Potential Negative Effects of Dextromethorphan as an Add-On Therapy to Methylphenidate in Children With ADHD.

Objectives: Methylphenidate (MPH) is highly effective in controlling the symptoms of attention-deficit/hyperactivity disorder (ADHD), but some children with ADHD either do not respond to, or do not tolerate, treatment. Dextromethorphan (DM) is a neuroprotective agent which has been used in the treatment of neuropsychiatric disorders. This clinical trial had examined the effect of DM on the use of MPH in the children with ADHD. Methods: This randomized double-blind clinical trial had evaluated 44 male outpatients, aged between 6 and 12 years, with a diagnosis of ADHD. The study subjects were randomly assigned into one of the two groups: receiving MPH alone (15-60 mg per day) or MPH plus DM (30-60 mg per day) for 8 weeks. Assessments, comprising the Chinese version of the Child Behavior Checklist (CBCL-C) scale and the Swanson, Nolan and Pelham Questionnaire (SNAP)-IV rating tests conducted by parents and the serum cytokines measured by microarray and enzyme-linked immunosorband assay (ELISA), were compared between groups at baseline and at 8 weeks after the medication was started. Results: There were a significant decrease at the mean scores of both CBCL-C and SNAP-IV scales after 8 weeks of treatment, but no significant differences between MPH and MPH+DM groups. Compared with the MPH-only group, the mean scores of some psychometric parameters reported on the CBCL-C and SNAP-IV scales regarding time effects as well as the attention problems on the CBCL-C scale regarding group effect were significantly higher in the DM+MPH group. Although there were no significant differences in the levels of various serum cytokines between groups, the subjects in the DM-MPH group had relatively fewer and lower levels of adverse effects. Significant interactions were found between the withdrawn/depression item reported on the CBCL-C scale and tumor necrosis factor α (ခTNF-α) (p = 0.027), as well as between thought problems item on the CBCL-C and TNF-α (p = 0.028) in subjects who had received DM+MPH treatment. Conclusion: Following the trial, DM+MPH was not superior to MPH alone for the treatment of children with ADHD, yet DM may potentially have negative effects on ADHD symptoms when combined with MPH. Clinical Trial Registration: Clinicaltrials.gov, trial number: NCT01787136.

FaPEx® Multipesticide Residues Extraction Kit for Minimizing Sample Preparation Time in Agricultural Produce.

Background: The quick, easy, cheap, effective, rugged, and safe method, generally applied to the determination of pesticide residues in food, has been recently modified and adopted for the analysis of pesticide residues worldwide, including Taiwan. Objective: The method still needs to be improved, particularly in efficiency and normalization, because the time costs 20-30 min for extraction and cleanup of multiple pesticides in every food. Methods: In this study, we present a highly efficient and simple sample preparation method that was developed for the determination of 380 pesticide residues in food, including mangoes, scallions, bok choy, apples, carrots, and pea seedlings. The homogenized 1 g samples mixed with 5 mL 1.0% acetic acid in acetonitrile were pushed through the FaPEx® (fast pesticide extraction) kits in a dropwise manner to obtain sample extracts. The total processing time was less than 15 min. The extracts were subject to chromatographic separation followed by GC-tandem MS (MS/MS) and LC-MS/MS analysis. Results: For more than 270 pesticide residues in these foods, the test gave acceptable mean recoveries, ranging between 70 and 120%, and relative SDs below 20%. The LOQ was at least 0.01 mg/kg for 380 pesticides. Conclusions: The developed method can greatly reduce the time needed for multiple pesticide residues analysis. Highlights: FaPEx is used for the extraction of pesticide residues that relies on single-use pre-filled sealed cartridges. FaPEx diminishes operation time, glassware demand, and laboratory space requirement. It also significantly decreases the amount of chemical solvents.

A simple approach for the ultrasensitive detection of paraquat residue in adzuki beans by surface-enhanced Raman scattering.

Paraquat (PQ), a broad-spectrum contact herbicide, has been used in many countries for controlling weed growth in agriculture because of its quick-acting and nonselective contact with green plant tissue. PQ is also toxic to humans, and even contributes to the development of neurodegenerative diseases. However, PQ is generally excluded from pesticide residue monitoring programs due to the lack of suitable determination methods. Thus, this study developed a detection method combined with simple extraction and surface-enhanced Raman spectroscopy (SERS) to rapidly determine and quantify the PQ residue on legumes without destructive procedures and high-cost instruments. Following the extraction procedure of the QuPPe-method, however, we took whole adzuki beans (Vigna angularis) extracted via a mixture of methanol and 1% formic acid at room temperature and followed by a 1 min cleanup by SPE. The PQ values for adzuki beans determined by LC/MSMS showed that regardless of whether extraction was followed by the QuPPe-method or the method we proposed, a consistent and low relative standard deviation (RSD) below <22% was found. In this study, we proposed to extract PQ on the surface of the beans by shaking briefly with solvent, and then the PQ molecules were detected and quantified by depositing Ag nanoparticles (AgNPs) and performing SERS within 10 min. Using a coating of deposited Ag nanoparticles, SERS can achieve a limit of detection (LOD) for PQ on the order of 1 µg L-1 (∼4 × 10-9 M) and a method detection limit (MDL) for adzuki beans of 0.8 µg kg-1 (∼3.3 × 10-9 M). This sensitivity at the ppb level absolutely met the maximum residue limit (MRL) for PQ in dried beans as declared by most countries, including the US (0.3 mg kg-1), Australia (1.0 mg kg-1) and Taiwan (0.2 mg kg-1). Taiwan will ban the use of PQ as a defoliating agent for harvest in adzuki bean fields in 2019; therefore, developing a method for detecting PQ residues in the field or in import markets is necessary for consumer health and for authorities. This study provided an opportunity to utilize SERS in the field of on-site pesticide residue screening.

Modified QuEChERS method for 24 plant growth regulators in grapes using LC-MS/MS.

A multiresidue analytical method was developed for grapes for the following 24 plant growth regulators: 1-naphthylacetamide, 2,3,5-triiodobenzoic acid, 2,4,5-T, 2-naphthoxyacetic acid, 3-indolylacetic acid, 4-(3-indolyl)-butyric acid, 4-chlorophenoxyacetic acid, 4-nitrophenol, 6-benzylaminopurine, N6-isopentenyladenine, butralin, chlormequat chloride, chlorphonim-Cl, cloprop, forchlorfenuron, gibberellic acid 3, gibberellic acid 4, gibberellic acid 7, inabenfide, mepiquat chloride, paclobutrazol, prohydrojasmon, thidiazuron and uniconizole-P. The compounds were extracted from grape samples using an extraction method modified from the Quick, Easy, Cheap, Effective, Rugged and Safe (QuEChERS) method. Liquid chromatography - tandem mass spectrometry was used for the detection and quantification of the compounds. Validation of the method was performed by using recovery studies at both intra-day and inter-day intervals, as well as by evaluation of the matrix effect, limit of quantification, trueness and precision. We used matrix-matched calibrations for the quantification of the compounds, which all resulted in determination coefficients (r2) higher than 0.995. The limit of quantification ranged from 0.1 to 5 ng/mL. Recovery studies using three spiking concentrations at varying levels showed recoveries of 70.2-112.6% and 67.5-101.8% at intra-day and inter-day intervals, respectively. Relative standard deviations were below 20% for the recovery studies. The extraction method were further validated by performing recovery study and matrix effect test in six different grape varieties from Taiwan and the United States and all resulted in comparable results. Application of the established method to 50 grape samples, resulted in the detection of chlormequat chloride and forchlorfenuron residues in the tested grapes. The results of the method validation and real sample analysis shows the extraction method is therefore suitable for routine monitoring of residue in grapes.

Amisulpride-associated mania in a young adult with schizophrenia and cerebral disease.

PURPOSE: A case of rapid-onset mania after initiating amisulpride in a patient with schizophrenia and cerebral disease is reported. SUMMARY: A 19-year-old Taiwanese man had a 1-year history of schizophrenia, paranoid type, and cerebral palsy. His only medication was a 12-week course of risperidone 6 mg orally daily. His positive symptoms of auditory hallucinations and paranoid delusions improved markedly, but negative symptoms of inattention, avolition, and anhedonia continued. His motor disability and athetosis of the hand related to cerebral palsy also worsened during risperidone therapy. After a discussion with the patient's guardian, conversion of antipsychotic therapy from risperidone to amisulpride was commenced. On days 1-8 of the conversion, amisulpride 400 mg was given orally daily. The daily risperidone dose on days 1, 2, and 3 was 6, 4, and 2 mg, respectively; risperidone was discontinued after day 3. On day 4, the patient exhibited a euphoric mood, with persistent laughing, expansive self-esteem, extreme talkativeness, flight of ideas, distractibility, and psychomotor agitation. On day 8, the amisulpride dosage was increased to 800 mg orally daily and his manic symptoms worsened. On day 17, amisulpride was withheld and risperidone 4 mg daily was resumed. The manic symptoms subsided within three days after the cessation of amisulpride. The patient was maintained on risperidone 4 mg daily for six months without any further hypomanic or manic symptoms. CONCLUSION: A 19-year-old man with schizophrenia and underlying cerebral disease developed rapid-onset mania after risperidone was replaced with amisulpride. The reaction resolved soon after amisulpride was discontinued and treatment with risperidone was reinstituted.

Service suspension for mental disorders in armed forces draftees in the Penghu area.

BACKGROUND: It is important to monitor draftees for mental disorders before or at an early stage of military service. The aim of this study was to characterize the draftees who were suspended from service for mental disorders among draftees in a high readiness military zone in the Taiwan Strait. METHOD: A total of 152 draftees consulted the outpatient service of the Department of Psychiatry at Penghu branch, Tri-Service General Hospital in Taiwan during the period between August 2004 and July 2008, and whose severity of mental disorder fit the criteria for service suspension were recruited as the study group (SG). Draftees who had adjusted normally were the control group (CG). RESULTS: The major causes for suspension were major depressive disorders and personality disorders. In the study group, the number of draftees seeking psychiatric outpatient treatment increased from 49.3% before service to 100% during service. In addition, higher rates of suicidal ideation, suicide plans, attempted suicide, and homicidal ideation were found in the study group than in the control group. The percentages of draftees who were unwilling to serve and absent without official leave (AWOL) during military service in Penghu were also significantly higher in the study group than in the control group. CONCLUSIONS: Based on the characteristics of the draftees who were suspended from service for mental disorders, psychological factors such as suicidal ideation, suicide attempts and adjustment disorders should be surveyed and monitored before the draft and at an early stage of military service.