(C) 2012 Elsevier B.V. All rights reserved.”
“MAHONY PH, MYERS JA, LARSEN PD, POWELL DMC, GRIFFITHS RE Symptom-based categorization of in-flight CT99021 nmr passenger medical incidents. Aviat Space Environ Med 2011; 82:1131-7.\n\nIntroduction: The majority of in-flight passenger medical events are managed by cabin crew. Our study aimed to evaluate the reliability of cabin crew reports of in-flight medical events and to develop a symptom-based categorization system. Methods: All cabin crew in-flight

passenger medical incident reports for an airline over a 9-yr period were examined retrospectively. Validation of incident descriptions were undertaken on a sample of 162 cabin crew reports where medically trained persons’ reports were available for comparison using a three Round Delphi technique and testing concordance using Cohen’s Kappa. A hierarchical symptom-based categorization system was designed and validated. Results: The rate was 159 incidents per 10(6) passengers carried, or 70.4/113.3 incidents per 10(6) revenue passenger kilometres/miles, respectively. Concordance between cabin crew and medical

reports was 96%, with a high validity rating (mean 4.6 on a 1-5 scale) and high Cohen’s Kappa (0.94). The most common in-flight medical events were transient loss of consciousness (410/0), nausea/vomiting/diarrhea (19.5%), and breathing difficulty (16%). Discussion: Cabin crew records provide reliable data regarding in-flight passenger medical incidents, complementary to diagnosis-based systems, and Entinostat Epigenetics inhibitor Torin 2 PI3K/Akt/mTOR inhibitor allow the use of currently underutilized data. The categorization system provides a

means for tracking passenger medical incidents internationally and an evidence base for cabin crew first aid training.”
“The stimulant designer drug mephedrone is a derivative of cathinone – a monoamine alkaloid found in khat – and its effect resembles that of 3,4-Methylenedioxymethamphetamine (MDMA). Abuse of mephedrone has been documented since 2007; it was originally a legal high’ drug, but it has now been banned in most Western countries. Using cDNA-expressed CYP enzymes and human liver microsomal preparations, we found that cytochrome P450 2D6 (CYP2D6) was the main responsible enzyme for the in vitro Phase I metabolism of mephedrone, with some minor contribution from other NAPDH-dependent enzymes. Hydroxytolyl-mephedrone and nor-mephedrone were formed in vitro, and the former was purified and identified by nuclear magnetic resonance (NMR). In four forensic traffic cases where mephedrone was detected, we identified hydroxytolyl-mephedrone and nor-mephedrone again; as well as 4-carboxy-dihydro-mephedrone, which has been previously described; and two new metabolites: dihydro-mephedrone and 4-carboxy-mephedrone. Fragmentation patterns for all detected compounds were determined by a UPLC-QTOF/MSE system, and a fragmentation pathway via a conjugated indole structure was proposed for most of the metabolites.