Analysis of 2-hydroxyimipramine in an imipramine-related fatality

A fatality following ingestion of the tricyclic antidepressant imipramine (Novopramine), acetaminophen, and ethyl alcohol is described. Imipramine, desipramine, acetaminophen, and 2-hydroxyimipramine were quantitated by high performance liquid chromatography, and ethyl alcohol by gas liquid chromatography. Concentrations of imipramine, desipramine, 2-hydroxyimipramine, and acetaminophen were: in blood--9.0, 1.1, 3.9, and 11 mg/L; in urine--92, 14, and 42 mg/L (acetaminophen not quantitated in urine). Ethyl alcohol concentration in blood was less than 10 mg/dL and 105 mg/dL in the urine by headspace gas chromatography. These findings are compared to previous reports of imipramine-related fatalities. To our knowledge, this is the first fatality reported involving imipramine where analysis included quantitation of 2-hydroxyimipramine in blood and urine.     

Six Lines: A Methodological Agenda for Critical Gang Studies

Critical Criminology - In the twenty-first century, the established methodological props for gang research have worn increasingly thin. Place-based definitions involving territorial groups confined...     

POSTDECREE LITIGATION Is Joint Custody to Blame?

The Joint Custody Symposium Project examined almost 600 court files in five judicial districts to investigate the common perception that joint custody contributes significantly to relitigation rates. Data indicated that joint custody as a factor accounted for only 10.8% of court returns. Financial concerns accounted for the majority of actions. Disputes over child custody appeared to be related to finances as well. Unfortunately, returns to court do not necessarily resolve the financial needs of divorced parents. The findings suggest that children may be used as pawns in court battles over money that are disguised as parenting concerns, as evidenced by the close relationship found between visitation or custody disputes and child support modification filings.     

A fatality involving clomipramine

A fatality following ingestion of the tricyclic antidepressant clomipramine (Anafranil), alprazolam (Xanax), and ethyl alcohol is described. Clomipramine and N-desmethylclomipramine were quantitated by high performance liquid chromatography and alprazolam by gas liquid chromatography. Concentrations of clomipramine and N-desmethylclomipramine were: in blood--0.84 and 1.4 mg/L; in urine--0.56 and 0.62 mg/L. Alprazolam concentration in blood was 0.069 mg/L. Ethyl alcohol was measured by headspace gas chromatography and found to be 375, 385, and 435 mg/dL in blood, urine, and vitreous humor, respectively. These findings are compared to previous reports of clomipramine related fatalities and alprazolam toxicity combined with ethyl alcohol.     

The Legal Case File as Border Object: On Self‐reference and Other‐reference in Criminal Law

What do case files do? With help of an ethnographic study on the care, maintenance, and use of legal case files in a Dutch, inquisitorial context, we work through Latour's and Luhmann's conceptualizations of law. We understand these case files as enacting and performing both self‐reference and other‐reference. We coin the term border object to denote the way the legal case file becomes the nexus between two worlds it itself performatively produces: the world of ‘law itself’ on the one hand, and the ‘world out there’ on the other. As such, our discussion offers clues for a partial reconciliation of Latour's and Luhmann's conceptualizations of law: while Luhmann's insistence on other‐referential operations assist in showing how law forges an ‘epistemic relationship’ with the realities it seeks to judge, Latour's concentration on the materialities of epistemic practices assists in situating these other‐referential and self‐referential operations.     

A carpipramine related fatality

A fatality following ingestion of the tricyclic antidepressant carpipramine (Prazinil) and ethyl alcohol is described. Carpipramine was quantitated by high performance liquid chromatography. The concentration of carpipramine was 2.0 mg/L in blood and 0.44 mg/L in urine. Ethyl alcohol was measured by headspace gas chromatography and found to be 105 mg/dL in blood and 55 mg/dL in the urine. Quantitative analysis of stomach contents was positive for carpipramine by thin-layer chromatography. To our knowledge, this is the first reported fatality involving carpipramine.     

Medicare reimbursement for hospice care: ethical and policy implications of cost-containment strategies

In several areas of health policy, current concern over rising costs has generated considerably political support for reforms that many in the business have advocated unsuccessfully on philosophical, ethical, or humanitarian grounds for years. Thus, for example, the spiraling cost of caring for the mentally ill and the developmentally disabled in an institutional setting has breathed new life into proposals to bring these groups out into the community where they can live more independently--and more cheaply. But this overlap of quality and frugality goals is only partial. Although alliances with cost-cutters can bring reform, health policy reformers are discovering that they may have to accept a lot of bathwater along with the baby. Medicare reimbursement for hospice care, authorized by Section 122 of PL 97-248, the Tax Equity and Fiscal Responsibility Act of 1982, provides one recent example of this dilemma. This article discusses the results of a survey--conducted by the Office of the Inspector General of the Department of Health and Human Services--to discover how many hospices would seek certification for reimbursement by Medicare, how many patients would be served, and the consequences of this legislation for cost, access, and quality of service.