A safe procedure? The unusual case of a fatal airway obstruction by silicone during the production process of a tracheostomal epithesis in a 13-year-old boy

A tracheostomal epithesis is a plastic prosthesis that serves for sealing a tracheostoma and ensuring the position of the tracheostomy tube. The production of a tracheostomal epithesis requires an impression of the tracheostoma. To this end, silicone impression material is applied by an anaplastologist in and around the tracheostomal region, including the trachea. The blocked cuff of the tracheostomy tube serves to prevent aspiration of the material. We report on a 13-year-old boy who died during this procedure because the lower airways were obstructed with cured silicone. Forensic autopsy confirmed asphyctic suffocation as cause of death. Forensic physical investigation of the tracheostomy tube and its cuff revealed no structural or functional defects. Yet, the investigation results prove that the viscous silicone must have passed the cuff. To conclude, this case report demonstrates that the production of an impression of a tracheostoma is a procedure with a potentially lethal outcome. Hence, professional guidelines, including clear safety precautions, are urgently needed.

Effect of Manual Grinding on Diclofenac Acid Nanocrystals: A Chemico-Physical Investigation

X-ray Powder Diffraction, Fourier Transform Infrared Spectroscopy and Differential Scanning Calorimeter were used to study the effect of the manual grinding in an agate mortar of the diclofenac acid polymorphs HD1 and HD2. In particular, we have tried to highlight how the HD2 form is more sensitive than the HD1 to the grinding process to achieve a nanometric crystal size. HD1 shows no change, while in the case of the HD2, changes in the molecular conformation and the formation of a new metastable form of the polymorph are observed after grinding.

Mechanical and physical investigation of an artificial stone produced with granite residue and epoxy resin

The incorporation of ornamental stones residues to a polymer resin to produce artificial stone is an alternative to reducing the environmental impacts of inadequate waste disposal; it also represents a technically viable method. The objective of study was to develop an artificial granitic stone (AGS) using 85% in mass of granite agglutinated by 15% epoxy resin, through a vacuum, vibration and compression process. The artificial stone presented superior properties when compared with the natural granite, it had satisfactory mechanical and physical properties, resistant to temperature oscillations, to impact and wear, therefore suitable for applications for flooring subject to instantaneous tension and high-traffic.