Characteristics of physical violence against pregnant women - analysis of medico-legal data and literature review.

Pregnancy is a period which is especially sensitive to physical violence and its aftermath. Subjecting a pregnant woman to violence can have negative effects on both the mother as well as the child. In Poland, there are programs, such as the Blue Card, aimed at protection against violence, however the phenomenon is underestimated. Documentation covering forensic examinations carried out at the request of the police or privately at the Department of Forensic Medicine in Poznan in the years 2015-2020 was analyzed. Out of 7,689 cases, 22 were concluded to meet the criteria of violence against pregnant women. The cases were then further analyzed, consideration of the victim's age, professional status, relations with the perpetrator, form of physical violence, and medical assistance. The average age of the women at the time of the incident was 31.1 years. In 90.1% of the cases, the perpetrator was a known man, usually a current or former partner. The most common injuries were abrasions and bruises, while the most common locations of injuries were the head, neck, and arms. The most common forms of violence were grappling, kicking, and hitting with an open hand. Over 72% of the women sought medical attention after the incident. There is a need for educational programs concerning the effects of violence during pregnancy and ways to help. Gynecologists and midwives play an especially important role, by having direct contact with the patient, thus being able to quickly identify victims of violence and take actions to secure safe environment for the woman and the child.

Prevalence of Physical Violence in the Medical-Forensic Approach in the Years 2015-2020 in City and Neighboring Municipalities: Perspectives from Poland-Poznan Study.

Forensic medical opinions serve the appropriate classification of a crime against health. Violence, a multifaceted phenomenon, requires forensic medical examination in the case of causing damage to health. Due to the effects caused by the perpetrator, the damage to health is divided into severe, medium, and light. This study analyzed 7689 incidents of violence from 2015-2020, taking place in the area subordinate to the Provincial Police Headquarters in Poznan, based on anonymized documentation of forensic medical examinations performed at the Department of Forensic Medicine in Poznan at the request of the Police and privately. The analysis took into account: units ordering the test, type of exposure, medical help, sex and age of the victim, places of the incident, classification and localization of injury, manner of impact, attitude of the perpetrator to the victim, profession of the victim, gender of the perpetrator, and remarks. In Poland, statistics on violence victims are underestimated, resulting from the low reporting of crimes committed to law enforcement authorities. There is a need for programs to educate the perpetrator of violence on methods of conflict resolution and programs to prevent violence, covering events taking place in public spaces.

Controversial Interactions of Tacrolimus with Dietary Supplements, Herbs and Food.

Tacrolimus is an immunosuppressive calcineurin inhibitor used to prevent rejection in allogeneic organ transplant recipients, such as kidney, liver, heart or lung. It is metabolized in the liver, involving the cytochrome P450 (CYP3A4) isoform CYP3A4, and is characterized by a narrow therapeutic window, dose-dependent toxicity and high inter-individual and intra-individual variability. In view of the abovementioned facts, the aim of the study is to present selected interactions between tacrolimus and the commonly used dietary supplements, herbs and food. The review was based on the available scientific literature found in the PubMed, Scopus and Cochrane databases. An increase in the serum concentration of tacrolimus can be caused by CYP3A4 inhibitors, such as grapefruit, pomelo, clementine, pomegranate, ginger and turmeric, revealing the side effects of this drug, particularly nephrotoxicity. In contrast, CYP3A4 inducers, such as St. John's Wort, may result in a lack of therapeutic effect by reducing the drug concentration. Additionally, the use of Panax ginseng, green tea, Schisandra sphenanthera and melatonin in patients receiving tacrolimus is highly controversial. Therefore, since alternative medicine constitutes an attractive treatment option for patients, modern healthcare should emphasize the potential interactions between herbal medicines and synthetic drugs. In fact, each drug or herbal supplement should be reported by the patient to the physician (concordance) if it is taken in the course of immunosuppressive therapy, since it may affect the pharmacokinetic and pharmacodynamic parameters of other preparations.

Changes in complete blood count parameters influenced by endocrine disorders.

Complete blood count is one of the most common diagnostic methods used in everyday practice. Hormonal status is known to affect blood count parameters. The aim of this study is to summarize changes in blood count that may indicate endocrine disorders, based on a literature review. Red cell parameters deteriorate in thyroid disorders including autoimmune thyroiditis and tend to resolve with appropriate treatment implementation. The most frequent form of anaemia associated with thyroid dysfunction is normocytic anaemia. Macrocytic anaemia is more typical of autoimmune thyroiditis-induced hypothyroidism, while microcytic anaemia is more common in hyperthyroidism. Unexplained anaemia or an increase in red cell distribution width should prompt the investigation of thyroid disorders. Cushing's disease may manifest as an increase in white blood cells and platelets. In the blood smear, neutrophilia is often present, while lymphocytes and eosinophils may be within the lower normal range. Hypercortisolism may induce both hyperaemia and anaemia. In hypopituitarism, a decrease in red blood cell count, haemoglobin, haematocrit, and platelets is observed. Acromegaly may be accompanied by an increase in mean corpuscular volume of erythrocytes. Testosterone deficiency is manifested by a decrease in red cell parameters, whereas hyperandrogenism may lead to polycythaemia. In polycystic ovary syndrome an increase in white blood cell count reflects an underlying inflammatory state. Complete blood count analysis is an easily available and cost-effective additional tool in the diagnosis and treatment monitoring of endocrine disorders.