Entity

Time filter

Source Type

San Giovanni Rotondo, Italy

Zini M.,Unita Operativa di Endocrinologia
Rivista Italiana della Medicina di Laboratorio | Year: 2011

There are many risk factors for osteoporosis, such as a sedentary lifestyle, poor sun exposure, tobacco smoking, family history and some medical treatments that cause osteopoenia. The evaluation of pathological fracture risk, related to osteoporosis, is mainly based on computerized bone densitometric analysis. Laboratory tests can be helpful in the diagnosis of osteoporosis secondary to other pathologies and in evaluating bone consumption in order to prevent further mineral loss. In this review we describe the different treatments available to prevent and reduce osteopenia. © Springer 2011. Source


Lamartina L.,University of Rome La Sapienza | Montesano T.,University of Rome La Sapienza | Trulli F.,University of Rome La Sapienza | Attard M.,Cervello | And 10 more authors.
Endocrine | Year: 2015

Papillary thyroid cancer (PTC) patients treated with thyroidectomy and radioiodine remnant ablation (RRA) often have detectable TSH-stimulated thyroglobulin (Tg) levels without localizable disease after primary treatment. To assess the value of repeat stimulated Tg assays in these patients’ follow-up, we retrospectively analyzed 86 cases followed in 5 Italian thyroid-cancer referral centers. We enrolled 86 patients with PTCs treated with total/near-total thyroidectomy plus RRA between January 1,1990 and January 31, 2006. In all cases, the initial postoperative visit revealed stimulated serum Tg ≥1 ng/mL, negative Tg antibodies, and no structural evidence of disease. None received empiric radioiodine therapy. Follow-up (median: 9.6 years) included neck ultrasound and basal Tg assays (yearly) and at least 1 repeat stimulated Tg assay. Of the 86 patients analyzed (initial risk: low 63 %, intermediate 35 %, high 2 %), one (1 %) had ultrasound-detected lymph node disease and persistently elevated stimulated Tg levels at 3 years. In 17 (20 %), imaging findings were consistently negative, but the final stimulated Tg levels was still >1 ng/mL (median 2.07 ng/mL, range 1.02–4.7). The other 68 (80 %) appeared disease-free (persistently negative imaging findings with stimulated Tg levels ≤1 ng/mL). Mean intervals between first and final stimulated Tg assays were similar (5.2 and 4.8 years) in subgroups with versus without Tg normalization. Reclassification as disease-free was significantly more common when initial stimulated Tg levels were indeterminate (<10 ng/mL). In unselected PTC cohorts with incomplete/indeterminate biochemical responses to thyroidectomy and RRA, periodic remeasurement of stimulated Tg allows most patients to be classified as disease-free. © 2015 Springer Science+Business Media New York Source


Durante C.,University of Rome La Sapienza | Montesano T.,University of Rome La Sapienza | Attard M.,Cervello | Torlontano M.,Unita Operativa di Endocrinologia | And 11 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2012

Context: Serum thyroglobulin (Tg) assays are considered fundamental in postoperative surveillance of differentiated thyroid cancer (DTC) patients. However, the postsurgical profile of Tg levels has never been specifically investigated in patients who do not undergo radioiodine remnant ablation (RRA). Objectives: Our objective was to explore the evolution of Tg levels over time in DTC patients treated with total or near-total thyroidectomy without RRA. Design: We retrospectively analyzed 290 consecutively diagnosed cases of low-risk (American Thyroid Association criteria) DTC treated with thyroidectomy alone and followed yearly with neck ultrasonography and serum Tg assays. We compared final Tg values in this group and a matched group of 495 RRA-positive patients. Temporal trends of serial Tg levels were also analyzed in 78 of the RRA-negative patients monitored with a high-sensitivity immunoradiometric assay. Results: After follow-up of 2.5-22 yr (median 5 yr), final Tg levels were undetectable (<1 ng/ml) in 274 of 290 RRA-negative patients (95%) and 492 of 495 RRA-positive controls (99%). In the subset of 78 RRA-negative patients, undetectable Tg levels (<0.2 ng/ml) were recorded in 60% at the first postoperative evaluation (3-12 months) and in 79% after 5 yr. Tg levels increased in the single patient who experienced disease recurrence during the observation period. Conclusion: In most RRA-negative patients, postoperative serum Tg values spontaneously drop to undetectable levels within 5-7 yr after thyroidectomy. Thus, in later phases, Tg assays may be a valuable tool for follow-up even in patients who do not undergo RRA. Copyright © 2012 by The Endocrine Society. Source


Cappa M.,Unita Operativa di Endocrinologia | Bizzarri C.,Unita Operativa di Endocrinologia | Petroni A.,University of Milan | Carta G.,University of Cagliari | And 7 more authors.
Journal of Inherited Metabolic Disease | Year: 2012

X-linked adrenoleukodystrophy is a rare inherited demyelinating disorder characterized by an abnormal accumulation of very long chain fatty acids, mainly hexacosanoic acid (26:0), due to a mutation of the gene encoding for a peroxisomal membrane protein. The only available, and partially effective, therapeutic treatment consists of dietary intake of a 4:1 mixture of triolein and trierucin, called Lorenzo's oil (LO), targeted to inhibit the elongation of docosanoic acid (22:0) to 26:0. In this study we tested whether, besides inhibiting elongation, an enhancement of peroxisomal beta oxidation induced by conjugated linoleic acid (CLA), will improve somatosensory evoked potentials and modify inflammatory markers in adrenoleukodystrophy females carriers. We enrolled five heterozygous women. They received a mixture of LO (40 g/day) with CLA (5 g/day) for 2 months. The therapeutic efficacy was evaluated by the means of plasma levels of 26:0, 26:0/22:0 ratio, modification of cerebrospinal fluid (CSF) inflammatory markers and somatosensory evoked potentials. Changes of fatty acid profile, and in particular CLA incorporation, were also evaluated in CSF and plasma. The results showed that CLA promptly passes the blood brain barrier and the mixture was able to lower both 26:0 and 26:0/22:0 ratio in plasma. The mixture improved somatosensory evoked potentials, which were previously found unchanged or worsened with dietary LO alone, and reduced IL-6 levels in CSF in three out of five patients. Our data suggest that the synergic activity of CLA and LO, by enhancing peroxisomal beta-oxidation and preventing 26:0 formation, improves the somatosensory evoked potentials and reduces neuroinflammation. © The Author(s) 2011. Source


Durante C.,University of Rome La Sapienza | Costante G.,University of Catanzaro | Lucisano G.,Center for Outcomes Research and Clinical Epidemiology | Lucisano G.,University of Bari | And 10 more authors.
JAMA - Journal of the American Medical Association | Year: 2015

IMPORTANCE Detection of asymptomatic thyroid nodules has increased. Consensus is lacking regarding the optimal follow-up of cytologically proven benign lesions and sonographically nonsuspicious nodules. Current guidelines recommend serial ultrasound examinations and reassessment of cytology if significant growth is observed. OBJECTIVE To determine the frequency, magnitude, and factors associated with changes in thyroid nodule size. DESIGN, SETTING, AND PARTICIPANTS Prospective, multicenter, observational study involving 992 consecutive patients with 1 to 4 asymptomatic, sonographically or cytologically benign thyroid nodules. Patients were recruited from 8 hospital-based thyroid-disease referral centers in Italy between 2006 and 2008. Data collected during the first 5 years of follow-up, through January 2013, were analyzed. MAIN OUTCOMES AND MEASURES Baseline nodule growth (primary end point)was assessed with yearly thyroid ultrasound examinations. Size changes were considered significant for growth if an increase of 20%or more was recorded in at least 2 nodule diameters, with a minimum increase of 2 mm. Baseline factors associated with growth were identified. Secondary end points were the sonographic detection of new nodules and the diagnosis of thyroid cancer during follow-up. RESULTS Nodule growth occurred in 153 patients (15.4%[95%CI, 14.3%-16.5%]). One hundred seventy-four of the 1567 original nodules (11.1%[95%CI, 10.3%-11.9%]) increased in size, with a mean 5-year largest diameter increase of 4.9mm(95%CI, 4.2-5.5 mm), from 13.2 mm(95%CI, 12.1-14.2 mm) to 18.1mm(95%CI, 16.7-19.4 mm). Nodule growth was associated with presence of multiple nodules (OR, 2.2 [95%CI 1.4-3.4] for 2 nodules; OR, 3.2 [95%CI, 1.8-5.6 for 3 nodules; and OR, 8.9 [95%CI, 4.4-18.0] for 4 nodules), main nodule volumes larger than 0.2mL (OR, 2.9 [95%CI, 1.7-4.9] for volumes >0.2 to <1mL and OR, 3.0 [95%CI, 1.8-5.1] for volumes≥1 mL), and male sex (OR, 1.7 [95%CI, 1.1-2.6]), whereas an age of 60 years or older was associated with a lower risk of growth than age younger than 45 years (OR, 0.5 [95%CI 0.3-0.9]). In 184 individuals (18.5%[95%CI, 16.4%-20.9%]), nodules shrank spontaneously. Thyroid cancer was diagnosed in 5 original nodules (0.3%[95%CI, 0.0%-0.6%]). Only 2 had grown. An incidental cancer was found at thyroidectomy in a nonvisualized nodule. New nodules developed in 93 patients (9.3%[95%CI, 7.5%-11.1%]), with detection of one cancer. CONCLUSIONS AND RELEVANCE Among patients with asymptomatic, sonographically or cytologically benign thyroid nodules, the majority of nodules exhibited no significant size increase during 5 years of follow-up and thyroid cancer was rare. These findings support consideration of revision of current guideline recommendations for follow-up of asymptomatic thyroid nodules. Copyright © 2015 American Medical Association. All rights reserved. Source

Discover hidden collaborations