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The birth of the Degree in Dentistry in Italy has been very troubled, and only in 1980 saw its effective implementation. Very "instructive" in this regard is the history on the establishment in 1924 (the period of the seizure of power by Fascism) of a "National School of Dentistry" at the University of Rome, which was withdrawn after only ten months. The biggest supporter and proponent of the School, Prof. Angelo Chiavaro, after a few years, was "punished" with the transfer from the University of Rome to that of Genoa. We present some brief notes on the biography of this courageous pioneer and the matter of which he was the protagonist.

Background: Anaemia is a risk factor for death, adverse cardiovascular outcomes and poor quality of life in patients with chronic kidney disease (CKD). Erythropoietin Stimulating Agents (ESA) are the most used treatment option. In observational studies, higher haemoglobin (Hb) levels (around 11-13 g/dL) are associated with improved survival and quality of life compared to Hb levels around 9-10 g/dL. Randomized studies found that targeting higher Hb levels with ESA causes an increased risk of death, mainly due to adverse cardiovascular outcomes. It is possible that this is mediated by ESA dose rather than haemoglobin concentration, although this hypothesis has never been formally tested., Methods: We present the protocol of the Clinical Evaluation of the Dose of Erythropoietins (C.E. DOSE) trial, which will assess the benefits and harms of a high versus a low ESA dose therapeutic strategy for the management of anaemia of end stage kidney disease (ESKD). This is a randomized, prospective open label blinded end-point (PROBE) design trial due to enroll 900 haemodialysis patients. Patients will be randomized 1:1 to 4000 UI/week i. v. versus 18000 UI/week i. v. of epoetin alfa, beta or any other epoetin in equivalent doses. The primary outcome of the trial is a composite of cardiovascular events. In addition, quality of life and costs of these two strategies will be assessed. The study has been approved and funded by the Italian Agency of Drugs (Agenzia Italiana del Farmaco (AIFA)) within the 2006 funding plan for independent research on drugs (registered at www.clinicaltrials.gov (NCT00827021)).

The most original contribution made by the Italian School to the study of caries aetiology is undoubtedly the "trophomicrobic theory" proposed by Arturo Beretta, the first teacher of dentistry at the University of Bologna in 1918. This article brings biographical and bibliographical notes about Beretta (who was, among other things, Dean of the Faculty of Medicine of Bologna and Senator), and summarises the principles of his theory, which adds to Miller's "chemical-parasitic" theory of caries-predisposing properties of the enamel and host saliva. It also recalls the work of major Italian and non-Italian researchers who have used or modified Beretta's idea.

Cystic dysplasia of the testis (CDT) is a rare, benign and congenital lesion causing scrotal mass in pediatric population that can mimic testicular cancer. This lesion consists of cystic dilation of the rete testis and it is frequently associated with renal or genitourinary tract anomalies as renal agenesis and multicystic dysplasia of the kidney. This frequent presentation suggests that testicular cystic dysplasia is associated with a defect of the metamesonephric system in particular with a defect in the connection between the efferent ducts derived from the mesonephros and the rete testis tubules derived from the gonadoblastoma. The role of ultrasound is of primary importance for clinical diagnosis and follow-up of untreated forms. The sonographic appearance of CDT consists of multiple cysts in the mediastinum testis. The cysts range in size from microscopic to several millimetres and may involve the whole testicular parenchyma or have a focal aspect. If the cysts are tiny, the ultrasound must be able to distinguish between CDT and testicular microlithiasis, a potential premalignant condition. Today it is possible thanks to high frequency 7.5 to 10 mHz probes. In the past orchiectomy has been considered as the treatment of the choice for CDT. Today, non operative management of CDT represents an effective alternative option in these patients and the primary benefit of this approach is the preservation of endocrine function and spermiogenic activity. However, the natural history of untreated CDT and its effect on normal testicular tissue are still unknown, therefore long-term follow-up is recommended.

T1 G3 bladder carcinoma are classified as superficial tumours and treatment results are included in low stage tumour groups. A review of survival rates shows that there is a high risk of progression about 50-70%. The grade is by now considered the most significant prognostic factor and many other prognostic biological tests have been suggested. We treated 41 cases of T1G3 bladder tumours with a first therapeutic TUR and second staging TUR two months later. Subsequently a group of 15 has had "wait" and see" endoscopic follow-up with bad results, a group of 7 underwent "early cystectomy", a group of 12 has been treated with adjuvant cytotoxic chemotherapy with poor results on recurrence and good results on progression percentages, a group of 6 radiotherapy with poor results. We got confirmation of high risk of progression, 4 cases with high stage from beginning, 3 with precocious metastatic disease. Apart the cases with precocious metastases, the best survival rates are achieved with early cystectomy.

The results of anesthesia and perioperative assistance on a series of 84 patients who underwent since 1982 to 1990 a one-stage radical cystectomy and urinary diversion are reported. Reduction of the high risk of operation is particularly dependent on preoperative preparation, use of a safe anesthesia technique with continuous evaluation of vital signs, control of blood loss and use of low dose of heparin for prevention of venous thromboembolism. The complication rate was low, 7.1% for the early one, 16.6% for late one. General mortality of 5.9% is dependent on the high average age of the patients and on the fact all the cases were deeply invasive cancer.

The association between gastroesophageal reflux and respiratory disease is recognized long time ago. We can distinguish two kinds of asthma: asthma caused by a gastroesophageal reflux and asthma complicated by a gastroesophageal reflux. In the clinic evaluation it is important to establish the nature of reflux. It is essential to effect the Bernstein's test.

Pathologic findings in 25 autopsies of AIDS. The common and severe changes of the central nervous system, lungs, adrenals, heart, kidneys and gonads are reviewed in a series of autopsies of AIDS. In the brain, HIV infection induces directly inflammatory infiltrates including the typical multinucleated giant cells described by Sharer. In addition, primary lymphomas are seen as well as reactive and inflammatory lesions that are caused by opportunistic infections, such as those of poliomavirus, Cytomegalovirus and Toxoplasma gondii. In the lung, interstitial inflammation prevails, which may be related to direct HIV infection and include rare multinucleated giant cells like the ones described by Sharer. Opportunistic infections are often associated, and are commonly sustained by Cytomegalovirus and Pneumocystis carinii. A peculiar findings is the evolution from septal inflammation to fine fibrosis and hyaline degeneration, either focal or diffuse. We believe that the severe respiratory insufficiency that is commonly seen in the advanced stages of AIDS could be related to the interstitial damage. In the adrenal gland, the most common change is Cytomegalovirus infection affecting both the cortex and the medulla, and inducing massive necrosis in the cortex with little or no reaction. Again, adrenal involvement should be related to adrenal functional insufficiency, which may be over-looked clinically because of the preponderant lesions of other sites. In the heart, myocarditis is often discrete, and may be complicated by perivascular fibrosis and rare foci of myocytolysis; in some cases primary lymphomas may also develop. In the kidney, several histological lesions are found, including glomerular damage with segmental necrosis, cortical areas of hyporeactive necrosis, and mild interstitial inflammation. In the gonads, the changes are partly induced by drug abuse, and consist of atrophy with secondary hypoplasia of the germ cells and interstitial fibrosis. In conclusion, the most important abnormalities consist of opportunistic infections, hyporeactive necrosis, fibrotic evolution of the inflammatory infiltrates and neoplasias (Kaposi's sarcoma and lymphomas). In this work, the changes of the lymphoid organs are only mentioned, for they have been widely reviewed elsewhere.