Are insulin resistance and non-alcoholic fatty liver disease associated with Peyronie's disease? A pilot study.

Risk factors for Peyronie's disease (PD) are serum lipid abnormalities, hypertension and type 2 diabetes mellitus (T2DM). Oxidative stress and inflammation are key-players in the pathogenesis of arterial diseases, leading to insulin resistance (IR), which is a major determinant of non-alcoholic fatty liver disease (NAFLD). We studied the potential relationship between PD, IR, and NAFLD. Forty-nine male patients were enrolled, fulfilling the well-accepted diagnostic criteria of stable PD. Fifty male individuals without PD, well-matched for age and BMI, were selected as the control group. Comorbidities (T2DM and hypertension), as well as the lipid profile and the glucometabolic asset, were evaluated. The triglycerides/HDL ratio (TG/HDL-C ratio) with a cut-off of ≥3 and the triglycerides-glucose index (TyG) with an optimal cut-point of 8.5 were used for diagnosis of IR and NAFLD, respectively. NAFLD diagnosis was confirmed by the presence of bright liver at ultrasonography. Hypertension was found more frequently in PD patients than in no-PD subjects (P=0.017), independently of age (P=0.99). Both IR and NAFLD were significantly associated with the presence of PD in our population of men (P=0.043 and 0.0001, respectively), no matter how old (P=0.11 and 0.74, respectively). At logistic regression, NAFLD was the only predictor of the PD presence (p=0.021). The AUROC of TyG to predict PD was 0.7437 (sensitivity 67.35% and specificity 80%) with a percentage of correctly classified patients of 73.74%. Oxidative stress markers were significantly associated with NAFLD. Testosterone level was significantly low in the subjects with NAFLD in cross-sectional analyses. Both factors, i.e., oxidative stress and hypogonadism, are central to PD pathogenesis. In conclusion, NAFLD and IR are strongly associated with PD. The pathogenic link between these conditions and the underlying mechanisms are only hypothetical and thoroughly summarized in the discussion.

Chronic frontal sinus disease: combined use of platelet-rich plasma and calvarial bone grafts for sinus obliteration in aggressive and secondary cases.

INTRODUCTION: The surgical management of chronic frontal sinusitis can be challenging. The most effective way to treat this condition is sinus obliteration. Several methods have been published. We evaluated the feasibility of a combined treatment, consisting of platelet-rich plasma (PRP) and autologous calvarial bone chips, in chronic frontal sinus diseases (CFSD). PATIENTS AND METHODS: From January 2001 to June 2006, seven patients (four women and three men) were admitted presenting with signs and symptoms of CFSD. Their ages ranged from 35 to 67 years. Two patients presented with signs of frontal osteomyelitis and a cutaneous fistula, while endoscopic drainage had failed for five patients. All patients were treated by sinus obliteration though bicoronal access. Free autologous calvarial bone graft combined with PRP was used to repair the frontal sinus. RESULTS: The frontal sinus repair was successful in all seven patients with progressive resolution of symptoms without perioperative complication. The CT scans at 12 postoperative months showed complete obliteration of sinuses. DISCUSSION: Combined PRP and autologous bone graft is a safe and reliable procedure for frontal sinus obliteration. The low rate of complications and the absence of donor site morbidity support using this technique in secondary and particularly complex cases.

A locally aggressive solitary fibrous tumor of the leg: Case report and literature review.

INTRODUCTION: The solitary fibrous tumor (SFT) is a rare soft tissue tumor with a substantially benign clinical behavior. However, malignant neoplasms with local recurrence or distant metastases have been reported. PRESENTATION OF THE CASE: The authors present a case of an aggressive SFT of the leg, in a 55 years old Caucasian man. Radiological, histological and molecular findings are reported. The differential diagnosis, therapy and outcome of this rare tumor are also discussed. DISCUSSION: An extensive review of literature showed SFT's clinical behavior as substantially benign, anyway aggressive or malignant neoplasms have been described. The potential risk of local recurrence and distant metastasis thus suggests wide surgical resection and careful long-term follow-up. Differential diagnosis may be quite laborious as SFT can mimic a variety of benign and malignant mesenchymal tumors; immunohistochemical analysis for CD34, CD99, vimentin and bcl-2 is then mandatory. CONCLUSION: Our clinical experience confirmed that SFT may have an aggressive behavior, however, conservative surgical treatment may be successful in the long term.