Verapamil toxicity: an unusual case report and review of the literature

Verapamil blocks the rapid influx of calcium into the cardiac myocytes of the cardiac conduction system and smooth muscle of the vasculature, resulting in decreased myocardial contractility, prolonged conduction time, and vascular relaxation. A sustained-release form, verapamil SR (or ER), is available that contains higher levels of medication and requires only once-daily dosing. The majority of reported fatal cases of verapamil toxicity are due to massive, intentional overdoses. Herein, we present an unusual case of fatal verapamil SR toxicity in a 57-year-old female that resulted from accidental overdose of only 3 tablets (720 mg), as witnessed by the decedent's daughter. In spite of the low dose ingested, the postmortem cardiac blood verapamil level was clearly toxic (6000 ng/mL, or 6 mg/L). Her preexisting medical conditions included hypercholesterolemia, hypertension, iron deficiency anemia, diabetes mellitus, and associated mild chronic renal failure. Complicating factors, which likely include the decedent's preexisting renal and cardiac disease, and a review of the available literature will be discussed.     

Schadenersatz wegen im Prozess verz?gerter R?umung

Immer wieder kommt es vor, dass Bestandnehmer in R?umungsprozessen Einwendungen erheben, um die R?umung zu verhindern bzw hinauszuschieben. Dadurch k?nnen dem Vermieter Sch?den entstehen, die durch die prozessrechtliche Kostenersatzpflicht und Benützungsentgelte nicht gedeckt sind. In deswegen geführten Schadenersatzprozessen hat der OGH die Frage der Beweislast zum Verschulden bisher unterschiedlich beantwortet. Oftmals wurde der Vermutung, dass die Anrufung des Gerichtes gutgl?ubig erfolgt, Vorrang gegenüber der Beweislastregel nach § 1298 ABGB gegeben. Zu diesem Rechtsstandpunkt ?u?erte sich der OGH nun ausdrücklich in der nachstehend besprochenen Entscheidung 1 Ob 153/11y.     

The evolution of the New Patriotic Party in Ghana

This paper examines the emergence and development of the ruling New Patriotic Party (NPP) government in the context of a broader examination of the roles of political parties within the Ghanaian political landscape. After describing the political architecture as well as some significant constitutional issues of Ghana's democracy and the roles played by other societal stakeholders, the paper examines the rationale for the formation of the NPP, its manifesto, structure, constituency, power brokers. It then analyses various aspects of the implementation (or not) of the NPP's political and economic objectives since it came to power in 2000 with a message of ‘positive change’. The electoral politics of the campaigns against its major opposition, the National Democratic Congress (NDC), and issues of regionalism, ethnicity and other factors are considered in detail. The paper concludes with some lessons learned and generic recommendations for emerging African political parties in relatively young democracies.