Carbohydrate-deficient transferrin (CDT): A reliable indicator of the risk of driving under the influence of alcohol when determined by capillary electrophoresis

Carbohydrate-deficient transferrin (CDT) is a marker of chronic alcohol abuse, which has recently been introduced to evaluate the physical fitness for obtaining a driving license. The aim of the present study was to evaluate the prevalence of elevated CDT levels in subjects stopped while driving under the influence of alcohol by using a validated method based on capillary electrophoresis. The study was carried out on a group of 40 drunken drivers (group A) and on a control group (n = 51) of subjects chosen from the general population (group B). CDT was directly determined by capillary electrophoresis in free solution and UV detection at 200 nm. CDT results from both groups were classified as “negative” or “positive” on the basis of the cut-off set at 2.00% (CDT index). The subjects classified as “positive” in group A were 24 (60%), whereas in group B were 2. The subjects classified as “negative” in group A were 16 (40%), whereas in group B was 49 (96.1%). The comparison of the observed percentages, evaluated with the χ²-test, was highly significant (p < 0.001). The present study confirms the high prevalence of chronic alcohol abusers among drunken drivers and the usefulness of CDT as a predictor of the risk of drunk driving.     

Sharp Force Injury Fatalities: A Retrospective Study (1982–2012) in Brescia (Italy)

A retrospective study was carried out on postmortem examination data of 131 sharp force‐related casualties recorded by the Brescia Institute of Forensic Medicine between 1982 and 2012. The objective was to identify relevant parameters that may be used to distinguish the manner of deaths between homicide, suicide, and accident. The following variables were considered: manner of death; demographic data; scene; type of sharp object; location and numbers of wounds; the presence of hesitation marks/defense wounds; toxicological findings; psychiatric history. There were 92 homicides, 28 suicides, and 11 accidents. Most victims were male, with an average age of 43. Injuries in isolation were present in 9.8% of homicides, in 35.7% of suicides, and in 54.5% of accidents. Most injuries involved the left anterior chest in homicides and the forearms in suicides. This study underlines the importance of a meticulous postmortem examination of injuries on the body and their relationship with other results from the death scene investigation.     

Medical care of individuals residing in substance abuse and recovery homes: an analysis of need and utilization

The current study examined medical care need and utilization patterns among a substance abusing and recovering population (n = 876), investigating factors such as employment and drug use categories (e.g., pharmaceutical use, cocaine use, heroin use, alcohol use). It was found that those who were unemployed needed and utilized greater medical care than those who were employed. Results indicated that heroin, cocaine, and/or alcohol use was not predictive of medical care need or utilization, whereas pharmaceutical drug use was predictive of medical care need and utilization. Trauma and risky use of substances were not significant predictors of medical care need or utilization whereas the suicide severity composite was significant. Potential implications for misuse of medical services (e.g., to obtain pharmaceutical drugs of use) and federal medical care expenditure allocation are discussed.     

Facilitating the Italian Mafia: The Grey Zone of Complicity and Collusion

Despite structural and operational differences, Italian mafias share an ability to expand and infiltrate global economies whilst remaining rooted within their local territory. They are not only the product of specific socio-economic and political conditions but also of the extensive complicity on which they can count. It is this fertile ‘grey zone’ of mafia relations with accomplices identified as enablers, facilitators, sponsors and helpers that is analysed here. Engaging with the existing literature and using a range of new judicial sources, including evidence from mafia trials, this article develops in-depth case studies to identify and examine the hidden face of Italian mafias.     

How the European Community Entered the United Nations, 1969–1976, and What It Meant for European Political Integration

During the first half of the 1970s, the European Community became a recognisable actor at the United Nations [UN]: The Community itself became a permanent observer, and it was customary for Community member-states to express common positions on most of the issues discussed within the organisation. It was a remarkable development for the Western European states—yet one not satisfactorily accounted for by the existing literature. The perspective adopted in this analysis highlights the connexions between the growing activity of the Community at the UN and the increasing co-ordination of its member-states even on matters falling outside the Community’s purview, as well as the connexions between the affirmation of the European Community at the UN and other major contemporary developments in European political integration. In this way, this analysis sheds light on some fundamental motives, features, and limits of Western European co-ordination on the international stage.     

Monitoring compliance to therapy during addiction treatments by means of hair analysis for drugs and drug metabolites using capillary zone electrophoresis coupled to time-of-flight mass spectrometry

Capillary electrophoresis coupled to time-of-flight mass spectrometry was used in the present work for the determination of therapeutic and abused drugs and their metabolites in the hair of subjects undergoing addiction treatments, in order to monitor their compliance to therapy. For this purpose a rapid, qualitative drug screening method was adopted based on capillary electrophoresis hyphenated with time-of-flight mass spectrometry, which had earlier been developed and validated for the forensic-toxicological analysis of hair, limitedly to illicit/abused drugs [1]. Sampling of hair was carried out in order to refer to a time window of about two months from the date of sampling (i.e. 2cm ca. from cortex). A single extraction procedure was applied, allowing the determination in the hair matrix of "drugs of abuse" referred to the past abuses, and therapeutic drugs prescribed in the detoxification program as well as their metabolites. Analyte identification was based on accurate mass measurements and comparison of isotope patterns, providing the most likely matching between accurate mass value and elemental formula. Small molecules (<500Da) of forensic and toxicological interest could be identified unambiguously using mass spectrometric conditions tailored to meet a mass accuracy ≤5ppm. In the present study, the proposed approach proved suitable for the rapid broad spectrum screening of hair samples, although needing further confirmation of results by using fragmentation mass spectrometry.     

Misidentified political figures: an underappreciated danger

A series of twelve patients is presented in which each patient suffered from one or more misidentification syndromes and also misidentified one or more political figures. The fact that misidentification syndromes have been associated with physical violence and that the majority of the patients studied had a history of physical violence suggests that these individuals could pose a significant danger of physical harm to others, including political figures. Persons who threaten political figures should be evaluated for misidentification syndromes.     

Hair analysis for driving licence in cocaine and heroin users. An epidemiological study

Diagnosis of drug exposure is strongly supported by analysis of hair samples. In the province of Brescia, Italy, for regranting driving license to drug addicts or occasional abusers, a control programme was adopted including analysis of illicit drugs in two hair segments (0-3 and 3-6 cm) and in urine. From January 1998 to April 1999, upon request of the Local Medical Commission, 697 hair samples were tested in our laboratory. One hundred and eighty subjects resulted positive in hair for one or two of the controlled drug classes (73.3% for cocaine, 10% for opiates, 16.7% for both). Positive subjects were classified by residence, age, sex and license category. Seventy-two subjects were called back after 6-12 months and submitted to a second hair and urine analysis: in 34 cases the result of the first analysis was confirmed (19 negatives, 15 positives for one or both drug classes). Another 37 cases tested positive at the first control and negative at the second, suggesting the hypothesis that a strict control may have a significant deterrent function. The high percentage of negative results at the second control may be explained by the prevalence of cocaine users in the examined population. Our results allow us to conclude that the strict application of control rules lead to a decrease of social risk behaviours.