Publications by authors named "Antonio Aversa"

151 Publications

Liver Stiffness in Obese Hypothyroid Patients Taking Levothyroxine.

Medicina (Kaunas) 2022 Jul 18;58(7). Epub 2022 Jul 18.

Department of Medical and Surgical Science, University Magna Grecia of Catanzaro, 88100 Catanzaro, Italy.

: Thyroid dysfunction is associated with non-alcoholic fatty liver disease, but its role in the progression of liver damage in obese patients remains unclear. In addition, several case reports have suggested the existence of a levothyroxine-induced liver injury, which has been poorly investigated. Our aim was to verify whether a difference in the prevalence of liver fibrosis exists in a population of obese individuals taking Levothyroxine. : We conducted a cross-sectional study on a population of 137 obese individuals, of which 49 were on replacement therapy with Levothyroxine. We excluded those who had hypertriglyceridemia and diabetes mellitus. All participants underwent a liver stiffness assessment by transient elastography as well as biochemical measurements. In subjects with liver fibrosis, other cause of liver fibrosis were ruled out. : Participants taking Levothyroxine had a higher prevalence of liver fibrosis than those not taking Levothyroxine (30.6% vs. 2.3%; < 0.001), and these results were obtained after we made an adjustment for age (Exp(B) = 18.9; 95% CI = 4.1-87.4; < 0.001). The liver stiffness value differed significantly between groups (6.0 ± 3.6 and 5.1 ± 1.2, = 0.033). Of those subjects taking Levothyroxine, there were no significant differences in the dose of medication (1.21 ± 0.36 vs. 1.07 ± 0.42; = 0.240) and treatment duration (13.7 ± 7.43 vs. 11.13 ± 6.23; = 0.380) between those with and without liver fibrosis. : We found, for the first time, a greater prevalence of liver fibrosis in obese individuals taking Levothyroxine than in those not taking this medication. This finding needs to be confirmed by longitudinal population studies as well as by cellular studies.
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http://dx.doi.org/10.3390/medicina58070946DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9316150PMC
July 2022

Resection of Skull Base Meningioma With Extensive Extracranial Extension: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2022 07 20;23(1):e51. Epub 2022 Apr 20.

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

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http://dx.doi.org/10.1227/ons.0000000000000220DOI Listing
July 2022

Oleuropein Counteracts Both the Proliferation and Migration of Intra- and Extragonadal Seminoma Cells.

Nutrients 2022 May 31;14(11). Epub 2022 May 31.

Department of Experimental and Clinical Medicine, University of Catanzaro "Magna Græcia", 88100 Catanzaro, Italy.

Recent and growing literature has reported that oleuropein (OLE), the main polyphenol in olive leaf extract, inhibits tumor cell proliferation and reduces the invasiveness properties of cancer cells; therefore, OLE may play a significant role in the development of new drugs for cancer treatment. These antineoplastic properties have been reported in many experimental cancer models, but the effect of OLE on seminoma cells is yet to be evaluated. In the present study, we demonstrate, for the first time, that OLE reduces cell viability in both intra- and extragonadal TCAM-2 and SEM-1 seminoma cells, respectively, in a dose-dependent manner. As shown by Western-blot analysis, OLE exposure reduced cyclin-D1 expression and upregulated p21, concomitantly affecting the upstream pathway of NF-κB, leading to the reduction of its nuclear content, thereby suggesting that OLE could modulate cell-cycle regulators by inhibiting NF-κB. Moreover, Annexin V staining revealed that OLE induced apoptosis in cancer cells and upregulated the pro-apoptotic factor BAX. Through wound-healing scratch and transmigration assays, we also demonstrated that OLE significantly reduced the migration and motility of TCAM-2 and SEM-1 cells, and downregulated the expression of TGFβ-1, which is known to be the main pro-fibrotic factor involved in the acquisition of the migratory and invasive properties of cancer cells. Collectively, our results indicate that OLE reduces seminoma cell proliferation, promotes apoptosis, and counteracts cell migration and motility. Further studies are needed to explore the molecular mechanisms underlying these observed effects.
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http://dx.doi.org/10.3390/nu14112323DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9182631PMC
May 2022

Impact of Chemical Endocrine Disruptors and Hormone Modulators on the Endocrine System.

Int J Mol Sci 2022 May 20;23(10). Epub 2022 May 20.

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro" (PROMISE), Section of Endocrinology, University of Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy.

There is growing concern regarding the health and safety issues of endocrine-disrupting chemicals (EDCs). Long-term exposure to EDCs has alarming adverse health effects through both hormone-direct and hormone-indirect pathways. Non-chemical agents, including physical agents such as artificial light, radiation, temperature, and stress exposure, are currently poorly investigated, even though they can seriously affect the endocrine system, by modulation of hormonal action. Several mechanisms have been suggested to explain the interference of EDCs with hormonal activity. However, difficulty in quantifying the exposure, low standardization of studies, and the presence of confounding factors do not allow the establishment of a causal relationship between endocrine disorders and exposure to specific toxic agents. In this review, we focus on recent findings on the effects of EDCs and hormone system modulators on the endocrine system, including the thyroid, parathyroid glands, adrenal steroidogenesis, beta-cell function, and male and female reproductive function.
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http://dx.doi.org/10.3390/ijms23105710DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9145289PMC
May 2022

Physical Examination for Endocrine Diseases: Does It Still Play a Role?

J Clin Med 2022 May 5;11(9). Epub 2022 May 5.

Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.

A physical examination represents a fundamental step in diagnosing diseases. Due to the role that hormones play in the regulation of numerous biological processes in various organs and systems, endocrine diseases cause a variety of clinical manifestations that can be easily identified with a careful physical examination and can guide the clinician to specific diagnoses. Furthermore, the presence of specific clinical signs in various endocrine-metabolic diseases can predict the risk of developing comorbidities and serious adverse events. In this article, we present some of the main clinical signs of endocrine-metabolic diseases and the risk of comorbidities, summarizing the pathogenetic mechanisms that lead to their formation. The aim is to highlight how the identification of these specific signs can reduce the number of dynamic tests and the costs necessary to reach the diagnosis and allow the early identification of any complications associated with these diseases, improving the clinical management of affected patients.
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http://dx.doi.org/10.3390/jcm11092598DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9102568PMC
May 2022

Tadalafil and Steroid Hormones Interactions in Adipose, Bone and Prostate Tissues: Focus on Translational Perspectives.

Int J Mol Sci 2022 Apr 11;23(8). Epub 2022 Apr 11.

Department of Movement, Human and Health Sciences, "Foro Italico" University, 00135 Rome, Italy.

Tadalafil is a selective phosphodiesterase type-5 (PDE5) inhibitor that is approved for the treatment of men with erectile dysfunction (ED) and/or benign prostate hyperplasia (BPH) -associated symptoms. Besides its classical actions on PDE5 within the genitourinary tract, where the specific enzyme expression is maximal, it may exert different systemic effects. This is mainly due to the pleiotropic distribution of PDE5 enzyme throughout the human (and animal) body, where it can exert protective effects in different clinical conditions. Recently, it has been demonstrated that tadalafil may display novel actions on androgen receptor (AR) expression and activity and cytochrome P19a1 (Cyp19a1) and estrogen receptor β (ERβ) expression in different in vitro systems, such as adipose, bone and prostate cancer cells, where it can act as a selective modulator of steroid hormone production. This may determine novel potential mechanism(s) of control in pathophysiologic pathways. In this review, we summarize basic research and translational results applicable to the use of tadalafil in the treatment of obesity, bone loss and prostate cancer.
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http://dx.doi.org/10.3390/ijms23084191DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9024809PMC
April 2022

Surgical Presets of Ruptured Dermoid Cyst Resection: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2022 05;22(5):e217

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

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http://dx.doi.org/10.1227/ons.0000000000000142DOI Listing
May 2022

Beneficial Effects of the Very-Low-Calorie Ketogenic Diet on the Symptoms of Male Accessory Gland Inflammation.

Nutrients 2022 Mar 4;14(5). Epub 2022 Mar 4.

Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.

Obesity exposes individuals to the risk of chronic inflammation of the prostate gland. A longitudinal clinical study was conducted on selected overweight/obese patients with male accessory gland inflammation (MAGI) to evaluate the effects of body weight loss on their urogenital symptoms. One hundred patients were selected and assigned to two groups undergoing two different nutritional programs. The first group ( = 50) started a Mediterranean diet (MedDiet) and the second ( = 50) a very-low-calorie ketogenic diet (VLCKD). Before and after three months on the diet, each patient was evaluated for body weight, waist circumference, and MAGI symptoms. The MAGI was assessed using the Structured Interview about MAGI (SI-MAGI), a questionnaire previously designed to assess the symptoms of MAGI. The questionnaire explores four domains, including urinary symptoms, ejaculatory pain or discomfort, sexual dysfunction, and impaired quality of life. Finally, in the two groups, the frequency of an α-blocker used to treat urinary tract symptoms was also evaluated. Patients on MedDiet experienced significant amelioration in urinary symptoms and quality of life. Patients under VLCKD reported not only significant improvement of the same parameters, but also in ejaculatory pain/discomfort and sexual dysfunction. Finally, the percentage of patients on VLCKD taking the α-blocker decreased significantly. Moreover, patients under VLCKD showed a greater loss of body weight than those following the MedDiet. The results of this study support the effectiveness of VLCKD in improving the symptoms of patients with MAGI. This improvement involved all of the domains of the SI-MAGI questionnaire and became manifest in a relatively short time. We suggest that a ketogenic nutritional approach can be used in overweight/obese patients with MAGI.
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http://dx.doi.org/10.3390/nu14051081DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8912840PMC
March 2022

Early decline of androgen levels in healthy adult men: an effect of aging per se? A prospective cohort study.

Minerva Endocrinol (Torino) 2022 Feb 23. Epub 2022 Feb 23.

Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy -

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http://dx.doi.org/10.23736/S2724-6507.21.03600-9DOI Listing
February 2022

Editorial overview: 'Caring for diabetes in its complexity: From targetable metabolic-organ crosstalk to novel drug interactions'.

Curr Opin Pharmacol 2022 04 15;63:102185. Epub 2022 Feb 15.

Department of Experimental and Clinical Medicine, University of Catanzaro "Magna Græcia", 88100 Catanzaro, Italy. Electronic address:

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http://dx.doi.org/10.1016/j.coph.2022.102185DOI Listing
April 2022

Is Chronic Varicocele a Risk Factor for Secondary Hyperparathyroidism?

J Clin Med 2022 Jan 28;11(3). Epub 2022 Jan 28.

Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.

Objective: To assess whether varicocele affects testicular 25-hydroxylase activity.

Methods: Twenty normozoospermic patients with bilateral varicocele (grade III according to the Dubin and Amelar classification) without indications to undergo varicocele repair (normal sperm parameters and testicular volume; no scrotal pain) were consecutively enrolled and followed-up for four years. Serum levels of parathyroid hormone (PTH), calcium, and 25-hydroxy-cholecalciferol [25(OH)D] along with serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (TT), conventional sperm parameters, sperm DNA fragmentation (SDF) rate, and testicular volume (TV) were measured annually for three years. PTH, calcium, and 25(OH)D serum levels over time were compared with those of age- and body mass index (BMI)-matched control group of twenty varicocelectomized patients.

Main Results: Both intra- and between-group analyses showed that serum PTH levels increased significantly over time in parallel with a significant decline in 25(OH)D levels. Serum calcium levels did not change significantly. At the same time, signs of mild Leydig and Sertoli cell dysfunction were found, such as an increase in gonadotropins and decreased TT and VT. However, conventional sperm parameters and SDF rate did not change significantly.

Conclusion: This prospective controlled study provides the first evidence of a negative impact of bilateral grade III varicocele on testicular 25-hydroxylase activity. Accordingly, the patients included in this study showed a significant increase in PTH and a decrease in 25(OH)D levels over time. Patients with varicocele deserve endocrinologic counseling.
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http://dx.doi.org/10.3390/jcm11030716DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836852PMC
January 2022

Sealing the Box: Microsurgical Repair of Skull Base Encephaloceles: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2022 Apr;22(4):e159-e160

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

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http://dx.doi.org/10.1227/ONS.0000000000000102DOI Listing
April 2022

Effects of Tadalafil on skeletal muscle tissue: exploring interactions and novel mechanisms of action.

Minerva Endocrinol (Torino) 2022 Feb 4. Epub 2022 Feb 4.

Unit of Endocrinology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy.

Beside its mechanical roles in controlling posture and locomotion, skeletal muscle system, the largest insulin and steroid hormones target tissue, plays a key role in influencing thermoregulation, secondary sexual characteristics, hormones metabolism, and glucose uptake and storage, as well as energetic metabolism. Indeed, in addition to insulin, several hormones influence the skeletal muscle metabolism/function and/or are influenced by skeletal muscles activity (i.e., physical exercise). Particularly, steroid hormones play a key role in modulating many biological processes in muscles, essential for overall muscle's function and homeostasis, both at rest and during all physical activities (i.e., physical exercise, muscular work). The phosphodiesterase type 5 (PDE5) is the enzyme engaged to hydrolyze cGMP in inactive 5'- GMP form. Therefore, through the inhibition of this enzyme, the intracellular level of cGMP increases, and the cGMP-related cellular responses are prolonged. Different drugs inhibiting PDE5 (PDE5i) exist, the main of which commercially available are sildenafil, vardenafil, tadalafil, and avanafil. The PDE5i tadalafil may influence cellular physiology and endocrine-metabolic pathways in skeletal muscles and exerts its functions both by activating the cell signaling linked to the insulin-related metabolic pathways and modulating the endocrine responses, protein catabolism and hormone-related anabolism/catabolism during and after physical exercise-related stress. Based on recent in vivo and in vitro findings, in this narrative review we summarized the available evidence describing the interactions between the PDE5i tadalafil and steroid hormones in skeletal muscle tissue and physical exercise adaptation, focusing our interest on their possible synergistic or competitive action(s) on muscle metabolism and function.
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http://dx.doi.org/10.23736/S2724-6507.21.03698-8DOI Listing
February 2022

Predicting the response to SGLT-2 inhibitors as add-on therapy to multiple day injection insulin with glycated albumin: a pilot study.

Minerva Endocrinol (Torino) 2022 Feb 1. Epub 2022 Feb 1.

Department of Experimental and Clinical Medicine, University Magna Græcia, Catanzaro, Italy.

Background: Achieving optimal glycemic targets is the main therapeutic goal in patients with type 2 diabetes (T2D) mellitus. HbA1c is the reference biomarker for monitoring glycemic control, but in specific conditions affecting erythrocyte turnover or in patients on multiple daily injection (MDI) insulin regimens, the determination of glycated albumin (GA) may be preferable. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors represent a novel class of antidiabetic drugs that lower plasma glucose concentrations quickly, with insulin-independent mechanisms. Herein, we explored the role of GA in predicting the short-term response to SGLT-2 inhibitors as add-on to MDI insulin.

Methods: Sixteen patients with long-standing, poorly controlled T2D on MDI insulin starting an SGLT-2 inhibitor were subjected to plasma GA and HbA1c measurements at 30 days intervals for up to 3 months in order to examine the temporal changes of these glycemic biomarkers.

Results: At the end of the study, grossly coincident with the life span of erythrocytes, a significant decrease in median HbA1c was observed, [from 8.7 (range 8.2-9.3) % at baseline to 7.2 (range 7.0-7.9) %], with the advantage of less insulin dose requirements. However, significant, and incremental reductions in median GA determinations could be already evident after 30 days [-3.5 (range -7.5, -2.5) %] and 60 days [-6.4 (range -10.5, -4.7) %] from the start of SGLT-2 inhibitor treatment and persisted for up to 3 months [-8.6 (range -12.1, 6.1) %]. The decrements of HbA1c observed at the 3-month visit were highly correlated with the concurrent absolute reductions of plasma GA (ρ=0.550, p=0.027), whereas a borderline significance could be demonstrated with reference to reductions in plasma GA at 30 and 60 days.

Conclusions: Although limited by the small number of participants, these preliminary findings suggest that GA, rather than HbA1c, could represent a useful and reliable biomarker in T2D to monitor the early glucose-lowering effects of antidiabetic drugs with rapid onset of action, such as SGLT-2 inhibitors and MDI insulin.
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http://dx.doi.org/10.23736/S2724-6507.22.03691-0DOI Listing
February 2022

The Utilization of the Cranio-Orbital Zygomatic Approach for the Resection of Juvenile Nasopharyngeal Angiofibroma: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2022 Jan;22(1):e44-e45

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Juvenile angiofibroma is a rare benign expansive lesion typically affecting young men. Surgery is the current mainstay of treatment. Because it is a very vascular lesion, preoperative transarterial embolization can decrease intraoperative bleeding.1,2 Transmaxillary or transpalatal approaches were used for totally extracranial lesions. Endonasal endoscopic resection became wildly used for radical excision with limited morbidity.2 In large lesions with intracranial extension and cavernous sinus involvement (Fisch type 4), purely anterior approaches (endoscopic or transmaxillary) can be associated with significant carotid artery and cranial nerves injuries and excessive hemorrhage from internal carotid artery supply that cannot be eliminated by preoperative embolization.3 Subtotal resection has been preconized in such cases, but tumor progression, cranial nerves and vision compromise, and major nasal postoperative bleeding could ensue. Radiotherapy of residual tumor has been associated with long-term complications, particularly given the young age of these patients.2 The cranio-orbital zygomatic approach provides an excellent exposure to the extensions into the middle fossa, anterior fossa, cavernous sinus, paranasal sinus, and infratemporal fossa components of large angiofibromas.4-6 It is particularly advantageous in the early interruption of the cavernous carotid feeders that are not amenable to safe embolization, rendering the tumor devascularized and bloodlessly resected. This article demonstrates the details and the advantages of this approach in a 13-year-old adolescent boy operated in 1997 for giant juvenile angiofibroma with extension in the middle fossa and the parasellar space with major vascularization from the cavernous carotid artery. The guardian consented to the procedure and publication of images. Image at 3:05 reprinted with permission from Al-Mefty O, Operative Atlas of Meningiomas. Vol 1, © LWW, 1998. Image at 3:25 from Arnautović KI, Al-Mefty O, Angtuaco E. A combined microsurgical skull-base and endovascular approach to giant and large paraclinoid aneurysms. Surg Neurol. 1998;50(6):504-520; © Elsevier, 1998. Used with permission. Image at 9:21 reprinted from Kempe LG and Krekorian EA,6 with permission from John Wiley and Sons, © 1969 The Triological Society.
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http://dx.doi.org/10.1227/ONS.0000000000000008DOI Listing
January 2022

Impact of seminal low-risk human papillomavirus infection on sperm parameters of adult men.

Aging Male 2022 Dec;25(1):17-22

Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.

We aimed to evaluate the impact of seminal low-risk human Papillomavirus (LR-HPV) infection on sperm conventional parameters. This was a retrospective case-control study including patients attending to our center for infertility. Patients with evidence for high risk (HR)-HPV infection previously or at the time of enrollment, and/or with severe oligozoospermia (sperm concentration <5 mil/ml) were ruled out. Twenty selected patients positive for a LR-HPV and 20 control subjects with no evidence of HPV DNA and with available results of sperm analysis were consecutively enrolled. Patients positive for LR-HPV had a mean age of 31.0 + 11.0 years, while controls were 35.0 + 8.0-year-old (p > .05). Sperm concentration, total sperm count, sperm progressive motility, morphology, and leukocyte concentration did not differ between patients and controls. However, the prevalence of oligozoospermia was significantly higher in patients than controls (50% vs. 15%). No difference in the prevalence of astenozoospermia (30% vs. 40%) or teratozoospermia (15% vs. 15%) was found. We found no difference in sperm conventional parameters in LR-HPV infected patients than in controls. These data might prompt to research the impact on LR-HPV genotype on male fertility. Particularly, evidence on sperm DNA fragmentation (SDF) and pregnancy outcome is needed.
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http://dx.doi.org/10.1080/13685538.2021.2023126DOI Listing
December 2022

Low-intensity shockwave treatment (liswt) improves penile rigidity in eugonadal subjects with erectile dysfunction: a pilot study.

Minerva Endocrinol (Torino) 2021 Dec 21. Epub 2021 Dec 21.

Endocrinology, Diabetology and Andrology Unit, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milano, Italy.

Background: Since low-intensity shockwave treatment (LISWT) has putative effects on penile hemodynamics remodeling, the aim of this study was to evaluate any improvement of penile vascular flows after LISWT treatment in patients with erectile dysfunction (ED) and poor response to PDE5i.

Methods: Twenty-one eugonadal patients with different ED severity underwent six weekly LISWT sessions (1500-4000 pulses) after 2 weeks withdrawal from PDE5i assumption. Once daily Tadalafil (2.5 mg daily) was reintroduced 4 weeks apart from LISWT termination and patients were evaluated at 1, 2 and 6 months follow-up (T1, T2, T6) by the International Index of Erectile Function-15 items questionnaire (IIEF-15) erectile function (EF) domain, Erection Hardness Score (EHS) and Global Assessment Questionnaires (GAQ). Basal Penile Color-Doppler Ultrasound parameters in the flaccid state (B-PCDU) were evaluated before, during and after interventional protocol.

Results: Mean EHS score improved in 35% of patients at T1, and in up to 50 % of patients at T2 and T6 follow-up visits (p<0.05). We found 25% improvement of EF scores at T1 session, 43.75% at T2 and 62.5% at T6, respectively (p<0.05). No statistically significant differences in flow parameters, EF-domain and testosterone levels were found when baseline and last observation carried forward (LOCF) parameters were compared. The GAQ questionnaire scored higher satisfaction rates either at the end of the treatment (100%), or at LOCF (92.5%).

Conclusions: Despite the study limitations with respect to B-PCDU in this setting, our results confirm a trend toward improvement of erectile questionnaire scores after LISWT with higher overall satisfaction rates among patients with ED. We conclude that LISWT may be an effective option in some difficult-to-treat patients with ED by improving the erectile response to PDE5i.
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http://dx.doi.org/10.23736/S2724-6507.21.03686-1DOI Listing
December 2021

The Scent of Monogamy: Self-Reported Olfactory Function Predicts Sexual Well-Being and Infidelity in an Italian Population.

Arch Sex Behav 2022 Aug 17;51(6):2879-2889. Epub 2021 Nov 17.

Department of Medical and Surgical Sciences, Università degli Studi "Magna Græcia" di Catanzaro, Catanzaro, Italy.

Previous studies have shown that olfactory function plays an essential role in the bonding of a romantic relationship. Body odors, in particular, seem involved in both mate choices and other intimate behaviors. Our sense of smell is also crucial to detect possible pathogen threats, by activating a suitable disgust reaction. Previous studies have shown that disgust sensitivity is negatively related to sociosexuality, and disgust generally inhibits our sexual drive. In the present study, we explored the possible relation between olfactory function, pathogen disgust sensitivity, sociosexuality, sexual well-being, and infidelity through a web survey. Our exploratory analyses found that, in a large Italian sample (N = 1107), among those in a stable relationship, self-reported olfactory function predicted sexual well-being (p < .05) and negatively predicted infidelity (p < .05) when controlling for other relevant sociodemographics variables. Moreover, the relation between self-reported olfactory function and sexual well-being was mediated by pathogen disgust sensitivity. Although significant, these results must be interpreted with caution, because the effect sizes were small.
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http://dx.doi.org/10.1007/s10508-021-02109-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8597879PMC
August 2022

Insulin Resistance and Cancer: In Search for a Causal Link.

Int J Mol Sci 2021 Oct 15;22(20). Epub 2021 Oct 15.

Department of Health Sciences, University of "Magna Græcia" Catanzaro, 88100 Catanzaro, Italy.

Insulin resistance (IR) is a condition which refers to individuals whose cells and tissues become insensitive to the peptide hormone, insulin. Over the recent years, a wealth of data has made it clear that a synergistic relationship exists between IR, type 2 diabetes mellitus, and cancer. Although the underlying mechanism(s) for this association remain unclear, it is well established that hyperinsulinemia, a hallmark of IR, may play a role in tumorigenesis. On the other hand, IR is strongly associated with visceral adiposity dysfunction and systemic inflammation, two conditions which favor the establishment of a pro-tumorigenic environment. Similarly, epigenetic modifications, such as DNA methylation, histone modifications, and non-coding RNA, in IR states, have been often associated with tumorigenesis in numerous types of human cancer. In addition to these observations, it is also broadly accepted that gut microbiota may play an intriguing role in the development of IR-related diseases, including type 2 diabetes and cancer, whereas potential chemopreventive properties have been attributed to some of the most commonly used antidiabetic medications. Herein we provide a concise overview of the most recent literature in this field and discuss how different but interrelated molecular pathways may impact on tumor development.
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http://dx.doi.org/10.3390/ijms222011137DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540232PMC
October 2021

The Socio-Sexual Experiences in Southern Italians during the COVID-19 Pandemic: A Clustering Analysis.

Psychiatr Danub 2021 Sep;33(Suppl 9):169-171

Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy.

The COVID-19 outbreak has dramatically impacted on socioeconomic structure, individual freedom, general wellbeing, psychological health and sexuality. Indeed, social distancing, home confinement and the fear of contagion have reduced the possibility of romantic encounters thus influencing sexual activity, desire and behavior and, consequently, modifying socio-sexual experiences. The aim of this study is to examine sociosexuality and sociosexual experiences in southern Italians during the COVID-19 pandemic.
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September 2021

Effects of Selenium Supplementation on Sperm Parameters and DNA-Fragmentation Rate in Patients with Chronic Autoimmune Thyroiditis.

J Clin Med 2021 Aug 23;10(16). Epub 2021 Aug 23.

Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.

Background: Selenium (Se) is an essential component of selenoenzymes, which have catalytic and antioxidant functions. A low Se status has been reported in patients with chronic autoimmune thyroiditis (AT) who benefit from Se supplementation. The role of Se in male reproduction is still a matter of debate. Although Se and selenoenzymes ensure sperm viability and protect against increased oxidative stress, only a few studies have assessed the effects of the administration of Se alone on sperm parameters, providing contrasting results.

Aim: The aim of this study was to assess the effects of oral Se supplementation on conventional sperm parameters and DNA fragmentation (SDF) in patients with AT of reproductive age with normal thyroid function.

Patients And Methods: Only patients with AT and normal thyroid function were selected for this study. All included patients underwent oral Se supplementation at the dose of 83 µg once daily (Syrel, IBSA) for six months. Sperm conventional parameters, SDF, and thyroid function were assessed before and at the end of the treatment.

Results: Twenty AT patients with normal weight were enrolled. After Se supplementation, they showed a higher sperm concentration, a higher percentage of sperm with progressive motility, and a higher percentage with normal morphology. They also had lower semen leukocyte concentration, and a lower percentage of spermatozoa with DNA fragmentation compared with pre-treatment values. Free-thyroxine serum levels increased significantly, whereas free triiodothyronine showed an upward trend. The thyroid-stimulating hormone did not change significantly.

Conclusion: Se supplementation may represent a possible non-hormonal therapeutic choice for the treatment of male infertility, although further studies are needed to confirm this evidence. The possible thyroid hormone dependency of these findings needs to be clarified.
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http://dx.doi.org/10.3390/jcm10163755DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397047PMC
August 2021

Simpson Grade I Resection of Type II Clinoidal Meningioma Through Cranio-orbital Zygomatic Approach: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2021 10;21(5):E433-E434

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Clinoidal meningiomas have been considered as a separate entity with distinguishing clinical, radiological, and surgical considerations.1-2 Surgical mortality and morbidity associated with anterior clinoidal meningiomas has remained high in the past, with radical resection considered unattainable.3 However, the extent of surgical removal is clearly the most determining factor in tumor recurrence and progression. Clinoidal meningiomas have been classified into 3 types according to their origin from the dura surface of the anterior clinoid and subsequent arachnoidal rearrangement around the parasellar neurovascular structures.1 In type II, there is an arachnoidal plane that allows the tumor dissection from the encased carotid artery and its branches and the optic nerve. In this type, the involvement of the cavernous sinus is limited to the external wall, which can also be removed. Hence, these tumors are amenable to Simpson grade I resection (tumor, dura, and bone). Approaching through the multidirectional axis provided by the cranio-orbital zygomatic approach allows safe exposure of the tumor and vascular control.4-5 Proximal carotid control is obtained in the petrous carotid canal, the invaded anterior clinoid is removed by and large extradurally, and the Sylvian fissure is split wide open to establish dissecting planes with the middle cerebral artery branches. The optic canal is opened, and tumor extension is removed.6 The invaded outer wall of the cavernous sinus and superior orbital fissure is removed. We demonstrate this technique in a 48-yr-old patient who consented for surgery and publication of images. All images at 2:27, center and right images at 2:46, and all images at 2:58, reused with permission from LWW, from Al-Mefty, Operative Atlas of Meningiomas. Left image at 2:46 reprinted from Surg Neurol, Vol 60/issue 6, Arnautović KI, Al-Mefty O, Angtuaco E, A combined microsurgical skull-base and endovascular approach to giant and large paraclinoid aneurysms, pp. 504-520, Copyright 1998, with permission from Elsevier. Image at 8:21 reprinted from Al-Mefty,1 Clinoidal meningiomas, by permission from JNSPG.
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http://dx.doi.org/10.1093/ons/opab270DOI Listing
October 2021

The Use of Penile Traction Devices for Peyronie's Disease: Position Statements from the European Society for Sexual Medicine.

Sex Med 2021 Aug 15;9(4):100387. Epub 2021 Jul 15.

Departamento de Urología, Hospital Universitario HM Montepríncipe, HM Hospitales. Universidad San Pablo-CEU, Madrid, Spain; Departamento de Urología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain. Electronic address:

Introduction: Penile traction therapy (PTT) aims to non-surgically reduce curvature, enhance girth, and recover lost length. Available clinical practice guidelines however lack clear recommendations regarding their use.

Aim: To present a comprehensive review and recommendation regarding the available evidence to the use of PTT in Peyronie's disease (PD).

Methods: A systematic literature search was performed on Pubmed and Medline for relevant studies from all times until 2019. Studies of PTT (monotherapy and in combination) in patients with PD with any documented degree of curvature and in either the acute or chronic phase of the disease were included. Full texts not published in English language were excluded.

Main Outcomes Measures: Several scenarios, including preclinical data have been investigated. For each topic covered evidence was analyzed and expert opinion was stated.

Results: The paucity of high-level studies precluded any strong recommendations, however, specific statements on this topic, summarizing the ESSM position, were provided. The available data about the use of PTT in PD are still poor, and the impact of this therapy for the treatment of PD has not been clearly stablished. Available data in the clinical setting are still poor, and the impact of these devices on PD evolution has not been clearly established.

Conclusion: PTT seems to be a valid treatment option for PD, although there is not enough evidence to give any definitive recommendation in any clinical scenario. García-Gómez B, Aversa A, Alonso-Isa M et al. The Use of Penile Traction Devices for Peyronie's Disease: Position Statements from the European Society for Sexual Medicine. Sex Med 2021;9:100387.
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http://dx.doi.org/10.1016/j.esxm.2021.100387DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8360933PMC
August 2021

The Burden of Hormonal Disorders: A Worldwide Overview With a Particular Look in Italy.

Front Endocrinol (Lausanne) 2021 16;12:694325. Epub 2021 Jun 16.

Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.

Endocrine diseases have a considerable impact on public health from an epidemiological point of view and because they may cause long-term disability, alteration of the quality-of-life of the affected patients, and are the fifth leading cause of death. In this extensive review of the literature, we have evaluated the prevalence of the different disorders of endocrine interest in the world and Italy, highlighting their epidemiological, clinical, and economic impact.
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http://dx.doi.org/10.3389/fendo.2021.694325DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8242938PMC
February 2022

Overexpression of p75 in Human Seminoma: A New Biomarker?

Life (Basel) 2021 Jun 29;11(7). Epub 2021 Jun 29.

Department of Experimental and Clinical Medicine, University "Magna Græcia", 88100 Catanzaro, Italy.

Several studies have demonstrated that the p75 low-affinity receptor of Nerve Growth Factor (NGF), is produced in abnormally large amounts in several human cancer types. However, the role of p75 varies substantially depending on cell context, so that a dual role of this receptor protein in tumor cell survival and invasion, as well as cell death, has been supported in recent studies. Herein we explored for the first time the expression of p75 in human specimens (nr = 40) from testicular germ cell tumors (TGCTs), mostly seminomas. Nuclear overexpression of p75 was detected by immunohistochemistry in seminoma tissue as compared to normal tissue, whereas neither NGF nor its high-affinity TrkA receptor was detected. An increased nuclear staining of phospho-JNK, belonging to the p75 signaling pathway and its pro-apoptotic target gene, p53, was concomitantly observed. Interestingly, our analysis revealed that decreased expression frequency of p75, p-JNK and p53 was related to staging progression, thus suggesting that p75 may represent a specific marker for seminoma and staging in TGCTs.
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http://dx.doi.org/10.3390/life11070629DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303822PMC
June 2021

Retrospective Monocentric Clinical Study on Male Infertility: Comparison between Two Different Therapeutic Schemes Using Follicle-Stimulating Hormone.

J Clin Med 2021 Jun 17;10(12). Epub 2021 Jun 17.

Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.

Follicle-stimulating hormone (FSH) is a therapeutic option in patients with idiopathic oligozoospermia and normal FSH serum levels. However, few studies have evaluated which dose of FSH is more effective. The aim of this study was to compare the clinical efficacy of the two most frequently used FSH treatment regimens: 75 IU daily vs. 150 IU three times a week. Patients were retrospectively assigned to two groups. The first group ( = 24) was prescribed highly purified FSH (hpFSH) 75 IU/daily (Group A), and the second group ( = 24) was prescribed hpFSH 150 IU three times a week (Group B) for three months. Before and after treatment, each patient underwent semen analysis, evaluation of the percentage of DNA-fragmented spermatozoa, assessment of testicular volume (by ultrasonography), and measurement of FSH and total testosterone (TT) serum levels. Treatment with hpFSH significantly improved conventional sperm parameters. In detail, sperm concentration increased significantly after treatment only in Group A, whereas total sperm count, percentage of spermatozoa with progressive motility, normal morphology, or alive improved significantly in both groups. Interestingly, the percentage of sperm DNA fragmentation decreased significantly in both groups after treatment with hpFSH. FSH serum levels were expectably higher at the end of the treatment than before hpFSH was administered to both groups. Remarkably, TT serum levels only increased significantly in Group A. Finally, testicular volume was significantly higher in Group A after treatment, while it did not change significantly compared to baseline in Group B. The percentage of FSH responders did not differ significantly between the two groups (8/24 vs. 6/24). The daily administration of hpFSH 75 IU seems more effective than using 150 IU three times a week. However, this therapeutic scheme implies a higher number of injections and slightly higher costs.
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http://dx.doi.org/10.3390/jcm10122665DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233778PMC
June 2021

Influence of 25-hydroxy-cholecalciferol levels on SARS-CoV-2 infection and COVID-19 severity: A systematic review and meta-analysis.

EClinicalMedicine 2021 Jul 18;37:100967. Epub 2021 Jun 18.

Department of Clinical and Experimental Medicine, University of Catania, via S. Sofia 78, Catania 95123, Italy.

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiological agent of coronavirus disease 19 (COVID-19), a respiratory infection that, starting from December 2019, has spread around the world in a few months, becoming a pandemic. The lack of initial knowledge on its management has led to a great effort in developing vaccines and in finding therapeutic weapons capable of improving the clinical outcome of the affected patients. In particular, the possible role of vitamin D status in the management of COVID-19 has been widely analysed, resulting in a great amount of data. This systematic review and meta-analysis aimed to assess whether hypovitaminosis D is a risk factor for developing SARS-CoV-2 infection and whether it affects the worsening of the clinical course of COVID-19.

Methods: Data were extracted through extensive searches in the Pubmed, MEDLINE, Cochrane, Academic One Files, Google Scholar, and Scopus databases from December 2019 to January 2021, using the keywords: "Vitamin D", "25 hydroxy Vitamin D", "25 hydroxycholecalciferol", "cholecalciferol", "COVID 19″, "SARS-CoV-2″. We included observational cohort, cross-sectional, and case-control studies that evaluated differences in serum levels of 25‑hydroxy-cholecalciferol [25(OH)D] in patients who were positive or negative for SARS-CoV-2, in patients with mild or severe forms of COVID-19, and in patients who died or were discharged from the hospital. Finally, studies that evaluated the risk of developing severe illness or death in patients with vitamin D deficiency (VDD), defined as levels of 25(OH) <20 ng/ml, were also included. We calculated the mean difference (MD) and the 95% confidence intervals (CI) for quantitative variables such as 25(OH)D levels in patients with or without SARS-CoV-2 infection, in those with mild vs. severe COVID-19, or those who have died vs. those who have been discharged. Instead, we calculated odds ratios and 95% CI for qualitative ones, such as the number of patients with severe illness/death in the presence of VDD vs. those with normal serum 25(OH)D levels. A p-value lower than 0.05 was considered statistically significant. The study was registered on PROSPERO (CRD42021241473).

Findings: Out of 662 records, 30 articles met inclusion criteria and, therefore, were included in the meta-analysis We found that the serum levels of 25(OH)D were significantly lower in patients with SARS-CoV-2 infection than in negative ones [MD -3.99 (-5.34, -2.64);  <0.00001; I= 95%]. Furthermore, its levels were significantly lower in patients with severe disease [MD -6.88 (-9.74, -4.03); <0.00001; I=98%] and in those who died of COVID-19 [MD -8.01 (-12.50, -3.51);  = 0.0005; I=86%]. Finally, patients with VDD had an increased risk of developing severe disease [OR 4.58 (2.24, 9.35); <0.0001; I=84%] but not a fatal outcome [OR 4.92 (0.83, 29.31);  = 0.08; I=94%].

Interpretation: This meta-analysis revealed a large heterogeneity of the studies included due to the different enrolment criteria of patient samples (age, body mass index, ethnicity, comorbidities), the country where they live, all factors influencing serum 25(OH)D levels, and the different criteria used to define the severity of COVID-19. Furthermore, the observational nature of these studies does not allow to establish a cause-effect relationship, even taking into account that 25(OH)D represents a marker of acute inflammation. Treatment with vitamin D might be considered for the primary prevention of SARS-CoV-2 infection and the management of patients with COVID-19. However, further intervention studies are needed to prove this hypothesis.
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http://dx.doi.org/10.1016/j.eclinm.2021.100967DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8215557PMC
July 2021

Aggressive Radiation-Induced Cavernous Sinus Meningioma: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2021 08;21(3):E231-E232

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Radiation-induced meningiomas are the most common radiation-induced neoplasms. They exhibit a distinct aggressive clinical behavior as rapid growth, recurrences, multiplicity, and malignant progression are common features.1-4 Atypical histological findings and aberrant cytogenetics are increasingly identified.5-7 Radical resection of aggressive radiation-induced meningiomas is the best treatment option and would offer the best chance for control of the disease. Wide bone and dural margins should be pursued in the resection. Parasellar extension creates significant surgical challenges. Cavernous sinus exploration through the multidirectional axis provided by the cranioorbital zygomatic approach allows radical resection of the tumor, cranial nerve decompression, and carotid artery preservation and control.8-11 This article describes a cavernous sinus radiation-induced meningioma after radiation for Cushing disease. It demonstrates the details of the extra- and intradural exploration and dissection of the neurovascular structures in the cavernous sinus, with proximal and distal control of the carotid artery. However, even after radical resection, recurrence is a common finding in this malignant behavioral radiation-induced tumor. Patient consented for surgery. Image at 9:41 comes from the Science Museum Group, United Kingdom. Refer to the Wellcome blog post (archive). This image is licensed under the CC-BY 4.0 International license.
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http://dx.doi.org/10.1093/ons/opab195DOI Listing
August 2021

The penile duplex ultrasound: How and when to perform it?

Andrology 2021 09 27;9(5):1457-1466. Epub 2021 May 27.

Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.

Background: Because it is a superficial structure, the penis is ideally suited to ultrasound imaging. A number of disease processes, including Peyronie's disease, penile fractures and tumors, are clearly visualized with ultrasound. Baseline and dynamic assessment of cavernosal arterial changes after pharmaco-stimulation with alprostadil allows standardized diagnosis of arterial and venogenic causes of erectile dysfunction (ED).

Objective: To illustrate how to correctly perform flaccid and dynamic penile duplex ultrasound (D-PDU) and in which patients to recommend it.

Materials/methods: An extensive search of the literature was carried out on Pubmed with the insertion of the following Medical Subjects Headings (MeSH) terms and keywords "penile color Doppler ultrasound" "peak systolic velocity" "end-diastolic velocity", "acceleration time", "resistance index".

Evidence: In our experience, arterial erectile dysfunction is identified after standardized intracavernous injection (ICI) of alprostadil (10 mcg) when values of peak systolic velocity (PSV) are <35 cm/s and, in the most severe forms, for values <25 cm/s. Arterial insufficiency can also be identified by increased acceleration time (AT) values (>110 ms) and/or by a lack of visualization of helicine arteries at power Doppler mode along with incomplete achievement of penile rigidity. The veno-occlusive incompetence is determined when end-diastolic velocity (EDV) values are >4.5-5 cm/s or in the case of resistance index (RI) values <0.75. The assessment of additional surrogate markers of endothelial dysfunction, that is, intima-media thickness, mean platelet volume (MPV), endothelial progenitor cells (EPC), endothelial cell specific molecule-1(endocan) are also useful in assessing the patient's cardiovascular risk but are still considered investigational in the interpretation of D-PDU results.

Conclusion: D-PDU scan after ICI with vasoactive drugs is a safe procedure and represents the gold standard for the diagnostics of penile pathologies and should be performed in men with ED not responding to oral conventional therapies and/or in those requiring accurate stratification of cardiovascular risk.
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September 2021
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