Transition in endocrinology: predictors of drop-out of a heterogeneous population on a long-term follow-up.

PURPOSE: To evaluate: (1) clinical and epidemiological characteristics of outpatients transitioned from Pediatrics Endocrine (PED) to Adult Endocrine Department (AED) in a tertiary center; (2) transition process features, and predictors of drop-out. METHODS: Demographic, clinical, and transition features of 170 consecutive patients with pediatric onset of chronic endocrine or metabolic disease (excluded type 1 diabetes) who transitioned from PED to AED (2007-2020) were retrospective evaluated. RESULTS: The age at transition was 18.4 ± 4 years (F:M = 1.2: 1), and mean follow-up 2.8 years. The population was heterogeneous; the most (69.4%) was affected by one, 24.1% by two or more endocrine diseases, 6.5% were followed as part of a cancer survivor's surveillance protocol. The comorbidity burden was high (37, 20.6, and 11.2% of patients had 2, 3, 4, or more diseases). The number of visits was associated with the number of endocrine diseases and the type of them. Adherent subjects had a higher number of comorbidities. Thyroid disorders and more than one comorbidity predicted the adherence to follow-up. Having performed one visit only was predictive of drop-out, regardless of the pathology at diagnosis. CONCLUSION: This is the first study that analyzed a specific transition plan for chronic endocrine diseases on long-term follow-up. The proposed "one-size-fits-all model" is inadequate in responding to the needs of patients. A structured transition plan is an emerging cornerstone.

Social determinants of vulnerabilities in type 2 diabetes: a call to action.

PURPOSE: Type 2 diabetes (T2D) is a chronic disease which leads to high morbidity, mortality and healthcare costs. Although relevant gains have been made towards evidence-based diabetes care, patients with T2D still experience diabetes complications and excess mortality risk, owing to multiple contributors, including non-clinical factors. The aim of this paper is to provide an overview of the main social determinants of vulnerabilities, which are known to have a relevant impact on T2D outcomes. RESULTS: As chronic diseases are under the influence of social inequalities, medicine and sociology are intertwined in the attempt to understand, explain and address them. There is robust evidence about a clear relationship between social determinants of health (SDOH), such as socio-economic status (occupation, education, income), and the likelihood of developing T2D and its complications. Furthermore, the uncontrolled widespread of T2D in urban areas, mainly among suburban communities, suggests that cities might act as amplifiers of SDOH, enhancing inequalities in health care and, therefore, life expectancy. CONCLUSION: In light of the strong association between socio-cultural aspects and T2D outcomes, a global action is needed to raise awareness about disparities in diabetes prevention and treatment to reduce the burden of the disease.

Symptoms of Orthorexia Nervosa are associated with time spent on social media: a web-based survey in an Italian population sample.

OBJECTIVE: Orthorexia Nervosa (ON) is an eating disorder of growing interest that is characterized by an obsession with healthy eating. Nowadays, people spend an increasing amount of time on social media, which may negatively impact eating behaviors. The aim of this study was to investigate the relationship between social media usage and risk of ON. SUBJECTS AND METHODS: We conducted an online survey using the 10-item Italian-Düsseldorf Orthorexia Scale questionnaire (I-DOS). A total of 4,107 individuals participated and were classified according to sex, age, education level, marital status, BMI, main occupation, and diet. RESULTS: The prevalence of ON was 28.5%. Participants who reported using social media for over 60 minutes per day had a higher prevalence of ON than those using social media for less than 15 minutes per day. CONCLUSIONS: The results of this study suggest that longer time spent on social media is associated with ON.

Abitudini, stili di vita e socialità: una cluster analysis di studenti universitari italiani.

The analysis of health determinants in the student population can be useful in raising awareness on safe living conditions in new generations. The selection of specific biomedical markers, like advanced glycation end products (AGEs), and the analysis of social behaviors can support lifestyle choices evaluation. A questionnaire, containing an anamnestic section, a physical activity evaluation section, and a sociological section, was administered to a total of 110 students from two Italian universities, selected from the Faculty of Science of Movement and from the Faculty of Medicine. In addition, all subjects recruited in this study underwent to an AGEs accumulation assessment through skin autofluorescence. A non-hierarchical cluster analysis was performed on the collected data allowed the identification of two group of students: group 1 mainly consisted of male subjects from the Faculty of Science of Movement, characterized by an active lifestyle and a rather detached affective family condition; group 2 largely consisted of female subjects from the Faculty of Medicine, more sedentary and with stable relationships. The data analysis confirmed the correlation between low AGEs levels and healthy lifestyles, but at the same time underlined divergences between students from different Faculties.