Insight into stress-induced cardiomyopathy and sudden cardiac death due to stress. A forensic cardio-pathologist point of view

Emotional, physiological and physical stress is associated with increased rates of cerebrovascular events and sudden deaths. The pathophysiology of stress-induced cardiomyopathy is not well understood. Proposed mechanisms for catecholamine-mediated stunning in stress cardiomyopathy include epicardial vasospasm, microvascular dysfunction, hyperdynamic contractility with midventricular or outflow tract obstruction, and direct effects of catecholamines on cardiomyocytes. Studies show evidence of significant heritable influences on individual responses to adrenergic stimulation. Data from such studies may be of help for a more accurate comprehension of clinical and morphological alterations of the heart. Irrespective of the cause, patients with the classic stress-induced cardiomyopathy morphology deserve special attention because this extensive distribution of wall motion abnormalities has implications for potential associated complications. Cardiac response may be significantly coupled to genetic differences at candidate loci that encode components of catecholamine biosynthesis, storage, and metabolic pathway. Given the role of the sympathetic nervous system in responses to acute stress, it is reasonable to explore whether genetically determined alterations in catecholamine system functions contribute to acute and chronic cardiovascular disorders such as stress-induced cardiomyopathy.     

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.     

Not the only game in towns: explaining changes in municipal councils in post-revolutionary Tunisia

This study sheds light on the relationship between local and national elites during political transitions. Examining local councils in post-revolutionary Tunisia (2011–2013), it examines why and when the composition of councils changed in the absence of local elections. The study yields two important lessons. First, changes in councils resulted from a power struggle between national and local elites. Councils were more likely to remain in place when local parties and unions helped council members resist pressures from above. The interplay of local and national actors, and not the council’s competencies, explains when changes took place. Second, all councils became politicized in the process. Far from being caretaker councils impartially addressing local needs, the councils were institutions playing important roles in the struggles between local and national political elites. Councils were arenas in which political power, and notions of legitimate representation, were contested in the absence of elections. The argument is supported by quantitative analyses of original data and four comparative case studies based on qualitative fieldwork. The findings highlight the importance of local councils in transition processes and provide a basis for further work exploring local-national engagement in democratization.