On status epilepticus and pins: A systematic content analysis

Status epilepticus (SE) can be defined as abnormally prolonged, persistent, or recurrent clinical and/or electrographic epileptic activity and, as such, is a challenging medical emergency requiring an aggressive treatment aimed at promptly terminating the seizures. It imposes a relevant clinical burden, both in terms of comorbidity and mortality. In the era of the Web 2.0, most people search the Web to obtain SE-related information. The current investigation aimed at qualitatively characterizing the pins related to SE: Pinterest, "the world's catalog of ideas", is a visual social networking site that enables users to freely upload visual material, to bookmark, and to share it (repin). Using SE as a keyword, 192 pins were extracted and analyzed on the basis of their content. Fifty-five were found to meet the inclusion criteria. Fifty-six point four percent of the pins reported at least one cause of SE, the most quoted of which being remote brain injuries (47.3% of the pins); 54.5% and 45.5% of the included pins reported SE symptoms and diagnosis, respectively; 72.7% and 40.0% of pins focused on SE treatment and on prognosis, respectively; and 50.9%, 30.9%, and 40.0% of the pins were intended for physicians, medical/nursing students, and lay people, respectively. Only 12.7% of pins were patient-centered and devoted to fund-raising and advocacy. In the field of neurological diseases, Pinterest, despite being a "pinstructive" tool, is too much overlooked and underused for advocacy purposes. Healthcare workers and stakeholders should be aware of the opportunities offered by Pinterest and exploit this visual social networking site for raising awareness of the life-threatening condition of SE, promoting fund-raising campaigns.

Data of the Modified Somatic Perception Questionnaire (MSPQ) administered to a sample of immigrants in Genoa (Italy)

This article reports the data of the Modified Somatic Perception Questionnaire (MSPQ) administered to a sample of 143 immigrants accessing an outpatient clinic or the general practitioners offices in Genoa (Italy) compared with 186 Italian patients. For further details and for the interpretation of the data, the reader is referred to the original publication “Somatic perception, cultural differences and immigration: results from administration of the Modified Somatic Perception Questionnaire (MSPQ) to a sample of immigrants” by Bragazzi et al. (2014) [1].

The Public Health Impact of the So-Called "Fluad Effect" on the 2014/2015 Influenza Vaccination Campaign in Italy: Ethical Implications for Health-Care Workers and Health Communication Practitioners

Seasonal influenza, causing complications, hospitalizations and deaths, generates a serious socio-economic burden, especially among elderly and high-risk subjects, as well as among adult individuals. Despite the availability and active free-of charge offer of influenza vaccines, vaccine coverage rates remain low and far from the target established by the Ministry of Health. Notwithstanding their effectiveness, vaccines are victims of prejudices and false myths, that contribute to the increasing phenomenon of vaccine hesitancy and loss of confidence. Media and, in particular, new media and information and communication technologies (ICTs) play a major role in disseminating health-related information. They are extremely promising devices for delivering health education and promoting disease prevention, including immunization. However, they can also have a negative impact on population's health attitudes and behaviors when channeling wrong, misleading information. During the 2014/2015 influenza vaccination campaign, the report of four deaths allegedly caused by administration of an adjuvanted influenza vaccine, Fluad - the so-called "Fluad case" - received an important media coverage, which contributed to the failure of the vaccination campaign, dramatically reducing the influenza vaccine uptake. In the extant literature, there is a dearth of information concerning the effect of the "Fluad case". The current study aims at quantifying the impact of the "Fluad effect" at the level of the Local Health Unit 3 (LHU3) ASL3 Genovese, Genoa, Italy. Ethical implications for health-care workers and health communication practitioners are also envisaged.

Ethnopsychiatry fosters creativity and the adoption of critical and reflexive thinking in higher education students: insights from a qualitative analysis of a preliminary pilot experience at the Faculty of Medicine and Surgery, University of Genoa, Italy

Creativity is an ability that plays a major role in the modern economy and society. It should represent an important component of the medical syllabus. However, it is often overlooked by the formal courses at universities. The current study aimed at evaluating whether the interactive educational models, recently adopted by the Faculty of Medicine and Surgery, at the University of Genoa, Italy, would favor the adoption of critical thinking, attitudes to changes, cultural diversity acceptance, and the adoption of relational soft skills versus traditional and frontal didactic teaching. Thirty students, who attended the last year of health care professional course at the Faculty of Medicine, volunteered to take part in the study and were randomly allocated to two groups: one group receiving an innovative, interactive excellence course and the other group receiving a more traditional approach. Ethnopsychiatry was chosen as the topic since it was hypothesized that it would have contributed to generation of a new approach toward diseases and patients. The first group of students, exposed to interactive lectures with the aim of promoting the adoption of critical thinking, were more satisfied than the second group. Participants who were involved in an active manner and had to work in small groups, actively finding their own solutions to solve the problems, perceived the utilized teaching method and experience more stimulating, involving, and effective. Implications for education policy makers are also envisaged.

Infodemiological data of West-Nile virus disease in Italy in the study period 2004-2015

Google Trends (GT) was mined from 2004 to 2015, searching for West-Nile virus disease (WNVD) in Italy. GT-generated data were modeled as a time series and were analyzed using classical time series analyses. In particular, correlation between GT-based Relative Search Volumes (RSVs) related to WNVD and “real-world” epidemiological cases in the same study period resulted r=0.76 (p<0.0001) on a monthly basis and r=0.80 (p<0.0001) on a yearly basis. The partial autocorrelation analysis and the spectral analysis confirmed that a 1-year regular pattern could be detected. Correlation between GT-based RSVs related to WNVD yielded a r=0.54 (p<0.05) on a regional basis. Summarizing, GT-generated data concerning WNVD well correlated with epidemiology and could be exploited for complementing traditional surveillance.

History and evolution of influenza control through vaccination: from the first monovalent vaccine to universal vaccines

Influenza is a highly infectious airborne disease with an important epidemiological and societal burden; annual epidemics and pandemics have occurred since ancient times, causing tens of millions of deaths. A hundred years after this virus was first isolated, influenza vaccines are an important influenza prevention strategy and the preparations used display good safety and tolerability profiles. Innovative tools, such as recombinant technologies and intra-dermal devices, are currently being investigated in order to improve the immunological response. The recurring mutations of influenza strains has prompted the recent introduction of a quadrivalent inactivated vaccine. In the near future, scientific research will strive to produce a long-lasting universal vaccine containing an antigen that will offer protection against all influenza virus strains.

Mind the gap between high school and university! A field qualitative survey at the National University of Caaguazú (Paraguay)

Paraguay has eight public universities and 45 private universities. The National University of Caaguazú (Universidad Nacional de Caaguazú or UNCA), with its main campus located in Coronel Oviedo, is one of the most recently founded public universities, being established in 2007. The UNCA has launched a project aiming at exploring the potentiality of its educational system, as well as its gaps. In particular, the UNCA wants to assess the effectiveness of preparatory courses for preparing students for admission to the degree course in medicine (Cursos Probatorios de Ingreso or CPI), in order to identify the main strong and weak points of the system, the popularity and usefulness of CPI as perceived by the students, the students' and teachers' opinions regarding the limits of school, and their suggestions. This paper is based on a field survey and highlights the care that must be taken in order to develop conditions respectful of the wellbeing of those participating in the educational context.

Ramadan Fasting and Patients with Cancer: State-of-the-Art and Future Prospects

Ramadan fasting represents one of the five pillars of the Islam creed. Even though some subjects (among which patients) are exempted from observing this religious duty, they may be eager to share this particular moment of the year with their family and peers. However, there are no guidelines or standardized protocols that can help physicians to properly address the issue of patients with cancer fasting in Ramadan and correctly advising them. Moreover, in a more interconnected and globalized society, in which more and more Muslim patients live in the Western countries, this topic is of high interest also for the general practitioner. For this purpose, we carried out a systematic review on the subject. Our main findings are that (1) very few studies have been carried out, addressing this issue, (2) evidence concerning quality of life and compliance to treatment is contrasting and scarce, and (3) generally speaking, few patients ask their physicians whether they can safely fast or not. For these reasons, further research should be performed, given the relevance and importance of this topic.

Ramadan fasting and infectious diseases: a systematic review

Ramadan represents the fourth of the five pillars of the Islamic creed. Although patients are exempted from observing this duty, they may be eager to share this moment of the year with their peers. However, there are no guidelines that can help physicians to address the concerns of patients with infectious diseases fasting during Ramadan. For this purpose, we performed a systematic review. of 51 articles. Our main findings are that: 1) patients suffering from diabetes at risk of developing infectious complications should not fast; 2) Ramadan fasting has little impact on diarrheal patients; 3) HIV represents a challenge, and ad hoc drug combinations should be recommended to patients, and the patients should be advised not to take fatty meals that could interfere with the treatment; 4) Ramadan has no effect on the effectiveness of anti-helminthic therapy; and 5) patients with active ulcers should not fast, as they have a higher probability of developing complications.

Quartz-Crystal Microbalance (QCM) for Public Health: An Overview of Its Applications

Nanobiotechnologies, from the convergence of nanotechnology and molecular biology and postgenomics medicine, play a major role in the field of public health. This overview summarizes the potentiality of piezoelectric sensors, and in particular, of quartz-crystal microbalance (QCM), a physical nanogram-sensitive device. QCM enables the rapid, real time, on-site detection of pathogens with an enormous burden in public health, such as influenza and other respiratory viruses, hepatitis B virus (HBV), and drug-resistant bacteria, among others. Further, it allows to detect food allergens, food-borne pathogens, such as Escherichia coli and Salmonella typhimurium, and food chemical contaminants, as well as water-borne microorganisms and environmental contaminants. Moreover, QCM holds promises in early cancer detection and screening of new antiblastic drugs. Applications for monitoring biohazards, for assuring homeland security, and preventing bioterrorism are also discussed.

Porous Alumina as a Promising Biomaterial for Public Health

Porous aluminum is a nanostructured material characterized by unique properties, such as chemical stability, regular uniformity, dense hexagonal porous lattice with high aspect ratio nanopores, excellent mechanical strength, and biocompatibility. This overview examines how the structure and properties of porous alumina can be exploited in the field of public health. Porous alumina can be employed for fabricating membranes and filters for bioremediation, water ultrafiltration, and microfiltration/nanofiltration, being a promising technique for having clean and fresh water, which is essential for human health. Porous alumina-based nanobiosensor coated with specific antibodies or peptides seem to be a useful tool to detect and remove pathogens both in food and in water, as well as for environmental monitoring. Further, these applications, being low-energy demanding and cost-effective, are particularly valuable in resource-limited settings and contexts, and can be employed as point of use devices in developing countries, where there is an urgent need of hygiene and safety assurance.

Ramadan fasting and chronic kidney disease: does estimated glomerular filtration rate change after and before Ramadan? Insights from a mini meta-analysis

Ramadan fasting represents one of the five pillars of the Islam creed. Even though patients are exempted from this religious duty, they may be eager to share this particular moment of the year with their family and peers, taking part in the intense spiritual ceremonies and events that characterize this month. However, there are no guidelines or standardized protocols that can help physicians to properly address the issue of patients with chronic kidney disease fasting in Ramadan and correctly advising them. For this purpose, we carried out a systematic review and a meta-analysis to see whether glomerular filtration rate value changed before and after Ramadan. Our main findings are that: chronic kidney disease patients can safely fast during Ramadan since glomerular filtration rate does not change in a statistically significant way and, even though most studies have been carried out during Ramadan falling in cold seasons, the sensitivity analysis did not reveal any impact of seasonality. Further research in the field is needed.

Investigating Aggressive Styles and Defense Mechanisms in Bipolar Patients and in their Parents

Bipolar disorder (BD) is a very common mental health disorder, whose etiology concerning aggressive styles and defense mechanisms is still poorly known despite the efforts dedicated to develop psychological and biological theories. After obtaining written signed informed consent, this study will recruit inpatients with a clinical diagnosis of BD, based on Structured Clinical Interview and the Diagnostic and Statistical Manual of Mental Disorders criteria, and their parents. The Bus-Perry Aggression Questionnaire, the Defense Style Questionnaire 40, the Symptom check list SCL-90-R, developed by DeRogatis will be administered to the participants, together with a semi-structured questionnaire concerning demographic data (age, gender, employment, education) and only for the patients clinical information (onset year of the disorder, presence of co-morbidities, alcohol and drug use, suicide tendencies, kind of treatment). All the questionnaires are in the Italian validated version. The successful completion of this study will shed light on the relationship between aggressive styles and defensive mechanisms in bipolar inpatients and in their parents, helping the clinicians to develop ad hoc psychological interventions.

Ramadan fasting and chronic kidney disease: A systematic review

Ramadan fasting represents one of the five pillars of the Islam creed according to the Sunnah and the second practice of faith for the Shiaa. Even though patients are exempted from observing this religious duty, they may be eager to share this particular moment of the year with their family and peers. However, there are no guidelines or standardized protocols that can help physicians to properly address the issue of patients with chronic kidney disease (CKD) fasting in Ramadan and to correctly advise them. Moreover, in a more interconnected and globalized society, in which more and more Muslim patients live in the Western countries, this topic is of high interest also for the general practitioner. For this purpose, we carried out a systematic review, including also articles written in Arabic, Turkish, and Persian languages. Our main findings are that: recipients of kidney allograft can safely fast during Ramadan;evidences for safety in patients with nephrolithiasis and CKD are instead mixed and controversial. On the other hand,most studies have been carried out during Ramadan falling in cold seasons, and there is scarce information about Ramadan fasting in hot seasons. For these reasons, the findings may be not generalizable and therefore cautions should be taken and applied; the physicians should carefully monitor their patients during the fasting period with an adequate follow-up, in order to avoid any injurious effect.

The Gap in the Current Research on the Link between Health Locus of Control and Multiple Sclerosis: Lessons and Insights from a Systematic Review

Multiple sclerosis (MS) is a chronic neurological disease whose etiology has not been fully understood yet in detail. Empirical findings show how psychosocial symptoms are very important features of the clinical presentation of MS, having a deep impact on patient's quality of life, and thus psychological coping strategies may play a central role in reducing the burden of the disease and improving patient's satisfaction of life. MS progression and relapses/exacerbations are unpredictable and may depend on factors such as stressor chronicity, frequency, severity, type, and individual patient characteristics such as depression, personality, locus of control (LOC), optimism, and perceived social support. Due to its importance for health-care delivery, rehabilitation, and nursing, here, we make a systematic review on the current state-of-the-art studies concerning the relationship between LOC and MS, according to the PRISMA guidelines, and we assess the quality and the completeness of the studies using the CONSORT instrument, underpinning their limitations, and suggesting how to fill the gap in this research field.

From P0 to P6 medicine, a model of highly participatory, narrative, interactive, and "augmented" medicine: some considerations on Salvatore Iaconesi's clinical story

Salvatore Iaconesi was recently diagnosed with a brain tumor. He decided to share his clinical records not only with doctors but with everybody who wishes to find him a cure. "Because cure is not unique," he emphasizes "there are cures for the body and cures for the soul, and everyone, from a painter to a musician, can find me a cure. Please, feel free to take my clinical history for example and let it become a game, a video, a music, a picture, whatever you like." The emblematic hallmark of the changing times, Salvatore Iaconesi's case is an example of how many profound revolutions and steps medicine has undertaken during the past few centuries. Stemming from a form of remote medical paternalism and arriving at the concept of a therapeutic alliance, medicine nowadays faces challenges and opportunities at a level before unforeseeable and unimaginable. The new concept of P6 medicine (personalized, predictive, preventive, participatory, psychocognitive, and public) is discussed, together with its profound implications.