Is the team leading surgeon criminally liable for his collaborators’ errors? judges confirm responsibility and condemn an otorhinolaryngologist

In current healthcare, delivery of medical and surgical treatment takes place in a multidisciplinary manner. This raises the problem of distinguishing the conditions under which the person who has properly carried out his duties, respecting the related leges artis, can be held responsible for damages materially caused by another member of the medical team. Jurisprudence has developed the so-called “principle of trust” for which every member of the team can rely on the fact that other members are acting in compliance with the leges artis of their specialisation. The Supreme Court has limited the application of this principle. The authors examine the jurisprudence on responsibility of the team in otolaryngology and conclude that individual liability should be limited to the specific expertise of the individual specialist

Liability arising from restraint use in psychiatry [Responsabilità professionale derivante dall’uso della contenzione in psichiatria]

Lo scopo del presente articolo è quello di valutare se e quando l'uso della contenzione può essere giustificato in psichiatria. Gli autori espongono i vari tipi di costrizione e i rischi che tali mezzi comportano per il benessere psicofisico del paziente, soffermandosi ad analizzare se tali pratiche costituiscano realmente forme di cura sanitaria. Infatti, una risposta negativa a tale domanda comporterebbe che la contenzione non è mai obbligatoria e può essere eseguita solo in stato di necessità. Una risposta affermativa, invece, significherebbe che condizioni straordinarie potrebbero rendere obbligatoria la contenzione. Di conseguenza, i medici possono essere ritenuti legalmente responsabili se non usano la contenzione quando necessario per impedire ai pazienti di compiere atti di autolesionismo o danni ad altri. Poiché la contenzione di per sé comporta pesanti limitazioni alla libertà personale (art. 13 Cost.) e gravi rischi per la salute (art. 32 Cost.) essa può considerarsi obbligatoria solo se sono rispettati i criteri dello stato di assoluta necessità (ex art. 54 Cost. della legge penale italiana). Tali parametri dovrebbero essere fissati a livello nazionale e non locale.This article aims to lay out an assessment of whether and when restraint use may be warranted in psychiatry. The authors lay out various types of restraints and the risks posed by such means for the patient’s psychophysical well-being, wondering whether such practices really constitute forms of health care treatment. A negative response to that question would entail that restraint is never compulsory and can only be performed under the state of necessity. An affirmative answer, on the other hand, would mean that extraordinary conditions could make restraint mandatory. As a consequence of that, doctors may be held legally liable whether they fail to use restraint when necessary to keep patients from engaging in self-harm or harm against others. Since restraint per se entails heavy limitations to personal freedom (art. 13 Cost.) and serious risks for health (art. 32 Cost.) it can only be considered compulsory if the standards of an absolute state of necessity are met (under article 54 of Italian criminal statutes). Such parameters should be set on a national, rather than local, level. © 2021 Author(s)

The transposition of council directive 2013/59 into italian law

By the European Directive no. 2013/59 Euratom, the European Union has aimed to provide Member States with updated instructions in order to prevent damages possibly arising from radiations in health care, work and social settings. Among the most relevant amendments, the authors have found: a) the introductions of new defining criteria; b) the updating of some dosage related standards, such as the one about the threshold absorbed by the crystalline lens; c) a new set of rules for the measurement of emissions from devices and data management; d) a greater degree of clarity in ascribing liability to anyone involved in utilizing ionizing radiation-emitting devices. The paper outlines the Italian legislative state of affairs by delving into all relevant aspects of the current legislation, what has been put in place in the process of enacting the European Directive and the measures that could be suitable for future improvement

L'evoluzione giurisprudenziale in materia di responsabilità professionale medica

in corso di stamp

Smart drugs and synthetic androgens for cognitive and physical enhancement: revolving doors of cosmetic neurology

Cognitive enhancement can be defined as the use of drugs and/or other means with the aim to improve the cognitive functions of healthy subjects in particular memory, attention, creativity and intelligence in the absence of any medical indication. Currently, it represents one of the most debated topics in the neuroscience community. Human beings always wanted to use substances to improve their cognitive functions, from the use of hallucinogens in ancient civilizations in an attempt to allow them to better communicate with their gods, to the widespread use of caffeine under various forms (energy drinks, tablets, etc.), to the more recent development of drugs such as stimulants and glutamate activators. In the last ten years, increasing attention has been given to the use of cognitive enhancers, but up to now there is still only a limited amount of information concerning the use, effect and functioning of cognitive enhancement in daily life on healthy subjects. The first aim of this paper was to review current trends in the misuse of smart drugs (also known as Nootropics) presently available on the market focusing in detail on methylphenidate, trying to evaluate the potential risk in healthy individuals, especially teenagers and young adults. Moreover, the authors have explored the issue of cognitive enhancement compared to the use of Anabolic Androgenic Steroids (AAS) in sports. Finally, a brief overview of the ethical considerations surrounding human enhancement has been examined

Top-Down Delivery of IoT-based Applications for Seniors Behavior Change Capturing Exploiting a Model-Driven Approach

Developing Internet of Things (IoT) requires expertise and considerable skills in different fields in order to cover all the involved heterogeneous technologies, communication formats and protocols. Developers and experts ask for new solutions that speed up the prototyping of IoT applications. One of these solutions is Web of Topics (WoX) middleware, a model-driven Cloud platform that aims to ease IoT applications developing, introducing a strong semantic abstraction of the IoT concepts. In WoX, almost all the IoT entities and concepts are limited to the concept of Topic, i.e. an entity containing the value of a feature of interest that we intend to detect. The local counterpart of WoX is L-WoX (Local-Web of Topics), which manages local instances of features of interest, allowing mobile applications to collaborate among them, offering and receiving data to/from smart objects, and enabling the communication with WoX Cloud platform. The presented study leverages WoX approach for showing an experience in rapid design and prototyping of an ambient assisted living system that detects the movements of elderly persons in their home, acquiring data through sensors in an unobtrusive way. Moreover, The paper shows that the chosen model-driven solution is very suitable in a top-down approach, starting from users requirements: the created system simplifies the user-centered design of IoT applications, adopting a full top-down approach from user required to the technological solution

beta-Secretase1 biological markers for Alzheimer's disease : state-of-art of validation and qualification

beta -Secretase1 (BACE1) protein concentrations and rates of enzyme activity, analyzed in human bodily fluids, are promising candidate biological markers for guidance in clinical trials investigating BACE1 inhibitors to halt or delay the dysregulation of the amyloid-beta pathway in Alzheimer's disease (AD). A robust body of evidence demonstrates an association between cerebrospinal fluid/blood BACE1 biomarkers and core pathophysiological mechanisms of AD, such as brain protein misfolding and aggregration, neurodegeneration, and synaptic dysfunction.In pharmacological trials, BACE1 candidate biomarkers may be applied to a wide set of contexts of use (CoU), including proof of mechanism, dose-finding, response and toxicity dose estimation. For clinical CoU, BACE1 biomarkers show good performance for prognosis and disease prediction.The roadmap toward validation and qualification of BACE1 biomarkers requires standardized pre-analytical and analytical protocols to reduce inter-site variance that may have contributed to inconsistent results.BACE1 biomarker-drug co-development programs, including biomarker-guided outcomes and endpoints, may support the identification of sub-populations with a higher probability to benefit from BACE1 inhibitors with a reduced risk of adverse effects, in line with the evolving precision medicine paradigm

New generation of optical robotic sensor applied to small notch detection

In this paper the experimental application of a new class of an optical pressure sensor based on polydimethylsiloxane (PDMS)-Au is shown. The sensor consists of a tapered bended optical fiber, where an optical signal goes across, embedded into a PDMS-gold nanocomposite material (GNM) and it is used for scanning surfaces while it is moved automatically by a controlled servomotor. The sensor data during the scanning may be used for detecting a small notch on a beam. The experimental results are very encouraging for foreseeing successful use of this new sensor in robotic applications

Relationship between coronary plaque morphology of the left anterior descending artery and 12 months clinical outcome: the CLIMA study

Abstract Aims The CLIMA study, on the relationship between coronary plaque morphology of the left anterior descending artery and twelve months clinical outcome, was designed to explore the predictive value of multiple high-risk plaque features in the same coronary lesion [minimum lumen area (MLA), fibrous cap thickness (FCT), lipid arc circumferential extension, and presence of optical coherence tomography (OCT)-defined macrophages] as detected by OCT. Composite of cardiac death and target segment myocardial infarction was the primary clinical endpoint. Methods and results From January 2013 to December 2016, 1003 patients undergoing OCT evaluation of the untreated proximal left anterior descending coronary artery in the context of clinically indicated coronary angiogram were prospectively enrolled at 11 independent centres (clinicaltrial.gov identifier NCT02883088). At 1-year, the primary clinical endpoint was observed in 37 patients (3.7%). In a total of 1776 lipid plaques, presence of MLA 180° (HR 2.4, 95% CI 1.2–4.8), and OCT-defined macrophages (HR 2.7, 95% CI 1.2–6.1) were all associated with increased risk of the primary endpoint. The pre-specified combination of plaque features (simultaneous presence of the four OCT criteria in the same plaque) was observed in 18.9% of patients experiencing the primary endpoint and was an independent predictor of events (HR 7.54, 95% CI 3.1–18.6). Conclusion The simultaneous presence of four high-risk OCT plaque features was found to be associated with a higher risk of major coronary events