Journal of Health and Social Sciences 2016,1(1) Click Free Full Open Access

15 March 2016

Table of Contents

JHSS 2016,1(1):9-10


Welcome to the Journal of Health and Social Sciences

Authors: Francesco Chirico*, Giuseppe Ferrari**

*Health Service State Police, Ministry of Interior, Italy
**SIPISS-Italian Society for Psychotherapy and Social Development

Dear Readers,

It gives us enormous pleasure to officially launch the inaugural issue of the Journal of Health and Social Sciences.

The Journal is an interdisciplinary, open access journal that focuses on the medical and health sciences. Topics of interest to the journal include all branches of medicine and other disciplines related to health such as psychology, social sciences and public, occupational and environmental sciences. According to the World Health Organization’s definition, health is ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’. Therefore, the leitmotiv throughout Journal of Health and Social Sciences will be “health” in every way.

Keywords: medicine; psychology; social sciences

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JHSS 2016,1(1):11-16


Spiritual well-being in the 21st century: It is time to review the current WHO’s health definition

Author: Francesco Chirico*

 * State Police, Health Service Department, Ministry of Interior, Italy   


Over the years, some critics argue that the dimension of spiritual well-being was missing from the World Health Organization’s (WHO) definition of health. Nevertheless, although the WHO’s definition has been criticized over the past 60 years, it has never been adapted. Spiritual well-being should not be confused with psychological well-being. Moreover, spirituality, personal beliefs and religiousness are not synonymous. Spirituality has received much interest in health care services; it can improve strategies for managing stress and can positively influence immune, cardiovascular (heart and blood vessels), hormonal, and nervous systems. For this reason, it may be implicated in a wide range of physical and mental health conditions, and I believe it’s time to review the WHO’s health definition, adding to it the ‘spiritual well-being’ dimension.

Keywords: spirituality; global health; holistic health; religion; spiritual therapies.

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JHSS 2016,1(1):17-22


Workplace conflicts and psychological work-related injuries: our experience in Italy

Authors: Giuseppe Taino*, Andrea Battaglia**, Marcello Imbriani**

*IRCCS “S. Maugeri” Foundation – Pavia – Unit Hospital of Occupational Medicine (UOOML)
** Department of Public Health, Experimental Medicine and Forensic – University of Pavia. IRCCS “S. Maugeri” Foundation – Pavia


In Europe, all countries regularly recognise mental disorders as workplace accidents (mainly post-traumatic stress disorders). However, there has been little emphasis on this emerging issue in Italy. Our discussion focuses on a recent case report regarding an employee who was affected by an acute anxiety disorder after a common workplace conflict with a coworker. Given that prolonged and unresolved relationship conflicts may result in more extreme forms of conflict known as workplace bullying, relationship conflicts should be minimised or prevented as early as possible. These conflicts can also lead to acute stress disorders, particularly in workers who are at-risk for stress disorders. To prevent psychological work-related injuries, occupational stakeholders should use assessments for work-related stress as a framework for addressing all organisational risk factors that are related to workplace relationships and conflict.

Keywords: occupational injuries; risk assessment; psychological trauma; stress disorders traumatic.

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JHSS 2016,1(1):23-28


Psychosocial risks within prison service

Author: Giuseppe Ferrari*

*SIPISS-Italian Society for Psychotherapy and Social Development


The action research was aimed at identifying psychosocial risks of the Penitentiary Police. We have specifically developed the PSrQ-p, a questionnaire consisting of 22 items that made it possible to investigate five dimensions: isolation, social image, firearms license, variety of work and role. This tool has been tested on a sample of 1346 subjects and testing is ongoing. From the data obtained it was confirmed the hypothesis of psychophysical and negative social image relative to a starting isolation experienced by the operators of the Penitentiary Police.

Keywords: psychosocial factors; police officers; prisons; social environment

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JHSS 2016,1(1):29-36

Viewpoint Article

The high cancer incidence in young people in Italy: do genetic signatures reveal their environmental causes?

Author: Ruggero Ridolfi*

*International Society of Doctors for the Environment (ISDE). ISDE Forlì Cesena, Italy. Honorary President of Italian Melanoma Intergroup (IMI).


The increased incidence of cancer in children and adolescents registered in Italy in the last few decades is one of the highest amongst Western countries. The causes are difficult to identify, but recent daily news and some epidemiological surveys, such as the ‘Sentieri’ study, suggest that environmental pollution has an important role. In the past 20 years, epigenetic studies have described how the changes induced by the cell microenvironment on the non-coding parts of the genome can heavily influence gene function, contributing to the carcinogenesis process. Connecting links amongst the external environment, cellular microenvironment and functional epigenetic and genetic mutations promote carcinogenesis. Today, the whole genome sequencing techniques for human cancers can help to formulate a map of mutational signatures in individual tumours, and a list of mutational fingerprints showing exposure to specific environmental mutagens is being developed. Determining the ethical, legal and economic consequences of known cancer causative agents in young people will be a crucial step for a serious reconsideration of primary prevention.

Keywords: neoplasms; primary prevention; carcinogens, environmental; epigenomics; DNA mutational analysis

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JHSS 2016,1(1):37-46

Viewpoint Article

Is there health inequity in Europe today? The ‘strange case’ of the application of an European regulation to cartilage repair

Author: Roberto Beretta*

*Biologist, Biotechnology Expert, Milan, Italy


An important regulation, issued by the European Community in 2008, regulates the authorisation and supervision of advanced therapy medicinal products (ATMP) and subsequent follow up in Europe. This law contains a Hospital Exemption clause, under which some hospitals in some countries can be exempted from the regulations governing ATMPs. The application of this regulation in Europe has resulted in differences in the costs of cell therapy for cartilage injuries in Germany compared with the costs in other European countries and in the U.S. The present paper argues on the real impact of political decisions on the health of citizens, on economy of healthcare systems, and highlights a possible case of inequality among European citizens with respect to cartilage repair procedures.

Keywords: ATMP; healthcare systems; healthcare economics; public health; tissue engineering

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JHSS 2016,1(1):47-56

Original Article

Terbinafine versus itraconazole: a long-term, randomized, double-blind, clinical trial in chronic pulmonary aspergillosis. A pilote study

Authors: Gianfranco Schiraldi1, Salvatore Lo Cicero2, Claudio Rossetti3,Delia Colombo4,  Michele Chiericozzi2, Fabio Colombo5, Maurizio Ferrarese6, Elvana Kola2, Luigi Allegra7

1 Pneumology Unit, IRCCS Auxologico, Milan, Italy
2 Pneumology Department, Niguarda Hospital, Milan, Italy
3 Nuclear Medicine Department, Niguarda Hospital, Milan, Italy
4 Novartis Pharma, Italy
5Villa Marelli Institute, Niguarda Hospital, Milan, Italy
6 TB Department, Villa Marelli Institute, Niguarda Hospital, Milan, Italy
7 Respiratory Diseases; Milan University, Italy


Background: The frequency of pulmonary aspergillosis has been increasing for decades. Standard oral treatment is associated with tolerability problems and interactions with commonly used medications. Present data suggest that terbinafine may be a useful alternative for chronic forms.

Methods: A randomised, double-blind, multicentre trial compared terbinafine (500 mg b.i.d) with itraconazole (200 mg b.i.d.) with respect to successful outcomes for up to 6 months in 24 patients with chronic pulmonary aspergillosis. The primary end-point was a global clinical assessment using a 4-point rating scale, including (thorax) X-ray or Tc features. Secondary end-points were mycological response, duration of treatment and tolerability based on adverse events, haematology, biochemistry and urinalyses.

Results: The patients were randomly allocated to terbinafine or itraconazole. No patients discontinued terbinafine, while 2 of 12 patients discontinued itraconazole because of protocol violation (n=1) or withdrawal of consent (n=1). The mean ± SD duration of the treatment was longer in the terbinafine group (139.8 ± 43.6 days vs 120.5 ± 41.8 days). The clinical success rate was also higher with terbinafine (91.7% vs 70.0%), as was the eradication rate (100% vs 75%). The proportion of patients who reported adverse events was higher with itraconazole (7 of 12 vs 3 of 12).

Conclusions: Terbinafine (500 mg b.i.d. for up to 6 months) is an effective, well-tolerated antifungal agent for the treatment of chronic infectious forms of pulmonary aspergillosis, representing a valid alternative to treatment with itraconazole in these clinical forms, due to better clinical efficacy and safety and lower costs vs new azoles.

Keywords: terbinafine; itraconazole; treatment; pulmonary aspergillosis; positron emission tomography

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JHSS 2016,1(1):57-66

Systematic Review

Liposarcomas of the hypopharynx: a systematic review of the literature

Authors: Andrea Corvino*, Giuseppe Riva*, Matteo Sensini*, Massimiliano Garzaro*, Giancarlo Pecorari*

 *ENT Division, Surgical Sciences Department, University of Turin, Via Genova,3,10126 Turin, Italy


Introduction: Liposarcomas are considered the most common type of soft tissue sarcoma in adults. They represent approximately 20% of all mesenchymal malignancies and most frequently involve the retroperitoneum, trunk and extremities. Hypopharyngeal localisation of a liposarcoma is extremely rare. To determine the prevalence of liposarcomas of the hypopharynx, we conducted a systematic review of the literature.

Methods: We performed a systematic search of the literature until 2015 using PubMed and Ovid. The search identified 28 cases of hypopharyngeal liposarcomas. The inclusion criteria were: clinical trials, cohort studies, case-control studies, case reports and case series on hypopharyngeal liposarcomas. From an initial 77 articles, 23 articles were selected for this systematic review. The natural history, imaging features, histology, treatment and prognosis were analysed.

Results: The incidence peaked in the sixth and seventh decades. Diagnostic procedures were based on the barium swallow test, endoscopic examinations, and computed tomography (CT)/magnetic resonance (MR) imaging. A well-differentiated liposarcoma represented the most frequent histological subtype. Surgical excision was the main treatment. Endoscopic resection appeared to be useful for peduncolated tumours of the hypopharynx. The 1-year disease-free survival rate was 89.47%.

Conclusions: A hypopharyngeal liposarcoma is a rare pathology, but it should kept in mind when a mass of the hypopharynx is discovered. A cervical approach is better, irrespective of the size of the tumour, except for cases in which an endoscopic approach is feasible. Local recurrence is common. Therefore, patients should undergo regular examinations, at least for up to 5 years.

Keywords: liposarcoma; hypopharyngeal neoplasms; hypopharynx; piriform sinus, lateral pharyngotomy; systematic review.

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JHSS 2016,1(1):67-70

Case Report

Dysphagia and trismus: an unusual case of tetanus

Authors: Antonio Villa* , Marianna Gregorio*, Francesca Bassi**, Alessandra Perego*, Maria Francesca Donato**, Vilma Galimberti**, Maria Grazia Bellotti**, Antonella Cheldi**

 * Emergency Department – Desio Hospital (Monza-Brianza), Italy
** Neurology Department – Desio Hospital (Monza-Brianza), Italy


Tetanus is a life-threatening infection that is rare in the developed world; it is more frequent in the elderly people and immunocompromised patients. We report a case of a 53-year-old woman who presented with dysphagia, mouth pain and trismus. She did not report any injuries. The suspected diagnosis of tetanus was made. The blood examination showed severe lymphocytopenia and a positive result for the antinuclear antibody (ANA) test, with a suspected diagnosis of Sjogren’s syndrome. It is possible that her immunocompromised conditions could have led to the onset of tetanus, even after casual and minimal contact with Clostridium spores.

Keywords: tetanus; trismus; dysphagia; lymphocytopenia; immunodepression; Sjogren’s syndrome

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