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Learning objectives Background Findings and procedure details Conclusion Personal information References, Learning objectives: To describe the typical magnetic resonance (MR) imaging findings of the different stages of the acute arterial spinal cord ischemic...

Aims and objectives Methods and materials Results Conclusion Personal information References, Aims and objectives: Aneurysms of the visceral arteries are rare, but can have a high mortality in case of rupture. 1 The frequency of these aneurysms is unclear; the best data available come from autoptic studies, ranging 0.019 to 17.3%. 2 Aneurysms of the...

Learning objectives Background Findings and procedure details Conclusion Personal information References, Learning objectives: To understand and to recognise the possible complications of Endovascular Abdominal Aortic Aneurysm Repair...

INTRODUZIONE: Abbiamo pensato di effettuare uno studio che indagasse circa la presenza delle citochine nell’albuginea di soggetti affetti da malattia di La Peyronie. Le citochine, in quanto responsabili della comunicazione intercellulare, potrebbero essere coinvolte nella patogenesi della malattia. L’individuazione di una o più citochine responsabili potrebbe, infatti, risultare utile nel trattamento farmacologico grazie ai c.d. farmaci biologici, in grado di interferire con le citochine. MATERIALI E METODI: Per lo studio sono stati reclutati tra gennaio 2009 e dicembre 2010 presso l’Ambulatorio di Chirurgia Andrologica del Policlinico di Palermo 20 soggetti affetti da malattia di La Peyronie (fig. 1) e 8 soggetti affetti da recurvatum penis congenito, questi ultimi adoperati come controllo. Come criteri di inclusione allo studio abbiamo considerato i criteri di operabilità con corporoplastica secondo Nesbit. I prelievi bioptici ottenuti dalle losanghe escisse in corso di intervento chirurgico sono stati utilizzati per saggiare l’espressione genica, attraverso Real-Time PCR, di citochine pro-fibrotiche e pro-infiammatorie. Inoltre sono stati sottoposti dopo fissazione ad esame istologico con la colorazione ematossilina-eosina. RISULTATI E DISCUSSIONE: L’esame istologico ha rilevato l’assenza di cellule infiammatorie in tutti i pazienti recensiti per lo studio. L’analisi dell’espressione dei geni codificanti per IL-4 (Interleuchina-4), IL-6 (Interleuchina-6), IL-13 (Interleuchina-13), TGF-β1 (Trasforming Growth Factor - β1), IL-2 (Interleuchina-2), IL-10 (Interleuchina-10), TNF-α (Tumor Necrosis Factor- α) e IFN-γ (Interferone- γ) ha evidenziato in tutti i campioni un livello molto basso di trascritti e in alcuni casi indosabili (fig. 2). Inoltre i livelli dei trascritti delle citochine prese in esame sono risultati minori nei campioni provenienti dagli individui affetti da malattia di La Peyronie rispetto ai controlli. CONCLUSIONI: Alla luce dei risultati ottenuti, l’utilizzo di farmaci biologici (anticorpi) contro le citochine non sembra essere applicabile nella fase stabile della malattia di La Peyronie

Scopo del lavoro Abbiamo condotto uno studio randomizzato a singolo cieco con gruppo sham per valutare gli effetti terapeutici della TECAR terapia su 96 pazienti affetti dalla malattia di La Peyronie (IPP) vista l’efficacia di questo trattamento sulle patologie fibrose. Materiali e metodi Novantasei pazienti affetti da IPP randomizzati con rapporto 2:1 sono stati suddivisi in 2 gruppi: gruppo trattato e gruppo sham. Abbiamo valutato l’efficacia TECAR sul dolore, sul grado di incurvamento penieno e sul deficit erettile (DE) al termine del trattamento ed a 1 (FU1) e 3 (FU3) mesi dal termine del trattamento mediante l’utilizzo della scala VAS per il dolore e di questionari specifici per l’IPP e per il DE (IIEF-5). Risultati Si è registrata una riduzione statisticamente significativa del dolore nel gruppo già al termine del trattamento in 48 (75%) dei pazienti (p

association between obesity and prostate cancer, yielding inconsistent results. Metabolic syndrome has been suggested to promote aggressive prostate tumors. In a previous study we failed to detect a relation between Body Mass Index (BMI) and prostate cancer Gleason score (1). BMI, although routinely adopted to measure obesity, has low sensitivity and specificity. A novel sex-specific obesity index, based on waist circumference (WC), BMI, triglycerides (TGs) and high density lipoproteins (HDL), the Visceral Adiposity Index (VAI), has been proposed to estimate the visceral adiposity dysfunction (2). The aim of our preliminary research was to correlate VAI and BMI with the presence of prostate cancer and the Gleason score at biopsy. Patients and Methods: Patients, undergoing prostate biopsy for palpable prostate nodule and/or elevated PSA levels, entered the study. After informed consent a transrectal prostate biopsy, 12 cores at least, was performed. The number of cores increased in rebiopsies (18-24 cores). A database including clinical, biochemical and pathological data was created. Prostate cancer detection at biopsy, Gleason score (6 or less versus 7 or higher), VAI, BMI and PSA values were statistically analyzed with Wilcoxon rank sum test. Results: Fifty-one patients were evaluated. The median age was 66 years (range 47-80). Two patients (3.9%) had a previous negative biopsy. The median BMI was 27.7 kg/m2 (range 18.7-40) and the median VAI was 4.4 (range: 1.6-15.6). Median PSA was 8.5 ng/ml (range 3.2- 53). A prostate nodule was palpable in 9 (17.6%) patients. The median prostate volume was 48 cc (range: 14-106). A prostate cancer was detected in 24 (47%) patients, with a Gleason pattern 6 in 14 (58.3%) patients and 7 or higher in the remaining 10 (41.7%). Among patients with positive prostate biopsy, median PSA BMI and VAI were 10.2 ng/ml, 27.8 Kg/m2 and 5.8, respectively. Among patients with negative prostate biopsy, median PSA BMI and VAI were 7.0 ng/ml, 26.8 Kg/m2 and 5.5, respectively. Only PSA levels were slightly related to biopsy positivity (p-value=0.08), no difference was detected for VAI (p-value=0.89) and BMI (pvalue= 0.19). Median PSA, BMI and VAI resulted 9.2 ng/ml, 27.8 Kg/m2 and 5.6, respectively in patients with Gleason score of 6 or less, and 10.9 ng/ml, 27.7 Kg/m2 and 5.8, respectively, in patients with Gleason score >6. Even in this case PSA levels were slightly related to prostate cancer aggressiveness (p-value=0.12), while no difference was highlighted for VAI (p-value=0.6665) and BMI (pvalue= 0.6394). Discussion and Conclusion: The identification of patients harboring an aggressive prostate cancer remains an important goal. The contradictory results on the relation between obesity and prostate cancer could be due to the low accuracy of BMI as a marker of metabolic syndrome. VAI has been recommended as an accurate indicator of adipose tissue activity. Nevertheless, our preliminary results do not detect any significant correlation between VAI, BMI, positivity of prostate biopsy and Gleason score

Premature Ejaculation (PE) is a sexual dysfunction that concern 20-30% of the male population. Dapoxetine is a new serotonine re-uptake inhibitor (SSRI)specific for PE treatment.Aim of the study is to assess compliance and effectiveness of the treatment with dapoxetine compared to the treatment with citalopram (a classic SSRI used to treat PE).

Introduction/Aim: Numerous clinical trials investigated the association between obesity and prostate cancer, but they yielded inconsistent results (1). Obesity has been found to be related to prostatic tumors at more advanced stages and higher Gleason grade when compared with normal population (2). An increased number of biopsy cores has been advocated by some Authors in obese and overweight men due to an increased difficulty and delay in cancer detection (3). The main aim of our research was to correlate Body Mass Index (BMI) with the pathological characteristics of prostate cancer at biopsy. Patients and Methods: Patients with positive prostate biopsy performed for palpable prostate nodule and/or elevated PSA levels were considered in the present study. A transrectal prostate biopsy procedure, not less than 12 cores, was performed. The number of specimens was increased in case of re-biopsy (18-24 cores or more). After informed consent, a database has been created, including clinical and pathological data: demographics, PSA, digital rectal examination, transrectal ultrasound and prostate cancer features at biopsy. Patients were divided into four categories according to their BMI as follows: 16-19,9 (underweight), 20.0-24.9 (normal weight), 25.0-29.9 (overweight) and ≥30.0 (obese). The statistical analysis was conducted with Fisher’s exact test for Gleason pattern 4 (