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BACKGROUND AND PURPOSE: Effective non-invasive techniques to monitor plaque psoriasis progression and treatment are desirable. The aim of the study was to evaluate changes in vascular pattern using videodermatoscopy (VD) and in skin thickness by ultrasound (US), along with clinical observation, during treatment with biologicals. METHODS: Forty-two patients with moderate-to-severe plaque psoriasis treated with adalimumab, etanercept, or ustekinumab were evaluated. Following the identification of a 'target' plaque at baseline, lesion changes were monitored at 15, 30 and 60 days by clinical observation using a Target Lesion Score (TLS), and by VD and US. RESULTS: After 60 days, a significant improvement in all three parameters was observed. In adalimumab-treated patients mean values of TLS, VD, and US were reduced by 83.9%, 73.5%, and 90%, respectively; in etanercept-treated patients by 67.9%, 49.7%, and 79.3%; in ustekinumab-treated patients by 80.9%, 66.4%, and 80.1%. Skin thickness was the first parameter to improve. Vascular improvement was slower compared to clinical and US responses. CONCLUSION: VD and US may be useful to monitor psoriasis treatment. Further investigations are warranted to assess if the persistence of an altered vascular pattern despite clinical and US normalization, as observed in 22% of patients, may influence disease progression and/or correlate with rate and severity degree of relapse.

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The installation of synthetic prosthesis in the repair of the hernial defects of the inguinal region, though it is part of cleaned surgical operations, it needs of an antibacterial prophylaxis for the prevention of the septic complications of the surgical wound and these, compared with complications following hernioplasty by straight suture, have a meaningful morbidity that can outweigh social and economic advantages of the hernioplasties. The Authors' experience is relative to 112 patients submitted to prosthetic hernioplasty by anterior approach (94 cases) and by transabdominal preperitoneal laparoscopy (TAPP) (18 cases) and underwent to "switch prophylaxis" with Levofloxacin using this posologic scheme: 500 mg ev 30 m' before the surgical operation and 500 mg os in seven days following. The evaluation of the surgical wound has never evidenced septic and suppurative complications; only 11 of the 122 surgical wounds (9%) have documented light phlogosis never advanced to evident suppuration. No patients have showed signs of pharmacologic local intolerance; about collateral general effects as sick and diarrhoea are appeared in 5% of patients, but these have been of light entity; an increase of the transaminase, quickly reverted to the suspension of the therapy, has interested 4% of cases. On the basis of these satisfactory results about clinical efficacy on the prophylaxis of the phlogistic complications of the surgical wound, with reduction of the incidence and gravity and in relation to large and complete antibacterial spectrum included Staphylococcus aureus and epidermidis, and about excellent tolerability without collateral effects, the Authors consider to be important the standardized use of this prophylaxis in the prosthetic hernial surgery of the inguinal region. This choice is correlated to the typical pharmacologic characteristics of the Levofloxacin and particularly to the total bioequivalence between endovenous and oral formulation and besides in relation to perseverance, not inferior to 24 hours, of the plasmatic and tissutal concentrations above bactericide IMC on the most part of organic districts, included skin and soft tissue. The assurance of Levofloxacin's employment in the "switch prophylaxis" also is correlated to patient's elevated compliance, above all if he is operated on regimen of "one day surgery", and to a favorable relationship between costs and benefits.

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The authors dwell upon the deep changes which the surgery of the inguinal hernia has recorded in the last years with the aim to reduce the rate of relapses and based on the philosophy tension free repair, particularly on the prosthetic patch and plug hernioplastics which represent the evolution of this concept and among these must be includes the D.SR.P. and flat plug hernia repair, that they have set with a sort of eclecticism and of integration of some of the operation times of Valenti's and Trabucco's methodologies and of some prosthetic protections used by themselves. Then, they dwell upon the rational of the variant in the Valenti's original technique put forward them, and this variant arise from a critical testing, they perform their preliminary clinic experience about primitive inguinal hernia repair through the methodology that has been proposed, then they declare that they can confirm it from the point of view of the effectiveness and safety only after further confirmations based on far wider surveys and on longer "follow-up" and after an objective comparison between this one and the two methods of whom it forms the technical compromise.

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A comparative study between modified Camey II and Studer ileal orthotopic neobladder was performed. The Camey II was modified as follows: 1) The ureters were implanted, using wallace technique, in an undetubularized ileal loop, 15-18 cm. long, to prevent vesico-ureteral reflux; 2) The neobladder was made using staplers. In such a way, time is saved (about one hour) and results are quite similar, with a low rate of ureteral stenosis in both groups.

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We treated 13 Hairy Cell Leukemia patients with rIFN a 2b. In case of complete/partial response, the patients were submitted to maintenance treatment, while, in case of minimal/no response, a second induction cycle was administered, followed by a maintenance one. The patients were followed, on an outpatients basis, for 18 months at least, obtaining a 100% overall response rate; one patient had complete response, 7 had partial response, and 5 only minimal response. Six patients (46%) relapsed an average of 13 months after the end of the treatment. The utility of a maintenance therapy is discussed.

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