1,720,984 research outputs found
Post-mortem routine practice in the era of the COVID-19 pandemic
No full textAt the beginning of March 2020 in a small town in Apulia (Southern Italy), a funeral ceremony for a 74-year-old man hit the news headlines because many people who attended the religious ceremony were subsequently found to be infected with severe acute respiratory syndrome coronavirus (SARS-CoV-2). Community transmission of the virus was attributed to the forensic pathologist who performed the routine post-mortem inspection of the man's body. The decedent died in his own home of natural causes. In the background history, the decedent reported that he was in Northern Italy during the initial outbreak of coronavirus disease 2019 (COVID-19). Diagnostic testing for detection of SARS-CoV-2 was performed before his death, but the forensic pathologist did not wait for the laboratory results and authorized a public funeral service. Two days later, the decedent's relatives were informed that they had tested positive for COVID-19 infection
Body length estimation during the post mortem interval: Preliminary study
Full text linkPurpose. Body height represents an essential parameter in forensic cases. Moreover, the evaluation of stature could be helpful also in malpractice lawsuits. The reliability of cadaver length can be influenced by several factors and the difficulties in obtaining data upon precise living stature are well-known. Methods. We prospectively evaluated 100 cadavers. The cadavers were admitted to the mortuary within 2 hours of death. The body length was measured using a portable stadiometer, in three different post-mortem intervals: within the first 2 hours (T0), at 4-6 hours (T1) and after 20-24 hours (T2). Results. Showed that at T1 there was a lengthening of the cadaver by almost 1 cm while there was a small decrease in the following hours. Thus, we can state that nearly 24 hours postmortem cadaver length increases slightly (0.6 cm) from the measurement taken 2 hours postmortem, and this is very close to the estimated living height. Conclusion. Variation of body size during post mortem interval has not been fully explored despite its important implication in forensics. The findings here observed, even considering the limitation exposed in the study, do not support the theory that there is a great difference in cadaver stature postmortem
Patricide and overkill: a review of the literature and case report of a murder with Capgras delusion
Full text linkDespite being an infrequent crime, parental homicide has been associated with schizophrenia spectrum disorders in adult perpetrators and a history of child abuse and family violence in adolescent perpetrators. Among severe psychiatric disorders there is initial evidence that delusional misidentification might also play a role in parricide. Parricides are often committed with undue violence and may result in overkill. The authors present the case of an adult male affected by schizoaffective disorder and Capgras syndrome who committed patricide. Forensic pathologists classify such cases as overkill by multiple fatal means comprising stabbing, blunt trauma and choking. Accurate crime scene investigations coupled with psychiatric examinations of perpetrator allow reconstruction of the murder stages. This overkill case is discussed in the context of a broad review of the literature
Medical responsibility, insurance policies, new laws and European directives. Is it time to reform the status of Italian medical residents?
Full text linkIn Italy there is an ongoing debate on the need to clarify the legal aspects related to the clinical activities of medical residents. While residents attend university medical schools, specific policies should be implemented to guarantee their proper utilization in health organizations also for the direct and indirect legal responsibilities of patients health and safety. It seems necessary to create an uniform and clearer legal framework to surmount criticism of the utilization of residents. We recommend Ministries of University and Health to change the current training contract into a job-training one, in line with experiences for residents of other European countries. This initiative could promote a no-blame culture and also help Italian specialist doctors of future generations to be trained in order to move and be competitive across European country borders and finally promote the sustainability of the Italian public NHS through a patient-centred and inter-professional integrated approach
Adoption and Implementation of the Surgical Safety Checklist: Improving Safety in an Italian Teaching Hospital
Full text linkAlthough it is known that clinical risk management tools such as the Surgical Checklist lead to greater safety for patients and protection for the operators, clinical risk management units have much work to do to implement and spread the use of quality health care tools
Sepsis and nosocomial infections: The role of medico-legal experts in Italy
Full text linkSepsis is a leading cause of morbidity and mortality worldwide. It is defined as the presence of a Systemic Inflammatory Response Syndrome, and it represents a significant burden for the healthcare system. This is particularly true when it is diagnosed in the setting of nosocomial infections, which are usually a matter of concern with regard to medical liability being correlated with increasing economic costs and people’s loss of trust in healthcare. Hence, the Italian governance promotes the clinical risk management with the aim of improving the quality and safety of healthcare services. In this context, the role of medico-legal experts working in a hospital setting is fundamental for performing autopsy to diagnose sepsis and link it with possible nosocomial infections. On the other hand, medico-legal experts are party to the clinical risk management assessment, and deal with malpractice cases and therefore contribute to formulating clinical guidelines and procedures for improving patient safety and healthcare providers’ work practices. Due to this scenario, the authors here discuss the role of medico-legal experts in Italy, focusing on sepsis and nosocomial infections
A fatal drowning filmed in a private pool: Analysis of the sequences of submersion
Full text linkInvestigating a body found in water, without eyewitnesses, to determine the cause and manner of death is often difficult. Video recorded by a surveillance camera can document events and provide useful data for case assessment. The authors report the case of a 26-year-old man found dead in a swimming pool. The images taken by the surveillance camera are useful for reconstructing what happened: to confirm the autopsy by attributing the cause of death by drowning, without the interference of extrinsic factors. The sequence of events related to the submergence of the body, as seen from the video surveillance recording, does not seem to differ much from that described in the experiments reported in the literature even if it presents some discrepancies on the times of death, having been able to precisely control the times of death by acquiring the video surveillance. Reporting this drowning in a swimming pool has yet to be considered an isolated important case study for the study of the drowning process in humans
Handover checklist: testing a standardization process in an Italian hospital
Full text linkDavide Ferorelli,1 Teresa Giandola,2 Mariangela Laterza,2 Biagio Solarino,2 Angela Pezzolla,3 Fiorenza Zotti,2 Alessandro Dell’Erba1 1Interdisciplinary Department of Medicine, 2Section of Legal Medicine, 3Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy Objectives: This study aimed to standardize and rationalize the handover, a critical and essential moment in common health care practices, through the realization of an efficient and standardized checklist, which could be used daily to ensure complete, thorough and effective handover. The principal purpose of the implementation of the handover is to reduce errors due to superficial and insufficient communication.Methods: The “operative group” defined the phases to the realization of the delineated aims: at first, the direct observation and the consequent realization of a handover checklist model and then, the experimental phases (trials). The handover checklist model was used for a month and it was daily and duly completed by the doctors who took part in the trial. To prove the success of the study, three questionnaires were distributed on different occasions.Results: Analyzing the answers to the questionnaires, the importance of the handover has come to light and that for the most part, the doctors consider it an essential and irreplaceable moment in daily health care work. Moreover, it became obvious that the use of the handover checklist guaranteed a considerable improvement in the traditional handover in terms of security, completeness, care continuity and clarity. The handover checklist was completely appreciated by the majority of the participant doctors who agree with the definitive introduction of it in their unit.Conclusions: Our study indicated the consistency of the handover checklist as an instrument to implement the handover and, indirectly, to improve the quality of the care. Keywords: clinical risk management, handover checklist, health care workers trainin
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
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