ABSTRACT
RESUMEN Introducción: La atención a los intoxicados, en las emergencias químicas, tiene un carácter sistémico en las instituciones hospitalarias, por lo que se hace necesario organizar áreas, que permitan la recepción masiva. Objetivo: Determinar la estructura de las áreas para la recepción masiva de intoxicados por emergencias químicas en los hospitales. Método: Se realizó una investigación en sistemas y servicios de salud, en el periodo comprendido de 2005 a 2017. Se revisaron y analizaron fuentes bibliométricas e infométricas y se consultaron informantes claves. Resultados: Bajo principios toxicológicos, en las emergencias químicas, se propone organizar el hospital en doce áreas fundamentales: recepción, tratamiento especial y descontaminación, clasificación, tratamiento de urgencia, hospitalización del intoxicado grave, hospitalización del intoxicado leve, aseguramiento al diagnóstico, aseguramiento médico material, información toxicológica, vigilancia toxicológica, asintomáticos, fallecidos. Conclusiones: La estructura organizacional del hospital en la recepción masiva de intoxicados por emergencias químicas difiere de otros tipos de eventos. Tiene carácter sistémico. Su dinámica depende de principios toxicológicos. El tipo de tóxico y la vía de entrada determinan la presencia o no de un área de tratamiento especial y descontaminación. El área de recepción cumple las funciones de recepción y clasificación, pero, esta última, determina el tipo de descontaminación. En el área de clasificación se define la prioridad de atención médica. Las áreas de tratamiento de urgencia, hospitalización, y, el área de aseguramiento médico material, se crean, en departamentos y servicios dotados de los recursos que permitan su funcionamiento. La propuesta, se caracteriza por ser flexible, participativa, objetiva y reproducible.
ABSTRACT Introduction: Care to poisoned people during chemical emergencies has a systemic nature in hospital institutions, so it is necessary to organize areas that allow mass reception. Objective: To determine the structure of the areas for the mass reception of poisoned people by chemical emergencies in hospitals. Method: A research was carried out in health systems and services in the period from 2005 to 2017. Bibliometric and infometric sources were reviewed and analyzed and key informants consulted. Results: Under toxicological principles, in chemical emergencies, it is proposed to organize the hospital into twelve fundamental areas: reception, special treatment and decontamination, classification, emergency treatment, hospitalization of severe poisoned, hospitalization of mild poisoned, assurance of diagnosis, medical material assurance, toxicological information, toxicological surveillance, asymptomatic patients, and deceased. Conclusions: The organizational structure of the hospital in the mass reception of people poisoned by chemical emergencies differs from other types of events. It has a systemic nature. Its dynamics depends on toxicological principles. The type of toxic substance and the way of entry determine the presence or not of a special area of treatment and decontamination. The reception area fulfills the functions of reception and classification but the latter determines the type of decontamination. In the classification area, the priority of medical attention is defined. The areas of emergency treatment, hospitalization, and the area of material medical assurance are created in departments and services endowed with the resources that allow their operation. The proposal is characterized by being flexible, participative, objective and reproducible.
ABSTRACT
INTRODUCCIÓN: Las intoxicaciones en pediatría constituyen un importante problema de salud pública mundial. El espectro de estas entidades es amplio, abarcando desde la exposición accidental con sustancias inocuas, hasta el contacto con sustancias potencialmente mortales. El objetivo de la presente investigación fue conocer la epidemiología de las intoxicaciones pediátricas presentadasen el Hospital Vicente Corral Moscoso en el año 2015. METODOLOGÍA: Se realizó un estudio descriptivo retrospectivo; el universo estuvo conformado por todos los pacientes de 0 a 15 años que acudieron al Hospital Vicente Corral Moscoso y fueron diagnosticados de intoxicación, durante el período de tiempo comprendido entre enero diciembre 2015. Se utilizó estadística descriptiva, para el análisis de la información se utilizó el programa SPSS versión 22.0. RESULTADOS: Se registraron un total de 76 casos; el 60.5% (n=46) de sexo femenino y el 39.5% (n=30) de sexo masculino. Las causas más frecuentes de intoxicación fueron: intoxicación por alcohol 34.3% (n=27), intoxicación alimentaria 21.1% (n=16) e intoxicación medicamentosa 13.2% (n=10); en el 18.4% (n=14) de los casos no se pudo determinar el agente causal. El relación al sitio de ocurrencia y gravedad de la patología, el 88.2% (n=67) de las intoxicaciones ocurrió en el domicilio del paciente, el 22.4% (n=17) requirió hospitalización, y se registró una mortalidad del 5.26% (n=4). CONCLUSIÓN: El perfil epidemiológico local de las intoxicaciones pediátricas en relación a edad, sexo y tóxicos más frecuentes; fue significativamente diferente al reportado por otras investigaciones internacionales. El consenso general es que el hogar del paciente es el sitio más frecuente de ocurrencia. Se requiere promover políticas de educación favorezcan la detección temprana, tratamiento y prevención de estas patologías.(au)
BACKGROUND: Poisoning in pediatrics is a major global public health problem. The spectrum of these entities is broad, ranging from accidental exposure with harmless agents, to contact with potentially deadly substances. The aim of this study was to know the epidemiology of pediatric poisoning presented at Vicente Corral Moscoso Hospital in 2015. METHODS: A retrospective descriptive study was performed; the universe included all patients from 0 to 15 years old who were diagnosed of poisoning at Vicente Corral Moscoso Hospital from January December 2015. Descriptive statistics was used, the analysis of information were performed with SPSS version 22.0. RESULTS: A total of 76 cases were identified; 60.5% (n=46) females and 39.5% (n=30) males. The most frequent etiologic agents were: alcohol intoxication 34.3% (n=27), food poisoning 21.1% (n=16) and medication poisoning 13.2% (n=10); in 18.4% (n=14) of the cases the causative agent could not be identified. In relation to the place of occurrence and severity of the pathology, 88.2% (n=67) of the poisonings occurred in the patient's home, 22.4% (n=17) required hospitalization, with a mortality of 5.26% (n=4). CONCLUSION: The local epidemiological profile of pediatric poisoning in relation to age, sex and etiology; was significantly different from that reported by other international investigations. The general consensus is that the patient's home is the most frequent site of occurrence. It is necessary to promote education policies that favor early detection, treatment and prevention of these pathologies.(au)
Subject(s)
Humans , Male , Female , Infant, Newborn , Child, Preschool , Child , Adolescent , Pediatrics , Poisoning , Emergencies , PrevalenceABSTRACT
In this brief communication the authors report eleven cases of human poisoning caused by ingestion of pufferfish meat. Three patients (two children and one adult) were seriously affected. The circumstances that precipitated the poisoning are discussed as well as the clinical aspects observed. No deaths were registered and the patients did not present sequelae after the episode.(AU)
Subject(s)
Tetraodontiformes , Eating , Meat/toxicity , Research Report , Foodborne DiseasesABSTRACT
In this brief communication the authors report eleven cases of human poisoning caused by ingestion of pufferfish meat. Three patients (two children and one adult) were seriously affected. The circumstances that precipitated the poisoning are discussed as well as the clinical aspects observed. No deaths were registered and the patients did not present sequelae after the episode.
Subject(s)
Humans , Animals , Foodborne Diseases , Tetraodontiformes , Tetrodotoxin/poisoning , Fish Venoms , BrazilABSTRACT
En este artículo se presenta el caso de un paciente con intoxicación crónica por plomo, cuya principal manifestación clínica fue dolor abdominal. Esta es una intoxicación quegeneralmente se presenta en pacientes que están en contacto laboral con este metal. En este artículo se revisan las manifestaciones clínicas más frecuentes y el manejo de estapatología, ya que de no identificarse y tratarse de forma oportuna, cursa con una alta morbimortalidad...
This article presents a case of chronic lead poisoning, which principal manifestation was abdominal pain. This usually occurs in patient who works with the metal. We reviewed the most frequent clinical manifestation and management. If is untreated thispoisoning has a high morbidity and mortality...
Subject(s)
Humans , Abdominal Pain/diagnosis , Poisoning , Lead Poisoning , Lead/radiation effectsABSTRACT
Foi realizado um levantamento das intoxicações por plantas em 20 municípios do Sertão Paraibano, onde foram entrevistados 50 produtores e 11 médicos veterinários. De acordo com o levantamento realizado, Ipomoea asarifolia e Mascagnia rigida são as intoxicações mais importantes. Indigofera suffruticosa, as plantas cianogênicas (Sorghum vulgare, Piptadenia macrocarpa e Manihot spp.), Mimosa tenuiflora, Aspidosperma pyrifolium e Crotalaria retusa são plantas importantes como causa de intoxicações na região. Os entrevistados relataram casos esporádicos de intoxicação por Ricinus communis, Enterolobium contortisiliquum, Prosopis juliflorae Brachiaria decumbens. Ziziphus joazeiro, Passiflora sp., Caesalpina ferrea e Crescentia cujete foram mencionadas como causa de abortos em ruminantes. Frutos de Crescentia cujete foram administrados a duas cabras prenhes causando mortalidade perinatal e abortos. As cascas de feijão (Phaseolus vulgaris e Vigna unguiculata) e as folhas de Licania rigida (oiticica) são associadas à sobrecarga ruminal em bovinos. As frutas de Mangifera indica (manga)e Anacardium occidentale (cajú) são responsabilizadas por causarem intoxicação etílica. Dalechampia sp. e Croton sp. foram citadas pelos entrevistados como possíveis plantas tóxicas, que ainda não tiveram sua toxicidade comprovada.
A survey of plant poisoning in ruminants and equidae was conducted in 20 municipalities of the semiarid region of the Sertão Paraibano. Fifty farmers and 11 veterinary practitioners were interviewed. Ipomoea asarifolia and Mascagnia rigida are the most important poisonous plants in the region. Indigofera suffruticosa, the cianogenic plants (Sorghum vulgare, Piptadenia macrocarpa, and Manihot spp.), Mimosa tenuiflora, Aspidosperma pyrifolium and Crotalaria retusa cause also important intoxications in the area. Sporadic outbreaks of poisonings by Ricinus communis, Enterolobium contortisiliquum, Prosopis juliflora and Brachiaria decumbens were also mentioned. Some farmers mentioned that Ziziphus joazeiro, Passiflora foetida, Caesalpina ferrea and Crescentia cujete cause abortion. The fruits of Crescentia cujete were administered to two pregnant goats causing perinatal mortality and abortion. The peels of the beans Phaseolus vulgaris and Vigna unguiculata, and the leaves of Licania rigida are associated with ruminal impactation in cattle. The fruits of Mangifera indica (mango) and Anacardium occidentale (cashew) are associated with ethanol poisoning in cattle. Dalechampia sp. and Croton sp. were also mentioned as possible toxic plants in the region.
Subject(s)
Animals , Plant Poisoning/epidemiology , Plant Poisoning/veterinary , Plants, Toxic/poisoning , Equidae/immunology , Plants, Toxic/adverse effects , RuminantsABSTRACT
A crença de que medicamentos à base de plantas são isentos de riscos à saúde faz parte da bagagem cultural da população afeita ao seu uso: "o que vêm da terra não faz mal". No entanto, o potencial tóxico, as características específicas do usuário, a possibilidade de contaminação e a falta de regulamentação constituem fatores de risco para a ocorrência de reações adversas, intoxicações e outras complicações decorrentes de seu uso. Foram realizadas entrevistas semi-estruturadas junto a 20 raizeiros (vendedores de ervas "in natura") na cidade de Diadema/SP. Foram relatados 40 casos de problemas relacionados ao uso de 22 espécies de plantas medicinais. As espécies mais citadas foram Luffa operculata - buchinha (7 casos), Senna alexandrina - sene (4 casos) e Paullinia cupana - guaraná (3 casos). Dentre os sinais e sintomas relatados, os mais freqüentes foram relacionados ao sistema nervoso central, problemas gastrointestinais e cardiovasculares. Os entrevistados também relataram um caso de aborto relacionado ao uso de S. alexandrina e três casos de óbito após a ingestão do chá do fruto de L. operculata. O caráter "natural" das plantas medicinais não é sinônimo de ausência de riscos para a população usuária. É necessária a implantação de políticas de fitofarmacovigilância eficientes, a fim de tornar o consumo mais racional e, deste modo, minimizar os riscos à população usuária.
Traditionally, medicinal herbs have been considered gentle and harmless because of their natural origin: "natural and therefore free of risks". However, toxic potential, various consumer-related factors (such as age, disease factors, pregnancy, etc), contamination, and lack of regulation concerning quality control are some of the risk factors deemed to be associated with herbal adverse reactions, poisonings and other complications. Over a 7-month period, semi-structured interviews were carried out with 20 "raizeiros" (traditional healers) in Diadema/SP. We found 40 unexpected events related to 22 species of medicinal herbs. The most frequent species reported were Luffa operculata - "buchinha" (7 reports), Senna alexandrina - "sene" (4 reports) and Paullinia cupana - "guaraná" (3 reports). Among the adverse events, the most frequent signs and symptoms reported involved the central nervous, gastrointestinal and cardiovascular systems. They also reported one case of abortion (related with S. alexandrina) and three deaths related with L. operculata. Adverse events that result from "natural" medicines are relatively uncommon, but they certainly occur more often than acknowledged. Medicinal plants are traditionally considered as innocuous, but as commercially available medicinal products they require sanitary surveillance in order to identify their risks, to give them a legal status, to evaluate their efficacy and to ascertain their safety.
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Seafood is an important source of dietary protein worldwide, especially for coastal and island dwellers who now comprise 70% of the world’s population. Besides being high in protein and providing 40% of the world’s protein intake, seafood is low in cholesterol and saturated fatty acids and contains unique long-chain omega-3 polyunsaturated fatty acids (PUFAs). Two seafood PUFAs, eicosapentanoic acid (EPA) and docosahexanoic acid (DHA) inhibit platelet aggregation and reduce mortality from myocardial infarction (MI) and ischemic stroke. Although the United States (U.S.) scientific community has recommended a Mediterranean-type diet, based on beneficial PUFAs in seafood, the European scientific community has cautioned that the increasing methylmercury levels in seafood may counteract any cardioprotective effects of PUFAs and actually increase risks of MI. This review describes the health benefits of seafood consumption and makes recommendations for the safe selection and preparation of seafood. In addition, this review describes the burden of seafood-borne diseases, separates seafood-borne toxic, heavy metal, and pesticide poisonings from seafood-borne infectious diseases; and makes recommendations for the management and prevention of seafood-borne illnesses. With the exception of some of the toxic seafood-borne illnesses, most seafood-borne infectious diseases, heavy metal poisonings, and pesticide poisonings can be prevented by careful selection and preparation of fresh seafood and adherence to weekly seafood consumption advisories, especially for those at highest risk of methylmercury poisoning, such as women who are pregnant, breastfeeding, or of child-bearing age, and children age seven and younger. A balanced diet combining protein from a variety of sources, including carefully selected and prepared seafood, along with natural antioxidants from fruits and vegetables is recommended to prevent seafood-borne diseases and to promote health and longevity.