Accidental childhood poisoning is a recognized preventable cause of morbidity and mortality among children worldwide. This study was aimed at determining the prevalence, pattern, and outcome of ...childhood poisoning among children in Abakaliki, Ebonyi State. Material and Methods: Medical records of all cases of accidental childhood poisoning admitted into Children’s emergency room (CHER) of the health facility of study between January 2014 and December 2018 were retrospectively identified and relevant data extracted and analyzed using SPSS version 22. Results: Out of the 7,700 children that presented to CHER over a 5- year period, 42 were cases of poisoning, giving prevalence rate of 0.5%. Of the 42 cases, only 20 case notes were retrieved. The male to female ratio was 2.3:1 while the ages ranged between 6months and 14 years with the mean age of 3.06±2.88. Kerosene poisoning had the highest proportion of 50.0% (10/20) with the overall mortality rate of 5.0% (1/20).The relationship between age, place of residence and outcome in poisoned children was statistically significant (p = 0.038, 0.045 respectively). Conclusion: Accidental childhood poisoning is common in Abakaliki. Kerosene still remained the major agent while male toddlers were most vulnerable. There is need to intensify enlightenment campaigns and education of the public about the hazard of improper storage of kerosene and other implicated substances at home.
Better understanding of the dynamics of the current U.S. overdose epidemic may aid in the development of more effective prevention and control strategies. We analyzed records of 599,255 deaths from ...1979 through 2016 from the National Vital Statistics System in which accidental drug poisoning was identified as the main cause of death. By examining all available data on accidental poisoning deaths back to 1979 and showing that the overall 38-year curve is exponential, we provide evidence that the current wave of opioid overdose deaths (due to prescription opioids, heroin, and fentanyl) may just be the latest manifestation of a more fundamental longer-term process. The 38+ year smooth exponential curve of total U.S. annual accidental drug poisoning deaths is a composite of multiple distinctive subepidemics of different drugs (primarily prescription opioids, heroin, methadone, synthetic opioids, cocaine, and methamphetamine), each with its own specific demographic and geographic characteristics.
Metrics that quantify economic and social spatial polarization at multiple geographical levels are not routinely used by health agencies, despite rising inequalities.
We employed the Index of ...Concentration at the Extremes (ICE), which quantifies how persons in a specified area are concentrated into the top vs bottom of a specified societal distribution, to examine associations with Massachusetts mortality data (2010-14). Our a priori hypotheses were that these associations would: be greater at the local census tract (CT) compared with city/town level; vary by race/ethnicity but not gender; and be greatest for our new ICE for racialized economic segregation. Mortality outcomes comprised: child (< 5 years); premature (< 65 years); and cause-specific (cancer; cardiovascular; diabetes; suicide; HIV/AIDS; accidental poisoning; smoking-attributable).
As illustrated by child mortality, in multilevel models jointly including CT and city/town metrics, the rate ratio comparing the worst to best-off ICE quintile for the total population ranged from 2.2 95% confidence interval (CI) 1.6, 3.0 for the CT-level ICE for racialized economic segregation down to 1.1 (95% CI 0.8, 1.7) for the city/town-level ICE for racial segregation; similar patterns occurred by gender and for the non-Hispanic White population. Larger associations for the ICE for racialized economic segregation were at the CT-level for the Black non-Hispanic population (6.9; 95% CI 1.3, 36.9) and at the city/town level for the Hispanic population (6.4; 95% CI 1.2, 35.4).
Results indicate that health agencies should employ measures of spatial social polarization at multiple levels to monitor health inequities.
Life expectancy in the US increased 3.3 years between 1990 and 2015, but the drivers of this increase are not well understood. We used vital statistics data and cause-deletion analysis to identify ...the conditions most responsible for changing life expectancy and quantified how public health, pharmaceuticals, other (nonpharmaceutical) medical care, and other/unknown factors contributed to the improvement. We found that twelve conditions most responsible for changing life expectancy explained 2.9 years of net improvement (85 percent of the total). Ischemic heart disease was the largest positive contributor to life expectancy, and accidental poisoning or drug overdose was the largest negative contributor. Forty-four percent of improved life expectancy was attributable to public health, 35 percent was attributable to pharmaceuticals, 13 percent was attributable to other medical care, and -7 percent was attributable to other/unknown factors. Our findings emphasize the crucial role of public health advances, as well as pharmaceutical innovation, in explaining improving life expectancy.
A cross-reactive sensor array is powerful for high-throughput discrimination of various kinds of metal ions. However, the construction of a multicomponent sensor array is always time-consuming and ...cost-ineffective. Herein, a practical four-component X1-based sensor array (X1SA) was obtained by simply dissolving a single dye molecule X1 in respective solvents such as methanol, ethanol, dimethyl sulfoxide, and acetonitrile. In this design, X1 exhibits strong solvatochromic fluorescence properties via an excited-state intramolecular proton transfer and intramolecular charge transfer combined mechanism. Moreover, rotation of the C–N bond between the pyridine and coumarin units in X1 enabled it to coordinate with metal ions through different binding modes, which acted as an additional dimension of the sensor array. Inspired by this C–N bond rotation strategy, X1SA was determined to be powerful in discriminating 20 kinds of metal ions in both phosphate-buffered saline and 5% serum media in a range of 0.1–100 μM. In addition, the sensor array was also successfully applied in differentiating similar and mixed metal ions such as Fe3+/Fe2+, Cd2+/Hg2+, and Sn2+/Pb2+ in serum samples, which is meaningful for investigating the biological roles of iron and early diagnosis of related metal poisoning accidents.
Suicide attempts by self-poisoning have become a critical health problem. This study aimed to investigate the trend, incidence, and the associated risk factors of suicide attempts by self-poisoning. ...A total of 7398 Egyptian patients were analyzed. The trend of suicide attempts by self-poisoning was analyzed using 6745 patients over four registry years from January 1, 2016, to January 1, 2020. Then, the associated risk factors behind attempted suicide by self-poisoning from January 1, 2019, to January 1, 2020, were assessed using 2523 suicide attempters by self-poisoning, 201 fatalities by self-poisoning, and another 653 survivors of accidental poisoning. Results showed a rising trend of suicide attempts by self-poisoning over the studied years. The incidence of suicide attempts through deliberate self-poisoning represented 26.63/1,000 (CI95%: 25.63-27.86) to the admitted patients and 26.10/100,000 (CI95%: 25.10-27.14) to the regional population. The death rate due to suicide attempts by self-poisoning was 2.08/100,000 (1.90-2.49). The case fatality rate and the proportionate mortality rate for suicide by self-poisoning were 7.38% (CI95%: 6.45-8.42) and 14.11% (CI95%: 12.4-16.0) respectively. Multivariate analysis revealed that attempted suicide by self-poisoning was predicted among patients aged <25 or 25-40 years old (OR = 27.49, CI95%: 15.28-49.64 and OR = 59.42, CI95%: 32.76-107.77 respectively), those of low or moderate socioeconomic status (OR = 35.03, CI95%: 21.32-57.56 and OR = 14.11, CI95%: 10.86-18.43 respectively), students (OR = 2.91, CI95%: 1.57-5.43) and those living in rural residency (OR = 4.12, CI95%: 3.27-5.19). Suicide attempts by self-poisoning exhibited an incremental rise across time which raises a serious concern. Efforts should be directed to overcome the mentioned risk factors triggering suicide attempts by self-poisoning.
AimsDespite numerous campaigns re storing medication safely away from children there are still many incidents of accidental poisoning each year. Parents often feel ‘childproof’ caps are 100% safe, ...even with inadequate storage. This study aims to assess how safe ‘childproof’ caps on medication are by determining if children of various ages can open these medication containers and if so, how quickly they can achieve this.MethodsChildren aged up to 16 years old without severe physical or intellectual disabilities were included in this study. Data collection was obtained in the outpatient department while patients awaited their OPD appointment. The time taken for a child to open each ‘childproof’ medication container was recorded up to a maximum of two minutes. The age of the child and any relevant diagnosis was also recorded. Information on safe storage of medication was provided to parents.ResultsSeventy-six children were included in this study to date. Ages ranged from 1 year to 16 years and were from a wide range of speciality clinics. Fourteen (18%) children were able to open at least one container within 2 minutes (age range 4 to 16 years). All children 11 years and older were successful. All children aged 7 years and younger were unable to open the container, except one child who had been taught how to open his medications.Twenty-five percent of females were able to open at least one medication bottle versus 14% of males, however there was a preponderance of females in the older age group. Of the children who were successful, the majority were able to open the container in less than 5 seconds. An incidental finding of this study was that in cases where the medication cap was not properly closed, most children were able to quickly open the container without difficulty.ConclusionThis study shows that the almost all children 7 years and younger were unable to open a childproof medication bottle in 2 minutes, however real-life data shows the majority of paracetamol and ibuprofen poisonings occur in children under 10 years old. Parents of young children often overestimate how safe ‘childproof’ medication containers are and underestimate what a child can do in a brief unsupervised period. Public awareness needs to be increased of the importance of proper closing and the safe storage of ‘childproof’ medications in order to minimize the risk of accidental poisoning.
Li et al used an observational target trial emulation analysis to investigate whether attention-deficit/hyperactivity disorder (ADHD) medication, continuously prescribed over the 2 years following ...initial diagnosis, was associated with reduced mortality rates compared with those who were not treated with ADHD medication during the same period. This Swedish register study boasts numerous strengths, including a large, well-powered sample (N=148 578) across a broad age range (6-64 years), who received an ADHD diagnosis between 2007 and 2018 following a thorough neuropsychiatric evaluation. This study used electronic health records (EHRs) data in a way that approximates a randomized clinical trial (RCT) to assess mortality rates by ADHD medication status over time. Individuals consistently treated with ADHD medication were compared with those who did not receive ADHD medication on 3 outcomes over a 2-year follow-up period: all-cause mortality, natural-cause mortality (eg, medical conditions), and unnatural-cause mortality (eg, accidental injuries, accidental poisoning, and suicide). Overall, those who initiated ADHD medication had a reduced risk for all-cause mortality and unnatural-cause mortality (but not natural-cause mortality) over the 2-year period, except for females, in whom only a reduction in natural-cause mortality was observed.
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