[Evaluation of the renal excretory function using estimated GFR in patients coming to Voivoidship St. Lukas Hospital in Tarnow in the years 2007-2010]. / Ocena funkcji wydalniczej nerek w oparciu o eGFR u pacjentów zglaszajacych sie do Szpitala Wojewódzkiego im. sw. Lukasza w Tarnowie w latach 2007-2010.

BACKGROUND: Studies concerning chronic kidney disease frequency are becoming of more and more interest. This is connected with an increased morbidity and diagnosis of chronic kidney disease. The aim of this study was an analysis of glomerular filtration rate results in patients coming to Emergency Department (ED) of Voivodship St. Lucas Hospital in Tarnów for various medical reasons. MATERIAL AND METHODS: We analyzed patients admitted to ED between 30th March 2007 and 31st December 2010. In that period 121116 patients were seen in ER (52660 females and 68456 males). A creatinine level test was performed using the kinetic Jaffe method with alkaline picrate. Glomerular filtration rate (eGFR) was automatically calculated using the abbreviated MDRD formula. eGFR was evaluated in 26176 persons aged 18-104 years (average 59 years) which constituted 21.6% of all people coming to the hospital. Due to lack of some data and some mistakes the final analysis was performed on 23845 patients (12472 females (52.3%) and 11373 males (47.4%)). The whole study population was divided according to sex and age range; 18-34 years, 35-64 years and above 65 years. Stratification of kidney failure was done using the classification of stages of chronic kidney disease according to NKF KDOQI. RESULTS: Patients with chronic kidney disease stages 3 to 5 comprised 25.2% of the study population. Patients above 65 years constituted 45.9%. That group had also the greatest number of patients with eGFR below 60 ml/min (stages 3, 4 and 5 respectively 79.6%, 83.2% and 60.3%), mostly females. Patients who had a creatinine test performed and eGFR evaluated were more frequently hospitalized than patients without creatinine and eGFR checking. CONCLUSIONS: Among patients admitted to ED 21.6% had eGFR evaluated which allowed classification of those patients to an appropriate stage of chronic kidney disease. 25.2% patients in that group had renal insufficiency. The majority of patients with renal insufficiency were above 65 years of age and mostly women. People who had eGFR evaluated were more frequently hospitalized. Evaluating eGFR in ED can help in diagnosing chronic kidney disease.

[Medical analytical toxicology in Poland in year 2012]. / Kliniczna analityka toksykologiczna w Polsce w 2012 roku.

There are 12 centers of acute poisoning treatment and 9 round the clock toxicological laboratories. Most of the laboratories access evidence of activity run by National Clinical Toxicology Consultant. The paper presents actual status of medical toxicology laboratories in Poland and summarizes activity of the laboratories in the year 2012. In 2012 toxicological laboratories reported 113,719 assays. There were diagnosed 63.8% men and 34.8% women. The toxicological laboratories determine most substances and markers of exposition to chemical compounds important for diagnosis and treatment of acute poisonings (i.e. ethanol, methanol, ethylene glycol, acetaminophen, salicylates, anticonvulsants, carboxyhemoglobin, methemoglobin). There is not possible to determine heavy metals, all medicines and "designed" drugs of abuse in all laboratories. Limited access to reference methods, that enable to confirm results obtained by screening methods (immunological cassette and strip tests) is also a problem.

[Immunoassay methods used to diagnose patients poisoned with psychoactive substances--analytical and interpretation problems]. / Metody immunoenzymatyczne w diagnostyce zatruc substancjami psychoaktywnymi--problemy analityczne i interpretacyjne.

Diagnostics of patients poisoned with psychoactive substances is usually performed by immunoenzymatic methods. The results obtained by the methods are not reliable. A few percent of results can be "false positive" or "false negative". The purpose of the paper was to present cases of "false positive" THC and amphetamine derivatives results obtained in urine of patients treated in Departments of Toxicology in Krakow and in Tarnow. Confirmation tests gave negative results. Interpretation of results obtained by immunoassay methods should include possibility of "false" result. The physician should consider verification of the results and refer confirmation by reference methods.

[Tasks and importance of the acute poisoning center at a multiprofile provincial hospital based on 10 years experience]. / Zadania i znaczenie osrodka ostrych zatruc w wieloprofilowym szpitalu wojewódzkim na bazie wlasnego 10-letniego doswiadczenia.

The thesis presents a short history and way of organization of acute poisoning centre functioning within the internal diseases department in multiprofile provincial hospital. The data show the number of patients treated in particular years as well as the types of toxic substances that caused poisoning, and the number of analyses carried out for the needs of the poisoning centre and other hospital departments, as well as for the local hospitals. Based on the said data the conclusions were presented referring to the role of the centre in helping the people suffering from acute poisoning in number 0.5 million population.