Publications by authors named "Laura Fugazzola"

Article Synopsis
  • The study examines the effectiveness of rapid TSH screening in detecting thyroid diseases in patients in the Emergency Department (ED), noting a 7% prevalence of previously undiagnosed thyroid dysfunctions.
  • The diagnostic process was enhanced by using a mobile ultrasound device, rPOCUS, to evaluate patients with suppressed rTSH in urgent care situations requiring iodinated contrast.
  • Results indicate that rPOCUS is both cost- and time-effective, aiding in the management of hyperthyroidism, reducing unnecessary rTSH tests, and identifying incidental findings that necessitate further evaluation.
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  • Fine-needle-aspiration-cytology (FNAC) is a safe and cost-effective method for assessing thyroid nodules, but indeterminate cytology (ITN) sometimes requires further diagnostic surgery.
  • Recent studies from Europe and the U.S. suggest that thyroid cancer (TC) behaves differently based on pre-surgical FNAC results, with ITN cases showing less aggressive characteristics compared to more suspicious diagnoses.
  • A commentary involving thyroid experts highlights the consistent finding that TC with ITN diagnosis has lower rates of complications and mutations, indicating a need to consider less aggressive treatment options for these patients.
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  • Thyroid cancer (TC) is the most common type of endocrine cancer, with undifferentiated forms (UTCs) being particularly lethal due to therapy resistance linked to tumor-initiating cells (TICs).
  • This study investigates the protein Epithelial Cell Adhesion Molecule (EpCAM) as a potential marker for TICs in thyroid cancer, utilizing techniques like Western Blot and immunofluorescence on patient samples and various cell cultures.
  • Findings reveal that EpCAM expression varies, and its cleavage in advanced forms of TC is significant, indicating its role in drug resistance and the development of 3D tumor models, which reflect patient samples accurately.
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The E3 SUMO ligase PIAS2 is expressed at high levels in differentiated papillary thyroid carcinomas but at low levels in anaplastic thyroid carcinomas (ATC), an undifferentiated cancer with high mortality. We show here that depletion of the PIAS2 beta isoform with a transcribed double-stranded RNA-directed RNA interference (PIAS2b-dsRNAi) specifically inhibits growth of ATC cell lines and patient primary cultures in vitro and of orthotopic patient-derived xenografts (oPDX) in vivo. Critically, PIAS2b-dsRNAi does not affect growth of normal or non-anaplastic thyroid tumor cultures (differentiated carcinoma, benign lesions) or cell lines.

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The reactivation of TERT is associated with poor outcome in papillary thyroid cancer (PTC). Extra-telomeric functions of TERT were reported, with a protective role against oxidative stress (OS). The aim of the present study was to explore the extra-nuclear TERT localization in PTC and its role in cancer progression.

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Objective: The aim was to evaluate the possible association between some endocrine disruptive chemicals and thyroid cancer (TC) in an Italian case-control cohort.

Methods: We enrolled 112 TC patients and 112 sex- and age-matched controls without known thyroid diseases. Per- and poly-fluoroalkyl substances (PFAS), poly-chlorinated biphenyls (PCBs), and dichlorodiphenyltrichloroethane (4,4'-DDT and 4,4'-DDE) were measured in the serum by liquid or gas chromatography-mass spectrometry.

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Background: Radiofrequency ablation (RFA) is effective in the treatment of thyroid nodules, leading to a 50-90% reduction with respect to baseline. Current guidelines indicate the need for a benign cytology prior to RFA, though, on the other side, this procedure is also successfully used for the treatment of papillary microcarcinomas. No specific indications are available for nodules with an indeterminate cytology (Bethesda III/IV).

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Background: Fatigue is a frequent adverse event during systemic treatments for advanced thyroid cancer, often leading to reduction, interruption, or discontinuation. We were the first group to demonstrate a correlation between fatigue and primary adrenal insufficiency (PAI).

Aim: The objective was to assess the entire adrenal function in patients on systemic treatments.

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  • * Evidence shows that oncocytic thyroid carcinoma has distinct genetic changes compared to other thyroid cancers, displaying higher rates of somatic gene variants and unique mitochondrial DNA variations.
  • * The cancer presents a greater likelihood of lymph node metastases and distant metastases than follicular and papillary thyroid carcinomas, and it has a lower tendency to absorb radioiodine for treatment.
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Thermal ablation (TA) is an established therapeutic option alternative to surgery in patients with solid benign thyroid nodules causing local symptoms. However, a variable part of thyroid nodules remain viable after these nonsurgical treatments, and as many as 15% of nodules treated with TA may require a second treatment over time. This study aimed to evaluate the outcomes of TA re-treatment on symptomatic benign thyroid nodules where the volume decreased by <50% after the first procedure ( = technique inefficacy).

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Although thyroid cancer (TC) is generally associated with a favourable prognosis, there are certain high-risk groups with a clear unmet therapeutic need. Unravelling the genomic landscape of TC has recently led to the development of novel effective targeted treatments. To date, these treatments have mostly been evaluated in non-randomised single-arm phase II clinical trials and are consequently non-reimbursed in several countries.

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There is some controversy on the potential relationship between autoimmune processes and clinicopathologic features as well as prognosis of differentiated thyroid cancer (DTC), and the evidence is limited by its largely retrospective nature. We examined the relationship between the presence of autoimmune thyroiditis (AT) and 1-year thyroid cancer treatment outcomes in a large multicenter study using prospectively collected data. We included data from consecutive DTC patients enrolled in the Italian Thyroid Cancer Observatory (ITCO) database (NCT04031339).

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  • - *Hypertension (HTN) is a common side effect of lenvatinib (LEN) treatment, affecting 76% of patients, with many developing it for the first time during therapy.* - *The severity of HTN varied among patients, with 50% experiencing grade 2 and 45% grade 3 hypertension, often accompanied by proteinuria but not linked to other adverse effects except diarrhea.* - *A management strategy involving calcium channel blockers and additional antihypertensive medications was implemented for most patients to effectively control HTN and potentially improve adherence to LEN treatment.*
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Purpose: The clinical outcome of COVID-19 disease is worse in males, and the reasons of this gender disparity are currently unclear, though evidences point to a combination of biological and gender-specific factors. A phenomenon unique to the female gender is the fetal cell microchimerism (FCM), defined as the presence of fetal microchimeric cells in maternal organs and in the circulation for years after delivery and usually evaluated by assessing the presence of male cells or DNA in a woman. In the present case-control study, we aimed to evaluate the possible effect of pregnancy and related FCM on the susceptibility to SARS-CoV-2 infection and on the clinical course and outcome of COVID-19.

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  • Recent research highlights the importance of improving risk stratification for patients with differentiated thyroid cancer (DTC) beyond the existing 2015 American Thyroid Association (ATA) guidelines.
  • A study utilizing the Italian Thyroid Cancer Observatory database analyzed 4,773 DTC cases to develop a decision tree model that predicts persistent/recurrent disease by considering a range of predictive factors.
  • The new model demonstrated better performance than the ATA guidelines by increasing sensitivity and predictive accuracy, suggesting that incorporating additional variables like age and tumor size can enhance patient risk assessment.
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Introduction: Certain trace elements are essential for life and affect immune system function, and their intake varies by region and population. Alterations in serum Se, Zn and Cu have been associated with COVID-19 mortality risk. We tested the hypothesis that a disease-specific decline occurs and correlates with mortality risk in different countries in Europe.

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Oxidative stress (OS) can have an impact in the pathogenesis and in the progression of thyroid cancer. We investigated the levels of reactive oxygen species (ROS) in 50 malignant and benign thyroid lesions and 41 normal tissues, and correlated them with the thyroid differentiation score-TDS and the clinico-pathologic features. NOX4 expression, GPx activity and the genetic pattern of tumors were evaluated.

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Scanty data are available on the progression risk in patients with persistent thyroid cancer (TC) before pregnancy. We aimed to evaluate this topic in our series and to review available literature data. This was a retrospective study performed in a tertiary care Italian TC center.

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Several toxicities are recorded during treatment of advanced thyroid cancer (TC) with antiangiogenic drugs, including lenvatinib (LEN). Hypocalcemia was reported in registration studies, but little data are available from real-life cohorts. The aim of our study was to describe the incidence, characteristics, and the management of hypocalcemia in patients on LEN treatment.

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Thyroid cancer (TC) is the most common malignancy of the endocrine system that affects the thyroid gland. It is usually treatable and, in most cases, curable. The central issues are how to improve knowledge on TC, to accurately identify cases at an early stage that can benefit from effective intervention, optimise therapy, and reduce the risk of overdiagnosis and unnecessary treatment.

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To date, the molecular mechanisms that underline aggressiveness and resistance to tyrosine kinase inhibitors in some thyroid carcinomas (TCs) are not known yet. We report the case of a young patient with a metastatic poorly differentiated (PDTC) and follicular thyroid carcinoma (FTC) refractory to conventional therapies and to Sorafenib. The patient, despite an initial partial response, died of progressive disease 21 months after diagnosis.

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Background: Thyroid dysfunctions are highly prevalent and can worsen underlying cardiopathies, but despite that the routine screening of thyroid function in the Emergency Department (ED) setting is not generally recommended.

Objective: To understand if staff training and implementation of rapid TSH screening (rTSH) could improve the management of patients arrived in the ED. Specifically, we aimed at evaluating the prevalence of undiagnosed thyroid diseases among ED patients; the effects of educational meetings in the clinical decision-making process; the usefulness of rTSH, in terms of variation of either the clinical work out or the existing treatment.

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