Causes of unexpected death in patients with multiple sclerosis: a forensic study of 50 cases

To determine the cause of death (as a result of neurologic or nonneurologic complications or accidents) in patients with multiple sclerosis (MS), we reviewed the autopsies of 50 subjects with MS from the Office of the Chief Medical Examiner of Maryland (OCME) between 1982 and 2004. The series included 32 females and 18 males (mean age, 45.8 years; range, 25-69 years) and the causes of death were classified into 3 categories: (A) neurologic complication directly related to MS; (B) nonneurologic complications or other medical causes; and (C) accidents, etc. Of the 50 cases, in 43 there was a history of MS, but in 7 subjects there was not, and the diagnosis was established by neuropathologic examination. In Group A, 21 (42%) cases, deaths were directly related to a neurologic complication; in Group B, 14 (28%) cases were related to the following nonneurologic and medical causes: ASCVD 9 (18%), metabolic disorder 1 (2%), pulmonary embolism 3 (6%), and bronchopneumonia 1 (2%); and in Group C, 15 (30%) cases, deaths were due to trauma, 9 (18%); intoxication, 5 (10%); and thermal injury, 1 (2%). Thus, among the 50 subjects, in 26, deaths occurred naturally; and in 24, from accidents, homicides, suicides, or undetermined causes. Pathologically, the majority of cases showed either chronic inactive (66.7%) or chronic active (15.6%) demyelinating lesions, mainly in the cerebral hemispheres. In some cases, it appears that demyelinating lesions, involving brain regions that regulate cardiorespiratory activity, could be considered as the immediate cause of death, but a large proportion appears to be due to other causes such as accidents and trauma. Thus, it seems likely that taking specific precautions could prevent some deaths in MS.     

Vertical Competition in the Spanish National Health System (NHS)

In unitary states, competitive decentralisation structures can take place by increasing the visibility of politically accountable jurisdictions in certain policy responsibilities such as health care. Drawing from the Spanish decentralisation process we examine the mechanisms (and determinants) of vertical competition in the development of health policies in the Spanish National Health System. The Spanish example provides qualitative evidence of vertical competition that assimilates government outcomes of unitary states to that of federal structures. The Spanish experience indicates that the specific vertical competition mechanisms in place until 2002 are likely to be responsible for significant policy innovation and welfare state development.     

Age estimation from teeth in children and adolescents

The aim of this cross-sectional study was to evaluate the dental formulas according to age because of possible changes during the last decades. From these dental formulas, the median age of emergence for the permanent teeth was deduced. The study population corresponded to the 1 to 15 year-old children who had consulted either a pediatric dentist or orthodontist in the city of Nice (France). Data were collected from the 5,848 patients' charts that included an orthopantomography. This permitted the observation of emerged teeth and agenesis. Bar charts were used to indicate the dental formula according to age. There was no significant difference in the emergence pattern of both controlateral maxillary and mandibular teeth. Only the anterior tooth emergence significantly differed according to the maxillary. The lower central incisor was the lone tooth with a median age earlier than others; the remaining teeth had an age equivalent to those of previously estimates.     

Imaginaries of the Pandemic in Chile: A Conceptual-Empirical Discussion

This article aims to reconstruct the social imaginaries of Coronavirus disease 2019 (COVID-19) in Chile. We seek to understand how families interpret their experience confronting the pandemic by identifying four main aspects: (a) the COVID-19 pandemic, (b) working and learning, (c) health and (d) family life. Following Habermas' distinction between lifeworld and social systems, we consider these issues as constituting the social imaginary of lifeworld, different but related to the imaginaries of social systems. The qualitative empirical data was gathered through a sample of 38 families interviewed online between September 2020 and January 2021 in four Chilean cities: Iquique, Valparaíso, Santiago and Concepción. Other complementary sources of information are multimodal ethnography (digital diaries), press articles and state reports.     

Una aproximació bourdieuana a tres plataformes de difusió de poesia a Mallorca (1974–1990)

Abstract

En aquest article em propòs analitzar tres plataformes de difusió de poesia sorgides en el context mallorquí dels anys 70, 80, i 90, aprofitant l’aportació del sociòleg francès Pierre Bourdieu al voltant de la teoria del camp literari. La pretensió és establir un diàleg amb aquesta proposta teòrica i il·lustrar-la amb casos com el dels quaderns de poesia Domini Fosc (1974–1975), la revista L’Ombra Vessada (1979–1981), i les Edicions Atàviques (1985–1990), tenint en compte, per una banda, que els productes literaris que examinaré s’inscriuen en una línia experimentalista i, per l’altra, que la literatura catalana és institucionalment deficitària – a diferència de la francesa, en la qual es basa Bourdieu.     

Critical legal and environmental view on the Ramsar Convention in protection from invasive plant species: an example of the Southern Pannonia region

The emergence and continued expansion of one of the most dangerous causes of biodiversity loss and habitat alteration such as invasive species at some Ramsar wetlands of the Southern Pannonia raise a series of questions of both an environmental as well as a legal character relevant to these fragile ecosystems. The Ramsar Convention provides a set of general instructions and guidelines, but it does not establish an adequate mechanism of sanctions that could be imposed on states or individuals who violate its provisions. Fully aware of the importance of wetlands and their wildlife for a healthy living environment and human welfare, the authors of this paper describe the present conditions of invasive plant species at some Ramsar Sites and briefly analyze the current legal framework for the implementation of the Ramsar Convention. Finally, the authors propose innovative normative solutions that would improve the protection of wetlands and contribute to the suppression and prevention of the presence of invasive species not only in this region, but also worldwide.     

Development and Validation of a Method Using Dried Oral Fluid Spot to Determine Drugs of Abuse

A liquid chromatography–mass spectrometry method using dried oral fluid spots was developed and validated for the simultaneous quantification of cocaine, benzoylecgonine, cocaethylene, amphetamine, and 3,4‐methylenedioxymethamphetamine. The oral fluid was applied to a Whatman 903 grade paper and submitted to a drying time of 2.5 h. The extraction procedure was optimized by chemometric approach using simplex centroid design. Spots were extracted with a mixture of acetonitrile, buffer, and methanol. Calibration curves covered a linear concentration range of 40–500 ng/mL. Validation parameters of linearity, precision, accuracy, selectivity, carryover, matrix effects, and stability were evaluated and showed satisfactory results. Spot homogeneity was also satisfactory, with less than 15% of deviation from nominal concentration. Spot volume did not influence accuracy when less than 100 μL of the sample was applied to the spot. The validation of the proposed method suggests a potential application in different scenarios in toxicology.