A fatal doxepin poisoning associated with a defective CYP2D6 genotype

It has been suggested that the polymorphism of the CYP2D6 gene can contribute to occurrence of fatal adverse effects. We therefore investigated postmortem toxicology cases of fatal drug poisonings related to CYP2D6 substrates, with the manner of death denoted as accidental or undetermined. CYP2D6 genotypes were determined in 11 consecutive cases with samples available for DNA analysis. A case of fatal doxepin poisoning with an undetermined manner of death was found to coincide with a completely nonfunctional CYP2D6 genotype (*3/*4), indicating a total absence of CYP2D6 enzyme and suggesting a poor metabolizer phenotype. The doxepin concentration was 2.4 mg/L, the concentration of nordoxepin 2.9 mg/L, and the doxepin/nordoxepin ratio 0.83, the lowest found among the 35 nordoxepin-positive postmortem cases analyzed during the same year. No alcohols or other drugs were detected in the case. The CYP2C19 genotype was determined as that of an extensive metabolizer. The high N-desmethylmetabolite concentration is not consistent with acute intoxication. It is therefore probable that the defective genotype has contributed to the death, possibly involving repeated high dosage of doxepin. Our case strongly emphasizes that a pharmacogenetic analysis in postmortem forensic setting may reveal new insight to the cause or manner of death.     

Strategic Candidate Entry and Congressional Elections in the Era of Fox News

Elections are designed to give voters the ability to hold elected officials accountable for their actions. For this to work, voters must be presented with credible alternatives from which to choose. In the United States, as in other weak-party systems, the decision to challenge an incumbent representative rests with individual, strategic-minded politicians who carefully weigh the available information. We investigate the role that one source of information—partisan media—plays in shaping electoral competition. We hypothesize that the haphazard expansion of the conservative Fox News Channel in the decade after its 1996 launch influenced congressional elections by affecting the decision calculus of high-quality potential candidates. Using congressional district-level data on the local availability of Fox News, we find that Fox News altered Republican potential candidates' perceptions about the vulnerability of Democratic incumbents, thereby changing their entry patterns.     

Favoritism and cooperation

Public Choice - In a series of laboratory experiments, two types of players were created randomly. Participants of one type were selected for a group based on performance on a task, whereas...     

Strafrechtliche Verantwortlichkeit von Sozialversicherungsträgern

Da Sozialversicherungstr?ger als K?rperschaften des ?ffentlichen Rechts neben der Hoheitsverwaltung eine breite Palette privatwirtschaftlicher T?tigkeit entfalten, wie etwa im Rahmen der Errichtung, des Erwerbs und der Führung von Krankenanstalten, Ambulatorien, Unfallkrankenh?usern, Heil- und Kuranstalten u?, er?ffnet sich insb im Bereich der auf Behandlungs- und Organisationsfehler des medizinischen Personals zurückzuführenden fahrl?ssigen K?rperverletzungs- und T?tungsdelikte ein nicht zu untersch?tzendes Anwendungsfeld für die strafrechtliche Verantwortlichkeit des Sozialversicherungstr?gers nach dem VbVG als Betreiber der betroffenen Gesundheitseinrichtung.     

A fatal intoxication by chloroprene

Objective Chloroprene, 2-chloro-1,3 butadiene, is a volatile synthetic liquid. The chloroprene monomer is extremely reactive and is used for the production of latexes and synthetic rubber such as Neoprene. Up to now an acute lethal human exposure has been described only once in the literature [19]. The intoxication is associated with nervous system depression, pulmonary edema, narcosis, and respiratory arrest. Case report A 29-year-old chemistry company worker was found unconscious in an empty vessel (depth: 3m) used for chloroprene. The man was dressed in shoes, trousers, a helmet and a respiratory mask. The upper part of the body was unclothed. In spite of reanimation, the man died three hours later in a hospital. Material and methods: All analyses were performed by headspace gas chromatography (HS/GC/FID). In addition, brain, muscle and myocardial muscle were analysed by headspace GC-MS. Results and discussion Autopsy findings: The cause of death could not be determined as the macromorphological findings were unspecific. Toxicology findings The calibration curve of chloroprene in serum shows linearity from 1.0 to 200 μg/ml (r(2)=0.9999) using benzene as internal standard. The LOD is 0.28 μg/ml, the LLOQ is 0.99 μg/ml. Tissues and body fluids were stored at -20 °C till the analysis. Chloroprene was quantified after addition of benzene as the internal standard. It was found in nearly all tissues and body fluids except in the urine and lung. The highest concentrations were detected in the kidney, liver, myocardial muscle and especially in the brain. Furthermore, hexanal was found in all samples except in the urine. The amount of hexanal in some specimens is high, especially in the lung, bile, gastric content and myocardial muscle. Conclusion We assume that a significant amount of chloroprene was not only inhaled but also absorbed through the skin because the man wore a respiratory mask. Presumably the accident would not have happened if the works safety protocols had been followed. The reason why high concentrations of hexanal were found in the tissues could not be clarified.     

Data processing by police and criminal justice authorities in Europe – The influence of the Commission's draft on the national police laws and laws of criminal procedure

The proposal for a fundamental reform of the European data protection law, published by the EU Commission on 25 January 2012 is composed of two elements. Apart from a General Data Protection Regulation, the Commission proposes a second regulatory instrument, namely a Directive with regard to data processing by police and criminal justice authorities that shall supersede the Council Framework Decision 2008/977/JHA. This paper seeks to analyse the draft Directive in the context of the entire reform approach and scrutinizes a number of specific issues in regard to the scope, the requirements of data processing, notification duties and data transfer to third countries.     

Assessing Callous-Unemotional traits across different groups of youths: further cross-cultural validation of the Inventory of Callous-Unemotional traits

The Inventory of Callous-Unemotional (CU) Traits (ICU) is a self-report questionnaire which was developed to measure the affective features of psychopathy in children and adolescents. Previous studies reported both support and difficulties with this promising new measure. The present study investigated the psychometric and discriminating qualities of the Dutch questionnaire across different groups by examining its structure, distribution and correlates. The ICU was administered to young clinical offenders (detained, N=127), healthy controls (community, N=172), non-clinical offenders (not detained, N=42) and an externalizing non-offender group (under treatment for behavioral problems, N=42). The age range for all groups was 13-20years. Since confirmatory factor analysis of models from earlier research did not yield an acceptable fit, exploratory factor analysis was conducted. Five factors were extracted: Lack of Conscience, Uncaring, Unemotional, Callousness and Lack of Empathy. The results indicated moderate to good test-retest stability and adequate internal consistency. CU traits correlated well with measures of conduct problems and aggression, indicating a good criterion and convergent validity. Results indicate weak associations with expert (Psychopathy Checklist: Youth Version, PCL:YV) and informant (Antisocial Process Screening Device, APSD) measures of psychopathic traits. Although groups could be differentiated on a statistical basis, no meaningful distinction based on CU traits alone was possible. Results of this study cast doubt on the validity of the current ICU. Suggestions are made for improvement.     

Suicide with a manipulated hand grenade

Explosion injuries in civilians are rare. An uncommon case of suicide with a manipulated hand grenade is presented. The findings at the scene and on the body (i.a. massive soot blackening of the skin, singeing, size and number of splinters) gave reason to doubt the use of trinitrotoluene (TNT), the usual explosive charge in hand grenades. Further investigations showed that parts of several hand grenades and black powder from standard fire-crackers commercially available without legal restriction had been used as propelling charge. The victim, who was in a sitting position, held the hand grenade in the left hand and triggered it with the right. He bled to death due to a fracture of the right femur and lacerations of the liver. The chronological course and total circumstances of the case suggested suicide in a strongly intoxicated condition (BAC 2.5 per mille). In the flat, a larger number of unlicensed weapons and weapon parts were found.