Morphine Concentrations in Stomach Contents of Intravenous Opioid Overdose Deaths

Abstract:  Death caused by heroin overdose is almost always the result of intravenous injection of the drug in Australia. We briefly describe a case where a heroin overdose was initially thought to be the result of oral ingestion of the drug, primarily as a result of higher concentrations of morphine in stomach contents than in blood. During the subsequent criminal trial and investigation, however, the issue of the entero-hepatic circulation of morphine was raised as a possible reason for the presence of morphine in the stomach contents. In this study, we report on the distribution of opioids in blood, stomach contents, urine, liver, and bile in 29 deaths caused by intravenous heroin overdose. The mean total and free blood morphine concentrations were 0.60 and 0.32 mg/L , respectively, and the mean stomach contents total morphine concentration was 1.16 mg/kg. All cases had detectable morphine in the stomach contents, and 24 of 29 cases (83%) had higher concentrations of total morphine in stomach contents than in blood. The mean total morphine concentration in bile was c. 100 times that in blood, and the liver total morphine concentration averaged twice that of blood levels. We conclude that the entero-hepatic circulation of morphine and subsequent reflux of duodenal contents back into the stomach can result in the deposition of morphine in gastric contents. Consequently, the relative levels of opioids in blood and stomach contents cannot be used to determine the site of administration of the drug.     

利多卡因在蛛网膜下腔和静脉注射致死犬体内的死后分布

目的比较利多卡因在蛛网膜下腔和静脉注射致死犬体内的死后分布特点。方法犬12只,其中6只经蛛网膜下腔,另6只经股静脉匀速注入利多卡因(5×15mg/kg)致死,迅速解剖动物,取大脑、侧脑室脑脊液、腰段脊髓腔脑脊液、不同脊髓节段(颈髓、胸髓、腰髓、骶髓),心、肺、肝、脾、肾、胆汁、尿、心血、周围血、注射部位肌肉和注射部位20 cm以外肌肉等脏器组织和体液,用气质联用法定性,气相色谱法定量检测其中利多卡因含量。结果蛛网膜下腔注射致死犬体内利多卡因的含量由高到低顺序依次为腰段脊髓腔脑脊液、骶段脊髓、胸段脊髓、侧脑室脑脊液、腰段脊髓、颈段脊髓、肺、肾、注射部位肌肉、心、大脑、脾、心血、肝、周围血、胆汁、注射部位20 cm以外的肌肉、尿;静脉注射致死犬体内利多卡因的含量由高到低顺序依次为肾、心、肺、脾、大脑、肝、周围血、胆汁、心血、颈段脊髓、胸段脑脊液、注射部位肌肉、腰段脊髓、注射部位20 cm以外的肌肉、侧脑室脑脊液、尿、腰段脊髓腔脑脊液、骶段脊髓。结论蛛网膜下腔注射致死犬背侧脊髓液中利多卡因含量最高,静脉注射致死犬肾脏利多卡因含量最高,此分布特征可为利多卡因麻醉意外法医学鉴定中入体途径的判定提供参考。     

Assessing Revenue Authority Performance in Developing Countries: A Synthetic Control Approach

In many developing countries, comprehensive reforms have been undertaken in tax administration during recent years and the implementation of semiautonomous revenue authorities (SARAs) constitutes one of their most visible expressions. To date, no comprehensive assessment has been undertaken to investigate how successful these SARAs have been in improving revenue collection in these countries. Therefore, this article attempts to fill this gap by assessing revenue collection trends in 20 developing countries after the SARA has been implemented. Using the synthetic control method, we show that in most countries, the implementation of a SARA did not significantly improve government revenues.     

Inter-Municipal Cooperation and Satisfaction with Services: Evidence from the Norwegian Citizen Study

We investigate the effects of inter-municipal cooperation on citizen satisfaction with fire services and refuse handling. While there is a growing interest in cooperation as a way of providing municipal services, little is known of the effect on citizen satisfaction. Through a multilevel analysis combining individual and municipal data, we find that inter-municipal cooperation has a negative effect on satisfaction with fire services, no effect on refuse collection but a positive effect on satisfaction with source separation. The results, we argue, show how the organizational form may affect satisfaction in different ways depending on service characteristics.     

Scale economies in local public administration

A renewed interest in decentralisation has profoundly affected local public governance around the world. Faced with an increasing number of tasks, Dutch municipalities have recently sought physical centralisation, merging into larger jurisdictions in order to target new policy areas more effectively and cost efficiently. Is such a policy of physical centralisation wise? We study economies of scale in local public administration, and find – given transfer payments from central government and current cooperation between municipalities and after controlling for geographical, demographic and socioeconomic variables – substantial unused scale economies of 17% for the average municipality. Between 2005 and 2014 the optimum size of municipalities increases from around 49,000 to 66,260 inhabitants, pointing at an increased importance of fixed costs relative to variable costs in local public administration.     

The Educational and Professional Goals of International Students in Public Service Degrees

International student enrollment in public service degrees such as Public Administration in the United States has grown rapidly. Harnessing this growth to improve the knowledge and expertise of employees in public service is a vital opportunity. However, our survey of public service schools shows that international students perceive an extensive lack of support with financial and linguistic challenges. Furthermore, schools practice little performance evaluation concerning international student experience. We conclude that schools collect more data on international students and communicate better information about programs to improve services and ensure that students know accurately what to expect from their overseas education.     

对现行治安处罚强制执行制度的理性思考

对现行的治安管理处罚强制执行制度,现有法律法规规定的不够完善,治安拘留能否延期执行和罚款执行罚中治安拘留的具体实施,都存在一些问题.因此,必须采取有效措施加以改进.     

电子政府与政府管理创新

电子政府是政府借助电子信息技术而进行的行政活动 ,可以使政府在行政管理中实现体制、机制、管理、服务的创新。文中阐述了电子政府与政府管理创新的关系。     

关于行政审批制度改革的若干思考

行政审批是政府的行政职能之一。现行的行政审批制度改革滞后于经济体制改革 ,其中存在的问题制约了市场经济的发展 ,需要深化行政审批制度改革。从行政审批与微观规制、微观规制和宏观调控的关系中分析当前行政审批制度存在的问题 ,可以看出行政审批制度改革的思路是简化审批 ,强化规制     

中国乡镇行政管理体制的历史沿革及其启示

在整个20世纪的“现代国家政权建设”中,我国出现了四种新型的乡镇行政管理模式,即晚清至民国时期推行的所谓“乡镇自治”、中国共产党建立的“议行合一制”的乡镇基层政权、“政社合一制”的人民公社和“乡政村治”的二元体制模式。中国传统小农经济的有限剩余根本无法支撑一个全面渗透穷乡僻壤的庞大国家机器和现代工业体系,致使我国乡镇行政管理体制频繁变动且反复无常。下一步的乡镇政府体制改革基本方向和总体目标应该是:进一步加强和改进党对农村工作的领导方式,完善“村民自治”制度,培育和发展农村新型合作经济组织和社会中介组织,加快建设适应社会主义市场经济体制的法制型、民主型、服务型乡镇基层政府,不断提高社会管理与公共服务水平。