北海市急性中毒过程的特点分析

目的探讨北海市急性中毒过程的特点。方法采用流行病学调查方法,调查了市、县、乡10个三级医疗单位2005-01~2012-12的2 127例急性中毒住院患者,并对相关资料进行分类分析。结果在2 127例中毒患者中,中毒地点以发生在家里、学校、工作场地、餐馆、娱乐场所与其他场地的病例数各占86.63%、0.24%、5.37%、3.25%、1.46%、3.06%;中毒途径以经口、呼吸、皮肤中毒病例数各占68.47%、19.01%、12.52%;中毒原因以意外性、自杀性、误食性、医疗性、职业性、他杀性、其他原因中毒的病例数各占36.05%、25.65%、15.20%、7.06%、2.45%、0.24%、13.35%。其中以家里、经口、意外性与自杀性中毒为中毒过程的4个主要特点。进一步分析这4个特点的中毒原因与毒物,其中家里中毒的主要原因与毒物为意外性与农药类中毒病例数最多,各占同类病例数的33.33%、29.18%;经口中毒的主要原因与毒物为自杀性与农药类中毒病例数最多,各占同类病例数的36.70%、31.99%;进一步分析意外性与自杀性中毒的主要毒物,以化学类与农药类毒物中毒病例数为多(各占同类原因总病例数的44.39%、68.62%)。结论北海地区以家里中毒、经口中毒与意外、自杀性原因中毒为急性中毒过程的突出特点,应针对这些特点采取针对性地防控对策。     

广西2005～2009年急性中毒6011例流行病学调查分析

目的 研究分析广西近年来急性中毒的基本情况.方法 采用回顾性流行病学调查方法,对广西63家医院从2005～2009年期间收治的6 011例各类急性中毒病例进行分析.结果 中毒人群特征分析显示女性病例占53.11%,男性占46.89%,以20～60岁年龄段(68.84%)居住在农村者为多(61.02%).前三位的中毒原因为意外性占39.42%、自杀性占31.41%、误食性占21.57%;毒物经口进入体内引起的中毒占70.89%、经呼吸道者占20.70%、经皮肤接触者占10.48%,且以散发病例为主(89.32%);中毒环境与年度分析表明,发生在家里者占79.53%.2009年中毒病例数比2005年增加了54.00%,每年平均递增13.50%.结论 广西急性中毒的基本情况与国内报道相似,但亦有广西某些突出特点,且每年递增较明显,值得进一步研究.     

2328例急性中毒患者中毒特征分析

目的分析急性中毒人群年龄、性别分布特征、毒物种类、性质以及中毒原因,为减少急性中毒事件的发生,制定防控措施提供参考依据。方法对广西玉林市6家县级以上综合医院收治的急性中毒患者2 328例的临床资料进行回顾性分析。结果在2 328例急性中毒患者中,男女比例接近(1.02∶1),20以下岁年龄段中毒所占比例最高(32.52%);60岁以上年龄段所占比例最低(11.25%),中毒人群主要集中在60岁以下年龄段(88.76%)。不同年龄段人群急性中毒6种原因所占比例各不相同,差异均有统计学意义(P0.01)。不同年龄段人群急性中毒毒物所占比例,除动物类毒物外,其余5类毒物比较,差异均有统计学意义(P0.01)。结论急性中毒人群以具有劳动能力的成年人为主,男女比例接近,中毒毒物以农药类与化学类毒物为主,中毒原因以意外中毒与自杀性中毒为主。加强人们的自我防范意识,对特殊人群如农村中青年女性等进行必要的心理疏导,可减少急性中毒事件的发生。     

广西2005～2009年引起急性中毒的相关毒物调查分析

目的 研究广西引起急性中毒的毒物分类及其特点.方法 对6 005例中毒病例采用四级毒物分类法结合中毒病例分布分析法进行统计分析.结果 引起6 005例中毒病例的毒物达532种,其中17种主要毒物引起的中毒病例数占总中毒病例数的62.38%,而另515种毒物引起的中毒病例数仅占总中毒病例数的37.62%;将这些毒物分为4个源类、10个性类,能大体上将调查中发现的毒物进行归类,并反映出各种急性中毒毒物的主要特点.结论 广西的毒物种类较多,但由此引起的中毒病例分布具有相对集中性,有必要进一步研究这些毒物分布的影响因素与变化规律.     

2011─2013年甘肃省食源性疾病暴发事件分析

目的分析2011─2013年甘肃省食源性疾病暴发事件发生的规律和流行特点,减少食源性疾病暴发事件的发生。方法对2011─2013年甘肃省食源性疾病暴发报告系统中所报告的食源性疾病暴发事件资料进行描述流行病学分析。结果甘肃省共报告食源性暴发事件81起,发病1 089例,死亡17例,病死率1.56%;报告事件多发生在第二、三季度,其中5月最多;中毒场所以家庭最多,占总报告起数的55.55%;微生物引起的食物中毒事件报告起数和发病人数均最多,分别占总数的45.68%和69.51%;化学性食物中毒引起的死亡人数最多,占总死亡人数的94.12%。结论甘肃省食源性疾病暴发事件的发生以细菌性为主,引起死亡的主要原因是误食农药、鼠药污染的食品;建议加强食源性疾病的健康教育及农药、鼠药的监管。     

2010—2022年重庆市食物中毒突发公共卫生事件流行特征分析

目的 了解重庆市食物中毒突发公共卫生事件的发生规律和特点,为有效应对和科学防控提供依据。方法在中国疾病预防控制信息系统突发公共卫生事件报告管理信息系统中,收集报告时间为2010年1月至2022年12月的重庆市食物中毒突发公共卫生事件的相关信息,对发生时间、场所、致病因素等流行病学特征进行描述性分析。结果 2010—2022年重庆市共报告食物中毒突发公共卫生事件116起,中毒人数3 415例,死亡22例。细菌性食物中毒事件数和中毒人数最多,分别为59起（占50.86%）和2 494例（占73.03%）。细菌性食物中毒事件的致病菌以副溶血性弧菌和沙门菌为主,这两种致病菌引起食物中毒的事件数和中毒人数为41起和1 720例,占细菌性食物中毒的69.49%和68.97%。真菌性食物中毒死亡人数最多,为10例（占45.45%）,均为误食毒蕈引起。事件高峰为5月和9月,共报告事件40起（占34.48%）、中毒人数1 378例（占40.35%）。报告事件数前三位的区（县）分别为九龙坡区（13起）、长寿区（12起）、黔江区（8起）。农村地区报告食物中毒事件68起（占58.62%）,中毒人数为1 831...     

2011-2018年甘肃省家庭内食源性疾病暴发事件分析

目的分析2011—2018年甘肃省家庭内食源性疾病暴发事件发生规律和流行特点。方法收集2011—2018年甘肃省食源性疾病暴发事件报告系统中报告的家庭内食源性疾病暴发事件资料,并开展描述流行病学分析。结果2011—2018年全省共报告家庭内食源性疾病事件250起,中毒病人887例,死亡22例,病死率2.48%;报告事件多发生在第三季度、占总报告起数的49.60%,误食毒蘑菇引发家庭内中毒事件起数最多、占总报告起数的24.80%,农药/鼠药引起的死亡数最多、占总死亡人数的45.45%。结论应加强由毒蘑菇和有机磷农药等主要致病因素引发的家庭内食源性疾病暴发事件的防控力度,以减少事件的发生和死亡。     

二巯基丙磷酸钠解救急性四亚甲基二砜四胺中毒的体会

四亚甲基二砜四胺 (毒鼠强 )为剧毒杀鼠剂 ,在我国 ,它的生产性和生活性急性中毒病例迄至 90年代仍屡见报道。但至今尚未有特效解毒剂 ,临床上除进行常规救治外 ,一般均采用安定进行对症治疗 ,虽有一定程度的疗效 ,但对重度中毒患者的解救效果难以令人满意。本院 2年半中应用二巯基丙磺酸钠 (Ｎａ ＤＭＰＳ) ,成功地救治了 13例重度急性毒鼠强中毒 (ＡＴＩ) ,报道如下。资料与方法一般资料　治疗组 :13例 (男 5,女 8) ,年龄 5～63岁 ,中毒途径均为口服 ,误食 8例 ,自杀 5例 ;进食毒物后就诊时间 :11例 <1ｈ ,2例约 2ｈ。对照组 :8例 (男 5,…     

急性有机磷农药中毒致迟发周围神经病变36例分析

我院1977～1986年共收治急性有机磷农药中毒患者724例,其中发生迟发周围神经病变36例,占急性中毒病例的5%。现就其临床资料作一分析。临床资料一、诊断依据: (1) 有确切的有机磷急性中毒史,包括具有毒蕈     

2014—2021年白银市生产性农药中毒流行病学分析

目的 探讨2014—2021年甘肃省白银市生产性农药中毒的流行病学特征，为减少和控制农药中毒提供科学依据。方法 通过职业病及健康危害因素监测信息系统，收集2014—2021年白银市生产性农药中毒病例数据，描述性分析病例资料。结果 2014—2021年白银市共报告生产性农药中毒171例，年均发病率为11.3/10万；死亡5例、死亡率为2.92%；其中生产性自用中毒161例，死亡5例、死亡率为3.11%，生产性受雇中毒10例，无死亡者；中毒以男性为主，主要分布在40岁～组和50岁～组2个年龄组、占病例总数的57.90%；死亡均为女性，以50岁及以上者为多；每年的第三季度是中毒高峰季节，靖远县最多占63.16%；中毒大多因杀虫剂所致（89例、占52.05%）。结论 白银市生产性农药中毒时有发生，具有季节性和区域性，应加强生产性农药使用的培训和宣传，积极采取综合防治措施减少农药中毒的发生。     

Suicide in young men

Suicide is second to only accidental death as the leading cause of mortality in young men across the world. Although suicide rates for young men have fallen in some high-income and middle-income countries since the 1990s, wider mortality measures indicate that rates remain high in specific regions, ethnic groups, and socioeconomic groups within those nations where rates have fallen, and that young men account for a substantial proportion of the economic cost of suicide. High-lethality methods of suicide are preferred by young men: hanging and firearms in high-income countries, pesticide poisoning in the Indian subcontinent, and charcoal-burning in east Asia. Risk factors for young men include psychiatric illness, substance misuse, lower socioeconomic status, rural residence, and single marital status. Population-level factors include unemployment, social deprivation, and media reporting of suicide. Few interventions to reduce suicides in young men have been assessed. Efforts to change help-seeking behaviour and to restrict access to frequently used methods hold the most promise.     

2016—2020年深圳市龙岗区院前死亡病例特征分析

目的 对院前死亡病例进行分析,为深圳市龙岗区死因监测管理及疾病防控工作提供依据.方法 收集2016—2020年龙岗区院前死亡病例的资料,比对全国人口死亡信息登记管理系统和深圳市殡仪馆死亡数据,对院前死亡病例的构成及死因进行分析.结果 2016—2020年深圳市龙岗区院前死亡病例共报告3887例,月报告数相对平稳,部分病...     

Accidental paraffin poisoning in Kenyan children

A serious and common accident in rural Kenyan homesteads is accidental ingestion of paraffin when it has been mistaken for water and offered to a young child. Here we report the incidence, parental practices and outcome of severe paraffin poisoning, requiring admission at Kilifi District Hospital, Kenya. Over a 2-year period, 48 children (0.5% of all admissions) were admitted with kerosene poisoning, constituting 62% of all poisoning cases. All cases were accidental. Ten per cent had induced vomiting. One child (2%) died. We suggest these data support assessment followed by implementation of practical and affordable measures to prevent paraffin poisoning.     

Acute fatal DDS poisoning. (Report of 4 cases).

Acute dapsone poisoning is rare and such cases are either accidental or suicidal. Though accidental DDS poisoning are reported in children, the same is fairly uncommon in adults. Only 2 such cases are reported in India literature. We here report 4 cases of fatal sucidial DDS poisoning in adults resulting death in 3 cases. The reported acute symptoms include nausea, vomiting, hyperexcitability followed by depression, Carpopedal spasm or convulsions. The most marked signs are dyspnoea and cyanosis. The symptoms are due to methaemoglobinaemia, and or sulphaemoglobinaemia. Normally dapsone induces red cell haemolysis and even with small therapeutic doses of 25-100 mg per day, and in toxic doses reduces the oxygen carrying capacity of blood and damages the red cells making them more vulnerable for haemolysis. The peculiarity of the presentation in this series are manifestation of severe haemorrhagic episode in one case and progressive jaundice in another besides cyanosis. None of the cases had carpopedal spasm or convulsion. Out of four cases three died inspite of intensive care, intravenous vitamin C, exchange transfusion (2 cases) and other supportive measures. Intravenous methylene blue could not be used in these cases due to non-availability.     

389例风湿性心脏瓣膜替换术后远期疗效观察

目的 :分析风湿性心脏病瓣膜置换术后远期疗效及其影响因素。方法 :1980年至 2 0 0 0年施行心脏瓣膜置换 4 33例 ,早期死亡 2 7例。术后获访 389例 ,获访时间为 2 16 8病人年 ,平均 5 92病人年。结果 :晚期死亡 35例。晚期死亡率为 1 6 1%病人年。机械瓣和生物瓣晚期死亡率分别为 1 17%和6 10 %病人年 ,15年生存率分别为 89 3%和 4 3 1%。结论 :影响心脏瓣膜置换晚期疗效的主要因素为术前心功、年龄和心房纤颤。机械瓣置换术后晚期死亡原因主要与抗凝有关并发症、心室纤颤、细菌性心内膜炎和心衰有关 ,而生物瓣膜置换术后死亡原因则为生物瓣衰败     

Concomitant drugs of misuse and drug using behaviours associated with fatal opiate-related poisonings in Sheffield,UK, 1997-2000

Aims To examine the degree of involvement of concomitant drugs of misuse and other previously identified behavioural risk factors in acute accidental opiate‐related poisoning fatalities in Sheffield, 1997–2000. Design Retrospective analysis of coroners’ records. Setting Sheffield, UK. Participants All those who died from an acute accidental opiate‐related poisoning in Sheffield between 1 January 1997 and 31 December 2000. Measurements Coronial data were collated under the headings: demographic characteristics, circumstances of death and toxicological findings. Findings Ninety‐four deaths occurred over the study period. The majority of cases were regular users of illicit drugs. Approximately 20% of deaths were preceded by a period of abstinence from drug use, with imprisonment and hospitalization as the most common reasons. Sixty‐one per cent of cases had concomitant drugs of misuse detected from toxicology most commonly benzodiazepines and/or alcohol. These were, however, found in relatively small concentrations and opiate blood concentrations were no lower in deaths where multiple substances were involved. Despite evidence to suggest that smoking is the preferred route of heroin administration in this region, the vast majority of cases involved injecting. Conclusions Administration of an opiate via intravenous injection was the most consistent factor associated with these deaths over the period of this study. Co‐administration of other central nervous system depressants, at least in lower quantities appear to be a feature rather than a risk factor per se in such fatalities.     

An ongoing Confidential Enquiry into asthma deaths in the Eastern Region of the UK, 2001-2003.

INTRODUCTION: The Eastern Region Confidential Enquiry into asthma deaths started in 2001. It incorporates the Norwich and East Anglian Enquiries started in 1988 and 1992, respectively. The aim of this study was to analyse all asthma deaths in the Eastern region between 2001 and 2003, to elicit any factors contributing to the patients' deaths, and to make comparisons with the previous Norwich and East Anglian data. METHOD: Patient details were obtained for all deaths in the Eastern Region under the age of 65 with asthma recorded in the first part of the death certificate. Patients' notes were reviewed by members of the Working Group - a consultant chest physician and a general practitioner (GP). In most cases, the patient's GP was contacted. Data were obtained on the patients' asthma care, asthma severity, terminal attack, psychosocial and behavioural factors, allergies, precipitating factors, and post-mortem findings. The quality of medical care was assessed and compared with national guidelines. RESULTS: Total study population was 5.25 million. Only 57/95 notified deaths (60%) were confirmed as asthma deaths. 311 asthma deaths have been studied between 1988 and 2003. In 2001-2003, male:female ratio was 3:2. Further data were unavailable on three cases. 53% of patients had severe asthma and 21% moderately severe disease. In 19 cases (33%) at least one significant co-morbid disease was present. Monthly death rates peaked in August, with a smaller peak in April. In 11 cases (20%), mostly males aged under 20, the final attack was sudden and 10/11 occurred between April and August. In 81% of cases there were significant behavioural and/or psychosocial factors such as poor compliance (61%), smoking (46%), denial (37%), depression (20%) and alcohol abuse (20%). The overall medical care of the patient was appropriate in 33% of cases. CONCLUSIONS: Between 1988 and 2003 there was a downward trend in asthma mortality rate in East Anglia. In 2001-2003, misclassification of deaths attributed to asthma was still common. Most patients who die of asthma have severe asthma. In 81% of cases, behavioural and psychosocial factors contributed to the patient's death. In 80% of deaths the final attack was not sudden, and may have been preventable. Almost all sudden deaths occurred between April and August, suggesting a seasonal allergic cause. In two-thirds of asthma deaths, medical management failed to comply with national guidelines. 'At-risk' asthma registers in primary care may improve recognition and management of 'at-risk' patients.     

Carbon monoxide poisoning – Asix year reviewat University Hospital Dubrava

Aim

Carbon monoxide (CO) poisoning is a common cause of population morbidity and mortality in Croatia and worldwide. Here we offer our experience.

Methods

During the period 2000–2006, 20 patients were admitted to the hospital for suspected CO poisoning; consequently carboxyhemoglobin (COHb) levels were measured. According to clinical manifestations, patients were described as having a mild, moderate, or severe intoxication level. Complications, treatment and outcome were analyzed.

Results

All intoxications were accidental; 18 of them occurred in winter months. Most represented were females (14 cases), age groups 20–30 and older than 60 yrs. Moderate levels (9 patients) having a COHb median of 18.5% (30–38) and mild levels (8 patients) with a COHb median of 24.6% (19.5–31) dominated. The most common symptoms and complications were the central nervous (20 cases), cardiovascular (8 cases), respiratory (7 cases) and gastrointestinal systems (7 cases). Only one female patient developed MOF syndrome. All patients were given 100% oxygen, 2 were mechanically ventilated, and 2 underwent hyperbaric oxygen therapy. Length of ICU treatment was 2.3 days for mild, 3.1 days for moderate, and 12.7 days for severe poisoning (p = 0.05). Only one patient died, the others were discharged in good condition.

Conclusion

CO poisoning, if detected early and the patient is supplied with oxygen, has good prognosis. Nonetheless, prevention is even more important, considering the high prevalence of accidental intoxications.     

2009年新疆监测县居民死因监测分析

目的掌握新疆监测县居民健康状况,确定严重影响居民健康的主要疾病,为政府部门制定卫生保健决策提供科学依据。方法分析新疆监测县2009年户籍居民死亡报告资料,以ICD-10进行死因分类;使用DeathReg2005和EpiInfo2002软件进行数据整理和统计分析。结果 2009年新疆监测县总死亡率485.33/10万,男性高于女性。慢性病死亡所占比例最高,达73.77%,伤害死亡占8.99%;按照死因构成比排序,前5位死因分别为心脏病、脑血管病、慢性下呼吸道疾病、恶性肿瘤和伤害。脑血管病、急性心肌梗死、其他冠心病、肺心病及高血压性心脏病是循环系统疾病主要死因;胃癌、食管癌、肺癌、肝癌是恶性肿瘤的主要死因;交通事故、溺水、自杀、意外中毒、意外跌落是意外伤害的主要死因。结论慢性非传染性疾病在总死亡中的比例最高,是危害新疆监测县居民健康的主要死因;心脑血管病发病和死亡高于往年,消化道恶性肿瘤依然比较严重,机动车辆交通事故是危害新疆监测县青壮年健康的主要危险因素,今后应加大新疆慢性非传染性疾病及伤害的防治力度。