Mario Maggi

University of Florence | UNIFI · mario serio

Pheochromocytomas and Paragangliomas (Pheo/PGL) are rare catecholamine-producing tumours derived from adrenal medulla or from the extra-adrenal paraganglia respectively. Around 10–15% of Pheo/PGL develop metastatic forms and have a poor prognosis with a 37% of mortality rate at 5 years. These tumours have a strong genetic determinism, and the prese...

Introduction: Calcitonin is the most specific marker for medullary thyroid carcinoma, thus, low detectable calcitonin values after surgery can conceal persistent disease. The present study aimed to explore the prognostic role of pre-operative and early calcitonin levels in patients without distant metastases at diagnosis. Methods: A retrospectiv...

In March 2020, the Italian government imposed a national lockdown which was almost completely removed in June 2020. Due to the abrupt stop of human activities, emissions of air pollutants decreased. Air pollution is an environmental risk factor for non‐communicable disease and mortality. Emerging evidence also suggests a role in male infertility. I...

Background Given the relationship between interiorized stigma and body image, it could be hypothesized that high levels of internalized transphobia (IT) might predict higher levels of body uneasiness in subjects with gender dysphoria (GD) and worse improvement of body image after gender affirming hormone therapy (GAHT). Aim We sought to evaluate t...

PurposeErectile dysfunction (ED) is one of the most prevalent male sexual dysfunctions. ED has been in the past mistakenly considered a purely psycho-sexological symptom by patients and doctors. However, an ever-growing body of evidence supporting the role of several organic factors in the pathophysiological mechanisms underlying ED has been recogn...

Purpose Adrenocortical carcinoma (ACC), a rare malignancy of the adrenocortex, is characterized by a crosstalk between the adipose microenvironment and tumor. Here, we assessed the involvement of carbonic anhydrase (CA) enzymes III and IX (CAIII and CAIX), in the metabolic alterations of the adipose tissue characterizing obesity and in the local cr...

Background: The level of education has been recognized as a cardiovascular (CV) risk factor; nevertheless, it is often neglected in CV risk prediction. Objectives: To evaluate the psychobiological correlates of the level of education and if it could predict incident major adverse CV events (MACE) in men consulting for erectile dysfunction (ED)....

Background Sex steroids have been demonstrated as important modulators of vaginal function. The RhoA/ROCK calcium-sensitizing pathway plays a role in genital smooth muscle contractile mechanism, but its regulation has never been elucidated. Aim This study investigated the sex steroid regulation of the vaginal smooth muscle RhoA/ROCK pathway using...

Background: Although it has been assumed that chronic cannabis use may have an unfavorable impact on male sexual function and its metabolic correlates, evidence from clinical studies remains inconclusive. Objective: To investigate the relationship between cannabis use and sexual behavior, anthropometrics and metabolic/vascular profiles in a larg...

Background: Type 2 diabetes mellitus (T2DM) and pre-diabetes are associated with reduced circulating testosterone (T) levels. However, the role of T replacement therapy (TRT) in these patients is still conflicting. Objectives: To summarize and critically analyze available data on the possible effect of T administration in men with glucose abnorm...

Hypogonadism is frequent with a prevalence of 2% in the general population. Hypogonadism may derive from any condition able to disrupt the hypothalamic-pituitary-testis (HPT) axis at one or more levels. Hypogonadism may be classified according to the age of onset, its potential reversibility and level of the HPT axis damage. The latter categorizati...

Introduction Hyperprolactinemia has been proven to induce hypogonadism and metabolic derangements in both genders, while the consequences of prolactin (PRL) deficiency have been poorly investigated. Areas covered To systematically review and analyze data from clinical studies focusing on the metabolic consequences of abnormally high prolactin leve...

Purpose Hyponatremia is the most frequent electrolytic disorder in clinical practice. In addition to neurological symptoms, hyponatremia, even when mild/moderate and chronic, has been related to other manifestations, such as bone demineralization and increased risk of fractures. To better elucidate tissue alterations associated with reduced serum s...

Background: Diabetes mellitus (DM) is a global epidemic characterized by high morbidity and mortality. DM can lead to acute and chronic systemic complications. Among them, a negative effect of DM on sperm quality and male/couple fertility has been suggested. However, available studies in DM men evaluated relatively small cohorts with discordant re...

Background Insulin-like peptide 3 (INSL3) is a constitutive hormone secreted in men by the mature Leydig cells of the testes. It is an accurate biomarker for Leydig cell functional capacity, reflecting their total cell number and differentiation status. Objectives To determine the ability of INSL3 to predict hypogonadism and age-related morbidity...

Purpose The aim of our study was to assess dermatological changes in transgender people after the start of gender-affirming hormonal treatment (GAHT) and to investigate whether various hormonal preparations differently affect dermatological changes in trans AFAB (assigned female at birth) people. Methods In a multicenter prospective study, 484 par...

Objectives To compare clinical, sexual, psychological characteristics of men with primary and secondary infertility and fertile men and evaluate associations between psychological and clinical parameters in these groups. Methods We evaluated clinical, sexual (erectile function [IIEF-15-erectile function domain];premature ejaculation [Premature Eja...

Objectives Cardiovascular (cv) implications of long-term gender affirming hormonal treatment (gaht) in transgender people still remain largely unknown. The aim of the present study is to evaluate changes in the 30-year framingham cardiovascular disease (cvd) risk in a large cohort of transgender people after the start of gaht. Methods In a multice...

Objectives Thepandemic of new severe acute respiratory syndrome (SARS) due to coronavirus (CoV) 2 (SARS-CoV-2) has stressed the importance of effective diagnostic and prognostic biomarkers of clinical worsening and mortality. Epidemiological data showing a differential impact of SARS-CoV-2 infection on women and men have suggested a potential role...

Objectives Recent studies showed that transgender (TGN) adolescents are more at risk of negative sexual outcomes than their peers. However, little is known about the psychopathological and sociodemographic correlates of sexual-related experiences in TGN adolescents. This cross-sectional study aimed at overcoming this limitation describing this asso...

Objectives To investigate the relationship between female sexual dysfunction (FSD) and eating disorders (EDs). Methods 123 retrospectively recruited women consulting for FSD underwent physical examination and completed the following validated questionnaires: Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), Eating...

Objectives Gender diverse people identify as neither (exclusively) male nor female. The present study evaluated the possible differences in terms of psychological wellbeing between gender diverse and binary transgender individuals, as well as the role of perceived social acceptance and religious fundamentalism as possible mediators of psychopatholo...

Objectives To evaluate, in a sample of n=34 women with impaired thyroid function, the prevalence of female sexual dysfunction (FSD) and the effect of the restoration of biochemical euthyroidism on sexual parameters. Methods In this prospective, multicenter, observational study, we consecutively recruited 34 women referred for an alteration of thyr...

Objectives Research on the relationship between physical activity (PA) and female sexual dysfunction (FSD) is lacking. Our aim was to investigate the clinical, psychological, and sexual correlates of PA in women with FSD. Methods A non-selected series of n=322 pre- and post-menopausal patients consulting for FSD was retrospectively studied. Involv...

Objectives To evaluate the effect of in vivo treatment with tadalafil 5mg daily on a population of adult men complaining LUTS/BPH waitlisted for simple prostatectomy in improving clinical and molecular outcomes of prostatic inflammation. Methods 86 subjects on the waiting list for simple prostatectomy have been enrolled and randomized to receive t...

Objectives The pandemic of new severe acute respiratory syndrome (SARS) due to coronavirus (CoV) 2 (SARS-CoV-2) has stressed the importance of effective diagnostic and prognostic biomarkers of clinical worsening and mortality. Epidemiological data showing a differential impact of SARS-CoV-2 infection on women and men have suggested a potential role...

Objectives To explore the psychosexual correlates of excitation and inhibition in women with Female Sexual Dysfunction (FSD). Methods We retrospectively recruited a consecutive series of 66 women consulting for FSD. Patients underwent clinical evaluation, a structured interview and completed several self-administered questionnaires, including Sexu...

Objectives To explore associations between prolactin (PRL) levels and sexual desire and to establish a cut-off for PRL able to predict Hypoactive Sexual Desire Disorder (HSDD). Methods A non-selected series of n = 234 sexually active pre- and post-menopausal patients consulting for sexual symptoms was retrospectively studied. Participants underwen...

Objectives We evaluated differences in Autism Spectrum Quotient (AQ) scores between a sample of hormone-naïve transgender and cisgender people, the possible impact of gender-affirming hormonal treatment (GAHT) on AQ scores across time and the role of alexithymia and social anxiety as possible mediators of changes in AQ scores. Methods A cross-sect...

Objectives To investigate the relationship between female sexual dysfunction (FSD) and eating disorders (EDs). Methods 123 retrospectively recruited women consulting for FSD underwent physical examination and completed the following validated questionnaires: Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), Eating...

Objectives To evaluate, in a sample of n=34 women with impaired thyroid function, the prevalence of female sexual dysfunction (FSD) and the effect of the restoration of biochemical euthyroidism on sexual parameters. Methods In this prospective, multicenter, observational study, we consecutively recruited 34 women referred for an alteration of thyr...

Objectives To evaluate the effect of in vivo treatment with tadalafil 5mg daily on a population of adult men complaining LUTS/BPH waitlisted for simple prostatectomy in improving clinical and molecular outcomes of prostatic inflammation. Methods 86 subjects on the waiting list for simple prostatectomy have been enrolled and randomized to receive t...

Objectives To explore the psychosexual correlates of excitation and inhibition in women with Female Sexual Dysfunction (FSD). Methods We retrospectively recruited a consecutive series of 66 women consulting for FSD. Patients underwent clinical evaluation, a structured interview and completed several self-administered questionnaires, including Sexu...

Objectives We evaluated differences in Autism Spectrum Quotient (AQ) scores between a sample of hormone-naïve transgender and cisgender people, the possible impact of gender-affirming hormonal treatment (GAHT) on AQ scores across time and the role of alexithymia and social anxiety as possible mediators of changes in AQ scores. Methods A cross-sect...

Objectives To evaluate whether family history (FH) for cardio-metabolic diseases could provide insights into metabolic and sexual features and predict the occurrence of forthcoming major adverse CV events (MACE). Methods A consecutive series of 4,693 individuals (aged 51.3 ± 13.3 years) attending an Andrology outpatient clinic for ED was studied....

Objectives The female sexual response is a complex phenomenon where multiple psychophysiological factors are involved. Sex steroids play a pivotal role in female health and sexuality. The aim of this study was to investigate the effects of sex hormones on the smooth muscle contractile mechanism in the distal vagina using a validated animal model of...

Objectives The present study assessed the efficacy of Gonadotropin-Releasing Hormone agonists (GnRHas) treament and Gender Affirming Hormonal Treatment (GAHT) in terms of psychological functioning and physical changes in a sample of adolescents with GD assessed at the Florence Gender Incongruence Unit. Methods Thirty adolescents -17 assigned Femal...

The neuroendocrine control of reproduction is strictly coordinated at the central level by the pulsatile release of gonadotropin-releasing hormone (GnRH) by the hypothalamic GnRH neurons. Alterations of the GnRH-network, especially during development, lead to long-term reproductive and systemic consequences, also causing infertility. Recent evidenc...

Purpose Hyponatremia occurs in about 30% of patients with pneumonia, including those with SARS-CoV-2 (COVID-19) infection. Hyponatremia predicts a worse outcome in several pathologic conditions and in COVID-19 has been associated with a higher risk of non-invasive ventilation, ICU transfer and death. The main objective of this study was to determin...

Gender-affirming treatment for transgender people is characterized by a multidisciplinary approach in which the endocrinologist plays a crucial role. Endocrinologists should explore the desired body changes of each person in order to guarantee a real personalized clinical approach. Most current guidelines include hormonal treatment protocols only f...

Context Despite the wide revision of current guidelines, the management of papillary thyroid microcarcinoma (mPTC) has still to be decided case-by-case. There is conflicting evidence about the role of more frequent histological subtypes and no data about potential differences at presentation. Objective Our aim was to compare the phenotype of the t...

PurposeTo provide the evidence-based recommendations on the role of testosterone (T) on age-related symptoms and signs remains.Methods The Italian Society of Andrology and Sexual Medicine (SIAMS) and the and the Italian Society of Endocrinology (SIE) commissioned an expert task force to provide an updated guideline on adult-onset male hypogonadism....

Sexual function, and testosterone (T) levels, progressively decline in aging men. Associated morbidities and metabolic disorders can accelerate the phenomenon. The specific contribution of low T to sexual function impairment in aging men has still not been completely clarified. Similarly, the role of T replacement therapy (TRT), as well as the comb...

Background: Pheochromocytoma (Pheo) and paraganglioma (PGL) are rare tumors, mostly resulting from pathogenic variants of predisposing genes, with a genetic contribution that now stands at around 70%. Germline variants account for approximately 40%, while the remaining 30% is attributable to somatic variants. Objective: This study aimed to descr...

Introduction Deficiency of the 17β-hydroxysteroid dehydrogenase type 3 (17 β-HSD3) is a rare autosomal recessive 46,XY Difference of sex development (DSD), resulting from pathogenetic variants in the HSD17B3 gene, which lead to absent or reduced ability to convert Δ4-androstenedione to testosterone in the fetal testes. Aim This study aimed to pres...

Introduction Data on the role of prolactin (PRL) in the physiologic range in the female sexual response are scanty. Objective We aimed at investigating the association between PRL levels and sexual function, and specifically, with the desire domain as assessed by the Female Sexual Function Index. We also explored the presence of a cut-off level of...

Introduction Eating and sexual behavior are driven by neurological mechanisms that are extremely intertwined; emerging evidence indicates that their deep relationship can be mediated by the presence of specific psychopathologies. Objective To investigate the relationship between female sexual dysfunction (FSD) and eating disorders (EDs). Methods...

Introduction Female sexual response is a complex phenomenon that involves multiple psychophysiological factors. Sex steroids play a fundamental role in the mechanisms of regulation of sexual arousal, modulating the sexual response and preserving the integrity and functionality of the vaginal tissue. For this reason, imbalances in the sexual environ...

Pheochromocytoma/paragangliomas (PPGLs) are neuroendocrine tumours, often non-metastatic, but without available effective treatment for their metastatic form. Recent studies have shown that metformin exhibits antiproliferative activity in many human cancers, including PPGLs. Nevertheless, no data are available on the role of metformin on PPGL cells...

Purpose: We evaluated differences in Autism Spectrum Quotient (AQ) scores between a sample of hormone-naïve transgender and cisgender people and the impact of gender-affirming hormonal treatment (GAHT) on AQ scores across time. Furthermore, we assessed alexithymia and social anxiety as possible mediators of changes in AQ scores. Methods: A cross...

Study question Can Vapor Fast Freezing conducted in 10µl tips (microVFF/tips) efficiently preserve sperm viability and motility in banking samples with very low sperm concentration? Summary answer MicroVFF resulted able to efficiently preserve sperm viability and motility in patients with severe oligozoospermia or criptozoospermia What is known a...

Background The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in human semen and its role in virus contagion and semen quality after recovery from coronavirus disease 2019 (COVID-19) is still unclear. Recent reports evidence that, after SARS-CoV-2 infection, male reproductive function and semen quality may be damaged. Aim...

Objectives: To challenge a vapour fast freezing (VFF) cryopreservation procedure (conventional VFF) with several vitrification protocols and VFF conducted with small semen volumes (10 μl, microVFF), in order to implement a procedure for sperm banking in subjects with small sperm number. Materials and methods: Conventional VFF was conducted with...

Background: Transrectal ultrasound(TRUS) parameters are not standardized, especially in men of reproductive age. Hence, the European Academy of Andrology(EAA) promoted a multicenter study to assess the TRUS characteristics of healthy-fertile men(HFM) to establish normative parameters. Objectives: To report and discuss the prostate and seminal ve...

Background: Aging in men is accompanied by a broad range of symptoms, including sexual dysfunction, cognitive and musculo-skeletal decline, obesity, type 2 diabetes, cardiovascular disease and hypertension, organ degeneration/failure, and increasing neoplasia, some of which are associated with declining levels of Leydig cell-produced testosterone....

Background Klinefelter syndrome (KS) is frustratingly under-diagnosed. KS have a broad spectrum of clinical features, making it difficult to identify. Objective We describe KS clinical presentation in a large Italian cohort. Design This is the first observational cohort study within a national network, the Klinefelter ItaliaN Group (KING). Prima...

Purpose Hyponatremia, the most frequent electrolyte alteration in clinical practice, has been associated with a worse prognosis in cancer patients. On the other hand, a better outcome has been related to serum sodium normalization. In vitro studies have shown that low extracellular sodium promotes cancer cells proliferation and invasiveness. Tolvap...

Background Oncocytomas are uncommon benign tumors that arise in various organs and are predominantly composed of oncocytes. Adrenocortical oncocytomas are extremely rare and are generally non-functioning. Methods We report the case of a 40-year-old patient with a progressively enlarging left adrenal mass. At the age of 19 he had undergone right ad...

Sommario I tumori neuroendocrini di grado 3 rappresentano una recente entità patologica con caratteristiche intermedie tra i carcinomi neuroendocrini e i tumori neuroendocrini a basso grado. Il pancreas rappresenta il primo organo in cui questa nuova categoria è stata identificata e riguardo alla quale si dispongono di maggiori evidenze cliniche. E...

The burden of sexually transmitted infections (STIs) in the transgender population remains an underestimated issue. The aims of the present study were to evaluate the prevalence of either self-reported and serological STIs and to describe socio-demographic and clinical characteristics of transgender individuals with STIs. A consecutive series of 70...

Purpose The short- and long-term andrological effects of coronavirus disease 2019 (COVID-19) have not been clarified. Our aim is to evaluate the available evidence regarding possible andrological consequences of COVID-19 either on seminal or hormonal parameters. The safety of the COVID-19 vaccines in terms of sperm quality was also investigated. M...

Introduction Female sexual response is a result of a complex interplay between central and peripheral mechanisms and the nitric oxide (NO)-mediated relaxation of clitoris and distal vagina vascular bed leads to clitoris tumescence and vagina lubrification. Objective The aim of this study was to evaluate sex steroids regulation of the relaxant/cont...

Introduction Research on the relationship between physical activity (PA) and female sexual dysfunction (FSD) is lacking. Objective To investigate the clinical, psychological, and sexual correlates of PA in women with FSD. Methods A non-selected series of n=322 pre- and post-menopausal patients consulting for FSD was retrospectively studied. Regul...

Introduction Preclinical studies show that, in the clitoris, testosterone (T) is necessary to maintain a functional contractile and relaxant machinery, which represents the underlying mechanism of the peripheral arousal response. Although there is clinical evidence suggesting that T treatment significantly improves multiple domains of sexual functi...

Introduction Eating and sexual behavior are driven by neurological mechanisms that are extremely intertwined; emerging evidence indicates that their deep relationship can be mediated by the presence of specific psychopathologies. Objective to investigate the relationship between female sexual dysfunction (FSD) and eating disorders (EDs). Methods...

Introduction The human vagina is extremely sensitive to hormonal changes occurring during the woman's lifetime, in particular the decline in estrogens that characterizes the menopause is known to induce a range of genital and sexual symptoms (dryness, burning, irritation, lack of lubrication, discomfort, pain), known as “genitourinary syndrome of m...

Introduction The “Dual control model” of sexual response postulates that sexual desire and associated behaviors depend on the balance between excitation and inhibition. These aspects have not been evaluated in women with sexual dysfunction (FSD). Objective To explore the psychosexual correlates of excitation and inhibition in women with FSD, accor...

The contribution of brain regions to visuospatial abilities according to sex differences and gender identity is inconsistently described. One potential explaining factor may be the different tasks employed requiring a variable load of working memory and other cognitive resources. Here we asked to 20 cis and 20 transgender participants to undergo fu...

Background erectile dysfunction is associated with mortality, whereas the association between low testosterone (T) and higher mortality remains controversial. Sexual dysfunction and low T often coexist, but the relative importance of sexual symptoms versus low T in predicting mortality is not known. We studied the interrelationships between sex ste...

Purpose Benign Prostatic Hyperplasia (BPH) is a result of prostate inflammation, frequently occurring in metabolic syndrome (MetS). Low testosterone is common in MetS. A randomized clinical trial was designed to evaluate if 24 weeks of testosterone therapy (TTh) in BPH men with MetS and low testosterone improve urinary symptoms and prostate inflamm...

The contribution of brain regions to visuospatial abilities according to sex differences and gender identity is inconsistently described. One potential explaining factor may be the different tasks employed requiring a variable load of working memory and other cognitive resources. Here we asked to 20 cis and 20 trans gender participants to undergo f...

Germline mutations in more than 20 genes, including those encoding for the succinate dehydrogenase (SDH), predispose to rare tumours, such as pheochromocytoma/paraganglioma (PPGL). Despite encoding for the same enzymatic complex, SDHC and SDHD mutated PHEO/PGLs are generally benign, while up to 80% of SDHB mutated ones are malignant. In this study,...

Purpose Female sexual response involves a complex interplay between neurophysiological mechanisms and the nitric oxide (NO)-mediated relaxation of clitoris and vagina. The aim of this study was to evaluate sex steroids regulation of the relaxant pathway in vagina, using a validated animal model. Methods Subgroups of OVX Sprague–Dawley rats were tr...

Sexual symptoms are the most specific determinants of low testosterone (T) observed during adulthood. In this narrative review, we summarize the most important evidence supporting the positive relationships between endogenous T levels and sexual activity in the adult male, by using preclinical and clinical observations. In addition, we also report...

Background The role of testosterone (T) replacement therapy (TRT) in subjects with late onset hypogonadism is still the object of an intense debate.Methods All observational studies and placebo-controlled or -uncontrolled randomized trials (RCTs) comparing the effect of TRT on different bone parameters were considered.ResultsOut of 349 articles, 36...