Drug-facilitated sexual assault using tetrahydrozoline

Drug-facilitated sexual assault (DFSA) has been defined as the use of a chemical agent to facilitate a sexual assault. We report two cases of the use of tetrahydrozoline for DFSA. We believe this is the first report with urinary quantification of tetrahydrozoline levels postassault. Blood and urine were obtained c. 20 h postexposure in two cases of reported DFSA. Tetrahydrozoline was not detected in blood but was identified in urine in both victims. After initial identification in the urine using the 2010 update to the AAFS mass spectrometry database library, tetrahydrozoline was quantified at 114 and 150 ng/mL, respectively, using GC/MS. Two unique clinical features reported in these cases were intermittent periods of consciousness and postexposure vomiting. Use of GC/MS was successful in identifying tetrahydrozoline in the 100 ng/mL range up to 20 h postexposure. For victims with late presentation, urine may be a better sample for evaluation for tetrahydrozoline.     

Requirements for submission of labeling for human prescription drugs and biologics in electronic format. Final rule

The Food and Drug Administration (FDA) is amending its regulations governing the format in which certain labeling is required to be submitted for review with new drug applications (NDAs), certain biological license applications (BLAs), abbreviated new drug applications (ANDAs), supplements, and annual reports. The final rule requires that certain labeling content be submitted electronically in a form that FDA can process, review, and archive. Submitting the content of labeling in electronic format will simplify the drug labeling review process and speed up the approval of labeling changes.     

Medicare program; electronic submission of cost reports. Final rule

This final rule amends regulation by requiring that, for cost reporting periods ending on or after December 31, 2004, all hospices, organ procurement organizations, rural health clinics, Federally qualified health centers, community mental health centers, and end-stage renal disease facilities must submit cost reports currently required under the Medicare regulations in a standardized electronic format. This rule also allows a delay or waiver of this requirement when implementation would result in financial hardship for a provider. The provisions of this rule allow for more accurate preparation and more efficient processing of cost reports.     

Medical devices; reprocessed single-use devices; requirement for submission of validation data. Direct final rule

The Food and Drug Administration (FDA or we) is amending certain classification regulations for reprocessed single-use devices (SUDs) whose exemption from premarket notification (510(k)) requirements have been terminated and other reprocessed SUDs already subject to premarket notification for which validation data, as specified under the Medical Device User Fee and Modernization Act of 2002 (MDUFMA), are necessary in a 510(k). Elsewhere in this issue of the Federal Register, we are publishing a companion proposed rule, under FDA's usual procedures for notice and comment, to provide a procedural framework to finalize the rule in the event we receive any significant adverse comment and withdraw the direct final rule. This action codifies actions taken in previous Federal Register notices in accordance with MDUFMA.     

BritCrits: Subversion and submission,past, present and future

This article explores some of the intellectual influences which have shaped the development of Critical Legal Studies in Britain and the contexts in which these influences made themselves felt. It then considers which influences might or should steer Critical Legal Studies in the future. In terms of the past, specific attention is given to the influence of Marxism, Freud and Lacan, feminism, Foucault and Derrida, and recent genres of history-writing. As to the future, the question is asked whether Critical Legal Studies will engage constructively with recent developments in the life sciences and the philosophy of science, and, more generally, whether it will be able to surpass its established mooring in the philosophy of history. This revised version was published online in July 2006 with corrections to the Cover Date.     

Medicare program; revision of the deadline for submission of emergency graduate medical education affiliation agreements. Final rule

This final rule responds to comments on and revises the deadline for submission of the 2006 emergency Medicare graduate medical education (GME) affiliation agreements. The deadlines to submit the emergency Medicare GME affiliation agreements for the 2005 through 2006 and 2006 through 2007 academic years are changed from on or before June 30, 2006 and July 1, 2006, respectively, to on or before October 9, 2006.     

Medicare program; physician self-referral regulations: change in date for submission of group attestation statement--HCFA. Final rule--technical amendment

This final rule changes (delays) the date by which a group of physicians that wishes to be identified as a group practice for purposes of the physician self-referral regulations (42 CFR 411.350 through 411.361) must file a statement attesting that it meets certain specified conditions.     

Forensic chemical testing of cadaveric material for acetonitrile

Gas chromatographic conditions for qualitative and quantitative evaluation of acetonitrile in biological material were determined, including those for reactive gas chromatography. Absolute and relative time of acetonitrile and concomitant substances retention in three columns of different polarity was determined. Study of the time of acetonitrile retention in biological material showed that acetonitrile concentration in the blood virtually did not change in cadaveric material stored in a hermetically closed flask for 2 weeks at 20 +/- 3 degrees C, while its concentration in the stomach decreased by 10-15%. Distribution of acetonitrile in human viscera in lethal poisoning was studied; the agent was evenly distributed in the gastric wall, intestine, liver, and kidney, while its concentrations in the lung and brain were 2-3 times higher. Forensic chemical expert analyses of the blood, urine, and viscera from corpses of humans dead from lethal acetonitrile poisoning showed that lethal concentration in the blood was 28.3-57.0 mg and in the urine 23.2-40.6 mg/100 ml.     

Comparison of chemical methods for determining postmortem interval

Accurate determination of postmortem interval (PMI) is a problem for the forensic thanatologist, especially in unwitnessed deaths. A number of objective chemical methods for determining PMI have been developed, the most widely used being accumulation of potassium in the vitreous humor. The authors previously have reported a chemical method for determining PMI from the predictable accumulation or clearance of the dopaminergic metabolite 3-methoxytyramine (3-MT) in the putamen of the brain. They have extended their previous study to compare directly the accuracy of determining PMI from the level of 3-MT in putamen with the level of potassium in vitreous humor. The data indicate that 3-MT is at least as accurate as, if not more accurate than, potassium accumulation in vitreous humor, although 3-MT levels can be affected by the cause of death and drugs present at the time of death. Nevertheless, determination of both the 3-MT and potassium levels can afford the most accurate method of determining PMI; preliminary nomograms for determining PMI from both variables are presented.     

Implications of trombiculid mite bites: report of a case and submission of evidence in a murder trial

Bites of Trombiculid mites implicated a suspect during a homicide investigation. Clinical documentation of the bites, correlation with entomological studies, and submission of evidence at trial are reported. Insects that have a discrete geographic distribution and leave bites of a characteristic nature may have important forensic science implications.     

Detection of bancol for the purpose of forensic chemical expertise

Optimal conditions for the extraction of bancol from the biological material with toluene are described. The possibility of its purification and separation from co-extracted compounds on a silicagel L column, 40/100 mcm is illustrated. Identification and quantitative determination of bancol isolated from the cadaverous liver were performed by the electron spectrophotometry technique, thin-layer chromatography, and high performance liquid chromatography using normal-phase sorbents. A method of bancol detection was adapted for the purpose of forensic medical expertise and applied for the postmortem examination of the cadaverous tissues.