1,721,119 research outputs found
The TALS – reduced form: An inventory for assessing the heroin post-traumatic stress disorder spectrum (H/PTSD-S)
No full textBackground: Using the TALS questionnaire, in many papers, we stressed the importance of including the PTSD spec-
trum symptomatology as an integral part of the psychopathology of addiction. Unfortunately, we duly noted the difficulty
our patients experienced in filling in the questionnaire, with negative consequences on recruitment data. So, in this study,
we propose a shorter TALS-SR form. Methods: The main aim of this study was to select items from TALS to obtain a
reduced form for HUD patients, so making it possible to differentiate patients with and without a PTSD spectrum com-
parable with the one developed by the survivors of the L’Aquila (Italy) 2009 earthquake (H/PTSD-S). The secondary
aim was to start the validation of our H/PTSD-S inventory by testing the items regarding its discriminatory effect, and
its reliability in treating HUD patients. Results: Out of the 26 items included initially in Domain II (Grief Reactions),
we retained only seven. Out of the 18 items initially assigned to Domain IV (Reaction to losses or upsetting events), we
kept five. Out of the 9 items that belonged to Domain V (Re-experiencing), we retained five. Out of the 12 items in the
first version of Domain VI (Avoidance & Numbing), we retained five. Out of 8 items once in Domain VII (Maladaptive
Coping), we maintained three. Out of 5 items originally in Domain VIII (Arousal), we saved three. Out of 6 items in the
longer version of Domain IX (Personal Characteristics/Risk Factors), we discarded four, leaving only two. The cut-off
value determined with the ROC analysis was 11. All the items demonstrated adequate variability. The internal consist-
ency (reliability) estimated using Cronbach’s alpha was optimal (0.88). Conclusions: The proposed H/PTSD-S inventory,
which is founded on the principle of achieving a satisfactory level of internal consistency, measures the stress reactivity
construct. It seems set to evolve into an easily accessible, practical tool for evaluating the stress reactivity that occurs in
heroin use disorder patients, whether outside or inside a treatment setting
Height Outcome of Recombinant Human Growth Hormone Treatment in Achondroplasia Children: A Meta-Analysis
No full textBackground/Aims: Although recombinant human growth hormone (rhGH) is not approved to treat short stature of achondroplasia (ACH), some studies suggested growth improvement during short-term rhGH treatment. Methods: A meta-analysis of rhGH therapy efficacy in ACH children was performed. Results: From 12 English-language studies, 558 (54.0% males) rhGH-treated ACH children were enrolled. Administration of rhGH (median dosage 0.21 mg/kg/week; range 0.16-0.42 mg/kg/week) improved height (Ht) from baseline [-5.069 standard deviation score (SDS; 95% CI-5.109 to-5.029); p < 0.0001] to 12 [-4.325 SDS (95% CI-4.363 to-4.287); p < 0.0001] and 24 months [-4.073 SDS (95% CI-4.128 to-4.019); p < 0.0001]. Then, Ht remained approximately constant up to 5 years [-3.941 SDS (95% CI-4.671 to-3.212); p < 0.0001]. Conclusions: In ACH children, rhGH treatment increased Ht from-5.0 to-4.0 SDS during 5 years, but insufficient data are available on both the adult Ht and the changes of body proportions
Incidence of Morbidity Following Thyroid Surgery: Acceptable Morbidity Rates
No full textThyroid complications and power analysis. The issue of complications of thyroid surgery is extremely difficult to consider due to the relative rarity of the complications themselves, when thyroidectomy is performed by an experienced surgeon. Almost every study present in the literature reports the morbidity following thyroidectomy but there are only a few specifically addressing this issue, and the results are generally obtained from a statistical analysis that is not thorough: the rarity of the complication event would need studies performed on large numbers of patients. This chapter will focus on two main issues: analysing, from the results reported in the literature, what is a ‘reasonable’ incidence rate of complications for any surgeon performing thyroidectomies, and not necessarily operating in a large-volume thyroid surgery department, and briefly examining the most important statistical problems regarding the analysis of a rare event, such as the morbidity after thyroid surgery, when performing a reliable study on complications
Height outcome of the recombinant human growth hormone treatment in patients with SHOX gene haploinsufficiency: a meta-analysis.
No full textBackground: Patients with mutations or deletions of the SHOX gene present variable growth impairment, with or without mesomelic skeletal dysplasia. If untreated, short patients with SHOX haplodeficiency (SHOXD) remain short into adulthood. Although recombinant human growth hormone (rhGH) treatment improves short-term linear growth, there are episodic data on the final height of treated SHOXD subjects. Patients & methods: After a thorough search of the published literature for pertinent studies, we undertook a meta-analysis evaluation of the efficacy and safety of rhGH treatment in SHOXD patients. Results: In SHOXD patients, administration of rhGH progressively improved the height deficit from baseline to 24 months, although the major catch-up growth was detected after 12 months. The rhGH-induced growth appeared constant until final height. Conclusion: Our meta-analysis suggested rhGH therapy improves height outcome of SHOXD patients, though future studies using carefully titrated rhGH protocols are needed
Height outcome of short children with hypochondroplasia after recombinant human growth hormone treatment: a meta-analysis
No full textHypochondroplasia (HCH) is a genetic skeletal dysplasia, characterized by rhizomelic short height (Ht) with facial dysmorphology and lumbar hyperlordosis. Albeit there are concerns that HCH children may not achieve optimal long-term outcome in response to recombinant human growth hormone (rhGH), anecdotal experiences suggested at least short-term Ht improvement. After thorough search of published studies, meta-analysis of rhGH use in HCH children was performed. In 113 HCH children, rhGH administration (median 0.25 mg/kg/week) progressively improved Ht pattern with 12 months catch-up growth (p < 0.0001). Then, Ht improvement resulted constant until 36 months (p < 0.0001), but stature remained subnormal. While bone age chronologically progressed, no serious adverse events were reported. In conclusion, our meta-analysis indicates that rhGH treatment progressively improved Ht outcome of HCH subjects
Dalle District Health Authority ai Primary Care Trust: i fattori di una complessa evoluzione
No full text
Impact of vitamin D deficiency on the clinical and biochemical phenotype in women with sporadic primary hyperparathyroidism
No full textThe purpose of the study was to evaluate the relationship between serum 25(OH)D and the clinical phenotype in 215 consecutive Italian Caucasian women with sporadic primary hyperparathyroidism (PHPT) not taking vitamin D supplements. The study was performed at a single Italian tertiary center. PHPT-related manifestations, serum 25(OH)D, and other parameters of calcium metabolism and bone mineral density (BMD) by DXA were recorded. Serum 25(OH)D was negatively correlated with age (r = −0.18; P = 0.006), BMI (r = −0.20; P = 0.002), PTH (r = −0.21; P = 0.001), bone-specific alkaline phosphatase (BSAP) (r = −0.27; P < 0.001), and eGFR (r = −0.22; P = 0.01), and positively with serum creatinine and 1/3 distal radius BMD (R-BMD; r = 0.17; P = 0.015). In a multivariate regression analysis, serum 25(OH)D remained significantly correlated with age (r = −0.18; P = 0.005), BMI (r = −0.23; P = 0.049), serum PTH (r = −0.01; P = 0.023), BSAP (r = −0.01; P = 0.023) and eGFR (r = −0.09; P = 0.001), but not with R-BMD. Serum 25(OHD) was higher in patients with nephrolithiasis than in those without nephrolithiasis (18.5 ± 8.8 vs. 15.6 ± 8.0 ng/ml; P = 0.029), whereas no difference was found between fractured and unfractured patients (16.8 ± 9.3 vs. 16.0 ± 7.7; P = 0.663). There was a statistically significant inverse correlation between vitamin D status [defined by quartiles of measured values as well as commonly accepted cutoffs of serum 25(OH)D] and severity of the disease, as reflected by higher PTH and BSAP, but not by meeting the latest guidelines for parathyroidectomy. In conclusion, a low vitamin D status is associated with some features reflecting a more severe biochemical and clinical phenotype of PHPT in Italian women not taking vitamin D supplements
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