1,721,036 research outputs found
Un caso di amputazione traumatica dell’arto inferiore dx da onda pressoria emessa dai gas di scarico di un mortaio
Dimostrazione autoptica di emorragia subaracnoidea da trauma cranico minore con fistola del seno cavernoso
Singolari esemplari di armi da fuoco rudimentali utilizzati nella pratica venatoria illecita, responsabili di ferimenti accidentali in campagna
Su un caso di morte asfittica in corso di intubazione oro-tracheale pre-anestesia su paziente con malformazione delle strutture del collo
SOMMINISTRAZIONE DI MERCURIO ELEMENTARE A SCOPO OMICIDIARIO
Somministrazione di mercurio
elementare a scopo omicidiario.
Gli Autori riportano un caso d'intossicazione da mercurio conseguente a somministrazione
endovenosa ed inoculazione sottocutanea a fini omicidiari in un
soggetto di sesso maschile di 75 anni che si trovava ricoverato presso un presidio
medico pubblico per embolia polmonare e attacco ischemico cerebrale. I rari casi
analoghi sono principalmente dovuti ad avvelenamento accidentale (prevalentemente
per rottura di termometri, ingestione da parte di bambini o inalazione di
vapori di Hg), somministrazione a scopo suicidiario e inoculazione in soggetti
tossicodipendenti. Nel caso in oggetto le indagini di sopralluogo giudiziario e
le analisi chimico-tossicologiche hanno permesso di affermare che si trattava di
mercurio nella sua forma elementare o metallica
Medical-legal aspects of the fungal infection drug therapy in neonatology: evidence-based medicine and off-label prescribing
The aim of this paper is to focus on the well-known issue of the clinical
use of off-label drug therapy in neonatology with respect to evidence-based
medicine, with particular reference to antifungal products, in comparison
with the wider use in pediatric and adult population.
Then we considered the new regulatory approaches carried out in the past
decade by the FDA (Food and Drug Administration) and the EMA (European
Medicine Agency), aimed to improve newborn and children population
inclusion into scientific trials and to promote drug labeling with respect to
pediatric indications, and the goals nowadays achieved through the American
Pediatric Research Equity Act / Best Pharmaceuticals for Children Act and
the European Pediatric Investigation Plans. Finally we pointed out, on the
basis of the Italian regulatory framework, the Italian medical-legal liability
profiles related to the use of off-label therapies in neonatology.
Further efforts are required in the international context to carry forward
the process started while in the particular Italian scenario it is to be hoped
that a general change of mind towards the off-label drug use in neonatology
clinical practice may take place
Cesarean section without clinical indication versus vaginal delivery as a paradigmatic model in the discourse of medical setting decisions
Natural childbirth has ceased to be considered the gold standard in the delivery room. For this reason cesarean section on demand is increasing. Many obstetricians justify this phenomenon on evidence-based obstetrical practice. However, other pieces of evidence demonstrate that the data are often a product of the social milieu, and as stated by Wendland, "technology magically wards off the unpredictability and danger of birth". In a recent paper, Kalish pointed out several problems with cesarean deliveries in the absence of medical indications regarding issues of good clinical practice, autonomy, and informed consent. From the late 1990s, the medical community began to speak in favor of women's autonomy in childbirth decisions thus supporting the maternal choice and request for a cesarean section. Starting from these new considerations, it is of primary importance to understand whether emphasizing patient's autonomy is the best, or the only, way to helping the medical decisional process. This general approach may be helpful in all the other cases in which patient's autonomy and physician's responsibility appear to be intertwined in an apparent conflicting manner. We fear that the rhetoric of autonomous choice represents a fundamental shift from medicine-based beneficence toward a perilous relationship founded mainly on patient's wishes, representing a dangerous slippery slope where the physician could be reduced to the role of a functionary delegated to execute patient's claims and demands
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