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Measuring the effectiveness of safety warnings
Sultana J, Fontana A, Giorgianni F, et al.

The impact of safety warnings on the risk of antipsychotic-associated stroke in elderly persons is known to have led to a change in antipsychotic utilisation patterns; however, the impact of stroke has not yet been described.
Sultana et al. provide the first direct evidence that safety warnings and associated policies in the UK significantly reduced the incidence of stroke among older antipsychotic users, while, in Italy, similar communications without supporting initiatives did not.
Drug Safety 2019; 42: 1471-85.

Antibiotic prescriptions in Italian hospitalised children after serial point prevalence surveys (PPSs): has anything actually changed over the years?
Tersigni C, Montagnani C, D’Argenio P, et al.

PPSs have been used in several studies to provide immediate and easily comparable information about antibiotic use and showed that about one third of hospitalised children had on ongoing antimicrobial prescription during their hospital admission.
Tersigni et al. showed that nothing has changed since the last PPS and that the quality improved targets, underlyined in previous studies, are always the same. Serial PPSs are not sufficient alone to produce changes in clinical practice.
Ital J Pediatr 2019; 45: 127.

MIF plasma level as a possible tool to predict steroid responsiveness in children with idiopathic nephrotic syndrome
Cuzzoni E, Iudicibus RF, De Iudicibus S, et al.

Idiopathic nephrotic syndrome (INS) is the most frequent form of childhood nephrotic syndrome. Steroids represent the best therapeutic option; however, inter-individual differences in their efficacy and side effects have been reported.
To date, there is no way to predict patients’ resistance and/or dependence. Alterations in the cytokine profile of INS patients might contribute to proteinuria and glomerular damage and affect drug sensitivity.
Cuzzoni et al. though a comprehensive cytokine analysis indicates that assessing macrophage migration inhibitory factor (MIF) plasma levels at diagnosis could predict response to glucocorticoids in children with INS.
Eur J Clin Pharmacol 2019; 75: 1675-83.

Vaccines: an achievement of civilization, a human right, our health insurance for the future
Rappuoli R, Santoni A, Mantovani A.

Vaccines represent a land of opportunity for research in fundamental immunology, vaccinology sensu stricto, and social sciences.
The latter is imperative to counter the spreading of anti-science attitudes, of which “no-vax” is the vanguard. Addressing the challenges and taking the opportunities that Rappuoli et al. briefly summarized at the level of civil society and research, in a global health perspective, is imperative to fulfill the reality and potential of vaccines to serve as a safety belt and insurance policy for humankind at present and in the future.

J Exp Med 2019; 216: 7-9.