1.
Elevated Postmortem Vitreous Sodium and Chloride Level in a Salt Water Drowning Death During Self-Contained Underwater Breathing Apparatus Diving With Diving Mask in Place: Case Report.
Tse, R, Garland, J, Kesha, K, Morrow, P, Elstub, H, Cala, A, Spark, A, Stables, S, Sage, M
The American journal of forensic medicine and pathology. 2018;(3):247-249
Abstract
Elevation of postmortem vitreous sodium and chloride (PMVSC) levels in salt water drowning (SWD) 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. This hypothesis was based on a study where bovine eyeballs were immersed in salt water. There is no human study that could confirm that SWD would result in an initial elevation of PMVSC with no effects from immersion. We present an SWD during self-contained underwater breathing apparatus diving in which the face mask remained in its correct position while the deceased was underwater. The face mask would have prevented the orbits from being in direct contact with salt water and therefore stopped any effects of immersion on PMVSC. The PMVSC was 294 mmol/L, above control levels, and the reported cut-off of 259 mmol/L for a diagnosis SWD. The elevated PMVSC would unlikely be owing to immersion but SWD. This case report supports the observation that during SWD PMVSC would initially increase from salt water inhalation and ingestion and not from immersion.
2.
Therapeutic approaches in pelvic bleeding of neoplastic origin.
Popovici, LR, Ciulcu, A, Dorobat, B, Dumitraşcu, M, Horhoianu, VV, Cirstoiu, M
Journal of medicine and life. 2014;(3):391-5
Abstract
OBJECTIVES The aim of this study is to present the main - surgical and non-surgical - therapeutic approaches (or methods) used in the treatment of pelvic bleeding of neoplastic origin. MATERIALS AND METHODS analysis of the materials found in the literature on this subject. RESULTS Among the surgical methods used, hypogastric artery ligation is the oldest therapeutic approach in cervical bleedings of neoplastic origin. Due to the frequent recurrence of haemorrhages, mere ligation has been proven not to be sufficient, but necessitating the concomitant ligation of the lumbo-ovarian, round and uterosacral ligaments. In the case of severe bleedings, difficult to control, direct embolization of the hypogastric artery below the level of ligation is usually practiced. As for the non-surgical methods used, we chose to present uterine artery embolization and the application of haemostatic Mohs' paste. Uterine artery embolization consists in the permanent occlusion of the uterine arteries in neoplastic abundant haemorrhages, when the intervention includes the use of permanent embolic material. Stopping the bleeding within the first 24 hours from the embolization means that the intervention has been a success, and provides the patient with the possibility to continue the therapy protocol according to her stadialization. Recent studies of the Japanese researchers have indicated the possibility to use the Mohs' paste for haemostatic purposes on patients with cervical bleedings of medium intensity, in cases of advanced cervical cancer. CONCLUSIONS With severe haemorrhages - occurring spontaneously or during surgery - the emergency haemostatic intervention consists in the bilateral hypogastric artery ligation. With long-lasting haemorrhages of medium intensity, we usually resort to uterine artery embolization, since this is a minimally invasive method and may also be performed with abundant bleeding under emergency pressure. The application of the Mohs' paste for haemostatic purposes is a new therapeutic method, whose efficiency cannot be yet estimated.
3.
Type 2 pseudohypoaldosteronism: new insights into renal potassium, sodium, and chloride handling.
Proctor, G, Linas, S
American journal of kidney diseases : the official journal of the National Kidney Foundation. 2006;(4):674-93