Cervical necrotizing fasciitis and descending necrotizing mediastinitis in a patient affected by neglected peritonsillar abscess: a case of medical negligence.

Abstract We report a case of fatal cervical necrotizing fasciitis (CNF) and descending necrotizing mediastinitis (DNM) due to primary peritonsillar abscess in 60-year-old male patient with no history or evidence of immunocompromising disorders. The patient was treated with antibiotic and corticosteroid drugs but he developed mediastinitis and septic shock and died of multiple organ failure six days later from recovery in hospital. After a clinical, diagnostic and therapeutical consideration of the cervical necrotizing fasciitis and some related risks of a delayed diagnosis and treatment, the authors analysed the clinical history of the patient and of the medical conduct pointing out profess…

Concealed arrhythmogenic rigth ventricula cardiomyopathy: pathologic substrates and high resolution MRI

A CASE OF SUDDEN DEATH FOR CARDIAC HEMANGIOMA IN CHILD.

La (indimostrata) relazione causale tra Thimerosal ed autismo infantile: revisione della letteratura scientifica e osservazione casistica

Il consenso informato nella responsabilità professionale

L’INFORMAZIONE E LA FORMAZIONE DEL SANITARIO NELLE INFEZIONI NOSOCOMIALI: LA NOSTRA ESPERIENZA

Gli Autori riportano i risultati ottenuti dalla somministrazione di un questionario, nel contesto siciliano dei Policlinici Universitari di Palermo e Messina, a sanitari operanti nel campo della terapia intensiva, selezionando e analizzando i quesiti maggiormente implicati nelle tematiche inerenti il clinical risk management delle IN, individuandone specifiche carenze a carico dei singoli professionisti e della struttura ospedaliera. È stato evidenziato che, sebbene siano già presenti specifici protocolli, nonché linee guida in materia, essi non trovano ancora un adeguato spazio nella realtà quotidiana di gestione del malato a causa di una generale inadeguatezza dell’informazione e della fo…

Casi emblematici di morte improvvisa cardiaca - Caso 1: anomalie congenite delle arterie coronarie

Fibrodisplasia arteriosa misconosciuta ad esito letale. Descrizione casistica e rivisitazione della letteratura

gli autori presentano due casi di displasia fibromuscolare (DFM) oggetto di indagine giudiziaria per ipotizzata responsabilità professionale nell'operato dei sanitari all'esordio clinico e nell'approccio chirurgico. Viene sottolineata la necessità di una rapida risoluzione chirurgica in ambiente specialistico e l'importanza delle linee guida che devono essere rispettate nell'approccio al pziente

Incesto e ciclo dell'abuso. Aspetti clinici e medico legali

l'incesto è un fenomeno ben conosciuto, che si concretizza in una relazione sessuale tra parnti ascendenti, discendenti o affini in linea retta. da un'analisi statistico-epidemiologica è emerso che, in molti casi, il giovane abusato in famiglia diventa a sua volta, da adulto, abusante, generando ed alimentando il cosiddetto ciclo dell'abuso. in tale ottica si riporta un caso giunto all'osservazione delgi Autori, i quali partndo dalla vicenda in esame, hanno poi analizato i profili psico-patologici sia delle vittime che degli abusanti

Refertazione in ecografia ostetrica e profili di responsabilità.

From 1997 to 2007: Modified Approach to Sexual Assault in Our Experience

Sudden death in adolescence caused by cardiac haemangioma

Primary tumors of the heart in infants and children are rare. The types of heart tumors in pediatric age groups are generally different from those in adults. Cardiac myxoma is by far the most common tumor in adults, but in infants and adolescents the prevalent tumor of the heart is rhabdomyoma. Among benign cardiac tumors, cardiac hemangiomas are rare and often diagnosed post-mortem due to the lack of specific clinical symptoms and signs. We report a case of sudden death due to cardiac hemangioma in an apparently healthy 15-year-old adolescent. The autopsy revealed a cardiac hemangioma located at the apex of the heart; the histopathological examination showed the tumor was a mixed capillary…

Behavioural and pharmacological characterization of a novel cannabimimetic adamantane-derived indole, APICA, in C57BL/6J mice

The novel adamantane derivative APICA (N-(adamtan-1-yl)-1-pentyl-1H-indole-3-carboxamide) was recently identified as a cannabimimetic indole of abuse (1, 2). Despite its novel structure, APICA recalls cannabimimetic indoles, such as representative member JWH-018. The emerging abuse problem, together with the paucity of information about the bioactivity of APICA (3) emphasize the need for further evaluation of the in vivo pharmacology of this novel indole-derived compound. In the present study, the effects of APICA (0 - 1 - 3 mg/Kg, i.p.) were tested in C57BL/6J mice, in a battery of tests that are sensitive to the effects of psychoactive cannabinoids, including body temperature; locomotor a…

Population Data of Nine STR Loci From Western Sicily, Italy

Tecnologia, etica e medicina legale

Il consenso informato in cardiologia interventistica

Lo scenario della responsabilità nel dolore toracico: illustrazione casistica

““MIGRANTES” PER MARE: DECESSI TRA GLI IMMIGRATI CLANDESTINI NELLA SICILIA OCCIDENTALE. ESPERIENZE E CASISTICA DEL SETTORATO MEDICO-LEGALE DI PALERMO

Il dolore toracico e le insidie medico legali.

Aspetti medico legali dei "nuovi" biomarkers dell'abuso cronico di alcool in vivente e cadavere

gli Autori analizzano gli aspetti medico legali dei "nuovi" biomarkers dell'abuso cronico di alcool in vivente e cadavere. Fra questi, l'utilizzo del dosaggio della CDT, potrebbe trovare una importante valenza in tema di accertamenti idoneativi alla guida in soggetti assuntori periodici o cronici di alcool

SINDROME COMPARTIMENTALE (su un caso di omessa diagnosi)

Homicide with post mortem dismemberment of the victim

A Particular Case of suicide Committed With a Double-Barreled Shotgun

SUDDEN UNEXPLAINED JUVENILE DEATH AND THE ROLE OF MEDICOLEGAL INVESTIGATION: UPDATE ON MOLECULAR AUTOPSY

In the past few years, contributions of molecular biology assays to the investigation of sudden juvenile death have permitted to clarify some of the pathogenetic aspects of sud-den arrhythmic death, opening the way to preventive action on victims’ relatives. We reviewed literature on the genetics of sudden juvenile death, and on molecular biol-ogy assays performed on autoptic samples. Biological investigation permits the detection of genetic mutations underlying the suscep-tibility to sudden cardiac death of individuals with rare inherited forms of arrhythmia (Long QT Syndrome, Brugada Syndrome, Lev’s disease etc.) through the analysis of criti-cal sequences codifying for ion channel subuni…

Informed consent and minors: hiv testing in italian legislation.

Linee guida per la valutazione del Parkinson in ambito di invalidità civile.

Il welfare in Italia.

Daphne II Project case report: a 3 years-old baby girl sexually abused from a young of 14 in a domestic extrafamily context

Lethal rupture of post-traumatic aneurysm of the vertebral artery case report.

Abstract Traumatic aneurysms or dissections of the vertebral artery have been reported in patients who have suffered minor craniofacial injuries in traffic accidents. A case is reported of ruptured traumatic vertebral artery aneurysm due to closed head injury without without penetrating injuries or skull fractures. The macroscopic and histological findings relevant to the vertebral wall were compatible with post-traumatic aneurysm; the rupture of the wall was assumed to be caused by sepsis and local infiltration of inflammatory cells.

La nutrizione artificiale: l'assistenza palliativa domiciliare. aspetti bioetici e possibili profili di responsabilità professionale

Gli Autori esaminano gli apsetti salienti della quetione bioetica della nutrizione artificiale, facendo riferimento anche ai più recenti casi di spospensione dlla NA e approfondiscono gli correlati ad evntuali profili di responsabilità professionale

RESPONSABILITA' PROFESSIONALE IN CARDIOLOGIA: DISCUSSIONE DI DUE CASI DI RESPONSABILITA' DA CONDOTTA OMISSIVA PER IMPLICAZIONI DI ORDINE PENALISTICO.

Mafia homicide During the 80's and Early 90's (1981-1985 1990-1992): The unusual Use of War Wespons (Kalashnikov AK-47) - An Analysis of Murder Cases in Sicily

Clinical risk management delle infezioni nosocomiali: profili di responsabilità

L’oggetto del rapporto obbligatorio tra paziente e struttura sanitaria rientra nella complessa prestazione di assistenza sanitaria. Il rapporto, nonché la responsabilità, tra ospedale e paziente, è di natura contrattuale e ad esso si fa riferimento sia in caso di inadempimento delle obbligazioni direttamente a carico della struttura (ex art. 1218 c.c.), sia in caso Di inadempimento delle prestazioni medico-professionale del sanitario (ex art. 1228 c.c.). Un’obbligazione importante a cui risponde la struttura ospedaliera è quella di garantire l’utilizzo di locali idonei sotto il profilo igienico, in quanto essa è l’ente responsabile delle infezioni nosocomiali dovute ad agenti patogeni event…

Forensic investigation in aircraft accident with the aid of CT (MSCT), and Magnetic Resonance Imaging (MRI): our experience

The autors report their experience in a case of air disaster in which a Tuninter airlines ATR 72 fallen down into the sea near Capo Gallo coast (Palermo, Italy) with 39 persons on board, resulting in six-teen victims. In the present contribute the authors argued the causes of the death and analysed patternes of injuries sustained by passengers involved in the fatal airplane accident using the conventional autopsy combined with postmortem Multi Slice Computed Tomography (MSCT) examination.

SUSPECTED CHILD ABUSE: UNUSUAL DEATH IN WESTERN COUNTRY. SUICIDE OR HOMICIDE?

This case report describes a particular case of carbonized corpse, found in his burnt-out car in an isolated Palermo’s west suburban zone. The goal of this case report is to describe the shame and the social stigma related with suspicious of pedophilia and how it led a man to suicide by fire, considering that is an unusual way to die in western countries

The relevance of Scientific evidences in Criminal Investigations of mafia's crime: the experience of "Capaci Bloodshed" and the Murder of the judge Giovanni Falcone

Mineurs et la consommation de drogues dans la province de Palerme durant les annees 1997-2006

Morte improvvisa giovanile inspiegata e ruolo dell'indagine medico-legale: aggiornamento dell'autopsia molecolare

Can Immunohistochemical stains aid torule out pitfalls in suffucation death?

MIGRAZIONE TRANS-LUMINALE DI “GOSSIPIBOMA”; PROBLEMI DIAGNOSTICI E MEDICO-LEGALI AI FINI DI CONNESSA RESPONSABILITA’ PROFESSIONALE

Death of a 23-year-old man from cardiac conduction system injury through a blunt chest impact after a car accident.

Abstract Cardiac contusion, usually caused by blunt chest trauma, has been recognized with increased frequency over the past decades. Traffic accidents are the most frequent causes of cardiac contusion resulting from a direct blow to the chest. Myocardial contusion is difficult to diagnose; the clinical presentation varies greatly, ranging from a lack of symptoms to cardiogenic shock and arrhythmia. Although death is rare, cardiac contusion can be fatal. The authors report a case of death due to a cardiac conduction system injury from a blunt chest impact following a car accident. The autopsy showed no external signs of thoracic trauma, no evident rib or sternum fractures. A small sub-endoc…

AN INTERVIEW STUDY OF THE AWARENESS AND UNDERSTANDING OF CHILD ABUSE AND NEGLECT IN THE EMERGENCY ROOM.

Can immunohistochemical stains aid to rule out pitfalls in suffocation deaths ?

La ricerca sulle cellule staminali al banco di prova

Role of MDCT virtopsy in valuation of burned bodies and its comparison with traditional autopsy

Aims and objectives Methods and materials Results Conclusion Personal information References

Incest: Medical-Legal perspectives

"Violation" of Mafia's honour code. Murders in young age

DNA e realazioni di parentela

Medicina legale orientata per problemi

L’area delle discipline medico-legali vive oggi un rinnovato interesse, sia per gli aspetti di approfondimento dottrinario di tematiche che si pongono a ponte tra scienza e diritto, sia per quanto attiene l’innovazione tecnologica delle scienze biomediche e il loro avanzamento applicativo; sembra così aprirsi un’era di estremo e sempre più diffuso interesse verso questa disciplina di studio, unitaria nel metodo (la metodologia medico legale ) e nell’approccio ( res medica sub specie iuris ), pur nella sua svariata congerie applicativa. Questo libro, utilizzando lo strumento pedagogico dell’apprendere per problemi, si rivolge sia allo studente universitario di area sanitaria sia al medico gi…

LA CARTELLA CLINICA NELL’ATTUALE CONTESTO DELLA PRIVACY

Coronary artery anomalies and juvenile sudden cardiac death

A possible biomarker for methadone related deaths

Abstract Methadone (MTH) concentrations in those dying of MTH toxicity totally overlap concentrations where the presence of MTH is only an incidental finding, making it very difficult to make distinctions in actual cases. A biomarker, be it anatomical or biochemical for MTH toxicity is badly needed, particularly if that markers were known to disrupt effective ventilation. Because the brainstem houses the regulatory centers for cardiorespiratory-control enters, it would seem to be the most likely anatomical site to seek abnormalities in cardiorespiratory control. Objective To locate and describe the cells of nucleus of the solitary tract (TS)(NTS) in human brainstem and determine if neuronal…

IMMIGRAZIONE CLANDESTINA NELLA SICILIA OCCIDENTALE. ESPERIENZE MEDICO-LEGALI SU UN NAUFRAGIO COLLETTIVO

La prevenzione del rischio clinico nel trattamento della calcolosi urinaria. Illustrazione casistica

DETERMINAZIONE DELLA DISTANZA DI SPARO IN ARMI CORTE DOTATE DI MUNIZIONAMENTO MULTIPLO A PALLINI - CALIBRO 38 SPECIAL

Role of virtopsy in the post-mortem diagnosis of drowning.

Purpose: Due to admitted limits of autopsy-based studies in the diagnosis of drowning, virtopsy is considered the new imaging horizon in these post-mortem studies. The aim of our study was to evaluate the role of virtopsy performed through computed tomography (CT) in the forensic diagnosis of drowning. Materials and methods: We retrospectively examined the CT data of four cadavers recovered from sea water and suspected to have died by drowning. Each patient underwent a full-body post-mortem CT scan, and then a traditional autopsy. Conclusion: To date, there are no autopsy findings pathognomonic of drowning. This study proves that virtopsy is a useful tool in the diagnosis of drowning in tha…

Il dolore cronico: profili di responsabilità medico legale

Sexual Abuse-Current Medico-legal, Forensic and Psychiatric Aspects

Abstract Violence against women and minors is a worldwide problem that has not yet been sufficiently acknowledged. There are many obstacles especially when sexual abuses have to be evaluated. These problems are present both when victims of sexual abuse are evaluated and when sex offenders are dealt with, especially when the offenders are juvenile sex offenders (JSO). These issues give cause for great concern about prognosis, and the resulting psychosocial implications, and call for a special effort from the scientific community in identifying appropriate prevention and treatment methods. This chapter is divided into two parts. The first part deals with the forensic and psychiatric features,…

Isolated coronary anomalies and sudden death in the young

Idoneità all'attività sportiva e doping: profili di responsabilità professionale.

Death Caused by Trash Collector Crushing: A Case Report

Percorsi di integrazione e modello operativo della rete anti-violenza: esperienza del progetto Daphne

Unexpected Traumatic Carotid Artery Lesion

La nutrizione artificiale: l'assistenza palliativa domiciliare. Aspetti bioetici e possobili profili di responsabilità professionale

Complicanze neurogene iatrogene in esito ad erronea esecuzione di tecnica di riduzione secondo weber di frattura del gomito.

Una riflessione Medico-Legale sulle linee guida di cui alla c.d, "Balduzzì": la metodologia nell’accertamento del nesso causale in penale Ruolo della perizia nel processo penale

Gli autori effettuano una analisi delle caratteristiche che deve possedere il perito/consulente tecnico del Giudice nell'ambito dell'attività espletata nei casi di responsabilità professionale medica alla luce della Legge Balduzzi e di quanto dettato dal vigente Codice deontologico. Viene infine effettuato un escursus sul valore delle linee guida

Homicide or Suicide? Unusual Death of Man Suspected of Sexual Harassment in Family Context

Anomalous Origin and Course of the Right Coronary Artery

Coronary anomalous origin from the wrong aortic sinus has been thought to be a risk factor for ischemia because of acute takeoff from the aorta and flow between the aorta and the pulmonary artery.1–4 A 30-year-old man suddenly died within an hour of waking. His clinical history revealed no evidence of any disease, and the postmortem toxicological examination was negative. Autopsy ruled out violent or natural noncardiac causes …

Il consenso informato per l’effettuazione del test per la diagnosi da HIV: come comportarsi in caso di minori.

Development and validation of a reliable method for studying the distribution pattern for opiates metabolites in brain

Abstract Brain distribution pattern of “street” heroin metabolites (morphine and codeine) was investigated in two fatalities due to “acute narcotism”. A suitable sample pretreatment prior to solid-phase-extraction was developed to achieve a good recovery of the analytes and to eliminate the interfering species. After derivatization with MSTFA, samples were analyzed by GC/MS. Specificity, accuracy, precision and linearity of the method were evaluated; LOD and LOQ were, respectively, 10 ng/25 ng for morphine and 5 ng/10 ng for codeine. This method was applied to the analysis of six brain areas (hippocampus, frontal lobe, occipital lobe, nuclei, bulb and pons) coming from two cases of heroin-r…

postmortem MDCT in the evaluation of air crash victims

A particular case of suicide committed with a double barreled shotgun

Self-injuries are some of the most frequently causes of death in youth; suicides has been reported as the second or third most common cause of death in children and adolescents worldwide. The autors describe a particular case of suicide of a 17-year-old-boy, who was found dead on the floor of his bedroom with a large shogun contact wound on his head.

Behavioural and pharmacological characterization of a novel cannabinomimetic adamantane-derived indole, APICA, and considerations on the possible misuse as a psychotropic spice abuse, in C57bl/6J mice

The novel adamantane derivative APICA (N-(adamantan-1-yl)-1-pentyl-1H-indole-3-carboxamide) was recently identified as a cannabinomimetic indole of abuse. Despite its novel structure, APICA recalls cannabinomimetic indoles, such as representative member JWH-018.In present study, the effects of APICA (1-3 mg/kg, i.p.) were tested in C57BL/6J mice, in the Tetrad task which includes the assessment of: body temperature; locomotor activity and behavioural reactivity; nociception; motor coordination; declarative memory. Furthermore, pre-treatment with the CB1 antagonist AM251 (3 mg/kg, i.p.) or the CB2 antagonist AM630 (3 mg/kg, i.p.) was carried out to characterize APICA activity.Our results sho…

Il dolore non toracico a genesi cardiaca nello scenario della responsabilità: illustrazione casistica

Comunicazione “DNA E RELAZIONI DI PARENTELA

Un caso di disfonia severa provocata da una lesione monolaterale iatrogena del nervo laringeo ricorrente Considerazioni medicolegali

di un intervento di emitiroidectomia, a causa di una lesione del nervo laringeo ricorrente di sinistra, riferibile ad una condotta colposa del chirurgo. Vengono considerati i risvolti medicolegali, porgendo particolare attenzione alla questione relativa al risarcimento cui l’operatore sanitario è obbligato, nei confronti del soggetto danneggiato. Tale compenso è stabilito in rapporto alla menomazione della funzione fonatoria subita dalla persona lesa e, pertanto, si riferisce non solo all’alterazione dell’integrità psicofisica e alle eventuali ripercussioni esistenziali che una tale condizione può determinare sulla qualità della vita, ma finanche alle conseguenze economicamente valutabili d…

L’uso diffuso delle statine nell’era della prevenzione di massa della cardiopatia ischemica: occasione per riflettere sugli eventi avversi dei farmaci e sulla possibile responsabilità medica.

L'assistenza al paziente politraumatizzato e la responsabilità professionale dell'équipe sanitaria

Fibroelastosi endocardica congenita in coso di autopsia fetale per sospetta malpractice professionale. Caso clinico e revisione della letteratura

Gli Autori presentano il caso di una donna giunta alla 39,4 settimana di gestazione, regolarmente sottoposta ad esami clinici e strumentali che evidenziavano un decorso regolare della gravidanza eccetto oligoamnios. La paziente espletava il parto con feto nato vivo ma non vitale. L'esame esterno del cadavere evidenziava esclusivamente cianosi generalizzata. L'esame autoptico ha evidenziato cardiomegalia con incremento di tutte le cavità cardiache con rapporto cardio-toracico 6.5/8.5 ed un aspetto porcellanaceo delle pareti ventricolari di sinistra. All'istologia tale ispessimento era causato da fibroelastosi diffusa dell'endocardio associata a marcata miocitolisi colliquativa del miocardio …

L'ETICA DELLA RESPONSABILITA' NELLA RICERCA SCIENTIFICA

Post-traumatic lethal carotid-cavernous fistula.

The authors report about an unexpected death by traumatic lesion of the internal carotid artery in a 30-year-old man who had fallen two metres. The man suffered a fracture of the left maxillary sinus and a fracture of the right orbit with bilateral haemorrhage of the maxillary sinus. Surgical treatment was performed with favorable outcome. Clinically, there were no neurological symptoms but about 60 days after his accident, the man died from uncontrolled epistaxis. He was submitted to the autopsy that show a linear fracture in the left side of the turcic sella and lesion of the left internal carotid artery with carotid-cavernous fistula.

Drowing in Fuel: A case report

Genetica e laboratorio di medicina legale

Evidence and witness of a child victim of sexual abuse in Italian penal process.

Detection of gamma-hydroxybutyrate in hair: Validation of GC–MS and LC–MS/MS methods and application to a real case

A gas chromatography-mass spectrometry (GC-MS) and a liquid chromatography tandem mass spectrometry (LC-MS/MS) method were validated for quantifying endogenous and exogenous hair concentrations of gamma-hydroxybutyrate (GHB). The GC-MS method is based on overnight extraction of 25 mg hair in NaOH at 56 °C, liquid/liquid extraction in ethylacetate and trimethylsylil derivatization; analysis is by electron ionization and single ion monitoring of three ions. The LC-MS/MS method entails a rapid digestion of 25 mg hair with NaOH at 75 °C for 40 min, liquid/liquid extraction in ethylacetate and reconstitution of the extract in the LC mobile phase; negative ion electrospray ionization and multiple…

A suspected case of hunting accident. Case report

Nowadays, the use of molecular biology in forensics has made it possible to identify human victim and sometimes even the circumstances under which the death occurred through. In our case, a corpse of a 50-years old man with a gunshot wound was found in the woods. The suspected murderer declared that it had been a hunting accident while he shot a wild boar. During the autopsy, a bullet (Borra-bullet Gualandi, 32 gr) was found in the abdomen of the victim. The authors investigated the presence of boar and victim blood both on the bullet, in order to substantiate the thesis of the hunting accident. Laboratory investigations underscored the presence of human cellular material on the bullet, whi…

La valutazione del danno biologico in implantoprotesi.

Sexual abuse and maltratment on child: protocols, cooperation strategies, daphne II - V.eR.S.O. (Violenza e reti sanitarie operative) Project- our experience

Possibili profili di responsabilità nelle fistole oro-sinusali iatrogene. illustrazione casistica

Conoscenze fondamentali della patologia forense per il sanitario non specialista in medicina legale

Governo clinico e sicurezza: il ruolo del medico legale.

La responsabilità professionale del cardiologo: il dialogo informato e la scelta terapeutica

La rilevanza medico-legale dei biofilms batterici nelle infezioni nosocomiali

Sexual abuse and maltreatment on child: protocols, cooperation strategies, Daphne II V.eR.S.O. project, our experience.

The Symbolism in Mafia Homicides: The "Violation" of Mafia's Honor Code

CARDIAC RUPTURE FOLLOWING BLUNT CHEST TRAUMA: REPORT OF TWO CASES.

An inusual catastrofic intra-abdominal hemorrhage caused by spontaneus segmental arterial mediolysis dissection

Aspetti medico legali dei “nuovi” biomarkers dell’abuso cronico di alcool in vivente e nel cadavere.

A fatal case of a paint thinner ingestion: Comparison between toxicological and histological findings

Toluene and xylene are aromatic hydrocarbons commonly used as an industrial solvent for the manufacturing of pharmaceuticals, paints, and chemicals. The Occupational Safety and Health Administration has determined that toluene levels of 2000 parts per million (ppm) are considered dangerous to life and health. Several studies have examined the absorption of toluene and xylene following inhalation and oral ingestion in humans. Volatile organic compounds that are absorbed into the blood are distributed throughout the body; in particular, distribution of absorbed toluene and xylene in humans and rodents is characterized by preferential uptake in well-perfused and lipophil tissues such as the br…

Consenso all'atto medico ed autonomia di "grandi minori": il caso del test HIV

Gli Autori approfonsicono il tema dell'auonomia del consenso informato dei minori con particolare riferimento al consnenso per l'effettuazione del test per HIV. traendo spunto da quanto stabilito nella L. 135/90, gli Autori, si soffermano sul concetto di necessità medica, ipotizzando possibili circostanze in cui il medico, dinanzi alla volontà dl minore, possa sentirsi esonerato dall'acquisizione del consenso del genitore o del legale rappresentante, rafforzando l'obbligo della dovuta ed idonea informazione del paziente

A CASE OF SUDDEN CARDIAC DEATH BY ARRHYTHMOGENIC RIGHT VENTRICULAR DYSPLASIA

Images in cardiovascular medicine. Anomalous origin and course of the right coronary artery.

Coronary anomalous origin from the wrong aortic sinus has been thought to be a risk factor for ischemia because of acute takeoff from the aorta and flow between the aorta and the pulmonary artery.1–4 A 30-year-old man suddenly died within an hour of waking. His clinical history revealed no evidence of any disease, and the postmortem toxicological examination was negative. Autopsy ruled out violent or natural noncardiac causes of death and revealed an underlying congenital heart disease, which was characterized by a congenital bicuspid aortic valve and an anomalous origin of the right coronary artery just above the median raphe of the anterior cusp

Profili di responsabilità professionale nella terapia antalgica

Role of virtopsy in the postmortem diagnosis of drowning

Aims and objectives Methods and materials Results Conclusion Personal information References

Origine e decorso anomalo della coronaria destra in un caso fatale di tromboembolismo polmonare post-operatorio

La rilevanza del tromboembolismo polmonare trova giustificazione nella sua grande incidenza, nei dati sulla mortalità e nella sua brusca modalità di insorgenza, che la rende trattabile durante la fase acuta. L'arma più efficace contro la TEP è la prevenzione e a tal fine sono state proposte numerose linee guida. Scopo del presente lavoro è illustrare un evento tromboembolico polmonare fatale determinatosi nonostante la somministrazione di una tromboprofilassi aderente alle più accreditate linee guida emanate sull'argomento. La particolare origine anomala della coronaria destra del soggetto, non nota in vita, ha certamente favorito il decesso. Gli Autori pertanto illustrano il ruolo causale …

Evidenze medico legali in tema di dolore toracico

Ethical and legal issues of end of life between past and future in the "globalized" european mediterranean culture: the Italian experience.

Analisi di Polimorfismi STR nella Sicilia Occidentale

Bacterial and chemical indicator of coastal water pollution.

This study has been carried out to compare the presence of some organic compounds of long environmental persistance (OCLEP) and heavy metals, in sea water samples, with faecal pollution indicators. Along the Sicily coast line three sites with different grade of pollution (urban, agricultural, industrial) were sampled. 69 samples were obtained from October 1987 to May 1990. Only indicators of faecal pollution were found linked to human settlements, while the other investigated anthropogenic activity related substances were found independently from sampling area.

A suspected case of hunting accident

Gli strumenti di valutazione delle difficoltà persistenti a svolgere i compiti e le funzioni dell'età nel minore

La valutazione del minore in ambito previdenziale ed assistenziale richiede una adeguato apporto multidisciplinare ed approccio interdisciplinare, di ordine clinico e psico-sociale; gli strumenti operativi di cui la scienza medica può dotarsi sono molteplici, ma nel contesto medico legale è soprattutto la valutazione secondo le direttive dell’Organizzazione Mondiale della sanità, nella recente codifica ICF (Classificazione Internazionale del Funzionamento, della Disabilità e della salute, Erikson ed.2001) nella versione YC, a fornire gli odierni strumenti di valutazione a supporto delle Commissioni Medico Legali.

“TRANSMURAL CORONARY INFLAMMATION «TRIGGER» OF INSTABLE PLAQUES RUPTURE”

LINEE GUIDA PER LA VALUTAZIONE DEL PARKINSON IN AMBITO DI INVALIDITA’ CIVILE

Ricerche sperimentali su colle in un caso giudiziario di effrazione di busta per gara d'appalto: aspetti tecnici ed identificativi

Progressive Isolated Hypoglossal Nerve Palsy and Sudden Asphyzial Death

Malpractice medica. Un osservatorio per una prevenzione. Atti delle prime giornate di studio del GISDI. Napoli 12-13 marzo 2004

SU UN CASO DI RICONOSCIMENTO MEDIANTE DETERMINAZIONE INDIRETTA DEL DNA

DOPING E RESPONSABILITA' PROFESSIONALE

Daphne II - Ve.R.S.O project: a new protocol for the management of sexual assault victims

Daphne II - Ve.R.S.O project: a new protocol for the management of sexual assault victims. Sexual assault is a worldwide problem that has not yet been sufficiently acknowledged, as confirmed by analyses and studies carried out at different levels and in different contexts. Internationally, different approaches are taken to the collection of forensic evi- dence and to the clinical and psychological treatment of alleged victims. Italian law n.96, 1996, foreseeing norms regarding rape and abuse, finally gave signifi- cant relevance to sex crimes. In 2004, the European Commission for Justice Internal Affairs and Social Politics promoted the Daphne II pro- gram to support victims of rape and abu…

Rischio clinico e sistemi di Incident Reporting a confronto: critesi ed ipotesi di miglioramento, quando funzionano e perché falliscono

gli Autori individuano alcune criticità del sistema di incident reporting attraverso un'analisi retrospettiva di esperienze nazionali ed internazionali, e, a conclusione, descrivono alcune possibili vie percorribili per il miglioramento del sistema.

La casistica di responsabilità professionale in ambito nefro-urologico esaminata alla luce dei principi di Clinical Risk Management

Role of post mortem computed tomography in diagnosis of upper cervical fractures in child due to road accident: A case report and literature review

The upper cervical spine has unique anatomical features that distinguish it from the remainder of the cervical spine. Its motion segments make up a large amount of total cervical spine motion and, as a result,predispose it to a unique set of injuries. Cervical spine trauma is a common problem with a wide range of severity from minor ligamentous injury to section of the spinal cord. The use of post mortem CT (PMCT), and the subsequent multi-planar and volume rendering reconstruction techniques can provide non-invasive, objective operator-independent imaging data set that may be further reviewed by other specialists. and can substantially add to forensic examinations of the skeleton, especial…

Unexpected variation of the codeine/morphine ratio following fatal heroin overdose.

Postmortem samples from 14 cases of suspected heroin overdose were subjected to a preliminary systematic toxicological analysis in order to highlight the presence of unknown exogenous compounds (e.g., drugs of abuse, alcohol) that may have played a role in the mechanism of death. This analysis unveiled histories of poly-drug use in seven of the cases under investigation. Moreover, the concentrations of morphine and codeine in the brain were also investigated, and the results were compared with the data obtained from the blood specimens. The concentration of morphine in blood ranged from 33 to 688 ng/mL, while the concentration of codeine ranged from 0 to 193 ng/mL. However, in the brain, th…

Definizione di una mappa del rischio della specialità urologica

Homicide with post mortem dismemberment of the victim with previous amputation of right lower limb: Case report and review of the literature

The dismemberment of a corpse is comparatively rare in forensic medicine and usually performed with different types of sharp tools. The victim is always the victim of a homicide. Dismemberment usually occurs where the killing took place without prior planning by the perpetrator. We report a case of homicide with post mortem mutilation of the victim’s body with previous amputation of right lower limb in which the perpetrator was not identified. At autopsy, several fractures were detected on the cranial vault, and the cause of death was due to skull and brain injuries from multiple blunt force traumas.

Alla ricerca della sicurezza e della qualità: il modello di miglioramento dell'Oncologia Medica nel Policlinico Universitario di Palermo

[In search of safety and quality: the improvement model proposed by the Oncology Department of the Palermo University] Over the past 20 years the field of oncology has product therapeutic innovations that have radically changed the prognosis of the most prevalent malignancies, since introduction of so-called targeted molecular agents. As a result of these changes, also the management of cancer patients has become more complex requiring technologies and skills that involve many professionals (medical oncologists, biologists, molecular geneticists, surgeons, pathologists, radiologists, nurses and psychologists), each engaged in a different stage of the disease, with the common goal of ensurin…

Virtual pedopornographia. Italian legislation and legal medicine "Assurance"

Determination of propofol by GC/MS and fast GC/MS-TOF in two cases of poisoning

Two cases of suspected acute and lethal intoxication caused by propofol were delivered by the judicial authority to the Department of Sciences for Health Promotion and Mother-Child Care in Palermo, Sicily. In the first case a female nurse was found in a hotel room, where she lived with her mother; four 10 mg/mL vials and two 20 mg/mL vials of propofol were found near the decedent along with syringes and needles. In the second case a male nurse was found in the operating room of a hospital, along with a used syringe. In both cases a preliminary systematic and toxicological analysis indicated the presence of propofol in the blood and urine. As a result, a method for the quantitative determina…

FORENSIC INVESTIGATION IN AIR CRASH OF TUNINTER