Case Report: Post-mortem Histopathological and Molecular Analyses of the Very First Documented COVID-19-Related Death in Europe.

In Europe, the first case of coronavirus disease (COVID-19) and the first COVID-19-related death were reported in France on January 24th and February 15th, 2020, respectively. Officially, the first case of COVID-19 infection in the Republic of Serbia was registered on March 6th. Herein, we presented the first case of retrospective detection of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in the post-mortem-obtained vitreous humor (VH), which took place on February 5th, 2020. This is the first death in Europe proven to be caused by COVID-19 by means of post-mortem histopathological and molecular analyses. Based on this finding, it appears that SARS-CoV-2 has been spreading faster and started spreading much earlier than it had been considered and that COVID-19 was probably the cause of the much-reported pneumonia of unknown origin in January and February 2020.

Death due to consumption of ibogaine: case report.

Ibogaine is a psychotropic indole alkaloid extracted from the roots of the Tabernanthe iboga shrub from the Apocynaceae family. Depending on the taken dose, it can lead to stimulant effects, euphoria, visual and auditory hallucinations, along with auditory, olfactory, and gustatory synesthesia. In addition to its historical usage in spiritual rituals of African tribes, these days iboga extract presents a prohibited, alternative drug widely used as a part of addiction treatment. Ibogaine used in opioid withdrawal is associated with serious side effects and sudden deaths. Besides its main use as an anti-addiction medication in alternative medicine, in moderate doses (from 100mg to 1g) ibogaine most commonly causes a "trance-like state".In this paper, we report the case of a heroin addict who died suddenly 5-12 hours after oral ingestion of powder labeled Tabernanthe iboga which had been bought online and used in the process of detoxification during an addiction treatment. The man was found dead in a rented apartment, where he was undergoing the addiction treatment.External examination revealed no lesions other than nonspecific injuries on the legs. The autopsy showed congestion of internal organs and pulmonary edema. Histopathological analysis of the heart showed neither macroscopic nor microscopic abnormalities. The concentration of ibogaine was 3.26mg/L. Moreover, systematic toxicological analyses of biological samples showed the presence of morphine and codeine. These data suggest that death, which occurred unnaturally after initiation of the "treatment", was probably the result of the cardiovascular effects caused by the ibogaine powder.The presented case highlights the worldwide problem of various products being widely available over the internet and the danger associated with consumption thereof.

The impact of elevated blood pressure on exercise capacity in elite athletes.

OBJECTIVES: Hypertension is one of the most prevalent cardiovascular disorders in athletes. The aims of our study were to assess the impact of elevated blood pressure (BP) on exercise capacity in athletes and evaluate the differences in left ventricular structure and function. METHODS: Elite male athletes (n=517, aged 23±5years) underwent Doppler echocardiography with tissue Doppler imaging. Diastolic function was assessed by measuring peak early and late transmitral (E and A) and annular diastolic filling velocities (e' and a'). Maximal cardiopulmonary exercise testing was performed to measure maximal oxygen consumption (VO2max), ventilatory anaerobic threshold (VAT) and heart rate reserve (HRR). After BP measurement, they were grouped according to the ESH/ESC guidelines on: optimal (OBP), normal (NBP), high normal BP (HNBP), and hypertensive (HT). RESULTS: We found significantly lower VO2max, VAT and HRR in the groups with HNBP and HT, after the adjustment for the type of sport, body fat content and age. There was an increasing trend in resting HR among groups (p<0.001). Although none of the subjects had impaired diastolic function, the HT group had higher left atrial volume, and lower e' and e'/a'. Resting systolic BP (p<0.05), HR (p<0.001), HRR (p<0.001) and e'/a' (p<0.01) independently predicted VO2max. Indexes E/e' and e'/a' were associated with resting systolic BP (p<0.05). CONCLUSION: Even in the absence of structural or functional heart damage, elevated BP in elite athletes, together with the presence of autonomic dysfunction, leads to decrease in exercise capacity. Staging of hypertension according to the BP level, on the one hand, and reflexion of BP on cardiopulmonary capacity, on the other, may be coupled for further risk stratification.

Body composition assessment in athletes: a systematic review.

Body composition represents an unbreakable unity of the human body basic structure elements and involves a relative representation of the various constituent elements of the human total body weight. It is well known that body composition changes under the influence of continuous physical activity, and, therefore, it is one of the major components of fitness, and general health of the athletes. Therefore, this topic has become a major field of interest for many exercise and sport scientists as well as clinicians who specialize not only in different training methods but also in the prevention of and rehabilitation from major injuries. To date, having considered issues of accuracy, repeatability and utility, there is no universally applicable criterion or 'gold standard' methodology for body composition assessment in athletes. The main objective of this review was to give a short overview of methods for body composition analysis in athletes and to show and compare the latest data on their usefulness and reliability in order to find the best solution for practical everyday work.