58 research outputs found
Haemorrhage and Survival Times: Medical–Legal Evaluation of the Time of Death and Relative Evidence
No full textHaemorrhage is the name used to describe the loss of blood from damaged blood vessels (arteries, veins, capillaries). Identifying the time of haemorrhage remains a clinical challenge, knowing that blood perfusion of systemic tissues is poorly correlated with the perfusion of specific tissues. In forensic science, one of the most discussed elements is the time of death. This study aims to provide the forensic scientist with a valid model to establish a precise time-of-death interval in cases of exsanguination following trauma with vascular injury, which can be useful as a technical aid in the investigation of criminal cases. To calculate the calibre and resistance of the vessels, we used an extensive literature review of distributed one-dimensional models of the systemic arterial tree as a reference. We then arrived at a formula that allows us to estimate, based on a subject’s total blood volume and the calibre of the injured vessel, a time interval within which a subject’s death from haemorrhage from vascular injury falls. We applied the formula to four cases in which death had been caused by the injury of a single arterial vessel and obtained comforting results. The study model we have offered is only a good prospect for future work. In fact, we intend to improve the study by expanding the case and statistical analysis with particular regard to the interference factors to confirm its actual usability in practical cases; in this way, useful corrective factors can be identified
VALUE OF THE MEDICAL-LEGAL INVESTIGATION. CORRESPONDENCE OF THE FINDINGS WITH LEGALLY ESTABLISHED REALITY
No full textIn recent years, violence against minors has been the subject of in-depth study in all its historical, social and cultural dimensions, being able to be identified and treated according to rigorous scientific methodologies.
The A.A. report the case of an 8-year-old girl, who disappeared in a rural area, found dead a few hours later, on the recommendation of a young man who, despite having admitted to having gone away with the child, had not provided further details. The forensic inspection revealed that the discovery area included an area with burnt undergrowth about 4 meters in diameter. Examination of the external genitalia showed that the hymen was hemorrhagic in the right hemicycle, at 11 o'clock, with laceration of the most superficial layers of the anterior face. In the present case, therefore, despite having limited historical and circumstantial data, it was possible to reconstruct the following damaging dynamic: the little girl, after having gone away with her aggressor, was first the victim of an attempt of sexual violence by the latter and later immobilized by placing a foot on the slender abdomen. She had been covered with brushwood which the attacker had set fire to, thus killing her. This reconstruction of the criminal events, proposed to the investigating magistrate, was confirmed in each passage by the confessions made by the murderer, during the various degrees of trial, so much so that the final sentence reported in full the specific steps of the medico-legal relationship
Fluorinated and Charged Hydrogenated Alkanethiolates Grafted on Gold: Expanding the Diversity of Mixed-Monolayer Nanoparticles for Biological Applications
No full textLow intrinsic toxicity, high solubility, and stability are important and necessary features of gold nanoparticles to be used in the biomedical field. In this context, charged nanoparticles proved to be very versatile, and among them charged mixed-monolayer gold nanoparticles, displaying monolayers with well-defined morphologies, represent a paradigm. By using mixtures of hydrogenated and fluorinated thiols, the formation of monolayer domains may be brought to an extreme because of the immiscibility of fluorinated and hydrogenated chains. Following this rationale, mixed monolayer gold nanoparticles featuring ammonium, sulfonate, or carboxylic groups on their surface were prepared by using amphiphilic hydrogenated thiols and 1H,1H,2H,2H-perfluoro-alkanethiols. The toxicity of these systems was assessed in HeLa cells and was found to be, in general, low even for the cationic nanoparticles which usually show a high cytotoxicity and is comparable to that of homoligand gold nanoparticles displaying amphiphilic charge neutral hydrogenated or fluorinated thiolates in their monolayer. These properties make the mixed ligand monolayer gold nanoparticles an interesting new candidate for medical application
Application of Multivariate Analysis Techniques for Selecting Soil Physical Quality Indicators: A Case Study in Long-Term Field Experiments in Apulia (Southern Italy)
No full textLong-term field experiments and multivariate analysis techniques represent research tools that may improve our knowledge on soil physical quality (SPQ) assessment. These techniques allow us to measure relatively stable soil conditions and to improve soil quality judgment, thereby reducing uncertainties. A monitoring of SPQ under long-term experiments, aimed at comparing crop residue management strategies (burning vs. incorporation of straw, FE1) and soil management (minimum tillage vs. no tillage, FE2), was established during the crop growing season of durum wheat. The relationships between five SPQ indicators (bulk density [BD], macroporosity [PMAC], air capacity [AC], plant available water capacity [PAWC], and relative field capacity [RFC]) were evaluated, and two techniques of multivariate analysis (principal component analysis and stepwise discriminant analysis) were applied to select key indicators for SPQ assessment. According to the used indicators, an SPQ from optimal to intermediate (i.e., not definitely poor) was detected in 65% of the observations in FE1 and in 54% in FE2. The main results showed a significant negative relationship between RFC and AC, and multivariate analysis identified RFC as a key SPQ indicator, mainly in FE2. Plant available water capacity and BD showed the highest discriminating capability in the FE1 dataset. The highest scores of RFC assessment were highlighted for burning and minimum tillage treatments (+1 and +2). An optimal AC range, derived from optimal RFC limits, was obtained and was suggested to better assess the AC of agricultural soils (0.10 ≤ AC ≤ 0.26 cm3 cm-3). © 2019 The Author(s)
Italian Legal Euthanasia: Unconstitutionality of the Referendum and Analysis of the “Italian” Problem
No full textThe term “euthanasia” refers to medical interventions that involve the direct administration of a lethal drug to the patient who requests it and meets certain requirements. Currently in Italy euthanasia constitutes a crime and falls within the hypotheses foreseen and punished by Article 579 (Murder of consenting person) or by article 580 (Instigation or aid to suicide) of the penal code. On the contrary, medically assisted suicide in some cases and the suspension of treatment constitute an inviolable right pursuant to art. Thirty two of the Constitution and Law 219/2017. Thanks to the sentence 242/2019 of the Constitutional Court, in Italy it is instead possible to request medically assisted suicide, that is, the indirect help of a doctor to die. There are four conditions required: whoever requests it must be fully capable of understanding and willing, must have an irreversible pathology that is the bearer of severe physical or mental disease, and must survive thanks to life-saving treatments. The Italian referendum “Free until the end” aims to introduce legal euthanasia through the partial repeal of art. 579 c.p. which punishes the murder of the consenting party. The authors analyze the reasons for the referendum in the light of the Italian and European scenario, analyzing the first Italian case of assisted suicide immediately after the referendum which inevitably becomes a starting point for ethical and medico-legal reflection on the issue. On 02.15.2022 the Italian Constitutional Court declared the Referendum on Legal Euthanasia inadmissible
Granular Cell Dermatofibroma: When Morphology Still Matters
No full textDermatofibroma, also known as “fibrous histiocytoma”, is one of the most common cutaneous soft-tissue tumors. Many variants of dermatofibromas have been described, and knowledge of these variations is important to avoid misdiagnosis of a possibly more aggressive tumor. Histological features of different variants can coexist in the same lesion, but typical common fibrous histiocytoma features are generally found, at least focally, in all cases. However, when cellular changes make up the majority of the lesion, the histopathological diagnosis can become more complex and requires immunohistochemical investigations for correct nosographic classification. We present the case of a cutaneous fibrous histiocytoma, “granular cell” variant, found on the left leg of a 74-year-old woman
Death Related to a Congenital Vascular Anomaly of Pulmonary Hamartoma Type: Malpractice or Tragic Fatality?
No full textIn forensic pathology, apparently straightforward cases can often hide rarities that, if not correctly interpreted, can alter the results of the entire investigation, leading to misinterpretations. This occurs when the investigation is conducted to assess medical malpractice. An unexpected death, with no known apparent cause, is often linked to an underlying disease process of unclear etiological origin whose nature can, unfortunately, be properly investigated only post-mortem. This presentation shows a case study, in which it was possible to reconduct the death of a patient to a natural pathology and not to medical treatment. Here, the authors illustrate a case with a hamartoma developed in chronic inflammatory conditions (bronchiectasis) that was difficult to differentiate from lung cancer due to the inability to perform specific instrumental examinations. The hamartoma, usually benign and identifiable by standard instrumental investigations, in this case, led to the patient’s death precisely during the execution of a bronchoscopy. However, in the absence of a certain cause of death, public opinion unanimously attributes a patient’s disease to medical error. Indeed, a routine practice such as bronchoscopy should not cause death and consequently, the doctor must have made a mistake. Fortunately, the autopsy not only demonstrated the origin of the bleeding but also unveiled the reason for this, as rare congenital lung disease. Fate, one might say
Alcohol and Drug Consumption among Drivers before and during the COVID-19 Pandemic: An Observational Study
No full textRestrictions imposed during the COVID-19 pandemic might have changed recreational habits. In this study, the results of toxicological tests for alcohol and drugs in blood were compared among drivers stopped at roadside checks in the periods before (1 January 2018 to 8 March 2020) and after the lockdown measures (9 March 2020 to 31 December 2021). A total of 123 (20.7%) subjects had a blood alcohol level above the legal limit for driving of 0.5 g/l, 21 (3.9%) subjects tested positive for cocaine, and 29 (5.4%) subjects positive for cannabis. In the COVID-19 period, the mean blood alcohol level was significantly higher than in the previous period. Cannabis use, which was more frequent among younger subjects, was statistically associated with cocaine use. There has also been a quantitative increase in alcohol levels in the population with values above the legal limits, indicative of greater use of alcohol in the population predisposed to its intake
Analysis of Italian requests for compensation in cases of responsibility for healthcare-related infections: A retrospective study
No full textIntroductionThe aim of this study was to examine the type of compensation claims for alleged medical malpractice in the field of healthcare-related infections in Italy.MethodsIt was analyzed which was the most frequent clinical context, the characteristics of the disputes established, which were the alleged damages most often complained of, which were the possibly censurable behaviors of the health professionals, and which were the reasons for acceptance or rejection of the request for compensation.ResultsIn 90.2%, the issue questioned regarded surgical site infections. The most common pathogens involved were coagulase-negative Staphylococci (34.1%) and Staphylococcus aureus (24.4%). The lack or non-adherence to protocols of prophylaxis and/or prevention of healthcare-related infections was the most reported cause of acceptance of the request of compensation.DiscussionAccording to our data, a stronger effort should be made in terms of risk management perspective in order to ensure the develop and application of protocols for prevention of Gram-positive healthcare-related infections and strengthen infection control and antimicrobial stewardship programs
Short-term effects of conversion to no-tillage on respiration and chemical - physical properties of the soil: a case study in a wheat cropping system in semi-dry environment
No full textNo-tillage (NT) is considered an agricultural practice to preserve soil organic carbon (C), however large uncertainties still affect land-use management measures for reducing carbon dioxide (CO2) emissions from agricultural soil. Short-term changes during the transition between conventional tillage (CT) and NT systems have to be further investigated. In this study, measurements of both actual CO2 fluxes in field and microbial mineralization activity were connected to chemical and physical properties of the soil in a winter wheat cropping system subject to semi-arid climate where NT, performed from only 4 years, has been compared to CT. Results showed no significant differences between CT and NT, confirming a similar turnover time of the organic C between the two treatments, probably due to the young changing in the management (4 years) and the period of measurements (far from ploughing)
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