Sickle cell lung disease and sudden death: a retrospective/prospective study of 21 autopsy cases and literature review

Sudden death in the setting of sickle cell lung disease (SCLD), is periodically seen in the practice of medical examiners. The goal of the present study was to identify the most common pathologic findings of SCLD associated with sudden or unexpected death. A retrospective/prospective review of 21 autopsy cases from sickle cell patients between 1990 and 2004 was performed. Review of medical records, autopsy reports, and H&E-stained slides of lung tissue was performed. Oil-Red-O and elastic staining of lung tissue were evaluated. All cases were screened for both acute and chronic forms of SCLD. Patients admitted for sickle cell pain crisis ranged in age from 8 months to 65 years. Fifteen out of 21 cases (71.4%) showed significant pulmonary pathology. The most frequent lung findings included pulmonary edema (47.6%), pulmonary thromboembolism (38.1%), fat emboli (33.3%), pulmonary hypertension, grades I-IV (33.3%), and microvascular occlusive thrombi (28.5%). Our study demonstrates higher-than-expected percentages of acute and chronic sickle cell-related lung injury such as fat embolism (33.3%) and pulmonary hypertension (33.3%), with right ventricular hypertrophy (33.3%). Therefore, we propose a simple and high-yield autopsy algorithm of ancillary procedures that should be applied on all known and suspected autopsy cases of sickle cell disease.     

Identification and quantification of phenobarbital in a mummified body 10 years after death

Abstract: This article reports the determination of phenobarbital in the mummified body of a 56‐year‐old man found completely mummified 10 years after his death. When alive, he was being treated for epilepsy with phenobarbital, and the recent analyses, performed with both immunochemical techniques and gas chromatography with mass spectrometry (GC‐MS), have revealed the presence of this substance in various tissues: the mean content of barbiturate in the mummified liver tissue was 93 μg/g, 216 μg/g in the heart, 17 μg/g in the lungs, 12 μg/g in muscles, and 31 μg/g in the skin. Preliminary screening tests with immunochemical techniques to evaluate the presence of other drugs were also performed. The sample resulted negative for all substances tested. Phenobarbital can be identified and quantified thanks to its excellent chemical stability and a hypothesis of what the concentrations in the fresh tissue could have been has also been reported.     

A Direct Aqueous Derivatization GSMS Method for Determining Benzoylecgonine Concentrations in Human Urine

A sensitive and reliable method for extraction and quantification of benzoylecgonine (BZE) and cocaine (COC) in urine is presented. Propyl‐chloroformate was used as derivatizing agent, and it was directly added to the urine sample: the propyl derivative and COC were then recovered by liquid–liquid extraction procedure. Gas chromatography–mass spectrometry was used to detect the analytes in selected ion monitoring mode. The method proved to be precise for BZE and COC both in term of intraday and interday analysis, with a coefficient of variation (CV) <6%. Limits of detection (LOD) were 2.7 ng/mL for BZE and 1.4 ng/mL for COC. The calibration curve showed a linear relationship for BZE and COC (r² >0.999 and >0.997, respectively) within the range investigated. The method, applied to thirty authentic samples, showed to be very simple, fast, and reliable, so it can be easily applied in routine analysis for the quantification of BZE and COC in urine samples.     

Constructing new environments versus attitude adjustment: contrasting the substance of democracy in UN and EU democracy promotion discourses

In contrasting UN with EU democracy promotion discourses, the article contributes to the debate on the substance of EU democracy promotion by approaching the question of ‘democratic substance’ from the vantage point of sovereignty. For its analytical framing, it draws on relevant aspects of Foucault's work on power. The article suggests that, due to their diverging obligations to sovereignty, the substance of democracy promotion in UN discourses revolves around an institutional-centric understanding, whereas in EU discourses we see a significant reconceptualization of democracy as a norms-based concept. The latter does not aim at the government of society but the ethical self-governance of socially embedded individuals. It is argued that, with the decreasing purchase of democracy as a universal political project and the growing concern with local contexts, the EU's norms-based conception emerges as better equipped to adapt to contemporary challenges of governing. The article concludes with raising some doubts about the democratic promise and potential of the democratic rationality underpinning EU discourses. Democracy, participation and political change are no longer conceived in terms of shaping and influencing public agenda but refer to socially shaping and influencing subjective perceptions and behaviours.     

More Than a Glance: Investigating the Differential Efficacy of Radicalizing Graphical Cues with Right-Wing Messages

European Journal on Criminal Policy and Research - In recent years, online radicalization has received increasing attention from researchers and policymakers, for instance, by analyzing online...     

Reform: economic policy administration

Beginning in 1992, Italy has undergone a dramatic process of fiscal consolidation. Within that framework, the policy strategy has covered a broad range of objectives and addressed the main structural imbalances of the Italian economy. This paper describes how the new policy course has been reshaping the role of the State within the Italian economy, with a view of reducing the State's weight and direct involvement in the management of businesses. This has also implied a profound transformation at the decisional and administrative levels, as testified by the ongoing merge of two separate administrations, the former Ministry of the Treasury and Ministry of the Budget, into a single entity.     

Survival strategies of widows and their families in early modern Holland, c. 1580–1750

This article analyses the impact of widowhood upon women in early modern urban society in Holland. Widows were able to maintain their households and to minimize the discontinuity with their lives when married. A remarkably egalitarian inheritance and marital property law, access to a broad range of occupations, a privileged status, an extended poor relief system, institutionalised mutual assistance and new forms of financial provisions for widows enabled widows to survive after the loss of an adult male breadwinner. However, legal rights, social provisions and economic opportunities available to women in the Dutch Golden Age and thereafter, could not prevent social polarization after women lost their spouse.     

Ist das neue Umwelt-Rechtsbehelfsgesetz europarechtskonform?

Zusammenfassung Das Umwelt-Rechtsbehelfsgesetz ist am 15.12.2006 in Kraft getreten. Damit kam der deutsche Gesetzgeber seinem Auftrag zur Umsetzung des Gemeinschaftsrechts – wenngleich sehr versp?tet – nach. Schon vor dem Erlass des Gesetzes war die Umsetzung der v?lker- und europarechtlichen Vorgaben ein hei? diskutiertes Thema und auch nach der Umsetzung in deutsches Recht erhitzt die Frage nach der Europarechtskonformit?t des Gesetzes weiterhin die Gemüter. In diesem Beitrag sollen einige der umstrittenen Bestimmungen des Gesetzes n?her beleuchtet und auf ihre Vereinbarkeit mit dem Gemeinschaftsrecht geprüft werden.