Certain Aspects Concerning Trial under Admission of Guilt

The trial under admission of guilt is an abbreviated procedure relying on a guilty plea, and it may be applied if the conditions stipulated in the New Criminal Procedure Code are fulfilled. One of these conditions is for the defendant to fully admit of the deeds presented by the prosecutor in the indictment (he must not, however, admit the same upon the legal classification of offences). Pursuant to the simplified procedure, in the case of conviction or postponement of the application of the sanction, the punishment limits stipulated under the law are reduced by one third for imprisonment , and by one fourth for fine sanctions. The present article is a a continuation of the author’s own research and it represents a clear comment regarding trial under admission of guilt according to the New Criminal Procedure Code, in the purpose of understanding the legislator’s intention and how the new regulations will apply

Reliable Messaging to Millions of Users with MigratoryData

Web-based notification services are used by a large range of businesses to selectively distribute live updates to customers, following the publish/subscribe (pub/sub) model. Typical deployments can involve millions of subscribers expecting ordering and delivery guarantees together with low latencies. Notification services must be vertically and horizontally scalable, and adopt replication to provide a reliable service. We report our experience building and operating MigratoryData, a highly-scalable notification service. We discuss the typical requirements of MigratoryData customers, and describe the architecture and design of the service, focusing on scalability and fault tolerance. Our evaluation demonstrates the ability of MigratoryData to handle millions of concurrent connections and support a reliable notification service despite server failures and network disconnections

Post-bariatric contour deformity correction: an endeavour to establish objective criteria nationally.

BACKGROUND A marked increase in bariatric surgery has led to higher numbers of patients with contour deformities after massive weight loss seeking plastic surgical correction. Insurance coverage for these post-bariatric interventions is highly subjective and a common set of objective criteria has not yet been established. AIM The aim was to evaluate the factors influencing insurance coverage for post-bariatric surgery, focusing on finding objective, reproducible criteria. METHODS This was a retrospective single centre chart review of all post-bariatric patients with redundant skin requesting body contouring surgery from 2013 to 2018. Demographic, bariatric and surgical, as well as insurance information were collected. A logistic regression model was used to identify predictors of successful insurance coverage. RESULTS 116 Patients were included in the study. Insurance approval for post-bariatric body contouring surgery was obtained for only 47 patients (41%). Mentioning the term "medical indication" in the application letter was associated with a 15.2 times higher rate of receiving a positive answer (p <0.001), whereas mentioning "mental suffering" was associated with 82.3% lower chance of getting a positive response (p <0.001). A high body mass index (BMI) (p <0.009) before the bariatric operation as well as a high BMI reduction (p <0.021) were associated with a higher approval rate by insurance companies . An additional application letter to the insurance company (p <0.024) as well as mentioning mechanical restriction (p <0.022) were associated with a positive response from the insurance companies. CONCLUSIONS We were able to establish certain objective predictive criteria for insurance coverage of post-bariatric surgery. However, it appears that the decisions of insurance companies for this condition are still rather randomly taken. Therefore, the establishment of objective criteria for insurance coverage may allow fairer treatment for this growing patient population

Jetrena osteodistrofija: globalni pre(po)gled problema

Hepatic osteodystrophy is a common and frequently untreated complication, manifested as osteoporosis or osteopenia, encountered in the evolution of chronic liver diseases. Th is article provides a narrative review of hepatic osteodystrophy. Th e aim is to revise the prevalence, pathophysiology, diagnosis and management of hepatic osteodystrophy. We searched medical literature via PubMed, Google Scholar, Wiley, Science Direct, and Springer Link using respective keywords to obtain data on low bone mineral density connected to chronic liver diseases. Many studies have reported an increased prevalence of osteoporosis/osteopenia in patients with chronic liver diseases. Th e pathogenesis is multifactorial, involving genetic factors, vitamin defi ciencies, proinfl ammatory cytokines, hypogonadism, hyperbilirubinemia, antiviral therapy, corticosteroid drugs, and lifestyle factors. Th e management of patients should include individualized assessment for fracture risk factors and bone mineral density. Vitamin D and calcium supplementation should be recommended in all patients with chronic liver diseases and osteoporosis. Bisphosphonates are the most effi cient drugs used in the treatment of hepatic osteodystrophy. In the future, it is necessary to defi ne better the management and specifi c treatment of hepatic osteodystrophy for prevention of fragility fractures and to improve the patient quality of life.Jetrena osteodistrofi ja je česta i nerijetko neliječena komplikacija koja se manifestira kao osteoporoza ili osteopenija, a susreće se u bolesnika s kroničnim bolestima jetre. Ovaj narativni pregled jetrene osteodistrofi je preispituje učestalost, patofiziologiju, dijagnostiku i liječenje jetrene osteodistrofi je. Proveli smo pretragu medicinske literature u bazama podataka PubMed, Google Scholar, Wiley, Science Direct i Springer Link pomoću prikladnih ključnih riječi kako bismo dobili podatke o niskoj mineralnoj gustoći kosti povezanoj s kroničnim bolestima jetre. Mnoga istraživanja izvještavaju o povećanoj učestalosti osteoporoze/osteopenije u bolesnika s kroničnim jetrenim bolestima. Patogeneza je multifaktorijalna i uključuje genetske čimbenike, pomanjkanje raznih vitamina, proupalne citokine, hipogonadizam, hiperbilirubinemiju, protuvirusnu terapiju, kortikosteroidne lijekove te čimbenike povezane s načinom života. Liječenje ovih bolesnika treba obuhvatiti individualiziranu procjenu čimbenika rizika za prijelome te mineralnu gustoću kosti. Svim bolesnicima s kroničnim bolestima jetre i osteoporozom treba preporučiti uzimanje dodataka vitamina C i kalcija. Bisfosfonati su najučinkovitiji lijekovi za liječenje jetrene osteodistrofi je. Potrebno je bolje defi nirati zbrinjavanje i specifi čno liječenje jetrene osteodistrofi je kako bi se sprije čili prijelomi zbog krhkih kosti te poboljšala kvaliteta života ovih bolesnika

Management of Postoperative Seroma: Recommendations Based on a 12-Year Retrospective Study.

INTRODUCTION Seroma formation is a serious postoperative complication. Since the management algorithms available in the literature are scarce, we aimed to analyze our experience with postoperative seroma in order to identify indicators for revisional surgery and propose recommendations for management. METHODS This retrospective study included all patients with postoperative seroma treated in a tertiary university hospital from 2008 to 2020. Patients' demographics, medical history, and seroma treatment details were recorded and analyzed. RESULTS Overall, 156 patients were included: 41% were initially treated through needle aspiration, with 61% eventually undergoing surgical treatment for postoperative seroma. Comorbidities, such as heart failure and coronary heart disease, were significantly associated with an increased need for revisional surgery (p &lt; 0.05). Both a duration of &gt;40 days of repeated needle aspirations and drain re-insertions were significantly correlated with an increased risk for revisional surgery (p &lt; 0.05). CONCLUSION Patients requiring seroma aspiration should be counseled on surgical treatment sooner rather than later, as prolonged aspiration time (over 40 days) greatly increases the risk of surgical revision. Moreover, the reinsertion of a drain should only be used as a temporizing measure, at most, and patients requiring a drain to control the size of the seroma should promptly be scheduled for a surgical revision

3D Face Reconstruction from 2D Pictures: First Results of a Web-Based Computer Aided System for Aesthetic Procedures

The human face is a vital component of our identity and many people undergo medical aesthetics procedures in order to achieve an ideal or desired look. However, communication between physician and patient is fundamental to understand the patient's wishes and to achieve the desired results. To date, most plastic surgeons rely on either "free hand” 2D drawings on picture printouts or computerized picture morphing. Alternatively, hardware dependent solutions allow facial shapes to be created and planned in 3D, but they are usually expensive or complex to handle. To offer a simple and hardware independent solution, we propose a web-based application that uses 3 standard 2D pictures to create a 3D representation of the patient's face on which facial aesthetic procedures such as filling, skin clearing or rejuvenation, and rhinoplasty are planned in 3D. The proposed application couples a set of well-established methods together in a novel manner to optimize 3D reconstructions for clinical use. Face reconstructions performed with the application were evaluated by two plastic surgeons and also compared to ground truth data. Results showed the application can provide accurate 3D face representations to be used in clinics (within an average of 2mm error) in less than 5mi

Transcutaneous sentinel lymph node detection in cutaneous melanoma with indocyanine green and near-infrared fluorescence: A diagnostic sensitivity study.

Sentinel lymph node (SLN) biopsy with preoperative radiocolloid-based lymphoscintigraphy and blue dye injection is considered the standard procedure for staging nodal metastases in early-stage cutaneous melanoma patients with clinically uninvolved lymph nodes. While this combination renders good accuracy in SLN detection, radiation exposure and the frequent allergic reactions to the blue dye are considered drawbacks of this technique. Indocyanine green (ICG) is a water-soluble fluorescent dye that can be identified through near-infrared fluorescence imaging (NIRFI). The aim of this prospective diagnostic sensitivity study was to assess the feasibility of ICG and NIRFI to identify SLNs in melanoma transcutaneously ("before skin incision") and to analyze the various factors influencing detection rate, in comparison to lymphoscintigraphy. This study included 93 patients undergoing SLN biopsy for cutaneous melanoma. The region and the number of the SLNs identified with lymphoscintigraphy and with ICG were recorded. Patients' characteristics, as well as tumor details were also recorded preoperatively. One hundred and ninety-four SLNs were identified through lymphoscintigraphy. The sensitivity of ICG for transcutaneous identification of the location of the SLNs was 96.1% overall, while the sensitivity rate for the number of SLNs was 79.4%. Gender and age did not seem to influence detection rate, but a body mass index >30 kg/m2 was associated with a lower identification rate of the number of SLNs (P = .045). Transcutaneous identification of SLNs through ICG and NIRFI technology is a feasible technique that could potentially replace in selected patients the standard SLN detection methodology in cutaneous melanoma