Search results for "legal medicine"
showing 9 items of 9 documents
Ancient bacterial genomes reveal a high diversity of Treponema pallidum Strains in early Modern Europe
2020
Syphilis is a globally re-emerging disease, which has marked European history with a devastating epidemic at the end of the 15th century. Together with non-venereal treponemal diseases, like bejel and yaws, which are found today in subtropical and tropical regions, it currently poses a substantial health threat worldwide. The origins and spread of treponemal diseases remain unresolved, including syphilis’ potential introduction into Europe from the Americas. Here, we present the first genetic data from archaeological human remains reflecting a high diversity of Treponema pallidum in early modern Europe. Our study demonstrates that a variety of strains related to both venereal syphilis and y…
Origin of modern syphilis and emergence of a pandemic Treponema pallidum cluster
2016
The abrupt onslaught of the syphilis pandemic that started in the late fifteenth century established this devastating infectious disease as one of the most feared in human history1 . Surprisingly, despite the availability of effective antibiotic treatment since the mid-twentieth century, this bacterial infection, which is caused by Treponema pallidum subsp. pallidum (TPA), has been re-emerging globally in the last few decades with an estimated 10.6 million cases in 2008 (ref. 2). Although resistance to penicillin has not yet been identified, an increasing number of strains fail to respond to the secondline antibiotic azithromycin3. Little is known about the genetic patterns in current infec…
Molecular characterization of Treponema pallidum subsp. pallidum in Switzerland and France with a new multilocus sequence typing scheme
2018
Syphilis is an important public health problem and an increasing incidence has been noted in recent years. Characterization of strain diversity through molecular data plays a critical role in the epidemiological understanding of this re-emergence. We here propose a new high-resolution multilocus sequence typing (MLST) scheme for Treponema pallidum subsp. pallidum (TPA). We analyzed 30 complete and draft TPA genomes obtained directly from clinical samples or from rabbit propagated strains to identify suitable typing loci and tested the new scheme on 120 clinical samples collected in Switzerland and France. Our analyses yielded three loci with high discriminatory power: TP0136, TP0548, and TP…
ustione corneale durante intervento di facoemulsificazione: contributo casistico e considerazioni medico-legali
2014
[Corneal burn during phacoemulsification surgery: case report and medico-legal considerations] The authors report a case of severe corneal burn, occured a few seconds later the beginning of the surgical procedure of phacoemulsification on a 63 years old woman affected by cataract. The authors analyzed the case as a result of claims for damage to the surgeons and the hospital by the patient. In terms of assessment of responsibility, medico-legal investigation is aimed at identifying whether the responsibility of the event of damage to the patient is to be attributed to the negligent conduct of the surgeon or to defects or damage to the equipment used by the same. The authors underline the im…
La sicurezza del paziente in ambiente ospedaliero e la responsabilità professionale dei vertici strategici
2016
[Patient safety in the hospital setting and the professional responsibilities of top managers] The authors underline the evolution of legislation concerning the creation of Hospital Companies and the reasons for the implementation of clinical risk management activities, then analyse the responsibilities involving the top figures of the top hospital management. In particular, the authors highlight the obligation and responsibilities of the strategic apex of a Hospital Company and show that, sometimes, the technical consultants – who express a medical-legal advice – underestimate the responsibility of these figures. It is a management responsibility that determines the obvious and inevitable …
Evolutionary processes in the emergence and recent spread of the syphilis agent, Treponema pallidum
2022
Abstract The incidence of syphilis has risen worldwide in the last decade in spite of being an easily treated infection. The causative agent of this sexually transmitted disease is the bacterium Treponema pallidum subspecies pallidum (TPA), very closely related to subsp. pertenue (TPE) and endemicum (TEN), responsible for the human treponematoses yaws and bejel, respectively. Although much focus has been placed on the question of the spatial and temporary origins of TPA, the processes driving the evolution and epidemiological spread of TPA since its divergence from TPE and TEN are not well understood. Here, we investigate the effects of recombination and selection as forces of genetic diver…
Valenza umana della cura (care) dei pazienti in SVP e ruolo dei caregivers
2016
[Human value of care and caregivers' role in the management of permanent vegetative state (SVP) patients] As stated by the Royal College of Physicians, «patients who remain in a vegetative or minimally conscious state following profound brain injury present a complex array of clinical and ethical challenges to those who care for them». Patients in clinical condition of Permanent Vegetative State (SVP) are unaware of self and environment, enable of language comprehension or expression; they are able to survive along provided that we are able to ensure primary care, such as eating and hydration. With regard to this existential landmark, caregiver’s role is not only legally related, as guardia…
Science and law in the time of cholera: the mystery of the biscuits in Torroja (1865)
2018
By focussing on a case of collective poisoning in 1865, four features of forensic cultures are analysed: technologies for detection, authorized voices, regulations in action and the predominant social anxieties. Local newspapers and archival documents kept in the medical academies of Barcelona and Madrid are analysed. The analysis shows the tensions between various types of proof employed in legal medicine and the ambiguities between epidemic diseases and poisoning accidents. In the first section, I review the fears caused by the cholera epidemic in 1865, which was the first explanation of the accident. The changes of popular perception are also discussed by analysing contemporary newspaper…
Ustioni da elettrobisturi: contributo casistico e considerazioni medico-legali
2016
[Electrosurgery burns: case series and medico-legal issues] In general and specialist surgical practice the use of the electrosurgical unit is consolidated for minimally invasive interventions, due to the ability to control the bleeding of the operative field and the interaction between the cutting and coagulative mechanisms. The authors take inspiration from four cases of personal observation, related to thermal injury produced by electrosurgery, to conduct a brief review of the literature on this issue and present some medical and legal aspects derived from their expert’s observation, in terms of healthcare liability. The authors underline the importance of an accurate knowledge of the pr…