Report on complementary/alternative health care and HIV/AIDS

In 2001, the Canadian HIV/AIDS Legal Network published a lengthy report on Complementary/Alternative Health Care and HIV/AIDS: Legal, Ethical & Policy Issues in Regulation. The document is the first in a series of papers to be produced by the Legal Network on priority legal and ethical issues related to HIV/AIDS care, treatment, and support. The article below summarizes the contents of the report.     

Compositional variation in bullet lead manufacture

The concentrations of antimony, copper, tin, arsenic, silver, bismuth, and cadmium in lead alloys produced by two smelters and one ammunition manufacturer were determined using inductively coupled plasma-atomic emission spectrometry. These element concentrations were used to measure the variations in composition of lead products that result from various processes involved in the manufacture of lead projectiles. In general, when a pot containing molten lead is used to cast a number of objects, these objects are similar, although not necessarily analytically indistinguishable in their elemental compositions. In each subsequent step in the processing of lead at the smelter and at the ammunition manufacturer, the size of an individual homogeneous melt of lead decreases as more distinct compositions are formed as a result of remelting and mixing of sources, including lead scrap. The ammunition manufacturer in this study produced at least 10 compositionally distinguishable groups of bullet wire in a 19.7-h period. The largest group could potentially be used to produce a maximum of 1.3 million compositionally indistinguishable 40 grain bullets.     

Interpretation of glass composition measurements: the effects of match criteria on discrimination capability

The concentrations of ten elements in 209 unrelated glass specimens received as evidence were used to assess the frequencies of errors of false association (Type II errors) using several comparison criteria at specified significance levels (Type I errors). Pairwise comparisons of the samples using either the equal-variance t-test or Welch's modification (unequal variances) result in a small number of errors of false association, even when adjusting the significance level (Bonferroni correction) for multivariate comparisons. At the 95% confidence level (overall Type I error of 0.05, or individual element comparison error of 0.005), only two Type II errors are made in 21736 comparisons (0.009%) when using the equal-variance t-test for comparison of sample means. In this study, the range overlap test using three replicate measurements per specimen results in no errors of false association. Most specimen pairs in this data set are readily discriminated either by differences in the concentrations of several elements or by an extremely large difference in the concentrations of one or more element.     

Detection of ketosis in vitreous at autopsy after embalming

Ketosis occurs in ketoacidosis or malnourishment. When either is suspected in relation to a death, it may be important to analyze for ketosis at autopsy. We encountered a case where starvation was suspected in a deceased nursing home resident, where the body had been embalmed prior to autopsy. Gas chromatography (GC) was unable to separate acetone from formaldehyde, a component of embalming fluid. The Acetest is a simple test that can detect acetone and acetoacetate in body fluids. We validated the Acetest with GC on vitreous. The Acetest and GC were consistent except at very low levels of acetone or acetoacetate. The sensitivity of the Acetest for acetoacetate in vitreous was 10 mg/dL, consistent with early starvation. Significant interference from embalming fluid did not occur. The Acetest was negative in the described case. The Acetest is a simple and useful test for the detection of ketosis in embalmed autopsies.