ABSTRACT
This study evaluated the most common toxic agents affecting domestic cats, the clinical signs of toxicity, and the therapeutic approaches for recovery. A survey on poisoning in cats was conducted among small animal veterinary practitioners from 2017 to 2018. Of the 748 completed questionnaires, 543 (72.6%) were evaluated. Pesticides and household cleaning supplies were the most common causes of poisoning in cats. The toxicant groups included pesticides and household cleaning supplies (organophosphates), human drugs (acetaminophen), plants/plant derivatives (lily), and veterinary drugs (tramadol). The major clinical signs for these four groups of toxicants were (1) acetaminophen poisoning, which caused oxidative erythrocyte damage; (2) muscarinic and nicotinic cholinergic syndrome, which resulted from organophosphate poisoning; (3) acute kidney injury, which resulted from intoxication of lily; and (4) serotonin syndrome, which resulted from tramadol toxicosis. Interventions for treating poisoning in cats were based on the clinical presentation of animals. In the present study, the significant toxins identified to be dangerous for cats were characterized using the obtained data in Brazil as well as the main associated clinical signs and therapy recommended by veterinarians.(AU)
Objetiva-se com este trabalho caracterizar os principais toxicantes para gatos domésticos, bem como os prevalentes sinais clínicos e a terapêutica associada. Uma pesquisa sobre envenenamento em gatos foi realizada entre médicos veterinários no período de 2017 a 2018. Dos 748 questionários preenchidos, 543 (72,6%) foram avaliados. Pesticidas e domissanitários foram os principais causadores de intoxicação em gatos. Entre os grupos tóxicos, destacaram-se, na categoria pesticidas e domissanitários (organofosforados), medicamentos humanos (acetaminofeno), plantas e derivados de planta (lírio) e medicamentos veterinários (tramadol). Os principais sinais clínicos para os quatro grupos de substâncias tóxicas foram: (1) intoxicação por acetaminofeno, que causou dano eritrocitário oxidativo; (2) síndrome colinérgica muscarínica e nicotínica, resultante do envenenamento por organofosforado; (3) lesão renal aguda, causada pela intoxicação por lírio; e (4) síndrome serotoninérgica, resultante da exposição ao tramadol. As intervenções realizadas para o tratamento dos envenenamentos foram justificáveis mediante a apresentação clínica dos animais. Por meio dos dados obtidos, puderam-se caracterizar os principais tóxicos para gatos no Brasil, bem como os principais sinais clínicos associados e a terapêutica preconizada pelos médicos veterinários.(AU)
Subject(s)
Animals , Cats , Organophosphorus Compounds/toxicity , Poisoning/etiology , Poisoning/veterinary , Tramadol/toxicity , Lilium/toxicity , Acetaminophen/toxicity , Serotonin Agents/toxicity , Oxidative Stress , Muscarinic Antagonists/toxicity , Acute Kidney Injury/chemically inducedABSTRACT
RESUMO: Introdução: No Brasil, os medicamentos são os principais agentes causadores de intoxicação, e o maior número de casos desse problema envolve menores de 5 anos. Assim, o objetivo deste estudo foi descrever as internações por intoxicação medicamentosa nessa população quanto a sua demografia, óbitos e indicadores de agravamento. Métodos: Verificou-se a frequência das internações por intoxicação medicamentosa entre 2003 e 2012, utilizando os dados do Sistema de Informação Hospitalar. As variáveis utilizadas foram ano, sexo, idade, município de residência e de internação, evolução do paciente, diagnóstico principal, diagnóstico secundário, natureza do estabelecimento de saúde e valor referente aos gastos de unidade de terapia intensiva. Resultados: Ocorreram 17.725 internações por intoxicação medicamentosa em menores de 5 anos de idade, com o predomínio do sexo masculino e de crianças de 2 anos. As internações fora do município de residência deram-se em 25% dos casos, com predomínio da Região Nordeste. A proporção de óbitos nas internações foi de 0,4%, com maior número de óbitos na Região Sudeste. Conclusão: Apesar da diminuição do número de internações no período, permaneceram disparidades regionais que podem ser atenuadas com a oferta de atenção especializada às intoxicações medicamentosas nos municípios, ampliando o acesso a cuidados de maior complexidade.
ABSTRACT: Introduction: In Brazil, drugs are the main causative agents of poisonings, and children under age five are the group with the highest number of cases. The objective of the present study was to describe hospitalizations due to drug poisoning in this population regarding demographics, deaths and worsening indicators in hospitalizations. Methods: The frequency of hospitalizations for drug poisoning between 2003 and 2012 was verified using data from the Hospital Information System. The study variables were year, gender, age, place of residence and hospitalization, patient follow-up, main diagnosis, secondary diagnosis, nature of the health establishment and amount related to Intensive Care Unit expenses. Results: There were 17,725 hospitalizations due to drug poisoning in children under five, predominantly two-year-old male children. The hospitalizations outside the city of residence occurred in 25% of the cases, with predominance in the Northeastern region. The proportion of deaths in hospitalizations was 0.4%, with a higher number of deaths in the Southeastern region. Conclusion: Despite the decrease in the number of hospitalizations in the period, regional disparities remained, which could be attenuated with the provision of specialized attention to drug poisonings in municipalities, expanding the access to a more complex care.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Poisoning/mortality , Pharmaceutical Preparations/administration & dosage , Drug Therapy/mortality , Drug-Related Side Effects and Adverse Reactions/mortality , Hospitalization/statistics & numerical data , Poisoning/etiology , Brazil/epidemiology , Hospital Information Systems/statistics & numerical data , Sex Distribution , Age DistributionABSTRACT
Systemic toxicity by local anesthetics an adverse reaction that occurs when local anesthetics (AL) reach significant systemic levels, primarily affects the central and cardiovascular nervous system, and while it is an infrequent event, it can be potentially fatal. The main determinant of the toxicity is the plasma concentration of LA, especially the free fraction. The most serious symptoms are seizures and cardiac arrest, which can occur with the administration of any LA. Bupivacaine is the most cardiotoxic of the commonly used LAs, followed in decreasing order by levobupivacaine, ropivacaine and lidocaine.
La intoxicación sistémica por anestésicos locales (ISAL), una reacción adversa que ocurre cuando los anestésicos locales (AL) alcanzan niveles sistémicos significativos, afecta principalmente al sistema nervioso central y cardiovascular, y si bien, es un evento infrecuente, puede ser potencialmente fatal. El principal determinante de la ISAL es la concentración plasmática de AL, en especial la fracción libre. Los síntomas más graves son las convulsiones y paro cardíaco, los cuales pueden ocurrir con la administración de cualquier AL. La bupivacaína es el más cardiotóxico de los AL comúnmente utilizados, seguido en orden decreciente por levobupivacaína, ropivacaína y lidocaína.
Subject(s)
Humans , Poisoning/etiology , Poisoning/prevention & control , Anesthetics, Local/adverse effects , Poisoning/physiopathology , Poisoning/therapy , Cardiovascular Diseases/chemically induced , Central Nervous System Diseases/chemically induced , Risk FactorsABSTRACT
Resumen El 27 de noviembre de 2008 ocurrió un brote de intoxicación alimentaria asociado al consumo de salpicón de ave en un jardín de infantes de Hurlingham, provincia de Buenos Aires. Treinta y siete niños y 10 adultos presentaron síntomas gastrointestinales. Cinco niños fueron internados con signos de deshidratación, y uno de ellos requirió cuidados intensivos. Se aisló Staphylococcus aureus subsp. aureus del alimento involucrado, de 4/5 muestras de materia fecal de pacientes y de 3/5 manipuladores (nariz del manipulador 1, manos de manipuladores 2 y 3). Las cepas aisladas portaban los genes que codifican las enterotoxinas SEA y SED. Por electroforesis de campo pulsado con la enzima SmaI, los patrones de macrorrestricción presentaron 100% de similitud. La investigación oportuna del brote permitió identificar al agente causal de la intoxicación, determinar las fallas en la elaboración del alimento e implementar las medidas correctivas correspondientes.
Abstract On November 27, 2008, a foodborne disease outbreak associated with the consumption of chicken salad occurred in a kindergarten in the District of Hurlingham, Province of Buenos Aires. Thirty-seven children and 10 adults with gastrointestinal symptoms were affected. Five children were hospitalized with signs of dehydration, one of them requiring intensive care. Staphylococcus aureus subsp. aureus was isolated from the mentioned food in 4 out of 5 stool specimens from the patients, and in 3 out of 5 food handlers (nose of food handler #1, hands of food handlers #2 and 3). The isolates carried the genes coding for enterotoxins SEA and SED. The macrorestriction patterns showed 100% similarity by pulsed-field gel electrophoresis using the SmaI enzyme. A timely outbreak investigation allowed us to identify the causative agent of the food poisoning as well as the failures in food processing and to implement corrective measures.
Subject(s)
Poisoning/etiology , Staphylococcus aureus/isolation & purification , Enterotoxins/analysis , Foodborne Diseases/diagnosis , Electrophoresis, Gel, Pulsed-Field/methodsABSTRACT
ABSTRACT Objective: to describe case of occupational exposure to chemical products. Method: descriptive retrospective study using record data of 382 workers assisted in the Outpatient Care for Occupational Toxicology of the Reference Center of Workers' Health of the Federal District, between 2009 and 2013. Results: From the total, 66.7% were men, 55.2% had up to 9 years of activity and 81% did not use personal protective equipment (PPE). Nearly 60% were farmers and environmental surveillance agents, exposed to pesticides (63%), of which 40% were organophosphorus insecticides. The majority (68%) presented butyrylcholinesterase activity decreased, mostly farmers (85.9%); 57.3% of workers were considered poisoned - 61.6% by pesticides and 37.9% by industrial chemicals -, and away from work for at least 10 days. Conclusion: The profile was male workers, from 30 to 39 years, which not used PPE, indicating the need for prevention together with them to prevent poisonings.
RESUMEN Objetivo: describir casos de exposición ocupacional a productos químicos. Método: estudio retrospectivo descriptivo utilizando datos del prontuario de 382 trabajadores atendidos en el Ambulatorio de Toxicología Ocupacional del Centro de Referencia en Salud del Trabajador del Distrito Federal entre 2009 y 2013. Resultados: El 66,7% eran hombres, el 55,2% tenía hasta 9 años de actividad y el 81% no usaba el equipo de protección individual (EPI). Casi el 60% eran agricultores y agentes de vigilancia ambiental, expuestos a agrotóxicos (63%), de los cuales 40% insecticidas organofosforados. La mayoría (68%) presentó actividad de butirilcolinesterasa disminuida, principalmente agricultores (85,9%); el 57,3% de los trabajadores fueron considerados intoxicados, 61,6% por agrotóxicos y 37,9% por productos químicos industriales, y alejados del trabajo por lo menos 10 días. Conclusión: El perfil de los trabajadores atendidos fue de hombres, predominantemente de 30 a 39 años, que no utilizaban el EPI, indicando la necesidad de acciones de prevención junto a esa población para evitar la ocurrencia de intoxicaciones.
RESUMO Objetivo: descrever casos de exposição ocupacional a produtos químicos. Método: estudo retrospectivo descritivo utilizando dados do prontuário de 382 trabalhadores atendidos no Ambulatório de Toxicologia Ocupacional do Centro de Referência em Saúde do Trabalhador do Distrito Federal, entre 2009 e 2013. Resultados: 66,7% eram homens, 55,2% tinham até 9 anos de atividade e 81% não usavam equipamento de proteção individual (EPI). Quase 60% eram agricultores e agentes de vigilância ambiental, expostos a agrotóxicos (63%), dos quais 40% inseticidas organofosforados. A maioria (68%) apresentou atividade de butirilcolinesterase diminuída, principalmente agricultores (85,9%); 57,3% dos trabalhadores foram considerados intoxicados, 61,6% por agrotóxicos e 37,9% por produtos químicos industriais, e afastados do trabalho por pelo menos 10 dias. Conclusão: O perfil dos trabalhadores atendidos foi de homens, predominantemente de 30 a 39 anos, que não utilizavam EPI, indicando a necessidade de ações de prevenção junto a essa população para evitar a ocorrência de intoxicações.
Subject(s)
Humans , Male , Female , Adult , Poisoning/etiology , Occupational Exposure/adverse effects , Pesticides/adverse effects , Poisoning/complications , Registries/statistics & numerical data , Surveys and Questionnaires , Retrospective Studies , Occupational Exposure/statistics & numerical data , Chemical Hazard Release/statistics & numerical data , Personal Protective Equipment , Farmers/statistics & numerical data , Middle AgedABSTRACT
RESUMO: Introdução: Os eventos toxicológicos relacionados a medicamentos têm alto impacto na morbimortalidade, representando a primeira causa de intoxicação no Brasil. Objetivo: Descrever as tendências de casos de eventos toxicológicos relacionados a medicamentos atendidos por um Centro de Informações Toxicológicas. Método: Estudo com abordagem quantitativa (transversal e de tendência), com análise dos dados referentes aos casos de eventos toxicológicos relacionados a medicamentos atendidos pelo Centro de Informações Toxicológicas do Hospital Universitário da Universidade Estadual de Londrina. Os dados foram coletados das fichas de atendimento, referentes ao período de 1985 a 2014. Para a análise estatística, utilizou-se um modelo de regressão linear simples. Resultados: Dos 36.707 casos atendidos pelo serviço, 22,5% (n = 8.608) foram eventos toxicológicos relacionados a medicamentos. Houve um aumento da proporção de casos em ambos os sexos (R2 = 0,195; p = 0,014) e no sexo masculino (R2 = 0,403; p < 0,001). Detectou-se tendência de elevação da proporção de casos envolvendo a classe de analgésicos, anti-inflamatórios e imunossupressores (R2 = 0,521; p = 0,018), antidepressivos (R2 = 0,923; p < 001) e antipsicóticos (R2 = 0,869; p < 0,001). Os antimicrobianos apresentaram tendência de redução da proporção de casos (R2 = 0,773; p = 0,001). Conclusões: Observou-se tendência de aumento da proporção de casos de eventos toxicológicos relacionados a medicamentos no sexo masculino. Também houve aumento nas tendências envolvendo analgésicos/anti-inflamatórios/imunossupressores, antidepressivos e antipsicóticos.
ABSTRACT: Introduction: Drug-related poisonings have a high impact on morbidity and mortality, representing the first cause of intoxication in Brazil. Objective: To describe the trends of cases of drug-related poisonings attended to by a poison control center. Method: A quantitative approach (cross-sectional trend study) with data analysis of cases of drug-related poisonings attended to at the Poison Control Center of University Hospital of the State University of Londrina. Data were collected from service notification records for the period 1985 to 2014. For statistical analysis, a simple linear regression model was used. Results: Of the 36,707 cases attended to by the service, 22.5% (n = 8,608) were drug-related poisonings. There was an increase in the proportion of cases for both sexes (R2 = 0.195, p = 0.014) and males (R2 = 0.403, p < 0.001). There was a trend towards a higher proportion of cases involving the analgesic, anti-inflammatory and immunosuppressive drug classes (R2 = 0.521, p = 0.018), antidepressants (R2 = 0.923, p < 0.001) and antipsychotics (R2 = 0.869; p < 0.001). Antibiotics showed a trend toward a lower proportion of cases (R2 = 0.773, p = 0.001). Conclusions: There was a trend for a higher proportion of cases of drug-related poisonings in males. Also, there was an increased trend towards cases involving analgesics/anti-inflammatories/immunosuppressants, antidepressants and antipsychotics.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Young Adult , Poisoning/etiology , Poisoning/epidemiology , Pharmaceutical Preparations , Drug-Related Side Effects and Adverse Reactions/epidemiology , Poison Control Centers , Brazil , Linear Models , Sex Factors , Cross-Sectional Studies , Age Factors , Drug-Related Side Effects and Adverse Reactions/classification , Middle AgedABSTRACT
A retrospective analysis (2000 to 2013) of cattle poisoning caused by toxic plants and other compounds was carried out in the Pampas region of Argentina by the Animal Health Group of INTA-EEA, Balcarce. During this period, 1263 reports of diseases of different etiologies (infectious, parasitic, toxic, metabolic and miscellaneous) were recorded in cattle, by collecting anamnestic, clinical and pathological information. A toxic etiology was diagnosed in 21.1% of these reports. Iatrogenic poisoning caused by ionophores was the most frequently recorded etiology. Consumption of toxic plants (Wedelia glauca, Solanum glaucophyllum, among others), mycotoxins (Claviceps purpurea, Claviceps paspali, Epichloë coenophiala, among others), and plants producing cyanide and nitrates/nitrites were also commonly diagnosed. The high frequency of toxic episodes and the difficulties in their diagnosis by practitioners in our livestock production systems emphasizes the importance of this report.(AU)
Subject(s)
Animals , Cattle , Argentina , Ionophores/toxicity , Plant Poisoning/veterinary , Poisoning/etiology , Plants, ToxicABSTRACT
BACKGROUND: Wear cannot be completely prevented after total hip arthroplasty. If severe polyethylene (PE) liner wear develops, the so-called catastrophic failure occurs and metallosis develops. We postulated that longevity of the new implant may be affected after revision surgery for metallosis following a catastrophic failure of a PE liner due to the substantial amount of PE wear particles and infiltration of the metal particles in this catastrophic condition. METHODS: Twenty-three hips of 23 patients were identified because they showed metallosis during revision total hip arthroplasties performed in Seoul National University Hospital between January 1996 and August 2004. They were followed for at least 6.5 years after the index revision total hip arthroplasty. The clinical and radiological results of revision total hip arthroplasties in these patients were evaluated. RESULTS: The median Harris hip score increased from 60 points before revision total hip arthroplasties to 90 points at the final follow-up. Osteolysis was detected at an average of 9.3 years after revision total hip arthroplasties in 13 hips and acetabular cup loosening at average 9.8 years after revision total hip arthroplasties in 9 hips. With radiographic evidence of osteolysis and loosening as the end points, the 15-year survival rates were 28.2% and 56.0%, respectively. CONCLUSIONS: The survival rate of revision total hip arthroplasty in patients with metallosis following a catastrophic failure of a PE liner was low.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Arthroplasty, Replacement, Hip , Biocompatible Materials , Hip Joint/diagnostic imaging , Hip Prosthesis/adverse effects , Joint Diseases/diagnostic imaging , Metals/adverse effects , Metals, Heavy/poisoning , Osteolysis/etiology , Poisoning/etiology , Polyethylene/adverse effects , Prosthesis Design , Prosthesis Failure/etiology , ReoperationABSTRACT
OBJECTIVE: To study the epidemiology of exogenous intoxications in children and adolescents of Barra Garças, Mato Grosso, from January 2008 to September 2013. METHOD: This was a cross-sectional, retrospective, and descriptive epidemiological study. Data were collected from the Disease Notification System (Sistema de Informação de Agravos de Notificação [SINAN]) of the municipality, processed using Microsoft Excel, and evaluated through BIOESTAT statistical software. The variables included were: sex; age; toxic agent; time and place of service; route of administration; circumstance; and classification of intoxication. The age range was established according to the Brazilian Institute of Geography and Statistics, comprising children aged from 0 to 9 years old and adolescents aged from 10 to 19 years old. RESULTS: A total of 125 cases of accidental exogenous poisoning was registered, including 77 children and 48 adolescents. Food and beverages (38.4%) and drugs (24.0%) were the most common groups of toxic agents responsible for the poisoning. The largest age group affected by intoxication was composed of children aged from 0 to 4 years old (43.2%) and adolescents aged from 10 to 14 years old (19.7%). Regarding the circumstances, intoxication occurred due to suicide attempts (16.8%) and accidental events (23.2%) in adolescents and children, respectively. The study revealed a higher frequency of poisoning in girls. CONCLUSION: Exogenous intoxications occurred predominantly in children up to 4 years old, through the accidental consumption of food or drinks. Thus, the adoption of educational prevention programs for children's family members and caregivers is necessary...
OBJETIVO: Caracterizar o perfil epidemiológico das intoxicações exógenas ocorridas em crianças e adolescentes em Barra do Garças, Mato Grosso, no período de janeiro/2008 a setembro/2013. MÉTODOS: Foi realizado um estudo epidemiológico descritivo transversal e retrospectivo . Os dados foram coletados através do Sistema de Informação de Agravos de Notificação (SINAN) do município e processados no Microsoft Excel e avaliados através do programa estatístico BIOESTAT. As variáveis avaliadas foram: sexo, idade, agente tóxico, local e tempo de atendimento, via de administração, circunstância e classificação final da intoxicação. A faixa etária foi a estabelecida segundo o Instituto Brasileiro de Geografia e Estatística: crianças com idade de 0 a 9 anos e adolescentes de 10 a 19 anos. RESULTADOS: Foram registrados 125 casos de intoxicações exógenas, sendo 77 em crianças e 48 em adolescentes. Os principais agentes tóxicos responsáveis pelas intoxicações foram alimentos e bebidas (38,4%) e medicamentos (24,0%). As faixas etárias mais acometidas por intoxicações foram: 0-4 anos (43,2%) e 10-14 anos (19,7%). Em relação às circunstâncias, as intoxicações ocorreram por tentativa de suicídio (16,8%) e acidental (23,2%), respectivamente em adolescentes e crianças. O estudo demonstrou maior frequencia de intoxicações no sexo feminino. CONCLUSÕES: Conclui-se que as intoxicações exógenas ocorreram predominantemente em crianças até 4 anos por meio do consumo de alimentos ou bebidas e de forma acidental. Assim, é necessária a adoção de medidas educativas de prevenção para os familiares e cuidadores de crianças...
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Poisoning/epidemiology , Poisoning/etiologyABSTRACT
Introducción: las intoxicaciones agudas son una emergencia médica determinada por la exposición a diferentes sustancias, las cuales pueden terminar con la vida del paciente. Objetivos: caracterizar los pacientes con intoxicaciones agudas atendidos en el Centro de Emergencias del Hospital General Docente Enrique Cabrera, La Habana, desde el 1 de enero de 2009 hasta el 31 de diciembre de 2010. Método: se realizó un estudio de serie clínica retrospectiva en 208 pacientes con intoxicaciones agudas. Se seleccionaron las variables para el estudio según los objetivos y se construyeron distribuciones de frecuencias absolutas y relativas. Resultados: predominaron los pacientes del sexo femenino y del grupo etario de 20 a 29 años. La intención de suicidio fue el tipo de intoxicación más frecuente y el tipo accidental mostró aumento según mayor edad. Los medicamentos fueron los agentes etiológicos más utilizados, predominando los psicofármacos y el uso de polimedicamentos en la intención de suicidio. La bronconeumonía bacteriana fue la complicación más frecuente de los casos ingresados. Conclusiones: Se apreciaron intoxicaciones principalmente en mujeres de edad joven y presentarse con intención suicida, siendo los medicamentos los agentes más utilizados.
Introduction. Acute poisoning is a medical emergency determined by exposure to different substances, which can result in patient demise. Objectives. To characterize patients exposed to acute poisoning treated at the Emergency Center of the Enrique Cabrera General Teaching Hospital, Havana, from January 1, 2009 to December 31, 2010. Method. A retrospective clinical series of 208 patients admitted with acute poisoning. Variables were selected for the study according to the objectives and distributions of absolute and relative frequencies were calculated. Results. Patients were predominantly female and in the 20-29 age group. Suicide intent was the most frequent factor while accidental poisoning increased with age. Pharmaceutical drugs were the most common etiologic agents, with predominance of psychotropic drugs and poly-medication. Bacterial bronchopneumonia was the most common complication of hospitalized cases. Conclusions. Acute poisoning was seen mainly in young women as suicidal intent, being drugs the most common agents.
Subject(s)
Humans , Male , Adult , Female , Poisoning/epidemiology , Psychotropic Drugs/adverse effects , Substance-Related Disorders/complications , Acute Disease , Age and Sex Distribution , Cuba/epidemiology , Poisoning/etiology , Hospitals, University/statistics & numerical data , Suicide, Attempted/statistics & numerical data , Polypharmacy , Retrospective Studies , Sex Factors , Emergency Service, Hospital/statistics & numerical dataABSTRACT
The incidence of acute childhood poisoning is increasing all over the world concurrent to rapid introduction of new medicines and household chemicals. The current study has addressed the characteristics of childhood poisoning in patients presented to the Emergency Unit of Children's Hospital in Assiut University. The aim were to evaluate the magnitude, pattern, associated demographic data of overall poisoning cases in addition to assessment of clinical data, laboratory investigations, treatment and outcome for a sample from the four most commonly reported poison types. Retrospective study of archived patient's data was employed. Results indicated that 724 poisoning cases were admitted to Children's Hospital during the year 2012 mostly from Assuit governorate, of 2-<5 years old, of rural origin and without significant gender differentiation. Seven poison categories have been identified among which scorpion stings, food poisoning, pharmaceuticals and pesticides were the most prevalent types in a descending order. The specific clinical presentation and treatment of each type of the four most common poisoning types have indicated overall favorable outcome. Those suffering respiratory complications in scorpion sting cases and central nervous system manifestations in pesticides and drug poisoning were more liable to adverse outcome. The total number of deaths was 18 cases [2.5%], 13 cases resulted from scorpion stings [1.8%] and 5 cases [0.7%] from insecticide poisoning. It is recommended to raise awareness and experiences of pediatric doctors fir proper management and treatment of affected children with special emphasis in sound toxicological laboratory diagnosis and antidotal therapy especially in complicated cases. Poison prevention should continue as an integral part of prophylactic activities of infant and child health care providers
Subject(s)
Humans , Male , Female , Poisoning/etiology , Child , Emergency Service, Hospital , Hospitals, University , Rural Population , Urban PopulationABSTRACT
Accidental Potassium bromate poisoning is uncommon in adults, can have varied manifestations in different patients and can sometimes be deceiving. Potassium bromate white powder and oxidizing agent is used predominantly in bakeries as a maturing agent for flour and as a dough conditioner. It is also occasionally used as a neutralizer in hair kits. This paper deals with nine cases of accidental potassium bromate poisoning working in a bakery. Almost all the patients present with pain abdomen, vomiting and diarrhea. Severe gastritis leading to hematemesis is one of the dreaded complications. Acute renal failure can ensue after 24-48 hours of intake and thus patient must be investigated in this line. All of them ingested potassium bromate powder considering it to be milk powder. Potassium bromate poisoning must be considered as a possibility in every case presenting as acute gastroenteritis like symptoms after intake of bakery products. Strict legislation is required to decrease the risk of such incidents.
Subject(s)
Adult , Bromates/adverse effects , Bromates/poisoning , Bromates/toxicity , Creatinine/blood , Humans , Male , Occupational Exposure , Poisoning/complications , Poisoning/epidemiology , Poisoning/etiology , Urea/bloodABSTRACT
This study was undertaken to study the patterns of poisoning cases admitted at Mamata General Hospital Khammam, Andhra Pradesh from June 2005 to June 2010. The poisoning was common mode of suicide and one of the common causes of death in developing countries, particularly in agricultural workers. The emphasis was given on age, sex, socioeconomic status, etc. type and mode of poisoning. Organophosphate compounds were the most commonly 74.10% abused substance. The common motive of poisoning was suicidal 93.43% in both male 85.85% and female 14.14% with male to female ratio 6.07: 1%. Peak incidence was observed in the age group 21-30 years 50.59% and majority were from Hindu community 90.83% as compared to other community. The overall mortality of poisoning is 17.33%. Majority 366 (72.90%) were consumed the approximate amount of poison is 400-500 ml and maximum number of deaths 74 985.05%) are associated with highly toxic amount of 400-500ml of poison consumed. The study observed increasing trend of suicide by organophosphate compounds and rat poison ,whereas other poisons for committing suicide are less commonly used and here with–reflecting the pattern of poisoning in Khammam.
Subject(s)
Adult , Cause of Death , Female , Humans , India/epidemiology , Male , Organophosphate Poisoning/epidemiology , Organophosphate Poisoning/mortality , Organophosphates/poisoning , Poisoning/epidemiology , Poisoning/etiology , Poisoning/mortality , Suicide , Young AdultABSTRACT
In India, acute aluminium phosphide poisoning (AAlPP) is a serious health care problem. This study aimed to determine the characteristics of AAlPP and the predictors of mortality at the time of patients' admission. We studied consecutive admissions of patients with AAlPP admitted to the intensive care unit (ICU). We noted 38 parameters at admission to the hospital and the ICU and compared survivor and non-survivor groups. A total of 54 patients were enrolled comprising 10 females and 44 males and the mean ingested dose of poison was 0.75 ± 0.745 grams. The mortality from AAlPP was 59.3%. We found the following factors to be associated with an increased risk of mortality: a serum creatinine concentration of more than 1.0 mg % (P = 0.01), pH value less than 7.2 (P = 0.014), serum bicarbonate value less than 15 mmol/L (P = 0.048), need for mechanical ventilation (P = 0.045), need for vasoactive drugs like dobutamine (P = 0.027) and nor adrenaline (P = 0.048) AAlPP causes high mortality primarily due to early haemodynamic failure and multi-organ dysfunction.
Subject(s)
Aluminum Compounds/poisoning , Cause of Death , Forensic Pathology , Humans , Mortality , Phosphines/poisoning , Poisoning/etiology , Poisoning/mortalityABSTRACT
Everyday around the world almost 700 people die from the poisoning and several thousands more are affected by poisoning. Poisoning occurs in all regions and countries and affects people in all age and income group. Major occupation in Saurashtra region of Gujarat is farming with majority of population living in rural areas where the cases of accidental and suicidal poisoning are common and incidences are increasing day by day due to the use of pesticides for a wider variety of purposes. A detailed knowledge about the nature and magnitude of the poisoning cases in this particular area is not only important for early diagnosis and prompt treatment but also it may help to form policies to curb the access of the population to certain very toxic substances. The present study was undertaken in the department of Forensic Medicine at Rajkot (Gujarat) to know the pattern of fatal poisoning. Total 208 cases of death due to fatal poisoning were selected for this prospective study, which were brought to us for postmortem examination during the span of one year (From January 2007 to December 2007). Our study revealed that most of the victims of fatal poisoning were Hindus, married males of middle socio-economic status who died due to self ingestion of some poison.
Subject(s)
Autopsy , Cause of Death , Fatal Outcome , Hinduism , Humans , India/etiology , Male , Poisoning/epidemiology , Poisoning/etiology , Poisoning/mortality , Poisons , SuicideABSTRACT
OBJECTIVE@#To provide references for forensic expertise by investigating the kinds of toxicant, routes of exposure and manners of poisoning deaths, etc.@*METHODS@#Six hundred and seven autopsy cases of poisoning deaths from 1957 to 2008 in Department of Forensic Medicine, Tongji Medical College (Tongji Forensic Science Identification Center of Hubei), were comparatively reviewed.@*RESULTS@#In 218 cases from 1999 to 2008, more than 50% of decedents were male in the ages of 30-49. The toxicants are usually taken orally and the most common manner of death was accidental. The common substances involved in poisoning death were rodenticide, poisoning gas and insecticide. Compared to the data of 1983-1998 and 1957-1982, the common toxic agents had changed significantly. The number of cases involving insecticide and cyanide poisoning decreased in recent years, and the number of cases of rodenticide, poisoning gas, alcohols poisoning displayed an increase tendency, especially for drugs abuse.@*CONCLUSION@#Poisoning deaths of pesticides remain a major public health problem for a long time and the awareness of prevention need to be raised, especially for the prevention of deaths from multiple poisons.
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Accidents/statistics & numerical data , Age Distribution , Alcoholic Intoxication/epidemiology , Anesthetics/poisoning , Autopsy , Carbon Monoxide Poisoning/epidemiology , Cause of Death , China/epidemiology , Forensic Medicine , Heroin/poisoning , Hypnotics and Sedatives/poisoning , Pesticides/poisoning , Poisoning/etiology , Retrospective Studies , Rodenticides/poisoning , Sex Distribution , Suicide/statistics & numerical dataABSTRACT
OBJETIVO: Investigar se a falta de conhecimento dos agentes tóxicos nos domicílios é fator de risco de evento tóxico individual acidental na infância. MÉTODOS: Grupo caso (n = 25) é composto por cuidadores de crianças com menos de 60 meses, do município de Porto Alegre (RS), que sofreram evento tóxico acidental oral, atendidas em dois hospitais de referência e com registro no Centro de Informação Toxicológica. O controle (n = 25) é formado por cuidadores de crianças pareadas por sexo, idade e presença nos domicílios de agente tóxico igual ao do caso, que buscaram atendimento médico emergencial nos mesmos hospitais, mas por outras causas. Foi aplicado um questionário próprio, estruturado, verificando-se as questões: sociodemográficas, história clínica, antecedentes comportamentais dos cuidadores, armazenamento dos agentes tóxicos, história pregressa de acidente toxicológico. RESULTADOS: A idade média das crianças foi de 31,8 meses (±0,97) e a estatura média, de 93 cm (±11). As famílias, nos dois grupos, apresentaram conhecimento da ação tóxica de agentes existentes nos domicílios, contudo, cuidadores do grupo-controle apresentaram duas vezes mais chances de possuir conhecimento em comparação ao grupo caso. Distração apresentou 15 vezes mais chances de ocorrer por parte de cuidadores de crianças que sofreram evento tóxico em comparação ao grupo-controle. A altura do agente tóxico estar abaixo de 150 cm apresentou aproximadamente 17 vezes mais chances de ocorrer no grupo de crianças que sofreram evento tóxico em comparação às crianças do grupo-controle. CONCLUSÕES: Falta de conhecimento da ação tóxica de agentes existentes nos domicílios não é um fator de risco para evento tóxico na infância. Os riscos atribuíveis descritos neste estudo indicaram que a eliminação de outros fatores, como distração ou armazenamento abaixo de 150 cm de altura, acarretariam a prevenção de 13 e 19 por cento de eventos tóxicos na infância, respectivamente.
OBJECTIVE: To investigate whether the lack of knowledge of toxic agents in households is a risk factor for individual unintentional childhood poisoning. METHODS: The case group (n = 25) was composed of caregivers of children under 60 months of age who underwent accidental oral poisoning and were treated at two reference hospitals in Porto Alegre, southern Brazil, and recorded in the Toxicology Information Center database. The control group (n = 25) was composed of caregivers of children matched for sex, age, and presence in their homes of the same toxic agents found in the case group, who sought emergency medical care at the same hospitals, but for other reasons. A structured questionnaire was administered to verify the following questions: sociodemographic data, clinical history, behavioral antecedents of caregivers, storage of toxic agents, history of previous poisoning accidents. RESULTS: The children's mean age was 31.8 months (±0.97) and mean height was 93 cm (±11). Families, in both groups, were aware of the toxic action of agents available in their homes; however, caregivers in the control group were twice as likely to have such knowledge compared to the case group. Distraction was 15 times more likely to occur among caregivers of children who underwent poisoning compared to the control group. Storage of toxic agents below 150 cm was approximately 17 times more likely to occur in the group of children who underwent poisoning compared to children in the control group. CONCLUSIONS: Lack of knowledge of the toxic action of agents stored in households is not a risk factor for childhood poisoning. The attributable risks described in this study indicated that the elimination of other factors, such as distraction and storage below 150 cm, would lead to the prevention of 13 and 19 percent of poisonings in childhood, respectively.
Subject(s)
Child, Preschool , Female , Humans , Male , Accidents, Home/statistics & numerical data , Poisoning/etiology , Accidents, Home/prevention & control , Case-Control Studies , Caregivers/education , Health Knowledge, Attitudes, Practice , Odds Ratio , Poisoning/prevention & control , Risk Factors , Sex Distribution , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
INTRODUCTION: The fishes of continental Brazil have socioeconomic importance due to their potential for sport fishing and commercial and subsistence uses, as seen in the Upper Paraguay River Basin, particularly in the municipalities of the Pantanal region, where it is the second largest economic activity. Injuries caused in professional fishermen are common and poorly studied, as in other regions of the country. METHODS: Data were obtained from questionnaires and interviews with 100 professional fishermen, 50 in each municipality, between December 2008 and October 2009. RESULTS: All the fishermen reported some kind of injury caused by fish stings (78 percent of injuries) and fish, alligator and snake bites (22 percent) on the hands (46 percent of cases) and feet (35 percent of cases). Most of the patients had mild symptoms. The most severe cases were associated with secondary bacterial infections and required specific treatment and prolonged recovery associated with social and economic losses. CONCLUSIONS: The results of this study indicate that the stressful work conditions, inattention to basic preventive measures and carelessness were factors that contributed to accidents and that the toxicity and ability to inflict mechanical trauma of some aquatic species, plus the ineffective use of first aid and hospital treatment, contributed to the high morbidity and complications in many cases. Data from this study are relevant to the fishing communities of the Pantanal region, since they reveal high rates of accidents, lack of knowledge concerning first aid, initial treatment, injury prevention and lack of medical follow-up of the population.
INTRODUÇÃO: Os peixes continentais do Brasil têm grande importância socioeconômica, tanto pelo potencial para a pesca esportiva, quanto para a pesca comercial e de subsistência, como é notado na bacia do Alto Rio Paraguai, particularmente, nos municípios da região do Pantanal. Ferimentos e envenenamentos em pescadores profissionais são comuns e pouco estudados. MÉTODOS: Foram entrevistados 100 pescadores profissionais, 50 em cada município, entre dezembro/2008 e outubro/2009. RESULTADOS: Todos relataram ter sofrido algum tipo de acidente, sendo estes causados por ferrões de peixes (78 por cento dos acidentados) e mordidas de peixes, jacarés ou serpentes (22 por cento), estes ocorridos em maioria nas mãos (46 por cento dos casos) e pés (35 por cento dos casos). A maioria dos pacientes apresentou sintomas leves. Os casos mais graves apresentavam infecções bacterianas e necessitaram de tratamento específico e tempo prolongado de recuperação, o que condicionou às vítimas prejuízos socioeconômicos. CONCLUSÕES: Os resultados deste estudo indicam que, no plano social, as condições estressantes do trabalho, a desatenção com medidas preventivas básicas e o descuido foram os fatores que mais contribuíram para os acidentes. Por outro lado, a capacidade de algumas espécies de envenenar ou de produzir traumas mecânicos e o emprego de primeiros socorros e tratamentos hospitalares ineficazes contribuíram para a grande morbidade e complicações em muitos casos. Os dados deste estudo são relevantes para as comunidades pesqueiras do Pantanal, uma vez que revelam altos índices de acidentes de trabalho, inexistência de noções de primeiros socorros ou prevenção dos acidentes e ausência de atendimento médico continuado junto a estas populações.
Subject(s)
Animals , Humans , Alligators and Crocodiles , Accidents, Occupational/statistics & numerical data , Bites and Stings/epidemiology , First Aid , Fishes , Fisheries/statistics & numerical data , Bites and Stings/therapy , Brazil/epidemiology , Poisoning/epidemiology , Poisoning/etiology , Retrospective Studies , Rivers , Severity of Illness Index , Snake Bites/epidemiologyABSTRACT
Death by Aluminium phosphide (AIP) and organo-phosphide poisoning are the commonest forms of poisoning in India. Aluminium phosphide is used as rodenticide and pesticide in grain storage facilities. It produces phosphine gas, which results in mitochondrial poisoning. There is no known antidote for AIP poisoning. The effects of AIP poisoning, mediated by phosphine and mechanism of action have not been established.The information related to this poisoning is available in the literature and substantiated by practical experience. Liberated phosphine cannot be detoxified but Magnesium sulphate has been reported to be effective. Another remedy can be rapid absorption by coconut oil which might be helpful. Treatment consists of gastric lavage with potassium permanganate solution, oral administration of charcoal and sorbitol suspension, intravenous administration of sodium bicarbonate, magnesium sulphate and calcium gluconate, and oral administration of sodium bicarbonate and coconut oil. Use of coconut oil for treatment in this poisoning is suggested, although clinical trials and scientific approval is still awaited. Every suggestion, news regarding new modality of treatment for this poisoning needs to be shared in the interest of saving precious human lives. It is with this aim the present paper is written.
Subject(s)
Aluminum Compounds/poisoning , Cause of Death , Humans , Pesticides/poisoning , Phosphines/poisoning , Poisoning/etiology , Poisoning/mortality , Poisoning/therapy , Poisoning/prevention & control , Rodenticides/poisoningABSTRACT
Intoxicações podem ter suas consequências minimizadas através da ampliação do conhecimento sobre suas origens, evoluções e providências quanto a medidas preventivas. No Brasil, o aumento progressivo das emergências tóxicas justifica a sua análise, de forma descentralizada e regionalizada. Este trabalho objetivou caracterizar dados sobre a ocorrência de intoxicações admitidas no Hospital Universitário/UFJF, entre 2000 e 2004. A coleta foi realizada mediante pesquisa em prontuários cadastrados no banco de dados do referido hospital. Os dados foram analisados através de estatística descritiva, permitindo estabelecer o perfil do grupo quanto às variáveis idade, sexo, local de origem do paciente, profissão, período de hospitalização, etiologia, razão da intoxicação, classe terapêutica de fármacos envolvidos e via de exposição ao agente toxicante. Crianças de zero a cinco anos e indivíduos do sexo masculino foram os mais acometidos, representando 24 por cento e 68 por cento, respectivamente. A maioria dos casos ocorreu em Juiz de Fora (78 por cento) e a via oral foi a mais frequente. Os psicotrópicos foram os principais agentes toxicantes (60 por cento). Os resultados evidenciaram a importância de atividades educativas dirigidas às comunidades e a relevância dos serviços de informação para prevenir e reduzir as intoxicações e o uso irracional de fármacos.
Poisonings may have their consequences minimized by the acquisition of knowledge concerning its etiologies, evolutions and means of prevention. In Brazil, the progressive increase of toxic emergencies justifies the acquisition and analysis of regional and decentralized data concerning toxic emergencies. The aim of this retrospective and descriptive study was to evaluate data on the toxicology occurrence registered at the University Hospital/UFJF from 2000 to 2004. Data were collected using a structured instrument which comprised: age range, gender, profession, average hospitalization time, etiology and possible reasons for the intoxication, drug categories, where the patients live and the most important exposure route to the poisonous agent. The possible relationship among the data was also examined. The profile found for poisoning in the 50 cases analyzed, was that accidents are more common from 0 to 5 years old (24 percent) and male gender (68 percent), the majority of the cases happened in the city of Juiz de Fora (78 percent) and oral exposure. The most important poisonous agents were found to be the psychotropics (60 percent). Definition of a profile helps promoting educative activities and expands poisoning prevention campaigns by public health agencies. Therefore, these facts strengthen the importance of an Information Service net to prevent and reduce intoxications and the irrational use of drugs.