Evaluation outcomes of a sex education strategy in high schools of Pavia (Italy).

AIM: We aimed to provide process and effectiveness evaluations of a sex education intervention realized with interactive techniques in high schools of Pavia (Italy). METHODS: Six public high schools, divided into 'treated' and 'control' units, voluntarily joined this mixed-methods study. Only second-year classes were enrolled: treated adolescents followed a sex education course, performed by trained 'near-peer educators' (undergraduate medical students) with interactive techniques. All adolescents compiled an anonymous effectiveness evaluation questionnaire at baseline (pre-test) and 3 months later (post-test). Sexual knowledge and reported behavioural changes were compared between the two groups through linear mixed-effects models. The process was assessed through a satisfaction questionnaire for treated students, monitoring cards for working group members and cards/diaries for educators. RESULTS: The final sample consisted of 547 treated and 355 control adolescents (mean age = 15.28 ± 0.61 years). Highly significant changes (p < 0.001) from pre-test to post-test, with strong improvements of treated adolescents, were evident for all knowledge items. No significant changes for behavioural items were reported. Process evaluation showed positive results in adolescents' satisfaction, highlighting the need for more youth gathering places. Working group members and educators generally provided positive evaluations, although difficult communication was perceived. CONCLUSIONS: The intervention was effective in improving adolescents' sexual knowledge. The present work highlighted that in Italy sex education in adolescence is still neglected: this could encourage misinformation and health-risk behaviour. Young people perceive the need for a serious health-promoting action in which they could play an active role, spreading educational messages with organized interactive methods.

Comparison of elastographic strain index and thyroid fine-needle aspiration cytology in 631 thyroid nodules.

CONTEXT: Ultrasound (US) elastography (USE) was recently been reported as a sensitive, noninvasive tool for identifying thyroid cancer. However, the accuracy of this technique is hampered by the intra- and interoperator variability, some US features of the nodule, and the coexistence of autoimmune thyroid disease (ATD). OBJECTIVES: The purpose of this article was to assess the accuracy of USE findings in the differential diagnosis of thyroid nodules compared with other US features to evaluate its feasibility in the presence of ATDs and identify the strain index (SI) cutoff with the highest diagnostic performance. DESIGN: We evaluated 528 consecutive patients for a total of 661 thyroid nodules. All nodules underwent fine-needle aspiration cytology (FNAC) and USE evaluation. The SI was calculated as a ratio of the nodule strain divided by the strain of the softest part of the surrounding normal tissue. RESULTS: The median SI value was significantly higher in THY4 and THY5 than in THY2 nodules in ATD-positive, ATD-negative, and ATD-unknown patients. The cutoff of SI for malignancy was estimated to be 2.905 by receiver operating characteristic curve analysis in a screening set (379 FNAC results), and then tested in a replication set (252 FNAC results). In all cases, a SI value of ≥ 2.905 conferred to the nodule a significantly greater probability of being malignant. This SI cutoff had the greatest area under the curve, sensitivity, and negative predictive value, compared with the conventional US features of malignancy. CONCLUSION: The elastographic SI has a high sensitivity, specificity, and negative predictive value for the diagnosis of thyroid malignancy both in the presence and in the absence of ATD. If our data on USE are also confirmed in THY3 nodules, FNAC could be avoided in a number of thyroid nodules with certain features.

5-HT7 receptor activation attenuates thermal hyperalgesia in streptozocin-induced diabetic mice.

The role of 5-HT7 receptors in the nociceptive processing received most attention during the last few years. The involvement of 5-HT7 receptors in nerve injury-induced neuropathic pain states have been reported only recently; however, there are no reports on its contribution in diabetic neuropathic pain. We therefore planned to investigate the effect of 5-HT7 receptor activation on the changes of nociceptive threshold in diabetic mice. Diabetes was induced by a single intraperitoneal injection of streptozocin (150 mg/kg, i.p.). The nociceptive responses in normal and diabetic animals were tested in the hot-plate and tail-flick assays. Both hot-plate and tail-flick latencies significantly shortened at 1-3/4 weeks (thermal hyperalgesia) and prolonged at 6-7 weeks (thermal hypoalgesia) after streptozocin administration. At the dose of 10 mg/kg, systemic injections of AS-19, a selective 5-HT7 receptor agonist, reduced thermal hyperalgesia at early stage of diabetes, but did not influence thermal hypoalgesia at late stage. Co-administration of SB-258719, a selective 5-HT7 receptor antagonist, at a dose that had no effect on its own (10 mg/kg), reversed the anti-hyperalgesic effect of AS-19. Our results indicate that systemic administration of 5-HT7 receptor agonists may have clinical utility in treating diabetic neuropathic pain.