"Asarcon", una causa mas de intoxicacion por plomo. / \"Asarcon\", one more cause of lead intoxication

Existen diversas fuentes de exposicion al plomo que pueden originar intoxicacion por este metal en los ninos. Una mas es la ingestion de "asarcon", polvo rojo empleado en medicina folklorica para el tratamiento de diversos padecimientos gastrointestinales conocidos popularmente como "empachos" Se informa del caso de una nina de dos anos que sufrio intoxicacion aguda por plomo causada por ingestion de este polvo y que, ademas, durante su atencion medica presento intoxicacion yatrogena por fenobarbital. La oportunidad en el diagnostico y en el tratamiento permitio su curacion, aparentemente sin secuelas. El analisis quimico del "asarcon" demostro que contenia 97 por ciento de plomo, que se identifico como tetroxico de plomo

Utilidad de la tecnica de inmunoensayo enzimatico homogeneo (EMIT) para el estudio de las intoxicaciones causadas por farmacos anticonvulsivos. / Usefulness of enzyme multiplied immunoassay technique (EMIT) in the study of intoxications caused by anticonvulsive drugs

La tecnica de inmunoensayo enzimatico homogeneo (EMIT), es de facil ejecucion y precisa en sus resultados, lo que permite la practica de estudios de farmacologia y toxicologia clinicas. Se demostro su utilidad en el estudio de 40 pacientes intoxicados por medicamentos anticonvulsivos.Estos farmacos se identificaron y cuantificaron en la sangre al ingreso de los pacientes al hospital, a las 24 y a las 48 horas. Con el primer estudio se establecio el diagnostico etiologico de las intoxicaciones al demostrar que las concentraciones de los agentes eran superiores a los umbrales toxicos teoricos. El seguimiento a las 24 y 48 horas mostro disminucion de las concentraciones, como resultado de los tratamientos instituidos, a niveles estadisticamente significativos

Intoxicacion por Karwinskia humboldtiana. Conceptos actuales. / Poinsoning by Karwinskia humboldtiana. Current concepts

Karwinskia humboldtiana es una planta ampliamente distribuida por el centro y el norte de Mexico. La investigacion de su fruto ("capulin tullidor") causa paralisis simetrica, progresiva y ascendente que, en los casos graves, origina paralisis respiratoria y bulbar. Se han identificado cuatro neurotoxinas en el fruto que son las que originan la alteracion primaria, desmielinizacion segmentaria con degeneracion axoniana. Se discuten la posible patogenia la sintomatologia, el diagnostico diferencial con poliomielitis y sindrome de Guillain-Barre y el tratamiento general de esta intoxicacion

[Acute-onset extrapyramidal syndromes caused by drugs]. / Síndromes extrapiramidales de evolución aguda causados por drogas.

In childhood, several drugs are the cause of acute extrapyramidal syndromes which are true medical emergencies. In the course of one year out of 321 children with acute poisoning, 49 (14.9%) showed these side effects. The responsible drugs were mainly the phenothiazines and haloperidol; only in two cases the metoclopramide. The extrapyramidal syndromes were characterized by akathisia, dyskinesia with dystonic reactions, parkinsonism and akinesia. Diphenhydramine has shown to be useful in treating acute extrapyramidal disturbances when used intravenously followed by oral administration.

Sindromes extrapiramidales de evolucion aguda causados por drogas. / Acute extrapyramidal syndromes caused by drugs

En la edad pediatrica, diversas drogas pueden causar sintomas extrapiramidales que por su evolucion aguda constituyen verdaderas urgencias medicas. En el transcurso de un ano, del total de 321 ninos internados con el diagnostico de intoxicacion aguda, 48 (14.9%) habian recibido ese tipo de drogas. De estas, las que con mayor frecuencia causaron los sintomas fueron las fenotiacinas y el haloperidol; la manera como los ninos se expusieron a ellas fue en la mayor parte de los casos por yatrogenia y despues por ingestion accidental. Las manifestaciones clinicas que predominaron fueron acatisia, discinesias paroxisticas del tipo de las crisis oculogiras, las distonias de torsion de cuello y tronco y las crisis bucolinguales, parkinsonismo caracterizado por temblores finos, sialorrea e hipertonia y finalmente, acinesia. Se propone un esquema de tratamiento empleando unicamente difenhidramina por via parenteral y bucal con lo que se obtienen buenos resultados terapeuticos

Intoxicacion por plomo. Origen de la exposicion al metal en tres familias.(Pediatria). / Lead poisoning. Origin of exposure to the metal in 3 families. (Pediatrics)

La intoxicacion por plomo es un padecimiento grave en la infancia, con gran indice de mortalidad y secuelas neurologicas El origen de la exposicion al plomo esta relacionado con diversas situaciones en el ambiente del nino. Presentamos aqui el estudio de tres familias en las que los adultos y los ninos tuvieron manifestaciones de intoxicacion o de incremento de plomo en el organismo. El origen de estas alteraciones fue, respectivamente, la existencia de talleres domesticos de fundicion del metal, la contaminacion a traves de los zapatos de los obreros y el empleo de loza de barro vidriada

[Methemoglobinemia caused by inhalation of aniline vapors by a newborn]. / Metahemoglobinemia por inhalación de vapores de anilina en un lactante.

Most cases of toxic methemoglobinemia in children are caused by direct contact of the methemoglobinizing agents with the skin and mucosa and in a shorter scale, by the ingestion of such compounds. The first case we know is reported where the toxic was inhaled. The basis to establish the diagnosis of methemoglobinemia, together with the differential diagnosis with other diseases in children that show cyanosis in their course are discussed.

[Fatal endrin poisoning]. / Intoxicación fatal por endrín.

Endrin is a cycladine organic chloride insecticide responsible for fatal poisoning due to food contamination, suicide or occupational cause. The case of an 18 months old infant who ingested Endrin that was being used at home by his parents as raticide is reported. There appeared sudden convulsive crises, coma and death within 24 hours. The pathological findings were unspecific. Experimental studies and clinical observations of other authors that are coincidental with the symptoms shown by this child are discussed. The possible etiopathogenesis of this poisoining, together with the necessity to control this type of toxics, for which there is no antidotal treatment, are also discussed.

[Hyperglycemia of the dehydrated infant]. / Hiperglicemia del lactante deshidratado.

Hyperglycemia and glucosuria are frequently seen during the acute phase of dehydration secondary to gastroenteritis. In this paper, 33 patients in hypovolemic shock due to diarrhea were studied. Serum glucose resulted above 140 mg/100 ml. in 14 patients (41%); it was below 27 mg/100 ml. in 2 more patients (5.8%). Despite high glucose concentration, only 4 out of the 14 hyperglycemic patients had serum insulin concentration above that observed in normal fasting children. Plasma cortisol was significantly higher in the group with hyperglycemia (54 +/- 24 micrograms/100 ml.) in comparison with the group with normal glucose levels (15 +/- 6.4 micrograms/100). No correlation was found between serum glucose and the concentrations of sodium, potassium, bicarbonate, growth hormone nor with plasma osmolarity. All disturbances observed turned normal after rehydration. Hyperglicemia is explained as a response to stress and is probably due to the gluconeogenic action of cortisol and the inhibitory effect of catecholamines upon insulin secretion.

Treatment of acute carbamazepine intoxication according to its pharmacological properties. Preliminary report.

Acute carbamazepine intoxication represents a pediatric emergency case with symptoms of CNS depression, seizures and water retention. A symptomatic, maintenance treatment is recommended. Taking into account some of the pharmacodynamic properties of this drug (low volume distribution, and antidiuretic activity) we propose a treatment protocol by means of forced diuresis and peritoneal dialysis. This is a preliminary report of the first four cases treated in this way. Objective assessment of intoxication and response to treatment were made based upon urine and blood determinations of the drug. In three cases cure was obtained with a single dose of furosemide; the fourth patient who was critically ill, was dialyzed and improvement was observed 12 hours after. In spite of the reduced number of patients studied, results obtained allow us to conclude that this procedure is advisable in the treatment of carbamazepine intoxication cases.