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Receptor targeted imaging using prostate specific membrane antigen (PSMA)-a labeled radioisotope currently plays a key role in prostate cancer imaging. This is due to the overexpression of PSMA, a type II Tran's membrane protein, in prostate cancer cells. Gallium-68 and fluorine-18 labeled PSMA are currently available for positron emission tomography/ computed tomography (PET/CT) imaging for the diagnosis, staging, treatment planning and follow-up of prostate cancer.In this case report we discuss a 70 year old male who presented with progressively rising serum prostate-specific antigen (PSA) levels. Three prostate biopsies performed at different time points were negative and failed to provide a histological diagnosis. 68Ga-PSMA PET/CT was subsequently requested to guide biopsy and appropriately stage the disease. PSA level at the time of imaging was 39ng/ml. Uptake was demonstrated in the left posterior-lateral aspect of the prostate gland (SUVmax=15.27), identifying the target biopsy site for histological confirmation of the diagnosis of prostate cancer (Figure 1).Unusual uptake was also noted in a right axillary lymph node (SUVmax=6.18). Biopsy of this lymph node confirmed Hodgkin’s Lymphoma (Figure 2&3).This clinical case demonstrates the non-specific nature of PSMA in prostate cancer, despite its name. We would like to advise caution in the interpretation of distant nodal uptake sites on 68Ga-PSMA PET/CT imaging for the diagnosis and/or staging of prostate cancer.

High quality post-abortion care (PAC) is needed to curb maternal deaths by providing effective treatment and preventing future unintended pregnancies through PAC family planning. This study aimed at assessing PAC services with a focus on women's satisfaction with care they received in two health facilities in Conakry. We conducted a cross-sectional mixed method study with 426 PAC clients from March 1 to August 31 , 2014. Data analyses were performed using Stata software version 14 for quantitative data and using a thematic approach for qualitative data. Overall, 92.5% of women were satisfied with PAC services they received. The short waiting time (30 min), the appropriate management of pain during the treatment, the affordable cost of the treatment, the confidentiality of services, the good patient-provider interaction and the cleanliness of the premises were factors statistically significantly associated with the satisfaction of women (P-value ˂ 0.001). This study showed a high rate of women's satisfaction. Nevertheless, health authorities should assure a regular follow-up on the application of official prices for the treatment of PAC patients; and providers should further consider aspects such as pain management during treatment, confidentiality of services, patient-provider interaction for optimal satisfaction of clients with PAC services.

Background: Significant TR is common in patients with cardiac disease and because of its prognostic importance, TV came to the spotlight in the last decades. Functional TR is mostly treated when undergoing left-sided valve surgery, whereas idiopathic TR surgery is uncommon. The aim of this study is to compare the durability of tricuspid valve annuloplasty techniques, and to explore the optimal method for TV repair surgery. Methods: 1005 patients who underwent tricuspid valve repair from February 2012 to March 2019, were retrospectively studied. The patients had tricuspid valve repair while receiving surgery for other cardiac conditions. The study population was divided into Suture group (n=483, 48.1%), and Ring group (n=522, 51.9%). Data variation between and within the groups was analyzed with Mann-Whitney U test, Wilcoxon rank-sum test, and Radit analysis. Results: At two-year follow-up, in the Suture group, none/trace TR subjects were 63.9%, and 1.4% had severe TR; In the Ring group were: 63.9% none/trace, and 0.6% severe. Both groups’ two-year follow-up TR status was significantly different with preoperative TR status (p0.05). Conclusions: Both annuloplasty techniques have good short-term outcomes. However, suture annuloplasty deteriorates faster than ring annuloplasty, making the latter to be the ideal technique for TV repair.

In Italy a national Plan for the surveillance of imported and autochthonous human vector-borne diseases (chikungunya, dengue, Zika virus disease and West Nile virus (WNV) disease) that integrates human and veterinary (animals and vectors) surveillance, is issued and revised annually according with the observed epidemiological changes. Here we describe results of the WNV integrated veterinary and human surveillance systems in Italy from 2008 to 2015. A real time data exchange protocol is in place between the surveillance systems to rapidly identify occurrence of human and animal cases and to define and update the map of affected areas i.e. provinces during the vector activity period from June to October. WNV continues to cause severe illnesses in Italy during every transmission season, albeit cases are sporadic and the epidemiology varies by virus lineage and geographic area. The integration of surveillance activities and a multidisciplinary approach made it possible and have been fundamental in supporting implementation of and/or strengthening preventive measures aimed at reducing the risk of transmission of WNV trough blood, tissues and organ donation and to implementing further measures for vector control.

Following a large West Nile virus (WNV) epidemic in northeastern Italy in 2008, human and animal surveillance activities were implemented in Emilia Romagna. Human surveillance was performed by serology or genome detection on blood and cerebrospinal fluid for all suspected cases suffering from acute meningoencephalitis in the regional territory. Animal surveillance consisted of passive and active surveillance of horses and active surveillance of wild birds and mosquitoes. Between 15 June and 31 October 2009, nine of 78 possible cases of West Nile neuroinvasive disease were confirmed (three fatal). From May to October, 26 cases of neurological West Nile disease were confirmed among 46 horses. The overall incidence of seroconversion among horses in 2009 was 13%. In 2009, 44 of 1,218 wild birds yielded positive PCR results for WNV infection. The planned veterinary and entomological surveillance actions detected WNV activity from the end of July 2009, about 2-3 weeks before the onset of the first human neurological case. Passive surveillance of horses seems to be an early and suitable tool for the detection of WNV activity, but it will be less sensitive in the future, because an intensive programme of horse vaccination started in June 2009.

In recent years an increase in vector-borne disease activity has been recorded in different regions. The epidemiology of such diseases is conditioned by complex interactions among environment, parasite, vector, man and eventually animal – either domestic or wild – reservoir. Global warming together with the increase of transport of goods, animals and people travels are impacting the risk that exotic species, both of insects and parasites, enter and establish in new territories. For these reasons a regional surveillance program focused on vectored diseases was implemented in Emilia-Romagna. The aim of the project is to create a regional surveillance and risk assessment system based on a multidisciplinary network, with the capability of collecting data about both vector populations dynamics, and possible presence of pathogens in vectors, men and animals. It has therefore been constituted a working group, coordinated by the General Direction for Health and Social Policy of the Emilia-Romagna Region, composed by physicians, veterinarians and entomologists. Activities have been addressed to the activation of an entomological monitoring system for key vectors, to the development of diagnostic procedures of selected zoonosis, to the predisposition of a training program. Because it is endemic in Emilia-Romagna Region, Leishmaniasis has been selected to test the system. After only two months from its constitution, the working group had to manage the Chikungunya epidemic occurred in Ravenna and Cervia municipalities during summer of 2007. After only 15 days from the reporting of the first human cases, it has been possible to perform the diagnosis, isolating the virus from the vector (Aedes albopictus), to define a reporting system of clinical suspects and diagnostic procedures in man. In the same time an intensive vector control program was carried out in infected areas. The timing organization of a multidisciplinary network focused on vector diseases surveillance and control is producing important positive output in terms of managing capacity of epidemic situation and risk assessment

Negli ultimi anni si è assistito ad un aumento degli episodi e degli allarmi connessi a malattie trasmesse da artropodi vettori, tra le quali infezioni virali (West Nile Disease, Bluetongue) e patologie protozoarie (Leishmaniosi), che rivestono un particolare interesse per la sanità pubblica. I cambiamenti climatici ed il contemporaneo aumento della movimentazione di merci, animali e degli spostamenti di persone, hanno incrementato la possibilità che specie esotiche di insetti e agenti patogeni entrino e si stabiliscano nel nostro territorio. Per tale motivo si è ritenuto necessario progettare e sviluppare un sistema regionale di sorveglianza in grado di rispondere adeguatamente a problematiche presenti e potenziali. Obiettivo del progetto è quello di creare un sistema regionale di sorveglianza tramite una rete interdisciplinare che fornisca, da un lato, informazioni sulle popolazioni (presenza e dinamica di popolazione) dei vettori potenziali e riconosciuti di agenti patogeni e dall’altro controlli, attraverso opportune indagini di laboratorio, la presenza di agenti patogeni nella popolazione dei vettori, degli animali domestici e umana. E’ stato quindi costituito un gruppo di lavoro, coordinato dalla DG Sanità e Politiche Sociali della Regione Emilia-Romagna, composto da medici, veterinari ed entomologi operanti sia sul territorio, sia in strutture di ricerca e sperimentazione. Le attività sono state indirizzate all’attivazione di un sistema di sorveglianza entomologica per alcuni vettori; allo sviluppo di metodiche diagnostiche per la rilevazione di arbovirus agenti di zoonosi; alla predisposizione di un percorso formativo, indispensabile alla costituzione di una rete di operatori sanitari addestrati alla gestione di un sistema di sorveglianza. E’ stata inoltre selezionata la leishmaniosi come item per lo sviluppo di sistema pilota. Disporre in loco di una rete di competenze multidisciplinare ha permesso, a solo due mesi dall’avvio del progetto, di gestire con successo l’epidemia di Chikungunya che si è verificata in Romagna durante l’estate 2007. A soli 15 giorni dalla segnalazione dei primi casi umani è stato possibile eseguire la diagnosi, isolando il virus dall’insetto vettore (Aedes albopictus), predisporre un sistema di segnalazione dei sospetti clinici e di conferma diagnostica dei casi umani, effettuare programmi di disinfestazione localizzati alle aree infette che hanno permesso di controllare ed estinguere in tempi relativamente rapidi l’epidemia.