Suicide presentation and the risk at the time of the mandatory quarantine for the SARS-Cov-2 pandemic: medico-legal and forensic aspects

Introduction

COVID-19 pandemic is the most important health emergency of the 21st century. Since the high number of infected people and as there is still no specific therapy worldwide, the pandemic has been countered through the application of prevention measures based on social distancing and home isolation. These elements are known risk factors for the development of various psychiatric conditions. From a forensic point of view, these pathologies are related to a high suicide rate.

Objectives

It is no coincidence that during the previous pandemics that have occurred in history there has been a significant increase in suicides. By this work, we therefore want to highlight the psychological consequences of a pandemic and the importance of preventive strategies.

Methods

It is important to focus not only on physical well-being but also on the psychological aspects that the pandemic produces in the daily life of each individual

Results

If the infecting agent causes the death of millions of people around the world, the socio-economic context that is created indirectly determines as many deaths.

Conclusions

Therefore it is necessary to underline how it is advisable to implement preventive measures in order to significantly reduce deaths from suicide, a problem with an important impact in the social and forensic fields.

Disclosure

No significant relationships.

The impact of the covid-19 pandemic on the risk of social stigma

Introduction

Social stigma indicates a process of negative connotation of a person which results in discrimination. The victim of stigma experiences a condition of social exclusion that negatively affects his relationships. The COVID-19 pandemic has spread the fear of being “contaminated”, which has led to the discrimination of a part of population.

Objectives

The purpose of this work is to analyze which people have suffered from stigma due to the COVID-19 pandemic by examining the negative effects on their health during this period.

Methods

A literature review of peer-reviewed articles was performed on Pubmed NCBI database by inserting the keywords: stigma and COVID-19 in the period 2020-2021.

Results

The data showed that the categories most at risk were positive patients and their families; healthcare workers in COVID-19 wards; Asian people. Discrimination has included avoidance attitudes, physical or verbal abuse, hypersurveillance in public places. Negative effects on victims included anxiety, depression, feelings of rejection and shame, self-harm and suicide. COVID-19 patients attempted to hide the disease by avoiding access to hospital; health personnel developed risk of burnout; Asian restaurants experienced a drop in reservations, even after quarantine period.

Conclusions

Social stigma is a public health problem and greater efforts are mandatory to reduce it including correct information, with the help of social and mass media; social interventions aimed at generating empathy; avoiding the use of negative language focused on stereotypes that could generate fear or discrimination. Such interventions are crucial to reduce discrimination in such a fragile period as COVID-19 pandemic.

Disclosure

No significant relationships.

“Second victims” in Covid-19 pandemic: A cross-sectional study among medical doctors of the Catanzaro Hospital

Introduction

Medical errors are a serious public health problem. The COVID-19 pandemic has caused further stress to doctors with the increase in patient mortality, the lack of definite guideline and growing work demands. In this scenario, the patient is not the only victim of the medical error. The “second victim” (SV) is defined as a health worker who was involved in an unforeseen and negative event for the patient, who suffers physically and psychologically, because he was traumatized by his own mistake and/or by the injuries caused to the patient. The SV phenomenon prevalence varies from 10.4% up to 43.3%.

Objectives

The aim of this study is to evaluate the second victim phenomenon during the COVID-19 pandemic among medical doctors of the Catanzaro University Hospital (Italy).

Methods

A cross-sectional study will be conducted by administering an anonymous questionnaire to the Catanzaro University Hospital medical doctors using SurveyMonkey software. Descriptive analysis will be performed.

Results

The data collection is ongoing. Currently, 300 subjects are included in the sample.

Conclusions

The second victim phenomenon has a negative impact on doctors, colleagues and patients. It is important to aid health workers involved in an adverse event by activating support networks and adopting appropriate strategies in order that the event is a source of learning and not of demotivation.

Disclosure

No significant relationships.

KAMBO: NATURAL DRUG OR POTENTIAL TOXIC AGENT? A LITERATURE REVIEW OF ACUTE POISONING CASES

Kambo is the name of a natural substance derived from the glandular secretions of the amphibian Phyllomedusa bicolor, a species native to regions in South America. The communities living in these areas administer the substance generally transdermally during rituals for religious-purifying purposes, producing small skin burns. The scientific literature has reported some cases of intoxication following the use of Kambo but this aspect is still poorly understood. In fact, no shared therapy protocols exist for these events nor any real legislation on Kambo. The purpose of this work was to examine all cases of acute intoxication resulting from the administration of Kambo and published over the last 10 years, illustrating clinical signs, laboratory findings, instrumental tests, and therapy. The several cases identified in our review confirm that acute Kambo intoxication can occur, with serious and life-threatening effects. We developed a protocol aimed at the early diagnosis of cases of suspected acute intoxication by creating a treatment algorithm. The study aims to investigate the pathophysiology of these events in humans, proposing a protocol for the diagnosis and treatment of these cases that can be used by healthcare professionals.

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The use of Kambo has spread for distribution worldwide through numerous websites.

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The literature review confirmed that acute Kambo intoxication include possible side effects.

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Intoxication may affect various systems with laboratory or instrumental alterations.

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Intoxication may be reversible if promptly diagnosed and treated.

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An algorithm with adequate triage can support diagnosis and treatment.

The Marigliano–Cacciafesta polypathological scale: A tool for assessing fragility

The aim of our studies was to establish a standard method of assessment that allows an early identification of frailty in the elderly, i.e., to predict who are at risk of developing disabilities, in order to be able to intervene with preventive global and individualized measures. A new multidimensional scale called Marigliano-Cacciafesta polypathological scale (MCPS) was used on 180 elderly people, together with the Barthel index (BI), the global evaluation functional index (GEFI), the geriatric depression scale (GDS), the mini mental state examination (MMSE), the mini nutritional assessment (MNA), and the Tinetti test. A strongly significant statistical correlation was found between the MCPS and the nutritional state, mood level, motor functionality, level of disability and global functionality. As the fragile patients are at a risk to develop disabilities, we think that our scale can be a significant contribution to the multidimensional geriatric assessment (MGA), aimed at identifying and quantifying the parameter of fragility of each patient, an information which should be known, if we intend to introduce preventive measures.

[Neoplastic inflammation: role of capillary electrophoresis]

Two electrophoretical methods have been compared, in order to evaluate the most precise and sensitive one as to recognize initial inflammatory conditions also of tumoral nature. Consequently, among 5,000 patients observed during one year, only 500 cases have been considered with pathologic electrophoretic diagram and, among those, 245 cases of which alteration of the electrophoretic diagram concerned the alfa 1 band and the alfa 2 band; among the latter only 127 cases were diagnosed various tumors. It is deduced from the obtained results that there is better sensitiveness with the capillary method, which is evidenced in the more substantial increase of the alfa 1. Such method allows, precociously, to put in evidence a possible presence of inflammation, induced by any kind of tumor, even in absence of positiveness of the specific tumoral markers, in 38% of examined cases.