Management of self-inflicted orchiectomy in psychiatric patient. Case report and non-systematic review of the literature.

INTRODUCTION: Self-inflicted orchidectomy and auto-castration, also known as "Eshmun complex" is a rare phenomenon. The aim of our study it to present the management of a patient who performed a self orchiectomy and propose a non-systematic review of literature about self-orchiectomy. MATERIAL AND METHOD: A 27-years old male Patient with psychiatric disorder was admitted to our ward to have been cutted his scrotum with scissors and cut away his left testicle causing active bleeding from the left spermatic artery. The patient underwent emergency surgery with clamping of the spermatic cord and hemostasis of the wound. RESULTS: After surgery the clinical condition of the patient remained good during whole hospitalization. Urgent psychiatric evaluation was performed in order to administer proper therapy for acute management. To best of our knowledge, only 11 cases of self-orchidectomy are reported in literature and all of them except 1 case, underwent surgical exploration. CONCLUSIONS: Self-orchidectomy is an extremely rare phenomenon, often associated with psychiatric disorders, compounded by the use of drugs. In our opinion, emergency surgery should be the first choice of treatment, offering diagnostic and hemostatic purpose in a single act, aimed to prevent acute and postacute complications

Detection of buttermilk solids in skimmilk powder by HPLC quantification of aminophospholipids

In considerazione delle sovvenzioni previste dalla Comunit\ue0 Economica Europea a sostegno del latte scremato in polvere (SMP) destinato all\u2019ammasso pubblico, l\u2019aggiunta illecita a questo prodotto di latticello in polvere (BMP), disponibile in abbondanza ed a basso costo negli Stati Membri, si presenta economicamente vantaggiosa ed \ue8 incentivata dalla mancanza di metodi analitici in grado di evidenziarla. Viene proposto un metodo per riconoscere la presenza di BMP nel SMP mediante dosaggio per HPLC della fosfatidilserina (PS) e della fosfatidiletanolammina (PE). L\u2019analisi prevede l\u2019estrazione degli amminofosfolipidi con metanolo, la derivatizzazione automatica con OPA (o-phtalaldeide), la separazione per HPLC in fase inversa su colonna C18 con una corsa di 28minuti e la rilevazione in fluorescenza. Sulla base dell\u2019analisi di numerosi campioni di SMP genuino vengono indicati valori soglia per il contenuto di PS+PE che consentono di riconoscere la presenza \u201csospetta\u201d (P<0.05) o \u201ccerta\u201d (P<0.01) di BMP. Il limite di rilevabilit\ue0 del BMP nel SMP risulta mediamente del 2-3% indipendentemente dalle condizioni di miscelazione utilizzate, solido+solido o liquido+liquido, prima della spraizzazione. Tuttavia causa la variabilit\ue0 del contenuto in amminofosfolipidi, la quantit\ue0 minima rilevabile di BMP pu\uf2 oscillare dall\u20191% al 10% un funzione di origine, condizioni di lavorazione ed et\ue0 dei prodotti utilizzati.Due to the high production of buttermilk in EEC Member States and the aids supported by Community for skimmilk powder (SMP), mixing of buttermilk powders (BMP) with SMP of public storage is economically advantageous and attractive, considering that no analytical methods are available to perform suitable control. A method to recognize buttermilk solids in SMP by quantification of phosphatidylserine (PS) and phosphatidylethanolamine (PE) with HPLC is described. The analysis includes extraction of aminophospholipids with methanol, automatic derivatization with OPA (o-Phtalaldehyde), reverse-phase HPLC on C18 column in a 28 min. run time and fluorescence detection. On the basis of several analyses of pure SMP samples, threshold values for PS + PE content of SMP, allowing to recognize \u201csuspected\u201d (P<0.05) or \u201ccertain\u201d (P<0.01) presence of buttermilk solids are reported. Usually a 2-3% of BMP in SMP is detected in powder samples obtained mixing both solid with solid and liquid with liquid material before drying. However, due to the variability of aminophospholipid content, the minimum detectable amount of buttermilk solids in SMP may range from 1% to 10% according to origin, processing conditions and age of raw material

Ejaculation Sparing Bladder Neck Incision with Holmium Laser in Patients with Urinary Symptoms and Small Prostates: Short-Term Functional Results

BACKGROUND: The treatment options for male lower urinary tract symptoms (LUTS) widely range from self-monitoring to oral medications to surgical procedures. As far as concerns surgical treatment of obstructive LUTS, transurethral incision of the prostate is considered as the gold standard in patients with mild benign prostatic enlargement. OBJECTIVES: The aim of our study is to describe this novel approach to perform ejaculation sparing Holmium laser bladder neck incision (ES-HoBNI), with particular regard to its effect on ejaculation and LUTS relief. METHODS: We evaluated prospective clinical data from 143 consecutive patients who underwent ES-HoBNI at our institution from January 2012 to February 2018. Procedures were performed with a continuous flow 26 Ch resectoscope and a 550 \ub5m holmium laser end-fire fiber. The stenotic bladder neck was deeply incised at 3 and 9'o clock down to the prostatic capsule in a retrograde direction to either side in front of the veromontanum. RESULTS: Median Qmax, postvoid residual volume, International Prostate Symptom Score, and quality of life were 9 mL/s (7.4-10.2), 130 mL (100-190), 15 (13-19), and 3 (2-4), respectively. In total, 110 (76.9) reported regular anterograde ejaculation. Median operative time was 20 min (15-26). Median catheterization time and hospital stay were 3 days (3-4) and 22 h (20-24), respectively. Moreover, we have compared the frequency of anterograde ejaculation, which slightly increases after ES-HoBNI (77 vs. 81.2%) when compared to baseline data, despite not reaching statistical significancy. CONCLUSIONS: ES-HoBNI is a safe, reproducible technique to relieve obstructive LUTS in men with small prostates while preserving ejaculation in younger and sexually active individuals

Pubis bone osteomyelitys after robotic radical cystectomy with continent intracorporeal urinary diversion: Multidisciplinary approach to a complex situation.

Pubic bone osteomyelitis is a rare infectious condition which is characterized by a complex diagnostic and therapeutic workup, due to its various clinical manifestations. Among the many causes of this condition, urinary fistula is the most common in case of previous urological procedures. In order to solve this complication, it is crucial to treat both the fistula and (moreover) the infectious locus arising from it, because treating the fistula alone does not provide any control on the infectious noxa. We present the first case of pubic bone osteomyelitis arising from a urinary fistula after a robotic radical cystectomy with intra corporeal continent neobladder, which has been successfully treated through a multidisciplinary approach