1,720,985 research outputs found
Chemotherapy-induced cognitive impairment from the forensic medicine perspective: A review of the updated literature
No full textChemotherapy treatments in some neoplastic patients can cause unwanted side-effects as chemotherapy-induced cognitive impairment (CICI), also known as post-chemotherapy cognitive impairment (PCCI), chemo-brain or chemo-fog
Editorial: Healthcare in the age of sapient machines: physician decision-making autonomy faced with artificial intelligence. Ethical, deontological and compensatory aspects
Get PDFThe decision to explore this topic was inspired by the growing recognition that artificial intelligence (AI) is assuming an increasingly significant role in medical practice. In recent years, in fact, AI has entered the healthcare sector in a significant way, thanks to the extraordinary technological developments that have enabled the transition from traditional AI systems, such as artificial neural networks, rule-based algorithms, expert systems, and knowledge-based artificial intelligence, to advanced AI systems, such as machine learning and deep learning. The use of these systems in healthcare, which are capable of operating with a high degree of autonomy, represents an invaluable resource in terms of the quality of care provided, but poses obvious ethical and deontological problems. In particular, the introduction of highly automated AI raises crucial questions concerning the decision-making autonomy of physicians, a crucial element in guaranteeing the quality of care and trust in the doctor-patient relationship
Editorial – From ruling No. 242/2019 of the Constitutional Court to the Italian law on medically assisted death: a complex transition
No full textOn 10 March 2022, the Chamber of Deputies of the Italian Parliament approved with a large majority
the draft law No. 3101 on medically assisted death (also called “assisted suicide”).
There were 253 votes in favour, 117 against and one abstention.
The approval of the law is, in fact, a response to the lively social pressure that has long been calling for
assisted suicide to be made lawful in Italy, as it is in other European countries1.
The existing law on the end of life, No. 219/2017, does not provide for the possibility of assisted
suicide2,3.
The text of the law, entitled “Provisions on medically assisted voluntary death”, will now have to be
discussed in the Senate for the final vote.
If definitively approved, the law would therefore exclude the punishability of medically assisted death,
i.e., the self-suppressive act practiced and realized by the patient through technical support made available
by a physician or a healthcare facility
Factors affecting mental health of seafarers on board merchant ships: A systematic review
Get PDFMerchant ships represent a peculiar working environment with several challenges and risks. The specific situation on board of ships may affect the mental health of seafarers more remarkably than ashore workers. A systematic review of the literature has been carried out to identify the main causes of mood disorders among seafarers and the impact that these disorders have on their health. This review has analyzed the scientific literature published between January 2006 and December 2021 using the search engines PubMed, Web of Science (WoS) and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Social isolation, distance from families, fatigue, stress and long work shifts represent the main causes of mood disorders among seafarers. Strategies aimed at improving conditions of cohabitation on board, and a greater consideration of these problems are key for improving the mental health of workers at sea. © 202
Long-term care insurance in Italy: medico-legal and socio-economic profiles
Get PDFLong-term care insurance (LTCI) plays a crucial role in providing substantial aid in non-self-sufficient situations and complementing existing state protection mechanisms. With an aging population and increasing demand for healthcare services LTC policies have become indispensable. While individual LTCI policies face adoption challenges, group insurances offer a more streamlined alternative. However, realizing the full potential of these insurances necessitates targeted legislative intervention to improve accessibility and ensure sustainability. This article explores the evolution of LTCI policies in Italy, offering an overview of the current landscape and highlighting the socio-economic and medico-legal factors shaping the present scenario. By providing this analysis, we seek to offer insights into the dynamic evolution of LTCI policies and the crucial role of legislative measures in enhancing their effectiveness and accessibility
Revenge porn in the Italian regulatory and social context: new crime or old blackmail?
Get PDFRevenge porn is the online publication on websites of explicit photographs or videos taken in intimate moments without the person’s consent. It is a new form of gender-based violence, as the majority of victims are women. This phenomenon has been growing in recent years due to the increase in popularity and spread of social networks. Since the start of social distancing measures due to the COVID-19 pandemic, the problem has undoubtedly become more serious. The most affected groups are women and adolescents. Phenomena such as revenge porn and cyber-bullying are aberrant aspects of online relationships. Although different in their specificity, they have many elements in common, which, unfortunately, in some cases, have led to dramatic out-comes, pushing the victims to suicide. This contribution aims at fully framing the issue from a social point of view and outlining its legal characteristics with reference to the European and Italian legal framework, starting from the analysis of the data presented within the report presented on 24 November 2020 by the Italian Ministry of Justice, containing a statistical analysis of the impact in terms of diffusion of the revenge porn phenomenon one year after the entry into force of the law of 19 July 2019 (the so-called “Codice Rosso”), which introduced the specific crime of unlawful dissemination of sexually explicit images or videos. © 2022 Author(s)
Verbal Autopsy as a Tool for Defining Causes of Death in Specific Healthcare Contexts: Study of Applicability through a Traditional Literature Review
Get PDFAutopsy examination, the gold standard for defining causes of death, is often difficult to apply in certain health care settings, especially in developing countries. The COVID-19 pandemic and its associated difficulties in terms of implementing autopsy examinations have made the need for alternative means of determining causes of death even more evident. One of the most interesting alternatives to the conventional autopsy is the verbal autopsy, a tool that originated in Africa and Asia in the 1950s and consists of a structured interview with the deceased’s family members concerning the symptoms manifested by the person and the circumstances of death. In the early 1990s, the first doubts emerged about the validity of verbal autopsies, especially about the real reliability of the cause of death identified through this tool. The objective of the review was to identify studies that had assayed the validity of verbal autopsies through a rigorous comparison of the results that emerged from it with the results of conventional autopsies. When starting from an initial pool of 256 articles, only 2 articles were selected for final review. These are the only two original research articles in which a verbal autopsy validation process was performed by employing the full diagnostic autopsy as the gold standard. The two papers reached opposite conclusions, one suggesting adequate validity of verbal autopsy in defining the cause of death and the other casting serious doubts on the real applicability of this tool. Verbal autopsy undoubtedly has extraordinary potential, especially in the area of health and demographic surveillance, even considering the implementation that could result from the use of artificial intelligence and deep learning. However, at present, there appears to be a lack of solid data to support the robust reliability of this tool in defining causes of death
Pressure Ulcers from the Medico-Legal Perspective: A Case Report and Literature Review
Get PDFIntroduction: The identification of professional liability profiles related to the development of pressure injuries is a very thorny issue from a medico-legal perspective. This is because no matter how strict the applied prevention protocols applied may be, the development of such injuries is largely dependent on endogenous factors. This paper aims to investigate the medico-legal issues related to this topic through the exposition of one case of medico-legal litigation and a traditional review of the literature. Methods: We performed a literature search using three databases (Pubmed, Scopus, and Web Of Science), restricting the search to the period between 2001 and 2021. We used “pressure ulcers” and “jurisprudence” as the main keywords. From an initial library of 236 articles, our selection resulted in 12 articles, which were included in the review. Results: We identified the ever-increasing expectations of patients and the concept of automatic attribution of responsibility when a pressure ulcer develops as the primary reasons for the increase in litigation over the past 20 years. The related corrective measures are numerous: a strict adherence to guidelines, an adequate documentation of preventive measures, a risk assessment, family involvement, and a successful collaboration between physicians and government institutions. Conclusions: The biological complexity of the pathogenetic development of pressure ulcers makes the subject very delicate from the medico-legal point of view. In principle, it is possible to state that a very large proportion of such injuries are preventable, but that there remains a percentage of them that cannot be prevented. In such cases, only a proper documentary demonstration of the adequacy of preventive measures can exclude liability profiles
Electronic unified therapy record as a clinical risk management tool in the Italian healthcare system
Get PDFDigitization of health records is still struggling to take hold in the Italian healthcare context, where medical records are still largely kept manually on paper. Besides being anachronistic, this practice is particularly critical if applied to the drug chart. Poor handwriting and transcription errors can generate medication errors and thus represent a potential source of adverse events. In the present study, we attempt to test the hypothesis that the application of a computerized medical record model may represent a useful tool for managing clinical risk and medical expenditure. We shall do so through the analysis of the preliminary results of the application of such a model in two private hospitals in Northern Italy. The results, although preliminary, are encouraging. Among the benefits of digitizing drug records, we recorded a greater accuracy and adequacy of prescriptions, a reduction in the overall workload for nurses (no longer required to manually transcribe the list of drugs from one chart to another), as well as an optimization of the management of drug stocks by hospital pharmacies. The results in terms of clinical risk reduction will be monitored through a prospective cohort study that will take place in the coming months
Survival of umbilicus on a superiorly based flap after fleur-de-lis abdominoplasty: A case report
Get PDFINTRODUCTION: Massive weight loss patients have a midline excess of abdominal adipose and skin tissue that contributes to an increased abdominal girth. This excess of tissue in these patients is not resolved with traditional techniques of abdominoplasty and usually the fleur-de-lis abdominoplasty technique is employed. PATIENT CONCERNS: A 22-year-old male patient came to our clinic after a massive weight loss of 170 kg, requesting an abdominoplasty for the excess adipose and skin tissue. DIAGNOSIS: Massive weight loss patient, with excess of adipose and skin tissue in the midline abdominal area. INTERVENTIONS: Fleur-de-lis abdominoplasty technique was employed for treatment of massive weight loss. OUTCOMES: During the surgery, it was decided that the umbilicus blood supply via the inferior epigastric artery and median umbilical ligament needed to be ligated, to remove more tissue for better aesthetic result. The umbilicus survived on the collateral blood supply from ligamentum teres and superior epigastric collaterals. CONCLUSION/LESSONS: In this case report we review our experience treating a massive weight loss patient using a fleur-de-lis abdominoplasty technique without preserving the umbilicus blood supply via the inferior epigastric artery and median umbilical ligament. We eventually relied on the collateral blood supply from ligamentum teres and superior epigastric collaterals, something that proved advantageous both in the survival of the umbilicus on the long run despite cutting off the main blood supply, and, the removal of further excess adipocutaneous tissue for a better aesthetic outcome
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