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Introduction: Demonstration of the role of persistent infection, with high-risk (HR) human papillomaviruses (HPV) as the causal agent of cervical cancer made the development of first and second generation prophylactic vaccines. Bivalent and quadrivalent HPV vaccines are at the moment available in Europe. In 2014 is licensing a nonavalent HPV vaccine against HPV types: 6/11/16/18/31/33/45/52/58. The aim of our study was to evaluate the potential impact on HPV infection and related low- and high-grade cervical lesions (LSIL, HSIL) of the candidate nonavalent HPV vaccine, compared to the impact of the quadrivalent, in a female population living in Sicily. Materials and Methods: HPV genotypes was identified by Linear Array HPV Genotyping Test (Roche Diagnostics) and with the INNO-LiPA HPV assay (Innogenetics) for ambiguous HPV 52 status. Low estimates of HPV vaccine impact was calculated as prevalence of HPV 6/11/16/18/31/33/45/52/58 genotypes alone or in association but excluding presence of another HPV type; high estimate as prevalence of HPV 6/11/16/18/31/ 33/45/52/58 genotypes alone or in association, in presence of another HPV type. Results:1794 samples had a HPV positive finding. HR HPV types, alone or with LR types, were present in 1466 (81.7%) samples. 584/1794 (32.5%) samples harboured at least one of the four HPV types covered by the quadrivalent vaccine (HPV 6/11/16 and 18), while 984 (54.8%) samples harboured at least one of the genotypes included in nonavalent vaccine, implying a significantly higher estimated coverage of HPV infection from the developing vaccine than the current quadrivalent (54.8% vs 32.5%; p

Obiettivi. Scopo del presente studio è esplorare il funzionamento psichico dei soggetti con disturbo bipolare I e II attraverso l’analisi e il confronto degli stili di pensiero e dei pattern difensivi. Metodi. Nel corso di un intero anno solare (2009-2010), presso la clinica Psichiatrica del Policlinico Universitario di Palermo sono stati reclutati 29 pazienti con disturbo bipolare I e II. È stato somministrato il seguente protocollo: Wechsler Adult Intelligent Scale-R (WAIS-R) per valutare il funzionamento cognitivo generale; Defense Mechanisms Inventory (DMI) per misurare i pattern difensivi. Sono stati quindi ana- lizzati e confrontati i risultati ai due reattivi. Risultati. I soggetti con diagnosi di disturbo bipolare utilizzano modalità cognitive e strategie difensive del tutto peculiari, differenti rispetto alla popolazione normativa. La diagnosi incide sul livello e sul tipo di funzionamento cognitivo nonché sui pattern difensivi. I bipolari I presentano compromissioni cognitive più serie ed estese e un profilo difensivo più rigido dei bipolari II. In generale, i pazienti bipolari manifestano una personalità immatura centrata su funzionamenti arcaici che si riscontrano in tutte le sfere della loro personalità: emozioni, affetti, cognizione, forza dell’Io, adattamento alla realtà. Discussione. Il profilo cognitivo e difensivo del tutto specifico ottenuto conduce a importanti riflessioni sul contributo che le strategie psicologiche possono dare al trattamento “su misura” per questi pazienti. Aim. The aim of this research is to explore the psychical functioning in bipolar I or bipolar II disorder people through the analysis and comparison of their thought styles and defense patterns. Methods. 29 bipolar I and bipolar II peo- ple afferent to Palermo University Policlinical Psychiatric Hospital Department were selected during the whole 2009-2010 year. The following tests were administred: Wechsler Adult Intelligent Scale-R (WAIS-R) in order to measure the general cognitive function; Defense Mechanisms Inventory (DMI) in order to measure defense patterns. Afterwards, the results of the two tests were analysed and compared. Outcome. Bipolar disorder people use cognitive mechanisms and defense strategies that are very different from standard population. Bipolar I subjects show both wider and more serious cognitive deterioration and stricter defense mechanisms than bipolar II subjects. Generally bipolar patients show an immature personality based on ar- chaic mechanisms that can be found in all the spheres of their personality: emotions, cognition, Ego-strength, adaptability to reality. Discussion. The peculiar achieved cognitive and defense profile leads to important considerations about how psychological strategies can contribute to use “bespoke” treatments for these patients.

To evaluate whether EBV-DNA can be used as a diagnostic and follow-up parameter for nasopharyngeal tumors in a non-endemic population. The study was carried out in a university hospital. A retrospective study was conducted on 40 paraffin samples of histological preparations. EB-DNA was detected by real-time PCR technique. A prospective study was also conducted on a group of 30 patients who underwent nasopharyngeal biopsy for suspected nasopharyngeal carcinoma (NPC) by comparing EBV-DNA concentrations between the histological specimen and the serum. Quantification of genomic copies of EBV-DNA in serum and detection of anti-EBV antibodies was performed. In both groups the presence of high viral load of EBV-DNA was found in nonkeratinizing squamous cell carcinomas, in three cases of lymphepitomyoma and in 4 out of 6 cases of non-differentiated non-carcinoma lymph node metastases. squamous keratinizing cells. In all cases of NPC, an antibody pattern typical of reactivations (IgGVCA+, IgG-EA+, IgG-EBNA+) and IgA-EA-D, frequently positive in cases of NPC, has been highlighted. A good correlation between the high EBV-DNA charges and the histological diagnosis was highlighted. Our study also found that the assessment of viral EBV load can also be considered in the prognostic evaluation and in the follow-up of patients with NPC.

While bivalent and quadrivalent HPV vaccines have been used for about 10 years, a nonavalent vaccine against HPV types 6/11/16/18/31/33/45/52 and 58 has been recently approved by FDA and EMA and is now commercially available. The objective of our study was to evaluate the potential impact of the nonavalent vaccine on HPV infection and related low- and high-grade squamous intraepithelial lesions (LSIL, HSIL), compared to the impact of the quadrivalent vaccine, in a female population living in Sicily (Italy). Low estimates of HPV vaccine impact were calculated as prevalence of HPV 6/11/16/18/31/33/45/52 and 58 genotypes, alone or in association, but excluding presence of other HPV types; high estimates were calculated as prevalence of HPV 6/11/16/18/31/33/45/52 and 58 genotypes alone or in association, in the presence of other HPV types. The nonavalent HPV vaccine showed increased impact, compared to the quadrivalent vaccine. Estimates of potential impact varied from 30.9% (low estimate) to 53.3% (high estimate) for LSIL, and from 56.9% to 81,0% for HSIL. The proportion of additional cases potentially prevented by the nonavalent vaccine was 14.4%–23.8% for LSIL, and 19.0%–32.8% for HSIL. The benefit of the nonavalent vaccine compared to the quadrivalent vaccine was more than 80% for both low and high impact estimates for LSIL and more than 50% for both low and high impact estimates for HSIL. The present study confirms that the switch from a first generation HPV vaccines to a nonavalent vaccine would increase the prevention of cervical HSIL in up to 90% of cases.

A model developed for Zostera marina was adapted and used to select suitable areas for Posidonia oceanica transplantation in the Gulf of Palermo, where recent rehabilitation programmes have reduced human pressure. This model consists of three steps: (1) habitat selection, by calculation of the Preliminary Transplant Suitability Index (PTSI); (2) field assessments and test-transplanting, to evaluate the site suitability and to estimate the effects of tearing on transplant units (about 50%); (3) identification of suitable restoration sites, by calculation of the Transplant Suitability Index (TSI). A new parameter was added to the literature model: the number of grids detached, which is linked to factors (hydrodynamic regime, anchoring, fishing) that have a potentially great effect on the final outcome of the transplant. Only one site (TSI = 16) in the Gulf of Palermo was indicated as potentially suitable for restoration with P. oceanica. In this site, a transplant of 40 m2 was implemented. From 2008 to 2014, transplant effectiveness was evaluated in terms of establishment, detachment and mortality of cuttings and shoot density. The long-term monitoring (6 years) allowed us to detect changes in the structural conditions of the transplanted meadow and to identify the possible turning point in P. oceanica recovery (2 years after transplanting). Moreover, 6 years after transplantation the P. oceanica meadow has exceeded the transplant shoot density of about 16%, with a mean and a maximum value of 11.6 and 17 shoots per cutting, respectively.

Human papillomaviruses (HPVs) are agents of the most common sexually transmitted diseases. Both in men and in women, HPVs cause a variety of clinical symptoms ranging from warts to cancer. It has been shown that infection with oncogenic HPV is the major cause of development of cervical cancer in women and less frequently of penile cancers in men. HPV infects epithelial cells and can bind other cell types. Its presence in semen is widely known, but the effects on fertility and reproductive function are still controversial. Partners of women with high-grade squamous intraepithelial lesions were enrolled. From each subject seminal parameters were evaluated. HPV was detected and genotyped both in total semen and in swim up-fraction. In order to verify the cause-effect relationship between HPV presence in semen and sperm quality, we developed a new approach (differential cell lysis, DNA extraction and nested PCR) to evaluate virus localization in the different semen components. Our data indicate a correlation between HPV infection of exfoliated cells and reduction of sperm cell motility. Moreover, we analyzed the physical state of HPV18 DNA in sperm cells by qPCR. Our results suggest a possible integration event during which a disruption of the HPV genome occurs, causing the deletion of E1 and E2 genes. The data support the proposed role of HPV in decreased male and couple fertility and prompt new possible consequences of the viral infection in semen.

Introduction: Infection Human Papillomavirus (HPV) is the cause of several disease in men and in women: genital warts, penile and cervical intraepithelial neoplasia, invasive penile carcinoma and cervical cancer. However, less is known about HPV infection and prevalence of HPV types in men. Materials and Methods: 820 genital samples of men (age 19-77; mean age: 36.7 ys) who had come to the Virology laboratory of the Department of Sciences for Health Promotion and Mother and Child Care (Policlinico, University of Palermo, Italy) were examined for HPV infection. The study included men with genital warts, men with atypical genital lesion, partners of HPV-positive women and asymptomatic men for Sexually Transmitted Diseases (STD) diagnostic evaluation. HPV-DNA genotyping was performed by the INNOLiPA HPV Genotyping Extra II Test (Fujirebio) and nested PCR/sequencing method. Results: 461/820 (56.2%) genital samples were HPV positive. The highest HPV detection rate was found in the 25-34 year age group (41.4%), followed by the 35-44 group (31.7%). Oncogenic types were found in 360 (78.1%) samples, alone 228 (63.3%) or with non-oncogenic types 132 (36.7%). Multiple HPV type infections were shown in 225 (48.8%) samples of whom 109 (23.6%) had two genotypes, 58 (12.6%) three genotypes, 38 (8.2%) four genotypes, 15 (3.2%) five genotypes, 3 (0.6%) six genotypes and then only 2 (0.4%) eight genotypes. Thirty-eight different HPV types were identified: the mostly frequent were HPV-16 (19.9% of HPV positive patients), -51 and -6 (18.2%), -31 (13.9%), -66 (13.7%), -53 (11%), -18 (7.6%), -44 (7.1%), -56 (7%), -11 (5.8%), -39 and –52 (5.6%), -54 (5.2%), -58 (5%), -62 (4.5%); other viral types occurred at a frequency of less than 4.0%. Men who have made the HPV test: 138 (16.8%) were diagnosed with genital warts, 3 (0.4%) carcinomas, 413 (50.3%) were HPV-positive women partners, 30 (3.6%) presence of an atypical genital lesion, 236 (28.7%) men who wanted a full assessment of sexual transmitted diseases. HPV infection was evident in 100% men with carcinomas, in 103 (74.6%) men with genital warts, in 254 men (61.5%) partners of HPV-positive women, in 11 (36.6%) men with presence of an atypical genital lesion and in 90 (38.1%) in asymptomatic men. HPV-16 was prevalent in 2 (66.7%) men with carcinoma, in 55 (21.6%) men HPV-positive women partners and in 3 (27.3) men with atypical genital lesion; HPV-6 in 36 (35%) men with genital warts and in 19 (21.1%) asymptomatic men. Discussion and conclusions: this study showed a high prevalence of genital HPV infection in Sicilian men. This information will contribute to elucidating the epidemiology of HPV infection in man, and it will also be helpful in the implementation of future prevention strategies.

Introductions: The characteristics of HPV infection in women have been extensively investigates, however, only a few studies have analyzed the characteristics of HPV infection in men and in sexual couples. Materials and methods: 195 sexual couples positive for HPV-DNA were examined, at the Virology laboratory of the Department of Sciences for Health Promotion and Mother and Child Care (Policlinico, University of Palermo, Italy). HPV-DNA detection was performed by the INNOLiPA HPV Genotyping Extra II Test (Fujirebio) and nested PCR/sequencing method. All women (range: 20-60, mean age: 31.5 ys) had performed a pap smear and knew the cytological diagnosis: 73 (37.4%) negative at Pap smear, 21 (10.8%) with atypical squamous cell of undetermined significance (ASCUS), 82 (42.1%) with low grade squamous intraepithelial lesion (LSIL), 18 with high grade squamous intraepithelial lesion (HSIL) and 1 carcinoma, For ease of computation, these two latter categories were grouped together, and thus represented a total of 19 cases of ≥HSIL (9.7%). As for the partners (range 20-70; mean age: 36.7 ys) only two had genital warts . Results: 36 types of HPV were identified: 27 were present in both men and women, two (HPV-67, -90) only in women and seven types (HPV-43, -81, -82, -83, -87, -91, -107) only in men. Infection with or containing high risk HPV types (HR-HPV) was in 112/195 (57.4%) women and in 57/195 (29.2%) men; low risk HPV types (LR-HPV) was in 17/195 (8.7%) women and in 32/195 (16.4%) men. Multiple infections was in 66/195 (33.8%) women and in 106/195 (54.4%) men. Mostly frequent types, the same in men and women, were: HPV-16 (27.7% and 21% respectively), HPV-51 (13.8% and 19% ), and -66 (13.8% and 18.5%). HPV-group specific (HR or LR) concordance between sexual partners was found in 163/195 (83.6%; 95%CI=[78.4-88.8]) couples. HPV-type specific concordance was found in 99/195 (50.8%; 95%CI=[43.8-57.8]) couples, of which 82 (82.8%) shared one types, 12 (12.1%) two types and 4 (4.1%) three types, 1 (1%) four types. Cytological diagnosis was not statistically significantly associated neither with HPV-group specific concordance (p=0.206) nor with HPV-type specific concordance (p=0.312). Conclusions: partners of positive women represent a population at high risk of infection and in turn can be a source of (re)infection to the partner. Studied are needed to improve knowledge of the natural history of HPV infection in sexual couples, to control viral transmission and provide adequate counseling to HPV infected sexual partners.

Human papillomavirus (HPV) infection is the commonest sexually transmitted infection, and high-risk HPV types are associated with cervical carcinogenesis. This study investigated: the HPV type-specific prevalence in 970 women with an abnormal cytological diagnosis; and the association of HPV infection and cervical disease in a subset of 626 women with a histological diagnosis. HPV-DNA was researched by nested PCR/sequencing and the INNOLiPA HPV Genotyping assay. The data were analysed by the chi-square test (p ? 0.05 significant). Overall, the HPV prevalence was 37.7%; high-risk genotypes were found in 88.5% of women and multiple-type infections in 30.9% of the HPV-positive women. The commonest types were HPV-16 (8.2%), HPV-6 (5.0%), HPV-51 (4.2%) and HPV-53 (3.6%). Among the women with histological diagnosis, HPV was evident in 19.9% of those without lesions, 65.8% of those with low-grade lesions and 100% (p = 0.002) of those with high-grade lesions. The commonest types were HPV-16 (in 14.7% low-grade and 42.8% high-grade lesions), HPV-31 (4.7% and 14.3%, respectively) and HPV-33 (2.0% and 14.3%, respectively). Two high-grade lesions contained exclusively one uncommon type, namely, HPV-83 and -85. This study confirmed the high prevalence of HPV infection and high-risk genotypes among women with cervical abnormalities living in Italy. These data may contribute to increasing the knowledge of HPV epidemiology and designing adequate vaccine strategies. © 2008 Elsevier B.V. All rights reserved.

Objective To evaluate the prevalence of human papillomavirus (HPV) sperm infection and its correlation with sperm parameters in patients who attended a fertility clinic. Design Cross-sectional clinical study. Setting University-affiliated reproductive medicine clinic. Patient(s) A total of 308 male partners of couples undergoing in vitro fertilization techniques. Intervention(s) Specimens of semen were collected from all patients. Main Outcome Measure(s) Sperm parameters were evaluated according to the World Health Organization manual. The presence of HPV DNA was researched by the combined use of two HPV assays and a highly sensitive nested polymerase chain reaction assay followed by HPV genotyping. To examine whether HPV was associated with the sperm, in situ hybridization (ISH) analysis was performed. Result(s) Results of HPV investigation were compared with sperm parameters and ISH analysis. Twenty-four out of 308 semen samples (7.8%) were HPV DNA positive, but HPV infection did not seem to affect semen quality. Moreover, ISH revealed a clear HPV localization at the equatorial region of sperm head in infected samples. Conclusion(s) Oncogenic HPV genotypes were detected on spermatozoa from asymptomatic subjects, but a role of the infection in male infertility was not demonstrated.

Summary A key issue in oral HPV infection is whether it can be associated with a genital HPV infection, or whether it can be considered as an independent event. This analysis evaluated the frequency and type-concordance of oral HPV infection in women with cervical HPV infection by means of: (i) a cross-sectional study on a sample (n = 98) of Italian women; and (ii) a literature-based metanalysis, including the experimental study the subject of this Paper and nine other published studies (n = 1017), which also examined the influence of oral sampling procedure (oral brushing vs oral rinse) and HIV status on oral HPV detection. The prevalence of oral HPV infection in the Italian study was 14.3% (95% CI: 7.4–21.2); the prevalence of type-concordance was 21.4% (95% CI: 0.0–43.6) and it was only marginally significant (P = 0.05). The prevalence of oral HPV infection in the metanalysis was estimated as 18.1% (95% CI: 10.3–25.9); the prevalence of type-concordance was 27.0% (95% CI: 12.3–41.7), and it was statistically significant (P = 0.002). The metanalysis also showed that the oral sampling procedure was not a determinant of HPV detection; however, HIV status increased the likelihood of oral HPV infection (HIV-positive vs negative: 27.2%; 95% CI: 22.1–32.2 vs 15.5%; 95% CI: 6.9–24.2) and type-concordance (HIV-positive vs negative: 46.8%; 95% CI: 34.7–58.9 vs 15.6%; 95% CI: 0.8–30.4). Oral HPV infection and type-concordance in women with cervical HPV infection are more prevalent than could be expected by chance; this finding is consistent with the notion of a degree of dependence of the oral site on the cervical site. Furthermore, oral HPV prevalence and type-concordance are influenced by immunity.

We determined the prevalence of human papillomavirus (HPV) cervical infection and HPV genotypes among 115 women immigrating to Sicily (Italy), with regard to abnormal cytology and socio-behavioral characteristics in a cross-sectional, observational study. Information was collected with the help of cultural mediators/translators. HPV-DNA was assayed by the INNOLiPA HPV assay and a nested PCR/sequencing method. Sixty (52.2%) women came from sub-Saharan Africa and 55 (47.8%) from Eastern Europe. HPV infection was found in 55 (47.8%) women. The most frequent types were the oncogenic types HPV-16 (7.8%), HPV-18 and 51 (6.0% each), HPV-52 (5.2%), 31, 53, and 68 (4.3% each). Twenty-seven (23.5%) women had cytological abnormalities associated with HPV infection (p=0.04). Being single (OR = 2.98; 95%CI: 1.30-6.84) and parity (OR = 0.29; 95%CI: 0.12-0.65) were consistent predictors of HPV infection. Only 21 (18.2%) women returned to collect the results of their Pap and HPV tests. The high prevalence of HPV infection and oncogenic types among immigrant women make them a priority group for cervical cancer screening. Linguistically and culturally appropriate prevention efforts are needed to sensitize immigrant women regarding HPV-related issues and to conduct vaccine strategies for cervical cancer prevention.

The concordance of human papillomavirus (HPV) groups and types was evaluated in 45 sexual couples with both partners HPV infected, by analyzing cervical samples from women and three genital sites (penile brushing, urethral brushing, and semen) from men. When grouping HPV types, no significant HPV group sharing was found between partners, either considering samples from any male site (concordance: 55.5%; P = 0.11) or from each site (concordance by penile brushing, 37.8%; urethral brushing, 24.5%; semen, 22.3%; P > 0.05). Examining individual HPV types, using samples from any male site, concordance was found in 29 (64.4%; P = 0.036) couples; significant concordance was evident for 16 HPV genotypes, the most frequent being HPV-6, -66, -31, -51, and -53. Using samples from specific male sites, concordance was found by penile brushing in 24 (53.3%) couples, urethral brushing in 16 (35.5%), and semen in 7 (15.5%; P = 0.014). Among the 16 HPV types shared by examining samples from any male site, 9 (56.3%) were in common by penile brushing, 11 (68.7%) by urethral brushing, and 6 (37.5%; P = 0.48) by semen. Combined penile brushing and urethral brushing sampling identified all the 29 couples concordant by the three male sites; combined penile brushing and semen detected 26 (89.6%) concordant couples. The most adequate approach to the assessment of HPV concordance in sexual couples could be based on the analysis of individual HPV types and the sampling of men by penile brushing combined with urethral brushing. The high and significant degree of HPV type-specific concordance confirms HPV transmission between sexual partners. J. Med. Virol. 79:1882–1888, 2007. © 2007 Wiley-Liss, Inc.

Methods that used specimens from three genital sites (penile brushing [PB], urethral brushing [UB], and the retrieval of semen [SE]) from 50 men were examined for human papillomavirus (HPV) DNA detection. The rates of detection by PB, UB, SE, PB and UB, and PB and SE were 88.9%, 50.0%, 33.3%, 100%, and 97.2%, respectively. The use of PB and UB appears to be the most accurate method; as an alternative to UB, the use of SE with PB could be used to improve the rate of HPV DNA detection in men.