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1. The Italian law on body donation: A position paper of the Italian College of Anatomists

Author

De Caro, R, Boscolo-Berto, R, Artico, M, Bertelli, E, Cannas, M, Cappello, F, Carpino, G, Castorina, S, Cataldi, A, Cavaletti, G, Cinti, S, Cocco, L, Cremona, O, Crivellato, E, De Luca, A, Falconi, M, Familiari, G, Ferri, G, Fornai, F, Gesi, M, Geuna, S, Gibelli, D, Giordano, A, Gobbi, P, Guerra, G, Gulisano, M, Macchi, V, Macchiarelli, G, Manzoli, L, Michetti, F, Miscia, S, Montagnani, S, Montella, A, Morini, S, Onori, P, Palumbo, C, Papa, M, Porzionato, A, Quacci, D, Raspanti, M, Rende, M, Rezzani, R, Ribatti, D, Ripani, M, Rodella, L, Rossi, P, Sbarbati, A, Secchiero, P, Sforza, C, Stecco, C, Toni, R, Vercelli, A, Vitale, M, Zancanaro, C, Zauli, G, Zecchi, S, Anastasi, G, Gaudio, E, De Caro R., Boscolo-Berto R., Artico M., Bertelli E., Cannas M., Cappello F., Carpino G., Castorina S., Cataldi A., Cavaletti G. A., Cinti S., Cocco L. I., Cremona O., Crivellato E., De Luca A., Falconi M., Familiari G., Ferri G. L., Fornai F., Gesi M., Geuna S., Gibelli D. M., Giordano A., Gobbi P., Guerra G., Gulisano M., Macchi V., Macchiarelli G., Manzoli L., Michetti F., Miscia S., Montagnani S., Montella A. C. M., Morini S., Onori P., Palumbo C., Papa M., Porzionato A., Quacci D. E., Raspanti M., Rende M., Rezzani R., Ribatti D., Ripani M., Rodella L. F., Rossi P., Sbarbati A., Secchiero P., Sforza C., Stecco C., Toni R., Vercelli A., Vitale M., Zancanaro C., Zauli G., Zecchi S., Anastasi G. P., Gaudio E., De Caro, R, Boscolo-Berto, R, Artico, M, Bertelli, E, Cannas, M, Cappello, F, Carpino, G, Castorina, S, Cataldi, A, Cavaletti, G, Cinti, S, Cocco, L, Cremona, O, Crivellato, E, De Luca, A, Falconi, M, Familiari, G, Ferri, G, Fornai, F, Gesi, M, Geuna, S, Gibelli, D, Giordano, A, Gobbi, P, Guerra, G, Gulisano, M, Macchi, V, Macchiarelli, G, Manzoli, L, Michetti, F, Miscia, S, Montagnani, S, Montella, A, Morini, S, Onori, P, Palumbo, C, Papa, M, Porzionato, A, Quacci, D, Raspanti, M, Rende, M, Rezzani, R, Ribatti, D, Ripani, M, Rodella, L, Rossi, P, Sbarbati, A, Secchiero, P, Sforza, C, Stecco, C, Toni, R, Vercelli, A, Vitale, M, Zancanaro, C, Zauli, G, Zecchi, S, Anastasi, G, Gaudio, E, De Caro R., Boscolo-Berto R., Artico M., Bertelli E., Cannas M., Cappello F., Carpino G., Castorina S., Cataldi A., Cavaletti G. A., Cinti S., Cocco L. I., Cremona O., Crivellato E., De Luca A., Falconi M., Familiari G., Ferri G. L., Fornai F., Gesi M., Geuna S., Gibelli D. M., Giordano A., Gobbi P., Guerra G., Gulisano M., Macchi V., Macchiarelli G., Manzoli L., Michetti F., Miscia S., Montagnani S., Montella A. C. M., Morini S., Onori P., Palumbo C., Papa M., Porzionato A., Quacci D. E., Raspanti M., Rende M., Rezzani R., Ribatti D., Ripani M., Rodella L. F., Rossi P., Sbarbati A., Secchiero P., Sforza C., Stecco C., Toni R., Vercelli A., Vitale M., Zancanaro C., Zauli G., Zecchi S., Anastasi G. P., and Gaudio E.

Abstract

In Italy, recent legislation (Law No. 10/2020) has tuned regulations concerning the donation of one's postmortem body and tissues for study, training, and scientific research purposes. This study discusses several specific issues to optimise the applicability and effectiveness of such an important, novel regulatory setting. Critical issues arise concerning the learners, the type of training and teaching activities that can be planned, the position of academic anatomy institutes, the role of family members in the donation process, the time frame of the donation process, the eligibility of partial donation, or the simultaneous donation of organs and tissues to patients awaiting transplantation. In particular, a universal time limit for donations (i.e., one year) makes it impossible to plan the long-term use of specific body parts, which could be effectively preserved for the advanced teaching and training of medical students and surgeons. The abovementioned conditions lead to the limited use of corpses, thus resulting in the inefficiency of the whole system of body donation. Overall, the donors’ scope for the donation of their body could be best honoured by a more flexible and tuneable approach that can be used on a case-by-case basis. Furthermore, it is deemed necessary to closely monitor the events scheduled for corpses in public nonacademic institutions or private enterprises. This paper presents useful insights from Italian anatomists with the hope of providing inspiration for drafting the regulations. In conclusion, this paper focuses on the critical issues derived from the recently introduced Italian law on the donation and use of the body after death and provides suggestions to lawmakers for future implementations.

Published
2021

4. The Italian law on body donation: A position paper of the Italian College of Anatomists

Author

Raffaele De Caro, Rafael, Boscolo-Berto, Marco, Artico, Eugenio, Bertelli, Mario, Cannas, Francesco, Cappello, Guido, Carpino, Sergio, Castorina, Amelia, Cataldi, Guido Angelo Cavaletti, Saverio, Cinti, Lucio Ildebrando Cocco, Ottavio, Cremona, Enrico, Crivellato, Antonio De Luca, Mirella, Falconi, Giuseppe, Familiari, Gianluca, Ferri, Francesco, Fornai, Marco, Gesi, Stefano, Geuna, Daniele Maria Gibelli, Antonio, Giordano, Pietro, Gobbi, Germano, Guerra, Massimo, Gulisano, Veronica, Macchi, Guido, Macchiarelli, Lucia, Manzoli, Fabrizio, Michetti, Sebastiano, Miscia, Stefania, Montagnani, Andrea, Costantino, Mario, Montella, Sergio, Morini, Paolo, Onori, Carla, Palumbo, Michele, Papa, Andrea, Porzionato, Daniela Elena Quacci, Mario, Raspanti, Rende, Mario, Rita, Rezzani, Domenico, Ribatti, Maurizio, Ripani, Luigi Fabrizio Rodella, Pellegrino, Rossi, Andrea, Sbarbati, Paola, Secchiero, Chiarella, Sforza, Carla, Stecco, Roberto, Toni, Alessandro, Vercelli, Marco, Vitale, Carlo, Zancanaro, Giorgio, Zauli, Sandra, Zecchi, Giuseppe Pio Anastasi, Eugenio, Gaudio, De Caro, R., Boscolo-Berto, R., Artico, M., Bertelli, E., Cannas, M., Cappello, F., Carpino, G., Castorina, S., Cataldi, A., Cavaletti, G. A., Cinti, S., Cocco, L. I., Cremona, O., Crivellato, E., De Luca, A., Falconi, M., Familiari, G., Ferri, G. L., Fornai, F., Gesi, M., Geuna, S., Gibelli, D. M., Giordano, A., Gobbi, P., Guerra, G., Gulisano, M., Macchi, V., Macchiarelli, G., Manzoli, L., Michetti, F., Miscia, S., Montagnani, S., Montella, A. C. M., Morini, S., Onori, P., Palumbo, C., Papa, M., Porzionato, A., Quacci, D. E., Raspanti, M., Rende, M., Rezzani, R., Ribatti, D., Ripani, M., Rodella, L. F., Rossi, P., Sbarbati, A., Secchiero, P., Sforza, C., Stecco, C., Toni, R., Vercelli, A., Vitale, M., Zancanaro, C., Zauli, G., Zecchi, S., Anastasi, G. P., Gaudio, E., De Caro, R, Boscolo-Berto, R, Artico, M, Bertelli, E, Cannas, M, Cappello, F, Carpino, G, Castorina, S, Cataldi, A, Cavaletti, G, Cinti, S, Cocco, L, Cremona, O, Crivellato, E, De Luca, A, Falconi, M, Familiari, G, Ferri, G, Fornai, F, Gesi, M, Geuna, S, Gibelli, D, Giordano, A, Gobbi, P, Guerra, G, Gulisano, M, Macchi, V, Macchiarelli, G, Manzoli, L, Michetti, F, Miscia, S, Montagnani, S, Montella, A, Morini, S, Onori, P, Palumbo, C, Papa, M, Porzionato, A, Quacci, D, Raspanti, M, Rende, M, Rezzani, R, Ribatti, D, Ripani, M, Rodella, L, Rossi, P, Sbarbati, A, Secchiero, P, Sforza, C, Stecco, C, Toni, R, Vercelli, A, Vitale, M, Zancanaro, C, Zauli, G, Zecchi, S, Anastasi, G, Gaudio, E, De Caro R., Boscolo-Berto R., Artico M., Bertelli E., Cannas M., Cappello F., Carpino G., Castorina S., Cataldi A., Cavaletti G.A., Cinti S., Cocco L.I., Cremona O., Crivellato E., De Luca A., Falconi M., Familiari G., Ferri G.L., Fornai F., Gesi M., Geuna S., Gibelli D.M., Giordano A., Gobbi P., Guerra G., Gulisano M., Macchi V., Macchiarelli G., Manzoli L., Michetti F., Miscia S., Montagnani S., Montella A.C.M., Morini S., Onori P., Palumbo C., Papa M., Porzionato A., Quacci D.E., Raspanti M., Rende M., Rezzani R., Ribatti D., Ripani M., Rodella L.F., Rossi P., Sbarbati A., Secchiero P., Sforza C., Stecco C., Toni R., Vercelli A., Vitale M., Zancanaro C., Zauli G., Zecchi S., Anastasi G.P., and Gaudio E.

Subjects
0301 basic medicine, Students, Medical, Tissue and Organ Procurement, education, Tissue Donor, Legislation, Body donation programme, Law Regulation, Cadaver lab, Education, Cadaver lab, NO, Education, 03 medical and health sciences, Body donation, Anatomist, Body donation programme Law Regulation Cadaver lab Education, Political science, Medical, Cadaver, Humans, Anatomists, Students, Implementation, Settore BIO/16, Body donation programme, Settore BIO/16 - Anatomia Umana, General Medicine, Tissue Donors, Transplantation, Subordination (finance), 030104 developmental biology, Italy, Law, Donation, Regulation, Position paper, 030101 anatomy & morphology, Anatomy, Inefficiency, Developmental Biology, Human
Abstract

In Italy, recent legislation (Law No. 10/2020) has tuned regulations concerning the donation of one's postmortem body and tissues for study, training, and scientific research purposes. This study discusses several specific issues to optimise the applicability and effectiveness of such an important, novel regulatory setting. Some of these unsolved issues may involve the grantees of teaching and training activities, the role of academic anatomical institutes, the role of family members in the donation process, the universal time limit indicated for any donation, the handling of corpses, and the limited body donation and its subordination to the donation of organs and tissues. Critical issues arise concerning the learners, the type of training and teaching activities that can be planned, the position of academic anatomy institutes, the role of family members in the donation process, the time frame of the donation process, the eligibility of partial donation, or the simultaneous donation of organs and tissues to patients awaiting transplantation. In particular, a universal time limit for donations (i.e., one year) makes it impossible to plan the long-term use of specific body parts, which could be effectively preserved for the advanced teaching and training of medical students and surgeons. The abovementioned conditions lead to the limited use of corpses, thus resulting in the inefficiency of the whole system of body donation. Overall, the donors' scope for the donation of their body could be best honoured by a more flexible and tuneable approach that can be used on a case-by-case basis. Furthermore, it is deemed necessary to closely monitor the events scheduled for corpses in public nonacademic institutions or private enterprises. This paper presents useful insights from Italian anatomists with the hope of providing inspiration for drafting the regulations. In conclusion, this paper focuses on the critical issues derived from the recently introduced Italian law on the donation and use of the body after death and provides suggestions to lawmakers for future implementations.

Published
2021

5. Three-dimensional superimposition for patients with facial palsy: an innovative method for assessing the success of facial reanimation procedures

Author

Daniele Gibelli, Fabiana Allevi, Chiarella Sforza, E. Ulaj, Federico Biglioli, Claudia Dolci, Daniela Ciprandi, Valentina Pucciarelli, Filippo Tarabbia, G. Dell'Aversana Orabona, Sforza, C., Ulaj, E., Gibelli, D. M., Allevi, F., Pucciarelli, V., Tarabbia, F., Ciprandi, D., Dell'Aversana Orabona, G., Dolci, C., and Biglioli, F.

Subjects
Adult, Male, Facial Paralysis, facial reanimation, Facial Muscles, Sural nerve, Stimulus (physiology), Sensitivity and Specificity, Smiling, 03 medical and health sciences, Imaging, Three-Dimensional, 0302 clinical medicine, Tongue, facial palsy, Humans, stereophotogrammetry, Medicine, Superimposition, Asymmetry Index, Aged, Orthodontics, Analysis of Variance, Palsy, business.industry, Otorhinolaryngology2734 Pathology and Forensic Medicine, Neuroma, Acoustic, 030206 dentistry, Middle Aged, Facial nerve, Facial Expression, Facial Nerve, 3D-3D superimposition, medicine.anatomical_structure, Biting, Otorhinolaryngology, Face, Photogrammetry, 030220 oncology & carcinogenesis, Female, Surgery, Anatomic Landmarks, Oral Surgery, business
Abstract

Facial palsy is a severe condition that may be ameliorated by facial reanimation, but there is no consensus about how to judge its success. In this study we aimed to test a new method for assessing facial movements based on 3-dimensional analysis of the facial surfaces. Eleven patients aged between 42 and 77 years who had recently been affected by facial palsy (onset between 6 and 18 months) were treated by an operation based on triple innervation: the masseteric to temporofacial nerve branch, 30% of the hypoglossal fibres to the cervicofacial nerve branch, and the contralateral facial nerve through two cross-face sural nerve grafts. Each patient had five stereophotogrammetric scans: at rest, smiling on the healthy side (facial stimulus), biting (masseteric stimulus), moving the tongue (hypoglossal stimulus), and corner-of-the-mouth smile (Mona Lisa). Each scan was superimposed onto the facial model of the "rest" position, and the point-to-point root mean square (RMS) value was automatically calculated on both the paralysed and the healthy side, together with an index of asymmetry. One-way and two-way ANOVA tests, respectively, were applied to verify the significance of possible differences in the RMS and asymmetry index according to the type of stimulus (p=0.0329) and side (p

Published
2018
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6. The effect of the medico-legal evaluation on asylum seekers in the Metropolitan City of Milan, Italy: a pilot study.

Author

Franceschetti L, Magli F, Merelli VG, Muccino EA, Gentilomo A, Agazzi F, Gibelli DM, Gambarana M, De Angelis D, Kustermann A, and Cattaneo C

Subjects
Adult, Humans, Italy epidemiology, Male, Pilot Projects, Young Adult, Forensic Medicine, Refugees statistics & numerical data, Wounds and Injuries epidemiology
Abstract

In the present-day situation, the clinical forensic documentation of an asylum seeker's narrative and his or her examination, together with the physical and psychological findings, may have very important effects on the outcome of the request for political asylum. Since 2012, the Municipality of Milan, the University Institute of Legal Medicine, and other institutions have assembled a team with the task of examining vulnerable asylum seekers and preparing a medical report for the Territorial Commission for International Protection (Prefecture, Ministry of Interiors), who will assess the application. We compared medico-legal reports and outcomes of 57 cases which were evaluated by the Commission after having undergone a medico-legal evaluation through the Istanbul Protocol criteria and examined, in particular, which medico-legal variables seem associated to the outcome. The results show that forensic assessment seems to have a significant and interesting correlation with the final assessment given by the Commission. For example, the higher the level of consistency, according to the Istanbul Protocol, the more frequently protection is granted. These data show how important clinical forensic medicine can be in such scenarios and how the presence of clinical forensic experts should be encouraged in such evaluations, as has been recently enshrined in Italy in the guidelines of a Ministerial Decree of April 3rd, 2017 for the assistance and the rehabilitation as well as the treatment of psychiatric disorders in refugees and asylum seekers who have undergone torture, rape, and other severe forms of psychological, physical, or sexual violence.

Published
2019
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