Assessing parental utilization of the poison center: an emergency center-based survey.

The purpose of this study was to identify and characterize caretakers who fail to utilize the poison center for unintentional poisonings involving children. We interviewed 210 caretakers of children evaluated for unintentional poisoning in the emergency center of an urban, university-based teaching hospital to determine (1) whether demographic differences exist between those caretakers who contacted a poison center prior to the emergency center visit and those who did not and (2) whether differences exist in prevalence of poison prevention knowledge and behaviors between the two groups. Ninety-six (46%) of caretakers did not contact the poison center prior to the emergency center visit. Significant differences were found between the two groups for the following caretaker variables: race/ethnicity, language preference, age, level of education, country in which schooling occurred, and type of insurance coverage for the child. When logistic regression was used to control for confounding, the two variables associated with failure to use the poison center were black race and schooled outside the United States (primarily in Mexico). Poison center callers reported a higher prevalence of poison prevention knowledge and behaviors than noncallers. Educational interventions should be targeted to the groups of caretakers identified who do not use the poison center.

Evaluation of three concentrations of tebufenpyrad for the control of Varroa destructor (Acari: Varroidae).

We evaluated three concentrations of tebufenpyrad (17.5, 15 and 12.5%) in strip formulations for controlling varroa mites, Varroa destructor Anderson and Trueman (2000), in honey bee colonies. We also included colonies treated with Apistan, CheckMite+, and untreated colonies in our evaluation. The three concentrations we evaluated reduced varroa populations but also reduced the amount of brood and adult bees when compared with untreated colonies and colonies treated with Apistan or CheckMite+. Alternative delivery methods, lower concentrations of tebufenpyrad, and the evaluation of related compounds are logical next steps in evaluating the varroacidal potential of tebufenpyrad and related compounds.

Automatic dishwashing detergents: their pH, ingredients, and a retrospective look.

Ingestion of automatic dishwasher detergents is an increasing problem in households with small children. Historically these ingestions have been handled as alkaline corrosive ingestions. However, after many formulation changes since the late 1950's, a re-evaluation of treatment modality is in order. This report examines the pH of varying concentrations of many of the available automatic dishwashing detergents, their specific ingredients, and include a retrospective study of childhood ingestion of these products from 1978-1984.

Urine fluorescence using a Wood's lamp to detect the antifreeze additive sodium fluorescein: a qualitative adjunctive test in suspected ethylene glycol ingestions.

Antifreeze ingestions require rapid and accurate differential diagnosis to prevent fatal outcomes. Sodium fluorescein is added to some commercial antifreeze preparations (ethylene glycol) to a final concentration of approximately 20 micrograms/mL as a colorant to aid in detection of automobile cooling-system leaks. For an adult human being, a potentially toxic volume of antifreeze is 30 mL, which contains 0.4 to 0.6 mg sodium fluorescein. Six male volunteers were given a 0.6-mg oral bolus of sodium fluorescein on an empty stomach. Urine was collected at two-hour intervals. Using a Wood's lamp, visually detectable fluorescence was seen with 100% reliability for two hours and 60% reliability for four hours. A second group of male volunteers was given the same dose of sodium fluorescein, and fluorescence was measured with a fluorometer during a six-hour period. Detectable fluorescence was present in all samples except the zero time point, including those with no fluorescence present by visual examination. We conclude that exposing urine to a Wood's lamp may be a useful adjunctive diagnostic test for early evaluation of patients with suspected antifreeze ingestion while awaiting definitive quantitative analysis of serum ethylene glycol concentration. A prospective clinical trial is needed to evaluate the frequency of false-positives and false-negatives.

Sudden death in a child following jellyfish envenomation by Chiropsalmus quadrumanus. Case report and autopsy findings.

Sudden death following coelenterate envenomation is not uncommon in Australia where the Pacific box jellyfish is indigenous. However, few cases of sudden fatal reactions have been reported in the Northern Hemisphere, and those that have occurred have all been attributed to the Portuguese man-of-war, Physalia physalis. We report the case of a child who died within 40 minutes of accidental envenomation with tentacles of a jellyfish, Chiropsalmus quadrumanus, and describe the findings at autopsy. This coelenterate may be of special danger to small children.

Effectiveness of a poison center: impact on medical facility visits.

To estimate the effectiveness of a poison center by determining the number of potential medical facility visits for childhood poisonings which are prevented, and to determine how callers learned about the poison center in order to help guide future public educational efforts, a cross-sectional telephone survey was done. A systematic sample of caretakers of children < 6-y-of-age living in Harris County, TX, and who called the poison center about a poisoning incident between February 1993 and January 1994, was taken. One hundred sixty-six/197 eligible caretakers (84%) completed the survey. Of the 166 caretakers, only 5 (3%) were referred by the poison center to a medical facility for treatment, although 6 (3.6%) actually sought medical attention. The remaining 160 (96.4%) were successfully managed at home. The majority of these (74%) required no intervention and the remaining 26% required only minimal treatment, including ipecac, dilution, irrigation or observation. Of the 160 caretakers managed at home, 69 (43%) would have sought medical attention for the child at a health care facility if the poison center did not exist, and of those 81% would have gone to an emergency center or hospital for evaluation. Callers learned about the poison center most often from family/ friends, doctors, Mr Yuk stickers, television, previous use, or pharmacists. Poison centers decrease health care costs by preventing unnecessary medical facility visits for minor childhood poisonings which can be successfully managed at home. Methods effective in educating the public about poison centers should be continued and other methods explored to increase poison centers' use.

Eicosanoids act in nodulation reactions to bacterial infections in newly emerged adult honey bees, Apis mellifera, but not in older foragers.

Nodulation is the first, and qualitatively predominant, cellular defense reaction to bacterial infections in insects. We tested the hypothesis that eicosanoids also mediate nodulation reactions to bacterial challenge in adults of a social insect, the honey bee, Apis mellifera. Treating newly-emerged experimental bees with the eicosanoid biosynthesis inhibitor, dexamethasone, impaired nodulation reactions to bacterial infections, and the influence of dexamethasone was reversed by treating infected insects with arachidonic acid, an eicosanoid precursor. Several other eicosanoid biosynthesis inhibitors, including the cyclooxygenase inhibitor, indomethacin, and the dual cyclooxygenase/lipoxygenase inhibitor, phenidone, also impaired the ability of experimental honeybees to form nodules in reaction to bacterial challenge. The influence of phenidone on nodulation was expressed in a dose-dependent manner. However, in experiments with older honey bees foragers, similar bacterial challenge did not evoke nodulation reactions. We infer from our results that while eicosanoids mediate cellular immune responses to bacterial infections in newly emerged honey bees, and more broadly, in most insect species, nodulation reactions to bacterial challenge probably do not occur in all phases of insect life cycles.