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Background Fine needle cytology (FNC) of a parathyroid neoplasia (PN) is reliable, but needs to be confirmed by Parathormone (PTH) and Thyroglobulin (TG) immunoassay on needle washing or by immunocytochemistry (ICC) evaluation. The differentiation between parathyroid adenoma (PA), atypical adenoma (PAA) and carcinoma (PC) is difficult on histology or even impossible on FNC. The aim of this study was to evaluate possible cytological criteria to classify FNC-PN further. Methods Twenty-three FNC samples of PN and parathyroid cysts were rather then have been reviewed. The series includes 18 PNs, 4 cysts and 1 Thyr3B (histologically diagnosed as PA). Cytological features were: cellularity, patterns (follicular, solid or papillary), clear, oncocytic, isolated cells, nuclear atypia, cytoplasmic inclusions, nucleoli and mitoses. Data were compared with the histological controls. Results Seventeen PNs, 2 cysts and 1 Thyr3B FNC samples were histologically diagnosed as PA (16), PAA (2) and PC (2). Two cysts and 1 PN were not confirmed histologically. Cytological features and incidences were: high cellularity (1 PA, 1 PAA, 2 PCs), follicular (8 PAs, 1 PAA), solid (5 PAs, 1 PC), papillary pattern (1PA, 1 PAA, 1 PC), clear cells (4 PAs, 1 PAA, 2 PCs), oncocytic cells (6 PAs, 1 PAA, 2 PCs), isolated cells (5 PAs, 2 PAAs, 2 PCs), nuclear atypia (2 PAs, 1 PAA, 2 PCs), cytoplasmic inclusions (4 PAs, 2 PCs), nucleoli (2 PCs) and mitoses (2 PCs). Conclusion Evident nucleoli and mitoses may suggest the differentiation between PA and PC. However, further investigations are required to confirm these preliminary observations.

Food supply in the Mediterranean area has been recently modified by big retail distribution; for instance, industrial retail has favored shipments of groceries from regions that are intensive producers of mass food, generating a long supply chain (LSC) of food that opposes short supply chains (SSCs) that promote local food markets. However, the actual functional role of food retail and distribution in the determination of the risk of developing metabolic syndrome (MetS) has not been studied hitherto. The main aim of this study was to test the effects of food chain length on the prevalence of MetS in a population accustomed to the Mediterranean diet. We conducted an observational study in Southern Italy on individuals adhering to the Mediterranean diet. We examined a total of 407 subjects (41% females) with an average age of 56 ± 14.5 years (as standard deviation) and found that being on the Mediterranean diet with a SSC significantly reduces the prevalence of MetS compared with the LSC (SSC: 19.65%, LSC: 31.46%; p: 0.007). Our data indicate for the first time that the length of food supply chain plays a key role in determining the risk of MetS in a population adhering to the Mediterranean diet.

La mastocitosi e una malattia rara caratterizzata dalla proliferazione clonale e dall’accumulo di mastociti in diversi organi e tessuti, tra cui il midollo osseo, il fegato, la milza, la cute, il tratto gastrointestinale e i linfonodi. La manifestazione cutanea piu frequente e piu tipica della mastocitosi e definita urticaria pigmentosa. Tuttavia, in una percentuale variabile tra il 10% e il 30% dei pazienti, la mastocitosi esordisce senza le caratteristiche lesioni cutanee; in questi pazienti il quadro clinico e spesso caratterizzato da sintomi correlati al rilascio di mediatori chimici, come l’orticaria, il flushing, l’osteoporosi, la diarrea e gli episodi ricorrenti di anafilassi. Nei pazienti senza lesioni cutanee la diagnosi di mastocitosi puo essere difficile: in questo studio abbiamo valutato le modalita di presentazione clinica e i livelli di triptasi sierica in una coorte di pazienti con mastocitosi senza lesioni cutanee. Nella nostra popolazione di 67 soggetti adulti affetti da mastocitosi sistemica (44 femmine e 23 maschi; eta media 28 anni) abbiamo selezionato i 10 pazienti che non presentavano le classiche lesioni cutanee e abbiamo valutato le loro caratteristiche cliniche di esordio. Nei pazienti con manifestazioni cliniche suggestive, e stata effettuata la determinazione dei livelli sierici di triptasi con il sistema analitico Phadia 250 (Thermo Fisher Scientific, Waltham, MA, USA). La diagnosi definitiva di mastocitosi sistemica e stata effettuata con la biopsia osteomidollare, in accordo con i criteri della World Health Organization (WHO). Il 15% (10/67) dei pazienti esaminati non presentava lesioni cutanee. La maggior parte di essi (7/10) era affetta da mastocitosi sistemica indolente (ISM), uno presentava la forma isolata al midollo osseo (BMM), uno era affetto da mastocitosi sistemica associata a disordine clonale non mastocitario (SM-AHNMD) e uno soltanto era affetto da mastocitosi sistemica avanzata (ASM). Le modalita di esordio piu frequenti in questi pazienti erano rappresentate da fratture vertebrali secondarie a osteoporosi severa, gravi episodi di anafilassi, progressiva monocitosi periferica e intenso dolore osseo. In un solo paziente la diagnosi era incidentale, poiche la biopsia del midollo osseo era stata effettuata per confermare un’altra patologia (trombocitemia essenziale). In tutti i casi sono stati riscontrati valori elevati di triptasi sierica. I valori di triptasi in questi pazienti variavano da 15 a 120 μg/L con una media di 52 μg/L (valori normali: fino a 11,4 μg/L). Nei pazienti senza lesioni cutanee, la diagnosi di mastocitosi puo essere difficile. Le manifestazioni di esordio della mastocitosi possono essere eterogenee, potendo variare da quadri clinici di grave osteoporosi fino a isolate anomalie ematologiche in pazienti per altro asintomatici. I nostri dati confermano l’importanza della determinazione dei livelli di triptasi sierica per la diagnosi di mastocitosi in pazienti senza lesioni cutanee, ma con sintomi e/o segni suggestivi, e la sua utilita per selezionare con accuratezza i pazienti che devono essere sottoposti alla biopsia osteomidollare.

25-Hydroxyvitamin D insufficiency and increased cardiovascular risk (CVR) association is still debated. The vitamin D (VitD)-dependent parathyroid hormone (PTH) is considered as the possible actuator of VitD effects on CVR. To investigate the association of CVR, PTH and VitD, we carried out blood pressure measurements and blood samples and collected information on dietary habits, anamnestic, clinical and metabolic data of 451 participants in the Salerno area (Southern Italy) during the World Hypertension Day (17 May). CVR was calculated according to the Framingham CVR charts. The overall population mean age was 51.6 ± 0.7 years, and female sex was slightly prevalent (55%). VitD deficiency (

We report the case of a man with a clear diagnosis of coeliac disease who nevertheless drank gluten-containing beer. We found that a 4-week period of drinking gluten-containing beer did not provoke significant changes in the intestinal mucosa of this patient with coeliac disease nor did it elicit any relevant symptoms. Serum antibody levels rose but did not reach a pathological threshold. However, a more prolonged gluten challenge may have led to clinically relevant changes in IgA antitransglutaminase titres. This case demonstrates how important individual sensitivity to gluten in a patient with coeliac disease is in determining symptoms, immunological response and intestinal mucosa damage.