Lethal poisoning with theophylline in the form of rectally administered tablets

The paper discusses the case of death of a 56-year-old man who died in a municipal hospital from which his body was taken to the Chair and Department of Forensic Medicine, Jagiellonian University Medical College, Krakow. The man was said to have been found unconscious by accidental passers-by. While being transported to the hospital’s emergency department, he suffered an attack of convulsions and went into cardiac arrest. He was subsequently successfully resuscitated. A physical examination performed at the hospital revealed the presence of multiple, only slightly dissolved tablets in the man’s rectum. The patient died on the 25th day of hospitalization. A toxicological analysis showed a toxic concentration of theophylline (25 mg/l) in the man’s blood. Theophylline was identified as the main ingredient of the tablets. The cause of death was thus given as theophylline poisoning. The reported case is unusual in that the poisoning occurred as a result of overdosing on an oral drug which was administered by the victim rectally, and in that the chosen substance currently is not very commonly used in medicine, and does not cause symptoms of intoxication

Distribution of facial injuries in cases involving a fall on a flat surface

Aim of the study : Determination whether injuries identified on the victim’s head were caused by a blow made by another person or by a fall resulting in hitting a surface. Material and methods : An analysis of archive photographs taken routinely at the Forensic Institute in Krakow, Poland, to document post-mortem examinations in the years 2004–2012. Results : A comparative analysis of the images clearly shows that certain areas are much more vulnerable to contact with the surface and thus to injuries; other areas are clearly protected in the case of a fall on a flat surface. Conclusions : In the case of a fall on a solid, flat surface, injuries are located first of all on brow ridges, nasal bridge and nasal apex, on the malar area and on the front surface of the chin. The following areas are clearly protected: eyelids, eyebrows, medial and upper parts of the cheeks, lips and the lower part of the chin

Homicides with corpse dismemberment in the material collected by the Department of Forensic Medicine, Krakow, Poland

Aim of the study : To determine the circumstances which can be useful for offenders profiling in homicide cases with victim’s body dismemberment. Material and methods: Study of all homicide cases with victim’s corpse dismemberment examined in Krakow Department of Forensic Medicine over the last 50 years. Results : Within the past 50 years, a total number of 30 cases of homicides with dismembered bodies were examined in Krakow. 22 cases represent defensive mutilations performed by offender, 3 cases can be classified as offensive muti­lations and 3 cases represent aggressive mutilations – decapitation as a method of committing homicide. In this period the only 1 case of necrophilic mutilations was examined, when the body was dismembered without murder. In most cases the background of homicide was the family conflict, 6 was cause of mental illness of perpetrator and in 3 was sexual motive. Only in 3 cases (from 25 when the offender was known) perpetrator kill a stranger. In the other the offender belonged to the family or friends of the victim. In all cases where the perpetrator was determined, homicide and dismemberment was performed in his place of residence. The findings of the Police investigations indicate that in most cases homicides were not planned, occurred under the influence of emotion, only two have been previously scheduled. Conclusions : Homicides with corpses dismemberment usually are committed by offenders who is in close relationship with victim (family or friend). Dismemberment is almost always performed in the same place as murder – home of perpetrator. This type of homicide usually is not planned

Medico-legal aspect of amphetamine-related deaths

The subject of the work included 41 cases of death in which amphetamine was involved as the direct or indirect cause. Identification and determination of xenobiotics in blood samples collected from post-mortem cases were performed by high-performance liquid chromatography coupled with tandem mass spectrometry with electrospray ionisation (HPLC-ESI-MS-MS). Only for two cases was the cause of death amphetamine poisoning. In most of the investigated cases the death was caused by poisoning due to complex amphetamine and other psychoactive substances (e.g. opiates, benzodiazepines, cocaine). In other cases, multi-organ damage (fall from a height, traffic accident), a puncture wound and wound incised, drowning, or asphyxiation by hanging were reported. It can be explained as risky, murderous, or suicidal actions of people who were under the influence of amphetamines. The presented paper focuses on the interpretation of amphetamine concentration in blood samples from the perspective of direct or indirect cause of death

Security theory and practice: Medical rescue and disater medicne in crisis response

Ze wstępu: Nieznany jest autor powiedzenia, że wojny wygrywa się nie liczbą żołnierzy, lecz liczbą sanitariuszy – na pewno jednak nie należy traktować tej sentencji wyłącznie jako zręcznego bon mot, lecz jako głęboką mądrość. Od liczebności, sprawności i skuteczności służb ratowniczych zależy bowiem, czy przetrwamy kataklizmy, tj. czy będziemy umieli minimalizować liczbę ofiar katastrof, zamachu terrorystycznego lub konfliktu zbrojnego, gdyby do takiego miało dojść. Po raz pierwszy zajęliśmy się w naszym czasopiśmie problematyką ratownictwa, rozważanego na tle reagowania kryzysowego i medycyny katastrof, postanawiając przyjrzeć się kondycji polskiego ratownictwa oraz głównym wyzwaniom, jakie stoją przed służbami ratowniczymi RP, wreszcie – nowym trendom rozwojowym ratownictwa. Do podjęcia tematyki skłoniły nas także narastające w społeczeństwie obawy przed pogarszaniem się jakości zarówno podstawowych usług medycznych oraz szpitalnictwa, jak i medycyny ratunkowej1. Zmiany w systemie medycyny ratunkowej podyktowane są względami oszczędnościowymi, a także szczupłością kadry lekarzy specjalistów medycyny ratunkowej, których liczba nie przekracza dwóch tysięcy wobec czternastu tysięcy ratowników medycznych. Bieżący rok przebiega pod znakiem akcji protestacyjnych różnych grup pracowniczych służby zdrowia – lekarzy rezydentów, pielęgniarek i ratowników medycznych. Polska plasuje się dziś na przedostatnim miejscu w Europie, jeśli chodzi o dostępność specjalistycznej pomocy medycznej, i nic nie zapowiada, by w najbliższym czasie sytuacja miała ulec poprawie. Tym większe znaczenie społecznych organizacji ratowniczych i postawa tysięcy wolontariuszy gotowych nieść pomoc potrzebującym. W numerze zarysowujemy obraz współczesnego polskiego ratownictwa, piszemy o ratownictwie medycznym, wodnym i górskim, a także o psychologicznym wsparciu poszkodowanych w formie ratownictwa psychologicznego. Sygnalizujemy znaczenie nowoczesnych technologii, które pozwalają na skuteczne prowadzenie akcji poszukiwawczych i ratunkowych w górach, jaskiniach i nad wodą. Całości numeru dopełniaja recenzje książek związanych tematycznie z profilem numeru oraz seria komunikatów

The First Evidence of Cryptosporidium meleagridis Infection in a Colon Adenocarcinoma From an Immunocompetent Patient

Objectives: The potential linkage between Cryptosporidium spp. infection and colorectal human cancer was suggested by limited reports showing higher prevalence of C. parvum and C. hominis in patients with colon cancer. Here we conducted research concerning presence of Cryptosporidium spp. in malignant tissue collected from patients with colorectal cancer.Methods: Cancerous colon tissue samples collected from 145 non-HIV infected patients with colorectal cancer were screened for Cryptosporidium spp. by immunofluorescence antibody test and genus-specific nested polymerase chain reaction followed by sequencing.Results: Screened pathogen was found in cancerous tissue originating from immunocompetent man with colon adenocarcinoma. Genotyping revealed presence of Cryptosporidium meleagridis. The presence of Cryptosporidium life cycle stages (oocysts and endogenous stages) in colon carcinoma tissue was confirmed by genus-specific FITC-labeling.Conclusions: Herein, we report on a C. meleagridis infection of a colon adenocarcinoma in an immunocompetent patient. This is the first report of C. meleagridis infection in the human colon and first evidence of active development of this species in cancer tissue