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Background Pheochromocytoma (PHEO) and paraganglioma (PGL) are rare neuroendocrine tumors releasing catecholamines. Metastatic pheochromocytomas/paragangliomas (PPGLs) occur in about 5–26% of cases. To date, the management of patients affected by metastatic disease is a challenge in the absence of guidelines. Aim The aim of this study was to evaluate the overall survival (OS) and the progression-free survival (PFS) in metastatic PPGLs. Methods Clinical data of 20 patients referred to the Careggi University Hospital (Florence, Italy) were retrospectively collected. Follow-up ranged from 1989 to 2019. Site and size of primary tumor, biochemical activity, genetic analysis and employed therapies were considered. Data were analyzed with SPSS version 27. Results Nine PHEOs (45%) and 11 PGLs (55%) were enrolled. Median age at diagnosis was 43.5 years [30–55]. Mean follow-up was 104.6 ± 89.3 months. Catecholamines were released in 70% of cases. An inherited disease was reported in 50% of patients. OS from the initial diagnosis (OSpt) and from the metastatic appearance (OSmtx) were lower in older patients (OSpt p = 0.028; OSmtx p p = 0.007; OSmtx p = 0.041), larger tumors (OSpt p = 0.008; OSmtx p = 0.025) and sporadic disease (OSpt p = 0.013; OSmtx p = 0.008). Conclusion Our data showed that older age at the initial diagnosis, sympathetic extra-adrenal localization, larger tumors and wild-type neoplasms are related to worse prognosis. Notably, the employed therapies do not seem to influence the survival of our patients. At present, effective treatments for metastatic PPGLs are missing and a multidisciplinary approach is indispensably required.

Purpose Low free testosterone (T) level in men is independently associated with presence and severity of Non-Alcoholic Steatohepatitis (NASH). The histological and molecular effects of oral testosterone prodrug LPCN 1144 treatment on hepatic fibrosis and NASH features are unknown. A metabolic syndrome-induced NASH model in rabbits consuming high fat diet (HFD) has been previously used to assess treatment effects of injectable T on hepatic fibrosis and NASH features. Here we present results on LPCN 1144 in this HFD-induced, NASH preclinical model. Methods Male rabbits were randomly assigned to five groups: regular diet (RD), HFD, HFD + 1144 vehicle (HFD + Veh), HFD + 1144 (1144), and HFD + 1144 + α-tocopherol (1144 + ALPHA). Rabbits were sacrificed after 12 weeks for liver histological, biochemical and genetic analyses. Histological scores were obtained through Giemsa (inflammation), Masson’s trichrome (steatosis and ballooning), and Picrosirius Red (fibrosis) staining. Results Compared to RD, HFD and HFD + Veh significantly worsened NASH features and hepatic fibrosis. Considering HFD and HFD + Veh arms, histological and biomarker features were not significantly different. Both 1144 and 1144 + ALPHA arms improved mean histological scores of NASH as compared to HFD arm. Importantly, percentage of fibrosis was improved in both 1144 (p p = 0.05) treatment arms vs. HFD. Both treatment arms also reduced HFD-induced inflammation and fibrosis mRNA markers. Furthermore, 1144 treatments significantly improved HFD-induced metabolic dysfunctions. Conclusions Histological and biomarker analyses demonstrate that LPCN 1144 improved HFD-induced hepatic fibrosis and NASH biochemical, biomolecular and histochemical features. These preclinical findings support a therapeutic potential of LPCN 1144 in the treatment of NASH and of hepatic fibrosis.

The relationship between the age-dependent decline of testosterone (T) and cardiovascular (CV) risk in men is still a matter of intense debate. In particular, over the last 5 years, several scientific reports have shed a new negative light on the association between T treatment (TTh) and forthcoming CV diseases (CVD). Based on this evidence, the US Food and Drug Administration agency has recommended that all T supplementations carry a warning that they may increase the risk of heart attack and stroke. To better clarify the available data on this topic, we scrutinized and summarized, also by using meta-analytic methods, the data generated during the last 5 years, as derived from the analysis of observational (either longitudinal or pharmaco-epidemiological) studies and from randomized controlled trials (RCTs) on TTh and CVD risk. Our analysis shows that there is a clear association between baseline T deficiency and overall mortality and CVD-related mortality when longitudinal surveys were analyzed, although a specific pathogenetic link cannot be made. When interventional trials were studied, several but not all pharmaco-epidemiological studies reported a possible protective role of TTh on CV risk; however, data from RCTs and their meta-analysis, presented here, do not provide us with sufficient information on this point. Present data do not indicate an increased risk with TTh, but there is also insufficient definitive evidence that TTh is protective. Therefore, further and more specific trials are advisable to better clarify the possible relationship between low T, TTh, and CVD in aging men.

The aim of the present study was to evaluate the role of hypothyroidism as a cause of hyponatremia in a clinical model of iatrogenic acute hypothyroidism due to thyroid hormone withdrawal prior to ablative radioactive iodine (RAI) therapy after total thyroidectomy. The study group consisted of 101 differentiated thyroid cancer (DTC) patients (77 women and 24 men). Plasma concentration of thyroid-stimulating hormone ([TSH]) and sodium ([Na+]) was evaluated before total thyroidectomy (pre[TSH] and pre[Na+]) and on the day of RAI therapy (post[TSH] and post[Na+]). The frequency of hypothyroidism-associated hyponatremia was 4 % (4/101). Pre[Na+] was significantly higher than post[Na+] (140.7 ± 1.6 vs 138.7 ± 2.3 mEq/L, p = 0.012). Moreover, a linear correlation was identified between pre[Na+] and post[Na+]. Iatrogenic acute hypothyroidism-related hyponatremia is uncommon. However, because of the significant reduction of [Na+] in the transition from euthyroidism to iatrogenic hypothyroidism, the value of pre[Na+] should be viewed as a parameter to be considered. Since it acts as an independent risk factor for the development of hyponatremia, patients with a pre[Na+] close to the lower limit of normal range may deserve a closer monitoring of [Na+].

To analyze possible relationships between gynecomastia and clinical and biochemical parameters in a large cohort of subjects with sexual dysfunction (SD). A consecutive series of 4,023 men attending our Outpatient Clinic for SD was retrospectively studied. After excluding Klinefelter’s syndrome patients, the prevalence of gynecomastia was 3.1 %. Subjects with gynecomastia had significantly lower testosterone (T) levels; the association retained statistical significance after adjusting for age and life-style. However, only 33.3 % of subjects with gynecomastia were hypogonadal. Gynecomastia was associated with delayed puberty, history of testicular or hepatic diseases, as well as cannabis abuse. Patients with gynecomastia more frequently reported sexual complaints, such as severe erectile dysfunction [odds ratio (OR) = 2.19 (1.26–3.86), p = 0.006], lower sexual desire and intercourse frequency [OR = 1.23 (1.06–1.58) and OR = 1.84 (1.22–2.78), respectively; both p

Disfunzione erettile, sindrome metabolica e ipogonadismo sono condizioni interconnesse. La comparsa di disfunzione erettile puo fornire l’opportunita di approfondimenti clinici specifici che consentano di modificare eventuali fattori di rischio in una fase di malattia cardiovascolare ancora precoce.

Il ruolo fisiologico della prolattina (PRL) nell’uomo non e ancora completamente chiaro. Il gruppo di Autori del presente articolo ha gia dimostrato in passato che, nei soggetti ch e si sottopongon o a controlli per disfunzioni sessuali, bassi livelli di PRL sono associati ad alterati profili glicemici e lipidici, cosi come a piu alta prevalenza di sindrome metabolica e disfunzione erettile (DE) di origine vascolare. L’obiettivo di questo studio e quello di verificare la possibile associazione tra i livelli di PRL e l’incidenza degli eventi cardiovascolari maggiori (ECAM) nei soggetti con DE. A tale scopo sono stati arruolati 1.687 pazienti afferiti all’Unita Andrologica del Dipartimento di Fisiopatologia Clinica dell’Universita di Firenze per DE; ciascuno di essi e stato sottoposto a una valutazione ormonale completa basale e alla somministrazione dell’intervista strutturata sulla DE (SIEDY) costituita da 13 item (suddivisi in tre categorie: Scale 1, 2, 3 corrispondenti rispettivamente ai disordini organici, ai disturbi nella relazione con la partner primaria e alla descrizione del tratto psicologico del paziente) che individuano e quantificano le componenti che concorrono al le determinazione della DE. In aggiunta, ai pazienti e stato somministrato il Middlesex Hospital Questionnaire (MHQ) per valutare l’eventuale presenza di tratti di psicopatologia ansiosa; inoltre, e stata valutata l’interferenza sui livelli di PRL dei medicamenti eventualmente assunti.