1,721,120 research outputs found
Testosterone therapy and cardiovascular diseases
No full textSince it was first synthesized in 1935, testosterone (T) has been viewed as the mythical Fountain of Youth, promising rejuvenation, restoring sexual appetites, growing stronger muscles, and quicker thinking. T is endowed with direct effects on myocardial and vascular structure and function, as well as on risk factors for cardiovascular (CV) disease. Indeed, low serum T levels are a risk factor for diabetes, metabolic syndrome, inflammation, and dyslipidaemia. Moreover, many studies have shown that T deficiency per se is an independent risk factor of CV and all-cause mortality. On this background and due to direct-to-patient marketing by drug companies, we have witnessed to the widespread use of T replacement therapy without clear indications particularly in late-life onset hypogonadism. The current review will dwell upon current evidence and controversies surrounding the role of T in the pathophysiology of CV diseases, the link between circulating T levels and CV risk, and the use of replacing T as a possible adjuvant treatment in specific CV disorders. Specifically, recent findings suggest that heart failure and type 2 diabetes mellitus represent two potential targets of T therapy once that a state of hypogonadism is diagnosed. However, only if ongoing studies solve the CV safety issue the T orchid may eventually 'bloom'. p.com/cardiovascres/advance-article/doi/10.10
The Italian Endo-COVID-19. Our response to the emergency
No full textThe Sars-COV-2 virus, a mutated coronavirus spreading from China in the last months of 2019, has a marked respiratory tropism, but in some subjects can causes an aberrant inflammatory response leading to a systemic disease for the simultaneous involvement of the lung, cardiovascular, coagulative, gastrointestinal and nervous system. Therefore an internist management is advised and many Endocrinologists and Endocrinology trainees have been called to help in those NHS hospitals facing the epidemic crisis. In summary, this survey demonstrates the ability and readiness of endocrinology—in all its subspecialties diabetes, metabolism and andrology—to support our NHS bringing competence, dedication and sense of responsibility. Our response to COVID-19 is not only the best handling of endocrine patients [1–5] but also a large scale human resources mobilization that should be a source of pride for all Endocrinology Programs, Directors, Coordinators and all physicians and trainees who dedicate their lives to science and healthcare of our country
Priming metabolism with the type 5 phosphodiesterase: the role of cGMP-hydrolyzing enzymes
No full textThe cyclic guanosine monophosphate (cGMP) signaling system is one of the most prominent regulators of many physiopathological processes in humans and rodents. It has been strongly established as an accomplished cellular signal involved in the regulation of energy homeostasis and cell metabolism, and pharmacological enhancement of cGMP has shown beneficial effects in metabolic disorders models. cGMP intracellular levels are finely regulated by phosphodiesterases (PDEs). The main enzyme responsible for the degradation of cGMP is PDE5. Preclinical and clinical studies have shown that PDE5 inhibitors (PDE5i) have beneficial effects on improving insulin resistance and glucose metabolism representing a promising therapeutic strategy for the treatment of metabolic disorders. This review aims to describe the molecular basis underlying the use of PDE5i to prompt cell metabolism and summarize current clinical trials assessing the effects of PDE5i on glucose metabolism
Diagnostic and Therapeutic Workup of Erectile Dysfunction: Results From a Delphi Consensus of Andrology Experts
No full textIntroduction: Erectile dysfunction is a highly prevalent condition. Existing guidelines provide recommendations for diagnosis and treatment, but they are often disregarded in clinical practice in favor of a “patient-tailored” approach. Objectives: We planned a Delphi consensus method to bridge the gap between evidence-based medicine and the real-life approach in daily practice. Materials and Methods: The Advisory Board prepared 15 statements on debated topics in andrology, each including 4–6 items designed as a 5-point Likert scale. After a validation phase, the questionnaire was sent by e-mail to a panel of experts for a first round of voting; members of the panel were later invited to a second round of voting, preceded by discussion of the “hot topics” identified in the first round. Results: The first round of the Delphi consensus involved 101 experts; 71 (70%) also took part in the second round of voting. The Advisory Board deemed 22 items to be worthy of debate, and these underwent the second round of voting. “Real-life” results from the survey proved quite different from evidence-based recommendations. Conclusion: Although guidelines suggest the best approach for a “standard” patient, real-life settings require flexibility. Diagnostic and therapeutic approaches should be tailored to the patients’ needs. Phosphodiesterase type 5 inhibitors are recognized as the first-line therapy in both settings, including the newly introduced sildenafil orodispersible film. Indications from the panel might help close the gap between recommendations from guidelines and real-life practice in relation to the diagnosis and treatment of erectile dysfunction. Isidori AM, Giammusso B, Corona G, et al. Diagnostic and Therapeutic Workup of Erectile Dysfunction: Results From a Delphi Consensus of Andrology Experts. Sex Med 2019;7:292–302
Imaging andrology of the future: Where functional imaging embraces the clinic
No full textIn the past decade, andrological imaging has gained momentum, revealing an unprecedented role in the diagnostic workup of gonadal and genitourinary tract disorders. Clinical examination often yields nonspecific signs and symptoms which need to be confirmed. Laboratory testing is often inconclusive and biased by many confounding factors. The widespread use of conventional and advanced imaging has helped match clinical and laboratory data with the morphological assessment of the male reproductive tract
Erectile dysfunction and cardiovascular risk: a review of current findings
No full textIntroduction: A large body of evidence has clearly documented that erectile dysfunction (ED) represents not only a complication of cardiovascular (CV) diseases (CVD) but often an early sign of forthcoming CVD. Areas covered: All the available data from meta-analyses evaluating the association between ED and CV risk were collected and discussed. Similarly, all available meta-analyses investigating the significance of ED as a possible early marker for major adverse cardiovascular events (MACE) were analyzed. In addition, data originally obtained in a Florence cohort, dealing with a large series of patients seeking medical care for sexual dysfunction, will be also reported. Expert opinion: Available evidence indicates that ED represents a risk factor of CV mortality and morbidity. Not only conventional CV risk factors but also unconventional ones, derived from a perturbation of the relational and intrapsychic domains of ED, might play a possible role in CV risk stratification of ED subjects. Finally, penile doppler ultrasound can give important information on CV risk, especially in younger and low risk subjects. The presence of ED should become an opportunity–for the patient and for the physician–to screen for the presence of comorbidities improving not only sexual health but, more importantly, men’s overall health. © 2020, © 2020 Informa UK Limited, trading as Taylor & Francis Group
Diagnosis and Management of Testicular Tumours in Children and Adolescents
No full textTesticular tumours can occur at any age but are most common in adolescents and young men. The tumours are histologically heterogeneous and can be derived from several cell types. Germ cells are by far the most common cell of origin, followed by Leydig cells and other somatic cells. Testicular tumours in children and adolescents/young adults differ from each other in many aspects, including pathogenesis and biological features, in particular the association with germ cell neoplasia in situ and isochromosome 12p of only post-pubertal TGCT. Hence the management options must be based on careful imaging, histopathological analysis, tissue and serum markers, and age-specific staging. Treatment outcomes are usually very good in any age: Testicular location contributes to an early diagnosis in many patients, and surgery alone is successful in the vast majority of patients. The extent of surgery depends on the tumour type; in malignant germ cell tumours radical orchiectomy is usually practiced, while testis-sparing surgery should be considered in boys with teratomas and in all patients with benign somatic tumours. Chemotherapy is used mainly in malignant tumours and in the disseminated disease. Young age of the survivors of testicular cancer requires close attention to the late effects of disease and treatment, hence different specialists (urologists, oncologists, paediatricians, endocrinologists, andrologists) ought to be included in the management team
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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