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Cherubini, Valentino, Marino, Monica, Scaramuzza, Andrea E.; Tiberi, Valentina, Bobbio, Adriana, Delvecchio, Maurizio, Piccinno, Elvira, Ortolani, Federica, Innaurato, Stefania, Felappi, Barbara, Gallo, Francesco, Ripoli, Carlo, Ricciardi, Maria Rossella, Pascarella, Filomena, Stamati, Filomena A.; Citriniti, Felice, Arnaldi, Claudia, Monti, Sara, Graziani, Vanna, De Berardinis, Fiorella, Giannini, Cosimo, Chiarelli, Francesco, Zampolli, Maria, De Marco, Rosaria, Bracciolini, Giulia Patrizia, Grosso, Caterina, De Donno, Valeria, Piccini, Barbara, Toni, Sonia, Coccioli, Susanna, Cardinale, Giuliana, Bassi, Marta, Minuto, Nicola, D’Annunzio, Giuseppe, Maffeis, Claudio, Marigliano, Marco, Zanfardino, Angela, Iafusco, Dario, Rollato, Assunta S.; Piscopo, Alessia, Curto, Stefano, Lombardo, Fortunato, Bombaci, Bruno, Sordelli, Silvia, Mameli, Chiara, Macedoni, Maddalena, Rigamonti, Andrea, Bonfanti, Riccardo, Frontino, Giulio, Predieri, Barbara, Bruzzi, Patrizia, Mozzillo, Enza, Rosanio, Francesco, Franzese, Adriana, Piredda, Gavina, Cardella, Francesca, Iovane, Brunella, Calcaterra, Valeria, Berioli, Maria Giulia, Lasagni, Anna, Pampanini, Valentina, Patera, Patrizia Ippolita, Schiaffini, Riccardo, Rutigliano, Irene, Meloni, Gianfranco, De Sanctis, Luisa, Tinti, Davide, Trada, Michela, Guerraggio, Lucia Paola, Franceschi, Roberto, Cauvin, Vittoria, Tornese, Gianluca, Franco, Francesca, Musolino, Gianluca, Maltoni, Giulio, Talarico, Valentina, Iannilli, Antonio, Lenzi, Lorenzo, Matteoli, Maria Cristina, Pozzi, Erica, Moretti, Carlo, Zucchini, Stefano, Rabbone, Ivana, Gesuita, Rosaria.
Frontiers in endocrinology ; 13, 2022.
Article in English | EuropePMC | ID: covidwho-1998567
Int J Behav Med ; 29(5): 638-647, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-1649024


BACKGROUND: Given that the widely acknowledged influence of the doctor-patient relationship on objective health parameters and treatment adherence in chronic illnesses, this study sought to explore how patients perceived the patient-doctor relationship across virtual and in-person contexts. METHODS: Parents' and patients' perceptions of doctor-patient relationship were evaluated in 610 children and adolescents (12.17 ± 4.19 years, 50.9% girls) with type 1 diabetes who visited via video-conferencing or in person during the COVID-19 pandemic. RESULTS: No differences were found between video consultations and in-person visits in terms of care satisfaction (p > .05), doctor-patient relationship-for the dimensions agreement on tasks (p = .506) and bond (p = .828)-as perceived by parents and physician empathy as perceived by patients (p = .096). Parents rated patient-doctor agreement on explicit goals of treatment higher in video consultation than in person (p = .009, d = .211). Agreement on goals (ß = - .180, p = .016) and bond with doctor (ß = - .160, p = .034) were negatively and significantly associated with HbA1c values, but only in participants who visited in person. CONCLUSIONS: Parents' care satisfaction and perceptions of doctor-patient relationship, along with patients' perceptions of physician empathy, did not substantially differ between visits carried out in person or via video consultations. Given the high risk of psychological problems described in young people with diabetes, video consultation can be considered a useful opportunity to maintain access to a healthcare provider in a challenging time, such as the COVID-19 pandemic.

COVID-19 , Diabetes Mellitus, Type 1 , Adolescent , Child , Female , Glycated Hemoglobin A , Humans , Male , Pandemics , Parents , Patient Satisfaction , Physician-Patient Relations , Referral and Consultation
Ital J Pediatr ; 47(1): 121, 2021 Jun 02.
Article in English | MEDLINE | ID: covidwho-1255953


BACKGROUND: Cystic Fibrosis Related Diabetes (CFRD) is a frequent comorbidity of patients with Cystic Fibrosis (CF). A worsening of clinical conditions appears before CFRD. It has been demonstrated a decline in pulmonary function and nutritional status also in patients with prediabetes. Few trials show that insulin may be beneficial in prediabetic CF patients, to date guidelines do not recommend for this condition. CASE PRESENTATION: We report a case of a patient treated with insulin glargine at 13 years, due to glycemic intolerance, and with Lumacaftor/Ivacaftor at 15 years. A reduction of pulmonary exacerbations was observed after glargine therapy, also confirmed after the starting of Lumacaftor/ Ivacaftor in this patient. Pulmonary function improved only after the first year of glargine therapy, then a deterioration appeared due to the natural history of CF lung damage. During the COVID-19 lockdown, poor adherence to care contributed to diabetes mellitus onset needing high insulin requirements. After two weeks the patient returned to prediabetic condition and his previous dose of glargine. CONCLUSIONS: our case highlights firstly that insulin glargine has contributed to preserve him from further clinical worsening due to prediabetes in the years before pandemic, secondly the negative impact of COVID-19 lockdown on the clinical course of a chronic disease as CF.

COVID-19/epidemiology , Cystic Fibrosis/complications , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/drug therapy , Hypoglycemic Agents/therapeutic use , Insulin Glargine/therapeutic use , Adolescent , Cystic Fibrosis/physiopathology , Humans , Male , Pandemics , Prediabetic State , Respiratory Function Tests , SARS-CoV-2
J Public Health (Oxf) ; 2021 05 13.
Article in English | MEDLINE | ID: covidwho-1226554


BACKGROUND: The aims of this study were: to investigate the capacity of the rare disease healthcare network in Campania to diagnose patients with rare diseases during the outbreak of Covid-19; and to shed light on problematic diagnoses during this period. METHODS: To describe the impact of the Covid-19 pandemic on the diagnosis of patients with rare diseases, a retrospective analysis of the Campania Region Rare Disease Registry was performed. A tailored questionnaire was sent to rare disease experts to investigate major issues during the emergency period. RESULTS: Prevalence of new diagnoses of rare disease in March and April 2020 was significantly lower than in 2019 (117 versus 317, P < 0.001 and 37 versus 349, P < 0.001, respectively) and 2018 (117 versus 389, P < 0.001 and 37 versus 282, P < 0.001, respectively). Eighty-two among 98 rare disease experts completed the questionnaire. Diagnostic success (95%), access to diagnosis (80%) and follow-up (72%), lack of Personal Protective Equipment (60%), lack of Covid-19 guidelines (50%) and the need for home therapy (78%) were the most important issues raised during Covid-19 outbreak. CONCLUSIONS: This study describes the effects of the Covid-19 outbreak on the diagnosis of rare disease in a single Italian region and investigates potential issues of diagnosis and management during this period.