17 research outputs found

    Combined oral contraceptives and gonadotropin releasing hormone agonistic analogs in polycystic ovary syndrome: Clinical and experimental studies

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    Polycystic ovary syndrome is a common endocrine disorder, presenting with menstrual irregularities, hirsutism, obesity, infertility and abnormal ovarian morphology. In addition, polycystic ovary syndrome is associated with a self-perpetuating imbalance involving the endocrine system and metabolic pathways, in which carbohydrates, lipids and growth factors are involved. Because of its chronicity, it is considered to be a substantial risk factor for atherogenesis and hormone-dependent neoplasia. The etiology and pathophysiology of the syndrome remain elusive. However, during the last decade, several clues have emerged from human and animal studies that may have significant repercussions in the treatment of polycystic ovary syndrome. Therapeutic maneuvers should be directed towards the dominant abnormalities present in individual patients with polycystic ovary syndrome. Gonadotropin releasing hormone (GnRH) agonists can directly affect the gonadotropin generator and secondary downstream derangements, whereas combined oral contraceptives (COCs) can modify hypothalamic as well as peripheral abnormalities. In view of the fact that GnRH agonistic analogs (GnRH-a) will induce hypoestrogenemia and its sequelae, the add-back strategy of estrogenic supplementation is recommended for preventive reasons and, as it transpires from some studies, for enhancement of GnRH-a effectiveness

    Hypoparathyroidism in a patient presenting with severe myopathy and skin rash. Case report and review of the literature.

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    A 47-year old man with idiopathic hypoparathyroidism (IHP), presented as severe myopathy and skin rash is described. The serum muscle enzymes were increased. After treatment with calcium and vitamin D, the clinical condition improved, the skin rash gradually disappeared, and the muscle enzymes decreased and remained within the normal range thereafter

    Gestione e pubblicazione di dati geografici con GFOSS software: l'esempio della Provincia di Imperia nell'ambito del progetto strategico Alcotra-RiskNat.

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    The effective use of information and communication technologies (ICT) is an evolutionary trend which many countries of the European Union (EU) are currently experiencing, including Italy. In this contribution, we deal with the options of applying GRASS GIS and other Geographic Free OpenSource Software (GFOSS) in the process of informatisation of public administration (PA). The activities have been carried out on the behalf of the EU Alcotra - RiskNat strategic cross-border project, under the guidance of the Imperia Province (Liguria, Italy). The main focus is the design and creation of a geographical database (DB) for managing spatial and non spatial information, using PostgreSQL/ PostGIS, GRASS and Quantum GIS (QGIS). A few geowebservices have been published according to the OGC Web Services (OWS) standards using the GeoServer platform. INSPIRE guidelines and specifications have been implemented for the related metadata files. The aim is to enable interoperability and reuse of geographical data and services which are also inserted as a layer in the RiskNat geoportal. A digital DVD ATLAS has been created for further navigation and interrogation of the various thematic layers of the cross-border basin of Roia river, using OpenLayers

    THE CONTRIBUTION OF GIS IN FLOOD MAPPING: TWO APPROACHES USING OPEN SOURCE GRASS GIS SOFTWARE

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    The first step of a risk assessment analysis is the evaluation of flood-prone areas. Its importance is considered for both managing and planning emergency activities, such as hydraulic risk reduction management, and also town planning. Nowadays, using GIS technology for risk assessment analysis is very common. However, it is not widely used for defining inundated areas. LiDAR data, such as Digital Elevation Models (DEM), makes GIS numerical models attractive methods for obtaining a flooded area automatically. Using GIS tools, is beneficial for effective processing and accuracy assessment in comparison to the traditional methods which are based on topographic maps and field surveys. A first approach (Federici and Sguerso, 2007; Marzocchi et al. 2009) is the use of a GIS module in order to create perifluvial flood maps, having as prerequisites (i) the conformation of the river floodplain by a high resolution DEM and (ii) a water surface profile along the river axis calculated for a given water discharge through a generic one-dimensional (1D) hydraulic model (HEC-RAS, Basement, MIKE 11, etc). On the other hand, a second approach is the use of a 2D model GIS embedded in order to create flooded areas due to a dam break (Cannata & Marzocchi, 2012). This module solves the conservative form of the 2D Shallow Water Equations (SWE) using a Finite Volume Method (FVM). The intercell flux is computed by a one-side upwind conservative scheme extended to a 2D problem (Ying et al., 2004). The new developed GIS module gives as an output maximum intensity maps which can be directly used during the risk assessment process. Both models implemented in GRASS GIS software (GRASS, 2013) and two new commands (r.inund.fluv and r.damflood) have been created. They are all available on the official GRASS website and they are distributed under the terms of the GNU General Public License (GPL). In this work we present a comparison between the two models mentioned above. We analyse the possibility of integrating these two approaches. We intend to use the 1D model, GIS embedded if possible, to calculate the water surface profile along the river axis and the 2D numerical one to analyse inundation beside the river levees

    Comparison of one-dimensional and two-dimensional GRASS GIS models for flood mapping.

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    The first step of a risk assessment analysis is the evaluation of flood-prone areas. Nowadays, using Geographic Information System (GIS) technology for risk assessment analysis is very common. However, it is not widely used for defining inundated areas. LiDAR data, such as digital elevation models (DEM), makes GIS numerical models attractive methods for obtaining a flooded area automatically. A first approach (Federici & Sguerso, 2007; Marzocchi, 2009) uses a GIS module in order to simulate perifluvial flood maps, having as prerequisites (i) the conformation of the river floodplain by a high-resolution DEM and (ii) a water surface profile along the river axis calculated for a given water discharge through a generic one-dimensional (1D) hydraulic model (HEC-RAS, Basement, MIKE 11, etc.). On the other hand, a second approach uses a GIS-embedded two-dimensional (2D) model in order to simulate flooded areas due to a dam break (Cannata&Marzocchi, Nat Hazards 61(3):1143\u20131159, 2012). This module solves the conservative form of the 2D shallow water equations (SWE) using a finite volume method (FVM). We present a comparison between the two models mentioned above, and we analyse the possibility of integrating these two approaches

    Antithyroid drug-induced aplastic anemia

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    Background: Antithyroid drugs have been used for more than 50 years for the management of hyperthyroidism. Most patients tolerate treatment well but some may develop life threatening side effects such as agranulocytosis and aplastic anemia (AA). We review all cases of antithyroid drug induced AA and describe, as illustrative cases, two women with Graves' disease who developed AA after 8 and 24 weeks of carbimazole (CBM) and methimazole (MMI) treatment respectively. Patient findings and summary: To date, at least 34 cases of aplastic anemia (AA) due to antithyroid drugs [(1 with CMZ, 31 with MMI, and 2 with propylthiouracil (PTU)] have been published, not including the two patients described here. In addition, at least another 14 patients in whom AA developed after treatment with antithyroid drugs (11 with CMZ, and 3 with MMI) have been reported in Yellow Card Scheme data analysis. Patients with AA usually exhibit sudden onset of symptoms after a relative short time of exposure to the drugs, and all have concomitant agranulocytosis. Most have a rapid recovery following discontinuation of the drug and supportive treatment. Although only two antithyroid drug induced AA deaths have been published, the mortality rate was higher in the Yellow Card Scheme data analysis. Conclusions: Aplastic anemia associated with antithyroid drug treatment is rarer than antithyroid drug associated agranulocytosis. The prognosis of patients with antithyroid drug induced AA is good overall, but may not be as favorable as that of antithyroid drug induced isolated agranulocytosis. © Copyright 2008, Mary Ann Liebert, Inc

    Are patients with autoimmune thyroid disease and autoimmune gastritis at risk of gastric neuroendocrine neoplasms type 1?

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    Objective The aim of this study was to investigate the prevalence of autoimmune gastritis, enterochromaffin-like cell (ECL-cell) hyperplasia and gastric neuroendocrine neoplasms type 1 (GNEN1) in patients with autoimmune thyroid disease. Design Prospective observational study in a single institutional study. Patients and Measurements One hundred and twenty patients with autoimmune thyroid disease were consecutively recruited from the Endocrine Unit. Upper gastrointestinal tract endoscopy (UGE) and biochemical parameters for autoimmune thyroid disease and autoimmune gastritis were assessed at recruitment and annually thereafter in patients with a mean follow-up of 37.5 ± 14.4 months. Autoimmune gastritis was defined by the presence of antiparietal cell antibodies (APCA) and histological confirmation after UGE. Serum gastrin and chromogranin I were also measured. Results One hundred and eleven patients had Hashimoto's thyroiditis and nine Graves' disease. Autoimmune gastritis was identified in 40 (38 with Hashimoto's thyroiditis and two with Graves' disease) patients all of whom had increased levels of gastrin and chromogranin I; Helicobacter pylori infection was histologically identified in 15 of 40 (37.5%) patients. Six patients had isolated nodular ECL-cell hyperplasia and one mixed nodular and linear ECL-cell hyperplasia [7 of 40 (17.5%)]. Only increased gastrin (P = 0.03) levels predicted the presence ECL-cell hyperplasia. A GNEN1 developed in one patient with nodular ECL-cell hyperplasia after 39 months of follow-up. Conclusions Concomitant autoimmune gastritis was found in 33.3% of patients with autoimmune thyroid disease, 17.5% of whom had ECL-cell hyperplasia that evolved to GNEN1 in one (2.5%). Larger studies with longer follow-up are needed to define the incidence of GNEN1 in patients with autoimmune thyroid disease and ECL-cell hyperplasia and potential implications. © 2013 John Wiley & Sons Ltd

    Maltoma of the thyroid and Sjögren's syndrome in a woman with Hashimoto's thyroiditis

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    We report the case of a 70-yr-old woman with maltoma of the thyroid, Sjögren's syndrome, and a history of Hashimoto's thyroiditis. The patient underwent a total thyroidectomy for a recently growing mass of the thyroid, while being treated with L-thyroxine for Hashimoto's thyroiditis. Postoperatively, routine histologic examination was consistent with the diagnosis of chronic lymphocytic thyroiditis of autoimmune etiology. Three years later, the patient presented with high temperature, anorexia, and coughing. This time, a microscopic examination of deeper thyroid tissue sections and an immunohistochemical study revealed a low-grade, non-Hodgkin lymphoma, MALT type. Simultaneously, the diagnosis of Sjögren's syndrome was established and the patient is currently under investigation for generalized lymphoma. This case clearly demonstrates the difficulty in differentially diagnosing Hashimoto's thyroiditis from low-grade MALT lymphoma by the use of routine histologic examination. © Copyright 2006 by Humana Press Inc. All rights of any nature whatsoever reserved

    Corticomedullary mixed adrenal tumor: Case report and literature review

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    We report a 66-year-old woman with a mixed corticomedullary tumor of the left adrenal gland. The patient was found to harbor an adrenal incidentaloma while investigated for a spigelian hernia. Due to the atypical radiological features and the relatively large size of the adrenal lesion she underwent a left adrenalectomy following endocrine testing to exclude a functional lesion. Subclinical Cushing's syndrome was suggested by the failure to obtain adequate cortisol suppression (less than 1.8 μg/dL) following dexamethasone administration pre-operatively; cortisol suppression was restored postoperatively following the excision of the tumor. Histology was consistent with a corticomedullary mixed adenoma, a lesion for which, there is paucity of published data regarding its natural history and long term outcome. The finding of this case highlights the importance of this extremely rare entity which should be included in the long list of causes of adrenal incidentaloma since cases with intra-operative complications have been described. The previously reported reappearance of this tumor in the contralateral adrenal gland emphasizes the need for prolonged follow-up
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