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At least 127 records · Page 7Linked to original sources
PubMed1992

Comparison of pediatric poisoning hazards: an analysis of 3.8 million exposure incidents. A report from the American Association of Poison Control Centers.

This analysis of life-threatening and fatal pediatric poisonings was conducted to aid poison prevention educational efforts, guide product reformulations and aversive agent use, reassess over-the-counter status for selected pharmaceuticals, and identify research areas for clinical advances in the treatment of pediatric poisonings. A hazard factor was devised to assess more objectively the pediatric poisoning hazard posed by pharmaceutical and nonpharmaceutical products. By considering the frequency and extent of injury following actual exposures, the hazard factor reflects more than the acute toxicity of individual ingredients and is also influenced by such variables as packaging, accessibility, availability (as a reflection of marketing), formulations, and closure types. Of the 3,810,405 exposures involving children younger than 6 years of age reported to poison centers in 1985 through 1989, 2117 patients experienced a major outcome (life-threatening effect or residual disability) and an additional 111 fatalities occurred. The three most commonly implicated substance categories, accounting for 30.4% of reported exposures, include cosmetics and personal care products, cleaning substances, and plants. All had low hazard factors, with significant hazards being limited to a small number of products identified herein. Thus this analysis of hazard factors demonstrates that frequent exposure does not imply toxicity. Iron supplements were the single most frequent cause of pediatric unintentional ingestion fatalities, accounting for 30.2% of reported pediatric pharmaceutical unintentional ingestion fatalities reported over an 8-year period. Antidepressants, cardiovascular medications, and methyl salicylate follow in frequency of pediatric pharmaceutical deaths. Hydrocarbons (including five lamp oil deaths) and pesticides were each implicated in 12 pediatric ingestion fatalities during the 8-year period.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗
PubMed1979

[Mortality from accidental poisoning in Budapest during 1961-1975. II. Carbon monoxide poisoning].

In the examined 15 year period accidental deaths from carbon monoxide poisoning amounted to 641 persons--341 males and 300 females. The number of poisonings increased evenly and at a progressive rate, although the frequency of carbon monoxide poisoning--among the accidental poisonings--decreased. The majority of the deceased from accidental carbon monoxide poisoning was older 60 years. 90.4 per cent of cases occurred at home. In 37.7 per cent of the cases the source of the gas appeared to be the gap-tap turned off wrongly and in 36.4 per cent the escape of gas. 4.4 per cent of the cases survived. 14.4 per cent of the deceased had alcohol in their blood.

Accidents↗
PubMed1979

[Mortality from accidental poisoning in Budapest during 1961-1975. IV. Various types of poisoning].

In the 15-year-period analyzed 242 persons--170 males and 72 females--died from various kind of poisons (alcohol and carbon monoxide excluded). The fatal poisonings were as follows: 69 cases--due to mushroom, 33--organic solvents, 23--23 cases--caustic material (soda and acids), 21--methylalcohol, 18--weedkillers and insecticides. Some types of poisonings seems to be more frequent among males, others among females. The frequency of above mentioned poisonings decreases. The majority of deceased appeared to be of elderly age. The type of poisoning and the age of the deceased are not correlated.

Accidents↗
PubMed1994

Poison centers, poison prevention, and the pediatrician.

The first poison centers were established in the United States in the early 1950s, stimulated by an American Academy of Pediatrics' survey of office-based pediatric practices which ascertained that its members had no place to turn for ingredient information on medications and household products. With the help of the Academy, pediatrician Dr. Edward Press, the Illinois Department of Health, and several community hospitals, the first poison center emerged. Over the subsequent 40 years, remarkable progress has occurred in the fields of clinical toxicology, poison control, and poison prevention. Yet despite these accomplishments, challenging clouds are appearing on the horizon which threaten these gains. This commentary, by the authors who have viewed and participated in a large part of the history of this progress, will focus on these major accomplishments with an emphasis on (a) poison prevention utilizing the pre-event (primary prevention), (b) the event (secondary prevention), and (c) the postevent (tertiary prevention) model.

Child↗
PubMed1996

[Analysis of toxicological information rendered by the staff of the National Poison Information Center and physicians at the Clinic of Acute Poisoning of the Institute of Occupational Medicine in Lódź].

The article presents structure of toxicological information given by phone to the physicians involved in treatment of acute poisonings, private persons the services monitoring the working environment. The information comprises data on toxic effect on human organism, chemical composition, therapeutic procedure in acute poisonings as well as the data on hazards occurring in every day life. The consultations chiefly regarded poisonings with drugs, pesticides, alcohols, organic solvents and corrosive substances. The analysis has shown that poisonings of children aged below 14 years pose a significant problem. Moreover, it has been noted that there is a growing demand for toxicological consultations among the general population. They play a significant role in education of the society, making them aware of the hazards created by various chemicals used in the households and occurring in the working environment which contributes to promotion of the poisonings prevention.

Adolescent↗
PubMed2006

Lessons to be learnt from organophosphorus pesticide poisoning for the treatment of nerve agent poisoning.

The increasing threat of nerve agent use for terrorist purposes against civilian and military population calls for effective therapeutic preparedness. At present, administration of atropine and an oxime are recommended, although effectiveness of this treatment is not proved in clinical trials. Here, monitoring of intoxications with organophosphorus (OP) pesticides may be of help, as their actions are closely related to those of nerve agents and intoxication and therapy follow the same principles. To this end, the clinical course of poisoning and the effectiveness of antidotal therapy were investigated in patients requiring artificial ventilation being treated with atropine and obidoxime. However, poisoning with OP pesticides shows extremely heterogeneous pictures of cholinergic crisis frequently associated with clinical complications. To achieve valuable information for the therapy of nerve agent poisoning, cases resembling situations in nerve agent poisoning had to be extracted: (a) intoxication with OPs forming reactivatable OP-AChE-complexes with short persistence of the OP in the body resembling inhalational sarin intoxication; (b) intoxication with OPs resulting rapidly in an aged OP-AChE-complex resembling inhalational soman intoxication; (c) intoxications with OPs forming a reactivatable AChE-OP complex with prolonged persistence of the OP in the body resembling percutaneous VX intoxication. From these cases it was concluded that sufficient reactivation of nerve agent inhibited non-aged AChE should be possible, if the poison load was not too high and the effective oximes were administered early and with an appropriate duration. When RBC-AChE activity was higher than some 30%, neuromuscular transmission was relatively normal. Relatively low atropine doses (several milligrams) should be sufficient to cope with muscarinic symptoms during oxime therapy.

Animals↗
PubMed2003

Skin manifestations in acute arsenic poisoning from the Wakayama curry-poisoning incident.

BACKGROUND: Four people died and 63 others became ill after eating arsenic-laced curry served at a community festival in Wakayama, Japan, on 25 July 1998. Although dermatological manifestations after the acute ingestion of arsenic have seldom been documented, they were observed in 56% of the victims in the Wakayama curry-poisoning incident. OBJECTIVES: To characterize the skin manifestations due to acute arsenic poisoning. METHODS: Four of the 67 patients with arsenic poisoning died, and the remaining 63 patients served as subjects for this study. The dermatological findings were extracted from the medical charts at the institutions which admitted the victims, and from the results of a medical inquiry and examinations during a health screening 3 months after the incident. RESULTS: Dermatological findings were observed in 56% of the victims during the acute stage of poisoning. Facial oedema was observed in 13 patients, transient flushing erythema in five, conjunctival haemorrhage in 15, maculopapular eruptions in the intertriginous areas in eight, acral desquamation in 11, and herpesvirus infection in three. The histopathological findings of the maculopapular eruptions showed moderate to marked perivascular infiltration with endothelial swelling. Examination of 21 patients at 3 months after their exposure to arsenic revealed ungual changes including Mee's or Beau's lines in 17 cases, periungual pigmentation in nine, and acral desquamation in four cases. CONCLUSIONS: Our observations indicate that skin lesions are common in patients with acute arsenic poisoning; these findings may provide information of diagnostic significance.

Acute Disease↗
PubMed1999

Position statement and practice guidelines on the use of multi-dose activated charcoal in the treatment of acute poisoning. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists.

In preparing this Position Statement, all relevant scientific literature was identified and reviewed critically by acknowledged experts using agreed criteria. Well-conducted clinical and experimental studies were given precedence over anecdotal case reports and abstracts were not usually considered. A draft Position Statement was then produced and subjected to detailed peer review by an international group of clinical toxicologists chosen by the American Academy of Clinical Toxicology and the European Association of Poisons Centres and Clinical Toxicologists. The Position Statement went through multiple drafts before being approved by the Boards of the two societies. The Position Statement includes a summary statement for ease of use and is supported by detailed documentation which describes the scientific evidence on which the Statement is based. Although many studies in animals and volunteers have demonstrated that multiple-dose activated charcoal increases drug elimination significantly, this therapy has not yet been shown in a controlled study in poisoned patients to reduce morbidity and mortality. Further studies are required to establish its role and the optimal dosage regimen of charcoal to be administered. Based on experimental and clinical studies, multiple-dose activated charcoal should be considered only if a patient has ingested a life-threatening amount of carbamazepine, dapsone, phenobarbital, quinine, or theophylline. With all of these drugs there are data to confirm enhanced elimination, though no controlled studies have demonstrated clinical benefit. Although volunteer studies have demonstrated that multiple-dose activated charcoal increases the elimination of amitriptyline, dextropropoxyphene, digitoxin, digoxin, disopyramide, nadolol, phenylbutazone, phenytoin, piroxicam, and sotalol, there are insufficient clinical data to support or exclude the use of this therapy. The use of multiple-dose charcoal in salicylate poisoning is controversial. One animal study and 2 of 4 volunteer studies did not demonstrate increased salicylate clearance with multiple-dose charcoal therapy. Data in poisoned patients are insufficient presently to recommend the use of multiple-dose charcoal therapy for salicylate poisoning. Multiple-dose activated charcoal did not increase the elimination of astemizole, chlorpropamide, doxepin, imipramine, meprobamate, methotrexate, phenytoin, sodium valproate, tobramycin, and vancomycin in experimental and/or clinical studies. Unless a patient has an intact or protected airway, the administration of multiple-dose activated charcoal is contraindicated. It should not be used in the presence of an intestinal obstruction. The need for concurrent administration of cathartics remains unproven and is not recommended. In particular, cathartics should not be administered to young children because of the propensity of laxatives to cause fluid and electrolyte imbalance. In conclusion, based on experimental and clinical studies, multiple-dose activated charcoal should be considered only if a patient has ingested a life-threatening amount of carbamazepine, dapsone, phenobarbital, quinine, or theophylline.

Acute Disease↗
PubMed1993

Accidental poisoning of children in Japan: a report from the Japan Poison Information Center.

The Japan Poison Information Center (JPIC) was founded only 6 years ago as a result of co-operation between the Ministry of Health and Welfare, the Japanese Association for Acute Medicine, the Japan Pediatric Society and other related medical organizations. The JPIC is the only poison information center admitted by the Ministry of Health and Welfare to provide toxicological information to medical personnel and the general public, and has two offices on duty in alternating 24 h shifts. Every year, JPIC receives about 30,000 inquiries. About 82% of these inquiries are from the general public and 84% of the patients are children 5 years and younger. We contrasted the data in the fiscal year 1991 with the data of the American Association of Poison Control Centers (AAPCC). Child poison exposure in Japan is characterized by a high exposure rate of children under 1 year of age to (mostly) household products. The JPIC also analyzed the cause of tobacco ingestion. It is considered that the Japanese lifestyle causes differences from those reported by AAPCC. We report the accidental poisoning of children in Japan.

Accidents↗
PubMedDate not supplied

A review of a preventable poison: pediatric lead poisoning.

PURPOSE: A review of lead poisoning in pediatric populations enables nurses to increase their knowledge base about lead poisoning and to further the work on the Healthy People 2010 goal of eliminating childhood lead poisoning as a public health issue in the United States. CONCLUSION: Nurses should be aware of and use the variety of primary, secondary, and tertiary prevention strategies that are available to address pediatric lead poisoning. PRACTICE IMPLICATIONS: Prevention, education, and evidence-based treatment plans can decrease the occurrence of pediatric lead poisoning.

Chelating Agents↗
PubMed2000

[Poison elimination methods in acute poisoning].

This paper presents current ideas about the application of poison elimination methods in acute poisoning. The methods are divided into two groups: poison elimination before absorption; and enhancement of elimination after drug absorption. The former include washes, emesis, gastric lavage, and administration of activated charcoal and cathartics, while the latter include forced diuresis and extracorporeal toxin elimination such as hemodialysis or hemoperfusion. The indications, contraindications, techniques, and complications, associated with these elimination methods, except for extracorporeal toxin elimination, are discussed. In the treatment of poisoning, early and comprehensive poison elimination is important.

Acute Disease↗
PubMed2003

[Examination of drugs and poisons in institutions not equipped with an analyzer of them and poisons--focusing on the simple qualitative test of surfactants].

We examined the simple qualitative test of surfactants, and discussed its possible usefulness in clinical emergency medicine and the analysis system in institutions not equipped with an analyzer of drugs and poisons. The procedures for the cobalt thiocyanate ammonium test, methylene blue chloroform test, and bromphenol blue test are easy, if reagents are prepared beforehand. If concomitantly used, these tests enable analysis of ion properties of surfactants. These tests thus seem useful for the screening of drugs and poisons in emergency medicine. We think that it is possible for institutions not equipped with an analyzer of drugs and poisons to establish a system to support clinical practice by giving priority to the establishment of drugs and poisons that frequently cause intoxication as well as of items for the simple qualitative test that are specified in "proposals for the guidelines for the analysis of drugs and poisons" advanced by the Japanese Society for Clinical Toxicology.

Chemistry Techniques, Analytical↗
PubMedDate not supplied

[Acute diltiazem (DTZ) poisoning. Survey of french poison control centers].

UNLABELLED: The end-points of this study upon 134 cases reports by the french Poison Centers from 1979 to 1988 (10 years) were to specify the acute toxicity of diltiazem (DTZ). There were 83 self-poisonings in adults, with diltiazem alone (36 cases) or associated with other non cardiotoxic drugs (47), the doses of DTZ ranging from 300 to 5400 mg, and 51 acute accidental overdose in children, the doses of DTZ ranging from 60 to 420 mg. One case of hypotension was observed in a child, without rhythmic disorder, occurring twelve hours post-ingestion of 180 mg of DTZ. In adults, the clinical effects were observed following 360 mg of dose DTZ, occurring 1 1/2 hour post-ingestion. There were discomfort, brady-cardia in 16% of the cases, hypotension in 23% of the cases, cardiogenic shock in 4% of the cases and cardiac arrest in 2.4% of the cases. The rhythmic disorders occurred 2 to 15 hours post-ingestion. There were conduction defects like atrio-ventricular heart bloc I degree in 9% of the cases, II degree in 2.4% of the cases and III degree in 9% of the cases. Less frequently, sinusal bradycardia in 11% of the cases or sino-auricular heart block in 4% of the cases with sometimes auriculo ventricular heart block. These cardiac disorders occurred with 600 mg of DTZ. A cardiac arrest happened in a young healthy man who had absorbed 5400 mg of DTZ. The cardiogenic shocks occurred in patients with an history of coronary on heart disease. The poison removal is likely to prevent the occurrence of clinical or EKG effects when performed within 2 hours post-ingestion, whatever toxic the dose is. The inotropic drugs have been used in 18% of the cases; a percutaneous ventricular pacing was always effective in patients with II or III degree atrio-ventricular block or/and cardiogenir shock. These data confirm the data in thirteen patients of the literature. IN CONCLUSION: The acute diltiazem poisoning can occur after 600 mg of DTZ and can induce severe cardiac disorders which can be prevented with poison removal or treated with supportive care.

Acute Disease↗
PubMedDate not supplied

[Epidemiology of pediatric paracetamol poisoning (retrospective analysis of calls received by the Poison Control Center of Tours)].

The authors analysed 101 phone calls received in 3 years and 8 months at the Poison Control Center of Tours for paracetamol poisoning in children under 15 years of age. 70% of children were between 1 and 5 years old, 15% under 1 year and 15% over 5 years old. The kind of poisoning differ according to age: iatrogenic in 93% of cases under 1 year old (medication given by parents; error in dosage); accidental in 85% of cases between 1 and 5 years old and "willful" poisoning (43%) or accidental (36%) over 5 years old. The average quantity of ingested paracetamol was low (58mg/kg). The delay before phone call from an individual or a doctor was usually quite short. The neurologic or digestive signs were present in 12% of the children. The outcome was uneventful in all cases indicating that this form of poisoning is being in childrens.

Acetaminophen↗
PubMed1989

[Lead poisoning due to drug addiction: a new source of poisoning with clinical interest and important epidemiological consequences].

Lead poisoning has accompanied the human being throughout history. Owing to the increasing levels of safety at work, the incidence of occupational poisoning has decreased and new forms of non-occupational poisoning have emerged. We present 3 cases of drug addicts, with lead poisoning, as a result of using adulterated drugs. One of them was an intravenous drug addict who had abdominal pain and anemia. The other 2 inhaled heroin, one being slightly anemic and the other without symptoms and with normal hemoglobin levels. The drug adulterated with lead had not been previously recognized as a source of lead poisoning, being likely to cause serious epidemiological effects.

Adult↗
PubMed1994

The effect of acute carbon monoxide poisoning on the respiratory system efficiency. I. Values of spirometric parameters in different degrees of poisoning.

The examination of 91 patients, performed as soon as possible after CO poisoning, revealed that the values of ventilatory parameters obtained from the flow-volume loop recorded by a computer-aided spirometer were significantly lower then those after treatment. Ventilatory efficiency closely related with the degree of poisoning, was assessed according to age, COHb concentration, blood lactate level, and neurological symptoms. Ventilatory parameters in 48 persons with medium and acute poisoning were significantly lower than in the group of slightly poisoned patients. The strong relationship between the major spirometric parameters, blood lactate level and duration of exposure to carbon monoxide was noted. However, the correlation between ventilatory parameters and the degree of poisoning taken as a total of all mentioned parameters was strongest.

Adolescent↗
PubMed1983

The pediatrician's role in the poison control movement and poison prevention.

When Oliver Wendell Holmes wrote "To guard is better than to heal, the shield is nobler than the spear!" he must have had in mind the origin, many years later, of the poison control center movement. In 1952, the American Academy of Pediatrics (AAP), through a survey by its newly appointed Committee on Accident Prevention, found that the most common medical emergency in children was poisoning. The study brought forth many requests for up-to-date information on toxic ingredients in household products, as well as for improved therapeutic measures. This gave impetus to the development and implementation of poison control centers in the United States, an endeavor practically all-pediatric oriented. Then, the development of safety closures and packaging and the Poison Prevention Packaging Act in 1970 rapidly followed. This is a historical account of the AAP's role and the combined efforts of practicing and academic pediatricians in a mid-20th century movement that has saved countless children's lives.

Accident Prevention↗
PubMed1995

Physiology of food poisoning microorganisms and the major problems in food poisoning control.

There remains considerable public concern regarding the current high level of food poisoning disease in Europe and the fact that, year by year, it continues to rise rather than fall. At the same time, there are strong and increasing demands from consumers for foods that are more convenient, fresher, more natural, less heavily processed (e.g. 'REPFEDS' and 'Sous Vide' foods, mildly heated and distributed at chill temperatures; Lund and Notermans, 1992), less heavily preserved (e.g. less acid, less salt, less sugar; Gould, 1995) and less reliant on additive preservatives than hitherto (e.g. sulphite, nitrite, organic acids and esters; Russell and Gould, 1991). Most of these trends result in a general reduction in the intrinsic preservation of foods. Furthermore, many food poisoning microorganisms escape the attention of preservation techniques altogether, reaching the consumer more or less directly from contaminated foods, most often foods of animal origin. It has therefore been argued that a substantial reduction in food poisoning in the near future will be difficult to achieve unless we obtain a greatly improved understanding of the physiology of the most important target organisms (Knochel and Gould, 1995). This knowledge must then be exploited in ways which effectively improve our means for the control of these hazards and reduce the risk to the consumer. A three year AAIR Concerted Action Programme (PL920630: 'Physiology of Food Poisoning Microorganisms') was therefore initiated in 1992 in order to bring together research groups working on the physiology and related aspects of food poisoning microorganisms. The principal objectives of the programme were: 1. To determine the physiological, biochemical and genetical bases of the organisms' survival of and responses to food-relevant stresses; 2. to determine the physiological and genetical factors influencing infectivity and toxinogenesis; 3. to understand the physiological bases of those synergistic systems that are already empirically applied or that have future potential; 4. to make a wide range of modern techniques in which particular members have expertise more widely available. As can be read in the subsequent contributions to this special issue, the area is a fruitful one for microbiological research and the Programme has been successful in bringing together disparate strands of the topic. It has also highlighted areas where this scientific knowledge may be better exploited in improving the microbiological safety of foods for the consumer.

Bacterial Physiological Phenomena↗