@article{ref1,
title="Stimulant toxicity in children: a retrospective study on 147 patients",
journal="Pediatric critical care medicine",
year="2015",
author="Hassanian-Moghaddam, Hossein and Ranjbar, Maryam and Farnaghi, Fariba and Zamani, Nasim and Alizadeh, Afshin Mohammad and Sarjami, Saeedeh",
volume="16",
number="8",
pages="e290-6",
abstract="OBJECTIVE: To evaluate the signs/symptoms of different stimulant toxicities in children to determine differences among them. <br><br>DESIGN: Observational, retrospective, single-center case-series. SETTING: The only referral hospital for pediatric poisoned patients in Tehran-IRAN covering 12.5 million permanent and 6.5 million temporary residents. PATIENTS: All children between 2007 and 2012 were evaluated. Their clinical findings, laboratory tests, electrocardiogram, and outcome were evaluated. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 147 patients were enrolled (115, 24, three, and five with methamphetamine, methylphenidate, ecstasy, and unknown stimulant toxicities, respectively). Median (interquartile range) age of the methamphetamine-intoxicated children (16 mo [22-42 mo]) was significantly less than those with methylphenidate toxicity (66 mo [33-105 mo]). Almost 79% of the patients had ingested the stimulant, whereas 9% had passively been exposed to the methamphetamine smoke. The frequency of stimulant toxicity had significantly increased during the 5-year period of the study. Restlessness, mydriasis, stereotypic movements, and talkativeness were the most common signs and symptoms. Whereas bruxism only seen in 66.7% (95% CI, 21-94%) of ecstasy users, the prevalence of restlessness, sweating, and tremor was also more in this group of children. On the other hand, mydriasis and stereotypic movements were more common in crystal-meth patients by 76.5% (95% CI, 68-83%) and 53% (95% CI, 44-62%), respectively. A comparison between different routes of crystal-meth intoxication showed that flushing was more common in those who had passively/actively smoked/inhaled methamphetamine (odds ratio, 6.3 [95% CI, 1.5-26]). Palpitation was more seen in methylphenidate toxicity by 12.5% (95% CI, 4-31%). Restlessness was more detected in toddlers, whereas talkativeness and ataxia were more common in older children. Nineteen children (21%) had prolonged QTc according to normal values in different ages. None of them died. <br><br>CONCLUSIONS: More studies are warranted to evaluate the frequency and outcome of this poisoning in children. Educational preventive programs are also recommended.<p /> <p>Language: en</p>",
language="en",
issn="1529-7535",
doi="10.1097/PCC.0000000000000506",
url="http://dx.doi.org/10.1097/PCC.0000000000000506"
}