[Drug poisonings in children hospitalized in The Regional Hospital No. 2 in Rzeszow in the years 2010-2014]. / Zatrucia lekami u dzieci hospitalizowanych w Szpitalu Wojewódzkim Nr 2 w Rzeszowie w latach 2010-2014.

INTRODUCTION: Drug poisoning is a frequent cause of hospitalization in children and youth. The aim of the study was to evaluate the prevalence of drug poisoning in children in the region of Rzeszów city. MATERIAL AND METHODS: Medical records of paediatric patients hospitalized in The Regional Hospital No. 2 in Rzeszow between 2010 and 2014 was reviewed and data were collected using scientific protocol. The following factors were analyzed: type of medication causing intoxication, the causality of the event, duration and seasonality of hospitalization as well as demographic data, such as the patient's age and sex. RESULTS: Within the analyzed period 295 children (194 girls and 101 boys) aged between 6 months and 18 years were hospitalized due to acute drug poisoning. Nonopioid painkillers, antiepileptic drugs and sedatives, affecting the cardiovascular system were the main classes of ingested medications. A growing phenomenon of recreational use of drugs which induce euphoria, especially dextromethorphan, was observed among young people. CONCLUSIONS: Due to rising incidence of drug poisoning in childhood physicians and pharmacists should extend their efforts to instruct and educate parents and caregivers about correct drag dosing, safe storage conditions and principles of poisoning prevention.

Microstructure and Mechanical Properties of In Situ Synthesized Metastable ß Titanium Alloy Composite from Low-Cost Elemental Powders.

The titanium matrix composite was produced through a hot compaction process at 1250 °C using the mixture of elemental powders with chemical composition of Ti-5Al-5Mo-5V-3Cr and 2 wt.% addition of boron carbide. The phase analysis via X-ray diffraction method was performed to confirm the occurrence of an in situ reaction between boron carbide and titanium. Then, the wide-ranging microstructural analysis was performed using optical microscopy as well as scanning electron microscopy along with energy-dispersive X-ray spectroscopy and electron backscatter diffraction. Based on this investigation, it was possible to describe the diffusion behavior during hot compaction and possible precipitation capabilities of TiC and TiB phases. Tensile and compression tests were conducted to determine the strength properties. The investigated composite has an ultimate tensile strength of about 910 ± 13 MPa with elongation of 10.9 ± 1.9% and compressive strength of 1744 ± 20 MPa with deformation of 10.5 ± 0.2%. Observation of the fracture surface allowed us to determine the dominant failure mechanism, which was crack propagation from the reaction layer surrounding remaining boron carbide particle, through the titanium alloy matrix. The study summarizes the process of producing an in situ titanium matrix composite from elemental powders and B4C additives and emphasizes the importance of element diffusion and reaction layer formation, which contributes to the strength properties of the material.

Management of Metastatic Pancreatic Cancer-Comparison of Global Guidelines over the Last 5 Years.

Pancreatic cancer (PC) is usually diagnosed at an advanced stage of its development, which results in lower overall survival (OS). Prognosis is also poor even with curative-intent surgery. Approximately 80% of patients with localized PDAC have micrometastases at the time of diagnosis, which leads to a worse prognosis than in other cancers. The objective of this study is to present the progress in the treatment of metastatic pancreatic cancer based on the recommendations of oncological scientific societies, such as ESMO, NCCN, ASCO, NICE and SEOM, over the last 5 years. Combined FOLFIRINOX therapy is mostly a recommended therapy among patients with good performance statuses, while gemcitabine is recommended for more fragile patients as a first-line treatment. The newest guidelines suggest that molecular profiling of the tumor should be the first step in determining the course of treatment. The use of modern molecular therapies in patients with specific gene mutations should extend the survival of patients with this disease.

Processing and Characterization of ß Titanium Alloy Composite Using Power Metallurgy Approach.

The ß titanium alloy matrix composite was made from a mixture of elemental metal powders, including boron carbide. During the high-temperature sintering process, in situ synthesis took place as a result of the TiB and TiC reinforcing phases formed. The identification of these phases was confirmed by X-ray diffraction and microstructural analyses. The presence of unreacted B4C particles and the surrounding reaction layers allowed for the evaluation of diffusion kinetics of alloying elements using SEM and EDS analyses. The direction of diffusion of the alloying elements in the multicomponent titanium alloy and their influence on the in situ synthesis reaction taking place were determined. In addition, the relationship between the microstructural components, strengthening phases, and hardness was also determined. It was shown that in situ reinforcement of titanium alloy produced from a mixture of elemental powders with complex chemical composition is possible under the proposed conditions. Thus, it has been demonstrated that sufficiently high temperature and adequate holding time allows one to understand the kinetics of the synthesis of the strengthening phases, which have been shown to be controlled by the concentrations of alloying elements.

Application of the Strain Compensation Model and Processing Maps for Description of Hot Deformation Behavior of Metastable ß Titanium Alloy.

The flow behavior of metastable ß titanium alloy was investigated basing on isothermal hot compression tests performed on Gleeble 3800 thermomechanical simulator at near and above ß transus temperatures. The flow stress curves were obtained for deformation temperature range of 800-1100 °C and strain rate range of 0.01-100 s-1. The strain compensated constitutive model was developed using the Arrhenius-type equation. The high correlation coefficient (R) as well as low average absolute relative error (AARE) between the experimental and the calculated data confirmed a high accuracy of the developed model. The dynamic material modeling in combination with the Prasad stability criterion made it possible to generate processing maps for the investigated processing temperature, strain and strain rate ranges. The high material flow stability under investigated deformation conditions was revealed. The microstructural analysis provided additional information regarding the flow behavior and predominant deformation mechanism. It was found that dynamic recovery (DRV) was the main mechanism operating during the deformation of the investigated ß titanium alloy.

Evaluation of Hot Workability of Nickel-Based Superalloy Using Activation Energy Map and Processing Maps.

The stress-strain curves for nickel-based superalloy were obtained from isothermal hot compression tests at a wide range of deformation temperatures and strain rates. The material constants and deformation activation energy of the investigated superalloy were calculated. The accuracy of the constitutive equation describing the hot deformation behavior of this material was confirmed by the correlation coefficient for the linear regression. The distribution of deformation activation energy Q as a function of strain rate and temperature for nickel-based superalloy was presented. The processing maps were generated upon the basis of Prasad stability criterion for true strains ranging from 0.2 to 1 at the deformation temperatures range of 900-1150 °C, and strain rates range of 0.01-100 s-1. Based on the flow stress curves analysis, deformation activation energy map, and processing maps for different true strains, the undesirable and potentially favorable hot deformation parameters were determined. The microstructural observations confirmed the above optimization results for the hot workability of the investigated superalloy. Besides, the numerical simulation and industrial forging tests were performed in order to verify the obtained results.

Impact of Time to Initiation of Treatment on the Quality of Life of Women with Breast Cancer.

INTRODUCTION: Breast cancer is the most common malignancy in women. Due to the large number of women living with breast cancer and the increasing incidence of this cancer, it is very important to understand the factors determining the quality of life (QOL) of patients. THE AIM OF THE STUDY: The aim of the study was to determine the impact of time to initiation of treatment on the quality of life of women with breast cancer. MATERIALS AND METHODS: The study involved 324 women with breast cancer, treated at the Podkarpackie Oncology Centre in Brzozów, Poland. The study was conducted using a diagnostic survey, using a standardised questionnaire to measure the quality of life of women treated for breast cancer, i.e., the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC) QLQ-C30 and the QLQ-BR23 module, as well as a proprietary survey questionnaire. Statistical analysis was performed using the Statistica 10.0 software (StatSoft Inc., 2011). A p value of <0.05 was considered statistically significant. RESULTS: The examined women had a reduced overall quality of life and health (M = 53.88). The quality of life was higher in women who consulted a doctor the earliest after noticing initial symptoms of the disease, i.e., up to one week (M = 57.58), compared to patients who delayed the decision (over four weeks; M = 47.8) (p = 0.002). The quality of life was also considered higher by women who received treatment within two weeks of diagnosis (M = 56.79) and was lower for patients who waited for treatment for more than two months (M = 43.68). Statistically significant relationships were demonstrated for functional scales and disease intensity. CONCLUSIONS: Women diagnosed with breast cancer had a considerably lower overall quality of life. A relatively higher quality of life was experienced by patients who consulted a doctor the earliest after discovering symptoms of the disease and those whose waiting time for treatment was shorter. In a systematic manner, the individual stages of diagnosis should be maximally reduced and breast cancer treatment initiated without delay.

Family presence during resuscitation - The experiences and views of Polish nurses.

Understanding healthcare professionals perceptions of family presence during resuscitation (FPDR) may help in choosing an effective strategy of implementing this concept in everyday clinical practice. OBJECTIVES: To determine the experiences and views of Polish nurses about family witnessed resuscitation. DESIGN: A cross sectional survey study. SETTING: Delegates (n = 720) attending the Polish Association of Anaesthesia and Intensive Care Nurses conference participated in the study. A total of 240 questionnaires were correctly completed and returned. MAIN OUTCOME MEASURES: Validation of the Polish version of the tool was undertaken. Exploratory factor analysis extracted three main factors: staff opinions on the benefits of FPDR (α-Cronbach 0.86), opinions on the negative effects (α-Cronbach 0.74) and general views on this practice (α-Cronbach 0.54). These three extracted factors were defined as dependent variables. RESULTS: Out of the sample, 113 (47%) nurses worked in adult intensive care units (ICUs) and 127 (53%) in other acute clinical settings. ICU nurses reported having experiences of FPDR (n = 66, 54%); out of this group 12 (10%) had positive encounters and 46 (38%) reported negative ones. ICU nurses had undetermined opinions on the benefits and potential negative effects of FPDR. Having positive experiences with FPDR influenced ICU nurses' views on the negative effects of FPDR (Z = -2.16, p< 0.03). CONCLUSION: A positive experience of FPDR influences a nurse's views and attitudes in this evolving area of practice.

Changes of procalcitonin level in multiple trauma patients.

BACKGROUND: Some aspects of the pathophysiology of complications in multiple-trauma patients still remain unclear. Mediators of inflammation have been postulated as playing a key role in being responsible for life threatening complications of multiple trauma patients. The objective of this study was to evaluate the prognostic value of procalcitonin (PCT) level in multiple trauma patients. METHODS: A prospective study took place including patients with multiple trauma hospitalised in several hospital units. PCT level was measured in blood from 45 patients, aged 18-70 years using enzyme-linked immunoassay. The patients were divided into three groups: group I - individuals with multiple trauma with central nervous system injury; group II - those with multiple trauma without CNS injury; and group III - patients with isolated central nervous system injury. RESULTS: Initial PCT levels were below 0.5 ng mL(-1) regardless of the cause of trauma. In the 24th hour of observation, a statistically significant increase of PCT concentration vs. initial levels was recorded in all groups of patients. Then PCT levels decreased significantly at the 3rd measurement point in all groups, and they remained unchanged until the last measurement. The highest levels of PCT were observed in multiple trauma patients without CNS injury (group II). In this group of patients, a significantly longer duration of surgery in the post-trauma period affected PCT levels. PCT concentrations in patients who died were significantly greater than in survivors. CONCLUSIONS: A long lasting elevated concentration of procalcitonin in the post-traumatic period, or its repeated increase, is a good marker of developing complications observed earlier than clinical manifestations.