31 results match your criteria: "Villa Donatello Hospital[Affiliation]"

Parathyroid carcinoma and atypical parathyroid tumor: analysis of an Italian database.

Eur J Endocrinol

September 2024

Fondazione FIRMO Onlus, Italian Foundation for the Research on Bone Diseases, 50129 Florence, Italy.

Article Synopsis
  • Atypical parathyroid tumors (aPT) and parathyroid carcinoma (PC) are very rare types of tumors in the parathyroid glands, making up less than 2% of all such tumors.
  • The study looked at patients with aPT and PC to see how they compare in terms of medical features and problems.
  • Both types showed similar symptoms, but PCs had more kidney issues and a higher chance of the disease coming back after surgery, leading to plans for better tracking and study of these tumors in Italy and Europe.
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Effective strategies for pregnancy and lactation-associated osteoporosis: teriparatide use in focus.

Endocrine

November 2024

Fondazione FIRMO Onlus; Italian Foundation for the Research on Bone Diseases, Florence, Italy.

Introduction: Pregnancy and lactation-associated osteoporosis (PLO) is a rare condition characterized by fragility fractures occurring during late pregnancy or lactation, primarily affecting the spine and causing significant morbidity and back pain. PLO can lead to mobility impairment and work incapacity, with recovery taking up to several years. Due to the lack of clinical trials, treatment strategies remain poorly defined, historically focusing on calcium supplements, vitamin D, and weaning from breastfeeding.

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Skeletal abnormalities, pediatric-onset severe osteoporosis, and multiple fragility fractures in a patient with a novel variant.

Bone Rep

June 2024

Fondazione FIRMO Onlus, Fondazione Italiana per la Ricerca sulle Malattie dell'Osso, Via San Gallo 123, Florence 50129, Italy.

We report a case of a patient with a germline heterozygous truncating variant of gene (c.2172del, p.Tyr724Ter) causing neurodevelopmental disorder with spastic diplegia and visual defects syndrome (NEDSDV) associated with a new clinical feature - severe pediatric-onset osteoporosis and multiple fractures.

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Role of Nutrition in the Management of Patients with Multiple Endocrine Neoplasia Type 1.

Nutrients

May 2024

Fondazione Italiana Ricerca Sulle Malattie dell'Osso (FIRMO Onlus), 50129 Florence, Italy.

Article Synopsis
  • - Multiple endocrine neoplasia type 1 (MEN1) is a rare genetic syndrome linked to mutations in the MEN1 tumor suppressor gene, primarily showing as primary hyperparathyroidism, neuroendocrine tumors in the pancreas, and pituitary tumors.
  • - Unlike sporadic tumors, MEN1 tumors tend to be diagnosed at a younger age and present in multiple forms, requiring care from a multidisciplinary team that includes various medical specialists.
  • - Diet plays a critical role in managing MEN1, with emphasis on adequate intake of calcium, vitamin D, and other nutrients to prevent complications like osteoporosis and kidney stones, while addressing potential digestive issues following pancreatic surgery through personalized dietary planning.
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Few studies have evaluated the association between circulating levels of 25-hydroxyvitamin D (25(OH)D), 1,25-dihydroxyvitamin D (1,25(OH)D), and the endocrine disruptor bisphenol A (BPA), with risk of cardiovascular (CV) disease in elderly individuals. This was a cross-sectional study in a subgroup of elderly people from the InCHIANTI Biobank in Italy. We examined the association between circulating serum vitamin D metabolites, 1,25(OH)D, 25(OH)D, and the endocrine disrupting agent BPA, with an arbitrary CV risk score and the European Society of Cardiology-based 10-year CV risk (SCORE2/SCORE2-OP) using univariate and multiple regression.

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Genetic disorders and insulinoma/glucagonoma.

Endocr Relat Cancer

May 2024

Fondazione FIRMO Onlus, Italian Foundation for the Research on Bone Diseases, Florence, Italy.

Article Synopsis
  • * Most cases occur sporadically, but about 10% are linked to inherited conditions like multiple endocrine neoplasia type 1 (MEN1), neurofibromatosis type 1 (NF1), and tuberous sclerosis complex (TSC), resulting from mutations in tumor-suppressor genes.
  • * The text reviews the main epidemiological and clinical features of these tumors, particularly in relation to genetic syndromes.
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Background: Osteoporosis in males is largely under-diagnosed and under-treated, with most of the diagnosis confirmed only after an osteoporotic fracture. Therefore, there is an urgent need for highly accurate and precise technologies capable of identifying osteoporosis earlier, thereby avoiding complications from fragility fractures.

Aims: This study aimed to evaluate the diagnostic accuracy and precision of the non-ionizing technology Radiofrequency Echographic Multi Spectrometry (REMS) for the diagnosis of osteoporosis in a male population in comparison with conventional Dual-energy X-ray Absorptiometry (DXA).

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Serum phosphate concentration is regulated by renal phosphate reabsorption and mediated by sodium-phosphate cotransporters. Germline mutations in genes encoding these cotransporters have been associated with clinical phenotypes, variably characterized by hyperphosphaturia, hypophosphatemia, recurrent kidney stones, skeletal demineralization, and early onset osteoporosis. We reported a 33-year-old male patient presenting a history of recurrent nephrolithiasis and early onset osteopenia in the lumbar spine and femur.

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Hypophosphatasia: presentation and response to asfotase alfa.

Osteoporos Int

April 2024

F.I.R.M.O. Italian Foundation for the Research on Bone Diseases, Florence, Italy.

Unlabelled: Hypophosphatasia (HPP) is a rare bone disease with limited scientific evidence on the tolerability and safety of its novel treatment, Asfotase Alfa (AA). We report 7 HPP patients' heterogenous presentations and the significant improvement in various clinical outcomes attained with AA shedding light on this highly effective and safe therapy.

Introduction: Hypophosphatasia (HPP) is a rare inherited metabolic bone disorder characterized by a deficiency in the tissue non-specific alkaline phosphatase (TNSALP) due to loss of function mutation in the ALPL gene.

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Background: This manuscript provides a summary of the current evidence to support the criteria for diagnosing a child or adult with hypophosphatasia (HPP). The diagnosis of HPP is made on the basis of integrating clinical features, laboratory profile, radiographic features of the condition, and DNA analysis identifying the presence of a pathogenic variant of the tissue nonspecific alkaline phosphatase gene (ALPL). Often, the diagnosis of HPP is significantly delayed in both adults and children, and updated diagnostic criteria are required to keep pace with our evolving understanding regarding the relationship between ALPL genotype and associated HPP clinical features.

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Article Synopsis
  • Hypophosphatasia (HPP) is a rare metabolic disorder caused by low activity of the alkaline phosphatase enzyme, linked to mutations in the ALPL gene, and can present in various forms from severe neonatal cases to mild adult manifestations.
  • Diagnosing HPP in adults is challenging due to mild and non-specific symptoms, leading to underdiagnosis or misdiagnosis, especially among clinicians unfamiliar with the condition.
  • The HPP International Working Group analyzed existing studies to identify effective diagnostic criteria, ultimately proposing four major and five minor criteria for diagnosing HPP in adults, advocating for a combined approach in diagnosis.
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Hypophosphatasia (HPP) is a rare inborn error of metabolism that presents variably in both age of onset and severity. HPP is caused by pathogenic variants in the ALPL gene, resulting in low activity of tissue nonspecific alkaline phosphatase (TNSALP). Patients with HPP tend have a similar pattern of elevation of natural substrates that can be used to aid in diagnosis.

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Article Synopsis
  • * The main findings indicated that 14.8% of patients suffered from unfavorable outcomes due to significant complications or low quality-of-life scores post-surgery, with most patients showing good satisfaction overall.
  • * Logistic regression revealed that middle-aged men faced a higher risk of dissatisfaction after PPI compared to younger and older patients, while other factors like erectile dysfunction cause and surgical volume didn't significantly affect outcomes.
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Pancreatic Neuroendocrine Tumors in MEN1 Patients: Difference in Post-Operative Complications and Tumor Progression between Major and Minimal Pancreatic Surgeries.

Cancers (Basel)

October 2023

Fondazione F.I.R.M.O. Onlus, Fondazione Italiana per la Ricerca sulle Malattie dell'Osso (Italian Foundation for the Research on Bone Diseases), 50129 Florence, Italy.

Pancreatic neuroendocrine neoplasms (PNENs) affect over 80% of patients with multiple endocrine neoplasia type 1 (MEN1). Surgery is usually the therapy of choice, but the real immediate and long-term therapeutic benefit of a partial extensive pancreatic resection remains controversial. We analyzed, in 43 PNEN MEN1 patients who underwent 19 pancreaticoduodenectomies (PD), 19 distal pancreatectomies (DP), and 5 minimal pancreatectomies, the prevalence of surgery-derived early complications and post-operative pancreatic sequelae, and the PNEN relapse-free survival time after surgery, comparing major (PD+DP) and minimal pancreatic surgeries.

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Calcifediol: Mechanisms of Action.

Nutrients

October 2023

Fondazione Italiana Ricerca Sulle Malattie dell'Osso (FIRMO Onlus), 50129 Florence, Italy.

Due to its essential role in calcium and phosphate homeostasis, the secosteroid hormone calcitriol has received growing attention over the last few years. Calcitriol, like other steroid hormones, may function through both genomic and non-genomic mechanisms. In the traditional function, the interaction between the biologically active form of vitamin D and the vitamin D receptor (VDR) affects the transcription of thousands of genes by binding to repeated sequences present in their promoter region, named vitamin D-responsive elements (VDREs).

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Case Report: Calcium sensing receptor gene gain of function mutations: a case series and report of 2 novel mutations.

Front Endocrinol (Lausanne)

September 2023

Fondazione Italiana Ricerca sulle Malattie dell'Osso (FIRMO) Onlus, Italian Foundation for the Research on Bone Diseases, Florence, Italy.

Autosomal dominant hypocalcemia (ADH1) is a genetic disorder characterized by low serum calcium and low or inappropriately normal levels of parathyroid hormone. The disease is caused by a heterozygous activating mutation of the calcium-sensing receptor () gene, encoding a G-Protein-coupled cell membrane sensor of extracellular calcium concentration mainly expressed by parathyroid glands, renal tubules, and the brain. ADH1 has been linked to 113 unique germline mutations, of which nearly 96% are missense mutations.

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Parathyroid carcinoma: molecular therapeutic targets.

Endocrine

September 2023

Fondazione FIRMO Onlus (Fondazione Italiana per la Ricerca sulle Malattie dell'Osso), Florence, Italy.

Parathyroid carcinoma (PC) is an extremely rare malignant tumor of the parathyroid glands, accounting for less than 1% of primary hyperparathyroidism, commonly characterized by severe and unmanageable hypercalcemia, aggressive behavior, high metastatic potential, and poor prognosis. PC manifests prevalently as a sporadic tumor and only occasionally it is part of congenital syndromic and non-syndromic endocrine diseases. Molecular pathogenesis of this form of parathyroid tumor is not fully elucidated and it appears to be caused by multiple genetic and epigenetic drivers, differing among affected patients and not yet clearly stated in distinguishing PC from the benign parathyroid adenoma (PA).

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A Velocity-Based Approach to Noninvasive Methodology for Urodynamic Analysis.

Int Neurourol J

March 2023

Unit of Urological Minimally Invasive Robotic Surgery and Renal Transplantation, Careggi Hospital, Florence, Italy.

Purpose: To date, invasive urodynamic investigations have been used to define most terms and conditions relating to lower urinary tract symptoms. This invasiveness is almost totally due to the urethral catheter. In order to remove this source of discomfort for patients, the present study investigated a noninvasive methodology able to provide diagnostic information on bladder outlet obstruction or detrusor underactivity without any contact with the human body.

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Objective: Atypical femur fractures (AFFs) are rare fragility fractures originating at the lateral cortex of the femur, affecting the subtrochanteric or diaphyseal area of thebone with a transverse morphology. Occurrence of AFF is specifically associated with a small number of rare monogenic congenital metabolic bone disorders, such as hypophosphatasia, and with long-term treatment with antiresorptiondrugs. The exact pathogenesis of these fractures remains poorly understood and, except for cases of diagnosed HPP or other AFF-causing bone diseases, it is not possible to assess which patients are at higher riskof developing AFFs as a consequence of anti-resorption therapy.

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Background: Penile prosthesis implantation has been associated with overall good functional outcomes. Of relevance, some patients reported higher level of satisfaction and quality of life.

Aim: We investigated the profile of the patients who may benefit the most from penile prosthesis implantation.

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Role of Wnt signaling and sclerostin in bone and as therapeutic targets in skeletal disorders.

Osteoporos Int

February 2023

Fondazione FIRMO Onlus, Italian Foundation for the Research on Bone Diseases, Via San Gallo 123, 50129, Florence, Italy.

Unlabelled: Wnt signaling and its bone tissue-specific inhibitor sclerostin are key regulators of bone homeostasis. The therapeutic potential of anti-sclerostin antibodies (Scl-Abs), for bone mass recovery and fragility fracture prevention in low bone mass phenotypes, has been supported by animal studies. The Scl-Ab romosozumab is currently used for osteoporosis treatment.

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Introduction:: Neovascular age-related macular degeneration (nAMD) is treated with antivascular endothelial growth factor (anti-VEGF) drugs. However, resistance to anti-VEGF therapy is observed in some patients. Brolucizumab is a new-generation anti-VEGF drug for the treatment of nAMD, with proven efficacy in fluid resolution and long-lasting effects.

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