RESUMEN

BACKGROUND: The in situ classification of bullets is of interest in forensic investigations when the bullet cannot be removed. Although computed tomography (CT) is usually performed on shooting victims, visual assessment, or caliber measurements using CT can be challenging or infeasible if the bullets are deformed or fragmented. Independent from the bullet's intactness, x-ray attenuation values (CT numbers) may provide information regarding the material of the bullet. METHODS: Ethical approval was not required (animal cadavers) or waived by the ethics committee (decedents). Copper and lead bullets were fired into animal cadavers, which then underwent CT scanning at four energy levels (80, 100, 120, and 140 kVp). CT numbers were measured within regions of interest (ROIs). In addition to comparing CT numbers, the dual-energy index (DEI), representing the ratio between the CT numbers of two energy levels, was calculated. The most appropriate method was applied for decedents with fatal gunshot wounds. RESULTS: CT numbers demonstrated no significant difference between copper and lead bullets, and false classifications can easily occur. DEI calculations revealed significant differences between the two groups of bullets. The 120/140 DEIs calculated from the maximum CT numbers obtained from ROIs at the edge of copper versus lead bullets presented a significant difference (p = 0.002) and a gap between the CT numbers of copper and lead bullets and was successfully applied for the decedents. CONCLUSIONS: This study presents a viable method for distinguishing copper and lead bullets in situ via CT and highlights the potential pitfalls of incorrect classifications.

Asunto(s)

Cobre , Cuerpos Extraños/clasificación , Cuerpos Extraños/diagnóstico por imagen , Plomo , Tomografía Computarizada por Rayos X/métodos , Heridas por Arma de Fuego/diagnóstico por imagen , Animales , Cadáver , Oveja Doméstica

Asunto(s)

Cuerpos Extraños/clasificación , Procedimientos Quirúrgicos Ginecológicos/normas , Cuerpos Extraños/epidemiología , Procedimientos Quirúrgicos Ginecológicos/métodos , Procedimientos Quirúrgicos Ginecológicos/estadística & datos numéricos , Humanos , Gestión de Riesgos/estadística & datos numéricos

RESUMEN

The aim of this study was to determine the risk factors for lower respiratory tract infection (LRTI) in children caused by tracheobronchial foreign body aspiration (TFBA).A total of 351 patients were retrospectively reviewed; all patients were diagnosed with TFBA at West China Hospital of Sichuan University from 2015 to 2017. Univariate analyses and multivariate analysis were used.Age (<2 years) (P < .001), type of foreign body (plant) (P < .001), shape of foreign body (nonsmooth) (P < .001), and residence time of foreign body (>7 days) (P = .001) were risk factors for LRTI on univariate analysis. Multivariate analysis showed age (<2 years) (hazard ratio [HR] = 4.457; 95% confidence interval [CI] = 2.031-6.884; P < .001), type of foreign body (plant) (HR = 2.686; 95% CI = 1.577-3.452; P < .001), shape of foreign body (nonsmooth) (HR = 1.649; 95% CI = 1.437-3.663; P < .008), and residence time of foreign body (>7 days) (HR = 1.751; 95% CI = 1.329-3.554; P = .004) were independent risk factors for LRTI. Furthermore, children with LRTI also had longer lengths of hospital stays and antibiotic use than did children without LRTI.Age, plant foreign body, nonsmooth foreign body, and long-term incarceration were all independent risk factors for LRTI in children. These results can help us to select more appropriate intervention times and stratified treatment for children with TFBA.

Asunto(s)

Antibacterianos/uso terapéutico , Bronquios , Cuerpos Extraños , Infecciones del Sistema Respiratorio , Tráquea , Preescolar , China/epidemiología , Femenino , Cuerpos Extraños/clasificación , Cuerpos Extraños/complicaciones , Cuerpos Extraños/diagnóstico , Cuerpos Extraños/epidemiología , Humanos , Lactante , Tiempo de Internación , Masculino , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/etiología , Infecciones del Sistema Respiratorio/terapia , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Tiempo de Tratamiento

RESUMEN

OBJECTIVES: The purpose of the present study was to determine the presence of radiopaque foreign bodies on oral and maxillofacial radiographs and classify them. METHOD AND MATERIALS: The Study Comment section of the Picture Archiving and Communication System of Chonnam National University Dental Hospital was searched using 30 key words to identify images with radiopaque foreign bodies recorded between November 2008 and March 2017. A total of 503 cases of radiopaque foreign bodies were selected from among the recovered images. The radiopaque foreign bodies were sorted into 19 types, which were subsequently divided into two categories according to whether the foreign bodies were inserted intentionally or unintentionally. The two categories were subdivided into five groups based on the cause of insertion: Treatment, Esthetics, Cultural, Iatrogenesis, and Accident. RESULTS: In this study, the proportions of foreign bodies inserted intentionally (48%) and unintentionally (52%) were similar. When the foreign bodies were grouped based on the cause of insertion, the following frequencies were observed: Treatment, 41%; Esthetics, 7%; Cultural, <1%; Iatrogenesis, 51%; and Accident, 1%. CONCLUSION: For adequate case management and to avoid unnecessary embarrassment and misinterpretation of unexpected radiopacities, clinicians should be familiar with the various types of foreign bodies and should ensure that detailed patient medical/dental history is obtained.

Asunto(s)

Tomografía Computarizada de Haz Cónico , Cuerpos Extraños/clasificación , Cuerpos Extraños/diagnóstico por imagen , Radiografía Dental , Artefactos , Implantes Cocleares , Instrumentos Dentales , Audífonos , Humanos , Anamnesis , Agujas , Prótesis e Implantes , Estudios Retrospectivos , Instrumentos Quirúrgicos

RESUMEN

PURPOSE: This study aimed to analyze the clinical characteristic of different foreign body injuries in children and offer the preventions. METHODS: A retrospective study and the demographic information, injury causes, foreign body injury types and other clinical factors were recorded and analyzed. RESULTS: Of the 2999 patients, 1877 (62.6%) were boys and 1122 (37.4%) were girls. The majority (72.8%, n = 2184) of the injuries were found in 1-3 years old children. The most common anatomical site was the respiratory tract (73.4%, n = 2201) followed by the digestive tract (18.6%, n = 558), the genitourinary tract (1.93%, n = 58) and other sites (6.07%, n = 182). There were 60.4% of the in-patients from rural areas and 53.2% of the patients without medical insurance, the rate of cost by medical insurance increased with age. The medians of length of hospital stay and hospitalization cost were four days and 4767.3 CNY respectively. Most of the patients had surgical treatment (90.6%, n = 2717) and 64.9% of them had the complications (n = 1946). The cure rates of the all foreign body injuries types were above 90%, especially in genitourinary tract (98.3%). CONCLUSION: Different types of the foreign body injuries had dissimilar clinical characteristics. The effective prevention and control measures should be taken according to the variety of high-risk population, incidence season and foreign body injury types.

Asunto(s)

Sistema Digestivo , Cuerpos Extraños/epidemiología , Sistema Respiratorio , Factores de Edad , Niño , Preescolar , China/epidemiología , Femenino , Cuerpos Extraños/clasificación , Cuerpos Extraños/etiología , Cuerpos Extraños/prevención & control , Genitales , Humanos , Lactante , Masculino , Riesgo , Población Rural/estadística & datos numéricos , Factores de Tiempo , Sistema Urinario

RESUMEN

Os corpos estranhos esofágicos (CEE), ocasionados geralmente por objetos pontiagudos, são comuns em cães, sendo uma das causas que frequentemente levam à regurgitação e disfagia. Seu tratamento consiste na remoção endoscópica ou cirúrgica do corpo estranho e tratamento de suas complicações. Relata-se um caso clínico de corpo estranho esofágico em paciente canino mestiço, de um ano, atendido no Hospital Veterinário da Universidade Paranense, apresentando histórico de ingestão de osso e regurgitação por um período de três dias anteriores à consulta, diagnosticado com CEE por meio do histórico e de radiografias torácicas obtidas durante seu internamento. O tratamento consistiu na remoção cirúrgica do CEE e tratamento sintomático das complicações e patologias concomitantes desenvolvidas ao longo do período pós-operatório, incluindo-se piotórax, babesiose e erliquiose. O método cirúrgico de remoção do corpo estranho esofágico no paciente canino relatado permitiu uma abordagem terapêutica e diagnóstica, proporcionando completa remoção do CEE e resolução da perfuração esofágica secundária.(AU)

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Esophageal foreign bodies (EFB), usually caused by sharp objects, are common in dogs, being one of the causes frequently leading to regurgitation and dysphagia. Treatment consists in endoscopic or surgical removal and treatment of any resulting complications. This is a report of a clinical case of esophageal foreign body in a one-year-old mixed-breed dog treated in the Teaching Veterinary Hospital of Universidade Paranense, with a history of bone ingestion and regurgitation for a period of three days prior to the visit. The EFB diagnosis was reached based on the history and chest radiographs obtained during hospitalization. The treatment consisted of the surgical removal of the EFB, symptomatic treatment of complications and concomitant conditions developed during the postoperative period, including pyothorax, babesiosis and erlichiosis. The surgical removal of the esophageal foreign body in the reported case allowed a therapeutic and diagnostic approach, providing the complete removal of the EFB and the resolution of a secondary esophageal perforation.(AU)

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Los cuerpos extraños esofágicos (CEE), ocasionados generalmente por objetos puntiagudos, son comunes en perros, siendo una de las causas que frecuentemente conduce a la regurgitación y disfagia. Su tratamiento consiste en la remoción endoscópica o quirúrgica del cuerpo extraño y el tratamiento de sus complicaciones. Se relata un caso clínico de cuerpo extraño esofágico en paciente canino mestizo, de un año, atendido en el Hospital Veterinario de la Universidad Paranaense, presentando histórico de ingestión de hueso y regurgitación por un período de tres días anteriores a la consulta, diagnosticado con CEE por medio del histórico y de radiografías torácicas obtenidas durante su internamiento. El tratamiento consistió en la remoción quirúrgica del CEE y tratamiento sintomático de las complicaciones y patologías concomitantes desarrolladas a lo largo del período postoperatorio, incluyendo piotórax, babesiosis y erliquiosis. El método quirúrgico de remoción del cuerpo extraño esofágico en el paciente canino relatado permitió un abordaje terapéutico y diagnóstico, proporcionando completa remoción del CEE y resolución de la perforación esofágica secundaria.(AU)

Asunto(s)

Animales , Perros , Endoscopía/métodos , Cuerpos Extraños/clasificación , Cuerpos Extraños/diagnóstico , Cuerpos Extraños/veterinaria , Modelos Anatómicos , Toracotomía/estadística & datos numéricos

RESUMEN

AIM: to present the results of treatment of rectal foreign bodies. MATERIAL AND METHODS: 15-year outcomes of 112 patients with rectal foreign bodies were analyzed. RESULTS: Outpatient and hospital care were applied in 52 (46%) and 60 (54%) of cases respectively. Transanal removal was made in 97 (87%) patients including 28 (25%) cases of general anaesthesia. 14 (13%) patients underwent surgery. Colostomy was performed in 7 (6%) cases. We presented cases of foreign bodies removal through laparotomy, colotomy and SILS-assisted transanal approach. DISCUSSION: From clinical point of view foreign bodies should be first of all classified by their dimensions. Anamnesis and physical examination are very important. Abdominal X-ray survey is obligatory. Transanal removal under general anaesthesia is advisable if perforation is absent. If such procedure is impossible laparotomy is indicated. CONCLUSION: Algorithm of survey and treatment is presented.

Asunto(s)

Cuerpos Extraños , Perforación Intestinal , Complicaciones Intraoperatorias , Laparotomía , Recto , Cirugía Endoscópica Transanal , Adulto , Femenino , Cuerpos Extraños/clasificación , Cuerpos Extraños/diagnóstico , Cuerpos Extraños/cirugía , Humanos , Perforación Intestinal/etiología , Perforación Intestinal/prevención & control , Perforación Intestinal/cirugía , Complicaciones Intraoperatorias/etiología , Complicaciones Intraoperatorias/prevención & control , Complicaciones Intraoperatorias/cirugía , Laparotomía/efectos adversos , Laparotomía/métodos , Masculino , Persona de Mediana Edad , Evaluación de Procesos y Resultados en Atención de Salud , Radiografía Abdominal/métodos , Recto/diagnóstico por imagen , Recto/lesiones , Recto/cirugía , Cirugía Endoscópica Transanal/efectos adversos , Cirugía Endoscópica Transanal/métodos , Ultrasonografía/métodos

RESUMEN

Se realizó un estudio prospectivo observacional en el Hospital Pediátrico Eliseo Noel Camaño de la provincia de Matanzas que incluyó a todo paciente que acudió al Cuerpo de Guardia con la presencia de un cuerpo extraño en la esfera otorrinolaringológica, desde Jjnio del 2011 a junio del 2013. La recolección de la información se realizó por las historias clínicas y una ficha de recolección de datos diseñada al efecto. Se procesaron los datos por el método porcentual, se confeccionaron tablas . La mayor frecuencia de estos accidentes, se concentró entre los 5 y 11 años de vida y entre el primer año y los 4. La mayor frecuencia correspondió a los cuerpos inorgánicos y en especial a los materiales escolares y de juegos, en presencia de adultos, con una localización mayormente, en oído y nariz, con valoración total por un especialista en Otorrinorangología y bajo porcentaje de complicaciones(AU)

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We carried out an observational prospective study in the Pediatric Hospital Eliseo Noel Caamaño, of the province of Matanzas, including every patient who assisted the Emergency Unit with the presence of a foreign body in the otolaryngological areas, from June 2011 to June 2013. The information was collected from the medical records and a card for collecting data designed for that. Data were processed using the percentage method; tables were elaborated. The highest frequency of these accidents was concentrated in the ages between 5 and 11 and between 1 and 4. The highest frequency corresponded to inorganic bodies, especially school and games materials, in the presence of adults, located mainly in the ear and nose, with the total assessment of an specialist in Otolaryngology and low percent of complications(AU)

Asunto(s)

Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Cuerpos Extraños/clasificación , Cuerpos Extraños/complicaciones , Cuerpos Extraños/epidemiología , Nariz , Oído , Faringe , Esófago , Bronquios , Otolaringología , Estudios Prospectivos

RESUMEN

BACKGROUND: An estimated 1,500 operations result in retained surgical items (RSIs) each year in the United States, resulting in substantial morbidity. The rarity of these events makes studying them difficult, but miscount incidents may provide a window into understanding risk factors for RSIs. METHODS: A cohort study of all consecutive operative cases during a 12-month period was conducted at a large academic medical center to identify risk factors for surgical miscounts. A multidisciplinary electronic miscount reconciliation checklist (necessitating both surgeon and nurse input) was introduced into the internally developed electronic Perioperative Information Management System to build a predictive model for RSI cases. RESULTS: Among 23,955 operations, 84 resulted in miscount incidents (0.35% [95% confidence interval: 0.28% to 0.43%]). Increased case duration was strongly associated with increased risk of a miscount in unadjusted analyses (p < .0001). In the nested case-control analysis, both the case duration and the number of providers present were independently associated with a more than doubling of the odds of a miscount, even after adjustment for one another, the elective/urgent/emergent status of a case, and personnel changes occurring during the case. CONCLUSIONS: The finding that both the length of the case and the number of providers involved in the case were independent risk factors for miscount incidents may offer insight into risk-targeted strategies to prevent RSIs, such as postoperative imaging, bar-coded surgical items, and radiofrequency technology. Miscounts trigger use of the Incorrect Count Safety Checklist, which can be used to determine whether a count completed at the procedure's conclusion is consistent across disciplines (circulating nurses, scrub persons, surgeons).

Asunto(s)

Centros Médicos Académicos/estadística & datos numéricos , Cuerpos Extraños/clasificación , Cuerpos Extraños/epidemiología , Procedimientos Quirúrgicos Operativos/estadística & datos numéricos , Factores de Edad , Estudios de Cohortes , Humanos , Personal de Hospital/estadística & datos numéricos , Calidad de la Atención de Salud , Factores de Riesgo , Factores de Tiempo , Estados Unidos

RESUMEN

This case report describes a foreign body retained in the liver long after perihepatic gauze packing. A 64-year-old female patient had suffered a rib fracture and liver rupture during a traffic accident in 1973. She discovered a mass in her right hypochondrium. Her hepatic ultrasonography showed a round mass (20.3 cm × 17.3 cm × 16.0 cm in size) with fluid echogenicity in the right lobe of her liver, and a hepatic cystic-solid mass (19.7 cm × 18.5 cm × 15.6 cm in size) was identified in an abdominal computerized tomography scan. Several pieces of gauze were extracted, and brown pus from the hepatic mass was suctioned during her exploratory laparotomy. Histology documented gauze remnants with necrotic material inclusions and fibrotic capsules. To our knowledge, this patient's case represents the longest time for which a foreign body has been retained in the liver. In addition, we conducted a comprehensive literature review of foreign bodies retained in the liver. Foreign bodies may be introduced into the liver via penetrating trauma, surgical procedures or the ingestion of foreign bodies (which then migrate from the gut). Thus, they can be classified into the following three categories: penetrating, medical and migrated foreign bodies. The details of the case are thoroughly described.

Asunto(s)

Cuerpos Extraños/etiología , Hígado/cirugía , Errores Médicos , Mallas Quirúrgicas , Heridas Penetrantes/cirugía , Femenino , Cuerpos Extraños/clasificación , Cuerpos Extraños/diagnóstico , Cuerpos Extraños/cirugía , Humanos , Hígado/diagnóstico por imagen , Hígado/lesiones , Persona de Mediana Edad , Reoperación , Factores de Tiempo , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Ultrasonografía

RESUMEN

OBJECTIVE: To assess the common foreign bodies in urban areas of Sindh, and the presentation, problems and complications during their removal through rigid bronchoscopy. METHODS: The descriptive study was conducted at the Ear, Nose and Throat Department and the Department of Head and Neck Surgery of Liaquat University Hospital, Hyderabad, and Abbasi Shaheed Hospital, Karachi, from April 2009 to October 2010. Fifty patients with strong suspicion of foreign body inhalation in whom rigid bronchoscopy was done were included in the study. A definitive diagnostic protocol was applied and rigid bronchoscopy was done to search and remove the foreign bodies. The data was fed into SPSS version 15 for descriptive analysis. RESULTS: In our study,28(56%) cases were male and 22(44%) were female. The age range was 1-7 years. Most of the victims (n=21; 42%) were over 3 years of age. Commonest symptom of presentation was dyspnoea (n=34; 68%) and the commonest sign of presentation was decreased unilateral air entry (n=25; 50%). Most of the foreign bodies were impacted in the right main bronchus (n=26; 52%). The most retrieved foreign body was betel nut (n=23; 46%). The commonest complication of bronchoscopy was airway oedema which occurred in 13 (26%) patients. The successful removal of exogenous foreign body was achieved in 41 (82%), and the mortality rate was 3 (6%). CONCLUSION: Delay in the diagnosis of foreign body inhalation translates into a higher risk of complications. Therefore, early bronchoscopy should be done on suspicion. Early recognition at both parental and clinical levels should be promoted through public awareness.

Asunto(s)

Obstrucción de las Vías Aéreas , Broncoscopía , Diagnóstico Tardío , Cuerpos Extraños , Sistema Respiratorio/fisiopatología , Obstrucción de las Vías Aéreas/diagnóstico , Obstrucción de las Vías Aéreas/etiología , Obstrucción de las Vías Aéreas/fisiopatología , Obstrucción de las Vías Aéreas/terapia , Broncoscopía/efectos adversos , Broncoscopía/métodos , Niño , Preescolar , Participación de la Comunidad/psicología , Diagnóstico Tardío/efectos adversos , Diagnóstico Tardío/prevención & control , Diagnóstico Tardío/psicología , Femenino , Cuerpos Extraños/clasificación , Cuerpos Extraños/complicaciones , Cuerpos Extraños/mortalidad , Cuerpos Extraños/terapia , Reacción a Cuerpo Extraño/diagnóstico por imagen , Reacción a Cuerpo Extraño/etiología , Humanos , Lactante , Masculino , Pakistán/epidemiología , Padres/educación , Padres/psicología , Radiografía , Factores de Riesgo , Resultado del Tratamiento , Población Urbana

RESUMEN

INTRODUCTION: The objective of this study was to evaluate the success rates of standardized techniques for removing or bypassing fractured instruments from root canals and determine whether visualization of the fractured instrument with the aid of an operating microscope has any impact on the success rates. METHODS: In this prospective study, attempts were made to visualize 112 fractured instruments under a dental operating microscope after creating a straight-line access to the fragment. By using ultrasonic tips alone or associated with bypassing, the Ruddle technique was attempted to remove the 68 visible instruments. Bypassing was performed for the 44 nonvisible fragments. The χ(2) test was performed to assess whether any significant difference occurred between the success rates observed for the visible and nonvisible fractured instrument groups. RESULTS: The overall success rate (removal and bypassing) was 70.5% (n = 79). In the visible fragment group, the success rate was 85.3% (n = 58), and in the nonvisible fragment group it was 47.7% (n = 21). Success rates were significantly higher when the fragment was visible (P = .0009). CONCLUSIONS: The standardized techniques used in this study for removing or bypassing fractured instruments were effective, and approximately 2 times greater success rate was obtained when the fragment was visible inside the root canal compared with when it was nonvisible.

Asunto(s)

Cavidad Pulpar , Cuerpos Extraños/terapia , Preparación del Conducto Radicular/instrumentación , Diente Premolar/patología , Diente Canino/patología , Materiales Dentales/química , Cavidad Pulpar/patología , Diseño de Equipo , Falla de Equipo , Cuerpos Extraños/clasificación , Humanos , Incisivo/patología , Microcirugia/instrumentación , Diente Molar/patología , Piezocirugía/instrumentación , Estudios Prospectivos , Irrigantes del Conducto Radicular/uso terapéutico , Preparación del Conducto Radicular/efectos adversos , Hipoclorito de Sodio/uso terapéutico , Titanio/química , Resultado del Tratamiento , Circonio/química

RESUMEN

OBJECTIVES: The entry of a small item into the respiratory or digestive tract is still one of the leading causes of injuries in children up to 14 years old. The aim of the paper is to provide a quantitative risk assessment analysis for identifying consumer product features which contribute to increase the risk of sustaining a severe injury. METHODS: Data on foreign body injuries were collected in 28 European countries and one Pakistani hospital. A total of 7296 cases were classified according to ICD-9CM 931-935. Information about injuries included age and gender of the injured child, circumstances of the accident and foreign body features. A classification tree was set up in order to analyze the impact of the item features like volume shape and rigidity on the severity of the injury. RESULTS: Males are involved in severe injuries more often than females. Most severe injuries when the foreign body is localized in the ears were due to objects with volume lesser than 49 mm(3). Volume cut-off is slightly higher for foreign bodies that have been found in the nose (55 mm(3)). Objects with conforming rigidity pose children to higher risk of severe injury. CONCLUSIONS: The presence and supervision of an adult is crucial in reducing the risk for severe injuries both in pharynx and laryhnx and in mouth.

Asunto(s)

Cuerpos Extraños/epidemiología , Tracto Gastrointestinal/lesiones , Hospitalización/estadística & datos numéricos , Sistema Respiratorio/lesiones , Adulto , Europa (Continente)/epidemiología , Femenino , Cuerpos Extraños/clasificación , Humanos , Clasificación Internacional de Enfermedades , Masculino , Pakistán/epidemiología , Medición de Riesgo , Distribución por Sexo

RESUMEN

OBJECTIVE: 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. STUDY DESIGN AND METHOD: 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. RESULTS: 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. CONCLUSION: 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.

Asunto(s)

Características Culturales , Cuerpos Extraños/clasificación , Lenguaje , Adolescente , Adulto , Obstrucción de las Vías Aéreas/diagnóstico , Obstrucción de las Vías Aéreas/etiología , Broncoscopía , Niño , Preescolar , Deglución/fisiología , Dieta/etnología , Femenino , Alimentos , Cuerpos Extraños/complicaciones , Cuerpos Extraños/diagnóstico , Hospitales Pediátricos/estadística & datos numéricos , Humanos , Lactante , Laringoscopía , Tiempo de Internación/estadística & datos numéricos , Masculino , Registros Médicos/estadística & datos numéricos , Nueva Gales del Sur/epidemiología , Padres/educación , Estudios Retrospectivos , Factores de Riesgo

RESUMEN

OBJECTIVE: To evaluate the staging criteria and surgical treatment strategy of traumatic intrathoracic esophageal perforations by foreign bone. METHODS: Fifty-seven patients with intrathoracic esophageal perforations caused by foreign bone in our department from January 1980 to June 2006 were studied. Patients were divided into 4 grades: grade I was esophageal perforation without mediastinitis (n=17), grade II was esophageal perforation with severe mediastinitis (n=13), grade III was esophageal perforation with severe empyema (n=21), grade IV was esophageal perforation with tracheal or aorto-esophageal fistula (n=6). Based on the stage of esophageal perforation, operative procedures were selected including esophagotomy, esophageal repair, esophagectomy, mediastinal drainage, and esophagus reconstruction with colon. RESULTS: In grade I, II and III, all but one patient experienced satisfactory healing of the esophagus. One patient died of multi-organ failure from septic complication. No leakage was observed. Normal swallowing function and improved weight gain was achieved in all the patients. There were 2 deaths in grade IV (2/6). CONCLUSIONS: Grading of esophageal perforation caused by foreign bone is helpful to the decision of surgical treatment strategy.

Asunto(s)

Perforación del Esófago/clasificación , Esófago/patología , Cuerpos Extraños/clasificación , Adolescente , Adulto , Anciano , Niño , Preescolar , Perforación del Esófago/cirugía , Esófago/cirugía , Femenino , Cuerpos Extraños/cirugía , Humanos , Lactante , Masculino , Persona de Mediana Edad , Adulto Joven

RESUMEN

Rectal foreign bodies present a difficult diagnostic and management dilemma because of delayed presentation, a variety of objects, and a wide spectrum of injuries. An orderly approach to the diagnosis, management, and post-extraction evaluation of the patient with a rectal foreign body is essential. This article outlines and describes the stepwise evaluation and management of the patient with a rectal foreign body. The authors also describe the varied techniques needed to successfully remove the different foreign bodies that may be encountered.

Asunto(s)

Cuerpos Extraños , Recto , Remoción de Dispositivos , Endoscopía Gastrointestinal , Cuerpos Extraños/clasificación , Cuerpos Extraños/diagnóstico , Humanos , Laceraciones/etiología , Examen Físico , Radiografía , Recto/diagnóstico por imagen , Recto/lesiones , Sigmoidoscopía

RESUMEN

Many articles have detailed local accidents and complications in dental implant treatment. Comparisons of the data they report are not always easy because different criteria have been followed in the various classifications and there is confusion between the terms accident and complication. The aim of this paper is to propose a classification that considers the timing of the events and makes a distinction between the two terms. Accidents are events that occur during surgery, and complications are any pathologic conditions that appear postoperatively. The proper diagnostic procedures and surgical techniques for their prevention and treatment are also described.

Asunto(s)

Implantación Dental Endoósea/efectos adversos , Implantes Dentales/efectos adversos , Complicaciones Intraoperatorias/prevención & control , Complicaciones Posoperatorias/prevención & control , Pérdida de Sangre Quirúrgica , Traumatismos del Nervio Craneal/clasificación , Falla de Equipo , Cuerpos Extraños/clasificación , Humanos , Complicaciones Intraoperatorias/clasificación , Complicaciones Intraoperatorias/terapia , Seno Maxilar/lesiones , Cavidad Nasal/lesiones , Complicaciones Posoperatorias/clasificación , Complicaciones Posoperatorias/terapia , Traumatismos de los Tejidos Blandos/clasificación , Dehiscencia de la Herida Operatoria/clasificación , Terminología como Asunto , Factores de Tiempo , Traumatismos de los Dientes/clasificación

RESUMEN

OBJECTIVE: Foreign bodies (FB) of the ear and nose are common findings in the pediatric population. The objective of this project is to present our experience of cases presented to our department and to correlate the insertion of the FB in relation to the child's handedness. METHODS: This project was carried out at the Department of Otorhinolaryngology Head and Neck Surgery of "Aghia Sophia" Children's Hospital (Athens, Greece), between December 2007 and August 2008. Data collected includes age and sex of the child, time elapsed between the insertion of the FB and its removal, type of FB, site of insertion, description of the child's handedness, conditions of removal and complications. RESULTS: 46 FB were removed from the nasal cavities. On the right nasal cavity, 29/31 (93.55%) children were right handed and 2/31 (6.45%) were left handed. On the left nasal cavity, 11/14 (78.57%) were right handed and 3/14 (21.43%) children were left handed. One right handed child had a FB in both nasal cavities. 44 FB were removed from the ear (external auditory canal: EAC), 30 (68.18%) from the right EAC and 14 (31.82%) from the left. On the right EAC, 28/30 (93.33%) children were right handed and 2/30 (6.67%) were left handed. Children with FB of the left EAC were 9/14 (64.29%) right handed and 5/14 (35.71%) left handed. CONCLUSIONS: Children insert FB into their nasal cavities randomly (P=0.308). As a result, there is no correlation with the child's handedness and right/left nasal cavities FB insertion. On the other hand, children do insert FB into their right/left EAC according whether they are right/left handed (P=0.014). Consequently, right handed children insert FB into their right EAC and left handed children into their left EAC.

Asunto(s)

Conducto Auditivo Externo , Cuerpos Extraños/clasificación , Lateralidad Funcional , Cavidad Nasal , Niño , Preescolar , Femenino , Humanos , Masculino , Estudios Retrospectivos

RESUMEN

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.

Asunto(s)

Accidentes/estadística & datos numéricos , Cuerpos Extraños/epidemiología , Hospitalización/estadística & datos numéricos , Adolescente , Brasil/epidemiología , Niño , Preescolar , Estudios Transversales , Femenino , Primeros Auxilios , Cuerpos Extraños/clasificación , Cuerpos Extraños/mortalidad , Humanos , Incidencia , Lactante , Masculino , Distribución por Sexo , Factores Sexuales

RESUMEN

Analisou-se os acidentes com corpo estranho entre menores de 15 anos, residentes em Londrina, Paraná, Brasil, atendidos em serviços de emergência/internação ou que morreram por estas causas, em 2001. Os dados foram obtidos nos hospitais gerais e no Núcleo de Informação em Mortalidade do município. Foram estudadas 434 crianças vítimas de acidentes com corpo estranho, revelando uma taxa de internação de 3,7 por cento e uma taxa de óbito de 0,7 por cento. Houve predomínio do sexo masculino (53,7 por cento) e o maior coeficiente foi na faixa etária de 1 a 3 anos (7,2 por mil crianças). A penetração de corpo estranho em orifício natural (olho, fossas nasais e conduto auditivo) representou 94 por cento, a inalação/ingestão de alimentos ocorreu em 2,8 por cento, a inalação/ingestão de objetos em 2,5 por cento e a inalação de conteúdo gástrico em 0,7 por cento dos casos, sendo responsável por todos os óbitos. A presente investigação pode contribuir no sentido de permitir aos planejadores analisar tendências, priorizar ações que contemplem a prevenção e atenção às vítimas desses eventos e desenvolver estratégias para a reestruturação dos serviços a fim de tornar mais eficiente o gerenciamento dos recursos.

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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 percent hospitalization rate and 0.7 percent mortality. Boys predominated (53.7 percent), 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 percent, inhalation/ingestion of food 2.8 percent, inhalation/ingestion of objects 2.5 percent, and aspiration of gastric contents 0.7 percent, 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.

Asunto(s)

Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Accidentes/estadística & datos numéricos , Cuerpos Extraños/epidemiología , Hospitalización/estadística & datos numéricos , Brasil/epidemiología , Estudios Transversales , Primeros Auxilios , Cuerpos Extraños/clasificación , Cuerpos Extraños/mortalidad , Incidencia , Distribución por Sexo , Factores Sexuales