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Claudio Conforti, Maria Silvestre, Caterina Dianzani
A 52-year-old man was admitted for clinical counseling at the Campus Bio-Medico in Rome in the early days of August 2017. He presented with multiple erythemato-hemorrhagic papules localized on the abdomen (Figure 1), back, arms, and thighs (Figure 2). The wide eruption was characterized by an intense reddish color that disappeared with diascopy. The patient stated that the eruption had appeared overnight after helping his mother-in-law dispose of a piece of antique furniture from her country villa the previous afternoon...
2018: Skinmed
P Collinet, X Fritel, C Revel-Delhom, M Ballester, P A Bolze, B Borghese, N Bornsztein, J Boujenah, N Bourdel, T Brillac, N Chabbert-Buffet, C Chauffour, N Clary, J Cohen, C Decanter, A Denouël, G Dubernard, A Fauconnier, H Fernandez, T Gauthier, F Golfier, C Huchon, G Legendre, J Loriau, E Mathieu-d'Argent, B Merlot, J Niro, P Panel, P Paparel, C A Philip, S Ploteau, C Poncelet, B Rabischong, H Roman, C Rubod, P Santulli, M Sauvan, I Thomassin-Naggara, A Torre, J M Wattier, C Yazbeck, M Canis
First-line investigations to diagnose endometriosis are clinical examination and pelvic ultrasound. Second-line investigations include pelvic examination performed by a referent clinician, transvaginal ultrasound performed by a referent, and pelvic MRI. It is recommended to treat endometriosis when it is symptomatic. First-line hormonal treatments recommended for the management of painful endometriosis are combined hormonal contraceptives or levonorgestrel 52mg IUD. There is no evidence to recommend systematic preoperative hormonal therapy for the unique purpose of preventing the risk of surgical complications or facilitating surgery...
March 14, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Jiyoung Hwang, Lisa Wang, Jodi Siever, Talia Del Medico, Charlotte A Jones
OBJECTIVES: Loneliness and social isolation (L&SI) are associated with physical and cognitive decline in older adults. Walk 'n' Talk for your Life (WTL) is a community-based program of socialization, health education, falls prevention exercise and walking for community-dwelling older adults. This qualitative study was done to gain further insight into the experience and impacts of the WTL on seniors' L&SI. METHODS: One-on-one semi-structured interviews were conducted with sixteen participants who had completed the WTL ...
March 15, 2018: Aging & Mental Health
Francesco Plotti, Corrado Terranova, Stella Capriglione, Stefania Crispino, Alessandra Li Pomi, Carlo de Cicco Nardone, Roberto Montera, Pierluigi Benedetti Panici, Roberto Angioli, Giuseppe Scaletta
AIMS: The aim of this study was to evaluate long-term quality of life and urinary and sexual function in long-term cervical cancer survivors previously treated with radical hysterectomy (RH) type C2/type III. METHODS: All patients who presented at Campus Bio-Medico of Rome for RH type C2/type III for cervical cancer were considered eligible for this retrospective study protocol. We included exclusively patients with complete response to primary treatment with at least 36 months of follow up...
March 14, 2018: International Journal of Gynecological Cancer
Su-Hee Cho, Ji-Ye Lee, Kyeong-Hwa Ryu, Dae Chul Suh
Purpose: False positive diagnoses of cerebral aneurysm via magnetic resonance angiography (MRA) screening may increase unnecessary cerebral catheter angiography. The purpose of this study was to investigate the effects of medical liability on medical decision-making during radiologic interpretation. Materials and Methods: We included 56 consecutive patients who were referred with suspected aneurysm based on MRA or computed tomography angiography (CTA) and showed no aneurysm on subsequent digital subtraction angiography (DSA)...
March 2018: Neurointervention
(no author information available yet)
Cardiac rupture caused by traffic accident: Cases report and a literature review DOI: 10.1177/0025817218759164 Medico-Legal Journal In this article, six co-authors were omitted in the initial OnlineFirst version. The online version has been updated to list all co-authors and affiliations as below. S Zerbo1 , E Ventura Spagnolo1 , S Salerno2 , G Lo Re2 , A Guajana1 , A Alongi1 and A Argo1 1 Dpt. For Health Promotion, Maternal and Child Care, University of Palermo, Section of Legal Medicine. Palermo - Italy2 Dpt of Radiology, University of Palermo...
January 1, 2018: Medico-legal Journal
Frank Ursin, Florian Steger
INTRODUCTION:  Gallstones are rarely mentioned in the medical texts of antiquity. The physician, Alexander of Tralles mentions-for the first time-stones in the gallbladder as a possible cause for obstructive jaundice. This designation is found in his textbook on medicine under the heading "obstruction of the liver". Based on that observation, we describe the ancient history of hepatic obstruction and investigate the connection with the rare reference of gallstones in the medical texts of antiquity...
March 2018: Zeitschrift Für Gastroenterologie
Michael J Moses, Jared C Tishelman, Saqib Hasan, Peter L Zhou, Ioanna Zevgaras, Justin S Smith, Aaron J Buckland, Yong Kim, Afshin Razi, Themistocles S Protopsaltis
STUDY DESIGN: Cross-Sectional Study. OBJECTIVE: The goal of this study is to investigate how surgeons differ in collar and narcotic use, as well as return to driving recommendations following cervical spine surgeries and the associated medico-legal ramifications of these conditions. SUMMARY OF BACKGROUND DATA: Restoration of quality of life is one of the main goals of cervical spine surgery. Patients frequently inquire when they may safely resume driving after cervical spine surgery...
March 9, 2018: Spine
B Rosenfeld, V Delvenne
The complexity of depressive diagnosis and other forms of expression of psychological suffering during adolescence explain why particular caution is required. The medico-psycho-social determinants of teenager's mental health enjoin us to support a holistic analysis of these situations. Different analysis spectra - symptomatic, environnemental, anthropological, cultural - allow us to understand a situation at different levels of interpretation. As we will see through a clinical case examination, the difficulty of depressive diagnosis in a multicultural background is increased by the ethnocentrical aspect of this category...
2018: Revue Médicale de Bruxelles
Sanjeev Jain, Pratima Murthy, Alok Sarin
Specialists in psychiatry, in the Indian sub-continent, were trained in the UK in the early 20th century. Just before Independence, an Indian branch of the Royal Medical Psychological Association was established. Many issues of contemporary concern were discussed, as also plans for the further development of psychiatry in the region. Soon after the Second World War, and the Independence of India, the association was disbanded. However, a large number of psychiatrists from south Asia now live and work in the UK, and the Indian Psychiatric society and the Royal College continue to have close links...
February 2018: Indian Journal of Psychiatry
Silvia D Visonà, Onno J de Boer, Claire Mackaaij, Hans H de Boer, Kartika R Pertiwi, Ruben W de Winter, Antonio Osculati, Allard C van der Wal
Acute medial dissection of aorta can occur in the context of a sudden and unexpected death. For medico-legal reasons it is important to estimate as accurately the histological age of dissections. We evaluated the additional value of a systematic application of immunohistochemistry, compared with conventional histology only, in determining chronological steps of injury and repair. Thirty two paraffin embedded specimens of aortic dissection were retrospectively allocated to one of four defined stages: acute (I), subacute (II), early organizing (III) and scarring (IV) using Hematoxylin and Eosin and Elastica van Gieson stained sections...
February 10, 2018: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
Gerzaín Rodríguez, Elga Johanna Vargas, María Claudia Abaúnza, Diana Marcela Díaz Quijano, Mario Melo-Uribe
BACKGROUND: No previous studies have been conducted to determine the normal number of nail matrix melanocytes in Latin American individuals. The objective of this work was to determine the number of melanocytes per linear millimeter present in the nail matrix and the nail bed in samples obtained from Colombian individuals. METHODS: Twenty-six unilateral biopsies were taken from 19 cadavers subjected to clinical and medico-legal autopsies. These biopsy samples were processed with conventional histotechnology and immunohistochemistry (IHC) with anti-HMB-45 and anti-MiTF...
March 10, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Fiona Ma MacCormick, Charlotte Emmett, Paul Paes, Julian C Hughes
BACKGROUND: Concerns about decision making related to resuscitation have led to two important challenges in the courts resulting in new legal precedents for decision-making practice. Systematic research investigating the experiences of doctors involved in decisions about resuscitation in light of the recent changes in law remains lacking. AIM: To analyse the practice of resuscitation decision making on hospital wards from the perspectives of doctors. DESIGN: The data presented in this paper were collected as part of a wider research study of end-of-life care in an acute hospital setting...
March 9, 2018: Journal of Medical Ethics
C Chauffour, J-L Pouly, A-S Gremeau
Should the presence of endometriosis change the management of assisted reproductive technology? There is no difference in pregnancy rate after IVF between an agonist or antagonist protocol in patients with endometriosis, so the choice between one or the other of these protocols is free. But the review of the literature has shown an improvement in the chances of pregnancy in case of prolonged ovulation suppression before stimulation for IVF with a GnRH agonist analogue or with oral contraception, especially in cases of severe endometriosis...
March 6, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Arturo Carpio, Agnès Fleury, Matthew L Romo, Ronaldo Abraham
Neurocysticercosis (NC) is a neglected disease that contributes substantially to neurological morbidity/mortality in lower-income countries and increasingly among high-income countries due to migration. Many advances have been made in understanding NC, but unanswered questions remain Areas covered: This review discusses the epidemiology, pathophysiology, immunology, diagnosis, treatment, and eradication of NC. Expert commentary: The global NC prevalence remains unknown and needs proper ascertainment. Further understanding of the pathophysiology of extraparenchymally located cysts is needed to improve management...
March 14, 2018: Expert Review of Neurotherapeutics
Ana Paula Cavalcante de Oliveira, Mario Roberto Dal Poz, Isabel Craveiro, Mariana Gabriel, Gilles Dussault
This study aims to analyze whether the process by which policies for human resources for health that aim to improve the geographic distribution of physicians have been informed by scientific evidence in Brazil and Portugal. This was a multiple case study on a decision-making process for human resources for health in Brazil and Portugal. The respective case studies were based on Brazil's More Doctors Program (Programa Mais Médicos - PMM) and Portugal's strategy of hiring foreign physicians through bilateral agreements, to work in the country's National Health Service (SNS)...
March 1, 2018: Cadernos de Saúde Pública
Geoffrey David Debelle, Sabine Maguire, Patrick Watts, Rosa Nieto Hernandez, Alison Mary Kemp
The Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) has recently published what they purported to be a systematic review of the literature on 'isolated traumatic shaking' in infants, concluding that 'there is limited evidence that the so-called triad (encephalopathy, subdural haemorrhage, retinal haemorrhage) and therefore its components can be associated with traumatic shaking'. This flawed report, from a national body, demands a robust response. The conclusions of the original report have the potential to undermine medico-legal practice...
March 6, 2018: Archives of Disease in Childhood
Briony J Murphy, Lyndal C Bugeja, Jennifer L Pilgrim, Joseph E Ibrahim
OBJECTIVES: Suicide among nursing home residents is a growing public health concern, currently lacking in empirical research. This study aims to describe the frequency and nature of suicide among nursing home residents in Australia. METHODS: This research comprised a national population-based retrospective analysis of suicide deaths among nursing home residents in Australia reported to the Coroner between July 2000 and December 2013. Cases were identified using the National Coronial Information System, and data collected from paper-based coroners' records on individual, incident, and organizational factors, as well as details of the medico-legal death investigation...
March 5, 2018: International Journal of Geriatric Psychiatry
Silvia Spoto, Emanuele Valeriani, Damiano Caputo, Eleonora Cella, Marta Fogolari, Elena Pesce, Maria Tea Mulè, Mariacristina Cartillone, Sebastiano Costantino, Giordano Dicuonzo, Roberto Coppola, Massimo Ciccozzi, Silvia Angeletti
Postsurgical infections represent an important cause of morbidity after abdominal surgery. The microbiological diagnosis is not achieved in at least 30% of culture with consequent worsening of patient outcome. In this study, procalcitonin measurement, during the first 3 days after abdominal surgery, has been evaluated for the early diagnosis of postsurgical infection.Ninety consecutive patients subjected to major abdominal surgery at the University Campus Bio-Medico of Rome, have been included. PCT concentrations were measured by time-resolved amplified cryptate emission (TRACE) assay at admission and at the first, second, and third day after surgery...
January 2018: Medicine (Baltimore)
Nicolas Albin, Anne Mc Leer, Linda Sakhri
In recent years, high-throughput sequencing techniques have been developed for cancerology and many clinical trials are currently structured around biomarkers that can guide specific treatment choices. This approach is characteristic of precision medicine, which is actually a concept initiated several decades ago with, for example, retinoic acid in promyelocytic leukemia. This paper will review the different types of molecular alterations and « -omics » biological analyses, bioinformatics tools, coupled drug/biomarkers already validated, the ethical issues of whole genomic sequencing of an individual as part of an inclusion in a clinical trial and finally the first results of precision medicine trials...
February 28, 2018: Bulletin du Cancer
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