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Biomedical subjects

N Magnavita

Publications and source records attributed to N Magnavita.

At least 19 recordsLinked to original sources
PubMed2006

A 12-year follow-up study of malpractice claims against radiologists in Italy.

PURPOSE: Malpractice claims filed against radiologists have become a relevant phenomenon in Italy and are a real risk in the radiologists' professional activity. MATERIALS AND METHODS: Insurance claims of Italian radiologists over the 1993-2004 period were anonymously assessed. A total of 990 insurance claims were classified according to cause: (1) missed diagnosis, (2) complications of the radiological procedure, (3) failure to order further radiological examinations, (4) radiation treatment, (5) slip-and-fall injuries, (6) miscellaneous causes. RESULTS: A total of 990 claims were filed during the period, with most claims being filed a considerable time after the event. As a consequence, the estimated incidence may be 44 per 1,000. In other words, 44% of Italian radiologists have received, or will receive, a summons regarding their professional activity of the past 10 years. Misdiagnosis made up the first and most important claim category. Missed abnormalities on breast radiographs accounted for the greatest percentage of cases. Missed bone abnormalities were the following most common diagnostic errors. Complications following interventional procedures accounted for 10% of all cases. A few cases resulted from the radiologist's failure to order further diagnostic examinations. Lastly, radiologists were frequently named as one of multiple defendants, together with medical (or surgical) doctors, in cases of patient death in roughly 6% of all cases. CONCLUSIONS: The risk of medical malpractice litigation for Italian radiologists is by now comparable to that for American radiologists. Strict adherence to radiological standards may be a means of reducing the risk of legal action and obviating litigation.

Follow-Up Studies↗
PubMed2004

SARS and masks.

Explore the source record for details and available documents.

Disease Transmission, Infectious↗
PubMed2003

Occupational head injury and subsequent glioma.

We report the case of a policeman who suffered a severe head injury to the right temporoparietal lobe while driving a police car. Four years later, the patient developed a neoplasm at the precise site of the meningocerebral scar. Histological examination confirmed a glioblastoma multiforme adjacent to the dural scar. Radiological documentation of the absence of tumor at the time of injury, exact localization of the neoplasm in the injured cerebral area, and latency of the cancer supported the hypothesis of a causal relationship with brain trauma. Physicians faced with brain neoplasms in adults should carefully investigate the patient's personal history of head trauma. When a relationship with occupational head injury is probable, reporting of suspect occupational illness is compelling.

Accidents, Occupational↗
PubMed2003

Aesthesioneuroblastoma in a woodworker.

A case is described of aesthesioneuroblastoma in a woodworker who had been exposed to wood dust for 25 years, without any individual or environmental protection. The case described supports the contention that occupational exposure to wood dust may have caused the neoplasm.

Air Pollution, Indoor↗
PubMed2002

Photoretinitis: an underestimated occupational injury?

Non-ionizing radiation, which is produced in large amounts by welding arcs, may induce photophthalmia, keratoconjunctivitis and cataracts. Retinal injuries resulting from exposure to electric welding arcs have been reported, but such injuries are not commonly seen and may be misdiagnosed. A case is described of bilateral maculopathy in a millwright exposed to metal arc inert gas-shielded welding and oxygen lance light. Insurance adjudicators denied his claim, as they did not acknowledge the cause-and-effect relationship between welding and retinopathy. Welding emits a wide spectrum of radiation, ranging from IR to UV and beyond. UV and far-IR radiation are adsorbed by the cornea and the lens, whereas visible light and near-IR radiation penetrate to the retina. According to the intensity and time of exposure, they may cause thermal or photochemical retinal damage, which may be permanent and sight-threatening. Workers covered by compulsory collective insurance should be eligible for compensation in every case of welding light-induced retinal damage.

Humans↗
PubMed2001

Destructive spondyloarthropathy of the cervical spine in long-term hemodialyzed patients: a five-year clinical radiological prospective study.

OBJECTIVE: To describe the radiographic features and progression of cervical spine destructive spondyloarthropathy (DSA) in hemodialyzed patients, and to evaluate the relationship between this disease and patient characteristics, biochemical values, and hemodialysis duration. DESIGN AND PATIENTS: Standard radiographs, and lateral flexion and extension views of the cervical spine, were performed annually for 5 years in 31 hemodialyzed patients who were divided into three groups at the commencement of the study: those showing (I) DSA, (II) vertebral rim erosions (VRE) without DSA, and (III) absence of DSA and VRE. Magnetic resonance (MR) imaging and computed tomography (CT) were performed in seven and two patients respectively. The imaging features were evaluated for the presence and progression of spondyloarthropathy and correlated with clinical and biochemical variables. Statistical analysis was performed using one-way analysis of variance. RESULTS: The duration of hemodialysis appeared to be the main predictive factor (P=0.0003) for DSA, which was found in six patients (19%). DSA was found to correlate with higher levels of beta2-microglobulin (P<0.00001), parathyroid hormone (P<0.05), and alkaline phosphatase (P<0.05). Clinical symptoms were minimal. In two patients, MR imaging revealed changes mimicking spondylodiscitis. In another patient, CT of the craniocervical junction showed bone resorption due to a pseudotumor, and basilar invagination. CONCLUSIONS: DSA of the cervical spine is often clinically silent. Pathogenesis of DSA may be multifactorial but its progression is most influenced by the duration of hemodialysis. On MR imaging, DSA may mimic spondylodiscitis.

Adult↗
PubMed2001

Cacosmia in healthy workers.

Self-reported cacosmia (i.e. feeling ill from the odour of xenobiotic substances) was studied in 151 young, healthy workers, unexposed to unpleasant odours and working in food stores without air-conditioning. Almost half (46%) of the sample reported feeling ill from the smell of chemical materials. Chemical odour intolerance induced headache, itching eyes, irritated or congested nose, dry and/or sore throat, cough, dizziness, and itching or rash. Cacosmic subjects showed a slight prevalence of the female sex, and had significantly higher symptom scores, anxiety, and depression than non-cacosmic subjects. Cacosmia may be related to multiple chemical sensitivity, sick-building syndrome and psychopathology. Individual variability in odour tolerance may substantially bias epidemiological studies on indoor air quality and health.

Adult↗
PubMed2001

[Liability claims in radiology: an 8-year follow-up and future projections].

AIM: The analysis of the liability claims filed by Italian radiologists over the past 8 years allows us to evaluate past trends and predict the future evolution of litigation in radiology. MATERIAL AND METHODS: The assurance claims of Italian radiologists over the 1993-2000 period were anonymously evaluated. A total number of 422 claims were classified according to the cause as due to: 1) missed diagnoses; 2) complications; 3) failure to order further radiological examinations; 4) iatrogenic lesions due to radiation therapy; 5) slip-and-fall injuries; 6) miscellaneous cases. The data were analysed using descriptive statistics and curve estimation, i.e. selection of the regression models which best fit the observed data. RESULTS: Claims showed a linear increase from 1993 to 2000; however exponential increase could not be ruled out. The incidence risk-rate of claims rose over 45 per thousand persons/year. Misdiagnosis represented the first and most important claim category (>60% of total). Missed bone and joint abnormalities accounted for the greatest percentage of cases (37.8%). Missed abnormalities on breast and chest radiographs were the following most common diagnostic errors (25.2% and 15.0%, respectively). Within this class of claims, missed malignant lesions of the breast showed the greatest increase in number. Claims alleging complications resulting from radiological examinations or procedures were 13% of all cases. These complications mostly occurred following administration of i.v. contrast medium, or due to interventional procedures, or barium edema. Slip-and-fall accounted for 6% of cases. A few cases (0.7%) resulted from failure of the radiologist to order further diagnostic examinations. Finally, in roughly 12% of all cases, the radiologists were named as one of multiple defendants, together with medical doctors or other clinicians, in cases of patient's death. CONCLUSIONS: The risk of being sued for Italian radiologists is now comparable to that radiologists in the United States. Strict adherence to radiological standards will probably not be sufficient to reduce the risk of being sued. Special legislative measures may be required to obviate litigation.

Forecasting↗
PubMed2000

Industrial mass psychogenic illness: the unfashionable diagnosis.

Two previously unpublished outbreaks of Mass Psychogenic Illness (MPI) in Italy are reported. The first outbreak involved 427 female workers at an electro-mechanical plant. Workers complained of work-related stressors, and high levels of conflict between their job and home duties. We conclude that the episode resulted from the interaction of environmental and work-related factors, the persons and the social organization of the workplace. The second case is one in which risk of MPI developing seems to have been successfully prevented. An effective stress coping strategy, coupled with workplace improvement, may have succeeded in eliminating cases of illness and preventing an outbreak of MPI.

Adaptation, Psychological↗
PubMed2000

[Complaints against radiologists in Italy].

INTRODUCTION: Legal claims against radiologists are a relevant phenomenon also in our country and represent an increasing risk for a radiologist's professional activity. MATERIAL AND METHODS: We reviewed the 1993-1998 insurance claims against Italian radiologists. We found 259 claims subdivided by type into: 1) misdiagnosis; 2) complications of the examination; 3) missed referral for further examinations/treatment; 4) (non)ionizing radiation treatment; 5) slip-and-fall injuries; 6) miscellaneous cases. All claims were reviewed anonymously. RESULTS AND DISCUSSION: Most of the 259 malpractice claims were filed late after the event, which makes the actual incidence of the phenomenon difficult to evaluate. Nevertheless the incidence of malpractice claims can be estimated at 32 per thousand people a year, meaning that an Italian radiologist's risk of being sued by a patient at least once in his/her professional life exceeds 1. Alleged misdiagnosis was the most frequent claim category. Missed bone abnormalities of any type, including fractures, dislocations, malignant lesions and other nonspecific conditions accounted for 52.9% of cases. Missed abnormalities on breast and chest examinations accounted for 17.5% and 15.3%, respectively. Within this claim category, missed breast lesions exhibited the most increasing trend. Alleged complications from radiological examinations accounted for 20% of cases and mostly involved i.v. contrast agent administration, interventional procedures and barium enema. Slip-and-fall injuries, where the patients falls off the examination table, slips on the floor, bumps into a piece of equipment and so on, accounted for 7% of cases. Missed referral to further examinations accounted for 1.5% only. Finally, radiologists were frequently sued as one of many defendants, together with medical/surgical doctors, in case of patient's death, in 20% of all cases. CONCLUSIONS: Italian radiologists currently run the same risk of being sued for malpractice as their American colleagues. Strict compliance with radiological standards is recommended to try to decrease the risk and to obviate litigation.

Diagnostic Errors↗
PubMed1999

Marked elevation of myocardial trace elements in idiopathic dilated cardiomyopathy compared with secondary cardiac dysfunction.

OBJECTIVES: We sought to investigate the possible pathogenetic role of myocardial trace elements (TE) in patients with various forms of cardiac failure. BACKGROUND: Both myocardial TE accumulation and deficiency have been associated with the development of heart failure indistinguishable from an idiopathic dilated cardiomyopathy. METHODS: Myocardial and muscular content of 32 TE has been assessed in biopsy samples of 13 patients (pts) with clinical, hemodynamic and histologic diagnosis of idiopathic dilated cardiomyopathy (IDCM), all without past or current exposure to TE. One muscular and one left ventricular (LV) endomyocardial specimen from each patient, drawn with metal contamination-free technique, were analyzed by neutron activation analysis and compared with 1) similar surgical samples from patients with valvular (12 pts) and ischemic (13 pts) heart disease comparable for age and degree of LV dysfunction; 2) papillary and skeletal muscle surgical biopsies from 10 pts with mitral stenosis and normal LV function, and 3) LV endomyocardial biopsies from four normal subjects. RESULTS: A large increase (>10,000 times for mercury and antimony) of TE concentration has been observed in myocardial but not in muscular samples in all pts with IDCM. Patients with secondary cardiac dysfunction had mild increase (< or = 5 times) of myocardial TE and normal muscular TE. In particular, in pts with IDCM mean mercury concentration was 22,000 times (178,400 ng/g vs. 8 ng/g), antimony 12,000 times (19,260 ng/g vs. 1.5 ng/g), gold 11 times (26 ng/g vs. 2.3 ng/g), chromium 13 times (2,300 ng/g vs. 177 ng/g) and cobalt 4 times (86,5 ng/g vs. 20 ng/g) higher than in control subjects. CONCLUSIONS: A large, significant increase of myocardial TE is present in IDCM but not in secondary cardiac dysfunction. The increased concentration of TE in pts with IDCM may adversely affect mitochondrial activity and myocardial metabolism and worsen cellular function.

Adult↗
PubMed1999

Work-related musculoskeletal complaints in sonologists.

The prevalence of musculoskeletal complaints of the hand and wrist, and the neck and back, in physicians who operate sonography equipment was evaluated, and associations between these complaints and various work-related and personal variables were studied. A questionnaire survey was distributed among physician sonographers (sonologists) in Italy. The relationship between work habits and musculoskeletal complaints was analyzed by logistic regression models adjusted for gender, age, and duration of work with ultrasound. A total of 2041 physician sonographers completed the questionnaire. It was found that a large proportion of the subjects regularly had work-related complaints, such as neck and back pain (NBP) (18.5%) or hand and wrist cumulative trauma disorder (HWD) (5.3%). Roughly 80% of the sonographers were currently affected, or had been affected in the past, by one or more work-related symptoms. Various work-related factors appeared to be related to musculoskeletal syndromes. The average time spent for each examination was related both to NBP and HWD. Discomfort for transducer design was the best predictor of HWD, whereas a comfortable chair and correct position of the body protected from the onset of NBP. These results support the role of ergonomic factors in the pathogenesis of both NBP and HWD in sonographers.

Adult↗
PubMed1999

A preventive intervention program in adolescent schoolgirls: a longitudinal study.

BACKGROUND: To explore the impact of a prevention program on the eating and body attitudes of a sample of adolescent schoolgirls. METHODS: The program involved lessons and group discussions of general adolescent problems and eating disorders. A total of 254 16-year-old schoolgirls were evaluated, of whom 154 participated in the program and a further 154 subjects formed the control group. Variations in weight, Eating Attitudes Test and Eating Disorders Inventory at a 1-year follow-up were compared for the two groups. RESULTS: Among high-risk subjects, no significant differences were found between the prevention and the control group. The preventive program appeared to reduce significantly body dissatisfaction and to decrease the risk of bulimic attitudes in low-risk subjects. CONCLUSIONS: Providing schoolgirls with the correct information about eating disorders did not encourage unhealthy attitudes to eating and weight regulation practices. However, for high-risk subjects more intensive and specific intervention may be required, for which further research is needed.

Adolescent↗
PubMed1999

Neuropeptide Y plasma levels and immunological changes during academic stress.

Academic stress is a good model of psychological stress in humans for studying psychoneuroimmune correlations. We looked for correlations between psychological scores, immune tests and plasma levels of cortisol and neuropeptide Y (NPY). A group of medical students were evaluated at the beginning of the academic year (Baseline) and the day before an examination (Stress). They underwent evaluation by The Profile of Mood States (POMS), The Malaise Inventory, The Self Efficacy Scale and A Global Assessment of Recent Stress (GARS). The lymphocyte subsets, the lymphocyte proliferative response and the cytokine production were also evaluated. We detected modifications of some psychological test scores between the Baseline and Stress evaluation, a significant reduction of lymphocyte proliferation, IL-2 production and percentage of the lymphocyte CD19, and an increase in plasma cortisol levels during stress. The lymphocyte proliferation negatively correlated with the POMS score as well as the percentage of CD16+ cells with NPY plasma levels. NPY levels were not different from Baseline. The emotional and mood states seem to influence immunity. Copyrightz1999S.KargerAG,Basel

Adaptation, Psychological↗
PubMed1999

[Frequency of musculoskeletal symptoms in diagnostic medical sonographers. Results of a pilot survey].

INTRODUCTION: We report the results of a pilot survey in diagnostic medical sonographers. Aim of the study was to evaluate the frequency of musculoskeletal disorders in sonologists and the relationship of these symptoms to ergonomic factors. MATERIALS AND METHODS: 340 sonographers (258 male, 82 female doctors; mean age 41.5 +/- 7.2 years) were given a questionnaire to fill out. The questionnaire asked questions about the sonologist's age, gender, technique of ultrasound procedure, physical activity, and work-related musculoskeletal complaints. Two symptom lists regarded carpal tunnel syndrome (CTS) symptoms (8 items) and other work-related musculoskeletal symptoms (13 items). The categorized response variables "have now" or "in the past" were provided. The symptoms experienced were categorized into three levels as no symptoms, few symptoms (1-4 symptoms), and many symptoms (> 5 symptoms). RESULTS: One third of the respondents reported having at least one or more work-related symptoms in the upper extremities. The most frequent symptoms were tingling (17.6%), numbness or finger pain (13.5%). Carpal tunnel syndrome had been diagnosed in 5 cases (1.5%). More than 60% of all respondents have experienced one or more musculoskeletal symptoms in the cervical or lumbar spine. The commonest symptom was neck and low back pain (67%). The pain was generally intermittent and occurred at the end of the workday. Motion impairment in the neck and/or back was present in 23.5% of cases. Twenty-five percent of respondents had received treatments for their symptoms and 10% reported having stopped work because of their symptoms. Data analysis showed that muscular efforts such as gripping the transducer, applying sustained pressure, and scanning with a correlated flexed or hyperextended wrist were significantly correlated with increasing severity of symptoms in the hand, wrist, and forearm area. On the other hand, low back pain appeared to be negatively correlated with correct position of the body. CONCLUSIONS: Several physical risk factors (e.g., repetitive work and force exertion, twisting of the body and poorly-adjustable chairs) have been identified for work-related upper extremity and spine disorders. Ergonomic redesign of the workstation configuration as well as allowing sufficient recovery time to body and arm muscles appear to be the main goals to achieve prevention of musculoskeletal disorders in sonographers.

Adult↗
PubMed1998

[Malpractice claims against radiologists. Analysis of the five-year period 1993-1997].

INTRODUCTION: The insurance claims against Italian radiologists over a five-year period (1993-97) were anonymously evaluated, based on pertinent data provided by the Insurance Company of the Italian Society of Medical Radiology. MATERIAL AND METHODS: The database analyzed represents over one third of Italian radiologists. A total number of 171 insurance claims were analyzed and classified by cause as due to: 1) misidiagnosis; 2) alleged malpractice when performing the examination; 3) missed referral to other diagnostic/therapeutic procedures; 4) iatrogenic lesions by ionizing/nonionizing radiations; 5) patient's injury occurring during the examination; 6) lawsuits after the Italian Code of Criminal Procedure (art. 589) in case of patient's death (although not directly related to the radiologist's work). RESULTS: In the first three-year period, the rate of claims was 25.8 per thousand persons/year. Each Italian radiologist has a 90% risk of being sied by a patient once in his/her professional life (35 years). Alleged malpractice accounted for more than 75% of the claims. Misdiagnosis represented the first and most important claims category (43.9% of total). The most common misdiagnoses were the failure to diagnose lesions affecting bones and joints, chest, abdomen and breast. The second most important claim category (20.5%) was complications, frequently occurring during interventional procedures and contrast media injection. Fewer claims (7.6%) originated from patient's injury occurring in the radiology department during the execution of the examination. Finally, radiologists were frequently sved together with medical (or surgical) doctors in case of patient's death, according to the Italian Code of Criminal Procedure. CONCLUSIONS: Legal claims against radiologists are a relevant phenomenon also in our country and represent an actual risk for radiologists' professional activity.

Humans↗
PubMed1997

Type A behaviour pattern and traffic accidents.

This study examines the possible relationship between Type A behaviour pattern (TABP) and traffic accident risk in a cohort of traffic policemen. Data were gathered from 86 police drivers from a small Italian town, using the Bortner questionnaire. Results reveal that police drivers with Type A behaviour had higher traffic accident risk than those with lower scores at the Bortner scale. Adjusted odds ratio was 4.2 (95 per cent CI: 1.17-15.17) after correction for confounding variables in multiple logistic regression.

Accidents, Traffic↗