The PhD course consists of four curricula: Infectious Diseases, Public Health Sciences and Social Medicine, Microbiology and Parasitology, Legal Medicine and Forensic Sciences..
A. INFECTIOUS DISEASES
The course has the aim of preparing researchers able to face the study of a complex branch with the assistance of updated technological and knowledge resources. This Ph.D course will be oriented to acquiring knowledge on immune pathogenesis, diagnostics and therapy of infectious diseases.
It will be structured on 3 years: the first one directed to scientific training and the following two-year period dedicated to carrying out a research project.
Three different research fields will be available.
1. Antibiotic therapy of infectious diseases
The PhD student should acquire a good knowledge of anti-infective drug characteristics,including experimental ones, and of their use in therapy and prevention of infectious diseases. He/she should also acquire microbiological and immunological methodologies essential in order to study interactions between antibiotics and immune system. Finally, he/she should obtain adequate clinical research skills which are needed in order to develop expert knowledge on antibiotic therapy prescription, performing studies concerning antimicrobial resistance, pharmacokinetics and pharmacoeconomics.
2. Clinical microbiology and diagnosis of emerging and re-emerging infectious diseases
The main aim is to form researchers able to act in the field of virology diagnosis and therapy with a modern cultural and technological knowledge. The PhD student should develop knowledge about pathogenic, clinical, diagnostic and therapeutic aspects of viral infections. It will be very important to acquire research ability in the management of clinical trials with antiviral drugs. Another very important aspect which will be developed is the study of the correlation between virus, malignancies and degenerative diseases. In the microbiology setting the main aim is to form researchers able to apply the most recent techniques in the microbiological diagnosis of bacterial and fungal infections.
The aim of this research field will be the development of microbiological, immunological and molecular methodology for the rapid diagnosis of emerging and re-emerging infectious diseases, both of viral, bacterial and parasitic etiology, including tropical diseases. The PhD student should acquire specific ability in the field of microbiological and parasitic diseases and should focus research on the development of immunodiagnostics techniques. The PhD student should also develop research directed to the application of new biomedical technologies for the rapid diagnosis and identification of microbial diseases.
Another research field will be the study of hospital acquired infections,especially as far as the effect upon the health system in terms of costs, morbidity and mortality is concerned.The PhD student should also acquire the ability of synthesis and research in the area of the management of hospital epidemic, employing correct epidemiologic, microbiological, clinic and therapeutic knowledge
3. Immunopathogenesis, virology and vaccines
PhD students will expand knowledge on the following fields: a) immunology and virology of HIV infection; b) pathogenesis of coinfections of HIV with tuberculosis, HCV hepatitis or malaria; c) experimental therapies for HIV infection. Researches will be started on pathogenesis and vaccines for AIDS, on coinfection of HIV with tuberculosis, HCV epatiti and malaria. Such researches will be performed in collaboration with the Emory University of Atlanta (USA) and the Department of Microbiology and Immunology of the Yerkes Center of the same University. The Center of Atlanta has a high level tradition of scientific research in the field of AIDS and possesses the greatest colonies of laboratory macaques, mangabeys and chimpanzees, which are available for scientific research. With the collaboration of this Center it will be possible to apply to humans diagnostic and therapeutic concepts derived from primates, and in particular those concerning the therapy of residual inflammation in HIV-infected patients treated with anti-retroviral therapy and the therapy of HIV coinfection with HCV hepatits, malaria and tuberculosis.
B. HEALTH SCIENCES AND SOCIAL MEDICINE
1. Health sciences
This training gives answer to the great need of expert researchers in health promotion and in health policies. Many specialists look at this curriculum for its specific orientation in tropical public health that encouraged the application of a large number of foreign students. The curriculum is articulated in the following historical areas: planning and evaluation of public health intervention; environmental health; tropical public health; and microbiology for public health.
Beside the preparation of graduates and specialists able to The recent evolution of EU legislation on protection of citizens from working and environmental risks, has created a new training needs at all levels
perform risk assessment (under the new teaching regulations), it was also found by the need to train researchers capable of designing and running research projects that can provide definitive answers on the issues of relationship between environmental exposures and effects on the environment and human health.
These are research projects that require expertise not only in biosanitary field, but also and especially in more specific scientific fields, with contents of chemical, physical, environmental and statistics sciences.
The doctorate is designed to prepare experts in the methodology of scientific research able to detect, measure and evaluate the effects of physical, chemical and biological hazards concerning environment and human health through modern detection and monitoring systems, both in terms of quality and quantity
The formation is particularly addressed to the ability of a critical selection and application of new analytical technologies through a monitoring system based on biological systems as well as through the study of pathogenic effects on the environment here as biosphere, and on human populations that are part of it. Examples of these technologies are the application of Mass Spectrometry and Nuclear Magnetic Resonance also in the metabolomic, Bioassays to detect DNA damages or cytogenetic alterations in plant and animal systems, and use of biological and epidemiological indicators for the risk evaluation in human populations.
2. Social and Forensic Medicine
Social medicine spans over the fields of social care and security, disease control and prevention and health promotion. The aim of doctorate course is to give methodological and scientific tools towards communitarian health and social medicine needs. Various methodologies of epidemiological research of main social diseases are promoted by means of different curriculum pertaining to health service and social security: 1) health planning; 2) regional health service; 3) ethical and legal problems; 4) welfare system in Italy and Institutes (INPS, INAIL); 5) public and private insurance; 6) moral and social implications in interventions on the environment, clinical trials and genetic research and their relation with ethics, law and biology; 6) new trends in health politics and economy; 7) traditional medicine; 8) palliative cures; 7) mental health; 8) social phenomena relevant to medicine and emerging social issues.
Long-term objective of the PhD is to contribute to the formation of researchers who can work independently and authoritatively in the public and private institutions on research themes concerning industrial and environmental hygiene to a level equal with colleagues in other countries in the EU. This need is particularly felt by public research institutions such as the Institute of Health (ISS), the National Energy and Environment (ENEA), the 'National Environmental Protection Agency (ANPA), and the former Institute for the Occupational Prevention and Safety (ex ISPESL now INAIL).
A key aspect, particularly stressed in the scientific formation of the students, is the development of capacity to collect, organize, and especially to interpret scientific data not only in order to bring to the scientific community new knowledge and greater certainties on the role of environmental health risks, but also with the intent to provide concrete realistic and socially acceptable advice, for the protection of public health. The formation project also provides the study of regulatory and legal aspects as well as matters of perception and communication of environmental risks.
C. MICROBIOLOGY AND PARASITOLOGY
1. Microbiology and Parasitology
The aim is to provide a deep knowledge of the organisms that cause bacterial and viral infectious diseases and parasitic diseases together with awareness on molecular mechanisms of microbiological and parasitological pathogenesis. The curriculum investigates diagnostic, epidemiological and pathogenic aspects such as: 1) recognition by the parasite of the host; 2) subversion of the host cell metabolism and parasitic protection mechanisms; 3) host-parasite interaction as a drug target; inefficacy of drugs with a selective toxicity against parasites as the cause of new resistant genotypes and problems related to opportunistic infections that stimulated the research of new drugs and new pharmacological approaches; 4) immunological studies on host-parasite interaction; 5) taxonomy studies' contribution to diagnostic, prevention and therapy. The curriculum is articulated in the following areas: A) host-parasite relationship, taxonomy and diagnosis; B) genetic-molecular analysis of virulence factors; C) emergence of new bacterial and viral organisms; D) molecular basis of antibiotic resistance, new antibiotics, and new approaches to vaccines production.
2. Pharmaceutical Microbiology
The main goal of this curriculum is to train PhD doctors with an advanced and wide knowledge, effective abilities and project-management capacities in the following fields: 1) research and development of new drugs with antimicrobial activity (antibacterial, antiviral and antimycotic); 2) individuation and analysis of mechanisms involved in drug resistance stimulation and development of new strategies to fight the phenomenon in vitro and in vivo; 3) research of new molecular targets for the development of antibacterial, antiviral and antimycotic drugs and for the individuation of molecules able to interact with them. Therefore, the study will particularly focus on the molecules currently employed to treat viral, bacterial and fungic pathologies and to the analysis of their action mechanisms. The students will be able to acquire the ability to evaluate the reasons of successful or unsuccessful clinic employment of different molecules. They will deepen the study of innovative research trends for the development of more effective therapeutic molecules classes. Moreover, they will focus on the physiological and biological aspects in microorganisms' cause of infectious diseases, essential to give to the students basic cognitive tools for carrying on research and development of original therapeutic strategies.
3. Microbial Biotechnology
This curriculum has been created to train PhD doctors in complex and innovative microbial biotechnology. The aim of this curriculum is focused on different microbial lifestyles such as their ability to aggregate, adhere to abiotic or cell surfaces, form biofilms and penetrate into the host cells. Infections, related to microorganisms able to multiply and colonize host in the above mentioned lifestyle, play a crucial role in human health because they are able to successfully counteract host defense mechanisms as well as to be resistant to classical antibiotic therapies.
The difficulty to eradicate these infections is mainly due to impossibility to enumerate microorganisms in aggregated, adherent, biofilm forms through the classical microbiological methods. The standard method used to evaluate the number of bacteria, based on determination of the Colony Forming Units (CFUs), can be considered fully appropriate only when bacterial cells are in planktonic lifestyle but are unreliable to count bacteria in biofilm. The design and discovery of innovative methods as biosensors to enumerate microorganisms in different lifestyle is a fundamental requisite in studying, controlling and/or counteracting these infections. The novel methods can be also applied in quality control of materials to be used in vivo as biomaterials for protesis or catheters and nanoparticles for drug delivery. Even if different analytical strategies have been attempted to enumerate bacteria aggregated, adherent or in biofilm, the detection of the actual number of bacteria in this lifestyle is still a great challenge for microbiologists.
Usually, antibiotic treatment of catheter-related infections is based on antibiotic susceptibility tests performed on planktonic counterpart of the clinical isolates instead of on biofilm. It is well known that microorganisms organized in biofilm exhibit higher levels of antibiotic resistance than in planktonic form, so that a great part of therapeutic regimens based on susceptibility of planktonic forms fails to eradicate biofilm infections.
The increase in life expectancy will increasingly require the use of dental, ocular, skeletal, and cardiac implants. Therefore, the discovery of new biomaterials and novel drugs to counteract implant-associated bacterial infections will be increasingly urgent. The application of biosensors and new pharmacological strategies emerging from the biotechnology will be very promising in the light of interdisciplinary nature of these studies.
Microbial genetics together with the biochemistry, microbiology, mathematical models and electronics will be essential to perform in vitro models mimicking the in vivo environment in order to study the various phases of these infections as well as to find new and effective methods to eradicate this type of infection, otherwise not eradicable.
This curriculum will provide knowledge to PhD doctors to discover and develop novel biotechnological products to be industrially synthesized and produced.
For this purpose, the requirements and methodologies to fill a patent on innovative drugs or new diagnostic procedures will be described.
D: FORENSIC AND LEGAL MEDICINE
The doctoral program offers a wide range training in the specific field spanning from forensic laboratory research in the specific field morphology, and the classic themes such as those proposed by the doctrinal system of medicine which is composed of a homogeneous consequential interpretation - with the methodological steps that good interpenetrate one another by prediction to prevention, from personalization to active participation. Ethics, deontology, and law are ready to face a similar conceptual shift operation with no more ill - centric but more broad approach so as to reach even to cover the fields of behavioral interest.
The main objective of this curriculum is to enable young doctoral students to acquire a working methodology paid to the relationship between science and the law and, more pragmatically, between scientific knowledge and procedural dynamics that recently has become increasingly becoming complex. The most significant aspect of the development at issue seems to be scientific knowledge always ready to use and ready to be applied in an almost automatic way, without hesitation. The " certainty" , in other words, is a conceptual category for the Judge having a "qualitative " and " descriptive " and not merely "quantitative" and "numbering". The Forensic Medicine, therefore , interprets the phenomenon especially in terms of etiology and needs to apply a method to explain deductively and with the scientific view that the uniformity required, the law employs the interpretation medico - legal and processes, along with other parameters, for demonstration of proof of causation, unequivocally characterize so the diversity of substance and that there should exist between the biological assessment and evaluation of legal and jurisprudential, not related to each other according to rigorous numerical paradigms, but according anchors of an intellectual nature.
The professionals formed as part of this curriculum will therefore be not only independent, competent and knowledgeable scientists but also skilled professionals. The addresses of the curriculum will indeed be characterized by an interdisciplinary approach in order to provide PhD students with the scientific foundation for putting them not only in the field of academic research, but also in other sectors of the labor market , eg . as part of the advice to the Judicial Authority, in which increasingly specialized skills are required for medico-legal purposes. In the final analysis, according to the variety of skills of the members of the Academic Board relating to the above curriculum, the training of graduate students will be addressed, according to the modern approach of Translational Medicine, towards issues ranging from knowledge to care and to translatable scientific results as quickly as possible in clinical practice ( " from bench to bedside "). This approach seems perfectly in line with the primary goals of the PhD in Systems Medicine , of which the present curriculum in Forensic Science is an integral part.
Finally, we must also ask ourselves a further aspect, perhaps more than the border and wide-ranging, engaging ways to deal with the "modern medicine": the level of corporate attention. Of course it can also become, not just a problem of ethics distribution over the classical canons of the basic criteria that the bioethical approach, as conceptual evolution of personalized medicine, may show the limits of a vision too, and again, the disease - centric with a personalized attention to a possible ethics that we want to define "potential" (P5 then). It is well known that "chance plays it as a term that refers to that which is within the reach of man, and therefore can be quickly reached by increasing our power", in an attempt, we hope not unrealistic, to penetrate in the freedom and responsibility of the individual and the community.
Cultural content and experimental activities of the PhD have been identified in order to train qualified researchers for institutions aimed at basic and applied biomedical research, as well as the pharmaceutical and biotechnology industries.