RESUMEN
OBJECTIVES: to evaluate and indicate the procedure to be followed in the health unit, both for diagnosis and the treatment of acute exogenous intoxications by carbamates or organophosphates. METHODS: a descriptive study based on retrospective analysis of the clinical history of patients diagnosed with intoxication by carbamates or organophosphates admitted at the emergency unit of the Hospital de Urgências de Sergipe Governador João Alves (HUSE) between January and December of 2012. Some criteria were evaluated, such as: intoxicating agent; patient's age and gender; place of event, cause, circumstances and severity of the intoxication; as well as signs and symptoms of the muscarinic, nicotinic and neurological effects. RESULTS: seventy patients (average age: 25 ± 19.97) formed the study's population. It was observed that 77.14% of them suffered carbamate intoxication. However, organophosphate intoxications were more severe, with 68.75% of patients presenting moderate to severe forms. Suicide attempt was the leading cause of poisoning, with 62 cases (88.57% of total). Atropine administration was an effective therapeutic approach for treating signs and symptoms, which included sialorrhea (p = 0.0006), nausea (p = 0. 0029) and emesis (p < 0.0001). The use of activated charcoal was shown effective, both in combating the signs and symptoms presented by both patient groups (p < 0.0001). CONCLUSION: it is concluded that the use of atropine and activated charcoal is highly effective to treat the signs and symptoms developed by patients presenting acute exogenous intoxication by carbamates or organophosphates.
Asunto(s)
Carbamatos/envenenamiento , Intoxicación por Organofosfatos/tratamiento farmacológico , Adolescente , Adulto , Anciano , Atropina/administración & dosificación , Atropina/uso terapéutico , Brasil/epidemiología , Carbón Orgánico/administración & dosificación , Carbón Orgánico/uso terapéutico , Niño , Preescolar , Antagonistas Colinérgicos/administración & dosificación , Antagonistas Colinérgicos/uso terapéutico , Servicio de Urgencia en Hospital , Femenino , Lavado Gástrico/normas , Humanos , Lactante , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Intoxicación por Organofosfatos/epidemiología , Estudios Retrospectivos , Intento de Suicidio/estadística & datos numéricos , Adulto JovenRESUMEN
Summary Objectives: to evaluate and indicate the procedure to be followed in the health unit, both for diagnosis and the treatment of acute exogenous intoxications by carbamates or organophosphates. Methods: a descriptive study based on retrospective analysis of the clinical history of patients diagnosed with intoxication by carbamates or organophosphates admitted at the emergency unit of the Hospital de Urgências de Sergipe Governador João Alves (HUSE) between January and December of 2012. Some criteria were evaluated, such as: intoxicating agent; patient's age and gender; place of event, cause, circumstances and severity of the intoxication; as well as signs and symptoms of the muscarinic, nicotinic and neurological effects. Results: seventy patients (average age: 25±19.97) formed the study's population. It was observed that 77.14% of them suffered carbamate intoxication. However, organophosphate intoxications were more severe, with 68.75% of patients presenting moderate to severe forms. Suicide attempt was the leading cause of poisoning, with 62 cases (88.57% of total). Atropine administration was an effective therapeutic approach for treating signs and symptoms, which included sialorrhea (p=0.0006), nausea (p=0. 0029) and emesis (p lt0.0001). The use of activated charcoal was shown effective, both in combating the signs and symptoms presented by both patient groups (p <0.0001). Conclusion: it is concluded that the use of atropine and activated charcoal is highly effective to treat the signs and symptoms developed by patients presenting acute exogenous intoxication by carbamates or organophosphates.
Resumo Objetivo: avaliar e indicar os procedimentos a serem seguidos na unidade de saúde tanto para o diagnóstico como para o tratamento de intoxicações agudas exógenas por carbamatos ou organofosforados. Métodos: estudo descritivo baseado na análise retrospectiva da história clínica de pacientes diagnosticados com intoxicação por carbamatos ou organofosforados admitidos em uma unidade de emergência, entre janeiro e dezembro de 2012. Foram avaliados alguns critérios, como: agente intoxicador; idade do paciente e gênero; causa de envolvimento, circunstâncias e gravidade da intoxicação; sinais e sintomas dos efeitos neurológicos muscarínicos e nicotínicos. Resultados: setenta pacientes (idade média: 25±19,97 anos) formaram a população de estudo. Foi observado que 77,14% deles sofreram intoxicação por carbamatos. Os casos mais graves foram intoxicados por organofosforados, com 68,75% dos pacientes apresentando formas moderadas a graves. Tentativa de suicídio foi a causa principal de envenenamento, com 62 casos (88,57% do total). A administração de atropina foi uma medida terapêutica efetiva para tratamento de sinais e sintomas, como sialorreia (p=0,0006), náusea (p=0,0029) e êmese (p<0,0001). O uso do carvão ativado mostrou efetividade para o combate dos sinais e sintomas apresentados por pacientes em geral (p<0,0001). Conclusão: o uso de atropina e de carvão ativado é uma medida terapêutica altamente efetiva para combater os sinais e sintomas apresentados por pacientes vítimas de intoxicação aguda exógena por carbamatos ou organofosforados.
Asunto(s)
Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Adulto Joven , Carbamatos/envenenamiento , Intoxicación por Organofosfatos/tratamiento farmacológico , Atropina/administración & dosificación , Atropina/uso terapéutico , Brasil/epidemiología , Carbón Orgánico/administración & dosificación , Carbón Orgánico/uso terapéutico , Antagonistas Colinérgicos/administración & dosificación , Antagonistas Colinérgicos/uso terapéutico , Servicio de Urgencia en Hospital , Lavado Gástrico/normas , Tiempo de Internación/estadística & datos numéricos , Intoxicación por Organofosfatos/epidemiología , Estudios Retrospectivos , Intento de Suicidio/estadística & datos numéricosRESUMEN
INTRODUCTION: Schistosomiasis is endemic in 74 countries and is considered a serious public health problem in some locations. METHODS: A transverse study was performed of 13 landless settlements in southern Sergipe from February to December 2009. The study included 822 settlers, of whom 601 underwent stool testing. RESULTS: The prevalence of schistosomiasis in landless workers was 4.3%. The population has a low education level, and basic sanitation services are not available to all residents. CONCLUSIONS: The prevalence of schistosomiasis was low in the population and among different settlements, possibly because of different forms of water use by the settlers.