Determination of carbohydrate deficient transferrin (CDT) with capillary electrophoresis: an inter laboratory comparison

Carbohydrate deficient transferrin (CDT) is currently the most specific laboratory marker of chronic or sustained alcohol abuse. CDT is increasingly being used as a diagnostic tool in the areas employment, traffic safety and forensic medicine. In recent times, capillary electrophoresis (CE) has been proposed as a convenient tool for rapid, precise and accurate CDT determination, not only for research but also for routine analyses. Quite recently, commercial kits have been introduced which, reportedly, could simplify and standardize CDT analysis with capillary electrophoresis. The present work was aimed at testing the ruggedness of a capillary electrophoretic method based on a commercial kit (CEofix, Analis), by comparing the results obtained with different instruments in different laboratories, on a panel of sera randomly collected and exchanged. The results showed, notwithstanding few outliers, excellent correlation of the results obtained in the two laboratories (R=0.974). Also high concordance was found when results were classified as positive or negative on the basis of a cut-off (1.25%) established from a control group of teetotalers. In conclusion the present data support the usefulness of capillary electrophoresis for CDT determination for clinical, forensic and administrative diagnosis of chronic alcohol abuse.     

Case report of a fatal intoxication by citalopram

Citalopram is an antidepressant drug within the group of the selective serotonin reuptake inhibitors (SSRI). It is widely prescribed both in Europe and in United States, and it has always been considered a "safe" drug as pure intoxication with lethal outcome is rare, and most cases of overdose, even with high doses of citalopram ingested, are reported to have an uneventful course.We report the case of a young woman found dead at home. She had been prescribed citalopram by her family doctor 3 weeks before her death for a depressive syndrome. Police found in her house 3 empty blister packages of 28 citalopram tablets (20 mg) and 2 bottles of citalopram oral solution (4%, 15 mL each). The autopsy findings were unremarkable. Nasal swabs, blood from femoral vein, urine, bile and tissue samples were collected for toxicologic investigation. Citalopram separation was performed by solid/liquid method, using Bond-Elute columns. The extracts were analyzed by GLC and GC/MS methods. The toxicologic analysis showed high levels of citalopram in all the examined fluids and tissue samples (blood concentration: 11.60 mg/L). No other drugs and alcohol were detected. Our data confirm that if no other drug is involved, fatal complications occur only after ingestion of very high doses. However, there is no predefined "toxic dose," and the conditions under which the overdose occurs can be very important. We report the exact concentrations of the citalopram in the organs, and wethink that this can be useful in the cases where the blood samples were not available (ie, carbonized or decomposed body).     

Parenting,Peer Orientation,Drug Use,and Antisocial Behavior in Late Adolescence: A Cross-National Study

The objective of this study was to investigate the links between maternal and paternal bonding, parental practices, orientation toward peers, and the prevalence of drug use and antisocial behavior during late adolescence. A model was tested using structural equation modeling in order to verify the robustness of the investigated links across 3 countries: Canada, France, and Italy. A self-report questionnaire was given to a sample of 908 adolescents, with an equivalent number of girls and boys, in Grade 11. The questionnaire assessed the following variables: parental bonding, parental supervision, parental tolerance, orientation toward peers, involvement in physically aggressive antisocial behavior, non-physically aggressive antisocial behavior, and drug use. The model was robust across the 3 countries, thus confirming a path that identified quality of emotional bonds between adolescents and their parents as a distal variable acting upon deviant behaviors through the following mediators: parental supervision, parental tolerance, frequency of conflicts, and orientation toward peers. Michel Claes is full professor at the Université de Montréal, Canada. He received his Ph.D. in Education from Université Catholique de Louvain, Belgium. His major research interest is in social development in adolescence, with a special focus on intercultural studies.     

Tax Amnesties and the Self-Selection of Risk-Averse Taxpayers

In this paper we model taxpayers participation in an unexpected tax amnesty, which can be entered by paying a fixed amount. Taxpayers are characterized by a Constant Relative Risk Aversion (CRRA) utility function and differ in relative risk aversion coefficient and in income. We show that amnesties may fail as a self-selective device to fully separate big from small evaders and to extract resources from the former. Only taxpayers whose relative risk aversion falls within a given interval participate, while those whose evasion is too small or too large do not enter. The model is used to estimate relative risk aversion and tax evasion of participants in 1991 and 1994 Italian income tax amnesties.JEL Classification: H260, D890, K420     

The cocaine "body stuffer" syndrome: a fatal case

Body stuffer, sometimes called "mini packer", is the definition of someone who admits to or is strongly suspected of ingesting illegal drugs in order to escape detection by authorities, and not for recreational purposes or to transport the drug across borders. Cocaine is the drug most commonly involved in the body stuffer syndrome. Reported cases of body stuffer deaths are rare, however a fatality related to the ingestion of a plastic bag containing cocaine is described regarding a 17-year-old dealer. The authors describe how the cocaine body stuffer syndrome differs from the usual body packer. Histological and toxicological findings are examined and discussed for a better definition of this unique syndrome.     

An Unusual Case Showing Fatal Rupture of a Gastric Ulcer or Gastromalacia? The Importance/Role of Histology for Differential Diagnosis

Gastromalacia is the acute autolytic erosion of the gastric wall. It generally occurs postmortem, and it appears as a slimy brownish black region of the wall which occurs principally in the gastric fundus. A 59‐year‐old woman died in the Emergency Department following a 2‐day period of mild abdominal pain, vomiting, and diarrhea. A forensic autopsy was performed which revealed a rupture of the gastric fundus that had caused leakage of gastric content into the abdominal cavity. There was no macroscopic evidence of peritonitis, and the stomach wall adjacent to the rupture site showed marked thinning. The gross appearance was typical of gastromalacia. In contrast, histological observations revealed the presence of an ulcer at the site of perforation and a severe acute inflammatory reaction indicating a robust reaction with an antemortem rupture.     

Handling manipulated evidence

Bayesian Networks have been advocated as useful tools to describe the relations of dependence/independence among random variables and relevant hypotheses in a crime case. Moreover, they have been applied to help the investigator structure the problem and evaluate the impact of the observed evidence, typically with respect to the hypothesis of guilt of a suspect. In this paper we describe a model to handle the possibility that one or more pieces of evidence have been manipulated in order to mislead the investigations. This method is based on causal inference models, although it is developed in a different, specific framework.