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We present this interesting note on the petrification of corpses, published in 1890 in the Italian Journal of Natural Sciences. After a brief review of the oldest forms of embalming, the author, Michele Martone, presents petrification as the only way to obtain the perfect conservation of the corpse. CONCLUSION: This scientific note presents some considerations regarding the constant search of humanity to arrest, if not the death of a person, the decomposition of their body.

Background: Varicella is a common pediatric infection. Even if it generally has a benign course, it may complicate and require hospitalization. The aim of our study was to estimate the acute hospitalization cost (AHC) for varicella in the acute phase in a pediatric population. Methods: We calculated the AHC of pediatric patients admitted for varicella at Bambino Gesù Children Hospital, Rome, Italy, from 1 November 2005 to 1 November 2020. Results: In the study period, 825 pediatric patients affected by varicella were hospitalized. The mean hospitalization cost was EUR 4015.35 (range from EUR 558.44 to EUR 42,608.00). Among patients, 55% were unvaccinable due to either their age or their immunosuppression status. They would benefit from herd immunity, reducing the overall AHC by EUR 182,196,506. Since the introduction of the compulsory vaccination against varicella in Italy, we observed a significant reduction in AHC cost of 60.6% in 2019 and of 93.5% in 2020. Finally, from the beginning of the COVID-19 pandemic, we documented a decline of 81.2% and 76.9% in varicella hospitalization, compared to 2018 and 2019, respectively. Conclusions: Varicella AHC is an important economic and health assessment point and can be useful for improving preventive strategies.

The medical examination of asylum seekers plays a significant role in helping them to obtain any form of international protection (refugee status or subsidiary or humanitarian protection). The Brescia Institute of Forensic Medicine has been increasingly involved in the medical examination of alleged victims of torture. Based on the Istanbul Protocol, the purpose of this study was to correlate the degree of consistency between the information provided by asylum seekers and the results of clinical examinations. A total of 185 asylum seekers were examined between September 2008 and September 2017. Almost all of the victims were male (94.0%) and aged between 11 and 30 years old (89.2%). Most victims were from Nigeria (23.2%), Gambia (16.2%) and Mali (10.8%), and the majority of the aggressions happened in Nigeria (18.9%), Gambia (14.5%) and Libya (12.9%). More than half of the instances of torture were related to political motives (57.3%); in 22% of cases, the victims referred to more than one act of aggression at different times. Blunt instruments were the most frequent means of injury (33.8%), followed by sharp instruments (23.3%). The most commonly involved anatomical regions were the lower and the upper limbs (23.6% and 20.5%, respectively). In terms of the degree of consistency between the lesion and the alleged torture, 50.4% of lesions were consistent with the information provided by the asylum seekers.

Fatal intoxications due to accidental or voluntary intake of synthetic opioids represent an actual emerging issue. We report a case where we have analyzed furanyl fentanyl and its metabolite 4–anilino-N-phenetyl-piperidine (4-ANPP) in blood, urine, gastric content, bile and cerebrospinal fluid. In this case, a 53-year-old man was found dead at home with a needle still inserted in a vein; a plastic bag containing a white powder (later identified as a furanyl fentanyl-based product) was discovered in the room. Biological samples were collected during autopsy and extracted/purified onto a SPE cartridge before instrumental analysis. Qualitative and quantitative analyses were performed by LC–MS/MS on peripheral and cardiac blood, urine, cerebrospinal fluid (CSF), bile and gastric content. Furanyl fentanyl was identified and quantified in all the biological fluids collected. Interestingly, gastric content revealed an unexpected high amount of furanyl fentanyl; yet, cardiac blood and femoral blood provided significantly different concentrations (11.8 and 2.7 ng/g respectively). The concentration of furanyl fentanyl in CSF was similar to that measured in femoral blood (2.6 ng/mL), thus confirming that CSF could be a good alternative biological fluid whenever a postmortem redistribution is suspected. Concentrations of 93.5, 50.4, 171.7, 41.9, 10.2 ng/mL(g) were measured for 4-ANPP in cardiac blood, femoral blood, urine, bile and cerebrospinal fluid, respectively. The outcomes from the presented case report suggest that the two substances have been not only injected intravenously, but probably also ingested by the man. Fentanyl derivative and its precursor seemed to undergo an extensive postmortem redistribution.

Background Meningococcal meningitis (MM) is known to be responsible of high cost for the Public Health Administration. Aim of the work is to calculate the costs for the hospitalization of pediatric patients affected by MM. Methods We calculate the costs for the hospitalization of pediatric patients affected by MM in the acute phase (HAP) over a nine year period. We performed a MEDLINE search to verify the cost of MM HAP reported in other studies. Results At Bambino Gesù Children Hospital, the median cost of HAP was of 12,604 euro (range from 9203 to 35,050 euro). Comparing our data with the previous studies, we find out similar results of approximately 16,750 euro (range 12,000–20,000 euro). Discussion Despite the relative rarety of the disease, MM is associated to direct high cost of HAP. Conclusions Hospital costs are an important end-point in health economic evaluation of the disease and may be useful to policy makers and health economists to understand the potential benefit of improving meningococcal vaccination programmes.

In the past, autoptic examinations were usually performed for research. This type of examination, for obvious reasons, did not appeal to paleopathologists as these procedures potentially damaged the finds destined to musealization. Since the discovery of X-ray, radiology has been used to study mummies as a noninvasive technique. The radiology of mummies allows us to discover pathologies, to elaborate on the type of ritual mummification for the artificial embalming, to comprehend the diagenetic process that guaranteed a natural mummification, or to conclude anthropological identification. We present a review on the latest studies on mummies that have shown that the radiological approach has been essential to conduct research.

In paleopathology, biomechanics allows us to investigate traumas in ancient skeletal remains. The aim of our current research is to reconstruct pathomechanics, treatment and gait of an individual from a Late Medieval femur with evident bone callus. In particular, to reconstruct the dynamic of the trauma that caused the injury and the adopted therapeutic measures, taking into account medical knowledges of that time. The femur was recovered during the archaeological investigation in the Sanctuary of Sacro Monte, Varese (Northern Italy). Classical physical anthropological methods and CT scans were used for macroscopic and radiological measurements of the bone. Finally, the reconstruction of the static and dynamic functional outcomes of the lesion were performed by Observation Gait Analysis (OGA) procedure. The femur shows an important callus at the middle third proximal of the shaft. The antemortem fracture was oblique and caused by a direct trauma probably related to occupational activities. The alignment of the segments in the frontal plane lead us to assume that the fracture was treated and the femur was immobilized with splints. The overlap and the angle of the segments indicate that the subject was not submitted to traction or fracture reduction. Good bone remodeling and consolidation of the fracture suggest that the subject had gradually led to the resumption of load and walking, although with important effects on posture and movement. The use of the OGA allows us to highlight the subject's kind of gait after healing.

Background: The recovery of foetal remains is very sporadic in archaeology, especially due the scarce degree of bone mineralisation. This paper presents the singular archaeological discovery of a foetal tile preserving the bone remains, object of our anthropological examination.Materials and methods: The foetal tile was discovered during an archaeological excavation in a medieval site (Northern Italy). The tile was analysed by CT scan and later, human remains were anthropologically examined.Results: The archaeological investigation revealed a special ritual destined to foetuses while forensic anthropological analysis allowed estimating the gestational age near to 21–24 weeks.

Background Acute central nervous system (ACNS) infections such as meningitis, encephalitis and cerebellitis still cause morbidity and mortality among children. The aim of this study was to verify whether neuropsychological impairment may develop in ACNS survivors. Methods The study included pediatric patients affected by ACNS disorders, aged 3-16 years admitted to the Bambino Gesù Children Hospital, Rome from June 2013 till June 2015. The patients and their parents underwent a psychological interview and neuropsychological tests during the first week of hospital admission and 1 year after, during a follow-up control. Wilcoxon signed rank tests for paired data were conducted to verify if the results were statistically importance. Patients underwent a cognitive profile test through the Leiter international performance scale – revised, motor skills evaluation through the test of visual-motor integration and a psychopathological evaluation by the child behavior checklist. The K-SADS-PL test was administered in children 6-11 years old to check psychopathological disorders. Results Forty-four patients were included in the study. At the 1 year follow-up, “anxiety problems” (dependency, fears, worries, nervousness) developed in 47% of patients, “somatic problems” (aches, headaches, nausea, vomiting) in 29% and “affective problems” (crying, self-harming, worthlessness, guilt, tiredness, sadness) in 29%. Visual perception was statistically increased at the 1 year follow-up in our patient cohort (p = 0.0297), mainly among the meningitides group (p = 0.0189). Motor-coordination also increased at the follow-up check in the study participants (p = 0.0076), especially in the group affected by cerebellitis (p = 0.0302). Conclusions Neuropsychological disorders are often difficult to recognize in the early stage. They must, however, be promptly identified through specific and standardized neuropsychological examinations in order to avoid long term sequelae in adulthood.

Background Varicella pneumonia has been studied extensively in adults; it may also affect children and may require hospitalization. Methods We examined pneumonia complications in children hospitalized for varicella, over a 13 year period. Results Pneumonia occurred in 8.2% of children hospitalized for varicella. The median length of hospitalization was 6 days. No statistically significant difference in length of stay was detected between immunodepressed children and previously healthy children. The hospitalization was on average shorter in patients who started antiviral therapy within 24 h of varicella onset. None of the included patients had been previously immunized for varicella. Conclusions Our results support the need for increased awareness of current varicella prevention recommendations among both immunocompetent and immunodepressed individuals. In children affected by varicella, prompt antiviral therapy may be indicated to reduce the number of days of hospitalization.