[Epidemiology and mortality factors of acute intoxication in intensive care in Bouaké (Ivory Coast) from 2015 to 2018]. / Epidemiologie et facteurs de mortalite des intoxications aiguës en reanimation a Bouake (Cote d'Ivoire) de 2015 a 2018.

INTRODUCTION: Acute poisoning is a common reason for admission to intensive care. OBJECTIVE: To describe the epidemiological profile, to analyze the mortality factors of patients admitted to intensive care for acute intoxication. PATIENTS AND METHODS: A retrospective, descriptive and analytical study covering four years (from January 1, 2015 to December 31, 2018) .Includes patients admitted to intensive care in Bouaké for acute intoxication. The variables studied were: socio-demographic characteristics, intoxication characteristics, clinical, therapeutic, evolutionary and prognostic characteristics. RESULTS: Of a total of 1476 admissions during the study period, 131 patients were admitted for acute intoxication, with a hospital prevalence of 8.8%. The average age was 19 (range: 1 month to 70 years). The sex ratio was 0.84. The majority of poisonings occurred at home (94%). Psychiatric history was present in 11% of patients. The poisoning occurred in urban areas in 72% of cases. The place of intoxication was the family home in 94% of cases. The nature of the intoxication and the type of poison toxin depended on the age of the intoxicated patients. The average admission time was 7.38 hours ± 12 hours (range: 30 minutes to 72 hours). The poisoning was symptomatic in 93% of the patients. The clinical symptoms observed were: gastrointestinal (70%), respiratory (62%) and neurological (43%). Vomiting attempts associated with self-medication were performed in 69% of patients. The substances used for self-medication were: palm oil (80%) and milk (20%). The treatment in intensive care was initially symptomatic then secondarily adapted to the nature of the incriminated or suspected toxin. The use of tracheal intubation and mechanical ventilation was necessary for 10% of the patients. The average stay in hospital was 1.64 ± 1.5 days (range: 1 to 10 days). The lethality was 8%. The factors of poor prognosis were the existence of a cardiovascular collapse (p <0.001), the presence of a deep coma (p <0.001) and the use of mechanical ventilation (p <0. 001). CONCLUSION: Acute intoxication is a public health problem in Bouaké and requires preventive action.

INTRODUCTION: Les intoxications aiguës constituent un motif fréquent d'admission en réanimation. OBJECTIF: Décrire le profil épidémiologique, analyser les facteurs de mortalité des patients admis en réanimation pour intoxications aiguës. PATIENTS ET MÉTHODES: Etude rétrospective, descriptive et analytique, portant sur quatre ans (du 1er janvier 2015 au 31 décembre 2018).Etaient inclus les patients admis en réanimation à Bouaké pour une intoxication aiguë. Les variables étudiées étaient: les caractéristiques sociodémographiques, les caractéristiques de l'intoxication, les caractéristiques cliniques, thérapeutiques, évolutives et le pronostic. RÉSULTATS: Sur un total de 1476 admissions durant la période d'étude, 131 patients ont été admis pour une intoxication aiguë, soit une prévalence hospitalière de 8,8 %. L'âge moyen était de 19 ans (extrême : 1 mois et 70 ans). Le sex-ratio était de 0,84. La majorité des intoxications avaient eu lieu au domicile (94 %). Les antécédents psychiatriques étaient présents chez 11% des patients. Les intoxications avaient lieu en milieu urbain dans 72% des cas. Le lieu de l'intoxication était le domicile familial dans 94% des cas. La nature de l'intoxication et le type de toxique incriminé était fonction de l'âge des patients intoxiqués. Le délai moyen d'admission était de 7,38 heures ± 12heures (extrêmes: 30 mn et 72 heures). Les intoxications étaient symptomatiques chez 93% des patients. Les symptômes cliniques observés étaient : gastro-intestinaux (70%), respiratoires (62 %) et neurologique (43%). Des tentatives de vomissements associées à une automédication ont été réalisées chez 69% des patients. Les substances utilisées pour l'automédication étaient : l'huile de palme (80 %) et de lait (20%). Le traitement en réanimation était initialement symptomatique puis secondairement adapté à la nature du toxique incriminé ou suspecté. Le recours à l'intubation trachéale et à la ventilation mécanique a été nécessaire chez 10% des intoxiqués. Le séjour moyen en hospitalisation a été de 1,64±1,5 jours (extrêmes : 1 et 10 jours). La létalité était de 8 %. Les facteurs de mauvais pronostic étaient : l'existence d'un collapsus cardiovasculaire (p <0,001), la présence d'un coma profond (p <0,001) et la réalisation d'une ventilation mécanique (p <0,001). CONCLUSION: Les intoxications aiguës constituent un problème de santé publique à Bouaké et nécessite des actions de prévention.

Acute poisonings during pregnancy and in other non-pregnant women in emergency departments of four government hospitals, Addis Ababa, Ethiopia: 2010-2015.

OBJECTIVE: To characterise acute poisonings in pregnant and non-pregnant women treated at emergency departments of government hospitals in Addis Ababa, Ethiopia, between 2010 and 2015. METHODS: All data for acutely poisoned women were retrospectively collected from patient medical charts at the emergency departments of Saint Paul's Hospital Millennium Medical College, Ras Desta Memorial Hospital, Yekatit 12 Hospital Medical College and Zewditu Memorial Hospital. Data were collected by extraction questionnaire and analysed using SPSSv. 20 statistical software. RESULTS: During the study period, 998 cases of acutely poisoned women were listed in the hospital registries. Of these, complete data for inclusion in the study were available for 592. 36.3% of the study participants were in the age group of 20-24, with a mean (±SD) age of 23.03 (±6.3) years. 80.9% were from Addis Ababa; 4.6% were pregnant. The mean arrival time of all cases was 4.14 h. 85.5% of all study cases were due to intentional self-poisoning, of whom 42.1% were discharged without complications. The most common poisons were bleach and organophosphates; 25.9% of pregnant cases and 32.6% of non-pregnant cases were poisoned by bleach; and 18.5% of pregnant cases and 18.9% of non-pregnant cases had organophosphate poisoning. 0.7% had a history of poisoning; all were non-pregnant women. The common route of poison exposure was oral, and the case fatality rate of organophosphate poisoning in pregnant and non-pregnant women was 20 and 1.87%, respectively. The pre-hospital intervention for the majority of the women was milk, in 12.0% of cases. CONCLUSION: Acute poisoning remains a public health problem in our community. Bleach is the most common poisons. Our present findings indicate the necessity of educational programmes on preventable reasons of acute poisonings and their outcomes on pregnant and non-pregnant women.

[Acute blindness secondary to quinine toxicity: role of hyperbaric oxygen treatment]. / Amaurose bilatérale aiguë par surdosage accidentel en quinine: intérêt de l'oxygénothérapie hyperbare.

We report a rare case of quinine toxicity causing acute bilateral blindness, followed by documented partial recovery within 24 hours. The patient was treated with hyperbaric oxygenotherapy and intravenous nitrates. Visual defects persist after 6 months.

[Ten practical issues concerning acute poisoning with carbon monoxide in pregnant women]. / Dix questions pratiques concernant l'intoxication aiguë au monoxyde de carbone chez la femme enceinte.

BACKGROUND: The poisoning of carbon monoxide (CO) is the leading cause of death by poisoning in France. Its consequences are potentially serious to the fetus. Literature is ancient and little known. PURPOSE AND METHOD: Make an inventory of knowledge about carbon monoxide poisoning during pregnancy. RESULT: The CO causes maternal then fetal tissue hypoxia primarily by binding to hemoglobin with which it has a high affinity. Its transplacental passage may cause fetal harm, predominantly in the brain. Severity seems correlated with maternal symptoms during exposure. In the absence of maternal symptoms, however, the available data are reassuring. Hyperbaric oxygen therapy may reduce the risk to the fetus. DISCUSSION: Oxygen therapy should be offered in all cases of CO poisoning, especially if there are maternal symptoms during exposure. In addition, a fetal echography directed on the cephalic pole - even a fetal magnetic resonance imaging three weeks after exposure - should also be proposed.

[Not Available]. / Acute Indoramin Poisoning: a Review of 55 Cases Reported to the Paris Poison Centre from 1986 to 2010.

Authors report a retrospective study of all cases of indoramin-only poisoning notified to the Paris poison Centre from 1986 to 2010. Fifty five cases of indoramin self-poisoning were included: 40 adults and 15 children. The mean supposed ingested dose was about 701mg±464mg. ECG showed a prolonged QTc interval (equal to or greater than 0.50s) in 30% of patients. The lowest observed dose for prolonged QTc was 625mg. This series includes two cases of seizures occurring around two hours after ingestion of 900 and 2 250mg of indoramin. A review of the literature showed cardiac disorders, with a delayed mechanism of action up until 18hours after ingestion. Therefore, rapid medical resuscitation and prolonged cardiac monitoring for at least 24hours after ingestion of 625mg are recommended.