ABSTRACT
The Regional Topographic Geodatabase (DBTR) was officially defined in 2005 as the multi-scale (1:1,000 - 1:2,000 - 1:5,000 - 1:10,000) cartographic reference for urban and regional planning in Lombardy Region. The DBTR had been previously introduced at national level to take over traditional numerical topographic maps adopted for urban planning, with the aim to provide a base map to be implemented either at regional level (Regional Geoportal) and by local administrations. The DBTR is structured by following some national guidelines that define either the content and the topological structure, that makes simple its implementation in GIS environment. The construction of the entire DBTR has historically gone through different phases, with the consistent support of the regional subsidiary policy. But when the effects of the world economic crisis in 2008 became tangible in the budget of public administrations, the growth of the project faced an important break. In 2017 the administration of Lombardy Region has promoted and financed a new project finalized to the completion of the DBTR. A temporary association of mapping companies won the tender and completed the project by summer 2020, despite of the difficulties related to the COVID-19 pandemic. A team led by Politecnico di Milano was appointed for the quality assessment. The proposed paper would like to present this project and the operational solutions applied for the production of the new subsections of the DBTR, as well as its quality assessment/validation.
ABSTRACT
BACKGROUND: Thyroid dysfunction has been observed in patients with COVID-19, and endocrinologists are requested to understand this clinical issue. Pandemic-related restrictions and reorganization of healthcare services may affect thyroid disease management. OBJECTIVE AND METHODS: To analyze and discuss the relationship between COVID-19 and thyroid diseases from several perspectives. PubMed/MEDLINE, Google Scholar, Scopus, ClinicalTrial.gov were searched for this purpose by using free text words and medical subject headings as follows: "sars cov 2", "covid 19", "subacute thyroiditis", "atypical thyroiditis", "chronic thyroiditis", "hashimoto's thyroiditis", "graves' disease", "thyroid nodule", "differentiated thyroid cancer", "medullary thyroid cancer", "methimazole", "levothyroxine", "multikinase inhibitor", "remdesivir", "tocilizumab". Data were collected, analyzed, and discussed to answer the following clinical questions: "What evidence suggests that COVID-19 may induce detrimental consequences on thyroid function?"; "Could previous or concomitant thyroid diseases deteriorate the prognosis of COVID-19 once the infection has occurred?"; "Could medical management of thyroid diseases influence the clinical course of COVID-19?"; "Does medical management of COVID-19 interfere with thyroid function?"; "Are there defined strategies to better manage endocrine diseases despite restrictive measures and in-hospital and ambulatory activities reorganizations?". RESULTS: SARS-CoV-2 may induce thyroid dysfunction that is usually reversible, including subclinical and atypical thyroiditis. Patients with baseline thyroid diseases are not at higher risk of contracting or transmitting SARS-CoV-2, and baseline thyroid dysfunction does not foster a worse progression of COVID-19. However, it is unclear whether low levels of free triiodothyronine, observed in seriously ill patients with COVID-19, may worsen the disease's clinical progression and, consequently, if triiodothyronine supplementation could be a tool for reducing this burden. Glucocorticoids and heparin may affect thyroid hormone secretion and measurement, respectively, leading to possible misdiagnosis of thyroid dysfunction in severe cases of COVID-19. High-risk thyroid nodules require a fine-needle aspiration without relevant delay, whereas other non-urgent diagnostic procedures and therapeutic interventions should be postponed. DISCUSSION: Currently, we know that SARS-CoV-2 could lead to short-term and reversible thyroid dysfunction, but thyroid diseases seem not to affect the progression of COVID-19. Adequate management of patients with thyroid diseases remains essential during the pandemic, but it could be compromised because of healthcare service restrictions. Endocrine care centers should continuously recognize and classify priority cases for in-person visits and therapeutic procedures. Telemedicine may be a useful tool for managing patients not requiring in-person visits.