Child Resistant Packaging: Regulations and Effectiveness, 1980–2002

Author(s):  
Cheryl A. Pattin

Poisoning from household substances has been and continues to be a hazard to children under 5 years of age. In an effort to address this problem, the Poison Prevention Packaging Act (PPPA) of 1970 was enacted as of December 30, 1970. This act is a federally preemptive piece of legislation covering an ever expanding group of substances. The test methods used to establish compliance with the PPPA do not address the range of substances covered (e.g. liquids); the changing patterns of use of household substances such as increased use of liquid medications for children; or repeated access to and multiple reclosures of containers, as seen in the home situation. To examine the effectiveness of the PPPA in addressing actual poisonings in children under 5, national databases from 1980 through March 13, 2002 were examined. Reports mentioning the use of a CRC (child resistant container) were then analyzed. Assisted Access incidents involved an older child gaining access to the contents of a CRC and giving those contents to the younger victim. Transfer of Contents incidents involved ingestion of a substance that was originally packaged in a CRC and was transferred to a non-CRC The average age of children seen in hospitals is under 2, and fatalities due to Assisted Access and Transfer of Contents incidents were seen in children averaging under one year of age. These age ranges are below those of children used in CRC testing (3.5 to 4.25 years). More importantly, the average body weights — directly related to the susceptibility to poisoning injury — of children seen in hospitals is less than the 25 pound weight used to set toxicity thresholds by the PPPA. Training for children, the elderly, and parents would help increase awareness of Transfer of Contents and Assisted Access poisonings, which are disproportionately represented in fatal poisoning incidents of young children.

2005 ◽  
Author(s):  
Patricia Martens ◽  
◽  
Randy Fransoo ◽  
Elaine Burland ◽  
Charles Burchill ◽  
...  

2017 ◽  
Vol 63 (2) ◽  
pp. 221-233
Author(s):  
Vakhtang Merabishvili

Malignant melanoma of the skin (MMS) is less than 2% (1.74%) among all malignant tumors in Russia but this is more than 10,000 (10236-2015) of new cases. It is important to monitor the trend in dynamics of morbidity and mortality from this cause. From 1995 to 2015 a number of MMS primary cases was more than doubled in absolute numbers and “crude” rates. A slightly smaller increase is indicated by standardized indicators - 62.5% for men and 70.2% for women. Annually in Russia 3670 people die from MMS (2015), which is 1.2% of all cancer deaths. In recent years the previously revealed regularities have been largely preserved: lower rates of specific gravity detected in the early stages among people in the elderly and senile and in a smaller proportion in this group who received special treatment. At the same time a change in the detailed structure of the incidence of women has been revealed where currently the leading localization of MMS was not the lower extremities but the back. The index accuracy improved however the official statistics of the distribution of patients by stages of a disease was significantly distorted (weight of the early stages was increased from the real values). The index of one-year lethality and survival was significantly improved.


1990 ◽  
Vol 157 (3) ◽  
pp. 425-427 ◽  
Author(s):  
O. Ben-Arie ◽  
M. Welman ◽  
A. F. Teggin

In a 1982 community survey, 23 elderly respondents were rated as having a depressive disorder by catego. Twenty survivors were followed up three and a half years later. The depression had remitted within one year in seven cases but nine were still depressed. There is a need for ongoing education of GPs about the recognition and course of depression in the elderly.


2005 ◽  
Vol 94 (1) ◽  
pp. 59-66 ◽  
Author(s):  
T. Heikkinen ◽  
P. Jalovaara

Background and Aims: As a rule, follow-up for at least one year is recommended for fracture studies. This is considered the shortest reliable interval. Still, in the case of hip fractures of the elderly, shorter follow-up might be more practical, since the life expectancy of these patients is often short. The aim of this study was to see if a short four months follow-up period would be acceptable in hip fracture surveys. Material and Methods: Information on 196 consecutive non-pathological hip fracture patients aged 50 years or over (mean 79 years) was collected using a standardised hip fracture audit concentrating on functional measurements at admission and at four and twelve months' follow-ups. Results: 167 patients were alive at four months and 152 and at one year. The patients who died between four and twelve months had poorer functional capacity in the four-month evaluation than those who survived one year. The analysis of repeated measures, including only the patients alive at the last follow-up, showed that residential status, use of walking aids and 6 out of 10 and ADL variables (bathing, toileting, shopping, household activities, doing laundry, banking) did not change significantly. Walking ability and the rest 4 ADL variables (dressing, eating, food preparation, use of transportation) improved and pain decreased. Conclusions: Due to high mortality and age-related deterioration of functioning, no steady state i.e. “final result” is ever reached after hip fracture in the elderly. Four-month follow-up is justified as the shortest possible period, because the socioeconomically most important variable, i.e. place of living, and most of the ADL functions do not change significantly after that.


2016 ◽  
Vol 224 ◽  
pp. 440-446 ◽  
Author(s):  
Salvatore Scandura ◽  
Piera Capranzano ◽  
Anna Caggegi ◽  
Carmelo Grasso ◽  
Giuseppe Ronsivalle ◽  
...  

2009 ◽  
Vol 7 (3) ◽  
pp. 139-144
Author(s):  
D. Chatzidimitriou ◽  
M. Exidari ◽  
G. Gioula ◽  
P. Papakonstantinou ◽  
A. Melidou ◽  
...  

The prevalence of IgG and IgA antibodies to Chlamydia pneumoniae was evaluated in a group of an apparently healthy population in northern Greece. Serum samples were obtained over a period of one year (June 2006 to May 2007) from 530 individuals (300 males and 230 females, aged from 1 month to 90 years). The sera were tested for specific antibodies to C. pneumoniae by two commercial methods, an ELISA and a micro-IF assay based on the principles of MIF. The prevalence of IgG and IgA antibodies to C. pneumoniae was 53.2% and 45.9%, respectively, and was found to be unrelated to gender, even in the elderly >61 years old. The IgG antibody prevalence was low in children under 5 years old (7.7%), sharply increased by the age of 20 (40%) and continued to increase, gradually, to reach 80.1% in the elderly. IgA antibodies also increased with similar kinetics to IgG, although at a lower level (3.8–66.1%). Our results show that infection with C. pneumoniae is common in northern Greece. The high prevalence of IgA specific antibodies reported in the present study is due to primary infection at a young age, while in the elderly is probably due to infection or reinfection, although the option of persistence cannot be excluded.


2020 ◽  
Vol 40 (4) ◽  
pp. 298-304
Author(s):  
Khalid A. Alsheikh ◽  
Firas M. Alsebayel ◽  
Faisal Abdulmohsen Alsudairy ◽  
Abdullah Alzahrani ◽  
Ali Alshehri ◽  
...  

ABSTRACT BACKGROUND: Hip fractures are one of the leading causes of disability and dependency among the elderly. The rate of hip fractures has been progressively increasing due to the continuing increase in average life expectancy. Surgical intervention is the mainstay of treatment, but with an increasing prevalence of comorbid conditions and decreased functional capacity in elderly patients, more patients are prone to postoperative complications. OBJECTIVES: Assess the value of surgical intervention for hip fractures among the elderly by quantifying the 1-year mortality rate and assessing factors associated with mortality. DESIGN: Medical record review. SETTING: Tertiary care center. PATIENTS AND METHODS: All patients 60 years of age or older who sustained a hip fracture between the period of 2008 to 2018 in a single tertiary healthcare center. Data was obtained from case files, using both electronic and paper files. MAIN OUTCOME MEASURES: The 1-year mortality rate for hip fracture, postoperative complications and factors associated with mortality. SAMPLE SIZE: 802 patients. RESULTS: The majority of patients underwent surgical intervention (93%). Intra- and postoperative complications were 3% and 16%, respectively. Four percent of the sample died within 30 days, and 11% died within one year. In a multivariate analysis, an increased risk of 1-year mortality was associated with neck of femur fractures and postoperative complications ( P =.034, <.001, respectively) CONCLUSION: The 1-year mortality risk in our study reinforces the importance of aggressive surgical intervention for hip fractures. LIMITATION: Single-centered study. CONFLICT OF INTEREST: None.


2021 ◽  
Author(s):  
Ester Elisabet Holmström ◽  
Ilmar Efendijev ◽  
Rahul Raj ◽  
Pirkka T. Pekkarinen ◽  
Erik Litonius ◽  
...  

Abstract Background: Cardiac arrest (CA) is a leading cause of death worldwide. As population ages, the need for research focusing on CA in elderly increases. This study investigated treatment intensity, 12-month neurological outcome, mortality and healthcare-associated costs for patients aged over 75 years treated for CA in an intensive care unit (ICU) of a tertiary hospital. Methods: This single-centre retrospective study included adult CA patients treated in a Finnish tertiary hospital’s ICU between 2005 and 2013. We stratified the study population into two age groups: <75 and 75 years. We compared interventions defined by the median daily therapeutic scoring system (TISS-76) between the age groups to find differences in treatment intensity. We calculated cost-effectiveness by dividing the total one-year healthcare-associated costs of all patients by the number of survivors with a favourable neurological outcome. Favourable outcome was defined as a cerebral performance category (CPC) of 1–2 at 12 months after cardiac arrest. Logistic regression analysis was used to identify independent association between age group, mortality and neurological outcome. Results: This study included a total of 1,285 patients, of which 212 (16%) were 75 years of age. Treatment intensity was lower for the elderly compared to the younger group, with median TISS scores of 116 and 147, respectively (p < 0.001). The effective cost in euros for patients with a good one-year neurological outcome was €168,000 for the elderly and €120,000 for the younger group. At 12 months after CA 24% of the patients in the elderly group and 47% of the patients in the younger group had a CPC of 1-2 (p < 0.001). Age was an independent predictor of mortality (multivariate OR = 3.36, 95% CI:2.21-5.11, p < 0.001) and neurological outcome (multivariate OR = 3.27, 95% CI: 2.12-5.03, p < 0.001). Conclusions: The elderly ICU-treated CA patients in this study had worse neurological outcomes, higher mortality and lower cost-effectiveness than younger patients. Further efforts are needed to recognize the tools for assessing which elderly patients benefit from a more aggressive treatment approach in order to improve the cost-effectiveness of post-CA management.


2021 ◽  
Vol 9 (09) ◽  
pp. 961-972
Author(s):  
K. Shivaraju ◽  
◽  
Karanam Sai Arun ◽  
Mandhala Saikrishna ◽  
◽  
...  

Background: Anemia is often considered as a normal physiological process that occurs with aging. but recently since past 2 decades anemia of any degree is being recognized as significant independent contributor to morbidity mortality and frailty in elderly patients. It is easy to overlook anemia in elderly as symptoms of anemia like fatigue, SOB etc are often attributed to aging process itself. many evidences accumulated states that anemia of any degree reflects poor health and increased vulnerability to poor outcomes. Materials and methods: This study was conducted in the department of internal medicine in a tertiary care hospital over a period of one year with sample size of 362 subjects satisfying the inclusion and exclusion criteria after taking the consent form. Results: Moderate degree anaemia was the commonest around, 65.6% followed by severe degree anemia 20.1%. Easy fatigability was the commonest symptom and pallor was the commonest sign of anaemia in elderly. Anemia is not always a consequence of aging. Anemia of unexplained etiology constituted 15.97% of total study population. Conclusion: Anaemia in elderly is a challenge and has to be approached in an organized manner for appropriate diagnosis and evaluation to look into its cause and plan management to improve the quality of life of the elderly persons.An effort should always be made to reach etiological diagnosis before instituting specific therapy.


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