PubMed Health⌕ Search

Biomedical subjects

C Moreschi

Publications and source records attributed to C Moreschi.

6 recordsLinked to original sources

Corrective rhinoplasty: medical and legal aspects.

Preoperative planning of any surgical procedure, especially rhinoplasty, is crucial in order to achieve an optimal outcome which will satisfy both the surgeon and patient. Use of imaging and the possibility of virtually displaying the changes planned by the surgeon definitely lead to a better understanding between doctor and patient. Although these new technologies have led to undeniable advantages, they have also generated unprecedented medical and legal problems. The Authors discuss a number of reflections on the legal consequences of image digital processing, the problems related to the storage of such images, and the appropriate way to draft an informed consent.

Adult↗

[Post-traumatic anosmia: description of a clinical case, proposal of a standardized protocol and medico-legal comments].

Man's olfactory perception is considerably limited compared to that of other animals; this sense is, however, extremely important in our social lives: it helps us to "savour" our food, it enables us to appreciate perfumes and, even more important, to pick up smells that signal a danger, such as a gas leak or a fire. We describe the clinical case of a patient with anosmia and hypogeusia that appeared immediately after suffering a concussive head injury. We go through the diagnostic protocol for medico-legal assessment of hypoanosmias previously described in the literature, which includes a clinical and an imaging section. In 9% of all anosmic patients, a traumatic event precedes the onset of the disorder, with repercussions on the olfactory channels and centres of the peripherical and/or central nervous system. The overall rate of anosmia following head injury is estimated to be around 7.5%. Among the principal causes of anosmia, those of medico-legal interest constitute 35% of the total. On the basis of our personal experience and of clinical studies conducted by other Authors, we propose that a bioptic investigation of the olfactory mucosa be added to the existing protocol. The olfactory neuroepithelium of patients suffering from post-traumatic anosmia, in fact, evidences some characteristic degenerative aspects. In conclusion, we report several comments regarding the quantification of the reduction of the olfactory function in different areas of medico-legal interest.

Adult↗

Prospective study on the relationship between depressive symptoms and chronic musculoskeletal pain.

Chronic pain and depression often coexist, but there is still uncertainty about the nature of this relationship. Virtually all the available data are cross-sectional and therefore do not clarify the causal relationship between the two variables. In epidemiological studies, chronic pain has often been defined fairly liberally in terms of the actual duration. In this study, the definition of chronic pain was based upon self-reports of pain present for most of the days in at least 1 month of the 12 months preceding the interview. We tested the hypotheses that depression causes pain and that pain causes depression in a sample of 2324 subjects who were assessed for the presence of musculo-skeletal pain and the presence of depression, using for the latter a standardized published instrument called the Center for Epidemiologic Studies Depression scale (CES-D). The subjects were first examined using the National Health and Nutrition Survey (NHANES 1) of the United States National Center for Health Statistics from 1974 to 1975, and were followed-up from 1981 to 1984. Those with data on both occasions represent 76% of an initial population of 3059 persons. On logistic regression analysis depressive symptoms at year 1 significantly predicted the development of chronic musculo-skeletal pain at year 8 with an odds ratio of 2.14 for the depressed subjects compared with the non-depressed subjects. In patients in whom pain was present at baseline no socio-demographic variable alone predicted its persistence; however, male sex and white race together with 2 items of the CES-D did predict the persistence of existing pain.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Risk factors for multiple births.

STUDY OBJECTIVE: To analyze risk factors for multiple births. DESIGN: A case-control study. Cases were 103 women (median age 31 years, range 20-44) who delivered multiple births not related with treatment for infertility at the 'Clinica Luigi Mangiagalli' of Milan. A total of 27 women delivered monozygotic twins and 76 dizygotic ones. Controls were 308 women (median age 30, range 17-45) admitted for normal delivery on selected days to the same clinic where cases had been identified. RESULTS: Cases tended to be less educated than controls and the relative risk of multiple pregnancy, compared with women reporting seven years of schooling or less, was 0.4 in those reporting 7-11 and 12 or more years of education. When the analysis was done separately for dizygotic and monozygotic multiple pregnancies, this relationship was restricted to dizygotic multiple pregnancies (chi 2 (1) trend for dizygotic pregnancies = 3.82, p = 0.05). A family history of multiple pregnancies was reported in 36 women (48%) with dizygotic multiple pregnancy and 13 (52%) monozygotic ones and 88 (30%) controls. The corresponding relative risks (RR) were 2.2 and 2.5 respectively for dizygotic and monozygotic pregnancies. Compared with nulliparae, the estimated RR of dizygotic multiple pregnancies was 0.5 in women reporting two or more births, but the trend in risk with number of births was not statistically significant. No relationship emerged with spontaneous or induced abortions, body mass index, oral contraceptive or IUD use, age at menarche and risk of multiple pregnancies. CONCLUSIONS: This study confirms the role of familiarity in the risk of multiple pregnancies and suggests some different epidemiological characteristics in dizygotic and monozygotic multiple pregnancies.

Adolescent↗

[Fatal risks in the domestic use of gaseous hydrocarbons examined in the light of legislation in force].

The authors, in order to identify the causes of mortal poisonings by carbon monoxide in the domestic use of gaseous hydrocarbons and to evaluate the efficacy of the inherent law in force, in particular, the italian law 5 March 1990, n. 46, report 43 cases of mortal poisoning occurred in the Parma district and observed at the Istituto di Medicina legal of Parma University. The authors, for each of these cases, have pointed out responsibilities, causal factors and mechanisms, examining also judicial inquiries and, when possible, experts' technical reports. From the evaluation of the results of their researches, the authors, even if with some perplexity, judge the law in force as suitable to a correct prevention, but only on condition that the controls provided for in law, should be actually carried out. Finally, they evidence a lacking of publicizing about the mortal risk deriving from the non-observation of the legal regulations.

Adolescent↗

Enzymes of lysosomal origin in the serum of infants of diabetic mothers behavior in the first days after birth.

The serum levels of the two enzymes of lysosomal origin, beta-N-acetyl-D-glucosaminidase and beta-D-glucuronidase, and the isozyme pattern of the former, were determined in control infants and in infants of diabetic mothers (IDM) on the 1st and 5th day after birth. IDM were divided into three groups. Group 1: class A diabetic mothers treated dietetically; Groups 2 and 3: class A and classes B, C, D diabetic mothers, respectively, treated with insulin. All, but one, diabetic mothers were in excellent metabolic control. In the controls the serum levels of both enzymes were quite elevated on the 1st day after birth, reflecting the condition of the mothers at the end of pregnancy, and increased further on the 5th day, presumably as a result of the concurrent burst of antiinsulin hormones. In Group 1 IDM the serum levels of the two enzymes were higher than in controls, on the 1st day, probably reflecting the higher concentrations present in the mothers at the end of pregnancy than in controls, but equalling the condition of normal neonates on the 5th day. This indicates that IDM of this group had a normal post-natal response of the lysosomal apparatus to hormone stress. In Groups 2-3 IDM the enzyme levels on the 1st day could not be distinguished from those of controls, while on the 5th day a decrease was seen, suggesting reduced effect of the antiinsulin hormone burst on the lysosomal apparatus. The isozyme pattern of beta-N-acetyl-D-glucosaminidase in all IDM was similar to that of controls. The behavior of serum lysosomal enzymes of Groups 2-3 IDM is a further indication that the lysosomal apparatus is extremely sensitive to even small metabolic perturbations occurring in diabetic mothers during pregnancy.

Acetylglucosaminidase↗