1,721,007 research outputs found
INDAGINI STRUMENTALI ELETTROMIOGRAFICHE IN PAZIENTI CON DISORDINI TEMPOROMANDIBOLARI
Full text linkSurface electromyography (EMG) can make an objective recording of the masticatory muscle function and dysfunction. Normalized EMG data will inform on the influence of occlusion (teeth contact) on the neuromuscular activity, avoiding individual variability (anatomical variations, physiological and psychological status, etc.) and technical variations (muscle cross-talk, electrode position, etc.).
In the first study, the normalized electromyographic characteristics of masticatory muscles in patients with temporomandibular joint disorders (TMD) with long lasting pain (more than 6 months) were analyzed. Overall, patients with long lasting TMD have an increased and more asymmetric standardized activity of their temporalis anterior muscle, and reduced mean power frequencies, relative to healthy controls.
In the second study, a group of TMD patients were categorized according to both RDC/TMD and magnetic resonance imaging (MRI) in patients with disk displacement, osteoarthrosis and/or disk displacement. The quantitative sEMG characteristics of their masticatory muscles were examined. A significant correlatio between diagnostic data obtained by MRI and sEMG was found, permitting to propose sEMG as a first diagnostic tool, reserving MRI to more complex situations.
In the third study, the surface electromyographic spectral characteristics of masticatory and neck muscles during the performance of maximum voluntary clench (MVC) tasks, were considered. A set of data to characterize the sEMG spectral characteristics of jaw and neck muscles in young adult subjects performing MVC tasks currently in use within the dental field was obtained.
The outcomes suggest that the proposed method could be a useful tool to evaluate functionally altered stomatognathic conditions. Diagnosis of alterations of the stomatognatic apparatus and assessment of the effects of therapy would both profit from this quantitative approach, thus reducing the discordance among several clinical examinations
Child sexual abuse: the impact of medical evidence on the legal outcome of criminal cases
No full textINTRODUCTION: CSA represents a public health problem with a global lifetime prevalence of sexual abused children aged <18 years in 2011 of 7.6% (for male) and 18% (for female). The evidence of the conviction procedure has been hypothesized to depend on many factors as physical findings and quality of the child’s disclosures and testimonies. Nevertheless, most sexually abused children will not have signs of genital or anal injury, especially when examined non-acutely. The objective of this review is to investigate the impact of medical evidence (i.e. bodily and/or anogenital injuries) found during medical examination on the outcome of criminal proceedings for CSA, in order to understand the contribution of the healthcare providers.
EVIDENCE ACQUISITION: This review was conducted in adherence to the guidelines by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020). After the screening phase, 13 publications were assessed as eligible for full-text assessment. Finally, four articles were added though backward search (analyzing the cited references in the selected articles), resulting in 17 articles included in the conceptual review.
EVIDENCE SYNTHESIS: Overall, four studies found a positive association between medical evidence and the legal resolution of cases, six studies found no association, and seven studies showed that medical findings are only relevant for the initial stages of the legal process or in the final stages of the process if associated with other variables.
CONCLUSIONS: This review revealed contrasting results concerning the influence of medical examination findings on the judicial outcome of criminal cases of child sexual abuse, highlighting the complexity of the issue. Health professionals and all criminal justice system personnel need to be better informed about how to interpret the presence or absence of injuries and other medical findings. Anyway, it is crucial that medical documentation follows rigorous forensic standards and provides a detailed description of the evidence for investigative and judicial authorities
The face in Down's syndrome : indices of overall size and harmony in Sudanese vs Italian subjects
No full textUterine leiomyosarcoma as a rare cause of fatal retroperitoneal haemorrhage due to compression and rupture of the renal vein
Full text linkAbnormal uterine bleeding (AUB) can be caused by uterine tumors, both benign and malignant, although they rarely lead to fatal vascular complications. We present a case of a woman found dead in her home, in which the autopsy highlighted a massive retroperitoneal haemorrhage extending to the left renal lodge and a voluminous uterine tumor of stony consistency and exophytic growth weighing 2250g. The histopathological examination identified the mass as a leiomyosarcoma and demonstrated the presence of a dilation with rupture of the left renal vein, in the absence of neoplastic cells infiltrating the vascular wall. On these findings, it was concluded that the neoplastic mass had caused external compression of the left renal vein, leading to its rupture and to a fatal retroperitoneal haemorrhage. The case was considered of interest as it involved a peculiar etiopathogenetic mechanism causing a lethal complication from uterine leiomyosarcoma which has not yet been reported in the literature
Criticità dell’attività di medicina necroscopica territoriale: risultati di un sondaggio esplorativo rivolto ai medici di medicina generale e continuità assistenziale
No full textQuesto lavoro ha lo scopo di esplorare applicativamente i diversi comportamenti attuati dai medici operanti sul territorio di fronte a situazioni di interesse necroscopico, mediante la somministrazione di un sondaggio.
Tale sondaggio è stato articolato in 3 parti. Nella prima parte si sono richieste informazioni generali dei partecipanti (genere, età, esperienza lavorativa, Regione e Provincia di lavoro). Nella seconda parte (sezione tanatologica), si è chiesto di indicare il comportamento che verrebbe adottato in 10 diversi scenari di potenziale comune riscontro sul territorio con richiesta di constatazione di decesso dell’assistito. Sono state fornite 4 diverse risposte: 1) constatazione decesso e compilazione scheda ISTAT; 2) constatazione decesso e avviso Forze dell’Ordine; 3) constatazione decesso, avviso Forze dell’Ordine ed esecuzione preliminare ispezione esterna in loco; 4) constatazione decesso e richiesta riscontro diagnostico ex art. 37. Nella terza parte (sezione certificativa) si è voluto investigare il ragionamento causale adottato dai medici territoriali in riferimento all’identificazione della causa di morte, indicando tra 5 opzioni quale potesse essere il primo evento che avrebbe dato avvio alla sequenza causale del decesso. Per tutti gli scenari è stata prevista l’opzione “è necessario chiedere l’esame autoptico”. Infine, si sono chieste le ragioni per cui tale accertamento non fosse stato eventualmente richiesto. Il sondaggio è stato preparato sulla piattaforma digitale Google Forms con obbligo di risposta a tutte le domande, ed è stato veicolato ai medici di medicina generale e di continuità assistenziale tramite gli Ordini Provinciali dei Medici Chirurghi aderenti al progetto da febbraio 2024.
261 medici hanno partecipato al sondaggio. Tale campione è risultato statisticamente significativo [IC: 90%, errore: 5%, DS: 50%] per la specifica popolazione selezionata composta da circa 50.000 medici. Il rapporto M:F è stato di 1.3:1. Hanno risposto medici di età comprese tra 24-35 anni (29.9%), 36-45 (18.4%), 46-55 (9.2%), 56-75 (42.5%). Le Regioni più rappresentative sono state: Lombardia (37.9%), Piemonte (20.3%), Veneto (9.6%), Emilia-Romagna (9.2%) e Campania (4.6%). Nella sezione tanatologica è risultato altamente significativo [p<0.001] un diverso modo di operare dei medici se di fronte a cadaveri di soggetti più giovani (≤50 anni) o meno giovani/anziani (>50 anni), limitandosi per questi ultimi a rilasciare la sola constatazione di decesso e scheda ISTAT (65.30% vs 1.87%), anche di fronte a quadri lesivi ad interpretazione non univoca. Viceversa, sono altamente significative [p<0.001] l’attivazione delle Forze dell’Ordine e l’esecuzione di una preliminare ispezione esterna per soggetti più giovani (rispettivamente 59.53% vs 13.24% e 23.72% vs 10.05%). Significativa è anche la diversa attitudine a valutare il cadavere in avanzato stato di decomposizione in cui è prevalentemente non eseguita una preliminare ispezione esterna cadaverica in loco [p=0.008] o ci si limita all’attivazione delle Forze dell’Ordine [p<0.001]. Nella sezione certificativa, la maggior parte delle risposte è frutto di speculazioni invece che di reali evidenze scientifiche, talune formalmente errate. La scelta di richiedere prevalentemente l’esame autoptico per la definizione della causa di morte è in percentuale significativamente [p<0.0001] maggiore per soggetti più giovani indipendentemente dalla presenza/assenza di reperti morfologici utili per la definizione della denuncia di causa di morte (31.18% vs 1.16%). Infatti, il 74.7% dei medici ha risposto che i dati anamnestici e clinici fossero più che sufficienti per formulare un'appropriata causa di morte, mentre il 34.5% che non a ritenuto utile un accertamento invasivo in questi casi.
Questo studio ha rilevato che l’età anagrafica e lo stato di conservazione del cadavere sono scriminanti (statisticamente significative) usate dai medici del territorio per decidere se adottare comportamenti maggiormente cautelativi di potenziale interesse giudiziario. Altresì, sono emerse severe criticità nel denunciare correttamente le cause di morte, ed una tendenza a rinunciare all’autopsia quale strumento di tutela sociale e valore epidemiologico-sanitario
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
CONTENUTO MINERALE OSSEO IN PAZIENTI CON NEFROLITIASI CALCICA RECIDIVANTE E IPERCALCIURIA IDIOPATICA
No full textMorphometry of the Orbital Region Soft Tissues in Down Syndrome
Full text linkThe orbital region of subjects with Down syndrome (DS) has been scanty described so far. We wanted to detail the morphologic characteristics of the soft tissue orbital region in Italian and North Sudanese subjects with DS.The three-dimensional coordinates of 10 landmarks on the orbital soft tissues were obtained using computerized anthropometry in 53 Italian and 64 North Sudanese subjects with DS aged 4 to 52 years, and in 461 (Italian) and 682 (North Sudanese) sex- and age-matched controls. From the landmarks, linear distances, ratios, areas, and angles were calculated, z scores computed, and compared by t-tests and analyses of covariance.In North Sudanese DS subjects, intercanthal width and height-to-length ratio were increased; biorbital width, eye height, length, and area were reduced. Eye fissure and orbital inclinations relative to Frankfort plane were reduced, whereas orbital inclinations versus the true horizontal were increased. In Italian DS men, orbital height and height-to-length ratio were increased, eye length was decreased; orbital inclination versus the true horizontal was increased. For almost all measurements, a significant effect of age was found. No effects of sex were found. Ethnic group influenced orbital height, area, and orbital inclination versus Frankfort plane. All paired measurements had similar discrepancies on both sides.The orbital soft tissues of North Sudanese DS subjects differed from those of their reference subjects, but this was only partially true for Italian subjects. The 2 ethnic groups had different alterations in their soft tissue orbital regions that were influenced by age, but not by sex
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