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Beata Szkolnicka

Publications and source records attributed to Beata Szkolnicka.

17 recordsLinked to original sources

Frequency and pattern of poisoning in adult and adolescent Kraków population in 2003 and 1983.

The pattern (frequency, type of exposure, toxic substance) of adolescent and adult poisonings in Kraków in 2003 is compared with 1983. The analysis includes data for poisoned patients treated at the Kraków Department of Clinical Toxicology and all on the spot fatal cases subjected to post-mortem autopsy and toxicological examinations at the Department of Forensic Medicine Jagiellonian University Medical College in both the years. As much as 4341 poisoning cases (2852 males; 1489 females) were treated in 2003 compared with 2132 (1078 males; 1054 females) in 1983. In 1983 in group of 154 poisoned persons who died at the place of accident there were 138 (89.6%) men and 16 (10.4%) women. In 2003 among 121 deaths at the scene there were 93 (76.9%) males and 28 (23.1%) females. Poisonings due to suicidal attempts decreased significantly from 53.6% in 1983 to 19% in 2003. Incidence of poisoning per 10 000 of general Kraków population increased from 36.17 in 1983 to 57 in 2003 or up to 65.7 if the population of adults and teenagers (above 15 years old) was only considered. Pharmaceuticals (40.6%) followed in frequency by ethanol (25%) and ethanol co-ingested with pharmaceuticals (12.2%) and carbon monoxide (10.6%) were the most common reasons for poisoning in 1983. In 2003 the most common cause of poisonings was ethanol (46.2%) followed by pharmaceuticals alone (25%) or co-ingested with ethanol (6.4%) and carbon monoxide (6.2%). An ingestion of mixed pharmaceuticals (55.1%) followed In frequency by non-barbiturate hypnotics and psychotropic drugs (26.3%) were a most common in 1983 whereas a non-barbiturate hypnotics and psychotropic drugs (34.4%) followed by mixed pharmaceuticals (32.9%) in 2003. A mortality both concerning only the people who died in hospital and also those who died on the spot (prior to any treatment) was significantly higher in 1983 compared with 2003.

Adolescent↗

[The role of poison information center in the health service structures].

Poison information centres (PIC) provide telephone advice on the treatment of poisonings to the lay public and medical professionals. The number of inquiries increases every year. Poison Information Centre of Collegium Medicum of Jagiellonian University in Krakow provided 1611 items of advice in 1999 and 2263--five years later--in 2004. Each incoming call is recorded and documented by standardized protocol. Another aspect of PIC activity of is prevention and education. Inquiries protocols' analysis shows the most frequent reasons and circumstances of poisonings. Thus, it is possible to conduct appropriate prophylactic campaigns. The above aspects of activity of PIC do not bring direct financial benefit. There is one index which shows that PIC saves the money. There were 335 cases in 2004 (above 50% consulted lay public) when unnecessary hospital admissions were prevent. It should be noted that the others were refer to proper specialist. This aspect of PIC's activity significantly decreases the costs which should be paid in any medical intervention.

Health Education↗

Toxic exposure of children in 2004--telephone service of toxicology.

509 toxicological telephone inquiries concerning children under 15 years have been provided by Kraków Poison Information Centre (PIC) in the year 2004. Medication drugs were involved in almost one half (n=208) the cases noted. 63.7% of calls concerned children under 4 years with a two-year-old group predominance. The main reason for poisoning in children under 4 were pharmaceuticals (42.6%), followed by pesticides (9.8%), corrosives (8.8%), hydrocarbons (8.1%), plants (5.5%) and detergents (3.7%); all exposure were accidental. Suicide attempts reached 32.3% in the 12-14 age group. In that group also a cases of psychoactive substances overdosing were noted. Most exposures in children reported to poison centre were accidental (87.2%). Thus, it is absolutely necessary to intensify prevention and education activity both for parents and primary school children to avoid the poisoning.

Acute Disease↗

Prescription and over-the-counter medication in deliberate self-poisoning and accidental overdosing--preliminary study.

186 case records of patients who overdosed pharmaceuticals (confirmed by toxicological lab analysis) hospitalized at the Department of Clinical Toxicology during three months of 2000 were analyzed for age, sex, type of medication, reason for poisoning (intentional or accidental overdosing). Patients poisoned with prescription medication (Rx group) were compared with those who overdosed nonprescription (OTC-group) medications (alone or combined with Rx). Relative frequency of medication drug poisoning was highest in the 40-49 age group (28.5%) and was followed by the group of young adults (20-29 years; 24.2%). The lowest frequency (2.2%) was noted in the 60-69 age group. Of 186 cases analyzed, in 163 (87.6%) prescription medication (Rx) and in 23 (12.4%) OTC alone or co-ingested with Rx were involved (chi2 = 63.9; p < 0.001). The Rx and OTC groups were not significantly different as to reason for poisoning (chi2 = 0.7; p = 0.792) with significant overrepresentation of deliberate ingestion in both the group analysed (chi2 = 114.39; p < 0.001 for Rx, and chi2 = 13.49; p = 0.002 for OTC). Most adults attempting suicide used Rx with the highest incidence in the 40-49 age group (31.1%). Adolescents (14-19 years) with female over-representation ingested rather OTC pharmaceuticals (40.9%). Acetaminophen (alone or combined with benzodiazepines or/and ethanol) and nonsteroidal anti-inflammatory drugs (NSAIDs) were the most common OTC medications used for deliberate self-poisoning.

Acute Disease↗

[Dangerous aquaria].

World trends for a home breeding of exotic freshwater and marine fishes did not miss Poland. There are almost all species of aquarium fishes available in Polish pet shops, but there is not enough information about threat given to customers. In some fish, there are masses of one-cell glands, mainly serous, in the proximity of the spines. In others, those one-cell glands may be grouped in larger aggregates of cells called venom glands, that may form organs resembling multicellular glands of terrestrial animals. They are usually located around the spines or hard rays of the fins. Even if covered with a connective tissue sheath, the aggregates of the venom cells do not have any common outlet; they are not, therefore, proper multicellular glands. The venom glands of the catfish are covered with a thin sheath and they release their contents when the fin ray is pressed. Spines are derived from fin rays. When the spine penetrates the body of its prey, it presses its base against the cells, squashes them and squeezes the venomous contents into the wound. Catfish, lionfish and stonefish have the venom glands producing secretion which could be dangerous. The eels and morays blood is also dangerous, as well as slime of reduced squamae. Poison information centers noted several cases of fishes' stings in Poland.

Animals↗

[Poisonous animals registration in Poland].

The Act on Nature Conservation of 16.04.2004 (Official Journal, 2004, No 92, item 880) imposes on private individuals the duty to register some animals. The data collected by Kraków municipal authorities and delivered to the Poison Information Centre (Colleglum Medicum, Jagiellonian University) indicate that there are following species in private hands in the city and its surroundings: 11 individuals of Naja naja, 2--Hydrodynates gigas and 55-- Dendrobates spp. According to these information the employees of the PIC elaborated the advice on the treatment of specific animals' poisoning. In the period May 2003 - May 2004 (before the above Act came into force) there were 143 individuals from Brachypelma genus and 3 scorpions (Pandinus imperator) registered in Krakow. These species produce venoms which take local effect. According to art. 64 (1) of the above Act it is compulsory to register amphibians, reptiles, birds and mammals. However, it would be desirable to introduce the duty to register also dangerous species of invertebrates and fishes. It would provide the complete list of poisonous animals kept in private hands. Thus, it would be possible to estimate any possible threats and to elaborate adequate treatment in case of specific animals' poisoning.

Animal Husbandry↗

[Cardiotoxic plants].

In statistics from Poison Information Center in Kraków plant poisonings comprise 2% of the total registered poisonings. In toxicology cardiac glycosides poisonings existing in common foxglove plant, lilies of the valley, oleander are essential. Species of cardiotoxic plants which may cause a danger in Poland are presented in the research. The toxic mechanisms of cardiac glycosides are specified.

Cardiac Glycosides↗

Chemical poisonings among Kraków inhabitants in 1972 and 2002.

The patterns (frequency, poisoning type, toxic agent involved) of adolescent and adult poisonings in Kraków in 1972 and 2002 are presented. The analysis includes data for poisoned patients treated at the Kraków Department of Clinical Toxicology in 2002 and 1972, and all on the spot fatal cases subjected to post-mortem autopsy and toxicological examinations at the Department of Forensic Medicine in both the years. As much as 4116 poisoned cases (males 2722; females 1394) were treated in 2002 compared to 1485 (males 649; females 836) in 1972. There was no substantial difference between a number of poison related fatalities on the spot in years analysed: 126 (males 105; females 21) in 2002 and 122 (males 84; females 38) in 1972. An elevation in poisoning incidence rate per 10,000 of Kraków inhabitants was also noted in 2002 compared to 1972 (54.3 vs. 30.0). A pharmaceuticals (32.9%) followed by CO (18.2%) and mixed pharmaceuticals (16.2%) were mostly involved in poisoning cases in 1972, whereas ethanol (46%), pharmaceuticals (13.2%), pharmaceuticals co-ingested with ethanol (7.8%), narcotics (7.8%), mixed pharmaceuticals (6.7%), and CO (5.2%) were mostly involved in poisoning cases treated in 2002. A mortality rate both concerning only a people who died in hospital or/and those who died on the spot (prior to any treatment) was significantly higher in 1972 compared to 2002.

Adolescent↗

[The frequency of suicide attempts depending on gender and the age structure].

Sex and the age structure have been for decades the crucial factors determining the dimensions of suicide. In the literature of the subject, it is possible to find different interpretations concerning the widely known facts of larger effectiveness of suicide among males. Females, on the other hand, exhibit suicidal behaviour and suicide attempts several times bigger than the number of completed suicides. In comparison with wide literature dealing with the problematic of completed suicide, the number of publications concerning suicide attempts is, both in foreign and in Polish literature rather scarce. That is why the present authors have undertaken the analysis of suicide attempts by subjects hospitalized in the Department of Clinical Toxicology Jagiellonian University College of Medicine in Krakow in the years 2000-2002. On the basis of the medical documentation, 2757 cases of attempted suicide through self-intoxication by subjects undergoing treatment in the toxicological department. In the period concerned, the number of hospitalizations after suicide attempts increased from 856 cases in the year 2000 to 971 cases in 2001, and subsequently slightly decreased to 930 cases in 2002. The highest indicator of suicide attempts through self-intoxication has been observed among adolescents and young adults. In the absolute values, within the span of the years in question, there is a substantial predominance of suicide attempts undertaken by adults ranging in age from 20 and 50. On the contrary, in the oldest age group (over 60), the number of suicide attempts through self-intoxication was in the years concerned the lowest. In contrast with completed suicide, where the proportion of males to females is 4:1, in the group examined, females constituted 50% of subjects after suicide attempts. The number of females after suicide attempts in the consecutive years analysed was higher among adolescents and young women under 30. Despite drawbacks in data gathering, there is convincing testimony indicating that suicide is the result of number of complex risk factors. Sex and the age structure belong to non-modifiable factors, and thus emphasis should be put on the importance of the gathering of relevant data and on further research into the factor of sex and age structure in suicide attempts and completed suicide.

Adolescent↗

[Fluctuations and seasonality in suicidal attempts].

The aim of the study was to analyze seasonality and temporal fluctuations in suicide attempts by persons living in Krakow and hospitalized in the Department of Clinical Toxicology CMUJ in the years 2000-2002. The research focussed on the frequency of suicide attempts in relation to the time of the day, day of the week, and month of the year. Temporal fluctuations in the frequency of suicide attempts have been assessed on the basis of the data from medical documentation concerning 2757 suicide attempts by individuals ranging in age from 14 to 90 years. The group consisted of 1607 females and 1150 males. According to the results of the research, seasonality and temporal fluctuations in the frequency of suicide attempts is different for males and females. In the case of the males examined, no dependence between the frequency of suicide attempts and a particular month or season has been observed. In the case of females, on the contrary, the data indicate the existence of a seasonal pattern with the peak in the spring (or early part of the summer), and in the autumn--in October and November. In males, the peak day for attempted suicide was Monday, whereas in females--Sunday and Monday. As regards the time of the day, both the results of the present research and data collected by WHO/EURO indicate that suicide attempts occurred most frequently in the evening, late in the evening or in the early part the night. In conclusion, it has been emphasized that the majority of suicide attempts, especially by females, occurs late in the evening or early in the night. This finding seems to be of particular importance for suicide prevention--it can contribute to the increase in the effectiveness of the organization of work in the Crisis Intervention Centres and make therapists and patients' families aware of the existence of periods of an increased suicide risk. The research has been conducted owing to the cooperation between the department of Clinical Toxicology, CMUJ and the Department of Adult Clinical Psychiatry, CMUJ in Kraków. The results obtained, together with the results of the research conducted by the centres participating in WHO/EURO are vital for suicide prevention and treatment.

Adolescent↗

[Risk factors for suicide attempts in elderly and old elderly patients].

The aim of the study was to assess the phenomenon of suicide attempt in the elderly inhabitants of Kraków. Special attention has been paid to the group of "seniors"--aged 75 years or over. The authors have analyzed all the 136 cases of suicide attempts by individuals aged over 60 years, selected from the cases of suicide attempts by self-intoxications by patients hospitalized in the Department of Clinical Toxicology, CMUJ in Kraków in the years 2000-2002. The group concerned included 45 males and 91 females. A large number of subjects (over a half of the total) ranged in age from 60 to 65 years. The group of seniors comprised 35 individuals (aged 75 years or over), including 7 males and 28 females. On the basis of the data from medical documentation, the subjects were analysed from the point of view of their health condition and in the psycho-social context. In the majority of cases the subjects are pensioners residing in Kraków, often living alone. In the case of 98% of the subjects, it was their first suicide attempt. Pharmaceuticals used for self-poisoning were most frequently psychotropic, or mixed-type drugs. The assessment of the severity of poisoning indicates that in about 20% patients poisoning was severe. 70% of the subjects suffered from depressive, reactive, or situational disorders, affective depression or organic brain disorders, often with dementive signs. A significant number of subjects suffered from hypertension, coronary artery disease, arteriosclerosis, or alimentary tract diseases. In the group of the seniors, the most conspicuous problems included serious somatic diseases (malignant diseases and chronic respiratory system diseases), depression, organic dementia, loneliness, and bad family situation. Taking into consideration the scantiness of research into attempted and completed suicide in the elderly and in the old elderly, the present authors stress the importance of the continuation of the research to prevent suicide in the aforesaid age group.

Age Distribution↗

[Attempted suicide among teenagers and young adults].

The aim of the study was to present the phenomenon of suicide attempts by self-poisoning in a group of females and males ranging in age from 15 to 29 years, and treated in the Department of Clinical Toxicology Jagiellonian University College of Medicine in Kraków in the years 2000-2002. The group analyzed comprised of 1117 patients, 629 (69.1%) women and 425 (38.1%) men. In the female group, teenagers under 19 constituted 48.9%, whereas young females ranging in age from 20 to 29 years--51.1%. In the male patients group teenagers under 19 constituted 29.4%, the young men (20-29 years of age)--70.6%. The group was analyzed from the point of view of demographic, clinical and social factors such as gender, age, level of education, marital status and occupation (if applicable), the course of self-poisoning and kind of toxic substance involved. In the majority of cases, self-poisoning had been caused by taking one type of medicines, and less frequently by taking mixed-type medicines or by simultaneously taking medicines and ethanol. The most typical drugs used in the attempts included benzodiazepines, phenothiazines, nonsteroidal antiinflammatory and antiepileptic drugs. The assessment of the poisoning severity based on the PSS classification, indicates the predominance of the minor and moderate poisoning. Up to 50% of subjects suffered from mental disorders--most frequently from affective disorders, neurotic disorders, and personality disorders. As an essential part of the problem of suicidal behaviors in teenagers and young adults, suicide attempts among young population require an in-depth analysis. The scale of the problem indicates the necessity of initiating appropriate preventive actions and organizing appropriate psychological and psychiatric care.

Adolescent↗

[Rules of telephone poison information service: guidelines for call management].

A rules of telephone poison information service for general public and telephone toxicological consultation for medical staff, mainly physicians, are presented in the study. Guidelines for call management: necessity of caller assessment while dealing with information given to the general public and factors that influence successful telephone encounters are presented. The types of questions that are appropriate to ask about patient, considering both the patient state and the toxin(s) involved while dealing with a telephone toxicological consultation are also presented.

Drug Information Services↗

[Proper use of own data bases warranted by call recording system].

A newly created computer system for call (toxicological information) recording and a Base of Toxic Substances created in native Polish language are presented in the paper. An extended structure of this data base enable to catalogue different groups of toxic substances (e.g. medication drugs, psychoactive substances, pesticides), and toxins (animals' poisons, toxic plants and mushrooms) concerning their specificity. Construction of the Base also enable to reach necessary information quickly. What more, identification of toxic substances could be easier due to possibility enclosing photos.

Databases as Topic↗

[Animal model of addiction].

Animal models are a valuable tool in the investigation of the nervous system. Many similarities between animal and human dependency behaviours have been observed. Animal model based on the self-administration response has contributed to understanding of the neurobiological basis of particular stages of the dependence process. Animals are used also to study the mechanism of alcohol dependence. Working out an animals model of addiction should include references to the clinically important phenomena related to psychological dependence which has not been displayed. This situation get us to consider the latest findings and theories about evolution of the wise human.

Animals↗

[The pattern of poisonings with chemical compounds in Krakow inhabitants hospitalized at the Department of Clinical Toxicology of the Jagiellonian University Medical College in 1997-2001 in relation to age].

The pattern of poisonings in patients hospitalised in the Department of Clinical Toxicology Jagiellonian University Medical College in 1997-2001 was presented in the study. The analysis includes 17,931 patients: 6,016 (33.5%) women and 11,915 (66.4%) men. The rate of patients between 20-39 years old was highest in all the analysed year, however downward trend was noticed. The upward tendency was noted in older group of poisoned patients. A suicidal poisonings were mostly common in 1998 and 1999 in the youngest and oldest groups: 37.1%, 37% in 1998, and 25.5%, 22.2% in 1999 respectively. The medication drugs were the most common cause of acute poisoning only in the group of adolescent patients. Ethyl alcohol was the common cause of poisoning in adult groups. The highest rate of ethanol intoxication was noted in patients between 40 to 59 years old. A 89 lethal intoxication were noted in analysed period. The average mortality rate was low (0.5). A medication drugs (30.4%) followed by ethanol (17.4%), carbon monoxide (13%) and solvents (13%) were involved in lethal poisonings in the oldest group of patients.

Adult↗