Characterization of Acute Poisoning in Hospitalized Children in Southwest China

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.

Mortality by opioid poisoning in children and teenagers and opioid prescriptions

Background No comparisons between mortality from opioids in children and teenagers and opioid prescription patterns have been made in England. Aim To investigate if an association exists between mortality rates from opioid poisoning in persons aged 19 years old and under and community opioid prescription in England. Methods A retrospective analysis was undertaken for 2016 to 2019, comparing community opioid prescriptions and mortality rates from opioid poisoning. Results The number of opioid prescriptions decreased over the study period (− 2.4%, p < 0.001). Most deaths due to opioid poisoning in children and teenagers were seen in those under one year old and those aged between 15 and 19 years old (Kruskal-Wallis: p = 0.12; Dunn’s test: p = 0.01). Deaths in all age ranges did not change significantly (Poisson Regression Analysis: p > 0.05). Conclusion Despite the reduction in community opioid prescriptions, there was no decrease in the number of deaths in children and teenagers due to opioid poisoning.

Poisoning in Children and adolescents assisted during the COVID-19 pandemic at the Toxicological Information and Assistance Center in Federal District, Brazil (CIATOX -DF): Descriptive, Cross-sectional, and Analytical study with 1.037 patients

Exogenous poisonings are one of the principal accidents involving children and adolescents. The social isolation promoted by the COVID-19 pandemic raises concerns about the possibility of an increase in poisoning among children since most cases of poisoning occur in home environments. Therefore, the present study evaluated exogenous poisonings in children under ten years of age and adolescents aged 11 to 20 years old through data recorded at the Toxicological Information and Assistance Center in the Federal District (CIATOX-DF) from January to September 2020. The results showed a change in the number of notifications, with 1.037 poisonings registered in patients under 20 years of age. Registrations of poisoning by venomous animals, medications, and household cleaning products in children tend to be higher in months of vacation. This study demonstrated poisoning notifications by non-venomous animals in March and April and household cleaning products as the second leading cause of exogenous poisoning, demonstrating a clear temporal association among social isolation, increased use of household cleaning products, and exposure to these products. The multivariate analysis methodology managed to show the significant characteristics of the studied sample, contributing to creating local actions that aim to reduce the number of preventable cases of poisonings.

Dynamics of acute poisoning with narcotic and psychotropic drugs in children

Introduction. Acute poisoning of chemical aetiology in children and adolescents is a significant medical and social problem. The average overall assessment of the state of the drug situation in St. Petersburg by all criteria is: in 2018 - 3.6 (pre-crisis condition), in 2019 - 3.5 (pre-crisis), in 2020 - 3.3 (severe). The aim of this work is to analyze the structure of acute poisoning with narcotic and psychodysleptic drugs in children of St. Petersburg. Materials and methods. An analysis was carried out of 4256 cases of acute chemical poisoning in children (form No. 64) admitted to the acute poisoning department of N.F. Filatov St. Petersburg State Children Hospital from 2016 to 2018. Results. The total number of chemical aetiology poisonings was 1441 cases in 2016, 1,527 in 2017 and 1,288 in 2018. Poisoning with narcotic and psychodysleptic drugs was (of the total number of poisonings) in 2016 - 3.1%, in 2017 - 5.8% and 2018 - 4.9%. The top place among poisonings with toxic substances of this group are opiates, methadone, LSD, hashish. The maximum poisoning with psychotropic drugs is psychostimulants such as methamphetamine - 2.6%, amphetamine - 1.4%, ecstasy - 1.2%. There was a significant increase in acute poisoning with unspecified psychotropic drugs from 0.7% (2016) to 4.6% (2018). Conclusions. The obtained results of the study revealed a decrease in the total number of acute chemical poisoning by 18.9%. On the background of a reduction in the total number of poisonings, there is an increase in the frequency of poisoning with neurodestructive substances (methadone, hashish, LSD, benzodiazepine, amphetamine, methamphetamine and ecstasy). The most frequent cause of acute chemical intoxication in children is poisoning with psychotropic drugs.

OLANZAPINE POISONING IN CHILDREN : A CASE SERIES

Olanzapine is a readily available atypical antipsychotic usually prescribed in adults for psychotic disorders. Olanzapine overdose or poisoning is rarely seen in children. It is often due to accidental intake of drug and sometimes suicidal.We are reporting two case of olanzapine poisoning in children presenting with altered sensorium and pinpoint pupils. The mainstay of treatment of olanzapine poisoning is supportive and symptomatic measures. Both children recovered well and were discharged.

PATTERN AND OUTCOME OF ACUTE POISONING IN CHILDREN OF 1-12 YEARS AGE GROUP ADMITTED IN THE PAEDIATRIC WARD OF A TERTIARY CARE HOSPITAL

BACKGROUND: Acute poisoning, a common, yet an important preventable cause of morbidity and mortality in children, is a paediatric emergency globally, responsible for 0.33% to 7.6% of the total paediatric admissions among various hospitals of India. This study was done to assess the changing trends, in the pattern and outcome of poisoning among 1-12 years children. METHODS: This is an institution-based descriptive epidemiological study with cross-sectional design that includes a hundred children of one to twelve years age, conducted over a period of one and half years in the paediatric department of a tertiary care hospital in India. RESULTS: In the study period, majority of the patients out of 100 admitted, were male (65%).Most of those (68%) belonged to the 1-3 years age group. The share of hydrocarbon poisoning (46%) was highest with 26 cases of Kerosene ingestion being the most in it. Important presenting complaints were vomiting, pain abdomen, tachypnoea, and pneumonitis. Only 1 patient died during the course, the cause of which remained unknown. CONCLUSION: The pattern and outcome of acute poisoning in children was quite similar when compared to other studies from different hospitals in India. Survival rates have been increasing due to ongoing improvement in medical infrastructure, which one hopes, shall keep improving along with focus on preventive measures at community levels.

Pathogenetic features of acute naphazoline poisoning in children

Introduction: Acute poisoning by nasal decongestants is an important issue in pediatrics due to physiological and anatomical characteristics of the child’s body and pharmacokinetics of drugs in early childhood. Epidemiology: The number of poisonings by this group of drugs ranged from 4% to 39% during the period from 2000 to 2018. All the studies reported that the most severe degree of intoxication was observed in children aged 1–3 years. Mechanism of action of nasal decongestants: The peculiarity of selective alpha2-adrenergic agonists is that when taken orally, misused or overdosed, they lose their selectivity for the target receptor. As a result, the drug causes acute poisoning and most often this effect occurs in children and adolescents. Clinical features and diagnostic criteria: Clinical signs of acute poisoning can appear both as a result of an overdose of the nasal decongestants and due to a therapeutic use of the drug according to the instruction. The symptoms are manifested by hypothermia, skin pallor, bradycardia, arterial hypotension, profuse sweating, and acrocyanosis. Imidazoline receptors and new opportunities: It is assumed that toxic effect of topical decongestants occurs not only by activation of alpha2-adrenergic receptors, but also through their influence on the selective imidazoline receptors. Based on the structure of these drugs, it is assumed that imidazoline receptors are the primary binding site for these drugs. Conclusion: Understanding the described mechanisms of alpha2-adrenergic agonist action and peculiarities of the child’s symptoms in acute poisoning is necessary for the timely diagnosis and selection of the correct treatment strategy.