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1. Subacute thyroiditis in the SARS-CoV-2 era: a multicentre prospective study

Author

Sara De Vincentis, Simona Loiacono, Eleonora Zanni, Roberta Sueri, Maria Laura Monzani, Daniele Santi, Ilaria Muller, Francesco Di Marco, Erica Crivicich, Mirco Armenti, Uberto Pagotto, Lorenzo Tucci, Carolina Cecchetti, Tommaso Trenti, Valentina Pecoraro, Giulia Canu, Manuela Simoni, and Giulia Brigante

Subjects
thyroid, sars-cov-2, vaccine, pandemic, thyrotoxicosis, covid-19, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

Objective: Many cases of subacute thyroiditis (SAT) have been described related to SARS-CoV-2 infection, but no prospective data about follow-up are known. This prospective, longitudinal, 3-year, multicentre study aims to explore the clinical peculiarities and outcome of SAT in relation to SARS-CoV-2 infection, ascertained with antibody dosage. Methods: All patients receiving SAT diagnosis from November 2020 to May 2022 were enrolled. Data on anamnesis, physical examination, blood tests (TSH, freeT4, freeT3, thyroglobulin, anti-thyroid antibodies, C-reactive protein, erythrocyte sedimentation rate, complete blood count), and thyroid ultrasound were collected. At baseline, the presence of IgG against the SARS-CoV-2 spike protein or nucleocapsid was investigated. Patients were evaluated after 1, 3, 6, and 12 months. Results: Sixty-six subjects were enrolled. At baseline, 54 presented with pain, 36 (67%) for at least 15 days. Serum SARS-CoV-2 IgG measurements documented that 7 out of 52 subjects (13.5%) had infection before SAT diagnosis (COVID+). No significant differences between the COVID+ and COVID− groups were found at baseline, except for respiratory symptoms and fever, which were more common in COVID+ (P = 0.039 and P = 0.021, respectively). Among the 41 subjects who completed follow-up, COVID+ and COVID− did not differ for therapeutic approach to SAT or outcome, all having an improvement in neck pain, inflammation parameters, and ultrasound features. Conclusion: This is the first prospective study investigating any difference both at diagnosis and at follow-up between SAT presentation in patients with previous SARS-CoV-2 infection and those without. Our data demonstrate that SARS-CoV-2 does not impact on SAT onset, evolution, and outcome.

Published
2024
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2. Comparison of the effects of lockdown due to COVID-19 on glucose patterns among children, adolescents, and adults with type 1 diabetes: CGM study

Author

Giulio Maltoni, Stefano Zucchini, Andrea Pession, Guido Di Dalmazi, Claudio Bongiorno, Lorenzo Tucci, Valeria Di Natale, Simona Moscatiello, Gilberto Laffi, and Uberto Pagotto

Subjects
Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

Introduction The COVID-19 pandemic forced the Italian government to issue extremely restrictive measures on daily activities since 11 March 2020 (‘lockdown’), which may have influenced the metabolic control of type 1 diabetes mellitus (T1D). The aims of the study were to investigate continuous glucose monitoring (CGM) metrics in children and adults with T1D during lockdown and to identify their potentially related factors.Research design and methods We enrolled 130 consecutive patients with T1D (30 children (≤12 years), 24 teenagers (13–17 years), and 76 adults (≥18 years)) using either Dexcom or FreeStyle LibreCGM>70% during the study period, without hybrid closed-loop insulin pump. CGM metrics during the 20 days before and the 20 days after lockdown were calculated. By telephonic contact, we performed validated physical activity and perceived stress questionnaires.Results In children, significantly lower glucose SD (SDglu) (p=0.029) and time below range (TBR)

Published
2020
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3. Day-Night and Inter-Habitat Variations in Ant Assemblages in a Mosaic Agroforestry Landscape

Author

Filippo Frizzi, Lorenzo Tucci, Lorenzo Ottonetti, Alberto Masoni, and Giacomo Santini

Subjects
ant community, Mediterranean basin, olive plantations, forest management, mosaic landscape, daily activity, Agriculture
Abstract

Throughout the Mediterranean basin, the long-term interaction between human activities and natural processes has led to the formation of unique ecosystems whose biodiversity may be higher than that of the “original” systems. This is particularly true in the case of transformations of continuous stretches of closed forest into a complex mosaic of open and closed habitat over the course of centuries. In this study, we assessed the variation in diversity of ant assemblages in a typical patchy landscape, sampling ants in the three most important constituting habitats: olive plantation, harvested forest, and mature forest. In the study we used two different sampling methods—pitfall traps and observation at baits—which provided information on species presence at different temporal scales. The three habitats displayed different species assemblages, and considerable variation in species composition was observed at different times of the day, particularly in the harvested forest. Functional group analysis showed that the olive plantation, although the most artificial habitat, displayed the highest number of functional groups, suggesting a wider spectrum of available ecological niches for ant species within this habitat type. Overall, it was concluded that each of the three habitats contributes to enhance diversity at the landscape scale, which is greater than that expected from a more homogeneous habitat composition.

Published
2021
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4. Age-dependent and sex-dependent disparity in mortality in patients with adrenal incidentalomas and autonomous cortisol secretion : an international, retrospective, cohort study

Author

Timo Deutschbein, Giuseppe Reimondo, Guido Di Dalmazi, Irina Bancos, Jekaterina Patrova, Dimitra Argyro Vassiliadi, Anja Barač Nekić, Miguel Debono, Pina Lardo, Filippo Ceccato, Luigi Petramala, Alessandro Prete, Iacopo Chiodini, Miomira Ivović, Kalliopi Pazaitou-Panayiotou, Krystallenia I Alexandraki, Felicia Alexandra Hanzu, Paola Loli, Serkan Yener, Katharina Langton, Ariadni Spyroglou, Tomaz Kocjan, Sabina Zacharieva, Nuria Valdés, Urszula Ambroziak, Mari Suzuki, Mario Detomas, Soraya Puglisi, Lorenzo Tucci, Danae Anastasia Delivanis, Dimitris Margaritopoulos, Tina Dusek, Roberta Maggio, Carla Scaroni, Antonio Concistrè, Cristina Lucia Ronchi, Barbara Altieri, Cristina Mosconi, Aristidis Diamantopoulos, Nicole Marie Iñiguez-Ariza, Valentina Vicennati, Anna Pia, Matthias Kroiss, Gregory Kaltsas, Alexandra Chrisoulidou, Ljiljana V Marina, Valentina Morelli, Wiebke Arlt, Claudio Letizia, Marco Boscaro, Antonio Stigliano, Darko Kastelan, Stylianos Tsagarakis, Shobana Athimulam, Uberto Pagotto, Uwe Maeder, Henrik Falhammar, John Newell-Price, Massimo Terzolo, and Martin Fassnacht

Subjects
Sex Characteristics, hypertension, Endocrinology, Diabetes and Metabolism, Sexual Behavior, dexamethasone, Article, retrospective studies, Endocrinology, female, cohort studies, male, middle aged, adrenal gland neoplasms, Internal Medicine, adenoma, hydrocortisone, humans
Abstract

Background\ud \ud The association between cortisol secretion and mortality in patients with adrenal incidentalomas is controversial. We aimed to assess all-cause mortality, prevalence of comorbidities, and occurrence of cardiovascular events in uniformly stratified patients with adrenal incidentalomas and cortisol autonomy (defined as non-suppressible serum cortisol on dexamethasone suppression testing).\ud \ud \ud \ud Methods\ud \ud We conducted an international, retrospective, cohort study (NAPACA Outcome) at 30 centres in 16 countries. Eligible patients were aged 18 years or older with an adrenal incidentaloma (diameter ≥1 cm) detected between Jan 1, 1996, and Dec 31, 2015, and availability of a 1 mg dexamethasone suppression test result from the time of the initial diagnosis. Patients with clinically apparent hormone excess, active malignancy, or follow-up of less than 36 months were excluded. Patients were stratified according to the 0800–0900 h serum cortisol values after an overnight 1 mg dexamethasone suppression test; less than 50 nmol/L was classed as non-functioning adenoma, 50–138 nmol/L as possible autonomous cortisol secretion, and greater than 138 nmol/L as autonomous cortisol secretion. The primary endpoint was all-cause mortality. Secondary endpoints were the prevalence of cardiometabolic comorbidities, cardiovascular events, and cause-specific mortality. The primary and secondary endpoints were assessed in all study participants.\ud \ud \ud \ud Findings\ud \ud Of 4374 potentially eligible patients, 3656 (2089 [57·1%] with non-functioning adenoma, 1320 [36·1%] with possible autonomous cortisol secretion, and 247 [6·8%] with autonomous cortisol secretion) were included in the study cohort for mortality analysis (2350 [64·3%] women and 1306 [35·7%] men; median age 61 years [IQR 53–68]; median follow-up 7·0 years [IQR 4·7–10·2]). During follow-up, 352 (9·6%) patients died. All-cause mortality (adjusted for age, sex, comorbidities, and previous cardiovascular events) was significantly increased in patients with possible autonomous cortisol secretion (HR 1·52, 95% CI 1·19–1·94) and autonomous cortisol secretion (1·77, 1·20–2·62) compared with patients with non-functioning adenoma. In women younger than 65 years, autonomous cortisol secretion was associated with higher all-cause mortality than non-functioning adenoma (HR 4·39, 95% CI 1·93–9·96), although this was not observed in men. Cardiometabolic comorbidities were significantly less frequent with non-functioning adenoma than with possible autonomous cortisol secretion and autonomous cortisol secretion (hypertension occurred in 1186 [58·6%] of 2024 patients with non-functioning adenoma, 944 [74·0%] of 1275 with possible autonomous cortisol secretion, and 179 [75·2%] of 238 with autonomous cortisol secretion; dyslipidaemia occurred in 724 [36·2%] of 1999 patients, 547 [43·8%] of 1250, and 123 [51·9%] of 237; and any diabetes occurred in 365 [18·2%] of 2002, 288 [23·0%] of 1250, and 62 [26·7%] of 232; all p values

Published
2022

5. Association between alterations of corneal sub-basal nerve plexus analyzed with in vivo confocal microscopy and long-term glycemic variability

Author

Gilberto Laffi, Piera Versura, Marco Pellegrini, Stefano Sebastiani, Giuseppe Giannaccare, Simona Moscatiello, Guido Di Dalmazi, Uberto Pagotto, Lorenzo Tucci, and Marco Pellegrini, Stefano Sebastiani, Lorenzo Tucci, Giuseppe Giannaccare, Simona Moscatiello, Gilberto Laffi, Uberto Pagotto, Guido Di Dalmazi, Piera Versura

Subjects
Pathology, medicine.medical_specialty, Diabetic neuropathy, type 1 diabetes, In vivo confocal microscopy, Ophthalmic Nerve, 030209 endocrinology & metabolism, NO, Cornea, 03 medical and health sciences, Basal (phylogenetics), Nerve Fibers, 0302 clinical medicine, Diabetic Neuropathies, Humans, Medicine, Glycemic variability, Glycemic, Type 1 diabetes, Corneal nerves, in vivo confocal microscopy, diabetic neuropathy, HbA1C, type 1 diabetes, Glycemic variability, Microscopy, Confocal, HbA1C, business.industry, Nerve plexus, General Medicine, medicine.disease, diabetic neuropathy, Ophthalmology, medicine.anatomical_structure, 030221 ophthalmology & optometry, business, Corneal nerves, in vivo confocal microscopy
Abstract

Purpose: The effect of long-term glycemic variability upon corneal sub-basal nerve plexus (CSNP) morphology analyzed by in vivo confocal microscopy (IVCM) has been poorly investigated in the setting of type 1 diabetes mellitus (T1DM). Our purpose was to analyze the association between morphometric parameters of CSNP and new markers of glycemic variability in a population of patients with T1DM. Methods: Forty patients with T1DM underwent: assessment of diabetic neuropathy (DN); analysis of subcutaneous advanced glycated end-products; IVCM scans of CSNP. The fully automated software ACCMetrics was employed to analyze IVCM images and calculate seven corneal nerve parameters. Data of diabetes duration, mean and standard deviation (SD) of either last-year and all-time glycated hemoglobin (HbA1C) were retrieved. Results: Diabetes duration and all-time SD of HbA1C were independently associated with CNFD (R = –0.26, p = 0.01; R = –0.27, p = 0.047 respectively), CNFL (R = –0.12; p = 0.01; R = –0.17, p = 0.01 respectively) and CNFrD (R = –0.001, p = 0.009; R = –0.002, p = 0.007 respectively). The analysis of the association among IVCM parameters and specific subtypes of DN showed that altered cold sensitivity was independently associated with CNFD (B = –0.24, p = 0.01), CNFL (B = –0.46, p = 0.01) and CNFrD (B = –28.65, p = 0.03). Conclusions: All-time SD of HbA1C and disease duration were found to be independent predictors of damage to CSNP in patients with T1DM.

Published
2021

6. Prevalence and Incidence of Atrial Fibrillation in a Large Cohort of Adrenal Incidentalomas: A Long-Term Study

Author

Andrea Repaci, Alessandra Gambineri, Caterina Balacchi, Valentina Vicennati, Eugenio Roberto Cosentino, Flaminia Fanelli, Carmine Pizzi, Guido Di Dalmazi, Claudio Borghi, Carla Pelusi, Uberto Pagotto, Cristina Mosconi, Lorenzo Tucci, Rita Golfieri, Nazzareno Galiè, Pasquale Paolisso, Silvia Garelli, and Guido Di Dalmazi, Valentina Vicennati, Carmine Pizzi, Cristina Mosconi, Lorenzo Tucci, Caterina Balacchi, Eugenio Roberto Cosentino, Pasquale Paolisso, Flaminia Fanelli, Alessandra Gambineri, Carla Pelusi, Andrea Repaci, Silvia Garelli, Nazzareno Galiè, Claudio Borghi, Rita Golfieri, Uberto Pagotto

Subjects
Cortisol secretion, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, Population, 030209 endocrinology & metabolism, Context (language use), 030204 cardiovascular system & hematology, adrenal incidentaloma, Rate ratio, arrhythmia, Biochemistry, autonomous cortisol secretion, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Primary aldosteronism, Internal medicine, medicine, atrial fibrillation, education, education.field_of_study, business.industry, Biochemistry (medical), Hazard ratio, Retrospective cohort study, Odds ratio, medicine.disease, cortisol, business
Abstract

Context Chronic glucocorticoids excess leads to morphological and functional cardiac alterations, a substrate for arrhythmias. Autonomous cortisol secretion (ACS) in adrenal incidentalomas is a model of chronic endogenous hypercortisolism. Objective To investigate prevalence and incidence of atrial fibrillation (AF) in a large cohort of patients with ACS. Design Retrospective study. Setting University hospital. Patients Patients evaluated between 1990 and 2018 for adrenal incidentalomas (n = 632), without pheochromocytoma, primary aldosteronism, Cushing syndrome, congenital adrenal hyperplasia, and adrenal malignancy. Cortisol after 1-mg dexamethasone suppression test 50 nmol/L defined nonsecreting tumors (NST) (n = 420) and ACS (n = 212), respectively. Intervention Assessment of AF at baseline (n = 632) and during a median follow-up of 7.7 years retrospectively (NST, n = 249; ACS, n = 108). Comparison with general population. Main Outcome Measure Prevalence and incidence of AF. Results AF prevalence was higher in patients with ACS (8.5%) than NST (3.1%, P = 0.003) and the general population (1.7%; P Conclusions Patients with adrenal incidentalomas and ACS are at risk of AF. Electrocardiogram monitoring may be recommended during follow-up.

Published
2020

7. Radiologically defined lipid-poor adrenal adenomas: histopathological characteristics

Author

Stefano Fanti, Donatella Santini, Valentina Vicennati, Francesco Minni, Caterina Balacchi, Cristina Mosconi, Saverio Selva, G. Di Dalmazi, Cristina Nanni, Uberto Pagotto, A. De Leo, Lorenzo Tucci, Guido Zavatta, Maria Abbondanza Pantaleo, Claudio Ceccarelli, Rita Golfieri, De Leo A., Mosconi C., Zavatta G., Tucci L., Nanni C., Selva S., Balacchi C., Ceccarelli C., Santini D., Pantaleo M.A., Minni F., Fanti S., Golfieri R., Pagotto U., Vicennati V., and Di Dalmazi G.

Subjects
Cortisol secretion, Adenoma, Adult, Male, medicine.medical_specialty, Adrenal tumor, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Biopsy, Adrenal Gland Neoplasms, 030209 endocrinology & metabolism, Lipid-poor adenoma, Gastroenterology, Cohort Studies, 03 medical and health sciences, Cushing syndrome, 0302 clinical medicine, Endocrinology, Primary aldosteronism, Adrenocorticotropic Hormone, Fluorodeoxyglucose F18, Predictive Value of Tests, Internal medicine, medicine, Humans, In patient, Borderline-malignant, Cushing Syndrome, Aged, Retrospective Studies, Adrenal oncocytoma, Heterogeneous group, drenal oncocytoma, business.industry, Adrenalectomy, Middle Aged, medicine.disease, Lipid Metabolism, Prognosis, Contrast medium, ACTH Syndrome, Ectopic, Italy, 030220 oncology & carcinogenesis, Positron-Emission Tomography, Histopathology, Female, business, Tomography, X-Ray Computed
Abstract

Background: Adrenal lipid-poor adenomas (LPA) are defined by high unenhanced density (≥ 10 HU), and absolute and relative contrast medium washout > 60% and > 40%, respectively, at computerized tomography (CT). To date, no thorough histopathological characterization has been performed in those frequent lesions (one-third of adrenal adenomas). Our aim was to analyze the histopathological characteristics of adrenal LPA. Methods: Patients with LPA (n = 57) were selected among consecutive subjects referred for an adrenal incidentaloma or ACTH-independent Cushing syndrome. FluoroDeoxyGlucose-Positron Emission Tomography (FDG-PET) was performed in 37 patients. In patients treated by adrenalectomy (n = 17), Weiss score and Lin–Weiss–Bisceglia score (in tumors composed entirely or predominantly of oncocytes) were calculated. Results: Radiological parameters did not differ among patients with ACTH-independent Cushing syndrome (n = 6) and those with adrenal incidentalomas associated with primary aldosteronism (n = 2), autonomous cortisol secretion (n = 14), or non-functioning (n = 35). Patients treated by adrenalectomy had larger tumors (28.9 ± 11.2 vs 17.3 ± 8.4mm, P < 0.001), higher CT unenhanced density (29.1 ± 11.0 vs 23.1 ± 9.0 HU, P = 0.043), and FDG-PET adrenal uptake (9.0 ± 6.4 vs 4.4 ± 2.3 SUV, P = 0.003) than non-operated ones. Oncocytic features > 75% of the tumor were detected in 12/17 cases (70.6%). Five of those showed borderline-malignant histopathological characteristics by Lin–Weiss–Bisceglia score. Among remaining non-oncocytic tumors, 1/5 had a Weiss score ≥ 3. Overall, 6/17 tumors (35.3%) had borderline-malignant potential. Radiological parameters were similar between patients with benign and borderline-malignant tumors. Conclusions: Adrenal LPA are a heterogeneous group of tumors, mostly composed of oncocytomas. Up to 1/3 of those tumors may have a borderline-malignant potential at histopathology.

Published
2020

8. Changes in ground-foraging ant assemblages along a disturbance gradient in a tropical agricultural landscape

Author

Guido Chelazzi, Lorenzo Tucci, Lorenzo Ottonetti, Filippo Frizzi, and Giacomo Santini

Subjects
Ecology, Agroforestry, Biodiversity, Tropics, Species diversity, Biology, Common species, Habitat, Agricultural land, Secondary forest, Animal Science and Zoology, Species richness, Ecology, Evolution, Behavior and Systematics, Ant assemblages, Nicaragua
Abstract

Changes in ground-foraging ant assemblages occurring along an agricultural intensification gradient were analysed in Nicaragua (Central America). Five habitat types were compared: secondary forest fragments, organic shade coffee and cocoa plantations, corn fields and active pastures. Ants were captured by tuna baiting following standardised protocols. Species richness and diversity decreased along the gradient from forest to the pasture, and each of the agricultural systems (cocoa, coffee and corn plantations) significantly differed in diversity. Species composition also differed along the disturbance gradient, as shown by multivariate analysis. Forest and pasture were at the extremes of the gradient and shared no common species. The ant assemblages associated with coffee plots, although poorer in species, were more similar to those of the forest than to those of the cocoa plantations. The observed trends confirm that shaded agro-forestry plantations can help to maintain high biodiversity levels in tropic...

Published
2010

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