Search

Objectives: The aim of this study has been to assess the characteristics of acute poisoning deaths in Poland over a period of time 2009-2013., Material and Methods: The analysis was based on the data obtained from the patient records stored in toxicology departments in 6 cities - Łódź, Kraków, Sosnowiec, Gdańsk, Wrocław and Poznań. Toxicological analyses were routinely performed in blood and/or urine. Major toxic substances were classified to one of the following categories: pharmaceuticals, alcohol group poisonings (ethanol and other alcohols), gases, solvents, drugs of abuse, pesticides, metals, mushrooms, others. Cases were analyzed according to the following criteria: year, age and gender of analyzed patients, toxic substance category and type of poisoning. The recorded fatal poisonings were classified according to the International Classification of Diseases., Results: The record of 261 deaths were retrospectively reviewed. There were 187 males (71.64%) and 74 females (28.36%) and the male to female ratio was 2.52. Alcohol group poisonings were more frequently responsible for deaths in men compared to all poisonings, 91.1% vs. 71.6%, respectively (p < 0.05), and pharmaceutical agents were more frequently responsible for deaths in women, 47.4% vs. 28.4%, (p < 0.05). Methanol was the most common agent in the alcohol group poisonings, accounting for 43.75% (N = 49), followed by ethylene glycol, 39.29% (N = 44), and ethanol, 16.96% (N = 19)., Conclusions: Epidemiological profile data from investigation of poisoning deaths in Poland may be very useful for the development of preventive programs. Int J Occup Med Environ Health 2017;30(6):897-908., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

The consumption of energy beverages is increasing, especially among young people. The increasing consumption of these drinks increases the data of side effects. Case report: A 26-year old male was admitted to Toxicology Department suspected of intoxication due to ethyl alcohol and unknown psychoactive substances. The patient lost consciousness during a party in which he drank an unknown amount of ethyl alcohol mixed with an energy beverage ("Red Bull"). The patient and his friends strongly denied the use of psychoactive substances. On admission, the patient was stable, but unconscious (GCS 8 points), pupils wide, symmetric with weak reaction to light, respiratory rate 15/min. Neurological examination did not reveal any abnormalities. During the hospitalization, somnolence slowly disappeared and the patient became restless, with recurrent episodes of seizures not reacting to diazepam, clonazepam and midazolam infusion. The seizures finally abated after administration of barbiturates (Thiopental). This, in turn, caused respiratory insufficiency, requiring patient intubation and mechanical ventilation. The patients mental status and respiratory status slowly improved. After regaining consciousness, the patient strongly denied the use of psychoactive substances or of chronic alcohol use. He confirmed the single use of high, but not clearly defined, caffeine dosage (in the form of "Red Bull") mixed with alcohol. He mentioned that eight months earlier in similar circumstances he was admitted to the neurology department due to an episode of seizures. Ultimately the origin was not established, despite broad diagnostic testing. Thus the origin of the seizures was suggested to be of a toxicological origin. The patient was released home in good condition, without any side effects of the poisoning. The psychological examination doe not reveal any symptoms of alcohol or psychoactive substances addiction. In our case, due to the unclear nature of the history, we preformed broad diagnostic testing on admission to the hospital, which do not reveal the presence of any toxic substances except ethanol; concentration in the blood was 2,41 gil. Unfortunately, serum caffeine levels were not measured. There was no identification of any other factors that could be responsible for the observed symptoms. It appears that based on the interview, clinical manifestation, and negative toxicology laboratory testing (excluding the presence of ethanol), it is possible to connect the seizure state with the consumption of a high dose of energy drinks, rich in caffeine and taurine.

This theoretical research paper refers to the psychological consequences ofhypospadias, a male congenital deficiency of the urethra. Hypospadias is defined as an abnormal opening of the urethra on the underside of the penis and is a frequently found malformation with an incidence of 1 per 300 males. This malformation affects one of the most personal parts of the male anatomy and its psychological repercussions are undeniable. The vast majority of studies concerning this condition are found in the medical domain: surgical and pediatric urology and endocrynology. The difficulty in finding data about psychological implications of hypospadias, along with the lack of opportunities for discussing it was an objective to contribute a modest advancement in the field of psychology. Because of the fact that hypospadias is a psychological condition as well as a physical one, this theoretical paper discusses the influenceses of the condition on the patient's psychosocial (in the view of E. H. Erikson's theory) and psychosexual development (relation to the object theory of O. F. Kernberg).

"Poppers" is the street name for volatile nitrites offered by online shops and sex-shops for their aphrodisiac and euphoric properties. Although nitrites have been abused since the late 1960s, recently they became popular in Poland. Recreational poppers using was associated with homosexual men at first. Currently they are commonly reported among heterosexual men and regular dicso participants. Advertisements of these substances tempt potential buyers with the promise of a legal narcotic high. Easy access and the sense of safety make these products the reason of acute toxicity. Volatile nitrites relaxes smooth muscle, the consequent intense peripheral vasodilatation produces flushing, a fall in blood pressure, and reflex increase in heart rate. These effects are accompanied by feeling of warmth, euphoria and intensifying of sexual pleasure. Serious poisoning results in severe methaemoglobinaemia, coma, respiratory and cardiovascular failure, and even death. Skin and mucous contact with poppers can produce a crusty lesion at the site. This article presents the case of 44-years old male hospitalized three times in Toxicology Department after history of poppers abusing. Methaemoglobinaemia (26.4%) and tracheobronchial irritation were the main symptoms observed. Patient was given specific therapy with methylene blue.

Background: The professional role of the physician embraces a relatively permanent and internally coherent system of behaviors perceived as the reaction of other people to expectations and actions related to health problems. Performing this role is the main source of income, social status and prestige. It should be stressed that the role of specialist in occupational medicine differs from that of specialists in other disciplines. Its distinctive feature is that it is not oriented towards treatment, but towards prevention., Material and Methods: The study was carried out in 2006, using a questionnaire mailed to a random sample of 820 specialists in occupational medicine or industrial medicine (response rate, 35%) and conducting free interviews with 15 experts., Results: The positive response to the question whether he or she would choose again the specialization in occupational medicine was an indicator of the acceptance of the assumed professional role. The results of the survey showed that 76% of respondents were positive and only 19% would have chosen another specialization. The responses to this question were diversified by the socio-demographic factors. On the basis of this diversification two profiles were constructed, favorable and unfavorable for the acceptance of the choice made in the past. Lack of work satisfaction, poor opportunities for professional advancement, and limited financial profits were reported as the major reasons for choosing other specialization than occupational medicine. The most frequently reported motives for choosing specialization in occupational medicine were the need to meet the requirements of the occupied position, the interest in this branch of knowledge and professional skills. It was also indicated that the acceptance of the role performed by the occupational medicine physician was strongly associated with the above mentioned motives and the expected financial profits., Conclusions: The majority of specialists in occupational medicine are satisfied with the choice of their specialization. Their choice was mostly inspired by autotelic (interests) and instrumental (financial profits and meeting the job requirements) motives.

Previous studies on a limited number of ataxia-telangiectasia (A-T) patients with detectable levels of intracellular ATM protein have suggested a genotype/phenotype correlation. We sought to elucidate this possible correlation by comparing ATM protein levels with mutation types, radiosensitivity, and clinical phenotype. In this study, Western blot analysis was used to measure ATM protein in lysates of lymphoblastoid cell lines (LCLs) from 123 unrelated A-T patients, 10 A-T heterozygotes, and 10 patients with phenotypes similar to A-T. Our Western blot protocol can detect the presence of ATM protein in as little as 1 microg of total protein; at least 25 microg of protein was tested for each individual. ATM protein was absent in 105 of the 123 patients (85%); most of these patients had truncating mutations. The remaining subset of 18 patients (15%) had reduced levels of normal-sized ATM protein; missense mutations were more common in this subset. We used a colony survival assay to characterize the phenotypic response of the LCLs to radiation exposure; patients with or without detectable ATM protein were typically radiosensitive. Nine of 10 A-T heterozygotes also had reduced expression of ATM, indicating that both alleles contribute to ATM protein production. These data suggest that although ATM-specific mRNA is abundant in A-T cells, the abnormal ATM protein is unstable and is quickly targeted for degradation. We found little correlation between level of ATM protein and the type of underlying mutation, the clinical phenotype, or the radiophenotype., (Copyright 2000 Academic Press.)

To facilitate the evaluation of ATM heterozygotes for susceptibility to other diseases, such as breast cancer, we have attempted to define the most common mutations and their frequencies in ataxia-telangiectasia (A-T) homozygotes from 10 ethnic populations. Both genomic mutations and their effects on cDNA were characterized. Protein-truncation testing of the entire ATM cDNA detected 92 (66%) truncating mutations in 140 mutant alleles screened. The haplotyping of patients with identical mutations indicates that almost all of these represent common ancestry and that very few spontaneously recurring ATM mutations exist. Assays requiring minimal amounts of genomic DNA were designed to allow rapid screening for common ethnic mutations. These rapid assays detected mutations in 76% of Costa Rican patients (3), 50% of Norwegian patients (1), 25% of Polish patients (4), and 14% of Italian patients (1), as well as in patients of Amish/Mennonite and Irish English backgrounds. Additional mutations were observed in Japanese, Utah Mormon, and African American patients. These assays should facilitate screening for A-T heterozygotes in the populations studied.

An 8-year-old girl with severe microcephaly of prenatal onset, borderline intelligence, defects of skin pigmentation, deficiency of both humoral and cellular immunity, a normal serum alpha-fetoprotein level and hypersensitivity to ionizing irradiation is described. Spontaneous chromosomal breakage in lymphocytes together with the clinical presentation led to the diagnosis of ataxia telangiectasia variant (AT-V). In addition, the patient carried a constitutional translocation of paternal origin: 46,XX,t(3;7)(q12;q31.3) pat. In subsequent linkage and haplotype studies in 12 AT-V families with microsatellite markers from each of the translocation breakpoint regions, we could clearly exclude the localization of an AT-V gene to these regions.

The effect of work-related diseases on the health condition of the population at large has increased the interest in etiology and epidemiology of these diseases and intensified activities aimed at providing effective treatment of occupational diseases, but first of all at preventing their occurrence. That is why workers are now recognised as the largest population group subjected to active counselling. In order to meet the recommendations of the International Labour Organization, Polish labour law has been modified so that every worker is guaranteed an opportunity to benefit from medical prevention within the range required by his/her working conditions. This concern for workers' health contributed to the fact that health has now become a supreme value to which all other values and human needs are submitted. The author discusses the issues of compulsory prophylactic examinations and protection against employment at a workplace that is inadmissible because of health reasons, in the perspective of the human right to keep his/her own ailments in secret and the right to freedom of choice concerning his/her own health and living and conditions.

We have examined the distal half of the ataxia-telangiectasia (A-T) gene transcript for truncation mutations in 48 A-T affecteds. We found 21 mutations; 4 of the mutations were seen in more than one individual. Genotyping of the individuals sharing mutations, by using nearby microsatellite markers, established that three of the four groups shared common haplotypes, indicating that these were probably founder effects, not public mutations. The one public mutation was found in two American families, one of Ashkenazi Jewish background and the other not. Most truncations deleted the PI3-kinase domain, although some exceptions to this were found in patients with typical A-T phenotypes. All patients not previously known to be consanguineous were found to be compound heterozygotes when mutations could be identified--that is, normal and abnormal protein segments were seen on SDS-PAGE gels. All 48 patients gave RT-PCR products, indicating the presence of relatively stable mRNAs despite their mutations. These results suggest that few public mutations or hot spots can be expected in the A-T gene and that epidemiological studies of A-T carrier status and associated health risks will have to be designed around populations with frequent founder-effect mutations, despite the obvious limitations of this approach.

X-linked agammaglobulinaemia (XLA) is an inherited immunodeficiency resulting from mutations in the gene for a cytoplasmic protein tyrosine kinase (Btk). We have utilised reverse-transcription-based PCR in combination with the chemical cleavage and mismatch technique (CCM) to screen for Btk mutations in 42 unrelated patients having classical XLA or 'leaky' XLA-like phenotypes. A variety of mutations, including point mutations, large deletions and splicing defects were detected using this strategy. In total, 20 mutations were found in these patients. All the mutations were different with the exception of three unrelated patients who all showed the same Arg-->His amino acid substitution (R641H) at a highly-conserved residue in the kinase domain. We have also used structural modelling of the Btk kinase domain to predict how two different amino acid substitution mutations at highly-conserved residues are likely to affect the Btk kinase activity.

A prospective open study was carried out on 30 pediatric patients with most severe chest disease whose serum immunoglobulin levels were normal. The patients entered into the study had had two or more documented episodes of pneumonia, and/or six episodes of bronchitis with fever within a year, and/or severe asthma (steroid-dependent), and/or hospitalization for chest disease for more than 30 days within the year preceding the study. Eleven patients had sinopulmonary infections, 19 had asthma. Twenty patients had low levels of one or two IgG subclasses: 11 were deficient in IgG3, three in IgG4, three in IgG3 + IgG4, and three in IgG2 + IgG4. Patients with low IgG subclass levels were distributed throughout the different clinical entities. These children had significantly longer periods of hospitalization than the patients in whom all IgG subclasses were within the normal range. They suffered more often from sinopulmonary infections. Asthmatic children with low levels of an IgG subclass reported more days with wheezing and needed more steroids than the children without subclass deficiencies.