The heart in rare endocrine diseases: cardiometabolic studies in Cushing’s syndrome and acromegaly

Introduction: Cushing’s syndrome (CS) and acromegaly are two rare endocrine diseases associated to increased morbidity and mortality, mainly for cardiovascular events. Cardiac magnetic resonance (CMR) is the established non-invasive gold standard method for measuring (left ventricle) LV volume, cardiac function and LV mass (LVM) due to its higher accuracy and reproducibility and lower variability in comparison with echocardiography. Aim: The aim of the current study was to evaluate the metabolic profile and to perform a cardiological study through CMR in patients with CS and acromegaly. Materials and methods: This was a prospective multicentric case-control study. Consecutive patients with CS and acromegaly, both cured and with active disease, entered the study. The control group included patients with non-functioning adrenal incidentaloma matched with patients for sex, age and BMI. Metabolic and clinical parameters and CMR parameters have been compared between patients and controls. Results: Sixteen patients with CS, 20 patients with acromegaly and 18 controls entered the study. Fasting glucose levels were significantly lower in CS patients than controls (p=0.003), whereas they were significantly higher in acromegaly patients than controls (p=0.033). No significant differences were found neither in lipid levels nor in systolic and diastolic blood pressure levels between patients and controls. No significant differences in the prevalence of cardiometabolic complications were found between patients and controls. LV end-systolic volume (LV-ESV) and LV-ESV indexed with respect to the body surface (LV-ESVi) were significantly higher in CS patients than controls (p=0.041; p=0.030). Right ventricle enddiastolic volume (RV-EDV), RV-EDVi, RV-ESV and RV-ESVi were significantly higher in CS patients than controls (p=0.025; p=0.033; p=0.004; p=0.008). LV-EDV, LV-EDVi, LV-ESV and LV-ESV were significantly and markedly higher in acromegaly patients than controls (p=0.001; p=0.003; p=0.001; p=0.001). LVM was significantly higher in acromegaly patients 3 than controls (p=0.002). RV-EDV, RV-EDVi, RV-ESV and RV-ESVi were significantly and markedly higher in acromegaly patients than controls (p=0.000; p=0.001; p=0.000; p=0.000). Consequently, acromegaly patients had a significantly lower RV-EF than controls (p=0.002). Moreover, a significant correlation was found between IGF-1 levels and cardiac parameters at CMR in acromegaly patients. Conclusions: CS and acromegaly have been demonstrated to have biventricular cardiac structural and functional impairment at CMR, which seem to have a multifactorial pathogenesis: the presence of disease-related cardiovascular risk factors and a direct effect of hormone excess. The results of the current studies suggest that CMR may have a place in the cardiac work-up of selected patients with rare endocrine diseases, such as CS and acromegaly

Role of FGF System in Neuroendocrine Neoplasms. Potential Therapeutic Applications

Neuroendocrine neoplasms (NENs) are a heterogeneous group of tumors originating from neuroendocrine cells dispersed in different organs. Receptor tyrosine kinases are a subclass of tyrosine kinases with a relevant role in several cellular processes including proliferation, differentiation, motility and metabolism. Dysregulation of these receptors is involved in neoplastic development and progression for several tumors, including NENs. In this review, we provide an overview concerning the role of the fibroblast growth factor (FGF)/fibroblast growth factor receptor (FGFR) system in the development and progression of NENs, the occurrence of fibrotic complications and the onset of drug-resistance. Although no specific FGFR kinase inhibitors have been evaluated in NENs, several clinical trials on multitarget tyrosine kinase inhibitors, acting also on FGF system, showed promising anti-tumor activity with an acceptable and manageable safety profile in patients with advanced NENs. Future studies will need to confirm these issues, particularly with the development of new tyrosine kinase inhibitors highly selective for FGFR

The S100A4 Transcriptional Inhibitor Niclosamide Reduces Pro-Inflammatory and Migratory Phenotypes of Microglia: Implications for Amyotrophic Lateral Sclerosis

S100A4, belonging to a large multifunctional S100 protein family, is a Ca2+-binding protein with a significant role in stimulating the motility of cancer and immune cells, as well as in promoting pro-inflammatory properties in different cell types. In the CNS, there is limited information concerning S100A4 presence and function. In this study, we analyzed the expression of S100A4 and the effect of the S100A4 transcriptional inhibitor niclosamide in murine activated primary microglia. We found that S100A4 was strongly up-regulated in reactive microglia and that niclosamide prevented NADPH oxidase 2, mTOR (mammalian target of rapamycin), and NF-kappa B (nuclear factor-kappa B) increase, cytoskeletal rearrangements, migration, and phagocytosis. Furthermore, we found that S100A4 was significantly up-regulated in astrocytes and microglia in the spinal cord of a transgenic rat SOD1-G93A model of amyotrophic lateral sclerosis. Finally, we demonstrated the increased expression of S100A4 also in fibroblasts derived from amyotrophic lateral sclerosis (ALS) patients carrying SOD1 pathogenic variants. These results ascribe S100A4 as a marker of microglial reactivity, suggesting the contribution of S100A4-regulated pathways to neuroinflammation, and identify niclosamide as a possible drug in the control and attenuation of reactive phenotypes of microglia, thus opening the way to further investigation for a new application in neurodegenerative conditions

Pituitary adenoma consistency affects postoperative hormone function: a retrospective study

Background: Tumor consistency recently emerged as a key factor in surgical planning for pituitary adenomas, but its impact on postoperative endocrine function is still unclear. Our study aimed to evaluate the impact of tumor consistency on the development of postoperative pituitary deficiencies. Methods: Single-center, retrospective analysis of consecutive pituitary surgeries performed between January 2017 and January 2021 at Policlinico Umberto I in Rome. All patients underwent radiological and biochemical evaluations at baseline, and hormone assessments 3 and 6 months after pituitary surgery. Postoperative MRI studies were used to determine resection rates following surgery. Data on tumor consistency, macroscopic appearance, neurosurgical approach, and intraoperative complications were collected. Results: Fifty patients [24 women, mean age 57 ± 13 years, median tumor volume 4800 mm3 [95% CI 620-8828], were included. Greater tumor volume (χ2 = 14.621, p = 0.006) and male sex (χ2 = 12.178, p < 0.001) were associated with worse preoperative endocrine function. All patients underwent transsphenoidal adenomectomy. Fibrous consistency was observed in 10% of patients and was associated with a Ki-67 greater than 3% (χ2 = 8.154, p = 0.04), greater risk of developing postoperative hormone deficiencies (χ2 = 4.485, p = 0.05, OR = 8.571; 95% CI: 0.876-83.908), and lower resection rates (χ2 = 8.148, p = 0.004; OR 1.385, 95% CI; 1.040-1.844). Similarly, worse resection rates were observed in tumors with suprasellar extension (χ2 = 5.048, p = 0.02; OR = 6.000, 95% CI; 1.129-31.880) and CSI (χ2 = 4.000, p = 0.04; OR = 3.857, 95% CI; 0.997-14.916). Conclusions: Tumor consistency might provide useful information about postoperative pituitary function, likely due to its impact on surgical procedures. Further prospective studies with larger cohorts are needed to confirm our preliminary findings

May the odds be ever in your favor: The Hunger Games and the fight for a more equal society. (Negative) Media vicarious contact and collective action

Various studies have found that reading books about positive interactions between ingroup and outgroup characters, known as media vicarious contact, can reduce prejudice. Focusing on the fantasy saga of The Hunger Games, we examined the effects of negative vicarious contact on collective action across two studies. Specifically, we tested whether reading about fantasy characters living in a postapocalyptic conflictual society with large social disparities between advantaged and disadvantaged groups leads advantaged group members to display greater willingness to engage in collective action on behalf of the disadvantaged group. Results from Study 1 (correlational survey in the United Kingdom and United States) and Study 2 (experimental intervention in Italy) revealed that reading The Hunger Games is indirectly associated with greater collective action intentions via increased anger toward injustice. In both studies social dominance orientation (SDO) acted as a moderator, but in opposite directions: mediation was significant for low-SDOs in Study 1, and for high-SDOs in Study 2. Results are discussed in relation to the importance of media vicarious contact via book reading for social change, and to the need to identify the contextual conditions allowing to anticipate the specific moderation pattern that is more likely to emerge

Notulae to the Italian alien vascular flora: 12

In this contribution, new data concerning the distribution of vascular flora alien to Italy are presented. It includes new records, confirmations, exclusions, and status changes for Italy or for Italian administrative regions. Nomenclatural and distribution updates published elsewhere are provided as Suppl. material 1

Disturbios endocrinos e metabolicos variados

Si descrive il caso clinico di un giovane paziente con sospetta Sindrome di Cushing da secrezione ectopica di ACT

Edible Flowers Used in Some Countries of the Mediterranean Basin: An Ethnobotanical Overview

Edible flowers are becoming an essential component of people’s nutrition in the Mediterranean basin. In the last decades, many researchers also have focused their attention on the nutritional composition of the edible flowers, as well as their antioxidant and antimicrobial properties, including studies on their safety issues. Despite the growing interest in the use of flowers in human nutrition, the ethnobotanical literature is lacking coverage of some important issues, particularly those which concern the use of flowers in the folk tradition. Only recently, a review regarding the contribution of 32 edible flowers to the Mediterranean diet was published. The aim of the present review is to document the plant lore regarding the wild and cultivated edible flowers consumed in the Mediterranean basin. Based on the 112 studies reviewed, we documented 251 taxa as being used in the Mediterranean basin as edible flowers. The plant species belong to 45 families and 141 genera. Asteraceae (54 taxa) is the most frequently cited family. Sambucus nigra L. is the most cited species. This study can be the basis for future research on the supposed bioactivity and toxicity of wild and cultivated flowers

The Role of Emotion Regulation as a Potential Mediator between Secondary Traumatic Stress, Burnout, and Compassion Satisfaction in Professionals Working in the Forced Migration Field

Background: Professionals working with refugees are vicariously exposed to complex traumatic experiences lived by forced migrants, which can lead to the risk of developing secondary traumatic stress, burnout, and a poor compassion satisfaction. The current study aimed to explore the effects of secondary traumatic stress on burnout and compassion satisfaction in 264 Italian professionals working with refugees and forced migrants. Moreover, it examined the mediating role of emotion regulation between secondary traumatic stress and both burnout and compassion satisfaction. Methods: A structural equation modeling (SEM) was performed to test the hypothesis. Results: The results showed that increased levels of secondary traumatic stress were associated with an increase of burnout both directly and indirectly through the mediation of emotion regulation. Emotion regulation also totally mediated the relationship between secondary traumatic stress and compassion satisfaction. Conclusions: The results suggested that prevention or interventions programs targeting emotion regulation might be important to improve the professional quality of life of operators working with refugees and forced migrants