Laura Vuolo

Vitamin D and Cancer

Vitamin D system is a complex pathway that includes precursors, active metabolites, enzymes, and receptors. This complex system actives several molecular pathways and mediates a multitude of functions. In addition to the classical role in calcium and bone homeostasis, vitamin D plays “non-calcemic” effects in host defense, inflammation, immunity, and cancer processes as recognized in vitro and in vivo studies. The aim of this review is to highlight the relationship between vitamin D and cancer, summarizing several mechanisms proposed to explain the potential protective effect of vitamin D against the development and progression of cancer. Vitamin D acts like a transcription factor that influences central mechanisms of tumorigenesis: growth, cell differentiation, and apoptosis. In addition to cellular and molecular studies, epidemiological surveys have shown that sunlight exposure and consequent increased circulating levels of vitamin D are associated with reduced reduced occurrence and a reduced mortality in different histological types of cancer. Another recent field of interest concerns polymorphisms of vitamin D receptor (VDR); in this context, preliminary data suggest that VDR polymorphisms more frequently associated with tumorigenesis are Fok1, Bsm1, Taq1, Apa1, EcoRV, Cdx2; although further studies are needed to clarify their role in the cancer. In this review, the relationship between vitamin D and cancer is discussed.

Exercise training improves autonomic function and inflammatory pattern in women with polycystic ovary syndrome (PCOS)

Background  Polycystic ovary syndrome (PCOS) is a common female reproductive‐age endocrine disease predominantly characterized by chronic anovulation, hyperandrogenism, insulin‐resistance and low‐grade inflammatory status. Exercise training (ET) favourably modulates cardiopulmonary function and insulin‐sensitivity markers in PCOS women. The present study investigated the effects of ET on autonomic function and inflammatory pattern in PCOS women.

Inflammatory markers and visceral fat are inversely associated with maximal oxygen consumption in women with polycystic ovary syndrome (PCOS)

Background  We investigated whether several different inflammatory markers including C‐reactive protein (CRP) and fibrinogen and white blood cells (WBCs) count, are associated with maximal oxygen consumption (VO2max) in women with polycystic ovary syndrome (PCOS).

Clinical and prognostic implications of the genetic diagnosis of hereditary NET syndromes in asymptomatic patients.

Neuroendocrine tumors (NETs) can be sporadic or they can arise in complex hereditary syndromes. Patients with hereditary NETs can be identified before the development of tumors by performing genetic screenings. The aim of the study was to evaluate the clinical and prognostic impact of a preclinical genetic screening in subjects with hereditary NET syndromes. 46 subjects referred for hereditary NET syndrome [22 MEN1, 12 MEN2, 12 Familial Paragangliomatosis (FPGL)] were enrolled and divided in 2 groups (group A, 20 subjects with clinical appearance of NET before the genetic diagnosis; group B, 26 subjects with genetic diagnosis of hereditary NET syndromes before the clinical appearance of NETs). The main outcome measures were severity of disease, prognosis, and survival. The rate of surgery for MEN1-, MEN2-, FPGL4-related tumors was 90% in group A and 35% in group B (p<0.01). Both symptoms related to tumors and symptoms related to therapies were significantly less frequent in group B than in group A (p<0.05). Tumor stage was locally advanced or metastatic in 50% of group A and in no one of group B (p<0.01). The mortality rate was 25% in group A and 0% in group B (p<0.05). An early genetic screening for hereditary NET syndromes results in an improvement in clinical presentation and morbidity. A potential impact of the genetic screening on the mortality rate of these subjects is suggested and needs to be investigated in further and more appropriate studies.

Lack of electrocardiographic changes in women with polycystic ovary syndrome.

Objective  The aim of the present study was to investigate the potential alterations in electrocardiographic (ECG) pattern in patients with polycystic ovary syndrome (PCOS).

NutriLive: An Integrated Nutritional Approach as a Sustainable Tool to Prevent Malnutrition in Older People and Promote Active and Healthy Ageing—The EIP-AHA Nutrition Action Group

The present document describes a nutritional approach that is nested in the European Innovation Partnership for Active and Healthy Aging (EIP-AHA) and aims to provide the first common European program translating an integrated approach to nutritional frailty in terms of a multidimensional and transnational methodology. The document has been developed by the A3 Nutrition Action Area of the EIP-AHA and aims at providing a stepwise approach to malnutrition in older citizens, identifying adequate interventions based on a unified assessment and ICT-supported solutions. “NutriLive” is an integrated nutritional approach, represented by a structured Screening-Assessment-Monitoring-Action-Pyramid-Model (SAM-AP). Its core concept is the stratification of the nutritional needs, considered by the working group as the key for targeted, effective, and sustainable interventions. “NutriLive” tries to close gaps in epidemiological data within an aging population, creating a unified language to deal with the topic of nutrition and malnutrition in Europe. By assembling all the validated screening, assessment, and monitoring tools on malnutrition in a first pyramid, which is interrelated to a second intervention pyramid, the A3 Nutrition WG identifies a common, integrated vision on the nutritional approach to frailty, which applies to the various health care settings.

Medical Therapy in Porotic Patients

Osteoporosis is a multifactorial skeletal disorder characterized by reduced bone mass and deterioration of the micro-architecture of bone. These features predispose affected subjects to increased susceptibility to fractures. According to the World Health Organization, osteoporosis is diagnosed if the bone mineral density (BMD) is 2.5 standard-deviations below the mean peak value in young adults of the same ethnicity and sex (T-score less than −2.5). The “gold standard” for measuring BMD is dual-energy X-ray absorptiometry (DEXA). Other diagnostic modalities include computed tomography (CT), peripheral quantitative CT, and ultrasonography (which has not been shown to provide additional information about bone quality).

Etiopathogenesis and Clinical Aspects of BIONJ

Osteonecrosis of the jaw (ONJ) was previously known as an entity mainly associated with radiation therapy to the head and neck (osteoradionecrosis of the jaw), but recent evidence of a relationship between necrotic lesions of the jaw and chronic bisphosphonates (BPs) therapy has led to a rising interest in investigating the pathogenesis of bisphosphonates-induced osteonecrosis of the jaw (BIONJ). Several studies have indicated the importance of BPs in the development of ONJ. Most published cases have described patients with advanced malignancies, particularly multiple myeloma and breast cancer, who received frequent and high doses of intravenous nitrogen-containing bisphosphonates. Advanced age, diabetes mellitus, renal insufficiency, immunosuppressant therapies such as corticosteroids, specific treatments other than BPs, alcohol consumption, cigarette smoking, among others, are considered co-morbid factors for ONJ, as the available data are conflicting and not strong enough to support these conditions as risk factors. The clinical findings in BIONJ patients include the exposure of non-vital, white-yellowish bone tissue surrounded by an inflamed and edematous mucosa in the mouth. This situation can be anticipated in patients describing a vague sensation of pain or discomfort in the affected area.

Tumore bruno della mandibola in un paziente con iperparatiroidismo primitive

dL, 3 mesi dalla prima valutazione effettuata in Odontostomatologia) (Tab. I). Sulla base della storia anamnestica (nefrolitiasi da circa 30 anni prima), delle elevate concentrazioni di PTH (>1500 pg/mL) e del quadro eco-color-Doppler, che mostrava un adenoma paratiroideo di 4,5 cm alla base del lobo sinistro della tiroide (Fig. 1), si escludeva la diagnosi di iperparatiroidismo terziario (autonomizzazione funzionale in corso di pregresso iperparatiroidismo secondario) e si poneva la diagnosi di iperparatiroidismo Caso clinico