Artemis Dona

Health Risks of Genetically Modified Foods

As genetically modified (GM) foods are starting to intrude in our diet concerns have been expressed regarding GM food safety. These concerns as well as the limitations of the procedures followed in the evaluation of their safety are presented. Animal toxicity studies with certain GM foods have shown that they may toxically affect several organs and systems. The review of these studies should not be conducted separately for each GM food, but according to the effects exerted on certain organs it may help us create a better picture of the possible health effects on human beings. The results of most studies with GM foods indicate that they may cause some common toxic effects such as hepatic, pancreatic, renal, or reproductive effects and may alter the hematological, biochemical, and immunologic parameters. However, many years of research with animals and clinical trials are required for this assessment. The use of recombinant GH or its expression in animals should be re-examined since it has been shown that it increases IGF-1 which may promote cancer.

Off-line HPLC method combined to LC-MS for the determination of sildenafil and its active metabolite in post-mortem human blood according to confirmation criteria.

A simple HPLC method has been validated for the determination of sildenafil and its active metabolite (N-desmethylsildenafil) in human blood, using an octadecyl silica (ODS) hypersil column. The chromatographic run time is less than 25 min using a mobile phase of 35:65 (v/v) acetonitrile-0.015 M disodium hydrogen phosphate (Na(2)HPO(4)), triethylamine 0.1%, pH 7.4 at 1 mL/min flow rate and UV-vis detection at 230 nm. The method is linear in the concentration range of 10-500 ng/mL (r>0.999, n=5) for each analyte, with relative standard deviation (R.S.D.) less than 5.05%. Interday and intraday errors were found to be < or =11.94%. The limits of detection and quantitation for both analytes were 5.0 ng/mL (s/n>3) and 10.0ng/mL (s/n>10), respectively. The method was applied in two post-mortem human blood samples, concerning two fatal cases from sildenafil citrate use, reported for the first time in Greece, and the results were further confirmed with LC-MS. The method is proposed as supplementary to LC-MS when inadequate mass fragmentation does not provide information appropriate to meet confirmation criteria.

The use of alcohol and other psychoactive substances by victims of traffic accidents in Greece

Alcohol is one of the main causes of traffic accidents worldwide. Its use decreases significantly the driving ability of an individual as well as the reflexes of a pedestrian increasing in this way the possibilities of their involvement in motor-vehicle accidents. The above possibilities are increased when a psychoactive substance has been taken in combination with alcohol due to their synergistic effect. The Laboratory of Forensic Medicine and Toxicology of the University of Athens is authorized to perform the toxicological investigation of traffic accidents that happen in the major part of Greece. The findings of the toxicological analyses that were performed in our laboratory during the years 1995 to 1997 are classified according to the alcohol concentration and the kind of psychoactive substance detected as well as to the gender and the age of the victims, drivers or pedestrians. The results of the above classification are evaluated and the conclusions regarding alcohol, drugs and traffic accidents in Greece are discussed thoroughly.

Direct urine analysis for the identification and quantification of selected benzodiazepines for toxicology screening.

A simple and rapid LC/MS method with direct injection analysis was developed and validated for the identification and quantification of ten benzodiazepines (flunitrazepam, nordiazepam, diazepam, 7-aminoflunitrazepam, flurazepam, bromazepam, midazolam, alprazolam, temazepam and oxazepam) in human urine using diazepam-d5 as internal standard (IS). The main advantage of the proposed methodology is the minimal sample preparation procedure, as diluted urine samples were directly injected into LC/MS system. Electrospray ionization in positive mode using selected ion monitoring was chosen for the identification and quantification of the analytes. The linear range was 50-1000 ng/mL for each analyte, with square correlation coefficient (r(2))≥0.981. Interday and intraday errors were found to be ≤5.72%. The LC/MS method was applied at ten real samples found initially to be positive and negative, using immunoassay technique. Finally the results were confirmed with GC/MS. The method demonstrates simplicity and fast sample preparation, accuracy and specificity of the analytes which make it suitable for replacement of immunoassay screening in urine avoiding thus false negative/false positive results. Using this method, laboratories may overcome the problem of high cost instrumentation such as LC-MS/MS by providing similar sensitivity and specificity with other methods.

Development and validation of a method for the determination of buprenorphine and norbuprenorphine in breast milk by gas chromatography-mass spectrometry.

Buprenorphine (BUP) is used for the maintenance of opioid-addicted pregnant women. Because BUP and its main metabolite nor-BUP are excreted into breast milk, a sensitive and specific GC/MS method has been developed, optimized and validated for their determination in breast milk. BUP-d4 was used as internal standard. The sample preparation includes combination of protein precipitation with solid-phase extraction and derivatization (acetylation). The absolute recovery for both analytes was found to be higher than 87.3%. The limits of detection and quantification were 0.07 and 0.20 µg/L, respectively. The calibration curves were linear within the dynamic range 0.20-20.0 µg/L, with a correlation coefficient higher than 0.996. Intra- and inter-day accuracies were ranged from -7.06 to 4.50 and from -5.88 to 7.00%, respectively, while intra- and inter-day precision were less than 5.7 and 6.1%. The analytes were found to be stable in breast milk at 4 °C for one week, at -20 °C for one month, and after three freeze-thaw cycles. The method can be used for the determination of BUP and nor-BUP in breast milk of BUP-maintained mothers, in order to calculate the amount of drug that could pass to the newborn via breast milk and to avoid toxic consequences of breastfeeding.

Naphyrone: a “legal high” not legal any more

Naphyrone, also known as naphthylpyrovalerone and O-2482, is a cathinone derivative that has been recently advertized for purchase on a number of websites. Naphyrone belongs to a new class of “designer drugs” that has emerged on the drugs abuse market and has gained popularity as the new “legal high.” Legal highs have been circulating for a number of years in Europe and are becoming popular in the United States. They are affordable, widely available, legal to use and possess, and legal to supply. This review presents any available information about safety profile, clinical data, analytical profile, and legislation of this legal high, which is not legal any more. Any available information has been collected by various literature search engines and the World Wide Web. The structure of naphyrone is similar to that of pyrovalerone, a monoamine uptake inhibitor. This new designer drug does not have a long history of use, so there is little evidence of its long-term effects or on the risks from its use. Because of its similarity to other cathinone derivatives, naphyrone is likely to share the same risks, such as anxiety, paranoia, and overstimulation of the heart and circulatory system. Naphyrone was classified as a controlled drug under the UK Misuse of Drugs Act of 1971 (Amendment No. 2) Regulation 2010.

Flour Contamination as a Source of Lead Intoxication

CASE REPORT A 43-year-old man was hospitalized because of severe anemia and recurrent bouts of abdominal pain over 20 days. There was no known occupational exposure to toxins. Concomitantly, the patients father complained of having the same symptoms. Familial lead poisoning was diagnosed when all 6 family members tested had high blood leads (31-64 micrograms/dL). RESULTS Following detailed examination of the potential sources common to all members of the household, the cause of poisoning was determined to be corn flour containing 38.7 mg/g lead. Physicians are reminded to consider lead poisoning in the differential diagnosis of individuals with unexplained symptoms, particularly those of abdominal discomfort and anemia.

Carbon Monoxide-Related Deaths in Greece: A 23-Year Survey

Abstract Carbon monoxide (CO) is the cause of more than one half of the fatal poisonings throughout the world. The aim of this study was to assess the characteristics of nonfire CO-related deaths in Greece, as they were recorded at the Department of Forensic Medicine and Toxicology, School of Medicine, University of Athens. This retrospective study concerned the toxicological records of all fatal cases of CO poisoning received by the Department of Forensic Medicine and Toxicology during the period 1987 to 2009. The records were reviewed and compiled according to the official coroner’s verdict as to the manner of poisoning (accident or suicide), as well as according to the sex and the nationality of the victims. The registered victims were 176 (131 males, 45 females). Of CO deaths, 97.2% were accidental, and 2.8% were suicides, through automobile exhaust. Among the decedents, 32 victims were immigrants (30 males, 2 females). The average annual death rate for males was nearly 3½ times higher than that for females. This increase suggests a need for preventive strategies targeting not only high-risk population, such as homeless or immigrants, but also the general population. Preventive messages in many languages through the media about potential sources of CO exposure are recommended. Precautions should also be taken during periods of low temperatures.

Drug-facilitated sexual assault provoked by the victim's religious beliefs: a case report.

The number of drug-facilitated sexual assault incidents has lately been increased all over the world leading law enforcement agencies and hospital doctors to constant alert. The drugs involved may be benzodiazepines, hypnotics, other sedatives, anesthetics, drugs of abuse or ethanol. The detection of these agents in biologic fluids is difficult, since most of them are shortly acting, and provoke victims amnesia which in turn leads the victim to report the allegation late. An unusual case-study of a 35-year-old, married woman who was admitted to the hospital with dizziness and loss of memory for a period of 10 days is here reported. The toxicological analysis of the victims blood and urine for unknown sedative drugs, achieved by GC-MS, revealed the presence of zolpidem (Stilnox), a nonbenzodiazepine hypnotic. Concentration of zolpidem in blood, 11 hours after the last supposedly intake, was 47 μg/L. After family counseling at the hospital, the victims husband confessed that he was replacing the contents of Losec capsules of his wife, with Stilnox tablets. This unjust act was committed by the husband in order for him to have sex with his wife, since she was not willing to participate in a sexual intercourse due to her religious restraints for a fasting period of 40 days. The aim of this article is 2-fold. First, to emphasize the fact that a sexual assault can take place not only between 2 strangers, but also within a happily married couple. Second, to remind doctors that any case of sexual assault must be examined toxicologically, for a better and thorough investigation.

Reduction of Lead Pollution in Greece During the Past Two Decades

We studied blood lead levels of children who lived in 3 locations in Greece. We then compared blood lead levels in our study with results of previous studies conducted in Athens and other areas of Greece. The significant reduction of blood lead levels in Greece during the past 2 decades was obvious. We also discussed the factors responsible for the overall reduction in blood lead levels.