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In Italy in the last ten years tetanus incidence has been considerably decreased. It is a result first of the application of national laws that make compulsory the tetanus vaccine for some workers' group and for the population in general, and on the other hand for the working class as a consequence of D.Lgs 626/94. It was carried out by the U.O.O.M.L. of Garbagnate an activity of sanitary surveillance towards the working class with a tetanus biological risk (i.g. builder, metalworker, cleaning staff policemen, health visitors, cooks, etc.). During this activity it was considered the possibility of a tetanus vaccine cycle for those people that couldn't provide any certification about previous tetanus vaccine. The justification for this propose is to reduce the risk of side effects due to iperimmunization in case of close vaccinations and the safety and low cost of the tritation test of antibody anti-tetanus toxin method. Therefore it was decided to determine the personal condition of tetanus immunization for all those people without a valid certification. It resulted that 38% of people subject to sanitary surveillance were not protected and 55 years people resulted to be the group with highest risk. This result was also confirmed by the Ministry of Health that considers older population the highest risk group. It becomes clear that the vaccination for working purposes protects the population in general too. In conclusion we firmly think the procedure we followed completely accomplish the general principle of healthcare for infectious risk on the application of the tit. VIII of D.Lgs. 626/94.

The Carpal tunnel syndrome is a common problem in various jobs, but not in the cleaning farms. A population of 99 women working in hospital cleaning activities was investigated to define if, although the risk assessment was negative for cumulative trauma diseases (CTD), the Occupational physician should search or not the CTS. We found that CTS prevalence in exposed group is higher than the common female population not exposed and the female workers are younger, so we can suppose the occupational risk exist although the negative risk assessment. The age and the working-age seem not to be determinant in the pathology of the disease, nether the different working-risks is, therefore the risk assessment doesn't consider other risk factor of the cleaning activities: strength, duration, frequency and recover time. This study confirms that the CTS seems to be a disease related with the cleaning workers and although the risk assessment is negative for CTD the Occupational physician should perform the health survaillance for CTD.

A retrospective analysis of 1,000 consecutive cases was conducted in each histopathology lab of seven general hospitals. The collected information included the date of specimen withdrawal (six labs only), receipt in the laboratory, and reporting. Time intervals between withdrawal and receipt. Two labs, received 3/4 of cases the same day, while the others had a very low prevalence of receipt. All labs but one, received 80-90% of cases within 48 hours. In one lab, 17% of cases arrived five days after from the withdrawal. Time intervals between receipt and reporting. The mean observed in the seven labs ranged from 3.1 to 6.1 days. Two labs were able to report within 24 hours, but this occurred only in 6% of their cases. The reporting prevalence within three days ranged between 5 and 64%, with a mean for the seven labs of 37%. The reporting prevalence within 6 days was about 95% (four labs), 60-70% (two labs) and 20% (one lab). All labs but one reported 95-100% of cases within ten days. Time intervals between withdrawal and reporting. Our labs were not able to report within 24 hours from the withdrawal (frozen sections excluded). The reporting prevalence within 2-3 days was about 35-40% (three labs), 16% (one lab), 2% (two labs), and within six days it was about 90% (three labs), and 61%, 38% and 14% (the remaining). These latter reported 95% of their cases within twenty days. The turnaround times we found are unsatisfactory. Probably, there are many sources of delay, and these are multifactorial. However, a major factor involved in these delays seems to be related to poor arrangements in the allocation and managing of human resources.

Following a major reorganization of the National Health Service, competition for resources will depend to a great extent on the quality of the service offered, and audit will be of increasing importance. The present investigation deals with the quantitative aspects of the histopathology workload. A retrospective analysis of the biopsy handling of 1,000 consecutive cases was conducted in each histopathology lab of seven general hospitals. The data collected included information on specimen type, diagnosis, block/section/stain details for each specimen, as well as information about human resources, total workload and technical equipment. Among the seven labs, the histopathology workload ranged between 6,600 and 15,600 cases/year. The workload per person/year ranged between 1,400 and 2,600 (mean 1,900) for pathologists, between 800 and 3,000 (mean 1,500) for technicians, and between 2,200 and 8,300 (mean 4,400) for secretarial staff. The prevalence of biopsy fragments (endoscopic, endometrial curettage , etc.), "small" surgery (skin, appendix, gallbladder, etc.) and surgery was, respectively, between 42 and 50%, 34 and 47%, 9 and 21%. In all labs but one, 80% of cases were within 1-3 blocks; the seven labs had a mean of blocks/case ranging from 1.8 to 4.0 (total mean = 2.8). Differences in performing special stains were astonishing: one lab performed special stains in about 40%, and another in only 0.6% of cases (mean of the seven labs = 15%). Finally, the labs performed immunohistochemical stains within a range of 2.7-8% of cases (mean of the seven labs = 4.6%). The data we have collected provided baseline information on the laboratory running, and this is likely to be an integral part of laboratory administration in the near future.

Description of a clinical case diagnosed in the first hours of life in apparently well newborn. Diagnostic suspicion by palpation and transillumination. Absence of any subjective sign. Inspective symptom the light scrotal swelling. The neonate received an immediate surgical exploration with subsequent orchiectomy.

Fibroepithelial polyps of the ureter, a mesodermal benign tumor, are rare. The first case of a fibroepithelial ureteral polyp associated with bilateral complete ureteral duplication and another case associated with bilateral hydronephrosis are reported. The first case suggested a malformative congenital etiology. The two fibroepithelial polyps were treated by conservative surgery.

Experience is described in the use of indirect immunofluorescence to reveal ABO surface antigens in transitional tumours of the bladder on histological preparations from 50 patients given endoscopic resection or demolitive surgery. After an adequate period of follow-up (mean 13.7 months) of the same patients it is concluded that the prognostic validity of the survey still fails to offer sufficient specificity for guaranteed support of therapeutic decisions.

Eight cases of primary gastric lymphomas encountered in a series of 164 cases of extranodal NHL are analysed. The clinical aspects, the modality of onset and diffusion of the lymphoma, its macroscopic and histopathological features and the different therapeutic approaches are discussed. In particular while the distinction between localised and diffuse forms remains valid, it is pointed out that it is not always possible to treat the former by gastric resection, the latter by chemotherapy. In fact the choice of treatment will often be influenced by the patient's age, the presence of a bulk disease, the inoperability of the lymphoma and its degree of malignancy.

The clinical and anatomopathological features of 7 personally observed cases of granulomatous prostatitis are described. The possibility of confusion between this pathology and cancer of the prostate is pointed out. This is particularly the case when the entire gland is inflammed and only bioptic examination will confirm the diagnosis. The symptoms mostly related to the cervicourethral obstruction, the diagnostic procedure and the treatment, prevalently medical, adopted in each are described.

Two cases of leiomyosarcoma of the spermatic cord are reported. Prognostic factors and therapy of this kind of tumors are discussed.

Testicular biopsy was once much used in the diagnosis of male infertility. Current clinical experience suggests that it should be confined to a prioritary method in cases of azocytospermia and serious oligozoospermia with low or normal plasma FSH, and as a routine procedure in corrective surgery (varicocelectomy, orchidopexy, etc.). An account is given of the technical variants of the operation, its complications and contraindications, and a brief reference is made to discordant opinions expressed by leading andrologists concerning its indications. It is felt that it should only be performed in suitably selected cases, and always in the event of thorough exploration of the testis and its adnexa.

A case of primary adenocarcinoma of the cervix of probable endometrial origin is described in a 37 year-old woman.

Pathology and Cytology departments are making increasing use of cytological examination of the semen as an aid to the diagnosis and prognosis of male infertility. Even in cases where it may seem superfluous, as in azoospermia, it can be used to reveal the presence of immature reproductive cells indicating retarded maturation. It may also reveal a greater or lesser number of inflamed cells, indicating swelling of the spermatic vesicles. In this case the patient will be subjected to more specific tests (the Stamey EPS-EVS tests). Spermatic and prostatic vesicle cells are not often examined but this may be done to investigate the origin of the secretion and the site of any swelling.