The spanish influenza pandemic: a lesson from history 100 years after 1918

In Europe in 1918, influenza spread through Spain, France, Great Britain and Italy, causing havoc with military operations during the First World War. The influenza pandemic of 1918 killed more than 50 million people worldwide. In addition, its socioeconomic consequences were huge. "Spanish flu", as the infection was dubbed, hit different agegroups, displaying a so-called "W-trend", typically with two spikes in children and the elderly. However, healthy young adults were also affected. In order to avoid alarming the public, several local health authorities refused to reveal the numbers of people affected and deaths. Consequently, it was very difficult to assess the impact of the disease at the time. Although official communications issued by health authorities worldwide expressed certainty about the etiology of the infection, in laboratories it was not always possible to isolate the famous Pfeiffer's bacillus, which was, at that time, deemed to be the cause of influenza. The first official preventive actions were implemented in August 1918; these included the obligatory notification of suspected cases and the surveillance of communities such as day-schools, boarding schools and barracks. Identifying suspected cases through surveillance, and voluntary and/or mandatory quarantine or isolation, enabled the spread of Spanish flu to be curbed. At that time, these public health measures were the only effective weapons against the disease, as no vaccines or antivirals were available. Virological and bacteriological analysis of preserved samples from infected soldiers and other young people who died during the pandemic period is a major step toward a better understanding of this pandemic and of how to prepare for future pandemics

Molecular Big Data in Sports Sciences: State-of-Art and Future Prospects of OMICS-Based Sports Sciences

Together with environment and experience (that is to say, diet and training), the biological and genetic make-up of an athlete plays a major role in exercise physiology. Sports genomics has shown, indeed, that some DNA single nucleotide polymorphisms (SNPs) can be associated with athlete performance and level (such as elite/world-class athletic status), having an impact on physical activity behavior, endurance, strength, power, speed, flexibility, energetic expenditure, neuromuscular coordination, metabolic and cardio-respiratory fitness, among others, as well as with psychological traits. Athletic phenotype is complex and depends on the combination of different traits and characteristics: as such, it requires a \u201ccomplex science,\u201d like that of metadata and multi-OMICS profiles. Several projects and trials (like ELITE, GAMES, Gene SMART, GENESIS, and POWERGENE) are aimed at discovering genomics-based biomarkers with an adequate predictive power. Sports genomics could enable to optimize and maximize physical performance, as well as it could predict the risk of sports-related injuries. Exercise has a profound impact on proteome too. Proteomics can assess both from a qualitative and quantitative point of view the modifications induced by training. Recently, scholars have assessed the epigenetics changes in athletes. Summarizing, the different omics specialties seem to converge in a unique approach, termed sportomics or athlomics and defined as a \u201cholistic and top-down,\u201d \u201cnon-hypothesis-driven research on an individual\u2019s metabolite changes during sports and exercise\u201d (the Athlome Project Consortium and the Santorini Declaration) Not only sportomics includes metabonomics/metabolomics, but relying on the athlete\u2019s biological passport or profile, it would enable the systematic study of sports-induced changes and effects at any level (genome, transcriptome, proteome, etc.). However, the wealth of data is so huge and massive and heterogenous that new computational algorithms and protocols are needed, more computational power is required as well as new strategies for properly and effectively combining and integrating data

Liposomes for intra-articular analgesic drug delivery in orthopedics: State-of-art and future perspectives. Insights from a systematic mini-review of the literature

Background and objectives: Liposomal structures are artificial vesicles composed of one or several lamellae of phospholipids which surround an inner aqueous core. Given the amphoteric nature of phospholipids, liposomes are promising systems for drug delivery. The present review provides an updated synthesis of the main techniques for the production of liposomes for orthopedic applications, focusing on the drawbacks of the conventional methods and on the advantages of high pressure techniques. Materials and Methods: Articles published in any language were systematically retrieved from two major electronic scholarly databases (PubMed/MEDLINE and Scopus) up to March 2020. Nine articles were retained based on the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA) guidelines. Results: Liposome vesicles decrease the rate of inflammatory reactions after local injections, and significantly enhance the clinical effectiveness of anti-inflammatory agents providing controlled drug release, reducing toxic side effects. Conclusions: This review presents an update on the improvement in musculoskeletal ailments using liposome treatment

Psychoactive drug consumption among truck-drivers: A systematic review of the literature with meta-analysis and meta-regression

Few studies have assessed the extent of psychoactive drug consumption in the occupational setting. The trucking sector, in particular, is an important cause for concern, since psychoactive substance use has a relevant impact on the drivers\u2019 health and safety, increasing the risk of injuries and traffic accidents, potentially affecting the general public health as well. A systematic review of the literature and meta-analysis was performed in order to provide Occupational Health Professionals and policymakers with an updated epidemiological perspective regarding this important issue. The results showed a prevalence of overall drug consumption of 27.6% [95%CI 17.8-40.1], particularly high considering illicit CNS-stimulants (amphetamine consumption of 21.3% [95%CI 15.7-28.1], and cocaine consumption of 2.2% [95%CI 1.2-4.1]). It appears that truck-drivers choose stimulant substances as a form of performance enhancing drug, in order to increase productivity. However, chronic and high dose consumption has been shown to decrease driving skills, placing these professional drivers at risk for health and road safety. Further research is required, particularly in Europe, in order to fill the knowledge gap and improve the strength of evidence

The history of tuberculosis: The social role of sanatoria for the treatment of tuberculosis in Italy between the end of the 19th century and the middle of the 20th

Since ancient times, the most frequently prescribed remedy for the treatment of tuberculosis was a stay in a temperate climate. From the middle of the 19th century to the middle of the 20th, Europe saw the development of sanatoria, where patients were able to benefit from outdoor walks, physical exercise and a balanced diet. Moreover, the institutionalisation and isolation of patients deemed to be contagious remains one of the most efficacious measures for the control of this type of infection. The first sanatorium opened in Germany in 1854, while in Italy the earliest experiments were conducted at the beginning of the 20th century. At that time, it was widely believed in Italy that pulmonary tuberculosis could improve in a marine climate. By contrast, the scholar Biagio Castaldi described the salubrious effects of mountain air and documented a lower incidence of tuberculosis among mountain populations, which supported the hypothesis of a hereditary predisposition to the disease. In 1898, several local committees (Siena, Pisa, Padua) were founded to fight tuberculosis. The following year, these gave rise to the Lega Italiana (Italian League) under the patronage of the King of Italy, which helped to promote state intervention in the building of sanatoria. The pioneer of the institution of dedicated facilities for the treatment of tuberculosis was Edoardo Maragliano in Genoa in 1896. A few years later, in 1900, the first specialised hospital, with a capacity of 100 beds, was built in Budrio in a non-mountainous area, the aim being to treat patients within their habitual climatic environment. In the following years, institutes were built in Bologna, Livorno, Rome, Turin and Venice. A large sanatorium for the treatment of working-class patients was constructed in Valtellina by the fascist government at the beginning of the century, in the wake of studies by Eugenio Morelli on the climatic conditions of the pine woods in Sortenna di Sondalo, which he deemed to be ideal. In December 1916, the Italian Red Cross inaugurated the first military sanatorium in the \u201cLuigi Merello\u201d maritime hospice in Bergeggi (SV) to treat soldiers affected by curable tuberculosis. In 1919, a specific law mandated a 10-fold increase in funding for the construction of dispensaries and sanatoria. As a result, the Provincial Anti-tuberculosis Committees were transformed into Consortiums of municipal and provincial authorities and anti-TB associations, with the aim of coordinating the action to be undertaken. In 1927, the constitution of an Anti-tuberculosis Consortium in every province became a legal obligation. Despite this growth in social and healthcare measures, tuberculosis in Italy continued to constitute a major public health problem until the advent of antibiotics in the 1950s. Until that time, the sanatorium played a leading role in the treatment of tuberculosis in Italy, as in the rest of Europe

Knowledge, attitudes, practices (KAP) of Italian occupational physicians towards tick borne encephalitis

Tick-Borne Encephalitis (TBE) is an occupational health threat with increasing incidence in the geographic area of Italy. Despite this, TBE vaccination rates have ranged from 10% to 40% in Italy, even in at-risk workers. The reasons for this low rate are investigated in this present study of the knowledge, attitudes, and practices of occupational physicians (OP) regarding TBE disease and vaccination in at-risk workers. A total of 229 OP participated in an internet-based survey by completing a structured questionnaire. Adequate general knowledge of TBE disease was found in 58% of OP. Accurate perception of TBE risk in occupational settings was found in 20%. TBE vaccination for at-risk workers was recommended by 19%. Willingness to recommend TBE vaccination was more likely by OP practicing in endemic areas (Odds Ratio 3.10, 95% confidence intervals 1.47-6.55), who knew the existence of the term “arboviruses” (3.10, 1.29-7.44), or exhibited a better understanding of TBE (2.38, 1.11-5.12)-and were positive predictors for promoting TBE vaccine, while acknowledging that TBE as a severe disease was a negative one. Tick-borne disorders in Italy are a still rare (but increasing) occupational health threat, and vaccination gaps for TBE virus may find an explanation in OP incomplete knowledge of evidence-based recommendations

Anti-rabies vaccination between the 18th and 19th centuries and its pioneer Eusebio Giacinto Valli (1755-1816)

An eclectic, versatile Tuscan doctor, Eusebio Giacinto Valli (1755-1816) was a scholar of several branches of medicine, particularly public health, preventive medicine and epidemiology. His brilliant and wide-ranging education, and his intense passion for physics and chemistry, as applied to the human body, enabled him to conduct numerous studies in the field of vaccinology. He travelled to the Middle East in order to study the epidemiology of the plague and carried out experiments aimed at discovering a cure and a prophylaxis for rabies, succeeding in attenuating the rabies virus by inoculating a mixture of saliva from rabid dogs and gastric juice from frogs. Having travelled to Spain and then to Cuba, where he undertook the study of yellow fever, he died in Havana in September 1816, after injecting attenuated germs of the disease into his own body. He was buried in the great Monumental Cemetery \u201cCristobal Colon\u201d, where his tomb bears the epigraph: \u201cvictima de su amor \ue0 la humanidad (\u201ca victim of his love for humanity\u201d

Liposomes for Intra-Articular Analgesic Drug Delivery in Orthopedics: State-of-Art and Future Perspectives. Insights from a Systematic Mini-Review of the Literature.

Background and objectives: Liposomal structures are artificial vesicles composed of one or several lamellae of phospholipids which surround an inner aqueous core. Given the amphoteric nature of phospholipids, liposomes are promising systems for drug delivery. The present review provides an updated synthesis of the main techniques for the production of liposomes for orthopedic applications, focusing on the drawbacks of the conventional methods and on the advantages of high pressure techniques. Materials and Methods: Articles published in any language were systematically retrieved from two major electronic scholarly databases (PubMed/MEDLINE and Scopus) up to March 2020. Nine articles were retained based on the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) guidelines. Results: Liposome vesicles decrease the rate of inflammatory reactions after local injections, and significantly enhance the clinical effectiveness of anti-inflammatory agents providing controlled drug release, reducing toxic side effects. Conclusions: This review presents an update on the improvement in musculoskeletal ailments using liposome treatment

Nabiximols effect on blood pressure and heart rate in post-stroke patients of a randomized controlled study

Background: Cannabinoids may be useful to treat pain, epilepsy and spasticity, although they may bear an increased risk of cardiovascular events. This study aims to evaluate the cardiovascular safety of nabiximols, a cannabis-based drug, in patients with spasticity following stroke, thus presenting an increased cardiovascular risk. Methods: This is an ancillary study stemming from the SativexStroke trial: a randomized double-blind, placebo-controlled, crossover study aimed at assessing the effect of nabiximols on post-stroke spasticity. Patients were treated with nabiximols oromucosal spray or placebo and assessed before and after two phases of 1-month duration each. Only the phase with the active treatment was considered for each patient who completed the study. The average values of blood pressure (diastolic, systolic, differential) and heart rate from the first 5 days of the phase (lowest nabiximols dosage) were compared to the average values recorded during the last 5 days at the end of the phase (highest nabiximols dosage). Baseline comparisons between gender, stroke type and affected side and correlation between age and blood pressure and heart rate were performed. The study was registered with the EudraCT number 2016-001034-10. Results: Thirty-four patients completed the study and were included in the analysis. Thirty-one were taking antihypertensive drugs and, among these, 12 were taking beta-blockers. During the study, no arrhythmic events were recorded, blood pressure and heart rate did not show pathological fluctuations, and no cardiovascular or cerebrovascular events occurred. At baseline blood pressure and heart rate were comparable concerning gender, stroke type and affected side. A significant direct correlation emerged between differential blood pressure and age and an inverse correlation between diastolic blood pressure and age. No correlation emerged between systolic blood pressure or heart rate and age. Blood pressure and heart rate did not change during nabiximols treatment compared to the baseline condition. Conclusion: This ancillary study adds evidence that, in patients who already underwent a cerebrovascular accident, nabiximols does not determine significant blood pressure and heart rate variation or cardiovascular complications. These data support the cardiovascular safety of nabiximols, encouraging more extensive studies involving cannabinoids characterized by slow absorption rates