ELECTROTHERAPY IN THE TREATMENT OF PATIENTS AFFECTED BY RABIES: EXPERIMENTS CONDUCTED AT THE “MAGGIORE” HOSPITAL OF MILAN IN 1865

During the nineteenth century, the scientific context of rabies treatment was weak due to the lack of the literature on specific nosology of the rabies disease, and unspecific and ineffective therapy approaches. Electrotherapy already represented an important therapeutic approach for nervous system diseases, although not specifically for rabies. In the present paper, the authors discuss the use of electrotherapy in the treatment of humans affected by rabies in an experimental study conducted at the Maggiore Hospital of Milan, with the aim of establishing the discovery of a possible specific therapy. By analyzing the printed scientific sources available in the Braidense Library of Milan, the authors describe four experiments conducted on patients of different ages. Symptoms and effects both during and after the electrotherapy are also highlighted. The experiments demonstrated that electricity is not an effective therapy in the treatment of rabies, being rather able to cause serious functional and organic alterations in all the patients. Analyzing the Milanese experiments, the authors reported specific Italian history of a scientific and medical approach to rabies at the end of the 18th century, which led to the promotion of health education, reinforced prevention strategies and opened the way to the vaccination era

The "Canone Inverso": when tobacco was not so bad. A Look Back at the Primordial Debate on the tobacco effects in the Occupational Medicine

AIM: The article provides an overview on the beginning and evolutions of medical observations on tobacco induced diseases between Eighteenth and Nineteenth century. METHODS: By searching for historical medical literature, first studies on tobacco-induced diseases focused on production risks rather than on adverse effects that the use of tobacco has for the human health. RESULTS: The approach induced first eighteenth-century authors to define this substance as a non-pathogenic and, consequently, not to consider tobacco factories dangerous for health workers. In those years, tobacco was employed in therapy as a stimulant treatment and it was considered harmless and even healthy and preventive of several acute diseases. CONCLUSIONS: Authors will show that studies on pathogenic effects of smoking will only start around late nineteenth century, when the idea of the healthiness of tobacco industry was already supported

Does defensive medicine change the behaviors of vascular surgeons? a qualitative review

Although in literature few successful claims have been shown in comparison with other medical specialties such as gynaecology and orthopaedics, vascular surgery is included among high-risk specialties. The high-risk of receiving medical claims may lead vascular surgeons to practice defensive medicine, as is normal in several other areas of clinical practice. No studies are available to our knowledge of the incidence of defensive medicine in the field of vascular surgery. Taking into consideration the scarce amount of information, the authors provide a critical discussion regarding the application of defensive medicine behaviour among vascular surgeon

Two sides of the same coin: educational and professional pathway for surgical residents

Aim: To provide a review of medical malpractice cases ruled by the Italian Supreme Court with the aims at identifying lawsuits targeting involved with surgical residents. Material and methods: Legal cases ruled by the Italian Supreme Court, from September 2020 to October 2020, pertaining to medical claims involving surgical residents were examined, using the main online databases. Results: Of a total of eleven (n=11; 100%) cases identified, four (n= 4; 36,4%) cases addressed the standard of care pertaining to the surgical residents' medical activity. The legal reasoning of the Italian Supreme Court does not focus on the manual skill in the resident's medical performance, but rather on the choice to accept to treat the patient, regardless of the participation of the tutor. Conclusions: The performance of the surgical residents is made more difficult due to their peculiar nature, characterized by the complex interactions between the directives given by the tutor and the need to guarantee patients' needs

Palliative care and covid-19 pandemic between hospital-centric based approach and decentralisation of health services: a valuable opportunity to turn the corner?

Italy was the first Western EU country to have dealt with the severe effects of the widespread Covid-19 virus since the pandemic began. Many healthcare services were negatively affected, and the delivery of palliative care has been no exception. The Italian healthcare system has suffered more than others due to public spending cuts. The hospital-based approach has not allowed all patients to receive appropriate care. This situation was brought about not only by the pandemic emergency but mainly by pre-existing shortages due to the cut in financial resources before the Covid-19 pandemic. For countries similar to Italy, it is necessary to develop territorialised health care, decongestion hospitals, and strengthen the Third Sector, particularly the voluntary sector

ELEKTROTERAPIJA U LIJEČENJU PACIJENATA ZARAŽENIH BJESNOĆOM: POKUSI PROVOĐENI U BOLNICI MAGGIORE U MILANU TIJEKOM 1865. GODINE

During the nineteenth century, the scientific context of rabies treatment was weak due to the lack of the literature on specific nosology of the rabies disease, and unspecific and ineffective therapy approaches. Electrotherapy already represented an important therapeutic approach for nervous system diseases, although not specifically for rabies. In the present paper, the authors discuss the use of electrotherapy in the treatment of humans affected by rabies in an experimental study conducted at the Maggiore Hospital of Milan, with the aim of establishing the discovery of a possible specific therapy. By analyzing the printed scientific sources available in the Braidense Library of Milan, the authors describefour experiments conducted on patients of different ages. Symptoms and effects both during and after the electrotherapy are also highlighted. The experiments demonstrated that electricity is not an effective therapy in the treatment of rabies, being rather able to cause serious functional and organic alterations in all the patients. Analyzing the Milanese experiments, the authors reported specific Italian history of a scientific and medical approach to rabies at the end of the 18th century, which led to the promotion of health education, reinforced prevention strategies and opened the way to the vaccination era.Tijekom 19. stoljeća znanstvena osnova liječenja bjesnoće bila je slaba zbog nedostatka literature o specifičnom uzročniku bjesnoće te nespecifične i neučinkovite terapije. Elektroterapija je već predstavljala važan terapijski pristup kod bolesti živčanog sustava, iako ne specifično za bjesnoću. U ovom radu autori raspravljaju o uporabi elektroterapije u liječenju ljudi oboljelih od bjesnoće u eksperimentalnoj studiji provedenoj u bolnici Maggiore u Milanu, s ciljem ustanovljenja otkrića moguće specifične terapije. Kroz analizu tiskanih znanstvenih izvora, dostupnih u knjižnici Braidense u Milanu, autori opisuju četiri pokusa provedena na pacijentima različite dobi. Istaknuti su simptomi i učinci tijekom i nakon elektroterapije. Prikazani pokusi pokazali su da struja nije učinkovita terapija u liječenju bjesnoće, već može uzrokovati ozbiljne funkcionalne i organske promjene kod pacijenata. Analizirajući milanske pokuse, autori su prikazali specifično talijansku povijest znanstvenoga i medicinskoga pristupa bjesnoći na kraju 18. stoljeća, što je dovelo do promocije zdravstvenoga odgoja, ojačalo strategiju prevencije i otvorilo put prema eri cijepljenja

Colpa medica, la cassazione a sezioni unite fa il punto sul diritto del neonato malformato al risarcimento del danno

La Corte di cassazione a Sezione Unite con la sentenza del 22 dicembre 2015, n. 25767, oggetto di commento, è stata chiamata dalla terza civile a dirimere un importante contrasto giurisprudenziale su una delle tematiche più attuali e controverse, anche a livello europeo, dell’inizio vita: il « wrongful birth » e il « wrongful life ». I motivi di ricorso presi in esame dall’organo giudicante di fatto vertono su due punti nodali: 1) il primo attiene all’onere probatorio e a chi questo competa ovvero se possa corrispondere a regolarità causale che la gestante interrompa la gravidanza, se informata di gravi malformazioni del feto, secondo un orientamento giurisprudenziale più risalente nel tempo; oppure se sia da escludere tale presunzione semplice, ponendo a carico della parte attrice di allegare e dimostrare che, se informata delle malformazioni del concepito, avrebbe interrotto la gravidanza, secondo l’orientamento più recente; 2) il secondo motivo di ricorso solleva un contrasto giurisprudenziale ancora più netto, interessando la questione della legittimazione del nato a pretendere il risarcimento del danno a carico del medico e della struttura sanitaria. La Corte di Cassazione a Sezione Unite ha accolto il primo motivo di ricorso con rinvio alla Corte d’Appello di Firenze, in diversa composizione, per un nuovo giudizio, e rigettato il secondo.The Supreme Court of Cassation in Joint Sitting, with the judgment no. 25767 of 22nd December 205, was called to solve an important conflict of the case law about one of the most actual and controversial topics, also in Europe, regarding the beginning of life: the “wrongful birth” and “wrongful life”. The grounds of appeal examined by the Court focus on two key points: 1) the first one concerns the issue of the burden of proof and of who is responsible for it, i.e. if the pregnant woman, informed of severe fetal malformations, is allowed to interrupt the pregnancy, according to an elder case-law trend; or if this simple presumption is to be excluded, charging the complaining party to demonstrate that, if informed of the presence of fetal malformations, she would have terminated the pregnancy, according to a more recent trend; 2) the second one raises an even more sharp jurisprudential conflict, concerning the issue of the legitimacy of the child’s request of compensation borne by the physician and the related health-care structure. The Supreme Court of Cassation in Joint Sitting, admitted the first ground of appeal referring to the Court of Appeal of Florence, in different composition, for a new judgment, and rejected the second one

L'evoluzione giurisprudenziale in materia di responsabilità professionale medica

in corso di stamp