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Decontamination in Children

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541. Cardiotoxicity associated with accidental bupropion ingestion in a child. (PubMed)

Cardiotoxicity associated with accidental bupropion ingestion in a child. Bupropion, an atypical antidepressant commonly used for depression and smoking cessation, is well known to cause seizures in both therapeutic use and overdose, but cardiac effects have been reported as minimal, usually sinus tachycardia. We describe an ingestion of bupropion estimated to be greater than 2 g by a 3-year-old boy that resulted in seizures. The child was decontaminated with whole bowel irrigation (WBI (...) ), and he experienced aspiration of polyethylene glycol and electrolyte solution used for the WBI. The patient ultimately developed hypotension and bradycardia requiring cardiopulmonary resuscitation due to the effects of the bupropion combined with the complications of WBI. In contrast to previous literature, which showed few clinical effects aside from seizures from ingestion of bupropion by children, our case highlights the dangers of pediatric bupropion ingestion and highlights risks of WBI.

2007 Pediatric Emergency Care

542. Emergency visits for childhood poisoning: a 2-year prospective multicenter survey in Spain. (PubMed)

Emergency visits for childhood poisoning: a 2-year prospective multicenter survey in Spain. To describe the characteristics of childhood poisoning leading to consultation to 17 pediatric emergency departments in Spain.During a 2-year period (January 2001 to December 2002), accompanying people of 2157 children with acute intoxication who visited consecutively at the emergency room were prospectively surveyed.Childhood poisoning accounted for 0.28% of all emergency visits during the study period (...) . The median (interquartile range, 25th-75th percentile) age was 24 months (22-60 months); 67% of children were younger than 4 years. Drug ingestion was involved in 54.7% of cases (paracetamol was the most frequent drug), domestic products in 28.9%, alcohol in 5.9%, carbon monoxide in 4.5%, and illicit drugs in 1.5%. A total of 61.3% of patients were admitted within 1 hour after exposure to the toxic substance, and 10.3% had been already treated before arrival; 29.1% of patients were referred for clinical

2006 Pediatric Emergency Care

543. Are 1 or 2 dangerous? Clozapine and olanzapine exposure in toddlers. (PubMed)

manifestations. We review here the available reported clinical experience with toxic doses of these medications that in small children may amount to as little as a single tablet. Although such doses may be lethal, supportive care and gastrointestinal decontamination in this population will generally lead to a good outcome. (...) of Poison Control Centers Toxic Exposure Surveillance System included a separate subcategory for atypical antipsychotics under the heading of sedatives/hypnotics/antipsychotics. The toxidrome resulting from these drugs is predominately central nervous system depression and anticholinergic effects. Although the desirable lack of extrapyramidal symptoms in adults results in their greatest clinical utility, several reports of toxic ingestions in small children are noteworthy for having extrapyramidal

2004 Journal of Emergency Medicine

544. Hospital disaster preparedness in Los Angeles County. (PubMed)

of hospital disaster plan structure, vendor agreements, modes of communication, medical and surgical supplies, involvement of law enforcement, mutual aid agreements with other facilities, drills and training, surge capacity (assessed by monthly emergency department diversion status, available beds, ventilators, and isolation rooms), decontamination capability, and pharmaceutical stockpiles were assessed by survey.Forty-three of 45 hospital plans (96%) were based on the Hospital Emergency Incident Command (...) System, and the majority had protocols for hospital lockdown (100%), canceling elective surgeries (93%), early discharge (98%), day care for children of staff (88%), designating victim overflow areas (96%), and predisaster "preferred" vendor agreements (96%). All had emergency medical services-compatible radios and more than three days' worth of supplies. Fewer hospitals involved law enforcement (56%) or had mutual aid agreements with other hospitals (20%) or long-term care facilities (7%). Although

2006 Academic Emergency Medicine

545. Pattern of dipyrone exposure in Texas, 1998 to 2004 (PubMed)

to the Mexican border (53% vs 9%). Of 81 dipyrone exposures, 52 (64%) were isolated and 29 (36%) were non-isolated. Most of the dipyrone exposures occurred at the patient's own residence (72/76 or 95%) and the patients were more likely to be female (54/81 or 67%). Although the majority of both types of dipyrone exposures were adults (47/78 or 60%), children, less than 6 years of age, accounted for a higher proportion of isolated exposures (33% vs 10%) while a higher proportion of non-isolated exposures (...) involved older children (28% vs 8%). Twenty-two percent (11/51) of isolated cases were intentional while 59% (17/29) of non-isolated cases were intentional. Of those cases with a known medical outcome, the medical outcome was no adverse clinical effect for 76% (16/21) of isolated exposures and 42% (8/19) of non-isolated exposures. The specific adverse clinical effects reported for isolated exposures were primarily neurological (n = 6), gastrointestinal (n = 4), and dermal (n = 3). The most frequently

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2006 Journal of Medical Toxicology

546. Reducing the health impact of infectious agents: the significance of preventive strategies (PubMed)

losing all that we accomplished during the last decades. After all, over the past 40 years we witnessed progress in the development of reliable and affordable anti-infectives and vaccines. As a result of this, today parents have their children vaccinated less often since they are no longer aware of the risks posed by lack of vaccination. This will give rise to the sudden reemergence of certain infectious diseases. And we overlook the fact that by observing basic rules of hygiene (hand hygiene; water (...) decontamination; etc), we could save many lives on this earth. It is becoming increasingly more difficult to treat with antibiotics patients harboring resistant bacterial strains on their skin. Hospitals need surface disinfection to prevent microbes such as Clostridiium difficile or norovirus. The institutional use of alcohol-based hand disinfectants has by now become an accepted practice in North America. But some of these substances have dangerous side effects where humans and the environment are concerned

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2007 GMS Krankenhaushygiene Interdisziplinar

547. Pediatric "body packing". (PubMed)

Pediatric "body packing". Recent events in the United States have led to increased security at national borders, resulting in an unexpected increase in drug seizures. In response, drug smugglers may begin using children as couriers, including using them as "body packers."To look at the occurrence of body packing, the concealing of contraband within the human body, which is well documented in adults, in the pediatric literature.Two cases of pediatric body packing, in boys aged 16 years and 12 (...) years. Patient 1, a 16-year-old boy, presented with findings consistent with opioid intoxication after arriving in the United States on a transcontinental flight. His mental status improved after he received naloxone hydrochloride, and he subsequently confessed to body packing heroin. He was treated with a naloxone infusion and aggressive gastrointestinal decontamination. He ultimately passed 53 packets of heroin, one of which had ruptured. He recovered uneventfully. Patient 2, a 12-year-old boy

2003 Archives of Pediatrics & Adolescent Medicine

548. Following more than a dozen cases of viral gastroenteritis in the practice, I wondered whether there was any evidence on the risks of cross infection via toys in GP waiting rooms?

gastroenteritis in the practice, I wondered whether there was any evidence on the risks of cross infection via toys in GP waiting rooms? We found a small number of studies that made a link between cross infection and toys, although the link was not made specifically to viral gastroenteritis. A 2002 paper that appeared in the British Journal of General Practice (1) states "The waiting rooms of general practitioners' surgeries usually have toys provided for children. The level of contamination of these toys (...) and the effectiveness of toy decontamination was investigated in this study. Hard toys from general practitioners' waiting rooms had relatively low levels of contamination, with only 13.5% of toys showing any coliform counts. There were no hard toys with heavy contamination by coliforms or other bacteria. Soft toys were far more likely to be contaminated, with 20% of toys showing moderate to heavy coliform contamination and 90% showing moderate to heavy bacterial contamination. Many waiting-room toys

2002 TRIP Answers

549. Presentation and outcome of severe anticholinesterase insecticide poisoning (PubMed)

features, route of exposure, treatment, complications, and mortality were recorded. Data were analysed by the Fisher's exact and Mann-Whitney tests.More children than expected were from a rural area (46% versus 25%). Decontamination occurred in 50% of children prior to PICU admission. Enteral exposure was most common (n = 27; 50%). Median pseudocholinesterase level was 185 IU/l (range 75-7404). Median total dose of atropine required to maintain mydriasis was 0.3 mg/kg (range 0.03-16.7) over a median (...) of 10 hours (range 1-160). Complications included coma (31%), seizures (30%), shock (9%), arrhythmias (9%), and respiratory failure requiring ventilation (35%). No significant differences were detected in incidence of seizures, cardiac arrhythmias, respiratory failure, mortality, duration of ventilation, or PICU stay, according to route of exposure, or state of decontamination. Four children died (7%). Mortality was associated with the presence of a cardiac arrhythmia (likelihood ratio 8.3

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2002 Archives of Disease in Childhood

550. Toys are a potential source of cross-infection in general practitioners' waiting rooms. (PubMed)

Toys are a potential source of cross-infection in general practitioners' waiting rooms. The waiting rooms of general practitioners' surgeries usually have toys provided for children. The level of contamination of these toys and the effectiveness of toy decontamination was investigated in this study. Hard toys from general practitioners' waiting rooms had relatively low levels of contamination, with only 13.5% of toys showing any coliform counts. There were no hard toys with heavy contamination

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2002 The British Journal of General Practice

551. Prophylactic co-trimoxazole and lactobacilli preparation in neutropenic patients. (PubMed)

Prophylactic co-trimoxazole and lactobacilli preparation in neutropenic patients. A randomized study of intestinal decontamination was undertaken in 68 children with leukemia and solid tumours. Framycetin, colymycin, nystatin, and metronidazole were given in 35 neutropenic episodes in 33 children, while co-trimoxazole and lactobacilli preparation were administered in 35 episodes in 35 children. The diseases, severity of neutropenia, and incidence of infection at entry into study were comparable

1980 Medical and pediatric oncology Controlled trial quality: uncertain

552. Pediatric ingestions: charcoal alone versus ipecac and charcoal. (PubMed)

Pediatric ingestions: charcoal alone versus ipecac and charcoal. To determine the effect of syrup of ipecac (SOI) on time to receive and retention of activated charcoal (AC) and on total ED time.During a two-year period, patients were enrolled in a prospective, randomized, unblinded, controlled trial.All patients were recruited and studied in a pediatric emergency department.Seventy children less than 6 years old (mean age, 2.4 +/- 0.2 years) who presented with mild-to-moderate acute oral (...) ingestions.Group 1 received SOI before AC. Group 2 received only AC.Group 1 patients took significantly longer to receive AC than group 2 from the time of ED arrival (2.6 +/- 0.1 vs 0.9 +/- 0.1 hours, P less than .0001). Group 1 children were significantly more likely to vomit AC than were group 2 children (18 of 32 vs six of 38, P less than .001). Patients receiving SOI who were subsequently discharged spent significantly more time in the ED than those receiving only AC (4.1 +/- 0.2 vs 3.4 +/- 0.2 hours, P

1991 Annals of Emergency Medicine Controlled trial quality: uncertain

553. Vancomycin for controlling contamination of selective Kirchner's liquid medium in the culture of gastric lavage for tubercle bacilli. (PubMed)

Vancomycin for controlling contamination of selective Kirchner's liquid medium in the culture of gastric lavage for tubercle bacilli. Gastric lavage (GL) was collected for culture of tubercle bacilli from children too young to expectorate sputum. The selective Kirchner's liquid medium (SKLM), routinely used as one of the media for culture of all extrapulmonary specimens, was found to often get contaminated when cultured with GL. We have shown that vancomycin at a concentration of 10 mg/l (...) successfully reduced the contamination from about 60 to 20 per cent, and enhanced the isolation rate of tubercle bacilli from 3 to 6 per cent. Decontamination of the liquid culture before subculture on solid medium also helped to reduce the contamination rate. Vancomycin was found to be an effective selective drug for use in the Kirchner's liquid medium for culture of tubercle bacilli.

1995 The Indian journal of medical research Controlled trial quality: uncertain

554. Evaluation of the Efficacy and Safety of Recombinant Human Growth Hormone (rhGH) in the Treatment of Children With Short Bowel Syndrome

Evaluation of the Efficacy and Safety of Recombinant Human Growth Hormone (rhGH) in the Treatment of Children With Short Bowel Syndrome Evaluation of the Efficacy and Safety of Recombinant Human Growth Hormone (rhGH) in the Treatment of Children With Short Bowel Syndrome - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning (...) You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Evaluation of the Efficacy and Safety of Recombinant Human Growth Hormone (rhGH) in the Treatment of Children With Short Bowel Syndrome The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier

2005 Clinical Trials

555. Chemical-biological terrorism and its impact on children. (PubMed)

appeared over the last 5 years, this policy statement provides an update of the 2000 policy statement. The roles of both the pediatrician and public health agencies continue to be emphasized; only a coordinated effort by pediatricians and public health can ensure that the needs of children, including emergency protocols in schools or child care centers, decontamination protocols, and mental health interventions, will be successful. (...) Chemical-biological terrorism and its impact on children. Children remain potential victims of chemical or biological terrorism. In recent years, children have even been specific targets of terrorist acts. Consequently, it is necessary to address the needs that children would face after a terrorist incident. A broad range of public health initiatives have occurred since September 11, 2001. Although the needs of children have been addressed in many of them, in many cases, these initiatives have

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2006 Pediatrics

556. Fluoxetine exposures: are they safe for children? (PubMed)

Fluoxetine exposures: are they safe for children? Although it is generally believed that unintentional ingestions of fluoxetine by children are relatively safe, there are no large published studies supporting this concept. The goal of this retrospective study is to determine the signs and symptoms of these children. Inclusion criteria included fluoxetine exposures from six certified regional poison centers: <6 years old, known amount, single substance, 20 mg or more ingested, and follow up done (...) to determine outcome. One hundred twenty cases met all inclusion criteria. Average age was 25 months +/- 12 months. Median amount ingested was 20 mg. Mild signs and symptoms were noted in 3.3%, and no major signs or symptoms were reported. In 48 cases, a milligram per kilogram dose was calculated, and the median dose ingested was 2.26 mg/kg. In 92% of the cases, the amount ingested was 60 mg or below. These children will have no adverse effects or only minimal effects and require no emergency treatment

2004 American Journal of Emergency Medicine

557. Unintentional Organophosphate Intoxication in Children. (PubMed)

. Treatment included decontamination, administration of antidote, and supportive care. Most patients responded well to treatment, but 2 patients (6.4%) died.The manifestations of OP poisoning in children are different from those of adults. Pediatricians should be aware of these differences because in some cases, a history of OP exposure is not obtained. (...) Unintentional Organophosphate Intoxication in Children. To describe the demographic characteristics, clinical course, and outcome of children with acute organophosphate (OP) poisoning admitted to a regional medical center.The clinical charts of all children admitted to the pediatric wards in Hadassah University Hospital with a diagnosis of acute OP intoxication were reviewed.During the study period (1989-2003), 31 children, mean age 5.6 +/- 3.9 years, presented with manifestations of acute OP

2007 Pediatric Emergency Care

558. Comparison of idarubicin to daunomycin in a randomized multidrug treatment of childhood acute lymphoblastic leukemia at first bone marrow relapse: a report from the Children's Cancer Group. (PubMed)

Comparison of idarubicin to daunomycin in a randomized multidrug treatment of childhood acute lymphoblastic leukemia at first bone marrow relapse: a report from the Children's Cancer Group. The outcome of children with acute lymphoblastic leukemia (ALL) and bone marrow relapse has been unsatisfactory largely because of failure to prevent subsequent leukemia relapses. Ninety-six patients were enrolled and received vincristine, prednisone, L-asparaginase, and an anthracycline as reinduction (...) and intestinal decontamination.

1996 Medical and pediatric oncology Controlled trial quality: uncertain

559. Backyard Mushroom Ingestions: No Gastrointestinal Decontamination-No Effect. (PubMed)

Backyard Mushroom Ingestions: No Gastrointestinal Decontamination-No Effect. Treating the unintentional "backyard" mushroom ingestion continues to be controversial. A review of pediatric "backyard" mushroom ingestions was conducted. A Regional Poison Information Center (RPIC) conducted a retrospective review of all mushroom ingestions in children younger than 6 years of age. Data were extracted from the RPIC electronic record system for the years 2000-2003. All exposures that involved "backyard (...) " mushroom ingestions with no gastrointestinal decontamination were included. There were 322 mushroom exposures in children younger than 6 years of age reviewed. The mean age reported was 2.1 years (SD +/- 1.18). All exposures with a definitive outcome had a 24-h follow-up post-exposure to make this determination. There was no effect in 256 cases (79.5%); minor effect in 6 (1.9%); judged as nontoxic, expect no effect in 20 (6.2%); minimal clinical effects possible in 31 (9.6%); and unrelated effect in 9

2007 Journal of Emergency Medicine

560. Prevention of nosocomial infection in a pediatric intensive care unit (PICU) through the use of selective digestive decontamination. (PubMed)

Prevention of nosocomial infection in a pediatric intensive care unit (PICU) through the use of selective digestive decontamination. To assess the effectiveness of selective digestive decontamination (SDD) on the control of nosocomial infection (NI) in critically ill pediatric patients.A prospective, randomized, non-blinded and controlled clinical microbiology study.The pediatric intensive care unit (PICU) of a tertiary level pediatric university hospital. CRITERIA FOR INCLUSION: Patients 1 (...) and the control group, 110 patients.The treatment group received a triple therapy of colimycin, tobramycin and nystatin administered orally or via nasogastric tube every 6 hours. All patients with mechanical ventilation or immune-depression received decontamination treatment of the oropharyngeal cavity with hexitidine (Oraldine 0.5 mg/ml) every 6-8 hours in accordance with the PICU's conventional protocol.Up to 10 types of nosocomial infection were diagnosed following criteria of the Centers for Disease

1998 European journal of epidemiology Controlled trial quality: uncertain

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