Prevalence and concentrations of new designer stimulants,synthetic opioids,benzodiazepines, and hallucinogens in postmortem hair samples: A 13-year retrospective study

Hair samples are frequently analyzed in order to characterize consumption patterns of drugs. However, the interpretation of new psychoactive substance (NPS) findings in hair remains difficult because of lacking data for comparison. In this study, selected postmortem hair samples (n = 1203) from 2008 to 2020 were reanalyzed for synthetic cathinones, piperazines, phenethylamines, hallucinogens, benzodiazepines and opioids to evaluate prevalence data and concentration ranges. Hair samples were extracted using a two-step extraction procedure and analyzed using a validated liquid chromatography–tandem mass spectrometry (LC–MS/MS) method. Overall NPSs were detected in 381 cases (31.6%). Many cases were tested positive for more than one NPS in the same time span. A variety of NPS with a large range of concentrations was observed. For better comparability and interpretation of positive cases in routine work, quantitation data for 13 NPS were calculated as percentiles. The most frequently detected NPS in this study were N-ethylamphetamine, α-pyrrolidinovalerophenone, mephedrone, benzedrone, metamfepramone, and 4-fluoroamphetamine. In conclusion, a high prevalence of these drugs was observed from postmortem hair samples. The results show a growing use of many different NPSs by mainly young drug-using adults. Consequently, NPS screening procedures should be included in forensic toxicology. Our quantitative data may support other toxicologists in their assessment of NPS hair concentrations.     

Effectiveness of massage, sucrose solution, herbal tea or hydrolysed formula in the treatment of infantile colic

Aim and objective. The aim of the study was to evaluate the effectiveness of massage, sucrose solution, herbal tea or hydrolysed formula, each used individually in the treatment of infantile colic. Background. The term colic describes a group of symptoms that occur frequently in infants, consisting of paroxysmal abdominal pain and severe crying. Infant colic is of importance for both parents and the community health services that provide families with care, and is therefore an important clinical problem that is amenable to nursing interventions. Design. This prospective and randomised‐controlled study involved 175 infants in Turkey. Methods. Data were gathered by using Wessel criteria; parents wrote a daily structured diary, recording the onset and duration of crying. Patients were assigned randomly into four different intervention groups (massage, sucrose solution, herbal tea and hydrolysed formula) and control group. Duration of crying following each intervention was recorded in the diary by parents for a one week period. Results. There was a significant reduction in crying hours per day in all intervention groups. The difference between mean duration of total crying (hours/day) before and after the intervention infants in hydrolysed formula group was found higher than massage, sucrose and herbal tea group. The difference between mean duration of total crying(hours/day) before and after the intervention infants in massage group was found lower than other intervention groups and all groups. Conclusion. Our findings demonstrated that varied interventions such as administration of massage, sucrose solution, herbal tea and hydrolysed formula are effective in the treatment of colic. The difference between mean duration of total crying (hours/day) before and after the intervention in hydrolysed formula group was found higher than other intervention groups. Hydrolysed formula was the most effective in reducing the duration of crying (hours/day) when compared with the other intervention groups. Massage intervention yielded the least symptomatic improvement among all the interventions. Relevance to clinical practice. Colic treatment models used in this study can be used by nurses in neonatal and primary healthcare settings as an aid to families for the treatment of infantile colic.     

A Review of CAM for Procedural Pain in Infancy: Part I. Sucrose and Non-nutritive Sucking

There is increasing concern regarding the number of painful medical procedures that infants must undergo and the potential risks of alleviating infant pain with conventional pharmacologic agents. This article is Part I of a two-part series that aims to provide an overview of the literature on complementary and alternative (CAM) approaches for pain and distress related to medical procedures among infants up to six weeks of age. The focus of this article is a review of the empirical literature on sucrose with or without non-nutritive sucking (NNS) for procedural pain in infancy. Computerized databases were searched for relevant studies including prior reviews and primary trials. The most robust evidence was found for the analgesic effects of sucrose with or without NNS on minor procedural pain in healthy full-term infants. Despite some methodological weaknesses, the literature to date supports the use of sucrose, NNS and other sweetened solutions for the management of procedural pain in infancy.     

高浓度钾在体外循环术后的早期应用及护理对策

目的探讨高浓度补钾方法在纠正体外循环术后低钾血症中的作用。方法将体外循环术后的低钾血症患者按不同血钾浓度分为三组，观察高浓度补钾方法对纠正低血钾的作用。结果三组不同浓度的低钾血症患者，经高浓度补钾方法，均能在1～6h内达到正常水平。结论在严密监测血钾浓度和尿量等护理指标的情况下，高浓度补钾方法是治疗体外循环术后低钾血症的有效手段之一。     

Nociceptive responses to chronic stress of restraint and noxious stimuli in sucrose fed rats

Stress produces analgesia and sucrose ingestion immediately relieves the stress in both the rat and human models, however the effect of sucrose feeding on chronic stress of repeated varying pain is not known. Adult male rats were subjected to a stress regimen of restraint and various degrees of noxious stimuli given repeatedly during 58 h in six sessions with a rest of 32 h. In a 4‐h session, the rats were subjected to the stress of thermal noxious stimulation, pin prick and electrical stimulation of nociceptive afferents (six, one and nine times at intervals of 5 min) in addition to the restraint stress. The effect of this stress on their nociceptive responses was noted as hind paw lick latency, HPL; tail flick latency, TFL; threshold of tail flick, TF; vocalization during stimulus, SV and vocalization after discharge, VA. On the fourth day, the rats received sucrose solution (20 percent orally) ad libitum, which was withdrawn after session IV. During session II–IV in pre‐sucrose fed state, the TFL remained unaffected as compared to session I, while the HPL decreased (18.53 ± 4.96 s, 12.01 ± 4.64 s in sessions I, VI respectively); and the thresholds for TF, SV and VA (0.34 ± 0.16 and 0.71 ± 0.32 mA in session I, VI respectively) progressively increased. After sucrose ingestion during sessions II–IV, the above‐mentioned decrease in HPL and increase in thresholds was not observed. However, they appeared after discontinuation of sucrose during sessions V and VI. The results of our experiment suggest that exposure to our novel model of chronic (58 h) albeit intermittent stress of noxious stimuli and restraint produced an analgesic response in the threshold of TF, SV and VA, an hyperalgesic response in HPL and no effect in TFL; which were attenuated by ingesting a palatable sucrose solution ad libitum. Copyright © 2001 John Wiley & Sons, Ltd.     

Rice consumption and urinary concentrations of arsenic in US adults

Exposure to inorganic arsenic in the general population occurs mainly from drinking water and food sources. This study examined the association between rice consumption and urinary concentrations of arsenic in US adults, aged 20–85 years, in the 2003–2006 National Health and Nutrition Examination Survey. Significantly higher geometric means of creatinine-corrected urinary concentrations of total arsenic (TAs) and dimethylarsinic acid (DMA) were found in participants who consumed rice more than twice per week, compared to the reference group. Multivariate logistic regression analysis revealed a statistically significant association between rice consumption and urinary concentrations of TAs [odds ratio (OR) = 1.51 (1.08, 2.09)] and DMA [OR = 2.24 (1.57, 3.21)] after adjustment for demographic variables, seafood intake (the main source of organic arsenic), and source of drinking water. Furthermore, significant variations in rice consumption and urinary concentrations of arsenic were observed in different racial groups. This study demonstrated that rice consumption contributed to inorganic arsenic exposure in US adults.     

Plasma and Erythrocyte Concentrations of Mercaptopurine after Oral Administration in Children

Plasma and erythrocyte concentrations of 6-mercaptopurine (6-MP) were determined by gas chromatography-mass spectrometry. Eleven children (9 with acute lymphatic leukemia) were studied after oral intake of 6-MP doses ranging between 31 and 128 mg/m² body surface area. The concentrations of 6-MP in plasma were found to vary considerably between patients even after dose normalization to 75 mg/m². After dose normalization the mean peak plasma concentration was 0.68 μM (range 0.12-1.38) and the area under the plasma concentration-time curve (AUC) was 1.37 μM.h (range 0.12-3.04). The mean time taken to reach the peak concentration was 1.3 h (range 1-2), and the half-life of elimination was 1.8 h (range 0.6-2.5). No patient had detectable 6-MP concentrations 12 h after dose intake. The concentrations of 6-MP tended to be higher in erythrocytes than in plasma. The mean peak concentration in erythrocytes was 131% and the AUC 145% of that found in plasma. The mean half-life of elimination from erythrocytes was 2.0 h (range 0.7-2.8). These data indicate that 6-MP can pass through cell membranes rapidly to reach intracellular concentrations equal to or even higher than in plasma. In summary, marked interindividual differences in pharmacokinetics were found, probably due to highly variable bioavailability of oral 6-MP. Further studies are needed to determine whether measurements of plasma concentrations of 6-MP can be used to optimize maintenance treatment of childhood leukemia.     

Occupational exposure to sevoflurane, halothane and nitrous oxide during paediatric anaesthesia Waste gas exposure during paediatric anaesthesia

We report the findings of a study on exposure of operating room staff to sevoflurane, halothane and nitrous oxide during induction and maintenance of anaesthesia in children. Concentrations of anaesthetic agents in the operating theatre were measured directly by highly sensitive, photoacoustic infrared spectrometer during 20 anaesthetics. Samples were taken from the breathing zones of the anaesthetist and the circulating nurse. The operating theatre was of modern design with an air conditioning system providing 20 changes of air each hour. The threshold values of 100 ppm N₂O, 50 ppm isoflurane and 10 ppm halothane recommended by the United Kingdom Committee for Occupational Safety and Health (COSH) were exceeded in several cases for a short time during mask induction. After tracheal intubation, trace concentrations of sevoflurane, halothane and N₂O were mostly under the recommended levels and comparable to levels measured during adult anaesthesia.     

山东省环境中氡及其子体浓度与所致剂量的研究

本文采用闪烁法和Thomas三段法测量了山东省室外148个测量点的氧浓度、92个测量点的氧子体浓度, 其几何均值分别为4.76Bq·m^-3、1.54×10^-3J·m^-3 F值为0.60；室内46个测量点的氡及其子体浓度, 几何均值分别为18.0Bq·m^-3、4.50×10^-8·Jm^-3 F值为0.45。室内、外氡及其子体浓度均遵从对数正态分布。垒省每个居民吸八氧及其子体所致年有效剂量当量为0.58mSv。     

Transdermal delivery of bupranolol: Pharmacodynamics and beta-adrenoceptor occupancy

Summary Bupranolol is a non-selective beta-adrenoceptor antagonist with a K_i-value of 6–15 nmol/l (equivalent to 1.5–4 ng/ml in plasma) at beta₁- (rat salivary gland) and beta₂-adrenoceptors (rat reticulocytes) in receptor binding studies with³H-CGP 12177 in the presence of human plasma. After oral administration of 200 mg bupranolol to healthy volunteers, the maximal plasma concentration was observed within 1.2 h but it only reached a level close to the K_i-value. Elimination from plasma was rapid (t_1/2=2.0 h).Administration of 30 mg bupranolol in a transdermal delivery system (TTS) every 24 h to 6 healthy volunteers for 72 h yielded steady state plasma concentrations 4- to 5-times above the K_i-value as shown by in vitro inhibition of beta-adrenoceptor binding by plasma samples. The pharmacodynamic effect, measured as the reduction in exercise tachycardia, showed a stable inhibitory effect; antagonism of a bolus injection of isoprenaline indicated a 10- to 15-fold right shift of the dose-response curve during the observation period of 72 h.It is concluded that steady-state plasma concentrations and effect of the elsewise rapidly eliminated beta-blocker bupranolol can be achieved by a transdermal delivery system applied each day.Some of the results were presented at the joint meeting of the Belgian, Dutch and German Pharmacological Societies. September 1985, Aachen (Naunyn-Schmiedebergs Arch Pharmacol 330 [Suppl]: R 64The paper is dedicated to Prof. Dr. H. Oelschläger (Frankfurt am Main, FRG) on occasion of his 65th birthday