Retained sponges in abdomen: an analysis of the judgments of the Italian Supreme Court.

The administration of justice in Italy includes first, second and third instance. The first and second instances are represented by the Court of First Instance and the Court of Appeal: these are judgment of Romamerit. The court of last appeal for both the civil and the criminal jurisdiction is the Court of Cassation, the Italian Supreme Court. It is a court of legitimacy that should provide for a consistent and uniform interpretation of the law and that only on points of law, not on factual evidence. The Court of Cassation can confirm the sentence of second instance, can dismiss it without referral, can deciding and closing the trial definitively, or dismiss it referring the case to the judge of merit that must decide according to the principles set out in the legitimacy. The aim of this study is to analyze the Supreme Cassation Court's judgments on the legal proceedings about retained sponges in abdomen.

[Dilated cardiomyopathy. Multivariate discriminant analysis of main hemodynamic-angiographic indices]. / Cardiomiopatia dilatativa. Analisi discriminante multivariata dei principali indici emodinamico-angiografici.

The study group consisted of 47 consecutive patients (38 men and 9 women) aged between 16 and 56 years with dilated cardiomyopathy studied invasively between January 1980 and December 1986. Follow-up observation (40 +/- 29 months) showed that 28 patients were mildly symptomatic (group 1) and 19 patients were severely symptomatic (group 2: eight of them died due to intractable congestive heart failure). At univariate analysis, group 2 was characterized by higher pulmonary vascular resistance, larger end-diastolic and end-systolic left ventricular volumes, increased left ventricular mass, lower ratio of mass to volume index, depressed angiographic ejection fraction, lower ratio of end-systolic stress and peak systolic pressure to volume index. Multivariate analysis was used to determine which combination of factors might be a better effective predictor of prognosis in these patients: the most important factors were mass to volume index ratio (M/V) and end-systolic stress to volume index ratio (sigma TS/VTS). An equation was developed that can be applied to the prognosis of patients with dilated cardiomyopathy (F = 7.41573 M/V + 0.87805 sigma TS/VTS - 10.34571). A score system was devised on the basis of the summed-up value of these two parameters. When the patients were assigned (according to the score) to one of the previously mentioned two groups, the classification proved to be correct in 98% of the cases. Thus, these factors can accurately predict the development of congestive heart failure or the risk of death in patients with dilated cardiomyopathy, who are reasonable candidates for cardiac transplantation.