Fatal intoxication with amisulpride and presentation of organ distribution

Amisulpride is a substituted benzamide used as an atypical antipsychotic drug. It antagonizes dopamine D2 and D3 receptor-mediated effects with greater affinity for the limbic system suggesting better neurological tolerance than classical neuroleptics. However, occasionally amisulpride intoxications associated with seizures, comatose conditions and agitation, hyperthermia, tachycardia, prolongation of the QT interval and extrapyramidal features have been described. A 27-year-old female with a medical history of psychosis and amisulpride therapy was found dead at home. By means of high performance liquid chromatography coupled with mass spectrometry (LC/MS) an amisulpride concentration of 13.4 mg/l was found in the peripheral blood. A lower concentration in the brain and an extremely high concentration in bile can be explained by the polarity and hydrophobic character of the substance. After macroscopic and histological exclusion of other causes of death the results of the toxicological analysis were consistent with the assumption of a fatal amisulpride overdose.     

Medicolegal aspects of witnessed suicide due to gunshot to the head. Part 1: Circumstances and psychopathology

In the USA the frequency of witnessed suicide, i.e. suicide committed in the presence of at least one further individual, is reported to range between 5 and 15%. As up to now no detailed analysis of this special issue has been given in the medicolegal literature, this article presents and discusses a number of cases including 8 males and 1 female (age 19-58 years, mean 41.2 years) who had all committed suicide by inflicting a gunshot to the head. In 3 cases post-mortem blood alcohol concentrations of 1.73, 1.88 and 2.23 g/kg respectively were observed. Toxicological tests produced negative results. 5 cases had a medical history of psychiatric disorder with endogenous depression in 3, chronic alcohol abuse and drug abuse with concomitant psychosis in one case each. As far as the motives were known, domestic arguments were of prevailing importance. With one exception the suicides were committed at home. In 6 cases one witness was present, in 2 cases 2 individuals and in one case 22 persons witnessed the suicide. The reported cases are discussed in comparison with the psychiatric-psychological classification according to McDowell et al. with the aim to provide a solid and comprehensive medicolegal method to distinguish between homicide and suicide. Furthermore aspects of psychiatric sequelae and psychological support of the witnesses, which are also of importance for the forensic pathologist called to the scene, are discussed.     

Why is it hard to solve environmental problems? The perils of institutional reductionism and institutional overload

International Environmental Agreements: Politics, Law and Economics - Many efforts to solve environmental problems arising at the international or transnational level meet with limited success or...     

Common pool effects and local public debt in amalgamated municipalities

This paper investigates whether the large scale municipal amalgamations in the German state of Baden-Wuerttemberg in the early 1970s led to considerable common pool exploitation. Through amalgamation the resources of several municipalities are pooled together disclosing the former independent municipalities a larger source of funds. Additionally, the pooling also decreases the cost of local public goods, as those have to be borne by the whole of the amalgamated municipality. By exploiting the huge variance in the amalgamation process in terms of number of participating municipalities, but also in municipality size or amalgamation strategy, we identify considerable common pool effects. Amalgamated municipalities show considerably stronger acceleration in debt accumulation compared to non-amalgamating municipalities. This common pool exploitation is stronger if more municipalities participate and when municipalities amalgamate by annexation.

     

德国应对世界经济危机的措施

本文全面分析了德国政府迄今采取的应对当前经济危机的各项举措,包括金融市场稳定措施和两套经济振兴计划。与此同时,本文也简要介绍了欧盟层面的经济振兴计划。作者最后指出,德国所采取的应对危机的经济政策措施带有明显的凯恩斯主义的赤字开支政策的特征,并提出忠告,要避免重蹈六、七十年代凯恩斯主义经济政策的覆辙。