Ospedali Riuniti Research Articles

Analysis of immune-phenotype in squamous cells carcinoma of the tongue

Event Abstract Back to Event Analysis of immune-phenotype in squamous cells carcinoma of the tongue Marco Mascitti1, Giuseppe Troiano2*, Rodolfo Mauceri3, Lorenzo Lo Muzio2, Corrado Rubini1 and Andrea Santarelli1 1 Polytechnical University of Marche, Department of Clinical Specialistic and Dental Sciences, Italy 2 University of Foggia, Department of Clinical and Experimental Medicine, Italy 3 University of Palermo, Department of Surgical, Oncological and Oral Sciences, Italy Aim. The recent success in the treatment of head and neck squamous cell carcinoma with checkpoint inhibitors has stimulated researchers in the understanding of the role that the immune system plays in cancer. The immune system interacts intimately with tumors over the entire process of disease development and progression to metastasis. Recently, Chen and Mellman classified cancer in relation to the immune system, distinguishing three phenotypes: Inflamed, Immune-escaped and Immune-desert. In this paper, we analyzed tongue squamous cell carcinoma (TSCC) samples, according to the aforementioned classification, in order to study the role of the immune system in this subtype of tumors. Materials and Methods. In this study, 82 patients surgically treated for SCCTs at the Department of Maxillofacial Surgery, “Ospedali Riuniti” General Hospital (Ancona, Italy), between 2011 and 2016 were included. Clinical and radiologic data were obtained from each patient’s medical record, and pathologic data were retrieved from the archives of the Sections of Pathology, Marche Polytechnic University, Italy. Tumors were classified on the basis of the immune infiltrated in: Inflamed, Immune-escaped and Immune-desert; and correlated with clinic pathological parameters. Results. Pathological analysis of immune-phenotype of TSCC samples revealed that: 59.8% (49/82) were classified as Inflamed, 30.5% (25/82) as Immune-Excluded and 9.8% (8/82) as Immune-desert. In addition, the ratio carcinoma stroma in TSCC inversely correlated with the size of the tumor at the time of diagnosis. Discussion. The analysis of the immune-phenotype could be used to further stratify patients with TSCC. A possible inclusion of this parameter in the clinical staging needs to be evaluated in further well-standardized studies. References Chen DS, Mellman I. Elements of cancer immunity and the cancer-immune set point. Nature. 2017 Jan 18;541(7637):321-330. Cogdill AP, Andrews MC, Wargo JA. Hallmarks of response to immune checkpoint blockade. Br J Cancer. 2017 Jun 27;117(1):1-7. Chen DS, Mellman I. Oncology meets immunology: the cancer-immunity cycle. Immunity. 2013 Jul 25;39(1):1-10. Keywords: OSCC (oral squamous cell carcinoma), head and neck, Immunity, Immune System, Tongue Conference: 5th National and 1st International Symposium of Italian Society of Oral Pathology and Medicine., Ancona, Italy, 19 Oct - 20 Oct, 2018. Presentation Type: Poster Presentation Topic: Oral Diseases Citation: Mascitti M, Troiano G, Mauceri R, Lo Muzio L, Rubini C and Santarelli A (2019). Analysis of immune-phenotype in squamous cells carcinoma of the tongue. Front. Physiol. Conference Abstract: 5th National and 1st International Symposium of Italian Society of Oral Pathology and Medicine.. doi: 10.3389/conf.fphys.2019.27.00020 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 24 Oct 2018; Published Online: 09 Dec 2019. * Correspondence: Dr. Giuseppe Troiano, University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Apulia, 71122, Italy, giuseppe.troiano@unifg.it Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Marco Mascitti Giuseppe Troiano Rodolfo Mauceri Lorenzo Lo Muzio Corrado Rubini Andrea Santarelli Google Marco Mascitti Giuseppe Troiano Rodolfo Mauceri Lorenzo Lo Muzio Corrado Rubini Andrea Santarelli Google Scholar Marco Mascitti Giuseppe Troiano Rodolfo Mauceri Lorenzo Lo Muzio Corrado Rubini Andrea Santarelli PubMed Marco Mascitti Giuseppe Troiano Rodolfo Mauceri Lorenzo Lo Muzio Corrado Rubini Andrea Santarelli Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Osteonecrosis of the jaws caused by myelodysplasia: a case report

Osteonecrosis of the jaws caused by myelodysplasia: a case report

An unusual case of recurrent oral cancer in a young woman HPV-negative, non-smoker and non-drinker

An unusual case of recurrent oral cancer in a young woman HPV-negative, non-smoker and non-drinker

175. A preliminary study on the correlation of modulation plan parameters with dosimetric accuracy of VMAT treatment plans performed in two centres with different linear accelerators and treatment planning systems

PurposeTo evaluate a correlation between plan parameters and Γ passing rate that could predict dosimetric accuracy of VMAT treatment plans. MethodsTen pelvis treatment plans (irradiation of prostate, seminal vesicles and pelvis nodes with simultaneous integrated boost technique) have been performed on the same CT series and contoured structure sets in Istituti Clinici Scientifici Maugeri (ICSM) and in Azienda Ospedaliera Ospedali Riuniti Marche Nord (AORMN). Two 6 MV VMAT beams have been planned with Philips Pinnacle3 v16 (ICSM) and Elekta Monaco v 5.11(AORMN) for Varian Clinac iX® with Millenium MLC® 120-leaves and Elekta Synergy® with MLCi2 80 leaves respectively. The total prescribed dose has been 70.2 Gy in 26 fractions. The same planning criteria have been followed in both centres; the dose constraints on OARs (in particular peritoneal cavity) had been always achieved and preferred to the PTV coverage. RTPlan files were analyzed with Matlab® to obtain MUs and plan parameters used to calculate MCS, average Leaf Travel (LT) and their combination (LTMCS) whose definition is found in literature [1]. Local, global and normalized to dose prescription Γ index (3%, 3 mm) enabled the comparison between calculated and measured dose on the PTW Octavius 4D® volume phantom. The Pearson coefficient between Γ passing rate values and all the considered parameters has been computed to looking for a correlation. ResultsPearson coefficients are shown in Table 1 for all the parameters and Γ passing rate considered. The correlation is always strong for MU and moderate for all Γ indexes against MCS for ICSM and for the two Γ global indexes for Pesaro against MCS and LTMCS (Table 1). ConclusionsThe results show a strong correlation against MU for both centres that could be useful to predict VMAT dosimetric accuracy expressed as Γ passing rate. [Display omitted]

Feasibility single-arm study of a medical device containing Desmodium adscendens and Lithothamnium calcareum combined with chemotherapy in head and neck cancer patients.

BackgroundNeoplasms of the head and neck represent approximately 5% of cancers and they require complex multidisciplinary clinical management. Desmodium adscendens (Desmodium) is a plant that possesses anti-allergic, antioxidant and hepatoprotective properties. Lithothamnium calcareum (Lithothamnium) is a calcified seaweed that possesses remineralization properties and the ability to maintain homeostasis.AimIn this single-arm study, we investigated the efficacy of a combination therapy based on Desmovit® which contains Desmodium and Lithothamnium, and chemotherapy in patients with head and neck cancer.MethodsTwelve patients with histological or cytological diagnosis of stage IV head and neck cancer were enrolled in this study that was approved by the ethics committee of the Unità Operativa Complessa (UOC) di Oncologia Medica Azienda Ospedaliera Ospedali Riuniti Marche Nord and followed the Declaration of Helsinki guidelines. The patients were monitored by investigation of the performance status according to the Glasgow Prognostic Score (GPS), which evaluates the plasma level of C-reactive protein and albumin levels, and the Eastern Cooperative Oncology Group (ECOG) examination. Pain and fatigue were also monitored using the visual analog scale and visual analog fatigue scale, respectively. All the above parameters were assessed biweekly to week 10.ResultsGPS, ECOG, and albumin remained stable throughout the study with a trend towards a decrease in GPS and albumin at week 10 post-treatment. Pain significantly improved at week 8 (P<0.05) while fatigue improved at weeks 8 and 10 (all P<0.01).ConclusionWe found that chemotherapy, combined with Desmodium and Lithothamnium, improved pain and fatigue in head and neck cancer patients, although we cannot confirm if this was due to Desmodium and Lithothamnium or chemotherapy. The improvement in pain and fatigue was supported by the ECOG performance status remaining stable with the highest score being equal to 2 throughout the study and a trend towards an improvement in GPS performance status and albumin levels.

Management Control Systems and Integrated Reporting: Which Relationships? The Case of the Azienda Ospedaliero Universitaria Ospedali Riuniti Ancona

This article explores the contribution that management accountants and management control systems can give to the design and the implementation of an integrated reporting system. In particular, the case of the Azienda Ospedaliero Universitaria Ospedali Riuniti Ancona is analysed in the aim of highlighting the role played by the management accountant in promoting the design and implementation of the integrated report in the specific context under investigation. The empirical evidence adds to the extant literature on this issue by showing the relevant role played by management control systems and by management accountants as well and, in particular, how the latter can significantly influence the whole design and implementation process at an organisational, technical, and motivational level.

Developments in the management of advanced soft-tissue sarcoma - olaratumab in context.

Lartruvo® (olaratumab) is a fully human immunoglobulin G subclass 1 (IgG1) monoclonal antibody that inhibits platelet-derived growth factor receptor alpha (PDGFRα). The antitumor activity of olaratumab has been tested in vitro and in vivo, and inhibition of tumor growth has been observed in cancer cell lines, including glioblastoma and leiomyosarcoma cells. It represents the first-in-class antibody to be approved by regulatory authorities for the treatment of advanced soft-tissue sarcomas (STSs) in combination with doxorubicin, based on the results of the Phase Ib/II trial by Tap et al. The median progression-free survival (PFS), which was the primary end point of the study, was improved for patients treated with olaratumab plus doxorubicin compared to those treated with doxorubicin monotherapy (6.6 vs 4.1 months, respectively; HR 0.672, 95% CI 0.442–1.021, p=0.0615). Moreover, final analysis of overall survival (OS) showed a median OS of 26.5 months with olaratumab plus doxorubicin vs 14.7 months with doxorubicin, with a gain of 11.8 months (HR 0.46, 95% CI 0.30–0.71, p=0.0003). In October 2016, olaratumab was admitted in the Accelerated Approval Program by the US Food and Drug Administration (FDA) for use in combination with doxorubicin for the treatment of adult patients with STSs. In November 2016, the European Medicines Agency (EMA) granted conditional approval for olaratumab in the same indication under its Accelerated Assessment Program. A double-blind, placebo-controlled, randomized Phase III study (ANNOUNCE trial, NCT02451943) is being performed in order to confirm the survival advantage of olaratumab and to provide definitive drug confirmation by regulators. The study is ongoing, but enrollment is closed. The purpose of this review was to evaluate the rationale of olaratumab in the treatment of advanced STSs and its emerging role in clinical practice.

Lengthening Temporalis Myoplasty: Objective Outcomes and Site-Specific Quality-of-Life Assessment.

Objective Evaluate outcomes of the lengthening temporalis myoplasty in facial reanimations. Study Design Case series with planned data collection. Setting Ospedali Riuniti, Bergamo, and AOUC Careggi, Florence, Italy. Subjects and Methods From 2011 to 2016, 11 patients underwent lengthening temporalis myoplasty; demographic data were collected for each. Pre- and postoperative photographs and videos were recorded and used to measure the smile angle and the excursion of the oral commissure, according to the SMILE system (Scaled Measurements of Improvement in Lip Excursion). All patients were tested with the Facial Disability Index, and they also completed a questionnaire about the adherence to physiotherapy indications. Results All patients demonstrated a significant improvement in functional parameters and in quality of life. On the reanimated side, the mean z-line and a-value, measured when smiling, significantly improved in all patients: from 22.6 mm (95% CI, 20.23-25.05) before surgery to 30.9 mm (95% CI, 27.82-33.99) after surgery ( P < .001) and from 100.5° (95% CI, 93.96°-107.13°) to 111.6° (95% CI, 105.63°-117.64°; P < .001), respectively. The mean postoperative dynamic gain, passing from rest to a full smile at the reanimated side, was 3.1 mm (95% CI, 1.30-4.88) for the z-line and 3.3° (95% CI, 1.26°-5.29°) for the a-value. The Facial Disability Index score increased from a preoperative mean of 33.4 points (95% CI, 28.25-38.66) to 49.9 points (95% CI, 47.21-52.60) postoperatively ( P < .001). Conclusions The lengthening temporalis myoplasty can be successfully used for smile reanimation, with satisfying functional and quality-of-life outcomes.

Intentional roundings in general medical practice: the experience of the Azienda Ospedali Riuniti Marche Nord (Italy).

The "intentional roundings" are planned rounds, conducted at regular intervals by nursing staff to anticipate care, comfort, hospitality and psychological needs of hospitalized users. These purposes are achieved with a structured way to make observations and carry out activities for well-being and patient safety, documenting what was done with a structured ad hoc form. In the United Kingdom, as well as in the USA, intentional rounding is an established model of care that improve the safety of provided care, to reduce the occurrence of preventable events, address proactively basic caring needs, and that increase users and staff satisfaction. Implementing in a medical pilot unit the care model named "intentional rounding". The care team carried intentional rounds every two hours, in a systematic and documented manner. All patients received admission informations about the organizational method and were invited to participate by completing a satisfaction questionnaire at discharge. At the end of the experimental period organizational impact have been investigated, specifically users and hospital staff satisfaction. About privacy, courtesy, nurse support and quality of care provided, level of satisfaction of patients and caregivers reached high percentage of approval (90-99%). Nurses and other healthcare personnel have perceived they delivered either a safer and most satisfying healthcare (90-94%) as well as inter- and intra-professional dynamics communications (95%). Value of roundings have been less appreciated concerning the optimization about the worktime management (79%). Calls to the bell have had a notable change of their reasons unlikely about the quantity. Intentional roundings affects very positively to users satisfaction level and to the perception of the quality of care provided; the care team, though express the need to make some changes for a real implementation, recognize the proactivity of intentional roundings as an added value.

Safety and efficacy of non-continuous echocardiography-guided pericardiocentesis: a single-center study of 478 patients.

There are limited contemporary data on the safety and efficacy of echocardiography-guided pericardiocentesis in Italy. The aim of the study was to evaluate safety and efficacy of pericardiocentesis, performed with non-continuous echocardiography monitoring. All the procedures performed at Department of Cardiovascular Disease, Ospedali Riuniti Ancona, from January 2001 to June 2013, were retrospectively analyzed to determine risks connected to the procedure and its success rate. Epidemiological data, procedure indications and etiology of the effusions were also recorded. In the study period, 478 pericardiocentesis were performed for cardiac tamponade (N.=161), to remove large amount of fluid (N.=215) or for diagnostic purposes (N.=102). Echocardiographic evaluation, performed just before the procedure, was used to define the site of entry, to measure the distance from the skin to the fluid, and to establish how to direct the needle. We observed an extremely low rate of complications (<1%), without any death. The procedure was fully successful in 98% of cases and achieved only partial fluid removal in the remained 10 patients. The etiology of the effusion was malignancy or post cardiothoracic surgery in almost 60% of cases. Over the years there was an increase of pericardiocentesis performed after a cardiothoracic surgery (P=0.002); There was a significant reduction of the average amount of drained fluid in the years 2010-2013 vs. the period 2001-2009. Echocardiography-guided pericardiocentesis is an effective and safe procedure, with a low rate of complications.

EP-1459: Testing the self-sufficiency of the Radiotherapy Department of Ospedali Riuniti Marche Nord

EP-1459: Testing the self-sufficiency of the Radiotherapy Department of Ospedali Riuniti Marche Nord

Perioperative management of facial bipartition surgery

Perioperative management of facial bipartition surgery Marco Caruselli,1 Michael Tsapis,1,2 Fabrice Ughetto,1 Gregoire Pech-Gourg,3 Dario Galante,4 Olivier Paut1 1Anesthesia and Intensive Care Unit, La Timone Children&rsquo;s Hospital, 2Pediatric Transport Team, SAMU 13, La Timone Hospital, 3Pediatric Neurosurgery Unit, La Timone Children&rsquo;s Hospital, Marseille, France; 4Anesthesia and Intensive Care Unit, University Hospital Ospedali Riuniti of Foggia, Foggia, Italy Abstract: Severe craniofacial malformations, such as Crouzon, Apert, Saethre-Chotzen, and Pfeiffer syndromes, are very rare conditions (one in 50,000/100,000 live births) that often require corrective surgery. Facial bipartition is the more radical corrective surgery. It is a high-risk intervention and needs complex perioperative management and a multidisciplinary approach. Keywords: craniofacial surgery, facial bipartition surgery, craniofacial malformations, pediatric anesthesia

Neural hypernetwork approach for pulmonary embolism diagnosis.

BackgroundHypernetworks are based on topological simplicial complexes and generalize the concept of two-body relation to many-body relation. Furthermore, Hypernetworks provide a significant generalization of network theory, enabling the integration of relational structure, logic and analytic dynamics. A pulmonary embolism is a blockage of the main artery of the lung or one of its branches, frequently fatal.ResultsOur study uses data on 28 diagnostic features of 1427 people considered to be at risk of pulmonary embolism enrolled in the Department of Internal and Subintensive Medicine of an Italian National Hospital “Ospedali Riuniti di Ancona”. Patients arrived in the department after a first screening executed by the emergency room. The resulting neural hypernetwork correctly recognized 94 % of those developing pulmonary embolism. This is better than previous results obtained with other methods (statistical selection of features, partial least squares regression, topological data analysis in a metric space).ConclusionIn this work we successfully derived a new integrative approach for the analysis of partial and incomplete datasets that is based on Q-analysis with machine learning. The new approach, called Neural Hypernetwork, has been applied to a case study of pulmonary embolism diagnosis. The novelty of this method is that it does not use clinical parameters extracted by imaging analysis.

O040. Migraineurs and self-consciousness of illness in a population of hospital workers.

Background The World Health Organization has classified headache as the 14 cause of disabling illnesses. Millions of people are affected by this pathology, especially during their working life. Surprisingly, subjects affected by headache, in particular by migraine, present a low degree of self-awareness of their pathology, and they do not usually consult any headache center [1]. For this reason migraineurs often go towards serious complications, such as chronicization or drug abuse. We investigated, in a selected population of workers, employees of the Ospedali Riuniti in Ancona, the number of people affected by headache and their awareness. We also investigated the drugs used to verify the use of a specific therapy for such a diffused pathology.

Pathophysiology of Complex Regional Pain Syndrome Type I: Update

1 O.U. of Anesthesia, Intensive Care and Pain Therapy of Sant’Antonio Abate Hospital, Erice Casa Santa, Trapani, Italy. 2 O.U. of Anesthesia, Intensive Care and Pain Therapy of Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy. 3 Anesthesiology, Intensive Care and Pain Therapy Department, Catholic University, Medical School, Rome, Italy. 4 Plastic and Reconstructive Surgery Department, University 'Sapienza' of Rome, Italy.

Seven essential tools of a cardiologist's survival kit

a ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands b Medical University of Vienna, Center for Medical Statistics, Informatics and Intelligent Systems, Section for Clinical Biometrics, Vienna, Austria c CNR-IFC Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Renal and Transplantation Unit, Ospedali Riuniti, 89125 Reggio Cal., Italy

Radiation exposure of an anaesthesiologist in catheterisation and electrophysiological cardiac procedures.

Sometimes, cardiac catheterisation and electrophysiological procedures, diagnostic and interventional, require an anaesthesiological support. The anaesthesiologist receives radiation doses depending on various factors, such as type of procedure and exposure modality, anaesthesiological technique, individual protective devices and operator experience. The aim of this study was to investigate the dose per procedure, the exposure inhomogeneity and the effective dose, E, of a senior anaesthesiologist in the haemodynamic laboratory of Ospedali Riuniti, Bergamo. The dose monitoring was routinely performed with sets of several thermoluminescent dosemeters and an electronic personal dosemeter. The study covered 300 consecutive procedures over 1 y. The anaesthesiologist wore a protective apron, a thyroid collar and glasses (0.5 mm lead-equivalent).

Jargon in reading aloud sparing Arabic digits but not number words

Jargon in reading aloud sparing Arabic digits but not number words

A single-centre, tertiary-care, Italian registry of celiac disease: Incidence and clinical presentation

s / Digestive and Liver Disease 46 (2014) e85–e127 e95 4.5±0.6pg/ml, mean FT4 1.2± .4 ng/dl. TSH levels were above cutoff laboratory range in 10% of our population and the 2 patients (0.2%) of the whole population presented TSH≥10 UI/ml. We found a significant positive correlation between TSH levels and BMI z-score (rho=0.121, p=0.001), even after adjustment for age and sex (r=0.117, p=0.001); a positive correlation was also observed between FT3 and BMI z-score (rho=0.161, p<0.001), but not for Ft4 (p=0.787). TSH and FT3 were also positively associated with Waist to Height ratio (WtHr, rho=0.114, p=0.002 and rho=0.095, p=0.011 respectively). No correlation was found between thyroid functionality and: Homa index, z-score of blood pressure and hepatic steatosis. Conclusions: Our data suggest a relationship between obesity and serum TSH and FT3 levels. In particular, WtHr, marker of visceral fat, is directly related to TSH levels. It is not clear whether thyroid alteration are cause or consequence of fat excess, but metabolic active visceral fat could have a role. http://dx.doi.org/10.1016/j.dld.2014.07.078 A SINGLE-CENTRE, TERTIARY-CARE, ITALIAN REGISTRY OF CELIAC DISEASE: INCIDENCE AND CLINICAL PRESENTATION Valentina Giorgio ∗, Maria Rita Sartorelli, Claudia Della Corte, Donatella Comparcola, Daniela Liccardo, Arianna Alterio, Valerio Nobili, Francesca Ferretti Malattie EpatoMetaboliche, Ospedale Pediatrico “Bambino Gesu”, Roma, Italy Objectives: The aim of this study was to assess clinical pattern and the incidence of celiac disease (CD) currently diagnosed in children living in Rome, describing a single-Italian-center experience. Methods: A prospective, single-center registry of new cases of CD in children under 18 years was conducted from 1 January 2011 to 1 June2013. The variables studiedwere: age at diagnosis, gender, breast feeding, clinical symptoms, associated diseases, IgA serum levels, CD serology, histological lesions, and HLA DQ2/QQ8. The crude incidence rate of CD was calculated as new cases per 1000 live births. Results: 800 new cases of CD were included (39% males). The median age at diagnosis was 8 years (range 0.9–18). 483/800 (60%) were breast fed≥2months, with amean breast feeding duration of 15.2±11.4months. Mean age at first gluten exposurewas 6.4±2.2 months. Regarding clinical presentation 68.9% showed classical symptoms, 27.1% were non-classical, and 4% were asymptomatic. Among atypical symptoms, celiac crises was present and seen in 3% of all children. 96.7% were positive for IgA endomysial antibodies, 97.3% were positive for IgA anti-transglutaminase type 2 antibodies. IgA selective deficiency was seen in 4% children. 85,6% performed duodenal biopsy. Villous atrophy was observed in 91% and increased intraepithelial lymphocytes with crypt hyperplasia in 10.3%. 3 children (0.37%) were diagnosed with CD after cutaneous biopsy for dermatitis herpetiformis. The HLA phenotype was performed in 200 children (25%) and was: DQ2: 84.5%, DQ2/DQ8: 5.5% and DQ8: 10%. The incidence rate was 7.08 cases of CD per 1000 live births. Conclusions: InRome, themost frequent clinicalpresentationof CD in the pediatric age is the classical form. The observed incidence of CD in children ismuchhigher than the current CD incidence rates observed in other countries. A multicenter study on larger series would be needed to verify this increasing incidence. http://dx.doi.org/10.1016/j.dld.2014.07.079 EVALUATION OF VITAMIN D STATUS IN A PEDIATRIC POPULATION OF SOUTHERN ITALY Donatella De Giovanni1,∗, Irene Rutigliano1, Clementina Calabrese1, Giovanna Nardella1, Maria Pia Falcone1, Angelo Guida1, Antonio Longo2, Massimo Pettoello-Mantovani1, Angelo Campanozzi1 1 Clinica Pediatrica, Universita’ di Foggia, Foggia, Italy 2 U.O. Pediatria, Ospedali Riuniti di Foggia, Foggia,

Sodium and potassium intake in children: Relationship with age, body mass and blood pressure

s / Digestive and Liver Disease 46 (2014) e85–e127 e95 4.5±0.6pg/ml, mean FT4 1.2± .4 ng/dl. TSH levels were above cutoff laboratory range in 10% of our population and the 2 patients (0.2%) of the whole population presented TSH≥10 UI/ml. We found a significant positive correlation between TSH levels and BMI z-score (rho=0.121, p=0.001), even after adjustment for age and sex (r=0.117, p=0.001); a positive correlation was also observed between FT3 and BMI z-score (rho=0.161, p<0.001), but not for Ft4 (p=0.787). TSH and FT3 were also positively associated with Waist to Height ratio (WtHr, rho=0.114, p=0.002 and rho=0.095, p=0.011 respectively). No correlation was found between thyroid functionality and: Homa index, z-score of blood pressure and hepatic steatosis. Conclusions: Our data suggest a relationship between obesity and serum TSH and FT3 levels. In particular, WtHr, marker of visceral fat, is directly related to TSH levels. It is not clear whether thyroid alteration are cause or consequence of fat excess, but metabolic active visceral fat could have a role. http://dx.doi.org/10.1016/j.dld.2014.07.078 A SINGLE-CENTRE, TERTIARY-CARE, ITALIAN REGISTRY OF CELIAC DISEASE: INCIDENCE AND CLINICAL PRESENTATION Valentina Giorgio ∗, Maria Rita Sartorelli, Claudia Della Corte, Donatella Comparcola, Daniela Liccardo, Arianna Alterio, Valerio Nobili, Francesca Ferretti Malattie EpatoMetaboliche, Ospedale Pediatrico “Bambino Gesu”, Roma, Italy Objectives: The aim of this study was to assess clinical pattern and the incidence of celiac disease (CD) currently diagnosed in children living in Rome, describing a single-Italian-center experience. Methods: A prospective, single-center registry of new cases of CD in children under 18 years was conducted from 1 January 2011 to 1 June2013. The variables studiedwere: age at diagnosis, gender, breast feeding, clinical symptoms, associated diseases, IgA serum levels, CD serology, histological lesions, and HLA DQ2/QQ8. The crude incidence rate of CD was calculated as new cases per 1000 live births. Results: 800 new cases of CD were included (39% males). The median age at diagnosis was 8 years (range 0.9–18). 483/800 (60%) were breast fed≥2months, with amean breast feeding duration of 15.2±11.4months. Mean age at first gluten exposurewas 6.4±2.2 months. Regarding clinical presentation 68.9% showed classical symptoms, 27.1% were non-classical, and 4% were asymptomatic. Among atypical symptoms, celiac crises was present and seen in 3% of all children. 96.7% were positive for IgA endomysial antibodies, 97.3% were positive for IgA anti-transglutaminase type 2 antibodies. IgA selective deficiency was seen in 4% children. 85,6% performed duodenal biopsy. Villous atrophy was observed in 91% and increased intraepithelial lymphocytes with crypt hyperplasia in 10.3%. 3 children (0.37%) were diagnosed with CD after cutaneous biopsy for dermatitis herpetiformis. The HLA phenotype was performed in 200 children (25%) and was: DQ2: 84.5%, DQ2/DQ8: 5.5% and DQ8: 10%. The incidence rate was 7.08 cases of CD per 1000 live births. Conclusions: InRome, themost frequent clinicalpresentationof CD in the pediatric age is the classical form. The observed incidence of CD in children ismuchhigher than the current CD incidence rates observed in other countries. A multicenter study on larger series would be needed to verify this increasing incidence. http://dx.doi.org/10.1016/j.dld.2014.07.079 EVALUATION OF VITAMIN D STATUS IN A PEDIATRIC POPULATION OF SOUTHERN ITALY Donatella De Giovanni1,∗, Irene Rutigliano1, Clementina Calabrese1, Giovanna Nardella1, Maria Pia Falcone1, Angelo Guida1, Antonio Longo2, Massimo Pettoello-Mantovani1, Angelo Campanozzi1 1 Clinica Pediatrica, Universita’ di Foggia, Foggia, Italy 2 U.O. Pediatria, Ospedali Riuniti di Foggia, Foggia,