[Multiple firearm injury caused with a blank pistol]. / Viacnásobné strelné poranenie spôsobené expanznou strelnou zbranou.

The authors present a case of a complex suicide of a 60-year-old woman found dead on her bed. A blank pistol Umarex caliber 9-mm, several blank cartridges and a lot of drug packages were discovered near the body. The woman suffered from a psychiatric depression. There were three gunshot wounds on the body: in the right temporal region, on the palatum of the mouth and on the left chest wall. The gunshot wounds in the right temporal region and in the mouth had central circle defects with the margins of stellate or star-like appearance and blackening. In the right temporal region the temporal muscle was contused but skull and intracranial tissues were without any injury. On the palatum of the mouth there was neither facial skeleton nor skull injury. The numerous small tears of lips and contusions of buccal mucosa were observed. On the left chest wall there was an abrasion with a bruise on the skin and contusion of thoracic muscles. Neither ribs nor intrathoracic organs were inflicted. At autopsy blood in the amount of 600 ml and a few tablets were found in the stomach as well as an insignificant blood aspiration into lungs. In spite of the fact that all the gunshot wounds were caused by shots fired at contact range they were not lethal. The woman died of lethal intoxication with tramadol and dibenzepin. Although this report differs from the ones published in literature, the authors believe that can contribute to the issue of gunshot wounds caused by gas weapons.

Variable outcome of experimental interferon-gamma therapy of disseminated Bacillus Calmette-Guerin infection in two unrelated interleukin-12Rbeta1-deficient Slovakian children.

UNLABELLED: Mycobacterium bovis Bacillus Calmette-Guerin (BCG) is an attenuated live vaccine that may cause life-threatening clinical disease in children with impaired immunity. In particular, patients with any of the nine known inherited disorders of the interleukin-12/23 interferon-gamma (IL-12/23-IFNgamma) axis are highly vulnerable to BCG. We describe two unrelated young Slovakian children suffering from disseminated BCG infection which developed shortly after routine BCG vaccination after birth. During treatment with selected anti-BCG antibiotics, resistance against several of these drugs developed. In both children, interleukin-12/23 receptor beta1 (IL-12/23Rbeta1) deficiency was diagnosed. Thus, in addition to chemotherapy, immunomodulatory treatment with recombinant IFN-gamma was performed as the pathogenesis of BCG disease in IL-12Rbeta1 deficiency involves impaired IL-12- and IL-23-dependent IFN-gamma production by lymphocytes. One child responded to treatment and is presently doing well whereas the second patient died. CONCLUSION: The marked variability of outcome of disseminated Bacillus Calmette-Guerin disease in interleukin-12/23 receptor beta1-deficient children sharing the same ethnic origin and exposed to a similar environment as presented in these case reports has to be taken into consideration for diagnosis and treatment of infections due to this genetic defect.