1,720,967 research outputs found
La valutazione medico legale nei reimpianti digitali degli arti superiori
No full textGli arti superiori e le mani in particolare rappresentano organi principe di interazione tattile
con il mondo esterno, permettendo all’uomo di svolgere una miriade di attività che lo
caratterizzano e lo distinguono dal regno animale.
Una lesione a carico di una o di entrambe le mani comporta importanti sequele di ordine
anatomico-funzionale che si ripercuotono sulla vita del soggetto e che assumono notevole
rilevanza non solo sul piano clinico, ma anche, e, per quanto riguarda la Nostra disciplina,
soprattutto, in ambito giuridico.
Infatti l’esito di un evento traumatico o uno stato di malattia generale possono modificare,
parzialmente o totalmente, le caratteristiche della mano con conseguente perdita delle sue
funzioni o parte di esse.
Assume quindi rilevanza la possibilità di emendare una lesione attraverso l’intervento
chirurgico in modo da restituire, per quanto possibile, l’armonia estetica e funzionale del
segmento traumatizzato. Particolarmente importante a tal fine risulta il trattamento chirurgico
delle lesioni amputanti una o più dita delle mani.
La Comunità scientifica internazionale (Hattori Y et al 2007, Chung KC 2006, Hattori Y et
al 2006, Freidrich, Jeffrey B et al 2005) ha tuttavia osservato, fin dalle prime esperienze sul
campo, che non tutte le lesioni amputanti hanno tratto un beneficio da questa procedura, in
quanto sussistono variabili non solo di ordine clinico, ma anche culturale, come esamineremo nei
prossimi capitoli.
Al fine di supportare al meglio una organizzazione assistenziale che consenta nel maggior
numero di casi possibile tale pratica chirurgica, si è cercato di quantificare il guadagno in termini
di funzionalità che deriva dal reimpianto di segmenti corporei amputati, utilizzando parametri
che possano permettere un reale confronto tra i differenti casi.
A questo scopo, nel presente lavoro si è cercato di quantificare l’efficacia della chirurgia
microvascolare, in situazioni nelle quali la storia naturale della malattia avrebbe comportato la
perdita del segmento anatomico interessato dal trauma, non tanto e non solo rispetto al recupero
funzionale, ma anche al cosiddetto “ risparmio di costo sociale”, per tale intendendo il valore
economico del recupero funzionale che si ottiene attraverso il reimpianto.
A tale fine abbiamo fruito della prassi liquidatoria nell’ambito della responsabilità civile e
della infortunistica sul lavoro (Legge n. 57 del 5/3/2001; DM 3/7/2003; Decreto Legislativo n.
209 del 7/9/2005; Tabelle per la liquidazione del danno alla persona adottate dal Tribunale di
Milano e aggiornate al 1° gennaio 2006; Luvoni R et al 2002; Cimaglia G et al 2006).
Alla luce dei risultati delle ricerca espletata si è poi proceduto ad esaminare ulteriori aspetti
medico legali, con particolare riferimento alla valutazioni di profili di responsabilità
professionale a carico del chirurgo in caso di ritardo o di omissione di intervento di reimpianto,
discutendo le implicazioni sul piano penale e civile.not availabl
Serious vascular complication of proximal locked tibial nailing: delaying of clinical manifestation and medical malpractice
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A new case of Lazarus Phenomenon?
No full textThe international medical literature described sporadical cases of an exceptional event called the ‘‘Lazarus phoenomenon’’.
This is the spontaneous reviviscence of an individual after a long time of asystolia following a cardiac accident depending on
different pathogenesis (i.e. aritmia, ischaemic stroke, haemorrhage, brainstem death). All of the reported cases concerned
patients presenting recovery after discontinuation of cardiopulmonary resuscitation. Different explanations of the phisiopathology
of the phoenomenon can be given, first of all, the latency of catecholamine action in such patients. We report the case of an
81-year-old woman who experienced a cardiac accident on the street. Once the cardiopulmonary resuscitation was interrupted,
the patient presented life activities after some minutes
Third mandibular molar: development as an indicator of chronological age in a European population.
No full textAssessing biological age in the youth nearby legal age has always represented a stimulating issue for the Italian forensic scientist as far as he deals with matter of imputability and legal or illegal immigration of uncertain age subjects. Since any method of evaluation should of course be accurate, not invasive, reproducible and, as possible, easily exploitable, radiological investigation of age dependent features is the most appropriate instrument to the purpose. Dental development is slower and delayed compared with skeletal bone one, occurring according to a known, regular pattern from whose evaluation a biological age can be assessed with a reasonably restricted span for a certain radiological image. This is the assumption which inspired since 1941 (Schour e Massler) so many anthropologists and forensic and clinic odontologist in investigating biological age by the study of radiological dental morphology. Demirjian and Goldstein [New systems for dental maturity based on seven and four teeth, Ann. Hum. Biol. 3 (1976) 411-421] obtained no differences between two groups of subjects whose age was extimated by the evaluation of 14 teeth in one case and 7 teeth in another, the last being greatly simpler. Afterwards, Thorson (1991), Mincer et al. [The A.B.F.O. study of third molar development and its use as estimator of chronological age, J. Forensic Sci. 38 (1993) 379], Solari and Abramovitc [The accuracy and precision of third molar development as an indicator of chronological age in Hispanic, J. Forensic Sci. (3) (2002) 531-535] and then Prieto Carrero [Evaluation of Chronological Age Based on Third Molar Development in the Spanish Population, Atti del XIX Congresso IALM, Milano, 2003], developed a method based on the evaluation of the radiological development of the alone third molar, according to Demirjian's schematic definitions of crown and root formation. Eight stages of development of the third molar are defined from the time of mineralization appearance of the cusp tips up to complete closing of the apexes. In order to achieve grater precision in discriminating stages F and G, Solari added two stages (F1 and G1), determining 10 stages of maturation of root and crown. Prieto tested the accuracy and precision of this method by the evaluation of about 1300 orthopantomographs of juveniles and young Spanish adults of known age, divided for gender. We analyzed a total of 400 orthopantograms of young Spanish dental patients to evaluate the chronology of the right mandibular third molar development and to assess its correlation with the biological age of the tested. Biological age is attributed with a maximum standard deviation of 2.47 from the mean in the eight stages outline. The greatest limit of the method seems to be the operator experience in determining the dental stage of development. We think that age data coming from such evaluation method should be clearly explained to the magistrate in their true statistical significance and limits
La diagnosi generica di sangue umano su microtraccia: un retaggio del passato od una esigenza probatoria ancora attuale ?
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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
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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