Prevalence of Taurodontism in Contemporary and Historical Populations from Radom: A Biometric Analysis of Radiological Data.

Taurodontism is a morphological anomaly of multirooted molars characterized by apical displacement of the pulp chamber, shortened roots, and the absence of constriction at the dentoenamel junction. It can negatively impact the outcome of dental treatment plans. This study aimed to compare the prevalence of taurodontism among contemporary and historical populations from Radom, Poland. Five hundred eighty-two panoramic radiographs of contemporary patients and 600 radiographs of historical individuals were analyzed using the Shifman and Chanannel index. Group differences were determined with Pearson's chi-square tests according to sex, site, tooth group, and historical period. The study also evaluated the degree of severity of taurodontism in relation to dental groups, gender, and the periods from which contemporary patients as well as historical individuals originated. In the contemporary population, taurodontism was observed in 34% of individuals. In the historical data, the highest prevalence of taurodontism (31%) was observed among individuals from the 18th and 19th centuries, while earlier periods exhibited considerably lower prevalence rates. Across contemporary and historical populations, the maxillary molars were the most commonly affected teeth. Hypotaurodontism was the most prevalent form of taurodontism. The prevalence of taurodontism has gradually increased from the 11th century to the current day. The results of the research are of great importance for the clinician in terms of planning comprehensive dental treatment.

Frequency of occurrence of taurodontism in the historical population of Radom (11th-19th centuries).

OBJECTIVE: The aim of the work was to trace possible changes in the frequency of taurodontism in individuals who inhabited historical Radom from the early Middle Ages to modern periods. DESIGN: The research was based on the analysis of X-ray images of 640 molars of individuals from the 11th/12th c. (n = 120), 14th/17th c. (n = 76), and 18th/19th c. (n = 444). Radiological images were made with the use of a portable X-ray machine, and the results were biometrically analysed using the Shiffman and Chanannel index. RESULTS: The highest frequency of taurodontism was observed in the 18th/19th c. (31 %, 138/444). In the 11th/12th and 14th/17th centuries, this percentage was significantly lower (22 %, 26/120 vs. 16 %, 12/76). In subsequent chronological periods, no statistically significant differences between sexes in the occurrence of taurodontism were observed. The highest number of taurodontal teeth was observed among the second and first upper molars (73 % and 52 %, respectively), and the lowest number was observed among the first and second lower molars (16 % and 23 %, respectively). In all historical periods, hypotaurodont forms were most often observed. CONCLUSIONS: Variations in the frequency of taurodontism may result from many reasons, for example environmental factors. However, it cannot be ruled out that the observed differences result from the increased migration of people to Radom in the 18th/19th century.

Clinical implications of a diagnosis of taurodontism: A literature review.

Taurodontism is a morphological anomaly involving multirooted teeth that is characterized by a vertical shift of the pulp chamber and shortening of the roots. The literature was analyzed to determine the impact of a diagnosis of taurodontism on dental treatment. A total of 85 full-text publications from the years 2005-2021 were analyzed and 20 publications were included in this research. The endodontic treatment of a taurodont tooth is challenging due to the apical displacement of the pulpal chamber floor and the incorrect configuration of the root canal system, or the presence of additional canals. In terms of prosthetics, the use of taurodont teeth as abutments is not recommended as they lack stability due to shorter roots. The extraction of taurodont teeth can be complicated due to an apical shift of the root furcation. In periodontology, taurodont teeth can have a better prognosis as there is less chance of furcation involvement. From an orthodontic point of view, it is important to note that taurodont teeth are not sufficiently embedded in the alveolus and have a greater tendency for root resorption. With regard to genetic diseases, it has been reported that this anomaly can exist as an isolated feature. However, the majority of authors agree that taurodontism is associated with conditions such as Down syndrome, Klinefelter syndrome, cleft lip and palate, hypodontia, amelogenesis imperfecta, and others. From a clinical standpoint, it is very important to diagnose taurodontism before treatment. A diagnosis of taurodontism can be important in the early diagnosis of malformations that commonly occur with this condition.

[A significance of measurement of breathing nervous regulation, respiratory resistance and spirometry in clinical toxicology - retrospective review].

The exogenous central nervous system depressants such opioides, alcohol and carbon monoxide may affect nervous respiratory regulation and lead to disturbances in respiratory system efficiency. The aim of this study was to evaluate the breathing nervous regulation and ventilatory efficiency in patients treated in Clinical Toxicology, UJCM in Krakow in the period 1994- 2000. Methods: There were 385 persons under examination: 144 alcohol abusers and 70 opiate abusers (group I), 91 persons treated because of acute carbon monoxide poisoning (group II) and 80 healthy persons - control group. The examinations performed before and after treatment included measurements of respiratory pattern parameters, occlusion pressure and evaluation of ventilatory efficiency determined on the basis of "flow-volume" loop results, spirometry and the measurements of respiratory tract resistance. Results: The central respiratory drive (VT/T(in) index) and the parasympathetic control of breathing cycle (T(in)/ T(tot) index) were similar in alcohol and opiate abusers in the initial examination but in abusers classified to methadone maintenance treatment programme the VT/T(in) index was elevated. After treatment the values of both indices were similar. In the group of acute CO poisoned patients the disturbances in breathing regulation were connected with increased value of the VT/Tin parameter and the diminished of T(in)/T(tot) value. After treatment in the slightly CO poisoned patients the both respiratory pattern components were comparable to the healthy control group but in the moderately and severely poisoned group the VT/T(in) index was elevated and the T(in)/T(tot) index was lessened compared to the controls. The values of respiratory resistance were higher than upper level of normal values (except participants of methadone programme). The bronchial obturation was most often stated disturbance in respiratory system efficiency, especially in alcohol abusers. Ventilatory parameters in moderate and severe CO poisoned were significantly lower than in the slightly poisoned patients. Conclusion: Presented methods of evaluation of respiratory system efficiency and nervous breathing regulation are of special value and should be implemented in clinical toxicology as essential to diagnosis and monitoring, especially in case of alcohol and drug dependent patients and in patients poisoned with central nervous system depressants.

[Evaluation of chemical compounds acute poisoning risk among Kraków inhabitants in 1966, 1983 and 2015].

The total number of out-patients and hospitalized poisoned patients above 14 years old in Krakow in 1966 was 520 and 2132 in 1983. The incidence of poisoning per 10 000 of Kraków population in 1966 was 25.0 and increased to 36.2 in 1983. The mortality in 1966 was 0.75%. It was low also in 1983 ­ 1.01%, whatever reached 7.8% if forensic data were included (the fatalities on the spot). There were 847 poisoned patient hospitalized in Clinic of Toxicology UJ CM in 2015 and mortality in this group was 1.06%. Forensic analysis shown decreasing number of deaths on the spot (154 in 1983 and 89 in 2015). The percentage of poisoned with ethanol was declining (78.9% in 1983 and 57.3% in 2015). The frequency of patients treated in intensive care unit were increased from 6% in 1966 to 21.7% in 2015. The percentage of addicted acute intoxicated patients was lower (8%) in 1983 and achieved 21.7% in 2015. Poisoning structure, particularly pharmaceuticals, significantly influenced medical procedures performed in intensive care unit, especially administration of antidotes (5% in 1966 and 48.9% in 2015). Social evolution and changes of culture habits increased percentage of addiction but the number of deaths caused by ethanol on the spot was smaller.

[Cracovian clinical toxicologists international activity in last 50 years].

We present 50 years of scientific activity Depertment of Toxicology Jagiellonian University Medical Collage in Krakow on national and international arena. Scientific achievements are presented divided into thematic groups. The subject group covers a broad spectrum of research taking into account the epidemiology of poisoning, occupational and population exposure to chemical substances, specific toxicological problems like; diagnosis of poisoning, predicting the severity of poisoning, the implementation of appropriate treatment depending on the phase of intoxication and its severity, effectiveness evaluation diagnostic and treatment procedures, prevention and prophylaxis of poisoning.

[The assessment of factors affecting acute ethanol poisonings clinical status in 1974-1975, 1984-1985 and 2011-2013]. / Ocena czynników wplywajacych na obraz kliniczny w ostrym zatruciu alkoholem etylowym w latach 1974-1975, 1984-1985 i 2011-2013.

UNLABELLED: The aim of the study was an evaluation of clinical factors affecting relationship between ethanol concentration and clinical status in case of acute ethanol poisoning in the 70s and the 80s of the 20th century and 2011-2013 y. Ethanol blood concentration was a criterion of ethanol dose, grade of coma was a decisive factor of toxic effect. MATERIAL AND METHODS: 112 patients treated at the Department of Clinical Toxicology Jagiellonian University Medical College in 1974-1975 y, 232 treated in 1984-1985 y and 663 treated in 2011-2013 y because of acute ethanol poisoning were analyzed. The degree of coma was evaluated according to Matthew's scale. Ethanol plasma concentration in each case was measured. RESULTS: The lowest ethanol blood concentrations in the youngest (<19 y) and the oldest (>60 y) groups were noted also the highest in group of adults (30-49 y). The three-gradual relationship between ethanol plasma level and degree of toxic coma was distinguished. However, the average of ethanol blood concentration were statistically significant in every degree of coma in 2011-2013 y. A statistically significant increase in number of patients in 0 coma grade with severe withdrawal symptoms, alcohol psychosis or epilepsy were noted, also decrease of patient in IV degree of coma. CONCLUSIONS: The increase ethanol tolerance in the group of acute ethanol poisoned patients shows their ethanol addiction.

Abnormal glucose metabolism in men with alcohol withdrawal syndrome.

UNLABELLED: The aim of the study was to evaluate the glucose metabolism in patients suffering from ethanol withdrawal syndrome. The study group comprised 88 alcohol dependent men aged 21- 50 y (mean 39.18 years, SD ±7.78), treated at the Clinical Toxicology Ward. Alcohol dependence was diagnosed accord- ing to the criteria of the International Statistical Classification of Diseases and Related Human Problems (ICD-10). The degree of alcohol withdrawal syndrome was assessed according to the scale CIWA-Ar. The blood ethanol concentration, and glucose serum concen- tration were measured on admission. On the next post-admission day blood glucose were determined after fasting and at the 0, 60th and 120th minute of an oral glucose tolerance test (OGTT) using 75 g glucose. Basing on the recommendations of Polish Diabetes Association (2013y) the patients were classified into one of groups according to their glucose tolerance test results. RESULTS: Mean duration of alcohol dependence was 10.56 years ± 7.78. A mean CIWA-Ar scale score was 23.95 points ± 2.81. Mean BMI was 24.65 ±3.74, overweight and obesity were determined in 35.22% examined men. Normal glucose tolerance were found in 54.55%, abnormal fasting glucose and/or abnormal glucose tolerance were noted in 23.87%, diabetes in 10.23%, and hypoglycemia in 11.36% of examined patients. Intensity of withdrawal syndrome according to the CIWA- Ar (OR -1.59, p= 0.05) and duration of alcohol consumption (OR -1.01, p=0.03) were the risk factors of diabetes type 2 in examined group. Greater BMI was a protective factor against diabetes type 2 in the study group. There was no significant correlation between risk of hypoglycemia and age, BMI, duration of alcohol consumption, alcohol blood concentration on admission, intensity ofwithdrawal syndrome according to the CIWA- Ar scale. A higher frequency of hypoglycemia was found in patients who declared vodka drinking in interview (at the borderline of statistical significance OR - 7.43, p=0.06). CONCLUSIONS: 1. In the study group of alcohol-dependent men, the risk of diabetes was inversely proportional to BMI value. 2. The risk factors of type 2 diabetes in the alcohol-dependent group included the duration of lasting alcohol drinking and the intensity of withdrawal symptoms according to the CIWA- Ar scale. 3. According to the preference of alcohol type, a higher frequency of hypoglycemia was confirmed only in persons preferring to drink vodka.

[Selected data of acute intoxications with glycol and methanol in Poland in the year 2009]. / Wybrane zagadnienia dotyczace ostrych zatruc glikolem i metanolem w Polsce w roku 2009.

BACKGROUND: There are no reliable studies in Poland evaluating the scale of acute intoxications with different types of xenobiotics. OBJECTIVE: The aim of the study was to evaluate selected problems referring to the patients intoxicated with glycol and methanol, who were given the medical treatment in all Toxicological (TUs) and Intensive Care Units (ICUs), having contract with Polish National Fund of Health, in the year 2009. METHODS: All cases of acute intoxications treated in Polish hospitals in 2009 and reported to the Polish National Fund of Health were included to the analysis. To further analysis were chosen only those patients, whose main diagnosis or comorbidities were coded as T51.1 or T52.3 according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision and, according to the state of health, patients were treated in TUs and ICUs. All the cases, in which intoxication was not the main health problem were excluded. RESULTS: There were 85 398 acute intoxications in Poland in 2009, 470 of them referred to glycol and methanol poisonings. 192 patients were treated in TUs and ICUs. The most common methods of therapy in those units were extracorporeal toxin removal (60.2% in TUs and 62.5% in ICUs) and conservative treatment (39.8% in TUs and 37.5% in ICUs). The mortality rate in glycol and methanol poisonings in TUs and ICUs were 24.2%, and 56.3% respectively. In the conservatively treated group the mortality rates in TUs and ICUs were 23.5%, and 66.7% respectively, while in extracorporeal toxin removal group the mortality rates in TUs and ICUs were 24.7%, and 50% respectively. The authors also observed two regions (Maków Mazowiecki and Slubice), in which the amount of glycol and methanol intoxications was much higher than in the rest part of the country. CONCLUSIONS: 1. All the cases of acute intoxications of glycol and methanol should be consulted with Polish Poison Control Centers. 2. It is necessary to establish diagnostic and treatment protocols for intoxicated patients in Poland. 3. There is a strong need for popularization of the modern methods of glycol and methanol poisonings therapy and increasing the availability of modern antidotes. 4. It is necessary to monitor diagnostics, treatment and mortality rate of glycol and methanol intoxicated patients in all types of hospital units in Poland. 5. There is a need of further toxicological education of medical students and doctors as well. 6. The cases of abnormally high rate of glycol and methanol intoxications in some hospitals should be investigated.

[Resuscitation in acute poisonings based on 2005 and 2010 Resuscitation Guideline]. / Postepowanie resuscytacyjne w ostrych zatruciach w oparciu o Wytyczne Resuscytacji z 2005 i 2010 roku.

Acute poisonings in USA are a leading cause of cardiac arrest, especially in youngsters. Primary survey and cardiopulmonary resuscitation for poisoning is based on ABCDE procedure. One of the most common manifestation of acute poisoning is coma. An open airway should be ensured. Endotracheal intubation should be performed by an experienced person. The mouth-to mouth method of artificial respiration can be applied ultimately. In case of cyanide, hydrogen sulfide, organophosphates and corrosives poisonings a special caution is needed and pocket mask or self-inflating bag with a face mask should be rather used. A quick poison identification and a contact with regional poison information centre regarding patient management are crucial. Different procedures include prolonged cardiopulmonary resuscitation.

[The causes and consequences of the cellular death (apoptosis and necrosis) in the course of acute poisoning with carbon monoxide]. / Apoptoza i nekroza--przyczyny i skutki w przebiegu ostrego zatrucia tlenkiem wegla.

The flow cytometry is acquiring more and more clinical importance. Despite its wide application in diagnostics, it is not used commonly in the clinical toxicology. The goal of the current investigation was to evaluate the mechanism for cell death (apoptosis or necrosis) and its manifestation in circulating human lymphocytes exposed to toxic concentration of carbon monoxide (CO). Since the large subpopulation of leukocytes have undergone apoptosis the next step of the studies was to assess the mobilization of progenitor cells (CD 34+) occurring in the peripheral blood after CO intoxication. Data were compared with those of 25 healthy controls comparable in terms of age, gender and physical activity. The application of the method in clinical reasoning was also evaluated. Significantly increased apoptosis of the lymphocytes in research group compared to control individuals correlates with the poisoning severity but does not depend on hypoxia. Decreased number of leukocytes caused by the cytotoxic effect of CO, stimulates the release of the CD 34+ to the peripheral blood. Increased cell death seems to be the relevant mechanism in the pathophysiology of acute carbon monoxide poisoning--the delayed apoptosis as the consequence of the reoxygenation can influence the delayed neurological and cardiological sequelae in patients after acute CO poisoning. In order to improve the treatment and help choose best fitting therapy, there should be need to introduce the new diagnostic methods like flow cytometry or innovative imaging techniques to the standard diagnostics in clinical toxicology.

[Students knowledge on carbon monoxide toxicity]. / Poziom wiedzy studentów na temat toksycznosci tlenku wegla.

The results of questionnaire research on carbon monoxide (CO) poisoning in students of State Higher Vocational School in Nowy Sacz (Institutes of Economy, Pedagogic, Technical and Health) are presented in the study. The mean age of the group examined, with a female predomination (77.6%) was 22.7 +/- 4.94 years. The questionnaire covered demographic data and knowledge on CO source, exposure, most frequent and most severe symptoms, most severe sequels, risky behavior and risk groups in CO poisoning. The results obtained indicate on inadequate knowledge on CO poisoning even in young students population. The proper education and prophylaxis activity is necessary to avoid accidental CO poisoning, especially that they also occur in spring-summer season.

[Evaluation of cardiovascular autonomic nervous system in ethanol withdrawal]. / Ocena ukladu autonomicznego sercowo-naczyniowego w zespole odstawiennym u chorych przewlekle uzaleznionych od alkoholu.

UNLABELLED: The aim of the study was to assess the risk factors and state of cardiovascular autonomic nervous system injury in ethanol dependent patients. The group examined consisted of 85 alcoholics (17 females and 68 males) aged from 27 to 68 y (45.7 +/- 8.82) hospitalized at the Ward of Toxicology and Environmental Diseases because of alcohol withdrawal. Ethanol dependence was diagnosed according to ICD -10 criteria, withdrawal syndrome was scored according to CIWA - A scale. A blood ethanol concentration, creatinine, urine, coagulation parameters and liver enzymes activity were measured on admission. Cardiovascular autonomic nervous system was evaluated by standard Ewing battery tests using VariaCardio TF5 system. The parasympathetic system was assessed by the heart rate response to forced breathing, the heart rate response to standing up, and to heart response to the Valsalva maneuver. The sympathetic system was evaluated by the blood pressure response to standing up. The original Ewing normal values were used. RESULTS: The mean duration of ethanol dependence was 13.7 +/- 8.2 y. In 92% of examined patients heavy and in 8% moderate ethanol withdrawal syndrome was diagnosed. The mean blood ethanol concentration was 1.07 +/- 1.21g/l. Liver injury was diagnosed in 43.5% of the examined group. No changes in autonomic battery tests were found only in 28.2% of the examined subjects. Early parasympathetic damage was stated in 23.5%, definite parasympa-thetic damage in 44.7%, combined para-sympathetic and sympathetic damage was diagnosed in 3.5% of patients examined. The relative risk for parasympathetic and sympathetic system injury rose together with CIWA - scoring, blood ethanol concentration on admission (OR = 1,4 95% CI: 0,81 +/- 2,4), and when GTP activity was three times greater than normal (OR = 1.2 95% CI: 0.92 +/- 1.7).

[Clinical practice guidelines in acetaminophen poisoning--pre-hospital management]. / Wytyczne postepowania w przypadku zatrucia acetaminofenem--postepowanie przedszpitalne.

We described guidelines for personel working in poison information service in case of acute paracetamol overdose. The guidelines were created with respect to EBM (Evidence Based Medicine) by the American Association of Control Centers.

Usefulness of 13C-methacetin breath test in liver function testing in Amanita phalloides poisoning; breast feeding woman case.

INTRODUCTION: Mortality from ingestion of the mushroom Amanita phalloides still remains as high as 8-10%. In critical patients, liver dialysis can bridge the patient to liver transplantation, which may be a lifesaving procedure. We report the use of 13C-methacetin breath test (13C-MBT) in monitoring hepatic function in a case of A. phalloides poisoning. CASE REPORT: A 33-year-old woman ate mushrooms that she had picked. After 8 h, she developed nausea and vomiting, abdominal cramps, and diarrhea, which lasted for another 24 h. On the third day, features of liver injury were seen. Pharmacologic therapy failed and she underwent liver dialysis on days 4 and 5. A 13C-MBT was used to evaluate hepatic functional reserve before the first and after the second dialysis. A liver transplantation on day 6 was successful. DISCUSSION: The breath test results showed that at 40 min after substrate ingestion the mean 13C-MBT cumulative oxidation percentage was 10.5 +/- 3.8% in healthy controls, whereas in our patient this parameter decreased from 0.09% on the fourth day to 0.02% on the fifth day. CONCLUSIONS: 13C-MBT is a simple, non-invasive diagnostic tool which may be useful as a predictor of outcome and as a marker of the severity of liver damage.

Drug free universities--trends in illicit drugs use among Kraków university students.

Social survey by questioning people is a significant source of information, valuable for planning and developing of prophylactic strategies. An illicit drugs use among a first-year students of Kraków's universities and factors determining the usage were analysed. The research by completing the questionnaire designed by National Bureau for Drug Prevention, Poland was performed in 725 a first-year students of six Kraków's universities. The students were asked to complete the questionnaire confidentially, while the lecture on psychoactive substances. 83.6% of those polled know some students who use a drugs, 38.3% already initiated into drugs, 61.9% reported that they needed at least one day to get drugs. The male students reach for drugs more often then females, and those first-year students being already 20 years old compared to the younger. The greater risk was also noted among students who rent apartments or when a parents earned together more than 3500 PLN. The medical students reached for drugs more rarely than the others. Our survey is one of the first source of information about trends in the drugs usage by Kraków's students. The results will help to develop a preventive standards and creation of effective anti-drugs campaign to be accomplished by college authorities and the Kraków Environmental Diseases Out-patient Clinic for students and academic teachers. The clinic was organised in 2004.

Clinical status of carbon-monoxide-poisoned patients and the results of rest 99mTc-MIBI and 99mTc-Amiscan heart scintigraphy performed in the acute phase of intoxication and stress-rest 99mTc-MIBI scintigraphy six month later.

The double tracer (99mTc-MIBI and 99mTc-Amiscan) scintigraphy is an useful technique to imagine cardiac injury due to CO intoxication. Accumulation (retention) of 99mTc-MIBI is dependent on blood flow and cellular and mitochondrial electrical potential of myocytes. The lower tracer accumulation is seen not only in necrotic heart tissue regions, but also in ischemic area of worse metabolic rate and perfusion. 99mTc-Amiscan contrary to 99mTc-MIBI, is accumulated only in regions of early necrosis so it can be can distinguished from transitory ischemia. Mechanisms of cardiac injury due to CO toxicity is different than due to coronary occlusion and the process of the heart damage is usually much longer. Results of control stress-rest 99mTcMIBI scintigraphy, performed after 6 months from CO exposure in relation to the clinical state on admission and results of 99mTc-MIBI and 99mTc-Amiscans scans obtained in acute phase of poisoning are presented in the study. Initial 99mTc-MIBI SPET examination had confirmed transitory myocardial ischemia of different degree in all the examined patients. The mutual dependence between degree of scintigraphic changes and blood lactate level and CK activity was found. 99mTc-Amiscan scintigraphy demonstrated areas of necrosis in myocardium of some patients; they had statistically higher COHb and blood lactate concentration compared to the rest. A control stress-rest 99mTc-MIBI SPET performed 6 months after CO intoxication, confirmed a late consequences of metabolic abnormalities and a necessity of cardiovascular system follow-up controlling.