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Licata, M.; Giuffra, V.; Minozzi, S.; Lencioni, R.; Naccarato, A. G.; Castagna, M.; Chericoni, S.; Fornaciari, G.; Catalano, P.; Campana, S.; Felici, C.; Riccomi, G.; Fornaciari, A.; Gaeta, R.; Chericoni, S.; Stefanelli, F.; Naccarato, A. G.; Castagna, M.; Lencioni, R.; Giuffra, V.; Fornaciari, G.; Ferrari, L.; Formisano, E.; Mondello, A.; Maresi, E.; Florena, A. M.; Rossetti, C.; Boano, R.; Vellone, V. G.; Larentis, O.; Birkhoff, J. M.; Fulcheri, E.; Ferrari, L.; Bramanti, B.; The Medplug, Team, Olivieri, A.; Pallotti, F.; Capodiferro, M. R.; Colombo, G.; Licata, M.; Tesi, C.; Semino, O.; Achilli, A.; Torroni, A.; Minozzi, S.; Pantano, W.; Caldarini, C.; Catalano, P.; Giuffra, V.; Castiglioni, A.; Massa, S.; Lampugnani, P.; Mandelli, C.; Medin, T.; Licata, M.; Gorini, I.; Larentis, O.; Larentis, O.; Massa, S.; Lampugnani, P.; Mandelli, C.; Medin, T.; Licata, M.; Gorini, I.; Mattia, M.; Biehler-Gomez, L.; Poppa, P.; Candia, D. Di, Giordano, G.; Cosentini, E.; Galimberti, P. M.; Slavazzi, F.; Cattaneo, C.; Foscati, A.; Gaeta, R.; Ventura, L.; Cilli, J.; D’anastasio, R.; Viciano, J.; Monza, F.; Fanelli, E.; Capasso, L.; Cozza, A.; Magno, G.; Basso, C.; Thiene, G.; Zanatta, A.; Ciliberti, R.; Petralia, P.; Massa, E. Rabino, Bonsignore, A.; Ricci, S.; Capecchi, G.; Boschin, F.; Arrighi, S.; Ronchitelli, A.; Condemi, S.; Bini, A.; Bandiera, P.; Milanese, M.; Vellone, V. G.; Cinti, A.; Boano, R.; Garbarino, G. B.; Rocchietti, D.; Paudice, M.; Biatta, C. M.; Buffelli, F.; Minetti, G.; Fulcheri, E.; Biehler-Gomez, L.; Mattia, M.; Poppa, P.; Sala, C.; Petrosino, D.; Tagliabue, G.; Galimberti, P.; Slavazzi, F.; Cattaneo, C.; Emanuele, S.; Masotti, S.; Oggiano, M.; Gualdi-Russo, E.; Mongillo, J.; Vescovo, G.; Bramanti, B.; Guerriero, M.; Colasurdo, F.; Pollio, A. M.; Morrone, A.; Piombino-Mascali, D.; Toscano-Raffa, A.; Campagna, L.; Venuti, M.; Piombino-Mascali, D.; Morrone, A.; Tigano, G.; Maniscalco, L.; Distefano, G.; Cultraro, M.; Guzzardi, L.; Errickson, D.; Márquez-Grant, N.; Usai, G.; Milanese, M.; Bini, A.; Zedda, N.; Saguto, I.; Frisoni, P.; Rinaldo, N.; Roggio, C.; Bandiera, P.; Milanese, M.; Traversari, M.; Gabanini, G.; Ciucani, M. M.; Serventi, P.; De Fanti, S.; Sarno, S.; Fregnani, A.; Bazaj, A.; Ferri, G.; Cornaglia, G.; Gruppioni, G.; Luiselli, D.; Cilli, E.; Pangrazzi, C.; Tonina, E.; Tomasi, C.; Rossetti, C.; Larentis, O.; Tesi, C.; Ricci, S.; Crezzini, J.; Badino, P.; Rossetti, C.; Fusco, R.; Gorini, I.; Masseroli, S. M.; Licata, M.; Tonina, E.; Larentis, O.; Pangrazzi, C.; Licata, M.; Gorini, I.; Fusco, R.; Moroni, E.; Capuzzo, D.; Locatelli, D. P.; Bramanti, B.; Fusco, R.; Tesi, C.; Larentis, O.; Tonina, E.; Licata, M.; Magno, G.; Zampieri, F.; Zanatta, A.; Scianò, F.; Pasini, A.; Gualdi-Russo, E.; Rinaldo, N.; Bramanti, B.; Pasini, A.; Gualdi-Russo, E.; Bramanti, B.; Rinaldo, N.; Riccomi, G.; Minozzi, S.; Casaccia, J.; Felici, C.; Giuffra, V.; Licata, M.; Larentis, O.; Tesi, C.; Tonina, E.; Ciliberti, R.; Garanzini, F.; De Luca, D.; Lucà, M.; Patratanu, S. M.; Polidoro, F.; Guzzetti, S.; Fusco, R..
Pathologica ; 114(3):246-273, 2022.
Article in English | EuropePMC | ID: covidwho-1940091

ABSTRACT

The presence of numerous scientific contributions in the program is certainly demonstrative of the fact that research in the field of paleopathology and anthropology has not stopped since the beginning of Covid-19. Furthermore, the same emergency that we are still partially feeling, has pushed our community scientific research to question itself more intensely in connection to the epidemic relationship and measures that repeatedly led to profound transformations in the societies of the past from different points of view: demographic, economic, social and the history buried under the bioarchaeological strata is today more capable than ever to show this connection. It can do this by bringing to light the paleodemographic data that is obtained from the study of human remains. Today we will listen to many paleopathological stories and among these I am very happy to also present ours. Twenty years ago, the University of Insubria started a collaboration with the Archaeological Superintendence of Lombardy for the study of osteological remains found mostly during emergency archaeology recoveries. These experiences led us to reach those bioarchaeological sites again with the aim of extracting all those cemetery layers that remained there because they were not subjected at that time by building reclamation interventions. Returning to those sites that in the past brought to light fragmentary anthropological data means allowing oneself the possibility of obtaining new palaeodemographic and palaeopathological data which are decisive for reconstructing the demographic and epidemiological history of the populations of the past. These new interventions led us to create an operational model that immediately intended to underline the importance of an evident continuity between the archaeological recovery and the anthropological study of the finds through the setting up of physical anthropology and paleopathology laboratories directly on the sites of the finds. All this in harmony with the final design of the projects or the museumization of bioarchaeological sites in their complexity aimed at enhancing cultural tourist routes in the area. In this regard, I would like to thank the community foundation of Varese and the Cariplo foundation for supporting our current initiatives. These include the project financed by the emblematic provincial tender and which has as its final objective the enhancement of three bioarchaeological sites in Valcuvia: the medieval sites of San Biagio in Cittiglio, Sant’Agostino in Caravate, and the modern crypt of the church of the Convent of Azzio. Today, our Research Centre works in Piedmont in different sites in the province of Vercelli and Alessandria. Aware of the importance of a physical anthropological approach in the field, our young Centre goes beyond the continental borders to reach Eritrea, the ancient city of Adulis, because it is in dissecting the taphonomic events and the funeral actions that will make it possible to identify the funerary ritual adopted by the ancient populations. The operational model of paleopathological research, which gradually enriches itself thanks to the multidisciplinary nature of the interventions and thanks to the individual experiences in the field, is thus continuously transferred and adapted to other anthropological contexts that retain potential both in terms of investigative and enhancement of the bioarchaeological heritage. Through the musealization of the sites it is also possible to acquire an attractive force towards all those potentially bioarchaeological areas but which today are in conditions of neglect because they are marginal with respect to the conventionally understood cultural tourist good. And we all know how important it is to transfer the study data even outside the academic context because making this aspect of archaeology, the truly human one, usable too, cannot fail to arouse a strong awareness of our past. We also know how much more we will have to work, following in the footsteps of the professors who started this path, to ensure that the d sciplines of paleopathology and physical anthropology arrive within all those degree courses still discovered today by these teachings to heal an important lack: knowing the human past from a physical and pathological point of view allows us to understand the evolutionary path of some pathologies, especially those of infectious nature. If my title of the speech “Paleopathology and osteoarchaeology in the province of Varese” does not respond to what is being said today, it is because my feeling about paleopathology and osteoarchaeology in the province of Varese is understood as that of carrying out research, what I could feel everywhere, through the operational model, the enthusiasm for paleopathological research and of course the people I am lucky enough to work with. The Morgagni Museum of Pathological Anatomy of the University of Padua preserves a wide series of pathological specimens, mostly from the second half of the 19th century and the early 20th century. The Museum was recently renewed, as the result of an intervention of enhancement of the museum and cultural heritage of the University of Padua and its Medical School, being also testimony to the history and evolution of human pathology and past population lifestyle. In the collection of the Morgagni Museum there are several specimens affected by atherosclerotic lesions. Atherosclerosis is characterized by a chronic inflammatory disease in which different factors are involved, such as lipoproteins, immune cells and endothelial damage. The main clinical syndromes related to atherosclerosis are angina pectoris, acute myocardial infarction, transient ischemic attack, cerebral stroke, intermittent claudication, aortic aneurysm and nephro-vascular hypertension. Atherosclerosis was believed to be a modern disease, related almost exclusively to age and current lifestyle. The cases from the Morgagni Museum are therefore useful for studying the presence of the atherosclerosis in a recent past population. In the collection there were identified six atherosclerotic cases: an atherosclerotic aneurysm of the ascending aorta: the specimen highlights the left ventricular outflow tract and the aortic root. There is a severe atherosclerosis of the ascending aorta with saccular aneurysm including a large thrombus;a syphilitic aortitis complicated by atherosclerosis: the finding highlights the left ventricular outflow tract and aortic root. It is possible to note the intima of the ascending aorta with ulcer-calcific atherosclerotic plaques and “tree-bark” whitish areas;an atherosclerotic aneurysm of the abdominal aorta: abdominal aorta with saccular atherosclerotic aneurysm, proximal to the iliac bifurcation;a case of aortic atherosclerosis: aorta with severe atherosclerosis complicated by calcification and thrombosis;a case of aortic atherosclerosis: massive dissemination of atheromatous-calcific plaques;a case of aortic atherosclerosis with parietal thrombi: widespread presence of plaques along the aortic wall. Thanks to this collection, it is possible to notice the spread of pathology on an atheromatous basis in the recent past populations. Moreover, current paleopathological investigations on ancient populations mummified remains also showed traces of atherosclerotic lesions in both sexes and different ages. It is therefore possible to support a ubiquitous diffusion in space and time of this complex multifactorial pathology which has so far considered to be almost an exclusive prerogative of old age and current lifestyle. The Morgagni Museum of Pathological Anatomy of the University of Padua, founded by Lodovico Brunetti (1813-1899) in the 1860s, gathers important pathological specimens mainly from the 19th century. Among them, there is a very peculiar preparation: it consists of a dried head representing a case of argyria dating back to 1873. The specimen is preserved in a sealed jar, all the skin has a blue-gray coloration with white-blonde hair and beard. The eyes are not preserved, but since the ocular cavities remain open, it is possible to presume that origin lly there were glass eyes. Two glass sticks are inserted inside the mouth to show that also tongue and gums have the same blue-gray pigmentation as the face. The upper teeth are strongly eroded. Argyria is a rare disease caused by chronic absorption of products with a high silver content, which surpass body’s renal and hepatic excretory capacities, leading to silver granules being deposited in the skin and its appendages, mucosae and internal organs. It is characterized by blue-gray or black staining of the skin and mucous membranes. Our case was first mentioned in 1862 as a syphilitic man who was treating himself with some caustic silver nitrate, the so called “infernal stone”, since 1840s. According to him, this medicament cured the syphilis, but turned him into a “graphite man”. The patient died in 1873 of an intestinal infection, most likely related to the prolonged ingestion of the silver nitrate. This case was described as “spectacular” by Austrian dermatologist Isidor Neumann (1832-1906), who studied a sample of the tongue of the specimen sent by Brunetti. In fact, Brunetti performed the autopsy on the body of the individual and prepared also a plaster cast of the head along with the sample for Neumann. Thus, we can assume Brunetti was also the one who preserved the original head, taxidermizing it (so-called stuffed head preparation) in order to preserve the skin color, because his famous tannisation method would not maintained the original characteristics. Human taxidermy is quite rare, and it is limited to a few cases in the 19th century. Moreover, there are just a few known human stuffed heads in the world, making the Paduan specimen particularly unique both for the pathology and the technique used for the preparation.

2.
Minerva Cardiology and Angiology ; 70(3):303-309, 2022.
Article in English | MEDLINE | ID: covidwho-1841790

ABSTRACT

BACKGROUND: The Lombardy region, in Northern Italy, suffered a major outbreak of Coronavirus disease 2019 (COVID-19) at the end of February 2020. The health system was rapidly overwhelmed by the pandemic. It became evident that patients suffering from time-sensitive medical emergencies like stroke, cerebral hemorrhage, trauma and acute myocardial infarction required timely, effective and safe pathways to be treated. The problem was addressed by a regional decree that created a hub-and-spoke system for time-sensitive medical emergencies. METHODS: We report the re-organizational changes adopted at a hub hospital (despite having already destined to COVID-19 patients most resources), and the number of emergent procedures for medical emergencies on the first 30-day of activity. These data were compared with the hospital activity in the same period of the previous year. RESULTS: Organizational changes were implemented in few hours. Dedicated pathways for non-COVID-19 patients affected by a medical emergency were set up in the emergency department, in the labs and in the operating theater. Ten intensive beds were implemented from a high-dependency unit;two operating rooms were reserved 24 h/day to neurosurgical or trauma emergencies. The number of emergent procedures was not different from that of the previous year, no admission refusal, no treatment delay and no viral transmission to the treated patients were recorded. No viral transmission to health care workers was observed. CONCLUSIONS: Re-organization of a hospital in order to adopt a hub-and-spoke model resulted feasible and allowed to face acute coronary syndrome and other time-sensitive medical emergencies timely and safely.

4.
European Journal of Neurology ; 28(SUPPL 1):103, 2021.
Article in English | EMBASE | ID: covidwho-1307709

ABSTRACT

Background and aims: Several studies reported increased incidence of Guillain-Barre' Syndrome (GBS) after Zika epidemic, SARS-CoV and MERS, and more recently SARS-CoV-2 infection. We estimate incidence and describe clinical characteristics and outcome of GBS in COVID-19 patients in one of the most affected regions by COVID-19 of the world, Lombardia. Methods: A multi-center observational study on neurological complications in COVID-19 patients was conducted in 20 Neurology Units by the Italian society of Hospital Neuroscience (SNO). Adult patients admitted to Neurological units between February-April 2020 with COVID19-GBS were included. Results: 38 COVID19-GBS patients had mean age of 60.7 years and male frequency of 86.8%. Mean interval between COVID-19 onset and GBS onset was 15.1 days. CSF albuminocytologic dissociation was detected in 71.4% of cases, PCR for SARS-CoV-2 negative in all 15 tested patients, and anti-ganglioside antibodies positive in 43.7%. Based on neurophysiology, 81.8% of patients had a diagnosis of AIDP diagnosis, 12.1% AMSAN and 6% AMAN. 29 patients have been treated with intravenous Immunoglobulin (IVIg), two with plasma exchange (PE), two with PE followed by IVIg and five untreated. The course was favorable in 76.3% of patients, stable in 10.5%, while 13.1% worsened, of which three died. The estimated occurrence rate in Lombardia is 0.5 GBS cases per 1000 COVID-19 infections. Conclusion: We detected an increased incidence of GBS in COVID-19 patients which can reflect higher risk of GBS in COVID-19 patients or be secondary to an increase of prevalence of prior infection in that period.

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