Stinging catfish poisoning.
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Adolescent↗
Biomedical subjects
Janusz Pach
Publications and source records attributed to Janusz Pach.
Drug free universities--trends in illicit drugs use among Kraków university students.
Social survey by questioning people is a significant source of information, valuable for planning and developing of prophylactic strategies. An illicit drugs use among a first-year students of Kraków's universities and factors determining the usage were analysed. The research by completing the questionnaire designed by National Bureau for Drug Prevention, Poland was performed in 725 a first-year students of six Kraków's universities. The students were asked to complete the questionnaire confidentially, while the lecture on psychoactive substances. 83.6% of those polled know some students who use a drugs, 38.3% already initiated into drugs, 61.9% reported that they needed at least one day to get drugs. The male students reach for drugs more often then females, and those first-year students being already 20 years old compared to the younger. The greater risk was also noted among students who rent apartments or when a parents earned together more than 3500 PLN. The medical students reached for drugs more rarely than the others. Our survey is one of the first source of information about trends in the drugs usage by Kraków's students. The results will help to develop a preventive standards and creation of effective anti-drugs campaign to be accomplished by college authorities and the Kraków Environmental Diseases Out-patient Clinic for students and academic teachers. The clinic was organised in 2004.
Adult↗
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↗
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↗
[The frequency of suicide attempts depending on gender and the age structure].
Sex and the age structure have been for decades the crucial factors determining the dimensions of suicide. In the literature of the subject, it is possible to find different interpretations concerning the widely known facts of larger effectiveness of suicide among males. Females, on the other hand, exhibit suicidal behaviour and suicide attempts several times bigger than the number of completed suicides. In comparison with wide literature dealing with the problematic of completed suicide, the number of publications concerning suicide attempts is, both in foreign and in Polish literature rather scarce. That is why the present authors have undertaken the analysis of suicide attempts by subjects hospitalized in the Department of Clinical Toxicology Jagiellonian University College of Medicine in Krakow in the years 2000-2002. On the basis of the medical documentation, 2757 cases of attempted suicide through self-intoxication by subjects undergoing treatment in the toxicological department. In the period concerned, the number of hospitalizations after suicide attempts increased from 856 cases in the year 2000 to 971 cases in 2001, and subsequently slightly decreased to 930 cases in 2002. The highest indicator of suicide attempts through self-intoxication has been observed among adolescents and young adults. In the absolute values, within the span of the years in question, there is a substantial predominance of suicide attempts undertaken by adults ranging in age from 20 and 50. On the contrary, in the oldest age group (over 60), the number of suicide attempts through self-intoxication was in the years concerned the lowest. In contrast with completed suicide, where the proportion of males to females is 4:1, in the group examined, females constituted 50% of subjects after suicide attempts. The number of females after suicide attempts in the consecutive years analysed was higher among adolescents and young women under 30. Despite drawbacks in data gathering, there is convincing testimony indicating that suicide is the result of number of complex risk factors. Sex and the age structure belong to non-modifiable factors, and thus emphasis should be put on the importance of the gathering of relevant data and on further research into the factor of sex and age structure in suicide attempts and completed suicide.
Adolescent↗
[Examination of students' working environment during laboratory training].
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Chemical Phenomena↗
Clinical and scintigraphic (99mTc-MIBI SPECT) heart evaluation in young acutely carbon monoxide poisoned patients.
The results of myocardial (99mTc-MIBI SPECT) perfusion scintigraphy according to clinical evaluation, ECG, biochemical factors of necrosis and indicators of carbon monoxide (CO) poisoning severity are described in the paper. Under examination there were 88 young (mean age 26 +/- 8.5) acutely CO poisoned patients without previous cardiac illness history, treated at the Department of Clinical Toxicology Jagiellonian University Medical College in Krakow in 1996 to 2002. Measurement of COHb level, blood lactate concentration, duration of exposure and ECG examination were performed on admission. The enzymes activity ALT, AST, CK, MB-CK, was evaluated after 24-48 h. The severity of CO poisoning was estimated basing on age, duration of exposure, COHb level, blood lactate concentration and the patient neurological state on admission. 99mTc-MIBI SPECT was performed on days 1 to 5 post admission. The abnormalities in scintigraphic scans were assessed according to arbitrary accepted scale (0-IV). Conventional biomarkers creatine kinase, ALT and AST were insufficient for evaluation the heart injury in CO cutely poisoned patients. A statistically significant differences in the blood lactate concentration with regard to degree of scintigraphic changes have been observed. The ECG curves monitored from admission to discharge were analyzed in the study. Tachycardia was observed in all the patients but no statistically significant differences were found between the subgroups divided according to the degree of scintigraphic scans. Conductivity disturbances were detected mainly in patients qualified to higher then the first degree of scintigraphic changes. ECG signs of myocardial ischemia were the most frequent in patients with biggest pathological changes in 99mTc-MIBI scans. The changes in 99mTc-MIBI SPECT were observed in the majority of acutely CO poisoned patients. The mutual dependence of patient's condition based on neurological symptoms, carbon monoxide poisoning severity scoring and the degree of scintigraphy changes was found. The examination performed indicate that 99mTc-MIBI SPECT scintigraphy can be method of choice for evaluation the heart injury in patients after acute CO intoxication.
Acute Disease↗
[Preliminary research on opioid mutagenicity].
The aim of the study was a preliminary recognition of genotoxic effect of methadone, using a culture of lymphocytes obtained from the blood of 23 opiate dependent patients from methadone maintenance treatment programme conducted at the Department of Clinical Toxicology of Jagiellonian University Medical College. The micronuclei (MN) occurrence and the number of sister chromatids exchange in methaphasal plate were the examined markers of mutagenesis. Two control groups differently exposed to environmental mutagenic factors were used to verification of results. The increased fraction of cells with the high number of sister chromatids exchange (HFC) indicate on possible genotoxic effect of methadone, however in the populations exposed also to other mutagenic factors the effect is not so evident.
Adult↗
Concentration of ethanol and other volatile compounds in the blood of acutely poisoned alcoholics.
The presence of volatile compounds, such as acetone, acetaldehyde, methanol, ethanol, isopropanol, and n-propanol, in the blood of 169 acutely poisoned alcoholics was determined. The clinical diagnosis of addiction was made on the basis of a patient interview as well as physical, psychological, and psychiatric examination. At the time of the patients' admission to the clinic, the mean concentration of ethanol in blood was 3.14 +/- 1.10 g/l and its elimination rate in the studied group was 0.27 +/- 0.08 g/kg/hr, an elimination rate significantly higher (P <.001) than that of social drinkers, which averages to 0.014 +/- 0.04 g/kg/h. The presence of other volatile compounds in the blood of alcohol-addicted patients is common. The calculated elimination rate constant of methanol was about 0.2 h(-1). This rate seems to indicate that, in heavy drinkers, the elimination of methanol may be relatively fast even if the ethanol concentration is above 1 g/l. The elimination of other volatile compounds can be accelerated by large doses of ethanol, although it is not correlated with actual blood ethanol level. Moreover, in most of the blood samples with a methanol concentration below 10 mg/l, the measured concentration of acetone was below 7 mg/l and that of isopropanol was below 2 mg/l.
1-Propanol↗
[Suicide attempts by self-poisoning among the elderly].
The aim of the study was to present suicidological problems in the elderly. The investigation assessed patients treated for self-intoxication in the Department of Toxicology of Collegium Medicum, Jagiellonian University in Cracow. Medical documentation of the entire population of subjects aged over 65 and hospitalized in the years 1999-2001 was examined from the point of view of demographic and clinical factors. The examined population consisted of 68 subjects including 20 males and 48 females ranging in age from 65 to 90 years (mean age = 72.6). The majority of subjects were retired and, in many cases, lived alone. The majority of female subjects were widows living in Kraków or in small towns or villages around Kraków. A significant number of subjects had been undergoing psychiatric treatment or even repeated hospitalization prior to the suicide attempt. A significant percentage had suffered from severe somatic diseases. For 55 of the subjects (79.7%), it was the first suicide attempt, and for 14 subjects (20.3%)--a repeated one. The drugs most frequently used in the attempts were psychotropic, cardiological and mixed-type drugs. The assessment included the state of consciousness and the degree of intoxication on the subjects' admission to hospital. The mean duration of hospitalization was 13.7 days. The most frequently determined somatic diseases were hypertension (33.3%) and coronary artery decease (30.4%), atherosclerosis (15.9%) and diabetes (10.1%). In the process of a complex diagnostic and therapeutic procedure, the mental state of the patients was assessed. Depressive disorders (reactive) and endogenic depression (affective) were recognized in 51 subjects (73.9%). Organic brain disorders, often with dementive signs, were detected in 44 subjects. Schizophrenia was recognized in only a small percentage of subjects (5.8%). The description of the data indicate a close connection between depression and social factors in the case of the elderly. Therefore, an adequate treatment of depression should be give priority in programs for preventing suicide among the elderly.
Aged↗
[The pattern of poisonings with chemical compounds in Krakow inhabitants hospitalized at the Department of Clinical Toxicology of the Jagiellonian University Medical College in 1997-2001 in relation to age].
The pattern of poisonings in patients hospitalised in the Department of Clinical Toxicology Jagiellonian University Medical College in 1997-2001 was presented in the study. The analysis includes 17,931 patients: 6,016 (33.5%) women and 11,915 (66.4%) men. The rate of patients between 20-39 years old was highest in all the analysed year, however downward trend was noticed. The upward tendency was noted in older group of poisoned patients. A suicidal poisonings were mostly common in 1998 and 1999 in the youngest and oldest groups: 37.1%, 37% in 1998, and 25.5%, 22.2% in 1999 respectively. The medication drugs were the most common cause of acute poisoning only in the group of adolescent patients. Ethyl alcohol was the common cause of poisoning in adult groups. The highest rate of ethanol intoxication was noted in patients between 40 to 59 years old. A 89 lethal intoxication were noted in analysed period. The average mortality rate was low (0.5). A medication drugs (30.4%) followed by ethanol (17.4%), carbon monoxide (13%) and solvents (13%) were involved in lethal poisonings in the oldest group of patients.
Adult↗