succimer and Wounds-and-Injuries

Although lead encephalopathy has virtually disappeared from the United States, thousands of children still have sufficient lead exposure to produce cognitive impairment. It is not known whether treating children with blood lead levels < 45 microg/dL (2.2 microM) is beneficial and can be done with acceptable safety. We conducted a 780-child, placebo-controlled, randomized trial of up to three courses of succimer in children with blood lead levels of 20-44 microg/dL (1.0-2.1 microM). Children were aged 12-33 mo, 77% were African-American, 7% were Hispanic, and they lived in deteriorating inner city housing. Placebo-treated children had a gradual decrease in blood lead level. Succimer-treated children had an abrupt drop in blood lead level, followed by rebound. The mean blood lead level of the succimer-treated children during the 6 mo after initiation of treatment was 4.5 microg/dL (95% confidence intervals, 3.7 to 5.3 microg/dL; 0.22 microM, 0.18 to 0.26 microM) lower than that of placebo-treated children. There were more scalp rashes in succimer-treated children (3.5% versus 1.3%) and an unanticipated excess of trauma. Succimer lowers blood lead level with few side effects. The unanticipated excess of trauma requires confirmation.

Topics: Chelating Agents; Child, Preschool; Drug Eruptions; Humans; Infant; Lead; Lead Poisoning, Nervous System, Childhood; Safety; Scalp; Succimer; Wounds and Injuries

Renal injuries are classified as minor, major, and critical/catastrophic for purposes of management. The radionuclide renal scintigram is a safe, simple, and extremely sensitive means of establishing the presence of an injury and monitoring kidney function during conservative management, which is utilized in the vast majority of cases. The information that may be obtained from radionuclide imaging is the state of overall and regional blood transit, overall and regional parenchymal function, and urinary extravasation.

Topics: Adolescent; Arteriovenous Fistula; Female; Humans; Kidney; Organotechnetium Compounds; Pentetic Acid; Radionuclide Imaging; Succimer; Sugar Acids; Sulfur; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Pentetate; Technetium Tc 99m Sulfur Colloid; Wounds and Injuries