This investigation is aimed at providing information about structural and organizational characteristics of smoking cessation services (SCS) set up within the Italian National Health Service. Local health units and hospitals are the main institutions connected with SCS which are mainly located within the Department of Drug Addiction and the Department of Lung and Breath Care. SCS provide different tobacco-use cessation programs. Although pharmacotherapy is always used, a combination of therapeutic treatments is highly preferred. This study shows the importance of maintaining a national coordination among different SCS supporting their activity and encouraging the start up of additional services throughout the country.
A case of 15-years old, Roman male twins affected by balanic hypospadia is reported. Previous corrective surgery had not been satisfactory, leaving both boys with a curvature of the last portion of the penis. Urographic examination, carried out upon presentation, revealed in both patients a mirror renal ectopy with fusion of the two kidneys. In both, the displaced malformed kidney is below the normally situated one. In depth examination shows: 1) that the malformation concerns not only external genitals but also internal urogenital organs because of the monolateral ectopy of the normal kidney and the malformation of the ectopic kidney in both twins; 2) that the twins are MZ and that their teratological specularity is biologically of interest.Specularity, or mirror imaging, is a well known phenomenon in twins, particularly MZ twins. It may involve slight forms, such as handedness, or rare forms, such as those involving single organs, like the heart, which can be on the left side in one twin and on the right in the MZ cotwin. That must occur in the early embryogenetic stages, and various environmental and genetic factors may be involved. In particular, one can speculate that genetic variations in cell-adhesion molecules (CAM) and/or the late time of splitting of the conceptus to originate the two twins, may all play a role.
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