Enrique Paris M

Epidemiología de las intoxicaciones en Chile: una década de registros

Background: The existence of Poison Centers for management and prevention of intoxications has been endorsed by the international experience. In Chile, the Toxicological Information Center at the Pontifical Catholic University of Chile has been active since 1992, receiving about 130.000 calls until 2002. Aim: To analyze the statistical data gathered throughout the first ten years of our Research Center. To delineate the epidemiological pattern of intoxications in Chile. Material and methods: Retrospective study in which records from calls for toxicological information received during the 1992-2002 period reviewed. Analyzed data were total calls per year, place of call, exposure circumstances, age, sex, route of exposure and involved agents. Results: 96,468 calls analyzed. The main exposure circumstance was «unintentional» (78.6%), followed by «intentional» (16.9%). Intoxications in children under 5 years old motivated 50% of calls. According to route of exposure, ingestions involved 75,992 calls (78.8%). Medications were the most common substances, accounting for 49.2% of calls, followed by cleaning products (12.1%), pesticides (11.3%), industrial and chemical products (10.5%) and cosmetics (2.7%). Medications acting on the CNS were the most recurrent, with 19,096 reports. Conclusions: The epidemiological pattern for intoxications in Chile is very similar to that reported in developed and other Latin American countries. Children under 5 years old, are a high risk group for intoxications. It is imperative to improve the recording and followup of patients that call to the Center, to improve epidemiological data of intoxications in Chile (Rev Med Chile 2004; 132: 493-9).

La importancia de la salud ambiental y el alcance de las unidades de pediatría ambiental

In the last decades there has been an important decrease ininfant mobidity and mortality, but these achievements are not equally distributed across thewhole population. Children are one of the most susceptible groups due to their uniquevulnerabilities to environmental factors. Unhealthy environments, indoor pollution, poordrainage, inadequate waste disposal, and many others, are significant environmental riskfactors to children. Currently, Chile is experiencing an advanced demographical transition, asituation that requires a precise approach to guarantee that the population has an adequatehealth status. It is important to take care of children, since their present health status willcondition their health as adults. Pediatric Environmental Health Specialty Units arestructures specialized in pediatric conditions related to the environment, formed by aninterdisciplinary and highly specialized team. These centers provide assistance, informationand treatment, promote research, educate health care providers or the public, and reportproblems to authorities. Health authorities should emphasize the importance of having a safeenvironment for children and encourage efforts to reduce exposure to environmental hazardspromoting healthy behaviors, education and awareness at all levels of society (Rev Med Chile2009; 137: 101-5).(

Unidades de Pediatría Ambiental

Se considera que una Unidad de Pediatria Ambiental es una estructura con roles claramente definidos, situada preferentemente en un centro de salud, especializada en afecciones pediatricas, relacionadas al ambiente. Estos centros pueden proporcionar asesoramiento, informacion y tratamiento, promover la investigacion, entrenar a profesionales, educar al publico e informar a las autoridades responsables. Su personal, especialmente entrenado en problemas ambientales, incluye: pediatras, toxicologos, enfermeras y enfermeros, medicos de familia, obstetras, expertos de la salud publica, medicos ocupacionales, trabajadores sociales, ingenieros y consejeros de otras areas relevantes. Solamente este tipo de equipo multidisci-plinario, ayuda a capturar la complejidad de la salud ambiental y la vulnerabilidad unica de los ninos/ adolescentes frente a los peligros de sus entornos. Estos centros, capaces de reconocer, determinar y manejar enfermedades infantiles relacionadas al ambiente y de proporcionar educacion y entrenamiento, fueron creados en los EE.UU. por la Agencia para las Sustancias Toxicas y el Registro de las enfermedades (ATSDR) del Departamento de los Servicios Humanos y de Salud de la Agencia de Proteccion del Medio Ambiente de los EE.UU. (USEPA)

Barotrauma y otras complicaciones frecuentes de la ventilación mecánica en niños

Noninfectious complications in 225 pediatric patients assisted by mechanical ventilation, among 459 patient[ages 12 days to 14 years/ admitted to c pediairic intensive care unit olong a 32 monlh period (november 1990throughout June 1993) are described. The most common indications for mechanical ventilation were cardiacsurgery (n:76), pneumonia or difuse lung disease |n:43|, septic shock (n;23), meningitis [n:17)

Aplicación de un índice de estabilidad fisiológica en unidad de cuidados intensivos pediátrica

This study was conducted to evaluate usefulness of the physiologic stability index (PSI) in a pediatric intensive care Unit (PICU) of a University based hospital at Santiago, Chile. Subjects include all patients (n = 152) consecutively admitted to our PICU between april 1987 and august 1988. The PSI system was applied during the first four days from admission. The age of the patients ranged from 10 days to 15 years. Scores obtained from survivors and non survivors were compared using an analysis of variance. For maximum PSI, survivors had significantly lower scores (9.39 points) that non survivors (21.71 points). Multiple logistic regression was used to display associations between mean obtained scores and probability of death and a curve was plotted which is similar to that obtained in previous experiences from other countries.

Cateterismo venoso central por vía percutánea

A prospective study was held between January 1986 and April 1987 to evaluate the use of percutaneous central catheters through internal jugular vein; 47 childrens were catheterized during a 15 months period. Right jugular vein was the most frequent site of puncture. The age range of patients varied from 2.5 months and 14 years old; their varied between 2.5 kg and 37 kg. The catheters were in use for an average of 4.2 days, range 1 to 17 days. Complications consisted in carotid arterial punction in 4 patients, pneumothorax in 2 cases and transitory bradichardia in 1 case. (