[Community-associated MRSA and Panton-Valentine leukocidin (PVL): novel trends in epidemiology and forensic implications].

The propagation of multi-resistant bacteria, especially methicilline-resistant Staphylococcus aureus strains (MRSA), in hospitals and nursing homes is a well-known sanitary and therapeutic problem (Healthcare-associated MRSA, HA-MRSA). For some years, an increasing incidence of MRSA outside the hospital environment (Community-acquired or Community-Associated MRSA, CA-MRSA) has been observed all over the world, which, contrary to the hospital strains, produces the leukocytotoxic toxin PVL and causes purulent inflammations of the skin and necrotizing pneumonia. In previously healthy children and adolescents these pneumonias are fatal in most cases.

Diagnostic approaches to acute transfusion reactions.

The erroneous transfusion of ABO-incompatible red cells may lead to life-threatening hemolysis and complement-induced shock, resulting in death in less than 10% of cases (acute hemolytic transfusion reaction, AHTR). Identification of the cause of an erroneous transfusion is accomplished in nearly all incidents merely by checking the identity of the patient, blood sample and blood bag. The erroneous transfusion is confirmed by serological and--in the case of a fatality- immunohistochemical methods.

[Has the transdermal patch gone up in smoke? A fatal fentanyl intoxication].

Recently, there has been an increase in fentanyl-related overdoses following administration of transdermal patches by the buccal, oral or intravenous route or via inhalation. A fatal intoxication is reported with clear evidence from toxicological analysis. However, the administration route and the fate of the patch remained elusive at the end of the investigations.

Macrophage subsets in mechanical brain injury (MBI)--a contribution to timing of MBI based on immunohistochemical methods: a pilot study.

Cortical hemorrhages as a consequence of closed mechanical brain injury (MBI) trigger an inflammatory response including a distinct increase of macrophages. According to published data this reactive macrophage population is heterogenous as to their immunological properties. The expression of certain immunohistochemically detectable epitopes of macrophages, however, may correlate with the posttraumatic interval (PTI).

Shaken baby syndrome: re-examination of diffuse axonal injury as cause of death.

The discussion surrounding shaken baby syndrome (SBS) arose from the lack of evidence implicating diffuse axonal injury (DAI) as a cause of death. It was assumed instead that injury to the cervical cord, medulla, and nerve roots played a causal role. The present pathomorphological study examines 18 selected infants (<1-year-old) whose deaths were highly suspicious for SBS, exhibiting the classical SBS triad of acute subdural hemorrhage (SDH), retinal bleeding, and encephalopathy.