Endocrinology


Curriculum vitae

 

Alessandro Marsili

I graduated with honors in medicine and surgery from the University of Pisa in 2000 and again in Pisa in 2005, I specialized in Endocrinology and Metabolic Diseases at the prestigious school then directed by Prof. Aldo Pinchera. From 2007 to 2011 I perfected my education in the United States, at Harvard Medical School in Boston, under the guidance of Prof. Reed Larsen. Subsequently I continued to carry out my clinical and research activity both within the Endocrinology Department of the University of Pisa and as a freelancer, with particular clinical and research interest aimed at the study of thyroid pathologies and obesity (and relationships between them). I am the author of over 30 original articles in international scientific journals reviewed on PubMed. I am a member of national and international scientific societies: Italian Society of Endocrinology, Italian Society of Obesity; Former Alumni Endocrinology Association of Pisa, European Thyroid Association, Endocrine Society. I participated as a speaker at national and international conferences. I have received research awards from the Endocrine Society, the Harvard Medical School, the Italy Thyroid Association, the Tuscany region.

Insights

Main pathologies treated

Thyroid

  • Hypothyroidism
  • Hyperthyroidism
  • Thyroiditis of Hashimoto
  • Subacute thyroiditis
  • Basedow's disease
  • Thyroid nodules
  • Thyroid tumors

Obesity

  • From overweight to severe obesity
  • Metabolic syndrome
  • Ketogenic diet-VLCKD
  • Pharmacological therapy of obesity
  • Preparation for bariatric surgery
  • Bariatric post-surgical management 

Insulin resistance and type II diabetes mellitus

  • Pathologies of phospho-calcium metabolism
  • Hyperparathyroidism
  • Hypoparathyroidism
  • Osteoporosis
  • Adrenals
  • Adrenal adenomas
  • Cushing
  • Feocromocitona
  • Addison's disease and hyposurrenalism
  • Hyperandrogenism
  • Acne
  • Hirsutism
  • Alopecia
Endocrine pathologies in pregnancy
  • Disorders of the menstrual cycle
  • Polycystic ovary syndrome
  • Amenorrhea
  • Early menopause
  • Menopause

Pathologies of the pituitary gland
Changes in growth and development

Ultrasound of the neck

Neck ultrasound is an instrumental investigation that, through the use of ultrasound, allows to evaluate in a non-way invasive soft parts such as the thyroid gland, the parathyroid glands,
salivaries and lymph node stations.
It is used in particular for the study of the thyroid gland, whose position, size, appearance is detected, the presence or absence of structural inhomogeneity or solid nodules or
cystic, vascularization. Through ultrasound you can also highlight the presence of increased parathyroid glands in volume, which can lead to suspicion of hyperparathyroidism primitive. It is also used for the evaluation of lymph nodes of the cervical / supraclavicular district that can
change size and structure during infections,
inflammations and oncological diseases.
The exam takes place after positioning the patient supine on the table ultrasound and after having freed the neck from clothes and objects
metal so that the ultrasound probe can be placed directly on the skin.
It's a examination lasting a few minutes, for which it is not needed specific preparation and that anyone can perform (including women in
pregnancy and children) because it does not involve any risk.

Eco-guided needle aspiration of the thyroid and lymph nodes

Needle aspiration Thyroid is a minimally invasive outpatient procedure that serves confirm or rule out the malignant nature of a lump.
Consists inserting a very thin needle in the front of the neck using the ultrasound guide, to take a sample cytological (i.e. cellular material or small quantities of liquid) from the lesion in question.
The exam is performed by the endocrinologist on thyroid nodules later an accurate anamnestic, clinical and ultrasound evaluation (or possibly scintigraphic).
It's a few minutes procedure, which anyone can undergo and for which no specific preparation is needed, however Temporary suspension of therapies is advisable abasis of anticoagulant drugs.
There puncture can cause slight discomfort, like a normal one injection. In some cases, pain may be felt behind in the ear, due to the connections between the nerves. In any case the pain sensation is limited to the time of execution
survey. If it continues, common analgesics are enough for alleviate it.
For carry out the examination of the needle-guided ultrasound, the patient comes made to lie on his back on the ultrasound bed, with the head extended. After skin disinfection, it comes
positioned the ultrasound probe with which it will be possible to follow the advancement of the needle up to the nodule that must be studied.
The needle is then introduced, mounted on a syringe that allows aspiration of thyroid cells.
The material extracted with the aspirated needle is swiped on slides and sent to the Pathological Anatomy service, for analysis at microscope of collected cells.
After the exam applies an ice pack on the neck for about 15 minutes. At that point you can resume normal activities.
There is no need to be accompanied because it is almost risk-free. In a small percentage of cases small hematomas within the thyroid gland may form, which they can be slightly annoying, but they reabsorb spontaneously in a few days and can be prevented by the addition of ice or relieved by common painkillers.
Not there is no long-term risk. The belief that the needle can helping to disseminate malignant cells in the body has been scientifically proven wrong.

For appointment and info send an e-mail to Dr. Marsili