32 research outputs found
L’onere probatorio e il doppio ciclo di causalità per il risarcimento danni da malpractice
No full textL’autrice legge in modo critico-ricostruttivo una decisione della Corte di cassazione che conferma e rinforza l’orientamento giurisprudenziale in materia di responsabilità medica, con specifico riferimento alla ripartizione dell’onere della prova tra paziente e struttura sanitaria e all’accertamento del nesso di causalità. Spetta, infatti, al paziente che voglia ottenere un risarcimento dimostrare il nesso di causalità tra il danno subìto e la condotta del sanitario e, solo a quel punto, incombe sulla struttura sanitaria l’onere di provare la corretta esecuzione della prestazione ovvero che l’inadempimento (o l’inesatto adempimento) è dipeso da cause imprevedibili ed inevitabili con l’ordinaria diligenza. La pronuncia sottolinea inoltre la centralità del doppio ciclo causale, distinguendo il nesso causale dall’inadempimento e applicando al giudizio civile criteri inferenziali come il principio del “più probabile che non”.The author critically analyses the Supreme Court confirms the prevailing judicial case law in the field of medical malpractice, on the allocation of the burden of proof between the patient and the healthcare facility, as well as the determination of causation. A patient seeking compensation must demonstrate the causal link between the harm suffered and the healthcare professional’s conduct. Only then, the burden of proof shifts to the healthcare facility called to prove either the proper execution of the medical service or that the non-performance (or mis performance) was due to unforeseeable and unavoidable circumstances despite the exercise of ordinary diligence. The decision emphasizes also the centrality of the double causal cycle, distinguishing causation from non-performance and applying inferential criteria such as the “more probable than not” standard
APOPTOSIS IN NORMAL AND PATHOLOGIC HUMAN SPERMATOZOA. ULTRASTRUCTURAL AND TUNEL OBSERVATIONS.
No full textATTI PUBBLICATI SU: ITALIAN JOURNAL OF ANATOMY AND EMBRIOLOGY VOL 105, SUPPL 1 PAG 7
Native specific activity of glutathione peroxidase (GPx-1), phospholipid hydroperoxide glutathione peroxidase (PHGPx) and glutathione reductase (GR) does not differ between normo- and hypomotyle human sperm samples
No full textGlutathione-dependent selenoenzymes in human spermatozoa are responsible for a generalized protection against reactive oxygen species (ROS) as well as some other metabolic and structural regulation during spermiogenesis and sperm cell maturation. Glutathione peroxidase (GPx-1), phospholipid hydroperoxide glutathione peroxidase (GPx-4 or PHGPx) and glutathione reductase (GR) native specific activities have been studied in human Percoll-purified spermatozoa from healthy fertile subjects and asthenozoospermic patients. The mean values obtained for the three enzymes in normal specimens are 1.52 +/- 0.90 mU/10(6) sperm cells (PHGPx), 4.26 +/- 1.73 mU/10(6) sperm cells (GPx-1) and 1.95 mU/10(6) sperm cells (GR). No statistically significant differences for any of the three enzymes were encountered between these values and those of asthenozoospermic patients. These results are discussed and compared with recent literature data on both rescued and native PHGPx specific activity in human spermatozoa, as well as with data obtained for GPx in human seminal plasma
Study of apoptotic DNA fragmentation in human spermatozoa
No full textThe aim of our work was to define and better understand apoptosis in the spermatozoa of normal subjects, infertile patients and patients affected by specific tumoral diseases employing the method of the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labelling and confirming the results by electron microscopy. We studied 23 healthy, normozoospermic subjects (group A), 29 oligoasthenoteratozoospermic patients, affected by various andrological pathologies (group B), 28 patients with Hodgkin's disease (C1) and 30 patients with testicular cancer (C2), Our data demonstrate that the percentage of apoptosis in normozoospermic subjects (group A) is significantly lower than in all the other groups (B, C1, C2) (P < 0.001). This confirms that high DNA fragmentation is one of the characteristics of spermatogenetic failure, The induction of apoptosis, which can also be a basic response to neoplastic disease, can even act right up to the mature male gamete, Our results suggest that apoptosis could be the final result of various pathologies and of a deregulation of spermatogenesis control systems
«Antisperm antibody detection: 1. Methods and standard protocol»
No full textPROBLEM:
Today, antisperm antibody (ASA) detection is one of the most important steps in the evaluation of male infertility. This practice is generally accepted even though there is still some disagreement about the meaning of antisperm immunity and a good deal of controversy about the test regarded as the most suitable for the detection of antibodies directed against sperm antigens. International workshops have tried to standardize universally accepted protocols. A panel of three or four methods is generally advised to provide a correct and complete screening of patients with antisperm immunity.
METHOD OF STUDY:
This paper reports on the results of a serum exchange workshop for the standardization of the ASA detection in the sera carried out under the auspices of the Italian Society of Endocrinology, which was used as reference laboratory. A careful description of the most widely used methods is reported and proposed as a standard protocol also on the basis of the results of the correlation studies carried out by our group is also reported.
CONCLUSIONS:
If the proposed methods and procedures will be accepted by the members of the Alps-Adria Society for Immunology of Reproduction, a Study Group for Sperm Antibody Testing, could start its activity having the goal of reaching a consensus on methodology and carrying out a European serum exchange workshop
Native specific activity of glutathione peroxidase (GPx-1), phospholipid hydroperoxide glutathione peroxidase (PHGPx) and glutathione reductase (GR) does not differ between normo- and hypomotile human sperm samples.
No full textGlutathione-dependent selenoenzymes in human spermatozoa are responsible for a generalized protection against reactive oxygen species (ROS) as well as some other metabolic and structural regulation during spermiogenesis and sperm cell maturation. Glutathione peroxidase (GPx-1), phospholipid hydroperoxide glutathione peroxidase (GPx-4 or PHGPx) and glutathione reductase (GR) native specific activities have been studied in human Percoll-purified spermatozoa from healthy fertile subjects and asthenozoospermic patients. The mean values obtained for the three enzymes in normal specimens are 1.52 +/- 0.90 mU/10(6) sperm cells (PHGPx), 4.26 +/- 1.73 mU/10(6) sperm cells (GPx-1) and 1.95 mU/10(6) sperm cells (GR). No statistically significant differences for any of the three enzymes were encountered between these values and those of asthenozoospermic patients. These results are discussed and compared with recent literature data on both rescued and native PHGPx specific activity in human spermatozoa, as well as with data obtained for GPx in human seminal plasma
Use of carnitine therapy in selected cases of male factor infertility: a double-blind crossover trial
No full textOBJECTIVE: To determine the efficacy of L-carnitine therapy in selected cases of male factor infertility. DESIGN: Placebo-controlled, double-blind, crossover trial. SETTING: University tertiary referral center. PATIENT(S): One hundred infertile patients (ages 20-40 years) with the following baseline sperm selection criteria: concentration, 10-20 x 10(6)/mL; total motility, 10%-30%; forward motility, <15%; atypical forms, <70%; velocity, 10-30 micro/s; linearity, <4. Eighty-six patients completed the study. INTERVENTION(S): Patients underwent L-carnitine therapy 2 g/day or placebo; the study design was 2 months of washout, 2 months of therapy/placebo, 2 months of washout, and 2 months placebo/therapy. MAIN OUTCOME MEASURE(S): Variation in sperm parameters used in the patients selection criteria, in particular, sperm motility. Excluding outliers, a statistically significant improvement in semen quality, greater than after the placebo cycle, was seen after the L-carnitine therapy for sperm concentration and total and forward sperm motility. The increase in forward sperm motility was more significant in those patients with lower initial values, i.e., <5 x 10(6) or <2 x 10(6) of forward motile sperm/ejaculate or sperm/mL. CONCLUSION(S): Based on a controlled study of efficacy, L-carnitine therapy was effective in increasing semen quality, especially in groups with lower baseline levels. However, these results need to be confirmed by larger clinical trials and in vitro studies. Comment in J Urol. 2003 Aug;170(2 Pt 1):677
Immature germ cell separation using a modified discontinous Percoll Gradient technique in human semen
No full textThe difficulty of identifying immature germ cells in unstained, fresh semen has led most laboratories to use the broad definition 'round cells' to indicate cells other than spermatozoa, thus grouping together both leukocytes and immature germ cells. This is also the case in research andrology, where very little attention has been given to immature germ cells in the semen apart from some rare exceptions, such as the attempts to study meiosis. Here we report on the use of a discontinuous Percoll gradient method modified to enable the best separation possible of immature germ cells from the other cells found in the ejaculate, in order to obtain a cellular suspension free of spermatozoa. Our technique (intra-assay variation in duplicates < 10%) demonstrated a high immature germ cell concentration in gradient fractions with 30% to 45% Percoll with a small contamination (1.5-6%) of leukocytes, confirmed by May-Grünwald-Giemsa staining, immunofluorescence and cytofluorimetry. The concentrations of immature germ cells ranged from zero in obstructive azoospermia to 2.0 x 10(6)/ml in oligozoospermia and genital tract infection. The purified immature germ cell suspensions obtained can be useful for diagnostic and research purposes
Ethernet burst transport: A scalable solution for optical metro networks
No full textAn optical packet transport solution relying on a new Ethernet burst aggregation concept is presented. It allows to simplify and scale switch forwarding functionalities paving the way to 100GE/1TBE. Simulations show 90% packet processing reduction. ©2010 IEEE
