ABSTRACT
The article presents a case of sudden death of a 56-year-old woman at the workplace, caused by a very rare primary cardiac tumor. The patient's family reported a crime to the prosecutor's office suggesting participation of third parties in causing the death or malpractice in physical examinations before the death. A review of clinical data concerning cardiac angiosarcoma, available in electronic databases (e.g., Web of Science, PubMed), was presented, which could be useful in the practice of occupational medicine specialists. A legal analysis of potential claims to occupational medicine specialist in the case of failure to recognize primary cardiac tumors was also included in the article. Med Pr. 2020;71(6):757-64.
Subject(s)
Hemangiosarcoma/diagnosis , Hemangiosarcoma/mortality , Malpractice/legislation & jurisprudence , Occupational Medicine/legislation & jurisprudence , Occupational Medicine/standards , Physical Examination/mortality , Physical Examination/standards , Workplace/legislation & jurisprudence , Female , Heart Neoplasms/diagnosis , Heart Neoplasms/mortality , Heart Neoplasms/physiopathology , Hemangiosarcoma/physiopathology , Humans , Malpractice/statistics & numerical data , Middle Aged , Poland , Workplace/statistics & numerical dataABSTRACT
OBJECTIVES: A rare case of a suicidal use of gases from the car exhaust system of the car petrol engine in an open space is presented. CLINICAL PRESENTATION AND INTERVENTION: To verify suicidal intent of poisoning, an experimental reconstruction of the crime scene was performed. This demonstrated that appropriately long exposure to carbon monoxide with unfavorable weather conditions can cause acute carbon monoxide poisoning in an open space. CONCLUSIONS: This case was studied to observe the pattern of fatal carbon monoxide poisoning in an open space. This might be helpful for forensic medicine, emergency medicine, and occupational medicine.
Subject(s)
Carbon Monoxide Poisoning/diagnosis , Suicide , Autopsy , Forensic Medicine , Humans , Male , Middle Aged , Motor VehiclesABSTRACT
Henoch-Schoenlein nephritis (HSN) is the most common secondary childhood nephropathy, leading to end-stage renal disease in up to 20% of pediatric patients after long-term follow-up. Forty-four cases of HSN were reviewed (32 children, 12 adults). Electron microscopy (EM) was performed in 7 cases and immunohistochemistry for Ki-67, PCNA, and p27 in all. Light microscopy: grade II (18), III (15), IV (3), and VI (8). Glomerulosclerosis and interstitial fibrosis were important prognostic markers and coexisted with poor outcome. EM was performed mainly in grade VI and was useful in recognition of early glomerulosclerosis. No correlations were found between the Ki67 and PCNA mesangial expression and outcome. Progressive decrease in p27 podocyte expression was noted with more severe HSN grades.
