 |
BRUNO MADEO
Tutor di tirocinio
Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze sede ex-Medicina, Endocrinologia, Metabolismo e Geriatria
|
Home |
Curriculum(pdf) |
Didattica |
Pubblicazioni
2022
- COVID-19 lockdown negatively impacted on adherence to denosumab therapy: incidence of non-traumatic fractures and role of telemedicine
[Articolo su rivista]
De Vincentis, S; Domenici, D; Ansaloni, A; Boselli, G; D'Angelo, G; Russo, A; Taliani, E; Rochira, V; Simoni, M; Madeo, B
abstract
Purpose Coronavirus disease (COVID-19) lockdowns have impacted on management of osteoporosis and the use of telemedicine is increasingly widespread albeit supported by little evidence so far. The aim of the study is to assess adherence to denosumab and incidence of non-traumatic fractures during the lockdown compared to the pre-COVID-19 year and to explore the effectiveness of telemedicine in the management of osteoporotic patients. Methods Retrospective, longitudinal, single-center study on patients receiving subcutaneous denosumab therapy every 6 months. Each patient was scheduled to undergo 2 visits: one during the pre-COVID-19 period (March 2019-March 2020) and another visit during the lockdown period (March 2020-March 2021). Data on new fractures, adherence, risk factors for osteoporosis and the modality of visit (telemedicine or face-to-face) were collected. Results The prevalence of non-adherent patients was higher during the lockdown (35 of 269 patients, 13.0%) than the pre-COVID-19 period (9 of 276 patients, 3.3%) (p < 0.0001). During the lockdown, the number of new non-traumatic fractures was higher than the pre-COVID-19 year (p < 0.0001): 10 patients out of 269 (3.7%) experienced a fragility fracture and 2 patients (0.7%) a probable rebound fracture during the lockdown period, whereas no patient had fragility/rebound fractures during the pre-COVID-19 period. No difference was found in the prevalence of non-adherence and new non-traumatic fractures comparing patients evaluated with tele-medicine to those evaluated with face-to-face visit. Conclusion Non-adherent patients and new non-traumatic fractures (including rebound fractures) were more prevalent during the lockdown in comparison to the pre-COVID-19 period, regardless of the modality of medical evaluation.
2021
- Long-Term Use of Temozolomide as Safe and Effective Therapy for an Aggressive Corticotroph Adenoma in a Very Old Patient
[Articolo su rivista]
Decaroli, Maria Chiara; Ansaloni, Anna; Monzani, Maria Laura; Losa, Marco; Zunarelli, Elena; Rochira, Vincenzo; Madeo, Bruno
abstract
Background: Temozolomide (TMZ) is safe and effective in the treatment of aggressive pituitary adenomas (PAs). However, the optimal duration of TMZ therapy is still unknown. Moreover, data about administration of TMZ in elderly (≥65 years) people to treat aggressive PAs are scarce. We report the case of the oldest female patient undergoing the longest TMZ protocol described so far to treat an aggressive, initially silent corticotroph PA. Case report: The patient initially underwent partial surgical removal of the PA. Subsequent treatment with cabergoline was applied, but it was unsuccessful in controlling the growth of the residual tumor. Pasireotide and external radiation also showed to be ineffective; therefore, treatment with TMZ was started at the standard dose of 200 mg/m2/day for 5 days every 4 weeks for a total of 47 cycles. At the time of treatment's beginning, the patient was 83 years old. Radiological follow-up documented a progressive, remarkable reduction of the adenoma and the last imaging, after 39 cycles of TMZ, showed an intrasellar lesion with large areas of cystic degeneration. The patient also developed adrenal deficiency managed with glucocorticoid replacement. No major side effects were observed throughout the treatment, with exception of nausea, well controlled with anti-emetic medication. TMZ therapy was discontinued after 47 cycles; hormonal and imaging follow-up investigations documented sustained functional and dimensional response. Conclusions: Our case supports the long-term use of TMZ, confirming its safety and efficacy also for elderly patients.
2021
- Response to the letter to the Editor by Dr. Rosario: “The calcium-to-phosphorous (Ca/P) ratio in the diagnosis of primary hyperparathyroidism and hypoparathyroidism: a multicentric study”.
[Articolo su rivista]
Madeo, B.; De Vincentis, S.; Rochira, V.
abstract
not available
2021
- Robotic Versus Laparoscopic Adrenalectomy: Pluriannual Experience in a High-Volume Center Evaluating Indications and Results
[Articolo su rivista]
Piccoli, Micaela; Pecchini, Francesca; Serra, Francesco; Nigro, Casimiro; Colli, Giovanni; Gozzo, Davide; Zirilli, Lucia; Madeo, Bruno; Rochira, Vincenzo; Mullineris, Barbara
abstract
Background:
Robotic adrenalectomy offers several clinical benefits if compared with laparoscopic adrenalectomy; however, its superiority is still under debate. The aim of this study was the investigation of differences between the two techniques, and a comparison when approaching right or left side adrenal lesions was further conducted.
Materials and Methods:
All patients undergoing laparoscopic and robotic unilateral adrenalectomy at our institution from January 2006 to December 2019 were collected and retrospectively analyzed. Statistical analysis was conducted; differences between the two cohorts were reported.
Results:
A total of 160 cases were included (84 patients in laparoscopic adrenalectomy-group [LA-g] 76 cases in robotic adrenalectomy-group [RA-g]). The groups were homogeneous for demographic data. No intraoperative complications were reported; mean amount of intraoperative blood loss was comparable. No cases of conversion to open surgery were required. RA-g presented a longer operative time than LA-g for right adrenalectomy (P = .05), no differences were noted for left side (P = .187). Overall morbidity was 21% for LA-g and 10.5% for RA-g (P = .087), with an inferior rate of surgical complications for RA-g (P = .024), and for robotic left adrenalectomy than robotic right procedure (P = .03). Length of hospital stay was shorter for RA-g (P = .005).
Conclusions:
Robotic adrenalectomy presents similar outcomes as laparoscopic approach with some benefits for selected cases. Left adrenal lesions seem to receive greater advantages from robotic technique. Large randomized controlled trials are required to determine the role of robotic adrenal surgery and if the indication can be standardized based on the laterality of adrenal procedure.
2021
- Ruolo diagnostico del dosaggio della calcitonina su liquido di lavaggio da agoaspirato tiroideo nel carcinoma midollare della tiroide
[Articolo su rivista]
Brigante, Giulia; Madeo, Bruno; Diazzi, Chiara; Simoni, Manuela; Rochira, Vincenzo
abstract
2020
- De novo Lesions Frequently Develop in Adult Normal Thyroid Over Almost Six Years
[Articolo su rivista]
Brigante, Giulia; Monzani, Maria Laura; Locaso, Michela; Gnarini, Valentina Luisa; Graziadei, Luigi; Kaleci, Shaniko; De Santis, Maria Cristina; Tagliavini, Simonetta; Simoni, Manuela; Rochira, Vincenzo; Madeo, Bruno
abstract
Purpose: In order to understand how thyroid abnormalities emerge over time in adults,
we evaluated incidence of thyroid diseases in healthy subjects, after almost 6 years from
a previous negative ultrasound.
Methods: Anamnestic and physical data were collected. Ultrasound neck evaluation
was performed by an experienced endocrinologist, recording detailed thyroid and
nodules characteristics. Nodules were classified according to American Thyroid
Association classification for prediction of cancer risk. Serum samples were collected for
subsequent evaluations (TSH, free thyroid hormones, calcitonin, anti-thyroid antibodies).
Anamnestic, clinical, sonographic, and serological characteristics were analyzed with
logistic regression analysis for subjects with nodules vs. those without.
Results: One hundred and eleven subjects were enrolled (43M, 68F). Half of them
developed nodules, mainly smaller than 1 cm and without suspicious characteristics.
Ninety-seven percent were euthyroid. Only 4% had serological diagnosis of thyroiditis.
Incidence of thyroid diseases was higher in women, especially nulliparous. Comparing
clinical characteristics of subjects with and without nodules, the only statistically
significant difference concerned thyroid volume adjusted for body weight or surface
(p < 0.05), but not residual volume excluding nodules. Multivariate logistic regression
analysis showed that female gender, higher BMI-adjusted thyroid volume and residual
thyroid volume excluding nodules, nulliparity, age, and fT3 increase the risk of
developing nodules.
Conclusions: These results demonstrate that adult thyroid tissue undergoes changes
that are already detectable by US after almost 6 years. Half of the enrolled subjects
developed de novo nodules or colloid cysts of poor clinical relevance.
2020
- Early diagnosis of medullary thyroid cancer in case of low serum calcitonin: Role of calcitonin measurement in fine-needle aspiration washout fluid
[Abstract in Atti di Convegno]
Greco, C.; Madeo, B.; Rochira, V.; De Santis, M. C.; Brigante, G.
abstract
Background
Screening serum calcitonin (sCT) measurement in patients with thyroid nod- ules is still debated. Moreover, sCt cutoffs for medullary thyroid carcino- ma (MTC) are not univocally defined. Also, sensitivity of cytology by fine needle aspiration biopsy (FNAb) has been demonstrated to detect approx- imately half of MTCs. Ct measurement in fine-needle aspiration washout fluid (Ct-FNAb) has high sensitivity and specificity and is helpful in case of non-diagnostic cytology1. Recently, a series oflow sCt MTC has been collected2.
Aim
The objectives of this retrospective observational study were to define Ct- FNAb levels in subjects with low sCt (below cutoffs diagnostic for MTC) and to evaluate their clinical, ultrasonographic (US), cytological and histo- logical characteristics.Methods
We selected subjects with sCt above local normal ranges but below one of the diagnostic cutoff proposed for MTC (26 pg/ml in females and 68 pg/ ml in males), subjected to FNAb with Ct-FNAb measurement and then thy- roidectomized.
Results
Surprisingly, 50% (8/16) had MTC at histology, 19% cellular C hyperplasia (CCH) and only 31% neither MTC nor CCH. Ct-FNAb was significantly higher in MTC compared to both no MTC no CCH (2001 vs 25.32±55.72 pg/ml; P = 0.013) and to CCH (2001 vs 195.56 ± 286.09 pg/ml; P = 0.008). Even if below the diagnostic cutoff, also sCt was higher in MTC compared to no CCH and no MTC group (19±7 vs 9±4 pg/ml; P=0.019) but was not able to discriminate MTC from CCH. US failed to identify suspicious nod- ules, since MTC differed only for being solid and not haloed. At cytology nearly 90% of MTC lesions were non-diagnostic or, mainly, indeterminate. At histology, 7/8 were low risk micro MTCs.
Conclusion
HighCt-FNAb despite sCt only slightly elevated suggests: i) early detection of MTC before the onset of high secretion of Ct, ii) a peculiar variant of MTC, able to produce Ct but not to secrete it in bloodstream because of intracellular secretory pathway alteration, iii) possible methodological in- terferences in the dosage of sCt. In conclusion, this study demonstrates the importance of Ct-FNAb to discover early stages of MTC with sCt below diagnostic cutoffs.
2020
- Effect of a standard schema of self-monitoring blood glucose in patients with poorly controlled, non-insulin-treated type 2 diabetes mellitus: A controlled longitudinal study
[Articolo su rivista]
Madeo, B.; Diazzi, C.; Granata, A. R. M.; Ghoch, M. E.; Greco, C.; Romano, S.; Scaltriti, S.; Rochira, V.
abstract
The effect of self-monitoring of blood glucose (SMBG) on glycemic control with regard to non-insulintreated Type 2 diabetes mellitus (NIT-Type 2 DM) is still a controversial topic. Against this backdrop, we sought to compare the effect of a continuous short-term SMBG schema with as-usual treatment, based on changes in oral antidiabetic treatment in patients with poorly controlled Type 2 DM. We reviewed 492 NIT-Type 2 DM record charts, selecting 27 patients, with poor glycemic control, who were thought to self-monitor their blood glucose levels (SMBG group). We then compared them with 27 patients treated with modifying drugs or diets to achieve and maintain the glycemic target (Control Group). Haemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) were evaluated at baseline, after 3 and 6 months. HbA1c values decreased after 3 and 6 months in the SMBG group (P < 0.001 on both occasions) and in the control group (P < 0.05 and P < 0.01, respectively), but without a significant difference between the two groups when compared at the same time. The FPG progressively decreased in both groups, reaching a significant difference in the SMBG group after 3 months and in the control group after 6 months, and without a significant difference between the two groups. The SMBG schema used in our study could be adopted for target groups before proceeding to the next therapeutic enhancement drug step, representing a useful tool that can help diabetic patients in raising awareness of and treating their disease.
2020
- Estrogens and Male Osteoporosis.
[Capitolo/Saggio]
Rochira, V.; Madeo, B.
abstract
The chapter deals with the role of estrogens on the development of osteoporosis in men.
2020
- How Much Vitamin D is Too Much? A Case Report and Review of the Literature
[Articolo su rivista]
De Vincentis, S.; Russo, A.; Milazzo, M.; Lonardo, A.; De Santis, M. C.; Rochira, V.; Simoni, M.; Madeo, B.
abstract
Background: The beneficial effects of vitamin D, together with the high prevalence of vitamin D deficiency, have led to an expanding use of vitamin D analogues. While inappropriate consumption is a recognized cause of harm, definition of doses at which vitamin D becomes toxic remain elusive.
Case presentation: A 56-year woman was admitted to our Hospital following a 3-week history of nausea, vomiting and muscle weakness. The patient had been assuming very high dose of cholecalciferol since 20 months (cumulative 78,000,000UI, mean daily 130,000UI), as indicated by a non-conventional protocol for multiple sclerosis. Before starting vitamin D integration, serum calcium and phosphorus levels were normal, while 25OH-vitamin D levels were very low (12.25 nmol/L). On admission, hypercalcemia (3.23 mmol/L) and acute kidney injury (eGFR 20 mL/min) were detected, associated with high concentrations of 25OH-vitamin D (920 nmol/L), confirming the suspicion of vitamin D intoxication. Vitamin D integration was stopped and, in a week, hypercalcemia normalized. It took about 6 months for renal function and 18 months for vitamin D values to go back to normal.
Conclusions: This case confirms that vitamin D intoxication is possible albeit with a really high dose. The doses used in clinical practice are far lower than these and, therefore, intoxication rarely occurs even in those individuals whose baseline vitamin D serum levels have never been assessed. Repeated measurements of vitamin D are not necessary in patients under standard integrative therapy. However, patients and clinicians should be aware of the potential dangers of vitamin D overdose.
2020
- The added value of operator’s judgement in thyroid nodule ultrasound classification arising from histologically based comparison of different risk stratification systems.
[Articolo su rivista]
Madeo, B.; Brigante, G.; Ansaloni, A.; Taliani, E.; Kaleci, S.; Monzani, M. L.; Simoni, M.; Rochira, V.
abstract
Objective: Several ultrasound classifications for thyroid nodules were proposed but their accuracy is still debated, since mainly estimated on cytology and not on histology. The aim of this study was to test the diagnostic accuracy and the inter-classification agreement of AACE/ACE-AME, American Thyroid Association (ATA), British Thyroid Association (BTA), and Modena Ultrasound Thyroid Classification (MUT) that stratifies malignancy risk considering also the clinician subjective impression.
Methods: A prospective study collecting thyroid nodule features at ultrasound and histological diagnosis was conducted. Ultrasound features were collected following a preformed checklist in candidates for surgery because of indeterminate, suspicious, or malignant cytology. All the nodules, besides the cytologically suspicious one, were blinded analyzed. MUT score was applied prospectively, and the others retrospectively. Sensitivity, specificity, diagnostic cut-off value, and accuracy of each classification were calculated. The overall agreement between classifications was tested by Bland-Altman, and agreement between single nodule analysis by different classifications by Weighted Cohen's Kappa.
Results: In classifying a total of 457 nodules, MUT has the highest accuracy (AUC 0.808) and specificity (89%), followed by ATA and BTA, and finally by AACE/ACE-AME. ATA, BTA, and MUT are highly interchangeable. Considering agreement between single nodule analyses, ATA and BTA had the best (κ = 0.723); AACE/ACE-AME showed slight agreement with BTA (κ = 0.177) and MUT (κ = 0.183), and fair agreement with ATA (κ = 0.282); MUT had fair agreement with both ATA (κ = 0.291) and BTA (κ = 0.271).
Conclusion: Classifications have an acceptable overall diagnostic accuracy, improved using a less rigid system that takes into consideration operator subjective impression.
2020
- The calcium-to-phosphorous (Ca/P) ratio in the diagnosis of primary hyperparathyroidism and hypoparathyroidism: a multicentric study.
[Articolo su rivista]
Madeo, B.; De Vincentis, S.; Repaci, A.; Altieri, P.; Vicennati, V.; Kara, E.; Vescini, F.; Amadori, P.; Balestrieri, A.; Pagotto, U.; Simoni, M.; Rochira, V.
abstract
Purpose The diagnosis of primary hyperparathyroidism (PHPT) and chronic hypoparathyroidism (HypoPT) is still challenging, especially in patients asymptomatic or with non-classical phenotypes and for physicians not skilled in calcium-phosphorous (Ca–P) disorders. The serum calcium/phosphorous (Ca/P) ratio has been proposed as accurate index to identify PHPT, while it has never been tested in HypoPT. The aim of this study is to investigate the diagnostic power of the serum Ca/P ratio in the diagnosis of primary parathyroid dysfunctions (both PHPT and HypoPT) in a large series of data.
Methods A multicentric, retrospective, cross-sectional study (ClinicalTrials.gov: NCT03747029) was carried out including 432 PHPT patients and 217 HypoPT patients compared with 389 controls. Serum Ca, P, creatinine, parathyroid hormone and 25OH-vitamin D were collected. Serum Ca and P were expressed in mmol/L. Ca/P diagnostic performance was evaluated by receiver operating characteristic (ROC) curve, sensitivity, specificity and accuracy.
Results The Ca/P ratio was significantly higher in PHPT and lower in HypoPT patients than controls (p < 0.0001). At ROC curve analysis, the Ca/P ratio above 2.55 was defined to identify PHPT patients (sensitivity 85.7%, specificity 85.3%) and below 1.78 to identify HypoPT patients (sensitivity 88.2%, specificity 87.9%).
Conclusions The Ca/P ratio is a highly accurate index to identify PHPT when Ca/P is above 2.55 and HypoPT when it is below 1.78. These results demonstrate the reliability of this index to rule in/out primary parathyroid dysfunctions and remark the importance of measuring serum P in clinical practice.
2019
- Calcium to Phosphorous (Ca/P) Ratio as an accurate index for the diagnosis of primary hyperparathyroidism (PHPT) and hypoparathyroidism (HYPOPT)
[Abstract in Atti di Convegno]
De Vincentis, S.; Repaci, A.; Altieri, P.; Kara, E.; Amadori, P.; Balestrieri, A.; Rochira, V.; Madeo, B.
abstract
2019
- Calcium to Phosphorus (Ca/P) ratio as an accurate index for the diagnosis of primary hyperparathyroidism (PHPT) and hypoparathyroidism (HypoPT)
[Abstract in Atti di Convegno]
De Vincentis, S.; Repaci, A.; Altieri, P.; Kara, E.; Vescini, F.; i Amadori, P.; Balestrieri, A.; Rochira, V.; Madeo, B.
abstract
2019
- Classification of thyroid nodules by ultrasound in clinical practice: the added value of the judgement of the skilled endocrinologist
[Abstract in Atti di Convegno]
Madeo, B.; Brigante, G.; Ansaloni, A.; Taliani, E.; Kaleci, S.; Monzani, M. L.; Simoni, M.; Rochira, V.
abstract
2019
- Classification of thyroid nodules by ultrasound in clinical practice: the added value of the judgment of the skilled endocrinologist
[Abstract in Rivista]
Madeo, B.; Brigante, G.; Ansaloni, A.; Taliani, E.; Kaleci, S.; Monzani, M. L.; Simoni, M.; Rochira, V.
abstract
2019
- Concomitant medullary thyroid carcinoma with paraganglioma-like pattern and papillary thyroid carcinoma
[Articolo su rivista]
Greco, C.; Brigante, G.; Taliani, E.; Corrado, S.; Simoni, M.; Madeo, B.
abstract
A 74-year-old man was referred to the Endocrinology Unit because of multinodular goiter. The dominant nodule (1.7 × 1.9 × 2.4 cm), at the medium-superior third of the left lobe, was inhomogeneously hypoechoic, with irregular margins, macrocalcifications and intranodular vascularization. Fine-needle aspiration biopsy (FNAB) was performed. The cytological diagnosis was TIR 2, benign, according to the 2013 Italian thyroid cytology classification system. Moderately high serum calcitonin (s-Ct) (61.5 pg/mL, n.r. 0–7.5) and normal CEA were detected. The Ct level in FNAB wash-out fluid (Ct-FNAB) was 1450 pg/mL. Based on s-Ct and Ct-FNAB levels, patient underwent total thyroidectomy. Macroscopically, a dominant circumscribed nodule of 2 ecm was described; the histological and immunohistochemical features identified medullary thyroid carcinoma (MTC) with paraganglioma (PG)-like pattern positive for Ct, CEA and chromogranin and negative for S-100 sustentacular cells (SC). Moreover, papillary carcinoma of 3 mm in the right lobe was also associated. No areas of hyperaccumulation of the tracer were documented at Ga68 PET/CT. No RET-proto-oncogene mutations were found. Post-surgery s-Ct levels were within normal range (4 pg/mL). Two years after thyroidectomy, the patient is still disease-free. We reported a case of sporadic and rare variant of MTC: this is the ninth described case of PG-like MTC. In this case, cytologically benign, the clinical suspicion arose from high Ct values at FNAB wash-out fluid. Even if clinical behavior of this variant seems indolent, additional studies are necessary to understand prognoses and predictive factors.
2019
- Diagnostic Accuracy of Different Thyroid Ultrasound Classification Systems and the Added Value of Operator Subjective Impression in Stratifying Nodule Risk
[Abstract in Atti di Convegno]
Madeo, Bruno; Brigante, G.; Ansaloni, A.; Taliani, E.; Kaleci, S.; Monzani, M. L.; Simoni, M.; V. Rochira.,
abstract
2019
- Expression and clinicopathological role of miR146a in thyroid follicular carcinoma.
[Articolo su rivista]
Pignatti, E.; Vighi, E.; Magnani, E.; Kara, E.; Roncati, L.; Maiorana, A.; Santi, D.; Madeo, B.; Cioni, K.; Carani, C.; Rochira, V.; Simoni, M.; Brigante, Giulia
abstract
PURPOSE: Dysregulation of microRNA expression has been involved in the development and progression of follicular thyroid carcinoma (FTC). The aim of this work was to study the expression of miRNA146a in FTC and the association with clinicopathological features of the disease.
METHODS:
Thirty-eight patients affected by FTC were included in the study. Twenty patients carrying follicular thyroid adenoma (FA) were also enroled as the benign counterpart of FTC. Total RNA including miRNA146a was extracted from formalin-fixed paraffin-embedded (FFPE) pairs of affected/unaffected tissue and its expression was assessed by real-time PCR. Two selected target genes, TRAF6 (tumour necrosis factor receptor-associated factor 6) and IRAK1 (Il-1 receptor-associated kinase 1/2), were also analysed.
RESULTS:
miR146a expression in FTC tissue was overall not downregulated in malignant versus unaffected tissue, but its expression was inversely correlated with clinicopathological features of FTCs at diagnosis. A decreased expression of miR146a became apparent in FTC thyroid tissue of widely compared to minimally invasive tumours. However, miR146a expression differences between contralateral unaffected tissue (extra-FTC) and FTC were not observed regardless of clinicopathological features. IRAK1, a known target for miR146a, was upregulated in FTC and the increase was mainly appreciable in Hurtle FTC variant. Unexpectedly, miR146a did not correlate with TRAF6 showing an inverse trend compared to IRAK1 although both genes regulate the activity of nuclear factor- kB (NF-kB).
CONCLUSION:
The results of this study indicate that downregulation of miR146a, inversely correlated with clinicopathological features of FTCs at diagnosis and suggest a possible involvement of miR146a in FTC development. IRAK1 over-expression in FTC may be related to tumour development/progression. In vitro experiments are needed to support this hypothesis.
2019
- Identificazione ecografica di un nodulo sottocutaneo rilevato alla
palpazione del collo e risultato un microcarcinoma papillare tiroideo
persistente in sede sottocutanea atipica 25 anni dopo terapia
chirurgica locale, tiroidectomia e linfadenectomia
[Articolo su rivista]
Spaggiari, Giorgia; Piccinini, Francesca; Ansaloni, Anna; Madeo, Bruno; Zirilli, Lucia; Simoni, Manuela; Santi, Daniele
abstract
Descrizione di un caso clinico di particolare interesse
2019
- Non semplice magrezza…
[Articolo su rivista]
Miceli, Andrea; Madeo, Simona Filomena; Madeo, Bruno; Iughetti, Lorenzo
abstract
2019
- Reliability of calcium-phosphorus (Ca/P) ratio as a new, accurate and inexpensive tool in the diagnosis of some Ca-P disorders.
[Articolo su rivista]
Madeo, B.; De Vincentis, S.; Kara, E.; Vescini, F.; Trenti, T.; Guaraldi, G.; Rochira, Vincenzo
abstract
PURPOSE: The serum calcium/phosphorus (Ca/P) ratio is an accurate tool to differentiate patients with primary hyperparathyroidism (PHPT) from healthy subjects. However, other disorders of the Ca-P metabolism might impair the Ca/P ratio, such as hypophosphatemia (HypoP) not PHPT related. The aim of this study is to examine the diagnostic value of Ca/P ratio in the diagnosis of PHPT and HypoP not PHPT related.
METHODS:
Single-center, retrospective, case-control study, including 150 patients with PHPT and 306 patients with HypoP, compared with 150 controls. HypoP patients were enrolled among HIV-infected patients by selecting those with Fanconi-like syndrome due to antiretroviral treatment. Parameters which were measured were serum Ca, P, parathyroid hormone (PTH), 25-OH vitamin D, albumin and creatinine).
RESULTS:
The Ca/P ratio was significantly higher in PHPT and HypoP patients, compared to controls (p < 0.0001). At receiver operator characteristic (ROC) curve analysis, the cut-off of 3.56 (2.75 SI) for Ca/P ratio was able to identify patients with PHPT and HypoP (sensitivity 95%; specificity 93%). Among patients with Ca/P ratio above 3.56, the thresholds of 10.3 mg/dL (2.6 mmol/L) for serum Ca (sensitivity 93%; specificity 98%) and 80.5 pg/mL for PTH (sensitivity 91%; specificity 91%) were defined for the specific diagnosis of PHPT.
CONCLUSIONS:
The Ca/P ratio above 3.56 (2.75 SI) is a highly accurate tool to identify PHPT and HypoP not PHPT-related patients. Thanks to its simplicity, this index can be proposed as a screening and first-line examination in the diagnostic work-up when a disorder of Ca-P metabolism is suspected or should be ruled out.
2019
- Ultrasound Changes of Healthy Thyroides over Six Years in Adults
[Abstract in Atti di Convegno]
Brigante, G.; Monzani, M. L.; Locaso, M.; Gnarini, V. L.; Graziadei, L.; Kaleci, S.; De Santis, M. C.; Tagliavini, S.; Simoni, M.; Rochira, V.; Madeo, B.
abstract
2019
- Ultrasound changes of healthy thyroides over six years in adults
[Abstract in Atti di Convegno]
Brigante, G.; Monzani, M. L.; Locaso, M.; Gnarini, V. L.; Graziadei, L.; Kaleci, S.; De Santis, M. C.; Tagliavini, S.; Simoni, M.; Rochira, V.; Madeo, B.
abstract
2018
- Reliability of serum calcium to phosphorous (Ca/P) ratio as an accurate and inexpensive tool to define disorders of Ca/P metabolism.
[Abstract in Atti di Convegno]
Madeo, B.; De Vincentis, S.; Kara, E.; Vescini, F.; Trenti, T.; Guaraldi, G.; Rochira, Vincenzo
abstract
This study investigates the accuracy of a simple, inexpensive index such as the Calcium (Ca) to Phosphorous (P) ratio in the diagnosis of disease of bone metabolism such as hyperparathyroidism and hypoposphoremia.
2018
- Reliabilty of serum Calcium to Phosphorus (Ca/P) ratio as an accurate and inexpensive tool to define disorders of Ca-P metabolism: preliminary data
[Abstract in Rivista]
De Vincentis, S.; Monzani, M.; Kara, E.; Guaraldi, G.; Rochira, V.; Madeo, Bruno
abstract
Background: Primary hyperparathyroidism (PHPT) is the third most common endocrine disorder. The Ca/P ratio is an accurate tool to differentiate patients with PHPT (>3.5 if Ca and P are expressed in mg/dl) from healthy subjects [1]. The reliability of this index is based on the fact that serum Ca and P are inversely related together. However, other disorders of the Ca-P metabolism, such as hypophosphoremia (HypoP), might impair the Ca/P ratio.
Aim: To validate the accuracy of Ca/P ratio in the diagnosis of Ca-P metabolism disorders, including also patients with documented HypoP.
Methods: A single-center, retrospective, case-control study was carried out, including 130 patients with documented PHPT and 300 patients with HypoP, compared with 120 controls. HypoP patients were enrolled among HIV-infected patients on HAART treatment from the large Modena cohort. The main outcome measures were: serum Ca, P, parathyroid hormone (PTH), 25-OH vitamin D, albumin and creatinine.
Statistical analysis: Comparisons among groups were performed by the nonparametric Kruskal-Wallis, followed by the Dunn’s post hoc test. The diagnostic accuracy of Ca/P ratio was investigated by receiver operator characteristics (ROC) curves in order to define cut-off points (with the highest sensitivity and specificity).
Results: The Ca/P ratio was significantly higher in the group of PHPT together with HypoP, compared to controls (P<0.0001). Also Ca and PTH were significantly different among groups, in particular they were higher (P<0.0001) in PHPT than both controls and HypoP, as expected. At ROC curves analysis, the cut-off of 3.6 for Ca/P ratio was able to identify patients with PHPT and HypoP (sensitivity 91%; specificity 93%). Among patients with Ca/P ratio above 3.6, the thresholds of 10.2 mg/dl for serum Ca (sensitivity 91%; specificity 98%) and of 83.6 pg/ml for PTH (sensitivity 92%; specificity 93%) were defined for the specific diagnosis of PHPT.
Conclusions: In this study we confirm the role of serum Ca/P ratio as a reliable index to diagnose a Ca-P metabolism disorder, especially PHPT and HypoP. In clinical practice, when a Ca/P ratio above 3.6 is found, the presence of serum Ca>10.2 mg/dl or PTH>83.6 pg/ml is able to discriminate patients with PHPT from those with HypoP.
Reference: 1. Madeo et al, Serum Calcium to Phosphorous (Ca/P) Ratio Is a Simple, Inexpensive and Accurate Tool in the Diagnosis of Primary Hyperparathyroidism. JRBM Plus, 2017. DOI: 10.1002/jbm4.10019.
2018
- Serum Calcium to Phosphorous (Ca/P) Ratio is a simple, inexpensive, and accurate tool in the diagnosis of primary hyperparathyroidism
[Articolo su rivista]
Madeo, B.; Kara, E.; Cioni, K.; Vezzani, S.; Trenti, T.; Santi, D.; Simoni, M.; Rochira, V.
abstract
Primary hyperparathyroidism (PHPT) diagnosis is challenging and is based on serum calcium (Ca) and parathyroid hormone (PTH). Because serum Ca and phosphorous (P) are inversely related in PHPT, we investigated the diagnostic value of the serum Ca/P ratio in the diagnosis of PHPT. We report a single-center, case-controlled, retrospective study including 97 patients with documented PHPT and compared them with those of 96 controls (C). The main outcome measures were: serum PTH, 25-OH vitamin D, Ca, P, albumin, and creatinine. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the serum Ca/P ratio were calculated. The results were verified using an independent, anonymous set of data extracted from a laboratory database containing over 900 million entries. A total of 35 (36.1%) PHPT patients had normocalcemic PHPT (NCHPT). Ca and PTH were significantly higher in PHPT than in C (p < 0.0001). P was significantly lower in PHPT than in C (p < 0.0001). The Ca/P ratio was significantly higher in PHPT than in C (p < 0.0001). Receiver-operating characteristic (ROC) curves analyses identified a cutoff of 2.71 (3.5 if Ca and P are expressed in mg/dL) for Ca/P ratio with a sensitivity and specificity of 86% and 87%, respectively (p < 0.0001), confirmed by the independent, big data approach. In conclusion, Ca/P is a valuable tool for the diagnosis of PHPT and is of superior value compared to serum Ca alone, especially in NCPHT. Because Ca/P is simple, inexpensive, and easily accessible worldwide, this ratio is useful for PHPT diagnosis, especially in laboratory/medical settings relying on limited resources, such as low-income countries. © 2017 The Authors. JBMR Plus is published by Wiley Periodicals, Inc. on behalf of the American Society for Bone and Mineral Research.
2018
- Thyroid ultrasound alterations occurrence in patients with previous negative examination: A 6-years observational follow-up trial
[Abstract in Rivista]
Monzani, Maria Laura; Brigante, Giulia; Locaso, Michela; Santi, Daniele; Graziadei, Luigi; Gnarini, Valentina Luisa; Simoni, Manuela; Madeo, Bruno
abstract
10.1530/endoabs.56.P1051
2017
- Calcium to phosphorous ratio (Ca/P) as helpful index to recognize primary hyperparathyroidism, but not primary hypoparathyroidism: a big-data approach.
[Abstract in Rivista]
De Vincentis, Sara; Santi, Daniele; Rochira, Vincenzo; Setti, M.; Tagliavini, S.; Varani, M.; Trenti, T.; Simoni, Manuela; Madeo, Bruno
abstract
Background
Primary hyperparathyroidism (HyperPT) and primary hypoparathyroidism (HypoPT) are often underdiagnosed. Several strategies have been investigated in the past in order to identify diagnostic parameters, although the diagnosis of both HyperPT and HypoPT remains challenging so far, especially in asymptomatic patients. Calcium (Ca) and phosphorus (P) are inversely related together, thus the Ca/P ratio could be an useful tool to define these conditions. Recently, we proposed for the first time a cut-off of 3.5 for Ca/P ratio for the diagnosis of HyperPT.
Aim
To evaluate the diagnostic value of the Ca/P ratio for HyperPT and HypoPT through a big-data approach.
Methodology
A retrospective, observational, case-control study on big-data was carried out. All examinations of parathyroid hormone (PTH), Ca and P performed at the laboratory of Modena Hospital from 2010 to 2016 were consecutively included. We considered only patients between 18 and 90 years of age. Laboratory ranges of normality for both PTH and Ca were used to divide records in HyperPT, HypoPT and controls.
Statistical analysis
The diagnostic accuracy of Ca/P ratio was investigated using receiver operator characteristics (ROC) curves in order to define cut-off points, which show higher sensitivity and specificity for the identification of affected patients.
Results
46 597 records were considered. 576 HyperPT (1.2%), 323 HypoPT (0.7%) and 45 698 controls (98.1%) were found. Ca/P ratio was significantly different among groups (P!0.001). In particular, Ca/P ratio was significantly higher in HyperPT than controls (P!0.001). For the diagnosis of HyperPT, the threshold of 3.17 for Ca/P ratio was obtained by means of the ROC curve analysis, with 85% of both sensitivity and specificity. HypoPT showed lower Ca/P ratio compared to controls (P!0.001), although no useful threshold for the diagnosis was found at ROC curve because of the low sensitivity.
Conclusions
We confirm the high sensitivity and specificity of Ca/P ratio for the diagnosis of HyperPT using the largest cohort of patients available so far in the literature. On the contrary, Ca/P ratio does not contribute to identify patients with HypoPT and further researches are needed to better describe this condition. In conclusion, Ca/P ratio is a simple and inexpensive diagnostic tool to recognize HyperPT.
2017
- Calcium to phosphorous ratio (Ca/P) as helpful index to recognize primary hyperparathyroidism, but not primary hypoparathyroidism: a big-data approach.
[Abstract in Atti di Convegno]
Santi, Daniele; De Vincentis, Sara; Rochira, Vincenzo; Setti, M.; Tagliavini, S.; Varani, M.; Trenti, T.; Simoni, Manuela; Madeo, Bruno
abstract
BACKGROUND: Primary hyperparathyroidism (HyperPT) and primary hypoparathyroidism (HypoPT) are often underdiagnosed. Several strategies have been investigated in the past in order to identify diagnostic parameters, although the diagnosis of both HyperPT and HypoPT remains challenging so far, especially in asymptomatic patients. Calcium (Ca) and phosphorus (P) are inversely related together, thus the Ca/P ratio could be an useful tool to define these conditions. Recently, we proposed for the first time a cut-off of 3.5 for Ca/P ratio for the diagnosis of HyperPT.
AIM: to evaluate the diagnostic value of the Ca/P ratio for HyperPT and HypoPT through a big-data approach. METHODOLOGY: a retrospective, observational, case-control study on big-data was carried out. All examinations of parathyroid hormone (PTH), Ca and P performed at the laboratory of Modena Hospital from 2010 to 2016 were consecutively included. We considered only patients between 18 and 90 years of age. Laboratory ranges of normality for both PTH and Ca were used to divide records in HyperPT, HypoPT and controls. Statistical analysis: The diagnostic accuracy of Ca/P ratio was investigated using receiver operator characteristics (ROC) curves in order to define cut-off points, which show higher sensitivity and specificity for the identification of affected patients.
RESULTS: 46597 records were considered. 576 HyperPT (1.2%), 323 HypoPT (0.7%) and 45698 controls (98.1%) were found. Ca/P ratio was significantly different among groups (p<0.001). In particular, Ca/P ratio was significantly higher in HyperPT than controls (p<0.001). For the diagnosis of HyperPT, the threshold of 3.17 for Ca/P ratio was obtained by means of the ROC curve
analysis, with 85% of both sensitivity and specificity. HypoPT showed lower Ca/P ratio compared to controls (p<0.001), although no useful threshold for the diagnosis was found at ROC curve because of the low sensitivity.
CONCLUSIONS: We confirm the high sensitivity and specificity of Ca/P ratio for the diagnosis of HyperPT using the largest cohort of patients available so far in the literature. On the contrary, Ca/P ratio does not contribute to identify patients with HypoPT and further researches are needed to better describe this condition. In conclusion, Ca/P ratio is a simple and inexpensive diagnostic tool to recognize HyperPT.
2017
- Cured primary hyperparathyroidism after fine-needle aspiration biopsy-induced parathyroid disappearance
[Articolo su rivista]
Kara, E.; Della Valle, E.; De Vincentis, S.; Rochira, V.; Madeo, B.
abstract
Spontaneous or fine-needle aspiration (FNAB)-induced remission of primary hyperparathyroidism (PHPT) may occur, especially for cystic lesions. However, the disease generally relapses over a short time period. We present a case of PHPT due to an enlarged hyperfunctioning parathyroid that underwent long-term (almost 9 years) clinical and ultrasonographic remission after the disappearance of the lesion following ultrasound (US)-assisted FNAB. A 67-year-old woman with PHPT underwent biochemical and US examinations that confirmed the diagnosis and showed a lesion suggestive for parathyroid adenoma or hyperplasia. US-FNAB of the lesion confirmed its parathyroid nature by means of elevated levels of parathyroid hormone within the needle washing fluid. At the second visit, the patient referred slight neck swelling that resolved spontaneously in the days after the US-FNAB. At subsequent follow-up, the enlarged parathyroid was not found; it was visible neither with US nor with magnetic resonance imaging. Biochemical remission persists after 9 years. This is the first reported case of cure of PHPT after US-FNAB performed on a hyperfunctioning parathyroid resulting in its complete disappearance over a period of 9 years of negative biochemical and ultrasonographic follow-up.
2017
- Serum calcium to phosphorous ratio (Ca/P) as a simple, inexpensive screening tool in the diagnosis of primary hyperparathyroidism (PHPT).
[Abstract in Atti di Convegno]
Madeo, Bruno; Kara, Elda; Cioni, K.; Vezzani, Silvia; Simoni, Manuela; Rochira, Vincenzo
abstract
Background The diagnosis of primary hyperparathyroidism (PHPT) is challenging and is based on serum calcium (Ca) and parathyroid hormone (PTH). As serum Ca and phosphorous (P) are inversely related in PHPT, the Ca/P ratio might be considered a good candidate tool in the diagnosis of PHPT. The aim of this study is to investigate the diagnostic value of the Ca/P ratio in the diagnosis of PHPT.
Methods For this single-centre, case-controlled, retrospective study we collected data from review charts of 97 patients with documented PHPT (69 females; 28 males) and compared them with those of 96 controls (C) (44 females; 52 males). The retrospective nature of the study allows obtaining for certain the diagnosis of PHPT. Main outcome measures were: serum PTH, 25-OH Vitamin D, Ca, P, albumin, and creatinine.
Results Among PHPT patients, 35 (36.1%) had normocalcemic PHPT (NCHPT). Ca was significantly higher in PHPT (median: 11; min-max: 9.4-15.5) than C (9.4; 8.3-10.2) (p<0.0001). P was significantly lower in PHPT (2.4; 1.4-3.9) than in C (3.5; 2.1-4.5) (p<0.0001). PTH was significantly higher in PHPT (135.2; 57.6-1748) than in C (32.1; 14-80.7) (p<0.0001). Ca/P ratio was significantly higher in PHPT (4.6; 2.7-8.8) than in C (2.7; 2.0-4.6) (p<0.0001). ROC curves analyses identified a of 3.5 for Ca/P ratio with a sensitivity and specificity of 86% and 87%, respectively (p<0.0001).
Conclusions Ca/P ratio is a valuable highly sensitive, highly specific tool for the diagnosis of PHPT. Besides, Ca/P has the best diagnostic value in identifying normocalcemic PHPT (NCPHPT). Considering that Ca/P is simple to obtain, easily accessible in every clinical and laboratory setting worldwide, and inexpensive even when used in large sample size of patients, this diagnostic tool could be useful for screening PHPT, especially in patients accessing emergency rooms or in the general practitioner setting. This biochemical index has the advantage to be universally used in all clinical settings for both the diagnosis and the screening of PHPT thanks to its low costs and worldwide availability in any laboratory setting (even in developing countries).
2017
- Thyroid nodules ultrasound classification and the importance of the endocrinologist clinical feeling.
[Abstract in Rivista]
Madeo, Bruno; Brigante, Giulia; Ansaloni, Anna; Taliani, Erica; Simoni, Manuela; Rochira, Vincenzo
abstract
Background and aim of the study
Several ultrasound (US) classifications for estimating thyroid nodules risk have been proposed. Since most of them are hardly applicable in clinical practice, we created a local tool, named Modena classification (MC), considering US characteristics and clinician subjective impression. The aim is to verify the diagnostic accuracy of MC and to compare it to US classifications of American Thyroid Association(ATA) (1) and British Thyroid Association(BTA) (2). Methods
We prospectively enrolled 111 patients (33M, 78F; age 19–75; total 457 nodules) with an indeterminate, suspicious for malignancy or malignant cytology. All the patients underwent neck US before surgery and a score risk was assigned, according to MC: low (not certainly nodular or not suspect); intermediate (indeterminate); high (suspect or very suspect). Then, we retrospectively classified nodules according to ATA and BTA. The US pattern was related to hystology.
Results
All the classifications had low sensitivity and positive predictive value (PPV), and high specificity and negative predictive value (NPV) for low risk categories. For the intermediate risk category, BTA had the highest accuracy (68%). For higher risk categories, MC had good sensitivity (62%), high specificity (89%) and accuracy (81%); ATA had high sensitivity (83%), low specificity (48%), accuracy 58%; BTA had high sensitivity (88%), low specificity (44%), accuracy 57%. Conclusions
A classification that considers the subjective impression of the clinician, in addition to the known US characteristics, has highest accuracy and specificity compared to guidelines classifications, particularly if the nodule has suspect US features.
References
(1) Haugen et al. Thyroid. 2016, 26: 1–133.
(2) Perros et al. Clin Endocrinol (Oxf). 2014; 81 (Suppl 1):1–122.
DOI: 10.1530/endoabs.49.EP1383
2016
- Estrogens and male reproduction
[Capitolo/Saggio]
Rochira, Vincenzo; Madeo, Bruno; Diazzi, Chiara; Zirilli, Lucia; Santi, Daniele; Carani, Cesare
abstract
n males, estrogens exert pleiotropic effects by acting on several tissue and organs, including the male reproductive system. The action of estrogens is manifest from prenatal life during which the exposure to estrogen excess might influence the development of some structures of the male reproductive tract. Male fertility is under the control of estrogens, especially in rodents. The loss of function of estrogen receptor alpha and/or of the aromatase enzyme leads to infertility in mice. In men, estrogens are able to exert their actions at several levels through the reproductive tract and on several different reproductive cells. However, the regulation of human male reproduction is more complex and the role of estrogens is less clear compared to mice. During fetal and perinatal life, estrogen acts on the central nervous system by modulating the development of some areas within the brain that are committed to controlling male sexual behavior in terms of setting gender identity, sexual orientation development and the evolution of normal adult male sexual behavior. This organizational, central effect of estrogens is of particular significance in other species (especially rodents and rams), being probably less important in men where psychosocial factors become more determining. Other relevant, non-reproductive physiological events depend on estrogen in men and they involve bone maturation and mineralization as well as metabolic functions. In this chapter we provide an update of estrogen’s role in male reproductive function by reviewing the physiological actions of estrogen on male reproduction and the pathophysiology related to estrogen deficiency and estrogen excess. Phenotypes associated with estrogen deficiency and excess in rodents and in man have shed new light on the mechanisms involved in male reproduction, challenging the perception of the predominant importance of androgens in men. It is now clear that the imbalance between estrogen and androgen in men might affect male reproductive function even in presence of normal circulating androgens. Some uncertainties still remain, especially regarding the impact of abnormal serum estrogen levels on male health, particularly due to the fact that estrogen is not routinely measured in men in clinical practice. Advancements in methods to precisely measure estrogens in men, together with a reduction of their costs, should provide better evidence on this issue and inform clinical practice. New basic and clinical research is required to improve our knowledge on the role of estrogen in male reproductive function and men’s health in general. For complete coverage of all related areas of Endocrinology, please see our online FREE web-book, www.endotext.org.
2016
- Familial paraganglioma syndrome: a rare cause of carotid artery occlusion
[Articolo su rivista]
Rosafio, Francesca; Dell’Acqua, Maria Luisa; Madeo, Bruno; Kara, Elda; Vandelli, Laura; Vallone, Stefano; Bigliardi, Guido; Picchetto, Livio; Nichelli, Paolo Frigio; Zini, Andrea
abstract
We describe the case of a carotid body paraganglioma who was admitted for sudden onset of left-sided throbbing headache and visual
impairment. We suggest to follow-up and treat CBPs, in order to avoid not only symptoms due to compressing and secreting effects, but also possible thrombotic complications in case of an aggressive course.
2016
- Italian association of clinical endocrinologists (AME) position statement: drug therapy of osteoporosis
[Articolo su rivista]
Vescini, F.; Attanasio, R; Balestrieri, Antonio; Bandeira, F.; Bonadonna, S.; Camozzi, V.; Cassibba, S.; Cesareo, R.; Chiodini, I.; Francucci, C. Maria; Gianotti, L.; Grimaldi, F.; Guglielmi, R.; Madeo, Bruno; Marcocci, C.; Palermo, A.; Scillitani, A.; Vignali, E.; Rochira, Vincenzo; Zini, M.
abstract
Treatment of osteoporosis is aimed to prevent fragility fractures and to stabilize or increase bone mineral density. Several drugs with different efficacy and safety profiles are available. The long-term therapeutic strategy should be planned, and the initial treatment should be selected according to the individual site-specific fracture risk and the need to give the maximal protection when the fracture risk is highest (i.e. in the late life). The present consensus focused on the strategies for the treatment of postmenopausal osteoporosis taking into consideration all the drugs available for this purpose. A short revision of the literature about treatment of secondary osteoporosis due both to androgen deprivation therapy for prostate cancer and to aromatase inhibitors for breast cancer was also performed. Also premenopausal females and males with osteoporosis are frequently seen in endocrine settings. Finally particular attention was paid to the tailoring of treatment as well as to its duration.
2016
- Serum Calcium to Phosphorous Ratio (Ca/P) As a Simple, Inexpensive Screening Tool in the Diagnosis of Primary Hyperparathyroidism (PHPT)
[Abstract in Rivista]
Madeo, Bruno; Kara, Elda; Cion, K.; Vezzani, Silvia; Simoni, Manuela; Rochira, Vincenzo
abstract
Background: PHPT is the third most common endocrine disease, but it remains often overlooked and underdiagnosed. Several strategies, including biochemical markers used alone or combined in complex algorithms, have been investigated in the past with the aim to identify tools useful to easily diagnose or screen PHPT. At present, however, the diagnosis of PHPT remains challenging, especially in asymptomatic patients. As serum calcium (Ca) and phosphorous (P) are inversely related in PHPT, the Ca/P ratio might be considered a good candidate tool in the diagnosis of PHPT. Surprisingly, no data on Ca/P ratio are available in literature, despite they are very simple biochemical measurements largely available in any clinical laboratory setting. The aim of this study is to investigate the diagnostic value of the Ca/P ratio in the diagnosis of PHPT. Material and Methods: Data retrospectively obtained from review charts of 97 patients with documented PHPT (69 females; 28 males) were compared with those of 96 controls (C) (44 females; 52 males). Exclusion criteria: age <18yrs, severe chronic diseases, cancer, bone metabolic diseases, use of medications affecting serum Ca. Biochemical measurements included PTH, Vitamin D (LIASON, XL, Diasorin device), serum Ca, P, albumin, and creatinine (AU 680 Beckman device). Normal ranges were 15-88 pg/mL, 8.5-11, and 2.5-5.1 mg/dl for PTH, Ca, and P, respectively. SPSS 19.0 and SigmaPlot 11.0 were used for statistical analyses for group comparisons, ROC curves and cutoffs performance. Results: Among PHPT patients, 16 (17%) had severe hypercalcemia (>12 mg/dL), 44 (45%) mild hypercalcemia, and 36 (38%) normocalcemic PHPT (NCHPT). Ca was significantly higher in PHPT (median: 11; min-max: 9.4-15.5) than C (9.4;8.3-10.2) (p<0.0001). P was significantly lower in PHPT (2.4;1.4-3.9) than in C (3.5;2.1-4.5) (p<0.0001). PTH was significantly higher in PHPT (135.2;57.6-1748) than in C (32.1;14-106.1) (p<0.0001). Ca/P ratio was significantly higher in PHPT than in C. ROC curves analyses identified a cutoff of 3.5 for both Ca/P ratio and Ca/P ratio obtained by using Ca corrected by albumin. The sensitivity and specificity were 86% and 87%, respectively for Ca/P ratio and 89% and 93%, respectively for corrected Ca/P ratio (p<0.0001).The diagnostic value of Ca/P ratio was significantly better if compared with PTH and Ca used alone or in combination. Conclusions: Ca/P ratio is a valuable highly sensitive, highly specific tool for the diagnosis of PHPT. Considering that Ca/P is simple to obtain, easily accessible in every clinical and laboratory setting worldwide, and inexpensive even when used in large sample size of patients, this diagnostic tool could be useful for screening PHPT, especially in patients accessing emergency rooms or in the general practitioner setting. - See more at: http://press.endocrine.org/doi/abs/10.1210/endo-meetings.2016.BCHVD.9.PP26-4#sthash.Onic06Oc.dpuf
2016
- Serum calcium to phosphorous ratio (Ca/P) as a simple, inexpensive screening tool in the diagnosis of primary hyperparathyroidism (PHPT)
[Abstract in Rivista]
Madeo, Bruno; Kara, Elda; Cioni, Katia; Vezzani, Silvia; Simoni, Manuela; Rochira, Vincenzo
abstract
Background
PHPT is often overlooked/underdiagnosed. Several strategies (biochemical markers alone or combined in complex algorithms) have been investigated to easily diagnose/screen PHPT, but PHPT diagnosis remains challenging at present, especially in asymptomatic patients. As serum calcium (Ca) and phosphorous (P) are inversely related in PHPT, the Ca/P ratio could be a good candidate tool for PHPT diagnosis. Surprisingly, no literature data on Ca/P ratio are available, despite they are very simple biochemical measurements largely available in any clinical lab setting.
Aim
To investigate the Ca/P ratio diagnostic value in the diagnosis of PHPT. Methods
Data retrospectively obtained from review charts of 97 patients with documented PHPT (69 females; 28 males) [16 (17%) with severe hypercalcemia (O12 mg/dl); 44 (45%) mild hypercalcemia, 36 (38%) normocalcemic PHPT (NCHPT)] were compared with those of 96 controls (C) (44 females; 52 males). Exclusion criteria: age !18 years, severe chronic diseases, cancer, bone metabolic diseases, use of medications affecting serum Ca. Biochemical measurements: PTH, Vitamin D, serum Ca, P, albumin, and creatinine. Normal ranges: PTH (15–88 pg/ml), Ca (8.5–11 mg/dl), P (2.5–5.1 mg/dl). SPSS 19.0 and SigmaPlot 11.0 were used for statistics (group comparisons, ROC curves, cutoffs performance).
Results
Ca and PTH were significantly higher in PHPT [(Ca median:11; min-max:9.4– 15.5); (PTH 135.2; 57.6–1748)] than C [(Ca 9.4; 8.3–10.2); (PTH 32.1; 14–106.1) (P!0.0001). P was significantly lower in PHPT (2.4; 1.4–3.9) than in C (3.5; 2.1– 4.5) (P!0.0001). Ca/P ratio was significantly higher in PHPT than in C. ROC curves analyses identified a cutoff of 3.5 for both Ca/P ratio and Ca/P ratio obtained by using albumin corrected-Ca. The sensitivity and specificity were 86 and 87%, respectively for Ca/P ratio and 89 and 93%, respectively for corrected Ca/P ratio (P!0.0001). The diagnostic value of Ca/P ratio performed better than PTH and Ca used alone or in combination.
Conclusions
Ca/P ratio is a valuable highly sensitive, highly specific tool for the diagnosis of PHPT. Since Ca/P is simple to obtain, easily accessible in every clinical and lab setting worldwide, and inexpensive even when used in large sample size of patients, this diagnostic tool could be useful for screening PHPT, especially in patients accessing emergency rooms or in the general practitioner setting.
2016
- Serum total estradiol, but not testosterone is associated with reduced bone mineral density (BMD) in HIV-infected men: a cross-sectional, observational study
[Articolo su rivista]
Santi, Daniele; Madeo, Bruno; Carli, Federica; Zona, Stefano; Brigante, Giulia; Vescini, F.; Guaraldi, Giovanni; Rochira, Vincenzo
abstract
By investigating the relationship between serum testosterone, estradiol, and bone mineral density (BMD) in a large cohort of HIV-infected men, estradiol was associated with BMD, relative estrogen deficiency being involved in bone loss in men with hypogonadism, in addition to all HIV-related factors. Increased aromatization in adipose tissue does not counteract HIV-related bone loss.
INTRODUCTION:
The purpose of this study is to evaluate the relationship between serum testosterone, estradiol, and BMD in a large cohort of HIV-infected men.
METHODS:
We investigated biochemical, hormonal parameters, and BMD in 1204 HIV-infected men (age 45.64 ± 7.33 years) participating in a cross-sectional, observational study. Among other parameters, the main outcome measures were serum total testosterone and estradiol, gonadotropins, 25-hydroxyvitamin D [25(OH)D], parathormone (PTH), calcium, phosphorous, femoral, and lumbar BMD.
RESULTS:
In men with HIV, the prevalence of osteoporosis and osteopenia is 15.1 and 63.2 % with 25(OH)D insufficiency being very common (60.1 %). After age adjustment, BMD is positively associated with estradiol, but not testosterone, at linear (p < 0.001) and stepwise (p < 0.05) multiple regression. Lumbar BMD significantly increases across the estradiol quartiles but not among testosterone quartiles. Femoral and lumbar BMD are significantly higher in men with estradiol ≥ 27 pg/mL than in those with estradiol <27 pg/mL. Apart from estradiol, only age, calcium, and BMI predict BMD at stepwise linear multiple regression, but the strength of this association is weak.
CONCLUSIONS:
Estradiol, but not testosterone, is associated with BMD in HIV-infected men and exerts a protective role on bone especially when it is above 27 pg/mL. Relative estrogen deficiency is a potential mechanism involved in bone loss in hypogonadal HIV-infected men, in addition to all HIV-related factors. Increased aromatization in adipose tissue does not counteract HIV-related bone loss. Finally, reduced BMD in young-to-middle-aged HIV-infected men might be considered a peculiar hallmark of HIV infection due to its relevant prevalence, representing one of the several pieces composing the complicated puzzle of premature aging related to HIV infection.
2016
- Thyroid Ultrasound Pitfalls: Esophageal Fibrovascular Polyp Mimicking Thyroid Nodule
[Articolo su rivista]
Ansaloni, Anna; Brigante, G; Madeo, B
abstract
Background. Ultrasound (US) is the most accurate tool in the diagnosis of thyroid nodules if performed by expert physician. Misdiagnosis due to extrathyroidal lesions mimicking thyroid nodules is reported in literature. We describe the first case of an esophageal fibrovascular polyp misdiagnosed as a thyroid nodule on US examination. Patient Findings. A 54-year-old woman presented to emergency department for headache and underwent carotid Doppler extended to neck ultrasound with incidental finding of a nodule in the posterior side of the left thyroid lobe. A following thyroid US performed by an endocrinologist allowed the characterization of the lesion as an esophageal pathology, considering the extrathyroidal position, the typical peripheral hyperechoic spots and hypoechoic rim, the connection to the esophagus, and the swallowing connected movement. The patient was addressed to further investigations and finally to anterior pharyngotomy with histological diagnosis of esophageal fibrovascular polyp. Summary. Differential diagnosis between thyroid nodules and other neck lesions is important to prevent an unnecessary fine needle aspiration biopsy and to treat the extrathyroidal pathology. In this case, an US performed by an expert endocrinologist allowed detecting an esophageal fibrovascular polyp requiring surgical removal. In conclusion, the possibility of an esophageal pathology, and even fibrovascular polyp, should be considered during US thyroid examination.
2015
- High-Resolution Melting is a sensitive, cost-effective, time-saving technique for BRAF V600E detection in thyroid FNAB washing fluid: a prospective cohort study
[Articolo su rivista]
Marino, Marco; Monzani, Maria Laura; Brigante, Giulia; Cioni, Katia; Madeo, Bruno; Santi, Daniele; Maiorana, Antonino; Bettelli, Stefania Raffaella; Moriondo, Valeria; Pignatti, Elisa; Bonacini, Lara; Carani, Cesare; Rochira, Vincenzo; Simoni, Manuela
abstract
aa
2014
- BRAF V600E mutation in washing liquid of thyroid fine-needle aspiration: a surprising tool in cytological benign nodules.
[Abstract in Rivista]
Monzani, Maria Laura; Brigante, Giulia; Marino, Marco; L., Bonacini; Pignatti, Elisa; K., Cioni; Madeo, Bruno; Rochira, Vincenzo; Santi, Daniele; Maiorana, Antonino; Carani, Cesare; Simoni, Manuela
abstract
The good diagnostic value of a new method for BRAF V600E detection within the washing fluid of thyroid fine-needle aspiration biopsy has been demonstrated together with time and cost saving characteristics of this procedure.
2014
- Identificazione di BRAF V600E nel liquido di lavaggio dell’agoaspirato: un nuovo strumento nella diagnostica del nodulo tiroideo
[Abstract in Atti di Convegno]
Monzani, Maria Laura; Brigante, Giulia; Marino, Marco; L., Bonacini; Pignatti, Elisa; K., Cioni; Madeo, Bruno; Rochira, Vincenzo; Santi, Daniele; Maiorana, Antonino; Carani, Cesare; Simoni, Manuela
abstract
This study investigates the diagnostic value of a new methodology for the detection of the BRAF mutation in samples of washing fluid of thyroid fine needle aspiration biopsies. The study demonstrates that this method is valid, and time and cost saving.
2014
- Voluminosa cisti paratiroidea cervico-mediastinica di riscontro occasionale in paziente affetto da sindrome di Boerhaave
[Articolo su rivista]
K., Cioni; Spaggiari, Giorgia; Madeo, Bruno; Rochira, Vincenzo
abstract
The description and the imaging of a great parathyroid cyst in a mans with Boerhaave Syndrome is described
2013
- Are pre-miR-146a and PTTG1 associated with papillary thyroid cancer?
[Articolo su rivista]
Marino, Marco; Valentina, Cirello; Gnarini, Valentina; Carla, Colombo; Pignatti, Elisa; Casarini, Livio; Diazzi, Chiara; Rochira, Vincenzo; Katia, Cioni; Madeo, Bruno; Carani, Cesare; Simoni, Manuela; Laura, Fugazzola
abstract
Papillary thyroid carcinoma (PTC) is the most common endocrine malignancy, with a steadily increasing incidence in the last few decades worldwide. The predisposition to developing this carcinoma by the heterozygous state of rs2910164 within the precursor of the miR-146a has been reported, but recently not confirmed. Interestingly, on the same chromosome, almost 50 kb separate the pre-miR-146a from the pituitary tumor-transforming gene 1 (PTTG1), a proto-oncogene involved in several tumors, including thyroid cancers. In this study, we analyzed, using a case–control design, the genetic association between PTC and the genomic region encompassing pre-miR-146a rs2910164 and PTTG1 rs1862391 and rs2910202. We enrolled 307 affected patients and 206 healthy controls. The possible presence of thyroid nodules in controls was excluded by ultrasonography. All the cases were submitted to single- nucleotide polymorphism (SNP) genotyping of pre-miR-146a and PTTG1, and risk association analyses were carried out. The genotypic and allelic frequencies of pre-miR-146a rs2910164 were not statistically different in the patients and controls, and this SNP was not in linkage disequilibrium with the investigated PTTG1 SNPs. Consistently, meta-analyses, the first including all the affected cases published to date, did not confirm the previously reported association of the heterozygous CG genotype with PTC. The PTTG1 SNPs exhibited the same allelic frequency in the patients and controls and were not associated with the disease.
In conclusion, in a well-selected Italian population, neither pre-miR-146a rs2910164 nor PTTG1 rs1862391 and rs2910202 were found to be associated with the risk of developing PTC.
2013
- Association of pre-miR-146a rs2910164 GG genotype with papillary thyroid cancer: a new case control study on two adjacent genes on chromosome 5, pre-miR-146a and PTTG1
[Abstract in Rivista]
Marino, Marco; Valentina, Cirello; Gnarini, Valentina; Pignatti, Elisa; Casarini, Livio; Diazzi, Chiara; Rochira, Vincenzo; Katia, Cioni; Madeo, Bruno; Simoni, Manuela; Laura, Fugazzola
abstract
Role of the pre-miR-146a and PTTG1 on papilary thyroid cancer
2013
- Effects of treatment for acromegaly on Bone Mineral Density (BMD): is Pegvisomant protective on lumbar BMD?
[Abstract in Rivista]
Brigante, Giulia; Santi, Daniele; Diazzi, Chiara; S., De Vincentis; G., Ferrannini; Madeo, Bruno; Simoni, Manuela; Carani, Cesare; Rochira, Vincenzo
abstract
The abstract deals with the different effects of treatments for acromegaly on bone
2013
- Effects of treatment for acromegaly on bone mineral density (BMD): is pegvisomant protective on lumbar BMD?
[Abstract in Rivista]
Brigante, Giulia; Santi, Daniele; Diazzi, Chiara; S., De Vincetis; G., Ferrannini; Madeo, Bruno; Simoni, Manuela; Rochira, Vincenzo; Carani, Cesare
abstract
The type of medical therapy for acromegaly may have different effects on bone mineral density
2013
- Effects of treatment for acromegaly on bone mineral density: is pegvisomant protective on lumbar BMD?
[Abstract in Rivista]
Brigante, Giulia; Santi, Daniele; Diazzi, Chiara; Sara De, Vincentis; Giulia, Ferrannini; Madeo, Bruno; Carani, Cesare; Simoni, Manuela; Rochira, Vincenzo
abstract
The type of pharmacological treatment used for the control of acromegaly might have different effect in the prevention of bone loss.
2013
- Mutations and somatic changes in the genotype of rs2910164 in pre-miR146a are frequent in follicular thyroid carcinoma
[Abstract in Rivista]
Vighi, Eleonora; Pignatti, Elisa; Roncati, Luca; Rochira, Vincenzo; Kara, Elda; Madeo, Bruno; E., Magnani; Maiorana, Antonino; Carani, Cesare; Simoni, Manuela
abstract
Mutations and somatic changes in the genotype of rs2910164 in pre-miR146a are frequent in follicular thyroid carcinoma and may be associated with its biological behavior
2013
- New insights on follicular thyroid carcinoma: the role of pre-mir-146a
[Abstract in Rivista]
Pignatti, Elisa; Vighi, Eleonora; Roncati, Luca; E., Magnani; Kara, Elda; Madeo, Bruno; Rochira, Vincenzo; Maiorana, Antonino; Carani, Cesare; Simoni, Manuela
abstract
Role of pre-mir-146a on follicular thyroid cancer
2013
- Papillary thyroid cancer: a new case-control study involving pre-mir-146a and PTTG1 genes
[Abstract in Rivista]
Marino, Marco; V., Cirello; Gnarini, Valentina; Pignatti, Elisa; Casarini, Livio; Diazzi, Chiara; Rochira, Vincenzo; K., Cioni; Madeo, Bruno; Simoni, Manuela; L., Fugazzola
abstract
Studio genetico dei carcinomi papillari della tiroide
2013
- Prevalence of olfactory and other developmental anomalies in patients with central hypogonadotropic hypogonadism
[Articolo su rivista]
DELLA VALLE, Elisa; Vezzani, Silvia; Rochira, Vincenzo; Antonio R. M., Granata; Madeo, Bruno; Genovese, Elisabetta; Pignatti, Elisa; Marino, Marco; Carani, Cesare; Simoni, Manuela
abstract
Introduction: Hypogonadotropic hypogonadism (HH) is a heterogeneous disease caused by mutations in several genes. Based on the presence of hyposmia/anosmia it is distin- guished into Kallmann syndrome (KS) and isolated HH. The prevalence of other develop- mental anomalies is not well established.
Methods: We studied 36 patients with HH (31 males, 5 females, mean age 41.5), 9 with familial and 27 with sporadic HH (33 congenital, 3 adult-onset), by physical examination, smell test (BSIT Sensonics), audiometry, renal ultrasound, and magnetic resonance imag- ing of the olfactory structures.
Results: Based on the smell test, patients were classified as normosmic (n = 21, 58.3%) and hypo/anosmic (n = 15, 41.6%). Hypoplasia/agenesis of olfactory bulbs was found in 40% of patients (10/25; 75% hypo/anosmic, 7.6% normosmic, p<0.01, Fisher’s test). Remarkably, olfactory structures were normal in two anosmic patients, while one nor- mosmic patient presented a unilateral hypoplastic bulb. Fourteen of 33 patients (42.4%) presented neurosensorial hearing loss of various degrees (28.5% hypo/anosmic, 52.6% normosmic, p=NS). Renal ultrasound revealed 27.7% of cases with renal anomalies (26.6% hypo/anosmic, 28.5% normosmic, p = NS). At least one midline defect was found in 50% of the patients (53.3% hypo/anosmic, 47.6% normosmic, p = NS), including abnor- mal palate, dental anomalies, pectus excavatum, bimanual synkinesis, iris coloboma, and absent nasal cartilage. Anamnestically 4/31 patients reported cryptorchidism (25% hypo/anosmic, 5.2% normosmic, p = NS).
Conclusion: Hypo/anosmia is significantly related to anatomical anomalies of the olfac- tory bulbs/tracts but the prevalence of other developmental anomalies, especially midline defects and neurosensorial hearing loss, is high both in HH and KS and independent of the presence of anosmia/hyposmia. From the clinical standpoint KS and normosmic HH should be considered as the same complex, developmental disease.
2013
- SNP RS2910164 in pre-mir146a undergoes somatic changes in follicular thyroid carcinoma
[Abstract in Rivista]
Vighi, Eleonora; Pignatti, Elisa; Roncati, Luca; Rochira, Vincenzo; Kara, Elda; Madeo, Bruno; E., Magnani; Maiorana, Antonino; Carani, Cesare; Simoni, Manuela
abstract
Role of SNP in follicular thyroid cancer
2013
- TSH-deficiency is associated with a lower thyroid gland volume in hypopituitaric patients compared to healthy volunteers: a cross-sectional study
[Abstract in Rivista]
Santi, Daniele; Brigante, Giulia; Gnarini, Valentina; Madeo, Bruno; S., De Vincentis; Carani, Cesare; M., Faustini Fustini; Balestrieri, Antonio; Rochira, Vincenzo
abstract
TSH deficiency is related to a lower volume of the thyroid in the case of absent thyroid disease, but it has no effect on nodular thyroid disease.
2013
- TSH-deficiency is associated with a lower thyroid gland volume in hypopituitaric patients compared to healthy volunteers: a cross-sectional study
[Abstract in Rivista]
Santi, Daniele; Brigante, Giulia; Gnarini, Valentina; Madeo, Bruno; Sara De, Vincentis; Carani, Cesare; Marco Faustini, Fustini; Balestrieri, Antonio; Rochira, Vincenzo
abstract
The lack of TSH secretion due to hypopituitarism does not influence thyroid nodules volume and their respective progressive growth. Otherwise growth of normal thyroid tissue is under the control of TSH; when the latter is undetectable thyroid volume appears to be reduced compared to controlsonly if thyroid nodules are absent.
2013
- TSH-deficiency is associated with a lower thyroid gland volume in hypopituitaric patients compared to healthy volunteers: a cross-sectional study.
[Abstract in Rivista]
Rochira, Vincenzo; Santi, Daniele; Brigante, Giulia; Gnarini, Valentina; Madeo, Bruno; Sara De, Vincentis; Marco Faustini, Fustini; Balestrieri, Antonio; Carani, Cesare
abstract
The study investigated the effects of long-term TSH-deficiency on thyroid volume suggesting that only healthy thyroid tissue is TSH-dependent, while nodular thyroid tissue is less TSH-dependent
2013
- The diagnostic value of calcitonin measurement in wash-out fluid from fine-needle aspiration of thyroid nodules in the diagnosis of medullary thyroid cancer
[Articolo su rivista]
Diazzi, Chiara; Madeo, Bruno; Taliani, Erica; Zirilli, Lucia; Romano, Stefania; Antonio R. M., Granata; Maria Cristina De, Santis; Simoni, Manuela; Katia, Cioni; Carani, Cesare; Rochira, Vincenzo
abstract
Objectives: The diagnostic value of calcitonin measurement in fine-needle aspiration biopsy (FNAB) wash-out fluid (Ct-FNAB) for medullary thyroid cancer (MTC) remains to be determined. This prospective study aims to assess the diagnostic value of Ct-FNAB in thyroid nodules in comparison with basal serum calcitonin (Ct), Pentagastrin-stimulated Ct (Pg-sCt), and cytology.
Methods: Among patients with goiter addressed to US-FNAB having initial clinical suggestion for thyroidectomy, 27 patients with thyroid nodule/s (n=60), normal, borderline or increased Ct, fulfilled criteria for thyroidectomy. All 27 patients (enrolled according to exclusion/inclusion criteria) underwent ultrasonography (US), Ct, Pg-sCt, US-assisted FNAB of each patient’s nodule for both cytology, and Ct-FNAB before thyroidectomy.
Results: Ct-FNAB resulted always >1000 pg/mL in MTC nodules at histology. For values between 36 and 1000 pg/mL, MTCs and nodular or micronodular C-cell Hyperplasia (CCH) results overlapped. Most of the nodules without MTC and/or CCH had Ct-FNAB<17 pg/mL. Ct-FNAB diagnostic power was superior to and similar to other diagnostic procedures (Ct, Pg-sCt, and cytology) in identifying both MTC and CCH, and MTC alone, respectively.
Conclusion: The diagnostic power of Ct-FNAB is valuable compared with other routine procedures. Ct-FNAB is highly reliable for the early detection and accurate localization of MTC in thyroid nodules, but it does not differentiate between MTC and CCH. Ct-FNAB is an extremely valuable diagnostic tool, especially considering that other diagnostic procedures do not provide a definitive diagnosis, and it can be included in the clinical work up of thyroid nodules when MTC is suspected.
2013
- Very high prevalence of ultrasound thyroid scan abnormalities in healthy volunteers in Modena, Italy
[Articolo su rivista]
Gnarini, Valentina; Brigante, Giulia; DELLA VALLE, Elisa; Diazzi, Chiara; Madeo, Bruno; Carani, Cesare; Rochira, Vincenzo; Simoni, Manuela
abstract
Background: Italy is characterized by high preva- lence of goiter. To date, only limited data about the preva- lence of goiter in the Italian adult population are available. Aim: To investigate the prevalence of thyroid ultrasound ab- normalities in adults unaware of any thyroid disease and eval- uate the rate of differentiated thyroid cancer (DTC) obtained by this intervention. Methods: Ultrasound (US) thyroid scan was performed in adult volunteers recruited by advertisement in Modena, Italy. One hundred and thirty-five women and 66 men (no.= 201), unaware of any thyroid disease (mean age of 46±10.7 yr) underwent their first thyroid US scan. Results: US thyroid abnormalities were found in 101 subjects (50.3%): 91 nodular goiters (45.2%) and 13 US-thyroiditis (6.5%) associ- ated with positive auto-antibodies in 11 of them. Seventeen subjects (18%) with nodules underwent US-fine needle aspiration biopsy with the following cytological class (C) outcome: 14 patients C2 (82%), 1 patient C3 (6%), 2 patients had C4 (12%), the latter received histological confirmation. Conclu- sions: The prevalence of thyroid abnormalities is very high in subjects unaware of any thyroid disease. DTC was found in 1% of subjects and in 2% of those affected by nodular goi- ter. Compared to the detection rate of the well-established screening programs for breast (0.45%) and colorectal (0.27%) cancer, the prevalence of DTC seems to be much higher. Thy- roid US screening could allow the detection of DTC in asymp- tomatic subjects and this diagnosis often includes DTC at an advanced stage. Thus, US screening not necessarily results in the over-diagnosis of clinically not relevant thyroid diseases.
2012
- Erectile dysfunction is more common in young to middle-aged HIV-infected men than in HIV-uninfected men.
[Articolo su rivista]
Zona, Stefano; Guaraldi, Giovanni; Luzi, Kety; M., Beggi; Santi, Daniele; Stentarelli, Chiara; Madeo, Bruno; Rochira, Vincenzo
abstract
Introduction. The penis has been compared to a barometer of endothelial health, erectile dysfunction (ED) being an early sign of endothelial dysfunction.
Aim. The aim of the study was to investigate the extent of the association between ED and endothelial dysfunction in patients with human immunodeficiency virus (HIV) infection on antiretroviral therapy.
Methods. In this observational cross-sectional study, we evaluated the prevalence and factors associated with ED in a cohort of 133 HIV-infected men.
Main Outcome Measures. The International Index of Erectile Function, ultrasound assessment of brachial artery flow mediated dilatation (FMD), and multi-slice computed tomography for coronary artery calcifications (CAC) as surrogates of endothelial dysfunction, the Adult Treatment Panel III criteria to diagnose metabolic syndrome (MS), plasma total testosterone (hypogonadism), and a visual analogue scale (VAS) of aesthetic satisfaction of the face and of the body (psychological distress associated with lipodystrophy).
Results. Thirty-nine (29.32%) patients had mild ED, 14 (10.52%) patients had moderate ED, and 26 (19.55%) patients had severe ED. Prevalence of ED ranged from 45% to 65%, respectively, in patients less than 40 and more than 60 years old. MS was present in 20 (25%) patients with ED and 13 (24%) patients without ED (P value = 0.87). Prevalence of ED neither appeared to be associated with MS as a single clinical pathological entity nor with the numbers of its diagnostic components. FMD < 7% was present in 25 (32%) patients with ED and 18 (33%) patients without ED (P value = 0.83), and CAC > 100 was present in 8 (10%) patients with ED and 5 (9%) patients without ED (P value = 0.87). A stepwise multivariable logistic regression analysis was used to find predictors of ED. Independent predictors were VAS face (odds ratio [OR] = 0.85, 95% confidence interval [CI] 0.73–0.99, P = 0.049) and age per 10 years of increase (OR = 1.73, 95% CI 1.02–2.94, P = 0.04).
Conclusions. Age constituted the most important risk factor for ED, which was related to aesthetic dissatisfaction of the face leading to negative body image perception.
2012
- GH response to GHRH plus arginine is impaired in lipoatrophic women with human immunodeficiency virus compared with controls
[Articolo su rivista]
Zirilli, Lucia; Orlando, Gabriella; Carli, Federica; Madeo, Bruno; Cocchi, Stefania; Diazzi, Chiara; Carani, Cesare; Guaraldi, Giovanni; Rochira, Vincenzo
abstract
Objective: GH secretion is impaired in lipodystrophic human immunodeficiency virus (HIV) patients and inversely related to lipodystrophy-related fat redistribution in men. Less is known about the underlying mechanisms involved in reduced GH secretion in HIV-infected women.Design: A case–control, cross-sectional study comparing GH/IGF1 status, body composition, and metabolic parameters in 92 nonobese women with HIV-related lipodystrophy and 63 healthy controls matched for age, ethnicity, sex, and body mass index (BMI).Methods: GH, IGF1, IGF binding protein 3 (IGFBP3), GH after GHRH plus arginine (GHRHCArg), several metabolic variables, and body composition were evaluated.Results: GH response to GHRHCArg was lower in HIV-infected females than in controls. Using a cutoff of peak GH %7.5 mg/l, 20.6% of HIV-infected females demonstrated reduced peak GH response after GHRHCArg. In contrast, none of the control subjects demonstrated a peak GH response %7.5 mg/l. Bone mineral density (BMD), quality of life, IGF1, and IGFBP3 were lowest in the HIV-infected females with a GH peak %7.5 mg/l. BMI was the main predictive factor of GH peak in stepwise multiregression analysis followed by age, with a less significant effect of visceral fat in the HIV-infected females. Conclusions: This study establishes that i) GH response to GHRHCArg is lower in lipoatrophic HIV- infected women than in healthy matched controls, ii) BMI more than visceral adipose tissue or trunk fat influences GH peak in this population, and iii) HIV-infected women with a GH peak below or equal to 7.5 mg/l demonstrate reduced IGF1, IGFBP3, BMD, and quality of life.
2012
- Nursing assistance increases the efficiency of ultrasound-guided fine-needle aspiration biopsy (US-FNAB) in the management of thyroid nodules: the MoCyThy (Modena's Cytology of the Thyroid) DATABASE
[Abstract in Rivista]
Belli, Serena; Carani, Cesare; Ansaloni, Anna; Katia, Cioni; Zirilli, Lucia; Marietta, Velasco; Simoni, Manuela; Madeo, Bruno; Rochira, Vincenzo
abstract
The study investigate the role of nursing assistance during ultrasound-guided fine-needle aspiration.
2012
- Osteoporosi maschile.
[Capitolo/Saggio]
Madeo, Bruno; Rochira, Vincenzo; Balestrieri, Antonio
abstract
The chapter deals with the clinical management of male osteoporosis
2012
- Prevalence of Erectile Dysfunction Is Greater in Young Middle-Aged HIV-Infected Men Than in HIV-Uninfected Men
[Abstract in Rivista]
Madeo, Bruno; Santi, Daniele; Zona, Stefano; Guaraldi, Giovanni; A., Granata; Carani, Cesare; Rochira, Vincenzo
abstract
Erectile dysfunction is more frequent in men living with HIV than in HIV-uninfected men. Erectile function is impaired in men with HIV even at a young age.
2012
- Prevalence of Erectile Dysfunction is greater in young middle-aged HIV-infected Men than in HIV-uninfected Men
[Abstract in Rivista]
Madeo, Bruno; Santi, Daniele; Zona, Stefano; Guaraldi, Giovanni; Rochira, Vincenzo
abstract
The study investigates the prevalence of erectile dysfunction in men with HIV infection in comparison with normal healthy men. Erectile dysfunction seems to be more prevalent in HIV and seems to occur at a younger age.
2012
- Prevalence of differentiated thyroid cancer is relevant in patients with familial adenomatous polyposis: a case-control, prospective study
[Abstract in Rivista]
Diazzi, Chiara; Benatti, Piero; Zirilli, Lucia; Gnarini, Valentina; Madeo, Bruno; Romano, Stefania; Rossi, Giuseppina; Carani, Cesare; PONZ DE LEON, Maurizio; Roncucci, Luca; Rochira, Vincenzo
abstract
Studio sulla prevalenza dei tumori differenziati della tiroide in pazienti con poliposi adenomatosa famigliare. Lo studio ha permesso di stabilire che la prevalenza di tumori della tiroide è aumentata in questi pazienti in confronto alla popolazione normale.
2012
- The Value of Repeated US-Guided Fine-Needle Aspirations (US-FNAB) in the Follow-Up of Thyroid Nodules: Preliminary Results from the MoCyThy (Modena's Cytology of the Thyroid) Database
[Abstract in Rivista]
Rochira, Vincenzo; Ansaloni, Anna; Belli, Serena; Vezzani, Silvia; Diazzi, Chiara; Zirilli, Lucia; Simoni, Manuela; Carani, Cesare; Madeo, Bruno
abstract
Repeating ultrasound guided fine needle aspiration might be useful for detecting thyroid malinìgnant nodules
2012
- Ultrasound (US) Features of Thyroid Nodules with Cytology Suspicious for Malignancy
[Abstract in Rivista]
Rochira, Vincenzo; Taliani, Erica; Ansaloni, Anna; Diazzi, Chiara; Brigante, Giulia; Carani, Cesare; Madeo, Bruno
abstract
Several US features are associated with and predict thyroid malignancy
2012
- Ultrasound (US) features of thyroid nodules with cytology suspicious for malignancy
[Abstract in Rivista]
Taliani, Erica; Ansaloni, Anna; Diazzi, Chiara; Antonio R. M., Granata; Carani, Cesare; Rochira, Vincenzo; Madeo, Bruno
abstract
Studio dell'associazione di determinate caratteristiche ecografie con la malignità dei noduli tiroidei.
2012
- Ultrasound-guided fine-needle aspiration biopsy (US-FNAB) of thyroid nodules: effects of the operator’s experience on adequacy of sampling: the MoCyThy (Modena’s Cytology of the Thyroid) DATABASE
[Abstract in Rivista]
Vezzani, Silvia; Ansaloni, Anna; Zirilli, Lucia; Katia, Cioni; Diazzi, Chiara; Simoni, Manuela; Madeo, Bruno; Rochira, Vincenzo
abstract
Lo studio ha permesso di evidenziare come l'esperienza (in termini di anni e di numero di prestazioni eseguite) sia importante per i risultati dell'agoaspirato tiroideo ecoguidato dei noduli tiroidei
2012
- Value of repeated US-guided fine-needle aspirations (US-FNAB) in the follow-up of thyroid nodules: the MoCyThy (Modena’s Cytology of the Thyroid) DATABASE
[Abstract in Rivista]
Ansaloni, Anna; Belli, Serena; Vezzani, Silvia; Antonio R. M., Granata; Zirilli, Lucia; Katia, Cioni; Carani, Cesare; Madeo, Bruno; Rochira, Vincenzo
abstract
Lo studio ha valutato il valore diagnostico della ripetizione dell'agoaspirato ecoguidato nella diagnosi dei noduli tiroidei
2011
- A case of painful thyroid, an unexpected clinical outcome
[Abstract in Rivista]
Taliani, Erica; Guidi, Alessandro; Rochira, Vincenzo; Barbara, Mullineris; Micaela, Piccoli; Rossi, Giulio; Antonio RM, Granata; Carani, Cesare; Madeo, Bruno
abstract
Description of a case of metastatic squamous cell carcinoma in the thyroid mimicking a thyroid nodule
2011
- Bone mineral density and sex hormones in HIV-infected men
[Abstract in Rivista]
Madeo, Bruno; Santi, Daniele; Orlando, Gabriella; Guaraldi, Giovanni; Fabio, Vescini; Simoni, Manuela; Carani, Cesare; Rochira, Vincenzo
abstract
In men with HIV bone mineral density depends on estrogens and not from testosterone as in non HIV-infected men.
2011
- Fratture vertebrali in giovane età da osteoporosi grave in un paziente con sindrome di Kallmann.
[Articolo su rivista]
Rochira, Vincenzo; A. R. M., Granata; Madeo, Bruno
abstract
Le immagini delle fratture vertebrali e della densitometria ossea sono mostrate in un paziente giovane con Sindrome di Kallmann
2011
- Lower serum testosterone (T) and estradiol (E2) in adult men with infuse epiphyses due to unrecognized and untreated congenital hypogonadotropic hypogonadism (HH): evidence for an E2-threshold for bone maturation in men
[Abstract in Rivista]
Rochira, Vincenzo; Balestrieri, Antonio; Zirilli, Lucia; Madeo, Bruno; Sgarbi, Ilaria; Luberto, Alessandra; Carani, Cesare
abstract
Estrogens rather than androgens are able to complete bone maturation only if the value is above a thresholds. In men with hypogonadotropic hypogonadism who have a serum estrogen below this threshold the growth plate does not fuse and the patient continues to growth in height.
2011
- Lower serum testosterone and estradiol (E2) in adult men with unfused epiphyses due to unrecognized and untreated congenital hypogonadotropic hypogonadism: evidence for an E2 threshold for bone maturation in men
[Abstract in Rivista]
Rochira, Vincenzo; Balestrieri, Antonio; Zirilli, Lucia; Madeo, Bruno; Sgarbi, Ilaria; Luberto, Alessandra; Carani, Cesare
abstract
This study confirms that estrogen and relative estrogen deficiency are responsible for the lack of bone maturation in men with severe hypogonadism
2011
- Pituitary Function in Type 2 Diabetic Men with Good or Poor Glycemic Control
[Abstract in Rivista]
Scaltriti, Sara; Madeo, Bruno; Monica, Bertolini; Romano, Stefania; Zirilli, Lucia; Emma Rita, Cavani; Balestrieri, Antonio; Carani, Cesare; Rochira, Vincenzo
abstract
The study explore the effects of a poor glycaemic control on the hypothalamic-pituitary gonadal axis in men.
2011
- Pituitary function in type 2 diabetic men with good or poor glycaemic control
[Abstract in Rivista]
Scaltriti, Sara; Madeo, Bruno; Monica, Bertolini; Romano, Stefania; Zirilli, Lucia; Emma Rita, Cavani; Antonio, Balestrieri; Carani, Cesare; Rochira, Vincenzo
abstract
The study investigates the role of hyperglycemia on the gonadotropin feedback in men with type-2 diabetes
2011
- Remission of primary hyperparathyroidism after parathyroid adenoma fine needle-aspiration biopsy
[Abstract in Rivista]
DELLA VALLE, Elisa; Rochira, Vincenzo; Carani, Cesare; Madeo, Bruno
abstract
Fine-needle aspiration biopsy could in some particular circumstances lead to remission of parathyroid adenoma. A case-report.
2011
- Ruolo del dosaggio di calcitonina (Ct) nei liquidi di lavaggio da agoaspirato (FNA-B) nella diagnosi di carcinoma midollare della tiroide (MTC): confronto con la calcitonina basale, la citologia e il test di stimolo alla pentagastrina (Pg-test)
[Abstract in Rivista]
Baraldi, Enrica; Rochira, Vincenzo; Maria Cristina De, Santis; Diazzi, Chiara; Laura, Roli; Madeo, Bruno; Carani, Cesare; Tommaso, Trenti
abstract
Ruolo diagnostico del dosaggio della calcitonina nel liquido di lavaggio ottenuto mediante agoaspirato ecoguidato dei noduli tiroidei sospetti per carcinoma midollare tiroideo.
2011
- Self-Monitoring of Blood Glucose in Type 2 Diabetes Mellitus: Effect on Glycemic Control in Non-Insulin-Treated Patients
[Abstract in Rivista]
Madeo, Bruno; Scaltriti, Sara; Romano, Stefania; Diazzi, Chiara; El Goch, Marwan; Antonio R. M., Granata; Emma Rita, Cavani; Rochira, Vincenzo
abstract
Glucose self-monitoring improve glucose control
2011
- Self-monitoring of blood glucose in type 2 diabetes mellitus: effect on glycemic control in non-insulin-treated patients
[Abstract in Rivista]
Madeo, Bruno; Scaltriti, Sara; Romano, Stefania; Diazzi, Chiara; Marwan El, Goch; Antonio RM, Granata; Emma Rita, Cavani; Carani, Cesare; Rochira, Vincenzo
abstract
The role of self-monitoring of blodd glucose on the control of the disease
2011
- Sex steroids and HIV-related osteoporosis in men: low circulating estrogens are associated with impaired bone mineral density (BMD)
[Abstract in Rivista]
Santi, Daniele; Brigante, Giulia; Orlando, Gabriella; Ciccarese, Michela; Diazzi, Chiara; Guaraldi, Giovanni; Carani, Cesare; Rochira, Vincenzo; Madeo, Bruno
abstract
The study investigates the role of sex steroids on HIV-related osteoporosis, suggesting that relative estrogen deficiency might play a role even in this particular type of bone demineralization.
2011
- Testosterone (T) ed estradiolo (E2) sierici in maschi adulti con ipogonadismo ipogonadotropo congenito (IIC) non diagnosticato e non trattato: evidenza di un valore soglia per l’E2 nella maturazione
[Abstract in Atti di Convegno]
Rochira, Vincenzo; Balestrieri, Antonio; Zirilli, Lucia; Madeo, Bruno; Carani, Cesare
abstract
Il ruolo degli estrogeni nella maturazione scheletrica del maschio si evince dallo studio di pazienti con ipogonadismo ipogonadotropo severo diagnosticato con ritardo in cui solo estrogeni sierici al di sopra di una certa soglia sono in grado di garantire una normale maturazione ossea.
2011
- Thyroid Disease in Patients with Type-1 Neurofibromatosis: A New Chapter?
[Abstract in Rivista]
Diazzi, Chiara; Guidi, Alessandro; Luberto, Alessandra; Taliani, Erica; Madeo, Bruno; Rochira, Vincenzo; Carani, Cesare
abstract
The study explore the prevalence of thyroid diseases (mainly thyroid nodules) in patients with the neurofibromatosis.
2011
- Thyroid disease in patients with type-1 neurofibromatosis: an underestimated issue ?
[Abstract in Rivista]
Diazzi, Chiara; Guidi, Alessandro; Luberto, Alessandra; Taliani, Erica; Madeo, Bruno; Rochira, Vincenzo; Carani, Cesare
abstract
The study deals with the incidence of medullary thyroid cancer in patients with type-1 neurofibromatosis
2011
- Thyroid disease in patients with type-1 neurofibromatosis: an underestimated issue?
[Abstract in Rivista]
Diazzi, Chiara; Guidi, Alessandro; Luberto, Alessandra; Taliani, Erica; Madeo, Bruno; Rochira, Vincenzo; Carani, Cesare
abstract
The study investigates the prevalence of medullary thyroid cancer in Neurofibromatosis type 1
2011
- Unfused Epiphyses Due to Unrecognized and Untreated Congenital Hypogonadotropic Hypogonadism (HH): Evidence for an E2 Threshold for Bone Maturation in Men
[Abstract in Rivista]
Rochira, Vincenzo; Antonio, Balestrieri; Zirilli, Lucia; Madeo, Bruno; Luberto, Alessandra; Carani, Cesare
abstract
The study identify a threshold for serum estradiol below which bone maturation in men is not possible.
2010
- Effetto di uno schema di autocontrollo domiciliare sul compenso glicemico nel paziente diabetico tipo 2 non insulino-trattato
[Abstract in Rivista]
Romano, Stefania; Scaltriti, Sara; Marwan El, Goch; Carani, Cesare; Rochira, Vincenzo; Madeo, Bruno
abstract
Study on the effects of self-monitoring of serum glucose on the control of Diabetes
2010
- Role of Calcitonin (Ct) in wash-out fluid from fine-needle aspiration (FNAB) in the diagnosis of medullary thyroid cancer (MTC): comparison with basal calcitonin, citology and pentagastrin stimulation test (Pg-Test)
[Abstract in Rivista]
Rochira, Vincenzo; Diazzi, Chiara; Zirilli, Lucia; Romano, Stefania; Carani, Cesare; Madeo, Bruno
abstract
The study provides evidence on the usefulness of measurement of calcitonin into the fine needle aspiration wash-out fluid of thyroid nodules for the diagnosis of medullary thyroid cancer.
2010
- Role of Calcitonin (Ct) in wash-out fluid from fine-needle aspiration (FNAB) in the diagnosis of medullary thyroid cancer (MTC): comparison with basal calcitonin, citology and pentagastrin stimulation test (Pg-Test)
[Abstract in Rivista]
Rochira, Vincenzo; Diazzi, Chiara; Zirilli, Lucia; Romano, Stefania; Carani, Cesare; Madeo, Bruno
abstract
Preliminary results regarding the role of calcitonin measurement in the wash-out fluid of thyroid fine-needle aspiration samples for the diagnosis of medullary thyroid cancer
2010
- Sex steroids and HIV-related osteoporosis in men: low circulating estrogens are associated with impaired bone mineral density (BMD)
[Abstract in Rivista]
Santi, Daniele; Brigante, Giulia; Orlando, Gabriella; Ciccarese, Michela; Diazzi, Chiara; Guaraldi, Giovanni; Carani, Cesare; Rochira, Vincenzo; Madeo, Bruno
abstract
Preliminary data on the effects of sex steroids on bone max in men with HIV
2009
- Estrogens and male reproduction
[Capitolo/Saggio]
Rochira, Vincenzo; Madeo, Bruno; Zirilli, Lucia; Carani, Cesare
abstract
The chapter deals with the study of estrogen role in male reproduction, in particulare the role on hypothalamic-pituitary-gonadal axis
2009
- Osteoporosi maschile: il ruolo degli estrogeni.
[Articolo su rivista]
Madeo, Bruno; Rochira, Vincenzo; Carani, Cesare
abstract
L'osteoporosi è un problema rilevante non solo nella donna ma anche nell’ uomo. Molto si conosce sull’osteoporosi nella donna mentre ancora poco nell’uomo. Negli ultimi anni anche nel maschio gli estrogeni hanno acquisito un ruolo sempre maggiore nel metabolismo osseo tanto da essere coinvolti nell’osteoporosi correlata all’età e in quella secondaria a ipogonadismo. Questo comporta modificazioni nella pratica clinica e possibili implicazioni terapeutiche.
2009
- Testosterone action on erythropoiesis does not require its aromatization to estrogen: Insights from the testosterone and estrogen treatment of two aromatase-deficient men.
[Articolo su rivista]
Rochira, Vincenzo; Zirilli, Lucia; Madeo, Bruno; Laura, Maffei; Carani, Cesare
abstract
Androgens act on erythropoiesis, but the relative role of testosterone (T) and estradiol (E2) on erythropoieticparameters in men is a poorly investigated issue. In order to evaluate separately the effects onerythropoiesis of high-dose T administration alone and of physiological dose of E2 administration alonetwo adult men with aromatase deficiency were assessed before and during each treatment. Blood cellcount, hemoglobin (Hb), hematocrit (Hct), erythrocyte mean cell volume (MCV), erythrocyte mean corpuscularhemoglobin (MCH), erythrocyte mean corpuscular hemoglobin concentration (MCHC), serumferritin, iron and total iron-binding capacity (TIBC), serum erythropoietin, serum total testosterone andestradiolwere evaluated. Hb, Hct and red cell count rose during testosterone treatment, consistently withthe increase in circulating testosterone, but failed to increase during estradiol treatment. A decrease inHb, Hct and red cell count was recorded in one of the two subjects during estradiol treatment, with aconcomitant decrease in serum testosterone. Circulating T alone is capable of and sufficient to influenceerythropoiesis, especially at supraphysiological dosage, while circulating E2 have not the same effecton erythropoietic parameters, suggesting the hypothesis that the erythropoietic changes induced byandrogens are not mediated via its aromatization to estrogens.
2009
- Testosterone action on erythropoiesis does not require its aromatization to estrogen: insights from the testosterone and estrogen treatment of two aromatase-deficient men
[Abstract in Atti di Convegno]
Rochira, Vincenzo; Zirilli, Lucia; Madeo, Bruno; Laura, Maffei; Diazzi, Chiara; Carani, Cesare
abstract
The study of testosterone and estrogen action on erythropoiesis of two aromatase-deficient men provides evidence that testosterone directly increases red cells count and that this action does not require testosterone aromatization into estradiol.
2008
- 21-hydroxylase deficiency and klinefelter syndrome in an adult man: striking a balance between androgen excess and insufficiency.
[Articolo su rivista]
Balestrieri, Antonio; Zirilli, Lucia; Madeo, Bruno; Pignatti, Elisa; Rossi, Giulio; Carani, Cesare; Rochira, Vincenzo
abstract
Objective We describe the rare case of an adult man with normal virilization affected by both Klinefelter Syndrome (KS) and Congenital Adrenal Hyperplasia (CAH) due to 21-hydroxylase deficiency, consulting for painful gynecomastia. A complete clinical workup included endocrinological, genetic, sexological evaluation and testis histology. Genetic analyses included karyotype, CYP21 sequencing and the CAG and GGC repeat polymorphism in the androgen receptor gene. Findings KS was diagnosed by karyotype analysis (47,XXY), the testis biopsy revealed Leydig cell hyperplasia. The CAH was diagnosed by the direct detection of a I2 homozygous mutation in the CYP21 gene. The hormonal analysis revealed a mild hypergonadotropic hypogonadism, serum levels of androstenedione and ACTH above the normal range and a slightly reduced cortisol response with exaggerated 17-OH progesterone increase to ACTH stimulation. Cortisone acetate treatment disclosed a clinically relevant pre-existent hypogonadism in the relatively short time of 6 months, thus suggesting that the reduction in adrenal steroids impaired the balance in the androgen status previously created by the two syndromes. Only the combined therapy with cortisone acetate and testosterone restored a normal androgenization and a male sexual behavior. Conclusions The simultaneous occurrence of KS and CAH is extremely rare. The clinical phenotype of our patient was characterized by mild symptoms of the two syndromes, probably because the high levels of adrenal androgens due to CAH counterbalanced the partial androgen deficiency due to KS.
2008
- Association of serum vitamin D levels nd type 2 diabetes in HIV infection in the Modena cohort
[Abstract in Rivista]
Zsofia, Szep; Guaraldi, Giovanni; Samir S., Shah; Orlando, Gabriella; Squillace, Nicola; Rochira, Vincenzo; Madeo, Bruno; Diazzi, Chiara; Baraldi, Enrica; Carani, Cesare; Esposito, Roberto; Pablo, Tebas
abstract
Metabolic complications, including type 2 diabetes mellitus and metabolic syndrome, are increasingly recognized among HIV-infected individuals. Low vitamin D levels increase the risk of type 2 diabetes mellitus. Our study demonstrates an association between vitamin D deficiency and type 2 diabetes mellitus.
2008
- Effects of Tadalafil on nocturnal penile tumescence and rigidity in normal men: randomized, placebo-controlled, crossover study
[Abstract in Rivista]
Antonio R. M., Granata; Madeo, Bruno; DE MOLA, Giovanni; Guidi, Alessandro; Pugni, Valeria; Rochira, Vincenzo; Carani, Cesare
abstract
This Randomized, Placebo-Controlled, Crossover Study evaluates the effects of tadalafil on Nocturnal Penile Tumescence and Rigidity in normal men
2008
- Higher prevalence of nodular goiter and thyroid carcinoma in patients with familial adenomatous poliposis (FAP)
[Abstract in Atti di Convegno]
Zirilli, Lucia; Romano, Stefania; Roncucci, Luca; Benatti, Piero; Madeo, Bruno; Diazzi, Chiara; Scaltriti, Sara; Carani, Cesare; PONZ DE LEON, Maurizio; Rochira, Vincenzo
abstract
The evaluation of 46 patients with familial adenomatous poliposis showed that nodular goiter is very common, and the prevalence of thyroid cancer is higher than that of a control group.
2008
- Higher prevalence of nodular goiter and thyroid carcinoma in patients with familial adenomatous poliposis (FAP)
[Abstract in Rivista]
Zirilli, Lucia; Romano, Stefania; Madeo, Bruno; Carani, Cesare; Benatti, Piero; PONZ DE LEON, Maurizio; Roncucci, Luca; Rochira, Vincenzo
abstract
The evaluation of 46 patients with familial adenomatous poliposis showed that nodular goiter is very common and the prevalence of thyroid cancer is higher than that of a control group
2008
- Tadalafil and sleep-related erections in normal men: randomized, placebo-controlled, crossover study
[Abstract in Rivista]
Antonio R. M., Granata; Madeo, Bruno; DE MOLA, Giovanni; Guidi, Alessandro; Pugni, Valeria; Rochira, Vincenzo; Carani, Cesare
abstract
This randomized, placebo-controlled, crossover study evaluated the effect of tadalafil on sleep-related erections in normal men
2008
- Tadalafil and sleep-related erections in normal men: randomized, placebo-controlled, crossover study.
[Abstract in Rivista]
Antonio R. M., Granata; Madeo, Bruno; DE MOLA, Giovanni; Guidi, Alessandro; Pugni, Valeria; Rochira, Vincenzo; Carani, Cesare
abstract
This randomized, placebo-controlled, crossover study evaluated the effect of Tadalafil on sleep-related erections in normal men.
2008
- The effects of citalopram and fluoxetine on sexual behavior in healthy men: evidence of delayed ejaculation and unaffected sexual desire. A randomized, placebo-controlled, double-blind, double-dummy, parallel group study.
[Articolo su rivista]
Madeo, Bruno; Paolo, Bettica; Stefano, Milleri; Balestrieri, Antonio; Antonio R. M., Granata; Carani, Cesare; Rochira, Vincenzo
abstract
INTRODUCTION: Selective serotonin reuptake inhibitors (SSRIs) are known to induce delayed orgasm and delayed ejaculation, while their effect on other aspects of sexual function, such as sexual motivation, arousal, and erectile function are unclear. AIM: In order to evaluate the effect of chronic administration of two SSRIs, citalopram and fluoxetine, on normal sexual function, we studied the parameters of male sexual behavior, erectile function, and ejaculation on 48 healthy male volunteers, aged 29.5 +/- 4.9, in a randomized, placebo-controlled, double-blind, double-dummy study. Methods. The subjects were randomized to receive placebo (16 subjects), or fluoxetine (20 mg/day) (16 subjects) or citalopram (20 mg/day) for the first week, and 40 mg/day in the following 3 weeks (16 subjects). MAIN OUTCOME MEASURES: Sexual function was investigated at the screening and at the end of the study by means of test of penile erection (TPE) and masturbation ejaculation latency time (MELT) performed during visual erotic stimulation, and at each visit by self-filled questionnaires (International Index Erectile Function [IIEF-15] and Golombock Rust Inventory of Sexual Satisfaction [GRISS]). RESULTS: All the erectile parameters, evaluated by means of RigiScan Plus during TPE, were not significantly different when both fluoxetine and citalopram were compared with placebo. A delay in the ejaculation time was observed both during citalopram and during fluoxetine treatment when compared with placebo, reaching a statistical significance only with citalopram. During the treatment with citalopram and fluoxetine, the IIEF-15 score of all items decreased except for those items related to sexual desire; however, the scores were significantly lower only for the citalopram treatment. CONCLUSIONS: The treatment with citalopram or with fluoxetine was confirmed to delay ejaculation, but was significant only for citalopram. Citalopram and fluoxetine did not affect sexual desire. Citalopram and fluoxetine did not directly affect penile erection as objectively assessed by RigiScan, although an impairment in the subjective assessment of erectile function was observed, but was significant only for citalopram, and it was thought to be a possible consequence of the delayed ejaculation perceived as a trouble.
2007
- Effect of Age and Testosterone on Sleep Related Erections
[Abstract in Atti di Convegno]
Antonio R. M., Granata; Rochira, Vincenzo; Pugni, Valeria; Luberto, Alessandra; DE MOLA, Giovanni; Madeo, Bruno; Zirilli, Lucia; Carani, Cesare
abstract
The abstract deals with the decline of NPTRM parameters that are due to aging and, at least in part, depends on serum testosterone
2007
- Effect of age and testosterone on sleep related erections
[Abstract in Rivista]
Antonio R. M., Granata; Rochira, Vincenzo; Madeo, Bruno; Pugni, Valeria; Zirilli, Lucia; Carani, Cesare
abstract
The abstract deals with the effects of aging and testosterone decline on sleep-related erections in men
2007
- Impaired GH secretion in women with HIV-related lipodystrophy
[Abstract in Rivista]
Zirilli, Lucia; Madeo, Bruno; Caffagni, Giovanni; Sanguanini, Alessia; Antonio R. M., Granata; Maria C., De Santis; Orlando, Gabriella; Squillace, Nicola; Guaraldi, Giovanni; Carani, Cesare
abstract
This study suggests that relative GH deficiency is common among females with HIV-related lipodystrophy if compared with matched controls
2007
- Impairment of GH Secretion in Women Affected by HIV-Related Adipose Tissue Redistribution Syndrome (HARS)
[Abstract in Atti di Convegno]
Zirilli, Lucia; Orlando, Gabriella; Caffagni, Giovanni; Squillace, Nicola; Diazzi, Chiara; Madeo, Bruno; Guaraldi, Giovanni; Carani, Cesare
abstract
This study suggests that relative GH deficiency is common among females with HIV-related lipodystrophy if compared with matched controls
2007
- Impairment of GH response to GHRH+Arginine in women affected by HIV-related adipose tissue redistribution syndrome (HARS)
[Abstract in Rivista]
Rochira, Vincenzo; Zirilli, Lucia; Orlando, Gabriella; Caffagni, Giovanni; Squillace, Nicola; Diazzi, Chiara; Madeo, Bruno; Guaraldi, Giovanni; Carani, Cesare
abstract
This study suggests that relative GH deficiency is common among females with HIV-related lipodystrophy if compared with matched controls.
2007
- Le metastasi polmonari da tumori della tiroide: diagnosi e terapia.
[Capitolo/Saggio]
Diazzi, Chiara; Zirilli, Lucia; Madeo, Bruno; Sanguanini, Alessia; Carani, Cesare; Rochira, Vincenzo
abstract
The chapter deals with the lung metastases due to thyroid cancer and particularly it regards the diagnostic and therapeutic aspects.
2007
- Preliminary Results of Thyroid Disease Screening Program "Ambulatorio Mobile" of 6153 Thyroid Ultrasounds Performed on the Population of a Geographical Area in Belarus Contaminated by Chernobyl Accident.
[Abstract in Atti di Convegno]
Zirilli, Lucia; Rochira, Vincenzo; Andrei, Alekseev; Natalia, Antanovich; Madeo, Bruno; Sanguanini, Alessia; Scaltriti, Sara; Romano, Stefania; Pignatti, Elisa; Massimotosti, Balducci; Carani, Cesare
abstract
The abstract deals with the effects of Chernobyl release of 131I on thyroid volume in subjects exposed to the fall-out. In particular no difference in thyroid volume was found as a consequence of 131I exposure.
2007
- Preliminary results of thyroid disease screening program “Ambulatorio Mobile” of 6153 thyroid ultrasounds performed on the population of a geographical area in Belarus contamined by Chernobyl accident
[Abstract in Rivista]
Zirilli, Lucia; Andrei, Alekseev; Natalia, Antanovich; Madeo, Bruno; Sanguanini, Alessia; Scaltriti, Sara; Romano, Stefania; Pugni, Valeria; Carani, Cesare; Massimo Tosti, Balducci; Rochira, Vincenzo
abstract
The radio iodine exposure does not influence thyroid volume not it changes the predictor (age, sex, BMI, body area surface) of thyroid volume.
2007
- Relevance of unitary clinical and diagnostic management for evaluation of cervical lymphadenopathy
[Abstract in Rivista]
Rochira, Vincenzo; Madeo, Bruno; Romano, Stefania; Zirilli, Lucia; Antonio R. M., Granata; Borghi, Francesca; DE MOLA, Giovanni; Katia, Cioni; Carani, Cesare
abstract
This study evaluated the relevance of a unitary clinical approach to cervical lymphnodes lesions.
2007
- Skeletal effects of long-term estrogen and testosterone replacement treatment in a man with congenital aromatase deficiency: evidences of a priming effect of estrogen for sex steroids action on bone.
[Articolo su rivista]
Rochira, Vincenzo; Zirilli, Lucia; Madeo, Bruno; C., Aranda; Caffagni, Giovanni; B., Fabre; Ve, Montangero; Eja, Roldan; L., Maffei; Carani, Cesare
abstract
The relative contribution of each sex steroid (i.e. estrogen and androgen) on bone in men and the relationships among sex steroids and changes in BMD and bone strength are still unknown. A defective BMD of bone tissue is constantly present in men with aromatase deficiency. This study evaluates the effects of different regimens of treatment with sex steroids over 7.3 years follow-up on BMD in an adult man affected by aromatase deficiency and by a concomitant mild hypogonadism, as previously described. The aim of the study is to provide additional data on the relative roles of androgens and estrogens in male bone metabolism. The effects of testosterone (T) treatment alone and estrogen (tE2) treatment alone as well as the effects of the combined treatment with testosterone and estradiol (T plus tE2) on areal BMD (aBMD) at dual-energy X-ray absorptiometry (DXA) and the effects of T plus tE2 on volumetric BMD (vBMD), particular at cortical site, measured by peripheral quantitative computed tomography (pQCT), are investigated. Hormones and markers of bone turnover were monitored during all phases of the study. Treatment with tE2 normalized serum estradiol, but only the combined treatment with T plus tE2 normalized both serum estradiol and testosterone. Markers of bone turnover reached a pattern close to normality during T plus tE2. The aBMD was little modified by T, but increased more during tE2. T plus tE2 resulted in a further increase in both aBMD at DXA and vBMD at pQCT. Cortical thickness increased during T plus tE2 both in radius and tibia. Only the combined treatment led to optimal parameters of aBMD suggesting that testosterone needs estrogens as a permissive factor for a direct androgen anabolic action on bone in men.
2007
- The osteoporotic male: overlooked and undermanaged?
[Articolo su rivista]
Madeo, Bruno; Zirilli, Lucia; Caffagni, Giovanni; Diazzi, Chiara; Sanguanini, Alessia; Pignatti, Elisa; Carani, Cesare; Rochira, Vincenzo
abstract
Age-related bone loss in men is a poorly understood phenomenon, although increasing data on the pathophysiology of bone in men is becoming available. Most of what we know on bone pathophysiology derives from studies on women. The well-known association between menopause and osteoporosis is far from been disproven. However, male osteoporosis is a relatively new phenomenon. Its novelty is in part compensated for by the number of studies on female osteoporosis and bone pathophysiology. On the other hand, the deeper understanding of female osteoporosis could lead to an underestimation of this condition in the male counterpart. The longer life-span exposes a number of men to the risk of mild-to-severe hypogonadism which in turn we know to be one of the pathogenetic steps toward the loss of bone mineral content in men and in women. Hypogonadism might therefore be one among many corrigible risk factors such as cigarette smoking and alcohol abuse against which clinicians should act in order to prevent osteoporosis and its complications. Treatments with calcium plus vitamin D and bisphophonates are widely used in men, when osteoporosis is documented and hypogonadism has been excluded. The poor knowledge on male osteoporosis accounts for the lack of well shared protocols for the clinical management of the disease. This review focuses on the clinical approach and treatment strategy for osteoporosis in men with particular attention to its relationship with male hypogonadism.
2006
- Analisi di una serie di esami citologici da agoaspirato tiroideo ecoguidato eseguiti in bambini, adolescenti ed adulti in un’area geografica della Bielorussia contaminata dall’incidente di Chernobyl
[Abstract in Atti di Convegno]
Madeo, Bruno; Andrei, Alekseev; Natalia, Antanovich; Zirilli, Lucia; Vaccari, Vittoria; Diazzi, Chiara; Scaltriti, Sara; Luberto, Alessandra; Rochira, Vincenzo; Carani, Cesare; Massimo Tosti, Balducci
abstract
Analysis of 285 FNAB of thyroid nodules in a population living in a rural area exposed to radiation after Chernobyl radiation accident.
2006
- Antiestrogeni e inibitori dell’aromatasi nel trattamento dell’infertilità maschile.
[Relazione in Atti di Convegno]
Madeo, Bruno; Antonio, Balestrieri; Scaltriti, Sara; Pugni, Valeria; Zirilli, Lucia; Antonio R. M., Granata; Rochira, Vincenzo; Carani, Cesare
abstract
The possible use of antiestrogens for the treatment of male infertility is reviewed.
2006
- Carcinoma papillare e Sindrome di Peutz-Jeghers: una rara associazione
[Abstract in Atti di Convegno]
Rochira, Vincenzo; Romano, Stefania; Zirilli, Lucia; Madeo, Bruno; Caffagni, Giovanni; Diazzi, Chiara; Valeria, Pugni; Pignatti, Elisa; Roncucci, Luca; PONZ DE LEON, Maurizio; Carani, Cesare; Benatti, Piero
abstract
Case report of a patient with Peutz-Jeghers syndrome and concomitant papillary thyroid cancer that indicates that thyroid cancer might be more frequent in patients with Peutz-Jeghers
2006
- Effect of age and testosterone on sleep related erctions
[Abstract in Rivista]
Antonio R. M., Granata; Rochira, Vincenzo; Madeo, Bruno; Valeria, Pugni; Zirilli, Lucia; Carani, Cesare
abstract
Study of the effect of age and testosterone on sleep related erctions
2006
- Effects of carbohydrate counting on glycaemic control on patients with type I diabetes with glargine in a basal/bolus multiple daily insulin regimen
[Abstract in Rivista]
Zirilli, Lucia; Madeo, Bruno; Franco, Ghini; Patrizia, Toschi; Rochira, Vincenzo; Scaltriti, Sara; Patrizia, Tondi; Chiara, Pacchioni; Carani, Cesare; Augusto, Baldini
abstract
Carbohydrate counting improves glycaemic control in patients with type I diabetes treated with glargine in a basal/bolus multiple daily insulin regimen
2006
- Il Sildenafil e il Testosterone migliorano le erezioni correlate al sonno in maschi ipogonadici, con effetto sinergico se assunti in combinazione: studio randomizzato, placebo-controllato, crossover.
[Relazione in Atti di Convegno]
Rochira, Vincenzo; Madeo, Bruno; Antonio, Balestrieri; Antonio R. M., Granata; Zirilli, Lucia; Sanguanini, Alessia; Carani, Cesare
abstract
Not available
2006
- Impaired GH secretion in women with HIV-related lipodystrophy
[Abstract in Rivista]
Rochira, Vincenzo; Zirilli, Lucia; Madeo, Bruno; Caffagni, Giovanni; Sanguanini, Alessia; Antonio R. M., Granata; Maria C., De Santis; Orlando, Gabriella; Squillace, Nicola; Guaraldi, Giovanni; Carani, Cesare
abstract
Women with HIV-related lipodystrophy present an impaired GH secretion at the stimulation test with GHRH+Arginine
2006
- Impatto del conteggio dei carboidrati sul compenso glicemico di pazienti con diabete tipo I in trattamento insulinico sostitutivo secondo uno schema bolus-basale
[Abstract in Rivista]
Madeo, Bruno; Franco, Ghini; Patrizia, Toschi; Rochira, Vincenzo; Scaltriti, Sara; Vania, Salvioli; Carani, Cesare; Chiara, Pacchioni
abstract
Carbohydrate counting improves glycaemic control on patients with type I diabetes with glargine in a basal/bolus multiple daily insulin regimen
2006
- Importanza della gestione unitaria nel management clinico-diagnostico dei linfonodi del collo sospetti per patologia neoplastica.
[Abstract in Atti di Convegno]
Rochira, Vincenzo; Madeo, Bruno; Romano, Stefania; Zirilli, Lucia; Antonio R. M., Granata; Montanini, Vanna; Katia, Cioni; Carani, Cesare
abstract
Study of the relevance of unified clinical and diagnostic management of suspicious neck lymph nodes based. The comparison of subjects evaluated by the radiologist and endocrinologist with dose managed only by the endocrinologist showed a better outcome in terms of early diagnosis provided by the latter type of organization.
2006
- Osteoporosis and male age-related hypogonadism: role of sex steroids on bone (patho)physiology
[Articolo su rivista]
Rochira, Vincenzo; Balestrieri, Antonio; Madeo, Bruno; Zirilli, Lucia; Antonio R. M., Granata; Carani, Cesare
abstract
Male age-related bone loss is caused, at least, in part, by hypogonadism that, Occurs with advancing age. The Study of the effects of sex steroids on bone physiology in men has recently highlighted the central role of estrogens on bone pathophysiology. This review focuses on particular aspects of bone physiology and pathophysiology in aging men, noting both the similarities to and the differences from female counterparts. In particular, the role of sex steroids on bone sexual dimorphism in health and disease has been analyzed.
2006
- Prevalence of secondary causes of osteoporosis among HIV infected individuals
[Abstract in Rivista]
Guaraldi, Giovanni; Orlando, Gabriella; Squillace, Nicola; Rochira, Vincenzo; Madeo, Bruno; Zirilli, Lucia; Diazzi, Chiara; Caffagni, Giovanni; Baraldi, Enrica; Carani, Cesare; Esposito, Roberto; Pablo, Tebas
abstract
Although osteopenia/osteoporosis is very
frequent among HIV infected individuals. Vitamin D deficiency is frequent in this Italian population and might be a contrib-
utor to this problem.
2006
- Risultati preliminari del progetto di screening della patologia tiroidea ‘Ambulatorio Mobile’ su 6153 ecografie tiroidee eseguite in una popolazione di un’area geografica della Bielorussia contaminata dall’incidente di Chernobyl.
[Abstract in Atti di Convegno]
Rochira, Vincenzo; Andrei, Alekseev; Natalia, Antanovich; Madeo, Bruno; Zirilli, Lucia; Borghi, Francesca; Sanguanini, Alessia; DE MOLA, Giovanni; Caffagni, Giovanni; Romano, Stefania; Antonio R. M., Granata; Massimo Tosti, Balducci; Carani, Cesare
abstract
Preliminary results of a study conducted on a population living in a rural area exposed to radiation after Chernobyl accident. Ultrasound screening of thyroid gland was performed in 6153 patients and showed no effect on thyroid volume.
2006
- Ruolo degli estrogeni sull’asse ipotalamo-ipofisi-gonadi in due uomini affetti da deficit di aromatasi: gli estrogeni sono indispensabili per l’integrità del feedback negativo a livello ipotalamico
[Abstract in Atti di Convegno]
Rochira, Vincenzo; Antonio, Balestrieri; Madeo, Bruno; Zirilli, Lucia; Diazzi, Chiara; Paula, Antunez; Laura, Maffei; Carani, Cesare
abstract
Estrogen administration to aromatase deficient men discloses a feedback modulation both at pituitary and hypothalamic level demonstrating that estrogens but not testosterone are the main modulator of gonadotropins in men
2006
- Sildenafil improves sleep-related erections in hypogonadal men: evidence from a randomized, placebo-controlled, crossover study of a synergic role for both testosterone and sildenafil on penile erections
[Articolo su rivista]
Rochira, Vincenzo; Balestrieri, Antonio; Madeo, Bruno; Antonio R. M., Granata; Carani, Cesare
abstract
To study the effects of sildenafil on human sleep-related erections according to the state of androgenization, we evaluated the effects of sildenafil on sleep-related erections in hypogonadal men before and during testosterone replacement treatment and in control subjects. We enrolled 24 hypogonadal men and 24 healthy men as a control group. All hypogonadal subjects had very low testosterone levels (< 200 ng/dL [8.93 nmol/L]). All subjects underwent nocturnal penile tumescence and rigidity monitoring (NPTRM) for 3 consecutive nights and were randomly assigned to consume either 50 mg of sildenafil or placebo 1 hour before bedtime on the second or third night of nocturnal penile monitoring. The hypogonadal subjects were tested twice, first without replacement treatment (H-T) and then after at least 6 months of testosterone replacement therapy (H+T). The subjects of the control group (C) were tested once. The following parameters of sleep-related erections were analyzed: total number of valid erections, total duration of both rigidity greater than or equal 70% and increase in penile circumference greater than or equal 30 mm, maximum rigidity, and maximum increase in penile circumference. NPTRM parameters were reduced in hypogonadal men before testosterone treatment (H-T+P) when compared with control subjects taking placebo (C+P). NPTRM parameters after testosterone (H+T+P) and sildenafil (H-T+S) administration were similar to that of control subjects taking placebo (C+P). When the statistical analysis was restricted to the hypogonadal men before testosterone treatment, sildenafil alone significantly increased NPTRM parameters when compared with placebo (H-T+S vs H-T+P). Testosterone restored normal erections when administered to hypogonadal subjects (H+T+P vs H-T+P); in hypogonadal men, however, the combined treatment (sildenafil plus testosterone) resulted in the maximum positive effect on NPTRM parameters. When the increase from baseline was analyzed, the effects of testosterone plus sildenafil were greater than the sum of the effects of each drug used alone. In conclusion, sildenafil administered at bedtime improves sleep-related erections in hypogonadal men, suggesting that the nitric oxide pathway may be pharmacologically enrolled and enhanced despite low serum testosterone. Furthermore, these data strongly support the idea of a synergic effect on sleep-related erections of sildenafil and testosterone.
2006
- Skeletal effects of estrogen and testosterone in a man with aromatase deficiency: priming effect of estrogen for sex steroids action on bone strength
[Abstract in Rivista]
Zirilli, Lucia; Rochira, Vincenzo; Madeo, Bruno; Pignatti, Elisa; Luberto, Alessandra; Caffagni, Giovanni; Diazzi, Chiara; Sanguanini, Alessia; Emile, Roldan; Laura E., Maffei; Carani, Cesare
abstract
The combined treatment with estradiol and testosteron led to optimal parameters of BMD suggesting that testosterone needs estrogens as a permissive factor for a direct androgen anabolic action on bone in men
2006
- Skeletal effects of long-term estrogen and testosterone replacement treatment in a man with congenital aromatase deficiency: evidences of a priming effect of estrogen for sex steroids action on bone strenght
[Abstract in Atti di Convegno]
Laura, Maffei; Zirilli, Lucia; Madeo, Bruno; Paula, Antunez; Caffagni, Giovanni; Claudio, Aranda; Bibiana, Fabre; Sanguanini, Alessia; Victor E., Montagero; Emilio J. A., Roldan; Carani, Cesare; Rochira, Vincenzo
abstract
The combined treatment with estradiol and testosteron led to optimal parameters of BMD suggesting that testosterone needs estrogens as a permissive factor for a direct androgen anabolic action on bone in men
2006
- Skeletal effects of long-term estrogen and testosterone replacement: treatment in a man with congenital aromatase deficiency: evidences of a priming effect of estrogen for sex steroids action on bone strength
[Abstract in Atti di Convegno]
Carani, Cesare; Laura, Maffei; Zirilli, Lucia; Madeo, Bruno; Paula, Antunez; Caffagni, Giovanni; Claudio, Aranda; Bibiana, Fabre; Sanguanini, Alessia; Victor E., Montagero; Emilio J. A., Roldan; Rochira, Vincenzo
abstract
The combined treatment with estradiol and testosteron led to optimal parameters of BMD suggesting that testosterone needs estrogens as a permissive factor for a direct androgen anabolic action on bone in men
2006
- Synergic effect of sildenafil and testosterone on sleep-related erections in hypogonadal men in a randomized placebo-controlled, crossover study
[Abstract in Rivista]
Rochira, Vincenzo; Antonio, Balestrieri; Madeo, Bruno; Zirilli, Lucia; Antonio R. M., Granata; Carani, Cesare
abstract
Randomized placebo-controlled, crossover study demonstrating a synergic effect of sildenafil and testosterone on sleep-related erections in hypogonadal men
2006
- Synergic effect of sildenafil and testosterone on sleep-related erections in hypogonadal men in a randomized, placebo-controlled, crossover study
[Abstract in Rivista]
Antonio R. M., Granata; Antonio, Balestrieri; Madeo, Bruno; Valeria, Pugni; DE MOLA, Giovanni; Rochira, Vincenzo; Carani, Cesare
abstract
Randomized placebo-controlled, crossover study evaluating a synergic effect of sildenafil and testosterone on sleep-related erections in hypogonadal men
2005
- Bone loss, sex steroids and male age related hypogonadism.
[Articolo su rivista]
Rochira, Vincenzo; Balestrieri, Antonio; Madeo, Bruno; Zirilli, Lucia; Granata, Ar; Carani, Cesare
abstract
Male aged-related bone loss depends at least in part from hypogonadism that occurs with advancing aging. Recently the study of sex steroids on bone physiology in men highlighted the central role of estrogens on bone pathophysiology. This review focuses on the relative role of sex steroids on bone loss in aging men.
2005
- Endocrine correlates in a case of Allgrove Syndrome with diagnosis in adulthood
[Abstract in Atti di Convegno]
Rochira, Vincenzo; Zirilli, Lucia; Andrea, Salmaggi; Chiara, Pantaleoni; Angela, Huebner; Madeo, Bruno
abstract
Late-onset triple A syndrome caused by a novel homozygous missense mutation in the AAAS gene (A167V in exon 6) was diagnosed at least 17 years after symptom onset
2005
- Estrogens in males: what have we learned in the last 10 years?
[Articolo su rivista]
Rochira, Vincenzo; Antonio R. M., Granata; Madeo, Bruno; Zirilli, Lucia; Rossi, Giuseppina; Carani, Cesare
abstract
This review focuses on the role of estrogen in men, mainly in male reproduction. The continuing increase in data obtained, and recent discoveries in this area will enable a better understanding of male physiology; these, in turn, will have important clinical implications.
2005
- L'endocrinologia del desiderio
[Articolo su rivista]
Zirilli, Lucia; Balestrieri, A; Madeo, Bruno; Rossi, Giuseppina; Granata, Arm; Carani, Cesare; Rochira, Vincenzo
abstract
Il comportamento sessuale nel maschio è principalmente sotto il controllo delle funzioni cognitive, ma alcuni ormoni, in particolare gli steroidi sessuali, sono in grado di modulare alcuni aspetti della sessualità maschile. Questa review pone l’attenzione sul ruolo sia degli estrogeni sia degli androgeni sul desiderio sessuale maschile, sulla base di studi sugli animali e sull’uomo. Gli estrogeni possono giocare un ruolo nella’attività sessuale dell’uomo in maniera simile a quanto avviene negli animali, ma nonostante siano probabilmente necessari livelli fisiologici di estrogeni per avere un comportamento sessuale maschile del tutto normale, il testosterone rimane il principale determinante del comportamento sessuale nell’uomo. Infine è schematizzato l’approccio clinico e terapeutico dei disturbi del desiderio sessuale.
2005
- Modificazioni scheletriche nella PADAM
[Abstract in Atti di Convegno]
Rochira, Vincenzo; Madeo, Bruno; Antonio, Balestrieri; Zirilli, Lucia; Antonio R. M., Granata; Carani, Cesare
abstract
The main role of the decline of serum estrogen in determining osteoporosis in aging men is discussed
2005
- Pituitary function in two adult men with congenital aromatase deficiency: evidences of impaired pituitary reserve which is not restored by different doses of transdermal estradiol (TE2) treatment
[Abstract in Atti di Convegno]
Rochira, Vincenzo; Antonio, Balestrieri; Madeo, Bruno; Antonio R. M., Granata; Zirilli, Lucia; Diazzi, Chiara; Claudio, Aranda; Paula, Antunez; Laura E., Maffei; Carani, Cesare
abstract
Estrogen modulate pituitary function, particularly GH and prolactin secretion in men, Aromatase deficiency constitutes a model to study the effect of the lack of estrogen on pituitary function.
2005
- Pituitary function in two adult men with congenital aromatase deficiency: evidences of impaired pituitary reserve which is not restored by different doses of transdermal estradiol (TE2) treatment
[Abstract in Rivista]
Rochira, Vincenzo; Antonio, Balestrieri; Madeo, Bruno; Antonio R. M., Granata; Zirilli, Lucia; Diazzi, Chiara; Laura, Maffei; Carani, Cesare
abstract
Estrogen modulates pituitary function, particularly GH and prolactin secretion in men, Aromatase deficiency constitutes a model to study the effect of the lack of estrogen on pituitary function. Men with aromatase deficiency have GH deficiency despite their increased height.
2005
- Sex steroids and body proportions in two men with aromatase deficiency: evidences for a key role of estrogen deficiency on eunuchoid skeleton
[Abstract in Rivista]
Rochira, Vincenzo; Madeo, Bruno; Zirilli, Lucia; Carani, Cesare; Antonio, Balestrieri
abstract
Aromatase deficiency, a human model of estrogen deficiency provides evidences for a key role of estrogen deficiency on the development of the eunuchoid body proportions of the skeleton
2005
- Sex steroids and body proportions in two men with aromatase deficiency: evidences for a key role of estrogen deficiency on eunuchoid skeleton
[Abstract in Atti di Convegno]
Rochira, Vincenzo; Madeo, Bruno; Zirilli, Lucia; Antonio, Balestrieri; Emile J. A., Roldan; Laura E., Maffei; Carani, Cesare
abstract
Aromatase deficiency, a human model of estrogen deficiency give evidences for a key role of estrogen deficiency on the development of eunuchoid skeleton
2005
- Sex steroids and sexual desire in a man with a novel mutation of aromatase gene and hypogonadism
[Abstract in Atti di Convegno]
Laura E., Maffei; Antonio R. M., Granata; Diazzi, Chiara; Zirilli, Lucia; Claudio, Aranda; Paula B., Antunez; Madeo, Bruno; Rochira, Vincenzo; Carani, Cesare
abstract
Sexual behavior was investigated by a sexological interview in a man with aromatase deficiency and hypogonadism, suggesting that in men estrogens could play a role in sexual activity while are not necessary for the development of sexual identity and orientation.
2005
- Sex steroids, glucose metabolism and insulin resistance in two adult men with congenital aromatase deficiency: evidences for a positive role of estrogens and for a key role of E2 to T ratio
[Abstract in Atti di Convegno]
Rochira, Vincenzo; Madeo, Bruno; Zirilli, Lucia; Antonio, Balestrieri; Antonio R. M., Granata; Caffagni, Giovanni; Paula, Antunez; Claudio, Aranda; Laura E., Maffei; Carani, Cesare
abstract
The study suggests a direct involvement of oestrogens in insulin sensitivity, and supports a possible role of oestradiol to testosterone ratio, which may be as important as the separate actions of each sex steroid on glucose homeostasis
2005
- Sex steroids, glucose metabolism and insulin resistance in two adult men with congenital aromatase deficiency: evidences for a positive role of estrogens and for a key role of E2 to T ratio
[Abstract in Rivista]
Rochira, Vincenzo; Madeo, Bruno; Zirilli, Lucia; Antonio, Balestrieri; Antonio R. M., Granata; Caffagni, Giovanni; Laura, Maffei; Carani, Cesare
abstract
The study suggests a direct involvement of oestrogens in insulin sensitivity, and supports a possible role of oestradiol to testosterone ratio, which may be as influencial as the separate actions of each sex steroid on glucose homeostasis
2005
- Testosterone and sildenafil in hypogonadal men: evidence for a synergical effect
[Abstract in Atti di Convegno]
Rochira, Vincenzo; Madeo, Bruno; Zirilli, Lucia; Diazzi, Chiara; Antonio R. M., Granata; Antonio, Balestrieri; Carani, Cesare
abstract
Randomized placebo-controlled, crossover study demonstrating a synergic effect of sildenafil and testosterone on sleep-related erections in hypogonadal men
2005
- Testosterone and sildenafil in hypogonadal men: evidence for a synergical effect
[Abstract in Rivista]
Rochira, Vincenzo; Madeo, Bruno; Zirilli, Lucia; Diazzi, Chiara; Antonio R. M., Granata; Antonio, Balestrieri; Carani, Cesare
abstract
Randomized placebo-controlled, crossover study demonstrating a synergic effect of sildenafil and testosterone on sleep-related erections in hypogonadal men
2005
- Testosterone and sildenafil in hypogonadal men: evidence for a synergistic effect
[Abstract in Atti di Convegno]
Rochira, Vincenzo; Madeo, Bruno; Zirilli, Lucia; Diazzi, Chiara; Antonio R. M., Granata; Antonio, Balestrieri; Carani, Cesare
abstract
Randomized placebo-controlled, crossover study evaluating a synergic effect of sildenafil and testosterone on sleep-related erections in hypogonadal men
2004
- Is the lack of estrogen responsible for aging in the male?
[Abstract in Rivista]
Rochira, Vincenzo; Madeo, Bruno; Antonio, Balestrieri; Antonio R. M., Granata; Carani, Cesare
abstract
The study of the effects of sex steroids on bone physiology in aging men with particular concern to the central role of estrogens on bone pathophysiology in men with late-onset hypogonadism.
2004
- Role of estrogens on human male reproductive system
[Articolo su rivista]
Rochira, Vincenzo; Zirilli, Lucia; Madeo, Bruno; Antonio, Balestrieri; Carani, Cesare; A. R. M., Granata
abstract
Abstract: This review focuses on estrogen role on human male physiology. Biological estrogen actions on male reproductive system are summarized with particular regard to the effects of congenital estrogen deprivation in men. The effects of estrogen on spermatogenesis, hormonal secretion and gonadotropin feedback and on sexual behavior are discussed. It is remarked that the role of estrogens in male reproduction is a very recent acquisition in reproductive endocrinology, but it promises new future fields of research to be investigated as well as the possible disclosure of new strategies in clinical practice.
2003
- A new case of juxtaglomerular cell tumor in a patient with bilateral adrenalectomy because of MEN2A
[Abstract in Atti di Convegno]
Madeo, Bruno; Antonio, Balestrieri; Antonio R. M., Granata; Maiorana, Antonino; Carani, Cesare; Rochira, Vincenzo
abstract
Case report: juxtaglomerular cell tumor in a patient with bilateral adrenalectomy because of MEN2A
2003
- A new case of juxtaglomerular cell tumor in a patient with bilateral adrenalectomy because of MEN2A
[Abstract in Rivista]
Madeo, Bruno; Rochira, Vincenzo; Antonio, Balestrieri; Antonio R. M., Granata; Maiorana, Antonino; Zirilli, Lucia; Carani, Cesare
abstract
Case report: juxtaglomerular cell tumor in a patient with bilateral adrenalectomy because of MEN2A
2003
- A new case of juxtaglomerular cell tumor in a patient with bilateral adrenalectomy because of MEN2A
[Abstract in Atti di Convegno]
Madeo, Bruno; Antonio, Balestrieri; Antonio R. M., Granata; Maiorana, Antonino; Curatola, Carlo; Zirilli, Lucia; Carani, Cesare; Rochira, Vincenzo
abstract
Case report: juxtaglomerular cell tumor in a patient with bilateral adrenalectomy because of MEN2A
2003
- Bilateral osteonecrosis of the femoral head in an adult man affected by congenital estrogen deficiency
[Articolo su rivista]
Balestrieri, Antonio; Madeo, Bruno; Rochira, Vincenzo; Baldini, Luca; Carani, Cesare
abstract
Osteonecrosis of femoral head is related to different predisposing factors. The pathogenesis is not completely understood, but an ischemic impairment seems to be one of the major determinants of bone necrosis. The association of bilateral necrosis of femoral heads and congenital aromatase deficiency is here reported. The absence of estrogen activity, as well as the persistence of unfused epiphyses for a long period of life, may be involved in the determinism of bilateral necrosis of bone femoral heads. The possibility of development of bone necrosis in patients affected by congenital estrogen deficiency needs to be considered and magnetic resonance imaging can be a useful method for an early detection of this disease.
2003
- Effetto del sildenafil e del testosterone sulle erezioni correlate al sonno in pazienti affetti da ipogonadismo
[Abstract in Atti di Convegno]
Antonio R. M., Granata; Madeo, Bruno; Antonio, Balestrieri; Rochira, Vincenzo; Carani, Cesare
abstract
Randomized placebo-controlled, crossover study evaluating a synergic effect of sildenafil and testosterone on sleep-related erections in hypogonadal men
2003
- Estrogeni e riproduzione maschile
[Abstract in Atti di Convegno]
Madeo, Bruno; Rochira, Vincenzo; Antonio R. M., Granata; Carani, Cesare; Antonio, Balestrieri
abstract
Description of the role of estrogens in the control of gonadotropin secretion, in male fertility determination
2003
- Estrogeni e riproduzione maschile.
[Relazione in Atti di Convegno]
Rochira, Vincenzo; Fabbi, Matteo; Valassi, Elena; Madeo, Bruno; Carani, Cesare
abstract
The effects of estrogen excess and estrogen deprivation on male reproductive function is reviewed and summarized.
2003
- Estrogens and male reproduction
[Articolo su rivista]
Rochira, Vincenzo; Matteo, Fabbi; Madeo, Bruno; Carani, Cesare; Valassi, Elena
abstract
Abstract The role of estrogen on male reproductive function has become clearer in the last decade. During these years the study of the effect of testosterone, estrogen or an aromatase inhibitor in hypogonadal men provided a first evidence of the effects of estrogens in the regulation of gonadotropin secretion. At the same time, the development of a line of transgenic male mice lacking estrogen receptor α, estrogen receptor β or aromatase gene provided further evidence about the role of estrogens not only in the regulation of gonadotropin secretion, but also on the effects of estrogens on testicular function and development. A confirmation of these actions of estrogens came from the observation of naturally occurring mutations of the estrogen receptor and of the aromatase gene in human males. Based on these data it has been demonstrated that estrogens are major regulators of gonadotropin secretion acting both at pituitary and hypotalamic level. The presence in the human reproductive structures of estrogen receptor α, estrogen receptor β and the aromatase enzyme indicates the existence of receptor α, estrogen receptor β or aromatase estrogen actions at this level. Anyway, the precise role of estrogens in testicular development and function and on the regulation of human spermatogenesis has not yet been precisely clarified.
2003
- Estrogens and male sexual behavior: insights from the natural model of congenital estrogen deficiency
[Abstract in Rivista]
Rochira, Vincenzo; Madeo, Bruno; Antonio, Balestrieri; Valassi, Elena; Zirilli, Lucia; Antonio R. M., Granata
abstract
Sexual behavior was investigated by a sexological interview in a man with aromatase deficiency and hypogonadism, suggesting that in men estrogens could play a role in sexual activity, but are not responsible for the development of a male gender identity and male sexual orientation.
2003
- Ruolo degli estrogeni sulla funzionalità ipofisaria e sulla maturazione scheletrica nell'uomo
[Abstract in Atti di Convegno]
Rochira, Vincenzo; Antonio, Balestrieri; Madeo, Bruno; Antonio R. M., Granata; Carani, Cesare
abstract
Aromatase deficiency, a human model of estrogen deficiency give evidences for a key role of estrogen on the development of skeleton adn pituitary function
2003
- Sex steroids and sexual desire mechanism.
[Articolo su rivista]
Rochira, Vincenzo; Zirilli, Lucia; Madeo, Bruno; Balestrieri, Antonio; Antonio R. M., Granata; Carani, Cesare
abstract
Sexual behavior is mainly controlled by cognitive functions in men, though hormones, particularly sex steroids, may modulate some aspects of male sexuality. This review focuses on the role of both estrogens and androgens on male sexual desire, starting from both animal and human studies. Estrogens could play a role in human male sexual activity, similarly to what happens in animals, but even though physiological levels of estrogens could be probably required for a completely normal male sexual behavior, testosterone remains the major determinant of human male sexual behavior.
2003
- Sildenafil is effective in improving sleep-related erection in healthy men: evidences for a more prolonged action. Therapeutical implications. A randomised, placebo-controlled, crossover study
[Abstract in Rivista]
Madeo, Bruno; Rochira, Vincenzo; Antonio, Balestrieri; Fabbi, Matteo; Carani, Cesare; Antonio R. M., Granata
abstract
This randomized, placebo-controlled, crossover study demostrate that sildenafil is effective in improving sleep-related erection in healthy men
2003
- Sleep related erections in hypogonadal men: effect of both sildenafil and testosterone replacement therapy. A randomized controlled study
[Abstract in Atti di Convegno]
Madeo, Bruno; Antonio, Balestrieri; Rochira, Vincenzo; Carani, Cesare; Antonio R. M., Granata
abstract
Peliminary results from a randomized placebo-controlled, crossover study demonstrating a synergic effect of sildenafil and testosterone on sleep-related erections in hypogonadal men
2003
- Sleep related erections in hypogonadal men: effect of both sildenafil and testosterone replacement therapy. Preliminary data of a randomized controlled study
[Abstract in Rivista]
Antonio R. M., Granata; Madeo, Bruno; Antonio, Balestrieri; Fabbi, Matteo; Carani, Cesare; Rochira, Vincenzo
abstract
Preliminary data on a randomized placebo-controlled, crossover study evaluating a synergic effect of sildenafil and testosterone on sleep-related erections in hypogonadal men
2003
- The effect of sildenafil on sleep related erections in hypogonadal men with and without testosterone replacement therapy. Preliminary data of randomized controlled study
[Abstract in Atti di Convegno]
Madeo, Bruno; Antonio, Balestrieri; Rochira, Vincenzo; Valassi, Elena; Fabbi, Matteo; Carani, Cesare; Antonio R. M., Granata
abstract
Preliminary data of a randomized placebo-controlled, crossover study evaluating a synergic effect of sildenafil and testosterone on sleep-related erections in hypogonadal men
2002
- Congenital estrogen deficiency in men: a new syndrome with different phenotypes; clinical and therapeutic implications in men
[Articolo su rivista]
Rochira, Vincenzo; Balestrieri, Antonio; Madeo, Bruno; Spaggiari, Antonio; Carani, Cesare
abstract
The report focuses on the role of estrogens in human male, dealing with two human models of congenital estrogen deficiency: estrogen resistance and aromatase deficiency. Similarities and differences of clinical phenotypes of these models are described and progresses of estrogen treatment of aromatase-deficient men are reported. Finally, the putative use of estrogen in men and the use of aromatase inhibitors and antiestrogen for male disorders are discussed.
2002
- Effects of Sildenafil on Sleep-Related Erection in Healthy Men
[Abstract in Rivista]
Madeo, Bruno; Fabbi, Matteo; Rochira, Vincenzo; Antonio R. M., Granata; Valassi, Elena; Antonio, Balestrieri; Carani, Cesare
abstract
This randomized, placebo-controlled, crossover study demostrate that sildenafil is effective in improving and ameliorate sleep-related erection, that are just normal, in healthy men
2002
- Effects of Sildenafil on sleep-related erections in normal men: randomized, placebo-controlled, crossover study
[Abstract in Atti di Convegno]
Madeo, Bruno; Antonio R. M., Granata; Fabbi, Matteo; Rochira, Vincenzo; Antonio, Balestrieri; Carani, Cesare
abstract
This randomized, placebo-controlled, crossover study demostrate that sildenafil is effective in improving sleep-related erection in healthy men
2002
- Effects of sildenafil on nocturnal penile tumescence and rigidity in normal men: Randomized, placebo-controlled, crossover study
[Articolo su rivista]
Rochira, Vincenzo; Antonio R. M., Granata; Balestrieri, Antonio; Madeo, Bruno; Carani, Cesare
abstract
We studied the effects of sildenafil on sleep-related erections in 44 adult healthy men not affected by erectile dysfunction (mean age +/- SD: 39.3 +/- 10.5 years). No subjects were administered any medication the first night, but all were randomly administered sildenafil 50 mg or placebo the second night and vice versa the third night. Sildenafil and placebo were administered 1 hour before bedtime. The following parameters of sleep-related erections, after taking sildenafil or placebo, were analyzed: total number of valid erections, total duration of rigidity more than or equal to 70% of a tightening force of 2.8 N applied by the recording device, total duration of increase in penile circumference more than or equal to 30 mm, maximum rigidity, mean of maximum rigidity, and maximum increase of tumescence. Apart from the maximum increase of tumescence, all the parameters analyzed were significantly higher after sildenafil than after placebo administration during the first 4 hours of monitoring in all subjects (n = 44) (study 1). All the parameters were significantly higher after sildenafil than after placebo administration during the whole 8 hours of monitoring in 25 of 44 subjects (study 2A) who slept at least 8 hours. Comparing both the first and the second 4 hours in the 25 of 44 subjects who slept at least 8 hours (study 2B), all the parameters were significantly higher after sildenafil than after placebo administration, apart from maximum rigidity and mean of maximum rigidity during the first 4 hours. Our data suggest that sildenafil, administered at bedtime, is efficacious in improving sleep-related erections in normal men, indirectly confirming that the nitric oxide pathway is crucial in the physiology of erections during sleep. The effect of sildenafil is prolonged up to 89 hours after its administration.
2002
- Effects of sildenafil on nocturnal penile tumescence and rigidity in normal men: randomized, placebo-controlled, crossover study - Comment
[Articolo su rivista]
Rochira, Vincenzo; Granata, Antonio R. M.; Balestrieri, Antonio; Madeo, Bruno; Carani, Cesare
abstract
not available
2002
- GH, PRL, TSH, and ACTH evaluation in a man with aromatase deficiency: effect of different doses of transdermal estradiol
[Abstract in Atti di Convegno]
Rochira, Vincenzo; Antonio, Balestrieri; Madeo, Bruno; Antonio R. M., Granata; Stefano, Borgato; Paolo Beck, Peccoz; Carani, Cesare
abstract
To clarify the role of estrogen on male pituitary function, the effects of different doses of transdermal E2 on pituitary secretion were evaluated in a man with aromatase deficiency.
2002
- Maturazione ossea e steroidi sessuali.
[Relazione in Atti di Convegno]
Antonio, Balestrieri; Valassi, Elena; Madeo, Bruno; Rochira, Vincenzo; Carani, Cesare
abstract
Not available
2002
- Pathophysiological significance of estrogens in men
[Abstract in Rivista]
Carani, Cesare; Laura, Maffei; Gloria, Tubert; Antonio, Balestrieri; Madeo, Bruno; Rochira, Vincenzo
abstract
Aromatase deficient men represent a human model of estrogen deficiency and play an important role in understanding the pathophysiological significance of estrogens in men
2002
- Sex hormones in aging male and female
[Abstract in Rivista]
Madeo, Bruno; Rochira, Vincenzo; Valassi, Elena; Zirilli, Lucia; Sgarbi, Ilaria; Balestrieri, Antonio
abstract
Differences in declining sex steroid function between aging male and female
2001
- Congenital estrogen deficiency: in search of the estrogen role in human male reproduction
[Articolo su rivista]
Rochira, Vincenzo; Balestrieri, Antonio; Madeo, Bruno; Baraldi, Enrica; Marco Faustini, Fustini; Antonio R. M., Granata; Carani, Cesare
abstract
Recently, a remarkable progress has been made in our understanding about the role of sex steroids in male physiology. In this paper, we consider the clinical aspects of congenital estrogen deficiency - notably, estrogen resistance and aromatase deficiency - in men and we discuss both well-established and supposed estrogen roles in the human male reproductive function. These topics include the role of estrogens in the control of gonadotropin secretion, in male fertility determination and psychosexual behavior. Briefly, estrogens play a pivotal role in the control of serum gonadotropin concentrations in the human male. Furthermore, a possible role of estrogens on both human male fertility and sexuality has also been suggested by recent studies, even though the available data are far from being conclusive. Conversely, for what concern Fertility and sexual behavior, a well-established effect of estrogens has been provided by recent studies on male rodents, which show impaired sexual behavior and fertility as a consequence of estrogen defect. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.
2001
- Effects of different doses of transdermal estradiol on gonadotopin feedback in a man with congenital aromatase deficiency
[Abstract in Atti di Convegno]
Rochira, Vincenzo; Antonio, Balestrieri; Madeo, Bruno; Marco Faustini, Fustini; Paolo Beck, Peccoz; Carani, Cesare
abstract
In order to clarify the role of estrogen on male pituitary gonadotropin feedback, the effects of different doses of transdermal E2 on pituitary secretion were evaluated in a man with congenital aromatase deficiency. Estrogen, but not testosterone was able to reduce gonadotropins serum levels.
2001
- Effects of sildenafil on sleep-related erections in normal men
[Abstract in Rivista]
Antonio R. M., Granata; Madeo, Bruno; Antonio, Balestrieri; Rochira, Vincenzo; Carani, Cesare
abstract
This randomized, placebo-controlled, crossover study demonstrates that sildenafil is effective in improving sleep-related erection in healthy men
2001
- Effects of sildenafil on sleep-related erections in normal men
[Abstract in Atti di Convegno]
Antonio R. M., Granata; Madeo, Bruno; Antonio, Balestrieri; Rochira, Vincenzo; Carani, Cesare
abstract
This randomized, placebo-controlled, crossover study demonstrates that sildenafil is effective in improving sleep-related erection in healthy men
2001
- Effetti del Sildenafil sull'erezione notturna nel soggetto sano: aspetti fisiologici.
[Relazione in Atti di Convegno]
Madeo, Bruno; Antonio R. M., Granata; Rochira, Vincenzo; Antonio, Balestrieri; Carani, Cesare
abstract
Not available
2001
- Human models of estrogen deficiency
[Abstract in Atti di Convegno]
Rochira, Vincenzo; Antonio, Balestrieri; Madeo, Bruno; Valassi, Elena; Antonio R. M., Granata; Carani, Cesare
abstract
Description of human models of estrogen deficiency plays a key role in understanding the effect of estogens in men
2001
- Ormoni gonadici e sessualità. (Capitolo 12)
[Capitolo/Saggio]
Madeo, Bruno; Rochira, Vincenzo; Attilia, Pizzini; Fabbi, Matteo; Caterina, Cappi; Antonio, Balestrieri; Carani, Cesare
abstract
Il ruolo degli ormoni sulla funzione gonadica e sulla sessualità viene illustrato in maniera esaustiva/This chapter deals with the role of hormones on human male sexuality.
2001
- Sex Steroids in ageing male
[Abstract in Atti di Convegno]
Madeo, Bruno; Rochira, Vincenzo; Fabbi, Matteo; Zirilli, Lucia; Carani, Cesare
abstract
Estrogens and testosterone declines with aging and serum estradiol remains higher in older men than in women
2001
- Sex steroids in ageing male and female
[Abstract in Rivista]
Madeo, Bruno; Zirilli, Lucia; Rochira, Vincenzo; Antonio, Balestrieri; Fabbi, Matteo; Gabriella, Pini; Paola, Guaresi; Leonarda, Troiano; Carani, Cesare
abstract
This study demonstrates the sex differences in sex steroid function between aging male and female
2000
- Case Report: Congenital Adrenal Hyperplasia in a man with Klinefelter Syndrome
[Abstract in Rivista]
Rochira, Vincenzo; Antonio, Balestrieri; Madeo, Bruno; Antonio R. M., Granata; Carani, Cesare
abstract
Case Report of a patient with coexisting congenital Adrenal Hyperplasia and Klinefelter Syndrome. The coexistence of a condition of androgen excess masked most of the features of the androgen deficiency due to the Klinefelter Syndrome
2000
- Clinical aspects of congenital estrogen defect and physiological role of estrogens in the human male
[Abstract in Rivista]
Rochira, Vincenzo; Antonio, Balestrieri; Madeo, Bruno; Antonio R. M., Granata; Carani, Cesare
abstract
Until the discovery of cases of men with congenital estrogen deficiency the role of estrogens in men remained underestimated. This abstract summarize the increasing evidence about estrogen action on bone, fertility, sexual behavior and several metabolic functions in men.
2000
- Clinical aspects of congenital estrogen defect and physiological role of estrogens in the human male.
[Relazione in Atti di Convegno]
Rochira, Vincenzo; Antonio, Balestrieri; Madeo, Bruno; Antonio R. M., Granata; Carani, Cesare
abstract
The chapter deals with the clinical aspects of congenital estrogen deficiency and the study of the role estrogen of human male
2000
- Congenital aromatase deficiency: bilateral osteonecrosis of the femoral head
[Abstract in Rivista]
Rochira, Vincenzo; Antonio, Balestrieri; Madeo, Bruno; Sgarbi, Ilaria; Luca, Baldini; Carani, Cesare
abstract
The association of bilateral necrosis of femoral heads and congenital aromatase deficiency is here reported and the underlying aspect discussed
2000
- Effect of different doses of transdermal estradiol (TE) on bone mineral density (BMD) and hormonal parameters in a man with congenital aromatase deficiency (AD)
[Abstract in Rivista]
Rochira, Vincenzo; Antonio, Balestrieri; Fabbi, Matteo; Madeo, Bruno; Marco Faustini, Fustini; Carani, Cesare
abstract
To clarify the role of estrogen on male pituitary function and bone mineral density, the effects of different doses of transdermal E2 were evaluated in a man with aromatase deficiency
2000
- Effect of different doses of transdermal estradiol on bone mineral density and hormonal parameters in a man with congenital aromatase deficiency
[Abstract in Atti di Convegno]
Rochira, Vincenzo; Marco Faustini, Fustini; Antonio, Balestrieri; Chiara, Grisolia; Madeo, Bruno; Luca, Baldini; Carani, Cesare
abstract
To clarify the role of estrogen on male pituitary function and bone mineral density, the effects of different doses of transdermal E2 were evaluated in a man with aromatase deficiency
2000
- Il ruolo degli estrogeni nel maschio
[Relazione in Atti di Convegno]
Madeo, Bruno; Rochira, Vincenzo; Carani, Cesare
abstract
The article summarizes all the aspects related to the role of estrogens in the human male
2000
- Sildenafil and sleep related erections in men not affected by erectile dysfunction
[Abstract in Rivista]
Antonio R. M., Granata; Rochira, Vincenzo; Annalisa, Perina; Madeo, Bruno; Carani, Cesare
abstract
Evaluation of the effect of Sildenafil and sleep related erections in men not affected by erectile dysfunction showing that sildenfil is able to improve penile erection even in men not suffering from erectile dysfunction.
1999
- Effects of long term transdermal estradiol treatment on bone mineral density in a man with aromatase deficiency
[Abstract in Rivista]
Rochira, Vincenzo; Antonio, Balestrieri; Madeo, Bruno; Marco Faustini, Fustini; Vincenzo, Spina; Carani, Cesare
abstract
To clarify the role of estrogen on bone mineral density, the effects of different titrated doses of transdermal E2 were evaluated in a man with aromatase deficiency
1999
- Il deficit estrogenico nell’uomo: aspetti clinici
[Abstract in Atti di Convegno]
Carani, Cesare; Rochira, Vincenzo; Vincenzo, Spina; Fabbi, Matteo; Madeo, Bruno; Antonio, Balestrieri
abstract
The improvement of our knowledge of the natural history of congenital estrogen deficiency in men clarify the real impact of estrogens on men
1999
- Oestrogen role in the male sexual behaviour: insights from the natural model of aromatase deficiency
[Abstract in Rivista]
Antonio R. M., Granata; Rochira, Vincenzo; Madeo, Bruno; Antonio, Balestrieri; Augusto, Baldini; Carani, Cesare
abstract
The study of the sexual behaviour in men with aromatase deficiency suggests that oestrogens in humans do not affect gender-identity and sexual orientation but could have a role in male sexual activity
1999
- Sexual steroids and bone maturation.
[Articolo su rivista]
Rochira, Vincenzo; Balestrieri, Antonio; Spina, Vincenzo; M., Fabbi; Madeo, Bruno; A., Baldini; Carani, Cesare
abstract
Sex steroids, particularly estrogens promote bone elongation at puberty and the closure of epiphyseal growth plates. The latter event is under the control of estrogens, while testosterone is not able to determine the epiphyseal closure and the stop of growth.
Even bone accrual and the achievement of peak bone mass are mainly regulated by estrogens in both men and women.
1998
- Differenziazione psicosessuale nell'uomo
[Articolo su rivista]
Coppa, B; Granata, Arm; Rochira, Vincenzo; Madeo, Bruno; Carani, Cesare
abstract
not available
1998
- Ipotiroidismo definitivo dopo alcolizzazione percutanea di adenoma tossico: descrizione di un caso “insolito”
[Abstract in Atti di Convegno]
Katia, Cioni; Antonio, Balestrieri; Rochira, Vincenzo; Madeo, Bruno; Augusto, Baldini; Carani, Cesare
abstract
The case report of a female patient with a Plummer Adenoma who became hypothyroid after PEI is here reported.
1998
- Sexual behavior in a man with aromatase deficiency: role of estrogen on male sexuality
[Abstract in Rivista]
Antonio R. M., Granata; Rochira, Vincenzo; Marco Faustini, Fustini; Monica, Bevini; Madeo, Bruno; Carani, Cesare
abstract
The evaluation of sexual behavior in a man with aromatase deficiency explains the role of estrogen on male sexuality. In particular estrogen are not necessary for gender identity and sexual orientation development.
1997
- A case of hermaphroditism: psychoendocrine pattern
[Abstract in Atti di Convegno]
Antonio R. M., Granata; Daniela, Rebecchi; Raffaella, Mantovani; Rochira, Vincenzo; Beniamino, Coppa; Madeo, Bruno; Carani, Cesare
abstract
Description of psychological and endocrine features of an hermaphrodite