RESUMO
A diagnosis of drowning is a challenge in legal medicine, as there is generally a lack of pathognomonic findings indicative of drowning. Diatom analysis has been considered very supportive for a diagnosis of drowning, although the test is still controversial for some investigators. We assessed diatoms association with drowning in the peripheral tissues of drowned rats and the effects of the drowning medium on the diatom yield. A modified acid digestion method was optimised for diatom recovery in water and rat tissues. Eighteen adult Wistar rats were employed for the study, subdivided into six groups of three rats. Groups 1, 3 and 5 were drowned in seawater, lake water, or river water respectively, while groups 2, 4 and 6 were controls (immersed after death in seawater, lake water or river water respectively). Water samples were taken from the sea, lake and river in Málaga and Córdoba (Spain) for the purposes of diatomological mapping and drowning of the rats. Diatoms were successfully recovered from all water samples and matched with tissues of the drowned rats. There were significant differences in diatom numbers between control and test samples for all the tissues studied, as well as within test samples. Histological investigations conducted on lung samples obtained from drowned rats provided complementary and valuable information. This study demonstrates the feasibility of the diatom test as a reliable method for the diagnosis of drowning, especially if adequate precautions are taken to avoid contamination, and if interpretation of the analysis is performed in light of other complementary investigations.
Assuntos
Diatomáceas/isolamento & purificação , Afogamento/diagnóstico , Animais , Encéfalo/patologia , Fêmur/patologia , Patologia Legal , Rim/patologia , Lagos , Fígado/patologia , Pulmão/patologia , Modelos Animais , Músculo Esquelético/patologia , Ratos Wistar , Rios , Água do Mar , Baço/patologiaRESUMO
El tronco arterioso es una anomalía cardiaca relativamente rara, con una incidencia del 0,21-0,34% de los pacientes nacidos con anomalías cardiacas congénitas. Sin reparación quirúrgica precoz, menos del 10% de los pacientes superan el primer año de vida. Presentamos un caso de muerte súbita en una paciente de 32 años con tronco arterioso persistente sin corregir quirúrgicamente, y que había llevado una vida compatible con la normalidad hasta los 28 años. Los principales hallazgos de autopsia son un tronco arterial único, donde desembocan los conos de salida de ambos ventrículos. Las arterias coronarias tienen su origen por encima de la válvula truncal. La arteria descendente anterior está lateralizada hacia la izquierda, mientras que las ramas ventriculares de la coronaria derecha son de un tamaño y longitud superiores a lo normal. La descompensación originada por un episodio de vómitos y diarrea previo a su fallecimiento podría justificar una muerte súbita por taquiarritmia (AU)
Truncus arteriosus is a serious cardiac malformation, accounting for 0.21-0.34% of all congenital heart diseases. Without an early surgical treatment, less than 10% of these patients survive more than one year. We reported a case of sudden death in a 32-year-old female patient with persistent truncus arteriosus without surgical correction, who had lived without noticeable symptoms until she was 28. The main autopsy findings were a single arterial truncus in which both right and left ventricles infundibula flow into. Coronary arteries are originated above the tricuspid truncal valve. Left anterior descending coronary artery was displaced towards the left, whereas ventricular branches of the right coronary artery were larger than normal. he unbalanced state due to an episode of vomiting and diarrhea few days before her death could justify an arrhythmic sudden death (AU)