Assessment of the stability of 30 antipsychotic drugs in stored blood specimens

The accuracy of antemortem diagnosis of pulmonary embolism is within the range of just 10-30%, so representing one of the most frequent missed diagnosis in sudden, unexpected death. We describe 43 fatal cases of pulmonary embolism as confirmed by post-mortem examination. The aim of our study was to verify the systematic search for the most common genetic thrombophilias (Factor V Leiden (G1691A) and FII (G20210A) gene variants) and dating the thrombus. As a whole, 41 patients (95.3%) had at least one risk factor. Pre-existing symptoms are described just before fatal embolism in 18 (41.9%) out 43 patients. In 18 out of 43 (41.9%) it was not possible to find the thrombotic site. In 24 out of the remaining 25 cases the involvement of the deep veins of one leg was shown; in 1 case the thrombus was localised in the inferior caval vein. 10 (41.7%) were iliac vein thromboses, 7 (29.1%) femoral, 2 (8.3%) popliteal, 3 (12.6%) posterior-tibial, 1 (4.1%) anterior-tibial and 1 (4.1%) peroneal vein thromboses. In our cohort of patients, 4 (10%) out of 40 cases carried the 20210A prothrombin gene variant in heterozygosis. One (2.5%) out of 40 carried the Factor V Leiden (G1691A) gene variant in heterozygosis. Patients carrying these gene variants in homozygosis or carrying both were not present in our case-series. We strongly underline the relevance of a complete methodological approach, integrating clinical data by means of autopsy findings and histological study. On the contrary, investigating common inherited thrombophilia is not warranted.     

Whose Reason or Reasons Speak Through the Constitution? Introduction to the Problematics

In the following paper sources of a constitution are put in question in general, and more specifically, the constitutional culture of the European Union Law is being investigated in-depth with regard to principles of deliberative democracy and rulings of the Court of Justice of the European Union. The change of a law application paradigm as well as the change of a legal systems?? nature are taken into account.     

Dynamischer Erhaltungsbegriff und Verbesserungspflicht des Vermieters im MRG

Im Bereich voller Anwendbarkeit des MRG hat der Vermieter für eine Erhaltung des Mietgegenstandes "im jeweils ortsüblichen Standard" zu sorgen. Der vorliegende Beitrag versucht, dem unbestimmten Gesetzesbegriff der Ortsüblichkeit anhand der bisherigen Rechtsprechung Konturen zu verleihen sowie Kriterien für die bisher unklare Abgrenzung zwischen dem dynamischen Erhaltungsbegriff des § 3 MRG und der Verbesserung nach § 4 MRG herauszuarbeiten.     

The Royal Harem of Naser al-Din Shah Qajar (r. 1848–96): The Literary Portrayal of Women's Lives by Taj al-Saltana and Anonymous ‘Lady from Kerman’

The aim of this paper is to describe and analyse the royal harem and its functions during the reign of Naser al-Din Shah Qajar (r. 1848–96), on the basis of two independent Persian-language sources written by noble Iranian women at the turn of nineteenth and twentieth centuries: Naser al-Din's daughter, Taj al-Saltana (1884–1936), who in her famous memoirs vividly rendered her early years spent on her imperial father's court, and ‘Lady from Kerman’ (whose identity remains, for the moment, unclear), who authored a latterly published travelogue of pilgrimage to Mecca and the holy Shi'a places in contemporary Iraq held by her in the early 1890s. The second part of the latter account is entirely dedicated to the sojourn in Tehran, where, upon coming back from the sacred journey, the woman was a frequent guest at the royal harem. Both accounts are unique as they are the only known first-hand sources penned by the female insiders of the harem in nineteenth-century Iran. Furthermore, both authors, who actually met each other, describe the same figures and events – which provide an opportunity to compare their relations and augment our knowledge about Iran in the late Naseri period.     

Review: Pharmacokinetics of illicit drugs in oral fluid

This article reviews studies that have measured drug concentrations in oral fluid following controlled dosing regimens. A total of 23 studies have been identified over the last 15 years. These show that the amphetamines including designer amphetamines, cocaine, cannabis and cocaine are quickly found in oral fluid following dosing and usually have similar time-courses to that in plasma. Following common doses peak oral fluid concentrations exceed 0.1 μg/mL and often even 1 μg/mL. The drug concentration will depend on whether a dilution step occurs with buffer as part of the sampling procedure. The uses of collectors that stimulate oral fluid usually reduce the drug concentration compared to a non-stimulated manner. This reduction will not disadvantage the recipient since it will potentially reduce the detectablity of drug in oral fluid compared to non-stimulated collections. Only one recent study has been reported for a benzodiazepine. This showed nanogram per milliliter concentrations for flunitrazepam. More studies are required for benzodiazepines and indeed for other drugs, particularly in multiple drug situations and where disease may affect the pharmacokinetics of drugs.     

Drugs in oral fluid in randomly selected drivers

There were 13,176 roadside drug tests performed in the first year of the random drug-testing program conducted in the state of Victoria. Drugs targeted in the testing were methamphetamines and Δ⁹-tetrahydrocannabinol (THC). On-site screening was conducted by the police using DrugWipe^®, while the driver was still in the vehicle and if positive, a second test on collected oral fluid, using the Rapiscan^®, was performed in a specially outfitted “drug bus” located adjacent to the testing area. Oral fluid on presumptive positive cases was sent to the laboratory for confirmation with limits of quantification of 5, 5, and 2 ng/mL for methamphetamine (MA), methylenedioxy-methamphetamine (MDMA), and THC, respectively. Recovery experiments conducted in the laboratory showed quantitative recovery of analytes from the collector. When oral fluid could not be collected, blood was taken from the driver and sent to the laboratory for confirmation. These roadside tests gave 313 positive cases following GC–MS confirmation. These comprised 269, 118, and 87 cases positive to MA, MDMA, and THC, respectively. The median oral concentrations (undiluted) of MA, MDMA, and THC was 1136, 2724, and 81 ng/mL. The overall drug positive rate was 2.4% of the screened population. This rate was highest in drivers of cars (2.8%). The average age of drivers detected with a positive drug reading was 28 years. Large vehicle (trucks over 4.5 t) drivers were older; on average at 38 years. Females accounted for 19% of all positives, although none of the positive truck drivers were female. There was one false positive to cannabis when the results of both on-site devices were considered and four to methamphetamines.