Researches on thalassemia and malaria in Italy and the origins of the "Haldane hypothesis".
ABSTRACT This paper aims to shed light on Italian contribution to the origins of malaria hypothesis, also known as Haldane hypothesis. The first studies on the association between hemoglobinopathies and malaria, in fact, were done in Italy since the end of the 1920s. These studies tried to explain the correlation between malaria and thalassemia observed by clinicians in various Italian regions. Later, since the beginning of the 1940s, this singular correlation was documented by thorough and wide-ranging epidemiological researches that revealed a strong geographic correspondence between the frequency of the thalassemic features and endemic malaria in Italy. These researches raised clearly the question of maintaining the frequency of a gene that, at the time, doomed homozygotes to death within the first two years of life. In 1948, Silvestroni, Bianco and Montalenti started investigating the causes of the persistence of the thalassemic foci in Italy. In 1949 J.B.S. Haldane finally hypothised for the first time an evolutionary advantage of thalassemic condition due to the concomitant presence of malarial infection. Since 1948, Montalenti and Haldane had various occasions to discuss on this topic. I try to demonstrate the role of Silvestroni, Bianco and Montalenti's research and data on the formation of Haldane hyphothesis.
- SourceAvailable from: Sreekanth NamaInternational Journal of Current Trends in Pharmaceutical Research. 06/2013; 1.
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ABSTRACT: OBJECTIVES:: Pain is the most common reason for admission to the Emergency Department (ED) in patients with sickle cell disease (SCD). It can be associated with severe complications and impairs quality of life. Pain management in the ED should be well-defined and aggressive. The objective of this study was to evaluate pain management in the pediatric ED of a country recently facing SCD and to identify priority areas of intervention. METHODS:: The charts of SCD children who had accessed the ED from January 2003 to December 2010 were retrospectively reviewed. Pain management was compared before and after 2008. During 2008, educational events on SCD-pain management involved the ED personnel. RESULTS:: Twenty-three/28 patients (82%) accessed the ED for/with pain, of a total of 96/185 accesses for/with pain. Mean age was 5.9 years (range, 8 mo to 17.9 y). Fifty-four percent of the episodes resulted in hospital admissions, with a mean length of stay of 6.2 days. Pain was scored in 30% of the episodes; analgesics were administered in 50%. After the educational interventions, high score at triage was assigned more frequently (72% vs. 40%), waiting time for analgesics administration reduced (64 vs. 87 min), and use of Visual Analogue Scale increased (50% vs. 8%). DISCUSSION:: Pain represents the main reason for admission to the ED in children with SCD even in countries recently facing SCD. Educational interventions obtained significant but still limited improvement in pain management. The diffusion of national guidelines with defined pain evaluation and treatment protocols represents a priority to further ameliorate care of SCD children.The Clinical journal of pain 06/2012; · 3.01 Impact Factor