Diatr. 2017;35(1):11-Toxic exposures in young children to household sanitizersgastrointestinal endoscopy and hospitalizations. With regard to exposure to illegal rodenticide “chumbinho,” just one child of 12 young children evolved with clinical manifestations of a cholinergic syndrome and needed to use atropine. These data recommend a achievable reflection from the removal of ML348 aldicarb (Temik 150) from the Brazilian industry since the finish of 2012.13 The occurrence of postexposure clinical manifestations as risks markers for evolution to really serious esophageal injury continues to be a matter of debate.14-17 Normally, in unintentional ingestions of caustic substances, endoscopy should be performed in all patients with stridor and in any patient who evolve with two or a lot more symptoms which include vomiting, salivation, and discomfort.15 Endoscopic findings as circumferential lesions of the submucosa, with presence of ulcers and exudates (classification IIb), or deep ulcers with necrosis of esophageal tissue layers (classification III), are essential predictive risk markers of evolution to esophageal stricture scar.9,16,17 Hence, early endoscopy, between 12 and 24 hours right after exposure in sufferers with indicative clinical manifestations of caustic injury has prognostic value and assists in indicating a more acceptable therapy in significant circumstances, for example placement of intraluminal stents and nasogastric tubes, aiming at stopping or minimizing the improvement for esophageal stenosis in individuals at risk.16,17 In this series, in only two young children among those 22 PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20170336 undergoing endoscopy the Zargar grading was applied.9 The relevance on the use of this classification within the issuance of reports must be emphasized towards the endoscopists inside the region. Multicenter study conducted in Italy in 2008 showed a correlation with the presence of clinical manifestations (oral/ oropharynx burns, vomiting, dyspnea, dysphagia, salivation, and hematemesis) with progression to significant esophageal burns (Zargar III) in 162 youngsters, just after accidental ingestion of caustic substances, and revealed that individuals with a single, two, 3, or more signs/symptoms showed evolution of odds ratios for significant esophageal injury of 7.71, six.69, and 11.97, respectively.17 In our series, individuals who developed esophageal necrosis presented with 4 signs/symptoms on hospital admission, such as oral burns, several episodes of vomiting, dysphagia, and abdominal discomfort following ingestion of caustic soda that was stored inside a soft drink bottle. In contrast, no endoscopic abnormality was detected in five individuals undergoing endoscopy who showed only one particular sign/symptom — four with isolated oral burns and a single with many episodes of vomiting.The usage of packages with child-proof caps is often a preventive measure which proved to be productive in reducing youngster mortality by poisoning.1,18,19 Hence, in 2013, ANVISA published a resolution that requires rigid tear-resistant plastic packing, with double safety child-proof cap for corrosive merchandise.20 This regulation came into force in the similar period the data collection for this study was initiated; for that reason, it was not achievable to assess its effect. However, as advisable in other countries, we understand that security packaging should be mandatory not merely for corrosive solutions but in addition for drugs, other sanitizers, hydrocarbons, and pesticides.1,two,18,19 As current tragic example, we had the case of a 1-year boy assisted in early 2015 and monitored by our CIATOX who died soon after accidental ingestion of a l.
