Further evidence of in vitro production of gamma-hydroxybutyrate (GHB) in urine samples

This study was designed to supplement previous studies that documented in vitro production of gamma-hydroxybutyrate (GHB) in urine samples. Urine samples were provided by subjects who reported that they had never used GHB (n=31). The specimens were stored under standard conditions of refrigeration (5 degrees C) without any preservatives added. All specimens were repeatedly analyzed for the presence of endogenous GHB over a 6-month period using a previously reported headspace GC-MS method. Significant elevations in GHB were observed in many of the urine samples as storage time increased. As a result, the in vitro production of GHB may increase the apparent GHB concentrations in urine during storage. This potential for an artificial increase in GHB concentration must be appreciated when establishing the threshold between endogenous and exogenous concentrations of GHB.     

Cause of death and drug use pattern in deceased drug addicts in Sweden, 2002-2003

Compared with their contemporaries, individuals abusing illicit drugs suffer a higher risk of premature death. In Sweden, a simple protocol for registration of fatalities among abusers of alcohol, pharmaceuticals, illicit drugs, or other substances, has been used by the forensic pathologists since 2001. This routine was introduced to allow for an evaluation of the cause and manner of death, and patterns of abuse among different groups of abusers. We explored the data on drug abusers (i.e. abusers of illicit drugs) subjected to a forensic autopsy 2002-2003. The Swedish forensic pathologists examined 10,273 dead victims during the study period and 7% (743/10,273) of the cases were classified as drug abusers. Toxicological analyses were carried out in 99% (736/743) and illicit drugs were detected in 70% (514/736) of these. On average, 3.8 substances (legal or illegal) were found per case. The most common substances were ethanol and morphine, detected in 43 and 35% of the cases, respectively. When exploring the importance of the different substances for the cause of death, we found that the detection of some substances, such as fentanyl and morphine, strongly indicated a poisoning, whereas certain other substances, such as benzodiazepines more often were incidental findings. In total, 50% (372/743) died of poisoning, whereas only 22% (161/743) died of natural causes. Death was considered to be directly or indirectly due to drug abuse in 47% (346/743), whereas evidence of drug abuse was an incidental finding in 21% (153/743) or based on case history alone in 33% (244/743). We believe that this strategy to prospectively categorize deaths among drug addicts constitutes a simple means of standardizing the surveillance of the death toll among drug addicts that could allow for comparisons over time and between countries.     

Criminal Behavior in Opioid‐Dependent Patients Before and During Maintenance Therapy: 6‐year Follow‐Up of a Nationally Representative Cohort Sample

Lifetime prevalence of opioid dependence is about 0.4% in western countries. Opioid‐dependent patients have high morbidity and mortality and a high risk of criminal behavior. Few studies have addressed the long‐term impact of opioid maintenance therapy on convictions and criminal behavior. The PREMOS study is a prospective, longitudinal, naturalistic clinical study of a nationally representative sample of 2694 opioid‐dependent patients to investigate convictions and criminal behavior at baseline and after 6 years of maintenance treatment. At follow‐up, 2284 patients still were eligible (84.7%). A comprehensive assessment including a patient and doctor questionnaire, and the EuropASI was completed at baseline and follow‐up. Data on criminality at follow‐up had been received for 1147 (70.6%) patients. A large number (84.5%) of them had been charged or convicted at any time before baseline assessment, most frequently with drug‐related offenses (66.8%), acquisitive crime (49.1%), or acts of violence (22.0%). Reported charges and convictions had declined to 17.9% for the last 12 months before follow‐up, which was also reflected by a significant decrease in the EuropASI subscore “legal problems” from 1.52 at baseline to 0.98 after 6 years. These data indicate a significant and clinically relevant reduction in criminal behavior in opioid‐dependent patients in long‐term maintenance treatment. Maintenance therapy is effective in the reduction in both narcotics‐related and acquisition crime.     

Differential diagnosis: blue gastric mucosa. Post-mortem staining of the gastric mucosa with methylene blue

An intense discoloration of the gastric mucosa or the gastrointestinal tract found at autopsy gives rise to the question of its cause. Such discolorations are mostly described in the context of intoxications. However, traditional foods and diagnostic procedures using indicator dyes can also lead to an unusual discoloration of the mucous membranes. The authors report on the autopsy findings in a man who died from a bleeding gastric ulcer and whose gastric mucosa showed intense blue discoloration. Experimental postmortem examinations (on stomachs) were performed with methylene blue, a dye used in gastroenterology, resulting in a blue discoloration resembling the appearance of the stomach in the autopsy case. Together with the outcome of the toxicological analyses, the experiments pointed to a diagnostic procedure using methylene blue (chromoendoscopy).     

EU General Data Protection Regulation: Changes and implications for personal data collecting companies

The General Data Protection Regulation (GDPR) will come into force in the European Union (EU) in May 2018 to meet current challenges related to personal data protection and to harmonise data protection across the EU. Although the GDPR is anticipated to benefit companies by offering consistency in data protection activities and liabilities across the EU countries and by enabling more integrated EU-wide data protection policies, it poses new challenges to companies. They are not necessarily prepared for the changes and may lack awareness of the upcoming requirements and the GDPR's coercive measures. The implementation of the GDPR requirements demands substantial financial and human resources, as well as training of employees; hence, companies need guidance to support them in this transition. The purposes of this study were to compare the current Data Protection Directive 95/46/EC with the GDPR by systematically analysing their differences and to identify the GDPR's practical implications, specifically for companies that provide services based on personal data. This study aimed to identify and discuss the changes introduced by the GDPR that would have the most practical relevance to these companies and possibly affect their data management and usage practices. Therefore, a review and a thematic analysis and synthesis of the article-level changes were carried out. Through the analysis, the key practical implications of the changes were identified and classified. As a synthesis of the results, a framework was developed, presenting 12 aspects of these implications and the corresponding guidance on how to prepare for the new requirements. These aspects cover business strategies and practices, as well as organisational and technical measures.     

Fraud,Free Speech and Fossil Fuel: Lessons from Big Tobacco for Big Oil

Recent journalistic investigations revealed that ExxonMobil carried out research beginning in the 1970s indicating fossil fuel's dangerous role in global warming. Rather than heed the warnings of its research, for the next few decades, ExxonMobil instead chose to become a leader in climate change denial; stressing uncertainty, propagating misinformation, funding denial, and politicizing and undermining the expert scientific consensus. Exxon's behavior invoked the tactics used by the tobacco industry years earlier, tactics which wound up the subject of a successful federal government lawsuit under the Racketeer Influenced and Corrupt Organizations (RICO) Act. The parallels with the tobacco industry prompted legislators and environmentalists to call on the Department of Justice to use RICO again to hold the fossil fuel industry to account. This article will consider the legal issues associated with bringing such an action, and whether useful lessons can be drawn from the tobacco litigation.     

Rapid Separation of Organophosphate Pesticides using Micellar Electrokinetic Chromatography and Short‐end Injection,

Organophosphate (OP) pesticides are highly toxic substances and are frequently represented as poisons. In order to qualify and quantify the selected OP pesticides (methyl paraoxon, ethyl paraoxon, methyl parathion, fenitrothion, and ethyl parathion), micellar electrokinetic chromatography and short‐end injection were investigated. This is the first time that this combination has been used to separate OP pesticides. A capillary with 8.5 cm effective length was used, and the analytes were separated within 2.1 min. Separation conditions including buffer (type, pH, and concentration), sodium dodecyl sulfate concentration, and separation voltage were optimized. The limit of detection (LOD) was estimated in the range of 10–20 μM. The OP pesticides spiked in artificial saliva and drinking water gave superior peak profiles, and good average recoveries 95.6% and 62.3%, respectively. Overall, a rapid method with excellent resolution and efficiency was developed and successfully applied in the analysis of potential sample matrixes.     

The adoption of children from out-of-home care: how decision-makers explain the low rates of adoption in Victoria,Australia

The adoption of children from out-of-home care is uncommon in Australia and rarely occurs in the state of Victoria. This paper reports on how professionals involved in making decisions about the permanent placement of children explain the current rates of adoption from out-of-home care in Victoria. Interviews were conducted with eight child welfare specialists, eight adoption and permanent care specialists and five judicial officers. The current low rates of adoption were attributed to the effect of current legislation, the impact of past adoption practices and the establishment of a culture in Victoria in which adoption is now rarely considered an option for children in out-of-home care.     

Author Index of Volume 14

Authors Index

Author Index of Volume 14