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Clothing damage analysis is an important tool for forensic investigations and, even it is a niche field, it is gaining interest. Moreover, the attention is shifting from evaluating just the “biological” traces found on the clothes to the modifications that clothes themselves undergo in the context of a specific traumatic dynamic. The Authors analyze a case of the investigation on a hole in the jacket worn by the victim when he was attacked, performed through optical microscope and morphological and elemental SEM/EDX analysis, to determine the origin of this texture damage to verify a witness story.

Phenobarbital (PB) has a reputation for safety, and it is commonly believed that PB-related increases in serum aminotransferase levels do not indicate or predict the development of significant chronic liver disease. Here we report of two adult patients with a long history of epilepsy treated with PB who died suddenly: one as consequence of cardiac arrest, the other of acute bronchopneumonia. At autopsy, analysis of liver parenchyma revealed rich portal inflammatory infiltrate, which consisted of mixed eosinophil and monocyte cells, associated with several foci of necrosis surrounded by a hard ring of non-specific granulomatous tissue. Inflammatory reactions of internal and external hepatic biliary ducts were also seen. Our findings illustrate that PB may be associated with chronic liver damage, which may lead to more serious and deleterious consequences. For this reason, each clinician should recognize this entity in the differential diagnosis of PB-related asymptomatic chronic hepatic enzyme dysfunction.

Recent clinical investigations have demonstrated that an early restriction of dietary protein intake may reduce the rate of progression of chronic renal failure in humans. In this study the effects of a restricted-protein diet on kidney function in type I diabetic patients with clinical nephropathy were evaluated. Sixteen patients (9 men, 7 women) with mean age 37.1 ± 9.8 yr, mean duration of diabetes 17.7 ± 6.6 yr, proteinuria > 0.5 g/24 h, and serum creatinine concentration of 0.7−1.9 mg/dl were studied. Patients were randomly divided into two groups. The low-protein diet (LPD) group comprised seven patients who were kept for 4.5 ± 1 mo on a diet containing 0.71 ± 0.12 g × kg−1 × day−1 protein. The normal-protein diet (NPD) group comprised nine patients as controls maintained for 11.7 ± 7 mo on their usual diabetic diet containing 1.44 ± 0.12 g × kg−1 × day−1 protein. All patients were studied every 1–2 mo. Metabolic control was assessed by evaluation of 5–8 blood glucose determinations/day and by glycosylated hemoglobin, whereas renal function was evaluated by albumin, IgG and β2-microglobulin urinary excretion rates, serum creatinine concentration, and creatinine clearance. At each visit, serum concentrations of total protein, albumin, phosphate, calcium, and electrolytes and weight and blood pressure were also measured. A significant reduction (434 ± 244 to 205 ± 212 μg/min, mean ± SD) in albumin excretion rate was found in all LPD patients after dietary protein restriction, with a significant reincrease (689 ± 201 μg/min) in the same patients several months after interruption of diet. In contrast, a significant increase in albumin (452 ± 200 to 850 ± 288 μg/min) and IgG (82 ± 63 to 129 ± 79 μg/min) urinary excretion rates was found in NPD patients. No significant variations were noticed during the study regarding creatinine clearance, serum creatinine, urinary β2-microglobulin, arterial blood pressure, and other parameters. Mean daily insulin requirements remained unchanged in all patients. We conclude that our study supports the hypothesis that diabetic nephropathy, like other forms of chronic renal disease, might benefit from an early restriction of dietary protein intake.

Background: Healthcare-associated infections are one of the most serious Public Health concern, as they prolong the length of hospitalization, reduce the quality of life, and increase morbidity and mortality. Despite they are not completely avoidable, the number of healthcare-associated infections related to negligence claims has risen over the last years, contributing to remarkable economic and reputation losses of Healthcare System. Methods: In this regard, several studies suggested a key role of medical records quality in determining medical care process, risk management and preventing liability. Clinical documentation should be able to demonstrate that clinicians met their duty of care and did not compromise patient’s safety. Results: Therefore, it has a key role in assessing healthcare workers’ liability in malpractice litigation. Our risk management experience has confirmed the role of medical records accuracy in preventing hospital liability and improving the quality of medical care. Conclusion: In the presented healthcare-associated infections cases, evidence-based and guidelinesbased practice, as well as a complete/incomplete medical record, have shown to significantly affect the verdict of the judicial court and inclusion/exclusion of hospital liability in healthcare-associated infections related claims.

The limitations caused by the spread of the SARS-CoV2 virus have had repercussions on the voluntary termination of pregnancy. During the pandemic, Italy issued updated guidelines regarding voluntary termination of pregnancy by means of mifepristone and prostaglandin. This included news concerning the time limit and location in which this procedure could be accessed: updates partially recognize women’s needs, and they are into line with the European parliament’s recent exhortations. However, these updates do not change the previously provided responsibilities that lie with doctors. This article aimed to compare regulations concerning medical abortion in Italy and other countries, with a focus on recent Italian updates in the context of pandemic.

Background: Whenever a crime is committed, forensic personnel are requested to collect every kind of evidence to establish the relationship between the suspects and the crime. When any evidence is accidentally destroyed or not found, there is one type of latent evidence that is always deposited at the crime scene: unique human scent. Recently, the use of trained canines to detect selective human scent at a crime scene has increased. To consolidate this kind of evidence, it is essential to have an exact knowledge and an awareness of the chemical signature of the volatile compounds that could indicate the presence of the alleged offender at the crime scene. This experimental study aims to detect the volatile organic compounds (VOCs) released from subjects who handled scent-articles to imprint their odor on. After handling, each scent-article was wrapped in sterile and VOC-free cotton gauzes for 48h for secondary transfer. VOCs were detected by headspace/solid-phase microextraction-gas chromatography/mass spectrometry (HS/SPME-GC/MS) and well-trained dogs, at different time points (up to 15days). Furthermore, the possibility of further DNA detection after contact was also investigated to propose a novel approach able to identify a subject from this latent forensic trace. Results: Data show that inter-individual human scent composition includes different VOCs, but dogs were able to discriminate the individual who touched the object at the crime scene. The dog training procedure showed excellent sensitivity (between 99.48 and 100%) and specificity (between 60 and 100%), having a positive predictive value (PPV) ranging between 97.94 and 100% and a negative predictive value (NPV) ranging between 85.71 and 100%. Preliminary work on DNA analysis released after contact yielded positive results, even if further studies are necessary, expanding the same experimentation to a larger sample with the aim of obtaining a statistically significant result. Conclusion: Data show that human scent is a good source of VOCs and a good target for canine training. The well-trained dog represents a specialized biological device able to discriminate personal human odor from any contaminants in the mixture detected by instrumental analysis. Furthermore, this study proposes the use of human scent as a forensic latent trace for DNA profiling.

The World Health Organization (WHO) declared the outbreak of the Coronavirus disease-2019 (COVID-19) infection a pandemic on 11 March 2020. As of the end of October 2020, there were 50 million cases of infection and over one million deaths recorded worldwide, over 45,000 of which occurred in Italy. In Italy, the demand for intensive care over the course of this pandemic crisis has been exceptionally high, resulting in a severe imbalance between the demand for and availability of the necessary resources. This paper focuses on elements of preventive medicine and medical treatments in emergency and non-emergency situations which, based on the international scientific literature, may prove to be useful to physicians on a behavioral level and avert professional liability problems. In order to achieve this objective, we have performed a search on MEDLINE to find published articles related to the risks associated with the pandemic that contain useful suggestions and strategies for mitigating risks and protecting the safety of the population. The results have been collocated in line with these specific study areas.