Toxicological analysis of a fatal baclofen (Lioresal) ingestion

A fatality following ingestion of the drug baclofen (Lioresal) is described. Baclofen was identified in urine by gas chromatography/mass spectrometry. After derivatization with trinitrobenzene sulfonic acid, baclofen was quantitated in serum and urine by high-performance liquid chromatography. The concentration of baclofen was 17 mg/L in serum and 760 mg/L in urine collected approximately 12 h after the overdose. To our knowledge, this is only the second reported fatality involving a baclofen overdose. The previous case did not include quantitation of baclofen in any biological fluid.     

Has PPS increased Medicare expenditures on physicians?

We use data from 1983 and 1985 on the volume of Medicare physician services to analyze whether Medicare's Prospective Payment System (PPS), which resulted in a significant decline in hospital spending, led to a partially offsetting increase in real expenditures for physician services. We also analyze the effect of increases in assignment rates, increasing incomes of the elderly, and other factors on real expenditures during this period. Our main conclusion is that PPS has at most a small positive effect on real physician expenditures. Because people spent less time in the hospital, Medicare physician spending declined; but because of incentives to shift radiology and other services out of the hospital, some of this decline was offset. We also conclude that the sharp increase in Medicare assignment rates over this period, along with the rising incomes of the elderly during this period, contributed to the observed growth.     

RELATIONSHIP BETWEEN THE OFFENDING FREQUENCY (λ) OF IMPRISONED AND FREE OFFENDERS*

In the public debate over incarceration policy, there is considerable disagreement about what value of individual offending frequency (λ) is appropriate to use in estimating incapacitative effects. This article provides an approach for estimating the mean values of λ for diverse subsets of the total offender population, with particular emphasis on subsets generated by filtering through various stages of the criminal justice system. Sharp differences in offending frequency are displayed between robbery and burglary inmates, across three states, and particularly between resident inmates and free, active offenders. Free offenders average 1 to 3 robberies and 2 to 4 burglaries per year, while resident inmates have λ values 10 to 50 times higher. Differences result from the underlying levels of criminal activity and the sanction Levels that offenders face. A highly heterogeneous distribution of offending frequency in the total population of offenders combines with relatively Low imprisonment levels to lead to substantial selectivity of high-λ offenders among resident inmates and a correspondingly low mean value of λ among those offenders who remain free. These results have important implications for estimating incapacitative effects of an increase in incarceration, since the additional inmates will be drawn from free offenders whose mean λ is at least an order of magnitude Lower than that of the current inmate population.     

"First pass phenomenon" of inhaled gas in the fire victims

We investigated the differences in the levels of carboxyhemoglobin (COHb), cyanide (HCN) and petroleum fuels (gasoline and kerosene) between left and right ventricular bloods from fire victims. COHb was slightly, and HCN and petroleum fuels were markedly higher levels in the left than those in the right. These effects were so called 'first pass phenomena' due to the circulation, diffusion and metabolization before the deaths of fire victims.     

Book Review International Environmental Negotiations: The Current State of Empirical and Analytic Study

Negotiation Journal -