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Abstract Background In Italy, HBV vaccination is recommended and offered free of charge through the National Health Service to selected population groups – e.g., family members of an HBsAg carrier, healthcare workers, newborns and those who were 12-years old in 1991. However, a significant proportion of cases of acute hepatitis B still occur in Italy among persons who should have been vaccinated. We analysed HBV sero-prevalence data of two vaccination target populations (people born after 1980 and household contacts of an HBV carrier) living in a southern Italian area in order to evaluate HBV vaccine coverage and its possible determinants. Methods Between 2003 and 2006, we carried out a cross-sectional, population-based, sero-epidemiological survey on HBV infection on 4496 randomly selected individuals (aged 20 years or more) from the general population of the province of Naples. Sera were tested for antibodies to hepatitis B core antigen (anti-HBc) and to hepatitis B surface antigen (anti-HBsAg) by commercial immunoassays. Prevalence of past or current HBV infection and of HBV vaccination-induced immunity was calculated in two vaccination target populations. To analyze the association of epidemiological and socioeconomic characteristics with HBV vaccination of household contacts, we calculated crude and multiple logistic regression (MLR) odds ratio (OR). Results Prevalence of HBV vaccine-induced immunity (anti-HBs alone) was much lower among household contacts (25%) than among those who had been targeted for universal adolescent vaccination (81.6%). Male sex, older age, unemployment and lower education levels were associated to lower immunization rates. Conclusion Understanding the different uptake of hepatitis B vaccination in these populations may provide useful information for optimizing vaccination campaigns in other contexts. Our data clearly demonstrated the need of improving the uptake of vaccination for household contacts of HBV carriers.

The efferent venous system of gills was examined by scanning electron microscopy and the vascular cast technique. The gill laminae showed a regular but complex architecture. The shape of the wall indicates some contractile activity, especially in second-order vessels. At high magnification the surface showed an unevenness, on the whole “wrinkled” for the presence of gibbosity and small fossae, probably due to the drawing in of cells of the vascular wall. The presence of pores, microvilli and vescicles suggests an exchange activity and exocytosis of the cellular components of the vessel wall. [ABSTRACT FROM PUBLISHER]

Angiomyolipomas (AML) are mesenchymal tumors of the kidney consisting of varying proportions of vascular, immature smooth muscle and mature fat cells. A rare case of testicular AML is described. A 53 year old male with a history of congenital motor defects, mental retardation, and hypertension, presented to the emergency room with sudden onset, severe left testicular pain. Scrotal sonography demonstrated an hypoechoic mass in the patient's left testicle. The patient was offered and underwent a trans-inguinal exploration of the left testicle which ended in a left inguinal orchiectomy. Pathologic examination of the mass revealed medium to large calibre thick-walled blood vessels with ectatic lumina, surround by sclerotic, fibrous smooth muscle bundles in a fatty milieu. Immunohistochemistry of the lesion demonstrated positive staining for smooth muscle actin (SMA+) and endothelial marker CD34. The lesion did not, however, stain positively for smooth muscle antigen S100 or melanocytic antigen HMB-45.

Introduction: Chronic benign prostate diseases are very common and certainly feature significantly in urological practice.The treatment of chronic benign prostate diseases is a common problem in clinical practice: few studies have been conducted in routine clinical practice to evaluate the efficacy of the treatments for this clinical condition. The objective of this study was to evaluate the efficacy of an extract of Serenoa repens (Permixon) in the treatment of lower urinary tract symptoms (LUTS) in patients with chronic benign prostate diseases with associated inflammation, also taking into consideration the influence of treatment on sexual function and, therefore, on patients' quality of life., Materials and Methods: All the 591 eligible subjects were evaluated on entering the study; after a screening visit, including medical history, physical examination, physical examination and digital rectal examination (DRE) and laboratory tests, the patients underwent uroflowmetry. The subjects under investigation were also asked to complete the IPSS, NIH-CPSI and IIEF-5 questionnaires, for the purpose of evaluating urinary symptoms and erectile function in relation to sexual activity in the previous 6 months., Results: The analysis of the uroflowmetry results showed that treatment with extract of Serenoa repens distinctly improves bladder voiding and lower urinary tract symptoms, as highlighted also by the improvement in the scores for the IPSS and NIH-CPSI questionnaires which serve as a basis for evaluating the urinary symptoms of patients with prostatic hyperplasia and chronic prostatitis respectively. The results also suggest that using an extract of Serenoa repens for 6 months in patients with chronic benign prostate diseases gives rise to an improvement in erectile function, as demonstrated by the increase in the scores for the IIEF-5 questionnaire after 6 months of treatment., Conclusions: The results of this study demonstrate how treatment for 6 months with an extract of Serenoa repens in routine clinical practice gives rise to a statistically significant improvement in Qmax values and in the IPSS, NHI-CPSI and IIEF-5 questionnaire scores, resulting not only in an improvement in urinary symptoms but also in an overall improvement in patients' quality of life.

Objective: Aim of this study was to evaluate if saturation biopsy (SB) technique increases the cancer detection rate in patients with PSA < 10 ng/ml, after a first negative biopsy., Material and Methods: From January 2004 to January 2006, 780 patients underwent prostate ultrasound guided transrectal (UGT) core biopsy: 186 (23.8%) presented prostate cancer (PCa) while 594 pts (76.2%), were disease free. For 1 year all the patients with no evidence of cancer were observed according to a follow-up schedule including PSA every 3 months and DRE every 6 months. During this period 140 patients showed an increase of PSA (< 10 ng/ml) or a low PSA free/total. This group underwent a second prostate UGT core biopsy with SB technique. In all the patients we evaluated PCa detection rates (DR) according to the PSA range. We also checked peri/post-operative complication rate (total post-operative hospitalization time, haemoglobin loss, catheterisation rate, pain rate, QOL)., Results: Of the 140 patients 50 (35.7%) had PCa showing a Gleason score (GS) of 4 or 5 in 26%, 6 or 7 in 75% and 8 to 10 in 9% respectively. Sectors apical biopsies carried out in the anterior horn of peripheral zone tissue presented over 70% (35 patients) of cancer detection rate. Rectal bleeding was the major common complication. Cancer was clinically significant in 47 patients (94%) but 34 (68%) presented an organ confined disease after radical surgery., Conclusions: SB technique increases of 35.7% the cancer detection rate (DR) in patients with PSA < 10 ng/ml, after a first negative biopsy, showing a higher positivity (70% PCaDR) if the SB included the anterior horn of peripheral zone tissue. No significantly pain and side effects were observed.

Objectives: With the advent of medical management and minimally techniques for benign prostate hypeplasia (BPH), invasive surgical procedures such open prostatectomy (OPSU) have become less common, although selected patients may still benefit from open prostatectomy. Aim of this study was to evaluate efficacy and safety of Bipolar TURP (Gyrus electro surgical system) versus standard open prostatectomy in patients with lower urinary tract symptoms (LUTS) due to bladder outlet obstruction (BOO) with markedly enlarged glands refractory to medical therapy., Methods: From January 2003 to January 2004, 140 patients affected by mild-severe LUTS, secondary to BOO from BPH, refractory to medical therapy, with markedly enlarged glands, were randomized in two groups (1:1), and subjected to open prostatectomy (OPSU) carried out with traditional method (Bracci Thechnique) versus transurethral resection of the prostate (TURP) utilizing the bipolar methodology. Preoperative work-up included IPSS, IIEF-5 and Qol questionnaires. All patients were submitted to uroflowmetry, transrectal ultrasound (TRUS), measurament of postvoidal residual urine and PSA determination. IPSS, IIEF-5 and Qol, uroflowmetry, TRUS, measurement of post-voidal residual urine, PSA determination and number of reoperations were evaluated at 1, 3, 6, 12, 18, 24, 30 and 36 months. Operative time, resected tissue weight and perioperative complications were also registered. Total post-operative catheter time, total postoperative hospital stay, haemoglobin loss were recorded in the 2 groups., Results: Comparative data on IPSS symptom score, IIEF-5 and Qol, PSA, peak urinary flow rates and post-void residual urine volume in the 2 groups were similar but showed a significative improvement with respect to baseline value. Postoperative haemoglobin levels, postoperative catheterization, hospital stay and 3-yr overall surgical re-treatment-free rate were significantly better in the Bipolar group., Conclusions: In the treatment of LUTS due to bladder outlet obstruction (BOO) with markedly enlarged glands refractory to medical therapy, Bipolar TURP has a comparable outcome to open prostatectomy at short and medium term according to both subjective and objective outcome measures.

Introduction: It is advisable to submit a patient with isolated HGPIN to re-biopsy every 3-6 months, performing an increasing number of samples in order to increase the detection rate. The aim of this study is to evaluate if the use of saturation needle biopsy technique may increase this rate., Materials and Methods: From January 2004 to June 2006, 780 patients with hypoecogenic nodule at TRUS and/or PSA values between 2.5 and 10 ng/ml, underwent TRUS 10-core prostate needle biopsy, performed by the same operator Isolated HGPIN was detected in 26 cases (3.3%). Within a year all these patients underwent saturation needle re-biopsy. This procedure consisted of 24 samples obtained using a tru-cut needle 18 G under soft anesthesia by a major opiate. All the patients received a single dose of Levofloxacin per os before the biopsy and for the following 2 days., Results: Prostate cancer was found in 8 (33.3%) of the 24 eligible patients: 40% showed a Gleason Score 6 and 60% > 7. Concerning PSA, we observed 35% of neoplasms for values between 2.5 and 3.9 ng/ml and the remaining 65.0% for values between 4.0 and 9.9 ng/ml., Conclusions: The use of saturation needle biopsy allowed to detect 30.8% of prostatic cancer performing the first re-biopsy within a year. This result does not differ from others obtained with 8-10 cores techniques, therefore the indication of the 24-cores procedure should be limited to carefully selected patients with a high risk of developing cancer after that other techniques had not been successful.

Background: In vitro studies have demonstrated that interleukin (IL)-1beta decreases insulin and DNA contents in pancreatic islet beta cells, causing structural damage, that it is toxic to cultured human islet beta cells and that it is able to induce apoptosis in these cells., Materials and Methods: Isolated rat islets of Langerhans were exposed in vitro to interleukin (IL)-1beta and either the imidazoline compound RX871024 (RX) or/and M40403, an Mn-containing superoxide dismutase mimetic (MnSODm)., Results: Insulin secretion, on days 1, 2 and 3 after challenge with 3 ng/ml of IL-1beta, was almost abolished and this was accompanied by an early increase in MnSOD activity. By days 2 and 3, SOD activities were lower than those of untreated controls and NO significantly increased by day 2. Moreover, IL-1beta induced a significant increase in MnSOD transcripts, while iNOS mRNA appeared by days 2 and 3 when MnSOD mRNA was absent. RX blocked all toxic effects of IL-1beta by maintaining insulin secretion and islet beta cell phenotype, including the inhibition of nonspecific proteins and of iNOS induction. In contrast, the MnSODm, failed to counteract iNOS induction as well as the reduced insulin secretion., Conclusions: In summary, our findings stress that IL-1beta-induced suppression of insulin secretion may be related to iNOS induction in beta cells and that RX can reverse this effect, by maintaining insulin secretion. Oppositely, the MnSODm is not able to restore IL-1beta-suppressed insulin secretion. Hence, imidazoline compounds may protect beta cells against damage caused by IL-1beta-induced free oxygen and nitrogen radicals.