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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).

Unlabelled: Suicide is among ten leading causes of death in each country and the third most common cause of death in the age group 16-35. The presence of mental illness is the most important risk factor for suicide. Affective disorders contribute to 15-25% of deaths due to suicide attempts. Depression is the most likely cause of the patients attempt on his life. Contrary to popular opinion, manic episode can also increase the risk of suicide, especially if the patient dominates by productive symptoms in the form of delusions. The aim of study was to determine the frequency of suicide attempts and their determinants in an episode of mania in bipolar disorder., Materials and Methods: The study included 16 people with a diagnosed bipolar disorder, hospitalized with manic episode at the age of 28-76. Patients hospitalized in the Department of Adult Psychiatry were selected randomly. The number of suicide attempts, comorbid conditions, and basic epidemiological data were estimated., Results: Five patients declared suicide attempt, one of which wanted to make more than one attempt at suicide. 3 people took it during an episode of depression, two in an episode of mania. The methods of suicide were associated with an overdose of medication and this was accompanied by a greater amount of alcohol intake. 11 persons did not declare any willingness to attempt suicide., Conclusions: A mania episode did not increase the risk of suicide in bipolar disorder compared to an episode of depression in the study conducted. The importance of somatic illness in patients with bipolar disorder is increased if the suicide attempt occurs in an episode of depression. Alcohol abuse showed no negative effects on suicidal behavior of patients. During abuse was the most common way of commit suicide.

Dextromethorphan (DXM) is a derivative of codeine with an antitussive properties. Acute poisonings with this drug are related to serious, often life-threatening clinical symptoms. In the last decade the number of DXM poisonings increased and the problem was particularly noticeable among adolescents. The aim of this study was to analyze selected demographic and clinical parameters of patients who were hospitalized due to DXM poisoning in Pomeranian Centre of Toxicology between 2009-2011. The study included 170 individuals which was 2.7% of all admissions in this period. In 2009 and 2010, the proportion of patients poisoned with DXM did not exceed 1.5%, while in the years 2011- 2013 it tripled and reached up to 3.5%. The age of patients ranged from 12 to 42 (mean 18) years. Women were more frequently hospitalized. The dose of ingested DXM ranged from 150 to 2700 (mean 588.7) mg. The analysis revealed that the dose of ingested DXM was increasing with the age of patients.

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.

Unlabelled: Poisoning is a clinical syndrome caused by the poison, which entered into the body. Poison is every substance that taken in the specified amounts may cause adverse effects., Objective: Statistical analysis of acute poisoning in children in the years 2010-2012., Material and Methods: The study group consisted of 308 children who went to the Admissions Room of the Specialized Health Care Mother and Child in Poznań because acute poisoning suspicion or diagnosis, in the period from 1 January 2010 to 31 December 2012., Results: In the group of 308 children, girls accounted for 57.14% and 42.86% boys. Children age ranged from 5 day old to 215 months of age (average 122 +/- 74). Toxic substances, which children have been exposed were drugs in 144 patients, ethyl alcohol in 75 children, carbon monoxide - 55 injured and chemicals in 34. The most commonly acute poisoning occurred in October (11.69%), December (11.04%) and September (10.71%). Of the 308 admitted children, 278 (90.26%) were hospitalized, including 11 patients (3.57%) in the Intensive Care Unit (ICU). In study population poisonings with drugs were dominated and related to 63.89% of girls and 36.11% of boys, aged from 2 to 213 months of age (average 120 +/- 75). In 50.69% of children intentional poisoning was diagnosed, in 18 patients (12.5%) mixture of different drugs was ingested, in five of them together ethyl alcohol. At 4.86% of the children reported a suicide attempt. This group accounted for girls with an average age of 178 +/- 8 months. Ethyl alcohol poisoning related to 56% of girls and 44% of boys between the ages of 152 to 215 months, giving an average age of 184 +/- 17 months. At 5.33% of the patients reported alcohol consumption along with medication, and 2.66% in addition took psychoactive substances. Because carbon monoxide poisoning aid granted to 50.91% girls and 49.09% boys between the ages of five day old to 209 months of age (mean 96 +/- 64). Poisoning with household chemicals related to 58.82% of boys and 41.18% of girls (mean age 32 +/- 36 months). Detergents were the most frequent ingested chemicals in 50% of children with an average age of 3 years., Conclusions: Acute poisoning with the exception of household products ingestion were more common in girls than in boys. The most common cause of poisoning in children were drugs overdose and ethanol ingestion. Cases of suicidal poisoning target group included only female sex. Accidental poisoning were observed mainly in young children and usually caused by chemicals.

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.

Recent stressful life events (ASLE) are considered to be one of the factors precipitating suicidal behavior. They precede a suicide attempt in most cases and according to research occur more often during the month or week before the suicide attempt. Interpersonal events are most common. The article presents an analysis of ASLE timing and incidence of events from specific categories during the month preceding suicide attempt by drug overdose. 124 patients admitted to the hospital because of suicidal intoxication were included in the study. Data regarding ASLE were collected with the use of a structured interview. Majority of patients attempting suicide by drug overdose experience a stressful event during the month prior to the suicide attempt. Nearly 4 out of 10 study subjects experience a stressful event on the day of the attempt or on the preceding day. Most common events that occur during the month prior to the attempt and immediately before the attempt are interpersonal events and most of them are related to relationships with spouses or partners.

Introduction: Intoxication poses significant challenge for medical staff due to diagnostic difficulties, complex clinical pattern, resulting from polyethiology of poisoning and potential risk of life threatening complications., Objectives: the epidemiology of acute poisonings, observed in Toxicology Unit (TU) in Lodz during the period 2002-201--is the main objective of the study. Authors present their frequency and associated mortality and discuss the structure of poisonings with regard to type and causative agents., Materials: The data used for analysis were drawn from National Poison Information Center in Lodz. They were divided into two groups. The first one comprised informations about patients treated in TU, whereas the second one included cases treated in other hospitals and only consulted by TU staff., Results: Analysis of obtained data showed that medications overdose was the most frequent cause of hospitalization during 2002-2011. Patients between 15 and 30 years constituted the largest group in comparison with total number of poisonings. Medications, alcohols and gases constituted also the leading cause of deaths due to poisoning during the analysed period. Suicidal poisonings composed the largest group in 2002 and 2003 y respectively, whereas poisonings caused by abuse or abuse in the course of dependence were the most frequent in subsequent years.

Unlabelled: Intoxication with novel recreational drugs poses significant challenge for medical staff due to diagnostic difficulties, complex clinical pattern, resulting from polyethiology of poisoning and potential risk of life threatening complications., Objectives: Description of clinical pattern novel drug intoxication., Methods: retrospective review of medical records patients hospitalized in the Toxicology Unit (TU) with diagnosis of intoxication with novel recreational drugs., Results: During the period from 2008-2010--431 patients were admitted to TU with mentioned above diagnosis. 159 (36.9%) patients were positive for ethanol with its average concentration in blood 150 mg%. Presence of other substances like amphetamine, cannabinoids, atropine, ephedrine, carbamazepine, benzodiazepines and dextrometorphan was confirmed. The most frequent clinical symptoms observed on admission were: anxiety, agitation, complaints associated with circulatory system and vertigo Average pulse rate and both: diastolic and systolic pressure were within normal limits, however authors noted slight tendency toward tachycardia. One patients died due to multiorgan failure. Average period of hospitalization amounted 2.24 days. Co-poisoning with ethanol was associated with higher frequency of circulatory system disturbances., Results: Clinical pattern of poisoning with novel drugs could partially correspond with mild sympathomime. tic syndrome.

The paper proposes tests to assess psychomotor impairment in drivers suspected of using substances acting similarly to alcohol. The authors also present a proposal for the protocol to be used in sampling and testing of saliva, blood and urine when psychoactive substance abuse has been suspected. A detailed procedure is based on the joined experience of German, U.S. and Polish police from Gdansk. The purpose of the appendix is to help police officers to perform and document tests confirming psychomotor impairment, as well as to provide the basis for saliva, urine and blood analysis.

Exposure to carbon monoxide (CO) accounts for a frequent cause for patient hospitalization in the Children's Clinical Hospital (DSK). The most common source of exposure includes the use of defective heating appliances operating on gas or coal and less frequently the fire toxic fumes. The purpose of the present study was to estimate the number of hospitalized patients in DSK in Lublin between the years 2006-2012 according to age, sex, urban-rural residence, season, carboxyheamoglobin (COHb) levels and hospitalization period. The subjects were assigned to three age groups: I - neonates and infants, II - children from 1 to 6 years of age, III - children aged between 7 to 17 years. In total 99 patients (50 female, 49 male) were admitted to hospital on account of carbon monoxide intoxication. Children aged 6 years and above constituted the most numerous age group. Furthermore 1 neonate and 5 infants (6.1%) and 43 children aged 1 to 6 years (43.4%) were hospitalized. The intoxications were visibly season-related. The highest frequency of CO poisoning lasted from October until March. The largest incidence was recorded in December and January. The majority of the children were urban residents - 67%, 33% were from rural areas. Carboxyhaemoglobin levels upon admission ranged from 0 to 26.7%. The average hospitalization lasted 2.4 days. Carbon monoxide intoxication remains a pressing health concern. The awareness of CO intoxication hazards among general public, application of appropriate first aid techniques, identification of clinical symptoms and treatment methods present the opportunity to save lives and reduce the long-term effects of CO poisoning.

Unlabelled: There is a lot of data in medical literature which point at the phenomenon of seasonality of suicide attempts through self-intoxication. The aim of this study was to evaluate the seasonality of acute, suicide poisonings in 2002-2005 period. We analysed all self-poisoning cases hospitalized in 2002-2005 period in our Department. The study group consisted of 1416 patients including 836 female (59.1%) and 580 (40.9%) male. The average age was 35.4 +/- 15.5 years. The evaluation of suicide attempts' seasonality was made on two levels, i.e. days of the week and months of the year. This means we analysed the number of admissions to the Clinic due to deliberate self-poisoning in each month of the year and each day of the week. Based on the analysis of the number of cases admitted to the Department due to suicide poisoning it was established that there was a phenomenon of seasonality on both levels (days of the week and months of the year). The number of intoxication-related admissions proved to be significantly higher on Monday whereas significantly lower on Saturday. As far as the yearly seasonality is concerned the number of admissions to the Clinic was significantly below the average in February and in the period from August to October while it was significantly above the average in January and March. In respect to gender however we examined no statistically significant differences in the prevalence of intoxication in each day of the week or each month of the year., Conclusions: 1. The seasonality of suicide attempts was detected on both day of the week and month of the year levels. 2. No significant differences in the prevalence of intoxication were established in respect to gender on either day of the week or month of the year levels.

Unlabelled: There are no reliable studies in Poland evaluating the amount of acute intoxications by drugs, chemical substances, animal venom, plant toxins. The aim of the study was to evaluate selected problems referring to intoxicated patients, who were given medical treatment in all hospitals having contract with National Fund of Health in 2010. All medical interventions, in which the main diagnosis were coded as T36-T65 (with four-character subcategories) according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision, were involved to the study. Also all poisonings with those codes put as comorbidities and positively verified by the authors, were included to the analysis. There were 85 230 acute intoxications in Poland in 2010. In 41 653 cases there were no need of further hospital treatment. Ethanol poisonings were the most common diagnosis among patients treated in the Emergency Departments. The average hospitalization in Toxicology Centers lasted 3.35 days while in other hospitals about 3 days. There is the high percentage of discharges on "patient's demand" (about 12% of all hospitalizations). In Toxicological Units this kind of discharges reaches up to 18%. In 2010 there were 580 deaths because of acute intoxications. It presents 1.33% of all hospitalizations. It's worth to indicate that the mortality rate in critical care departments has reached the level of 17.82%, while in Toxicology Centers the mortality rate was 0.96% in all cases and less than 3% in most severe poisonings., Conclusions: In Poland, as it is in other countries, the national toxicological information and control system should be brought into being. The system should be based on Toxicology Centers which should exist in all Polish districts. Taking into consideration the high mortality rate outside the Toxicological Units, there is a need of toxicological education of doctors, nurses and other medical staff. It's necessary to monitor permanently diagnostics, treatment and mortality rate of intoxicated patients.

Unlabelled: A lot of data in medical literature shows significant influence of social factors on the incidence of suicide attempts. The aim of this study was to evaluate the significance of several sociological aspects in cases of patients after deliberate self poisoning with xenobiotics, who in the 2002-2005 period were treated in our Department. We analysed all self-poisoning cases of hospitalized patients. The study group consisted of 1416 patients: 836 (59.1%) female and 580 (40.9%) male. The average age of the subjects was 35.4 +/- 15.5 years. The sociological aspects included in the analysis were as follows: marital status, dwelling situation, financial situation and employment status or current level of education (in cases of patients still attending school). Among 1416 hospitalized subjects, 38.6% were married or cohabited; 35.7% described themselves as single and 12.2% were divorced or separated. Patients who in the moment of a suicide attempt were living with their families or friends represented the largest proportion of subjects (87.2%). Nearly a half of the patients (47.8%) stated that the financial means at their disposal hardly covered their most basic existential needs while more than 41% described their financial situation in the moment of a suicide attempt as poor. The largest group of the subjects consisted of professionally active people (27%), the second largest (25.6%) - of the unemployed. Almost 20% of patients willing to commit suicide were drawing a state pension due to their partial or complete incapacity to work. Just under 6% of patients in question were retired. The proportion of the unemployed or pensioners in the population aged 15-64 (n=1339) was as large as 47.9%. The dominant group in the population of patients still in their school years consisted of students of post-secondary schools., Conclusions: More than a half of the patients treated due to a suicide poisoning attempt claimed to live a single life, without a long-lasting relationship. The percentage of the divorced or the separated in the analysed popu- lation was high. In the group of the deliberately self-poisoned patients in their productive age (15-64 years), the proportion of the unemployed or pensioners reached almost 48%. Over 90% of the subjects after a suicidal episode described their financial situation as bad or unsatisfying.

The main objective of this study was an analysis of the cohort of patients hospitalized due to intoxication with this agent during the period 2000-2009 and investigate factors, which determined the course of poisoning. During the search process, 288 (1.07%) patients were identified within total number of 26801 patients hospitalized. Within analysed cohort male patients formed majority with 227 males, whereas only 61 females were found within this group. The mean methanol blood concentration was 50.09 mg/dl and ethanol - 292.90 mg/dl. Patients condition on admission varied, the most frequently noted pathologies were consciousseness disturbances and tachycardia, namely the former was recorded in 171 cases (59.4%) whereas the latter in 89 patients (30.90%). 11 patients died within the analysed group and 72 developed single or multiorgan complications in the course of poisoning. The most commonly encountered complication was pneumonia. Features of central nervous system (CNS) damage were found in 20 cases (6.94%). Average concentrations of methanol in the group of the 11 deceased patients were: 158.73 mg/ dl, 20.91 mg/dl for ethanol. The average values of arterial blood gases parameters in this group were pH= 6.98; BE=(-) 22.482; HCO3=9.67 mmol/l. Within the non survivors group such complications as CNS damage, seizures, pneumonia, liver injury and pancreatitis were noted more frequently, with statistical significance. The concentrations of methanol and ethanol in the blood on admission and such ABG parameters as pH, BE, HCO3, pCO2 i pO2 also measured on admission should be considered as the prognostic factors, determining the course of the disease and the outcomes of treatment. Poor prognosis may be associated with such clinical features on admission, as: respiratory and circulatory disturbances and cerebral sequelae.

Name-day party is a feature of the Polish culture. During these parties alcoholic drinks are served very often. In this paper it is shown that there is a positive correlation between the popularity of a name-day and the number of ethanol poisonings. Another finding of this paper is that the popularity of a name-day is also associated with the average age of ethanol-poisoned patients. This association is mediated by gender and a day of the week. On days of popular names the average age of poisoned woman is lower comparing to days of unpopular names. In case of males the pattern is more complicated. If a name-day of common names occurs on a week day then the male patients tend to be older, but if such a day occurs at the weekend then average age of male patients is higher.

In recent years the commonest kind of poisonings observed in the Department of Clinical Toxicology in Kraków has been the poisonings with ethanol. Since this substance is so popular a detailed analysis of trends of poisonings with ethanol has been undertaken. The analysis has been based on the database of toxicological laboratory, the data collected in the period December 2001 - August 2004 were analyzed. It has been shown in this paper that the number of poisoned males is decreasing at the rate of 0.029% per day. Days such as Friday, Sunday, Saturday and the New Year's Eve are days of high number of ethanol-poisoned patients. At the beginning of the studied period a nonlinear increase of average age of patients was observed. This trend reached its plateau and maximum in winter 2002 and spring 2003 and since this time a decreasing non-linear trend has been observed. The average concentration of ethanol in the blood of patients is increasing at the rate 0.00002 g/L per day. The average concentration varies between gender and age groups. The group with the highest concentration is the group of about 50-years-old males. In the middle of the studied period the average concentration of ethanol in the blood of patients of this group was about 2.71 g/L. The concentration depends also on the day of the week. Patients investigated on days from Tuesday till Saturday show a higher concentration than those treated on Sundays and Mondays.

The aim of this study was to determine relations between the clinical state and the severity of liver damage comparing to the amount of ingested paracetamol, time since ingestion and serum concentration of paracetamol with patients after acute intoxication with this drug. A retrospective analysis of medical records of 95 patients hospitalized in the Toxicology Department in Kraków or treated in the Toxicological Admission Room in 2002-2004 years because of acute paracetamol intoxication was performed. The general clinical state connected with intoxication and the severity of liver damage were determined using the Poisoning Severity Score (PSS). The level of consciousness was determined with the Glasgow Coma Scale and Matthew's scale. The serum concentration of paracetamol during admission to the hospital, levels of biochemical markers of liver damage (AST, ALT), bilirubin and INR index were also performed. We found a statistically significant positive correlation between the ingested dose of paracetamol comparing to the gravity of poisoning, the severity of liver damage, levels of aminotransferases and bilirubin. A positive correlation between time since ingestion of paracetamol to hospitalization and the gravity of poisoning according to PSS scale was also statistically significant. A paracetamol concentration measured during admission to the hospital had no influence on neither the clinical state of patient nor the severity of liver damage. We conclude that the therapeutical approach should consider possibly shortening of the time since drug ingestion to hospitalization and institution of specific treatment (N-acetylcysteine) as well as minimalization of the paracetamol dose, which could be absorbed, by different methods of elimination from the GI tract (eg., gastric lavage, activated charcoal laxatives).

191 cases of fatal suicidal poisonings in the years 1991-2000 were analysed. Postmortem examinations were conducted in the Institute of Forensic Medicine of the Jagiellonian University. The group of poisonings was selected from a total of 1937 fatal suicidal cases examined in our Institute. Frequency of suicidal attempts, kind of chemicals/drugs used, age and sex relationships, probable motives and seasonal a variables were taken into account in our investigation. The results were compared to previous studies. Poisonings comprise about 10% of the total number of suicidal cases. The most frequent are poisonings using drugs, then using chemicals. The number of cases of males committing suicide by poisoning is about twice as many as seen in females in such cases. The most important motives were mental disturbances, the latter most frequent motives were alcoholism and somatic illnesses. The peak of number of cases was noted in the summer months, June and July (about 1/3 of the total number of cases). In the last decade we systematically observed both a rise in the total number of suicides and a lower percentage of poisonings.