Expression and distribution of key proteins of the endocannabinoid system in the human seminal vesicles.

The endocannabinoid system (ECS), comprising the cannabinoid receptors (CBR), their ligands, and enzymes controlling the turnover of endocannabinoids, has been suggested to be involved in male reproductive function. As information is scarce on the expression of the ECS in human male reproductive tissues, this study aimed to investigate by means of molecular biology (RT-PCR) and immunohistochemistry/immunofluorescence the expression and distribution of CB1 and CB2, GPR55 (an orphan G protein-coupled receptor that recognises cannabinoid ligands) and FAAH (isoforms 1 and 2) in the human seminal vesicles (SV). The specimens expressed PCR products corresponding to CB1 (66 bp), CB2 (141 bp), GPR55 (112 bp), FAAH1 (260 bp) and FAAH2 (387 bp). Immumohistochemistry revealed dense expression of CB1, CB2 and GPR55 located to the pseudo-stratified columnar epithelium and varicose nerves (also characterised by the expression of vasoactive intestinal polypeptide and calcitonin gene-related peptide). Cytosolic staining for FAAH1 and FAAH2 was seen in cuboidal cells of all layers of the epithelium. No immunoreactivity was detected in the smooth musculature or nerve fibres. CB1, CB2, GPR55, FAAH1 and FAAH2 are highly expressed in the human SV. Considering their localisation, the ECS may be involved in epithelial homeostasis, secretory function or autonomic mechano-afferent signalling.

Efficacy and safety of dapoxetine in treatment of premature ejaculation: an evidence-based review.

BACKGROUND: Premature ejaculation (PE) is a major issue in male sexual health, with a global prevalence estimated to be between 20% and 40%, making it the most common sexual dysfunction in men. PE causes distress and reduced quality of life for patients and has a negative impact on interpersonal relationships. Historically, it has been treated with cognitive therapy, behavioural methods and off-label use of selective serotonin reuptake inhibitors (SSRIs) usually used to treat depression and other psychological disorders. Dapoxetine is the only SSRI specifically designed to treat PE. MECHANISM OF ACTION: Dapoxetine hydrochloride is a potent inhibitor of serotonin reuptake transporters. Dapoxetine is suited for 'on-demand' treatment of PE because of its rapid absorption and short initial half-life. EFFICACY: Evidence from published studies showed that dapoxetine 30 mg or 60 mg taken 'on-demand' results in a significant increase in intravaginal ejaculatory latency time (IELT) when compared with placebo. Most patient-reported outcomes are clearly improved relative to placebo following dapoxetine therapy, indicating greater control over ejaculation, more satisfaction with intercourse, less ejaculation-related distress and significantly reduced interpersonal difficulties. SAFETY: The most common adverse events with dapoxetine are nausea, dizziness, somnolence, headache, diarrhoea and insomnia. Usually they do not lead to drug discontinuation. CONCLUSION: Dapoxetine is the only effective and safe available on-label oral treatment for PE, and its use can result in better quality of life for the patient and their sexual partner.

Metabolic syndrome in white European men presenting for primary couple's infertility: investigation of the clinical and reproductive burden.

Despite complex interactions between obesity, dyslipidemia, hyperinsulinaemia, and the reproductive axis, the impact of metabolic syndrome on human male reproductive function has not been analysed comprehensively. Complete demographic, clinical, and laboratory data from 1337 consecutive primary infertile men were analysed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (categorised 0 vs. 1 vs. 2 or higher). NCEP-ATPIII criteria were used to define metabolic syndrome. Semen analysis values were assessed based on the 2010 World Health Organisation (WHO) reference criteria. Descriptive statistics and logistic regression models tested the association between semen parameters and clinical characteristics and metabolic syndrome. Metabolic syndrome was found in 128 (9.6%) of 1337 men. Patients with metabolic syndrome were older (p < 0.001) and had a greater Charlson Comorbidity Index of 1 or higher (chi-square: 15.6; p < 0.001) compared with those without metabolic syndrome. Metabolic syndrome patients had lower levels of total testosterone (p < 0.001), sex hormone-binding globulin (p = 0.004), inhibin B (p = 0.03), and anti-Müllerian hormone (p = 0.009), and they were hypogonadal at a higher rate (chi-square: 32.0; p < 0.001) than patients without metabolic syndrome. Conversely, the two groups did not differ significantly in further hormonal levels, semen parameters, and rate of either obstructive or non-obstructive azoospermia. At multivariate logistic regression analysis, testicular volume (OR: 0.90; p = 0.002) achieved independent predictor status for WHO pathological semen concentration; conversely, age, Charlson Comorbidity Index scores, metabolic syndrome, and inhibin B values did not. No parameters predicted normal sperm morphology and total progressive motility. Metabolic syndrome accounts for roughly 9% of men presenting for primary couple's infertility. Although metabolic syndrome patients have a lower general male health status, semen analysis values seem independent of the presence of metabolic syndrome.

Lower urinary tract symptoms among Caucasian-European men who have sex with men: findings from a real-life survey.

BACKGROUND: Prevalence of and severity of lower urinary tract symptoms (LUTS) according to male sexual orientation have been scantly analysed. We aimed to assess the prevalence and severity of LUTS in a cohort of Caucasian-European men who have sex with men seeking medical help for uroandrologic reasons other than LUTS. METHODS: Data from 949 consecutive individuals in an outpatient setting were analysed. Severity of LUTS was measured with the International Prostate Symptom Score (IPSS). Men with storage symptoms scored 1-3 and ⩾ 4 (of 15), and voiding symptoms scored 1-4 and ⩾ 5 (of 20) were considered as having mild and moderate-to-severe symptoms, respectively. For individual symptoms, patients with scores ⩾ 1 were deemed symptomatic (according to Apostolidis et al.(15)). Descriptive statistics and logistic regression models tested the association between LUTS and sexual orientation. RESULTS: Complete data were available for 213 (22.4%) men who have sex with men (MSM) and 736 (77.6%) heterosexuals (mean age (s.d.): 41.0 (12.2) vs 39.9 (12.1) years). Compared with heterosexuals, MSM reported higher rates of total IPSS scores suggestive of moderate (21.6% vs 20%) and severe LUTS (3.8% vs 2.4%) (P=0.004). Similarly, MSM showed higher rates of mild (48.8% vs 45.2%) and moderate-to-severe (39.4% vs 30.4%) storage symptoms (all P<0.001), and of mild (45.1% vs 34.8%) and moderate-to-severe (20.2% vs 19.2%) voiding symptoms (all P<0.01). MSM status was an independent predictor of mild voiding symptoms (odds ratio (OR): 1.40; P=0.004), moderate-to-severe storage symptoms (OR: 1.40; P=0.04) and severe total IPSS (OR: 1.49; P=0.03), after adjusting for other variables. CONCLUSIONS: These findings suggest a higher prevalence and severity of LUTS in MSM compared with heterosexual men seeking medical help for uroandrologic reasons other than LUTS.

Óxido nítrico, GSTP-1 e p53: qual o papel desses biomarcadores nas lesões prostáticas do cão? / Nitric oxide, GSTP-1 and p53: what's the role of these biomarkers in dog´s prostate lesions?

Confeccionou-se um microarranjo de tecido (TMA) com 146 amostras de lesões prostáticas caninas. Este continha 17,2 por cento de hiperplasia prostática benigna (HPB), 32,4 por cento de atrofia inflamatória proliferativa (PIA), 2,6 por cento de prostatite, 8,6 por cento de focos de neoplasia intraepitelial prostática (PIN), 29,1 por cento de carcinomas e 9,3 por cento de próstatas normais. Cortes histológicos sequenciais foram feitos e utilizados para reação de imunoistoquímica com os anticorpos primários anti-p-53, anti-NOS-2 e anti-GSTP. Avaliou-se de cada core o escore de células marcadas para cada anticorpo utilizado. Os resultados foram tabulados por grupo diagnóstico e submetidos ao teste Tuckey. Os carcinomas prostáticos do cão e a PIA apresentaram maior número de amostras (41) com mais de 75 por cento das células positivas para NOS-2, demonstrando a influência do estresse oxidativo no desenvolvimento dessas lesões. As próstatas normais e as afecções desta glândula, HPB, PIA, PIN, prostatite e carcinoma, expressaram a proteína GSTP-1, o que conferiu proteção ao tecido prostático canino a danos oxidativos. A proteína p53 estava presente em todas as amostras estudadas, incluindo o tecido prostático normal, porém as lesões prostáticas apresentaram maior número de amostras com escores mais elevados de marcação (escores três e quatro), presente em 95 por cento dos focos de PIA e carcinoma. Concluiu-se que o aumento de expressão de óxido nítrico nas lesões prostáticas no cão e a expressão de GSTP-1 podem ter protegido o tecido prostático canino e que a expressão de p53 foi positiva e uniforme nas próstatas normais e com lesões hiperplásicas e displásicas.

A tissue microarray (TMA) with 149 samples of canine prostatic lesions contained 17.2 percent benign prostatic hyperplasia (BPH), 32.4 percent proliferative inflammatory atrophy (PIA), 2.6 percent prostatitis, 8.6 percent foci prostatic intraepithelial neoplasia (PIN), 29.1 percent carcinomas and 9.3 percent normal prostates. Sequential histological sections were made and used for immunohistochemistry reaction with primary antibodies anti p-53, anti-NOS-2 and anti-GSTP. The score for each antibody employed was evaluated. The results were tabulated by diagnostic group and subjected to Tuckey test. Prostatic carcinomas and PIA had a higher number of samples (41) with over 75 percent of cells positive for NOS-2, demonstrating the influence of oxidative stress in the development of these lesions. The prostates of normal dogs, as well as the disorders of this gland (BPH, PIA, PIN, prostatitis and carcinoma), expressed GSTP-1 protein, which gives protection to the canine prostate tissue against oxidative damage. The p53 protein was present in all samples studied, including normal prostate tissue, but the prostatic lesions had a higher number of samples with higher scores (more than 50 percent of positive cells), in 95 percent of foci of PIA and carcinoma. It was found that an increased expression of NO in prostatic lesions of dogs and that the expression of GSTP-1 can protect the canine prostate tissue, which would contribute to the low frequency of prostate adenocarcinoma in this species. The expression of p53 was positive in all lesions as well as the in normal prostate.

The use of clays to sequestrate organic pollutants. Leaching experiments.

Leaching experiments are performed from clay-pollutant systems in order to evaluate the capability of clays to sequestrate organic pollutants from wastewaters. Reference kaolinite KGa-1b, montmorrillonite SWy-2 and reference soil BCR-700 are the sorbent materials. 2,4,6-trichloroaniline (2,4,6-TCA) and 4-chlorophenol (4-CP) are the typical pollutants, sorbed at amounts of 10.0 mg g(-1) and 5.8 mg g(-1) on SWy-2 and 7.3 mg g(-1) and 2.2 mg g(-1) on KGa-1b, respectively. The leaching agents are ultrapure water and model solutions of acid rain and surface waters that simulate meteoric leaching. 1.0mM HNO(3), 1.0mM H(2)SO(4) solutions and a methanol/water 50/50 (v/v) mixture simulate leaching agents of industrial source. The results are compared and the preferential capability of the clays to sequestrate the more lipophilic 2,4,6-TCA is evidenced. The bond interactions are discussed and explained through preferential adsorption reactions. For montmorrillonite also a simultaneous intercalation in the phyllosilicate interlayer is proposed.

SBA-15 ordered mesoporous silica inside a bioactive glass-ceramic scaffold for local drug delivery.

The paper reports the synthesis of an ordered silica mesostructure of the SBA-15 type inside a macroporous bioactive glass-ceramic scaffold of the type SiO(2)-CaO-K(2)O, to combine the bioactivity of the latter with the release properties of the former, in view of local drug delivery from implants designed for tissue engineering. The standard procedure for SBA-15 synthesis has been modified to minimize the damage to the scaffold caused by the acidic synthesis medium. The composite system has been characterized by means of Scanning Electron Microscopy (coupled with EDS analysis), Small Angle X-Ray Diffraction, Thermogravimetry analysis and Infrared Spectroscopy: the formation of a well ordered hexagonal mesostructure was confirmed. Ibuprofen has been chosen as model drug. The uploading properties have been investigated of the scaffold-mesoporous silica composite as compared with the scaffold as such, and a five-fold increase in the adsorbing properties toward ibuprofen was found, due to the presence of the ordered mesoporous silica. The ibuprofen release to a SBF solution in vitro is complete in 1 day. Retention of bioactivity from the glass-ceramic scaffold after the silica mesostructure incorporation has been observed.

Arthroscopic treatment of post-traumatic elbow stiffness.

AIM: The treatment of post-traumatic elbow stiffness has seen many important changes over the years, particularly through the development of arthroscopy, greater knowledge of anatomy and improvements in operative techniques, that reduce the incidence of complications and facilitate postoperative recovery. In this study mid-term clinical results of arthroscopy for post-traumatic elbow stiffness are evaluated in 15 sporting patients, with an average age of 32 years. METHODS: Eight patients reported post-traumatic stiffness due to fracture of the radial head, 3 to fracture-dislocation, 1 to fracture of the radial diaphysis complicated by osteosynthesis, and the remaining 3 patients to stress syndromes with osteochondral detachment. Surgical treatment consists in debridement, arthroscopic capsular release, and removal of bone fragments by arthroscopy. Patients were followed up from 4 up to 36 months, with a mean follow-up time of 18 months. RESULTS: Results obtained have been good to excellent in 84% of cases with an average range in postoperative movement of 13 degrees-137 degrees and reduction in pain symptomatology. The statistic results obtained from this study, under the same conditions and with a confidence interval = 0.01, show that the treatment will have favorable outcomes in 63% of patients of entire population (0.6285

Weed control in rice with metham-sodium.

Metam-sodium is a soil fumigant with herbicidal properties. A field experiment was conducted in 2000 at Copiano (Pavia, Italy) to determine the efficacy of three rates of metam-sodium (300, 450 and 600 l/ha) at three different planting times (5, 12 and 18 days after chemical treatments) for the control of weeds in rice cultivation. The study mainly focused on the control of red rice (Oryza sativa var. selvatica), a weed which is worldwide distributed in rice fields and difficult to eradicate Test design was a split-plot with four replications. The main plot size was 13, 5 by 15 m and the subplot size was 13, 5 by 5 m. The chemical treatments were carried out as pre-sowing. Two days after chemical treatments, all field plots were flooded with 10 cm of water as practiced locally. An early variety of rice (Loto) was sown at 150 kg/ha. Weed control was visually evaluated as a percentage of ground covering by all weeds and by each weed individually at three, four and five weeks after treatments. Observations were made also on rice selectivity, and rice grain yield was assessed at the end. Metam-sodium did not injure the rice plants. Metam-sodium at 450 l/ha controlled 100%, 97% and 92% of red rice at the first, second and third observations, respectively. Good results were also obtained with metam-sodium at 300 and 600 l/ha, which controlled 94 to 82% of red rice during the season. Echinochloa crus-galli was better controlled with the higher rates of metam-sodium, particularly in the early part of the season. Metam-sodium did not show enough efficacy in this study against Heteranthera reniformis, Bulboschoenus maritimus and Lindernia spp. The best rice grain yield was obtained with all rates of metam-sodium, when rice was sown 5 days after treatment.

A conjugate heat transfer procedure for gas turbine blades.

A conjugate heat transfer procedure, allowing for the use of different solvers on the solid and fluid domain(s), is presented. Information exchange between solid and fluid solution is limited to boundary condition values, and this exchange is carried out at any pseudo-time step. Global convergence rate of the procedure is, thus, of the same order of magnitude of stand-alone computations.

A randomized 4-arm multicenter study of interferon alfa-2b plus ribavirin in the treatment of patients with chronic hepatitis C not responding to interferon alone.

To determine whether a higher dosage of interferon (IFN) associated with ribavirin and/or prolonged time of administration may improve therapeutic efficacy, we conducted a 4-arm randomized trial on patients with chronic hepatitis C not responding to one or more previous treatment courses with IFN monotherapy. Group 1 (n = 139) received 3 million units (MU) IFN-alpha2b 3 times a week (t.i.w.) plus ribavirin 1,000 mg/d for 12 months; group 2 (n = 162) received 5 MU t.i.w. plus ribavirin for 12 months; group 3 (n = 142) received 3 MU t.i.w. plus ribavirin for 6 months; and group 4 (n = 151) received 5 MU t.i.w. plus ribavirin for 6 months. The primary end point was hepatitis C virus (HCV)-RNA clearance at the end of 6-month follow-up. HCV-RNA was negative in 15% of group 1, 23% of group 2, 11% of group 3, 16% of group 4 (group 2 vs. group 3, P =.04). Among patients with genotypes 1 and 4, sustained response was significantly higher in group 2 vs. group 3 (18% vs. 7%, P =.03; group 1 = 9%, group 4 = 12%, P = not significant [NS]). In patients with genotypes 2 and 3, sustained virologic response was not affected by the different regimens (group 1 = 32%, group 2 = 30%, group 3 = 30%, group 4 = 35%, P = NS). In conclusion, about 23% of nonresponders to IFN monotherapy may achieve a sustained response if re-treated by 5 MU t.i.w. IFN plus ribavirin 1,000 mg/d for 1 year. Patients with genotype 1 should receive a high dosage of IFN plus ribavirin for 12 months, whereas therapy for patients with genotype 2 or 3 should be less aggressive.

[Dysmetabolic syndrome related to HIV-1 protease inhibitors. Review of the literature and personal data]. / Sindrome dismetabolica da inibitori della HIV-1 proteasi. Revisione della letteratura e dati personali.

HIV-positive patients receiving antiretroviral therapy with HIV-1 protease-inhibitors (PI) frequently show insulin-resistance, impaired glucose tolerance, hypertriglyceridaemia and lipodystrophy (LD). LD has often been reported only after the beginning of PI therapy. Some authors link LD to HIV chronic infection, some others suggest that PIs increase pre-existent disturb. Preliminary data of an observational study drawn in IV day-hospital of Spallanzani Institute in Rome showed hypertriglyceridaemia in 36.4% and hyperglycaemia in 11.2% of patients treated with PI. Carr suggests that such drugs should have this lipid-increasing effect because of their inhibition of low density lipoprotein-receptor-related protein, cytoplasmic retinoic-acid binding protein type 1 and P450 3A cytochrome. This theory doesn't explain why both untreated patients and treated with only reverse transcriptase inhibitors show sometimes the same disorders. According to another hypothesis Tumor necrosis factor-alpha, through inhibition of lipoprotein-lipase, would determine high fat-storage in the adipose tissue. Cardiovascular risk factors have always to be assessed before starting a therapy with PI. Glycaemia, triglyceridaemia, cholesterolaemia have to be performed every three months during the treatment and, if necessary, C-Peptide and insulinaemia too. A treatment with lipid-lowering drugs is always recommended in patients with hypertriglyceridaemia > 500 mg/dl and/or hypercholesterolaemia LDL > 190 mg/dl in two following checks. Fibrates have proven to be effective in reducing hypertriglyceridaemia, but there is no certainty that such therapies could have good effects on the LD itself too.

Drug-resistance of Mycobacterium tuberculosis in time.

Tuberculosis is heavily worldwide spreading in the last years. More and more signalations seem to indicate that the incidence of drug-resistant Mycobacteria is increasing in almost all industrialized countries. The authors have carried on a study on the percentage of drug-resistant strains of Mycobacterium Tuberculosis (MT) among isolates from patients affected by active pulmonary tuberculosis hospitalized through the years 1992-94. Out of 59 isolates of MT, 20.3% were drug-resistant: 25% of them to 2 drugs and 16.6% to 3 or more drugs. Resistance to single drug was so distributed: Streptomycin 11.8%, Isoniazid 6.7%, Rifampycin 3.4%, Ethambutol 6.7%, Ansamycin 3.4%, Pyrazinamide 5.0%, Ethionamide 1.7%. These results were confronted with analogous data on MT drug-resistance collected in the same hospital division in the years 1978-82 and 1985-87. The data analysis shows that actual incidence of drug resistant strains of MT is only slightly decreased but quite similar to that observed in 1978-82, except for Ethambutol, while there is a remarkable reduction vs. 1985-87; in that period, in fact, the highest incidence of drug resistance was recorded. The authors' conclusion is that only little differences were observed in the total amount of resistant strains of MT through 20 years; they also outline that resistance to Ansamycin, most recent out of all tested drugs, is quite similar to that observed for Rifampycin, that is chemically analogous.

Post-tuberculosis chronic empyema of the "forty years after".

The authors present 110 cases of patients hospitalized in the last 5 years, with long-term disabling sequelae of pulmonary tuberculosis. Twelve out of them (= 10.9%) suffered from post-tuberculous chronic empyema, with an average latency period of 44.83 years between the acute tuberculous illness and the clinical manifestation of the empyema. Nine of the patients had been treated with collapsotherapy, induced by artificial intrapleural pneumothorax, 1 with thoracoplasty, and 2 only with late and inadequate anti-mycobacterial chemotherapy. Eleven patients (91.6%) also had a cutaneous fistula (7 cases) and/or a bronchopleural fistula (4 cases). The authors show how the issue of tuberculous sequelae is a significant not only from the numerical standpoint, but also for the seriousness of the caused pathological conditions, often posing problems for differential diagnosis. Moreover, they stress how tuberculosis should never be neglected or considered last in the differential diagnosis of empyema and pyopneumothorax.

Binding of human alpha-thrombin to platelet GpIb: energetics and functional effects.

Thrombin interaction with platelet glycocalicin (GC), the 140 kDa extracytoplasmic fragment of the membrane glycoprotein Ib, was investigated by using a solid-phase assay. Thrombin bound to GC-coated polystyrene wells was detected by measuring the hydrolysis of a chromogenic substrate. The monoclonal antibody LJ-Ib10, which specifically binds to the thrombin-binding site of GC, could displace thrombin from immobilized GC, whereas the monoclonal antibody LJ-Ib1, which interacts with the von Willebrand factor-binding domain of GC, did not affect thrombin binding to GC. Competitive inhibition of thrombin binding to immobilized GC was also observed using GC in solution or ligands that bind to the thrombin heparin-binding site, such as heparin and prothrombin fragment 2. Furthermore functional experiments demonstrated that GC binding to thrombin competes with heparin for thrombin inactivation by the antithrombin III-heparin complex as well. Thrombin-GC interaction was also studied as a function of temperature over the range 4-37 degreesC. A large negative heat capacity change (DeltaCp), of -4.14+/-0.8 kJ.mol-1.K-1, was demonstrated to dominate the thermodynamics of thrombin-GC complex-formation. Finally it was demonstrated that GC binding to thrombin can allosterically decrease the enzyme affinity for hirudin via a simultaneous decrease in association rate and increase in the dissociation velocity of the enzyme-inhibitor adduct. Together these observations indicate the GC binding to the heparin-binding domain of thrombin is largely driven by a hydrophobic effect and that such interaction can protect the enzyme from inhibition by the heparin-anti-thrombin III complex.

Successful meropenem therapy of a brain abscess and meningitis arising from acute purulent otomastoiditis: case report.

We describe a case of a 25-year-old female with an acute left otomastoiditis, accompanied by a left temporal extradural abscess with moderate perifocal edema and meningitis. Intravenous meropenem (2 g 8-hourly) and intravenous methylprednisolone (40 mg once daily) were commenced empirically. Teicoplanin (400 mg once daily intravenously) was added after 5 days when culture results were available. Teicoplanin was discontinued on day 25 but meropenem and methylprednisolone were continued for a further 15 days, after which the abscess completely resolved without sequelae. No treatment-induced adverse effects or seizures were observed. Thus, in selected patients, antibacterials (in conjunction with a corticosteroid) may be successfully used without surgery to treat brain abscesses and in such circumstances meropenem is a useful option for empiric therapy.

[The history of nasal valve surgery]. / Storia della chirurgia della valvola nasale.

Nasal valve surgery involves the Nasal Valve Area and its deformities, as well as its surrounding structures. Since there is no single technique to solve every type of pathology, there are numerous works on this topic in the literature. The rhinologist to perform such surgery should thoroughly deal with all the components (i.e. nasal valve area, nasal bones, tip, spine, vestibulum and turbinates). However, even more so, he should be able to precisely locate the cartilaginous and/or osseous structural deformity impairing nasal air flow. Therefore, intuition and experience play a key role in planning such surgery. It is not easy to recognize the unique, or even more difficult, the partial defect the correction of which would improve overall nasal function. Every surgical technique has some "biologic cost": sclerosis, adhesions, and scar retraction. However, in this case the surgery could prove even more biologically costly as it could worsen the already poor nasal breathing. Therefore, the surgeon must strictly follow two basic rules: a) employ a proper approach to the region; b) do not endanger nasal valve function to satisfy esthetics. Valve area anomalies can be divided into primary and secondary. The latter are caused by trauma or surgery (1.2%). Among the wide range of techniques mentioned in the literature, the authors prefer the anatomical, surgical classification by Zijilker and Quaedvilieg as it incorporates the philosophy the rhinosurgeon must keep in mind when aiming to restore both nasal functions and esthetics through different, specific techniques.

[Clarithromycin in pediatric age. Personal experience]. / La claritromicina nell'età pediatrica. Esperienza personale.

The authors report their experience on the use of oral suspension of Clarithromycin in respiratory infections in the pediatric age. Thirty-three patients affected by various infectious pathologies of the respiratory tract, treated with oral Clarithromycin at the dosage of 15 mg/kg/day, were studied. The therapeutic outcome was very encouraging, the drug well tolerated and without side effects.

Ocular pseudomyasthenia: report of a case with a pineal region tumor.

A case presenting with clinical features of ocular myasthenia and a false-positive edrophonium test is reported. Brain CT and MRI scan revealed a pineal region tumor histologically verified as germinoma. We recommend evaluating patients with clinical features of myasthenia gravis (MG) confined to the ocular muscles for intracranial mass lesions.