ABSTRACT
BACKGROUND: From 2021, PSDTA for women with pregnancy complicated by diabetes will be active in the ASL city of Turin; given the city's increasing multiculturalism, we decided to evaluate from this point of view the patients who entered this pathway. METHODS: Data on women from 1/10/2022 to 30/09/2023 were collected from the computerized medical record. RESULTS: Total patients: 304, Type of diabetes: T1D 3%; MODY < 1%; T2D 4% Diabetes manifested in pregnancy (DMIP) 2%, GDM 90%, Foreigners prevalence: GDM: 67%, T2D%, T1D: Foreign 11%, Planned vs. neglected pregnancies: GDM 47% vs 18%, T2D 31% vs 32%, DMIP 28% vs 50%, T1D: 66% vs 11%, Therapy: GDM: insulin 31% (multi-injective <30%), metformin 5%, T2D: insulin 100% (multi-injective 68%, metformin in 20%); continuous glycemic sensor in 48%, DMIP: insulin 50% (multi-injective 50%), T1D: multi-injective therapy 33%; pump and glycemic sensor 33%; integrated sensor-micro-infuser system 33%. CONCLUSION: In the aspect of ISTAT data indicating that for northern Italy, a foreign origin for 26% of mothers, our population is "unbalanced" between GDM, T2D, and DMIP on one side and T1D on the other. The higher percentage of foreigners in the GDM group could be attributable to the higher share of Italian women opting for private practice, conversely, the "missing" share of foreign women with T1D is more difficult to interpret. Unplanned or even neglected pregnancies are significant in women with GDM and DMIP (who are mostly foreign). If these data are confirmed in other Italian realities, corrective strategies need to be planned.
ABSTRACT
BACKGROUND: Tuberculosis is a common cause of mortality and morbidity among people living with HIV/AIDS. Despite the increased prognosis of tuberculosis among HIV infected patients, diagnosis of pulmonary tuberculosis (PTB) smear microscopy has a low sensitivity due to low bacterial load in a sputum specimen of HIV patients. Having alternative specimens for increasing detection of Mycobacterium tuberculosis (Mtb) is very important. OBJECTIVE: The aim of this study was to evaluate the efficacy of urine as clinical specimen for the diagnosis of pulmonary tuberculosis in people living with HIV. METHOD: A total of 117 HIV-seropositive individuals from three public health facilities in Addis Ababa, Ethiopia were enrolled consecutively from December 2013 to July 2014. A total of 117 paired morning sputum and urine samples were simultaneously collected from anti-retroviral therapy (ART) naïve PTB suspected individuals living with HIV. Both sputum and urine samples were processed for culture using Lowenstein-Jensen medium, and the left was subjected to PCR using RD9 primers. Chi-square test and kappa value were used to compare different methods used. RESULT: Out of 117 suspected PTB HIV-infected people, sputum culture alone detected more mycobacterial isolates 33 (28.2%) than the urine specimen alone 17 (14.5%). Of the 33 patients positive for sputum culture, 13 patients were observed as a urine culture positive. Of the 84 individuals negative for mycobacterial by sputum culture, four (4.8%) were urine culture positive and thus, the sensitivity, and the agreement between urine culture as compare to sputum culture were 39.4% and 0.49, respectively. On the other hand, the sensitivity of RD9-based PCR directly on urine was 72.7% by considering sputum culture as a reference standard. Moreover, RD9-based PCR directly on sputum detected 9 (7.7%) individuals who were sputum culture negative for M. Tuberculosis. The detection rate of M. tuberculosis from urine in patients those who couldn't produce sputum were 9(34.6%). CONCLUSION: PCR and culture examination of urine samples also can improve the detection rate of M. tuberculosis in PTB suspected HIV positive individuals.