1,721,116 research outputs found
Enabling true decision making through personalized informed consent: omne ignotum pro terribili
No full textCurrent surgical concepts and medicolegal aspects on rhizoarthrosis
No full textArthrosis of the trapeziometacarpal joint is one of the most frequent degenerative pathologies of the wrist and the hand. This pathology presents a slow evolution mainly characterized by pain, which is associated with joint deformities and consequent functional limitations. The severity of the disease can be assessed according to the classification of Eaton. In cases where conservative treatment (pharmacological therapy, infiltration therapy, physical and rehabilitative therapies) has not had positive effects on pain and joint function, it will be necessary to plan surgical treatment. The aim of our article was to analyze the possible surgical indications and the most used procedures in the treatment of rhizoarthrosis, with particular attention to the potential risks and related medico-legal implications
Nerve lesions during arthroscopic procedure: a literature overview
Full text linkArthroscopy is more and more popular. Although minimally-invasive, it's not completely free of complications as nerves lesions which can be invalidating for the patient and frustrating for the surgeon with significant economic, psychological and medico-legal implications. The purpose was to review the literature about nerve injuries related to arthroscopy. A scientific literature review was performed in PubMed/Medline, including articles dealing with cases of iatrogen lesions of the peripheral nerves occurred during arthroscopic procedures. These lesions are mainly due to direct damage by nerve section while cutting for making the portals or during surgical maneuvers, or indirect damage due to traction or pressure mechanisms especially for errors in patient positioning. Also the tourniquet can lead to compression and ischemic nerve injury. Arthroscopy can cause both transient and permanent neurological lesions manifested with dysesthesia up to paralysis according to Seddon's classification in neuroapraxia, axonotmesis and neurotmesis. Incidence of complications in general and of nerve injuries during arthroscopy are reported by joint. A rigorous respect for surgical technique and all perioperative precautions, particularly in relation to the positioning of the patient, greatly reduce the risk of nerve injury. The suggested waiting time before surgical nerve revision is 6 months. In the meanwhile the patient should perform physiotherapy constantly and improvements should be evaluated with clinical examination and electromyography 15-20 days after the lesion, and thereafter at 3 and 6 months
Politrauma stradale con esiti di pseudoartrosi dell'astragalo
No full textANALISI DI UN CASO CON VALUTAZIONE FUNZIONALE ED ESTETIC
LA SPALLA: Diagnosi e Valutazione Medico-Legale
No full textDiagnosi e valutazione Medico-Legale della patologia di spalla
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Female obesity and infertility: outcomes and regulatory guidance
Full text linkObesity has been associated with reduced fertility, although the dynamics and mechanisms which link excess weight to reduced fertility are not yet fully clarified. Obese women, especially those with central obesity, are less likely to conceive per cycle. Obese women suffer from perturbations of the hypothalamus-pituitary-ovary axis, disturbances of the menstrual cycle and are up to three times more likely to suffer from oligo/anovulation. A delicate hormonal balance regulates follicular development and the maturation of oocytes and it has been observed that obesity can alter the hormonal environment: adipocytes, in fact, are responsible for the production of a hormone called leptin (present in high quantities in obese women) which has been associated with reduced fecundity. In addition to compromising ovulation, obesity negatively affects the development and implantation of the endometrium. The expression of polycystic ovary syndrome (PCOS) is regulated, in part, by weight, so obese women with PCOS often have a more severe phenotype and higher subfertility rates. Furthermore, obesity impairs women’s response to medically assisted procreation (MAP) treatments. The authors have set out to delineate a broad-ranging overview of obesity’s impact on female fertility, by drawing upon sources spanning the 1994-2022 period. Assisted reproductive technology (ART) procedures are also discussed as they relate to obese patients. In addition the dynamics by which maternal obesity reportedly affects fetal, neonatal and child development have also been briefly enunciated. (www.actabiomedica.it
The medico-legal implications of intraoperative neurophysiological monitoring, in compliance with good clinical-assistance practices, according to the current Italian legal system
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