No abstract

In 2005, a national pilot harm reduction program (PHRP), which mainly included a methadone maintenance treatment program (MMTP) and a needle/syringe exchange program (NSP), was implemented in Taiwan. We conducted this study to evaluate the effectiveness of harm reduction measures on HIV control among injecting drug users (IDUs) between PHRP and nonPHRP. The data on HIV, collected from incumbent Taiwanese authorities, were analyzed for their associations, risk and protective factors with PHRP measures. While the monthly HIV incidences did not show significant differences before and after PHRP in the four areas with PHRP (Taipei City, Taipei County, Taoyuan County and Tainan County), a significant increase in the HIV incidence was found in the 21 areas without PHRP. Hence, the implementation of the PHRP did result in a significant difference in the monthly HIV incidence between areas with and without the PHRP. Mandatory HIV testing was significantly associated with the HIV incidence according to the generalized estimation equations (GEE) model. With adjustments of time period and area with PHRP, and urban area, protective factors associated with HIV incidence were: educational materials, condoms, dilution water, and alcohol sponges/swabs. MMTP contributed to a higher HIV incidence, probably due to the concurrent HIV testing upon admission. Since HIV testing was not required in the NSP, the HIV testing-dependent MMTP may explain the association of the PHRP intervention and an increased HIV incidence. In summary, HIV testing and education were essential for effective HIV control upon implementing the PHRP.

A rapid and reliable high-performance liquid chromatographic method was developed and validated for the simultaneous determination of norephedrine (NE), norpseudoephedrine (NPE), ephedrine (E), pseudoephedrine (PE), methylephedrine (ME) and methylpseudoephedrine (MPE) in both a Mahwang traditional Chinese medicine (TCM) preparation and in urine using alpha-ethylbenzylamine as the internal standard. The method uses a Spherisorb C(18) column for an isocratic elution in a tetraethylammoniumphosphate-methanol mobile phase at a wavelength of 206 nm. The limits of detection of NE, NPE, E, PE, ME and MPE in sample solutions ranged from 0.1 to 0.3 microg[sol ]mL at a signal-to-noise ratio of 3. The within-day precision as calculated from the Mahwang TCM preparation and urine samples was below 6.2 and 1.4% for each analyte. The between-day precision as calculated from the Mahwang TCM preparation and urine samples was below 6.8 and 5.9% for each analyte. The between-day accuracy as determined from the Mahwang TCM preparation and urine samples was below 2.2 and 6.8% for each analyte. The recoveries for six compounds, obtained with compounds spiked into the Mahwang TCM preparation and urine, were found to be more than 93.6%. This method can be successfully applied to doping and excretion rate studies.

Kakkon-to is one of the most common Traditional Chinese Medicine preparations for the attenuation of colds. Ephedrae Herba is one of the prescriptions of Kakkon-to. The major ingredients of Ephedrae Herba, ephedrines, are banned substances on the World Anti-Doping Agency (WADA) list. The purpose of this study was to investigate the elimination of urinary ephedrines after administering Kakkon-to and to determine the possibility of urinary positive ephedrine test results. Six healthy volunteers took one single dose of 2.5 g Kakkon-to extract granules. The concentrations of urinary ephedrines were analyzed by high-performance liquid chromatography. The result showed that ephedrine and norpseudoephedrine were excreted in the urine after taking one single dose of Kakkon-to. However, the highest amount of ephedrines in urine was ephedrine and the peak concentration was 4.35 +/- 1.82 microg/mL (mean +/- standard deviation), which was lower than the WADA permitted value (10 microg/mL). The estimated elimination half-lives of ephedrine, norephedrine, pseudoephedrine, and norpseudoephedrine following administration of this preparation were: 5.2 +/- 1.2, 4.2 +/- 1.3, 4.2 +/- 0.9, and 6.5 +/- 2.8 h, respectively. This study concluded that the urine would not violate the rule of doping after administering a single dose of Kakkon-to. Nevertheless, a further study on administering the preparation for 3 times per day for 3 days showed a positive ephedrine result. Athletes should be careful when taking more than a single dose of Kakkon-to.

Solid dispersion systems of water-insoluble piroxicam in polyethylene glycol (PEG) 4000 and in urea were prepared by fusion and solvent methods and were characterized in this study. The in vitro dissolution studies showed that the dispersion systems containing piroxicam and PEG4000 or urea gave faster dissolution than the corresponding simple mixtures. The differential scanning calorimetry (DSC) study indicated that the piroxicam-PEG system prepared by the fusion method is a solid dispersion, while the piroxicam-urea system prepared by the solvent method is likely to be a solid solution of piroxicam in urea. The storage testings showed that all dispersions were stable, except that uptake of water during storage may occur in the PEG system. A single-dose study with rabbits showed that the dispersion systems provided statistically significant to a higher extent and rate of bioavailability than the corresponding physical mixture (p < 0.05).