Disposition of citalopram in biological specimens from postmortem cases

Citalopram is a bicyclic phthalate compound approved in 1998 by the U.S. Food and Drug Administration for the treatment of depression. It is a highly selective serotonin reuptake inhibitor that appears to have little effect on noradrenaline or dopamine reuptake. Since this drug has only recently been released on the U.S. market, information regarding therapeutic, toxic, and lethal concentrations is sparse. This study reports the detection of citalopram in 22 postmortem cases. Citalopram was identified and quantitated by capillary column gas chromatography with nitrogen phosphorus detection after basic liquid-liquid extraction. Confirmation was achieved by full scan electron impact gas chromatography/mass spectrometry. In the 22 cases studied, heart blood citalopram concentrations ranged from 0.09 to 1.64 mg/L (n = 22, mean +/- SD = 0.51+/-0.43, median = 0.34); femoral blood concentrations ranged from 0.09 to 0.76 mg/L (n = 14, mean +/- SD = 0.34+/-0.23, median = 0.28); and urine concentrations ranged from 0.05 to 276.00 mg/L (n = 13). Liver was analyzed in three cases with citalopram concentrations ranging from 2.22 to 8.08 mg/kg. The average heart blood/femoral blood ratio was 1.26 (range 0.75 to 1.98, n = 14). In each case, the cause of death was not considered to be related to citalopram toxicity. These data may therefore provide a basis for establishing post mortem citalopram concentrations following therapeutic doses.     

AFTER EXCELLENCE: MODELS OF ORGANISATIONAL CULTURE FOR THE PUBLIC SECTOR

Abstract: Organisational culture is recognised as a critical ingredient of organisational effectiveness. However, the popular "excellence" model of managing organisational culture is unsuited to the contingencies and character of many public sector organisations. Termed here the cultural control model, it is the only widely shared understanding of good culture and haw to create it. As a generic prototype of culture it is limited, since it relies on management imposing a culture on a work force devoid of subcultural conflict. Three other models of organisational culture are introduced which offer more promise for the public sector: the subcultural model; the professional-managerial multiculture; and the public service or public interest model. These other models recognise in the culture-building strategies they prescribe that culture is deeply-rooted and not readily malleable by management and that subcultures affect organisations in various, not necessarily negative, ways. While the cultural control model reminds us of the significance of culture to better management, subsequent research has refined models of organisational culture which are more Consistent with the values and ethics of professionalism and good administration.