<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1688-0390</journal-id>
<journal-title><![CDATA[Revista Médica del Uruguay]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Méd. Urug.]]></abbrev-journal-title>
<issn>1688-0390</issn>
<publisher>
<publisher-name><![CDATA[Sindicato Médico del Uruguay]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1688-03902024000201701</article-id>
<article-id pub-id-type="doi">10.29193/rmu.40.2.4</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Intoxicación por paracetamol en adolescentes. Reporte de una serie de casos]]></article-title>
<article-title xml:lang="en"><![CDATA[Paracetamol poisoning in adolescents. Report of a series of cases]]></article-title>
<article-title xml:lang="pt"><![CDATA[Intoxicação por paracetamol em adolescentes. Relato de uma série de casos]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<given-names><![CDATA[Yessica]]></given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Casuriaga]]></surname>
<given-names><![CDATA[Ana Laura]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Notejane]]></surname>
<given-names><![CDATA[Martín]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Giachetto]]></surname>
<given-names><![CDATA[Gustavo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de la República Facultad de Medicina Unidad Académica Pediatría C]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de la República Facultad de Medicina Unidad Académica Pediatría B]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de la República Facultad de Medicina Unidad Académica Pediatría C]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<volume>40</volume>
<numero>2</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S1688-03902024000201701&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S1688-03902024000201701&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S1688-03902024000201701&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción: la intoxicación por paracetamol puede producir falla hepática aguda. El pronóstico depende del diagnóstico precoz e inicio oportuno de las medidas terapéuticas.  Objetivo:  sensibilizar acerca del adecuado abordaje diagnóstico-terapéutico de la intoxicación aguda por paracetamol.  Casos clínicos:  se trata de 10 adolescentes de sexo femenino, mediana de edad 13,5 años, con intoxicación aguda intencional. Presentaban psicopatología 9; intentos de autoeliminación (IAE) previos 5, y seguimiento por equipo de salud mental 7. Cuatro recibían tratamiento con psicofármacos. Mediana de dosis de paracetamol 10 g (5 - 40). Se realizó carbón activado en ocho, asociado a lavado gástrico en seis pacientes. Mediana de tiempo entre ingesta y rescate 2,5 horas (1 - 3,5). Presentaron síntomas digestivos seis, fueron asintomáticas tres. Se dosificó el paracetamol luego de las 4 horas y en las primeras 24 horas de la ingesta en siete, siendo indetectable en una paciente. En las restantes, el riesgo de toxicidad hepática fue: posible en dos, probable en tres y sin riesgo en una. Se administró dosis carga de n-acetil cisteína a siete pacientes y tratamiento completo de mantenimiento a seis. Nueve ingresadas a cuidados moderados y una paciente a cuidados intensivos. No hubo complicaciones, ni fallecimientos. Se abordaron junto al toxicólogo.  Conclusiones: la intoxicación aguda por paracetamol en adolescentes es habitualmente secundaria a IAE. La prevalencia de los problemas de salud mental y de IAE en esta población constituye una alerta para los profesionales de la salud que deben conocer el perfil de los fármacos utilizados y el abordaje diagnóstico-terapéutico de las posibles intoxicaciones. Dado el riesgo de hepatotoxicidad severa es necesario actuar rápidamente considerando dosis ingerida, tiempo desde la ingesta y factores de riesgo de hepatotoxicidad.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  Paracetamol poisoning can produce acute liver failure. Its prognosis depends on early diagnosis and timely initiation of specific therapeutic measures.  Objective: To make health professionals aware of the appropriate diagnostic-therapeutic approach to acute paracetamol poisoning.  Clinical cases:  These are ten female adolescents, median age 13.5 years, with acute and intentional poisoning. 9 presented psychopathology, 5 previous self-elimination attempts (AEIs), and 7 were monitored by a mental health team. 4 received treatment with psychoactive drugs. Median dose of paracetamol 10 g (5-40 g). Drug rescue was performed with activated charcoal in 8, associated with gastric lavage in 6. The median time between intake and rescue was 2.5 hours (1-3.5 hours). They presented digestive symptoms 6 and were asymptomatic 3. Paracetamol was dosed after 4 hours and in the first 24 hours of ingestion in 7, being undetectable in 1. In the remainder, the risk of liver toxicity was classified as: possible 2, probable 3 and 1 without risk. A loading dose of n-acetyl cysteine was administered to 7 and full maintenance treatment to 6. 9 were admitted to moderate care and 1 to intensive care. There were no complications or deaths.  Discussion/Conclusions:  Acute paracetamol poisoning in adolescents is usually secondary to AEI. The prevalence of mental health problems and AEI in this population constitutes an alert for health professionals who must know the profile of the drugs used and the diagnostic-therapeutic approach to possible poisoning. Given the risk of severe hepatotoxicity, it is necessary to act quickly considering the dose ingested, time since ingestion, and risk factors for hepatotoxicity.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução: O envenenamento por paracetamol pode levar à insuficiência hepática aguda. O prognóstico depende do diagnóstico precoce e do início oportuno das medidas terapêuticas.  Objetivo: Aumentar a conscientização sobre a abordagem diagnóstica e terapêutica adequada para a intoxicação aguda por paracetamol.  Casos clínicos: Dez adolescentes do sexo feminino, com idade média de 13,5 anos, com intoxicação agudada intencional. Nove apresentavam psicopatologia, 5 haviam feito tentativas anteriores de automutilação (SAI) e 7 tinham acompanhamento pela equipe de saúde mental, 44 recebiam tratamento com drogas psicotrópicas. Dose média de paracetamol 10 g (5 - 40 g). O carvão ativado foi usado em 8, associado à lavagem gástrica em 6. O tempo médio entre a ingestão e o resgate foi de 2,5 horas (1 a 3,5 horas). O paracetamol foi dosado após 4 horas e dentro de 24 horas da ingestão em 7, sendo indetectável em 1 caso. Nas demais pacientes, o risco de toxicidade hepática foi: possível em 2, provável em 3 e sem risco em 1. Uma dose de ataque de n-acetilcisteína foi administrada a 7 e o tratamento de manutenção completo a 6. Nove foram admitidas em cuidados moderados e 1 em cuidados intensivos. Esses dados foram discutidos com o toxicologista.  Discussão/Conclusões: A intoxicação aguda por paracetamol em adolescentes geralmente é secundária a tentativa de autoextermínio (TAE). A prevalência de problemas de saúde mental e TAE nessa população é um alerta para os profissionais de saúde, que devem estar cientes do perfil dos medicamentos utilizados e da abordagem diagnóstica-terapêutica de possíveis intoxicações. Dado o risco de hepatotoxicidade grave, é necessário agir rapidamente, considerando a dose ingerida, o tempo decorrido desde a ingestão e os fatores de risco para hepatotoxicidade.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Intoxicación]]></kwd>
<kwd lng="es"><![CDATA[Adolescente]]></kwd>
<kwd lng="es"><![CDATA[Intentos de autoeliminación]]></kwd>
<kwd lng="es"><![CDATA[Paracetamol]]></kwd>
<kwd lng="en"><![CDATA[Poisoning]]></kwd>
<kwd lng="en"><![CDATA[Adolescent]]></kwd>
<kwd lng="en"><![CDATA[Self-elimination attempts]]></kwd>
<kwd lng="en"><![CDATA[Paracetamol]]></kwd>
<kwd lng="pt"><![CDATA[Intoxicação]]></kwd>
<kwd lng="pt"><![CDATA[Adolescente]]></kwd>
<kwd lng="pt"><![CDATA[Tentativas de auto-eliminação]]></kwd>
<kwd lng="pt"><![CDATA[Paracetamol]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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