Metal dust deposition in a shotgun wound associated with barrel modification

Contact-range gunshot wounds commonly demonstrate deposition of black soot in and around the wound. Deposition of other visible pigments originating from the firearm has not been specifically described. In the current case, an adult male was found dead adjacent to a shotgun fixed in a vice grip with a modified, shortened barrel. A handheld, powered, metal grinding wheel was nearby. Autopsy revealed an intraoral gunshot wound, including soot deposition in and around the mouth and within the wound track. In addition, there was a peculiar, gray, lustrous film on the lips, gingiva, and anterior teeth. The material was concentrated around the most severe areas of injury in the anterior mouth and easily rubbed off with a cotton swab. It was not visualized in the rest of the mouth and not present in the larynx, or the esophagus. Overall, our opinion is that this unique, gray, lustrous film represents deposition of fine metallic dust that accumulated in the barrel of the shotgun during its modification with the grinding wheel. This type of unique pigment deposition should be recognized by forensic pathologists as possibly being related to the discharge of a firearm with a recently modified barrel or other cause for fine metallic dust accumulation within the barrel. Depending on the circumstances of the case, collection of samples of such metal dust deposits could be indicated for subsequent analysis.     

Novel Approaches to Optimization of Levodopa Therapy for Parkinson’s Disease

Levodopa (LD) is the most effective medication to treat Parkinson’s disease (PD). However, motor fluctuations and drug-induced dyskinesia compromise the long-term success of levodopa therapy in PD. These response complications are due, at least in part, to fluctuating LD plasma levels (as a result of erratic gastric emptying, variable jejunal absorption, and most importantly, the short half-life of LD) with standard levodopa formulations. Keeping levodopa concentrations as constant as possible is the target for improving the pharmacokinetics and developing new ways of LD administration. In this article, we review novel oral and non-oral LD formulations including the ones that have successfully completed phase 3 clinical trials and have come to market and ones that are still in earlier phases of clinical development.     

The Mechanisms of Mindfulness in the Treatment of Mental Illness and Addiction

Consistent with its growing popularity amongst the general public and medical community, throughout recent decades there have been increasing attempts to understand the mechanisms that underlie therapeutic improvement in individuals receiving mindfulness training. The current paper draws upon findings from various remits of scientific enquiry and summarises key evidence-based mechanisms of mindfulness that have been proposed in the academic literature to date. Empirical findings indicate that mindfulness targets biological, psychological, social, and spiritual psychopathology determinants. Furthermore, the mechanistic pathways exploited by mindfulness are likely to vary according to factors such as (i) the type of mindfulness-based intervention that is administered (e.g., first- or second-generation mindfulness-based interventions), (ii) the specific clinical disorder that is being targeted, (iii) the educational, social, and spiritual history of the participant, and (iv) the extent to which the mindfulness instructor truly embodies the principles of mindful living. It is hoped that the mechanisms of mindfulness discussed in this paper will contribute to the formulation of a more complete picture that can be tested and expanded upon during future scientific enquiry.