Retrospective study on the incidence of envenomation and accessibility to antivenom in Burkina Faso

Snakebite is a common neglected public health issue, especially in poor rural areas of sub-Saharan Africa, Asia and Latin America. Passive immunotherapy with safe and effective antivenom is the only approved treatment for it. This study aimed to determine the incidence of snakebites, and to assess the availability and accessibility of antivenoms, from 2010 to 2014, in Burkina Faso. Methods The assessment of snakebite cases managed in all health facilities from 2010 to 2014 was performed from the Statistical Yearbook of the Ministry of Health. Antivenom consumption data were collected from the drug wholesalers established in Burkina Faso. Results Snakebites are among the five leading causes of consultations in health districts. From 2010 to 2014, 114,126 envenomation cases occurred in Burkina Faso, out of which 62,293 (54.6 %) victims have been hospitalized resulting in 1,362 (2 %) deaths. The annual incidence and mortality were respectively 130 bites and 1.75 deaths per 100,000 inhabitants. The amount of antivenom sold by wholesalers were 5,738 vials with a total cost of US$ 539,055 (annual average = US$ 107,811). The high cost of these antivenoms (between US$ 42 and 170 per dose according to brand) limited their use by rural people, the main victims of snakebites, whose income is insufficient. Thus, only 4 % of patients received antivenom treatment over the past five years. The price of antivenom was reduced in 2015 to US$ 3.4 by a public drug wholesaler. Conclusion The study confirmed the high burden of snakebites in Burkina Faso. To better manage envenomation, Burkina Faso implemented a strategy consisting in seeking affordable sources of antivenom supply of good quality and innovative mechanisms of subsidy.

Manejo general del intoxicado / General management of intoxicated

Intoxications have become a relevant complaint in the emergency room since the second half of the last century. Toxidromes have been replaced by a more practical combined analysis of vital signs, directed physical examination and selected laboratory tests. Most of the mortality can be prevented by the correct and opportune implementation of general management strategies, including supportive care, prevention of absortion, enhancement of elimination and extracorporeal removal of toxins. Through the following pages we will review many of different diagnostic and therapeutic alternatives...

Prevalence and costs of hospitalizations for poisoning and accidental intoxication in Brazilian elderly

A cross-sectional study of secondary data/information obtained from the Hospital Information System (HIS) spanning the years 2008 - 2009 was performed. The distribution of the main hospital admissions by gender, age, color/race, region and federal unit of residence, average expenditure and average length of hospital stay, year of hospitalization and mortality rates (MR) were studied. The data collected were tabulated by TabNet and keyed into Microsoft Excel 2007. It was verified that elderly males (54.3%), from 60 to 69 years old (50.6%), nonwhites (36.3%) and residents of Southeast and North regions of the country had the highest rates of hospitalization. Seniors were hospitalized for an average of 4.8 days, and the major causes were exposure to alcohol (43.7%) and to drugs (33.9%). Expenses related to hospital admissions were, on average, R$ 529,817.70. The highest mortality rates were recorded among females (MR = 4.34), in elderly, 80 years or older (MR = 10.16) and Caucasians (MR = 3.95), where pharmacological substances with action on the Autonomic Nervous System were the leading cause of death. There are demographic differences in morbi-mortality of these elderly since, although men and younger elderly were the main victims, women and elderly of advanced age have greater mortality. The leading causes of hospitalization were alcohol and drugs.

Realizou-se um estudo transversal de dados secundários obtidos no Sistema de Informação Hospitalar (SIH), nos anos 2008/2009. Estudou-se a distribuição das principais internações segundo sexo; faixa etária; cor/raça; região e unidade federativa de residência; valor médio pago e média de permanência das internações hospitalares; ano de internação e as taxas de mortalidade (TM). Os dados coletados foram tabulados por meio do TabNet e transcritos para o Programa Microsoft Excel® 2007. Verificou-se que idosos do sexo masculino (54,3%), com 60 e 69 anos de idade (50,6%), não brancos (36,3%) e residentes nas regiões Sudeste e Norte do País apresentaram os maiores percentuais de internação hospitalar. Idosos ficam em média 4,8 dias internados, sendo as principais causas a exposição ao álcool (43,7%) e a medicamentos (33,9%). Os gastos com as internações equivaleram a R$ 529.817,70. As maiores taxas de mortalidade foram registradas no sexo feminino (TM=4,34), em idosos entre 80 anos e superior (TM=10,16) e pessoas brancas (TM=3,95), sendo as substâncias farmacológicas de ação sobre o Sistema Nervoso Autônomo maiores causas do óbito. Existem diferenças demográficas na morbimortalidade desses idosos, visto que apesar de homens e idosos mais jovens serem as principais vítimas, mulheres e idosos com idade mais avançada morrem mais. Sendo as principais causas de internação o álcool e os medicamentos.

Intensive care unit [ICU] admission and discharge criteria in acute poisoned cases admitted to Menoufiya university hospital over one year [2008] [A prospective study]

Poisoning emergency is a common occurrence which constitutes a significant source of aggregate morbidity, mortality, and health care expenditure. The aim of the present study was to clinically evaluate the ICU admitted poisoned cases as regard criteria of ICU admission, approach to treatment and discharge criteria during the period from 1-1-2008 to 31-12-2008. Data were collected from self designed admission clinical sheet which included all needed data. The present study revealed that the total poisoned cases that were admitted to Menoufiya poison control center [MPCC] were, 423 cases from 35550 total menoufiya hospitals admission during the year of the study i.e [1.18%] of which 86 cases have been admitted to ICU i.e. [20.33%] and they represented about [2.79%] of total hospital ICU admission [3073 cases]. Most of admitted poisoned cases throughout the year of the study were due to anticholinesterase poisoning 126 cases [29.78%] from those 34 cases were admitted to ICU i.e. [26.98%] from total ICU admitted poisoned cases. Regarding the admission criteria the present work represents that the patients who were admitted due to both hemodynamic instability and altered mental status were the commonest ones [61.63%], followed by altered mental status [16.3%], hemodynamic instability [13.9%] while those presenting with the three admission criteria were [8.1%]. There is a statistically significant relationship between type of poison and admission criteria where all digitalis poisoned cases were admitted with hemodynamic instability [100%] while a high proportion of anticholinesterase poisoned cases were admitted for both hemodynamic instability and altered mental status were [67.6%]. As regards the poisoning characteristics, the present work shows that suicidal cases who were admitted due to hemodynamic instability were [66.7%], ingestion of solution form of poison, represented in both homodynamic instability and altered mental status were [62.3%] and high percentage of patients that were transported by ambulance were admitted due to both haemodynamic instability and altered mental status [85.7%]. Regarding the discharge criteria from ICU, the present study revealed that the patients who were discharged due to death represented [19.76%] of cases. Discharge of patients as hemodynamic instable [in the form of no need for mechanical ventilation, normal ABG] were [26%], controlled arrhythmia [7.2%], shocked patients discharged with no need for inotropic drugs [5.8%]. The patient who were admitted to ICU due to altered mental status and didn't receive mechanical ventilation were discharge as fully conscious [alert and aware] and represented [76.8%] of ICU discharged cases. This study revealed that an ideal ICU must be available in each PCC [poison control center] and ICU admission and discharge criteria are an important part of clinical evaluation for acutely poisoned patients in emergency room

Intoxicações exógenas em crianças menores de seis anos atendidas em hospitais da região metropolitana do Rio de Janeiro / Profile of hospital admissions due to acute poisoning among children under 6 years of age in the metropolitan region of Rio de Janeiro, Brazil

OBJETIVO: Descrever o perfil dos casos de intoxicações exógenas de crianças admitidas em hospitais de emergência da região metropolitana do Rio de Janeiro, durante três anos. MÉTODOS: Realizou-se levantamento dos dados a partir dos boletins de atendimento de emergência, tendo sido identificados os casos suspeitos ou confirmados de intoxicação nas seguintes categorias: drogas, medicamentos e substâncias biológicas; solventes orgânicos e hidrocarbonetos halogenados; produtos químicos; monóxido de carbono e outros gases, fumaças e vapores; e pesticidas. RESULTADOS: Foram registrados 1.574 casos de intoxicação entre crianças até cinco anos de idade, sendo que cerca de 40 por cento dos casos envolveu produtos químicos de uso doméstico, 35 por cento os medicamentos, e 15 por cento algum tipo de pesticida. Mais da metade das intoxicações por pesticidas envolveu o chumbinho, um produto ilegalmente vendido como raticida, que frequentemente contém o agrotóxico carbamato. A distribuição dos agentes envolvidos variou significativamente segundo sexo, sendo a frequência relativa das intoxicações por medicamentos e chumbinho maior no sexo feminino em comparação ao masculino. Observou-se que a participação dos produtos químicos de uso doméstico decresceu com a idade, enquanto aumentou a dos medicamentos como agentes da intoxicação. No período analisado não observou-se redução significativa no número total de casos registrados anualmente. CONCLUSÃO: Fortalecer a rede de Centros de Controle de Intoxicações, intervir na linha de produção de embalagens para medicamentos e produtos químicos, aumentar a fiscalização sobre a comercialização ilegal do chumbinho, e enfatizar atividades de educação em saúde são ações que podem contribuir para mudar este panorama.

OBJECTIVE: To describe the profile of poisoning cases among children attended during three years at emergency hospitals in the metropolitan area of Rio de Janeiro, Brazil. METHODS: All confirmed or suspected poisoning cases, due to drugs and biological substances; organic solvents and hydrocarbons; chemical products; carbon monoxide and other gases; and pesticides, were collected. RESULTS: 1,574 cases of poisoning in children up to 5 years of age were detected. Around 40 percent of the cases involved chemical products of domestic use, 35 percent were caused by drugs, and 15 percent by pesticides. More than half of pesticide poisonings involved the "chumbinho", an illegal product sold as a rodenticide, and usually including in its formulation a carbamate. Distribution of agents varied significantly by gender, the relative frequency of poisonings due to drugs and "chumbinho" being higher among females than males. Participation of chemical products of domestic use decreased with age, but the role of drugs increased as agents of poisoning. During the observation period there was no significant reduction in the total number of annual cases. CONCLUSION: Supporting the expansion of the network of Poison Control Centers, developing intervention for the production of safer packaging devices for drugs chemical products, suppressing the illegal commerce of "chumbinho", and fostering health education activities might contribute to modify this situation.

Self-inflected poisoning at Assiut University Hospitals retrospective study

Suicide is a self-inflected death that is intentional rather than accidental. In the last 45 years suicide rates have increased by 60% worldwide. Deliberate self-poisoning [DSP] is the most common method of suicide in developed countries. Many substances and drugs are used; the most common are organophosphate insecticides and CNS-acting drugs. In this work a retrospective hospital-based study has been done for cases of suicidal poisoning admitted, to the emergency unit of Assuit University Hospitals from January 2004 to December 2007 were studied as regards the age group, sex, the residence, the substance used, the month of the year and the fate of cases. Statistical analysis was done for the cases. The total number of cases was 843, males represent 48.9% of them and females represent 51.1%. Using of Medications represent 46.7% of total number of cases .while Pesticides, Unknown and Miscellaneous poisons represent 29.3%, 18.5%, 5.5% respectively. The highest percentage was found among cases of age group from 15- < 25 in both males and females for all poisons. In Cities and Centers the highest percentage was recorded for medications [20.5 and 17.3 respectively], while in Villages the highest percentage was for pesticides [12.3]. The percentage of pesticides poisoning was high in June and January [14.2 and 10.9 respectively], while for medications the highest percentage was in January [13.5]. As regards the fate of cases, recovery was determined to be 70.8% of the total number of cases. Death percentage was the highest [3.8] among unknown poisons. In conclusion sex, age, residence and month of the year may have influence on suicide and the substances used for committing it

The first poison control center in Vietnam: experiences of its initial years.

Poisoning is a sparsely studied but major health problem in Vietnam. In this hospital-based retrospective study, the medical records of all cases of poisoning admitted to the Poison Control Center in Hanoi from 1999 to 2003 were carefully reviewed. A total of 1,836 poisoning emergencies were recorded. The female:male ratio was approximately 1:1. The largest number of poisoned patients was found in the age-group 15-24 years. A vast majority of the toxic exposures (74.1%) occurred at the patients' homes. Suicidal poisoning constituted about one third of all cases. The most commonly involved toxic agents consisted of the heterogeneous group "food poisoning" (35.1%), pharmaceuticals (33.8%), toxins from poisonous animals, mostly snake bites (12.6%), and pesticides (9.1%). On admission, two thirds of the patients had mild symptoms (Poisoning Severity Score, PSS grade 1), while more than a quarter displayed pronounced clinical signs of poisoning (PSS grades 2-4). The most frequently used poisoning-specific treatments were gastric lavage (30.2%) and administration of activated charcoal (35.4%) and cathartics (34.2%). Intensive care measures, such as mechanical ventilation and dialysis, were applied less frequently, in 6.5% and 1.7%, respectively. Specific antidotes were given in 5.2% of the cases. The total number of fatalities was 21 (1.1%) and 10 patients were discharged with a neurological sequela. Hypnotic pharmaceuticals (mainly barbiturates), heroin, and pesticides were involved in a majority of the fatalities. These data provide an important basis for poisoning prevention efforts in developing countries\such as Vietnam.

A study on mortality and morbidity pattern of acute childhood poisoning cases admitted in block primary health centres of Sundarban, West Bengal.

A hospital - record based study was conducted in Sundarban of West Bengal to explore the profile of mortality and morbidity pattern of acute accidental poisoning among children. Sundarban is an underdeveloped coastal region of West Bengal. Three years retrospective (1999 - 2001) data of childhood accidental poisoning cases were collected from the indoor admission registers and case history sheets of 11 Block Primary Health Centers (BPHC) of the region. A total of 1056 children with accidental poisoning were admitted during those three years of which 58% were males. Mean age of males was slightly higher than females in all the three years. Organophosphorus pesticide poisoning was the commonest.

Current trend of poisoning--a hospital profile.

A one-year study was carried out among the poisoning cases admitted in the emergency wing of Guru Nanak Dev Hospital attached to Government Medical College, Amritsar during the period from 10-5-1997 to 9-5-1998. Out of 10,664 admitt emergencies, 3.19% were poisoning cases. Male to female ratio was nearly 3:1. Majority (45.59%) of the victims were in the age group of 21-30 years, 69.12% were married and 51.47% belonged to urban area. At the time of admission 61.47% cases were conscious, 26.17% were partially conscious and 12.36% were unconscious. Majority (76.47%) of the victims committed suicide, in 20.88% cases manner of death was accident and homicide was reported in 1.76% cases. Commones poison was aluminium phosphide (38.23%) followed by organophosphorus compounds (17.64%). The study observed increasing trend of suicide by aluminium phosphide and organophosphorus compounds, whereas other poisons for committing suicide were less commonly used.

Epidemiología de las intoxicaciones que generaron llamadas durante el año 2004 al Centro de Información Toxicológica (CITUC) de la Pontificia Universidad Católica de Chile: Región Metropolitana / Epidemiology of intoxication cases that originated calls to the Toxicology Information Centre (CITUC) of the Catholic University of Chile: Metropolitan Region, 2004

Objetivo: Describir y caracterizar la epidemiología de las consultas por intoxicaciones, reportados al Centro de Información Toxicológica de la Universidad Católica (CITUC). Método: Se realizó un estudio retrospectivo y descriptivo de las llamadas registradas por el centro durante el período del año 2004. Se analizarán los siguientes datos: número total de llamadas, lugar de la llamada, circunstancias de la exposición, tipo y nº de agentes involucrados, vías de exposición, tiempo desde la exposición, sexo y edad de los pacientes, y las indicaciones y tratamientos recomendados. Resultados: Se registraron 22.168 llamadas. El 52,5 por ciento de las consultas provenían del hogar y el 40,2 por ciento de los Servicios de Urgencia. El 71,6 por ciento de las consultas eran exposiciones accidentales y el 19,8 por ciento fueron intencionales. Los medicamentos se presentaron en un 53,6 por ciento de las llamadas, seguidos por los Productos de Aseo (13,7 por ciento), Productos industriales y Químicos (10,2 por ciento), y Pesticidas (7,1 por ciento). El 92,5 por ciento de las exposiciones eran con un agente tóxico. La ingestión fue la vía de exposición que se registró en un 82 por ciento. El 44,6 por ciento del total de las llamadas, se realizaron dentro de la primera hora post-exposición. Las intoxicaciones en niños menores de 6 años correspondieron al 47,9 por ciento de las llamadas. Conclusiones: Los medicamentos constituyen el principal agente de intoxicación. La principal vía de exposición es la ingesta y que el principal grupo de población afectado son los niños menores de 6 años. Estos son indicadores evidentes y claros de la necesidad imperante de desarrollar campañas publicitarias preventivas e informativas, avaladas por el Ministerio de Salud, respecto al correcto almacenaje de los medicamentos y el manejo de las intoxicaciones en el hogar. La introducción del envase resistente a niños y la educación constituyen dos piezas fundamentales en la prevención de las intoxicaciones pediátricas.

Análise dos casos de intoxicação atendidos pelo Conjunto Hospitalar de Sorocaba / Analysis of intoxication cases admitted to the Conjunto Hospitalar de Sorocaba

The notification of intoxication is not compulsory in Brazil and this data is underestimated, although is recognizedly a public health problem. The objective of this article was to evaluate the intoxication case admitted to the hospitalar unity of regional reference, the Conjunto Hospitalar de Sorocaba (CHS). It was made a retrospective analysis of the datas (date, age, gender and toxic agent) obtained from bulletins of poisoned patients between september 2002 to septemmber 2003. Analysis was performed, initially, using a descriptive analysis following by Pearson Chi-Square and Fisher's Exact tests. There were 2,992 poisoning cases: the predominant age range was 36-50years: gender: male predominance (2,754 cases: 92%); toxic agent: abusive drugs (2,721 cases; 90.9%) with alcoholic predominance (2,383 cases; 87.6%), use of medicine together with dependence between toxic agent and gender (p<0.01), showing that abusive drugs are more used by men than women, whwreas the medicine are more used by womwn than men. The Fisher's Exact test, on the other hand, showed that the intoxication by abusive drugs occurs between 36-50 age range (p<0.01) and the medicine occurs between 21-35 years. We conclude that the psychoactive drugs are the responsible by the intoxication cases admitted to the CHS and we suggest the adoption of measures aiming to contain the intoxication cases mainly by alcohol and medicines...

Manejo de la intoxicación por fósforo de aluminiom en la Unidad de Cuidados Intensivos del Hospital Escuela Doctor Roberto Calderón Gutiérrez: enero 1998 - noviembre 2000 / Handilng of intoxication by aluminium phosphurus in the Intensive Care Unit of Hospital Escuela Dr. Roberto Calderón G.: January 1998 - novenber 2000

La intoxicación con plaguicidas constituye un serio problema de índole laboral con importante implicación en la salud mental por la frecuente utilización de estos agentes con propósitos suicidas. La intoxicación por fosfuro de aluminio, insecticida fumigante, sin antídoto específico y con una elevada tasa de mortalidad, plantea un desafío terapético. Considerando los fenómenos fisiopatológicos desencadenados por la intoxicación por fosfuro de aluminio (fosfina), nos propusimos evaluar la respuesta clínica a la terapia con coloides (plasma corriente) en los pacientes que ingresaron en la Unidad de Cuidados Intensivos (UCI) del Hospital Dr. Roberto Calderón. Se realizó un estudio de tipo ensayo clínico no controlado, no aleatorizado, ambivalente, de corte transversal, en el período de enero de 1998 a noviembre de 2000. Por razones éticas se recurrió a controles históricos. El universo y la muestra fueron de 52 pacientes. Se incluyeron pacientes de ambos sexos, mayores de 14 años, que hayan cursado más de6 horas de estancia en la UCI, o que recibieron terapia indicada según grupo de estudio. Se excluyeron 17 pacientes por no reunir los criterios de selección. Los pacientes estudiados se dividieron en dos grupos desigandos por unaletra distintiva para cada grupo. El grupo A no recibió terapia con coloides, grupo control, pacientes hospitalizados entre enero de 1998 y noviembre de 1999. El grupo B recibió terapia con coloides en el peíodo de diciembre 1999 a noviembre 2000. Se estudiaron 35 pacientes, 12 del grupo A y 15 del grupo B. La edad promedio fue de 27 años (rango de 15 a 50 años). El sexo masculino predominó en ambos grupos. La mayoria de los pacientes requirieron sostén dopaminérgico (mediana de 15 mcg/kg/min). El 57 porciento ameritó ventilación mécanica. La mortalidad fue significativamente mayor en los pacientes que no fueron tratados con plasma corriente (P: 0.002). La utilización de coloides podría contrarestar la vasoplejía y colapso provocados por la fosfina....

Epidemiologia de las intoxicaciones asistidas en la clínica Madre Bernarda (1992-1997), Clínica Vargas (1994-1997), Clínica Blas De Lezo (1994-1997) y Hospital Universitario de Cartagena (1992-1997) / Epidemiological study in registered poisoning cases in the clinics Madre Bernarda (1992-1997), Vargas (1994-1997), Blas de Lezo (1994-1997) and the University of Cartagena (1992-1997)

Un estudio descriptivo retrospectivo fue realizado en la Facultad de Ciencias Químicas y Farmacéuticas de la Universidad de Cartagena, sobre la epiodemiología de las intoxicaciones asistidas en la Clínica Madre Bernarda, Clínica Vargas, Clínica Blas de Lezo y Hospital Universitario de Cartagena, en el cual se analizaron los diferentes casos de intoxicaciones atendidos en los centros asistenciales anteriormente mencionados. Para el estudio se tuvo en cuenta los siguientes aspectos: género, grupos etarios,etiología de las intoxicaciones, agentes involucrados y condiciones de egreso de los pacientes. Se registraron en total 4255 casos de intoxicaciones, el género más comprometido fue el masculino con 2212 y en el género femenino se registraron 2043 casos; el grupo etyario que presento mayor número de intoxicaciones fue el comprendido entre 21 a 30 años con 981 casos. Según la etiología, las intoxicacionrs accidentales ocuparon el primer lugar con un 62,04 por ciento, seguida de las intencionales con 29,24 por ciento. Los alimentos constituyeron el agente causante del mayor número de intoxicaciones con 2433 casos, con relación a la evolución de los casos, 152 requirieron hospitalización, se presentaron 4245 egresos satisfactoriosy 10 intoxicaciones fueron fatalñes. Se encontro un significativo número de suicidio en mujeres jovenes utilizando medicamentos, plaguicidas, hidriocarburos y productos del hogar

Incidencia de intoxicaciones exógenas: cuerpo de guardia Hospital Infantil Sur / Incidence of exogenous intoxications: body of guard Hospital Infantile South

Se realizó un estudio prospectivo descriptivo a 35 pacientes que se atendieron en el cuerpo de guardia del Hospital Infantil sur de Santiago de Cuba en el primer trimestre de 1995, por presentar intoxicaciones exógenas por diferentes sustancias.Se confecionó una planilla, la cual recogió las variables necesarias para la realización de este trabajo.Se destaca que la mayor incidencia de los intoxicados fueron ingresados quedando una estrecha relación con el sexo femenino.Un porciento muy elevado no tenía antecedentes psiquiátricos, fue muy evidente que el tiempo de mayor incidencia que transcurrrió desde el momento de la intoxicación hasta las atenciones recibidas en el cuerpo de guardia no excedió de los 30 minutos; y es muy significativo que la sustancia ingerida fue los psicofármacos fundamentalmente entre 1 a 3 años, evolucionándose satisfactoriamente, sin fallecidos.Los datos obtenidos se expresan en tablas estadísticas y en términos de porciento para su mejor comprensión

Intoxicaçöes na cidade do Panamá / Poisoning in the Panamá city

Analisa os diferentes tipos de intoxicaçöes causadas por medicamentos, produtos químicos de uso domiciliar e industrial, pesticidas, animais peçonhentos, alimentos, drogas e bebidas alcoolicas. Foram analisados os prontuários dos pacientes com diagnóstico de intoxicaçäo segundo a CID-9, no período de junho a dezembro de 1993, no "Hospital del Niño" e "Caja del Seguro Social", e de junho de 1993 a maio de 1994 no "Hospital Santo Tomas", na Cidade do Panamá, República do Panamá. A seguir, os resultados mais relevantes: o sexo masculino foi o que apresentou um maior número de intoxicaçöes, acompanhando os índices de outros países; o sexo feminino apresentou a maior freqüência de casos de tentativas de suicídio em todas as idades e o maior número de intoxicaçöes por medicamentos; nos Hospitais "del Niño" e o da "Caja del Seguro Social" as intoxicaçöes por agente desconhecido ocuparam o primeiro lugar; os produtos químicos ocuparam o primeiro lugar como agente conhecido no "Hospital del Niño"; os medicamentos ocuparam o segundo lugar dentro dos agentes conhecidos e o primeiro lugar entre todos os tipos de agente tóxico incluídos neste estudo; a maioria dos casos ocorreram no ambiente domiciliar urbano; no Hospital Santo Tomás os acidentes por animais peçonhentos ocuparam o primeiro lugar das intoxicaçöes

Intoxicación por fósforo blanco. Manejo y utilidad de la exanguineotransfusión. A propósito de un caso

Presentamos el caso de una mujer de 21 años de edas, que ingirió 30 diablillos, y que tuvo manifestaciones gatro intestinales y tempranamente afectación hepática con sgnos de encefalopatía. Fue sometida a exanguineotransfusión desdde las 48 horas potingestion del tóxico, obteniéndose buenos resultados, Se realiza una descripción de las observaciones clínicas, monitoreo del comportamiento de las pruebas de función hepática y una revisión de la literatura...

A enfermaria de emergência do Hospital das Clínicas da UNICAMP e o atendimento aos intoxicados; janeiro de 1971 - dezembro de 1992 / The infirmary of emergency of the Unicamp Clinical Hospital; january of 1971 a december of 1992

Consideraçöes gerais: criada em janeiro de 1971 nas dependências da Santa Casa e transferida para a Cidade Universitária em abril de 1986, a Enfermaria de Emergência do HC da UNICAMP, com 14 leitos e vem prestando atendimento aos adultos portadores de situaçöes clínicas de emergência ou de urgência até a presente data. Foram coletados, de nossos arquivos, dados sobre os 25.787 pacientes internados na Enfermaria des de janeiro de 1971 a dezembro de 1992, dentre os quais havia 921 intoxicados; os dados foram colocados em computador, utilizando-se o Programa Epi Info 5 para elaboraçäo de tabelas e cálculos estatísticos. Foram feitas comparaçöes entre intoxicados e näo intoxicados e destacados tópicos ou casos que possam contribuir para melhor conhecimentos das intoxicaçöes ou atendimento aos intoxicados