Search

Introduction and Aim: Adolescent suicide attempts are a significant clinical and social issue. Often, young people resort to medications, alcohol, or psychoactive substances in their suicide attempts. The aim of this study was to analyze the factors contributing to suicidal behaviors and the characteristics of substances used by adolescents for suicidal purposes. Materials and Methods: In this retrospective study, medical documentation analysis was used. The study included the medical records of 45 individuals up to 18 years of age who were admitted to the Clinical Toxicology-Cardiology Department due to poisoning for the purpose of suicide in the year 2022. Results: The study group consisted of 45 individuals aged 15 to 18 years. Suicide attempts accounted for 37.5% of toxicology hospitalizations in the under 18 age group. The dominant group consisted of females (82.2%) and urban residents (62.2%). Those hospitalized following a suicide attempt primarily used medications, often over-the-counter analgesics. The majority (71.1%) suffered from mental disorders, predominantly depressive disorders (81.2%). Conclusions: Among suicide attempts involving intoxication, those utilizing medications are dominant. A concerning phenomenon is the use of over-the-counter (OTC) medications, commonly considered safe. Girls are particularly vulnerable to emotional difficulties that can lead to suicide. Mental disorders pose a suicidal risk, and patients with such disorders have access to psychiatric medications that can become tools for self-harm.

Introduction and purpose: Detergents are compounds that constitute the main component of cleaning products. Due to their varied chemical structure, they have different functions and a wide range of applications. The aim of this study is to draw attention to the problem of toxic effects of detergents on the basis of analysis of cases of detergent poisoning by patients of the Toxicology and Cardiology Ward of the Stefan Cardinal Wyszyński Provincial Hospital in Lublin. Material and methods: The study was retrospective in nature. It used an analysis of the medical records of 11707 intoxications in patients between 01.01.2013 and 31.12.2022, from which a group of individuals with a diagnosis of T55 according to the ICD 10 classification "Toxic effects of soaps and detergents" consisting of 36 cases was selected. Results: The study population consisted of 18 (50%) women and 18 (50%) men. The majority- 19 patients (52.78%) were exposed to the toxic effects of detergents accidentally. 10 patients (27.78%) were suicide attempts. Accompanying medical conditions were mostly psychiatric disorders, with alcohol dependence syndrome predominating - 9 cases (25%). The majority - 33 patients (91.67%) intoxified themselves with detergents in the form of liquids and solids by the oral route . Conclusions: Despite their usefulness in households and industry, detergents contribute to adverse health effects in situations of accidental exposure or intentional intake. In order to reduce the number of complications, preventive measures should be implemented - such as storing detergents in less accessible areas, in original boxes with retained labels, and increasing funding for psychological-psychiatric care in a crisis situation.

Introduction: Poisonings with non-beverage alcohols remain a significant problem in contemporary toxicology. Due to the large quantity and severe course of intoxications with methanol, the authors of this study focused primarily on poisonings with this substance. Methanol is widely used in industry. Its toxicity is attributed to its metabolites - formaldehyde and formic acid. Poisonings with methanol often lead to the patient's death due to a wide range of complications associated with progressive metabolic acidosis. Material and Methods: The study is of a retrospective nature. It involved the analysis of medical records of patients admitted to the department of toxicology in 2022 after the consumption of non-beverage alcohols, with a particular focus on methanol. Data on the number of individuals admitted due to non-beverage alcohol intoxication between 2018 and 2022 was also analyzed. Results: Over the last 5 years (2018-2022), 36 individuals were hospitalized in the Clinical Toxicological-Cardiological Department due to non-beverage alcohol poisoning, with 16 (44.4%) cases involving methanol. In the year 2022, the department admitted 10 individuals aged 18 to 68, and 5 (50%) of them consumed methanol. Among the hospitalized, 90% were male, and 60% came from rural areas. Deliberate intoxications accounted for 70% of the cases. Four hospitalizations (40%) resulted in patient death. All deaths were associated with methanol intoxication. Conclusions: Non-beverage alcohol is often used by people with alcohol dependence syndrome. Among non-beverage alcohols, patients most often reached for methanol. Its consumption is associated with a high mortality rate and should be taken very seriously and treated immediately.

Introduction and purpose: Poisoning among children and adolescents is occurring on an ever-increasing scale. Women are particularly susceptible to intentional poisoning, and they predominate in the statistics of self-poisoning. The aim of the study is to analyze cases of poisoning in girls under 18 years of age hospitalized in the Clinical Toxicology and Cardiology Department of the Stefan Cardinal Wyszynski Regional Hospital in Lublin in 2022, taking into account the type of substance ingested, the place of residence of the patients and comorbidities. Material and methods: The study was retrospective in nature. It used the analysis of medical records of 84 cases of intoxication in girls under 18 years of age. Results: During the time period studied, 84 girls aged 13-18 were hospitalized for poisoning. Most of the cases were urban residents (64.3%). The toxic substances causing poisoning were mainly drugs (63.1%), narcotics (17.9%) and ethanol (17.8%). Poisoning of an intentional nature involved 80 (95.2%) cases, 37 (44%) cases were suicide attempts. In 54 (64.3%) cases, the patient was burdened with a mental illness, the most common being depressive disorders. There were no deaths in the study group. Conclusions: Due to the increasing phenomenon of mental disorders, as well as intentional poisoning among adolescent girls, special emphasis should be placed on psychological care, pedagogical care, of girls in adolescence. This is the time when girls have problems with acceptance of their bodies, with acceptance among peers. Parents and teachers should be made aware of this.

Introduction and purpose: Drug poisoning is one of the more common reasons for patients being hospitalized in toxicology wards. The wide availability and ease of obtaining a wide variety of drugs and supplements are the cause of adverse reactions associated with their use. Increasing life expectancy and emerging chronic diseases also require the use of sometimes many drugs to control people's health. This can lead to poly-pragmasy, which is an undesirable condition and leads to poisoning. The purpose of our work is to demonstrate the most common causes of drug poisoning considering the criterion of division according to ICD-10. Brief description of the state of knowledge: Any preparation, drug, supplement can cause negative effects on the organism. This depends on the dose, improper use, or cross-reactions of the relevant substances. The study compiled statistics on the cause of hospitalization of drug-poisoned patients based on ICD-10. 5433 patients were included in the study. Conclusions: Our work shows that the most common causes of hospitalization due to drug poisoning are those caused by antiepileptic drugs, sedative-hypnotics and antiparkinsonism medications. The data compiled in this article agree with scientific reports from different countries compiling the most common reason for hospitalization related to drug poisoning.

Introduction and aim: Paracetamol (acetaminophen) is a commonly used analgesics and antipyretics and it is a nonprescription medicine. Improper use of it may lead to accidental or intentional poisoning. The aim of the study was to analyse paracetamol poisonings in children and adolescents admitted to the Clinical Department of Toxicology and Cardiology in Stefan Wyszyński Regional Specialist Hospital in Lublin in 2022. Material and methods: The research was retrospective. Medical records of poisoning cases in patients up to the age of 18 were analysed specifically emphasizing acetaminophen poisonings. Results: In the studied period 120 adolescents were hospitalized due to intoxication, 65 of them due to medications intake, the most commonly used medicine was acetaminophen. There were 20 cases of hospitalization because of acetaminophen intake, 17 (85%) patients were female and 3 (15%) of them were male. Patients were from 15 to 17 years old. In 12 cases (60%) patients came from urban areas. The intentional intoxications were found in 18 (90%) cases, 13 of them were suicide attempt. Majority of cases of attempted suicide were female (92%). The other intoxications were accidental, where patients took acetaminophen as a painkiller. In the researched group there were no deaths. Conclusions: Paracetamol overdosing is always associated with the risk of liver damage.This medicament as a potentially hepatotoxic drug should not be sold over the counter. The availability of paracetamol is too widespread, which poses a risk especially to children and adolescents. The ubiquitous advertising of acetaminophen products as well as their popular use, for example, in menstrual pain, favor their presence in almost every Polish home. Parents and guardians should be educated about the dangers of uncontrolled use of so-called OTC drugs - incorrectly commonly considered safe.

Introduction and purpose: Cardiological drugs are widely used in the management of various cardiovascular diseases, such as hypertension, angina, heart failure, and arrhythmias. However, when these drugs are taken in excessive amounts or are not used as prescribed, they can become toxic and cause significant harm to the heart and other organs. Our study aims to illustrate the most frequent causes of poisoning with cardiological drugs in patients hospitalized in the toxicological and cardiological department from April 2013 to December 2021. Brief description of the state of knowledge: Poisoning with cardiological drugs is a growing concern for healthcare professionals. In 2019, cardiovascular toxins were one of the top 10 categories of poisons evaluated by medical toxicologists. Data collected from the analyzed toxicology and cardiology department include a group of 387 hospitalized patients. The largest proportion were cases intoxicated by beta-adrenoreceptor antagonists. The second most common group was poisonings by angiotensin-converting-enzyme inhibitors. A slightly lower proportion implicated poisonings caused by other, unidentified substances affecting the cardiovascular system - calcium channel blockers and other antihypertensive drugs. Conclusions: All of the data demonstrated in our study shows the importance of understanding the pharmacology, pathophysiology, and treatment strategies of poisonings caused by cardiological drugs which are one the most widely used medications worldwide.

Introduction and purpose: Poisoning in children and adolescents remain a serious medical, psychological and social problem. The aim of the study was to analyse poisonings in patients up to 18 years old admitted to the Clinical Department of Toxicology and Cardiology in Stefan Wyszyński Regional Specialist Hospital in Lublin in 2022. Material and method: The research was retrospective. Medical records of 120 cases of poisoning in patients up to the age of 18 were analysed. Results: In the studied period 120 patients from 13 to 18 years old were hospitalized due to intoxication, 84 (70%) of them were female and 36 (30%) of them were male. Majority of cases came from urban areas (69,2%). The most frequent causes of poisonings were medicaments (55%), drugs (29,2%) and alcohol (28,3%). The intentional intoxications were found in 113 (94,2%) cases, 45 (39,8%) of them were suicide attempt. Mental diseases were found in 71 (59,1%) cases, the most common one was depressive disorder. There were no deaths in the researched group. Conclusions: Because of the relevance of child patients poisoning young people should be provided with psychological care. Female teenagers must get special kind of support. The availability of child psychiatrists and psychologists is still too poor. Prohibition of selling alcohol to minors should be enforced stricly. It seems that acces to OTC drugs is way much too easy for people. There is a necessity of parents’education about children poisoning.

Introduction Clinical manifestation of organophosphates toxicity may be differentiate and include cholinergic toxidrome, intermediate syndrome, OP-induced delayed polyneuropathy to chronic OP-induced neuropsychiatric disorder (OPIDN). Patients symptoms, along with decrease in cholinesterase serum level, determines the possible diagnosis of organophosphate poisoning. Objective The aim of the study was to present the clinical manifestation and cholinesterase level changes in intoxication with organophosphorus compounds in patients. Material and methods A data base was created by analysis of the hospital documents of 34 patients hospitalized due to organophosphate intoxication. Statistical analysis involved frequency tables with percentage values, the application of non-parametric Chi-square test and parametric t-Student test (with homogeneity of variance Levine test). The level of static significance was set to p=0.05. Results In fatal hospitalizations (20.6%), cholinesterase level was significantly lower (265.87 U/l) than in other patients (4254.78 U/l; p

During the autumn season, it is common for mushroom pickers to eat poisonous mushrooms. This is due to many reasons, including the ignorance of pickers. The most common is the misidentification of inedible species as edible mushrooms. The result is poisoning, which in many cases requires hospitalization. This paper presents a case report of toadstool poisoning by a 62-year-old female patient. In addition, other relevant publications on intoxication, diagnostic methods and treatment are reviewed. The purpose of this paper is to present the management and treatment of a case of toadstool poisoning. The effects of mushroom poisoning can range from mild disorders, mainly gastrointestinal to organ failure and even death. Significant elevations of liver enzymes and prothrombin time are important in laboratory tests in cases of intoxication. Treatment most often involves specific antidotes, such as Sylimarin, Acetylcysteine. The diagnosis in most cases is made on the basis of the clinical picture and a thorough interview with the patient, and the diagnosis is established by detecting toxins in a urine test. The prognosis is better if patients with toadstool poisoning are admitted to the hospital early. It is worth noting that gastrointestinal syndromes can also result from eating raw or inadequately cooked mushrooms, and by eating them excessively or too often. Proper diagnosis and treatment of mushroom poisoning can save lives. It is very important to raise public awareness of mushroom poisoning, as well as early detection of potential signs of intoxication. Cooperation with the poison center and mycologists is very important, especially in high-risk cases.

Introduction and purpose: Designer drugs also known as legal highs, research chemicals or herbal highs become more and more popular not only in Poland but also in other countries around the world. That might have many reasons but the most crucial is their easy availability and rather cheap price in comparison to other psychoactive substances. Material and methods: We analyzed the data of patients hospitalized in years 2013-2018 in the Toxicology Department in Lublin and evaluated patients hospitalized due to psychoactive substance poisoningT40 according to ICD10). Moreover the review of available scientific articles was done. Results: After analysis the data of patients hospitalized in years 2013-2018 we can observe increasing tendency of poisonings. The growing number of designer drug poisonings may be the result of many factors - the phenomenon of these substances is based not only on a wide range of products, but also on various advertising strategies and patterns of use. Conclusions: There can occur big diagnostic difficulties due to unpredictability of the course of poisoning and unpredictability of composition. Therefore it is very important to react quickly and choose the right treatment. Many of these poisonings are really severe and often cause death. It is worth saying that side effects occur more often in combined preparations. It is also very important to educate young people and warn against using NPS, which are particularly dangerous and risky for human organism.

Introduction: The meteoric rise of new psychoactive substances' use has been a public health problem for at least few years. Their presence was noticed by EU authorities around 2005. First cases of NPS poisoning in Poland appeared shortly thereafter, in 2008. Due to great variety of used substances and lack of information about them, precise diagnosis and targeted treatment remain a significant problem. Hereby, we present a patient with multi-drug poisoning related to NPS abuse and discuss new psychoactive substances that are often found in such cases. Aim of study: To discuss most common new psychoactive substances and their health effects on the basis of the case report Results: A 28-year old patient was admitted to the Department of Toxicology and Cardiology with symptoms suggesting acute intoxication with psychoactive substances. The patient had a history of drug abuse. A few pouches containing unidentified psychoactive substances were found near the patient. On admission, his condition was serious- he was unconscious and required mechanical ventilation. Tachycardia and aspiration pneumonia were present as well.The applied therapy focused on restoring acid- base homeostasis, electrolyte balance and mitigating toxic influence of detected drugs, with preventive antibiotic administration used as well. His general and psychological condition improved with treatment, and he was discharged from the department after ten days, with continuation of the therapy in ambulatory setting. Conclusions: An increasing amount of patients present cases of polysubstance abuse, whose treatment may prove especially difficult. Such cases require extensive therapy to prevent debilitating complications. A focus on drug regulation and patient education could diminish the number of such cases in the future.

Introduction: Public healthcare systems throughout the world are strained by demographic changes, soaring costs and insufficient resources. This can negatively affect access to health services, which forces patients to seek other treatment options. Websites and online forums have become one of the most common sources of health advice, with online medicine trade burgeoning as well. However, while the internet provides vast knowledge database, using unverified advice or product can have dangerous consequences. We present a patient with acute amphetamine poisoning, caused by ingestion of substance marketed online as weight loss drug. Aim of study: to discuss potential risks and problems of using online advice and products in self medication Results: Our patient, the 36 year old female, was admitted to Department of Toxicology and Cardiology with symptoms suggestive of poisoning of some kind. She admitted to using a weight- loss medication throughout the last month, in increasing dosages. The drug was bought from online trading platform. She lost 8 kilograms of body weight through this period. Subsequently, she noticed some disturbing symptoms, including dystonia movements of limbs, paresthesia in right half of the body and blurred vision. Episodes of tachycardia were reported as well. On admission, the patient was weakened and mildly depressed. She reported not eating anything for the last 2 days. Toxicological examination revealed the presence of psychoactive substances in the urine- amphetamine at 7800 ng/ml and LSD at 1,08ng/ml. Our patient was consulted by psychiatrist and psychologist. Fluid therapy was applied, along with Relanium, low molecular weight heparin, Dexaven and Polprazol. Due to elevated blood pressure, a 24-hour blood pressure measurement was performed. Next, hypotensive therapy was administered. The patient’s condition improved and she was discharged from the hospital after 4 days, with scheduled control in ambulatory setting and recommendation of beginning the psychotherapy. Conclusions: Online health advice and products can be dangerous if used inappropriately. A focus on education and provision of freely available, high quality medical information can make it safe and useful complement to healthcare systems throughout the world. Appropriate systems controlling online medicine distribution should also be instituted, with patients’ safety and wellbeing as prime goals.

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.

Introduction: Amygdaline, one of the most common cyanogenic glycosides, is present in the seeds and fruit pits of Prunus species. The excessive administration of this glycoside might lead to cyanide poisoning. Aim: The aim of the study is to depict the risk associated with apricot kernels ingestion on the base of the case report. Methods: The analysis of the patient’s medical history and the review of available literature. Results: 80- year- old female with the medical history of papillary thyroid cancer was admitted to the toxicology department due to accidental cyanide poisoning. The patient consumed extract consisted of milled apricot kernels, then suffered from dyspnea, vertigo and vomiting. After that, she lost consciousness. Lactic acidosis, highly specific for cyanide intoxication, was diagnosed during hospitalization. The patient was treated with fluid and steroid therapy, sodium bicarbonate and supplemental oxygen. On the 3rd day of stay, the patient was discharged with recommendation of control in toxicological clinic. Conclusions: Initial symptoms of cyanide poisoning are not specific, therefore it is worth taking this poisoning into account in differential diagnosis, especially in oncological patients or in children.