Investigation of morphine and morphine glucuronide levels and cytochrome P450 isoenzyme 2D6 genotype in codeine-related deaths

Compared to morphine and morphine-6-glucuronide (M6G), codeine and its other major metabolites codeine-6-glucuronide and norcodeine have weak affinity to opioid μ-receptors. Analgesic effects of codeine are thus largely dependent on metabolic conversion to morphine by the polymorphic cytochrome P450 isoenzyme 2D6 (CYP2D6). How this relates to toxicity and post-mortem whole blood levels is not known. This paper presents a case series of codeine-related deaths where concentrations of morphine, M6G and morphine-3-glucuronide (M3G), as well as CYP2D6 genotype, are taken into account. Post-mortem toxicological specimens from a total of 1444 consecutive forensic autopsy cases in Central Norway were analyzed. Among these, 111 cases with detectable amounts of codeine in femoral blood were identified, of which 34 had femoral blood concentrations exceeding the TIAFT toxicity threshold of 0.3mg/L. Autopsy records of these 34 cases were retrieved and reviewed. In the 34 reviewed cases, there was a large variability in individual morphine to codeine concentration ratios (M/C ratios), and morphine levels could not be predicted from codeine concentrations, even when CYP2D6 genotype was known. 13 cases had codeine concentrations exceeding the TIAFT threshold for possibly lethal serum concentrations (1.6 mg/L). Among these, 8 individuals had morphine concentrations below the toxic threshold according to TIAFT (0.15 mg/L). In one case, morphine as well as M6G and M3G concentrations were below the limit of detection. A comprehensive investigation of codeine-related fatalities should, in addition to a detailed case history, include quantification of morphine and morphine metabolites. CYP2D6 genotyping may be of interest in cases with unexpectedly high or low M/C ratios.     

Whole body postmortem magnetic resonance angiography

Computed tomography (CT) and magnetic resonance (MR) imaging have become important elements of forensic radiology. Whereas the feasibility and potential of CT angiography have long been explored, postmortem MR angiography (PMMRA) has so far been neglected. We tested the feasibility of PMMRA on four adult human cadavers. Technical quality of PMMRA was assessed relative to postmortem CT angiography (PMCTA), separately for each body region. Intra-aortic contrast volumes were calculated on PMCTA and PMMRA with segmentation software. The results showed that technical quality of PMMRA images was equal to PMCTA in 4/4 cases for the head, the heart, and the chest, and in 3/4 cases for the abdomen, and the pelvis. There was a mean decrease in intra-aortic contrast volume from PMCTA to PMMRA of 46%. PMMRA is technically feasible and allows combining the soft tissue detail provided by MR and the information afforded by angiography.     

The 1972 Memorandum to the United Nations and its repercussions: Émigré politics and Soviet Estonian dissent during the ‘era of stagnation’

The Estonian dissidents’ Memorandum to the United Nations, drafted as a call for national self-determination in 1972, set new standards for the émigré community’s campaigns. Although its political message was initially dismissed as utopian, the subsequently emerging cooperation between émigré and homeland activists via intricate courier networks significantly strengthened the authority of Estonian voices in the West. By the early 1980s, the political alliances across the Iron Curtain eventually bore fruit. The Memorandum’s core demands reappeared in political debates on Baltic issues on both sides of the Atlantic, foreshadowing the massive Western support for the Baltic cause during the Singing Revolutions.     

Diversifying Nature Protection: Evaluating the Changing Tools for Forest Protection in Canada and Norway

Governments increasingly struggle to protect representative nature types and ecological diversity within their territories only via the instrument of publicly designated protected areas. This article examines the rise of voluntary conservation and certification (i.e., private conservation) as tools for forest protection in Norway and Canada. We contrast the differing potential of these private conservation tools with protection through government legislation and regulation using four evaluative criteria: the representativeness of protected areas, the strength of protection, the longevity of protection, and the information generated through protection. We find that private conservation tools can match the strength of legal protection and help to dispel conflict, but that private tools create protection that is more likely to be reversed in the future. However, we also show that voluntary private conservation can become public protection, which highlights the importance of examining different paths toward secure and long‐lasting protection.     

Legal Regulation and Communicative Couplings

From 1989 to 1991 we studied the relationship between legal regulation and decisions about acceptable risk at off‐shore installations in the North Sea. The study focused on the interaction between authorities and private actors, when they develop subsidiary rules, discuss projects, and execute audits. This article discusses the case of regulation within the framework of communicative systems theory; the problem is how to couple differentiated, closed functional systems (e.g., law and economy). Applying empirical data we attempt to create a more complex understanding of the communicative processes, on the basis of which we can elaborate upon the coupling between systems, and the potential effects of law. The point of the article is that the coupling itself may develop into a new independent system (the discursive system). If this is correct and fairly generalizable, legal regulation contributes to the differentiation of society into closed systems. At the practical level the differentiation will have consequences for both regulation and democracy.     

Using a natural experiment to measure the impact of swifter punishment on criminal recidivism

Journal of Experimental Criminology - Measure the impact of swifter punishment on the timing of first imprisonment and on criminal recidivism among young violent offenders. A policy reform in 1994...     

Antwort auf die Replik von Daniel Göler zum Beitrag “Das Regieren jenseits des Nationalstaates und der Mythos einer 80-Prozent-Europäisierung in Deutschland”

Ohne Zusammenfassung “In zehn Jahren werden 80% der Wirtschaftsgesetzgebung, vielleicht auch der steuerlichen und sozialen, gemeinschaftlichen Ursprungs sein.“ Rede von Jacques Delors am 6.7.1988 vor dem Europ?ischen Parlament (Nr. 2-367/157)     

Economic Models in Politics: An Introduction

The constitutional future of the European Union (EU) has attracted many scholars in economics and political science to apply their knowledge on political institutions and propose concrete suggestions. We highlight that economists and political scientists proceed quite differently in this endeavour and suggest that, due to this, they also are exposed to different pitfalls. We illustrate this by critically assessing specific proposals made in the context of the proposed constitution for the EU.