Publications by authors named "Ginevra Malta"

9 Publications

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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

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

Telemedicine during Covid-19 pandemic: Advantage or critical issue?

Med Leg J 2020 Jul 3;88(2):76-77. Epub 2020 Jun 3.

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

Telemedicine offers a support to traditional medicine, delivering clinical services when distance is a critical factor. Although this tool does not replace a medical examination, during Covid-19 pandemic, it reduces the spread of infection and avoids the need for a patient's visit. It is useful in the management of chronic disorders or for patients undergoing palliative treatment. The University Hospital of Palermo has applied this in cases of chronic illness caring for patients who cannot stop their treatment, such as Department of Onco-Haematology, Internal Medicine, Dermatology, etc. The Department of Legal Medicine of Palermo, in particular, is also using telemedicine to manage medico-legal sudden natural death investigations and dealing with the Public Prosecutor's office of Palermo. Even after the Covid-19 emergency, telemedicine will be essential to streamline outpatient visits, while at the same time limiting costs, with significant benefits for the Italian National Public Health Service budget. In conclusion, telemedicine can offer a valuable support to the doctor's activity by streamlining and facilitating their work. In this sense, the Covid-19 pandemic represents a positive input for the acceleration and enhancement of these tools.
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http://dx.doi.org/10.1177/0025817220926926DOI 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

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

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
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