Sevoflurane concentrations in blood, brain, and lung after sevoflurane-induced death

Sevoflurane concentrations in blood, brain, and lung were measured in an individual apparently dying from sevoflurane inhalation. Sevoflurane is a volatile nonflammable fluorinated methyl isopropyl ether inhaled anesthetic, chemically related to desflurane and isoflurane. The incidence of abuse of sevoflurane is lower than that of other drugs of abuse possibly due to its inaccessibility to the general public and less pleasurable and addicting effects. The dead subject was an anesthetist found prone in bed holding an empty bottle of sevoflurane (Ultane). Serum, urine, and liver were screened for numerous drugs and metabolites using enzyme immunoassays and gas chromatography-mass spectrometry. Analysis did not reveal presence of any drug, including ethanol, other than sevoflurane. Sevoflurane was determined by headspace gas chromatography and revealed concentrations of 15 microg/mL in blood and 130 mg/kg in brain and lung. Autopsy revealed pulmonary edema and frothing in the lung, pathological findings associated with death by sevoflurane or hypoxia. The cause of death was ruled as sevoflurane toxicity and the manner of death as accident.     

Going Underground: the political economy of the ‘left turn’ in South America

This article argues that South America’s ‘revolutionary’ left turn can be best explained by its assertion of state property over natural resource extraction. The recent history of the leftist movements in Venezuela, Bolivia and Ecuador relates to the failures of the neoliberal reforms applied in the region decades before, hence the dismantling of core orthodox policies has been critical for them once in power. This has been possible through the expansion of state action in the economy, but mainly through the governance of hydrocarbon extraction and the control of subsoil rents. Resource extraction has been central to the political economy of Andean left-wing revolutionaries, responsible for many of their successes but also their impending challenges. This rearticulation of underground governance is linked to global transformations that give prominence to emerging economies and reinforces these countries’ position in the world economy as providers of primary commodities.     

Liberal reformism and democratic citizenship

Although not its sole dimension, the idea of equality of rights and resources is one of the basic tenets of liberalism. Liberal equality introduces a reformist thrift in government by determining that government action should aim to create opportunities for the realization of the civil condition. This is a legal and political condition, thereby citizens enjoy a statute of equal rights. Hence, the liberal idea of reformism proceeds by removing the obstacles to the realization of the civil condition and by providing the legal and the material resources for the exercise of citizenship rights. This interpretation is not self‐evident, especially in times when neoliberalism seems to represent the entire liberal tradition. I shall argue that liberal reformism makes up a vital foundation for democracy. Even more, the own survival of democracy in our times depends on its rooting in liberalism.     

Empirical analysis of civil litigation determinants: The Case of Spain

This paper analyses the determinants of civil litigation in Spain drawing on the Law and Economics approach. Using a panel data for 50 Spanish provinces, this study makes a first exploratory approach to empirically investigate the effect of the 2000 Civil Procedural Law Reform on the demand for civil justice over the period 1995–2010, controlling for other determinants of litigation such as the economic growth, the expansion of the Bar, the number of judges, and other socio-demographic characteristics. According to the results, the growing number of civil cases filed in Spain in recent years seems to be a consequence of the combination of the law reform, relevant socio-economic factors, and most importantly the economic recession.     

An Exploratory Framework for Community-Led Research to Address Intimate Partner Violence: a Case Study of the Survivor-Centered Advocacy Project

This case study discusses the Survivor-Centered Advocacy (SCA) Project, a community-based participatory research (CBPR) project that convened anti-violence advocates from culturally specific communities to design and implement research. The project used a unique approach to build grassroots research capacity and center survivors of intimate partner violence from historically marginalized communities. This approach coalesced into the creation of an exploratory Community-Led Research (CLR) framework that incorporated trauma-informed, research justice and language justice principles. The CLR framework responded to community members’ desire to lead, rather than simply participate in, the research process. As a result, five studies were designed and executed by practitioners turned community-based researchers, most of whom had never before engaged in research, except as subjects. The CLR framework integrated the skills and experiences of community-based and external researchers, and led to high levels of engagement, rich data, more equitable research processes and innovative research projects.     

Detection and confirmation of fentanyls in high clay-content soil by electron ionization gas chromatography-mass spectrometry

Detection of illicit drugs in the environment, particularly in soils, often suggests the present or past location of a clandestine production center for these substances. Thus, development of efficient methods for the analysis and detection of these chemicals is of paramount importance in the field of chemical forensics. In this work, a method involving the extraction and retrospective confirmation of fentanyl, acetylfentanyl, thiofentanyl, and acetylthiofentanyl using trichloroethoxycarbonylation chemistry in a high clay-content soil is presented. The soil was spiked separately with each fentanyl at two concentrations (1 and 10 μg/g) and their extraction accomplished using ethyl acetate and aqueous NH₄OH (pH ~ 11.4) with extraction recoveries ranging from ~56% to 82% for the high-concentration (10 μg/g) samples while ranging from ~68% to 83% for the low-concentration (1 μg/g) samples. After their extraction, residues containing each fentanyl were reacted with 2,2,2-trichloroethoxycarbonyl chloride (Troc-Cl) to generate two unique and predictable products from each opioid that can be used to retrospectively confirm their presence and identity using EI-GC-MS. The method's limit of detection (MDL/LOD) for Troc-norfentanyl and Troc-noracetylfentanyl were estimated to be 29.4 and 31.8 ng/mL in the organic extracts. In addition, the method's limit of quantitation for Troc-norfentanyl and Troc-noracetylfentanyl were determined to be 88.2 and 95.5 ng/mL, respectively. Collectively, the results presented herein strengthen the use of chloroformate chemistry as an additional chemical tool to confirm the presence of these highly toxic and lethal substances in the environment.     

From partisan to pluralist ideology: the changing practices of democracy through Spain’s 20th-century constitutional moments

This article explores the practices of democracy in Spain through the lens of its 20th-century constitutional moments, namely, those around the 1931 and the 1978 constitutions, with the aim of elucidating its changing ideological significance. Whereas in 1931, supporting democracy had a strongly partisan meaning, as every endorsement of the democratic ideal entailed a conflicting understanding of the Republic’s democratic character, in 1978 it gave rise to an integrative form of pluralism. Even if the former has left a deep imprint on Spanish politics, anticipating a kind of seemingly irreconcilable opposition between left and right, the latter has proved instrumental in the consolidation of the new democratic regime. After the institutional distortion of democracy during the four-decade dictatorship’s ‘organic democracy’, since 1977 the ideal of democracy was thoroughly recast into a pluralist ideology. Unlike views describing it as a consensual regime, the article argues that the politics of consensus tested since the 1977 constitutional debates paved the way for the accommodation of democratic pluralism; furthermore, the culture of pacts it contributed to set up has continued to inspire a new form of adversarial, parliamentary politics well beyond the transition years.