Sudden unexpected death due to a previously undiagnosed plasma cell dyscrasia

The plasma cell dyscrasias are a diverse group of disorders characterized by the production of a clonal paraprotein. Sudden death is a recognized complication of the plasma cell dyscrasias, most commonly in individuals with cardiac involvement by amyloidosis. However, the current forensic literature has no reported cases in which sudden death resulted from complications of a plasma cell dyscrasia that was first diagnosed by postmortem histologic examination. We present the case of a woman whose sudden and unexpected death resulted from a seizure. Postmortem examination revealed no evidence of trauma or a grossly identifiable natural disease process that would have accounted for her death. However, microscopic and immunohistologic studies revealed a previously undiagnosed plasma cell dyscrasia, the clonality of which was determined by immunohistochemical studies for immunoglobulin light chains, that was not associated with amyloid deposition. This case elucidates a previously unrecognized cause of sudden unexpected death and illustrates the importance of microscopic studies in selected cases examined in medical examiner/coroner offices.     

Analysis of the First- and Second-Generation Raving Dragon Novelty Bath Salts Containing Methylone and Pentedrone

In recent years, a large number of designer drugs sold as “Bath Salts” have appeared on the market. In July of 2011, Raving Dragon Novelty Bath Salts was obtained over the Internet. This product became unavailable in October of that year coinciding with the DEA issuing a temporarily schedule of mephedrone, methylone, and MDPV. Four months later in February of 2012, a new product was released from the same company under the new name Raving Dragon Voodoo Dust. The contents of both products were identified using spectroscopy methods: nuclear magnetic resonance, infrared, UV–visible, tandem mass spectrometry, and high-resolution time-of-flight mass spectrometry. It was determined that Raving Dragon Novelty Bath Salts contained methylone. The replacement product Raving Dragon Voodoo Dust contained the unscheduled drug pentedrone. The Raving Dragon brand of products illustrates the rapid change of ingredients in these products to circumvent laws restricting availability, distribution, and use.     

Genetic Testing and the Future of Disability Insurance: Ethics, Law & Policy

Predictive genetic testing poses fundamental questions for disability insurance, a crucial resource funding basic needs when disability prevents income from work. This article, from an NIH-funded project, presents the first indepth analysis of the challenging issues: Should disability insurers be permitted to consider genetics and exclude predicted disability? May disabilities with a recognized genetic basis be excluded from coverage as pre-existing conditions? How can we assure that private insurers writing individual and group policies, employers, and public insurers deal competently and appropriately with genetic testing?     

CT‐Guided,Minimally Invasive,Postmortem Needle Biopsy Using the B‐Rob II Needle‐Positioning Robot

CT‐guided, minimally invasive needle biopsy techniques can be used to retrieve tissue or body fluid samples for histologic tissue diagnoses in forensic investigations. The purpose of this study was an evaluation of CT‐guided needle‐positioning robot B‐Rob II. To operate under CT guidance, we adopted the B‐Rob II robotic needle placement system and its workflow. The accuracy and speed of the procedure were tested on a gelatin phantom in a series of 21 biopsies. We achieved an average needle placement accuracy of 1.8 mm (±1.1 mm) using robotic assistance. The procedure required an average of 2 min 21 s. The needle placement accuracy for minimally invasive needle biopsies using the B‐Rob II biopsy robot is sufficiently accurate and fast for forensic postmortem examinations of focal organ changes. Further tests will be performed to test the feasibility of the robot for performing biopsies of focal organ changes in human bodies.     

Switzerland and the EU: the puzzling effects of Europeanisation without institutionalisation

Switzerland is not a member of the EU and in 1992 refused to join the European Economic Area (EEA) treaty in a popular vote. A conservative majority preferred to keep utmost national autonomy, and consequently, relations between the EU and Switzerland are regulated by a series of bilateral treaties. This process of Europeanisation without institutionalisation has led to profound changes of Swiss politics over the last two decades. While many effects of economic liberalisation and internationalisation are similar to those found in EU countries, some specific problems like the acceleration of immigration present rising social conflict. Social cleavages between urban and rural regions, and between capital and labour are deepening. The continuous rise of the conservative nationalist Swiss People's Party and the growing polarisation between the political Right and Left have put the traditional political culture of accommodation and power sharing at risk. Twenty years after the No-vote on the EEA-treaty, Switzerland is a divided country. Why do Swiss politicians still practice consensus democracy, and what does the divide mean for the future relations between the EU and Switzerland?     

Correspondence

‘Machiavelli's solitude’ is a new English translation by Ben Brewster of a lecture delivered by Louis Althusser in 1977, so far unpublished in French. O'Hagan presents it as exemplifying a side of Althusser which is often neglected: his skill as lecturer and stylist. He compares the content of this 1977 lecture with that of an earlier series of lectures on the same theme, delivered by Althusser at the École Normale Supérieure in 1972. He suggests that there is a striking shift in emphasis in Althusser's political and philosophical position between the two, in particular a move towards a more negative view of the role of the law in a popular democracy. In passing O'Hagan reflects on changing fashions in the writing of intellectual history.     

Academic freedom 1979: The West German case

Abstract

Given the continued significance of ideology as a social and political phenomenon, political science must consider the important contributions made to ideology theory made over the last thirty years by Louis Althusser. In this essay, I offer a critical exegesis of Althusser's views, focusing on the concept of reading, on the various conceptions of ideology held by Althusser, on the distinction Althusser made between ideology and science, and on his theory of the subject. This study of his thought makes three claims: (1) that Althusser's views, billed as a radical break with bourgeois thought, can be assimilated easily into social scientific understandings about ideology; (2) that Althusser's theory has internal difficulties rooted in the tension between positive and negative conceptions of ideology; and, (3) that Althusser left unanswered the key question of the means to ideological liberation.     

Cops,Teachers, and the Art of the Impossible: Explaining the Lack of Diffusion of Innovations That Make Impossible Jobs Possible

In their 1990 book Impossible Jobs in Public Management, Erwin C. Hargrove and John C. Glidewell argue that public agencies with limited legitimacy, high conflict, low professional authority, and weak agency myths have essentially impossible jobs. Yet some such positions have proven operationally possible. For example, over a 17‐year period, the New York City Police Department achieved dramatic reductions in crime. A second impossible job discussed by James Q. Wilson, the urban school superintendent, has also proven possible, with Washington, D.C., having considerable success educating disadvantaged children. However, these successes in urban crime control and public schooling have not been widely copied. Building on the work of Manuel P. Teodoro, the authors use these cases to discuss how the inflexibility of personnel systems and political costs of disruptive reforms combine with the professional norms and progressive ambition of agency leaders to limit the diffusion of innovations in law enforcement and schooling. The article concludes with hypotheses for future testing.     

Independence day explosion on lovers key

The display of fireworks is a popular holiday celebration in the United States. Because injuries due to recreational fireworks-related explosions among private consumers are relatively common, the sale of fireworks is regulated by the federal government and is also limited by state and local laws. In contrast, because fireworks display companies are under tight safety regulations, explosions in the professional pyrotechnics industry are uncommon occurrences, and the literature contains rare reports of injuries and fatalities resulting from such explosions. We report the 2003 Fourth of July commercial fireworks explosion on Lovers Key in southwest Florida that resulted in five fatalities. Events occurring during the investigation of the scene of this explosion illustrate the unique considerations and hazards for medicolegal death investigators, law enforcement and other investigative agencies. Additionally, this case demonstrates unusual aspects of the postmortem examinations performed on victims of fireworks-related incidents.