Subject(s)
Child Abuse, Sexual , Age Factors , Alcoholism/complications , Child , Child Abuse, Sexual/diagnosis , Child Abuse, Sexual/ethnology , Child Abuse, Sexual/prevention & control , Child Abuse, Sexual/statistics & numerical data , Domestic Violence/ethnology , Domestic Violence/statistics & numerical data , Female , Guidelines as Topic , Health Education , Humans , Incest/statistics & numerical data , Indians, North American , Male , Mexico/epidemiology , Mexico/ethnology , Sex FactorsSubject(s)
Poisoning/diagnosis , Poisoning/therapy , Adolescent , Age Factors , Antidotes , Charcoal , Child , Crime , Dialysis , Female , Humans , Iatrogenic Disease , Male , Munchausen Syndrome by Proxy , Risk Factors , Self Medication , Substance-Related Disorders , Suicide, AttemptedABSTRACT
To determine children's perception of their own psychosocial functioning, to compare it with their parents' perception, and determine the type and rate of their psychopathological syndromes and family functioning, and to investigate correlation among these data. Nineteen children with craniofacial deformities and their parents responded to the Columbia Impairment Scale, the Child Behavior Checklist and the McMaster General Functioning Subscale. Psychosocial impairment is a trend in children with craniofacial deformities. There is a correlation between children's and parents' perception of the patient's psychosocial adaptation, global psychopathology and externalizing and aggressive syndromes. A less strong correlation was found with internalizing, somatization and attention deficit syndromes, and with family functioning. Craniofacial deformities in childhood pose special risks for psychosocial adjustment due to type of illness and environmental and family factors.
Subject(s)
Adaptation, Psychological , Craniofacial Abnormalities/psychology , Adolescent , Child , Family/psychology , Female , Humans , Male , Psychiatric Status Rating Scales , Psychology, Social , Psychopathology , Self Concept , SyndromeABSTRACT
The aim of the study was to evaluate continuous administration of multiple-dose activated charcoal (MDAC) in enhancing elimination of carbamazepine (CBZ) in eight consecutive adolescent suicide attempters. Diluted charcoal was administered through a nasogastric tube at a dose of 1 g/kg every 4 h, and a saline cathartic at the same dosage was administered every 12 h. Plasma CBZ concentrations were measured at 0.0, 12, 24 and 36 h by means of a modified EMIT technique. As a measure of CBZ disappearance, half life of elimination (t1/2 beta) and exogenous total body clearance (CLB) were calculated. Clinical improvement occurred after 12 to 24 h, except in one patient who was the most severely intoxicated and who required advanced life-support therapy. Pharmacokinetic data reported a mean t1/2 beta of 9.5 h, shorter than the reference value of 18-54 h (p < 0.05), and a mean CLB of 103.13 ml/ min/kg, higher than the reference of 75.01 ml/min/ kg (p < 0.05). Initial mean CBZ levels of 27.9 decreased to 0.82 microgram/ml (97% of elimination, p < 0.05). MDAC was free from adverse side effects. In conclusion, MDAC is an effective procedure in enhancing CBZ elimination in overdosed patients as well as being relatively free from serious side effects, widely available, inexpensive and non-invasive.
Subject(s)
Anticonvulsants/poisoning , Carbamazepine/poisoning , Charcoal/therapeutic use , Drug Overdose/therapy , Suicide Prevention , Adolescent , Anticonvulsants/pharmacokinetics , Carbamazepine/pharmacokinetics , Cardiovascular System/physiopathology , Depression/therapy , Female , Half-Life , Humans , Intubation, Gastrointestinal , Suicide/psychologyABSTRACT
The authors point out a correlation between regulatory disorders in infants and the problem of excessive crying. The literature describes other behavioral problems involving excessive crying in very young children, but with little emphasis on this association. The recognition and diagnosis of regulatory disorders in infants who cry excessively can help practitioners design appropriate treatment interventions. Understanding these conditions can also help parents tailor their caretaking style, so that they provide appropriate soothing and stimulation to their child. In so doing, they will be better able to develop and preserve a satisfactory parent-child relationship, as well as to maintain their own sense of competence and self-esteem as parents.
Subject(s)
Child Development , Crying , Female , Humans , Infant , Male , Parenting , Pregnancy , Prenatal Exposure Delayed Effects , Terminology as TopicABSTRACT
Twelve pediatric patients with acute poisonings caused by carbamazepine, digoxin and acetylsalicylic acid were treated with multiple doses of activated charcoal combined with a saline cathartic (adsorption surface of activated charcoal nearly 950 m2/g). This procedure was effective to shorten the plasmatic levels of the drugs, besides the clinical improvement of the poisoned patients. The average initial and final levels of the drugs were: carbamazepine 21.64 and 0.9 micrograms/ml (lowering 95.81%, p < 0.05), digoxin 5.14 and 1.1 ng/ml (lowering 78.6%, P < 0.05) and acetylsalicylic acid 418.5 and 57.5 micrograms/ml, respectively, (lowering 86.3%, p < 0.05). These results suggest the usefulness of activated charcoal in the clearance of the four overdosed drugs.
Subject(s)
Antidotes/administration & dosage , Aspirin/poisoning , Carbamazepine/poisoning , Charcoal/administration & dosage , Digoxin/poisoning , Acute Disease , Adolescent , Child , Drug Administration Schedule , Drug Overdose , Female , Humans , Infant , MaleABSTRACT
In hospitalized and chronically ill children, the prevalence of psychopathology is very high. It is necessary that in its prevention, diagnosis and treatment not only professionals of the mental health disciplines intervene but also that the pediatricians, nurses and the family of the patient himself participate actively. Consultation Liaison Child Psychiatry activities at the Pediatric Hospital of the National Medical Center "Siglo XXI" are described. Its goal is to incorporate the mental health professional to the team of hospital care and promote that pediatricians gain a greater conscience of psychological and social factors that are crucial for the sick child.
Subject(s)
Mental Disorders/therapy , Patient Care Team , Psychiatry/methods , Child , Hospitals, Pediatric , Humans , Mexico , Program Development , Psychiatry/trendsABSTRACT
A description is made of the situation of neonates and their families during hospitalization in the Neonatal Intensive Care Unit (NICU). Emphasis is made on the stressful situations faced by the infants, the families and the caregivers as well as on potential interventions to ameliorate their negative impact and to promote a favorable outcome. With the infants, the situation is one of overwhelming aversive stimulation, noncontingent responses and painful procedures, coupled with deprivation of normative experiences, propiciated by their illness and the structure of the unit. With the families, their feelings of impotence, guilt, and separation from their infant are highlighted, and interventions are described that may help them in this situation of crisis. With the staff the intervention consists on education and sensitization to the infant's needs. The liaison psychiatrist is the infant's voices with the families and the staff. The literature is reviewed in terms of the potential effects of favorable stimulation and of the negative experiences of neonates while at the NICU.
Subject(s)
Infant, Newborn/psychology , Intensive Care Units, Neonatal , Medical Staff, Hospital/psychology , Parents/psychology , Psychiatry , HumansABSTRACT
We report the case of a preschool boy who, without knowledge of his relatives, ingested thallium sulfate in a dose calculated in 30 mg/kg. He presented a systemic lupus erythematosus-like syndrome and only further alopecia oriented the diagnosis of thallium toxicosis; thallium blood levels were; 37.2 micrograms/dl and in urine: 2330 micrograms/L. Treatment with the chelating agent D. penicillamine was effective, the clinical picture disappeared and the decrease of the thallium levels was observed. Thallium intoxication should be considered in the differential diagnosis of connective tissue disease as the above mentioned.
