Objective: In the Drug Informatics in Department of Pharmacy, Kitasato Institute Hospital (hereinafter “the hospital”), we have had question-and-answer sessions regarding doping agents (banned drugs) among doctors and other workers and prepared an Anti-doping Quick Reference List (hereinafter “the list”), facing an urgent need to provide precise information quickly.
Methods: The list consists of drugs adopted by the hospital and over-the-counter drugs according to package inserts, interview forms, and other sources of information.
Results: In the list, hospital and over-the-counter drugs are classified into three categories in terms of a doping test: (1) “Non-banned” (drugs that can be used), (2) “Banned” (drugs that cannot be used), and (3) “Suspected” (unclear drugs) with their half lives for elimination as an indicator of the disappearance time from the body and divided by medicinal effect.  In addition, we indicated any drug for which the Therapeutic Use Exemption (TUE) application (hereinafter, TUE application) is required before use.
Conclusion: The list prepared in this investigation offers many benefits, including precise and quickly available information on banned and non-banned drugs, ease in suggesting alternatives, and avoidance of failure in TUE application.

Little is known regarding the effects of mineral-containing supplemention on oxidative stress markers, carbohydrate and lipid metabolism in response to an acute bout of exercise in humans. The present study investigated whether prior mineral-containing supplemention can improve oxidative stress status and how this supplementation influences on carbohydrate and lipid metabolism after a single bout of cycling in young men. Twelve, healthy young men (aged 22.5 ± 2.4 years, mean ± SD) underwent two, 150-min trials in a random order. Each participant received oral administration of mineral supplement containing 13.4 mg of sulphur or placebo one minute before exercise. In both trials, participants cycled at 75% of heart rate reserve for 60 minutes and then rested for 90 minutes. Blood samples were collected pre-exercise supplementation, immediately after exercise, 30 minutes after exercise, 60 minutes after exercise and 90 minutes after exercise. Circulating concentrations of derivatives of reactive oxygen metabolites, biological antioxidant potential, glucose and insulin did not differ between trials. Elevated circulating concentrations of non-esterified fatty acids were observed immediately after exercise in the supplementation trial compared with the placebo trial (mean ± SD: 1.1 ± 0.5 and 0.9 ± 0.3 mmol/L, respectively: trial × time interaction, p = 0.036). The present study showed that acute mineral-containing antioxidant supplemention appears to have no effect on improving oxidative stress markers in response to a single bout of cycling in healthy young men. In addition, the findings of this study suggested that mineral-containing supplemention may influence lipids metabolism during exercise.

Purpose: Integrated care pathway (ICP) is structured multidisciplinary care plan that aim to improve the quality of care. ICP could be effective in providing quality End-of-Life (EOL) care in long-term care facilities (LTCFs). However, the outcomes and components of ICP for EOL care in LTCFs are not clear. Methods: We conducted a scoping review to identify the outcomes and components. We searched electronic databases (PubMed, CINAHL, Cochrane Library, PsycINFO, Ichushi) and conducted an additional hand search for relevant journal articles related to EOL care. We searched intervention and implementation studies for ICP in EOL care in LTCFs. Results: Thirteen papers met the inclusion criteria. We identified the following components of ICP: documents, education regarding EOL care and ICP, support by experts, and regular conferences among care providers. The effects of ICP were reported as reductions in transfers to hospitals and improvement in staff confidence regarding EOL care. Conclusion: With reference to the components of ICP identified in this study, ICP should be developed based on the characteristics of LTCFs, and the effects of intervention or implementation studies using a more robust design should be examined.

BACKGROUND: There have been inconsistent findings reported on maternal passive smoking during pregnancy and child risk of ADHD. In this study, ADHD symptoms at pre-school age children in association with prenatal passive and active tobacco smoke exposure determined by maternal plasma cotinine levels in the third trimester were investigated. METHODS: This was a follow-up study of the birth cohort: the Hokkaido Study on Environment and Children's Health. Children whose parents answered Strengths and Difficulties Questionnaire (SDQ) to identify child ADHD symptoms (hyperactivity/inattention and conduct problems) and total difficulties at age 5 years with available maternal plasma cotinine level at the third trimester were included (n = 3216). Cotinine levels were categorized into 4 groups; ≦ 0.21 ng/ml (non-smoker), 0.22-0.51 ng/ml (low-passive smoker), 0.52-11.48 ng/ml (high-passive smoker), and ≧ 11.49 ng/ml (active smoker). RESULTS: Maternal cotinine levels of active smokers were significantly associated with an increased risk of total difficulties (OR = 1.67) and maternal low- and high-passive smoking also increased the risk (OR = 1.11, 1.25, respectively) without statistical significance. Similarly, maternal cotinine levels of active smokers were associated with an increased risk of hyperactivity/inattention (OR = 1.49). Maternal low- and high-passive smoking and active smoking increased the risk of hyperactivity/inattention (OR = 1.45, 1.43, and OR = 1.59, respectively) only in boys. CONCLUSION Our findings suggested that maternal active smoking during pregnancy may contribute to the increased risk of child total difficulties and hyperactivity/inattention at pre-school age. Pregnant women should be encouraged to quit smoking and avoid exposure to tobacco smoke.
Adult ; Attention Deficit Disorder with Hyperactivity ; epidemiology ; etiology ; physiopathology ; psychology ; Child, Preschool ; Cotinine ; blood ; Female ; Follow-Up Studies ; Humans ; Japan ; epidemiology ; Male ; Maternal Exposure ; adverse effects ; Mothers ; Pregnancy ; Pregnancy Trimester, Third ; Prenatal Exposure Delayed Effects ; epidemiology ; etiology ; Risk ; Sex Factors ; Tobacco Smoking ; adverse effects ; epidemiology

BACKGROUND: Studies reported adverse behavioral development including internalizing and externalizing problems in association with prenatal exposure to bisphenol A (BPA) and phthalates; however, findings were not sufficient due to using different assessment tools and child ages among studies. This study aimed to examine associations between maternal serum levels of BPA and phthalate metabolites and behavioral problems at preschool age. METHODS: The Strengths and Difficulties Questionnaire (SDQ) was used to assess behavioral problems at 5 years of age. BPA and phthalate metabolite levels in the first trimester maternal serum was determined by LC-MS/MS for 458 children. Variables used for adjustment were parental ages, maternal cotinine levels, family income during pregnancy, child sex, birth order, and age at SDQ completed. RESULTS: The median concentrations of BPA, MnBP, MiBP, MEHP, and MECPP, primary and secondary metabolites of phthalates, were 0.062, 26.0, 7.0, 1.40, and 0.20 ng/ml, respectively. MECPP level was associated with increase conduct problem risk (OR = 2.78, 95% CI 1.36-5.68) overall and the association remained after child sex stratification, and odds ratios were increased with wider confidence interval (OR = 2.85, 95% CI 1.07-7.57 for boys, OR = 4.04, 95% CI 1.31-12.5 for girls, respectively). BPA, ∑DBP (MnBP + MiBP), and ∑DEHP (MEHP+MECPP) levels were not associated with any of the child behavioral problems. CONCLUSIONS Our analyses found no significant association between BPA or summation of phthalate metabolite levels and any of the behavioral problems at 5 years of age but suggested possible association between MECPP levels and increased risk of conduct problems.
Adult ; Age Factors ; Benzhydryl Compounds ; blood ; Child, Preschool ; Environmental Exposure ; analysis ; Female ; Humans ; Male ; Phenols ; blood ; Phthalic Acids ; blood ; Pregnancy ; Prenatal Exposure Delayed Effects ; epidemiology ; Problem Behavior ; Smoking ; epidemiology ; Socioeconomic Factors

BACKGROUND: The Hokkaido Study on Environment and Children's Health is an ongoing study consisting of two birth cohorts of different population sizes: the Sapporo cohort and the Hokkaido cohort. Our primary objectives are to (1) examine the effects that low-level environmental chemical exposures have on birth outcomes, including birth defects and growth retardation; (2) follow the development of allergies, infectious diseases, and neurobehavioral developmental disorders, as well as perform a longitudinal observation of child development; (3) identify high-risk groups based on genetic susceptibility to environmental chemicals; and (4) identify the additive effects of various chemicals, including tobacco. METHODS: The purpose of this report is to provide an update on the progress of the Hokkaido Study, summarize recent results, and suggest future directions. In particular, this report provides the latest details from questionnaire surveys, face-to-face examinations, and a collection of biological specimens from children and measurements of their chemical exposures. RESULTS: The latest findings indicate different risk factors of parental characteristics on birth outcomes and the mediating effect between socioeconomic status and children that are small for the gestational age. Maternal serum folate was not associated with birth defects. Prenatal chemical exposure and smoking were associated with birth size and growth, as well as cord blood biomarkers, such as adiponectin, leptin, thyroid, and reproductive hormones. We also found significant associations between the chemical levels and neuro development, asthma, and allergies. CONCLUSIONS Chemical exposure to children can occur both before and after birth. Longer follow-up for children is crucial in birth cohort studies to reinforce the Developmental Origins of Health and Disease hypothesis. In contrast, considering shifts in the exposure levels due to regulation is also essential, which may also change the association to health outcomes. This study found that individual susceptibility to adverse health effects depends on the genotype. Epigenome modification of DNA methylation was also discovered, indicating the necessity of examining molecular biology perspectives. International collaborations can add a new dimension to the current knowledge and provide novel discoveries in the future.
Biomarkers/blood* ; Child ; Child Health ; Child, Preschool ; Cohort Studies ; Environmental Exposure/adverse effects* ; Environmental Health ; Environmental Pollutants/adverse effects* ; Female ; Fetal Blood/chemistry* ; Follow-Up Studies ; Growth/drug effects* ; Humans ; Hypersensitivity/etiology* ; Infant ; Japan/epidemiology* ; Male ; Neurodevelopmental Disorders/etiology* ; Pregnancy ; Prenatal Exposure Delayed Effects/etiology* ; Prevalence ; Smoking/adverse effects*