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Both comorbidity burden and low testosterone can explain symptoms and signs of testosterone deficiency in men consulting for sexual dysfunction

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Asian Journal of Andrology 2020年第3期22卷 265-273页

作者： Giulia Rastrelli Giovanni Corona Mario maggi Sexual Medicine and Andrology Unit Department of Experimental and Clinical Biomedical SciencesUniversity of FlorenceViale Pieraccini 6Florence 50139Italy Endocrinology Unit Medical DepartmentMaggiore-Bellaria HospitalLargo Nigrisoli 2Bologna 40133Italy I.N.B.B. Biostructures and Biosystems National InstituteViale delle Medaglie d'Oro 305Rome(X)136Italy Endocrinology Unit Department of Experimental Clinical and Biomedical Sciences**Mario Serio"University of FlorenceViale Pieraccini 6Florence 50139Italy.

Low testosterone(T)is frequent in men with chronic *** clinical features of T deficiency(TD)overlap with those of chronic *** aim of this study is to evaluate the relative contribution of chronic disease score(CDS)and low T to the presenee of TD symptoms.A consecutive series of 3862 men(aged 52.1±13.1 years)consulting for sexual dysfunction were *** clinical and biochemical parameters were collected,in eluding the structured interview,ANDROTEST,for the assessme nt of TD *** color Doppler ultrasound(PCDU)was also *** on the medications taken,the CDS was *** a subset of 1687 men,information on mortality was collected(follow-up of 4.3±2.6 years).Higher CDS was associated with lower free and total T(TT)as well as with higher ANDROTEST *** introducing CDS and TT in multivariable models adjusted for age,severe erectile dysfunctio n and impaired morning erectio ns were associated with both CDS(odds ratio and 95%confide nee interaval,OR[95%Cl]=1.25[1.13;1.37]and 1.38[1.29;1.48],respectively)and low TT(OR[95%Cl]=1.11[1.00;1.23]and 1.13[1.06;1.21],respectively).Similar results were obtained for PCDU *** sexual desire was associated with low TT(OR[95%Cl]=1.21[1.13;1.30]),whereas it was inversely related with CDS(OR[95%Cl]=0.91[0.84;0.97]).When considering mortality for major cardiovascular events,TT<8 nmol I1,but not CDS,was a significant predictor(hazard ratio[95%Cl]=5.57[1.51;20.63]).Chronic illnesses are associated with an overt *** chronic diseases and low T can be invoIved in determining symptoms present in subjects complaining for sexual *** should be considered in the diagnostic workup for TD.

关键词： chronic diseases erectile dysfunction sexual symptoms testosterone deficiency

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Testosterone therapy: a friend or a foe for the aging men with benign prostatic hyperplasia?

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Asian Journal of Andrology 2020年第3期22卷 233-235页

作者： Giulia Rastrelli Linda Vignozzi Mario maggi Sexual Medicine and Andrology Unit Department of Experimental and Clinical Biomedical SciencesUniversity of FlorenceViale PieracciniFlorence 61-50139Italy LN.B.B. Biostructures and Biosystems National InstituteViale delle Medaglie d'Oro305Rome 1-00136Italy Endocrinology Unit Department of Experimental Clinical and Biomedical Sciences"Mario Serio"University of FlorenceViale PieracciniFlorence 61-50139Italy.

One of the major concerns for the prescription of medications containing testosterone(T)in the aging men with T deficiency(TD)is prostate disorders(such as benign prostatic hyperplasia,BPH)and their related symptoms(lower urinary tract symptoms,LUTS).This is because prostate is an androgen-responsive gland;however,the androgen dependence of prostate growth,well demonstrated in earlier phases of life,has no clear evidence in late adulthood and *** fact,after the age of 40 years,BPH becomes increasingly more *** the other hand,in men older than 40 year,a progressive decline in T is *** epidemiological data are a starting point for questioning a putative detrimental role of T on the prostate health in the ageing man.

关键词： prostatic BPH prescription

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Klotho:A new therapeutic target in diabetic retinopathy?

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World Journal of Diabetes 2023年第7期14卷 1027-1036页

作者： Alessandra Puddu Davide Carlo maggi Department of Internal Medicine and Medical Specialties University of GenovaGenova 16132Italy

Klotho(Kl)is considered an antiaging gene,mainly for the inhibition of the insulin-like growth factor-1 *** exists as full-length transmembrane,which acts as co-receptor for fibroblast growth factor receptor,and in soluble forms(sKl).The sKl may exert pleiotropic effects on organs and tissues by regulating several pathways involved in the pathogenesis of diseases associated with oxidative and inflammatory *** diabetic Patients,serum levels of Kl are significantly decreased compared to healthy subjects,and are related to duration of *** diabetic retinopathy(DR),one of the most common microvascular complications of type 2 diabetes,serum Kl levels are negatively correlated with progression of the disease.A lot of evidences showed that Kl regulates several mechanisms involved in maintaining homeostasis and functions of retinal cells,including phagocytosis,calcium signaling,secretion of vascular endothelial growth factor A(VEGF-A),maintenance of redox status,and melanin *** data have been shown that Kl exerts positive effects on several mechanisms involved in onset and progression of *** particular,treatment with Kl:(1)Prevents apoptosis induced by oxidative stress in human retinal endothelial cells and in retinal pigment epithelium(RPE)cells;(2)reduces secretion of VEGF-A by RPE cells;and(3)decreases subretinal fibrosis and preserves autophagic ***,Kl may become a novel biomarker and a good candidate for the treatment of DR.

关键词： Klotho Diabetic retinopathy Retinal pigment epithelium Vascular endothelial growth factor A Epithelial to mesenchimal transition Ocular neovascularization

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How to recognize late-onset hypogonadism in men wit sexual dysfunction

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Asian Journal of Andrology 2012年第2期14卷 251-259页

作者： Giovanni Corona Giulia Rastrelli Linda Vignozzi Edoardo Mannucci Mario maggi Sexual Medicine and Andrology Unit Department of Clinical Physiopathology University of Florence Florence 50139 Italy Endocrinology Unit Maggiore-Bellaria Hospital Medical Department Azienda-Usl Bologna Bologna 40133 Italy Diabetes Section Geriatric Unit Department of Critical Care University of Florence Florence 50139 Italy

Late-onset hypogonadism （LOH） has been considered the most common form of male hypogonadism with a prevalence of approximately 1 in 100 men. Diagnosis of LOH should be made in symptomatic men with unequivocally low serum testosterone （T） levels. However, its clinical presentation is often insidious and difficult to recognize because it is characterized by nonspecific symptoms that make differential diagnosis with physiological ageing problematic. Sexual dysfunction is the most important determinant for medical consultation and the most specific symptom associated with low T. We therefore analysed a consecutive series of 1734 subjects who attended our unit for sexual dysfunction to investigate the associations between low T （different thresholds）, sexual parameters, medical history data （delayed puberty, pituitary disease or cryptorchidism） and their physical exam results. Metabolic parameters, in particular waist circumference, display the greatest accuracy in detecting low T. We found that only the association of several symptoms and signs could significantly raise the clinical suspicion of low T. Structured inventories, which cluster together symptoms and signs of hypogonadism, can help clinicians suspect androgen deficiency. In particular, structured interviews, such as ANDROTEST, have been demonstrated to have a greater accuracy when compared to self reported questionnaires in detecting low T levels.

关键词： late-onset hypogonadism (LOH) male hypogonadism testosterone sexual dysfunction

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Evaluation of the anticonvulsant activity of the essential oil of Myrothamnus moschatus in convulsion induced by pentylenetetrazole and picrotoxin

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Asian Pacific Journal of Tropical Biomedicine 2016年第6期6卷 501-505页

作者： Emmanuel Randrianarivo Filippo maggi Marcello Nicoletti Philippe Rasoanaivo Malagasy Institute of Applied Research Rakoto Ratsimamanga Foundation School of Pharmacy University of Camerino Department of Environmental Biology Sapienza University

Objective: To evaluate the anticonvulsant effect of the essential oil of Myrothamnus moschatus(M. moschatus) in convulsion induced by pentylenetetrazole and picrotoxin in rodent ***: The essential oil of the aerial parts of M. moschatus was extracted by steam distillation. Thereafter, it was injected subcutaneously to rats and mice at escalating doses(0.1–0.8 m L/kg). Ten minutes after drug injection, pentylenetetrazole was injected intraperitoneally to rats and picrotoxin was administered to mice by the same *** served as the positive control. Every single animal was placed into transparent cage and observed for convulsive behavior for 30 min by using ordinary security cameras connected to a video recorder. Death occurring for a period of 24 h was also ***: The essential oil at 0.8 m L/kg completely arrested the pentylenetetrazole-induced convulsion without any sedative effect and delayed its appearance at lower doses, but showed moderate activities on picrotoxin-induced convulsion. For the rats treated with pentylenetetrazole alone, the mortality was 100% within 1 h, but for the rats pre-treated with the essential oil, the mortality was 0%. For the mice treated with picrotoxin, the mortality rate was also 100%, while 20%–100% died in those that had been pre-treated with the ***: The results confirmed at least partly the traditional uses of the smoke of M. moschatus for the management of convulsion, and implied that the essential oil may inhibit the convulsion by GABAergic neuromodulation.

关键词： Myrothamnus moschatus Essential oil Convulsions Pentylenetetrazole Picrotoxin

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Relation between skeletal muscle volume and prognosis in rectal cancer patients undergoing neoadjuvant therapy

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World Journal of Gastrointestinal Oncology 2022年第2期14卷 423-433页

作者： Paola De Nardi Alessandro Giani Giulia maggi Marco Braga Department of Gastrointestinal Surgery IRCCS San Raffaele Scientific InstituteMilano 20132Italy Department of Surgery School of MedicineUniversity of Milano-BicoccaMilan ItalyMonza 20900Italy Department of Oncologic Surgery Policlinico CasilinoRome 00169Italy Department of Surgery San Gerardo HospitalUniversity Milano BicoccaMonza 20900Italy

The prognostic role of body composition indexes,and specifically sarcopenia,has recently been explored in different cancer ***,conflicting results have been *** in cancer type,cancer stage or oncological treatments,as well as different methodology and definition of sarcopenia,could be accounted for different conclusions retrieved from *** focusing on colorectal cancer,it clearly appears that colon and rectal cancers are often treated as a single entity though they have different behaviors and ***,patients with advanced rectal cancer represent a peculiar group of patients that according to current guidelines are treated with neoadjuvant chemotherapy and radiotherapy followed by radical *** review was restricted to a homogeneous group of patients with advanced lower rectal cancer and the aim of exploring whether there is a correlation between skeletal muscle depletion and *** was searched for articles related to patients with advanced rectal cancer undergoing neoadjuvant chemo-radiotherapy(NCRT)followed by radical surgery,in whom muscle mass and/or change in muscle mass during neoadjuvant treatment were *** full-text articles were selected and included in the present *** main findings of our review were:(1)The majority of the studies defined sarcopenia as muscle mass alone over muscle strength or physical performance;(2)There was a great deal of heterogeneity in the definition and measures of sarcopenia,in the definition of cut-off values,and in the method to measure change in muscle mass;(3)There was not full agreement on the association between sarcopenia at baseline and/or after chemoradiotherapy and prognosis,and only few studies found a significance in the multivariate analysis;and(4)It seems that a loss in skeletal muscle mass during NCRT is associated with the worst outcomes in terms of disease-free *** conclusion,analysis of muscle mass might provid

关键词： Advanced rectal cancer Sarcopenia Neoadjuvant treatment Chemoradiotherapy Surgery Muscle mass change Prognosis Survival Review

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Association of upper gastrointestinal symptoms with functional and clinical characteristics in the elderly

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World Journal of Gastroenterology 2011年第25期17卷 3020-3026页

作者： Alberto Pilotto Stefania maggi Marianna Noale Marilisa Franceschi Giancarlo Parisi Gaetano Crepaldi Geriatrics Unit Azienda ULSS 16 PadovaS.Antonio Hospital Aging Section National Research CouncilInstitute of Neuroscience Endoscopy Unit Department of Surgery Department of Internal Medicine General Hospital

AIM： To evaluate the prevalence of upper gastrointestinal symptoms and their association with clinical and functional characteristics in elderly outpatients. METHODS： The study involved 3238 outpatients ≥ 60 years consecutively enrolled by 107 general practitioners. Information on social, behavioral and de- mographic characteristics, function in the activities of daily living （ADL）, co-morbidities and drug use were collected by a structured interview. Upper gastroin- testinal symptom data were collected by the 15-items upper gastro-intestinal symptom questionnaire for the elderly, a validated diagnostic tool which includes the following five symptom clusters：（1） abdominal pain syndrome; （2） reflux syndrome; （3） indigestion syn- drome; （4） bleeding, and （5） non-specific symptoms. Presence and severity of gastrointestinal symptoms were analyzed through a logistic regression model. RESULTS： 3100 subjects were included in the final analysis. The overall prevalence of upper gastrointes- tinal symptoms was 43.0%, i.e. cluster （1） 13.9%, （2） 21.9%, （3） 30.2%, （4） 1.2%, and （5） 4.5%. Upper gastrointestinal symptoms were more frequently re- ported by females （P 〈 0.0001）, with high number of co-morbidities （P 〈 0.0001）, who were taking higher number of drugs （P 〈 0.0001） and needed assistance in the ADL. Logistic regression analysis demonstrated that female sex （OR = 1.39, 95% CI： 1.17-1.64）, dis- ability in the ADL （OR = 1.47, 95% CI： 1.12-1.93）, smoking habit （OR = 1.29, 95% C]： 1.00-1.65）, and body mass index （OR = 1.06, 95% CI： 1.04-1.08）, as well as the presence of upper （OR = 3.01, 95% C]： 2.52-3.60） and lower gastroenterological diseases （OR = 2.25, 95%CI： 1.70-2.97）, psychiatric （OR = 1.60, 95% CI： 1.28-2.01） and respiratory diseases （OR = 1.25, 95% C]： 1.01-1.54） were significantly associated with the presence of upper gastrointestinal symptoms. CONCLUSION： Functional and clinical characteristics are associated with upper gastrointestinal symptoms. A multidimension

关键词： Upper gastrointestinal symptoms Elderly Upper gastro-intestinal symptom questionnaire for theelderly Gastroesophageal reflux disease Disability

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Erectile dysfunction and central obesity： an Italian perspective

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Asian Journal of Andrology 2014年第4期16卷 581-591页

作者： Giovanni Corona Giulia Rastrelli Sandra Filippi Linda Vignozzi Edoardo Mannucci Mario maggi Endocrinology Unit Maggiore-Bellaria Hospital Azienda-Usl Bologna Bologna Sexual Medicine and Andrology Unit Department of Experimental Clinical and Biomedical Sciences University of Florence Florence Diabetes Agency Careggi Hospital Florence Italy.

Erectile dysfunction （ED） is a frequent complication of obesity. The aim of this review is to critically analyze the framework of obesity and ED, dissecting the connections between the two pathological entities. Current clinical evidence shows that obesity, and in particular central obesity, is associated with both arteriogenic ED and reduced testosterone （T） levels. It is conceivable that obesity-associated hypogonadism and increased cardiovascular risk might partially justify the higher prevalence of ED in overweight and obese individuals. Conversely, the psychological disturbances related to obesity do not seem to play a major role in the pathogenesis of obesity-related ED. However, both clinical and preclinical data show that the association between ED and visceral fat accumulation is independent from known obesity-associated comorbidities. Therefore, how visceral fat could impair penile microcirculation still remains unknown. This point is particularly relevant since central obesity in ED subjects categorizes individuals at high cardiovascular risk, especially in the youngest ones. The presence of ED in obese subjects might help healthcare professionals in convincing them to initiate a virtuous cycle, where the correction of sexual dysfunction will be the reward for improved lifestyle behavior. Unsatisfying sexual activity represents a meaningful, straightforward motivation for consulting healthcare professionals, who, in turn, should take advantage of the opportunity to encourage obese patients to treat, besides ED, the underlying unfavorable conditions, thus not only restoring erectile function, but also overall health.

关键词： androgens erectile dysfunction impotence vasculogenic

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A novel PNPLA2 mutation causing total loss of RNA and protein expression in two NLSDM siblings with early onset but slowly progressive severe myopathy

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Genes & Diseases 2021年第1期8卷 73-78页

作者： Daniela Tavian Lorenzo maggi Marina Mora Lucia Morandi Cinzia Bragato Sara Missaglia Laboratory of Cellular Biochemistry and Molecular Biology CRIBENSUniversita`Cattolica del Sacro Cuorepz Buonarroti 30Milan20145Italy Department of Psychology Universita`Cattolica del Sacro CuoreLargo Gemelli 1Milan20123Italy Neuromuscular Diseases and Neuroimmunology Unit Fondazione IRCCS Istituto Neurologico“Carlo Besta”MilanItaly PhD program in Neuroscience University of Milano-BicoccaVia Cadore 48Monza20900Italy

Neutral lipid storage disease with myopathy(NLSDM)is a rare autosomal recessive disorder,due to an enzymatic error of lipid *** present always with skeletal muscle myopathy and variable cardiac and hepatic *** is caused by mutations in the PNPLA2 gene,which encodes the adipose triglyceride lipase(ATGL).Here we report the molecular characterization and clinical findings of two NLSDM siblings carrying the novel c.187t1G>C homozygous PNPLA2 mutation,localized in the splice site of intron *** analyses revealed that neither aberrant PNPLA2 mRNA isoforms,nor ATGL mutated protein were detectable in patient’s ***,both patients presented early onset muscle weakness,in particular of proximal upper limb *** almost 15 years,muscle damage affected also distal upper *** is a NLSDM family,displaying a severe PNPLA2 mutation in two siblings with clinical presentation characterized by an early onset,but a slowly evolution of severe myopathy.

关键词： Cardiomyopathy Lipid metabolism Neutral lipid storage disease with myopathy PNPLA2 Splicing mutation Triglyceride lipase

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Associations between cardiac arrhythmia,incident disability in activities of daily living and physical performance:the ILSA study

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Journal of Geriatric Cardiology 2020年第3期17卷 127-132,I0002-I0004页

作者： Marianna Noale Nicola Veronese Lee Smith Andrea Ungar Stefano Fumagalli Stefania maggi the Italian Longitudinal Study on Aging Working Group National Research Council(CNR) Neuroscience InstituteAging BranchVia Giustiniani 235128 PaduaItaly Azienda ULSS 3 Serenissima Primary Care DepartmentDistrict 3VeniceItaly The Cambridge Centre for Sport and Exercise Sciences Department of Life SciencesAnglia Ruskin UniversityCambridge CB11PTUK Geriatrics and Intensive Care Unit Department of Experimental and Clinical MedicineUniversity of Florence and AOU CareggiFlorenceItaly 不详

Background Cardiac arrhythmias are common conditions in older ***,there is limited literature on associations between cardiac arrhythmias and physical performance or *** therefore aimed to prospectively investigate associations between cardiac arrhythmias and changes in disability and physical performance during 8 years of follow-up,using data from the Italian Longitudinal Study on Aging(ILSA).Methods Cardiac arrhythmias diagnosis was posed through a screening phase,confirmed by a *** onset of disability in activities of daily living(ADL)and the changes in several physical performance tests during follow-up were considered as ***-adjusted and propensity-score Cox Proportional Hazard models and mixed models were used for exploring associations between cardiac arrhythmia and the outcomes of *** The prevalence of cardiac arrhythmia at baseline was 23.3%.People reporting cardiac arrhythmia at the baseline were significantly older,more frequently male,smokers and reported a higher presence of all medical conditions investigated(hypertension,heart failure,angina,myocardial infarction,diabetes,stroke),but no difference in dementia,Parkinsonism,cognitive or mood *** arrhythmia at baseline was significantly associated with the incidence of disability in ADL(HR=1.23;95%:CI:1.01–1.50;P=0.0478 in propensity score analyses;HR=1.28;95%CI:1.01–1.61;P=0.0401 in fully adjusted models).Cardiac arrhythmia at baseline was also associated with a significant worsening in balance test(P=0.0436).Conclusions The presence of cardiac arrhythmia at baseline was associated with a significant higher risk of disability and of worsening in some physical performance tests,particularly those relating to *** and frequently assessing physical performance in older people affected by cardiac arrhythmia can be important to prevent a loss of physical performance,with further,potential,complications of medical managemen

关键词： Atrial fibrillation Cardiac arrhythmia Disability Physical activity Physical performance

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