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Biomedical subjects

Donatella Lippi

Publications and source records attributed to Donatella Lippi.

14 recordsLinked to original sources
PubMed2006

The contributions of Paul Ehrlich to infectious disease.

Paul Ehrlich (1854-1915) is nowadays considered a pioneer in a number of medical fields, and in the course of time his role in the establishment and development of disciplines such as histology, immunology, oncology and haematology has been acknowledged. Aim of this historical note is to illustrate, in the area of chemotherapy, the special importance of this brilliant scientist whose 150th anniversary of birth occurred in 2004. Already as a medical student, Ehrlich was obsessed by structural organic chemistry and dyes, and, continually studying these issues, he elaborated his theory regarding the discovery of a "magic bullet", able to specifically destroy tumour cells and micro-organisms. In practice he applied methylene blue to the treatment of malaria patients, following his intuition that such a dye could destroy parasites. However, his culminating achievements in the chemotherapic field, reached even at the expense of his health, were the concept of the one-dose treatment of Helicobacter pylori infection, and the creation of arsphenamine (compound 606, or Salvarsan), the first really effective compound in controlling human syphilis. Within the many and various contributions of Ehrlich to the development of experimental and clinical medicine, a special mention of his experimental studies and clinical applications in the area of chemotherapy is essential, since his achievements in this biomedical area remain a paramount legacy in the history of the therapy of infections.

Allergy and Immunology↗
PubMed2005

[Internal medicine: background, present status and perspectives].

Internal Medicine is a very ancient branch of medicine furnishing unique opportunities for interchange and innovation, essential for the development and renovation of contemporary medicine. It is a fact that during the last twenty years a clear shift in clinical medicine towards extreme specialisation has occurred, but more recently the figure of the "clinician" has once again become central, since he/she is called upon to play a role of great importance in which knowledge of the complexity involved in the management of problematic diseases has to blend and integrate with the fundamental simplicity of the search for so-called "economy" in diagnostic hypotheses.

Internal Medicine↗
PubMed2005

[Neoplastic angiogenesis and age-related macular degeneration: historic aspects of the microcirculation of new vessels].

Angiogenesis is the process through which newly-formed vessels develop from pre-existing ones, following a series of sequential steps. The appearance of new vessels is essential in a number of physiological processes, but it is also associated with several pathological phenomena, such as arthritis, diabetic retinopathy and cancer. In the XIX century Rudolph Virchow ("Die Zellularpathologie", 1858) had already observed and described the rich vascularization which characterizes malignant tumors. This line of research was further developed by Goldman in the early XX century. With specific reference to the history of age-related macular degeneration, a disease model whose understanding is linked to the study of angiogenesis, in 1905 Oeller coined the definition "disciform macular degeneration", and twenty years later this expression was taken up by Kuhnt and Junius to describe disc-shaped lesions in the macula of elderly individuals. The historical evolution of the concept of angiogenesis, its characterizing evolutional steps and the most relevant scientific achievements in the field of macular degeneration up to the eighties of the XX century are here presented and discussed.

Aged↗
PubMed2004

[The past and present history of the term "quality" in medicine].

In the medieval hospital the terms "care" and "cure" constituted a kind of hendiadys; in the XVIII century the quality of services was precisely identified for the first time, and, between the XVIII and the XIX centuries, medicine also began to assess the quality of professional competence, recognizing the need for a fair allocation of resources, and directing the health services only towards those who really needed them. In the XIX century the "Regolamenti" of hospital institutions are made compulsory in Italy, as foreseen by the Public Health Law of 1888. However, only during the XX century, and particularly in the second half of the century, quality standards are defined, together with the structuring of a health service and with the ever more widely felt need for a new relationship between the physician and the patient, and between the patient and the institution. In even more recent times, during the 1990s, Evidence Based Medicine has given a further stimulus to every currently interpreted quality systems.

History, 18th Century↗
PubMed2004

[The historical evolution of regulation XVIII in the Italian medical curriculum].

In 1932 Bindo de Vecchi published a paper in Florence in which he underlined the need for a change in the teaching of medicine in Italy, in view of the continuous progress taking place in the health field. He recommended a constant social and preventive monitoring in medicine, and suggested a better distribution in the time and number of lessons, tests during degree courses and greater attention towards the practical aspects of medical studies. In 1933 the State examination was established, and in 1938 Regulation XVIII of the Italian Medical curriculum was approved. The first relevant revision of Regulation XVIII took place in 1986; it introduced a brief description of the formative objectives in the different areas of medical teaching, doubling the number of examinations and abolishing complementary courses. In 1996 a new version of Regulation XVIII appeared, including for the first time the so-called University Formative Credits. In 2000 a Ministerial Decree concerning Specialistic Degree Courses introduced the new Class constituted by the Specialistic Curriculum in Medicine and Surgery.

Curriculum↗
PubMed2004

[The historical evolution of obstetrician formation].

The evaluation of the historical development of obstetrician formation presents features of great modernity. At the end of the XVIII century in Florence the first School of Obstetrics for midwives was established. In the School two relevant complementary formative approaches were privileged: ex cathedra didactics and clinical training. The basic tools for these educational methodologies were constituted by handbook production and by wax anatomical models, the latter a field for the meeting and confrontation of surgeons and craftsmen. The historical-social scenario in which this original evolution took place was Tuscany society in the period of Enlightenment, that promoted the formation of professional figures capable of managing natural childbirth in an autonomous way, while nevertheless placing them under a previously lacking health policy control. In this cultural environment particularly impressive was the influence of J.P. Frank (Austria and Lombardy), but also present were other forces, deriving from other European countries, that aimed at including the formation of obstetricians in a scientific programme, thus excluding an unguarded non-structured training.

Education, Medical↗
PubMed2004

[The historical bases of a super-specialty: electrocardiography].

In the XVIII century the first structured experiments in the field of bioelectricity were performed, and the Italian scientist Luigi Galvani documented the muscular contraction of a frog undergoing an electric shock. In 1791 he showed that the electric stimulation of the heart of a frog determined the contraction of the heart itself. In the first thirty years of the XIX century galvanometers were developed, and in 1842-42 Carlo Matteucci documented that electric activity was present even in the cardiac muscle at rest. At the end of the XIX century Augustus Waller was among the first scientists to publish an electrocardiographic recording obtained from the human body surface; most of his contemporaneous, however, did not retain that electrocardiography might have been an effective clinical application. Willem Einthoven, instead, was convinced of the widespread feasibility of clinical electrocardiography, and promoted a number of improvements and refinements in electrocardiographic technique. The most important and diagnostic-technical development of electrocardiography occurred in the second half of the XX century, and still today, even if many different sophisticated instrumental examinations are available for cardiologic evaluation, electrocardiography represents an essential first-line diagnostic tool in clinical cardiology.

Cardiology↗
PubMed2002

Plague, policy, saints and terrorists: a historical survey.

Plague is an infectious disease of humans and animals caused by the bacterium Yersinia pestis. During the Middle Ages millions of people in Europe died from plague, whose current mortality-if untreated-ranges from 50% to 90%. The plague has been a great protagonist in history because it has often been grimly present in the collective events of humans. Its plurisecular history, tied to the whole chain of ecological balance, has had a strong influence on the collective imagination on account of its sudden occurrence and unavoidable mortality. In the past, the passage from contagion to illness ended in death, as human remedies had no effect. The only way to conquer it was invoke the incorruptible spirit of a saint. Therefore, in the past, the major plague icons were saints to whom ordinary people attributed a fame for healing. More recently, many epidemic diseases have ceded place to biological weapons, and terrorists have become the modern icons of such a threatening reality. As a matter of fact, bioterrorism has become a great public health and infection control threat, and, among the number of potential biological agents, plague has assumed a key role.

Bioterrorism↗
PubMed2002

[The renin-angiotensin-aldosterone system, angiotensin I converting enzyme, and the ACE-inhibitors. Historical perspective and recent findings].

The renin-angiotensin-aldosterone system (RAAS) is committed to the regulation of circulatory homeostasis. This system, present in the majority of animal species, is constituted by several elements which behave as effectors able to increase their levels in response to the reduction of the intravascular volume and to the decrease of the renal perfusion. In turn, RAAS is regulated by a number of mechanisms. In our review a historical view precedes the description of the major functions of RAAS, i.e. the regulation of arterial pressure and the control of the hydroelectrolytic homeostasis. The evolution of the achievements about the angiotensin I converting enzyme is reviewed and the currently investigated relationship between RAAS and hemostatic system is assessed. The historical perspective of this review is useful to follow the key passages leading from clinical research to evidence-based therapeutic applications, in particular to the development of ACE-inhibitors. The evaluation of the rationale of ACE-inhibitors therapy in the treatment of arterial hypertension, acute myocardial infarction, heart failure, and diabetic nephropathy, and a discussion of the angiotensin receptor blockers, close the review.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed2002

Enrico Pieragnoli and the prevention of tuberculosis: Florence 1906.

Tuberculosis (TBC) is today a health priority in Asia, Africa, and South America and a re-emerging social disease in the Western World. While the pharmacological therapy of TBC is nowadays well established, preventive measures are still under-powered and under-estimated. Current failures in the prevention of tuberculosis are even more surprising considering that, already a century ago a comprehensive preventive of defence against TBC had been designed by clinicians and ante-litteram 'health care managers' such as Enrico Pieragnoli. Pieragnoli was an Italian physician who lived in Florence between the XIX and XX century, and who, after many years of accurate planning, succeeded in 1906 in opening the first Italian tuberculosis preventive centre. Pieragnoli considered it his mission to 'fight' against TBC, a public enemy that was to be defeated using the weapons of global prevention; Pieragnoli had crystal clear concepts of prevention, of the predisposing factors to the disease, and of the need for aggressive treatment. He established his preventive institute with two main aims: the modification of the individual substratum in which the germs grew and the removal of contagion. The prophylactic and diagnostic accuracy of his preventive institute are shown in a number of clinical documents containing objective body measurements (height, weight, thoracic circumference), quantitative clinical comparisons (intra-and inter-subjects) and field epidemiology. We may therefore conclude that the cornerstone of 'evidence-based' prevention of tuberculosis was present in Italy almost a century ago.

Academies and Institutes↗