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Magri F.,Unit of Internal Medicine and Endocrinology
Current Opinion in Endocrinology, Diabetes and Obesity | Year: 2016

PURPOSE OF REVIEW: Elastography is a novel noninvasive diagnostic tool that is helpful in the evaluation of thyroid nodules. The purpose of this review is to provide a comprehensive summary of the use of elastography in the clinical thyroid setting. RECENT FINDINGS: Initial and subsequent studies show that elastography has both a sensitivity and specificity that approaches 100% for the determination of thyroid cancer within a thyroid nodule. In addition, the technique also has a very high negative predictive value and thus, may also be helpful in identification of thyroid nodules that do not need further diagnostic evaluation, including fine-needle aspiration biopsy. These characteristics also apply to both strain and shear wave elastography. However, as both the extent of tissue compression and the operatorʼs classification of a nodule using a qualitative color code are subjective, intra and interobserver variability is an important reason for some conflicting findings. SUMMARY: Elasticity within a thyroid nodule, as evaluated by elastography, offers diagnostic results that are equal to or sometimes even greater than that of conventional ultrasonography for the determination of thyroid malignancy. The integration of both techniques in the clinical work-up of thyroid nodules can thus significantly improve the accuracy of the diagnosis of thyroid nodules. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. Source

Emanuele E.,University of Pavia | Boso M.,University of Pavia | Cassola F.,Unit of Internal Medicine and Endocrinology | Broglia D.,University of Pavia | And 4 more authors.
Neuroendocrinology Letters | Year: 2010

BACKGROUND: People with autistic spectrum disorder (ASD) are affected by a long-life disabling condition, characterized by communication deficits, severe impairments in social functioning, and stereotyped behaviors. Although ASD individuals display several problems in interactions, it has been reported that they may show a peculiar interest in music. Previous studies have suggested a pivotal role for the dopaminergic system in the psychobiology of reward, including the pleasure of music. DESIGN: In the present study, we sought to investigate dopamine DRD3 and DRD4 receptor expression in peripheral blood lymphocytes of adult healthy musicians and age- and gender-matched patients with ASD against the background hypothesis that the dopaminergic system may contribute a biological cause to the reward dimensions of the musical experience in both healthy and autistic individuals. RESULTS: ANOVA showed significant differences in DRD4 mRNA expression between the groups (P = 0.008). Post-hoc analysis showed significant differences between the control group and both musicians (P < 0.05) and ASD individuals (P < 0.05). No differences were found for DRD3 mRNA expression between the groups. CONCLUSION: Our current results provide intriguing preliminary evidence for a possible molecular link between dopamine DRD4 receptor, music and autism, possibly via mechanisms involving the reward system and the appraisal of emotions. © 2010 Neuroendocrinology Letters. Source

Bellastella G.,The Second University of Naples | Rotondi M.,Unit of Internal Medicine and Endocrinology | Pane E.,The Second University of Naples | Colella C.,The Second University of Naples | And 7 more authors.
Journal of Endocrinological Investigation | Year: 2011

Background: Chemokines play a key role in the recruitment of the immune cells into the autoimmune process. Thus, the simultaneous evaluation of circulating levels of Th1-related chemokines, such as CX chemokine ligand 10 (CXCL10) and macrophage inflammatory proteins 1α (CCL3/MIP-1α), and Th2-related chemokines, such as macrophage inflammatory proteins 1 β (CCL4/MIP-1β) could be useful in the approach to some autoimmune diseases, including autoimmune Addison's disease (AAD). Aim: To evaluate plasmatic levels of MIP-1α, MIP-1β, CXCL10 and adrenocortical antibodies in patients with AAD under treatment with corticosteroids. Patients and methods: Twelve women and 5 men (group 1) were divided-in 2 subgroups: 9 subsjects with isolated AAD (group 1a) and 8 with AAD associated with chronic autoimmune thyroiditis (group 1b). MIP-1α, MIP-1β and CXCL10 were evaluated in the serum of all patients and in 20 healthy controls, using a system for microarray suspension. Results: The levels of MIP-1α, MIP-1β and CXCL10 resulted significantly increased vs controls (p<0.001). An inverse significant correlation between the serum levels of MIP-1β and the duration of the disease was observed. Conclusion: High levels of MIP-1α and MIP-1β associated with increased levels of CXCL10 in AAD seem to indicate a role of these chemokines in the autoimmune pathology of adrenal gland through the recruitment in loco of Th1 and Th2 cells. The simultaneous measurement of Th1-related chemokines (CXCL10 and MIP-1α) and of Th2-related chemokine MIP-1β in the serum of patients with AAD would sustain a novel preliminary hypothesis on the immune microenvironment of chronic autoimmune inflammation within adrenal glands. ©2011, Editrice Kurtis. Source

Segagni D.,Laboratory of System Engineer for Clinical Research | Sacchi L.,University of Pavia | Dagliati A.,University of Pavia | Tibollo V.,Laboratory of System Engineer for Clinical Research | And 5 more authors.
Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS | Year: 2015

To improve the access to medical information is necessary to design and implement integrated informatics techniques aimed to gather data from different and heterogeneous sources. This paper describes the technologies used to integrate data coming from the electronic medical record of the IRCCS Fondazione Maugeri (FSM) hospital of Pavia, Italy, and combines them with administrative, pharmacy drugs purchase coming from the local healthcare agency (ASL) of the Pavia area and environmental open data of the same region. The integration process is focused on data coming from a cohort of one thousand patients diagnosed with Type 2 Diabetes Mellitus (T2DM). Data analysis and temporal data mining techniques have been integrated to enhance the initial dataset allowing the possibility to stratify patients using further information coming from the mined data like behavioral patterns of prescription-related drug purchases and other frequent clinical temporal patterns, through the use of an intuitive dashboard controlled system. © 2015 IEEE. Source

Magri F.,Unit of Internal Medicine and Endocrinology | Chytiris S.,Unit of Internal Medicine and Endocrinology | Capelli V.,Unit of Internal Medicine and Endocrinology | Gaiti M.,Unit of Internal Medicine and Endocrinology | And 6 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2013

Italy Context: Ultrasound (US) elastography (USE) was recently been reported as a sensitive, noninvasive tool for identifying thyroid cancer. However, the accuracy of this technique is hampered by the intra- and interoperator variability, some US features of the nodule, and the coexistence of autoimmune thyroid disease (ATD). Objectives: The purpose of this article was to assess the accuracy of USE findings in the differential diagnosis of thyroid nodules compared with other US features to evaluate its feasibility in the presence of ATDs and identify the strain index (SI) cutoff with the highest diagnostic performance. Design: We evaluated 528 consecutive patients for a total of 661 thyroid nodules. All nodules underwent fine-needle aspiration cytology (FNAC) and USE evaluation. The SI was calculated as a ratio of the nodule strain divided by the strain of the softest part of the surrounding normal tissue. Results: The median SI value was significantly higher in THY4 and THY5 than in THY2 nodules in ATD-positive, ATD-negative, and ATD-unknown patients. The cutoff of SI for malignancy was estimated to be 2.905 by receiver operating characteristic curve analysis in a screening set (379 FNACresults), and then tested in a replication set (252FNACresults). In all cases, a SI value of≥2.905 conferred to the nodule a significantly greater probability of being malignant. This SI cutoff had the greatest area under the curve, sensitivity, and negative predictive value, compared with the conventional US features of malignancy. Conclusion: The elastographic SI has a high sensitivity, specificity, and negative predictive value for the diagnosis of thyroid malignancy both in the presence and in the absence of ATD. If our data on USE are also confirmed in THY3 nodules, FNAC could be avoided in a number of thyroid nodules with certain features. © 2013 by The Endocrine Society. Source

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