IDIOPATIC LIVER RUPTURE: AN ITALIAN CASE REPORT

The liver can be damaged from an impact (such as in a car accident) or from penetrating trauma (such as a stab or gunshot wound). Liver lesions range from relatively small collections of blood (hematomas) to large deep lacerations. Since the liver is supplied with many large blood vessels, the main problem following a liver injury is severe bleeding. Almost all bleeding from a liver injury occurs in the abdominal cavity. Spontaneous rupture of the liver is a rare occurrence. This is often associated with underlying pathological conditions (pregnant women with HELLP syndrome, liver pathologies such as adenoma, hepatic lymphoma, hepatocellular carcinoma HCC, macronodular cirrhosis, hemangioma, metastatic tumors and peliosis hepatis) or following traumatic insults. The authors report a rare case of spontaneous rupture of the liver that occurred in a 72-year-old man without underlying pathologies predisposing this condition, in the absence of evident traumatic lesions in the abdominal area and with a near-negative pathological history of trauma (falls, road accidents, etc.)

An unusual suicide by carbon monoxide intoxication: 91% HbCO saturation in a sealed setting

Carbon monoxide (CO) is the most common lethal poison in every community yet studied. Accidental or suicidal CO poisoning has been reported as the most frequent manner of death. In the case we report here, a man was found dead inside his house with a strong smell of burning. The house presented no signs of effraction, and a lot of scotch tape was placed around the windows and doors edges as well as the keyholes to avoid any passage of air. Near the bed, there was an extinguished brazier with combusted carbon. After the external examination of the body a toxicological analysis was performed. The results pointed out 91% HbCO saturation in absence of signs of intermediate intoxication on the body or on the scene. This article aims to outline the importance of performing a multidisciplinary approach that includes an accurate crime scene investigation and a proper toxicological assessment, to evaluate the cause of death in cases of suspected CO inhalation suicide. The crime scene investigation together with the very high levels of HbCO saturation detected, suggest a possible correlation between time of exposure, source of CO, and saturation levels

Evolutionary History of Chromosome 20

The evolutionary history of human chromosome 20 in primates was investigated using a panel of human BAC/PAC probes spaced along the chromosome. Oligonucleotide primers derived from the sequence of each human clone were used to screen horse, cat, pig, and black lemur BAC libraries to assemble, for each species, a panel of probes mapping to chromosomal loci orthologous to the loci encompassed by the human BACs. This approach facilitated marker-order comparison aimed at defining marker arrangement in primate ancestor. To this goal, we also took advantage of the mouse and rat draft sequences. The almost perfect colinearity of chromosome 20 sequence in humans and mouse could be interpreted as evidence that their form was ancestral to primates. Contrary to this view, we found that horse, macaque, and two New World monkeys share the same marker-order arrangement from which the human and mouse forms can be derived, assuming similar but distinct inversions that fully account for the small difference in marker arrangement between humans and mouse. The evolutionary history of this chromosome unveiled also two centromere repositioning events in New World monkey species

Investigation into the Coupling of Micro Gas Turbines with CSP Technology: OMSoP Project☆

Abstract Solar power generation has been gaining worldwide increasing interest by virtue of its ability to meet both the growing energy needs and the increasing concerns on the carbon dioxide emissions. One of the most promising Concentrated Solar Power (CSP) technologies under development uses a parabolic dish to concentrate solar power into a focal point, raising thetemperature of a working fluid which is then used in a thermodynamic cycle to generate electricity. In the OMSoP project, funded by the European Commission, it is proposed to use a Brayton cycle in the form of a micro-gas turbine (MGT), which replaces the more conventional Stirling engine,with the aim of increasing the ratio of the electric power generated to the solar energy collected and improving the operability in relation to solar energy short time fluctuations. To achieve these objectives, research and development will be conducted in all aspects of the system leading to a full scale demonstrative plant to be located at the ENEA Casaccia Research Centre.The present work deals with the activities carried out so far by ENEA, which is principally involved in the development and experimental characterization of the dish component, and in the integration of the complete system, both in terms of modelling and realization

Evolutionary history of chromosome 11 featuring four distinct centromere repositioning events in Catarrhini.

Abstract Panels of BAC clones used in FISH experiments allow a detailed definition of chromosomal marker arrangement and orientation during evolution. This approach has disclosed the centromere repositioning phenomenon, consisting in the activation of a novel, fully functional centromere in an ectopic location, concomitant with the inactivation of the old centromere. In this study, appropriate panels of BAC clones were used to track the chromosome 11 evolutionary history in primates and nonprimate boreoeutherian mammals. Chromosome 11 synteny was found to be highly conserved in both primate and boreoeutherian mammalian ancestors. Amazingly, we detected four centromere repositioning events in primates (in Old World monkeys, in gibbons, in orangutans, and in the Homo–Pan–Gorilla (H-P-G) clade ancestor), and one in Equidae. Both H-P-G and Lar gibbon novel centromeres were flanked by large duplicons with high sequence similarity. Outgroup species analysis revealed that this duplicon was absent in phylogenetically more distant primates. The chromosome 11 ancestral centromere was probably located near the HSA11q telomere. The domain of this inactivated centromere, in humans, is almost devoid of segmental duplications. An inversion occurred in chromosome 11 in the common ancestor of H-P-G. A large duplicon, again absent in outgroup species, was found located adjacent to the inversion breakpoints. In Hominoidea, almost all the five largest duplicons of this chromosome appeared involved in significant evolutionary architectural changes

Medical Legal Aspects of Telemedicine in Italy: Application Fields, Professional Liability and Focus on Care Services During the COVID-19 Health Emergency

Telemedicine services can be classified into the macro-categories of specialist Telemedicine, Tele-health and Tele-assistance. From a regulatory perspective, in Italy, the first provision dedicated to the implementation of Telemedicine services is represented by the Agreement between the Government and the Regions on the document bearing “Telemedicine—National guidelines,” approved by the General Assembly of the Superior Health Council in the session of 10th July 2012 and by the State Regions Conference in the session of 20th February 2014. Scientifically, several studies in the literature state that information and communication technologies have great potential to reduce the costs of health care services in terms of planning and making appropriate decisions that provide timely tools to patients. Another clear benefit is the equity of access to health care. The evolution of telemedicine poses a series of legal problems ranging from the profiles on the subject of authorization and accreditation to those concerning the protection of patient confidentiality, the definition and solution of which, in the absence of specific regulatory provisions, is mainly left to the assessment of compatibility of the practices adopted so far, with the general regulatory framework. In terms of professional liability, it is necessary to first clarify that the telemedicine service is comparable to any diagnostic-therapeutic health service considering that the telemedicine service does not replace the traditional health service, but integrates the latter to improve its effectiveness, efficiency and appropriateness

Off-label use of covid-19 vaccines from ethical issues to medico-legal aspects: An italian perspective

During the COVID-19 outbreak, the lack of official recommendations on the treatment has led healthcare workers to use multiple drugs not specifically tested and approved for the new insidious disease. After the availability of the first COVID-19 vaccines (Comirnaty Pfizer-BioNTech and Moderna COVID19 vaccine), an authorization was issued by national and international Drug Regulatory Agencies in order to speed up their introduction on the market and their administration on a large scale. Despite the authorization, the off-label use of these vaccines may still be possible especially to answer specific concerns as the lack of vaccine doses, the delay in the delivery of planned doses or the pressure from public opinion and political influence also in relation to the evolution of the pandemic. This paper aims to assess the possible off-label use of COVID-19 vaccines and the ethical and medico-legal implications of this eventuality. The scope of this paper is to point out the possible consequences of off-label use of COVID-19 vaccines and possible mitigation and preventive measures to be taken by healthcare workers involved in vaccination procedures