Smrtna otrovanja u gradu Zagrebu

The paper deals with the results of analysis of fatal poisonings in the city of Zagreb from 1981 to 1990. The work is an extension of earlier analyses for the same area that were carried out from the foundation of the Department for Forensic Medicine and Criminology, School of Medicine, University of Zagreb in 1934 to 1967, and from 1968 to 1980. Comparative analysis of all data shows that despite the increasing rate of poisoning the number of cases of fatal poisoning has been steadily diminishing - from 11 cases per 100.000 population in the 1934-1967 period and eight cases between 1968 and 1980 to five cases in the latest period 1981-1990.Analizirani su smrtni slučajevi otrovanja na području grada Zagreba za razdoblje od 1981, do 1990. godine. Analiza je nastavak ranijih proučavanja smrtnih otrovanja na području grada, od osnutka Zavoda za sudsku medicinu i kriminalistiku Medicinskog fakulteta Sveučilišta u Zagrebu 1934. godine do 1967. godine, te od 1968. do 1980. godine. Unatoč sve većem broju otrovanja analiza između ostaloga pokazuje stalni pad broja smrtno otrovanih, od 11 osoba na 100,000 stanovnika grada između 1934. i 1967. godine, na osam smrtno otrovanih u vremenu između 1968. i 1980. godine, na pet stanovnika na 100.000 stanovnika grada Zagreba u vremenu od 1981, do 1990, godine

Death poisoning with Reopin of a two-year old girl

Dvogodišnja djevojčica je prema izjavi bake progutala dvije Reopin-G dražeje. Nakon 7 sati hospitalizirana je, ali unatoč poduzetoj intenzivnoj terapiji dijete je umrlo 30-ak sati nakon trovanja, uslijed zatajivanja vitalnih centara. Izvršena obdukcija i histološke pretrage pokazale su nespecifične promjene na organima. Kemijsko-toksikološkom analizom u tkivu jetre i tkivu bubrega, krvi i urina nađen je aminofenazon, dok je fenilbutazon nađen samo u tkivu jetre i bubrega.A two-year-old girl according to her grandmother, swallowed two Reopin-G tablets. After seven hours she was hospitalized, but although an intensive therapy was applied, the child died 30 hours after poisoning, because of failure of vital centres. At autopsy, histological examination showed non-specific changes of parenchymal organs. Chemical-toxicological analysis demonstrated the presence of aminophenazone in the liver and renal tissue, and in blood and urine. Phenylbutazone was found only in the liver and renal tissue

Sudden Death Due to Recreational Exercise in Physicians

In a period from 1982-2002 we noticed five dead among Croatian male physicians aged 34 to 67, during or after recreational physical exercise: swimming, soccer, tennis and jogging. Three of them who were autopsied, have been non-smokers and without previous symptoms. In all coronary heart disease was found. The left descending anterior artery was stenotic in one and occluded in two, with myocardial scars in one. An acute myocardial infarction was found in none of them, and in two-left ventricular hypertrophy 15 and 18 mm. We could not find a recent medical record in those physicians including a clinical finding and other findings. Two physicians who were not been autopsied, had possible an alcohol cardiomyopathy. Both of them were smokers. In Croatia about 7 % of the whole population are engaged in recreational physical exercise. In a period of twenty years (1982–2002) we noticed 43 sudden and unexpected deaths during or immediately after physical exercise: it reached 43/6,300,000 sudden death in Croatia in twenty years or 2.15/315,000 yearly among persons engaged in physical exercise. In Croatia there are 4,957 male physicians-specialists, and a rate of sudden cardiac death during or immediately after physical exercise in this group reached 5/99,140 in 20 years or 1/19,828 every four years. A medical check up before recreational physical exercise is essential including a clinical examination, a serum concentration of risk factors and other risk factors, an electrocardiogram at rest, a stress test and echocardiography in clinical indication, as are medical controls over persons taking exercise. This study shows that medical evaluation is important because of the underlying problems such as sudden death during exercise. In non-trained persons and in the elderly a physical exercise should be recommended of a gradually intensity, which could not exceed 6 METs

Sudden Death Due to Physical Exercise in the Elderly

Physical exercise has a beneficial effect to the humans. Sudden death in healthy persons engaged in physical exercise is extremely rare since healthy heart is protected from complications. The records of five elderly men who died during or immediately after exercise in the period between 1988–2001 in our region have been given, out of 23 men (and no one woman) aged 14–68 who died due to physical exercise in that time. They have been engaged in tennis, jogging and swimming recreatively. In all of them coronary heart disease has been found by the forensic autopsy. Only one has had arterial hypertension, symptoms of chest pain few years before accident and acute myocardial infarction has been found. The other four have been without symptoms. In three of them myocardial scars have been found of past myocardial infarctions. In all of them the thickness of the left ventricle wall was 15 mm or more (from 15 to 25 mm). It seems that the thickness of the wall of the left ventricle increases cardiovascular risk in persons without symptoms. In Croatia about 7% of the whole population are engaged in recreation. In this population 13% are elderly: 40,950. The reported five deaths due to recreational physical exercise in the elderly reached 1/114,660 persons every three years, or 1/573,300 persons during fourteen years