Button battery ingestion: the Greek experience and review of the literature.

OBJECTIVES: Foreign body ingestion is a common cause of admission in the pediatric emergency room. In the past, button batteries accounted for less than 2% of the foreign bodies ingested by small children, but in the last 2 decades, they show a rapidly increased frequency. The aim of the present study was to evaluate the potential risk after button battery ingestion in relation with the clinical manifestations and to perform a treatment-observation protocol in accordance with the international procedure. METHODS AND RESULTS: In a prospective observational analysis from November 2007 through February 2008, 31 cases of button battery ingestion were recorded by the Greek Poison Information Center. The interval between the accidental ingestion and first medical contact ranged from 5 minutes to 10 days. After initial evaluation including clinical examination and radiological localization of the foreign body, all cases were treated as outpatients. Reported complications included "black stools" in 9% and diarrhea in 3% of cases. In 1 case, the battery was endoscopically removed. CONCLUSIONS: The role of primary care physicians in informing the public about the potential danger of button battery digestion is crucial. Pediatricians should educate the parents about this hazard, as part of the routine guidelines for childproofing at home. Once again, prolepsis is the best policy.

Prevalence of GJB2 mutations in prelingual deafness in the Greek population.

OBJECTIVE: Mutations in the gene encoding the gap junction protein connexin 26 (GJB2) have been shown as a major contributor to prelingual, sensorineural, nonsyndromic, recessive deafness. One specific mutation, 35delG, has accounted for the majority of the mutations detected in the GJB2 gene in Caucasian populations. The aim of our study was to determine the prevalence and spectrum of GJB2 mutations in prelingual deafness in the Greek population. METHODS: In a collaboration with the major referral centers for childhood deafness in Greece, patients were examined by an extensive questionnaire to exclude syndromic forms and environmental causes of deafness and by allele-specific polymerase chain reaction (PCR) for the detection of the 35delG mutation. Patients heterozygous for the 35delG mutation were further analyzed by direct genomic sequencing of the coding region of the GJB2 gene. RESULTS: The 35delG mutation was found in 42.2% of the chromosomes in 45 familial cases of prelingual, nonsyndromic deafness (18 homozygotes and 2 heterozygotes) and in 30.6% of the chromosomes in 165 sporadic cases (45 homozygotes and 11 heterozygotes). Direct genomic sequencing in heterozygous patients revealed the L90P (2 alleles), W24X (2 alleles), R184P (2 alleles), and 291insA (1 allele) mutations. CONCLUSION: Mutations in the GJB2 gene are responsible for about one third of prelingual, sensorineural, nonsyndromic deafness in the Greek population, and allele-specific PCR is an easy screening method for the common 35delG mutation.