Anorectic sibutramine detected in a Chinese herbal drug for weight loss

In the presented case, a young healthy woman had ordered a Chinese herbal medicine, called "LiDa Dai Dai Hua Jiao Nang", via internet. She took this product for approximately 1 week, but on the second day she developed severe headache, vertigo and sensation of numbness. After discontinuing medication, symptoms disappeared within 2 days. For identification of the ingredients, a urine sample as well as a sample of the "LiDa" capsule were analysed by GC-MS and HPLC-DAD. One major ingredient was detected in urine as well as in the "LiDa" capsule and was identified as sibutramine. Quantification by HPLC-DAD yielded 27.4 mg sibutramine base, which is approximately two times the amount of the highest authorized single dose available on the pharmaceutical market in Germany. This case demonstrates a common problem with herbal medicines, where adulterations with synthetic therapeutic substances can lead to severe side effects and/or potentially fatal interactions with conventional medicines.     

Survival of severe amlodipine intoxication due to medical intensive care

We report the case of attempted suicide with amlodipine, chlorthalidone and mefenamic acid and subsequent medical intensive care measures which resulted in total recovery of a 42-year-old male. After admission to the medical intensive care unit the intoxicated patient was deeply hypotensive and needed fluid replacement, dobutamine and norepinephrine. Additionally insulin and calcium gluconate were given. Since hypotension persisted and the patient developed oliguria, terlipressin was applied and finally showed an effect on blood pressure and on urinary output. A volume overload of 7 L in the first 24 h resulted in a pulmonary edema. The patient was started on non-invasive ventilation with continuous positive airway pressure (CPAP) and frusemide was added to the therapy with good success. Quantitative determination of amlodipine in plasma samples was performed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The highest amlodipine concentrations was measured in the plasma sample collected approximately 8 h after ingestion of the drug, and was 393 microg/L. Four days later, it was possible to stop the treatment with catecholamines, at that time the amlodipine plasma concentration had declined to 132 microg/L, still tenfold higher than therapeutic (5-18 microg/L). Elimination half-life of amlodipine is approximately 55 h. After 6 days in the intensive care unit the patient was transferred to psychiatric treatment. Intensive care management and plasma levels in this intoxication case are compared to data from literature on other cases.     

Confucian bioethics and cross-cultural considerations in health care decision-making

This article discusses the similarities and differences between Beauchamp and Childress's principlism and Confucian bioethics in terms of autonomy, beneficence, nonmaleficence, and justice. The author presents sensitive approaches for culturally diverse groups in health care areas and cautions against dichotomy in cross-cultural studies, which ignores the dynamic nature and intravariations of cultures. As a way of health care providers to become engaged in cultural diversity in nursing practice and research, the author suggests that they do not only have a general knowledge about the theoretical differences among groups through "normative analysis" but also learn to appreciate each individual's particular beliefs and values through narratives of morality. Health care providers as well as legal professionals need to cultivate "cultural humility," which is the willingness to explore the similarities and differences between their own and each client's priorities and values and to develop courses of action with patients.     

Adolescent sexual activity and pregnancy: Socioenvironmental problems,physical health,and mental health

This paper examines the association between adolescent pregnancy and socioenvironmental, physical, and mental health problems in 1590 inner-city females aged 13–18 who use health clinics. Adolescents who have become pregnant, those who are sexually active but never have been pregnant, and those who are sexually inactive are compared. The sexually active youngsters come from more psychosocially disadvantaged backgrounds than their sexually inactive peers; the sexually active girls who become pregnant come from more psychosocially disadvantaged backgrounds than those who have never been pregnant. Despite this, the youths who have become pregnant do not have more current relationship problems, more stressful life events, or worse physical health than the never-pregnant sexually active youths. Although sexually inactive youths have the lowest rates of mental health problems, adolescents who have been pregnant have lower rates of anxiety and conduct disorder symptoms than those who are sexually active but never pregnant.Supported by the Robert Wood Johnson Foundation. Fieldwork conducted by Survey Research Associates.Research interests include adolescents and children, parenting, and families.Research interests include epidemiology of child and adolescent psychiatric disorder.Research interests include psychiatric epidemiology/deviant behavior.Research interests include mental health and statistical issues.Research interests include health behavior and mental health issues.     

Barriers to technology transfer and their elimination

An analogy between the flow of technology and the flow of electricity is used as a method to analyze technology transfer. This effort is expanded by an analogy to the Lewin's field theory in Social Science. An effort is then made to understand better the types of barriers to technology transfer. Several classes of barriers are identified and are then discussed in detail.     

Development of a specific fragment pattern-based quadrupole-Orbitrap mass spectrometry method to screen adulterated products of phosphodiesterase-5 inhibitors and their analogues

Recently, adulterated supplements with phosphodiesterase-5 inhibitors (PDE-5i) have frequently observed. New synthetic analogues obtained from the chemical modification of parent compounds are frequently found in illicit products despite continuous efforts to inspect for these adulterants. A rapid and accurate method based on quadrupole-Orbitrap mass spectrometry was developed for simultaneously confirming and quantifying 85 PDE-5i and derived analogues present in illicit products for erectile dysfunction (ED). Common ions of PDE-5i according to their similar structures were proposed based on MS/MS fragmentations. These common ions could be an important diagnosis of their presence targets or new emerging analogues in supplements. Several validation parameters were employed, resulting in a limit of detection and quantification of 0.09–8.55 ng/mL and 0.24–17.10 ng/mL, respectively. The linear correlation coefficient (r²) was higher than 0.995, and mean recoveries of target compounds were in the range of 82–118%. A total of 187 illicit products, obtained from on/offline markets over a period of 3 years (2015–2017), were screened by the established method. Approximately 53% of them were adulterated with PDE-5i or derived analogues at concentrations of 0.1–726.0 mg/g in the illicit products. In the interests of public health, this study describes a rapid and accurate method to determine PDE-5i and new emerging analogues in adulterated products.     

Development of Latent Fingermarks on Surfaces of Food‐A More Realistic Approach

Latent fingermark developing methods from food (mandarin, egg, banana, apple, potato, carrot, eggplant, onion, bell pepper, and tomato) surface has been studied by 10 methods, including powdering method, small particle reagent method, and cyanoacrylate fuming method. The foods were stored under two conditions (room temperature and refrigerator) before fingermark deposition and aged for 2, 24, 48, and 72 h before fingermark development. In most of the food surfaces used in this study, cyanoacrylate fuming with 80% relative humidity was superior to the powder or small particle reagent methods. The quality of the fingermarks varied depending on the storage conditions before the fingermark deposition (in the refrigerator or at ambient temperature) and the time elapsed since the fingermark deposition. However, the storage conditions before the fingermark deposition and the time elapsed since the fingermark deposition did not show any correlation with the quality of the fingermark.     

The Impact of Management Capacity on Government Innovation in Korea: An Empirical Study

ABSTRACT

A common assertion within public management is that management capacity drives policy outcomes. This study tests that argument, focusing on an important policy outcome—innovation. Data were drawn from the Korean government to examine the impact of government's management capacity for the adoption and implementation of innovation. The results confirm that both managerial behaviors and structures are drivers of government innovation. The adoption and implementation of innovative projects require full-scale management capacity, encompassing innovative leadership, a quality workforce, appropriate structures/systems, and the ability to manage external influences. These results suggest that public management capacity drives innovation in government by changing managerial behaviors and structures. Implications of these results for managing government innovation are discussed.     

Inducing state compliance with international fisheries law: lessons from two case studies concerning the Republic of Korea’s IUU fishing

International Environmental Agreements: Politics, Law and Economics - Despite the expansion of international fisheries law, fish stocks are still threatened by illegal, unreported and unregulated...