Seroprevalence of Tick-Borne Infections in Horses from Northern Italy.

Tick-borne diseases in horses are considered an emergent problem worldwide; the geographical redistribution of ticks, due to climatic and ecological changes, and the movements of infected horses between different nations play important roles in the spread of tick-borne diseases affecting these hosts. In this study, a survey was planned to estimate the seroprevalence of the Gram-negative bacterium Anaplasma phagocytophilum and the piroplasmid protozoa Babesia caballi and Theileria equi in Italian horses, as well as to evaluate possible risk factors associated with seropositive cases. Serum samples from 261 horses reared in northern Italy were collected and analyzed by indirect immunofluorescence antibody test for the detection of A. phagocytophilum-, B. caballi- and T. equi-specific antibodies. The overall seroprevalence to at least one of the investigated pathogens was 51%; sixty-one horses were seropositive to A. phagocytophilum (23.4%), forty-nine to B. caballi and the same number to T. equi (18.8% each). Seropositivity for more than one of the investigated agents was detected in thirty-two horses and the most common co-infection was observed between B. caballi and T. equi (5.7%). A significant risk factor for all the three pathogens was the elevation above sea level; indeed, the risk of infection was higher with an increase and decrease in elevation for A. phagocytophilum and for B. caballi and T. equi, respectively. Tick control in horses is strongly recommended considering the high seroprevalence values of transmitted pathogens.

A Cross Sectional Study on Serological Prevalence of Ehrlichia canis and Rickettsia conorii in Different Canine Population of Sicily (South-Italy) during 2017-2019.

Vector-borne pathogens such as Erlichia canis and Rickettsia conorii are widespread in the Mediterranean basin. Rhipicephalus sanguineus, is considered the main vector in Mediterranean climatic areas. Seroprevalence in dogs is variable in relation to environmental factors, presence of vectors, and dogs' management. We investigated the seroprevalence in Sicilian dogs during 2017-2019, considering temporal as well as spatial variations, and different canine population. A total of 11,009 sera were analyzed: 7568 and 3441 sera were tested to detect antibodies to E. canis and to R. conorii, respectively, by immunofluorescence assay. The rainfall average in the sampling sites during the three-year period was also considered. Statistical analyses were performed using chi-square tests for association between two or more variables. We reported a prevalence of 29.6% and 53.6% for E. canis and R. conorii, respectively. Significant temporal variation was found in R. conorii, while significant difference was found considering canine population and spatial variation regarding both pathogens. Our study updates the previous results of E. canis and R. conorii seroprevalence in dogs in Sicily, and confirms the wide distribution of these pathogens. In addition, we considered, for the first time, three different variables to identify the areas and the canine populations most exposed to risk.

Surgical implantation of artificial urinary device and penile prosthesis through trans-scrotal incision for postprostatectomy urinary incontinence and erectile dysfunction: synchronous or delayed procedure?

OBJECTIVE: To compare simultaneous and 2-stage surgical implantation of an artificial urinary sphincter (AUS) and penile prosthesis (PP) for patients with severe urinary incontinence and erectile dysfunction after prostatectomy. METHODS: The data from 23 patients were reviewed, 15 (group 1) underwent simultaneous implantation and 8 (group 2) underwent 2-stage surgery. The operative time, complications, postoperative pain, incidence of pre- and postoperative urinary incontinence, erectile dysfunction rating (International Consultation on Incontinence questionnaire, Incontinence Quality of Life, International Index of Erectile Function, and Erectile Dysfunction Inventory of Treatment Satisfaction), and patient satisfaction were evaluated. RESULTS: The mean operative time was 140 minutes for the simultaneous procedure (group 1) and 105 minutes for AUS placement and 65 minutes for PP placement (group 2). No major postoperative complications were recorded. The average postoperative hospital stay was 2.5 days after the double-implant procedure and 2.4 days after AUS and 1.2 days after PP placement. The visual analog scale score at 6 and 24 hours after surgery was 5 and 3 in group 1, and 4 and 3 after AUS and 3 and 2 after PP (group 2; P > .05). At 1 year, all patients were socially continent, with an average International Consultation on Incontinence score of 2 in group 1 and 2 in group 2. Of the patients in groups 1 and 2, 65% and 68% were completely dry, respectively (P > .05). The Incontinence Quality of Life score increased from 37 to 84 in group 1 and from 41 to 82 in group 2. The Patient Global Impression of Improvement revealed that 92% of group 1 and 95% of group 2 experienced "great improvement" (P > .05). The International Index of Erectile Function and Erectile Dysfunction Inventory of Treatment Satisfaction score was 70 of 75 and 87 of 100 in group 1 and 72 of 75 and 86 of 100 in group 2, respectively (P > .05). Group 1 patients were completely satisfied, and all group 2 patients stated they would have preferred synchronous surgery. CONCLUSION: AUS and PP synchronous placement is feasible and safe and as effective as the 2-stage procedure, with better acceptance by patients.

[Surgical resection of a massive residual retroperineal mass after chemotherapy in non-seminomatous germ cell tumor of the testis: a borderline case]. / Chirurgia su voluminosa massa residua retroperitoneale dopo chemioterapia per tumore non seminomatoso del testicolo: un caso limite.

BACKGROUND: According to the last EAU Guidelines about testicular cancer, surgical resection of residual masses after chemotherapy in NSGCT is indicated in the case of visible residual masses and when serum levels of tumor markers are normal or normalizing. If markers are not normalized and when several chemotherapeutic regimens have failed to cure metastatic disease, resection of residual tumors (so called "desperation surgery") should be offered to these patients. METHODS: We are going to present the case of a 30-year-old patient, affected by metastatic NSGCT. According to the prognostic-based staging system for metastatic germ cell cancer, our patient was in the poor prognosis group. The retroperitoneal mass involved all major vascular structures and still caused a bilateral obstruction of the upper urinary tract. Histological examination after radical orchiectomy revealed embryonal carcinoma and immature teratoma. The patient underwent a four-cycle VIP chemotherapy and then salvage chemotherapy with four cycles of TIP. After chemotherapy, the patient still presented large multiple metastatic localizations. Tumor markers were reduced but not normalized. The patient was then proposed for the resection of residual tumor. The residual mass could not be dissected from the left renal pedicle, so the left nephrectomy was unavoidable. The mass was hardly detached from vena cava and aorta. A bilateral iliac and retroperitoneal lymphadenectomy was performed. At the end of the procedure, the retroperitoneal space was completely free. RESULTS: Post-operative hospital stay was regular. A CT scan performed 3 months after the procedure did not show any residual lesion in the retroperitoneum. Three and six months later, the patient underwent the residual tumor resection of the right mediastinum and then of the left mediastinum and supraclavear metastases. Afterwards the patient underwent an EP consolidation chemotherapy. The patient is alive, 12 months after the retroperitoneal surgery. CONCLUSIONS: Our experience confirms that resection of residual tumors is safe and feasible also in cases of very large abdominal disease.