La c.d. aggravante dell'agevolazione mafiosa ha natura soggettiva, ma può estendersi ai concorrenti nel reato: le Sezioni Unite riscrivono l'art. 118 c.p.

Con la sentenza 3 marzo 2020 n. 8545, le Sezioni Unite penali intervengono per sanare un contrasto giurisprudenziale avente ad oggetto la natura oggettiva o soggettiva della circostanza aggravante dell’agevolazione mafiosa (art. 416 bis 1, comma 1°, c.p.) ed il conseguente regime di comunicabilità della stessa ai concorrenti nel reato: la Cassazione attribuisce natura soggettiva all’aggravante in esame, ritenendola riconducibile ai motivi a delinquere (artt. 70 e 118 c.p.), ma ne afferma l’estensione anche al concorrente che, pur avendo agito senza dolo specifico, sia stato consapevole dell’altrui finalità di agevolare l’associazione mafiosa.The essay focuses the recent judgement n. 8545/2020 of the Joint Criminal Chambers of the Court of Cassation, with regard to the nature of an aggravating circumstance: the intention of helping a Mafia association (art. 416 bis 1, c. 1°, 2nd part, c.p.). The Court of Cassation established that the aggravating circumstance is subjective, because it is linked to the categories provided by art. 118 c.p., anyway it applies also to the co-accused person, if he or she is aware of the intention of the other accused person

Presunzioni legali e onere della prova nel processo penale.

Il diritto di cittadinanza delle presunzioni legali nel processo penale è stato fortemente posto in discussione, posto che esse potrebbero determinare un’inversione dell’onere della prova incompatibile con la presunzione di non colpevolezza, stabilita dal 2° comma dell’art.27 Cost. e dall’art. 6 CEDU, oltre che dall’art. 14 del Patto internazionale sui diritti civili e politici: infatti, posto che il thema probandum del processo penale è la colpevolezza dell’imputato, gli elementi fondanti la sua responsabilità penale dovrebbero essere provati (uno per uno) al di là di ogni ragionevole dubbio, senza possibilità di semplificazioni dell’accertamento che possano gravare l’imputato dell’onere di dimostrare la propria innocenza. Orbene, per esaminare il ruolo delle presunzioni legali all’interno dell’accertamento della responsabilità penale, sembra necessario domandarsi, in primo luogo, se si possa correttamente parlare di onere della prova, oltre che all’interno del processo civile, anche in quello penale: solo una volta affrontata tale questione, sarà possibile verificare se le presunzioni legali ne determinino un’inversione e, in caso di risposta positiva, se la stessa sia o meno compatibile con i principi costituzionali

Estinzione del reato per condotte riparatorie e "confisca senza condanna": problemi applicativi alla luce dei più recenti approdi della giurisprudenza.

Con l’entrata in vigore della legge 23 giugno 2017 n. 103 e l’introduzione nel nostro ordinamento dell’art. 162 ter c.p. (“Estinzione del reato per condotte riparatorie”), si pone nuovamente all’attenzione dell’interprete l’annosa questione dell’applicazione della confisca obbligatoria prevista dall’art. 240 c.p. 2° comma in caso di estinzione del reato: come è vero, infatti, che l’art. 162 ter c.p. prevede espressamente l’applicazione del 2° comma dell’art. 240 c.p., è anche vero che la causa di estinzione in questione è giuridicamente incompatibile con la condanna dell’imputato, giacché le condotte riparatorie devono intervenire entro il termine perentorio “della dichiarazione di apertura del dibattimento di primo grado” (art. 162 ter c.p.). La controversa relazione fra l’estinzione del reato e l’applicazione della confisca ha da sempre catturato l’attenzione degli studiosi, i quali, riconoscendo a tale istituto ciascuno una natura giuridica (ed una disciplina) diversa, inevitabilmente sono pervenuti sul punto a diverse conclusioni; i dibattiti in materia all’interno del mondo giuridico sono negli ultimi anni aumentati ulteriormente, peraltro, a causa di alcuni incisivi interventi da parte della Corte Europea dei Diritti dell’Uomo, che hanno stimolato attente riflessioni della dottrina ed una veemente reazione da parte della più autorevole giurisprudenza. Per evitare equivoci, anzitutto, è bene precisare che nel nostro ordinamento non è presente un istituto unico di confisca, ma se ne rilevano tipi diversi, ciascuno dei quali si distingue dagli altri per una peculiare natura giuridica ed una sua disciplina: alla luce di queste considerazioni, è opportuno precisare che la presente trattazione si concentrerà sulla specifica confisca espressamente richiamata dall’art. 162 ter c.p., cioè quella prevista dall’art. 240 comma 2° c.p

L'estinzione del reato per condotte riparatorie: luci ed ombre dell'art. 162-ter c.p.

Il contributo approfondisce la disciplina in materia di «Estinzione del reato per condotte riparatorie», prevista dall’art. 162 ter c.p., introdotto nell’ordinamento dalla L. 23 giugno 2017 n. 103: pur essendo ispirato a finalità condivisibili quali lo snellimento della giustizia penale e la riduzione della durata del processo, l’istituto in questione così come formulato lascia residuare alcuni interrogativi in ordine al suo funzionamento ed al suo coordinamento con altri istituti, oltre ad insinuare alcuni sospetti di illegittimità costituzionale.The essay focuses the regulation of «Extinguishing of the offence for restorative conduct», laid down in Article 162 ter c.p., introduced in the legislation by L. 23 giugno 2017 n. 103: even if it is aimed to reasonable objectives, such as reducing the number and the duration of criminal trials, as far as this legal arrangement is concerned there are some questions of constituzional illegitimacy and some regulatory gaps also with reference to coordination with other legal arrangements

Musica nei locali notturni e disturbo della "quiete pubblica": quando si configura il reato.

L’Autore analizza la sentenza n. 25424/2016 della Corte di Cassazione in tema di disturbo della “quiete pubblica” e reati di “pericolo presunto”. In particolare, muovendo da un generale inquadramento sistematico delle diverse categorie dei reati di pericolo, si concentra sulle peculiarità che caratterizzano i reati di “pericolo presunto”, con riferimento alla tematica nevralgica dell’onere della prova, alla luce delle riflessioni svolte in materia dalla Suprema Corte.The Author analyses the judgment n. 25424/2016 of the Court of Cassation in the fields of “public nuisance” and crimes of “assumed danger”. In particular, taking into account a general and systematic framework of the different categories of crimes of danger, He focuses on the features of crimes of “assumed danger”, with regard to the delicate subject of the burden of proof, in the light of the considerations of the Supreme Court

L'estinzione del reato per condotte riparatorie alla luce dei più recenti orientamenti della giurisprudenza ordinaria e di quella onoraria.

Nel contributo è esaminata la disciplina delle «condotte riparatorie», introdotte, dapprima, nel procedimento dinanzi al Giudice di Pace (art. 35 d. lgs. 28 agosto 2000 n. 274) e, successivamente, in quello ordinario (art. 162-ter c.p., introdotto dalla l. 23 giugno 2017 n. 103).Subject of the essay is the cause of extinguishment of the offence following compensation of the victim, which was introduced, first of all, in the Justice of Peace (art. 35 d. lgs. 28 August 2000 n. 274), and, then, in the ordinary proceeding (art. 162-ter c.p., introduced by l. 23 June 2017 n. 103)

Appropriateness of antiplatelet therapy for primary and secondary cardio- and cerebrovascular prevention in acutely hospitalized older people

Aims: Antiplatelet therapy is recommended for the secondary prevention of cardio- and cerebrovascular disease, but for primary prevention it is advised only in patients at very high risk. With this background, this study aims to assess the appropriateness of antiplatelet therapy in acutely hospitalized older people according to their risk profile. Methods: Data were obtained from the REPOSI register held in Italian and Spanish internal medicine and geriatric wards in 2012 and 2014. Hospitalized patients aged ≥65 assessable at discharge were selected. Appropriateness of the antiplatelet therapy was evaluated according to their primary or secondary cardiovascular prevention profiles. Results: Of 2535 enrolled patients, 2199 were assessable at discharge. Overall 959 (43.6%, 95% CI 41.5–45.7) were prescribed an antiplatelet drug, aspirin being the most frequently chosen. Among patients prescribed for primary prevention, just over half were inappropriately prescribed (52.1%), being mainly overprescribed (155/209 patients, 74.2%). On the other hand, there was also a high rate of inappropriate underprescription in the context of secondary prevention (222/726 patients, 30.6%, 95% CI 27.3–34.0%). Conclusions: This study carried out in acutely hospitalized older people shows a high degree of inappropriate prescription among patients prescribed with antiplatelets for primary prevention, mainly due to overprescription. Further, a large proportion of patients who had had overt cardio- or cerebrovascular disease were underprescribed, in spite of the established benefits of antiplatelet drugs in the context of secondary prevention

Multimorbidity and polypharmacy in the elderly: Lessons from REPOSI

The dramatic demographic changes that are occurring in the third millennium are modifying the mission of generalist professionals such as primary care physicians and internists. Multiple chronic diseases and the related prescription of multiple medications are becoming typical problems and present many challenges. Unfortunately, the available evidence regarding the efficacy of medications has been generated by clinical trials involving patients completely different from those currently admitted to internal medicine: much younger, affected by a single disease and managed in a highly controlled research environment. Because only registries can provide information on drug effectiveness in real-life conditions, REPOSI started in 2008 with the goal of acquiring data on elderly people acutely admitted to medical or geriatric hospital wards in Italy. The main goals of the registry were to evaluate drug prescription appropriateness, the relationship between multimorbidity/polypharmacy and such cogent outcomes as hospital mortality and re-hospitalization, and the identification of disease clusters that most often concomitantly occur in the elderly. The findings of 3-yearly REPOSI runs (2008, 2010, 2012) suggest the following pertinent tasks for the internist in order to optimally handle their elderly patients: the management of multiple medications, the need to become acquainted with geriatric multidimensional tools, the promotion and implementation of a multidisciplinary team approach to patient health and care and the corresponding involvement of patients and their relatives and caregivers. There is also a need for more research, tailored to the peculiar features of the multimorbid elderly patient

Therapeutic Duplicates in a Cohort of Hospitalized Elderly Patients: Results from the REPOSI Study.

BACKGROUND: Explicit criteria for potentially inappropriate prescriptions in the elderly are recommended to avoid prescriptions of duplicate drug classes and to optimize monotherapy within a single drug class before a new agent is considered. Duplicate drug class prescription (or therapeutic duplicates) puts the patient at increased risk of adverse drug reactions with no additional therapeutic benefits. To our knowledge, the prevalence of elderly inpatients receiving therapeutic duplicates has never been studied. OBJECTIVES: Our objective was to assess the prevalence of therapeutic duplicates at admission, discharge, and 3-month follow-up of hospitalized elderly patients. METHODS: This cross-sectional prospective study was conducted in 97 Italian internal medicine and geriatric wards. Therapeutic duplicates were defined as at least two drugs of the same therapeutic class prescribed simultaneously to a patient. A patient's drug therapy at admission relates to prescriptions from general practitioners, whereas prescriptions at discharge are those from hospital internists or geriatricians. RESULTS: The study sample comprised 5821 admitted and 4983 discharged patients. In all, 143 therapeutic duplicates were found at admission and 170 at discharge. The prevalence of patients exposed to at least one therapeutic duplicate rose significantly from hospital admission (2.5 %) to discharge (3.4 %; p = 0.0032). Psychotropic drugs and drugs for peptic ulcer or gastroesophageal reflux disease were the most frequently involved. A total of 86.8 % of patients discharged with at least one therapeutic duplicate were still receiving them at 3-month follow-up. CONCLUSIONS: Hospitalization and drugs prescribed by internists and geriatricians are both factors associated with a small but definite increase in overall therapeutic duplicates in elderly patients admitted to internal medicine and geriatric wards. More attention should be paid to the indications for each drug prescribed, because therapeutic duplicates are not supported by evidence and increase both the risk of adverse drug reactions and costs. Identification of unnecessary therapeutic duplicates is essential for the optimization of polypharmacy

Brain and kidney, victims of atrial microembolism in elderly hospitalized patients? Data from the REPOSI study.

Background: It is well known that atrial fibrillation (AF) and chronic kidney disease (CKD) are associated with a higher risk of stroke, and new evidence links AF to cognitive impairment, independently from an overt stroke (CI). Our aim was to investigate, assuming an underlying role of atrial microembolism, the impact of CI and CKD in elderly hospitalized patients with AF. Methods: We retrospectively analyzed the data collected on elderly patients in 66 Italian hospitals, in the frame of the REPOSI project. We analyzed the clinical characteristics of patients with AF and different degrees of CI. Multivariate logistic analysis was used to explore the relationship between variables and mortality. Results: Among the 1384 patients enrolled, 321 had AF. Patients with AF were older, had worse CI and disability and higher rates of stroke, hypertension, heart failure, and CKD, and less than 50% were on anticoagulant therapy. Among patients with AF, those with worse CI and those with lower estimated glomerular filtration rate (eGFR) had a higher mortality risk (odds ratio 1.13, p=0.006). Higher disability levels, older age, higher systolic blood pressure, and higher eGFR were related to lower probability of oral anticoagulant prescription. Lower mortality rates were found in patients on oral anticoagulant therapy. Conclusions: Elderly hospitalized patients with AF are more likely affected by CI and CKD, two conditions that expose them to a higher mortality risk. Oral anticoagulant therapy, still underused and not optimally enforced, may afford protection from thromboembolic episodes that probably concur to the high mortality