Frida Kahlo's 70th death anniversary: a reflection on congenital anomalies and chronicities and on the role of the physician-friend.

INTRODUCTION AND AIM OF THE STUDY: This contribution explores the many pathologies that plague the existence of the renowned Mexican artist Frida Kahlo (1907-1954) and the impact they had on her character. METHODOLOGY AND RESULTS: Moving from a mere pathobiographical reassessment, this note, through historico-medical research, highlights the patient-physician relationship that the painter developed with Dr. Leo Eloesser (1881-1976) and underlines the role this form of friendship may play in patients' wellbeing. CONCLUSION: The special friendship between the artist/patient, Frida Kahlo, and her physician, Dr. Eloesser, shows that medicine is not just the sum of diagnoses and therapies but a much more dynamic and complex process involving trust and humane qualities.

Hypoactive sexual desire disorder in women: new possibilities to ensure better understanding, diagnosis, and response to treatment.

BACKGROUND: Hypoactive Sexual Desire Disorder (HSDD) is a frequent sex-related problem in women; however, a specific tool to characterize HSDD subtypes based on sexual inhibitory and excitatory factors is still lacking. AIM: (1) To find a cutoff value in Sexual Inhibition Scale (SIS)/Sexual Excitation Scale (SES) scores predicting a diagnosis of HSDD in women consulting for sexual symptoms, (2) to explore the sexual inhibitory and excitatory profiles in women referred to a clinic for female sexual dysfunction by stratifying the sample according to the newfound cutoffs, and (3) to identify biopsychosocial factors significantly associated with the 2 profiles. METHODS: An overall 133 women consulting for sexual symptoms were retrospectively evaluated for clinical, biochemical, and psychosexologic data collected at the first visit. A subgroup of 55 women treated with transdermal testosterone was retrospectively analyzed at baseline and the 6-month visit. OUTCOMES: Patients underwent physical and laboratory examinations and completed the SIS/SES, Female Sexual Function Index, Female Sexual Distress Scale-Revised, Emotional Eating Scale, and Middlesex Hospital Questionnaire. RESULTS: Specific cutoffs for SIS1 (≥32.5; indicating threat of performance failure) and SES (≤46.5) predicted HSDD diagnosis with an accuracy of 66.4% (P = .002) and 68.7% (P < .0001), respectively. Patients with impaired SIS1 scores showed higher distress and psychopathologic symptoms, while those with impaired SES scores demonstrated lower desire and arousal and a negative association with some metabolic and hormonal parameters. SES score also showed a significant predictive value on testosterone treatment efficacy for HSDD. CLINICAL TRANSLATION: A better characterization of HSDD would enable individualized treatment based on the main underlying etiologies. STRENGTHS AND LIMITATIONS: Limitations of the study include the small sample size and cross-sectional retrospective design, with the choice of treatment for HSDD limited to transdermal testosterone. Strengths comprise the thorough and multifactorial evaluation of every aspect potentially affecting inhibitory and excitatory components of sexual desire. CONCLUSION: Validated cutoffs of SIS/SES scores could allow deep characterization of women diagnosed with HSDD, thus ensuring better tailoring of therapy and prediction of the probability of response to specific treatments.

Why couple infertility is historically a female-driven problem?

BACKGROUND: The history of studies in the field of infertility represents a chapter of great interest in gender issues. OBJECTIVES: This paper aims to delve deep into the historical roots of the aspect of gender inequality related to couple infertility, with a journey back in time, from classical antiquity to the contemporary age, reporting junctions and metaphors linked to particular historical moments as well as to cultural and religious constructs. METHODS: This is a narrative review based on an extensive literature search of publications regarding the role of women in couple infertility over the centuries. RESULTS: Rarely in the ancient world, male infertility was taken into consideration, and the sources deal with it mainly indirectly. This attitude of "blaming" the woman for the lack of children had, in fact, strong social implications, which only the scientific research of recent years has managed to bring back into the context of a more egalitarian approach. CONCLUSIONS: In the "journey" narrated in this article, the reader starts from the responsibility of couple infertility attributed exclusively to women in some ancient societies, whose central role was determined by their ability to procreate, going up to the medicalization of infertility in the contemporary age, which contributed to sharing with men this participation in the impossibility of having children.

Picasso's Science and Charity and the evolution of the medical art.

The present article reflects on the evolution of clinical medicine throughout time by commenting on Picasso's painting Science and Charity (1897) through a biomedical lens. The two souls of medicine, namely the cold scientific one and the compassionate one, are examined in their dichotomy and their relationship with today's concepts of cure and well-being.

Fifteenth century Florentine mural investigated in situ with VNIR Hyperspectral Imaging and NIR Photography supports interpretation as a bloodletting scene.

This study provides new data which suggest a novel interpretative hypothesis not only on the specific painting, but on the use of bloodletting as medical practice in the Florentine Quattrocento. As a part of a cycle of frescoes devoted to the Seven Corporal Works of Mercy, the examined lunette depicts the "Visit to the sick" in a domestic interior, but it has never been considered as an historical document of precise medical practices. The scene's definitive interpretation is still unresolved because of the uncertainty of some iconographic details. A campaign of in-situ and non-invasive technical investigations was performed to retrieve possible traces of previous details today concealed. The technical solutions adopted to implement the measurements campaign are illustrated, as an experimental example for remote sensing inspection of mural paintings in-situ. The position of the painting high up on a wall of an historical venue led to opting for stand-alone optical imaging techniques which could operate in remote sensing mode. By combining the use of portable Hyperspectral Imaging with Near Infrared photography a set of detailed images could be obtained that highlighted details not otherwise detectable. Focused on the objects held by the persons present, the analysis of the mural of Visit of the Buonomini in her Lying in Bed, the gift of swaddling cloth could be a tourniquet, shadows of folds of a blanket a thumb lancet, and an object held a blood collection bowl, supported the hypothesis that it could be a medieval bloodletting scene.

One hundred years after the death of the writer and novelist Giovanni Verga (1922) and his relationship with public health: a glimpse of the past in the era of the SARS-CoV-2 (COVID-19) pandemic.

Background: In 1922 the famous Italian novelist Giovanni Verga died in Catania (Italy). In Verga's works there are many suggestions to the world of medicine, in particular the diseases described in the poor society of southern Italy of that time. One of the most common diseases described by Verga was cholera. Methods: The authors researched and reviewed Verga's works, detecting references to public health. These are topical issues in the current period of the COVID pandemic. In Verga's works the theme of hygiene, epidemiology, and infectious diseases occur. There are many hints related to medicine, especially as far as the typical diseases of poor society and the difficult social environments of the time are concerned. One of the most common diseases described by Verga was cholera but also malaria and tuberculosis occur. Results: It was estimated that 69,000 people died of cholera in Sicily, of whom 24,000 in Palermo. The public health situation in Italy was difficult. Verga denounces people's ignorance and the survival of past beliefs. Conclusion: Verga describes a culturally and economically humble society, in a region characterized by large class gaps. It draws a difficult picture of the public health situation in the second half of the 19th Century and people's daily lives. The authors believe that today it is important that the centenary of Verga's death be an opportunity to read his works, also from a medical historical point of view.

History of medicine in medical education: new Italian pathways.

Objective: There is little doubt that there are currently obstacles in measuring the impact of the history of medicine within medical training. Consequently, there is a clear need to support a vision that can historicize Euro-Western medicine, leading to a greater understanding of how the medical world is a distinct form of reality for those who are about to immerse themselves in the study of medicine. Methods: History teaches that changes in medicine are due to the processes inherent to the interaction among individuals, institutions, and society rather than individual facts or individual authors. Results: Therefore, we cannot ignore the fact that the expertise and know-how developed during medical training are the final product of relationships and memories that have a historical life that is based social, economic, and political aspects. Conclusion: Moreover, these relationships and memories have undergone dynamic processes of selection and attribution of meaning, as well as individual and collective sharing, which have also been confronted with archetypes that are still able to influence clinical approaches and medical therapy today.

Pain and its management: Dante's Divine Comedy.

Dante Alighieri died in 1321; therefore, 2021 is the 700th anniversary of his death. His best known work is the Divine Comedy, which explores Dante's journey through the three realms of the underworld. Each realm is associated with three different sensations: Inferno, bodily (pain); Purgatorio, acoustic (music); and Paradiso, visual (light). The progression of the painful experiences and the resolution through music and light mirror the modern understanding of pain and its management. Music has both direct and indirect benefits and can help with coping. Sunlight promotes well-being and self-awareness.

From Baltimore to Italy: The contribution of Grace Baxter (1869-1954) to the development of Italian nursing.

The recent discovery of unpublished documents in the archives of the Camerata hospital, (Florence, I) sheds light on an important chapter in the history of nursing education and the role played by Grace Baxter (1869-1954), of English parentage but born and lived in Florence. The introduction of professional nurses was part of the international movement for the emancipation of women that included education for an active role in society. Her contribution, with other women, to the history of Italian nursing resulted in the secularisation the profession away from the attitudes of the nuns, permeation of relevant ethical standards, and the beginning of professionalisation of nurses in Italy in accordance with Florence Nightingale's teaching.

Dino Buzzati's 50th death anniversary: an appraisal of medicine and infectivology's influence on his literary production.

BACKGROUND AND AIM: This paper, in the 50th anniversary of the author's death, examines the overall impact and influence of medicine, in particular of infectious diseases, on the literary production of Italian writer and novelist Dino Buzzati (1906-1972). METHODS: Analysis of literary sources and historical study. RESULTS AND CONCLUSIONS: Buzzati's literary world is great fun for the reader, being both intriguing and anxiety forming at the same time. One finishes reading his books only to discover the one truth which overturns everything that seemed to be true. In particular, in his short stories, which stem mostly from episodes taken from everyday life, the plot suddenly comes to life. The atmosphere becomes surreal, and in a moment the incredible happens. Behind the apparent lightness of the fairytale narrative there lies hidden the important issues addressed by the author. He uses the hospital as a metaphor for a categorised life, in which we are at risk of no longer being masters of ourselves, in which we suffer a continuous steady drip that makes us head downwards day after day, floor after floor. We will come back up, but not today, tomorrow perhaps, or at the latest, the day after tomorrow. Corte on the second floor hopes, and screams to give strength to his hope, that he will soon return to the top, towards the seventh floor.

In Search of a Lost Father: Adrien Proust (1834-1903), An Almost Forgotten Public Health Pioneer.

OBJECTIVES: In this communication, we wish to remember the important historical role played by Marcel Proust's father, the now mostly forgotten Achille-Adrien Proust (1834-1903). STUDY DESIGN AND METHODS: His career, scientific interests and, above all, his brilliant intuitions and suggestions in the fight against cholera in the 19th century are recalled. RESULTS AND CONCLUSIONS: His role in the promotion of a globally effective vision of public hygiene and health is stressed as a bright example for modern physicians fighting contemporary epidemics.

Intertwining art, religion and anatomy: did Michelangelo Buonarroti influence Berengario da Carpi's representation of a maternal death?

AIM: To confirm that the sixteenth century surgeon-anatomist, Jacopo Berengario da Carpi, used a woman who died of a ruptured uterus as a model for a woodcut of female genital anatomy, and that the presentation was based on the cloak in Michelangelo's Creation of Adam after visiting the Sistine Chapel in the Vatican whilst he was in Rome. METHOD: Analysis of the woodcut for evidence of a uterus at term, and comparison with the shape of the cloak in the Creation of Adam, coupled with Berengario's own description. RESULTS: The size of the uterus is that in the 38th to 40th week of pregnancy, further supported by striations of the endometrial surface, rather than the smooth surface of the non-gravid. By rotating the woman's image 90° counterclockwise, the outline of the woman's cloak becomes almost perfectly superimposed over God's cloak. CONCLUSION: In the woodcut, the open belly of the model shows typical features of the full-term uterus. The use of God's cloak softens the features. At the same time, it exemplifies the creative power of God and describes the birth of humanity in both theological and physiological ways. Intertwining art, religion and anatomy, Michelangelo and Berengario allow scholars to appreciate the concepts of divinity and humanity at multiple levels.

SARS-CoV-2 (COVID-19) and the Teaching of Ignaz Semmelweis and Florence Nightingale: a Lesson of Public Health from History, after the "Introduction of Handwashing" (1847).

Ignác Fülöp Semmelweis (1818-1865) and Florence Nightingale (1820-1910) were two important personalities in the history of medicine and public health. They dealt with the problem of handwashing. Semmelweis is also known as the "father of hand hygiene"; just in 1847 he discovered the etiology and prophylaxis of puerperal sepsis and imposed a new rule mandating handwashing with chlorine for doctors. He also tried to persuade European scientific community of the advantages of handwashing. During the Crimean War, in Scutary (Turkey), Florence Nightingale strengthened handwashing and other hygiene practices in the war hospital where she worked and her handwashing practices reached a reductions in infections. Unfortunately the hygiene practices promoted by Semmelweis and Nightingale were not widely adopted. In general handwashing promotion stood still for over a century. During current pandemic SARS-CoV-2 (COVID-19) one of the most important way to prevent the spread of the virus is still to wash the hands frequently.

Why paleomedicine is useful for medical education.

What is the place of medico-historical cases in the professional practice of the disciplinary field of medicine and biology? How can these patients from the past be used for teaching and continuing medical education? How to justify their place in biomedical publications? In this article, we explain all the legitimacy of paleomedicine, and the need to intensify such research in the form of a well-individualised branch of paleopathology and the history of medicine.