[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.

[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.

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.

Long-term administration of 3-deazaadenosine does not alter progression of advanced atherosclerotic lesions in apolipoprotein E-deficient mice.

Inflammatory mechanisms are involved in initiation and progression of atherosclerotic lesions. Previous studies demonstrated antiinflammatory and consecutive antiatherosclerotic effects of the adenosine analogue 3-Deazaadenosine (c(3) Ado) on early lesion development. The present study evaluated the effect of long-term administration of c(3) Ado in a mouse model of advanced atherosclerosis.

[Fulminant liver failure in a patient on carbamazepine and levetiracetam treatment associated with status epilepticus].

A 22-year-old female with a history of developmental delay and seizures successfully treated with carbamazepine and levetiracetam developed fulminant hepatic failure and subsequently died. She had been admitted to the hospital following secondary generalized seizures of 35 min duration. A circulatory shock as well as intoxication was taken into consideration during the clinical course.

[Causality of an accident in subsequent fatal pulmonary embolism a few hours after trauma].

An 87-year-old woman, who was largely immobilized in a wheelchair, suffered rib fractures and an unstable fracture of the pelvic ring in a fall. Approximately 2 1/2 hours later she developed marked clinical symptoms of pulmonary thromboembolism and died 5 hours after the accident. The question to be discussed with regard to the causality was the unusually short interval of only 2 1/2 to 5 hours between the accident and the clinical signs of embolism leading to her death.

[Traumatic heart rupture or infarct?].

A 70-year-old motorist driving on the wrong side of the road caused a car-to-car head-on collision and died some minutes later. The autopsy revealed a lethal rupture of the right heart ventricle. The insurance company argued that driving on the wrong side was an act of gross negligence so that the damage was not covered by the full comprehensive insurance.

CD14 expression by activated parenchymal microglia/macrophages and infiltrating monocytes following human traumatic brain injury.

The immune response in the central nervous system (CNS) is under tight control of regulatory mechanisms, resulting in the establishment of immune privilege. CNS injury induces an acute inflammatory reaction, composed mainly of invading leukocytes and activated microglial cells/macrophages. The generation of this robust immune response requires binding of receptors such as CD14, a pattern recognition receptor of the immune system.