Muerte accidental atípica. A propósito de un caso / Fortuitous atypical death. A case report

En la Medicina Legal se presentan con frecuencia casos que tienen como etiología médico-legal la accidental, en sus más variadas situaciones. Accidente es cualquier hecho o fenómeno traumático o morboso espontáneo que sobreviene en el individuo sano, o en el curso de una enfermedad. La amplitud de los términos de esta definición obliga a tener presente que los diferentes tipos de accidentes se hallan condicionados por múltiples fenómenos de carácter imprevisible e incontrolable. En el presente estudio, se expone un caso poco común y atípico de accidente doméstico, que lamentablemente culminó con la muerte de la víctima. Se trata de una anciana de 72 años que, según datos aportados por la instrucción policial, fue hallada en su domicilio, tendida en la cocina, con una herida incisa penetrante en la cavidad torácica. Tenía antecedentes de epilepsia desde la infancia, para lo cual seguía un tratamiento, y se pudo conocer que había manifestado sentirse mal antes de quedarse sola en la vivienda

In Legal Medicine, there are frequently cases having an accidental medico-legal etiology in its more varied situations. An accident is any spontaneous traumatic or morbid fact or phenomenon that happens in a healthy individual or in the course of an illness. The wideness of this definition terms obliges us to take into the account that the different kinds of accidents are conditioned by multiple phenomena of unforeseeable and uncontrollable character. In the current work, we expose an uncommon, atypical home accident, unfortunately ending in the victim’s death; it deals with an elder woman aged 72 years who, according with the data provided by the police instruction was found lying in the kitchen of her house with an incised penetrating wound in the thoracic cavity. She had antecedents of epilepsy since childhood, and for that was treated; it was obtained information that she referred feeling bad before staying alone at home

Aggregation of recombinant hepatitis B surface antigen induced in vitro by oxidative stress.

In order to examine whether oxygen radicals could be responsible for aggregation of recombinant hepatitis B surface antigen (HBsAg) during its assembly in yeast, purified HBsAg was oxidized with ammonium peroxodisulphate (AP) and analyzed by non-denaturing and denaturing size exclusion chromatography, immunoassay and immunoelectron microscopy. As a result, peroxodisulphate radicals induced a reproducible aggregation of HBsAg. At 44 mM AP, the aggregation process took a few hours and the resulting structures were large, branched and non-antigenic. During more gentle oxidation with 9 mM AP and 20-80 microM Cu2+, a continuous structural modification to HBsAg delaying for tens of hours preceded the aggregation event. During this pre-aggregation period, peroxidation of HBsAg lipids and covalent cross-linking of S protein chains occurred that led a complete loss of antigenicity of oxidized particles. In contrast, yeast-derived HBsAg aggregate is decomposed to S monomers under reducing conditions and recognized by anti-HBsAg polyclonal and monoclonal antibodies, suggesting that is has been assembled in vivo from antigenic and reversibly cross-linked particles. Based on these observations, we conclude that oxidation, at least with respect to the specific molecular sites oxidized by AP, is not a primary event in HBsAg aggregate formation in vivo. Since oxidized HBsAg was shown to be irreversibly cross-linked and non-antigenic, there are no suitable techniques for detection HBsAg oxidation in biological samples. Hence, at present, the magnitude of the in-vivo oxidative damage to HBsAg cannot be evaluated and thus, whether the plasma-derived HBsAg undergoes radical-induced oxidation in the course of viral hepatitis remains to be established. If this occurs, this process is expected to contribute to low HBsAg levels in chronic hepatitis B carriers, failure of the currently available immunoassays to identify HBsAg-positive blood donors and inconsistency in the results provided by HBsAg- and anti-HBsAg-based tests in several recent reports.