The Infanticide: Some Forensic and Ethical Issues

Forensic investigation and clinical treatment of infanticide mother is occasion to reflect about this crime, related to social stigma. The forensic-psychiatric assessment must be anchored on authentic and meaningful clinical relationship to criminal mother, without misinterpretation and controtransferal dynamics, such as emotional reactions of mistrust and stigmatization toward the offender, which prevent the evaluator from a correct psychological and psychopathological comprehension. Otherwise, diachronic, multidisciplinary diagnostic evaluation may lead to strategies for treatment and rehabilitation, which can bring the patient to regain his dignity, his working capacities and social role, in order to ensure the penalty be rehabilitative and not only retributiv

Le linee guida ed il loro valore nel contesto medico legale

Negli ultimi decenni, vi è stata una crescente ricerca di interventi efficaci per migliorare la prognosi dello stroke e numerose linee guida sono state prodotte in tal senso. Ciò ha comportato ultimamente, rispetto al passato, un incremento della sopravvivenza del 10% ed un aumento di soggetti che ha superato la malattia senza riportare gravi disabilità permanenti (paralisi, perdita della parola, della visione, della memoria, ecc.) con una percentuale all’incirca identica. E’ da sottolineare che, a differenza di quanto avviene per altre malattie, dove l’attenzione per migliorare la qualità delle cure è rivolta a promuovere l’uso di singoli farmaci o interventi terapeutici, nell’ictus gli sforzi sono stati essenzialmente concentrati sugli aspetti organizzativi e di gestione multidisciplinare dell’assistenza (stroke care), cioè sul management complessivo del paziente relativamente alla gestione clinica della fase acuta, alla prevenzione delle complicanze più frequenti ed alla riabilitazione, sia in fase precoce, sia in fase post-acuta

Il ruolo dell’odontoiatra nella medicina estetica: norme e indicazioni

Obiettivi. Scopo del lavoro e valutare al laureato in Odontoiatria e Protesi Dentaria se sia consentito attuare trattamenti di Medicina Estetica del volto prospettati per modulare gli effetti negativi dell’invecchiamento e, al contempo, analizzare i cambiamenti estetici delle strutture periorali associati all’et a. Materiali e metodi. Vengono descritti sinteticamente quali trattamenti coinvolgono clinicamente la professione odontoiatrica, con particolare riguardo alle infiltrazioni di tossina botulinica e di filler o volumizzanti, con un cenno anche agli aspetti civilistici e assicurativi correlati a tali trattamenti. Risultati e conclusioni. Nell’ultimo decennio si e registrato un imponente aumento dell’offerta e della domanda di trattamenti di Medicina Estetica del volto, a cui non e seguita, per l’odontoiatra, una chiara espressione normativa professionale; in questo scenario, nel giugno 2010, la presidenza della Commissione Albo Odontoiatri nazionale ha espresso il suo parere di liceit a dei trattamenti da parte degli odontoiatri. Secondo gli autori, il laureato in Odontoiatria ha competenza specifica, nel pedissequo rispetto dei limiti topografici e razionali della legge, nel somministrare trattamenti di Medicina Estetica

Circumcision and Sexually Transmitted Disease Prevention: Evidence and Reticence

Circumcision is one of the oldest surgical procedures and the most common surgical procedure performed on males. It is practiced for three main reasons: ritual or religious meanings, prophylactic hygienic purposes, and therapeutic indications. Male circumcision is advocated as an efficacious prevention strategy against sexually transmitted diseases. One of the main biological mechanisms responsible for the lower human immunodeficiency virus (HIV) infection rate in heterosexual circumcised men is the protective effect of keratinization of the glans. Moreover, male circumcision removes the inner part of the prepuce containing Langerhans cells that are targeted by HIV. Several observational studies showed a protective effect of male circumcision regarding the HIV acquisition in heterosexual men, in women with circumcised partners, and in men who have sex with men with an insertive anal role. Circumcision reduced the infection rate of other sexually transmitted diseases like human papillomavirus (HPV), mycoplasma, and genital ulcer disease. It seems now evident that circumcision has no negative effects on sexual function, sensitivity, sexual sensation, and satisfaction. When performed freely after informed consent, male circumcision is a lawful practice in adults. In children, the lack of an informed consent is overcome by the favorable risk/benefit ratio and the decision whether to circumcise or not pertains to the parents

From Undetectable Equals Untransmittable (U=U) to Breastfeeding: Is the Jump Short?

Background: Vertical transmission of HIV infection may occur during pregnancy, at childbirth or through breastfeeding. Recommendations on the safety of breastfeeding of HIV infected women on effective antiretroviral treatment are not univocal among international guidelines (WHO 2010, EACS 2017, DHHS 2017), leaving space for variability at the patient’s level. Methods: We collected clinical, laboratory and outcome data from 13 HIV-infected pregnant women who, between March 2017 and June 2021, elected to breastfeed their children against specific medical advice. All mothers were on antiretroviral therapy with darunavir or raltegravir plus emtricitabine/tenofovir disoproxil and remained HIV-RNA undetectable and >400 cells/mmc CD4+ lymphocytes during pregnancy and breastfeeding. Prophylactic antiretroviral therapy (zidovudine for 4 weeks) was started immediately after birth in all newborns. The mean duration of breastfeeding was 5.4 months. Newborns were tested for HIV-RNA multiple times: at birth, 1, 3, and 6 months after birth, and 1, 3 and 6 months after the end of breastfeeding. Results: None of the infants were infected by HIV. Conclusions: Our experience, gathered in the setting of freedom of choice on the patient’s side, while insufficient to address the eventual safety of breastfeeding in HIV-infected mothers since the represented cohort is numerically irrelevant, supports the extension of the U=U (Undetectable Equals Untransmittable) paradigm to this setting. Since breastfeeding is often requested by women with HIV planning pregnancy, more extensive comparative studies should be performed