Postmortem Vitreous Humor Magnesium Does Not Elevate in Salt Water Drowning When the Immersion Time Is Less Than an Hour.

BACKGROUND: Elevation in postmortem vitreous humor sodium and chloride (PMVSC) in salt water drowning (SWD) when the immersion time is less than 1 hour (SWD1) is hypothesized to result from electrolyte changes in blood from salt water inhalation/ingestion during drowning. After approximately 1 hour after death, electrolytes may diffuse into the vitreous humor via the eye coverings. Another abundant element in salt water is magnesium, which is approximately 50 times higher in concentration than the blood and vitreous humor magnesium levels. Magnesium is able to diffuse across the eye coverings but not as easily through the blood-ocular barrier. With these properties, we hypothesize that postmortem vitreous magnesium (PMVM) would not be elevated in SWD1 but become elevated in SWD with immersion times greater than 1 hour (SWD>1). AIM: The aim of this article was to investigate the differences in PMVM and PMVSC between nonimmersion deaths, SWD1, and SWD>1. METHODS: This is a 1-year retrospective study comparing PMVM and PMVSC in nonimmersion deaths, SWD1, and SWD>1. RESULTS: Postmortem vitreous magnesium is significantly higher in SWD>1 than SWD1 and nonimmersion deaths, with no significant difference between SWD1 and nonimmersion deaths. Postmortem vitreous humor sodium chloride is statistically higher in SWD1 and SWD>1 than nonimmersion deaths. CONCLUSIONS: As a conclusion, PMVSC elevates and PMVM does not elevate in SWD1.

Increased Epicardial Fat Thickness in Sudden Death From Stable Coronary Artery Atherosclerosis.

BACKGROUND: Sudden death from stable coronary artery atherosclerosis (SCAA) is well recognized. However, individuals can have ischemic heart disease or coronary artery atherosclerosis but die of noncardiac causes. Recently, it has been recognized that increased epicardial fat is detrimental to normal heart function. We hypothesize that individuals who die of SCAA have increased epicardial fat. AIM: The aim of this study was to investigate whether there is an increase in epicardial fat in individuals who suddenly died of SCAA. METHODS: This was a 1-year retrospective study comparing the average epicardial fat thickness using postmortem computed tomography scan between individuals who suddenly died of SCAA (SCAA group) with individuals who primarily died of natural noncardiac causes but had established ischemic heart disease or significant coronary artery atherosclerosis (NCC group). RESULTS: Average epicardial fat thickness was significantly higher in the SCAA group (8 ± 2 mm) than in the NCC group (6 ± 2 mm, P = 0.008). CONCLUSIONS: Individuals who die of SCAA appear to have higher epicardial fat thickness. The increase in epicardial fat may have an additional detrimental effect to the heart predisposing sudden death in individuals with coronary artery atherosclerosis.

Immersion of Bovine Eyeballs After 1 Hour in Seawater Does Not Result in Elevation of Postmortem Vitreous Humor Sodium and Chloride Levels.

BACKGROUND: Elevations in postmortem vitreous sodium chloride (PMVSC) levels may help in differentiating saltwater/seawater drowning (SWD) deaths from immersion deaths not related to drowning (DNRD). It is unclear whether the elevation is related to blood/plasma electrolyte changes after inhalation of seawater as hypothesized in SWDs or possibly caused by electrolyte diffusion and/or osmosis across the outer coats of the eyeball during immersion. AIM: To investigate the changes in bovine PMVSC levels at different time points while immersed in seawater. METHODS: Bovine eyeballs were obtained from an abattoir and randomized into 2 groups: a) submerged in seawater ("wet" group) or b) placed in an impermeable plastic bag that was immersed in seawater ("dry" group). The PMVSC levels from 6 eyeballs were measured from each group (without replacement) at 30 minutes, 1 hour, 6 hours, and 12 hours. RESULTS: There was no significant difference in mean PMVSC levels between the 2 groups at 30-minute and 1-hour intervals. A significant difference was noted from 6 hours onward. DISCUSSION: There is no statistically significant elevation in bovine PMVSC levels when immersed in seawater for up to 1 hour. Assuming similar physical properties in humans, any elevations in PMVSC levels in bodies immersed in seawater for less than 1 hour should not be caused by immersion.

A Fatal Case of Isolated Methiopropamine (1-(Thiophen-2-yl)-2-Methylaminopropane) Toxicity: A Case Report.

Methiopropamine (1-(thiophen-2-yl)-2-methylaminopropane) is a synthetic methamphetamine analogue and is classified as a novel psychoactive substance. The use of novel psychoactive substance has been increasing substantially for recreational purpose in recent years. Methiopropamine was first detected in 2011 in Finland and was later detected in the United Kingdom. It can be purchased on the Internet and is currently poorly regulated. Reported adverse effects of methiopropamine use are mostly anecdotal user reports on Internet forums, and there are limited data on its pharmacodynamics and toxicity in the literature. Death as a direct result from methiopropamine toxicity has not been reported in Australia. We report here the first case of death caused by recreational use of methiopropamine in Australia. This same incident highlights the first ever death from isolated methiopropamine use. Being an analogue of methamphetamine, we hypothesize that the mechanism of death caused by methiopropamine would not be dissimilar to methamphetamine.