Sicurezza e Fitosanitari

Gli Autori descrivono i rischi tossicologici dei prodotti fitosanitari illustrando la normativa di riferimento e le misure di prevenzione e protezioneThe authors describe the toxicological risks of plant protection products, illustrating the relevant regulations and measures of prevention and protectio

Clinical and psychosocial correlates of post-herpetic neuralgia

Post-herpetic neuralgia is the most challenging and debilitating complication of herpes zoster in the immunocompetent host. Because the effect of treatment is disappointing once the syndrome has developed, it is important to know which factors predict post-herpetic neuralgia occurrence to facilitate selection of herpes zoster patients with a higher risk of developing neuralgia and undertake preventative strategies. The present study aimed at identifying demographic, clinical and psychosocial correlates of post-herpetic neuralgia in a sample of 219 immunocompetent patients, who were examined by dermatologists in private practice in Italy and who completed a questionnaire designed to evaluate their clinical and psychosocial profile at the time of clinical diagnosis of herpes zoster and at a follow-up visit 6 months later. In a univariate analysis, post-herpetic neuralgia was associated significantly with older age, longer duration of prodromal pain, greater acute pain intensity, greater extent of rash, presence of abnormal sensations and use of systemic antiviral therapy. Compared to the values at herpes zoster onset, at the follow-up visit patients with post-herpetic neuralgia presented with similar high mean scores of pain intensity, anxiety and depression and greatly reduced quality of life, whereas patients without neuralgia presented with improved scores. In a multivariate model, older age, greater acute pain intensity, greater extent of rash and longer duration of prodromal pain were independently associated with post-herpetic neuralgia. The results of this study may help physicians to identify patients with a higher risk of developing post-herpetic neuralgia and undertaking preventative strategies

Environmental tobacco smoke: health policy and focus on Italian legislation.

Worldwide tobacco smoking kills nearly 6 million people each year, including more than 600,000 non-smokers who die from smoke exposure. Environmental tobacco smoke (ETS, also called secondhand smoke, involuntary smoke, or passive smoke) is the combination of sidestream smoke, the smoke given off by a burning tobacco product and mainstream smoke, the smoke exhaled by smokers. People may be exposed to ETS in homes, cars, workplaces, and public places, such as bars, restaurants, and recreational settings. In addition, there is another type of smoke which until now has not been recognized: the so-called thirdhand smoke, that comes from the reaction of mainstream smoke and environmental nitrous acid (HNO2) making carcinogenic tobacco-specific nitrosamines (TSNAs). The effects of ETS on human health are well-known, passive smoking is harmful to those who breathe the toxins and it is a serious problem for public health. The smoking ban in Italy had reduced ETS pollution, as in the United States and in other countries all over the world. However, the implementation of comprehensive legislation on smoking policy will necessitate other tobacco control measures for its successful fulfillment: increased media awareness, telephone smoking cessation helplines and smoking cessation support services could be an opportunity to ensure awareness, comprehension and support to those who want to quit smoking. The effectiveness of legislative efforts will also depend on successful enforcement of smoking bans and compliance with the legislation. This review summarizes the evidences about the effect of ETS and provides an overview of smoke-free laws and policies

Medical Liability: Review of a Whole Year of Judgments of the Civil Court of Rome

Background: Complaints about medical malpractice have increased over time in Italy, as well as other countries around the world. This scenario, perceived by some as a "malpractice crisis", is a subject of debate in health law and medical law. The costs arising from medical liability lawsuits weigh not only on individual professionals but also on the budgets of healthcare facilities, many of which in Italy are supported by public funds. A full understanding of the phenomenon of medical malpractice appears necessary in order to manage this spreading issue and possibly to reduce the health liability costs. Methods: The retrospective review concerned all the judgments drawn up by the Judges of the Civil Court of Rome, XIII Chamber (competent and specialized section for professional liability trials) published between January 2018 and February 2019. Results: The analysis of data concerning the involved parties showed that in 84.6% of the judgments taken into account, one or more health facilities were sued, while in 58.2% of cases, one or more health workers were present among the defendants. When healthcare providers are the only ones to be summoned, it is dentists and aesthetic doctors/plastic surgeons who undergo most of the claims. In the overall period analyzed, the amount paid was 23,489,254.08 EUR with an average of 163,119.82 EUR. Conclusion: The evidence provided by the reported data is a useful tool to understand medical malpractice in Italy, especially with regard to the occurrence of the phenomenon at a legal level, an aspect still hardly mentioned by existing literature

Telemedicine as a Medical Examination Tool During the Covid-19 Emergency: The Experience of the Onco-Haematology Center of Tor Vergata Hospital in Rome

Background: 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

Multi-messenger observations of a binary neutron star merger

On 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of ~1.7 s with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg2 at a luminosity distance of 40+8-8 Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 Mo. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at ~40 Mpc) less than 11 hours after the merger by the One- Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ~10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position ~9 and ~16 days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta

Il parere del medico legale

Discusses aspects of outsourcing in forensic imaging with particular reference to developments in case la