[Deliberate medication poisoning in adolescence as a medical and socially significant problem].

One of the urgent medical and social problems of modern society is the steady growth of auto-aggressive behavior and deliberate medication poisoning among adolescents and young adults. This investigation was held to optimize the provision of specialized medical care for acute deliberate self-poisoning in teenagers. We examined 498 patients admitted to the Toxicology Department of N. F. Filatov Children City Clinical Hospital No. 13 with a diagnosis of acute deliberate medication poisoning. The diagnosis was confirmed by chemical and toxicological urine test using thin-layer chromatography. From 2016 to 2018 the number of patients with deliberate medication poisoning increased by more than 2.5 times and amounted to 236 cases. Female patients were prevalent and accounted for up to 85% of cases. The leading position among medication self-poisoning is held by psychopharmacological drugs at 56%, in second place are non-steroidal anti-inflammatory drugs at 18.5%. The main causes of self-poisoning were social or family conflicts (47%), problems at school (35%), and Internet-related complaints (18%). The clinical manifestations of the disease in the acute period of chemical poisoning depended on the toxic agent and the dose taken. Psychological testing revealed a high level of neuroticism in 71% of adolescents, severe anxiety was observed in 57% of patients, and depression was diagnosed in 28% of cases. All patients were provided specialized medical care, including resuscitation, detoxification, and psychiatrist examination. Based on the accumulated clinical experience, an algorithm for managing adolescents with deliberate medication poisoning has been developed, which has reduced the number of repeated suicides by 1.8 times.

[About the safety of application of nasal decongestants in the practice of pediatricians]. / O bezopasnosti primeneniia nazal'nykh dekongestantov v pediatricheskoi praktike.

Undesirable effects of the application of the intransal vasoconstricting medications are a frequent occurrence in the pediatric practice. The objective of the present study was to evaluate the role of the intranasal vasoconstricting medications in the structure of the means and methods currently available for the treatment of toxicological pathologies based at a multi-field clinical hospital. The retrospective analysis of the medical histories of the patients admitted to the toxicological department and annual reports for the period from 2015 to 2016 was undertaken. The study has demonstrated that intoxication associated with the use of the intranasal vasoconstricting medications was the most common cause of hospitalization of the children in the toxicological departments. Intoxication of this origin accounted for 15-20% of the total number of toxicological pathologies among the children. The cases of intoxication are most frequently documented in the group of children at the age between 1 and 3 years. The risk of the undesirable serious complications is especially high after the application of naphazoline-based intranasal vasoconstricting medications (71.7-77.4% of all the cases of intoxication with these products). It is concluded that the use of intranasal vasoconstricting medications in the pediatric practice should be carried out under the strict control, with the naphazoline-based preparations being totally excluded from the application.

[Correction of hydrodynamic disorders in severe alcohol poisoning in adolescent].

OBJECTIVE: To improve the results of treatment of children with severe alcohol poisoning as a result of investigation of water sectors of the body. METHODS: The study included 54 patients aged from 13 to 15 years with a diagnosis of acute severe alcohol poisoning. All patients were divided into three groups. At the initial examination was determined the concentration of alcohol in saliva using Express-test "Alkoskan." Bioimpedance analysis was performed; water sectors of the body were investigated by analyzer of the balance of water sectors ABC-01 "Medass." The study was conducted at the time of admission, after 12, 24 and 48 hours. RESULTS: In severe alcohol poisoning at the time of admission, it was revealed a reduction of the fluid in all studied sectors. The most effective compensation of liquid was observed in groups, where was used combination therapy included intravenous fluids based 4.0 ml/kg/hour. CONCLUSION: The treatment of severe alcohol poisoning should include fluid resuscitation about 4 ml/kg/hour. This capacity of medical care give the ability to correct adequately the water-sectoral disturbances already in the first 12 hours of hospitalization, and the inclusion to the basic therapy reamberine can contribute more effective replenishment of water sectors.

[Detoxifying effect of intestinal lavage in children with acute oral poisoning by psychotropic agents].

Examinations of children with acute oral poisoning by psychotropic agents indicated that intestinal lavage significantly lowered the blood levels of a toxicant and more rapidly restored consciousness and hemodynamic parameters as compared with the control group.