Complicaciones perianales causadas por agentes modeladores inyectados en glúteos / Perianal complications caused by gluteal injection of modeling agents

En este reporte presentamos tres pacientes en quienes ocurrieron condiciones inflamatorias perianales tardías, luego de la administración de sustancias modeladoras no identificadas en los glúteos. El diagnóstico inicial y supuesto no fue correcto, ya que no se investigó durante la evaluación preliminar el antecedente de la administración de elementos modeladores. Recomendamos que los pacientes con patologías inflamatorias del ano, sobre todo aquellos cuyo curso es extraño, se les pregunte acerca de la administración de agentes modeladores en los glúteos. Esta práctica puede contribuir a la eficacia del diagnóstico de manifestaciones perianales caracterizadas por flogosis, que se presentan de forma inusual. (AU)

In this report we present three patients in which late perianal inflammatory conditions occurred after administration of unidentified modeling agents to the buttocks. The initial diagnosis was not correct because of the administration of modeling agents was not investigated during the initial eval-uation. We recommend inquiring patients with inflammatory pathologies of the anus, especially those whose course is unusual, about the adminis-tration of modeling agents to the buttocks. This approach can contribute to the efficiency of the diagnosis of perianal complaints characterized by inflammation, but rare in its appearance. (AU)

Keratitis in patients with corneal foreign bodies: a cross-sectional study in Cali, Colombia / Ceratite em pacientes com corpos estranhos na córnea: um estudo transversal em Cali, Colômbia

ABSTRACT Purposes: To describe the clinical characteristics and factors associated with keratitis in patients with corneal foreign bodies in Colombia. Methods: This cross-sectional study was based on a clinical records review of patients who had corneal foreign bodies and were admitted to the emergency department between June 2018 and June 2019 in Cali, Colombia. The primary outcome was the presence of keratitis diagnosed based on clinical criteria. Univariate and multivariate logistic regression models were used to identify associated factors. Results: A total of 381 corneal foreign bodies in 372 patients were analyzed (median age, 40.0; interquartile range, 29.0-53.0 years; male, 94.7% (n=352). Ninety-five patients developed keratitis (24.9%, 95% confidence interval [CI] 20.8%-29.5%). In the multivariate analysis, age 30 years (odds ratio [OR] 2.15, 95% CI 1.06-4.36), finding of aqueous flare (OR 2.81, 95% CI 1.39-5.66]), and a foreign body in the peripheral cornea (OR 2.05, 95% CI 1.19-3.50] were associated with an increased risk for keratitis. Sex, time between injury and admission, and corneal edema were not related to keratitis (p>0.05). Conclusion: In Cali, Colombia, a high proportion of keratitis was reported in patients with corneal foreign body. Age, an aqueous flare, and a foreign body in the peripheral cornea were the factors associated with keratitis.

RESUMO Objetivo: Descrever as características clínicas e os fatores associados à presença de ceratite em pacientes com corpos estranhos na córnea em uma população colombiana. Métodos: Trata-se de um estudo transversal baseado na revisão dos registros clínicos de pacientes com corpos estranhos na córnea admitidos em um departamento de emergência em Cali, Colômbia, entre junho de 2018 e junho de 2019. O desfecho primário foi a presença de ceratite diagnosticada através de critérios clínicos. Foram utilizados modelos de regressão logística univariada e multivariada para identificar os fatores associados. Resultado: Neste estudo, foi analisado um total de 381 corpos estranhos na córnea em 372 pacientes (idade média: 40,0 anos, intervalo interquartil: 29,0-53,0; sexo masculino: 94,7% [352 casos]). Noventa e cinco casos desenvolveram ceratite (24,9%, intervalo de confiança de 95% — IC 95%: 20,8%-29,5%). Na análise multivariada, para idade ≤30 anos (razão de chances — RC: 2,15, IC 95%: 1,06-4,36), o achado de flare aquoso (RC: 2,81, IC 95%: 1,39-5,66]) e a presença de corpo estranho na periferia da córnea (RC: 2,05, IC 95%: 1,19-3,50) foram associados a um risco aumentado de ceratite. Sexo, tempo entre a lesão e a internação, e edema da córnea não foram relacionados à ceratite (p>0,05). Conclusão: Há uma proporção elevada de ceratite em casos de corpos estranhos na córnea em Cali, Colômbia. Os três fatores associados à ceratite foram a idade, o achado de flare aquoso e a presença de corpo estranho na periferia da córnea.

Aspectos gerais do retículo peritonite traumática em bovinos / General aspects of traumatic reticulum peritonitis in cattle / Aspectos generales de la peritonitis del retículo traumático en ganado

A Retículo Peritonite Traumática está diretamente ligada à ingestão de objetos metálicos perfuro cortantes, como pregos e pedaços de arame, que podem penetrar ou perfurar a parede do retículo. Embora a ocorrência de corpos estranhos de alumínio seja rara, outros elementos, como fios de pneus usados para fixar lonas em silagens e até cerdas de arame de escovas utilizadas em pequenos aeroportos, têm sido registrados como causas dessa afecção. A ingestão desses objetos pode resultar em lesões no retículo, desencadeando episódios de retículo peritonite traumática e suas sequelas, como pericardite traumática, inflamação do fígado, abscessos no baço e muito mais. Os sinais clínicos podem variar, mas incluem comportamento anormal, motilidade reduzida do rúmen, fezes mal digeridas, febre e sinais de dor. O diagnóstico baseia-se na avaliação dos sinais clínicos do animal, juntamente com exames complementares, como hemograma, bioquímico, ultrassom e radiografia. É importante considerar as alterações hematológicas, como leucocitose e hiperfibrinogenemia, como indicadores-chave desta afecção. O diagnóstico também envolve testes de dor ao corpo estranho. O tratamento pode ser conservativo ou cirúrgico. A abordagem conservativa envolve a administração de antibióticos, anti-inflamatórios e soluções intravenosas, além do tratamento de deficiências nutricionais subjacentes. A opção cirúrgica exige a remoção do corpo estranho do retículo, seguida de cuidados pós-operatórios.

Traumatic Reticulum Peritonitis this directly linked to the ingestion of sharp metallic objects, such as nails and pieces of wire, which can penetrate or pierce the wall of the reticulum. Although the occurrence of aluminum foreign bodies is rare, other elements, such as tire wires used to attach tarpaulins to silage and even wire bristles from brushes used in small airports, have been recorded as causes of this condition. Ingestion of these objects can result in damage to the reticulum, triggering episodes of traumatic reticulum peritonitis and its sequelae, such as traumatic pericarditis, liver inflammation, spleen abscesses and more. Clinical signs may vary but include abnormal behavior, reduced rumen motility, poorly digested feces, fever and signs of pain. The diagnosis is based on the evaluation of the animal's clinical signs, together with complementary tests, such as blood count, biochemistry, ultrasound and radiography. It is important to consider hematological changes, such as leukocytosis and hyperfibrinogenemia, as key indicators of this condition. Diagnosis also involves foreign body pain testing. Treatment can be conservative or surgical. The conservative approach involves administering antibiotics, anti-inflammatories and intravenous solutions, in addition to treating underlying nutritional deficiencies. The surgical option requires removal of the foreign body from the reticulum, followed by post-operative care.

La peritonitis traumática del retículo esto directamente ligada a la ingestión de objetos metálicos punzantes, como clavos y trozos de alambre, que pueden penetrar o perforar la pared del retículo. Aunque la aparición de cuerpos extraños de aluminio es rara, se han registrado como causas de esta afección otros elementos, como los alambres de neumáticos utilizados para fijar las lonas al ensilaje e incluso las cerdas de alambre de los cepillos utilizados en los aeropuertos pequeños. La ingestión de estos objetos puede provocar daños en el retículo, desencadenando episodios de peritonitis traumática del retículo y sus secuelas, como pericarditis traumática, inflamación del hígado, abscesos del bazo y más. Los signos clínicos pueden variar, pero incluyen comportamiento anormal, motilidad ruminal reducida, heces mal digeridas, fiebre y signos de dolor. El diagnóstico se basa en la evaluación de los signos clínicos del animal, junto con pruebas complementarias, como hemograma, bioquímica, ecografía y radiografía. Es importante considerar los cambios hematológicos, como la leucocitosis y la hiperfibrinogenemia, como indicadores clave de esta afección. El diagnóstico también implica la prueba del dolor por cuerpo extraño. El tratamiento puede ser conservador o quirúrgico. El enfoque conservador implica la administración de antibióticos, antiinflamatorios y soluciones intravenosas, además de tratar las deficiencias nutricionales subyacentes. La opción quirúrgica requiere la extracción del cuerpo extraño del retículo, seguida de cuidados postoperatorios.

Alterações oculares decorrentes de picada de abelha na córnea / Ocular changes due to corneal bee sting

RESUMO O propósito deste estudo foi reportar as alterações oculares observadas após picada de abelha com ferrão retido na córnea. Destacamos o tratamento e o desfecho de uma lesão de córnea incomum e sua patogênese. Trata-se de relato de caso e revisão da literatura de lesões oculares por picada de abelha. Paciente do sexo feminino, 63 anos, procurou atendimento oftalmológico de urgência devido à picada de abelha na córnea do olho direito há 6 dias. Queixava-se de embaçamento visual, dor e hiperemia ocular. Apresentou acuidade visual de vultos no olho afetado. Ao exame, notaram-se hiperemia moderada de conjuntiva bulbar, edema corneano com dobras de Descemet e presença do ferrão alojado na região temporal, no estroma profundo da córnea. A paciente foi internada para ser abordada no centro cirúrgico sob anestesia geral. Durante a cirurgia, o ferrão teve que ser retirado via câmara anterior, mediante a realização de uma paracentese e uma lavagem da câmara anterior, com dupla via e solução salina balanceada. Ainda não existe na literatura um tratamento padrão na abordagem de pacientes com lesões oculares por picada de abelha, sendo importantes a identificação e o reconhecimento precoce de possíveis complicações que ameacem a visão.

ABSTRACT The purpose of this study was to report the ocular changes observed after a bee sting with a stinger retained in the cornea. We show the treatment and outcome of an unusual corneal injury and its pathogenesis. This is a case report and literature review of ocular injuries caused by bee stings. A 63-year-old female patient sought emergency ophthalmic care because of a bee sting on the cornea of her right eye six days before. She complained of blurred vision, pain, and ocular hyperemia. She had glare sensitivity on visual acuity in the affected eye. Examination revealed moderate hyperemia of the bulbar conjunctiva, corneal edema with Descemet's folds and a stinger lodged in the temporal region, in the deep stroma of the cornea. The patient was admitted to the operating room under general anesthesia. During surgery, the stinger had to be removed via the anterior chamber, by performing a paracentesis and washing the anterior chamber with a double flushing and balanced saline solution. There is still no standard treatment in the literature for patients with eye injuries caused by bee stings, and early identification and recognition of possible sight-threatening complications is important.

Odontogenic maxillary sinusitis associated with foreign body displacement after tooth extraction: report of an unusual case / Sinusite maxilar odontogênica por corpo estranho após extração dentária: relato de um caso incomum

Background: Odontogenic maxillary sinusitis caused by a foreign body presents diagnostic and therapeutic challenges due to its infrequent occurrence and unique characteristics compared to sinusitis originating from other sources. CaseReport:Illustrating such fact, this report presents the clinical case of a 37-year-old woman referred complaining of pain in the same region where she had extracted her upper right first molar five days before. The intraoral examination revealed the presence of an orifice in the region, suggesting oroantral communication. Imaging exams revealed opacification of the right maxillary sinus and the unexpected presence of a highly radiodense object. With the diagnosis of maxillary sinusitis due to a foreign body established, the surgical approach initially consisted of administering preoperative medication, preceded by access to the maxillary antrum using the Caldwell-Luc technique. The object was found and removed, consisting of a surgical drill. At follow-up there was complete absence of symptoms and complete closure of communication. Conclusion: Cases of odontogenic maxillary sinusitis caused by drill detachment after tooth extraction are fairly uncommon. A thorough clinical evaluation proved to be essential and the Caldwell-Luc access was effective, safe and with good postoperative results, even with the absence of standardized diagnostic and management methods(AU)

Contexto: A sinusite maxilar odontogênica causada por corpo estranho apresenta desafios diagnósticos e terapêuticos devido à sua ocorrência infrequente e características únicas em comparação com sinusites originadas de outras fontes. Relato do Caso: Ilustrando tal fato, este relato apresenta o caso clínico de uma mulher de 37 anos de idade encaminhada com queixa de dor em mesma região que havia extraído o primeiro molar superior direito cinco dias antes. Ao exame intraoral verificou-se a presença de um orifício na região, sugerindo comunicação oroantral. Os exames de imagem revelaram opacificação do SM direito e a inesperada presença de um objeto altamente radiodenso. Com o diagnóstico de sinusite maxilar por corpo estranho estabelecido, a abordagem cirúrgica consistiu inicialmente na administração de medicação pré-operatória, precedida pelo acesso ao antro maxilar através da técnica de Caldwell-Luc. O objeto foi encontrado e removido, consistindo em uma broca cirúrgica. Ao acompanhamento houve ausência completa dos sintomas e total fechamento da comunicação. Conclusão: Casos de sinusite maxilar odontogênica causada por descolamento da broca após extração dentária são bastante incomuns. Uma avaliação clínica minuciosa mostrou-se primordial e o acesso de Caldwell-Luc eficaz, seguro e com bons resultados pós-operatórios, mesmo com as ausências de métodos de diagnóstico e manejo padronizados.(AU)

Practice and Reflection on Building Community of Doctor-patient in Foreign Aid Medical Work: Taking the Eighth Batch of China (Shaanxi) Medical Team Assisting Malawi as an Example / 中国医学伦理学

China’s foreign aid medical work is an important part of development of friendly relations with foreign countries and an important way to build a human health community. African countries generally have backward economic and social development, poor medical and health conditions and different languages and cultures, which makes the development of foreign aid medical work special and challenging. Foreign aid doctors and local patients share common feelings, mutual respect, equality, mutual trust and sincere cooperation, and building a community of destiny with the common goal of defeating diseases is an essential content to promote the health of the people of the recipient countries and realize the community of human health. Taking the work practice of the eighth batch of China (Shaanxi) medical team assisting Malawi as an example, this paper expounded the specific practice of building a community of doctor-patient in foreign aid medical work and discussed its significance, to provide theoretical and practical basis for the smooth development of foreign aid medical work in the future.

Clinical application of Visual throat forceps in the removal of hypopharyngeal foreign body / 临床耳鼻咽喉头颈外科杂志

Objective:To explore the feasibility of using self-made visual throat forceps to remove hypopharyngeal foreign bodies. Methods:The throat forceps were combined with the endoscope and connected to a monitor via a data cable resulting in a visual throat forceps apparatus. This device was utilized to examine and treat the hypopharyngeal foreign bodies. Results:Among 53 patients, foreign bodies were detected in 51,with 48 cases involving hypopharyngeal foreign bodies. All were successfully extracted using the visual throat forceps. Three cases, diagnosed as esophageal foreign bodies by electronic gastroscopy, were treated using the same method. Conclusion:Visual throat forceps can be used to examine the hypopharynx and remove foreign bodies. It has the advantages of simple operation, rapid operation, and high success rate of foreign body removal from the hypopharynx. It is worthy of clinical application.

Gastrointestinal Foreign Bodies: 14 Years of Experience in a University Clinic

Introduction: Ingesting foreign bodies is a common medical problem, especially in the emergency department. Some small studies describe experiences in this regard. Materials and methods: A descriptive retrospective study included patients with suspected ingestion of foreign bodies admitted to the gastroenterology and GI endoscopy service of the Clínica Universitaria Colombia between January 2007 and August 2020. Results: The age of occurrence of the event was 18 to 95 years, and the average age was 45 years. The foreign bodies ingested and found were variable. The most frequent was fish bones, representing 64.11% of the cases, followed by chicken bones and dietary impaction. Thirty-eight percent of patients required foreign body removal; the most frequently used tool was the foreign body forceps. The primary location was the esophagus in 12.53% of cases, followed by the cricopharynx in 11.18% and the hypopharynx in 10%. Conclusions: The Clínica Universitaria Colombia is a referral site for many gastroenterology emergencies due to its high technological level and extensive human resources. This paper probably describes the largest number of patients with this reason for consultation, which is why this retrospective descriptive study was designed. It shows the demographic characteristics, foreign body types, radiological and endoscopic findings, and associated complications, which help to provide a more accurate knowledge of this pathology.

Introducción: La ingesta de cuerpos extraños es un problema médico frecuente, especialmente en el servicio de urgencias. Existen algunos estudios pequeños que describen las experiencias al respecto. Materiales y métodos: Estudio descriptivo, retrospectivo, en el cual se incluyó a pacientes con sospecha de ingesta de cuerpos extraños, ingresados al servicio de gastroenterología y endoscopia digestiva de La Clínica Universitaria Colombia, entre enero de 2007 y agosto de 2020. Resultados: La edad de ocurrencia del evento se presentó en pacientes desde los 18 hasta los 95 años, y la edad promedio fue de 45 años. Los cuerpos extraños ingeridos y encontrados fueron variables; los más frecuentes fueron la ingesta de espinas de pescado, que representó el 64,11% de los casos, seguido por la ingesta de huesos de pollo y la impactación alimentaria. Un 38% de los pacientes requirieron la extracción de cuerpo extraño y la herramienta usada con mayor frecuencia fue la pinza de cuerpo extraño. La localización principal fue el esófago, en el 12,53% de los casos, seguido por la cricofaringe, en el 11,18%, y la hipofaringe, en el 10%. Conclusiones: La Clínica Universitaria Colombia es un sitio de referencia de una gran cantidad de urgencias en gastroenterología debido a su alto nivel tecnológico y al gran recurso humano que requieren. Este trabajo representa probablemente la cantidad más grande de pacientes con este motivo de consulta, razón por la que se diseñó este estudio descriptivo retrospectivo, que muestra las características demográficas, los tipos de cuerpo extraño, los hallazgos radiológicos y endoscópicos y las complicaciones asociadas, que son de utilidad para tener un conocimiento más real de esta patología.

Experiencia de cuerpos extraños en vía aérea en el Hospital Clínico UC

Introducción: El cuerpo extraño en vía aérea es una patología infrecuente en el área Otorrinolaringológica, siendo la primera causa de muerte accidental de la especialidad. La alta sospecha clínica es fundamental para lograr un diagnóstico precoz. El Hospital Clínico de la Universidad Católica es un centro de referencia a nivel nacional para el manejo de esta patología. Objetivo: Realizar una descripción epidemiológica de los pacientes con diagnóstico de cuerpo extraño en vía aérea sometidos a revisión de vía aérea de los pacientes atendidos en el Hospital Clínico de la Universidad Católica entre los años 2018-2021. Material y Método: Estudio retrospectivo y descriptivo. Se revisaron las fichas clínicas de pacientes con revisión de vía aérea realizada entre junio 2018 y julio 2021. Estudio cuenta con la aprobación del comité de ética de nuestro hospital. Resultados: Se incluyó un total de 13 pacientes con diagnóstico de cuerpo extraño en vía aérea. 62% de los pacientes fueron de sexo masculino. Rango de edad entre 0 y 11 años, mediana de edad de 1 año. El 100% de los pacientes presentó algún síntoma respiratorio y un 90% presentó síndrome de penetración. El cuerpo extraño se evidenció en el 30% de las radiografías. El 100% de las revisiones de vía aérea se hizo con ventilación espontánea. El 70% se localizó en los bronquios. No hubo mortalidad asociada al procedimiento. Conclusión: Las cifras encontradas en nuestro estudio fueron similares a las reportadas en las diferentes series a nivel internacional.

Introduction: Foreign body in the airway is a rare condition in the Otorhinolaryngology field, being the leading cause of accidental death in the specialty. High clinical suspicion is crucial for achieving an early diagnosis. The Hospital Clínico de la Universidad Católica is a national reference center for the management of this condition. Aim: To provide an epidemiological description of patients diagnosed with foreign bodies in the airway who underwent airway review at the Hospital Clínico de la Universidad Católica between the years 2018-2021. Materials and Method: A retrospective and descriptive study. Clinical records of patients who underwent airway review between June 2018 and July 2021 were reviewed. The study has received approval from our hospital's ethics committee. Results: A total of 13 patients with a diagnosis of foreign bodies in the airway were included. 62% of the patients were male. The age ranged from 0 to 11 years, with a median age of 1 year. 100% of the patients presented respiratory symptoms, and 90% presented with a penetration syndrome. The foreign body was evident in 30% of the X-rays. All airway reviews were conducted with spontaneous ventilation. 70% of the foreign bodies were located in the bronchi. There was no mortality associated with the procedure. Conclusion: The findings in our study were similar to those reported in various international series.

Cuerpo extraño en espacio paraglótico

Los cuerpos extraños en la vía aérea son una urgencia muy común en la práctica de la otorrinolaringología. La mayoría suelen encontrarse en población pediátrica donde la gravedad es mayor. En adultos estos episodios suelen ser accidentales, siendo la exploración física fundamental para su diagnóstico. Exponemos aquí el caso de un varón qué presentó una espina de pescado en el área interaritenoidea.

Foreign bodies in the airway are a very common emergency in the practice of otorhinolaryngology, the majority of which are usually found in the pediatric population. In adults, these episodes are usually accidental, and physical examination is fundamental for its diagnosis. We report a case of fish bone impaction in the interarytenoid area.

Cuerpos extraños en esófago: revisión de 84 casos

La presencia de cuerpo extraño esofágico (CEE) es una urgencia habitual en gastroenterología. El protocolo en el manejo y la intervención endoscópica puede ser variable entre las instituciones. Objetivo: Definir características clínicas del CEE en adultos, su diagnóstico radiológico y endoscópico, y complicaciones a partir de una muestra de pacientes en un centro de gastroenterología. Materiales y métodos: serie de casos de pacientes que ingresaron desde urgencias y fueron interconsultados al servicio de gastroenterología con diagnóstico presuntivo de CEE. Se recolectaron variables clínicas, así como características, comorbilidades, tiempo de evolución y oportunidad diagnóstica, estudios confirmatorios, y complicaciones. Resultados: 84 sujetos, 70% hombres, promedio de edad 45 (rango:17-87; SD 12,5) años. En 98,8% de los pacientes se realizó endoscopía digestiva alta de modo urgente, con estancia intrahospitalaria promedio de 2,5 días. 93% sin patología de base asociada, en 6/84 (7,14%) pacientes se documentó patología esofágica estructural o funcional. 59/84 70,2%) pacientes consultaron en las primeras 24 horas, en 57,6% se confirmó endoscópicamente presencia de cuerpo extraño. En 67/84 (79,76%) pacientes se realizó radiografía previa a endoscopia, de los cuales, 62/67 (92,5%) con resultado anormal. 70% de los CEE confirmados fueron espinas de pescado. El sitio más frecuente de localización fue en región cricofaringea en el 90% de los casos. En 66/84 (78,6%) sujetos hubo ausencia de complicaciones, seguido de laceración profunda en 10/84 (11,9%) casos. En 3/84 (3,6%) casos se identificaron complicaciones con requerimiento quirúrgico. Conclusiones: La intervención endoscópica en las primeras 24 horas es un momento oportuno para identificación de complicaciones y brindar el tratamiento indicado.

The presence of esophageal foreign body (EFB) is a common emergency in gastroenterology. The protocol for management and endoscopic intervention can be variable among institutions. Objective: to define the clinical characteristics of EFB in adults, its radiological and endoscopic diagnosis, and complications based on a sample of patients in a gastroenterology center. Materials and methods: case series of patients admitted from the emergency department and referred to the gastroenterology department with a presumptive diagnosis of EFB. Clinical variables were collected, as well as characteristics, comorbidities, time of evolution and diagnostic opportunity, confirmatory studies, and complications. Results: 84 subjects, 70% men, mean age 45 (range: 17-87; SD 12.5) years. Urgent upper endoscopy was performed in 98.8% of the patients, with an average in-hospital stay of 2.5 days. 93% had no associated underlying pathology, in 6/84 (7.14%) patients structural or functional esophageal pathology was documented. 59/84 (70.2%) patients consulted in the first 24 hours, in 57.6% the presence of foreign body was confirmed endoscopically. In 67/84 (79.76%) patients radiography was performed prior to endoscopy, of which 62/67 (92.5%) had an abnormal result. Seventy percent of confirmed EFB were fish bones. The most frequent site of localization was in the cricopharyngeal region in 90% of the cases. In 66/84 (78.6%) subjects there was absence of complications, followed by deep laceration in 10/84 (11.9%) cases. In 3/84 (3.6%) cases complications requiring surgery were identified. Conclusions: Endoscopic intervention in the first 24 hours is an opportune moment to identify complications and provide the indicated treatment.

Maternal temperament and anxiety sensitivity in children with foreign body aspiration

SUMMARY OBJECTIVE: Foreign body aspiration is one of the childhood emergencies that thoracic surgeons are interested in, and it can cause morbidity and mortality. Although the relationship between various behavioral problems related to children and foreign body aspiration has been investigated so far, there is no study investigating the relationship between maternal temperament and anxiety sensitivity. This study aimed to investigate the relationship between maternal emotional temperament, anxiety sensitivity, and foreign body aspiration. METHODS: Mothers of 18 children with foreign body aspiration have been evaluated by a thoracic surgeon, and 18 healthy controls have also been included in the study. Maternal emotional temperament has been measured with the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego - Auto questionnaire scale, and anxiety sensitivity has been measured with the Anxiety Sensitivity Index-3. RESULTS: There has been no statistically significant difference between groups in terms of maternal emotional temperament and anxiety sensitivity. In the logistic regression analysis conducted to determine the predictors of foreign body aspiration, it is determined that the mother's anxious temperament has predicted foreign body aspiration significantly. CONCLUSION: As a result of the study, it can be concluded that mothers' anxious temperament can be considered a risk factor for foreign body aspiration because it affects parenting skills and children's ability to manage behavioral problems. Consistent results could be able to be obtained with studies including larger samples on the subject.

POLYEMBOLOKOILAMANIA IN THE EMERGENCY DEPARTMENT.

Polyembolokoilamania is a rare but serious medical condition that involves the presence of multiple foreign bodies in the patient's body. This condition can be challenging to diagnose and manage in the emergency department. In this chapter, we will discuss the presentation, diagnosis, and management of polyembolokoilamania in the emergency department.

Foreign Body Accidents in a Pediatric Emergency Department

Abstract Introduction Foreign body accidents (FBAs) are frequent in children and can be severe, being a common cause of morbidity and mortality and a public health problem. As these accidents are multifactorial, their cause can only be determined by analyzing the clinical details and characteristics of the object. Knowing the associated mechanisms and factors is essential to determine a risk profile and have a preventive, therapeutic, and diagnostic purpose. Objective The present study aimed to describe the incidence of FBAs in otorhinolaryngology according to their anatomical location, focusing on the aerodigestive system. Methods This is a retrospective study performed by reviewing the medical records of 668 cases seen in the emergency department of a tertiary pediatric hospital in São Paulo, state of São Paulo, Brazil, between 2014 and 2017. Results Foreign bodies (FBs) were found in the digestive system (238/668), in the nasal cavities (206/668), in the ears (182/668), in the oropharynx (34/668), and in the respiratory system (8/668). A total of 91.77% of the patients were treated in the emergency room. The main age group affected was < 5 years old, with no difference between genders. The most frequent complications affected the digestive system and the most serious occurred in cases involving the respiratory system. Conclusion Multidisciplinary teams should be ready in the emergency room to provide adequate care in FBAs. Early diagnosis, FB removal in the emergency room or the surgical center and follow-up are essential. Developing prevention campaigns including a risk profile for certain products and/or materials, helping to ensure safety for consumers, is necessary. For this, a national database with compulsory notification containing relevant information on FBAs in the pediatric population should be created.

An Incidental Finding Of Button Battery In The Nose Without Any Complication- A Case Report Of A Rare Presentation

Aim And Background-A foreign body in nose presents with unilateral purulent nasal discharge, nasal obstruction and nasal bleed.We present a case in which a button battery remained uncomplicated in the nasal cavity for a year. However, if it is found, it should be removed as early as possible. A 6-year-old female child presented with aCase Description – one-year history of foul-smelling, left-sided nasal discharge. During anterior rhinoscopy, a black, rigid mass was observed. A circular foreign object was found in the floor of the left nasal cavity during a CT (computed tomography) scan of the Nose and PNS (paranasal sinuses). General anesthesia was used during the diagnostic nasal endoscopy on the child. A foreign body was visualized and removed using a curved curette. The nasal mucosa was normal on follow-up, and there was no septal perforation. A detailed history, assessment and radiological examination plays aConclusion- key role in management of foreign bodies.We report that a button battery was left in the nose for a long time without causing any problems. There were no complications from an unnoticed button battery in theClinical Significance: nose for a year. However, if it is found, it should be removed.

Creatively tiding over the crisis

Background: A patient with a retained intraocular metallic foreign body post?trauma was taken up for vitrectomy and intraocular foreign body removal. Unfortunately, the intraocular magnet was not available at the moment on the table! How a little bit of creativity and innovative thought helped us tide over this crisis is the content of this video. Purpose: To demonstrate magnetization of a metallic surgical instrument for temporary use in the event of unavailability of the intraocular magnet for intraocular foreign body removal. Synopsis: A ferromagnetic substance can be magnetized temporarily using an existing magnet. We obtained a general?purpose magnet and wrapped it in sterile plastic, using which we magnetized normal intraocular forceps and a Micro Vitreo Retinal (MVR) blade by giving about 20–30 strokes over the magnet in a single direction. This aligned the magnetic domains in the metal in a parallel fashion. These Do It Yourself (DIY)? magnetic instruments were then effectively utilized to remove the metallic intraocular foreign body. Highlights: The video showcases effectively harnessing the available resources and tiding over the dearth of a necessary instrument, with the right use of an innovative idea and some creativity!.

Proximate and Mineral Composition of Some Foreign and Local Rice Varieties Sold in Mile 3 Market, Port Harcourt, Rivers State, Nigeria

Rice is a staple food in many countries of Africa and it is nutritionally beneficial. This research work compared the proximate composition and mineral composition of some local and foreign rice varieties. Four varieties of rice were analyzed; two types of local rice designated as (L1 and L2) and two types of foreign rice (F1 and F2). The proximate composition such as moisture content, ash content, carbohydrate content, crude protein, crude fiber and total fat were evaluated using standard methods. The result of the analysis showed that the moisture content was lowest in L1 (8.56 ± 0.26g) and highest in sample L2 (9.47 ± 0.48g). All the four varieties recorded high carbohydrate content. The fat content of L1 and L2 (1.19±0.20 - 2.48±0.90) were significantly higher (p<0.05) when compared to F1 and F2 (1.69±0.30 – 1.99± 0.20a). Crude fiber content for L1 and L2 (1.49±0.09 -1.69±0.09) were statistically higher compared to F1 and F2 (0.29±0.09b -0.39±0.01b). Crude protein for L1 and L2 (7.89±0.09 – 8.09±0.22) were significantly higher when compared to F1 and F2 (6.34± 0.22b – 7.22± 0.66). Ash content for L1 and L2 (0.60± 0.01-0.68±0.32) were statistically lower compared to F1 and F2 (0.62±0.08 – 1.20± 0.20) Potassium and Zinc showed no significant difference in all samples apart from F1 where Potassium and Zinc were significantly different. Calcium values for foreign rice showed significant difference when compared to the values for local rice. Local rice appeared to have a relatively higher level of iron when compared to all the foreign rice samples. The values obtained from this study indicates that Nigerian local rice varieties are nutritionally better compared to foreign rice varieties.

An unusual case of nasal foreign body presenting as recurrent otitis media

Otitis media (OM) is a common problem involving children. In the majority, the cause is related to dysfunction of the Eustachian tube due to bacterial or viral rhinitis and less commonly due to nasopharyngeal tumors. We present a case of recurrent OM which was evaluated and incidentally found a nasal foreign body for which the patient was asymptomatic. This nasal body was the cause of recurrent OM which is very unusual.

Oblito como causa de fístula enteroentérica / Retained foreign object as a cause of entero-enteric fistula

RESUMEN Los oblitos son cuerpos extraños olvidados dentro de la cavidad después de una intervención quirúrgica; su incidencia es desconocida, ya que no se informan todos los casos debido a su implicancia legal. Su forma de presentación más frecuente es el abdomen agudo obstructivo y las fístulas enterocutáneas. Se presenta el caso clínico de una paciente de sexo femenino con antecentes de cesárea abdominal hace 30 años, que consultó por una formación palpable a nivel de hipogastrio; en la tomografía se evidenció una tumoración alargada, heterogénea, calcificada y con burbujas en su interior. Se realizó una laparotomía exploradora, se constató una formación duro-pétrea con múltiples adherencias al intestino delgado circundante. Se realizó la resección y anastomosis del intestino comprometido. La anatomía patológica informó: cuerpo extraño en la luz intestinal, y presencia de adherencias interasas, con fístula enteroentérica, lo que constituye un caso poco frecuente.

ABSTRACT Retained foreign objects are any items left inside a patient after a surgery. Their incidence is unknown as they are often the cause of lawsuits and are not reported. They usual present as acute intestinal obstruction or enterocutaneous fistulas. We report the case of a 65-year-old female patient, with a history of a cesarean section 30 years before, who presented with a palpable tumor in the hypogastrium. The computed tomography scan revealed an elongated, heterogeneous, calcified mass with bubbles inside. On exploratory laparotomy a stony-hard formation was observed with multiple adhesions to the surrounding small bowel. The intestinal segment involved was resected and anastomosed. The pathology examination reported a retained foreign object in the intestinal lumen and presence of adhesions between loops with entero-enteric fistula, constituting a rare case.

Ingestión de cuerpos extraños en ortodoncia: revisión de la literatura / Ingestion of Foreign Bodies in Orthodontics: A Literature Review

RESUMEN La ingestión de cuerpos extraños de origen dental es una complicación a la cual están expuestos los pacientes de los odontólogos y, en particular, de los ortodoncistas. Son emergencias poco comunes pero que pueden llegar a poner en riesgo la vida del paciente, sea por obstrucción de la vía aérea o por daño al tracto gastrointestinal. En esta revisión, se evalúan los antecedentes de reportes de casos donde el o la paciente haya ingerido un cuerpo extraño de origen ortodóncico, sea que ocurrió dentro de la consulta ortodóncica o fuera de ella. Se revisan las recomendaciones de prevención generales, particulares y el manejo inicial en caso de estas complicaciones.

ABSTRACT Ingestion of dental foreign bodies is a complication that patients of dentists, particularly orthodontists, may encounter. Although uncommon, these incidents can pose life-threatening risks to patients, including airway obstruction and gastrointestinal damage. This review examines case reports of patients who have ingested orthodontic foreign bodies, whether it occurred within or outside the orthodontic setting. General and specific preventive recommendations, as well as initial management approaches for these complications, are reviewed.