13 results on '"Assirelli V"'
Search Results
2. Treatment of congenital hypothyroidism: comparison between L-thyroxine oral solution and tablet formulations up to 3 years of age
- Author
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Maria Cristina Vigone, Rita Ortolano, Gaia Vincenzi, Clara Pozzi, Micol Ratti, Valentina Assirelli, Sofia Vissani, Paolo Cavarzere, Alessandro Mussa, Roberto Gastaldi, Raffaella Di Mase, Mariacarolina Salerno, Maria Elisabeth Street, Jessica Trombatore, Giovanna Weber, Alessandra Cassio, Vigone, M. C., Ortolano, R., Vincenzi, G., Pozzi, C., Ratti, M., Assirelli, V., Vissani, S., Cavarzere, P., Mussa, A., Gastaldi, R., Di Mase, R., Salerno, M., Street, M. E., Trombatore, J., Weber, G., Cassio, A., and Vigone MC, Ortolano R, Vincenzi G, Pozzi C, Ratti M, Assirelli V, Vissani S, Cavarzere P, Mussa A, Gastaldi R, Di Mase R, Salerno M, Street ME, Trombatore J, Weber G, Cassio A.
- Subjects
Oral ,Male ,medicine.medical_specialty ,Pediatrics ,Thyroid Hormones ,Hormone Replacement Therapy ,Endocrinology, Diabetes and Metabolism ,Statistical difference ,Administration, Oral ,Thyrotropin ,Thyroid Function Tests ,Endocrinology ,Internal medicine ,medicine ,Congenital Hypothyroidism ,Humans ,Child ,Preschool ,Developmental quotient ,Retrospective Studies ,business.industry ,Administration, Oral, Child, Preschool, Congenital Hypothyroidism, Female, Hormone Replacement Therapy, Infant, Infant, Newbor, Italy, Male, Retrospective Studies, oral solutions, Tablets, Thyroid Function Tests, Thyroid Hormones, Thyrotropin, Thyroxine, Treatment Outcome ,Infant, Newborn ,Infant ,General Medicine ,Child, Preschool ,Female ,Italy ,Solutions ,Tablets ,Thyroxine ,Treatment Outcome ,Newborn ,medicine.disease ,Congenital hypothyroidism ,congenital hypothyroidism, l_thyroxine formulation ,Multicenter study ,Administration ,Thyroid function ,business ,General Economics, Econometrics and Finance - Abstract
Objective Oral solution and tablet formulations of levothyroxine (L-T4) are both used in the treatment of congenital hypothyroidism (CH). However, few studies and with a limited follow-up period have been published comparing these two formulations in children. Design The aim of this multicenter study was to compare the effectiveness of L-T4 oral solution (with ethanol as excipient) and tablet formulation in children with CH up to 3 years of age. Methods Children diagnosed with CH between 2006 and 2015 were enrolled and divided into two groups according to the L-T4 formulation used: solution in drops (group D) or tablets (group T). Auxological parameters, thyroid-stimulating hormone (TSH) and free thyroxine (FT4) values and L-T4 dose were collected at diagnosis and at 15 days, 1, 3, 6, 12, 24 and 36 months of treatment. The developmental quotient (DQ) at 1 and 3 years of age was evaluated using Griffiths’ Scale. Results In this study, 254 children were enrolled among which 117 were treated with solution and 137 with tablets. Auxological parameters, dose and thyroid function values at diagnosis, 3, 6, 12, 24, 36 months were not significantly different. TSH at 15 days (P = 0.002) and 1 month (P = 0.009) was significantly reduced in group D. At 2-year follow-up, median TSH was significantly lower in group T (P = 0.03). No statistical difference was detected between the median DQ; however, group D showed lower values in the language subscale at 12 months and in eye–hand coordination at 36 months. Conclusions Both therapeutic strategies are effective in the treatment of CH. A higher risk of overtreatment in the first months of therapy seems to be associated with oral solution L-T4; therefore, a different strategy should be considered when starting and adjusting the dose. No negative effects on cognitive development were observed. The data obtained are encouraging but long-term follow-up is needed.
- Published
- 2021
3. Implicating factors in the increase in cases of central precocious puberty (CPP) during the COVID-19 pandemic: Experience of a tertiary centre of pediatric endocrinology and review of the literature
- Author
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C, Barberi, V, Di Natale, V, Assirelli, L, Bernardini, E, Candela, A, Cassio, Barberi, C, Di Natale, V, Assirelli, V, Bernardini, L, Candela, E, and Cassio, A
- Subjects
COVID - 19 ,Endocrinology, Diabetes and Metabolism ,isolated pubarche ,Puberty, Precocious ,COVID-19 ,BMI - body mass index ,early puberty ,thelarche premature ,endometrial rhyme ,electromagnetic field ,Communicable Disease Control ,Humans ,central precious puberty ,Female ,Child ,Pandemics ,Retrospective Studies - Abstract
Sexual development is a complex mechanism activated by the hypothalamic-pituitary-gonadal axis. Over the last one hundred years there has been a decline in the age at puberty onset in industrialised countries. Some Italian studies showed an increase in diagnoses of Central Precocious Puberty (CPP) during the COVID-19 pandemic. It is thus supposed that in this period there was an increased impact of factors that can influence pubertal development. Our retrospective monocentric study aimed to confirm the existence of this phenomenon and analysed possible related factors. We retrospectively evaluated clinical, laboratory, radiological and ultrasound (US) data of 154 girls referred to our Tertiary Centre of Paediatric Endocrinology from January 2019 to April 2021 for different forms of Precocious Puberty. We subdivided the cases into subgroups according to the final diagnosis: CPP, Early Puberty (EP), isolated thelarche and isolated pubarche. The observation period was subdivided into: Period 1, before lockdown (1 January 2019 – 8 March 2020) and Period 2, lockdown and the following months (9 March 2020 – 30 April 2021). Period 2 was further divided into “restrictive lockdown period” (Period 2.1) (March 2020 – 14 June 2020, in which the schools were closed) and “less restrictive lockdown period” (Period 2.2) (15 June 2020 – 30 April 2021). We analysed data regarding the use of electronic devices before and during lockdown in a group of girls with CPP diagnosed in Period 2 and we compared the data with that of a control group. Our data show an increase in the number of new diagnoses of CPP during lockdown and in the following months, compared with the previous period. We also detected a higher use of PCs and smartphones in girls with CPP diagnosed in Period 2, compared with the control group. The percentage of the presence of endometrial rhyme detected during the pelvic ultrasound was higher in girls with CPP in Period 2, compared with the previous period. Based on our data we assume there was an environmental effect on pubertal timing that calls our attention to factors such as food, use of electronic devices and stress. We will need further studies to better understand this data.
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- 2022
4. Transient Central Precocious Puberty: a new entity among the spectrum of Precocious Puberty?
- Author
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Valentina Assirelli, Alessandra Cassio, Rita Ortolano, Stefano Zucchini, Valeria Di Natale, Giulio Maltoni, Federico Baronio, and Assirelli V, Baronio F, Ortolano R, Maltoni G, Zucchini S, Di Natale V, Cassio A.
- Subjects
Pediatrics ,medicine.medical_specialty ,Transient precocious puberty ,Thelarche ,Central precocious puberty ,Puberty, Precocious ,Hypothalamic–pituitary–gonadal axis ,Herbicides and pesticides ,RJ1-570 ,Gonadotropin-Releasing Hormone ,medicine ,Precocious puberty ,Humans ,Child ,Endocrine disruptors ,Retrospective Studies ,Ultrasonography ,Central precocious puberty, Endocrine disruptors, Thelarche, Transient precocious puberty, Nutritional factors, Herbicides and pesticides ,Triptorelin Pamoate ,Estradiol ,Maternal and child health ,business.industry ,Research ,Uterus ,Mean age ,Homeopathic medicine ,Luteinizing Hormone ,medicine.disease ,Nutritional factors ,Female ,Follicle Stimulating Hormone ,business ,Hormone - Abstract
Objective Recently, we observed some cases of Precocious Puberty (PP) with a partial central activation of hypothalamic-pituitary-gonadal (HPG) axis that tended to normalized in 6–12 months. To evaluate the frequency of this form within the spectrum of forms of PP, we retrospectively assessed the clinical, hormonal and ultrasound characteristics of patients attending to our Center for signs of PP, between 2007 and 2017. To hypothesize some causes of this “pubertal poussée” a questionnaire about environmental data was provided to patients. Methods 96 girls were recruited for the study and divided into three Groups. Group 1: 56 subjects with Central PP (CPP) requiring treatment with GnRH analogue; Group 2: 22 subjects with transient activation of pubertal axis, that tended to normalize, “Transient CPP”(T-CPP); Group 3: 18 subjects with Isolated Thelarche (IT). Results Mean age at diagnosis was 6.8 ± 1.0 years in Group 1, 5.9 ± 1.3 years in Group 2 and 5.6 ± 1.5 years in Group 3. A significant increase of diagnosis of T-CPP was observed over the study period. Significantly higher use of some homeopathic medicines and potential exposure to pesticides was reported in Group 2 vs Group 1. Conclusions To our knowledge, we first reported a form defined as T-CPP, characterized by partial activation in the HPG axis normalizing over time. An increased use of homeopathic medicines and exposure to environmental pollutants in these patients was evidenced.
- Published
- 2021
5. Comparison between Liquid and Tablet Formulations in the Treatment of Congenital Hypothyroidism up to 3 Years of Age: The First Italian Study.
- Author
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Ortolano R, Cantarelli E, Baronio F, Assirelli V, Candela E, Mastrangelo C, Vissani S, Alqaisi RS, Lanari M, and Cassio A
- Abstract
Background/Objectives : Levothyroxine (L-T4) is available for use in congenital hypothyroidism (CH) in three formulations: tablets, drops, and oral solution. This study aims to compare the efficacy and safety of all three L-T4 formulations. Methods : We enrolled 63 children born between January 2019 and April 2023 in the Emilia-Romagna Region (Italy) and diagnosed with CH by newborn screening. They were divided according to the L-T4 formulation used: drops (Group D), oral solution (Group S), and tablets (Group T). Clinical and laboratory data were collected up to 3 years after the start of replacement therapy. Results : Serum-free thyroxine (sFT4) and thyroid stimulating hormone (sTSH) normalization occurred within the first month of treatment in most patients of all groups. No negative effects on growth and cognitive development were observed. At 7-15 days we found higher median sTSH levels ( p = 0.031) and a greater percentage of patients with sTSH > 5 µU/mL ( p = 0.011) in Group S than in Group T, but comparable sFT4 levels. At 12 months, a greater percentage of patients of Group D showed sFT4 values below the normal range than Group S ( p = 0.011) and Group T ( p = 0.038); Conclusions : Overall, our study reported an equal efficacy of the L-T4 oral solution compared to drops and tablets in CH treatment. A larger series of patients and a long-term follow-up are needed.
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- 2024
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6. Central Precocious Puberty in Italian Boys: Data From a Large Nationwide Cohort.
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Cassio A, Marescotti G, Aversa T, Salerno M, Tornese G, Stancampiano M, Tuli G, Faienza MF, Cavarzere P, Fava D, Parpagnoli M, Bruzzi P, Ibba A, Calcaterra V, Mameli C, Grandone A, Cherubini V, Assirelli V, Franchina F, Capalbo D, Di Mase R, Tamaro G, Cavasin J, Munarin J, Russo G, and Wasniewska M
- Subjects
- Humans, Male, Italy epidemiology, Child, Retrospective Studies, Child, Preschool, Cohort Studies, Gonadotropin-Releasing Hormone analogs & derivatives, Puberty, Precocious epidemiology, Puberty, Precocious diagnosis, Magnetic Resonance Imaging
- Abstract
Context: There are only a few nationwide studies on boys with central precocious puberty (CPP) and the last Italian study is a case series of 45 boys that dates back to 2000., Objective: We aimed to evaluate the causes of CPP in boys diagnosed during the last 2 decades in Italy and the relative frequency of forms with associated central nervous system (CNS) abnormalities on magnetic resonance imaging (MRI) compared to idiopathic ones., Methods: We performed a national multicenter retrospective study collecting data from 193 otherwise normal healthy boys with a diagnosis of CPP. Based on MRI findings, the patients were divided into: Group 1, no CNS abnormalities; Group 2, mild abnormalities (incidental findings) unrelated to CPP; and Group 3, causal pathological CNS abnormalities., Results: The MRI findings show normal findings in 86%, mild abnormalities (incidental findings) in 8.3%, and causal pathological CNS abnormalities in 5.7% of the cases. In Group 3, we found a higher proportion of patients with chronological age at diagnosis < 7 years (P = .00001) and body mass index greater than +2 SDS (P < .01). Gonadotropin-releasing hormone analogue therapy was started in 183/193 subjects. The final height appeared in the range of the target height in all groups and in 9 patients in whom the therapy was not started., Conclusion: In our study on a large nationwide cohort of boys referred for precocious puberty signs, the percentage of forms associated with CNS abnormalities was one of the lowest reported in the literature., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.)
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- 2024
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7. Does Basal Morning Luteinizing Hormone (bLH) Predict Central Precocious Puberty (CPP) in Girls?
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Baronio F, Assirelli V, Deiana G, AlQaisi R, Ortolano R, Di Natale V, Candela E, and Cassio A
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- Female, Humans, Follicle Stimulating Hormone, Retrospective Studies, Gonadotropin-Releasing Hormone, Luteinizing Hormone, Puberty, Precocious diagnosis
- Abstract
Background and Objectives : bLH is considered an excellent biochemical predictor of CPP. However, its utilization in clinical practice shows some uncertainties. This study aims to evaluate the diagnostic power of bLH and propose a diagnostic algorithm for CPP. Materials and Methods : We conducted a monocentric cohort retrospective study evaluating all females referred for suspicion of CPP between 1 January 2017 and 31 December 2020 who underwent a GnRH test. Auxological, hormonal, and instrumental data were collected, including pelvic ultrasonography and bone age (BA) assessment. Simple linear regression, t -test, and ROC tests were utilized to study the diagnostic value of basal hormone levels. Two hundred thirteen girls were included in the study. They were subdivided into two groups according to the results of the GnRH test: Group 1, with LH peak > 5 IU/L (pubertal) and 79 patients (37%), and Group 2, with an LH peak ≤ 5 IU/L (prepubertal) and 134 patients (63%). Results : The ROC curve showed that bLH level > 1.5 Ul/L best predicts a pubertal response to the GnRH test (AUC 0.8821, accuracy 82%), with low sensitivity (34%). The multivariate analysis found that bLH > 0.5 IU/L, basal FSH (bFSH) > 3.5 IU/L, bLH/bFSH ratio > 0.16, BA advancement > 1.7 years, uterine volume > 3.6 mL, longitudinal uterine diameter > 41 mm, and the presence of endometrial rhyme were significantly associated with a pubertal response at the GnRH test. An algorithm based on these features was created, and its application would reduce the number of GnRH tests by 34%. Overall, 96.2% of Group 1 patients reached the LH peak at the 30th minute of the GnRH test, supporting the hypothesis that the GnRH test duration could be reduced to 30 min. Conclusions : Morning bLH > 1.5 IU/L could be carefully used as a diagnostic predictor of CPP. The GnRH test, even reduced to 30 min, could be reserved for girls who show low intermediate morning bLH and specific clinical signs of pubertal development.
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- 2024
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8. Testicular Adrenal Rest Tumors in Congenital Adrenal Hyperplasia: Study of a Cohort of Patients from a Single Italian Center.
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Ortolano R, Cassio A, Alqaisi RS, Candela E, Di Natale V, Assirelli V, Bernardini L, Bortolamedi E, Cantarelli E, Corcioni B, Renzulli M, Balsamo A, and Baronio F
- Abstract
Testicular adrenal rest tumors (TARTs) are a common complication in male patients with congenital adrenal hyperplasia (CAH). The aim of our cross-sectional cohort study is to estimate the frequency of TARTs with the correlation of genotype and disease control on tumor development. Thirty-five male patients, aged 14-26 years, were included in the study, all followed by the same center of pediatric endocrinology in Bologna. We studied genotypes, hormonal profiles at different time intervals and testicular ultrasound. A logistic regression model with multivariant analysis was developed for the statistical analysis. TARTs were detected in 31.4% of the cases, 90.9% of them had a classic form with salt wasting, while 9.1% had a non-classic form. Additionally, a significant correlation between the incidence of TARTs and severity of genotype was detected. Patients with TARTs had markedly worse metabolic control on average ( p = 0.027), reflected by high ACTH, 17OH progesterone, and overall delta4-androstenedione. In conclusion, a screening tool is mandatory, especially (but not exclusively) in patients with the most severe forms of CAH and poor endocrine control of the disease.
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- 2023
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9. Auxological and endocrine findings in narcolepsy type 1: seventeen-year follow-up from a pediatric endocrinology center.
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Casale S, Assirelli V, Pizza F, Balsamo A, Gennari M, Pession A, Plazzi G, and Cassio A
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- Male, Female, Humans, Child, Orexins, Retrospective Studies, Follow-Up Studies, Cross-Sectional Studies, Obesity complications, Narcolepsy drug therapy, Narcolepsy epidemiology, Narcolepsy complications, Sodium Oxybate
- Abstract
Introduction: Narcolepsy Type 1 (NT1) is a rare hypersomnia of central origin linked to hypocretin deficiency, most frequently arising at pediatric age. NT1 could be associated with endocrine comorbidities involving the neuroendocrine axis, predominantly obesity, and Central Precocious Puberty (CPP). The primary aim of this study is the evaluation of endocrine and auxological parameters at diagnosis and during follow-up in patients with NT1, treated with Sodium Oxybate (SO) or not., Methods: We retrospectively evaluated the auxological, biochemical, and radiological parameters of 112 patients referred to our Center between 2004-2022. The design of our study is cross-sectional at the time of diagnosis followed by a longitudinal follow-up., Results: Our study confirms an increased frequency of CPP and obesity in patients with NT1. At first evaluation, obesity was found in 31.3% of patients, while overweight was found in 25.0%. A diagnosis of CPP was made in 19.6% of patients. Interestingly, this group showed a significantly lower level of CSF-hypocretin (hrct-1) at diagnosis compared to others. We found an improvement in BMI SDS in the SO-treated group compared to untreated patients, and this trend persisted also at 36 months of follow-up (0.0 ± 1.3 vs 1.3 ± 0.4; p<0.03). Sixty-three patients reached their final height, with a median SDS of 0.6 ± 1.1 in boys and 0.2 ± 1.2 in girls., Discussion: To our knowledge, these are the first results regarding the final height in a large series of pediatric patients with NT1, with a normal range of IGF1-SDS levels and stature SDS., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Casale, Assirelli, Pizza, Balsamo, Gennari, Pession, Plazzi and Cassio.)
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- 2023
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10. Cystathionine Beta-Synthase Deficiency: Three Consecutive Cases Detected in 40 Days by Newborn Screening in Emilia Romagna (Italy) and a Comprehensive Review of the Literature.
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Candela E, Zagariello M, Di Natale V, Ortolano R, Righetti F, Assirelli V, Biasucci G, Cassio A, Pession A, and Baronio F
- Abstract
Cysthiatonine beta-synthase (CBS) deficiency (CBSD) is an autosomal recessive rare disorder caused by variations on CBS that leads to impaired conversion of homocysteine (Hcy) to cystathionine. Marked hyperhomocysteinemia is the hallmark of the disease. The administration of pyridoxine, the natural cofactor of CBS, may reduce total plasma Hcy. Patient phenotype is classified on pyridoxine responsivity in two groups: pyridoxine-responsive and non-responsive patients. Ectopia lentis, bone deformities, developmental delay, and thromboembolism are the classic signs and symptoms of the disease. Early diagnosis and treatment impact patients' natural history. Therapy aims to lower promptly and maintain Hcy concentrations below 100 μmol/L. Depending on the patient's phenotype, the treatment goals could be obtained by the administration of pyridoxine and/or betaine associated with a methionine-restricted diet. CBSD could be diagnosed in the early days of life by expanded newborn screening (ENS), however, the risk of false negative results is not negligible. In Emilia-Romagna (Italy), during the first 10 years of screening experience, only three cases of CBSD identified have been diagnosed, all in the last two years (incidence 1:118,000 live births). We present the cases and a comprehensive review of the literature to emphasize the role of ENS for early diagnosis of CBSD and its potential pitfalls, reiterating the need for a more effective method to screen for CBSD.
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- 2023
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11. Treatment of congenital hypothyroidism: comparison between L-thyroxine oral solution and tablet formulations up to 3 years of age.
- Author
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Vigone MC, Ortolano R, Vincenzi G, Pozzi C, Ratti M, Assirelli V, Vissani S, Cavarzere P, Mussa A, Gastaldi R, Di Mase R, Salerno M, Street ME, Trombatore J, Weber G, and Cassio A
- Subjects
- Administration, Oral, Child, Preschool, Congenital Hypothyroidism blood, Congenital Hypothyroidism epidemiology, Female, Hormone Replacement Therapy adverse effects, Hormone Replacement Therapy methods, Humans, Infant, Infant, Newborn, Italy epidemiology, Male, Retrospective Studies, Solutions, Tablets, Thyroid Function Tests, Thyroid Hormones blood, Thyrotropin blood, Thyroxine adverse effects, Treatment Outcome, Congenital Hypothyroidism drug therapy, Thyroxine administration & dosage
- Abstract
Objective: Oral solution and tablet formulations of levothyroxine (L-T4) are both used in the treatment of congenital hypothyroidism (CH). However, few studies and with a limited follow-up period have been published comparing these two formulations in children., Design: The aim of this multicenter study was to compare the effectiveness of L-T4 oral solution (with ethanol as excipient) and tablet formulation in children with CH up to 3 years of age., Methods: Children diagnosed with CH between 2006 and 2015 were enrolled and divided into two groups according to the L-T4 formulation used: solution in drops (group D) or tablets (group T). Auxological parameters, thyroid-stimulating hormone (TSH) and free thyroxine (FT4) values and L-T4 dose were collected at diagnosis and at 15 days, 1, 3, 6, 12, 24 and 36 months of treatment. The developmental quotient (DQ) at 1 and 3 years of age was evaluated using Griffiths' Scale., Results: In this study, 254 children were enrolled among which 117 were treated with solution and 137 with tablets. Auxological parameters, dose and thyroid function values at diagnosis, 3, 6, 12, 24, 36 months were not significantly different. TSH at 15 days (P = 0.002) and 1 month (P = 0.009) was significantly reduced in group D. At 2-year follow-up, median TSH was significantly lower in group T (P = 0.03). No statistical difference was detected between the median DQ; however, group D showed lower values in the language subscale at 12 months and in eye-hand coordination at 36 months., Conclusions: Both therapeutic strategies are effective in the treatment of CH. A higher risk of overtreatment in the first months of therapy seems to be associated with oral solution L-T4; therefore, a different strategy should be considered when starting and adjusting the dose. No negative effects on cognitive development were observed. The data obtained are encouraging but long-term follow-up is needed.
- Published
- 2021
- Full Text
- View/download PDF
12. Transient central precocious puberty: a new entity among the spectrum of precocious puberty?
- Author
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Assirelli V, Baronio F, Ortolano R, Maltoni G, Zucchini S, Di Natale V, and Cassio A
- Subjects
- Child, Estradiol blood, Female, Follicle Stimulating Hormone blood, Gonadotropin-Releasing Hormone analogs & derivatives, Humans, Luteinizing Hormone blood, Retrospective Studies, Triptorelin Pamoate administration & dosage, Ultrasonography, Uterus diagnostic imaging, Puberty, Precocious diagnosis
- Abstract
Objective: Recently, we observed some cases of Precocious Puberty (PP) with a partial central activation of hypothalamic-pituitary-gonadal (HPG) axis that tended to normalized in 6-12 months. To evaluate the frequency of this form within the spectrum of forms of PP, we retrospectively assessed the clinical, hormonal and ultrasound characteristics of patients attending to our Center for signs of PP, between 2007 and 2017. To hypothesize some causes of this "pubertal poussée" a questionnaire about environmental data was provided to patients., Methods: 96 girls were recruited for the study and divided into three Groups. Group 1: 56 subjects with Central PP (CPP) requiring treatment with GnRH analogue; Group 2: 22 subjects with transient activation of pubertal axis, that tended to normalize, "Transient CPP"(T-CPP); Group 3: 18 subjects with Isolated Thelarche (IT)., Results: Mean age at diagnosis was 6.8 ± 1.0 years in Group 1, 5.9 ± 1.3 years in Group 2 and 5.6 ± 1.5 years in Group 3. A significant increase of diagnosis of T-CPP was observed over the study period. Significantly higher use of some homeopathic medicines and potential exposure to pesticides was reported in Group 2 vs Group 1., Conclusions: To our knowledge, we first reported a form defined as T-CPP, characterized by partial activation in the HPG axis normalizing over time. An increased use of homeopathic medicines and exposure to environmental pollutants in these patients was evidenced., (© 2021. The Author(s).)
- Published
- 2021
- Full Text
- View/download PDF
13. Eruptive Pseudoangiomatosis Induced by Mosquito Bites in an Infant.
- Author
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Neri I, Assirelli V, Chessa MA, Gurioli C, Filippi F, and Virdi A
- Abstract
Competing Interests: Competing interests: The authors have no conflicts of interest to disclose.
- Published
- 2019
- Full Text
- View/download PDF
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