Death following injection sclerotherapy due to phenol toxicity

Prolapse rectum (PR) or protrusion of the rectum beyond the anus occurs frequently in populations at both extremes of age. In the pediatric population, in developed countries, the commonest cause for PR is thought to be cystic fibrosis (CF). Treatment options for CF include conservative management, surgical resection and fixation, suturing, and injection sclerotherapy (IS). The last is considered an attractive treatment option because it is minimally invasive. In this case report, the authors present the details about a 2-year-old female child, with PR and CF, who died after IS, using phenol as the sclerotherapeutic agent. Autopsy findings and toxicology tests performed to establish phenol toxicity are documented. The available literature is reviewed. This case report underscores the risks of using phenol for IS and emphasizes the point that the procedure is not innocuous and an adverse outcome including fatality is a possibility.     

Congress and the political expansion of the U.S. districts courts

Expanding the number of U.S. district judgeships is often justifiedas a response to expanding caseloads. Increasing judgeshipsduring unified government, however, allows Congress and thePresident to engage in political (patronage and ideological)control of the federal district courts. This paper examinesempirically the relative importance of caseload pressure andpolitical motives for Congress to expand the number of federaldistrict judgeships. We demonstrate that politics dominatesthe timing of judgeship expansion in the U.S. District Courts.We also show that both politics and caseload affect the actualsize of those timed expansions. In particular, we find thatbefore 1970, Congress seemed to have strong political motivationsfor the size of an expansion. After 1970, Congress became muchmore attentive to caseload considerations.