Study on the Correlation between Barium Radiography and Pulmonary Infection rate in the Evaluation of Swallowing Function

OBJECTIVES: To compare the results respectively obtained from the utilization of 60% barium sulfate suspension and Iohexol as contrast agents for videofluoroscopic swallowing studies and the relationship between the clinical application of the two kinds of contrast agents and the incidence of pneumonia. METHODS: Sixty cases of stroke patients with dysphagia were selected in rehabilitation department of our hospital, and the gender, age, position of the disease, and stroke nature between groups had no significant difference. Among which, 30 patients who were administered 350 mgI/ml Iohexol, and the other 30 patients with 60% barium sulfate suspension as contrast agent. We performed videofluoroscopic swallowing studies with barium 60% versus Iohexol within 1 week after admission and 2 weeks after admission. RESULTS: After 2 weeks in hospital, the aspiration pneumonia incidence of two groups was statistically significant (p<0.05), the pneumonia incidence of Iohexol group was lower than barium sulfate group which might have a impossble relevance with barium aspiration. CONCLUSIONS: During the videofluoroscopic swallowing study of dysphagia after stroke, barium sulfate can enhance the pneumonia incidence, and Iohexol can be widely applied in videofluoroscopic swallowing study.

Barium enema reduction of intussusception in a developing country / Reducción de la intususcepción mediante enema de bario en un país en vías de desarrollo

OBJECTIVE: To determine the current success rate of barium enema reduction of intussusception and to investigate the factors affecting successful reduction. DESIGN AND METHODS: All patients admitted to the Eric Williams Medical Sciences Complex during the 8-year period from January 1, 2000 to December 31, 2007 with a diagnosis of intussusception were included. Patients' demographics, date and time of admission, clinical features, success of barium reduction, surgical findings and length of stay were recorded. The SPSS 12.0 programme was used for data analysis. RESULTS: There were 65 cases of intussusception. Vomiting and rectal bleeding were the most common presenting symptoms (55, 85% / 49, 75%). Fifty-eight patients underwent barium enema reduction with 41.4% (24/58) having successful reduction. Factors which significantly increased the success rate included males older than 12 months, non-opioid analgesia or no analgesia and an admission to enema reduction time of less than 6 hours. CONCLUSION: The successful reduction rate is relatively low (41%). A higher index of suspicion is needed in order to make a timely diagnosis and institute appropriate treatment quickly.

OBJETIVO: Determinar la tasa de éxito actual de reducción de la intususcepción por edema de bario e investigar los factores que afectan la reducción exitosa. PLAN Y MÉTODOS: Todos los pacientes ingresados en el Complejo de Ciencias Médicas Eric Williams por el período de 8 años que va del 1ero de enero de 2000 al 31 de diciembre de 2007 con diagnóstico de intususcepción, fueron incluidos. Se registró toda la información relacionada con los datos demográficos de los pacientes, fecha y tiempo de ingreso, características clínicas, éxito de la reducción por bario, resultados quirúrgicos, y duración de la hospitalización. Se usó el programa SPSS 12.0 para el análisis de los datos. RESULTADOS: Se produjeron 65 casos de intususcepción. Los vómitos y el sangramiento rectal fueron los síntomas presentes más comunes (55, 85%/49, 75%). A cincuenta y ocho pacientes se les practicó la reducción por enema de bario, logrando 41.4% (24/58) una reducción exitosa. Los factores que aumentaron la tasa de éxito de manera significativa fueron los varones con más de 12 meses, la analgesia no-opioide o ninguna analgesia, y un tiempo de ingreso para la reducción por enema, de menos de 6 horas. CONCLUSIÓN: La tasa de reducción exitosa es relativamente baja (41%). Se requiere un índice más alto de sospecha para hacer un diagnóstico oportuno e iniciar un tratamiento apropiado rápidamente.

Chronic abdominal pain: imaging of bowel

A 70-year-old-man was evaluated as an outpatient for chronic abdominal pain for the last two years. The pain was intermittent and not severe enough for him to seek immediate medical attention. There was no history of vomiting, abdomen distension, or of similar episodes in the past. He gave no history of any change in his bowel habits. There was no significant past medical history. On examination, his vital signs were stable. Abdominal examination was normal. An upper gastrointestinal series with small-bowel follow-through and a double contrast barium enema was performed, which clinched the diagnosis [Figures 1 and 2]. What is your diagnosis?

Viscosities reproductive patterns for use in videofluoroscopy and rehabilitation therapy of dysphagic patients / Padrões reprodutíveis de viscosidade para uso em videofluoroscopia e na terapia de reabilitação de pacientes disfágicos

BACKGROUND: Usually the suitable consistence identified and indicated as safe by videofluoroscopic method has been empirically obtained by association of barium sulfate solution with meals. However, it has been evidenced to be very difficult to reproduce this consistence in nutritional rehabilitation therapy from subjective information. AIM: To build two reproductive similar crescent viscosities series of solutions, with and without barium sulfate, to be used, the first, as radiological contrasted mean and the second, as base to reproduce the defined safer consistence, in the oral diet rehabilitation of dysphagic patients. METHODS: Two viscosity solutions series were obtained from starch and distilled water with and without 100 percent barium sulfate solution. The viscosity levels were defined step by step with digital viscosimeter (Brookfield, model LVTD-II) and with infrared thermometer Icel TD - 960. The fluids viscosity was register in centipoises, with their inferior and superior values followed by complimentary information about spindle kind, rotation speed and temperature. RESULTS: The two series of solutions, with and without barium sulfate, could be defined as aqueous (>1-143,5 cP), fine liquid (428 - 551 cP), thick liquid (4.284 -7.346,5 cP)), pasty (7.346,4 - 13.035 cP), pasty thick (19.260 - 34.320 cP) and creamy (163.500 - 255.300 cP). CONCLUSION: The study could offer reproductive formulas, with and without contrast mean, to be follow for obtaining the desirable viscosity to be used, each of them, in radiological evaluation and in nutritional diet minimizing the gaps fails between evaluation and therapy.

RACIONAL: Com freqüência, a consistência identificada e indicada pelo exame videofluoroscópico como segura, para uso nos pacientes disfágicos, tem sido empiricamente produzida pela mistura de alimentos com a solução de sulfato de bário. É expressiva a dificuldade observada quando se busca reproduzir esta consistência, subjetivamente indicada, para usá-la na terapia de reabilitação. OBJETIVO: Construir duas series de soluções, com valores reprodutíveis de viscosidade, uma com e outra sem a adição de sulfato de bário, a serem utilizadas a primeira, como meio de contraste radiológico, e a segunda, como base para reprodução da consistência definida como segura na reabilitação do paciente disfágico. MÉTODOS: As duas séries com viscosidades padrão foram buscadas com uso de amido, água destilada e solução de sulfato de bário a 100 por cento. Os níveis de viscosidade foram definidos passo à passo com o uso de um viscosímetro digital (Brookfield, model LVTD-II) e um termômetro de infravermelho Icel TD-960. As viscosidades foram registradas em centipoise (cP) e os limites superior e inferior de cada nível foi complementado pela informação do tipo e velocidade do "spindle" necessário e da temperatura da solução. RESULTADOS: As duas series de soluções, com e sem sulfato de bário, puderam ser definidas como aquosa (>1-143,5 cP), líquido fino (428-551 cp), liquido espesso (4.284-7.346,5 cp), pastosa (7.346,4-13.035 cP), pastosa espessa (19.260-34.320 cP) e cremosa (163.500-255.300 cP). CONCLUSÕES: Podem-se oferecer fórmulas com viscosidades reprodutíveis, com e sem adição de meio de contraste, a serem utilizadas, cada uma delas, na avaliação radiológica e na terapia nutricional, minimizando as falhas de reprodução entre a avaliação e a terapia.

Um novo método para avaliação da espessura gengival por meio de tomografia computadorizada helicoidal / A new method to evaluate the soft tissue thickness by using helicoid computed tomography

Os exames radiográficos têm sido de grande valor para a avaliação óssea e na obtenção de medidas do leito ósseo receptor para a instalação de implantes.Com a evolução das técnicas cirúrgicas e dos protocolos protéticos, novos exames tornaram-se necessários, tais como as tomografias computadorizadas helicoidais. Na seqüência desta evolução nos deparamos com a necessidade de se avaliar não só os tecidos ósseos como também os tecidos moles e, conseqüentemente, medir e separar esses tecidos com precisão. O presente artigo descreve uma técnica para obtenção de imagens por meio de tomografias computadorizadas que possibilitam, com precisão, a segmentação dos tecidos e com isso estimar a espessura dos tecidos gengivais.

Measurement of gastrointestinal transit time in non-anesthetized rats using barium sulfate as radiological contrast: preliminary results

Gastrointestinal-transit time may be accelerated or slowed down due to disease, hormones, metabolic conditions, surgery, or drug and plant action. There are severaI methods to measure intestinal transit, including the use of radioisotopes, stains, vegetal charcoal, radiopaque capsujes, and glass beads. Most experimental methods require anesthesia or euthanasia to remove the organs, which renders the procedures nonphysiologic or does not allow for the reutilization of the animais. The authors present a adiologicalmethod to measure gastrointestinal transit time in non-anesthetized adult rats, consisting of gastric introduction of 1 ml barium sulfate diluted 1:1 in water and follow-up with sequential radiographs until the contrast reaches the ileocecal region. The region was identified by the placement of a radiopaque ring 3 weeks before the procedure. The method was found to be simpie and easily performed, with transit time between the stomach and the ileocecal region ranging from 105 min to 150 min (mean 128 min).

O trânsito gastrintestinal pode ser acelerado ou diminuído por doenças, hormônios, condições metabólicas, cirurgias ou pela ação de drogas e plantas. Existem vários métodos para medir o trânsito intestinal. Alguns usam radioisótopos, corantes, carvão vegetal, substâncias radiopacas ou esferas de vidro. A maioria dos métodos experimentais requer anestesia ou eutanásia para remoção de órgãos, o que os torna não fisiológicos e impedem a reutilização dos animais. Estamos apresentando um método radiológico para medição do tempo de trânsito gastrointestinal em ratos adultos não anestesiados, no qual dministramos 1ml de sulfato de bário diluído com água 1:1, realizando-se radiografias seriadas até o contraste atingir a região ileocecal. O ceco foi previamente identificado pela instalação de um anel radiopaco três semanas antes. O método é simples, facilmente executado e mostrou um tempo de trânsito gastrointestinal variável entre 105 e 150min (M 128).

Barium peritonitis--following barium enema of the proximal colon through a colostomy

Perforation with extravasation of barium is a rare complication of contrast enema examination of the large bowel with a high associated mortality rate. The experience of performing a re-laparotomy in a patient previously exposed to barium peritonitis is even less common. We describe an elderly male patient with a Hartmann's procedure performed a year previously, presenting with peritonitis following barium enema evaluation of the proximal colon via an end descending colon stoma. Emergency laparotomy, segmental bowel resection and liberal peritoneal toilet resulted in a satisfactory outcome. The patient had a subsequent successful reversal of his Hartmann's procedure nine months later despite the presence of dense barium induced adhesions. This potentially preventable iatrogenic complication is discussed in this report, which is supplemented by a brief review of the English literature.