Possible Fatal Acetaminophen Intoxication with Atypical Clinical Presentation

Acetaminophen or paracetamol, a commonly used over‐the‐counter analgesic, is known to elicit severe adverse reactions when taken in overdose, chronically at therapeutic dosage or, sporadically, following single assumptions of a therapeutic dose. Damage patterns including liver damage and, rarely, acute tubular necrosis or a fixed drug exanthema. We present a case of fatal acetaminophen toxicity with postmortem blood concentration 78 μg/mL and unusual clinical features, including a visually striking and massive epidermolysis and rhabdomyolysis, disseminated intravascular coagulation and myocardial ischemia. This case is compared with the most similar previous reports in terms of organ damage, clinical presentation, and cause of death. We conclude that a number of severe patterns of adverse effects to acetaminophen are emerging that were previously greatly underestimated, thus questioning the adequacy of the clinical spectrum traditionally associated with acetaminophen intoxication and leading to the need to review this spectrum and the associated diagnostic criteria.     

The Reform of the Local Administration in Spain in Terms of Population

Spanish Local Corporations are playing an increasingly important role in the provision of public services without reducing their function of consolidation and structuring of the current sociopolitical system. This reality implies an increase in their need of financial funds without new compensation resources. Also, there is a certain tendency to loose population in many counties along with a greater organic and territorial dispersion that accelerates their financial weakening. This makes necessary to find management alternatives ensuring the appropriate provision of local public services and thus the Local Corporation reform becomes an alternative. In this context, the present paper approaches the analysis and the results based upon a territorial balance criterion on the population and its distribution, aiming ultimately to design an indicator able to measure the need of the Spanish local government structure according to its population and the size of its municipalities. This indicator might measure the regional impact to any variation both in the distribution of its population and in the number of municipalities.     

The sampling of ignitable liquids on suspects’ hands

In arson cases, the collection and detection of traces of ignitable liquids on a suspect's hands can provide information to a forensic investigation. Police forces currently lack a simple, robust, efficient and reliable solution to perform this type of swabbing.In this article, we describe a study undertaken to develop a procedure for the collection of ignitable liquid residues on the hands of arson suspects. Sixteen different collection supports were considered and their applicability for the collection of gasoline traces present on hands and their subsequent analysis in a laboratory was evaluated. Background contamination, consisting of volatiles emanating from the collection supports, and collection efficiencies of the different sampling materials were assessed by passive headspace extraction with an activated charcoal strip (DFLEX device) followed by gas chromatography–mass spectrometry (GC–MS) analysis. After statistical treatment of the results, non-powdered latex gloves were retained as the most suitable method of sampling.On the basis of the obtained results, a prototype sampling kit was designed and tested. This kit is made of a three compartment multilayer bag enclosed in a sealed metal can and containing three pairs of non-powdered latex gloves: one to be worn by the sampler, one consisting of a blank sample and the last one to be worn by the person suspected to have been in contact with ignitable liquids. The design of the kit was developed to be efficient in preventing external and cross-contaminations.     

Incentives, criminal defence lawyers and plea bargaining

Plea bargaining has become a central feature of criminal procedure in Anglo-Saxon jurisdictions. This paper explores an area seldom discussed in the economic literature on plea bargaining: the influence of the defence lawyer's fee contract on the terms of the bargain. In particular, it uses data from one jurisdiction of the impact on case trajectories of changes in publicly funded defence lawyers’ contracts to test the proposition that the nature of the lawyer's contract influences how cases are managed. An event study methodology on a pooled time-series cross-section data set of case trajectories before and after the change in the nature of the contract is used to examine whether the new payment regime significantly changed the trajectories of cases through the summary criminal justice system. Overall the results seem to suggest that the behaviour of defence lawyers may be influenced by financial incentives. This implies that the terms of plea bargains reached between prosecution and defence lawyers may be affected by the defence lawyer's remuneration contract. Consequently, the authors conclude that the role of defence lawyers has been under-researched in the literature on the economics of plea bargaining.     

Cannabis and driving: Results from a general population survey

The role of illicit drugs on driving, and particularly of cannabis and driving, is the object of increasing awareness. While there is increasing evidence of their effect on psychomotor performance and increased risk of involvement in traffic accidents, limited information is available concerning factors that can predict the likelihood of driving under the influence of cannabis. The present study aims to determine the past year prevalence of driving under the influence of cannabis, and of being a passenger in a vehicle driven by a person under the influence of cannabis, as well as to examine the correlations with a broad range of potential risk factors. A total of 2500 people, aged between 14 and 70 and living in Castille and Leon (Spain), were surveyed in 2004 with regard to their consumption of alcohol and illicit drugs. Among those who reported cannabis use in the previous year, further assessment was carried out. 15.7% of those surveyed reported cannabis consumption in the previous 12 months, of whom 9.7% reported driving a vehicle under the influence of cannabis during this period, on average eight times. One out of five (19.9%) reported being a passenger in a vehicle driven by a person under the influence of cannabis, on average five times in the previous 12 months. The predictors of driving under the influence of cannabis were the population size of community, the number of drugs consumed, reference to cannabis-related problems and to being a passenger in a vehicle driven by a person under the influence of alcohol. The data show that cannabis consumption and driving is common, and requires more attention from policy makers.