Fatal intoxication due to tramadol alone: case report and review of the literature

Poisoning may also lead to both coma and multiple organ failure, also in youngsters without a known major medical history. As not all toxic agents are routinely screened when a poisoning is suspected, it is useful to consider less frequently encountered poisons in certain cases. We describe the occurrence of asystole and multiple organ failure which occurred in a young man after a suspected tramadol overdose. The tramadol concentration on admission in the ICU was indeed 8 microg/ml (mg/l), far above the therapeutic range. Subsequently, the patient developed severe acute liver failure, finally leading to death. Post-mortem toxicology did not reveal any other poison responsible for this unfavourable course as only very high serum and tissue tramadol and desmethyltramadol concentrations were found. Only a few fatal poisonings attributable to tramadol alone, as observed in our case, have been reported. An overview of these cases is presented.     

The First Member State Rebellion? The European Court of Justice and the Negotiations of the ‘Luxembourg Protocol’ of 1971

This article delves into the history of the negotiations of the ‘Luxembourg protocol’ of 1971, which conferred jurisdiction upon the European Court of Justice (ECJ) for the interpretation of the 1968 Brussels convention. The protocol provided a preliminary ruling procedure that had undergone restrictive modifications in comparison with the European Economic Community (EEC) treaty's original (Article 177). Some have, therefore, interpreted the outcome of the negotiations as a sign that the mechanism was being criticised in national administrations. This article will, for the first time, bring to the surface archival evidence to explain why the protocol contained an altered version of Article 177 EEC. Furthermore, it will reveal that the governments' experts' intention to limit the procedure in the protocol caused serious concern inside the ECJ, of which some members consequently repeatedly urged national decision‐makers to opt for formulas identical with Article 177 EEC.     

Media Discourse and the Quality of Democracy in Serbia after Milošević

Abstract

The article examines the quality of democracy in Serbia via the quantitative analysis of media discourse. It reveals robust competition, participation and accountability in the first decade after regime change, followed by major recent decline, thus showing that expert assessments from influential indices of democracy underrated democratic quality in the former period and overrated it later. Also revealed are the advantages of complementing expert assessments with those based on media discourse. The content analysis examined 1,921 coded items from print and electronic media coverage of major political conflicts at strategic points in the country’s democratisation.     

Dialogue, distance and difference: Feminism in contemporary japan

In this article, I examine the ways in which women’s groups in Japan have attempted to deal with issues of difference prompted by the co-existence of residents of different ethnicities in contemporary Japan, and the new issues raised by labour migration in the context of globalization of economies and labour markets. Japan’s place in contemporary East Asia can be clarified by using the term colonial modernity, to refer to Japan’s early 20th-century history; and the term postcoloniality to refer to the legacy of the colonial project in the culture of the metropolitan society. In representations of Japan’s contemporary “Others,” notions of gendered difference interact with representations of ethnic and cultural difference. Contemporary attempts to deal with these issues will be placed in the context of several decades of feminist activism in Japan.     

Budgetary Politics and Veto Players

In this article we examine whether and how the policy‐oriented coalition building and the gridlock model of legislative choice explain changes in the allocation of German budgetary items between 1961 and 1994. The policy‐oriented coalition‐building approach suggests that only policy‐connected budgetary actors can make changes in the budgetary composition, while the location of the status quo is essential for budgetary modifications according to the gridlock model. We also draw the attention to the identification of the set of relevant budgetary veto players and their preferences by distinguishing between models of the government, the political parties of the Bundestag, and the two of them. We test the predictive power of these approaches and conceptions in a competitive manner and control for macroeconomic and other political factors that might influence changes in the budgetary allocation. Our findings show that the gridlock model better explains budgetary changes, and that the government is responsible for decreasing, but the political parties of the Bundestag majority are decisive for increasing the size of budgetary items. We conclude that identifying the relevant veto players and using these more sophisticated approaches on budgetary decision making provide significant insights into the political reasons for changing the allocation of the German budget.