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Sommerfeld-Klatta K, Jiers W, Łukasik-Głębocka M, Tezyk A, Dolińska-Kaczmarek K, Walter K, Świderski P, Rzepczyk S, Zielińska-Psuja B, Żaba C. Severe and Fatal Fentanyl Poisonings from Transdermal Systems after On-Skin and Ingestion Application. Toxics 2023; 11:872. [PMID: 37888722 PMCID: PMC10610823 DOI: 10.3390/toxics11100872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/12/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023]
Abstract
In recent years, the administration of fentanyl (FNTL) implicitly in transdermal drug delivery systems (TDDS) has vastly increased in chronic pain treatment. Non-medical and uncontrolled use of FNTL in TFDS (transdermal fentanyl delivery systems) may reveal toxic effects by the route of exposure, dermal or alternative, by ingestion of patches, and drug release in the stomach. The purpose of this study was to present three different cases of FNTL poisonings, two of which resulted in death due to TFDS abuse. The first case is a 66-year-old woman treated for accidental FTNL poisoning resulting in acute respiratory distress syndrome. Two remaining cases are a 31-year-old woman and a 25-year-old man who died as a result of FNTL overdose after on-skin and ingestion application of the drug patches. During the hospitalization of the 66-year-old patient, in blood samples, FNTL was confirmed at a concentration of 10.0 ng/mL. Tests run on blood taken from the corpses of 25- and 31-year-old patients exhibited FNTL presence in concentrations of 29.1 ng/mL and 38.7 ng/mL, respectively. The various routes of administration and ultimately toxic effects are important to present because, in TDDS, fentanyl can be a reason for severe to fatal poisoning, as shown by the three cases above.
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Affiliation(s)
- Karina Sommerfeld-Klatta
- Department of Toxicology, Poznań University of Medical Sciences, 30 Dojazd Street, 60-631 Poznan, Poland
| | - Wiktoria Jiers
- Department of Toxicology, Poznań University of Medical Sciences, 30 Dojazd Street, 60-631 Poznan, Poland
| | - Magdalena Łukasik-Głębocka
- Department of Emergency Medicine, Poznań University of Medical Sciences, 7 Rokietnicka Street, 60-806 Poznan, Poland
| | - Artur Tezyk
- Department of Forensic Medicine, Poznań University of Medical Sciences, 10 Rokietnicka Street, 60-806 Poznan, Poland
| | - Klaudia Dolińska-Kaczmarek
- Department of Forensic Medicine, Poznań University of Medical Sciences, 10 Rokietnicka Street, 60-806 Poznan, Poland
| | - Kamil Walter
- Department of Forensic Medicine, Poznań University of Medical Sciences, 10 Rokietnicka Street, 60-806 Poznan, Poland
| | - Paweł Świderski
- Department of Forensic Medicine, Poznań University of Medical Sciences, 10 Rokietnicka Street, 60-806 Poznan, Poland
| | - Szymon Rzepczyk
- Department of Forensic Medicine, Poznań University of Medical Sciences, 10 Rokietnicka Street, 60-806 Poznan, Poland
| | - Barbara Zielińska-Psuja
- Department of Toxicology, Poznań University of Medical Sciences, 30 Dojazd Street, 60-631 Poznan, Poland
| | - Czesław Żaba
- Department of Forensic Medicine, Poznań University of Medical Sciences, 10 Rokietnicka Street, 60-806 Poznan, Poland
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Rzepczyk S, Świderski P, Sommerfeld-Klatta K, Tezyk A, Łukasik-Głębocka M, Zielińska-Psuja B, Żaba Z, Żaba C. Causes of Death during the Intravenous Infusion of Dimethylsulphoxide and Hydrogen Peroxide in the Course of Alternative Medicine Therapy. Toxics 2023; 11:652. [PMID: 37624158 PMCID: PMC10457729 DOI: 10.3390/toxics11080652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/26/2023]
Abstract
Unconventional (alternative, natural) medicine in Poland and worldwide includes hundreds of non-scientifically verified "treatment" modalities. Among the most popular are biological therapies using chemical or natural compounds administered with injection or drip infusion. The latter has found the most excellent use in treating rheumatological and dermatological diseases and certain types of cancer. Vitamin infusions, curcumin, glutathione, perhydrol and dimethylsulphoxide (DMSO) have gained popularity among clients of natural medicine clinics. The present study aims to analyse the case of a 37-year-old woman who was administered infusions containing perhydrol and DMSO (0.5 mL 0.04% hydrogen peroxide/0.5 mL p.d.a DMSO in saline) due to a MTHFR A1298C mutation. After having the next infusion, the woman complained of nausea and then became unconscious. Subsequently, she suffered respiratory and cardiac arrest. Adequate resuscitation was undertaken. After being taken to the hospital, the patient was in critical condition and died due to increasing multiple-organ failure. Initially, there was suspected DMSO poisoning as it was the only compound to have been administered as an intravenous infusion. However, it was not until the analysis of the secured evidence that it became clear that the patient had also been given an intravenous solution of hydrogen peroxide, H2O2, and that there had been a mistake in preparing the intravenous perhydrol solution. The autopsy concluded that the immediate cause of death was an acute cardiopulmonary failure due to the toxic effects of intravenously administered hydrogen peroxide. This conclusion was established after the toxicological testing of the evidence and biological material secured during the patient's treatment and autopsy. Products containing DMSO and perhydrol are not included in the lists of medicinal/therapeutical forms and preparations and thus are not authorised for marketing in Poland. In the case of perhydrol, apart from the topical use of diluted preparations for washing and cleansing wounds, no data on therapeutic use exist in the available scientific literature. Furthermore, "DMSO and perhydrol therapy" cannot even be considered a placebo effect, as both are toxic compounds which could, at most, cause poisoning symptoms rather than improve health.
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Affiliation(s)
- Szymon Rzepczyk
- Department of Forensic Medicine, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
| | - Paweł Świderski
- Department of Forensic Medicine, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
| | - Karina Sommerfeld-Klatta
- Department of Toxicology, Poznan University of Medical Sciences, Dojazd 30, 60-631 Poznan, Poland
| | - Artur Tezyk
- Department of Forensic Medicine, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
| | - Magdalena Łukasik-Głębocka
- Department of Emergency Medicine, Poznan University of Medical Sciences, Rokietnicka 7, 60-806 Poznan, Poland
| | - Barbara Zielińska-Psuja
- Department of Toxicology, Poznan University of Medical Sciences, Dojazd 30, 60-631 Poznan, Poland
| | - Zbigniew Żaba
- Department of Emergency Medicine, Poznan University of Medical Sciences, Rokietnicka 7, 60-806 Poznan, Poland
| | - Czesław Żaba
- Department of Forensic Medicine, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
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Kowalczewska J, Rzepczyk S, Okła M, Nijakowski K, Słowik Ł, Makuch A, Hryniewicz O, Krasnoborska J, Żaba C, Osmola K. Characteristics of E-Scooter-Related Maxillofacial Injuries over 2019-2022-Retrospective Study from Poznan, Poland. J Clin Med 2023; 12:jcm12113690. [PMID: 37297885 DOI: 10.3390/jcm12113690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
Recently, there has been a considerable rise in the popularity and use of electric scooters. Because of this, the number of accidents involving them has also risen. Head and neck injuries are the most common. The aim of the study was to determine the most frequent craniofacial injuries resulting from accidents involving electric scooters, and to identify the risk factors directly related to their placement and severity. The study carried out a retrospective analysis of the medical records of patients of the Clinic of Maxillofacial Surgery over 2019-2022, in terms of craniofacial injuries suffered as a result of e-scooter-related accidents. In the study population (31 cases), of which 61.3% were men, the median age was 27 years. At the time of the accident, 32.3% patients were under the influence of alcohol. Accidents were most common in the 21-30 age group; more often than not, they occurred during warm months and on weekends. The study identified a total of 40 fractures in the patients. The most common craniofacial injuries were mandibular fractures (37.5%), zygomatic-orbital fractures (20%) and frontal bone fractures (10%). A multidimensional correspondence analysis was also performed, which showed that at an age of under 30, alcohol consumption and female gender were associated with a higher likelihood of mandibular fracture. Proper education on the risks associated with the use of e-scooters is essential, with particular emphasis on the impact of alcohol on the driver. It is important to develop diagnostic and therapeutic algorithms for doctors, both in ED and in specialised departments.
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Affiliation(s)
- Justyna Kowalczewska
- Department of Neurosurgery and Neurotraumatology, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Szymon Rzepczyk
- Department of Forensic Medicine, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
| | - Maciej Okła
- Department of Maxillofacial Surgery, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Kacper Nijakowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland
| | - Łukasz Słowik
- Department of Maxillofacial Surgery, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Aleksandra Makuch
- Department of Maxillofacial Surgery, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Oliwia Hryniewicz
- Department of Maxillofacial Surgery, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Julia Krasnoborska
- Department of Maxillofacial Surgery, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Czesław Żaba
- Department of Forensic Medicine, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
| | - Krzysztof Osmola
- Department of Maxillofacial Surgery, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland
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Skibińska I, Andrusiewicz M, Jendraszak M, Żbikowska A, Żaba C, Kotwicka M. PELP1 and SRC kinase as important molecules in the estrogen-mediated pathway in human testis and epididymis. Acta Biochim Pol 2023:6803. [PMID: 37159918 DOI: 10.18388/abp.2020_6803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 04/26/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Estrogens have pleiotropic mechanisms of action, and their cellular transduction pathways can modulate various proteins with differential tissue expression. Proline-, glutamic acid-, and leucine-rich protein 1 (PELP1) is one such protein whose role seems important, although little is known about this protein. However, very little is known about the expression of modulators involved in the estrogen-mediated pathways in the tissues of the male reproductive tract. METHODS In this study, we obtained autopsy specimens of testis and epididymis from 13 men of Caucasian descent. Expression levels were analyzed for both estrogen receptors (ESR1 and ESR2) and their co-regulators, including PELP1 and kinase c-Src (SRC). RESULTS Protein expression was confirmed with western blot and immunocytochemistry techniques. The expression of both SRC and PELP1 was significantly higher in the testis compared to the epididymis (p=0.040 and p=0.002, respectively). Furthermore, a significant, positive correlation was observed between SRC and PELP1, regardless of tissue type p<0.0001, R=0.78). In the testis, PELP1 expression positively correlated with ESR1 expression (p=0.367, R=0.6). CONCLUSIONS Our study suggests a possible relationship between PELP1, SRC, and ESR1 in the human testis and epididymis. This study makes a valuable contribution to the field of estrogen-mediated pathways in the male reproductive tract and describes trends of analyzed genes' expression and presence. We think our results may open some new research directions of the estrogen signaling in the male reproductive system.
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Affiliation(s)
- Izabela Skibińska
- Chair and Department of Cell Biology, Poznan University of Medical Sciences, Poznań, Poland
| | - Mirosław Andrusiewicz
- Chair and Department of Cell Biology, Poznan University of Medical Sciences, Poznań, Poland
| | - Magdalena Jendraszak
- Chair and Department of Cell Biology, Poznan University of Medical Sciences, Poznań, Poland
| | - Aleksandra Żbikowska
- Chair and Department of Cell Biology, Poznan University of Medical Sciences, Poznań, Poland
| | - Czesław Żaba
- Chair and Department of Forensic Sciences, Poznan University of Medical Sciences, Poznań, Poland
| | - Małgorzata Kotwicka
- Chair and Department of Cell Biology, Poznan University of Medical Sciences, Poznań, Poland
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Van der Veer J, Rzepczyk S, Żaba C. Keep an eye on the crime – a new look at the forensic use of post-mortem eye examination to estimate time of death. JMS 2023. [DOI: 10.20883/medical.e753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Determining the time of death plays a crucial role in a forensic post-mortem examination. Many methods for the time of death (TOD) determination have been developed. However, most are not applicable during the first hours after death and produce large post-mortem interval (PMI) ranges. Eye examination makes it possible to precisely determine the time of death during the initial period after death with half-hour accuracy.. In recent years methods for estimating the time of death by measuring the changes in the eye have made great strides. Those methods use the changes in the reaction to drugs and macroscopically visible morphological changes. Experimental studies also produced equations that can estimate the post-mortem interval using biochemical, electrochemical and thermal changes within the eye.
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Rzepczyk S, Dolińska-Kaczmarek K, Burchardt B, Skowrońska D, Hałasiński P, Bielecka A, Koniarek K, Żaba C. Prevalence of Physical Violence in the Medical-Forensic Approach in the Years 2015-2020 in City and Neighboring Municipalities: Perspectives from Poland-Poznań Study. Int J Environ Res Public Health 2023; 20:2922. [PMID: 36833620 PMCID: PMC9964175 DOI: 10.3390/ijerph20042922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Forensic medical opinions serve the appropriate classification of a crime against health. Violence, a multifaceted phenomenon, requires forensic medical examination in the case of causing damage to health. Due to the effects caused by the perpetrator, the damage to health is divided into severe, medium, and light. This study analyzed 7689 incidents of violence from 2015-2020, taking place in the area subordinate to the Provincial Police Headquarters in Poznań, based on anonymized documentation of forensic medical examinations performed at the Department of Forensic Medicine in Poznań at the request of the Police and privately. The analysis took into account: units ordering the test, type of exposure, medical help, sex and age of the victim, places of the incident, classification and localization of injury, manner of impact, attitude of the perpetrator to the victim, profession of the victim, gender of the perpetrator, and remarks. In Poland, statistics on violence victims are underestimated, resulting from the low reporting of crimes committed to law enforcement authorities. There is a need for programs to educate the perpetrator of violence on methods of conflict resolution and programs to prevent violence, covering events taking place in public spaces.
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Affiliation(s)
- Szymon Rzepczyk
- Forensic Medicine Departament, Poznan University of Medical Sciences, ul. Rokietnicka 10, 60-806 Poznan, Poland
| | - Klaudia Dolińska-Kaczmarek
- Forensic Medicine Departament, Poznan University of Medical Sciences, ul. Rokietnicka 10, 60-806 Poznan, Poland
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Kowalczewska J, Rzepczyk S, Żaba C. E-scooters and the City – head to toe injuries. JMS 2022. [DOI: 10.20883/medical.e672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
In the recent years electric scooters have become much more common. As the number of drivers increased, so did the number of accidents and injuries involving e-scooters. The most common are head and neck injuries, including open wounds of soft tissues, traumatic brain injuries (TBIs), fractures of the skull bones, and intracerebral hemorrhages (ICH). The second most frequent are injuries to both upper and lower limbs. Fractures of the spine and injuries to the chest and abdominal cavity are less common. Many injuries could be avoided by using helmets, not driving e-scooters under the influence of intoxicating substances, and systematizing the rules of using e- scooters among other road traffic users.
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Sławek-Szmyt S, Szmyt K, Żaba C, Grygier M, Lesiak M, Araszkiewicz A. The importance of autopsy studies in elucidating coronary venous diseases: Authors' reply. Europace 2021; 23:1867-1868. [PMID: 34463723 DOI: 10.1093/europace/euab206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sylwia Sławek-Szmyt
- 1st Department of Cardiology, Poznan University of Medical Sciences, Dluga Street ½, 61-848 Poznan, Poland
| | - Krzysztof Szmyt
- Department of General, Endocrine and Gastrointestinal Oncology Surgery, Przybyszewski Street 49, 60-355 Poznan, Poland
| | - Czesław Żaba
- Department of Forensic Medicine, Poznan University of Medical Sciences, Swiecicki Street 6, 60-789 Poznan, Poland
| | - Marek Grygier
- 1st Department of Cardiology, Poznan University of Medical Sciences, Dluga Street ½, 61-848 Poznan, Poland
| | - Maciej Lesiak
- 1st Department of Cardiology, Poznan University of Medical Sciences, Dluga Street ½, 61-848 Poznan, Poland
| | - Aleksander Araszkiewicz
- 1st Department of Cardiology, Poznan University of Medical Sciences, Dluga Street ½, 61-848 Poznan, Poland
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Sławek-Szmyt S, Szmyt K, Żaba C, Grygier M, Lesiak M, Araszkiewicz A. Peculiarities in coronary sinus anatomy: implications for successful cannulation from an autoptic study. Europace 2021; 23:1787-1794. [PMID: 33864081 PMCID: PMC8576278 DOI: 10.1093/europace/euab108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 04/02/2021] [Indexed: 11/23/2022] Open
Abstract
Aims The number of cardiovascular procedures using the coronary sinus (CS) as a gateway is constantly increasing. The present study aimed to define specific structures within CS, which could potentially complicate CS cannulation and to develop a new Thebesian valve (TV) classification system. Methods and results The study was performed on 560 consecutive unfixed cadaveric hearts during routine autopsy examination (1–3 days post-mortem). Basic CS dimensions were measured and the presence and dimensions of the TV and the Vieussens valve (VV) were assessed. Thebesian valves were classified according to their morphology into six main types: remnant fold, semilunar, fenestrated, chord, fused strands, and mixed shaped. The median age of hearts was 48 years (range 16–95 years), and 38.9% were female. Thebesian valve was present in 79.5%. The most common TV type was semilunar (54%) followed by fenestrated (8.2%), remnant fold (5.5%), fused strands (4.8%), chord (4.0%), and mixed shaped (3.0%). In 1.1% of hearts, TV totally covered the coronary sinus ostium (CSO). The VV was detected in 67.9%. Potentially occlusive VV was found in 1.1% hearts and in all of which it coexisted with obstructive TV. The median CSO area was 87.9 mm2 [interquartile range (IQR): 56.5–127.1 mm2] and median CS length was 38 mm (IQR: 29.5–45 mm). The CSO area and CS length correlated with each other and with the right atrium’s dimensions. Conclusion We identified six types of TVs, among which only 1.1% TVs caused total occlusion of CSO. The obstructive TV co-existed with potentially occlusive VV what might hinder CS cannulation.
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Affiliation(s)
- Sylwia Sławek-Szmyt
- 1st Department of Cardiology, Poznan University of Medical Sciences, Dluga Street ½, 61-848 Poznan, Poland
| | - Krzysztof Szmyt
- Department of General, Endocrine and Gastrointestinal Oncology Surgery, Poznan University of Medical Sciences, Przybyszewski Street 49, 60-355 Poznan, Poland
| | - Czesław Żaba
- Department of Forensic Medicine, Poznan University of Medical Sciences, Swiecicki Street 6, 60-789 Poznan, Poland
| | - Marek Grygier
- 1st Department of Cardiology, Poznan University of Medical Sciences, Dluga Street ½, 61-848 Poznan, Poland
| | - Maciej Lesiak
- 1st Department of Cardiology, Poznan University of Medical Sciences, Dluga Street ½, 61-848 Poznan, Poland
| | - Aleksander Araszkiewicz
- 1st Department of Cardiology, Poznan University of Medical Sciences, Dluga Street ½, 61-848 Poznan, Poland
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Grzegorzewska AE, Adamska P, Iwańczyk-Skalska E, Ostromecka K, Niepolski L, Marcinkowski W, Mostowska A, Warchoł W, Żaba C, Jagodziński PP. Paraoxonase 1 concerning dyslipidaemia, cardiovascular diseases, and mortality in haemodialysis patients. Sci Rep 2021; 11:6773. [PMID: 33762698 PMCID: PMC7990965 DOI: 10.1038/s41598-021-86231-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 02/23/2021] [Indexed: 01/31/2023] Open
Abstract
Paraoxonase 1 (PON1) is known for preventing atherosclerosis through lipid-modifying features, antioxidant activity, anti-inflammatory, anti-apoptosis, anti-thrombosis, and anti-adhesion properties. Uremic patients requiring haemodialysis (HD) are especially prone to atherosclerosis and its complications. We analysed the PON1 gene (PON1) polymorphisms and serum PON1 (paraoxonase) activity concerning dyslipidaemia and related cardiovascular diseases and mortality to show how they associate under uremic conditions modified by maintenance HD treatment. The rs662 AA + AG (OR 1.76, 95%CI 1.10-2.80, P = 0.018), rs854560 TT (OR 1.48, 95%CI 1.04-2.11, P = 0.031), and rs854560 AT + TT (OR 1.28, 95%CI 1.01-1.63, P = 0.040) contributed to the prevalence of atherogenic dyslipidaemia diagnosed by the triglyceride (TG)/HDL-cholesterol ratio ≥ 3.8. The normalized serum PON1 activity positively correlated with atherogenic dyslipidaemia (ẞ 0.67 ± 0.25, P = 0.008). The PON1 rs854560 allele T was involved in the higher prevalence of ischemic cerebral stroke (OR 1.38, 1.02-1.85, P = 0.034). The PON1 rs705379 TT genotype contributed to cardiovascular (HR 1.27, 95% CI 1.03-1.57, P = 0.025) and cardiac (HR 1.34, 95% CI 1.05-1.71, P = 0.018) mortality. All P-values were obtained in multiple regression analyses, including clinical variables. Multifaceted associations of PON1 with dyslipidaemia, ischemic cerebral stroke, and cardiovascular mortality in HD patients provide arguments for the consideration of PON1 and its protein product as therapeutic targets in the prevention of atherosclerosis and its complications in uremic patients.
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Affiliation(s)
- Alicja E. Grzegorzewska
- grid.22254.330000 0001 2205 0971Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznań, Poland
| | - Paulina Adamska
- grid.22254.330000 0001 2205 0971Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznań, Poland
| | - Ewa Iwańczyk-Skalska
- grid.22254.330000 0001 2205 0971Department of Biochemistry and Molecular Biology, Poznan University of Medical Sciences, 60-781 Poznań, Poland
| | - Kamila Ostromecka
- grid.22254.330000 0001 2205 0971Nephrology Research Group, Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznań, Poland
| | - Leszek Niepolski
- B. Braun Avitum Poland, Dialysis Center, 64-300 Nowy Tomyśl, Poland
| | | | - Adrianna Mostowska
- grid.22254.330000 0001 2205 0971Department of Biochemistry and Molecular Biology, Poznan University of Medical Sciences, 60-781 Poznań, Poland
| | - Wojciech Warchoł
- grid.22254.330000 0001 2205 0971Department of Ophthalmology and Optometry, Poznan University of Medical Sciences, 60-806 Poznań, Poland
| | - Czesław Żaba
- grid.22254.330000 0001 2205 0971Department of Forensic Medicine, Poznan University of Medical Sciences, 60-781 Poznań, Poland
| | - Paweł P. Jagodziński
- grid.22254.330000 0001 2205 0971Department of Biochemistry and Molecular Biology, Poznan University of Medical Sciences, 60-781 Poznań, Poland
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11
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Pluta-Hadas K, Świderski P, Urbaniak M, Macioszek N, Pawełek T, Żaba C. [Diagnostic difficulties and legal analysis of potential claims to occupational medicine specialists based on a case of unrecognizable cardiac angiosarcoma]. Med Pr 2020; 71:757-764. [PMID: 32925897 DOI: 10.13075/mp.5893.00949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The article presents a case of sudden death of a 56-year-old woman at the workplace, caused by a very rare primary cardiac tumor. The patient's family reported a crime to the prosecutor's office suggesting participation of third parties in causing the death or malpractice in physical examinations before the death. A review of clinical data concerning cardiac angiosarcoma, available in electronic databases (e.g., Web of Science, PubMed), was presented, which could be useful in the practice of occupational medicine specialists. A legal analysis of potential claims to occupational medicine specialist in the case of failure to recognize primary cardiac tumors was also included in the article. Med Pr. 2020;71(6):757-64.
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Affiliation(s)
- Katarzyna Pluta-Hadas
- Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu / Poznan University of Medical Sciences, Poznań, Poland (Wydział Nauk o Zdrowiu, Katedra Prawa Medycznego, Organizacji i Zarządzania w Opiece Zdrowotnej / Faculty of Health Sciences, Department of Medical Law and Medical Care Organization and Management)
| | - Paweł Świderski
- Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu / Poznan University of Medical Sciences, Poznań, Poland (Wydział Lekarski, Katedra i Zakład Medycyny Sądowej / Faculty of Medicine, Department of Forensic Medicine)
| | - Monika Urbaniak
- Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu / Poznan University of Medical Sciences, Poznań, Poland (Wydział Nauk o Zdrowiu, Katedra Prawa Medycznego, Organizacji i Zarządzania w Opiece Zdrowotnej / Faculty of Health Sciences, Department of Medical Law and Medical Care Organization and Management)
| | - Natalia Macioszek
- Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu / Poznan University of Medical Sciences, Poznań, Poland (Wydział Lekarski, Katedra i Zakład Medycyny Sądowej / Faculty of Medicine, Department of Forensic Medicine)
| | - Tadeusz Pawełek
- Szpital Wojewódzki w Poznaniu / Poznan Provincial Hospital, Poznań, Poland (Zakład Patomorfologii / Department of Pathology)
| | - Czesław Żaba
- Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu / Poznan University of Medical Sciences, Poznań, Poland (Wydział Lekarski, Katedra i Zakład Medycyny Sądowej / Faculty of Medicine, Department of Forensic Medicine)
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Sommerfeld-Klatta K, Łukasik-Głębocka M, Teżyk A, Panieński P, Żaba C, Zielińska-Psuja B. Clonazolam a new designer benzodiazepine intoxication confirmed by blood concentration. Forensic Sci Int 2020; 310:110237. [PMID: 32172178 DOI: 10.1016/j.forsciint.2020.110237] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 02/28/2020] [Accepted: 03/04/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Recently the number of new psychoactive substances have significantly increased, becoming popular among experienced users of designer drugs. A significant group includes benzodiazepine derivatives, which have not been introduced as medications but are abused by people experimenting with new and classical psychoactive substances. CASE PRESENTATION The aim of this paper was to present the case of a clonazolam ingestion by a person who was not habituated to benzodiazepines. The intake caused only prolonged coma, decreased muscle tone, and deep tendon reflexes without any other concomitant toxicity and cardio-respiratory failure. CONCLUSIONS Clonazolam concentrations in patient's blood, measured three times were 0.077 mg/L, 0.015 mg/L, 0.009 mg/L after 4, 8 and 12 h, respectively. Clonazolam's human toxicity has not been well established, so any case of poisoning should be closely monitored.
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Affiliation(s)
| | - Magdalena Łukasik-Głębocka
- Department of Emergency Medicine, Poznan University of Medical Sciences, Poznan, Poland; Department of Toxicology, Raszeja Hospital, Poznan, Poland
| | - Artur Teżyk
- Department of Forensic Sciences, Poznan University of Medical Sciences, Poznan, Poland
| | - Paweł Panieński
- Department of Emergency Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Czesław Żaba
- Department of Forensic Sciences, Poznan University of Medical Sciences, Poznan, Poland
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Michalak E, Abreu-Głowacka M, Konarzewska M, Pepiński W, Skawrońska M, Wójcik M, Sołtyszewski I, Żaba C. Population genetics of 30 insertion-deletion polymorphism in polish Populations. Forensic Science International: Genetics Supplement Series 2019. [DOI: 10.1016/j.fsigss.2019.09.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mularski A, Żaba C. Fatal meningococcal meningitis in a 2-year-old child: A case report. World J Clin Cases 2019; 7:636-641. [PMID: 30863763 PMCID: PMC6406201 DOI: 10.12998/wjcc.v7.i5.636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 01/14/2019] [Accepted: 01/30/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND In fatal cases of meningococcal septicemia, bacteriological diagnosis may not be straightforward due to postmortem replication and relocation of endogenic microflora. In medicolegal practice, aside from routine autopsy and histopathology, also other diagnostic methods, such as microbiological tests, immunohistochemistry and polymerase chain reaction (PCR), are used to examine body fluids and tissues.
CASE SUMMARY We present the case of sudden death in a 2-year-old child. The patient died approximately 30 min after hospital admission before any routine diagnostic procedures were undertaken. Presence of whole-body rash and fulminant course of the disease raised suspicion of meningococcal septicemia. An autopsy was performed seven days after death when the body showed the signs of late postmortem decomposition. No etiological factor of septicemia could be identified based on macro- and microscopic findings. However, PCR demonstrated the presence of genetic material of group W Neisseria meningitidis in patient’s cerebrospinal fluid and blood.
CONCLUSION Microbiological PCR should be conducted postmortem whenever a specific etiological factor could not be identified with conventional methods.
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Affiliation(s)
- Aleksander Mularski
- Department of Legal and Forensic Medicine, Poznan University of Medical Sciences, Poznan 60-781, Poland
| | - Czesław Żaba
- Institute of Forensic Research, Cracow 31-033, Poland
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Żaba C, Świderski P, Sommerfeld-Klatta K, Żaba Z, Pluta-Hadas K, Urbaniak M. Suicidal Carbon Monoxide Poisoning Using Motor Vehicle Exhaust in an Open Space. Med Princ Pract 2019; 28:490-492. [PMID: 30995650 PMCID: PMC6771054 DOI: 10.1159/000500009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 03/31/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES A rare case of a suicidal use of gases from the car exhaust system of the car petrol engine in an open space is presented. CLINICAL PRESENTATION AND INTERVENTION To verify suicidal intent of poisoning, an experimental reconstruction of the crime scene was performed. This demonstrated that appropriately long exposure to carbon monoxide with unfavorable weather conditions can cause acute carbon monoxide poisoning in an open space. CONCLUSIONS This case was studied to observe the pattern of fatal carbon monoxide poisoning in an open space. This might be helpful for forensic medicine, emergency medicine, and occupational medicine.
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Affiliation(s)
- Czesław Żaba
- Department of Forensic Medicine, Poznan University of Medical Sciences, Poznan, Poland
- Road Accidents Analysis Section in Poznan, Department of Road Accidents Analysis, Institute of Forensic Research in Krakow, Poznan, Poland
| | - Paweł Świderski
- Department of Forensic Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Zbigniew Żaba
- Department of Teaching Anesthesiology and Intensive Therapy, Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Pluta-Hadas
- Department of Medical Law and Medical Care Organization and Management, Poznan, Poland,
| | - Monika Urbaniak
- Department of Medical Law and Medical Care Organization and Management, Poznan, Poland
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Świderski P, Żaba C, Macioszek N. [Health state assessment in people sentenced to the penalty of restriction of liberty]. Med Pr 2016; 67:765-775. [PMID: 28005085 DOI: 10.13075/mp.5893.00439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Assessment of the health state of people sentenced to the penalty of restriction of liberty makes up a significant percentage of cases annually elaborated in the Department of Forensic Medicine, Poznan University of Medical Sciences. The analysis of such cases was accomplished to point out the difficulties that expert physicians could encounter in formulating their opinions. MATERIAL AND METHODS The analysis involved 1051 medico-legal opinions issued in the years 2004-2013, considering the health state of people performing the duty of free, controlled social labor. The authors collected data on age, sex, type of diseases and the ability to control social work of convicted subjects. RESULTS Among those sentenced to the penalty of restriction of liberty the men aged 51-60 were in the majority. Individuals able to work only in specified conditions were the most numerous group (56.3%). People able to work in all conditions were the smallest set (9.5%). Light work was the type of work most frequently recommended to the persons able to work only in specific conditions (58.4%). The largest group of diseases comprised spondylopathies and osteoarthropathies (51.4%). It was followed by the group of cardiac diseases and angiopathies, including hypertension (38.7%). CONCLUSIONS The number of cases concerning the ability of the sentenced persons to serve the penalty of restriction of liberty annually elaborated in the Department of Forensic Medicine, Poznan University of Medical Sciences and the number of sentences imposed on the national scale indicate that medical experts may be obliged to provide opinions of this kind. Assessment of the health state of people sentenced to the penalty of restriction of liberty in some cases can be a difficult task for the expert physicians because of frequent lack of information about a specific type of work performed by the sentenced persons having only the data about their diseases. Med Pr 2016;67(6):765-775.
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Affiliation(s)
- Paweł Świderski
- Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu / Poznan University of Medical Sciences, Poznań, Poland (Wydział Lekarski, Katedra i Zakład Medycyny Sądowej / Faculty of Medicine, Department of Forensic Medicine).
| | - Czesław Żaba
- Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu / Poznan University of Medical Sciences, Poznań, Poland (Wydział Lekarski, Katedra i Zakład Medycyny Sądowej / Faculty of Medicine, Department of Forensic Medicine)
| | - Natalia Macioszek
- Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu / Poznan University of Medical Sciences, Poznań, Poland (Wydział Lekarski, Katedra i Zakład Medycyny Sądowej / Faculty of Medicine, Department of Forensic Medicine)
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Łukasik-Głębocka M, Sommerfeld K, Teżyk A, Zielińska-Psuja B, Panieński P, Żaba C. Flubromazolam--A new life-threatening designer benzodiazepine. Clin Toxicol (Phila) 2015; 54:66-8. [PMID: 26585557 DOI: 10.3109/15563650.2015.1112907] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT In addition to designer benzodiazepines such as etizolam, deschloroetizolam, pyrazolam, diclazepam, nifoxipam, or clonazolam, a new psychoactive substance like flubromazolam, triazole of flubromazepam has become available. Flubromazolam is currently not marketed as a medication but rather as a research chemical and recreational drug. It mostly causes sedative effects but also has moderate anti-anxiety and muscle relaxant effects. A case of a severe intoxication of flubromazolam has been reported. CASE DETAILS A 27-year-old man, presented with deep coma, bilateral pinpoint unreactive pupils, acute respiratory failure and hypotension, complicated by hypoxic ischemic changes in the central nervous system. A positive result of a urine screening test confirmed the presence of benzodiazepines, which resulted in administration of flumazenil and improved patient consciousness. Quantitative method of liquid chromatography indicated flubromazolam in the patient's serum at 59 ng/mL and urine at 105 ng/mL about 19 h after ingestion of 3 mg dose. On admission, serum creatine kinase was 15,960 U/L. The patient was treated with mechanical ventilation, intravenous fluids, flumazenil and continuous infusion of norepinephrine at a dose of 0.12 µg/kg/min. The patient survived and on the ninth day of hospitalization he was transferred to the Department of Neurology. DISCUSSION Flubromazolam is a new designer drug. Recreational use may be a cause of prolonged, severe intoxication associated with coma, hypotension, and rhabdomyolysis.
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Affiliation(s)
- Magdalena Łukasik-Głębocka
- a Department of Emergency Medicine , Poznan University of Medical Sciences , Poznan , Poland ;,b Department of Toxicology , Raszeja Hospital , Poznan , Poland
| | - Karina Sommerfeld
- c Department of Toxicology , Poznan University of Medical Sciences , Poznan , Poland
| | - Artur Teżyk
- d Department of Forensic Sciences , Poznan University of Medical Sciences , Poznan , Poland
| | | | - Paweł Panieński
- a Department of Emergency Medicine , Poznan University of Medical Sciences , Poznan , Poland
| | - Czesław Żaba
- d Department of Forensic Sciences , Poznan University of Medical Sciences , Poznan , Poland
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Lorkiewicz-Muszyńska D, Kociemba W, Sroka A, Kulczyk T, Żaba C, Paprzycki W, Przystańska A. Accuracy of the anthropometric measurements of skeletonized skulls with corresponding measurements of their 3D reconstructions obtained by CT scanning. Anthropol Anz 2015; 72:293-301. [PMID: 26131560 DOI: 10.1127/anthranz/2015/0481] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 02/02/2015] [Indexed: 11/05/2022]
Abstract
BACKGROUND The anthropometric measurements of the skeletonized skull are crucial in the investigation of human remains, mostly for personal identification. The images of the skull are used if the superimposition or approximation of the facial appearance is to be performed. The aim of the study was to compare the accuracy of the anthropometric measurements of skeletonized skulls with corresponding measurements of their 3D reconstructions obtained by CT scanning. METHODS Ten skeletonized skulls and their 3D digital reconstructions were measured according to standard anthropometric procedures. The results were compared and statistical analysis was performed. RESULTS The statistical analysis revealed that the 3D reconstruction is absolutely reliable for any measurements within the skull. The results of the measurements obtained from the CT image were accurate and comparable to the results of the anthropometric analysis of the skeletonized skull. The correlation between the anthropometry of the skeletonized skulls and the CT reconstructions was strong. CONCLUSIONS It is relevant that 3D reconstructions of the skull can be used in forensic anthropology for personal identification.
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Affiliation(s)
| | | | - Alicja Sroka
- Department of Anatomy, Poznan University of Medical Sciences
| | - Tomasz Kulczyk
- Section of Dental Radiology, Department of Biomaterials and Experimental Dentistry, Poznan University of Medical Sciences
| | - Czesław Żaba
- Department of Forensic Medicine, Poznan University of Medical Sciences
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Łukasik-Głębocka M, Sommerfeld K, Teżyk A, Panieński P, Żaba C, Zielińska-Psuja B. Post-Injection Delirium/Sedation Syndrome after Olanzapine Long-Acting Intramuscular Injection - Who is at Risk? Basic Clin Pharmacol Toxicol 2015; 117:213-4. [DOI: 10.1111/bcpt.12394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 02/16/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Magdalena Łukasik-Głębocka
- Department of Emergency Medicine; Poznan University of Medical Sciences; Poland
- Department of Toxicology; Raszeja Hospital; Poznan Poland
| | - Karina Sommerfeld
- Department of Toxicology; Poznan University of Medical Sciences; Poland
| | - Artur Teżyk
- Department of Forensic Sciences; Poznan University of Medical Sciences; Poland
| | - Paweł Panieński
- Department of Emergency Medicine; Poznan University of Medical Sciences; Poland
| | - Czesław Żaba
- Department of Forensic Sciences; Poznan University of Medical Sciences; Poland
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20
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Lorkiewicz-Muszyńska D, Przystańska A, Glapiński M, Kociemba W, Żaba C. Difficulties in personal identification caused by unreliable dental records. J Forensic Leg Med 2013; 20:1135-8. [PMID: 24237837 DOI: 10.1016/j.jflm.2013.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 09/05/2013] [Accepted: 09/07/2013] [Indexed: 11/27/2022]
Abstract
This paper demonstrates a case of personal identification that initially seemed straightforward, mainly because complete and comprehensive antemortem dental records of a missing person were made available for analysis. Skeletal remains were found and the skull (most crucial for human identification) was delivered for analysis. Comparative analysis of antemortem and postmortem dental records excluded identification, while the results of superimposition (simultaneously performed by another team member) revealed sufficient concordant points to establish identity. The results caused confusion and additional information was required. The need for more evidence resulted in delivery of elements of the postcranial skeleton. Identification was finally achieved when concordant points were established in a comparison of antemortem X-rays and the humerus. Team members concluded that the dental records were in fact not adequate and that mistakes in numbering the teeth (superior canine instead inferior canine and right and left premolars) were considered to be the initial reason a positive identification had not been made. The authors conclude that a multidisciplinary approach is crucial to making a positive identification and that caution should be exercised when carrying out personal identification from dental records alone. The need to adequately train police officers to collect and preserve dental evidence is also emphasized.
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Affiliation(s)
- Dorota Lorkiewicz-Muszyńska
- Department of Forensic Medicine, Poznań University of Medical Sciences, ul. Święcickiego 6, 60-781 Poznań, Poland.
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Lorkiewicz-Muszyńska D, Przystańska A, Kociemba W, Sroka A, Rewekant A, Żaba C, Paprzycki W. Body mass estimation in modern population using anthropometric measurements from computed tomography. Forensic Sci Int 2013; 231:405.e1-6. [PMID: 23751731 DOI: 10.1016/j.forsciint.2013.05.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 04/13/2013] [Accepted: 05/16/2013] [Indexed: 11/16/2022]
Abstract
Forensic anthropologists are able to estimate the stature of a skeleton, its sex and biological age at death, with a relatively high degree of accuracy. Body mass estimation from the stature and bi-iliac (maximum pelvic) breadth and femoral head breadth can be useful in forensic investigations involving unidentified skeletal remains. Predicting the body mass of skeletal remains always involves significant inaccuracy, however when body mass extremes are disregarded average figures provide the best estimation. The aim of the study was to investigate whether the methods usually used in body mass estimation are accurate in different BMI ranges. The usefulness of these methods in forensic anthropology was discussed. The study was performed using CT images of widely differing body types of modern central European populations. Maximum pelvic breadth and anteroposterior femoral head breadth were measured directly from the appropriate CT scan slices for each individual. Body mass index was established for each individual. Four different methods of body mass estimation were applied. The statistical analysis showed that body mass prediction methods based on the bi-iliac breadth with known stature and the femoral head breadth show strong correspondence. The results of body mass estimation using different methods were in high correlation with normal BMI. The accuracy of body mass prediction of underweight and obesity cases (BMI extremes) showed significant inaccuracy. Body mass estimation methods can provide important information for forensic anthropological investigation and personal identification. However, one should be aware of the discrepancies and should apply the equations carefully as they can carry significant errors.
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22
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Lorkiewicz-Muszyńska D, Kociemba W, Żaba C, Łabęcka M, Koralewska-Kordel M, Abreu-Głowacka M, Przystańska A. The conclusive role of postmortem computed tomography (CT) of the skull and computer-assisted superimposition in identification of an unknown body. Int J Legal Med 2012; 127:653-60. [PMID: 23238809 PMCID: PMC3631520 DOI: 10.1007/s00414-012-0805-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 11/30/2012] [Indexed: 11/08/2022]
Abstract
Computed tomography is commonly used in modern medicine, and thus, it is often helpful for medicolegal purposes, especially as part of the antemortem record. The application of postmortem computed tomography and 3D reconstruction of the skull in challenging cases is reported, and its valuable contribution to positive identification is discussed. This paper presents a case in which the body of an unknown individual is identified. Positive identification had not been possible despite a multidisciplinary examination. The postmortem use of computerized tomography and 3D reconstruction of the skull followed by the comparison of individual morphological characteristics of the viscerocranium showed the concordant points between the deceased and a missing person. Finally, superimposition using a 3D-reconstructed skull instead of the skeletonized skull demonstrated an adequate degree of morphological consistency in the facial images of the analyzed individuals that lead to positive identification. It was concluded that where other methods of personal identification had failed, the use of postmortem computed tomography had proved to be instrumental in the positive identification of the deceased.
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Affiliation(s)
- Dorota Lorkiewicz-Muszyńska
- Department of Forensic Medicine, Poznań University of Medical Sciences, 60-781 Poznań, ul. Święcickiego 6, Poland.
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Karaźniewicz-Łada M, Danielak D, Teżyk A, Żaba C, Tuffal G, Główka F. HPLC–MS/MS method for the simultaneous determination of clopidogrel, its carboxylic acid metabolite and derivatized isomers of thiol metabolite in clinical samples. J Chromatogr B Analyt Technol Biomed Life Sci 2012; 911:105-12. [DOI: 10.1016/j.jchromb.2012.11.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 10/30/2012] [Accepted: 11/01/2012] [Indexed: 11/27/2022]
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Bienert A, Wiczling P, Żaba C, Żaba Z, Wolc A, Marciniak R, Grześkowiak E, Kusza K. Influence of demographic factors, basic blood test parameters and opioid type on propofol pharmacokinetics and pharmacodynamics in ASA I–III patients. ACTA ACUST UNITED AC 2012; 61:545-52. [DOI: 10.1055/s-0031-1300552] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Agnieszka Bienert
- Department of Clinical Pharmacy and Biopharmacy, Karol Marcinkowski University of Medical Sciences
| | - Paweł Wiczling
- Department of Biopharmaceutics and Pharmacodynamics, Medical Univeristy of Gdansk
| | - Czesław Żaba
- Department of Forensic Medicine, Karol Marcinkowski University of Medical Sciences
| | - Zbigniew Żaba
- Department of Anesthesiology, Intensive Care and Pain, Karol Marcinkowski University of Medical Sciences
| | - Anna Wolc
- Department of Genetics and Animal Breeding Poznan University of Life Sciences
| | - Ryszard Marciniak
- Department of General, Gastroenterological and Endocrinological Surgery, Karol Marcinkowski, University of Medical Sciences
| | - Edmund Grześkowiak
- Department of Clinical Pharmacy and Biopharmacy, Karol Marcinkowski University of Medical Sciences
| | - Krzysztof Kusza
- Department of Anaesthesiology and Intensive Therapy Collegium Medicum, Nicolaus Copernicus University
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Jakubowicz O, Żaba C, Nowak G, Jarmuda S, Żaba R, Marcinkowski JT. Heracleum Sosnowskyi Manden. Ann Agric Environ Med 2012; 19:327-328. [PMID: 22742809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Heracleum Sosnowskyi was discovered in 1772 and described as a separate species in 1944 by I. P. Mandenova. Its name is derived from the surname of a botanist studying Caucasian flora, Prof. D.I. Sosnowski. In the area of the Caucasus foothills, the plant reaches approximately 1-1,5 m in height, whereas in Poland its size is significantly larger, up to 3-3.5 m. Heracleum blooms from mid-June to the end of July. The flowers are arranged in umbels and last for 2-3 weeks. In Central Europe, the species colonizes mostly neglected green areas, ruins and riversides. Heracleum poses a serious threat to the human population due to its photoallergic properties, resulting from the presence of intensely toxic furanocoumarin in its sap. Furanocoumarins are found in small hairs that cover the leaves and stem, and are the components of the essential oil. They may penetrate the skin through the epithelial layer, posing a direct threat to human health. Contact with the plant, followed by sun exposure, may lead to the development of large blisters and symptoms of burns. Heracleum, in the event of consumption, is also harmful to farm animals, causing, among others, internal bleeding and diarrhea. Although the toxic properties of Heracleum have been known for many years, every summer people who had contact with the plant present at physicians of different medical specialties.
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Affiliation(s)
- Oliwia Jakubowicz
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
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26
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Żaba C, Marcinkowski JT, Wojtyła A, Tężyk A, Tobolski J, Zaba Z. Acute collective gas poisoning at work in a manure storage tank. Ann Agric Environ Med 2011; 18:448-451. [PMID: 22216829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Cases of deaths in manure or septic tanks are rare in legal-medical practice, more frequently as unfortunate occupational accidents. Poisoning with toxic gases, especially with hydrogen sulfide, is reported as the cause of death, while the exhaustion of oxygen in the air is omitted with the simultaneous excess of carbon dioxide. In such cases, determination of the direct cause of death constitutes a big problem because post-mortem examination does not reveal the specific changes. A case of acute collective poisoning by gases in a manure storage tank is presented of 5 agricultural workers, 2 of whom died. While explaining the cause of poisoning and deaths, toxicological blood tests were performed in the victims of the accident, as well as gases inside the manure storage tank. The post-mortem examinations and toxicological blood tests performed did not allow determination of the direct cause of death. Toxicological tests of gases from inside the manure tank showed a very low concentration of oxygen, with a simultaneous very high concentration of carbon dioxide, and a considerable level of hydrogen sulfide. The cause of fainting of three and deaths of two workers was not the poisoning with hydrogen sulfide, but oxygen deficiency in the air of the tank.
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Affiliation(s)
- Czesław Żaba
- Department of Forensic Medicine, Karol Marcinkowski Medical University, Poznań.
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