Monitoring the effects of iodine prophylaxis in the adult population of southern Italy with deficient and sufficient iodine intake levels: a cross-sectional, epidemiological study.

I prophylaxis is the most effective strategy to eradicate I deficiency disorders, but it has been shown to affect the thyroid disease pattern. In this study, we assessed the frequency of thyroid disorders in an adult population living in two areas of southern Italy after implementing I prophylaxis. To this aim, a cross-sectional, population-based study including 489 subjects from an I-deficient rural and an I-sufficient urban area of southern Italy was conducted. Thyroid ultrasound was performed on all participants, and urine and blood samples were collected from each subject. The levels of thyroid-stimulating hormone (TSH), thyroglobulin (TgAb) and thyroperoxidase antibodies (TPOAb), urinary I excretion (UIE), and thyroid volume and echogenicity were evaluated. We found that the median UIE was higher in the urban than in the rural area (P=0·004), whereas the prevalence of subjects affected by goitre was higher in the rural compared with the urban area (P=0·003). Positive TgAb rather than TPOAb were more frequent in subjects from the urban area compared with the rural area (P=0·009). The hypoechoic pattern at thyroid ultrasound (HT-US) was similar between the two areas, but TgAb were significantly higher (P=0·01) in HT-US subjects from the urban area. The frequency of elevated TSH did not differ between the two screened populations, and no changes were found for TgAb positivity in subjects with high TSH in the urban compared with the rural area. Our findings support that the small risks of I supplementation are far outweighed by the substantial benefits of correcting I deficiency, although continued monitoring of populations is necessary.

Prognostic Role of Rib Hump in Overlying Thoracic Curve Correction Above Selective Fusion for Lenke 5 Idiopathic Adolescent Scoliosis.

STUDY DESIGN: Prospective study. OBJECTIVE: To assess whether rib hump is a prognostic factor of final thoracic Cobb angle. SUMMARY OF BACKGROUND DATA: Correction of thoracolumbar/lumbar curve, preoperative thoracic curves angle, thoracic curves angle on bending, the thoracolumbar-lumbar angle/thoracic curves angle ratio, thoracic kyphosis, and growth stage influences spontaneous correction of uninstrumented thoracic curves angle above selective fusion for Lenke 5 Adolescent Idiopathic Scoliosis. Indeed, preoperative rib hump has never been expressly evaluated as a prognostic factor of final thoracic curves angle. METHODS: In total, 50 patients with Lenke 5 Adolescent Idiopathic Scoliosis, selectively instrumented with posterior construct were included. Two patients were lost to follow-up and 48 had follow-up ≥2 years. Demographic data, preoperative thoracic rib hump (measured in millimeter in trunk anteflexion), and radiologic spinal parameters were recorded preoperatively and at last consultation. T test was used to compare mean values, linear and logistic regressions to assess predictability of final thoracic curve angle. RESULTS: Main thoracolumbar-lumbar curve angle decreased from 47 degrees (range, 36-72 degrees) to 12 degrees at the final consultation (range, 1-28 degrees). Thoracic curves angle decreased from 26 degrees (range, 2-40 degrees) preoperatively to 16 degrees (range, 2-41 degrees) at the final consultation (P=0.001) (correction=37%). Preoperative rib hump was present in 10 patients. Final thoracic Cobb angle was 27 degrees (8-41 degrees) in patients with rib hump and 14 degrees (0-32 degrees) in patients without rib hump (P<0.001).Multiregression highlighted thoracic curves angle on bending (P=0.001), preoperative thoracic curves angle (P=0.011) and rib hump (P=0.012) as prognostic factors of higher final thoracic curves angle. CONCLUSION: Rib hump significantly influenced final thoracic curves angle. LEVEL OF EVIDENCE: Level III-prospective study.

Analysis of cystic fibrosis gene mutations in children with cystic fibrosis and in 964 infertile couples within the region of Basilicata, Italy: a research study.

INTRODUCTION: Cystic fibrosis is the most common autosomal recessive genetic disease in the Caucasian population. Extending knowledge about the molecular pathology on the one hand allows better delineation of the mutations in the CFTR gene and the other to dramatically increase the predictive power of molecular testing. METHODS: This study reports the results of a molecular screening of cystic fibrosis using DNA samples of patients enrolled from January 2009 to December 2013. Patients were referred to our laboratory for cystic fibrosis screening for infertile couples. In addition, we identified the gene mutations present in 76 patients affected by cystic fibrosis in the pediatric population of Basilicata. RESULTS: In the 964 infertile couples examined, 132 subjects (69 women and 63 men) resulted heterozygous for one of the CFTR mutations, with a recurrence of carriers of 6.85%. The recurrence of carriers in infertile couples is significantly higher from the hypothetical value of the general population (4%). CONCLUSIONS: This study shows that in the Basilicata region of Italy the CFTR phenotype is caused by a small number of mutations. Our aim is to develop a kit able to detect not less than 96% of CTFR gene mutations so that the relative risk for screened couples is superimposable with respect to the general population.

Use of a sealant to prevent prolonged air leaks after lung resection: a prospective randomized study.

BACKGROUND: Pulmonary air leaks are common complications of lung resection and result in prolonged hospital stays and increased costs. The purpose of this study was to investigate whether, compared with standard care, the use of a synthetic polyethylene glycol matrix (CoSeal®) could reduce air leaks detected by means of a digital chest drain system (DigiVent™), in patients undergoing lung resection (sutures and/or staples alone). METHODS: Patients who intraoperatively showed moderate or severe air leaks (evaluated by water submersion tests) were intraoperatively randomized to receive just sutures/staples (control group) or sutures/staples plus CoSeal® (sealant group). Differences among the groups in terms of air leaks, prolonged air leaks, time to chest tube removal, length of hospital stay and related costs were assessed. RESULTS: In total, 216 lung resection patients completed the study. Nineteen patients (18.1%) in the control group and 12 (10.8%) patients in the sealant group experienced postoperative air leaks, while a prolonged air leak was recorded in 11.4% (n=12) of patients in the control group and 2.7% (n=3) of patients in the sealant group. The difference in the incidence of air leaks and prolonged air leaks between the two groups was statistically significant (p=0.0002 and p=0.0013). The mean length of hospital stay was significantly shorter in the sealant group (4 days) than the control group (8 days) (p=0.0001). We also observed lower costs in the sealant group than the control group. CONCLUSION: The use of CoSeal® may decrease the occurrence and severity of postoperative air leaks after lung resection and is associated with shorter hospital stay. TRIAL REGISTRATION: Not registered. The trial was approved by the Institutional Review Board of the IRCCS-CROB Basilicata Regional Cancer Institute, Rionero in Vulture, Italy.