Case Report of Presumed (In)voluntary Capsaicin Intoxication Mimicking an Acute Abdomen

Background. The clinical features of a presumed capsaicin intoxication have not been reported so far. Case Presentation. A 27-year-old man took part in a qualifying for a competition in spicy food tolerance. During this qualifying, he swallowed 4 chili peppers type Bhut jolokia (about 1 million Scoville units) and other extremely spicy foods; the total amount of capsaicin ingested (roughly calculated retrospectively) accounted for at least 600 mg. After 2½ hours, the patient developed severe abdominal pain, which led to hospital admission. In contrast to the severe symptoms, clinical, laboratory, and imaging examinations (ultrasound and plain X-ray of the abdomen) did not reveal any significant abnormalities. Treatment with analgesics resulted in complete regression of the abdominal pain within 30 hours. Conclusions. The clinical picture in the view of pharmacological investigations on intestinal capsaicin infusions suggests that excessive doses of capsaicin can induce severe abdominal pain; the prolonged symptoms were probably due to the failure to vomit. Thus, a capsaicin intoxication must be considered in the differential diagnosis of an acute abdomen.

Tolerance in Preterm Infants Fed Exclusively with Human Milk. Prospective Analytic Study

Human milk is the best feeding for premature infants. When Own Mother’s Milk (OMM) is insufficient or unavailable, the alternative is represented by the Donor Milk (DM). OMM and DM must be fortified to support the adequate growth. Objectives: Evaluation of the food tolerance on preterm fed exclusively with fortified Human Milk (HM). Materials and Methods: This prospective analysis has been performed on a sample of 48 preterm with GA ≤ 32 weeks. Gastric Residual (GR), Vomiting (V) and Feeding Suspension (FS) are the parameters performed. We identified two categories (OMM/DM) and 4 groups: newborns fed exclusively with OMM (EOMM), with prevalent OMM (POMM), with exclusively DM (EDM) and with prevalent DM (PDM). Results: The overall incidence of GRs was 18%, the incidence of bilious residuals was 4%, the incidence of Vs was 4.5%, there was no indication of blood in the stool, the total percentage of days of FS was 12.7%. There was no statistical correlation between the incidence of GR, V, FS in the two categories (OMM/DM). The relationship between the kind of feeding and the GA or the BW was not statistically significant. Conclusions: The study highlights the irreplaceability of the OMM in feeding the preterm and that the DM is a valid substitute of OMM.

The efficiency of vitamin D using in the formation of food tolerance to cow’s milk protein in children with food allergy

The problem of vitamin D deficiency is one of the most actual today, because, according to the results of numerous studies, its deficiency is registered in half the worlds population. The article presents the results of a study on the level of vitamin D in children of first year of life, suffering from cows milk proteins allergy, as well as in children who have formed a secondary food tolerance to this allergen. In the article was evaluated the effectiveness of the additional use of vitamin D against the background of the therapeutic dairy-free diet use. It was found that the 57.1 4.8% children of first year of life with cows milk proteins allergy have vitamin D insufficiency. Normal vitamin D level was found in only 36.2 4.7% of patients. In turn, vitamin D deficiency was found in 6.7 2.4% children, suffering from cows milk proteins allergy. It was found that the additional daily intake of vitamin D on the background of the use of therapeutic dairy-free diet may reduce the time of development of food tolerance to cows milk proteins and achieve the formation of secondary food tolerance for the three years in 92.0 3.8% of children with cows milk proteins allergy. It was found, that the use of only therapeutic dairy-free diet allows to achieve the formation of secondary food tolerance only in 76.0 6.0% children (p 0.05). The normal level of vitamin D were established in 97.6 1.7 % children, formed a secondary food tolerance to cows milk proteins.

Oromandibular reconstruction with free fibula osteocutaneous flap after oncologic resection: retrospective analysis of surgical experience and operative outcome of 56 cases

Background: Reconstruction of post oncologic resection oromandibular defect is challenging and it provides the base for subsequent radiotherapy and oromaxillary rehabilitation for functional and aesthetic outcome. Multiple reconstructive options including different free flaps exist in the present time of greater awareness, facility and expertise in the field of free tissue transfer surgery. But free fibula osteocutaneous flap (FFOCF) has been the state of art in this area. FFOCF is technically difficult but believed to be reliable even to start with and has a progressively comprehensive surgical technique and learning curve. We are presenting here our experience of FFOCF reconstruction of 56 cases over the last 3 years.Methods: 56 patients operated between 2015 to 2018 were assessed retrospectively for operative and surgical outcome.Results: Flap was successful in 54 (96.43%) cases. Re-exploration was done in 4 cases and was successful in 2 cases. Jaw shape and contour was satisfactory in 70.37% and solid food tolerance was noted in 80.35% cases. Recurrence was seen in 5 cases.Conclusions: FFOCF is a reliable reconstructive option for complex oromandibular defect with a predictable outcome. Flap harvest is reliable and contouring is comprehensive. It gives good functional and aesthetic results with high success rate. Thus this flap is truly the preferred reconstructive option for all type of oncologic oromandibular defect with micro vascular surgery facilities.