Medical privacy issues in the age of AIDS: legislative options

Promises of confidentiality of HIV-related medical records and protection from discrimination based on HIV seropositivity are two of the legislative inducements state governments have offered to encourage voluntary HIV testing. Yet neither can be granted without impact on others whose interests range from those of a lover to those of an insurer. Politics as well as practicalities prevent the absolute protection of records from unauthorized disclosure and of individuals from discrimination. This article details the already enacted statutory compromises that have been made to resolve the conflicts of these competing interests and closely examines the myriad fine decisions made in reaching those legislative decisions.     

G. A. Cohen's Conception of Law: A Critique*

This note will challenge G. A. Cohen's view of the interaction between legal systems and economic structures; such interaction raises the so-called problem of legality, which Cohen sets out to solve in the eighth chapter of Karl Marx's Theory of History (Cohen 1978, 216–47). In the course of this note, we shall interrogate the presumed rigor of Cohen's theory of base/superstructure relations, to which his understanding of law is central. His approach will not be simply destroyed, but will be resituated in a network of problems that can highlight a certain fissure between his aspirations and his performance.     

Studies on asphyxia: lipids in the alveoli of rats in hypoxic state

Biochemical characterization in alveolar lavage fluids of rats which had inhaled 5% oxygen, carbon dioxide and carbon monoxide was studied in comparison with control rats. The protein content, consisting mainly of serum albumin, markedly increased in the hypoxic states. The phospholipid content also increased one and a half to two times as much as in the control rats. The phospholipids which increased in the alveoli were mainly pulmonary surfactant phospholipids, i.e. phosphatidylcholine and phosphatidylglycerol. The phospholipid profiles did not appear to be affected by the leakage of plasma lipids. These findings indicate that pulmonary surfactant phospholipids accumulate in the alveoli of rats in the hypoxic states examined here.     

THE MANAGEMENT OF VIOLENCE BY POLICE PATROL OFFICERS*

This study examines the dynamics of potentially violent encounters between police and public. It is based on systematic observation of about 350 eight-hour tours of duty by patrol officers in three precincts of New York City during the summer of 1986. It compares the tactics and resulting outcomes found in encounters handled, respectively, by patrol officers believed by their peers to be especially skilled at minimizing violence and a cross section of all other patrol officers. Its major conclusions are (1) violence, even verbal aggression, is relatively rare in police work: (2) most conflict is dampened by the arrival of the police, leaving little scope for the use of defusing tactics: and (3) the behavior of officers judged by colleagues to be skilled in minimizing violence is measurably different from the behavior of “average” patrol officers, and in ways that suggest that colleagues may be good judges of on-street performance.     

A study on the vital reaction in wounded skin: simultaneous determination of histamine and polyamines in injured rat skin by high-performance liquid chromatography

This paper describes a modified method of simultaneous quantitative determination of histamine and polyamines (putrescine, cadaverine, spermidine and spermine) in incised skin wounds of rats using high-performance liquid chromatography (HPLC) with a strong-cation exchange column, shim-pack ISC-05/S0504P, employing a linear gradient of 0.7-2.5 M sodium chloride. There was scarcely any change in the histamine content of the vital wounds throughout the one week experimental period, although content decreased slightly in 1-h-old wounds. On the other hand, concentrations of putrescine and spermidine increased suddenly 12 h after wounding, and spermine content increased slightly in 4-day-old wounds. There was no post-mortem change in the histamine, spermidine and spermine contents of vital wounds allowed to stand at 25 degrees C up to 24 h after death. Based on these results, this HPLC method may be useful for the determination of wound age during the period of healing.     

Field performance of the Intoxilyzer 5000: a comparison of blood- and breath-alcohol results in Wisconsin drivers

Intoxilyzer 5000 and blood-alcohol results from drivers arrested for operating a motor vehicle while intoxicated and for related offenses were compared during a two-year period. Three hundred and ninety-five pairs of results were studied. The breath- and blood-alcohol specimens in this study were collected within 1 h of each other. The mean blood-alcohol concentration obtained was 0.180 g/dL, with a range from zero to 0.338 g/dL. By comparison, the mean Intoxilyzer 5000 result was 0.16 g/210 L with a range from zero to 0.32 g/210 L. Compared with the blood-alcohol result, Intoxilyzer 5000 results were lower by more than 0.01 g/210 L 67% of the time, within 0.01 g/210 L 31% of the time, and higher by more than 0.01 g/210 L 2% of the time.     

Melatonin concentrations in the sudden infant death syndrome

To examine a possible relationship between pineal function and the sudden infant death syndrome (SIDS), samples of whole blood, ventricular cerebrospinal fluid (CSF) and/or vitreous humor (VH) were obtained at autopsy from 68 infants (45 male, 23 female) whose deaths were attributed to either SIDS (n = 32, 0.5-5.0 months of age; mean +/- S.E.M., 2.6 +/- 0.2 months) or other causes (non-SIDS, n = 36, 0.3-8.0 months of age 4.3 +/- 0.3 months). The melatonin concentrations were measured by radioimmunoassay. A significant correlation was observed for melatonin levels in different body fluids from the same individual. After adjusting for age differences, CSF melatonin levels were significantly lower among the SIDS infants (91 +/- 29 pmol/l; n = 32) than among those dying of other causes (180 +/- 27; n = 35, P less than 0.05). A similar, but non-significant trend was also noted in blood (97 +/- 23, n = 30 vs. 144 +/- 22 pmol/l, n = 33) and vitreous humor (68 +/- 21, n = 10 vs. 81 +/- 17 pmol/l, n = 15). These differences do not appear to be explainable in terms of the interval between death and autopsy, gender, premortem infection or therapeutic measures instituted prior to death. Diminished melatonin production may be characteristic of SIDS and could represent an impairment in the maturation of physiologic circadian organization.