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1
Content available remote Time-optimal boundary control of an infinite order parabolic system with time lags
100%
Kowalewski A. , Krakowiak A.
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tom 18
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nr 2
189-198
EN
In this paper the time-optimal boundary control problem is presented for a distributed infinite order parabolic system in which time lags appear in the integral form both in the state equation and in the boundary condition. Some specific properties of the optimal control are discussed.
2
Content available Acute intentional poisonings within an urban agglomeration in Poland in 2004–2013
80%
Piekarska-Wijatkowska A. , Kobza-Sindlewska K. , Przyłuska J. , Krakowiak A.
International Journal of Occupational Medicine and Environmental Health
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2019
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tom 33
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nr 1
77-90
EN
ObjectivesThe aim of the research was to analyze the nature of changes and tendencies observed in the frequency, circumstances and causes of acute intentional poisonings within the agglomeration of Łódź, Poland. The study related to adults.Material and MethodsAs the research material, medical records of patients hospitalized due to an acute poisoning in the Department of Toxicology in Łódź were used. Information on the hospitalized patients was gathered in the database created in accordance with the assumed criteria and an approved system of the collection of variables describing the issues of intentional acute poisonings.ResultsIn the analyzed period, within the group of 18 918 adult patients hospitalized due to an acute poisoning, male patients prevailed, accounting for 57.17% of the whole group. Intentional poisonings constituted 40.19% of all poisonings, with women dominating within that group of patients – accounting for approximately 58.63%. The largest group was formed by young people, 18–35 years old, accounting for 43.22%. The average age of the intentionally poisoned patients showed an upward tendency; this tendency concerned women to a larger extent. Medications played the most powerful role in acute intentional poisonings. Within the whole population, they were responsible for 97.27% of intoxications. The analysis of the dynamics of changes in the percentage of patients referred for further mental treatment revealed that the number of patients continuing hospital treatment in psychiatric wards tended to grow.ConclusionsObservations indicating that women are more likely to attempt intentional poisoning, and that the number of patients with psychiatric disturbances tended to grow in the analyzed period, demonstrate an urgent need for preventive measures to be taken in the local communities.
3
Content available Clinical pattern of poisoning among patients declared as taking novel recreational drugs
80%
Krakowiak A. , Bąk M. , Politański P. , Piekarska-Wijatkowska A.
International Journal of Occupational Medicine and Environmental Health
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2020
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tom 33
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nr 4
445-455
EN
ObjectivesIntoxication with novel psychoactive drugs poses a significant challenge for medicine due to diagnostic difficulties, complex clinical patterns resulting from the polyethiology of poisoning, and the risk of fatal complications.Material and MethodsThe authors of the present work have made a retrospective review of medical records of the patients hospitalized at the Toxicology Unit (TU), diagnosed with poisoning by novel recreational drugs.ResultsIn 2008–2013, 576 patients diagnosed with that type of poisoning were admitted to the TU. Of those, 192 (33.3%) patients were positive for ethanol in addition to the most popular toxins found in the material collected from the patients, such as tetrahydrocannabinol (50 [8.6%] patients) and amphetamine (35 [6.1%] patients). The most frequent clinical symptoms observed on admission were: anxiety (433 [75.1%] patients), agitation (275 [47.7%] patients), and complaints associated with the circulatory system (225 [39.1%] patients). In the subgroup of 104 (18.0%) psychiatrist-interviewed people, a relationship was found between the suicidal ideation reported during history-taking and the following factors: earlier psychiatric treatment (p = 0.000), financial problems (p = 0.015) and prolonged unemployment (p = 0.022).ConclusionsThe observed clinical pattern may be associated with sympathomimetic syndrome due to poisoning by novel psychoactive substances. Preliminary results of this research show that financial problems and a history of psychiatric treatment may enhance suicidal ideation in patients after acute poisoning by psychoactive substances.
4
Content available Acute mercuric chloride poisoning at a potentially lethal dose ended with survival: symptoms, concentration in cerebrospinal fluid, treatment
70%
Krakowiak A. , Janasik B. , Sadowski Ł. , Szwabe K. , Machała W.
International Journal of Occupational Medicine and Environmental Health
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2023
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tom 36
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nr 5
685-692
EN
This study aims to present a case of acute mercuric chloride poisoning at a potentially lethal dose treated with the antidote – 2,3-dimercapto- 1-propanesulfonic acid (DMPS) and continuous renal replacement therapy (CRRT) combined with CytoSorb. A 21-year-old woman was admitted to a hospital with abdominal pain, vomiting, and suspected gastrointestinal bleeding after taking 5000 mg of mercuric chloride for suicidal purposes. Due to the patient deteriorating general condition and multiple organ damage, on the third day she was transported to the Clinic of Anaesthesiology and Intensive Care (CAaIC), Łódź, Poland. Laboratory tests confirmed features of acute kidney injury and high mercury levels in the blood (1051 μg/l) and urine (22 960 μg/l) – DMPS therapy and CRRT combined with CytoSorb were instituted. Due to nervous system complaints (headache, dizziness), a lumbosacral puncture was performed – the mercury concentration in the cerebrospinal fluid (CSF) was 5.45 μg/l. During a colonoscopy, significant diagnostic abnormalities revealed features of colonic mucosal necrosis. The treatment resulted in a decrease in subjective complaints, decreased mercury levels in biological material, and improved parenchymal organ function. On the 15th day of therapy, the patient was transferred to the primary care center for further treatment. The case confirms the possibility of improvement of patient condition following ingestion of a potentially lethal dose (5 g) as a result of the initiation of appropriate therapy even on the third day. The presence of mercury in CSF confirms that inorganic mercury compounds (mercuric chloride) can pass through the blood-brain barrier after oral ingestion.
5
Content available Lithium batteries safety, wider perspective
70%
Łukasz B. , Rybakowska I. , Krakowiak A. , Gregorczyk M. , Waldman W.
International Journal of Occupational Medicine and Environmental Health
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2022
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tom 36
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nr 1
3-20
EN
Energy production and storage has become a pressing issue in recent decades and its solutions bring new problems. This paper reviews the literature on the human and environmental risks associated with the production, use, and disposal of increasingly common lithium-ion batteries. Popular electronic databases were used for this purpose focused on the period since 2000. Assessment of the toxicological and environmental impact of batteries should then have a holistic scope to precede and guide the introduction of appropriate safety measures. In this short review the authors will try to touch upon this complex subject and point out some important issues related to an unprecedented development of lithium ion batteries-powered world. Given the multi-billion dollar business with the risks associated with the development of new technologies requires careful consideration of whether the balance of profits and losses is beneficial to humans and the planet. Int J Occup Med Environ Health. 2023;36(1):3–20
6
Content available YouTube as a source of information on carbon monoxide poisoning: a content-quality analysis
61%
Krakowiak M. , Rak M. , Krakowiak P. , Racisz K. , Słoniewski P. , Ilczak T. , Krakowiak A.
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nr 3
285-295
EN
ObjectivesThe variety of clinical presentation on the topic of carbon monoxide (CO) intoxication ranges from slight headache to coma or death. YouTube allows patients to search not only for entertainment but also medical advice. Therefore, the aim of this study was to evaluate the content and quality of YouTube videos concerning CO poisoning as a source of knowledge for non-medical audience.Material and MethodsOn the December 8, 2020 a YouTube search was conducted for the following phrases: “carbon monoxide poisoning,” “carbon monoxide symptoms,” “CO poisoning,” “carbon monoxide asphyxiation,” “carbon monoxide intoxication” using the “incognito mode” and without attachment to Google Account. The search results were set as: “default” in the YouTube browser. The first 50 results were taken into consideration. Two raters, a specialist in emergency medicine and a specialist in clinical toxicology rated videos with Quality Criteria for Consumer Health Information (DISCERN), Global Quality Score (GQS) and Journal of the American Medical Association (JAMA). “VidIQ Vision for YouTube” plug-in was used.ResultsNinety-five videos were included. The interclass coefficient for DISCERN, GQS and JAMA scores were: 0.8, 0.74 and 0.62 reaching good and moderate reliability. The mean DISCERN/GQS/JAMA was 28.1 (SD 7.9), 2.5 (SD 0.8) and 1.1 (SD 0.7) respectively. Higher DISCERN/GQS/JAMA had videos providing information on: exposure time, treatment options, hyperbaric chamber indications as well as physician speaker (p < 0.05). Video Power Index was higher when the video contained animations and presented patients own history of CO exposure but not influenced the DISCERN/GQS/JAMA scores. Videos providing misleading information had a higher like ratio.ConclusionsThe overall video quality was poor indicating inappropriate educational and informative value for patients who search information about carbon monoxide poisoning.
7
Content available Cardiotoxic effect due to accidental ingestion of an organic solvent
51%
Cieślik-Guerra U. I. , Rechciński T. , Trzos E. , Wierzbowska-Drabik K. , Uznańska-Loch B. , Winnicka R. , Krakowiak A. , Kasprzak J. D. , Fröhlich C. , Kurpesa M.
International Journal of Occupational Medicine and Environmental Health
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2015
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tom 28
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nr 1
174-179
EN
Toxic myocardial injury can be misdiagnosed as a myocardial infarction, resulting in the patient undergoing standard treatment for cardiac rehabilitation. However, such inadequate therapeutic strategies can lead to cardiovascular complications including dilated cardiomyopathy. This study presents a case of a 65-year-old man after accidental ingestion of organic solvents (toluene and xylene), whose condition demonstrated all the criteria for diagnosis of myocardial infarction. The qualitative determinations of the above mentioned volatile organic compounds (VOCs) in whole blood were carried out using a headspace sampling by means of gas chromatography. Cardiac catheterization revealed no specific coronary lesions, only a muscular bridge causing a 30–50% stenosis in the middle of the circumflex branch of the left coronary artery.
8
Content available Predictors of stress among emergency medical personnel during the COVID-19 pandemic
51%
Ilczak T. , Rak M. , Ćwiertnia M. , Mikulska M. , Waksmańska W. , Krakowiak A. , Bobiński R. , Kawecki M.
International Journal of Occupational Medicine and Environmental Health
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2020
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tom 34
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nr 2
139-149
EN
ObjectivesThe COVID-19 pandemic has forced emergency services to implement new standards of practice around the world. The dynamic and unpredictable nature of many clinical situations has placed emergency service personnel in direct danger of contracting the disease. This work uses a validated survey developed for the study to assess the predictors of stress that paramedics, nurses and doctors experience in the face of the COVID-19 pandemic.Material and MethodsThe study group included 955 medical staff, and the level of significance adopted for statistical analysis was p = 0.05. Non-parametric Mann-Whitney and Kruskal-Wallis tests were used to analyze the qualitative variables divided into groups. The selection of tests was carried out based on the distribution of variables, verified using the Shapiro-Wilk test. In order to determine the predictors that caused the feelings of stress, it was necessary to use the linear regression model.ResultsDuring the COVID-19 pandemic, stress among emergency medical personnel has increased considerably due to new factors that did not previously exist. The predictors of stress in the professional environment include the fear of contracting COVID-19, a decrease in the level of safety while conducting emergency medical procedures, and the marginalization of treatment for patients not suffering from COVID-19. Additional socio-demographic factors that increase stress among emergency medical personnel are being female and working in the nursing profession. Appropriate training, the supply of personal protective equipment and opinions on the preparedness of the system to deal with the outbreak of the pandemic did not affect the level of stress among health service personnel.ConclusionsThe factors that can be considered to act as predictors of occupational stress include the fear of contracting COVID-19, a decrease in the level of safety and security while conducting emergency medical procedures, and the marginalization of patients not suffering from COVID-19.
9
Content available Poisoning deaths in Poland: Types and frequencies reported in Łódź, Kraków, Sosnowiec, Gdańsk, Wrocław and Poznań during 2009–2013
41%
Krakowiak A. , Piekarska-Wijatkowska A. , Kobza-Sindlewska K. , Rogaczewska A. , Politański P. , Hydzik P. , Szkolnicka B. , Kłopotowski T. , Picheta S. , Porębska B. , Antończyk A. , Waldman W. , Sein Anand J. , Matuszkiewicz E. , Łukasik-Głębocka M.
International Journal of Occupational Medicine and Environmental Health
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2017
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tom 30
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nr 6
897-908
EN
Objectives The aim of this study has been to assess the characteristics of acute poisoning deaths in Poland over a period of time 2009–2013. Material and Methods The analysis was based on the data obtained from the patient records stored in toxicology departments in 6 cities – Łódź, Kraków, Sosnowiec, Gdańsk, Wrocław and Poznań. Toxicological analyses were routinely performed in blood and/or urine. Major toxic substances were classified to one of the following categories: pharmaceuticals, alcohol group poisonings (ethanol and other alcohols), gases, solvents, drugs of abuse, pesticides, metals, mushrooms, others. Cases were analyzed according to the following criteria: year, age and gender of analyzed patients, toxic substance category and type of poisoning. The recorded fatal poisonings were classified according to the International Classification of Diseases. Results The record of 261 deaths were retrospectively reviewed. There were 187 males (71.64%) and 74 females (28.36%) and the male to female ratio was 2.52. Alcohol group poisonings were more frequently responsible for deaths in men compared to all poisonings, 91.1% vs. 71.6%, respectively (p < 0.05), and pharmaceutical agents were more frequently responsible for deaths in women, 47.4% vs. 28.4%, (p < 0.05). Methanol was the most common agent in the alcohol group poisonings, accounting for 43.75% (N = 49), followed by ethylene glycol, 39.29% (N = 44), and ethanol, 16.96% (N = 19). Conclusions Epidemiological profile data from investigation of poisoning deaths in Poland may be very useful for the development of preventive programs. Int J Occup Med Environ Health 2017;30(6):897–908
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