Laryngeal anatomical variants and their impact on the diagnosis of mechanical asphyxias by neck pressure.

The aims of this investigation were to determine the characteristics and prevalence of anatomical variants of the larynx apparatus and to evaluate the impact of these variants on the accurate diagnosis of laryngeal fractures. A population-based study was carried out, analyzing a series of 207 consecutive autopsied cases in the Institute of Legal Medicine of Galicia (Northwestern Spain). The prevalence of triticeal cartilage was 52.7% and that of agenesis of thyroid horns 10%. Calcification of the stylo-hyoid ligament accounted for 1.4%. We identified three new anatomical variants: the terminal segmentation of the thyroid horns (11.6%), ectopic superior thyroid horns (8%) and lateral thyrohyoid ossification (5.3%). These three names, based on anatomical criteria, are the author's proposal to solve the lack of uniformity in the designation of these variants. Agenesis of thyroid horns were related to the presence of ectopic superior thyroid horns in 93% of cases, either uni or bilateral. The combination of variants was present in 6.8% of the cases, being the terminal segmentation of the thyroid horns in association with triticeal cartilage the most frequent (3.8%). The probability of misdiagnosis due to the presence of anatomical variations in deaths by pressure on the neck was high in this population (71.5%). The prevalence of triticeal cartilage in more than half of the sample, determined an important rate of potential errors (46.4%), followed by the mistaken diagnoses induced by terminal segmentation of thyroid horns (7.3%) and by ectopic superior thyroid horns (6.3%). The likelihood of a misdiagnosed laryngeal fracture was greater if the thyroid cartilage was affected, with a higher proportion of false positives comparing to the hyoid bone (p<0.001). The higher frequency of thyroid fractures in neck pressure together with the prevalence and location of triticeal cartilage on the lower third of the lateral thyrohyoid ligament are the main reasons for these results. Further studies should be done with larger samples to expand epidemiological data and consolidate these results and their influence on the diagnosis of mechanical asphyxias.

Efecto inhibidor de Lactobacillus casei 206/1 contra Escherichia coli O157:H7 / Inhibiting effect of Lactobacillus casei 206/1 against Escherichia coli O157:H7

Se ha investigado, mediante estudios de cinética de muerte celular, el efecto inhibidor de una cepa de Lactobacillus casei, aislada de un alimento cárnico fermentado producido en la región santafesina (Argentina), y de su sobrenadante libre de células (SLC), frente a tres cepas de Escherichia coli O157:H7. La cepa de L. casei 206/1 se seleccionó sobre la base de resultados obtenidos en estudios previos donde, aplicando la técnica de agar spot, se determinó que su SLC produjo el mayor efecto inhibitorio sobre E. coli O157:H7. En los ensayos de cinética de muerte celular se observó una reducción significativa de las cepas de E. coli O157:H7 estudiadas, tanto en cocultivos como en el ensayo con el SLC, no detectándose bacterias viables luego de 24 horas de incubación. Estos resultados demuestran que cepas de bacterias ácido lácticas aisladas a partir de un determinado ecosistema regional, pueden convertirse en una herramienta biotecnológica útil para controlar a E. coli O157:H7 en alimentos.

Through the study of cell death kinetics, we have analyzed the inhibiting effect of a Lactobacillus casei strain isolated from a fermented meat product produced at the Santa Fe region in Argentina, and of its cell-free supernatant (CFS), against three Escherichia coli O157:H7 strains. The L. casei 206/1 strain was selected on the basis of results obtained in previous studies where using the agar spot technique, it was determined that CFS produced the greatest inhibitory effect over E. coli O157:H7. The studies of cell death kinetics showed a significant reduction of the E. coli O157:H7 strains tested, both in cocultures and in assays with CFS, and no viable bacteria were detected after 24-hours of incubation. These results show that lactic acid bacterial strains isolated from a determined regional ecosystem, can become a useful biotechnological tool for controlling E. coli O157:H7 in food.