Background: Fibromyalgia syndrome is a chronic multifaceted disease characterized by widespread pain, muscle stiffness, fatigue, unrefreshing sleep and cognitive disorders. To date, no medication has been shown to significantly improve pain, associated symptoms and Quality of Life in fibromyalgic patients. Methods: In this retrospective observational study, we analyzed data regarding 407 patients with diagnosis of fibromyalgia syndrome who between 2013 and 2016 have been prescribed orally ultramicronized palmitoylethanolamide tablets (Normast® Epitech Group SpA, Saccolongo, Italy) regardless of the concomitant pharmacological therapy (add-on treatment). Results: Regarding efficacy, in the 359 analyzed patients, the change over time in Visual Analogue Scale pain score was statistically significant, ranging from 75.84 (±15.15) to 52.49 (±16.73) (p<0.001). Regarding quality of life, the change over time in Fibromyalgia Impact Questionnaire score was statistically significant, ranging from 68.4 (±14.1) to 49.1 (±19.6) (p<0.001). In the treated population, only 36 patients (13,7%) reported Adverse Events predominantly of gastrointestinal type (diarrhea, dyspepsia, bloating, constipation, vomiting). Globally, 151 patients (57,63%) left the treatment due to inefficacy. Conclusion: The results of ultramicronized palmitoylethanolamide treatment in this retrospective analysis represent an important step for the development of a new and well-tolerated therapy for fibromyalgia syndrome, mostly suitable for these patients who need long-term treatments. Further methodologically stronger studies will be necessary to validate our observation.

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The diatom test is widely used by forensic pathologists as proof of drowning, notwithstanding some criticisms mainly concerning the occurrence of false-positive results (presence of diatoms in the tissues of subjects who died from causes other than drowning). The aim of the present study was to verify the claimed inaccuracy of the method caused by an excessive rate of false-positives related to inadvertent exposure to diatoms of the general population. The study was carried out to investigate the presence of diatoms in the tissues (lungs and sternum) of subjects who died from causes other than drowning. Two groups of cadavers that underwent an autopsy at the Institute of Forensic Medicine of the University of Verona were included in the study. Group A comprised 45 individuals who died from causes other than drowning, whereas Group B comprised 20 bodies which had been recovered from water. The extraction of the diatoms was performed by incubation of samples in nitric acid for 48 hours at 60°C. The analysis of the samples from Group A showed the absence of diatoms in both lung and sternum samples. In Group B all lung samples showed the presence of diatoms, whereas only six sternum samples were shown to contain diatoms. The difference between Groups A and B was statistically highly significant. The absence of diatoms in the samples collected from Group A falsified the hypothesis that false-positive results from the diatom test may occur due to diatoms entering living bodies through the respiratory and/or digestive tracts via air, water or food, supporting the validity of the diatom test as proof of drowning.