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Poland is among the infamous leaders among countries when it comes to the percentage of suicide attempts among young people. Methadone is a long-acting opioid agonist, which is mainly used as substitution treatment for heroin and morphine addiction. There is a typical triad for methadone overdose consisting of respiratory failure, myopic pupils and central nervous system depression. It may also lead to QT prolongation with following torsade de pointes. We present two teenager patients, who were poisoned with methadone. They were both under the influence of their boyfriend who was drug addicted. What is more, the girls both were in toxic relationship with the same man, who had similar influence on them. First patient was 18 years old. She was admitted to Department of Toxicology and Cardiology because of intravenous methadone overdose. The treatment used improved the general condition. No abnormalities were seen in the clinical examination. Teenager was examined by psychiatrist and psychologist. Second patient, 16 years old, was hospitalized twice. Teenager admitted that she got methadone from her boyfriend who is being treated for drug addiction. At the time of admission, the patient was emotionally disturbed, tearful, and periodically aroused. After two days of hospitalization girl was discharged home under mother’s protection. Three months later, 16 years old patient was admitted to the hospital again, because of intoxication with psychoactive substances and self-injuries. After three days of hospitalization, she was transferred to psychiatric hospital for further therapy. We can indicate methadone use not only as methadone’s level in urine, but also as EDDP, methadone’s metabolite concentration in urine. Every person with symptoms of behavioural disorder should be as fast as possible be examined by psychiatrist and psychologist, to avoid suicide attempts.

Pompe disease is estimated to happen in 1 out of 40 000 borns. It is rare metabolic disease connected to autosomal recessive genetic mutation. Disease is characterised by deficit of α-glucosidase (GAA) which is lysosomal glycogen hydrolizing enzyme acid. Decreased activity of enzyme leads to glycogen storage in lysosomes which appears as disfunction of tissues, especially cardiac muscle and skeletal muscles. In Poland, we have two common and very simple methods to diagnose Pompe disease. First test is dried blood spot (DBS), second is full peripheral blood test. Currently, in Poland, drug containing alglucosidase alpha is refunded. Drug is available as powder for infusion. Periodic assessment of therapy effectiveness is performed at least every 6 months based on rating the patient's clinical condition and assessment of the effectiveness of the therapy used.

In Poland in 2016, there were almost 10,000 suicide attempts, in which about 55% ended up with death. Suicidal attempts are more often taken by women, but they are more effective in the case of men. Most of these people are afflicted with mental illness such as depression. A 49 year old man was admitted to Cardiology and Toxicology Department, because of poisoning with antipsychotic drugs and ethanol. It was his second suicide attempt. The day he was admitted to the hospital he was in serious condition. Patient was monitored, symptomatic treatment and pharmacotherapy were initiated. The patient required intubation and the use of respiratory therapy because of breathing problems. In the clinical study and imaging examinations massive pneumonia, was confirmed. His pharmacotherapy was modified and the antibiotics were given because of inflammation of a lungs. For patients poisoned by various substances, respiratory failure often has a complex medium. It may result from the depression itself of the xenobiotics on the respiratory system, the influence of the indirect mechanism of breathing or the result of aspiration and development of pneumonia. In therapy the most important is the monitoring of the patient's condition, electrolyte imbalance and symptomatic treatment. In a few cases and only for some drugs, we can use a specific antidote.

Backgrounds: Ethylene glycol poisoning is one of the heaviest poisonings in the toxicological practice of. Ethylene glycol is quickly absorbed from the digestive tract. Its toxicity is the result of combining few different mechanisms. Metabolites of decomposition, especially glycolic acid, are responsible for appearance of metabolic acidosis. Precipitated crystals of calcium oxalate additionally impair the function of organs such as kidneys, central nervous system (CNS) and circulatory system. Worldwide, from 2013 to 2018 about 30% of ethylene glycol poisoning cases end in death. Case report: We present the case of 56 years old woman, who was admitted to Toxicology Department because of ethylene glycol poisoning. We could observe presence of metabolic acidosis, respiratory insufficiency and organ damage. The patient has been treated pharmacologically and has been given specific antidote. Due to the ethylene glycol intoxication, metabolic acidosis and increasing parameters of kidney failure the patient also underwent hemodialysis. Conclusions: In pathogenesis of ethylene glycol poisoning toxic metabolits are crucial. The diagnosis of ethylene glycol is often a very hard task. In the clinical aspect it is based on the interview, a set of syndromes and biochemical tests and targeted toxicological tests. This kind of poisoning occur the most often among patients addicted to alcohol. It may lead to multi- organ damage or even death. It is very important to react quickly and implement pharmacotherapy and hemodialysis. The other essential aspect is to improve the level of knowledge of students and doctors about symptoms, diagnostics and proper proceeding with a patient poisoned with ethylene glycol. According to statistics and knowing how often the alcohol poisoning happens it is necessary to have knowledge in this field, be fluent in management and choosing methods of treatment in such cases.

Pompe disease is estimated to happen in 1 out of 40 000 borns. It is rare metabolic disease connected to autosomal recessive genetic mutation. Disease is characterised by deficit of α-glucosidase (GAA) which is lysosomal glycogen hydrolizing enzyme acid. Decreased activity of enzyme leads to glycogen storage in lysosomes which appears as disfunction of tissues, especially cardiac muscle and skeletal muscles. In Poland, we have two common and very simple methods to diagnose Pompe disease. First test is dried blood spot (DBS), second is full peripheral blood test. Currently, in Poland, drug containing alglucosidase alpha is refunded. Drug is available as powder for infusion. Periodic assessment of therapy effectiveness is performed at least every 6 months based on rating the patient's clinical condition and assessment of the effectiveness of the therapy used.

Poland is among the infamous leaders among countries when it comes to the percentage of suicide attempts among young people. Methadone is a long-acting opioid agonist, which is mainly used as substitution treatment for heroin and morphine addiction. There is a typical triad for methadone overdose consisting of respiratory failure, myopic pupils and central nervous system depression. It may also lead to QT prolongation with following torsade de pointes. We present two teenager patients, who were poisoned with methadone. They were both under the influence of their boyfriend who was drug addicted. What is more, the girls both were in toxic relationship with the same man, who had similar influence on them. First patient was 18 years old. She was admitted to Department of Toxicology and Cardiology because of intravenous methadone overdose. The treatment used improved the general condition. No abnormalities were seen in the clinical examination. Teenager was examined by psychiatrist and psychologist. Second patient, 16 years old, was hospitalized twice. Teenager admitted that she got methadone from her boyfriend who is being treated for drug addiction. At the time of admission, the patient was emotionally disturbed, tearful, and periodically aroused. After two days of hospitalization girl was discharged home under mother’s protection. Three months later, 16 years old patient was admitted to the hospital again, because of intoxication with psychoactive substances and self-injuries. After three days of hospitalization, she was transferred to psychiatric hospital for further therapy. We can indicate methadone use not only as methadone’s level in urine, but also as EDDP, methadone’s metabolite concentration in urine. Every person with symptoms of behavioural disorder should be as fast as possible be examined by psychiatrist and psychologist, to avoid suicide attempts.

In Poland in 2016, there were almost 10,000 suicide attempts, in which about 55% ended up with death. Suicidal attempts are more often taken by women, but they are more effective in the case of men. Most of these people are afflicted with mental illness such as depression. A 49 year old man was admitted to Cardiology and Toxicology Department, because of poisoning with antipsychotic drugs and ethanol. It was his second suicide attempt. The day he was admitted to the hospital he was in serious condition. Patient was monitored, symptomatic treatment and pharmacotherapy were initiated. The patient required intubation and the use of respiratory therapy because of breathing problems. In the clinical study and imaging examinations massive pneumonia, was confirmed. His pharmacotherapy was modified and the antibiotics were given because of inflammation of a lungs. For patients poisoned by various substances, respiratory failure often has a complex medium. It may result from the depression itself of the xenobiotics on the respiratory system, the influence of the indirect mechanism of breathing or the result of aspiration and development of pneumonia. In therapy the most important is the monitoring of the patient's condition, electrolyte imbalance and symptomatic treatment. In a few cases and only for some drugs, we can use a specific antidote.

Backgrounds: Ethylene glycol poisoning is one of the heaviest poisonings in the toxicological practice of. Ethylene glycol is quickly absorbed from the digestive tract. Its toxicity is the result of combining few different mechanisms. Metabolites of decomposition, especially glycolic acid, are responsible for appearance of metabolic acidosis. Precipitated crystals of calcium oxalate additionally impair the function of organs such as kidneys, central nervous system (CNS) and circulatory system. Worldwide, from 2013 to 2018 about 30% of ethylene glycol poisoning cases end in death. Case report: We present the case of 56 years old woman, who was admitted to Toxicology Department because of ethylene glycol poisoning. We could observe presence of metabolic acidosis, respiratory insufficiency and organ damage. The patient has been treated pharmacologically and has been given specific antidote. Due to the ethylene glycol intoxication, metabolic acidosis and increasing parameters of kidney failure the patient also underwent hemodialysis. Conclusions: In pathogenesis of ethylene glycol poisoning toxic metabolits are crucial. The diagnosis of ethylene glycol is often a very hard task. In the clinical aspect it is based on the interview, a set of syndromes and biochemical tests and targeted toxicological tests. This kind of poisoning occur the most often among patients addicted to alcohol. It may lead to multi- organ damage or even death. It is very important to react quickly and implement pharmacotherapy and hemodialysis. The other essential aspect is to improve the level of knowledge of students and doctors about symptoms, diagnostics and proper proceeding with a patient poisoned with ethylene glycol. According to statistics and knowing how often the alcohol poisoning happens it is necessary to have knowledge in this field, be fluent in management and choosing methods of treatment in such cases.