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This work was performed under the sponsorship of Contract No. Archives of Pediatrics A case of Pb poisoning is presented in a 3-yr-old boy who was admitted to the hospital in a comatose condition, with subsequent convulsions.
The diag- nosis was obscure until basophilic stippling of the erythrocytes, the Pb line in the long bones, as seen in X-ray studies, were noted. The patient was treated by administration of Ca gluconate and vitamins C and D in order to promote storage of Pb in bones.
The child was discharged in good physi- cal condition 45 days after admission to the hos- pital. Revista Clinica Espan- ola 38, No. Thirty-eight cases of Pb poisoning treated by BAL are presented. The intoxications were caused by products having a Pb arsenate base. All the clas- sical symptoms described until the present time were seen.
The author emphasizes the radiologic aspect of the bones in the course of the intoxica- tion: Clement and his coworkers in nursing infants fed by syphilitic nurses treated with Bi injections although the opacities were less dense and less precise.
In discussing BAL therapy in Pb poisoning, the author refers to the work by Hesse in who believed that an antidote for Pb should be a substance which would cause the elim- ination of the poison by transforming it into non- toxic salts.
This work was carried out with aro- matic compounds containing phenyl hydroxyl groups. Sixteen children with Pb encephalopathy admitted and treated with BAL in the past 3 yr were divided into 2 categories according to the degree of se- verity of illness.
Using these cri- teria 9 were severe and 7 mild. For control, 31 children treated between with citrates and phosphates were used; in this group there were 18 severe and 13 mild cases.
Several cases received shorter courses of treatment. No severe toxic effects were noted at this dosage. Some postinjection vomiting was seen but it was not severe enough to cause discontinu- ance of the therapy. The mortality rates and evi- dences of permanent nervous system injury in the BAL group were 2 deaths out of 9 severe cases against 12 out of 18 in the control group and neurologic residua in total of 6 and 13, respec- tively.
Blood Pb concentration fell in each case irrespective of treatment and was not influenced by BAL administration. Urinary excretion checked coincidently with blood levels generally showed increase at first but in some cases returned to normal pretreatment levels during the treatment. The authors conclude that although BAL is ap- parently effective in lowering the mortality rate in children with severe Pb encephalopathy, no con- clusive effects of therapy could be demonstrated in subacute or mild cases.
Sakana shel har'alat oferet etsel tinokot. Dapim R'fujim Tel- Aviv 9, No. The case of an infant is reported who was breast fed for 3 mo and started suffering in his 5th mo from unexplainable diarrhea and anemia.
After cessation of diarrhea the anemia continued unin- fluenced by treatment. At the age of 13 mo Pb poisoning was suspected. Although there was no stippling of red blood cells and no increase of Pb in the urine, a diagnosis of Pb poisoning was reached on account of X-ray findings in the long bones.
It could be proved that the baby's mother had used a Pb-containing ointment against cracks in her nipples at the time of breast feeding. The author warns against the use of Pb-containing ointments as well as Pb nipple-caps in the treatment of cracked nip- ples.
From Biological Abstracts Industrial Health Monthly Because 83 children have died of Pb poisoning in the last 20 yr, Baltimore has passed a new housing regulation barring the use of paint containing Pb pigment for use in the interior painting of any dwelling or dwelling unit or any part thereof.
Of these, 83 died. The majority of the cases occurred in the summer months, July and August. While most of the children were in their 2nd yr of life and so of teething age, the reporting of most of the cases in the 2 hot summer months is as yet not easily ex- plained.
Usually children lived in old rented properties where Pb paint had been used for many years on window sills and frames where it had often flaked and scaled. Investigations made by the nurse assigned to the Bureau of Industrial Hygiene most often revealed that the children chewed the window sills or picked up the paint flakes and put them in their mouths.
Of the cases, 93 were white and colored, were male and fe- male.Acupuncture schools and practitioners need to maintain an awareness of informational updates concerning safety in many areas of practice (including healthcare associated infections and OSHA bloodborne pathogens standards).
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