Granular Cell Dermatofibroma: When Morphology Still Matters

Dermatofibroma, also known as "fibrous histiocytoma", is one of the most common cutaneous soft-tissue tumors. Many variants of dermatofibromas have been described, and knowledge of these variations is important to avoid misdiagnosis of a possibly more aggressive tumor. Histological features of different variants can coexist in the same lesion, but typical common fibrous histiocytoma features are generally found, at least focally, in all cases. However, when cellular changes make up the majority of the lesion, the histopathological diagnosis can become more complex and requires immunohistochemical investigations for correct nosographic classification. We present the case of a cutaneous fibrous histiocytoma, "granular cell" variant, found on the left leg of a 74-year-old woman

Analysis of Italian requests for compensation in cases of responsibility for healthcare-related infections: A retrospective study

IntroductionThe aim of this study was to examine the type of compensation claims for alleged medical malpractice in the field of healthcare-related infections in Italy.MethodsIt was analyzed which was the most frequent clinical context, the characteristics of the disputes established, which were the alleged damages most often complained of, which were the possibly censurable behaviors of the health professionals, and which were the reasons for acceptance or rejection of the request for compensation.ResultsIn 90.2%, the issue questioned regarded surgical site infections. The most common pathogens involved were coagulase-negative Staphylococci (34.1%) and Staphylococcus aureus (24.4%). The lack or non-adherence to protocols of prophylaxis and/or prevention of healthcare-related infections was the most reported cause of acceptance of the request of compensation.DiscussionAccording to our data, a stronger effort should be made in terms of risk management perspective in order to ensure the develop and application of protocols for prevention of Gram-positive healthcare-related infections and strengthen infection control and antimicrobial stewardship programs

Superparamagnetic Nanoparticles as High Efficiency Magnetic Resonance Imaging T-2 Contrast Agent

Nanoparticle-based magnetic resonance imaging T-2 negative agents are of great interest, and much effort is devoted to increasing cell loading capability while maintaining low cytotoxicity. Herein, two classes of mixed-ligand protected magnetic-responsive, bimetallic gold/iron nano particles (Au/Fe NPs) synthesized by a two-step method are presented. Their structure, surface composition, and magnetic properties are characterized. The two classes of sulfonated Au/Fe NPs, with an average diameter of 4 nm, have an average atomic ratio of Au to Fe equal to 7 or 8, which enables the Au/Fe NPs to be superparamagnetic with a blocking temperature of 56 K and 96 K. Furthermore, preliminary cellular studies reveal that both Au/Fe NPs show very limited toxicity. MRI phantom experiments show that r(2)/r(1) ratio of Au/Fe NPs is as high as 670, leading to a 66% reduction in T-2 relaxation time. These nanoparticles provide great versatility and potential for nanopartide-based diagnostics and therapeutic applications and as imaging contrast agents

COVID-19 Vaccination Policies: Ethical Issues and Responsibility

The World Health Organization (WHO) declared coronavirus 2 (SARS-CoV-2, COVID-19) a global pandemic on 11 March 2020. The emergence of the reliability of vaccines, the fear of possible vaccination-related side effects, and mass-media information created situations in which families and even health professionals developed hesitations regarding the need for vaccines, with a consequent decrease in vaccination coverage. This study discusses ethical issues and responsibility for the possible side effects of SARS-CoV-2 vaccination raised by vaccination policies

Forensic Analysis and Identification Processes in Mass Disasters: Explosion of Gun Powder in the Fireworks Factory

A mass disaster is a situation that involves criticality between the number of victims and resources, in terms of both men and means, present on the site of an event that is mostly unexpected and sudden. In the multidisciplinary teams that intervene, the role of forensic pathologists, who are responsible for the direction and coordination of post-mortem operations, is central, and must remain so. The authors report the case of an explosion of a pyrotechnic artifice factory, as a result of which numerous victims and injuries are recorded. So, the team completed the autopsies and created a protocol to obtain biological samples (bones, blood, teeth, muscles), while the forensic pathologists contacted the families of the alleged victims and each provided a blood sample that was collected for the DNA. The geneticist, using the method of gene extraction and amplification, obtained the DNA from each bone, tooth, and muscle of blood taken from the victims and then compared it with that extracted from the blood samples of the relatives; the electropherograms showed at least one allele for each genetic marker of the “Combined DNA Index System” in common between the victims and the families, thus allowing to establish the identity of all the subjects involved in the event. Having established the identity of all workers, it was possible to determine their whereabouts in the environment at the time of the location of fires and explosions. The results of the various forensic analyzes (autopsies, genetic investigations and even traumatological investigations) have allowed us to validate a scientific method useful in all mass disasters even when any type of anthropological or forensic dental research is difficult

VALUE OF THE MEDICAL-LEGAL INVESTIGATION. CORRESPONDENCE OF THE FINDINGS WITH LEGALLY ESTABLISHED REALITY

In recent years, violence against minors has been the subject of in-depth study in all its historical, social and cultural dimensions, being able to be identified and treated according to rigorous scientific methodologies. The A.A. report the case of an 8-year-old girl, who disappeared in a rural area, found dead a few hours later, on the recommendation of a young man who, despite having admitted to having gone away with the child, had not provided further details. The forensic inspection revealed that the discovery area included an area with burnt undergrowth about 4 meters in diameter. Examination of the external genitalia showed that the hymen was hemorrhagic in the right hemicycle, at 11 o'clock, with laceration of the most superficial layers of the anterior face. In the present case, therefore, despite having limited historical and circumstantial data, it was possible to reconstruct the following damaging dynamic: the little girl, after having gone away with her aggressor, was first the victim of an attempt of sexual violence by the latter and later immobilized by placing a foot on the slender abdomen. She had been covered with brushwood which the attacker had set fire to, thus killing her. This reconstruction of the criminal events, proposed to the investigating magistrate, was confirmed in each passage by the confessions made by the murderer, during the various degrees of trial, so much so that the final sentence reported in full the specific steps of the medico-legal relationship

Haemorrhage and Survival Times: Medical–Legal Evaluation of the Time of Death and Relative Evidence

Haemorrhage is the name used to describe the loss of blood from damaged blood vessels (arteries, veins, capillaries). Identifying the time of haemorrhage remains a clinical challenge, knowing that blood perfusion of systemic tissues is poorly correlated with the perfusion of specific tissues. In forensic science, one of the most discussed elements is the time of death. This study aims to provide the forensic scientist with a valid model to establish a precise time-of-death interval in cases of exsanguination following trauma with vascular injury, which can be useful as a technical aid in the investigation of criminal cases. To calculate the calibre and resistance of the vessels, we used an extensive literature review of distributed one-dimensional models of the systemic arterial tree as a reference. We then arrived at a formula that allows us to estimate, based on a subject’s total blood volume and the calibre of the injured vessel, a time interval within which a subject’s death from haemorrhage from vascular injury falls. We applied the formula to four cases in which death had been caused by the injury of a single arterial vessel and obtained comforting results. The study model we have offered is only a good prospect for future work. In fact, we intend to improve the study by expanding the case and statistical analysis with particular regard to the interference factors to confirm its actual usability in practical cases; in this way, useful corrective factors can be identified

Fluorinated and Charged Hydrogenated Alkanethiolates Grafted on Gold: Expanding the Diversity of Mixed-Monolayer Nanoparticles for Biological Applications

Low intrinsic toxicity, high solubility, and stability are important and necessary features of gold nanoparticles to be used in the biomedical field. In this context, charged nanoparticles proved to be very versatile, and among them charged mixed-monolayer gold nanoparticles, displaying monolayers with well-defined morphologies, represent a paradigm. By using mixtures of hydrogenated and fluorinated thiols, the formation of monolayer domains may be brought to an extreme because of the immiscibility of fluorinated and hydrogenated chains. Following this rationale, mixed monolayer gold nanoparticles featuring ammonium, sulfonate, or carboxylic groups on their surface were prepared by using amphiphilic hydrogenated thiols and 1H,1H,2H,2H-perfluoro-alkanethiols. The toxicity of these systems was assessed in HeLa cells and was found to be, in general, low even for the cationic nanoparticles which usually show a high cytotoxicity and is comparable to that of homoligand gold nanoparticles displaying amphiphilic charge neutral hydrogenated or fluorinated thiolates in their monolayer. These properties make the mixed ligand monolayer gold nanoparticles an interesting new candidate for medical application

The Job that Kills the Worker: Analysis of Two Case Reports on Work-Related Stress Deaths in the COVID-19 Era

The COVID-19 pandemic caused an increasing number of corporate layoffs and downsizing, as well as causing many employees to be absent due to illness, with inevitable consequences on the health of active workers both from a physical point of view, due to the need to make up for staff and organizational shortages, and from a mental point of view, due to the inevitable consequences related to the uncertainty of the social context. This context has certainly caused an increase in work-related stress, which is the pathological outcome of a process that affects workers who are subjected to excessive (emotional-relational or high or low or inadequate activity) or improper work loads. The purpose of this paper is to evaluate the main aspects of this issue, through the analysis proposed by two case reports, both of which occurred during the COVID-19 pandemic, in which occupational stress emerged as an etiological agent in the determinism of death