Detection and determination of C12-, C14-, C16-alkyldimethylamines in human blood using gas chromatography-mass spectrometry.

RATIONALE: N,N-Dimethyldodecylamine is produced from lauryl alcohol and dimethylamine. C12-C16 alkyldimethylamines are used as intermediates for the manufacture of amineoxides and quaternary amino compounds. In the present study a gas chromatography-mass spectrometry (GC/MS) method for the determination of C12-C16 alkyldimethylamines in blood was developed and validated. The reason for this study was the detection of the above compounds in the postmortem blood sample of a fatal suicide case. METHODS: Analysis of amines was performed using a gas chromatograph (Agilent Technologies 7890A) with an MS 5975C inrXL, EI/CI MSD with triple-axis detector in selected ion monitoring mode, after liquid-liquid extraction. Four different organic solvents (butyl acetate, ethyl acetate, n-hexane and n-heptane) were used for the optimization of the extraction procedure, resulting in ethyl acetate being the solvent of choice for the extraction procedure. A QuEChERS step was applied (20 mg of MgSO4 , 5 mg of NaCl) to 1 mL of blood and pH was adjusted at 12 (K2 CO3 buffer solution). After the addition of the extraction solvent, samples were vortexed, centrifuged and directly injected into the GC/MS system. RESULTS: In validation, the method was found to be selective and sensitive (limit of detection from 0.3 to 0.5 ng/mL, limit of quantitation from 10.0 to 20.0 ng/mL), whilst validation included recovery, stability, accuracy and precision (relative standard deviation). Validation results were found satisfactory: intra- and interday precision ranged from 0.4% to 2% and from 0.6% to 1.9% respectively, while intra- and interday accuracy ranged from 87% to 109% and from 86% to112.8%. C12-C16 alkyldimethylamines were detected in blood samples at a concentration of 8.39 µg/mL (C12), 3.01 µg/mL (C14) and 0.42 µg/mL (C16). CONCLUSIONS: A rapid, sensitive and reliable method was developed for the determination of C12-C16 alkyldimethylamines in postmortem blood, after optimization of the sample preparation procedure, and finally successfully applied to a real postmortem blood sample from a fatal case involving these compounds.

Trends in suicidality amid the economic crisis in Greece.

For the decade 2000-2010, suicidal rates appear to be both low and stable in Greece and unrelated to the socioeconomic environment. It is highly possible that the recent crisis caused a significant increase in dysphoria, stress, depression and maybe suicidal ideation in the general population, but completed suicides do not seem to have increased so far. Measures are needed to make sure there will be no increase in completed suicides in the near future, since historically, periods of socioeconomic instability might be related to increased suicidality. Community interventions reduce stigma and enhance help-seeking. However, only those including the creation of social support networks are essential in the fight against suicidality.

Microanatomic Morphometric Characteristics of the Third Ventricle Floor.

Background: Endoscopic third ventriculostomy (ETV) is an effective treatment for hydrocephalus. The in-depth understanding of microanatomy is essential for accurate diagnosis, treatment and complications prevention. The aim of this study is to supplement the knowledge gap regarding the microanatomical metrics and correlations for which the literature includes only scarce mentions at best. Methods: This is a descriptive microanatomical study including 25 cadaver brains. Specimens from donors with neurological, psychiatric disorders or alcohol abuse were excluded. Surgical loops were used for harvesting. High-precision tools were employed to dissect and measure the anatomical landmarks under a surgical microscope. Each measurement was performed in three consecutive attempts and outliers were rejected. RStudio was used for statistical analysis. Distribution was evaluated employing the Shapiro-Wilk test. Normally distributed values were presented as mean and standard deviation, and others as median and interquartile range. Results: The age of the donors was 61.72 (±10.08) years. The distance from the anterior aspect of the foramen of Monro to the anterior margin of the mamillary body was 16.83 (±1.04) mm, and to the posterior margin was 16.76 (±1.9) mm. The distance from the anterior mamillary body margin to the infundibulum was 6.39 (±1.9) mm, to the optic recess was 8.25 (±1.84) mm, and to the apex of the vertebral artery was 5.05 (±1.62) mm. The distance from the anterior commissure to the brain aqueduct was 22.46 (±2.29) mm, and to the infundibulum was 13.93 (±2.54) mm. The mamillary body diameter was 4.91 (±0.34) mm in the anteroposterior and 4.21 (±0.48) mm in the cranio-caudal plane. The intraventricular segment was protruding by 1.63 (±0.46) mm. The diameter of the hypothalamus on the anterior margin of mamillary bodies was 1.37 (±0.75) mm, of the Liliequist membrane was 0.19 (±0.07) mm and of the lamina terminalis was 0.35 (±0.32) mm. Conclusion: The presented microanatomical measurements and correlations are expected to contribute to the improvement of ETV safety.

The Effects of Pilates Exercise Training Combined with Walking on Cardiorespiratory Fitness, Functional Capacity, and Disease Activity in Patients with Non-Radiologically Confirmed Axial Spondylitis.

The objective of the study was to examine the effects of Pilates exercise training combined with walking on cardiorespiratory fitness, functional capacity, and disease activity in patients with non-radiologically confirmed axial spondylitis (nr-axSpA). Thirty patients with nr-axSpA (seven women (90%), with a mean age of 46.07 ± 10.48 years old and C-reactive protein (CRP) 2.26 ± 2.14 mg/L) were randomly divided into two groups: A (n1 = 15 patients) and B (n2 = 15 patients). Group A followed a 6-month home-based Pilates exercise training program, while Group B remained untrained until the end of the study. A cardiopulmonary exercise test (CPET), timed up and go test (TUG), five times sit-to-stand test (5×STS), sit-and-reach test (SR), back scratch test for the right (BSR) and the left arm (BSL), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Ankylosing Spondylitis Disease Activity Score (ASDAS) were applied to all patients, both at the beginning and at the end of the study. After 6 months, Group A showed higher values in exercise time by 37.41% (p = 0.001), higher peak oxygen uptake (VO2peak) by 25.41% (p = 0.01), a higher ratio between oxygen uptake and maximum heart rate (VO2/HRmax) by 14.83% (p = 0.04), and higher SR by 18.70% (p = 0.007), while lower values were observed in TUG by 24.32% (p = 0.001), 5×STS by 12.13% (p = 0.001), BASDAI score by 20.00% (p = 0.04) and ASDAS score by 23.41% (p = 0.03), compared to Group B. Furthermore, linear regression analysis showed a positive correlation in Group A between BASDAI and 5×STS (r = 0.584, p = 0.02), BASDAI and TUG (r = 0.538, p = 0.03), and ASDAS and 5×STS (r = 0.538, p = 0.03), while a negative correlation was found between BASDAI and VO2peak (r = -0.782, p < 0.001), ASDAS and SR (r = -0.548, p = 0.03), and ASDAS and VO2peak (r = -0.659, p = 0.008). To sum up, cardiorespiratory fitness, functional capacity, and disease activity improved after a long-term Pilates exercise training program in patients with nr-axSpA.

Investigating the phenomenon of overkill in Greece: A forensic psychiatric autopsy study between 2005 and 2020.

The purpose of this study was to investigate overkill in the Greek population from a criminological and victimological point of view and explore possible correlations of the phenomenon with socio-cultural or psychiatric factors. Overall, 158 autopsies of overkill victims were identified throughout the 15-year records of the national forensic laboratories throughout the northern Greek mainland. The pattern that has emerged from the statistical results of the present study on the victims of overkill within the Greek borders was generally in line with global statistics on homicide victims, but also presented differences. The phenomenon correlated more with homicides in the context of mental disorders (within schizophrenia spectrum), other crimes (such as burglary) as well as domestic violence. Overall, males outnumbered females both as victims (approximately threefold) and as perpetrators in overkill homicide cases, but regarding domestic violence, the sad majority of overkill victims stood for females murdered with excessive violence by male relatives. Close female relatives (especially mothers and grandmothers) were also victimized by psychiatrically ill offenders. Female perpetrators tended to attack male individuals with whom they shared a relationship (intimate partners). An important finding was the fact that less than half the offenders' population with major mental disorders were diagnosed at the time of the offense. Overkill victims were found, on average, to be older than average homicide victims, being probably associated with the entailed difference in the physical strength ratio between the victim and the perpetrator.

Alprazolam and Zolpidem in Skeletal Tissue of Decomposed Body Confirms Exposure.

In several medico-legal cases, bone samples analysis may provide the only source of toxicological information. This case study reports the analysis of a human bone specimen, belonging to a 46-year-old man, found 3 months after his death due to cervical-thoracic injuries in a motorcycle accident. Bone specimen was the only available material for toxicological analysis, among few skull hair and rotten skin. Analysis was performed by a newly developed and validated ultra-high-pressure liquid chromatography-mass spectrometry/mass spectrometry (UHPLC-MS/MS) method, following simple and efficient sample pretreatment. The results were in accordance with the man's medical record: Alprazolam and zolpidem were found at 2.2 and 5.4 ng/g of bone, respectively. Both these drugs were prescribed to the deceased.

Determination of drugs of abuse and pharmaceuticals in skeletal tissue by UHPLC-MS/MS.

In several medico legal cases bone analysis may provide the only source of toxicological information. The present study reports the development of an UHPLC-MS/MS method for the detection and quantification of 27 drugs and pharmaceuticals in human bones. The target compounds comprise pharmaceuticals (antipsychotics and antidepressants) and some of the most important groups of drugs of abuse: opiates, cocaine, cannabinoids, amphetamines and benzodiazepines. Sample pretreatment was studied and the best results were obtained after extraction with methanol, stirring and ultra-sonication. The extract, after filtration, evaporation and reconstitution was analysed on a reversed-phase column (C18) in gradient elution over 17min. The method was found to be selective, and sensitive offering limits of detection (LOD) from 0.03 to 1.35ng/g of bone. Validation included evaluation of limit of quantification (LOQ), recovery, carry-over, matrix effect, accuracy and precision (RSD%) of the method. The method performed satisfactory in relation to established bioanalytical criteria and was therefore applied to the analysis of bone and bone marrow obtained post-mortem from chronic drug abusers, offering unambiguous identification and quantitative determination of drugs in bones from legal cases where the analysis of blood was not feasible.

Rate of suicide and suicide attempts and their relationship to unemployment in Thessaloniki Greece (2000-2012).

INTRODUCTION: Recently there was a debate concerning the relationship between the economic crisis and an increase in attempted and completed suicides in Europe and especially in Greece. The aim of the current study was to calculate the rates of attempted and completed suicide per year in the county of Thessaloniki, Macedonia, northern Greece, for the years 2000-12, and to investigate their relationship with unemployment. MATERIAL AND METHODS: The archive of the Emergency Outpatient Units of three hospitals was investigated and the results were projected to the county population. Data from the Hellenic statistics authority concerning regional general population and suicides and unemployment were used. RESULTS: The rate of attempted suicides was 16.69-40.34 per 10(5) inhabitants for males and 41.43-110.82 for females. Medication was the preferred method for 95.93%. The completed suicide rates varied from 3.62 to 5.47 for males and from 0.19 to 1.95 per 10(5) inhabitants for females. The male attempt rate correlated negatively with regional male unemployment (-0.63). For females the respected value was similar (-0.72). Concerning competed suicide rates, the respected values were 0.34 and 0.65. The attempt was repeated by 15.34%; almost half-repeated within the same year and 75% within two years. The female to male ratio varied significantly across years with 2:1 (more females) being the probable value for attempts and 1:3.6 (more males) for completed suicides. CONCLUSION: This is the first study from Greece reporting rates on the basis of hospital archives. Attempt and suicide rates are low in Greece. Attempts are negatively and suicides are positively correlated with unemployment.