BackgroundIn the age of digitalization and big data, personal health information is a key resource for health care and clinical research. This study aimed to analyze the determinants and describe the measurement of the willingness to disclose personal health information.MethodsThe study conducted a systematic review of articles assessing willingness to share personal health information as a primary or secondary outcome. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol. English and Italian peer-reviewed research articles were included with no restrictions for publication years. Findings were narratively synthesized.ResultsThe search strategy found 1,087 papers, 89 of which passed the screening for title and abstract and the full-text assessment.ConclusionNo validated measurement tool has been developed for willingness to share personal health information. The reviewed papers measured it through surveys, interviews, and questionnaires, which were mutually incomparable. The secondary use of data was the most important determinant of willingness to share, whereas clinical and socioeconomic variables had a slight effect. The main concern discouraging data sharing was privacy, although good data anonymization and the high perceived benefits of sharing may overcome this issue.

Necrotizing fasciitis (NF) is an infection characterized by necrosis of the superficial muscle fascia and surrounding soft tissues. It usually occurs following skin breaches from penetrating traumas or high-degree burns. Less frequently, it could be related to major abdominal surgery. However, no cases of thigh NF after minor abdominal procedures have ever been reported. A previously healthy 59-year-old male patient underwent a colonoscopic polypectomy. After the procedure, the patient developed an increasing right groin pain. The CT scan showed a gas collection in the right retroperitoneum space and in the right thigh soft tissues. Thus, a right colon perforation was hypothesized, and the patient was moved to the nearest surgery department and underwent a right hemicolectomy procedure. During surgery, the right thigh was also incised and drained, with gas and pus leakage. Nevertheless, the right lower limb continued to swell, and signs of systemic infection appeared. Afterward, clinical conditions continued to worsen despite the drainage of the thigh and antibiotic therapy, and the patient died of septic shock after just two days. This case shows that, although rare, lower limb NF should be considered among the causes of early post-operative local painful symptoms.

In forensic cases where standard macroscopic examination and conventional radiological analysis are inconclusive, mammography can be a useful technique. This applies especially when bodies are found in an advanced state of decomposition, with the dissolution of the soft tissues, and with fragile skeletal structures. This study proposes the use of soft X-rays (i.e., mammography) in particular cases for forensic evaluation, with specific regard to the cause of death, age estimation, and body identification. Here we report three cases in which mammography was particularly useful to obtain fundamental medico-legal information. The first case involved a body that had reached the mummification stage, the second a woman who died from asphyxiation by strangulation, and the last a charred femur found in a field. Mammography uses low-energy X-rays. This technique provides increased image quality through better contrast and higher definition. In the first case, it highlighted a complete fracture of the thyroid cartilage; in the second, it revealed a complete fracture of the horn of the hyoid bone; in the last, it showed rarefaction of the reticular substance of the charred bone. As shown in this study, in selected cases, mammography is a useful tool for post-mortem imaging.