Behavioral antecedents of pediatric poisonings.

To determine how the behavior of 3- to 7-year-olds might contribute to pediatric poisoning, a taxonomy of pediatric ingestions was conceptualized and tested. Thirty-nine of 50 caretakers who called the Middle Tennessee Poison Center about poison ingestions by a child in this age group provided details of the poisoning history and family characteristics. Histories were coded by a psychologist according to the 14 antecedent conditions of the poisoning taxonomy. Improper storage, noncompliant behavior, curiosity, misinterpretation of the substance, improper child monitoring, and imitative behavior were judged the most common antecedent conditions of these ingestions. Lack of knowledge of poison prevention methods was infrequently coded. Noncompliant behavior as a condition of the poisoning was associated with parental reports of general child behavioral problems. Ingestions involving imitative behavior were associated with parental report of poor social supports. The findings highlight the need to address behavior in designing poison prevention programs.

Elemental mercury vapour toxicity, treatment, and prognosis after acute, intensive exposure in chloralkali plant workers. Part I: History, neuropsychological findings and chelator effects.

Mercury poisoning occurred after the acute, prolonged exposure of 53 construction workers to elemental mercury. Of those exposed, 26 were evaluated by clinical examination and tests of neuropsychological function. Patients received treatment with chelation therapy in the first weeks after exposure. Eleven of the patients with the highest mercury levels were followed in detail over an extended period. Observations included the evaluation of subjective symptoms of distress, using the 'Symptom Check List 90-Revised' (SCL-90R) and tests of visual-motor function such as 'Trailmaking Parts A and B', 'Finger Tapping', 'Stroop Colour Word Test' and 'Grooved Pegboard.' On day 85 +/- 11 (mean +/- s.d.) after exposure, these 11 men again received either 2,3-dimercaptosuccinic acid (DMSA) or N-acetyl-D, L-penicillamine (NAP) in a short-term study designed to compare the potential to mobilize mercury and the incidence of drug-induced toxicity of these two chelating agents. Rapidly resolving metal fume fever was the earliest manifestation of symptoms. CNS symptoms and abnormal performance on neuropsychological tests persisted over the prolonged period of follow-up. There were significant correlations between neuropsychological tests and indices of mercury exposure. Serial mercury in the blood and urine verified the long half-life and large volume of distribution of mercury. Chelation therapy with both drugs resulted in the mobilization of a small fraction of the total estimated body mercury. However, DMSA was able to increase the excretion of mercury to a greater extent than NAP. These observations demonstrate that acute exposure to elemental mercury and its vapour induces acute, inorganic mercury toxicity and causes long-term, probably irreversible, neurological sequelae.

Common plants and their toxicity.

This article contains information about plants that have a potential for producing acute toxicity. The two largest sections are in tabular format, that is, a list of plants reported to have a potential for producing acute toxicity and a table of plants that have been used as food suggesting that they have little toxic potential. For each plant cited in the first table, at least one specific category of toxicity is listed, and references are made to brief management overviews that are presented at the end of the article.

The role of drug information centers with consumers.

Heightened concern about drug abuse during the late 1960s prompted community leaders to request that the University of Cincinnati's Drug Information Center extend its services to the public. More than 500,000 inquiries have been handled by the Center since it first offered these services. The Center's "hotline" provides information, advice, counseling, and/or emergency treatment and referral information and is extensively involved in community outreach and prevention efforts. Providing reliable, authoritative, and beneficial information requires that all staff be professionally qualified and receive extensive training, pass specialized certification tests, follow structured policies and guidelines, and effectively use consultants. Impressions of the roles, impact, and need for such services in the 1980s are discussed.

Investigation of clonidine and lofexidine for the treatment of barbiturate withdrawal in mice.

This study was designed to determine the effectiveness of clonidine (CL) and CL analogue, lofexidine (LF), in reducing the incidence and/or severity of convulsion associated with barbiturate withdrawal in mice. CL and LF have been shown to be useful in blocking opioid withdrawal symptoms in rodents and man. Some of the symptoms and possibly the mechanism(s) of the barbiturate withdrawal syndrome are similar to those of the opioid withdrawal syndrome. Therefore, we hypothesized that LF and CL may be efficacious in treating barbiturate withdrawal. The method of Belknap et al as modified by Blum et al for inducing barbiturate dependence in mice was used. Phenobarbital was thoroughly mixed with the animals' milled diet. After 10 days 45 pre-treated mice were divided into withdrawal, control, clonidine- and lofexidine-treated groups. Withdrawal scores were graded as 0 = no effect, 1 = tremor, 2 = wild running, 3 = tonic-clonic seizures, 4 = death, and were collected for each group every 5 hr for 2.5 days. The data in this model suggest that CL and LF offer no protective effect in treating barbiturate withdrawal-induced seizures in mice.