1,721,115 research outputs found
I principi dell'autonomia vincolata, dell'autonomia limitata e dell'affidamento nella definizione della responsabilità medica. Il ruolo del capo-equipe e dell'assistente alla luce della recente giurisprudenza
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The Post-Lockdown Era: What Is Next in Italy?
Full text linkThe current outbreak of the COVID-19 infection, which started in December 2019 in Wuhan
(China), was declared a pandemic by the World Health Organization (WHO) on the 11th of
March, 2020
A fatal case due to a pitchfork penetrating head injury
No full textPenetrating head injuries can be the result of numerous intentional or unintentional events, including missile wounds, stab wounds, and motor vehicle or occupational accidents (nails, screwdrivers). The most common wound is a knife injury, although bizarre craniocerebral-perforating injuries have been reported that were caused by nails, metal poles, ice picks, keys, pencils, chopsticks, and power drills. Here is presented the case of a farmer wounded with a pitchfork.
In a country area in the South of Italy, a 56-year-old Caucasian farmer was found unresponsive from his father-in-law, few meters before their farmland, with a tine of the pitchfork penetrated in the right eye. He was quickly taken by helicopter to the nearest hospital in serious clinical condition and immediately accepted in the Intensive Care Unit. Glasgow Coma Scale score was 3. In the right eye, was detected a penetrating circular wound. The cranium CT showed a large haemorrhagic area in the right frontal-temporal-parietal lobe, hemoventricle and right to left brain shift; in right occipital region was present radiological evidence of subarachnoid hemorrhage and fractures of lateral wall of orbital bone. Neurosurgical treatment was performed for subarachnoid hemorrhage, but four days after the penetrating stab trauma, the man was pronounced dead
A case of death related to underwater propeller at a desalination plant during illegal scuba fishing
No full textCave canem: bite mark analysis in a fatal dog pack attack
No full textDeaths resulting from animal attacks are rare, and according to The Humane Society of the United States, more than 300 individuals died of dog attacks in the United States from 1979 to 1996. The case of a fatal dog-pack attack on an 83-year-old woman is presented. Wide lacerations of the scalp, several tooth puncture wounds, and bruises reproducing bite marks were recorded on the whole body. Exsanguinations due to brachial artery laceration subsequent to multiple dog bites were indicated as the main cause of death. An integrated study in association with a veterinary doctor was performed on 27 dogs of different breed (24 Cane Corso, 1 Dalmatian, 2 German Shepherds) collecting dental formula and dental casts. Dental casts were superimposed on the victim's wound samples collected at autopsy and analyzed for compatibility-the patterns taken from the jaws of 3 suspected dogs could be clearly adapted on the bite marks. At the end of investigation, the son of the victim indicated the 3 dogs of his own as the responsible ones and he was condemned for manslaughter. Bite marks analysis provided conclusive evidences in identifying the offending animals. The results may be important to give details about bite circumstances and predisposition of specific breeds of dogs to bite or inflict severe bite
L’oggettività morfologica nella morte improvvisa cardiaca: diagnostica e valutazione medico – legale
No full textGli Autori analizzano il fenomeno morte improvvisa cardiaca con particolare riferimento allo studio dei peculiari reperti istomorfologici cardiaci. L’obiettivo dello studio è quello di raggiungere o, perlomeno, avvicinarsi ad una definizione patogenetica, su base istomorfologica, della morte cardiaca, nell’intento di fornire elementi alla autonomia nosologica della categoria medico –legale in questione. Come premessa, gli AA. ripercorrono il ciclo perpetuo di contrazione – rilassamento della fibra miocardica e, soprattutto, dei momenti alterativi di tale ciclo, ognuno caratterizzato da un suo particolare aspetto morfologico (morte atonica; morte tetanica; morte da insufficienza; morte aritmica). Infine, gli AA. si soffermano sui casi di morte improvvisa in cui la morfologia cardiaca è del tutto negativa e nei quali è auspicabile un protocollo di studio che tenga conto delle più aggiornate conoscenze in materia di genomica cardiovascolare
Oxidative-Nitrosative Stress and Myocardial Dysfunctions in Sepsis: Evidence from the Literature and Postmortem Observations
No full textBackground. Myocardial depression in sepsis is common, and it is associated with higher mortality. In recent years, the hypothesis that the myocardial dysfunction during sepsis could be mediated by ischemia related to decreased coronary blood flow waned and a complex mechanism was invoked to explain cardiac dysfunction in sepsis. Oxidative stress unbalance is thought to play a critical role in the pathogenesis of cardiac impairment in septic patients. Aim. In this paper, we review the current literature regarding the pathophysiology of cardiac dysfunction in sepsis, focusing on the possible role of oxidative-nitrosative stress unbalance and mitochondria dysfunction. We discuss these mechanisms within the broad scenario of cardiac involvement in sepsis. Conclusions. Findings from the current literature broaden our understanding of the role of oxidative and nitrosative stress unbalance in the pathophysiology of cardiac dysfunction in sepsis, thus contributing to the establishment of a relationship between these settings and the occurrence of oxidative stress. The complex pathogenesis of septic cardiac failure may explain why, despite the therapeutic strategies, sepsis remains a big clinical challenge for effectively managing the disease to minimize mortality, leading to consideration of the potential therapeutic effects of antioxidant agents
Myocardial tumor necrosis factor-alpha expression in a sudden death due to dilated cardiomyopathy with endomyoelastofibrosis
No full textDuring the clinical course of dilated cardiomyopathy, arrhythmias, thromboembolism and sudden death are common and may occur at any stage. In patients with dilated cardiomyopathy, elevated plasma levels of tumor necrosis factor-α are associated with poor prognosis. In animal experiments and clinical trials, myocardial tumor necrosis factor-α expression correlates with increased mortality rates. A case of sudden death of a previously asymptomatic young man, having a definitive autoptic diagnosis of dilated cardiomyopathy with endomyoelastofibrosis, is presented. We investigated the cardiac morphology and the expression of tumor necrosis factor-α in cardiac tissue specimens to elucidate the role of tumor necrosis factor-α expression in this fatal case. Our results demonstrate a strong positive myocytes reaction for tumor necrosis factor-α in the heart specimens. The pathogenesis of the fatal event is discussed with particular reference to the histological findings and myocytes expression of tumor necrosis factor-α
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