Histopathological Findings in a Fatal Case of Paraquat Poisoning.

ABSTRACT: Fatal paraquat ingestion presents many interesting pathological findings for the forensic pathologist. The majority of prior research regarding paraquat poisoning has focused on the lung and liver, this article is further directed to and presents some of the histopathological findings present in the brain. Typical macroscopic and histopathological findings of paraquat poisoning were identified in the liver and lungs. The brain was found to be edematous with widening of the centrum semiovale, whereas histologically, it was found that there was extravasation of erythrocytes into the surrounding Virchow-Robin spaces, a finding normally associated with blunt force head injury and, therefore, commonly interpreted by forensic pathologists as a cortical contusion hemorrhage.

A qualitative, cross-cultural investigation into the impact of potentially traumatic work events on Saudi and UK ambulance personnel and how they cope.

BACKGROUND: Post-traumatic stress disorder (PTSD) is common among ambulance personnel, but its prevalence varies between developed and developing countries. This study aimed to investigate the lived experience of potentially traumatic work events between Saudi and UK ambulance personnel. METHODS: Semi-structured interviews with 16 ambulance workers from Saudi Arabia and the United Kingdom (8 participants from each country) were conducted to explore their lived experiences of potentially traumatic events at work. Data were analyzed using thematic analysis. RESULTS: Four key themes were identified from interviews: (1) some events are inherently more stressful than others; (2) pressure of organizational and interpersonal stressors; (3) convergence and divergence in cross-cultural coping strategies; and (4) preferring formal and confidential support. CONCLUSIONS: There were differences in the nature of traumatic events and the ways of coping between the two cultures, but paramedics in both cultures had an agreement about their preference for individual and formal support. The results of this study may help inform the development of interventions and PTSD prevention programs for ambulance personnel.

Histopatholological Findings in a Fatal Case of Rinkhals Envenomation: A New Forensic Pathology Finding?

Although cobra envenomation continues to pose a threat to life and therefore constitutes a major cause of death in Africa, India, and Sri Lanka, the forensic pathology reports are not always histologically well documented or illustrated. The reports in the literature, although providing graphic evidence of the macroscopic appearances of the bite and its ensuing tissue necrosis, should the victim survive, often do not illustrate the histopathological findings to a sufficient degree. We present an unusual case of fatal envenomation by a rinkhals (Hemachatus haemachatus) in which the victim had been bitten a second time after a previous rinkhals' bite. Two issues therefore arose: (a) whether the histopathological findings in the spleen were an acute reaction to the snake bite or were due to immunostimulation as a consequence of the previously inflicted bite, and (b) the previously undocumented finding of extravasation of erythrocytes into the surrounding Virchow-Robin spaces in the brain, a finding usually associated with blunt head trauma and therefore interpreted as a cortical contusion hemorrhage by forensic pathologists.

Rapid efficacy of the highly selective α(1A)-adrenoceptor antagonist silodosin in men with signs and symptoms of benign prostatic hyperplasia: pooled results of 2 phase 3 studies.

PURPOSE: We evaluated the efficacy and safety of silodosin for treatment of benign prostatic hyperplasia symptoms in 2 randomized, placebo controlled, phase 3 studies. MATERIALS AND METHODS: Men 50 years or older with an International Prostate Symptom Score of 13 or greater and peak urinary flow rate of 4 to 15 ml per second received placebo or 8 mg silodosin daily with breakfast for 12 weeks. The primary end point was International Prostate Symptom Score change from baseline to last observation. Change in peak urinary flow rate was a secondary end point. Differences in treatment efficacy were assessed by ANCOVA. RESULTS: Of 923 patients (mean age 65 years) 466 received silodosin and 457 placebo. After 0.5 week (range 3 to 4 days) of treatment patients receiving silodosin vs placebo achieved significant improvement in total International Prostate Symptom Score (difference -1.9, p <0.0001) and irritative (-0.5, p = 0.0002) and obstructive (-1.4, p <0.0001) subscores. The mean ± SD change from baseline in total International Prostate Symptom Score was -4.2 ± 5.3 for silodosin vs -2.3 ± 4.4 for placebo. Differences (silodosin vs placebo) in International Prostate Symptom Score and subscores increased by week 12 (p <0.0001). Mean change from baseline in peak urinary flow rate (ml per second) 2 to 6 hours after initial dose was greater (p <0.0001) with silodosin (2.8 ± 3.4) than placebo (1.5 ± 3.8). Differences remained significant (p <0.001) through week 12. The most common treatment emergent adverse event was (mostly mild) retrograde ejaculation (silodosin 28.1% of patients, placebo 0.9%). Few patients receiving silodosin (2.8%) discontinued because of retrograde ejaculation. Proportions of patients with treatment emergent orthostatic hypotension were similar for silodosin (2.6%) and placebo (1.5%). CONCLUSIONS: Treatment with silodosin produced rapid improvement in urinary symptoms that was sustained for 12 weeks. Silodosin was well tolerated with a low incidence of orthostatic hypotension.

The paramedics' pledge: a short commentary on its inception and development.

This article discusses the creation and evolution of a unifying pledge designed to encapsulate the identity of paramedics and convey the essence of belonging to this professional group.

Exploring paramedic professional identity.

The notion of a paramedic (as a title protected in law) has recently entered its third decade, but the history of the paramedic is considerably older than that. Who are we as a profession? What does it mean to be a paramedic? What makes us who we are? These intriguing and yet seldom asked philosophical questions are at the heart of this article, which is intended to provoke discussion and serve as a foundation for further inquiry into questions of identity and philosophy in paramedicine. Literature pertaining to paramedic professional identity was explored and contextualised within current paramedic practice. Although the overall picture is complex, four key areas for discussion emerged: the history of the paramedic profession; role diversity; the influence of ambulance work; and the education and training of paramedics. The influence of ambulance work permeates all areas, suggesting that it is central to the development of paramedic professional identity. This discussion article is an exploration of the unique contexts and experiences that are associated with the process of being and becoming for paramedics.

The association between skeletal lesions and tuberculosis in a pre-antibiotic South African sample.

OBJECTIVE: This study assessed the sensitivity and specificity of skeletal lesions to accurately diagnose TB in a pre-antibiotic South African skeletal sample. MATERIALS: A total of 435 skeletons of individuals who died before 1950 from the Raymond A. Dart Collection of Human Skeletons. 176 died of TB, 109 died of other pulmonary diseases, and 150 died of other causes. METHODS: The presence / absence of 23 skeletal lesions were assessed for differences in frequency between groups. Sensitivities and specificities were calculated and compared to Dangvard Pedersen et al. (2019). RESULTS: Lesions on the ventral surface of thoracic and lumbar vertebral bodies were observed significantly more often in TB and pulmonary cases than in other cause of death group and yielded a 55% probability of a true TB diagnosis, if observed. An association between skeletal lesions and TB was found for rib and vertebral lesions. CONCLUSIONS: The results suggest that even when not documented to have died of TB, TB-related changes are observed in many individuals in a South African skeletal sample, indicating that they may have been infected with the disease. SIGNIFICANCE: The study provides information that can assist palaeopathologists in making inferences about the prevalence of TB in past populations. LIMITATIONS: Sample sizes were small, and the inclusion of a pulmonary disease group may have confounded the results. SUGGESTIONS FOR FURTHER RESEARCH: The selection of a control group without any possible contact with TB may improve the results and should be investigated.

Expected frequency of use and proficiency of core surgical skills in entry-level veterinary practice: 2009 ACVS core surgical skills diplomate survey results.

OBJECTIVES: ACVS Diplomates were surveyed to identify a complete list of core surgical skills, determine the expected frequency of use of these skills, and ascertain the level of skills proficiency expected of entry-level practicing veterinarians. STUDY DESIGN: Internet-based survey. SAMPLE POPULATION: Randomly chosen ACVS Diplomates (n = 750). METHODS: Rating scale items were used to construct the main portion of the survey with 26 skills that were scored by participants based on rankings of proficiency expected of entry-level veterinarians, as well as expected frequency of use of these skills. Additional demographic questions were included to gather information regarding gender, practice type, year of veterinary school, year of ACVS membership, job description, primary surgical discipline, practice location, average number of procedures performed on a weekly basis, and number of new graduates mentored in the last 5 years. RESULTS: Of 337 Diplomates (44.9%) who responded to the survey, >60% expected entry-level graduates to have good skills with minimal supervision or complete skills for 21 of the 26 skills categories listed. More than 60% of respondents ranked 7 skills with a lower frequency score (seldom or occasionally use). Orthopedic instrument handling and fixation skills as well as electrosurgical and laser skills received some of the lowest expected proficiency and frequency rankings. No additional skills categories were identified in the open-ended survey questions. CONCLUSIONS: A complete list of core surgical skills was identified. There was broad consensus between boarded surgeons irrespective of their practice type, experience, or discipline for ranked proficiency and frequency scores among the core surgical skills expected of entry-level veterinarians.

A Degradable Difunctional Initiator for ATRP That Responds to Hydrogen Peroxide.

Mid-chain degradable polymers can be prepared by atom transfer radical polymerization from difunctional initiators that include triggers for the desired stimuli. While many difunctional initiators can respond to reducing conditions, procedures to prepare difunctional initiators that respond to oxidizing conditions are significantly less available in the literature. Here, a difunctional initiator incorporating an oxidizable boronic ester trigger was synthesized over four steps using simple and scalable procedures. Methyl methacrylate was polymerized by atom transfer radical polymerization using this initiator, and the polymerization kinetics were consistent with a controlled polymerization. The polymer synthesized using the difunctional initiator was found to decrease in molecular weight by 58% in the presence of hydrogen peroxide, while a control experiment using poly(methyl methacrylate) without a degradable linkage showed a much smaller decrease in molecular weight of only 9%. These observed molecular weight decreases were consistent with cleavage of the difunctional initiator via a quinone methide shift and hydrolysis of the methyl ester pendent groups in both polymers, and both polymers increased in polydispersity after oxidative degradation.

Silodosin for men with chronic prostatitis/chronic pelvic pain syndrome: results of a phase II multicenter, double-blind, placebo controlled study.

PURPOSE: We evaluated the efficacy and safety of 2 doses of silodosin vs placebo in men with moderate to severe abacterial chronic prostatitis/chronic pelvic pain syndrome who had not been treated previously with α-blockers for chronic prostatitis/chronic pelvic pain syndrome. MATERIALS AND METHODS: In this multicenter, randomized, double-blind, phase II study, men 18 years old or older with chronic prostatitis/chronic pelvic pain syndrome, a total National Institutes of Health Chronic Prostatitis Symptom Index score of 15 or greater and a National Institutes of Health Chronic Prostatitis Symptom Index pain score of 8 or greater received 4 or 8 mg silodosin, or placebo once daily for 12 weeks. The primary efficacy end point was change from baseline to week 12 in National Institutes of Health Chronic Prostatitis Symptom Index total score. RESULTS: Of 151 patients (mean age 48 years) 52 received 4 mg silodosin, 45 received 8 mg silodosin and 54 received placebo. Silodosin 4 mg was associated with a significant decrease in total National Institutes of Health Chronic Prostatitis Symptom Index score (mean ± SD change -12.1 ± 9.3) vs placebo (-8.5 ± 7.2, p = 0.0224), including a decrease in urinary symptom (-2.2 ± 2.7, placebo -1.3 ± 3.0, p = 0.0102) and quality of life (-4.1 ± 3.1, placebo -2.7 ± 2.5, p = 0.0099) subscores. The 4 mg dose of silodosin also significantly increased Medical Outcomes Study Short Form 12 physical component scores (4.2 ± 8.1, placebo 1.7 ± 9.0, p = 0.0492). During global response assessment 56% of patients receiving 4 mg silodosin vs 29% receiving placebo reported moderate or marked improvement (p = 0.0069). Increasing the dose of silodosin to 8 mg resulted in no incremental treatment effects. CONCLUSIONS: Silodosin 4 mg relieved symptoms and improved quality of life in men with chronic prostatitis/chronic pelvic pain syndrome but its efficacy requires confirmation in additional studies.

Intra- and interobserver variability of board-certified veterinary radiologists and veterinary general practitioners for pulmonary nodule detection in standard and inverted display mode images of digital thoracic radiographs of dogs.

OBJECTIVE: To determine intra- and interobserver variability of 2 veterinary radiologists and 2 veterinary general practitioners for detection of pulmonary nodules in standard and inverted (reversed grayscale) displays of digital thoracic radiographs of dogs. DESIGN: Evaluation study. SAMPLE: 114 sets of 3-view (right lateral, left lateral, and ventrodorsal or dorsoventral views) digital thoracic radiographs from 114 dogs. PROCEDURES: 2 experienced board-certified veterinary radiologists and 2 experienced veterinary general practitioners individually evaluated 114 randomized sets of radiographs. Pulmonary nodules were present in radiographs of 60 of 114 dogs. Each reviewer examined all images in standard or inverted display mode and scored nodule detection on a confidence scale of 1 to 5. After ≥ 2 months, the same individuals evaluated the same images in the remaining display mode. Intraobserver agreement for each display mode was determined via a κ statistic; results between the 2 groups of reviewers were compared via receiver operator curve analysis. RESULTS: There was no significant intraobserver variability in pulmonary nodule detection between the 2 display modes. Detection accuracy for board-certified radiologists was significantly greater than that of veterinary general practitioners for both display modes. Near-perfect intraobserver agreement was detected between the 2 display modes for board-certified radiologists, whereas moderate to slight intraobserver agreement was detected for the veterinary general practitioners. CONCLUSIONS AND CLINICAL RELEVANCE: Detection of pulmonary nodules in digital thoracic radiographs was comparable, whether a standard or inverted mode was used for evaluations. However, the board-certified radiologists had greater detection accuracy than did veterinary general practitioners.

Dental Therapists' Impact on Access to Care and Oral Health Equity.

Dental therapists (DTs) have been treating patients in the United States since 2004, and the evidence is unequivocal. DTs provide safe, high-quality, cost-effective care to thousands of patients.1-3 Presently, 12 states have authorized DTs, and an additional eight states are pursuing legislation to bring these professionals to the oral healthcare team.4,5.

Modeling Temperature Variations Using Monte Carlo Simulation: Implications for Estimation of the Postmortem Interval Based on Insect Development Times*, †.

The association between insect development and temperature is well established. Thermal summation using accumulated degree-day measures is commonly used. However, the time at which evidence is collected is important in these estimates. The aim of this study was to provide a simulated model of the effect of temperatures on six dipteran species commonly associated with cadavers, from the death scene to the refrigerator, and finally at the time of autopsy. Temperatures measurements were sampled over a 16-month period from the external environment (external to the mortuary), within the mortuary refrigerator, and within the mortuary autopsy suite. Monte Carlo simulation using accumulated degree-days (ADD) was used to estimate the variations based on the mean and standard deviation of the temperature measurements. It was found that there was a negative correlation between the base temperature of the fly species (lowest temperature at which the flies will survive) and developmental likelihood. Species with high base temperatures (Chrysomya albiceps, Chrysomya chloropyga, and Musca domestica) were less likely to continue development in refrigerators than species with lower base temperatures (Lucilia sericata and Piophila casei). The findings of this study highlight the importance of recording temperature measurements and the period of refrigeration on PMI estimation especially when continued development occurs in spite of a period of cooling of the insect evidence.

Rapid efficacy of the highly selective alpha1A-adrenoceptor antagonist silodosin in men with signs and symptoms of benign prostatic hyperplasia: pooled results of 2 phase 3 studies.

PURPOSE: We evaluated the efficacy and safety of silodosin for treatment of benign prostatic hyperplasia symptoms in 2 randomized, placebo controlled, phase 3 studies. MATERIALS AND METHODS: Men 50 years or older with an International Prostate Symptom Score of 13 or greater and peak urinary flow rate of 4 to 15 ml per second received placebo or 8 mg silodosin daily with breakfast for 12 weeks. The primary end point was International Prostate Symptom Score change from baseline to last observation. Change in peak urinary flow rate was a secondary end point. Differences in treatment efficacy were assessed by ANCOVA. RESULTS: Of 923 patients (mean age 65 years) 466 received silodosin and 457 placebo. After 0.5 week (range 3 to 4 days) of treatment patients receiving silodosin vs placebo achieved significant improvement in total International Prostate Symptom Score (difference -1.9, p <0.0001) and irritative (-0.5, p = 0.0002) and obstructive (-1.4, p <0.0001) subscores. The mean +/- SD change from baseline in total International Prostate Symptom Score was -4.2 +/- 5.3 for silodosin vs -2.3 +/- 4.4 for placebo. Differences (silodosin vs placebo) in International Prostate Symptom Score and subscores increased by week 12 (p <0.0001). Mean change from baseline in peak urinary flow rate (ml per second) 2 to 6 hours after initial dose was greater (p <0.0001) with silodosin (2.8 +/- 3.4) than placebo (1.5 +/- 3.8). Differences remained significant (p <0.001) through week 12. The most common treatment emergent adverse event was (mostly mild) retrograde ejaculation (silodosin 28.1% of patients, placebo 0.9%). Few patients receiving silodosin (2.8%) discontinued because of retrograde ejaculation. Proportions of patients with treatment emergent orthostatic hypotension were similar for silodosin (2.6%) and placebo (1.5%). CONCLUSIONS: Treatment with silodosin produced rapid improvement in urinary symptoms that was sustained for 12 weeks. Silodosin was well tolerated with a low incidence of orthostatic hypotension.

Deposition of metal particles onto semiconductor nanorods using an ionic liquid.

The current study investigates whether metal deposition onto an existing nanorod can be carried out using an ionic liquid, and the effect this has on catalytic performance. Platinum, gold, and silver nanoparticles were deposited onto CdSe@CdS (core@shell) nanorods from metal salts in an ionic liquid (1-butyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide) without additional surfactants or reducing agents. Photocatalytic dye degradation experiments showed that catalysts with platinum particles deposited using the ionic liquid out-performed similar materials synthesized using organic solvents and ligands. We concluded that metal particles can be deposited onto well-defined semiconductor nanorods using ionic liquids and metal salts without the need for additional reagents, and the deposited particles did not cause significant aggregation even when these materials were taken into organic media. It is possible that a broad range of metal/semiconductor heterostructured particles can be prepared using the methods reported here.

Promoting collaboration in emergency medicine.

BACKGROUND: Collaborative practice between paramedics and medical staff is essential for ensuring the safe handover of patients. Handover of care is a critical time in the patient journey, when effective communication and collaborative practice are central to promoting patient safety and to avoiding medical error. To encourage effective collaboration between paramedic and medical students, an innovative, practice-based simulation exercise, known as interprofessional clinical skills (ICS) was developed at the University of East Anglia, UK. Emphasising patient safety, effective handover of care and teamwork, within the context of emergency medicine, the ICS promotes collaborative practice amongst health care students through the use of high- and low-fidelity simulation, human factors and values-based practice. METHODS: A total of 123 undergraduate students from paramedic (60) and medical backgrounds (63) took part in the ICS. Evaluation data were collected from all students through the completion of an internal feedback/satisfaction questionnaire with 13 statements and one open-ended comment box. RESULTS: The response rate for the questionnaire was 100%. Of the 123 students from paramedic and medical disciplines, 99% agreed or strongly agreed with the statement 'I enjoyed this session'. Students also felt that the ICS helped them to build mutual respect (98%), enhance understanding of roles (94%) and develop as collaborative practitioners (92%). Collaborative practice between paramedics and medical staff is essential CONCLUSION: The ICS is an innovative, enjoyable and meaningful intervention for promoting interprofessional collaborative practice between paramedic and medical students in a simulated practice setting. It encourages students to gain core training in clinical skills and patient safety, within a safe, supervised environment.

Pharmacokinetics of Oral and Intravenous Paracetamol (Acetaminophen) When Co-Administered with Intravenous Morphine in Healthy Adult Subjects.

BACKGROUND AND OBJECTIVE: Several features favor paracetamol (acetaminophen) administration by the intravenous rather than the oral route in the postoperative setting. This study compared the pharmacokinetics and bioavailability of oral and intravenous paracetamol when given with or without an opioid, morphine. METHODS: In this randomized, single-blind, parallel, repeat-dose study in healthy adults, subjects received four repeat doses of oral or intravenous 1000 mg paracetamol at 6-h intervals, and morphine infusions (0.125 mg/kg) at the 2nd and 3rd intervals. Comparisons of plasma pharmacokinetic profiles were conducted before, during, and after opioid co-administrations. RESULTS: Twenty-two subjects were included in the pharmacokinetic analysis. Observed paracetamol peak concentration (C max) and area under the plasma concentration-time curve over the dosing interval (AUC0-6) were reduced when oral paracetamol was co-administered with morphine (reduced from 11.6 to 7.25 µg/mL and from 31.00 to 25.51 µg·h/mL, respectively), followed by an abruptly increased C max and AUC0-6 upon discontinuation of morphine (to 13.5 µg/mL and 52.38 µg·h/mL, respectively). There was also a significantly prolonged mean time to peak plasma concentration (T max) after the 4th dose of oral paracetamol (2.84 h) compared to the 1st dose (1.48 h). However, pharmacokinetic parameters of paracetamol were not impacted when intravenous paracetamol was co-administered with morphine. CONCLUSIONS: Morphine co-administration significantly impacted the pharmacokinetics of oral but not intravenous paracetamol. The abrupt release of accumulated paracetamol at the end of morphine-mediated gastrointestinal inhibition following oral but not intravenous administration of paracetamol suggests that intravenous paracetamol provides a better option for the management of postoperative pain. CLINICALTRIALS. GOV IDENTIFIER: NCT02848729.

Effects of preadoption counseling for owners on house-training success among dogs acquired from shelters.

OBJECTIVE: To determine the effect of preadoption counseling for owners on house-training success among dogs acquired from shelters. DESIGN: Prospective study. SAMPLE POPULATION: 113 dog owners. PROCEDURES: Participants were randomly assigned to a treatment (n = 54) or a control (59) group. Dog owners in the treatment group received counseling (5 minutes' duration) regarding house-training. Owners in the control group did not receive counseling, but all other adoption procedures were otherwise identical to those applied to the treatment group. All participants were contacted by telephone 1 month after adoption of a dog for assessment of house-training status and related issues by use of a standardized survey method; data were compared between groups. RESULTS: Most shelter dogs were considered successfully house-trained by their owners 1 month after adoption. Furthermore, dogs were considered house-trained by significantly more owners who received preadoption counseling than control group owners (98.1% vs 86.4%). Owners who received counseling used verbal punishment on their dogs during house-training less frequently and applied enzymatic cleaners to urine- or feces-soiled areas more frequently than owners in the control group. CONCLUSIONS AND CLINICAL RELEVANCE: Results have suggested that brief preadoption counseling for owners enhances successful house-training of dogs adopted from shelters. Counseling owners at the time of pet acquisition may thus have beneficial effects in the prevention of inappropriate elimination behaviors. Veterinarians and animal care staff should be encouraged to devote time to counsel new pet owners on successful house-training, as well as other healthcare and behavioral needs.

Conjugated linoleic acid (CLA) modulates prostaglandin E2 (PGE2) signaling in canine mammary cells.

BACKGROUND: Conjugated linoleic acid (CLA), a naturally occurring linoleic acid isomer found in ruminant-produced foods, has the potential to serve as an effective chemopreventive nutriceutical factor for breast cancer prevention based upon previous published studies. There are several CLA isomers in ruminant-produced food products, among which t10,c12-CLA and c9,t11-CLA are more potent. Expression of cyclooxygenase 2 (COX-2) in mammary tumors has been correlated with poor prognosis. Prostaglandin E2 (PGE2) is a major COX-2 product in various cancers and, as in humans, PGE2 concentrations in canine tumor tissues were frequently elevated. Moreover, a PGE2 receptor subtype, EP2, is highly expressed in mammary tumors. Thus, various studies have implicated the important role of PGE2 and EP2 in COX-2-regulated tumor development. MATERIALS AND METHODS: Mammary tumor and normal mammary tissues were both collected from a female dog with mammary tumor. Both malignant and normal mammary tissues were subjected to isolation of epithelial and stromal cells. The effects of t10,c12-CLA and c9,t11-CLA on proliferation, as well as COX-2 and EP2 protein expression in canine mammary normal and cancerous cells, were detected by CellTiter 96 AQueous assay and Western blot assay, respectively. RESULTS: Both t10,c12-CLA and c9,t11-CLA not only suppressed malignant mammary cell growth, but also exerted inhibitory effects on tumor-associated non-malignant mammary cells. Similarly, both t10,c12-CLA and c9,t11-CLA suppressed EP2 protein expression in both normal and malignant mammary cells. t10,c12-CLA was more effective in decreasing COX-2 protein expression in malignant mammary cells, while, in contrast, c9,t11-CLA down-regulated COX-2 protein expression in both normal and malignant mammary cells. CONCLUSION: The results indicate that the dietary component CLA regulates COX-2 and EP2 protein expression in both malignant mammary cells and cells from the tumor-associated stromal compartment. In turn, this may suppress PGE2 signaling, leading to better prognosis. We further speculate that the knowledge obtained from canine studies may also be beneficial to study human breast cancer.

An Appraisal of Decomposition Cases Received at the Johannesburg Forensic Pathology Service Medico-legal Mortuary During 2010-2011.

Decomposed bodies pose many questions for researchers regarding environmental effects, cause of death, and patterns. This study aimed to observe the factors associated with decomposed bodies autopsied at the Johannesburg Forensic Pathology Service Medico-legal Mortuary. A total of 4876 autopsies were conducted from 2010 to 2011, of which 109 were decomposed. Black individuals made up the largest proportion (67%) followed by White (26%). Males comprised 86.2%, while 12.8% were female. The mean age was 42.78 years. Most cases were in the early stages of decomposition (49.5%), with 32.1% bloated, 11.9% in active decay, 2.8% in advanced decay, and 3.7% were skeletal. Insect activity was identified in 25.7% of decomposition cases. Cause of death was determined in 48.6% of cases. Of all the cases, 64% were found indoors and 23% outdoors, while 23% had insufficient information regarding the location. Of considerable interest was the number of cases from hospitals and clinics.