Human genetics in post-WWII Italy: blood, genes and platforms.

Italian Life sciences in post-WWII faced important challenges: the reconstruction of a scientific panorama suffering heavily after two decades of Fascism and the damages of war. Modernization was not only a matter of recreating a favorable environment for research, by modernizing Italian biomedical institutions and connecting the Italian scientists with the new ideas coming from abroad. The introduction of new genetics required a new array of concepts and instruments, but also, the ability to connect to international networks and to become active members of a broader scientific community. Because of the several socio-cultural issues involved (eugenics, racism, religion, politics), human genetics is a good case study in order to analyze how Italian life sciences managed the transition towards a new research system, and the influences Italian human geneticists received. The paper focuses primarily on the development of the early career of Luigi Luca Cavalli-Sforza, probably the most prominent scientist in post-WWII human genetics in Italy, and his friend and colleague Ruggero Ceppellini. In following their path, a healthy mix of local traditions and international stimuli emerges, allowing for the establishment-within and beyond national borders-of the discipline.

History of anaesthesia: Nurse anaesthesia practice in the G7 countries (Canada, France, Germany, Italy, Japan, the United Kingdom and the United States of America).

: Many factors determine whether nurses, physicians or both administer anaesthesia in any country. We examined the status of nurse-administered anaesthesia in the Group of Seven (G7) countries (Canada, France, Germany, Italy, Japan, the United Kingdom and the United States of America) and explored how historical factors, mixing global and local contexts (such as professional relations, medical and nursing education, social status of nurses, demographics and World Wars in the 20th century), help explain observed differences. Nearly equal numbers of physicians and nurses are currently engaged in the delivery of anaesthesia care in the United States but, remarkably, although the introduction or re-introduction of nurse anaesthesia in the 20th century was attempted in all the other G7 countries (except Japan), it has been successful only in France because of the cooperation with the United States during World War II.

"A Chain is gonna come". Building a penicillin production plant in post-war Italy.

In 1947, Ernst Chain moved from Oxford to Rome, hired as head of a new biochemistry department and of a penicillin production pilot plant in the Istituto Superiore di Sanità (Higher Health Institute). Here, he managed to make Rome one of the most important centres in the international network of antibiotic science. However, the development of the state-operated centre was not easy. Political and economic pressures, exerted both from home and abroad, posed many obstacles to the plan devised by Domenico Marotta, the general director of the Institute. The paper reconstructs Chain's venture in Rome, which lasted until 1964, while framing the history of the penicillin production plant in the context of diplomatic negotiations, national politics, and science policies.

A New Medical Record Proposal to the Prognostic Risk Assessment for MRONJ in Oncologic Patients: "Sapienza Head and Neck Unit" Proposal.

Medication-related osteonecrosis of the jaw (MRONJ) is an adverse event associated with antiresorptive and antiangiogenic drugs. The use of these drugs in the treatment of cancer patients with bone metastasis is necessary and standardized in the literature. A multidisciplinary approach for the patient's management is strongly recommended. Therefore, it should be necessary to integrate the path of these subjects with a dedicated dental screening in order to first assess the individual risk of developing a MRONJ, and then to plan dental treatments and oral hygiene sessions, and finally to schedule a follow-up to intercept and treat early osteonecrosis. The aim of this manuscript is to propose a new simple medical report to evaluate patients affected by metastatic bone cancer in order to reduce the risk of developing MRONJ.

Thomas Hunt Morgan and the invisible gene: the right tool for the job.

The paper analyzes the early theory building process of Thomas Hunt Morgan (1866-1945) from the 1910s to the 1930s and the introduction of the invisible gene as a main explanatory unit of heredity. Morgan's work marks the transition between two different styles of thought. In the early 1900s, he shifted from an embryological study of the development of the organism to a study of the mechanism of genetic inheritance and gene action. According to his contemporaries as well as to historiography, Morgan separated genetics from embryology, and the gene from the whole organism. Other scholars identified an underlying embryological focus in Morgan's work throughout his career. Our paper aims to clarify the debate by concentrating on Morgan's theory building-characterized by his confidence in the power of experimental methods, and carefully avoiding any ontological commitment towards the gene-and on the continuity of the questions to be addressed by both embryology and genetics.

[The international network and Italian modernization. Ruggero Ceppellini, genetics, and HLA]. / NETWORK INTERNAZIONALI E MODERNIZZAZIONE ITALIANA. RUGGERO CEPPELLINI, LA GENETICA E L'HLA.

The paper reconstructs the scientific career of Ruggero Ceppellini, focusing especially on his role in the discovery of the genetic system underlying the Human Leucocyte Antigen. From his earliest investigations in blood group genetics, Ceppellini quickly became an internationally acknowledged authority in the field of immunogenetics--the study of genetics by means of immunological tools--and participated to the endeavor that ultimately yelded a new meaning for the word: thanks to the pioneering research in the HLA field, immunogenetics became the study of the genetic control of immune system. The paper will also place Ceppellini's scientific work against the backdrop of the modernization of Italian genetics after WWII, resulting from the efforts of a handful of scientists to connect to international networks and adopting new methodologies in life sciences.

Cold drugs. Circulation, production and intelligence of antibiotics in post-WWII years.

The paper details how the earliest antibiotics were subject to a strict control during the earliest phase of the Cold War. Because of antibiotics strategic and economic value, Anglo-American Governments restricted circulation of scientists, techno-scientific know-how and technology related to penicillin production, as well as closely controlling the circulation of the drugs in the Communist countries. These efforts are documented by archival documents, testifying how drugs were actual instruments of propaganda and political strategies, affecting pharmaceutical development both in the Western and the Eastern bloc.

The life and times of Ferruccio Ritossa.

Ferruccio Ritossa wrote these lines only a few months before he died, as a preface to a book he wanted to write and that, unfortunately, we will never be able to read. It was to be the story of his life, an amazing story indeed. With this article, we want to take a picture of Ferruccio's life, a mosaic of events, facts, ideas, hopes, and memories linked in a way that they will not go away, even after "a stroll in our brain."

The "CROMa" Project: A Care Pathway for Clinical Management of Patients with Bisphosphonate Exposure.

Aim. To describe 7 years of activity of "CROMa" (Coordination of Research on Osteonecrosis of the Jaws) project of "Sapienza" University of Rome. Materials and Methods. A preventive and therapeutic care pathway was created for patients with bisphosphonates (BPs) exposure. Demographic, social, behavioural, pharmacological, and clinical variables were registered in a dedicated database. Results. In the project, 502 patients, 403 females and 99 males, were observed. Bone pathologies were 79% osteometabolic diseases (OMD) and 21% metastatic cancer (CA). Females were 90% in OMD group and 41% in CA. BP administration was 54% oral, 31% IV, and 11% IM; 89% of BPs were amino-BP and 11% non-amino-BP. Consistently with bone pathology (OMD/CA), alendronate appears to be prevalent for OMD (40% relative), while zoledronate was indicated in 92% of CA patients. Out of 502 cases collected, 28 BRONJ were detected: 17 of them were related to IV BP treatment. Preventive oral assessment was required for 50% of CA patients and by 4% of OMD patients. Conclusions. The proposed care pathway protocols for BP exposed patients appeared to be useful to meet treatment and preventive needs, in both oncological and osteometabolic diseases patients. Patients' and physicians' prevention awareness can be the starting point of a multilevel prevention system.

Making biomedicine in twentieth-century Italy: Domenico Marotta (1886-1974) and the Italian Higher Institute of Health.

This paper focuses on the role played by Domenico Marotta, director of the ISS (Higher Institute of Health) for over twenty-five years, in the development of twentieth-century Italian biomedicine. We will show that Marotta aimed to create an integrated centre for research and production able to interact with private industry. To accomplish this, Marotta shifted the original mission of the ISS, from public health to scientific research. Yet Mussolini's policy turned most of the ISS resources towards controls and military tasks, opposing Marotta's aspiration. By contrast, in the post-war years Marotta was able to turn the ISS into the most important Italian biomedical research institution, where research and production fruitfully cohabited. Nobel laureates, such as Ernst Chain, and future Nobel laureates, such as Daniel Bovet, were hired. The ISS built up an integrated research and production centre for penicillin and antibiotics. In the 1960s, Marotta's vision was in accord with the new centre-left government. However, he pursued his goals by ruling the ISS autocratically and beyond any legal control. This eventually led to his downfall and prosecution. This also marked the decline of the ISS, intertwined with the weakness of the centre-left government, who failed to achieve structural reforms and couple the modernization of the country with the democratization of its scientific institutions.

[The historical roots of regeneration research]. / Prima delle cellule staminali. Appunti da due secoli di ricerche sulla rigenerazione.

The paper reconstructs the historical roots of regeneration research, now a major subject in biomedicine, focusing on the development of concepts and practices from the epigenesis vs preformation debate in the late XVIII century to the experimental embryology in the first half of XX century. In this time span, regeneration attracted a good deal of attention because of its role as a natural experiment for testing developmental as well as physiological hypotheses. It is therefore a useful historical subject in order to understand the pathways of progress in life sciences and to shed some light on the epistemological debates of contemporary biomedicine.

The low level laser therapy in the management of neurological burning mouth syndrome. A pilot study.

BACKGROUND AND OBJECTIVE: Burning Mouth Syndrome (BMS) is a common disease but still a diagnostic and therapeutic challenge for clinicians. Despite many studies its nature remains obscure and controversial; nowadays there is no consensus about definition, diagnosis and classification. BMS is characterized clinically by burning sensations in the tongue or other oral sites, often without clinical and laboratory findings. According to the etiology, BMS cases should be subdivided into three subtypes: BMS by local factors (lfBMS), BMS by systemic factors (sfBMS) and neurological BMS (nBMS), the most frequent, in which the symptom is caused by central or peripheral neurological malfunctions affecting in particular the taste pathway. To establish the type of BMS, both anamnesis and clinical examination, including laboratory tests, are necessary; nBMS cases will be recognized by exclusion of any other type. In case of lfBMS or sfBMS, the treatment of the main pathology will be resolutive; in nBMS cases many Authors proposed different pharmacological trials without satisfactory results and the current opinion is that a multidisciplinary approach is required to keep the condition under control. This pilot study aimed to investigate whether the biostimulative effect of Low Level Laser Therapy (LLLT) could enhance the symptoms of nBMS cases, improving patients' quality of life. STUDY DESIGN/MATERIALS AND METHODS: Among 160 patients affected by oral burning sensation attending to the Oral Pathology Complex Operative Unit of the Department of Stomatological Sciences of Sapienza University of Rome, 77 resulted affected by nBMS. Twenty-five of these patients, 16 females and 9 males, were randomly selected for low level laser applications. All the patients were irradiated with a double diode laser (Lumix 2 Prodent, Italy) emitting contemporarily at 650 nm and 910 nm, with a fluence of 0.53 J/cm(2) for 15 minutes twice a week for 4 weeks. The areas of irradiation were the sides of the tongue on the path of taste fibers. A NRS (numerical rating scale) evaluation of maximum and minimum pain was registered before and after the treatment. In each case to the total value of NRS rates registered before the treatment was deducted the total NRS rate registered after the treatment. The difference was estimated effective if over two points. The Kruskall-Wallis test revealed the significance of the study (p<0.0001) and the Dunn's Multiple Comparison test, applied to compare NRS rates before and after the treatment, showed that there is not a statistically relevant difference between min NRS ratings before and after treatment, while there are statistically significant differences between max NRS ratings (p<0.05). RESULTS: All the patients agreed the treatment confirming the general good compliance related to laser treatments. No side effects were registered and all the patients completed the therapy without interruption. Seventeen patients (68%) had relevant benefits from the treatment with valid reduction of NRS ratings. In 8 cases the differences of NRS rates were not relevant being under the limit of reliability established in study design. In no case there was a worsening of the symptoms. CONCLUSIONS: According to the results of this pilot study it is reasonable to suppose that LLLT may play an important role in the management of nBMS cases, more investigations are needed to clarify, by a greater number of cases and a placebo control group, the real effectiveness of this innovative LLLT application.

Southern genes. Genetics and its institutions in the Italian South, 1930s-1970s.

The paper examines the historical vicissitudes of Genetics and Medical Genetics in the "Mezzogiorno", focussing on the emergence of local traditions and their mingling with international trends. The development of these disciplines took place in a peculiar mix of politics and science that lead to a rapid growth in the '50s and the '60s, followed by an harsh crisis. Though important and enduring results were attained, Italian genetics community failed to maintain the status reached in the two preceding decades, and quickly moved to the periphery of international networks.

[Biology and utopia. Adriano Buzzati Traverso and Italian science]. / Tra biologia e utopia. Adriano Buzzati Traverso nella scienza Italiana.

The paper aims at reconstructing the scientific career of Adriano Buzzati-Traverso, a prominent character in Italian biology after the Second World War. In the Fifties and the Sixties, he was able to introduce the new molecular approaches in life sciences. A great scientific manager, much ahead of his times (at least in Italy), he successfully organized the first postgraduate courses of genetics and molecular biology in Pavia, and later created the International Laboratory of Genetics and Biophysics in Naples. Between 1962 and 1969, this institution gained the greatest respect in the scientific community, but the political turmoil in 1969 abruptly ended this fascinating attempt to modernize Italian science. Buzzati-Traverso's personal archive allows us to reconstruct the detailed history of his scientific enterprises, focusing particularly on the hard struggle to modernize management and policies of Italian science.