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3. Continuous Subcutaneous Insulin Infusion in Italy: Third National Survey

Author

Bruttomesso D., Laviola L., Lepore G., Bonfanti R., Bozzetto L., Corsi A., Di Blasi V., Girelli A., Grassi G., Iafusco D., Rabbone I., Schiaffini R., Montani V., Colleluori P., Paciotti V., Alfidi P., Grosso J., Tumini S., Cipriano P., Vitacolonna E., Di Vieste G., Minnucci A., Antenucci D., La Penna G., Taraborrelli M., Macerala B., Citro G., De Morelli G., Gnasso A., Irace C., Citriniti F., Lazzaro N., Bruzzese M., Mammi F., De Berardinis F., Santoro E., Corigliano G., Corigliano M., Parillo M., Schettino M., Fresa R., Annuzzi G., Bassi V., Santinelli C., Buono P., Mozzillo E., De Feo E., Esposito K., Petrizzo M., Foglia A., Gatti A., Gentile S., Guarino G., Zanfardino A., Lambiase C., Vitale A., Zucchini S., Maltoni G., Forlani G., Moscatiello S., Suprani T., Bensa M., Tomasi F., Monesi M., Nizzoli M., Acquati S., Chierici G., Milli B., Iughetti L., Predieri B., Cavani R., Romano S., Manicardi V., Michelini M., Cimicchi M. C., Ugolotti D., Zavaroni I., Dei Cas A., Dall'Aglio E., Papi M., Tardio S. M., Calderini M. C., Riboni S., D'Amato L., Zavaroni D., Gastaldi L., Di Bartolo P., Pellicano F., Cirillo A., Graziani V., Di Secli C., Amarri S., Lasagni A., Marsciani A., Pedini A., Pagliani U., Rossi C., Tortul C., Brunato B., Assaloni R., Zanette G., Livolsi P., Petrucco A., Tercelj K., Manca E., Candido R., Tommasi E., Tornese G., Faleschini E., Tonutti L., Agus S., Zanatta M., Rosolen A., Comici A., Graziano F. M., Misischi I., Pozzilli P., Maurizi A. R., Falasca P., Tuccinardi F., Ricciardi G. P., Di Masa P., Ragonese M., Cipolloni L., Buzzetti R., Moretti C., Leto G., Crino A., Bocchini S., Di Perna P., Giuliano M., Frontoni S., Malandrucco I., Pitocco D., Scalpone R., Toscanella F., Cappa M., Ventura C., Bonato V., De Bernardinis M., Cavallo M. G., Leonetti F., Morano S., Mandosi E., Cicconetti E., Ciampittiello G., Marini M. A., Sabato D., Napoli A., Giraudo F., Toscano V., Massimiani F., Fava D., Gargiulo P., Mecca N., Tubili C., Nardone M. R., Morviducci L., Manca-Bitti M. L., Arcano S., Leotta S., Suraci C., Chiaramonte F., Visalli N., Forte E., Palmacci C., Arnaldi C., Tosini D., Querci F., Trevisan R., Bonfadini S., Prandi E., Felappi B., Locatelli F., Fuso V., Rocca A., Meneghini E., Massafra C., Terni T., Elli P., Ruggeri P., Carrai E., Musacchio N., Lovagnini Scher C. A., Marelli G., Vilei V., Richini D., Inversini C., Franzetti I., Bonacina M., Ciucci A., Sciangula L., Duratorre E., Bonomo M., Bertuzzi F., Chebat E., Muratori M., Scaramuzza A., Zuccotti G. V., Bollati P. M., Colapinto P., Orsi E., Palmieri E., Laurenzi A., Molinari C., Frontino G., Veronelli A., Zecchini B., Bianchi A., Torchio G., Lovati E., Ghilardi G., Dagani R., Carugo D., Berra C., Favacchio G., Fochesato E., Pissarelli A., Bucciarelli L., Bulgheroni M., Guerraggio L., Zonca S., Bossi A. C., Berzi D., Mangone I., Cazzaniga E., Rabini R. A., Boemi M., Faloia E., Boscaro M., Sternari G., Iannilli A., Cherubini V., Busciantella Ricci N., Cartechini M. G., Tesei A. M., Maolo G., Galetta M., Vespasiani G., Tinti G., Manfrini S., Aiello A., Di Vincenzo S., Vitale C., Di Caro P., Lera R., Secco A., Lesina A., Romeo F., Origlia C., Giorda C., Chiambretti A. M., Fornengo R., De Donno V., Gallarotti F., Manti R., Marafetti L., Cadario F., Savastio S., Barbieri P., Massucco P., Ali A., Gottero C., Degiovanni M., Bertaina S., Maghenzani G., Tinti D., Fontana F., Giorgino F., Stefanelli G., Cavallo L., Zecchino C., Piccinno E., Ortolani F., Gallo F., Moramarco F., Marino A., Sparasci G., Mileti G., Lamacchia O., Picca G., Coccioli M. S., Micale F., Serra R., Romano I., Savino T., De Cosmo S., Rauseo A., Delvecchio M., Lapolla R., Braione A. F., Papagno G., Baroni M., Melis M., Cossu E., Songini M., Cambuli V. M., Lo Presti D., Timpanaro T. A., Chiavetta A., Garofalo M. R., Tommaselli L., Tumminia A., Scarpitta A. M., Di Benedetto A., Giunta L., Lombardo F., Salzano G., Cardella F., Roppolo R., Provenzano V., Fleres M., Migliorini S., De Luca A., Leopardi A., Beltrami C., Toni S., Guasti G., Lenzi L., Lamanna C., Mannucci E., Lucchesi S., Dicianni G., Aragona M., Del Prato S., Fattor B., Eisath J., Pasquino B., Reinstadler P., Kaufmann P., Incelli G., Rauch S., Romanelli T., Cauvin V., Franceschi R., Soldani C., Scattoni R., Norgiolini R., Celleno R., Torlone E., Bolli G. B., Lalli C., Scarponi M., Bobbio A., Bechaz M., Pianta A., Marangoni A., Arico C. N., Alagona C., Confortin L., Rossi E., Boscolo Bariga A., Nogara A., Bettio M., Frison V., Guidoni G. L., Fongher C., Contin M. L., Cosma A., Vianello S., Bondesan L., Morea A., Volpi A., Coracina A., Panebianco G., Lombardi S., Costa S., Cipponeri E., Vedovato M., Scotton R., Monciotti C. M., Galderisi A., Dalfra M. G., Lapolla A., Zanon M., Lisato G., Mollo F., Calcaterra F., Miola M., Paccagnella A., Sambataro M., Moro E., Trombetta M., Negri C., Sabbion A., Maffeis C., Strazzabosco M., Mesturino C. A., Mingardi R., Bruttomesso, D., Laviola, L., Lepore, G., Bonfanti, R., Bozzetto, L., Corsi, A., Di Blasi, V., Girelli, A., Grassi, G., Iafusco, D., Rabbone, I., Schiaffini, R., Montani, V., Colleluori, P., Paciotti, V., Alfidi, P., Grosso, J., Tumini, S., Cipriano, P., Vitacolonna, E., Di Vieste, G., Minnucci, A., Antenucci, D., La Penna, G., Taraborrelli, M., Macerala, B., Citro, G., De Morelli, G., Gnasso, A., Irace, C., Citriniti, F., Lazzaro, N., Bruzzese, M., Mammi, F., De Berardinis, F., Santoro, E., Corigliano, G., Corigliano, M., Parillo, M., Schettino, M., Fresa, R., Annuzzi, G., Bassi, V., Santinelli, C., Buono, P., Mozzillo, E., De Feo, E., Esposito, K., Petrizzo, M., Foglia, A., Gatti, A., Gentile, S., Guarino, G., Zanfardino, A., Lambiase, C., Vitale, A., Zucchini, S., Maltoni, G., Forlani, G., Moscatiello, S., Suprani, T., Bensa, M., Tomasi, F., Monesi, M., Nizzoli, M., Acquati, S., Chierici, G., Milli, B., Iughetti, L., Predieri, B., Cavani, R., Romano, S., Manicardi, V., Michelini, M., Cimicchi, M. C., Ugolotti, D., Zavaroni, I., Dei Cas, A., Dall'Aglio, E., Papi, M., Tardio, S. M., Calderini, M. C., Riboni, S., D'Amato, L., Zavaroni, D., Gastaldi, L., Di Bartolo, P., Pellicano, F., Cirillo, A., Graziani, V., Di Secli, C., Amarri, S., Lasagni, A., Marsciani, A., Pedini, A., Pagliani, U., Rossi, C., Tortul, C., Brunato, B., Assaloni, R., Zanette, G., Livolsi, P., Petrucco, A., Tercelj, K., Manca, E., Candido, R., Tommasi, E., Tornese, G., Faleschini, E., Tonutti, L., Agus, S., Zanatta, M., Rosolen, A., Comici, A., Graziano, F. M., Misischi, I., Pozzilli, P., Maurizi, A. R., Falasca, P., Tuccinardi, F., Ricciardi, G. P., Di Masa, P., Ragonese, M., Cipolloni, L., Buzzetti, R., Moretti, C., Leto, G., Crino, A., Bocchini, S., Di Perna, P., Giuliano, M., Frontoni, S., Malandrucco, I., Pitocco, D., Scalpone, R., Toscanella, F., Cappa, M., Ventura, C., Bonato, V., De Bernardinis, M., Cavallo, M. G., Leonetti, F., Morano, S., Mandosi, E., Cicconetti, E., Ciampittiello, G., Marini, M. A., Sabato, D., Napoli, A., Giraudo, F., Toscano, V., Massimiani, F., Fava, D., Gargiulo, P., Mecca, N., Tubili, C., Nardone, M. R., Morviducci, L., Manca-Bitti, M. L., Arcano, S., Leotta, S., Suraci, C., Chiaramonte, F., Visalli, N., Forte, E., Palmacci, C., Arnaldi, C., Tosini, D., Querci, F., Trevisan, R., Bonfadini, S., Prandi, E., Felappi, B., Locatelli, F., Fuso, V., Rocca, A., Meneghini, E., Massafra, C., Terni, T., Elli, P., Ruggeri, P., Carrai, E., Musacchio, N., Lovagnini Scher, C. A., Marelli, G., Vilei, V., Richini, D., Inversini, C., Franzetti, I., Bonacina, M., Ciucci, A., Sciangula, L., Duratorre, E., Bonomo, M., Bertuzzi, F., Chebat, E., Muratori, M., Scaramuzza, A., Zuccotti, G. V., Bollati, P. M., Colapinto, P., Orsi, E., Palmieri, E., Laurenzi, A., Molinari, C., Frontino, G., Veronelli, A., Zecchini, B., Bianchi, A., Torchio, G., Lovati, E., Ghilardi, G., Dagani, R., Carugo, D., Berra, C., Favacchio, G., Fochesato, E., Pissarelli, A., Bucciarelli, L., Bulgheroni, M., Guerraggio, L., Zonca, S., Bossi, A. C., Berzi, D., Mangone, I., Cazzaniga, E., Rabini, R. A., Boemi, M., Faloia, E., Boscaro, M., Sternari, G., Iannilli, A., Cherubini, V., Busciantella Ricci, N., Cartechini, M. G., Tesei, A. M., Maolo, G., Galetta, M., Vespasiani, G., Tinti, G., Manfrini, S., Aiello, A., Di Vincenzo, S., Vitale, C., Di Caro, P., Lera, R., Secco, A., Lesina, A., Romeo, F., Origlia, C., Giorda, C., Chiambretti, A. M., Fornengo, R., De Donno, V., Gallarotti, F., Manti, R., Marafetti, L., Cadario, F., Savastio, S., Barbieri, P., Massucco, P., Ali, A., Gottero, C., Degiovanni, M., Bertaina, S., Maghenzani, G., Tinti, D., Fontana, F., Giorgino, F., Stefanelli, G., Cavallo, L., Zecchino, C., Piccinno, E., Ortolani, F., Gallo, F., Moramarco, F., Marino, A., Sparasci, G., Mileti, G., Lamacchia, O., Picca, G., Coccioli, M. S., Micale, F., Serra, R., Romano, I., Savino, T., De Cosmo, S., Rauseo, A., Delvecchio, M., Lapolla, R., Braione, A. F., Papagno, G., Baroni, M., Melis, M., Cossu, E., Songini, M., Cambuli, V. M., Lo Presti, D., Timpanaro, T. A., Chiavetta, A., Garofalo, M. R., Tommaselli, L., Tumminia, A., Scarpitta, A. M., Di Benedetto, A., Giunta, L., Lombardo, F., Salzano, G., Cardella, F., Roppolo, R., Provenzano, V., Fleres, M., Migliorini, S., De Luca, A., Leopardi, A., Beltrami, C., Toni, S., Guasti, G., Lenzi, L., Lamanna, C., Mannucci, E., Lucchesi, S., Dicianni, G., Aragona, M., Del Prato, S., Fattor, B., Eisath, J., Pasquino, B., Reinstadler, P., Kaufmann, P., Incelli, G., Rauch, S., Romanelli, T., Cauvin, V., Franceschi, R., Soldani, C., Scattoni, R., Norgiolini, R., Celleno, R., Torlone, E., Bolli, G. B., Lalli, C., Scarponi, M., Bobbio, A., Bechaz, M., Pianta, A., Marangoni, A., Arico, C. N., Alagona, C., Confortin, L., Rossi, E., Boscolo Bariga, A., Nogara, A., Bettio, M., Frison, V., Guidoni, G. L., Fongher, C., Contin, M. L., Cosma, A., Vianello, S., Bondesan, L., Morea, A., Volpi, A., Coracina, A., Panebianco, G., Lombardi, S., Costa, S., Cipponeri, E., Vedovato, M., Scotton, R., Monciotti, C. M., Galderisi, A., Dalfra, M. G., Lapolla, A., Zanon, M., Lisato, G., Mollo, F., Calcaterra, F., Miola, M., Paccagnella, A., Sambataro, M., Moro, E., Trombetta, M., Negri, C., Sabbion, A., Maffeis, C., Strazzabosco, M., Mesturino, C. A., Mingardi, R., Bruttomesso, D, Laviola, L, Lepore, G, Bonfanti, R, Bozzetto, L, Corsi, A, Di Blasi, V, Girelli, A, Grassi, G, Iafusco, D, Rabbone, I, Schiaffini, R, Montani, V, Colleluori, P, Paciotti, V, Alfidi, P, Grosso, J, Tumini, S, Cipriano, P, Vitacolonna, E, Di Vieste, G, Minnucci, A, Antenucci, D, La Penna, G, Taraborrelli, M, Macerala, B, Citro, G, De Morelli, G, Gnasso, A, Irace, C, Citriniti, F, Lazzaro, N, Bruzzese, M, Mammi, F, De Berardinis, F, Santoro, E, Corigliano, G, Corigliano, M, Parillo, M, Schettino, M, Fresa, R, Annuzzi, G, Bassi, V, Santinelli, C, Buono, P, Mozzillo, E, De Feo, E, Esposito, K, Petrizzo, M, Foglia, A, Gatti, A, Gentile, S, Guarino, G, Zanfardino, A, Lambiase, C, Vitale, A, Zucchini, S, Maltoni, G, Forlani, G, Moscatiello, S, Suprani, T, Bensa, M, Tomasi, F, Monesi, M, Nizzoli, M, Acquati, S, Chierici, G, Milli, B, Iughetti, L, Predieri, B, Cavani, R, Romano, S, Manicardi, V, Michelini, M, Cimicchi, M, Ugolotti, D, Zavaroni, I, Dei Cas, A, Dall'Aglio, E, Papi, M, Tardio, S, Calderini, M, Riboni, S, D'Amato, L, Zavaroni, D, Gastaldi, L, Di Bartolo, P, Pellicano, F, Cirillo, A, Graziani, V, Di Secli, C, Amarri, S, Lasagni, A, Marsciani, A, Pedini, A, Pagliani, U, Rossi, C, Tortul, C, Brunato, B, Assaloni, R, Zanette, G, Livolsi, P, Petrucco, A, Tercelj, K, Manca, E, Candido, R, Tommasi, E, Tornese, G, Faleschini, E, Tonutti, L, Agus, S, Zanatta, M, Rosolen, A, Comici, A, Graziano, F, Misischi, I, Pozzilli, P, Maurizi, A, Falasca, P, Tuccinardi, F, Ricciardi, G, Di Masa, P, Ragonese, M, Cipolloni, L, Buzzetti, R, Moretti, C, Leto, G, Crino, A, Bocchini, S, Di Perna, P, Giuliano, M, Frontoni, S, Malandrucco, I, Pitocco, D, Scalpone, R, Toscanella, F, Cappa, M, Ventura, C, Bonato, V, De Bernardinis, M, Cavallo, M, Leonetti, F, Morano, S, Mandosi, E, Cicconetti, E, Ciampittiello, G, Marini, M, Sabato, D, Napoli, A, Giraudo, F, Toscano, V, Massimiani, F, Fava, D, Gargiulo, P, Mecca, N, Tubili, C, Nardone, M, Morviducci, L, Manca-Bitti, M, Arcano, S, Leotta, S, Suraci, C, Chiaramonte, F, Visalli, N, Forte, E, Palmacci, C, Arnaldi, C, Tosini, D, Querci, F, Trevisan, R, Bonfadini, S, Prandi, E, Felappi, B, Locatelli, F, Fuso, V, Rocca, A, Meneghini, E, Massafra, C, Terni, T, Elli, P, Ruggeri, P, Carrai, E, Musacchio, N, Lovagnini Scher, C, Marelli, G, Vilei, V, Richini, D, Inversini, C, Franzetti, I, Bonacina, M, Ciucci, A, Sciangula, L, Duratorre, E, Bonomo, M, Bertuzzi, F, Chebat, E, Muratori, M, Scaramuzza, A, Zuccotti, G, Bollati, P, Colapinto, P, Orsi, E, Palmieri, E, Laurenzi, A, Molinari, C, Frontino, G, Veronelli, A, Zecchini, B, Bianchi, A, Torchio, G, Lovati, E, Ghilardi, G, Dagani, R, Carugo, D, Berra, C, Favacchio, G, Fochesato, E, Pissarelli, A, Bucciarelli, L, Bulgheroni, M, Guerraggio, L, Zonca, S, Bossi, A, Berzi, D, Mangone, I, Cazzaniga, E, Rabini, R, Boemi, M, Faloia, E, Boscaro, M, Sternari, G, Iannilli, A, Cherubini, V, Busciantella Ricci, N, Cartechini, M, Tesei, A, Maolo, G, Galetta, M, Vespasiani, G, Tinti, G, Manfrini, S, Aiello, A, Di Vincenzo, S, Vitale, C, Di Caro, P, Lera, R, Secco, A, Lesina, A, Romeo, F, Origlia, C, Giorda, C, Chiambretti, A, Fornengo, R, De Donno, V, Gallarotti, F, Manti, R, Marafetti, L, Cadario, F, Savastio, S, Barbieri, P, Massucco, P, Ali, A, Gottero, C, Degiovanni, M, Bertaina, S, Maghenzani, G, Tinti, D, Fontana, F, Giorgino, F, Stefanelli, G, Cavallo, L, Zecchino, C, Piccinno, E, Ortolani, F, Gallo, F, Moramarco, F, Marino, A, Sparasci, G, Mileti, G, Lamacchia, O, Picca, G, Coccioli, M, Micale, F, Serra, R, Romano, I, Savino, T, De Cosmo, S, Rauseo, A, Delvecchio, M, Lapolla, R, Braione, A, Papagno, G, Baroni, M, Melis, M, Cossu, E, Songini, M, Cambuli, V, Lo Presti, D, Timpanaro, T, Chiavetta, A, Garofalo, M, Tommaselli, L, Tumminia, A, Scarpitta, A, Di Benedetto, A, Giunta, L, Lombardo, F, Salzano, G, Cardella, F, Roppolo, R, Provenzano, V, Fleres, M, Migliorini, S, De Luca, A, Leopardi, A, Beltrami, C, Toni, S, Guasti, G, Lenzi, L, Lamanna, C, Mannucci, E, Lucchesi, S, Dicianni, G, Aragona, M, Del Prato, S, Fattor, B, Eisath, J, Pasquino, B, Reinstadler, P, Kaufmann, P, Incelli, G, Rauch, S, Romanelli, T, Cauvin, V, Franceschi, R, Soldani, C, Scattoni, R, Norgiolini, R, Celleno, R, Torlone, E, Bolli, G, Lalli, C, Scarponi, M, Bobbio, A, Bechaz, M, Pianta, A, Marangoni, A, Arico, C, Alagona, C, Confortin, L, Rossi, E, Boscolo Bariga, A, Nogara, A, Bettio, M, Frison, V, Guidoni, G, Fongher, C, Contin, M, Cosma, A, Vianello, S, Bondesan, L, Morea, A, Volpi, A, Coracina, A, Panebianco, G, Lombardi, S, Costa, S, Cipponeri, E, Vedovato, M, Scotton, R, Monciotti, C, Galderisi, A, Dalfra, M, Lapolla, A, Zanon, M, Lisato, G, Mollo, F, Calcaterra, F, Miola, M, Paccagnella, A, Sambataro, M, Moro, E, Trombetta, M, Negri, C, Sabbion, A, Maffeis, C, Strazzabosco, M, Mesturino, C, Mingardi, R, Bruttomesso, Daniela, Laviola, Luigi, Lepore, Giuseppe, Bonfanti, Riccardo, Bozzetto, Lutgarda, Corsi, Andrea, Di Blasi, Vincenzo, Girelli, Angela, Grassi, Giorgio, Iafusco, Dario, Rabbone, Ivana, Schiaffini, Riccardo, and Tornese, Gianluca

Subjects
Blood Glucose, Male, Pediatrics, Glucose control, IMPACT, Cost-Benefit Analysis, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, CHILDREN, Practice Patterns, Infusions, Subcutaneous, law.invention, Settore MED/13, Endocrinology, Randomized controlled trial, law, Surveys and Questionnaires, Insulin, Practice Patterns, Physicians', Child, Adult, Diabetes Mellitus, Type 1, Female, Guideline Adherence, Health Care Surveys, Humans, Hypoglycemic Agents, Italy, Medical Laboratory Technology, Medicine (all), PUMP THERAPY, Subcutaneous, Diabetes, Diabetes and Metabolism, TERM METABOLIC-CONTROL, Human, Type 1, Infusions, medicine.medical_specialty, Keywords KeyWords Plus:TERM METABOLIC-CONTROL, BOLUS CALCULATOR, PEDIATRIC-PATIENTS, CONTROLLED-TRIAL, CSII, Diabetes mellitus, Diabetes Mellitus, medicine, term metabolic-control, bolus calculator, pump therapy, pediatric-patients, controlled-trial, children, impact CSII, Glucose sensors, Cost-Benefit Analysi, Intensive care medicine, Type 1 diabetes, Physicians', Hypoglycemic Agent, business.industry, medicine.disease, Subcutaneous insulin, Infusions, Subcutaneou, Multicenter study, Health Care Survey, business
Abstract

Background: Continuous subcutaneous insulin infusion (CSII) is increasing worldwide, mostly because of improved technology. The aim of this study was to evaluate the current status of CSII in Italy. Materials and Methods: Physicians from 272 diabetes centers received a questionnaire investigating clinical features, pump technology, and management of patients on CSII. Results: Two hundred seventeen centers (79.8%) joined the study and, by the end of April 2013, gave information about 10,152 patients treated with CSII: 98.2% with type 1 diabetes mellitus, 81.4% adults, 57% female, and 61% with a conventional pump versus 39% with a sensor-augmented pump. CSII advanced functions were used by 68% of patients, and glucose sensors were used 12 days per month on average. Fifty-eight percent of diabetes centers had more than 20 patients on CSII, but there were differences among centers and among regions. The main indication for CSII was poor glucose control. Dropout was mainly due to pump wearability or nonoptimal glycemic control. Twenty-four hour assistance was guaranteed in 81% of centers. A full diabetes team (physician+ nurse + dietician + psychologist) was available in 23% of adult-care diabetes centers and in 53%of pediatric diabetes units. Conclusions: CSII keeps increasing in Italy. More work is needed to ensure uniform treatment strategies throughout the country and to improve pump use.

Published
2015
Full Text
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4. Personalized therapy algorithms for type 2 diabetes: a phenotype-based approach

Author

Ceriello A, Gallo M, Candido R, De Micheli A, Esposito K, Gentile S, and Medea G

Subjects
lcsh:Therapeutics. Pharmacology, lcsh:RM1-950
Abstract

Antonio Ceriello,1,2 Marco Gallo,3 Riccardo Candido,4 Alberto De Micheli,5 Katherine Esposito,6 Sandro Gentile,6 Gerardo Medea71Department of Endocrinology, Hospital Clinic de Barcelona, Institut d’Investigacions Biomèdiques August Pi iSunyer, 2Centro de Investigacion Biomèdica en Red de Diabetes y Enfermedades Metabolicas Asociadas, Barcelona, Spain; 3Oncological Endocrinology, AOU Città della Salute e della Scienza-Molinette, Turin, 4Diabetes Center, ASS 1 Triestina, Trieste, 5Ligurian Health Agency, Genoa, 6Department of Clinical and Experimental Medicine, Second University of Naples, Naples, 7Italian College of General Practitioners, Florence, ItalyAbstract: Type 2 diabetes is a progressive disease with a complex and multifactorial pathophysiology. Patients with type 2 diabetes show a variety of clinical features, including different "phenotypes" of hyperglycemia (eg, fasting/preprandial or postprandial). Thus, the best treatment choice is sometimes difficult to make, and treatment initiation or optimization is postponed. This situation may explain why, despite the existing complex therapeutic armamentarium and guidelines for the treatment of type 2 diabetes, a significant proportion of patients do not have good metabolic control and at risk of developing the late complications of diabetes. The Italian Association of Medical Diabetologists has developed an innovative personalized algorithm for the treatment of type 2 diabetes, which is available online. According to the main features shown by the patient, six algorithms are proposed, according to glycated hemoglobin (HbA1c, ≥9% or ≤9%), body mass index (≤30 kg/m2 or ≥30 kg/m2), occupational risk potentially related to hypoglycemia, chronic renal failure, and frail elderly status. Through self-monitoring of blood glucose, patients are phenotyped according to the occurrence of fasting/preprandial or postprandial hyperglycemia. In each of these six algorithms, the gradual choice of treatment is related to the identified phenotype. With one exception, these algorithms contain a stepwise approach for patients with type 2 diabetes who are metformin-intolerant. The glycemic targets (HbA1c, fasting/preprandial and postprandial glycemia) are also personalized. This accessible and easy to use algorithm may help physicians to choose a personalized treatment plan for each patient and to optimize it in a timely manner, thereby lessening clinical inertia.Keywords: type 2 diabetes, treatment guidelines, personalized treatment, Italian Association of Medical Diabetologists, Italian algorithm

Published
2014

5. Diabetes and sexual dysfunction: current perspectives

Author

Maiorino MI, Bellastella G, and Esposito K

Subjects
RC581-951, Specialties of internal medicine
Abstract

Maria Ida Maiorino,1 Giuseppe Bellastella,1 Katherine Esposito2 1Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, Second University of Naples, Naples, Italy; 2Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy Abstract: Diabetes mellitus is one of the most common chronic diseases in nearly all countries. It has been associated with sexual dysfunction, both in males and in females. Diabetes is an established risk factor for sexual dysfunction in men, as a threefold increased risk of erectile dysfunction was documented in diabetic men, as compared with nondiabetic men. Among women, evidence regarding the association between diabetes and sexual dysfunction are less conclusive, although most studies have reported a higher prevalence of female sexual dysfunction in diabetic women as compared with nondiabetic women. Female sexual function appears to be more related to social and psychological components than to the physiological consequence of diabetes. Hyperglycemia, which is a main determinant of vascular and microvascular diabetic complications, may participate in the pathogenetic mechanisms of sexual dysfunction in diabetes. Moreover, diabetic people may present several clinical conditions, including hypertension, overweight and obesity, metabolic syndrome, cigarette smoking, and atherogenic dyslipidemia, which are themselves risk factors for sexual dysfunction, both in men and in women. The adoption of healthy lifestyles may reduce insulin resistance, endothelial dysfunction, and oxidative stress – all of which are desirable achievements in diabetic patients. Improved well-being may further contribute to reduce and prevent sexual dysfunction in both sexes. Keywords: diabetes mellitus, diabetes complications, erectile dysfunction, female sexual dysfunction, lifestyle changes

Published
2014

6. The role of inferior petrosal sinus sampling in ACTH-dependent Cushing's syndrome: review and joint opinion statement by members of the Italian Society for Endocrinology, Italian Society for Neurosurgery, and Italian Society for Neuroradiology

Author

Pecori Giraldi, Francesca, Cavallo, Luigi Maria, Tortora, Fabio, Pivonello, Rosario, Colao, Annamaria, Cappabianca, Paolo, Mantero, Franco, Albiger, N, Alviggi, C, Ambrogio, Ag, Arnaldi, G, Arvat, E, Baldelli, R, Boscaro, M, Campo, M, Cannavo', Salvatore, Cavagnini, F, Chiodini, I, Corsello, Sm, Cozzolino, A, Di Leo, M, De Martino, Mc, Di Somma, C, Esposito, K, Ferone, D, Gatto, F, Giordano, R, Giugliano, D, Graziadio, C, Grimaldi, F, Iacuaniello, D, Isidori, A, Karamouzis, I, Lenzi, A, Loli, P, Mannelli, M, Marzullo, P, Morelli, V, Paragliola, Rm, Parenti, G, Pivolenno, C, Reimondo, G, Scaroni, C, Alfredo, S, Simeoli, C, Stigliano, A, Talco, M, Terzolo, M, Trementino, L, Urbani, C, Vitale, G, Zatelli, Mc, Giraldi, F, Cavallo, Lm, Tortora, F, Pivonello, Rosario, Colao, Annamaria, Cappabianca, Paolo, Mantero, F, Albiger, N, Alviggi, Carlo, Ambrogio, Ag, Arnaldi, G, Arvat, E, Baldelli, R, Boscaro, M, Campo, M, Cannavò, S, Cavagnini, F, Chiodini, I, Corsello, Sm, Cozzolino, A, Di Leo, M, De Martino, M, Di Somma, C, Esposito, K, Ferone, D, Gatto, F, Giordano, R, Giugliano, D, Graziadio, C, Grimaldi, F, Iacuaniello, D, Isidori, A, Karamouzis, I, Lenzi, A, Loli, P, Mannelli, M, Marzullo, P, Morelli, V, Paragliola, Rm, Parenti, G, Pivolenno, C, Reimondo, G, Scaroni, C, Alfredo, S, Simeoli, C, Stigliano, A, Talco, M, Terzolo, M, Trementino, L, Urbani, C, Vitale, G, Zatelli, Mc, Pecori Giraldi, F, Tortora, Fabio, Pivonello, R, Colao, A, Cappabianca, P, Giugliano, Dario, and Esposito, Katherine

Subjects
ACTH = adrenocorticotropic hormone, diagnosis, ACTH = adrenocorticotropic hormone, or corticotropin, CRH = corticotropin-releasing hormone, Cushing's disease, Cushing's syndrome, IPSS = inferior petrosal sinus sampling, NIH = National Institutes of Health, diagnosis, inferior petrosal sinus sampling, pituitary adenoma, pituitary imaging, pituitary surgery, adrenocorticotropic hormone, Cushing syndrome, endocrinology, humans, Italy, neuroradiography, neurosurgery, petrosal sinus sampling, societies, medical, Cushing's syndrome, pituitary adenoma, Petrosal Sinus Sampling, urologic and male genital diseases, or corticotropin, ACTH = adrenocorticotropic hormone, or corticotropin, medical, Endocrinology, Cushing Syndrome, Societies, Medical, Neuroradiology, General Medicine, inferior petrosal sinus sampling, Inferior petrosal sinus sampling, CRH = corticotropin-releasing hormone, Cushing's disease, IPSS = inferior petrosal sinus sampling, NIH = National Institutes of Health, pituitary imaging, pituitary surgery, Italy, Neuroradiography, Diagnosis, Pituitary adenoma, Pituitary imaging, Pituitary surgery, Adrenocorticotropic Hormone, Humans, Neurosurgery, Surgery, Neurology (clinical), hormones, hormone substitutes, and hormone antagonists, medicine.medical_specialty, education, Context (language use), Neuroradiologist, Adrenocorticotropic hormone, societies, Internal medicine, medicine, business.industry, Settore MED/13 - ENDOCRINOLOGIA, medicine.disease, business
Abstract

In the management of adrenocorticotropic hormone (ACTH)–dependent Cushing's syndrome, inferior petrosal sinus sampling (IPSS) provides information for the endocrinologist, the neurosurgeon, and the neuroradiologist. To the endocrinologist who performs the etiological diagnosis, results of IPSS confirm or exclude the diagnosis of Cushing's disease with 80%–100% sensitivity and over 95% specificity. Baseline central-peripheral gradients have suboptimal accuracy, and stimulation with corticotropin-releasing hormone (CRH), possibly desmopressin, has to be performed. The rationale for the use of IPSS in this context depends on other diagnostic means, taking availability of CRH and reliability of dynamic testing and pituitary imaging into account. As regards the other specialists, the neuroradiologist may collate results of IPSS with findings at imaging, while IPSS may prove useful to the neurosurgeon to chart a surgical course. The present review illustrates the current standpoint of these 3 specialists on the role of IPSS.

Published
2015

7. Molecular basis of pharmacological therapy in Cushing’s disease

Author

Ferone, Diego, Pivonello, Claudia, Vitale, Giovanni, Zatelli, Maria Chiara, Colao, Annamaria, Pivonello, Rosario, Albiger, ABC Group: N., Ambrogio, A., Arnaldi, G., Arvat, E., Baldelli, R., Berardelli, R., Boscaro, M., Cannavo', Salvatore, Cavagnini, F., Corsello, S. M., Cozzolino, A., De Bartolomeis, A., De Leo, M., Di Minno, G., Di Somma, C., Esposito, K., Fabbrocini, G., Foresta, C., Galderisi, M., Giordano, C., Giugliano, D., Giustina, A., Grimaldi, F., Isidori, A. M., Jannini, E., F. Lombardo, L. Manetti, Mannelli, M., Mantero, F., Marone, G., Mazziotti, G., Moretti, S., Nazzari, E., Paragliola, R. M., Pasquali, R., Pecorelli, S., Pecori Giraldi, F., Reimondo, G., Scaroni, C., Scillitani, A., Simeoli, C., Stigliano, A., Toscano, V., Trementino, L., Ferone, D, Pivonello, Claudia, Vitale, G, Zatelli, Mc, Colao, Annamaria, and Pivonello, Rosario

Subjects
business.industry, Endocrinology, Diabetes and Metabolism, Humans, Hypothalamus, Pituitary ACTH Hypersecretion, Pituitary Gland, Receptors, Glucocorticoid, Disease, Cushing's disease, medicine.disease, Bioinformatics, Clinical trial, Endocrinology, Pituitary adenoma, Diabetes mellitus, Immunology, medicine, Endocrine system, business, Receptor, Glucocorticoid, medicine.drug
Abstract

Cushing's disease (CD) is a severe endocrine condition caused by an adrenocorticotropin (ACTH)-pro- ducing pituitary adenoma that chronically stimulates adrenocortical cortisol production and with potentially serious complications if not or inadequately treated. Active CD may produce a fourfold increase in mortality and is associated with significant morbidities. Moreover, excess mortality risk may persist even after CD treatment. Although predictors of risk in treated CD are not fully understood, the importance of early recognition and ade- quate treatment is well established. Surgery with resection of a pituitary adenoma is still the first line therapy, being successful in about 60-70 % of patients; however, recur- rence within 2-4 years may often occur. When surgery fails, medical treatment can reduce cortisol production and ameliorate clinical manifestations while more definitive therapy becomes effective. Compounds that target hypo- thalamic-pituitary axis, glucocorticoid synthesis or adre- nocortical function are currently used to control the deleterious effects of chronic glucocorticoid excess. In this review we describe and analyze the molecular basis of the drugs targeting the disease at central level, suppressing ACTH secretion, as well as at peripheral level, acting as adrenal inhibitors, or glucocorticoid receptor antagonists. Understanding of the underlying molecular mechanisms in CD and of glucocorticoid biology should promote the development of new targeted and more successful therapies in the future. Indeed, most of the drugs discussed have been tested in limited clinical trials, but there is potential ther- apeutic benefit in compounds with better specificity for the class of receptors expressed by ACTH-secreting tumors. However, long-term follow-up with management of per- sistent comorbidities is needed even after successful treatment of CD.

Published
2013
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8. Dipeptidyl peptidase-4 inhibitors in type 2 diabetes therapy – focus on alogliptin

Author

Capuano A, Sportiello L, Maiorino MI, Rossi F, Giugliano D, and Esposito K

Subjects
lcsh:Therapeutics. Pharmacology, lcsh:RM1-950
Abstract

Annalisa Capuano,1 Liberata Sportiello,1 Maria Ida Maiorino,2 Francesco Rossi,1 Dario Giugliano,2 Katherine Esposito3 1Department of Experimental Medicine, 2Department of Medical, Surgical, Neurological, Metabolic Sciences, and Geriatrics, 3Department of Clinical and Experimental Medicine and Surgery, Second University of Naples, Naples, Italy Abstract: Type 2 diabetes mellitus is a complex and progressive disease that is showing an apparently unstoppable increase worldwide. Although there is general agreement on the first-line use of metformin in most patients with type 2 diabetes, the ideal drug sequence after metformin failure is an area of increasing uncertainty. New treatment strategies target pancreatic islet dysfunction, in particular gut-derived incretin hormones. Inhibition of the enzyme dipeptidyl peptidase-4 (DPP-4) slows degradation of endogenous glucagon-like peptide-1 (GLP-1) and thereby enhances and prolongs the action of the endogenous incretin hormones. The five available DPP-4 inhibitors, also known as 'gliptins' (sitagliptin, vildagliptin, saxagliptin, linagliptin, alogliptin), are small molecules used orally with similar overall clinical efficacy and safety profiles in patients with type 2 diabetes. The main differences between the five gliptins on the market include: potency, target selectivity, oral bioavailability, long or short half-life, high or low binding to plasma proteins, metabolism, presence of active or inactive metabolites, excretion routes, dosage adjustment for renal and liver insufficiency, and potential drug–drug interactions. On average, treatment with gliptins is expected to produce a mean glycated hemoglobin (HbA1c) decrease of 0.5%–0.8%, with about 40% of diabetic subjects at target for the HbA1c goal

Published
2013

9. Lifestyle recommendations for the prevention and management of metabolic syndrome: an international panel recommendation

Author

BULLÓ BONET, MÒNICA, Pérez-Martínez, P., Mikhailidis, DP., Athyros, VG., Couture, P., Covas, MI., de Koning, L., Delgado-Lista, J., Díaz-López, A., Drevon, CA., Estruch, R., Esposito, K., Fitó, M., Garaulet, M., Giugliano, D., García-Ríos, A., Katsiki, N., Kolovou, G., Lamarche, B., Maiorino, MI., Mena-Sánchez, G., Muñoz-Garach, A., Nikolic, D., Ordovás, JM., Pérez-Jiménez, F., Rizzo, M., SALAS SALVADÓ, JORGE, Alimentació, Nutrició, Creixement i Salut Mental, Departament de Bioquímica i Biotecnologia, and Universitat Rovira i Virgili

Subjects
Ciències de la salut, 0029-6643, Health sciences, METABOLISME TRASTORNS, DIETOTERÀPIA, Dietary patterns, Lifestyle, Ciencias de la salud, metabolic syndrome
Abstract

The importance of metabolic syndrome (MetS) lies in its associated risk of cardiovascular disease and type 2 diabetes, as well as other harmful conditions such as nonalcoholic fatty liver disease. In this report, the available scientific evidence on the associations between lifestyle changes and MetS and its components is reviewed to derive recommendations for MetS prevention and management. Weight loss through an energy-restricted diet together with increased energy expenditure through physical activity contribute to the prevention and treatment of MetS. A Mediterranean-type diet, with or without energy restriction, is an effective treatment component. This dietary pattern should be built upon an increased intake of unsaturated fat, primarily from olive oil, and emphasize the consumption of legumes, cereals (whole grains), fruits, vegetables, nuts, fish, and low-fat dairy products, as well as moderate consumption of alcohol. Other dietary patterns (Dietary Approaches to Stop Hypertension, new Nordic, and vegetarian diets) have also been proposed as alternatives for preventing MetS. Quitting smoking and reducing intake of sugar-sweetened beverages and meat and meat products are mandatory. Nevertheless, there are inconsistencies and gaps in the evidence, and additional research is needed to define the most appropriate therapies for MetS. In conclusion, a healthy lifestyle is critical to prevent or delay the onset of MetS in susceptible individuals and to prevent cardiovascular disease and type 2 diabetes in those with existing MetS. The recommendations provided in this article should help patients and clinicians understand and implement the most effective approaches for lifestyle change to prevent MetS and improve cardiometabolic health.

Published
2017

10. Treatment of skeletal impairment in patients with endogenous hypercortisolism: when and how?

Author

Scillitani A, Mazziotti G, Di Somma C, Moretti S, Stigliano A, Pivonello R, Giustina A, Colao A, Albiger N, Ambrogio A, Arnaldi G, Arvat E, Baldelli R, Berardelli R, Boscaro M, Cannavò S, Cavagnini F, Corsello SM, Cozzolino A, De Bartolomeis A, De Leo M, Di Minno G, Esposito K, Fabbrocini G, Ferone D, Foresta C, Galderisi M, Giordano C, Grimaldi F, Isidori AM, Jannini E, Lombardo F, Manetti L, Mannelli M, Mantero F, Marone G, Nazzari E, Paragliola RM, Pasquali R, Pecorelli S, Pecori Giraldi F, Pivonello C, Reimondo G, Scaroni C, Simeoli C, Toscano V, Trementino L, Vitale G, Zatelli M.C.)., ESPOSITO, Katherine, GIUGLIANO, Dario, Scillitani, A, Mazziotti, G, Di Somma, C, Moretti, S, Stigliano, A, Pivonello, R, Giustina, A, Esposito, Katherine, Colao, A, Albiger, N, Ambrogio, A, Arnaldi, G, Arvat, E, Baldelli, R, Berardelli, R, Boscaro, M, Cannavò, S, Cavagnini, F, Corsello, Sm, Cozzolino, A, De Bartolomeis, A, De Leo, M, Di Minno, G, Esposito, K, Fabbrocini, G, Ferone, D, Foresta, C, Galderisi, M, Giordano, C, Giugliano, Dario, Grimaldi, F, Isidori, Am, Jannini, E, Lombardo, F, Manetti, L, Mannelli, M, Mantero, F, Marone, G, Nazzari, E, Paragliola, Rm, Pasquali, R, Pecorelli, S, Pecori Giraldi, F, Pivonello, C, Reimondo, G, Scaroni, C, Simeoli, C, Toscano, V, Trementino, L, Vitale, G, and Zatelli, M. C. ).

Published
2014

11. Metabolic syndrome and risk of cancer:a sistematic review and meta-analysis

Author

Esposito K, Chiodini P, Lenzi A, Giugliano D., COLAO, ANNAMARIA, Esposito, K, Chiodini, P, Colao, Annamaria, Lenzi, A, and Giugliano, D.

Abstract

OBJECTIVE - Available evidence supports the emerging hypothesis that metabolic syndrome may be associated with the risk of some common cancers. We did a systematic review and meta-analysis to assess the association between metabolic syndrome and risk of cancer at different sites. RESEARCH DESIGN AND METHODS - We conducted an electronic search for articles published through October 2011 without restrictions and by reviewing reference lists from retrieved articles. Every included study was to report risk estimates with 95% CIs for the association between metabolic syndrome and cancer. RESULTS - We analyzed 116 datasets from 43 articles, including 38,940 cases of cancer. In cohort studies in men, the presence of metabolic syndrome was associated with liver (relative risk 1.43, P < 0.0001), colorectal (1.25, P < 0.001), and bladder cancer (1.10, P = 0.013). In cohort studies in women, the presence of metabolic syndrome was associated with endometrial (1.61, P = 0.001), pancreatic (1.58, P < 0.0001), breast postmenopausal (1.56, P = 0.017), rectal (1.52, P = 0.005), and colorectal (1.34, P = 0.006) cancers. Associations with metabolic syndrome were stronger in women than in men for pancreatic (P = 0.01) and rectal (P = 0.01) cancers. Associations were different between ethnic groups: we recorded stronger associations in Asia populations for liver cancer (P = 0.002), in European populations for colorectal cancer in women (P = 0.004), and in U.S. populations (whites) for prostate cancer (P = 0.001). CONCLUSIONS - Metabolic syndrome is associated with increased risk of common cancers; for some cancers, the risk differs betweens sexes, populations, and de finitions of metabolic syndrome.

Published
2012

12. Therapeutic management of hyperglycemia in cancer patients in hospital

Author

Gallo, Marco, Clemente, G., Esposito, K., Gentile, L., Berardelli, R., Boccuzzi, G., and Arvat, E.

Subjects
Clinical management, Diabetes, Artificial nutrition, Glucocorticoids, Cancer
Abstract

Diabetes and cancer are an increasingly common combination and managing oncologic patients with diabetes as a co-morbidity is often complicated. Diabetes has been linked to an increased risk of different cancer types, and coexisting diabetes confers a greater risk of mortality for many malignancies. Diabetes in cancer patients poses several complex questions about management, including what level of glycemic control should be achieved in persons who may have a limited life expectancy, and what is the best therapeutic approach to control hyperglycemia. Glucocorticoids and artificial nutrition, frequently used in cancer treatment, can lead to acute episodes of hyperglycemia. The first important distinction to be made is the patient's position on the trajectory of the oncologic illness. The management of diabetes during terminal illness is also complex, when the aim of care is to improve and maintain quality of life, maximizing comfort. Severe hyperglycemia and hypoglycemia can both impair the quality of life of these patients. In the clinical setting, in hospital or at home, there is little evidence-based guidance on the best course of management on which to base clinical decisions. A practical solution is to set up care networks based on communication and continuous collaboration between oncologists, endocrinologists, and nursing staff, with the patient at the center of the care process.

Published
2015

13. The hypertension of Cushing's syndrome: Controversies in the pathophysiology and focus on cardiovascular complications

Author

Isidori, Am, Graziadio, C, Paragliola, Rm, Cozzolino, A, Ambrogio, Ag, Colao, A, Corsello, Sm, Pivonello, R, Albiger, N, Arnaldi, G, Arvat, E, Baldelli, R, Berardelli, R, Boscaro, M, Cannavo', Salvatore, Cavagnini, F, De Bartolomeis, A, De Leo, M, Di Minno, G, Di Somma, C, Esposito, K, Fabbrocini, G, Ferone, D, Foresta, C, Galderisi, M, Giordano, C, Giugliano, D, Giustina, A, Grimaldi, F, Jannini, E, Lombardo, F, Manetti, L, Mannelli, M, Mantero, F, Marone, G, Mazziotti, G, Moretti, S, Nazzari, E, Pasquali, R, Pecorelli, S, Pecori Giraldi, F, Pivonello, C, Reimondo, G, Scaroni, C, Scillitani, A, Simeoli, C, Stigliano, A, Toscano, V, Trementino, L, Vitale, G, Zatelli, Mc, Isidori, A, Graziadio, C, Paragliola, R, Cozzolino, A, Ambrogio, A, Colao, A, Corsello, S, Pivonello, R, and Giordano, C

Subjects
Male, antihypertensive treatment, blood pressure, corticosteroids, Cushing's syndrome, hypercortisolism, hypertension, metabolic syndrome, vascular system, Animals, Blood Pressure, Cushing Syndrome, Female, Glucocorticoids, Humans, Hypertension, Metabolic Syndrome, medicine.medical_specialty, Physiology, Hypercortisolism, Reviews, Settore MED/13 - Endocrinologia, Cushing syndrome, Internal medicine, Antihypertensive treatment, Internal Medicine, Medicine, Corticosteroid, Intensive care medicine, S syndrome, business.industry, medicine.disease, Metabolic syndrome, antihypertensive treatment, blood pressure, corticosteroids, Cushing's syndrome, hypercortisolism, hypertension, metabolic syndrome, vascular system, Pathophysiology, Clinical trial, Critical appraisal, Endocrinology, Blood pressure, Vascular system, Corticosteroids, Cardiology and Cardiovascular Medicine, business, Glucocorticoid, medicine.drug
Abstract

Cushing's syndrome is associated with increased mortality, mainly due to cardiovascular complications, which are sustained by the common development of systemic arterial hypertension and metabolic syndrome, which partially persist after the disease remission. Cardiovascular diseases and hypertension associated with endogenous hypercortisolism reveal underexplored peculiarities. The use of exogenous corticosteroids also impacts on hypertension and cardiovascular system, especially after prolonged treatment. The mechanisms involved in the development of hypertension differ, whether glucocorticoid excess is acute or chronic, and the source endogenous or exogenous, introducing inconsistencies among published studies. The pleiotropic effects of glucocorticoids and the overlap of the several regulatory mechanisms controlling blood pressure suggest that a rigorous comparison of in-vivo and in-vitro studies is necessary to draw reliable conclusions. This review, developed during the first ‘Altogether to Beat Cushing's syndrome’ workshop held in Capri in 2012, evaluates the most important peculiarities of hypertension associated with CS, with a particular focus on its pathophysiology. A critical appraisal of most significant animal and human studies is compared with a systematic review of the few available clinical trials. A special attention is dedicated to the description of the clinical features and cardiovascular damage secondary to glucocorticoid excess. On the basis of the consensus reached during the workshop, a pathophysiology-oriented therapeutic algorithm has been developed and it could serve as a first attempt to rationalize the treatment of hypertension in Cushing's syndrome.

Published
2015

15. La terapia insulinica sottocutanea continua (CSII) in Italia. Terza indagine nazionale [Subcutaneous insulin infusion (CSII) in italy: The third national survey]

Author

Bruttomesso, D, Laviola, L, Lepore, G, Bonfanti, R, Bozzetto, L, Corsi, A, Di Blasi, V, Girelli, A, Grassi, G, Iafusco, D, Rabbone, I, Schiaffini, R, Montani, V, Colleluori, P, Paciotti, V, Alfidi, P, Grosso, J, Tumini, S, Cipriano, P, Vitacolonna, E, Di Vieste, G, Minnucci, A, Antenucci, D, La Penna, G, Taraborrelli, M, Macerala, B, Citro, G, De Morelli, G, Gnasso, A, Irace, C, Citriniti, F, Lazzaro, N, Bruzzese, M, Mammì, F, De Berardinis, F, Santoro, E, Corigliano, G, Corigliano, M, Parillo, M, Schettino, M, Fresa, R, Annuzzi, G, Bassi, V, Santinelli, C, Buono, P, Mozzillo, E, Russo, V, Esposito, K, Petrizzo, M, Foglia, A, Gatti, A, Gentile, S, Guarino, G, Zanfardino, A, Lambiase, C, Vitale, A, Zucchini, S, Maltoni, G, Forlani, G, Moscatiello, S, Suprani, T, Bensa, M, Tomasi, F, Monesi, M, Nizzoli, M, Acquati, S, Chierici, G, Milli, B, Iughetti, Lorenzo, Predieri, Barbara, Cavani, R, Romano, S, Manicardi, V, Michelini, M, Cimicchi, M. C, Ugolotti, D, Zavaroni, I., Dei Cas, A, Dall’Aglio, E, Papi, M, Tardio, S, Calderini, M, Riboni, S, D’Amato, L, Zavaroni, D, Gastaldi, L, Cirillo, A, Di Bartolo, P, Pellicano, F, Di Seclì, C, Amarri, S, Lasagni, A, Marsciani, A, Pedini, A, Pagliani, U, Rossi, C, Tortul, C, Brunato, B, Assaloni, R, Zanette, G, Livolsi, P, Petrucco, A, Tercelj, K, Manca, E, Candido, R, Tommasi, E, Tornese, G, Faleschini, E, Tonutti, L, Agus, S, Zanatta, M, Rosolen, A, Comici, A, Falasca, P, Graziano, F. M, Misischi, I, Forte, E, Palmacci, C, Tuccinardi, F, Ricciardi, G. P, Di Masa, P, Ragonese, M, Cipolloni, L, Buzzetti, R, Moretti, C, Leto, G, Crinò, A, Bocchini, S, Pozzilli, P, Maurizi, A. R, Di Perna, P, Giuliano, M, Frontoni, S, Malandrucco, I, Pitocco, D, Scalpone, R, Toscanella, F, Cappa, M, Ventura, C, Bonato, V, De Bernardinis, M, Cavallo, M. G, Leonetti, F, Morano, S, Mandosi, E, Cicconetti, E, Ciampittiello, G, Marini, M. A, Sabato, D, Lauro, D, Napoli, A, Giraudo, F, Toscano, V, Pugliese, G, Massimiani, F, Fava, D, Gargiulo, P, Mecca, N, Tubili, C, Nardone, M. R, Morviducci, L, Manca Bitti, M. L, Arcano, S, Leotta, S, Suraci, C, Chiaramonte, F, Visalli, N, Strollo, F, Arnaldi, C, Tosini, D, Ponzani, P, Patrone, M, Guido, R, Aglialoro, A, Ghisoni, G, Fabbri, F, Bordone, C, Maggi, D, Cordera, R, Minuto, N, Rotondo, E, Speranza, D, Siri, M, Carro, S, Zappa, A, Parmigiani, S, Nieri, S, Briatore, L, Calvo, G, Querci, F, Trevisan, R, Bonfadini, S, Prandi, E, Felappi, B, Locatelli, F, Fuso, V, Rocca, A, Meneghini, E, Massafra, C, Terni, T, Elli, P, Ruggeri, P, Carrai, E, Musacchio, N, Marelli, G, Vilei, V, Richini, D, Inversini, C, Franzetti, I, Bonacina, M, Ciucci, A, Sciangula, L, Duratorre, E, Bonomo, M, Bertuzzi, F, Chebat, E, Muratori, M, Scaramuzza, A, Zuccotti, G. V, Bollati, P. M, Colapinto, P, Orsi, E, Palmieri, E, Laurenzi, A, Molinari, C, Frontino, G, Veronelli, A, Zecchini, B, Bianchi, A, Torchio, G, Lovati, E, Ghilardi, G, Dagani, R, Berra, C, Fochesato, E, Pissarelli, A, Bucciarelli, L, Bulgheroni, M, Guerraggio, L, Zonca, S, Bossi, A. C, Berzi, D, Mangone, I, Cazzaniga, E, Rabini, R. A, Boemi, M, Faloia, E, Boscaro, M, Sternari, G, Iannilli, A, Cherubini, V, Tinti, G, Manfrini, S, Tesei, A. M, Maolo, G, Galetta, M, Vespasiani, G, Busciantella Ricci, N, Cartechini, M. G, Aiello, A, Di Vincenzo, S, Vitale, C, Di Caro, P, Lera, R, Secco, A, Lesina, A, Romeo, F, Origlia, C, Giorda, C., Chiambretti, A. M, Fornengo, R, De Donno, V, Gallarotti, F, Manti, R, Marafetti, L, Cadario, F, Savastio, S, Barbieri, P, Massucco, P, Alì, A, Gottero, C, Degiovanni, M, Bertaina, S, Maghenzani, G, Tinti, D, Fontana, F, Giorgino, F, Stefanelli, G, Cavallo, L, Zecchino, C, Piccinno, E, Ortolani, F, Gallo, F, Moramarco, F, Marino, A, Sparasci, G, Mileti, G, Lamacchia, O, Picca, G, Coccioli, M. S, Micale, F, Serra, R, Romano, I, Savino, T, Giovanni, S, De Cosmo, S, Rauseo, A, Delvecchio, M, Lapolla, R, Braione, A. F, Papagno, G, Baroni, M, Melis, M, Cossu, E, Songini, M, Cambuli, V. M, Lo Presti, D, Timpanaro, T, Chiavetta, A, Garofalo, M. R, Tommaselli, L, Tumminia, A, Scarpitta, A. M, Di Benedetto, A, Giunta, L, Lombardo, F, Salzano, G, Cardella, F, Roppolo, R, Provenzano, V, Fleres, M, Migliorini, S, De Luca, A, Leopardi, A, Beltrami, C, Toni, S, Guasti, G, Lenzi, L, Lamanna, C, Mannucci, E, Lucchesi, S, Di Cianni, G, Aragona, M, Del Prato, S, Fattor, B, Eisath, J, Pasquino, B, Reinstadler, P, Kaufmann, P, Incelli, G, Rauch, S, Romanelli, T, Cauvin, V, Franceschi, R, Ospedale, S. C, Soldani, C, Scattoni, R, Norgiolini, R, Celleno, R, Torlone, E, Bolli, G. B, Lalli, C, Scarponi, M, Bobbio, A, Bechaz, M, Pianta, A, Marangoni, A, Aricò, C. N, Alagona, C, Confortin, L, Rossi, E, Boscolo, B. A, Nogara, A, Bettio, M, Frison, V, Guidoni, G. L, Fongher, C, Contin, M. L, Cosma, A, Vianello, S, Bondesan, L, Morea, A, Volpi, A, Coracina, A, Panebianco, G, Lombardi, S, Costa, S, Cipponeri, E, Vedovato, M, Scotton, R, Monciotti, C. M, Galderisi, A, Dalfrà, M. G, Lapolla, A, Portogruaro, S, Zanon, M, Lisato, G, Mollo, F, Calcaterra, F, Miola, M, Paccagnella, A, Sambataro, M, Moro, E, Trombetta, M, Negri, C, Sabbion, A, Maffeis, C, Strazzabosco, M, Mesturino, C. A, and Mingardi, R.

Subjects
Diabetes and Metabolism, Continuous subcutaneous insulin infusion, Diabetes mellitus, Insulin pump, Endocrinology, Internal Medicine, Endocrinology, Diabetes and Metabolism
Published
2015

16. Subcutaneous insulin infusion (CSII) in italy: The third national survey

Author

Bruttomesso, D., Laviola, L., Lepore, G., Bonfanti, R., Bozzetto, L., Corsi, A., Di Blasi, V., Girelli, A., Grassi, G., Iafusco, D., Rabbone, I., Schiaffini, R., Montani, V., Colleluori, P., Paciotti, V., Alfidi, P., Grosso, J., Tumini, S., Cipriano, P., Vitacolonna, E., Di Vieste, G., Minnucci, A., Antenucci, D., La Penna, G., Taraborrelli, M., Macerala, B., Citro, G., De Morelli, G., Gnasso, A., Irace, C., Citriniti, F., Lazzaro, N., Bruzzese, M., Mammi, F., De Berardinis, F., Santoro, E., Corigliano, G., Corigliano, M., Parillo, M., Schettino, M., Fresa, R., Annuzzi, G., Bassi, V., Santinelli, C., Buono, P., Mozzillo, E., Russo, V., De Feo, E., Esposito, K., Petrizzo, M., Foglia, A., Gatti, A., Gentile, S., Guarino, G., Zanfardino, A., Lambiase, C., Vitale, A., Zucchini, S., Maltoni, G., Forlani, G., Moscatiello, S., Suprani, T., Bensa, M., Tomasi, F., Monesi, M., Nizzoli, M., Acquati, S., Chierici, G., Milli, B., Iughetti, L., Predieri, B., Cavani, R., Romano, S., Manicardi, V., Michelini, M., Cimicchi, M. C., Ugolotti, D., Zavaroni, I., Dei Cas, A., Dall'Aglio, E., Papi, M., Tardio, S. M., Calderini, M. C., Riboni, S., D'Amato, L., Zavaroni, D., Gastaldi, L., Cirillo, A., Di Bartolo, P., Pellicano, F., Di Secli, C., Amarri, S., Lasagni, A., Marsciani, A., Pedini, A., Pagliani, U., Rossi, C., Tortul, C., Brunato, B., Assaloni, R., Zanette, G., Livolsi, P., Petrucco, A., Tercelj, K., Manca, E., Candido, R., Tommasi, E., Tornese, G., Faleschini, E., Tonutti, L., Agus, S., Zanatta, M., Rosolen, A., Comici, A., Falasca, P., Graziano, F. M., Misischi, I., Forte, E., Palmacci, C., Tuccinardi, F., Ricciardi, G. P., Di Masa, P., Ragonese, M., Cipolloni, L., Buzzetti, R., Moretti, C., Leto, G., Crino, A., Bocchini, S., Pozzilli, P., Maurizi, A. R., Di Perna, P., Giuliano, M., Frontoni, S., Malandrucco, I., Pitocco, D., Scalpone, R., Toscanella, F., Cappa, M., Ventura, C., Bonato, V., De Bernardinis, M., Cavallo, M. G., Leonetti, F., Morano, S., Mandosi, E., Cicconetti, E., Ciampittiello, G., Marini, M. A., Sabato, D., Lauro, D., Napoli, A., Giraudo, F., Toscano, V., Pugliese, G., Massimiani, F., Fava, D., Gargiulo, P., Mecca, N., Tubili, C., Nardone, M. R., Morviducci, L., Manca-Bitti, M. L., Arcano, S., Leotta, S., Suraci, C., Chiaramonte, F., Visalli, N., Strollo, F., Arnaldi, C., Tosini, D., Ponzani, P., Patrone, M., Guido, R., Aglialoro, A., Ghisoni, G., Fabbri, F., Bordone, C., Maggi, D., Cordera, R., Minuto, N., Rotondo, E., Speranza, D., Siri, M., Carro, S., Zappa, A., Parmigiani, S., Nieri, S., Briatore, L., Calvo, G., Querci, F., Trevisan, R., Bonfadini, S., Prandi, E., Felappi, B., Locatelli, F., Fuso, V., Rocca, A., Meneghini, E., Massafra, C., Terni, T., Elli, P., Ruggeri, P., Carrai, E., Musacchio, N., Marelli, G., Vilei, V., Richini, D., Inversini, C., Franzetti, I., Bonacina, M., Ciucci, A., Sciangula, L., Duratorre, E., Bonomo, M., Bertuzzi, F., Chebat, E., Muratori, M., Scaramuzza, A., Zuccotti, G. V., Bollati, P. M., Colapinto, P., Orsi, E., Palmieri, E., Laurenzi, A., Molinari, C., Frontino, G., Veronelli, A., Zecchini, B., Bianchi, A., Torchio, G., Lovati, E., Ghilardi, G., Dagani, R., Berra, C., Fochesato, E., Pissarelli, A., Bucciarelli, L., Bulgheroni, M., Guerraggio, L., Zonca, S., Bossi, A. C., Berzi, D., Mangone, I., Cazzaniga, E., Rabini, R. A., Boemi, M., Faloia, E., Boscaro, M., Sternari, G., Iannilli, A., Cherubini, V., Tinti, G., Manfrini, S., Tesei, A. M., Maolo, G., Galetta, M., Vespasiani, G., Busciantella Ricci, N., Cartechini, M. G., Aiello, A., Di Vincenzo, S., Vitale, C., Di Caro, P., Lera, R., Secco, A., Lesina, A., Romeo, F., Origlia, C., Giorda, C., Chiambretti, A. M., Fornengo, R., De Donno, V., Gallarotti, F., Manti, R., Marafetti, L., Cadario, F., Savastio, S., Barbieri, P., Massucco, P., Ali, A., Gottero, C., Degiovanni, M., Bertaina, S., Maghenzani, G., Tinti, D., Fontana, F., Giorgino, F., Stefanelli, G., Cavallo, L., Zecchino, C., Piccinno, E., Ortolani, F., Gallo, F., Moramarco, F., Marino, A., Sparasci, G., Mileti, G., Lamacchia, O., Picca, G., Coccioli, M. S., Micale, F., Serra, R., Romano, I., Savino, T., Giovanni, S., De Cosmo, S., Rauseo, A., Delvecchio, M., Lapolla, R., Braione, A. F., Papagno, G., Baroni, M., Melis, M., Cossu, E., Songini, M., Cambuli, V. M., Lo Presti, D., Timpanaro, T. A., Chiavetta, A., Garofalo, M. R., Tommaselli, L., Tumminia, A., Scarpitta, A. M., Di Benedetto, A., Giunta, L., Lombardo, F., Salzano, G., Cardella, F., Roppolo, R., Provenzano, V., Fleres, M., Migliorini, S., De Luca, A., Leopardi, A., Beltrami, C., Toni, S., Guasti, G., Lenzi, L., Lamanna, C., Mannucci, E., Lucchesi, S., Di Cianni, G., Aragona, M., Del Prato, S., Fattor, B., Eisath, J., Pasquino, B., Reinstadler, P., Kaufmann, P., Incelli, G., Rauch, S., Romanelli, T., Cauvin, V., Franceschi, R., Ospedale, S. C., Soldani, C., Scattoni, R., Norgiolini, R., Celleno, R., Torlone, E., Bolli, G. B., Lalli, C., Scarponi, M., Bobbio, A., Bechaz, M., Pianta, A., Marangoni, A., Arico, C. N., Alagona, C., Confortin, L., Rossi, E., Boscolo, B. A., Nogara, A., Bettio, M., Frison, V., Guidoni, G. L., Fongher, C., Contin, M. L., Cosma, A., Vianello, S., Bondesan, L., Morea, A., Volpi, A., Coracina, A., Panebianco, G., Lombardi, S., Costa, S., Cipponeri, E., Vedovato, M., Scotton, R., Monciotti, C. M., Galderisi, A., Dalfra, M. G., Lapolla, A., Portogruaro, S., Zanon, M., Lisato, G., Mollo, F., Calcaterra, F., Miola, M., Paccagnella, A., Sambataro, M., Moro, E., Trombetta, M., Negri, C., Sabbion, A., Maffeis, C., Strazzabosco, M., Mesturino, C. A., and Mingardi, R.

Subjects
Diabetes mellitus, Continuous subcutaneous insulin infusion, Insulin pump
Published
2015

17. Treatment of skeletal impairment in patients with endogenous hypercortisolism: when and how?

Author

Scillitani, A, Mazziotti, G, Di Somma, C, Moretti, S, Stigliano, A, Pivonello, R, Giustina, A, Colao, A, Albiger, N, Ambrogio, A, Arnaldi, G, Arvat, E, Baldelli, R, Berardelli, R, Boscaro, M, Cannavo', Salvatore, Cavagnini, F, Corsello, Sm, Cozzolino, A, De Bartolomeis, A, De Leo, M, Di Minno, G, Esposito, K, Fabbrocini, G, Ferone, D, Foresta, C, Galderisi, M, Giordano, C, Giugliano, D, Grimaldi, F, Isidori, Am, Jannini, E, Lombardo, F, Manetti, L, Mannelli, M, Mantero, F, Marone, G, Nazzari, E, Paragliola, Rm, Pasquali, R, Pecorelli, S, Pecori Giraldi, F, Pivonello, C, Reimondo, G, Scaroni, C, Simeoli, C, Toscano, V, Trementino, L, Vitale, G, Zatelli, M. C., Scillitani, A, Mazziotti, G, Di Somma, C, Moretti, S, Stigliano, A, Pivonello, R, Giustina, A, Colao, A, Giordano, C, DI SOMMA, C, Giustina, Andrea, Colao, A., DI SOMMA, Carolina, Pivonello, Rosario, Colao, Annamaria, Abc, Group, and Fabbrocini, Gabriella

Subjects
Oncology, medicine.medical_specialty, FRAX, Endocrinology, Diabetes and Metabolism, Osteoporosis, Hypercortisolism, Adrenal incidentaloma, Cushing's disease, Glucocorticoids, Bone Density Conservation Agents, Cushing Syndrome, Humans, Osteoporotic Fractures, Risk Factors, Endogeny, Disease, adrenal incidentaloma, Bone remodeling, Internal medicine, medicine, glucocorticoids, business.industry, cushing's disease, medicine.disease, osteoporosis, Rheumatology, Endocrinology, CUSHING'S DISEASE, business, Glucocorticoid, medicine.drug
Abstract

Guidelines for the management of osteoporosis induced by endogenous hypercortisolism are not available. Both the American College of Rheumatology and the International Osteoporosis Foundation recommend to modulate the treatment of exogenous glucocorticoid-induced osteoporosis (GIO) based on the individual fracture risk profile (calculated by FRAX) and dose of glucocorticoid used, but it is difficult to translate corticosteroid dosages to different degrees of endogenous hypercortisolism, and there are no data on validation of FRAX stratification method in patients with endogenous hypercortisolism. Consequently, it is unclear whether such recommendations may be adapted to patients with endogenous hypercortisolism. Moreover, patients with exogenous GIO take glucocorticoids since suffering a disease that commonly affects bone. On the other hand, the correction of coexistent risk factors, which may contribute to increase the fracture risk in patients exposed to glucocorticoid excess, and the removal of the cause of endogenous hypercortisolism, may lead to the recovery of bone health. Although the correction of hypercortisolism and of possible coexistent risk factors is necessary to favor the normalization of bone turnover with recovery of bone mass; in some patients, the fracture risk could not be normalized and specific anti-osteoporotic drugs should be given. Who, when, and how the patient with endogenous hypercortisolism should be treated with bone-active therapy is discussed.

Published
2014

22. The effect of Mediterranean diet on metabolic syndrome and its components: a meta-analysis of 50 studies and 534,906 individuals

Author

Kastorini, C. M., Milionis, H. J., Esposito, K., Giugliano, D., Goudevenos, J. A., and Panagiotakos, D. B.

Subjects
Clinical Trials as Topic/methods, Cross-Sectional Studies, Risk Factors, Cardiovascular Diseases/diet therapy/epidemiology, Disease Progression, Humans, Metabolic Syndrome X/*diet therapy/*epidemiology, Diet, Mediterranean
Abstract

OBJECTIVES: The aim of this study was to meta-analyze epidemiological studies and clinical trials that have assessed the effect of a Mediterranean diet on metabolic syndrome (MS) as well as its components. BACKGROUND: The Mediterranean diet has long been associated with low cardiovascular disease risk in adult population. METHODS: The authors conducted a systematic review and random effects meta-analysis of epidemiological studies and randomized controlled trials, including English-language publications in PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials until April 30, 2010; 50 original research studies (35 clinical trials, 2 prospective and 13 cross-sectional), with 534,906 participants, were included in the analysis. RESULTS: The combined effect of prospective studies and clinical trials showed that adherence to the Mediterranean diet was associated with reduced risk of MS (log hazard ratio: -0.69, 95% confidence interval [CI]: -1.24 to -1.16). Additionally, results from clinical studies (mean difference, 95% CI) revealed the protective role of the Mediterranean diet on components of MS, like waist circumference (-0.42 cm, 95% CI: -0.82 to -0.02), high-density lipoprotein cholesterol (1.17 mg/dl, 95% CI: 0.38 to 1.96), triglycerides (-6.14 mg/dl, 95% CI: -10.35 to -1.93), systolic (-2.35 mm Hg, 95% CI: -3.51 to -1.18) and diastolic blood pressure (-1.58 mm Hg, 95% CI: -2.02 to -1.13), and glucose (-3.89 mg/dl, 95% CI:-5.84 to -1.95), whereas results from epidemiological studies also confirmed those of clinical trials. CONCLUSIONS: These results are of considerable public health importance, because this dietary pattern can be easily adopted by all population groups and various cultures and cost-effectively serve for primary and secondary prevention of the MS and its individual components. Journal of the American College of Cardiology

Published
2011

24. Olive oil and health: Summary of the II international conference on olive oil and health consensus report, Jaén and Córdoba (Spain) 2008

Author

López-Miranda, J. Pérez-Jiménez, F. Ros, E. De Caterina, R. Badimón, L. Covas, M.I. Escrich, E. Ordovás, J.M. Soriguer, F. Abiá, R. Alarcón de la Lastra, C. Battino, M. Corella, D. Chamorro-Quirós, J. Delgado-Lista, J. Giugliano, D. Esposito, K. Estruch, R. Fernandez-Real, J.M. Gaforio, J.J. La Vecchia, C. Lairon, D. López-Segura, F. Mata, P. Menéndez, J.A. Muriana, F.J. Osada, J. Panagiotakos, D.B. Paniagua, J.A. Pérez-Martinez, P. Perona, J. Peinado, M.A. Pineda-Priego, M. Poulsen, H.E. Quiles, J.L. Ramírez-Tortosa, M.C. Ruano, J. Serra-Majem, L. Solá, R. Solanas, M. Solfrizzi, V. de la Torre-Fornell, R. Trichopoulou, A. Uceda, M. Villalba-Montoro, J.M. Villar-Ortiz, J.R. Visioli, F. Yiannakouris, N.

Abstract

Olive oil (OO) is the most representative food of the traditional Mediterranean Diet (MedDiet). Increasing evidence suggests that monounsaturated fatty acids (MUFA) as a nutrient, OO as a food, and the MedDiet as a food pattern are associated with a decreased risk of cardiovascular disease, obesity, metabolic syndrome, type 2 diabetes and hypertension. A MedDiet rich in OO and OO per se has been shown to improve cardiovascular risk factors, such as lipid profiles, blood pressure, postprandial hyperlipidemia, endothelial dysfunction, oxidative stress, and antithrombotic profiles. Some of these beneficial effects can be attributed to the OO minor components. Therefore, the definition of the MedDiet should include OO. Phenolic compounds in OO have shown antioxidant and anti-inflammatory properties, prevent lipoperoxidation, induce favorable changes of lipid profile, improve endothelial function, and disclose antithrombotic properties. Observational studies from Mediterranean cohorts have suggested that dietary MUFA may be protective against age-related cognitive decline and Alzheimer's disease. Recent studies consistently support the concept that the OO-rich MedDiet is compatible with healthier aging and increased longevity. In countries where the population adheres to the MedDiet, such as Spain, Greece and Italy, and OO is the principal source of fat, rates of cancer incidence are lower than in northern European countries. Experimental and human cellular studies have provided new evidence on the potential protective effect of OO on cancer. Furthermore, results of case-control and cohort studies suggest that MUFA intake including OO is associated with a reduction in cancer risk (mainly breast, colorectal and prostate cancers). © 2009 Elsevier B.V.

Published
2010

25. Olive oil and health: Summary of the II international conference on olive oil and health consensus report, Jaen and Cordoba (Spain) 2008

Author

Lopez-Miranda, J, Perez-Jimenez, F, Ros, E, De Caterina, R, Badimon, L, Covas, MI, Escrich, E, Ordovas, JM, Soriguer, F, Abia, R, de la Lastra, CA, Battino, M, Corella, D, Chamorro-Quiros, J, Delgado-Lista, J, Giugliano, D, Esposito, K, Estruch, R, Fernandez-Real, JM, Gaforio, JJ, La Vecchia, C, Lairon, D, Lopez-Segura, F, Mata, P, Menendez, JA, Muriana, FJ, Osada, J, Panagiotakos, DB, Paniagua, JA, Perez-Martinez, P, Perona, J, Peinado, MA, Pineda-Priego, M, Poulsen, HE, Quiles, JL, Ramirez-Tortosa, MC, Ruano, J, Serra-Majem, L, Sola, R, Solanas, M, Solfrizzi, V, de la Torre-Fornell, R, Trichopoulou, A, Uceda, M, Villalba-Montoro, JM, Villar-Ortiz, JR, Visioli, F, and Yiannakouris, N

Subjects
Diabetes, Mediterranean diet Phenolic compounds, Obesity, Cardiovascular disease, Metabolic syndrome, Olive oil, Cancer
Abstract

Olive oil (OO) is the most representative food of the traditional Mediterranean Diet (MedDiet). Increasing evidence suggests that monounsaturated fatty acids (MUFA) as a nutrient, OO as a food, and the MedDiet as a food pattern are associated with a decreased risk of cardiovascular disease, obesity, metabolic syndrome, type 2 diabetes and hypertension. A MedDiet rich in OO and OO per se has been shown to improve cardiovascular risk factors, such as lipid profiles, blood pressure, postprandial hyperlipidemia, endothelial dysfunction, oxidative stress, and antithrombotic profiles. Some of these beneficial effects can be attributed to the OO minor components. Therefore, the definition of the MedDiet should include OO. Phenolic compounds in OO have shown antioxidant and anti-inflammatory properties, prevent lipoperoxidation, induce favorable changes of lipid profile, improve endothelial function, and disclose antithrombotic properties. Observational studies from Mediterranean cohorts have suggested that dietary MUFA may be protective against age-related cognitive decline and Alzheimer's disease. Recent studies consistently support the concept that the OO-rich MedDiet is compatible with healthier aging and increased longevity. In countries where the population adheres to the MedDiet, such as Spain, Greece and Italy, and OO is the principal source of fat, rates of cancer incidence are lower than in northern European countries. Experimental and human cellular studies have provided new evidence on the potential protective effect of OO on cancer. Furthermore, results of case-control and cohort studies suggest that MUFA intake including OO is associated with a reduction in cancer risk (mainly breast, colorectal and prostate cancers). (C) 2009 Elsevier B.V. All rights reserved.

Published
2010

30. The ubiquitin-proteasome system and inflammatory activity in diabetic atherosclerotic plaques: Effects of rosiglitazone treatment

Author

Marfella, R., michele d'amico, Esposito, K., Baldi, A., Di Filippo, C., Siniscalchi, M., Sasso, F. C., Portoghese, M., Cirillo, F., Cacciapuoti, F., Carbonara, O., Crescenzi, B., Baldi, F., Ceriello, A., Nicoletti, G. F., D Andrea, F., Verza, M., Coppola, L., Rossi, F., Giugliano, D., Marfella, R, D'Amico, Michele, Esposito, Katherine, Baldi, Alfonso, DI FILIPPO, Clara, Siniscalchi, M, Sasso, Ferdinando Carlo, Portoghese, M, Cirillo, F, Cacciapuoti, Federico, Carbonara, O, Crescenzi, B, Baldi, F, Ceriello, A, Nicoletti, Giovanni Francesco, D'Andrea, Francesco, Verza, M, Coppola, L, Rossi, Francesco, Giugliano, Dario, Raffaele, M, D'Amico, M, Esposito, K, Baldi, A, DI FILIPPO, C, Sasso, F, Cacciapuoti, F, Nicoletti, Gf, Rossi, F, and Giugliano, D.

Subjects
Ubiquitin-Proteasome System, inflammation, diabete, Atherosclerotic Plaque, Rosiglitazone Treatment
Abstract

The role of ubiquitin-proteasome system in the accelerated atherosclerotic progression of diabetic patients is unclear. We evaluated ubiquitin-proteasome activity in carotid plaques of asymptomatic diabetic and nondiabetic patients, as well as the effect of rosiglitazone, a peroxisome proliferator-activated receptor (PPAR)-γ activator, in diabetic plaques. Plaques were obtained from 46 type 2 diabetic and 30 nondiabetic patients undergoing carotid endarterectomy. Diabetic patients received 8 mg rosiglitazone (n = 23) or placebo (n = 23) for 4 months before scheduled endarterectomy. Plaques were analyzed for macrophages (CD68), T-cells (CD3), inflammatory cells (HLA-DR), ubiquitin, proteasome 20S activity, nuclear factor (NF)-κB, inhibitor of κB (IκB)-β, tumor necrosis factor (TNF)-α, nitrotyrosine, matrix metalloproteinase (MMP)-9, and collagen content (immunohistochemistry and enzyme-linked immunosorbent assay). Compared with nondiabetic plaques, diabetic plaques had more macrophages, T-cells, and HLA-DR cells (P < 0.001); more ubiquitin, proteasome 20S activity (TNF-α), and NF-κB (P < 0.001); and more markers of oxidative stress (nitrotyrosine and O 2- production) and MMP-9 (P < 0.01), along with a lesser collagen content and IκB-β levels (P < 0.001). Compared with placebo-treated plaques, rosiglitazone-treated diabetic plaques presented less inflammatory cells (P < 0.01); less ubiquitin, proteasome 20S, TNF-α, and NF-κB (P < 0.01); less nitrotyrosine and superoxide anion production (P < 0.01); and greater collagen content (P < 0.01), indicating a more stable plaque phenotype. Similar findings were obtained in circulating monocytes obtained from the two groups of diabetic patients and cultured in the presence or absence of rosiglitazone (7.0 μmol/l). Ubiquitin-proteasome over-activity is associated with enhanced inflammatory reaction and NF-κB expression in diabetic plaques. The inhibition of ubiquitin-proteasome activity in atherosclerotic lesions of diabetic patients by rosiglitazone is associated with morphological and compositional characteristics of a potential stable plaque phenotype, possibly by downregulating NF-κB-mediated inflammatory pathways. © 2006 by the American Diabetes Association.

31. Subcutaneous insulin infusion (CSII) in italy: The third national survey,La terapia insulinica sottocutanea continua (CSII) in Italia. Terza indagine nazionale

Author

Bruttomesso, D., Laviola, L., Lepore, G., Bonfanti, R., Bozzetto, L., Corsi, A., Di Blasi, V., Girelli, A., Grassi, G., Iafusco, D., Rabbone, I., Schiaffini, R., Montani, V., Colleluori, P., Paciotti, V., Alfidi, P., Grosso, J., Tumini, S., Cipriano, P., Vitacolonna, E., Di Vieste, G., Minnucci, A., Antenucci, D., La Penna, G., Taraborrelli, M., Macerala, B., Citro, G., Morelli, G., Gnasso, A., Irace, C., Citriniti, F., Lazzaro, N., Bruzzese, M., Mammì, F., Berardinis, F., Santoro, E., Corigliano, G., Corigliano, M., Parillo, M., Schettino, M., Fresa, R., Annuzzi, G., Bassi, V., Santinelli, C., Buono, P., Mozzillo, E., Russo, V., Feo, E., Esposito, K., Petrizzo, M., Foglia, A., Gatti, A., Gentile, S., Guarino, G., Zanfardino, A., Lambiase, C., Vitale, A., Zucchini, S., Maltoni, G., Forlani, G., Moscatiello, S., Suprani, T., Bensa, M., Tomasi, F., Monesi, M., Nizzoli, M., Acquati, S., Chierici, G., Milli, B., Iughetti, L., Predieri, B., Cavani, R., Romano, S., Manicardi, V., Michelini, M., Cimicchi, M. C., Ugolotti, D., Zavaroni, I., Dei Cas, A., Dall’aglio, E., Papi, M., Tardio, S. M., Calderini, M. C., Riboni, S., D’amato, L., Zavaroni, D., Gastaldi, L., Cirillo, A., Di Bartolo, P., Pellicano, F., Di Seclì, C., Amarri, S., Lasagni, A., Marsciani, A., Pedini, A., Pagliani, U., Rossi, C., Tortul, C., Brunato, B., Assaloni, R., Zanette, G., Livolsi, P., Petrucco, A., Tercelj, K., Manca, E., Candido, R., Tommasi, E., Tornese, G., Faleschini, E., Tonutti, L., Agus, S., Zanatta, M., Rosolen, A., Comici, A., Falasca, P., Graziano, F. M., Misischi, I., Forte, E., Palmacci, C., Tuccinardi, F., Ricciardi, G. P., Di Masa, P., Ragonese, M., Cipolloni, L., Buzzetti, R., Moretti, C., Leto, G., Crinò, A., Bocchini, S., Pozzilli, P., Maurizi, A. R., Di Perna, P., Giuliano, M., Frontoni, S., Malandrucco, I., Pitocco, D., Scalpone, R., Toscanella, F., Cappa, M., Ventura, C., Bonato, V., Bernardinis, M., Cavallo, M. G., Leonetti, F., Morano, S., Mandosi, E., Cicconetti, E., Ciampittiello, G., Marini, M. A., Sabato, D., Lauro, D., Napoli, A., Giraudo, F., Toscano, V., Pugliese, G., Massimiani, F., Fava, D., Gargiulo, P., Mecca, N., Tubili, C., Nardone, M. R., Morviducci, L., Manca-Bitti, M. L., Arcano, S., Leotta, S., Suraci, C., Chiaramonte, F., Visalli, N., Strollo, F., Arnaldi, C., Tosini, D., Ponzani, P., Patrone, M., Guido, R., Aglialoro, A., Ghisoni, G., Fabbri, F., Bordone, C., Maggi, D., Cordera, R., Minuto, N., Rotondo, E., Speranza, D., Siri, M., Carro, S., Zappa, A., Parmigiani, S., Nieri, S., Briatore, L., Calvo, G., Querci, F., Trevisan, R., Bonfadini, S., Prandi, E., Felappi, B., Locatelli, F., Fuso, V., Rocca, A., Meneghini, E., Massafra, C., Terni, T., Elli, P., Ruggeri, P., Carrai, E., Musacchio, N., Marelli, G., Vilei, V., Richini, D., Inversini, C., Franzetti, I., Bonacina, M., Ciucci, A., Sciangula, L., Duratorre, E., Bonomo, M., Bertuzzi, F., Chebat, E., Muratori, M., Scaramuzza, A., Zuccotti, G. V., Bollati, P. M., Colapinto, P., Orsi, E., Palmieri, E., Laurenzi, A., Molinari, C., Frontino, G., Veronelli, A., Zecchini, B., Bianchi, A., Torchio, G., Lovati, E., Ghilardi, G., Dagani, R., Berra, C., Fochesato, E., Pissarelli, A., Bucciarelli, L., Bulgheroni, M., Guerraggio, L., Zonca, S., Bossi, A. C., Berzi, D., Mangone, I., Cazzaniga, E., Rabini, R. A., Boemi, M., Faloia, E., Boscaro, M., Sternari, G., Iannilli, A., Cherubini, V., Tinti, G., Manfrini, S., Tesei, A. M., Maolo, G., Galetta, M., Vespasiani, G., Busciantella Ricci, N., Cartechini, M. G., Aiello, A., Di Vincenzo, S., Vitale, C., Di Caro, P., Lera, R., Secco, A., Lesina, A., Romeo, F., Origlia, C., carlo giorda, Chiambretti, A. M., Fornengo, R., Donno, V., Gallarotti, F., Manti, R., Marafetti, L., Cadario, F., Savastio, S., Barbieri, P., Massucco, P., Alì, A., Gottero, C., Degiovanni, M., Bertaina, S., Maghenzani, G., Tinti, D., Fontana, F., Giorgino, F., Stefanelli, G., Cavallo, L., Zecchino, C., Piccinno, E., Ortolani, F., Gallo, F., Moramarco, F., Marino, A., Sparasci, G., Mileti, G., Lamacchia, O., Picca, G., Coccioli, M. S., Micale, F., Serra, R., Romano, I., Savino, T., Giovanni, S., Cosmo, S., Rauseo, A., Delvecchio, M., Lapolla, R., Braione, A. F., Papagno, G., Baroni, M., Melis, M., Cossu, E., Songini, M., Cambuli, V. M., Lo Presti, D., Timpanaro, T. A., Chiavetta, A., Garofalo, M. R., Tommaselli, L., Tumminia, A., Scarpitta, A. M., Di Benedetto, A., Giunta, L., Lombardo, F., Salzano, G., Cardella, F., Roppolo, R., Provenzano, V., Fleres, M., Migliorini, S., Luca, A., Leopardi, A., Beltrami, C., Toni, S., Guasti, G., Lenzi, L., Lamanna, C., Mannucci, E., Lucchesi, S., Di Cianni, G., Aragona, M., Del Prato, S., Fattor, B., Eisath, J., Pasquino, B., Reinstadler, P., Kaufmann, P., Incelli, G., Rauch, S., Romanelli, T., Cauvin, V., Franceschi, R., Ospedale, S. C., Soldani, C., Scattoni, R., Norgiolini, R., Celleno, R., Torlone, E., Bolli, G. B., Lalli, C., Scarponi, M., Bobbio, A., Bechaz, M., Pianta, A., Marangoni, A., Aricò, C. N., Alagona, C., Confortin, L., Rossi, E., Boscolo, B. A., Nogara, A., Bettio, M., Frison, V., Guidoni, G. L., Fongher, C., Contin, M. L., Cosma, A., Vianello, S., Bondesan, L., Morea, A., Volpi, A., Coracina, A., Panebianco, G., Lombardi, S., Costa, S., Cipponeri, E., Vedovato, M., Scotton, R., Monciotti, C. M., Galderisi, A., Dalfrà, M. G., Lapolla, A., Portogruaro, S., Zanon, M., Lisato, G., Mollo, F., Calcaterra, F., Miola, M., Paccagnella, A., Sambataro, M., Moro, E., Trombetta, M., Negri, C., Sabbion, A., Maffeis, C., Strazzabosco, M., Mesturino, C. A., Mingardi, R., Bruttomesso, D, Laviola, L, Lepore, G, Bonfanti, R, Bozzetto, L, Corsi, A, Di Blasi, V, Girelli, A, Grassi, G, Iafusco, D, Rabbone, I, Schiaffini, R, Montani, V, Colleluori, P, Paciotti, V, Alfidi, P, Grosso, J, Tumini, S, Cipriano, P, Vitacolonna, E, Di Vieste, G, Minnucci, A, Antenucci, D, La Penna, G, Taraborrelli, M, Macerala, B, Citro, G, De Morelli, G, Gnasso, A, Irace, C, Citriniti, F, Lazzaro, N, Bruzzese, M, Mammi, F, De Berardinis, F, Santoro, E, Corigliano, G, Corigliano, M, Parillo, M, Schettino, M, Fresa, R, Annuzzi, G, Bassi, V, Santinelli, C, Buono, P, Mozzillo, E, Russo, V, De Feo, E, Esposito, K, Petrizzo, M, Foglia, A, Gatti, A, Gentile, S, Guarino, G, Zanfardino, A, Lambiase, C, Vitale, A, Zucchini, S, Maltoni, G, Forlani, G, Moscatiello, S, Suprani, T, Bensa, M, Tomasi, F, Monesi, M, Nizzoli, M, Acquati, S, Chierici, G, Milli, B, Iughetti, L, Predieri, B, Cavani, R, Romano, S, Manicardi, V, Michelini, M, Cimicchi, M, Ugolotti, D, Zavaroni, I, Dei Cas, A, Dall'Aglio, E, Papi, M, Tardio, S, Calderini, M, Riboni, S, D'Amato, L, Zavaroni, D, Gastaldi, L, Cirillo, A, Di Bartolo, P, Pellicano, F, Di Secli, C, Amarri, S, Lasagni, A, Marsciani, A, Pedini, A, Pagliani, U, Rossi, C, Tortul, C, Brunato, B, Assaloni, R, Zanette, G, Livolsi, P, Petrucco, A, Tercelj, K, Manca, E, Candido, R, Tommasi, E, Tornese, G, Faleschini, E, Tonutti, L, Agus, S, Zanatta, M, Rosolen, A, Comici, A, Falasca, P, Graziano, F, Misischi, I, Forte, E, Palmacci, C, Tuccinardi, F, Ricciardi, G, Di Masa, P, Ragonese, M, Cipolloni, L, Buzzetti, R, Moretti, C, Leto, G, Crino, A, Bocchini, S, Pozzilli, P, Maurizi, A, Di Perna, P, Giuliano, M, Frontoni, S, Malandrucco, I, Pitocco, D, Scalpone, R, Toscanella, F, Cappa, M, Ventura, C, Bonato, V, De Bernardinis, M, Cavallo, M, Leonetti, F, Morano, S, Mandosi, E, Cicconetti, E, Ciampittiello, G, Marini, M, Sabato, D, Lauro, D, Napoli, A, Giraudo, F, Toscano, V, Pugliese, G, Massimiani, F, Fava, D, Gargiulo, P, Mecca, N, Tubili, C, Nardone, M, Morviducci, L, Manca-Bitti, M, Arcano, S, Leotta, S, Suraci, C, Chiaramonte, F, Visalli, N, Strollo, F, Arnaldi, C, Tosini, D, Ponzani, P, Patrone, M, Guido, R, Aglialoro, A, Ghisoni, G, Fabbri, F, Bordone, C, Maggi, D, Cordera, R, Minuto, N, Rotondo, E, Speranza, D, Siri, M, Carro, S, Zappa, A, Parmigiani, S, Nieri, S, Briatore, L, Calvo, G, Querci, F, Trevisan, R, Bonfadini, S, Prandi, E, Felappi, B, Locatelli, F, Fuso, V, Rocca, A, Meneghini, E, Massafra, C, Terni, T, Elli, P, Ruggeri, P, Carrai, E, Musacchio, N, Marelli, G, Vilei, V, Richini, D, Inversini, C, Franzetti, I, Bonacina, M, Ciucci, A, Sciangula, L, Duratorre, E, Bonomo, M, Bertuzzi, F, Chebat, E, Muratori, M, Scaramuzza, A, Zuccotti, G, Bollati, P, Colapinto, P, Orsi, E, Palmieri, E, Laurenzi, A, Molinari, C, Frontino, G, Veronelli, A, Zecchini, B, Bianchi, A, Torchio, G, Lovati, E, Ghilardi, G, Dagani, R, Berra, C, Fochesato, E, Pissarelli, A, Bucciarelli, L, Bulgheroni, M, Guerraggio, L, Zonca, S, Bossi, A, Berzi, D, Mangone, I, Cazzaniga, E, Rabini, R, Boemi, M, Faloia, E, Boscaro, M, Sternari, G, Iannilli, A, Cherubini, V, Tinti, G, Manfrini, S, Tesei, A, Maolo, G, Galetta, M, Vespasiani, G, Busciantella Ricci, N, Cartechini, M, Aiello, A, Di Vincenzo, S, Vitale, C, Di Caro, P, Lera, R, Secco, A, Lesina, A, Romeo, F, Origlia, C, Giorda, C, Chiambretti, A, Fornengo, R, De Donno, V, Gallarotti, F, Manti, R, Marafetti, L, Cadario, F, Savastio, S, Barbieri, P, Massucco, P, Ali, A, Gottero, C, Degiovanni, M, Bertaina, S, Maghenzani, G, Tinti, D, Fontana, F, Giorgino, F, Stefanelli, G, Cavallo, L, Zecchino, C, Piccinno, E, Ortolani, F, Gallo, F, Moramarco, F, Marino, A, Sparasci, G, Mileti, G, Lamacchia, O, Picca, G, Coccioli, M, Micale, F, Serra, R, Romano, I, Savino, T, Giovanni, S, De Cosmo, S, Rauseo, A, Delvecchio, M, Lapolla, R, Braione, A, Papagno, G, Baroni, M, Melis, M, Cossu, E, Songini, M, Cambuli, V, Lo Presti, D, Timpanaro, T, Chiavetta, A, Garofalo, M, Tommaselli, L, Tumminia, A, Scarpitta, A, Di Benedetto, A, Giunta, L, Lombardo, F, Salzano, G, Cardella, F, Roppolo, R, Provenzano, V, Fleres, M, Migliorini, S, De Luca, A, Leopardi, A, Beltrami, C, Toni, S, Guasti, G, Lenzi, L, Lamanna, C, Mannucci, E, Lucchesi, S, Di Cianni, G, Aragona, M, Del Prato, S, Fattor, B, Eisath, J, Pasquino, B, Reinstadler, P, Kaufmann, P, Incelli, G, Rauch, S, Romanelli, T, Cauvin, V, Franceschi, R, Ospedale, S, Soldani, C, Scattoni, R, Norgiolini, R, Celleno, R, Torlone, E, Bolli, G, Lalli, C, Scarponi, M, Bobbio, A, Bechaz, M, Pianta, A, Marangoni, A, Arico, C, Alagona, C, Confortin, L, Rossi, E, Boscolo, B, Nogara, A, Bettio, M, Frison, V, Guidoni, G, Fongher, C, Contin, M, Cosma, A, Vianello, S, Bondesan, L, Morea, A, Volpi, A, Coracina, A, Panebianco, G, Lombardi, S, Costa, S, Cipponeri, E, Vedovato, M, Scotton, R, Monciotti, C, Galderisi, A, Dalfra, M, Lapolla, A, Portogruaro, S, Zanon, M, Lisato, G, Mollo, F, Calcaterra, F, Miola, M, Paccagnella, A, Sambataro, M, Moro, E, Trombetta, M, Negri, C, Sabbion, A, Maffeis, C, Strazzabosco, M, Mesturino, C, and Mingardi, R

Subjects
Continuous subcutaneous insulin infusion, Diabetes mellitus, Insulin pump
Abstract

Continuous subcutaneous insulin infusion (CSII) is increasingly being used worldwide, mostly thanks to technical improvements. This study examined the current status of CSII in Italy. Physicians in charge of 272 diabetes centers caring for patients using CSII were sent a questionnaire investigating clinical features, pump technology and management of these patients; a large proportion (217 centers, 79.8%) joined the study. By end-April 2013, data had been collected on 10152 patients treated with CSII; 98.2% had type 1 diabetes, 82.4% were adults, 57% female. Only just over half the centers (59%) managed more than 20 CSII patients each. The distribution of patients varied widely both among and within different regions. The main indication for CSII was the de- sire to improve glycemic control. Dropouts (8.65%) were mainly due to difficulties with pump wearability or non-optimal glycemic control. Among CSII patients 61% used a traditional pump, 39% a sensor augmented pump. Only 68% used the CSII advanced functions and glucose sensors were used twelve days per month on average. Round-the-clock assistance was guaranteed in 81% of centers; a full diabetes team followed patients in only 40% of adult-care centers and 50% of pediatric units. CSII is increasingly used in Italy, by adults and pediatric patients. However, further work is needed to unify treatment strategies throughout the country and to encourage optimal pump use and applications.

36. Subcutaneous insulin infusion (CSII) in italy: The third nationa survey | La terapia insulinica sottocutanea continua (CSII) in Italia. Terza indagine nazionale

Author

Bruttomesso, D., Laviola, L., Lepore, G., Bonfanti, R., Bozzetto, L., Corsi, A., Di Blasi, V., Girelli, A., Grassi, G., Iafusco, D., Rabbone, I., Schiaffini, R., Montani, V., Colleluori, P., Paciotti, V., Alfidi, P., Grosso, J., Tumini, S., Cipriano, P., Ester VITACOLONNA, Di Vieste, G., Minnucci, A., Antenucci, D., La Penna, G., Taraborrelli, M., Macerala, B., Citro, G., Morelli, G., Gnasso, A., Irace, C., Citriniti, F., Lazzaro, N., Bruzzese, M., Mammì, F., Berardinis, F., Santoro, E., Corigliano, G., Corigliano, M., Parillo, M., Schettino, M., Fresa, R., Annuzzi, G., Bassi, V., Santinelli, C., Buono, P., Mozzillo, E., Russo, V., Feo, E., Esposito, K., Petrizzo, M., Foglia, A., Gatti, A., Gentile, S., Guarino, G., Zanfardino, A., Lambiase, C., Vitale, A., Zucchini, S., Maltoni, G., Forlani, G., Moscatiello, S., Suprani, T., Bensa, M., Tomasi, F., Monesi, M., Nizzoli, M., Acquati, S., Chierici, G., Milli, B., Iughetti, L., Predieri, B., Cavani, R., Romano, S., Manicardi, V., Michelini, M., Cimicchi, M. C., Ugolotti, D., Zavaroni, I., Dei Cas, A., Dall’aglio, E., Papi, M., Tardio, S. M., Calderini, M. C., Riboni, S., D’amato, L., Zavaroni, D., Gastaldi, L., Cirillo, A., Di Bartolo, P., Pellicano, F., Di Seclì, C., Amarri, S., Lasagni, A., Marsciani, A., Pedini, A., Pagliani, U., Rossi, C., Tortul, C., Brunato, B., Assaloni, R., Zanette, G., Livolsi, P., Petrucco, A., Tercelj, K., Manca, E., Candido, R., Tommasi, E., Tornese, G., Faleschini, E., Tonutti, L., Agus, S., Zanatta, M., Rosolen, A., Comici, A., Falasca, P., Graziano, F. M., Misischi, I., Forte, E., Palmacci, C., Tuccinardi, F., Ricciardi, G. P., Di Masa, P., Ragonese, M., Cipolloni, L., Buzzetti, R., Moretti, C., Leto, G., Crinò, A., Bocchini, S., Pozzilli, P., Maurizi, A. R., Di Perna, P., Giuliano, M., Frontoni, S., Malandrucco, I., Pitocco, D., Scalpone, R., Toscanella, F., Cappa, M., Ventura, C., Bonato, V., Bernardinis, M., Cavallo, M. G., Leonetti, F., Morano, S., Mandosi, E., Cicconetti, E., Ciampittiello, G., Marini, M. A., Sabato, D., Lauro, D., Napoli, A., Giraudo, F., Toscano, V., Pugliese, G., Massimiani, F., Fava, D., Gargiulo, P., Mecca, N., Tubili, C., Nardone, M. R., Morviducci, L., Manca-Bitti, M. L., Arcano, S., Leotta, S., Suraci, C., Chiaramonte, F., Visalli, N., Strollo, F., Arnaldi, C., Tosini, D., Ponzani, P., Patrone, M., Guido, R., Aglialoro, A., Ghisoni, G., Fabbri, F., Bordone, C., Maggi, D., Cordera, R., Minuto, N., Rotondo, E., Speranza, D., Siri, M., Carro, S., Zappa, A., Parmigiani, S., Nieri, S., Briatore, L., Calvo, G., Querci, F., Trevisan, R., Bonfadini, S., Prandi, E., Felappi, B., Locatelli, F., Fuso, V., Rocca, A., Meneghini, E., Massafra, C., Terni, T., Elli, P., Ruggeri, P., Carrai, E., Musacchio, N., Marelli, G., Vilei, V., Richini, D., Inversini, C., Franzetti, I., Bonacina, M., Ciucci, A., Sciangula, L., Duratorre, E., Bonomo, M., Bertuzzi, F., Chebat, E., Muratori, M., Scaramuzza, A., Zuccotti, G. V., Bollati, P. M., Colapinto, P., Orsi, E., Palmieri, E., Laurenzi, A., Molinari, C., Frontino, G., Veronelli, A., Zecchini, B., Bianchi, A., Torchio, G., Lovati, E., Ghilardi, G., Dagani, R., Berra, C., Fochesato, E., Pissarelli, A., Bucciarelli, L., Bulgheroni, M., Guerraggio, L., Zonca, S., Bossi, A. C., Berzi, D., Mangone, I., Cazzaniga, E., Rabini, R. A., Boemi, M., Faloia, E., Boscaro, M., Sternari, G., Iannilli, A., Cherubini, V., Tinti, G., Manfrini, S., Tesei, A. M., Maolo, G., Galetta, M., Vespasiani, G., Busciantella Ricci, N., Cartechini, M. G., Aiello, A., Di Vincenzo, S., Vitale, C., Di Caro, P., Lera, R., Secco, A., Lesina, A., Romeo, F., Origlia, C., Giorda, C., Chiambretti, A. M., Fornengo, R., Donno, V., Gallarotti, F., Manti, R., Marafetti, L., Cadario, F., Savastio, S., Barbieri, P., Massucco, P., Alì, A., Gottero, C., Degiovanni, M., Bertaina, S., Maghenzani, G., Tinti, D., Fontana, F., Giorgino, F., Stefanelli, G., Cavallo, L., Zecchino, C., Piccinno, E., Ortolani, F., Gallo, F., Moramarco, F., Marino, A., Sparasci, G., Mileti, G., Lamacchia, O., Picca, G., Coccioli, M. S., Micale, F., Serra, R., Romano, I., Savino, T., Giovanni, S., Cosmo, S., Rauseo, A., Delvecchio, M., Lapolla, R., Braione, A. F., Papagno, G., Baroni, M., Melis, M., Cossu, E., Songini, M., Cambuli, V. M., Lo Presti, D., Timpanaro, T. A., Chiavetta, A., Garofalo, M. R., Tommaselli, L., Tumminia, A., Scarpitta, A. M., Di Benedetto, A., Giunta, L., Lombardo, F., Salzano, G., Cardella, F., Roppolo, R., Provenzano, V., Fleres, M., Migliorini, S., Luca, A., Leopardi, A., Beltrami, C., Toni, S., Guasti, G., Lenzi, L., Lamanna, C., Mannucci, E., Lucchesi, S., Di Cianni, G., Aragona, M., Del Prato, S., Fattor, B., Eisath, J., Pasquino, B., Reinstadler, P., Kaufmann, P., Incelli, G., Rauch, S., Romanelli, T., Cauvin, V., Franceschi, R., Ospedale, S. C., Soldani, C., Scattoni, R., Norgiolini, R., Celleno, R., Torlone, E., Bolli, G. B., Lalli, C., Scarponi, M., Bobbio, A., Bechaz, M., Pianta, A., Marangoni, A., Aricò, C. N., Alagona, C., Confortin, L., Rossi, E., Boscolo, B. A., Nogara, A., Bettio, M., Frison, V., Guidoni, G. L., Fongher, C., Contin, M. L., Cosma, A., Vianello, S., Bondesan, L., Morea, A., Volpi, A., Coracina, A., Panebianco, G., Lombardi, S., Costa, S., Cipponeri, E., Vedovato, M., Scotton, R., Monciotti, C. M., Galderisi, A., Dalfrà, M. G., Lapolla, A., Portogruaro, S., Zanon, M., Lisato, G., Mollo, F., Calcaterra, F., Miola, M., Paccagnella, A., Sambataro, M., Moro, E., Trombetta, M., Negri, C., Sabbion, A., Maffeis, C., Strazzabosco, M., Mesturino, C. A., and Mingardi, R.

37. Improvement of glycemic control and reduction of major cardiovascular events in 18 cardiovascular outcome trials: an updated meta-regression

Author

Lorenzo Scappaticcio, Katherine Esposito, Giuseppe Bellastella, Maria Ida Maiorino, Paolo Chiodini, Dario Giugliano, Miriam Longo, Maiorino, M. I., Longo, M., Scappaticcio, L., Bellastella, G., Chiodini, P., Esposito, K., and Giugliano, D.

Subjects
Blood Glucose, Male, Time Factors, Endocrinology, Diabetes and Metabolism, Meta-regression, Type 2 diabetes, Review, DPP-4i, Cardiovascular outcome trials, Glycemic control, Risk Factors, Cause of Death, Stroke, Randomized Controlled Trials as Topic, Hazard ratio, Cardiorenal outcome, Middle Aged, GLP-1RA, Hospitalization, Treatment Outcome, Cardiovascular Diseases, Female, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, MACE, Incretins, Risk Assessment, Glucagon-Like Peptide-1 Receptor, Internal medicine, Diabetes mellitus, medicine, Humans, Diseases of the circulatory (Cardiovascular) system, Sodium-Glucose Transporter 2 Inhibitors, Glycemic, Aged, Glycated Hemoglobin, Dipeptidyl-Peptidase IV Inhibitors, business.industry, Cardiorenal outcomes, SGLT-2i, Protective Factors, medicine.disease, Confidence interval, Cardiovascular outcome trial, Diabetes Mellitus, Type 2, RC666-701, business, Mace, Biomarkers
Abstract

Background Besides providing reassurance about cardiovascular (CV) safety of newer diabetes drugs, cardiovascular outcome trials (CVOTs) have also shown encouraging benefits on some CV endpoints. The contribution of the better glycemic control in the reduction of major cardiovascular events (MACE) remains an open question. The aim of this study is to evaluate the associations between the reduction of HbA1c and risk of MACE, MACE components, hospitalization for heart failure (HF) and all-cause death in CVOTs. Methods An electronic search up to July 2021 was conducted to determine eligible trials. Systematic review identified eighteen CVOTs reporting prespecified CV outcomes. Pooled summary estimates and 95% confidence intervals (CI) were calculated according to the random effects model using the Paule-Mandel method; restricted maximum likelihood estimators were used to estimate model parameters in the metaregression. Results The eighteen CVOTs evaluated 161,156 patients and included four trials with dipeptidyl-peptidase-4 inhibitors (DPP-4i), eight trials with glucagon-like peptide-1 receptor agonists (GLP-1RA) and six trials with sodium-glucose cotransporter-2 inhibitors (SGLT-2i). Random-effects model meta-analysis showed an association between treatment and risk of MACE (hazard ratio [HR] 0.90; 95% CI 0.86, 0.94, P 2 = 45.2%, Q statistic P = 0.040). In meta-regression, there was an association between the reduction in HbA1c at the end of the trial and the HR reduction for MACE (beta = − 0.298, P = 0.007), with significant heterogeneity (I2 = 40%, Q statistic P = 0.04); this association was totally driven by the risk reduction of non-fatal stroke, which explained 100% of between-study variance (beta = − 0.531, R2 = 100%), without heterogeneity (I2 = 24%, Q statistic P = 0.206). There was no association between the reduction in HbA1c and the HR for heart failure or all-cause death. Conclusions The reduction of HbA1c in eighteen CVOTs was significantly associated with reduction of non-fatal stroke, explaining all (R2 = 100%) of the between-study variance. While the contribution of glucose lowering in some CV benefits of newer agents does not influence their indications for the patient with type 2 diabetes, it may hopefully facilitate their use.

Published
2021

38. Feasibility of Simplification From a Basal-Bolus Insulin Regimen to a Fixed-Ratio Formulation of Basal Insulin Plus a GLP-1RA or to Basal Insulin Plus an SGLT2 Inhibitor: BEYOND, a Randomized, Pragmatic Trial

Author

Maria Ida Maiorino, Rosa Di Fraia, Paola Caruso, Miriam Longo, Lorenzo Scappaticcio, Michela Petrizzo, Maurizio Gicchino, Katherine Esposito, Giuseppe Bellastella, Dario Giugliano, Giugliano, D., Longo, M., Caruso, P., Di Fraia, R., Scappaticcio, L., Gicchino, M., Petrizzo, M., Bellastella, G., Maiorino, M. I., and Esposito, K.

Subjects
Blood Glucose, medicine.medical_specialty, Glycated Hemoglobin A, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 030209 endocrinology & metabolism, Type 2 diabetes, Hypoglycemia, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Glucagon-Like Peptide 1, Internal medicine, Diabetes mellitus, Internal Medicine, Medicine, Humans, Hypoglycemic Agents, Insulin, 030212 general & internal medicine, Sodium-Glucose Transporter 2 Inhibitors, Glycemic, Advanced and Specialized Nursing, Glycated Hemoglobin, Hypoglycemic Agent, Emerging Therapies: Drugs and Regimens, business.industry, medicine.disease, Feasibility Studie, Regimen, Endocrinology, Diabetes Mellitus, Type 2, Feasibility Studies, business, Gliflozin, Human, medicine.drug
Abstract

OBJECTIVE BEYOND trial evaluated the feasibility of either basal insulin plus glucagon-like peptide 1 receptor agonist (GLP-1RA) or basal insulin plus sodium–glucose cotransporter 2 inhibitor (SGLT2i) to replace a full basal-bolus insulin (BBI) regimen in participants with type 2 diabetes and inadequate glycemic control. RESEARCH DESIGN AND METHODS Participants were randomized (1:1:1) to: 1) intensification of the BBI regimen (n = 101), 2) fixed ratio of basal insulin plus GLP-1RA (fixed-combo group; n = 102), and 3) combination of basal insulin plus SGLT2i (gliflo-combo group; n = 102). The primary efficacy outcome was change from baseline in HbA1c at 6 months. RESULTS Baseline characteristics were similar among the three groups (mean HbA1c was 8.6% [70 mmol/mol]). At 6 months, patients experienced similar reduction in HbA1c level (−0.6 ± 0.8, −0.6 ± 0.8, and −0.7 ± 0.9%, mean ± SD, respectively; noninferiority P < 0.001 vs. BBI), and the proportion of patients with HbA1c ≤7.5% was also similar (34%, 28%, and 27%, respectively; P = 0.489). Total insulin dose increased in the BBI group (62 units/day) and decreased both in the fixed-combo and gliflo-combo groups (27 units/day and 21 units/day, respectively; P < 0.01). The proportion of patients with hypoglycemia was 17.8%, 7.8%, and 5.9%, respectively (P = 0.015). There were 12 dropouts in the fixed-combo group, 9 in the gliflo-combo group, and none in the BBI group. CONCLUSIONS BEYOND provides evidence that it is possible and safe to switch from a BBI regimen to either a once-daily fixed-combo injection or once-daily gliflozin added to basal insulin, with similar glucose control, fewer insulin doses, fewer injections daily, and less hypoglycemia.

Published
2021

39. Neutropenia in patients with hyperthyroidism: Systematic review and meta‐analysis

Author

Katherine Esposito, Giuseppe Bellastella, Antonietta Maio, Maria Ida Maiorino, Lorenzo Scappaticcio, Scappaticcio, L., Maiorino, M. I., Maio, A., Esposito, K., and Bellastella, G.

Subjects
medicine.medical_specialty, Pediatrics, Neutropenia, white blood cells, Neutrophils, Endocrinology, Diabetes and Metabolism, Graves' disease, 030209 endocrinology & metabolism, Hyperthyroidism, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, hemic and lymphatic diseases, Internal medicine, Prevalence, medicine, Forest plot, Humans, Contraindication, business.industry, Publication bias, medicine.disease, Graves Disease, Confidence interval, 030220 oncology & carcinogenesis, Meta-analysis, Absolute neutrophil count, Graves’ disease, business
Abstract

Background and Objective: Neutropenia, a low absolute neutrophil count (ANC), may be a sign of new-onset hyperthyroidism. The aim of this systematic review and meta-analysis was to provide the most reliable estimates of prevalence, degree and response to treatments of neutropenia in the pure hyperthyroidism setting. Methods: A comprehensive literature search was performed in PubMed and Scopus databases for retrieving articles in English and non-English languages reporting ANC values/neutropenic cases at presentation and after therapy in patients with hyperthyroidism. A proportion meta-analysis was performed with DerSimonian and Laird method (random-effects model). Pooled data were presented with 95% confidence intervals (95% CI) and displayed in a forest plot. I2 statistic index was used to quantify the heterogeneity among the studies. Sensitivity analyses for the prevalence of neutropenia and the mean of ANC in hyperthyroid patients were performed by excluding the studies without full details. Trim and fill analysis and Egger's linear regression test were carried out to evaluate the publication bias. A two-sided P-value of

Published
2020
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40. Graves’ hyperthyroidism-related pancytopenia: a case report with literature review

Author

Giuseppe Paolisso, Lorenzo Scappaticcio, Maria Ida Maiorino, Maria Rosaria Rizzo, Claudia Catalano, Katherine Esposito, Giuseppe Bellastella, Miriam Longo, Scappaticcio, L., Bellastella, G., Maiorino, M. I., Longo, M., Catalano, C., Esposito, K., Paolisso, G., and Rizzo, M. R.

Subjects
Male, Pediatrics, medicine.medical_specialty, endocrine system diseases, Pancytopenia, Graves hyperthyroidism, Endocrinology, Diabetes and Metabolism, Graves' disease, 030209 endocrinology & metabolism, Context (language use), Review, Disease, 030204 cardiovascular system & hematology, 03 medical and health sciences, Methimazole, 0302 clinical medicine, Antithyroid Agents, hemic and lymphatic diseases, Humans, Medicine, business.industry, General Medicine, Middle Aged, medicine.disease, Graves Disease, Liver dysfunction, Graves’ disease, business, Complication, medicine.drug
Abstract

Introduction: Occurrence of pancytopenia in patients with untreated hyperthyroidism is extremely rare. To the best of our knowledge, only 30 cases have been reported in the English literature. Accurate diagnosis and appropriate tailored therapy are challenging due to the variegated causes of pancytopenia and the potential hematological toxicity of antithyroid drugs (ATDs). Case report: We present a 51-year-old Caucasian man with newly diagnosed Graves’ disease showing pancytopenia and liver dysfunction. Although in this context the use of ATDs is still under debate, low-dose methimazole therapy was able to induce resolution of both pancytopenia and liver dysfunction, along with euthyroidism restoration. Conclusion: Searching in the English literature for previous studies, we identified only 30 cases worldwide to form our database. A demographic as well as clinical, laboratory, and histopathological analysis was performed. In most cases, the recovery of biochemical euthyroidism through the use of ATDs induced the resolution of pancytopenia (at laboratory and histological levels). Our review provides clinical, laboratory, and histopathological features of Graves’s hyperthyroidism-related pancytopenia with a view to improving the knowledge of this rare hematological complication and assisting in the decision-making process regarding therapeutic options.

Published
2020
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41. Remission of Pituitary Autoimmunity Induced by Gluten-Free Diet in Patients With Celiac Disease

Author

Vlenia Pernice, Carmen Annunziata, Maria Ida Maiorino, Annamaria De Bellis, Antonio Bellastella, Miriam Longo, Katherine Esposito, Giuseppe Bellastella, Angela Costantino, Paolo Cirillo, Bellastella, G., Maiorino, M. I., Cirillo, P., Longo, M., Pernice, V., Costantino, A., Annunziata, C., Bellastella, A., Esposito, K., and De Bellis, A.

Subjects
Adult, Male, medicine.medical_specialty, Hypophysitis, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, Context (language use), Disease, Hypopituitarism, medicine.disease_cause, Biochemistry, Gastroenterology, antipituitary antibodie, Autoimmunity, Diet, Gluten-Free, Young Adult, Endocrinology, gluten-free diet, Internal medicine, medicine, Humans, lymphocytic hypophysitis, Autoimmune Hypophysitis, Longitudinal Studies, Subclinical infection, business.industry, autoimmunity, Biochemistry (medical), Hazard ratio, medicine.disease, Treatment Outcome, Disease Progression, Female, Gluten free, business, celiac disease
Abstract

Context An improvement of some autoimmune diseases associated with celiac disease (CD) has been observed after a gluten-free diet (GFD). Objective The aim of this longitudinal study was to evaluate the effect of a GFD on autoimmune pituitary impairment in patients with CD and potential/subclinical lymphocytic hypophysitis (LYH). Design Five-year longitudinal observational study. Setting Tertiary referral center for immunoendocrinology at the University of Campania “Luigi Vanvitelli”. Patients Ninety-three newly diagnosed LYH patients (high titer of antipituitary antibodies [APA] and normal or subclinically impaired pituitary function) were enrolled from 2000 to 2013 and grouped as follows: group 1, consisting of 43 patients with LYH + CD, and group 2, consisting of 50 patients with isolated LYH only. Intervention A GFD was started in patients in group 1 after the diagnosis of CD. Main outcome measures APA titers and pituitary function were evaluated at the beginning of the study and then yearly for 5 years in both groups. Patients progressing to a clinically overt LYH were excluded from the follow-up. Results Complete remission of LYH (disappearance of APA and recovery of pituitary function in patients with previous subclinical hypopituitarism) occurred in 15 patients in group 1 after a GFD (34%) and spontaneously in only 1 patient in group 2 (2%) (P Conclusion In patients with LYH and CD, a GFD may be able to induce remission of subclinical LYH, or prevent the progression to clinical stage of this disease.

Published
2020
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42. The effect of DPP-4 inhibitors, GLP-1 receptor agonists and SGLT-2 inhibitors on cardiorenal outcomes: a network meta-analysis of 23 CVOTs

Author

Dario, Giugliano, Miriam, Longo, Simona, Signoriello, Maria Ida, Maiorino, Bruno, Solerte, Paolo, Chiodini, Katherine, Esposito, Giugliano, D., Longo, M., Signoriello, S., Maiorino, M. I., Solerte, B., Chiodini, P., and Esposito, K.

Subjects
Heart Failure, Dipeptidyl-Peptidase IV Inhibitors, GLP-1 receptor agonist, Endocrinology, Diabetes and Metabolism, Network Meta-Analysis, SGLT-2 inhibitors, Myocardial Infarction, Network meta-analysi, Glucagon-Like Peptide-1 Receptor, Stroke, Cardiovascular outcome trial, Diabetes Mellitus, Type 2, Cardiovascular Diseases, Glucagon-Like Peptide 1, Humans, Hypoglycemic Agents, DPP-4 inhibitor, Cardiology and Cardiovascular Medicine, Sodium-Glucose Transporter 2 Inhibitors
Abstract

Background Glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium glucose co-transporter-2 (SGLT-2) inhibitors reduce cardiorenal outcomes. We performed a network meta-analysis to compare the effect on cardiorenal outcomes among GLP-1 RAs, SGLT-2 inhibitors and dipeptidyl peptidase-4 (DPP-4) inhibitors. Methods We searched the PUBMED, Embase and Cochrane databases for relevant studies published up until 10 December 2021. Cardiovascular and renal outcome trials reporting outcomes on GLP-1RA, SGLT-2 inhibitors and DPP-4 inhibitors in patients with or without type 2 diabetes mellitus were included. The primary outcome was major adverse cardiovascular events (MACE); other outcomes were cardiovascular and total death, nonfatal myocardial infarction (MI), nonfatal stroke, hospitalization for heart failure (HHF), and renal outcome. Results Twenty-three trials enrolling a total number of 181,143 participants were included. DPP-4 inhibitors did not lower the risk of any cardiorenal outcome when compared with placebo and were associated with higher risks of MACE, HHF, and renal outcome when compared with the other two drug classes. SGLT-2 inhibitors significantly reduced cardiovascular (RR = 0.88) and total (RR = 0.87) death, as compared with DPP-4 inhibitors, while GLP-1 RA reduced total death only (RR = 0.87). The comparison between GLP-1RA and SGLT-2 inhibitors showed no difference in their risks of MACE, nonfatal MI, nonfatal stroke, CV and total death; SGLT-2 inhibitors were superior to GLP-1RA in reducing the risk of HHF and the renal outcome (24% and 22% lower risk, respectively). Only GLP-1RA reduced the risk of nonfatal stroke (RR = 0.84), as compared with placebo. There was no head-to-head trial directly comparing these antidiabetic drug classes. Conclusions SGLT-2 inhibitors and GLP-1RA are superior to DPP-4 inhibitors in reducing the risk of most cardiorenal outcomes; SGLT-2 inhibitors are superior to GLP-1RA in reducing the risk of HHF and renal events; GLP-1RA only reduced the risk of nonfatal stroke. Both SGLT-2 inhibitors and GLP-1RA should be the preferred treatment for type 2 diabetes and cardiorenal diseases.

Published
2022
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43. Impact of COVID-19 on the thyroid gland: an update

Author

Lorenzo Scappaticcio, Arnoldo Piccardo, Katherine Esposito, Fabián Pitoia, Pierpaolo Trimboli, Scappaticcio, L., Pitoia, F., Esposito, K., Piccardo, A., and Trimboli, P.

Subjects
Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Systemic inflammation, Bioinformatics, TMPRSS2, Hyperthyroidism, Virus, Article, Thyroid cancer, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Hypothyroidism, Diabetes mellitus, medicine, Humans, Pandemics, Thyroid, business.industry, SARS-CoV-2, COVID-19, medicine.disease, Thyroid Diseases, medicine.anatomical_structure, 030220 oncology & carcinogenesis, medicine.symptom, business
Abstract

Coronavirus disease 2019 (COVID-19) is the pandemic of the new millennium. COVID-19 can cause both pulmonary and systemic inflammation, potentially determining multi-organ dysfunction. Data on the relationship between COVID-19 and thyroid have been emerging, and rapidly increasing since March 2020. The thyroid gland and the virus infection with its associated inflammatory-immune responses are known to be engaged in complex interplay. SARS-CoV-2 uses ACE2 combined with the transmembrane protease serine 2 (TMPRSS2) as the key molecular complex to infect the host cells. Interestingly, ACE2 and TMPRSS2 expression levels are high in the thyroid gland and more than in the lungs. Our literature search provided greater evidence that the thyroid gland and the entire hypothalamic–pituitary–thyroid (HPT) axis could be relevant targets of damage by SARS-CoV-2. Specifically, COVID-19-related thyroid disorders include thyrotoxicosis, hypothyroidism, as well as nonthyroidal illness syndrome. Moreover, we noticed that treatment plans for thyroid cancer are considerably changing in the direction of more teleconsultations and less diagnostic and therapeutical procedures. The current review includes findings that could be changed soon by new results on the topic, considering the rapidity of worldwide research on COVID-19.

Published
2022

44. When amputation is not the end of the challenge: A successful therapy for osteomyelitis and soft tissue infection in a patient with type 1 diabetes

Author

Miriam Longo, Katherine Esposito, Ferdinando Campitiello, Lorenzo Scappaticcio, Paola Caruso, Maurizio Gicchino, Caruso, P., Gicchino, M., Longo, M., Scappaticcio, L., Campitiello, F., and Esposito, K.

Subjects
Adult, Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Case Report, Diseases of the endocrine glands. Clinical endocrinology, Gangrene, Diabetes mellitus, Anti-Bacterial Agent, Medical Illustration, Internal Medicine, medicine, Osteomyeliti, Amputation, Soft Tissue Infection, Type 1 diabetes, business.industry, Osteomyelitis, General Medicine, RC648-665, medicine.disease, Diabetic foot, Surgery, Clinical Science and Care, Diabetic foot ulcer, medicine.anatomical_structure, Diabetes Mellitus, Type 1, Treatment Outcome, Debridement, Postoperative Complication, Ankle, Complication, business, Human
Abstract

Infection is a common complication in patients with diabetic foot ulcer, leading to lower extremities amputation and healing failure. In this article, we report the case of a 39‐year‐old man with diabetes who developed a severe soft tissue infection and osteomyelitis after experiencing a major amputation for wet gangrene of both the foot and the ankle.

Published
2022

45. Thyroid surgery during the COVID-19 pandemic: results from a systematic review

Author

C Camponovo, Lorenzo Scappaticcio, Arnoldo Piccardo, Pierpaolo Trimboli, Katherine Esposito, Giovanni Docimo, Giuseppe Bellastella, Maria Ida Maiorino, Sergio Iorio, Scappaticcio, L., Maiorino, M. I., Iorio, S., Camponovo, C., Piccardo, A., Bellastella, G., Docimo, G., Esposito, K., and Trimboli, P.

Subjects
Adult, Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Hypoparathyroidism, Endocrinology, Diabetes and Metabolism, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Thyroid Disease, MEDLINE, 030209 endocrinology & metabolism, Comorbidity, Malignancy, Laryngeal Nerve Injuries, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Endocrinology, Pandemic, medicine, Humans, Thyroid Neoplasms, Lymph node, Thyroid Neoplasm, Aged, Thyroid, Aged, 80 and over, Cross Infection, Elective Surgical Procedure, business.industry, SARS-CoV-2, COVID-19, Middle Aged, medicine.disease, Thyroid Diseases, Surgery, medicine.anatomical_structure, Elective Surgical Procedures, 030220 oncology & carcinogenesis, Thyroidectomy, Lymph Node Excision, Original Article, Female, Laryngeal Nerve Injurie, Postoperative Complication, business, Human
Abstract

Purpose During the COVID-19 pandemic, elective thyroid surgery is experiencing delays. The problem is that the COVID-19 pandemic is ongoing. The research purposes were to systematically collect the literature data on the characteristics of those thyroid operations performed and to assess the safety/risks associated with thyroid surgery during the COVID-19 pandemic. Methods We used all the procedures consistent with the PRISMA guidelines. A comprehensive literature in MEDLINE (PubMed) and Scopus was made using ‘‘Thyroid’’ and “coronavirus” as search terms. Results Of a total of 293 articles identified, 9 studies met the inclusion criteria. The total number of patients undergoing thyroid surgery was 2217. The indication for surgery was malignancy in 1347 cases (60.8%). Screening protocols varied depending on hospital protocol and maximum levels of personal protection equipment were adopted. The hospital length of stay was 2–3 days. Total thyroidectomy was chosen for 1557 patients (1557/1868, 83.4%), of which 596 procedures (596/1558, 38.3%) were combined with lymph node dissections. Cross-infections were registered in 14 cases (14/721, 1.9%), of which three (3/721, 0.4%) with severe pulmonary complications of COVID-19. 377 patients (377/1868, 20.2%) had complications after surgery, of which 285 (285/377, 75.6%) hypoparathyroidism and 71 (71/377, 18.8%) recurrent laryngeal nerve injury. Conclusion The risk of SARS-CoV-2 transmission after thyroid surgery is relatively low. Our study could promote the restart of planned thyroid surgery due to COVID-19. Future studies are warranted to obtain more solid data about the risk of complications after thyroid surgery during the COVID-19 era.

Published
2022

46. SGLT-2 inhibitors and cardiorenal outcomes in patients with or without type 2 diabetes: a meta-analysis of 11 CVOTs

Author

Dario Giugliano, Miriam Longo, Lorenzo Scappaticcio, Giuseppe Bellastella, Maria Ida Maiorino, Katherine Esposito, Giugliano, D., Longo, M., Scappaticcio, L., Bellastella, G., Maiorino, M. I., and Esposito, K.

Subjects
Male, Kidney Disease, Time Factors, Time Factor, Heart Diseases, Endocrinology, Diabetes and Metabolism, Risk Assessment, Type 2 diabete, Cardiovascular outcome trials, Diseases of the circulatory (Cardiovascular) system, Humans, Sodium-Glucose Transporter 2 Inhibitors, Original Investigation, Aged, Clinical Trials as Topic, Sodium-Glucose Transporter 2 Inhibitor, Cardiorenal outcomes, SGLT-2 inhibitors, Cardiorenal outcome, Type 2 diabetes, Heart Disease Risk Factor, Middle Aged, Cardiovascular outcome trial, Heart Disease, Treatment Outcome, Diabetes Mellitus, Type 2, Heart Disease Risk Factors, RC666-701, SGLT-2 inhibitor, Female, Kidney Diseases, Cardiology and Cardiovascular Medicine, Human
Abstract

Background It has been suggested that sodium–glucose cotransporter 2 (SGLT-2) inhibitors reduce the cardiorenal risk in patients with type 2 diabetes (T2D). The purpose of this study is to provide an update of all large cardiovascular outcome trials (CVOTs) with SGLT-2 inhibitors to assess their cardiorenal efficacy in patients with and without T2D. Methods An electronic search up to 30 September 2021 was conducted in PubMed, EMBASE, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov. to determine eligible trials. We included CVOTs comparing any SGLT-2 inhibitor with placebo, reporting desired cardiovascular or renal outcomes and with a follow-up duration of at least 6 months. Results Eleven CVOTs, with data from five SGLT-2 inhibitors (empagliflozin, canagliflozin, dapagliflozin, ertugliflozin and sotagliflozin) and 77,541 participants, were included. In the overall analysis, the risk of the composite CV mortality or hospitalization for heart failure (HF) was reduced by 23% (HR = 0.77, 95% CI 0.73–0.82, P 2 = 26%, P = 0.20), and irrespective of the presence of T2D (P for interaction = 0.81) and age (> 65 vs ≤ 65 years, P for interaction = 0.78). The risk of CV mortality, total mortality and hospitalization for HF was significantly reduced by 16%, 13%, and 32%, respectively; similarly, the risk of the composite renal outcome was reduced by 35% (HR = 0.65, 95% CI 0.56–0.75), with moderate heterogeneity (I2 = 32%). In the analysis of 6 CVOTs reporting the data, the risk of major cardiovascular events (MACE) was reduced by 12%, with low heterogeneity (I2 = 21.2%, P = 0.19) and irrespective of the presence of established CV disease at baseline (P for interaction = 0.46). Conclusions Therapy with SGLT-2 inhibitors in patients with cardiometabolic and renal diseases results in a sustained to moderate reduction of the composite CV death or hospitalization for HF, robust reduction of HF and renal outcomes, moderate reduction of CV mortality, total mortality and MACE.

Published
2021

47. Reply to the letter to the editor by Mungmunpuntipantip et al

Author

Miriam Longo, Maria Ida Maiorino, Katherine Esposito, Longo, M, Maiorino, M I, and Esposito, K

Subjects
Endocrinology, Letter to the editor, business.industry, Endocrinology, Diabetes and Metabolism, Medicine, Theology, business
Published
2021

48. GLP-1 receptor agonists and cardiorenal outcomes in type 2 diabetes: an updated meta-analysis of eight CVOTs

Author

Antonio Ceriello, Miriam Longo, Katherine Esposito, Giuseppe Bellastella, Paola Caruso, Dario Giugliano, Lorenzo Scappaticcio, Maria Ida Maiorino, Paolo Chiodini, Giugliano, D., Scappaticcio, L., Longo, M., Caruso, P., Maiorino, M. I., Bellastella, G., Ceriello, A., Chiodini, P., and Esposito, K.

Subjects
Male, Endocrinology, Diabetes and Metabolism, Type 2 diabetes, Cardiovascular outcome trials, Risk Factors, Efpeglenatide, Cause of Death, Original Investigation, Clinical Trials as Topic, Incidence, Hazard ratio, Cardiorenal outcome, Middle Aged, GLP-1RA, Hospitalization, Treatment Outcome, Cardiovascular Diseases, Female, Kidney Diseases, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Oral semaglutide, Lixisenatide, Placebo, Incretins, Risk Assessment, Glucagon-Like Peptide-1 Receptor, Albiglutide, Diabetes mellitus, Internal medicine, medicine, Humans, Hypoglycemic Agents, Diseases of the circulatory (Cardiovascular) system, Dulaglutide, Aged, Cardio-Renal Syndrome, business.industry, Cardiorenal outcomes, Semaglutide, Liraglutide, medicine.disease, Confidence interval, Cardiovascular outcome trial, Diabetes Mellitus, Type 2, RC666-701, Heart failure, Exenatide, business, Mace
Abstract

Background A meta-analysis is presented of cardiovascular outcome trials (CVOTs) comparing glucagon-like peptide-1 receptor agonists (GLP-1RA) versus placebo on cardiorenal outcomes in patients with type 2 diabetes mellitus (T2DM). Methods We did an electronic search up to June 30, 2021, for eligible trials. We did a meta-analysis of available trial data using a random-effects model to calculate overall hazard ratios (HRs) and 95% CI (confidence intervals). We included data from 8 CVOTs and 60,080 patients (72.4% with established cardiovascular disease). Results GLP-1RA reduced major cardiovascular events (MACE) by 14% (HR = 0.86, 95% CI 0.79–0.94, P = 0.006) with a non-significant heterogeneity between subgroups of patients with and without cardiovascular disease (P = 0.127). GLP-1RA also reduced the risk of cardiovascular death by 13% (P = 0.016), nonfatal stroke by 16% (P = 0.007), hospitalization for heart failure by 10% (P = 0.023), all-cause mortality by 12% (P = 0.012), and the broad composite kidney outcome by 17% (P = 0.012), which was driven by a reduction in macroalbuminuria only (HR = 0.74, 0.67–0.82, P Conclusions GLP-1RA have moderate benefits on MACE, and also reduce hospitalization for heart failure and all-cause mortality; they also have robust benefits on reducing the incidence of macroalbuminuria.

Published
2021
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49. Glycemic Control and the Heart: The Tale of Diabetic Cardiomyopathy Continues

Author

Miriam Longo, Lorenzo Scappaticcio, Paolo Cirillo, Antonietta Maio, Raffaela Carotenuto, Maria Ida Maiorino, Giuseppe Bellastella, Katherine Esposito, Longo, M., Scappaticcio, L., Cirillo, P., Maio, A., Carotenuto, R., Maiorino, M. I., Bellastella, G., and Esposito, K.

Subjects
Diabetic Cardiomyopathies, Heart failure, Type 2 diabetes, Heart, Diabetic cardiomyopathy, Glycemic Control, Cardiovascular disease, Biochemistry, Diabetes Mellitus, Type 2, Hyperglycemia, Glucose control, Humans, Glucose-lowering agent, Molecular Biology
Abstract

Cardiovascular diseases are the leading cause of death in people with diabetes. Diabetic cardiomyopathy (DC) is an important complication of diabetes and represents a distinct subtype of heart failure that occurs in absence of cardiovascular diseases. Chronic hyperglycemia and hyperinsulinemia along with insulin resistance and inflammatory milieu are the main mechanisms involved in the pathophysiology of DC. Changes in lifestyle favoring healthy dietary patterns and physical activity, combined with more innovative anti-diabetes therapies, are the current treatment strategies to safeguard the cardiovascular system. This review aims at providing an updated comprehensive overview of clinical, pathogenetic, and molecular aspects of DC, with a focus on the effects of anti-hyperglycemic drugs on the prevention of pump dysfunction and consequently on cardiovascular health in type 2 diabetes.

Published
2021

50. Different Formulations of Levothyroxine for Treating Hypothyroidism: A Real-Life Study

Author

Luca Giovanella, Lorenzo Scappaticcio, Maria Ida Maiorino, Annamaria De Bellis, Pierpaolo Trimboli, Katherine Esposito, Giuseppe Bellastella, Luisa Knappe, Trimboli, P., Scappaticcio, L., De Bellis, A., Maiorino, M. I., Knappe, L., Esposito, K., Bellastella, G., and Giovanella, L.

Subjects
endocrine system, medicine.medical_specialty, Article Subject, Endocrinology, Diabetes and Metabolism, Levothyroxine, 030209 endocrinology & metabolism, Newly diagnosed, Gastroenterology, Diseases of the endocrine glands. Clinical endocrinology, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Internal medicine, medicine, Statistical analysis, Endocrine and Autonomic Systems, business.industry, Active principle, RC648-665, Regimen, Before Breakfast, 030220 oncology & carcinogenesis, Postsurgical hypothyroidism, Life study, business, Research Article, medicine.drug
Abstract

Objective. Hypothyroid patients are treated by sodium levothyroxine (LT4). Tablet is the mostly used LT4 formulation, and the fasting regimen is required for the absorption of active principle. Also, gastrointestinal diseases and drugs may impair the LT4 bioavailability when tablet is used. Nonsolid LT4 formulations (i.e., liquid solution (LS) and soft gel (SG) capsule) were manufactured to overcome the limitations of LT4 tablet. This study was conceived to evaluate the performance of nonsolid LT4 formulations in a real-life scenario. Methods. Two institutions participated in the study that was conducted in two phases (i.e., enrollment and re-evaluation). Adults with autoimmune or postsurgical hypothyroidism and on LT4 from a few months were selected. A nonparametric statistical analysis for paired or unpaired data was performed. Results. 121 consecutive cases were included. At the enrollment phase, a 52% of patients took the therapy at least 30 min before breakfast with no difference between tablet and SG/LS users. TSH was 1.65 mIU/L (0.86–2.70) in patients on LT4 tablet and 1.70 mIU/L (1.10–2.17) in those on SG/LS (p=0.66). At the re-evaluation phase, among the patients using correct LT4 assumption, the TSH value was stable in the tablet group (p=0.22) and significantly reduced in SG/LS group (p=0.004); among the patients using incorrect LT4 assumption, TSH was significantly increased in those on tablet (p=0.0029) and stable in those on SG/LS (p=0.36). Conclusion. The performance of nonsolid LT4 formulations is not influenced by correct or incorrect use of therapy. On the contrary, LT4 tablet does not guarantee euthyroidism when it is ingested without waiting for at least 30 minutes before breakfast. These new data, obtained in a real-life scenario, suggest that LT4 SG/LS should be regarded as first-line therapy for treating adults with newly diagnosed hypothyroidism.

Published
2020
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