The influence of ethanol on the level of ketone bodies in hypothermia

Presently available possibilities of macro- and microscopic diagnosis of death from hypothermia are very limited as the changes observed are either weakly specific (ecchymoses in the mucous membrane of the stomach, histological features of haemorrhagic pancreatic necrosis, cardiomyocyte necrosis or decreased content of glycogen in hepatocytes) or represent only local action of low temperatures (frostbites, violet patches in the region of knees and elbows, red livores) and they may not be present in cases of death from cooling at environmental temperature close to zero or higher.The study evaluated the usefulness of acetoacetic acid (Ac-Ac), beta-hydroxybutyric acid (beta-HBA) and acetone determinations in blood, urine and vitreous humour for diagnosis of death from hypothermia. These three substances called ketone bodies, are easily assimilated energetic substrates that get oxidized preferentially before glucose and fatty acids. In hypoglycaemia (also hypothermia-induced one), the tissues dependent on glucose (e.g. the brain) cover most of their energetic needs from oxidation of these compounds.The analysis of 16 cases of death in circumstances suggesting hypothermia (mainly of the alcohol abusers) showed that the degree of ketosis was inversely proportional to the blood ethanol concentration. This relation may result from stimulation of insulin release and a decrease in the release of its antagonists by ethanol, as well as from inhibition of free fatty acid (FFA) beta-oxidation due to increase in the NADH/NAD ratio. So, the antiketonaemic effects of ethanol (together with its influence on the dilatation of the peripheral vessels and inhibition of shivering thermogenesis by muscle relaxation), explain increased sensitivity of intoxicated persons to low temperatures.     

Extra-Legal Values in Judicial Interpretation of Law: A Model Reasoning and Few Examples

International Journal for the Semiotics of Law - Revue internationale de Sémiotique juridique - The aim of the paper is to analyze the types of interpretative reasoning determining the content...     

Marriage patterns among Lutherans from the parish of Trzebosz in the second half of the 19th century and the beginning of the 20th century

The aim of this study is to characterize marriage patterns in a rural parish of Trzebosz in the borderland between Greater Poland (Wielkopolska) and Silesia in the years 1855–1913. A total of 343 data on marriages were gathered from the parish registers. The percentage of Lutheran–Catholic marriages was calculated. The distribution of age at marriage by martial status was assessed. The intensity of endogamy and exogamy was calculated as well as the coefficients of exogamy and biological polygamy. The annual rhythm of marriages was determined. In Trzebosz mixed marriages accounted for 3.94% in 1855–1899 and 14% in 1900–1913. The average age of brides and grooms was 25.36 and 26.22 years, while of widows and widowers they were 37.26 and 42.35 years, respectively. The average age of brides and grooms declined over time. In 1855–1899 the levels of endogamy and exogamy outside the parish were 19% and 81%, respectively. In 1900–1913 exogamy outside the parish decreased to 62%, while endogamy increased to 37%. The average mating distances for all marriages and exogamous ones were 24 and 42 km, respectively, in 1855–1899, while for 1900–1913 the respective figures were 7.4 and 8.7 km. The coefficient of exogamy declined from 0.78 in 1855–1899 to 0.67 in 1900–1913, while the coefficient of biological polygamy grew from 1.19 to 1.30 between those periods. The religious factor, apart from an economic strategy, shaped the annual rhythm of marriage. The outflow of the parishioners from Trzebosz in the early 20th century led to its ageing.     

Iatrogenic Burns of the Neckline in a Patient with Tetraparesis During Tracheotomy

The paper presents a case of an atypical iatrogenic complication after tracheotomy analyzed on the basis of the case dossier materials submitted to the authors by the court of justice to prepare a forensic medical opinion concerning the correctness of the medical procedure. A 37‐year‐old woman was brought by the ambulance service to the hospital with acute respiratory failure due to post‐tracheostomy tracheal stenosis. Tracheotomy was performed on an emergency basis. The patient suffered severe burns of the chest and neck. The experts concluded that the most probable cause of the incident was electrocautery‐induced ignition of the disinfectant used for cleaning the skin before the surgery. It was established that with correct handling of the procedure, the aforementioned incident should not have taken place. Therefore, it cannot be regarded as a normal complication inherent in the risk associated with the procedure, but as a consequence of a medical error.     

Regional parliamentary empowerment in EU affairs. Building an analytical framework

ABSTRACT

This article analyses the effects of the Lisbon Treaty provisions for regional parliaments in EU decentralised systems by looking at the early warning system (EWS) for subsidiarity control. It argues that the implications of this mechanism for parliamentary empowerment at the regional level should be assessed carefully and their links with political mobilisation, institutional restructuring and policy involvement in a particular context should be analysed as precisely as possible. For this reason, this article proposes a conceptual and analytical framework that allows the detection of several kinds of regional empowerment under the EWS and explains their transformative effects in different national contexts.