The exposure of the pediatric population to xenobiotics is an important public health problem because children are particularly vulnerable to the unfavorable consequences of intoxications due to their age-related peculiarities, having limited physiological reserves, and poorly developed metabolic pathways. Numerous studies emphasize the importance of targeted therapeutic intervention and as soon as possible in patients with severe acute intoxications that associate signs of cardiogenic shock due to the severity of cases and the risk of adverse evolution. This paper presents a statistical analysis of the time-lapse impact between exposure to the toxicant and the toxicological examination on the patient's prognosis. Its purpose is to identify both qualitative and quantitative correlations between a series of parameters associated with unfavorable evolution and the time elapsed until the specific toxicological management is performed.
Aspiraţia de corpi străini în arborele traheobronşic reprezintă o urgenţ ă diagnostică şi terapeutică în practica specialiştilor pediatri şi ORL-işti. Întârzierea diagnosticului şi, implicit, a extragerii bronhoscopice a corpului străin poate conduce la o serie de complicaţii, unele chiar cu prognostic vital. În lucrarea de faţă, autorii prezintă din experienţa personală două cazuri pediatrice de corpi străini traheobronşici diagnosticaţi şi trataţi la intervale diferite de timp faţă de momentul aspiraţiei.
Tracheobronchial foreign body aspiration in children represents a diagnostic and therapeutic emergency in the practice of pediatricians and ENT specialists. Delaying the diagnostic and, implicitly, the bronchoscopic extraction of the foreign body can lead to complications, some even with vital prognosis. In this paper, the authors present from their personal experience two pediatric cases of tracheobronchial foreign bodies diagnosed and treated at different time intervals after the moment of aspiration.
Baclofen is a structural analogue of gamma-aminobutyric acid with central myorelaxant effect. Ingestion of a toxic dose of baclofen induces a clinical presentation with neurological, cardiac, respiratory and metabolic expression, sometimes life-threatening. The authors present the case of a 17-year old teenage girl who developed deep coma, sinus bradycardia, fi rst-degree atrioventricular block, arterial hypertension and hyperglycemia after ingesting a large dose of baclofen. The patient was successfully treated with supportive measures. Early diagnosis and prompt therapeutic intervention are key-steps in the management of acute baclofen poisoning.
Introduction. Exposure to various cardiovascular and non-cardiovascular drugs, drugs of abuse, chemicals and plants may cause secondary hypertension. The authors report their personal experience related to secondary hypertension due to acute poisoning in children and adolescents. Materials and methods. We conducted a 24 month prospective study that included 151 children and adolescents with acute poisoning who developed cardiovascular abnormalities. In order to detect cases of secondary hypertension, vital signs were assessed on admission and in evolution, considering the normal values by age. Results. 11.1% of all cases with acute poisoning admitted and treated in our department have associated cardiovascular impairment. Of these, 18.5% were cases of secondary hypertension. The main cause of hypertension in the study group was exposure to organophosphate insecticides, followed by exposure to sympathomimetic drugs. We noticed a dual effect exerted by organophosphate insecticides. At the beginning patients experienced a short period of tachycardia and hypertension, followed by the installation of the classic cholinergic feature of acute poisoning with organophosphate insecticides, with bradycardia and / or hypotension. All cases of hypertension were transient, self-limiting elevations of blood pressure, which did not require association of antihypertensive agents in the therapeutic approach. Conclusion. In children and adolescents, acute poisoning may be complicated by hypertension, which is mostly mild and transient. Vital signs monitoring is essential to address these cases. Medical staff must know thoroughly age peculiarities, including reference ranges for blood pressure in children and adolescents.
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