Vaccination through time: from the first smallpox vaccine to current vaccination campaigns against the COVID-19 pandemic.

The systematic study of the evolution of the concept of vaccination constitutes a fascinating journey through time and the scientific development of effective and safe vaccines against infectious diseases is one of the greatest achievements in the history of medicine. In the western world vaccination dates back to the eighteenth century, a period in which smallpox was a diffused and often lethal disorder, and in many countries attempts at the prevention of such a medical and social threat were conducted. The English surgeon Edward Jenner (1749-1823) is commonly considered the discoverer of the vaccination for smallpox. Moving from remote history to recent periods, the ongoing 2019-2021 coronavirus disease (COVID-19) pandemic has posed a tremendous challenge to the health systems and consequently to entire society of the countries involved. It has triggered all over the world the rapid development of several effective vaccines, never before prepared in such a brief span of time. It must be acknowledged that modern vaccinology as a science stands at the crossroads of multiple medical specialities and scientific disciplines, being in particular debtor to health care branches born and developed between the end of the nineteenth century (infectivology) and the beginning of the twentieth (immunology). In turn, twentieth century explosive progress in the field of vaccination has triggered the development of other important medical areas, from immunopathology to infectious diseases therapy, and from prevention to anti-cancer treatment. Nowadays, effective and diffused control of infectious diseases cannot do without  the presence of vaccines, as the COVID-19 pandemic has once again demonstrated, and the role of well structured vaccine programs and of capillary and systematic vaccine campaigns has become central not only for the health but also for the existence itself of entire populations all over the world.

Historical and methodological highlights of quarantine measures: from ancient plague epidemics to current coronavirus disease (COVID-19) pandemic.

The ongoing 2020 coronavirus disease (COVID-19) pandemic is an enormous challenge for the health systems and the entire societies of the countries involved. Since at present the outbreak continues to evolve (April 2020), the World Health Organization (WHO) has declared it a public health emergency of international concern, specifying that public health interventions aimed at the prevention of the further spread of this disease include quarantine. Quarantine, that may be defined as a restraint on the activities of people or on the traffic of goods, targeted to the prevention of the diffusion of communicable pathologies, is a health concept profoundly rooted in the history of mankind. The lessons of the past are always pertinent for the present and for the future, in particular from a public health standpoint. One of the most relevant of them is connected with previous influenza pandemics, similar to the current COVID-19 2019/2020 pandemic, and it indicates that it is practically impossible, even in recent times, to contain the infection in the geographic area where it has risen and to prevent its trans-national disseminated spread. With specific reference to the COVID-19 pandemic, therefore, health authorities still adopt "classical" preventive interventions, namely workplace social distancing measures and quarantine, to reduce the transmission of the disease. Only the future will testify the precise overall effectiveness of preventive public health measures in containing the impact of the present coronavirus pandemic. However, what in this epidemiological scenario is already known, is that the multi-century international health value of quarantine remains essential and unavoidable.

Protective face masks through centuries, from XVII century plague doctors to current health care professionals managing the COVID-19 pandemic.

The adoption of items similar to face masks by human beings dates back to the remote past. With specific regard to the use of face protections for medical purposes, from the beginning of the XVII century onwards in Europe physicians in charge of curing patients with plague wore a complicated, and subsequently typical, costume. The face mask included eye sockets of glass and leather headdresses with long, pointed beaks. These beaks were filled with scented spices, aromatic substances and perfumes to filter out the plague and to mask "bad air", which was considered to be the vehicle of the disease. In the XVIII and XIX centuries a number of advances regarding personal protection devices in health care were achieved. In the course of the 1918 influenza pandemic (Spanish flu), health care professionals began to use face masks in a routine way to protect themselves and their patients. From the sixties (XX century) onwards, the explosion of health care technology has led to a continuous refinement in the study of individual protection devices, also because, even in the presence of an increasing number of powerful antimicrobial agents, infectious diseases have remained dominant during these last decades. It is not by chance, therefore, that one of the consequences of the 2020 ongoing COVID-19 pandemic should be the fact that face masks have become essential again both inside and outside health care environments. Even if more than a century has passed from Fluegge's historical definition of bacteria-laden droplets, the role of certain medical-preventive achievements of the past, including the paradigmatic model of protective face masks, continues to remain pivotal in this third millennium.

"Nobel Prizes in Medicine as an overview on XX and XXI centuries biomedicine and health sciences: historical and epistemological considerations".

Nobel Prizes are prestigious world awards attributed for intellectual achievements. There are six prizes awarded each year from a fund bequeathed by the Swedish industrialist Alfred Bernhard Nobel (1833-1896). Each Prize consists of a diploma, a gold medal and a sum of money and it may be attributed to one, two or three different persons. The Nobel Prize in Physiology or Medicine is regarded as the most relevant scientific acknowledgement in the biomedical area and is annually assigned to the living researcher, or researchers, who has/have more contributed to progress in this field. Nobel Prizes in Medicine so far attributed are 110 with 219 medicine laureates, of whom the youngest was 32 years old and the oldest 87. Twelve women have been awarded the prize and nobody has been awarded it more than once. The Nobel Prize in Physiology or Medicine is fundamental and its more than secular history certifies this. Generations of distinguished scientists have rightly been awarded it for discoveries, demonstrations and applications of paramount relevance. The geographical distribution and the number of scholars appointed with the Nobel Prize in Medicine, the areas of health sciences and biomedical research related to the awards and the motivations of the annually attributed Nobel Prize in Medicine provide a complete and stimulating historical and epistemological panorama of medicine, biology and health sciences in the course of the XX and XXI centuries.

Anatomical study in the Western world before the Middle Ages: historical evidence.

Although modern anatomy is commonly retained to begin in the XVI century, the roots of anatomical study in the Western world may be identified beforehand. An anatomical practice was present in the Western world well before the Middle Ages, starting in ancient Greece. Hippocrates of Cos (V-IV centuries B.C.) provided descriptions of the heart and vessels, and the so-called "Hippocratic Corpus" largely deals with anatomy. Aristotle of Stagira (IV century B.C.) was one of the first well-known scholars of the past to perform dissections of animals. The anatomical interest of Aristotle contained a "physiological" background too, since he was convinced that all parts of human organisms had one or more specific functions. Galen of Pergamum (II century A.D.) was the performer of hundreds of dissections of animals, and he described a great number of anatomical parts of apes, dogs, goats and pigs. The anatomical system of Galen became a gold standard for medicine for more than a thousand years, and in the Middle Ages (V-XV centuries A.D.) the human anatomy that was taught and acquired in European universities remained based on Galenic anatomy. In conclusion, Greek-speaking scholars between the IV century B.C. and the II century A.D. set the basis for the systematic dissection of animals and the comparative investigation of animal anatomical findings. These scholars also began to study the structures of the human body, interestingly taking into account the relationship between the macroscopical morphology of observed structures and their more evident functions. (www.actabiomedica.it).

Historical evolution of the concept of health in Western medicine.

"Health" is a positive multi-dimensional concept involving a variety of features, ranging from ability to integrity, from fitness to well-being. According to the first principle of the constitution of the World Health Organization "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity". This constitution was adopted by the International Health Conference held in New York in June-July 1946 and became operative in April 1948. This classical, seventy-year old definition of the World Health Organization is nowadays considered a historical one and it stands as a fundamental milestone of a diachronic track beginning, in Western medicine, with the definition of health proposed by Hippocrates and his School. For Hippocrates health was the state of equilibrium of four humours. This philosophical-naturalistic definition has been flanked in the history of Western medicine by various concepts of health and disease, alternatively based, according to different scientists and in different medical contexts and periods, on epidemiological, anatomical, physiological, functional, social and molecular perspectives. Since biomedical definitions are always prone to integration and updating, depending on the continuous achievements of medical science and bioethics, the fascinating journey through the concepts of health and disease, the fundamental milestones of which are here briefly proposed, is still in progress.

From informed consent to informed dissent in health care: historical evolution in the twentieth century.

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An Analysis of the Changes in Communication Techniques in the Italian Codes of Medical Deontology.

BACKGROUND AND AIM OF THE WORK: The code of deontology of the Italian National Federation of the Colleges of Physicians, Surgeons and Dentists (FNOMCeO) contains the principles and rules to which the professional medical practitioner must adhere. This work identifies and analyzes the medical-linguistic choices and the expressive techniques present in the different editions of the code, and evaluates their purpose and function, focusing on the first appearance and the subsequent frequency of key terms. METHODS: Various aspects of the formal and expressive revisions of the eight editions of the Codes of Medical Deontology published after the Second World War (from 1947/48 to 2014) are here presented, starting from a brief comparison with the first edition of 1903. Formal characteristics, choices of medical terminology and the introduction of new concepts and communicative attitudes are here identified and evaluated. RESULTS: This paper, in presenting a quantitative and epistemological analysis of variations, modifications and confirmations in the different editions of the Italian code of medical deontology over the last century, enucleates and demonstrates the dynamic paradigm of changing attitudes in the medical profession. CONCLUSIONS: This analysis shows the evolution in medical-scientific communication as embodied in the Italian code of medical deontology. This code, in its adoption, changes and adaptations, as evidenced in its successive editions, bears witness to the expressions and attitudes pertinent to and characteristic of the deontological stance of the medical profession during the twentieth century.

Driving and effectively treated Obstructive Sleep Apnea Syndrome.

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The Italian Code of Medical Deontology: characterizing features of its 2014 edition.

The latest edition of the Italian Code of Medical Deontology has been released by the Italian Federation of the Registers of Physicians and Dentists in May 2014 (1). The previous edition of the Italian Code dated back to 2006 (2), and it has been integrated and updated by a multi-professional and inter-disciplinary panel involving, besides physicians, representatives of scientific societies and trade unions, jurisconsults and experts in bioethics....

The birth and evolution of the Ministry of Health and of the National Health Service in Italy.

Current Ministries of Health (MH) have fundamental commitments in the body of modern States and exercise a number of functions that mainly regard the safeguard of human and animal health and medical-health planning and management. The many and various tasks of third millennium MH range from the surveillance of the safety of alimentary products, workplaces and the general environment to the organization of health professions and structures, from veterinaryservices to scientific research in the health context, from prevention of disorders to care and rehabilitation of diseases (1). [...].

Scientific profile and professional responsibility of Court-appointed Medical Technical Consultants in Italy: time for a specific educational curriculum?

Court-appointed Technical Consultants (CTCs) are fundamental figures in the Italian judicial system. CTCs are experts appointed by judges in order to supplement their activities by ascertaining, collecting and analyzing facts concerning the specific subject of a lawsuit. These experts formulate opinions, gather motivations and perform checks to provide clear, objective and irrefutable answers to the questions posed by judges. With direct reference to the medical field, while police doctors (specialists in forensic medicine) follow an academic, dedicated, well-structured educational curriculum, the University specialty school in Forensic Medicine, other medical CTCs, though not infrequently luminaries with one or many medical specialties and professional acknowledgments, may have no specific legal-medicine and juridical expertise, precisely because a similar expertise is not formally required of them. In the light of these considerations, in Italy some professionals of the legal world, and of the health context too, have proposed for medical CTCs targeted educational pathways, which would provide these experts with formal specific qualifications. In synthesis and in conclusion, a full knowledge and a rigorous respect of the rules of legal proceedings emerge as increasingly important characteristics for current and future Court-appointed Technical Consultants, together with a specific educational curriculum.

Medicine and wagering: same terms, different concepts.

Medicine and wagering are apparently distant contexts. However, they share a number of basic terms and expressions. In effect, shaping estimates and making forecasts are fundamental tasks common both to medicine and betting. In conclusion, a series of terms are used both in medicine and wagering, and the analogous statistical roots and the common necessity of computing risks and formulating predictions explain the presence of the same terms, indicating the permeability of the medical context to the insertion of terminology taken from other fields. Obviously, the meaning and application of words change in the two contexts, as the history of medicine well documents.

[Clinical profiling of a complex, asyntomatic patient beyond the standard assessment of cardiovascular risk]. / Un paziente asintomatico complesso che impone di andare oltre la valutazione tradizionale del rischio cardiovascolare.

The multi-dimensional evaluation of an elderly hypertensive subject, asyntomatic yet complex, evidences the need for a clinical assessment going beyond the limits of the traditional analysis of cardiovascular risk. The case here described provides a reasoned guide for the integration of all risk elements and factors in the global definition of the risk profile of an individual in primary prevention, and only apparently at moderate cardiovascular risk.