196,023 research outputs found
Iatrogenic injury of the spinal accessory nerve in selective superficial parotidectomy
No full textThe spinal accessory nerve, also known as accessory nerve, is the eleventh cranial nerve. It is responsible for the motor innervation of the sternocleidomastoid and trapezius muscle. The sternocleidomastoid muscle tilts and rotates the head, while the trapezius muscle, connecting to the scapula, elevate the shoulder girdle and retract the girdle dorsally. Spinal accessory nerve injury commonly occurs during neck dissection surgery, either elective or therapeutic procedure, performed to treat head and neck carcinoma. The Authors described the case of a 50-year-old man who underwent surgery for a parotid neoformation. After the superficial left parotidectomy emerged neck pain, weakness of the trapezius muscle and functional impotence of the left shoulder. Following diagnostic tests, was properly diagnosed an iatrogenic accessory nerve injury. The main purpose is to determine possible predictive factors related to the occurrence of accessory nerve injury during superficial parotidectomy and the possibility to recognize the error immediately after surgery when surgical repair has the great chance of success. Probably the awareness of the possibility of a iatrogenic injury and its consequences, even during reconstruction using the SMAS flap after superficial parotidectomy, would avoid delays in diagnosis and treatment
p MATRICIDE DURING COVID-19 PANDEMIC: AN UNUSUAL CASE OF FAMILY VIOLENCE
No full textThe need to limit the spread of the virus in the population has forced many countries to impose strict measures of social distancing and home isolation. These measures, although necessary, have caused unprecedented social disruption. One of the most worrying effects of this social crisis is the increase in episodes of family violence which can be extremely serious up to the killing of family members. Matricide is a fairly rare event worldwide. Many authors have over time attempted to figure out the origins of a pathological condition - but not limited to - underlying such crimes often executed through particularly brutal criminal acts against the victims. In this study we present a case of a 66-year-old woman who was killed with multiple stab wounds from a diving knife and then burned. It was determined that the victim was murdered by her 36-year-old son, unemployed for about a year and with a history of alcohol abuse, had a suspected diagnosis of bipolar disorder in treatment with antidepressant drugs. On the victim's body there were 31 stab wounds, localized mostly to the skull, face and thorax. Some of the typical characteristics highlighted in the literature regarding individuals who commit matricide are actually found in this case. This correspondence underscores the need to recognize and, in some cases, prevent the possible occurrence of such an eventuality within a family
Law proposal "provisions on the post-mortem body donation and the use of bodies for the purposes of study, scientific research and training": Comment and analysis of the bill and the historical-juridical-ethical aspects of cadaveric dissection and practice of the donation of a corpse for scientific and medical training purposes
No full textIntroduction: The practice of human cadaveric dissection represents an irreplaceable tool for learning, training and scientific research. However, the lack in some countries including Italy, of a regulatory framework aimed at regulating cadaveric donation for study and research makes it an activity poorly proposed within the educational paths of students and young doctors. Materials and methods: After discussing the historical-juridical evolution of cadaveric dissection, the authors analyzed in detail and commented the bill recently adopted by the Senate of the Italian Republic concerning the institution of body donation programs. The authors further considered in the analysis also the state of the art in some other European countries. Results: The analysis carried out showed that nowadays there are many differences in the legislation of the states. The adoption of this law proposal equates the Italian regulatory framework with that of other European nations. Conclusion: The law proposal analyzed, updating the now outdated Italian legislation about cadaveric donation, represents a major step forward. It will facilitate scientific research and medical training in our country. It is nevertheless necessary, to make an additional effort in order to raise public awareness on this topic in order to ensure a successful application of the rule in question. Conclusion: The law proposal analyzed, updating the now outdated Italian legislation about cadaveric donation, represents a major step forward. It will facilitate scientific research and medical training in our country. It is nevertheless necessary, to make an additional effort in order to raise public awareness on this topic in order to ensure a successful application of the rule in question
Traumatic injuries by conducted electrical weapons. Case report of self-injury to the hand during stun gun training
No full textThe use of non-lethal weapons has spread worldwide, being introduced as an alternative to firearms in many countries such as the United States or the United Kingdom. Among non-lethal weapons, conducted electrical weapons have been adopted worldwide, to control unruly suspected criminals or to neutralise violent situations. The stun gun belongs to this category and is the most widely available, with more than 140,000 units in use by police officers in the field in the US, and an additional 100,000 electrical stun guns owned by civilians worldwide. In Italy, the use of conducted electrical weapons by law enforcement has only recently been introduced, with private use and commercialisation still prohibited, mainly due to controversies related to the potential dangers of such devices.Before the official adoption, several experiments had to be carried out, with mechanisms that reproduced the ballistics of the stun gun. Here we present the case of a man who suffered a self-injury trauma to his hand during a ballistics exercise with a crossbow loaded with stun gun probes
SPLENIC RUPTURE DURING COLONOSCOPY: COMPLICATION OR MEDICAL ERROR? CASE REPORT AND MEDICO LEGAL IMPLICATIONS
No full textIl consenso informato e i farmaci off-label durante l'emergenza covid-19
No full textII consenso informato è l’atto di volontà espresso dal paziente, che presuppone l’informazione dettagliata del medico, in ordine alla terapia a cui il soggetto si sottoporrà. Durante l'epidemia COVID-19 il medico è costretto a usare farmaci off label, che impediscono la corretta informazione terapeutica a causa della mancanza di studi scientific
Law proposal “provisions on the post-mortem body donation and the use of bodies for the purposes of study, scientific research and training”: comment and analysis of the bill and the historical-juridical-ethical aspects of cadaveric dissection and practice of the donation of a corpse for scientific and medical training purposes.
No full textLisfranc fracture-dislocation: A case report
No full textThe tarsometatarsal joint is an anatomic area where a wide spectrum of injuries can occur. Regarding the damage mechanism, indirect injuries are more frequent and usually occur during bending or twisting movements applied to the midfoot. This mechanism is very common in sports but also possible in household accidents and falls. Patients can present with pain localized in the midfoot which can include swelling and functional disability to bear weight after trauma. Due to the diversity of injuries, there is no single evidence-based policy for treating all Lisfranc injuries in a similar manner. The goal of initial presentation of these injuries is directed towards improving the overall alignment of the foot. The diagnosis can be made by evaluating anteroposterior, lateral and 30° oblique X-rays of the foot bearing weight because in some cases the instability will only be evident after load is placed on the feet; minor displacement and smaller fractures may only be detected with CT or MRI. The diagnosis can be difficult and it is missed in up to one third of cases. It is important to recognize these injuries early and start treatment promptly because delayed treatment can lead to chronic pain, functional disability and, in some cases, to medical liability. This case illustrates a traumatic Lisfranc injury misdiagnosed at initial evaluation, which led to chronic pain and permanent functional disability. The aim of this paper is to raise awareness of this rare injury for orthopedic surgeons to avoid cases of malpractice claims and medical liability
“PROVISIONS ON VOLUNTARY MEDICALLY ASSISTANCE IN DYING” BILL: REVIEW AND ANALYSIS OF THE BILL FROM THE HISTORICAL, ETHICAL, AND LEGAL PERSPECTIVE CONCERNING EUTHANASIA IN THE CURRENT ITALIAN AND EUROPEAN CONTEXT"
No full textTelemedicine as a Medical Examination Tool During the Covid-19 Emergency: The Experience of the Onco-Haematology Center of Tor Vergata Hospital in Rome
No full textBackground: Our study analysed the outpatient activity of the onco-hematology Complex Operative Unit (UOC) of Tor Vergata Hospital, Rome coronavirus disease 2019 (Covid-19) center, where, as a result of the sudden and unexpected emergency, healthcare services were provided through telemedicine procedures that can be considered very close to Telehealth. Aim of the study: our retrospective study aimed to assess the widespread use of telemedicine in terms of feasibility and safety related to adverse events, a crucial experience which will make it possible to predict any effective use of such a method in patients with hematological disorders even after the end of the Covid-19 emergency. Materials and methods: At the Day Hospital clinic, from 8 March to 31 May 2020, an outpatient group received 3828 medical teleconsultations and 11,484 additional contacts following the first examination; each patient examined through the telematic method required an average of three supplementary contacts via e-mail or telephone. Results: The follow-up lasted 145 days, and all the events that occurred were monitored. In total, we recorded 16 clinical adverse events, 5 of which classified as major events, and 11 as minor events. Conclusion: The 3828 telematic clinical examinations and the 11,484 additional contacts following the first examination carried out by the onco-haematology UOC of Tor Vergata Hospital, proved how telemedicine, albeit in its basic form, was a key tool in facing the sanitary emergency caused by the sudden spread of Covid-19. An experience that can be considered reliable enough to be replicated in possible post-Covid-19 emergencies. From a medical forensic point of view, the main issues to consider are informed consent, personal data management and professional responsibility profiles
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