Cel pracy: Analiza metod wykonywania nielegalnych aborcji oraz przyczyn śmierci kobiet, które poddały się zabiegowi w okresie międzywojennym. Materiał i metody: Badania przeprowadzono na podstawie protokołów sekcyjnych z lat 1920-1939 archiwizowanych w Katedrze Medycyny Sądowej na Uniwersytecie Jagiellońskim Collegium Medicum w Krakowie. Zgłębiono przypadki śmierci kobiet w ciąży lub w okresie okołoporodowym. Wykluczone zostały przypadki aborcji wykonanej legalnie ze względów medycznych. Wyniki: W omawianym okresie stwierdzono 101 przypadków nielegalnych aborcji -21 wykonanych było przez akuszerkę, a trzy przez wykwalifikowany personel medyczny. Użycie cewnika lub drutu odnotowano w 19 przypadkach, wstrzyknięcie substancji poronnej lub ostrzyknięcie płodu w ośmiu. Urazy bądź perforacja ściany pochwy lub macicy -odpowiednio 27 i 10 przypadków, były najczęściej stwierdzonymi zmianami świadczącymi o spędzeniu płodu. Wnioski: W większości przypadków (71) śmierć nastąpiła na skutek zapalenia otrzewnej lub sepsy, których źródłem zakażenia były narządy płciowe.
Comparison of Suicidal Poisonings with Chemicals and Drugs in the Years 1930–1939 and 2010–2019 in the Materials of the Forensic Medicine Institute in Krakow
The study aims to compare suicide poisoning and poisons used to commit suicide in the 1930s and today. The focus is on autopsy protocols from 1930–1939 and 2010–2019 collected at the Forensic Medicine Institute in Krakow. In the years 1930–1939, there were 184 cases, 65 of which were among men and 119 among women. The most common poisons were corrosives, accounting for 69 cases, 43 were carbon monoxide, 24 were drugs and narcotics, 17 were heavy metals, and the remaining 31 were other substances. Of the 138 suicide poisonings in modern times, 96 were committed by men and 42 by women. The most common poisoning was multi-drug poisoning – 62 cases. Opioids, benzodiazepines, neuroleptics and antidepressants were the most frequently chosen substances today. Fatal intoxications with drugs/new psychoactive substances (NCAs) were observed in 28 cases, while other substances were used in the remaining 17. The conducted analysis showed a significant decrease in suicidal poisoning with the use of corrosive substances and gases, while the percentage of drug overdoses is systematically growing. Poisons used for suicide purposes in the 1930s left macroscopic changes that could be instantly noticed during the autopsy. The fact that drugs that are currently used most often do not leave such changes may justify the dynamic development of forensic toxicology.
BACKGROUND: The usefulness of echocardiographic characteristics for dementia prediction in patients with heart failure decompensation (HFD) is not determined. Therefore, we sought to investigate the echocardiographic features of patients with HFD and screening diagnosis of dementia (SDD). METHODS: 139 patients aged over 65 years were hospitalized with the diagnosis of HFD. Clinical characteristics and echocardiographic characteristics were recorded during hospitalization. SDD was defi ned based on the result of ALFI-MMSE of < 17 points. RESULTS: Patients with SDD were older (p = 0.013), had thicker IVSd (p = 0.021), thicker PWd (p = 0.005) and had a higher RWT (0.40 vs 0.35, p = 0.004) than patients without SDD, without differences in LVMI (p = 0.13). There was no correlation between RWT and LVMI (r = −0.01, p = 0.88). In the multivariate analysis, an older age (β = −0.116, 95% CI −0.224 -−0.008, p = 0.035, per year) and a higher RWT (β =−0.069, 95% CI −0.137 -−0.002, p=0.045, per 0.01) infl uenced a lower ALFI-MMSE. For a prediction of SDD, the RWT reached the area under a ROC curve of 0.67 (95% CI 0.56-0.77, p = 0.004 with sensitivity of 60% and specifi city of 70% for RWT of ≥0.375). CONCLUSIONS: Apart from age, RWT refl ecting left ventricular geometry changes but not hypertrophy was independently but moderately associated with SDD in patients following HFD (Tab. 4, Fig. 1, Ref. 35).
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