Women in the medical profession in 1900 from extended maternity to social equity. The life of Lucia Servadio.

The history of social medicine in Italy between the late nineteenth and early twentieth centuries was characterised by a marked presence of gender and the consequent commitment of women of Jewish origin to the issues of early childhood education, as well as safeguarding of work and motherhood and health prevention with regard to social and cultural fragility. Some of the roles of women engaged in social medicine campaigns have been widely studied in the historiography of medicine, having recognized their roles and commitment to attempting to create a fair society through their expertise in medicine and health. However, there are some biographies and professional lives that are still unpublished and worthy of attention by historical medical research. Lucia Servadio, who was of Jewish origin (1900-2006), was the youngest Italian doctor of the first twenty years of the twentieth century. She successfully worked, despite the degrading identification of women at the time, in the field of medicine and welfare, thanks to her qualified professional, cultural and social commitment. Dr Servadio's professionalism was constantly defined by a vision of health as a right that the doctor must protect by pursuing the goal of social equity. Precisely on the basis of these principles, solidified by the practical and social activism of women's groups of the time, Dr Servadio's professional and private life was continuously shaped between medicine and social activism. However, her story is also pervaded by the ambiguity of the role played by women, often highly educated and with considerable professional standing, engaged in forms of scientific intellectual collaboration of a conjugal nature.

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.

Once again on the Empress Zoe: Women, dermatology, cosmetics, and materia medica (medical matter) in the ancient world.

BACKGROUND: An article published in 2012 in the Journal of Cosmetic Dermatology discussed the historical sources presenting the Byzantine Empress Zoe Porphyrogenita as an expert in cosmetic and pharmacological remedies that could give their users a youthful appearance and a kind of eternal youth. However, it did not take into account a dermatological recipe attributed to Zoe which text transmission has preserved. AIMS: To examine some ingredients of Zoe's recipe from a historical medical point of view and contextualize the text in the tradition of ancient medical matter, physiology of aging, and gender pharmacological skills. METHODS: After contextualizing the recipe from the historical medical point of view, some of its ingredients have been analyzed in relation not only to their use in the most authoritative pharmacological and medical sources of antiquity but also to their symbolic meaning. RESULTS: The analysis of Zoe's dermatological recipe allowed to highlight: The links between cosmetics and medicine in Greek and Roman Antiquity. The reason why ancient sources dealing with medical matter attributed to certain substances and plants the power to save the human body from old age and decay. The consistency between the ingredients of Zoe's recipe and the humoral physiology by genders and by age of Hippocrates. The existence of a female tradition in pharmacological competence. CONCLUSION: Cosmetic dermatology of antiquity is the perfect point in which survival of the myth and rational pharmacology overlap.

The kinesthetic diagnosis in a homeric item of pathological heartbeat: An overview in the history of ancient greek medicine.

The Iliad, by the Greek poet Homer, is a precious mine of examples of war traumatology. In the specific case of spear wounds in the chest, the death of the Trojan warrior Alcathous is particularly interesting from the point of view of the history of medicine and the evolution of cardiology and knowledge of the heart at the time of ancient Greece. In particular this paper aims to evidence and reconstruct the main anatomical and physiological knowledge of the heart at that time. Indeed, a historical-linguistic analysis of the Greek text prompts some reflections and thoughts on the heartbeat in pathological conditions and on the function of the heart as a hematopoietic organ. Furthermore, Homer's account is a critical text that highlights the relevance of the use of the senses in the ancient description of nosological pictures and it allows us an interesting and suggestive approach to reconstruction from the historical and historiographical point of view.

Soft Skills Are Hard Skills-A Historical Perspective.

The increasingly swift changes in the field of medicine require a reassessment of the skills necessary for the training of technically qualified doctors. Today's physicians also need to be capable of managing the complex issue of personal relationships with patients. Recent pedagogical debates have focused on so-called "soft skills", whose acquisition is presented in literature as a quite recent addition to medical studies. Moreover, the historical investigation of deontological texts dating from the mid-nineteenth century back to the Hippocratic Oath shows that medicine has always discussed the need to integrate technical expertise in medicine with specific personal and relationship-based skills. Debates have often circled around whether these "soft skills" could actually be taught or how they could be successfully transmitted to training physicians. The belief that defining medicine is more complex than defining other similar sciences and that the instruments to be used in the relationship with patients cannot be limited to those provided by technical aspects shows a new awareness. Today, this view is often stated as an innovative realization on the part of doctors with regard to the complexity of training and action in a delicate area in which they are entrusted with the management of the balance of the system that is the human body.

First Glimpse into the Genomic Characterization of People from the Imperial Roman Community of Casal Bertone (Rome, First-Third Centuries AD).

This paper aims to provide a first glimpse into the genomic characterization of individuals buried in Casal Bertone (Rome, first-third centuries AD) to gain preliminary insight into the genetic makeup of people who lived near a tannery workshop, fullonica. Therefore, we explored the genetic characteristics of individuals who were putatively recruited as fuller workers outside the Roman population. Moreover, we identified the microbial communities associated with humans to detect microbes associated with the unhealthy environment supposed for such a workshop. We examined five individuals from Casal Bertone for ancient DNA analysis through whole-genome sequencing via a shotgun approach. We conducted multiple investigations to unveil the genetic components featured in the samples studied and their associated microbial communities. We generated reliable whole-genome data for three samples surviving the quality controls. The individuals were descendants of people from North African and the Near East, two of the main foci for tannery and dyeing activity in the past. Our evaluation of the microbes associated with the skeletal samples showed microbes growing in soils with waste products used in the tannery process, indicating that people lived, died, and were buried around places where they worked. In that perspective, the results represent the first genomic characterization of fullers from the past. This analysis broadens our knowledge about the presence of multiple ancestries in Imperial Rome, marking a starting point for future data integration as part of interdisciplinary research on human mobility and the bio-cultural characteristics of people employed in dedicated workshops.

The Frontal Assessment Battery (FAB) and its sub-scales: validation and updated normative data in an Italian population sample.

BACKGROUND: Deficits of executive functioning (EF) are frequently found in neurological disorders. The Frontal Assessment Battery (FAB) is one of the most widespread and psychometrically robust EF screeners in clinical settings. However, in Italy, FAB norms date back to 15 years ago; moreover, its validity against "EF-loaded" global cognitive screeners (e.g., the Montreal Cognitive Assessment, MoCA) has yet to be tested. This study thus aimed at (a) providing updated normative data for the Italian FAB and (b) assessing its convergent validity with the MoCA. METHODS: Four-hundred and seventy-five healthy Italian native speakers (306 females, 169 males; mean age: 61.08 ± 15.1; mean education: 11.67 ± 4.57) were administered by the MoCA and the FAB. FAB items were divided into three subscales: FAB-1 (linguistically mediated EF), FAB-2 (planning), and FAB-3 (inhibition). Regression-based norms were derived (equivalent scores) for all FAB measures. RESULTS: Age and education were predictive of all FAB measures, whereas no gender differences were detected. The FAB and its sub-scales were related to MoCA measures-the strongest associations being found with MoCA total and MoCA-EF scores. FAB sub-scales were both internally related and associated with FAB total scores. DISCUSSION: The FAB proved to have convergent validity with both global cognitive and EF measures in healthy individuals. The present study provides updated normative data for the FAB and its sub-scales in an Italian population sample, and thus supports an adaptive usage of this EF screener.

The Montreal Cognitive Assessment (MoCA): updated norms and psychometric insights into adaptive testing from healthy individuals in Northern Italy.

BACKGROUND: The availability of fine-grained, culture-specific psychometric outcomes can favor the interpretation of scores of the Montreal Cognitive Assessment (MoCA), the most frequently used instrument to screen for mild cognitive dysfunctions in both instrumental and non-instrumental domains. This study thus aimed at providing: (i) updated, region-specific norms for the Italian MoCA, by also (ii) comparing them to pre-existing ones with higher geographical coverage; (iii) information on sensitivity and discriminative capability at the item level. METHODS: Five hundred and seventy nine healthy individuals from Northern Italy (208 males, 371 females; age: 63.4 ± 15, 21-96; education: 11.3 ± 4.6, 1-25) were administered the MoCA. Item Response Theory (IRT) was adopted to assess item difficulty and discrimination. Normative values were derived by means of the Equivalent Scores (ESs) method, applied to the MoCA and its sub-scales. Average ESs were also computed. Agreement with previous ESs classification was assessed via Cohen's k. RESULTS: Age and education significantly predicted all MoCA measures except for Orientation, which was related to age only. No sex differences were detected when tested along with age and education. Substantial disagreements with previous ESs classifications were detected. Several items proved to be scarcely sensitive, especially the place item from Orientation and the letter detection task. Memory items showed high discriminative capability, along with certain items assessing executive functions and orientation. DISCUSSION: Item-level information herewith provided for the Italian MoCA can help interpret its scores by Italian practitioners. Italian practitioners should consider an adaptive use of region-specific norms for the MoCA.

The teaching of the History of Medicine in Italy: a path in progress.

BACKGROUND: The increasing attention to the potential application of technology in medicine represents a dangerous warning in the direction of a reductionist approach. The academic system should therefore be strongly engaged to ensure even in medical practice the greatest enhancement of the human dimension. Targets: How much space is offered to the teaching of History of Medicine (HM) in Italian Universities? This work aims to answer this question through an in-depth analysis of the teaching plans of the degree courses in Medicine and Surgery (CLMC) activated in Italy. MATERIALS AND METHODS: The survey was carried out through the consultation of information, relating to the year 2019-2020, contained in the UniversItaly portal of the Italian Ministry of Education, University and Research, created to accompany students in their studies, as well as through the information published in the web portals of the various universities. RESULTS AND DISCUSSION: In Italy in 43 out of 97 Universities there is the Degree Course in Medicine and Surgery for a total of 66 degree courses; some Universities have activated more degree courses depending on the number of learners or on issues of territorial distribution. The teaching of HM is present in the curricula of 54 CLMC (82%) and in these is mandatory. In 93% of the cases, it is included in integrated courses (CI) and for only 4 CLMC it results as autonomous teaching. For the most part (86%) it is included in the first year's educational plan. The typology of the different CIs is extremely varied, both in terms of denomination, year and content, as well as in the overall CFUs assigned. The current teaching staff is divided as follows: 6 full professors; 12 associate professors; 13 Researchers (RU/RD); 20 contract professors. 19 are the researchers/professors engaged in the scientific field of the HM (MED/02). CONCLUSION: Those findings indicate that the HM subject in the Italian medical education programs is not yet universally recognized as able to stimulate medical students to a holistic view of the person and illness and therefore not sufficiently valued.

From the past, a long way to future challenges for a greater control of tuberculosis.

Tuberculosis (TB) and humans have coexisted for more than 40,000 years; however TB remains a global threat to human kind. The international community has developed new tools for early detection, but TB strains evolved acquiring resistance to first-line therapeutic drugs with increasing treatment challenges. Furthermore, TB has formed also an alliance with human immunodeficiency virus; in this way the poorest populations are most affected. The current vaccine planning activity includes 14 new vaccines against TB (11 of those in the phaseII/III) developed with different techniques. Now, more than ever, new anti-TB drugs and new anti-TB regimens are urgently required as well as universal health care and social protection in order to tackle down both hard to treat TB and the social determinants of TB. Coordinated actions and sharing of information are needed to aspire everywhere to the best clinical practices and improve quality of life of patients and their families.

G. B. Morgagni Among Human Pathology, Forensic Medicine and Mummiology. The Beatification of Gregorio Barbarigo of Padua

The article is the first step of a research project aimed at investigating new perspectives and aspects of Morgagni's role and work. His activities as a medical examiner and forensic doctor are yet to be truly discovered. Manuscripts, written by Morgagni when he was a forensic expert for the Health Magistrate of Venice, currently preserved at the City Library in Forli (Italy), shed light on a new aspect of his cultural background. As a forensic doctor, he also helped push an increase in "social medicine" in Italy, when physicians began to collaborate with the administrative and political institutions in order to plan environmental and urban regulations to control air quality. While reading his reports, his contribution to the primordial medical Hygiene and Public Health emerges. Among his reports, the authors focused on the one concerning the Beatification of Gregorio Barbarigo, which clearly highlights his pathological approach, as well as his knowledge and application of embalming systems and mummiology. Moreover, this report could be considered as an issue in the history of paleopathology.

HIV and tuberculosis: The paradox of dual illnesses and the challenges of their fighting in the history.

Tuberculosis is an ancient infectious disease caused by the bacillus Mycobacterium tuberculosis that is still nowadays afflicting humans all over the world. It causes ill-health for 10 million people each year. Tuberculosis (TB) has been the leading cause of death from a single infectious agent, ranking above HIV/AIDS. In recent years, infection with HIV represents a major risk factor predisposing for infection and TB is the most common cause of AIDS-related death. Despite the treatment of HIV-associated TB has essentially retraced that recommended in HIV-negative cases, it has disclosed some additional challenges over the years. The association of delayed and missed diagnoses, logistic accidents and some well-known complications of HIV and TB treatment co-administration has contributed to 300,000 people living with HIV died from a preventable and curable disease like TB in 2017. The evaluation of new diagnostic and therapeutic approaches with the struggle to erase stigma are essential to successfully manage HIV-TB coinfection.

Public hygiene and funeral rituals during the Risorgimento: mummies and ashes.

Starting in 1865, regulations pursuant to public hygiene issued by the Unitary Government provided for administrative and political control of the funerary practice. Specifically, they regulated the management of cemeteries and the burials, increasingly drawing the funeral rituals from the control of the Church and of Catholicism, therefore secularising death for the construction of a new political religion. Hygiene became fundamental in order to promulgate cremation as a system of preserving the integrity of the bodies, preserving the ashes as a tangible and indestructible product of body matter and as a measure to protect public health by eliminating the risk of miasmatic pollution of the air caused by the cadaveric fumes. In the early 1870s, the practice of cremation began to spread, especially in the territories of Lombardy-Veneto and Savoy, as an expression of the progressive policies of the new Italian state, antagonistic to the old Catholic religious traditions. This paper intends to highlight the key aspects of the political significance that the cremation took on during the Risorgimento period, while also illustrating the methods adopted by important authors from that time period regarding incineration techniques and cremation methods.