity was the CFR more prevalent in both groups. The hypothyroid women had a significantly higher risk for BMI increased (OR=0.36; 95%CI=0.21-0.59; p=0.0001) and WC altered (OR=0.53; 95%CI=0.34-0.84; p=0.006) with respect to the euthyroid women.Conclusions: Found a prevalence of hypothyroidism in approximately half of the sample. The altered nutritional status CRF was the only significantly associated with hypothyroidism.Introducción: El hipotiroidismo se asocia con factores de riesgo cardiometabólicos (FRC) además de la edad y del sexo femenino. El principal objetivo fue conocer la prevalencia de hipotiroidismo y su asociación con FRC en mujeres adultas concurrentes a un Centro de Endocrinología de la Ciudad Autónoma de Buenos Aires, Argentina.Material y Métodos: Diseño transversal y observacional en muestra no probabilística de 316 mujeres adultas (40 a 65 años), categorizadas en hipotiroideas controladas con tratamiento farmacológico y eutiroideas. Variables: Se estudiaron los siguientes FRC: Índice Masa Corporal (IMC), &lt;25kg/m2 y ≥25,0Kg/m2; circunferencia cintura (CC) ≤88cm y &gt;88cm; etapa biológica (premenopausia y posmenopausia), tabaquismo, sedentarismo; perfil lipídico alterado (ColT&gt;200mg/dl; LDL-c&gt;130mg/dl; Tg&gt;150mg/dl; HDL-c&lt;40mg/dl); HTA≥120/80mmHg y glucemia basal aumentada &gt;100mg/dl. Estadística con SPSS 15.0 estableciendo medidas de tendencia central, ANOVA y OR con intervalos de confianza 95% (IC) y diferencia de proporciones con valor p&lt;0,05.Resultados: 46,2% hipotiroideas controladas y 53,8% eutiroideas; 64,2% posmenopáusicas; 68% con sobrepeso u obesidad y 45,2% con CC aumentada. La edad fue similar en ambos grupos: 53,3 (DS=6,4) años hipotiroideas y 53,9 (DS=6,6) años eutiroideas. Sedentarismo fue el FRC más prevalente en ambos grupos. Las hipotiroideas presentaron más riesgo de IMC aumentado (OR=0,36 IC95%=0,21-0,59; p=0,0001) y CC alterada (OR=0,53 IC95%=0,34-0,84; p=0,006) que las eutiroideas.Conclusiones: La prevalencia de hipotiroidismo se presentó aproximadamente en la mitad de la muestra. El estado nutricional alterado fue el único FRC asociado significativamente con el hipotiroidismo

Quality in perinatal care: applying performance measurement using joint commission on accreditation of healthcare organizations indicators in Italy

Abstract Background Maternal and child health are internationally considered to be among the best measures for assessing health-care quality. The study was carried out with the following aims: 1) to assess the quality of perinatal care (PC) by measuring the frequencies of the five PC indicators developed by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and comparing results with international standards; 2) to examine whether maternal, pregnancy care and neonatal characteristics could be factors associated with the quality of perinatal care hospital performance, measured through these indicators. Methods We retrospectively reviewed medical charts of women over the age of 18 who experienced delivery in Gynecology/obstetrics wards between January–December 2016, and those of their newborns hospitalized in the Neonatology or Neonatal Intensive Care Unit (NICU) of a public non-teaching hospital in Catanzaro (Italy). Indicators were calculated according to the methodology specified in the manual for JCAHO measures. Univariate and multivariate analyses were performed to test the independent association of maternal, pregnancy care and neonatal characteristics on the adherence to JCAHO PC indicators. Results The records of 1943 women and 1974 newborns were identified and reviewed in order to be included in at least one of the PC indicators. Elective/early-term delivery, was performed in 27.6% of eligible women, far from the recommended goal (0%); cesarean section in nulliparous women with a term, singleton baby in a vertex position exceeded the suggested target of < 24% and the adherence to antenatal steroids administration was suboptimal (87%). Results of the exclusive breastfeeding indicator achieved a better performance (81%) and compliance with the PC-04 indicator was satisfactory with only 0.4% healthcare-associated bloodstream infection developed in eligible newborns. Conclusions This is the first study performed in Italy that has evaluated the quality of PC by using all the five JCAHO indicators. The application of this feasible set of indicators allowed us to measure several aspects of PC for which there is no standardized monitoring system in Italy. Our findings revealed significant deficiencies in the adherence to recommended processes of PC and suggest that there is still substantial work required to improve care

Relación TG/HDL-C y resistencia a la insulina en mujeres adultas argentinas según su estado nutricional

Introduction: The ratio assessment TG/HDL-C is an indicator of LDL size, facilitating the detection of individuals with increased atherogenic risk. Estimating the size of the LDL becomes important, especially in patients with TG values near the upper limit of normal values of reference and HDL-C. The objective of the study is to estimate the association between TG/HDL-C and insulin resistance (IR) by nutritional status in adult women attending the Foundation for Endocrine Metabolic Diseases Research and Applied Clinical Research (FIEEM). Material and methods: Design Cross-sectional, non-pregnant adult women, apparently healthy, older than 30 years old, attending FIEEM in the Autonomous City of Buenos Aires. Dependent variable: TG/HDL-C = 3.0 considered high value. Independent variables: IR by homeostatic model index HOMA-IR = 2.5 categorizing the sample into two groups: with and without IR, and controlled by nutritional status using body mass index (BMI) and waist circumference (CC). SPSS Statistics 15.0, calculating X2 or Fisher exact test, OR with confidence intervals of 95% and establishing logistic regression p value < 0.05. Results: We evaluated a purposive sample of 104 women (31.4% and 26% IR with TG/HDL-C high). 84.6% were overweight or obese and 88.5% increased CC. Women with BMI had significantly increased 0.15-fold increased risk (95% CI = 0.01 to 1.26) for TG/HDL-C high (p = 0.04) than the control women. There was no significance with increased CC. The ratio TG/HDL-C high IR was significantly correlated (r = 0.30 p = 0.002). Conclusions: Body weight was significantly associated with IR and the ratio TG/HDL-C increased. This ratio correlated significantly with IR in apparently healthy women.Introducción: la valoración del índice TG/HDL-C resulta un indicador del tamaño de las LDL, facilitando la detección de individuos con riesgo aterogénico aumentado. El objetivo del estudio fue estimar la asociación entre TG/HDL-C y resistencia a la insulina (RI) según el estado nutricional en mujeres adultas. Material y métodos: diseño descriptivo transversal, de mujeres adultas no embarazadas, y aparentemente sanas, mayores de 30 años de edad, concurrentes a la Fundación para Investigación de Enfermedades Endócrino Metabólicas e Investigación Clínica Aplicada (FIEEM) en la Ciudad Autónoma de Buenos Aires. Variable dependiente: relación TG/HDL-C considerando valor elevado = 3,0. Variables independientes: RI por Índice modelo homeostático HOMA-IR = 2,5 categorizando a la muestra en dos grupos: con y sin RI, y controladas según el estado nutricional mediante índice de masa corporal (IMC) y circunferencia de la cintura (CC). Estadística con SPSS 15,0, calculando X2 o prueba exacta de Fisher, OR con intervalos de confianza del 95% y regresión logística estableciendo valor p < 0,05. Resultados: se evaluó una muestra intencional de 104 mujeres (31,4% con RI y 26% con TG/HDL-C elevada). El 84,6% presentó sobrepeso u obesidad y el 88,5% CC aumentada. Las mujeres con IMC aumentado presentaron significativamente 0,15 veces (IC 95% = 0,01-1,26; p = 0,04) más riesgo de TG/HDL-C elevada que las mujeres normopeso. No hubo significación con la CC aumentada. La relación TG/HDL-C elevada se correlacionó significativamente con RI (r = 0,30 p= 0,002). Conclusiones: el peso corporal se asoció significativamente con RI y la relación TG/HDL-C aumentada. Esta relación se correlacionó con la RI en mujeres aparentemente sanas

Prevalencia de hipotiroidismo y su asociación con factores de riesgo cardiometabólicos en mujeres adultas argentinas

Introduction: It is known that hypothyroidism is associated with cardiometabolic risk factors (CRF) as well as age, female gender. The main objective was determine the prevalence of hypothyroidism and its association with cardiometabolic risk factors in adult women attending the Foundation for Endocrine Metabolic Diseases Research of the Autonomous City of Buenos Aires, Argentina. Material and Methods: Cross-sectional and observational design. Probabilistic sample of 316 adult women (40-65 years), randomized into two groups: hypothyroid controlled with pharmacological treatment and euthyroid. Variable: the following were studied CRF: body mass index (BMI), normal <25kg/m2 and increased ≥25.0kg/m2; waist circumference (WC) normal ≤88cm and increased >88cm; biological stage (premenopausal and postmenopausal), smoking, sedentary lifestyle; altered lipid profile (TC>200mg/dl; LDL>130mg/dl; Tg>150mg/dl; HDL-c100mg/dl. Statistics with SPSS 15.0 establishing measures of central tendency, ANOVA and OR with 95% confidence intervals (CI) and difference of proportions with p<0.05. Results: The 46.2% of the sample were women controlled hypothyroid and euthyroid 53.8%. The 64.2% were postmenopausal, 68% overweight or obese and 45.2% with WC increased. Age was similar in both groups: 53.3 (SD=6.4) years the hypothyroid and 53.9 (SD=6.6) years the euthyroid. The inactivity was the CFR more prevalent in both groups. The hypothyroid women had a significantly higher risk for BMI increased (OR=0.36; 95%CI=0.21-0.59; p=0.0001) and WC altered (OR=0.53; 95%CI=0.34-0.84; p=0.006) with respect to the euthyroid women. Conclusions: Found a prevalence of hypothyroidism in approximately half of the sample. The altered nutritional status CRF was the only significantly associated with hypothyroidism.Introducción: El hipotiroidismo se asocia con factores de riesgo cardiometabólicos (FRC) además de la edad y del sexo femenino. El principal objetivo fue conocer la prevalencia de hipotiroidismo y su asociación con FRC en mujeres adultas concurrentes a un Centro de Endocrinología de la Ciudad Autónoma de Buenos Aires, Argentina. Material y Métodos: Diseño transversal y observacional en muestra no probabilística de 316 mujeres adultas (40 a 65 años), categorizadas en hipotiroideas controladas con tratamiento farmacológico y eutiroideas. Variables: Se estudiaron los siguientes FRC: Índice Masa Corporal (IMC), 88cm; etapa biológica (premenopausia y posmenopausia), tabaquismo, sedentarismo; perfil lipídico alterado (ColT>200mg/dl; LDL-c>130mg/dl; Tg>150mg/dl; HDL-c100mg/dl. Estadística con SPSS 15.0 estableciendo medidas de tendencia central, ANOVA y OR con intervalos de confianza 95% (IC) y diferencia de proporciones con valor p<0,05. Resultados: 46,2% hipotiroideas controladas y 53,8% eutiroideas; 64,2% posmenopáusicas; 68% con sobrepeso u obesidad y 45,2% con CC aumentada. La edad fue similar en ambos grupos: 53,3 (DS=6,4) años hipotiroideas y 53,9 (DS=6,6) años eutiroideas. Sedentarismo fue el FRC más prevalente en ambos grupos. Las hipotiroideas presentaron más riesgo de IMC aumentado (OR=0,36 IC95%=0,21-0,59; p=0,0001) y CC alterada (OR=0,53 IC95%=0,34-0,84; p=0,006) que las eutiroideas. Conclusiones: La prevalencia de hipotiroidismo se presentó aproximadamente en la mitad de la muestra. El estado nutricional alterado fue el único FRC asociado significativamente con el hipotiroidismo

Attitudes toward the SARS-CoV-2 and Influenza Vaccination in the Metropolitan Cities of Bologna and Palermo, Italy

Vaccine hesitancy (VH) is known to play a relevant role in thwarting the efforts toward reaching satisfactory influenza vaccination coverage, and has caused similar difficulties during the COVID-19 pandemic. This study aims to describe the phenomenon and produce insights on the reasons behind VH. A survey was administered between December 2020 and February 2021 to adults living in the cities of Bologna and Palermo. Of the 443 subjects enrolled, 47.3% were likely to get the influenza vaccination, while 75.6% were willing to receive the COVID-19 vaccination. The most frequent determinants that motivated the willingness to get the COVID-19 vaccine were trust in the safety of vaccines and belief that the vaccine is an effective tool. As for people’s unwillingness to be vaccinated, being exposed to information that produced doubts about the vaccine and lack of trust in a newly developed vaccine were the most frequently involved determinants. Statistically significant positive associations were found between the willingness to be vaccinated and postgraduate education and the propensity towards influenza vaccination. A negative association with being over 40 years old and of female gender was also found. These results might have an impact in better understanding individual reasons behind VH, identifying which categories are more exposed to it and which strategies should be implemented

Would Parents Get Their Children Vaccinated Against SARS-CoV-2? Rate and Predictors of Vaccine Hesitancy According to a Survey over 5000 Families from Bologna, Italy

In the near future, COVID-19 vaccine efficacy trials in larger cohorts may offer the possibility to implement child and adolescent vaccination. The opening of the vaccination for these strata may play a key role in order to limit virus circulation, infection spreading towards the most vulnerable subjects, and plan safe school reopening. Vaccine hesitancy (VH) could limit the ability to reach the coverage threshold required to ensure herd immunity. The aim of this study was to investigate the prevalence and determinants of VH among parents/guardians toward a potentially available COVID-19 vaccination for children and adolescents. An online survey was performed in parents/guardians of children aged &lt;18 years old, living in Bologna. Overall, 5054 questionnaires were collected. A vast majority (60.4%) of the parents/guardians were inclined to vaccinate, while 29.6% were still considering the opportunity, and 9.9% were hesitant. Highest vaccine hesitancy rates were detected in female parents/guardians of children aged 6-10 years, ≤29 years old, with low educational level, relying on information found in the web/social media, and disliking mandatory vaccination policies. Although preliminary, these data could help in designing target strategies to implement adherence to a vaccination campaign, with special regard to web-based information