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January 2000 - August 2015
Publications
Publications (430)
The number of adrenal incidentaloma (AI) cases has increased in the last few years due to the widespread use of imaging diagnostics. Management requires evaluation of the malignant nature and hormonal activity. The aim of the present study is to assess possible clinical abnormalities in 132 AI patients both at baseline and during follow-up (mean 48...
Myocarditis is an inflammatory disease of the myocardium caused by infectious and noninfectious agents. Clinical manifestations range from mildly symptomatic forms to acute heart failure, cardiogenic shock, life-threatening arrhythmias and sudden death. Myocarditis is still a challenging diagnosis because of its wide variability in clinical present...
Background
The aim of this study was to investigate the association between peri‐implant diseases and systemic inflammation assessed by serum C‐reactive protein (CRP) levels in a sample of patients with hypertension.
Methods
A total of 151 participants with hypertension were included in a cross‐sectional study. The population was divided into six...
Objective
Hypertension is relevant cardiovascular comorbidity. Adipose tissue represents a metabolically active tissue involved in the regulation of blood pressure and metabolic alterations. In recent decades several classifications for the Metabolic Syndrome (MS) have been proposed. Recently, a new syndrome called “Cardiovascular-kidney-metabolic”...
Transient or persistent immunosuppression is a known risk factor for morbidity and mortality in critically ill patients. Aim of the present study is to evaluate the lymphopenia in patients admitted to the Emergency Unit of AOU Policlinico Umberto I, to investigate its prevalence at admission and the persistence during hospitalization until discharg...
Introduction
Hypertension is a relevant cardiovascular comorbidity. Adipose tissue represents a metabolically active tissue involved in the regulation of blood pressure and metabolic alterations. In recent decades, several classifications for the metabolic syndrome (MS) have been proposed. Recently, a new syndrome called the “Cardiovascular-kidney-...
Surgery is the treatment of choice for adrenocortical carcinoma (stage I–III). In recent years, many authors demonstrated the safety and feasibility of minimally invasive approaches when applied to highly selected cases. The aim of the present study is to provide an overview about technical details and surgical and oncological outcomes of robotic a...
Covid-19 infection is characterized by several acute complications, as well long-term sequelae, mostly sustained by endothelial dysfunction; several studies show that complications as pulmonary embolism (PE) are described both in the acute phase and after negativization. Aim of research was to evaluate anthropometric, bio-humoral, instrumental para...
Objective:
SARS-CoV-2 causes acute respiratory disease, interstitial and alveolar pneumonia, and involves numerous organs and systems such as the kidney, heart, digestive tract, blood, and nervous system. We aimed to evaluate the incidence of renal manifestations in patients diagnosed with COVID-19 infection.
Patients and methods:
We performed a...
Objective
Posterior reversible encephalopathy syndrome (PRES) is a reversible subcortical vasogenic cerebral oedema involving parieto-occipital regions in patients with acute neurological symptoms. The aim of this study is to analyse an interesting case of PRES after heart transplant.
Design and method
A heart transplant was performed in a 53-year...
Objective
The aim of the study was to evaluate the changes in eGFR in patients with idiopathic primary aldosteronism (IHA) and with aldosterone-secreting adenoma (APA) after specific therapy.
Design and method
From January 2018 to March 2022, we consecutively enrolled 99 patients with PA distinguishing 75 with IHA (mean age 53.41±11.97 years) and...
Objective
The aim of the study was to evaluate a possible relationship between plasma metanephrine concentrations and some surrogate parameters of cardio-metabolic damage such as carotid intima media thickness (IMT), cardiac left ventricular mass (LVM) and left ventricular hypertrophy (LVH) in patients with essential hypertension (EH).
Design and...
Objective
Pulmonary embolism (PE) is a potentially life-threatening disorder. Beyond its usefulness in the prognostic stratification of heart failure, sST2 can represent a biomarker with high utility in several acute conditions. Our study was aimed to investigate whether sST2 can be used as a clinical marker of severity and prognostic outcome in ac...
Background:
The present study was conducted to evaluate the impact of enhanced recovery after surgery (ERAS) pathway in patients undergoing laparoscopic adrenalectomy (LA) for primary and secondary adrenal disease, in reducing the length of primary hospital stay and return to daily activities.
Materials and methods:
This retrospective study was...
Objective:
In this study, we aimed to evaluate the kidney involvement assessed by estimated glomerular filtration rate (eGFR), the associations with specific clinical disease variables and laboratory findings, and the predictive role of eGFR on clinical outcomes of patients admitted with COVID-19 in Internal Medicine ward in the first wave.
Patie...
Pulmonary embolism (PE) is a potentially life-threatening disorder. Beyond its usefulness in the prognostic stratification of heart failure, sST2 can represent a biomarker with high utility in several acute conditions. Our study was aimed to investigate whether sST2 can be used as a clinical marker of severity and prognostic outcome in acute PE. We...
Objective:
COVID-19 clinical presentation ranges from asymptomatic infection to an inflammatory cytokine storm with multi-organ failure and fatal outcomes. The identification of high-risk patients for severe disease is crucial to plan an early treatment and intensive follow-up. We aimed to investigate negative prognostic factors in a group of pati...
Arterial hypertension (AH) and periodontitis are among the most common non-communicable chronic diseases worldwide. Besides sharing common risk factors, an increasing body of evidence supports an independent association between the two conditions, with low-grade systemic inflammation acting as the plausible biological link with increased cardiovasc...
This article is protected by copyright. All rights reserved. 2 One sentence summary: Observational data from this study suggest that inflammation at the gingival and peri-implant mucosal level is associated in a linear fashion with c-IMT values independently of traditional cardiovascular risk factors. Abstract Background: The aim of this cross-sect...
Background:
The aim of this cross-sectional study was to investigate the association between carotid intima-media thickness (c-IMT) values and periodontal and peri-implant diseases in a sample of patients with hypertension.
Methods:
A total of 151 participants with presence of at least one dental implant in function for >5 years were recruited....
Background
Primary aldosteronism (PA) is characterized by several metabolic changes such as insulin resistance, metabolic syndrome, and adipose tissue (AT) inflammation. Mi(cro)RNAs (miRNAs) are a class of non-coding small RNA molecules known to be critical regulators in several cellular processes associated with AT dysfunction. The aim of this stu...
The importance of cardiovascular biomarkers in clinical practice increased dramatically in the last years, and the interest extends from the diagnosis purpose to prognostic applications and response to specific treatment. Acute heart failure, ischemic heart failure, and COVID-19 infection represent different clinical settings that are challenging i...
Background
Pain management in patients undergoing laparoscopy is still a matter of debate as several techniques have been proposed to reduce postoperative analgesic consumption and improve recovery. Among these, transversus abdominis plane (TAP) block is considered as safe, effective, and easy to perform under ultrasound guidance; even so, recently...
Background:
Accumulating evidence suggests that primary aldosteronism (PA) is associated with several features of the metabolic syndrome, in particular with obesity, type 2 diabetes mellitus and dyslipidemia. Whether these manifestations are primarily linked to aldosterone producing adenoma (APA) or bilateral idiopathic hyperaldosteronism (IHA) rem...
Purpose
Aldosterone plays important role in cardiovascular damage. Aim was to evaluate arterial subclinical damage through arterial stiffness parameters in patients with Essential Hypertension (EH) and Primary Aldosteronism (PA).
Methods
From 2018 to 2019 we consecutively enrolled 82 subjects (37 males and 45 women), distinguished in two groups: 6...
Background
The association between cortisol secretion and mortality in patients with adrenal incidentalomas is controversial. We aimed to assess all-cause mortality, prevalence of comorbidities, and occurrence of cardiovascular events in uniformly stratified patients with adrenal incidentalomas and cortisol autonomy (defined as non-suppressible ser...
[This corrects the article DOI: 10.1371/journal.pone.0237297.].
Background
There is no consensus on pain control in patients undergoing laparoscopy; nowadays, conventional therapy may be improved by transversus abdominis plane block. The aim of this evaluation is to investigate the role of laparoscopic-assisted trocar-site ropivacaine infiltration during adrenalectomy in pain control
Methods
This is a retrospe...
No studies have carried out an extensive analysis of the possible association between non-syndromic pheochromocytomas and paragangliomas (PPGLs) and other malignancies. To assess the risk of additional malignancy in PPGL, we retrospectively evaluated 741 patients with PPGLs followed-up in twelve referral centers in Italy. Incidence of second malign...
IntorductionAldosterone is known to play important role in developing cardiovascular, metabolic, renal damage in hypertensive patients.AimAim of study was to evaluate parameters obtained by eco-color Doppler study, as non-invasive and easly performed method in asyntomatic patients with Essential Hypertension (EH) and Primary Aldosteronism (PA), wit...
Background:
Abnormal aldosterone signaling is a recognized source of cardiovascular damage. Its influence on cardiomyocyte structure, function, and hormonal receptors when associated with heart failure is still unreported.
Methods:
Twenty-six consecutive patients with heart failure (LVEF < 40%) and normal coronaries and valves underwent left ven...
Systemic capillary leak syndrome (SCLS) is a very rare and lethal disease characterized by hemoconcentration and hypoalbuminemia caused by reversible plasma extravasation. The underlying cause for SCLS remains largely unknown and acute treatment has remained mainly supportive. Prophylaxis with intravenous immunoglobulin (IVIG) has been shown to suc...
[This corrects the article DOI: 10.1371/journal.pone.0237297.].
Background:
Paragangliomas (PGL) are neuroendocrine tumors arising from neural crest-derived chromaffin cells in the parasympathetic ganglia or in sympathetic ganglia located in the adrenal glands (Pheochromocytoma, PHEO), or extra-adrenal location and around 30-40% of PGL can be hereditary (MEN2, Von Hippel Lindau syndrome, von Reklingausen syndr...
Introduction:
Adrenocortical carcinoma (ACC) is a rare tumor, often discovered at an advanced stage and associated with poor prognosis. Treatment is guided by staging according to the European Network for the Study of Adrenal Tumors (ENSAT) classification. Surgery is the treatment of choice for ACC. The aim of this review is to provide a complete...
There is a lack of knowledge on the possible influence of systemic conditions on peri-implantitis. The aim of this case-control study is to evaluate the difference in terms of oral pathogens’ concentrations in the peri-implant sulcus of a group of patients affected by metabolic syndrome (Mets) compared to healthy subjects. For each patient, peri-im...
Aims
Necrotizing coronary vasculitis (NCV) is a rare entity usually associated to myocarditis which incidence, cause, and response to therapy is unreported.
Methods and results
Among 1916 patients with biopsy-proven myocarditis, 30 had NCV. Endomyocardial samples were retrospectively investigated with immunohistochemistry for toll-like receptor...
Objective:
The burst of COVID-19 epidemics in Italy prompted the Italian Society of Hypertension to start an observational study to explore the characteristics of the hospitalized victims of the disease. The current analysis aimed to investigate the predictors of healing among Italian COVID-19 patients. We also assessed the effect of angiotensin-c...
Background
Necrotizing coronary vasculitis (NCV) is a rare entity usually associated to myocarditis (M), which incidence, cause and responsiveness to therapy is unreported.
Purpose
We set out a retrospective study to report our experience in the diagnosis and management of myocarditis-associated necrotizing coronary vasculitis (M-NCV) and patients...
Background
Phaeochromocytoma or paraganglioma (collectively known as PPGL) in pregnant women can lead to severe complications and death due to associated catecholamine excess. We aimed to identify factors associated with maternal and fetal outcomes in women with PPGL during pregnancy.
Methods
We did a multicentre, retrospective study of patients w...
Background
The global rate of intensive care unit (ICU) admission during the COVID-19 pandemic varies within countries and is among the main challenges for health care systems worldwide. Conflicting results have been reported about the response to coronavirus infection and COVID-19 outcomes in men and women. Understanding predictors of intensive ca...
PurposeAdrenal incidentalomas (AI) are discovered after work-up unrelated to adrenal gland diseases; up to 30% of AI show subclinical endogenous cortisol excess (SH), frequently associated to hypertension, obesity, metabolic disorders and increased incidence of cardiovascular events (CVEs).Methods
We analysed 628 AI patients divided into two groups...
Cardiomyopathies are myocardial disorders in which heart muscle is structurally and/or functionally abnormal. Previously, structural cardiomyocyte disorders due to adrenal diseases, such as hyperaldosteronism, hypercortisolism, and hypercatecholaminism, were misunderstood, and endomyocardial biopsy (EMB) was not performed because was considered dan...
Several factors have been proposed to explain the high death rate of the coronavirus disease 2019 (COVID-19) outbreak, including hypertension and hypertension-related treatment with Renin Angiotensin System inhibitors. Also, age and multimorbidity might be confounders. No sufficient data are available to demonstrate their independent role. We desig...
The aim of our cross-sectional study was to evaluate skin microvascular alterations in patients with hypertension secondary to primary aldosteronism (PA) and in subjects with essential hypertension (EH). Skin microcirculation was detected by nailfold videocapillaroscopy (NVC) and laser Doppler perfusion imaging (LDPI), both noninvasive techniques f...
Objective. Several smaller studies on adrenal incidentalomas (AI) suggested an association between autonomous cortisol secretion (ACS) and mortality (Di Dalmazi Lancet Diabetes Endocrinol 2014, Debono J Clin Endocrinol Metab 2014, Patrova Endocrine 2017). However, a recent meta-analysis (9 studies, 1356 patients) could not confirm these findings (E...
Background and aim
Considering the amount of novel knowledge generated in the last five years, a team of experienced hypertensionlogists was assembled to furnish updated clinical practice guidelines for the management of primary aldosteronism.
Methods
To identify the most relevant studies, the authors utilized a systematic literature review in int...
Adrenal gland diseases, such as primary aldosteronism and Cushing’s syndrome, are associated with higher cardiovascular risk. Excessive production of aldosterone can lead to accumulation of epicardial adipose tissue (EAT), interfering with functional state. In fact, increased mineralocorticoid signaling is critically involved in the secretion of pr...
Background:
Laparoscopic adrenalectomy (LA) has become the treatment of choice for benign adrenal lesions. Lateral Transperitoneal Laparoscopic Adrenalectomy (LTLA) is considered the gold standard. The number of LTLAs a surgeon must perform, in order to complete his learning curve, is not well defined in Literature. Moreover, the few papers dealin...
Purpose. Starting from the description of two interesting cases, we wondered to review the literature on pelvic and bladder paragangliomas (PGLs) in order to illustrate clinical characteristics and current management, lightening the needed of a prompt diagnosis to avoid the onset of several complications. Although PGLs may arise at any site where p...
Background:
Over the past 25 years, mini-invasive adrenalectomy has become the treatment of choice for most adrenal diseases, and even adrenal malignancies in selected cases. The aim of this retrospective evaluation is to assess the effectiveness of laparoscopic adrenalectomy as a treatment of choice for adrenal metastases.
Methods:
From 2008 to...
Purpose . Starting from the description of two interesting cases, we wondered to review the literature on pelvic and bladder paragangliomas (PGLs) in order to illustrate clinical characteristics and current management, lightening the needed of a prompt diagnosis to avoid the onset of several complications. Although PGLs may arise at any site where...
Background
Although PGLs may arise at any site where physiologic paraganglionic tissue exists, pelvic origins are not frequent (about 2%), and the most common localization is the retroperitoneal space, whereas bladder PGLs account for less than 0.06% of all bladder neoplasms and less than 1% of all PGLs. Starting from the description of two interes...
Background:
Despite hyperaldosteronism being suggested as predisposing to arrhythmias, the relationship between atrial fibrillation and primary aldosteronism remains uncertain. Therefore, we tested the hypothesis that atrial fibrillation is a presentation of primary aldosteronism in hypertensive patients with unexplained atrial fibrillation.
Desi...
Background Although PGLs may arise at any site where physiologic paraganglionic tissue exists, pelvic origins are not frequent (about 2%), and the most common localization is the retroperitoneal space, whereas bladder PGLs account for less than 0.06% of all bladder neoplasms and less than 1% of all PGLs. Starting from the description of two interes...
Objectives:
Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic kidney disease characterized by multiple and bilateral cystic dilation of renal tubules. Hypertension, endothelial dysfunction, systemic inflammation, and accelerated atherosclerosis are alterations found at a very early stage of the disease and are respons...
The correlation of peri-implantitis with systemic diseases is still highly debated and controversial in literature. The objective of this work was to evaluate the possible association between peri-implant diseases and metabolic syndrome.
METHODS:
In this case-control study, subjects healthy or affected by metabolic syndrome, with at least one denta...
Background:
Over the years, only few authors have studied the association of systemic conditions with peri-implantitis. The aim of this study is to detect frequency and severity of peri-implant diseases among an Italian population of patients affected by metabolic syndrome (MetS).
Methods:
In this cross-sectional study, patients with at least on...
Background:
The correlation of peri-implantitis with systemic diseases is still highly debated and controversial in literature. The objective of this work was to evaluate the possible association between peri-implant diseases and metabolic syndrome.
Methods:
In this case-control study, subjects healthy or affected by metabolic syndrome, with at...
Background and aims:
The adrenal mineralocorticoid system plays a key role in cardiovascular, metabolic and renal damage. This study aimed to assess the relationship between plasma aldosterone concentration (PAC) and some surrogate markers of subclinical atherosclerosis, such as carotid intima-media thickness (cIMT), ankle-brachial index (ABI) and...
Background:
Primary aldosteronism (PA) causes a cardiomyopathy (CM) which substrate and evolution after aldosterone normalization are unreported.
Methods:
Four male patients with aldosterone-secreting adrenal adenoma and cardiomyopathy (PACM, group A) were evaluated with 2D-echo, Magnetic Resonance (CMR), coronary angiography and left ventricula...
Data on short-term blood pressure variability (BPV), which is a well-established cardiovascular prognostic tool, in pheochromocytoma and paraganglioma (PPGL) patients is still lack and conflicting. We retrospectively evaluated 23 PPGL patients referred to our unit from 2010 to 2019 to analyze 24 h ambulatory blood pressure monitoring (24-h ABPM)-de...
Background: Arterial hypertension is associated with obstructive sleep apnoea, poor quality and duration of sleep, which might contribute to hypertension-mediated organ damage.
Methods: We investigated the presence of insomnia, restless legs syndrome, and obstructive sleep apnoea using validated questionnaires (Insomnia Severity Index, Restless Leg...
Background:
Multiple endocrine neoplasia type 2B is a rare syndrome caused mainly by Met918Thr germline RET mutation, and characterised by medullary thyroid carcinoma, phaeochromocytoma, and extra-endocrine features. Data are scarce on the natural history of multiple endocrine neoplasia type 2B. We aimed to advance understanding of the phenotype a...
Introduction:
Cushing's syndrome (CS) is a clinical condition characterized by excessive cortisol production, associated with metabolic complications, such as diabetes mellitus, dyslipidemia, metabolic syndrome, hypertension, and cardiovascular diseases. Nowadays, the occurrence of autoimmune diseases in CS have not been completely evaluated in th...
Rationale:
Catecholamine-producing tumors are rare, occurring in less than 0.2% of patients with hypertension, but can have relevant cardiovascular morbidity and mortality.
Patient concerns:
A 37-year-old woman presented with a history of dyspnea, chest pain, palpitations, and paroxysmal hypertension. Electrocardiogram, echocardiogram, and cardi...
INTRODUCTION
Autosomal dominant polycystic kidney disease (ADPKD) is the most common renal hereditary disorder. Several authors have attempted to identify a kidney damage marker for predicting the prognosis and the effectiveness of therapy in ADPKD. The aim of this study was to identify and quantify in ADPKD, through a novel MR protocol with 3 Tesl...
Paragangliomas (PGL) are rare neuroendocrine tumours arising
from extra-adrenal paraganglia and consist of specialized neural crest-derived cells (catecholamine-secreting chromaffin cells).
Primary PGL of the bladder is very rare making up less than 0.05% of all bladder malignancy. It can appear as clinical symptoms secondary to catecholamine hyper...