scholarly journals Hemorrhagic shock secondary to button battery ingestion

2014 ◽  
Vol 132 (3) ◽  
pp. 184-188 ◽  
Author(s):  
Naomi Andreia Takesaki ◽  
Marcelo Conrado dos Reis ◽  
Maria Luisa Ferreira de Miranda ◽  
Emílio Carlos Elias Baracat
Keyword(s):  
Emergency Service ◽  
Delayed Diagnosis ◽  
Exploratory Laparotomy ◽  
Easy Access ◽  
High Morbidity ◽  
Cardiorespiratory Arrest ◽  
Button Battery ◽  
X Ray ◽  
Severe Hypotension ◽  
High Level

CONTEXT:Button battery ingestion is a frequent pediatric complaint. The serious complications resulting from accidental ingestion have increased significantly over the last two decades due to easy access to gadgets and electronic toys. Over recent years, the increasing use of lithium batteries of diameter 20 mm has brought new challenges, because these are more detrimental to the mucosa, compared with other types, with high morbidity and mortality. The clinical complaints, which are often nonspecific, may lead to delayed diagnosis, thereby increasing the risk of severe complications.CASE REPORT:A five-year-old boy who had been complaining of abdominal pain for ten days, was brought to the emergency service with a clinical condition of hematemesis that started two hours earlier. On admission, he presented pallor, tachycardia and hypotension. A plain abdominal x-ray produced an image suggestive of a button battery. Digestive endoscopy showed a deep ulcerated lesion in the esophagus without active bleeding. After this procedure, the patient presented profuse hematemesis and severe hypotension, followed by cardiorespiratory arrest, which was reversed. He then underwent emergency exploratory laparotomy and presented a new episode of cardiorespiratory arrest, which he did not survive. The battery was removed through rectal exploration.CONCLUSION:This case describes a fatal evolution of button battery ingestion with late diagnosis and severe associated injury of the digestive mucosa. A high level of clinical suspicion is essential for preventing this evolution. Preventive strategies are required, as well as health education, with warnings to parents, caregivers and healthcare professionals.

Radiological safety and assessment of the performance of X-ray systems in veterinary facilities

2020 ◽  
Author(s):  
S. Economides ◽  
C.J. Hourdakis ◽  
C. Pafilis ◽  
G. Simantirakis ◽  
P. Tritakis ◽  
...  
Keyword(s):  
Decision Making ◽  
Radiation Protection ◽  
Atomic Energy Commission ◽  
Atomic Energy ◽  
Regulatory Control ◽  
Continuous Training ◽  
X Ray ◽  
The Public ◽  
Radiological Safety ◽  
High Level

This paper concerns an analysis regarding the performance of X-ray equipment as well as the radiological safety in veterinary facilities. Data were collected from 380 X-ray veterinary facilities countrywide during the on-site regulatory inspections carried out by the Greek Atomic Energy Commission. The analysis of the results shows that the majority of the veterinary radiographic systems perform within the acceptable limits; moreover, the design and shielding of X-ray rooms as well as the applied procedures ensure a high level of radiological safety for the practitioners, operators and the members of the public. An issue that requires specific attention in the optimization process for the proper implementation of veterinary radiology practices in terms of radiological safety is the continuous training of the personnel. The above findings and the regulatory experience gained were valuable decision-making elements regarding the type of the regulatory control of veterinary radiology practices in the new radiation protection framework.

Der Einfluß der Inaktivitätsosteoporose auf die szintigraphische Darstellung knöcherner Verletzungen im Bereich des Handgelenks

1989 ◽  
Vol 28 (04) ◽  
pp. 124-128 ◽  
Author(s):  
J. Spitz ◽  
N. Clemenz ◽  
K. Tittel ◽  
H. Weigand
Keyword(s):  
Bone Scintigraphy ◽  
Plaster Cast ◽  
Scaphoid Bone ◽  
X Ray ◽  
The Third ◽  
High Level ◽  
Clinical Conditions ◽  
Rate Of Accumulation

In addition to its established oncological indications the sensitivity of bone scintigraphy is of steadily increasing significance in traumatology. Inactivity- induced osteoporosis plays a major role during the immobilization period in the plaster cast. In the region of the joints remodelling intensity may reach such a high level that the non-injured bone shows a higher rate of accumulation than the fracture. This process already begins between the third and fourth week of immobilization. The highest uptake is found after fracture of the scaphoid bone at the end of twelve weeks of immobilization. Control scintigraphies at intervals of several days are indicated to differentiate between various clinical conditions (pseudoarthrosis, activated osteoarthrosis, algodystrophy in case of doubtful x-ray results).

Statistical analysis of distribution, dynamics and etiological structure of bovine diseases in Vologda region

2020 ◽  
pp. 3-4
Author(s):  
Oksana B. Badeeva ◽  
Keyword(s):  
Respiratory Diseases ◽  
Birth Rate ◽  
Statistical Data ◽  
Delayed Diagnosis ◽  
Specific Weight ◽  
Gastrointestinal Diseases ◽  
Vologda Region ◽  
High Incidence ◽  
Young Cattle ◽  
High Level

Statistical data of livestock for 30 years is reflected in the article. Author used the materials of the state veterinary reporting. A comparative analysis of the number, incidence and death rate of adult animals and young cattle for two five-year periods (2001-2005 and 2014-2018). the data of the analysis of veterinary statistical reports for 2018 on the specific weight of the large horned cattle and age dynamics of calves in farms of the Vologda region are shown. A significant decrease in livestock of the large horned cattle by 56.3% (from 1990 to 2018) is shown in the analysis of the data. Over the five years 2014-2018, there was a decrease in the number of the large horned cattle by 31.3%, the birth rate of calves - by 26.2%, and the incidence of calves - by 12.3% and the mortality rate decreased by 3.3%. Despite the decline in the number of livestock, in 2018 there is a high incidence of animal diseases (49.6%). The highest incidence rate was observed among calves under 10 days of age 43.3%, 31.7% - from 11 to 30 days, 15.8% - from one to three months, 6.5% - from three to six months and 2.7% - from 6 to 12 months. Of the total number of sick calves in 2018, 63.2% had gastrointestinal diseases, and death for this reason is 49.6% of the total number of victims. Respiratory diseases affect 21.8% of young animals, and death due to respiratory diseases is 18.2%. Analysis of statistical data showed that, despite the complex of veterinary and sanitary measures, the incidence and death of calves remain at a high level. This can be explained by delayed diagnosis and low therapeutic effectiveness in gastrointestinal and respiratory diseases of cattle.

Perforazione ileale da febbre tifoide

2021 ◽  
Vol 24 (9) ◽  
pp. 280-282
Author(s):  
Margherita Piqué ◽  
Elisabetta Ladisa ◽  
Luca Brasili ◽  
Giovanni Putoto ◽  
Lorenzo Iughetti
Keyword(s):  
Typhoid Fever ◽  
Public Health Problem ◽  
Wound Dehiscence ◽  
Exploratory Laparotomy ◽  
Watery Diarrhoea ◽  
Pelvic Cavity ◽  
Major Public Health Problem ◽  
General Malaise ◽  
X Ray ◽  
Clinical Conditions

Typhoid fever continues to be a major public health problem in developing countries and mortality is mainly related to its most frequent complication, namely: intestinal perforation. The paper presents the case of a 12-year-old girl with abdominal pain associated with watery diarrhoea, vomiting, fever and general malaise for two weeks. Typhoid fever was suspected, therefore therapy with ceftriaxone was started. Clinical conditions were worsening, so X-ray of the abdomen was performed with evidence of hydro-aerial levels and ultrasound showing abundant non-homogeneous echogenic material in the pelvic cavity, consistent with purulent ascites. Exploratory laparotomy was performed showing an isolated perforation of the ileus, which was sutured. In the postoperative period, antibiotic therapy was boosted with metronidazole and gentamicin. Due to the wound dehiscence, surgical revision with secondary tension sutures was necessary.

scholarly journals Severe hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with fluoxetine: case report

2006 ◽  
Vol 64 (1) ◽  
pp. 142-145 ◽  
Author(s):  
Carlos Alexandre Twardowschy ◽  
Cristina Buselatto Bertolucci ◽  
Cleverson de Macedo Gracia ◽  
Marta Ângela de Souza Brandão
Keyword(s):  
Emergency Service ◽  
Patient Experiences ◽  
Motor Deficits ◽  
Muscle Rigidity ◽  
Severe Hyponatremia ◽  
Drug Induced ◽  
Urinary Osmolality ◽  
X Ray ◽  
Inappropriate Secretion ◽  
Chest X Ray

Hyponatremia is a significant complication of treatment with serotonin selective reuptake inhibitors (SSRI). We describe a case of a 53-year-old woman that was started on fluoxetine 20 mg/day for depression. Nine days later, the patient started with weakness, nausea, progressing to confusion, inapetence and vomit. Three hours later she became unresponsive and had a generalized seizure. She was brought to our emergency service. On admission, the patient was normovolemic, without focal motor deficits, but had mild generalized muscle rigidity and Babinski's sign bilaterally. Serum sodium was 105 mmol/L, serum osmolality, 220 mmol/L, and urinary osmolality, 400 mmol/L. The other laboratory exams, chest X-ray, cerebrospinal fluid and cranium tomography were normal. She was found to have fluoxetine-induced SIADH and it was descontinued. We started the hyponatremia correction and, in 5 days, the mental status of the patient gradually returned to a normal baseline, paralleling the resolution of her hyponatremia, without recurrence. Hyponatremia and SIADH should be considered if a patient experiences deterioration in his or her clinical condition while taking SSRI. The use of SSRI antidepressants should be remembered in the differential diagnosis of drug-induced hyponatremia.

scholarly journals Community-acquired pneumonia in children – problems and solutions

2021 ◽  
Vol 66 (1) ◽  
pp. 9-21
Author(s):  
V. K. Tatochenko
Keyword(s):  
Pulmonary Infiltrate ◽  
Community Acquired Pneumonia ◽  
Atypical Pneumonia ◽  
Contributing Factors ◽  
X Ray ◽  
High Doses ◽  
Severity Of The Disease ◽  
Unclear Etiology ◽  
High Level

Pneumonia in children remains one of the most serious diseases. Despite intensive study, the diagnosis and treatment still present a variety of problems. The article is aimed to identify these problems and show the ways of their solution.One of the criteria for the diagnosis of pneumonia is pulmonary infiltrate on the X-ray image. Community-acquired pneumonia is often caused by Pneumococci and mycoplasma; respiratory viruses, influenza usually serve as contributing factors for bacterial infection. The high level of hyperand underdiagnosis of community-acquired pneumonia is associated with its similarity with ARVI; the registration of general violations (signs of the severity of the disease) improves the quality of diagnosis. The clinical and radiological picture helps to distinguish pneumococcal pneumonia from pneumonia caused by mycoplasma. To improve the diagnosis of community-acquired pneumonia, it is necessary to study inflammation markers during the first examination of the patient, which is impossible in the conditions of home care. Due to the growth of resistance of pneumococci to macrolides a community-acquired pneumonia of pneumococcal (and unclear) etiology requires the use of amoxicillin in high doses and macrolides (in case of atypical pneumonia). Gentle therapy of destructive pneumonia, steroids for metapneumonic pleurisy allow avoiding invasive interventions and help to repair lung tissue.

scholarly journals Burnout level and associated factors in a Sub-Saharan African medical setting: prospective cross-sectional survey.

2020 ◽  
Author(s):  
Jean-Rodolphe MACKANGA ◽  
Emeline Gracia MOUENDOU MOULOUNGUI ◽  
Josaphat IBA-BA ◽  
Pierre POTTIER ◽  
Jean-Baptiste MOUSSAVOU KOMBILA ◽  
...  
Keyword(s):  
Associated Factors ◽  
University Hospital ◽  
Hospital Environment ◽  
Easy Access ◽  
Cross Sectional ◽  
Middle Income ◽  
Medical Context ◽  
Sub Saharan ◽  
High Level ◽  
Hospital Center

Abstract Background: burnout in the hospital environment is a problem that affects care and training. Often explored in the high-income medical context, burnout is poorly studied in low and middle-income countries characterized by a precarious hospital situation and a high stake linked to the Millennium Development Goals. The aim of our study was to determine in medical practitioners, in a sub-Saharan African country’s medical context, the burnout level and associated factors. Methods: a prospective cross-sectional study by using a self-administered Likert-scale questionnaire addressed to doctors and doctoral medical students in Gabon. Maslach Burnout Inventory scale has been used. Burnout symptoms were defined by high level in at least one of the 3 dimensions. Severe burnout defined by high level in all dimensions. Explored factors: socio-demographic and psychometric. Multiple logistic regression has been performed. Results: among 104 participants, severe burnout prevailed at 1.9% (95% CI: 0.2% -6.8%) and burnout symptoms at 34.6% (95% CI: 25, 6% -44.6%). The associated factors with burnout symptoms: age (OR = 0.86, p = 0.004), clinical activity in a university hospital center (OR = 5.19, p = 0.006), the easy access to the hospital (OR = 0.59, p = 0.012), number of elderly dependents living with the practitioner (OR = 0.54, p = 0.012), to live in the borough where the hospital is located (OR = 0.24, p = 0.039) and to be favorable to traditional medicine (OR = 1.82, p = 0.087). Nagelkerke’s R-squared:53.1%. Conclusion: in Gabon, middle-income country, almost one practitioner in two has burnout symptoms. The young age, the university hospital center, the difficulty to access to hospital and to live in the borough where the hospital is located increase the probability of burnout symptoms. These results must put question to relevant authorities regarding health and medical education, to set up: a public transport for practitioners, an optimal primary health care system, a regulation of medical tasks in hospitals, a training in clinical supervision.

scholarly journals Emergency surgical management of sub-hepatic appendicular perforation with abscess; rare presentation of a common disease: a case report

2021 ◽  
Vol 9 (11) ◽  
pp. 3478
Author(s):  
S. K. Sekendar Ali ◽  
Narendra Nath Mukhopadhyay
Keyword(s):  
Case Report ◽  
Surgical Management ◽  
Perforated Appendicitis ◽  
Exploratory Laparotomy ◽  
Clinical Suspicion ◽  
Common Disease ◽  
Emergency Setting ◽  
Atypical Presentation ◽  
Rare Presentation ◽  
High Level

Subhepatic appendicitis is a very rare presentation that has been rarely reported, accounting for 0.01% of acute appendicitis case. It is difficult to diagnose and prime to be aware of variants, manage such challenging case in emergency setting. We present a case of 29 years male patient with subhepatic perforated appendicitis and its sequelae-abscess and peritonitis who underwent an exploratory laparotomy and appendectomy. The initial diagnosis and surgical management of such patients is challenging due to very rare and atypical presentation in emergency setting. A high level of clinical suspicion, promote decision to operate and skillful surgical approach is discussed with briefly.

scholarly journals Visible disability as a presenting feature of leprosy: a rare but real concern in post-elimination phase in India

2021 ◽  
Vol 7 (3) ◽  
pp. 457
Author(s):  
Vasudha A. Belgaumkar ◽  
Ravindranath B. Chavan ◽  
Nitika S. Deshmukh ◽  
Dhanshri D. Gangode
Keyword(s):  
Social Stigma ◽  
Delayed Diagnosis ◽  
Motor Impairment ◽  
Careful Examination ◽  
Easy Access ◽  
Saddle Nose ◽  
Global Rate ◽  
Rare Manifestation ◽  
Leprosy Patients ◽  
Health Significance

<p class="abstract">Leprosy (Hansen's disease) is a chronic infectious disease caused by <em>Mycobacterium leprae</em>, affecting mainly peripheral nerves and skin. Delayed diagnosis contributes to sensory-motor impairment leading to deformity and disability, thereby imposing a major impact on the physical, social, economic and psychological domains of the quality of life of affected individuals. Deformities and disabilities are largely preventable complications associated with tremendous social stigma and discrimination, assuming public health significance. India declared elimination of leprosy more than a decade and half ago in 2005. Hence, grade 2 disability is expected to be a rare manifestation in the post-elimination era. However, to the contrary, the proportion of new leprosy patients with visible disability recorded in India exceeds the global rate. Herein we report a middle-aged female presenting with saddle nose, bilateral fixed ulnar and mobile median claw hands (grade 2 disability) with multiple trophic ulcers. This case emphasizes that clinical suspicion after careful examination of skin and neural manifestations is of utmost importance for the early diagnosis of leprosy. Timely self-reporting and management with WHO-multi drug therapy (MDT) remains the key to minimize the risk of deformity and disability. Above all, it is essential to create awareness amongst the community regarding prompt recognition of symptoms and easy access to appropriate care along with intensified efforts to address the associated stigma.</p>

scholarly journals Serial Electron Diffraction Data Processing With diffractem and CrystFEL

2021 ◽  
Vol 8 ◽  
Author(s):  
Robert Bücker ◽  
Pascal Hogan-Lamarre ◽  
R. J. Dwayne Miller
Keyword(s):  
Electron Diffraction ◽  
Data Processing ◽  
Three Dimensional ◽  
Electron Diffraction Data ◽  
New Techniques ◽  
X Ray ◽  
X Ray Crystallography ◽  
Level Of Automation ◽  
Rotation Method ◽  
High Level

Serial electron diffraction (SerialED) is an emerging technique, which applies the snapshot data-collection mode of serial X-ray crystallography to three-dimensional electron diffraction (3D Electron Diffraction), forgoing the conventional rotation method. Similarly to serial X-ray crystallography, this approach leads to almost complete absence of radiation damage effects even for the most sensitive samples, and allows for a high level of automation. However, SerialED also necessitates new techniques of data processing, which combine existing pipelines for rotation electron diffraction and serial X-ray crystallography with some more particular solutions for challenges arising in SerialED specifically. Here, we introduce our analysis pipeline for SerialED data, and its implementation using the CrystFEL and diffractem program packages. Detailed examples are provided in extensive supplementary code.

Sign in / Sign up

Export Citation Format

Share Document