Drugs of abuse--an analysis based on cases from the Kraków Department of Clinical Toxicology of Jagiellonian University College of Medicine in 1997-2000.

The aim of the study was to present the frequency of acute drug overdosing by dependent patients in the years 1997, 1998, 1999 and 2000, and to compare the numbers of poisoned addicts suffering withdrawal syndrome and seeking detoxification. The analysis includes data for all drug addicts treated at the Kraków Department of Clinical Toxicology in years 1997, 1998, 1999 and 2000 because of drug overdosing and resultant acute intoxication, because of withdrawal syndrome and also the opiate dependent patients qualified to methadone maintenance programme. The patients dependent on ethanol were excluded. A progressive increase in number of poisonings with psychoactive substances was noted in analysed years, respectively 231, 298, 331 and 442 patients. Drugs of abuse, were the most frequent cause of admission. Also incidence rate of poisoning expressed per 10,000 of Kraków inhabitants was highest for the cases admitted because of overdosing or craving for narcotics. Opiate derivatives produced at home from poppy straw or from juice of poppy head (so called "kompot" or "Polish heroin") were the most common cause of admission in all the analysed years: increase in number of acutely poisoned, and also increase in number of opiate dependent patients who suffered withdrawal syndrome and sought detoxification was noted in 2000 as compared to years 1998 and 1999. Opiate derivatives followed by amphetamine, as the single toxic agent or in mixed combinations, were still the most common drugs of abuse detected in body fluids. The men were dominant in all the analysed years, but the increase in number of depended women was observed through the years under analysis.

[Diagnosis of ethanol dependence using the CAGE and SAAST questionnaire in selected therapeutic populations]. / Rozpoznawanie uzaleznienia alkoholowego przy pomocy kwestionariuszy CAGE i SAAST w wybranych populacjach terapeutycznych.

An diagnosing of ethanol dependence, despite of clear ICD 10 criteria, in patients treated particularly at the toxicological and detoxication wards, but also in other hospital wards is still a difficult task. Several questionnaires have been developed for easier detection of symptoms, the way of drinking and also for economic, family and medical effects of ethanol drinking in examined patients. A high sensitivity and specificity of CAGE and SAAST questionnaires allowing to identify problem drinkers or alcohol dependence in 192 patients of Kraków Department of Toxicology and 475 patients of Detoxification Unit was stated in the study. The CAGE questionnaire has allowed to identify the possibly ethanol dependence in group of 74 patients hospitalized at the Ward of Internal Diseases and Dialysis of Town Hospital in Sieradz, because of illness, that were not connected with alcohol drinking.

[Use of buprenorphine as a substitute treatment for opiate dependence in the Toxicology Clinics--introductory clinical report]. / Zastosowanie buprenorfiny w leczeniu substytucyjnym uzaleznienia od opiatów w Klinice Toksykologii--wstepne doniesienie kliniczne.

That the problem of drug addiction is still growing up, so there is the necessity for widen of treatment panel for psychoactive substances abuse, especially for opiates. Because of the fact, that substituting treatment became to be popular in patients' opinion, more attention were paid on new medicine-buprenorphine. It is an agonist- antagonist of opiates' receptors. Buprenorphine has been successfully used in long-term treatment in United States and in Western Europe. Treatment with buprenorphine has been started in Poland in Toxicological Department in Kraków. This article shows outcomes of substituting treatment with buprenorphine in period from December 2000 to February 2001.

[Contemporary methods in pharmacotherapy in the opiate dependent treatment].

In this review, we present methods of pharmacotherapy in opiate dependence currently used in Poland and worldwide. As problems associated with drug abuse increase in severity, it is particularly important to bring these methods to the attention of medical professionals, governmental agencies and the general public. Here we describe pharmacotherapeutic approaches used in detoxification as well as relapse prevention. The presented methods of detoxification include classical treatments with clonidine and methadone as well as newer methods of rapid and ultrarapid detoxification. Agonists, partial agonists, and antagonists can be used in preventing relapse in detoxified patients. Experimental therapeutic approaches in the treatment of drug dependence are also presented. Psychotherapy and psychiatric care, central to the successful treatment of opiate dependence, are reviewed as well.

[Psychoactive agents: an analysis based on cases from the Department of Clinical Toxicology College of Medicine of the Jagiellonian University in Kraków in the years 1997-1999]. / Substancje uzalezniajace w materiale Kliniki Toksykologii Collegium Medicum Uniwersytetu Jagiellonskiego w Krakowie w latach 1997-1999.

The aim of the study was to evaluate the frequency of acute poisoning with psychoactive substances in adult abusers of Kraków population in 1997, 1998 and 1999 and to compare the number of poisoned patients suffering withdrawal syndrome as predominant. 27.2% (n = 945) of all 3472 acute poisonings treated in the Department of Clinical Toxicology in 1997, 36.9% (n = 1193) of all 3236 treated in 1998 and 47.9% (n = 1546) of all 3233 treated cases that were acute poisoning with psychoactive substances among the abusers of Kraków adult population. Ethanol followed by narcotics in 1998, and by drugs coingested with ethanol and by narcotics in 1997 and 1999 was predominant psychoactive agent in all the analysed years. Organic solvents and glue sniffing and drug dependency increased again in 1999. Opiate derivatives produced at home from poppy straw or juice of poppy head were still the most common narcotic detected in body fluids, but decrease in number of acute opiates poisoning was noted in 1999 as compared to previous analysed years. The most of ethanol abusers aged from 30-49 years. The highest incidence of narcotic and drug dependency was noted in age between 20-29 years.

[Evaluation of selected parameters of lymphocyte activity in umbilical blood. I. Natural cytotoxicity]. / Ocena wybranych parametrów aktywnosci limfocytów krwi pepowinowej. I. Naturalna cytotoksyczno-s-c (NK).

Natural cytotoxic activity in the umbilical blood was estimated in 52 healthy newborns. Mononuclear cells were isolated from the umbilical blood using Boym's method. The mean natural cell cytotoxicity in the examined group was 7.05 +/- 0.9 (SD).

[Relationship between decreased activity of NK cells in umbilical cord blood and infection incidence in children]. / Zaleznosc pomiedzy obnizona aktywnoscia komorek NK we krwi pepowinowej a wystepowaniem infekcji u dzieci.

In our study the natural cytotoxic activity of the umbilical blood of healthy newborns born in 1987 was examined. All mothers of the examined children were healthy and pregnancy was normal. Blood was drawn from the umbilical vein immediately after the delivery to the heparinized tubes. Mononuclear cells of the blood were isolated using the modified Boyums method. The mean activity of the NK cells was 8.6 +/- 1.5 (SE), and was lower than in the studies by other authors. Three years after the delivery all mothers of the examined children got the questionnaire about the health of their babies. After the analysis of the results, the correlation between lowered NK cells activity in the umbilical blood and the morbidity of the children was shown.

[Case of Collet-Sicard-Villaret syndrome caused by metastasis of renal carcinoma]. / Przypadek zespolu Collet-Sicard-Villareta w wyniku przerzutu raka nerki.

The authors report a case in which the last cranial nerves were damaged with development of the Collet-Sicard-Villaret syndrome. The cause was metastasis of clear cell renal carcinoma. The syndrome is extremely rare. The fairly long, intermittent course in this case deserves attention.

[Post-traumatic intracranial bleeding in epilepsy]. / Pourazowe krwawienia sródczaszkowe w przebiegu padaczki

The authors describe 11 cases of intracranial haemorrhage developing during grand mal attacks. The attacks were frequent or very frequent, sometimes they were connected with withdrawal of anticonvulsant treatment or alcohol abuse. In the clinical pattern of changes disturbances of consciousness predominated together with signs of increasing intracranial pressure. In only one case subarachnoid haemorrhage was recognized, in the remaining cases multiple or single intracranial haematomas were found and treated successfully surgically. The possibility of traumatic origin of intracranial haemorrhages may be suggested by presence of cranial fractures. In the material of the authors intracranial bleedings were present in 40.2% of epileptic patients who suffered craniocerebral injury during a seizure.