Biomedical subjects

Dorota Pach

Publications and source records attributed to Dorota Pach.

At least 19 recordsLinked to original sources

PubMed2006

Panther cap Amanita pantherina poisoning case report and review.

An analysis of patients with mushroom poisoning hospitalized in the Clinic of Toxicology in Cracow revealed that only a small percentage of cases had been caused by the death cap Amanita phalloides (Vaill. ex Fr.) Secr. The most important factors contributing to intoxication are confusion of toxic mushrooms with edible species, and non-specific mushroom poisoning. The genus Amanita has a global distribution and is one of the most well-known genera of macrofungi. Active toxins present in the panther cap (A. pantherina) (DC ex Fr.) Secr are ibotenic acid and muscimol, which are rapidly absorbed from the gastrointestinal tract. It is likely that other substances also participate in the psychotropic effects. Five frayed panther cap fruiting bodies were eaten by mistake by two persons (27 and 47 years of age). Symptoms onset occurred after 120 min with central nervous system (CNS) depression, ataxia, waxing and waning obtundation, religious hallucinations and hyperkinetic behaviour. In the present case, successful general symptomatic treatment was administered, which consisted of controlling the nervous symptoms and stabilizing the electrolyte balance. The poisoning regressed with no organ complications.

Adult↗

PubMed2005

Fly agaric (Amanita muscaria) poisoning, case report and review.

Gathering and eating mushrooms and other plants containing psychoactive substances has become increasingly popular among young people experimenting with drugs. Dried fly agaric Amanita muscaria fruiting bodies were eaten by five young persons (18-21 years of age) at a party in order to evoke hallucinations. Visual and auditory hallucinations occurred in four of them, whereas a 18-year-old girl lost consciousness. The following morning, she went to the Clinic of Toxicology. Due to the fact that not all the active substances present in the fly agaric have been identified, and some of them have an effect after a period of latency, the patient was admitted for several days of observation during which check-up examinations were performed. After four days without any problems, she was discharged. The poisoning regressed with no organ complications. The remaining persons who had eaten the fly agaric were free from any complaints.

Adolescent↗

PubMed2005

Assessment of daily nutrition ratios of opiate-dependent persons before and after 4 years of methadone maintenance treatment.

The aim of the study was the evaluation of the changes in nutritional habits of opiates dependent persons during 4 years of attendance in methadone maintenance treatment conducted by the Department of Toxicology of CMUJ in Kraków. These criteria were fulfilled by 30 persons (23 males and 7 females). They were examined before the methadone treatment and after 4 years of treatment. During Initial and final examinations for each of examined person the 24-hour recall had been performed three times. The information about daily supply of main nutrients (proteins, fats, fatty acids, carbohydrates, dietary fibre, cholesterol), minerals (calcium, iron, phosphorus, zinc, sodium) and vitamins (vitamin A, B1, B2, niacin, C) were obtained. The results were compared with daily norms (N) recommended on the safe level of intake. The normal range was established on the level +/-10% of normal values (+/-10% N). The changes between the results of following examinations were tested by using the t-student test. After 4 years of methadone treatment an increase in energy, vitamins, minerals and main nutritional ingredients intake was noted in women group. In men group a decrease in energy, proteins and carbohydrates intake was noted and fats intake, mainly unsaturated fatty acids, was increased. Vitamins were consumed in lower amounts and among minerals lower consumption in case of iron and sodium was noticed. In comparison with the recommended values in the initial examination in women group too low intake concerned fibre and vit. A, B,, calcium, iron, zinc and magnesium was noticed. In group of men too low intake (below recommended values) of energy, carbohydrates, fiber, vit. B1, B2, C, niacin, calcium and magnesium was noticed. After 4 years of methadone maintenance treatment in group of women too low intake only of vit. B1 and iron was noticed. In group of men it concerned vit. B1, B2, C, niacin and minerals such as calcium, iron, magnesium and zinc.

Adult↗

PubMed2005

Nutritional status of the opiate dependent persons after 4 years of methadone maintenance treatment.

The aim of the study was to evaluate the nutritional status of opiate dependent patients before and after 4 years of participation in the methadone maintenance treatment. The examinations were performed in 30 opiates addicted persons (7 women and 23 men). The initial examination (exam 1) was done during the patients qualification for the methadone program, preceding methadone administration and final examination (exam 2) after 4 years of the treatment. In order to estimate the nutritional status body mass, the height, the arm circumference and the thickness of the triceps and subscapular fat-skin folds were measured. On the basis of them the BMI and mid arm muscle circumference (MAMC) were counted. The measurements of the body composition (using the bioimpedance method) were performed. The changes between the results of subsequent examination were tested using the t-Student test. In the examination that took place after 4 years of follow-up, body weight loss in the group of women was observed (mean--1.7 kg). It was followed by the decrease of BMI value (from 20.3 to 19.8 kg/m2). In both examinations the percentage of fatty tissue in general body mass was significantly below recommended values (10.7% in both examinations--the recommended values are 20%-22%). In the group of men an increase in body weight (mean--8.8 kg) and BMI value (from 23.3 to 25.9 kg/m2) was noticed. Arm circumference, muscle arm circumference and fat-skin folds values were increased. The analysis of particular body components showed increased fatty body mass (11.9% in the first and 18.5% in the second examination--the recommended values 16-19%) together with the decrease of lean body mass and body water.

Adult↗

PubMed2005

The changes in taste preferences during 4 years period of methadone maintenance treatment.

The aim of the study was the analysis of the changes in the kind and the frequency of particular nutritional products consumption by opiate addicted persons during 4-year lasting methadone programme. There were 30 opiate addicted patients under examination (23 men and 7 women). Food consumption quality was estimated with the use of the Intake Frequency of Food Products Questionnaire. The examinations were performed before methadone administration had started, after 9 months and after 4 years of methadone maintenance treatment. Three categories of consumption frequency were established: rarely, moderately and often. The classification of different products was done with the use of hierarchic cluster analysis. For general illustration of the data the consumed products were compared by the means of hierarchical cluster analysis (this was done with the help of Euclidean distances and the Ward's algorithm). Then the k-means (with k=3) method was used in order to identify groups of products that were similarly often consumed. Each k-means analysis was performed separately for each examination. This was done in order to find out the products that change the cluster from one examination to another. Twenty labile products were identified. The examined products were moving between the adherent categories. This means that the consumption pattern undergoes some changes over the course of methadone therapy. Additionally, the analysis of the diet of this group of people shows improper and unhealthy nutritional behaviours: too big intake of sweets and too low intake of complex carbohydrates, fish and vegetable fats. This was especially visible at the beginning of the therapy, later this unfavourable diet habits changed but not to the desired level.

Adult↗

PubMed2005

Evaluation of the effect of methadone maintenance treatment program on the frequency of DNA lesions revealed as micronuclei and sister chromatid exchanges.

The aim of the present paper was to examine the effect of substitution methadone treatment on the frequency of DNA lesions using a micronuclear and a sister chromatid exchange tests. The material under study were lymphocyte cultures from peripheral blood, collected 3 times at 3-month intervals from 24 patients. The obtained results may suggest that methadone treatment combined with a change in lifestyle significantly reduces the risk of genome lesions.

Adult↗

PubMed2005

Cytogenetic aspects of buprenorphine maintenance treatment program--preliminary report.

The study was aimed at a preliminary evaluation of the effect of buprenorphine, a synthetic opioid used as a substitute in the therapy of dependence on psychoactive substances, on the structure of the genetic material of patients receiving such treatment. The material for the study were lymphocyte cultures from peripheral blood, analysed by a cytogenetic micronuclear test. The obtained results were compared with the literature data on the mutagenic action of methadone.

Adult↗

PubMed2005

(99m)Tc-HmPAO single photon emission tomography, magnetic resonance proton spectroscopy and neuropsychological testing in evaluation of carbon monoxide neurotoxicity.

There were 10 acutely CO poisoned study patients without CNS history (head traumas, epilepsy, dementia, migraine or alcoholic diseases) in whom (99m)Tc-HmPAO SPET, HMRS and neuropsychological testing were performed. 99mTc-HmPAO SPET and neuropsychological testing were performed twice: in acute phase and at six months post CO exposure. HMRS was carried out at 8 months post CO exposure. A multidimensional analysis of variance (MANOVA) was used to statistical analysis. Regional CBF disturbances in acute phase of CO poisoning were observed in frontal cortex, basal ganglia and parietal cortex respectively. The most reversible, as seen in control (99m)Tc-HmPAO SPET examination, were the changes observed in parietal cortex. Diffuse generalized cortex hypoperfusion, both in acute phase and at 6 months post exposure, was seen only in one the patient. In all of the examined patients different elevation in mobile lipid or/and lactate concentration in frontal lobe or/and basal ganglia was revealed by HMRS evaluation at eight months post acute CO exposure. Results of neuropsychological testing at baseline and at 6 months partially correlated with neuro-imagine techniques applied.

Acute Disease↗

PubMed2005

B-type natriuretic peptide plasma concentration in acutely poisoned patients.

B-type natriuretic peptide (BNP) is synthesized in the cardiac ventricles upon ventricular myocyte stretch. BNP plasma concentration is useful in cardiology especially for identifying patients with congestive heart failure (CHF), as a prognostic marker of acute coronary syndromes and independent predictor of sudden cardiac death. Its value in clinical toxicology is unclear. As toxins frequently produce deleterious effects on the cardiovascular system we have decided to carry out the pilot study on BNP plasma levels in acutely poisoned patients. The 117 patients (65 males and 52 females) treated at the Department of Clinical Toxicology Jagiellonian University Medical College in Kraków in 2004 were included. 42 of them were intoxicated with ethanol, 35 with pharmaceuticals (mostly tricyclic antidepressants), 13 with CO. The mean age of examined group was 34.07 +/- 12.08 year. The control group consisted of 54 healthy volunteers and employees of the Department (mean age; 32.7 +/- 11.74). A significantly higher BNP concentration was found in poisoned patients than in the control group. The highest BNP plasma concentration was noted in pharmaceutical poisoned patients. Mean BNP concentration in poisonings of minor severity (grade 1) was significantly lower then in moderate (grade 2) or severe (grade 3) poisonings. BNP plasma measurement as an additional marker of cardiac disturbances in clinical toxicology practice may be suggested.

Acute Disease↗

PubMed2005

[The CNS damage due to methanol poisoning in the case of 23-year-old male patient addicted to organic solvents].

The aim of this study is the presentation of the case of acute methanol inhalation poisoning and CSN damage connected with this incidence. 23-years old male patient addicted to organic solvents for 5 years was admitted to the Toxicological Unit because of suspicion of organic solvents poisoning. In the case history the patient was exposed to organic solvents in the admission day, he denied drinking alcohol in last time. Phenol and TCA were not confirmed in the toxicological urine analysis. Because of marked metabolic acidosis which was present in the moment of admission subsequental toxicological investigations were conducted. The 0.23 g/l of methanol in blood was revealed. The vision loss was observed in the first day of hospitalization, up to total blind in the third day. Signs of toxic optic nerves neuropathy was revealed in ophthalmological examination. Brain perfusion disturbances in frontal and basal ganglia region was found in the brain perfusion scintigraphy examination. In the 6 month follow up outpatient observation, the partial vision recover was noted. The normalisation of frontal brain perfusion in the perfusion scintigraphy was found. Until now, there is no explanation the route of methanol intoxication--it could be suspect, that the solvents inhaled by patient were contaminated with methyl alcohol.

Acidosis↗

PubMed2004

Clinical status of carbon-monoxide-poisoned patients and the results of rest 99mTc-MIBI and 99mTc-Amiscan heart scintigraphy performed in the acute phase of intoxication and stress-rest 99mTc-MIBI scintigraphy six month later.

The double tracer (99mTc-MIBI and 99mTc-Amiscan) scintigraphy is an useful technique to imagine cardiac injury due to CO intoxication. Accumulation (retention) of 99mTc-MIBI is dependent on blood flow and cellular and mitochondrial electrical potential of myocytes. The lower tracer accumulation is seen not only in necrotic heart tissue regions, but also in ischemic area of worse metabolic rate and perfusion. 99mTc-Amiscan contrary to 99mTc-MIBI, is accumulated only in regions of early necrosis so it can be can distinguished from transitory ischemia. Mechanisms of cardiac injury due to CO toxicity is different than due to coronary occlusion and the process of the heart damage is usually much longer. Results of control stress-rest 99mTcMIBI scintigraphy, performed after 6 months from CO exposure in relation to the clinical state on admission and results of 99mTc-MIBI and 99mTc-Amiscans scans obtained in acute phase of poisoning are presented in the study. Initial 99mTc-MIBI SPET examination had confirmed transitory myocardial ischemia of different degree in all the examined patients. The mutual dependence between degree of scintigraphic changes and blood lactate level and CK activity was found. 99mTc-Amiscan scintigraphy demonstrated areas of necrosis in myocardium of some patients; they had statistically higher COHb and blood lactate concentration compared to the rest. A control stress-rest 99mTc-MIBI SPET performed 6 months after CO intoxication, confirmed a late consequences of metabolic abnormalities and a necessity of cardiovascular system follow-up controlling.

Acute Disease↗

PubMed2004

Evaluation of regional cerebral perfusion using 99mTc-HmPAO single photon emission tomography (SPET) in carbon monoxide acutely poisoned patients.

Carbon monoxide (CO) poisoning continues to be a significant health problem. An early assessment of organs injury due to carbon monoxide poisoning is even more difficult than confirming the diagnosis of CO poisoning. Numerous neuroimaging techniques have been used to evaluate CO intoxication. The aim of this pilot study was to estimate the regional cerebral perfusion in CO acutely poisoned patients using 99mTc-HmPAO SPET. Disturbances in cerebral perfusion mainly in frontal, parietal cortex and basal ganglia were observed in 17 (85%) of 20 examined CO poisoned patients. 99mTc-HmPAO scintigraphy seems be useful in demonstration of early CNS dysfunction and estimation to what extent perfusion abnormalities influence the brain injury. A further study to evaluate the rCBF in relation to poisoning severity scoring are needed.

Acute Disease↗

PubMed2004

[Difficulties in diagnosis of hepatic encephalopathy in ethanol dependent patients].

As a somatic evaluation by outpatient psychotherapy service for alcoholics is being done very rarely the patients are not informed about health harm related to alcohol having the "false feeling of safety". The aim of the study was to evaluate a functional and morphological liver state of patients served by such a service for minimum 5 years who were sent do the Department of Clinical Toxicology via intervention medicine. The changes in the central nervous system were also considered. The West Haven criteria of altered mental state in hepatic encephalopathy were applied. The Number Connection Test, part A and B, and "100-7" test were used to psychometric evaluation. A significantly higher serum ammonia concentration (p<0.02), AST, ALT and GTP enzymes activity, bilirubin (p<0.02), iron (p=0.005) concentration and significantly lower prothrombin index and albumin concentration were found in the group of ethanol dependent patients as compared to the reference group. A significantly lower RBC and platelets number, lower Ht and significantly elevated MCV compared to the control group were also found. The relationship between West Haven criteria and results of laboratory testing was shown: a worse West Haven criteria a worse metabolic disorders. The pathologic changes in the liver ultrasonography and scintigraphy were significantly higher in the group of ethanol dependent patients. The presented observations indicate on necessity of close co-operation between psychologists, therapeutics and clinical toxicologists in early diagnosing and treatment the organ injury in alcohol addicted patients.

Adult↗

PubMed2004

[Morphologic and functional status of the liver in patients with acute ethanol-intoxication and chronic alcoholism].

Current work is a continuation of the already published study on usefulness of enzymatic tests, biochemical parameters and ultrasonography for evaluation ethanol hepatotoxicity but histology testing of the liver bioptates is additionally included. Under examination there were 139 ethanol dependent patients admitted to the Department of Clinical Toxicology Jagiellonian University Medical College because of severe ethanol intoxication. The reference group comprised 30 healthy men, not exposed to hepatotoxic agents. Chosen enzymes activity and biochemical parameters were measured (before and after 3 weeks long controlled abstinence) and ultrasonography was performed in both the groups. Due to clinical indication the USG guided liver biopsy and histology testing was done in 20 patients from the ethanol dependent group. 68 of ethanol dependent patients underwent the post-abstinence control ultrasonography. A normalization in AST and ALT activity (p<0.001), bilirubin and Fe concentration as well as serum albumin elevation was noted in the ethanol dependent patients after controlled abstinence. The mean values of GGT, LDH, and PA activity were significantly diminished compared to the initial examination, but still significantly higher compared to the control group. The three weeks long abstinence did not change MCV and prothrombin index. The pathologic changes in liver ultrasonography were significantly higher in the group of ethanol dependent patients both in acute phase of intoxication and after abstinence and principally reflected the bioptate histology testing.

Acute Disease↗

PubMed2004

[Intake of nutrients in daily nutritional ratios by opiate dependent persons during methadone maintenance therapy].

The aim of the study was the evaluation of the nutritional habits of the opiates dependent persons before and during methadone maintenance treatment. We examined 48 persons (36 males and 12 females) three times: first time before the methadone treatment, then after 2 months of treatment, and third time after 9 months of treatment. During each examination we performed 24-hour recall four times. Collected data were processed by author's software in order to get information about daily supply of main nutrients (proteins, fat, fatty acids, carbohydrates, dietary fibre, cholesterol), minerals (calcium, iron, phosphorus, zinc, sodium) and vitamins (vitamin A, B1, B2, niacin, C). The changes between the results of following examinations were tested by using the t-Student test. The results were compared with daily norms recommended on the safe level of intake for each age and gender group. In the majority of cases the diet of examined persons was quite reach in protein, but we noticed too low daily intake of fats, essential fatty acids, some minerals (calcium, iron, magnesium, zinc) and vitamins B1, B2 and C. After 2 months of methadone treatment the daily intake of fats, saturated fatty acids, essential fatty acids, cholesterol, dietary fibre, some minerals and vitamins decreased in men group, but in the last examination we noticed renewed growth in quantity of those nutrients in daily diet of examined persons. We did not observe it in the group of women.

Adult↗

PubMed2004

[Nutritional status of opiate-dependent persons before and during methadone maintenance therapy].

The aim of the study was to evaluate the nutritional status of opiate dependent patients who where classified to participate in the methadone maintenance treatment and to give the answer to the question how the nutritional status of these patients was changing during this programme. We examined 48 persons (12 women aged 21-37 years and 36 men aged 20-46 years). All of them were participants of the methadone maintenance treatment. The patients were examined three times: first time just before the methadone treatment, then after 2 months and third time after 9 months of treatment. The anthropometrics measurement: body weight and height (it allowed us to calculate the BMI), two skin fat folds and the measurements of the body composition (using the bioimpedance method) were performed. The changes between the results of subsequent examination were tested using the t-Student test. As a result of the first examination we showed out that the majority of patients had a proper nutritional status evaluated by BMI. Poor nutritional status has been more often found than excessive nutritional status among examined patients, especially in the group of women. During the nine months of methadone maintenance treatment the statistically significant growth of body weight was observed and it derived from the increasing fat body mass and muscle mass. As a result of that we noticed the diminishing number of underweight people. More of examined people had overweight and in the group of men even obesity.

Adult↗

PubMed2004

[Use of a questionnaire and biomarkers for evaluation of tobacco smoking in parturient women].

According epidemiological study tobacco smoking is popular addiction around the world. It was estimated, that one third of world population smoking tobacco. The statistical data from 2002 show that in Poland 42% of men and 22% of women smoke tobacco on a daily basis. As many as 60% of non-smokers are exposed to environmental tobacco smoke (ETS). The aim of the study was verification the answer on a standardised survey questionnaire (related to tobacco smoking) by laboratory method--determination of cotinine in urine. In the study participated 244 delivering women. In the tested group 23.8% of surveyed declared smoking during their pregnancy and around 28% of non-smoking women were exposed to passive inhalation of tobacco smoke. More than 15% of women, which declared non smoking has concentration of cotinine higher than 50 ng/mg creatinine (mean 227.3 ng/mg creatinine) what indicated active smoking of cigarettes. From these results we can conclude that as much as 35.6% of women smoking tobacco during pregnancy and is higher than suggested the questionnaire examination.

Adult↗

PubMed2004

[Diagnostic problems in case of environmental exposure to tetraethyl lead].

UNLABELLED: The aim of this study was the presentation of the chronic tetraethyl lead poisoning of the 4 person family in the place of settlement. CASE REPORT: 15.5-years-old man was admitted to the regional Pediatric Ward because of changes of behavior, hallucinations, agitation. Nausea, vomiting, metallic taste and diarrhea were observed prior to the admission. In the case history, there were no data suggested of the toxic origin of the disorder . The CSF examination and CT of the brain were normal. Increased activity of CPK, ALT, AST, GTP, LDH in the blood were found. Paranoid syndrome was diagnosed by psychiatric evaluation. The patients' mother presented similar signs in almost the same time. The laboratory tests of the blood taken from the patients' father and older brother revealed the increase activity of the same enzymes (CPK, ALT, AST, LDH). All family was admitted to the Department of Clinical Toxicology in Kraków because of suspicion of the heavy metal poisoning. The toxicological laboratory test showed in all described patients the toxic serum lead concentration accordingly: 440 microg/l--older brother, 490 microg/l--father, 508 microg/l--mother and 635 microg/l--primary described patient. Because of the fact, that were no characteristic for lead poisoning changes in blood picture, the toxicological investigations were continued. As a result of these examinations presence of a diethyl lead in urine was confirmed. In the evaluation of the multiorgan damages connected with tetraethyl lead poisoning, we paid special attention on CSN dysfunctions. The USG and scintigraphy examinations revealed the liver damage. The different kinds of arrhythmias indicated on cardiovascular system damage. Based on clinical presentation and laboratory investigations the chronic tetraethyl lead poisoning was diagnosed.

Adolescent↗