Background: Many deaths during heat waves stem not only from body overheating but also from heat stress, which can intensify pre-existing medical conditions, leading to fatal outcomes. Aim: This study aimed to investigate whether the intensity of pathological changes in the heart muscle and lung tissue of albino rats exposed to hyperthermia correlates with different water temperatures (WT) and to determine whether the histological structure of the myocardium and lungs varies. Methods: A sample of 21 albino rats was exposed to water temperatures of 37°C, 41°C, and 44°C. Temperature readings were recorded before immersion, immediately after immersion, at the point of reaching hyperthermia, at 20 minutes, and at the time of death. Tissue samples were collected from the dissected rats, fixed in 10% buffered formalin at room temperature, embedded in paraffin, sectioned into 4–5 μm slices, and stained using the hematoxylin-eosin method. Results: The severity of myocardial histopathological alterations increased with both higher temperatures and longer exposure durations WT. However, the progression of morphological alterations in cardiomyocytes was not markedly significant, likely due to the brief exposure time, which limited the visualization of subcellular alterations in Hematoxylin and Eosin staining-stained tissue. All lung samples from the seven rats exposed to the highest temperatures displayed bronchiolitis and acute bronchitis, along with early bronchopneumonia. Conclusion: While some organs exhibit greater tolerance to heat stroke than other organs, most organs show similar alterations characterized by capillary dilation, vascular pathway disruption, and extravasation. The extent of pathological changes in myocardial and lung tissue intensified with higher temperatures and longer exposure durations to elevated WT. However, the progression of morphological alterations in cardiomyocytes did not demonstrate marked significance, likely because of the brief exposure period. This short duration may limit the detection of subcellular changes when using hematoxylin-eosin staining.

Background: Between 10% and 80% of surgical patients experience some form of fear and anxiety before surgery. This is often attributed to inadequate or incorrect preoperative information. Objectives: This study aimed to critically evaluate and compile research that describes the impact of preoperative information on the patient's well-being before surgery. Methods: A systematic search was conducted on PubMed, Medline, CHINAL, Embase, and the Cochrane Library database for qualitative and quantitative literature regarding factors influencing patients' well-being before surgery. An inductive thematic analysis generated categories and subcategories. Nineteen studies were included. Results: Two main categories emerged from the thematic analysis of the included articles. These were the direct impact of information on fear and anxiety and the indirect impact of information on fear and anxiety. Information from healthcare professionals, alternative sources of information, shortage of healthcare professionals, music, and inability to receive information were some of the factors that can influence the well-being of patients before surgery. There are different reasons for the patient's fear and anxiety preoperatively, as well as the importance of direct and indirect information and other methods. For some patients, however, too much information could cause more fear and anxiety. Conclusion: The importance of the patient's discomfort being highlighted by the healthcare professionals emerges clearly and shows negative experiences in those cases where the patient feels his fears and concerns are not being addressed. More qualitative and quantitative research in the same theme, education and using person-centred care, and the right amount of information based on the patient's wishes are needed to improve the patient's well-being.

Hypothermia-related deaths present significant diagnostic challenges due to non-specific and often inconsistent autopsy findings. This study investigated the histological and immunohistochemical alterations associated with primary and secondary hypothermia in an experimental Rattus norvegicus model, focusing on the effects of benzodiazepine and alcohol ingestion. Twenty-one male rats were divided into three groups: control (K), benzodiazepine-treated (B), and alcohol-treated (A). After two weeks of substance administration, hypothermia was induced and multiple organ samples were analyzed. Histologically, renal tissue showed hydropic and vacuolar degeneration, congestion, and acute tubular injury across all groups, with no significant differences in E-cadherin expression. Lung samples revealed congestion, emphysema, and hemorrhage, with more pronounced vascular congestion in the alcohol and benzodiazepine groups. Cardiac tissue exhibited vacuolar degeneration and protein denaturation, particularly in substance-exposed animals. The spleen showed preserved architecture but increased erythrocyte infiltration and significantly elevated myeloperoxidase (MPO)-positive granulocytes in the intoxicated groups. Liver samples demonstrated congestion, focal necrosis, and subcapsular hemorrhage, especially in the alcohol group. Immunohistochemical analysis revealed statistically significant differences in MPO expression in both lung and spleen tissues, with the highest levels observed in the benzodiazepine group. Similarly, CK7 and CK20 expression in the gastroesophageal junction was significantly elevated in both alcohol- and benzodiazepine-treated animals compared to the controls. In contrast, E-cadherin expression in the kidney did not differ significantly among the groups. These findings suggest that specific histological and immunohistochemical patterns, particularly involving pulmonary, cardiac, hepatic, and splenic tissues, may help differentiate primary hypothermia from substance-related secondary hypothermia. The study underscores the value of integrating toxicological, histological, and molecular analyses to enhance the forensic assessment of hypothermia-related fatalities. Future research should aim to validate these markers in human autopsy series and explore additional molecular indicators to refine diagnostic accuracy in forensic pathology.

This cross-sectional study investigates the global burden of nontraumatic subarachnoid hemorrhage in 2021.

Background: Primary hypothermia occurs when the body is exposed to extremely low temperatures in an environment with no underlying health conditions. Secondary hypothermia, on the other hand, results from disruptions in thermoregulation due to diseases, trauma, surgery, drugs, alcohol, or infections. Postmortem biochemistry has become a crucial factor in forensic examinations, offering valuable apprehension into tissue of and organ dysfunction associated with the process of dying. Aim: This research aims to explore various biochemical markers and their significance in distinguishing primary from secondary hypothermia. Methods: This study involved 21 Wistar rats, which were separated into three experimental groups: CG (n = 7), which were exposed only to hypothermic conditions; AHG (n = 7); and BHG (n = 7). We tested these parameters in each rat: glucose, urea, creatinine, blood urea nitrogen to creatinine ratio, phosphorus, calcium, sodium, potassium, sodium to potassium ratio, chloride, and calculated osmolality. Results: Distinct biochemical differences were noted between primary and secondary hypothermia. Glucose and creatinine levels exhibited significant variations (p < 0.001). Urea concentrations also manifested notable differences between the groups (p < 0.001). Phosphorus levels demonstrated significant differences (p = 0.004), with post hoc analyses revealing significant contrasts between the AHG and BHG (p = 0.014) and between the BHG and CG (p = 0.014). Potassium levels and the sodium-to-potassium ratio differed significantly (p < 0.001). Osmolality also varied significantly across experimental groups (p < 0.001), with post hoc tests confirming significant differences between the AHG and CG (p = 0.013) and between the BHG and CG (p = 0.002). Conclusion: The calculated osmolality exhibited significant variation among the different groups, indicating a notable impact of the substances on the biochemical profile related to hypothermia. This study focused on the effectiveness of biochemical markers in distinguishing primary hypothermia from secondary hypothermia.

Postmortem biochemistry is a valuable tool in forensic investigations, providing insights into the tissue damage and organ dysfunction associated with death. This study aimed to identify biochemical markers that distinguish primary and secondary hypothermia. Twenty-one Wistar rats were allocated into three groups: the Control group (n = 7), which was exposed only to hypothermic conditions, the Alcohol + Hypothermia group (n = 7), and the Benzodiazepines + Hypothermia group (n = 7). The temperature metrics assessed included the normal core temperature, the post-ketamine (0.3 ml injection) core temperature, the immersion temperature, temperature at the onset of hypothermia, and temperature at death. Blood samples were collected from the thoracic aorta in EDTA vacuum tubes for biochemical analysis. The key biochemical parameters measured included the Total Protein (g/L), Albumin (g/L), Globulin (g/L), Albumin to Globulin Ratio, Alanine Aminotransferase (U/L), Alkaline Phosphatase (U/L), Cholesterol (mmol/L), Amylase (U/L), and Lipase (U/L), using an automated IDEXX (Netherlands) cell counter. Significant between-group differences were found for the total protein and globulin levels (p < 0.001 and p = 0.002, respectively), with post-hoc tests confirming differences between the alcohol and control, and benzodiazepine and control groups. The cholesterol levels were found to be significantly different through an omnibus test (p = 0.03), but post hoc tests did not confirm these differences on a statistically significant level. The amylase levels varied significantly across all groups (p < 0.001), with post hoc tests confirming significant differences among all pairs: alcohol vs. benzodiazepine (p = 0.002), alcohol vs. control (p = 0.003), and benzodiazepine vs. control (p < 0.001). The lipase levels showed significant differences in the omnibus test (p = 0.030), but there was no significance in the post hoc tests. Amylase emerged as the most significant parameter in our study, with reduced levels strongly associated with secondary hypothermia. These findings highlight the potential use of total protein, globulin, and amylase levels as biomarkers to differentiate between primary and secondary hypothermia in forensic contexts.

Microscopic signs indicative of drowning are not specific to drowning but also to any other form of suffocation where mechanical obstruction is involved. Our study aimed to evaluate both macroscopic and microscopic findings across different groups sharing a common mechanism of death but differing causes and to compare the diatom test with pathohistological examination.Twenty-nine adult Wistar rats, weighing within recommended ranges, were divided into four groups (L1-L4). The diatom test followed established guidelines for diatoms in water from the Bosna River. Microscopic examination revealed diatoms in the lungs of rats in L3 and L4 groups. Pathohistological findings showed varying degrees of changes including consolidation and inflammatory cell infiltration, dominated by lymphocytes and macrophages, with some samples also showing eosinophilic leukocytes.Significant differences were observed between animals whose cause of death was mechanical asphyxia (suffocatio) and those that were submersed for1 hour versus those that were submersed for 72 hours after death. Diatoms identified in group L4 samples 3, 4, and 5 included Navicula sp. (U3 and U6) and Ulnaria ulna (U4).Our findings suggest combining the diatom test with pathohistological analysis to support a drowning diagnosis. Further examination of other organs could enhance result reliability.