Fentanyl and Sudden Death-A Postmortem Perspective for Diagnosing and Predicting Risk.

Sudden, unexpected deaths are extremely difficult for families, especially when the victim is a child. Most sudden deaths occur due to cardiovascular issues, and a smaller number (approximately one-quarter) are attributed to other causes, such as epilepsy. The medicinal and non-medicinal use of the synthetic opioid fentanyl, which can cause breathing problems, is frequently involved in these deaths.

Ocular Surface Fluid: More than a Matrix.

Although the eye can be subjected to therapeutic manipulation, some of its structures are highly inaccessible. Thus, conventional therapeutic administration pathways, such as topical or systemic routes, usually show significant limitations in the form of low ocular penetration or the appearance of side effects linked to physiology, among others. The critical feature of many xenobiotics is the drug gradient from the concentrated tear reservoir to the relatively barren corneal and conjunctival epithelia, which forces a passive route of absorption.

Ingestion of Fluids of the Ocular Surface Containing Eye Drops of Imidazole Derivatives-Alpha Adrenergic Receptor Agonists as Paragons.

Accidental poisonings by ingesting conjunctival fluid mixed with eye drops commonly involve alpha-2 adrenergic receptor agonists and tetrahydrozoline. These substances are recognized in commonly reported ingestions. Victims of all ages, otherwise in good health, often present as pale and lethargic to the emergency department (ED) after unintentionally ingesting topical eye medication.

Corneal Biomechanics and Other Factors Associated with Postoperative Astigmatism after Cataract Surgery.

This study aimed to investigate the impact of the cornea's biomechanical properties, corneal hysteresis (CH), and corneal resistance factor (CRF) on postoperative astigmatism after cataract surgery and determine the other factors that influence it. Forty eyes of 40 patients (13M/27F; the median age of 74) were included in this prospective study, underwent 2.75 mm incision cataract surgery, and were followed for 30 days.

Quetiapine-Related Deaths: In Search of a Surrogate Endpoint.

Quetiapine is a second-generation antipsychotic drug available for two and half decades. Due to increased misuse, prescription outside the approved indications, and availability on the black market, it is being encountered in medicolegal autopsies more frequently. For instance, it has been linked to increased mortality rates, most likely due to its adverse effects on the cardiovascular system.

Small intestinal bacterial overgrowth and non-alcoholic fatty liver disease diagnosed by transient elastography and liver biopsy.

Background: We aimed to determine if there was a higher incidence of small intestinal bacterial overgrowth (SIBO) in non-alcoholic fatty liver disease (NAFLD) than in patients without NAFLD. Moreover, we assessed whether patients with significant fibrosis (SF) had a higher incidence of SIBO compared with patients with non-significant or no liver fibrosis.

Methods: NAFLD was diagnosed in 117 patients by using Fibroscan with a controlled attenuation parameter (CAP) as well as liver biopsy (LB).

(Nematoda: Rhabditida) isolated in sugar cane soils in Mexico with potential to be used as entomopathogenic nematode.

A survey of entomopathogenic nematodes was conducted in sugar cane crops in a total of 14 soils, and positive results were obtained for strain MC5-2014 in the municipality of Tepalcingo, Morelos, in soil with a sandy loam texture and a pH of 6.4. Species determination was performed via morphological and morphometric techniques by searching for a tubular stoma with a swollen cylindrical pharyngeal body and a metacorpus in the basal part.

Efficacy of Hydromer-Coated and Antibiotic- Impregnated Shunt Systems in Reducing Early Shunt Infections in the Pediatric Population.

Objective: Shunt infection is the most common complication following a Cerebrospinal fluid (CSF) diversion procedure with devastating consequences. This study analyzes the efficacy of different shunt systems in reducing early shunt infections in the pediatric population.

Methods: Retrospective case study analysis of 177 pediatric patients with hydrocephalus de novo shunted using hydromer-coated (HC) shunt systems, antibiotic-impregnated (AI) shunt systems and standard non impregnated shunt systems was performed and compared for the incidence of shunt infection in the early postoperative period.

"Selfie"-related electrocution.

Electrical injuries contribute a small but significant fraction to all burn trauma cases, and an even smaller proportion to those that are lethal. Accidental death rates among teenagers are the highest of all age-groups, and taking a "selfie" has been a practice that has, on rare occasions, led to such a death, often from electrocution. The case of a young man and his friend, who were electrocuted after climbing onto the roof of a parked railway wagon to take selfies is reported.

Herpes simplex virus 1 miRNA sequence variations in latently infected human trigeminal ganglia.

Human herpes simplex virus 1 (HSV-1) expresses numerous miRNAs, the function of which is not well understood. Several qualitative and quantitative analyses of HSV-1 miRNAs have been performed on infected cells in culture and animal models, however, there is very limited knowledge of their expression in human samples. We sequenced small-RNA libraries of RNA derived from human trigeminal ganglia latently infected with HSV-1 and Varicella zoster virus (VZV) and detected only a small subset of HSV-1 miRNA.

How could analyzing the activity of two matrix metalloproteinases unveil the cause of sudden cardiac death.

Sudden cardiac death is natural, unexpected death, related to cardiovascular disease. Its postmortem elucidation is significant, as the family of the deceased aspires to prevent other sudden deaths. Irrespective of the proper etiological entity, the myocardial collagen matrix remodels, associated with the progression of cardiovascular diseases.

In vitro evaluation of mitochondrial dysfunction and treatment with adeno-associated virus vector in fibroblasts from Doberman Pinschers with dilated cardiomyopathy and a pyruvate dehydrogenase kinase 4 mutation.

Objective: To compare mitochondrial oxygen consumption rate (OCR) of fibroblasts from Doberman Pinschers with and without dilated cardiomyopathy (DCM) and mutation of the gene for pyruvate dehydrogenase kinase isozyme 4 (PDK4) and to evaluate in vitro whether treatment with adeno-associated virus (AAV) vector (i.e., gene therapy) would alter metabolic efficiency.

Putative hormone with anti-obesogenic and insulin-sensitizing effect.

It was confirmed that bone morphogenetic protein-9 (BMP-9), like insulin, improves glycemia in diabetic mice and regulates glucose metabolism in hepatocytes, which is why it is proposed as a candidate for the hepatic insulin-sensitizing substance (HISS). Regarding the fact that BMP-9 has a signaling pathway similar to other BMPs as well as insulin, it is expected that BMP-9 would also have certain effects on the liver. In our 2011 hypothesis, we aimed towards BMP-9 as a possible "hepatic insulin-sensitizing substance" (HISS) and in this article, we provide further evidence, derived from existing studies, suggesting that this putative hormone might in fact be none other than BMP-9.

Decubitus ulcers and ligature marks as evidence in a homicide case.

When abuse, maltreatment and neglect are suspected, a proper physical examination is essential. This is even more important at autopsy, when there is no possibility to gain information from the alleged victim and where the forensic pathologist has to link the evidenced signs or sequalae of abuse with the possible manner and cause of death. This case report presents the results and conclusions of the medico-legal autopsy of a 30-year-old woman found dead in her fiancé's home.

ESTABLISHMENT OF ECHOCARDIOGRAPHIC PARAMETERS OF CLINICALLY HEALTHY FLORIDA MANATEES (TRICHECHUS MANATUS LATIROSTRIS).

A standardized echocardiographic technique was recently established for the Florida manatee (Trichechus manatus latirostris). There are no available published data on normal echocardiographic parameters in any Sirenian species. The purpose of this study was to report reference parameters for various echocardiographic measurements.

High pressure injection injury of the foot: a role of negative pressure wound therapy.

High pressure injection injuries (HPII) of the foot are not common in every-day practice. We present a 50-year-old patient with a HPII of the left foot caused by water-gun in a self-inflicted accident working as a technical diver four meters under the sea surface. Surgical treatment included extensive debridement of necrotic tissue and fibrin deposits and removal of foreign material.

Echocardiographic evaluation of clinically healthy Florida manatees (Trichechus manatus latirostris).

Antemortem studies pertaining to the manatee cardiovascular and cardiopulmonary systems are limited despite reports of cardiac disease in postmortem specimens. The objective of this project was to develop a technique for echocardiography in the Florida manatee (Trichechus manatus latirostris). Because of their unique anatomy, a ventral approach was employed by use of an echocardiography table designed specifically for this study.

Dive-related fatalities among tourist and local divers in the northern Croatian littoral (1980-2010).

Background: The aim of the study was to retrospectively analyze diving fatalities occurring in Primorje-Gorski Kotar County (northern Croatian littoral), Croatia between 1980 and 2010 in order to identify differences between fatally injured tourist and resident divers, as well as temporal changes in the frequency of diver deaths.

Methods: Medico-legal and police reports of 47 consecutive fatal diving cases were reviewed to determine the frequency of death among divers in relation to year and month of death, age, sex, nationality, organization of diving, diving type, and health condition.

Results: The majority of victims were foreign citizens (59.

Car-to-pedestrian accident with a unique decollement injury.

The authors present a unique case of decollement injury found on an 85-year-old victim that was run-over by a tank truck. While external examination evidenced multiple severe injuries, autopsy confirmed the preliminary findings and revealed also the presence of an extensive decollement that spread from the left hemithorax to a wound on the left ankle, through which parts of the small intestines and pertaining mesentery protruded. The article offers an interpretation of the injuries sustained by the victim, focusing on the most probable decollement mechanism.