Research on supernumerary embryos: the challenge of recon- ciling opposing interests and fast-evolving technologies.

ABSTRACT: The paper addresses the issue of the legality and ethical admissi-bility of invasive experiments on embryos and the correlated one of the degree of legal protection and dignity to be recognized for human embryos, particularly in light of the growing importance that scientific research on embryonic stem cells has been gaining from the clinical and biomedical standpoints in the therapeutic treatments of diseases so far considered incurable, in the interest of public health. Furthermore, the issue of experimentation on cryopreserved supernumerary human embryos is still extremely polarizing, which makes it harder to arrive at shared solutions. The author hopes for a broad-ranging debate at the international level, for the ultimate purpose of achieving shared regulatory frameworks.

Uterus transplant update: innovative fertility solutions and the widening horizons of bioengineering.

Uterus transplantation (UTx) aimed at restoring fertility for women suffering from uterine factor infertility has been making significant strides over the past years, leading to the first successful outcome of live birth in 2014. Nonetheless, the ethical issues raised by such a procreative option are uniquely complex and multifaceted. UTx presents unique features, and the most significant risks it entails are the multiple surgeries required and the need for immunosuppressive drugs to prevent organ rejection. Post-transplantation immunosuppressive therapy, rejection monitoring, and immune tolerance are all crucial aspects That affect UTx outcomes and ensuing pregnancy success rates. In time, an alternative tool might become clinically available that could solve all those issues: tissue engineering relying on a combination of cells, biomaterials, and growth factors that harness the body's innate ability to regenerate and repair reproductive organs. Mastering such techniques could lead in the medium-long term to the creation of a bioengineered uterus for the purpose of transplantation, based on scaffolds derived from decellularized organs or tissues that can be recellularized by several types of autologous somatic/stem cells, in particular for uterine tissue engineering.

CRISPR -Cas9: a groundbreaking new technique which ushers in new prospects and just as many doubts.

Human germline engineering arguably constitutes one of the most promising and at the same time controversial prospects in the realm of gene editing overall, and particularly in the context of the current state of research. The issues raised by such techniques have sparked heated debate worldwide: the scientific and industrial establishments have been strongly supporting CRISPR-Cas9 research, but a well-balanced approach needs to be adopted in order to reconcile the needs of scientific research with the life and dignity of human embryos.

Childbirth Injuries: an issue fraught with risks from the health care and medicolegal perspectives.

Birth injuries caused by medical negligence are a real threat for mothers and their children, which can entail catastrophic, life-changing consequences, permanent disability, or even death. Families almost always seek redress from doctors and/or facilities, but in order for a birth injury malpractice claim to be successful, it needs to be proven that the medical care providers owed a duty to the child and that they were derelict in that duty and did not meet the proper standard of care; Furthermore, a causal relationship needs to be established between injury sustained by the child and the physician's or provider's breach of duty to the child. Relevant scientific articles have been collected by drawing upon medical search engines and archives such as Medline, Cochrane Central, Scopus, Web of Science, Science Direct, EMBASE and Google Scholar, through December 2019, using keywords such as "birth injuries", "malpractice", "claims". Moreover, the Authors have delved into legal databases (Justia, Lexis, De Jure, Leagle), identifying 6 meaningful instances of court cases centered around birth injuries with severe consequences, all stemming from malpractice and negligence. Ultimately, it can be concluded that demonstrable and adequately documented compliance with well-established guidelines and/or best practices are a determining factor in the legal defence of health care operators; that in turn can go a long way towards discouraging meritless claims and frivolous lawsuits, which constitute a challenging issue raising health care costs in many countries.

Fatal laryngeal angioedema: a case report and a workup of angioedema in a forensic setting.

Angioedema is an episodic swelling of the deep dermis, subcutis, and/or submucosal tissue due to an increase in local vascular permeability. Swelling may involve skin, respiratory, and gastrointestinal tracts. The most commonly involved areas are the periorbital region and the lips. Here we report a case of a fatal laryngeal obstruction due to angioedema likely caused by an angiotensin-converting-enzyme inhibitor. The decedent, a 58-year-old man, was witnessed developing sudden facial swelling and acute respiratory difficulties quickly followed by unresponsiveness. His past medical history suggested that this was his second episode of angioedema without urticaria. Postmortem examination revealed a complete laryngeal obstruction in the absence of infection, neoplasm, or autoimmune disease. Postmortem computed tomography of the head and neck showed a complete obstruction of the upper airway. Based on the current understanding of the pathophysiology of different types of angioedema, we will suggest a workup of angioedema without urticaria in the forensic setting and offer readers resources they can use in their practice.