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Am J Public Health ; 110(10): 1528-1531, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32816555


Data System. The American Association of Poison Control Centers (AAPCC) and the Centers for Disease Control and Prevention (CDC) jointly monitor the National Poison Data System (NPDS) for incidents of public health significance (IPHSs).Data Collection/Processing. NPDS is the data repository for US poison centers, which together cover all 50 states, the District of Columbia, and multiple territories. Information from calls to poison centers is uploaded to NPDS in near real time and continuously monitored for specific exposures and anomalies relative to historic data.Data Analysis/Dissemination. AAPCC and CDC toxicologists analyze NPDS-generated anomalies for evidence of public health significance. Presumptive results are confirmed with the receiving poison center to correctly identify IPHSs. Once verified, CDC notifies the state public health department.Implications. During 2013 to 2018, 3.7% of all NPDS-generated anomalies represented IPHSs. NPDS surveillance findings may be the first alert to state epidemiologists of IPHSs. Data are used locally and nationally to enhance situational awareness during a suspected or known public health threat. NPDS improves CDC's national surveillance capacity by identifying early markers of IPHSs.

Centers for Disease Control and Prevention, U.S./tendências , Bases de Dados Factuais , Centros de Controle de Intoxicações/tendências , Envenenamento/epidemiologia , Vigilância da População , Saúde Pública , Coleta de Dados , District of Columbia/epidemiologia , Epidemiologistas , Humanos , Estados Unidos/epidemiologia
MMWR Morb Mortal Wkly Rep ; 69(32): 1070-1073, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32790662


Alcohol-based hand sanitizer is a liquid, gel, or foam that contains ethanol or isopropanol used to disinfect hands. Hand hygiene is an important component of the U.S. response to the emergence of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). If soap and water are not readily available, CDC recommends the use of alcohol-based hand sanitizer products that contain at least 60% ethyl alcohol (ethanol) or 70% isopropyl alcohol (isopropanol) in community settings (1); in health care settings, CDC recommendations specify that alcohol-based hand sanitizer products should contain 60%-95% alcohol (≥60% ethanol or ≥70% isopropanol) (2). According to the Food and Drug Administration (FDA), which regulates alcohol-based hand sanitizers as an over-the-counter drug, methanol (methyl alcohol) is not an acceptable ingredient. Cases of ethanol toxicity following ingestion of alcohol-based hand sanitizer products have been reported in persons with alcohol use disorder (3,4). On June 30, 2020, CDC received notification from public health partners in Arizona and New Mexico of cases of methanol poisoning associated with ingestion of alcohol-based hand sanitizers. The case reports followed an FDA consumer alert issued on June 19, 2020, warning about specific hand sanitizers that contain methanol. Whereas early clinical effects of methanol and ethanol poisoning are similar (e.g., headache, blurred vision, nausea, vomiting, abdominal pain, loss of coordination, and decreased level of consciousness), persons with methanol poisoning might develop severe anion-gap metabolic acidosis, seizures, and blindness. If left untreated methanol poisoning can be fatal (5). Survivors of methanol poisoning might have permanent visual impairment, including complete vision loss; data suggest that vision loss results from the direct toxic effect of formate, a toxic anion metabolite of methanol, on the optic nerve (6). CDC and state partners established a case definition of alcohol-based hand sanitizer-associated methanol poisoning and reviewed 62 poison center call records from May 1 through June 30, 2020, to characterize reported cases. Medical records were reviewed to abstract details missing from poison center call records. During this period, 15 adult patients met the case definition, including persons who were American Indian/Alaska Native (AI/AN). All had ingested an alcohol-based hand sanitizer and were subsequently admitted to a hospital. Four patients died and three were discharged with vision impairment. Persons should never ingest alcohol-based hand sanitizer, avoid use of specific imported products found to contain methanol, and continue to monitor FDA guidance (7). Clinicians should maintain a high index of suspicion for methanol poisoning when evaluating adult or pediatric patients with reported swallowing of an alcohol-based hand sanitizer product or with symptoms, signs, and laboratory findings (e.g., elevated anion-gap metabolic acidosis) compatible with methanol poisoning. Treatment of methanol poisoning includes supportive care, correction of acidosis, administration of an alcohol dehydrogenase inhibitor (e.g., fomepizole), and frequently, hemodialysis.

Higienizadores de Mão/envenenamento , Metanol/envenenamento , Adulto , Idoso , Arizona/epidemiologia , Ingestão de Alimentos , Feminino , Higienizadores de Mão/química , Humanos , Masculino , Metanol/análise , Pessoa de Meia-Idade , New Mexico/epidemiologia , Envenenamento/epidemiologia , Envenenamento/mortalidade , Adulto Jovem
Nursing (Säo Paulo) ; 23(267): 4420-4424, ago.-2020.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1128885


Objetivo: Descrever o perfil das intoxicações exógenas atendidas em um hospital de ensino, no período de junho de 2015 a junho de 2019. Método: Estudo documental, retrospectivo, descritivo, com análise quantitativa. A coleta dos dados ocorreu no Sistema de Informação de Agravo de Notificação (SINAN), do período de junho de 2015 a junho de 2019. O total da amostra foi 152 notificações exógenas. Resultados: Quanto ao sexo predominou o feminino com 85 casos, houve predomínio para as idades, entre 20 a 34 anos, para o local de exposição, 132 casos aconteceram na residência, nos anos de 2017 e 2018 apresentaram maior incidência. Foram identificados 127 agentes toxicológicos dentre esses 98 casos, os anticoagulantes, benzodiazepínicos e antidepressivos tiveram maior incidência. Conclusão: Jovem adulto nas idades entre 20 a 34 anos, principalmente do sexo feminino predominam nas notificações de intoxicação exógena, com maior concentração para as pessoas com nível escolar incompleto.(AU)

Objective: Describe the profile of exogenous intoxication attended in a teaching hospital, between June 2015 and June 2019. Method: Documental, retrospective, descriptive study, with qualitative analysis. The data collection was done on the Information System of Notification Aggravation (SINAN), between June 2015 and June 2019. The total sample was 152 exogenous notifications. Results: The predominant gender was the female, with 85 cases, there was the predominance of the ages between 20 and 34 years old, in the local of exposition, 132 cases took place in the recidence, in 2017 and 2018 there was a higher incidence. 127 toxicological agents were identified among these 98 cases, the anticoagulants, benzodiazepines, and antidepressants had higher incidence. Conclusion: Young adults aged between 20 and 34 years old, especially of the female gender are predominant in notifications of exogenous intoxication, with bigger concentration of people with incomplete educational attainment.(AU)

Objetivo: Describir el perfil de intoxicaciones exógenas atendidas en un hospital docente, en el período de junio de 2015 a junio de 2019. Método: Estudio documental, retrospectivo, descriptivo, con análisis cuantitativo. La recopilación de datos tuvo lugar en el Sistema de Información de Divulgación Notificable (SINAN), en el periodo de junio de 2015 a junio de 2019. El total de la muestra fueron 152 notificaciones exógenas. Resultados: En cuanto al género, hubo un predominio de mujeres con 85 casos, hubo un predominio de edades, entre 20 y 34 años, para el lugar de exposición, 132 casos ocurrieron en la residencia, en los años 2017 y 2018 tuvieron una mayor incidencia. Se identificaron 127 agentes toxicológicos entre estos 98 casos, los anticoagulantes, las benzodiacepinas y los antidepresivos tuvieron una mayor incidencia. Conclusión: los adultos jóvenes entre 20 y 34 años, principalmente mujeres, predominan en las notificaciones de intoxicación exógena, con mayor concentración para las personas con escolarización incompleta.(AU)

Humanos , Envenenamento , Envenenamento/epidemiologia , Serviços de Vigilância Epidemiológica , Monitoramento Epidemiológico , Hospitais de Ensino , Sistemas de Informação em Saúde
Alcohol ; 88: 29-32, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32693023


The coronavirus disease 2019 (COVID-19) spread rapidly worldwide and led to the deaths of thousands of people. To date, there is not any vaccine or specific antiviral medicine that can prevent or treat this virus. This caused panic among people who try their best to prevent being infected. In Iran, methanol poisoning was reported and led to the death of hundreds of people in several provinces. The incident occurred after a rumor circulated in the country that drinking alcohol (ethanol) can cure or prevent being infected by COVID-19.

Comunicação , Infecções por Coronavirus/prevenção & controle , Etanol/uso terapêutico , Metanol/envenenamento , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Envenenamento/mortalidade , Solventes/envenenamento , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas , Bebidas Alcoólicas , Betacoronavirus , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Contaminação de Medicamentos , Feminino , Contaminação de Alimentos , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/epidemiologia , Envenenamento/epidemiologia , Envenenamento/etiologia , Solventes/uso terapêutico , Adulto Jovem
J Ayub Med Coll Abbottabad ; 32(2): 250-254, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584003


BACKGROUND: Poison is defined as any substance which harms, endangers or even kills a person irrespective of the quality or quantity. Pakistan is a developing country and farming is the major occupation of the majority of the population. Due to the easy availability and increased use of pesticides, the accidental and suicidal poisoning is very common. The objective of the study is to find out the most common poison used by the people in the general population and its frequency in our setup. METHODS: The present cross-sectional study with retrospective data collection was undertaken in the Department of Forensic Medicine, Khyber Medical College (KMC) Peshawar to determine the frequency of different poisons detected in various samples brought to the toxicological laboratory. A three-year data (1stJanuary 2014 to 31 December 2016) was retrieved from Forensic Laboratory of KMC, Peshawar. Different methods were used for the detection of poisons. All the cases coming from Khyber Pakhtunkhwa province were included whereas; cases from other provinces were excluded. RESULTS: The study revealed that poisoning was more common among females and the most common age group affected was 21-25 years. The incidence of positive cases was more in Peshawar district followed by Swat district. The common poison detected was phosphine (wheat pill). CONCLUSIONS: Female and young people from Peshawar and Swat are more prone to Aluminum Phosphide (wheat pill) poison. It is a dangerous and lethal poison, so healthcare workers at emergency department ought to be prepared for such cases. Furthermore, its routine use as a domestic pesticide has to be strictly prohibited by creating awareness among the public.

Envenenamento/epidemiologia , Adulto , Compostos de Alumínio/envenenamento , Estudos Transversais , Feminino , Medicina Legal , Humanos , Masculino , Paquistão , Fosfinas/envenenamento , Estudos Retrospectivos , Adulto Jovem
BMC Public Health ; 20(1): 404, 2020 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-32220225


BACKGROUND: Paraquat self-poisonings constitute a significant contributor to the global burden of suicide. Our aim was to evaluate the relationship between social and economic variables with the incidence of self-poisoning with Paraquat in the northeast of Colombia. METHODS: Records of 154 cases of self-poisoning with Paraquat and several socio-economic variables of six regions of northeast of Colombia were analyzed. RESULTS: Most of the cases were mestizos, farmworkers, between 20 and 29 years, with intentional exposure using the oral route. Multivariate analyses revealed significant associations among the incidence of self-poisoning with PQ with the ecological factors such as poverty greater than 30% (IRR 15.9 IC95% 5.56-44.72), land Gini index < 0.7 (IRR 7.11 IC95% 3.58-14.12), private health insurance < 40% (IRR 3.39 IC95% 1.30-8.82) and planted area > 10% (IRR 2.47 IC95% 1.60-3.80). CONCLUSION: There is a relationship between ecological factors and, as such, this study opens the way to further developments in the field.

Paraquat/envenenamento , Envenenamento/epidemiologia , Suicídio/estatística & dados numéricos , Adulto , Colômbia/epidemiologia , Feminino , Humanos , Incidência , Masculino , Fatores Socioeconômicos , Adulto Jovem
PLoS One ; 15(3): e0229939, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32130274


OBJECTIVE: This study aims to provide basic data on the types and frequency of chemical ingestions and the clinical outcomes of chemical ingestion injury. METHODS: This study retrospectively analyzed the data obtained from the Emergency Department-Based Injury In-depth Surveillance of the Korea Centers for Disease Control and Prevention (South Korea) from 2011 to 2016. Patients ingesting chemicals aged ≥ 18 years were included, but those ingesting unknown chemical substances or with unknown clinical outcomes were excluded. RESULTS: This study included 2,712 (47.2% were men and 52.8% were women, mean age, 47.05 years) patients ingesting chemicals. Unintentional and intentional ingestions were reported in 1,673 (61.7%) and 1,039 (38.3%), respectively. The most commonly ingested chemical substances were hypochlorites, detergents, ethanol, and acetic acid. In the unintentional ingestion group, the most common chemicals upon admission were hypochlorites (74), glacial acetic acid (60), and detergent (33). The admission rates were 60% for glacial acetic acid, 58.3% ethylene glycol, and 30.4% other alkali agents. In the intentional ingestion group, the most common chemicals upon admission were hypochlorites (242), glacial acetic acid (79), ethylene glycol (42), and detergent (41). The admission rates were 91.9% for glacial acetic acid, 87.5% ethylene glycol, 85.7% potassium cyanide, and 81.4% hydrochloric acid. In total, 79 deaths (10 unintentional ingestions, 69 intentional ingestion) were reported, and glacial acetic acid had an odds ratio of 9.299 for mortality. CONCLUSION: We compared the intentional and unintentional ingestion groups, and analyzed the factors affecting hospital admission and mortality in each group. The types and clinical outcomes of chemical ingestion varied depending on the purpose of chemical ingestion. The findings are considered beneficial in establishing treatment policies for patients ingesting chemicals.

Ingestão de Alimentos , Substâncias Perigosas/toxicidade , Envenenamento/epidemiologia , Ácido Acético/toxicidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antídotos/uso terapêutico , Detergentes/toxicidade , Serviço Hospitalar de Emergência/estatística & dados numéricos , Etanol/toxicidade , Etilenoglicol , Feminino , Humanos , Ácido Hipocloroso/toxicidade , Masculino , Pessoa de Meia-Idade , Centros de Controle de Intoxicações/estatística & dados numéricos , Envenenamento/fisiopatologia , República da Coreia/epidemiologia , Adulto Jovem
Hosp Pract (1995) ; 48(2): 100-107, 2020 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-32133895


BACKGROUND: Intentional poisoning is becoming an important public health concern particularly among young women globally. Consequently, there is a need to analyze this further within countries to establish pertinent policies to reduce current incidence rates. This includes sub-Saharan African countries where there has been a scarcity of information. Consequently, we sought to establish the nature and sources of poisoning in patients admitted to a leading hospital in Botswana to help develop pertinent future policies for Botswana and surrounding countries. METHODS: Retrospectively reviewing the medical records of all patients admitted to Princess Marina Hospital (PMH), which is a leading tertiary hospital in the capital city of Botswana, due to acute poisoning over a six-year period. RESULTS: The records for 408 patients were reviewed. The majority of admissions (58%) were females, and the mean age of patients was 21(±14) years. Most poisoning cases (53%) were intentional. The 15-45 years age group was most likely to intentionally poison themselves compared to other age groups, with females four and half times more likely to intentionally poison themselves compared to males (AOR 4.53, 95% CI: 2.68-7.89, p < 0.001). Half of the patients were poisoned by medicines followed by household chemicals (22%), with females overall four times more likely to be poisoned by medicines compared to males. The medicine mostly ingested was paracetamol (30%). Failing relationships (57%) were the principal reason for intentional poisoning. Six patients died from poisoning representing a 1.5% mortality rate. CONCLUSIONS: The findings suggest in-depth and urgent investigations on intentional poisoning are needed among young women across countries including sub-Saharan African countries to inform future policies on prevention strategies. Further, strategies for poisoning prevention should target social and family relationship problems. We will be following this up in the future.

Hospitalização/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Envenenamento/epidemiologia , Centros de Atenção Terciária/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Botsuana/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Adulto Jovem
Cien Saude Colet ; 25(2): 761-772, 2020 Feb.
Artigo em Português | MEDLINE | ID: mdl-32022215


Many studies analyze the epidemiological profile of deaths caused by a single toxic agent. However, broader mortality analyses can be obtained by evaluating multiple agents over the same period of time. For this purpose, a retrospective descriptive study was carried out of the deaths by intoxication registered in the Mortality Information System that occurred in Brazil from 2010 to 2015. Deaths were selected according to ICD-10 codes related to intoxication. There were 18,247 deaths and an increase of 3% of rates of mortality by intoxication during the period. The agents that caused the most deaths were pesticides (24%) followed by medication (23%) and street drugs (22%). With the exception of medication, where the female participation was 52%, there was a higher concentration of males for all agents and in most of the age groups. Only in the case of medication and pesticides was suicide the main circumstance of deaths. The results presented made it possible to define a mortality profile for each of the major toxic agents studied.

Sistemas de Informação/estatística & dados numéricos , Mortalidade/tendências , Envenenamento/epidemiologia , Suicídio/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Causas de Morte/tendências , Criança , Pré-Escolar , Feminino , Humanos , Drogas Ilícitas/envenenamento , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Praguicidas/envenenamento , Envenenamento/mortalidade , Estudos Retrospectivos , Distribuição por Sexo , Adulto Jovem
An. pediatr. (2003. Ed. impr.) ; 92(1): 37-45, ene. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-186816


Objetivo: Describir las características de los pacientes pediátricos con sospecha de intoxicación atendidos por unidades de soporte vital avanzado (SVA) y evaluar los indicadores de calidad (IC) para la atención urgente prehospitalaria de estos pacientes. Método: Estudio observacional de los pacientes menores de 18 años con exposición a tóxicos, que fueron atendidos por una unidad de SVA del Sistema de Emergencias Médicas en Cataluña, durante un año. Se definieron criterios de clínica grave. Se evaluaron 8 IC para la atención urgente prehospitalaria de los pacientes pediátricos intoxicados. Resultados: Se incluyó a 254 pacientes. La edad mediana fue de 14 años (p25-75 = 7-16), con exposición intencionada en el 50,8% de los casos. El tóxico más frecuentemente implicado fue el monóxido de carbono (CO) (33,8%). Presentó clínica de toxicidad el 48,8%, siendo grave en el 16,5%. La intencionalidad (OR 5,1; intervalo de confianza del 95%: 1,9-13,8) y el desconocimiento del tiempo transcurrido desde el contacto (OR 3,1; intervalo de confianza del 95%: 1,3-7,3) fueron factores de riesgo independientes asociados a clínica grave. Cinco IC no alcanzaron el estándar de calidad: disponibilidad de guías de actuación específicas, administración de carbón activado en pacientes seleccionados, aplicación de oxigenoterapia a la máxima concentración posible en intoxicación por CO, valoración electrocardiográfica en pacientes expuestos a sustancias cardiotóxicas y registro del conjunto mínimo de datos. Conclusiones: Los pacientes pediátricos expuestos a tóxicos y atendidos por unidades SVA presentan características propias. Destacan la implicación del CO y de los adolescentes con intoxicaciones voluntarias. La evaluación de los IC ha sido útil para detectar puntos débiles en la calidad asistencial de estos pacientes y desarrollar estrategias de mejora

Objective: To describe the characteristics of paediatric patients with suspected poisoning treated by advanced life support (ALS) units, and to evaluate quality indicators (QI) for the prehospital emergency care of these patients. Method: A one-year observational study of patients under 18 years of age exposed to poisoning and treated by an ALS unit of the Medical Emergency System in Catalonia. Severe clinical criteria were defined, with 8 QI being evaluated for prehospital emergency care of poisoned paediatric patients. Results: The study included a total of 254 patients, with a median age of 14 years-old (p25-75 = 7-16), with intentional poisoning in 50.8% of cases. The most frequently involved toxic agent was carbon monoxide (CO) (33.8%). Poisoning was found in 48.8% of those patients, being serious in 16.5%. Intentionally (OR 5.1; 95% CI: 1.9-13.8) and knowledge of the time of exposure (OD 3.1; 95% CI: 1.3-7.3) were independent risk factors associated with the appearance of severe clinical symptoms. Five QI did not reach the quality standard and included, availability of specific clinical guidelines, activated charcoal administration in selected patients, oxygen therapy administration at maximum possible concentration in carbon monoxide poisoning, electrocardiographic assessment in patients exposed to cardiotoxic substances, and recording of the minimum data set. Conclusions: Paediatric patients attended by ALS units showed specific characteristics, highlighting the involvement of CO and adolescents with voluntary poisoning. The QI assessment was useful to detect weak points in the quality of care of these patients and to develop strategies for improvement

Humanos , Masculino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Serviços Médicos de Emergência/estatística & dados numéricos , Qualidade da Assistência à Saúde , Envenenamento/epidemiologia , Substâncias, Produtos e Materiais Tóxicos , Intervalos de Confiança , Fatores de Risco , Indicadores de Qualidade em Assistência à Saúde , Epidemiologia Descritiva
Int J Occup Med Environ Health ; 33(1): 77-90, 2020 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-31942869


OBJECTIVES: The aim of the research was to analyze the nature of changes and tendencies observed in the frequency, circumstances and causes of acute intentional poisonings within the agglomeration of Lódz, Poland. The study related to adults. MATERIAL AND METHODS: As the research material, medical records of patients hospitalized due to an acute poisoning in the Department of Toxicology in Lódz were used. Information on the hospitalized patients was gathered in the database created in accordance with the assumed criteria and an approved system of the collection of variables describing the issues of intentional acute poisonings. RESULTS: In the analyzed period, within the group of 18 918 adult patients hospitalized due to an acute poisoning, male patients prevailed, accounting for 57.17% of the whole group. Intentional poisonings constituted 40.19% of all poisonings, with women dominating within that group of patients - accounting for approximately 58.63%. The largest group was formed by young people, 18-35 years old, accounting for 43.22%. The average age of the intentionally poisoned patients showed an upward tendency; this tendency concerned women to a larger extent. Medications played the most powerful role in acute intentional poisonings. Within the whole population, they were responsible for 97.27% of intoxications. The analysis of the dynamics of changes in the percentage of patients referred for further mental treatment revealed that the number of patients continuing hospital treatment in psychiatric wards tended to grow. CONCLUSIONS: Observations indicating that women are more likely to attempt intentional poisoning, and that the number of patients with psychiatric disturbances tended to grow in the analyzed period, demonstrate an urgent need for preventive measures to be taken in the local communities. Int J Occup Med Environ Health. 2020;33(1):77-90.

Envenenamento/epidemiologia , Suicídio/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Preparações Farmacêuticas , Envenenamento/mortalidade , Envenenamento/psicologia , Polônia/epidemiologia , Estudos Retrospectivos , Fatores Sexuais , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos