Fatal parvovirus B19 myocarditis in an 8-year-old boy

A report is given on an 8-year-old boy who suddenly and unexpected died. Autopsy findings point to acute heart failure. Microscopic examination of the heart showed increased interstitial and perivasal fibrosis and myocarditis with macrophage infiltration. Polymerase chain reaction (PCR) analysis for parvovirus B19 was positive in heart samples and in the spleen. Immunostaining for parvoviral surface antigens was negative. Although the virus does not appear to have infected the cardiomyocytes, we speculate that myocarditis arose from immunological cross-reaction to epitopes shared between the virus and the myocardium.     

Post-mortem SNP analysis of CYP2D6 gene reveals correlation between genotype and opioid drug (tramadol) metabolite ratios in blood

Tramadol is an opioid drug metabolised in phase I by cytochrome P450 (CYP) enzymes, of which CYP2D6 is mainly responsible for the O-demethylation of tramadol, but is not involved in N-demethylation. Defects in the genes encoding drug metabolising enzymes (DMEs) may lead to adverse drug effects, even to death. To aid interpretation of the forensic toxicology results, we studied how the genetic variation of the CYP2D6 gene is reflected in tramadol metabolite ratios found in post-mortem samples. In 33 Finnish autopsy cases where tramadol was found, we analysed both the CYP2D6 genotype and the concentrations of tramadol and its metabolites O- and N-demethyltramadol. As expected, we found a correlation between the number of functional CYP2D6 alleles and the ratio of tramadol to O-demethyltramadol. We also found a correlation between the number of functional alleles and the ratio of tramadol to N-demethyltramadol. This can be explained by the complementary nature of the two main tramadol demethylation pathways. No known CYP2D6 inhibitors were associated with exceptional metabolic ratios. Furthermore, no accidental tramadol poisonings were associated with a defective CYP2D6 gene. Our results on the tramadol are among the first to demonstrate that genetic variation in drug metabolising enzymes can be analysed in post-mortem blood, and that it correlates well with the parent drug to metabolite ratios. The results also suggest that genetic factors play, in general, a dominant role over other factors in the metabolism of individual drugs.     

Russia: new criminal process code promises a more tolerant incarceration policy

The population of Russian prisons is one of the largest in the world: as of 1 April 2002, there were 1,220,368 people living in prisons in the country. Some data suggest that 15 to 20 percent of all people living with HIV/AIDS in Russia are in prisons and detention facilities.     

Post–Conflict Global Governance: The Case of Microfinance Enterprise Networks in Bosnia and Herzegovina

The article examines the institutional infrastructure that supports the foreign aid flows in the mcrocredit sector in postconflict Bosnia and Herzegovina. It documents the mobilization of transnational networks between different international agencies in the course of the policy formulation and implementation, and elicits the effects that certain network attributes exert on the policy choices made by individual organizations. How and why do international governmental and nongovernmental organizations, with at times conflicting goals, join forces in such networks? More important, whose goals are eventually implemented, and under what conditions? Whose goals are diluted in the process of network mobilization? What are the policy implications of such "battles" for the postconflict reconstruction? The article seeks some answers to these questions, demonstrating how transnational networks intermediate between the organizational goals and the final policy outcomes that result from such a network–based mode of global governance in postconflict regions.     

Right,the state and the conception of the person

The contemporary world‐historical epoch involves both the universal extension of the state type of organization of society, and the development of a universal idea of the person in the discourse of human rights. The status of the person requires positive constitution, and such constitution requires an idea of the state that informs the actual working of states. The idea of the state cannot be developed unless the natural right conception of the basis of personhood is abandoned. Nor can the idea of the state be developed if it continues to be confused with the idea of the nation. Hegel offers us an idea of the state that we can continue to build. For Hegel the state denotes both the institutional reality of the state and the subjectivity that is required if the idea of the state is to be actualized. There is a dialectical relationship between the adequacy of the state‐centered institutional order for the effective support and facilitation of personhood and our subjective capacity to be and act as persons. Thus, processes by which the idea of the state is undermined are not independent of subjective experience and our willingness to be and act as persons.