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Aims. Evaluation of (hc knowledge and behavioral risks relatcd lo sexually transmiltcd infections (STIs) among the student population of the degree course in nursing at the University of Palermo. Materials and Methods. An anonymous online a survey was provided to students that investigate to socio-demographic information. sexual habits and the level of knowledge of the STIs. Multivariable logistic regression was performed. considering it as a dependent variable "Do you permanently have unprotected sex (without a condom)? Yes", in order to evaluate the role of the variables of the questionnaire. Results are expressed as adjusted Odds Ratio (aOR). Results. The sample size consists of 405. The average age of the sample is 21.65 years (standard deviation±3.24). The analysis shows that the risk of having permanently unprotected sex (without condom) is significantly associatcd with the following variables: "Are you engaged or single? Engagcd" (aOR 3.24,95% CI 1.66 - 6.33); "Sexual orientation. Homosexual or Bisexual (aOR4.45, 95% CI 1.30-15.29); "Have you occasionally had unprotected sex (without a condom)? Yes" (aOR 5.09, 95% CI 2.69 - 9.62); "How would you define your knowledge of sexually transmitted discases? Good" (aOR 2.07, 95% CI 1.05 -4.08); "How would you define your knowledge about contraceptive methods? Good" (aOR 2.51, 95% CI 1.23 - 5.15); "Have you or have you ever had a sexually transmitted discase? Yes (aOR 4.43,95% CI 1.71 - 11.53); "Do you know that men can also undergo HPV vaccination? Yes" (aOR 2.57,95% CI 1.03 -6.40); "Age. As the unit inercase" (aOR 1.14,95% CI 1.02- 1.26). Conclusions. These results highlight the importance of involving university students in programs aimed at improving the knowledge in terms of STIs and inercase of Sexual and reproductive health. Further. because STIs prevention is based mainly on human behavior. tailored intervention is needed especially because behavior change remains a complex challenge.

Introduction. Vaccines are one of the most successful and cost-effective public health interventions of modern times. This cross-sectional study investigated the perception of vaccinations and potential risks of adverse events following immunization among nursing students. Materials and Methods. An anonymous, self-administered questionnaire was distributed to students undertaking a nursing degree course at the University of Palermo. This questionnaire consisted of three sections: the first part focused on socio-demographic information; the second part contained one question regarding the terms associated with vaccination; and the third part posed a question regarding adverse reactions after immunization. A multivariable logistic regression model was used and adjusted Odds Ratios will be presented in this paper. Results. The sample consisted of 403 students and the mean age was 22.0 years (±3.0). Having considered the dependent variable “Have you ever had adverse reactions after being vaccinated? Moderate-severe”, the statistically-significant independent variables were: the second (adjusted Odds Ratios 0.32) and third (adjusted Odds Ratios 0.18) years of study, the nursing students perceiving their economic and health status to be low (adjusted Odds Ratios 3.52 and 15.92 respectively). The following items from questionnaire were found to be associated with the term vaccination: “I associate the term vaccination with fear” (adjusted Odds Ratios 4.98) and “I do not associate the term vaccination with fighting illnesses” (adjusted Odds Ratios 10.02). Conclusions. Although vaccines are generally safe if used correctly, no vaccination is completely risk-free. There was a general awareness of adverse events following immunization among nursing students in this study. The future healthcare workers have been identified as the most important information source regarding potential solutions in a rapidly evolving health scenario in fighting vaccine hesitancy.

Bone sarcoma; Clinical guidelines; Latin-America context Sarcoma óseo; Guías clínicas; Contexto latinoamericano Sarcoma ossi; Guies clíniques; Context llatinoamericà Bone sarcoma are infrequent diseases, representing < 0.2% of all adult neoplasms. A multidisciplinary management within reference centers for sarcoma, with discussion of the diagnostic and therapeutic strategies within an expert multidisciplinary tumour board, is essential for these patients, given its heterogeneity and low frequency. This approach leads to an improvement in patient’s outcome, as demonstrated in several studies. The Sarcoma European Latin-American Network (SELNET), aims to improve clinical outcome in sarcoma care, with a special focus in Latin-American countries. These Clinical Practice Guidelines (CPG) have been developed and agreed by a multidisciplinary expert group (including medical and radiation oncologist, surgical oncologist, orthopaedic surgeons, radiologist, pathologist, molecular biologist and representatives of patients advocacy groups) of the SELNET consortium, and are conceived to provide the standard approach to diagnosis, treatment and follow-up of bone sarcoma patients in the Latin-American context. The authors would like to thank the SELNET project, which has received funding from the EU Horizon 2020 research and innovation programme (grant number 825806).

Background: Violence in the workplace is now universally recognized as a significant global public health issue and is one of the most serious issues affecting the healthcare sector. Objectives: To assess the prevalence of workplace violence. Methods: We performed a multicenter cross-sectional study using an anonymous questionnaire submitted to doctors from Northern Italy. The survey investigates socio-demographic information, the number of years of work in the health sector and the physical and verbal aggressions that occurred in the workplace in the last 12 months. Results: The sample consists of 4545 healthcare workers, of whom 2603 (57.27%) are females. The mean age of the sample is 49.79 years (SD ± 12.63). The risk of being victim of physical aggression at work in the last 12 months is significantly associated with the following independent variables: male gender (aOR 2.09, 95% CI 1.51-2.88), work in the public sector (aOR 2.57, 95% CI 1.72-3.85), being victim of verbal aggression at work in the last 12 months (aOR 22.52, 95% CI 10.97-46.20), work in the operational units of the Medical area (aOR 2.36, 95% CI 1.33-4.21) and the Territorial area (aOR 1.97, 95% CI 1.04-3.74). Discussion: The prevalence of violent behaviour is difficult to assess, because violent incidents are underreported or unreported. The results of the study suggest that increased awareness is necessary to develop effective control strategies at individual, hospital and national levels.

Introduction. The purpose of this study was to ascertain the determinants of nursing students’ compliance with flu vaccination. Methods. In this cross-sectional study, an anonymous paper ques- tionnaire was administered to students attending the 3-year nurs- ing course at the University of Palermo. Adjusted Odds Ratios (aOR) are presented. Results. 403 nursing students (65% female) completed the ques- tionnaire (response rate 98.5%). The average age of the respond- ents was 22.0 years (SD ± 3.04). The dependent variable: “In the next season, do you intend to be vaccinated against flu? Yes”, displayed a statistically significant association with the follow- ing independent variables: “year of study: second” (aOR 2.66), “year of study: third” (aOR 1.72), “Perceived health status: medium-high” (aOR 6.61), “Did you get vaccinated against sea- sonal flu last year? Yes” (aOR 22.47). Conclusions. Although nursing students are not yet health pro- fessionals, they spend part of their time in health facilities for their clinical training and will be the health workers of the future. Involving nursing students in influenza vaccination campaigns can also help them take better care of themselves and their patients., Journal of Preventive Medicine and Hygiene, Vol. 61 No. 4 (2020): 2020614

Introduction: The aim of the study was to evaluate the knowledge, attitude and practices towards Sars-CoV-2 among nursing students of University of Palermo during the rapid rise period of the COVID-19 pandemic. Materials and Methods: This is cross-sectional study. A survey was provided to all nursing students and consisted of two parts: demographics and Knowledge, Attitude and Practices (KAP) survey. A multivariate linear regression model was used and adjusted Odds Ratios (aOR) are presented. Results: 575 students were interviewed and their mean age was 22.3. The overall score indicates good knowledge (p=0.046) and good practices among the four courses of study (p=0.038). Multivariate linear regression showed that Attitude score (ẞ=-0.29; p=0.024) and Knowledge score (ẞ=0.10; p=0.026) adjusted for age, gender, year of study, perceived economic status, perceived health status were significantly associated with Practice score. Conclusion: Our results suggest that proper health education is useful for encouraging optimistic attitudes and maintaining safe practices among future category of nurses., Journal of Preventive Medicine and Hygiene, Vol. 62 No. 2 (2021): 2021622

Introduction. The role of vaccinations is widely acknowledged. However, over the last decades, an alarming reduction in immunization coverage and a rising number of reported cases of vaccine-preventable diseases have been recorded. This multicentre cross-sectional study aimed at examining whether there is an association between self-reported vaccination knowledge and the immunization behaviour of Health Sciences students. Methods. A cross-sectional study was performed, using a validated questionnaire. A multivariate logistic regression with stepwise backward selection process with a univariate p-value

INTRODUCTION: Gambling disorder is recognized as a psychiatric disorder. It is shown that the prevalence of pathological gambling is on the rise among university students, especially involving students attending the nursing degree course. The aim of the study was to estimate the prevalence of gambling's problem and to analyze the associated factors in the population of nursing students at the University of Palermo. MATERIAL AND METHODS: It's a cross-sectional study. In April 2019, a self-administered, anonymous and voluntary questionnaire was provided to students who attend daily lessons of the 3-years nursing degree course of University of Palermo, after they gave informed consent. The questionnaire investigates on socio-demographic information, year of study, the perception of the economic and health status, alcohol use disorders and gambling problems. RESULTS: The average age of the sample is 22.0 years (standard deviation ±4.3), 67.6% of the interviewees are women. The analysis shows that the risk to be "Player at risk/Moderate gambling problems/Serious game problems" is significantly associated with the following independent variables: male gender (aOR 5.15); "Do you live with your family? No" (aOR 2.98); "perceived health status: low" (aOR 2.51); "Risky consumption of alcohol: At Risk" (aOR 3.40). CONCLUSIONS: It is important to develop an effective gambling prevention program that will reduce the risk that youths will develop gambling problems. Participation in the prevention program significantly improves youths' attitudes and knowledge regarding gambling activities.

Introduzione. Un tempo "barboni", oggi senzatetto, il loro numero sta aumentando considerevolmente negli ultimi anni. Molti di loro soffrono di malattie croniche, problemi di salute mentale, dipendenze e necessitano di cure mediche complesse. Il loro stato di salute è spesso esacerbato per maggiori difficoltà nell'accesso alle cure primarie rispetto alla popolazione generale. Materiali e Metodi. È stato distribuito un questionario autosomministrato al fine di valutare le condizioni di salute dei senzatetto che vivono a Palermo. È stato utilizzato un modello di regressione logistica multivariata calcolando gli Odds Ratios aggiustati (aOR). Risultati. Il campione è costituito da 52 senzatetto, di cui 35 (67,3%) maschi. La classe di età più rappresentativa (55,8%) ha un'età inferiore a 50 anni e l'88,5% è italiano. L'analisi ha mostrato che il sesso femminile è significativamente associato a: "non svolgere attività fisica regolare" (aOR 4.14, IC 95% 1,20 - 14,32, p=0,025), ad "avere malattie croniche" (aOR 3,52, IC 95% 1,02 - 12,11, p=0,046) e "ad assumere farmaci" (aOR 3,95, IC 95% 1,14 - 13,64, p=0,030). Conclusioni. La rilevanza e la complessità della situazione sociale dei senzatetto attira l'attenzione su questo fenomeno destinato ad avere un forte impatto sulle politiche e sui servizi sanitari. Questa fragile popolazione è esposta a malattie che sono in gran parte prevenibili o curabili attraverso un ampio e precoce accesso alle cure con conseguente riduzione del peggioramento degli esiti clinici e dei relativi costi sociali. Introduction. In Italy, as in the rest of the world, the number of homeless people is increasing considerably. Many of them suffer from chronic conditions, mental health problems and addiction to alcohol, drugs or smoking, and need complex medical care. Their health status is often exacerbated by greater difficulty in accessing primary care. The aim of the present study was to assess health conditions of homeless people living in Palermo, Southern Italy, and to find ways to limit the spread of common infectious diseases that can be prevented by vaccination. Materials and Methods. A self-administered questionnaire was distributed. The questionnaire was structured into two parts including an introduction with socio-demographic information, and a second part investigating health status, chronic diseases and vaccinations. A multivariable logistic regression model was used and adjusted Odds Ratios (aOR) are presented. Results. The sample consisted of 52 homeless, 35 (67.3%) of whom were male and the most represented age class (55.8%) was < 50 years of age. The average age of the sample was 49.6 years (SD ± 15.2) and 88.5% were born in Italy. A multivariable logistic regression model based on 52 observations was used. The analysis showed that the female gender was significantly associated with: not performing regular physical activity (aOR 4.14, 95% C.I. 1.20 - 14.32, p = 0.025), suffering from chronic diseases (aOR 3.52, 95% C.I. 1.02 - 12.11, p = 0.046) and taking medicines (aOR 3.95, 95% C.I. 1.14 - 13.64, p = 0.030). Conclusions. This particularly fragile population is exposed to diseases that are largely preventable or curable through a wider and more early access to care by local health facilities with a subsequent reduction in the worsening of clinical outcomes and related social costs.

The primary aim of this study was to evaluate the temporal correlation between Wikitrends and conventional surveillance data generated for measles infection reported by bulletin of Istituto Superiore di Sanità (ISS). The reported cases of measles were selected from July 2015 to October 2018. Wikipedia Trends was used to assess how many times a specific page was read by users, data were extracted as daily data and aggregated on a weekly and monthly basis. The following data were extracted: number of views by users from 1 July 2015 to 31 October 2018 of the Morbillo, Vaccinazione del Morbillo, Vaccinazione MPR and Macchie di Koplik pages (Measles, Measles Vaccination, MPR Vaccination and Koplik’s spots in English). Cross-correlation results were obtained as product-moment correlations between the two time series. Regarding the database with monthly data, temporal correlation was observed between the bulletin of ISS and Wikipedia search trends: the strongest correlation was at a lag of 0 for Measles (r=0.9164), Measles Vaccination (r=0.8622), MPR Vaccination (r=0.7852) and Koplik’s spots (r=0.8217). Regarding the database with weekly data, both moderate and strong correlation was observed. A possible future application for programming and management interventions of Public Health is proposed.

Introduction. The primary aim of this study is to evaluate the temporal correlation between Google Trends and the data on measles infection arising from the conventional surveillance system, reported by the Istituto Superiore di Sanità's (ISS) bulletin. Moreover, this study is also aimed at forecasting the trends of the reported infectious diseases cases over time. Materials and Methods. The reported cases of measles were selected from January 2013 until October 2018. The data on Internet searches have been obtained from Google Trends; the research data referred to the first 48 weeks of year 2017 have been aggregated on a weekly basis. The search volume provided by Google Trends has a relative nature and is calculated as a percentage of query related to a specific term in connection with a determined place and time-frame. The statistical analyses have been performed by using the Spearman's rank correlation coefficient (rho). The statistical significance level for such analyses has been fixed in 0.05. Outcomes. We have observed a strong correlation at a lag of 0 to -4 weeks (rho > 0.70) with the cases reported by ISS with the strongest correlation at a lag of -3 weeks (rho > 0.80 both for measles than for the symptoms of the measles). The database containing monthly data has shown a moderate correlation at a lag of -1 to +1 months and a strongest correlation at a lag of -1 (rho = 0.6152 for measles and rho = 0.5039 for symptoms of the measles). Conclusion. The surveillance systems based on Google Trends have a potential role in public health in order to provide near real-time indicators of the spread of infectious diseases. Therefore the huge potential of this approach could be used in the immediate future as a support of the traditional surveillance systems.

Introduction. Influenza is an infectious disease with a high burden, for which a safe and efficacy vaccine is available. However, vaccination coverage is generally low, also among Health Care Workers (HCW). Health Professions students are comparable to HCW in terms of workplace exposure. Aim. The study aim was to identify predictive factors of flu vaccination acceptance among Italian students of Health Professions. Methods. A cross-sectional study was performed using a validated, on-line, anonymous questionnaire. Data were analyzed performing both univariable and multivariable logistic analysis. Results. The results showed a statistically significant association between intention to vaccinate next year and: geographical distribution, considering themselves at higher risk due to their profession, having been vaccinated last year, having recommended the vaccination last year, and being willing to recommend it next year and being favorable to mandatory vaccination. In conclusion, identifying an effective vaccination strategy and including students in flu vaccination campaigns might have positive effect on vaccination acceptance.

Background. The aim of the study was to evaluate in the Italian smokers, the effects of implementation of the law about Pictorial Health Warnings (PHWs) on tobacco products.Methods. A quasi-experimental longitudinal design was conducted between 2016 and 2017. The data were collected before (pre-PHW/Wave 1) and after (post-PHW/Wave 2) the implementation of the law. The adopted questionnaire included impact of advertisement (Label Impact Index, LII), quitting behavior and knowledge of tobacco related diseases.Results. 455 respondents completed both the Waves. 7.7% of smokers declared to have stopped smoking in Wave 2 and 29% of these declared the PHWs as one of the reasons to quit. The knowledge of tobacco related diseases was significantly (p < 0.001) increased from Wave 1 to Wave 2 (58% versus 72%), similarly the LII (mean = 26.9, SD = 16.7 and mean = 40.4, SD = 16.2).Conclusion. Tobacco addiction is a problem that needs to be addressed from different angles. PHWs confirm their complementary role as a support for smokers along with other strategies such as text warnings and the tobacco quit line of the Istituto Superiore di Sanita (Italian National Institute of Health) reported on the packages. Nonetheless, over the years these measures have been not enough and policy makers should consider more strategies synergistically acting in the fight against tabagism.

Aim. Evaluation of the knowledge and behavioral risks related to sexually transmitted infections (STIs) among the students at the University of Palermo. Materials and Methods. Cross-sectional study. An anonymous online questionnaire has been submitted to the students of Palermo University. Survey investigates to socio-demographic information, sexual habits and the level of knowledge of the STIs. Results. The sample consists of 539 students; average age 22.65 (± 2.95). The risk to have unprotected occasional sexual intercourse is related to the following circumstances: the homosexual or bisexual status, the male gender, the age of the occurrence of the first sexual intercourse, that is at 17 year or earlier and the circumstance to have contracted a sexually transmitted infection during life. Conclusions. It is necessary to implement sexual education programs aimed at improving the knowledge in terms of STIs and increase of sexual and reproductive health. The findings presented should be interpreted with a degree of caution. Future studies are needed to as-sess the effectiveness and cost of education programs.

Introduction: The purpose of the study was to assess tobacco smoking habits among nursing students and how these are influenced by family members and cohabitants. Methods: Cross-sectional study. An anonymous papery questionnaire was administered to nursing students of the three-year course of the University of Palermo. Adjusted Odds Ratio (aOR) are presented. Results: 301 nursing students (63.12 % female) completed the questionnaire (response rate 61.17%). The average age of the sample is 21.88 years (SD ± 2.80). Considering as a dependent variable: “I currently smoke”, the statistically significant independent variables associated are: “Male gender” (aOR 2.09), “Single” (aOR 2.06), “Second year of study of the degree course in nursing” (aOR 0.46), “Third year of study of the degree course in nursing” (aOR 0.43), “Don’t think that warnings and pictures on cigarette packs can help stop smoking” (aOR 6.38), “Mother smoked in the past” (aOR 2.25) and “Brother or sister smoked in the past” (aOR 5.50). Conclusions: Students and graduate nurses need to be aware of current knowledge in the smoking cessation field and they have an influential role in modifying patient behavior in order to assist them to smoking cessation., Journal of Preventive Medicine and Hygiene, Vol 60 No 3 (2019): 2019603

Introduction. On the day of a workshop (named "Vaccino Day") on vaccinations, organized for the students of the University of Palermo by the ERSU (Regional Office for the Right to University Study), the sample of students were given a questionnaire to fill out. The aim of the survey was to investigate the perception of vaccinations on a sample population made up of university students. Materials and Methods. A self-administered paper questionnaire was given to participants of the workshop. The questionnaire is divided into 3 parts: demographic, economic and habits informations have been asked in the first part in the second part, they had to answer the question: "What term do you associate with vaccination?" in the third part, they were posed the question: "Have you ever had any adverse reactions after being vaccinated?". Therefore, the percentage response frequencies and the statistically significant Odds-Ratio (aOR) are presented with a corresponding 95% confidence interval (CI). Statistical analysis was performed using the STATA® 14 software. Results. A total of 350 students were asked to participate and the response rate was 100%, the 61.43% of the interviewed population was made up of females. Taking into account the dependent variable: "at least a moderate-severe adverse reaction after a vaccination" the statistically significant independent variables associated are "Have fear of side effects" (aOR 7.06, 95% CI 1.73-28.57, p=0.006), "I associate the term "vaccination" to Needles/syringes" (aOR 3.82, 95% CI 1.08-13.48, p=0.037), "I associate the term "vaccination" to Protection" (aOR 3.50, 95% CI 1.02-11.98, p=0.046). Discussions and Conclusions. Vaccination is still influenced by emotional factors and lack of campaigns providing adequate information, therefore negative judgement tend to outweigh the real risks and benefits. Considering that the sample was composed of university students, being highly educated and capable of becoming opinion leaders in the future, there is a need to create a more efficient communication protocol that make the student, and then the citizen, better aware of the actual risks associated with vaccinations and their real benefits.

Aim. The aim of the study was to evaluate the knowledge and behavioral risks associated with sexually transmitted infections (STIs) among the students of health professions at the University of Palermo divided into two age groups (18-22 years and 23-27 years). Materials and methods. A self-administered questionnaire was distributed. The questionnaire is structured in three parts in addition to an introduction to socio-demographic information. The first part investigates the quality of information provided by public institutions on the subject, the second part the knowledge of contraceptive methods used to reduce the risk of contagion and the third part the knowledge of STIs and HPV vaccination. A multivariable logistic regression model was used and adjusted Odds Ratios (aOR) are presented. Results. The sample was represented by 1022 respondents (70.8% females, 61.5% aged 18-22 years). In multivariate analyses males have a greater risk of not knowing HPV vaccine (aOR 3.52, 95% CI 2.26-5.49). The 18-22 age group has a higher risk than the 23-27 age group to think of being not sufficiently informed to avoid contagion (aOR 3.92, 95% CI 2.18-7.06), never having STIs specific tests (aOR 2.90, 95% CI 2.21-3.80), not knowing HPV vaccine (aOR 1.86, 95% CI 1.13-3.07) and not knowing that it can be administered to males (aOR 2.63, 95% CI 1.96-3.53). Conclusions. Based on our findings, it is necessary to implement sexual education programs for the improvement of knowledge in terms of STIs and the promotion of health. Future studies are needed to assess the effectiveness and cost of education programs that should also be addressed to young adults who do not attend university.

Background Preclinical models that mimic pathological and molecular features of solitary fibrous tumour (SFT) represent an important tool to select effective regimes and novel compounds to be tested in the clinic. This study was aimed at developing two preclinical models of SFT, assessing their predictive value in the clinic and selecting potential novel effective treatments. Material and methods Two dedifferentiated-SFT (D-SFT) models obtained from patients' biopsies were grown in immunodeficient mice. The antitumour activity on these models of doxorubicin, dacarbazine (DTIC), ifosfamide (monotherapy or combination), trabectedin and eribulin was tested. Twelve SFT patients were treated with doxorubicin and DTIC. Response by RECIST, progression-free survival and overall survival were retrospectively evaluated, distinguishing malignant-SFT (M-SFT) and D-SFT. Results Two D-SFT patient-derived xenografts (PDXs) that represent the first available preclinical in vivo models of SFT were developed and characterised. Doxorubicin/DTIC, DTIC/ifosfamide, doxorubicin/ifosfamide combinations consistently induced better antitumour activity than the single-agents. Particularly, doxorubicin/DTIC combination caused a max tumour volume inhibition >80% in both models. Doxorubicin/DTIC combo showed activity also in the case-series. Best RECIST responses were: 6 responses (M-SFT = 2 of 7, D-SFT = 4 of 5), 1 stable disease, 5 progressions, with a 6-month median progression-free survival (M-SFT = 6, D-SFT = 10 months). The PDXs were very sensitive to trabectedin and eribulin. Conclusion Doxorubicin plus DTIC combination was effective in our two D-SFT mice models and appeared to be active also in the clinic, especially in high-grade D-SFT patients. Among additional drugs tested in the PDXs, trabectedin and eribulin were highly effective, providing a rational to test these drugs in D-SFT patients.

Background Cardiovascular diseases are the leading causes of mortality and morbidity in Western countries. The possible synergistic effect of poor adherence to a Mediterranean diet (MD) and other risk factors for acute myocardial infarction (AMI) such as hypertension, cholesterol, ever smoker, BMI> 25, diabetes, has not been deeply studied. Design Case-control study. Methods Patients with first AMI and controls from four tertiary referral Italian centers were screened for enrolment. Dietary information was collected through a questionnaire and a MD adherence score was calculated. Physical activity and smoking habits were also registered. The Synergy Index was calculated according to Rothman. Results 127 cases and 173 controls were enrolled. The analysis was conducted using a dichotomous variable for the MD score with values ≥7 representing good adherence. Multivariate analysis showed the following variables associated to AMI: ever smoker (OR = 2.08), diabetes (OR = 1.42), hypertension (OR = 2.08), hypercholesterolemia (OR = 2.47), BMI> 25 (OR = 1.99), while a protective effect emerged both in subjects scoring > 7 on the MD score (OR = 0.55) and in subjects resident of Southern Italy (OR = 0.38). A synergistic effect does exist between poor adherence to the MD and the following risk factors: hypertension, hypercholesterolemia, BMI >25, diabetes and being a resident in central and northern Italy. Conclusion Synergy between heart disease risk factors and MD underlines the need to enlarge the list of known modifiable cardiovascular risk factors to include and promote adherence to Mediterranean dietary habits.

Background: Neutropenia and its complications represent one of the principal dose-limiting toxicity issues in chemotherapeutic regimens for soft tissue sarcoma. Prophylactic granulocyte colony-stimulating factor (G-CSF) reduces the risk of febrile neutropenia (FN). The correct timing of G-CSF administration should be considered in order to optimize the prophylactic treatment. Patients and Methods: Patients (≥18 years old) affected by soft tissue sarcoma and treated with epirubicin and ifosfamide, underwent prophylactic treatment with G-CSF (lenograstim at 263 μg) from day 5 to day 9. The proportion of patients experiencing FN and G4 neutropenia was considered. Results: A total of 36 patients receiving three cycles of chemotherapy with epirubicin plus ifosfamide were treated. None developed FN; G4 neutropenia was reported in 17% of patients. No treatment delay or dose reduction was required, no antibiotic therapy was administered and no hospitalization occurred. Conclusion: Five-day lenograstim treatment is efficient as prophylaxis of FN for soft tissue sarcoma chemotherapy regimens and allows maintenance of chemotherapy dose intensity.

Objective: To test the hypothesis that some metalloproteinases (MMP-2, MMP-9) and inducible nitric oxide synthetase (iNOS) enzymes in dental pulp samples do not vary when subjected to orthodontic treatment. Materials and Methods: Human dental pulps were taken from male and female patients (N=10; age 10–14 years). A straight wire technique was used with nickel-titanium or steel archwires. The increase of pressure applied on teeth was gradual. Five patients were subjected to premolar extractions after 14 months of treatment and one after 24 months. Samples were Bouin-fixed, paraffin-embedded, and afterwards processed for immunohistochemistry using anti-MMP-2, anti-MMP-9, and anti-iNOS antibodies. Results: A reduction of MMP-2, MMP-9, and iNOS expression occurred in treated samples. This became more evident with increased treatment time. Conclusion: The hypothesis is rejected. The reduction of expression of those proteins revealed a time-dependent relationship.

BACKGROUND: Zika virus (ZIKV) is an arthropod-borne virus transmitted through infected mosquitos. The aim of this Italian nation-wide study was to evaluate general population's knowledge and attitudes towards ZIKV, its transmission, and travel-related preventive measures. METHODS: This cross-sectional study was conducted between July and August 2017, through a validated questionnaire. Predictors of knowledge were analysed through multivariate regression. RESULTS: Among 1119 respondents, 20% and 71% knew etiological agent and transmission route of ZIKV infection, respectively. Approximately 43% ignored the preventive measures to be taken after returning from endemic areas. At multivariate analysis, predictors of poor knowledge were age, living in Central or South Italy and Islands, being poorly educated, having never heard of or attended a travel clinic. CONCLUSIONS: This study captures an overall poor knowledge of Zika among general public. This research highlights the need of designing and implementing measures to improve travellers' awareness and protection against ZIKV.

Background: The medium-term and long-term impact of COVID-19 in patients with cancer is not yet known. In this study, we aimed to describe the prevalence of COVID-19 sequelae and their impact on the survival of patients with cancer. We also aimed to describe patterns of resumption and modifications of systemic anti-cancer therapy following recovery from SARS-CoV-2 infection. Methods: OnCovid is an active European registry study enrolling consecutive patients aged 18 years or older with a history of solid or haematological malignancy and who had a diagnosis of RT-PCR confirmed SARS-CoV-2 infection. For this retrospective study, patients were enrolled from 35 institutions across Belgium, France, Germany, Italy, Spain, and the UK. Patients who were diagnosed with SARS-CoV-2 infection between Feb 27, 2020, and Feb 14, 2021, and entered into the registry at the point of data lock (March 1, 2021), were eligible for analysis. The present analysis was focused on COVID-19 survivors who underwent clinical reassessment at each participating institution. We documented prevalence of COVID-19 sequelae and described factors associated with their development and their association with post-COVID-19 survival, which was defined as the interval from post-COVID-19 reassessment to the patients’ death or last follow-up. We also evaluated resumption of systemic anti-cancer therapy in patients treated within 4 weeks of COVID-19 diagnosis. The OnCovid study is registered in ClinicalTrials.gov, NCT04393974. Findings: 2795 patients diagnosed with SARS-CoV-2 infection between Feb 27, 2020, and Feb 14, 2021, were entered into the study by the time of the data lock on March 1, 2021. After the exclusion of ineligible patients, the final study population consisted of 2634 patients. 1557 COVID-19 survivors underwent a formal clinical reassessment after a median of 22·1 months (IQR 8·4–57·8) from cancer diagnosis and 44 days (28–329) from COVID-19 diagnosis. 234 (15·0%) patients reported COVID-19 sequelae, including respiratory symptoms (116 [49·6%]) and residual fatigue (96 [41·0%]). Sequelae were more common in men (vs women; p=0·041), patients aged 65 years or older (vs other age groups; p=0·048), patients with two or more comorbidities (vs one or none; p=0·0006), and patients with a history of smoking (vs no smoking history; p=0·0004). Sequelae were associated with hospitalisation for COVID-19 (p

Objective A cross-sectional study on knowledge, perceptions, and adherence to cervical cancer screening was conducted using telephone interviews of Sicilian women that were performed in 2016. This study aimed to identify areas that need to be addressed to improve the validity of data collection and to minimize possible biases. Methods We performed a qualitative study through SWOT analysis, which is a multidimensional method based on evaluation of Strengths (S), Weaknesses (W), Opportunities (O), and Threats (T) of the research project. The contents of the SWOT forms underwent categorical, inductive, and deductive data analysis using the long table analysis method. Results The full availability of an updated address and phone number list was the main organizational aspect to be addressed. Socio-cultural context played a major role for understanding the questions and for acceptability of the topics. In some cases, a family member was a facilitating element, while in others, the family member hindered the interviews. Active involvement of general practitioners was considered essential for success of the interviews. Conclusions When performing a cross-sectional survey, organizational aspects and active involvement of general practitioners are crucial in the enrolment phase, regardless of the socio-cultural context.

Background: COVID-19 and the policies to contain it have been a social problem and public health emer-gency for people in Italy in 2020. The aim of the study is assessing the prevalence of depression symptoms among nursing students from the University of Palermo during the COVID-19 pandemic. Materials and methods: The study employed a cross-sectional study design. On April 2020, a survey was performed including all the nursing students of the University of Palermo. The survey was structured into two parts. The first part consisted in the collection of socio-demographic information, the second in the administration of the QIDS-SR16 questionnaire. A multivariable logistic regression model was used to elaborate the results and adjusted Odds Ratios are presented. Results: The sample consisted of 525 students (70.3% female). The probability to have a moderate/severe/very severe depressive symptomatology is significantly associated with the following variables: "Female gender" (aOR 1.96), "Low perceived economic status" (aOR 2.32), "Low perceived health status" (aOR 2.30) and "To be a smoker" (aOR 2.24). Conclusions: The global pandemic and the efforts to contain it represent a unique event and offer the oppor-tunity to advance our understanding of how to provide mental health care focused on online psychoeducation and psychotherapy programs for young students.

Vaccine hesitancy (VH) is a complex and country-specific issue, responsible for the decreasing vaccination rate and subsequent spread of vaccine-preventable diseases. In literature, several questionnaires were developed to assess VH. The aim of this systematic review was to evaluate the published questionnaires assessing parental VH. The search was conducted in PubMed/Medline, Web of Science and The Cochrane Library, in December 2017, following the PRISMA guidelines. The search strategy included 4 types of keywords: parents, vaccine hesitancy/acceptance, immunization and survey. Only English and Italian original papers were included. 17 reviewers independently screened titles and abstracts. Only the included articles were downloaded in full and, after a second screening, data were extracted and recorded in an ad hoc spreadsheet. A total of 5,139 articles were retrieved, after duplicates elimination 3,508 papers were screened. After a screening selection, 334 studies were included in the analysis. Most studies were cross-sectional (92.8%), followed by case-control (4.8%) and cohort studies (2.4%). The population interviewed was mainly parents, without any further details (73.1%); mothers were the only parent surveyed in approximately 20% of the studies, while only 1 study involved selectively the fathers. The sample size ranged from 7 to 59,897. Only 38% of the included studies reported both the number and type of items used. Regarding the type, more than half consisted of closed questions, followed by Likert scales, while open-ended questions were used in 14.8% of the surveys. Frequently, the survey was conducted using a self-reported questionnaire or interview. The questionnaires were mostly administered on paper, while online forms were used in 20.1% of the cases. However, 80.2% of the questionnaires were not attached to the paper. HPV vaccine was the most frequently investigated (39.2%), followed by influenza (13.5%) and measles (10.8%). While 22.4% of the articles referred to paediatrics vaccinations in general. Data about the immunization behaviours were reported in 294 studies: the subjects involved showed a behaviour defined as “acceptance” in 129 studies (38.6%), as “hesitancy/scepticism/doubt” in 145 studies (43.1%) and as “refusal” in 22 studies (6.6%). This information was not reported in 12% of the studies. VH is still a public health challenge, as confirmed by the high number of studies and questionnaires retrieved. This study offers a deeper perspec- tive on the available questionnaires, helping to identify the best one in terms of aim and study setting., Journal of Preventive Medicine and Hygiene, Vol. 61 No. 3 (2020): 2020613

The burden of pancreatic cancer varies greatly across countries, with the number of deaths, incident cases, and disability-adjusted life years more than doubling in recent years, and with high-income countries having the highest incidence and mortality rates. We conducted this systematic review with meta-analysis with the goal of summarizing the current evidence on dietary fiber intake and its role in reducing the risk of pancreatic cancer, given the importance of identifying risk factors. This systematic review followed the guidelines of the Cochrane Collaboration and the Meta-analysis of Observational Studies in Epidemiology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. The structured literature search was conducted on PubMed/Medline and Scopus, combining free text words and medical subject headings. Our review contained 18 records at the end of the process. Our results show that dietary fiber intake reduces the risk of pancreatic cancer. When the analysis was differentiated according to the type of fiber considered, sub-grouped by gender (reduction of around 60% among women), and when case-control studies were conducted, the strength of the association increased. Clinicians and policymakers should improve interventions to raise the population’s awareness regarding the consumption of high-fiber diets, both in practice and in terms of public health policy.

[Introduction] Desmoid tumour (DT) is a locally aggressive fibroblastic proliferative disease representing the most common extraintestinal manifestation of familial adenomatosis polyposis (FAP). As data on the activity of chemotherapy in these patients are limited, we examined the outcomes of patients treated with low-dose methotrexate (MTX)+vinca alkaloids (vinorelbine or vinblastine)., [Patients and methods] We retrospectively reviewed clinical and outcome data from all patients with confirmed FAP-associated DTs treated with weekly MTX+vinca alkaloids in seven European sarcoma reference centres between January 2000 and December 2018. Radiological responses were assessed using RECIST V.1.0 and V.1.1. The Kaplan-Meier method associated to the log-rank test was used to estimate and compare survival curves., [Results] We identified 37 patients (median age 29 years, range 7–44). According to RECIST, 20/37 (54.1%) patients achieved partial response (PR), 15/37 (40.5%) patients had stable disease and 2/37 (5.4%) had progressive disease as best response. Overall, the median progression-free survival (PFS) was 6.5 years (range, 0.3–12.1 years). In the subset of patients achieving PR as best response, the median PFS was not reached. In a subset of 11 patients with progressive disease offered MTX+vinca alkaloids rechallenge (after chemotherapy withdrawal following prolonged disease control), the disease control rate was 100%, resulting in a median PFS after rechallenge of 5.8 years., [Conclusions] This is the largest series on the activity of low-dose chemotherapy in patients with FAP-related DT. In this population, MTX+vinca alkaloids is an active combination, as already reported in patients with sporadic DT.

Introduction: Sexually transmitted diseases are an emerging problem especially among young people, increasing the burden of disease in this population. The aim of the study was to evaluate sexual habits, sexual relations and knowledge of STIs among the students in the nursing science course of the University of Palermo. Materials and Methods: In April 2019, a survey was provided to students that investigate on: personal information and habits, knowledge of sexually transmitted diseases, anti-HPV vaccination. Multivariable logistic regression was performed, considering it as a dependent variable “Have you occasionally had unprotected sex (without a condom)? Yes”, in order to evaluate the role of the variables of the questionnaire. Results are expressed as adjusted Odds Ratio (aOR). Results: 405 students completed the questionnaire. The mean age of the sample is 21.65 years, 69.63% of the interviewees are women. The multivariable logistic regression shows that the risk of having occasional unprotected sex (without condom) is significantly associated with “Do you permanently have unprotected sex (without a condom)? Yes” (aOR 4.46); “Have you ever received information on sex education and/or sexually transmitted diseases? No” (aOR 6.02); “Age Class

Background:Despite the free-of-charge offer of influenza vaccines to at-risk subgroups, vaccine coverage remains low and far from the target, probably due to the false myths and misperceptions. We aimed to explore the healthcare students’ vaccination behavior and beliefs to find any association between vaccination uptake during the last 5 years and future vaccination acceptance.Study design:A multicentre cross-sectional study.Methods:From Oct 2017 to Nov 2018, the Italian healthcare students from 14 different universities in 2017/2018 were enrolled, through an online and anonymous questionnaire previously validated. Absolute and relative frequencies were calculated and Pearson's Chi-square test was used. A multinomial logistic regression model was performed. Results are expressed as relative Risk Ratio (RR) with 95% Confidence Intervals (95% CI). The level of significance chosen was P-value Results:A total of 3137 students were enrolled and 3131 questionnaires were analysed. 82.7% of the sample declared they had not received any flu vaccination during the last 5 years. Students who received flu vaccination 4 times or more during the last 5 years were more likely to do it again next year as well (95.1% vs 4.9%). The regression model showed that having received flu vaccination over the last 5 years was statistically associated with the intention of getting vaccinated during next season.Conclusions:Frequency of flu vaccination is predictive for future acceptance among healthcare students. This association could have both implications for the organization of vaccination campaigns and improve educational strategies for this category of students.

he number of people travelling internationally increases year after year, mainly due to the more and more affordable cost of travelling and to the evergreater ease of transportation. Nowadays, any destination can be reached within 24 hours by plane, and the improvement of economic conditions facilitates both business and leisure travelling, as a matter of fact, according to data from the World Tourism Organization, the number of international trips is expected to increase by 3% to 4% per year.1 However, international travelling poses various health risks depending on travelers’ health conditions and the type of trip undertaken. Indeed, travelers may experience sudden changes in altitude, humidity, and temperature that can cause illness. Furthermore, serious health risks can result from poorquality housing, poor sanitary conditions, inadequate medical services, and the unavailability of drinking water. Potential risks strictly depend on the destination and the characteristics of the travel, and for this reason, anybody planning a trip should seek advice on the potential risks related to their destination and understand the protective measures needed to minimize the risk of contracting a disease. The risk of infection is linked to the epidemiology of the single country and to the different climatic conditions, which could expose travelers to etiological agents and vectors which are different from those which can be found in their countries of origin, but also to lower sanitary levels. Although doctors and tour operators can provide great help and good advice, it is crucial that travelers seek further information, understand the risks associated with travelling, and take the necessary precautions during their journey in order to travel safely. New technologies and application for smartphone (also known as app) might help more and more in promoting healthy behaviors.2 The greatest strength of health-related apps is that information is provided through channels already used by the citizen and perceived as “friendly.” Moreover, apps are a great way to communicate in “one-to-many” mode, in contrast to the standard “one-to-one” healthcare approach; this exponentially increases the quantity of educational content sent. Furthermore, by using the app, users produce new electronic data and make it available to researchers and policy makers, thus creating a new field of big-data-based research.3, 4 The aim of this study was to develop an applications for smartphones (“iViaggio: the travel app, traveling in safety”) (Figure 1), designed to provide information about the main risks associated with travelling, also taking into consideration the kind of trip (health risks related to environment, accidents, traumas, and violence, potential risks of infectious diseases).

Introduction. We aimed at carrying out a quantitative and qualitative analysis of claims for adverse events addressed to Palermo University Hospital Policlinico “Paolo Giaccone” in order to promote evidence-based interventions and increase patient safety. Methods. A retrospective study of 296 claims collected between 1st of January, 2014 and 31st of December, 2017 by Quality and Clinical Risk Management staff unit was performed along with descriptive analysis of any associated determinant factors. Results. The most frequent causes of claims consisted of wrong surgical procedures (33.8%), mistaken diagnoses (18.6%), falls (17.6%), infections (6.4%), postoperative complications (5.4%) and wrong therapies (3.1%). At the end of the survey, the judicial process was not concluded in the majority of cases (82.8%). Claims were closed by receipt payment in 12.2% of cases, without any payment in 5.1%. Conclusions. Clinical risk management plays a pivotal role in providing information and tools to prevent medical adverse events, avoid claims addressed to hospitals and improve the quality of health care. Evoluzione della gestione dei rischio clinico nel siste-ma sanitario: indagine sugli eventi avversi verificatasi nell'Azienda Ospedaliera Universitaria Policlinico “Paolo Giaccone” di Palermo.

Introduction. The internationally adopted child is a fragile subject who often shows an incomplete health documentation, which hinders the complete assessment of health status. Materials and Methods. Between January 2010 and June 2016, at the University Hospital "AOUP P. Giaccone" of Palermo, we reviewed the health documentations of 111 children recently arrived in Italy following the conclusion of the international adoption procedure. 62.2% of the children were male, of various nationalities and with an average age of 7 years (± 3.4). This study aims to detect, in the observed sample, the reliability of the vaccinal documentation and the real acquired immunization. We intend to estimate the presence of IgG against Measles, Mumps, Rubella and Hepatitis B viruses. Results. Percentages of subjects with a complete correspondence between documentation attesting the successful vaccination and the effective immunization were: 78% for measles, 66% for mumps, 84% for rubella, 71% for hepatitis B. Percentages of subjects without vaccinal documentation but with positive evidence of IgG were: 50% for measles, 38% for mumps, 71% for rubella, 50% for hepatitis B. Conclusion. The partial correspondence found between vaccinations performed and real immune status can be attributed to several reasons: poor reliability of the received health documentation, the complex economic situation of the health services in the countries of origin, the incorrect vaccines storage or the administration beyond the expiration date, the poor immunological response due to concomitant diseases or severe malnutrition, the probable non-administration of the expected booster dose. Particular attention needs to be paid to this population, which may represent a risk group susceptible to vaccine-preventable diseases.

During the university period, student wellbeing is exposed to the negative effects of many stressful factors, including the use and abuse of alcoholic beverages. The aim of this study is to estimate the risky alcohol consumption within the student population of the University of Palermo.An anonymous online questionnaire was provided to students enrolled in the mailing list of the Regional Agency for the Right to University Study (ERSU) of the University of Palermo. the first section investigated demographic and social data, while in the second section the A.U.D.I.T. C (Alcohol Use Disorders Identification Test-Consumption) test was administered.539 subjects agreed to the informed consent and completed the questionnaire. The average age of the sample is 22.65 years (SD ± 2.95). Considering as dependent variable "students with risky consumption of alcohol", the statistically significant independent variables associated were: "age class ≤22 years old" (aOR 2.02, 95% CI 1.18-3.44, p=0.019), "don't live with own family" (aOR 3.21, 95% CI 1.81-5.69, p0.001) and "I currently smoke" (aOR 6.44, 95% CI 3.85-10.79, p0.001).The results of the study show that about 19% of students experience risky alcohol consumption. This percentage seems not to be gender related. Information and training campaigns focused on alcoholism and related risks are of great importance in order to educate students on the socio-economic costs of alcohol related diseases to public health; parents can play a crucial role in minimising the use of alcohol in their sons/children through dialogue if properly trained to address these issues. In fact, our study seems to show that those who no longer live in the household have a higher risk of alcohol consumption.

To correlate the level of oxidative stress in serum and seminal fluid and the level of sperm deoxyribonucleic acid (DNA) fragmentation with sperm mitochondrial respiratory efficiency.Sperm mitochondrial respiratory activity was evaluated with a polarographic assay of oxygen consumption carried out in hypotonically treated sperm cells. A possible relationship between sperm mitochondrial respiratory efficiency, the level of oxidative stress, and the level of sperm DNA fragmentation was investigated.Sperm motility was positively correlated with mitochondrial respiration but negatively correlated with oxidative stress and DNA fragmentation. Interestingly, sperm mitochondrial respiratory activity was negatively affected by oxidative stress and DNA fragmentation.Our data indicate that sperm mitochondrial respiration is decreased in patients with high levels of reactive oxygen species by an uncoupling between electron transport and adenosine triphosphate synthesis. This reduction in mitochondrial functionality might be 1 of the reasons responsible for the decrease in spermatozoa motility.

Background To explore the activity of pazopanib in solitary fibrous tumour (SFT). Patients and methods In a preclinical study, we compared the activity of pazopanib, sorafenib, sunitinib, regorafenib, axitinib and bevacizumab in a dedifferentiated-SFT (DSFT) xenotransplanted into Severe Combined Immunodeficiency (SCID) mice. Antiangiogenics were administered at their reported optimal doses when mean tumour volume (TV) was 80 mm3. Drug activity was assessed as TV inhibition percentage (TVI%). From May 2012, six consecutive patients with advanced SFT received pazopanib, on a national name-based programme. In one case sunitinib was administered after pazopanib failure. Results In the xenograft model, pazopanib showed the lowest antitumour activity (21%TVI), while regorafenib was the most active (95%TVI). Sorafenib, bevacizumab, sunitinib were markedly active (78/70/65%TVI). Axitinib was marginally active (51%TVI). In the retrospective case-series, three patients carried malignant-SFT (MSFT), three DSFT. Best Response Evaluation Criteria in Solid Tumour (RECIST) responses were: three stable disease (SD), all MSFT, three progressive disease (PD), all DSFT, corresponding to one partial response (PR), two SD, three PD by Choi criteria. Median-progression-free survival was 3 months (range 1–15). In one patient, sunitinib was started after pazopanib failure, with a response. Conclusions In dedifferentiated-SFT xenograft pazopanib induced a marginal antitumour activity, while regorafenib appeared the most active and promising agent. When administered in patients, pazopanib showed a modest activity in terms of tumour growth stabilisation, observed only in non-dedifferentiated cases.

OBJECTIVE To correlate sperm mitochondrial respiratory efficiency with variations in sperm motility and with sperm morphologic anomalies. METHODS Sperm mitochondrial respiratory activity was evaluated with a polarographic assay of oxygen consumption carried out in hypotonically-treated sperm cells. A possible relationship among sperm mitochondrial respiratory efficiency, sperm motility, and morphologic anomalies was investigated. RESULTS Mitochondrial respiratory efficiency was positively correlated with sperm motility and negatively correlated with the percentage of immotile spermatozoa. Moreover, midpiece defects impaired mitochondrial functionality. CONCLUSION The results reported in this study support a strong and positive correlation between mitochondrial respiratory efficiency and sperm progressive motility. In addition and in strict agreement with these findings, morphologic alterations of the sperm midpiece, where mitochondria are found, are associated with lower mitochondrial functionality and lower sperm motility. These results confirm the important role played by mitochondria in supplying metabolic energy for sperm motility and provide more insights into the biochemical basis of mitochondria-based asthenozoospermia. On the other hand, the findings reported here open up new and interesting avenues of investigation in the case of semen samples from asthenozoospermic subjects, for which a more detailed investigation can be carried out at the level of single componente of the mitochondrial respiratory chain.

Full-term human umbilical cord contains three blood vessels: two arteries coiled around a vein and surrounded by Wharton’s jelly, a mucous tissue with few mesenchymal stromal cells and abundant extracellular matrix. Umbilical vessels lack innervations, thus endothelial cells must play a role in the control of blood flow. The aim of this study was to investigate in human umbilical cord the expression of five peptides that could be involved in the regulation of vascular tone: Orphanin FQ, Oxytocin, Atrial Natriuretic Peptide (ANP), endothelial Nitric Oxide Synthase (eNOS) and inducible Nitric Oxide Synthase (iNOS). The expression of these molecules in full-term human umbilical cord was investigated through immunohistochemistry and RT-PCR. Immunoreactivity for Orphanin FQ was detected in Wharton’s jelly, vessel musculature and endothelium; Oxytocin, ANP and eNOS were expressed by the umbilical epithelium, Wharton’s jelly and endothelium, whereas iNOS only by endothelial cells. RT-PCR analysis showed transcriptional expression of Oxytocin, ANP and eNOS mRNAs. The presence of Orphanin, Oxytocin, ANP, eNOS and iNOS proteins was identified in the human umbilical cord. mRNA expression for Oxytocin, ANP and eNOS suggest that these molecules are synthesized by umbilical cord cells themselves. The expression of these vasoactive molecules could be part of a general mechanism locally regulating vascular tone. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 2, pp. 211–218)

Cyclooxigenase (COX) is the rate-limiting enzyme for the conversion of arachidonic acid (AA) to prostaglandins (PGs). Two isoforms of COX have been identified: COX-1 is constitutively expressed in many cells and is involved in cell homeostasis, angiogenesis and cell-cell signalling; COX-2 is not expressed in normal condition however it is strongly expressed in inflammation. The oral cavity is costantly exposed to physical and chemical trauma that could lead to mucosal reactions such as hyperplasia, dysplasia and cancer. Early diagnosis is the most important issue to address for a positive outcome of oral cancer; therefore it would be useful to identify molecular markers whose expression is associated with the various stages of oral cancer progression. Since COX enzyme has been involved, with different mechanisms, in the development and progression of malignancies we decided to investigate the expression and localization of COX-1 and COX-2 in normal human oral mucosa and three different pathologies (hyperplasia, dysplasia and carcinoma) by immunohistochemistry and RT-PCR. COX-1 mRNA and protein have been detected already in normal oral mucosa and their expression progressively increases from normal samples towards hyperplasia, dysplasia and finally carcinoma. On the contrary, COX-2 is not expressed in the normal tissue, starts to be expressed in hyperplasia, reaches the maximum activation in dysplasia and then starts to be downregulated in carcinoma.

Soft tissue sarcoma (STS) is a heterogeneous group of neoplasms, encompassing >80 different histologic subtypes. Approximately three quarter of sarcoma arise from soft-tissue, about 15% are gastrointestinal stromal tumours (GISTs) and bone sarcoma represent the remaining 10%. The current guidelines will focus on soft-tissue and GIST, excluding Kaposi sarcoma and non-pleomorphic rhabdomyosarcoma