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Facial aging is a complex process and often poses a challenge for plastic and aesthetic surgeons. Injectable fillers and autologous adipose tissue are widely used for the restoration of soft tissue volume. However, lipotransfer currently lacks standardization and its unpredictable reabsorption rate remains an unresolved issue. Adipose-derived stem cells (ASCs) are multipotent mesenchymal stem cells that could be responsible for the main rejuvenation capabilities of fat grafts. Currently, ASCs are administered in conjunction with autologous fat, while injectable vehicles such as hyaluronic acid, or other injectable biomaterials, are under study for the treatment of facial aging with promising results. Indeed, bioengineered fillers are at a very early stage of development, and could be further developed as semi-permanent fillers with biological properties of engrafted adipose tissue. ASCs could emerge as an effective and novel anti-aging therapeutic agent. However, extensive analysis of their actual effectiveness and mechanism of action are required.


The current study aimed to explore the relationships between metacognition and anxiety, depression, and coping strategies in MS patients, compared to healthy subjects.  The study was conducted on a group of 50 MS patients and a control group of 50 healthy volunteers matched for gender, age, level of education and social status. Metacognitions were assessed with the Metacognitions Questionnaire-30, while anxiety and depression were assessed with the Hospital Anxiety and Depression Scale, and coping strategies were assessed with the Brief COPE. Results did not show significant differences between metacognitive factors for MS patients and healthy subjects. However, we found specific, contrasting correlations between the MS group and the control group. The results of this study could have some implications for clinical practice. Given the relationship between metacognitions and negative emotions, “psychological intervention”, based on the metacognitive approach, could have positive effects on MS patients.

Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of symptomatic gallbladder diseases such as cholecystitis and cholelithiasis and it is the most performed procedure in general surgery with more than 1.5 million cholecystectomies performed annually in the United States. The reasons behind the increasing number of laparoscopic surgeries are improved postoperative pain and improved healing time as compared to open cholecystectomy resulting in earlier recovery and discharge from the hospitals. However, even if it is considered a minimally invasive technique, the intensity of pain on the first postoperative day is significant. Appropriate pain control is essential for optimizing the clinical outcomes and to ensure the patient can walk as early as possible after surgery. 


Corruption affects healthcare effectiveness and efficiency and limits equity in access to health services. Aim of the survey was to document knowledge and viewpoints on the impact of corruption on healthcare system in a sample of students attending pre-lauream healthcare professional courses at Palermo University Medical school and to evaluate any improvement in their awareness on this topic after a dedicated multidisciplinary educational intervention. An anonymous questionnaire was administered to students before and after the intervention. Absolute and relative frequency of correct and incorrect answers was computed. Chi-squared test was used to compare answers given before and after the educational intervention. Approximately less than a quarter of the respondents were able to correctly estimate impact of corruption, inappropriateness and waste in healthcare on NHS. The study documented how improving students’ knowledge of the impact of corruption in the healthcare system could represent a possible strategy to prevent corruption in healthcare.

Pleomorphic adenoma is the most common benign tumor of the salivary glands. It arises mainly from the parotid, less frequently from the minor salivary glands of the oral cavity and, exceptionally, from the accessory glands widespread in the upper aero-digestive tract. Intranasal localization is rare and mainly affects the glands sited in the nasal septal mucosa. There are isolated case reports in literature regarding adult patients. We report a rare case of a young 14-year-old girl with pleomorphic adenoma arising from the nasal septum.

Coffee contains a wide variety of bioactive compounds including polyphenols, melanoidins, and diterpenes. Coffee consumption may have either neutral or beneficial effects toward human health. In this review, we summarize current evidence regarding the association between coffee consumption and breast, endometrial and ovarian cancer, as well as molecular mechanisms underlying the beneficial effects of coffee. The epidemiological evidence suggests a protective effect of coffee towards postmenopausal breast and endometrial cancer. However, no statistical association was found between coffee and ovarian cancer. The chemo-preventive effects of coffee phytochemicals may include activation of anti-oxidative and anti-inflammatory response. Finally, coffee bioactive components where shown to inhibit cancer cell proliferation and metastasis, as well as modulation of impaired angiogenesis.

We present our experience in the treatment of fractures of the tibial plateau with arthroscopic assistance. Between January 1997 and September 2001, we evaluated 23 patients with fractures of the tibial plateau. After their clinical and radiological evaluation, we included 17 patients in this study. Fractures were classified using the Schatzker classification. 14 patients were treated with arthroscopic reduction and percutaneous fixation, while 3patients underwent open reduction and osteosynthesis with platelets under arthroscopic control. The arthroscopic technique allows for a better articular visualization, decreases dissection of the tissues, and allows for an adequate diagnosis and treatment of the associated lesions. Arthroscopic reduction and percutaneous fixation can be considered the treatment of choice in a select group of fractures of the tibial plateau (Schatzker I and III).

Currently, surgical training of physicians in Italy has limited possibilities.Surgical training can be performed on dissection of human bodies as well as in animal laboratories, but experience is very poor. We conducted a survey through an anonymous questionnaire in order to evaluate the opinions of post-graduate physicians on their need for experience training on both human and animal bodies during their medical studies. A total of 165 young Sicilian physicians responded to the survey. Only 14 of them (8.5%) declared they had specific training on a live animal, while 46 (27.9%) reported they already attended cadaver labs. Over 70% assigned the maximum score to the utility of such courses as integration of medical academic offer. Our results showed that the majority of the subjects interviewed expressed a need for training using these practices and that it might be necessary to investigate patterns to promote the opportunity for direct practice on human and animal bodies.

Little is known about the relationship between laryngopharyngeal reflux (LPR) and periodontal or dental lesions. This study investigates the association of dental and periodontal involvement in patients with LPR compared to a control group. A prospective study was carried out on 102 patients complaining of LPR symptoms. The authors used the Reflux Symptom Index (RFS), Reflux Findings Score (RSI) and 24-h ambulatory pH monitoring to diagnose LPR disease. Two study groups were established, the LPR group included patients with LPR diagnosis and a control group selected from excluded patients. All patients underwent an oral examination for the evaluation of dental and periodontal status. Plaque index, gingival index and hemorrhage index were collected too. LPR was revealed to be associated with both an increased incidence of chronic periodontitis with significantly higher values of plaque index (p=0.018), hemorrhage index (p=0.048) , gingival recession (p=0.039) and higher tooth wear scores when compared to those of  the control group. We support the view that laryngopharyngeal reflux might play a considerable role in the manifestation of periodontal and dental lesions.


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