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1. Incidence of acute respiratory infections in preschool children in an outpatient setting before and during Covid-19 pandemic in Lombardy Region, Italy

Author

Mameli, C., Picca, M., Buzzetti, R., Pace, M. E., Badolato, R., Cravidi, C., Zuccotti, G. V., Marchisio, P., Sala, M., and Di Cosimo, M. E.

Subjects
Male, children, COVID-19, respiratory infection, Acute Disease, Adolescent, Child, Child, Preschool, Humans, Incidence, Infant, Infant, Newborn, Outpatients, Pandemics, Prospective Studies, SARS-CoV-2, Respiratory Tract Infections, Research, Newborn, Pediatrics, RJ1-570, Preschool
Abstract

Introduction The incidence of acute respiratory tract infections (ARTIs) in children is difficult to estimate because they are typically treated in outpatient settings and the majority of epidemiological data originate from hospital settings and refer to the most severe illnesses. Therefore, the incidence of ARTIs in a real-world setting remains largely unexplored. Therefore, this study aims to estimate the incidence of ARTIs, upper respiratory tract infections (URTIs), and lower respiratory tract infections (LRTIs) in children aged 0–5 years in an outpatient setting. Methods This prospective cohort study was conducted in Lombardy, Italy, from October 1st, 2019, to March 31st, 2021, before and during the COVID-19 pandemic that began in March 2020. Caucasian healthy children aged 0–5 years were recruited from 69 Family Pediatricians (FP) and followed-up in an outpatient setting. Data were collected whenever a child was referred to FP and ARTI was diagnosed (Covid-19 related ARTI were excluded). The primary outcome was an estimate of the incidence of ARTIs. The incidence of ARTIs in different age groups and the effect of the COVID-19 pandemic on the incidence of ARTIs were secondary outcomes. Results We enrolled 484 children, 249 male (51.8%), mean age of 2.39 ± 1.68 years. The mean estimated incidence of ARTIs was 12.1/100 children × 30 days (95% CIs: 9.5–12.9), with the highest value observed in infants aged 1–12 months (24.9/100 children × 30 days; 95% CIs: 17.6–28.9). The mean estimated incidence of URTIs was higher than that of LRTIs (8.3 – CIs: 7.6–8.9 vs 3.8/100 children × 30 days – CIs: 6.4–4.3, respectively). The comparison of ARTIs, which occurred in the pre-pandemic winter, to those measured during the COVID-19 pandemic, revealed an impressive 82.1% drop in the incidence rate (CIs: 77.8–85.7). Conclusions This study showed that infants aged 1–12 months are more likely to develop ARTIs than older children and that COVID-19 pandemic has dramatically altered the epidemiology of ARTIs in children aged 0–5 years.

Published
2022

2. The Iodine Rush: Over- or Under-Iodination Risk in the Prophylactic Use of Iodine for Thyroid Blocking in the Event of a Nuclear Disaster

Author

Calcaterra, V., Mameli, C., Rossi, V., Massini, G., Gambino, M., Baldassarre, P., and Zuccotti, G.

Subjects
Settore MED/38 - Pediatria Generale e Specialistica, Halogenation, Adolescent, iodine, the iodine rush, Iodides, Disasters, Iodine Radioisotopes, nuclear, children, prohpylaxis, hyperthyroidism, hypothyroidism, thyroid blocking, Child, Emergencies, Humans, Iodine, Thyroid Neoplasms
Published
2022

3. Recommendations for recognizing, risk stratifying, treating, and managing children and adolescents with hypoglycemia

Author

Stefano Zucchini, Stefano Tumini, Andrea Enzo Scaramuzza, Riccardo Bonfanti, Maurizio Delvecchio, Roberto Franceschi, Dario Iafusco, Lorenzo Lenzi, Enza Mozzillo, Stefano Passanisi, Claudia Piona, Ivana Rabbone, Novella Rapini, Andrea Rigamonti, Carlo Ripoli, Giuseppina Salzano, Silvia Savastio, Riccardo Schiaffini, Angela Zanfardino, Valentino Cherubini, Diabetes Study Group of the Italian Society for Pediatric Endocrinology Diabetes, Albino Claudia Accursia, Aloe Monica, Anzelotti Maria Teresa, Arnaldi Claudia, Barbetti Fabrizio, Bassi Marta, Berioli Maria Giulia, Bernardini Luca, Bertelli Enrica, Biagioni Martina, Bobbio Adriana, Bombaci Bruno, Bonfanti Riccardo, Bonura Clara, Bracciolini Giulia Patrizia, Bruzzese Mariella, Bruzzi Patrizia, Buono Pietro, Buscarino Piera, Cadario Francesco, Calcaterra Valeria, Calzi Elena, Cappa Marco, Cardani Roberta, Cardella Francesca, Cardinale Giuliana Marcella, Casertano Alberto, Castorani Valeria, Cauvin Vittoria, Cenciarelli Valentina, Ceruti Franco, Cherubini Valentino, Chiarelli Francesco, Chiari Giovanni, Cianfarani Stefano, Cicchetti Mario, Cipriano Paola, Cirillo Dante, Citriniti Felice, Coccioli Maria Susanna, Confetto Santino, Contreas Giovanna, Coro Anna, Correddu Antonella, Corsini Elisa, Crino’ Antonino, d’Annunzio Giuseppe, De Berardinis Fiorella, De Donno Valeria, De Filippo Gianpaolo, De Marco Rosaria, De Sanctis Luisa, Del Duca Elisabetta, Delvecchio Maurizio, Deodati Annalisa, Di Bonito Procolo, Di Candia Francesca, Faleschini Elena, Fattorusso Valentina, Favia Anna, Federico Giovanni, Felappi Barbara, Ferrari Mara, Ferrito Lucia, Fichera Graziella, Fontana Franco, Fornari Elena, Franceschi Roberto, Franco Francesca, Franzese Adriana, Frongia Anna Paola, Frontino Giulio, Gaiero Alberto, Galassi Sabrina Maria, Gallo Francesco, Gargantini Luigi, Giani Elisa, Gortan Anna Jolanda, Graziani Vanna, Grosso Caterina, Gualtieri Antonella, Guasti Monica, Guerraggio Lucia Paola, Guzzetti Chiara, Iafusco Dario, Iannicelli Gennaro, Iezzi Maria Laura, Ignaccolo Maria Giovanna, Innaurato Stefania, Inzaghi Elena, Iovane Brunella, Iughetti Lorenzo, Kaufmann Peter, La Loggia Alfonso, Lambertini Anna Giulia, Lapolla Rosa, Lasagni Anna, Lazzaro Nicola, Lazzeroni Pietro, Lenzi Lorenzo, Lera Riccardo, Levantini Gabriella, Lezzi Marilea, Lia Rosanna, Liguori Alice, Lo Presti Donatella, Lombardo Fortunato, Lonero Antonella, Longhi Silvia, Lorubbio Antonella, Lucchesi Sonia, Maccioni Rosella, Macedoni Maddalena, Macellaro Patrizia Cristiana, Madeo Simona Filomena, Maffeis Claudio, Mainetti Benedetta, Maltoni Giulio, Mameli Chiara, Mammì Francesco, Manca Bitti Maria Luisa, Mancioppi Valentina, Manco Melania, Marigliano Marco, Marino Monica, Marsciani Alberto, Matteoli Maria Cristina, Mazzali Elena, Minute Marta, Minuto Nicola, Monti Sara, Morandi Anita,, Morganti Gianfranco, Morotti Elisa, Mozzillo Enza, Musolino Gianluca, Olivieri Francesca, Ortolani Federica, Pampanini Valentina, Pardi Daniela, Pascarella Filomena, Pasquino Bruno, Passanisi Stefano, Patera Ippolita Patrizia, Pedini Annalisa, Pennati Maria Cristina, Peruzzi Sonia, Peverelli Paola, Pezzino Giulia, Piccini Barbara, Piccinno Elvira Eugenia Rosaria, Piona Claudia, Piredda Gavina, Piscopo Alessia, Pistone Carmelo, Pozzi Erica, Prandi Elena, Predieri Barbara, Prudente Sabrina, Pulcina Anna, Rabbone Ivana, Randazzo Emioli, Rapini Novella, Reinstadler Petra, Riboni Sara, Ricciardi Maria Rossella, Rigamonti Andrea, Ripoli Carlo, Rossi Virginia, Rossi Paolo, Rutigliano Irene, Sabbion Alberto, Salvatoni Alessandro, Salvo Caterina, Salzano Giuseppina, Sanseviero Mariateresa, Savastio Silvia, Savini Rosanna, Scanu Mariapiera, Scaramuzza Andrea Enzo, Schiaffini Riccardo, Schiavone Maurizio, Schieven Eleonardo, Scipione Mirella, Secco Andrea, Silvestri Francesca, Siri Giulia, Sogno Valin Paola, Sordelli Silvia, Spiri Daniele, Stagi Stefano, Stamati Filomena Andreina, Suprani Tosca, Talarico Valentina, Tiberi Valentina, Timpanaro Tiziana Antonia Lucia, Tinti Davide, Tirendi Antonina, Tomaselli Letizia Grazia, Toni Sonia, Torelli Cataldo, Tornese Gianluca, Trada Michela,, Trettene Adolfo Andrea, Tumini Stefano, Tumminelli Marilena, Valerio Giuliana, Vandelli Sara, Ventrici Claudia, Zampolli Maria, Zanatta Manuela, Zanfardino Angela, Zecchino Clara, Zonca Silvia, and Zucchini Stefano

Subjects
adolescents, automated insulin delivery, children, hypoglycemia, glucagon, oral glucose, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

There has been continuous progress in diabetes management over the last few decades, not least due to the widespread dissemination of continuous glucose monitoring (CGM) and automated insulin delivery systems. These technological advances have radically changed the daily lives of people living with diabetes, improving the quality of life of both children and their families. Despite this, hypoglycemia remains the primary side-effect of insulin therapy. Based on a systematic review of the available scientific evidence, this paper aims to provide evidence-based recommendations for recognizing, risk stratifying, treating, and managing patients with hypoglycemia. The objective of these recommendations is to unify the behavior of pediatric diabetologists with respect to the timely recognition and prevention of hypoglycemic episodes and the correct treatment of hypoglycemia, especially in patients using CGM or advanced hybrid closed-loop systems. All authors have long experience in the specialty and are members of the Italian Society of Pediatric Endocrinology and Diabetology. The goal of treating hypoglycemia is to raise blood glucose above 70 mg/dL (3.9 mmol/L) and to prevent further decreases. Oral glucose at a dose of 0.3 g/kg (0.1 g/kg for children using “smart pumps” or hybrid closed loop systems in automated mode) is the preferred treatment for the conscious individual with blood glucose

Published
2024
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4. Combined use of a wristband and a smartphone to reduce body weight in obese children: randomized controlled trial.

Author

Mameli, C., Brunetti, D., Colombo, V., Bedogni, G., Schneider, L., Penagini, F., Borsani, B., and Zuccotti, G. V.

Subjects
*PREVENTION of childhood obesity, *ENERGY metabolism, *WEIGHT loss, *WEARABLE technology, *BODY mass index, *RANDOMIZED controlled trials, *SMARTPHONES, *MOBILE apps, *INDIVIDUALIZED medicine
Abstract

Summary: Background: Technological instruments may help control paediatric obesity. Objective: We tested whether a personalized programme based on the energy expenditure obtained from a wristband (WB) and the energy intake obtained from a smartphone application (APP) is superior to a standard approach at promoting weight loss. Methods: We performed a randomized controlled trial in obese children aged 10–17 years. The experimental (EXP) and control (CTR) groups were given a low‐energy diet and a prescription for physical activity. The EXP group was equipped with a WB and an APP and given personalized feedback every 7 days. The main outcome was weight loss at 3 months. Results: The mean (standard deviation) z‐score of body mass index at the enrollment was 2.20 (0.47) in the EXP (n = 16 out of 23) and 2.09 (0.34) in the CTR group (n = 14 out of 20) of children who completed the trial. The mean (95%CI) difference in weight loss at 3 months was 0.07 kg (95%CI: 2.81 to 2.96) for EXP vs. the CTR. Conclusion: A personalized lifestyle programme based on a WB and an APP was not superior to a standard lifestyle programme at promoting weight loss in obese children. [ABSTRACT FROM AUTHOR]

Published
2018
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5. Real-world impact of rotavirus vaccination in European healthcare settings: a systematic literature review

Author

Goran Bencina, Claudio Costantino, Chiara Mameli, Ugne Sabale, Janice Murtagh, Rebecca Newman, Aideen Ahern, Rikal Bhaila, Alejandro Orrico Sanchez, Federico Martinon-Torres, Cristina Carias, Bencina G., Costantino C., Mameli C., Sabale U., Murtagh J., Newman R., Ahern A., Bhaila R., Sanchez A.O., Martinon-Torres F., and Carias C.

Subjects
Immunology, diarrhea, Rotavirus Infections, Drug Discovery, Humans, Children, gastroenteritis, rotavirus, systematic literature review, vaccines, Child, Aged, Pharmacology, Settore MED/38 - Pediatria Generale e Specialistica, rotaviru, Immunization Programs, Vaccination, Rotavirus Vaccines, Infant, Hospitalization, Molecular Medicine, gastroenteriti, Delivery of Health Care
Abstract

INTRODUCTION: Rotavirus is one of the most common pathogens causing diarrhea in children

Published
2022

6. Significant and persistent improvements in time in range and positive emotions in children and adolescents with type 1 diabetes using a closed-loop control system after attending a virtual educational camp

Author

Rabbone, Ivana, Savastio, Silvia, Pigniatiello, Ciro, Carducci, Chiara, Berioli, Maria Giulia, Cherubini, Valentino, Lo Presti, Donatella, Maltoni, Giulio, Mameli, Chiara, Marigliano, Marco, Minuto, Nicola, Mozzillo, Enza, Piccinno, Elvira, Predieri, Barbara, Rigamonti, Andrea, Ripoli, Carlo, Schiaffini, Riccardo, Lombardo, Fortunato, Tinti, Davide, Toni, Sonia, Zanfardino, Angela, Scaramuzza, Andrea Enzo, BassiBassi, Marta, Bonfanti, Riccardo, Bruzzi, Patrizia, Delvecchio, Maurizio, Giorda, Sara, Iafusco, Dario, Salzano, Giuseppina, Maffeis, Claudio, Redaelli, Francesca Chiara, Marino, Monica, Piccini, Barbara, Ricciardi, Maria Rossella, Rosanio, Francesco Maria, Tiberi, Valentina, Trada, Michela, Zanetta, Sara, Zucchini, Stefano, Calandretti, Michela, Daga, Federico Abate, Gesuita, Rosaria, Cavalli, Claudio, Rabbone, Ivana, Savastio, Silvia, Pigniatiello, Ciro, Carducci, Chiara, Berioli, Maria Giulia, Cherubini, Valentino, Lo Presti, Donatella, Maltoni, Giulio, Mameli, Chiara, Marigliano, Marco, Minuto, Nicola, Mozzillo, Enza, Piccinno, Elvira, Predieri, Barbara, Rigamonti, Andrea, Ripoli, Carlo, Schiaffini, Riccardo, Lombardo, Fortunato, Tinti, Davide, Toni, Sonia, Zanfardino, Angela, Scaramuzza, Andrea Enzo, Bonfanti, Riccardo, Rabbone, I., Savastio, S., Pigniatiello, C., Carducci, C., Berioli, M. G., Cherubini, V., Lo Presti, D., Maltoni, G., Mameli, C., Marigliano, M., Minuto, N., Mozzillo, E., Piccinno, E., Predieri, B., Rigamonti, A., Ripoli, C., Schiaffini, R., Lombardo, F., Tinti, D., Toni, S., Zanfardino, A., Scaramuzza, A. E., Bassibassi, Marta, Bruzzi, Patrizia, Delvecchio, Maurizio, Giorda, Sara, Iafusco, Dario, Salzano, Giuseppina, Maffeis, Claudio, Redaelli, Francesca Chiara, Marino, Monica, Piccini, Barbara, Ricciardi, Maria Rossella, Rosanio, Francesco Maria, Tiberi, Valentina, Trada, Michela, Zanetta, Sara, Zucchini, Stefano, Calandretti, Michela, Daga, Federico Abate, Gesuita, Rosaria, and Cavalli, Claudio

Subjects
Blood Glucose, Virtual educational camp, Type 1 diabete, Adolescent, Endocrinology, Diabetes and Metabolism, Emotions, Adolescents, Advanced hybrid closed loop, Children, Closed-loop control, Type 1 diabetes, Blood Glucose Self-Monitoring, Child, Humans, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Diabetes Mellitus, Type 1, Endocrinology, Diabetes Mellitus, Internal Medicine, Emotion, General Medicine, Type 1
Abstract

Objective To evaluate the six-month impact of the advanced automated functions of a closed-loop control (CLC) system (Control-IQ) and a virtual educational camp (vEC) on emotions and time in range (TIR) of children and adolescents with type 1 diabetes. Methods Children and their parents participated in a three-day vEC. Clinical, glucose, and emotion data were evaluated before, just after, and six months after the vEC. Emotions were evaluated using adapted Plutchik's and Geneva Emotion Wheels. Results Forty-three children and adolescents (7–16 years) showed significant improvements in positive emotions immediately and six months after the vEC (67% and 65% vs 38%, p < 0.05, respectively), while mixed emotions were reduced (32% and 15% vs 61%, p < 0.05 and p < 0.001, respectively). The median percentage TIR increased from 64% (IQR 54–72) to 75% (IQR 70–82) with Control-IQ (p < 0.001) six months after the vEC. Conclusions Positive emotions (joy, serenity, and satisfaction) significantly improved while mixed emotions were significantly worse six months after the initiation of a CLC system (Control-IQ) and a vEC.

Published
2022

7. A nationwide survey of Italian pediatric diabetologists about COVID-19 vaccination in children and adolescents with type 1 diabetes

Author

E Scaramuzza Andrea, Cherubini, Valentino, Schiaffini, Riccardo, Rabbone, Ivana, The Diabetes Study Group of the Italian Society for Pediatric Endocrinology and Diabetes, Francesco, Gallo, Graziella, Fichera, Claudia, Arnaldi, Riccardo, Bonfanti, Fortunato, Lombardo, Rosaria De Marco, Filomena, Pascarella, Gianluca, Tornese, Adriana, Bobbio, Tosca, Suprani, Nicola, Minuto, Roberto, Franceschi, Elvira, Piccinno, Enza, Mozzillo, Silvia, Savastio, Barbara, Piccini, Anna Paola Frongia, Chiara, Mameli, Gianluca, Musolino, Sonia, Toni, Emioli, Randazzo, Giulio, Frontino, Maurizio, Delvecchio, Paola Sogno Valin, Petra, Reinstadler, Valeria, Calcaterra, Luisa De Sanctis, Michela, Trada, Maria Susanna Coccioli, Lucia Paola Guerraggio, Felice, Citriniti, Anna, Lasagni, Irene, Rutigliano, Filomena Andreina Stamati, Fiorella De Berardinis, Maria, Zampolli, Giulio, Maltoni, Elena, Fornari, Carlo, Ripoli, Alberto, Gaiero, Silvia, Sordelli, Giuseppe, D’Annunzio, Predieri, Barbara, Giuliana, Cardinale, Francesca, Cardella, Dario, Iafusco, Anna, Corò, Stefano, Zucchini, Claudio, Maffeis, Elisa, Giani, Davide, Tinti, Claudio, Cavalli, Scaramuzza, Ae, Cherubini, V, Schiaffini, R, Rabbone, I, Iafusco, D, E Scaramuzza, Andrea, Cherubini, Valentino, Schiaffini, Riccardo, Rabbone, Ivana, Tornese, Gianluca, Scaramuzza, A. E., Cherubini, V., Schiaffini, R., Rabbone, I., Gallo, F., Fichera, G., Arnaldi, C., Bonfanti, R., Lombardo, F., De Marco, R., Pascarella, F., Tornese, G., Bobbio, A., Suprani, T., Minuto, N., Franceschi, R., Piccinno, E., Mozzillo, E., Savastio, S., Piccini, B., Frongia, A. P., Mameli, C., Musolino, G., Toni, S., Randazzo, E., Frontino, G., Delvecchio, M., Sogno Valin, P., Reinstadler, P., Calcaterra, V., De Sanctis, L., Trada, M., Coccioli, M. S., Guerraggio, L. P., Citriniti, F., Lasagni, A., Rutigliano, I., Stamati, F. A., De Berardinis, F., Zampolli, M., Maltoni, G., Fornari, E., Ripoli, C., Gaiero, A., Sordelli, S., D'Annunzio, G., Predieri, B., Cardinale, G., Cardella, F., Iafusco, D., Coro, A., Zucchini, S., Maffeis, C., Giani, E., Tinti, D., and Cavalli, C.

Subjects
COVID-19 Vaccines, Adolescent, Type 1 diabete, Endocrinology, Diabetes and Metabolism, Vaccination, COVID-19, General Medicine, Adolescents, Diabetes Mellitus, Type 1, Endocrinology, Type 1 diabetes, Italy, Children, Vaccine, Internal Medicine, Humans, Child
Abstract

N/A

Published
2022

8. Type 1 diabetes onset in Lombardy region, Italy, during the COVID-19 pandemic: The double-wave occurrence

Author

Barbara Felappi, Carmelo Pistone, Roberta Cardani, Silvia Sordelli, Chiara Mameli, Lucia Paola Guerraggio, Ilaria Brambilla, Valeria Calcaterra, Francesca Redaelli, Maddalena Macedoni, Patrizia Boracchi, Andrea Scaramuzza, Giuseppe Marano, Gian Vincenzo Zuccotti, Daniele Spiri, Giulio Frontino, Ciretta Pelliccia, Ester Luconi, Andrea Rigamonti, Patrizia Macellaro, Anna Cogliardi, Maria Zampolli, Riccardo Bonfanti, Elena Calzi, Elia Biganzoli, Mameli, C., Scaramuzza, A., Macedoni, M., Marano, G., Frontino, G., Luconi, E., Pelliccia, C., Felappi, B., Guerraggio, L. P., Spiri, D., Macellaro, P., Chiara Redaelli, F., Cardani, R., Zampolli, M., Calcaterra, V., Sordelli, S., Calzi, E., Cogliardi, A., Brambilla, I., Pistone, C., Rigamonti, A., Boracchi, P., Biganzoli, E., Zuccotti, G. V., and Bonfanti, R.

Subjects
Pediatrics, medicine.medical_specialty, Type 1 diabetes, Medicine (General), Diabetic ketoacidosis, Coronavirus disease 2019 (COVID-19), business.industry, Incidence (epidemiology), COVID-19, General Medicine, medicine.disease, Age and sex, New-onset, R5-920, Epidemiology, Pandemic, medicine, Cumulative incidence, business, Children, Research Paper
Abstract

Background The Italian Lombardy region has been the epicenter of COVID-19 since February 2020. This study analyses the epidemiology of pediatric type 1 diabetes (T1D) onset during the first two pandemic waves and three previous years. Methods All the 13 pediatric diabetes centers in Lombardy prospectively evaluated charts of children at T1D onset (0–17 years), during year 2020. After calculating the annual incidence, the data were compared with those of the 3 previous years, using generalized linear models, adjusted for age and sex. Monthly T1D new onsets and diabetic ketoacidosis (DKA) were investigated yearly from 2017 to 2020. Data were extracted from outpatients charts of the pediatric diabetes centers and from the database of the national institute of statistics. Findings The estimated incidence proportion of T1D was 16/100·000 in 2020, compared to 14, 11 and 12 in 2019, 2018 and 2017, respectively. When adjusting for age and gender, the incidence was significantly lower in 2018 and 2017 compared to 2020 (adjusted incidence ratio: 0.73 and 0.77 respectively, with 95% CI: 0.63 to 0.84, and 0.67 to 0.83; p = 0·002 and p = 0·01), but no difference was found between the years 2020 and 2019. A reduction trend in the percentage of T1D diagnosis during the first wave (March-April) over the total year diagnoses was observed compared to previous years (11·7% in 2020, 17·7% in 2019, 14·1% in 2018 and 14·4% 2017). No difference was observed during the second wave (October-December) (32·8% in 2020, 33·8% in 2019, 34% in 2018, 30·7% in 2017). The proportion of DKA over the total T1D diagnoses during the second wave had higher trend than the first one (41·7% vs 33·3%), while severe DKA over the total DKA appeared higher during the first wave (60% vs 37·1%). Interpretation The study suggests an increase in the incidence of pediatric T1D in Lombardy throughout the past five years. Pandemic waves may have affected the clinical presentation at onset. Funding None.

Published
2021

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