Glucose and lactate in vitreous humor compared with the determination of fructosamine for the postmortem diagnosis of diabetes mellitus

Diabetes mellitus is a chronic metabolic illness responsible for a great number of deaths. In postmortem diagnosis, because of the difficulty involved in interpreting blood glucose levels and relatively nonspecific pathologic features, biochemical markers in vitreous humor are useful. The aim of this study was to compare the results obtained for the combined determination of lactate and glucose with fructosamine levels recorded in the vitreous humor of two diagnostic groups (one diabetic and the other nondiabetic). The authors intended to ascertain the capacity of different markers measured in vitreous humor to diagnose diabetes mellitus. Fifty-one cadavers (mean age, 58.7 years; standard deviation, 17.09) were studied. The mean postmortem interval was 16.4 hours (standard deviation, 9.05). Cases were assigned to two diagnostic groups according to whether they were previously diagnosed as either diabetic or nondiabetic. Statistically significant differences for glucose, fructosamine, and the sum values of glucose and lactate were found between the two diagnostic groups. The highest levels were obtained in the group of cases with a previous diagnosis of diabetes mellitus. After the comparison of receiver operating characteristic curves, the sum values of glucose and lactate in vitreous humor is a better predictor of antemortem diabetes mellitus than the fructosamine.     

A Call to Action—The Essential Role of Advocacy

Editor's Note: The Perspectives featured in this issue of Public Administration Review were adapted from May 2016 commencement addresses: Anna Maria Chavez, the CEO of the Girl Scouts of the USA, spoke on the 12th at Arizona State University's College of Public Service and Community Solutions; Nancy Pelosi, the Democratic Leader in the United States House of Representatives spoke on the 7th at New York University's Wagner School of Public Service; and Tommy Thompson, the former Governor of Wisconsin and Secretary of Health & Human Services, spoke on the 15th at the University of Wisconsin's La Follette School of Public Affairs. These Perspectives reaffirm the highest principles of American public administration: that by and large, government is NOT the problem, and quite often indeed holds the solution; that effective and helpful public policy depends on informed expert opinion and research; and that those who enter public service should do so with a commitment to the notion that America best fulfills its promise when we seek the well‐being of all people, including the least fortunate. We chose these messages from among a wealth of commencement speeches because while they come from leaders with quite different political views, background, and experience, taken together they offer a coherent and inspiring call to public service. Dan Feldman, Perspective and Commentary Editor     

Horizontal mergers and efficiencies; theory and anti trust practice

Horizontal mergers can be challenged by anti trust authorities under both the US and EU Horizontal Merger Guidelines. More horizontal mergers are unconditionally approved in the US than in the EU. EU merger policy toughened after 1998 but became more in line with US practices after 2004. Differences in merger policies between the US and the EU can be explained by a greater scope of the efficiency argument in the US. The paper argues that firms only want to merge in oligopoly, if they expect to realize substantial merger specific efficiency gains, which counterbalances the price increasing effect of merger.