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An unusual case of cut throat injury and poisoning by penconazole - suicide or homicide? Medico-legal considerations and toxicological aspects. 一个不寻常的割喉伤和戊康唑中毒案例——自杀还是他杀?医学法律方面的考虑和毒理学方面。
Clinica Terapeutica Pub Date : 2025-03-01 DOI: 10.7417/CT.2025.5177
R Barranco, G Gaggero, A Salomone, F Ventura
{"title":"An unusual case of cut throat injury and poisoning by penconazole - suicide or homicide? Medico-legal considerations and toxicological aspects.","authors":"R Barranco, G Gaggero, A Salomone, F Ventura","doi":"10.7417/CT.2025.5177","DOIUrl":"10.7417/CT.2025.5177","url":null,"abstract":"<p><strong>Abstract: </strong>In some circumstances, forensic pathologists encounter cases of violent death where distinguishing between homicide, suicide, or accidental death is particularly complex. A multidisciplinary approach is essential to correctly identify the manner, circumstances, and cause of death. Often, the analysis of complex suicides raises doubts about the circumstances of death. In particular, the differential diagnosis between complex suicide and homicide is not always easy. We present here a case of a 73-year-old man found moribund in a rural farmhouse with a cut throat injury. Death occurred shortly after arrival at the hospital. The autopsy and toxicological results also documented penconazole poisoning. The case highlights the complexity of assessing the cause and manner of death in certain instances, requiring the integration of all available autopsy data and investigative information. Furthermore, the histological and toxicological data seem to suggest a severe nephrotoxicity of penconazole in humans. This aspect can have a strong clinical and toxicological relevance, also in terms of safety and biological monitoring.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 Suppl 1(2)","pages":"4-7"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of testamentary capacity: a systematic review of legal, neuropsychological, and bioethical perspectives across jurisdictions. 遗嘱能力评估:跨司法管辖区的法律、神经心理学和生物伦理观点的系统回顾。
Clinica Terapeutica Pub Date : 2025-03-01 DOI: 10.7417/CT.2025.5194
F Damato, M Lippi, V Adelini, F Orsini, M Arcangeli
{"title":"Assessment of testamentary capacity: a systematic review of legal, neuropsychological, and bioethical perspectives across jurisdictions.","authors":"F Damato, M Lippi, V Adelini, F Orsini, M Arcangeli","doi":"10.7417/CT.2025.5194","DOIUrl":"10.7417/CT.2025.5194","url":null,"abstract":"<p><strong>Background: </strong>Testamentary capacity (TC) refers to an individual's legal and cognitive ability to create or modify a valid will. The assessment of TC becomes particularly challenging in individuals with neurodegenerative and psychiatric disorders. While many jurisdictions have established legal criteria for evaluating TC, diagnostic and evaluative processes vary significantly across countries. This review synthesizes existing research on TC assessments, focusing on the methodologies, bioethical considerations, and legal frameworks utilized in different countries. Special emphasis is placed on the importance of evaluating cognitive abilities, including memory, comprehension, and decision-making, which are crucial for determining TC.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with the PRISMA guidelines. Articles were identified through searches in the PubMed, Scopus, and Web of Science databases, supplemented by grey literature from Google Scholar. The search strategy employed Boolean keyword combinations related to testamentary capacity (TC), dementia, cognitive assessment, and bioethics. Studies that addressed bioethical considerations and provided specific measures for TC evaluation were included.</p><p><strong>Results: </strong>The analysis revealed significant variability in both legal and medical approaches to testamentary capacity (TC) assessments across different countries. Some studies emphasize the importance of the \"lucid interval\" in dementia patients, suggesting that fluctuating pecognitive abilities can influence will-making decisions (Shulman et al., 2015). Other research focuses on the legal implications of deathbed wills, where diminished cognitive functioning near the end of life complicates TC evaluations (Purser & Rosenfeld, 2016). Neurolaw has provided a framework for understanding the impact of historical cases, such as Banks v Goodfellow (1870), which continues to serve as a reference point for modern assessments (Bennett, 2016). The role of neuropsychological tools in evaluating undue influence and cognitive abilities also emerged as a critical factor (Kaufmann, 2016). Recent advances in artificial intelligence (AI) present both opportunities and challenges for TC evaluations, particularly in the context of dementia (Economou & Kontos, 2023).</p><p><strong>Conclusion: </strong>The review highlights significant variability in testamentary capacity (TC) assessment methodologies across different countries. While legal precedents such as Banks v Goodfellow (Bennett, 2016) continue to influence current practice, the introduction of AI and other modern tools presents both opportunities and ethical challenges for future assessments (Economou & Kontos, 2023). Incorporating consistent bioethical frameworks and standardized neuropsychological assessments could help ensure more reliable and equitable TC evaluations across various jurisdictions.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 Suppl 1(2)","pages":"89-100"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiac valve hemangioma in two cases of sudden infant death. 心脏瓣膜血管瘤致婴儿猝死2例
Clinica Terapeutica Pub Date : 2025-03-01 DOI: 10.7417/CT.2025.5178
B Defraia, A M Buccoliero, I Bianchi, S Faccioli, R Grifoni, M Focardi
{"title":"Cardiac valve hemangioma in two cases of sudden infant death.","authors":"B Defraia, A M Buccoliero, I Bianchi, S Faccioli, R Grifoni, M Focardi","doi":"10.7417/CT.2025.5178","DOIUrl":"10.7417/CT.2025.5178","url":null,"abstract":"<p><strong>Abstract: </strong>SIDS (the sudden death of an infant <1 year of age) is a specific subcategory of Sudden Unexpected Infant Death (SUID). In Italy, managing SUID should be ruled by the National Protocol (7th October, 2014) however autopsies are not performed in all cases of sudden unexpected infant deaths. Autopsies should be performed, properly and in a timely manner in every SUID case since representing a crucial point in monitoring the phenomenon, providing an important contribution to research, and supporting bereaved families. The complexity of diagnosing SUID cases necessitates a well-structured organization to ensure a thorough approach. Many fatalities can be attributed to cardiovascular abnormalities identified through both macro and microscopic examinations, such as cardiomyopathies, congenital heart defects, coronary artery anomalies, and myocarditis. However, it is important to note that even after comprehensive autopsies and investigations, approximately one-third of these deaths remain unexplained. Cardiac hemangiomas (CH) are defined by the presence of benign proliferative endothelial cells that line blood vessels, accompanied by enhanced vascularization. Microscopically, these tumors exhibit vascular channels that are lined with endothelial cells displaying moderate pleomorphism, occasionally featuring atypical nuclei and localized tuft formations. Limited case reports indicate that CH can infiltrate the heart's conductive tissue, raising concerns about their clinical significance due to the potential for severe complications, including syncope, stroke, and even sudden death. The authors present two cases of sudden infant death in two see-mingly healthy infants, during which cardiac valve hemangiomas were identified in post-mortem examinations. Expanding awareness of such cases can significantly aid in the diagnosis of this condition, whether during the antenatal phase or at autopsy, thereby helping to mitigate the risk of recurrence in future pregnancies, which is notably heightened.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 Suppl 1(2)","pages":"8-13"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is the latest amendment to Law 40/2004 a positive evolution or a regressive move? 第40/2004号法律的最新修订是积极的发展还是倒退的举措?
Clinica Terapeutica Pub Date : 2025-03-01 DOI: 10.7417/CT.2025.5212
M Treglia, L Bassis, F Circosta, S Marinelli
{"title":"Is the latest amendment to Law 40/2004 a positive evolution or a regressive move?","authors":"M Treglia, L Bassis, F Circosta, S Marinelli","doi":"10.7417/CT.2025.5212","DOIUrl":"10.7417/CT.2025.5212","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this article is to illustrate the changes introduced by the rulings of the Constitutional Court and the Court of Cassation concerning the law on medically assisted procreation (MAP) and to offer some considerations on Law No. 169/2024 (Criminalization of Surrogacy, November 4, 2024), which introduces the notion of \"universal crime\" for transnational surrogacy.</p><p><strong>Methods: </strong>The authors have analyzed Italian constitutional and legitimacy jurisprudence, as well as the European Court of Human Rights' rulings, to reflect on the law's compliance with constitutional principles regarding the use of criminal law and the safeguarding of the best interests of the child. The national legal database \"De Jure\" and international databases such as Scopus and PubMed were consulted using the following keywords as search strings: 1) assisted reproduc-tion AND Italian Constitutional Court; 2) assisted reproduction AND Italian Supreme Court; 3) assisted procreation AND Italian Supreme Court; 4) cross-border/international surrogacy, \"best interests of the child\", \"intended/social parents\". The authors eliminated duplicates, read the full text of relevant articles, extended the investigation to related works cited in references, and excluded those with purely medical content.</p><p><strong>Results: </strong>Twenty years after the enactment of Law N. 40/2004, many aspects remain controversial. These include: the fate of surplus embryos; the access of single individuals to MAP techniques; the possibility for same-sex couples to access MAP and be recognized as parents of the child. A delicate issue also concerns granting access to MAP for single individuals. As of today, this possibility seems highly unlikely, as having only one parent is not considered in the best inter-est of the child.</p><p><strong>Conclusions: </strong>Always in the interest of the child, it is necessary to decide on a case-by-case basis whether to recognize a non-genetically or biologically related homosexual person as a parent. These are all issues to which judges cannot provide an answer. This task falls to Parliament, which, with the law on surrogacy classified as a universal crime, has shown that it does not intend to make progress on these matters.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 2","pages":"241-245"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
TVUS coated with power Doppler in endometrial hyperplasia in pre and postmenopausal women presenting with an abnormal uterine bleeding (A Cohort Study). 功率多普勒超声涂布对绝经前和绝经后出现异常子宫出血的妇女子宫内膜增生的诊断价值(一项队列研究)。
Clinica Terapeutica Pub Date : 2025-03-01 DOI: 10.7417/CT.2025.5205
A Z Boshra, M A Abd Elhalim, M A Hamdi, M E Fadila, A A Mohamed, G I A Yasser, S E Mohamed, R M Heba, S M E Mariam, M M Heba, H A Y Doaa, A B Shaimaa, H A M E Nela, F S Ahmed, M A A Walaa, B Mahmoud, A Osama, I E S Ghada
{"title":"TVUS coated with power Doppler in endometrial hyperplasia in pre and postmenopausal women presenting with an abnormal uterine bleeding (A Cohort Study).","authors":"A Z Boshra, M A Abd Elhalim, M A Hamdi, M E Fadila, A A Mohamed, G I A Yasser, S E Mohamed, R M Heba, S M E Mariam, M M Heba, H A Y Doaa, A B Shaimaa, H A M E Nela, F S Ahmed, M A A Walaa, B Mahmoud, A Osama, I E S Ghada","doi":"10.7417/CT.2025.5205","DOIUrl":"10.7417/CT.2025.5205","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to determine if power Doppler added to grey scale TVS can replace invasive methods for predicting endometrial pathology in pre- and postmenopausal women with abnormal uterine bleeding (AUB).</p><p><strong>Materials and methods: </strong>Following a thorough history and physical examination, 200 women (>45 year old) with pre- or postmeno-pausal AUB underwent evaluation with TVS, power Doppler, and hysteroscopic endometrial biopsy in this cohort study. Histopathology was regarded as the gold standard, and it was contrasted with other instruments such power Doppler greyscale TVS. Furthermore it was computed the positive and negative predictive values (NPV and PPV), specificity, sensitivity, and specificity.</p><p><strong>Results: </strong>TVPDUS diagnosed endometrial hyperplasia in 145 cases (72.5%). Endometrial hyperplasia was diagnosed in 158 (79%) cases by histopathological results including either simple cystic hyperplasia in 145 cases, simple atypical hyperplasia in 10 cases and 3 cases were complex hyperplasia. The accuracy, sensitivity, specificity, PPV, and NPV were 88.25%, 90.7%, 84%, 97.7%, and 84 % in premenopause while was 100 % in postmenopausal women in all reported results. hyperplasia. The accuracy, sensitivity, specificity, PPV, and NPV were 88.25%, 90.7%, 84%, 97.7%, and 84 % in premenopause.</p><p><strong>Conclusion: </strong>High resolution TVS with PD is an appropriate diagnostic tool in both pre and post menopausal females presenting with an abnormal uterine bleeding, and assessing endometrial hyperplasia. However, further studies by histopathological examinations are needed for demonstrating its accuracy in diagnosing EH.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 2","pages":"195-200"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Fistful of Lemons: Homicide or Self-Defense? A Multidisciplinary Approach in Forensic Sciences. 一把柠檬:杀人还是自卫?法医学的多学科方法。
Clinica Terapeutica Pub Date : 2025-03-01 DOI: 10.7417/CT.2025.5180
E Giglia, G Licciardello, C Barletta, A V M Failla, A Pallante, G Cocimano
{"title":"A Fistful of Lemons: Homicide or Self-Defense? A Multidisciplinary Approach in Forensic Sciences.","authors":"E Giglia, G Licciardello, C Barletta, A V M Failla, A Pallante, G Cocimano","doi":"10.7417/CT.2025.5180","DOIUrl":"10.7417/CT.2025.5180","url":null,"abstract":"<p><strong>Abstract: </strong>In the context of medico-legal investigations, one of the main challenges lies in the correct distinction between murder and self-defense. Italian legislation requires that, in order to qualify as legitimate defense, the actions taken by the person in danger are indispensable and proportionate to the offense received, as well as motivated by a present danger.Through the presentation of a specific case, the importance of a multidisciplinary forensic approach in forensic medicine is highlighted, useful for reconstructing the dynamics of events and arriving at a precise definition of the nature of the crime. The integration of CT examinations, autopsies, and toxicological and histological investigations is essential to ensure an accurate analysis that can minimize uncertainties about the time, cause and means of death. The case report presented focuses on an episode of double murder in which two men, respectively 29 and 30 years old, caught in the act of carrying out a theft of lemons against a 72-year-old landowner, were drawn by multiple gunshots, fired by the latter. First, subject A (30 aa) was subjected to a CT scan; The eidological investigations thus revealed a continuous oval-shaped solution of the skull, fractures in the right frontal and occipital areas, as well as the presence of foreign bodies retained at the level of the subgluteal region and the glans. During the autopsy investigation, these injuries were confirmed and the bullet retained in the soft skin tissues was recovered. On subject B (29aa), the external examination revealed the presence of two continuous lesions, both at the level of the right axillary region and the left deltoid region, on the other hand, a fracture of the third rib, hemopneumothorax, pneumomediastinum and a tracheal lesion were documented;During the autopsy experiment, the findings highlighted previously were confirmed, the presence of full-thickness lesions of the lungs was ascertained, and thanks to the in-depth evaluation of the organs drawn, in both cases, it was possible to reconstruct what was the direction and means of the bullet.Finally, the subsequent histological investigations conducted on the skin samples, performed in correspondence with the continuous solutions, made it possible to ascertain, in addition to the \"vitality\" of the lesions, also which was the \"entrance hole\" and which was the \"exit hole\". The case illustrated underlines the importance of a multidisci-plinary approach in forensic sciences, in order to provide technical elements useful for the resolution of complex cases. Future studies could explore the use of new applications based on artificial intelligence capable of crystallizing the surveys performed during the judicial inspection in order to compare them with those of subsequent post-mortem investigations.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 Suppl 1(2)","pages":"19-23"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Towards a new concept's applicability in the context of positive practice: The impact of route in Obstetric anesthesia. 面向新概念在积极实践中的适用性:路径在产科麻醉中的影响。
Clinica Terapeutica Pub Date : 2025-03-01 DOI: 10.7417/CT.2025.5200
A A Tarek, M A I Doaa, S E Amira, M A Suzan, L E Rasha, M G Marwa, A M Osama, M A Fatma, M E Mahmoud, Y E Mayada, M I Nashwa, M A Hend, A D Mohamed, F A Manal, M E Mostafa, A S G Samah, G M Mahmoud, S G Abeer
{"title":"Towards a new concept's applicability in the context of positive practice: The impact of route in Obstetric anesthesia.","authors":"A A Tarek, M A I Doaa, S E Amira, M A Suzan, L E Rasha, M G Marwa, A M Osama, M A Fatma, M E Mahmoud, Y E Mayada, M I Nashwa, M A Hend, A D Mohamed, F A Manal, M E Mostafa, A S G Samah, G M Mahmoud, S G Abeer","doi":"10.7417/CT.2025.5200","DOIUrl":"10.7417/CT.2025.5200","url":null,"abstract":"<p><strong>Patients and methods: </strong>We recruited 200 primigravida women with GA or SA who were scheduled for an elective lower segment caesarean section during the period from January 2021 till January 2023 in Alzhraa, Alhussein university hospital, Minia and Fayoum university hospital and Saudi German hospital, Saudi Arabia. The patient made the decision on the kind of anaesthetic. The self-administered EuroQoL-5 Dimensions-3 Levels (EQ-5D-3L) questionnaire was used by participants to assess their current state of health at four different intervals: six hours prior to a caesarean delivery, 24 hours following a caesarean delivery, one week following a caesarean delivery, and one month following a caesarean delivery. Patients also graded their health using the EQ visual analogue scale (EQ-VAS), which goes from 0 (the worst possible health condition) to 10 (the best possible health status).</p><p><strong>Results: </strong>A greater number of women who underwent spinal anaesthesia said that following the operation, their \"mobility,\" \"usual activities,\" and \"pain/discomfort\" were \"no problem\". Recurring measurement analysis showed that although the two groups' EQ-VAS scores were initially identical, they both declined over time with different slopes, producing differing values 24 hours after CS. After that, both groups' scores increased with time, being rather similar one month after CS.</p><p><strong>Conclusion: </strong>Spinal anaesthesia is a better than general anesthesia for caesarean sections because, apart from avoiding the risk of a failed intubation and general anaesthesia, it also provides new mothers with mobility, effective pain relief, and quick access to their daily activities.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 2","pages":"160-166"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Changing Paradigms: Neonatal Outcomes after Oral Metformin versus Insulin in the Control of Gestational Diabetes Mellitus (Randomized controlled trial). 改变范式:口服二甲双胍与胰岛素控制妊娠期糖尿病的新生儿结局(随机对照试验)。
Clinica Terapeutica Pub Date : 2025-03-01 DOI: 10.7417/CT.2025.5197
A E Abd El Tawwab, M S Mahmoud, H A El-Kady, A A Elashiry, H G Elsayed, M F Seifelnasr
{"title":"Changing Paradigms: Neonatal Outcomes after Oral Metformin versus Insulin in the Control of Gestational Diabetes Mellitus (Randomized controlled trial).","authors":"A E Abd El Tawwab, M S Mahmoud, H A El-Kady, A A Elashiry, H G Elsayed, M F Seifelnasr","doi":"10.7417/CT.2025.5197","DOIUrl":"10.7417/CT.2025.5197","url":null,"abstract":"<p><strong>Background: </strong>Although metformin can cross the placenta, its utility in treating gestational diabetes mellitus (GDM) is still debatable.</p><p><strong>Aim: </strong>The purpose of this study was to assess how metformin and insulin affect the outcomes for mothers and newborns in GDM patients.</p><p><strong>Patients and methods: </strong>200 individuals with gestational diabetes who were enrolled in the outpatient clinic at Fayoum University Hospitals (obstetrics and gynecology clinic and family medicine clinic) between March 2024 and August 2024 were the subjects of this randomized controlled research. Patients who satisfied the inclusion and exclusion criteria were randomized to receive either insulin or metformin therapy groups. Blood glucose levels were measured both at enrollment and follow-up appointments. Both maternal and fetal outcomes were the results.</p><p><strong>Results: </strong>Fasting blood sugar, glycated hemoglobin and 2 hours' postprandial blood sugar did not show significant differences (P >0.05) between the two groups. Additionally, Metformin was beneficial in reducing neonatal birth weight. Also, neonates in the metformin-treated group suffered fewer rates of neonatal hypoglycemia and NICU admission. Maternal hypoglycemia was lower in the metformin group, and patient compliance was higher in the same group (P <0.05).</p><p><strong>Conclusions: </strong>We may draw the following conclusions from the current study's results that oral metformin was just as effective in managing and controlling gestational diabetes mellitus as insulin injection. Oral metformin was more effective at controlling maternal and fetal hypoglycemia and neonatal birth weight than insulin injection. Complications for mothers and newborns were similar for both treatment modalities. Moreover, treatment with metformin was more complied with by women.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 2","pages":"148-149"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Philosophy and Medicine: an Aristotelian Reflection. 哲学与医学:亚里士多德的反思。
Clinica Terapeutica Pub Date : 2025-01-01 DOI: 10.7417/CT.2025.5174
M Karaboue, G V Lacasella
{"title":"Philosophy and Medicine: an Aristotelian Reflection.","authors":"M Karaboue, G V Lacasella","doi":"10.7417/CT.2025.5174","DOIUrl":"10.7417/CT.2025.5174","url":null,"abstract":"<p><strong>Abstract: </strong>The debate on the relationship between philosophy and medicine raised by both philosophers and physicians concerns the possibility of elaborating a practical philosophy of medicine as an autonomous discipline distinct from both philosophy and medicine as separate entities. Analysis reveals the close link between philosophy and medicine since its inception in ancient Greece as well as the difficulty of defining the epistemological status of medicine, which presents a dual character of science and practice. The impossibility of defining medicine as pure science, on a par with physics and mathematics, generates tensions between explanatory theories and therapeutic aims and between universal knowledge and understanding of the specific where medical science is confronted with the values that come into play in a clinical encounter. The doctor-patient relationship is the core of clinical medicine. The significant contribution that philosophical reflection (1) can offer to medical science is to be found in the practice of the therapeutic encounter and the analysis of the ethical dimensions involved in it. A practical philosophy, in the Aristotelian sense of the term, is understood as the expression of a form of rationality that differs from the scientific one, which does not seek knowledge as an end in itself but is directed towards an understanding that aims to guide actions. This reference is to that practical logic that allows the physician to deliberate on the most suitable means to achieve his end and the greatest good for the patient.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 1","pages":"114-117"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Simultaneous Enchondroma and Osteochondroma in the Hand: A Case Report. 手部同时发生内生软骨瘤和骨软骨瘤1例报告。
Clinica Terapeutica Pub Date : 2025-01-01 DOI: 10.7417/CT.2025.5219
A Agostinelli, G Touloupakis, I Merli, E Theodorakis, S Ghirardelli, G Antonini
{"title":"Simultaneous Enchondroma and Osteochondroma in the Hand: A Case Report.","authors":"A Agostinelli, G Touloupakis, I Merli, E Theodorakis, S Ghirardelli, G Antonini","doi":"10.7417/CT.2025.5219","DOIUrl":"https://doi.org/10.7417/CT.2025.5219","url":null,"abstract":"<p><strong>Abstract: </strong>The simultaneous occurrence of enchondroma and osteochondroma in the hand is exceptionally rare, with only a few cases documented in the literature. We report a unique presentation in a 12-year-old female patient with both lesions in the second metacarpal. Enchondromas, the most common primary bone tumors of the hand, are often asymptomatic but may cause deformities or pathologic fractures. Osteochondromas, conversely, are rare in the hand, may cause functional impairment or cosmetic concerns. Radiological evaluation, including X-ray, CT, and MRI, was cru-cial for diagnosis, revealing distinct features of both tumors. Surgical excision was undertaken due to mechanical symptoms and aesthetic considerations. Histopathological examination confirmed the diagnoses of enchondroma and osteochondroma. Postoperative follow-up at one year showed no recurrence. This case highlights the importance of early diagnosis, comprehensive radiologic and histopathologic assessment, and timely surgical intervention to prevent functional and cosmetic complications. It also underscores the necessity of monitoring cartilaginous lesions for potential malignant transformation, particularly in rare dual presentations.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 3","pages":"261-265"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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