Acute myoglobinuria as a fatal complication of heroin addiction

A fatal case of myoglobinuria complicating heroin addiction is described. Clinically the patient had no overt symptoms of rhabdomyolysis. Pathologists should be alerted to this rare complication in heroin addicts who die of no apparent cause. The antimyoglobin immunoperoxidase technique is useful in confirming the diagnosis.     

The view from below: Local government and Putin's reforms

Local government reforms in contemporary Russia are placed in the broader contexts of political reform under Putin and the historical relationship between local administration and the state. Reforms of local government thus help illuminate the architecture of contemporary state building in Russia and the degree to which contemporary Russia perpetuates political traditions. This study reviews the antecedent action in local government prior to the Putin era. It then examines the Kozak Commission and the new law on local government, assessing the strengths and weaknesses of these reforms. Finally, this study examines the challenges of implementing the reforms and what these challenges tell us about devolution and centralisation under Putin.     

A mesolevel comparative approach to maxi and mini strategies of public enterprise reform

Large-scale privatization is an unfamiliar area of public policy. The practice and study of property reforms and privatization needs to include mesolvel phenomena such as laws, regulations, institutions and standard operating procedures. There has been little comparative analysis of privatization programs around the world. The author argues that analysts should compare the most immediately relevant institutional environment of the enterprise. Conceptually, this mesolevel system is situated between the firm and the macroeconomy. This system of action is especially fruitful for cross-national comparisons of privatization programs because it is at this level that privatization strategies are designed. The problem for Eastern Europe and for less-developed countries is lack of experience with the relatively light economic regulation that characterizes industrial countries. Government leaders must also decide how much effort to devote to privatization of state-owned enterprises and how much to fostering private sector investment in new firms. Ernest J. Wilson, III is affiliated with the National Security Council, Washington, D.C.     

Proficiency testing (external quality assessment) of drug detection in oral fluid

Eighteen external quality assessment (proficiency testing) samples were prepared from client specimens collected with the Intercept^® oral fluid collection device and by spiking drug-free oral fluid. Samples were circulated in pairs at quarterly intervals to 13 UK and USA based laboratories for analysis by a panel of OraSure micro-plate Intercept^® enzyme immunoassay kits and hyphenated mass spectrophotometric techniques. During the survey, there was a single case of non-specificity in a false report for methadone. The major errors were of lack of sensitivity relative to the concentration thresholds specified for the immunoassays. The sensitivity for overall ‘present’/‘not found’ reports calculated as true positives/(true positives + false negatives) were for the amfetamine specific assay 50%, methyl-amfetamines 93%, barbiturates 64%, cannabinoids 73%, cocaine and metabolites 100%, benzodiazepines 69%, methadone 95%, opiates 79% (opiates excluding oxycodone 93%), phencyclidine 93% and human gamma-globulin 97%. A small number of the sensitivity errors were attributable to errors in chromatographic confirmation techniques.     

R&D spinoffs: Serendipity vs. a managed process

This paper describes some of the spinoff benefits that can result from R&D projects, and categorizes them in terms of the dimensions of market and technical newness. These dimensions are discussed with reference to two types of spinoffs: 1) alternative market applications, when the results of an R&D project are subsequently applied to a market or use that differs from the originally intended application, and 2) second-generation technologies, when the technology that was the subject of an R&D project is significantly altered or enhanced in unanticipated ways through subsequent R&D. Examples from the Department of Energy's Energy-Related Inventions Program are integrated into the results of literature review to illustrate key concepts, including core technologies, degrees of market and technology newness, technology robustness, and the nature of connections linking spinoffs to prior R&D investments. The paper concludes by discussing spinoffs as a managerial strategy.     

Last rights. In sickness and in health, more people are taking life's biggest decision away from doctors and into their own hands

When dying is all that awaits them, more and more people are choosing certain death now rather than uncertain life on medical support systems. But the decision seldom comes easy, as a Newsweek reporter discovers during three weeks with the doctors, nurses, patients and families in an intensive-care ward. A best-selling guide to suicide fires debate over when it is right to let life go--and who should make that choice when the patient no longer can.