Body stalk anomaly associated with maternal cocaine abuse

A case of body stalk anomaly diagnosed prenatally by ultrasound during the 24th week of pregnancy in a cocaine abusing mother is presented. Accurate visualization of the fetal organs was difficult due to the severe oligohydramnios caused by premature rupture of membranes, probably related to the cocaine use. The sonographic findings were an omphalocoele, fetal attachment to the placenta, kyphoscoliosis, and absence of a floating umbilical cord. The prenatal diagnosis of the syndrome and the possible relationship with cocaine abuse are discussed.     

抗生素与LED209对大肠杆菌的联合毒性机制

抗生素是一把双刃剑,在提高医疗水平的同时会促进抗性基因的发展。群体感应抑制剂(quorum sensing inhibitors,QSIs)可有效地避免这一缺陷,有望成为抗生素的替代品而与抗生素有环境共存的可能,但目前尚缺乏它们的联合毒性机制及其相关的环境风险评价研究。本文以大肠杆菌为受试生物,测定了群体感应抑制剂N-苯基-4-(3-苯基硫代脲基)苯磺酰胺(LED209)与5种抗生素的单一和二元联合毒性。结果表明,LED209与5种抗生素的联合毒性作用均表现为拮抗,推测是LED209通过影响鞭毛合成,减弱了抗生素对大肠杆菌的生物有效性;同时通过拆分分子式,发现了拮抗作用可能源于LED209分子式中的含苯基和硫代脲基的L1分子,因此建议未来在LED209药物优化时,应尽可能的保留L1部分的基团,从而保证混合体系的最小环境风险。本研究不仅为联合用药提供依据,而且从环境风险评价角度为抗生素替代品LED209的结构优化提供理论指导。     

Induction of hepatic drug metabolizing enzymes in mammals by pesticides: A review

Abstract

The induction of drug metabolizing enzymes in mammals is summarized including both enzymes of the cytochrome P‐450‐dependent microsomal mixed function oxidase system and glutathione S‐transferases. Particular emphasis is placed on the role of pesticides as inducers, the early work being summarized while investigations carried out at North Carolina State University are considered in greater detail. Finally, the possible significance of induction is considered.     

广东某市疫情期间污水中精神药物的分布特征和滥用评价

采用污水流行病学的方法，研究了2020年新冠疫情期间及前后广东省某市生活污水中两种典型精神药物甲基苯丙胺和氯胺酮的赋存特征及其变化情况，并运用手机信令数据分析人口总数、结构特征及其变动规律，进而将两者结合分析了疫情期间及前后两种药物的消费量变化特征.结果表明，疫情期间该市实际人口相对于疫情前下降了约45%，两种药物总消费量相对于疫情前下降了约75%.总消费量的显著下降很大程度是由疫情期间实际人口下降造成的.实际上，疫情期间该市甲基苯丙胺和氯胺酮的人均消费水平相对于疫情前下降不到50%.考虑到疫情期间严格的管控措施，这一下降幅度说明这两种精神类药物滥用极其顽固；而疫情后两种药物的消费量及在环境中的浓度又基本恢复到疫情前的水平，进一步证明了精神类药物滥用的顽固性.     

Governing sexual behaviour through humanitarian codes of conduct

Since 2001, there has been a growing consensus that sexual exploitation and abuse of intended beneficiaries by humanitarian workers is a real and widespread problem that requires governance. Codes of conduct have been promoted as a key mechanism for governing the sexual behaviour of humanitarian workers and, ultimately, preventing sexual exploitation and abuse (PSEA). This article presents a systematic study of PSEA codes of conduct adopted by humanitarian non‐governmental organisations (NGOs) and how they govern the sexual behaviour of humanitarian workers. It draws on Foucault's analytics of governance and speech act theory to examine the findings of a survey of references to codes of conduct made on the websites of 100 humanitarian NGOs, and to analyse some features of the organisation‐specific PSEA codes identified.     

Suspected flunixin poisoning of a wild Eurasian Griffon Vulture from Spain

Exposure to residues of the nonsteroidal anti‐inflammatory drug (NSAID) diclofenac present in livestock carcasses has caused extensive declines in 3 Gyps vulture species across Asia. The carcass of a wild Eurasian Griffon Vulture (Gyps fulvus) was found in 2012 on an Andalucian (Spain) game hunting reserve and examined forensically. The bird had severe visceral gout, a finding consistent with Gyps vultures from Asia that have been poisoned by diclofenac. Liver and kidney samples from this Eurasian Griffon Vulture contained elevated flunixin (an NSAID) levels (median = 2.70 and 6.50 mg/kg, respectively). This is the first reported case of a wild vulture being exposed to and apparently killed by an NSAID outside Asia. It is also the first reported instance of mortality in the wild resulting from environmental exposure to an NSAID other than diclofenac. Caso de Sospecha de Envenenamiento por Flunixin de un Buitre Leonado en España     

应对河南省特大洪涝灾害救援药品保障目录的研究与实践

为提高中国救援队救援任务中的药品保障效率,建立洪涝灾害救援药品保障目录.查阅洪涝灾害医学及救援相关文献270余篇,统计分析洪涝灾害疾病谱及发生率.根据不同疾病类型的发生比例,采用决策分析法,确定洪涝灾害救援药品保障目录,搭建国内药品紧急响应平台.研究结果为:消化系统疾病、呼吸系统疾病及皮肤科疾病占据疾病谱前三位.参照疾...     

Predicting categories of drugs used by suspected drug-impaired drivers using the Drug Evaluation and Classification Program tests

Objective: The purpose of this study was to statistically determine which combination(s) of drug-related signs and symptoms from the Drug Evaluation and Classification (DEC) protocol best predict the drug category used by the suspected drug-impaired driver.

Methods: Data from 1,512 completed DEC evaluations of suspected impaired drivers subsequently found to have ingested central nervous system (CNS) depressants, CNS stimulants, narcotic analgesics, and cannabis were analyzed using a multinomial logistic regression procedure. A set of evaluations completed on drug-free subjects was also included. The relative importance of clinical, behavioral, and observational measures in predicting drug categories responsible for impairment was also examined.

Results: Thirteen drug-related indicators were found to significantly contribute to the prediction of drug category, including being under the care of a doctor or dentist, condition of the eyes, condition of the eyelids, mean pulse rate, assessment of horizontal gaze nystagmus (HGN), convergence, performance on the One Leg Stand (OLS) Test, eyelid tremors, pupil size in darkness, reaction to light, presence of visible injection sites, systolic blood pressure, and muscle tone. Indicators related to the appearance and physiological response of the eye contributed the most to the prediction of drug category, followed closely by clinical indicators and performance on the psychophysical tests.

Conclusions: The findings from this study suggest that drug recognition experts (DREs) should be careful to review a set of key signs and symptoms when determining the category of drug used by suspected drug-impaired drivers. Drug use indicators related to the appearance and physiological response of the eye were found to contribute the most to the prediction of the drug category responsible for the impairment. These results could help form the basis of a core set of indicators that DREs could initially consult to form their opinion of drug influence. This in turn may enhance the validity, effectiveness, and efficiency of drug detection and identification by DREs and lead to a more effective and efficient DEC program, improved enforcement of drug-impaired driving, and greater acceptance of the DEC program by the courts.     

Driving under the influence of alcohol and drugs in the eastern part of Denmark in 2015 and 2016: Abuse patterns and trends

Objectives: The objective of this study was to examine the frequency of psychoactive drugs and alcohol in drivers under suspicion of driving under the influence of drugs and alcohol in 2015 and 2016 in the eastern part of Denmark. The trends in the number of traffic cases sent for drug analysis since 2000 and alcohol analysis since 2011 are also discussed.

Methods: Blood samples from drivers suspected of being under the influence of alcohol and/or medication and/or illicit drugs in 2015 and 2016 were investigated as requested by the police. The blood samples were screened for alcohol and/or tetrahydrocannabinol (THC) alone, for other drugs (covering all drugs, except THC, listed in the Danish list of narcotic drugs), or for THC and other drugs. Age and gender were also recorded. The number of drug traffic cases since 2000 and the number of alcohol cases since 2011 were extracted from our Laboratory Information Management System (LIMS).

Results: In total, 11,493 traffic cases were investigated. Alcohol and/or drugs exceeded the legal limit in 9,657 (84%) cases. Men constituted 95% of the drivers investigated for drugs and 88% of the alcohol cases. The drivers investigated for drugs consisted primarily of young men, whereas drivers investigated for alcohol were older.

The frequency was higher for positive alcohol cases above the legal limit (87%) than for drug cases (76%) above the fixed concentration limit. THC (67–69%) was the most frequently detected drug above the legal limit, followed by cocaine (27–28.5%), amphetamine (17%), and clonazepam (6–7%) in both years. Morphine (5.4%), included among the 5 most frequent drugs in 2015, was replaced by methadone (4.6%) in 2016. Few new psychoactive drugs (NPS) were detected.

The number of traffic cases sent for drug analysis has increased more than 30-fold since 2000–2006, and the number of traffic cases submitted in 2016 for drug analysis was higher than the number for alcohol analysis; the latter has decreased since 2011.

Conclusion: Overall, alcohol was the most frequent compound detected above the legal limit in both years, followed by the well-known illicit drugs THC, cocaine, and amphetamine. NPS were seldom seen. One consequence of the increased focus on drugs in traffic has been an immense increase in drug traffic cases sent for analysis since 2006 in the eastern part of Denmark. Although this survey revealed only minimal changes compared to earlier investigations, surveys like this are invaluable for monitoring abuse patterns and trends in drugged and drunken driving.