Some contributions from the doctor of the miners in the Simplon tunnel: The most human of victories. The Provinces of Italy to the Simplon tunnel. The family of the miner at Simplon. 1906.

Similarly to Daniele Pometta (1869-1949) on the northern front, Giuseppe Volante (1870-1936) from Turin, a valid clinician and hygiene expert was the field doctor for the firm of Brandt, Brandau e C., on the southern part of the Simplon tunnel for the whole period of its excavation (1898-1906). He meticulously organised and carried out with determination the main mission entrusted him which was to prevent the hookworm epidemic which a mere twenty years earlier had cast its shadow over the St. Gotthard tunnel. Volante also authoritatively directed the first aid post and the hospital that the company built at Nante. Evidence of Volante's vast medical experience was seen in the scientific works he published as well as in a report published in the acts of the International Conference on Work-related Illnesses (Volante, 1906a) and then in a comunication at No. 3 Italian Congress on Work-related Illnesses in Turin (Volante, 1911). There are three interesting works reproduced here (Volante, 1906b-c-d) which are substantially aimed at a broad readership and which clearly illustrate the work carried out, the experience gained and also the author's cultural background. Volante's remarks and the data he supplies are "official" but show no sign of partiality; they convey the grandness of the work he contributed towards creating and in some ways also the "generosity" of the company towards the labour force who "only" went on strike three times for better pay, fewer hours and improved working conditions. Volante's opinion on the low morbidity and mortality of the workers is certainly motivated although it is still relative, first and foremost because he had the tragedy of the St Gotthard as a yardstick, but also because it was swayed by the idea, widespread at the time, of fatalism about the potentially negative effects of the type of work. During the International Conference in 1906 Violante was awarded a gold medal for the work he had conducted, and for three years afterwards he worked under Luigi Devoto (1864-1936) in Milan. After that, he returned to his native Turin where he practised urology. According to his direct descendents, he died aged 64 from respiratory insufficiency the causes of which included a "pneumoconiosis" diagnosed by Prof. Quarelli (1881-1954), a renowned doctor of work-related illnesses, which he had obviously contracted in the period when he had been the doctor of the miners (Gius Volante, 2006).

Beta-2 microglobulin and neopterin as markers of disease activity in multiple sclerosis.

Multiple sclerosis (MS) is a predominately T helper 1-mediated autoimmune disease of the central nervous system. Magnetic resonance imaging (MRI) is the most useful tool for monitoring disease activity and progression. However, MRI is an expensive and time-consuming test. Therefore, the ability to measure biological markers in body fluids correlating with MRI disease activity is of great importance. Beta-2 microglobulin (beta2-MG) and neopterin have been found to correlate with disease activity in several autoimmune disorders and are used as pharmacodynamic markers of interferon beta treatment in MS. During the natural course of MS, beta2-MG is stable over time, and thus it is unlikely that monitoring its plasma levels will be a useful marker of disease changes. More controversial results have been found for neopterin evaluations in MS. Urinary excretion of neopterin is higher during a clinical relapse but blood levels of this molecule do not correlate with clinical and MRI measurements.

Interferon beta treatment of MS in the daily clinical setting: a 3-year post-marketing study.

We performed a post-marketing study of patients with multiple sclerosis (MS) attending the outpatient service to evaluate the impact of interferon beta-1b (IFNbeta-1b) in the daily clinical setting. The absolute changes in relapse frequency and in the mean EDSS score over a three-year period were compared between 83 patients with relapsing remitting MS treated with IFNbeta-1b and 83 RRMS patients who did not take the drug. Annualized relapse frequency significantly decreased in patients undergoing therapy while no statistically significant changes in EDSS score were observed. These findings point out the role of post-marketing studies in evaluating the impact of approved drugs in the daily clinical setting in terms of safety and tolerability. Furthermore, our results confirm the positive effect of immunomodulatory treatment in decreasing the occurrence of inflammatory events.