The assessment of risk factors for febrile seizures in children.

OBJECTIVE: The aim of the paper was to assess the risk factors of febrile seizures in children. METHODS: The paper presents an analysis of a group of 176 children aged 6 months to 5 years who were admitted to A&E because of febrile seizures. RESULTS: The analysed group of 176 children comprised 61.96% boys and 38.07% girls, and the average age equalled 23 months. Family history was significant in 9.66% of patients. A statistically significant difference was noticed between insignificant family history and the incidence of febrile seizures. In all the studied groups of children the factor that determined the incidence of febrile seizures was a sudden increase in the body temperature with an infection of the upper respiratory tract of several day's duration as another cause. Febrile seizure incident was most frequently associated with a sudden increase in the body temperature in 53.40% children. A statistically significant difference was observed between persisting fever and an increase thereof during the day. Yet another factor predisposing for febrile seizures incidence was an infection of the upper respiratory system that could be observed in 32.95% patients. The mean body temperature when the seizures occurred was 38.9°C. CONCLUSIONS: A sudden increase in the body temperature within the first day of pyrexia predisposes for the incidence of febrile seizures and it was proved that it depends on how long fever persists during the day. The other factor triggering the seizures was an infection of the upper respiratory tract of several days' duration.

The assessment of laboratory parameters in children with fever and febrile seizures.

OBJECTIVE: The aim of the research paper was to assess selected laboratory results in children with fever without seizures and febrile seizure. MATERIALS AND METHODS: The paper presents an analysis of a group of 306 children aged 6 months - 5 years who were admitted with diagnosed fever without seizures and febrile seizures in Specialized Health Care Centre for Mother and Child in Poznan between 1st January 2008 and 31st December 2009. Out of the diagnostics procedures performed in children the following ones were taken into consideration: BCC and CRP. RESULTS: Of the analyzed group of 306 children, 59.48% were boys and 40.52% were girls. In the studied group 61.93% were boys and control group 56.15% were boys. Mean age of admitted children was 22 months. In the study group mean body temperature was 39.0°C and in the control group 38.6°C. A statistically significant difference was found between body temperature of study and control group (p = .005). The mean C-reactive protein level in the study group was 15.73 mg/L and in the control group 58.20 mg/L. There was a statistically significant difference (p < .001). There was a statistically significant difference between the number of lymphocytes and neutrophils (p < .001). There was also a statistically significant difference between the number of hemoglobin, hematocrit and platelets. CONCLUSIONS: The study showed that children with FS, had statistically significant higher neutrophils level compared to those with fever without seizures. The number of lymphocytes was lower in children with FS than in children with fever without seizures.

[Deaths in the sobering station in Poznan]. / Zgony w izbie wytrzezwien w Poznaniu.

Post mortem examination protocols of the Chair and Department of Forensic Medicine, University of Medical Sciences in Poznan, pertaining to deaths occurring in the Sobering Station in Poznan in the years 1956-2008 were selected. In the analyzed period, 117 such cases were identified, what constituted approximately 2 deaths per annum. The majority of deaths occurred in males; women constituted a small percentage of all the cases. Over 3/4 of deaths were seen in patients between 26 and 50 years of life. Acute alcohol intoxication, acute respiratory and circulatory failure and cerebrocranial injuries constituted the main causes of death. Moreover, in few cases, the detained person committed suicide by hanging. Only in a few situations had the deceased patients been previously examined by a doctor in a hospital, but had been refused admission and had been referred to a sobering station. The results show that over 3/4 of deaths in the Poznan Sobering Station was a consequence of misdiagnosis, most frequently concerning unrecognized acute alcohol intoxication, cerebrocranial injuries or acute myocardial infarction. A change of regulations concerning the functioning of sobering stations involving introduction of breathanalyzers for testing blood alcohol levels and implementation of other tests did not result in a decreased number of deaths in sobering stations due to acute alcohol intoxication.

[Treatment based on patient's consent: controversies, doubts, ambiguities]. / Leczenie na podstawie zgody pacjenta - kontrowersje, watpliwosci, niejasnosci.

The authors aimed at directing the reader's attention to regulations by law related to the consent to treatment, the form and interpretation of which may induce controversies among clinicians. Among various problems associated with such a vast topic, the authors focused on the issue of the so called "printed form consent", commonly practiced, but legally groundless in view of the legal regulations in force. The report also presented selected aspects of obtaining consent to treatment of a juvenile patient, specifying and discussing unclear and doubtful situations. Another topic stressed in the paper involved treatment executed in the absence of consent or when preferences of the patient are unknown, particularly in emergencies. Finally, selected aspects of compulsory procedures were presented, in particular the principles of compulsory examination of a patient in penal proceedings and the use of constraint in the emergency detoxification centers.