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Introduction: The dominant cause of injuries in traffic crashes. A significant portion of them affects victims under the influence of ethyl alcohol. The goal of the studies was to assess the correlation between the state of sobriety and the severity of injuries expressed by injury severity scales in fatal pedestrian victims of traffic crashes. Research Material and Method: The data were obtained from the Warsaw Medical University's Department of Forensic Medicine. The analysis covered the data for 2009-2013 and included 200 fatal pedestrian victims hit by passenger cars. The assessment of the effect of risk factors on injury severity expressed in terms of injury severity scales such as Life Threat Indicator (LTI), International Classification based Injury Severity Score (ICISS), Injury Severity Score (ISS) and New Injury Severity Score (NISS), was made using adequately selected methods of statistical analysis.Results: As alcohol concentration increases in women, the values of LTI, ICISS-10 and ICISS-15 decrease, which denotes more severe injuries. In the ISS and NISS, the effect of alcohol concentration on the severity of injuries turned out to be negligible. However, these injuries are significantly heavier in women than in men. According to all the scales used, the older the victims, the milder injuries cause their death.Conclusions: The studies show that ethyl alcohol concentration may harm injury severity, especially in the case of women. The assessment of the severity of injuries in traffic crash victims is significantly influenced by their age and gender. The more risk factors the scale takes into consideration, the more precise is the assessment. [ABSTRACT FROM AUTHOR]

Aims An integral part of the World Health Organization (WHO) plan to reduce suicide by 10% by 2020 is to identify areas and demographic groups, which should be priority target groups for preventive activities. This study aimed to present the demographic differences between victims of suicide by hanging in the Warsaw metropolitan area, in Poland, by examining the sobriety of victims. Methods Data for analysis were obtained from the documentation of the Department of Forensic Medicine (DFM) at the Medical University of Warsaw (MUW). The retrospective analysis included 358 out of 466 victims of suicides by hanging in the Warsaw metropolitan area, in Poland, recorded in the DFM documentation covering 2011–2013. The data gathered included age, gender, the cause of death, a post-mortem examination as well as the level of ethanol in the blood and muscles of victims. Results In both groups, men accounted for a larger percentage of victims than women, P  = 0.068. In the no-alcohol group, the victims were older than in the alcohol group (47.52 ± 19.21 vs. 40.88 ± 12.77) (P  < 0.001). The majority of the studied population were victims aged 25–34 (22.90%), mainly men (20.95%). Young men were also the largest group among victims in the alcohol group (28.33%). The most numerous age group among no-alcohol group were older victims aged 55–64 (19.10%), especially men (16.29%). Conclusion Regardless of sobriety, men were the largest group of suicide victims in the study population, which means that men die suicide more often than women. Differences in gender proportions are related to age. In the studied population, it was primarily young victims, mainly men. These are the groups that should be priority target groups for preventive activities aimed at reducing the number of suicides. The presence of ethanol in more than half of the victims of suicide in the study population indicates that alcohol is an important suicidal risk factor. [ABSTRACT FROM AUTHOR]

Background: Metachromatic leukodystrophy (MLD) is a severe neurometabolic disease caused mainly by deficiency of arylsulfatase A encoded by the ARSA gene. Based on epidemiological surveys the incidence of MLD per 100 000 live births varied from 0.6 to 2.5. Our purpose was to estimate the birth prevalence of MLD in Poland by determining population frequency of the common pathogenic ARSA gene mutations and to compare this estimate with epidemiological data. Methodology: We studied two independently ascertained cohorts from the Polish background population (N∼3000 each) and determined carrier rates of common ARSA gene mutations: c.459+1G>A, p.P426L, p.I179S (cohort 1) and c.459+1G>A, p.I179S (cohort 2). Principal Findings: Taking into account ARSA gene mutation distribution among 60 Polish patients, the expected MLD birth prevalence in the general population (assuming no selection against homozygous fetuses) was estimated as 4.0/100 000 and 4.1/100 000, respectively for the 1st and the 2nd cohort with a pooled estimate of 4.1/100 000 (CI: 1.8-9.4) which was higher than the estimate of 0.38 per 100 000 live births based on diagnosed cases. The p.I179S mutation was relatively more prevalent among controls than patients (OR = 3.6, P = 0.0082, for a comparison of p.I179S frequency relative to c.459+1G>A between controls vs. patients). Conclusions/Significance: The observed discrepancy between the measured incidence of metachromatic leukodystrophy and the predicted carriage rates suggests that MLD is substantially underdiagnosed in the Polish population. The underdiagnosis rate may be particularly high among patients with p.I179S mutation whose disease is characterized mainly by psychotic symptoms. [ABSTRACT FROM AUTHOR]

The iodine-131 (I-131) content in the thyroid of staff members working with this radionuclides has been measured with about 500 employees in about 25 hospital's departments of nuclear medicine performing therapy and diagnosis of thyroid disease in Poland. The measurements were performed with portable detection unit for in situ measurements of radioiodine. This is consist with scintillation detector sodium iodine activated by thallium (NaI(Tl)) - battery-powered and portable tube base Multichannel Analyzer Canberra UniSPEC. Based on direct measurements of the iodine content, the effective dose equivalent for workers due to inhalation of I-131 was estimated. All individuals actively working with iodine show measurable amounts of this isotopes in their thyroids. The average measured activity in the thyroid of the nuclear medicine staff was found to be equal at average 550 Bq within the range 70 Bq-2.5 kBq. There is no apparent correlation between the measured I-131 levels and risk categories. Nevertheless the technical and nuclear medicine staff show higher I-131 thyroid level comparing to hospital services staff. Calculated maximum committed effective dose for particular exposed person is <10% of 20 mSv/year. Int J Occup Med Environ Health. 2023;36(5):587-95., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

According to the World Health Organization (WHO), more than half of all road fatalities involve vulnerable road users, i.e., pedestrians, cyclists, and motorcyclists. Poland is classified as one of the European Union (EU) countries marked by low road safety, with a higher frequency of accidents involving pedestrians compared to other EU countries (31% of all fatalities). Among unprotected road users, a significant group of victims are pedestrians, who are often under the influence of alcohol. This study aims to analyze the impact of alcohol on the risk of occurrence and consequences of road accidents among pedestrians. The source of data was the medical documentation of the Department of Forensic Medicine of the Medical University of Warsaw. In more than half of pedestrian deaths, the presence of alcohol was found; regardless of the place of the event and the place of death, among the victims under the influence of alcohol, males dominated; the average age of the victims under the influence of alcohol was significantly lower compared to the average age of sober victims, with younger victims being significantly more likely to die at the scene of the accident, especially in rural areas; significantly higher alcohol concentrations were found in males, in victims who died at the scene of the accident, and with victims of accidents in rural areas. Among pedestrian traffic accident fatalities, the most numerous group comprised young men under the influence of alcohol. In rural areas, a higher percentage of pedestrian victims died at the scene as a result of excessive alcohol consumption. These areas should be subject to intensive preventive measures to increase the safety of pedestrians as unprotected road users.

Suicide is one of the ten most common causes of death in the world. Of all deaths from suicide, 22% can be attributed to the use of alcohol, which means that every fifth suicide would not occur if alcohol were not consumed by the population. People under the influence of alcohol choose more radical and effective methods of dying by suicide, e.g., throwing themselves under a moving vehicle, such as a train. The presented analysis aimed to determine important risk factors affecting railway suicide in Poland and their relation to the state of alcohol intoxication of the victims, and the relationship between ethyl alcohol consumption and the phenomenon of suicide. Documentation obtained from the Department of Forensic Medicine at the Medical University of Warsaw, in the form of death registers and forensic medical records concerning examination and autopsy, was analyzed. This made it possible to identify suicide victims from among pedestrian victims of railway accidents recorded during the period under study. The research was carried out using unidimensional and multidimensional statistical analyses with IBM SPSS Statistics, version 25. Sober suicide victims were statistically significantly older than victims under the influence of alcohol; alcohol concentration was correlated with the age of the victims-the older the victims were, the higher the alcohol concentration. A significantly higher number of deaths attributed to suicide by sober victims was observed in autumn compared to other seasons. Multidimensional analysis showed a statistically significant effect of age and season on the probability of dying by suicide under the influence of alcohol-this probability decreases with the age of the victims and is also significantly lower in autumn. The observed relationship between age and the presence of alcohol in suicide victims can be the cause of railway suicides. Knowledge of the mechanisms of seasonal variability of suicidal behavior can help to develop effective strategies to prevent railway suicides. It is necessary to improve the system of reporting railway suicides, as only reliable statistics provide the possibility of assessing both the scale of the problem and the effectiveness of actions taken.

Objective: There are differences in the adoption rates of less invasive surfactant administration (LISA) worldwide. We aimed to describe and analyze the process of LISA introduction at the country level., Methods: A standardized training program (33 courses covering >500 neonatologists) was followed by a cohort study. Data regarding consecutive LISA procedures were acquired over 12 months in 31 tertiary neonatal centers, using a dedicated on-line platform., Results: Of 500 LISA procedures, 75% were performed by specialists and 25% by residents. The mean percentage share of LISA in all surfactant therapies was 24%, which represents a 6-fold increase compared to previous years. After 12 months, 76% of the procedures were rated "easy/very easy" vs 59% at baseline (p<0.05). Surfactant re-treatment rate was 15%. Twenty-three percent of infants required mechanical ventilation within 72 hours of life. Oxygen desaturation and surfactant reflux were the most frequent complications. Unlike previous reports describing exclusive use of nasal continuous positive airway pressure (nCPAP) during LISA, majority of procedures (63%) were carried out using nasal intermittent positive pressure ventilation (NIPPV) or Bilevel Positive Airway Pressure (BiPAP). Efficacy of LISA with NIPPV or BiPAP was not significantly different from that with nCPAP (22.4% vs 24.5% of cases requiring intubation). Ventilation was provided with nasal cannulas or nasal masks (90%) and rarely with "RAM" cannulas or nasopharyngeal tubes. Rigid catheters were preferred (88.4%); tracheal insertion was successful at first attempt in 87% of cases. Majority of infants (79%) received no premedication prior to the procedure and almost all were given caffeine citrate. Median time of instillation was 1.5 minutes., Conclusions: The LISA procedure does not appear to be technically difficult to master. Training combining theory with practical exercises is an efficient implementation strategy. Variations in adoption rates indicate the need for additional, more personalized teachings in some centers., Competing Interests: R.H. is an employee of Chiesi Poland, the sponsor of the study. T.S. and P.K. received honoraria from Chiesi Poland for scientific presentations and participation on advisory boards. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Introduction: Uncertainty exists regarding the optimal time for removal of central lines used to provide parenteral nutrition in preterm infants. The aim of this study is to determine whether earlier central line removal is non-inferior to its removal after reaching full enteral intake, in respect to growth outcome of preterm infants., Methods and Analysis: Very low birthweight premature infants will be recruited. Eligible infants will be randomised in equal proportions between two groups. In the intervention group central lines will be removed when infants reach 100 mL/kg/day of enteral intake. In the control group central lines will be removed when infants reach 140 mL/kg/day of enteral intake (full enteral intake). The primary outcome measure will be the difference between the two groups in weight at 36 weeks' postmenstrual age. Non-inferiority will be declared if the mean weight of children in the intervention group will be no worse than the mean weight of children from the control group, by a margin of -210 g., Ethics and Dissemination: The Bioethics Committee of the Medical University of Warsaw approved the study protocol prior to recruitment. The findings of this trial will be submitted to a peer-reviewed journal (neonatology, paediatrics or nutrition). Abstracts will be submitted to relevant national and international conferences., Trial Registration Number: NCT03730883., Protocol Version: Version 3. 14.08.2019., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: A substantial percentage of traffic crashes involve people under the influence of ethyl alcohol. In such circumstances, we speak of the possible effect of ethanol upon trauma outcomes. The present research aimed to assess the state of sobriety fatal pedestrian victims and the correlation between the level of sobriety and the severity of injuries., Research Material and Method: The data was obtained from the Warsaw Medical University's Department of Forensic Medicine. The analysis covered the data for the period of 2009-2013; it encompassed 158 fatal pedestrian victims hit by passenger cars. The appropriate methods of statistical analysis were applied., Results: The majority of the fatal pedestrian victims were individuals under the influence of ethyl alcohol (72.15%). Significant correlations were observed between the concentration of ethyl alcohol and the victims' gender (p<0.0001) and age (p = 0.0026). The analysis showed that pedestrians under the influence of ethyl alcohol more often died on the scene (78.95%)., Conclusions: Pedestrians under the influence of ethyl alcohol are a significant group of victims of traffic crashes. Ethyl alcohol is not an independent factor affecting the severity of injuries. A higher percentage of pedestrian victims die on the scene, especially in rural areas., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Suicide is one of the most frequent causes of death. According to the World Health Organization (WHO), each year, over eight hundred thousand people worldwide die as a result of suicide. The most common risk factors for suicide are depressive disorders and alcohol dependence. Alcohol can directly influence a decision about suicide, or be a factor facilitating this decision. The aim of the study was to analyse the seasonality of suicides among persons under the influence of alcohol., Material and Methods: Data for analysis were obtained from the Department of Forensic Medicine (DFM) of the Medical University of Warsaw. A retrospective analysis was performed on 317 victims of suicides by hanging, those which were entered into the registry of deaths kept by the DFM in the years 2009-2013. The analysis took into account the age and sex of victims, initial cause of death, date of post-mortem examination, autopsy result and alcohol concentration in the blood or muscles of the victims. Statistical analysis was performed using IBM SPSS Statistics version 20., Results: In the analysis, a spring peak of suicides was found for men, and an autumn peak was revealed for women. In addition, a significant correlation was observed between the age of victims and the concentration of alcohol; the older the victims, the higher the alcohol concentration. However, this correlation was reported only in the spring months., Conclusions: The results of the analysis seem to be consistent with seasonal patterns observed in other studies, and they indicate the occurrence of suicide seasonality. In order to improve the strategies of suicide prevention, it is necessary to identify factors which are related to the seasonal variation of suicidal behaviours, as well as to gain knowledge about the mechanisms behind this phenomenon.

Introduction: Every year more than 1.2 million people worldwide die due to trauma sustained in road crashes, with an additional number of people injured exceeding 50 million. To a large extent, this applies to so called "unprotected road users", including pedestrians. The risk involved in a traffic crash for pedestrians can result from many factors, one of which is participation in road traffic when under the influence of alcohol. The aim of this study was to analyze the impact of alcohol use among pedestrians as unprotected road traffic participants, and the consequences of them being struck by motor vehicles., Material and Methods: The source of data was the medical documentation of the Department of Forensic Medicine at the Medical University of Warsaw. The sample for this research consisted of 313 pedestrians who were victims of fatal road crashes resulting from a collision with a mechanical vehicle. The obtained results were subjected to statistical analysis using the STATISTICA version 12.5 program (StatSoft Polska, Cracow, Poland)., Results: Male fatalities constituted the majority of the study sample. Nearly half of the fatal pedestrian victims were found to be under the influence of alcohol. The statistical analysis demonstrated a significant relationship between the gender and age of the victims, as well as between the place of the event, the place of death, the mechanism of the event, and the presence of alcohol in pedestrians., Conclusions: Among pedestrians, victims of road crashes who were under the influence of alcohol were predominantly drunk young males. Victims under the influence of alcohol were more likely to become fatalities in crashes where the mechanism of the incident was being struck by a passenger car, and when the place of the incident was a rural area, in these cases the rates of death directly at the scene were much more frequent. The eradication of alcohol consumption by all road users should be the overriding objective of all measures aimed at reducing the number of road crashes.

Background: The efficiency of routine practices in the management of neonatal respiratory distress syndrome (RDS) have never been systematically investigated in Poland., Objective: To evaluate RDS treatment policies and short-term outcomes in neonatal intensive care units (NICUs)., Material and Methods: We retrospectively analyzed medical records of premature neonates ≤ 32 weeks' gestation, diagnosed with RDS in level-2 and level-3 referral centers. Collected data: comprised clinical variables, antenatal corticosteroids, respiratory support, surfactant (SFT) policies and short-term outcomes., Results: Data of 987 infants from 53 NICUs were analyzed. The median gestational age was 29 weeks (range 22-32) and birth weight 1190 g (range 340-2860). Infants requiring SFT had significantly lower exposure to antenatal corticosteroids (75%) vs. those managed without SFT (83%, p = 0.006). SFT was given to 59% infants in level-3 NICUs and 40% in level-2. There was significant variability of SFT use between level 2 and level 3 NICU. (9% to 100%). Poractant alfa was most commonly used (97%) in the median initial dose of 170 mg/kg (IQR 120-200). Single application was most frequent (79.8%). SFT administration methods were endotracheal instillation in babies maintained on mechanical ventilation (68.0%), INSURE (27.6%) and minimally-invasive delivery (MIST) 4.4%. Early rescue treatment remained core SFTstrategy (57.4% cases), while prophylaxis accounted for only 13.3% cases., Conclusions: There is considerable variation in the frequency of use of surfactant in Polish neonatal centers. Traditional intratracheal instillation with subsequent mechanical ventilation dominates, although newer methods INSURE and MIST are becoming increasingly popular. Early rescue SFT is a predominant strategy, which conforms to current standards. The rate of antenatal corticosteroids remains too low.

MTHFR C677T polymorphism (rs1801133) was associated with numerous psychiatric conditions but no prior study investigated whether it predisposes to completed suicide. We typed rs1801133 in 692 suicide victims and 3257 controls representative of a Polish adult population (the WOBASZ cohort). Although we had a power of 0.8 to detect (at alpha 0.05) an allelic OR=1.19, we did not find significant difference among suicides vs. controls in the prevalence of the MTHFR 677T allele (OR=1.02, p=0.759) or the TT genotype (OR=1.01, p=0.926). Since among controls we found an association between TT and depression defined by Beck Depression Inventory (BDI, OR=1.61, p=0.049) we also compared suicides with controls without signs of depression (BDI ≤ 11) but found no association (OR=1.0, p=0.976). Analyses within suicides showed trends (not significant after Bonferroni correction) for correlations between the dose of the T allele and age at death among males and blood ethanol concentration among females, who committed suicide under the influence of alcohol. We conclude that MTHFR C677T polymorphism is not a risk factor for completed suicide. The sex-specific trends for correlations between rs1801133 and age at death, and blood ethanol concentration should be studied further., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Background: We hypothesized that DNA variants affecting neurodevelopment such as rs4307059 (CDH10/CDH9), rs930752 (NRXN1), rs6265 (BDNF) or rs10868235 (NTRK2) may predispose to completed suicide., Methodology: We used a case-control two-stage approach based on a discovery cohort (557 cases and ∼550 controls) and replication cohort (159 cases and 186 controls). The suicides were ascertained as consecutive cases autopsied at the Department of Forensic Medicine, Medical University of Warsaw, Poland., Results: In the discovery cohort we found an association between suicide and the CC genotype in the rs4307059 polymorphism (OR 1.64, p = 0.012). The trend for an overrepresentation of the CC homozygotes among suicides was replicated in the second cohort (OR 1.97, p = 0.056). Analysis in the pooled cohorts showed that rs4307059 CC was associated with completed suicide (OR 1.71, p = 0.002) also after Bonferroni correction (p(cor.) = 0.024). In an exploratory search for genotype-phenotype correlation we found that males with the rs4307059 CC genotype committed suicide earlier than those with CT/TT genotypes (p = 0.049)., Conclusions: The CC genotype of rs4307059 located in the region between CDH9 and CDH10 is associated with completed suicide in a Polish cohort., (Copyright © 2012 S. Karger AG, Basel.)

The study focused on cases of perinatal deaths of infants delivered out of hospital. The objective of the investigation was to determine the number of such cases in the Warsaw region, focusing in particular on suspected infanticides, evaluate the most frequent causes of death of children born out of hospital and determine possibilities and limitations of autopsies performed in neonates. The material comprised autopsy reports pertaining to 27 forensic perinatal postmortem examinations performed at the Chair and Department of Forensic Medicine, Warsaw Medical University, Poland, in the years 2001-2008. Determination of cause of death was possible in more than half of the cases. The most frequent cause of death was prematurity. A congenital malformation was seen in one neonate only. The most common factor that hindered determination of cause of death was advanced putrefaction, as well as unavailability of the placenta for examinations noted in more than 50% of the cases.

The "Y-STR Poland" is a multicenter project, the aim of which is the construction of a widely available database of Y chromosome haplotypes determined in the Polish population in a range of sixteen loci in AmpFISTR Y-filer system. The database will be regularly updated and it will be used in assessment of evidence value in forensic genetics. The starting base "Y-STR Poland" contains 1600 Y-STR haplotypes and encompasses data collected in Lodz (two independent centers), Warsaw and Szczecin regions. The present report contains as an attachment the data in an Excel-type file, which serves as a tool in frequency determination of a given Y haplotype in the Polish population. The file will be updated on a regular basis along with updating the database, and will be freely available from www.genetyka-sadowa.pl.

Background: The thyroid stimulating hormone receptor (TSHR) gene is an established susceptibility locus for Graves' disease (GD), with recent studies refining association to two single nucleotide polymorphisms (SNPs), rs179247 and rs12101255, within TSHR intron 1., Methodology and Principal Findings: We aimed to validate association of rs179247 and rs12101255 in Polish and UK Caucasian GD case-control subjects, determine the mode of inheritance and to see if association correlates with specific GD clinical manifestations. We investigated three case-control populations; 558 GD patients and 520 controls from Warsaw, Poland, 196 GD patients and 198 controls from Gliwice, Poland and 2504 GD patients from the UK National collection and 2784 controls from the 1958 British Birth cohort. Both rs179247 (P = 1.2×10(-2)-6.2×10(-15), OR = 1.38-1.45) and rs12101255 (P = 1.0×10(-4)-3.68×10(-21), OR = 1.47-1.87) exhibited strong association with GD in all three cohorts. Logistic regression suggested association of rs179247 is secondary to rs12101255 in all cohorts. Inheritance modeling suggested a co-dominant mode of inheritance in all cohorts. Genotype-phenotype correlations provided no clear evidence of association with any specific clinical characteristics., Conclusions: We have validated association of TSHR intron 1 SNPs with GD in three independent European cohorts and have demonstrated that the aetiological variant within the TSHR is likely to be in strong linkage disequilibrium with rs12101255. Fine mapping is now required to determine the exact location of the aetiological DNA variants within the TSHR.

The objective of the study was to assess the usefulness of macroscopic criteria for determining the age of subdural hematoma (SDH) and, additionally, the effect of other than time-related factors on the evolution of SDH in a prospective study. The analysis included the results of forensic autopsies' performed in the Chair and Department of Forensic Medicine of Warsaw Medical University (Warsaw, Poland) in 76 cases with SDH after a head injury inflicted at a known time. The following parameters of SDH were analyzed: location, diameter, color and consistence. In every case, additional information regarding sex, age, the type of injury, trauma degree (AIS and ISS) was collected and included in the analysis. The results suggest that macroscopic hematoma evaluation is a useful method of dating the age of SDHs. In addition, the results of the study suggest that factors other than time had an effect on hematoma evolution, and the severity of head injury should be considered one of the factors involved.

The objective of the study was to assess the usefulness of selected microscopic changes for determining the age of subdural hematoma (SDH). The research was based on microscopic examination of histopathological preparations representing SDHs collected in the course of 76 forensic autopsies performed in the Chair and Department of Forensic Medicine, Warsaw Medical University, Poland. The deceased had SDH after head injuries and the time of injury was known. H.E. and Masson's staining was employed for qualitative and quantitative determinations. The presence of hematoma capsules, as well as hematoidin and hemosiderine deposits were analyzed. The results suggest that microscopic SDH examinations based on the afore-said features is a helpful method for determining the age of SDHs. Additionally, the results of this study indicate that qualitative techniques of SDHs dating are more accurate than quantitative ones.

Background: A sudden death of drug addicts is generally attributed to the depressive effect of substances in question on the respiratory center in the CNS. Microscopic morphology of lungs is relatively rarely dealt with., Purpose: This study probes into the morphology of individuals who were intoxicated by amphetamine and/or heroin and suddenly died., Material and Methods: The investigated group comprised lung specimens collected in the files of the Department of Forensic Medicine of Medical University of Warsaw in the years 2002-2004. A total of 41 autopsied drug addicts suddenly succumbed without any medical intervention. Formol-fixed paraffin blocks were stained with HE. The presence of opiates and/or amphetamine was investigated in body fluids at autopsy and recorded. The control group of 50 non-addicts originated from the files of the Department of Pathomorphology of the Rheumatologic Institute of Warsaw. Immunohistochemistry for alpha-1-antitripsin was performed in both groups., Results: The microscopic image of the lungs in the investigated group showed a pronounced hyperemia of the thickened interalveolar septa. The alveoli and alveolar ductules were enormously expanded by fluid, which contained numerous air bubbles of variable, rather striking sizes. The fluid showed multiple hemosiderin-loaded macrophages. The reaction for alpha-1-antitripsin was negative. Microscopy of the lungs from the control group failed to demonstrate any essential abnormalities. The reaction for alpha-1-antitripsin was positive., Conclusions: Microscopy of the lungs of drug addicts is characteristic and attributed to drug. The pathologist facing such a picture is obliged to review and discuss with the clinician the possibility of drug addiction, if it has not been indicated so far. The investigation into the contribution of alpha-1 -antitripsin deficit should be continued.

Objectives: The aim of this study was to evaluate the efficacy of carbetocin in prevention of PPH in women after cesarean section., Material and Methods: We enrolled 60 patients who had undergone cesarean section in tertiary referential center, Department of Perinatology, Medical University of Lodz, Poland, between January and June 2008. Each patient obtained a single 100 microg dose of carbetocin intravenously during cesarean section, immediately after the delivery of the baby and prior to the delivery of the placenta. We evaluated postoperative blood parameters in 2 and 12 hours after the operation, the proportion of patients requiring additional uterotonic agents and adverse events in the whole population and in the group of women with high risk of PPH., Results: 58.1% of patients underwent emergency and 41.3% elective cesarean section delivery. The risk factor of PPH was identified in 38 women (63.3%). The results of this study indicate that carbetocin produces rapid and long-lasting uterine tone. A small drop in mean hemoglobin and hematocrit levels 2 and 12 hours after the operation was observed. 15% of patients required the use of additional uterotonic agents. In the group of women with high risk of PPH, carbetocin appeared to be effective in 79% of the patients. Only 11.4% of patients had minor adverse events., Conclusions: Carbetocin appears to be an effective new drug in the prevention of postpartum hemorrhage, not only among women undergoing cesarean section but also in the group of women with PPH risk factors.

The purpose of this study was to evaluate the homogeneity of Polish populations with respect to STRs chosen as core markers of the Polish Forensic National DNA Intelligence Database, and to provide reference allele frequencies and to explore the genetic interrelationship between Poland and neighboring countries. The allele frequency distribution of 10 STRs included in the SGMplus kit was analyzed among 2176 unrelated individuals from 6 regional Polish populations and among 4321 individuals from Germany (three samples), Austria, The Netherlands, Sweden, Czech Republic, Slovakia, Belarus, Ukraine and the Russian Federation (six samples). The statistical approach consisted of AMOVA, calculation of pairwise Rst values and analysis by multidimensional scaling. We found homogeneity of present day Poland and consistent differences between Polish and German populations which contrasted with relative similarities between Russian and German populations. These discrepancies between genetic and geographic distances were confirmed by analysis of an independent data set on Y chromosome STRs. Migrations of Goths, Viking influences, German settlements in the region of Volga river and/or forced population resettlements and other events related to World War II are the historic events which might have caused these finding.

Evaluation of medical management in cases of deaths of women in childbirth often poses significant problems. Based on the available casuistry of the Forensic Medicine Department of the Medical University of Warsaw, the authors attempted an assessment of medical management based on the analysis of medical records from the period 1999-2007 along with the results of autopsies and histopathological examinations in selected cases of deaths, emphasizing the principles of management and therapeutic possibilities in amniotic fluid embolism.

Objective: To investigate whether a polymorphism in the ESR2 gene (rs4986938, previously associated with endometriosis, ovulatory dysfunction and premature onset of coronary heart disease) increases the risk of Graves' disease (GD)., Subjects and Design: A cohort of 375 GD patients (300 females and 75 males) and 1001 individuals representative of the background population of Poland (502 males and 499 females) were genotyped for rs4986938 using allele-specific polymerase chain reaction (PCR)., Results: We found an increased frequency of the ESR2 A allele among the patients vs. controls (38.0%vs. 32.7%, OR = 1.26, P = 0.009) that was caused by a co-dominant (OR = 1.25, P = 0.01, P(for model fit) = 0.127) or a recessive (OR = 1.67, P = 0.003, P(for model fit) = 0.554) effect. The association was found in both sexes (OR = 1.21, P = 0.046 and OR = 1.53, P = 0.029, respectively, for co-dominant and recessive models in females, and OR = 1.44, P = 0.034 and OR = 2.29, P = 0.01, respectively, for the two models in males) and was more pronounced among the DRB1*03-negative (OR = 1.63, P = 0.0002) than DRB1*03-positive patients (OR = 1.04, P = 0.822). No other statistically significant associations between the ESR2 genotype and GD subsets were found (age of onset, smoking, clinically evident ophthalmopathy, family history of GD, and PTPN22 and CTLA4 (CT60) genotypes were analysed)., Conclusions: In a Polish population the ESR2 A allele is associated with GD with a strength comparable to polymorphisms of PTPN22 and CTLA4 CT60 loci (OR approximately 1.7). The association with ESR2 is found in both sexes and may be particularly strong among the DRB1*03-negative individuals.

Objectives: to determine the relationship between the initial nucleated red blood cells (nRBC) count during the first 12 hours after birth and inborn infection in neonates., Materials and Methods: The retrospective study comprised of 306 neonates born in the Department of Perinatology of the I Chair of Gynaecology and Obstetrics in Łódź, Poland, in the years 2002-2007, among whom the nucleated red blood cells count were calculated within the first 12 hours after birth. Two categories of nRBC count: the normal and the elevated value, were statistically elaborated by a Mann-Whitney test and a chi-square test with two clinical outcome categories: the presence and the absence of inborn infection in the analyzed neonates. Statistical significance was indicated by p value lower than 0,05., Results: Among 306 newborns, there were 127 mature neonates (41.5%) and 179 prematures (58.5%). The mean of the initial nRBC count in the analyzed newborn population was 40, 15. The mean of the nRBC count in the infected neonates was three times higher (52.56) than the mean of the nRBC count in newborns without inborn infection (16.76) - (p=0.00001). Inborn neonatal infection concerned a vast majority of cases with an elevated value of the nRBC count (86.4%), but in 13.6%, inborn infection was not observed. Among the cases with a normal nRBC count, the presence and the absence of inborn infection was diagnosed in about 50% of the analyzed babies (50.83% vs 49.17%). The elevated value of the nRBC count in infected neonates concerned mainly premature babies, rather than mature neonates, and similarly in neonates with a lower Apgar score than in babies born in good condition., Conclusions: 1. The positive association between elevated initial nucleated red blood cells count after birth and inborn infection in newborns has been revealed. 2. An elevated nucleated red blood cells count may be an auxiliary, early indicator for inborn infection in neonates. 3. Prematurity and perinatal asphyxia favour the elevation of a nucleated red blood cells count in cases with inborn infection.

Introduction: The aim of the paper was to evaluate the usability of nucleated blood cells count in newborn infants in the first 12 hours after their birth as an early marker of intraventricular haemorrhage., Material and Methods: The retrospective research included 210 newborns (both born at term??? and prematurely), delivered at the Department of Clinical Sciences of Perinatology of the I Chair of Gynecology and Obstetrics of the Medical University in Lódź, Poland from 1 January 2003 to 31 December 2006. During the first 12 hours after the birth, the abovementioned infants were diagnosed with nucleated blood cells in their blood count. The correlation between the number of nucleated blood cells and the occurrence of intraventricular haemorrhage has been investigated. Intraventicular haemorrhage was diagnosed with the use of transfontanel ultrasonography between the third and the seventh day of life. The increased number of erythroblasts was established to be on the level above 20 nucleated blood cells/100 white blood. The material was subject to statistical analysis which included the use of a Spearman's rank correlation coefficient, a chi-square test, and a Mann-Whitney test. The statistically significant level adopted equaled p<0.05., Results: Out of 210 newborns included in the survey, among 71 (33.81%) intraventricular haemorrhage were diagnosed in the first week of their life. The I and II grade haemorrhage occurred in 61 newborns, which equals 85.92%, and the III or IV grade haemorrhage occurred in 10 patients (14.08%). In case of 50 newborns with IVH (70.42%) the number of nucleated blood cells exceeded 20/100 white blood cells. The average level of erythroblast for newborns with IVH equaled 87.46 (146.49), and in the group without IVH 38.86 (7.82). In order to examine the relation between the number of nucleated blood cells and the intraventricular haemorrhage a Spearman's rank correlation coefficient was used, as well as a chi-square test and a Mann-Whitney test On their basis it was concluded that there is a statistically significant relation between the level of erythroblast and the occurrence of intraventricular haemorrhage p=0.0048., Conclusions: The evaluation of the number of nucleated red blood cells in newborn infants can be an early, noninvasive marker of the intraventricular haemorrhage in newborns.

Unlabelled: Institute of Gynaecology and Obstetrics of Medical University in Lodz acceded the Polish Register of Congenital Malformations and keeps on propagating the program. The aim of the study was to estimate the frequency of congenital malformations in newborns delivered in the Institute of Gyneacology and Obstetrics in Lodz in the years 2001-2003 and to analyse some epidemiological parameters concerning inborn defects in the region of Lodz. The study is based on the retrospective analysis. All neonates born alive in our Institute in the years 2001-2003 were taking into consideration. The data about inborn malformations was collected from the medical documentation and the results were confronted with demographic analysis of the region of Lodz., Results: Among 66474 neonates born alive during analysed period of time in the region of Lodz, 4507 (6,78%) were delivered in the Institute of Gyneacology and Obstetrics in Lodz. There were 106 newborns congenitally malformed, so the percentage of inborn defects reached 2,35% of all neonatal population. From the region of Lodz 966 babies with inborn malformations were notified to the Polish Register of Congenital Malformations, and 106 (10,9%) malformed newborns were registered from our Institute. Malformations of heart and circulatory system were the most frequent--28,8%, defects of skeletal and muscular system were the next -18%, and malformations of urogenital system formed 16,2%. In the region of Lodz there were 477 neonatal deaths and 121 cases were caused by congenital anomalies, which makes the percentage of 25,4% of neonatal mortality., Conclusion: 1. Congenital malformations are the one of the main reasons of neonatal and infantile mortality. 2. The program of registrating malformations helps in exact epidemiological analysis of congenital anomalies in newborns.