Lucio Masserini

Disappearance of humoral thyroid autoimmunity after complete removal of thyroid antigens.

RiassuntoLe malattie autoimmuni della tiroide sono caratterizzate dalla presenza di anticorpi diretti contro la tireoperossidasi (TPO), la tireoglobulina (Tg) e il recettore per l’ormone tireotropo (TSH-R). Questo studio ha valutato se la rimozione completa degli antigeni tiroidei fosse in grado di indurre la scomparsa dei segni di autoimmunità tiroidea circolante. Lo studio è basato su una revisione retrospettiva delle cartelle cliniche di pazienti che erano stati seguiti e trattati secondo un protocollo standard. Sono stati studiati 182 pazienti affetti da tumore differenziato della tiroide i quali, per la coesistenza di una tiroidite cronica autoimmune, di un morbo di Basedow o di una tiroidite focale autoimmune, risultavano positivi per anticorpi anti-TPO (TPOAb), anti-Tg (TgAb) o anti-TSH-R (TRAb). Dei 182 soggetti, 151 erano di sesso femminile e 31 di sesso maschile; l’età media era di 39,7±13,7 anni, con un range da 6 a 81 anni. Tutti i pazienti sono stati sottoposti a tiroidectomia totale e a trattamento con iodio radioattivo allo scopo di ablare il tessuto tiroideo residuo o metastatico. Il follow-up è stato effettuato mediante scintigrafie corporee totali con radioiodio e dosaggio della Tg circolante. La media del follow-up era di 10,1±4,1 anni, con un range di 4–20 anni. A seguito del trattamento con tiroidectomia totale e iodio radioattivo, si è verificata la scomparsa dei TgAb, TPOAb e TRAb. La mediana di scomparsa è stata di 6,3 anni per iTPOAb e di 3,0 anni per i TgAb. La scomparsa del tessuto tiroideo e quella degli anticorpi antitiroide erano correlate in modo statisticamente significativo. La persistenza di TPOAb e TgAb non veniva influenzata dal sesso, dall’età e dalla concomitanza della tiroidite autoimmune o del morbo di Basedow.

Are the Clinical and Pathological Features of Differentiated Thyroid Carcinoma Really Changed over the Last 35 Years? Study on 4187 Patients from a Single Italian Institution to Answer this Question

BACKGROUND In the last decades, a marked increased prevalence of differentiated thyroid cancer (DTC) has been observed worldwide. The aim of this study was to evaluate the changing features of DTC referred to our institution between 1969 and 2004. METHODS Clinical and pathological features and prognostic factors were analyzed in 4187 DTC patients, subdivided into two groups: group 1 (n = 1215) and group 2 (n = 2972) diagnosed before and after 1990, respectively. RESULTS Group 2 showed an increased proportion of micropapillary carcinoma and a concomitant decrease of follicular histotype. Male percentage was greater in group 2, whereas median age at diagnosis was unchanged. DTC of group 2 were more frequently associated with multinodular goiter or autoimmune thyroiditis, but many were unexpected findings. Features of aggressiveness were significantly less frequent in group 2, and the survival rate was greater (98.7 vs. 91.4%, P < 0.0001). Gender, age, histotype, tumor size, extrathyroidal macroinvasion, and lymph node and/or distant metastases were found to be poor prognostic factors in both groups using univariate analysis, but with multivariate analysis, only advanced age (odds ratio = 22.52 for older patients) and advanced stage (odds ratio = 53.54 for more advanced cases) were independently correlated with a lower survival. CONCLUSIONS DTC patients diagnosed after 1990 have smaller tumors with less advanced stage and a better prognosis. The question of whether this is related to the finding of tumors with a low clinical penetrance or to the anticipation of diagnosis remains to be clarified. Despite these significant differences, both advanced stage and older age still represent the most important poor prognostic factors for survival.

Thyroid autoantibodies and thyroid function in subjects exposed to Chernobyl fallout during childhood: evidence for a transient radiation-induced elevation of serum thyroid antibodies without an increase in thyroid autoimmune disease.

CONTEXT An increase in the prevalence of thyroid autoantibodies (ATAs) was reported 6-8 yr after the Chernobyl accident in radiation-exposed children and adolescents. OBJECTIVE Our objective was to reassess the effects of childhood radiation exposure on ATAs and thyroid function 13-15 yr after the accident. DESIGN AND SETTING We measured the antithyroglobulin (TgAbs) and antithyroperoxidase (TPOAbs) antibodies and TSH in 1433 sera collected between 1999 and 2001 from 13- to 17-yr-old adolescents born between January 1982 and October 1986 in paired contaminated and noncontaminated villages of Belarus, Ukraine, and Russia. A total of 1441 sera was collected from age- and sex-matched controls living in Denmark and Sardinia (Italy). Free T(4) and free T(3) were measured when TSH was abnormal. RESULTS TPOAb prevalence was higher in contaminated than in noncontaminated Belarusian children (6.4 vs. 2.4%; P = 0.02) but lower than previously reported (11%) in a different contaminated Belarus village. No difference in TPOAb prevalence was found in Ukrainian and Russian villages. TgAbs showed no difference between contaminated and noncontaminated Belarus and Ukraine, whereas in Russia they showed a relative increase in the exposed subjects with respect to the unexposed, who showed an unexpectedly lower prevalence of TgAbs. Besides radiation exposure, female gender was the only variable significantly correlated with ATAs in all groups. ATA prevalence in nonexposed villages of Belarus, Ukraine, and Russian Federation did not differ from that found in Sardinia and Denmark. With few exceptions, thyroid function was normal in all study groups. CONCLUSIONS TPOAb prevalence in adolescents exposed to radioactive fallout was still increased in Belarus 13-15 yr after the Chernobyl accident. This increase was less evident than previously reported and was not accompanied by thyroid dysfunction. Our data suggest that radioactive fallout elicited a transient autoimmune reaction, without triggering full-blown thyroid autoimmune disease. Longer observation periods are needed to exclude later effects.

Endogenous and Environmental Determinants of Water Pricing Policy in Italy

A water pricing policy (WPP) should accomplish many purposes. Due to the growing importance of efficient water management, it has become crucial to understand the endogenous and environmental factors affecting water pricing, so as to provide guidance to policy makers in defining a suitable water management framework and in entrusting the service to those water utilities that are better inclined to fulfill the purposes of the WPP. Using multiple linear regression model with robust standard errors, this paper analyzes if and how some relevant variables affect the tariff levied by water utilities. Italy is considered a particularly appropriate case study, since the country characterized by diverse geographical features and is home to water utilities with differing characteristics. The results show a positive relationship between the tariff level and the realized investment per inhabitant. Furthermore, the paper shows a negative relationship between the tariff level and the average annual rainfall. Consistent with the environmental characteristics, the data show that tariffs are lowest in the north of Italy. Significantly, publicly owned companies levy lower tariffs than mixed and private utilities. Finally, neither firm size and diversification strategies show a significant relationship with the tariff level.

A Sample Survey on Inactive Students: Weighting Issues in Modelling the Inactivity Status

In this paper we analyze the issue of inactive university students, that is, students with zero university credits in career for at least a calendar year. A focus on this topic is important not only for the negative effects of inactivity on students and their families but also because an increasingly amount of the Ordinary Financing Fund (FFO) is allocated to the universities taking into account the performance of the students’ career. Data were collected through a CATI questionnaire administered to a stratified simple random sample of 1945 students enrolled at the University of Pisa in the academic year 2010–2011. The probability of being in the inactive status is modelled specifying a two-level random intercepts logistic regression model, after dealing with the issue of weighing the statistical units.

A Latent Growth Curve Analysis in Banking Customer Satisfaction

Customer satisfaction for banking services is, arguably, a construct that develops and changes over time for a number of different endogenous and exogenous factors (modification of customers contract terms, transparency of banking transactions and financial services, bank charges, customer relationships, changes of market conditions an so on). Measuring change requires a longitudinal perspective, with repeated measurements on the same individuals across multiple time points. Investigating individual differences in change may be of great practical interest for the strategic decisions of the general management of banking companies. Using a Latent Growth Curve Model, the aim of this paper is to analyze the dynamic process in satisfaction of meaningful sub groups of customers of an Italian bank company.

Small Area Models for Analysing Job Placement Survey Data of the STELLA Consortium

Abstract Job placement is a very important issue in nowadays governance of universities and data on career of graduates in the labour market are crucial also for evaluating the performance of the courses of study. The University of Pisa is member of the STELLA consortium whose aim is to perform periodic sample and census surveys for investigating and monitoring the career of graduates on the labor market. In this paper the level of satisfaction for the coherence of the employment condition with the studies of graduates one year after the degree is analysed. Small Area Models (SAE) are used to obtain more accurate estimates for the unplanned domains defined by the course of study. Focus is on the Economics and Statistics masters of science or single-cycle degree courses of the University of Brescia and Pisa.