Publications by authors named "Luca Tomisti"
The use of antivirals, corticosteroids, and IL-6 inhibitors has been recommended by the WHO to treat COVID-19. CP has also been considered for severe and critical cases. Clinical trials on CP have shown contradictory results, but an increasing number of patients, including immunocompromised ones, have shown benefits from this treatment.
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- A study was conducted to evaluate the effectiveness of total thyroidectomy versus medical therapy in patients with amiodarone-induced thyrotoxicosis (AIT), focusing on survival and heart function over 20 years.
- The results indicated that patients who underwent total thyroidectomy had lower overall and cardiac-specific mortality rates compared to those receiving medical therapy, particularly among those with severe heart dysfunction.
- The research suggests that total thyroidectomy may be the better option for AIT patients with significant heart issues, while its benefits are less clear for individuals with mild heart conditions.
Amiodarone-induced thyroid dysfunction occurs in about 15-20% of patients under amiodarone therapy. Amiodarone-induced hypothyroidism (AIH) can develop in patients with an apparently normal thyroid gland or in those with an underlying chronic autoimmune thyroiditis. On a clinical ground, AIH is not challenging and can be easily treated with L-thyroxine therapy.
View Article and Find Full Text PDFObjective: The primary objective of this study is to identify the predictors of comorbidities and major adverse cardiovascular events (MACE) that can develop after diagnosis of acromegaly. The role of therapy for acromegaly in the event of such complications was also evaluated.
Design And Methods: Retrospective cohort study was conducted on 200 consecutive acromegalic patients in a tertiary referral center.
Article Synopsis
- The study investigates how polychlorinated biphenyls (PCBs) affect apoptosis in normal pituitary cells, focusing on specific PCB types and their mechanisms of action.
- It finds that Aroclor 1254 promotes pituitary cell apoptosis primarily through the extrinsic pathway, while the effects of non-dioxin-like PCBs (PCB 180 and PCB 153) vary in their influence on apoptosis and cell proliferation.
- The research concludes that non-dioxin-like PCBs can either induce or inhibit apoptosis in pituitary cells and that these effects are influenced by the type of PCB and their interaction with specific receptors.
Objective: Considering the different pathogenic mechanisms of the two main forms of amiodarone-induced thyrotoxicosis (AIT), we ascertained whether this results in a different onset time as well.
Design And Methods: We retrospectively analyzed the clinical records of 200 consecutive AIT patients (157 men and 43 women; mean age 62.2±12.
Background: Minimally invasive video-assisted thyroidectomy (MIVAT) proved to be safe and effective in the treatment of both benign and malignant disease. The aim of the present study is to compare MIVAT approach with conventional approach for total thyroidectomy in a group of 99 pediatric patients operated in the Department of General Surgery of the University of Pisa between March 2007 and July 2012.
Patients: A total of 99 pediatric patients under the age of 18 years with thyroid disease referred to our Department to undergo total thyroidectomy.
Objective: To review the literature regarding the interaction among amiodarone therapy, thyroid hormone levels, and warfarin metabolism.
Methods: A 73-year-old male with type 2 after describing an unusual case of amiodarone-induced thyrotoxicosis (AIT) who experienced a severe rise in international normalized ratio (INR) values after initiating warfarin therapy due to an unusual combination of excessive thyroid hormones, amiodarone therapy, and a genetic abnormality affecting warfarin metabolism.
Results: Genetic analysis revealed that the patient was CYP2C9*2 wild-type, CYP2C9*3/*3 homozygous mutant, and VKORC1*3/*3 homozygous mutant.
Context: Patients with amiodarone-induced thyrotoxicosis (AIT) and left ventricular (LV) systolic dysfunction have a high mortality rate. Usually, medical therapy is the first choice for AIT patients, whereas the role of the thyroidectomy is unsettled.
Objective: The objective of the study was to evaluate the effect of a total thyroidectomy on cardiac function and survival of AIT patients with severe LV systolic dysfunction.
Context: Type 2 amiodarone-induced thyrotoxicosis (AIT) is a destructive thyroiditis usually responsive to glucocorticoids. Whether continuation of amiodarone affects treatment outcome is unsettled.
Objective: The objective of the study was to compare the outcome of glucocorticoid treatment in type 2 AIT patients who continued or withdrew amiodarone.
Context: Type 2 amiodarone-induced thyrotoxicosis (AIT) is a destructive thyroiditis usually responsive to glucocorticoids; however, recent surveys showed that many expert thyroidologists worldwide use thionamides for type 2 AIT patients.
Objective: The objective of the study was to compare the effectiveness of methimazole (MMI) or prednisone (GLU) in type 2 AIT patients who had a short cure time according to a published predictive model.
Design: This was a matched retrospective cohort study.
Context: Two main forms of amiodarone-induced thyrotoxicosis (AIT) exist. Type 1 AIT is a form of iodine-induced hyperthyroidism. Its management is complex and includes thionamides, potassium perchlorate and, occasionally, thyroidectomy.
View Article and Find Full Text PDFContext: Amiodarone-induced thyrotoxicosis (AIT) resulting from destructive thyroiditis (type 2) is commonly treated with glucocorticoids, but time needed to restore euthyroidism may be unacceptable for patients with underlying cardiac disorders.
Objective: The objective of this prospective study was to identify factors affecting the response to glucocorticoids in a large cohort of patients with type 2 AIT followed prospectively.
Setting: This study was conducted at university centers.
Background: Thyrotropin (TSH)-secreting pituitary adenoma (TSHoma) and resistance to thyroid hormone (RTH) are two forms of inappropriate TSH secretion. Thyroid blood flow is largely TSH dependent.
Objective: To assess whether thyroid blood flow may help to differentiate TSHoma and RTH.