196,143 research outputs found
MRI of cortical lesions and its use in studying their role in MS pathogenesis and disease course
No full textCortical grey matter (GM) demyelination is present from the earliest stages of multiple sclerosis (MS) and is associated with physical deficits and cognitive impairment. In particular, the rate of disability progression in MS, both in the relapsing and progressive phases, appears to be strictly associated with degenerative GM demyelination and diffuse cortical atrophy. In the last decade, several histopathological studies and advanced radiological methodologies have contributed to better identify the exact involvement/load of cortical pathology in MS, even if the specific inflammatory features and the precise cell and molecular mechanisms of GM demyelination and neurodegeneration in MS remain still not fully understood. It has been proposed that a combined neuropathology, imaging and molecular approach may help to define a more detailed characterization and precise assessment of the heterogeneous features of GM injury and inflammation in MS. This, in turn, will possibly identify specific imaging and biohumoral (cerebrospinal fluid/serum) correlates of cortical pathology that may have an important role in predicting and monitor the disease evolution. This article is protected by copyright. All rights reserved
A proposito di un caso di lesione del nervo sciatico in corso di artroprotesi di anca: revisione della letteratura e considerazioni medico-legail anche in tema di ripartizione dell'onere probatorio
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Un singolare caso di esplosione del colon durante colonscopia operativa: evento avverso o complicanza evitabile?
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Il suicidio nella popolazione anziana. Casistica del Dipartimento di Medicina Legale dell’Università di Roma ‘La Sapienza’ (1990-2005).
No full textMorte Per Anafilassi In Seguito A Somministrazione Intramuscolo Di Diclofenac
No full textLa diagnosi post mortem di shock anafilattico risulta sovente complessa in ragione soprattutto della non infrequente aspecificità del riscontro autoptico. Oggetto del presente contributo è il caso di una donna, con anamnesi positiva allergica al "Diclofenac" a cui veniva prescritto proprio tale farmaco da iniettare i.m., dal proprio medico curante. Come prescritto, il marito della donna effettuava la prima iniezione, seguita dopo pochi minuti da improvviso quanto intenso malore che si concludeva con il decesso. L'ispezione esterna rilevava segni aspecifici, mentre l'esame interno evidenziava edema cerebrale, iperemia, ed edema delle prime vie aeree, congestione polmonare. L'esame tossicologico su sangue ed urina escludeva la presenza di sostanze tossiche esogene di interesse tossicologico ad eccezione del Diclofenac (presente anche nella siringa e nella fiala sequestrate). L'esame istologico sulle vie aeree mostrava oltre a marcato edema e vasodilatazione, cospicua infiltrazione mastocitaria. La singolarità del caso risiede proprio nella perfetta coincidenza di tutti i classici elementi di giudizio in tema di morte per avvelenamento: anamnestico-circostanziale; clinico; anatomo-patologico; tossicologico; di esclusione di altra causa. Ancor più singolare è il fatto che a prescrivere la specialità medicinale fu proprio il medico curante della donna che la teneva in cura da ben trent'anni ed al quale era ben nota la sensibilità della paziente al farmacoPost-mortem diagnosis of anaphylactic shock due to many problems because the autopsy findings are not specific. The subject of this work is the case of a woman with a history of allergy to "Diclofenac" which was just prescribed the drug to be injected i.m. by her doctor. The woman's husband was the first injection followed after a few minutes from sudden illness that ended with the death. The external inspection noted non-specific signs, while the internal examination showed cerebral oedema, hyperaemia and oedema of the upper airways, lung congestion. The blood and urine drug test to rule out the presence of exogenous substances of toxicological interest with the exception of Diclofenac. Histological examination showed airway oedema, vasodilatation, and mast cell infiltration. The uniqueness of the case lies in the perfect coincidence of all the classic elements of assessment in terms of death from poisoning: circumstantial anamnestic, clinical, pathological, toxicological, exclusion of other causes. Even more remarkable is the fact that it was the prescribing physician of the woman who kept her under the care of thirty years and who had known the patient's sensitivity to the dru
Prevalence and accuracy of nursing diagnoses in patients with malignant bronchial and lung cancer: A retrospective observational study
No full textPurpose: To describe the prevalence and accuracy of nursing diagnoses (NDs) in adult patients with malignant bronchial and lung cancer. Methods: A retrospective, observational, monocentric study was conducted at the largest university hospital in Rome, Italy. Electronic health records (EHRs) of adult inpatients (≥18 years) hospitalized in 2022 with malignant bronchial and lung cancer were analyzed. NDs were documented using the Professional Assessment Instrument (PAI), a clinical nursing information system based on the Clinical Care Classification (CCC) standardized nursing terminology. The accuracy of nursing documentation was assessed with the D-Catch instrument, evaluating record structure, admission data, ND formulation, interventions, progress/outcome evaluations, and legibility. Descriptive statistics were used to analyze ND prevalence and documentation accuracy. Results: A total of 682 EHRs were examined, identifying 3510 NDs across 34 distinct labels. Patients had a mean of 5.15 NDs (SD: 2.99; range: 1–16). Ten high-frequency NDs were identified, with Infection Risk (76.7 %), Fall Risk (66.6 %), and Acute Pain (53.1 %) emerging as the most prevalent. Overall documentation accuracy was high across most dimensions; however, ND formulation showed comparatively lower accuracy (mean score: 6.38; SD: 0.98). Conclusions: Evaluating the prevalence and accuracy of nursing diagnoses enhances the understanding of the complex care needs of patients with malignant bronchial and lung cancer, a population marked by significant clinical vulnerability and multidimensional care requirements. Strengthening diagnostic reasoning—through structured documentation systems and continuous training—may improve care planning, facilitate interdisciplinary communication, and ultimately optimize patient outcomes
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