Emanuela Turillazzi

Adam (MDMA) and Eve (MDEA) misuse: an immunohistochemical study on three fatal cases

Three fatal cases of MDMA/MDEA misuse have been examined. These referred to white males between 19 and 20 years of age, in which post-mortem toxicology showed the presence of MDMA (in one case), MDEA (in one case) and both (in one case). The clinical data were analysed and the histopathological findings were studied following immunohistochemical investigations. A complete immunohistochemical study has made it possible to demonstrate rhabdomyolysis and myoglobinuria with alterations of the organs typical of a DIC. Clinical, histopathological and toxicological data suggest that severe or fatal complications following ecstasy ingestion could be related to idiosyncratic response.

Fatal anaphylactic shock during a fluorescein angiography

The Authors describe an extremely rare fatal case (sixth case in the literature) of anaphylactic shock following a fluorescein angiography. This is the first report in which the diagnosis of anaphylactic reaction to the dye was made through laboratory analyses. The diagnosis of fatal shock due to sodium fluorescein was made based on clinical, laboratory and immunohistochemical data. Mast-cell tryptase was dosed in serum and a pulmonary immunohistochemical evaluation was performed. Tryptase, a neutral protease of human mast-cells is a potentially important indicator of mast-cell involvement in anaphylactic events.

Neonatology and the law

Neonatology is an area of medicine that has received much attention in recent years. This interest primarily concerns the constant progress in this field and the inherent ethical and medico legal problems. The extensive debate about some issues reflects both the technical and scientific progress that has been made in neonatology. Tightly argued issues such as medical malpractice litigation have reached crisis proportions in the neonatology and pediatrics. Moreover pediatric claims are very expensive because damages cover the life of the child and the juries tend to be very sympathetic toward children and their families [1]. Care of extremely preterm infants at the limits of viability and the “brain damaged newborn” are some of the more contentious areas of legal medicine in neonatology.