No abstract

1 A 12 week prospective survey of all patients of any age with confirmed or suspected poisoning presenting to six accident and emergency departments in the North East of England was performed to establish the local incidence and patterns of presentation of poisoning. 2 945 episodes of poisoning involving 852 patients were recorded representing approximately 1.2% of all A&E presentations and suggesting an annual attendance rate of 2.7 per 1000 persons per year. 3 Attendance rates varied threefold between hospitals and were similar in males and females overall; between the ages of five and 14 attendances were more common in females (1.9 vs 0.6/103/y) while between 0 and 4 y (3.1 vs 2.4) and 25 and 34 y (3.9 vs 2.9/103/y) they were more common in males. 4 The median interval between poisoning and presenta tion was 2 h (mean 4.1 h) and only 19% of cases presented within 1 h. Presentation was most common between Friday evening and Tuesday morning and in the late afternoon and evening. 5 6% of the patients presented more than once with poisoning during the study period and 37% had a past history of deliberate self-harm. The most common poisons involved were paracetamol (43%), opioids (15%) and benzodiazepines (15%). 6 The study illustrates the frequency of presentations of poisoning to A&E departments. The high rate of poisoning in young men and the increasing use of paracetamol are particular causes for concern.

Total US suicides peak on the first day of each week, in the first week of each month, and in the late spring of each year. Although these cycles are assumed to characterize all US suicides, analyses by age and sex show that the cycles occur only in a few subpopulations. Day-of-the-week effects are found almost exclusively in middle-aged suicides; day-of-the-month effects are found almost exclusively in elderly male suicides; and month-of-the-year effects asre found almost exclusively in teenaged and elderly suicides.

Officals, media coverage and prevention programs have assumed that fathers of infants born to US school-age (10-18 years old) mothers are school-age peers. This study analyzes fathers' ages in 46 500 California births to school-age mothers in 1993, for which 85% of the fathers' ages were stated and whose distribution is similar to that of less complete national samples. Adult, postschool men father two thirds of the infants born to school-age mothers and average 4.2 years older than the senior-high mothers and 6.7 years older than the junior-high mothers. The extensive involvement of adult males in both school-age motherhood and its precursors represents a significant, undiscussed factor deserving greater attention.

1 Poisoning is a common reason for presentation to hospital and hospital admission but there is no agreed policy for managing these patients. This study exam ined the management of patients presenting with poisoning and the factors affecting the probability of hospital admission and prolonged stay. 2 Data on all cases of poisoning presenting to six Accident and Emergency departments in the North East of England over 12 weeks in 1994 was collected prospectively from A&E notes. Length of stay and outcome were recorded from hospital computer records. 3 Overall, 73% of patients were admitted to a medical ward. Probability of admission was not independently affected by age or gender but was increased in those with intentional poisoning (Odds Ratio (OR) 3.3 [95% CI 1.8, 6.1]), a history of self harm (OR 1.7, [1.0, 2.9]) or potentially hazardous poisoning (OR 3.7 [2.1, 6.6]). There were significant variations between hospitals (50 - 80%) which could not be attributed to case mix. 4 Prolonged stay ( > 2 nights) was more common in patients over 65 years (OR 6.8 [2.9, 16.1]), those with intentional poisoning (OR 2.7 [1.1, 6.6]) and those with potentially hazardous poisoning (OR 2.6 [1.4, 4.9]). Mean hospital stay was 1.5 days and varied signifi cantly between hospitals from 0.8 to 2.1 days and this was independent of case mix. 5 There are appreciable variations in the management of poisoning between hospitals which are not explained by patient characteristics. Savings would occur if rates of admission and duration of stay were reduced by those hospitals where admission is more frequent or hospital stay is longer. However, the impact of this on long term morbidity is unknown.