Death as a result of autoerotic activities : criminalistic, legal, forensic-medical and psychological aspects

abstract The aim of the paper is to discuss issues related to cases of death during autoerotic activities (defined in international literature as autoerotic death) on the basis of criminalistic, legal, forensic-medical and psychological knowledge. These are events in which death usually occurs as a result of rapid suffocation (autoerotic asphyxia, sexual asphyxia) due to the blocking of respiratory openings, hanging or strangulation, in the course of activities undertaken in order to evoke defined experiences of a sexual nature. A fatal consequence should be investigated rather as an unfortunate accident than the conscious intention of the victim/ perpetrator of the incident. As in the case of suicide, the victim is at the same time the perpetrator of the action, although other people may also have participated in the behaviour or provoked it. Some cases of this type must surely number among the dark figure of crimes. The case selected and described in this paper was studied at the Department of Forensic Medicine, Jagiellonian University Medical College in Kraków. It constituted both an example and a starting point for broader analysis of the issue with reference to various fields of science. Incidents consisting in self-strangulation with the aim of achieving sexual satisfaction have been noted by sexologists, and in situations ending in death, such cases are analysed by law enforcement agencies with the participation of forensic medical doctors. Cases of death as a result of autoerotic activities thus requires a complex, interdisciplinary approach in order to explain them

Death as a result of autoerotic activities - criminalistic, legal, forensic-meDical anD psychological aspects

abstract The aim of the paper is to discuss issues related to cases of death during autoerotic activities (defined in international literature as autoerotic death) on the basis of criminalistic, legal, forensic-medical and psychological knowledge. These are events in which death usually occurs as a result of rapid suffocation (autoerotic asphyxia, sexual asphyxia) due to the blocking of respiratory openings, hanging or strangulation, in the course of activities undertaken in order to evoke defined experiences of a sexual nature. A fatal consequence should be investigated rather as an unfortunate accident than the conscious intention of the victim/ perpetrator of the incident. As in the case of suicide, the victim is at the same time the perpetrator of the action, although other people may also have participated in the behaviour or provoked it. Some cases of this type must surely number among the dark figure of crimes. The case selected and described in this paper was studied at the Department of Forensic Medicine, Jagiellonian University Medical College in Kraków. It constituted both an example and a starting point for broader analysis of the issue with reference to various fields of science. Incidents consisting in self-strangulation with the aim of achieving sexual satisfaction have been noted by sexologists, and in situations ending in death, such cases are analysed by law enforcement agencies with the participation of forensic medical doctors. Cases of death as a result of autoerotic activities thus requires a complex, interdisciplinary approach in order to explain them

Long-term cenobamate retention, efficacy, and safety: outcomes from Expanded Access Programme

Aim of the study. To evaluate the long-term retention rate, efficacy, and tolerability of adjunctive cenobamate (CNB) in patients with drug-resistant epilepsy within the Polish Expanded Access Programme (EAP). Clinical rationale for the study. Long-term retention rate is a useful measure of effectiveness including efficacy, safety, and tolerability of antiseizure medications. Material and methods. We conducted a multicentre retrospective analysis of consecutive patients with focal epilepsy treated with CNB in the EAP between January 2020 and May 2023. All patients who completed the open-label extension phases of the YKP3089C013 and YKP3089C017 trials were offered the opportunity to continue CNB treatment within the EAP. We analysed cenobamate retention, seizure outcomes, and adverse events. Results. 38 patients (18 females; 47.3%) continued CNB treatment within the Expanded Access Programme for 41 months. The mean baseline age of patients was 39.3 years (range: 18–57). All patients were on polytherapy, with the most commonly used antiseizure medications being valproate, levetiracetam, and carbamazepine. Adjunctive CNB treatment resulted in a reduced mean seizure frequency from 8.1 seizures (range: 4-20) per month to 3 seizures (range: 0–8) per month. At the final follow-up, the median CNB dose was 200 mg/day (range: 50–350). Among the patients, 24 (63.1%) achieved ≥ 50% seizure reduction, and eight (21%) remained seizure-free for at least 12 months. One in three patients experienced adverse events, which resolved in half of the subjects. The most frequent adverse events were dizziness, somnolence, and headache. The retention rate after completing the open-label extension phase was 100%. Conclusions and clinical implications. Long-term effectiveness, including ≥ 50% seizure reduction and a 100% retention rate, was sustained over 41 months of CNB treatment within the Expanded Access Programme. No new safety issues were identified. These results provide support for the potential long-term clinical benefits of cenobamate

Security theory and practice: Energy security and environmental/climate protection in the second decade of the 21st century: Development trends

ZE WSTĘPU: W niniejszym tomie podjęte zostały aktualne zagadnienia związane z wybranymi aspektami bezpieczeństwa ekologicznego (w ujęciu przedmiotowym i narodowym), jak również implikacjami powiązania kwestii ochrony środowiska i klimatu z rozwojem społeczno-ekonomicznym oraz polityką i bezpieczeństwem energetycznym

Mechanical thrombectomy in acute stroke – Five years of experience in Poland

Objectives Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% – emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization – in 30.7%, mRS of 0–2 – in 31.4% and mRS of 6 in 22% of cases. Conclusion Our results can help harmonize standards for MT in Poland according to international guidelines

The Utility of BDNF Detection in Assessing Severity of Huntington’s Disease

Brain-derived neurotrophic factor (BDNF) is involved in the survival and maturation of neurons, and also promotes and controls neurogenesis. Its levels are lowered in many neurodegenerative diseases, including Huntington’s disease (HD). Clinical pictures of HD can be very diverse, which makes it difficult to assess its severity; however, molecular markers may be helpful. The aim of the study was to determine the relationship between HD severity and the plasma BDNF concentration in HD patients. The study recruited 42 patients with diagnosed and genetically confirmed HD and 40 healthy volunteers. BDNF levels were determined in plasma with the enzyme-linked immunosorbent assay (ELISA). Correlations between BDNF levels and clinical profiles and HD severity were also investigated. The BDNF level was significantly lower in HD patients compared to the control. There was no correlation between the BDNF level and motor symptoms and cognitive impairment. In the early disease stages, BDNF levels were associated with a better neurological examination, independence, and functional evaluation, in contrast to later HD stages, where the correlations were inverse. Multidirectional correlations between parameters of saccadic disorders and the BDNF level do not allow for drawing a conclusion, whether or not there is a relationship between the severity of saccadic disorders and the BDNF concentration

Assessment of the Prospects of Polish Non-Food Energy Agriculture in the Context of a Renewable Energy Source

This paper describes examples of energy crops that are profitable to burn, and whose cultivation is not complicated or expensive. Rapid growth of biomass, especially the green mass of energy crops, is indicated, which means that, in relation to fossil fuels, energy crops are considered renewable raw materials. An assessment of Polish non-food energy agriculture was conducted in the context of the prospects of a renewable energy source, namely, biomass. Recommendations for crop cultivation, the size of possible yields and the most important parameters of the obtained biomass, which have the greatest impact on the suitability of energy use, are presented. Materials of biological origin for combustion are divided into three groups: wood waste, by-products and plant products for the energy industry. It is indicated that 2 tons (Mg) of dry wood or straw is energetically equivalent to 1 Mg of coal, and 1 m3 of biogas is energetically equivalent to 1 kg of Polish coal. A novelty of this article is the interpretation of obtaining primary energy, including energy from renewable sources, in the European Union and Poland, taking into account the production of wood waste, straw, cereals and energy crops. The mechanism of the impact of the production parameters of energy crops was revealed during the prepared analysis of the prospects of Polish energy agriculture. Additionally, we conducted an analysis of the potential of biomass as a source of energy in the context of: obtaining primary energy, including energy from renewable sources, in the European Union and Poland; the number of biogas plants in Poland; and the area of agricultural land that is potentially useful for the cultivation of energy crops