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The aim of the paper was to study frequency of laboratory determinations and toxicological information related to over-the-counter drugs (OTC): paracetamol (acetaminophen), salicylates and dextromethorphan. The research was based on data from Toxicological Laboratory and Poison Information Center UJ CM in Krakow in years 2010-2015. Paracetamol was determined averagely 102 times a year, more than 50% (57 cases) were positive with confirmation of poisoning. The least number of paracetamol poisoning was noted in 2011 (35 cases), the most were in 2015 (98 cases). In the time span there were averagely 40 salicylates check measurements a year, less than 50% (15 cases) were positive. Dextromethorphane was confirmed averagely in 31 patients a year, decrease of the drug intoxications was noted in 2013-2015. Paracetamol and dextromethorphan were the most often the cause of poisoning in group of patients 13-18 years old, salicylates – more than 30 years. In the group of small children there were only a few poisonings with paracetamol. Toxicological information data related to paracetamol, salicylates and dextromethorphan were similar to data from toxicological laboratory. Mean year numbers of drug poisoning information were: 90 (paracetamol), 14 (salicylates), 30 (dextromethorphan). The differences were in patients age distribution. Acute poisonings with OTC were related mainly to paracetamol, young patients (13- 18 years) and young adults (19-29 years). Salicylates poisoning information were related mainly to the group of adult patients (> 30 years), dextromethorphan was abused mainly by oung patients (13-18 years). There were no observed poisonings with salicylates and dextromethorphan in children, but there were toxicological information about paracetamol and salicylates poisoning and overdose in group of children (1-6 years).

The total number of out-patients and hospitalized poisoned patients above 14 years old in Krakow in 1966 was 520 and 2132 in 1983. The incidence of poisoning per 10 000 of Kraków population in 1966 was 25.0 and increased to 36.2 in 1983. The mortality in 1966 was 0.75%. It was low also in 1983 – 1.01%, whatever reached 7.8% if forensic data were included (the fatalities on the spot). There were 847 poisoned patient hospitalized in Clinic of Toxicology UJ CM in 2015 and mortality in this group was 1.06%. Forensic analysis shown decreasing number of deaths on the spot (154 in 1983 and 89 in 2015). The percentage of poisoned with ethanol was declining (78.9% in 1983 and 57.3% in 2015). The frequency of patients treated in intensive care unit were increased from 6% in 1966 to 21.7% in 2015. The percentage of addicted acute intoxicated patients was lower (8%) in 1983 and achieved 21.7% in 2015. Poisoning structure, particularly pharmaceuticals, significantly influenced medical procedures performed in intensive care unit, especially administration of antidotes (5% in 1966 and 48.9% in 2015). Social evolution and changes of culture habits increased percentage of addiction but the number of deaths caused by ethanol on the spot was smaller.

Unlabelled: The aim of the study was an evaluation of clinical factors affecting relationship between ethanol concentration and clinical status in case of acute ethanol poisoning in the 70s and the 80s of the 20th century and 2011-2013 y. Ethanol blood concentration was a criterion of ethanol dose, grade of coma was a decisive factor of toxic effect., Material and Methods: 112 patients treated at the Department of Clinical Toxicology Jagiellonian University Medical College in 1974-1975 y, 232 treated in 1984-1985 y and 663 treated in 2011-2013 y because of acute ethanol poisoning were analyzed. The degree of coma was evaluated according to Matthew's scale. Ethanol plasma concentration in each case was measured., Results: The lowest ethanol blood concentrations in the youngest (<19 y) and the oldest (>60 y) groups were noted also the highest in group of adults (30-49 y). The three-gradual relationship between ethanol plasma level and degree of toxic coma was distinguished. However, the average of ethanol blood concentration were statistically significant in every degree of coma in 2011-2013 y. A statistically significant increase in number of patients in 0 coma grade with severe withdrawal symptoms, alcohol psychosis or epilepsy were noted, also decrease of patient in IV degree of coma., Conclusions: The increase ethanol tolerance in the group of acute ethanol poisoned patients shows their ethanol addiction.

The aim of the study was the analysis of exposure due to therapeutic mi. suse registered in Poison Information Centre in 2012. Of all 3084 telephone inquiries 87 were related to therapeutic misuse. The equal gender proportion were noted. More than 50% of calls registered were taken from a lay public. A most common therapeutic misuse was administration of medicine dose higher than recommended, to children of 1-6 y interval and younger, mostly by parents.

A telephone inquires to Poison Information Centre and data from toxicological laboratory of Jagiellonian University Medical College related to cases below 19 years of age in 2010 -2012 were analyzed. 37.3% of 3692 information given were related to children and adolescent toxic exposure. Most telephone inquires concerned youngest children (below 6 years); toxicological analysis were ordered in the oldest group (13-19 years) mostly.

Guideline for out - of Hospital triage and initial management of patients with suspected ingestion of dextromethorphan is presented in the study. The guideline was created by the American Association of Control Centers to assist poison center personnel while dealing with poison information service.

Designer drugs used often by teenagers have simulative, relaxing, hallucinogenic and psychedelic properties. The biological action, addictive potential, diagnostic problems and low regulations related to designer drugs are presented in the study.

There were 10 636 toxicological information given in 2004-2008 by the Poison Information Center Jagiellonian University Medical College. 538 of them concerned NonSteroidal Anti-Inflammatory Drugs (NSAIDs); 336 cases of NSAIDs ingested alone and 202 co-ingested with other drugs and/or with ethanol. 58,9% of them were intentional and 29,6% were accidental. Children (1-6 years) and adolescents (15-19 years) were mostly involved.

The Act on Nature Conservation of 16.04.2004 (Official Journal, 2004, No 92, item 880) imposes on private individuals the duty to register some animals. The data collected by Kraków municipal authorities and delivered to the Poison Information Centre (Colleglum Medicum, Jagiellonian University) indicate that there are following species in private hands in the city and its surroundings: 11 individuals of Naja naja, 2--Hydrodynates gigas and 55-- Dendrobates spp. According to these information the employees of the PIC elaborated the advice on the treatment of specific animals' poisoning. In the period May 2003 - May 2004 (before the above Act came into force) there were 143 individuals from Brachypelma genus and 3 scorpions (Pandinus imperator) registered in Krakow. These species produce venoms which take local effect. According to art. 64 (1) of the above Act it is compulsory to register amphibians, reptiles, birds and mammals. However, it would be desirable to introduce the duty to register also dangerous species of invertebrates and fishes. It would provide the complete list of poisonous animals kept in private hands. Thus, it would be possible to estimate any possible threats and to elaborate adequate treatment in case of specific animals' poisoning.

Poison information centres (PIC) provide telephone advice on the treatment of poisonings to the lay public and medical professionals. The number of inquiries increases every year. Poison Information Centre of Collegium Medicum of Jagiellonian University in Krakow provided 1611 items of advice in 1999 and 2263--five years later--in 2004. Each incoming call is recorded and documented by standardized protocol. Another aspect of PIC activity of is prevention and education. Inquiries protocols' analysis shows the most frequent reasons and circumstances of poisonings. Thus, it is possible to conduct appropriate prophylactic campaigns. The above aspects of activity of PIC do not bring direct financial benefit. There is one index which shows that PIC saves the money. There were 335 cases in 2004 (above 50% consulted lay public) when unnecessary hospital admissions were prevent. It should be noted that the others were refer to proper specialist. This aspect of PIC's activity significantly decreases the costs which should be paid in any medical intervention.

World trends for a home breeding of exotic freshwater and marine fishes did not miss Poland. There are almost all species of aquarium fishes available in Polish pet shops, but there is not enough information about threat given to customers. In some fish, there are masses of one-cell glands, mainly serous, in the proximity of the spines. In others, those one-cell glands may be grouped in larger aggregates of cells called venom glands, that may form organs resembling multicellular glands of terrestrial animals. They are usually located around the spines or hard rays of the fins. Even if covered with a connective tissue sheath, the aggregates of the venom cells do not have any common outlet; they are not, therefore, proper multicellular glands. The venom glands of the catfish are covered with a thin sheath and they release their contents when the fin ray is pressed. Spines are derived from fin rays. When the spine penetrates the body of its prey, it presses its base against the cells, squashes them and squeezes the venomous contents into the wound. Catfish, lionfish and stonefish have the venom glands producing secretion which could be dangerous. The eels and morays blood is also dangerous, as well as slime of reduced squamae. Poison information centers noted several cases of fishes' stings in Poland.

In statistics from Poison Information Center in Kraków plant poisonings comprise 2% of the total registered poisonings. In toxicology cardiac glycosides poisonings existing in common foxglove plant, lilies of the valley, oleander are essential. Species of cardiotoxic plants which may cause a danger in Poland are presented in the research. The toxic mechanisms of cardiac glycosides are specified.

The aim of the study was to present the phenomenon of suicide attempts by self-poisoning in a group of females and males ranging in age from 15 to 29 years, and treated in the Department of Clinical Toxicology Jagiellonian University College of Medicine in Kraków in the years 2000-2002. The group analyzed comprised of 1117 patients, 629 (69.1%) women and 425 (38.1%) men. In the female group, teenagers under 19 constituted 48.9%, whereas young females ranging in age from 20 to 29 years--51.1%. In the male patients group teenagers under 19 constituted 29.4%, the young men (20-29 years of age)--70.6%. The group was analyzed from the point of view of demographic, clinical and social factors such as gender, age, level of education, marital status and occupation (if applicable), the course of self-poisoning and kind of toxic substance involved. In the majority of cases, self-poisoning had been caused by taking one type of medicines, and less frequently by taking mixed-type medicines or by simultaneously taking medicines and ethanol. The most typical drugs used in the attempts included benzodiazepines, phenothiazines, nonsteroidal antiinflammatory and antiepileptic drugs. The assessment of the poisoning severity based on the PSS classification, indicates the predominance of the minor and moderate poisoning. Up to 50% of subjects suffered from mental disorders--most frequently from affective disorders, neurotic disorders, and personality disorders. As an essential part of the problem of suicidal behaviors in teenagers and young adults, suicide attempts among young population require an in-depth analysis. The scale of the problem indicates the necessity of initiating appropriate preventive actions and organizing appropriate psychological and psychiatric care.

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.

Animal models are a valuable tool in the investigation of the nervous system. Many similarities between animal and human dependency behaviours have been observed. Animal model based on the self-administration response has contributed to understanding of the neurobiological basis of particular stages of the dependence process. Animals are used also to study the mechanism of alcohol dependence. Working out an animals model of addiction should include references to the clinically important phenomena related to psychological dependence which has not been displayed. This situation get us to consider the latest findings and theories about evolution of the wise human.

The aim of the study was to analyze seasonality and temporal fluctuations in suicide attempts by persons living in Krakow and hospitalized in the Department of Clinical Toxicology CMUJ in the years 2000-2002. The research focussed on the frequency of suicide attempts in relation to the time of the day, day of the week, and month of the year. Temporal fluctuations in the frequency of suicide attempts have been assessed on the basis of the data from medical documentation concerning 2757 suicide attempts by individuals ranging in age from 14 to 90 years. The group consisted of 1607 females and 1150 males. According to the results of the research, seasonality and temporal fluctuations in the frequency of suicide attempts is different for males and females. In the case of the males examined, no dependence between the frequency of suicide attempts and a particular month or season has been observed. In the case of females, on the contrary, the data indicate the existence of a seasonal pattern with the peak in the spring (or early part of the summer), and in the autumn--in October and November. In males, the peak day for attempted suicide was Monday, whereas in females--Sunday and Monday. As regards the time of the day, both the results of the present research and data collected by WHO/EURO indicate that suicide attempts occurred most frequently in the evening, late in the evening or in the early part the night. In conclusion, it has been emphasized that the majority of suicide attempts, especially by females, occurs late in the evening or early in the night. This finding seems to be of particular importance for suicide prevention--it can contribute to the increase in the effectiveness of the organization of work in the Crisis Intervention Centres and make therapists and patients' families aware of the existence of periods of an increased suicide risk. The research has been conducted owing to the cooperation between the department of Clinical Toxicology, CMUJ and the Department of Adult Clinical Psychiatry, CMUJ in Kraków. The results obtained, together with the results of the research conducted by the centres participating in WHO/EURO are vital for suicide prevention and treatment.

A newly created computer system for call (toxicological information) recording and a Base of Toxic Substances created in native Polish language are presented in the paper. An extended structure of this data base enable to catalogue different groups of toxic substances (e.g. medication drugs, psychoactive substances, pesticides), and toxins (animals' poisons, toxic plants and mushrooms) concerning their specificity. Construction of the Base also enable to reach necessary information quickly. What more, identification of toxic substances could be easier due to possibility enclosing photos.

A rules of telephone poison information service for general public and telephone toxicological consultation for medical staff, mainly physicians, are presented in the study. Guidelines for call management: necessity of caller assessment while dealing with information given to the general public and factors that influence successful telephone encounters are presented. The types of questions that are appropriate to ask about patient, considering both the patient state and the toxin(s) involved while dealing with a telephone toxicological consultation are also presented.

The aim of the study was to assess the phenomenon of suicide attempt in the elderly inhabitants of Kraków. Special attention has been paid to the group of "seniors"--aged 75 years or over. The authors have analyzed all the 136 cases of suicide attempts by individuals aged over 60 years, selected from the cases of suicide attempts by self-intoxications by patients hospitalized in the Department of Clinical Toxicology, CMUJ in Kraków in the years 2000-2002. The group concerned included 45 males and 91 females. A large number of subjects (over a half of the total) ranged in age from 60 to 65 years. The group of seniors comprised 35 individuals (aged 75 years or over), including 7 males and 28 females. On the basis of the data from medical documentation, the subjects were analysed from the point of view of their health condition and in the psycho-social context. In the majority of cases the subjects are pensioners residing in Kraków, often living alone. In the case of 98% of the subjects, it was their first suicide attempt. Pharmaceuticals used for self-poisoning were most frequently psychotropic, or mixed-type drugs. The assessment of the severity of poisoning indicates that in about 20% patients poisoning was severe. 70% of the subjects suffered from depressive, reactive, or situational disorders, affective depression or organic brain disorders, often with dementive signs. A significant number of subjects suffered from hypertension, coronary artery disease, arteriosclerosis, or alimentary tract diseases. In the group of the seniors, the most conspicuous problems included serious somatic diseases (malignant diseases and chronic respiratory system diseases), depression, organic dementia, loneliness, and bad family situation. Taking into consideration the scantiness of research into attempted and completed suicide in the elderly and in the old elderly, the present authors stress the importance of the continuation of the research to prevent suicide in the aforesaid age group.

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.

An diagnosing of ethanol dependence, despite of clear ICD 10 criteria, in patients treated particularly at the toxicological and detoxication wards, but also in other hospital wards is still a difficult task. Several questionnaires have been developed for easier detection of symptoms, the way of drinking and also for economic, family and medical effects of ethanol drinking in examined patients. A high sensitivity and specificity of CAGE and SAAST questionnaires allowing to identify problem drinkers or alcohol dependence in 192 patients of Kraków Department of Toxicology and 475 patients of Detoxification Unit was stated in the study. The CAGE questionnaire has allowed to identify the possibly ethanol dependence in group of 74 patients hospitalized at the Ward of Internal Diseases and Dialysis of Town Hospital in Sieradz, because of illness, that were not connected with alcohol drinking.

The aim of the study was to evaluate the frequency of acute poisoning with psychoactive substances in adult abusers of Kraków population in 1997, 1998 and 1999 and to compare the number of poisoned patients suffering withdrawal syndrome as predominant. 27.2% (n = 945) of all 3472 acute poisonings treated in the Department of Clinical Toxicology in 1997, 36.9% (n = 1193) of all 3236 treated in 1998 and 47.9% (n = 1546) of all 3233 treated cases that were acute poisoning with psychoactive substances among the abusers of Kraków adult population. Ethanol followed by narcotics in 1998, and by drugs coingested with ethanol and by narcotics in 1997 and 1999 was predominant psychoactive agent in all the analysed years. Organic solvents and glue sniffing and drug dependency increased again in 1999. Opiate derivatives produced at home from poppy straw or juice of poppy head were still the most common narcotic detected in body fluids, but decrease in number of acute opiates poisoning was noted in 1999 as compared to previous analysed years. The most of ethanol abusers aged from 30-49 years. The highest incidence of narcotic and drug dependency was noted in age between 20-29 years.

During last 5 years only single cases of poisoning with plants containing psychoactive substances, especially Datura stramonium, were treated in the Department of Clinical Toxicology in Kraków. In autumn 1999, during 1 month, 7 patients, aged from 14 to 27 years (mean 18 years) poisoned with Datura stramonium were treated. On admission in all patients central and peripheral anticholinergic symptoms were stated. Four of them ingested seeds, three of them chewed seeds and leaves. Only one ingested Datura seeds in suicidal attempts. In the group, only one--20-years-old--previously abused amphetamine and smoked marihuana. For the remaining 5 boys (14-18 years-old), it was the first experience with psychoactive substances. All were successfully treated, in 5 patients physostigmine was used, in dose ranged from 2 to 6 mg, with no adverse effects. Seasonal accessibility of natural psychoactive products may be the first, easy, free step of addiction.

The role of toxicological information consisting of chemical substance toxicity, clinical signs and symptoms, treatment and diagnosis of poisonings is presented in the study. These data are collected in computer programmes TOKSY 5, TOKSY7 (MacroSoft Warazawa) which together with American CCIS data base (MICROMEDEX, Denver, Colorado) and IPCS INTOX Database are helpful instrument while giving the toxicological information or/and medical consulting. All cases are registered in IPCS (International Programme on Chemical Safety) INTOX SYSTEM data base that enables epidemiological analysis and also an evaluation of economical and social effects caused by poisonings.

The aim of the study was to evaluate a frequency and the course of acute poisonings with psychoactive substances in abusers, considering the kind of toxic substance. 25% of all acute poisonings treated in the Department of Clinical Toxicology in the year 1996 that were acute poisonings with psychoactive substances among the abusers of Kraków adult population. Alcohol followed by narcotics and drugs and by organic solvents was predominant cause of acute poisonings in that group. Opiates derivatives as the so called kompot produced at home from poppy straw or juice of poppy head were the most common narcotics. Pure amphetamine was detected only in 5.3%, while as combination with other narcotics (opioids, THC, LSD) was detected in 31.2% of narcomans and drug abusers. The combination of opioids, barbiturates and benzodiazepines was predominant cause of acute intoxications with mixed substances abuse. That was followed by combination of opiates and barbiturates in the group of patient identified positively as two or more substance abuse in the body fluids. Tramal and benzodiazepines were the most detected drugs responsible for acute intoxications between drug abusers. Acute intoxicated ethanol abusers aged from 30-49 years and were the oldest group compared to narcotics and drug abusers (20-29 years) and to organic solvent dependent patient (15-19 years).