Fatal venlafaxine overdose with acinar zone 3 liver cell necrosis

We present a case of fatal venlafaxine overdose in a 34-year-old male with a history of depression and previous suicide attempts. He presented unwell, and his condition deteriorated with the development of rhabdomyocytolysis and renal failure. Although treatment was provided, this was unsuccessful, and he died within a day of his admission. A postmortem examination was performed, and the findings included an acinar zone 3 pattern of liver cell necrosis and a very high level of serum venlafaxine in the deceased. No other elevated drug levels were detected. From this case, it is clear that venlafaxine overdose was the primary cause of a fatal acinar zone 3 pattern of liver cell necrosis. As far as we are aware, this is the first reported case of fatal acinar zone 3 liver necrosis caused by venlafaxine overdose alone.     

Party System Compactness: Measurement and Consequences

Jonathan Nagler Department of Politics, New York University, 726 Broadway, Room 752, New York, NY 10003 e-mail: jonathan.nagler{at}nyu.edu An important property of any party system is the set of choicesit presents to the electorate. In this paper we analyze thedistribution of parties relative to voters in the multidimensionalissue space and introduce two measures of the dispersion ofthe parties in the issue space relative to the voters, whichwe call measures of the compactness of the parties in the issuespace. We show how compactness is easily computed using standardsurvey items found on national election surveys. Because westudy the spacing of the parties relative to the distributionof the voters, we produce metric-free measures of compactnessof the party system. The measures can be used to compare partysystems across issues, over time within countries, and acrosscountries. Comparing the compactness of party systems acrosscountries allows us to determine the relative amount of issuechoice afforded voters in different polities. We examine thecompactness of the issue space and test the impact it has onvoter choice in four countries: the United States, the Netherlands,Canada, and Great Britain. We demonstrate that the more compactthe distribution of the parties in the issue space on any givenissue, the less voters weight that issue in their vote decision.Thus we provide evidence supporting theories suggesting thatthe greater the choice offered by the parties in an election,the more likely it is that issue voting will play a major rolein that election.     

Frank Meyer: The Fusionist as Federalist

Frank S. Meyer played a central role in defining the post-warAmerican conservative movement by defining and defending anideological "fusion" of traditional conservative principlesand libertarian political beliefs. While concerned with maintenanceof an objective moral order and the pursuit of virtue in theindividual, Meyer argued that the freedom of the person is thecentral and primary end of political society. The American systemof government, with its horizontal and vertical separationsof power, came closer than any political system in history toproviding the protection for individual liberties necessaryfor the effective pursuit of virtue. Federalism was particularlyimportant as it could forestall the centralization of governmentpower. Virtue, to have any meaning, had to be chosen freely,but providing for individual freedom provided no guarantee thatindividuals would pursue virtuous ends. By the same token, federalismand the separation of powers did not guarantee that state governmentswould adopt wise or moral policies, as the history of the civilrights struggle attests. Nonetheless, Meyer believed federalismwas essential if individual freedom was to endure.     

The role of mercantilism, humanitarianism, and gaiatsu in Japan's ODA programme in Asia

Objective. Three competing explanations for the distributionof Japan's ODA in Asia are empirically examined in this paper.The first explanation hypothesizes that Japan reacts to US pressureand interests as it formulates its foreign aid policy. The competingexplanations argue that Japanese ODA is used to promote Japan'snational economic interests or humanitarian goals. Methods.We examine the determinants of Japanese ODA in 14 Asian countriesfor the period of 1979–1998. The effects of the independentvariables are estimated using ordinary least squares (OLS) withpanel-corrected standard errors. Results. US strategic interestswere found to have no effect on aid disbursements for the periodin question. Rather, we find that Japan's national economicinterests have shaped Japanese aid decisions in Asia. The disbursementpattern of Japanese ODA is also influenced by poverty in therecipient country. Employing measures from the Political TerrorScale, Freedom House, and Polity IV, we find no effect for democracyor human rights.     

Japan's cautious new activism in the Middle East: a qualitative change or more of the same?

This article analyses Japanese policy towards the Middle Eastin the post-Cold War era. The article argues that Japanese policyhas begun to move beyond the reactive diplomacy of the ColdWar years. The focus of this new approach has been Japan's growingcontribution to ‘soft’ security in the region. However,Japan retains a tendency to focus on its narrow interests withoutfully taking into account the broader strategic consequencesof its policies. Yet, in order to protect its overall interestsin the region, Japan needs to recognize the diminishing utilityof this ‘free rider’ approach and adopt a more activerole regarding ‘hard’ security issues. Even allowingfor the domestic constraints on Japanese policy, there is muchJapan can do in this regard, especially in coordination withthe US.     

Interpreting small quantities of DNA: the hierarchy of propositions and the use of Bayesian networks

The dramatic increase in the sensitivity of DNA profiling systems that has occurred over recent years has led to the need to address a wider range of interpretational problems in forensic science. The issues surrounding questions of the kind "whose DNA is this?" have been the subject of considerable controversy but now it is clear that the emphasis is shifting to questions of the kind "how did this DNA get here?" Such issues are discussed in this paper and new insights are provided by two particular recent developments. First, the notion of the "hierarchy of propositions" that has arisen from a project called Case Assessment and Interpretation (CAI) that has been running in the British Forensic Science Service (FSS). Second, a technique for drawing inferences in the face of many interacting considerations, known as "Bayesian networks"--or "Bayes' nets" for short--that has been the subject of an earlier paper in this journal (1). The discussion is carried out by means of case studies, based on actual cases. It is clear that, whereas the inference in relation to the source of the DNA in a crime sample might be overwhelmingly strong, the inference in relation to the propositions that a jury must consider relating to the identity of the actual offender may be much more tentative.     

Ecstasy (MDMA) deaths in New York City: a case series and review of the literature

MDMA ("ecstasy") has gained renewed popularity as a drug of abuse. To access the epidemiology and causes of death of MDMA-positive fatalities, all deaths investigated by the OCME that tested positive for MDMA (22 deaths) between January 1997 and June 2000 were reviewed. There were three deaths in each 1997 and 1998, eleven in 1999, and five in the first part of 2000. Of these 22 deaths, 13 were due to acute drug intoxications, 7 due to mechanical injury (blunt trauma, gunshot wounds), and 2 due to a combination of natural disease and acute drug intoxication. Evidence of recent opiate and/or cocaine use was found in 7 of the acute intoxication deaths and in none of the traumatic or combination natural/intoxication deaths. The race of all decedents was White between the ages of 17-41 years, and 18 of 22 were men.     

Biosafety considerations for autopsy

An autopsy may subject prosectors and others to a wide variety of infectious agents, including bloodborne and aerosolized pathogens such as human immunodeficiency virus, hepatitis B and C viruses, and Mycobacterium tuberculosis. Other hazards include toxic chemicals (e.g., formalin, cyanide, and organophosphates) and radiation from radionuclides used for patient therapy and diagnosis. These risks can be substantially mitigated through proper assessment, personal protective equipment, appropriate autopsy procedures, and facility design.