RESUMO
The aim of the study was to evaluate tympanic thermometry when compared with conventional glass-mercury thermometry, in 186 consecutive pediatric patients. In patients of less than 6 years of age (n = 120), there were no differences between tympanic and rectal measurements, in febrile and afebrile ranges, and significantly different when compared with axillary range. Similar data were reported in children of more than than 6 years of age (n = 65), in whom oral temperatures replace the rectal one. Using the tympanic thermometer as the standard measurement device, the accuracy of rectal, oral and axillary thermometers in determining a febrile state was examined. When tympanic temperature was 38 degrees C, a febrile state was considered, in this condition sensitivity for rectal measurement was of 73%, for oral 64%, and 23 and 29% for the axillary, according to the age group: specificity was of 100% in all the them. According to our data, tympanic measurement was consistent with glass-mercurial, rectal and oral, temperature in a pediatric population. Advantages of tympanic thermometry are its good correlation with central temperature, substantial time reduction of measurement (1 second), easy and non-invasive procedure, improved patient comfort, and lack of mercurial thermometry disadvantages. The conclusion is that tympanic thermometry becomes an acceptable option for pediatric temperature measurement.
Assuntos
Temperatura Corporal/fisiologia , Termômetros , Membrana Timpânica/fisiologia , Adolescente , Fatores Etários , Axila , Criança , Pré-Escolar , Estudos de Avaliação como Assunto , Feminino , Febre/diagnóstico , Febre/fisiopatologia , Humanos , Lactente , Recém-Nascido , Raios Infravermelhos , Masculino , Boca , RetoRESUMO
We present a case of acute lethal poisoning by oil of "epazote" (oil of chenopodium), in a 2 y 9 m female. The volatile oil was administered according to the advice of a "curandera" (female healer), in a total quantity of 40 ml. Clinical features of the poisoning were: vomiting, deep coma, seizures, mydriasis, apnea, metabolic acidosis, neurogenic shock and death. The EEG suggested a diffuse encephalopathy, the CT scan with an image of severe brain edema and ventricular collapse. Relevant postmortem findings were brain edema and neuronal necrosis, pneumonia, enteritis, pericholangitis, mild pancreatitis and tubular necrosis. The phytochemical analysis of volatile oil identified ascaridol, the main active compound of the chenopodium herbs, in a quantity of 39 mg/ml (1,560 mg in the dose administered), and Chenopodium graveolens as the plant employed to prepare it. According to the age of the patient, 60 mg of ascaridol would be the recommended dose formerly used in the treatment of parasitic disease. Thus 1,560 mg was 26 times higher than the recommended dose, and exceeded by 56% the dose of 1,000 mg reported as lethal in humans.
Assuntos
Óleos de Plantas/intoxicação , Terpenos/intoxicação , Pré-Escolar , Evolução Fatal , Feminino , HumanosRESUMO
Twelve pediatric patients with acute poisonings caused by carbamazepine, digoxin and acetylsalicylic acid were treated with multiple doses of activated charcoal combined with a saline cathartic (adsorption surface of activated charcoal nearly 950 m2/g). This procedure was effective to shorten the plasmatic levels of the drugs, besides the clinical improvement of the poisoned patients. The average initial and final levels of the drugs were: carbamazepine 21.64 and 0.9 micrograms/ml (lowering 95.81%, p < 0.05), digoxin 5.14 and 1.1 ng/ml (lowering 78.6%, P < 0.05) and acetylsalicylic acid 418.5 and 57.5 micrograms/ml, respectively, (lowering 86.3%, p < 0.05). These results suggest the usefulness of activated charcoal in the clearance of the four overdosed drugs.