The impact of comorbidities on selexipag treatment effect in patients with pulmonary arterial hypertension: insights from the GRIPHON study.

AIMS: The number of pulmonary arterial hypertension (PAH) patients with comorbidities is increasing and there are limited data on response to PAH-targeted therapies in this population. These post hoc analyses explored the effect of selexipag in PAH patients with cardiovascular comorbidities in the GRIPHON study. METHODS AND RESULTS: Randomized patients (n = 1156) were classified using three methods: (i) by subgroups defined according to previously published comorbidity count and restrictive haemodynamic criteria: Subgroup A (<3 comorbidities and haemodynamic criteria met; n = 962) and Subgroup B (≥3 comorbidities and/or haemodynamic criteria not met; n = 144); comorbidities included body mass index ≥30 kg/m2 , essential hypertension, diabetes, history of coronary artery disease; (ii) by number of comorbidities, with addition of atrial fibrillation (0, 1, 2, 3, 4, or 5); (iii) by presence of individual comorbidities. Selexipag to placebo hazard ratios (HR) and 95% confidence intervals (CI) for morbidity/mortality (primary composite endpoint) were estimated using Cox regression adjusting selexipag effect for baseline covariates. Approximately half of the patients in GRIPHON (n = 584; 50.5%) had comorbidities. Selexipag reduced the risk of a morbidity/mortality event compared with placebo in both Subgroup A (HR 0.66, 95% CI 0.53, 0.82) and Subgroup B (HR 0.50, 95% CI 0.26, 0.96), with no evidence of an inconsistent treatment effect between subgroups (interaction p = 0.432). Consistent results were observed in analyses by number and by specific type of comorbidity. CONCLUSION: Selexipag reduces the risk of a morbidity/mortality event vs. placebo irrespective of patient comorbidity status, suggesting that comorbidity status does not influence the treatment effect of selexipag.

Impact of the female and hermaphrodite forms of Opuntia robusta on the plant defence hypothesis.

The optimal defence hypothesis predicts that increased plant defence capabilities, lower levels of damage, and lower investment in vegetative biomass will occur more frequently in sexual forms with higher resource-demanding tissue production and/or younger plant parts. We aimed to examine the effects of sexual form, cladode, and flower age on growth rate, herbivore damage, and 4-hydroxybenzoic acid (4-HBA), chlorogenic acid, and quercetin (QUE) concentrations in Opuntia robusta plants in central Mexico. Our findings demonstrated that hermaphrodite flowers showed faster growth and lesser damage than female flowers. The effect of cladode sexual forms on 4-HBA and QUE occurrence was consistent with the predictions of the optimal defence hypothesis. However, chlorogenic acid occurrences were not significantly affected by sexual forms. Old cladodes exhibited higher QUE and 4-HBA occurrences than young cladodes, and hermaphrodites exhibited higher 4-HBA concentrations than females. Resource allocation for reproduction and secondary metabolite production, and growth was higher and lower, respectively, in females, compared to hermaphrodites, indicating a trade-off between investment in reproduction, growth, and secondary metabolite production. Secondary metabolite concentrations in O. robusta plants were not negatively correlated with herbivore damage, and the two traits were not accurate predictors of plant reproductive output.

Randomized clinical trial: a double-blind, placebo-controlled study to assess the clinical efficacy and safety of alginate-antacid (Gaviscon Double Action) chewable tablets in patients with gastro-oesophageal reflux disease.

BACKGROUND: The alginate-antacid Gaviscon Double Action (Gaviscon DA) has a combined acid-neutralizing and reflux-suppressing action. Response to treatment in a symptomatic gastro-oesophageal reflux disease (GERD) population has not yet been tested in a large-scale clinical study. AIM: The aim of this study was to assess the efficacy and safety of Gaviscon DA compared with matched placebo tablets in the reduction of upper gastrointestinal symptoms in patients with GERD. PARTICIPANTS AND METHODS: In this multicentre, randomized, double-blind, placebo-controlled study, adults with GERD symptoms (N=424) received Gaviscon DA or placebo tablets for 7 days. The primary endpoint was a clinically important reduction of at least 1.5 points in the Reflux Disease Questionnaire (RDQ) GERD dimension (combined heartburn/regurgitation) between baseline and the end of the treatment. Secondary endpoints included the change in RDQ score from baseline for individual RDQ dimensions and Overall Treatment Evaluation. RESULTS: A significantly greater proportion of patients treated with Gaviscon DA met the primary endpoint compared with placebo (47.8 vs. 33.2%, respectively, P=0.0031; odds ratio: 1.85, 95% confidence interval: 1.23-2.78). A significant treatment effect was also observed for heartburn, regurgitation and dyspepsia individually. Patients in the Gaviscon DA group rated their overall treatment response greater than patients in the placebo group [mean Overall Treatment Evaluation (SD): 3.2 (3.08) vs. 2.2 (3.34); P<0.001]. No notable differences in the incidence of adverse events were observed between treatments. CONCLUSION: The alginate-antacid combination, Gaviscon DA, is an effective and well-tolerated treatment to reduce reflux symptoms and associated dyspepsia in symptomatic GERD patients.

First description of extrafloral nectaries in Opuntia robusta (Cactaceae): Anatomy and ultrastructure.

To our knowledge, there are no studies about the structure and ecological function of extrafloral nectaries (EFNs) in Opuntia robusta. This is the first description of EFNs in O. robusta, where young spines have an interesting structure and a secreting function, which are different from EFNs described in other Cactaceae species. We used light, scanning-electron, and transmission-electron microscopy to examine morphology, anatomy, and ultrastructure of the secretory spines in areoles in female and hermaphrodite individuals of O. robusta. Young cladodes develop areoles with modified and secretory spines as EFNs only active during the early growth phase. EFNs are non-vascularized structures, with no stomata, that consist of a basal meristematic tissue, a middle elongation region, and an apical secretory cone formed by large globular epidermal cells, containing nectar and medullar elongated cells. We observed the presence of Golgi apparatus, vesicles and plastids in the medullar and sup-epidermal cells of the spine. We propose that the nectar is stored in the globular cells at the apex of the spine and secreted by breaking through the globular cells or by pores. We recorded a more frequent presence of ants on younger cladode sprouts producing young secreting spines: this result is parallel with the predictions of Optimal Defense Hypothesis, which states that younger plant organs should be better defended than older ones because their loss produces a higher fitness impairment. Although Diaz-Castelazo's hypothesis states that a more complex structure of EFNs correlates with their lower among-organs dispersion, comparing to less complex EFNs, non-vascularized structure of EFNs in O. robusta is not associated with their higher among-organs dispersion likened to O. stricta, which produces vascularized EFNs. We provide evidence that this characteristic is not a good taxonomic feature of Opuntia genus. Moreover, the comparison of EFNs of O. robusta and O. stricta suggests that the hypothesis of Diaz-Castelazo should be revised: it is rather a rule but not a law.

Predicting rapid analgesic onset of ibuprofen salts compared with ibuprofen acid: Tlag, Tlow, Tmed, and a novel parameter, TCmaxRef.

OBJECTIVE: This study evaluated the early absorption characteristics of ibuprofen salt formulations and standard ibuprofen acid (the reference). METHODS: In this open-label, crossover, single-center study (NCT02452450) in 32 healthy, fasted adults receiving single oral doses (400 mg ibuprofen) of ibuprofen lysine, ibuprofen liquid capsule, ibuprofen sodium, ibuprofen acid, and paracetamol, intensive blood sampling was conducted for up to 6 h. Time between dosing and the start of absorption (Tlag); a novel parameter, time at which the test formulations (ibuprofen salts) reached the observed maximum plasma concentration (Cmax) of the reference (standard ibuprofen acid) (TCmaxRef); and time to achieve therapeutic plasma concentration were measured. RESULTS: Ibuprofen was absorbed more rapidly from the salt formulations than the reference; Tlag was 3.3-6.4 min for salt formulations compared with 10.9 min for the reference, and 100% of subjects had a Tlag ≤ 5 min for ibuprofen lysine, compared with 61% for ibuprofen liquid capsule, 21% for ibuprofen sodium, and 7% for the reference. TCmaxRef was 3.22-5.74-times shorter for salt formulations than for the reference (all p < .0001). The salt formulations reached therapeutic levels earlier than the reference (all p < .0001). All formulations were well tolerated. CONCLUSIONS: This study shows that ibuprofen salts are absorbed faster than ibuprofen acid. Tlag and TCmaxRef demonstrated early start and increased speed of absorption of salts compared with the reference, and may predict more rapid onset of analgesia.

Alginate antacid (Gaviscon DA) chewable tablets reduce esophageal acid exposure in Chinese patients with gastroesophageal reflux disease and heartburn symptoms.

OBJECTIVE: To assess the efficacy of Gaviscon Double Action (DA) alginate antacid chewable tablets for reducing esophageal acid exposure in Chinese patients with gastroesophageal reflux disease (GERD). METHODS: Altogether 44 patients reporting moderate to severe heartburn symptoms underwent two pH monitoring visits. The treatment sequence was randomized to patients received DA alginate antacid or placebo at one visit and the alternate treatment 7 days later. After a standardized reflux-provoking meal, patients took four tablets of DA alginate antacid or placebo. Esophageal pH was measured for 4 h post-dosing using an electrode positioned 5 cm above the lower esophageal sphincter. The primary end-point was the percentage of 4-h post-dosing period with pH <4. Secondary end-points were number of acid reflux episodes (pH <4), longest reflux time and DeMeester scores. RESULTS: All 44 patients completed the study and provided data for analysis. With DA alginate antacid, the mean percentage time with pH <4 was 5.1%, significantly less (P = 0.0003) than with placebo (14.8%). DA alginate antacid was statistically significantly superior (P = 0.0290) to placebo (from at least twofold to threefold better) for all other end-points. Two patients reported two mild adverse events (AEs) that resolved within a month of completing the study. No patients had serious and/or severe AEs and none withdrew due to AEs. CONCLUSIONS: DA alginate antacid was statistically significantly superior to placebo in reducing post-prandial acid exposure without serious clinically relevant health risks. These findings suggest DA alginate antacid tablets are appropriate for treating acid reflux in Chinese GERD patients with heartburn symptoms.

Contact allergy to nickel: patch test score correlates with IL-5, but not with IFN-gamma nickel-specific secretion by peripheral blood lymphocytes.

Traditionally, allergic contact dermatitis (ACD) has been associated with the activity of Th1 lymphocytes that secrete interferon gamma. Recent evidence indicates that other cells, e.g. interleukin 5 (IL-5)-secreting Th2 or Tc2 cells may be among the key effectors of ACD. The aim of the present study was to assess the influence of nickel-specific IFN-gamma secretion (marker of Th1 and Tc1 activity) and IL-5 secretion (Th2 and Tc2) on the clinical outcome (patch test score) in nickel-allergic patients. 40 women with suspicion of ACD were involved, aged from 14-54 (median 31.5) years. They were patch tested with NiSO(4). Peripheral blood mononuclear cells (PBMC) from the patients were cultured and analysed for IFN-gamma and IL-5 secretion in response to NiSO(4). A series of statistical models (classical logit or cloglog link function) were used. We demonstrate that nickel-specific IL-5 secretion by PBMC is correlated with the intensity of patch test reaction (p=0.05), with no significant effect of IFN-gamma. An increase in the nickel-specific IL-5 secretion from PBMC by 10 pg/ml is associated with a 10-20% increase (depending on statistical model) in the odds ratio of the patient to have a higher patch test score. These findings support the assumption that cells secreting IL-5 (e.g. Th2, Tc2) play a more important role in the pathogenesis of ACD than previously thought.

HSP90 antagonist, geldanamycin, inhibits proliferation, induces apoptosis and blocks migration of rhabdomyosarcoma cells in vitro and seeding into bone marrow in vivo.

In this study, geldanamycin (GA) was found to have an antiproliferative effect on both embryonal and alveolar rhabdomyosarcoma (RMS) cell lines. The maximum level of inhibition reached 80% for both embryonal and alveolar RMS. After GA treatment, cells also became apoptotic as judged by Annexin V-positive staining, activation of caspase-3 pathway and poly(ADP ribose) polymerase cleavage. GA was responsible for the arrest of RMS cells in both G1 and G2/M phases of the cell cycle. G1 blockade, however, was transient and was seen only in the first 24 h of GA treatment. RMS often gives distant metastases to various organs including bone marrow. RMS cells express high levels of MET receptor and respond to hepatocyte growth factor with increased motility. In our study, we found that GA decreased the level of MET expression and inhibited the chemotaxis of RMS cells toward the hepatocyte growth factor gradient. GA also blocked the homing of RMS cells into bone marrow of severe combined immune deficient mice. In all our experiments embryonal RMS cell lines were significantly more sensitive, and lower concentrations of GA were sufficient to block embryonal RMS cell proliferation, induce apoptosis and inhibit motility. Our data show that the HSP90 inhibitor GA has the potential to become a new drug in RMS treatment. It blocks RMS proliferation, decreases cell survival and inhibits motility of RMS cells.

The influence of carbamazepine plasma level on blood pressure and some ECG parameters in patients with acute intoxication.

BACKGROUND: Carbamazepine (CBZ) is an antiepileptic drug with tricyclic structure which implies its potential cardinotxic properties, especially in acute poisoning. AIM: To evaluate some cardiovascular effects connected with CBZtoxicity and tofind the relation between them and CBZ plasma level. MATERIAL AND METHODS: 34 patients (18 males, 16 females; median age 24.5) hospitalized in our Department in 1996-1997 and 2005-2006 due to acute CBZ poisoning. Analysis included following parameters: systolic (SBP) and diastolic (DBP) blood pressure, ECG parameters: heart rate (HR), duration of QRS complex, PQ interval and corrected QT interval (QTc) calculated with Bazett's (QTc(B)) and Hodges's (QTc(H)) formulas. These parameters were compared with reference values for general population available in the literature. Relations between above mentioned parameters and CBZ plasma level were studied by means of Generalized Additive Model (GAM). RESULTS: The reference values were exceeded most often for QRS (62%), DBP and QTc(B) (53%, both) and SBP (50%). The mean number of parameters with exceeded norms was 3.1 per patient (SD = 1.71). We failed to find any significant correlation between CBZ plasma level and any of the studied parameters. Positive correlation between SBP and DBP (r = 0.68; p < 0.001) and negative correlation between QRS and HR (r = -0.50; p = 0.003) were found. CONCLUSION: CBZ could affect different cardiovascular parameters which should be monitored in cases of acute drug poisonings.

[Epidemiological analysis of cases with confirmed presence of amphetamine and THC in the material of Department of Analytical Toxicology and Drug Monitoring UJ CM]. / Analiza epidemiologiczna przypadków z potwierdzona obecnoscia amfetaminy i THC w materiale Zakladu Toksykologii Analitycznej i Terapii Monitorowanej UJ CM.

UNLABELLED: The aim of this paper is epidemiological analysis of poisonings with amphetamine and tetrahydrocanabinols (THC), particularly in three aspects: (1) co-occurrence of other substances (mixed poisonings); (2) factors shaping dynamics in number of poisonings and 3) average age of patients. The data this paper is based on come from the data set "Duch" which is run by the Department of Analytical Toxicology and Drug Monitoring UJ CM in Kraków. The data were collected between 1 Dec. 2001 and 28 Feb. 2005 (1186 days). Amphetamine and THC were determined in patient's urine in semi-quantitative manner by means of EMIT and FPIA methods. RESULTS: Amphetamine: In the studied period amphetamine was confirmed in 493 patients. Other substances were confirmed in 57.6% of patients: opiates--28.6% THC--14.2%, opiates and THC--5.9%. Since the beginning of the studied period till mid Aug 2003 daily number of cases showed increasing trend (0.062% per day), then the tendency was reversed (-0.074% per day). We observed more males than females (3.24:1). Most cases were poisoned on Mondays, less during the week and least on weekends. At the beginning of the studied period males were older than females (27 vs. 20 years). As the time progressed average age of males was stable but in women average age was increasing at the rate 0.004 year per day. As a consequence of this trend in winter 2004/2005 average age of both sexes was equal. THC: We observed 410 cases with confirmed presence of THC in urine. Other substances were confirmed in 40.2% of patients: amphetamine 17.1% amphetamine and opiates 7.1, opiates 7.1%. There were 17 various substances accompanying THC. In our material the sex ratio was biased toward males (7.8 to 1). Weekly dynamics of poisonings with THC have the same pattern as the one observed in amphetamine. At the beginning of the studied period males were older than females (28 vs. 20 years). Changes in averages followed the same pattern as in amphetamine.

The changes in taste preferences during 4 years period of methadone maintenance treatment.

The aim of the study was the analysis of the changes in the kind and the frequency of particular nutritional products consumption by opiate addicted persons during 4-year lasting methadone programme. There were 30 opiate addicted patients under examination (23 men and 7 women). Food consumption quality was estimated with the use of the Intake Frequency of Food Products Questionnaire. The examinations were performed before methadone administration had started, after 9 months and after 4 years of methadone maintenance treatment. Three categories of consumption frequency were established: rarely, moderately and often. The classification of different products was done with the use of hierarchic cluster analysis. For general illustration of the data the consumed products were compared by the means of hierarchical cluster analysis (this was done with the help of Euclidean distances and the Ward's algorithm). Then the k-means (with k=3) method was used in order to identify groups of products that were similarly often consumed. Each k-means analysis was performed separately for each examination. This was done in order to find out the products that change the cluster from one examination to another. Twenty labile products were identified. The examined products were moving between the adherent categories. This means that the consumption pattern undergoes some changes over the course of methadone therapy. Additionally, the analysis of the diet of this group of people shows improper and unhealthy nutritional behaviours: too big intake of sweets and too low intake of complex carbohydrates, fish and vegetable fats. This was especially visible at the beginning of the therapy, later this unfavourable diet habits changed but not to the desired level.

[Social competence evaluated by patients on methadone maintenance treatment program]. / Kompetencje spoleczne w ocenie pacjentów w terapii metadonowej na tle zróznicowanych uwarunkowan.

Social competence were analysed using the origin Polish Questionnaire of Social Competence questionnaire (KKS). The competence gained during the life span are dependent on age, temperament, personality and partially on intelligence. There were 66 drug users (22 females, and 44 males) from methadone maintenance treatment programme conducted in Rydygier's Hospital. Social Exposure Scale, Scale of Assertiveness, Scale of Direct Interpersonal Contacts separately as well as the sum of information were used for estimation of the competence. The patient age at narcotic initiation, duration of being in methadone substitution programme, means of support were a statistically significant factors. A significant differences between two group as regard the psychopathology the drug abuse alone or coincidence with psychiatric diagnosis were also noted.

(99m)Tc-HmPAO single photon emission tomography, magnetic resonance proton spectroscopy and neuropsychological testing in evaluation of carbon monoxide neurotoxicity.

There were 10 acutely CO poisoned study patients without CNS history (head traumas, epilepsy, dementia, migraine or alcoholic diseases) in whom (99m)Tc-HmPAO SPET, HMRS and neuropsychological testing were performed. 99mTc-HmPAO SPET and neuropsychological testing were performed twice: in acute phase and at six months post CO exposure. HMRS was carried out at 8 months post CO exposure. A multidimensional analysis of variance (MANOVA) was used to statistical analysis. Regional CBF disturbances in acute phase of CO poisoning were observed in frontal cortex, basal ganglia and parietal cortex respectively. The most reversible, as seen in control (99m)Tc-HmPAO SPET examination, were the changes observed in parietal cortex. Diffuse generalized cortex hypoperfusion, both in acute phase and at 6 months post exposure, was seen only in one the patient. In all of the examined patients different elevation in mobile lipid or/and lactate concentration in frontal lobe or/and basal ganglia was revealed by HMRS evaluation at eight months post acute CO exposure. Results of neuropsychological testing at baseline and at 6 months partially correlated with neuro-imagine techniques applied.

[The influence of the dose, time since ingestion and concentration of the xenobiotic on the clinical state and severity of liver damage with patients intoxicated with paracetamol]. / Wplyw dawki, czasu od zazycia i stezenia ksenobiotyku na stan kliniczny i stopien uszkodzenia watroby u pacjentów zatrutych paracetamolem.

The aim of this study was to determine relations between the clinical state and the severity of liver damage comparing to the amount of ingested paracetamol, time since ingestion and serum concentration of paracetamol with patients after acute intoxication with this drug. A retrospective analysis of medical records of 95 patients hospitalized in the Toxicology Department in Kraków or treated in the Toxicological Admission Room in 2002-2004 years because of acute paracetamol intoxication was performed. The general clinical state connected with intoxication and the severity of liver damage were determined using the Poisoning Severity Score (PSS). The level of consciousness was determined with the Glasgow Coma Scale and Matthew's scale. The serum concentration of paracetamol during admission to the hospital, levels of biochemical markers of liver damage (AST, ALT), bilirubin and INR index were also performed. We found a statistically significant positive correlation between the ingested dose of paracetamol comparing to the gravity of poisoning, the severity of liver damage, levels of aminotransferases and bilirubin. A positive correlation between time since ingestion of paracetamol to hospitalization and the gravity of poisoning according to PSS scale was also statistically significant. A paracetamol concentration measured during admission to the hospital had no influence on neither the clinical state of patient nor the severity of liver damage. We conclude that the therapeutical approach should consider possibly shortening of the time since drug ingestion to hospitalization and institution of specific treatment (N-acetylcysteine) as well as minimalization of the paracetamol dose, which could be absorbed, by different methods of elimination from the GI tract (eg., gastric lavage, activated charcoal laxatives).

Comparison of fluorescence polarization immunoassay and high performance liquid chromatography for determination of carbamazepine concentration in blood of poisoned patients.

Carbamazepine is an antiepileptic drug widely used by neurological and psychiatric patients. Because of it's low therapeutic index and increasing number of acute carbamazepine intoxications there is a need of routine serum carbamazepine assay in toxicological laboratories. Determinations of serum carbamazepine concentrations are 5.3% of all toxicological analysis carried on in Department of Analytical Toxicology and Therapeutic Drug Monitoring, Collegium Medicum, Jagiellonian University in Kraków. The goal of the study was comparison of two analysis methods: FPIA and HPLC-DAD for the diagnostics of patients intoxicated with carbamazepine. Material for analysis were 21 samples of blood collected from poisoned patients treated in Department of Clinical Toxicology in Kraków. Measurements of serum carbamazepine concentration by FPIA method and carbamazepine and it's main active metabolite carbamazepine-10,11-epoxide concentrations by HPLC-DAD method were made. Statistical analysis showed that serum carbamazepine concentrations measured by FPIA method were higher than serum carbamazepine concentrations measured by HPLC-DAD method (t21 = 2.21, p = 0.0384). The mean difference of serum carbamazepine concentrations measured by the two methods was 2.67 mg/l (SD = 5.69 mg/l) and didn't depend on the carbamazepine concentration measured by FPIA method (r = -0.137, p = 0.5431). There was no statistical difference between serum carbamazepine concentration measured by FPIA method and the sum of serum carbamazepine and carbamazepine-10,11-epoxide concentrations measured by HPLC-DAD method (t21 = 1.42, p = 0.1690).

Positive determinations of tricyclic antidepressant drugs in the material of toxicological laboratory--analysis of trends.

This paper presents the analysis of trends in a number of cases and an average age of patients for whom determination of tricyclic antidepressants (TCA) showed positive results. The studied data were gathered in toxicological laboratory of Dept. of Analytical Toxicology and Therapeutic Drug, CM UJ in Kraków. The data were collected in period December 2001 August 2004. The main findings of this study are: The number of cases is exponentially increasing at the rate of 0.068% per day (p = 0.0165). No statistically significant correlation between the number of cases and: (a) day-length (p = 0.9819), (b) day-length change (p = 0.2312), (c) direction of change of day-length (p = 0.4640), d) day of the week (p = 0.7588) has been found, so periodicity of this phenomenon is questionable. It has been observed that the average age of patients is decreasing and the estimated rate of this decrease equals 0.0092-years per day (p = 0.0555). TCA positive patients treated in the Clinic on different days of the week differ in average age (p = 0.0016). From Tuesday till Friday the average age of patients is increasing. In the middle of the studied period the increase started from 30-year-olds on Mondays and ended with 48-year-old patients on Friday. At weekends the average dropped to 38 and stayed constant. On Mondays the average was about 46.

[Trends in ethanol-poisonings in the period December 2001 - August 2004, in the material of toxicological laboratory]. / Trendy w zatruciach etanolem w okresie: grudzien 2001-sierpien 2004, w materiale laboratorium toksykologicznego.

In recent years the commonest kind of poisonings observed in the Department of Clinical Toxicology in Kraków has been the poisonings with ethanol. Since this substance is so popular a detailed analysis of trends of poisonings with ethanol has been undertaken. The analysis has been based on the database of toxicological laboratory, the data collected in the period December 2001 - August 2004 were analyzed. It has been shown in this paper that the number of poisoned males is decreasing at the rate of 0.029% per day. Days such as Friday, Sunday, Saturday and the New Year's Eve are days of high number of ethanol-poisoned patients. At the beginning of the studied period a nonlinear increase of average age of patients was observed. This trend reached its plateau and maximum in winter 2002 and spring 2003 and since this time a decreasing non-linear trend has been observed. The average concentration of ethanol in the blood of patients is increasing at the rate 0.00002 g/L per day. The average concentration varies between gender and age groups. The group with the highest concentration is the group of about 50-years-old males. In the middle of the studied period the average concentration of ethanol in the blood of patients of this group was about 2.71 g/L. The concentration depends also on the day of the week. Patients investigated on days from Tuesday till Saturday show a higher concentration than those treated on Sundays and Mondays.

[Name-day parties--social factor shaping patterns of ethanol poisonings]. / Imieniny--czynnik socjologiczny ksztaltujacy zjawisko zatruc etanolem.

Name-day party is a feature of the Polish culture. During these parties alcoholic drinks are served very often. In this paper it is shown that there is a positive correlation between the popularity of a name-day and the number of ethanol poisonings. Another finding of this paper is that the popularity of a name-day is also associated with the average age of ethanol-poisoned patients. This association is mediated by gender and a day of the week. On days of popular names the average age of poisoned woman is lower comparing to days of unpopular names. In case of males the pattern is more complicated. If a name-day of common names occurs on a week day then the male patients tend to be older, but if such a day occurs at the weekend then average age of male patients is higher.

[Effect of tobacco smoke exposure on urine lead concentration of pregnant women]. / Wplyw narazenia na dym tytoniowy na zawartosc olowiu w moczu kobiet ciezarnych.

Among other toxic compounds, tobacco smoke contains also heavy metals, for example lead. Lead can cross the placenta barrier and have negative influences on fetus development. In the study compared urine lead concentration of pregnancy women exposed to tobacco smoke (active smokers and exposed to environmental tobacco smoke--ETS) with unexposed. There was find that mean urine lead concentrations in groups of pregnant women exposed and unexposed to tobacco smoke was no different (F2,189=0.2 p>0.8). However it was found that in urine of women exposed to tobacco smoke the concentration of lead increase with increase the concentration of cotinine (r2=0.14, t106=4.2, p<<0.0001).

[Cardiotoxic agents in the practice of the toxicological laboratory]. / Czynniki o wlasciwosciach kardiotoksycznych w materiale laboratorium toksykologicznego.

Basing on toxicological examination performed between December 1, 2001 and November 6, 2002 the analysis of cardiotoxic agents was carried out. As much as 69.7% of 2523 positive results was related to cardiotoxic agents. Ethanol (57.4%) followed by anticholinergic drugs (15.7%), amphetamine (11.6%) and carbon monoxide (8.9%) were most frequently determined cardiotoxic agents. Relatively small number of cardiovascular medication drugs (0.3%) was stated in biological samples. The cardiotoxic agents were detected mostly in men (68.8%), even after ethanol was excluded from the analysis (54.8%).