[Some aspects of suicide in the years 1980-1996]. / Niektóre aspekty zgonów samobójczych w latach 1980-1996.

The reduction of suicide death index in 1981 year and 1989 year, that is in the period of temporary and definitive "Solidarity" victory confirms Emile Durkheim theory that revolution processes increase social integration and prevent suicide decisions. In the years 1991-1994 the number of suicide deaths in Poland was distinctly lower than in other countries of the Soviet Block and republics of the Soviet Union.

[Mild clinical course of left ventricular pseudoaneurysm]. / Tetniak rzekomy lewej komory serca o lagodnym przebiegu klinicznym.

Left ventricular pseudoaneurysm from myocardial infarction is rare but is associated with a high risk of rapid enlargement and rupture. This report describes a 57 year old woman with left ventricular pseudoaneurysm and delayed surgical repair. Seven weeks after myocardial infarction control transthoracic echocardiography revealed a inferolateral left ventricular pseudoaneurysm. Early surgical intervention was recommended but the patient refused hospitalization and surgical repair and continued every day home activity. The symptoms and signs were so mild that she was qualified to 1st class of NYHA classification and 1st class of CCS classification. Six weeks later-ventriculography confirmed the primary diagnosis. During heart surgery the pseudoaneurysm was incised, its fibrous wall with thrombus was resected and the ruptured left ventricular myocardium was satured. She had an uneventful postoperative course. Definitive diagnosis of the pseudoaneurysm was confirmed by histopathological evaluation of the excised left ventricular wall.

[Patients with alcohol problem in the Emergency Department of Medical University of Gdansk]. / Pacjenci z problemem alkoholowym w praktyce Klinicznego Oddzialu Ratunkowego Akademii Medycznej w Gdansku.

Alcohol misuse are severe financial burden for health care system in Poland. AUDIT and CAGE are two questionnaires used for diagnosis of alcohol abuse. We analyzed the incidence of alcohol problem among emergency unit's patients and correlation of this phenomenon with the reason of admittance to the hospital. 30% patients of Clinical Hospital Emergency Unit of Gdansk misuse alcohol. Injuries and acute intoxications were considerably more frequent reason of attendances to emergency unit in population of patients with drinking problem. AUDIT questionnaire is more effective and sensitive diagnostic instrument comparing to CAGE and may be useful for identification for both, addicted and misusing alcohol patients.

[Acute oral double intoxication with caustic substance--a case report]. / Dwukrotne doustne zatrucie substancja zraca--opis przypadku.

Acute oral caustic ingestion may cause serious multiorgan failure. We described a case of patient who ingested twice large amount of liquid sodium hydroxide as a suicidal attempt. According to our knowledge this is the first case report of acute oral double intoxication with caustic substance in the medical literature. Late sequela (as esophagus stricture) after caustic ingestion may lead to extreme cachexia in spite of endoscopic and surgical treatment. Dual caustic ingestion obstructs the diagnostic and treatment and worsens patient's prognosis.

[Acute intoxication with hydrogen peroxide with air emboli in central nervous system--a case report]. / Ostre zatrucie nadtlenkiem wodoru powiklane zatorami powietrznymi osrodkowego ukladu nerwowego--opis przypadku.

UNLABELLED: 54-year-old woman with brain gas emboli after an accidental ingestion of concentrated hydrogen peroxide was described. Hydrogen peroxide (H2O2) is a water-soluble, caustic liquid. Exposure to concentrated (> 30-35%) hydrogen peroxide may cause cardiorespiratory insufficiency, shock, convulsions, coma, and chemical burns of skin and mucous membranes. Arterial gas embolization in central nervous system is a relatively rare complication. There are three possible mechanisms of gas embolization: persisting patent foramen ovale, pulmonary gas emboli caused by aspiration of hydrogen peroxide to the lower respiratory tract, formation of gas emboli after reaching the brain. Absence of gas emboli and cerebral infarction in CT does not exclude intoxication. Hyperbaric therapy is most effective for brain air embolism complicating hydrogen peroxide poisoning in acute phase. Some authors suggested that this therapy is also effective if administered during the subacute phase. CONCLUSIONS: Neurologic symptoms after ingestion of hydrogen peroxide may suggest gas embolism of the cerebral vasculature. The absence of atrial septal defect does not exclude the possibility of cerebral air embolism. The absence of gas and cerebral infarction in CT scans does not exclude brain gas embolism. The use of hyperbaric therapy should be considered in treating severe cases of hydrogen peroxide poisoning.

[Problems in tobacco smoking in opinion of VI year of medical students]. / Problematyka nikotynizmu w opinii studentów VI roku medycyny.

UNLABELLED: The aim of our study was the evaluation of tobacco smoking among students of VI year of Medical University of Gdansk. Anonymous questionnaire was done among one hundred and ten students including 70 women and 40 men in the age from 23 to 29 (24.82 +/- 1.03) years. CONCLUSIONS: 1. There were 12.7% of daily smoking students including 8.6% women and 15% men. 2. Almost 79% volunteers ineffectively attempted to give up smoking within last year. 3. The smoking students abused alcohol (with high likelihood) and used recreational drugs twice more than nonsmoking colleagues. 4. Almost all volunteers (96.4%) want to use smoking cessation intervention in their patients. 5. Above 75% students declared to broaden their knowledge about diagnostic and smoking cessation therapy.

The relationship between suicidal attempts and menstrual cycle in women.

The purpose of the study was to explore relationship between the menstrual cycle and suicidal attempts. A study was performed on 151 fertile females who were admitted to the Clinic of Internal Diseases and Acute Poisonings Medical University of Gdansk during the years 2002-2003 because of suicidal attempts. The inclusion criteria were as follows: fertility, regular menstrual cycle, lack of oral contraceptives, willingness to attend the follow up and willingness to see a psychiatrist. Using the anamnesis the patients were also grouped according to the menstrual cycle into menstrual, follicular, midcycle and luteal phase. According to psychiatric investigations every female was classified to the respective category: situational reaction, depression, schizophrenia, alcohol addiction and sociopathy. Severity of intoxication was classified according to Poisoning Severity Score (PSS). Statistical analysis was done with the use of chi-square test with Pearson correction. Suicidal attempts were the most frequent among females during menstrual phase. The most common diagnosis in females who have attempted suicide were situational reactions which dominated in patients aged 14-21 years. Among attempters with the psychiatric diagnosis of depression, schizophrenia and alcohol addiction the degree of poisoning was significantly more severe than in the patients with situational reaction.

Acute suicidal self-poisonings during pregnancy.

Selected clinical aspects of suicidal attempts during pregnancy were presented. Nineteen pregnant females, in the age range 17-27 (mean 22 +/- 2.58), were admitted to the Clinic of Acute Poisonings in Gdansk and Toxicological Ward in Poznan between 2001 and 2004 because of acute suicidal intoxication. The main attention was put on reasons of self-intoxication, the timing of attempted suicide as well as the influence of intoxication on the mother and the child. For most admitted women it was their first pregnancy (12 cases, 63.2%). The week of pregnancy varied from 4 to 37 (mean 19 +/- 9.3) weeks. The most popular drugs for attempting suicide among pregnant females were benzodiazepines (7 cases, 36.8%). The most often reason of suicidal attempts was unplanned pregnancy (9 cases, 47.4%). There were two miscarriages and one premature birth observed in our cases. Acute self-poisonings during pregnancy appeared to be a relatively marginal problem in the analyzed toxicology clinics and occurred in merely 0.38% of all women hospitalized between 2001 and 2004 in both clinics. The main reason of suicidal attempts in pregnant women was unplanned pregnancy (9 cases, 47.4%). None of the studied females admitted that the main reason of suicidal attempt was an abortion induction.

[Clinical aspects of acute intoxication with ethanol]. / Wybrane aspekty kliniczne ostrego zatrucia alkoholem etylowym.

UNLABELLED: Acute ethanol intoxication and pathologies resulting from its chronic usage are among the most common causes of hospitalization in many countries, affecting all age groups, both genders and almost all social groups. The aim of the study was to evaluate chosen clinical aspects of acute intoxication with ethanol among patients admitted to the Department of Toxicology from 2002 to 2003. Data of 180 patients with acute ethanol poisoning were analyzed. There were 29 women aged from 15 to 65 (mean 33.9 +/- 15.7) years and 151 men aged from 13 to 75 (mean 39.3 +/- 14.8) years in the group. The alcohol addiction was the most common among men (68.9%), and the people over 30 years old (53.9%). In the adolescents (up to 18 yrs. old) the serum ethanol level was significantly lower but the coma grade was higher then in the adult group. There were 20 patients in deep coma (IV grade according to Matthew scale), 6 of whom (3.3% of the intoxicated persons) had acute respiratory failure with the necessity of invasive mechanical ventilation. There were 95 (52.8%) patients with transient elevation of creatine kinase activity from 191 to 14,616 (mean 1056.4 +/- 2604.3) U/L, and 18 (10%) patients with transient serum creatinine concentration elevation (max. 1.8 mg/dl). CONCLUSIONS: The percentage of the addicted to ethanol were significantly higher among men (male to female 1:8.7), and patients over 30 years old. Despite the significantly lower serum alcohol level in adolescents the grade of coma was higher than in the adult group. There were 6 patients in deep coma and acute respiratory failure who required invasive mechanical ventilation.

[Psychological examinations of the personality of patients with cardiac syndrome X]. / Badania psychologiczne osobowosci chorych z zespolem kardiologicznym X.

76 patients with chest pain including 27 men and 49 women from 25 to 75 (mean 49.96 +/- 11.36) years old, were examined by means of the psychological test. All the patients showed positive exercise test and no changes in coronary arteries. Psychological test was done by the use of personality--MMPI--2 (Minnesota Multiphasic Personality Inventory) test and depression was diagnosed by GDS (Geriatric Depression Scale) by J. Yesavage--15 questions version. The highest mean values in MMPI--2 were obtained in neurotic scales. It indicates that emotional disorders in these patients emerge as hypochondriacal and hysterical neurosis. In 37 patients (48.7%) neurotic scales showed typical "conversion valley" and these who show such a change in MMPI--2 talk mainly about somatic complains (not psychological) during long-term stress situation. In 25 (32.9%) patients single psychological symptoms of depression could be seen and depression episodes were diagnosed in 17 patients (22.4%).