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

A home-based prism adaptation training for neglect patients

Spatial neglect is a debilitating disorder frequently observed after damage to the right cerebral hemisphere. Previous investigations have revealed that prism adaptation (PA) therapy can lead to improvements in neglect-related symptoms. In the typical PA protocol patients repeatedly point toward a visual target while wearing prism goggles. A few years ago, a novel PA procedure, involving a variety of more "ecological" visuo-motor activities during adaptation, less repetitive than a sequence of pointings, was introduced by our research group, and shown to be able to improve neglect-related symptoms to the same extent as the standard pointing task. The ecological procedure was easy to administer and pleasant for the patients. In all previous studies, patients were treated by specialized personnel during hospitalization. In the current study, we investigated the effectiveness of the ecological PA method when performed in a home-based setting, with the help of caregivers and family members. Seven right-brain-damaged patients with chronic left spatial neglect underwent a two-week ecological PA treatment, extended, for two extra weeks, in 6 patients, who were available for this additional rehabilitation session. As a control treatment, patients performed the same activities while wearing neutral goggles, before the PA procedure. Two weeks of ecological PA training proved to be able to significantly improve performance in neuropsychological tests (BIT, Cancellation tasks), a neurological scale (NIH), and functional abilities (CBS), when compared to both the baseline and the neutral control treatment, with improvements being maintained over 6 months. The ecological home-based PA training is effective in alleviating signs of spatial neglect. Importantly, this training is affordable, pleasant, and feasible to be performed in the comfort of the patient's home. Easily extendable to larger patient populations and prolonged periods, this method has a real potential to benefit the quality of life of brain-damaged patients with left spatial neglect

The Footprints of the Wreckage of the Italian Royal Navy Battleship Leonardo Da Vinci on the Mar Piccolo Sea-Bottom (Taranto, Southern Italy)

Over the last two decades, the scientific interest for marine geophysical surveys has shown a huge increase, mostly for multidisciplinary applicability on dierent studies, fromhistorical heritage to environmental remediation. One of the main research fields carried out through marine geophysical surveys is the study of the wreckage footprints connected to the seabed perturbation. In 2018, a strategic project planned by the Italian National Government Commissioner for the remediation in the Taranto area (Southern Italy) stands as a basic sample for such issues. The project aimed at the detection of anthropogenic impact in the highly polluted Mar Piccolo and Mar Grande basins seabed, through a multidisciplinary approach involving geological, biological, chemical, engineering, and ecological studies. The main purpose of the work was to identify any potential pollution source, focusing on anthropogenic sea-floor features such as uncontrolled dumping, wrecks, or other objects of peculiar origin. To achieve the purpose of the work, field surveys were planned and performed in order to direct a general policy and accurate planning for environmental remediation activities. Dierent marine geophysics methods were used to characterize the main sea-floor features and to detect each anthropogenic feature. A comparative analysis of a high-resolution dataset allowed to clarify the origin of some deep depressions on the Mar Piccolo sea-bottom, which at the first instance were associated with a natural origin, as the results of the Leonardo Da Vinci wreckage and related recovering activities. High-resolution morphobathymetric, magnetometric, and seismic data revealed the story of the Italian Royal Navy battleship which sunk on 2 August 1916 as a slight footprint on the Mar Piccolo seabed but a deep historical heritage of the city of Taranto. Moreover, final results demonstrate high-resolution marine survey methodologies’ complete applicability to environmental, historical, and scientific issues

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\u2009\ub1\u200913 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\u2009<\u20090.001). In the whole series, we found a significantly increased incidence of colorectal cancer (SIR 1.67; 95% CI, 1.07-2.58, P\u2009=\u20090.022), kidney cancer (SIR 2.87; 95% CI, 1.55-5.34, P\u2009<\u20090.001) and thyroid cancer (SIR 3.99; 95% CI, 2.32-6.87, P\u2009<\u20090.001). 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

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 ± 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

Predictors of morbidity and mortality in acromegaly, an Italian survey.

OBJECTIVE: To describe demographic and hormonal characteristics, co-morbidities (diabetes mellitus and hypertension), therapeutic procedures and their effectiveness, as well as predictors of morbidity and mortality in a nation-wide survey of Italian acromegalic patients. DESIGN: Retrospective multicentre epidemiological study endorsed by the Italian Society of Endocrinology and performed in 24 tertiary referral Italian centers . The mean follow-up time was 120 months. RESULTS: A total of 1512 patients, 41% M, mean age: 45\ub113 years, mean GH: 31\ub137 mcg/L, IGF-I: 744\ub1318 ng/ml, were included. Diabetes mellitus was reported in 16% of cases, hypertension in 33%. Older age and higher IGF-I levels at diagnosis were significant predictors of diabetes and hypertension. At the last follow-up, 65% of patients had a controlled disease, of whom 55% were off medical therapy. Observed deaths were 61, with a standardized mortality ratio (SMR) of 1.13 (IC95%: 0.87-1.46). Mortality was significantly higher in the patients with persistently active disease (1.93; IC95%: 1.34-2.70). Main causes of death were vascular diseases and malignancies with similar prevalence. A multivariate analysis showed that older age, higher GH at last follow-up, higher IGF-I levels at diagnosis, malignancy and radiotherapy were independent predictors of mortality.Conclusions. Pre-treatment IGF-I levels are important predictors of morbidity and mortality in acromegaly. The full hormonal control of the disease, nowadays reached in the majority of patients with modern management, reduces greatly the disease-related mortality