Lazzaro Spallanzani Research Articles

Severe Plasmodium ovale malaria complicated by acute respiratory distress syndrome in a young Caucasian man

BackgroundAlthough Plasmodium ovale is considered the cause of only mild malaria, a case of severe malaria due to P. ovale with acute respiratory distress syndrome is reported.Case presentationA 37-year old Caucasian man returning home from Angola was admitted for ovale malaria to the National Institute for Infectious Diseases Lazzaro Spallanzani in Rome, Italy. Two days after initiation of oral chloroquine treatment, an acute respiratory distress syndrome was diagnosed through chest X-ray and chest CT scan with intravenous contrast. Intravenous artesunate and oral doxycycline were started and he made a full recovery.ConclusionOvale malaria is usually considered a tropical infectious disease associated with low morbidity and mortality. However, severe disease and death have occasionally been reported. In this case clinical failure of oral chloroquine treatment with clinical progression towards acute respiratory distress syndrome is described.

The original batman

Lazzaro Spallanzani was the first to unravel the mystery of how bats could “see” and hunt in total darkness, with some ingenious, if gruesome, experiments

The invention of artificial fertilization in the eighteenth and nineteenth century.

Artificial insemination and other fertilization techniques are today considered central to the history of reproductive medicine. The medical treatment of infertile couples, however, constitutes just a small part of the whole story of artificial fertilization. Lazzaro Spallanzani (1729-1799) in particular, said to have been the inventor of artificial insemination, did not develop this method for medical purposes. He belonged to a generation of naturalists to whom artificial insemination was part of a heterogeneous series of investigations that were undertaken to explore the natural history of animal generation. Questions concerning conception, the role of the gametes, the definition of species, the production of hybrids or livestock breeding were all included in these investigations. Thus, no one strain of thought, nor single set of ideas or interests, entirely shaped the development of artificial fertilization.

Detection of Viral RNA in Tissues following Plasma Clearance from an Ebola Virus Infected Patient.

An unprecedented Ebola virus (EBOV) epidemic occurred in 2013–2016 in West Africa. Over this time the epidemic exponentially grew and moved to Europe and North America, with several imported cases and many Health Care Workers (HCW) infected. Better understanding of EBOV infection patterns in different body compartments is mandatory to develop new countermeasures, as well as to fully comprehend the pathways of human-to-human transmission. We have longitudinally explored the persistence of EBOV-specific negative sense genomic RNA (neg-RNA) and the presence of positive sense RNA (pos-RNA), including both replication intermediate (antigenomic-RNA) and messenger RNA (mRNA) molecules, in the upper and lower respiratory tract, as compared to plasma, in a HCW infected with EBOV in Sierra Leone, who was hospitalized in the high isolation facility of the National Institute for Infectious Diseases “Lazzaro Spallanzani” (INMI), Rome, Italy. We observed persistence of pos-RNA and neg-RNAs in longitudinally collected specimens of the lower respiratory tract, even after viral clearance from plasma, suggesting possible local replication. The purpose of the present study is to enhance the knowledge on the biological features of EBOV that can contribute to the human-to-human transmissibility and to develop effective intervention strategies. However, further investigation is needed in order to better understand the clinical meaning of viral replication and shedding in the respiratory tract.

The contribution of the European high containment laboratories during the 2014–2015 Ebola Virus Disease emergency

The authors are grateful to the European Commission and CHAFEA for financially and technically supporting the following Networks: EURONET-P4 2003214, ENP4Lab 2006208, QUANDHIP 2010-21-02, and EMLab (European Mobile Laboratory Project). Part of this work was also supported by the Italian Ministry of Health, ‘Ricerca Corrente’ grants awarded to the ‘Lazzaro Spallanzani’ National Institute for Infectious Diseases-IRCCS, Rome, Italy.

FRII-03 LAZZARO SPALLANZANI (1729-1799): THE FIRST SUCCESSFUL ARTIFICIAL INSEMINATION EXPERIMENTS

You have accessJournal of UrologyHistory of Urology: History Forum II1 Apr 2016FRII-03 LAZZARO SPALLANZANI (1729-1799): THE FIRST SUCCESSFUL ARTIFICIAL INSEMINATION EXPERIMENTS Giorgio Bozzini, Mauro Seveso, Pietro Bono, Oliviero De Francesco, Alberto Mandressi, and Gianluigi Taverna Giorgio BozziniGiorgio Bozzini More articles by this author , Mauro SevesoMauro Seveso More articles by this author , Pietro BonoPietro Bono More articles by this author , Oliviero De FrancescoOliviero De Francesco More articles by this author , Alberto MandressiAlberto Mandressi More articles by this author , and Gianluigi TavernaGianluigi Taverna More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2924AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Italian priest (Jesus Fellowship), physiologist and natural scientist, convincingly disproved the notion of spontaneous generation (creation of life from inanimate matter). He investigated the male contribution to procreation. METHODS Sources from medical journal, Italian and French manuscripts and European medical chronicles were analyzed regarding the life and contribution of Lazzaro Spallanzani. RESULTS Although Leeuwenhoek had first seen the spermatozoa, their function was not understood until some 30 years after the formulation of the cell theory in 1839. Using amphibians, Spallanzani showed that actual contact between egg and semen is essential for the development of a new animal and that filtered semen becomes less and less effective as filtration becomes more and more complete. He noted that the residue on the filter paper retained all its original power if it were immediately added to the water containing the eggs. Spallanzani concluded that the solid parts of the secretion, proteinaceous and fatty substances were essential for the fecundation, regarding the spermatozoa as inessential parasites. Despite this error, Spallanzani performed some of the first successful artificial insemination experiments on lower animals and on a dog. CONCLUSIONS Spallanzani with his insights and his ideas was the real inventor of artificial insemination. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e521 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Giorgio Bozzini More articles by this author Mauro Seveso More articles by this author Pietro Bono More articles by this author Oliviero De Francesco More articles by this author Alberto Mandressi More articles by this author Gianluigi Taverna More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Sampling Surfaces for Ebola Virus Persistence After Cleaning Procedures in High-Level Isolation Settings: The Experience With 2 Patients at the Lazzaro Spallanzani National Institute for Infectious Diseases.

Sampling Surfaces for Ebola Virus Persistence After Cleaning Procedures in High-Level Isolation Settings: The Experience With 2 Patients at the Lazzaro Spallanzani National Institute for Infectious Diseases.

Longitudinal characterization of dysfunctional T cell-activation during human acute Ebola infection.

Data on immune responses during human Ebola virus disease (EVD) are scanty, due to limitations imposed by biosafety requirements and logistics. A sustained activation of T-cells was recently described but functional studies during the acute phase of human EVD are still missing. Aim of this work was to evaluate the kinetics and functionality of T-cell subsets, as well as the expression of activation, autophagy, apoptosis and exhaustion markers during the acute phase of EVD until recovery. Two EVD patients admitted to the Italian National Institute for Infectious Diseases, Lazzaro Spallanzani, were sampled sequentially from soon after symptom onset until recovery and analyzed by flow cytometry and ELISpot assay. An early and sustained decrease of CD4 T-cells was seen in both patients, with an inversion of the CD4/CD8 ratio that was reverted during the recovery period. In parallel with the CD4 T-cell depletion, a massive T-cell activation occurred and was associated with autophagic/apoptotic phenotype, enhanced expression of the exhaustion marker PD-1 and impaired IFN-gamma production. The immunological impairment was accompanied by EBV reactivation. The association of an early and sustained dysfunctional T-cell activation in parallel to an overall CD4 T-cell decline may represent a previously unknown critical point of Ebola virus (EBOV)-induced immune subversion. The recent observation of late occurrence of EBOV-associated neurological disease highlights the importance to monitor the immuno-competence recovery at discharge as a tool to evaluate the risk of late sequelae associated with resumption of EBOV replication. Further studies are required to define the molecular mechanisms of EVD-driven activation/exhaustion and depletion of T-cells.

Enabling Rapid Response to the 2014-2016 Ebola Epidemic: The Experience and the Results of the National Institute for Infectious Diseases Lazzaro Spallanzani.

The unprecedented epidemic of Ebola virus disease (EVD) in West Africa highlighted the need for stronger systems for disease surveillance, response, and prevention worldwide. Tackling an epidemic event today requires a broader view, not only limited to medical management of the patients, but which also includes heroic efforts by clinicians and public health personnel.Since its foundation in 1936, INMI has been devoted to the prevention, diagnosis and care for infectious diseases. In 2009, INMI became a WHO collaborative center for clinical care, diagnosis, response and training on Highly Infectious Diseases. This paper is aimed to present the activities and the challenging issues encountered by INMI during the 2014-2015 EVD outbreak in terms of preparedness and response to the epidemiological, clinical, diagnostic and research controversial aspects of EVD, both in Italy and in the field.

Epidemiology of HEV in the Mediterranean basin: 10-year prevalence in Italy

ObjectivesThe present study is aimed at describing the seroprevalence and exploring potential risk factor(s) for hepatitis E virus (HEV) in participants who voluntarily underwent anti-HIV antibody testing.Study designSeroprevalence study.SettingThe HIV...

Radiographic imaging in Ebola Virus Disease: protocol to acquire chest radiographs

Proper procedures to minimize the risk of contamination in contagious and potentially lethal viral infections are needed; therefore radiology departments should develop appropriate imaging protocols. We describe the imaging protocol used by National Institute for Infectious Diseases Lazzaro Spallanzani to acquire chest radiographs in patients with Ebola virus disease. • Nosocomial transmission to healthcare workers can be prevented using protective equipment. • Chest radiographs can be required in Ebola Virus Disease. • The protocol for performing chest radiographs on patients with Ebola is described.

Lazzaro Spallanzani e a geração espontânea: os experimentos e a controvérsia

This article discusses the researches performed by the Italian naturalist Lazzaro Spallanzani (1729-1799) on spontaneous generation. For this is an idea no longer accepted, the theme is often dealt with irony by anachronistic historical reports. In such cases, it discredits that the idea has already been held by many researchers of nature, through many centuries. The goal of this work, after presenting a historical overview of ideas of the main authors concerned with the issue, is to analyze the experiments of Spallanzani on the generation in the context of the Eighteenth Century theories and the controversy between Spallanzani and John T. Needham (1713-1781). There will be also a brief discussion of the epistemic and non-epistemic elements that participate in the solution, or not, of scientific controversies.

Self-reported adherence supports patient preference for the single tablet regimen (STR) in the current cART era

ObjectiveTo analyze self-reported adherence to antiretroviral regimens containing ritonavir-boosted protease inhibitors, nonnucleoside reverse transcriptase inhibitors (NNRTI), raltegravir, and maraviroc.MethodsOverall, 372 consecutive subjects attending a reference center for HIV treatment in Florence, Italy, were enrolled in the study, from December 2010 to January 2012 (mean age 48 years). A self-report questionnaire was filled in. Patients were defined as “nonadherent” if reporting one of the following criteria: <90% of pills taken in the last month, ≥1 missed dose in the last week, spontaneous treatment interruptions reported, or refill problems in the last 3 months. Gender, age, CD4, HIV-RNA, years of therapy, and type of antiretroviral regimen were analyzed with respect to adherence.ResultsAt the time of the questionnaire, 89.8% of patients had <50 copies/mL HIV-RNA and 14.2% were on their first combined antiretroviral therapy. 57% of patients were prescribed a regimen containing ritonavir boosted protease inhibitors (boosted PI), 41.7% NNRTI, 17.2% raltegravir, and 4.8% maraviroc; 49.5% of the subjects were on bis-in-die regimens, while 50.5% were on OD regimens, with 23.1% of these on the single tablet regimen (STR): tenofovir/emtricitabine/efavirenz. The nonadherence proportion was lower in NNRTI than in boosted-PI treatments (19.4% vs 30.2%), and even lower in STR patients (17.4%). In multivariable logistic regression, patients with the NNRTI regimen (OR: 0.56, 95% CI: 0.34–0.94) and the STR (OR: 0.45, 95% CI: 0.22–0.92) reported lower nonadherence. Efavirenz regimens were also associated with lower nonadherence (OR: 0.42, 95% CI: 0.21–0.83), while atazanavir/ritonavir regimens were associated with higher nonadherence. No other relation to specific antiretroviral drugs was found. A higher CD4 count, lower HIV-RNA, and older age were also found to be associated with lower nonadherence, while a longer time on combined antiretroviral therapy was related to higher nonadherence.ConclusionSTR maintains an advantage in improving adherence with respect to other combined antiretroviral therapies, even though new antiretroviral drugs and drug classes have become available in recent years.

Lazzaro Spallanzani e os fósseis: das observações em viagens naturalísticas ao ensino de história natural

This article analyzes opinions expressed by Italian naturalist Lazzaro Spallanzani on the origin and constitution of fossils on three of his travels, which punctuated three courses in mineralogy he gave in the natural history discipline at the University of Pavia. These trips to Portovenere, the island of Cerigo and the Two Sicilies enabled him to address important topics, such as the discovery of fossilized shells inside volcanic rocks, the discovery of human fossils, and the existence of fossils of species that had 'been lost', incorporating knowledge being developed at the time that drew on mineral chemistry. His concern with fossils is demonstrative of how Spallanzani, in true eighteenth century fashion, integrated studies from the three kingdoms of nature.

Economic considerations of antifungal prophylaxis in patients undergoing surgical procedures

Fungi are a frequent cause of nosocomial infections, with an incidence that has increased significantly in recent years, especially among critically ill patients who require intensive care unit (ICU) admission. Among ICU patients, postsurgical patients have a higher risk of Candida infections in the bloodstream. In consideration of the high incidence of fungal infections in these patients, their strong impact on mortality rate, and of the difficulties in Candida diagnosis, some experts suggest the use of antifungal prophylaxis in critically ill surgical patients. A clinical benefit from this strategy has been demonstrated, but the economic impact of the use of antifungal prophylaxis in surgical patients has not been systematically evaluated, and its cost–benefit ratio has not been defined. Whereas the costs associated with treating fungal infections are very high, the cost of antifungal drugs varies from affordable (ie, the older azoles) to expensive (ie, echinocandins, polyenes, and the newer azoles). Adverse drug-related effects and the possibly increased incidence of fluconazole resistance and of isolates other than Candida albicans must also be taken into account. From the published studies of antifungal prophylaxis in surgical patients, a likely economic benefit of this strategy could be inferred, but its usefulness and cost–benefits should be evaluated in light of local data, because the available evidence does not permit general recommendations.

An Inexpensive and Easy Technique for Placing and Fixing Dorsal Grafts in Rhinoplasty

Sir: Cartilage grafting has been a common surgical practice in aesthetic and functional rhinoplasty since 1980.1 This technique is performed to augment the nasal dorsum, to support the lateral nasal wall, and to manage nasal valve collapse. In fixing the cartilage graft, the surgeon has to cope with the poor accessibility of the tunnel, which precludes the use of standard sutures in a situation where the graft must be placed accurately and firmly. Percutaneous sutures are widely used in anchoring cartilage grafts because they have been demonstrated to close dead space and thus prevent fluid accumulation or hematoma. Graft migration is avoided because of the anchoring of skin and soft tissues to the grafted nasal scaffold.2 Classically, a suture with a straight needle is used. Stephenson and Brotherston suggest using a straight-sucker tube,3 whereas other authors use straight and curved needles.4 We describe here an easy and accurate technique for proper placement of grafts in rhinoplasties by open and closed approaches, both for minimal nasal dorsum correction and for total nasal reconstruction. A polyglactin braided suture (3-0 or 4-0) and two spinal needles are required. Alternatively, two 23-gauge needles could be used. The free tip of the thread is first introduced into the spinal needle using the needle hub as a funnel (Fig. 1). The spinal needle is then crushed with a needle holder to block the thread inside. The needle hub is then removed by detaching it from the needle and sliding it along the thread. At this point, the graft is threaded onto the suture, with two passages, and the needle of the thread is cut. Then, this tip of the thread is introduced into the other spinal needle, from which the hub was previously removed, and the needle is crushed as for the case of the preceding one.Fig. 1.: (Above) The thread is introduced into the needle. In this case, the needle hub was previously removed. Alternatively, the needle hub can be used as a funnel in the first passage. (Below) The needle is then crushed with a needle holder.The two spinal needles are introduced into the nasal fossa and guided to the point where the anchoring stitch is required, using a retractor to better expose the area (Fig. 2). The spinal needles pass from inside to outside, leading the thread and thus fixing the graft. The two needles are cut from the thread and the two tips are tied externally, leaving the suture loose to let the skin expand in the event tissue edema occurs. Properly adapted paraffin gauze is placed under the suture knot to prevent skin damage. The suture is left in place for 6 to 7 days.Fig. 2.: (Above) An Aufricht is used to facilitate the needle placement. (Below) The two needles and the graft threaded onto the suture are introduced.The procedure is very simple and highly accurate, and requires no expensive tools. Moreover, the surgeon can use his or her hands to direct the needle and choose with absolute precision the point at which to fix the graft. By comparison, other techniques2,4 require more passages of the needle through the skin, which increase the risk of damage to soft tissues because they are less precise and increase the time required for surgery. We have used this method with success widely over the years, achieving good results in graft fixation, even in complete nasal reconstructions with large cartilage grafts. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article. No outside funding was received. Luciano Ariel Lanfranchi, M.D. Riccardo Gazzola, M.D. Unit of Plastic and Reconstructive Surgery IRCCS San Raffaele Hospital, and IRCCS Istituto Ortopedico Galeazzi Alessandro Addis, D.V.M. Centro di Ricerche e Applicazioni Biotecnologiche in Chirurgia Cardiovascolare “Piera Santambrogio” Istituto Sperimentale Italiano “Lazzaro Spallanzani” Valeria Puggioni, M.D. Matteo Marino, M.D. Franz Wilhelm Baruffaldi Preis, M.D. Unit of Plastic and Reconstructive Surgery IRCCS San Raffaele Hospital, and IRCCS Istituto Ortopedico Galeazzi Milan, Italy

Richard C. Sha . Perverse Romanticism: Aesthetics and Sexuality in Britain, 1750–1832. Baltimore : Johns Hopkins University Press . 2009 . Pp. xi, 359. $55.00.

At the heart of Richard C. Sha's book is the claim of a homology, emerging in the period under consideration, between new descriptions of sexuality in medical and physiological literature and new accounts of the work of art in aesthetic treatises and in the art itself. The keynote of this homology is struck in Immanuel Kant's characterization of artwork as “purposiveness without a purpose,” that special status of art's orientation toward ends without any prior determination of what the particular end might be or the sense of art's existing “as if” it were directed toward an end without the end ever being given. The proto-sexology of Sha's roster of physiologists—Albrecht von Haller, John Hunter, Lazzaro Spallanzani, Franz Gall, Erasmus Darwin, John Brown, and others—parallels Kant's aesthetic thesis by freeing sexuality from being solely determined by its reproductive function, recognizing the competing claims of pleasure, emotional mutuality, and interrelation, all grouped by Sha under the heading of “perversity” for their turning away from reproductive function.

Vom Samentier zur Samenzelle: Die Neudeutung der Zeugung im 19. Jahrhundert

At the end of the 18th and still at the beginning of the 19th century most naturalists considered spermatic animalcules to be parasites of the seminal fluid that played no role in procreation. This view was progressively questioned by 19th century physiologists. They gradually redefined the spermatic animals as (cellular) products of the male organism, as agents of fertilization and bearers of the male heredity material. This article discusses this change from two different perspectives: on a microhistorical level, it analyzes the experimental research of the naturalist Lazzaro Spallanzani (1729-1799) and of the physiologist Albert Kölliker (1817-1905) in order to show how spermatozoa were turned into a new epistemic object of biology--the sperm cell. Further, it asks how the role of the reconceptualization of spermatic animalcules affected the long-term transformations that gave rise of our modern understanding of heredity, generation and the sexed body. By combining these two perspectives, the article aims to connect historiographies that are often kept separate: the macrohistorical narratives about gender and the body in the modern age and the microhistorical studies of biomedical practices and objects.

Accuracy of Malaria Diagnosis by Microscopy, Rapid Diagnostic Test, and PCR Methods and Evidence of Antimalarial Overprescription in Non-Severe Febrile Patients in Two Tanzanian Hospitals

The study was aimed to evaluate the malaria over/underdiagnosis and over/underprescription of antimalarial drugs. Between February and March 2007 blood samples were collected from 336 non-severe febrile outpatients attended in two peripheral Tanzanian hospitals. Microscopy and a rapid diagnostic test (RDT) were done locally and the accuracy evaluated by qualitative polymerase chain reaction (PCR) for Plasmodium spp. The testing was performed at National Institute for Infectious Diseases Lazzaro Spallanzani (INMI), Rome, Italy. As a result of PCR, we identified 26 malaria cases out of 336 (7.7%) patients. Microscopy and RDT accuracies were 93.5% and 97.6%, respectively. Overprescription and underdiagnosis rates were 29.3% and 30.8%, respectively. On-field training, clinical management of febrile illness, and malaria microscopy in remote settings should be considered.

Adult Liver Transplantation With a Rotated Left Liver Lobe From an “In Situ” Splitting Procedure

The “in situ” split liver for two adults is an accepted procedure to improve graft pool in the present scenario of organs shortage (1). With this technique, we obtain a left (S I–IV) and a right split graft (S V–VIII). However, this technique is difficult to perform and still not very common. The European Liver Transplant Registry data report 584 left livers splits from 1989 to 2005 and only 28 in 2006 (personal communication). Moreover, the experience with transplantation of left lobe graft from deceased donors in Europe is poor with a 1-year graft survival of 47% (2). These disappointing results may be related to the inadequate liver mass for an adult recipient or to the technical issues such as disproportionate size of liver grafts. We describe a modification of the left split graft implantation, the graft deriving from an “in situ” splitting procedure for two adults. We placed the graft heterotopically in the right upper quadrant fossa after a 180° rotation, because it was too large to be placed in the epigastric region. The left graft, procured from a brain-dead 26-year-old man, was harvested with the middle hepatic vein and retro hepatic vena cava. The graft suprahepatic vena cava was anastomized to the three hepatic veins common cloacae of the recipient, followed-by end-to-end portal and biliary anastomosis. The aortic patch of the graft was implanted on the recipient right hepatic artery (Fig. 1). The graft (687 g) was transplanted in a 50-years-old woman (62 kg) with hepatitis C virus cirrhosis and hepatocellular carcinoma. The graft-to-recipient body-weight ratio was 1.1%. After surgery the left graft showed an adequate liver function (pick of alanine aminotransferase=446 at day 1) and the patient stayed in intensive care unit for 5 days. Computed tomography at day 10 after transplantation showed patent vascular and biliary anastomoses. In the postoperative course, the patient bled from esophageal varices and required endoscopic sclerotherapy. The discharge was 30 days after surgery with normal hepatic function. To our knowledge this procedure was previously performed only for a left lateral segment or for a left lobe split in the setting of living donor (3) but never for a left split graft derived from cadaveric donor (4). This case shows that the volume of the right upper quadrant fossa can host a rotated left liver when it cannot be placed orthotopically, without any evidence of compression or kinking of vascular anastomosis resulting in a good postoperative graft function. We hope that the described alternative placement of left liver graft will stimulate the more experienced transplant teams to split livers without strictly considering the anatomical parameters for graft placement, that is, recipient weight and abdominal transversal circumference. Considering that 85% of liver transplants in Europe are from cadaveric donors (5), the application of this technique would result in increased graft availability. It remains to be shown if and to what extent this left split graft placement technique will improve the split liver transplant programs.FIGURE 1.: Schematic representation of the rotated left liver split graft.Giuseppe Maria Ettorre Giovanni Vennarecci Roberto Santoro Pasquale Lepiane Riccardo Lorusso General Surgery and Liver Transplantation Department San Camillo Hospital Rome, Italy Mario Antonini Intensive Care Unit National Institute for Infectious Disease “Lazzaro Spallanzani” Rome, Italy