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(1) Background: Foreign body aspiration (FBA) is a significant public health concern among the pediatric population, and fatalities are dramatic for families. It typically involves organic foreign bodies (mainly food) aspirated by children under three years old, usually at home or school. This review aimed to focus on the preventive measures around four actual cases of fatal foreign body aspiration, emphasizing the correct execution of the Heimlich maneuver and cardiopulmonary resuscitation, supervised mealtimes, and high-risk foods. (2) Methods: Four fatal cases of foreign body aspiration in children are presented here. The children were in a free environment, such as school, home, and the countryside, and were in the presence of teachers, parents, and a grandmother who did not supervise the children adequately. A literature review was performed via the MEDLINE database using the key terms: “foreign body aspiration,” “infant choking, 1.5 to 3 years,” “food and foreign body aspiration,” “common household,” “prevention of foreign body aspiration,” “guidelines,” “recommendations,” “training of caregivers (parents, educators),” “resuscitation,” “Heimlich maneuver,” and “disengagement of the upper airways.” We focused on the prevention of foreign body aspiration. (3) Results: a complete postmortem examination was performed. In three cases, the foreign bodies were food (mozzarella cheese, pear, or raw bean), while in one case, the foreign body was a pebble. (4) Conclusions: This review aimed to discuss recent scientific literature and provide a perspective on the benefits of a dedicated approach to the management of fatal foreign body aspiration in children by caregivers who usually have no experience with the best ways of supervising children in a safe environment, especially regarding the correct execution of resuscitation maneuvers, such as the Heimlich maneuver. Recommendation updates could improve healthcare quality in a pediatric setting and reduce medico-legal implications.

Background: Matrix metalloproteinases (MMPs) are involved in vascular wall degradation, and drugs able to modulate MMP activity can be used to prevent or treat aneurysmal disease. In this study, we evaluated the effects of statins on MMP-2, MMP-9, and neutrophil gelatinase-associated lipocalin (NGAL) in both plasma and tissue in patients with aneurysmal disease. Methods: We performed a prospective, single-blind, multicenter, control group clinical drug trial on 184 patients of both sexes &gt, 18 years old with a diagnosis of arterial aneurysmal disease. Enrolled patients were divided into two groups: Group I under statin treatment and Group II not taking statins. In addition, 122 patients without aneurysmal disease and under statin treatment were enrolled as a control group (Group III). The expression of MMPs and NGAL in plasma was evaluated using ELISA, while their expression in endothelial tissues was evaluated using Western blot. Results: The ELISA test revealed greater plasma levels (p &lt, 0.01) of MMPs and NGAL in Groups I and II vs. Group III. Western blot analysis showed higher expression (p &lt, 0.01) of MMPs and NGAL in Group II vs. Group I, and this increase was significantly higher (p &lt, 0.01) in patients treated with low potency statins compared to high potency ones. Conclusions: MMPs and NGAL seem to play a major role in the development of aneurysms, and their modulation by statins suggests that these drugs could be used to prevent arterial aneurysmal disease.

Perrotta I, Russo E, Camastra C, Filice G, Di Mizio G, Colosimo F, Ricci P, Tripepi S, Amorosi A, Triumbari F & Donato G (2011) Histopathology59, 504–513 New evidence for a critical role of elastin in calcification of native heart valves: immunohistochemical and ultrastructural study with literature review Aims: Calcific aortic stenosis is a progressive disease characterized by massive fibrosis andmineralization of the valve leaflets. The aim of this study was to determine whether the onset of native calcific aortic stenosis is associated primarily with matrix remodelling events, and particularly with elastin degradation. Methods and results: The immunohistochemical expression profile of matrix degradating enzymes and tenascin-C was investigated in both healthy and native calcified aortic valves. Collagen and elastic tissue were studied by light microscopy and electron microscopy. Immunophenotypic analysis of inflammatory cells was carried out by using monoclonal antibodies to macrophages, T and B lymphocytes. Immunoreactivity for tenascin-C and matrix metalloproteinase-12 (MMP-12) was associated with areas of dense mineralization, which were characterized by fibrosis, fragmentation and calcification of elastic fibres a positive reaction was also found around small islands of calcification. MMP-11 was not detected in the diseased valves. Osteopontin and osteonectin were also found at sites of mineralization. All calcified valves examined showed inflammatory cell infiltration. Conclusions: Our results demonstrate the direct involvement of MMP-12 in native aortic valve stenosis. MMP-mediated degradation of elastic fibres might contribute actively to valve mineralization by inducing calcium deposition onto fragmented elastin.

Blunt chest trauma from rapid automobile airbag deployment causing coronary artery occlusion and myocardial infarction is a rare but potentially fatal condition. We present the case of a 37-year-old man who developed extensive anterior and inferior myocardial infarction because of occlusion of both left anterior and right coronary arteries following blunt injury to the chest in a car accident. The patient was scheduled for emergency coronary angiography but left and right coronary ostia were not cannulated because of thrombus formation probably. The patient died, and the autopsy revealed external compression by epicardial hematomas involving separately left and right coronary arteries and the coronary sinus without signs of coronary and/or aortic dissection. To our knowledge, this is the first case presenting occlusion of both coronary arteries secondary to blunt chest trauma causing acute myocardial infarction in a young man without signs of prior coronary artery disease.

Calcific aortic stenosis is a progressive disease characterized by massive fibrosis andmineralization of the valve leaflets. The aim of this study was to determine whether the onset of native calcific aortic stenosis is associated primarily with matrix remodelling events, and particularly with elastin degradation.The immunohistochemical expression profile of matrix degradating enzymes and tenascin-C was investigated in both healthy and native calcified aortic valves. Collagen and elastic tissue were studied by light microscopy and electron microscopy. Immunophenotypic analysis of inflammatory cells was carried out by using monoclonal antibodies to macrophages, T and B lymphocytes. Immunoreactivity for tenascin-C and matrix metalloproteinase-12 (MMP-12) was associated with areas of dense mineralization, which were characterized by fibrosis, fragmentation and calcification of elastic fibres a positive reaction was also found around small islands of calcification. MMP-11 was not detected in the diseased valves. Osteopontin and osteonectin were also found at sites of mineralization. All calcified valves examined showed inflammatory cell infiltration.Our results demonstrate the direct involvement of MMP-12 in native aortic valve stenosis. MMP-mediated degradation of elastic fibres might contribute actively to valve mineralization by inducing calcium deposition onto fragmented elastin.

Clinical and social background“The HR offers to dependent subjects, elderly and not,with an outcome of physical illnesses, mental or sensorymixed, not treatable at home, an average level of medi-cal, nursing and rehabilitation, accompanied by a highlevel of protect and hotel assistance, modulated accord-ing to the model of care adopted by the Regions andAutonomous Provinces (DPR 14.01.97). The HR areintended to subject self-sufficient, could not be treatedat home, affected by geriatric neurological and neurop-sychiatric stabilized diseases. Be expected: hospitalitypermanent relief to the family not exceeding 30 days, ofcompleting education and rehabilitation possible initia-tives in other principals of the NHS.” Essentially the HRare the practical response to the needs of actual society,more and more elderly, with various care needs that cannot be left solely to individual initiative resolvers house-hold. Depending on the provision of care to be paid,social workers and health board must ensure the ade-quacy of operation by the state of health of the subjectadmitted, in relation to “obligations of means” businessactivity, whereas the RSA however, is not a hospital or anursing home.ConclusionsSince the HR private structures, under the agreementwith the Regional Health Service, operating according tospecific rules, and receiving public money in respect ofservices rendered to citizens, thereby absolving - onbehalf of the State - constitutional requirements underArticle 32, can only portend a hypothesis of contractualliability in the event of default in the bonds due. Qualityfirst documented in Nursing, where the minimum per-formance level or base has now increased and qualifiedfor the presence in the so-called“modules” no longermere performers but by professionals who graduated inNursing. By providing the best qualified health RSA(medicalized HR) presence h24 nurses and the doctorworking in the daytime, with possible assistance at nightand weekend “on call” continuity of care or service orthe Emergency and Urgency 118 Service, it is clear howthe nursing care becomes - in these operational realities- an expression of the true guarantee of continuity ofcare and therapeutic. Remains decisive in achieving theoverall objectives, the operational integration of all theskills, both in health and social vocation, so that thequality of care may be considered appropriate to theneeds of users.