Learning objectives
Basic knowledge of the mechanisms underlying, tissue response to injury (inflammation, hemostasis, repair), genetic diseases, and tumors. Fundamentals of immune response and its alterations, with a peculiar emphasis on transfusion medicine and on subjects of particular relevance for midwifes.
Basic knowledge about the general
characteristics of the aetiological agents of the principal infectious diseases
(bacteria, fungi, parasites, viruses) with particular interest in the infectious diseases
of the obstetrical-gynaecological apparatus.
Knowledge of the main evolutionary steps in midwifery development.
Course unit content
GENERAL PATHOLOGY
1. The blood: composition and pathophysiology. Anemia. 2. Inflammation:Events of acute inflammation; Exudate; Types of exudate; Phagocytosis; Chronic inflammation and granulomas; Abscesses and ulcers;
Chemical mediators of inflammation; Systemic effects of inflammation; Tissue repair. 3. Hemostasis:Phases and events of the hemostatic response; Hemorrhagic disorders; Thrombosis and embolism; Infarction. 4. Genetic disorders: Mutations; Single gene diseases; Examples ofautosomic dominant, autosomic recessive and X-linked disorders; Multifactorial disorders (malformations); Cytogenetic disorders. 5. The diabetic syndrome. Gestational diabetes. 6. Tumors: Classification and nomenclature; Benign and malignant tumors; Tumor etiology; Fundamentals in molecular oncology; Invasivity and metastasis; Pathogenesis of neoplastic diseases; Grading and staging. 7. Immunology: innate and adaptive immunity; Antigens and Antibodies. Ag-Ab interaction; Lymphocyte receptors; The Major Histocompatibility Complex (MHC) and Ag presentation; Functional anatomy of the immune response; Lymphocyte activation and effector functions; Primary and secondary reaction. Principles of vaccination. Immune response to infections. 8. Immunopathology: Hypersensitivity. Primary and secondary immunodeficencies. HIV infection. 9. Blood groups. AB0 system. Rh system. The hemolytic disease of the newborn.
MICROBIOLOGY
Bacteriology. General characteristics of the prokaryotic cell. Morphological and
structural aspects of the prokaryotic cell (wall, external membrane, cytoplasmic
membrane, nucleus, flagella, pili and phymbria, capsule and spore). Outline about
the metabolism and the reproduction of bacteria. Pathogenic action of bacteria.
Interaction bacteria-host. The resident bacterial population in the human organism.
Pathogenicity and virulence of bacteria (adhesins, esoenzymes, bacterial eso- and
endotoxins).
Outline about the principles for the laboratory diagnosis of the main bacterial
infections: direct methods (demonstration of bacteria and/or its constituents in the
biological material); indirect methods (demonstration of a recent specific immune
response). Outline about the main antibacterial drugs (antibiotics and
chemotherapeutics) and determination of the in vitro susceptibility of bacteria:
outline about the antibiogram. The main bacteria responsible for human infectious
diseases. Staphylococci (S. aureus), Streptococci (pneumococcus, group B
streptococci), Neisseria gonorrhoeae. Outline about Mycobacteria. Outline about
anaerobic bacteria. Outline about Gram-negative and Gram-positive bacteria
responsible for nosocomial infections: Pseudomonas and S. aureus. Outline about
the bacterial infections of obstetrical-gynaecological interest and involving the
maternal-foetal district by: group B streptococci; Treponema pallidum. Outline about
the infections by TORCH complex.
Mycology: General characteristics of fungi. The fungal cell and colony; yeasts and
filamentous fungi. Outline about the infections by Candida albicans of the urogenital
district.
Parasitology: definition of parasite; interaction parasite-host; ways of penetration
and elimination of the parasites. Presentation of some parasitic protozoa of medical
interest: outline about the life cycles of: blood and tissues parasitic protozoa:
Toxoplasma gondii, uro-genital parasitic protozoa: Trichomonas vaginalis.
Virology. Principal biological, morphological and structural characteristics of the
viruses; definition of virus, viral sizes and shapes, chemical composition, nucleic
acid types. The classification of the viruses (outline). The phases of the viral
infection. Cultivation of the viruses: outline about the methods used.
Outline about the main methods used for the laboratory diagnosis of the viral
infections: search for the virus or its constituents; demonstration of a specific
humoral immune response. Ways of transmission of the viruses; ways of
penetration and elimination of the viruses. Outline about the active and passive
antiviral immunoprophylaxis. Outline about the infections by the principal sexuallyand
vertically-transmitted viruses: hepatitis B viruses (HBV), hepatitis C viruses
(HCV), human immunodeficiency virus (HIV), human papilloma virus (HPV),
herpetic viruses (Cytomegalovirus (CMV), Herpes simplex viruses, type 1 and type
2 (HSV-1; HSV-2)).
Outline about the main control and prevention systems of the bacterial, viral and
parasitic infections in the hospital setting: the disinfection, the disinfestation and the
sterilization. Outline about the principal biological samples and methods for the
collection for the laboratory diagnosis of bacterial, viral and parasitic infections.
HISTORY OF MIDWIFERY
The main steps in the historical development of midwifery practice.
Bibliography
Maier e Mariotti. Elementi di Patologia Generale e Fisiopatologia. McGrawHill.
Milano.
M. Bendinelli, C. Chezzi, G. Dettori, N. Manca, G. Morace, L. Polonelli, M.A.
Tufano
"Microbiologia Medica - gli agenti infettivi dell’uomo: biologia, azione patogena,
laboratorio"
Other material will be provided during the lessons.
Teaching methods
Oral lessons supported by iconographic material.
