Publications by authors named "Gamarra E"

Objectives: Ultrasound (US) evaluation is recognized as pivotal in assessing the risk of malignancy (RoM) of thyroid nodules (TNs). Recently, various US-based risk-classification systems (Thyroid Imaging and Reporting Data Systems [TIRADSs] have been developed. An important ongoing project concerns the creation of an international system (I-TIRADS) using unique terminology.

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Background And Aims: Scuba diving for people with diabetes was discouraged due to hypoglycemia risks. However, evolving guidelines now enable safe diving for people with diabetes. Among them, the Diabete Sommerso® safety protocol.

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: Mixed urinary incontinence (MUI) has always represented a major therapeutic challenge and the management of this type of incontinence is often complicated by uncertain outcomes. Surgical options include interventions targeting both stress urinary incontinence (SUI) and urge urinary incontinence (UUI), although there are no international published guidelines that dictate whether it is better to start with surgical management to address the SUI or UUI component after the failure of conservative treatment. The aim of the present study is to evaluate the effectiveness of the Macroplastique (MPQ) procedure on overactive bladder (OAB) symptoms in women with MUI with a minimum follow-up of 1 year.

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The use of tension-free vaginal tape obturator (TVT-O) for the treatment of stress urinary incontinence (SUI) has been widely debated over the last decade due to the lack of evidence on its long-term outcomes. The aim of this prospective study is to assess, for the first time in the available literature, the efficacy and safety of TVT-O implantation in women with pure SUI over a 17-year follow-up period. : We included all women who complained of pure SUI symptoms (confirmed urodynamically) and underwent the TVT-O procedure.

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Aims: A few studies have evaluated the performance of the American College of Radiology Thyroid Imaging Reporting And Data System (ACR-TIRADS) in pediatric and elderly patients and found differences between the latter two age groups and middle adulthood. Thus, the present study was undertaken to explore the possible variation of ACR-TIRADS performance across different ages of patients.

Methods: A retrospective population undergoing thyroidectomy was selected to use histology as the reference standard.

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Article Synopsis
  • The study investigates thyroid nodules (AFTNs) and the use of the TIRADS system to prevent unnecessary fine-needle aspiration cytologies (FNACs).
  • It found that only 37.5% of AFTNs had FNAC indications according to TIRADS, with low TSH levels and larger nodule size being significant predictors of unnecessary procedures.
  • The conclusion emphasizes that the risk of unnecessary FNACs is low for AFTNs undergoing scintigraphy, suggesting no need for additional imaging in the TIRADS framework.
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Scuba diving was previously excluded because of hypoglycemic risks for patients with type 1 diabetes mellitus(T1DM). Specific eligibility criteria and a safety protocol have been defined, whereas continuous glucose monitoring (CGM) systems have enhanced diabetes management. This study aims to assess the feasibility and accuracy of CGM Dexcom G7 and Free Style Libre 3 in a setting of repetitive scuba diving in T1DM, exploring the possibility of nonadjunctive use.

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Background: Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was firstly described in 2016. Since NIFTP is thought a non-malignant tumor, the Bethesda system for thyroid cytology proposes two estimations of risk of malignancy of the diagnostic categories, one considering NIFTP as cancer and another one considering it as a benign neoplasm. The present study aimed to review NIFTPs in a single center, re-assess them across categories of three Thyroid Imaging Reporting and Data Systems (TIRADSs), and define the indication for biopsy according to the category-specific size cut-offs.

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Background: Hypothyroidism is treated with daily levothyroxine (LT4). In recent years, soft gel caps of LT4 (LT4-C) have been commercialized, and their performance has been optimized. Since guidelines recommend dose LT4 according to the tablet preparation efficacy, the present study was undertaken to obtain data about the daily requirement, normalized per body weight, of LT4-C.

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The incidence of papillary thyroid carcinoma (PTC) is increasing and PTC ≤ 10 mm (PTMC) accounts for most new diagnoses. PTMCs are not always low risk, as detection of lymph nodes metastasis (LNM) may occur. The purpose of the study was to analyze the clinical pattern, frequency, and independent risk factors of patients with PTMC and LNM.

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Objective: Calcitonin (Ctn) measurement is crucial for the early diagnosis of medullary thyroid carcinoma (MTC). However, Ctn levels can be skewed/elevated due to other reasons, and the Ctn upper reference value remains controversial. In this field, studies have heterogeneous settings, published data are controversial, and no evidence has been achieved.

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Article Synopsis
  • Hypothyroidism (hT) has varying symptoms and is often studied in diverse populations, making it hard to draw clear conclusions about inflammation in this condition.
  • This research focused on thyroid cancer patients who had undergone standardized hT and measured specific blood inflammatory indexes (BIIXs) before treatment to understand the relationship between inflammation and hypothyroidism.
  • The study included 143 patients and found that BIIX values varied significantly based on factors like sex and BMI but showed no significant links to age or thyroid hormone levels, indicating potential implications for obesity and thyroid cancer prognosis.
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This study reports that most patients with NSCLC had a significant increase in the nAb response to the currently circulating Omicron variants after bivalent booster vaccination and had Ab titers comparable to healthy participants. Interestingly, though the durability of the nAb response persisted in most of the healthy participants, patients with NSCLC had significantly reduced nAb titers after 4-6 months of vaccination. Our data highlight the importance of COVID-19 bivalent booster vaccination as the standard of care for patients with NSCLC given the evolution of new variants of concern.

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Article Synopsis
  • Standard treatment for chronic hypoparathyroidism typically involves long-term calcium and vitamin D supplements, but not all patients respond well, leading to the exploration of continuous PTH infusion via pumps for better management.
  • A systematic literature review analyzed 14 relevant studies, including randomized controlled trials and case reports, revealing significant clinical improvements in 40 patients who switched to PTH pump therapy after failing standard treatments.
  • Findings suggest that pump PTH infusion could be a safe and effective alternative for treatment-resistant chronic hypoparathyroidism, emphasizing the need for proper patient selection and collaboration among healthcare professionals.
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The correlation between the menstrual cycle and glucose control in type 1 diabetes has been the focus of several studies since the 1920s, but a few critical aspects made it particularly challenging to reach conclusive evidence. The aim of this systematic review is to reveal more solid information about the impact of the menstrual cycle on glycaemic outcomes and insulin sensitivity in type 1 diabetes and highlight the less researched areas. The literature was searched by two authors independently using PubMed/MEDLINE, Embase and Scopus (last search on 2 November 2022).

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Background: Chagas disease is endemic throughout most of Bolivia, with prevalence rates of 25% observed in some geographic areas located mainly in the sub-Andean region.

Methods: Community-based entomological surveillance was carried out in the sub-Andean departments of Cochabamba (municipalities of Cochabamba, Punata and Sacaba), Tarija (municipality of Tarija) and Chuquisaca (municipality of Sucre). The surveillance parameters evaluated were: (i) the proportion of cards with the presence of triatomines; (ii) the distribution of positive cards by area; and (iii) the proportion of cards with the presence of infected triatomines.

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Objective: To generate recommendations on the management of radiotherapeutic treatments during the pandemic, adapted to a country with limited health resources.

Methods: We did a rapid review of the literature, searching for papers that describe any measures to reduce the risk of COVID-19 infection, as well as management guidelines to reduce the workload, in radiotherapy units. The following conditions were included in the scope of this review: gynecological tumors, breast cancer, gastrointestinal tumors, genitourinary tumors, head and neck tumors, skin cancer, tumors of the central nervous system, and lymphomas.

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Background: Involvement with Child Protective Services (CPS) provides an opportunity to recognize those children at risk for ongoing adverse childhood experiences (ACEs). The relationship between ACEs and child health among CPS-involved children and the role of primary care providers (PCPs) in moderating this relationship is unknown.

Methods: We conducted a convergent mixed-methods study of caregivers of children age 2 to 12 years with a CPS finding of physical abuse, modeling the association between cumulative ACEs and child health-related quality of life (HRQoL) using the PedsQL4.

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Background: In stressed people with diabetes (PWD) glycemia varies idiosyncratically. Coping is a relatively stable personality trait that assesses how individual deals with stress. Insulin pumps are considered the best insulin delivery system but require more attention from PWD, virtually increasing stress levels.

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Background: The US mainland is experiencing an epidemic of opioid overdoses. Unfortunately, the US Territories (Guam, Puerto Rico, and the Virgin Islands) have often been overlooked in opioid pharmacoepidemiology research. This study examined common prescription opioids over the last decade.

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We report a 12-day-old male who was admitted with vomiting because of an unusual early complication of Marfan's syndrome (MS): a sliding hiatal hernia. Initial ultrasound showed no stomach at its normal position and the chest X-ray presented an intrathoracic gas bubble with the nasogastric tube inside. An upper gastrointestinal contrast study confirmed the complete herniation of the stomach into the thorax.

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