Disk Battery Ingestion: A Simple User-Guide

2020 ◽  
Vol 15 ◽  
Author(s):  
Carmine Petruzziello ◽  
Paolo Maurizio Soave
Keyword(s):  
Emergency Physician ◽  
Case Reports ◽  
Flow Chart ◽  
Pediatric Age ◽  
Stable Patient ◽  
Publication Type ◽  
Severe Injuries ◽  
X Ray ◽  
Study Population ◽  
Serious Injuries

Introduction: Disk Battery Ingestion (DBI) is a cause of access to the emergency department (ED), especially in pediatric age. This problem, if not well managed, may lead to serious injuries, with several complications involving the gastrointestinal and respiratory tract. Objective: Aim of this review is to analyze the literature of the last 25 years to make a decisional flow-chart that may help the emergency physician. Methods: For this review 36 articles have been analyzed (8 articles and 28 case reports), from 1995 to 2019. Data considered from each study were: year of publication, type of study, population studied, type of battery, timing of ingestion, treatment, outcomes, complications. Results: A decisional flow-chart has been configured. X-ray should be performed as a first step in every stable patient, meanwhile CT scan should be performed in unstable patients. When the battery is still localized in the esophagus, endoscopy should be performed as soon as possible, meanwhile, when the battery is beyond the esophagus, it should be noted its diameter before taking a decision. Conclusion: The use of the flow-chart proposed may reduce the risk of consequences and severe injuries for the patients, helping the emergency physician in his decisional process.

Thickness and composition determinations from T.E.M. specimens using both x-ray and backscattered electron data

1984 ◽  
Vol 42 ◽  
pp. 576-577
Author(s):  
M.D. Ball ◽  
H. Lagace ◽  
M.C. Thornton
Keyword(s):  
Electron Microscope ◽  
Atomic Number ◽  
Transmission Electron Microscope ◽  
Convenient Method ◽  
Flow Chart ◽  
X Ray ◽  
Intensity Measurements ◽  
Transmission Electron ◽  
Electron Intensity ◽  
Backscattered Electron

The backscattered electron coefficient η for transmission electron microscope specimens depends on both the atomic number Z and the thickness t. Hence for specimens of known atomic number, the thickness can be determined from backscattered electron coefficient measurements. This work describes a simple and convenient method of estimating the thickness and the corrected composition of areas of uncertain atomic number by combining x-ray microanalysis and backscattered electron intensity measurements.The method is best described in terms of the flow chart shown In Figure 1. Having selected a feature of interest, x-ray microanalysis data is recorded and used to estimate the composition. At this stage thickness corrections for absorption and fluorescence are not performed.

scholarly journals Applicability of Moyers analysis in mixed dentition: A systematic review

2013 ◽  
Vol 18 (6) ◽  
pp. 100-105 ◽  
Author(s):  
Mariana de Aguiar Bulhões Galvão ◽  
Gladys Cristina Dominguez ◽  
Sérgio Thomaz Tormin ◽  
Alex Akamine ◽  
André Tortamano ◽  
...  
Keyword(s):  
Systematic Review ◽  
Literature Review ◽  
Clinical Case ◽  
Case Reports ◽  
Mixed Dentition ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Theoretical Probability ◽  
Study Population ◽  
Mixed Dentition Analysis

INTRODUCTION: Moyers analysis is widely used for analyzing mixed dentition, however, the accuracy of its theoretical probability tables has been recently questioned. Taking into consideration the fact the mixed dentition analysis is of paramount importance to precisely determine the space needed for alignment of canines and premolars, this research aimed at objectively assessing in the literature such an important step for orthodontic diagnosis. METHODS: A computerized search involving articles published on PubMed and Lilacs between 1990 and September, 2011 was conducted in accordance with the method described in the Cochrane 5.1.0 handbook. RESULTS: The research resulted in a sample composed of 629 articles. The inclusion criteria were: Articles using the Moyers analysis with a sample greater or equal to 40 patients. Conversely, the exclusion criteria were: Dental casts of patients with syndromes or oral cleft, researches conducted with a literature review, only, or clinical case reports and researches conducted before 1990. For this systematic review, 19 articles were selected. CONCLUSION: Based on the literature available, we can conclude that the Moyers mixed dentition analysis must be carefully used, since the majority of the articles analyzed showed that the probability of 75% was not as accurate as expected, leading to the need of adapting the probability levels depending on the study population.

scholarly journals Treatment of Cancer and Inflammation With Low-Dose Ionizing Radiation

Dose-Response ◽  
2017 ◽  
Vol 15 (1) ◽  
pp. 155932581769753 ◽  
Author(s):  
Shuji Kojima ◽  
Mitsutoshi Tsukimoto ◽  
Noriko Shimura ◽  
Hironobu Koga ◽  
Akishisa Murata ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Ulcerative Colitis ◽  
Bone Metastasis ◽  
Low Dose ◽  
Case Reports ◽  
Low Dose Radiation ◽  
X Ray ◽  
Radiation Hormesis ◽  
Irradiation Treatment ◽  
Dose Radiation

There is considerable evidence from experimental studies in animals, as well as from clinical reports, that low-dose radiation hormesis is effective for the treatment of cancer and ulcerative colitis. In this study, we present 3 case reports that support the clinical efficacy of low-dose radiation hormesis in patients with these diseases. First, a patient with prostate cancer who had undergone surgical resection showed a subsequent increase in prostate-specific antigen (PSA). His PSA value started decreasing immediately after the start of repeated low-dose X-ray irradiation treatment and remained low thereafter. Second, a patient with prostate cancer with bone metastasis was treated with repeated low-dose X-ray irradiation. His PSA level decreased to nearly normal within 3 months after starting the treatment and remained at the low level after the end of hormesis treatment. His bone metastasis almost completely disappeared. Third, a patient with ulcerative colitis showed a slow initial response to repeated low-dose irradiation treatment using various modalities, including drinking radon-containing water, but within 8 months, his swelling and bleeding had completely disappeared. After 1 year, the number of bowel movements had become normal. Interest in the use of radiation hormesis in clinical practice is increasing, and we hope that these case reports will encourage further clinical investigations.

The challenge of paediatric acquired demyelinating syndromes (ADS) in pediatric age: A case report description and a flow-chart proposal

2021 ◽  
Vol 429 ◽  
pp. 118874
Author(s):  
Mattia Pozzato ◽  
Vera Pacoova Dal Maschio ◽  
Sophie Guez ◽  
Alessandra Tozzo ◽  
Francesca Andreetta ◽  
...  
Keyword(s):  
Case Report ◽  
Flow Chart ◽  
Pediatric Age

The Likelihood of Injury Among Bias Crimes

2016 ◽  
Vol 32 (5) ◽  
pp. 703-729 ◽  
Author(s):  
Frank S. Pezzella ◽  
Matthew D. Fetzer
Keyword(s):  
Hate Crime ◽  
Hate Crimes ◽  
Severe Injuries ◽  
Bias Crimes ◽  
Physical Injuries ◽  
Severity Of Injury ◽  
And Gender ◽  
Minor Injuries ◽  
Sex Orientation ◽  
Serious Injuries

In 2009, President Barack Obama signed the Mathew Sheppard and James Byrd Jr. Hate Crimes Protection act and thereby extended the list of previously protected classes of victims from actual or perceived race, color, religion, national origin, disability and sex orientation to gender and gender identity. Over 45 states, the District of Columbia and the federal government now include hate crime statutes that increase penalties when offenders perpetrate hate crimes against protected classes of victims. Penalty enhancement statutes sanction unlawful bias conduct arguably because they result in more severe injuries relative to non-bias conduct. We contend that physical injuries vary by bias type and are not equally injurious. Data on bias crimes was analyzed from the National Incident Based Reporting System. Descriptive patterns of bias crimes were identified by offense type, bias motivation and major and minor injuries. Using Multivariate analyses, we found an escalating trend of violence against racial minorities. Moreover, relative to non-bias crimes, only anti-White and anti-lesbian bias crimes experienced our two prong “animus” criteria of disproportionate prevalence and severity of injury. However, when compared to anti-White bias, anti-Black bias crimes were more prevalent and likely to suffer serious injuries. Implications for hate crime jurisprudence are discussed.

Abstract 17289: Incidence of Cardiomyopathy and Mortality in Patients With Cobalt and Chromium Metal Hip Arthroplasty

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Shiva P Ponamgi ◽  
Sunita Sharma ◽  
Christopher V DeSimone ◽  
Cody Wyles ◽  
Philip Philip Sun ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Case Reports ◽  
P Value ◽  
Total Hip ◽  
Metal Implants ◽  
Arthroplasty Registry ◽  
Metal On Metal ◽  
Study Population ◽  
Metal Group

Introduction: One million patients around the world have had total hip arthorplasty with 35% of them having metal-on-metal implants. Although there have been some case reports of cobalt cardiotoxicity from arthroprosthetic cobaltism resulting in dilated cardiomyopathy, incidence of cardiomyopathy and mortality in these patients is unknown. Objective: We therefore sought to determine the incidence of new onset cardiomyopathy (EF <40%) and associated mortality, in patients with metal hip arthroplasty. Methods: We retrospectively examined the records of the patients form our institutional total hip arthroplasty registry (Metal on Metal: MoM, Metal on Polyethylene: MoP, Ceramic on Ceramic: CoC and Ceramic on Polyethylne: CoP). Among 122 patients with baseline and follow up echocardiograms, cobalt and chromium levels were available in 12 patients, none of which developed incident cardiomyopathy. Results: The mean age of the population with metal group (MoM and MoP) was 53 years, predominantly males. During the follow up period of 10 years, the cumulative incidence (KM curve probabilities) of low EF <=40% in our study population was 14% in metal group as compared to 5% in non-metal group (CoC and CoP), (p value 0.51). At 15 years of follow up, among 122 patients, there were16 deaths in the metal group (81) and only 2 deaths in the non-metal group (41) (p value 0.15). Conclusions: In conclusion, although the incidence of cardiomyopathy as well as mortality is low in patients with metal hip arthroplasty and not significantly, further studies maybe needed to assess its effect on diastolic dysfunction.

Retroperitoneal Xanthogranuloma; Priority of Case Reports

PEDIATRICS ◽  
1963 ◽  
Vol 31 (5) ◽  
pp. 883-883
Author(s):  
MELVIN S. KRUGLY
Keyword(s):  
British Journal ◽  
Case Reports ◽  
Retroperitoneal Space ◽  
Male Child ◽  
Age Group ◽  
Pediatric Age ◽  
The Third ◽  
Pediatric Age Group

I received a letter from Dr. Walton M. Edwards, requesting us to acknowledge his report of an xanthogranuloma in the retroperitoneal space as the second case in the pediatric literature. Since our paper, "Retroperitoneal Xanthogranuloma"(Pediatrics, 30:608, 1962) was submitted for publication this paper by Captain Douglas H. Sandberg, M.C., and Colonel Walton M. Edwards, M.C., appeared in the British Journal of Urology, 34:47, 1962, reporting a case of xanthogranuloma of the retroperitoneal space in a 3-year-old male child. Our case is therefore the third to be reported in the pediatric age group and not the second as we reported.

scholarly journals LO68: Patterns and predictors of emergency physician productivity

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S30-S31
Author(s):  
S. Campbell ◽  
S. Weerasinghe
Keyword(s):  
Emergency Department ◽  
Quality Of Care ◽  
Ct Scan ◽  
Resource Utilization ◽  
Emergency Physician ◽  
X Ray ◽  
Workload Measurement ◽  
Number Of Patients ◽  
Return Visits

Introduction: Emergency Physician (EP) performance comprises both quality of care and quantity of patients seen in a set time. Emergency Department (ED) overcrowding increases the importance of the ability of EPs to see patients as rapidly as is safely possible. Maximizing efficiency requires an understanding of variables that are associated with individual physician performance. While using the incidence of return visits within 48 hours as a quality measure is controversial, repeat visits do consume ED resources. Methods: We analysed the practice variables of 85 EPs working at a single academic ED, for the period from June 1, 2013 to May 31, 2017, using data from an emergency department information system (EDIS). Variables analysed included: number of shifts worked, number of patients seen per hour (pt/hr), an adjusted workload measurement (assigning a higher score to CTAS 1-3 patients), percentage of patients whose care involved an ED learner, and the percentage of patients who returned to the ED within 48 hours of ED discharge. Resource utilization was measured by percentage of diagnostic imaging (ultra sound (US), CT scan (CT), x-ray (XR)) ordered and percentage of patients referred to consulting services. We performed principal component analyses to identify bench marks of resource use, demographic (age, EM qualification, gender) and other practice related predictors of performances. Results: Mean pt/hr differed significantly by EM Qualification for CTAS 2-4, with 1.71/hr (95% Confidence Interval=1.63-1.77) by FRCPS physicians, compared to 1.89/hr by CCFP(EM) (CI=1.81-1.97). There were no differences for CTAS 1 and 5. Other variables associated with a significantly lower pt/hr, included a greater use of imaging, (CT: p=0.0003, XR: p=0.0008) although this was did not reach statistical significance with US (p=0.06%). Female gender, older age, number of patient consultations for CTAS 3 and more patients seen by a learner were all associated with lower pt/hr. Pt/hr was a better predictor (R2=45%) for EP resource utilization than adjusted workload measurement (R2 =35%). Higher use of CT was associated with fewer return visits in <48 hrs (0.13% lower). Male gender, younger age, number of patient consultation for CTAS 3 and fewer patients seen by a learner were all associated with an increase in return visits. Conclusion: We found a significant difference in pt/hr rates and return visits within 48 hours between EPs with different age ranges, gender, and EM certification. Increased use of CT scan and x-ray, and consultation for patients CTAS 3 were associated with lower pt/hr. Return visit rates also varied in association with diagnostic imagine use, age, gender and number of patients seen by a learner. Further research is needed to assess the association with these variables on quality of care.

1325Zero-fluoroscopy cryoablation for treatment of atrioventricular nodal reentry tachycardia in adult and pediatric patients

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
T Prolic Kalinsek ◽  
D Zizek ◽  
J Stublar ◽  
D Kuhelj ◽  
M Jan
Keyword(s):  
Pediatric Patients ◽  
Slow Pathway ◽  
Imaging Method ◽  
Rf Ablation ◽  
X Ray ◽  
Electroanatomic Mapping System ◽  
First Choice ◽  
Atrioventricular Nodal Reentry Tachycardia ◽  
Study Population ◽  
Reentry Tachycardia

Abstract Funding Acknowledgements None Introduction Cryoablation is considered a safe but somewhat less effective alternative to radiofrequency ablation (RF) for treatment of atrioventricular nodal reentry tachycardia (AVNRT). Additionally, it is traditionally performed with the aid of X-ray fluoroscopy as the principal imaging method causing radiation exposure, which is especially undesired in the pediatric population. Purpose The aim of our study was to assess feasibility, safety and success rate of nonfluoroscopic cryoablation for treatment of AVNRT. Methods Forty-eight consecutive patients with a diagnosed AVNRT (aged 40 ± 22 years, 29 (60%) female, 19 (40%) male) were included in the study. Among the study population, 14 (29%) were pediatric patients aged 11.5 ± 4.1 years. Cryoablation was used at the discretion of the operator. Only three dimensional electroanatomic mapping system and intracardiac electrograms were used to guide catheter movement and positioning. X-ray fluoroscopy was not used. The initial approach in all procedures was cryomapping in the region of the slow pathway during ongoing AVNRT, with a switch to cryoablation when termination of tachycardia within 20 seconds of reaching -30°C was achieved. When cryomapping was not possible due to catheter instability, cryoablation was used during ongoing AVNRT for up to 10 seconds at -70°C or lower. When AVNRT was not readily inducible, termination of slow pathway conduction was targeted with cryomapping during programmed stimulation with atrial extrastimuli. Procedural endpoint was noninducibility of AVNRT. Recorded residual slow pathway conduction was not considered a failure. Results Mean procedural duration was 79 ± 34 minutes. On average, 4 ± 2 cryoablations, with a 240 seconds of cryoablation time per each application. Cryoablation was used as a first choice in 45 (45/48, 93.7%) patients. In the remaining 3 patients (3/48, 6.3%) RF ablation failed as the first choice due to transient AV conduction disturbance and cryoablation had to be used to reach the endpoint. Cryoablation was unsuccessful only in 3 cases (6.6%) where RF ablation was needed to achieve procedural endpoint. Targeting termination of AVNRT during cryomapping or cryoablation was possible in 25 patients (25/48, 52%). In 14 patients AVNRT was not inducible and termination of the slow pathway conduction was targeted instead. In 9 patients inadvertent catheter tip contact mechanically terminated AVNRT or slow pathway conduction; site of mechanical termination was then targeted with cryoablation. After mean follow-up of 349 ± 201 days 47 patients were free of recurrence (47/48, 98%). There were no procedural complications. Conclusions In our study population with adult and pediatric patients, zero-fluoroscopy cryoablation of AVNRT proved feasible, safe and resulted in high success rates. Cryomapping or cryoablation for AVNRT termination was possible in approximately half of the procedures.

scholarly journals Use of Scheimpflug imaging in the management of intra-lenticular foreign body

2015 ◽  
Vol 7 (1) ◽  
pp. 82-84 ◽  
Author(s):  
R Singh ◽  
J Ram ◽  
R Gupta
Keyword(s):  
Foreign Body ◽  
Intraocular Lens ◽  
Foreign Bodies ◽  
Case Reports ◽  
Slit Lamp ◽  
Traumatic Cataract ◽  
X Ray ◽  
Scheimpflug Imaging ◽  
History Of ◽  
Post Traumatic

Introduction: Asymptomatic traumatic intra-lenticular foreign body is very uncommon and few case reports have been published.Objective: To report a case of post-traumatic intra-lenticular foreign body and use of Scheimpflug imaging in its management. Case: 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. Conclusion: An intra- lenticular foreign body may remain asymptomatic for months. Scheimpflug imaging can be useful in its localization. It can be removed during phacoemulsification.

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