1,721,015 research outputs found
Covid-19 pandemic and pediatric healthcare policy in Italy: time for a change
Full text linkThe outbreak of coronavirus disease 2019 pandemic forced the Italian Government to act extreme measures that put the entire country under lockdown. The citizens experimented a radical transformation of their lives while the healthcare system started building a novel COVID-system that quickly dissolved the former organization, included pediatric healthcare network. For a number of reasons COVID-19 pandemic is polite with children; however, the fear of this unknown disease drove to develop dedicated pathways in the Pediatric Emergency Departments for the suspected and diagnosed cases of COVID-19, together with their relatives. The combination of conflicting feelings resulted in an unexpected scenario: the number of accesses to the pediatric Hospital or Unit(s) sharply dropped to less than half. How do we explain this phenomenon? The authors believe that our health care system may learn a lesson from the catastrophe of COVID, if we will be able to redesign our way of providing our cares to children. Nothing should be taken for granted, because this might be a real “time for a change”
Little patients, large risks: An overview on patient safety management in pediatrics settings
Full text linkPatient safety is an emerging healthcare discipline with the ultimate goal to reduce errors and harm to patients by implementing quality health services. In 1999, the well-known “To Err is Human: Building a safer health system” reported that between 2% and 4% of people die annually in United States hospitals for medical errors. Since that publication, the focus on healthcare safety has encouraged efforts by legislators, hospital government, and health professionals to promote policies and behaviors heavily to reduce errors and implement a safe provision of healthcare delivery. In 2019, the World Health Organization (WHO) declared September 17th as Patient Safety Day, confirming that as a global priority.
The increasing interest in patient safety has significant repercussions on scientific publications with an ever-increasing production of studies in the growing interdisciplinary field of public health. New concepts and new terms had born, such as “clinical risk,” which refers to the probability that a patient can be the victim of an adverse event due to medical care, although unintentionally.
The WHO proposed to adopt a “universal vocabulary” thus standardizing the terminology and allowing effective scientific research. In clinical risk, the most explored field is adult patient safety, where growing interest is shown primarily to prevent nosocomial infections, falls, and pressure injuries. Instead, a little-explored area concerns the pediatric population.
This article aims to overview the spread of pediatric clinical risk management and organizational culture for healthcare quality improvement, looking at what has been done and enhancing healthcare practices to implement inpatient safety. The authors have reviewed the main concerns on pediatric patient safety and issued the main medico-legal aspects. After summarizing the relevant literature, the authors addressed their point of view by writing an opinion article
Children's health and safety: what we learned from the COVID-19 pandemic and future policy's perspective
Full text linkThe wellbeing of minors and older adults has always been a public health target. The health and wellbeing of children, enshrined in the Convention on the Rights of the Child (CRC) in 1989, refer to multiple physical, psychological, social, and economic aspects. The main factors reventing these rights from being secured are poverty, social isolation, and persistent discrimination.
It is well-known that the health system assumes primary importance in investigating and ensuring the wellbeing of little patients. (...
Ethical Challenges in Health Care Policy during COVID-19 Pandemic in Italy
Full text linkSince the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, Italy has proven to be one of the countries with the highest coronavirus-linked death rate. To reduce the impact of SARS-CoV-2 coronavirus, the Italian Government decision-makers issued a series of law decrees that imposed measures limiting social contacts, stopped non-essential production activities, and restructured public health care in order to privilege assistance to patients infected with SARS-CoV-2. Health care services were substantially limited including planned hospitalization and elective surgeries. These substantial measures were criticized due to their impact on individual rights including freedom and autonomy, but were justified by the awareness that hospitals would have been unable to cope with the surge of infected people who needed treatment for COVID-19. The imbalance between the need to guarantee ordinary care and to deal with the pandemic, in a context of limited health resources, raises ethical concerns as well as clinical management issues. The emergency scenario caused by the COVID-19 pandemic, especially in the lockdown phase, led the Government and health care decision-makers to prioritize community safety above the individuals’ rights. This new community-centered approach to clinical care has created tension among the practitioners and exposed health workers to malpractice claims. Reducing the morbidity and mortality rates of the COVID-19 pandemic is the priority of every government, but the legitimate question remains whether the policy that supports this measure could be less harmful for the health care system
Parachuting fatality: A case report video-recorded
Full text linkParachuting accidents are very uncommon and mostly related to landing and incorrect procedures. In these cases, the cause of death is usually easily identified but the events leading up to death are usually a matter for investigation. We describe the case of a former military parachutist who died after civilian skydiving. A total body computed tomography scan, an external examination, and a complete medico-legal autopsy were performed. Furthermore, the fatality was filmed from two different observation points so the specific dynamic of the events and the injuries observed could be explained. This unusual case highlights the importance of a multidisciplinary forensic investigation
A singular case of complex suicide by hanging with hesitation marks by axe
No full textWe present a case of complex suicide concerning a 55-year-old man who hanged himself using a rope anchored to a beam on the terrace of his apartment. Multiple parallel linear wounds were observed on his head. At the crime scene, an axe stained with blood and hair was found resting against the wall adjacent to the stairs leading to the upper floor. Forensic investigations identify the cause of death as mechanical asphyxia due to the hanging, in a complex suicide characterized by hesitation marks inflicted on the head with an axe. This specific type of complex suicide has never been described in the literature
Fatal Rupture of Brachial Pseudoaneurysm in a Drug Abuser: Case Report and Review of the Literature
No full textThe injection of drugs of abuse causes many millions of deaths each year; deaths are mostly due to fatal overdose and the trauma and infection caused by repeated injections. The scientific literature widely reports cases of infected pseudoaneurysm in injecting drug abusers; however, most of these autopsy cases deal with the rupture of pseudoaneurysm of the femoral artery. We present fatal hemorrhagic shock in a heroin-cocaine abuser subsequent to rupture of pseudoaneurysm of the brachial artery; the man collapsed just before injecting himself with a dose of heroin-cocaine (speedball)
Sudden cardiac death in the young: single-center study of Bari autopsy cases
No full textIntroduction: Sudden Cardiac Death (SCD) is one of the main causes of death in the world, with a significant impact especially on young people. Sudden Cardiac Death in the Young (SCDY) is characterized by multifactorial etiology, which includes cardiomyopathies, myocarditis, channelopathies, aortopathies and coronary artery diseases. Despite progress in prevention, a significant percentage of these deaths remain unexplained without a thorough autopsy. This study aims to SCDY cases registered between 2016 and 2024, exploring the association between type of autopsy, age, sex, causes of death and temporal changes. Methods: Data relating to subjects who died for suspected SCDY, who underwent forensic, or hospital autopsy were retrospectively analysed. Investigations included type of autopsy (diagnostic or judicial), age (in years), sex, available clinical data, gross and histological findings, and cause of death. The data were divided by age groups (0–10, 11–20, 21–30, 31–40 years), sex and cause of death (arrhythmias, congenital heart defects, myocarditis, vascular dissections and cardiomyopathies). The temporal distribution of cases was also evaluated. Results: A total of 62 cases were analysed, with a prevalence of male subjects (70%). Forensic autopsies (65%) were more frequent than diagnostic findings (35%). The most represented age groups were 11–20 years (30%) and 21–30 years (25%). Unknown arrhythmias were the main cause (40%), followed by congenital heart disease (20%) and cardiomyopathy (15%). Congenital heart defects prevailed in newborns and children, while hypertrophic or arrhythmogenic cardiomyopathies were more frequently observed in young adults. Temporally, there has been a progressive increase in molecular autopsies and genetic diagnoses, in particular after the introduction of the AECVP (2017) and SCVP (2023) guidelines. Discussion: The findings highlight the need for a multidisciplinary approach to diagnosis of SCDY, with particular emphasis on molecular autopsy to identify genetic causes. The male predominance and age-related etiological differences underline the importance of specific preventive strategies, such as genetic screening in newborns and victims’ relatives. The increase in diagnoses over time reflects the effectiveness of updated guidelines, but it remains crucial to expand the mandatory nature of autopsies to improve understanding of the causes of SCDY and reduce the incidence of these tragic events
Destruction of telecommunications hinders access to healthcare: A crime against humanity?
No full textTechnology infrastructures are key to both military and civilian activities and represented one of the first targets destroyed in past wars. Hence, telecommunication network outages are becoming more common in wars. However, telemedicine could be the only way to help treat military and civilian patients with routine and emergent conditions. There is no legal recognition of telemedicine as a (direct) fundamental right, although healthcare has been considered a human right since 1946
- …
