Ethnic-racial disparities in poisoning cases: analysis of drugs of abuse, medicines and pesticides in Brazil.

In Brazil, ethnic-racial inequalities exist in all fields, obstructing access to goods, services, and opportunities, including healthcare services. However, there are no apparent studies that assess, at a national level, ethnic-racial disparities in poisoning cases, emphasizing skin color as a determining factor. The study aimed to examine the relationship between race/ethnicity and general poisoning cases, by medications, pesticides, and drug of abuse in Brazilian states. Poisoning cases data were extracted for the years 2017, 2018, and 2019. Notification data for general poisoning cases and toxic agents were collected: medications, pesticides, and drugs of abuse. Data were categorized between whites and non-whites (blacks, browns, and indigenous) and without information on skin color/ethnicity. Rates of poisonings amongst ethnic-racial groups and cases of not declared skin color as well as relative risk (RR) of poisoning among non-whites were calculated. All states in the North, Northeast (states with the worst Human Development Index), Midwest, and 2 states in the Southeast exhibited higher rates of poisoning cases per 100,000 inhabitants among non-whites. The RR values for nonwhite individuals were higher in the North and Northeast regions for all types of poisonings. The type of poisoning cases that presented the highest RR for non-whites over the 3 years was drugs of abuse (2-2.44), when compared to other types of poisonings from pesticides (2-2.33) and medications (1.5-1.91). The spatial distribution of poisoning cases rates and RR of nonwhite population support public policies to reduce socioeconomic and environmental inequalities.

Perfil dos casos suspeitos de intoxicação exógena em cães e gatos atendidos no hvu ufpi de Teresina-Pi no período de 2017 a 2021 / Profile of suspected cases of exogenous intoxication in dogs and cats treated at the hvu ufpi in Teresina-Pi from 2017 to 2021 / Perfil de los casos sospechosos de intoxicación exógena en perros y gatos atendidos en el hvu ufpi de Teresina-Pi de 2017 a 2021

Os casos suspeitos de intoxicações exógenas são frequentes na clínica de cães e gatos. O presente trabalho objetivou realizar um estudo retrospectivo dos casos suspeitos de intoxicação em cães e gatos atendidos no Hospital Veterinário Universitário da UFPI, localizado em Teresina PI, durante o período de 2017 a 2021. Os casos foram classificados por agente tóxico suspeito, espécie, idade e ano de ocorrência. No total foram registrados 324 casos, sendo 58 em 2017, 88 em 2018, 94 em 2019, 50 em 2020 e 34 em 2021. A maioria dos casos ocorreu em 2019 (29,01%) tendo como causa principal a intoxicação medicamentosa (16,04%), seguida da intoxicação por agrotóxicos (10,80%). A maior prevalência foi em animais com idade inferior a cinco anos (87,03%); machos (56,79%); cães (68,20%). Foram observados: elevado número de casos sem agente tóxico identificado (28,08%) e de fichas de atendimento não preenchidas (8,33%) pelos médicos veterinários em atendimento. A prevenção, a educação continuada dos tutores e a capacitação dos médicos veterinários são destacadas como essenciais para a redução dos casos de intoxicações exógenas em cães e gatos.(AU)

Suspected cases of exogenous poisoning are frequent in the clinic of dogs and cats. The present study aimed to perform a retrospective study of suspected cases of intoxication in dogs and cats treated at the University Veterinary Hospital of UFPI, located in Teresina PI, during the period from 2017 to 2021. The cases were classified by suspected toxic agent, species, age and year of occurrence. A total of 324 cases were recorded, being 58 in 2017, 88 in 2018, 94 in 2019, 50 in 2020 and 34 in 2021. Most cases occurred in 2019 (29.01%) with drug intoxication (16.04%) as the main cause, followed by pesticide intoxication (10.80%). The highest prevalence was in animals less than five years old (87.03%); males (56.79%); dogs (68.20%). It was observed: high number of cases without identified toxic agent (28.08%) and unfilled attendance forms (8.33%) by the attending veterinarians. Prevention, continued education of guardians and training of veterinarians are highlighted as essential for the reduction of cases of exogenous poisoning in dogs and cats.(AU)

Los casos sospechosos de intoxicaciones exógenas son frecuentes en la clínica de perros y gatos. El presente estudio tuvo como objetivo realizar un estudio retrospectivo de los casos sospechosos de intoxicación en perros y gatos tratados en el Hospital Veterinario Universitario de la UFPI, ubicado en Teresina PI, durante el período de 2017 a 2021. Los casos se clasificaron por agente tóxico sospechoso, especie, edad y año de ocurrencia. Se registraron un total de 324 casos, 58 en 2017, 88 en 2018, 94 en 2019, 50 en 2020 y 34 en 2021. La mayoría de los casos se produjeron en 2019 (29,01%) siendo la intoxicación por fármacos la principal causa (16,04%), seguida de la intoxicación por plaguicidas (10,80%). La mayor prevalencia se dio en animales menores de cinco años (87,03%); machos (56,79%); perros (68,20%). Se observó un elevado número de casos sin agente tóxico identificado (28,08%) y de formularios asistenciales no cumplimentados (8,33%) por los veterinarios asistentes. Se insiste en que la prevención, la educación continuada de los propietarios de animales de compañía y la formación de los veterinarios son esenciales para reducir los casos de intoxicación exógena en perros y gatos.(AU)

Caracterización de la consulta por intoxicación medicamentosa en los adolescentes en el Hospital Municipal de Bahía Blanca, Buenos Aires / Characterization of drug poisoning among adolescents seen at the municipal hospital of Bahía Blanca, Province of Buenos Aires, Argentina

Introducción. La consulta por intoxicación medicamentosa en los niños se da con frecuencia en los servicios de emergencias médicas; en la adolescencia, es cuando ocurren de forma intencional. Objetivo. Caracterizar los patrones epidemiológicos de la intoxicación medicamentosa en adolescentes ingresados al Hospital Municipal de Bahía Blanca. Material y método. Estudio descriptivo, basado en la revisión de historias clínicas de pacientes de 10 a 19 años que consultaron por intoxicación medicamentosa, entre los años 2012 y 2016. Las variables analizadas fueron edad, sexo, fármaco consumido, causa, manifestaciones clínicas y días de internación. Resultados. Se recopilaron 72 pacientes. La edad media fue de 16 años, razón mujer-hombre de 2,5:1. Predominaron las intoxicaciones por ansiolíticos (30%), seguidas de las polimedicamentosas (25%). El 95% manifestaron intención suicida, de los cuales el 55% ya tenían antecedentes. Conclusión. La intoxicación medicamentosa ocurrió, predominantemente, en mujeres, y se destacó el gran porcentaje de adolescentes que presentaba episodios previos.

Introduction. Drug poisoning among children is a frequent reason for visits to the emergency department; among adolescents, it is intentional. Objective. To describe the characteristics of drug poisoning among adolescents admitted to the municipal hospital of Bahía Blanca. Material and method. Descriptive study based on the review of medical records of patients aged 10-19 years seen for drug poisoning between 2012 and 2016. The following outcome measures were analyzed: age, sex, drug used, cause, clinical manifestations, and length of stay in days. Results. Data from 72 patients were collected. Their mean age was 16 years, and the female:male ratio was 2.5:1. Anxiolytic poisoning (30%) predominated, followed by polydrug use (25%). Ninety-five percent of patients showed a suicidal intention; of these, 55% had a history of suicide attempt. Conclusion. Drug poisoning was observed predominantly among girls; it is worth noting the high percentage of youth who had a history of suicide attempt.

Characterization of drug poisoning among adolescents seen at the municipal hospital of Bahía Blanca, Province of Buenos Aires, Argentina. / Caracterización de la consulta por intoxicación medicamentosa en los adolescentes en el Hospital Municipal de Bahía Blanca, Buenos Aires.

INTRODUCTION: Drug poisoning among children is a frequent reason for visits to the emergency department; among adolescents, it is intentional. OBJECTIVE: To describe the characteristics of drug poisoning among adolescents admitted to the municipal hospital of Bahía Blanca. Material and method. Descriptive study based on the review of medical records of patients aged 10-19 years seen for drug poisoning between 2012 and 2016. The following outcome measures were analyzed: age, sex, drug used, cause, clinical manifestations, and length of stay in days. RESULTS: Data from 72 patients were collected. Their mean age was 16 years, and the female:male ratio was 2.5:1. Anxiolytic poisoning (30%) predominated, followed by polydrug use (25%). Ninety-five percent of patients showed a suicidal intention; of these, 55% had a history of suicide attempt. CONCLUSION: Drug poisoning was observed predominantly among girls; it is worth noting the high percentage of youth who had a history of suicide attempt.

Introducción. La consulta por intoxicación medicamentosa en los niños se da con frecuencia en los servicios de emergencias médicas; en la adolescencia, es cuando ocurren de forma intencional. Objetivo. Caracterizar los patrones epidemiológicos de la intoxicación medicamentosa en adolescentes ingresados al Hospital Municipal de Bahía Blanca. Material y método. Estudio descriptivo, basado en la revisión de historias clínicas de pacientes de 10 a 19 años que consultaron por intoxicación medicamentosa, entre los años 2012 y 2016. Las variables analizadas fueron edad, sexo, fármaco consumido, causa, manifestaciones clínicas y días de internación. Resultados. Se recopilaron 72 pacientes. La edad media fue de 16 años, razón mujer-hombre de 2,5:1. Predominaron las intoxicaciones por ansiolíticos (30%), seguidas de las polimedicamentosas (25%). El 95% manifestaron intención suicida, de los cuales el 55% ya tenían antecedentes. Conclusión. La intoxicación medicamentosa ocurrió, predominantemente, en mujeres, y se destacó el gran porcentaje de adolescentes que presentaba episodios previos.

Intento de suicidio vía ingesta de fármacos en niños / Suicide attempts secondary to self-inflicted drug poisoning

Suicide attempts in children are an important worldwide cause of morbidity and mortality and an emerging reason for admission in Pediatric Critical Care. Objective: Identify the epidemiologic and clinical characteristics of patients with drug poisoning with a suicide purpose as an admission cause in a Chilean Pediatric Intensive Care Unit (PICU). Design: Retrospective observational study. Setting: 14 beds PICU of a tertiary care public teaching hospital in Santiago de Chile. Material and Method: All patients admitted to the PICU between January 2005 and December 2008 for self-inflicted drug poisoning with an expressed intention of suicide were included. Analysis of the PICU clinical chart was performed with sampling on an excel data base. For seasonal distribution we used statistical analysis Xil. Results: 178 of 3045 PICU admissions were diagnosed as drug poisoning (5,8 percent), 108 of them for suicide attempts (60,6 percent).The number of annual patients increased, with highest incidence in spring and autumn and lowest in winter. Mean and median age was 13 years, 8,4 percent less than 12 years. 88,9 percent were females. They used polipharmacy in 57 percent. Drugs were taken from home. Antidepressants and sedatives were the most often used. An underlying psychiatric condition was present in 100 cases (92,6 percent). Associated factors were family disfunction, school problems, abuse and violation and bullying. Mean PICU stay was 1,46 days with 16,7 percent requiring transient mechanical ventilation No death was reported in this serie. Conclusions: The number of cases of suicide attempt via drug ingestion as a motive for admission in PICU is increasing, causing a raising number of short and transient admissions, more in spring less in winter. Risk factors were mostly an underlying psychiatric disorder and family disfunction.

Introducción: El intento de suicidio en pediatría, via ingestión de fármacos, es una importante causa de mor-bimortalidad en el mundo y un creciente motivo de ingreso a cuidados intensivos. Objetivo: Identificar las características clínicas y epidemiológicas de los pacientes con intoxicación por fármacos con un intento de suicidio, como causa de ingreso a una Unidad de Cuidados Intensivos Pediátricos en Chile (UC1P). Diseño: Estudio retrospectivo observacional. Pacientes y Método: UClP de 14 camas críticas en un hospital pediátrico de Santiago. Se incluyeron todos los pacientes ingresados a la UClP debido a intento de suicidio por ingestión de fármacos, entre enero 2005 a diciembre 2008. Resultados: 178 de 3 045 egresos se debieron a intoxicación por fármacos (5,8 por ciento) ,108 de ellos por intento de suicidio (60,6 por ciento). La tendencia observada es a un incremento anual, con mayor incidencia en primavera y otoño, y menor en invierno. La media y mediana de edad fue de 13 años, 8,4 por ciento menor de 12 años. 88,9 por ciento fueron mujeres, Se utilizó polifarmacia en un 57 por ciento con fármacos disponibles en el hogar. Antidepresivos y sedantes fueron los más usados. Patología psiquiátrica de base se diagnosticó en un 92,6 por ciento de los casos. Factores asociados fueron disfunción familiar, problemas en el colegio, abuso y violación, bullying. La estadía promedio en UClP fue de 1,5 días, requiriendo un 16,7 por ciento ventilación mecánica transitoria. No hubo fallecidos en esta serie. Conclusiones: El intento de suicidio por ingestión de fármacos como motivo de ingreso a UClP ha aumentado, requiriendo estadías cortas y transitorias, mayormente en primavera y menos en invierno. Factores asociados fueron patología psiquiátrica de base y disfunción familiar.