Erectile dysfunction is common among men with acromegaly and is associated with morbidities related to the disease

Background: The prevalence of erectile dysfunction (ED) and its correlates in men with acromegaly has never been investigated. Aim: To evaluate sexual function in men with acromegaly. Methods: Multicenter-based, retrospective analysis of a non-selected series of 57 acromegalic subjects (mean age: 52.7 14.2 years) was performed. Acromegalic subjects reporting ED (n = 24) were compared with matched ED- patients without acromegaly or pituitary disease (con- trols), selected from a cohort of more than 4000 subjects enrolled in the Flrence Sexual Medicine and Andrology Unit. Patients were interviewed using SIEDY structured interview, a 13-item tool for the assessment of ED-related morbidities. Several clinical and biochemical parameters were taken. Penile colour-Doppler ultrasound (PCDU) was performed in a subgroup of 37 acromegalic subjects. Results: ED was reported by 42.1% of acromegalic sub- jects. After adjusting for age and testosterone, acromegalic subjects with ED had a higher prevalence of hypertension, and more often reported an impairment of sleep-related erections and a longer smoking habit. Accordingly, acro- megaly-associated ED was characterized by a higher organic component and worse PCDU parameters. No rela- tionship between ED and testosterone levels or other acro- megaly-related parameters was found. However, acromegalic subjects with severe ED reported a longer dis- ease duration. In a case-control analysis, comparing acromegalic subjects with ED-matched-controls free from acromegaly (1:5 ratio), acromegalic men had a worse ED problem and a higher organic component of ED, as derived from SIEDY score. In line with these data, acrome- galic patients with ED had a higher prevalence of major adverse cardiovascular events (MACE) history at enrol- ment and lower PCDU parameters. Conclusions: Subjects with complicated acromegaly are at an increased risk of developing ED, especially those with cardiovascular morbidities. Our data suggest including a sexual function evaluation in routine acromegaly follow- up

Activation of Estrogen Receptor Is Crucial for Resveratrol-Stimulating Muscular Glucose Uptake via Both Insulin-Dependent and -Independent Pathways

OBJECTIVE—Estradiol (E2) is known to modulate insulin sensitivity and, consequently, glucose homeostasis. Resveratrol (RSV), an agonist of estrogen receptor (ER), has exerted antihyperglycemic effects in streptozotocin-induced type 1 diabetic rats in our previous study and was also shown to improve insulin resistance in other reports. However, it remains unknown whether activation of ER is involved in the metabolic effects of RSV via insulin-dependent and -independent mechanisms

Four domains for concurrency

AbstractWe give four domains for concurrency in a uniform way by means of domain equations. The domains are intended for modelling the four possible combinations of linear time versus branching time, and of interleaving versus noninterleaving concurrency. We use the linear time, noninterleaved domain to give operational and denotational semantics for a simple concurrent language with recursion, and prove that O = D

Acromegaly is associated with increased cancer risk: A survey in Italy

It is debated if acromegalic patients have an increased risk to develop malignancies. The aim of the present study was to assess the standardized incidence ratios (SIRs) of different types of cancer in acromegaly on a large series of acromegalic patients managed in the somatostatin analogs era. It was evaluated the incidence of cancer in an Italian nationwide multicenter cohort study of 1512 acromegalic patients, 624 men and 888 women, mean age at diagnosis 45 \uc2\ub1 13 years, followed up for a mean of 10 years (12573 person-years) in respect to the general Italian population. Cancer was diagnosed in 124 patients, 72 women and 52 men. The SIRs for all cancers was significantly increased compared to the general Italian population (expected: 88, SIR 1.41; 95% CI, 1.18-1.68, P < 0.001). In the whole series, we found a significantly increased incidence of colorectal cancer (SIR 1.67; 95% CI, 1.07-2.58, P = 0.022), kidney cancer (SIR 2.87; 95% CI, 1.55-5.34, P < 0.001) and thyroid cancer (SIR 3.99; 95% CI, 2.32-6.87, P < 0.001). The exclusion of 11 cancers occurring before diagnosis of acromegaly (all in women) did not change remarkably the study outcome. In multivariate analysis, the factors significantly associated with an increased risk of malignancy were age and family history of cancer, with a non-significant trend for the estimated duration of acromegaly before diagnosis. In conclusion, we found evidence that acromegaly in Italy is associated with a moderate increase in cancer risk

Adenomas of the pituitary gland: Diagnostic challenges, pitfalls and controversies

Pituitary adenomas account for about 10% of intracranial tumours and 90% of intrasellar lesions. They are classified according to histopathological and ultrastructural features and hormone immunoexpression but a comprehensive diagnosis requires a full knowledge of clinical and neuroimaging features. If the common histotypes can be easily identified at light microscopy, the diagnosis of rare variants can be challenging and may require ultrastructural examination or the use of more sophisticated immunostains. Similarly challenging and source of diagnostic pitfalls can be the changes that may occur during surgery or following medical treatment. Finally, controversies still surround the concept of atypical adenoma and pituitary carcinoma making a histopathological diagnosis of aggressive adenoma very difficult. This review will provide the essential diagnostic criteria to recognise rare adenoma variants and will address the questions of a diagnosis of adenoma with aggressive behaviour. © 2011 Elsevier Ltd

Adenomas of the pituitary gland: Diagnostic challenges, pitfalls and controversies

Pituitary adenomas account for about 10% of intracranial tumours and 90% of intrasellar lesions. They are classified according to histopathological and ultrastructural features and hormone immunoexpression but a comprehensive diagnosis requires a full knowledge of clinical and neuroimaging features. If the common histotypes can be easily identified at light microscopy, the diagnosis of rare variants can be challenging and may require ultrastructural examination or the use of more sophisticated immunostains. Similarly challenging and source of diagnostic pitfalls can be the changes that may occur during surgery or following medical treatment. Finally, controversies still surround the concept of atypical adenoma and pituitary carcinoma making a histopathological diagnosis of aggressive adenoma very difficult. This review will provide the essential diagnostic criteria to recognise rare adenoma variants and will address the questions of a diagnosis of adenoma with aggressive behaviour. © 2011 Elsevier Ltd