Carbon monoxide-related deaths in Greece: a 23-year survey.

Carbon monoxide (CO) is the cause of more than one half of the fatal poisonings throughout the world. The aim of this study was to assess the characteristics of nonfire CO-related deaths in Greece, as they were recorded at the Department of Forensic Medicine and Toxicology, School of Medicine, University of Athens. This retrospective study concerned the toxicological records of all fatal cases of CO poisoning received by the Department of Forensic Medicine and Toxicology during the period 1987 to 2009. The records were reviewed and compiled according to the official coroner's verdict as to the manner of poisoning (accident or suicide), as well as according to the sex and the nationality of the victims. The registered victims were 176 (131 males, 45 females). Of CO deaths, 97.2% were accidental, and 2.8% were suicides, through automobile exhaust. Among the decedents, 32 victims were immigrants (30 males, 2 females). The average annual death rate for males was nearly 3½ times higher than that for females. This increase suggests a need for preventive strategies targeting not only high-risk population, such as homeless or immigrants, but also the general population. Preventive messages in many languages through the media about potential sources of CO exposure are recommended. Precautions should also be taken during periods of low temperatures.

Activity of the growth hormone/insulin-like growth factor-I axis in critically ill children.

Critical illness has an important impact on the human endocrine system. Very few studies have been performed to elucidate the alterations of the GH/IGF-I axis in acutely ill children. The aim of this study was to investigate several parameters of this axis in children with trauma (TRA) and sepsis (SEP) requiring admission to the pediatric intensive care unit (PICU). A total of 16 children, ten with TRA and six with SEP (age 1-10 years) as well as 18 healthy children (CS) of similar age and gender were included in the study. Two children, one with TRA and one with SEP, died. Serum IGF-I and -II, IGFBP-1 and -3, and GH levels were measured on days 1, 3 and 7 after admission. GH levels were higher in the patients than in CS (p = 0.04), with no difference between TRA and SEP, and were elevated during PICU stay (p = 0.05). Serum IGF-I, -II and IGFBP-3 were lower in the patients than in CS (p = 0.03, 0.02 and 0.001, respectively) with a tendency to increase up to day 7. Finally, IGFBP-1 levels were similar in the patients and CS. These findings indicate that critically ill children are characterized by low levels of IGF-I and -II as well as IGFBP-3 accompanied by elevated levels of GH, probably reflecting the development of peripheral GH resistance. No significant differences were found between the different catabolic conditions, sepsis and trauma.

Driving under the influence in Greece: a 7-year survey (1998-2004).

Alcohol is one of the main causes of traffic accidents worldwide. Its use decreases significantly the driving ability of an individual increasing in this way the possibilities of their involvement in motor-vehicle accidents. The above possibilities are increased when a psychoactive substance has been taken in combination with alcohol due to their synergistic effect. The Laboratory of Forensic Medicine and Toxicology of the University of Athens is authorized to perform the toxicological investigation of traffic accidents that happen in the southern part of Greece. The objective of the present study was to identify the prevalence of alcohol and other psychoactive substances among drivers involved in road traffic accidents in Greece during the period 1998-2004. Alcohol was detected in the blood of about 37% of the drivers involved in traffic accident during the years 1998-2000. The detection of alcohol was lower (29%) in the years 2001-2004. Cannabis, benzodiazepines, opiates, and cocaine were found in 4%, 4%, 4% and 1% of the total number of cases, respectively. The above values were compared with those of a previous study concerning the period 1995-1997 and the reasons for the reduction of the number of alcohol-related traffic accidents during the last years are discussed.