Benefits of rescreening newborns of mothers affected by autoimmune hypothyroidism.

Introduction: Infants of mothers with autoimmune hypothyroidism (AH) are at risk of developing late-onset hypothyroidism, often escaping at newborn screening. This condition might be caused both by the action of maternal antibodies and/or by maternal treatment. Objectives: The aim of this study is to evaluate the prevalence of AH in the mothers of children born in Veneto region, Italy, and to define what is the most appropriate management for these newborns. Methods: Newborns of six different hospitals with a mother suffering from AH and with negative neonatal screening for congenital hypothyroidism (CH) were included in the study. Between 15 and 20 days of life, we collected a serum sample for the evaluation of thyroid function (thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3)) and anti-thyroid antibodies. On the same occasion, a capillary blood sampling was performed for a second screening test. Results: Maternal AH has a prevalence of 3.5%. A total of 291 newborns were enrolled from November 2019 to May 2021. Whereas the 11.4% of infants had a slight elevated serum TSH (>6 mU/L) and required a follow-up, only 2 children presented an elevated TSH level at the second screening test. One of these, with the gland in situ, showed persistently elevated serum TSH levels and required treatment with levothyroxine. Conclusions: Maternal AH rarely caused neonatal thyroid dysfunction. We suggest to reassess newborns from mothers with AH 15 days after birth by means of a second neonatal screening test. This procedure avoids false negatives due to maternal thyroid status, is less invasive and cheaper than the serum TSH evaluation, and prevents a long follow-up.

Correction: Quarantine and Appendicitis: A Macro-Area Experience.

[This corrects the article on p. 75 in vol. 24, PMID: 33505896.].

Quarantine and Appendicitis:A Macro-Area Experience / 대한소아소화기영양학회지

Purpose@#Appendicitis is the most frequent urgency in pediatric age; the aim of this study was to investigate the association of quarantine for severe acute respiratory syndrome coronavirus 2 pandemic and the incidence of pediatric appendicitis in a specific macro area. @*Methods@#We retrospectively analyzed the medical records of consecutive patients who underwent surgical exploration for acute appendicitis in the period March–April since 2014. This specific quarantine period was divided into two phases as indicated by National government. Patient data, demographics, characteristics and outcomes were studied and evaluated comparing patients treated during quarantine especially phase 1 vs. phase 2 (March–April 2020). @*Results@#After reviewing medical charts following the inclusion and exclusion criteria, 155 patients were studied; focusing on the final outcome, it is possible to show a decreased amount of appendicitis during phase 1 and a progressive increase during phase 2; respect to previous years, there was a statistical increase in severity of appendicitis during quarantine (gangrenous vs. phlegmonous appendicitis). @*Conclusion@#During this specific quarantine there was a reduction in appendicitis and a progressive increase during phase 2. These results offer new perspective among disease incidences during lockdown.

Quarantine and Appendicitis:A Macro-Area Experience / 대한소아소화기영양학회지

Purpose@#Appendicitis is the most frequent urgency in pediatric age; the aim of this study was to investigate the association of quarantine for severe acute respiratory syndrome coronavirus 2 pandemic and the incidence of pediatric appendicitis in a specific macro area. @*Methods@#We retrospectively analyzed the medical records of consecutive patients who underwent surgical exploration for acute appendicitis in the period March–April since 2014. This specific quarantine period was divided into two phases as indicated by National government. Patient data, demographics, characteristics and outcomes were studied and evaluated comparing patients treated during quarantine especially phase 1 vs. phase 2 (March–April 2020). @*Results@#After reviewing medical charts following the inclusion and exclusion criteria, 155 patients were studied; focusing on the final outcome, it is possible to show a decreased amount of appendicitis during phase 1 and a progressive increase during phase 2; respect to previous years, there was a statistical increase in severity of appendicitis during quarantine (gangrenous vs. phlegmonous appendicitis). @*Conclusion@#During this specific quarantine there was a reduction in appendicitis and a progressive increase during phase 2. These results offer new perspective among disease incidences during lockdown.

Post-operative use of human chorionic gonadotrophin (u-hCG) inpatients treated for intrabdominal unilateral undescended testes.

OBJECTIVE: To report our experience with post-operative use of human chorionic gonadotrophin to achieve higher testicular volume and function, respect to untreated patients. MATERIALS AND METHODS: A prospective study was done using subjects who underwent orchidopexy between Sptember 2010 and September 2016 for unilateral intrabdominal undescended testes. All patients were treated by the same surgeon with laparoscopic one-stage Fowler-Stephens technique. After surgery (2 weeks) those patient parents who accepted to use hormonal therapy, had to follow a 6 weeks scheme. Patients received subcutaneous 500 UI (Gonasi-HP) weekly. A follow-up was performed at the end of therapy and 6 months later. Testicular volume was measured at each visit by ultrasound and by sonoelastography and compared with the untreated ones. RESULTS: Forty-five patients were enrolled and treated with a mean age of 18.0±9.7 months. 32 patients received post-operative hormonal therapy. There were no cases of adverse effects nor droupout. All patients completed follow-up. There were no cases of testicular atrophy in both groups. At 6 months among treated patients 26 (81%) subjects achieved normal testicular size while the other had still smaller volume. Among untreated patients, 6 (46%) subject achieved normal testicular size (P < 0.05). CONCLUSION: Despite the role of hormonal therapy is still under discussion, especially for post-operative treatment, our results suggest that it is safe and useful to improve testicular volume and morphology; treated testes have also a good stiffness respect to untreated testes.

Lung Function in Women with Idiopathic Central Precocious Puberty: A Pilot Study
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BACKGROUND: Studies have reported that women with early menarche (≤10 years) have lower lung function. AIM: To investigate lung function in women with a history of idio pathic central precocious puberty (ICPP) treated during childhood with gonadotropin-releasing hormone agonist (GnRHa). METHODS: ICPP women (n = 23) were compared with healthy age-matched controls (n = 23). Subjects were clinically evaluated by means of a questionnaire, baseline and post-ß₂ agonist spirometry, impulse oscillometry (a measure of airway resistance), and measurement of fractional exhaled nitric oxide (FeNO). RESULTS: Patients had lower lung function values than controls: forced expiratory volume in 1 s (FEV₁) (median 97.90 vs. 109.45; p = 0.011), FEV₁ after ß₂ agonist (100.80 vs. 114.10; p = 0.013), peak expiratory flow (92.90 vs. 97.95; p = 0.031), and maximum mid-expiratory flow (MMEF) (80.80 vs. 106.30; p = 0.008). FeNO was significantly lower in the patients (p < 0.001). Significant reversibility of FEV₁ after ß₂ agonist was observed in 8.7% of the patients. FEV₁/forced vital capacity and MMEF after ß₂ agonist correlated negatively with hysterometry at diagnosis (p = 0.009 and p = 0.03, respectively). There was a negative correlation between age at diagnosis and airway resistance. CONCLUSIONS: Women with ICPP seem to have lower lung function despite treatment with GnRHa. Further research on the effects of sex hormones on the airways should take into account potential interplay with factors affecting the start of puberty.
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