A Rare Case of Sudden Death Due to Hypotension during Cesarean Section in a Woman Suffering from Pheochromocytoma and Neurofibromatosis

Sudden death following acute hypotension due to an undiagnosed pheochromocytoma (PHEO) is a rare event. Moreover, histopathology of the myocardium in such cases is rarely reported. We present a case of a woman who died during delivery. A 37‐year‐old parturient, who was 38 weeks pregnant, suffering from neurofibromatosis underwent a cesarean section following peridural anesthesia. Acute hypotension, acute intra‐operative pulmonary edema and supraventricular paroxysmal tachyarrhythmia occurred during delivery, followed by death. The autopsy revealed the presence of a PHEO, confirmed immunohistochemically with chromogranin‐A (CgA), CD20 antibody (L26), anti‐Keratocan antibody (KER‐1) and neuron‐specific enolase (NSE), and a PHEO‐induced cardiomyopathy. The physiopathology of both stress‐induced cardiomyopathy and PHEO‐induced cardiomyopathy, as well as the role of anesthesia in provoking the death, are discussed. The association of an undiagnosed PHEO with neurofibromatosis as the cause of sudden death in pregnancy is an obstetric urgency that raises forensic pathology issues.     

Surface-sampling and analysis of TATP by swabbing and gas chromatography/mass spectrometry

The method of sample recovery for trace detection and identification of explosives plays a critical role in several criminal investigations. After bombing, there can be difficulties in sending big objects to a laboratory for analysis. Traces can also be searched for on large surfaces, on hands of suspects or on surfaces where the explosive was placed during preparatory phases (e.g. places where an IED was assembled, vehicles used for transportation, etc.).In this work, triacetone triperoxide (TATP) was synthesized from commercial precursors following reported methods. Several portions of about 6 mg of TATP were then spread on different surfaces (e.g. floors, tables, etc.) or used in handling tests. Three different swabbing systems were used: a commercial swab, pre-wetted with propan-2-ol (isopropanol) and water (7:3), dry paper swabs, and cotton swabs wetted with propan-2-ol. Paper and commercial swabs were also used to sample a metal plate, where a small charge of about 4 g of TATP was detonated. Swabs were sealed in small glass jars with screw caps and Parafilm^® M and sent to the laboratory for analysis. Swabs were extracted and analysed several weeks later by gas chromatography/mass spectrometry. All the three systems gave positive results, but wetted swabs collected higher amounts of TATP. The developed procedure showed its suitability for use in real cases, allowing TATP detection in several simulations, including a situation in which people wash their hands after handling the explosive.     

Parties' Influence during Government Policy Negotiations: Parliamentary Dynamics and Spatial Advantages in the First Italian Republic

As long as parties are interested in policies, they will always have incentives for influencing the cabinet bargaining process, although they do not necessarily shape its outcome to the same extent. Being a member of the invested government, for example, should increase the leverage a party enjoys when bargaining over the cabinet programme. Nevertheless, depending on institutional and political conditions, non-cabinet parties may also play a role in affecting cabinet policy positions. Despite being widely recognised in the theoretical literature, this point has received considerably less attention in empirical studies. By focusing on cabinet bargaining outcomes during the First Italian Republic, the article shows that spatial advantages associated with parliamentary dynamics, including those possessed by non-cabinet parties, can be no less significant in capturing policy payoffs than government membership, even after controlling for other relevant institutional and behavioural factors.     

Government Alternation and Legislative Party Unity: The Case of Italy, 1988–2008

The large literature on legislative party unity identifies the confidence relationship, i.e. the threat of being voted out of office and losing agenda setting powers, as well as cabinet membership, as two crucial institutional sources of party discipline. However, by focusing on the dramatic change in the Italian political system following the 1994 election, the article shows that the impact of these factors on party unity (and the direction of this impact) hinge crucially on the possibility of government alternation rather than mere cabinet turnover. This is illustrated by an index of party unity that explicitly focuses on the behaviour of individual MPs derived from a roll-call analysis of the Italian Chamber of Deputies during the period 1988–2008.     

Trusts find a tax rule within the Italian financial bill 2007

The revision of the Italian tax laws on trusts reduces the riskof different interpretations on the taxation of trusts and whichshould encourage a better understanding and use of trusts byresidents in Italy. The authors examine the new law and discussthe interpretation of some of the more difficult provisions.     

Security challenges in alliance: The southern periphery

Barack Obama's first year should appear disappointing only to persons blind to the constraints imposed by the Bush legacy, the still reeling world economy, an intimidating agenda of domestic problems, a polarised domestic politics, and at least temporarily intractable opponents of the President's undoubted ambitions to tame the Middle East and promote cooperation among the leading states without jettisoning a commitment to liberal values. By ordering an end to torture and moving to close Guantanamo, he has signalled the restoration of moral restraint on the exercise of American power and implicitly expressed belief in the efficacy of soft power assets. Additionally, he has attempted to create political space for change by pushing the conventional limits of American presidential discourse. A decent start, but the hard part lies ahead.     

Age estimation by pulp/tooth ratio in lower premolars by orthopantomography

Accurate age estimation has always been a problem for forensic scientists, and apposition of secondary dentine is often used as an indicator of age. Since 2004, in order to examine patterns of secondary dentine apposition, Cameriere et al. have been extensively studying the pulp/tooth area ratio of the canines by panoramic and peri-apical X-ray images. The main aim of this paper is to examine the relationship between age and age-related changes in the pulp/tooth area ratio in monoradicular teeth, with the exception of canines, by orthopantomography. A total of 606 orthopantomograms of Spanish white Caucasian patients (289 women and 317 men), aged between 18 and 75 years and coming from Bilbao and Granada (Spain), was analysed. Regression analysis of age of monoradicular teeth indicated that the lower premolars were the most closely correlated with age. An ANCOVA did not show significant differences between men and women. Multiple regression analysis, with age as dependent variable and pulp/tooth area ratio as predictor, yielded several formulae. R(2) ranged from 0.69 to 0.75 for a single lower premolar tooth and from 0.79 to 0.86 for multiple lower premolar teeth. Depending on the available number of premolar teeth, the mean of the absolute values of residual standard error, at 95% confidence interval, ranged between 4.34 and 6.02 years, showing that the pulp/tooth area ratio is a useful variable for assessing age with reasonable accuracy.     

Independent auditors as fiscal gatekeepers

This paper develops a framework for the analysis of gatekeeping in tax enforcement, whereby independent auditors are assigned the duty of attesting taxpayers’ returns. The equilibrium of the market for gatekeepers’ services is characterized, as well as taxpayers’ and auditors’ optimal behavior. The paper identifies the conditions under which the introduction of a mandatory attestation system is likely to be desirable.The results of the paper suggest that: (1) collusion may disrupt the gatekeeping system if the compounded liability of the auditor and the taxpayer is not sufficiently high; (2) a more extended delegation of the enforcement power to private auditors is generally desirable; (3) the cartelization of the gatekeepers’ market has definitely detrimental effects; and (4) when the probability that erroneous attestations are detected and sanctioned depends on the effort exerted by a public enforcer, multiple equilibria may arise, due to the substitutability of public and private monitoring.