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Werner JGB, Platt VB. Acute exogenous intoxications in childhood: factors related to hospitalization. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 42:e2023028. [PMID: 38088677 PMCID: PMC10712941 DOI: 10.1590/1984-0462/2024/42/2023028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/06/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE To describe the profile of children assisted in the Emergency Room of a Children reference Hospital in the South of Brazil, victims of acute poisoning between 2016 and 2021, to characterize the toxic agents and to present the factors related to hospitalization. METHODS Retrospective, descriptive and observational study with data collection from medical records at a children's hospital from July 2016 to June 2021 based on the compulsory notification forms. The characteristics of victims, of the incident, the type and class of the substance involved, the procedures demanded and the need for the Intensive Care Unit were evaluated. The outcome considered was hospitalization. Absolute and relative frequencies were calculated for the categorical variables and measures of central tendency and dispersion for the numerical ones. Binary logistic regression was performed to identify variables related to hospitalization. RESULTS There were 411 consultations, with the mean age of 7.2±5.5 years, and predominance of females (59.9%). Most of the poisoning occurred at home (82.1%) and orally (93.7%). Chemicals or cleaning products were the main agents in children up to 1 year of age, whereas in the other age groups accidents occurred most frequently with medicines. Hospital admission occurred in 38.7% of the cases, with related variables being: number of agents, type of substance involved, medication that acts on the Central Nervous System, recurrence, motivation (accidental/intentional), and performance of simple exams. CONCLUSIONS More preventive actions are needed, such as legislation, as well as greater guidance to parents on how to store products in the domestic environment, in order to reduce the number of exogenous intoxications in the pediatric population.
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Nguyen SN, Vu LT, Nguyen HT, Nguyen LMT. Childhood Acute Poisoning at Haiphong Children's Hospital: A 10-Year Retrospective Study. Int J Pediatr 2023; 2023:2130755. [PMID: 37700774 PMCID: PMC10495236 DOI: 10.1155/2023/2130755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 08/16/2023] [Accepted: 08/24/2023] [Indexed: 09/14/2023] Open
Abstract
Introduction Children are most often harmed by acute poisoning, which may cause disability or even death. This demonstrates the critical necessity for epidemiologic studies specific to each nation and area since they aid in developing plans for the prevention of acute poisoning. There are no data or outdated data on acute poisoning in children in Vietnam. This research would partly fill this existing gap and compare the trend with other places across the globe. Methods A retrospective study was conducted in the 10-year period from 2012 to 2021 in Haiphong Children's Hospital, Vietnam. Results There were 771 children hospitalized due to acute poisoning. Children in the 1-5-year-old group accounted for the highest rate, at 506 (65.6%). The mean age was 4.5 ± 4.1 years old. The male-to-female ratio was 1.2/1. Nonpharmaceutical chemicals were the most common agent in 331 cases (42.9%), including cleaning products 63 (19.0%), rat poison 60 (18.1%), and petrol 42 (12.7%). Medications were the second most common agent in 290 cases (37.6%), mostly paracetamol 60 (20.7%) and sedatives 40 (13.8%). There were 633 (82.1%) children exposed to poisons unintentionally. Conclusion Children between the ages of 1 and 5 are more likely to be exposed to harmful substances. The most common agents were nonpharmaceutical chemicals followed by pharmaceuticals. Most incidents were inadvertent. Finally, our research may provide insights that public health authorities might use to plan practical actions.
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Affiliation(s)
| | - Lam Tung Vu
- Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
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Matalova P, Buchta M, Drietomska V, Spicakova A, Wawruch M, Ondra P, Urbanek K. Acute drug intoxication in childhood: a 10-year retrospective observational single-centre study and case reports. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2023; 167:294-302. [PMID: 37580980 DOI: 10.5507/bp.2023.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/04/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Medication poisoning in children is a severe condition that can endanger a child's life. Although drug intoxications are easily preventable, awareness of the proper handling of drugs and their safe storage out of the reach of children is not widespread among the general public. In this work, we investigated the demographic and clinical data of children admitted to the Department of Pediatrics of the University Hospital Olomouc for acute drug-induced intoxication. We also selected several case reports to illustrate the wide range of both presentations and outcomes in individual patients. METHOD Cases of drug-induced intoxications were selected from a group of patients under the age of 19 years admitted to the hospital for poisoning between January 1, 2010, and December 31, 2019. Medical records of these patients were prospectively evaluated, and overview tables and graphs of predefined research objectives were created. RESULTS During the given time period, 162 children with suspected drug intoxications were hospitalized at the Department of Pediatrics, University Hospital Olomouc. Of these, 108 cases were reported in girls and 54 in boys (66.7% vs. 33.3%). In 16 cases (9.9%), there was a severe intoxication requiring follow-up intensive care. There was also one case of fatal accidental intoxication. Most poisonings were seen in toddlers (65; 40.1%). Intoxication with suicidal ideation was found in 44 cases (27.2%), with a higher incidence of suicide attempts in girls (40 vs. 4). Repeated intoxication was recorded in nine cases. Analgesics were the most common drug group (61; 37.7%), with paracetamol (28; 17.3%) being the leading drug. In 154 cases (95.1%), the drugs were taken orally, most often in the form of tablets. CONCLUSION Accidental drug intoxications most frequently occurred in the age group from one to three years old. The second highest incidence was among adolescents most of which were suicide attempts. Analgesics and psychoactive agents accounted for the majority of cases. Medications should be kept in places where children cannot reach them.
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Affiliation(s)
- Petra Matalova
- Department of Pharmacology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Michal Buchta
- Department of Pharmacology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Vendula Drietomska
- Department of Pharmacology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Alena Spicakova
- Department of Pharmacology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Martin Wawruch
- Institute of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University Bratislava, Slovak Republic
| | - Peter Ondra
- Department of Forensic Medicine and Medical Law, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Karel Urbanek
- Department of Pharmacology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
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Ahmed A, Hasanul Banna Siam M, Shojon M, Mahdi Hasan M, Raheem E, Hossain MS. Accidental poisoning in children: a single centre case series study in Bangladesh. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001541. [PMID: 36053604 PMCID: PMC9305806 DOI: 10.1136/bmjpo-2022-001541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/03/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Accidental poisoning is a leading cause of unintentional injuries among children in low-income and middle-income countries (LMICs). The overall aspect of this unintentional poisoning is poorly understood in Bangladesh. The objectives of this study were (1) to explore the socio-demographic factors and circumstantial context of accidental poisoning and (2) the prevalence of the type of substances causing it. METHODS A descriptive case series study was conducted from April 2019 to February 2020 at a tertiary level hospital of the capital city Dhaka in Bangladesh. Children under 10 years of age admitted to the hospital with accidental poisoning were enrolled in this study. Parents of hospitalised children were interviewed face-to-face using a structured questionnaire. Descriptive statistics were used for data analysis. RESULTS A total of 223 children were recruited in this study. Children between 2 and 5 years (60%), men (61%) and children with agility (65.5%) were among the prevalent victims. The majority of cases occurred (65%) in a nuclear family setting. Most mothers (85%) of these children were non-working and most incidents took place in parents' homes (~82%). Nearly 70% of the poisoning incidents took place in the presence of parents and over half of these occurred in the bedroom. Kerosene was the prevalent cause (33%) of accidental poisoning while insecticide/pesticide ranked second (26.5%) followed by medicines (17%) and household chemicals (12). In one-third (31.4%) of the cases, poisoning chemicals were stored in soft drink bottles while two-thirds (67.3%) of the cases were kept in containers other than original ones. Although over 80 parents somewhat knew that chemicals could be harmful to the children if ingested, most of them did not take the safety measures. CONCLUSION In this present study we found that preschool-aged children were more victims of accidental poisoning mostly by ingesting kerosene and a majority of the incidents took place in the bedroom while parents were present at home. Our study findings would serve as a baseline for designing future intervention studies and policies.
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Affiliation(s)
- Ahsan Ahmed
- Department of Emerging and Neglected Diseases, Biomedical Research Foundation, Dhaka, Bangladesh.,Dhaka Medical College, Dhaka, Bangladesh
| | - Md Hasanul Banna Siam
- Department of Emerging and Neglected Diseases, Biomedical Research Foundation, Dhaka, Bangladesh
| | | | - Md Mahdi Hasan
- Department of Emerging and Neglected Diseases, Biomedical Research Foundation, Dhaka, Bangladesh
| | - Enayetur Raheem
- Department of Emerging and Neglected Diseases, Biomedical Research Foundation, Dhaka, Bangladesh
| | - Mohammad Sorowar Hossain
- Department of Emerging and Neglected Diseases, Biomedical Research Foundation, Dhaka, Bangladesh .,School of Environment and Life Sciences, Independent University, Bangladesh, Dhaka, Bangladesh
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Li Z, Xiao L, Yang L, Li S, Tan L. Characterization of Acute Poisoning in Hospitalized Children in Southwest China. Front Pediatr 2021; 9:727900. [PMID: 34956970 PMCID: PMC8705540 DOI: 10.3389/fped.2021.727900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 10/08/2021] [Indexed: 01/17/2023] Open
Abstract
Objective: Acute poisoning in children is characterized by regional differences. This study described the basic situation of childhood poisoning in southwest China based on hospitalized cases. Data and Methods: A total of 1,076 acute poisoning cases among hospitalized children admitted to Children's Hospital of Chongqing Medical University from January 2012 to December 2020 were included in this study. Clinical data such as gender, age, living environment, poisonous substance, and cause of poisoning were statistically described. Trends of length of hospital stay, population distribution, poisonous substances, and causes of acute poisoning in the hospitalized children were compared over time. Results: The cohort comprised 588 males and 488 females; 811 cases lived in rural areas and the rest resided in urban areas. Most cases were between early childhood and school age. Poisoning usually occurred at home (973 cases, 90.4%). Pesticides (381 cases, 35.4%) and drugs (275 cases, 25.6%) were the two most common poisonous substances. Two main causes of poisoning were accidental taking (755 cases, 70.2%) and suicide (177 cases, 16.4%). The results of univariate analysis of suicide showed significant correlations among gender, place of residence, age, poisonous substance, and place of suicide (P < 0.001), while living environment (town), age (adolescence), and poisonous substance (pesticide, drug) were independent risk factors (P < 0.05). There was no significant change in the length of hospital stay for poisoning over time. The overall number of hospitalizations presented a decreasing trend, while the number of urban children gradually increased. The proportion of adolescent poisoned children and suicidal children increased in the last 3 years. Conclusion: Optimizing the package and distribution channels of pesticides and drugs, raising safety awareness of children to avoid accidental injuries, and paying attention to children's mental health are measures that are necessary to prevent poisoning in children.
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Affiliation(s)
- Zhu Li
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children's Medical Big Data Intelligent Application Chongqing University Engineering Research Center, Department of Emergency, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Li Xiao
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children's Medical Big Data Intelligent Application Chongqing University Engineering Research Center, Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Lin Yang
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children's Medical Big Data Intelligent Application Chongqing University Engineering Research Center, Department of Emergency, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Shaojun Li
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children's Medical Big Data Intelligent Application Chongqing University Engineering Research Center, Department of Emergency, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Liping Tan
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children's Medical Big Data Intelligent Application Chongqing University Engineering Research Center, Department of Emergency, Children's Hospital of Chongqing Medical University, Chongqing, China
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Plis SS, Veselkina OV, Klevno VA, Vlassov VV. Acute lethal poisonings in children: a 10-year retrospective study of the Moscow Region, Russia. J Public Health Res 2021; 11. [PMID: 35166092 PMCID: PMC8874850 DOI: 10.4081/jphr.2021.1932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 08/08/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Poisoning is a critical public health problem. Toxic substances differ across time, region and age. Little is known about poisoning in Russia, and even less is known about lethal poisoning in children in Russia. We aimed to describe the characteristics of cases of lethal poisoning in children and adolescents. DESIGN AND METHODS Our retrospective study was based on autopsy reports from archives of the Moscow Region Bureau of Forensic Medical Examination for the period of 2009 to 2018. RESULTS A total of 438 lethal poisoning cases were recorded. The average age of the poisoned children was 11.3 years. Deaths predominantly occurred in boys, mostly due to the higher frequency of poisoning with household and technical chemicals (p<0.01). Accidental deaths were also higher in males (p < 0.01). Therapeutic drug poisoning (p<0.01) and suicide (p < 0.01) were more frequent in females. The leading cause of lethal poisoning in children was exposure to carbon monoxide, especially in children aged 5 to 9 years (p<0.01) and 1 to 4 years (p<0.01). Carbon monoxide poisoning occurred more often in winter (p<0.01). Regarding the structure of poisoning with household and technical chemicals, the most frequent was poisoning by a mixture of utility gases. CONCLUSION Our study shows that carbon monoxide poisoning is a serious problem in the region. This may be associated with the ongoing use of individual heating systems. A significant increase in the frequency of fatal poisoning by chemicals, especially by propane-butane gas mixtures while sniffing, has become a disturbing trend.
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Affiliation(s)
- Semyon S Plis
- Department of Complex Examinations, Moscow Region Bureau of Forensic Medical Examination, Moscow; Department of Forensic Medicine, Moscow Regional Research and Clinical Institute (MONIKI), Moscow.
| | - Olesya V Veselkina
- Department of Forensic Medicine, Moscow Regional Research and Clinical Institute (MONIKI), Moscow; Department of Innovative Health Care Management, Academy of Postgraduate Education under FSBU FSCC of FMBA of Russia, Moscow.
| | - Vladimir A Klevno
- Department of Forensic Medicine, Moscow Regional Research and Clinical Institute (MONIKI), Moscow.
| | - Vasiliy V Vlassov
- Department of Health Care Management and Economics, National Research University Higher School of Economics, Moscow.
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Matalová P, Poruba M, Wawruch M, Ondra P, Urbánek K. Acute medication poisoning causing hospital admissions in childhood: a 3-year prospective observational single-center study. Physiol Res 2020; 68:S31-S38. [PMID: 31755288 DOI: 10.33549/physiolres.934321] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Although the risks of medication poisoning in children are often reported, there is a lack of studies addressing this issue. The majority of papers deal with a wide range of xenobiotics poisoning and, in particular, alcohol intoxications. All hospital admissions during three years were prospectively recorded. Patients younger than 19 years of age admitted for acute drug intoxications were further evaluated. A total of 15,069 children were admitted. Of them, 55 were hospitalized for acute medication poisoning. The condition was more common in girls (72.7 % vs. 27.3 %, p<0.01). Toddlers were the largest patient group (36.4 %). Non-steroidal anti-inflammatory drugs (NSAIDs) were the most frequently used agents, with ibuprofen being the leading drug (20 % of all cases). The route of intoxication was almost exclusively oral. Solid drug forms were involved in 40 (72.7 %) cases. There was one fatal accidental poisoning. The highest occurrence of accidental drug intoxications was in the age group from one to three years. Attempted suicides were most frequent among adolescents. We are currently actively dealing with the issue. The cohort has been expanded to include a period of ten years and is being analyzed.
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Affiliation(s)
- P Matalová
- Department of Pharmacology, Faculty of Medicine and Dentistry, Palacký University in Olomouc, Olomouc, Czech Republic.
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Positive findings of ethyl glucuronide in hair of young children from families with addiction background. Int J Legal Med 2020; 134:523-532. [PMID: 31965236 DOI: 10.1007/s00414-019-02236-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 12/11/2019] [Indexed: 10/25/2022]
Abstract
AIMS Small children are expected to be abstinent from alcohol, and children's hair is frequently used as the blank matrix for calibration of the alcohol consumption marker ethyl glucuronide (EtG). The basal EtG concentrations of total abstainers were described to be 0.3-2.1 pg/mg (Pirro et al. 2013). It is examined whether this assumption is valid for children from families with addiction background. METHODS In a social support system for families with drug and/or alcohol addicted parents, 161 hair samples from 126 children (age 1-14 years, hair segment 0-3 cm) were analyzed for EtG by a validated LC-MS/MS method (LOD 0.56 pg/mg, LLOQ 2.3 pg/mg). For comparison, ethyl palmitate (EtPa) was measured and hair samples from parents were included. EtG ≥ 3 pg/mg was considered as an alarming result for children. RESULTS AND DISCUSSION EtG concentrations between 3.0 and 42.6 pg/mg (mean 9.55 pg/mg, median 6.40 pg/mg) were measured for 25 samples (15.5%, age 22 × 1-5 years, 3 × 9-11 years). Elevated EtPa (0.15-0.46 ng/mg) was found in 6 samples and cocaethylene (0.02-0.07 ng/mg) was detected in 5 samples with high cocaine findings. Hair results of one or both parents indicated drug abuse in 12 from 14 cases (85.7%) if both parents were tested. CONCLUSION Although accidental or voluntary intake of alcoholic beverages cannot be excluded, the external contamination of children's hair by EtG-containing wine and sweat or urine of the alcohol abusing parents is assumed to be the most probable explanation for the positive EtG results in hair of 1-5-year-old children.
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[Chinese expert consensus on the application of intravenous iron (2019)]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2019; 40:358-362. [PMID: 31207697 PMCID: PMC7342231 DOI: 10.3760/cma.j.issn.0253-2727.2019.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Feiz Disfani H, Kamandi M, Mousavi SM, Sadrzadeh SM, Farzaneh R, Doolabi N, Rahmani K. Risk factors contributing to the incidence and mortality of acute childhood poisoning in emergency department patients in Iran: a hospital-based casecontrol study. Epidemiol Health 2019; 41:e2019016. [PMID: 31010278 PMCID: PMC6533551 DOI: 10.4178/epih.e2019016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 04/23/2019] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES Since poisoning is one of the most important preventable factors contributing to the hospitalization and death of children who present to emergency departments, this study was carried out to investigate the risk factors contributing to the incidence and mortality of acute childhood poisoning. METHODS This hospital-based case-control study included 243 cases and 489 controls, drawn from daily admissions to the emergency departments of the included hospitals according to the inclusion and exclusion criteria. RESULTS Gastrointestinal poisoning was the most common poisoning type, found in 87.7% of subjects, and medications were the most common cause of poisoning (49.8%). Multiple logistic regression analysis showed that a history of poisoning (odds ratio [OR], 10.44; 95% confidence interval [CI], 5.58 to 19.51; p<0.001) and the availability of poisonous substances (OR, 8.88; 95% CI, 5.41 to 14.56; p<0.001) were among the most important predictors of childhood poisoning. Respiratory poisoning (OR, 6.72; 95% CI, 1.40 to 32.07; p<0.05) and the presence of addiction in the family (OR, 4.54; 95% CI, 1.10 to 18.68; p<0.05) were the most important predictors of mortality among children with poisoning. CONCLUSIONS Addiction and the presence of physical or psychological disorders in family members, a history of poisoning, and the availability of poisonous substances were significantly associated with the incidence of childhood poisoning and resultant mortality.
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Affiliation(s)
- Hamideh Feiz Disfani
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mostafa Kamandi
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mohammad Mousavi
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sayyed Majid Sadrzadeh
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Roohie Farzaneh
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Najme Doolabi
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kazem Rahmani
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Vrkić Boban I, Vrca A, Saraga M. Changing Pattern of Acute Alcohol Intoxications in Children. Med Sci Monit 2018; 24:5123-5131. [PMID: 30036885 PMCID: PMC6067040 DOI: 10.12659/msm.908841] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background In many countries, the number of children hospitalized for alcohol intoxication is increasing. This study analyzed changes in the number of hospitalizations for alcohol intoxication in children aged 0–18 years at the Department of Pediatrics, University Hospital of Split, from 2008 to 2015. Material/Methods Data were collected retrospectively from hospital medical records. Risk groups were classified according to sex, age, drinking habits, and possible benefits of early psychological or psychiatric interventions. Children were divided into 4 age groups: 0–5 years, 6–9 years, 10–13 years, and 14–18 years. Statistics 12.00 was used for statistical analyses, with P-value <0.05 considered as statistically significant. Results Out of 24 651 hospitalized children, 488 were treated for acute intoxication: 36.40% were girls and 63.60% were boys. Among them, 272 children (55.74%) were acutely intoxicated with alcohol, with the average age of 15.95 years and the average blood alcohol concentration of 2.00%. The proportion of children hospitalized for alcohol intoxication decreased from 1.33% in 2008 to 0.75% in 2015. Alcohol intoxications occurred in most cases outside children’s homes (92.42%, P=0.001), and on weekends and holidays (81.62%). Among all intoxicated children, 17 children (6.25%) were positive for drugs. A total of 51.29% of children received psychological support (58.59% of girls and 47.09% of boys). Conclusions In this study, the number of children hospitalized for alcohol intoxication decreased, possibly as a result of preventive, educational, and psychotherapeutic measures or changing drinking habits. Acute alcohol intoxication was most common in the group of children aged 14 to 18 years, and a significant number of these children were positive for drugs, thus, further preventive interventions should be provided.
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Affiliation(s)
- Ivona Vrkić Boban
- Department of Pediatrics, University Hospital of Split, Split, Croatia
| | - Andjelko Vrca
- School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Marijan Saraga
- Department of Pediatrics, University Hospital of Split, Split, Croatia.,School of Medicine, University of Split, Split, Croatia
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Kabíček P, Kobr J, Šašek L, Obdržálková Z, Svitálková L, Hůrková V, Zeman J. Alcohol and drug intoxications in adolescents admitted to paediatric wards in the Czech Republic: 5-year retrospective study 2006-2010. Cent Eur J Public Health 2018; 26:39-44. [PMID: 29684296 DOI: 10.21101/cejph.a4644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 12/06/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of the study was to establish frequency, severity and circumstances of alcohol and drug intoxications in adolescents admitted to inpatient wards in the Czech Republic. METHODS Chief physician of each participating ward (or their designated deputy) searched the patient records for required information. The data was then statistically processed. RESULTS Thirty inpatient paediatric wards participated in the study (27 district wards and 3 university hospital wards), amounting to more than a third of all paediatric wards in the country. The total number of intoxications reported was 2,176, the majority of which were alcohol-related (84.5%), followed by cannabinoids and, to a lesser degree, amphetamines. The number of alcohol intoxications increased by 22% during the 5-year observation period, whilst the frequency of illegal drugs intoxications remained the same. We also observed an increase in the percentage of alcohol intoxications in girls - from 42% to 45.5%. The mean age at intoxication was low - 15.5 years. The Glasgow Coma Scale in individual episodes of intoxication increased during the study duration/follow up period. The proportion of alcohol intoxications originating in pubs, clubs or other public institutions was 25%. CONCLUSION The number of alcohol intoxications has risen during the observation period. The age at which these intoxications occurred is very low. Of serious concern is the fact, that 25% of alcohol intoxications originated in places where alcohol is sold, despite the fact that majority of the adolescents were under the legal drinking age limit of 18 years.
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Affiliation(s)
- Pavel Kabíček
- Department of Paediatrics, Thomayer Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jiří Kobr
- Department of Paediatrics, Faculty of Medicine, Charles University, Pilsen, Czech Republic
| | - Lumír Šašek
- Department of Paediatrics, Faculty of Medicine, Charles University, Pilsen, Czech Republic
| | - Zita Obdržálková
- Department of Paediatrics, Faculty Hospital Ostrava, Ostrava, Czech Republic
| | - Ludmila Svitálková
- Department of Paediatrics, District Hospital of T. Bata, Zlín, Czech Republic
| | - Věra Hůrková
- Department of Paediatrics, District Hospital of T. Bata, Zlín, Czech Republic
| | - Jiří Zeman
- Department of Paediatrics, General Faculty Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
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Mdege ND, Meader N, Lloyd C, Parrott S, McCambridge J. The Novel Psychoactive Substances in the UK Project: empirical and conceptual review work to produce research recommendations. PUBLIC HEALTH RESEARCH 2017. [DOI: 10.3310/phr05040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BackgroundAlthough illegal drug use has largely been declining in the UK over the past decade, this period has witnessed the emergence of a range of novel psychoactive substances (NPS) (‘legal highs’). These are new, mostly synthetic, substances that mimic the effects of existing drugs). Despite there being many causes for concern in relation to NPS, there has been little prior study of the burden associated with their use in public health terms. Clarity is lacking on research priorities in this rapidly developing literature.ObjectivesTo inform the development of public health intervention research on NPS by reviewing existing data on their use, associated problems and potential responses to such problems.DesignA scoping review and narrative synthesis of selected bodies of evidence was undertaken to summarise and evaluate what is known about NPS use and the related harms of, and responses to, such use. Relevant literature was identified from electronic databases (covering January 2006 to June 2016 inclusive), Google (Google Inc., Mountain View, CA, USA), relevant websites and online drug forums and by contacting experts. Articles were included if they were primary studies, secondary studies involving the analysis and interpretation of primary research or discussion papers. A conceptual framework postulating an evidence-informed public health approach to NPS use in the UK was developed through a pragmatic literature review, the iterative development of concepts and finalisation in light of the results from the empirical review work. The process also involved feedback from various stakeholders. Research recommendations were developed from both strands of work.ResultsA total of 995 articles were included in the scoping review, the majority of which related to individual-level health-related adverse effects attributable to NPS use. The prevalence of lifetime NPS use varied widely between (e.g. with higher prevalence in young males) and within population subgroups. The most commonly reported adverse effects were psychiatric/other neurological, cardiovascular, renal and gastrointestinal manifestations, and there is limited evidence available on responses. In these and other respects, available evidence is at an early stage of development. Initial evidence challenges the view that NPS should be treated differently from other illicit drugs. The conceptual framework indicated that much of the evidence that would be useful to inform public health responses does not yet exist. We propose a systems-based prevention approach that develops existing responses, is multilevel and life course informed in character, and emphasises commonalities between NPS and other legal and illegal drug use. We make 20 recommendations for research, including nine key recommendations.LimitationsScoping reviews do not interrogate evidence in depth, and the disjunction between the scoping review and the conceptual framework findings is worthy of careful attention.ConclusionsKey research recommendations build on those that have previously been made and offer more evidence-based justification and detail, as previous recommendations have not yet been acted on. The case for decision-making on commissioning new research based on these recommendations is both strong and urgent.Future workThe validity of recommendations generated through this project could be enhanced via further work with research commissioners, policy-makers, researchers and the public.Study registrationThe systematic review element of this study is registered as PROSPERO CRD42016026415.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Noreen D Mdege
- Department of Health Sciences, University of York, York, UK
| | - Nick Meader
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Charlie Lloyd
- Department of Health Sciences, University of York, York, UK
| | - Steve Parrott
- Department of Health Sciences, University of York, York, UK
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Sadeghi-Bojd S, Khajeh A. Chronological variations of children poisoning causes in zahedan, South of iran. INTERNATIONAL JOURNAL OF HIGH RISK BEHAVIORS & ADDICTION 2015; 3:e19223. [PMID: 25632384 PMCID: PMC4295125 DOI: 10.5812/ijhrba.19223] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 05/01/2014] [Accepted: 05/11/2014] [Indexed: 11/16/2022]
Abstract
Background: Poisoning is a common pediatric emergency among children and adolescents in the Emergency Department of Zahedan University of Medical Sciences hospital. Objectives: The aim of this study was comparing the characteristics and variations of pediatric poisoning between two retrospective studies (1998 and 2008). We hypothesized that the epidemiology of pediatric patients admitted for poisoning is related to variations of environmental agents and drug usage. Patients and Methods: Records of 170 patients from 1998 and 147 from 2008 with acute poisoning were retrospectively evaluated and compared. Results: Poisoning mostly occurred in children younger than five years old via oral route (72.94%-87%) and by single exposure (94.12%-96.6%). It was also noted that 86.8%-90% of cases were accidentally poisoned. Drugs were the most common poisoning agents in both studies (52.94% and 37.41%, respectively) and analgesics-antipyretics were the most common poisoning drugs. Drug poisoning was more common among children under five years old in both the studies. Neurological signs including lethargy and coma were the main presenting signs. About 80%-95% of cases were referred to the hospital within three hours of poisoning and supportive-symptomatic therapy was provided to them; charcoal/naloxone was administered for most of the patients (26.2% in 2008 and 21% in 1998). Mortality rate due to drug poisoning was 3-4 cases in both studies; but, non-drug poisoning mortality rate was higher. Conclusions: Preventable accidental poisoning is a significant cause of morbidity in children in developing countries. The study provided information on evolving trends and the need for increasing awareness about potential toxins as well as appropriate storage of toxins in the house to reduce the occurrence of accidental poisoning.
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Affiliation(s)
- Simin Sadeghi-Bojd
- Department of Pediatrics, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Ali Khajeh
- Children and Adolescents Health Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Corresponding author: Ali Khajeh, Children and Adolescents Health Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran. Tel: +98-5412421638, E-mail:
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