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Two cases in a row demonstrate the importance of autopsy in the investigation of the cause of death, even when circumstantial information and preliminary examinations suggest potentially lethal pathology, such as sub-arachnoidal or intracranial haemorrhage, arteriovenous malformation (AVM) rupture, sudden cardiac death, aortic dissection, pulmonary embolism, intoxication, etc. These two cases show how every sudden death needs further investigation to figure out what the real cause is because there are so many fatal pathologies that can cause it. Indeed, the duodenal ulcer detected in these cases cannot be diagnosed without an autopsy. External examination only may be insufficient or too generic being able, if not followed by an autopsy, to direct towards incorrect causes of death. [ABSTRACT FROM AUTHOR]

The figure of the junior doctor is defined in different ways depending on age, educational path, and contract terms related to the conditions of the work contract. The issues related to this particular professional figure should be considered one of the greatest tests to which Health Systems have to respond. In this paper, these aspects are discussed together with practical advice that could be tailored to individual working situations in order to adequately address these issues. Cornerstones and common practices of clinical risk management which may be successfully applied in these contexts are also discussed. The application of Risk Management tools can both provide proactive solutions to reduce the risk of litigation, and create an environment based on trust and one in which junior doctors feel encouraged to signal adverse events and to learn from them. This could result in overall growth in the system, also from a cultural perspective, and better healthcare both for staff and patients. [ABSTRACT FROM AUTHOR]

Background and aims: In the last decade, the development of different methods of brain stimulation by electromagnetic fields (EMF) provides a promising therapeutic tool for subjects with impaired cognitive functions. Emisymmetric bilateral stimulation (EBS) is a novel and innovative EMF brain stimulation, whose working principle is to introduce very weak noise-like stimuli through EMF to trigger self-arrangements in the cortex of treated subjects, thereby improving cognitive faculties. The aim of this pilot study was to investigate in patients with cognitive impairment the effectiveness of EBS treatment with respect to global cognitive function, episodic memory, and executive functions. Methods: Fourteen patients with cognitive decline (six with mild cognitive impairment and eight with Alzheimer's disease) underwent three EBS applications per week to both the cerebral cortex and auricular-specific sites for a total of 5 weeks. At baseline, after 2 weeks and 5 weeks, a neuropsychological assessment was performed through mini-mental state examination, free and cued selective reminding tests, and trail making test. As secondary outcomes, changes in behavior, functionality, and quality of life were also evaluated. Results: After 5 weeks of standardized EBS therapy, significant improvements were observed in all neurocognitive assessments. Mini-mental state examination score significantly increased from baseline to end treatment (+3.19, P=0.002). Assessment of episodic memory showed an improvement both in immediate and delayed recalls (immediate recall =+7.57, P=0.003; delayed recall =+4.78, P,0.001). Executive functions significantly improved from baseline to end stimulation (trail making test A -53.35 seconds; P=0.001). Of note, behavioral disorders assessed through neuropsychiatric inventory significantly decreased (-28.78, P,0.001). The analysis concerning the Alzheimer's disease and mild cognitive impairment group confirmed a significant improvement of cognitive functions and behavior after EBS treatment. Conclusion: This pilot study has shown EBS to be a promising, effective, and safe tool to treat cognitive impairment, in addition to the drugs presently available. Further investigations and controlled clinical trials are warranted. [ABSTRACT FROM AUTHOR]