Sickle cell lung disease and sudden death: a retrospective/prospective study of 21 autopsy cases and literature review

Sudden death in the setting of sickle cell lung disease (SCLD), is periodically seen in the practice of medical examiners. The goal of the present study was to identify the most common pathologic findings of SCLD associated with sudden or unexpected death. A retrospective/prospective review of 21 autopsy cases from sickle cell patients between 1990 and 2004 was performed. Review of medical records, autopsy reports, and H&E-stained slides of lung tissue was performed. Oil-Red-O and elastic staining of lung tissue were evaluated. All cases were screened for both acute and chronic forms of SCLD. Patients admitted for sickle cell pain crisis ranged in age from 8 months to 65 years. Fifteen out of 21 cases (71.4%) showed significant pulmonary pathology. The most frequent lung findings included pulmonary edema (47.6%), pulmonary thromboembolism (38.1%), fat emboli (33.3%), pulmonary hypertension, grades I-IV (33.3%), and microvascular occlusive thrombi (28.5%). Our study demonstrates higher-than-expected percentages of acute and chronic sickle cell-related lung injury such as fat embolism (33.3%) and pulmonary hypertension (33.3%), with right ventricular hypertrophy (33.3%). Therefore, we propose a simple and high-yield autopsy algorithm of ancillary procedures that should be applied on all known and suspected autopsy cases of sickle cell disease.     

Fatalities temporally associated with the ingestion of ibogaine

Ibogaine is a naturally occurring psychoactive plant alkaloid that is used globally in medical and nonmedical settings for opioid detoxification and other substance use indications. All available autopsy, toxicological, and investigative reports were systematically reviewed for the consecutive series of all known fatalities outside of West Central Africa temporally related to the use of ibogaine from 1990 through 2008. Nineteen individuals (15 men, four women between 24 and 54 years old) are known to have died within 1.5-76 h of taking ibogaine. The clinical and postmortem evidence did not suggest a characteristic syndrome of neurotoxicity. Advanced preexisting medical comorbidities, which were mainly cardiovascular, and/or one or more commonly abused substances explained or contributed to the death in 12 of the 14 cases for which adequate postmortem data were available. Other apparent risk factors include seizures associated with withdrawal from alcohol and benzodiazepines and the uninformed use of ethnopharmacological forms of ibogaine.     

The integration hypothesis: How the European Union shapes economic voting

Whereas economic perceptions influence the national vote in Western European countries, globalization, or international openness, conditions the influence of economic perceptions on that national vote. But how do attitudes toward the EU itself influence the economic vote? After establishing the presence of a national economic vote in Southern Europe (Spain, Italy, Greece and Portugal) we test the hypothesis that heightened perception of European Union economic responsibility reduces the magnitude of the national economic vote coefficient. These tests are carried out on current (2009) survey data, via logistic regression analysis of fully specified voting behavior models, estimated country-by-country and in a data pool. Clearly, the national economic vote diminishes, to the extent the EU is held responsible for the economy.     

Economic crisis and elections: The European periphery

This paper introduces the articles in the symposium which address the issue of democratic accountability and economic voting in polities on the European periphery. The economic crisis that hit the world economy in 2008 has severely challenged the capacity of governments to steer the national economy and has had a strong impact on their electoral support. The papers discuss whether economic voting and democratic accountability are increasing or, on the other hand, they could be depressed by globalisation and by shifts of ruling competence from the national to the supranational European arena.     

A Multidimensional Approach to Ascertaining Individual Differentiation and Consistency in Serial Sexual Assault: Is It Time to Redefine and Refine?

Whilst investigative use of behavioural evidence to help link and solve serial offences has long been in use, the empirical and theoretical grounds for whether and how to use this evidence effectively have begun to emerge only in recent decades. The present study empirically tested (a) the potential for effectively differentiating between rape offence crime scenes using quantitative and qualitative distinctions within the behavioural dimensions of control, violence, and sexual activity, and (b) the extent to which redefining behavioural consistency more broadly to include dynamic trajectories of behavioural change may be more effective than limiting this definition to behavioural stability. Results confirmed that sexual offences can be successfully differentiated based on the specific degree and subtype of these behavioural dimensions present in each crime scene. The analysis of consistency and behavioural trajectories showed that whilst none of the offenders exhibited complete consistency across behavioural dimensions, a subsample of offenders remained fully consistent in at least one. Furthermore, of those who were not consistent, the vast majority followed an identifiable trajectory of change. Findings are discussed in the context of psychological theories of behavioural consistency as well as practical aspects of advancing the utility of behavioural linkage.     

Social Media as a Leverage Strategy for Open Government: An Exploratory Study

Social media are regarded to be a cornerstone for addressing the open government challenge that public administration faces. However, scientific knowledge about how social media can leverage open government is limited. Therefore, this study applies a mixed-methods research proceeding to develop a conceptual framework for the strategic use of social media concerning open government initiatives. The study concludes that social media applications can be strategically applied to foster open government and to improve citizen–government interaction. From the findings, strategic recommendations for open government-related social media adoption are developed and practical advice for responsible public managers is given.     

How Reliable are Parenchymal Tissues for the Evaluation of Carbon Monoxide Poisoning? A Pilot Study

Dealing with burnt bodies, the forensic pathologist must first of all answer the question whether the victim was alive at the moment of the fire. This study aims at clarifying whether some human solid tissues may be reliably used for the forensic diagnosis of Co poisoning on burnt bodies providing no collectable blood during the autopsy. From 34 selected cases, both cardiac blood and parenchymal samples were collected to perform CO‐oxymeter, spectrophotometry, and gas chromatography tests: blood CO estimations (blood COHb% and blood[CO]) and parenchymal[CO] values have been compared with special focus on R values. The solid tissues having the best correlations with blood CO amount turned out to be the lung (R 0.84), the liver (R 0.83), the kidney (R 0.79), and the spleen (R 0.92).     

Metis,migrants, and the autonomy of migration

This paper interweaves an ancient conceptualization of movement and mobility with the paradigmatic case of early twentieth-century Chinese migration to the USA in order to explore migrants’ ability to both re-interpret institutional control of movement and generate identities that garner institutional and community acceptance. By not ‘settling’ migrants into the discourse of (undocumented) immigrants, the paper (i) develops a framework for the study of migrants–state interactions that goes beyond claims to citizenship and demands for rights and (ii) explores practices and means through which migrants gain access to restricted territories and maintain presence in otherwise unwelcoming communities. The paper argues that such practices explicate the autonomy of migration: a phenomenon that is constitutive to processes of political transformation and is critical to the study of state sovereignty, citizenship rights, and political agency.