What Is the Role of Sex-Related Differences in the Effectiveness and Safety of Biological Drugs Used in Patients With Severe Asthma?

Biological drugs are used to treat severe asthma with an improvement of clinical symptoms. Data on sex difference of these drugs in patients with severe asthma are sparse. This study aimed to assess the effects of sex-related differences on biological drugs in patients with severe asthma. In this observational, open-label, prospective, noncontrolled, single-center cohort pilot study, we enrolled adult patients aged >18 years diagnosed with severe asthma and not previously treated with biological drugs. The first clinical end point was the statistical difference (P < .05) in the efficacy of biological drugs evaluated using the asthma control test and spirometry between sexes. The first safety end point was the statistical difference (P < .05) in developing adverse drug reactions between sexes. We enrolled 74 patients with severe asthma (48 women and 26 men) with a mean age of 59.4 (standard deviation, 11.8) years. The mean forced expiratory volume in 1 second was 6.9 (standard deviation, 13.9) for women and 9.4 (standard deviation, 10.7) for men and improved significantly after the treatment (P < .01), with no significant differences in sex (P = .8). Similarly, the asthma control test improved 12 months after the beginning of the treatment without significant differences between men and women (P = .5). The most common drug used was omalizumab (45.9% of the patients; P < .01) without significant differences between sex (P > .05). We did not observe the development of adverse drug reactions during the study. In conclusion, in asthmatic patients, sex does not have a role in either the effectiveness or safety of biological drugs.

Crime scene investigation and dynamic reconstruction: importance of synergic collaboration between forensic pathology and digital reconstruction for work-related fatalities.

A crime scene is the result of the dynamic interrelation of various factors. Where a fatality is involved, thorough analysis of the scene by a forensic pathologist produces the first data for verifying consistency between the necropsy results and witness testimonies toward defining the dynamics of injury and death. This step is extremely important in identifying any liability. We present the case of a construction worker who fell through a trapdoor between two floors while holding an iron beam at a building site. This case demonstrates the effectiveness of an integrated approach, using both classic forensic investigation techniques and digital 3-D reconstruction: it allowed verification of the dynamics of the injury and provided important information in assessing the employers liability.

Anabolic-androgenic steroids and brain injury: miRNA evaluation in users compared to cocaine abusers and elderly people.

Anabolic-androgenic steroids (AASs) can be used to treat both hormonal diseases and other pathologies characterized by muscle loss (aging, cancer, and AIDS). Even if the adverse effects related to the misuse of AASs have been well studied in different systems and apparatuses, knowledge about brain damage is poor.In this scenario, this experimental study aimed to analyze the role of several microRNAs (miRNAs) in brain damage after AAS misuse, to better comprehend the underlying mechanisms. The research hypothesis at the base of this experimental study is that the chronic use of AASs may be associated to brain damage with a dysregulation of these miRNAs. Moreover, miRNA expression values were compared among three different groups, "AAS" group, "Cocaine" group and "Aging" group, in order to define if AAS brain damage can be compared with the brain impairment linked to aging and/or cocaine assumption.This experimental study revealed that the tested miRNAs (hsa-miR-21-5p, hsa-miR-34a-5p, hsa-miR-124-5p, hsa-miR-132-3p, and hsa-miR-144-3p) were overexpressed in all enrolled groups. In the light of the presented results, the identification of specific circulating and/or tissue biomarkers is challenging for the scientific community. Further studies with larger samples are needed to confirm these interesting findings.

To be or not to be vaccinated? That is the question among Italian healthcare workers: a medico-legal perspective.

Vaccines are among the greatest medical and scientific achievements of the modern age. In this context, this article provides a medico-legal perspective on vaccinations among healthcare workers. The use of vaccines involves various issues, such as the possibility of side effects, which has led to fairly widespread suspicion and rejection, especially for vaccinations in the early years of life. Vaccine use also raises various ethical and legal problems, such as animal experimentation, obtaining informed consent, and the possibility of conflicts between individual rights and collective rights. Vaccinations is a key concept in the theme of life care, which is at the center of bioethical debate, but it also exacerbates the conflict between the good of the individual versus the good of the community. However, vaccination of healthcare workers represents a crucial measure of infection control within healthcare facilities.