Chest trauma is the leading cause of death in people under 40. It is estimated to cause around 140,000 deaths each year. The key aims are to reduce mortality and the impact of associated complications to expedite recovery and to restore patient’s conditions. The recognition of lesions through appropriate imaging and early treatment already in the emergency department are fundamental. The majority can be managed in a non-surgical way, but especially after traumatic cardiac arrest, a surgical approach is required. One of the most important surgical procedures is the Emergency Department Thoracotomy (EDT). The aim of this review is to provide a comprehensive synthesis about the management of thoracic trauma, the surgical procedures, accepted indications, and technical details adopted during the most important surgical procedures for different thoracic trauma injuries. Literature from 1990 to 2023 was retrieved from multiple databases and reviewed. It is also important to emphasize the medico-legal implications of this type of trauma, both from the point of view of collaboration with the judicial authority and in the prevention of any litigation.

Episodes of direct violence against healthcare workers and social workers represent a worrying and widespread phenomenon in Western countries. These violent attacks, whether verbal or physical, occur in various work environments, targeting professionals working in private facilities, medical practices, or those employed within the National Health System facilities. We conducted a search using a single search engine (PubMed) using the terms “violence against healthcare workers AND Western” for the period 2003–2023, identifying 45 results to which we added to the literature through hand searching. Our review thus analyzed the sector literature to highlight the phenomenon of violence against healthcare workers, particularly in Western countries. We began with an analysis of the problem and then focused on the true purpose of the study, which is to propose new solutions to protect healthcare workers in all work settings. Consequently, we aim to improve both the working environment for healthcare professionals and to enhance the overall healthcare and public health outcomes.

Venous thromboembolism (VTE), consisting of deep vein thrombosis (DVT) and pulmonary embolism (PE), requires a forensic age determination to ascertain their causal relationship with recent events, such as trauma or medical treatment. The main objective of this systematic review is to identify the current state-of-the-art immunohistochemical methods for age determination of fatal VTE. A literature search was performed through different databases, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Within the study, we have selected only cases represented by deceased patients for DVT and/or PTE in which thromboembolic material was collected during an autoptic examination and then subjected to a histological and an immunohistochemical investigation. Studies based on animal models were not included. We assessed bias risk. A database-based search produced a total of 19 articles. After excluding duplicate items from the selection, 14 articles were reviewed. Ten articles were excluded because they did not meet the inclusion criteria. The results have pointed out 4 studies that were included in the present analysis for a total of 157 samples of DVT and 171 PTE samples. These were analyzed using traditional histological and immunohistochemical techniques. The results must be interpreted with a critical eye because of their heterogeneity in terms of time, geography, and study design. The present review highlights the importance of associating specific immunohistochemical markers with a histological analysis for the timing of DVT/PTE fatal events. Further future experiences will hopefully endorse actual knowledge on the subject to increase the accuracy in the assessment of thrombus-embolus age.

Volatile substance abuse is widespread among adolescents due to its easy availability and methods of consumption. Inhalant abuse represents a current problematic issue, causing significant morbidity and mortality due to direct toxicity on several target organs and displacement of gas which results in a lack of oxygen. This review aims to evaluate post-mortem and toxicological investigations in cases of suspected butane intoxication. We performed comprehensive research using the Preferred Reporting Items for Systematic Review (PRISMA) standards. Forty scientific papers fulfilled the inclusion criteria. A total of 58 cases of butane-related deaths were found. Among these, we found 11 cases of suicide (18%), 1 case of homicide (2%), 44 cases of accidental poisoning (76%), and 2 cases of work-related deaths (4%). Autopsy and post-mortem examinations were performed in 54 cases, whereas toxicological analyses were presented in 56 cases. In autopsy, pulmonary edema (51%) and poli-visceral congestion (59%) were the most common findings. When death by butane inhalation is hypothesized, autopsy and histological findings may be nonspecific, therefore toxicological investigations assume a crucial role along with attention to the methods used to collect biological samples.

Background and aim: Artificial intelligence (AI) is gaining increasing relevance in orthopaedic surgery, particularly in prosthetic surgery, due to its ability to support preoperative planning through advanced imaging analysis, implant size prediction, and outcome forecasting. However, recent literature shows considerable variability in employed models, evaluated outcomes, and clinical applicability. The objective of this scoping review is to map AI applications in preoperative planning for orthopaedic arthroplasties and to assess their impact on radiographic and clinical outcomes, also discussing key ethical and medicolegal implications within both Italian and international contexts. Materials and methods: A literature review was conducted following scoping review methodology. The bibliographic search (10 September 2025) was performed in PubMed and Scopus using the query “preoperative planning WITH artificial intelligence AND prosthesis orthopaedic surgery AND outcomes”, restricted to the years 2020–2025, English-language studies, and research focused specifically on real-world AI techniques applied to preoperative planning in prosthetic surgery, reporting radiographic and/or clinical outcomes related to planning. Exclusion criteria included intra/postoperative studies, non-orthopaedic applications, robotic surgery, studies lacking clinical outcomes, case reports, and articles without full-text availability. After PRISMA screening and selection, 42 primary studies were included. Results: Of the 42 studies included, 20 focused on the hip, 19 on the knee, and 3 on the shoulder. Available evidence indicates that AI may improve templating accuracy and prosthetic component positioning, with more robust results in hip and knee arthroplasty, while applications in shoulder arthroplasty remain emerging. Nonetheless, important methodological limitations persist, including algorithm heterogeneity. Discussion: Overall, the findings suggest a promising role for AI in preoperative planning; however, the heterogeneity and variable quality of the evidence call for caution in interpretation and highlight the need for more rigorous prospective research. These considerations also carry relevant medicolegal implications, as the reliability and standardisation of AI-based tools represent essential prerequisites for their safe and conscious integration within diverse regulatory frameworks. Conclusions: AI appears to be a promising tool in the preoperative planning of orthopaedic arthroplasties, although further clinical validation and methodological standardisation are required. The evidence gathered also provides a useful foundation for addressing the associated medicolegal and regulatory implications, particularly in light of evolving Italian and European regulations and their differences from U.S. models.

The use of AI is transforming the production and legal validity of scientific evidence in the forensic context, raising critical questions regarding admissibility in court. While traditional forms of scientific evidence rely on methodologies already validated and accepted by the scientific community, AI systems introduce unprecedented challenges in terms of explainability. We conducted a search on PubMed using the keywords "artificial intelligence scientific proof" over the past 10 years. Applying the relevant filters, we obtained 243 results. The aim of this research is to analyze the reliability of AI in judicial proceedings and the potential admissibility of scientific evidence, by comparing major legal systems. This study examines the impact of AI with particular focus on compliance standards. For completeness, we also carried out additional hand-searching. The investigation reveals that the use of AI in the forensic field offers undeniable advantages. However, there are still several issues to address, primarily associated with the "black box" nature of AI. In this international context, there are also regulatory gaps between the EU system and the US approach, which is already utilizing such systems with flexible but controversial criteria. The integration of AI into legal processes requires a balance between innovation and procedural safeguards. The U.S. Daubert Standard provides a framework for assessing the scientific reliability of algorithmic evidence but needs adaptation to address the challenges posed by AI. The future challenge lies in reconciling technological advancement with the principles of procedural fairness, ensuring that AI does not become an "incontestable" form of evidence due to its complex nature.