What we mean when we talk about ‘fuel burns’? This pathological condition related to the tragic travel conditions experienced by migrants has not been prev

The increasing prevalence of cosmetic surgery among adolescents raises critical questions regarding medical responsibility and the legal standards for informed consent. Although the desire to meet aesthetic standards promoted by media and social networks is a key factor driving demand for these procedures, the psychological vulnerability typical of adolescence calls for careful evaluation of patient rights and medical obligations. Informed consent for adolescents, in particular, must be assessed within a multidimensional framework that considers psychological conditions, personal motivations, and the social and cultural pressures that can negatively affect young patients’ self-perception. This article examines the complexities of informed consent in adolescent cosmetic surgery, focusing on the physician's responsibility to ensure patients have a clear understanding of both the risks involved and realistic expectations of the procedure. It also discusses the value of a multidisciplinary approach, involving psychologists and legal professionals, to address the specific needs of adolescents. Emphasis is placed on the necessity for preoperative psychological assessments to distinguish between genuine desires and social pressures, with the goal of protecting adolescents’ psychological and physical well-being and preventing decisions driven by unstable motivations. The article concludes with recommendations for adopting guidelines and enhancing education, advocating for an approach that respects young patients’ rights and emphasizes physicians’ accountability for ethical and safe practice.

Background: Starvation represents a specific pathological entity characterized by severe nutritional deprivation leading to multi-organ failure. Despite its forensic relevance, a comprehensive synthesis of autopsy findings remains lacking. Methods: This systematic review was conducted in accordance with PRISMA 2020 guidelines. PubMed, Scopus, and Google Scholar were searched from inception to June 2025 using a pre-specified Boolean query. Eligible studies included case reports, case series and cohort investigations reporting post-mortem evidence of starvation or starvation-related malnutrition. Data extracted encompassed demographic, contextual, macroscopic, histological, and ancillary findings. Results: Fourteen studies were included, comprising 20 individual cases and two population-based cohorts (totaling 1647 deaths). Most cases (75%) involved children, predominantly victims of domestic neglect; adults accounted for 25%, mainly due to anorexia nervosa or voluntary fasting. Six cadavers were severely decomposed or mummified. Across studies, consistent autopsy findings included extreme emaciation, near-total loss of subcutaneous and visceral fat, empty gastrointestinal tract, and diffuse organ atrophy, especially of the liver, heart, thymus, and pancreas. Histology revealed hepatic steatosis, myocardial fibrosis, thymic involution and gelatinous transformation of adipose tissue. Ancillary methods (dual-energy X-ray absorptiometry, stable isotope and anthropological analyses) confirmed malnutrition in decomposed or skeletonized remains. Conclusions: This review delineates the morphological and histopathological hallmarks of starvation and suggests the possible diagnostic value of ancillary techniques in advanced decomposition. The predominance of neglect-related pediatric cases underscores starvation as a forensic indicator of social and caregiving failure. Establishing reproducible morphological and histological indicators may improve the consistency of forensic diagnosis and strengthen the evidentiary basis for determining starvation as a cause of death.

Asylum seekers often report exposure to persecution in their home countries, during transit, or while in detention. The primary purpose of a forensic medical certification is the objective documentation of physical and psychological findings associated with torture, abuse, or other forms of inhumane treatment. The study had two main objectives: (1) to analyze the demographic, clinical, and medico-legal data of individuals referred to the Specialized Outpatient Service for Survivors of Torture (SVT) at the Policlinic Hospital of the University of Palermo and (2) to evaluate how professional experience and specialized training shape the formulation of compatibility judgments according to the Istanbul Protocol, through a multicenter inter-rater analysis. This is a retrospective observational study that analyzed all consecutive forensic medical evaluations of asylum seekers at the Institute of Legal Medicine, University of Palermo, Italy, between January 1, 2018, and December 31, 2024. In total, 324 patients were examined at the institute's outpatient clinic for survivors of torture. Our findings highlight the essential role of specialized forensic experience in the medico-legal assessment of asylum seekers reporting torture and ill-treatment. Comparative analysis across multiple international centers confirmed that physical trauma, particularly blunt injury, was the most commonly documented form of abuse. The study demonstrated high inter-rater agreement for injury identification, classification, and recognizing associated physical and psychological sequelae. However, discrepancies emerged in assigning consistency levels under the Istanbul Protocol, highlighting the need for structured training and standardized protocols to ensure the accuracy, reproducibility, and evidentiary value of forensic assessments.

Background: The communication of bad news in healthcare is a critical factor in patient care and workplace safety. Ineffective communication can contribute to emotional distress and aggression toward healthcare professionals. Despite its importance, many professionals lack the necessary training to manage these conversations effectively, increasing the risk of conflict. This study investigates the relationship between communication breakdowns and workplace violence in healthcare settings. Methods: This retrospective observational study analyzed incident reporting data from two major Local Healthcare Authorities in Southern Italy (2019–2023). Reports of aggression toward healthcare professionals were categorized by type (verbal or physical), triggering event, location, severity, and aggressor identity. Chi-square tests and linear regression models were used to identify trends and associations. Results: A total of 248 reported incidents were analyzed, with 85.1% classified as verbal aggression and 14.9% as physical aggression. The primary trigger was disagreement over clinical management (57.4%), followed by perceived delays in care (25.5%) and denial of assistance by family members (11.7%). Most incidents occurred in community-based healthcare services (42.6%) and emergency departments (25.5%). Family members were the primary perpetrators of physical assaults (64.3%), while patients were responsible for most verbal aggression (55.3%). Conclusions: Poor communication strategies contribute to workplace violence. Improving healthcare professionals’ communication skills through structured training, implementing conflict management strategies, and strengthening security measures in high-risk areas are crucial for reducing aggression. Future research should explore additional risk factors and assess the effectiveness of targeted interventions.