Caustics
Burns, Chemical
Sodium Hydroxide
Esophagus
Upper Gastrointestinal Tract
Chemical Terrorism
Civil Defense
Disaster Planning
Extensive abdominal surgery after caustic ingestion. (1/69)
OBJECTIVE: To report the authors' experience in extensive abdominal surgery after caustic ingestion, and to clarify its indications. SUMMARY BACKGROUND DATA: After caustic ingestion, extension of corrosive injuries beyond the esophagus and stomach to the duodenum, jejunum, or adjacent abdominal organs is an uncommon but severe complication. The limit to which resection of the damaged organs can be reasonably performed is not clearly defined. METHODS: From 1988 to 1997, nine patients underwent esophagogastrectomy extended to the colon (n = 2), the small bowel (n = 2), the duodenopancreas (n = 4), the tail of the pancreas (n = 1), or the spleen (n = 1). Outcome was evaluated in terms of complications, death, and function after esophageal reconstruction. RESULTS: Five patients required reintervention in the postoperative period for extension of the caustic lesions. There were two postoperative deaths. Seven patients had secondary esophageal reconstruction 4 to 8 months (median 6 months) after initial resection. Three additional patients died 8, 24, and 32 months after the initial resection. Three survivors eat normally, and one has unexplained dysphagia. CONCLUSIONS: An aggressive surgical approach allows successful initial treatment of extended caustic injuries. Early surgical treatment is essential to improve the prognosis in these patients. (+info)European course on HPV associated pathology: guidelines for primary care physicians for the diagnosis and management of anogenital warts. (2/69)
The European Course on HPV Associated Pathology (ECHPV) was founded in 1990 by a group of clinicians, pathologists, and virologists to teach important principles for the practice and management of human papillomavirus (HPV) disease to gynaecologists, dermatologists, and other medical disciplines. These guidelines are intended to assist the practice of primary care physicians for diagnosis and treatment of anogenital warts. (+info)Patterns and problems of deliberate self-poisoning in the developing world. (3/69)
Deliberate self-harm is a major problem in the developing world, responsible for around 600 000 deaths in 1990. The toxicity of available poisons and paucity of medical services ensure that mortality from self-poisoning is far greater in the tropics than in the industrialized world. Few data are available on the poisons most commonly used for self-harm in different parts of the world. This paper reviews the literature on poisoning, to identify the important poisons used for self-harm in these regions. Pesticides are the most important poison throughout the tropics, being both common and associated with a high mortality rate. In some regions, particular pesticides have become the most popular method of self-harm, gaining a notoriety amongst both health-care workers and public. Self-poisoning with medicines such as benzodiazepines and antidepressants is common in urban areas, but associated with few deaths. The antimalarial chloroquine appears the most significant medicine, self-poisoning being common in both Africa and the Pacific region, and often fatal. Paracetamol (acetaminophen) is used in many countries but in few has it reached the popularity typical of the UK. Domestic and industrial chemicals are responsible for significant numbers of deaths and long-term disabilities world-wide. Self-poisoning with plant parts, although uncommon globally, is locally popular in some regions. Few of these poisons have specific antidotes. This emphasizes the importance of determining whether interventions aimed at reducing poison absorption actually produce a clinical benefit, reducing death and complication rates. Future research to improve medical management and find effective ways of reducing the incidence of self-harm, together with more widespread provision of interventions proven to be effective, could rapidly reduce the number of deaths from self-poisoning in the developing world. (+info)Purification and structure elucidation of the N-acetylbacillosamine-containing polysaccharide from Bacillus licheniformis ATCC 9945. (4/69)
The exopolysaccharide of Bacillus licheniformis ATCC 9945 (formerly B. subtilis ATCC 9945) contains among other glycoses 4-acetamido-2-amino-2,4,6-trideoxy-D-glucose, termed N-acetylbacillosamine (Bac2N4NAc). A similar diamino glycose, 2-acetamido-4-amino-2,4,6-trideoxy-D-glucose, was found in a surface layer (S-layer) glycoprotein preparation of Clostridium symbiosum HB25. Electron microscopic studies, however, showed that B. licheniformis ATCC 9945 is not covered with an S-layer lattice, indicating that the N-acetylbacillosamine present in that organism might be a constituent of a cell wall-associated polymer. For elucidation of the structure of the N-acetylbacillosamine-containing polysaccharide, it was purified from a trichloroacetic acid extract of B. licheniformis ATCC 9945 cells. Using different hydrolysis protocols and a hydrolysate of the S-layer glycoprotein preparation from C. symbiosum HB25 as reference, the purified polysaccharide was found to contain 2,4-diamino-2,4,6-trideoxy-glucose, 2-acetamido-2-deoxy-glucose, 2-acetamido-2-deoxy-galactose and galactose in a molar ratio of 1 : 1 : 1 : 2. One- and two-dimensional NMR spectroscopy, including 800 MHz proton magnetic resonance measurements, in combination with chemical modification and degradation experiments, revealed that the polysaccharide consists of identical pyruvylated pentasaccharide repeating units with the structure: [-->3)-[(S)Py-(3,4)-beta-D-Galp-(1-->6)]-alpha-D-GlcpNAc-(1-->3)-beta-D-Bacp2N4NA c-(1-->3)-[(S)Py-(3,4)-beta-D-Galp-(1-->6)]-beta-D-GalpNAc-(1-->](n) (+info)Ingestion of caustic substances and its complications. (5/69)
CONTEXT: Caustic substances cause tissue destruction through liquefaction or coagulation reactions and the intensity of destruction depends on the type, concentration, time of contact and amount of the substance ingested. OBJECTIVES: To analyze the complications in patients who ingested caustic substances and correlate them with the amount of caustic soda ingested. DESIGN: Retrospective study. SETTING: University hospital, a referral center. PARTICIPANTS: A total of 239 patients who ingested caustic soda. MAIN MEASUREMENTS: The amount of granulated caustic substance ingested was measured as tablespoonfuls and the following complications were analyzed: esophagitis, esophageal stenosis and progression to cancer, fistulas, perforations, stomach lesions, brain abscesses, and death. Stenosis was classified as mild, moderate or severe according to the radiological findings. RESULTS: We observed an 89.3 % incidence of esophagitis; 72.6 % of the cases involved progression to stenosis and 1 per cent died during the acute phase. Stenosis was mild in 17.6 % of cases, moderate in 59.3 % and severe in 23 %. The incidence of stenosis was 80.8 per cent in women and 62.5 % in men. The incidence of stenosis was 46.9 % in the group that ingested "fragments" and 93.6 % in the group that ingested one or more tablespoonfuls of caustic substances. Among subjects who ingested one or more tablespoonfuls, 32.2 % developed lesions of the stomach-duodenum, whereas the ingestion of "fragments" was not sufficient to induce these lesions. There was no correlation between the intensity of lesions of the esophagus and of the stomach. Progression to cancer of the esophagus occurred in 1.8 % of cases, death during the chronic phase in 1.4 %, perforations in 4.6 %, fistulas in 0.9 %, and brain abscesses in 1.4 %. CONCLUSIONS: The complications were related to the amount of caustic soda ingested. Small amounts caused esophagitis or stenosis and large amounts increased the risk of fistulas, perforations and death. (+info)In vitro gas production measurements to evaluate interactions between untreated and chemically treated rice straws, grass hay, and mulberry leaves. (6/69)
In vitro gas production was measured to investigate associative effects of untreated and chemically treated rice straw (RS) and of RS and grass hay or mulberry leaves (ML). The RS was treated with NaOH, urea, or (NH4)HCO3. Cumulative gas production was recorded at 2, 4, 6, 8, 12, 16, 24, 36, 48, 60, 72, and 96 h of incubation, and the Gompertz function was used to describe the kinetics of gas production. Treatment with NaOH, urea, and NH4HCO3 increased (P < 0.05) gas production at 48 h by 55, 52, and 37% and the maximum rate of gas production of RS from 0.64 to 1.51, 1.27, and 1.13 mL/h, respectively. The inclusion of treated straws, hay, and ML in a mixture with RS at increasing proportions (25, 50, 75, 100%) elevated cumulative gas production and its rate. Maximum gas production was not different between the RS and its mixtures with the treated straws, but inclusion of hay into RS or NH4HCO3-treated RS increased the maximum gas production. Associative effects were defined as the difference between the observed gas production for the mixtures and the sum of the individual component feeds. The NaOH-treated RS, included at higher proportions, had positive associative effects at all times of incubation < 96 h; effects were negative or absent at 96 h. No effects were observed with mixtures of RS with urea-treated RS. The NH4HCO3-treated RS mixture tended to have negative associative effects at all three levels. Positive associative effects (P < 0.05) were observed for both RS and NH4HCO3-treated RS at almost all inclusion levels of hay or ML after 12 to 96 h of incubation. The response was more pronounced with ML than with hay. Associative effects generally declined with duration of incubation. We conclude that positive associative effects on in vitro gas production occurred more consistently when RS was incubated in mixtures with hay or ML than when incubated in mixtures with chemically treated RS. (+info)Trichloroacetic acid as a biomarker of exposure to disinfection by-products in drinking water: a human exposure trial in Adelaide, Australia. (7/69)
We addressed the need for a biomarker of ingestion exposure to drinking water disinfection by-products by performing a human exposure trial. We evaluated urinary excretion of trichloroacetic acid (TCAA) as an exposure biomarker using 10 volunteers who normally consume their domestic tap water. We recruited the volunteers at a water quality research laboratory in Adelaide, Australia. Participants maintained a detailed consumption and exposure diary over the 5-week study. We also analyzed tap water and first morning urine (FMU) samples for TCAA, and tap water for chloral hydrate (CH). We documented both interindividual and intraindividual variability in TCAA ingestion and urinary excretion, and both were substantial. With a TCAA-free bottled water intervention, we used creatinine-adjusted urinary TCAA levels to estimate urinary TCAA excretion half-lives for three of the participants. We observed correspondence over time between estimated TCAA excretion, calculated from TCAA + CH ingestion levels, and measured TCAA urinary excretion. This study demonstrates the merits and feasibility of using TCAA in FMU as an exposure biomarker, and reveals remaining concerns about possible alternate sources of TCAA exposure for individuals with low drinking water ingestion exposure. (+info)IGF-I, IgA, and IgG responses to bovine colostrum supplementation during training. (8/69)
This study examined the effect of bovine colostrum (Dynamic colostrum) supplementation on blood and saliva variables (study 1) and the absorption of orally administered human recombinant insulin-like growth factor (IGF)-I (rhIGF-I) labeled with 123I (123I-rhIGF-I) (study 2). In study 1, adult male and female athletes were randomly assigned in a double-blind fashion to either an experimental (Dynamic; n = 19) or a control (Placebo; n = 11) group. The former consumed daily 20 g of Dynamic supplement, and the latter 20 g of maltodextrin during a 2-wk training period. After bovine colostrum supplementation, significant increases were noticed in serum IGF-I (P < 0.01) and saliva IgA (P < 0.01) in Dynamic compared with Placebo. In study 2, gel electrophoresis was carried out in 12 adult subjects with serum samples taken 60 min after ingestion of 123I-rhIGF-I and showed peaks at 0.6 and at 40-90 kDa, with the former inducing 96% and the latter 4% of the total radioactivity. It was concluded that a long-term supplementation of bovine colostrum (Dynamic) increases serum IGF-I and saliva IgA concentration in athletes during training. Absorption data show that ingested 123I-rhIGF-I is fragmented in circulation and that no radioactive IGF-I is eluted at the positions of free, or the IGF, binding proteins, giving no support to the absorption of IGF-I from bovine colostrum. (+info)In medical terms, "caustics" refer to substances that can cause burns or destroy living tissue due to their corrosive nature. They can cause chemical burns upon contact with skin, eyes, or mucous membranes, leading to inflammation, necrosis (tissue death), and potential scarring. Common caustic substances include strong acids and bases, such as sulfuric acid, hydrochloric acid, and sodium hydroxide (lye).
In dermatology, the term "caustics" may also refer to chemical peeling agents used for the treatment of various skin conditions, such as hyperpigmentation, acne scars, or fine lines. These substances, which include trichloroacetic acid (TCA) and phenol, cause a controlled injury to the skin, leading to exfoliation and the stimulation of new tissue growth. However, they must be used with caution, as improper application can result in unwanted side effects or complications.
Chemical burns are a type of tissue injury that results from exposure to strong acids, bases, or other corrosive chemicals. These substances can cause damage by reacting chemically with the skin or other tissues, leading to destruction of cells and potentially serious harm. The severity of a chemical burn depends on several factors, including the type and concentration of the chemical, the duration of exposure, and the amount of body surface area affected.
Chemical burns can occur through direct contact with the skin or eyes, inhalation of toxic fumes, or ingestion of harmful substances. Symptoms may include redness, pain, blistering, swelling, and irritation at the site of contact. In severe cases, chemical burns can lead to scarring, disability, or even death.
Immediate medical attention is required for chemical burns, as they can continue to cause damage until the source of the injury is removed, and appropriate first aid measures are taken. Treatment typically involves thorough cleaning and irrigation of the affected area, followed by administration of pain medication and other supportive care as needed. In some cases, skin grafting or other surgical interventions may be required to promote healing and minimize scarring.
Esophageal stenosis is a medical condition characterized by the narrowing or constriction of the esophagus, which is the muscular tube that connects the throat to the stomach. This narrowing can make it difficult to swallow food and liquids, leading to symptoms such as dysphagia (difficulty swallowing), pain or discomfort while swallowing, regurgitation, and weight loss.
Esophageal stenosis can be caused by a variety of factors, including:
1. Scarring or fibrosis due to prolonged acid reflux or gastroesophageal reflux disease (GERD)
2. Radiation therapy for cancer treatment
3. Ingestion of corrosive substances
4. Eosinophilic esophagitis, an allergic condition that affects the esophagus
5. Esophageal tumors or cancers
6. Surgical complications
Depending on the underlying cause and severity of the stenosis, treatment options may include medications to manage symptoms, dilation procedures to widen the narrowed area, or surgery to remove the affected portion of the esophagus. It is important to seek medical attention if you experience any difficulty swallowing or other symptoms related to esophageal stenosis.
Sodium hydroxide, also known as caustic soda or lye, is a highly basic anhydrous metal hydroxide with the chemical formula NaOH. It is a white solid that is available in pellets, flakes, granules, or as a 50% saturated solution. Sodium hydroxide is produced in large quantities, primarily for the manufacture of pulp and paper, alcohols, textiles, soaps, detergents, and drain cleaners. It is used in many chemical reactions to neutralize acids and it is a strong bases that can cause severe burns and eye damage.
The esophagus is the muscular tube that connects the throat (pharynx) to the stomach. It is located in the midline of the neck and chest, passing through the diaphragm to enter the abdomen and join the stomach. The main function of the esophagus is to transport food and liquids from the mouth to the stomach for digestion.
The esophagus has a few distinct parts: the upper esophageal sphincter (a ring of muscle that separates the esophagus from the throat), the middle esophagus, and the lower esophageal sphincter (another ring of muscle that separates the esophagus from the stomach). The lower esophageal sphincter relaxes to allow food and liquids to enter the stomach and then contracts to prevent stomach contents from flowing back into the esophagus.
The walls of the esophagus are made up of several layers, including mucosa (a moist tissue that lines the inside of the tube), submucosa (a layer of connective tissue), muscle (both voluntary and involuntary types), and adventitia (an outer layer of connective tissue).
Common conditions affecting the esophagus include gastroesophageal reflux disease (GERD), Barrett's esophagus, esophageal cancer, esophageal strictures, and eosinophilic esophagitis.
Dilation, also known as dilatation, refers to the process of expanding or enlarging a body passage or cavity. In medical terms, it typically refers to the widening of a bodily opening or hollow organ, allowing for increased flow or access. This can occur naturally, such as during childbirth when the cervix dilates to allow for the passage of a baby, or it can be induced through medical procedures or interventions.
For example, dilation of the pupils is a natural response to darkness or certain medications, while dilation of blood vessels is a common side effect of some drugs and can also occur in response to changes in temperature or emotional state. Dilation of the stomach or intestines may be necessary for medical procedures such as endoscopies or surgeries.
It's important to note that dilation can also refer to the abnormal enlargement of a body part, such as dilated cardiomyopathy, which refers to an enlarged and weakened heart muscle.
The Upper Gastrointestinal (GI) Tract refers to the segment of the digestive system that includes the mouth, pharynx, esophagus, stomach, and duodenum, which is the first part of the small intestine. This region is responsible for the initial stages of digestion, such as mechanical breakdown of food by chewing and churning, and chemical breakdown through enzymes and acids. It's also where the majority of nutrient absorption occurs. Various medical conditions, including infections, inflammation, and cancers, can affect the upper GI tract.
I'm sorry for any confusion, but "Household Products" is not a term with a specific medical definition. Household products generally refer to items that are used in the home for cleaning, maintenance, and personal care. They can include things like cleaning supplies, laundry detergent, dish soap, personal care products (such as shampoo, toothpaste, and lotion), and other similar items. However, there is no medical context in which "household products" has a specific or technical meaning. If you have any concerns about the safety or health effects of a particular household product, I would recommend consulting with a healthcare professional or reaching out to the manufacturer for more information.
Endoscopy of the digestive system, also known as gastrointestinal (GI) endoscopy, is a medical procedure that allows healthcare professionals to visually examine the inside lining of the digestive tract using a flexible tube with a light and camera attached to it, called an endoscope. This procedure can help diagnose and treat various conditions affecting the digestive system, including gastroesophageal reflux disease (GERD), ulcers, inflammatory bowel disease (IBD), and cancer.
There are several types of endoscopy procedures that focus on different parts of the digestive tract:
1. Esophagogastroduodenoscopy (EGD): This procedure examines the esophagus, stomach, and duodenum (the first part of the small intestine). It is often used to investigate symptoms such as difficulty swallowing, abdominal pain, or bleeding in the upper GI tract.
2. Colonoscopy: This procedure explores the large intestine (colon) and rectum. It is commonly performed to screen for colon cancer, as well as to diagnose and treat conditions like inflammatory bowel disease, diverticulosis, or polyps.
3. Sigmoidoscopy: Similar to a colonoscopy, this procedure examines the lower part of the colon (sigmoid colon) and rectum. It is often used as a screening tool for colon cancer and to investigate symptoms like rectal bleeding or changes in bowel habits.
4. Upper GI endoscopy: This procedure focuses on the esophagus, stomach, and duodenum, using a thin, flexible tube with a light and camera attached to it. It is used to diagnose and treat conditions such as GERD, ulcers, and difficulty swallowing.
5. Capsule endoscopy: This procedure involves swallowing a small capsule containing a camera that captures images of the digestive tract as it passes through. It can help diagnose conditions in the small intestine that may be difficult to reach with traditional endoscopes.
Endoscopy is typically performed under sedation or anesthesia to ensure patient comfort during the procedure. The images captured by the endoscope are displayed on a monitor, allowing the healthcare provider to assess the condition of the digestive tract and make informed treatment decisions.
Chemical terrorism is the use or threatened use of chemicals, typically in the form of toxic gases or liquids, with the intent to cause harm, death, disruption, or fear among a population. This type of terrorism falls under the broader category of weapons of mass destruction (WMD) and can pose significant risks to public health and safety. Chemical agents used in terrorist attacks can range from industrial chemicals that are easily accessible, such as chlorine and ammonia, to more sophisticated and deadly nerve agents like sarin and VX. The effects of chemical terrorism can be immediate and catastrophic, causing mass casualties and long-term health consequences for survivors. Preparation, response, and recovery efforts require a coordinated effort among local, state, and federal agencies, as well as the medical community, to effectively mitigate the impact of such attacks.
Civil defense refers to the measures taken by a government or organization to protect its citizens from military attack, sabotage, or other hostile actions. These measures may include evacuation plans, emergency response procedures, and the construction of protective structures such as bomb shelters. In the medical field, civil defense efforts might also involve planning for the provision of healthcare services during and after a disaster or emergency situation. This could include establishing alternate care sites, coordinating with volunteer organizations to provide medical care, and ensuring that medical supplies and equipment are available.
Disaster planning in a medical context refers to the process of creating and implementing a comprehensive plan for responding to emergencies or large-scale disasters that can impact healthcare facilities, services, and patient care. The goal of disaster planning is to minimize the impact of such events on the health and well-being of patients and communities, ensure continuity of medical services, and protect healthcare infrastructure and resources.
Disaster planning typically involves:
1. Risk assessment: Identifying potential hazards and assessing their likelihood and potential impact on healthcare facilities and services.
2. Developing a disaster plan: Creating a detailed plan that outlines the steps to be taken before, during, and after a disaster to ensure the safety of patients, staff, and visitors, as well as the continuity of medical care.
3. Training and education: Providing training and education to healthcare personnel on disaster preparedness, response, and recovery.
4. Exercises and drills: Conducting regular exercises and drills to test the effectiveness of the disaster plan and identify areas for improvement.
5. Resource management: Identifying and securing necessary resources, such as medical supplies, equipment, and personnel, to support disaster response efforts.
6. Communication and coordination: Establishing clear communication protocols and coordinating with local emergency responders, public health authorities, and other healthcare facilities to ensure a coordinated response to disasters.
7. Recovery and restoration: Developing plans for restoring medical services and infrastructure after a disaster has occurred.
Disaster planning is an essential component of healthcare delivery and is critical to ensuring the safety and well-being of patients and communities during emergencies or large-scale disasters.
I'm sorry for any confusion, but "terrorism" is not a term that has a specific medical definition. It is a concept that is typically defined within the contexts of criminal law, international relations, and political science. Generally, terrorism refers to the use of violence or threat of violence, especially against civilians, in the pursuit of political, religious, or ideological objectives. If you have any questions related to medicine or health, I'd be happy to try to help answer those for you!
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