Pediatric foreign bodies and their management.
Kay, Marsha; Wyllie, Robert
2005-06-01
Ingestion of foreign bodies is a common pediatric problem, with more than 100,000 cases occurring each year. The vast majority of pediatric ingestions are accidental; increasing incidence of intentional ingestions starts in the adolescent age group. In the United States, the most common pediatric foreign bodies ingested are coins, followed by a variety of other objects, including toys, toy parts, sharp objects, batteries, bones, and food. In adolescents and adults, meat or food impactions are the most common accidental foreign body ingestion. Esophageal pathology underlies most cases of food impaction. Management of foreign body ingestions varies based on the object ingested, its location, and the patient's age and size. Esophageal foreign bodies as a group require early intervention because of their potential to cause respiratory symptoms and complications, esophageal erosions, or even an aortoesophageal fistula. Ingested batteries that lodge in the esophagus require urgent endoscopic removal even in the asymptomatic patient due to the high risk of complications. Sharp foreign bodies increase the foreign body complication rate from less than 1% to 15% to 35%, except for straight pins, which usually follow a relatively benign course unless multiple pins are ingested. Magnets are increasingly ingested, due to their ubiquitous nature and the perception that they do not pose a risk. Ingestion of multiple magnets creates a significant risk of obstruction, perforation, and fistula development. Methods to deal with foreign bodies include the suture technique, the double snare technique, and the combined forceps/snare technique for long, large, and sharp foreign bodies, along with newer equipment, such as retrieval nets and a variety of specialized forceps.
Handheld Metal Detector for Metallic Foreign Body Ingestion in Pediatric Emergency.
Hamzah, Hazwani Binte; James, Vigil; Manickam, Suraj; Ganapathy, Sashikumar
2018-01-04
Foreign body ingestion is a common problem for which children present to the emergency department. The most common ingested foreign bodies among children are coins. Metal detector is an equipment, which measures a change in inductance of a coil when an electroconductive material is placed near it and produces an audio-visual signal. The present study was conducted to determine the effectiveness and feasibility of HMD in the local Pediatric population. This was a prospective study conducted in the pediatric emergency department among children presenting with history of foreign body ingestion. The outcome measured was presence or absence of metallic foreign body detected on handheld metal detector examination. During the study period, 36 patients with history of foreign body ingestion presented to the emergency department. Among these, 28 were metallic foreign body ingestions. Coins were the most common type of foreign body ingested. Among the metallic foreign bodies ingested, all the coins were accurately identified by the handheld metal detector. Non-coin metallic foreign bodies like metallic screw, needle and stapler pin were not identified by the handheld metal detector. The study demonstrates that handheld metal detector can be safely and reliably used as a screening tool in the process of detecting ingested coins. The plain radiograph still appears to be superior as it accurately localizes sharp metallic objects as well as cell batteries (button batteries) which need to be detected early and removed in order to prevent complications. Handheld metal detector is an effective tool that can be used in the follow up of patients to confirm whether the coin like metallic foreign body has been expelled. Handheld metal detector examination is more sensitive than traditional X-ray examination to detect radiolucent metallic foreign bodies like aluminium.
Kim, S Y; Park, B; Kong, I G; Choi, H G
2016-12-01
This study aimed to analyse the types and locations of ingested foreign bodies according to different age groups, from infants to the elderly. A retrospective chart review. Tertiary referral centre. A total of 4682 patients who ingested foreign bodies from January 2006 through February 2014. The frequencies of foreign bodies were investigated in each age group. The types of foreign bodies were categorised into fish bones, chicken bones, seafood, tablets, food, metal, batteries, glass, teeth, plastics and others. The anatomic locations of the objects were classified as the oral cavity, tongue base, tonsils, oropharynx, hypopharynx, oesophagus, stomach and colon. The types, locations and origins of the foreign bodies were analysed according to the age groups. The frequency of foreign body ingestion was high in patients up to 14 years of age, after which the risk of foreign body ingestion markedly decreased. Fish bones were the most commonly suspected foreign bodies in all of the age groups. However, non-food-type foreign bodies were more common in both the young and elderly groups. The tonsils were the most common anatomic site of foreign body impaction except in the group of patients older than 65 years. The stomach and oesophagus were also common locations of foreign bodies in the groups of patients younger than 10 years (10.5%) and older than 65 years (39.4%). The frequency of foreign body ingestion was highest in young children. However, we observed specific age-based characteristics that indicate specific precautions to take to avoid foreign body ingestion. © 2015 John Wiley & Sons Ltd.
Management of ingested foreign bodies in childhood: our experience and review of the literature.
Hachimi-Idrissi, S; Corne, L; Vandenplas, Y
1998-09-01
The management of foreign bodies in the gastrointestinal tract is not standardized. Retrospectively, we analysed the management of 174 cases of accidental ingestion of foreign bodies in children. No child had ingested more than one foreign object. The ingested foreign bodies were: coins, toy parts, jewels, batteries, 'sharp' materials such as needles and pins, fish and chicken bone, and 'large' amounts of food. Of the patients 51% had transient symptoms at the moment of ingestion, such as retrosternal pain, cyanosis and dysphasia. Attempts to extract the foreign body either by a magnet tube, endoscopy or McGill forceps was performed in 83 patients. The majority of the extracted foreign bodies were batteries and sharp materials. The outcome of all the patients was excellent. No complications were observed.
Endoscopic management of foreign bodies in the upper gastrointestinal tract: A review
Sugawa, Choichi; Ono, Hiromi; Taleb, Mona; Lucas, Charles E
2014-01-01
Foreign body ingestion is a common condition, especially among children who represent 80% of these emergencies. The most frequently ingested foreign bodies in children are coins, toys, magnets and batteries. Most foreign body ingestions in adults occur while eating, leading to either bone or meat bolus impaction. Flexible endoscopy is the therapeutic method of choice for relieving food impaction and removing true foreign bodies with a success rate of over 95% and with minimal complications. This review describes a comprehensive approach towards patients presenting with foreign body ingestion. Recommendations are based on a review of the literature and extensive personal experience. PMID:25324918
Endoscopic management of foreign bodies in the upper gastrointestinal tract: A review.
Sugawa, Choichi; Ono, Hiromi; Taleb, Mona; Lucas, Charles E
2014-10-16
Foreign body ingestion is a common condition, especially among children who represent 80% of these emergencies. The most frequently ingested foreign bodies in children are coins, toys, magnets and batteries. Most foreign body ingestions in adults occur while eating, leading to either bone or meat bolus impaction. Flexible endoscopy is the therapeutic method of choice for relieving food impaction and removing true foreign bodies with a success rate of over 95% and with minimal complications. This review describes a comprehensive approach towards patients presenting with foreign body ingestion. Recommendations are based on a review of the literature and extensive personal experience.
Management of foreign body ingestions in children: button batteries and magnets.
Kodituwakku, Ronan; Palmer, Sarah; Paul, Siba Prosad
2017-04-27
Foreign body ingestion and foreign body aspiration commonly affect young children between 6 months and 6 years. A large number of these events remain unwitnessed and asymptomatic while the swallowed foreign body traverses the gastrointestinal tract and is passed in the stool. Recent literature has shown an increase in morbidity associated with button battery and (neomydium) magnet ingestions in children, particularly over the last decade. Early identification and management in a time critical manner is required in cases where button batteries get lodged in the oesophagus or multiple magnets are swallowed. Deaths, although rare, have been reported with these dangerous foreign body ingestions in children where diagnoses were delayed. Nurses through their direct contact with children in different clinical settings play a vital role in managing foreign body ingestions.
Predictors of recurrent ingestion of gastrointestinal foreign bodies.
Grimes, Ian C; Spier, Bret J; Swize, Lisa R; Lindstrom, Mary J; Pfau, Patrick R
2013-01-01
Gastrointestinal foreign bodies are commonly encountered; however, little knowledge exists as to the causes of foreign body ingestions and why they occur repeatedly in some patients. To identify and define patients at high risk for recurrent foreign body ingestion. A retrospective chart review of foreign body ingestion was conducted at a tertiary care medical centre over an 11-year period. Variables analyzed included age, sex, incarceration status, Diagnostic and Statistical Manual of Mental Disorders-IV diagnosis, success of endoscopy, type of sedation used, method of extraction, complications, presence of gastrointestinal pathology, and incidence of recurrent food impaction or foreign body. A total of 159 patients with a foreign body ingestion were identified. One hundred fourteen (77%) experienced a single episode of ingestion and 45 (23%) experienced multiple ingestions. Of the patients with multiple ingestions, 27 (60%) had recurrent food impactions while 18 (40%) ingested foreign objects. In the recurrent ingestor group, a psychiatric disorder had been diagnosed in 16 patients (35.6%) and there were 13 incarcerated individuals (28.9%). The average number of recurrences was 2.6 per patient (117 total recurrences). Individuals with a psychiatric disorder experienced 3.9 recurrences per patient, while prisoners averaged 4.1 recurrences per patient. The combination of a psychiatric disorder and being incarcerated was associated with the highest recurrence rate (4.33 per patient). Multivariable logistic regression revealed that male sex (OR 2.9; P=0.022), being incarcerated (OR 3.0; P=0.024) and the presence of a psychiatric disorder (OR 2.5; P=0.03) were risk factors for recurrent ingestion. Risk factors for recurrent ingestion of foreign bodies were male sex, being incarcerated and the presence of a psychiatric disorder.
Predictors of recurrent ingestion of gastrointestinal foreign bodies
Grimes, Ian C; Spier, Bret J; Swize, Lisa R; Lindstrom, Mary J; Pfau, Patrick R
2013-01-01
BACKGROUND: Gastrointestinal foreign bodies are commonly encountered; however, little knowledge exists as to the causes of foreign body ingestions and why they occur repeatedly in some patients. OBJECTIVE: To identify and define patients at high risk for recurrent foreign body ingestion. METHODS: A retrospective chart review of foreign body ingestion was conducted at a tertiary care medical centre over an 11-year period. Variables analyzed included age, sex, incarceration status, Diagnostic and Statistical Manual of Mental Disorders-IV diagnosis, success of endoscopy, type of sedation used, method of extraction, complications, presence of gastrointestinal pathology, and incidence of recurrent food impaction or foreign body. RESULTS: A total of 159 patients with a foreign body ingestion were identified. One hundred fourteen (77%) experienced a single episode of ingestion and 45 (23%) experienced multiple ingestions. Of the patients with multiple ingestions, 27 (60%) had recurrent food impactions while 18 (40%) ingested foreign objects. In the recurrent ingestor group, a psychiatric disorder had been diagnosed in 16 patients (35.6%) and there were 13 incarcerated individuals (28.9%). The average number of recurrences was 2.6 per patient (117 total recurrences). Individuals with a psychiatric disorder experienced 3.9 recurrences per patient, while prisoners averaged 4.1 recurrences per patient. The combination of a psychiatric disorder and being incarcerated was associated with the highest recurrence rate (4.33 per patient). Multivariable logistic regression revealed that male sex (OR 2.9; P=0.022), being incarcerated (OR 3.0; P=0.024) and the presence of a psychiatric disorder (OR 2.5; P=0.03) were risk factors for recurrent ingestion. CONCLUSION: Risk factors for recurrent ingestion of foreign bodies were male sex, being incarcerated and the presence of a psychiatric disorder. PMID:23378983
Antoniou, Dimitris; Christopoulos-Geroulanos, George
2011-01-01
Although foreign body ingestion is a common problem in children, there are no clear guidelines regarding the management of ingested foreign bodies. The aim of this study was to evaluate the effectiveness of our protocol in the work-up and management of children with ingested foreign bodies. Between September 2002 and August 2010, a total of 675 children with suspected foreign body ingestion were seen in the emergency department. At initial presentation, the majority of foreign bodies were located in the stomach (n=392, 58.1%) followed by the small intestine (n=221, 32.7%) and esophagus (n=62, 9.2%). Based on our protocol, 84 (12.4%) patients were admitted at initial presentation, and 5 after a 48-hour observation period at home; 61 (9%) required prompt endoscopic removal. Sixty-eight (10.1%) patients returned for endoscopic removal after a four-week observation period, and 3 (0.4%) patients underwent delayed surgery due to complications. The overall success rate of endoscopic retrieval was 96.1%. There were no major complications. The majority of ingested foreign bodies will pass spontaneously and most children can be safely observed at home. Selective endoscopic intervention is the preferable method for the removal of ingested foreign bodies in pediatric patients.
[Foreign body ingestion in children: our experience and review of the literature].
Orofino, Antonio; Lanzillotto, Maria Paola; D'Amato, Michele; Rutigliano, Vincenzo; Fanelli, Benito
2009-01-01
Foreign body ingestion is a frequent event in paediatric population, especially in the first six years of life. Even if the event is normally cause of anxiety for the parents witness of the situation, fortunately most ingested foreign bodies ingestion, about 80-90%, pass spontaneously, 10-20% of cases needs an endoscopic intervention and only in less than 1% of cases surgery is necessary. Many authors suggest different guide-lines for diagnosis and therapy of foreign body ingestion in children. These purposes are discordant not only on potential danger of foreign body, but also on timing and last of waiting period before endoscopic extraction. Here we report our own experience: a retrospective review of three hundred consecutive paediatric cases of foreign body ingestion between June 2001 and February 2008. This study don't take in account patients with pathology either organic either functional, that can cause stop of food progression. We describe and discuss about medical diagnostic and therapeutic procedures that have been done during the time of hospitalization and performed according to classic and new international literature, with the objective to propose recommendations helpful for a correct management of children presenting with a history of suspected ingestion of a foreign body.
Foreign body ingestion in children
Dereci, Selim; Koca, Tuğba; Serdaroğlu, Filiz; Akçam, Mustafa
2015-01-01
Aim: Foreign bodies ingested by the oral route enter into the gastrointestinal tract and are considered a significant health problem in the childhood. In this study, we evaluated the pediatric patients who presented to our hospital with the complaint of ingestion of foreign body. Material and Methods: The hospital records of all children who presented to our clinic because of ingestion of foreign body between January 2008 and January 2015 were examined retrospectively. The complaints at admission, the types of foreign bodies ingested, the localization of the foreign body in the gastrointestinal tract and the approaches and treatment methods used were examined. Results: Thirty-six (56%) of 64 patients included in the study were male and 28 (44%) were female and the mean age was 5.7±4.6 years (10 months–17 years). Thirty eight (59%) of 64 children who were included in the assessment were below the age of five years. The most common complaint at presentation was parental recognition of the ingested object and dysphagia. The most commonly ingested foreign bodies included coins, sewing pins, safety pins and hairclips. Nail clipper detected in the stomach, sewing pin which penetrated through the duodenal wall and stuck to hepatic parenchyma were the first pediatric cases in the literature. Upper esophagus was the most common location for foreign bodies. Endoscopic examinations were performed in 55 of 64 children. Conclusions: Early detection and treatment of ingested foreign bodies in the upper gastrointestinal system is important in terms of preventing possible complications. In our study, the most frequent foreign bodies detected in the upper digestive tract were coins and they were most frequently detected in the upper esophagus. Most of our patients were below the age of five years. Flexible endoscopic method was used commonly for treatment. PMID:26884693
Overtube-Assisted Foreign Body Removal: A Review of Endoscopic Management and Case Illustration.
Ofosu, Andrew; Ramai, Daryl; Reddy, Madhavi
2017-09-29
The ingestion of foreign bodies is a common medical emergency seen in both adults and children. In children, the most commonly ingested foreign bodies include coins, toys, magnets, and batteries. In adults, food bolus impaction represents the most common cause of foreign body ingestion. The majority of foreign bodies pass spontaneously. Sharp or pointed objects increase the risk of perforation. Emergent endoscopic intervention is indicated in cases of esophageal obstruction, ingestion of disk batteries, and sharp pointed objects in the esophagus. Flexible endoscopy is the therapeutic method of choice for removing foreign bodies. It is preferred due to its high success rate and low risk for complications. Additionally, the use of an overtube provides gastric and esophageal protection from mucosal laceration. We present a 27-year-old male who ingested six razor blades and a curtain hook and review endoscopic management.
Ingested bone fragment in the bowel: Two cases and a review of the literature.
Emir, Seyfi; Ozkan, Zeynep; Altınsoy, Hasan Baki; Yazar, Fatih Mehmet; Sözen, Selim; Bali, Ilhan
2013-10-16
Generally, ingested foreign bodies are excreted from the digestive tract without any complications or morbidity. In adults, ingestion of foreign bodies frequently occurs in alcoholics and elderly individuals with dentures. The most commonly ingested foreign bodies are food stuffs or their parts, such as fish bones or fragments of bone and phytobezoars. Sharp foreign bodies like fish and chicken bones can lead to intestinal perforation and peritonitis. We report herein two cases, one of bowel perforation and another of anal impaction, both caused by ingested bone fragments. Complications due to ingested bone fragments are not common and preoperative diagnosis remains a challenge and therefore it must be considered in susceptible cases.
Removal of impacted esophageal foreign bodies with a dual-channel endoscope: 19 cases
WANG, CHANGXIONG; CHEN, PING
2013-01-01
There have been few reports concerning the endoscopic removal of impacted esophageal foreign bodies from patients. The objective of this study was to evaluate the effectiveness of dual-channel endoscopy in managing foreign-body ingestions in patients. A total of 19 patients with foreign-body ingestions between September 2008 and July 2011 were selected from the Digestive Endoscope Center in Lishui, a typical middle-sized city in China. The patients underwent endoscopy following admission. The impacted foreign bodies were successfully removed from 18 patients without complications using a dual-channel endoscope. One patient underwent surgery for an ingested denture following the failure of the endoscopic removal method. This study demonstrates that dual-channel endoscopic management may be a useful option for removing ingested foreign bodies from the esophagus. PMID:23935752
Emergency admissions due to swallowed foreign bodies in adults
Erbil, Bülent; Karaca, Mehmet Ali; Aslaner, Mehmet Ali; İbrahimov, Zaur; Kunt, Mehmet Mahir; Akpinar, Erhan; Özmen, Mehmet Mahir
2013-01-01
AIM: To study a retrospective analysis of patients who presented to the emergency departments (ED) with complaints related to foreign body ingestions. METHODS: Patients older than 16 years of age who presented to the ED between January 1st and December 31st of 2010 with complaints related to swallowed foreign bodies were identified from electronic health records and patient charts. RESULTS: A total of 100 patients presented with a complaint of foreign body ingestion during the study period. Overall, an X-ray was performed on 75 patients, and a fiberoptic evaluation was performed on 45 patients. A foreign body was detected in 46 (46%) patients. The diagnostic yield of the X-ray was 27 (36%) out of 75 patients, while the diagnostic yield of the fiberoptic evaluations was 21 (47%) out of 45 patients. The detected foreign bodies were mostly located in the esophagus (17 out of 46 foreign bodies detected). When the types of ingested foreign bodies were evaluated, 52 (52%) patients reported ingesting food, and 19 (19%) patients reported swallowing pins. An X-ray was performed on 33 patients with accidental food ingestions but yielded a positive result in only two cases. In 12 out of 21 patients with accidental food ingestion who underwent fiberoptic evaluation, the foreign material was detected and removed. CONCLUSION: Plain radiography is helpful in the localization of radiopaque swollen foreign bodies, while fiberoptic methods are useful as both diagnostic and therapeutic tools, regardless of radiopacity. PMID:24151363
Emergency admissions due to swallowed foreign bodies in adults.
Erbil, Bülent; Karaca, Mehmet Ali; Aslaner, Mehmet Ali; Ibrahimov, Zaur; Kunt, Mehmet Mahir; Akpinar, Erhan; Özmen, Mehmet Mahir
2013-10-14
To study a retrospective analysis of patients who presented to the emergency departments (ED) with complaints related to foreign body ingestions. Patients older than 16 years of age who presented to the ED between January 1(st) and December 31(st) of 2010 with complaints related to swallowed foreign bodies were identified from electronic health records and patient charts. A total of 100 patients presented with a complaint of foreign body ingestion during the study period. Overall, an X-ray was performed on 75 patients, and a fiberoptic evaluation was performed on 45 patients. A foreign body was detected in 46 (46%) patients. The diagnostic yield of the X-ray was 27 (36%) out of 75 patients, while the diagnostic yield of the fiberoptic evaluations was 21 (47%) out of 45 patients. The detected foreign bodies were mostly located in the esophagus (17 out of 46 foreign bodies detected). When the types of ingested foreign bodies were evaluated, 52 (52%) patients reported ingesting food, and 19 (19%) patients reported swallowing pins. An X-ray was performed on 33 patients with accidental food ingestions but yielded a positive result in only two cases. In 12 out of 21 patients with accidental food ingestion who underwent fiberoptic evaluation, the foreign material was detected and removed. Plain radiography is helpful in the localization of radiopaque swollen foreign bodies, while fiberoptic methods are useful as both diagnostic and therapeutic tools, regardless of radiopacity.
Increase in pediatric magnet-related foreign bodies requiring emergency care.
Silverman, Jonathan A; Brown, Julie C; Willis, Margaret M; Ebel, Beth E
2013-12-01
We describe magnetic foreign body injuries among children and obtain national estimates of magnetic foreign body injury incidence over time. We searched the National Electronic Injury Surveillance System for cases of magnetic foreign bodies in children younger than 21 years in the United States, from 2002 to 2011. Cases were analyzed by location: alimentary or respiratory tract, nasal cavity, ear canal, or genital area. We identified 893 cases of magnetic foreign bodies, corresponding to 22,581 magnetic foreign body cases during a 10-year period (95% confidence interval [CI] 17,694 to 27,469). Most magnetic foreign bodies were ingested (74%) or intranasal (21%). Mean age was 5.2 years for ingested magnetic foreign bodies and 10.1 years for nasal magnetic foreign bodies (difference 4.9; 95% CI 4.1 to 5.6), suggesting different circumstances of injury. The incidence of pediatric magnet ingestions increased from 2002 to 2003 from 0.57 cases per 100,000 children per year (95% CI 0.22 to 0.92) to a peak in 2010 to 2011 of 3.06 cases per 100,000 children per year (95% CI 2.16 to 3.96). Most ingested magnetic foreign bodies (73%) and multiple magnet ingestions (91%) occurred in 2007 or later. Patients were admitted in 15.7% of multiple magnet ingestions versus 2.3% of single magnet ingestions (difference 13.4%; 95% CI 2.8% to 24.0%). Magnet-related injuries are an increasing public health problem for young children, as well for older children who may use magnets for play or to imitate piercings. Education and improved magnet safety standards may decrease the risk small magnets pose to children. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.
Sink, Jacquelyn R; Kitsko, Dennis J; Mehta, Deepak K; Georg, Matthew W; Simons, Jeffrey P
2016-04-01
(1) To describe clinical and radiologic findings in patients with esophageal foreign bodies. (2) To examine the sensitivity and specificity of history, physical examination, and radiologic studies in children with suspected foreign body ingestion. A retrospective cohort study was performed evaluating all children who underwent esophagoscopy for suspected foreign body ingestion at our institution from 2006 to 2013. Five hundred forty-three patients were included (54% male). Average age was 4.7 years (SD = 4.1 years). Foreign bodies were identified on esophagoscopy in 497 cases (92%). Ingestion was witnessed in 23% of cases. Most common presenting symptoms were choking/gagging (49%), vomiting (47%), and dysphagia/odynophagia (42%). Most patients with foreign bodies had a normal exam (76%). Most foreign bodies were radiopaque (83%). In 59% of patients with normal chest radiographs, a foreign body was present. Sensitivity and specificity of 1 or more findings on history, physical examination, and imaging were 99% and 0%, 21% and 76%, and 83% and 100%, respectively. Most patients with esophageal foreign bodies are symptomatic. Although many patients will have a normal physical examination, an abnormal exam should increase suspicion for a foreign body. Most esophageal foreign bodies are radiopaque, but a normal chest radiograph cannot rule out a foreign body. © The Author(s) 2015.
Management of ingested foreign bodies in childhood and review of the literature.
Arana, A; Hauser, B; Hachimi-Idrissi, S; Vandenplas, Y
2001-08-01
The management of ingested foreign bodies in children is not standardised. During a 15-year period, we recorded 325 consecutive paediatric cases of accidental ingestion of foreign bodies or with symptoms suggesting oesophageal obstruction presented at the emergency department or the paediatric gastroenterology unit. The foreign bodies that had to be removed were, in decreasing order of frequency: coins, toy parts, jewels, batteries, sharp materials such as needles and pins, fish and chicken bones, and "large" amounts of food. Only 54% of the patients had transient symptoms at the moment of ingestion, such as retrosternal pain, cyanosis and dysphagia. A minority (28, 9%) of foreign bodies could be removed with a McGill forceps; 65 (20%) were removed with a magnet probe. Endoscopic removal was performed in 82 cases (25%). In the majority of cases (150, 46%) natural elimination occurred. The outcome of all patients was uneventful. Recommendations for management of children presenting with a history of suspected accidental ingestion of a foreign body for the community paediatrician are proposed.
An Interesting Cause of Mechanical Small Bowel Obstruction.
Anantha Sathyanarayana, Sandeep; Deutsch, Gary B; Friedman, Barak
2015-12-01
Foreign body ingestion is a known cause of abdominal pain in pediatric population occurring between 6 months and 3 years of age (Wyllie Curr Opin Pediatr 18:563, 2006, Uyemura Am Fam Physician 72:287, 2005, Banerjee Indian J Pediatr 72:173, 2005). Most of the ingested foreign bodies pass spontaneously with 10-20 % requiring endoscopic retrieval, and <1 % of cases require a surgical intervention (Wyllie Curr Opin Pediatr 18:563, 2006, Uyemura Am Fam Physician 72:287, 2005, Shivakumar Indian J Pediatr 71:689, 2004). Presence of intestinal obstruction necessitates surgical intervention to extract the ingested foreign body. Initial abdominal plain radiograph should be obtained when foreign body ingestion is suspected, which differentiates a radiopaque from radiolucent foreign bodies. A computed tomography with 3D reconstruction (3D-CT) is recommended with radiolucent foreign bodies (Uyemura Am Fam Physician 72:287, 2005, Kazam Am J Emerg Med 23:897, 2005). After 24 h of expectant management, failure of spontaneous passage requires further intervention. Timely intervention to relieve the obstruction is pivotal to prevent undue complications. We present an interesting case of a boy who ingested a radiolucent foreign body diagnosed on 3D-CT, successfully treated with surgical extraction.
Ingested foreign bodies in children: a report of two cases.
Singh, Gurjit; Sharma, Surendra; Khurade, Shrikant; Gooptu, Somnath
2014-01-01
Accidental foreign body ingestion and impaction of food bolus present as an emergency. Pediatric population is the most vulnerable. Since the act may go unnoticed, the child may present late. However, most foreign bodies pass spontaneously in the stools. Two children were brought with history of battery ingestion. In one case, an emergency gastro intestinal endoscopy had to be done for the foreign body removal which was made up of corroded battery. In the other case, no interventation was undertaken & an uncorroded battery passed per anum along with stools after 15 days of ingestion. Decision regarding immediate intervention or conservative approach will require consideration of the level of lodgement & type of foreign body. Prevention is possible if parents/guardians exercise control on their wards & are aware of implications of such an event.
Witnessed and unwitnessed esophageal foreign bodies in children.
Louie, Jeffrey P; Alpern, Elizabeth R; Windreich, Randy M
2005-09-01
The purpose of this study was to describe the clinical presentation of children with either an unwitnessed or witnessed esophageal foreign body. Retrospective chart review was performed. Patients were identified using ICD-9 code for esophageal foreign body. Clinical data and management techniques, along with complications were abstracted. For the 5-year period of review, 255 patients were identified with an esophageal foreign body. 214 children had a witnessed ingestion. The mean age of the unwitnessed ingestion group was 2.3 years, compared to 4.6 years for a witnessed ingestion. In both groups, males and females were distributed equally and the most common ingested object was a coin. Bivariate, unadjusted analysis revealed that history of wheeze (OR, 4.35) and fever (OR, 11.15) had the largest association with patients who had an unwitnessed ingestion. Multivariate analysis indicated that any physical findings of wheeze, rhonchi, stridor, or retractions were associated significantly with a diagnosis of an unwitnessed foreign body. Children less than 2 years of age and with a documented fever are also predictive of an unwitnessed ingestion. Eleven children (4.3%) with esophageal abnormalities were also noted to have foreign bodies. Children who present to the emergency department two years old and younger, who have a documented fever and with respiratory findings should be considered at risk for having a retained esophageal foreign body. Children with esophageal abnormalities may also be at risk for retained esophageal foreign bodies.
Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract of Adults
Yao, Chih-Chien; Wu, I-Ting; Lu, Lung-Sheng; Lin, Sheng-Chieh; Liang, Chih-Ming; Kuo, Yuan-Hung; Yang, Shih-Cheng; Wu, Cheng-Kun; Wang, Hsing-Ming; Kuo, Chung-Huang; Chiou, Shue-Shian; Wu, Keng-Liang; Chiu, Yi-Chun; Chuah, Seng-Kee; Tai, Wei-Chen
2015-01-01
Background. Foreign object ingestion and food bolus impaction are a common clinical problem. We report our clinical experiences in endoscopic management for adults, foreign body ingestion, and food bolus impaction. Method. A retrospective chart review study was conducted on adult patients with foreign body ingestion and food bolus impaction between January 2011 and November 2014. Patients with incomplete medical records were excluded. Results. A total of 198 patients (226 incidents) were included in the study (male/female: 1.54/1; age 57 ± 16 years). Among them, 168 foreign bodies were found successfully (74.3%). 75.6% of the foreign bodies were located in the esophagus. Food bolus impaction was most common (41.6%). 93.5% of foreign bodies in current study cohort were successfully extracted and 5 patients required surgical interventions. Comparisons between symptomatic and asymptomatic patients revealed that locations of foreign bodies in the pharynx and esophagus were the significant relevant factors (P < 0.001). Shorter time taken to initiate endoscopic interventions increased detection rate (289.75 ± 465.94 versus 471.06 ± 659.93 minutes, P = 0.028). Conclusion. Endoscopic management is a safe and highly effective procedure in extracting foreign body ingestion and food bolus impaction. Prompt endoscopic interventions can increase the chance of successful foreign bodies' detection. PMID:26258140
Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract of Adults.
Yao, Chih-Chien; Wu, I-Ting; Lu, Lung-Sheng; Lin, Sheng-Chieh; Liang, Chih-Ming; Kuo, Yuan-Hung; Yang, Shih-Cheng; Wu, Cheng-Kun; Wang, Hsing-Ming; Kuo, Chung-Huang; Chiou, Shue-Shian; Wu, Keng-Liang; Chiu, Yi-Chun; Chuah, Seng-Kee; Tai, Wei-Chen
2015-01-01
Foreign object ingestion and food bolus impaction are a common clinical problem. We report our clinical experiences in endoscopic management for adults, foreign body ingestion, and food bolus impaction. A retrospective chart review study was conducted on adult patients with foreign body ingestion and food bolus impaction between January 2011 and November 2014. Patients with incomplete medical records were excluded. A total of 198 patients (226 incidents) were included in the study (male/female: 1.54/1; age 57 ± 16 years). Among them, 168 foreign bodies were found successfully (74.3%). 75.6% of the foreign bodies were located in the esophagus. Food bolus impaction was most common (41.6%). 93.5% of foreign bodies in current study cohort were successfully extracted and 5 patients required surgical interventions. Comparisons between symptomatic and asymptomatic patients revealed that locations of foreign bodies in the pharynx and esophagus were the significant relevant factors (P < 0.001). Shorter time taken to initiate endoscopic interventions increased detection rate (289.75 ± 465.94 versus 471.06 ± 659.93 minutes, P = 0.028). Endoscopic management is a safe and highly effective procedure in extracting foreign body ingestion and food bolus impaction. Prompt endoscopic interventions can increase the chance of successful foreign bodies' detection.
Abdominal foreign body: late presentation as a rectus sheath abscess.
Noushif, M; Sivaprasad, S; Prashanth, A
2011-05-01
Intra-abdominal ingested foreign bodies are usually an incidental finding, typically encountered in mentally challenged patients. We present the case of a 65-year-old mentally sound woman who presented with recurrent abdominal pain and a lump in the hypogastrium. Evaluation revealed a rectus sheath abscess extending to the peritoneum, with a foreign body in situ. On enquiry, the patient revealed that she had accidentally ingested a tailoring needle 17 years ago. This case illustrates an unusual presentation of an ingested foreign body as a rectus sheath abscess after a long duration.
Palta, Renee; Sahota, Amandeep; Bemarki, Ali; Salama, Paul; Simpson, Nicole; Laine, Loren
2009-03-01
Previous reports of foreign-body ingestions focused primarily on accidental ingestions. To describe the characteristics and management of foreign-body ingestions, with predominantly intentional ingestion, in a lower socioeconomic status population. A retrospective case series. An urban county hospital. Patients >/=17 years old, with foreign-body ingestions between 2000 and 2006. Characteristics of ingestion cases, endoscopic extraction, need for surgery, and complications. Among 262 cases, 92% were intentional, 85% involved psychiatric patients, and 84% occurred in patients with prior ingestions. The time from ingestion to presentation was >48 hours in 168 cases (64%). The overall success rate for endoscopic extraction was 90% (165/183 cases). Surgery was performed in 30 cases (11%) and was more common for objects beyond the pylorus versus objects above the pylorus (16/43 [37%] vs 10/151 [7%], respectively) and in cases with a greater delay from ingestion to presentation (25/168 [15%] if >48 hours vs 4/77 [5%] if =48 hours) and from presentation to intervention (15/40 [38%] if >48 hours vs 14/165 [8%] if =48 hours). Perforation occurred in 16 cases (6%), with 6 perforations noted after endoscopy. A retrospective review of medical records. Foreign-body ingestions in an urban county hospital occurred primarily in psychiatric patients who had repeated episodes of intentional ingestions. Endoscopic extraction was unsuccessful in 10% of cases. Long delays from ingestion to presentation and intervention may account for relatively high rates of surgery and perforation. Strategies to prevent ingestions and delays in endoscopic management are needed in this population.
Endoscopic management of suspected esophageal foreign body in adults.
Wu, W-T; Chiu, C-T; Kuo, C-J; Lin, C-J; Chu, Y-Y; Tsou, Y-K; Su, M-Y
2011-04-01
Foreign bodies should not be allowed to remain in the esophagus beyond 24 hours after presentation. However, some patients with esophageal foreign body ingestion do not come to the hospital immediately and may delay medical intervention from the time of ingestion. The aim of this study was to investigate the outcomes of adults with suspected esophageal foreign body ingestion according to the time of ingestion and types of foreign bodies. A total of 326 adult patients (151 men and 175 women) were analyzed, and divided into two groups according to the time period: within or beyond 24 hours from ingestion to endoscopic intervention. A total of 172 patients (52.7%) were found to have ingested foreign bodies; 73.5% were removed smoothly, 10.3% were treated by push technique and 16.0% with failed retrieval received alternative treatments. A higher proportion of patients in the beyond-24 hours group suffered from odynophagia (25.9 vs. 12.9%, P < 0.05). Negative identification of esophageal foreign bodies was more frequent in the beyond-24 hours group (67 vs. 40.2%, P < 0.05), but these patients showed higher proportions of esophageal ulcers (21.1 vs. 7.2%, P < 0.05). The beyond-24 hours group also showed a significantly higher rate of foreign bodies in the lower esophagus (40.0 vs. 15.3%, P < 0.05). Patients with esophageal food bolus impaction had significant delayed endoscopic intervention, longer therapeutic endoscopic time, higher proportions of esophageal cancer, stricture and fewer complications. Endoscopic intervention within 24 hours from the time of ingestion should be considered early in adults, because delaying intervention may produce more symptomatic esophageal ulcerations with odynophagia. © 2010 Copyright the Authors. Journal compilation © 2010, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.
Factors predictive of risk for complications in patients with oesophageal foreign bodies.
Sung, Sang Hun; Jeon, Seong Woo; Son, Hyuk Su; Kim, Sung Kook; Jung, Min Kyu; Cho, Chang Min; Tak, Won Young; Kweon, Young Oh
2011-08-01
Reports on predictive risk factors associated with complications of ingested oesophageal foreign bodies are rare. The aim of this study was to determine the predictive risk factors associated with the complications of oesophageal foreign bodies. Three hundred sixteen cases with foreign bodies in the oesophagus were retrospectively investigated. The predictive risk factors for complications after foreign body ingestion were analysed by multivariate logistic regression, and included age, size and type of foreign body ingested, duration of impaction, and the level of foreign body impaction. The types of oesophageal foreign bodies included fish bones (37.0%), food (19.0%), and metals (18.4%). The complications associated with foreign bodies were ulcers (21.2%), lacerations (14.9%), erosions (12.0%), and perforation (1.9%). Multivariate analysis showed that the duration of impaction (p<0.001), and the type (p<0.001) and size of the foreign bodies (p<0.001) were significant independent risk factors associated with the development of complications in patients with oesophageal foreign bodies. In patients with oesophageal foreign bodies, the risk of complications was increased with a longer duration of impaction, bone type, and larger size. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Updates in pediatric gastrointestinal foreign bodies.
Wright, Christian C; Closson, Forrest T
2013-10-01
Although most ingested foreign bodies in children pass spontaneously, certain foreign bodies can be harmful and they require special attention and emergent medical intervention to prevent significant morbidity and mortality. This article presents an overview of the epidemiology, diagnosis, management, and complications of foreign body ingestions in children. Particular attention is paid to coins, sharp objects, long objects, food bolus, caustic liquids, batteries, and magnets. Copyright © 2013 Elsevier Inc. All rights reserved.
Zhang, Xiaowen; Jiang, Yan; Fu, Tao; Zhang, Xiaoheng; Tu, Chunmei
2017-01-01
Objective This study was performed to identify the differences in clinical characteristics, operative methods, complications, and postoperative hospitalization stays for adults with esophageal foreign bodies with different durations of time from ingestion to effective treatment. Methods We retrospectively reviewed the medical records of 221 patients with a diagnosis of a foreign body in the esophagus, confirmed by rigid esophagoscopy, flexible esophagoscopy, or surgery. The differences between the two groups (Group A, ≤24 hours from ingestion to effective treatment; Group B, >24 hours from ingestion to effective treatment) were analyzed. Results Sharp foreign bodies comprised the majority of objects in the two groups, including jujube pits, bones (excluding fish bones), fish bones, dentures, and seafood shells. Foreign bodies located in the upper esophagus were more commonly observed in Group A than B. Significant differences were observed in the complication rate and length of postoperative hospitalization stays. Adults with esophageal foreign bodies had a high complication rate. Conclusions Rigid esophagoscopy can be used to remove sharp and bulky foreign bodies if more effective methods are unavailable. Effective treatment within 24 hours resulted in fewer complications and shorter postoperative hospitalization stays. PMID:28606025
Katsinelos, Panagiotis; Kountouras, Jannis; Paroutoglou, George; Zavos, Christos; Mimidis, Kostas; Chatzimavroudis, Grigoris
2006-10-01
Ingested foreign bodies and food bolus impaction are frequently seen in endoscopic practice. Successful foreign body and food bolus removal may depend on the method used, the choice of device, and the experience level of the endoscopist, although few papers report experience and outcome of tertiary centers. To investigate the effectiveness of our protocol designed for removal of ingested foreign bodies and food boluses. We retrospectively reviewed all patients with a diagnosis of foreign body ingestion and food bolus impaction from 1994 to 2005 identified by computer search. Patients were excluded if medical record was incomplete. The analysis included 171 patients. Foreign bodies and impacted food boluses were found in 77 and 62 patients, respectively. In 32 cases (23%), the foreign bodies passed spontaneously through the gastrointestinal tract. The overall success rate for endoscopic management was obtained in 137 patients (98.6%). Surgical removal of a foreign body was required in only 2 cases (1.4%). According to the type and location of the foreign object and food bolus we used Dormia baskets, retrieval forceps, polypectomy snares, and all sizes of Roth net. No complications relating to the endoscopic procedure were observed; 50 patients (35.2%) had an underlying esophageal disease. Endoscopic removal of upper gastrointestinal tract foreign bodies and food bolus impaction is efficacious and safe. Especially the Roth net is the best device for safe retrieval of food boluses and button disc batteries.
Saz, Eylem Ulaş; Arikan, Ciğdem; Ozgenç, Funda; Duyu, Muhterem; Ozananar, Yeliz
2010-06-01
We aimed to identify the presence of ingested metallic foreign bodies with handheld metal detector in the pediatric population. All children (n=40) known or suspected to have ingested a MFB and who presented to the Emergency Department of the Children's Hospital of Ege University were prospectively ascertained. All patients underwent both radiographic evaluation and handheld metal detector scanning of the chest and abdomen on their presentation. In the present prospective study, we compared handheld metal detector scanning with plain radiography. The end point of the study compared metallic foreign body findings with handheld metal detector vs radiological findings during an eight-month period. Forty subjects with possible metallic foreign body ingestion were enrolled into the study. The principle investigator scanned all subjects. Disease was defined by the presence of a foreign body in the gastrointestinal tract on radiograph. Radiographically, 35 foreign bodies were found, and handheld metal detector revealed 31 of them. The sensitivity of handheld metal detector was 88.6% (95% confidence interval [CI]: 72.1%-96.5%), specificity 100% (95% CI: 61.8%-100%), positive predictive value (PPV) 100% (95% CI: 85.8%-100%), and negative predictive value 55.5% (95% CI: 34.3%-84.6%). Handheld metal detector revealed that 2 metallic foreign bodies (1 pushpin, 1 coin) were localized to the chest, which was confirmed by radiography, and urgent removal was performed with endoscopy. Handheld metal detector scanning is an accurate, inexpensive, radiation-free screening tool and should be used for evaluation of patients suspected of ingesting metallic foreign bodies.
Swallowed foreign bodies in adults.
Ambe, Peter; Weber, Sebastian A; Schauer, Mathias; Knoefel, Wolfram T
2012-12-01
Foreign-body ingestion is a common event most often seen in children from 6 months to 6 years of age. In adults, foreign bodies are usually ingested accidentally together with food. This happens more commonly in persons with certain pathological changes of the gastrointestinal tract. We present a selective review of pertinent literature retrieved by a search in the PubMed database. The foreign bodies most commonly ingested by adults are fish bones and chicken bones. The clinical approach to the problem depends on the type of material ingested and on the patient's symptoms and physical findings. In about 80% of cases, the ingested material passes uneventfully through the gastrointestinal tract; endoscopy is performed in about 20% of cases, and surgery in less than 1%. Emergency esophagogastroduodenoscopy (EGD) is recommended when the esophagus is completely occluded (because of the risk of aspiration and/or pressure necrosis), when the ingested object has a sharp point or edge (because of the risk of perforation, with ensuing mediastinitis or peritonitis), and when a battery has been ingested (because of the risk of necrosis and fistula formation). For non-occluding esophageal foreign bodies, including magnets, an urgent but non-emergency EGD within 12 to 24 hours is recommended. Most patients can be treated conservatively by observation alone, but there should be a low threshold for deciding to proceed to endoscopic retrieval. Surgery is reserved for complicated cases.
All the wrong places: an unusual case of foreign body ingestion and inhalation.
Tammana, V S; Valluru, N; Sanderson, A
2012-09-01
Intentional ingestion of foreign bodies is common in psychiatric patients and prison inmates. Timing of endoscopy for ingested foreign bodies varies and depends on the type and location of the foreign body in the gastrointestinal tract. We present the case of a 26-year-old man who was brought from a correctional facility after confessing to have swallowed a few shower curtain hooks. Abdominal X-ray done in the emergency room revealed multiple foreign bodies in the stomach. An upper endoscopy was done in the emergency room with the use of an overtube. The first metal piece was caught by a snare and removed with the endoscope. All other foreign bodies which were present on the abdominal X-ray could not be visualized initially as there was retained food in the stomach. After multiple attempts, four other foreign bodies were found and each one was caught by the forceps and then the scope was removed with the forceps holding the foreign body. There was an additional foreign body in the right mainstem bronchus. The patient had coughed up the foreign body and swallowed it into the gastrointestinal tract. A computed tomography scan of chest and abdomen was done for evaluation, which showed the foreign body in the cecum. To our knowledge, this is the first case report of a patient intentionally transferring a foreign body from one organ system to another. Colonoscopy was done and the foreign body was removed rectally with a snare without any complications.
Surgical intervention for gastrointestinal foreign bodies in adults: a case series.
Syrakos, Theodoros; Zacharakis, Emmanouil; Antonitsis, Polichronis; Zacharakis, Evangelos; Spanos, Constantinos; Georgantis, G; Kiskinis, Dimitrios
2008-01-01
The aim of our study was to demonstrate our experience regarding the surgical treatment of complications after foreign body ingestion. From 1997 to 2005, we treated 16 adult patients (mean age 44.8 years, range 21-77), who presented with complications after foreign body ingestion. The complications treated were perforation-peritonitis: n = 7 (44%), intra-abdominal abscess formation: n = 5 (31%), upper gastrointestinal bleeding: n = 3 (19%) and inflammatory mass formation: n = 1 (6%) patient. The diagnosis was made intra-operatively in 13 (81.3%) of the cases. The commonest anatomical position of the perforation was the large bowel, in 7 (43%) of the cases. Bony food parts were the commonest foreign bodies accidentally swallowed, in 9 (56%) patients. The median hospital stay was 7 days (2-18), while no death occurred in the postoperative period among the patients of the study. The postoperative morbidity rate was 22.2%. The most common complication after foreign body ingestion was the perforation of the gastrointestinal tract. The risk of perforation was higher when sharp foreign bodies were ingested. The pre-operative diagnosis was difficult, and it was usually achieved intra-operatively. (c) 2008 S. Karger AG, Basel
[Intestinal volvulus caused by the ingestion of magnet balls: unexpected risk in children].
Kubačková, D; Nosek, J; Třeška, V; Vacek, V; Pizingerová, K
2015-05-01
The occurrence of swallowed foreign bodies in the digestive system is a common problem in children with the highest incidence in children aged six months to five years. Most swallowed objects leave the human body per vias naturales while 10-20% of swallowed foreign bodies need to be removed with an endoscope. Serious and life-threatening situations are caused by the ingestion of foreign bodies in about 1% of all cases. The authors present a case of a two-year-old girl diagnosed with acute abdomen for which she was operated on. A small bowel volvulus and several intestinal fistulas were found intraoperatively. The cause of this finding was the ingestion of magnetic balls and a swallowed metal body drawn to them by magnetic force. If more than one magnetic body is ingested, it is necessary to admit the patient to hospital and to remove these foreign bodies using an endoscope. The position of the magnets which is not changing in a location inaccessible for an endoscope during 2448 hours is an indication for urgent operation.
Endoscopic management of foreign bodies in the upper-GI tract: experience with 1088 cases in China.
Li, Zhao-Shen; Sun, Zhen-Xing; Zou, Duo-Wu; Xu, Guo-Ming; Wu, Ren-Pei; Liao, Zhuan
2006-10-01
Reports on endoscopic management of ingested foreign bodies of the upper-GI tract in China are scarce. To report our experience and outcome in the management of ingestion of foreign bodies in Chinese patients. Between January 1980 and January 2005, a total of 1088 patients (685 men and 403 women; age range, 1 day to 96 years old) with suspected foreign bodies were admitted to our endoscopy center. All patients underwent endoscopic procedure after admission. Demographic and endoscopic data, including age, sex, and referral sources of patients, types, number and location of foreign bodies, associated upper-GI diseases, endoscopic methods, and accessory devices for removal of foreign bodies were collected and analyzed. A total of 1090 foreign bodies were found in 988 (90.8%) patients. The types of foreign bodies varied greatly: mainly food boluses, coins, fish bones, dental prostheses, or chicken bones. The foreign bodies were located in the pharynx (n = 12), the esophagus (n = 577), the stomach (n = 441), the duodenum (n = 50), and the surgical anastomosis (n = 10). The associated GI diseases (n = 88) included esophageal carcinoma (33.0%), stricture (23.9%), diverticulum (15.9%), postgastrectomy (11.4%), hiatal hernia (10.2%), and achalasia (5.7%). A rat-tooth forceps and a snare were the most frequently used accessory devices. The success rate for foreign-body removal was 94.1% (930/988). Ingestion of foreign bodies is a common clinic problem in China. Endoscopy procedures are frequently performed, and a high proportion of patients with foreign bodies require endoscopic intervention.
Travel of a mis-swallowed long spoon to the jejunum
Song, Yan; Guo, Hua; Wu, Jian-Yong
2009-01-01
Foreign-body ingestion is a relatively common presentation at emergency departments, but long metallic spoon swallowing is an infrequent occurrence. Unlike most cases of foreign-body ingestion, there have been no reported cases of long foreign bodies reaching the jejunum. We report a rare case of a coffee spoon that was swallowed accidentally and passed through the pylorus and duodenal loop and reached the jejunum, with no complications. PMID:19842235
Foreign bodies ingestion: what responsibility?
Ricci, Serafino; Massoni, Francesco; Schiffino, Luigi; Pelosi, Marcello; Salesi, Marialucia
2014-03-01
The ingestion of foreign bodies is one of the most important and difficult emergencies for a physician to diagnose. Accidental ingestion is more common in children, in patients with dental implants, in individuals with mental disability and in drug users. Voluntary ingestion is found in patients who are psychologically unstable, in prisoners or those who attempt suicide. Foreign bodies may be divided into food as fish bones, chicken bones, food bolus, meat, etc. or real foreign bodies such as orthodontic implants, needles, pins, glass, coins, etc. The authors present a case of management, from the medicolegal point of view, of a female patient age 80, who complained, for some weeks of modest pain in the left iliac fossa, and afterwards the endoscopy showed a toothpick into the wall of the sigmoid colon. Assessed of the clinical status of the patient presented severe cardiac comorbidities so that before processing the patient to a second resolutive endoscopy, it was necessary to obtain the hemodynamic stability. However the management of cases of accidental ingestion of foreign bodies is particularly difficult. Medical errors can arise from the very first contact with the patient resulting in delays in appropriate treatment. The doctor to avoid compromising its position on medical liability, must use all the knowledge and diligence known by the art and science of medicine. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Review of foreign body ingestion and esophageal food impaction management in adolescents.
Sahn, Benjamin; Mamula, Petar; Ford, Carol A
2014-08-01
Foreign body ingestion is a common clinical scenario among patients of all ages. The immediate risk to the patient ranges from negligible to life threatening. Initial and follow-up management strategies depend on multiple patient and ingested object-related factors. Available literature on this topic tends to focus on the small child or adult, leaving the clinician caring for adolescents to extrapolate this information to guide decision making for individual patients. This article reviews foreign body ingestion literature with important implications to the adolescent patient and raises awareness of some highly dangerous objects such as large button batteries, high-powered magnets, long sharps, narcotic packages, and super absorbent objects. An additional focus includes the management of esophageal food impaction. We highlight the unique aspects to the care of the adolescent with intentional ingestion and co-morbid psychiatric illness. The article concludes by discussing the challenges to prevention of ingestion in the at-risk patient. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
The catheter hub disinfection cap as esophageal foreign body.
Tawfik, Kareem O; Myer, Charles M; Shikary, Tasneem; Goldschneider, Kenneth R
2015-12-01
Disinfection caps are increasingly being used to prevent catheter-associated bloodstream infections. These devices, designed for continuous passive disinfection of catheter hubs, are typically small and often brightly colored. As such, they have the potential to become pediatric airway and esophageal foreign bodies. We report two patients who developed esophageal foreign body following ingestion of disinfection caps. Given the increasing use of these devices, it is imperative that health care providers be aware of this potential iatrogenic problem. We propose that the use of disinfection caps may not be appropriate in pediatric patients with risk factors for foreign body ingestion. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.
ERIC Educational Resources Information Center
Terreros, I. Gomez de; And Others
1996-01-01
An unusual case of Munchausen syndrome by proxy is reported. A mother with a psychiatric record of behavior disorders and family dysfunction perpetrated the ingestion of foreign bodies (for example, earrings, a screw, sewing needles) on a 10-month-old infant with a history of prematurity, repeated visits to emergency rooms, and nonjustified…
Risk factors for complications associated with upper gastrointestinal foreign bodies
Hong, Kyong Hee; Kim, Yoon Jae; Kim, Jae Hak; Chun, Song Wook; Kim, Hee Man; Cho, Jae Hee
2015-01-01
AIM: To investigate predictive risk factors associated with complications in the endoscopic removal of foreign bodies from the upper gastrointestinal tract. METHODS: We retrospectively reviewed the medical records of 194 patients with a diagnosis of foreign body impaction in the upper gastrointestinal tract, confirmed by endoscopy, at two university hospital in South Korea. Patient demographic data, including age, gender, intention to ingestion, symptoms at admission, and comorbidities, were collected. Clinical features of the foreign bodies, such as type, size, sharpness of edges, number, and location, were analyzed. Endoscopic data those were analyzed included duration of foreign body impaction, duration of endoscopic performance, endoscopic device, days of hospitalization, complication rate, 30-d mortality rate, and the number of operations related to foreign body removal. RESULTS: The types of upper gastrointestinal foreign bodies included fish bones, drugs, shells, meat, metal, and animal bones. The locations of impacted foreign bodies were the upper esophagus (57.2%), mid esophagus (28.4%), stomach (10.8%), and lower esophagus (3.6%). The median size of the foreign bodies was 26.2 ± 16.7 mm. Among 194 patients, endoscopic removal was achieved in 189, and complications developed in 51 patients (26.9%). Significant complications associated with foreign body impaction and removal included deep lacerations with minor bleeding (n = 31, 16%), ulcer (n = 11, 5.7%), perforation (n = 3, 1.5%), and abscess (n = 1, 0.5%). Four patients underwent operations because of incomplete endoscopic foreign body extraction. In multivariate analyses, risk factors for endoscopic complications and failure were sharpness (HR = 2.48, 95%CI: 1.07-5.72; P = 0.034) and a greater than 12-h duration of impaction (HR = 2.42, 95%CI: 1.12-5.25, P = 0.025). CONCLUSION: In cases of longer than 12 h since foreign body ingestion or sharp-pointed objects, rapid endoscopic intervention should be provided in patients with ingested foreign bodies. PMID:26185385
Geraci, Girolamo; Sciume', Carmelo; Di Carlo, Giovanni; Picciurro, Antonino; Modica, Giuseppe
2016-11-04
Ingestion of foreign bodies and food impaction represent the second most common endoscopic emergency after bleeding. The aim of this paper is to report the management and the outcomes in 67 patients admitted for suspected ingestion of foreign body between December 2012 and December 2014. This retrospective study was conducted at Palermo University Hospitals, Italy, over a 2-year period. We reviewed patients' database (age, sex, type of foreign body and its anatomical location, treatments, and outcomes as complications, success rates, and mortalities). Foreign bodies were found in all of our 67 patients. Almost all were found in the stomach and lower esophagus (77 %). The types of foreign body were very different, but they were chiefly meat boluses, fishbones or cartilages, button battery and dental prostheses. In all patients it was possible to endoscopically remove the foreign body. Complications related to the endoscopic procedure were unfrequent (about 7 %) and have been treated conservatively. 5.9 % of patients had previous esophageal or laryngeal surgery, and 8.9 % had an underlying esophageal disease, such as a narrowing, dismotility or achalasia. Our experience with foreign bodies and food impaction emphasizes the importance of endoscopic approach and removal, simple and secure when performed by experienced hands and under conscious sedation in most cases. High success rates, lower incidence of minor complications, reduction of the need of surgery and reduced hospitalization time are the strengths of the endoscopic approach.
Yuan, Fangfang; Tang, Xiaowei; Gong, Wei; Su, Lei; Zhang, Yali
2018-01-01
Foreign body ingestion is a relatively common occurrence, which may lead to morbidity and mortality. The aim of the present study was to report the experience of management of upper gastrointestinal foreign bodies by endoscopy in a large center. All patients who presented at the Department of Gastroenterology at Nanfang Hospital (Guangzhou, China) with complaints regarding upper gastrointestinal (GI) foreign body ingestion from December 1987 to December 2013. Hospital medical charts and endoscopic records were examined to evaluate etiology, treatment, and outcomes for these patients. A total of 846 patients were enrolled in the present study, from which foreign bodies were detected in 737 (87.1%) patients via X-ray or endoscopy. The objects most frequently ingested were bones (n=395, 53.6%). The detected foreign bodies were predominantly located in the cervical esophagus (n=325, 44.1%). Endoscopic foreign body extraction was successful in 92.5% of cases, whereas surgery was required in 6 patients. The most frequently used endoscopic accessory devices were retrieval forceps (n=480, 65.1%). The complication rate was 6.9%, including mucosal laceration (n=10) and others, all of which were managed conservatively. Associated GI diseases were reported in 74 (10.0%) patients, including postesophagectomy (n=34) and others. In conclusion, the endoscopic procedure was safe and effective for the removal of foreign bodies from the upper gastrointestinal tract, with a high success rate and low complication rate. PMID:29434711
Di Guglielmo, Matthew; Savage, Jillian; Gould, Sharon; Murphy, Stephen
2017-05-01
Abdominal pain in female adolescents is a common presentation to both the emergency department and the outpatient pediatric clinic. The broad differential diagnosis for abdominal pain requires a high index of suspicion to make an accurate diagnosis of foreign body ingestion as the etiology. Foreign body ingestion occurs in all age groups, but sequelae of gastrointestinal tract perforation in children are rare. Treatment for perforation requires consultation of the pediatric general surgeon. Clinicians should take care to not overlook subtle imaging findings or dietary/exposure history, even in the context of a patient with known history of abdominal pain. We report the accidental ingestion of a wire bristle from a grill cleaning brush by a female adolescent. The patient, previously treated and seen for constipation and irritable bowel syndrome in the outpatient gastroenterology clinic, was referred to the emergency department after identification of a foreign body on abdominal radiography. Emergency department physicians discovered the history of grilling and consumption of grilled food, facilitating diagnosis of a wire bristle as the foreign body. The metallic foreign body had migrated to the colon, where it perforated and lodged into the abdominal wall, causing acute, focal symptoms. Observation in the hospital with pain control and infection management allowed for elective laparoscopy. The surgical team removed the object with minimal morbidity and avoided laparotomy. Reports of unintended ingestion of wire bristles have been increasingly reported in the literature; however, most focus on injury to the upper airway or upper digestive tract and subsequent endoscopic or laryngoscopic removal. Most reports detail injury in adult patients, pediatric case reports with digestive tract injury are uncommon, and foreign body removal after lower digestive tract injury in children from a wire bristle has not been reported. We caution pediatric emergency medicine and ambulatory providers to consider such an ingestion and perforation in the differential diagnosis of acute-onset, focal, and localizable abdominal pain in children.
[Magnet ingestions in children: a French multicenter study].
Talvard, M; Mouttalib, S; Flaum, V; Viala, J; Galinier, P; Olives, J-P; Mas, E
2015-01-01
Digestive complications related to the ingestion of magnetic foreign bodies in children are increasing, especially in Asia and North America. In France, several case reports have been reported since 2008. We conducted a retrospective multicentric study to evaluate the frequency of ingestion of magnet foreign bodies and to describe the complicated cases that have occurred in France over the last 5 years. We report 40 cases of which 60% were multiple magnet ingestions. Eighty-eight percent of the children of the group who had swallowed multiple magnets needed interventional management by endoscopy (33%) or surgery (58%). Only two children (12.5%) of the group who swallowed one magnet required removal. This problem is not uncommon in France (2% of the 1132 foreign bodies investigated in the Toulouse center over 5 years), which justifies clear information for healthcare professionals and caregivers in order to avoid potential intestinal complications. We suggest interventional management or very close monitoring in the cases of multiple magnet ingestion. Meanwhile, in the majority of confirmed cases of simple magnet ingestions, we propose home monitoring. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
Endoscopic management of ingested foreign bodies and food impactions.
Malick, K Jane
2013-01-01
Endoscopy plays a major role in the management of foreign bodies and food impactions. Because of their frequent occurrence and potential for complications, it is important for the gastroenterology nurse and associate to gain an understanding of the incidence, diagnosis, and management of patients who present with ingested foreign bodies or food impaction. This article summarizes the clinical approach to patient: assessment, preparation for endoscopic procedure, preparation of endoscopic accessories, and follow-up care. Finally, an interesting case presentation highlights key components of caring for patients requiring endoscopic intervention.
Emergency endoscopic management of dietary foreign bodies in the esophagus.
Lin, Hsuan-Hwai; Lee, Shih-Chun; Chu, Heng-Cheng; Chang, Wei-Kuo; Chao, You-Chen; Hsieh, Tsai-Yuan
2007-07-01
We report our experience of endoscopy in the emergency management of dietary foreign bodies. One hundred thirty-six patients were admitted to the emergency department (ED) between January 1997 and October 2006 for the endoscopic removal of esophageal dietary foreign bodies. They had a mean age of 47.7 years, and 91 (67%) were women. Most of the ingested materials (98.5%) were successfully extracted using either flexible or rigid endoscope. The objects most frequently ingested were fish bones (48%) and chicken bones (46%). Most of the objects (84%) were lodged in the upper esophagus. Two patients with irretrievable foreign bodies or complicated perforations were taken to surgery. Because most of these foreign bodies lodged in the upper esophagus, physicians should take care of this area to avoid secondary injury or complications, especially with sharp bones.
Insurance status as a risk factor for foreign body ingestion or aspiration.
Arjmand, E M; Muntz, H R; Stratmann, S L
1997-10-18
To determine whether the lack of private health insurance places children at increased risk for foreign body ingestion or aspiration. Retrospective review. St. Louis Children's Hospital, a tertiary care center. Consecutive sample of 125 patients with esophageal or airway foreign bodies. Fifty percent of all patients had private health insurance. Fifty-six percent of all preschool patients and 20% of all school-age patients were uninsured (P < 0.01, Fisher's exact test). Eighty-five percent of patients with airway foreign bodies, and 84% of patients with esophageal foreign bodies were in the preschool group. Sixty-one percent of preschool patients and 21% of school-age patients with esophageal foreign bodies were uninsured (P < 0.05). Forty-six percent of preschool patients with food aspiration lacked health insurance (88% of these children were fed the aspirated item). No school-age group was available for comparison. Fifty percent of preschool children with aspiration of non food items were uninsured, as were 16% of their school-age counterparts. Insurance status must be considered as a risk factor for foreign body aspiration and ingestion. Preschool children are more likely to lack private health insurance than school-age children with the same diagnosis. In a majority of aspiration events, the child was being fed the inappropriate food item, perhaps indicating a lack of caretaker education and anticipatory guidance. A direct focus on 'passive protection', anticipatory guidance in clinics for all patients, and public education with emphasis on preventive care are proposed as means to decrease the incidence of airway and esophageal foreign bodies in children.
Endoscopic Management of Foreign Bodies in the Gastrointestinal Tract: A Review of the Literature
Andrade, Javier; Twersky, Yitzhak; Iqbal, Shahzad
2016-01-01
Foreign body ingestion is a common diagnosis that presents in emergency departments throughout the world. Distinct foreign bodies predispose to particular locations of impaction in the gastrointestinal tract, commonly meat boluses in the esophagus above a preexisting esophageal stricture or ring in adults and coins in children. Several other groups are at high risk of foreign body impaction, mentally handicapped individuals or those with psychiatric illness, abusers of drugs or alcohol, and the geriatric population. Patients with foreign body ingestion typically present with odynophagia, dysphagia, sensation of having an object stuck, chest pain, and nausea/vomiting. The majority of foreign bodies pass through the digestive system spontaneously without causing any harm, symptoms, or necessitating any further intervention. A well-documented clinical history and thorough physical exam is critical in making the diagnosis, if additional modalities are needed, a CT scan and diagnostic endoscopy are generally the preferred modalities. Various tools can be used to remove foreign bodies, and endoscopic treatment is safe and effective if performed by a skilled endoscopist. PMID:27807447
Spontaneous passage of long, sharp gastrointestinal foreign body in a child.
Karthikeyan, Vilvapathy Senguttuvan; Ansari, Mohammed Gaffoor; Suresh, Ramasamy; Easwaran, Bettaiyagowder
2015-01-19
Foreign body (FB) ingestion is a common problem in children. Up to 90% of these FBs pass spontaneously. FBs reaching the stomach usually pass out spontaneously. Exceptions to this spontaneous passage include a long FB that cannot cross the pylorus, duodenum or ileocaecal junction. We present a case of a 9-year boy who accidentally ingested a long paper pin, which spontaneously passed in 26 h. This case is being reported to highlight the successful spontaneous passage of a 4 cm long sharp foreign body in a child. 2015 BMJ Publishing Group Ltd.
Nation, Javan; Jiang, Wen
2017-01-01
To test the ability of a handheld metal detector (HHMD) to identify the presence and location of ingested metallic foreign bodies (MFBs) in children. Prospective case series enrolling children suspected of metallic foreign body ingestion presenting to the Emergency Department. Thirty-eight children were enrolled and the HHMD was used to detect the presence and location of a MFB. Results were compared to standard radiographic studies. Thirty-seven of the 38 ingested foreign bodies were MFBs. Of the 37 MFBs, the HHMD positively identified 33, and 4 were missed by HHMD but identified on radiography. When positive, the location indicated by HHMD correlated 100% with radiograph. There were 33 true positives, 0 false positives, 4 false negatives, and 1 true negative. This resulted in a sensitivity of 89% (95% CI of 75%-96%) and specificity of 100% (95% CI of 2.5%-100%). Our study demonstrates the accuracy of HHMD in the identification and localization of metallic foreign bodies. We propose an emergency room foreign body protocol that uses HHMD as an early screening tool in triage in order to expedite the process of obtaining Otolaryngology consultation and potentially shorten the wait time to the operating room or discharge. In instances were outside films are previously performed, HHMD use may be able to minimize the overall radiation exposure to children by obviating the need for repeat radiographs. As the sensitivity is not 100%, a negative HHMD screening does not negate the need for a standard radiograph in order to avoid missed MFBs. HHMD is best suited for detection of coins, which accounts for the majority of the MFB ingestions, and may not be suitable for all metallic objects since the amount of metal may decrease its sensitivity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Ramlakhan, S L; Burke, D P; Gilchrist, J
2006-06-01
To review compliance with our emergency department (ED) guideline on the imaging of ingested non-hazardous metallic foreign bodies in children, investigate adverse outcomes, and make suggestions for improving the guideline. Retrospective analysis of patients presenting in a 3 year period to a paediatric ED with a history of possible metallic foreign body (MFB) ingestion, who were managed according to an ED guideline. We identified 430 episodes of possible MFB ingestion, of which 422 were eligible for inclusion in the study. Compliance with the guideline was 77.8% with no significant adverse events. The exclusion of symptoms as a criterion for x ray results in a reduction in the x ray rate of 56% in the symptomatic group with no increase in adverse events. A handheld metal detector (HMD) can be safely and reliably used in lieu of plain radiography to investigate children with a history of MFB ingestion, irrespective of symptoms and without incurring any significant adverse events.
An unusual presentation of a chronic ingested foreign body in an adult.
Kropf, Jesse A H; Jeanmonod, Rebecca; Yen, David M
2013-01-01
Sore throat is a common complaint for patients presenting to the emergency department (ED). Although most are caused by viral and bacterial sources, an ingested foreign body must be considered in the right patient population. Retained foreign bodies occur in both children and adults. In children, the objects are usually non-food items, whereas adults are more likely to have impacted food boluses. Typically, patients present acutely, and chronic foreign bodies are rare, especially in adults. We use an unusual presentation of a retained foreign body in a previously undiagnosed Zenker diverticulum to review ingested foreign bodies and Zenker diverticuli. We report the case of an 82-year-old woman who presented to the ED with a chief complaint of 12 h of worsening pharyngitis and odynophagia. She reported she had a capsule endoscopy performed approximately 4 months earlier during which the device had malfunctioned and no images were transmitted from beyond the esophagus. A soft tissue film of the neck showed the endoscopic capsule retained at the level of the clavicles. Esophagogastroduodenoscopy demonstrated a previously undiagnosed Zenker diverticulum containing the endoscope capsule. This was subsequently removed with laryngoscopy. Complaints related to sore throat commonly have a simple explanation. Recurrent symptoms and a physical examination inconsistent with common explanations require the differential to be broadened and less common causes considered. Copyright © 2013 Elsevier Inc. All rights reserved.
Fluoroscopy-Guided Endoscopic Removal of Foreign Bodies.
Kim, Junhwan; Ahn, Ji Yong; So, Seol; Lee, Mingee; Oh, Kyunghwan; Jung, Hwoon-Yong
2017-03-01
In most cases of ingested foreign bodies, endoscopy is the first treatment of choice. Moreover, emergency endoscopic removal is required for sharp and pointed foreign bodies such as animal or fish bones, food boluses, and button batteries due to the increased risks of perforation, obstruction, and bleeding. Here, we presented two cases that needed emergency endoscopic removal of foreign bodies without sufficient fasting time. Foreign bodies could not be visualized by endoscopy due to food residue; therefore, fluoroscopic imaging was utilized for endoscopic removal of foreign bodies in both cases.
Yip, L W; Goh, F S; Sim, R S
1998-03-01
This is a case report of an elderly lady with odynophagia because she accidentally swallowed a tablet which was still wrapped in its blister pack. A discussion of foreign body ingestion, particularly in the elderly, is included. To the authors' knowledge, this is the first paper that includes a lateral cervical radiograph of an ingested blister pack.
Bowel obstruction due to ingestion of a water-absorbing bead.
Fuger, M; Desmoulins, C; Khen Dunlop, N; Gobbo, F; Blakime, P; Chéron, G
2018-02-01
Foreign body ingestion is a common pediatric complaint. Most foreign bodies pass spontaneously through the gastrointestinal tract, but bowel obstruction is a rare complication that can occur. We report a case of a 14-month-old infant with complete bowel obstruction due to ingestion of a polymer bead used for botanical arrangements. A laparotomy was performed to remove the object, resolving the symptoms. Polymer beads are brightly coloured and are of a size that is easy to swallow by very young children, increasing the risk of accidental ingestion. They increase in size over a short period of time during their passage through the gastrointestinal tract, causing significant morbidity. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
An ingested foreign body: two sides of the same coin?
Varadharajan, Kiran; Magill, Jennifer; Patel, Kalpesh
2014-04-09
A 2-year-old child presented to the emergency department with an acute onset of dysphagia and stertor. A plain anteroposterior chest X-ray revealed a single circular opacity in the middle third of the oesophagus consistent with an ingested coin. The child was taken to the theatre for rigid pharyngo-oesophagoscopy and removal of the coin. After the first coin was removed subsequent endoscopic examination revealed a second coin at the same location. This extremely rare case of two ingested coins becoming impacted with perfect radiological alignment emphasises the importance of thorough examination on endoscopy and the potential limitations of an X-ray in initial assessment of an ingested foreign body.
An ingested foreign body: two sides of the same coin?
Varadharajan, Kiran; Magill, Jennifer; Patel, Kalpesh
2014-01-01
A 2-year-old child presented to the emergency department with an acute onset of dysphagia and stertor. A plain anteroposterior chest X-ray revealed a single circular opacity in the middle third of the oesophagus consistent with an ingested coin. The child was taken to the theatre for rigid pharyngo-oesophagoscopy and removal of the coin. After the first coin was removed subsequent endoscopic examination revealed a second coin at the same location. This extremely rare case of two ingested coins becoming impacted with perfect radiological alignment emphasises the importance of thorough examination on endoscopy and the potential limitations of an X-ray in initial assessment of an ingested foreign body. PMID:24717590
An Ingested Orthodontic Wire Fragment: A Case Report.
Puryer, James; McNamara, Catherine; Sandy, Jonathan; Ireland, Tony
2016-08-01
Accidental ingestion or inhalation of foreign bodies has been widely documented, including incidents which occur whilst undertaking dental treatment. Most ingested objects pass through the gastrointestinal tract (GIT) spontaneously, but approximately 10%-20% need to be removed endoscopically and 1% require surgery. This case reports a complication arising from the accidental loss of an archwire fragment during maxillary archwire placement. It describes the immediate and subsequent management, including the use of radiographs to track the passage of the fragment through the gastro-intestinal tract. This case stresses the vigilance that dentists must take to prevent inhalation or ingestion of foreign bodies and the consequences of time-delays when management decisions are needed.
An Ingested Orthodontic Wire Fragment: A Case Report
Puryer, James; McNamara, Catherine; Sandy, Jonathan; Ireland, Tony
2016-01-01
Accidental ingestion or inhalation of foreign bodies has been widely documented, including incidents which occur whilst undertaking dental treatment. Most ingested objects pass through the gastrointestinal tract (GIT) spontaneously, but approximately 10%–20% need to be removed endoscopically and 1% require surgery. This case reports a complication arising from the accidental loss of an archwire fragment during maxillary archwire placement. It describes the immediate and subsequent management, including the use of radiographs to track the passage of the fragment through the gastro-intestinal tract. This case stresses the vigilance that dentists must take to prevent inhalation or ingestion of foreign bodies and the consequences of time-delays when management decisions are needed. PMID:29563466
Button battery ingestion: the Greek experience and review of the literature.
Amanatidou, Virginia; Sofidiotou, Vassiliki; Fountas, Kostas; Kalostou, Angeliki; Tsamadou, Athina; Papathanassiou, Vassiliki; Neou, Polyxeni
2011-03-01
Foreign body ingestion is a common cause of admission in the pediatric emergency room. In the past, button batteries accounted for less than 2% of the foreign bodies ingested by small children, but in the last 2 decades, they show a rapidly increased frequency. The aim of the present study was to evaluate the potential risk after button battery ingestion in relation with the clinical manifestations and to perform a treatment-observation protocol in accordance with the international procedure. In a prospective observational analysis from November 2007 through February 2008, 31 cases of button battery ingestion were recorded by the Greek Poison Information Center. The interval between the accidental ingestion and first medical contact ranged from 5 minutes to 10 days. After initial evaluation including clinical examination and radiological localization of the foreign body, all cases were treated as outpatients. Reported complications included "black stools" in 9% and diarrhea in 3% of cases. In 1 case, the battery was endoscopically removed. The role of primary care physicians in informing the public about the potential danger of button battery digestion is crucial. Pediatricians should educate the parents about this hazard, as part of the routine guidelines for childproofing at home. Once again, prolepsis is the best policy.
Foreign bodies and caustic lesions.
Dray, Xavier; Cattan, Pierre
2013-10-01
Foreign body ingestions, food bolus impactions, and caustic agent injuries are frequent but specific situations. Although most foreign bodies will naturally pass through the digestive tract, practitioners should recognize specific situations were endoscopic management is required. In such cases, timing and adequate equipment are critical. Endoscopic treatment is successful in about 95% of patients. Severe complications (including oesophageal perforations) are rare. Underlying diseases (including eosinophilic oesophagitis) must be investigated after food bolus impaction. Accidental or suicidal ingestion of corrosive agents may result in severe upper gastrointestinal tract injuries requiring a multidisciplinary approach including gastroenterologists, surgeons, otorhynolaryngologists, anaesthesiologists and psychiatrists. Treatment includes conservative management of patients with mild injuries, while patients with severe injuries undergo emergency surgical exploration. At distance of the ingestion episode, oesophageal reconstruction is required in patients who underwent oesophageal resection and in patients who developed oesophageal strictures that failed dilatation. Copyright © 2013. Published by Elsevier Ltd.
Santander-Flores, Selene Artemisa; Mata-Quintero, Carlos Javier; O'Farrill-Anzures, Ricardo; González-Villegas, Paloma; Calvo-Vázquez, Iván; Campos-Serna, Esteban Israel
Foreign body ingestion is the second cause of endoscopic emergency in the elderly, and dentures are the most frequent accidently ingested objects. Once in the stomach, their expulsion can be expected in 4 to 6 days. The treatment is wait and see in asymptomatic patients, but preventive endoscopic removal can also be performed. To present 2 scenarios of the outcome and treatment in patients with foreign body ingestion. Patient under study due to weight loss, with a denture detected by abdominal x-ray, ingested inadvertently a year ago. A laparotomy was required as extraction by colonoscopy failed, due to excessive inflammation. The second case, of 24-hour onset, was due to the ingestion of a partial denture. As duodenal endoscopy extraction was unsuccessful, the patient was kept under observation. When it did not pass the caecum, it was extracted by colonoscopy, with no further complications and shorter hospital stay. Follow-up can be by simple abdominal x-ray, with endoscopic management if there is insufficient progress. In one of our cases, the outcome was unfavourable due to time of ingestion, and endoscopic management was not possible, whereas in the second case colonoscopy was performed early with success. Proper diagnostic and timely treatment mark the difference in the progression and outcome of the ingestion of foreign bodies. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.
Ingested and Aspirated Foreign Bodies.
Green, S Sarah
2015-10-01
Esophageal and aspirated foreign bodies have important clinical significance, and both should be considered carefully when the history or physical examination findings raise sufficient suspicion. The published evidence regarding the diagnosis and management of foreign body ingestion or aspiration is weighted disproportionately with observational studies, case controls, expert opinion, and systematic reviews. Most of the publications would receive a categorization of C (observational studies including case-control and cohort design) and D (expert opinion, case reports, and clinical reasoning). One of the few prospective studies examining the diagnostic evaluation of foreign body aspiration in children could be considered level B evidence (randomized clinical trials, systematic reviews, or diagnostic studies with minor limitations). This study found that the medical history is the most important predictive part of the evaluation. There is evidence for considering bronchoscopy if there is significant history suggestive of foreign body aspiration, even in the setting of normal physical examination findings. (28). Most ingested foreign bodies spontaneously pass without incident. However, special attention should be paid to objects in the esophagus as well as to batteries and magnets. Based on a systematic review of the literature (level B evidence) and the potential for rapid and life-threatening damage, batteries in the esophagus should be removed immediately. (10) Other objects, such as coins, may be observed for passage in an asymptomatic patient. In addition, given the high risk of significant complications, ingestion of high-powered magnets should be quickly and carefully evaluated. Although single magnets are likely to pass without complication, multiple magnets or magnets ingested with other metal objects can cause significant damage and should be removed if there is any concern for mural entrapment, bowel perforation, or failure to progress. (10)(16)(17)(18)(19). Lastly, another systematic review of the literature (level B evidence) about the aspiration of food objects in children suggests that this is a significant public health concern with potentially devastating consequences. Despite clear legislation and regulation by the Consumer Product Safety Commission regarding toys, there is no similar regulation of high-risk foods. The data suggest that there is opportunity for improvement in legislation about the production and packaging of high-risk items as well as in the education of caregivers. (22)
Liao, Wenjing; Wen, Guangyi; Zhang, Xiaowen
2015-06-01
Button batteries have been recognized as one of the dangerous foreign bodies to children for more than 30 years, but few related studies have been published to give more concern in China. We reported 6 cases of button battery intake as foreign body in children. The Chinese literature on button battery as foreign body in children was reviewed. The interval between the accidental ingestion and battery removal ranged from 6 hours to 3 days. Two patients had no sequela, 3 patients had tracheoesophageal fistulas, and 1 patient had nasal septal perforation. Twenty-eight articles about button battery as foreign body in children were obtained by Chinese-language literature searches including 25 case reports, 2 health education articles, and 1 imaging article. In total, 172 cases of button battery intake as foreign body in children were identified, 23 and 10 of the 159 cases involving nasal button battery lodgment developed nasal septal perforation and nasal adhesion, respectively. Tracheoesophageal fistula was identified in 4 of the 12 ingestion cases. One case of button battery intake was in external auditory canal. A small number of children with button battery as foreign body were reported in China, which is 1 of the biggest countries with large population of children.
Birk, Michael; Bauerfeind, Peter; Deprez, Pierre H; Häfner, Michael; Hartmann, Dirk; Hassan, Cesare; Hucl, Tomas; Lesur, Gilles; Aabakken, Lars; Meining, Alexander
2016-05-01
This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the removal of foreign bodies in the upper gastrointestinal tract in adults. Recommendations Nonendoscopic measures 1 ESGE recommends diagnostic evaluation based on the patient's history and symptoms. ESGE recommends a physical examination focused on the patient's general condition and to assess signs of any complications (strong recommendation, low quality evidence). 2 ESGE does not recommend radiological evaluation for patients with nonbony food bolus impaction without complications. We recommend plain radiography to assess the presence, location, size, configuration, and number of ingested foreign bodies if ingestion of radiopaque objects is suspected or type of object is unknown (strong recommendation, low quality evidence). 3 ESGE recommends computed tomography (CT) scan in all patients with suspected perforation or other complication that may require surgery (strong recommendation, low quality evidence). 4 ESGE does not recommend barium swallow, because of the risk of aspiration and worsening of the endoscopic visualization (strong recommendation, low quality evidence). 5 ESGE recommends clinical observation without the need for endoscopic removal for management of asymptomatic patients with ingestion of blunt and small objects (except batteries and magnets). If feasible, outpatient management is appropriate (strong recommendation, low quality evidence). 6 ESGE recommends close observation in asymptomatic individuals who have concealed packets of drugs by swallowing ("body packing"). We recommend against endoscopic retrieval. We recommend surgical referral in cases of suspected packet rupture, failure of packets to progress, or intestinal obstruction (strong recommendation, low quality evidence). Endoscopic measures 7 ESGE recommends emergent (preferably within 2 hours, but at the latest within 6 hours) therapeutic esophagogastroduodenoscopy for foreign bodies inducing complete esophageal obstruction, and for sharp-pointed objects or batteries in the esophagus. We recommend urgent (within 24 hours) therapeutic esophagogastroduodenoscopy for other esophageal foreign bodies without complete obstruction (strong recommendation, low quality evidence). 8 ESGE suggests treatment of food bolus impaction in the esophagus by gently pushing the bolus into the stomach. If this procedure is not successful, retrieval should be considered (weak recommendation, low quality evidence). The effectiveness of medical treatment of esophageal food bolus impaction is debated. It is therefore recommended, that medical treatment should not delay endoscopy (strong recommendation, low quality evidence). 9 In cases of food bolus impaction, ESGE recommends a diagnostic work-up for potential underlying disease, including histological evaluation, in addition to therapeutic endoscopy (strong recommendation, low quality evidence). 10 ESGE recommends urgent (within 24 hours) therapeutic esophagogastroduodenoscopy for foreign bodies in the stomach such as sharp-pointed objects, magnets, batteries and large/long objects. We suggest nonurgent (within 72 hours) therapeutic esophagogastroduodenoscopy for medium-sized blunt foreign bodies in the stomach (strong recommendation, low quality evidence). 11 ESGE recommends the use of a protective device in order to avoid esophagogastric/pharyngeal damage and aspiration during endoscopic extraction of sharp-pointed foreign bodies. Endotracheal intubation should be considered in the case of high risk of aspiration (strong recommendation, low quality evidence). 12 ESGE suggests the use of suitable extraction devices according to the type and location of the ingested foreign body (weak recommendation, low quality evidence). 13 After successful and uncomplicated endoscopic removal of ingested foreign bodies, ESGE suggests that the patient may be discharged. If foreign bodies are not or cannot be removed, a case-by-case approach depending on the size and type of the foreign body is suggested (weak recommendation, low quality evidence). © Georg Thieme Verlag KG Stuttgart · New York.
An Unusual Cause of Dysphagia: Live Leech in the Tongue Base
Erdoğan, Osman; İsmi, Onur; Vayısoğlu, Yusuf; Azizoğlu, Mustafa; Görür, Kemal; Özcan, Cengiz
2015-01-01
Inhaled or ingested foreign bodies are relatively common causes of airway obstructions. They can be associated with significant morbidity and even mortality. Although various foreign bodies are aspirated or ingested, live leeches are rarely encountered. We reported a case of a live leech at the base of the tongue in an 18-year-old female patient with a history of unfiltered spring water drinking. We discussed the surgical technique and importance of anesthesia with this brief study. PMID:29392006
Gastrobronchial fistula after toothbrush ingestion.
Karcher, Jan Christoph; von Buch, Christoph; Waag, Karl-Ludwig; Reinshagen, Konrad
2006-10-01
Gastrobronchial fistulous communications are uncommon complications of disease processes with only 36 previously reported cases. Described as complication of a number of conditions, such as previous gastroesophageal surgery, subphrenic abscess, and gastric ulcers (Jha P, Deiraniya A, Keeling-Robert C, et al. Gastrobronchial fistula--a recent series. Interact Cardiovasc Thorac Sur 2003;2:6-8), we report a case of fistulization caused by ingestion of a foreign body. A patient with mental retardation, admitted for the treatment of osteomyelitis, presented during hospitalization symptoms of high fever, vomiting, and respiratory distress. Endoscopy showed the presence of a gastrobronchial fistula, which developed after ingestion of a toothbrush. The toothbrush was extracted endoscopically, and the fistula was subsequently closed by surgery. The patient recovered completely. We report the first case of a gastrobronchial fistula as a complication of foreign body ingestion.
Smith, Milton T; Wong, Roy K H
2007-04-01
The spectrum of gastrointestinal (GI) foreign bodies includes food bolus impaction in the esophagus, nonfood objects that are swallowed, and various objects that may be inserted into the rectum. The risk depends upon the type of object and its location. Fortunately, 80% to 90% of ingested foreign bodies will pass without intervention. Objects with sharp edges or pointed tips have the highest risk of complications, up to 35%. All objects impacted in the esophagus require urgent or emergent treatment. Rectal foreign bodies are usually removable transanally, although general anesthesia and operative intervention sometimes are required.
Use of a video laryngoscope to facilitate removal of a long, sharp-pointed blade from the esophagus.
Hiller, Kenneth N; Hagberg, Carin A
2016-08-01
Initial management of ingested esophageal foreign bodies involves airway assessment, determination of the requirement for and timing of therapeutic intervention, risk mitigation during removal, and identification of all indicated equipment for retrieval. Long, sharp-pointed objects lodged in the esophagus require emergent attention and should be retrieved endoscopically, if perforation has not occurred. Inducing general anesthesia and rapidly securing the airway can minimize the risk of aspiration, mitigate any effects of tracheal compression, avoid the potential of exacerbating existing trauma, and provide optimal conditions for removal of long, sharp-pointed esophageal foreign bodies. Video laryngoscopy provides improved recognition of anatomical structures in both normal and difficult airways, enabling assessment for hypopharyngeal and glottic trauma resulting from foreign body ingestion. The indirect view of video laryngoscopy also facilitates the coordinated manipulation of the airway by both the anesthesiologist and the surgeon as they visualize the anatomy together while securing the airway and removing the foreign body. Copyright © 2016 Elsevier Inc. All rights reserved.
Foreign bodies in the aerodigestive tract in pediatric patients.
Higo, Ryuzaburo; Matsumoto, Yu; Ichimura, Keiichi; Kaga, Kimitaka
2003-12-01
To investigate pediatric foreign body cases in the aerodigestive tract, and to elucidate the characteristic problems in Japan. A total of 310 pediatric patients (age 15 or below), gathered from two medical university hospitals (University of Tokyo and Jichi Medical School), were included in this study. Data were collected by retrospective chart review and were statistically analyzed. Two-year-olds were the most common patients, and the range from age 1 to age 4 included 67.7% of all the patients. The most involved sites were the nose (39.4%) and the pharynx (38.4%), followed by the esophagus (12.9%) and the trachea-bronchi (6.5%). Fish bones and toys were the representative foreign bodies (30.7 and 13.6%, respectively). Other foreign bodies often encountered included coins, food, candy, peanuts and nuts, and batteries. The type of foreign body was closely related to the site in which foreign bodies were lodged: 77.3% of foreign bodies in the pharynx were fish bones, and toys were the most common impacted foreign body in the nose. In the esophagus, representative impacted foreign bodies were coins (35.7%), but disk-type battery ingestion has been increasing in recent years. Although most foreign bodies in the esophagus were safely removed, one case of a disk-type battery had a serious sequela. In the trachea-bronchi, peanuts, food, cotton, and coins were impacted. A rigid bronchoscope was basically used to remove foreign bodies, but in some cases, a fine flexible endoscope, with a channel for fiber forceps, was useful, because it could be inserted into narrow bronchi. Advance of a flexible endoscope will make it an excellent tool for diagnosis and management of the trachea-bronchial foreign body. Fish bones in the pharynx, which were closely related to Japanese eating habits, and toys in the nose, were the typical foreign bodies encountered in this study. In the esophagus, an increased incidence of disk-type battery ingestion has become a serious problem in recent years. Since prevention is the most essential way to manage foreign body cases, feedback from studies to public education should be encouraged.
Esophageal button battery ingestion in children.
Şencan, Arzu; Genişol, İncinur; Hoşgör, Münevver
2017-07-01
Button battery lodged in the esophagus carries a high risk of morbidity and mortality. The purpose of this study was to present cases of patients with esophageal button battery ingestion treated at our clinic and to emphasize the importance of early diagnosis and treatment. Records of patients admitted to our hospital for foreign body ingestion between January 2010 and May 2015 were retrospectively reviewed. Cases with button battery lodged in the esophagus were included in the study. Patient data regarding age, sex, length of time after ingestion until admission, presenting clinical symptoms, type and localization of the battery, management, and prognosis were analyzed. Among 1891 foreign body ingestions, 71 were localized in the esophagus, and 8 of those (11.2%) were cases of button battery ingestion. Mean age was 1.7 years. Admission was within 6 hours of ingestion in 5 cases, after 24 hours had elapsed in 2, and 1 month after ingestion in 1 case. All patients but 1 knew the history of ingestion. Prompt endoscopic removal was performed for all patients. Three patients developed esophageal stricture, which responded to dilatation. Early recognition and timely endoscopic removal is mandatory in esophageal button battery ingestion. It should be suspected in the differential diagnosis of patients with persistent respiratory and gastrointestinal symptoms.
Magalhães-Costa, Pedro; Carvalho, Liliana; Rodrigues, José Pedro; Túlio, Maria Ana; Marques, Susana; Carmo, Joana; Bispo, Miguel; Chagas, Cristina
2016-01-01
Gastrointestinal foreign bodies (FB) are comprised of food bolus impaction and intentionally or unintentionally ingested or inserted true FB. Food bolus impaction and true FB ingestion represent a recurrent problem and a true challenge in gastrointestinal endoscopy. More than 80-90% of the ingested true FB will pass spontaneously through the gastrointestinal tract without complications. However, in 10-20% of the cases an endoscopic intervention is deemed necessary. True FB ingestion has its greatest incidence in children, psychiatric patients and prisoners. On the other hand, food bolus impaction typically occurs in the elderly population with an underlying esophageal pathology. The most serious situations, with higher rates of complications, are associated with prolonged esophageal impaction, ingestion of sharp and long objects, button batteries and magnets. Physicians should recognize early alarm symptoms, such as complete dysphagia, distressed patients not able to manage secretions, or clinical signs of perforation. Although many papers are yearly published regarding this subject, our knowledge is mainly based on case-reports and retrospective series. Herein, the authors summarize the existing evidence and propose an algorithm for the best approach to FB ingestion.
Ingested bony foreign body abutting thoracic aorta
Leahy, Travis William; Kuthubutheen, Jafri
2011-01-01
The authors present the case of a 38-year-old female who presented with an ingested oesophageal foreign body (lamb bone) following consumption of a casserole. The bone was initially not seen on plain x-ray but CT imaging revealed a 21×20 mm pyramid shaped bone distending the proximal oesophageal mucosa and lodged only 2 mm from the aortic arch. Cardiothoracic surgery services were available on standby to perform an emergency thoracotomy in the event of any haemorrhage. However, the bone was removed successfully with rigid oesophagoscopy and the patient made a full recovery. PMID:22689831
Use of the blue cotton screen method with endoscopy to detect occult esophageal foreign bodies
Xia, Yan; Zhang, Fan; Xu, Weiran
2017-01-01
More than 20,000 cases of upper gastrointestinal foreign bodies (FBs) have been reported in the last 5 years in China. Early detection and treatment is vital in these patients. Differential diagnosis of esophageal injury and occult esophageal foreign bodies is challenging, particularly in the case of non-radio-opaque foreign bodies. A diagnostic technique with high accuracy and low risk is needed for clinical practice. We describe successful use of the “blue cotton screen method” to detect esophageal foreign bodies in 2 patients. The advantages and disadvantages of various diagnostic modalities in the management of patients with foreign body ingestion are presented. This technique is safer and more effective than traditional methods for foreign body impaction in the esophageal cavity. It could be applied for screening and in the differential diagnosis of esophageal injury and FBs in the esophageal lumen. PMID:29362659
Ingested razor blades within the appendix: A rare case report.
Cui, Jason; Cross, Trent; Lockwood, David
2018-01-01
Foreign body ingestion is a common clinical presentation with less than 1% of the cases requiring surgical intervention. In this report, we present a rare case of razor blades lodged in the appendix as a result of intentional ingestion. A 25 year old male prisoner presented to our hospital with persistent right iliac fossa pain after razor blade ingestion. After 5 days of conservative management, there was no sign of transition on serial X-Rays. Laparoscopy with intraoperative image intensification confirmed the presence of the razor blades in the appendix and appendicectomy was subsequently performed without complications. Most ingested objected with diameter less than 2.5 cm and length less than 6 cm can pass through the gastrointestinal tract spontaneously in less than one week. The entry of foreign objects into the appendix is thought to be due to relative low motility of the caecum, the dependent position of the appendix and the size of the appendiceal orifice. Radiographic localisation to the appendiceal lumen was complicated by metallic artefact, but was consistent with failure to transit. Appendicectomy was felt to be the safest mode of retrieval. Ingested foreign body lodged in the appendix is a rare event. Once the exact location is confirmed, a simple laparoscopic appendicectomy can be performed to facilitate the removal. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.
ERIC Educational Resources Information Center
Rashid, Farhan; Davies, Laura; Iftikhar, S. Y.
2010-01-01
The pica phenomenon, where non-edible substances are repeatedly consumed, has been linked with developmental and behavioural disorders, particularly autism. The clinical presentation of foreign body ingestion in patients with autism is discussed, and recommendations for caregivers are provided based on the available literature. An 18-year-old man…
Hidden attraction: a menacing meal of magnets and batteries.
Brown, Julie C; Murray, Karen F; Javid, Patrick J
2012-08-01
Magnet and button battery ingestions are increasingly common, and can result in significant morbidity. Timely identification of hazardous foreign body ingestions can be difficult in non-verbal and non-disclosing children. We aim to present a case that demonstrates some of the challenges around identifying and correctly locating magnets and batteries, and the importance of prompt identification and removal. We describe an older child with the covert ingestion of multiple magnets and batteries, with magnets that attracted across the stomach and a loop of jejunum. Mild symptoms and signs resulted in a delayed diagnosis and serious consequences. Radiographs suggested a gastric location of the foreign bodies. Health care workers should consider the possibility of battery or magnet ingestions in children with vomiting and abdominal pain, even when well-appearing. Like esophageal batteries, multiple gastrointestinal magnets and combined magnet-battery ingestions can cause significant morbidity, and prompt identification is important. Providers should ask verbal children for ingestion histories, and consider radiographs when symptoms are atypical or persistent. Like esophageal batteries, gastrointestinal magnet-battery ingestions should be removed promptly to prevent complications. Caregivers should supervise or limit the use of toys that include magnets and batteries. Copyright © 2012 Elsevier Inc. All rights reserved.
Intestinal Perforation Due to Foreign Body Ingestion in a Schizophrenic Patient
Zarei, Mina; Shariati, Behnam; Bidaki, Reza
2016-01-01
Introduction Ingestion of foreign bodies has been previously reported in some patients with schizophrenia. This behavior may be a manifestation of delusional beliefs or a response to command hallucinations and can lead to severe complications. Case Presentation This paper reports a patient with schizophrenia who, as a manifestation of his illness, ingested a metallic skewer to kill ademon inside his abdomen that he believed was controlling him. As a result, he developed an acute intestinal perforation and underwent surgery. Conclusions It is of a great importance to closely monitor the therapy compliance of patients suffering from mental illnesses. This will benefit them by preventing some of the serious complications of their disease, which may include life-threatening conditions such as intestinal perforation that needs surgical intervention. PMID:27803892
Management of a patient with autism following ingestion of a foreign body.
McCain, Stephen; Tan, Samantha; Mark, David
2014-06-25
Patients with autism often find admission to hospital an anxious time. Awareness of the condition, a speedy diagnosis and flexibility in adapting treatment plans will facilitate early discharge and return to their familiar environment. We describe a patient with severe autism who presented with an acute abdomen secondary to ingestion of a foreign body which required laparotomy. Communication directly to medical staff was greatly limited due to severe autism and close liaison with family members was essential in interpreting scant clinical signs. At the time of surgery a rubber bottle teat was found causing transection of small bowel due to erosion of the foreign body. The postoperative course was fraught with challenges and ensuring side room nursing care with family members present throughout his admission minimised postoperative stress and confusion. We recommend awareness of management strategies for patients with autism to ensure rapid recovery and early discharge home. 2014 BMJ Publishing Group Ltd.
Garlipp, B; Schulz, H-U; Böttcher, S; Lemke, A; Meyer, F; Lippert, H
2012-11-01
Obstruction of bile flow following pancreatoduodenectomy can be caused by stenosis of the hepaticojejunostomy created at the time of surgery, obstruction of the bile-draining jejunal loop, stones or, very rarely, ingested foreign bodies in the common hepatic duct. In analogy with endoscopic sphincterotomy or the once popular side-to-side-choledochduodenostomy, the creation of a hepaticojejunostomy eliminates the barrier of the sphincter Oddi, enabling intestinal content such as ingested foreign bodies or food fibers to migrate into the bile duct. We report on the case of a patient developing biliary tract obstruction due to fibrous material in the common hepatic duct 15 years after pancreatoduodenectomy. In addition, an overview of the literature on the rare phenomenon of foreign body-associated obstructive jaundice is given. © Georg Thieme Verlag KG Stuttgart · New York.
ERIC Educational Resources Information Center
Mariano Beraldo, Carolina; Rondon Lopes, Érika; Hage, Raduan; Hage, Maria Cristina F. N. S.
2017-01-01
Ingested or penetrating foreign bodies are common in veterinary medicine. When they are radiolucent, these objects become a diagnostic challenge, but they can be investigated sonographically. However, successful object identification depends on the skill of the sonographer. Considering that these cases appear randomly during hospital routines, it…
Volpi, A; Laforgia, R; Lozito, C; Panebianco, A; Punzo, C; Ialongo, P; Carbotta, G; Sederino, M G; Minafra, M; Paterno, A; Palasciano, N
2017-01-01
We studied 21 episodes of ingestion of foreign bodies (IFO) among 15 prisoners. Rectrospective research in pts admitted to emergency from June 2005 to May 2105. Ingestion, management and pts outcome were analyzed. Prisoners with previous esophagogastroduodenal disease were excluded. All pts were males and ingestions were intentional. Esophagogastroduoduenoscopy (EGDS) was performed in 10pts (8 cases with successful removal, 1 case we did not find anything e 1 of unsuccessful EGDS, that required emergency surgey. 9 pts rejected EGDS: in 2 pts were not necessary.Among the 9 pts that rejected EGDS, 5 discharged voluntary. No mortality neither morbidity. Only 1 pt required surgery.The IFO were 34 (23 sharp, 6 flat,5 indefined). We did not observe any food bolus impaction. Multiple ingestion was found in 11 pts. Recurrent episodes were found in 4 pts. Almost all episodes can be treated conservatively with observation and endoscopy but the management of this pts has a financial impact on healthcare cost and on security costs. Prevention strategies are important to predict patient group at high risk for recurrent IFO.
Oesophageal foreign body and a double aortic arch: rare dual pathology.
O'Connor, T E; Cooney, T
2009-12-01
We report the rare case of an oesophageal foreign body which lodged above the site of oesophageal compression by a double aortic arch. Case report and a review of the literature surrounding the classification, embryology, diagnosis and management of vascular rings and slings. An eight-month-old male infant presented with symptoms of tracheal compression following ingestion of an oesophageal foreign body. Following removal of the oesophageal foreign body, the infant's symptoms improved initially. However, subsequent recurrence of respiratory symptoms lead to a repeat bronchoscopy and the diagnosis of a coexisting double aortic arch, causing tracheal and oesophageal compression. To our knowledge, this is only the second reported case of a double aortic arch being diagnosed in a patient following removal of an oesophageal foreign body.
Two Year Old With Water Bead Ingestion.
Jackson, Jami; Randell, Kimberly A; Knapp, Jane F
2015-08-01
Foreign body ingestion is a common pediatric complaint. Two case reports describe intestinal obstruction in children from an ingestion of a single superabsorbent water ball, requiring surgical removal. We describe nonsurgical management of an asymptomatic child who ingested approximately 100 superabsorbent water beads.Because of the risk for subsequent intestinal obstruction, the patient was admitted for whole bowel irrigation. This case report is the first describing use of whole bowel irrigation in the management of an asymptomatic patient with multiple water beads ingestion.
Prevalence, clinical features and management of pediatric magnetic foreign body ingestions.
Tavarez, Melissa M; Saladino, Richard A; Gaines, Barbara A; Manole, Mioara D
2013-01-01
Foreign body (FB) ingestions are frequent in children. Whereas the majority of FBs pass spontaneously through the gastrointestinal tract, ingestion of magnetic FBs pose a particular risk for obstruction due to proximate attraction through the intestinal wall. We aimed to identify the prevalence, clinical presentation, and management of magnetic FB ingestions at our tertiary care institution. We performed a retrospective chart review of medical records of patients presenting to the pediatric Emergency Department (ED) or admitted to the hospital with FB ingestions from June 2003-July 2009. From those cases, patients with magnetic FB ingestions were identified. During the study period, 337,839 patients presented to the ED; 38 cases of magnetic FB ingestion were identified (prevalence 0.01%). Abdominal radiography was obtained in all cases. Ingestion of a single magnet occurred in 30 of 38 cases (79%). Of those, 4 patients underwent endoscopic removal due to signs of FB impaction in the esophagus or pylorus; no complications were noted. Ingestion of multiple magnets (range 2-6) occurred in 8 of 38 cases. Four of the 8 patients with multiple magnetic FBs (50%) presented with signs of peritonitis and required operative repair of multiple intestinal perforations. No deaths were identified. Although ingestion of a single magnetic FB may, in most cases, be managed as a simple FB ingestion, the ingestion of multiple magnetic FB is associated with a high risk of complication and requires aggressive management. We propose an algorithm for management of children with magnetic FB ingestions. Copyright © 2013 Elsevier Inc. All rights reserved.
Ingested Metallic Spool: A Rare Cause of Acquired Tracheoesophageal Fistula.
Hashim, Imran; Talat, Nabila
2017-01-01
Foreign body (FB) ingestion is a common problem in children. Prolonged impaction of FB in esophagus may result in tracheoesophageal fistula (TEF). A 6-year-old girl presented with progressive dysphagia and recurrent chest infections. No history of FB ingestion was given by parents. Further investigations revealed FB (spool) in cervical esophagus. Patient was successfully managed by surgery through trans-cervical approach.
Ingested Metallic Spool: A Rare Cause of Acquired Tracheoesophageal Fistula
Talat, Nabila
2017-01-01
Foreign body (FB) ingestion is a common problem in children. Prolonged impaction of FB in esophagus may result in tracheoesophageal fistula (TEF). A 6-year-old girl presented with progressive dysphagia and recurrent chest infections. No history of FB ingestion was given by parents. Further investigations revealed FB (spool) in cervical esophagus. Patient was successfully managed by surgery through trans-cervical approach. PMID:28164003
Surgical management and morbidity of pediatric magnet ingestions.
Waters, Alicia M; Teitelbaum, Daniel H; Thorne, Vivian; Bousvaros, Athos; Noel, R Adam; Beierle, Elizabeth A
2015-11-01
Foreign body ingestion remains a common reason for emergency room visits and operative interventions in the pediatric population. Rare earth magnet ingestion represents a low percentage of all foreign bodies swallowed by children; however, magnets swallowed in multiplicity can result in severe injuries. Pediatric surgeons with membership in the Surgical Section of the American Academy of Pediatrics were surveyed to determine the magnitude and consequences of magnet ingestions in the pediatric population. About 100 (16%) participant responses reported on 99 magnet ingestions. The median age at ingestion was 3.7 y, and the majority of ingestions (71%) occurred after year 2010. Thirty-two children underwent endoscopy with successful removal in 70% of cases, and multiple magnets were found in 65% of these patients. Seventy-three children required either laparotomy (51) or laparoscopy (22) for magnet removal, and 90% of these children were discovered to have ingested more than one magnet. In addition, 17% of the children were found to have at least one perforation or fistula, and 34% of the children had multiple perforations or fistulae. Nine children required long-term care for their injuries including repeat endoscopies. One child died after hemorrhage from an esophago-aortic fistula. These results demonstrated the increasing need for magnet regulations and public awareness to prevent potentially serious complications. Copyright © 2015 Elsevier Inc. All rights reserved.
Martins, Christine Baccarat de Godoy; Andrade, Selma Maffei de
2008-09-01
This study aims to analyze accidents involving foreign bodies among children less than 15 years of age residing in Londrina, Paraná State, Brazil, in terms of first aid, hospitalization, and death (2001). Data were obtained from general hospital records and the Municipal Mortality Database. A total of 434 accidents were analyzed, with a 3.7% hospitalization rate and 0.7% mortality. Boys predominated (53.7%), and the incidence rate was highest among children one to three years of age (7.2 per 1,000 children). Foreign body penetration in natural orifices (eyes, nostrils, and ears) accounted for 94%, inhalation/ingestion of food 2.8%, inhalation/ingestion of objects 2.5%, and aspiration of gastric contents 0.7%, and these causes accounted for all the deaths. The results contribute to epidemiological knowledge on such accidents and indicate the need to restructure health services in order to decentralize care for less complex injuries, besides emphasizing the need for preventive measures.
Impaction of swallowed dentures in the sigmoid colon requiring sigmoid colectomy.
Flanagan, Michael; Clancy, Cillian; O Riordain, Micheal G
2018-05-07
Foreign body (FB) ingestion results in perforation in 1% of cases and is associated with significant morbidity and rarely mortality. Clinical presentation is variable and can present a diagnostic challenge. We report our experience and management of a patient with a delayed presentation of a sigmoid colon foreign body as a result of ingestion of a dental plate. A 67 year old female attended the colorectal outpatient clinic following an incidental finding of a sigmoid mass on computed tomography (CT) abdomen. Further investigation identified a dental plate impacted in a thickened sigmoid colon. On further questioning the patient recalled losing her dentures three years previously. At surgery the dental plate had partially eroded through the sigmoid colon into the pelvic side wall. A sigmoid colectomy and hand sewn end-to-end colo-colic anastomosis was performed. Localised perforation following ingestion of a foreign body may result in significant morbidity. Extra luminal migration and local inflammatory response resulted in the formation of a walled off collection. Delayed complications of perforation include abscess and fistula formation. Clinicians need to exhibit a high index of suspicion when treating edentulous patients and alcohol and drug abusers who present with an acute abdomen or a sub-acute presentation with associated atypical imaging and endoscopic findings. The decision regarding intervention and management strategy in cases of perforation by foreign body depends on chronicity of the case, extent of localised or diffuse peritonitis, and size of the lesion or area of bowel involved. Copyright © 2018. Published by Elsevier Ltd.
Esophageal foreign body ingestion in adults on weekdays and holidays
Zhong, Qian; Jiang, Ruiwei; Zheng, Xi; Xu, Guifang; Fan, Xiuqin; Xu, Yuanyuan; Liu, Fei; Peng, Chunyan; Ren, Wei; Wang, Lei
2017-01-01
Abstract The purpose of this study is to compare the clinicopathological characteristics and outcomes of esophageal foreign body (FB) ingestion in adults between weekdays and holidays. This is a retrospective study including 1058 patients with esophageal FB ingestion from 2012 to 2016. Patient characteristics, the types and locations of FB, and clinical outcomes were compared between patients on weekdays and holidays. Furthermore, independent risk factors of complication on weekdays and holidays respectively were evaluated. The locations of FB, underlying diseases, and complications significantly differed between weekdays and holidays groups, while no difference was found in the types of FB. Patients got higher percentage of erosion complication on holidays than that on weekdays (60.8% vs 47.6%, P < .0001). Multivariate logistic regression analysis revealed that jujube shell was a significant predictor of complication on weekdays (P < .001). However, complication was significantly associated with nonfood bolus FB ingestion on holidays (P < .001). Our data suggest that there were different clinicopathological characteristics of FB ingestion between weekdays and holidays, and more patients got complications on holidays. On holidays, a latex protector hood or an overtube should be applied to patients who swallowed nonfood bolus in order to reduce esophageal mucosal damage. PMID:29069038
Tsai, Jerry; Shaul, Donald B; Sydorak, Roman M; Lau, Stanley T; Akmal, Yasir; Rodriguez, Karen
2013-01-01
Increasing popularity of strong magnets as toys has led to their ingestion by children, putting them at risk of potentially harmful gastrointestinal tract injuries. To heighten physician awareness of the potential complications of magnetic foreign body ingestion, and to provide an updated algorithm for management of a patient who is suspected to have ingested magnets. A retrospective review of magnet ingestions treated over a two-year period at our institutions in the Southern California Permanente Medical Group. Data including patient demographics, clinical information, radiologic images, and surgical records were used to propose a management strategy. Five patients, aged 15 months to 18 years, presented with abdominal symptoms after magnet ingestion. Four of the 5 patients suffered serious complications, including bowel necrosis, perforation, fistula formation, and obstruction. All patients were successfully treated with laparoscopic-assisted exploration with or without endoscopy. Total days in the hospital averaged 5.2 days (range = 3 to 9 days). Average time to discharge following surgery was 4 days (range = 2 to 7 days). Ex vivo experimentation with toy magnetic beads were performed to reveal characteristics of the magnetic toys. Physicians should have a heightened sense of caution when treating a patient in whom magnetic foreign body ingestion is suspected, because of the potential gastrointestinal complications. An updated management strategy is proposed that both prevents delays in surgical care and avoids unnecessary surgical exploration.
Oesophageal Foreign Bodies--from Diagnostic Challenge to Therapeutic Dilemma.
Predescu, Dragoş; Predescu, Irina; Sarafoleanu, Codruţ; Constantinoiu, Silviu
2016-01-01
Ingestion of foreign bodies, common in the emergency services, remains a challenge for physicians despite preventive measures and technical progress due to the frequency and possible complications, serious complications that can darken vital prognosis or may be a source of remote morbidity. Clinical experience at "St. Mary" Hospital included, between 2000-2015, 39 patients diagnosed with FB ingestion, of which 26 fixed in the oesophagus, with the remaining 13 having spontaneously progressed along the digestive tract (5 recovered from the stomach, 6 naturally evacuated, and 2 cases with colic perforation). Oesophageal foreign bodies occur consecutively to (in)voluntary ingestion, the vast majority of them passing unnoticed. The most frequently encountered types are coins, batteries, needles, various sharps objects, food, bone fragments, cartilages, pieces of plastic, glass, etc., FB impaction at oesophageal level being usually conditioned by the 3 anatomical narrowings. Typically, FB ingestion occurs at extreme ages, 60% of patients being pre-school children (<6 years), with an even higher percentage--between 70-80% between 6 months and 2 years of age--and only 15% elderly, frequently edentulous. Usual clinical signs, in the absence of complications, are: dysphagia, hypersialorrhoea, low cervical and/or chest strain, sometimes vomiting. Not at all infrequently (30%!), we notice the absence of any sign. Alarming manifestations, which indicate the development of complications, are pyrexia, general physical health deterioration, pain (with vertebral/interscapular projection), pulping, subcutaneous cervical emphysema. Diagnosis via various imaging methods (simple radiography, barium swallow, CT, MRI) remains the essential link in identifying the lesion and establishing a therapeutic approach. Endoscopic evaluation (rigid or flexible) is mandatory, also allowing therapeutic gestures. In terms of progression, 80-90% of FB pass into the stomach, being eliminated naturally, about 10-20% require endoscopic extraction, and only 1% of cases require surgical intervention. Treatment of uncomplicated cases is essentially endoscopic, surgery to extract the foreign body being necessary in exceptional cases. In case of complications, surgery is the only reliable therapeutic resource. Oesophageal foreign bodies frequently represent an emergency, with symptomatic functional features contrasting with the poor clinical signs present, requiring extraction via the natural pathways as treatment in most cases. The most effective "treatment" remains prevention and raising awareness in parents with children ≤6 years, while the most important element in the management of FB is to maintain the airways free. Celsius.
Ingestion of safety razor blade and delayed hanging in a complex suicide.
Chauhan, Mohit Singh; Behera, C; Naagar, Sunil; Sreenivas, M
2016-12-01
Ingestion of a foreign body is mostly accidental in children and intentional in prisoners to achieve hospitalization; however, use of this method of suicide is rare. We report a case where the victim first ingested a safety razor blade, but failed to die and then hanged himself, but failed again and finally succumbed to the complications on the sixth day. He had also attempted suicide by inflicting multiple incised wounds on his neck four days before the safety blade ingestion, but none were fatal. © The Author(s) 2016.
Retrieval of a penny from the pediatric esophagus: a cost analysis.
Goins, Jeanne L; Evans, Adele K
2011-12-01
As part of the oral phase of development, children commonly ingest foreign bodies. The most common lodged foreign body, requiring operative removal, in the United States is the penny. Valued at 1 cent, comprised of materials valued at less than 1 cent, costing 1.62 cents to manufacture, and being never removed from circulation, pennies are aplenty. But ingestion can lead to mucosal damage, the consequences of which can be esophageal perforation or stricture formation. We hypothesize that the monetary value of the penny is far less than the cost of its ingestion and removal. This quality assurance study examines the effect of the penny on the purse. This retrospective review identified 180 foreign bodies in children under the age of 18 over a five year period. Eighty-two were pennies. Operative notes revealed degree of injury. Hospital charge assessments revealed the "cost" of each visit. There were no esophageal perforations, and cases were divided evenly among injury grades 0-III. The average total charge for all penny-related injuries was $7164.78. The purpose was to examine the actual cost of a penny (more than its value in production) and the potential cost of its damage (thousands of dollars in measurable costs, untold immeasurable costs). The goal of this study is to draw healthcare professional and public attention to a potentially serious and yet highly preventable injury in young children. Published by Elsevier Ireland Ltd.
Zhong, Qian; Jiang, Ruiwei; Zheng, Xi; Xu, Guifang; Fan, Xiuqin; Xu, Yuanyuan; Liu, Fei; Peng, Chunyan; Ren, Wei; Wang, Lei
2017-10-01
The purpose of this study is to compare the clinicopathological characteristics and outcomes of esophageal foreign body (FB) ingestion in adults between weekdays and holidays. This is a retrospective study including 1058 patients with esophageal FB ingestion from 2012 to 2016. Patient characteristics, the types and locations of FB, and clinical outcomes were compared between patients on weekdays and holidays. Furthermore, independent risk factors of complication on weekdays and holidays respectively were evaluated. The locations of FB, underlying diseases, and complications significantly differed between weekdays and holidays groups, while no difference was found in the types of FB. Patients got higher percentage of erosion complication on holidays than that on weekdays (60.8% vs 47.6%, P < .0001). Multivariate logistic regression analysis revealed that jujube shell was a significant predictor of complication on weekdays (P < .001). However, complication was significantly associated with nonfood bolus FB ingestion on holidays (P < .001). Our data suggest that there were different clinicopathological characteristics of FB ingestion between weekdays and holidays, and more patients got complications on holidays. On holidays, a latex protector hood or an overtube should be applied to patients who swallowed nonfood bolus in order to reduce esophageal mucosal damage.
Tsai, Jerry; Shaul, Donald B; Sydorak, Roman M; Lau, Stanley T; Akmal, Yasir; Rodriguez, Karen
2013-01-01
Context: Increasing popularity of strong magnets as toys has led to their ingestion by children, putting them at risk of potentially harmful gastrointestinal tract injuries. Objectives: To heighten physician awareness of the potential complications of magnetic foreign body ingestion, and to provide an updated algorithm for management of a patient who is suspected to have ingested magnets. Design: A retrospective review of magnet ingestions treated over a two-year period at our institutions in the Southern California Permanente Medical Group. Data including patient demographics, clinical information, radiologic images, and surgical records were used to propose a management strategy. Results: Five patients, aged 15 months to 18 years, presented with abdominal symptoms after magnet ingestion. Four of the 5 patients suffered serious complications, including bowel necrosis, perforation, fistula formation, and obstruction. All patients were successfully treated with laparoscopic-assisted exploration with or without endoscopy. Total days in the hospital averaged 5.2 days (range = 3 to 9 days). Average time to discharge following surgery was 4 days (range = 2 to 7 days). Ex vivo experimentation with toy magnetic beads were performed to reveal characteristics of the magnetic toys. Conclusions: Physicians should have a heightened sense of caution when treating a patient in whom magnetic foreign body ingestion is suspected, because of the potential gastrointestinal complications. An updated management strategy is proposed that both prevents delays in surgical care and avoids unnecessary surgical exploration. PMID:23596362
Chávez Rossell, Miguel
2012-01-01
The ingestion of a foreign body is one of the most common endoscopic emergencies. Foreign bodies in the upper gastrointestinal tract should be extracted as soon as possible to avoid serious complications such as perforation o bleeding. However, removals of foreign bodies with sharp edges are very difficult and can develop complications during their removal. Various devices have therefore been developed to prevent mucosal injury from the sharp edges during endoscopic extraction. We report a new technique for the successful foreign body extraction of upper digestive tract using the cap from six shooter variceal banding reused. We present 17 cases (9 males and 8 females). The types of foreign bodies removed were: chicken bones (n:7), fish bones (n:3), denture prosthesis (n:2), food bolus (n:2), long pin (n:1), golden thumb tack (n: 1) and press-through package (n:1). There were no complications. This new technique is safe and effective. Highlights its advantages: enhanced sight pharyngo esophageal junction, foreign bodies disimpact at that level, food bolus suck, avoid sharp object damage mucosal or scope and decrease time removal.
Creswell, Caleb H; Kille, Tony L; Hoffman, Matthew R; Kennedy, Tabassum; Dailey, Seth H
2017-01-01
Foreign body ingestion occurs in not only children but also adults, particularly those with history of neurologic disease, alcohol use, or psychiatric disease. We present the case of a 40-year-old male with schizophrenia who presented to the emergency room with a long history of pharyngeal foreign body sensation which had recently progressed to include trismus, odynophagia, and dyspnea. Flexible laryngoscopy demonstrated fullness of the right posterior pharyngeal wall and computed tomography (CT) showed a linear opaque foreign body extending from the level of the oropharynx to the thyroid ala. Further history elicited that he stabbed himself in the pharynx two years prior with a toothbrush following a command hallucination. The toothbrush was removed uneventfully via an external approach. The patient was discharged with psychiatry follow-up. This case is unusual due to the submucosal location of the foreign body and the length of retention. It demonstrates the atypical nature which patients with comorbid psychiatric illness may present following foreign body injury and the use of an external surgical approach for the removal of a retained foreign body based on CT reconstruction.
Management and endoscopic techniques for digestive foreign body and food bolus impaction.
Chauvin, Armelle; Viala, Jerome; Marteau, Philippe; Hermann, Philippe; Dray, Xavier
2013-07-01
Ingested foreign bodies, food bolus impaction, migration or retention of medical devices are frequent, in children as well as in adults. Most of these foreign bodies will naturally pass through the gastro-intestinal tract. Complications are rare but sometimes severe (oesophageal perforations are the most frequent and most feared). We aimed to review the literature on therapeutic management of digestive foreign bodies and food bolus impaction, with special focus on endoscopic indications, material, timing and techniques for removal. The role of the gastroenterologist is to recognise specific situations and to plan endoscopic removal in a timely manner with the most adequate conditions and extraction tools. Risk factors and underlying pathology, for example eosinophilic esophagitis, must be investigated and if necessary treated. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Pino Rivero, V; Trinidad Ramos, G; González Palomino, A; Pantoja Hernández, C G; Mogollón Cano-Cortés, T; Carrasco Claver, F; Guerra Camacho, M; Blasco Huelva, A
2006-01-01
We report a case of cervical abscess after the ingestion of foreign body (chicken bone) secondary to probable esophageal perforation that it was sent to us with suspicion of mediastinal complication. The girl, 17 years-old, nothing else to arrive our hospitalary center required entrance in ICU due to her severe clinical process: High fever, intense neck-thoracic pain, laterocervical diffuse and progressive left inflammation and bad general state. The CT showed the presence of a well defined abscess and abundant aerial component that dissected the cervical muscles that made necessary to perform drainage verifying intraoperatively no mediastinal involvement. The culture of the purulent collection revealed Streptococcus anginosus/milleri resistant to clindamicine but sensible to penicilina and derivatives. We exposed a serie of considerations at respect of such microorganism and its clinical signification.
Hiraki, Masatsugu; Miyoshi, Atsushi; Anegawa, Go; Kubo, Hiroshi; Ikeda, Osamu; Ohira, Keiichi; Azama, Shinya; Kido, Shinichi; Mori, Daisuke; Aibe, Hitoshi; Tanaka, Toshiya; Kitahara, Kenji; Sato, Seiji
2017-01-01
The ingestion of a foreign body is relatively common. However, it rarely results in the perforation of gastrointestinal tract. We herein report an unusual case of malignant lymphoma incidentally diagnosed after the perforation of the small intestine by a fish bone. A 90-year-old woman was admitted to our hospital because of abdominal pain and vomiting. Abdominal computed tomography demonstrated free air and ascites in the abdominal cavity. In the pelvic cavity, a radiopaque linear shadow about 35mm in diameter was shown in the small intestine, and the stricture was exposed to the abdominal cavity. Therefore, a diagnosis of perforation of the small intestine due to ingestion of a foreign body and panperitonitis was made. Emergent laparotomy was performed. The intraoperative findings revealed perforation of the small intestine with a fish bone in the jejunum. Local inflammation at the perforation site was seen, and circulated wall thickness was observed at the distal side of the jejunum. Partial resection of the jejunum and anastomosis of jejuno-jejunostomy was performed. A pathological examination and immunohistochemical study of the resected specimen resulted in a diagnosis of malignant lymphoma of follicular lymphoma Grade 1. It is very difficult to identify the existence malignancy accompanied with gastrointestinal perforation with ingestion of a foreign body. In cases suspected of involving malignancy, careful observation during surgery is needed in order to avoid missing the accompanying malignancy. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Foreign Body Ingestion in Children: Should Button Batteries in the Stomach Be Urgently Removed?
Lee, Jun Hee; Lee, Jee Hoo; Shim, Jung Ok; Lee, Jung Hwa; Eun, Baik-Lin; Yoo, Kee Hwan
2016-03-01
Foreign body (FB) ingestion is common in children, and button battery (BB) ingestion has been increasing in recent years. This study was to identify factors related to outcomes of FB ingestion, particularly BBs in the stomach. We evaluated whether the current recommendations are appropriate and aimed to suggest indications for endoscopic removal of BB in the stomach in young children. We investigated patient age, shape, size, location of FBs, spontaneous passage time and resulting complications among 76 children. We observed types, size, location of BB and outcomes, and analyzed their associations with complications. Coins and BB were the two most common FBs. Their shapes and sizes were not associated with the spontaneous passage time. Size, spontaneous passage time, and age were also not associated with any specific complications. For BB ingestion, all 5 cases with lithium batteries (≥1.5 cm, 3 V) presented moderate to major complications in the esophagus and stomach without any symptoms, even when the batteries were in the stomach and beyond the duodenum, while no complications were noted in 7 cases with alkaline batteries (<1.5 cm, 1.5 V) (p=0.001). All endoscopies were conducted within 24 hours after ingestion. The type and voltage of the battery should be considered when determining whether endoscopy is required to remove a BB in the stomach. For lithium battery ingestion in young children, urgent endoscopic removal might be important in order to prevent complications, even if the child is asymptomatic and the battery is smaller than 2 cm.
Incidence of foreign bodies in aerodigestive tract in vindhya region: our experience.
Gupta, Richa; Poorey, V K
2014-06-01
Foreign bodies in aerodigestive tract are frequent occurrence and may lead to life threatening situation due to obstruction caused in respiratory passages. To present foreign body ingestion cases observed in a 5-year period at the S.S. Medical College and G.M. Hospital, Rewa (MP). The present study is a retrospective analysis including 108 patients of foreign bodies of aerodigestive tract of Vindhya region who presented to the S.S. Medical College and G.M. Hospital, Rewa from January 2008 to August 2012. About 92 patients of total 108 patients had evidence of foreign body in food passage with age ranging from 9 month to 85 years. Most patients 65 (70.65 %) belong to <10 year age group. Radiological evidence was found in 76 (82.6 %) patients. Most common foreign body was found to be coin 75 (81.52 %). The commonest site of lodgement was cricopharynx. About 16 patients of total 108 patients had evidence of foreign body in airway with age ranging from 9 months to 72 years. Most cases 8 (50 %) belong to <10 year age. Maximum cases showed vegetative foreign body with right bronchus (58.33 %) as commonest site of lodgement. Early detection by meticulous history, imaging modality and prompt management remains basis for favourable outcome and prevents future complications.
Lead toxicity and endoscopic removal of ingested firearm cartridges.
Hatten, B W; Bueso, A; Craven, P; Hendrickson, R G; Horowitz, B Z
2013-06-01
Lead toxicity from the ingestion of a lead foreign body has been described in several case reports. Management of ingested live ammunition presents its own challenges due to the risk of accidental discharge. A safe and effective method of retrieving a live cartridge must be considered. We present two cases of lead toxicity due to intact firearm cartridge ingestion with the removal of the cartridges via endoscopy. The first case is of severe pediatric lead toxicity due to the ingestion of 30-mm rifle cartridges. The second case is an adult ingestion of .22 caliber cartridges resulting in mild lead toxicity. These cases illustrate a diagnostic dilemma in both the diagnosis of lead toxicity and the removal of live ammunition from the stomach.
Penetration of the duodenum by an ingested needle with migration to the pancreas: report of a case.
Toyonaga, T; Shinohara, M; Miyatake, E; Ouchida, K; Shirota, T; Ogawa, T; Yoshida, J; Sumitomo, K; Matsuo, K; Akao, M
2001-01-01
A case of a penetration of the duodenum by a needle with migration to the pancreas in a 50-year-old man is reported herein. The patient was referred to us with a chief complaint of diarrhea. An abdominal plain roentgenogram showed a needle in the upper abdominal area. An abdominal computed tomography scan and contrast X-ray revealed the foreign body to be located outside of the duodenum and in the head of the pancreas. An emergency operation was therefore performed on the first day and the needle in the head of the pancreas was thus extirpated safely. A perforation of the gastrointestinal tract by an ingested foreign body is difficult to accurately and quickly diagnose when no peritonitis or abscess formation is observed. Therefore, the use of contrast X-ray is considered to be useful in the diagnosis of such a perforation.
A Case of 2-Year-Old Child with Entero-Enteric Fistula Following Ingestion of 25 Magnets.
Pogorelić, Zenon; Borić, Matija; Markić, Joško; Jukić, Miro; Grandić, Leo
Magnet ingestion usually does not cause serious complications, but in case of multiple magnet ingestion or ingestion of magnet with other metal it could cause intestinal obstruction, fistula formation or even perforation. We report case of intestinal obstruction and fistula formation following ingestion of 25 magnets in a 2-year-old girl. Intraoperatively omega shaped intestinal loop with fistula caused by two magnetic balls was found. Intestine trapped with magnetic balls was edematous and inflamed. Resection of intestinal segment was performed, followed by entero-enteric anastomosis. A total of 25 magnets were removed from resected intestine. Single magnet ingestion is treated as non-magnetic foreign body. Multiple magnet ingestion should be closely monitored and surgical approach could be the best option to prevent or to cure its complications.
[Frequency and prevention of childhood domestic injury according to age].
Kanaizumi, Shiomi; Shibata, Mariko; Miyazaki, Yukiko; Nakashita, Tomiko; Sakou, Keiko; Hoshino, Yasue; Ichinohe, Shinko; Ohno, Ayako; Manabe, Shigeo
2009-04-01
This study aimed to: 1) obtain data about occurrence of childhood domestic injuries in Gunma prefecture according to children's age; 2) ascertain parental awareness of injury prevention; and 3) develop ideas for creating concrete strategies of childhood injury prevention. The participants were 551 parents of children living in 14 cities/towns in Gunma prefecture that showed interest in cooperating with this survey. A self-reported questionnaire was handed to parents when they took their children to health check-ups provided by the cities/towns either during the child's first year, at 18 months, or at 3 years. Parents completed the questionnaire asking whether their child had been injured at home during the past year, and if so, they were asked about the type of injury, the cause of injury, and what action they took. We also asked whether the parents took specific injury prevention measures at home. Data were analyzed statistically. The injury experienced most frequently during the first year of life was "fall" (30.8%), followed by "ingestion of a foreign body" (22.7%), and then "choking" (11.5%). For children around the age of 18 months, the most frequently experienced injury was "fall" (41.0%), followed by "burn" (20.3%), and "ingestion of a foreign body" (19.3%). At 3 years, "burn" was reported most frequently (32.3%), followed by "fall" (31.0%), and "choking" (14.5%). Chi2-test revealed significant correlations among the three age groups concerning the rate of burn injury, foreign body ingestion, and drowning. The rate of burn injury was higher at 3 years than at 18 months, and also higher at 18 months as compared to under the age of one. In contrast, the rate of foreign body ingestion was higher under the age of one than at 18 months, and also higher at 18 months as compared to the age of 3 years. Drowning was more common at 18 months and 3 years than under the age of one. As for prevention of domestic injury, investigation of preventive means taken according to type of injury revealed that parents taking any of the measures to prevent an injury were significantly more likely to also take other means to prevent that injury. Characteristics of injury differed according to children's age. Furthermore, it was clarified that parents' performance of injury prevention depends on their awareness of preventive measures.
Migrating pharyngeal foreign bodies: a series of four cases of saw-toothed fish bones.
Chung, Sung Min; Kim, Han Su; Park, Eun Hee
2008-09-01
Pharyngeal foreign bodies are common problems seen at emergency rooms or ENT outpatient clinics, and fish bones are the most common foreign bodies encountered in East Asia and in Korea. One of the rare complications of a swallowed sharp fish bone is its migration from the site of entry into the subcutaneous tissues of the neck. We present four unusual cases of ingested fish bones that migrated out of the upper digestive tract to the neck. In the first case, this caused a recurrent deep neck infection for 2 years; in the second case, there was penetration of the facial artery; in the third case, there was a hematoma of the floor of the mouth; in the fourth case, there was a retropharyngeal abscess.
Gulf of Maine Seals - Populations, Problems and Priorities
2010-06-01
3) rabies, (4) leptospirosis, (5) herpes, (6) toxoplasmosis, (7) pox, (8) lung worms, (9) Vibrio spp. and (10) harmful algal bloom toxins (HABs...Toxoplasmosis Pox Lungworms Vibrio HABs - We need to identify categories of disease and classify diseases opposed to simply stating that...infections Pox Vibrio Morbilli Pneumonia Dermatitis Alopecia Septicemia Body condition Dehydration Foreign body ingestion Natural
Webb, Joanna; Graham, Jennifer; Fordham, Margaret; DeCubellis, Julie; Buckley, Faith; Hobbs, Joshua; Berent, Allyson; Weisse, Chick
2017-08-15
CASE DESCRIPTION 3 ferrets (Mustela putorius furo), aged 1 to 2 years, were referred for evaluation of a 4-day to 2-week history of gastrointestinal signs, including anorexia, regurgitation, and vomiting. CLINICAL FINDINGS All 3 ferrets had clinical signs suggestive of dysphagia or esophagitis on initial examination. Esophagoscopy, barium-contrast esophagography, or both revealed foreign bodies with mucosal inflammation in 1 patient and an esophageal foreign body with stricture in 2 patients. One of the latter ferrets had a recent history of gastrotomy to remove a foreign body. TREATMENT AND OUTCOME 1 ferret was treated with endoscopic retrieval of the foreign bodies. Esophageal stricture was treated in 2 ferrets by means of endoscopic balloon dilation accompanied by placement of an esophageal stent in 1 ferret. After resolution of clinical signs and completion of all prescribed treatments, 2 of 3 ferrets successfully transitioned to a regular hard kibble diet; 1 ferret remained on a soft diet for 2 years. All owners were satisfied with the outcome of treatment. CLINICAL RELEVANCE Ferrets are prone to foreign body ingestion. Results of this small series of cases suggested that minimally invasive techniques may be useful for the management of esophageal disease in this species.
Leith, R; O'Connell, A C
2013-10-01
Young children habitually place objects in their mouths to discover and learn about the world and it is considered a normal stage of early childhood development. Ingestion and aspiration of foreign objects predominantly occurs in preschool toddlers with a peak incidence at age three years, and can have serious consequences. A 2-year-old boy presented to the Dublin Dental University Hospital with a tooth-coloured mass tightly adherent to a lower primary incisor. The lesion surrounded the cervical third of the crown on the lower right primary central incisor and extended subgingivally. The tooth was mobile but with minimal inflammation. The tooth was subsequently extracted under general anaesthesia to reveal that the mass was in fact a foreign body, although this was originally thought unlikely as a cause. The patient underwent an unremarkable recovery. The case of a foreign body disguised as a tooth-like abnormality was only identified under general anaesthesia, and even then it was impossible to prise the object from the tooth in situ. Misdiagnosis of impacted foreign bodies in young children presents complicated diagnostic problems.
Laparoscopic diagnosis of magnetic malrotation with fistula and volvulus.
Wooten, Kimberly E; Hartin, Charles W; Ozgediz, Doruk E
2012-01-01
Most foreign bodies that a child ingests pass harmlessly through the gastrointestinal tract. However, ingesting multiple magnets places a child at risk for serious viscus injury. A 16-y-old boy swallowed multiple magnets and presented with abdominal pain and emesis. Upon laparoscopy, the boy was found to have malrotation with volvulus caused by a cecal magnet attracted to a gastric magnet, resulting in a gastrocecal fistula. We review the management of magnet ingestion with an emphasis on a high index of suspicion and the use of laparoscopy for diagnosis, as well as the consequences of a coexisting rotational anomaly.
Ballpoint pen ingestion in a 2-year-old child.
Rameau, Anaïs; Anand, Sumeet M; Nguyen, Lily H
2011-07-01
A 2-year-old girl ingested a ballpoint pen, which was found on chest x-ray to have lodged in the lower esophagus and stomach. The pen, which measured nearly 15 cm in length, was removed via rigid esophagoscopy without complication. To the best of our knowledge, this is the longest nonflexible foreign body ingested by a young child ever reported in the English-language literature. We describe the presentation of this case and the current guidelines for safety as enumerated in the Small Parts Regulations established by the U.S. Consumer Product Safety Commission.
Accidental hijab pin ingestion in Muslim women: an emerging endoscopic emergency?
Goh, Jason; Patel, Neeral; Boulton, Ralph
2014-01-03
Ingested foreign body is an infrequent indication for emergency endoscopy in the adult gastroenterology practice. We describe the clinical features and endoscopic management of the first four cases of accidental ingestion of hijab pins by Muslim women in our unit, all presenting within a 12-month period. The pins were all successfully retrieved without any complications. In this report, we review published guidelines and the current literature, as well as discussing the approach (conservative vs proactive endoscopic retrieval) and timing of endoscopic treatment. The Muslim community may need to be alerted to the potential health hazard of hijab pins.
Multiple magnet ingestion: is there a role for early surgical intervention?
Salimi, Amrollah; Kooraki, Soheil; Esfahani, Shadi Abdar; Mehdizadeh, Mehrzad
2012-01-01
Children often swallow foreign bodies. Multiple magnet ingestion is rare, but can result in serious complications. This study presents three unique cases of multiple magnet ingestion: one case an 8-year-old boy with multiple magnet ingestion resulting in gastric obstruction and the other two cases with intestinal perforations due to multiple magnet intake. History and physical examination are unreliable in children who swallow multiple magnets. Sometimes radiological findings are not conclusive, whether one magnet is swallowed or more. If magnets are not moved in sequential radiology images, we recommend early surgical intervention before gastrointestinal complications develop. Toy companies, parents, physicians, and radiologists should be warned about the potential complications of such toys.
Imaging pediatric magnet ingestion with surgical-pathological correlation.
Otjen, Jeffrey P; Rohrmann, Charles A; Iyer, Ramesh S
2013-07-01
Foreign body ingestion is a common problem in the pediatric population and a frequent cause for emergency room visits. Magnets are common household objects that when ingested can bring about severe, possibly fatal gastrointestinal complications. Radiography is an integral component of the management of these children. Pediatric and emergency radiologists alike must be aware of imaging manifestations of magnet ingestion, as their identification drives decision-making for consulting surgeons and gastroenterologists. Radiology can thus substantially augment the clinical history and physical exam, facilitating appropriate management. This manuscript sequentially presents cases of magnet ingestion featuring imaging findings coupled with surgical and pathological correlation. Each case is presented to highlight ways in which the radiologist can make impactful contributions to diagnosis and management. Clinical overview with pitfalls of magnet ingestion imaging and an imaging decision tree will also be presented.
Use of Magill Forceps to Remove Foreign Bodies in Children.
Oncel, Murat; Sunam, Guven Sadi; Elsurer, Cagdas; Yildiran, Huseyin
2017-04-01
Introduction Esophageal foreign body (FB) in all age groups can cause serious morbidity or mortality. The study aims to report our experience retrieving FBs from the upper esophagus in children using Magill forceps. Materials and Methods In this study, 88 patients (45 males [51.1%] and 43 females [48.9%]) were presented with suspected FB ingestion. FB ingestion was determined via endoscopic analysis, or lateral and posterior-anterior radiographies, including oropharynx, neck, chest, and abdomen. Cases were classified into seven groups, according to history, diagnostic method, and postintervention findings, as follows: (1) coins, (2) toys, (3) metals, (4) bones, (5) battery, (6) glass, and (7) food. A laryngoscope was used to elevate the larynx and expose the esophageal entrance. Magill forceps were advanced into the esophagus and opened to observe and extract the FB. Results All 88 patients who underwent endoscopic examination due to suspected FB ingestion were confirmed to have ingested a FB. Median age was 12 years; 15 patients were aged < 5 years; 63 (71.5%) were diagnosed based on routine radiographic findings, and others were diagnosed based on physical findings and history. The most common type of FB was coins ( n = 51 [57.9%]). Mean surgical duration was 20 minutes. Conclusion FBs located at cervical esophageal level are usually the most difficult to remove. Magill forceps should be used before other methods.
Bekele, Abebe
2014-01-01
Introduction. Foreign bodies (FBs) in the aerodigestive tract are important causes of morbidity and mortality and pose diagnostic and therapeutic challenges. The best method of removal of an esophageal and tracheobronchial FB is endoscopic guided extraction. Objective. To present our experience of the removal of aerodigestive FBs in adult Ethiopian patients using rigid endoscopes. Methods. A hospital-based prospective study, at Tikur Anbessa Referral and Teaching Hospital, from January 2011 to December 2012 (over two years). Results. A total of 32 patients (18 males and 14 females) with a mean age of 28.0 ± 12.74 years were treated for FB ingestion and aspiration at Tikur Anbessa Hospital. The FBs were impacted at the esophagus in 18 (56.2%) patients, at the pharynx in 7 (21.8%), and at the air way in 7 (21.8%) patients. Pieces of bones were the commonest objects found in the esophagus (17/18 of the cases) and the pharynx (4/7), while fractured tracheostomy tubes and needles were frequently seen in the air way (3/7 cases each). The foreign bodies were visible in plain radiographs of 26 (81.2%) patients. Successful extraction of FBs was achieved by using Mc gill forceps in 11 cases, rigid esophagoscopes in 9 patients, and bronchoscopes in 4 cases. Four cases required open surgery to remove the foreign bodies. Two complications (one pneumothorax and one esophageal perforation) occurred. All patients were discharged cured. Discussion and Recommendations. Aerodigestive FBs are not so rare in the hospital and timely diagnosis and removal of accidentally ingested and aspirated foreign body should be performed so as to avoid the potentially lethal complications associated. Rigid esophagoscopy requires general anesthesia and is associated with its own complications, but our experience and outcome of its use are encouraging. PMID:24834074
ULTRASONOGRAPHIC DETECTION OF INGESTED FISHING LINES IN LOGGERHEADS ( CARETTA CARETTA).
Franchini, Delia; Valastro, Carmela; Ciccarelli, Stefano; Caprio, Francesco; Lenoci, Diana; Di Bello, Antonio
2018-05-23
Loggerhead sea turtles ( Caretta caretta) are among the most frequent victims of bycatch in drifting longlines, and the ingestion of fish hooks and fishing lines is one of the most frequent causes of death of sea turtles. The aim of this study was to evaluate whether coelomic ultrasound (US) can be decisive, not only for diagnosis but also to optimize surgical planning based on preoperative evaluation of the bowel conditions and, in addition, to see if there are characteristic sonographic findings in sea turtles associated with the ingestion of fishing lines. Physical examination, hematology, blood chemistry, radiographs, and US examination were performed in 37 loggerhead sea turtles with suspected or known ingestion of fish hooks or monofilament fishing lines. During the ultrasonographic examinations, the loggerhead sea turtles were placed in dorsal recumbency and the prefemoral left and right acoustic windows were used. Nine wild loggerheads had sonographic findings of intestinal and coelomic abnormalities, and the sonographic images were compared with the surgical findings. Ultrasonography positively identified the foreign body in 89% (8/9) animals. The presence of intestinal plication (in all loggerhead turtles) and ultrasonographic visualization of the linear foreign body was always consistent with the ingestion of a fishing line. In sea turtles, fishing lines cause a corrugated appearance in the small intestine due to increased/unproductive peristalsis. The affected small bowel loops are usually dilated with fluid. In the present study, coelomic US allowed us to make a thorough evaluation of the characteristics, number, and severity of the bowel wall lesions in the animals, thus ensuring the planning of a correct surgical procedure. We suggest that US examination of the coelomic cavity should be complementary to radiographic survey in cases of suspected ingestion of fish hooks and fishing lines by sea turtles.
Accidental hijab pin ingestion in Muslim women: an emerging endoscopic emergency?
Goh, Jason; Patel, Neeral; Boulton, Ralph
2014-01-01
Ingested foreign body is an infrequent indication for emergency endoscopy in the adult gastroenterology practice. We describe the clinical features and endoscopic management of the first four cases of accidental ingestion of hijab pins by Muslim women in our unit, all presenting within a 12-month period. The pins were all successfully retrieved without any complications. In this report, we review published guidelines and the current literature, as well as discussing the approach (conservative vs proactive endoscopic retrieval) and timing of endoscopic treatment. The Muslim community may need to be alerted to the potential health hazard of hijab pins. PMID:24390968
Investigations of foreign bodies in the fore-stomach of cattle at Ngoma Slaughterhouse, Rwanda.
Mushonga, Borden; Habarugira, Gervais; Musabyemungu, Aline; Udahemuka, Jean C; Jaja, Festus I; Pepe, Dunisani
2015-07-30
Ingestion of indigestible foreign bodies in cattle is a pathological condition of both economic and health importance. It is has mostly been reported in association with feed scarcity. The aim of this study was to investigate the occurrence and nature of indigestible foreign materials in abattoir fore-stomach specimens in Ngoma district, Rwanda. Each chamber was opened by incision, then given a thorough macroscopic examination by visual inspection and palpation for the presence of foreign materials. The results show that there is an overall occurrence of 17.4% foreign bodies in cattle. The highest occurrence (25.3%) was recorded in June (the driest month). Results further show that the majority of the foreign bodies were plastics (65.0%). More foreign bodies (29.5%) were found in older animals (5 years and above) than in younger and middle-aged animals (16.5 % and 6.0%, respectively). There was a higher prevalence of foreign bodies in female cattle (20.0%) than in males (15.7%). The presence of cassette tape, as observed in the study, has not been reported elsewhere. The high representation of plastics in animals (65.5%) in the light of a government plastic bag ban in supermarkets presents a major challenge to livestock production in Rwanda. What is disturbing is that it is not known if this problem is increasing or decreasing as there are no previous studies for comparison. However, the results will serve as a reference point for future studies to understand the true trend and true burden of plastic bags in livestock.
Office Removal of a Subglottic Bread Clip
Rosow, David E.; Chen, Si
2013-01-01
Objective. The presence of an upper airway foreign body is an emergent, potentially life-threatening situation that requires careful but rapid evaluation and management. Organic or nonorganic material may typically be found in the pyriform sinuses or tongue base or may be aspirated directly into the tracheobronchial tree. We present here an unusual case report of a patient who accidentally ingested a plastic bread clip that was lodged in his subglottis for 15 months and report successful removal in the office under local anesthesia. Methods. Mucosal anesthesia was achieved with inhaled 4% lidocaine spray. Flexible laryngoscopic removal of the foreign body was then successfully accomplished. Results. The patient's symptoms resolved completely following removal, with no sequelae. Conclusions. Office removal of airway foreign bodies is feasible and can be safely done with adequate topical anesthesia, but great caution and emergency planning must be exercised. PMID:24379980
Lin, Xiao-Kun; Wu, Da-Zhou; Lin, Xiao-Fang; Zheng, Na
2017-05-01
The aim of this study is to report our experience with patients with intestinal perforation secondary to ingested foreign bodies (FBs) who were treated surgically at our institution. Between 2001 and 2015, a total of 38 pediatric patients with the diagnosis of intestinal perforation secondary to FBs were retrospectively reviewed. The series comprised 22 males and 16 females. The average age of the patients was 1.9 years. A definitive preoperative history of the ingestion of FBs was obtained for only eight patients. Crying and abdominal pain were the main clinical manifestations. Perforation repair was performed in 29 patients (76.3%), while enterostomy was utilized in five patients (13.2%) and enterectomy in four patients (10.5%). Five perforations occurred in the large intestine, and 33 perforations occurred in the small intestine with the most common site being the distal ileum. Of the 38 FBs recovered, 26 were food objects, while non-food objects were found in 12 patients. All patients recovered well, except one patient with an intestinal obstruction from adhesions that occurred approximately 1 month after discharge. Clinical performance of intestinal perforation secondary to FBs in children is atypical. Most perforations occur in the small intestine. Primary perforation repair is safe and effective, and better outcomes can be achieved.
Diagnosis and Treatment of Hardware Disease.
Miesner, Matt D; Reppert, Emily J
2017-11-01
Eating habits in cattle are less discriminant than other ruminants, and they more often accidentally ingest strange objects while feeding. Penetrating foreign bodies may cause mild to severe peritonitis, penetrate the diaphragm to cause pleuritis or pericarditis, or cause localized abscesses in the thorax or abdomen. Because these objects are most often metal, a common term for this problem is hardware disease. An accurate history and thorough physical examination often yields a diagnosis; however, ancillary diagnostics can enhance accuracy and disease magnitude before exploratory surgery. Treatment encompasses controlling infection and inflammation and foreign body removal; preventive measures are emphasized. Copyright © 2017 Elsevier Inc. All rights reserved.
14 CFR 33.77 - Foreign object ingestion-ice.
Code of Federal Regulations, 2014 CFR
2014-01-01
... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Foreign object ingestion-ice. 33.77 Section... object ingestion—ice. (a)-(b) [Reserved] (c) Ingestion of ice under the conditions of paragraph (e) of... by engine test under the following ingestion conditions: (1) Ice quantity will be the maximum...
14 CFR 33.77 - Foreign object ingestion-ice.
Code of Federal Regulations, 2012 CFR
2012-01-01
... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Foreign object ingestion-ice. 33.77 Section... object ingestion—ice. (a)-(b) [Reserved] (c) Ingestion of ice under the conditions of paragraph (e) of... by engine test under the following ingestion conditions: (1) Ice quantity will be the maximum...
14 CFR 33.77 - Foreign object ingestion-ice.
Code of Federal Regulations, 2013 CFR
2013-01-01
... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Foreign object ingestion-ice. 33.77 Section... object ingestion—ice. (a)-(b) [Reserved] (c) Ingestion of ice under the conditions of paragraph (e) of... by engine test under the following ingestion conditions: (1) Ice quantity will be the maximum...
Tsesmeli, Niki E; Savopoulos, Christos G; Hatzitolios, Apostolos I; Karamitsos, Dimitrios T
2007-12-01
Various foreign bodies (FB) may be ingested. Most of them harmlessly pass through the anus but sharp or pointed ones are likely to cause complications. Although FB's ingestion is commonly seen by the emergency room personnel, a case of an ingested tongue-ring in the stomach of a female adolescent has not been reported. A 16-year-old female was referred to us for swallowing a tongue-ring while eating, a day after she had swallowed its clip. After finishing her meal, she had replaced the ingested tongue-ring with a similar one! She had a history of accidental swollowing the clip during breakfast a day before as well. She had no history of mental illness, alcohol or drug abuse. An abdominal X-ray confirmed their presence in the gastrointestinal tract. On endoscopy, an intact esophagus' mucosa, a stomach filled with food, her tongue-ring in its greater curvature and a patulous pyloric channel were observed. She was turned in the right lateral position and small amounts of water were carefully used in order to shift the food residues to the antrum. The slippery object was grasped by a biopsy forceps and it was pulled out gently. The procedure was uneventful and she was discharged home on the same day. Our case of a tongue-ring ingested by an adolescent demonstrates a troublesome and possibly dangerous consequence of certain fashion accessories' easy adoption especially by younger subjects. It does not only send a social message, but it also might represent the first example of a potentially emerging medical condition.
Dawe, N; Puvanendran, M; Flood, L
2013-01-01
To describe a case of unwitnessed lithium ion disc battery ingestion, with a review of radiology findings and current best practice management. A three-year-old girl presented following ingestion of a foreign body, which her four-year-old brother claimed was a one pound coin. The patient was managed non-urgently and transferred for specialist ENT assessment 6 hours following the initial ingestion, with no evidence of airway compromise. A corroded battery was removed from the level of the cricopharyngeus after 8 hours, with an associated circumferential mucosal burn. There is increasing concern regarding the acknowledged rising incidence of lithium ion disc battery ingestion. The lack of a high index of suspicion and the inability to recognise subtleties on imaging may lead to suboptimal management with a higher degree of unnecessary immediate and delayed morbidity. The recently published American Academy of Pediatrics Guidelines may guide the approach to managing battery ingestions.
Accidental aspiration/ingestion of foreign bodies in dentistry: A clinical and legal perspective
Yadav, Rakesh Kumar; Yadav, Hemant Kumar; Chandra, Anil; Yadav, Simith; Verma, Promila; Shakya, Vijay Kumar
2015-01-01
The potential of foreign body aspiration or ingestion is a worldwide health problem in dentistry. The general dental practitioners should be extremely attentive in handling of minor instruments during any intervention related to the oral cavity, especially in the supine or semi-recumbent position of the patient. Aspiration cases are usually more critical and less common than ingestion. We report a case of iatrogenic aspiration of an endodontic broach, which gets disclosed during the recording of past dental history of the patient. The patient was asymptomatic during that time. A quick posterior-anterior chest radiograph was taken which revealed the presence of broach in the lower lobe of the left lung. The patient was immediately referred to the pulmonary medicine department where the fiberoptic bronchoscope retrieval was planned, and the same was carried out successfully under local anesthesia. Although such accidents have rare occurrence, the associated risks and morbidity are too high to be overlooked, especially from the viewpoint of special care, resources, and the associated financial cost required for their management. Moreover, practitioners are also liable for malpractice litigation given the fact that such cases are avoidable. This article also discusses relevant review literature, risk factors, symptoms, and management of such iatrogenic accidents along with drawing attention to the significance of preventive measures and their role in avoiding meritorious legal and ethical issues. PMID:27390487
Thomson, Mike; Tringali, Andrea; Dumonceau, Jean-Marc; Tavares, Marta; Tabbers, Merit M; Furlano, Raoul; Spaander, Manon; Hassan, Cesare; Tzvinikos, Christos; Ijsselstijn, Hanneke; Viala, Jérôme; Dall'Oglio, Luigi; Benninga, Marc; Orel, Rok; Vandenplas, Yvan; Keil, Radan; Romano, Claudio; Brownstone, Eva; Hlava, Štěpán; Gerner, Patrick; Dolak, Werner; Landi, Rosario; Huber, Wolf D; Everett, Simon; Vecsei, Andreas; Aabakken, Lars; Amil-Dias, Jorge; Zambelli, Alessandro
2017-01-01
This guideline refers to infants, children, and adolescents ages 0 to 18 years. The areas covered include indications for diagnostic and therapeutic esophagogastroduodenoscopy and ileocolonoscopy; endoscopy for foreign body ingestion; corrosive ingestion and stricture/stenosis endoscopic management; upper and lower gastrointestinal bleeding; endoscopic retrograde cholangiopancreatography; and endoscopic ultrasonography. Percutaneous endoscopic gastrostomy and endoscopy specific to inflammatory bowel disease has been dealt with in other guidelines and are therefore not mentioned in this guideline. Training and ongoing skill maintenance are to be dealt with in an imminent sister publication to this.
Gelberg, Howard B
2014-01-01
The alimentary system may be thought of as an open-ended tube within a tube that begins at the oral cavity and ends at the anus. Gastrointestinal lumens are potential spaces that accommodate ingested substances and are lined by polarized epithelium that is smooth and shiny (with the exception of the rumen) when healthy and intact. Because xenobiotics most frequently enter the body via ingestion, the gastrointestinal system and its ancillary glands are the first line of defense against foreign materials and pathogens of all types. The anatomic, biochemical, physical, secretory, and endocrinologic properties of the epithelium, resident, and blood-borne effector cells, microbiota, genetic polymorphisms, and gut-associated lymphoid tissue (which comprises one-quarter of the body's total) must be physically or functionally altered for diarrhea to occur. The average person ingests 700 tons of antigens in their lifetime. That enteritis does not occur more often than it does is testimony to the efficacy of gastrointestinal protective systems.
FOREIGN-BODIES IN THE EAR, NOSE AND ESOPHOGUS IN PEDIATRIC AGE GROUP, AT MEKELLE HOSPITAL ETHIOPIA.
Hagos, Mekonnen
2015-04-01
The ingestion of foreign body is a common problem in children, some of which may cause damage or may be associated with toxicity. To evaluate and analyze the pattern of foreign bodies in children in the esophagus, ears and nose with review of the techniques for removal in the emergency department. From Sept 1, 2008 to May 30, 2010, a review of all children with foreign bodies in the esophagus, ears and in the nose was done to assess the patterns and treatment outcomes. The source and the study group were (N-72). Data concerning socio- demographics, characterization, presenting symptoms and signs, techniques of retrieval and outcomes were extracted and filled in a previously prepared protocol sheet. Descriptive analysis was done using SPSS- computer statistical software. During the study period, 72 children, victims of foreign bodies in the esophagus, ears and in the nose were included in the study. Of these 44 (61.1%), 28 (38.9%) were male and female children, respectively. The age ranged from 11 months to 14 years with (mean = 4 years). The most affected age group was between 0-5 years accounting for 46 (63.9%) followed by the age group between 6-10 years accounting for 20 (27.8%) of all cases. Males 44 (61.1%) were predominantly most affected than females 28 (38.8%). The location of foreign bodies in this study were in the ears 45 (62.5%), esophagus 17 (23.6%) and in the nose 10 (13.9%) in order of their frequency. Swallowed foreign bodies were successfully removed by Magill forceps. Foreign bodies in the ears and in the nose were removed by careful but different techniques depending on the type and the clinical condition of the patient at time of intervention. Our study revealed a higher number of patients with foreign bodies in the ears and in the esophagus. Only a small number ofpatients presented with FBS in the nose. Food items in the ears, in the nose and coins in the esophagus were items frequently observed. Early suspicion, early diagnosis and prompt intervention have attributed to reduce morbidities of major events.
Panella, Nicholas J; Kirse, Daniel J; Pranikoff, Thomas; Evans, Adele K
2013-02-01
Commonly, foreign objects are incidentally ingested and pass harmlessly through the gastrointestinal tract; however, disk batteries present exceptional risk. In 2009, the American Association of Poison Control Centers listed disk batteries as the number 1 cause of fatal ingestions in children younger than 5 years. Lithium batteries are the most dangerous, and they are rapidly rising in use by manufacturers. Paralleling that rise, there has been a 6.7-fold increase in major or fatal outcomes between 1985 and 2009. This study describes the variability in patient presentations, the courses of patients' evaluations, and the clinical and financial consequences of disk battery ingestion. In this retrospective study, cases from 2001 to 2011 were reviewed for details of care for disk battery ingestions including presentation and management details. Cost of care information from our patients' records was compared with that of national averages on esophageal foreign bodies using the Healthcare Cost and Utilization Project's Kids' Inpatient Database. Six cases are presented. The patients' age averaged 1.85 years. Presentations varied with respect to symptoms, time course, and steps in treatment. Mean length of stay was 9.0 days, and mean cost was $14,994. Emergency medicine physicians, otolaryngologists, radiologists, gastroenterologists, and pediatric surgeons may be able to mitigate, albeit not entirely prevent, potential serious complications in patients with disk battery ingestions by proper diagnosis and timely treatment. Recommendations for management are presented, which highlight the need for emergent removal of any battery that is lodged and close follow-up of these patients once they are out of the hospital.
Management and Case Outcome of Gastric Impaction in Four Raptors: A Case Series.
Applegate, Jeffrey R; Van Wettere, Arnaud; Christiansen, Emily F; Degernes, Laurel A
2017-03-01
Four captive raptors, an American kestrel ( Falco sparverius ), peregrine falcon ( Falco peregrinus ), golden eagle ( Aquila chrysaetos ), and barn owl ( Tyto alba ), were diagnosed with ventricular and/or proventricular foreign material impactions consisting of artificial turf substrate, paper and plastic substrate, grass, and newspaper. Partial or total anorexia was reported in all birds and decreased casting in 2 birds. Survey radiographs confirmed presence of gastric enlargement in all 4 birds. The kestrel and eagle were treated unsuccessfully with gastroscopy and gastric lavage, respectively, followed by surgical intervention to remove the ventricular impactions. Both birds died of undetermined causes after surgery. The peregrine falcon died before medical or surgical intervention was started, and the owl was managed successfully with oral mineral oil and liquid diet to facilitate egestion of the foreign material as a pellet. Lead poisoning was suspected as the predisposing cause for foreign body ingestion in the eagle, but underlying causes for pica in the other birds were not determined. Radiographs can provide useful diagnostic information in sick raptors that exhibit vomiting or changes in appetite or casting frequency, and may help guide treatment decisions of impacted birds. Careful consideration of substrate, enrichment items, and access to potential foreign material that could be ingested may be the best pre-emptive management strategy in captive raptors.
De Lutio di Castelguidone, Elisabetta; Pinto, Antonio; Merola, Stefanella; Stavolo, Ciro; Romano, Luigia
2005-03-01
To assess the role CT in the evaluation of traumatic and spontaneous oesophageal perforation. From March 2001 to May 2003, we studied 12 patients (7 males and 5 females; age range: 25-66 years, mean age: 43.5 years) with suspected oesophageal perforation due to motor-vehicle accidents (4 cases), stab wound (one case), post-intubation (2 cases), foreign body ingestion (2 cases) and spontaneous (3 cases). Five patients underwent standard chest and cervical radiography; two patients with suspected foreign body ingestion also underwent a gastrografin swallow study; all of the 12 patients underwent CT of the neck, chest and abdomen before and after intravenous, and in four cases oral, administration of contrast material. In 5 patients with cervical, thoracic and abdominal trauma, the CT examination showed the presence of pleuroparenchymal injury (pneumothorax, pleural effusion and subcutaneous emphysema) as well as findings suggestive of oesophageal perforation: peri-oesophageal air (5 cases), peri-oesophageal fluid (4 cases), oesophageal wall thickening (3 cases), oesophageal wall laceration (2 cases) with abnormal course of the nasogastric tube in one of them and extraluminal extravasation of oral contrast material (2 cases). In 2 patients with post-intubation complications, CT showed the presence of a small peri-oesophageal fluid collection containing small gas bubbles in one case, and a gross perioesophageal abscess-like collection in the second case. In the 2 patients with foreign body ingestion, the plain radiography associated with CT showed the presence of a thin metal object in the cervical region (fragment of a dental plate) and a small extraluminal extravasation of gastrografin in one case, whereas in the other case CT showed the presence of a foreign body (chicken bone) in the hypopharynx with oesophageal wall thickening and peri-oesophageal oedema. In the remaining three patients with suspected spontaneous oesophageal perforation, CT showed the presence of a intramural haematoma in one case, oesophageal fluid distension with gas and a small peri-oesophageal fluid effusion (Mallory-Weiss syndrome) in another, and oesophageal rupture (Boerhaave syndrome) in the last case. Our experience shows that in patients with suspected traumatic and spontaneous oesophageal perforation, standard cervical and chest radiography may suggest a suspected oesophageal perforation in only a small proportion of cases, whereas oral contrast oesophagography has a higher sensitivity. Through the careful analysis of suggestive and specific signs of oesophageal perforation, a correct CT examination enables an accurate and timely diagnosis which significantly affects prognosis and provides valuable indications for treatment.
X-ray detection of ingested non-metallic foreign bodies.
Saps, Miguel; Rosen, John M; Ecanow, Jacob
2014-05-08
To determine the utility of X-ray in identifying non-metallic foreign body (FB) and assess inter-radiologist agreement in identifying non-metal FB. Focus groups of nurses, fellows, and attending physicians were conducted to determine commonly ingested objects suitable for inclusion. Twelve potentially ingested objects (clay, plastic bead, crayon, plastic ring, plastic army figure, glass bead, paperclip, drywall anchor, eraser, Lego™, plastic triangle toy, and barrette) were embedded in a gelatin slab placed on top of a water-equivalent phantom to simulate density of a child's abdomen. The items were selected due to wide availability and appropriate size for accidental pediatric ingestion. Plain radiography of the embedded FBs was obtained. Five experienced radiologists blinded to number and types of objects were asked to identify the FBs. The radiologist was first asked to count the number of items that were visible then to identify the shape of each item and describe it to a study investigator who recorded all responses. Overall inter-rater reliability was analyzed using percent agreement and κ coefficient. We calculated P value to assess the probability of error involved in accepting the κ value. Fourteen objects were radiographed including 12 original objects and 2 duplicates. The model's validity was supported by clear identification of a radiolucent paperclip as a positive control, and lack of identification of plastic beads (negative control) despite repeated inclusion. Each radiologist identified 7-9 of the 14 objects (mean 8, 67%). Six unique objects (50%) were identified by all radiologists and four unique objects (33%) were not identified by any radiologist (plastic bead, Lego™, plastic triangle toy, and barrette). Identification of objects that were not present, false-positives, occurred 1-2 times per radiologist (mean 1.4). An additional 17% of unique objects were identified by less than half of the radiologists. Agreement between radiologists was considered almost perfect (kappa 0.86 ± 0.08, P < 0.0001). We demonstrate potential non-identification of commonly ingested non-metal FBs in children. A registry for radiographic visibility of ingested objects should be created to improve clinical decision-making.
X-ray detection of ingested non-metallic foreign bodies
Saps, Miguel; Rosen, John M; Ecanow, Jacob
2014-01-01
AIM: To determine the utility of X-ray in identifying non-metallic foreign body (FB) and assess inter-radiologist agreement in identifying non-metal FB. METHODS: Focus groups of nurses, fellows, and attending physicians were conducted to determine commonly ingested objects suitable for inclusion. Twelve potentially ingested objects (clay, plastic bead, crayon, plastic ring, plastic army figure, glass bead, paperclip, drywall anchor, eraser, Lego™, plastic triangle toy, and barrette) were embedded in a gelatin slab placed on top of a water-equivalent phantom to simulate density of a child’s abdomen. The items were selected due to wide availability and appropriate size for accidental pediatric ingestion. Plain radiography of the embedded FBs was obtained. Five experienced radiologists blinded to number and types of objects were asked to identify the FBs. The radiologist was first asked to count the number of items that were visible then to identify the shape of each item and describe it to a study investigator who recorded all responses. Overall inter-rater reliability was analyzed using percent agreement and κ coefficient. We calculated P value to assess the probability of error involved in accepting the κ value. RESULTS: Fourteen objects were radiographed including 12 original objects and 2 duplicates. The model’s validity was supported by clear identification of a radiolucent paperclip as a positive control, and lack of identification of plastic beads (negative control) despite repeated inclusion. Each radiologist identified 7-9 of the 14 objects (mean 8, 67%). Six unique objects (50%) were identified by all radiologists and four unique objects (33%) were not identified by any radiologist (plastic bead, Lego™, plastic triangle toy, and barrette). Identification of objects that were not present, false-positives, occurred 1-2 times per radiologist (mean 1.4). An additional 17% of unique objects were identified by less than half of the radiologists. Agreement between radiologists was considered almost perfect (kappa 0.86 ± 0.08, P < 0.0001). CONCLUSION: We demonstrate potential non-identification of commonly ingested non-metal FBs in children. A registry for radiographic visibility of ingested objects should be created to improve clinical decision-making. PMID:25254180
Fish bone penetration of the duodenum extending into the pancreas: report of a case.
Yasuda, Takashi; Kawamura, Shiro; Shimada, Etsuji; Okumura, Shuichi
2010-07-01
We report a case of fish bone penetration of the duodenum extending into the pancreatic head, which was successfully treated by surgery. A 73-year-old woman was admitted with upper abdominal dull pain that had persisted for 3 days. Computed tomography showed a linear calcified body, which appeared to penetrate the posterior wall of the duodenal bulb into the pancreatic head. A laparotomy was performed based on the preoperative diagnosis of localized peritonitis caused by penetration of the duodenum into the pancreas by an ingested foreign body. The foreign body was safely removed from both the pancreas and duodenum and was found to be a fish bone, measuring 4 cm in length. Neither an abscess nor hematoma was detected at the site of the pancreatic head. The postoperative course was uneventful. This case demonstrates an unusual presentation of fish bone penetration of the duodenum with a migration to the pancreas.
[Trans-uranium elements in food products (review)].
Vasilenko, I Ia
1994-01-01
The data of Russian and foreign authors concerning of level environmental contamination and migration of transuranic elements in food chains, metabolism and biological danger of nuclides entering in human body with foods are reviewed. A level of radionuclide load of population and doses of radiation are discussed and the danger is estimated. The doses of radiation from radionuclide ingestion are lower than level of allowed radiation safety standards.
Liu, Shiqi; Li, Qifeng; Li, Yumei; Lv, Yi; Niu, Jianhua; Xu, Quan; Zhao, Jingru; Chen, Yajun; Wang, Dayong; Bai, Ruimiao
2018-06-01
This case study is concerning the meticulous observation of the moving process and track of 2 ingested needles using interval x-ray radiography, trying to localize the foreign bodies and reduce unnecessary exploration of digestive tract. An unusual case of a 1-year, 9-month-old female baby, with incarcerated hernia perforation caused by sewing needles with sharp ends, was reported herein. The patient had swallowed 2 sewing needles. One needle was excreted uneventfully after 8 days. On the contrary, the other needle stabbed the ileocecal junction wall into the right side of inguinal hernia sac after 9 days, and the patient received successful operation management. Interval x-ray confirmed that 1 needle-like foreign body moving down in 8 days until excretion along with feces. However, the other pierced into the incarcerated hernia. Preoperative x-ray radiography successfully monitored the moving process and tract of the sewing needles. Considering the penetrating-migrating nature of the foreign bodies, once the sharp-pointed objects were located, they should be removed as the mortality and risk of related complications may be increased. Interval x-ray radiography represents a meticulous preoperative monitoring method of the moving process and tract of needle-like foreign bodies. Interval x-ray with real-time images accurately detecting the moving foreign bodies could be help to reduce the unnecessary exploration of digestive tract and subsequently prevent possible complications. Based on the basic findings from the interval x-ray, treatment choices of endoscopic removal and surgical intervention may be attempted.
Single-stage endovascular treatment of an infected subclavian arterio-oesophagal fistula.
Floré, Bernard; Heye, Sam; Nafteux, Philippe; Maleux, Geert
2014-03-01
Oesophagal perforation after foreign body ingestion may result in an arterio-oesophageal fistula. We present a case of a man who presented with haematemesis and hypovolemic shock after ingestion of a chicken bone. Imaging revealed an infected fistula between the oesophagus and the left subclavian artery. Haemorrhage stopped after endovascular deployment of a stent graft in the subclavian artery. Aftercare consisted of intravenous antibiotics and parenteral feeding. The patient was discharged after 3 weeks and he encountered no infectious or vascular problems on follow-up. This unique case deals with a patient in whom an infected arterio-oesophageal fistula was successfully treated with a vascular stent-graft, thereby avoiding open surgical repair.
Magnet foreign body ingestion: rare occurrence but big consequences.
Sola, Richard; Rosenfeld, Eric H; Yu, Yangyang R; St Peter, Shawn D; Shah, Sohail R
2017-08-24
To review the outcomes of magnet ingestions from two children's hospitals and develop a clinical management pathway. Children <18years old who ingested a magnet were reviewed from 1/2011 to 6/2016 from two tertiary center children's hospitals. Demographics, symptoms, management and outcomes were analyzed. From 2011 to 2016, there were 89 magnet ingestions (50 from hospital 1 and 39 from hospital 2); 50 (56%) were males. Median age was 7.9 (4.0-12.0) years; 60 (67%) presented with multiple magnets or a magnet and a second metallic co-ingestion. Suspected locations found on imaging were: stomach (53%), small bowel (38%), colon (23%) and esophagus (3%). Only 35 patients (39%) presented with symptoms and the most common symptom was abdominal pain (33%). 42 (47%) patients underwent an intervention, in which 20 (23%) had an abdominal operation. For those undergoing abdominal surgery, an exact logistic regression model identified multiple magnets or a magnet and a second metallic object co-ingestion (OR 12.9; 95% CI, 2.4 - Infinity) and abdominal pain (OR 13.0; 95% CI, 3.2-67.8) as independent risk factors. Magnets have a high risk of requiring surgical intervention for removal. Therefore, we developed a management algorithm for magnet ingestion. Level III. Copyright © 2017 Elsevier Inc. All rights reserved.
Barium appendicitis after upper gastrointestinal imaging.
Novotny, Nathan M; Lillemoe, Keith D; Falimirski, Mark E
2010-02-01
Barium appendicitis (BA) is a rarely seen entity with fewer than 30 reports in the literature. However, it is a known complication of barium imaging. To report a case of BA in a patient whose computed tomography (CT) scan was initially read as foreign body ingestion. An 18-year-old man presented with right lower quadrant pain after upper gastrointestinal imaging 2 weeks prior. A CT scan was obtained of his abdomen and pelvis that revealed a finding that was interpreted as a foreign body at the area of the terminal ileum. A plain X-ray study of the abdomen revealed radiopaque appendicoliths. Pathology confirmed the diagnosis of barium appendicitis. BA is a rare entity and the pathogenesis is unclear. Shorter intervals between barium study and presentation with appendicitis usually correlate with fewer complications. Copyright (c) 2010 Elsevier Inc. All rights reserved.
Pathophysiology of esophageal impairment due to button battery ingestion.
Völker, Johannes; Völker, Christine; Schendzielorz, Philipp; Schraven, Sebastian P; Radeloff, Andreas; Mlynski, Robert; Hagen, Rudolf; Rak, Kristen
2017-09-01
The increased use of button batteries with high energy densities in devices of daily life presents a high risk of injury, especially for toddlers and young children. If an accidental ingestion of a button battery occurs, this foreign body can become caught in the constrictions of the esophagus and cause serious damage to the adjacent tissue layers. The consequences can be ulcerations, perforations with fistula formation and damage to the surrounding anatomical structures. In order to gain a better understanding of the pathophysiology after ingestion, we carried out systematic studies on fresh preparations of porcine esophagi. The lithium button battery type CR2032, used most frequently in daily life, was exposed in preparations of porcine esophagi and incubated under the addition of artificial saliva at 37 °C. A total of eight esophagi were analysed by different methods. Measurements of the pH value around the battery electrodes and histological studies of the tissue damage were carried out after 0.5-24 h exposure time. In addition, macroscopic time-lapse images were recorded. Measurements of the battery voltage and the course of the electric current supplemented the experiments. The investigations showed that the batteries caused an electrolysis reaction in the moist environment. The positive electrode formed an acidic and the negative electrode a basic medium. Consequently, a coagulation necrosis at the positive pole, and a deep colliquation necrosis at the minus pole occurred. After an exposure time of 12 h, tissue damage caused by the lye corrosion was observed on the side of the negative electrode up to the lamina muscularis. The corrosion progressed up to the final exposure time of 24 h, but the batteries still had sufficient residual voltage, such that further advancing damage would be expected. Button battery ingestion in humans poses an acute life-threatening danger and immediate endoscopic removal of the foreign body is essential. After only 2 h exposure time, significant damage to the tissue could be detected, which progressed continuously to complete esophageal perforation. The primary prevention of battery ingestion is therefore of particular importance. Copyright © 2017 Elsevier B.V. All rights reserved.
After the Recall: Reexamining Multiple Magnet Ingestion at a Large Pediatric Hospital.
Rosenfield, Daniel; Strickland, Matt; Hepburn, Charlotte Moore
2017-07-01
To evaluate the effectiveness of a mandatory product recall on the frequency of multiple mini-magnet ingestion at a large tertiary pediatric hospital, and to examine the morbidity and mortality associated with these ingestions. In this retrospective chart review, we searched our institution's electronic patient record for patients aged <18 years who had been diagnosed with ingested magnetic foreign bodies between 2002 and 2015, a period that included the mandatory product recall. We compared the frequency and character of ingestions before and after the recall. Comparing the postrecall years (January 1, 2014, to December 31, 2015) with the 2 years immediately preceding the recall year (January 1, 2011, to December 31, 2012) yields an incidence rate ratio of 0.34 (95% CI, 0.18-0.64) for all magnet ingestions and 0.20 (95% CI, 0.08-0.53) for ingestion of multiple magnets. Based on the Fisher exact test, the incidence of both magnet ingestion (P < .001) and multiple magnet ingestion (P < .001) decreased, and the morbidity associated with magnet ingestion decreased. There were no deaths in either study period. There was a significant decrease in multiple mini-magnet ingestion following a mandatory product recall. This study supports the effectiveness of the recall, which should bolster efforts to keep it in place in jurisdictions where it is being appealed. More broadly, the result provides general evidence of a recall helping decrease further harm from a product that carries a potential hazard. Copyright © 2017 Elsevier Inc. All rights reserved.
Management of an ingested fish bone in the lung using video-assist thoracic surgery: a case report.
Tan, Sichuang; Tan, Sipin; Peng, Muyun; Yu, Fenglei
2015-06-01
We report a case of lung abscess caused by an ingested fish bone that was successfully treated by minimally invasive surgery. Although cases of ingested foreign body abscess are well reported, lung abscess caused by ingested fish bone is extremely rare. To date, less than 10 similar cases have been reported in the literature. To the best of our knowledge, the case presented in this case report is the first report of this kind that was successfully treated by video-assist thoracic surgery (VATS). A 47-year-old man was admitted to department of thoracic surgery with the complaint of continues dry cough and fever. The patient accidentally swallowed a long sharp-blade-shaped fish bone 20 days before, which perforated the upper thoracic esophagus on the right and embedded in the right upper lobe.The diagnosis was verified by computed tomography scan and a video-assist thoracic surgery procedure was successfully performed to treat the patient. The patient survived the esophageal perforation fortunately without involvement of great vessel injury and probable mediastinitis. This report may provide additional experience on lung abscess caused by ingested fish bones. However, it is also important to educate the public of the risks of trying to force an ingested object down into the stomach.
Toys in the upper aerodigestive tract: evidence on their risk as emerging from the ESFBI study.
Foltran, Francesca; Gregori, Dario; Passàli, Desiderio; Bellussi, Luisa; Caruso, Giuseppe; Passàli, Francesco Maria; Passàli, Giulio Cesare
2011-10-01
Foreign body inhalation/aspiration or ingestion is a relatively common event in young children and, despite many efforts made in several Countries to reach acceptable safety levels for products devoted to children, small toys or toy parts are frequently mentioned among risky foreign bodies. The aim of the present study is to characterize the risk of complications and prolonged hospitalization due to toys inhalation/aspiration or ingestion according to age and gender of patients, FB characteristics and FB location, circumstances of the accident, as emerging from the ESFBI study. A retrospective study in major hospitals of 19 European Countries was realized on children aged 0-14 having inhaled/aspired or ingested a toy, with regard to the characteristics of the child and the FB (shape, volume, consistency), the FB location, the hospitalization's details and the occurrence of complications. In the years 2000-2003 a total of 2094 FB injuries occurred in children aged 0-14 years. Among them 121 (5.8%) were due to toys (mainly parts of toys) and 95 (4.5%) occurred in the lower/upper aero-digestive tract. 58 children needed hospitalization. The first determinant of a damage requiring hospitalization is the rigid consistence of the object. Almost 27% of toys related injuries happened under adults' supervision. Despite the adoption of preventive strategies, including products modification by manufacturers, has resulted in a decrease of children's mortality rate for choking in the last decades, our results seem to testify that preventive strategies imposing a regulation of industrial production, even if fundamental, are not sufficient and need to be integrated with other preventive intervention addressed to improve parents ability to be conscious of FB injuries and attentive toward a proper surveillance of children. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Safety-pin ingestion in children: a cultural fact.
Gün, Feryal; Salman, Tansu; Abbasoglu, Latif; Celik, Rüya; Celik, Alaaddin
2003-08-01
Pediatric foreign-body (FB) ingestion is a common problem. Many of these FBs are sharp objects such as needles, toothpicks and safety pins (SP). This report reviews the management of SP ingestion in children. During a 16-year period, we recorded 49 pediatric cases of witnessed SP ingestion. In all children, SPs were used to attach the blue beads to the child's suits with the belief of averting the evil eye. The mean age was 8 months ranging from 4 months to 2 years, and 30 patients were males and 19 were females. SPs were most commonly sited in esophagus (37%) and stomach (37%). In the remainder, the SPs have already reached the duodenum and intestine. In this series, 20 (41%) children passed SPs spontaneously, 14 (28.5%) required endoscopic removal and 15 (30.5%) underwent surgery. The outcome of all patients was uneventful. All of the esophageal SPs require endoscopic intervention, however, after passing into stomach the patients can be observed with keeping the surgical intervention in mind if the SP displays a fixed position for more than three days.
A unique case of magnet ingestion with respect to presentation and management.
Yalçin, Sule; Karnak, Ibrahim; Ekinci, Saniye; Senocak, Mehmet Emin
2012-01-01
Magnet ingestion may lead to serious complications with delay in diagnosis and treatment. The forceful attraction between magnets, with gastric and/or intestinal wall entrapped between them, can cause injury through pressure necrosis. The radiological appearance of more than one magnet on X-ray can be easily misinterpreted as belonging to only one rod-like radiopaque foreign body, even if the magnets are located in different parts of the gastrointestinal tract, thus delaying the management up to the onset of emergent surgical complications. A 17-month-old female with ingestion of a pair of magnets is presented, together with introduction of the clinical picture and therapeutic approach, which differed from the other previously reported cases. The ovoid shape of the magnets, their localization in the gastrointestinal tract (leading to entrapped gastric and intestinal wall between them), absence of any complication, and the therapeutic approach of endoscopic retrieval are the main distinguishing features of this case from those previously reported.
Tringali, Andrea; Thomson, Mike; Dumonceau, Jean-Marc; Tavares, Marta; Tabbers, Merit M; Furlano, Raoul; Spaander, Manon; Hassan, Cesare; Tzvinikos, Christos; Ijsselstijn, Hanneke; Viala, Jérôme; Dall'Oglio, Luigi; Benninga, Marc; Orel, Rok; Vandenplas, Yvan; Keil, Radan; Romano, Claudio; Brownstone, Eva; Hlava, Štěpán; Gerner, Patrick; Dolak, Werner; Landi, Rosario; Huber, Wolf Dietrich; Everett, Simon; Vecsei, Andreas; Aabakken, Lars; Amil-Dias, Jorge; Zambelli, Alessandro
2017-01-01
This Executive summary of the Guideline on pediatric gastrointestinal endoscopy from the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) refers to infants, children, and adolescents aged 0 - 18 years. The areas covered include: indications for diagnostic and therapeutic esophagogastroduodenoscopy and ileocolonoscopy; endoscopy for foreign body ingestion; endoscopic management of corrosive ingestion and stricture/stenosis; upper and lower gastrointestinal bleeding; endoscopic retrograde cholangiopancreatography, and endoscopic ultrasonography. Percutaneous endoscopic gastrostomy and endoscopy specific to inflammatory bowel disease (IBD) have been dealt with in other Guidelines and are therefore not mentioned in this Guideline. Training and ongoing skill maintenance will be addressed in an imminent sister publication. © Georg Thieme Verlag KG Stuttgart · New York.
Identification and topographic localization of metallic foreign bodies by metal detector.
Muensterer, Oliver J; Joppich, Ingolf
2004-08-01
Exact localization of ingested metal objects is necessary to guide therapy. This study prospectively evaluates the accuracy of foreign body (FB) identification and localization by metal detector (MTD) in a systematic topographic fashion. Patients who presented after an alleged or witnessed metal FB ingestion were scanned with an MTD. In case of a positive signal, the location was recorded in a topographic diagram, and radiographs were obtained. The diagnostic accuracy of the MTD scan for FB identification and topographic localization was determined by chi(2) analysis, and concordance was calculated by the McNemar test and expressed as kappa. A total of 70 MTD examinations were performed on 65 patients (age 6 months to 16 years); 5 patients were scanned twice on different days. The majority had swallowed coins and button batteries (n = 41). Of these, 29 items were correctly identified, and 11 of 12 were correctly ruled out (coins and button batteries: sensitivity, 100% [95% Confidence Interval 95% to 100%]; specificity, 91.7% [95% CI 76% to 100%], kappa = 0.94). When all metallic objects were included, 41 of 46 were correctly identified, and 22 of 24 were correctly ruled out (sensitivity, 89.1% [95% CI 80% to 98%]; specificity, 91.7% [95% CI 81% to 100%], kappa = 0.78). Five miscellaneous objects were not identified (sensitivity for items other than coins and button batteries 71% [95% CI 49% to 92%], kappa = 0.56). Localization by MTD was correct in 30 of 41 identified objects (73%). The error rates of junior and senior pediatric surgery residents did not differ significantly (P =.82). Ingested coins and button batteries can be safely and accurately found by metal detector. For these indications, the MTD is a radiation-free diagnostic alternative to conventional radiographs. Other items, however, cannot be ruled out reliably by MTD. In these cases, radiographic imaging is still indicated.
Pill in the blister pack: a rare cause of dysphagia in an elderly adult
Laeeq, Syed Mudassir; Rai, Ayesha Aslam; Tasneem, Abbas Ali; Luck, Nasir Hassan; Majid, Zain
2015-01-01
Foreign body impaction in the esophagus amongst adults is not a common cause of dysphagia. Fish bone, food bolus, dentures may cause symptoms of dysphagia, odynophagia, chest pain or respiratory distress. It needs prompt evaluation along with removal of the substance either surgically or endoscopically to avoid the development of life threatening complications. Here we are reporting a case of an elderly male, who presented to us with a history of absolute dysphagia for one week, as a consequence of ingestion of a pill in blister pack. PMID:26918072
Schubbert, R; Hohlweg, U; Renz, D; Doerfler, W
1998-10-01
We have previously shown that, when administered orally to mice, bacteriophage M13 DNA, as a paradigm foreign DNA without homology to the mouse genome, can persist in fragmented form in the gastrointestinal tract, penetrate the intestinal wall, and reach the nuclei of leukocytes, spleen and liver cells. Similar results were obtained when a plasmid containing the gene for the green fluorescent protein (pEGFP-C1) was fed to mice. In spleen, the foreign DNA was detected in covalent linkage to DNA with a high degree of homology to mouse genes, perhaps pseudogenes, or to authentic E. coli DNA. We have now extended these studies to the offspring of mice that were fed regularly during pregnancy with a daily dose of 50 microg of M13 or pEGFP-C1 DNA. Using the polymerase chain reaction (PCR) or the fluorescent in situ hybridization (FISH) method, foreign DNA, orally ingested by pregnant mice, can be discovered in various organs of fetuses and of newborn animals. The M13 DNA fragments have a length of about 830 bp. In various organs of the mouse fetus, clusters of cells contain foreign DNA as revealed by FISH. The foreign DNA is invariably located in the nuclei. We have never found all cells of the fetus to be transgenic for the foreign DNA. This distribution pattern argues for a transplacental pathway rather than for germline transmission which might be expected only after long-time feeding regimens. In rare cells of three different fetuses, whose mothers have been fed with M 13 DNA during gestation, the foreign DNA was detected by FISH in association with both chromatids. Is maternally ingested foreign DNA a potential mutagen for the developing fetus?
NASA Astrophysics Data System (ADS)
Milovanovic, Lazar; Agrawal, Arun; Bak, Peter; Bender, Duane; Koff, David
2015-03-01
The deployment of regional and national Electronic Health Record solutions has been a focus of many countries throughout the past decade. Most of these deployments have taken the approach of "sharing" imaging exams via portals and web-based viewers. The motivation of portal/web-based access is driven by a) the perception that review of imaging exams via portal methods is satisfactory to all users and b) the perceived complexity of ingesting foreign exams into local systems. This research project set out to objectively evaluate who really needs foreign exams within their local systems, what those systems might be and how often this is required. Working on the belief that Foreign Exam Management (FEM) is required to support clinical workflow, the project implemented a FEM capability within an XDSI. b domain to identify the design challenges and nuances associated with FEM.
Elmoghrabi, Adel; Mohamed, Mohamed; Wong, Kristoffer; McCann, Michael
2016-06-20
We report a case of a 70-year-old woman who presented with progressively increasing intensity of lower abdominal, pelvic and rectal pain of 3-day duration. She had similar symptoms intermittently over the preceding 2 years. CT of the abdomen and pelvis revealed the presence of a 3.8×0.4 cm linear foreign body in the colorectal region. History obtained from relatives recalled inadvertent ingestion of a chicken bone 2 years prior to presentation. Trials of foreign body retrieval, both manually and via rigid and flexible sigmoidoscopy, however, were unsuccessful due to the presence of obstruction by a circumferential rectal stricture. Consequently, an exploratory laparotomy was performed, with segmental resection of 17 cm of rectum and distal sigmoid. Dissection of the strictured segment revealed the presence of a chicken bone. The patient had an uneventful postoperative course, was discharged and is to continue following up on an outpatient basis. 2016 BMJ Publishing Group Ltd.
Franzen-Klein, Dana; McRuer, David; Slabe, Vincent; Katzner, Todd
2018-01-01
A male juvenile bald eagle (Haliaeetus leucocephalus) was admitted to the Wildlife Center of Virginia with a left humeral fracture a large quantity of anthropogenic debris in the ventriculus, a blood lead level of 0.616 ppm, and clinical signs consistent with chronic lead toxicosis. Because of the poor prognosis for recovery and release, the eagle was euthanatized. Lead isotope analysis was performed to identify potential anthropogenic sources of lead in this bird. The lead isotope ratios in the eagle's femur (0.8773), liver (0.8761), and kidneys (0.8686) were most closely related to lead paint (0.8925), leaded gasoline (0.8450), and zinc smelting (0.8240). The lead isotope ratios were dissimilar to lead ammunition (0.8179) and the anthropogenic debris in the ventriculus. This case report documents foreign body ingestion in a free-ranging bald eagle and demonstrates the clinical utility of lead isotope analysis to potentially identify or exclude anthropogenic sources of lead poisoning in wildlife patients.
Mariano Beraldo, Carolina; Rondon Lopes, Érika; Hage, Raduan; Hage, Maria Cristina F N S
2017-03-01
Ingested or penetrating foreign bodies are common in veterinary medicine. When they are radiolucent, these objects become a diagnostic challenge, but they can be investigated sonographically. However, successful object identification depends on the skill of the sonographer. Considering that these cases appear randomly during hospital routines, it is not always possible to train all students to identify them correctly. Therefore, the aim of this study was to produce homemade simulations of radiolucent foreign bodies for veterinary student demonstrations that could be identified sonographically and to evaluate the acceptability, applicability, and usefulness of these simulations according to a visual analog scale questionnaire and subjective questions. For this purpose, object models (a pacifier nipple, a toy ball, a sock, nylon thread, and a mango seed) were designed, produced, and immersed in gelatin. To simulate wood splinters in the integumentary and musculoskeletal system, a piece of meat punctured with a toothpick and ice cream stick splinters were used. The type of phantom had a determinant effect on the visualization (chi-square = 36.528, P < 0.0001) and recognition (chi-square = 18.756, P = 0.0021) capability of the students. All of the students answered that their experience with the models could help in real situations. The student responses to the questionnaire indicated that the project was well accepted, and the participants believed that this experience could be applicable to and useful in veterinary routines. Copyright © 2017 the American Physiological Society.
Newell, K J; Taylor, B; Walton, J C; Tweedie, E J
2000-01-01
Plastic bread-bag clips have been identified as a cause of local perforation or obstruction at many sites in the gastrointestinal tract. This study is the largest case series yet reported, consisting of 3 cases presenting as small-bowel perforation, 1 case in which the clip was found incidentally in the small bowel at laparotomy during vascular surgery and 1 case in which the clip was found incidentally in the small bowel at autopsy. In all cases there was no radiographic evidence to suggest a foreign body in the gastrointestinal tract. People older than 60 years of age who have either partial or full dentures seem to be particularly at risk for the accidental ingestion of these devices. If accidentally ingested, plastic bread-bag clips represent a significant health hazard. As the population ages, small-bowel perforation secondary to ingestion of such clips may occur with increasing frequency. The authors recommend elimination or redesign of the clips, to prevent their being swallowed and becoming impacted in the small bowel or to allow them to be identified in the gastrointestinal tract by conventional radiography. PMID:10701390
Stegink, L D; Filer, L J; Baker, G L
1985-02-01
Plasma glutamate concentrations in human subjects are markedly lower when monosodium L-glutamate is ingested in a water solution containing partially hydrolyzed starch than when ingested in water alone. This study was carried out to investigate whether starch ingested as crackers had a similar effect. Eight normal adult subjects (four male, four female) ingested three servings of a beef consommé providing 50 mg/kg body weight monosodium L-glutamate. One serving was consommé alone, the other two were accompanied by sufficient crackers to provide 0.25 or 0.5 g starch per kilogram body weight, respectively. Ingestion of consommé containing glutamate significantly increased the mean plasma glutamate concentration above baseline to a mean peak value 30 min later. The peak after consumption of 0.5 g starch per kilogram body weight, but not 0.25 g/kg body weight, was significantly lower than when consommé alone was ingested. These data indicate that simultaneous ingestion of metabolizable carbohydrate with glutamate has a marked effect on the plasma glutamate response and indicate that the threshold value for carbohydrate is greater than 0.25 g/kg body weight.
Gastrointestinal damage caused by swallowing multiple magnets.
Liu, Shiqi; Li, Jianhui; Lv, Yi
2012-09-01
Swallowing multiple magnets is not uncommon worldwide and it frequently leads to serious consequences. However, most patients fail to receive timely and correct diagnosis and treatment. A literature search was performed to establish an algorithm for these accidents by the authors to identify relevant articles published from June 1987 to October 2010 in Google, Medline, ISI Web of Knowledge Ovid, CNKI, Korea Med and library document delivery, using search terms "magnet ingestion, " "fistula," and "perforation." A total of 149 patients with ingestion of magnetic foreign bodies from 20 countries and areas were identified. 22 of them were companioned with neurological and psychiatric disorders. Swallowing magnets occurred throughout childhood and adolescent, mostly ranging 2 to 4 years in age. Various gastrointestinal damages such as necrosis and intestinal perforation or fistula were encountered. Damage from swallowing multiple magnets carries a significant risk of morbidity and even mortality throughout childhood to adolescent worldwide. Older children and adults with neurological and psychiatric problems may be at high risk for such accidents. Early intervention is crucial.
14 CFR 33.77 - Foreign object ingestion-ice.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 33.77 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Design and Construction; Turbine Aircraft Engines § 33.77 Foreign... this section may not— (1) Cause a sustained power or thrust loss; or (2) Require the engine to be...
14 CFR 33.77 - Foreign object ingestion-ice.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 33.77 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Design and Construction; Turbine Aircraft Engines § 33.77 Foreign... this section may not— (1) Cause a sustained power or thrust loss; or (2) Require the engine to be...
Plastic laryngeal foreign bodies in children: a diagnostic challenge.
Bloom, David C; Christenson, Tom E; Manning, Scott C; Eksteen, Eduard C; Perkins, Jonathan A; Inglis, Andrew F; Stool, Sylvan E
2005-05-01
To review Children's Hospital and Regional Medical Center experience with pediatric airway foreign bodies, and examine the incidence and treatment of laryngeal foreign bodies. To determine if plastic laryngeal foreign bodies present differently than other laryngeal foreign bodies. A retrospective review of all cases of children (1874 patients) undergoing direct laryngoscopy and/or bronchoscopy from 1st January 1997 to 9th September 2003 at a tertiary care children's hospital. Patients with endoscopically documented laryngeal foreign bodies were identified and the medical record reviewed in more detail. Patient age, gender, foreign body location, foreign body type, duration of foreign body presence, radiographic findings, endoscopic findings and treatment complications were recorded. One hundred and five aspirated foreign bodies were identified. The nine laryngeal foreign bodies included five clear plastic radiolucent items, two radiolucent food items, and two sharp radioopaque pins. Time to diagnosis and treatment was on average 11.6 days with 17.6 days for thin/plastic foreign bodies and 1.6 days for metal/food foreign bodies. Laryngeal foreign bodies represent a small portion of all pediatric airway foreign bodies. Difficulty in identifying laryngeal foreign bodies, especially thin, plastic radiolucent foreign bodies can delay treatment. Thin plastic foreign bodies can present without radiographic findings, can be difficult to image during endoscopy and can be particularly difficult to diagnose. A history of choking and vocal changes is associated with laryngeal foreign bodies. Laryngeal foreign bodies should be in the differential diagnosis of all children presenting with atypical upper respiratory complaints especially if a history suggestive of witnessed aspiration and dysphonia can be obtained.
Zinc Toxicosis in a Boxer Dog Secondary to Ingestion of Holiday Garland.
Bischoff, Karyn; Chiapella, Anne; Weisman, Jaime; Crofton, Lisa M; Hillebrandt, Joseph
2017-09-01
Increased admissions occur in small animal veterinary emergency clinics during some holidays, and some of the increased caseload is due to ingestion of toxic substances. This report documents zinc toxicosis contributing to the death of a dog after ingestion of holiday tinsel garland. A mature boxer dog presented with a 4-day history of vomiting and diarrhea. Radiodense foreign material was detected in the stomach and removed via gastrotomy. The patient clinically worsened over the next several days with evidence of hemolytic anemia, severe hypernatremia, and an elevated WBC count with a suspected dehiscence of the surgical site and acute renal failure. The serum zinc concentration was moderately elevated. Postmortem findings included surgical dehiscence from the gastrotomy and enterotomy sites, hepatic extramedullary hematopoiesis, hemoglobinuric nephrosis, and pancreatic fibrosis. The foreign material removed from the stomach also contained zinc. Ingestion of holiday tinsel garland made from metal-coated plastic film has not previously been implicated in zinc toxicosis. Zinc toxicosis has a good prognosis in veterinary medicine when diagnosed and treated promptly, but the unique source of zinc in this dog contributed to the delay in diagnosis and grave outcome in this case.
Severe Vaginal Burns in a 5-Year-Old Girl Due to an Alkaline Battery in the Vagina.
Semaan, Alexander; Klein, Tobias; Vahdad, Mohammad Reza; Boemers, Thomas M; Pohle, Rebecca
2015-10-01
The ingestion or insertion of alkaline batteries in the body can cause severe damage to hollow organs. We report here a case of severe vaginal burns in a young patient caused by an alkaline battery. A 5-year-old girl presented to our outpatient department with pelvic pain and vaginal discharge. Further workup suggested the presence of a vaginal foreign body. Under general anesthesia, an alkaline battery was removed from her vagina, which showed severe burns with partial-thickness necrosis. Complete healing was confirmed at 3 months after initial presentation. In this rare case of an alkaline battery present in the vagina of a prepubescent girl, we discuss the available treatment and management options in comparison to similar previously reported cases. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
Clukey, Katherine E.; Lepczyk, Christopher A.; Balazs, George H.; Work, Thierry M.; Lynch, Jennifer M.
2017-01-01
Ingestion of marine debris is an established threat to sea turtles. The amount, type, color and location of ingested plastics in the gastrointestinal tracts of 55 sea turtles from Pacific longline fisheries from 2012 to 2016 were quantified, and compared across species, turtle length, body condition, sex, capture location, season and year. Six approaches for quantifying amounts of ingested plastic strongly correlated with one another and included: number of pieces, mass, volume and surface area of plastics, ratio of plastic mass to body mass, and percentage of the mass of gut contents consisting of plastic. All olive ridley (n = 37), 90% of green (n = 10), 80% of loggerhead (n = 5) and 0% of leatherback (n = 3) turtles had ingested plastic; green turtles ingested significantly more than olive ridleys. Most debris was in the large intestines. No adverse health impacts (intestinal lesions, blockage, or poor body condition) due directly to plastic ingestion were noted.
Clukey, Katharine E; Lepczyk, Christopher A; Balazs, George H; Work, Thierry M; Lynch, Jennifer M
2017-07-15
Ingestion of marine debris is an established threat to sea turtles. The amount, type, color and location of ingested plastics in the gastrointestinal tracts of 55 sea turtles from Pacific longline fisheries from 2012 to 2016 were quantified, and compared across species, turtle length, body condition, sex, capture location, season and year. Six approaches for quantifying amounts of ingested plastic strongly correlated with one another and included: number of pieces, mass, volume and surface area of plastics, ratio of plastic mass to body mass, and percentage of the mass of gut contents consisting of plastic. All olive ridley (n=37), 90% of green (n=10), 80% of loggerhead (n=5) and 0% of leatherback (n=3) turtles had ingested plastic; green turtles ingested significantly more than olive ridleys. Most debris was in the large intestines. No adverse health impacts (intestinal lesions, blockage, or poor body condition) due directly to plastic ingestion were noted. Copyright © 2017. Published by Elsevier Ltd.
Lead poisoning following ingestion of pieces of lead roofing plates: pica-like behavior in an adult.
Sabouraud, Sabine; Testud, François; Descotes, Jacques; Benevent, Monique; Soglu, Gilbert
2008-03-01
A 37-year-old man was admitted to hospital after complaining of abdominal pain for the past two weeks. On admission the abdominal radiograph showed multiple radio-opaque flecks dispersed throughout the gastrointestinal tract. Blood testing showed hemoglobin level 8.7 g/dL and a blood lead level of 112.4 microg/dL. The family interview revealed that the patient had pica-like behavior since childhood. He was a site foreman and had been ingesting pieces of roofing plates for a few weeks. The patient was treated with laxatives and CaNa(2)EDTA therapy was initiated. The blood lead level then dropped to 69.9 microg/dL. The patient received two subsequent courses of oral succimer and the blood lead level decreased to 59 microg/dL 21 days after the first course. The follow-up abdominal X-ray 20 days after the first examination was normal. Four months later, an outpatient follow-up visit showed a blood lead level within normal limits (14.5 microg/dL) and a psychiatric follow-up was initiated. Lead poisoning following the ingestion of lead-containing foreign bodies is particularly rare in adults, while it is sometimes observed in children. Pica behavior is a well-identified risk factor of lead intoxication in children but is quite exceptional in adults, where it is usually considered to be a psychiatric condition. Other unusual sources of lead poisoning include the ingestion of lead bullets, ceramic lead glaze or glazed earthenware, lead-contaminated candies, ethnic or herbal remedies.
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Macrophages are scavenger cells that can ingest dead tissue and foreign cells. Macrophages form tentacles called pseudopods to surround an invader. Once inside the macrophage, the invader is walled off and ...
Review of ear, nose and throat foreign bodies in Sarawak General Hospital. A five year experience.
Chiun, Kian Chai; Tang, Ing Ping; Tan, Tee Yong; Jong, Doris Evelyn Yah Hui
2012-02-01
Ear, nose and throat foreign bodies are common in ENT clinical practice. This study was designed to establish the local data of otorhinolaryngeal foreign bodies in term of prevalence among paediatric and adult groups, the clinical features, types of foreign body at different sites, and laterality of foreign bodies. This study was carried out at ENT department, Sarawak General Hospital, Malaysia, from 1st January 2005 to 31st December 2009. A total of 1084 cases were included and statistically analyzed. Ear foreign bodies showed the highest incidence which was consisted of 480 (44.3%) cases, followed by nose in 270 (24.9%) cases, pharynx in 251 (23.2%) cases, esophagus in 57 (5.3%) cases and laryngo-tracheobronchial tree in 26 (2.4%) cases. Otorhinolaryngeal foreign bodies occurred more frequently in 0-10 year old age group which constituted 651 (60.1%) cases. The descending order of frequency for foreign body sites in adult was pharynx (17.2%), ear (12.8%), esophagus (3.1%), nose (1.7%) and laryngo-tracheobronchial tree (1.1%). The type of foreign bodies varies with age group and site of foreign body lodgement. In general, common foreign bodies in both adult and children were food related, with the additional of small objects such as plastic toy in paediatric group. Otorhinolaryngeal foreign bodies were found more frequently in children. The types of foreign body were different from age group and sites of foreign body lodgement. The local food constituted the highest incidence of ear, nose, and throat foreign bodies with additional of plastic toys in paediatric group.
Miniature ingestible telemeter devices to measure deep-body temperature
NASA Technical Reports Server (NTRS)
Pope, J. M.; Fryer, T. B. (Inventor)
1976-01-01
A telemetry device comprised of a pill-size ingestible transmitter developed to obtain deep body temperature measurements of a human is described. The device has particular utility in the medical field where deep body temperatures provide an indication of general health.
Clinical experience of removing aerodigestive tract foreign bodies with rigid endoscopy in children.
Ozguner, I Faruk; Buyukyavuz, B Ilker; Savas, Cagri; Yavuz, M Sunay; Okutan, Huseyin
2004-10-01
This study was undertaken to document the aerodigestive tract foreign body accidents among children, and to investigate the circumstances surrounding these events. A review of the charts of pediatric patients admitted with the definitive or suspicious diagnosis of aerodigestive tract foreign bodies was carried out in the period between January 1, 1998 to December 31, 2002. There were 53 eligible children; 39 boys and 14 girls, with an age range of 7 months to 14 years. Food items were the most common airway foreign bodies and coins were the most common esophageal foreign bodies. Among the 32 patients who underwent bronchoscopy, no foreign body was identified in 9 patients. Among the 21 patients who underwent esophagoscopy, foreign body was removed in 19 patients. In 2 cases, large foreign bodies which we could not extract with forceps were pushed into the stomach. Foreign bodies in the airway and esophagus constitute a constant hazard in all age groups, which demands immediate approach and management. Although the rigid endoscopic removal of aerodigestive foreign bodies was successful in this series, the most effective treatment of foreign body accidents is their prevention.
Management of foreign bodies in the airway and oesophagus.
Rodríguez, Hugo; Passali, Giulio Cesare; Gregori, Dario; Chinski, Alberto; Tiscornia, Carlos; Botto, Hugo; Nieto, Mary; Zanetta, Adrian; Passali, Desiderio; Cuestas, Giselle
2012-05-14
Ingestion and/or aspiration of foreign bodies (FB) are avoidable incidents. Children between 1 and 3 years are common victims for many reasons: exploration of the environment through the mouth, lack of molars which decreases their ability to properly chew food, lack of cognitive capacity to distinguish between edible and inedible objects, and tendency to distraction and to perform other activities, like playing, whilst eating. Most FBs are expelled spontaneously, but a significant percentage impacts the upper aerodigestive tract. Approximately 80% of children's choking episodes are evaluated by pediatricians. The symptoms of aspiration or ingestion of FBs can simulate different paediatric diseases such as asthma, croup or pneumonia, delaying the correct diagnosis. There are three clinical phases both in aspiration and in ingestion of FBs: initial stage (first stage or impaction or FB) shows choking, gagging and paroxysms of coughing, obstruction of the airway (AW), occurring at the time of aspiration or ingestion. These signs calm down when the FB lodges and the reflexes grow weary (second stage or asymptomatic phase). Complications occur in the third stage (also defined as complications' phase), when the obstruction, erosion or infection cause pneumonia, atelectasis, abscess or fever (FB in AW), or dysphagia, mediastinum abscess, perforation or erosion and oesophagus (FB in the oesophagus). The first symptoms to receive medical care may actually represent a complication of impaction of FB. LOCATIONS AND MANAGEMENT: Determining the site of obstruction is important in managing the problem. The location of the FB depends on its characteristics and also on the position of the person at the time of aspiration. Determining the site of obstruction is important in managing the problem. Larynx and trachea have the lowest prevalence, except in children under 1year. They are linked with the most dangerous outcomes, complete obstruction or rupture. Bronchus is the preferred location in 80-90% of AW's cases. Esophageal FBs are twice more common than bronchial FBs, although most of these migrate to the stomach and do not require endoscopic removal. Diagnosis of FB proceeds following the traditional steps, with a particular stress on history and radiological findings as goal standards for the FB retrieval. The treatment of choice for AW's and esophageal FBs is endoscopic removal. Endoscopy should be carried out whenever the trained personnel are available, the instruments are checked, and when the techniques have been tested. The delay in the removal of FBs is potentially harmful. The communication between the endoscopist and the anaesthesiologist is essential before the procedure to establish the plan of action; full cooperation is important and improves the outcome of endoscopy. Ingestion and or aspiration of FB in children are multifactorial in their aetiology, in their broad spectrum of different resolutions for the same FB and in the response of each patient to the treatment. Prevention remains the best treatment, implying an increased education of parents on age-appropriate foods and household items, and strict industry standards regarding the dimensions of toy parts and their secure containers. Copyright © 2012. Published by Elsevier Ireland Ltd.
Pal, Madan; Singh, Prem; Tayal, Rishi; Dehmiwal, Dinesh; Behl, S. M.; Kumar, Sarvan; Chandolia, R. K
2015-01-01
Aim: The objective of the study was to obtain and compare the two-dimensional (2D) and three-dimensional (3D) ultrasonographic images of pathological conditions of the stomach in dogs in clinical cases. Materials and Methods: In our study, 12 clinical conditions of the stomach were recorded using ultrasonography. The ultrasound machine used for this study was 3D ultrasound machine (Nemio-XG: Toshiba, Japan) having four-dimensional volumetric transducer. Results: Present study was done to compare 2D and 3D ultrasonographic images in different gastric affections in dogs. In case of uremic gastropathy due to inflammatory response, the wall of the stomach was 0.6 cm thick and hyperechoic and gastric folds were also hyperechoic indicative of gastritis. In second, third, and fourth case of gastritis the wall of the stomach was 0.7, 0.6, and 0.55 cm, respectively thick and hyperechoic. In fifth and sixth case of gastritis, inflammatory response due to ingestion of polythene and sand led to gastritis and ultrasonographically, the wall of the stomach was 0.6 cm and 0.7 cm thick, respectively, and hyperechoic. In case of gastric ulcer, ultrasonographically, there was a disruption of gastric mucosal layer. In cases of gastric dilatation, anechoic content indicating fluid was seen in stomach area and due to dilatation boundary of the stomach was not clear and the increase in the lumen of the stomach was observed. In case of foreign body, ultrasonographically the wall of the stomach was 0.55 cm thick and hyperechoic. In the middle of the stomach, multiple hyperechoic shadows of the foreign bodies i.e. leather and bunch of straw of grass were observed. In case of pyloric stenosis ultrasonographically, anechoic lumen of the pylorus surrounded by 0.5 cm hypoechoic thickened muscle. In some cases, 3D ultrasonography was not diagnostic i.e. gastric foreign bodies and gastric dilatation. These conditions were better visualized on the 2D sonogram. Conclusion: The appearance of clinical conditions of the stomach such as gastritis and pyloric stenosis were more distinct on 3D ultrasonogram than 2D ultrasonogram. The 3D ultrasonography was not diagnostic in cases of gastric foreign bodies and gastric dilatation. PMID:27065634
Demura, Shinichi; Morishita, Koji; Yamada, Takayoshi; Yamaji, Shunsuke; Komatsu, Miho
2011-11-01
L-Ornithine plays an important role in ammonia metabolism via the urea cycle. This study aimed to examine the effect of L-ornithine hydrochloride ingestion on ammonia metabolism and performance after intermittent maximal anaerobic cycle ergometer exercise. Ten healthy young adults (age, 23.8 ± 3.9 year; height, 172.3 ± 5.5 cm; body mass, 67.7 ± 6.1 kg) with regular training experience ingested L-ornithine hydrochloride (0.1 g/kg, body mass) or placebo after 30 s of maximal cycling exercise. Five sets of the same maximal cycling exercise were conducted 60 min after ingestion, and maximal cycling exercise was conducted after a 15 min rest. The intensity of cycling exercise was based on each subject's body mass (0.74 N kg(-1)). Work volume (watt), peak rpm (rpm) before and after intermittent maximal ergometer exercise and the following serum parameters were measured before ingestion, immediately after exercise and 15 min after exercise: ornithine, ammonia, urea, lactic acid and glutamate. Peak rpm was significantly greater with L-ornithine hydrochloride ingestion than with placebo ingestion. Serum ornithine level was significantly greater with L-ornithine hydrochloride ingestion than with placebo ingestion immediately and 15 min after intermittent maximal cycle ergometer exercise. In conclusion, although maximal anaerobic performance may be improved by L-ornithine hydrochloride ingestion before intermittent maximal anaerobic cycle ergometer exercise, the above may not depend on increase of ammonia metabolism with L-ornithine hydrochloride.
Domeki, Yasushi; Kato, Hiroyuki
2015-07-01
An esophageal foreign body is the term for a foreign body in the esophagus. The 2 age groups most prone to this condition are children age 9 and under (and especially toddlers age 4 and under) and elderly individuals age 70 and over. A foreign body often lodges where the esophagus is most constricted. In toddlers, the foreign body is often currency or coins or a toy. In adults, the body is often a piece of fish, dentures, a piece of meat, a pin or needle, or a drug in its blister pack packaging. In children, an esophageal foreign body is treated by fluoroscopically guided removal of the body with a balloon catheter or magnetic catheter or removal of the body via endoscopy or direct esophagoscopy under general anesthesia. In adults, the best choice for treating an esophageal foreign body is removing the body with an endoscope but there are instances where surgery is performed because the body is hard to remove endoscopically, a puncture has occurred, or empyema or mediastinitis has developed. This paper reviews the diagnosis and treatment of an esophageal foreign body.
Endobronchial foreign bodies in Vietnamese adults are related to eating habits.
Nguyen, Lan Huu; Nguyen, Dung Huy; Tran, Thach Ngoc; Nguyen, Phung Tran; Thi, Quy Hoang; Aelony, Yossef; Homasson, Jean Paul Daniel
2010-04-01
A high percentage of bronchoscopically extracted foreign bodies in Ho Chi Minh City were pits of the sapote fruit, a finding previously unreported. This paper presents a review of foreign body extractions, which identifies the substances found, documents the diagnostic pathway and draws attention to the specific aspiration risk of the sapote pit. The records of 100 consecutive adults who were found to have a bronchial foreign body during flexible bronchoscopy were reviewed. In 83% of patients, the foreign body extraction was performed more than 2 weeks after the aspiration had occurred. In only 34% of patients was the diagnosis of an aspirated foreign body considered early in the patient's clinical course. The most frequent foreign bodies found were sapote pits (41%), followed by small bones (38%). Foreign bodies were lodged more frequently in the right bronchial tree (64%). In 98% of patients, the foreign bodies were successfully removed with the flexible scope. There was one postoperative death, which was not ascribed to the procedure. Physicians need to consider foreign body aspirations when evaluating patients with recurrent pneumonia, unexplained cough or atelectasis. Awareness of this problem might lead to public health measures that could reduce the incidence of these aspirations.
Tracheobronchial foreign bodies in children. Experience at ORL clinic Tuzla, 1954-2004.
Brkić, Fuad; Umihanić, Sekib
2007-06-01
To determine the clinical characteristics and the results of bronchoscopic treatment of children due to foreign body aspiration in a university hospital. Department of Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center Tuzla, Bosnia and Hercegovina. The analysis of the cases of aspirated foreign bodies within the period from January 1954 to December 2004. The analyzed patients were the children up to 14 years of age. All cases underwent the bronchoscopy. Each patient was analyzed for age, sex, nature and location of the foreign body, results of bronchoscopic removal, complications of bronchoscopy and presence of foreign bodies in the airways. Six hundred and sixty-two children who underwent bronchoscopy for removal of foreign body in the airways were evaluated. From evaluated children 66.8% were boys, ages ranging from 9 months to 14 years. Foreign bodies were more frequent in children under 3 years of age (65.2%). Most of the foreign bodies removed were organic (87.1%) and more frequently found in the right bronchial tree (53%). More attention is necessary to the prevention of aspirations. Prevention of aspiration of foreign bodies is better than cure. Public awareness through mass media needs attention to prevent foreign body inhalation.
Etiology and management of esophageal impaction in children: A review of 11 years.
Alrazzak, Baraa Alabd; Al-Subu, Awni; Elitsur, Yoram
2013-04-01
Esophageal impaction in children is a medical emergency that needs an immediate medical attention. In the last years multiple objects have been detected and were removed endoscopically. In the last decade, Eosinophilic Esophagitis (EoE) has been associated with esophageal stenosis, leading to esophageal impaction with various objects including toys, food, coins and other. To determine the various objects and symptoms associated with impactions and to develop algorithm that guides Emergency Department Physicians and Primary care Providers when facing such problem in pediatric patient. A retrospective chart review of all children referred to the pediatric gastroenterology service at Marshall University for FB impaction between 2000 and 2010 was performed. Foreign bodies treated by other specialties were excluded from this review. Clinical and demographic data were retrieved. A total of 291 charts with the diagnosis of foreign body reviewed of which only 126 met the inclusion criteria and considered for final calculation. Male/Female ratio and mean age were 1.17:1.0, and 3.65 ± 0.75 years, respectively. Time of impaction before ER evaluation was: < 24hrs in 75 patients, >24hrs in 17 and in 34 the time of ingestion was not known. Radiology was performed in 118 patients, of whom 1 had pneumo-mediastinum and 1 had pneumothorax. Endoscopic localization of the objects showed: 81- proximal, 23- middle esophagus, and 22- in the distal esophagus. The esophageal mucosa showed non-specific changes in 37 patients, 5 with EoE features, 1 patient with hiatal hernia, 1 patient with candidiasis, and in 5 pts had no mucosal description. Children with foreign body in the esophagus are commonly seen in our Hospital ER. Those children may harbor undiagnosed medical conditions that will need future therapy. Careful endoscopic assessment with mucosal biopsies is needed to diagnose those conditions earlier. Referral to a GI specialist may be warranted.
Obinwa, Obinna; Cooper, David; O'Riordan, James M
2016-01-01
This case report is intended to inform clinicians, endoscopists, policy makers and industry of our experience in the management of a rare case of mobile phone ingestion. A 29-year-old prisoner presented to the Emergency Department with vomiting, ten hours after he claimed to have swallowed a mobile phone. Clinical examination was unremarkable. Both initial and repeat abdominal radiographs eight hours later confirmed that the foreign body remained in situ in the stomach and had not progressed along the gastrointestinal tract. Based on these findings, upper endoscopy was performed under general anaesthesia. The object could not be aligned correctly to accommodate endoscopic removal using current retrieval devices. Following unsuccessful endoscopy, an upper midline laparotomy was performed and the phone was delivered through an anterior gastrotomy, away from the pylorus. The patient made an uneventful recovery and underwent psychological counselling prior to discharge. In this case report, the use of endoscopy in the management when a conservative approach fails is questioned. Can the current endoscopic retrieval devices be improved to limit the need for surgical interventions in future cases? An ingested mobile phone in the stomach may not be amenable for removal using the current endoscopic retrieval devices. Improvements in overtubes or additional modifications of existing retrieval devices to ensure adequate alignment for removal without injuring the oesophagus are needed. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
Ultrasonography in Detection of Vaginal Foreign Bodies in Girls: A Retrospective Study.
Yang, Xiuzhen; Sun, Liying; Ye, Jingjing; Li, Xiaoying; Tao, Ran
2017-12-01
In this study we investigated the sonographic features of vaginal foreign bodies in girls and the diagnostic role of combined transperineal and transabdominal ultrasonography in the detection of vaginal foreign bodies in this population. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A retrospective review of the records of 249 girls seen in the outpatient pediatric and adolescent gynecology clinic of our hospital and referred to our department for sonographic evaluation of suspected vaginal foreign bodies between 2013 and 2016 was performed. All patients were transperineally and transabdominally scanned using an ultrasound machine with 3-MHz and 7.5-MHz transducers. The sonographic features of the detected foreign bodies were recorded and reported. All patients also underwent pelvic radiography. The presence of foreign bodies was confirmed using vaginoscopy. Two hundred forty-nine patients were included in this study, and vaginal foreign bodies were detected in 181 patients. Vaginal foreign bodies often present in girls aged from 2 to 12 years old. The most common vaginal foreign bodies were toilet paper, beads, small parts of toys, cap of water color brush, and crayons. The overall sensitivity, specificity, positive and negative predictive values of transperineal/transabdominal sonography in the diagnosis of vaginal foreign bodies were 81%, 53%, 82%, and 51%, respectively. The sensitivity, specificity, and positive and negative predictive values of transabdominal sonography were 33%, 49%, 63%, and 21%, respectively. The sensitivity, specificity, and positive and negative predictive values of transperineal sonography were 64%, 49%, 77%, and 33%, respectively. Abnormal findings were detected using x-ray in only 43 of the 181 cases (23.7%). The sensitivity, specificity, and positive and negative predictive values of x-ray were 24%, 91%, 88%, and 31%, respectively. The size of the foreign bodies ranged from 2 mm to 35 mm. For foreign bodies larger than 5 mm, the rate of sonographic accuracy reached 100%. For foreign bodies smaller than 5 mm, 32 false positive results, and 34 false negative results were identified. One hundred thirty-nine of 181 foreign bodies were less than 2 cm from the vaginal orifice (77%). All foreign bodies were hyperechoic compared with adjacent tissues. Some vaginal foreign bodies had characteristic echo patterns. With the exception of 1 patient with a detained AAA battery that caused vaginal ulceration, the other patients had a full recovery. Vaginal foreign bodies were hyperechoic compared with adjacent tissues and often had characteristic echo patterns. The use of combined transperineal and transabdominal ultrasonography might be helpful in diagnosing foreign bodies, especially when the size of the foreign body is larger than 5 mm. Therefore, ultrasonography might be preferred for the initial evaluation of suspected vaginal foreign bodies, because it is a noninvasive, radiation-free, and inexpensive technique. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
Is Radiologic Evaluation Necessary to Find out Foreign Bodies in Nasal Cavity?
Oh, Hoon; Min, Hyun Jin; Yang, Hoon Shik; Kim, Kyung Soo
2016-01-01
Although there were previous studies on the clinical aspects such as etiology, treatment modalities, studies regarding the necessity of radiologic evaluation for nasal foreign body were limited. The aim of this study is to evaluate the necessity and indication of radiologic evaluation for nasal foreign bodies. There are consecutive patients aged less than 10 years who presented with suspected foreign bodies in nasal cavity. We reviewed the patient's age and sex, including the methods of evaluation, management tools, and types of foreign bodies. There were 35 cases (11.4%) on whom radiographs were performed in the 24 uncooperative patients and 11 cooperative patients who were not identified with any foreign bodies via nasal endoscopy. Among them, only 4 cases had positive reports of foreign body and the others were normal radiologic findings. We suggest that the radiologic evaluation is always not necessary to find the location of nasal foreign bodies. It, however, should be performed in cases of negative findings of physical examination with anterior rhinoscopy or sinus endoscopy and unwitnessed foreign bodies to rule out metallic contents, especially button type battery.
Fostering design for avoiding small parts in commonly used objects.
de Koning, Ton; Foltran, Francesca; Gregori, Dario
2012-05-14
Injuries due to the accidental ingestion or aspiration of small parts have became a matter of interest in the last 30 years, focusing on the relationship between a proper prevention and the diminished frequency of occurrences. Small parts in commonly used objects represent a large sector of potential danger, taking explicit mouthing behavior of children in the first four years of life. In this paper the intent is to show the current situation of design projects and legislation around the world, meant to avoid the casual accidents due to manufacturing reasons. Proposed process and quality control standards seek to eliminate production errors and control materials to avoid deviation from the design. The present study draws its data from the Susy Safe registry, a European Commission co-funded project started in February 2005, whose aim is to establish an international registry of cases of Foreign Bodies (FB) injuries in children aged 0-14 years. Information collected from the data base concern age and gender of the child, location, shape, volume, consistency and elipticity of the foreign body, any complication occurred, hospitalization, and behavioral aspects linked to the injury, like the supervision of the parents or the activity concomitant to the injury. Cases are prospectively collected using the Susy Safe system from 06/2005; moreover, also information regarding past consecutive cases available in each center adhering to the project have been entered in the Susy Safe Registry. Data evidenced that the majority of small parts related injuries are related to stationery. The majority of objects (56.7%), were located in the nose, followed by the ears (31.5%). The distribution on incidence of FB injuries by age class shows that the majority of injuries due to small parts in common objects occurred in children older than >3 years. Male and female were affected with the same frequency when concerning the nose, while all other locations showed a higher frequency in males. Data suggested that hospitalization occurred in 32% of those who compiled the form, resulting in complication just in 16% of injured. Although the most frequent location needing hospitalization was the tracheobronchial tree, the most frequent location showing complication was the nose, 80.3% of the complications, having an infection as most frequent outcome. In children younger than 1 year median volume reached 333.62 mm(3), in children between 1 and 2 years, median volume was 81.12 mm(3), in older children (>3 years) it showed 37.68 mm(3). The same considerations can be seen for the ellipticity, where the median ellipticity was 2.79 in children <1 year, while it was 1.94 in children between 1 and 2 years, and 1.17 in the older ones. Consistency is similar for all age classes, stressing that rigid small parts were those more involved in injuries with foreign bodies. Behavioral aspects pointed out that the 80% of children were playing before the accident, and 65.3% were under adults' supervision. Adult presence resulted associated to the absence of complication, with a p-value of 0.04. The study stresses the importance of primary prevention, seen as the active care of adults toward children manipulating foreign bodies potentially dangerous. This presence may not avoid the event, but in case of FBs aspiration, ingestion, insertion or inhalation, it could be the main factor leading to fewer complications. Copyright © 2012. Published by Elsevier Ireland Ltd.
Wang, Li-Gang; Zhang, Gen-Min
2010-06-01
To study the practicability of single-electrode metal detector by using it to take off foreign bodies from swine. The single-electrode metal detector was invented based on the theory of complementary oscillator. Twelve extremities were obtained from 3 Minnesota-Hormel stains 7-month old male swine. All the extremities were divided into 3 groups: lump metal foreign bodies were planted in group A, needle shape metal foreign bodies were planted in group B, and sand shapd metal foreign bodies were planted in group C. The self-invented single-electrode metal detector was used to take off these foreign bodies, and the taking times were recorded. After the operation, the X-ray was used to examine if the foreign bodies were still in the extremities of the swine. The foreign bodies were taken off completely in the 3 groups, and the average time were 38 s, 3 min and 12 s, and 3 min and 59 s respectively. The X-ray examination confirmed that the detector could take off the foreign bodies completely. This detector has satisfactory effect in animal experiment, which could detect and extract metal foreign bodies quickly and exactly without X-ray help duration the operation, and can be used in clinical cases secondly.
Ingested hyaluronan moisturizes dry skin.
Kawada, Chinatsu; Yoshida, Takushi; Yoshida, Hideto; Matsuoka, Ryosuke; Sakamoto, Wakako; Odanaka, Wataru; Sato, Toshihide; Yamasaki, Takeshi; Kanemitsu, Tomoyuki; Masuda, Yasunobu; Urushibata, Osamu
2014-07-11
Hyaluronan (HA) is present in many tissues of the body and is essential to maintain moistness in the skin tissues, which contain approximately half the body's HA mass. Due to its viscosity and moisturizing effect, HA is widely distributed as a medicine, cosmetic, food, and, recently marketed in Japan as a popular dietary supplement to promote skin moisture. In a randomized, double-blind, placebo-controlled clinical study it was found that ingested HA increased skin moisture and improved treatment outcomes for patients with dry skin. HA is also reported to be absorbed by the body distributed, in part, to the skin. Ingested HA contributes to the increased synthesis of HA and promotes cell proliferation in fibroblasts. These effects show that ingestion of HA moisturizes the skin and is expected to improve the quality of life for people who suffer from dry skin. This review examines the moisturizing effects of dry skin by ingested HA and summarizes the series of mechanisms from absorption to pharmacological action.
FOREIGN BODY REACTION TO BIOMATERIALS
Anderson, James M.; Rodriguez, Analiz; Chang, David T.
2008-01-01
The foreign body reaction composed of macrophages and foreign body giant cells is the end-stage response of the inflammatory and wound healing responses following implantation of a medical device, prosthesis, or biomaterial. A brief, focused overview of events leading to the foreign body reaction is presented. The major focus of this review is on factors that modulate the interaction of macrophages and foreign body giant cells on synthetic surfaces where the chemical, physical, and morphological characteristics of the synthetic surface are considered to play a role in modulating cellular events. These events in the foreign body reaction include protein adsorption, monocyte/macrophage adhesion, macrophage fusion to form foreign body giant cells, consequences of the foreign body response on biomaterials, and cross-talk between macrophages/foreign body giant cells and inflammatory/wound healing cells. Biomaterial surface properties play an important role in modulating the foreign body reaction in the first two to four weeks following implantation of a medical device, even though the foreign body reaction at the tissue/material interface is present for the in vivo lifetime of the medical device. An understanding of the foreign body reaction is important as the foreign body reaction may impact the biocompatibility (safety) of the medical device, prosthesis, or implanted biomaterial and may significantly impact short- and long-term tissue responses with tissue-engineered constructs containing proteins, cells, and other biological components for use in tissue engineering and regenerative medicine. Our perspective has been on the inflammatory and wound healing response to implanted materials, devices, and tissue-engineered constructs. The incorporation of biological components of allogeneic or xenogeneic origin as well as stem cells into tissue-engineered or regenerative approaches opens up a myriad of other challenges. An in depth understanding of how the immune system interacts with these cells and how biomaterials or tissue-engineered constructs influences these interactions may prove pivotal to the safety, biocompatibility, and function of the device or system under consideration. PMID:18162407
Image-guided percutaneous removal of ballistic foreign bodies secondary to air gun injuries.
Rothermund, Jacob L; Rabe, Andrew J; Zumberge, Nicholas A; Murakami, James W; Warren, Patrick S; Hogan, Mark J
2018-01-01
Ballistic injuries with retained foreign bodies from air guns is a relatively common problem, particularly in children and adolescents. If not removed in a timely fashion, the foreign bodies can result in complications, including pain and infection. Diagnostic methods to identify the presence of the foreign body run the entire gamut of radiology, particularly radiography, ultrasound (US) and computed tomography (CT). Removal of the foreign bodies can be performed by primary care, emergency, surgical, and radiologic clinicians, with or without imaging guidance. To evaluate the modalities of radiologic detection and the experience of image-guided ballistic foreign body removal related to air gun injuries within the interventional radiology department of a large pediatric hospital. A database of more than 1,000 foreign bodies that were removed with imaging guidance by the interventional radiologists at our institution was searched for ballistic foreign bodies from air guns. The location, dimensions, diagnostic modality, duration, complications and imaging modality used for removal were recorded. In addition, the use of sedation and anesthesia required for the procedures was also recorded. Sixty-one patients with ballistic foreign bodies were identified. All foreign bodies were metallic BBs or pellets. The age of the patients ranged from 5 to 20 years. The initial diagnostic modality to detect the foreign bodies was primarily radiography. The primary modality to assist in removal was US, closely followed by fluoroscopy. For the procedure, 32.7% of the patients required some level of sedation. Only two patients had an active infection at the time of the removal. The foreign bodies were primarily in the soft tissues; however, successful removal was also performed from intraosseous, intraglandular and intratendinous locations. All cases resulted in successful removal without complications. Image-guided removal of ballistic foreign bodies secondary to air guns is a very effective procedure that can obviate the need for open surgical procedures in children.
Foreign bodies retained in the vagina: a case report.
Nanda, Smiti; Singhal, Savita Rani; Marya, Ashima
2006-04-01
Foreign bodies have been found in the vagina in a variety of forms. A 3-year-old girl had a variety of foreign bodies in her vagina. One should always think of foreign bodies in the vagina in cases of vaginal discharge in childhood.
Use of Scheimpflug imaging in the management of intra-lenticular foreign body.
Singh, R; Ram, J; Gupta, R
2015-01-01
Asymptomatic traumatic intra-lenticular foreign body is very uncommon and few case reports have been published. To report a case of post-traumatic intra-lenticular foreign body and use of Scheimpflug imaging in its management. A 41-year-old male with history of injury to right eye during hammering a chisel 1 year back presented with decreased vision since 6 months. An intra-lenticular foreign body was found on slit lamp bio-microscopy and was confrmed by Scheimpflug imaging. Posterior capsule was intact on Scheimpflug imaging. Thus, Scheimpflug imaging helps in exact localization of the foreign body in the intralenticular space or behind the iris. We ruled out other foreign bodies by x-ray and ultrasonography of the orbit. The foreign body with post-traumatic cataract was removed using phacoemulsification and three piece foldable intraocular lens was implanted in the bag. An intra- lenticular foreign body may remain asymptomatic for months. Scheimpflug imaging can be useful in its localization. It can be removed during phacoemulsification. © NEPjOPH.
PENETRATING OCULAR INJURY WITH RETAINED INTRAOCULAR FOREIGN BODY FROM DRYWALL.
Syed, Reema; Kim, Sung-Hye; Palacio, Agustina; Nunery, William R; Schaal, Shlomit
2018-03-23
To present a case of open globe injury and retained intraocular foreign body secondary to drywall. Interventional case report. A 21-year-old man presented with corneal laceration, iris defect, and vitreous hemorrhage after hammering drywall. Computed tomography scan was negative for intraocular foreign body, but a drywall intraretinal foreign body was found on 25-gauge vitrectomy. Intraoperative findings and 6-month follow-up are presented. Intraocular foreign body must always be suspected in all cases of penetrating ocular trauma. Although magnetic resonance imaging is ideal in diagnosing nonmetallic foreign bodies, computed tomography scan with Hounsfield units should be used in an emergency setting.
Yoo, Sylvia H; Rootman, Dan B; Goh, Alice; Savar, Aaron; Goldberg, Robert A
2016-01-01
A patient was found to have a metallic foreign body in the left anterior orbit on CT imaging, but the foreign body was not evident on clinical examination. On high-resolution ultrasonography, an object was identified in the left upper eyelid; however, the typical shadow with metallic foreign bodies was not seen. A high-power oscillating magnet was then applied to the eyelid, which revealed a subcutaneous metallic foreign body in the left upper eyelid. When used in conjunction, the high-resolution ultrasound and oscillating magnet successfully localized and facilitated retrieval of the metallic foreign body from the left upper eyelid.
Risk factors for granuloma formation in children induced by tracheobronchial foreign bodies.
Huang, Zhenghua; Zhou, Ai; Zhang, Jianya; Xie, Lisheng; Li, Qi
2015-12-01
The aim of this study was to analyze the risk factors for granuloma formation caused by plant-based tracheobronchial foreign bodies in children, and investigate the underlying pathogenesis. In this retrospective analysis of 153 cases with tracheobronchial foreign bodies (peanuts and watermelon seeds), 35 cases of granuloma formation as granulation group (G), and 118 cases of no granuloma formation as non-granulation group (NG) were studied. Clinical data pertaining to sex (S), age (A), foreign body surface smoothness (SF), foreign body shape (SH), foreign body oil release state (O), the location of foreign bodies (L), and foreign body retention time (T) were collected for statistical analysis. Univariate analysis showed no significant difference between the two groups (G and NG) with respect to S, A, SH and L. Significant factors based on univariate analysis included SF, O and T. Multivariate logistic regression analysis revealed that SF and T were independent risk factors associated with development of granuloma. SF, O and T had relationship with the granuloma formation. Local trauma caused by an irregular and sharp foreign body, and extended period of time represent the main factors causing granuloma formation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
A case of child death caused by intestinal volvulus following magnetic toy ingestion.
Olczak, Mieszko; Skrzypek, Ewa
2015-05-01
An 8-year boy was admitted to the ER of one of Warsaw's pediatric hospitals with a history of having bloody vomiting the day before. During admission the boy collapsed and lost consciousness. CPR was unsuccessful. On medico-legal autopsy, two foreign objects (small magnetic spheres--0.5 cm in diameter) were found in two different places in the small and large intestines and were notably attracted magnetically one to another. A loop of approximately 1-m length with features of small intestinal hemorrhagic necrosis and small intestinal mechanical obstruction was found. The cause of death was intestinal volvulus and small intestinal mechanical obstruction caused by ingestion of foreign objects (two neodymium magnets). Most likely these small magnetic spheres were part of a popular toy, the safety of which, lately, has been widely discussed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Gonzalez, Javier T; Fuchs, Cas J; Smith, Fiona E; Thelwall, Pete E; Taylor, Roy; Stevenson, Emma J; Trenell, Michael I; Cermak, Naomi M; van Loon, Luc J C
2015-12-15
The purpose of this study was to define the effect of glucose ingestion compared with sucrose ingestion on liver and muscle glycogen depletion during prolonged endurance-type exercise. Fourteen cyclists completed two 3-h bouts of cycling at 50% of peak power output while ingesting either glucose or sucrose at a rate of 1.7 g/min (102 g/h). Four cyclists performed an additional third test for reference in which only water was consumed. We employed (13)C magnetic resonance spectroscopy to determine liver and muscle glycogen concentrations before and after exercise. Expired breath was sampled during exercise to estimate whole body substrate use. After glucose and sucrose ingestion, liver glycogen levels did not show a significant decline after exercise (from 325 ± 168 to 345 ± 205 and 321 ± 177 to 348 ± 170 mmol/l, respectively; P > 0.05), with no differences between treatments. Muscle glycogen concentrations declined (from 101 ± 49 to 60 ± 34 and 114 ± 48 to 67 ± 34 mmol/l, respectively; P < 0.05), with no differences between treatments. Whole body carbohydrate utilization was greater with sucrose (2.03 ± 0.43 g/min) vs. glucose (1.66 ± 0.36 g/min; P < 0.05) ingestion. Both liver (from 454 ± 33 to 283 ± 82 mmol/l; P < 0.05) and muscle (from 111 ± 46 to 67 ± 31 mmol/l; P < 0.01) glycogen concentrations declined during exercise when only water was ingested. Both glucose and sucrose ingestion prevent liver glycogen depletion during prolonged endurance-type exercise. Sucrose ingestion does not preserve liver glycogen concentrations more than glucose ingestion. However, sucrose ingestion does increase whole body carbohydrate utilization compared with glucose ingestion. This trial was registered at https://www.clinicaltrials.gov as NCT02110836. Copyright © 2015 the American Physiological Society.
The missing "Bratz" doll: a case of vaginal foreign body.
Someshwar, Jean; Lutfi, Riad; Nield, Linda S
2007-12-01
Young female patients with gynecologic complaints, including vaginal discharge, commonly seek care in the emergency department. Prepubertal vaginal discharges have various potential etiologies including nonspecific vulvovaginitis, infections, inflammatory or dermatologic processes, precocious puberty, malignancy, anatomical anomaly, trauma, sexual abuse, and foreign body. We present the case of a 4-year-old girl with vaginal odor and discharge secondary to a foreign body. The foreign body was part of a toy, the lower half of the patient's missing "Bratz" (MGA Entertainment) doll. Although it is well known that a vaginal foreign body can cause a vaginal discharge, the unusual nature of the foreign body in this case and the revealing radiograph made this a case of particular interest.
Khan, M. D.; Kundi, N.; Mohammed, Z.; Nazeer, A. F.
1987-01-01
A survey of 198 patients (210 eyes) with intraocular or intraorbital foreign bodies is presented. Most were males between 16 and 30 years of age, and 6.1% of cases were bilateral. The commonest cause was a flying particle while using a hand hammer, followed by fragments of bomb and mine blasts. Intraorbital foreign bodies occurred in 78 eyes and intraocular foreign bodies in 132 eyes. Irreparable damage caused 13 eyes (6.2%) to be enucleated. Ten eyes developed severe endophthalmitis or panophthalmitis requiring evisceration. One hundred and thirty-four (63.8%) foreign bodies were removed, and 76 (36.2%) foreign bodies could not be removed. The causes of non-removal, the various complications, and the pattern of foreign bodies in the eye or orbit in Pakistan are discussed and compared with those of other regions. PMID:3663566
Correlative factors for the location of tracheobronchial foreign bodies in infants and children.
Xu, Ying; Feng, Rui-Ling; Jiang, Lan; Ren, Hong-Bo; Li, Qi
2018-02-01
This study aims to analyze factors related to the location of tracheobronchial foreign bodies in infants and children, and provide help in the assessment of the disease, surgical risk and prognosis. The clinical data of 1,060 pediatric patients with tracheobronchial foreign bodies diagnosed from January 2015 to December 2015 were retrospectively studied, the association of the location of the foreign bodies with age, gender, granulation formation, chest computed tomography and 3D reconstruction results, preoperative complications, operation time, and hospital stay was analyzed. The location of foreign bodies was not correlated with age, gender, operation time and length of hospital stay, but was correlated to granulation formation, chest computed tomography and 3D reconstruction results, and preoperative complications. The location of foreign bodies was correlated to granulation formation, the location of foreign bodies displayed by chest computed tomography, and preoperative complications.
Foreign bodies in tracheobronchial tree in children: a review of cases over a twenty-year period.
Yeh, L C; Li, H Y; Huang, T S
1998-03-01
Foreign body inhalation into the tracheobronchial tree of children is rather rare but serious problem. It may be hazardous and even cause fatal sequelae in the children if misdiagnosed and not managed promptly. We retrospectively reviewed the records of 81 patients with foreign bodies inhaled into the larynx, trachea and bronchi. The children were all treated during the 20-year period from July 1976 through June 1996 at Chang Gung Memorial Hospital. Of these patients, 82% were 36 months of age or younger. The male to female ratio was 3:1. All of the patients initially received flexible fiberoptic bronchoscopy to identify the foreign objects. The foreign bodies were removed by jet ventilation bronchoscopy with apneic techniques under general anesthesia. Peanuts were found to be the most common causative foreign body agent which occurred in 53 instances (65%). The most common manifestation was coughing, with subsequent dyspnea and audible wheezing. The foreign bodies were lodged in the left bronchus more than in the right. The most obvious radiologic evidence observed in aspirated children were emphysematous changes at same side of the foreign bodies caused by "expansile check-valve" phenomenon. Four patients showed radio-opaque objects on chest roentgenograms. Six patients required second extraction procedures due to the retained foreign bodies. Neither serious complications nor deaths occurred in these patients due to the foreign body inhalation. Early diagnosis and management is essential in children with foreign bodies in the airways to prevent morbidity or death. Small materials or food bits should be kept far away from young child.
Predictors of radiolucent foreign body aspiration.
Mortellaro, Vincent E; Iqbal, Corey; Fu, Roxanna; Curtis, Heather; Fike, Frankie B; St Peter, Shawn D
2013-09-01
Children frequently present for suspected foreign body aspiration, many have mild symptoms and/or negative radiographs raising the question of a radiolucent foreign body aspiration. Retrospective review of patients having bronchoscopy for suspected radiolucent foreign body aspiration from 2000 to 2010 collecting demographics, history, hospital presentation, radiographic, and operative details. Pearson's correlation was used between event history, presentation, radiographic details and bronchoscopically identified foreign body with P value <0.01. 138 patients, mean age 2.6 years, mean weight 15.6 kg, 68% male. Event symptoms: 81% witnessed events, 64% wheezing, 43% coughing, 39% choking, 6% stridor, and 0.7% lethargy. Hospital presentation: 70% persistent symptoms, wheezing 56%, coughing 15%, desaturations 11%, stridor 7%, choking 4%, and lethargy 1%. 92% of patients had a chest x-ray; air trapping found in 38%, and lung collapse in 21%. 2 patients received CT scans; 1 had lung collapse. Bronchoscopy identified foreign bodies in 93% of patients: food 68%, plastic 18%, non-descript 11%, rocks 3%. No correlations between event symptoms, hospital presentation, radiographs and foreign body presence. Event history, hospital presentation, and radiographs are insufficient in proving the absence of a radiolucent foreign body. Patients with suspected radiolucent foreign body aspiration should undergo diagnostic bronchoscopy prior to discharge. Copyright © 2013 Elsevier Inc. All rights reserved.
Foreign Bodies in Trachea: A 25-years of Experience.
Altuntas, Bayram; Aydın, Yener; Eroglu, Atilla
2016-06-01
Tracheobronchial foreign body aspirations may cause cardiopulmonary arrest and sudden death. The incidence in children is higher than in adults. Rapid diagnosis and treatment is live saving. In this paper, we aimed to present our experience in tracheal foreign body aspirations and rigid bronchoscopy for 25-years. From January 1990 to January 2015, 805 patients with suspected tracheobronchial foreign body aspiration were admitted to our department. Hundred and twelve patients with tracheal foreign body were included in this study. We evaluated patients' records, retrospectively. Age, gender, clinical symptoms, physical examination findings, radiological evidences, type of foreign body and intervention types were noted. Sixty-five of the patients were female (58%) and 47 patients were male (42%), and mean age was 8.1 years (8 month-58 years). Coughing was the main symptom (n=112, 100%). Other symptoms and findings included dyspnoea and bilateral decreased lung sounds (n=73, 65.1%), bilateral rhonchi (n=68, 60.7%) and cyanosis (n=41, 36.6%). Rigid bronchoscopy was performed in all patients. The most common foreign body was nuts (n=75, 67%). The main radiologic finding was radiopaque image of the related foreign body in 27 patients (n=27, 24.1%). Cardio-pulmonary arrest occurred in 11 patients and two of them died. Tracheobronchial aspirations of foreign bodies are life-threatening events. If not diagnosed and treated rapidly, distressful results can be seen. Warning people by skilled persons on this topic will reduce the incidence of foreign body aspirations.
Intraorbital foreign bodies--5 own cases and review of literature.
Markowski, Jarosław; Dziubdziela, Włodzimierz; Gierek, Tatiana; Witkowska, Małgorzata; Mrukwa-Kominek, Ewa; Niedzielska, Iwona; Paluch, Jarosław
2012-01-01
Five patients were surgically treated for intraorbital foreign body: a 14-year-old girl had a door glass splinter, a 23-year-old man a metallic foreign body--gunshot pellet, a 55-year-old man a splinter from a metallic bar, a 48-year-old patient the splinters of circular saw and 61-year-old man with shot. Two foreign bodies were removed using the Krönlein-Reese-Berk lateral orbitotomy, two others by Sewell medial orbitotomy and one with superior orbitotomy of Dandy-Naffziger. Radiographs and CT scans were used to identify and localize intraorbital foreign bodies. In one case we found coexistence foreign body (shot) and tumor--inflammation pseudotumor of the orbita. It is possible, that in this case long-time occupy foreign body in the orbita was a cause of that tumor. All foreign bodies were successfully removed, and postoperative course was uneventful. The Krönlein-Reese-Berk orbitotomy provides a satisfactory access to the lateral and posterior orbit, which is of particular importance in the case of a deeply penetrating foreign body (metallic or glass). Surgical removal of intraorbital foreign bodies is a classic example of an interdisciplinary therapeutic approach. Best outcome is usually a result of a team of an ophtalmologist, ENT surgeon, maxillary surgeon and possibly also neurosurgeon performing the operation. Copyright © 2012 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.
Foreign body in ear, nose and oropharynx: experience from a tertiary hospital.
Tiago, Romualdo Suzano Louzeiro; Salgado, Daniel Cauduro; Corrêa, Juliano Piotto; Pio, Márcio Ricardo Barros; Lambert, Ernani Edney
2006-01-01
The occurrence of foreign bodies in otorhinolaryngology is reason of constant searches for emergency services. To value the incidence of patients with foreign body, to analyze the clinical situation and the treatment in these cases. The prospective study was realized in 81 patients with diagnosis of foreign body of nose, ear or oropharynx in the otorhinolaryngology service of the Hospital do Servidor Público Municipal de São Paulo between april/2003 and march/2005. 57 cases of foreign body of ear, 13 cases of nose and 11 of oropharynx. These patients, 51.85% were men and 48.15% were women. The age average was 23 years old. The average of the evolution time was 18.36 days, being that 38.27% these cases were taken care in less 24 hours of evolution. Inside the total of patients, 83.95% received initial attendance in the otorhinolaryngology clinic, and 16.05% came of another service after some previous removal attempt. The most common symptom of the foreign bodies cases of oropharynx it was odinofagia present in 90.91% of the cases; in the foreign bodies of nose, the unilateral rhinorrhea and cacosmia were present in 46.15 of the cases; in the foreign bodies of ear, 38.60% evolved without symptoms and 28.07 with hipoacusia. The most frequent foreign body of oropharynx it was the fish spine (54.55%); in the nose it was the paper (30.77%); and in the ear it was the cotton (31.58%). The complications resulting of the presence of foreign body or about the manipulation of these had been found in 13 cases (16.05%). Most cases of foreign body conditions, in which a non-specialist professional or a non-professional person previously handles its removal, have a bad evolution with emerging complications. Such outcomes strengthen the fact that an otorhinolaryngologist using the proper equipment must treat patients with foreign body.
Intralenticular foreign body: a D-Day reminder.
Dhawahir-Scala, Felipe E; Kamal, A
2005-12-01
Intralenticular foreign bodies are not uncommon after penetrating eye injuries. This is an observational case report where a patient was found to have an embedded lenticular foreign body for more than 60 years. Following such a long period of time the patient has not experienced any significant cataract formation or compromised ocular function due to the foreign body.
Code of Federal Regulations, 2011 CFR
2011-10-01
... plume and ingestion exposure pathways respectively. (h) Plume Exposure Pathway refers to whole body... to days. (i) Ingestion Exposure Pathway refers to exposure primarily from ingestion of water or foods... exposure pathway EPZ when any of these entities has specific roles in emergency planning and preparedness...
Code of Federal Regulations, 2010 CFR
2010-10-01
... plume and ingestion exposure pathways respectively. (h) Plume Exposure Pathway refers to whole body... to days. (i) Ingestion Exposure Pathway refers to exposure primarily from ingestion of water or foods... exposure pathway EPZ when any of these entities has specific roles in emergency planning and preparedness...
Code of Federal Regulations, 2013 CFR
2013-10-01
... plume and ingestion exposure pathways respectively. (h) Plume Exposure Pathway refers to whole body... to days. (i) Ingestion Exposure Pathway refers to exposure primarily from ingestion of water or foods... exposure pathway EPZ when any of these entities has specific roles in emergency planning and preparedness...
Code of Federal Regulations, 2014 CFR
2014-10-01
... plume and ingestion exposure pathways respectively. (h) Plume Exposure Pathway refers to whole body... to days. (i) Ingestion Exposure Pathway refers to exposure primarily from ingestion of water or foods... exposure pathway EPZ when any of these entities has specific roles in emergency planning and preparedness...
Code of Federal Regulations, 2012 CFR
2012-10-01
... plume and ingestion exposure pathways respectively. (h) Plume Exposure Pathway refers to whole body... to days. (i) Ingestion Exposure Pathway refers to exposure primarily from ingestion of water or foods... exposure pathway EPZ when any of these entities has specific roles in emergency planning and preparedness...
Shine, Richard; Thomas, Jai
2005-07-01
Adaptations of snakes to overpower and ingest relatively large prey have attracted considerable research, whereas lizards generally are regarded as unable to subdue or ingest such large prey items. Our data challenge this assumption. On morphological grounds, most lizards lack the highly kinetic skulls that facilitate prey ingestion in macrostomate snakes, but (1) are capable of reducing large items into ingestible-sized pieces, and (2) have much larger heads relative to body length than do snakes. Thus, maximum ingestible prey size might be as high in some lizards as in snakes. Also, the willingness of lizards to tackle very large prey items may have been underestimated. Captive hatchling scincid lizards (Bassiana duperreyi) offered crickets of a range of relative prey masses (RPMs) attacked (and sometimes consumed parts of) crickets as large as or larger than their own body mass. RPM affected foraging responses: larger crickets were less likely to be attacked (especially on the abdomen), more likely to be avoided, and less likely to provide significant nutritional benefit to the predator. Nonetheless, lizards successfully attacked and consumed most crickets < or =35% of the predator's own body mass, representing RPM as high as for most prey taken by snakes. Thus, although lizards lack the impressive cranial kinesis or prey-subduction adaptations of snakes, at least some lizards are capable of overpowering and ingesting prey items as large as those consumed by snakes of similar body sizes.
The role of fluid temperature and form on endurance performance in the heat.
Tan, P M S; Lee, J K W
2015-06-01
Exercising in the heat often results in an excessive increase in body core temperature, which can be detrimental to health and endurance performance. Research in recent years has shifted toward the optimum temperature at which drinks should be ingested. The ingestion of cold drinks can reduce body core temperature before exercise but less so during exercise. Temperature of drinks does not seem to have an effect on the rate of gastric emptying and intestinal absorption. Manipulating the specific heat capacity of a solution can further induce a greater heat sink. Ingestion of ice slurry exploits the additional energy required to convert the solution from ice to water (enthalpy of fusion). Body core temperature is occasionally observed to be higher at the point of exhaustion with the ingestion of ice slurry. There is growing evidence to suggest that ingesting ice slurry is an effective and practical strategy to prevent excessive rise of body core temperature and improve endurance performance. This information is especially important when only a fixed amount of fluid is allowed to be carried, often seen in some ultra-endurance events and military operations. Future studies should evaluate the efficacy of ice slurry in various exercise and environmental conditions. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Nagels, Jason; MacDonald, David; Parker, David
2015-04-01
A challenge for many clinical users is that a patient may receive a diagnostic imaging (DI) service at a number of hospitals or private imaging clinics. The DI services that patients receive at other locations could be clinically relevant to current treatments, but typically, there is no seamless method for a clinical user to access longitudinal DI results for their patient. Radiologists, and other specialists that are intensive users of image data, require seamless ingestion of foreign exams into the picture archiving and communication system (PACS) to achieve full clinical value. Most commonly, a clinical user will depend on the patient to bring in a CD that contains imaging from another location. However, a number of issues can arise when using this type of solution. Firstly, a CD will not provide the clinical user with the full longitudinal record of the patient. Secondly, a CD often will not contain the report associated with the images. Finally, a CD is not seamless, due to the need to manually import the contents of the CD into the local PACS. In order to overcome these limitations, and provide clinical users with a greater benefit related to a patient's longitudinal DI history, the implementation of foreign exam management (FEM) at the local site level is required. This paper presents the experiences of FEM in practice. By leveraging industry standards and edge devices to support FEM, multiple sites with disparate PACS and radiology information system (RIS) vendors are able to seamlessly ingest foreign exams within their local PACS as if they are local exams.
Unusual foreign bodies in the orofacial region.
Passi, Sidhi; Sharma, Neeraj
2012-01-01
Foreign bodies may be deposited in the oral cavity either by traumatic injury or iatrogenically. Among the commonly encountered iatrogenic foreign bodies are restorative materials like amalgam, obturation materials, broken instruments, needles, and so forth. The discovery of foreign bodies in the teeth is a special situation, which is often diagnosed accidentally. Detailed case history, clinical and radiographic examinations are necessary to come to a conclusion about the nature, size, location of the foreign body, and the difficulty involved in its retrieval. It is more common to find this situation in children as it is a well-known fact that children often tend to have the habit of placing foreign objects in the mouth. Sometimes the foreign objects get stuck in the root canals of the teeth, which the children do not reveal to their parents due to fear. These foreign objects may act as a potential source of infection and may later lead to a painful condition. This paper discusses the presence of unusual foreign bodies-a tip of the metallic compass, stapler pin, copper strip, and a broken sewing needle impregnated in the gingiva and their management.
Nasal foreign bodies in children: should they have a plain radiograph in the accident and emergency?
Glynn, Fergal; Amin, Mohamed; Kinsella, John
2008-04-01
To determine the proportion of children with nasal foreign bodies who had button batteries as the foreign body. To describe the clinical care and outcome of those children with a button battery foreign body. A retrospective review of all children presenting to the accident and emergency room with a nasal foreign body or unilateral nasal discharge during a 6-month period was assessed. Forty-four children were included. The most common object found was a plastic bead (27%), followed by foam, paper, or tissue fragments (23%); food matter represented 15%. A button battery was found in 3 patients (7%); other foreign bodies included stones, buttons, crayons, erasers, and a pellet. Thiry-six (82%) had their foreign body removed without anesthetic and 8 (18%) required a general anesthetic. All 3 children with a button battery went undiagnosed until examination in the operating theater. Because there was no previous indication of the presence of a button battery in the 3 children, the removal of the foreign body under general anesthesia was scheduled for the following day. The removal of the button batteries would have been expedited had a plain radiograph been obtained, possibly resulting in less morbidity for our patients. We recommend a plain radiograph in all children presenting with a nonvisible foreign body or unilateral nasal discharge.
Foreign Body in the Oral Cavity Mimicking a Benign Connective Tissue Tumor
Ram, Saravanan; Sedghizadeh, Parish P.
2013-01-01
Foreign bodies may be embedded in the oral cavity either by traumatic injury or iatrogenically. The commonly encountered iatrogenic foreign bodies are restorative materials like amalgam, obturation materials, broken instruments, needles, and impression materials. This paper describes an asymptomatic presentation of a foreign body in the oral mucosa which clinically appeared like a benign connective tissue tumor. PMID:23634307
Foreign body in the oral cavity mimicking a benign connective tissue tumor.
Puliyel, Divya; Balouch, Amir; Ram, Saravanan; Sedghizadeh, Parish P
2013-01-01
Foreign bodies may be embedded in the oral cavity either by traumatic injury or iatrogenically. The commonly encountered iatrogenic foreign bodies are restorative materials like amalgam, obturation materials, broken instruments, needles, and impression materials. This paper describes an asymptomatic presentation of a foreign body in the oral mucosa which clinically appeared like a benign connective tissue tumor.
Surgical treatment of late-diagnosed bronchial foreign body aspiration: a report of 23 cases.
Duan, Liang; Chen, Xiaofeng; Wang, Hao; Hu, Xuefei; Jiang, Gening
2014-07-01
Late-diagnosed bronchial foreign bodies can lead to irreversible changes in the bronchi and the lungs. To date, few reports are available concerning surgical treatment for this condition. The present report summarizes clinicopathological features and surgical treatment options for late-diagnosed bronchial foreign body aspiration. Clinical data of 23 patients who underwent surgical treatment for late-diagnosed bronchial foreign body aspiration in our hospital from 1980 to 2010 were reviewed. The patients included 17 male and six female patients, aged 6 to 66 years. To remove the foreign body, bronchotomy was performed in six patients and pulmonary resection in 17 patients. Foreign bodies were located on the right side in 17 cases and on the left side in six cases. The majority of the foreign bodies were of food origin. Postoperative bronchopleural fistula occurred in two patients. One patient died of renal failure subsequent to lung infections. Detailed history, awareness of potential foreign body aspiration and thorough bronchoscopic examination are helpful to avoid pulmonary resection. However, the latter is necessary in patients with the associated substantial lung lesions to prevent these from progressing into serious lung infections such as pulmonary suppuration or empyema. © 2013 John Wiley & Sons Ltd.
Foreign bodies in the ear, nose, and throat.
Heim, Steven W; Maughan, Karen L
2007-10-15
Foreign bodies in the ear, nose, and throat are occasionally seen in family medicine, usually in children. The most common foreign bodies are food, plastic toys, and small household items. Diagnosis is often delayed because the causative event is usually unobserved, the symptoms are nonspecific, and patients often are misdiagnosed initially. Most ear and nose foreign bodies can be removed by a skilled physician in the office with minimal risk of complications. Common removal methods include use of forceps, water irrigation, and suction catheter. Pharyngeal or tracheal foreign bodies are medical emergencies requiring surgical consultation. Radiography results are often normal. Flexible or rigid endoscopy usually is required to confirm the diagnosis and to remove the foreign body. Physicians need to have a high index of suspicion for foreign bodies in children with unexplained upper airway symptoms. It is important to understand the anatomy and the indications for subspecialist referral. The evidence is inadequate to make strong recommendations for specific removal techniques.
Magnetic spheres as foreign body into the bladder.
Graziottin, Tulio M; de Freitas G Soares, Daniel; Da Ros, Carlos T; Sogari, Paulo R; Telöken, Cláudio; Laste, Paulo Roberto
2013-10-01
A great variety of foreign bodies in the lower urinary tract have been described; many of them are self-inflicted by the patient with masturbatory purposes. Depending on the nature of the foreign body the diagnostic and management might be challenging. We report a case of an unusual magnetic self-inserted foreign body into the bladder for autoerotism and briefly discuss the diagnostic and therapeutic implications in this challenging situation. We describe all the steps we have used to adequately diagnose the problem, describe the foreign body and treatments for the patient. Related articles were found by utilizing the PubMed database and are summarized in this study. The management approach must be planned according to the nature of the foreign body and should minimize bladder and urethral trauma. However, most of cases can be managed endoscopically. Removal of magnetic foreign body may be quite challenging, requiring high-level surgical skills and minimally invasive techniques resulting in fast recovery and low complication rate. © 2012 International Society for Sexual Medicine.
Environmental Assessment: Zebra Mussel Eradication from the Base Lake at Offutt Air Force Base
2008-09-11
water flow even in large diameter piping, increase sedimentation rates , and promote surface corrosion. Natural populations of 5,000 to 30,000...Body Weight (kg) Foraging Territory (ha) Food Ingestion Rate (kg dw/day) Food Ingestion Rate (kg ww/day) Water (L/day) Sediment / Soil Ingestion...Composition - based on diets for Missouri; Korschgen (1958) in USEPA (1993) Soil/ Sediment Ingestion Rate – Assumed 1% of dw ingestion rate ; USEPA (2000
Vaginal foreign body presenting as bleeding with defecation in a child.
Abdessamad, Hasan M; Greenfield, Marjorie
2009-04-01
Symptoms secondary to a vaginal foreign body are responsible for approximately 4% of pediatric gynecologic outpatient visits.(1) The classic symptom is vaginal bleeding, but vaginal discharge, foul odor, irritation, abdominal pain, and hematuria have been described. We are reporting a case of a microscopic vaginal foreign body presenting as hematochezia in a preadolescent girl. This case is unique in that the patient presented with bleeding with defecation, without vaginal bleeding. Vaginal foreign bodies can present with diverse symptomatology. Physicians should consider the diagnosis of vaginal foreign body when presented with a young female patient with unexplained hematochezia.
14 CFR 135.415 - Service difficulty reports.
Code of Federal Regulations, 2014 CFR
2014-01-01
...; (4) An exhaust system that causes damage during flight to the engine, adjacent structure, equipment... or aircraft structure occurs; (8) Engine shutdown during flight due to foreign object ingestion or... structure that requires major repair; (15) Cracks, permanent deformation, or corrosion of aircraft...
14 CFR 135.415 - Service difficulty reports.
Code of Federal Regulations, 2013 CFR
2013-01-01
...; (4) An exhaust system that causes damage during flight to the engine, adjacent structure, equipment... or aircraft structure occurs; (8) Engine shutdown during flight due to foreign object ingestion or... structure that requires major repair; (15) Cracks, permanent deformation, or corrosion of aircraft...
14 CFR 135.415 - Service difficulty reports.
Code of Federal Regulations, 2012 CFR
2012-01-01
...; (4) An exhaust system that causes damage during flight to the engine, adjacent structure, equipment... or aircraft structure occurs; (8) Engine shutdown during flight due to foreign object ingestion or... structure that requires major repair; (15) Cracks, permanent deformation, or corrosion of aircraft...
Role of virtual bronchoscopy in children with a vegetable foreign body in the tracheobronchial tree.
Behera, G; Tripathy, N; Maru, Y K; Mundra, R K; Gupta, Y; Lodha, M
2014-12-01
Multidetector computed tomography virtual bronchoscopy is a non-invasive diagnostic tool which provides a three-dimensional view of the tracheobronchial airway. This study aimed to evaluate the usefulness of virtual bronchoscopy in cases of vegetable foreign body aspiration in children. The medical records of patients with a history of foreign body aspiration from August 2006 to August 2010 were reviewed. Data were collected regarding their clinical presentation and chest X-ray, virtual bronchoscopy and rigid bronchoscopy findings. Cases of metallic and other non-vegetable foreign bodies were excluded from the analysis. Patients with multidetector computed tomography virtual bronchoscopy showing features of vegetable foreign body were included in the analysis. For each patient, virtual bronchoscopy findings were reviewed and compared with those of rigid bronchoscopy. A total of 60 patients; all children ranging from 1 month to 8 years of age, were included. The mean age at presentation was 2.01 years. Rigid bronchoscopy confirmed the results of multidetector computed tomography virtual bronchoscopy (i.e. presence of foreign body, site of lodgement, and size and shape) in 59 patients. In the remaining case, a vegetable foreign body identified by virtual bronchoscopy was revealed by rigid bronchoscopy to be a thick mucus plug. Thus, the positive predictive value of virtual bronchoscopy was 98.3 per cent. Multidetector computed tomography virtual bronchoscopy is a sensitive and specific diagnostic tool for identifying radiolucent vegetable foreign bodies in the tracheobronchial tree. It can also provide a useful pre-operative road map for rigid bronchoscopy. Patients suspected of having an airway foreign body or chronic unexplained respiratory symptoms should undergo multidetector computed tomography virtual bronchoscopy to rule out a vegetable foreign body in the tracheobronchial tree and avoid general anaesthesia and invasive rigid bronchoscopy.
A Diagnostic Dilemma for the Pediatrician: Radiolucent Tracheobronchial Foreign Body.
Taşkınlar, Hakan; Bahadır, Gökhan Berktuğ; Erdoğan, Cankat; Yiğit, Doğakan; Avlan, Dinçer; Naycı, Ali
2017-06-01
The purpose of this study is to determine the role of clinical history, physical examinations, and radiological findings in the evaluation of patients with suspected radiolucent foreign body aspiration. The medical records of 236 children (under the age of 18 years), on whom a rigid bronchoscopy was performed between 1999 and 2015 because of suspected radiolucent foreign body aspiration, were analyzed retrospectively. Sensitivity, specificity, positive and negative predictive values of clinical history, physical examinations, and radiological findings were evaluated. In 71.1% of all cases, the children were under the age of 3 years. The bronchoscopy showed the presence of a foreign body in 52.9% of cases, with the locations of the foreign bodies being as follows: (1) right main bronchus, 47.2%; (2) left main bronchus, 36.0%; (3) trachea, 11.2%; (4) both bronchi, 5.6%. Organic foreign bodies were found in 78% of the patients, whereas inorganic foreign bodies were detected in 22% of the patients. The sensitivity and specificity of clinical history, physical examinations, and radiological findings were 98.4% and 54.9%, 47.2% and 74.7%, and 35.2% and 92.7%, respectively. Tracheobronchial foreign body aspirations usually occur prior to the age of 3 years, with the most frequently aspirated foreign bodies being food or items of a radiolucent nature. Clinical history, physical examinations, and radiological findings are not able to detect the presence of a radiolucent foreign body aspiration in children. Therefore, a bronchoscopy should be performed on children in whom a choking event has been witnessed, even in cases of normal radiological and clinical findings. Copyright © 2016. Published by Elsevier B.V.
Degernes, Laurel A; Wolf, Karen N; Zombeck, Debbie J; MacLean, Robert A; De Voe, Ryan S
2012-12-01
A captive parakeet auklet at the North Carolina Zoo evaluated for weight loss, lethargy, and dyspnea had radiographic evidence of a distended, stone-filled ventriculus (bird 1). Multiple stones (n = 76) were removed surgically, but the bird died and a large ventricular diverticulum was diagnosed at necropsy. This bird and seven other parakeet auklets had been transferred 3 yr earlier from a zoo in Ohio. Radiographic investigation revealed that 6 of 7 Ohio birds had stones in their ventriculus (n= 2-26), but only 1 of 7 radiographed North Carolina Zoo auklets had one small stone. Further diagnostic imaging (survey and contrast radiographs, fluoroscopy, CT scans [n = 2]) of six Ohio and two North Carolina birds was conducted to determine if other birds had ventricular abnormalities (birds 2-9). No ventricular diverticula were diagnosed using imaging techniques, although two Ohio birds (birds 6 and 7) required surgical intervention to remove 12-26 stones. A small ventricular diverticulum was identified in bird 6 during surgery. That bird died of unrelated causes 11 mo after surgery, but bird 7 remains clinically normal more than 4 yr later, along with four other auklets with stones (n = 2-15; birds 2-5). It is possible that without surgical intervention, these birds may develop ventricular disease, presumably due to chronic mechanical trauma to the thin-walled ventriculus. It was hypothesized that the Ohio birds ingested stones in their previous exhibit, with a loose stone substrate, and retained them for at least 3 yr. Possible causes for stone ingestion include trituration (for grinding, mixing coarse ingesta), gastric parasite reduction, hunger suppression, accidental ingestion while feeding, or behavioral causes, but the underlying cause in these birds was not determined. Based on these results, parakeet auklets and other alcids should not be housed, or at least fed, on a loose stone substrate.
Mandava, Nageswara; Chang, Richard S; Wang, John H; Bertocchi, Michael; Yrad, Jonathan; Allamaneni, Shyam; Aboian, Edouard; Lall, Malini H; Mariano, Rosalind; Richards, Neil
2011-02-01
'Mules' or body packers are people who transport illegal drugs by packet ingestion into the gastrointestinal tract. These people are otherwise healthy and their management should maintain minimal morbidity. In this study, experience with body packers is presented and an algorithm for conservative and surgical management is provided. The clinical patient database for all body packer admissions at Mary Immaculate Hospital of the Caritas Health Care Inc. from 1993 to 2005 was interrogated. 56 patients (4.5%) required admission out of a total of 1250 subjects confirmed to be body packers and apprehended by United State Customs officials at JFK International Airport, New York. The retrieved patient data were analysed retrospectively. 70% of the body packers were men, with a male to female ratio of 2.8 to 1. The mean age was 33 years and 52% were from Columbia. Heroin was the most common illegally transported substance (73%). 25 patients (45%) required surgical intervention, whereas 31 patients (55%) were successfully managed conservatively. Indications for intervention included: bowel obstruction, packet rupture/toxicity, and delayed progression of packet transit on conservative management. Multiple intraoperative manoeuvres were used to remove the foreign bodies: gastrotomy, enterotomy and colotomy. Wound infection was the most common complication and is associated with distal enterotomy and colotomy. Men were more likely to present as body packers than women. Proximal enterotomies are preferred and multiple enterotomies should be avoided. A confirmatory radiological study is needed to demonstrate complete clearance of packets. A systematic protocol for the management of body packers results in minimal morbidity and no mortality.
An ingestible temperature-transmitter
NASA Technical Reports Server (NTRS)
Pope, J. M.; Fryer, T. B.; Sandler, H.
1972-01-01
Pill-sized transmitter measures deep body temperature in studies of circadian rhythm and indicates general health. Ingestible device is a compromise between accuracy, circuit complexity, size and transmission range.
Noninvasive photoacoustic detecting intraocular foreign bodies with an annular transducer array.
Yang, Diwu; Zeng, Lvming; Pan, Changning; Zhao, Xuehui; Ji, Xuanrong
2013-01-14
We present a fast photoacoustic imaging system based on an annular transducer array for detection of intraocular foreign bodies. An eight-channel data acquisition system is applied to capture the photoacoustic signals using multiplexing and the total time of data acquisition and transferring is within 3 s. A limited-view filtered back projection algorithm is used to reconstruct the photoacoustic images. Experimental models of intraocular metal and glass foreign bodies were constructed on ex vivo pig's eyes and clear photoacoustic images of intraocular foreign bodies were obtained. Experimental results demonstrate the photoacoustic imaging system holds the potential for in clinic detecting the intraocular foreign bodies.
[Studies of time-course changes in human body balance after ingestion of long-acting hypnotics].
Nakamura, Masahiro; Ishii, Masanori; Niwa, Yoji; Yamazaki, Momoko; Ito, Hiroshi
2004-02-01
Falling accidents are a serious nocosomial problem, with balance disorders after the ingestion of hypnotics said to be a cause. Based on the results of animal studies, it was postulated that this problem involves the muscle relaxation that is a pharmacological effect of benzodiazepines (BZP). No reports have, to our knowledge, been made of time-course changes in human body balance after ingestion of hypnotics. Accordingly, we used quazepam (Doral), a long-acting hypnotic considered to show comparatively weak muscle relaxation, to study static balance after drug ingestion in human volunteers. Briefly, informed consent was obtained from 8 healthy adults, then a gait analytic system (Gangas) was used to test static balance after drug ingestion (Mann and Romberg tests). We also measured circulating drug concentration over time. Our results showed that balance disorders occurred after quazepam ingestion with an unstable posture particularly striking. Given the function of quazepam receptors, it is difficult to surmise that balance disorders after drug ingestion were due to the drug's muscle relaxation. We surmised that inhibition from the central nervous system in connection with nerves awakening was involved. We found a strong correlation between the manifestation of balance disorders after drug ingestion and circulating drug concentration.
Effects of ingested crude and dispersed crude oil on thermoregulation in ducks (Anas platyrhynchos)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Jenssen, B.M.
1989-02-01
Thermoregulatory effects of ingested doses of Statfjord A crude oil and of this oil mixed with the dispersant Finasol OSR-5 were studied in adult domestic ducks (Anas platyrhynchos) exposed to ambient temperatures of +16 degrees C and -17 degrees C. The data show that ingestion of both the crude and the oil-dispersant mixture resulted in an increased body temperature during exposure to the low ambient temperature (-17 degrees C). Neither contaminant had any effect on body temperature during exposure to +16 degrees C. Ingestion of the contaminants had no effect on metabolic heat production at either ambient temperature. The breastmore » skin temperature of the ducks in both contaminated groups was significantly decreased when the ducks were exposed to the low ambient temperature. This indicates that the increase in body temperature observed in the contaminated ducks at the low ambient temperature is due to an increase in peripheral vasoconstriction.« less
Unusual Foreign Bodies in the Orofacial Region
Passi, Sidhi; Sharma, Neeraj
2012-01-01
Foreign bodies may be deposited in the oral cavity either by traumatic injury or iatrogenically. Among the commonly encountered iatrogenic foreign bodies are restorative materials like amalgam, obturation materials, broken instruments, needles, and so forth. The discovery of foreign bodies in the teeth is a special situation, which is often diagnosed accidentally. Detailed case history, clinical and radiographic examinations are necessary to come to a conclusion about the nature, size, location of the foreign body, and the difficulty involved in its retrieval. It is more common to find this situation in children as it is a well-known fact that children often tend to have the habit of placing foreign objects in the mouth. Sometimes the foreign objects get stuck in the root canals of the teeth, which the children do not reveal to their parents due to fear. These foreign objects may act as a potential source of infection and may later lead to a painful condition. This paper discusses the presence of unusual foreign bodies—a tip of the metallic compass, stapler pin, copper strip, and a broken sewing needle impregnated in the gingiva and their management. PMID:22830058
Penis swelling due to foreign body reaction after injection of silicone.
Plaza, Tobias; Lautenschlager, Stephan
2010-09-01
A 19-year-old man presented with phimosis and painful swelling of the penis four weeks after augmentation with silicone in Thailand. Histology revealed a foreign body reaction to silicone. Infectious causes were ruled out. Granulomatous foreign body reactions to silicone are common, but there are few case reports on reactions following silicone injection for penis enlargement. Foreign body reactions should be included in the differential diagnosis of penis swelling.
Suction-based grasping tool for removal of regular- and irregular-shaped intraocular foreign bodies.
Erlanger, Michael S; Velez-Montoya, Raul; Mackenzie, Douglas; Olson, Jeffrey L
2013-01-01
To describe a suction-based grasping tool for the surgical removal of irregular-shaped and nonferromagnetic intraocular foreign bodies. A surgical tool with suction capabilities, consisting of a stainless steel shaft with a plastic handle and a customizable and interchangeable suction tip, was designed in order to better engage and manipulate irregular-shaped in-traocular foreign bodies of various sizes and physical properties. The maximal suction force and surgical capabilities were assessed in the laboratory and on a cadaveric eye vitrectomy model. The suction force of the water-tight seal between the intraocular foreign body and the suction tip was estimated to be approximately 40 MN. During an open-sky vitrectomy in a porcine model, the device was successful in engaging and firmly securing foreign bodies of different sizes and shapes. The suction-based grasping tool enables removal of irregular-shaped and nonferromagnetic foreign bodies. Copyright 2013, SLACK Incorporated.
[Foreign body in the tricuspid valve with valvular insufficiency and right-left shunt].
Delebarre, P; Augustin-Normand, C; Capronier, C; Cramer, J; Godeau, P; Letac, B; Forman, J; Maurice, P; Ourbak, P
1987-05-01
We present the case of a 50-year old man who progressively developed tricuspid valve insufficiency with opening of a patent foramen ovale responsible for right-to-left shunt with polycythaemia. The tricuspid valve insufficiency was due to a foreign body, probably of surgical origin as suggested by its radiological image and by the patient's previous history. It would have been introduced, far away from the tricuspid valve (compound fracture of the wrist), several years previously. At surgery, we found the foreign body embedded in the valve system. As a possible mechanism for the mutilation, an undiagnosed endocarditis was suspected but could not be confirmed. Three cases tricuspid endocarditis (with foreign bodies in the right ventricle) and 3 cases of asymptomatic tricuspid valve foreign bodies have been published. Fifty-five cases of foreign bodies introduced peripherally and migrated into the heart, the pericardium and the pulmonary artery are reviewed.
Ureterovaginal fistula: A complication of a vaginal foreign body.
Lo, Tsia-Shu; Jaili, Sukanda Bin; Ibrahim, Rami; Kao, Chuan Chi; Uy-Patrimonio, Ma Clarissa
2018-02-01
To know the diagnostic tools and proper management of ureterovaginal fistula following neglected vaginal foreign body in order to achieve optimal outcome. A case of ureterovaginal fistula associated with a neglected vaginal foreign body. The patient was complaining of a foul-smelling vaginal discharge and lower abdominal pain. On vaginal examination, a hard and large foreign body was found. Examination under anesthesia was performed, and an aerosol cap was removed from her vagina. The patient developed urinary incontinence after removal of the foreign body. Subsequent work-up demonstrated the presence of a right ureterovaginal fistula. The patient underwent an abdominal ureteroneocystostomy. At one year follow up, the patient had fully recovered. Ureterovaginal fistula following neglected vaginal foreign body is a serious condition. Early diagnosis, treatment of infection and proper surgical management can improve the outcome and decrease complications. Copyright © 2018. Published by Elsevier B.V.
Macrophages: development and tissue specialization.
Varol, Chen; Mildner, Alexander; Jung, Steffen
2015-01-01
Macrophages are myeloid immune cells that are strategically positioned throughout the body tissues, where they ingest and degrade dead cells, debris, and foreign material and orchestrate inflammatory processes. Here we review two major recent paradigm shifts in our understanding of tissue macrophage biology. The first is the realization that most tissue-resident macrophages are established prenatally and maintained through adulthood by longevity and self-renewal. Their generation and maintenance are thus independent from ongoing hematopoiesis, although the cells can be complemented by adult monocyte-derived macrophages. Second, aside from being immune sentinels, tissue macrophages form integral components of their host tissue. This entails their specialization in response to local environmental cues to contribute to the development and specific function of their tissue of residence. Factors that govern tissue macrophage specialization are emerging. Moreover, tissue specialization is reflected in discrete gene expression profiles of macrophages, as well as epigenetic signatures reporting actual and potential enhancer usage.
Rashotte, Michael E; Ackert, Allison M; Overton, J Michael
2002-01-01
The relationship between ingestive behavior (eating + drinking) and core body temperature (T(b)) in naturally cycling female rats was compared in a normotensive strain (Sprague-Dawley; SD) and a hypertensive strain reputed to have chronically elevated T(b) (spontaneously hypertensive rats; SHR). T(b) (by telemetry) and ingestive behavior (automated recording) were quantified every 30 s. Ingestive behavior and T(b) were related on all days of the ovarian cycle in both strains, but the strength of that relationship was reduced on the day of estrus (E) compared with nonestrous days. Several strain differences in T(b) were found as well. In SHR, dark-phase T(b) was elevated on E, whereas SD remained at the lower nonestrous values. Fluctuations in dark-phase T(b) were correlated with ingestive behavior in both strains but had greater amplitude in SHR except on E. Short-term fasting or sucrose availability did not eliminate elevated dark-phase T(b) on E in SHR. We propose that estrus-related changes unique to SHR may indicate heightened thermal reactivity to hormonal changes, ingestive behavior, and general locomotor activity.
Clinical Utility and Pitfalls of Ultrasound Guided Foreign Body Removal in War Fighters
2013-10-01
training, with pre-test and post-test components. Physicians will undergo pre-testing with the removal of one wooden foreign body from a turkey breast ...project. The physicians are trained with a turkey breast simulator. They will be evaluated and measured on their performance and competency development...foreign bodies were the same. A 1 cm piece of a wooden toothpick was used to represent a traditional foreign body implanted in the cadaver tissue
Proposal for methods of diagnosis of fish bone foreign body in the Esophagus.
Woo, Seung Hoon; Kim, Kyung Hee
2015-11-01
To investigate the methods of diagnosis of fish bone foreign body in the esophagus and suggest a diagnostic protocol. Prospective cohort study. A prospective study was performed on 286 patients with a history of fish bone foreign body impaction. Among them, 88 patients had negative findings in the oral cavity and laryngopharynx. Subsequent radiologic assessment of these patients included plain radiography and computed tomography (CT). Sixty-six patients showed positive findings in the esophagus, and an attempt was made to remove the obstruction using transnasal esophagoscopy. In 66 patients, a fish bone foreign body was detected in the esophagus by CT. In contrast, plain radiography detected a foreign body in only 30 patients. The overall detection rate of plain radiography compared with CT for fish bones was 45.5%. Plain radiography detected 35.9% of the simple type fish bones and 54.5% of the gill bone detected by CT. However, jaw bones had a detection rate of 100% with both methods. The fish bone foreign bodies were most commonly located in the upper esophagus (n=65, 98.5%), followed by the lower esophagus (n=1, 1.5%). CT is a useful method for identification of esophageal fish bone foreign bodies. Therefore, CT should be considered as the first-choice technique for the diagnosis of esophageal fish bone foreign body. 4. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.
Foreign body aspiration and language spoken at home: 10-year review.
Choroomi, S; Curotta, J
2011-07-01
To review foreign body aspiration cases encountered over a 10-year period in a tertiary paediatric hospital, and to assess correlation between foreign body type and language spoken at home. Retrospective chart review of all children undergoing direct laryngobronchoscopy for foreign body aspiration over a 10-year period. Age, sex, foreign body type, complications, hospital stay and home language were analysed. At direct laryngobronchoscopy, 132 children had foreign body aspiration (male:female ratio 1.31:1; mean age 32 months (2.67 years)). Mean hospital stay was 2.0 days. Foreign bodies most commonly comprised food matter (53/132; 40.1 per cent), followed by non-food matter (44/132; 33.33 per cent), a negative endoscopy (11/132; 8.33 per cent) and unknown composition (24/132; 18.2 per cent). Most parents spoke English (92/132, 69.7 per cent; vs non-English-speaking 40/132, 30.3 per cent), but non-English-speaking patients had disproportionately more food foreign bodies, and significantly more nut aspirations (p = 0.0065). Results constitute level 2b evidence. Patients from non-English speaking backgrounds had a significantly higher incidence of food (particularly nut) aspiration. Awareness-raising and public education is needed in relevant communities to prevent certain foods, particularly nuts, being given to children too young to chew and swallow them adequately.
Çelik, Necla; Arikan, Duygu
2013-11-01
This study was semi-experimentally conducted in order to determine knowledge levels of child development students about foreign body aspiration and to explore the effect of the training given to these students about foreign body aspiration upon their knowledge levels. The research was conducted with a total of 231 students who studied at the department of child development of two high schools and one vocational higher school in Erzincan Province located in the east of Turkiye between May 2011 and February 2012. The data were gathered using a questionnaire form of 38 questions. The training on foreign body aspiration (Power point presentation, video presentation and practice on a dummy) was provided in three phases. For the data evaluation; percentages, chi-square test and Mc Nemar test were used. It was found out in the study that 91.8% of the students did not take any training/course about foreign body aspiration and 55% confronted situations of foreign body aspirations (ear, nose, airway). After the training about foreign body aspiration; it was noted that the number of the students who knew risky behaviors for foreign body aspiration increased and the increase in the number of the students was at the highest level among high schools (p<0.05). It was seen that the training was most effective among the university students in terms of knowing first-aid intervention in case a foreign body would obstruct airway among the children aged<1 year (p<0.05). It was noted that the training which was applied on the dummy by using visual aids about foreign body aspiration increased the knowledge level of the students. Based on this finding, it may be recommended that nurses should perform their counseling and educator roles more actively for the families and those who are responsible for the baby care about foreign body aspiration by playing a more active role in the health care team. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Ancona, E; Guido, E; Cutrone, C; Bocus, P; Rampado, S; Vecchiato, M; Salvador, R; Donach, M; Battaglia, G
2008-01-01
There is no clear consensus concerning the best endoscopic treatment of benign refractory esophageal strictures due to caustic ingestion. Different procedures are currently used: frequent multiple dilations, retrievable self-expanding stent, nasogastric intubation and surgery. We describe a new technique to fix a suspended esophageal silicone prosthesis to the neck in benign esophageal strictures; this permits us to avoid the frequent risk of migration of the expandable metallic or plastic stents. Under general anesthesia a rigid esophagoscope was placed in the patient's hypopharynx. Using transillumination from the optical device, the patient's neck was pierced with a needle. A n.0 monofilament surgical wire was pushed into the needle, grasped by a standard foreign body forceps through the esophagoscope and pulled out of the mouth (as in percutaneous endoscopic gastrostomy procedure). After tying the proximal end of the silicone prosthesis with the wire, it was placed through the strictures under endoscopic view. This procedure was successfully utilized in four patients suffering from benign refractory esophageal strictures due to caustic ingestion. The prosthesis and its suspension from the neck were well-tolerated until removal (mean duration 4 months). A postoperative transitory myositis was diagnosed in only one patient. One of the most frequent complications of esophageal prostheses in refractory esophageal strictures due to caustic ingestion is distal migration. Different solutions were proposed. For example the suspension of a wire coming from the nose and then fixed behind the ear. This solution is not considered optimal because of patient complaints and moreover the aesthetic aspect is compromised. The procedure we utilized in four patients utilized the setting of a silicone tube hanging from the neck in a way similar to that of endoscopic pharyngostomy. This solution is a valid alternative both for quality of life and for functional results.
The effect of carbohydrate ingestion on performance during a simulated soccer match.
Goedecke, Julia H; White, Nicholas J; Chicktay, Waheed; Mahomed, Hafsa; Durandt, Justin; Lambert, Michael I
2013-12-16
This study investigated how performance was affected after soccer players, in a postprandial state, ingested a 7% carbohydrate (CHO) solution compared to a placebo (0% CHO) during a simulated soccer match. Using a double-blind placebo-controlled design, 22 trained male league soccer players (age: 24 ± 7 years, wt: 73.4 ± 12.0 kg, VO2max: 51.8 ± 4.3 mL O2/kg/min) completed two trials, separated by 7 days, during which they ingested, in random order, 700 mL of either a 7% CHO or placebo drink during a simulated soccer match. Ratings of perceived exertion (RPE), agility, timed and run to fatigue were measured during the trials. Change in agility times was not altered by CHO vs. placebo ingestion (0.57 ± 1.48 vs. 0.66 ± 1.00, p = 0.81). Timed runs to fatigue were 381 ± 267 s vs. 294 ± 159 s for the CHO and placebo drinks, respectively (p = 0.11). Body mass modified the relationship between time to fatigue and drink ingestion (p = 0.02 for drink × body mass), such that lower body mass was associated with increased time to fatigue when the players ingested CHO, but not placebo. RPE values for the final stage of the simulated soccer match were 8.5 ± 1.7 and 8.6 ± 1.5 for the CHO and placebo drinks respectively (p = 0.87). The group data showed that the 7% CHO solution (49 g CHO) did not significantly improve performance during a simulated soccer match in league soccer players who had normal pre-match nutrition. However, when adjusting for body mass, increasing CHO intake was associated with improved time to fatigue during the simulated soccer match.
The Effect of Carbohydrate Ingestion on Performance during a Simulated Soccer Match
Goedecke, Julia H.; White, Nicholas J.; Chicktay, Waheed; Mahomed, Hafsa; Durandt, Justin; Lambert, Michael I.
2013-01-01
Aim: This study investigated how performance was affected after soccer players, in a postprandial state, ingested a 7% carbohydrate (CHO) solution compared to a placebo (0% CHO) during a simulated soccer match. Methods: Using a double-blind placebo-controlled design, 22 trained male league soccer players (age: 24 ± 7 years, wt: 73.4 ± 12.0 kg, VO2max: 51.8 ± 4.3 mL O2/kg/min) completed two trials, separated by 7 days, during which they ingested, in random order, 700 mL of either a 7% CHO or placebo drink during a simulated soccer match. Ratings of perceived exertion (RPE), agility, timed and run to fatigue were measured during the trials. Results: Change in agility times was not altered by CHO vs. placebo ingestion (0.57 ± 1.48 vs. 0.66 ± 1.00, p = 0.81). Timed runs to fatigue were 381 ± 267 s vs. 294 ± 159 s for the CHO and placebo drinks, respectively (p = 0.11). Body mass modified the relationship between time to fatigue and drink ingestion (p = 0.02 for drink × body mass), such that lower body mass was associated with increased time to fatigue when the players ingested CHO, but not placebo. RPE values for the final stage of the simulated soccer match were 8.5 ± 1.7 and 8.6 ± 1.5 for the CHO and placebo drinks respectively (p = 0.87). Conclusions: The group data showed that the 7% CHO solution (49 g CHO) did not significantly improve performance during a simulated soccer match in league soccer players who had normal pre-match nutrition. However, when adjusting for body mass, increasing CHO intake was associated with improved time to fatigue during the simulated soccer match. PMID:24352094
Neglected foreign body aspiration mimicking bronchial carcinoma.
Afghani, Reza; Khandashpour Ghomi, Mahmoud; Khandoozi, Seyed Reza; Yari, Behrouz
2016-07-01
Foreign body aspiration can occur in any age group, but it is more commonly seen in children. In adults, there is usually a predisposing condition that poses a risk of aspiration. If aspiration occurs, prompt diagnosis and extraction of the foreign body is needed to prevent early and late complications. We report a rare case of neglected foreign body aspiration in a 45-year-old schizophrenic opium addicted patient, which resulted in an occlusive lesion in the bronchus, mimicking bronchial carcinoma. © The Author(s) 2016.
Clinical Utility and Pitfalls of Ultrasound Guided Foreign Body Removal in War Fighters
2015-12-01
1 AD_________________ AWARD NUMBER: W81XWH-08-2-0162 TITLE: Clinical Utility and Pitfalls of Ultrasound Guided Foreign Body Removal in War...Clinical Utility and Pitfalls of Ultrasound Guided Foreign Body Removal in War Fighters 5a. CONTRACT NUMBER 5b. GRANT NUMBER: W81XWH-08-2-0162 5c...Purpose: To demonstrate that 1) ultrasound guided foreign body removal (USFBR) is superior to conventional surgery in the cadaver model, 2) USFBR can be
Stricker, T; Navratil, F; Sennhauser, F H
2004-04-01
To evaluate the clinical features and outcome in girls with a vaginal foreign body. Retrospective review of medical records of 35 girls with a vaginal foreign body seen in an outpatient clinic for paediatric and adolescent gynaecology between 1980 and 2000. The ages ranged from 2.6 to 9.2 years. The most common symptom was blood-stained vaginal discharge/vaginal bleeding (49%). Duration of symptoms varied from 1 day to 2 years. Fifty-four percent of the patients recalled insertion of the foreign object, usually by the girl herself. All but three patients (91%) either recalled insertion of the foreign object and/or had vaginal bleeding or blood-stained or foul-smelling vaginal discharge, and/or visualization or palpation of the foreign body in physical examination. Symptoms resolved after removal of the foreign body followed by a single irrigation with Providon-Iod (Betadine). In the majority of patients a carefully obtained history and physical examination suggest the diagnosis of a vaginal foreign object. The leading symptoms are vaginal bleeding and blood-stained or foul smelling vaginal discharge. Removal of the foreign object followed by a single irrigation with Providon-Iod is the definitive treatment and does not require additional measures.
Comparison of rigid and flexible endoscopy for removing esophageal foreign bodies in an emergency.
Tseng, Chia-Chen; Hsiao, Tzu-Yu; Hsu, Wei-Chung
2016-08-01
Despite the effectiveness of endoscopies in removing ingested foreign bodies (FBs) impacted in the esophagus, the merits and limitations of flexible endoscopy (FE) and rigid endoscopy (RE) remain unclear. Therefore, this study compares the advantages and disadvantages of both endoscopic procedures from a clinical perspective. A retrospective review was made of 273 patients suspected of esophageal FBs in emergency consultations of a tertiary medical referral center from March 2010 to March 2014. All patients received routine physical examinations, otolaryngological examinations, and X-rays of the neck and chest. The door-to-endoscopy time, procedure time, postendoscopic hospital stay, successful removal rates, and complications were analyzed as well. In this study, the most common esophageal FBs were fish and animal bones (76%) in adults and coins (74%) in children. The patients with existing esophageal FBs had significantly more frequent symptoms of dysphagia and signs of linear opacity as detected with lateral neck radiography than those without FB. Additionally, the door-to-endoscopy time, procedure time, and postendoscopic hospital stay was significantly shorter in FE patients than in RE patients. However, both RE and FE patients had high rates of successful FB removal (95%) and low complication rates (2%). Both FE and RE remove esophageal FBs successfully, as evidenced by their high success rates, low complication rates, and high detection rates. Although FE under local anesthesia is a less time-consuming procedure for adults, RE under general anesthesia may be preferable for children and can serve as an alternative to FE. Copyright © 2015. Published by Elsevier B.V.
Su, Yuxi; Nan, Guoxin
2016-05-01
Embedment of metallic foreign bodies in the soft tissues is commonly encountered in the emergency room. Most foreign bodies are easily removed, but removal is difficult if the foreign body is very small or deeply embedded. To determine the usefulness of methylene blue staining in the surgical removal of tiny metallic foreign bodies embedded in the soft tissue. This prospective study involved 41 children treated between May 2007 and May 2012. The patients were randomly divided into a methylene blue group and a control group. In the control group, foreign bodies were located using a C-arm and removed via direct incision. In the methylene blue group, foreign bodies were located using a C-arm, marked with an injection of methylene blue and then removed surgically. The clinical outcomes, complications, operation time, surgical success rate, incision length, frequency of C-arm use, and length and depth of the foreign body were compared between the two groups. The surgical success rate was significantly higher in the methylene blue group. The average operation time was significantly shorter in the methylene blue group. The C-arm was used significantly less frequently in the methylene blue group than in the control group. The incision length was significantly shorter in the methylene blue group than in the control group. Methylene blue staining facilitated the location and removal of tiny metallic foreign bodies from the soft tissue, and significantly reduced operation time, incision length and radiation exposure compared to the conventional method. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.
Finkelstein, M; Legmann, A; Rubin, P A
1997-01-01
Intraorbital projectile metallic foreign bodies are associated with significant ocular and orbital injuries. The authors sought to evaluate epidemiologic factors, the incidence of associated ocular and orbital injury, and the nature and necessity of surgical intervention in these cases. Charts of all patients with projectile intraorbital metallic foreign bodies seen at our institution (27) over the preceding 7 years were evaluated with respect to age, sex, type of injury, associated ocular and orbital injuries, location of the projectile (anterior, epibulbar, or posterior), postinjury visual acuity, and surgical intervention. The majority of patients were male, between the ages of 11 and 30, and had BB pellet injuries. Thirteen projectiles were lodged anteriorly, 4 were in an epibulbar position, and the remaining 10 were posterior to the equator. Twelve of 13 anterior, and 4 of 4 epibulbar foreign bodies were removed surgically, whereas only 2 of 10 posterior foreign bodies required surgery. No case of surgical intervention resulted in a decrease of visual acuity. Associated ocular injuries were both more common and severe in patients with posteriorly located foreign bodies. Final visual acuity was better at presentation and at discharge in patients with anteriorly located foreign bodies. Intraorbital projectile metallic foreign bodies can be a source of significant ocular morbidity. Management of these cases is dependent on the location of the projectile. Ancillary radiographic studies can be helpful. Surgery to remove the projectile should be considered in each case, but foreign bodies that are not readily accessible often may be left safely in place. Closer regulation of the pellet gun industry, with an emphasis on education and protective eyewear use, would be helpful in reducing these injuries.
Clinical study of esophageal foreign bodies attributable to PTP material.
Sakakura, A; Yamamoto, Y; Terada, M; Takenaka, H; Ueda, N; Furuya, T
1997-10-01
Retrospective survey of patients with esophageal foreign bodies who were treated in the Osaka Medical College over the past 21 years, and the patients with esophageal foreign bodies attributed to press through package (PTP) who were treated at the Osaka Central Emergency Clinic, a representative holiday emergency institution in Japan, was carried out. The incidence of foreign bodies attributed to PTP material tends to increase throughout the period reviewed. The patients over 60 years of age accounted for 25/28 (89%) of all PTP patients in Osaka Medical College and 27/32 (84%) in Osaka Central Emergency Clinic, strongly suggesting that PTP dysphagia is most common in elderly patients. Diagnostic methods and preventive measures against PTP foreign bodies were discussed.
Ingested hyaluronan moisturizes dry skin
2014-01-01
Hyaluronan (HA) is present in many tissues of the body and is essential to maintain moistness in the skin tissues, which contain approximately half the body’s HA mass. Due to its viscosity and moisturizing effect, HA is widely distributed as a medicine, cosmetic, food, and, recently marketed in Japan as a popular dietary supplement to promote skin moisture. In a randomized, double-blind, placebo-controlled clinical study it was found that ingested HA increased skin moisture and improved treatment outcomes for patients with dry skin. HA is also reported to be absorbed by the body distributed, in part, to the skin. Ingested HA contributes to the increased synthesis of HA and promotes cell proliferation in fibroblasts. These effects show that ingestion of HA moisturizes the skin and is expected to improve the quality of life for people who suffer from dry skin. This review examines the moisturizing effects of dry skin by ingested HA and summarizes the series of mechanisms from absorption to pharmacological action. PMID:25014997
Case report: vertebral foreign body granuloma mimicking a skeletal metastasis.
Vossen, Josephina A; Bathaii, Seyed M; Hatfield, Bryce; Hayes, Curtis W
2018-06-01
Intraosseous foreign body granuloma formation related to migrated surgical material is a rarely reported condition with variable imaging appearance. In this case report, we describe a foreign body granuloma that occurred in a lumbar vertebral body one level above a prior surgical fusion. The lytic appearance mimicked a skeletal metastasis in a 65-year-old patient with recently diagnosed renal cell carcinoma. To the best of our knowledge, this is the first reported case of a lumbar vertebral foreign body granuloma occurring distant from the site of surgery, indistinguishable from skeletal metastasis on radiologic examination.
Removal of a foreign body from the skull base using a customized computer-designed guide bar.
Wei, Ran; Xiang-Zhen, Liu; Bing, Guo; Da-Long, Shu; Ze-Ming, Tan
2010-06-01
Foreign bodies located at the base of the skull pose a surgical challenge. Here, a customized computer-designed surgical guide bar was designed to facilitate removal of a skull base foreign body. Within 24h of the patient's presentation, a guide bar and mounting platform were designed to remove a foreign body located adjacent to the transverse process of the atlas and pressing against the internal carotid artery. The foreign body was successfully located and removed using the custom designed guide bar and computer operative planning. Ten months postoperatively the patient was free of complaints and lacked any complications such as restricted opening of the mouth or false aneurysm. The inferior alveolar nerve damage noted immediately postoperatively (a consequence of mandibular osteotomy) was slightly reduced at follow-up, but labial numbness persisted. The navigation tools described herein were successfully employed to aid foreign body removal from the skull base. Copyright (c) 2009 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
Management of retained foreign bodies in missile injuries of the maxillofacial region.
Bede, Salwan Yousif Hanna; Ahmed, Firas Taha
2011-07-01
This study evaluates 22 patients with retained foreign bodies in the maxillofacial region that were all caused by penetrating missile injuries. Surgical intervention for the retrieval of the foreign bodies was carried out in 20 patients through the existing wounds and through separate incisions; all patients were followed up for a minimum of 2 months during which all the complications were registered and managed. Preoperative imaging is a prerequisite for the accurate localization of the foreign body and the subsequent successful removal of it. All patients developed complications that were categorized in this study into those that result from the injury itself and those that occur because of the retrieval procedure, the latter category being mostly easily managed. In general, all foreign bodies in the maxillofacial region should be removed; the surgeon involved should weigh the benefits and the perils of the removal, and the patient should be well informed about the possibility of the failure of removal of the foreign body.
Foreign bodies in the larynx and tracheobronchial tree in children. A review of 225 cases.
Rothmann, B F; Boeckman, C R
1980-01-01
In a study of 225 patients with foreign bodies in the larynx, trachea and bronchi, 77% were 36 months of age or less. The male-female ratio was 2:1. Food or food derivatives were the causative agent in 70% of the cases, with 38% due to a portion of nut. The foreign body involved the right and left bronchus with equal frequency. A choking episode followed by an audible wheeze (55%) was the most common presenting complaint. Obstructive emphysema was demonstrated in 60% and was best demonstrated by inspiration-expiration chest roentgenograms or fluoroscopy. A radio-opaque object was seen in 13%. Two hundred ten foreign objects (93%) were removed by endoscopy. Four patients required pulmonary resection for bronchiectasis and in three patients bronchotomy was performed. Five patients expelled the foreign body spontaneously, two patients were transferred to another hospital, and one foreign body was not recovered. There was no mortality.
Virtopsy: postmortem imaging of laryngeal foreign bodies.
Oesterhelweg, Lars; Bolliger, Stephan A; Thali, Michael J; Ross, Steffen
2009-05-01
Death from corpora aliena in the larynx is a well-known entity in forensic pathology. The correct diagnosis of this cause of death is difficult without an autopsy, and misdiagnoses by external examination alone are common. To determine the postmortem usefulness of modern imaging techniques in the diagnosis of foreign bodies in the larynx, multislice computed tomography, magnetic resonance imaging, and postmortem full-body computed tomography-angiography were performed. Three decedents with a suspected foreign body in the larynx underwent the 3 different imaging techniques before medicolegal autopsy. Multislice computed tomography has a high diagnostic value in the noninvasive localization of a foreign body and abnormalities in the larynx. The differentiation between neoplasm or soft foreign bodies (eg, food) is possible, but difficult, by unenhanced multislice computed tomography. By magnetic resonance imaging, the discrimination of the soft tissue structures and soft foreign bodies is much easier. In addition to the postmortem multislice computed tomography, the combination with postmortem angiography will increase the diagnostic value. Postmortem, cross-sectional imaging methods are highly valuable procedures for the noninvasive detection of corpora aliena in the larynx.
Risk factors for otolaryngological foreign bodies in Eastern Poland.
Rybojad, Beata; Niedzielski, Artur; Niedzielska, Grazyna; Rybojad, Pawel
2012-11-01
To identify the sociodemographic characteristics and risk factors associated with suspected foreign bodies in the ear, nose, throat, airway, and esophagus among Polish children. Case series with chart review. Setting Tertiary care medical center. A retrospective analysis of the medical records of patients hospitalized for a suspected foreign body (FB) between 1998 and 2008 was conducted. Data regarding place of residence, presence of siblings, parents' educational status, seasonality, psychomotor development, age, and sex were collected and statistically analyzed. Of the 1011 patients with suspected foreign body insertion, 849 (84%) had a positive diagnosis. Of the confirmed foreign bodies, 96 were found in the tracheobronchial tree, 142 were found in the esophagus, and 611 were located in the external auditory canals, nasopharyngeal passage, tonsils, auricles, or lips. Sociodemographically, 596 of the children came from urban areas, with a preponderance of males (55%). Objects were removed more frequently in summer and autumn (60%). Children with siblings (53%) predominated. The majority of patients (52%) had parents with an elementary education. Food was the most frequent foreign body in children under 3 years of age. Patients with delayed psychomotor development constituted 1.6% of the analyzed population. Being male, 1 to 3 years of age, belonging to an urban family with siblings, and having parents with an elementary education increased the risk of foreign body insertion. Training caregivers about proper nutrition and safety rules when playing with children can reduce the risk of accidents related to foreign body insertion.
Hidaka, Hiroshi; Obara, Taku; Kuriyama, Shinichi; Kurosawa, Shin; Katori, Yukio; Kobayashi, Toshimitsu
2013-10-01
Foreign body aspiration is a life-threatening emergency for children. Fried chicken is commonly available all over the world, but no cases have previously been reported addressing this food as a tracheobronchial foreign body. We report an extremely rare case of tracheobronchial aspiration of fried chicken complicated by severe bronchitis and postoperative atelectasis. To clarify predisposing factors related to bronchopulmonary complications, we also reviewed paediatric cases of tracheobronchial foreign bodies treated in our department over the past 14 years. We retrospectively reviewed a total of 77 cases of tracheobronchial foreign bodies from 1988 to 2011. The main outcome measure was duration of hospitalisation, reflecting postoperative therapy. Logistic regression analyses were conducted to determine risk factors for longer hospitalisation. Age, sex, and interval between the aspiration episode and bronchoscopy were not significantly associated with longer hospitalisation. Regarding kinds of foreign bodies, higher rates of longer hospitalisation were noted for patients who had aspirated peanut or animal material, as compared to patients who had aspirated non-organic material (odds ratio, 5.80; 95% confidence interval, 1.12-30.43). In terms of predicting the risk of pulmonary complications, the type of foreign body aspirated offers a more meaningful factor than the interval between aspiration and operation. Specifically, peanuts or animal material containing oils appear to be associated with a more prolonged pulmonary recovery even after retrieval of the foreign body. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Patterns of nasal foreign body in northeast Malaysia: A five-year experience.
Yaroko, A A; Baharudin, A
2015-11-01
The aim of this study was to determine the common presentations and management outcomes in case of nasal foreign body. A retrospective study was carried out over 5 years, from January 2008 to December 2012. The total number of patients was 43; maximum age was 9 years. Patient biodata, clinical presentation, type of foreign body and management outcome were obtained and analyzed from the medical records of the Universiti Sains Malaysia Hospital. Of the total 43 patients, 60.5% were male and 39.5% female. The most frequent age at which nasal foreign bodies were found was 3 years (48.83%) and the least frequent age bracket was 7-9 years (2.33%). Most patients had foul smelling nasal discharge (34.88%) or were asymptomatic (34.88%); the least common presentation was nasal discomfort (2.33%). Seeds (23.26%) were the most common foreign body, followed by rubber and batteries (16.28%). In most cases (58.14%), the foreign body had been inserted into the right nostril; 39.53% were inserted into the left nostril, and 2.33% were bilateral. Foreign bodies were removed under general and local anesthesia in 53.49% and 41.86% of cases respectively; 4.65% were dislodged spontaneously. Nasal foreign bodies are encountered daily in our routine clinical practice in the pediatric age group. General anesthesia is required in uncooperative agitated patients to avoid complications. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Kawada, Chinatsu; Yoshida, Takushi; Yoshida, Hideto; Sakamoto, Wakako; Odanaka, Wataru; Sato, Toshihide; Yamasaki, Takeshi; Kanemitsu, Tomoyuki; Masuda, Yasunobu; Urushibata, Osamu
2015-01-01
Hyaluronan (HA) has been increasingly used as a dietary supplement to improve the skin. However, the effect of ingested HA may depend on its molecular weight (MW) because its physiological activities in the body vary with its MW. In this study, we examined the effects of ingested HA with varying MW on the skin. In this randomized, double blind, placebo controlled study, 61 subjects with dry skin received oral HA (120 mg/day), of MWs 800 k and 300 k or placebo, for 6 weeks. The skin moisture contents of the first two groups increased more than those of the placebo group during the ingestion period. In addition, group HA 300 k exhibited significant improvements in skin moisture content 2 weeks after ingestion ended compared with the placebo group. A questionnaire survey about subjective facial aging symptoms showed that the HA treated groups exhibited significantly improved the skin condition compared with the placebo treated group. Furthermore, dermatologists objectively evaluated the clinical symptoms of the facial and whole body skin, showing that no adverse events were related to daily ingestion of HA. This study shows that both of ingesting HAs (MWs 800 k and 300 k) improved the skin condition by increasing the moisture content.
Heni, Martin; Kullmann, Stephanie; Ketterer, Caroline; Guthoff, Martina; Bayer, Margarete; Staiger, Harald; Machicao, Fausto; Häring, Hans-Ulrich; Preissl, Hubert; Veit, Ralf; Fritsche, Andreas
2014-03-01
Eating behavior is crucial in the development of obesity and Type 2 diabetes. To further investigate its regulation, we studied the effects of glucose versus water ingestion on the neural processing of visual high and low caloric food cues in 12 lean and 12 overweight subjects by functional magnetic resonance imaging. We found body weight to substantially impact the brain's response to visual food cues after glucose versus water ingestion. Specifically, there was a significant interaction between body weight, condition (water versus glucose), and caloric content of food cues. Although overweight subjects showed a generalized reduced response to food objects in the fusiform gyrus and precuneus, the lean group showed a differential pattern to high versus low caloric foods depending on glucose versus water ingestion. Furthermore, we observed plasma insulin and glucose associated effects. The hypothalamic response to high caloric food cues negatively correlated with changes in blood glucose 30 min after glucose ingestion, while especially brain regions in the prefrontal cortex showed a significant negative relationship with increases in plasma insulin 120 min after glucose ingestion. We conclude that the postprandial neural processing of food cues is highly influenced by body weight especially in visual areas, potentially altering visual attention to food. Furthermore, our results underline that insulin markedly influences prefrontal activity to high caloric food cues after a meal, indicating that postprandial hormones may be potential players in modulating executive control. Copyright © 2013 Wiley Periodicals, Inc.
Glucose Plus Fructose Ingestion for Post-Exercise Recovery-Greater than the Sum of Its Parts?
Gonzalez, Javier T; Fuchs, Cas J; Betts, James A; van Loon, Luc J C
2017-03-30
Carbohydrate availability in the form of muscle and liver glycogen is an important determinant of performance during prolonged bouts of moderate- to high-intensity exercise. Therefore, when effective endurance performance is an objective on multiple occasions within a 24-h period, the restoration of endogenous glycogen stores is the principal factor determining recovery. This review considers the role of glucose-fructose co-ingestion on liver and muscle glycogen repletion following prolonged exercise. Glucose and fructose are primarily absorbed by different intestinal transport proteins; by combining the ingestion of glucose with fructose, both transport pathways are utilised, which increases the total capacity for carbohydrate absorption. Moreover, the addition of glucose to fructose ingestion facilitates intestinal fructose absorption via a currently unidentified mechanism. The co-ingestion of glucose and fructose therefore provides faster rates of carbohydrate absorption than the sum of glucose and fructose absorption rates alone. Similar metabolic effects can be achieved via the ingestion of sucrose (a disaccharide of glucose and fructose) because intestinal absorption is unlikely to be limited by sucrose hydrolysis. Carbohydrate ingestion at a rate of ≥1.2 g carbohydrate per kg body mass per hour appears to maximise post-exercise muscle glycogen repletion rates. Providing these carbohydrates in the form of glucose-fructose (sucrose) mixtures does not further enhance muscle glycogen repletion rates over glucose (polymer) ingestion alone. In contrast, liver glycogen repletion rates are approximately doubled with ingestion of glucose-fructose (sucrose) mixtures over isocaloric ingestion of glucose (polymers) alone. Furthermore, glucose plus fructose (sucrose) ingestion alleviates gastrointestinal distress when the ingestion rate approaches or exceeds the capacity for intestinal glucose absorption (~1.2 g/min). Accordingly, when rapid recovery of endogenous glycogen stores is a priority, ingesting glucose-fructose mixtures (or sucrose) at a rate of ≥1.2 g·kg body mass -1 ·h -1 can enhance glycogen repletion rates whilst also minimising gastrointestinal distress.
Glucose Plus Fructose Ingestion for Post-Exercise Recovery—Greater than the Sum of Its Parts?
Gonzalez, Javier T.; Fuchs, Cas J.; Betts, James A.; van Loon, Luc J. C.
2017-01-01
Carbohydrate availability in the form of muscle and liver glycogen is an important determinant of performance during prolonged bouts of moderate- to high-intensity exercise. Therefore, when effective endurance performance is an objective on multiple occasions within a 24-h period, the restoration of endogenous glycogen stores is the principal factor determining recovery. This review considers the role of glucose–fructose co-ingestion on liver and muscle glycogen repletion following prolonged exercise. Glucose and fructose are primarily absorbed by different intestinal transport proteins; by combining the ingestion of glucose with fructose, both transport pathways are utilised, which increases the total capacity for carbohydrate absorption. Moreover, the addition of glucose to fructose ingestion facilitates intestinal fructose absorption via a currently unidentified mechanism. The co-ingestion of glucose and fructose therefore provides faster rates of carbohydrate absorption than the sum of glucose and fructose absorption rates alone. Similar metabolic effects can be achieved via the ingestion of sucrose (a disaccharide of glucose and fructose) because intestinal absorption is unlikely to be limited by sucrose hydrolysis. Carbohydrate ingestion at a rate of ≥1.2 g carbohydrate per kg body mass per hour appears to maximise post-exercise muscle glycogen repletion rates. Providing these carbohydrates in the form of glucose–fructose (sucrose) mixtures does not further enhance muscle glycogen repletion rates over glucose (polymer) ingestion alone. In contrast, liver glycogen repletion rates are approximately doubled with ingestion of glucose–fructose (sucrose) mixtures over isocaloric ingestion of glucose (polymers) alone. Furthermore, glucose plus fructose (sucrose) ingestion alleviates gastrointestinal distress when the ingestion rate approaches or exceeds the capacity for intestinal glucose absorption (~1.2 g/min). Accordingly, when rapid recovery of endogenous glycogen stores is a priority, ingesting glucose–fructose mixtures (or sucrose) at a rate of ≥1.2 g·kg body mass−1·h−1 can enhance glycogen repletion rates whilst also minimising gastrointestinal distress. PMID:28358334
[Uncommon foreign body in a nose].
Alagić-Smailbegović, Jasminka; Hadzić, Edina; Sutalo, Kamenko; Resić, Mudzahid
2007-01-01
Foreign body in the nose most frequently occurs in childhood. It could be of various origin, pieces of toys, paper and uncommon metal body. Consequences include one- sided nasal breathing problem, nasal secretion and in some cases pain and secretion become purulent. The aim of this paper is to present uncommon foreign body in the nose. RTG diagnosis and extraction are the methods of choice.
A light bulb moment: an unusual cause of foreign body aspiration in children.
Lau, C T; Lan, Lawrence; Wong, Kenneth; Tam, Paul Kwong Hang
2015-08-26
A 15-month-old girl developed persistent cough with no associated history of foreign body aspiration. Chest X-ray showed a U-shaped radiopaque foreign body, which was initially thought to be a hairpin, in the right main bronchus. Rigid bronchoscopy was performed and the foreign body turned out to be a light-emitting diode (LED) bulb. In this article, we report our experience of LED bulb aspiration in children, with the view to raise the awareness of clinicians about this potentially life-threatening emergency. 2015 BMJ Publishing Group Ltd.
Early surgical managment of penetrating ocular injuries involving the posterior segment.
Michels, R G
1976-09-01
Pars plana vitrectomy technic can be used in the early management of certain penetrating ocular injuries involving the posterior segment, including selected intraocular foreign bodies. This study reports the results of ten consecutive cases of intraocular foreign bodies in the posterior segment treated by a combination of vitrectomy (including lensectomy when necessary) and foreign-body extraction with forceps. The foreign body was successfully removed in nine of ten eyes, and nine of ten eyes were salvaged. This favorable experience using early vitreous surgery suggests that the vitrectomy technic can be used in other penetrating injuries involving the posterior segment that are not associated with intraocular foreign bodies. Possible indications for early vitrectomy are presented, including cases with a poor prognosis when managed by conventional methods.
Bantis, Athanasios; Sountoulides, Petros; Kalaitzis, Christos; Giannakopoulos, Stelios; Agelonidou, Eleni; Foutzitzi, Soultana; Touloupidis, Stavros
2010-01-01
The urethra is a usual site of introduction of foreign bodies for autoerotic stimulation. We present an unusual case of bladder perforation caused by foreign body that was self-inserted in the urethra and consequently slipped inside the bladder in a 29-year-old female patient with psychiatric disease. The patient was referred to our department for macroscopic hematuria and abdominal pain. Imaging studies revealed the presence of a foreign body in the pelvic area which had perforated the left lateral wall of the bladder. The foreign body was removed via open cystotomy. In psychiatric patients hematuria and pelvic pain may result from insertion of a foreign body in the bladder usually during masturbation.
Bantis, Athanasios; Sountoulides, Petros; Kalaitzis, Christos; Giannakopoulos, Stelios; Agelonidou, Eleni; Foutzitzi, Soultana; Touloupidis, Stavros
2010-01-01
The urethra is a usual site of introduction of foreign bodies for autoerotic stimulation. We present an unusual case of bladder perforation caused by foreign body that was self-inserted in the urethra and consequently slipped inside the bladder in a 29-year-old female patient with psychiatric disease. The patient was referred to our department for macroscopic hematuria and abdominal pain. Imaging studies revealed the presence of a foreign body in the pelvic area which had perforated the left lateral wall of the bladder. The foreign body was removed via open cystotomy. In psychiatric patients hematuria and pelvic pain may result from insertion of a foreign body in the bladder usually during masturbation. PMID:20862362
Multidisciplinary surgical management of an unusual penetrating foreign body of the face.
Villarmé, A; Savoldelli, C; Jean-Baptiste, E; Guevara, N
2018-06-07
Facial injuries by penetrating foreign body are unusual and require specific multidisciplinary surgical management. This case report concerns a 20-year-old man who experienced a penetrating injury by a piece of wood to the face and describes the surgical approach to remove the wood and repair the injury. The foreign body had penetrated the infratemporal fossa, with an entry wound situated below the right eye and an exit wound in the neck, in contact with the left internal carotid artery. An adapted surgical strategy was necessary in view of the site of the foreign body. The internal carotid artery was controlled in order to follow the foreign body as far as its entry into the base of the skull. The proximity of the eye and carotid and jugular vessels and the deep penetration of the foreign body required the participation of interventional radiologists, head and neck and vascular surgeons and ophthalmologists. The site of the foreign body, precisely determined preoperatively, justified management by a multidisciplinary team to ensure rapid extraction, while limiting the risk of additional lesions. With a follow-up of 6 months, the patient did not present any sequelae of his facial injury. Copyright © 2018 Elsevier Masson SAS. All rights reserved.
The effect of cool water ingestion on gastrointestinal pill temperature.
Wilkinson, David M; Carter, James M; Richmond, Victoria L; Blacker, Sam D; Rayson, Mark P
2008-03-01
Telemetric gastrointestinal (GI) temperature pills are now commonly used to measure core body temperature and could minimize the risk of heat illness while maximizing operational effectiveness in workers subject to high levels of thermal strain. To quantify the effect of repeated cool water ingestion on the accuracy of GI pill temperature. Ten operational firefighters ingested a pill to measure GI temperature (T1int) before overnight sleep. Two hours following breakfast and 11.5 h after ingesting T1int, the firefighters ingested a second pill (T2int) before performing 8.5 h of intermittent activity (repetitive cycles of 30 min of seated rest followed by 30 min of general firefighter duties). During the first 2 min of each 30-min rest period, the firefighters consumed 250 mL of chilled water (5-8 degrees C). Water ingestion had a highly variable effect both within and between subjects in transiently (32 +/- 10 min) reducing the temperature of T2int in comparison with T1int. In general, this transient reduction in T2int became progressively smaller as time following ingestion increased. In some firefighters, the difference between T1int and T2int became negligible (+/- 0.1 degrees C) after 3 h, whereas in two others, large differences (peaking at 2.0 degrees C and 6.3 degrees C) were still observed when water was consumed 8 h after pill ingestion. These results show that a GI pill ingested immediately prior to physical activity cannot be used to measure core body temperature accurately in all individuals during the following 8 h when cool fluids are regularly ingested. This makes GI temperature measurement unsuitable for workers who respond to emergency deployments when regular fluid consumption is recommended operational practice.
An Unusual Foreign Body in the Urinary Bladder Mimicking a Parasitic Worm
Schmitt, Bryan H.; Feder, Marc T.; Rokke, Denise L.; Moyer, Thomas P.
2012-01-01
We report an unusual case of a foreign body removed from the urinary bladder of a 63-year-old male which mimicked a parasitic worm. The foreign body was identified as an artificial fishing worm by morphological comparison to a similar commercially produced product and by infrared spectrum analysis. PMID:22535991
The foreign body response: at the interface of surgery and bioengineering.
Major, Melanie R; Wong, Victor W; Nelson, Emily R; Longaker, Michael T; Gurtner, Geoffrey C
2015-05-01
The surgical implantation of materials and devices has dramatically increased over the past decade. This trend is expected to continue with the broadening application of biomaterials and rapid expansion of aging populations. One major factor that limits the potential of implantable materials and devices is the foreign body response, an immunologic reaction characterized by chronic inflammation, foreign body giant cell formation, and fibrotic capsule formation. The English literature on the foreign body response to implanted materials and devices is reviewed. Fibrotic encapsulation can cause device malfunction and dramatically limit the function of an implanted medical device or material. Basic science studies suggest a role for immune and inflammatory pathways at the implant-host interface that drive the foreign body response. Current strategies that aim to modulate the host response and improve construct biocompatibility appear promising. This review article summarizes recent basic science, preclinical, and clinicopathologic studies examining the mechanisms driving the foreign body response, with particular focus on breast implants and synthetic meshes. Understanding these molecular and cellular mechanisms will be critical for achieving the full potential of implanted biomaterials to restore human tissues and organs.
Surgical Removal of Neglected Soft Tissue Foreign Bodies by Needle-Guided Technique
Ebrahimi, Ali; Radmanesh, Mohammad; Rabiei, Sohrab; kavoussi, Hossein
2013-01-01
Introduction: The phenomenon of neglected foreign bodies is a significant cause of morbidity in soft tissue injuries and may present to dermatologists as delayed wound healing, localized cellulitis and inflammation, abscess formation, or foreign body sensation. Localization and removal of neglected soft tissue foreign bodies (STFBs) is complex due to possible inflammation, indurations, granulated tissue, and fibrotic scar. This paper describes a simple method for the quick localization and (surgical) removal of neglected STFBs using two 23-gauge needles without ultrasonographic or fluoroscopic guidance. Materials and Methods: A technique based on the use of two 23-gauge needles was used in 41 neglected STFBs in order to achieve proper localization and fixation of foreign bodies during surgery. Results: Surgical removal was successful in 38 of 41 neglected STFBs (ranging from 2–13mm in diameter). Conclusion: The cross-needle-guided technique is an office-based procedure that allows the successful surgical removal of STFBs using minimal soft tissue exploration and dissection via proper localization, fixation, and propulsion of the foreign body toward the surface of the skin. PMID:24303416
Impacted thoracic foreign bodies after penetrating chest trauma.
Sersar, Sameh I; Albohiri, Khalid A; Abdelmohty, Hysam
2016-10-01
Retained foreign bodies in the chest may include shell fragments, bullets, shrapnel, pieces of clothing, bones, and rib fragments. The risks of removal of foreign bodies must be weighed against the complications of leaving them inside the chest. We treated 90 cases of retained intrathoracic foreign bodies in patients admitted to 3 tertiary centers in Saudi Arabia between March 2015 and March 2016. Sixty patients were injured by shrapnel, 26 had one or more bullets, 3 had broken rib fragments, and one had a metal screw. The chest wall was site of impaction in 48 cases, the lungs in 24, pleura in 14, and mediastinum in 4. Removal of the retained foreign body was carried out in 12 patients only: bullets in 9 cases, bone fragments in 2, and a metal screw in one. The predictors for removal were bullets, female sex, and mediastinal position with bilateral chest injury, especially with fracture ribs. Retained intrathoracic foreign bodies due to penetrating chest trauma are treated mainly conservatively unless there is another indication for chest exploration. © The Author(s) 2016.
Effect of fluid ingestion on orthostatic responses following acute exercise
NASA Technical Reports Server (NTRS)
Davis, J. E.; Fortney, S. M.
1997-01-01
Orthostatic tolerance is impaired following an acute bout of exercise. This study examined the effect of fluid ingestion following treadmill exercise in restoring the cardiovascular responses to an orthostatic stress. Five men (age, 29.6 +/- 3.4 yrs) were exposed to a graded lower body negative (LBNP) pressure protocol (0 to -50 mmHg) during euhydration without exercise (C), 20 minutes after exercise dehydration (D), 20 minutes after exercise and fluid ingestion (FI20), and 60 minutes after exercise and fluid ingestion (FI60). Fluid ingestion (mean +/- SE) consisted of water-ingestion equivalent to 50% of the body weight lost during exercise (520 +/- 15 ml). Exercise dehydration resulted in significantly higher heart rates (119 +/- 8 vs 82 +/- 7 bpm), lower systolic blood pressures (95 +/- 1.7 vs 108 +/- 2.3 mmHg), a smaller increase in leg circumference (3.7 +/- 4 vs 6.9 +/- 1.0 mm), and an attenuated increase in total peripheral resistance (2.58 +/- 1.2 vs 4.28 +/- 0.9 mmHg/L/min) at -50 mmHg LBNP compared to the C condition. Fluid ingestion (both 20 and 60), partially restored the heart rate, systolic blood pressure, and total peripheral resistance responses to LBNP, but did not influence the change in leg circumference during LBNP (4 +/- 0.3 for R20 and 2.8 +/- 0.4 mm for R60). These data illustrate the effectiveness of fluid ingestion on improving orthostatic responses following exercise, and suggest that dehydration is a contributing factor to orthostatic intolerance following exercise.
Tsukiyama, Atsushi; Tagami, Takashi; Kim, Shiei; Yokota, Hiroyuki
2014-01-01
Computed tomography (CT) is useful for evaluating esophageal foreign bodies and detecting perforation. However, when evaluation is difficult owing to the previous use of barium as a contrast medium, 3-dimensional CT may facilitate accurate diagnosis. A 49-year-old man was transferred to our hospital with the diagnosis of esophageal perforation. Because barium had been used as a contrast medium for an esophagram performed at a previous hospital, horizontal CT and esophageal endoscopy could not be able to identify the foreign body or characterize the lesion. However, 3-dimensional CT clearly revealed an L-shaped foreign body and its anatomical relationships in the mediastinum. Accordingly, we removed the foreign body using an upper gastrointestinal endoscope. The foreign body was the premaxillary bone of a sea bream. The patient was discharged without complications.
Markov, G; Kondarev, G
1999-01-01
During 1991-1997 period 37 patients with foreign bodies in the esophagus were treated in our clinic. In 36 cases the foreign body was "starlet". That is a construction made for this special purpose. It lodges mainly in the upper digestive tract. The most usual localization is the middle third of the esophagus. Unlike the foreign bodies that impact there by accident the operative activity is very high in these cases. Out of the total number of 37 patients 22 were operated, in 7 cases an endoscopic extraction was performed and in one case the foreign body eliminated spontaneously. Three patients died before we performed any manipulations whatsoever and four of them refused any treatment. We offer methods for treating such patients which in our opinion are the most appropriate ones for this type of pathology.
Managing corneal foreign bodies in office-based general practice.
Fraenkel, Alison; Lee, Lawrence R; Lee, Graham A
2017-03-01
Patients with a corneal foreign body may first present to their general practitioner (GP). Safe and efficacious management of these presentations avoids sight-threatening and eye-threatening complications. Removal of a simple, superficial foreign body without a slit lamp is within The Royal Australian College of General Practitioners' (RACGP's) curriculum and scope of practice. Knowing the rele-vant procedural skills and indications for referral is equally important. The objective of this article is to provide an evidence-based and expert-based guide to the management of corneal foreign bodies in the GP's office. History is key to identifying patient characteristics and mechanisms of ocular injury that are red flags for referral. Examination tech-niques and methods of superficial foreign body removal without a slit lamp are outlined, as well as the procedural threshold for referral to an ophthalmologist.
Tracheobronchial foreign body aspiration in children.
Burton, E M; Brick, W G; Hall, J D; Riggs, W; Houston, C S
1996-02-01
In this retrospective study, we reviewed the demographic and radiographic findings of 155 children with bronchoscopy-proven tracheobronchial foreign body aspiration (FBA). Two thirds of the patients were male, and most were children between 1 and 2 years of age. An aspirated peanut accounted for one third of all cases. Foreign body location was distributed nearly evenly to the right and left primary bronchi; tracheal foreign body was noted in 16 patients. The most frequent symptoms of FBA were cough (85 patients) and wheezing (60 patients). Although most patients were seen within 1 day of aspiration, 30 patients had symptoms that lasted at least 1 week before diagnosis. The most common radiographic findings were unilateral or segmental hyperlucency (59) or atelectasis (38). The trachea was the site of the foreign body in one half of children with a normal chest radiograph and FBA.
A mathematical model for foreign body reactions in 2D.
Su, Jianzhong; Gonzales, Humberto Perez; Todorov, Michail; Kojouharov, Hristo; Tang, Liping
2011-02-01
The foreign body reactions are commonly referred to the network of immune and inflammatory reactions of human or animals to foreign objects placed in tissues. They are basic biological processes, and are also highly relevant to bioengineering applications in implants, as fibrotic tissue formations surrounding medical implants have been found to substantially reduce the effectiveness of devices. Despite of intensive research on determining the mechanisms governing such complex responses, few mechanistic mathematical models have been developed to study such foreign body reactions. This study focuses on a kinetics-based predictive tool in order to analyze outcomes of multiple interactive complex reactions of various cells/proteins and biochemical processes and to understand transient behavior during the entire period (up to several months). A computational model in two spatial dimensions is constructed to investigate the time dynamics as well as spatial variation of foreign body reaction kinetics. The simulation results have been consistent with experimental data and the model can facilitate quantitative insights for study of foreign body reaction process in general.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sheth, Rahul; Someshwar, Vimal; Warawdekar, Gireesh
2007-02-15
Purpose. We report our experience of the retrieval of intravascular foreign body objects by the percutaneous use of the Gemini Dormia basket. Methods. Over a period of 2 years we attempted the percutaneous removal of intravascular foreign bodies in 26 patients. Twenty-six foreign bodies were removed: 8 intravascular stents, 4 embolization coils, 9 guidewires, 1 pacemaker lead, and 4 catheter fragments. The percutaneous retrieval was achieved with a combination of guide catheters and the Gemini Dormia basket. Results. Percutaneous retrieval was successful in 25 of 26 patients (96.2%). It was possible to remove all the intravascular foreign bodies with amore » combination of guide catheters and the Dormia basket. No complication occurred during the procedure, and no long-term complications were registered during the follow-up period, which ranged from 6 months to 32 months (mean 22.4 months overall). Conclusion. Percutaneous retrieval is an effective and safe technique that should be the first choice for removal of an intravascular foreign body.« less
Ultrasound detection of simulated intra-ocular foreign bodies by minimally trained personnel.
Sargsyan, Ashot E; Dulchavsky, Alexandria G; Adams, James; Melton, Shannon; Hamilton, Douglas R; Dulchavsky, Scott A
2008-01-01
To test the ability of non-expert ultrasound operators of divergent backgrounds to detect the presence, size, location, and composition of foreign bodies in an ocular model. High school students (N = 10) and NASA astronauts (N = 4) completed a brief ultrasound training session which focused on basic ultrasound principles and the detection of foreign bodies. The operators used portable ultrasound devices to detect foreign objects of varying location, size (0.5-2 mm), and material (glass, plastic, metal) in a gelatinous ocular model. Operator findings were compared to known foreign object parameters and ultrasound experts (N = 2) to determine accuracy across and between groups. Ultrasound had high sensitivity (astronauts 85%, students 87%, and experts 100%) and specificity (astronauts 81%, students 83%, and experts 95%) for the detection of foreign bodies. All user groups were able to accurately detect the presence of foreign bodies in this model (astronauts 84%, students 81%, and experts 97%). Astronaut and student sensitivity results for material (64% vs. 48%), size (60% vs. 46%), and position (77% vs. 64%) were not statistically different. Experts' results for material (85%), size (90%), and position (98%) were higher; however, the small sample size precluded statistical conclusions. Ultrasound can be used by operators with varying training to detect the presence, location, and composition of intraocular foreign bodies with high sensitivity, specificity, and accuracy.
A penal problem: the increasing incidence of implantation of penile foreign bodies.
Flynn, Ryan M; Mostafa, Hesham I; Khan, Omar A; Haselhuhn, Gregory D; Jain, Samay
2014-12-01
Our objective is to describe a novel presentation of subcutaneous penile insertion of foreign bodies. This is a practice performed globally and mostly has been reported outside of the United States. We present three cases of incarcerated males that implanted sculpted dominos into the penile subcutaneous tissue. The patients presented with erosion of the foreign bodies through the skin without evidence of infection. We believe that insertion of foreign bodies into penile subcutaneous tissue by incarcerated American males for sexual enhancement is more widespread than previously reported. Erosion is a novel presentation.
A rare case of foreign body causing recurrent vaginal discharge in prepubertal child.
Gobbur, Vijayalakshmi R; Gobbur, Raghavendra H; Patil, Ashwini G; Endigeri, Preetish
2015-01-01
Vaginal discharge in prepubertal children is mainly due to hypoestrogenic state of vaginal mucosa making it thin and alkaline leading to mucosal invasion by pathogen. In a paediatric case with persistent foul smelling , blood stained vaginal discharge not responding to medical therapy, vaginal foreign body should always be ruled out. Here, we report a 3 -year -old girl with complaint of recurrent vaginal discharge occasionally blood stained not relieved despite few antibiotics courses. On X -ray pelvis, a radioopaque foreign body hair clip was seen. Under sedation foreign body was removed by forceps following which child became asymptomatic.
Bain, A R; Lesperance, N C; Jay, O
2012-10-01
To assess whether, under conditions permitting full evaporation, body heat storage during physical activity measured by partitional calorimetry would be lower with warm relative to cold fluid ingestion because of a disproportionate increase in evaporative heat loss potential relative to internal heat transfer with the ingested fluid. Nine males cycled at 50% VO(2max) for 75 min at 23.6 ± 0.6 °C and 23 ± 11% RH while consuming water of either 1.5 °C, 10 °C, 37 °C or 50 °C in four 3.2 mL kg(-1) boluses. The water was administered 5 min before and 15, 30 and 45 min following the onset of exercise. No differences in metabolic heat production, sensible or respiratory heat losses (all P > 0.05) were observed between fluid temperatures. However, while the increased internal heat loss with cold fluid ingestion was paralleled by similar reductions in evaporative heat loss potential at the skin (E(sk) ) with 10 °C (P = 0.08) and 1.5 °C (P = 0.55) fluid, the increased heat load with warm (50 °C) fluid ingestion was accompanied by a significantly greater E(sk) (P = 0.04). The resultant calorimetric heat storage was lower with 50 °C water ingestion in comparison to 1.5 °C, 10 °C and 37 °C (all P < 0.05). In contrast, heat storage derived conventionally using thermometry yielded higher values following 50 °C fluid ingestion compared to 1.5 °C (P = 0.025). Under conditions permitting full sweat evaporation, body heat storage is lower with warm water ingestion, likely because of disproportionate modulations in sweat output arising from warm-sensitive thermosensors in the esophagus/stomach. Local temperature changes of the rectum following fluid ingestion exacerbate the previously identified error of thermometric heat storage estimations. © 2012 The Authors Acta Physiologica © 2012 Scandinavian Physiological Society.
Ward, W Kenneth; Li, Allen G; Siddiqui, Yasmin; Federiuk, Isaac F; Wang, Xiao-Jing
2008-01-01
The purpose of this study was to better understand whether interleukin-13 (IL-13) and connective tissue growth factor (CTGF) are highly expressed during foreign body encapsulation of subcutaneous devices. Mock biosensors were implanted into rats for three lengths of time (7-, 21- and 48-55 days) to address different stages of the foreign body response. Using quantitative real-time PCR and immunofluorescence, the expression of IL13, CTGF, collagen 1, decorin and fibronectin were measured in this tissue. IL-13, a product of Th2 cells, was highly expressed at all time points, with greatest expression at day 21. The IL-13 expression was paralleled by increased presence of T-cells at all time points. CTGF was also found to be more highly expressed in foreign body tissue than in controls. Collagen and decorin were highly expressed at the middle and later stages. Given the increased expression of IL-13 and CTGF in foreign body tissue, and their roles in other fibrotic disorders, these cytokines may well contribute to the formation of the foreign body capsule. Since the peak gene expression of IL-13 occurred later than the previously-reported TGFbeta expression peak, IL-13 is probably not the major stimulus to TGFbeta expression during foreign body encapsulation and may contribute to fibrosis independently.
Williams, Paul; Jameson, Samuel; Bishop, Phyllis; Sawaya, David; Nowicki, Michael
2013-06-01
Esophageal foreign body impaction (EFBI) is a common problem requiring urgent endoscopy. EFBI may be the first sign of underlying esophageal pathology, yet mucosal biopsies are rarely performed. We report a retrospective analysis of 572 children requiring removal of an EFBI over a 12-year period by pediatric otolaryngologists (ENT), surgeons (PS), and gastroenterologists (PGI). The method of removal [direct laryngoscopy (DL), rigid endoscopy (RE), flexible endoscopy (FE)], type of foreign body (inanimate or food), whether mucosal biopsies were performed, and histologic findings of biopsy samples were recorded for each patient. Foreign body removal was most commonly performed by PGI (298 [52 %]); the remaining were equally distributed between ENT (136 [24 %]) and PS (138 [24 %]). The method of foreign body removal used by ENT was RE (89 %), DL (8 %), and FE (3 %). Pediatric surgery preferred FE (62 %), followed by RE (27 %) and DL (11 %). Pediatric gastroenterology used FE exclusively. Esophageal biopsies were never performed by ENT or PS; PGI performed esophageal biopsies more commonly in children with meat bolus impactions (50 %) than in children with inanimate foreign bodies (12 %). Mucosal pathology was more common in children with meat bolus impaction (100 %) than in children with inanimate foreign bodies (45 %). Esophageal mucosal biopsy should be considered for all children with EFBI not attributed to stricture, particularly those with meat bolus impaction.
Fischer, Kristin; Hendrix, Diane
2012-03-01
To describe six cases of conjunctivitis and ulcerative keratitis secondary to plant foreign bodies from weed-contaminated grass hay which were lodged within the temporal conjunctival fornix in a herd of alpacas. A total of 21 alpacas from the same farm developed blepharospasm and mucopurulent ocular discharge. Six of the 21 were evaluated at the University of Tennessee College of Veterinary Medicine within a 2-week period. The six animals evaluated received an ophthalmic examination including slit-lamp biomicroscopy, fluorescein staining, and topical corneal anesthesia for foreign body removal when necessary. Six animals had conjunctivitis characterized by hyperemia and mucopurulent discharge. Five animals had superficial ulcerative keratitis with intense corneal neovascularization and edema. In all cases, the keratitis was located at the temporal limbus. Seven plant foreign bodies were observed and were removed following topical corneal anesthesia in five animals. The plant seeds were identified as three common weed species found in orchard grass hay. Complete resolution of all clinical signs was achieved with foreign body removal and medical therapy. Fan-shaped temporal corneal ulcers may signify the presence of conjunctival foreign bodies in alpacas. Plant foreign bodies should be considered in addition to ocular infection when multiple animals of a herd are affected as outbreaks may occur with weed-contaminated hay. © 2011 American College of Veterinary Ophthalmologists.
Scholes, Melissa A; Jensen, Emily L
2016-09-01
To examine rates of otolaryngology intervention in children presenting to our emergency department with nasal foreign bodies, factors associated with otolaryngology involvement, rates of complications, and details on nasal button battery exposure. All patients presenting with a nasal foreign body to Children's Hospital Colorado from 2007 to 2012 were identified. Factors leading to referral to otolaryngology and operative intervention were examined, as well as complications. 102 patients were included. 36 (35%) patients were referred to the otolaryngology clinic, of which 58.9% required operating room intervention. 66 (64.7%) children had their nasal foreign bodies removed in the emergency room, however 30 (45%) of these were removed by an otolaryngology resident or attending physician. Overall, 64.7% of nasal foreign bodies required removal by otolaryngology. Of the 15 objects removed in the operating room, six were button batteries. No septal perforations occurred as a result of nasal button battery exposure. Multivariable logistic regression showed two significant predictors of OR removal: age and disc shaped objects. While emergency department providers are comfortable attempting removal of nasal foreign bodies, there was a high rate of otolaryngology intervention. Based on this data, there is a need to educate emergency room providers on nasal anatomy and techniques for nasal foreign body removal. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Optoacoustic multispectral imaging of radiolucent foreign bodies in tissue.
Page, Leland; Maswadi, Saher; Glickman, Randolph D
2013-01-01
Optoacoustic imaging is an emerging medical technology that uniquely combines the absorption contrast of optical imaging and the penetration depth of ultrasound. While it is not currently employed as a clinical imaging modality, the results of current research strongly support the use of optoacoustic-based methods in medical imaging. One such application is the diagnosis of the presence of soft tissue foreign bodies. Because many radiolucent foreign bodies have sufficient contrast for imaging in the optical domain, laser-induced optoacoustic imaging could be advantageous for the detection of such objects. Common foreign bodies have been scanned over a range of visible and near infrared wavelengths by using an optoacoustic method to obtain the spectroscopic properties of the materials commonly associated with these foreign bodies. The derived optical absorption spectra compared quite closely to the absorption spectra generated when using a conventional spectrophotometer. By using the probe-beam deflection technique, a novel, pressure-wave detection method, we successfully generated optoacoustic spectroscopic plots of a wooden foreign body embedded in a tissue phantom, which closely resembled the spectrum of the same object obtained in isolation. A practical application of such spectra is to assemble a library of spectroscopic data for radiolucent materials, from which specific characteristic wavelengths can be selected for use in optimizing imaging instrumentation and provide a basis for the identification of the material properties of particular foreign bodies.
Castaño-Jiménez, Paula A; Trent, Ava M; Bueno, Irene
2016-03-01
Anterior gastrointestinal tract obstruction by a foreign body has been reported in several avian species, most commonly in captive birds. It is often associated with behavioral issues that lead to compulsive consumption of bedding materials or bright moving objects. In penguins, foreign bodies are most commonly identified at necropsy and often are found in the ventriculus because of anatomic characteristics of the species. A captive African black-footed penguin ( Spheniscus demersus ) was diagnosed with a ventricular foreign body. The anatomic and physiologic differences that should be taken into account when surgically removing a ventricular foreign body in a penguin are described. These differences include the caudal location in the coelom and the large size of the ventriculus in proportion to the penguin's body size; the presence of a simple stomach, uniform in thickness and lacking muscular development; a simple gastrointestinal cycle (gastric contraction); and variability in pH of stomach contents. No complications were observed after surgery, and the bird recovered completely. Management of foreign bodies in birds should be based on the clinical signs of the individual bird, the species affected and its anatomic characteristics, the nature and location of the foreign body, available tools, and the preference and experience of the surgeon. This particular case demonstrates that the most indicated and preferred method is not always possible and that knowledge of biologic, anatomic, and physiologic differences of the species may allow the use of an alternative and more invasive approach with favorable outcomes.
Kawada, Chinatsu; Yoshida, Takushi; Yoshida, Hideto; Sakamoto, Wakako; Odanaka, Wataru; Sato, Toshihide; Yamasaki, Takeshi; Kanemitsu, Tomoyuki; Masuda, Yasunobu; Urushibata, Osamu
2015-01-01
Hyaluronan (HA) has been increasingly used as a dietary supplement to improve the skin. However, the effect of ingested HA may depend on its molecular weight (MW) because its physiological activities in the body vary with its MW. In this study, we examined the effects of ingested HA with varying MW on the skin. In this randomized, double blind, placebo controlled study, 61 subjects with dry skin received oral HA (120 mg/day), of MWs 800 k and 300 k or placebo, for 6 weeks. The skin moisture contents of the first two groups increased more than those of the placebo group during the ingestion period. In addition, group HA 300 k exhibited significant improvements in skin moisture content 2 weeks after ingestion ended compared with the placebo group. A questionnaire survey about subjective facial aging symptoms showed that the HA treated groups exhibited significantly improved the skin condition compared with the placebo treated group. Furthermore, dermatologists objectively evaluated the clinical symptoms of the facial and whole body skin, showing that no adverse events were related to daily ingestion of HA. This study shows that both of ingesting HAs (MWs 800 k and 300 k) improved the skin condition by increasing the moisture content. PMID:25834304
Accumulation of deuterium oxide in body fluids after ingestion of D/sub 2/O-labeled beverages
DOE Office of Scientific and Technical Information (OSTI.GOV)
Davis, J.M.; Lamb, D.R.; Burgess, W.A.
A simple low-cost procedure was developed to compare the temporal profiles of deuterium oxide (D/sub 2/O) accumulation in body fluids after ingestion of D/sub 2/O-labeled solutions. D/sub 2/O concentration was measured in plasma and saliva samples taken at various intervals after ingestion of 20 ml of D/sub 2/O mixed with five solutions differing in carbohydrate and electrolyte concentrations. An infrared spectrometer was used to measure D/sub 2/O in purified samples obtained after a 48-h incubation period during which the water (D/sub 2/O and H/sub 2/O) in the sample was equilibrated with an equal volume of distilled water in a sealedmore » diffusion dish. The procedure yields 100% recoveries of 60-500 ppm D/sub 2/O with an average precision of 5%. When compared with values for distilled water, D/sub 2/O accumulation in serial samples of plasma and saliva was slower for ingested solutions containing 40 and 15% glucose and faster for hypotonic saline and a 6% carbohydrate-electrolyte solution. These differences appear to reflect known differences in gastric emptying and intestinal absorption of these beverages. Therefore, this technique may provide a useful index of the rate of water uptake from ingested beverages into the body fluids.« less
Acute neurotoxicity after yohimbine ingestion by a body builder.
Giampreti, Andrea; Lonati, Davide; Locatelli, Carlo; Rocchi, Loretta; Campailla, Maria Teresa
2009-09-01
Yohimbine is an alkaloid obtained from the Corynanthe yohimbe tree and other biological sources. Yohimbine is currently approved in the United States for erectile dysfunction and has undergone resurgence in street use as an aphrodisiac and mild hallucinogen. In recent years yohimbine use has become common in body-building communities for its presumed lipolytic and sympathomimetic effects. We describe a 37-year-old bodybuilder in which severe acute neurotoxic effects occurred in 2 h after yohimbine ingestion. The patient presented with malaise, vomiting, loss of consciousness, and repeated seizures after ingestion of 5 g of yohimbine during a body-building competition in a gymnasium. His Glasgow Coma Score was 3, requiring orotracheal intubation. Two hours after admission, vital signs were blood pressure 259/107 mmHg and heart rate 140 beats/min. Treatment with furosemide, labetalol, clonidine, and urapidil and gastrointestinal decontamination were performed. Twelve hours later the patient was extubated with normal hemodynamic parameters and neurological examination. The yohimbine blood levels at 3, 6, 14, and 22 h after ingestion were 5,240; 2,250; 1,530; and 865 ng/mL, respectively, with a mean half-life of 2 h. Few data are available about yohimbine toxicity and the related blood levels. This is a case of a large ingestion of yohimbine in which severe hemodynamic and neurological manifestations occurred and elevated blood levels of yohimbine were detected.
Portillo, Javier; Del Coso, Juan; Abián-Vicén, Javier
2017-12-01
Portillo, J, Del Coso, J, and Abián-Vicén, J. Effects of caffeine ingestion on skill performance during an international female rugby sevens competition. J Strength Cond Res 31(12): 3351-3357, 2017-The aim of this study was to establish the effects of a caffeine-containing energy drink on skills and technical performance during a match in female elite rugby sevens players. On 2 nonconsecutive days of a friendly tournament, 16 women from the Spanish national rugby sevens team (mean age = 23 ± 2 years) ingested 3 mg of caffeine per kilogram of body mass in the form of an energy drink or the same drink without caffeine (placebo drink). After 60 minutes for caffeine absorption, participants played 3 rugby sevens matches against another national team. Body impacts during the matches were assessed by triaxial accelerometers. The matches were videotaped, and each individual technical action was notated afterward by 2 experienced observers. In comparison with the placebo drink, the ingestion of the caffeinated energy drink increased the rate of body impacts in zone 1 (16.1 ± 4.9 vs. 20.8 ± 9.9 impacts/min, p < 0.05), zone 2 (12.2 ± 10.6 vs. 16.2 ± 15.2 impacts/min, p < 0.05), zone 3 (3.8 ± 1.5 vs. 4.7 ± 2.6 impacts/min, p < 0.05), and zone 5 (0.8 ± 0.4 vs. 1.1 ± 0.6 impacts/min, p < 0.05). The pre-exercise ingestion of the caffeinated energy drink did not affect the frequency or the quality of any rugby-specific technical actions during the games. In conclusion, the ingestion of 3 mg·kg of caffeine in the form of an energy drink increased the number of body impacts during a rugby sevens international competition which suggests a higher engagement of the players during the game. However, the caffeine ingestion did not influence the quality of the technical actions performed during the competition.
Muirhead, J Fraser
2013-02-01
In 1792, a priest in Germany consulted a young doctor about a buried corneal foreign body hidden in a small, hard mass that partly covered the pupil. During removal of the foreign body, the doctor inspected the corneal incision with a microscope to confirm the suspected presence of the foreign body. This may be the first use of a microscope in eye surgery.
Techniques for Intravascular Foreign Body Retrieval
DOE Office of Scientific and Technical Information (OSTI.GOV)
Woodhouse, Joe B.; Uberoi, Raman, E-mail: raman.uberoi@orh.nhs.uk
2013-08-01
As endovascular therapies increase in frequency, the incidence of lost or embolized foreign bodies is increasing. The presence of an intravascular foreign body (IFB) is well recognized to have the potential to cause serious complications. IFB can embolize and impact critical sites such as the heart, with subsequent significant morbidity or mortality. Intravascular foreign bodies most commonly result from embolized central line fragments, but they can originate from many sources, both iatrogenic and noniatrogenic. The percutaneous approach in removing an IFB is widely perceived as the best way to retrieve endovascular foreign bodies. This minimally invasive approach has a highmore » success rate with a low associated morbidity, and it avoids the complications related to open surgical approaches. We examined the characteristics, causes, and incidence of endovascular embolizations and reviewed the various described techniques that have been used to facilitate subsequent explantation of such materials.« less
Corneal injury from a metallic foreign body: an occupational hazard.
Gumus, Koray; Karakucuk, Sarper; Mirza, Ertugrul
2007-09-01
To describe a patient with a corneal injury from a metallic foreign body caused by negligence, and to highlight the importance of measures that must be taken to prevent corneal injuries. A 21-year-old man experienced a foreign body sensation, pain, and redness in his left eye after he cut some iron material without using any eye protection. Slitlamp examination showed a thin, curled piece of iron material stuck into the cornea horizontally. The nasal part had penetrated the nasal tarsal conjunctiva below the upper lid. After removal of the foreign body, the cornea healed without scarring after a short follow-up. A corneal foreign body is a common cause of ocular morbidity and loss of working hours. Most workers do not use protective eyewear during work. By consistently wearing proper safety eyewear, which is the easiest and most effective preventive measure, loss of sight can easily be prevented after an eye injury.
The national cost burden of bronchial foreign body aspiration in children.
Kim, Irene A; Shapiro, Nina; Bhattacharyya, Neil
2015-05-01
Foreign body aspiration (FBA) continues to be a concerning pediatric problem, accounting for thousands of emergency room visits and more than 100 deaths each year in the United States. The costs incurred with hospitalizations and procedures following these events are the focus of this study. Retrospective review. The Nationwide Inpatient Sample from 2009 to 2011 was analyzed, and all cases with pediatric bronchial foreign body aspirations (International Classification of Diseases-9 codes: 934.0, 934.1, 934.8, and 934.9) were reviewed. Cases were analyzed to determine type of foreign body aspiration, procedural interventions performed, duration of inpatient stay, mortality rate, complications, and posthospitalization disposition. The median length of hospital stay and total costs associated with aspiration events were determined. An estimated 1,908 ± 273 pediatric bronchial FBA patients were admitted annually over the 3-year period (mean age, 3.6 ± 0.3 years; 61.3% ± 1.9% male). The ratio of foreign object aspiration to food aspiration was 5:3. Overall, 56%.0 ± 3.6% of the patients underwent a bronchoscopic procedure for foreign body removal; of those, 41.5% ± 2.5% had a foreign body removed at the time of the endoscopy. The hospital mortality rate associated with bronchial aspiration was 1.8% ± 0.4%; and 2.2% ± 0.5% of patients were diagnosed with anoxic brain injury. The median length of stay was 3 days (25th-75th interquartile range, 1-7 days).The median charges and actual costs per case were $20,820 ($10,800-$53,453) and $6,720 ($3,628-$16,723), respectively. The annual overall inpatient cost associated with pediatric bronchial foreign-body aspiration is approximately $12.8 million. Combined, the rate of death or anoxic brain injury associated with pediatric foreign body is approximately 4%. 2C. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.
Computed tomography diagnosis of a thoracic and abdominal penetrating foreign body in a dog
Appleby, Ryan; zur Linden, Alex; Singh, Ameet; Finck, Cyrielle; Crawford, Evan
2015-01-01
A 1.5-year-old, spayed female, mixed-breed dog was presented for hemoabdomen associated with an abdominal mass. Upon presentation bicavitary effusion was diagnosed. A penetrating intra-abdominal wooden foreign body was identified using computed tomography. This case describes a thoracic penetrating wooden foreign body causing bicavitary effusion following migration into the retroperitoneal space. PMID:26538669
Foreign body in the vagina of a four-year-old-girl: a childish prank or sexual abuse.
Sakhavar, Nahid; Teimoori, Batool; Ghasemi, Marzie
2014-06-01
Foreign body in the vagina is a common cause of vaginal discharge, which may be either purulent or hemorrhagic. This problem may produce symptoms or be asymptomatic for long periods of time and may result from ignorance, accident, malice, psychotic tendencies, attempts at sexual stimulation or sexual abuse. The current report presents the case of a girl that had inserted a foreign body in her vagina probably due to childish prank. The clinicians should always think of foreign bodies in the vagina in cases of chronic, antibiotic resistant vaginal discharge and lower abdominal pain especially in young girls.
A Rare Case of Foreign Body Causing Recurrent Vaginal Discharge in Prepubertal Child
Gobbur, Raghavendra.H.; Patil, Ashwini.G; Endigeri, Preetish
2015-01-01
Vaginal discharge in prepubertal children is mainly due to hypoestrogenic state of vaginal mucosa making it thin and alkaline leading to mucosal invasion by pathogen. In a paediatric case with persistent foul smelling , blood stained vaginal discharge not responding to medical therapy, vaginal foreign body should always be ruled out. Here, we report a 3 -year -old girl with complaint of recurrent vaginal discharge occasionally blood stained not relieved despite few antibiotics courses. On X -ray pelvis, a radioopaque foreign body hair clip was seen. Under sedation foreign body was removed by forceps following which child became asymptomatic. PMID:25738041
Deroy, C; Corcuff, J Benoit; Billen, F; Hamaide, A
2015-10-01
To compare complication rates and outcomes after removal of oesophageal foreign bodies by endoscopy or by oesophagotomy. Retrospective evaluation of medical records of dogs with oesophageal foreign bodies treated by endoscopy and/or oesophagotomy. Postoperative clinical signs, management, length of hospitalisation, type and rate of complications, and time interval to return to eating conventional diet were compared. Thirty-nine dogs diagnosed with oesophageal foreign bodies between 1999 and 2011 were included in the study. Most common breeds included West Highland white terrier, Jack Russell terrier and shih-tzu. Successful endoscopic removal was possible in 24 out of 32 cases (Group 1), while surgical removal was successful in 15 out of 15 cases (7 of which had unsuccessful attempts at endoscopic removal) (Group 2). Length of hospitalisation, time to removal of gastrostomy tube and time to eat conventional diet did not differ between the groups. After foreign body removal, the incidence of oesophagitis, oesophageal stricture and perforation observed during repeated endoscopy were similar between the groups. In this retrospective study, removal of oesophageal foreign bodies either by oesophagoscopy or oesophagotomy had a similar outcome. © 2015 British Small Animal Veterinary Association.
Endodontic management of an unusual foreign body in a maxillary central incisor.
Chand, Keerthi; Joesph, Sam; Varughese, Jolly Mary; Nair, Mali G; Prasanth, Santhosh
2013-09-01
The discovery of foreign bodies in the teeth is often diagnosed accidentally. It is commonly seen in children. These foreign objects may act as a potential source of infection and may later lead to a painful condition. Detailed case history, clinical and radiographic examinations are necessary to come to a conclusion about the nature, size, and location of the foreign body, and the difficulty involved in its retrieval. This paper discusses the types of foreign objects found in and around the teeth and reports an unusual case of a stapler pin in the root canal of a tooth, its retrieval, and associated management of the involved teeth.
Obr, Teresa D; Fry, Joanna K; Lee, Justine A; Hottinger, Heidi A
2017-09-01
To describe a case of necroulcerative gastritis in a cat secondary to administration of 3% hydrogen peroxide as an emetic agent. A 10-year-old neutered male domestic shorthair was evaluated for hematemesis less than 24 hours following ingestion of a piece of foam. The pet owner had administered 2 doses of 0.5-1.0 tablespoons (7.5-15 mL) of 3% hydrogen peroxide in an attempt to induce emesis at home; emesis was achieved and produced the foam foreign body. Due to the presence of protracted vomiting and hematemesis, the patient was then presented to an emergency facility for further diagnostics and treatment. Initial blood work was normal on presentation, and advanced imaging of the abdomen was performed. An exploratory laparotomy revealed no foreign material in the gastrointestinal tract; however, severe ulceration of approximately 60% of the gastric mucosa was observed around the cardia and extended from the fundus down through the body of the stomach to the lesser curvature. Due to the severity of ulceration and presumed poor prognosis, the patient was euthanized intraoperatively. Histopathology of the stomach wall was consistent with severe confluent necroulcerative and hemorrhagic pleocellular gastritis, presumed to be secondary to administration of 3% hydrogen peroxide, which was used as the primary emetic agent in this case. The oral administration of 3% hydrogen peroxide solution in cats can result in necroulcerative gastritis as a possible sequel. While hydrogen peroxide is considered a safe emetic agent in dogs, its use in cats is not recommended. As a result, the use of emetic agents in cats should be limited to veterinary administration, using alternative, safer emetic agents such as alpha-adrenergic agonists. © Veterinary Emergency and Critical Care Society 2017.
Oesophageal foreign bodies in dogs: factors affecting success of endoscopic retrieval.
Juvet, Florence; Pinilla, Manuel; Shiel, Robert E; Mooney, Carmel T
2010-03-01
Oesophageal foreign bodies are common in dogs. Endoscopic removal is a viable treatment option but few studies have assessed the clinical and radiographic features that would be useful in decision-making and prognosis.Dogs (n = 44) with oesophageal foreign bodies presented to the University Veterinary Hospital were assessed. Terriers and West Highland White Terriers were significantly overrepresented (p < 0.0001) and in those breeds the foreign body was significantly (p < 0.0001) more likely to be located caudal to the heart base. The majority (88.6%) of foreign bodies were bones or bone fragments.Group 1 (n = 30) included animals where endoscopic removal was successful and Group 2 (n = 14) animals where it was unsuccessful or not attempted because of evidence of oesophageal rupture. There was no statistically significant difference in age, sex, body weight, type, location and size of foreign body, recovery rate, short-term complications and long-term outcome between the two groups. Duration of signs prior to presentation and time to spontaneous oral feeding were significantly longer (p < 0.01 in each case) in Group 2 (five days and 120 hours, respectively) compared to Group 1 (2 days and 24 hours, respectively). Mortality was 11.1%. Long-term follow-up of 29 dogs suggested oesophageal stricture formation manageable by feeding alone in seven (24.1%) cases.Terriers appear predisposed to oesophageal foreign bodies. Success of endoscopic removal is adversely affected by duration of signs prior to presentation. Surgical removal negatively influences time to recovery. Stricture formation appears to be a relatively common complication and alternate measures for its prevention should be sought.
Oesophageal foreign bodies in dogs: factors affecting success of endoscopic retrieval
2010-01-01
Oesophageal foreign bodies are common in dogs. Endoscopic removal is a viable treatment option but few studies have assessed the clinical and radiographic features that would be useful in decision-making and prognosis. Dogs (n = 44) with oesophageal foreign bodies presented to the University Veterinary Hospital were assessed. Terriers and West Highland White Terriers were significantly overrepresented (p < 0.0001) and in those breeds the foreign body was significantly (p < 0.0001) more likely to be located caudal to the heart base. The majority (88.6%) of foreign bodies were bones or bone fragments. Group 1 (n = 30) included animals where endoscopic removal was successful and Group 2 (n = 14) animals where it was unsuccessful or not attempted because of evidence of oesophageal rupture. There was no statistically significant difference in age, sex, body weight, type, location and size of foreign body, recovery rate, short-term complications and long-term outcome between the two groups. Duration of signs prior to presentation and time to spontaneous oral feeding were significantly longer (p < 0.01 in each case) in Group 2 (five days and 120 hours, respectively) compared to Group 1 (2 days and 24 hours, respectively). Mortality was 11.1%. Long-term follow-up of 29 dogs suggested oesophageal stricture formation manageable by feeding alone in seven (24.1%) cases. Terriers appear predisposed to oesophageal foreign bodies. Success of endoscopic removal is adversely affected by duration of signs prior to presentation. Surgical removal negatively influences time to recovery. Stricture formation appears to be a relatively common complication and alternate measures for its prevention should be sought. PMID:21851744
Role of plasma fibronectin in the foreign body response to biomaterials.
Keselowsky, Benjamin G; Bridges, Amanda W; Burns, Kellie L; Tate, Ciara C; Babensee, Julia E; LaPlaca, Michelle C; García, Andrés J
2007-09-01
Host responses to biomaterials control the biological performance of implanted medical devices. Upon implantation, synthetic materials adsorb biomolecules, which trigger an inflammatory cascade comprising coagulation, leukocyte recruitment/adhesion, and foreign body reaction. The foreign body reaction and ensuing fibrous encapsulation severely limit the in vivo performance of numerous biomedical devices. While it is well established that plasma fibrinogen and secreted cytokines modulate leukocyte recruitment and maturation into foreign body giant cells, mediators of chronic inflammation and fibrous encapsulation of implanted biomaterials remain poorly understood. Using plasma fibronectin (pFN) conditional knock-out mice, we demonstrate that pFN modulates the foreign body response to polyethylene terephthalate disks implanted subcutaneously. Fibrous collagenous capsules were two-fold thicker in mice depleted of pFN compared to controls. In contrast, deletion of pFN did not alter acute leukocyte recruitment to the biomaterial, indicating that pFN modulates chronic fibrotic responses. The number of foreign body giant cells associated with the implant was three times higher in the absence of pFN while macrophage numbers were not different, suggesting that pFN regulates the formation of biomaterial-associated foreign body giant cells. Interestingly, cellular FN (cFN) was present in the capsules of both normal and pFN-depleted mice, suggesting that cFN could not compensate for the loss of pFN. These results implicate pFN in the host response to implanted materials and identify a potential target for therapeutic intervention to enhance the biological performance of biomedical devices.
Foreign bodies in a pediatric emergency department in South Africa.
Timmers, Maarten; Snoek, Kitty G; Gregori, Dario; Felix, Janine F; van Dijk, Monique; van As, Sebastian A B
2012-12-01
Foreign body-related pediatric trauma has a high incidence, but studies with large data sets are rare and typically stem from Western settings. The aim of this study was to identify characteristics of foreign body-related trauma in children treated at our trauma unit in South Africa. In this retrospective study, we analyzed all foreign body-related trauma admissions from 1991 to 2009. We collected detailed data including age, sex, type of foreign body, injury severity, and anatomical location of the foreign body. We analysed 8149 cases. Marginally more boys (54.9%) than girls were involved. The overall median age was 3 years (interquartile range, 2-6 years); 78.8% were younger than 7 years. The predominant anatomical sites were the respiratory tract and the gastrointestinal tract (39.1%); ears (23.9%); nose (19.4%); and extremities (8.8%). The commonest objects were coins (20.8 %), (parts of) jewelry (9.5%), and food (8.7%). Three quarters (74.5%) of patients presented between 1 and 2 hours after the injury (median, 1 hour). A total of 164 cases (2.0%) were marked as possible child abuse; 17 cases were filed as confirmed child abuse. Preventive parent education programs targeting foreign body-related injury should mainly focus on both sexes younger than 7 years. Parents should be taught to keep small objects out of reach of young children, especially coins, because these most often result in a trauma unit visit.
Foreign bodies in the urinary bladder and their management: a Pakistani experience.
Mannan, A; Anwar, S; Qayyum, A; Tasneem, R A
2011-01-01
This was a retrospective study conducted to assess the nature, presentation, mode of insertion, diagnosis and management of foreign bodies in the urinary bladder. Between January 1998 and December 2007, 20 patients with foreign bodies in their urinary bladder were treated at our centre. The records of these patients were reviewed and analysed for their symptoms, mode of insertion, diagnosis, management and complications. A total of 20 foreign bodies were recovered from the urinary bladders during the study period. These included JJ stents with calculi, intrauterine contraceptive devices with stones, a rubber stick, ribbon gauze, encrusted pieces of Foley catheter, proline thread with calculus, a suture needle, broken cold knives, the ceramic beak of a paediatric resectoscope, a knotted suprapubic tube, a hair clip, a nail, an electrical wire and a hairpin. The common presenting features were dysuria and haematuria. The diagnosis was established radiologically in most of the cases. The circumstances of insertion were variable; iatrogenic in 16 (80.0 percent) cases, sexual stimulation in two (10.0 percent), accidental insertion by a child in one (5.0 percent) and physical torture in one (5.0 percent). 17 (85.0 percent) foreign bodies were recovered endoscopically, and cystolithotomy was required in three (15.0 percent) patients. The instances of foreign bodies in the urinary bladder are uncommon. A diagnosis is usually made radiologically. Iatrogenic foreign bodies were found to be the most frequent type of insertion encountered. Endoscopic retrieval is usually successful, with minimal morbidity.
The effects of Fu Zi on changes in the body heat of dogs.
Chen, Tian-Tian; Qi, Chunhua; Guo, Huijun; Cheng, Ziqiang; Zhou, Dong; Liu, Haitao; Liu, Jianzhu
2009-03-01
The aim of the present study was to investigate the effects of Fu Zi on changes in the body heat of dogs. Twelve clinically healthy dogs were divided into two groups: the control group (six dogs) and the experimental group (six dogs). The control group was made to ingest normal saline mixed with canned meat, while the experimental group was made to ingest the Fu Zi solution mixed with canned meat. The infrared thermographic system was used to determine the level of body heat generated by these dogs. These areas include the dorsocranial (DCr), dorsocaudal (DCd), ventrocranial (VCr), and ventrocaudal (VCd) regions at pretreatment and were determined at 10, 20, 30, 50, 90, 120, 240, and 360 minutes after treatment for each of these areas. The results showed a tendency toward increased body heat until 30 minutes after ingestion of the Fu Zi powder mixed with canned meat. The significant differences in the changes of body heat were detected at 360 minutes in the DCd regions, 20 minutes in the VCr regions, and 30 minutes in the VCd regions between the experimental and control groups (p < 0.05). Based from our results, we find that Fu Zi can increase and maintain the dogs' body heat for at least 6 hours.
Ciullo, Dana L.
2015-01-01
Introduction Decades of research have suggested that nutritional intake contributes to the development of human disease, mainly by influencing the development of obesity and obesity-related conditions. A relatively large body of research indicates that functional variation in human taste perception can influence nutritional intake as well as body mass accumulation. However, there are a considerable number of studies that suggest that no link between these variables actually exists. These discrepancies in the literature likely result from the confounding influence of a variety of other, uncontrolled, factors that can influence ingestive behavior. Strategy In this review, the use of controlled animal experimentation to alleviate at least some of these issues related to the lack of control of experimental variables is discussed. Specific examples of the use of some of these techniques are examined. Discussion and conclusions The review will close with some specific suggestions aimed at strengthening the link between gustatory neural input and its putative influence on ingestive behaviors and the maintenance of body weight. PMID:26557212
Reticular foreign bodies. Causative or coincidence?
Farrow, C S
1999-07-01
A radiographically identified penetrating reticular foreign body is a near-certain cause of traumatic reticulitis, parareticular abscessation, or peritonitis. An extrareticular wire or nail is the most likely cause of reticulitis or peritonitis in an animal with compatible clinical signs. An immobile reticular foreign body may be trapped in the reticular mucosa, penetrating a mucosal fold (but not the reticular wall), or piercing the wall of the reticulum.
[Intrabronchial migratory cereal-ear, an unusual foreign body inhalation].
Douira-Khomsi, W; Merghni, A; Louati, H; Ben Hassine, L; Khemakhem, R; Ould Mohamed Sghair, Y; Jlidi, S; Hamzaoui, M; Chaouachi, B; Bellagha, I
2009-09-01
Bronchial foreign body inhalation is a frequent and potentially serious accident in children. It can provoke long-term complications such as bronchiectasis and recurrent pulmonary infections. The foreign body is generally blocked in a bronchus and induces obstructive emphysema with superinfection. We report 2 cases of bronchial inhalation of a migrating cereal-ear, eliminated by parietal fistulization, in 9- and 11-year-old boys.
Knife blade as a facial foreign body.
Gardner, P A; Righi, P; Shahbahrami, P B
1997-08-01
This case demonstrates the unpredictability of foreign bodies in the face. The retained knife blade eluded detection on two separate examinations. The essential components to making a correct diagnosis of a foreign body following a stabbing to the face include a thorough review of the mechanism of injury, a complete head and neck examination, a high index of suspicion, and plain radiographs of the face.
Ear, Nose and Throat Foreign Bodies Removed under General Anaesthesia: A Retrospective Study.
Shunyu, Neizekhotuo Brian; Akhtar, Hanifa; Karim, Habib Md Rezaul; Lyngdoh, Nari M; Yunus, Md; Jamil, Md
2017-02-01
For Otorhinolaryngologist, removal of Foreign Bodies (FB) from the ear, nose and throat is one of the common emergency procedures done. Most of the cases especially of the ear and nose can be managed without General Anaesthesia (GA). But in some cases GA may be needed. There are very few studies that address the scenario of ear, nose and throat foreign body that required GA for its removal and the complications associated with it. This study was conducted with the aim to study the patient's profile, types and distribution of FB removed under GA, and the associated complications. The present study is a hospital based retrospective, cross-sectional study conducted in the Department of Otorhinolaryngology in association with Department of Anaesthesiology and Critical Care in North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India from year 2009 to 2014. Information was collected from indoor patient file and operation record book. Those patients where foreign body was not found after examination under GA were excluded. A total of 112 cases of foreign body in ear, nose and throat removed under GA were selected. There was variation of age from youngest case being 11 months to 74 years with a slight male predominance. Two third of the patients belonged to paediatric age group. Most of the FB were inanimate with high number of inorganic type found in majority. Foreign body in food passage was found in most cases. Coin and meat bone were the common FB in children and adults respectively. We found no complications related to removal of foreign body from the food passage and nose. But some complications were seen in foreign body of ear and tracheo-bronchial tree. Ear, nose and throat FB that required GA were seen in all age groups. FB of food passage constitute the majority. Type of foreign body varies between children and adults. In children most common types were related to toys and their part and food materials. In adults, food materials were most common.
The Phagocytic Function of Macrophage-Enforcing Innate Immunity and Tissue Homeostasis.
Hirayama, Daisuke; Iida, Tomoya; Nakase, Hiroshi
2017-12-29
Macrophages are effector cells of the innate immune system that phagocytose bacteria and secrete both pro-inflammatory and antimicrobial mediators. In addition, macrophages play an important role in eliminating diseased and damaged cells through their programmed cell death. Generally, macrophages ingest and degrade dead cells, debris, tumor cells, and foreign materials. They promote homeostasis by responding to internal and external changes within the body, not only as phagocytes, but also through trophic, regulatory, and repair functions. Recent studies demonstrated that macrophages differentiate from hematopoietic stem cell-derived monocytes and embryonic yolk sac macrophages. The latter mainly give rise to tissue macrophages. Macrophages exist in all vertebrate tissues and have dual functions in host protection and tissue injury, which are maintained at a fine balance. Tissue macrophages have heterogeneous phenotypes in different tissue environments. In this review, we focused on the phagocytic function of macrophage-enforcing innate immunity and tissue homeostasis for a better understanding of the role of tissue macrophages in several pathological conditions.
Characterization of phagocytic hemocytes in Ornithodoros moubata (Acari: Ixodidae).
Inoue, N; Hanada, K; Tsuji, N; Igarashi, I; Nagasawa, H; Mikami, T; Fujisaki, K
2001-07-01
Effects of fetal bovine serum (FBS) and complement on phagocytic activity in Ornithodaros moubata (Murray 1877) hemocytes and protease activity in the hemocytes were examined. At least three morphologically different cell types, granulocytes, plasmatocytes, and prohemocytes, were detected in hemolymph of O. moubata, and granulocytes and plasmatocytes showed phagocytic activity. FBS altered phagocytic activity of granulocytes, and complement affected phagocytic activity of plasmatocytes. Ticks were inoculated with fluorescent polystyrene beads in combination with FBS or complement. The average number of beads in granulocytes was significantly higher in the FBS injected group than the control (P < 0.01). The percentage of bead-ingesting plasmatocytes in complement inoculated ticks was significantly lower than that in heat-inactivated complement inoculated and control ticks (P < 0.05). Proteases of tick hemocytes localized in small granules in the cytoplasm not only in phagocytic hemocytes but also in prohemocytes. Results suggested modulation of tick hemocyte function through serum components, and digestion of phagocytosed foreign bodies in the hemocytes.
Recurrent and acquired tracheoesophageal fistulae (TEF)-Minimally invasive management.
Nazir, Zafar; Khan, Muhammad Arif Mateen; Qamar, Javaria
2017-10-01
Recurrent and acquired fistulae are a serious complication of congenital esophageal atresia and tracheoesophageal fistula (TEF) repair and foreign body ingestion (FBI) (e.g., button battery). We report our experience with a minimally invasive approach to recurrent and acquired TEF. Medical records of patients referred for management of recurrent and acquired TEF between 2003 and 2015 were reviewed retrospectively. Patients underwent endoscopic procedures (de-epithelization of fistulous tract and fibrin tissue adhesive-Tisseel R ) under general anesthesia. Nine children (7 male, 2 female) with age range 3months to 3years (mean 1.5year) were managed. TEF closed spontaneously in four patients, whereas in 5 patients the TEF closed after combined endoscopic procedure. Three patients required repeat endoscopic procedures. Follow-up ranged between 7months to 10years (mean 4.2years). Active observation and repeat combined endoscopic procedures are safe alternatives to open surgical repair of acquired and recurrent TEF. Level IV study. Copyright © 2017 Elsevier Inc. All rights reserved.
Endodontic management of an unusual foreign body in a maxillary central incisor
Chand, Keerthi; Joesph, Sam; Varughese, Jolly Mary; Nair, Mali G; Prasanth, Santhosh
2013-01-01
The discovery of foreign bodies in the teeth is often diagnosed accidentally. It is commonly seen in children. These foreign objects may act as a potential source of infection and may later lead to a painful condition. Detailed case history, clinical and radiographic examinations are necessary to come to a conclusion about the nature, size, and location of the foreign body, and the difficulty involved in its retrieval. This paper discusses the types of foreign objects found in and around the teeth and reports an unusual case of a stapler pin in the root canal of a tooth, its retrieval, and associated management of the involved teeth. PMID:24082582
Foreign body aspiration in adult airways: therapeutic approach
Hewlett, Justin C.; Rickman, Otis B.; Lentz, Robert J.; Prakash, Udaya B.
2017-01-01
Tracheobronchial foreign body (FB) aspiration is an uncommon but potentially life-threatening event in adults. Symptoms typically consist of a choking event followed by cough and dyspnea, however, these findings are inconsistent and symptoms may mimic more chronic lung diseases such as asthma or chronic obstructive pulmonary disease. Chest radiography and computed tomography can provide information regarding the location and characteristics of foreign bodies and aid in diagnosis. Bronchoscopy remains the gold standard for diagnosis and management of FB aspiration. The authors describe the typical clinical presentation, diagnostic evaluation, and bronchoscopic management of foreign bodies in adult airways with a focus on bronchoscopic techniques and potential complications of FB extraction. PMID:29221325
Foreign Body in the Vagina of A Four-Year-Old-Girl: A Childish Prank or Sexual Abuse
Sakhavar, Nahid; Teimoori, Batool; Ghasemi, Marzie
2014-01-01
Introduction: Foreign body in the vagina is a common cause of vaginal discharge, which may be either purulent or hemorrhagic. Case Presentation: This problem may produce symptoms or be asymptomatic for long periods of time and may result from ignorance, accident, malice, psychotic tendencies, attempts at sexual stimulation or sexual abuse. The current report presents the case of a girl that had inserted a foreign body in her vagina probably due to childish prank. Conclusions: The clinicians should always think of foreign bodies in the vagina in cases of chronic, antibiotic resistant vaginal discharge and lower abdominal pain especially in young girls. PMID:25032156
Hearing aid silicone impression material as a foreign body in the middle ear.
Lee, Hyun-Min; Yi, Keun-Ik; Jung, Jae-Hoon; Lee, Il-Woo
We report an extremely rare case of hearing aid silicone impression material as a foreign body in the middle ear. Symptoms of the patient were otorrhea and vertigo after taking of a mold impression on his only hearing ear, and the symptoms mimicked chronic otitis media. A temporal bone CT scan revealed foreign body material in the middle ear and Eustachian tube. An intact canal wall mastoidectomy with a facial recess approach and type IV tympanoplasty was performed to remove the silicone impression material. In addition to the case report, we review the literature regarding impression material foreign bodies. Copyright © 2016 Elsevier Inc. All rights reserved.
Lavers, Jennifer L; Bond, Alexander L; Hutton, Ian
2014-04-01
To provide much needed quantitative data on the lethal and sublethal effects of plastic pollution on marine wildlife, we sampled breast feathers and stomach contents from Flesh-footed Shearwater (Puffinus carneipes) fledglings in eastern Australia. Birds with high levels of ingested plastic exhibited reduced body condition and increased contaminant load (p < 0.05). More than 60% of fledglings exceed international targets for plastic ingestion by seabirds, with 16% of fledglings failing these targets after a single feeding (range: 0.13-3.21 g of plastic/feeding). As top predators, seabirds are considered sentinels of the marine environment. The amount of plastic ingested and corresponding damage to Flesh-footed Shearwater fledglings is the highest reported for any marine vertebrate, suggesting the condition of the Australian marine environment is poor. These findings help explain the ongoing decline of this species and are worrying in light of increasing levels of plastic pollution in our oceans. Copyright © 2013 Elsevier Ltd. All rights reserved.
Intraorbital foreign body projectile as a consideration for unilateral pupillary defect
2012-01-01
Intraorbital foreign bodies are frequently the result of high-velocity injuries with varying clinical presentations. The resultant diagnosis, management, and outcome depend on the type of foreign body present, anatomical location, tissue disruption, and symptomatology. A patient who presented to the Emergency Department with a large intraorbital foreign body projectile that was not evident clinically, but found incidentally on computed tomography and subsequent plain films is reported. The emergency room physician needs to be aware of the differential diagnosis of a unilateral irregular pupil with or without visual acuity changes. The differential diagnosis for any trauma patient with an irregular pupil with significant visual loss must include intraorbital foreign body and associated injury to the optic nerve directly or via orbital compartment syndrome secondary to hemorrhage and/or edema. Patients with significantly decreased visual acuity may benefit from emergent surgical intervention. In patients with intact visual acuity, the patient must be monitored closely for any visual changes as this may require emergent surgical intervention. PMID:22390406
Foreign body aspiration in children: A study of children who lived or died following aspiration.
Mohammad, Maha; Saleem, Mohammad; Mahseeri, Mohamad; Alabdallat, Imad; Alomari, Ali; Za'atreh, Ala'; Qudaisat, Ibraheem; Shudifat, Abdulrahman; Nasri Alzoubi, Mohammad
2017-07-01
Foreign body aspiration (FBA) is a preventable cause of mortality and morbidity in children. We conducted a chart review of children who presented to a university hospital due to FBA in the period 1999-2014. Children were either managed with bronchoscopy for removal of the foreign body or died due to FBA. A total of 103 children were seen due to FBA including 27 deaths. The majority of children were boys and were less than 3 years old. Most aspirated foreign bodies were food-related, mainly peanuts. The majority of children presented with acute choking incidents, a smaller number presented with recurrent chest infections, and few children's choking incidents were unwitnessed. X-ray had a high rate of false negatives and bronchoscopy was the gold standard technique for assessment and management. Aspiration of foreign bodies is a preventable, life-threatening condition that calls for increased parent education and awareness. Copyright © 2017 Elsevier B.V. All rights reserved.
[Foreign bodies aspiration in pediatrics. 15-year experience. Analysis of 337 cases].
Aguirre Vázquez, I R; Blanco Rodríguez, G; Penchyna Grub, J; Teyssier Morales, G; Serrano Salas, A L
2013-01-01
Foreign body aspiration is a pediatric urgency that occurs primarily between 1 and 3 years old. The aim of this paper is to present the symptomatology, clinical and radiological findings, and the therapeutic used in our hospital with patients with foreign body aspiration diagnosis from 1995 until 2011. Patient's age was between 0 and 16 years old. We included 337 patients; where males predominate (205). The medium age was 23 months. The most frequent foreign bodies founded were seeds (192) in 57% and metallic objects in 18.3%. Cough (74.5%), dyspnea (70%), cyanosis (42.4%) and stridor (26%), were the main symptoms. Right bronchus was the most frequent localization (37.7%). In 21% of the patients the reference diagnostic was wrong due to treating it as a respiratory infection. All foreign bodies were extracted by rigid bronchoscopy. No deaths were reported in any proceeding. In our experience, infants are the most affected group, and the primordial symptoms are cough and dyspnea. Organic objects had the highest prevalence of aspiration.
Detecting Foreign Bodies in a Head Laceration
Fowler, Thomas R.; Crellin, Steven J.; Greenberg, Marna Rayl
2015-01-01
Open wounds represent a potential area of medicolegal risk if foreign bodies are not identified prior to wound closure. The importance of imaging of lacerations was underscored by a recent case where a 20-year-old male collided with a friend's mouth on a trampoline sustaining a simple, superficial scalp laceration. The wound was evaluated in typical fashion including irrigation and local exploration and was prepared for closure. The friend was then evaluated and noted to have multiple extensive dental fractures. An increased index of suspicion generated further evaluation of the first patient's wound. Plain radiography obtained of the first patient's skull was noted to have bony foreign bodies consistent with teeth, which were then removed after further exploration. Superficial wounds are common and complications arising from retained foreign bodies are a potential source of substantial morbidity and consequently medical litigation. This case serves as a reminder to be vigilant and maintain a high index of suspicion regarding the potential for foreign body. PMID:25802770
Detecting foreign bodies in a head laceration.
Fowler, Thomas R; Crellin, Steven J; Greenberg, Marna Rayl
2015-01-01
Open wounds represent a potential area of medicolegal risk if foreign bodies are not identified prior to wound closure. The importance of imaging of lacerations was underscored by a recent case where a 20-year-old male collided with a friend's mouth on a trampoline sustaining a simple, superficial scalp laceration. The wound was evaluated in typical fashion including irrigation and local exploration and was prepared for closure. The friend was then evaluated and noted to have multiple extensive dental fractures. An increased index of suspicion generated further evaluation of the first patient's wound. Plain radiography obtained of the first patient's skull was noted to have bony foreign bodies consistent with teeth, which were then removed after further exploration. Superficial wounds are common and complications arising from retained foreign bodies are a potential source of substantial morbidity and consequently medical litigation. This case serves as a reminder to be vigilant and maintain a high index of suspicion regarding the potential for foreign body.
Wang, Jincheng; Newman, Michael C
2013-04-01
Dietary Hg exposure was modeled for Carolina wren (Thryothorus ludovicianus), Eastern song sparrow (Melospiza melodia), and Eastern screech owl (Otus asio) nesting on the contaminated South River floodplain (Virginia, USA). Parameterization of Monte-Carlo models required formal expert elicitation to define bird body weight and feeding ecology characteristics because specific information was either unavailable in the published literature or too difficult to collect reliably by field survey. Mercury concentrations and weights for candidate food items were obtained directly by field survey. Simulations predicted the probability that an adult bird during breeding season would ingest specific amounts of Hg during daily foraging and the probability that the average Hg ingestion rate for the breeding season of an adult bird would exceed published rates reported to cause harm to other birds (>100 ng total Hg/g body weight per day). Despite the extensive floodplain contamination, the probabilities that these species' average ingestion rates exceeded the threshold value were all <0.01. Sensitivity analysis indicated that overall food ingestion rate was the most important factor determining projected Hg ingestion rates. Expert elicitation was useful in providing sufficiently reliable information for Monte-Carlo simulation. Copyright © 2013 SETAC.
Ingestion, inhalation, and dermal exposures to chloroform and trichloroethene from tap water.
Weisel, C P; Jo, W K
1996-01-01
Individuals are exposed to volatile compounds present in tap water by ingestion, inhalation, and dermal absorption. Traditional risk assessments for water often only consider ingestion exposure to toxic chemicals, even though showering has been shown to increase the body burden of certain chemicals due to inhalation exposure and dermal absorption. We collected and analyzed time-series samples of expired alveolar breath to evaluate changes in concentrations of volatile organic compounds being expired, which reflects the rate of change in the bloodstream due to expiration, metabolism, and absorption into tissues. Analysis of chloroform and trichloethene in expired breath, compounds regulated in water, was also used to determine uptake from tap water by each route (inhalation, ingestion, or absorption). Each route of exposure contributed to the total exposure of these compounds from daily water use. Further, the ingestion dose was completely metabolized before entering the bloodstream, whereas the dose from the other routes was dispersed throughout the body. Thus, differences in potential biologically effective doses depend on route, target organ, and whether the contaminant or metabolite is the biologically active agent. Images Figure 1. A Figure 1. B Figure 1. C Figure 2. A Figure 2. B PMID:8834861
Late sequelae of retained foreign bodies after world war II missile injuries.
Surov, Alexey; Thermann, Florian; Behrmann, Curd; Spielmann, Rolf-Peter; Kornhuber, Malte
2012-09-01
A number of people injured during the second world war harbour foreign bodies such as grenade splinters or bullets in some part of the body. Most of these metal fragments remain clinically silent. Some of them, however, may cause delayed complications. The purpose of this study was to determine the characteristics of delayed complications associated with foreign bodies after world war II injuries. 159 patients with retained foreign bodies after world war II injuries were retrospectively identified radiologically in our data bases in the time interval from 1997 to 2009. Diverse delayed complications secondary to the metal objects were diagnosed in 3 cases (2%): one patient with grenade splinter migration into the choledochal duct, one case with pseudotumoural tissue reaction, and one patient with late osteomyelitis. The time from injury to clinical presentation varied from 56 to 61 years. PubMed and Medline were screened for additional cases with delayed sequelae after foreign body acquisition during the 2nd world war. A 30 year search period from 1980 up to date was selected. 15 cases were identified here. Our study demonstrates that health consequences of the 2nd world war extend into the present time, and therefore physicians should be aware of the presence of hidden foreign bodies and their different possible late reactions. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.
Foreign body aspiration in dentistry: a review.
Cameron, S M; Whitlock, W L; Tabor, M S
1996-08-01
This article reviews the dangers of aspirating foreign bodies of dental origin. Two illustrative cases are presented, including an unusual case involving aspiration of an elastomeric impression material. The authors describe the techniques used to identify the foreign body. A radiodensimetric study of four impression materials demonstrates the difficulty of identifying most impression materials. The authors also present some strategies for reducing the risk of aspiration during dental procedures.
Foreign body aspiration in infants and toddlers: recent trends in British Columbia.
Morley, Rebecca E; Ludemann, Jeffrey P; Moxham, J Paul; Kozak, Frederick K; Riding, Keith H
2004-02-01
The objectives of this study were to (1) examine recent trends in the demographics and presentation of children with foreign body aspiration at British Columbia's Children's Hospital and (2) develop safety guidelines regarding feeding nuts and other hard, crunchy foods to infants and toddlers. The methods used were a retrospective chart review and a review of swallowing mechanics in early childhood. Between July 1997 and July 2001, 51 children under 3 years of age underwent rigid bronchoscopy for suspected foreign body aspiration. Of these patients, 27 (53%) were 18 months of age or younger. Of these 27 infants and toddlers, 24 (89%) had a witnessed choking event and 22 (81%) had an airway foreign body. Nuts, raw carrots, and popcorn kernels accounted for 14 (64%) of the foreign bodies aspirated by these infants and toddlers. Before 2 years of age, children are poorly equipped to grind and swallow hard, crunchy food because they lack second molars and are still adjusting to the descent of the larynx. Infants and toddlers in British Columbia have been aspirating foreign bodies at an alarmingly high rate. Most cases would have been prevented with better public awareness. Caregivers should be informed that children under 3 years of age should never be fed nuts or other hard, crunchy foods. A public awareness campaign is warranted.
Unusual presentation of cactus spines in the flank of an elderly man: a case report
2010-01-01
Introduction Splinters and spines of plant matter are common foreign bodies in skin wounds of the extremities, and often present embedded in the dermis or subcutaneous tissue. Vegetative foreign bodies are highly inflammatory and, if not completely removed, can cause infection, toxic reactions, or granuloma formation. Older patients are at increased risk for infection from untreated plant foreign bodies. The most common error in plant splinter and spine management is failure to detect their presence. Case presentation Here we report a case of cactus spines in an 84-year-old Caucasian man presenting on the right flank as multiple, red papules with spiny extensions. This presentation was unusual both in location and the spinous character of the lesions, and only after punch biopsy analysis was a diagnosis of cactus matter spines made. Conclusions Our patient presented with an unusual case of cactus spines that required histopathology for identification. Skin lesions with neglected foreign bodies are a common cause of malpractice claims. If not removed, foreign bodies of the skin, particularly in elderly individuals, can result in inflammatory and infectious sequela. This report underscores the importance of thoroughly evaluating penetrating skin lesions for the presence of foreign bodies, such as splinters and spines. PMID:20500838
Nasal Foreign Bodies: A Sweet Experiment.
Leopard, D C; Williams, R G
2015-10-01
It is generally accepted that paediatric intranasal foreign bodies should be removed in the emergency setting. In the case of a difficult to access dissolvable foreign body in an uncooperative child, the question must be raised regarding whether or not a watch and wait strategy is more appropriate. We ask: How long does it take for popular sweets (candy) to dissolve in the human nose? Five popular UK sweets were placed in the right nasal cavity of a 29-year-old male (the author) with no sino-nasal disease. Time taken to dissolve was recorded. All five sweets were completely dissolved in under one hour. A watch and wait strategy in favour of examination under anaesthetic may be a viable option in some cases. Limitations of the study include the age of the participant and size of the sweets. It is also important in practice that the clinician is able to elicit an accurate history regarding the exact nature of the foreign body. It remains prudent to perform an examination under anaesthetic of an uncooperative child with a solid or unknown nasal foreign body. However, if the clinician can be certain the foreign body is a small sugar or chocolate based sweet only, a watch and wait strategy may be a reasonable choice. © 2015 John Wiley & Sons Ltd.
[Foreign body aspiration in children: ten-years experience at the Ha'Emek Medical Center].
Shlizerman, Lev; Ashkenazi, Dror; Mazzawi, Salim; Rakover, Yosef
2006-08-01
Foreign body aspiration is common in young children. Delay in treatment may lead to complications and an emergency bronchoscopy must be performed in suspicious cases. Prevention is the most critical element needed to reduce this morbidity. To examine the demographic data of children at high risk of foreign body aspiration in order to develop precautionary measures oriented to this population. A retrospective review was prepared of all the charts of children under 16 years old who underwent bronchoscopy for suspected foreign body aspiration in Ha'Emek Medical Center during the period 1994-2004. The review presented a total of 136 children who had undergone bronchoscopy. Foreign bodies were found in 73% of the cases. Two thirds of the patients were male and two thirds were children less then two years old. The incidence of bronchoscopies that were positive for foreign bodies was higher in children less then two years old (82.6%) compared with older children (57.1%), p = 0.001. The incidence of Arab children was higher when compared to Jewish children and significantly higher than their percentage in the general child population (p = 0.001). The rate of bronchoscopies was 11 procedures per 100,000 children per year. In the majority of cases food was aspirated (82%) especially nuts and seeds. We found that children under the age of two years, male children and Arab children were at the highest risk of foreign body aspiration. Nuts and seeds are particularly dangerous and it is recommended to prevent young children from eating them. Well-defined public education programs should achieve prevention.
Urethral Foreign Bodies: Clinical Presentation and Management.
Palmer, Cristina J; Houlihan, Matthew; Psutka, Sarah P; Ellis, K Alexandria; Vidal, Patricia; Hollowell, Courtney M P
2016-11-01
To review a single institution's 15-year experience with urethral foreign bodies, including evaluation, clinical findings, and treatment. In total, 27 patients comprising 35 episodes of inserted urethral foreign bodies were reviewed at Cook County Hospital between 2000 and 2015. Retrospective chart review was performed to describe the clinical presentation, rationale for insertion, management, recidivism, and sequelae. Median patient age was 26 (range 12-60). Twenty-six patients (97 %) were male, 1 was female (3%). Items inserted included pieces of plastic forks, spoons, metal screws and aluminum, pieces of cardboard or paper, staples, writing utensils such as pens and pencils, as well as coaxial cable and spray foam sealant. Reported reasons for insertion were self-stimulation, erectile enhancement, and attention seeking. Presenting symptoms included dysuria, gross hematuria, urinary retention, urinary tract infection, and penile discharge. The most common technique for removal was manual extraction with extrinsic pressure (n = 19, 54%). Other methods include endoscopic retrieval (n = 8, 23%), open cystotomy (n = 1, 3%), and voiding to expel the foreign body (n = 7, 20%). Postremoval complications included urinary tract infection (n = 7), sepsis (n = 4), urethral false passage (n = 5), laceration (n = 5), and stricture (n = 1). We present the largest single-institutional series of urethral foreign bodies to date. Urethral foreign body insertion is a relatively rare occurrence and, commonly, is a recurrent behavior. Urethral trauma related to foreign body insertion is associated with significant risk of infection and urethral injury with long-term sequelae. Copyright © 2016 Elsevier Inc. All rights reserved.
Braun, U; Gansohr, B; Flückiger, M
2003-04-01
The goal of this study was to describe the findings in four cows with non-magnetic reticular foreign bodies composed of copper. The cows were referred to our clinic because of reduced appetite and a marked decrease in milk production. Based on the clinical findings, a tentative diagnosis of traumatic reticuloperitonitis was made in all cows. The reticulum of all cows was then examined ultrasonographically and radiographically. In all cows, radiographs of the reticulum showed wire-shaped foreign bodies, ranging from 3 to 7 cm in length, which appeared to have penetrated the reticular wall. Two cows (No. 3, 4) had a magnet in the reticulum close to the foreign body but there was no direct contact between the two. A magnet was administered to cows No. 1 and 2, and radiography of the reticulum was performed for a second time the following day. The magnets were observed in the reticulum; however, they did not contact the foreign bodies. Because all the magnets were correctly placed in the reticulum yet, despite close proximity, did not contact the foreign bodies, the latter were thought to be non-magnetic. Cow No. 1 was slaughtered. Left flank laparoruminotomy was performed in the remaining three cows. In all cows, copper foreign bodies ranging in length from 3.0 to 7.0 cm, were found in the reticulum. They had penetrated the reticular wall and were not attached to magnets. The radiographic findings described in the present study are strongly indicative of a non-magnetic foreign body. Ruminotomy is the treatment of choice but slaughter may also be considered.
Wooden Foreign Body in the Skull Base: How Did We Miss It?
Jusué-Torres, Ignacio; Burks, S Shelby; Levine, Corinna G; Bhatia, Rita G; Casiano, Roy; Bullock, Ross
2016-08-01
Timely detection of intraorbital and skull base wooden foreign bodies is crucial. Wooden foreign bodies are difficult to detect on imaging. The radiologist may fail to identify wooden foreign bodies on two thirds of initial scans and can miss them in almost one third of total cases. A 66-year-old woman sustained a penetrating injury through the left upper eyelid with a small tree branch. The branch was immediately removed in the field, and she was provided with prompt medical care at a local hospital. Initial computed tomography (CT) scan diagnosis was "posttraumatic sinusitis," and this was treated empirically with vancomycin and piperacillin/tazobactam. On the eighth day after injury, she developed progressive swelling and pain of her eyelid with left trigeminal/supraorbital numbness and complete left ophthalmoplegia. A new CT scan showed an open "track" from the region of the left upper orbit/superior rectus to the contralateral sphenoid sinus, which raised suspicion for a retained foreign body. Further imaging confirmed the suspicion. Endoscopic sinus surgery was performed with extraction of the wooden object and evacuation of the left orbital infection. This case indicates that intraorbital and skull base wooden foreign bodies are elusive, demanding a high index of suspicion from both clinicians and radiologists to identify retained material in the setting of ocular or sinus trauma. For better identification of wooden foreign bodies, bone windows on CT should have a width of -1000 Hounsfield units with a soft tissue window level of -500 Hounsfield units. Published by Elsevier Inc.
Non food foreign body injuries.
Slapak, Ivo; Passali, Francesco Maria; Gulati, Achal
2012-05-14
The aim of the present study is to acquire a better understanding of Non Food Foreign Bodies (NFFB) injuries in children with particular regard to the quantification of the risk of complications and hospitalization associated with patient characteristics, FB features, FB location and circumstances of the accident, as emerging from the SUSY Safe Web-Registry. The present study uses data provided by the SUSY Safe Project, a DG SANCO co-funded project which was aimed to collect as many scientific data as possible regarding Foreign Bodies (FB) injuries in children aged 0-14 years and to serve as a basis for a knowledge-based consumer protection activity in the Europe market. FBs were characterized by size, shape and consistency. Descriptive statistics (absolute and relative number or median, I and III quartile according to the categorical or continuous variable, respectively) were calculated for each considered non food item characteristics; FB features distribution by children class age and site of obstruction were assessed. Two different outcomes were considered: hospitalization and complication. FBs which most frequently cause complications were identified. The association between children age, adult presence, object characteristics and outcomes was computed using crude odds ratios and the related 95% confidence intervals. 16,878 FB injuries in children aged 0-14 yrs have been recorded in the Susy Safe databases. FB type was specified in 10,564 cases; among them 7820 (74%) were due to a non food item. Almost two thirds of injuries occurred in patients 3 years or more old. 53% of patients were males, while 47% were females. When injury happened, the great part of children (86%) was playing. Almost 30% (2339) of injuries happened under adults' supervision. Complications occurred in 299 cases and the most documented was infections (10% of cases) followed by perforation (5%). The inhalation/aspiration of a FB, as well as the ingestion and the insertion in the orifices of a FB may result in significant morbidity. Particularly, long-standing or hazardous foreign bodies can cause extensive damage. Some objects, because of their composition, contour, or location, are particularly hazardous: for instance, objects with sharp edges pose a significant risk of laceration and perforation, while fragments of toys have been found only in 2 cases. Parents are frequently unconscious of hazard related with some objects and they are not adequately able to promptly recognize dangerous objects and risky situations. Moreover, also clinicians seem to pay little attention to adult role in the dynamic of the accident: in fact in case series descriptions, data regarding adult presence are often under-reported. On the contrary, since many injuries to children cannot be prevented without some degree of active behavior on the part of parents, the dissemination of information regarding safe behaviors and the implementation of educational strategies aiming to improve parent's attention toward this issue could be fundamental in preventing injuries and need to be promoted by family pediatricians and health practitioners. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
[A morbidity study of intraocular foreign bodies].
Mocanu, C; Bădescu, S
1993-01-01
190 patients presenting intraocular foreign bodies, hospitalized between 1981-1991, are examined. The study of accidents: cases showed a clear prevalence of work accidents--127 cases (66.84%); 86 of these cases occurred in industry (45.26%), the rest of 41 occurred in agriculture (21.58%). The professions most exposed to such accidents are those of locksmith, mechanic in agriculture or automobile industry. The postsurgical evolution and the incidence of complications show that intraocular foreign bodies are wosse-making factors of ocular plagues, because of anatomical structures disorganization, transparency modifications and infectious complications implied, which determined the diminishing of visual acuity in 88.08% of cases. The big percentage of work accidents in the etiology of intraocular foreign bodies emphasize the great importance of foreign the work-protection rules (regarding a especially the wearing of protection glasses) and of introducing of automation in technological processes involving great risks.
Impalement of an unusual foreign body on the temporomandibular joint causing severe trismus.
Ito, Ryohei; Kubota, Kosei; Furudate, Ken; Nakagawa, Hiroshi; Kon, Takao; Tamura, Yoshihiro; Kobayashi, Wataru
2016-12-01
A penetrating injury by a foreign body is comparatively common in the oral and maxillofacial region. On the other hand, injury to the temporomandibular joint (TMJ) by a foreign object is very rare. The TMJ is an anatomically narrow space surrounded by hard bony processes. An unusual case of trauma with severe trismus caused by a foreign body that impaled the TMJ is reported. A 55-year-old man presented with a 5 × 1-cm laceration to the right cheek caused by a flying object propelled during the use of a lawn mower. The edge of the foreign body had a metallic wire, which became imbedded in the wound. His jaw opening was severely limited. Computed tomography revealed that the foreign body was 3 mm in diameter and was impaled on the articular capsule. The object was successfully removed, and the wound and interior of the TMJ were irrigated. Rehabilitation of mouth opening was started on postoperative day 3. On day 9, mouth opening had improved to 35 mm, and he was discharged. After 1 year, mouth opening was 45 mm with no sign of any TMJ disorders. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
van Vliet, Stephan; Shy, Evan L; Abou Sawan, Sidney; Beals, Joseph W; West, Daniel Wd; Skinner, Sarah K; Ulanov, Alexander V; Li, Zhong; Paluska, Scott A; Parsons, Carl M; Moore, Daniel R; Burd, Nicholas A
2017-12-01
Background: Protein in the diet is commonly ingested from whole foods that contain various macro- and micronutrients. However, the effect of consuming protein within its natural whole-food matrix on postprandial protein metabolism remains understudied in humans. Objective: We aimed to compare the whole-body and muscle protein metabolic responses after the consumption of whole eggs with egg whites during exercise recovery in young men. Design: In crossover trials, 10 resistance-trained men [aged 21 ± 1 y; 88 ± 3 kg; body fat: 16% ± 1% (means ± SEMs)] received primed continuous l-[ ring - 2 H 5 ]phenylalanine and l-[1- 13 C]leucine infusions and performed a single bout of resistance exercise. After exercise, participants consumed intrinsically l-[5,5,5- 2 H 3 ]leucine-labeled whole eggs (18 g protein, 17 g fat) or egg whites (18 g protein, 0 g fat). Repeated blood and muscle biopsy samples were collected to assess whole-body leucine kinetics, intramuscular signaling, and myofibrillar protein synthesis. Results: Plasma appearance rates of protein-derived leucine were more rapid after the consumption of egg whites than after whole eggs ( P = 0.01). Total plasma availability of leucine over the 300-min postprandial period was similar ( P = 0.75) between the ingestion of whole eggs (68% ± 1%) and egg whites (66% ± 2%), with no difference in whole-body net leucine balance ( P = 0.27). Both whole-egg and egg white conditions increased the phosphorylation of mammalian target of rapamycin complex 1, ribosomal protein S6 kinase 1, and eukaryotic translation initiation factor 4E-binding protein 1 during postexercise recovery (all P < 0.05). However, whole-egg ingestion increased the postexercise myofibrillar protein synthetic response to a greater extent than did the ingestion of egg whites ( P = 0.04). Conclusions: We show that the ingestion of whole eggs immediately after resistance exercise resulted in greater stimulation of myofibrillar protein synthesis than did the ingestion of egg whites, despite being matched for protein content in young men. Our data indicate that the ingestion of nutrient- and protein-dense foods differentially stimulates muscle anabolism compared with protein-dense foods. This trial was registered at clinicaltrials.gov as NCT03117127. © 2017 American Society for Nutrition.
Thermoregulatory effects of caffeine ingestion during rest and exercise in men
NASA Technical Reports Server (NTRS)
Dunagan, Nancy; Greenleaf, John E.; Cisar, Craig J.
1994-01-01
Body temperatures and thermoregulatory responses were measured at rest and during submaximal exercise under normal ambient conditions in 11 aerobically-conditioned men (age = 29.2 +/- 6.2 yr, VO2(max) = 3.73 +/- 0.46 min(sup -1), relative body fat = 12.3 +/- 3.7 percent, mean +/- SD) with (CT) and without (NCT) the ingestion of 10 mg of caffeine per kg of body weight. Oxygen uptake (VO2), heart rate (HR), and rectal (T(sub re)) and mean skin (T-bar(sub sk)) temperatures were recorded for 100 minutes starting one minute after ingestion of caffeine or a placebo. Data were collected throughout 30 minutes of rest (sitting) and the following 70 minutes of sitting leg ergometer exercise using the same constant load (1,088 +/- 153 kgm/min) in both NCT and CT. The load resulted in a mean relative exercise intensity equal to approximately 68 percent of VO2(sub max). Skin heat conductance (H(sub sk)) and sweat rate were calculated. Two-way analysis of covariance revealed no significant (P greater than 0.05) differences between NCT and CT in VO2, HR, T(sub re), T-bar(sub sk), or H(sub sk). A dependent t-test indicated no significant difference between NCT and CT in sweat rate. Thus, a high level of caffeine ingestion has no detrimental effects on body temperatures and thermoregulatory responses during moderately heavy exercise in normal ambient conditions.
Thermographic techniques and adapted algorithms for automatic detection of foreign bodies in food
NASA Astrophysics Data System (ADS)
Meinlschmidt, Peter; Maergner, Volker
2003-04-01
At the moment foreign substances in food are detected mainly by using mechanical and optical methods as well as ultrasonic technique and than they are removed from the further process. These techniques detect a large portion of the foreign substances due to their different mass (mechanical sieving), their different colour (optical method) and their different surface density (ultrasonic detection). Despite the numerous different methods a considerable portion of the foreign substances remain undetected. In order to recognise materials still undetected, a complementary detection method would be desirable removing the foreign substances not registered by the a.m. methods from the production process. In a project with 13 partner from the food industry, the Fraunhofer - Institut für Holzforschung (WKI) and the Technische Unsiversität are trying to adapt thermography for the detection of foreign bodies in the food industry. After the initial tests turned out to be very promising for the differentiation of food stuffs and foreign substances, more and detailed investigation were carried out to develop suitable algorithms for automatic detection of foreign bodies. In order to achieve -besides the mere visual detection of foreign substances- also an automatic detection under production conditions, numerous experiences in image processing and pattern recognition are exploited. Results for the detection of foreign bodies will be presented at the conference showing the different advantages and disadvantages of using grey - level, statistical and morphological image processing techniques.
Retrieval of bronchial foreign body with central lumen using a flexible bronchoscope.
Wong, Kin-Sun; Lai, Shen-Hao; Lien, Reyin; Hsia, Shao-Hsuan
2002-02-25
A 5 year-old boy aspirated a metal spring accidentally. The right bronchial foreign body was removed by threading the alligator of a biopsy forceps through the lumen of the spring while opening its jaws distally. This case illustrates that a foreign body with a central lumen in a child can be successfully removed using a flexible bronchoscope, thus obviating the need for general anesthesia and rigid bronchoscopy.
Fiber composite fan blade impact improvement program
NASA Technical Reports Server (NTRS)
Oller, T. L.
1976-01-01
The results of a 20-month program, designed to investigate parameters which effect the foreign object damage resulting from ingestion of birds into fan blades are described. Work performed on this program included the design, fabrication, and impact testing of QCSEE fan blades to demonstrate improvement in resistance relative to existing blades and also the design and demonstration of a pin root attachment concept.
McKenzie, Jennifer; Cooper Murphy, Megan; Broome, Cameron; Tayari, Hamaseh; Gutierrez-Quintana, Rodrigo
2017-07-20
A 4-year-old Border collie was presented with one episode of collapse, altered mentation, and a suspected pharyngeal stick injury. Magnetic resonance imaging (MRI) and computed tomography showed a linear foreign body penetrating the right oropharynx, through the foramen ovale and the brain parenchyma. The foreign body was surgically removed and medical treatment initiated. Complete resolution of clinical signs was noted at recheck 8 weeks later. Repeat MRI showed chronic secondary changes in the brain parenchyma. To the authors' knowledge, this is the first report of the advanced imaging findings and successful treatment of a penetrating oropharyngeal intracranial foreign body in a dog. © 2017 American College of Veterinary Radiology.
USDA-ARS?s Scientific Manuscript database
Ingestion of nanoparticles from products such as agricultural chemicals, processed food, and nutritional supplements is nearly unavoidable. The gastrointestinal tract serves as a critical interface and a barrier between the body and the external environment, and is the site of essential nutrient abs...
Implantable, Ingestible Electronic Thermometer
NASA Technical Reports Server (NTRS)
Kleinberg, Leonard
1987-01-01
Small quartz-crystal-controlled oscillator swallowed or surgically implanted provides continuous monitoring of patient's internal temperature. Receiver placed near patient measures oscillator frequency, and temperature inferred from previously determined variation of frequency with temperature. Frequency of crystal-controlled oscillator varies with temperature. Circuit made very small and implanted or ingested to measure internal body temperature.
Effect of Carbohydrate and Caffeine Ingestion on Badminton Performance.
Clarke, Neil D; Duncan, Michael J
2016-01-01
To investigate the effect of ingesting carbohydrate and caffeine solutions on measures that are central to success in badminton. Twelve male badminton players performed a badminton serve-accuracy test, coincidence-anticipation timing (CAT), and a choice reaction-time sprint test 60 min before exercise. Participants then consumed 7 mL/kg body mass of either water (PLA), 6.4% carbohydrate solution (CHO), a solution containing a caffeine dose of 4 mg/kg, or 6.4% carbohydrate and 4 mg/kg caffeine (C+C). All solutions were flavored with orange-flavored concentrate. During the 33-min fatigue protocol, participants were provided with an additional 3 mL/kg body mass of solution, which was ingested before the end of the protocol. As soon as the 33-min fatigue protocol was completed, all measures were recorded again. Short-serve accuracy was improved after the ingestion of CHO and C+C compared with PLA (P = .001, η(p)(2) = .50). Long-serve accuracy was improved after the ingestion of C+C compared with PLA (P < .001, η(p)(2) = .53). Absolute error in CAT demonstrated smaller deteriorations after the ingestion of C+C compared with PLA (P < .05; slow, η(p)(2) = .41; fast, η(p)(2) = .31). Choice reaction time improved in all trials with the exception of PLA, which demonstrated a reduction (P < .001, η(p)(2) = .85), although C+C was faster than all trials (P < .001, η(p)(2) = .76). These findings suggest that the ingestion of a caffeinated carbohydrate solution before and during a badminton match can maintain serve accuracy, anticipation timing, and sprinting actions around the court.
Shiraishi, Toshie; Kurosaki, Dai; Nakamura, Mitsuyo; Yazaki, Taiji; Kobinata, Satomi; Seki, Yosuke; Kasama, Kazunori; Taniguchi, Hideki
2017-04-01
Although preoperative fluid intake 2 hours before anesthesia is generally considered safe, there are concerns about delayed gastric emptying in obese subjects. In this study, the gastric fluid volume (GFV) change in morbidly obese subjects was investigated after ingesting an oral rehydration solution (ORS) and then compared with that in nonobese subjects. GFV change over time after the ingestion of 500 mL of ORS containing 2.5% carbohydrate (OS-1) was measured in 10 morbidly obese subjects (body mass index [BMI], >35) scheduled for bariatric surgery and 10 nonobese (BMI, 19-24) using magnetic resonance imaging. After 9 hours of fasting, magnetic resonance imaging scans were performed at preingestion, 0 min (just after ingestion), and every 30 minutes up to 120 minutes. GFV values were compared between morbidly obese and control groups and also between preingestion and postingestion time points. The morbidly obese group had a significantly higher body weight and BMI than the control group (mean body weight and BMI in morbidly obese, 129.6 kg and 46.3 kg/m, respectively; control, 59.5 kg and 21.6 kg/m, respectively). GFV was significantly higher in the morbidly obese subjects compared with the control group at preingestion (73 ± 30.8 mL vs 31 ± 19.9 mL, P = .001) and at 0 minutes after ingestion (561 ± 30.8 mL vs 486 ± 42.8 mL; P < .001). GFV declined rapidly in both groups and reached fasting baseline levels by 120 minutes (morbidly obese, 50 ± 29.5 mL; control, 30 ± 11.6 mL). A significant correlation was observed between preingestion residual GFV and body weight (r = .66; P = .001). Morbidly obese subjects have a higher residual gastric volume after 9 hours of fasting compared with subjects with a normal BMI. However, no differences were observed in gastric emptying after ORS ingestion in the 2 populations, and GFVs reached baseline within 2 hours after ORS ingestion. Further studies are required to confirm whether the preoperative fasting and fluid management that are recommended for nonobese patients could also be applied to morbidly obese patients.
Mahadevappa, Nagabhushana; Kochhar, Gaurav; Vilvapathy, Karthikeyan Senguttuvan; Dharwadkar, Sachin; Kumar, Sumit
2016-01-01
Objectives: To study retrospectively the frequency, demographic, phenomenological, and psychiatric profile in patients presented with self-insertion of foreign bodies in the lower genitourinary tract in our institute. Materials and Methods: From January 2009 to 2015, the records of patients admitted with self-insertion of foreign bodies into the lower urinary tract were analyzed retrospectively regarding demographic and phenomenological profile, the mode of presentation, diagnosis, management, complications, and possible contributing factors leading to the event. Results: Out of 17,978 inpatients, ten patients (0.055%) presented with foreign body insertion in the lower genitourinary tract in last 6 years. Mean age was 28.1 ± 13.9 (7–50) years. Objects used for insertion were varied from seeds, twigs to the electric wire. The contributing factors were lack of partner, misconception about masturbation, and underlying psychiatric illness. The presenting symptoms were pain and swelling of the penis, difficulty in voiding, and skin ulceration. The diagnosis was possible by simple observation in four patients, X-ray kidney, ureter, and bladder, and sonography of the pelvis in six patients. Five patients had endoscopic retrieval of foreign body, 2 had an open, suprapubic cystotomy, urethrotomy was needed in one patient, and forceps removal in two patients. There were no postoperative complications. Psychiatric profile was evaluated in nine patients. Conclusions: Foreign body insertion to lower urinary tract was rare. A main cause for insertion of foreign bodies was autoerotism, misconceptions regarding masturbation, and underlying psychiatric illness. In addition to suitable method of surgical removal, counseling and psychiatric evaluation are necessary to prevent recurrences or for early detection of psychiatric problems. PMID:27453657
Kumar, Manish; Mohanty, Ajeet Kumar; Sreenivasamurthy, Sreelakshmi K; Dey, Gourav; Advani, Jayshree; Pinto, Sneha M; Kumar, Ashwani; Prasad, Thottethodi Subrahmanya Keshava
2017-09-01
Malaria remains a grand challenge for disruptive innovation in global health therapeutics and diagnostics. Anopheles stephensi is one of the major vectors of malaria in Asia. Vector and transmission control are key focus areas in the fight against malaria, a field of postgenomics research where proteomics can play a substantive role. Moreover, to identify novel strategies to control the vector population, it is necessary to understand the vector life processes at a global and molecular scale. In this context, fat body is a vital organ required for vitellogenesis, vector immunity, vector physiology, and vector-parasite interaction. Given its central role in energy metabolism, vitellogenesis, and immune function, the proteome profile of the fat body and the impact of blood meal (BM) ingestion on the protein abundances of this vital organ have not been investigated so far. Therefore, using a proteomics approach, we identified the proteins expressed in the fat body of An. stephensi and their differential expression in response to BM ingestion. In all, we identified 3,218 proteins in the fat body using high-resolution mass spectrometry, of which 483 were found to be differentially expressed in response to the BM ingestion. Bioinformatics analysis of these proteins underscored their role in amino acid metabolism, vitellogenesis, lipid transport, signal peptide processing, mosquito immunity, and oxidation-reduction processes. Interestingly, we identified five novel genes, which were found to be differentially expressed upon BM ingestion. Proteins that exhibited altered expression in the present study are potential targets for vector control strategies and development of transmission blocking vaccines in the fight against malaria.
Campbell, Bill; Roberts, Mike; Kerksick, Chad; Wilborn, Colin; Marcello, Brandon; Taylor, Lem; Nassar, Erika; Leutholtz, Brian; Bowden, Rodney; Rasmussen, Chris; Greenwood, Mike; Kreider, Richard
2006-09-01
We evaluated the pharmacokinetics, safety, and efficacy of l-arginine alpha-ketoglutarate (AAKG) in trained adult men. Subjects participated in two studies that employed a randomized, double-blind, controlled design. In study 1, 10 healthy men (30-50 y old) fasted for 8 h and then ingested 4 g of time-released or non-timed-released AAKG. Blood samples were taken for 8 h after AAKG ingestion to assess the pharmacokinetic profile of L-arginine. After 1 wk the alternative supplement was ingested. In study 2, which was placebo controlled, 35 resistance-trained adult men (30-50 y old) were randomly assigned to ingest 4 g of AAKG (three times a day, i.e., 12 g daily, n = 20) or placebo (n = 15). Participants performed 4 d of periodized resistance training per week for 8 wk. At 0, 4, and 8 wk of supplementation the following tests were performed: clinical blood markers, one repetition maximum bench press, isokinetic quadriceps muscle endurance, anaerobic power, aerobic capacity, total body water, body composition, and psychometric parameters tests. Data were analyzed by repeated measures analysis of variance. In study 1, significant differences were observed in plasma arginine levels in subjects taking non-timed-release and timed-release AAKG. In study 2, significant differences were observed in the AAKG group (P < 0.05) for 1RM bench press, Wingate peak power, blood glucose, and plasma arginine. No significant differences were observed between groups in body composition, total body water, isokinetic quadriceps muscle endurance, or aerobic capacity. AAKG supplementation appeared to be safe and well tolerated, and positively influenced 1RM bench press and Wingate peak power performance. AAKG did not influence body composition or aerobic capacity.
Clinical Utility and Pitfalls of Ultrasound Guided Foreign Body Removal in War Fighters
2014-10-01
test with the removal of one wooden foreign body from a turkey breast that simulated the tissue of a human with documentation of procedural omissions...subjects practicing removal of both wooden and metal foreign bodies from a turkey breast while the trainers taught them ways to improve their...Part 2 was an educational efficacy research project. The physicians were trained with a turkey breast simulator. They were evaluated and measured on
Clinical Utility and Pitfalls of Ultrasound Guided Foreign Body Removal in War Fighters
2010-10-01
research project. The physicians are trained with a turkey breast simulator. They will be evaluated and measured on their performance and competency...The anatomical m aterials used were hum an cadaver thighs. To remain consistent, all foreign bodies were the same. A 1 cm piece of a wooden ...the subcutaneous fat and not the muscle which made locating the foreign body easier. The wooden toothpicks were colo red which the surgeon commented
Tracheo-bronchial foreign bodies: a retrospective study and review of literature.
Jaswal, Abhishek; Jana, Utpal; Maiti, Pradip Kumar
2014-01-01
Tracheobronchial foreign body aspiration is a common emergency in childhood constituting major cause of mortality. Although ample studies regarding airway foreign bodies are present in western literature, studies in Indian context are however lacking. The aim of the study is to present an epidemiological data regarding airway foreign bodies in Indian context thereby helping to analyze the situation with regard to our socio-economic condition. Retrospective file review of all case (n = 82) that underwent rigid bronchoscopy for suspected tracheo-bronchial foreign body over a period of 7 years (2001-2008) in the department of otolaryngology of a tertiary care centre of eastern India. Patient characteristics, history, clinical, radiographic and bronchoscopic findings were noted in an attempt to define the epidemiology, clinical presentation, management and associated morbidity. Most common age of presentation was between 1 and 3 years (56.4%). Most common symptom in our study was Cough, wheezing and respiratory distress (63.4%). Most common clinical signs at presentation were diminished breath sound in unilateral lung field seen in 36.6% cases. Most common radiological finding on chest radiograph was collapse seen in 41.65% cases. Most common type of foreign body below 3 years of age was food material (seeds, beans) removed in 48.78%. Complications were encountered in 14.6% cases of which most common complication was bronchospasm and acute respiratory distress seen in 41.6% cases.
Huang, Yan-Ming; Yan, Hua; Cai, Jin-Hong; Li, Hai-Bo
2017-01-01
To introduce a novel approach in removal of anterior chamber angle foreign body (ACFB) using a prism contact lens and 23-gauge foreign body forceps. Data of 42 eyes of 42 patients who had undergone removal of ACFB using a prism contact lens and 23-gauge foreign body forceps from January 2008 to October 2013 were collected and analyzed. Twenty eyes in group A received the conventional approach by using toothed forceps through corneal limbus incision, and 22 eyes in group B underwent the novel method through the opposite corneal limbus incision. The success rate of ACFB once removal was 75% (15/20) in group A, and 100% (22/22) in group B. The average operation time of group A was significantly longer compared with group B (34.9±9.88min vs 22.13±8.85min; P <0.05). The average size of corneal limbus incision in group A was significantly larger than that of group B (4.85±1.89 mm vs 3.95±1.17 mm; P <0.05). The corneal limbus incision suturing were conducted in all eyes in group A, and only 5 eyes in group B. Removal of ACFB using a prism contact lens and 23-gauge foreign body forceps is a safer, more effective, and convenient technique compared with the conventional approach.
Body Composition Changes Resulting from Fluid Ingestion and Dehydration
ERIC Educational Resources Information Center
Girandola, Robert N.
1977-01-01
It is recommended that when obtaining measures of body density by hydrostatic weighing, the subjects normal level of hydration be ascertained, since variance in body fat calculation from the hyperhydrated to the hydrated state can amount to twenty percent (two percent in actual body fat). (MB)
Aerodigestive tract foreign bodies in the older child and adolescent.
Lemberg, P S; Darrow, D H; Holinger, L D
1996-04-01
This study was undertaken in order to establish the incidence of aerodigestive tract foreign body accidents among older children and adolescents, and to investigate the circumstances surrounding these events. A review of patients treated over a 5-year period identified 367 children from whom aerodigestive tract foreign bodies were removed. Seventeen percent of these patients were 5 years of age or older. Among these children, 88% aspirated nonfood items, half of which were school supplies; 78% of the group 5 years old and under aspirated food items. Among older children with esophageal foreign bodies, 31% had food impactions, compared with 7% in the younger group; 70% of these children had a history of some anatomic abnormality of the esophagus. These data suggest that older children and adolescents represent a distinct group of patients at risk for foreign body accidents. Pediatricians and parents of children in this age group should discourage the practice of using the oral cavity as a repository for school supplies, and should stress the need for adequate preparation and mastication of food, particularly among children with esophageal abnormalities.
A Case of Retained Graphite Anterior Chamber Foreign Body Masquerading as Stromal Keratitis
Han, Eun Ryung; Wee, Won Ryang; Lee, Jin Hak
2011-01-01
We report a case of a retained graphite anterior chamber foreign body that was masquerading as stromal keratitis. A 28-year-old male visited with complaints of visual disturbance and hyperemia in his right eye for four weeks. On initial examination, he presented with a stromal edema involving the inferior half of the cornea, epithelial microcysts, and moderate chamber inflammation. Suspecting herpetic stromal keratitis, he was treated with anti-viral and anti-inflammatory agents. One month after the initial visit, anterior chamber inflammation was improved and his visual acuity recovered to 20/20, but subtle corneal edema still remained. On tapering the medication, after three months, a foreign body was incidentally identified in the inferior chamber angle and was surgically removed resulting in complete resolution of corneal edema. The removed foreign body was a fragment of graphite and he subsequently disclosed a trauma with mechanical pencil 12 years earlier. This case showed that the presence of an anterior chamber foreign body should always be considered in the differential diagnosis of idiopathic localized corneal edema. PMID:21461226
Metallic foreign body in the sphenoid sinus after ballistic injury: a case report.
Akhaddar, A; Abouchadi, A; Jidal, M; Gazzaz, M; Elmostarchid, B; Naama, O; Rzin, A; Boucetta, M
2008-05-01
Paranasal sinus injuries by foreign bodies have a lower incidence compared with facial injuries. Among them, penetrating maxillofacial injuries to the sphenoid sinus and skull base remain rare. We report the case of a 41-year-old man who presented with, after a missile-related maxillofacial injury, a metallic foreign body enclosed within the sphenoid sinus with carotid-canal fracture. Angiographic evaluation showed a mass in the right internal carotid artery. The foreign object was successfully extracted through a transmaxillary sublabial approach with a good outcome. We discuss the extensive preoperative evaluation and interdisciplinary management of this unusual injury.
Shigemura, Yasutaka; Kubomura, Daiki; Sato, Yoshio; Sato, Kenji
2014-09-15
The presence of hydroxyproline (Hyp)-containing peptides in human blood after collagen hydrolysate ingestion is believed to exert beneficial effects on human health. To estimate the effective beneficial dose of these peptides, we examined the relationship between ingested dose and food-derived Hyp levels in human plasma. Healthy volunteers (n=4) ingested 30.8, 153.8 and 384.6 mg per kg body weight of collagen hydrolysate. The average plasma concentration of Hyp-containing peptides was dose-dependent, reaching maximum levels of 6.43, 20.17 and 32.84 nmol/ml following ingestion of 30.8, 153.8 and 384.6-mg doses of collagen hydrolysate, respectively. Ingesting over 153.8 mg of collagen hydrolysate significantly increased the average concentrations of the free and peptide forms of Hyp in plasma. The Hyp absorption limit was not reached with ingestion of as much as 384.6 mg of collagen hydrolysate. These finding suggest that ingestion of less than 30.8 mg of collagen hydrolysate is not effective for health benefits. Copyright © 2014 Elsevier Ltd. All rights reserved.
Avery-Gomm, Stephanie; Valliant, Michelle; Schacter, Carley R; Robbins, Katherine F; Liboiron, Max; Daoust, Pierre-Yves; Rios, Lorena M; Jones, Ian L
2016-12-15
Quantification of plastic ingestion across a range of seabirds is required to assess the prevalence of plastics in marine food webs. We quantified plastic ingestion in beached Dovekies (Alle alle), following a wreck in Newfoundland, Canada. Of 171 birds, 30.4% had ingested plastic (mean 0.81±0.30 SE pieces per bird, mass 0.005±0.002 SE g per bird). Most plastics were fragments of polyethylene and polypropylene. Surprisingly, 37% were burned or melted, indicating a previously unreported source of ingested plastics (incinerated waste). We found no relationship between plastic ingestion and age, sex or body condition. By comparing our results with a similar nearby study, we illustrate the need for researchers to adopt standardized methods for plastic ingestion studies. We underline the importance of using histological techniques to reliably identify gastric pathologies, and advise caution when inferring population level trends in plastic ingestion from studies of emaciated, wrecked birds. Copyright © 2016 Elsevier Ltd. All rights reserved.
Pulse granuloma as a complication following dental trauma in children.
Padmanabhan, Makkada Yuvaraj; Aparna, Radhakrishnan; Karthikeyani, Shanmugasundaram; Dinakar, Jayakumar; Manickaraj, Menaka
2013-01-01
Contamination and subsequent retention of foreign bodies within wound surfaces may negatively influence healing following maxillofacial injuries. Larger foreign bodies that produce embedded or impalement injuries of soft tissues are easily detected. However, smaller contaminants, such as sand, gravel, food particles, wood splinters, and glass fibers, may not be easily identified in the initial examination, and their remnants may remain within the injury site even after debridement. Tissue reactions depend on the host response, type of foreign body, and nature of the wound surface. The purposes of this report are to: (1) detail the diagnosis and management of a peripheral pulse granuloma following retention of food particles within gingival sulci during a dental injury; and (2) provide a brief review of the diagnosis of foreign body-induced granulomas following maxillofacial injuries in children.
Cranial injury caused by penetrating non-missile foreign body: an autopsy case.
Eren, B; Türkmen, N; Toprak Ergönen, A; Gündogmus, U N
2012-10-01
Presented case was 32-year-old male marble worker, who underwent industrial accident at workplace. On gross physical examination; on forehead region round skin wound in 0.9 cm diameter was detected, radiological examination showed the image of metallic object. in the skull cavity. Brain dissection showed obvious brain injury, haemorrahge explaining the pattern of injury caused by the metallic bodys path, from left frontal lobe to the left cerebellar hemisphere was identified. We presented rare case of penetrating injury of the cranial region caused by non-missile foreign body. cranial injury - non-missile foreign body - autopsy.
Lim, C B B; Goldin, R D; Darzi, A; Hanna, G B
2008-08-01
Staples are made of titanium, which elicits minimal tissue reaction. The authors have encountered foreign body reaction associated with stapled human gastrointestinal anastomoses, although the literature has no reports of this. The aim of this study was to identify the refractile foreign materials causing this reaction. Histological sections were taken from 14 gastrointestinal specimens from patients with a history of a stapled anastomosis within the specimen excised. These were reviewed by light and polarization microscopy. Scanning electron microscopy and energy dispersive X-ray analysis were carried out on these sections, staples and stapler cartridges used for gastrointestinal surgery. Foreign bodies rich in fluorine were found in three patients, and those rich in carbon in 12. Other elements identified included oxygen, calcium, sodium, potassium, magnesium, aluminium and silicon. One specimen was found to contain titanium with no surrounding foreign body reaction. Stapler cartridges contained carbon, oxygen, fluorine, calcium, sodium, potassium, magnesium, aluminium, silicon and traces of titanium. Staples were composed of pure titanium with some fibrous material on the surface containing elements found in stapler cartridges. The presence of foreign body reaction was confirmed in stapled human gastrointestinal anastomoses. The source of refractile materials eliciting this reaction was the stapler cartridges. (c) 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Foreign bodies in the aerodigestive tract.
Lawson, V G; Middleton, W G
1986-04-01
Foreign bodies in the aerodigestive tract are common. They may cause minimal disturbance of function, severe morbidity or even sudden death. They enter the aerodigestive tract because of haste during eating, disturbances in physical function, impairments due to extreme youth or age, or contamination of food with foreign bodies. Common symptoms are pain, dysphagia, odynophagia, cough, airway distress, hemoptysis and hematemesis. Signs include point tenderness, respiratory distress and surgical emphysema. Clinical, radiological and endoscopic investigations are described, as are principles of crisis and elective management.
Clinical Utility and Pitfalls of Ultrasound Guided Foreign Body Removal in War Fighters
2009-10-28
with a turkey breast simulator. They will be evaluated and measured on their performance and competency development with USFBR. Part 3 is a clinical...The anatom ical m aterials used were hum an cadaver thighs. To rem ain consistent, all foreign bodies were the sam e. A 1 cm piece of a wooden ...uscle which m ade locating the foreign body easier. The wooden toothpicks were colored which the surgeon com mented helped when searching for the
McLemore, Jerri; Hallengren, Aaron L
2010-01-01
The authors present a case of a deceased man with numerous subcutaneous nodules identified as foreign bodies on radiographic films. The foreign bodies were gemstones inserted underneath the skin as a form of holistic medicine. The X-ray findings of this case and a review of the literature for similar subcutaneously implanted foreign bodies used in holistic, alternative, or folk medicine are presented. Copyright 2010 Elsevier Inc. All rights reserved.
An unexpected cause of vaginal bleeding: the role of pelvic radiography.
Kyrgios, Ioannis; Emmanouilidou, Eleftheria; Theodoridis, Theodoros; Galli-Tsinopoulou, Assimina
2014-02-14
Vaginal bleeding and/or discharge in young girls may result from infection, urological problems, endocrine causes, bleeding disorders, dermatological conditions, trauma, sexual abuse, masses or foreign bodies. We report a case of excessive vaginal bleeding caused by a foreign body in a prepubertal girl with emphasis on the diagnostic challenges and pitfalls regarding imaging techniques. In our patient, although invasive and expensive investigations had been initially made, the foreign body was last detected only when a plain pelvic radiography was performed.
Kuzaka, Bolesław; Kobryń, Andrzej; Niemierko, Maciej; Czaplicki, Maciej
2009-01-01
Authors have reported a case report of life threatening complications due to insertion of foreign bodies into the vagina, because of masturbation purpose. In this case subsequently came to perforation of the urinary bladder by the huge calculus that developed over the foreign body, and next to the peritoneum with development peritonitis and acute renal insufficiency with the need of dialysotherapy. After a number of surgical operations, the patient with a definitive percutaneous nephrostomy was discharged.
Multimodality imaging of foreign bodies of the musculoskeletal system.
Jarraya, Mohamed; Hayashi, Daichi; de Villiers, Richard V; Roemer, Frank W; Murakami, Akira M; Cossi, Alda; Guermazi, Ali
2014-07-01
The purpose of this article is to clarify the most relevant points in managing suspected foreign bodies of the musculoskeletal system on the basis of a literature review and published reports with cases to illustrate each type on different imaging modalities. Foreign bodies of the musculoskeletal system are a common problem in emergency departments, with more than a third missed in the initial clinical evaluation. These retained objects may result in various complications and also offer fertile ground for litigation.
Ingestible Thermometer Pill Aids Athletes in Beating the Heat
NASA Technical Reports Server (NTRS)
2006-01-01
Developed by Goddard Space Flight Center and the Johns Hopkins University Applied Physics Laboratory to monitor the core body temperature of astronauts during space flight, the ingestible "thermometer pill" has a silicone-coated exterior, with a microbattery, a quartz crystal temperature sensor, a space-aged telemetry system, and microminiaturized circuitry on the interior.
Vlietstra, Lucy S; Parga, Joyce A
2002-09-01
We report the current (1997-1999, 2001) incidence and amount of ingested plastic in short-tailed shearwaters (Puffinus tenuirostris) in the southeastern Bering Sea and compare our results with plastic reported in shearwaters during 1970-1978. We also examine correlations between plastic loads and shearwater body mass. We found that 84% (N = 330) of shearwaters sampled in 1997-1999 and 2001 contained plastic. The incidence and amount of ingested plastic have not significantly changed since the 1970s. In contrast, the predominant type of plastic has changed over time, from industrial plastic to user plastic. S,asonal patterns in the incidence and amount of ingested plastic also changed from peak levels during early and late summer in the 1970s to mid summer in the late 1990s and 2001. We suggest that the availability of neuston plastic to seabirds in the Bering Sea has undergone a shift in composition since the 1970s. Shearwater body mass appears little if at all impaired by plastic, at least at present levels of consumption.
Evidence of viscerally‐mediated cold‐defence thermoeffector responses in man
Morris, Nathan B.; Filingeri, Davide; Halaki, Mark
2016-01-01
Key points Visceral thermoreceptors that modify thermoregulatory responses are widely accepted in animal but not human thermoregulation models.Recently, we have provided evidence of viscerally‐mediated sweating alterations in humans during exercise brought about by warm and cool fluid ingestion.In the present study, we characterize the modification of shivering and whole‐body thermal sensation during cold stress following the administration of a graded thermal stimuli delivered to the stomach via fluid ingestion at 52, 37, 22 and 7°C.Despite no differences in core and skin temperature, fluid ingestion at 52°C rapidly decreased shivering and sensations of cold compared to 37°C, whereas fluid ingestion at 22 and 7°C led to equivalent increases in these responses.Warm and cold fluid ingestion independently modifies cold defence thermoeffector responses, supporting the presence of visceral thermoreceptors in humans. However, the cold‐defence thermoeffector response patterns differed from previously identified hot‐defence thermoeffectors. Abstract Sudomotor activity is modified by both warm and cold fluid ingestion during heat stress, independently of differences in core and skin temperatures, suggesting independent viscerally‐mediated modification of thermoeffectors. The present study aimed to determine whether visceral thermoreceptors modify shivering responses to cold stress. Ten males (mean ± SD: age 27 ± 5 years; height 1.73 ± 0.06 m, weight 78.4 ± 10.7 kg) underwent whole‐body cooling via a water perfusion suit at 5°C, on four occasions, to induce a steady‐state shivering response, at which point two aliquots of 1.5 ml kg–1 (SML) and 3.0 ml kg–1 (LRG), separated by 20 min, of water at 7, 22, 37 or 52°C were ingested. Rectal, mean skin and mean body temperature (T b), electromyographic activity (EMG), metabolic rate (M) and whole‐body thermal sensation on a visual analogue scale (WBTS) ranging from 0 mm (very cold) to 200 mm (very hot) were all measured throughout. T b was not different between all fluid temperatures following SML fluid ingestion (7°C: 35.7 ± 0.5°C; 22°C: 35.6 ± 0.5°C; 37°C: 35.5 ± 0.4°C; 52°C: 35.5 ± 0.4°C; P = 0.27) or LRG fluid ingestion (7°C: 35.3 ± 0.6°C; 22°C: 35.3 ± 0.5°C; 37°C: 35.2 ± 0.5°C; 52°C: 35.3 ± 0.5°C; P = 0.99). With SML fluid ingestion, greater metabolic rates and cooler thermal sensations were observed with ingestion at 7°C (M: 179 ± 55 W, WBTS: 29 ± 21 mm) compared to 52°C (M: 164 ± 34 W, WBTS: 51 ± 28 mm; all P < 0.05). With LRG ingestion, compared to shivering and thermal sensations with ingestion at 37°C (M: 215 ± 47 W, EMG: 3.9 ± 2.5% MVC, WBTS: 33 ± 2 mm), values were different (all P < 0.05) following ingestion at 7°C (M: 269 ± 77 W, EMG: 5.5 ± 0.9% MVC, WBTS: 14 ± 12 mm), 22°C (M: 270 ± 86 W, EMG: 5.6 ± 1.0% MVC, WBTS: 18 ± 19 mm) and 52°C (M: 179 ± 34 W, EMG: 3.3 ± 2.1% MVC, WBTS: 53 ± 28 mm). In conclusion, fluid ingestion at 52°C decreased shivering and the sensation of coolness, whereas fluid ingestion at 22 and 7°C increased shivering and sensations of coolness to similar levels, independently of core and skin temperature. PMID:27929204
Ice Slurry Ingestion Leads to a Lower Net Heat Loss during Exercise in the Heat.
Morris, Nathan B; Coombs, Geoff; Jay, Ollie
2016-01-01
To compare the reductions in evaporative heat loss from the skin (Esk) to internal heat loss (Hfluid) induced by ice slurry (ICE) ingestion relative to 37 °C fluid and the accompanying body temperature and local thermoeffector responses during exercise in warm, dry conditions (33.5 °C ± 1.4 °C; 23.7% ± 2.6% relative humidity [RH]). Nine men cycled at approximately 55% VO2peak for 75 min and ingested 3.2 mL · kg(-1) aliquots of 37 °C fluid or ICE after 15, 30, and 45 min of exercise. Metabolic heat production (M-W), rectal temperature (Tre), mean skin temperature (Tsk), whole-body sweat loss (WBSL), local sweat rate (LSR), and skin blood flow (SkBF) were measured throughout. Net heat loss (HLnet) and heat storage (S) were estimated using partitional calorimetry. Relative to the 37 °C trial, M-W was similar (P = 0.81) with ICE ingestion; however, the 200 ± 20 kJ greater Hfluid (P < 0.001) with ICE ingestion was overcompensated by a 381 ± 199-kJ lower Esk (P < 0.001). Net heat loss (HLnet) was consequently 131 ± 120 kJ lower (P = 0.01) and S was greater (P = 0.05) with ICE ingestion compared with 37 °C fluid ingestion. Concurrently, LSR and WBSL were lower by 0.16 ± 0.14 mg · min(-1) · cm(-2) (P < 0.01) and 191 ± 122 g (P < 0.001), respectively, and SkBF tended to be lower (P = 0.06) by 5.4%maxAU ± 13.4%maxAU in the ICE trial. Changes in Tre and Tsk were similar throughout exercise with ICE compared to 37 °C fluid ingestion. Relative to 37 °C, ICE ingestion caused disproportionately greater reductions in Esk relative to Hfluid, resulting in a lower HLnet and greater S. Mechanistically, LSR and possibly SkBF were suppressed independently of Tre or Tsk, reaffirming the concept of human abdominal thermoreception. From a heat balance perspective, recommendations for ICE ingestion during exercise in warm, dry conditions should be reconsidered.
The effect of a water load on cutaneous water loss in man
Allen, Judith A.; Roddie, I. C.
1973-01-01
1. Ingestion of 1 l. water at 37° C had no effect on the rate of water loss from forearm and hand skin although ingestion of a similar volume at 16° C significantly decreased the rate. 2. Ingestion of 1 l. water at 37° C had no physiologically significant effect on the expiratory minute volume. 3. Ingestion of 500 ml. water at 37° C caused small increases in total body weight loss in environmental temperatures of 29 and 40° C. 4. It is concluded that neither cutaneous nor respiratory water loss play an important part in the excretion of a water load in man. PMID:4766216
Salp distribution and grazing in a saline intrusion off NW Spain
NASA Astrophysics Data System (ADS)
Huskin, Iñaki; Elices, Ma. José; Anadón, Ricardo
2003-07-01
Salp distribution and grazing were studied along three transects (19 stations) and a Lagrangian phase (7 stations) off Galician coast (NW Spain) in November 1999 during GIGOVI 99 cruise. A poleward saline intrusion was detected at the shelf-break, reaching salinity values above 35.90 u.p.s. at 100-m depth. The salp community was dominated by Salpa fusiformis, although Cyclosalpa bakeri, Thalia democratica and Iasis zonaria were also found in the study area. Total salp abundance ranged from 4 to 4500 ind m -2, representing biomass values between 0.2 and 2750 mg C m -2. Maximum densities were located in the frontal area separating the saline body from coastal waters. S. fusiformis pigment ingestion was estimated using the gut fluorescence method. Gut contents were linearly related to salp body size. Total pigment ingestion ranged from 0.001 to 15 mg Chl- a m -2 d -1, with maximum values at the coastal edge of the saline body. Estimated ingestion translates into an average daily grazing impact of 7% of chlorophyll standing stock, ranging from <1% to 77%.
Alopecia with foreign body granulomas induced by Radiesse injection: A case report.
Liu, Ren-Feng; Kuo, Tseng-Tong; Chao, Yen-Yu; Huang, Yu-Huei
2018-02-26
Radiesse is a soft tissue filler which has been widely used for cosmetic enhancement. The safety of Radiesse has been thoroughly investigated via numerous studies. A late-onset complication of Radiesse injection consists of foreign body granulomas, with only three case reports in over 10 years of clinical use. Herein, we describe the case of a patient who experienced alopecia with foreign body granulomas at the injection region one month after receiving a Radiesse injection. To our knowledge, this is the first report in the English literature of alopecia as an adverse event associated with Radiesse injection. The present case reminded physicians to evaluate more cautiously the necessity of injecting filler into hair-bearing area for lifting purpose. This procedure may cause foreign body granulomatous reaction, which may result in hair loss at the injection region.
Foreign body granuloma of the penis caused by occupational glass fibre exposure.
Hinnen, U; Elsner, P; Barraud, M; Burg, G
1997-01-01
We report a patient who presented with the suspected diagnosis of syphilis. Clinical findings included a penile ulcer, positive history of syphilis more than 20 years ago, and positive syphilis serology (TPHA, FTA-Abs). A biopsy showed a plasma-cell rich inflammation with granuloma formation. Since a birefractory structure was observed in the biopsy possibly corresponding to a foreign body, the patient's occupational exposure was investigated. Working in the fiber reinforced plastics industry, he was heavily exposed to glass fibre that was even detected on the inside of his underwear. Taking the serological pattern into account that was not consistent with active syphilis, a penile ulcer following a foreign body reaction was diagnosed. This case report demonstrates the difficulties of differentiating foreign body granuloma of the genital region from venereal diseases with granuloma formation. Images PMID:9582491
Water used to visualize and remove hidden foreign bodies from the external ear canal.
Peltola, T J; Saarento, R
1992-02-01
Small foreign bodies lodged anteriorly in the tympanic sulcus are usually not visible, due to the curve of the external ear canal. Such objects can be seen with the aid of an otomicroscope and micromirror or with an endoscope, and removed by irrigation. If irrigation fails, epithelial migration on the tympanic membrane may remove lodged foreign bodies, although this may take months. Our new method, which uses water to locate small objects lodged in the tympanic sulcus, includes irrigation of the ear, adjustment of the water level to the middle curve of the external ear canal, and use of the water surface as a concave lens, making the tympanic sulcus visible. With otomicroscopy a curved ear probe can then be used to remove lodged foreign bodies from behind the curve.
Seif, S; Provencher, J F; Avery-Gomm, S; Daoust, P-Y; Mallory, M L; Smith, P A
2018-04-01
Plastic debris is recognized as a widespread, common and problematic environmental pollutant. An important consequence of this pollution is the ingestion of plastic debris by wildlife. Assessing the degree to which different species ingest plastics, and the potential effects of these plastics on their health are important research needs for understanding the impacts of plastic pollution. We examined debris (plastic and other types) ingestion in three sympatric overwintering gull species (Herring gulls Larus smithsonianus, Great Black-backed Gulls Larus marinus, and Iceland Gulls Larus glaucoides) to understand how debris ingestion differs among species, age classes and sexes in gulls. We also assessed how plastic burdens were associated with body condition to investigate how gulls may be affected by debris ingestion. There were no differences among the species, age classes or sexes in the incidence of debris ingestion (plastic or otherwise), the mass or number of debris pieces ingested. We found no correlation between ingested plastics burdens and individual condition. Gulls ingested plastic debris, but also showed high levels of other debris types as well, including metal, glass and building materials, including a metal piece of debris found within an abscess in the stomach. Thus, when the health effects of debris ingestion on gulls, and other species that ingest debris, is of interest, either from a physical or chemical perspective, it may be necessary to consider all debris types and not just plastic burdens as is often currently done for seabirds.
Failure of surgical treatment in methamphetamine body-stuffers.
Bahrami-Motlagh, Hooman; Hassanian-Moghaddam, Hossein; Behnam, Behdad; Arab-Ahmadi, Mehran
2015-05-01
Body stuffing is defined as ingestion of unpackaged or packaged illicit drugs in a quick process. The drugs have usually been wrapped loosely in cellophane, plastic bags, paper, or aluminum foil. Methamphetamine toxicity is a dangerous state that occurs during methamphetamine leakage from the ingested packages in the gastrointestinal tract. This is usually occurring with cocaine and heroin, but methamphetamine body stuffing may less commonly happen, as well. Accordingly, management of methamphetamine body-stuffers is an important subject that has remained a controversy in clinical and legal aspects. We have reported two body-stuffer cases who underwent exploratory laparotomy. Although surgery was done, it was not useful to exit packs and even led to severe methamphetamine toxicity. These cases show that surgical treatment may be ineffective and even harmful in body-stuffers. On the other hand, this report suggests that pre and post-operation abdominal CT-scan is necessary for evaluating surgical treatment in patients who are still symptomatic. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Ultrasonographic and radiographic findings in 503 cattle with traumatic reticuloperitonitis.
Braun, Ueli; Gerspach, Christian; Warislohner, Sonja; Nuss, Karl; Ohlerth, Stefanie
2018-05-26
This study involved 503 cattle with traumatic reticuloperitonitis (TRP), 494 of which underwent ultrasonographic and 484 radiographic examination of the reticulum. Ultrasonography revealed changes in the reticulum and/or peritoneum suggestive of peritonitis in 403 (83%) cattle, a decrease in the amplitude of reticular contractions in 244 (54%) and reduced or absent reticular motility in 173 (37%). A total of 536 foreign bodies were seen on 465 (96%) radiographs and a magnet was seen on 311 (64%) radiographs. Of the 536 foreign bodies, 300 (56%) were not attached to a magnet and 236 (44%) were attached. Of 300 radiographs showing foreign bodies not attached to a magnet, the foreign body was lying flat on the floor of the reticulum on 98 (18%) radiographs, was at an angle of greater than 30 degrees to the ventral aspect of the reticulum on 54 (10%), had penetrated the dorsal reticular wall on 76 (14%), had perforated the reticulum on 64 (12%) and was completely outside of the reticulum on 8 (1%) radiographs. Ultrasonography provides information about the scale and localisation of inflammatory changes of the peritoneum, and radiography allows the visualisation of ferromagnetic foreign bodies and magnets. Copyright © 2018. Published by Elsevier Ltd.
Burk, Andres; Timpmann, Saima; Medijainen, Luule; Vähi, Mare; Oöpik, Vahur
2009-06-01
We hypothesized that during prolonged resistance training, time-divided ingestion pattern of casein-based protein supplement is of superior efficiency in comparison with the ingestion of the same supplement immediately before each training session. In a crossover study, 13 men aged 18 to 19 years were evaluated during 2 well-controlled, 8-week training and supplementation periods. In the time-focused supplementation regimen (TFR), the subjects consumed the supplement in the morning and in the afternoon, immediately before the training session. Time-divided supplementation regimen (TDR) included 1 morning dose, whereas the second dose was ingested in the evening, 5 hours after training. The daily dose of the supplement contained approximately 70 g of protein (82% casein) and less than 1 g of carbohydrate and fat. Body mass, body composition (dual-energy x-ray absorptiometry scanned), and one-repetition maximum (1RM) for bench press and squat were determined at the beginning and at the end of both 8-week training and supplementation periods. Training produced a significant increase in 1RM strength both in the bench press (9.4% and 7.2%) and the squat exercise (10.7% and 17.8%) in the TFR and TDR, respectively, with no differences between the supplementation regimens. Fat-free mass increased from 62.4 +/- 1.2 to 63.5 +/- 1.3 kg (P = .046) with TDR, whereas no change was evident with TFR. The increase in 1RM strength in the squat exercise was related to the increase in fat-free mass in TDR (r = 0.569; P = .041). These findings may have practical implications for the timing of ingestion of protein supplements to enhance the efficacy of resistance training.
NASA Astrophysics Data System (ADS)
Kim, Garam; Kang, Hyung-Ku
2018-03-01
We investigated the feeding habits of Calanus sinicus during its four developmental stages as copepodite 4 (CIV), copepodite 5 (CV), adult males and females in early June 2015 at 12 sampling stations along the southern coast of Korea to the northern East China Sea, to better understand the role of C. sinicus in controlling phytoplankton stocks. Ingestion rate, daily ration as body carbon, population ingestion rate, and grazing impact were estimated using the gut pigment method. The mean biomass of CVs was the greatest (13.5 mg C m-3) and that of adult males was the lowest (0.7 mg C m-3). The ingestion rate per C. sinicus individual tended to increase with developmental stage, with the highest rate in adult females (519 ng chl ind-1 d-1) and the lowest rate in CIVs (305 ng chl ind-1 d-1). A significant correlation was found between ingestion rate and temperature, but not salinity or chlorophyll-a concentration. The daily ration of C. sinicus as body carbon significantly decreased with increased body weight, with the highest value found in CIVs (66.4%) and the lowest value in adult males (30%). Despite the high ingestion rate of the adults, the mean grazing impact of C. sinicus on phytoplankton biomass, in terms of chlorophyll-a concentration, was the highest in CVs (2.6%), followed by CIVs and adult females, and was the lowest in adult males (0.1%). The higher grazing impact of copepodites than adults underscores the importance of evaluating copepodite stages in the feeding studies of marine food webs.
James, Lewis J; Clayton, David; Evans, Gethin H
2011-02-01
The present study examined the effects of milk protein on rehydration after exercise in the heat, via the comparison of energy- and electrolyte content-matched carbohydrate and carbohydrate-milk protein solutions. Eight male subjects lost 1·9 (SD 0·2) % of their body mass by intermittent exercise in the heat and rehydrated with 150% of their body mass loss with either a 65 g/l carbohydrate solution (trial C) or a 40 g/l carbohydrate, 25 g/l milk protein solution (trial CP). Urine samples were collected before and after exercise and for 4 h after rehydration. Total cumulative urine output after rehydration was greater for trial C (1212 (SD 310) ml) than for trial CP (931 (SD 254) ml) (P < 0·05), and total fluid retention over the study was greater after ingestion of drink CP (55 (SD 12) %) than that after ingestion of drink C (43 (SD 15) %) (P < 0·05). At the end of the study period, whole body net fluid balance (P < 0·05) was less negative for trial CP (-0·26 (SD 0·27) litres) than for trial C (-0·52 (SD 0·30) litres), and although net negative for both the trials, it was only significantly negative after ingestion of drink C (P < 0·05). The results of the present study suggest that when matched for energy density and fat content, as well as for Na and K concentration, and when ingested after exercise-induced dehydration, a carbohydrate-milk protein solution is better retained than a carbohydrate solution. These results suggest that gram-for-gram, milk protein is more effective at augmenting fluid retention than carbohydrate.
Statistical population based estimates of water ingestion play a vital role in many types of exposure and risk analysis. A significant large scale analysis of water ingestion by the population of the United States was recently completed and is documented in the report titled ...
Complications in children from foreign bodies in the airway.
Rodríguez, Hugo; Cuestas, Giselle; Botto, Hugo; Nieto, Mary; Cocciaglia, Alejandro; Passali, Desiderio; Gregori, Dario
2016-01-01
Foreign body aspiration in childhood is a common and potentially serious problem. Complications may be the result of the aspiration episode itself, delayed diagnosis or treatment. We describe our experience in a paediatric hospital in Argentina. We retrospectively evaluated 56 patients with complications due to foreign body aspiration recorded in the Susy Safe Project between January 2010 and November 2013. The clinical variables analysed were sex, age at time of aspiration, foreign body location and type, time elapsed from the event until object removal, extraction technique, complications, need for hospitalisation and circumstances of the event. 58.9% of the cases described occurred in males, with high presence of adults (76.8%) at the time of aspiration. The incidence was slightly higher in children older than 3 years. In 37 cases (66.1%), the foreign body was located in bronchus; sunflower seeds and ballpoint caps were the most common foreign objects. Only in 10 cases (17.9%) was the object extracted within 24h of the event. The most common complications were pneumonia (18 cases), granuloma (15 cases) and mucosal erosion (9 cases). Hospitalisation was necessary for 41 patients. Early diagnosis and immediate control through specialised teams are essential to ensure proper treatment, usually endoscopic, without risk of complications. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.
Olaoye, Iyiade Olatunde; Adensina, Micheal Dapo
2013-10-01
Retained rectal foreign bodies are most commonly seen in homosexuals and after assault. A few have been reported after self-treatment of anorectal conditions and prostatic massage. Harmful traditional medical practices have been reported in many communities in Africa but therapeutic anal insertion of foreign bodies for the management of haemorrhoids is rare. We present a patient with features of peritonitis following insertion of a wine bottle into his rectum in an attempt to manage his prolapsed haemorrhoids.
MRI-induced soft tissue pain: incidental finding of a 15-year-old foreign body
El Sayed Omar, Theofilos; El-Khani, Ussamah; Nehme, Jean
2013-01-01
We present the case of an 82-year-old woman who developed intense right middle finger pain during MRI scan This alerted the clinical team to the incidental finding of a 15-year-old metallic foreign body in the distal phalanx of the right middle finger. This case report is a reminder that the responsible clinician should be vigilant when screening for metallic foreign body on completion of the MRI checklist, and should adopt a low threshold for plain imaging prior to MRI. PMID:23417938
[Recommendations for the prevention of organic foreign bodies aspiration].
Rodríguez, Hugo; Cuestas, Giselle; Gregori, Darío; Lorenzoni, Giulia; Tortosa, Susana; Rodríguez D'Aquila, Máximo; Rodríguez D'Aquila, Juan A; Carrera, Sandra; Passali, Desiderio
2017-10-01
Foreign body aspiration remains a common and potentially serious pediatric problem. Most aspirated foreign bodies are food. The education of parents and caregivers about choking hazards and how to avoid them is critical to reduce the incidence of these events. The pediatricians play a key role in promoting injury prevention. We indicate the main characteristics of hazardous food and we present recommendations on age-appropriate meals, adequate forms of food preparation and behavioral rules at mealtimes in order to reduce food choking. Sociedad Argentina de Pediatría.
Windshield safety glass foreign body masquerading as a root fragment.
Gray, S T
1994-02-01
A 42-year-old woman presented with a persistent radiopacity suggestive of an apparent root fragment after full dental clearance. This was caused by a foreign body lying within the buccal soft tissues. The foreign body was identified as a portion of soda-lime-silica glass which had penetrated during a road traffic accident but which had remained undetected for 6 years. Following its removal, further chemical analyses were undertaken to compare the radiographic characteristics of the windscreen glass in this case with other glass samples.
A Very Long Foreign Body in the Bladder
Imai, Atsushi; Suzuki, Yuichiro; Hashimoto, Yasuhiro; Sasaki, Atsushi; Saitoh, Hisao; Ohyama, Chikara
2011-01-01
In the urinary tract, foreign body is most commonly found in the urinary bladder. But it is anatomically very difficult for a man to self-insert a long object into the urinary bladder. Here we report a case of a 49-year-old Japanese man who has inserted a 140-cm vinyl tube in the bladder for masturbation. He could not retrieve it, and the bladder foreign body remained in this position for about two years. He was referred to our hospital and open surgery was performed. PMID:21687624
Clukey, Katharine; Lepczyk, Christopher A.; Balazs, George H.; Work, Thierry M.; Li, Qing X.; Bachman, Melanie J.; Lynch, Jennifer M.
2017-01-01
In addition to eating contaminated prey, sea turtles may be exposed to persistent organic pollutants (POPs) from ingesting plastic debris that has absorbed these chemicals. Given the limited knowledge about POPs in pelagic sea turtles and how plastic ingestion influences POP exposure, our objectives were to: 1) provide baseline contaminant levels of three species of pelagic Pacific sea turtles; and 2) assess trends of contaminant levels in relation to species, sex, length, body condition and capture location. In addition, we hypothesized that if ingesting plastic is a significant source of POP exposure, then the amount of ingested plastic may be correlated to POP concentrations accumulated in fat. To address our objectives we compared POP concentrations in fat samples to previously described amounts of ingested plastic from the same turtles. Fat samples from 25 Pacific pelagic sea turtles [2 loggerhead (Caretta caretta), 6 green (Chelonia mydas) and 17 olive ridley (Lepidochelys olivacea) turtles] were analyzed for 81 polychlorinated biphenyls (PCBs), 20 organochlorine pesticides, and 35 brominated flame-retardants. The olive ridley and loggerhead turtles had higher ΣDDTs (dichlorodiphenyltrichloroethane and metabolites) than ΣPCBs, at a ratio similar to biota measured in the South China Sea and southern California. Green turtles had a ratio close to 1:1. These pelagic turtles had lower POP levels than previously reported in nearshore turtles. POP concentrations were unrelated to the amounts of ingested plastic in olive ridleys, suggesting that their exposure to POPs is mainly through prey. In green turtles, concentrations of ΣPCBs were positively correlated with the number of plastic pieces ingested, but these findings were confounded by covariance with body condition index (BCI). Green turtles with a higher BCI had eaten more plastic and also had higher POPs. Taken together, our findings suggest that sea turtles accumulate most POPs through their prey rather than marine debris.
26 CFR 1.957-1 - Definition of controlled foreign corporation.
Code of Federal Regulations, 2011 CFR
2011-04-01
... of that body of persons exercising, with respect to such corporation, the powers ordinarily exercised...-half of the members of such governing body of such foreign corporation, either to cast a vote deciding an evenly divided vote of such body or, for the duration of any deadlock which may arise, to exercise...
26 CFR 1.957-1 - Definition of controlled foreign corporation.
Code of Federal Regulations, 2014 CFR
2014-04-01
... of that body of persons exercising, with respect to such corporation, the powers ordinarily exercised...-half of the members of such governing body of such foreign corporation, either to cast a vote deciding an evenly divided vote of such body or, for the duration of any deadlock which may arise, to exercise...
26 CFR 1.957-1 - Definition of controlled foreign corporation.
Code of Federal Regulations, 2013 CFR
2013-04-01
... of that body of persons exercising, with respect to such corporation, the powers ordinarily exercised...-half of the members of such governing body of such foreign corporation, either to cast a vote deciding an evenly divided vote of such body or, for the duration of any deadlock which may arise, to exercise...
26 CFR 1.957-1 - Definition of controlled foreign corporation.
Code of Federal Regulations, 2012 CFR
2012-04-01
... of that body of persons exercising, with respect to such corporation, the powers ordinarily exercised...-half of the members of such governing body of such foreign corporation, either to cast a vote deciding an evenly divided vote of such body or, for the duration of any deadlock which may arise, to exercise...
Yang, Xiuzhen; Ye, Jingjing; Gao, Zhan
2017-10-01
In this article, we report a rare case of double aortic arch. The case presented initially with a foreign object in the oesophagus. The patient was a 2-year-old boy, who was referred with primary symptoms of tussis (15 days) and emesis (2 days). He had a history of ingesting a coin. Routine chest X-ray indicated a rounded, metal foreign object in the upper oesophagus. A half-Yuan coin was removed by gastroduodenoscopy. Echocardiographic imaging suggested that the patient had double aortic arch, which was subsequently diagnosed by CT angiography with three-dimensional reconstruction. The right subclavian artery arose from the right loop of the double aortic arch. The left subclavian artery as well as left and right common carotid arteries had distinct origins from the left aortic arch. Imaging also indicated atresia of the distal left arch. The patient underwent corrective surgery and made a full recovery. Despite the rarity, double aortic arch should be considered when patients present with a foreign object in the oesophagus. Echocardiography and CT angiography can inform the diagnosis.
Food choking hazards in children.
Sidell, Douglas R; Kim, Irene A; Coker, Tumaini R; Moreno, Candice; Shapiro, Nina L
2013-12-01
To review the literature on pediatric food choking risks, with the long-term goal of supporting legislation regulating the production, labeling, and distribution of high-risk foods. A PubMed search (Keywords: choking, obstruction, asphyxiation, foreign body, food) was conducted in July-September 2010 with publication dates ranging from 1966 to 2010. Articles related to pediatric foreign body aspiration (FBA) were selected by three independent reviewers. 1145 articles were initially identified. Abstracts were then screened utilizing a tool designed to isolate relevant pediatric choking events; this tool helped to only select abstracts which presented data on patients younger than 18 years of age who had choked on food items. Through this, a total of 72 pertinent articles were isolated (55 observational studies, 17 case reports/series). For each study, patient age, sex, foreign body location, presenting signs and symptoms, utility of radiographic studies, and type of foreign body detected in the majority of study participants were determined. A "majority" of patients for each study was predetermined arbitrarily to be 2/3 of the studied population. The majority of patients in each observational study was determined to be: male (87% of all studies) and age <5 years (95% of all studies). Aspirated foreign bodies were mostly detected in the right main bronchus foreign body (72% of all studies), and there were abnormal radiographic signs (81% of all studies) at the time of evaluation. Food-object foreign bodies were the most frequent factors associated with choking (94% of all studies). Childhood aspiration of food-objects is a significant public health issue. Although there is substantial legislation regulating non-food items that pose a choking hazard, equivalent guidelines do not exist for high-risk foods. Our study identifies and confirms several risk factors for pediatric FBA events. In doing so, it echoes the concerns and suggestions of various groups in supporting the development of legislation which may reduce the incidence of food-object aspiration. Copyright © 2013. Published by Elsevier Ireland Ltd.
Droplet bubbling evaporatively cools a blowfly.
Gomes, Guilherme; Köberle, Roland; Von Zuben, Claudio J; Andrade, Denis V
2018-04-19
Terrestrial animals often use evaporative cooling to lower body temperature. Evaporation can occur from humid body surfaces or from fluids interfaced to the environment through a number of different mechanisms, such as sweating or panting. In Diptera, some flies move tidally a droplet of fluid out and then back in the buccopharyngeal cavity for a repeated number of cycles before eventually ingesting it. This is referred to as the bubbling behaviour. The droplet fluid consists of a mix of liquids from the ingested food, enzymes from the salivary glands, and antimicrobials, associated to the crop organ system, with evidence pointing to a role in liquid meal dehydration. Herein, we demonstrate that the bubbling behaviour also serves as an effective thermoregulatory mechanism to lower body temperature by means of evaporative cooling. In the blowfly, Chrysomya megacephala, infrared imaging revealed that as the droplet is extruded, evaporation lowers the fluid´s temperature, which, upon its re-ingestion, lowers the blowfly's body temperature. This effect is most prominent at the cephalic region, less in the thorax, and then in the abdomen. Bubbling frequency increases with ambient temperature, while its cooling efficiency decreases at high air humidities. Heat transfer calculations show that droplet cooling depends on a special heat-exchange dynamic, which result in the exponential activation of the cooling effect.
31 CFR 800.213 - Foreign government.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Foreign government. 800.213 Section... TAKEOVERS BY FOREIGN PERSONS Definitions § 800.213 Foreign government. The term foreign government means any government or body exercising governmental functions, other than the United States Government or a...
31 CFR 800.213 - Foreign government.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Foreign government. 800.213 Section... TAKEOVERS BY FOREIGN PERSONS Definitions § 800.213 Foreign government. The term foreign government means any government or body exercising governmental functions, other than the United States Government or a...
31 CFR 800.213 - Foreign government.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Foreign government. 800.213 Section... TAKEOVERS BY FOREIGN PERSONS Definitions § 800.213 Foreign government. The term foreign government means any government or body exercising governmental functions, other than the United States Government or a...
31 CFR 800.213 - Foreign government.
Code of Federal Regulations, 2013 CFR
2013-07-01
... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Foreign government. 800.213 Section... TAKEOVERS BY FOREIGN PERSONS Definitions § 800.213 Foreign government. The term foreign government means any government or body exercising governmental functions, other than the United States Government or a...
31 CFR 800.213 - Foreign government.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Foreign government. 800.213 Section... TAKEOVERS BY FOREIGN PERSONS Definitions § 800.213 Foreign government. The term foreign government means any government or body exercising governmental functions, other than the United States Government or a...
Fatal aspiration of foreign bodies in infants and children.
Bamber, Andrew R; Pryce, Jeremy; Ashworth, Michael; Sebire, Neil J
2014-02-01
To investigate the frequency, circumstances, demographics and autopsy findings of infants and children dying as a result of foreign body aspiration. Retrospective review of autopsy cases in children aged between seven days and 18 years, at one specialist centre over a 16-year period, in which death was the result of aspiration of a foreign body. Ten cases were identified out of a total autopsy population of 2165. Only one individual had an underlying diagnosis potentially contributing to aspiration. All but one case involved aspiration of food, with grapes being a feature of four cases. In cases with a prolonged survival interval, autopsy demonstrated bronchopneumonia and hypoxic-ischaemic encephalopathy. In the remaining cases autopsy findings were non-specific. Fatal aspiration of a foreign body is rare in this population. The cases involve normal children who aspirate food, particularly grapes. There are typically minimal, non-specific findings at autopsy.
Photoacoustic tomography of foreign bodies in soft biological tissue.
Cai, Xin; Kim, Chulhong; Pramanik, Manojit; Wang, Lihong V
2011-04-01
In detecting small foreign bodies in soft biological tissue, ultrasound imaging suffers from poor sensitivity (52.6%) and specificity (47.2%). Hence, alternative imaging methods are needed. Photoacoustic (PA) imaging takes advantage of strong optical absorption contrast and high ultrasonic resolution. A PA imaging system is employed to detect foreign bodies in biological tissues. To achieve deep penetration, we use near-infrared light ranging from 750 to 800 nm and a 5-MHz spherically focused ultrasonic transducer. PA images were obtained from various targets including glass, wood, cloth, plastic, and metal embedded more than 1 cm deep in chicken tissue. The locations and sizes of the targets from the PA images agreed well with those of the actual samples. Spectroscopic PA imaging was also performed on the objects. These results suggest that PA imaging can potentially be a useful intraoperative imaging tool to identify foreign bodies.
Yang, Zeyin; Yang, Xiaohong
2013-07-01
The patient was male, 20 years old, and complained of pain, bleeding and decreased vision after the right eye was injured by nail for an hour. right exophthalmos, conjunctival edema, skin laceration at the lower eyelid of right eye, limitation of eye movement, asymmetric eyes and weak light-reflecting. X-ray showed: metallic foreign body shadow in the right orbit, 0.5 cm x 0.4 cm approximately. Orbit and paranasal sinus CT showed: 1 hematoma of the right eye and inside. 2 high density foreign body embedded in the bone wall of the inside of right orbit and ethmoid. 3 medial wall fracture of right eye orbit. 4 bilateral maxillary sinus and right ethmoidal sinus effusion. 5 slightly left side of nasal septum. The patient was initially diagnosed as foreign body in right ethmoidal sinus, skin laceration of right lower eyelid, retrobulbar hematoma.
Silicone impression material foreign body in the middle ear: Two case reports and literature review.
Suzuki, Nobuyoshi; Okamura, Koji; Yano, Takuya; Moteki, Hideaki; Kitoh, Ryosuke; Takumi, Yutaka; Usami, Shin-ichi
2015-10-01
We report two cases of impression material foreign body in the middle ear. The first case had been affected with chronic otitis media. The silicone flowed into the middle ear through a tympanic membrane perforation during the process of making an ear mold. About 4 years and 8 months after, the patient had severe vertigo and deafness. We found bone erosion of the prominence of the lateral semicircular canal and diagnosed labyrinthitis caused by silicone impression material. In the second case silicone flowed into the canal wall down mastoid cavity. Both cases required surgery to remove the foreign body. The clinical courses in such cases are variable and timing of surgery is sometimes difficult. In addition to reporting these two cases, we present here a review of the literature regarding impression material foreign bodies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Program for impact testing of spar-shell fan blades, test report
NASA Technical Reports Server (NTRS)
Ravenhall, R.; Salemme, C. T.
1978-01-01
Six filament-wound, composite spar-shell fan blades were impact tested in a whirligig relative to foreign object damage resulting from ingestion of birds into the fan blades of a QCSEE-type engine. Four of the blades were tested by injecting a simulated two pound bird into the path of the rotating blade and two were tested by injecting a starling into the path of the blade.
Orito, Kensuke; Kawarai-Shimamura, Asako; Ogawa, Atsushi; Nakamura, Atsushi
2017-12-22
A prospective observational study was performed in canine clinical medicine to evaluate the emetic action and adverse effects of tranexamic acid. Veterinarians treated 137 dogs with a single dose of tranexamic acid (50 mg/kg, IV) after accidental ingestion of foreign substances. If needed, a second (median, 50 mg/kg; range, 20-50 mg/kg, IV) or third dose (median, 50 mg/kg; range, 25-50 mg/kg, IV) was administered. Tranexamic acid induced emesis in 116 of 137 (84.7%) dogs. Median time to onset of emesis was 116.5 sec (range, 26-370 sec), median duration of emesis was 151.5 sec (range, 30-780 sec), and median number of emesis episodes was 2 (range, 1-8). Second and third administrations of tranexamic acid induced emesis in 64.7 and 66.7% of dogs, respectively. In total, IV administration of tranexamic acid successfully induced emesis in 129 of 137 (94.2%) dogs. Adverse effects included a tonic-clonic convulsion and hemostatic disorder in two different dogs, both of which recovered after receiving medical care. Tranexamic acid induced emesis in most dogs following a single-dose. When a single dose was not sufficient, an additional dosage effectively induced emesis. Overall, adverse effects were considered low and self-limiting.
Intravesical foreign body–induced bladder calculi resulting in obstructive renal failure
Kamal, Fadi; Clark, Aaron T.D.; Lavallée, Luke Thomas; Roberts, Matthew; Watterson, James
2008-01-01
We report the case of a 30-year-old man who presented with obstructive renal failure and urosepsis due to bladder outlet–obstructing bladder calculi that formed around 3 copper wires that were self-inserted into his urinary bladder 15 years previously. We present the evaluation, imaging and management of the unique complications resulting from the self-insertion of an intra-vesical foreign body. Our patient’s case was unique for 2 reasons. First, the length of time (15 yr) from foreign body insertion to presentation is the longest interval reported in the literature. Second, this is the first report of bladder calculi induced by the insertion of a foreign body that resulted in obstructive renal failure. PMID:18953457
DOE Office of Scientific and Technical Information (OSTI.GOV)
Di Giulio, R.T.; Scanlon, P.F.
1985-08-01
The single and combined effects of cadmium ingestion and food restriction were examined in a 42-day experiment with male, juvenile mallard ducks. A 2 x 3 factorial design was employed consisting of two levels of food supply (ad libitum and 55% of ad libitum intake) and three levels of cadmium in the food (0, 5 or 50 ..mu..g Cd/g food). Cadmium ingestion alone had no effect on body or tissue weights, liver glycogen, plasma concentrations of glucose, urea, uric acid, nonesterified fatty acids (NEFA), triiodothyronine (T/sub 3/), thyroxine (T/sub 4/), or plasma or adrenal concentrations of corticosterone. The food restrictionmore » resulted in reduced body weights and reduced weights of livers, kidneys, and testes, increased adrenal weights, reduced liver glycogen, increased plasma NEFA concentrations, reduced plasma T/sub 3/ and T/sub 4/ concentrations, and increased adrenal corticosterone concentrations. In combination with the food restrictions, cadmium ingestion further reduced plasma T/sub 3/ concentrations and a similar trend was noted for T/sub 4/. Additionally, the highest plasma NEFA concentrations and highest plasma and adrenal concentrations of corticosterone were observed in food-restricted ducks receiving the highest level of dietary cadmium. These results suggest that ability of cadmium ingestion to enhanced food restriction-induced alterations in energy metabolism at levels of dietary cadmium that are by themselves without apparent effect. Also, cadmium ingestion resulted in increased kidney concentrations of copper and zinc: this effect on kidney zinc concentrations was increased in food-restricted ducks.« less
Ice slurry ingestion reduces both core and facial skin temperatures in a warm environment.
Onitsuka, Sumire; Zheng, Xinyan; Hasegawa, Hiroshi
2015-07-01
Internal body cooling by ingesting ice slurry has recently attracted attention. Because ice slurries are ingested through the mouth, it is possible that this results in conductive cooling of the facial skin and brain. However, no studies have investigated this possibility. Thus, the aim of this study was to investigate the effects of ice slurry ingestion on forehead skin temperature at the point of conductive cooling between the forehead skin and brain. Eight male subjects ingested either 7.5g/kg of ice slurry (-1°C; ICE), a cold sports drink (4°C; COOL), or a warm sports drink (37°C; CON) for 15min in a warm environment (30°C, 80% relative humidity). Then, they remained at rest for 1h. As physiological indices, rectal temperature (Tre), mean skin temperature, forehead skin temperature (Thead), heart rate, nude body mass, and urine specific gravity were measured. Subjective thermal sensation (TS) was measured at 5-min intervals throughout the experiment. With ICE, Tre and Thead were significantly reduced compared with CON and COOL conditions (p<0.05). The results of the other physiological indices were not significantly different. TS with ICE was significantly lower than that with CON and COOL (p<0.05) and was correlated with Tre or Thead (p<0.05). These results indicate that ice slurry ingestion may induce conductive cooling between forehead skin and brain, and reduction in core and forehead skin temperature reduced thermal sensation. Copyright © 2015 Elsevier Ltd. All rights reserved.
Igarashi, Yutaka; Yokobori, Shoji; Yoshino, Yudai; Masuno, Tomohiko; Miyauchi, Masato; Yokota, Hiroyuki
2017-10-01
In Japan, the number of patients with foreign body airway obstruction by food is rapidly increasing with the increase in the population of the elderly and a leading cause of unexpected death. This study aimed to determine the factors that influence prognosis of these patients. This is a retrospective single institutional study. A total of 155 patients were included. We collected the variables from the medical records and analyzed them to determine the factors associated with patient outcome. Patient outcomes were evaluated using cerebral performance categories (CPCs) when patients were discharged or transferred to other hospitals. A favorable outcome was defined as CPC 1 or 2, and an unfavorable outcome was defined as CPC 3, 4, or 5. A higher proportion of patients with favorable outcomes than unfavorable outcomes had a witness present at the accident scene (68.8% vs. 44.7%, P=0.0154). Patients whose foreign body were removed by a bystander at the accident scene had a significantly high rate of favorable outcome than those whose foreign body were removed by emergency medical technicians or emergency physician at the scene (73.7% vs. 31.8%, P<0.0075) and at the hospital after transfer (73.7% vs. 9.6%, P<0.0001). The presence of a witness to the aspiration and removal of the airway obstruction of patients by bystanders at the accident scene improves outcomes in patients with foreign body airway obstruction. When airway obstruction occurs, bystanders should remove foreign bodies immediately. Copyright © 2017 Elsevier Inc. All rights reserved.
Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-09
... request would add deodorant/antiperspirant and body wash gift sets and certain foreign components to the... the duty rates during customs entry procedures that apply to deodorant/antiperspirant and body wash...
Is there a relationship between dietary MSG and [corrected] obesity in animals or humans?
Brosnan, John T; Drewnowski, Adam; Friedman, Mark I
2014-09-01
The sodium salt of glutamate (monosodium glutamate; MSG) imparts a savory/meaty taste to foods, and has been used as a flavoring agent for millennia. Past research on MSG/glutamate has evaluated its physiologic, metabolic and behavioral actions, and its safety. Ingested MSG has been found to be safe, and to produce no remarkable effects, except on taste. However, some recent epidemiologic and animal studies have associated MSG use with obesity and aberrations in fat metabolism. Reported effects are usually attributed to direct actions of ingested MSG in brain. As these observations conflict with past MSG research findings, a symposium was convened at the 13th International Congress on Amino Acids, Peptides and Proteins to discuss them. The principal conclusions were: (1) the proposed link between MSG intake and weight gain is likely explained by co-varying environmental factors (e.g., diet, physical activity) linked to the "nutrition transition" in developing Asian countries. (2) Controlled intervention studies adding MSG to the diet of animals and humans show no effect on body weight. (3) Hypotheses positing dietary MSG effects on body weight involve results from rodent MSG injection studies that link MSG to actions in brain not applicable to MSG ingestion studies. The fundamental reason is that glutamate is metabolically compartmentalized in the body, and generally does not passively cross biologic membranes. Hence, almost no ingested glutamate/MSG passes from gut into blood, and essentially none transits placenta from maternal to fetal circulation, or crosses the blood-brain barrier. Dietary MSG, therefore, does not gain access to brain. Overall, it appears that normal dietary MSG use is unlikely to influence energy intake, body weight or fat metabolism.
Zytoon, E M; el-Belbasi, H I; Matsumura, T
1993-08-01
We investigated whether concurrent ingestion of chikungunya virus and microfilariae of Dirofilaria immitis increases viral dissemination and multiplication in a mosquito vector. The increased rate of dissemination of this virus in mosquitoes concurrently ingesting both agents was found when homogenates of bodies and those of legs only were examined. It was significantly higher than that of controls ingesting the virus alone through the end of the experiment on day 14 after infection. We next studied the mechanism by which the presence of microfilariae enabled the virus to enter into the hemocoel and to reach the salivary glands. We checked our results using histopathologic procedures and electron microscopy by identifying holes produced by the microfilariae that penetrated the midgut epithelial layer. When the midgut of mosquitoes was punctured with a thin needle immediately after the mosquitoes ingested viruses, higher infection rates were observed than in mosquitoes without such punctures.
Abdominal emergencies in pediatrics.
Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E
2016-05-01
Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition. Copyright © 2016 SERAM. Published by Elsevier España, S.L.U. All rights reserved.
Plain abdominal radiography in acute abdominal pain; past, present, and future
Gans, Sarah L; Stoker, Jaap; Boermeester, Marja A
2012-01-01
Several studies have demonstrated that a diagnosis based solely on a patient’s medical history, physical examination, and laboratory tests is not reliable enough, despite the fact that these aspects are essential parts of the workup of a patient presenting with acute abdominal pain. Traditionally, imaging workup starts with abdominal radiography. However, numerous studies have demonstrated low sensitivity and accuracy for plain abdominal radiography in the evaluation of acute abdominal pain as well as various specific diseases such as perforated viscus, bowel obstruction, ingested foreign body, and ureteral stones. Computed tomography, and in particular computed tomography after negative ultrasonography, provides a better workup than plain abdominal radiography alone. The benefits of computed tomography lie in decision-making for management, planning of a surgical strategy, and possibly even avoidance of negative laparotomies. Based on abundant available evidence, major advances in diagnostic imaging, and changes in the management of certain diseases, we can conclude that there is no place for plain abdominal radiography in the workup of adult patients with acute abdominal pain presenting in the emergency department in current practice. PMID:22807640
Modifications in endoscopic practice for pediatric patients.
Lightdale, Jenifer R; Acosta, Ruben; Shergill, Amandeep K; Chandrasekhara, Vinay; Chathadi, Krishnavel; Early, Dayna; Evans, John A; Fanelli, Robert D; Fisher, Deborah A; Fonkalsrud, Lisa; Hwang, Joo Ha; Kashab, Mouen; Muthusamy, V Raman; Pasha, Shabana; Saltzman, John R; Cash, Brooks D
2014-05-01
We recommend that endoscopy in children be performed by pediatric-trained endoscopists whenever possible. We recommend that adult-trained endoscopists coordinate their services with pediatricians and pediatric specialists when they are needed to perform endoscopic procedures in children. We recommend that endoscopy be performed within 24 hours in symptomatic pediatric patients with known or suspected ingestion of caustic substances. We recommend emergent foreign-body removal of esophageal button batteries, as well as 2 or more rare-earth neodymium magnets. We recommend that procedural and resuscitative equipment appropriate for pediatric use should be readily available during endoscopic procedures. We recommend that personnel trained specifically in pediatric life support and airway management be readily available during sedated procedures in children. We recommend the use of endoscopes smaller than 6 mm in diameter in infants and children weighing less than 10 kg. We recommend the use of standard adult duodenoscopes for performing ERCP in children who weigh at least 10 kg. We recommend the placement of 12F or 16F percutaneous endoscopic gastrostomy tubes in children who weigh less than 50 kg.
Kato, Yushi; Sawada, Atsushi; Numao, Shigeharu; Suzuki, Masashige
2011-01-01
We have previously reported on the possibility that light resistance exercise performed with a high plasma amino acid concentration resulting from the ingestion of a high-protein snack (HPS; 15 g protein, 18 g sugar) 3 h after a basal meal promotes the utilization of amino acids in peripheral tissues such as muscle in both rats and humans. In the present study, we further examined the effectiveness of a daily routine involving ingestion of HPS 3 h after a basal meal and subsequent light resistance exercise (dumbbell exercise) in increasing the mass and strength of human muscle. Ten young adult males were subject to the following 3 conditions for 5 wk each, with sufficient recovery period between each condition: (1) Snack-Exercise (SE), (2) Snack-Sedentary (SS), and (3) No snack-Exercise (NE). The SE group showed a significant increase in lean body mass and total cross-sectional area (CSA) of the right forearm muscles along with a significant decrease in body fat mass. The SS group showed no change in body composition. Furthermore, the SE group showed significant increase in grip strength and isometric knee extensor muscle strength, while the SS group showed no increase in muscle strength. The NE group showed significant increase in grip strength. In conclusion, daily routine ingestion of HPS 3 h after a basal meal and subsequent light resistance exercise is effective in increasing the mass and strength of human muscle.
Management of tracheo-bronchial foreign bodies in children.
Sisenda, T M; Khwa-Otsyula, B O; Wambani, J O
2002-11-01
To review alternative surgical and anaesthetic options in the management of foreign bodies lodged in the tracheobronchial tree in children aged below 10 years. A five year retrospective secondary data analysis. Three hospitals based in Eldoret Municipality, Kenya. Outcome variables included morbidity and mortality. Of the thirty two children studied, 74.1% had bronchoscopy and 25.9% thoracotomy. The overall mortality rate was 3.3%. Foreign bodies in the tracheo-bronchial tree are a major cause of morbidity and mortality in children aged below 10 years. In settings where appropriate equipment is inadequate, timely thoracotomy may be life saving.
An unusual intracranial metallic foreign bodies and panhypopituitarism.
Lakouichmi, Mohammed; Baïzri, Hicham; Mouhsine, Abdelilah; Boukhira, Abderrahmane; Akhaddar, Ali
2014-01-01
A 49 years old man, with a history of aggression at the age of 18 years by a pair of scissors, who consulted for unilateral migraine headaches look straight. Paraclinical explorations concluded that trauma to anterior pituitary by a metallic foreign body from the right nostril to the sella, responsible for panhypopituitarism and sinusitis. The headaches are frequent causes of consultation, often treated symptomatically but rarely explored. The direct trauma to the pituitary gland, by a metallic foreign body, is exceptional. We report the case of neglected panhypopituitarism, discovered 31 years after injury with a pair of scissors.
An unusual intracranial metallic foreign bodies and panhypopituitarism
Lakouichmi, Mohammed; Baïzri, Hicham; Mouhsine, Abdelilah; Boukhira, Abderrahmane; Akhaddar, Ali
2014-01-01
A 49 years old man, with a history of aggression at the age of 18 years by a pair of scissors, who consulted for unilateral migraine headaches look straight. Paraclinical explorations concluded that trauma to anterior pituitary by a metallic foreign body from the right nostril to the sella, responsible for panhypopituitarism and sinusitis. The headaches are frequent causes of consultation, often treated symptomatically but rarely explored. The direct trauma to the pituitary gland, by a metallic foreign body, is exceptional. We report the case of neglected panhypopituitarism, discovered 31 years after injury with a pair of scissors. PMID:25667695
Fatal hemothorax following management of an esophageal foreign body.
Cohn, Leah A; Stoll, Melissa R; Branson, Keith R; Roudabush, Alice D; Kerl, Marie E; Langdon, Paige F; Johannes, Chad M
2003-01-01
A 10.8-year-old, spayed female toy poodle presented with an esophageal foreign body. The foreign body was removed endoscopically, and a gastrostomy tube was placed to provide nutritional support during esophageal healing. The gastrostomy tube was later removed by endoscopic retrieval of the bulb through the esophagus. Immediately afterward, the dog developed hemothorax and eventually died. It was determined that many small arterial branches were avulsed from the aorta. The involved sections of aorta histopathogically evidenced medial necrosis, which was believed to be related to a prior disruption of blood flow through the vasa vasorum.
Langer, D; Petermann, C; Lübbers, H; Lankisch, P G
1999-04-01
In the great majority of cases of long-standing intrathoracic foreign bodies, patients are asymptomatic. However, symptoms may occur years later from the migration of the foreign body. We report on a 70-year-old patient who developed relapsing pneumonia due to obstruction of a bronchial branch of the left apical group by a migrating infantry bullet impacting 53 years ago. This was not diagnosed until the second attack of pneumonia in 1998. The bullet remains were removed bronchoscopically and the pneumonia resolved completely without further complications.
Khan, M Sarwar; Kirkland, P M; Kumar, R
2002-02-01
Firework injuries can manifest themselves in many different ways; usually as an explosive or burn injury. This case describes an unusual presentation of a firework penetrating injury resulting in a sharp coiled metal foreign body travelling through a small entry wound in the neck and subsequently lodging itself in the tracheobronchial tree. A foreign body such as this can potentially travel a considerable distance through the soft tissues and end up in an unsuspecting distant site. There must, therefore, be a high index of suspicion with the appropriate radiological investigations for appropriate management of such cases.
Increasing trend in retained rectal foreign bodies.
Ayantunde, Abraham A; Unluer, Zynep
2016-10-27
To highlight the rising trend in hospital presentation of foreign bodies retained in the rectum over a 5-year period. Retrospective review of the cases of retained rectal foreign bodies between 2008 and 2012 was performed. Patients' clinical data and yearly case presentation with data relating to hospital episodes were collected. Data analysis was by SPSS Inc. Chicago, IL, United States. Twenty-five patients presented over a 5-year period with a mean age of 39 (17-62) years and M: F ratio of 2:1. A progressive rise in cases was noted from 2008 to 2012 with 3, 4, 4, 6, 8 recorded patients per year respectively. The majority of the impacted rectal objects were used for self-/partner-eroticism. The commonest retained foreign bodies were sex vibrators and dildos. Ninty-six percent of the patients required extraction while one passed spontaneously. Two and three patients had retrieval in the Emergency Department and on the ward respectively while 19 patients needed examination under anaesthesia for extraction. The mean hospital stay was 19 (2-38) h. Associated psychosocial issues included depression, deliberate self-harm, illicit drug abuse, anxiety and alcoholism. There were no psychosocial problems identified in 15 patients. There is a progressive rise in hospital presentation of impacted rectal foreign bodies with increasing use of different objects for sexual arousal.
Boomer, Laura A; Watkins, Daniel J; O'Donovan, Julie; Kenney, Brian D; Yates, Andrew R; Besner, Gail E
2015-03-01
Penetrating thoracic trauma is relatively rare in the pediatric population. Embolization of foreign bodies from penetrating trauma is very uncommon. We present a case of a 6-year-old boy with a penetrating foreign body from a projectile dislodged from a lawn mower. Imaging demonstrated a foreign body that embolized to the left pulmonary artery, which was successfully treated non-operatively. We reviewed the penetrating thoracic trauma patients in the trauma registry at our institution between 1/1/03 and 12/31/12. Data collected included demographic data, procedures performed, complications and outcome. Sixty-five patients were identified with a diagnosis of penetrating thoracic trauma. Fourteen of the patients had low velocity penetrating trauma and 51 had high velocity injuries. Patients with high velocity injuries were more likely to be older and less likely to be Caucasian. There were no statistically significant differences between patients with low vs. high velocity injuries regarding severity scores or length of stay. There were no statistically significant differences in procedures required between patients with low and high velocity injuries. Penetrating thoracic trauma is rare in children. The case presented here represents the only report of cardiac foreign body embolus we could identify in a pediatric patient.
Canale, Angelo; Cosci, Francesca; Canovai, Roberto; Giannotti, Paolo; Benelli, Giovanni
2014-01-01
Propolis is a resinous material collected by honeybees from the exudates and buds of plants. It has been widely used as a remedy by humans since ancient times, as well as for dietary supplements and cosmetics. European legislation recently focused on the quality and hygiene standards of foods, including beehive products, and extensive efforts have been made to avoid the presence of chemical contaminants, whilst in contrast few studies have investigated the magnitude of contamination by physical ones. We conducted a filth-test survey to evaluate the contamination of ethanolic extract of propolis by foreign materials. We also compared the abundance of contaminants in propolis extracts currently marketed by small beekeepers and industrial producers. We found different foreign materials in the ethanol extract of propolis. Contaminants differed in abundance, with a higher number of carbon particles (small beekeepers: 2.70 ± 0.63; industrial producers: 1.25 ± 0.49; mean (n/30 ml) ± SE) and other inorganic fragments (small beekeepers: 3.50 ± 0.31; industrial producers: 3.88 ± 1.11) than arthropod fragments (small beekeepers: 0.30 ± 0.21; industrial producers: 0.38 ± 0.26) and mammal hairs (small beekeepers: 0.10 ± 0.10; industrial producers: 0.38 ± 0.26). No differences in the abundance of foreign matter between propolis from small beekeepers and industrial producers were found, allowing us to point out an increased awareness by small producers of issues inherent in hygiene management. Contamination of propolis extracts by animal body parts, such as insect fragments, mites and rodent hairs, indicates poor management of hygiene in the production process and low effectiveness of the filtration phase. Animal-borne contaminants can act as pathogen vectors as well as introducing dangerous allergens when ingested or applied to human skin. The filth-test applied to ethanolic propolis extract quality control can be considered a promising tool, also for small beekeeper activities, since it is cheap and allows the quick interpretation of results.
The presence of food-derived collagen peptides in human body-structure and biological activity.
Sato, Kenji
2017-12-13
It has been demonstrated that the ingestion of some protein hydrolysates exerts health-promoting effects. For understanding the underlying mechanisms responsible for these effects, the identification of bioactive peptides in the target organ is crucial. For this purpose, in vitro activity-guided fractionation for peptides in the protein hydrolysate has been performed. However, the peptides in the hydrolysate may be further degraded during digestion. The concentration of the active peptides, which were identified by in vitro activity-guided fractionation, in human blood is frequently very low (nanomolar levels). In contrast, micromolar levels of food-derived collagen peptides are present in human blood. Pro-Hyp, one of the major food-derived collagen peptides, enhances the growth of fibroblasts and synthesis of hyaluronic acid. These observations partially explain the beneficial effects of collagen hydrolysate ingestion on the enhancement of wound healing and improvement in the skin condition. The recent advancement involving liquid chromatography and mass spectrometry coupled with a pre-column derivatization technique has enabled the identification of food-derived peptides at nanomolar levels in the body post-ingestion of protein hydrolysates. Thus, this technique can be used for the identification of bioactive food-derived peptides in the body.
[Three cases of an intracranial wooden foreign body].
Fujimoto, S; Onuma, T; Amagasa, M; Okudaira, Y
1987-07-01
Three cases of intracranial wooden foreign body are reported discussing the diagnostic and therapeutic problems. First case is a 50-year-old man. After drinking, he drove a bike and fell to the ground. On admission the wooden foreign body could not been detected in appearance. CT scan showed low density area similar to air in bilateral anterior horn of lateral ventricle. The patient was treated for traumatic pneumocephalus at first. Later, it proved that he was stabbed with a foreign body penetrating into the contralateral frontal lobe through the left nasal cavity. It was extracted by endonasal approach by otolaryngologist, fortunately without trouble. The foreign body was a branch of tree. The second case is an 18-year-old man. He was driving a car, and suffered injury. He was stabbed with a wooden stake penetrating into his left eye. Immediately, bifrontal craniotomy was performed and the stake was withdrawn carefully. Moreover bone fragments were removed. The third case is a 61-year-old man. When he cut the timber by chain saw, a piece of wood hit and stabbed his right eye directly. Immediately right front temporal craniotomy was performed. The piece of wood was withdrawn from the right eye, and pieces of glass, wood and bone fragments were evacuated. It is difficult to confirm intracranial foreign body accurately by means of only plain skull film and usual CT scans. It is necessary to utilize various function of CT scanner. For example, it is useful to know CT values or select measure mode with window width and level or make reconstruction image to sagittal or coronal section, and so on.(ABSTRACT TRUNCATED AT 250 WORDS)
Alomar, C; Sureda, A; Capó, X; Guijarro, B; Tejada, S; Deudero, S
2017-11-01
A total of 417 striped red mullet, Mullus surmuletus, were analyzed to study microplastic ingestion and livers of fish were assessed to study effects of microplastics. Nearly one third (27.30%) of the individuals were quantified to ingest microplastics although there was no evidence of oxidative stress or cellular damage in the liver of fish which had ingested microplastics. A small increase in the activity of glutathione S-transferase (GST) of M. surmuletus was detected which could be suggesting an induction of the detoxification systems but these findings should be tested in laboratory conditions under a controlled diet and known concentration of microplastics. Fish from trammel fisheries, operating closer to land and targeting larger individuals, showed higher mean ingestion values than fish from trawling fisheries, and were related to body size, as microplastics ingested increased with total fish length. Consequently, ingestion values of microplastics were not related to sampling distance from land giving further evidence of the ubiquity of microplastics in the marine environment. Finally, Fourier Transform Infrared Spectroscopy (FTIR) analysis showed that the vast majority of microplastics were filament type and polyethylene terephthalate (PET) was the main identified component. Copyright © 2017 Elsevier Inc. All rights reserved.
The effects of the Lactobacillus casei strain on obesity in children: a pilot study.
Nagata, S; Chiba, Y; Wang, C; Yamashiro, Y
2017-08-24
There are few data regarding the role of probiotics as a dietary intervention in the management of obesity in children. An open prospective examination was conducted to clarify the effects of Lactobacillus casei strain Shirota (LcS)-containing beverages in obese children. We compared the intestinal microbiota and organic acid levels between 12 obese (average age, 10.8 years; body mass index (BMI) Z score, 2.7±1.7) and 22 control children(average age, 8.5 years; BMI Z score, 0.1±0.7), and pre- and post-intervention in the obese children. The obese group underwent diet and exercise therapy for 6 months and then were given an LcS beverage daily for another 6 months and the body weight and serological markers were monitored. Significant reductions in the faecal concentrations of Bifidobacterium (obese group, 7.9±1.5 vs non-obese group, 9.8±0.5 Log 10 cells/g; P<0.01) along with a significant decline in the Bacteroides fragilis group, Atopobium cluster and Lactobacillus gasseri subgroup, and acetic acid (obese group, 45.1±16.9 vs non-obese group, 57.9±17.6 μmol/g; P<0.05) were observed in the obese group at baseline. A significant decline in body weight (-2.9±4.6%; P<0.05) and an elevation in the high density lipoprotein cholesterol level (+11.1±17.6%; P<0.05) were observed 6 months after ingestion of the LcS beverage compared to baseline. Furthermore, a significant increase in the faecal concentration of Bifidobacterium (7.0±1.2 before ingestion vs 9.1±1.2 Log 10 cells/g after ingestion; P<0.01) and an apparent increase in the acetic acid concentration (7.0±1.2 before ingestion vs 9.1±1.2 Log 10 cells/g after ingestion; P<0.01) were observed 6 months after ingestion. LcS contributed to weight loss while also improving the lipid metabolism in obese children via a significant increase in the faecal Bifidobacterium numbers and the acetic acid concentration.
Effects of alcohol on body-sway patterns in human subjects.
Nieschalk, M; Ortmann, C; West, A; Schmäl, F; Stoll, W; Fechner, G
1999-01-01
The vestibulospinal aspects of vestibular function are commonly neglected in the evaluation of alcohol-induced intoxication. Thus, in the present study the effect of an acute intoxication with a low or moderate quantity of alcohol was examined with respect to the equilibrium in 30 healthy subjects. The blood alcohol concentration (BAC) was measured 30 min after the ingestion of the last alcohol, ranging between 0.22 and 1.59 per thousand. Stability of stance was quantified by static platform posturography in Romberg-test conditions with eyes open and eyes closed. Among other parameters, the average body sway path (SP) and area of body sway (SA) were assessed. Posturography revealed a significant increase in body sway. There was a positive correlation between SA (or SP) and BAC both with eyes open and eyes closed. Multiple group comparisons revealed that the large-alcohol-dose group (BAC > or = 1.0 per thousand) could be clearly differentiated from test cases with BAC lower than 0.8 per thousand. Sway area was the most sensitive parameter for detecting increased body sway after alcohol ingestion. The area increase, present not only with eyes closed but with eyes open, revealed an inadequate compensation of the ethanol-induced ataxia by visual stabilization. The Romberg's quotient, which denotes eyes closed relative to eyes open, remained constant. The increase in sway path with eyes closed showed an omnidirectional sway. A comparison of the sway pattern of subjects after acute ethanol ingestion with the data of patients with permanent cerebellar lesions suggested that the acute effect of alcohol resembles that of a lesion of the spinocerebellum. This finding contrasts with earlier studies, which postulated an acute effect of ethanol resembling that in patients with an atrophy of the anterior lobe of the cerebellum due to chronic alcohol abuse. In seven cases of the lower dose group (BAC < or = 0.8 per thousand), a reduction in body sway after alcohol ingestion was observed. This finding may be consistent with a dose-related biphasic action of alcohol, which - besides its well-known depressant effects with high doses - also shows stimulatory action with small doses.
Pathways of nucleopolyhedrosis virus infection in the gypsy moth, Lymantria dispar
K. S. Shields
1985-01-01
Gypsy moth nucleopolyhedrosis virus polyhedral inclusion bodies dissolve slowly in host digestive fluids, in vitro. Infectious viral material is in the hemocoel two hours after ingestion of inclusion bodies. Hemocytes produce and release nucleocapsids throughout the course of infection, but in the fat body, nearly all nucleocapsids are enveloped and...
Effect of sodium and calcium ingestion on thermoregulation during exercise in man
NASA Technical Reports Server (NTRS)
Greenleaf, J. E.; Brock, P. J.; Morse, J. T.; Van Beaumont, W.; Montgomery, L. D.; Convertino, V. A.; Mangseth, G. R.
1978-01-01
The effects of hypertonic sodium and calcium ingestion on body temperature during exercise in cool and hot environments are investigated. Rectal and mean skin temperatures, sweat rates and arm and leg total blood flows were measured in men during periods of rest, submaximal exercise and recovery at temperatures of 26.5 C and 39.4 C after ingestion of NaCl and CaCl2 solutions. In both environments, higher rectal temperatures are observed after hypertonic sodium ingestion, which is also associated with attenuated blood flow in the extremities, lower sweat rates and slightly higher skin temperature in the heat, indicating significant thermoregulatory responses. Hypertonic calcium and isotonic sodium cause no temperature change, although calcium caused a reduction of blood flow in the extremities.
Esophageal foreign bodies in pediatric patients: a thirteen-year retrospective study.
Rybojad, Beata; Niedzielska, Grazyna; Niedzielski, Artur; Rudnicka-Drozak, Ewa; Rybojad, Pawel
2012-01-01
We discuss clinical symptoms and radiological findings of variable esophageal foreign bodies as well as therapeutic procedures in Caucasian pediatric patients. A retrospective study of 192 cases of suspected esophageal foreign bodies between 1998 and 2010 was conducted. Data were statistically analyzed by chi-square test. A foreign body was removed from a digestive tract of 163 children aged 6 months to 15 years (mean age 4.9). Most objects were located within cricopharyngeal sphincter. Dysphagia occurred in 43%, followed by vomiting (29%) and drooling (28%). The most common objects were coins. Plain chest X-rays demonstrated aberrations in 132 cases, and in doubtful situations an esophagram test was ordered. In the group of thirty-seven patients whose radiograms were normal, esophagoscopy revealed fifteen more objects, which were eventually successfully removed. No major complications occurred. Esophagram should be a second X-ray examination if an object is not detected in plain chest X-ray. We recommend a rigid esophagoscopy under general anesthesia in doubtful cases as a safe treatment for pediatric patients.
Infections and foreign bodies in ENT.
Kullar, Peter; Yates, Philip D
2012-10-30
Infections play a major role in the practice of ENT. Microbial penetration into tissues of the head and neck can initiate a focal reaction causing superficial self-resolving infections. However, some of these have the potential to develop into life-threatening disease. We provide an overview of the most common ENT infections with focus on the presentation, diagnosis and management. Foreign bodies of the ear, nose and throat are a common presentation to primary and emergency care. Most commonly these are seen in children and include plastic toys, beads and foodstuffs inserted into the ears and nose. Diagnosis is often delayed as insertion is usually not witnessed. In exceptional cases airway foreign bodies can present as a life-threatening emergency. Removal of foreign bodies can usually be achieved by a skilled practitioner with minimal complications. Methods of removal include suction catheters, syringing, and use of instrumentation. In adults, the treatment of oesophageal food bolus obstruction may require a combination of medical and surgical intervention.
Fan, Jian; Wang, Ming-Ming; Liu, Yu-Ping
2017-01-01
Abstract Penetrating sacral injuries are very rare, but foreign bodies that penetrate the sacrum often cause pain, cerebrospinal fluid leakage, and neurological symptoms. Careful preoperative medical and imaging examinations, determining the position of the foreign body, and surgical exploration are essential in the management of such cases. We present the case of a woman who visited our emergency department with a broken sewing needle in her sacrum. The incident occurred when the patient accidentally sat on the needle while sewing by hand. Pain while sitting was the main clinical finding after the accident. The patient was treated successfully by surgical exploration aided by a permanent magnet. At follow-up a few months later, she was symptom-free. In clinical practice physicians often encounter patients with metallic foreign bodies. Permanent magnets play an important role in the removal of metallic foreign bodies, and emergency department physicians should master the methods and techniques. PMID:29318191
Fan, Jian; Wang, Ming-Ming; Liu, Yu-Ping
2017-01-01
Penetrating sacral injuries are very rare, but foreign bodies that penetrate the sacrum often cause pain, cerebrospinal fluid leakage, and neurological symptoms. Careful preoperative medical and imaging examinations, determining the position of the foreign body, and surgical exploration are essential in the management of such cases. We present the case of a woman who visited our emergency department with a broken sewing needle in her sacrum. The incident occurred when the patient accidentally sat on the needle while sewing by hand. Pain while sitting was the main clinical finding after the accident. The patient was treated successfully by surgical exploration aided by a permanent magnet. At follow-up a few months later, she was symptom-free. In clinical practice physicians often encounter patients with metallic foreign bodies. Permanent magnets play an important role in the removal of metallic foreign bodies, and emergency department physicians should master the methods and techniques.
Taheri, Abolfazl; Mehmandari, Sina Navaei; Shahidi, Mojtaba; Mehdizadeh, Hamidreza; Mirlohi, Seyyed Mohammad Javad; Aref, Nasrin Mohammadi; Avanaki, Mahsa Alborzi; Khosravi, Mohammad Hossein
2017-12-01
To evaluate the prevalence of external ear complications among Iranian aural foreign body users attending to otolaryngology clinic of our hospital. In this cross-sectional study patients attending to Otolaryngology clinics of Baqiyatallah hospital were enrolled regardless of their age, gender and reason of attending. Patients between 15 and 60 years of age were included in the present study. Those with positive history of chronic ear diseases, ear surgery, congenital ear disorders, trauma to ear or head and neck region or shock wave trauma were excluded from the study. Demographic information as well as data on chief complaint, educational level, frequency and type of used foreign body and findings of physical examination and Otoscopy by a single otolaryngologist were recorded in a predesigned checklist. Eventually 362 patients (232 male and 130 female) with a mean age of 40.32 ± 16.90 years underwent analysis. Of all patients 244 (67.2%) were using a kind of aural foreign body frequently and Cotton bud was the most popular (63.5%) used foreign body among patients. Drying ear canal was the most common (54.9%) reason of using AFBs among study individuals followed by itching (29.5%) and pyorrhea (11.06%). Also 11 (4.5%) patients were using AFBs as a habit with no specific reason. Itching was the most prevalent symptom reported by both aural foreign body users (78%) and non-users (45.5%); however it was significantly higher among AFB users (p = 0.026). Also hearing loss was significantly more reported by AFB users (p = 0.033). A majority of patients had normal physical examination in both AFB users and non-users group. Inflammation of ear canal was significantly more detected in AFB users (p = 0.004). In addition, rate of right ear wax impaction was higher among AFB users (p = 0.016). In conclusion we realized that 67.2% of patients attending to Otolaryngology clinic of our hospital were using a kind of aural foreign bodies and itching was the most common chief complaint of these patients.
Crawford, Graham; Puschner, Birgit; Affolter, Verena; Stalis, Ilse; Davidson, Autumn; Baker, Tomas; Tahara, John; Jolly, Alison; Ostapak, Susan
2015-06-01
Leucaena (Leucaena leucocephala) is a leguminous tree that is nutritious forage for domestic livestock when ingested in limited amounts. Unfortunately, leucaena contains mimosine, a plant amino acid, that can be toxic when ingested at higher concentrations. Reported toxic effects include alopecia (fur loss), poor body condition, infertility, low birth weight, thyroid gland dysfunction, and organ toxicity. Originally native to Mexico and Central America, leucaena has been introduced throughout the tropics, including Berenty Reserve, Madagascar where it was planted as supplemental browse for livestock. In Berenty, a seasonal syndrome of alopecia in ringtailed lemurs (Lemur catta) is associated with eating leucaena. Although much is known about the toxic effects of leucaena and mimosine on domestic animals and humans, the systemic effects on wildlife had not been studied. In a comparison of lemurs that include leucaena in their diet and those that do not, we found that animals that ingest leucaena absorb mimosine but that ingestion does not affect body condition, cause kidney or liver toxicity, or affect the intestinal tract. Alopecia is due to mimosine's interference of the hair follicle cycle. Leucaena ingestion is associated with higher serum albumin, α-tocopherol, and thyroxine concentrations, suggesting that leucaena may provide some nutritional benefit and that lemurs can detoxify and convert mimosine to a thyroid stimulating metabolite. The primary conservation consequence of leucaena ingestion at Berenty may be increased infant mortality due to the infants' inability cling to their alopecic mothers. The widespread introduction of leucaena throughout the tropics and its rapid spread in secondary forest conditions mean that many other leaf-eating mammals may be including this tree in their diet. Thus, exposure to leucaena should be considered when wildlife health is being evaluated, and the potential effects on wildlife health should be considered when contemplating leucaena introduction into or near wildlife habitat. © 2015 Wiley Periodicals, Inc.
Alghannam, Abdullah F.; Betts, James A.
2018-01-01
The importance of post-exercise recovery nutrition has been well described in recent years, leading to its incorporation as an integral part of training regimes in both athletes and active individuals. Muscle glycogen depletion during an initial prolonged exercise bout is a main factor in the onset of fatigue and so the replenishment of glycogen stores may be important for recovery of functional capacity. Nevertheless, nutritional considerations for optimal short-term (3–6 h) recovery remain incompletely elucidated, particularly surrounding the precise amount of specific types of nutrients required. Current nutritional guidelines to maximise muscle glycogen availability within limited recovery are provided under the assumption that similar fatigue mechanisms (i.e., muscle glycogen depletion) are involved during a repeated exercise bout. Indeed, recent data support the notion that muscle glycogen availability is a determinant of subsequent endurance capacity following limited recovery. Thus, carbohydrate ingestion can be utilised to influence the restoration of endurance capacity following exhaustive exercise. One strategy with the potential to accelerate muscle glycogen resynthesis and/or functional capacity beyond merely ingesting adequate carbohydrate is the co-ingestion of added protein. While numerous studies have been instigated, a consensus that is related to the influence of carbohydrate-protein ingestion in maximising muscle glycogen during short-term recovery and repeated exercise capacity has not been established. When considered collectively, carbohydrate intake during limited recovery appears to primarily determine muscle glycogen resynthesis and repeated exercise capacity. Thus, when the goal is to optimise repeated exercise capacity following short-term recovery, ingesting carbohydrate at an amount of ≥1.2 g kg body mass−1·h−1 can maximise muscle glycogen repletion. The addition of protein to carbohydrate during post-exercise recovery may be beneficial under circumstances when carbohydrate ingestion is sub-optimal (≤0.8 g kg body mass−1·h−1) for effective restoration of muscle glycogen and repeated exercise capacity. PMID:29473893
Ueda, Keisuke; Sanbongi, Chiaki; Takai, Shoko; Ikegami, Shuji; Fujita, Satoshi
2017-07-01
During exercise, blood levels of several hormones increase acutely. We hypothesized that consumption of a specific combination of amino acids (arginine, alanine, and phenylalanine; A-mix) may be involved in secretion of glucagon, and when combined with exercise may promote fat catabolism. Ten healthy male volunteers were randomized in a crossover study to ingest either A-mix (3 g/dose) or placebo (3 g of dextrin/dose). Thirty minutes after ingesting, each condition subsequently performed workload trials on a cycle ergometer at 50% of maximal oxygen consumption for 1 h. After oral intake of A-mix, the concentrations of plasma ketone bodies and adrenalin during and post-exercise were significantly increased. The area under the curve for glycerol and glucagon was significantly increased in the post-exercise by A-mix administration. These results suggest that pre-exercise ingestion of A-mix causes a shift of energy source from carbohydrate to fat combustion by increasing secretion of adrenalin and glucagon.
Blended Wing Body Systems Studies: Boundary Layer Ingestion Inlets With Active Flow Control
NASA Technical Reports Server (NTRS)
Geiselhart, Karl A. (Technical Monitor); Daggett, David L.; Kawai, Ron; Friedman, Doug
2003-01-01
A CFD analysis was performed on a Blended Wing Body (BWB) aircraft with advanced, turbofan engines analyzing various inlet configurations atop the aft end of the aircraft. The results are presented showing that the optimal design for best aircraft fuel efficiency would be a configuration with a partially buried engine, short offset diffuser using active flow control, and a D-shaped inlet duct that partially ingests the boundary layer air in flight. The CFD models showed that if active flow control technology can be satisfactorily developed, it might be able to control the inlet flow distortion to the engine fan face and reduce the powerplant performance losses to an acceptable level. The weight and surface area drag benefits of a partially submerged engine shows that it might offset the penalties of ingesting the low energy boundary layer air. The combined airplane performance of such a design might deliver approximately 5.5% better aircraft fuel efficiency over a conventionally designed, pod-mounted engine.
A rare cause of gastric obstruction: Lighters swallowing.
Aday, Ulas; Tardu, Ali; Yagci, Mehmet Ali; Yonder, Huseyin
2015-01-01
The majority of swallowed foreign bodies are thrown spontaneously without causing complications in the digestive system. Multiple number of foreign bodies may be swallowed by psychiatric patients which delay diagnosis and increase the complication rate. Long and hard objects cannot pass through the pylorus, and may cause obstruction, ulceration, bleeding and perforation. Endoscopy is used as an effective method in such cases. An exploratory laparatomy was performed after unsuccessful endoscopic foreign object removal in a 28-year-old schizophrenic patient with gastric outlet obstruction due to multiple cigarette lighter swallowing. Ten lighters were removed from the stomach through gastrotomy and one more lighter was removed from the descending colon by milking through the anus. The aim of this paper is to discuss encountered difficulties in psychiatric patients who underwent surgery due to intake of foreign bodies.
[Local foreign body reactions to biodegradable implants. A classification].
Hoffmann, R; Weller, A; Helling, H J; Krettek, C; Rehm, K E
1997-08-01
Biodegradable implants are increasingly used in orthopedic and trauma surgery. Many different implants consisting of different biodegradable polymers are currently available. Different factors contribute to the biocompatibility of these implants, and local foreign-body reactions remain a matter of concern. Therefore, it is mandatory to document and compare the tissue reactions caused by various biodegradable implants in experimental or clinical studies. We have developed a standardized system of classification based on our previous experimental and clinical observations. Foreign-body reactions are differentiated into osteolysis (0-0 to 0-4), extra-articular (EA-0 to EA-4) and intraarticular (IA-0 to A-4) soft-tissue reactions.
An unusual case of intraorbital foreign body and its management
Mukherjee, Bipasha; Goel, Shubhra; Subramanian, Nirmala
2011-01-01
Intraorbital foreign bodies are usually the result of accidental trauma and can lead to considerable morbidity. We report an unusual case of an industrial injury in a plastic manufacuring unit wherein hot molten plastic splashed and solidified inside the orbit. The resultant increased intraorbital pressure led to loss of vision in that eye. The extreme temperature of the foreign body caused extensive thermal damage to the surrounding adnexal structures. Staged reconstructive surgery was undertaken to repair the damage, with an acceptable final cosmetic outcome. Employment of protective eye wear to prevent such accidents in high-risk occupations should be made mandatory. PMID:21157077
Intraocular foreign-body hazard during vitrectomy.
Bovino, J A; Marcus, D F
1982-03-01
We noted two instances of forceps-induced fragmentation of the bar used for scleral plug storage during vitreous surgery. The silicone bar material was adherent to the plug in both cases. Because this represents a significant intraocular foreign body hazard, the scleral plug should be carefully inspected before insertion.
21 CFR 524.1982 - Proparacaine ophthalmic solution.
Code of Federal Regulations, 2014 CFR
2014-04-01
... is used as an anesthetic in cauterization of corneal ulcers, removal of foreign bodies and sutures from the cornea, and measurement of intraocular pressure (tonometry) when glaucoma is suspected; as an... cauterization of corneal ulcers, removal of foreign bodies and sutures from the cornea, and measurement of...
Temperature of Ingested Water during Exercise Does Not Affect Body Heat Storage.
Lamarche, Dallon T; Meade, Robert D; McGinn, Ryan; Poirier, Martin P; Friesen, Brian J; Kenny, Glen P
2015-06-01
The objective of this study was to examine the effect of ingested water temperature on heat balance during exercise as assessed by direct calorimetry. Ten healthy males (25 ± 4 yr) cycled at 50% V˙O2peak (equivalent rate of metabolic heat production (M-W) of 523 ± 84 W) for 75 min under thermocomfortable conditions (25°C, 25% relative humidity) while consuming either hot (50°C) or cold (1.5°C) water. Four 3.2 mL·kg⁻¹ boluses of hot or cold water were consumed 5 min before and at 15, 30, and 45 min after the onset of exercise. Total heat loss (HL = evaporative heat loss (HE) ± dry heat exchange (HD)) and M-W were measured by direct and indirect calorimetry, respectively. Change in body heat content (ΔHb) was calculated as the temporal summation of M-W and HL and adjusted for changes in heat transfer from the ingested fluid (Hfluid). The absolute difference for HL (209 ± 81 kJ) was similar to the absolute difference of Hfluid (204 ± 36 kJ) between conditions (P = 0.785). Furthermore, the difference in HL was primarily explained by the corresponding changes in HE (hot: 1538 ± 393 kJ; cold: 1358 ± 330 kJ) because HD was found to be similar between conditions (P = 0.220). Consequently, no difference in ΔHb was observed between the hot (364 ± 152 kJ) and cold (363 ± 134 kJ) conditions (P = 0.971) during exercise. We show that ingestion of hot water elicits a greater HL relative to cold water ingestion during exercise. However, this response was only compensated for the heat of the ingested fluid as evidenced by similar ΔHb between conditions. Therefore, our findings indicate that relative to cold water ingestion, consuming hot water does not provide a thermoregulatory advantage. Both hot and cold water ingestion results in the same amount of heat stored during prolonged moderate-intensity exercise.
Beals, Joseph W; Sukiennik, Richard A; Nallabelli, Julian; Emmons, Russell S; van Vliet, Stephan; Young, Justin R; Ulanov, Alexander V; Li, Zhong; Paluska, Scott A; De Lisio, Michael; Burd, Nicholas A
2016-10-01
Excess body fat diminishes muscle protein synthesis rates in response to hyperinsulinemic-hyperaminoacidemic clamps. However, muscle protein synthetic responses after the ingestion of a protein-dense food source across a range of body mass indexes (BMIs) have not been compared. We compared the myofibrillar protein synthetic response and underlying nutrient-sensing mechanisms after the ingestion of lean pork between obese, overweight, and healthy-weight adults. Ten healthy-weight [HW; BMI (in kg/m 2 ): 22.7 ± 0.4], 10 overweight (OW; BMI: 27.1 ± 0.5), and 10 obese (OB; BMI: 35.9 ± 1.3) adults received primed continuous l-[ring- 13 C 6 ]phenylalanine infusions. Blood and muscle biopsy samples were collected before and after the ingestion of 170 g pork (36 g protein and 3 g fat) to assess skeletal muscle anabolic signaling, amino acid transporters [large neutral and small neutral amino acid transporters (LAT1, SNAT2) and CD98], and myofibrillar protein synthesis. At baseline, OW and OB groups showed greater relative amounts of mammalian target of rapamycin complex 1 (mTORC1) protein than the HW group. Pork ingestion increased mTORC1 phosphorylation only in the HW group (P = 0.001). LAT1 and SNAT2 protein content increased during the postprandial period in all groups (time effect, P < 0.05). Basal myofibrillar protein synthetic responses were similar between groups (P = 0.43). However, myofibrillar protein synthetic responses (0-300 min) were greater in the HW group (1.6-fold; P = 0.005) after pork ingestion than in the OW and OB groups. There is a diminished myofibrillar protein synthetic response to the ingestion of protein-dense food in overweight and obese adults compared with healthy-weight controls. These data indicate that impaired postprandial myofibrillar protein synthetic response may be an early defect with increasing fat mass, potentially dependent on altered anabolic signals, that reduces muscle sensitivity to food ingestion. This trial was registered at clinicaltrials.gov as NCT02613767. © 2016 American Society for Nutrition.
Uy, Harvey S; Kenyon, Kenneth R
2013-11-01
To compare the anatomic and refractive outcomes in eyes having phacoemulsification with 1 of 3 clear corneal incision (CCI) closure methods. Ambulatory surgical center, Makati, Philippines. Prospective randomized clinical trial. Patients having phacoemulsification cataract surgery had wound closure using no additional treatment (control), a single 10-0 nylon suture, or a liquid adhesive ocular bandage (Ocuseal). The main outcome measures were wound-edge closure rates, surgically induced astigmatism (SIA), foreign-body sensation, and intraocular pressure (IOP) 1, 3, 5, 7, and 14 days postoperatively. The study evaluated 90 eyes. There was a significant improvement in wound-edge closure rates in the suture group and the ocular bandage group compared with the control group (P<.001). A significant increase in SIA occurred in the sutured group but not in the control or ocular bandage groups (P<.001). The ocular bandage group had significantly less foreign-body sensation than the control and suture groups (P<.001). There were no significant differences in IOP between the groups (P=.515). The liquid adhesive ocular bandage resulted in improved wound-edge closure, reduced SIA, and diminished foreign-body sensation. Suturing was associated with improved wound-edge closure but increased SIA and foreign-body sensation. Unsutured incisions led to delayed wound-edge closure and increased foreign-body sensation. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
Increasing trend in retained rectal foreign bodies
Ayantunde, Abraham A; Unluer, Zynep
2016-01-01
AIM To highlight the rising trend in hospital presentation of foreign bodies retained in the rectum over a 5-year period. METHODS Retrospective review of the cases of retained rectal foreign bodies between 2008 and 2012 was performed. Patients’ clinical data and yearly case presentation with data relating to hospital episodes were collected. Data analysis was by SPSS Inc. Chicago, IL, United States. RESULTS Twenty-five patients presented over a 5-year period with a mean age of 39 (17-62) years and M: F ratio of 2:1. A progressive rise in cases was noted from 2008 to 2012 with 3, 4, 4, 6, 8 recorded patients per year respectively. The majority of the impacted rectal objects were used for self-/partner-eroticism. The commonest retained foreign bodies were sex vibrators and dildos. Ninty-six percent of the patients required extraction while one passed spontaneously. Two and three patients had retrieval in the Emergency Department and on the ward respectively while 19 patients needed examination under anaesthesia for extraction. The mean hospital stay was 19 (2-38) h. Associated psychosocial issues included depression, deliberate self-harm, illicit drug abuse, anxiety and alcoholism. There were no psychosocial problems identified in 15 patients. CONCLUSION There is a progressive rise in hospital presentation of impacted rectal foreign bodies with increasing use of different objects for sexual arousal. PMID:27830039
Manson, William C; Ryan, James G; Ladner, Heidi; Gupta, Sanjey
2011-01-01
Introduction We compared the immediate cosmetic outcome of metallic foreign-body removal by emergency medicine (EM) residents with ultrasound guidance and conventional radiography. Methods This single-blinded, randomized, crossover study evaluated the ability of EM residents to remove metallic pins embedded in pigs' feet. Before the experiment, we embedded 1.5-cm metallic pins into numbered pigs' feet. We randomly assigned 14 EM residents to use either ultrasound or radiography to help remove the foreign body. Residents had minimal ultrasound experience. After a brief lecture, we provided residents with a scalpel, laceration kit, a bedside portable ultrasound machine, nipple markers, paper clips, a dedicated radiograph technician, and radiograph machine 20 feet away. After removal, 3 board-certified emergency physicians, who were blinded to the study group, evaluated the soft-tissue model by using a standardized form. They recorded incision length and cosmetic appearance on the Visual Analog Scale. Results In total, 28 foreign bodies were removed. No significant difference in the time of removal (P = 0.12), cosmetic appearance (P = 0.96), or incision length (P = 0.76) was found. Conclusion This study showed no difference between bedside ultrasound and radiography in assisting EM residents with metallic foreign-body removal from soft tissue. No significant difference was found in removal time or cosmetic outcome when comparing ultrasound with radiography. PMID:22224139
Syed, Reema; Kim, Sung-Hye; Palacio, Agustina; Nunery, William R; Schaal, Shlomit
2017-06-06
The study was inspired after the authors encountered a patient with a penetrating globe injury due to drywall, who had retained intraocular drywall foreign body. Computed tomography (CT) was read as normal in this patient. Open globe injury with drywall has never been reported previously in the literature and there are no previous studies describing its radiographic features. The case report is described in detail elsewhere. This was an experimental study. An ex vivo model of 15 porcine eyes with 1 mm to 5 mm fragments of implanted drywall, 2 vitreous only samples with drywall and 3 control eyes were used. Eyes and vitreous samples were CT scanned on Days 0, 1, and 3 postimplantation. Computed ocular images were analyzed by masked observers. Size and radiodensity of intraocular drywall were measured using Hounsfield units (HUs) over time. Intraocular drywall was hyperdense on CT. All sizes studied were detectable on Day 0 of scanning. Mean intraocular drywall foreign body density was 171 ± 52 Hounsfield units (70-237) depending on fragment size. Intraocular drywall foreign body decreased in size whereas Hounsfield unit intensity increased over time. Drywall dissolves in the eye and becomes denser over time as air in the drywall is replaced by fluid. This study identified Hounsfield Units specific to intraocular drywall foreign body over time.
Plickert, H D; Tichy, A; Hirt, R A
2014-03-01
To compare characteristics of nasal discharge caused by different intranasal aetiologies in dogs. Medical records of 105 dogs with nasal discharge due to intranasal disease were retrospectively reviewed with special focus on composition, severity, duration and localisation of discharge. On the basis of diagnostic findings, cases were classified into different disease groups and characteristics of discharge were compared between groups. Cases were classified as having non-specific rhinitis (n=42), nasal neoplasia (n=23), foreign bodies (n=21), nasal mycosis (n=7) and miscellaneous disorders (n=13). Dogs with foreign bodies or nasal mycosis were significantly younger. Mucous components of discharge occurred more often in non-specific rhinitis and nasal neoplasia, although haemorrhagic components predominated in nasal neoplasia when discharge lasted ê14 days. Pure or mixed haemorrhagic discharge was significantly more common with nasal neoplasia, foreign bodies and nasal mycosis. Purulent components were associated with longer duration of discharge and predominantly seen in non-specific rhinitis and foreign bodies. Dogs with foreign bodies were presented earlier and sneezing was more frequent. Nasal stridor was significantly more often observed in dogs with nasal neoplasia. Characteristics of nasal discharge and associated clinical signs might aid in planning the diagnostic approach, but a combination of diagnostic techniques is still required to confirm a diagnosis. © 2014 British Small Animal Veterinary Association.
Scarf pin-related hijab syndrome: A new name for an unusual type of foreign body aspiration
Kakamad, Fahmi H.; Bakir, Delan Ahmed
2017-01-01
Background Foreign body aspiration refers to the inhalation of an object into the respiratory system and is a serious and potentially fatal event. A distinct group of patients has recently been recognized among Muslim nations. These patients include women who wear headscarves and place the safety pin in their mouth prior to securing the veils, leading to accidental foreign body aspiration. The aim of this study was to analyze the main presentation, diagnosis, treatment, and outcome of patients with scarf pin aspiration. Methods This prospective study involved patients with a history of scarf pin aspiration admitted to a single center during an 18-month period. Their main presentation, diagnosis, treatment, and outcome were analyzed. Results In total, 27 patients were included. The needle was extracted by flexible bronchoscopy in 12 (44.4%) patients, rigid bronchoscopy in 13 (48.1%), and thoracotomy in 2 (74%). One patient died during rigid bronchoscopy. All remaining 26 patients were satisfied with the postsurgical outcome at a mean follow-up of 1 week. Conclusions Scarf pin aspiration differs from other types of foreign body aspiration considering the specific population affected, and its management algorithm may thus differ from that of other foreign bodies. The left main bronchus is the most common site of pin impaction. Rigid bronchoscopy is the most commonly performed procedure for successful retrieval. PMID:28627978
Scarf pin-related hijab syndrome: A new name for an unusual type of foreign body aspiration.
Baram, Aram; Kakamad, Fahmi H; Bakir, Delan Ahmed
2017-12-01
Background Foreign body aspiration refers to the inhalation of an object into the respiratory system and is a serious and potentially fatal event. A distinct group of patients has recently been recognized among Muslim nations. These patients include women who wear headscarves and place the safety pin in their mouth prior to securing the veils, leading to accidental foreign body aspiration. The aim of this study was to analyze the main presentation, diagnosis, treatment, and outcome of patients with scarf pin aspiration. Methods This prospective study involved patients with a history of scarf pin aspiration admitted to a single center during an 18-month period. Their main presentation, diagnosis, treatment, and outcome were analyzed. Results In total, 27 patients were included. The needle was extracted by flexible bronchoscopy in 12 (44.4%) patients, rigid bronchoscopy in 13 (48.1%), and thoracotomy in 2 (74%). One patient died during rigid bronchoscopy. All remaining 26 patients were satisfied with the postsurgical outcome at a mean follow-up of 1 week. Conclusions Scarf pin aspiration differs from other types of foreign body aspiration considering the specific population affected, and its management algorithm may thus differ from that of other foreign bodies. The left main bronchus is the most common site of pin impaction. Rigid bronchoscopy is the most commonly performed procedure for successful retrieval.
Detection of drugs in the urine of body-packers.
Gherardi, R K; Baud, F J; Leporc, P; Marc, B; Dupeyron, J P; Diamant-Berger, O
1988-05-14
The presence of opiates and benzoylecgonine, the major metabolite of cocaine, in the urine was detected by means of enzyme immunoassay in a series of 120 smugglers who had either ingested or inserted into their rectum cocaine or heroin packaged for transportation. There was a striking relation between the presence of drugs in the urine and swallowing of drug-filled bundles (cocaine 49 of 50 cases, heroin 9 of 10). The proportion of positive results was also high in cases of rectal insertion (cocaine 2 of 2, heroin 35 of 58). In 30 cases of cocaine-packet ingestion, serial measurements showed that the accuracy of the test progressively decreased with respect to the detection of residual packets in the body. Drug detection in the urine of suspected body-packers seems to be a useful test, positive results justifying subsequent radiological investigations.
Smith, JohnEric W; Krings, Ben M; Shepherd, Brandon D; Waldman, Hunter S; Basham, Steven A; McAllister, Matthew J
2018-05-01
The purpose of this investigation was to examine the individual and combined effects of ingesting carbohydrates (CHO) and branched-chain amino acids (BCAA) during high-volume upper body resistance exercise (RE) on markers of catabolism and performance. Thirteen resistance-trained males completed 4 experimental trials with supplementation, ingesting beverages containing CHO, BCAA, CHO+BCAA, or placebo (PLA) in a randomized, double-blind design. The beverages were ingested in 118-mL servings 6 times during an ∼60-min RE session consisting of bench press, bent-over row, incline press, and close-grip row. Each RE was performed with 5 sets of repetitions at 65% 1-repetition maximum until volitional fatigue. Blood samples were collected at baseline, immediately postexercise, and 60 min postexercise to assess glucose and insulin. Cortisol was assessed immediately and at 60 min postexercise. No significant performance benefits were observed for any RE. CHO+BCAA (152.4 ± 71.4 ng/mL) resulted in the lowest cortisol levels, which was lower than BCAA and PLA (193.7 ± 88.5, 182.8 ± 67.5 ng/mL, p < 0.05), but not different from CHO (165 ± 76.5 ng/mL, p = 0.342). Postexercise insulin concentrations were significantly higher with CHO (4.79 ± 3.4 mU/L) compared with BCAA and PLA (3.7 ± 2.0, 3.5 ± 1.8 mU/L, p < 0.05), but not different from CHO+BCAA (4.3 ± 2.5 mU/L, p = 0.339). There was no treatment effect for glucose, but glucose significantly increased from baseline to immediately postexercise and significantly decreased at 60 min postexercise. Ingesting beverages containing CHO with or without BCAA during upper body resistance exercise may promote a more favorable postexercise less catabolic environment.
21 CFR 874.4710 - Esophagoscope (flexible or rigid) and accessories.
Code of Federal Regulations, 2013 CFR
2013-04-01
... disease, or to remove foreign bodies from the esophagus. When inserted, the device extends from the area.... 874.4710 Section 874.4710 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... generic type of device includes the flexible foreign body claw, flexible biopsy forceps, rigid biopsy...
21 CFR 874.4710 - Esophagoscope (flexible or rigid) and accessories.
Code of Federal Regulations, 2014 CFR
2014-04-01
... disease, or to remove foreign bodies from the esophagus. When inserted, the device extends from the area.... 874.4710 Section 874.4710 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... generic type of device includes the flexible foreign body claw, flexible biopsy forceps, rigid biopsy...
21 CFR 874.4710 - Esophagoscope (flexible or rigid) and accessories.
Code of Federal Regulations, 2012 CFR
2012-04-01
... disease, or to remove foreign bodies from the esophagus. When inserted, the device extends from the area.... 874.4710 Section 874.4710 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... generic type of device includes the flexible foreign body claw, flexible biopsy forceps, rigid biopsy...
Computer vision for foreign body detection and removal in the food industry
USDA-ARS?s Scientific Manuscript database
Computer vision inspection systems are often used for quality control, product grading, defect detection and other product evaluation issues. This chapter focuses on the use of computer vision inspection systems that detect foreign bodies and remove them from the product stream. Specifically, we wi...
ORITO, Kensuke; KAWARAI-SHIMAMURA, Asako; OGAWA, Atsushi; NAKAMURA, Atsushi
2017-01-01
A prospective observational study was performed in canine clinical medicine to evaluate the emetic action and adverse effects of tranexamic acid. Veterinarians treated 137 dogs with a single dose of tranexamic acid (50 mg/kg, IV) after accidental ingestion of foreign substances. If needed, a second (median, 50 mg/kg; range, 20–50 mg/kg, IV) or third dose (median, 50 mg/kg; range, 25–50 mg/kg, IV) was administered. Tranexamic acid induced emesis in 116 of 137 (84.7%) dogs. Median time to onset of emesis was 116.5 sec (range, 26–370 sec), median duration of emesis was 151.5 sec (range, 30–780 sec), and median number of emesis episodes was 2 (range, 1–8). Second and third administrations of tranexamic acid induced emesis in 64.7 and 66.7% of dogs, respectively. In total, IV administration of tranexamic acid successfully induced emesis in 129 of 137 (94.2%) dogs. Adverse effects included a tonic-clonic convulsion and hemostatic disorder in two different dogs, both of which recovered after receiving medical care. Tranexamic acid induced emesis in most dogs following a single-dose. When a single dose was not sufficient, an additional dosage effectively induced emesis. Overall, adverse effects were considered low and self-limiting. PMID:29093310
Labadie, Magali; O'Mahony, Elisabeth; Capaldo, Lise; Courtois, Arnaud; Lamireau, Thierry; Nisse, Patrick; Blanc-Brisset, Ingrid; Puskarczyk, Emmanuel
2017-12-13
Although the ingestion of button batteries is an infrequent situation, it leads to a significant risk of causing serious damage. This study was carried out to describe all the cases of button battery ingestion recorded by the French Poison Control Centers over 16 years. All the cases of button battery ingestion were recorded from 1 January 1999 to the end of June 2015, analysed (age, sex, number of ingested button batteries, clinical signs and treatments) and graded for severity according to the poisoning severity score. The incidence of button batteries ingestions was constant over the 16-year period, with an average of 266±98.5 cases per year and a total of 4030 cases. Nevertheless, 21 cases were severe and two deaths occurred. Interestingly, for the two patients who died, the battery was stuck in the oesophagus and they presented anorexia and/or dysphagia, abdominal pain and fever and in one case, a melena 3 weeks after ingestion. Importantly, these symptoms were observed even if the battery was expelled in one fatal case. Ingestions of button batteries still occur and may cause serious damage, especially in children, and if the button battery is stuck in the oesophagus as it might cause severe symptoms. Patients who have ingested a button battery must be directed to the emergency department for medical evaluation, even if the button battery has been expelled from the body and even more if gastrointestinal symptoms are present.
Microplastic Contamination of Wild and Captive Flathead Grey Mullet (Mugil cephalus)
Lui, Ching Yee
2018-01-01
A total of 60 flathead grey mullets were examined for microplastic ingestion. Thirty wild mullets were captured from the eastern coast of Hong Kong and 30 captive mullets were obtained from fish farms. Microplastic ingestion was detected in 60% of the wild mullets, with an average of 4.3 plastic items per mullet, while only 16.7% of captive mullets were found to have ingested microplastics, with an average of 0.2 items per mullet. The results suggested that wild mullets have a higher risk of microplastic ingestion than their captive counterparts. The most common plastic items were fibres that were green in colour and small in size (<2 mm). Polypropylene was the most common polymer (42%), followed by polyethylene (25%). In addition, the abundance of microplastics was positively correlated with larger body size among the mullets. PMID:29587444
Suggestion of a Numerical Model for the Blood Glucose Adjustment with Ingesting a Food
NASA Astrophysics Data System (ADS)
Yamamoto, Naokatsu; Takai, Hiroshi
In this study, we present a numerical model of the time dependence of blood glucose value after ingesting a meal. Two numerical models are proposed in this paper to explain a digestion mechanism and an adjustment mechanism of blood glucose in the body, respectively. It is considered that models are exhibited by using simple equations with a transfer function and a block diagram. Additionally, the time dependence of blood glucose was measured, when subjects ingested a sucrose or a starch. As a result, it is clear that the calculated result of models using a computer can be fitted very well to the measured result of the time dependence of blood glucose. Therefore, it is considered that the digestion model and the adjustment model are useful models in order to estimate a blood glucose value after ingesting meals.
Attempted suicide by ingestion of hair dye containing p-phenylenediamine: a case report.
Beshir, Lamis; Kaballo, Babiker; Young, Donald
2017-07-01
Para-phenylenediamine is widely used as a chemical in hair dyes and in combination with henna. This dye is used to paint the body for decorative reasons, to speed the processing time of henna and to intensify the results. Para-phenylenediamine is widely used in the Middle East, North Africa and India. Several reports have been published of the fatal ingestion of hair dye containing para-phenylenediamine. Here, we describe the case of a 14-year-old girl who ingested the compound but whose prompt treatment prevented her death. Ingestion of para-phenylenediamine produces a typical triad of angioneurotic oedema, rhabdomyolysis and acute tubular necrosis. Awareness of signs of these associated conditions in our patient, together with a comprehensive history, facilitated appropriate treatment to be instituted. We document the steps we took to enable her complete physical recovery.
Microplastic Contamination of Wild and Captive Flathead Grey Mullet (Mugil cephalus).
Cheung, Lewis T O; Lui, Ching Yee; Fok, Lincoln
2018-03-26
A total of 60 flathead grey mullets were examined for microplastic ingestion. Thirty wild mullets were captured from the eastern coast of Hong Kong and 30 captive mullets were obtained from fish farms. Microplastic ingestion was detected in 60% of the wild mullets, with an average of 4.3 plastic items per mullet, while only 16.7% of captive mullets were found to have ingested microplastics, with an average of 0.2 items per mullet. The results suggested that wild mullets have a higher risk of microplastic ingestion than their captive counterparts. The most common plastic items were fibres that were green in colour and small in size (<2 mm). Polypropylene was the most common polymer (42%), followed by polyethylene (25%). In addition, the abundance of microplastics was positively correlated with larger body size among the mullets.
Mendel, Ron W; Hofheins, Jennifer E
2007-09-14
The purpose of this placebo-controlled, double-blind cross-over study was to compare the effects of two commercially available soft drinks on metabolic rate. After giving informed consent, twenty healthy men and women were randomly assigned to ingest 12 ounces of Celsiustrade mark and, on a separate day, 12 ounces of Diet Coke(R). All subjects completed both trials using a randomized, counterbalanced design. Metabolic rate (via indirect calorimetry) and substrate oxidation (via respiratory exchange ratio) were measured at baseline (pre-ingestion) and at the end of each hour for 3 hours post-ingestion. Two-way ANOVA revealed a significant interaction (p < 0.001) between trials in metabolic rate. Scheffe post-hoc testing indicated that metabolic rate increased by 13.8% (+ 0.6 L/min, p < 0.001) 1 hr post, 14.4% (+0.63 L/min, p < 0.001) 2 hr post, and 8.5% (+0.37 L/min, p < 0.004) 3 hr post Celsiustrade mark ingestion. In contrast, small (~4-6%) but statistically insignificant increases in metabolic rate were noted following Diet Coke(R) ingestion. No differences in respiratory exchange ratio were noted between trials. These preliminary findings indicate Celsiustrade mark has thermogenic properties when ingested acutely. The effects of repeated, chronic ingestion of Celsiustrade mark on body composition are unknown at this time.
Mendel, Ron W; Hofheins, Jennifer E
2007-01-01
Background The purpose of this placebo-controlled, double-blind cross-over study was to compare the effects of two commercially available soft drinks on metabolic rate. Methods After giving informed consent, twenty healthy men and women were randomly assigned to ingest 12 ounces of Celsius™ and, on a separate day, 12 ounces of Diet Coke®. All subjects completed both trials using a randomized, counterbalanced design. Metabolic rate (via indirect calorimetry) and substrate oxidation (via respiratory exchange ratio) were measured at baseline (pre-ingestion) and at the end of each hour for 3 hours post-ingestion. Results Two-way ANOVA revealed a significant interaction (p < 0.001) between trials in metabolic rate. Scheffe post-hoc testing indicated that metabolic rate increased by 13.8% (+ 0.6 L/min, p < 0.001) 1 hr post, 14.4% (+0.63 L/min, p < 0.001) 2 hr post, and 8.5% (+0.37 L/min, p < 0.004) 3 hr post Celsius™ ingestion. In contrast, small (~4–6%) but statistically insignificant increases in metabolic rate were noted following Diet Coke® ingestion. No differences in respiratory exchange ratio were noted between trials. Conclusion These preliminary findings indicate Celsius™ has thermogenic properties when ingested acutely. The effects of repeated, chronic ingestion of Celsius™ on body composition are unknown at this time. PMID:17908290
Neulander, Endre Z; Tiktinsky, Alex; Romanowsky, Igor; Kaneti, Jacob
2010-02-01
Vaginal foreign bodies in children usually present with foul-smelling discharge and/or vaginal bleeding. Rarely, these basic clinical diagnostic signs are not present. We report on a 5(1/2)-year-old girl with recurrent lower urinary tract infection as the sole presentation of multiple vaginal foreign bodies. Ultrasound of the lower urinary tract was inconclusive, and cystography indicated for recurrent urinary tract infections was declined by the patient in an outpatient setting. Cystography under general anesthesia raised the suspicion of foreign vaginal objects, and the definitive diagnosis was made by vaginoscopy. The relevant literature covering this subject is reviewed. High level of suspicion and strict basic diagnostic protocol are the most important steps for a timely diagnosis of this condition. Copyright 2010 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
Jagim, Andrew R; Jones, Margaret T; Wright, Glenn A; St Antoine, Carly; Kovacs, Attila; Oliver, Jonathan M
2016-01-01
Multi-ingredient pre-workout supplements (MIPS) are popular among resistance trained individuals. Previous research has indicated that acute MIPS ingestion may increase muscular endurance when using a hypertrophy-based protocol but less is known in regard to their effects on strength performance and high intensity running capacity. Therefore, the purpose was to determine if short-term, MIPS ingestion influences strength performance and anaerobic running capacity. In a double-blind, randomized, placebo controlled, crossover design; 12 males (19 ± 1 yrs.; 180 ± 12 cm; 89.3 ± 11 kg; 13.6 ± 4.9 %BF) had their body composition assessed followed by 5-repetition maximum (5RM) determination of back squat (BS; 119.3 ± 17.7 kg) and bench press (BP; 92.1 ± 17.8 kg) exercises. On two separate occasions subjects ingested a MIPS or a placebo (P) 30-minutes prior to performing a counter movement vertical jump test, 5 sets of 5 repetitions at 85 % of 5RM of BS and BP, followed by a single set to failure, and an anaerobic capacity sprint test to assess peak and mean power. Subjective markers of energy levels and fatigue were also assessed. Subjects returned one week later for a second testing session using counter treatment. MIPS resulted in a greater number of repetitions performed in the final set to failure in the BP (MIPS, 9.8 ± 1.7 repetitions; P, 9.1 ± 2; p = 0.03, d = 0.38), which led to a greater total volume load (set x repetitions x load) in the MIPS (753 ± 211 kg) compared to P (710 ± 226 kg; p =0.03, d = .20). MIPS ingestion improved subjective markers of fatigue (p = 0.01, d = 3.78) and alertness (p = 0.048, d = 2.72) following a bout of resistance training. An increase in mean power was observed in the MIPS condition (p = 0.03, d = 0.25) during the anaerobic sprint test. Results suggest that acute ingestion of a MIPS study may increase upper body muscular endurance. In addition, acute MIPS ingestion improved mean power output during an anaerobic capacity sprint test. However, the practical significance of these performance related outcomes may be minimal due to the small effect sizes observed. MIPS ingestion does appear to positively influence subjective markers of fatigue and alertness during high-intensity exercise.
Foreign bodies; or, how did Darwin invent the symptom?
Rowlinson, Matthew
2010-01-01
Beginning with a discussion of the sources in Darwin's writing for Freud's theory of the hysterical symptom, this essay proceeds to a symptomatic reading of Darwin himself. With reference to "The Origin of Species," "The Descent of Man," and "The Expression of the Emotions," this essay shows that Darwin's theories of involuntary expressive behavior and of aesthetic preference in sexual selection are linked by their role in his understanding of racial difference and also by their reliance on the idea that learned habits can be inherited as instincts, a view often identified with Lamarck. They are thus at once theories of the foreign body and theories that appear as foreigners within the body of Darwin's work.
TRAUMATIC (FOREIGN BODY) PERICARDITIS IN A TOCO TOUCAN (RAMPHASTOS TOCO).
Máinez, Mireia; Rosell, Jorge; Such, Roger; Cardona, Teresa; Juan-Sallés, Carles
2016-12-01
An approximately 10-yr-old, captive-born female toco toucan ( Ramphastos toco ) was presented due to an acute onset of depression and apathy. On visual and physical examination, it showed an abnormal posture and dehydration, respectively. Serum biochemistry revealed hyperuricemia (39.4 mg/dl) and elevated glutamic oxaloacetic transaminase (GOT; 1,050 U/L). Radiographs demonstrated an enlargement of the cardiac silhouette. The bird died 7 days after presentation, despite treatment with enrofloxacin, allopurinol, a preparation of hepatorenal protectors, and complex B vitamins with dextrose. Necropsy revealed severe fibrinohemorrhagic pericarditis with a 15 mm long and 2.5 mm diameter, rigid foreign body in the pericardial exudate. Microscopically, this foreign body was of vegetal origin.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Tapping, C. R.; Gallo, A.; Silva, R. J. De
2012-12-15
We present a case of endovascular retrieval of a penetrating foreign body that was originally lodged in the mediastinum and then migrated to the hepatic vein. The steel nail entered the thorax and traversed the left lung causing a pneumothorax. The patient underwent a thoracotomy, but the foreign body had migrated from its original mediastinal position. A postsurgical CT showed that the object was below the right hemidiaphragm. Diagnostic venogram demonstrated that the object was in the main hepatic vein. Using a double-snare technique, the object was safely and successfully removed from the hepatic vein via the right common femoralmore » vein.« less
Branch retinal artery occlusion post-penetrating globe injury with intraocular foreign body.
Nagpal, Manish; Chaudhary, Pranita; Jain, Ashish
2018-01-01
Intraocular foreign body (IOFB) in cases of penetrating eye injury accounts for an important indication of vitreoretinal intervention following ocular trauma. Vascular occlusion as a complication of IOFB is rare. Here we present a case of a 34-year-old male with post-traumatic cataract and an intraocular metallic foreign body (IOFB) lodged in the superficial layers of the retina inferotemporal to the disc, causing an inferotemporal branch retinal artery occlusion. The case was managed by lensectomy with pars plana vitrectomy and IOFB removal followed by a second procedure of secondary IOL implantation. Final best-corrected visual acuity improved to 6/24. This case highlights an unusual sequelae following penetrating ocular trauma.
Endovascular retrieval of dental needle retained in the internal carotid artery.
Moore, Kenneth; Khan, Nickalus R; Michael, L Madison; Arthur, Adam S; Hoit, Daniel
2017-03-08
Intravascular foreign bodies are a known complication of medical and dental procedures. Dental anesthetic needles may be broken off and retained in the oropharynx. These needles have occasionally been reported to migrate through the oral mucosa in to deeper structures. Here we present the case of a 57-year-old man who had a retained dental needle that had migrated into his internal carotid artery. The needle was removed using endovascular techniques. To our knowledge, this is the first report of a retained dental needle being retrieved using this method. We review the literature on intravascular foreign bodies, retained dental needles, and endovascular techniques for retrieval of such foreign bodies. 2017 BMJ Publishing Group Ltd.
Retrobulbar lymphoma associated with a ballistic foreign body in a cat.
Robat, C; Bemelmans, I; Marescaux, L
2016-04-01
A seven-year-old domestic shorthair cat, adopted 5 years previously with a corneal perforation of the left eye, was presented for investigation of a left orbital mass. Computed tomography revealed a metallic foreign body within a contrast-enhancing, heterogeneous orbital mass. Large cell lymphoma was diagnosed from a fine needle aspirate. The cat staged negatively and was treated with L-asparaginase, prednisolone and three fractions of radiation therapy. A rapid clinical remission was obtained and the cat remained in remission for 3 years after therapy. This is the first report of large cell lymphoma likely occurring secondary to a foreign body. © 2015 British Small Animal Veterinary Association.
Neural Control Mechanisms and Body Fluid Homeostasis
NASA Technical Reports Server (NTRS)
Johnson, Alan Kim
1998-01-01
The goal of the proposed research was to study the nature of afferent signals to the brain that reflect the status of body fluid balance and to investigate the central neural mechanisms that process this information for the activation of response systems which restore body fluid homeostasis. That is, in the face of loss of fluids from intracellular or extracellular fluid compartments, animals seek and ingest water and ionic solutions (particularly Na(+) solutions) to restore the intracellular and extracellular spaces. Over recent years, our laboratory has generated a substantial body of information indicating that: (1) a fall in systemic arterial pressure facilitates the ingestion of rehydrating solutions and (2) that the actions of brain amine systems (e.g., norepinephrine; serotonin) are critical for precise correction of fluid losses. Because both acute and chronic dehydration are associated with physiological stresses, such as exercise and sustained exposure to microgravity, the present research will aid in achieving a better understanding of how vital information is handled by the nervous system for maintenance of the body's fluid matrix which is critical for health and well-being.
Beuerlein, Knut; Löhr, Sandra; Westermann, Bettina; Ruth, Peter; Schipp, Rudolf
2002-12-01
Endocytotic-active cells in the branchial heart complex of Sepia officinalis were studied by in situ injection of different types of xenobiotics and by in vitro perfusion of the organ complex with a bacterial suspension. The rhogocytes (ovoid cells) ingest particles of all tested sizes by endocytosis and phagocytosis. The hemocytes of the circulating blood and the adhesive hemocytes in the wall of the branchial heart incorporate all tested kinds of foreign materials, including bacterial cells due to phagocytosis achieved by the triangular mesenchymatic cells. The ultrastructural findings also give strong evidence that the triangular mesenchymatic cells are fixed hemocytes that have migrated into the branchial heart tissue. The ingestion and digestion of allogeneic substances and bacteria or their debris by rhogocytes and/or all (forms of) hemocytes suggests the involvement of these either fixed or mobile endocytotic-active cells in the defense and detoxification system of cephalopods.
2010-01-01
In vitro bioaccessibility (IVBA) studies were carried out on samples of mercury (Hg) mine-waste calcine (roasted Hg ore) by leaching with simulated human body fluids. The objective was to estimate potential human exposure to Hg due to inhalation of airborne calcine particulates and hand-to-mouth ingestion of Hg-bearing calcines. Mine waste calcines collected from Hg mines at Almadén, Spain, and Terlingua, Texas, contain Hg sulfide, elemental Hg, and soluble Hg compounds, which constitute primary ore or compounds formed during Hg retorting. Elevated leachate Hg concentrations were found during calcine leaching using a simulated gastric fluid (as much as 6200 μg of Hg leached/g sample). Elevated Hg concentrations were also found in calcine leachates using a simulated lung fluid (as much as 9200 μg of Hg leached/g), serum-based fluid (as much as 1600 μg of Hg leached/g), and water of pH 5 (as much as 880 μg of Hg leached/g). The leaching capacity of Hg is controlled by calcine mineralogy; thus, calcines containing soluble Hg compounds contain higher leachate Hg concentrations. Results indicate that ingestion or inhalation of Hg mine-waste calcine may lead to increased Hg concentrations in the human body, especially through the ingestion pathway. PMID:20491469
Gray, John E; Plumlee, Geoffrey S; Morman, Suzette A; Higueras, Pablo L; Crock, James G; Lowers, Heather A; Witten, Mark L
2010-06-15
In vitro bioaccessibility (IVBA) studies were carried out on samples of mercury (Hg) mine-waste calcine (roasted Hg ore) by leaching with simulated human body fluids. The objective was to estimate potential human exposure to Hg due to inhalation of airborne calcine particulates and hand-to-mouth ingestion of Hg-bearing calcines. Mine waste calcines collected from Hg mines at Almaden, Spain, and Terlingua, Texas, contain Hg sulfide, elemental Hg, and soluble Hg compounds, which constitute primary ore or compounds formed during Hg retorting. Elevated leachate Hg concentrations were found during calcine leaching using a simulated gastric fluid (as much as 6200 microg of Hg leached/g sample). Elevated Hg concentrations were also found in calcine leachates using a simulated lung fluid (as much as 9200 microg of Hg leached/g), serum-based fluid (as much as 1600 microg of Hg leached/g), and water of pH 5 (as much as 880 microg of Hg leached/g). The leaching capacity of Hg is controlled by calcine mineralogy; thus, calcines containing soluble Hg compounds contain higher leachate Hg concentrations. Results indicate that ingestion or inhalation of Hg mine-waste calcine may lead to increased Hg concentrations in the human body, especially through the ingestion pathway.