Acute poisoning in children. Cases hospitalized during a three-year period in Trinidad

The aim of this study is to describe the epidemiological features of acute poisoning in children less than 16 years old who were admitted to a paediatric hospital in north Trinidad. The specific objectives included the determination of the age range most susceptible to poisoning, which agents are mainly responsible, an examination of the need for preventive strategies and educational programmes as well as to evaluate the need for a poison control centre in the country. Data were extracted from the medical records of 169 patients (83 males (49) and 86 females (51) with acute poisoning during the period of January 1998 to December 2000. The results revealed that the majority of cases of poisoning were accidental (84.6), suicide (11.2) and forced poisoning (4.1). The largest category of poisoning was a miscellaneous group (24.8) followed by the drug category (21.8), kerosene (19.5), pesticides (15.9) and bleach (9.4). Paraquat ingestion constituted 5.3 of cases. The highest prevalence of acute poisoning occurred within the age group of 0-4 years (69.2), followed by the age group of 10-13 years (13.6), 5-9 years (9.4) and the age group with the lowest incidence was 14-16 years (7.6). The only fatality was a female (10-13 year-group) and this was due to suicidal ingestion of paraquat. All other cases were treated and subsequently discharged. The frequency of accidental poisoning in Trinidad merits more widespread public education aimed at preventing exposure to toxic substances while increasing the use of deterrents such as child-resistant containers

Altered biological distribution and decreased neuromuscular toxicity of niosome encapsulated vincristine.

Effects of encapsulation within niosomes (nonionic surfactant vesicles) on the biological distribution and toxicity of vincristine-a widely used anticancer drug have been investigated. Plasma kinetics, tissue distribution profile and neuromuscular toxicity of niosomal vincristine (NVCR) were compared with those of free vincristine (FVCR). NVCR was cleared from the plasma much more slowly [t1/2(beta) = 1.388 hr] than FVCR [t1/2(beta) = 0.74 hr]. Over the 48 hr period of experiment, the niosome formulation delivered significantly more drug to the plasma compartment than FVCR and resulted in reduced accumulation of drug in gut and skeletal muscle. Encapsulation caused a marked alteration in the tissue disposition of the drug. NVCR was less toxic both in terms of mortality and morbidity. Importantly, histopathological studies of skeletal muscle, spinal cord and sciatic nerve of NVCR treated albino wistar rats demonstrated the less toxic potential of encapsulated vincristine. Further, the biochemical studies, estimation of enzymes plasma creatine phosphokinase and lactate dehydrogenase, confirmed the safety profile of NVCR. The decreased partitioning of NVCR to non active sites resulted in a significant amelioration of the toxic side effects, gastrointestinal and myological in particular, of the drug. The results indicate that the delivery of vincristine by encapsulating it in niosomes offer an efficient means of decreasing its toxic effects.