Fatal blunt trauma with rare and undetected superior vena cava rupture: A case report and literature review

Laceration of the superior vena cava is an uncommon clinical entity almost always related to penetrating trauma. Rarely, however, it may occur after blunt thoracic trauma. The authors describe an unusual case of rupture of the vena cava and tear of the aortic arch in a 51-year-old man struck on the chest by a falling tree he was felling. The man arrived at the emergency ward still conscious, but after about 4 hours from the accident was pronounced dead. Autopsy findings consisted in a rupture at the lower third of the superior vena cava, just above the cavo-atrial junction, and an aortic laceration at the level of the isthmus, measuring approximately 3 cm in length. The mechanism of death was attributed to cardiac arrest secondary to hypovolemic shock from massive hemorrhage resulting from rupture of the superior vena cava and aorta laceration

Unexpected sudden death due to acute myeloid leukemia subtype M5: A case report and review of the literature

Acute myeloid leukemia (AML) is one of the most frequent myeloid malignancies. In patients with the disease, death often occurs due to complications of marrow failure, such as sepsis or significant hemorrhage. Rarely, undiagnosed and rapid evolving cases may present with fatal multi-organ failure. The authors report a case of sudden death in a 67-year-old woman who had been in apparent good health. A thorough post-mortem investigation performed on the decedent led to the diagnosis of acute myeloid leukemia subtype M5. Autopsy and histopathologic findings allowed us to determine AML complicated by multiple organ failure as the cause of the death. The case report suggests that underlying acute myeloid leukemia should be included in the differential diagnosis of sudden death with multisystem organ failure, however rare. Actually, it represents a quite unusual cause of sudden death, rarely reported in the medicolegal literature. A complete forensic approach by means of autopsy, histological and immunohistochemical analyses is deemed essential in order to correctly determine both the cause and the mode of death

A Fatal Case of Coin Battery Ingestion in an 18-Month-Old Child: Case Report and Literature Review

The ingestion of extraneous substances is quite common in clinical practice; it usually befalls in the pediatric age, mostly between 6 months and 6 years. In most cases, complications do not emerge, and the prognosis is considered favorable. However, when a case of battery ingestion occurs, serious adverse events may develop. The ingestion of these components is a potential life-threatening event for children. In this article, we report the case of an 18-month-old child who died from hemorrhagic shock due to an aortoesophageal fistula caused by a 20 mm lithium button battery lodged in the esophagus. The child presented vomiting blood, and laboratory results revealed a severe anemization, which later led to death. The autopsy showed a coin battery located in the middle third of the esophagus as well as a transmural erosion of the esophageal wall with fistulization into the aortic wall. The histological examination revealed a severe necrosis of the esophageal and aortic walls in line with the junction between the aortic arch and the descending part

The PROVENT-C19 registry: A study protocol for international multicenter SIAARTI registry on the use of prone positioning in mechanically ventilated patients with COVID-19 ARDS

Background: The worldwide use of prone position (PP) for invasively ventilated patients with COVID-19 is progressively increasing from the first pandemic wave in everyday clinical practice. Among the suggested treatments for the management of ARDS patients, PP was recommended in the Surviving Sepsis Campaign COVID-19 guidelines as an adjuvant therapy for improving ventilation. In patients with severe classical ARDS, some authors reported that early application of prolonged PP sessions significantly decreases 28-day and 90-day mortality. Methods and analysis: Since January 2021, the COVID19 Veneto ICU Network research group has developed and implemented nationally and internationally the "PROVENT-C19 Registry", endorsed by the Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care…'(SIAARTI). The PROVENT-C19 Registry wishes to describe 1. The real clinical practice on the use of PP in COVID-19 patients during the pandemic at a National and International level; and 2. Potential baseline and clinical characteristics that identify subpopulations of invasively ventilated patients with COVID-19 that may improve daily from PP therapy. This web-based registry will provide relevant information on how the database research tools may improve our daily clinical practice. Conclusions: This multicenter, prospective registry is the first to identify and characterize the role of PP on clinical outcome in COVID-19 patients. In recent years, data emerging from large registries have been increasingly used to provide real-world evidence on the effectiveness, quality, and safety of a clinical intervention. Indeed observation-based registries could be effective tools aimed at identifying specific clusters of patients within a large study population with widely heterogeneous clinical characteristics. Trial registration: The registry was registered (ClinicalTrial.Gov Trials Register NCT04905875) on May 28,2021