thyroid diseases (tDs) have been widely associated with HiV infection. However, data about tDs prevalence and distribution are controversial, and few published studies are available. the aim of our study was to assess prevalence and risk factors of symptomatic thyroid disturbances, including thyroid cancers, in a large cohort of HiV-infected patients. A retrospective cohort study was performed at the Department of infectious and tropical Diseases of the University of Brescia, italy, in the period 2005-2017. We identified all HIV-positive patients with a diagnosis of symptomatic TD in the electronic database of our Department (HiVeDB); we also operated a record-linkage between our data and the Health protection Agency database (HpADB) of Brescia province. Multivariate logistic regression analysis was used to determine risk factors associated with tDs onset; an incidence rate analysis was also performed. During the study period, 6343 HIV-infected patients have been followed at our Department; 123 received a diagnosis of symptomatic TD (1.94% of the entire cohort). In the TDs group, almost half of patients were females (n = 59, 48%), mean age was 47.15 years (SD: 11.56). At TD diagnosis, mean T CD4+ cell count was 491 cell/uL and most patients showed undetectable HIV-RNA (n = 117, 95.12%). Among them, 81 patients were found to have hypothyroidism (63 with Hashimoto's thyroiditis), 21 hyperthyroidism (17 suffered from Graves' disease), while 11 subjects were diagnosed with a primitive thyroid cancer. papillary thyroid cancer was the most frequent histotype (n = 7, 63.63%), followed by medullary (n = 2, 18.18%) and follicular thyroid cancer (n = 1, 9.1%). Male gender was a protective factor for tDs development, especially for hypothyroidism (p < 0.001); age emerged as a variable associated with both hypothyroidism (p = 0.03) and thyroid cancer (p = 0.03), while CD4+ cell nadir <200 cell/ mm 3 was associated with symptomatic hyperthyroidism (p = 0.005). To conclude, symptomatic thyroid dysfunctions rate in well-treated HiV-infected patients is low. Age and gender are crucial elements in the onset of thyroid abnormalities, together with T CD4+ cell nadir. interestingly, medullary thyroid cancer seems to be much more frequent in HiV-infected patients compared to the general population. Various alterations in endocrine homeostasis were described in HIV-infected patients 1-3. In particular, thyroid diseases (TDs) have been widely associated with HIV infection since the start of the epidemic, long before the beginning of the combination antiretroviral therapy (cART) era 4-6. However, there are controversial data concerning thyroid dysfunctions in people living with HIV (PLWH), as previous studies reported both a higher than expected prevalence of TDs 7-13 and no apparent increased prevalence of TDs in this population 14-17. In well-treated HIV-positive individuals, subclinical hypothyroidism 7,9,11-13,18 and isolated low free thyroxine (FT4) levels 6,10,19 are the most common described alterations. Anyway, although it is es...
Background Identifying individual and contextual factors that influence adolescent well-being is a research priority. This study aimed to assess the prevalence of symptoms of mental health problems and some related factors in Italian adolescents in 2017–2018. Methods The present study was a cross-sectional survey among 3002 students aged 15–16 years who resided in two Italian provinces, in North and South Italy. Symptoms of mental health problems were assessed using the SDQ and CES-DC, and students’ risk-taking behaviors and school climate perception were assessed. All information was collected anonymously. Logistic regression models were used to assess the associations of tobacco and alcohol use, screen time, bullying, and school climate with symptoms of mental health problems. Results One student out of five reported symptoms of mental health problems, with a more than double proportion among girls than boys (28.7% vs 10.4% with depressive symptoms, respectively). Thirty percent and 40% of students smoked tobacco or drank alcoholic beverages at least once in the past month, and more than 40% reported being victims or authors of bullying in the past 6 months. Smoking behavior, alcohol consumption, screen time, bullying, and negative school climate had 1.2- to 3.3-fold increased odds of symptoms of mental health problems without substantial differences between sexes and geographical areas. Conclusions Tobacco and alcohol use, screen time, bullying, and school climate were independently associated with symptoms of mental health problems in a large sample of 15–16-year-old Italian adolescents without substantial gender and geographical differences.
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