Effects of complete water fasting and regeneration diet on kidney function, oxidative stress and antioxidants.

OBJECTIVE: The aim of the study was to observe the influence of 11-days complete water fasting (WF) and regeneration diet (RD) on renal function, body weight, blood pressure and oxidative stress. BACKGROUND: Therapeutic WF is considered a healing method. METHODS: Ten volunteers drank only water for 11 days, followed by RD for the next 11 days. Data on body weight, blood pressure, kidney functions, antioxidants, lipid peroxidation, cholesterols, triacylglycerols and selected biochemical parameters were obtained. RESULTS: WF increased uric acid and creatinine and decreased glomerular filtration rate. After RD, the parameters were comparable to baseline values. Urea was not affected. Lipid peroxidation (TBARS) decreased and maintained stable after RD. Fasting decreased α-tocopherol and increased γ-tocopherol, no significant changes were found after RD. Coenzyme Q10 decreased after RD. HDL-cholesterol decreased in WF. Total- and LDL-cholesterol decreased after RD. Other biochemical parameters were within the range of reference values. CONCLUSIONS: The effect of the complete fasting on kidney function was manifested by hyperuricemia. Renal function was slightly decreased, however maintained within the reference values. After RD, it returned to baseline values. The positive effect of the complete water fasting was in the reduction of oxidative stress, body weight and blood pressure (Tab. 3, Ref. 25).

Psychoactive substances related to the deaths.

The study included all deceased who died in relation to psychoactive substances abuse in the regions of Bratislava and Trnava city districts within a two-year period of the years 2007-2008. All the cases were autopsied by the standard method completed with toxicological analyses. There were reported total 84 fatalities related to psychoactive substances. From this amount, 38 cases (45 %) belong to the group of direct deaths (poisonings) and 46 cases (55 %) to the group with other cause of death. Out of the total number, 83 % were related to men and 17 % to women. More than 50 % of the cases were related to the age up to 34 years. In the group of poisonings, the most frequently detected substances were opioids themselves or in combination with other substances in 53 %. In the group of the indirect deaths, the most frequent category of death was suicide in 39 %. The most frequently detected psychoactive substances were central nervous system stimulants in 40 % of cases (Tab. 6, Fig. 1, Ref. 16).

Diagnostics of fatal hydrogen sulfide poisonings.

INTRODUCTION: Cases of fatal hydrogen sulfide poisonings are rarely presented in forensic medicine practice. They mostly occur in occupational settings and occasionally are mass. Due to occupational poisonings caused by gases, hydrogen sulfide is ranked second regarding frequency-dependent incidence. Hydrogen sulfide at high concentrations is undetectable to human senses resulting in increased risk of fatal poisoning. Such poisonings represent a particular group with respect to their objectification by toxicological analysis. AIM: The aim of this paper is to demonstrate possibilities of laboratory diagnostics of fatal hydrogen sulfide poisonings. PATIENTS AND METHODS: The paper provides a retrospective overview of 15 cases of fatal hydrogen sulfide poisonings which occurred in the history of the Institute of Forensic Medicine of the School of Medicine, Comenius University in Bratislava. All cases were completely analysed by morphological and toxicological methods. The samples of blood and pulmonary tissue were examined in the toxicological analysis. The method of analysis of alveolar air was developed by Bauer. An experiment for detection of post-mortem production of hydrogen sulfide in the body was performed. RESULTS: Morphological findings in all autopsied and analysed cases were similar and nonspecific for poisoning diagnosis. A significant change in possibilities of toxicological analysis occurred in 1968. Since then a direct identification of toxic gas through the analysis of alveolar air has been possible. CONCLUSION: Taking into consideration summarization and comparison of the analysis results of the cases from archive materials of the authors, it is possible to claim that at the workplace in Bratislava a unique objective method of proving this gaseous poison in biological material used so far has been developed. Some negative or unconvincing results of toxicological analysis again refer to pitfalls of diagnostics of hydrogen sulfide poisonings, which must be complex and based upon an efficient collaboration particularly between a medical examiner and toxicologist-analyst together with other bodies complementing the required spectrum of investigated circumstances and clinical data.

Fatal methadone intoxication in a 11-month-old male infant.

INTRODUCTION: The number of fatal methadone intoxications in adults has been increasing in parallel with the use of methadone for opiate substitution therapy. Methadone intoxication in children occurs rarely. Its diagnostic possibilities on the basis of clinical findings are often limited. The aim of this paper is to demonstrate a case of an 11-month-old male infant, who unexpectedly died without a previous disease history. METHODS: The complex morphological analysis of the case was performed by routine methods. Toxicological analysis was aimed at detection of the presence of ethanol, psychoactive and other forensically relevant substances in available biological materials. RESULTS: Morphological findings were non-specific. Toxicological analysis of biological materials failed to reveal the presence of ethanol in body fluids. In analysed materials the presence of methadone was found at the following concentrations: in blood serum 1.3 microg/mL (calculated to 0.7 microg/mL in whole blood), in the liver 5.0 microg/g, in the kidney 2.6 microg/g and in urine 3.2 microg/mL. CONCLUSIONS: The cause of death in an 11-month-old male infant who had been referred to the autopsy with a diagnosis of sudden infant death syndrome was established as fatal methadone intoxication. With respect to determined results of toxicological analysis apart from setting the diagnosis of intoxication it is not possible to comment on the question concerning repeated administration of methadone. A high likelihood of administrating methadone to the infant by another person exists. Neither mother nor her partner who was not the infant's father is registered in the Centre for Treatment of Drug Dependencies and thus the origin and source of the methadone still remains unknown.

Collaboration between medical examiner and toxicologist-analyst.

Negative effects of the increasing number of toxic substances in the external environment affecting the human organism are highly reflected in everyday forensic practice. In parallel with new circumstances also the methods enabling identification of heterogeneous substances have been developing. Demonstrating evidence is more challenging and sophisticated particularly in cases with proving several xenobiotics including metabolites and their possible interaction. Poison intoxications of unknown origin can represent a diagnostic problem. Consequently close collaboration between involved forensic professionals i.e. medical examiner and forensic toxicologist-analyst is inevitable. The data provided by police investigators are significant as well--investigated circumstances, testimonies and in case of hospitalization detailed data from clinicians. In everyday forensic practice the shortage of medical examiners specialised in toxicology and knowledgeable toxicologists-analysts has been increasingly experienced. The urgent requirement for more specialists arises more frequently not only in suspected fatal poisonings but also in assessing of analysis results particularly in cases of persons directly involved in road traffic accidents, work-related injuries, etc. The number of cases requiring detecting psychoactive substances is also increasing. On the other hand recent experience demands expanding the spectrum and increasing the number of indications of toxicological analyses from medical examiners involved in performing autopsies. At present the Slovak forensic workplaces are in the process of being equipped with instrumentation designed for expanding the spectrum of toxicological analyses and improving their quality. There hence emerges a need for developing the contemporary concept of Slovak forensic toxicology with respect to both organizational and methodological aspects focused on better interaction of activities carried out by medical examiners and toxicologist-analysts. The essential part of developing the coordination of both expert groups is also postgraduate education with an emphasis on improving mutual recognition principles of their work.

[Verification and determination of opiates in the urine and blood with thin-layer chromatography followed by densitometry in fatal cases of drug abuse]. / Dôkaz a stanovenie opiátov v moci a v krvi pri ich zneuzívaní v letálnych prípadoch metódou tenkovrstvovej chromatografie s následnou denzitometriou.

Urine and blood concentrations of free and total morphin or 6-monoacetylmorphin were presented in fatal cases of morphin type opiates abuse. A solid phase extraction method was developed for isolation of drugs and their metabolities from biological material which used Separcol small columns with non-polar contents SI C 18T. Thin layer chromatography with densitometry anabled screening for quality evaluations. Resultes were compared with those obtained by fluoropolarizing immunodetection on Abbotts TDxFLx device. Possibility and cause of false positive results were discussed when using initial, screening, commercially available immunotests.

[The effect of streptozotocin diabetes on lipid levels in the myocardium in young rats]. / Vplyv streptozotocínového diabetu na obsah lipidov v myokarde mladých potkanov.

The effect of intraperitoneally administered streptozotocin was studied in 8-, 10-, and 12-week-old rats. The total triacylglycerol content was found to be significantly increased in all the three groups studied, and that by 59.64% in the 8-week old group, by 54.86% in the 10-week-old group, and by 50.57% in the 12-week-old group. The level of total phospholipids increased only in the 8-week-old group of diabetic animals, and that by 11.09%, whereas in the other age groups studied it remained unchanged. In the level of individual phospholipids changes occurred in 8-week-old rats, namely phosphatidylcholine increased by 53.0% and sphingomyelin by 23.8%. In 10- and 12-week-old diabetic rats the only change was recorded in the level of cardiolipin which increased by 54.23% in 12-week-old animals.

Genetic polymorphism of the C4 component of human complement in the Slovak population.

The distribution of C4 phenotypes and gene frequencies were studied in 104 genetically unrelated persons of Slovakia using high-voltage agarose gel electrophoresis with subsequent immunofixation. Five C4A alleles and three C4B alleles were detected. The gene frequencies were as follows: A2 = 0.0576, A3 = 0.7644, A4 = 0.0336, A6 = 0.0625, AQ0 = 0.817, B1 = 0.7836, B2 = 0.1009, BQ0 = 0.1153. The C4AQ0 and C4BQ0 alleles established by densitometry appeared in the Slovak population in 16.34% and 23.07%, respectively.

[Phospholipids in the human myometrium in various stages of contraction before and during labor]. / Fosfolipidy humánneho myometria pri rôznych stavoch kontrakcnej cinnosti pred termínom a v termíne pôrodu.

A detailed analysis of the myometrium showed that the physical state of phospholipids--fluidity--depends on the ratio of their individual components and changes in relation to the state of contractile activity. The results indicate that before term of labor changes in the fluidity of myometrial phospholipids as well as increased availability of arachidonic acid for prostaglandin synthesis can induce preterm onset of contractile activity. Possibilities of affecting these mechanisms, which belong to the many potential factors inducing preterm labor, are discussed.

[Lipid composition of the myometrium during labor]. / Lipidické zlozky myometria pocas pôrodnej cinnosti.

Lipids represent one of the basic components of each cellular and subcellular membrane of the myometrium and their fluidity has a strong influence upon membrane function. Human myometrium was obtained at cesarean sections. Lipids were separated by one-dimensional thin layer chromatography. The chromatoplates were determined on the densitometer Shimadzu CS 930. Lipid profile of the myometrium was studied before the 37th week of pregnancy, at term without contractile activity, further during at term labor with normal contractile activity and at failure of myometrial contractility. Analysis of the obtained data showed changes in lipid fluidity, namely a decrease before the 37th week of pregnancy and at failure of myometrial contractions during at term labor. The decrease of fluidity was caused by a higher content of total cholesterol and a lower content of total phospholipids in the myometrium.