Do Circulating Redox Biomarkers Have Diagnostic Significance in Alcohol-Intoxicated People?

The toxic properties of ethanol are inextricably linked to oxidative stress. Despite many reports on the effects of alcohol dependence on blood redox homeostasis, there are no data on the oxidative stress profile in alcohol-poisoned cases. There are also no data on the diagnostic usefulness of redox biomarkers determined post-mortem in various biological fluids. This work investigates the utility of enzymatic and non-enzymatic antioxidant barrier, redox status, and oxidative/nitrosative stress biomarkers in different biological fluids (such as blood, urine, vitreous humor, and cerebrospinal fluid) in the post-mortem study of patients with acute alcohol intoxication. The study group included those who died due to acute ethanol intoxication (n = 22). The research showed a significant increase in glutathione peroxidase activity, total antioxidant status, ferric reducing antioxidant power, and tryptophan concentration only in the study group's urine compared to the control. In other circulating fluids, both antioxidant enzyme activities and glycoxidation product concentrations were not significantly different in individuals who died of alcohol overdose compared with those who died suddenly. We also did not observe a connection between oxidation-reduction balance and the amount of alcohol consumed before death. These unexpected observations may be caused by irreversible post-mortem changes occurring at the cellular level due to autolysis and putrefaction. In summary, the use of circulating body fluids to assess redox homeostasis is limited in the post-mortem analysis. Our results indicate the increased stability of urine collected post mortem compared to other circulating bioliquids. Further studies are needed to assess the intensity of oxidative and carbonyl stress in ethanol-damaged organs and the effects of post-mortem processes on cellular redox balance.

Salivary Biomarkers of Stress, Anxiety and Depression.

Stress, anxiety and depressive disorders are often characterized by the activation of the stress axis, which results in similar symptoms at some point in these disorders. These disorders are closely related to each other-they occur simultaneously or follow one another. The diagnosis of stress, anxiety and depression is not a perfect procedure currently-it is based on patient observation and an interview with the patient and their family. There are no laboratory tests that would dispel the doubts of the doctor making the diagnosis and allow the appropriate treatment to be implemented as soon as possible. Therefore, this study will review the components of saliva that could be helpful in the quick diagnosis of stress, anxiety and/or depression. Such potential salivary biomarkers could also be useful in monitoring the effectiveness of pharmacological treatment prescribed by a psychiatrist. The following are promising salivary biomarkers of stress, anxiety or depression: cortisol, immunoglobulin A (sIgA), lysozyme, melatonin, α-amylase (sAA), chromogranin A (CgA) and fibroblast growth factor 2 (FGF-2). To the best valuable potential salivary markers of stress, we can include cortisol, lysozyme, sAA and CgA. To differentiate depression from stress, salivary cortisol and melatonin can be helpful. Fluctuations in the concentrations of the above-mentioned substances in saliva indicate a particularly strong relationship with typical human psychological problems, such as stress, depression or anxiety.

The Activity of N-acetyl-ß-hexosaminidase in the Blood, Urine, Cerebrospinal Fluid and Vitreous Humor Died People Due to Alcohol Intoxication.

BACKGROUND: The article aimed to assess the activity of the hexosaminidase (HEX) and its HEX A and HEX B isoenzymes in persons who suddenly died due to ethanol poisoning and explain the cause of their death. METHODS: The research involved two groups of the deceased group A-22 people (20 males, 2 females; the average age 46 years) who died due to alcohol intoxication (with the blood alcohol content of 4‱ and above in all biological materials at the time of death-blood, urine, cerebrospinal fluid, and vitreous humor), and group B-30 people (22 males, 8 females; the average age 54 years), who died suddenly due to other reasons than alcohol. RESULTS: The highest activity of the HEX was found in the serum of A and B groups. A significantly lower activity of HEX, HEX A, and HEX B was observed in the urine of group A in comparison to the sober decedents. CONCLUSION: The lower activity of HEX and its isoenzymes in the dead's urine due to ethanol poisoning may suggest its usefulness as a potential marker of harmful alcohol drinking. Damage done to the kidneys by ethanol poisoning may be one of the possible mechanisms leading to death. Kidneys may be damaged intravitally via the inflammatory agent. Thus, it is necessary to conduct further research to evaluate the diagnostic usefulness of exoglycosidases while determining the death mechanisms of people who lost their lives due to ethanol poisoning.

Post-mortem detection of six human herpesviruses (HSV-1, HSV-2, VZV, EBV, CMV, HHV-6) in trigeminal and facial nerve ganglia by PCR.

BACKGROUND: Among over 100 types of Herpesviridae viruses, eight can infect humans: herpes simplex viruses (HSV-1, HSV-2), varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), and human herpesviruses 6, 7, and 8 (HHV-6, HHV-7, HHV-8). After initial infection, the viruses remain latent for the lifetime of the host. The aim of this study was to determine the distribution of six different herpesviruses: HSV-1, HSV-2, VZV, EBV, CMV, and HHV-6 in trigeminal and facial nerve ganglia among a random group of Polish population. METHODS: The studied group consisted of 47 individuals (40 male, seven female); mean age of 47.4 ± 16.5 years) who died of independent causes (suicide, traffic accident, and poisoning, among others). Bilateral trigeminal and facial nerve ganglia of each cadaver were collected during the autopsy. Herpesviruses were detected using multiplex polymerase chain reaction technique. RESULTS: Herpesviruses were found in trigeminal and/or facial ganglia in 30/47 (63.8%) of cadavers. HHV-6 was the most prevalent of the herpesviruses and was found in nearly half of cadavers (n = 22; 46.8%), followed by HSV-1 (n = 7; 14.9%), VZV (n = 4; 8.5%), EBV (n = 4; 8.5%), HSV-2 (n = 2; 4.3%), and CMV (n = 1; 2.1%). Facial nerve ganglia (n = 23; 48.9%) were more often infected than trigeminal ganglia (n = 13; 27.7%). DISCUSSION: The results of this study have revealed a common presence of the herpesviruses in trigeminal and facial nerve ganglia among a random group of Polish population. Furthermore, the data also demonstrate simultaneous infection of the ganglia with different herpesviruses. This study has contributed to the knowledge of prevalence and localization of herpesviruses in different structures of the nervous system.

Optimization of the method for α-l-fucosidase, ß-d-galactosidase and ß-d-glucuronidase determination in serum from hemolyzed blood.

PURPOSE: Adaptation of the colorimetric method for the determination of ß-d-galactosidase, ß-d-glucuronidase and α-l-fucosidase activities in serums from hemolyzed blood, the material currently being discarded. MATERIALS AND METHODS: The materials included serums from hemolyzed and non-hemolyzed blood, obtained from 26 healthy volunteers. The adaptation of the method involved precipitation of the proteins with trichloroacetic acid after incubating serums with substrates, but before determining the products of enzymatic reactions. RESULTS: In serums from hemolyzed and non-hemolyzed blood of the same persons, we found high correlations among the results obtained using hemolyzed blood (with adapted) and non-hemolyzed blood (with non-adapted) methods. CONCLUSION: We are able to determine the ß-d-galactosidase, ß-d-glucuronidase and α-l-fucosidase activities in serums from hemolyzed blood (with adapted) and non-hemolyzed blood (with non-adapted) methods, with the same accuracy and precision.

Battered child syndrome in the records of the Department of Forensic Medicine, Medical University of Bialystok.

Violence against children has been until now recognised as physical aggression escalating from corporal punishment, hard physical labour to homicide. Nowadays child abuse is considered as maltreatment occurring in four different aspects: physical abuse, psychological abuse, sexual abuse and neglect. Child abuse is difficult to disclose, as it is concealed both by the perpetrators and the victims. The child is afraid and at the same time, almost always ashamed of looking for help. The victim frequently feels guilty, considers the violence as a norm, but in many cases is not able to speek precisely and very often has problems in contacting the required person. The objective of this study is to analyse the phenomenon of child abuse on the basis of Department of Forensic Medicine records. The victims were characterized in terms of their age, sex, place of residence and the type and location of injuries. The kind of abuse and perpetrators were also determined by researchers.

Evaluation of Chosen Cytokine Levels among Patients with Herpes Zoster as Ability to Provide Immune Response.

AIM AND BACKGROUND: Herpes zoster is a viral disease caused by the reactivation of varicella-zoster virus (VZV) which remained latent in the cranial nerve or dorsal root ganglia. Cell-mediated immunity is known to decline with age as part of immunosenescence and can lead to the reactivation of VZV. Whereas herpes zoster is usually mild in healthy young persons, older patients are at increased risk for complications. In the present study we investigated the serum cytokine profile (IL-17, IL-23, IL-21, IL-4, IL-12), representing cellular and humoral immunity and assessed the level of VZV IgG antibodies in patients with herpes zoster. METHODS: We investigated the serum concentrations of IL-17, IL-23, IL-21, IL-4, IL-12 and the level of VZV IgG antibodies in 23 patients with herpes zoster who did not develop superinfection. The control group was represented by 21 individuals in similar age with no inflammatory and infectious diseases. Cytokine and antibodies levels were measured by ELISA method. Statistical analysis was performed using the ROC curve (receiver operating characteristic), t-test, Welch's t-test, and nonparametric tests with STATISTICA 10 software. RESULTS: In patients with herpes zoster, the serum level of IL-17, IL-23, IL-21, IL-4 and IL-12 as well as VZV IgG antibodies titer were statistically significantly increased compared to control group. CONCLUSION: Our results confirm the broad activation of the immune system involving humoral and cell-mediated immunity.

Review of fatal gunshot cases in the files of the Department of Forensic Medicine in Bialystok, Poland, in the years 1964-2015.

Aim of the study was to assess gunshot fatalities on the basis of post-mortem examination reports collected at the Department of Forensic Medicine in the Medical University of Bialystok. Material and methods: The research covered 87 gunshot fatalities occurring in the Podlasie district (north-eastern Poland) over the period from 1964 to 2015. The analysis included demographic data such as the victims' gender, age, place of residence and such data as time of year, circumstances of the event and causes of death. The study also investigated blood alcohol level in the victims. The results were analysed statistically using the Mann-Whitney and Kruskal-Wallis tests. Results: The majority of victims were young males, most of whom committed suicide. The most common cause of death among the suspected suicides was gunshot wounds in the skull area. The second most frequent gunshot wound location among non-suicides was the chest. The majority of male victims were intoxicated at the time of death. Conclusions: In the area of the city of Bialystok and its surroundings, there are approximately two gunshot fatalities per year. In most cases, the victims were urban-dwelling young males (aged 21-30) committing suicide. The most common cause of death among the suspected suicides was gunshot wounds in the skull area and the chest. The majority of male victims were intoxicated at the time of death.

Vasculitis and stroke due to Lyme neuroborreliosis - a review.

Abstract Lyme neuroborreliosis (LNB) is a rare cause of vasculitis and stroke. It may manifest as subarachnoid hemorrhage, intracerebral hemorrhage, and most often ischemic stroke due to cerebral vasculitis. The vast majority of reported cases have been described by European authors. A high index of suspicion is required in patients who live or have traveled to areas with high prevalence of tick-borne diseases, and in the case of stroke-like symptoms of unknown cause in patients without cardiovascular risk factors. In this review, we also present four illustrative cases of vasculitis and stroke-like manifestations of LNB.

Analysis of the prevalence of medicines and psychoactive substances among drivers in the material of the Department of Forensic Medicine at the Medical University of Bialystok.

OBJECTIVES: To evaluate the prevalence of medicines and psychoactive substances in the blood of drivers. MATERIAL AND METHODS: The data, recorded in 2010-2011, was comprised of 274 blood samples of sober drivers (269 men and 5 women). 126 drivers within the group died immediately on the spot (mean age 29.7 years, range 19-53 years), 31 drivers survived the accident (mean age 32.4 years, range 24-69 years), and 117 drivers were stopped for traffic control (mean age 26.4 years, range 17-49 years). ELISA immuno-enzymatic blood tests detecting medicines and psychoactive substances were performed by the Neogen company. The presence of the tested substances was confirmed by gas chromatography and liquid chromatography with a mass detector (GC/MS and LC/MS). RESULTS: From the total number of 274 individuals, the presence of psychoactive substances was found in 132 cases, which accounted for 48.2% of all subjects. The drivers found to be under the influence of medicines and psychoactive substances were most often stopped for a roadside survey, among whom the percentage of positive results was 92.3% (108 cases out of 117 subjects). Among the total number of positive findings the psychoactive substances used, alone or in combination with other agents, were tetrahydrocannabinols (42.4%), amphetamines (26.5%), opiates (25.7%) and benzodiazepines (15.1%), and their concentration in the blood did not exceed toxic levels. CONCLUSIONS: In the group of psychoactive substances most often used, either alone or in combination with other agents, there were tetrahydrocannabinols, whose high percentage of positive results in drivers stopped for a roadside control may be explained by commissioning studies on early screening. Concentrations of the substances in most cases did not exceed toxic levels. Roadside examinations, on the basis of their alcohol-like effect, were performed primarily on male drivers.

[Morphological, microscopic changes in the thyroid gland in the cases of hanging in vertical position with open and closed noose]. / Morfologiczne, mikroskopowe zmiany w tarczycy w przypadkach powieszen w pozycji stojacej w zamknietej i otwartej petli.

The aim of the morphological study was to search for traumatic changes in the thyroid in the cases of hanging in a vertical position with an open and closed noose. These changes would constitute an additional proof of intravital hanging and they would be useful in postmortem diagnosis of the hangings in which other commonly acknowledged features of intravitality are not discovered. In 33% of all cases, petechiae were observed in the thyroid gland. They appeared in 20% of the hangings with the closed noose, and in 13% of the hangings with the use of the open noose. The study showed that there was no difference between the open or closed, hard noose in terms of changes in the thyroid gland. There was also no correlation between the body position and the injury of the thyroid gland. In all the cases, hyperemia of the thyroid was observed and segmental expansion of blood vessels. The histopathological analysis showed that in one third of all the cases with negative macroscopic examination, it was discovered that microscopic changes indicated hanging alive.

[Microscopic diagnosis of pituitary gland damages resulting from cranio-cerebral trauma with the base of the skull fracture]. / Mikroskopowa diagnostyka uszkodzen przysadki u zmarlych w nastepstwie urazu czaszkowo-mózgowego ze zlamaniem podstawy czaszki.

The aim of this research was a macro- and microscopic investigation of pituitary glands in people who died after head injuries with the base of the skull fractures in the sella turcica. No macroscopic changes in the pituitary glands were discovered during an autopsy examinations. Histopathology demonstrated traumatic changes of the pituitary glands in all the cases, which were correlated with sella trurcica fractures. The evolution of traumatic alterations correlated with survival time after the injury. In the pituitary glands of people who died directly after head injuries, hyperemia and focal hemorrhages were discovered. Apart from hyperemia, focal necrosis was found in the pituitary glands among those who survived from 48 to 72 hours after head injury. The examined pituitary glands of those people who lived from 2 to 3 weeks after head injury showed considerable necrotic changes and numerous calcificationss.

[The analysis of neonatal deaths based on autopsy protocols of the Department of Forensic Medicine in Bialystok in the years 1955-2009]. / Analiza zgonów noworodków w oparciu o protokoly sekcyjne Zakladu Medycyny Sadowej w Bialymstoku w latach 1955-2009.

The authors performed an analysis of the causes of deaths of newborns with special emphasis placed on cases when neonaticide was suspected. In the discussed period, 17838 medico-legal autopsies were performed, 124 of them (0.695 per cent of all postmortem examinations) involved children who meet the WHO criteria for newborn - children under 28th day of life. The newborns were divided into two groups according to their exact age at the time of death - newborns who died within a short time after birth and newborns who died after the perinatal period. Their sex, body length and body weight were also taken into consideration. A total of 108 autopsies (87.1 per cent of all autopsied newborns) involved cases of suspected criminal infanticide within the first score of hours postnatally. In the majority of these cases, the cause of death was suffocation, rarely mechanical trauma. The case of death of older newborns was broadly understood trauma.

[Medico-legal assessment in civil lawsuits in patients with neurological disorders in the case material of the Forensic Medicine Department, Medical University of Bialystok, in the years 2004-2008]. / Opiniowanie w postepowaniu cywilnym u osób ze schorzeniami neurologicznymi w materiale Zakladu Medycyny Sadowej UM w Bialymstoku w latach 2004-2008.

Opinionating in civil proceeding is difficult and carries much responsibility, especially in the period of increasing claiming for damages. The authors analyzed civil opinions issued by the Forensic Medicine Department, Medical University of Bialystok, in the years 2004-2008. The above-mentioned opinions addressed neurologic diseases and symptoms. The victims were invited to the Department for examinations which were performed by a forensic medicine expert and a neurologist, alternatively also by other specialists depending on the reported ailments. The paper presents an analysis of the victims' age and sex, type of the event, injuries and ailments, duration of physical and mental suffering, percentage of health impairment. The study comprised 126 civil opinions issued. Occupationally active persons were predominantly subject to injuries. The most common symptoms reported were headache, vertigo and pain in the C, L-S spine.

[Opinionating in cases referring to estimation of ability to participate in legal proceedings and estimation of ability to serve a sentence of imprisonment or restriction of freedom in the material of Department of Forensic Medicine in Bialystok in the years 2005-2009]. / Opiniowanie w sprawach dotyczacych oceny zdolnosci do udzialu w czynnosciach procesowych oraz oceny zdolnosci do odbywania kary pozbawienia lub ograniczenia wolnosci w materiale Zakladu Medycyny Sadowej w Bialymstoku w latach 2005-2009.

In the last years in Poland, the number of medicolegal opinions issued concerning the health status of defendants or convicts with regard to their ability to participate in legal proceedings (taking part in trial) and serve a sentence of imprisonment or restriction of freedom (doing free social labor) has been increasing. In the years 2005-2009, in our department, 115 opinions about defendants, convicts, one witness and one sufferer were issued. In this number, 37 opinions were associated with estimation of ability to serve a sentence of imprisonment, 22--estimation of ability to serve a penalty of restricted liberty or possibility of alternative serving a sentence of imprisonment, 56--estimation of ability to take part in legal proceedings. In 8 cases the experts estimated if the health status allowed a defendant to be detained awaiting trial and be detained in custody pending inquiry. The age, sex, place of residence, diseases the opinioned persons suffered from and the judicial organ that commissioned the opinion were taken into consideration in the analysis. The opinions were issued on the basis of court files and medical documentation only--18 opinions, or on the basis of court files, documentation and medical examination--97 opinions. In 52 cases, only specialists of forensic medicine issued the opinions, but in 63 instances, participation of experts in other medical specialties was necessary. Most often, the opinions of cardiologists were sought.

[The Polish helicopter crash in Belarus--an analysis of the accident]. / Wypadek polskiego smiglowca na Bialorusi--analiza zdarzenia.

The subject of analysis was the crash of a helicopter of the Polish Border Guards, which happened on October 31, 2009, in the Byelorussian territory about two hundred meters from the Polish border. In the accident, three crew members perished: the pilot, navigator and operator. Based on the accounts obtained directly after the crash on the site of the tragedy, it was established that the pilot tried to land, but the impact was so strong that the aircraft sank about one meter into the ground. On November 3, 2009, a committee consisting of two prosecutors from the County Prosecutor Office in Bialystok, a forensic science expert and a representative from the Border Guards, went to Department of Forensic Medicine in Brzesc. The prosecutors and forensic science expert took part in recovering the bodies. During the process of internal and external examination, severe body injuries were noted, without any surviving tissue and intestines. Samples of blood, urine and fragments of internal organs were collected for chemical, biochemical, toxicological and histopathological examinations. Muscle DNA was also taken.

[Declaration of death in a living individual--a case report]. / Stwierdzenie zgonu u zywego czlowieka--opis przypadku.

Declaration of death in a human being is a medical diagnosis, which results in numerous legal consequences. The demise of an individual can only be recognized by a doctor on the basis of a conscientious, personally conduced examination. Declaration of death releases a doctor from the obligation to rescue and save the individual's life. In the case of an incorrect death declaration, necessary aid is neglected by omission and the threat to human life is increased. Incorrect declaration of death in a living woman provided the basis for adopting an erroneous, contrary to current medical standards in force, management strategy.

[Posttraumatic cerebrasthenia and posttraumatic encephalopathy--difficulties in opinionating]. / Cerebrastenia pourazowa i encefalopatia pourazowa-- trudnosci opiniodawcze.

Post-traumatic cerebrasthenia and post-traumatic encephalopathy are the effects of a head trauma. Most physicians overuse these diagnoses. They do not perform differential diagnostic management, what leads to issuing erroneous opinions. The aim of this report is to show the symptoms of posttraumatic cerebrasthenia and posttraumatic encephalopathy and diagnostic investigations, which could be helpful for diagnosing these conditions. Cerebrasthenia (the subjective posttraumatic syndrome, subjective syndrome, posttraumatic neurosis) is usually a functional--"unorganic" disorder. It happens in the cases of many people who had brain concussion. The most common symptoms are: headache, vertigo, irritability, insomnia, attention deficits, fatigability. Posttraumatic encephalopathy is a persistent brain tissues injury which could be caused by more severe trauma (brain contusion, endocranial bleeding). The clinical picture of this disease entity is not unambiguous. The most frequently encountered form is a simple (common) form, which is similar to cerebrasthenia, but with differences in the neurological examination (focal signs) and with persistent changes in EEG.

[Evaluation of visualization of biological stains with the use of alternative light source (ALS) for the purpose of genetic identification. Part II. Semen samples analysis]. / Ocena wizualizacji sladów biologicznych z uzyciem alternatywnego zródla swiatla (ALS) w aspekcie identyfikacji genetycznej. Czesc II. Analiza sladów nasienia.

Detection of seminal stains on items such as clothing and bedding is a significant element of investigation in sexual assault cases. The use of alternative light source may assist in their identification. The objective of the investigation was the evaluation of human semen visualization with the use of alternative light source for the purpose of genetic identification. The tests demonstrated that experimentally prepared semen stains on the bright base could be best seen in the natural light and white light when the semen was diluted at a ratio 1:10. The complete typeability of AmpFISTR SGM Plus kit loci was evaluated in semen which was diluted at a ratio 1:1750 and typeability of AmpFISTR SGM Plus kit loci was incomplete in semen diluted at a ratio 1:2000. After washing with laundry detergents, semen stains were still recognizable under ALS wavelength 455 nm, while wearing orange goggles.

[Evaluation of visualization of biological stains with the use of alternative light source (ALS) for the purpose of genetic identification. Part I. Blood and saliva stains analysis]. / Ocena wizualizacji sladów biologicznych z uzyciem alternatywnego zródla swiatla (ALS) w aspekcie ich identyfikacji genetycznej. Czesc I. Analiza sladów krwi i sliny.

The objective of the investigation was evaluation of visualization of human blood and saliva stains with the use of alternative light source for the purpose of genetic identification. Experimental bloodstains on the bright base were the most clearly seen in the natural light and white light, up to blood dilution of 1:600. Complete typeability of AmpFISTR SGM Plus kit profiles was obtained from bloodstains at dilution 1:1500. Partial AmpFISTR SGM Plus kit profiles were typed from bloodstains at dilutions 1:1750 and 1:2000. Experimental saliva stains on the light-colored base were completely invisible in the natural light and white light, while they were visualized at wavelength range 300-415 nm through yellow goggles, and at wavelength range 300-455 nm through orange goggles at saliva dilution 1: 600. Complete typeability of AmpFISTR SGM Plus kit loci was obtained from saliva stains at dilution 1:1750. Partial AmpFISTR SGM Plus kit profiles were typed from saliva stains at dilution 1:2000. The wavelength of 455 nm and orange goggles were the optimal set for visualization of bloodstains on various, noncontrasting materials. Other useful wavelength/combinations of goggles were CSS light/red goggles. In case of saliva, the most useful general condition for visualization of stains on various, non-contrasting materials was with the wavelength set to 300-415 nm, while wearing yellow goggles. Other useful combinations of wavelength/goggles were 300-455 nm/orange or red goggles, and also CSS light/orange or red goggles.