Complex Congenital Heart Malformation Including Transposition of the Great Vessels,Presenting as Sudden Unexplained Infant Death

Transposition of the great vessels (TGV) is a common congenital heart defect that is difficult to diagnose before birth. Antenatal diagnosis is associated with increased survival. Unusual features such as anomalous pulmonary artery origin may delay cyanosis, decreasing clinical suspicion. A three‐week old female infant who had never been cyanotic presented for forensic autopsy due to onset of unresponsiveness at home. History included risk factors for TGV and signs of heart enlargement that were not recognized during life. Cardiac pathology consultation identified D‐type TGV with additional rare anomalies. TGV may present as sudden unexplained infant death (SUID) for forensic autopsy if variant features prevent development of cyanosis. Cardiac pathology consultation is helpful in clarifying these features.     

Risk and Protective Factors for Peer Victimization in Adolescents with ADHD

ABSTRACT

Youth with ADHD are more at-risk for peer victimization than their typically developing peers, and may not be benefiting from current interventions. Thus, we sought to examine risk (i.e., anxiety, depression, and forms of aggression) and protective (i.e., social skills and social acceptance) factors for peer victimization in this group. Participants were 123 young adolescents diagnosed with ADHD, who were attending grades six through eight. We found that relational aggression (i.e., excluding others from activities) and anxiety symptoms were among the strongest risk factors for victimization. Anxiety symptoms were associated with victimization over and above depressive symptoms. Social acceptance buffered risk conferred by the risk factors. Future work is needed to investigate the degree to which the relations among internalizing symptoms and victimization differ in youth with ADHD relative to typically developing youth, and assess causality of the relations.     

Human Cutaneous Myiasis by the Australian Sheep Blowfly,Lucilia cuprina (Diptera: Calliphoridae), in Oklahoma

This case report describes an incident of myiasis in Oklahoma City, Oklahoma. Paramedics treated a 53‐year‐old man in the field when he suffered cardiac arrest. He was intubated by the paramedics and transported to an emergency room, where he received two stents and a balloon pump. He was found to have a GCS of three and remained in the hospital for 7 days before passing away. After his death, the breathing tube was removed, revealing the presence of several maggots. On closer inspection, the dipteran larvae were found in both the oral and nasal cavities. Four of these larvae were reared to adulthood and identified as Lucilia cuprina (Weidemann) (Diptera: Calliphoridae), commonly known as the Australian sheep blowfly, by the Biology Department of the University of Oklahoma. Based on the fly's life cycle and rate of development, the infestation is suspected to be hospital acquired.