Publications by authors named "Antonina Argo"

26 Publications

  • Page 1 of 1

Cardiovascular Implantable Electronic Device Infection and New Insights About Correlation Between Pro-inflammatory Markers and Heart Failure: A Systematic Literature Review and Meta-Analysis.

Front Cardiovasc Med 2021 3;8:602275. Epub 2021 May 3.

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, Palermo, Italy.

Surgical approaches to treat patients with abnormal pro-inflammatory parameters remain controversial, and the debate on the correlation between hematological parameter alteration in cardiac implantable electronic device (CIED) infection and the increase in mortality continues. We performed a systematic review using the PubMed, Scopus, and Cochrane Library databases. Twenty-two articles from May 2007 to April 2020 were selected and divided according to the following topics: prevalence of microbes in patients with CIED infection; characteristics of patients with CIED infection; comparison between patients who underwent and did not undergo replantation after device extraction; and correlation between alteration of hematological parameters and poor prognosis analysis. Epidemiological analysis confirmed high prevalence of male sex, staphylococcal infection, and coagulase-negative staphylococci (CoNS). The most common comorbidity was heart failure. Complete removal of CIED and antimicrobial therapy combination are the gold standard. CIED replacement was associated with higher survival. High preoperative white blood cell count and C-reactive protein levels increased the risk of right ventricular failure (RVF) development. Increased red blood cell distribution width (RDW) value or decreased platelet count was correlated with poor prognosis. No correlation was noted between preoperative leukocytosis and CIED infection. A relevant correlation between leukocytosis and RVF was observed. Heart failure may be related to high RDW values and decreased platelet count. Data on the correlation between hematological parameter alteration and poor prognosis are missing in many studies because of delayed implantation in patients showing signs of infection.
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http://dx.doi.org/10.3389/fcvm.2021.602275DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8126630PMC
May 2021

Violence against women in heterosexual couples: A review of psychological and medico-legal considerations.

Med Sci Law 2021 Jan;61(1_suppl):113-124

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties - Medico Legal Section, University of Palermo, Italy.

Intimate partner violence against women (IPVAW) is the most pervasive violation of women's rights worldwide, causing devastating lifelong damage. Victims can suffer physical, emotional or mental health problems, and experience detrimental effects in social, psychological and relational health with their families, especially children. Due to the complexity regarding violence against women in heterosexual couples, it is important to make a clear distinction between psychological and physical mistreatment, which also includes psychological violence. This differentiation is important in determining different emotional and psychological aspects of mistreatment in order to understand the reasons why some women stay in such relationships and to explain the personality profiles of victims and perpetrators. In this short narrative review, we have combined perspectives of depth psychology and attachment theory from studies on trauma, traumatic bonds and the perpetrator/victim complex in gender violence. We have also considered the growing literature on IPVAW as it relates to the medico-legal field. Our search strategy included intimate partner violence, attachment styles, risk factors and the victim/perpetrator relationship. Distinguishing the different types of IPVAW is a necessary step in understanding the complexity, causes, correlations and consequences of this issue. Above all, it enables the implementation of effective prevention and intervention strategies.
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http://dx.doi.org/10.1177/0025802420936081DOI Listing
January 2021

Preventable fatal injury during rally race: a multidisciplinary approach.

Int J Legal Med 2021 May 25;135(3):893-901. Epub 2020 Nov 25.

Radiology Section, DIBIMED, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy.

Introduction: The motor vehicle crash (MVC) constitutes an important challenge for forensic pathology in order to identify the manner and cause of death. Our study focuses on a fatal accident during a rally race corresponding to MVC sub-category.

Materials And Method: Postmortem computed tomography (PMCT) was performed before the conventional autopsy. Autoptic and PMCT data were compared. Data collection allowed analyzing biomechanical dynamics of the incident and post-traumatic injuries through qualitative-statistics and solicitation quantitative indices.

Results: Photo and circumstantial evidence analysis showed a wrong installation of double shoulder belt system of head and neck support (HANS) collar. PMTC clearly highlighted multiple and bilateral fractures involving roof and base of skull; a displaced fracture of the right acetabulum was also encountered. Autopsy confirmed PMCT data and revealed a brainstem laceration. AIS (Abbreviated Injury Scale) achieved a maximum score in consideration of fatal injuries.

Discussion: The injuries analysis resulting from photographic surveys examination, conventional autopsy, and PMCT has led us to confirm a fatal front collision with a tree trunk. Head trauma represents a major injury in the present case. In this case, head injuries, related to whiplash trauma, are a consequence of a double shoulder belt system (HANS collar component) wrong installation.

Conclusion: MVC and especially high-speed motor racing represent an important death cause. There was, for this reason, a marked development of cars and occupants' safety systems, such as HANS collar. PMCT improves the diagnostic performance of conventional autopsy and increases forensic medical knowledge related to traumatic injuries.
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http://dx.doi.org/10.1007/s00414-020-02470-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8036227PMC
May 2021

Psychological support and psychotherapy via digital devices in Covid-19 emergency time: Some critical issues.

Med Leg J 2020 Jul 3;88(2):73-76. Epub 2020 Jun 3.

Department of Health Promotion, Maternal and Child Care, "G. D'Alessandro", University of Palermo, Palermo, Italy.

The Covid-19 pandemic and the resulting fear, quarantine and lockdown measures implemented in Italy and other countries to contain the risk of contagion have seriously impacted the mental health of a large number of people. The need to offer psychological and psychotherapeutic support to these people, while respecting the government's pressing calls to "stay home", have led many psychologists and psychotherapists, both in the public and private sectors, to provide their professional services via teleconference, telephone, smartphone, etc. The aim of this work is to highlight some critical issues related to the sudden switch from the traditional method of providing psychological services to the digital one in Italy.
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http://dx.doi.org/10.1177/0025817220926942DOI Listing
July 2020

Myocardial bridge pathology and preventable accidents during physical activity of healthy subjects: A case report and a literature review.

Med Leg J 2020 Dec 21;88(4):209-214. Epub 2020 May 21.

Department Pro.Mi.Se, Legal Medicine, School of Medicine, University of Palermo, Palermo, Italy.

Myocardial bridging is a congenital coronary pathology described as a segment of coronary artery which courses through the myocardial wall under the muscle bridge. Although the prognosis of myocardial bridging is benign, sports medicine recognises myocardial bridging as a leading cause of sudden death among young basketball, football and soccer players. The authors report a case of a 42-year-old man who collapsed while playing football. He died notwithstanding prompt medical assistance and cardiopulmonary resuscitation. At autopsy, gross examination of the heart revealed the intramural course of the left anterior descending coronary artery to be 2 cm from its coronary ostial origin. Histological examination of ventricular septal and left myocardium showed early signs of ischaemic injury without disease of small coronary vessels and hypertrophic cardiomyopathy. The cause of the death was due to malignant ventricular arrhythmia during intense physical activity.
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http://dx.doi.org/10.1177/0025817220923638DOI Listing
December 2020

Covid-19: A new challenge for forensic medicine.

Med Leg J 2020 07 21;88(2):104-105. Epub 2020 May 21.

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, Palermo, Italy.

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http://dx.doi.org/10.1177/0025817220923696DOI Listing
July 2020

The risk of the 'prison-emptying' effect in Italy due to the Covid-19 pandemic.

Med Leg J 2020 07 15;88(2):103-104. Epub 2020 May 15.

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, Palermo, Italy.

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http://dx.doi.org/10.1177/0025817220923697DOI Listing
July 2020

A novel LC-MS/MS analytical method for detection of articaine and mepivacaine in blood and its application to a preliminary pharmacokinetic study.

J Pharm Biomed Anal 2020 Aug 29;187:113335. Epub 2020 Apr 29.

U.R.I.To.N - Unit of Research of University of Florence, Florence, Italy; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy. Electronic address:

Local anaesthetics (LAs) are commonly used in surgery, especially in dentistry. They cause a transitory inhibition of nerve signal due to the blockade of the voltage-gated sodium channels. LAs are administrated alone or with vasoconstriction agents, such as adrenaline. Toxicity of LAs is associated to neurological and cardiovascular alterations. Tachycardia, arrhythmia, tremors, tonic-clonic seizure and respiratory depression (at high doses) are the main symptoms of intoxication by LAs. Lidocaine, articaine and mepivacaine are among the most used anaesthetics. This study aimed to fully validated a new method for the simultaneous detection of articaine and mepivacaine in whole blood. Sample treatment consisted in a liquid-liquid extraction with phosphate buffer (pH 8, 0.1 M) and ethyl-acetate. Analysis was performed by liquid chromatography-tandem mass spectrometry in multiple reaction monitoring mode (transitions: articaine, 285→8658 m/z; mepivacaine, 247→9870 m/z; lidocaine - internal standard -, 235→8658 m/z). The method proved to be highly sensitive with limit of quantifications for articaine and mepivacaine of 0.8 and 0.1 ng/mL, respectively. Accuracy and precision were always within the acceptance criteria. The new procedure was also successfully applied to a preliminary pharmacokinetics study.
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http://dx.doi.org/10.1016/j.jpba.2020.113335DOI Listing
August 2020

Guidelines and Current Assessment of Health Care Responsibility in Italy.

Risk Manag Healthc Policy 2020 10;13:183-189. Epub 2020 Mar 10.

Department of Health Promotion, Maternal and Child Care, "G. D'Alessandro", Legal Medicine Section, University of Palermo, Palermo, Italy.

Clinical guidelines are a potential tool for improving the effectiveness and quality of healthcare, decreasing variability in clinical practice, and preventing adverse events. In the purview of Law no. 24/2017, adherence to national guidelines can lead to a reduction in medical malpractice claims and the practice of so-called "defensive medicine". The law has assigned a central role to the guidelines, establishing the National Institute of Health through the new Italian National Center for Clinical Excellence, Quality, and Security (CNEC) as the methodological guarantor in the process of national guideline development. Here we discuss the issue of professional liability as recently outlined by the Gelli-Bianco Law (no. 24/2017), taking into account the clinical significance and medicolegal value of the guidelines.
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http://dx.doi.org/10.2147/RMHP.S238353DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073368PMC
March 2020

The violence of men against women: Medico-legal and psychological issues.

Med Leg J 2020 Mar 18;88(1):37-40. Epub 2019 Dec 18.

Department PROMISE - Medico Legal Section, University of Palermo, Palermo, Italy.

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http://dx.doi.org/10.1177/0025817219882169DOI Listing
March 2020

Toxicological investigations in a fatal and non-fatal accident due to hydrogen sulphide (HS) poisoning.

Forensic Sci Int 2019 Jul 1;300:e4-e8. Epub 2019 May 1.

Department "G.F. Ingrassia", University of Catania, Catania, Italy.

Hydrogen sulphide (HS) is one of the most toxic natural gas and represents a not rare cause of fatal events in workplaces. We report here a serious accidental poisoning by hydrogen sulphide inhalation involving six sailors. Three of them died while the other three survived and were transported to the emergency room. No greenish discolouration of the body, that could be a feature of these type of deaths, was observed at autopsy. Given that blood and/or urine HS detection does not allow to discriminate if it is related to inhalation or to putrefactive processes, the determination of thiosulphate, HS main metabolite, is decisive. The succession of fatal events reported here can be rebuilt by toxicological data interpretation: the subject 1 died after a longer interval of time as demonstrated by the highest blood and urine thiosulfate concentrations; the subject 2 died after a short interval of time as showed by a lower blood and urine thiosulfate concentrations than subject 1; the subject 3 died almost immediately after HS inhalation since he showed the lowest blood thiosulfate concentration, and no trace of sulphide and thiosulfate was found in the urine.
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http://dx.doi.org/10.1016/j.forsciint.2019.04.026DOI Listing
July 2019

Forensic microbiology applications: A systematic review.

Leg Med (Tokyo) 2019 Feb 3;36:73-80. Epub 2018 Nov 3.

Legal Medicine Section - Department for Health Promotion and Mother-Child Care, University of Palermo, Via del Vespro, 129, 90127, Italy. Electronic address:

According to the Human Microbiome Project (HMP), a healthy human body contains ten times more microbes than human cells. Microbial communities colonize different organs of the body, playing fundamental roles both in human health and disease. Despite the vast scientific knowledge of the role of microbial communities in a living body, little is known at present about microbial changes occurring after death, thus leading many authors to investigate the composition of the thanatomicrobiome and its potential applications in the forensic field. The aim of the following review is to provide a general overview of the advances of postmortem microbiology research, mainly focusing on the role of microbiological investigations carried out on internal organs and fluids. To this end, a total of 19 studies have been sistematically reviewed, each one chosen according to specific inclusion/exclusion criteria. The selected studies assess the contribution of contamination, postmortem transmigration and agonal spread to microbial isolation from dead body samples, and shed light on the role of postmortem microbiological investigations in several forensic fields, such as cause of death or PMI determination.
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http://dx.doi.org/10.1016/j.legalmed.2018.11.002DOI Listing
February 2019

Self-inflicted long bone fractures for insurance fraud.

Int J Legal Med 2019 Jul 26;133(4):1083-1088. Epub 2018 Jun 26.

Department of Orthopaedic Surgery (DICHIRONS), University of Palermo, Via del Vespro, 90100, Palermo, Italy.

Self-inflicted fractures simulating traffic accident represent a new social fraud opportunity for criminality. Recognising scams through an increase of awareness of existence of self-inflicted arm fractures for insurance fraud could help community health workers to report these injuries to the competent authorities. In this article, authors have recognised an unusual but consistent pattern of upper and lower limb fractures whose incidence does not coincide in numerical terms with what is reported in literature. The aim of the present study is to describe fracture patterns observed over the past 2 years. Further, authors describe clinical presentations of these fractures and attempt to define a possible mechanism of these types of injuries.
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http://dx.doi.org/10.1007/s00414-018-1884-7DOI Listing
July 2019

An unusual case of sudden cardiac death during sexual intercourse.

Med Leg J 2018 12 1;86(4):188-192. Epub 2018 Dec 1.

2 Legal Medicine Section - Department for Health Promotion and Mother-Child Care, University of Palermo, Palermo, Italy.

The most common cause of sudden death during sexual intercourse in adults is heart disease, and it is usually the male, whereas the death of the woman is unusual. Generally, in these cases, death occurs as a result of cardiovascular disease. The authors report an unusual case of the sudden death of a young woman during sexual intercourse. The post-mortem investigations (autopsy, cardiac nuclear magnetic resonance and cardiac histology) demonstrated a previously undiagnosed arrhythmogenic right ventricular cardiomyopathy. The terminal cause of death was a malignant arrhythmia from arrhythmogenic right ventricular cardiomyopathy. This is the first report of a case in which sexual activity can be regarded as the triggering factor combined with cardiac disease to the woman's death.
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http://dx.doi.org/10.1177/0025817218759630DOI Listing
December 2018

Forensic tools for the diagnosis of electrocution death: Case study and literature review.

Med Leg J 2018 Jun 5;86(2):89-93. Epub 2018 Jan 5.

3 Legal Medicine Section, Department for Health Promotion and Mother-Child Care, University of Palermo, Palermo, Italy.

Diagnosis of death by electrocution may be difficult when electric marking is not visible or unclear. Accordingly, the body of a man who appeared to have died from accidental electrocution was carefully forensically analysed. Macroscopic and microscopic analysis of the current mark was carried out using a variable-pressure scanning electron microscope equipped with energy dispersive X-ray microanalyser to highlight skin metallisation, indicating the presence of iron and zinc. The histological findings of electrocution myocardial damage were supported by the results of biochemical analysis which demonstrated the creatine kinase-MB and cardiac troponin I elevation. The effects of electric current flow were also highlighted by perforations of endothelial surface of a pulmonary artery using scanning electron microscope, and all the results were analysed by the main tools suggested in the literature.
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http://dx.doi.org/10.1177/0025817217749503DOI Listing
June 2018

A possible biomarker for methadone related deaths.

J Forensic Leg Med 2017 Jul 3;49:8-14. Epub 2017 May 3.

MD, FFFLM, FFSSoc, Berkeley, CA 94705, United States.

Methadone (MTH) concentrations in those dying of MTH toxicity totally overlap concentrations where the presence of MTH is only an incidental finding, making it very difficult to make distinctions in actual cases. A biomarker, be it anatomical or biochemical for MTH toxicity is badly needed, particularly if that markers were known to disrupt effective ventilation. Because the brainstem houses the regulatory centers for cardiorespiratory-control enters, it would seem to be the most likely anatomical site to seek abnormalities in cardiorespiratory control.

Objective: To locate and describe the cells of nucleus of the solitary tract (TS)(NTS) in human brainstem and determine if neuronal cell death, either necrotic or apoptotic, within the TS of humans is more common in deaths due directly to MTH toxicity than with in the solitary tract itself.

Design, Setting, Participants: This was a single cohort study of MTH related decedents autopsied at a large university hospital. Each decedent had a recent history of non medical/illicit MTH use and had been pronounced dead in the field, prior to ever reaching the hospital. Complete autopsy and complete toxicology testing were performed on the formalin fixed brains of each individual. Multiple blocks were prepared of the area of interest, namely the tissue lying immediately between the inferior and the super colliculi. This volume, by definition, would have included the area of the Rostral Ventrolateral Medulla (RVLM), the location of the TS. Immunohistochemistry studies utilizing caspase-9 reaction (a protease enzyme involved in the process of preprogrammed death) were performed in order to estimate the degree and proportion of neuronal apoptosis, and also access the degree of classical necrosis within the NTS.

Main Outcomes And Measures: The primary outcome measure was the presence or absence of neuronal apoptosis and/or necrosis within the NTS.

Results: Cells displaying evidence of early apoptosis and advanced apoptosis, consisting primarily of nuclear fragmentation, admixed with other neurons displaying the features of classic necrosis were found. Evidence of classic necrosis was identifiable in most of the controls, though minor degrees of apoptosis were identifiable with Caspase staining and quantitative image analysis of immunohistochemical stains.

Conclusions: and Relevance: Our study shows that neurons, primarily along the TS, but occasionally in other cell nuclei (even controls) are vulnerable, both to direct MTH toxicity (via apoptosis) and indirectly (via hypoxia leading to classical cell necrosis). When MTH is found to be present in significant concentrations, but apoptotic lesions are absent, it would be reasonable to assume that MTH was not primarily the cause of cardiorespiratory arrest.
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http://dx.doi.org/10.1016/j.jflm.2017.05.010DOI Listing
July 2017

Behavioural and pharmacological characterization of a novel cannabinomimetic adamantane-derived indole, APICA, and considerations on the possible misuse as a psychotropic spice abuse, in C57bl/6J mice.

Forensic Sci Int 2016 Aug 6;265:6-12. Epub 2016 Jan 6.

Department of Pharmaceutical Sciences, University of Milan, Via Mangiagalli, 25, Milano 20133, Italy.

The novel adamantane derivative APICA (N-(adamantan-1-yl)-1-pentyl-1H-indole-3-carboxamide) was recently identified as a cannabinomimetic indole of abuse. Despite its novel structure, APICA recalls cannabinomimetic indoles, such as representative member JWH-018. In present study, the effects of APICA (1-3mg/kg, i.p.) were tested in C57BL/6J mice, in the Tetrad task which includes the assessment of: body temperature; locomotor activity and behavioural reactivity; nociception; motor coordination; declarative memory. Furthermore, pre-treatment with the CB1 antagonist AM251 (3mg/kg, i.p.) or the CB2 antagonist AM630 (3mg/kg, i.p.) was carried out to characterize APICA activity. Our results show that APICA was able to dose-dependently decrease locomotor activity and behavioural reactivity in the open field, whereas only the highest dose was able to induce hypothermia, analgesia, motor incoordination and recognition memory impairment, with respect to vehicle (p<0.01; p<0.001). The pretreatment with the CB1 antagonist AM251 elicited an increase in body temperature, total distance travelled in the open field, latency to fall down in the Rotarod, and a decrease in tail flick latency (p<0.05; p<0.01). On the other hand, pretreatment with AM630 did not induced significant differences on APICA effects. This study supports preliminary reports on APICA cannabinomimetic properties, extending its detrimental effects on cognitive function. Moreover, these properties can be attributed to the CB1 receptor activity, indicating APICA as a selective CB1 receptor agonist.
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http://dx.doi.org/10.1016/j.forsciint.2015.12.035DOI Listing
August 2016

Female genital mutilations: genito-urinary complications and ethical-legal aspects.

Urologia 2015 Jul-Sep;82(3):151-9. Epub 2015 Feb 28.

Surgical Disciplines, Oncology and Dentistry, University of Palermo, Palermo - Italy.

Many women in the world are still undergoing female genital mutilations (FGMs) even if in almost all the countries, the practice of FGM is illegal. The increase of immigration, particularly from African Countries, to Europe, and Italy too, led to consider this phenomenon with particular attention and skill. All the operators in health services need to know the different types of FGMs and the related complications and the psychological and sexual sequels. Urological complications, in particular, are not rare and the changing anatomy of the external genital apparatus can also make the catheter insertion sometimes difficult. This review analyzes the epidemiology of FGMs, the reasons why the practice is still made, the complications, the ethical, and the principal legal aspects of this practise that must be hopefully early banned.
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http://dx.doi.org/10.5301/uro.5000115DOI Listing
April 2017

Detection of gamma-hydroxybutyrate in hair: validation of GC-MS and LC-MS/MS methods and application to a real case.

J Pharm Biomed Anal 2012 Nov 25;70:518-22. Epub 2012 Jul 25.

Forensic Toxicology Division, Institute of Legal Medicine, University of Florence, Italy.

A gas chromatography-mass spectrometry (GC-MS) and a liquid chromatography tandem mass spectrometry (LC-MS/MS) method were validated for quantifying endogenous and exogenous hair concentrations of gamma-hydroxybutyrate (GHB). The GC-MS method is based on overnight extraction of 25 mg hair in NaOH at 56 °C, liquid/liquid extraction in ethylacetate and trimethylsylil derivatization; analysis is by electron ionization and single ion monitoring of three ions. The LC-MS/MS method entails a rapid digestion of 25 mg hair with NaOH at 75 °C for 40 min, liquid/liquid extraction in ethylacetate and reconstitution of the extract in the LC mobile phase; negative ion electrospray ionization and multiple reaction monitoring (MRM) analysis are employed for the LC-MS/MS detection. In both cases, GHB-d6 is used as an internal standard. The endogenous amount in "blank" hair are estimated by the standard addition method. Limits of detection are 0.4 and 0.5 ng/mg for GC-MS and LC-MS/MS respectively, while the limit of quantification (LOQ) is 0.6 ng/mg for both methods; the GC-MS method proved to be linear in the range 1-50 ng/mg whereas linearity was demonstrated from 0.6 to 50 ng/mg for the LC-MS/MS; imprecision and inaccuracy were always lower than 23% for quality controls samples. The two methods were applied to a real case of a man addicted to GHB; the drug concentration in segments from 17 cm hair strand well correlated with self-reported use of GHB in different periods of his life. Performances of the two methods were similar.
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http://dx.doi.org/10.1016/j.jpba.2012.07.009DOI Listing
November 2012

A fatal case of a paint thinner ingestion: comparison between toxicological and histological findings.

Am J Forensic Med Pathol 2010 Jun;31(2):186-91

Department of Biotechnology and Legal Medicine, University of Palermo, Palermo, Italy.

Toluene and xylene are aromatic hydrocarbons commonly used as an industrial solvent for the manufacturing of pharmaceuticals, paints, and chemicals. The Occupational Safety and Health Administration has determined that toluene levels of 2000 parts per million (ppm) are considered dangerous to life and health. Several studies have examined the absorption of toluene and xylene following inhalation and oral ingestion in humans. Volatile organic compounds that are absorbed into the blood are distributed throughout the body; in particular, distribution of absorbed toluene and xylene in humans and rodents is characterized by preferential uptake in well-perfused and lipophil tissues such as the brain, liver, lungs, and body fat and also in central nervous system. The available studies indicate that xylenes are rapidly absorbed independently from the kind of exposition. We illustrate a fatal case of self-poisoning by ingestion of varnishes diluting solvents, reporting the identification and quantification of volatile organic compounds (toluene, o-m-p xylene) from human biologic liquids and viscera samples using the Solid-Phase Microextraction-Headspace-Gas Chromatography/Mass Spectrometry to toxicological analysis, and the histopathological findings evaluated in liver, kidney, and lungs.
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http://dx.doi.org/10.1097/PAF.0b013e3181c6c11fDOI Listing
June 2010

Lethal rupture of post-traumatic aneurysm of the vertebral artery case report.

J Forensic Leg Med 2009 Apr 30;16(3):168-71. Epub 2008 Oct 30.

University of Palermo, Department of Legal Medicine, Via del Vespro 127, 90129 Palermo, Italy.

Traumatic aneurysms or dissections of the vertebral artery have been reported in patients who have suffered minor craniofacial injuries in traffic accidents. A case is reported of ruptured traumatic vertebral artery aneurysm due to closed head injury without without penetrating injuries or skull fractures. The macroscopic and histological findings relevant to the vertebral wall were compatible with post-traumatic aneurysm; the rupture of the wall was assumed to be caused by sepsis and local infiltration of inflammatory cells.
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http://dx.doi.org/10.1016/j.jflm.2008.07.011DOI Listing
April 2009

Sudden death in adolescence caused by cardiac haemangioma.

J Forensic Leg Med 2009 Apr 25;16(3):156-8. Epub 2008 Oct 25.

Department of Legal Medicine, Via Del Vespro, 127, 90129 Palermo, Italy.

Primary tumors of the heart in infants and children are rare. The types of heart tumors in pediatric age groups are generally different from those in adults. Cardiac myxoma is by far the most common tumor in adults, but in infants and adolescents the prevalent tumor of the heart is rhabdomyoma. Among benign cardiac tumors, cardiac hemangiomas are rare and often diagnosed post-mortem due to the lack of specific clinical symptoms and signs. We report a case of sudden death due to cardiac hemangioma in an apparently healthy 15-year-old adolescent. The autopsy revealed a cardiac hemangioma located at the apex of the heart; the histopathological examination showed the tumor was a mixed capillary and arteriolar hemangioma, a very rare type of primary tumor in adolescents.
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http://dx.doi.org/10.1016/j.jflm.2008.08.020DOI Listing
April 2009

Cervical necrotizing fasciitis and descending necrotizing mediastinitis in a patient affected by neglected peritonsillar abscess: a case of medical negligence.

J Forensic Leg Med 2008 Aug 18;15(6):391-4. Epub 2008 Mar 18.

Department of Legal Medicine, University of Palermo, Via Del Vespro, 127-90129 Palermo, Italy.

We report a case of fatal cervical necrotizing fasciitis (CNF) and descending necrotizing mediastinitis (DNM) due to primary peritonsillar abscess in 60-year-old male patient with no history or evidence of immunocompromising disorders. The patient was treated with antibiotic and corticosteroid drugs but he developed mediastinitis and septic shock and died of multiple organ failure six days later from recovery in hospital. After a clinical, diagnostic and therapeutical consideration of the cervical necrotizing fasciitis and some related risks of a delayed diagnosis and treatment, the authors analysed the clinical history of the patient and of the medical conduct pointing out professional malpractice chargeable to doctors.
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http://dx.doi.org/10.1016/j.jflm.2007.12.008DOI Listing
August 2008

Post-traumatic lethal carotid-cavernous fistula.

J Forensic Leg Med 2008 May 23;15(4):266-8. Epub 2007 Oct 23.

University of Palermo, Department of Legal Medicine, Via del Vespro, 127, 90129 Palermo, Italy.

The authors report about an unexpected death by traumatic lesion of the internal carotid artery in a 30-year-old man who had fallen two metres. The man suffered a fracture of the left maxillary sinus and a fracture of the right orbit with bilateral haemorrhage of the maxillary sinus. Surgical treatment was performed with favorable outcome. Clinically, there were no neurological symptoms but about 60 days after his accident, the man died from uncontrolled epistaxis. He was submitted to the autopsy that show a linear fracture in the left side of the turcic sella and lesion of the left internal carotid artery with carotid-cavernous fistula.
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http://dx.doi.org/10.1016/j.jflm.2007.07.004DOI Listing
May 2008

Images in cardiovascular medicine. Anomalous origin and course of the right coronary artery.

Circulation 2006 Nov;114(22):e609-11

Dipartimento di Patologia Umana, Università degli Studi di Palermo, Corso Tukory 256, Palermo, Si 90127, Italy.

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http://dx.doi.org/10.1161/CIRCULATIONAHA.106.634667DOI Listing
November 2006