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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,TTpredictor(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

Assimilation of NDVI data in a land surface-Vegetation model for leaf area index predictions in a tree-grass ecosystem

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International Journal of Digital Earth 2023年第1期16卷 3810-3837页

作者： Nicola Montaldo Andrea Gaspa Roberto corona Dipartimento di Ingegneria civile ambientale e architetturaUniversita di CagliariCagliariItaly

periodic observations of vegetation index,such as the normalized difference vegetation index(NDVI),can be used for data assimilation in heterogenous ***,the new Sentinel 2 Multispectral instrument and Landsat 8 Operational Land Imager sensor data are available at such high temporal and spatial resolutions that can be used to detect the patches of the main vegetation components(grass and trees)of heterogenous ecosystems,and capture their *** demonstrate the possibility to merge grass and tree NDVI observations and models,to optimally provide robust predictions of grass and tree leaf area *** proposed assimilation approach assimilates NDVI data through the Ensemble Kalman filter(EnKF)and dynamically calibrates a key vegetation dynamic model parameter,the maintenance respiration coeffcient(ma).In the presence of large bias of the grass and tree ma base values,only the use of the proposed assimilation approach removes the large bias in the biomass balance,dynamically calibrating maintenance respiration coefficients,and corrects the *** performance of a land surface-vegetation model was improved by assimilating observations of *** effective impact of the proposed assimilation approach on the evapotranspiration and CO_(2) uptake predictions in the heterogenous ecosystem is also demonstrated.

关键词： Data assimilation leaf area index heterogenous ecosystem vegetation dynamic model Landsat 8 Sentinel 2

Sampling strategies for estimating forest cover from remote sensing-based two-stage inventories

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Forest Ecosystems 2015年第3期2卷 208-219页

作者： piermaria corona Lorenzo Fattorini Maria Chiara pagliarella Consiglio per la ricerca in agricoltura e l’analisi dell’economia agraria-Forestry Research Centre University of Siena-Department of Economic and Statistics University of Molise-Department of Biosciences and Territory

Background: Remote sensing-based inventories are essential in estimating forest cover in tropical and subtropical countries, where ground inventories cannot be performed periodically at a large scale owing to high costs and forest inaccessibility(e.g. REDD projects) and are mandatory for constructing historical records that can be used as forest cover baselines. Given the conditions of such inventories, the survey area is partitioned into a grid of imagery segments of pre-fixed size where the proportion of forest cover can be measured within segments using a combination of unsupervised(automated or semi-automated) classification of satellite imagery and manual(i.e. visual on-screen)enhancements. Because visual on-screen operations are time expensive procedures, manual classification can be performed only for a sample of imagery segments selected at a first stage, while forest cover within each selected segment is estimated at a second stage from a sample of pixels selected within the segment. Because forest cover data arising from unsupervised satellite imagery classification may be freely available(e.g. Landsat imagery)over the entire survey area(wall-to-wall data) and are likely to be good proxies of manually classified cover data(sample data), they can be adopted as suitable auxiliary ***: The question is how to choose the sample areas where manual classification is carried out. We have investigated the efficiency of one-per-stratum stratified sampling for selecting segments and pixels, where to carry out manual classification and to determine the efficiency of the difference estimator for exploiting auxiliary information at the estimation level. The performance of this strategy is compared with simple random sampling without ***: Our results were obtained theoretically from three artificial populations constructed from the Landsat classification(forest/non forest) available at pixel level for a study area located in central Italy,

关键词： Spatially balanced sampling Auxiliary information

Douglas-fir climate sensitivity at two contrasting sites along the southern limit of the European planting range

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Journal of Forestry Research 2020年第6期31卷 2193-2204页

作者： Cristiano Castaldi Maurizio Marchi Giorgio Vacchiano piermaria corona CREA-Research Centre for Forestry and Wood Viale S.Margherita 8052100 ArezzoItaly Universitàdegli Studi di Milano DISAAVia Celoria 220133 MilanItaly

Douglas-fir(pseudotsuga menziesii(Mirb.)Franco)is an important exotic tree species that was planted across a large part of Europe during the last *** both experimental trials and conventional forest plantations,the trees grow at a high rate and produce high-quality *** present study investigated climate-growth relationships of Douglas-fi r at two Italian sites that contrast in climate:a Mediterranean area in southern Italy(Mercurella site)and a cooler,moister site in the northern Apennines without summer aridity(Acquerino).The relationship between tree-ring chronologies and monthly climatic variables was evaluated by a moving average and correlation *** showed that the minimum temperature in February and in March play a key role for Douglas-fi r at both sites,with a positive eff ect on *** the northern site,it is also highly sensitive to late summer temperatures(negative correlation)and spring–summer precipitation(positive correlation).Growth rates in southern latitudes were high even in Europe and in the Mediterranean environment,with low sensitivity to climatic fl *** the basis of our results,further common garden experiments should test adaptation and the interaction between genetics and environment of second-or third-generation seeds from old stands across Europe such as done by the old International Union of Forest Research Organizations(IUFRO)or the European Douglasfi r Improvement Research Cooperative(EUDIREC)experimentation programmes.

关键词： pseudotsuga menziesii Tree ring analysis Dendroclimatology Forest plantations Exotic forest species

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

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

Intestinal pseudo-obstruction caused by herpes zoster:Case report and pathophysiology

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World Journal of Clinical Cases 2018年第6期6卷 132-138页

作者： Roberto Anaya-prado José V pérez-Navarro Ana corona-Nakamura Michelle M Anaya-Fernández Roberto Anaya-Fernández Marian Eliza Izaguirre-pérez Department of Surgery at Western Medical Center the Mexican Institute of Social Security Division of Research at Autonomous University of Guadalajara Department of Infectious Diseases at Western Medical Center the Mexican Institute of Social Security Division of Research at University of Guadalajara

Herpes zoster(HZ) infection occurs in approximately 10% to 30% of individuals. Visceral neuropathies secondary to HZ can cause cystitis and urinary retention. But colonic pseudo-obstruction can also occur. peripheral neuropathy may reveal segmental motor paresis of either upper or lower limbs, the abdominal muscles or the diaphragm. We report the case of a 62-year-old male patient who presented with abdominal distention and cutaneous vesicular eruption on the left side of the abdominal wall. plain X-rays and computed tomography scan showed distended small bowel. A diagnosis of intestinal pseudo-obstruction was made secondary to segmental paresis of the small intestine and visceral neuropathy. Conservative management was successful and the patient was discharged uneventfully. Intestinal pseudo-obstruction ought to be consideredwhen dealing with non-obstructive(adynamic) conditions of the digestive tract associated with HZ infection; since early recognition may help to avoid unnecessary surgery.

关键词： Ogilvie’s symdrome Herpes zoster virus Neuropathies Intestinal pseudo-obstruction

Rare cause of odynophagia: Giant esophageal ulcer

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World Journal of Gastroenterology 2016年第14期22卷 3875-3878页

作者： Massimiliano Veroux Giuseppe Aprile Francesca F Amore Daniela corona Alessia Giaquinta pierfrancesco Veroux the Vascular Surgery and Organ Transplant Unit Department of Medical and Surgical Sciences and Advanced Technologies University Hospital of Catania 95123 Catania Italy Endoscopy Unit Department of Surgical Specialties University Hospital of Catania 95123 Catania Italy pathology Unit Department of Medical and Surgical Sciences and Advanced Technologies University Hospital of Catania 95123 Catania Italy

Gastrointestinal complications are a frequent cause of morbidity after transplantation and may affect up to 40% of kidney transplant recipients. Here we report a rare case of idiopathic giant esophageal ulcer in a kidney transplant recipient. A 37-year-old female presented with a one-week history of odynophagia and weight loss. Upon admission, the patient presented cold sores, and a quantitative cytomegalovirus polymerase chain reaction was positive(105 copies/ml). An upper endoscopy demonstrated the presence of a giant ulcer. Serological test and tissue biopsies were unable to demonstrate an infectious origin of the ulcer. Immunosuppression was reduced and everolimus was introduced. An empirical i.v. therapy with acyclovir was started, resulting in a dramatic improvement in symptoms and complete healing of the ulcer. Only two cases of idiopathic giant esophageal ulcer in kidney transplant recipients have been reported in the literature; in both cases, steroid therapy was successful without recurrence of symptoms or endoscopic findings. However, this report suggests that correction of immune imbalance is mandatory to treat such a rare complication.

关键词： Acyclovir Gastrointestinal complications Kidney transplantation Endoscopy Steroid Idiopathic

Metabolic syndrome and prostate abnormalities in male subjects of infertile couples

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Asian Journal of Andrology 2014年第2期16卷 295-304,I0011页

作者： Francesco Lotti Giovanni corona Linda Vignozzi Matteo Rossi Elisa Maseroli Sarah Cipriani Mauro Gacci Gianni Forti Mario Maggi Sexual Medicine and Andrology Unit Department of Experimental and Clinical Biomedical Sciences University of Florence Florence Endocrinology Unit Maggiore-Bellaria Hospital Bologna Department of Urology Careggi Hospital University of Florence Florence Italy

No previous study has evaluated systematically the relationship between metabolic syndrome （MetS） and prostate-related symptoms and signs in young infertile men. We studied 171 （36.5 ±8.3-years-old） males of infertile couples. MetS was defined based on the National Cholesterol Education program Third Adult Treatment panel. All men underwent hormonal （including total testosterone （TT） and insulin）, seminal （including interleukin-8 （IL-8）, seminal plasma IL-8 （sIL-8））, scrotal and transrectal ultrasound evaluations. Because we have previously assessed correlations between MetS and scrotal parameters in a larger cohort of infertile men, here, we focused on transrectal features. prostate-related symptoms were assessed using the National Institutes of Health Chronic prostatitis Symptom Index （NIH-CpSI） and the International prostate Symptom Score （IpSS）. Twenty-two subjects fulfilled MetS criteria. In an age-adjusted logistic ordinal model, insulin levels increased as a function of MetS components （Wald = 29.5, p〈 0.0001） and showed an inverse correlation with TT （adjusted r = -0.359, p 〈 0.0001）. No association between MetS and NIH-CpSI or IpSS scores was observed. In an age-, TT-, insulin-adjusted logistic ordinal model, an increase in number of MetS components correlated negatively with normal sperm morphology （Wald -- 5.59, p〈 0.02） and positively with slL-8 levels （Wald = 4.32, p〈 0.05）, which is a marker of prostate inflammation, with prostate total and transitional zone volume assessed using ultrasound （Wald = 17.6 and 12.5, both p〈 0.0001）, with arterial peak systolic velocity （Wald = 9.57, p= 0.002）, with texture nonhomogeneity （hazard ratio （HR） = 1.87 （1.05-3.33）, p 〈 0.05）, with calcification size （Wald = 3.11, p 〈 0.05）, but not with parameters of seminal vesicle size or function. In conclusion, in males of infertile couples, MetS is positively associated with prostate enlargement, biochemical （slL8） and ultrasound-derived signs of prostate inflammation but

关键词： infertile men interleukin-8 metabolic syndrome prostate-related symptoms and sisns semen analysis transrectal ultrasound