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Mizuta S, Miyakoshi T, Matsui K, Nakayama Y, Koshida Y. Three Cases of Chemical Burns Caused Due to Dimethyl Sulfate Poisoning. Cureus 2024; 16:e57060. [PMID: 38681359 PMCID: PMC11052507 DOI: 10.7759/cureus.57060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2024] [Indexed: 05/01/2024] Open
Abstract
Dimethyl sulfate (DMS) is a drug widely used as a pharmaceutical and synthetic raw material. On the other hand, it is highly toxic and requires management and treatment as a hazardous substance. A mass outbreak of chemical burns resulting from DMS poisoning occurred at a drug factory. All three patients were brought to our hospital, a tertiary emergency medical facility, several hours after exposure. Their vital signs were stable, with only eye pain and a sore throat. However, after admission, two patients required emergency tracheostomy or endotracheal intubation due to laryngeal edema. Improvement was achieved through the administration of steroids, but a severely injured patient required an extended treatment period. DMS poisoning is rare; however, it can be fatal depending on the exposure concentration. Furthermore, even if the initial symptoms are mild, laryngeal edema may develop later, requiring careful monitoring and appropriate airway interventions.
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Affiliation(s)
- Shiori Mizuta
- Intensive Care Medicine, Toyama Prefectural Central Hospital, Toyama, JPN
| | - Tatsuya Miyakoshi
- Intensive Care Medicine, Toyama Prefectural Central Hospital, Toyama, JPN
| | - Kotaro Matsui
- Emergency Medicine, Toyama Prefectural Central Hospital, Toyama, JPN
| | - Yuko Nakayama
- Emergency Medicine, Toyama Prefectural Central Hospital, Toyama, JPN
| | - Yosinao Koshida
- Intensive Care Medicine, Toyama Prefectural Central Hospital, Toyama, JPN
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Reddy K, Gharde P, Tayade H, Patil M, Reddy LS, Surya D. Unknown and Unacknowledged Dangers to Every Medical Student: A Rare Case of Nitric Acid Burns. Cureus 2024; 16:e52203. [PMID: 38348010 PMCID: PMC10860366 DOI: 10.7759/cureus.52203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/13/2024] [Indexed: 02/15/2024] Open
Abstract
This case report delves into the often overlooked and unacknowledged hazards faced by medical students, exemplified by a rare incident of nitric acid burns. A 19-year-old male medical student with no notable medical, surgical, or familial history suffered a spillage of 69% nitric acid on the anterior aspect of the right thigh while engaged in laboratory work. Swift action, including immediate wound irrigation, application of silver sulfadiazine, and subsequent hospitalization, proved crucial in mitigating the burn's severity. Though vitally stable, the patient exhibited a distinctive color change in the wound during observation. Admitted to the general surgery ward, outpatient follow-ups revealed successful wound healing within four weeks, emphasizing the importance of prompt intervention and meticulous care in addressing chemical burn injuries among medical students. This report sheds light on the often-underestimated dangers inherent in pursuing medical education.
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Affiliation(s)
- Kavyanjali Reddy
- Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pankaj Gharde
- Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Harshal Tayade
- Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Mihir Patil
- Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Lucky Srivani Reddy
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Dheeraj Surya
- Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Kate A, Sharma S, Yathish S, Das AV, Malepati N, Donthineni PR, Basu S, D’Souza S, Shanbhag SS. Demographic profile and clinical characteristics of patients presenting with acute ocular burns. Indian J Ophthalmol 2023; 71:2694-2703. [PMID: 37417107 PMCID: PMC10491055 DOI: 10.4103/ijo.ijo_3330_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/23/2023] [Accepted: 05/30/2023] [Indexed: 07/08/2023] Open
Abstract
Purpose To study and compare the demographic and clinical profile of acute ocular burns (AOB) in children and adults. Methods This retrospective case series included 271 children (338 eyes) and 1300 adults (1809 eyes) who presented to two tertiary eye care centers within one month of sustaining AOB. Data regarding demographics, causative agents, severity of injury, visual acuity (VA), and treatment were collected and analyzed. Results Males were more commonly affected particularly among adults (81% versus 64%, P < 0.00001). Among children, 79% sustained domestic injuries, whereas 59% of adults had work-place injuries (P < 0.0001). Most cases were due to alkali (38%) and acids (22%). Edible lime (chuna, 32%), superglue (14%), and firecrackers (12%) in children, and chuna (7%), insecticides, lye, superglue (6% each), toilet cleaner (4%) and battery acid (3%) in adults, were the main causative agents. The percentage of cases with Dua grade IV-VI was greater in children (16% versus 9%; P = 0.0001). Amniotic membrane grafting and/or tarsorrhaphy were needed in 36% and 14% of affected eyes in children and adults, respectively (P < 0.00001). The median presenting VA was logMAR 0.5 in children and logMAR 0.3 in adults (P = 0.0001), which improved significantly with treatment in both groups (P < 0.0001), but the final VA in eyes with Dua grade IV-VI burns was poorer in children (logMAR 1.3 versus logMAR 0.8, P = 0.04). Conclusion The findings clearly delineate the at-risk groups, causative agents, clinical severity, and treatment outcomes of AOB. Increased awareness and data-driven targeted preventive strategies are needed to reduce the avoidable ocular morbidity in AOB.
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Affiliation(s)
- Anahita Kate
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Vijayawada, Andhra Pradesh, India
| | - Supriya Sharma
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
- Cornea and Anterior Segment Services, Shantilal Shanghvi Eye Institute, Mumbai, Maharashtra, India
| | - S Yathish
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, Karnataka, India
| | - Anthony Vipin Das
- Department of Eye Smart EMR and AEye, Indian Health Outcomes, Public Health and Economics Research Center, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Nikhila Malepati
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Pragnya R Donthineni
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sayan Basu
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
- Center for Ocular Regeneration (CORE), L V Prasad Eye Institute, Hyderabad, Telangana, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sharon D’Souza
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, Karnataka, India
| | - Swapna S Shanbhag
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Peng WY, He LW, Yin XF, Zhou BB, Zhou T, Zhou SY. Successful regression of newly formed corneal neovascularization by subconjunctival injection of bevacizumab in patients with chemical burns. Front Med (Lausanne) 2023; 10:1210765. [PMID: 37425330 PMCID: PMC10324651 DOI: 10.3389/fmed.2023.1210765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Purpose To investigate the effect and timing of subconjunctival bevacizumab injection on inhibiting corneal neovascularization (CorNV) in patients after chemical burns. Methods Patients with CorNV secondary to chemical burns were involved. Two subconjunctival injections of bevacizumab (2.5 mg/0.1 mL per involved quadrant) with an interval of 4 weeks were administered, and followed up a year. The area occupied by neovascular vessels (NA), accumulative neovascular length (NL), mean neovascular diameter (ND), best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were evaluated. Complication was also recorded. Results Eleven patients with CorNV were involved. Eight patients had a history of surgery (four had amniotic grafts, one had keratoplasty, and three had amniotic grafts and keratoplasty). Decreasing in NA, NL, and ND were statistically significant at each time point compared to the baseline (p < 0.01). CorNV that developed within 1 month was considerably regressed, and vessels with fibrovascular membranes were found to be narrower and shorter than pretreatment. BCVA improved in five patients (from one to five lines), remained unchanged in five patients, and decreased in one patient compared to pretreatment. Conclusion Subconjunctival bevacizumab injection has a particular potential for the regression of CorNV, especially newly formed within 1 month in patients after chemical burns.
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Affiliation(s)
- Wen-yan Peng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Li-wen He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiao-fang Yin
- Department of Ophthalmology, The Second People's Hospital of Foshan, Foshan, China
| | - Bin-Bing Zhou
- Department of Ophthalmology, The Affiliated First Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Tao Zhou
- Department of Ophthalmology, First People’s Hospital of Guiyang, Guiyang, China
| | - Shi-you Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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Lindén J, Taponen S, Talvitie V, Leppävuori E, Hänninen L. Histopathological findings in a pilot study of dairy calves disbudded with hot cauterization or caustic paste. J Comp Pathol 2023; 201:118-122. [PMID: 36806891 DOI: 10.1016/j.jcpa.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 11/03/2022] [Accepted: 01/07/2023] [Indexed: 02/17/2023]
Abstract
We describe the histological tissue damage and compare the healing process in 16 dairy calves disbudded at a mean age of 6 days by cauterization or alkaline caustic paste application. Biopsies were taken 2 days (T2) and 2 weeks (T14) after disbudding from sedated calves treated with local anaesthetic and non-steroidal anti-inflammatory drugs. At T2, the cauterized horn buds generally had eosinophilic coagulative necrosis of the epidermis and superficial dermis, bordered basally by a neutrophilic demarcation zone. Lateral to the direct heat contact area, dermal blood vessels were thrombosed, with wall damage and perivascular neutrophils. In the caustic paste-treated horn buds, the epidermis and dermis had diffuse full-thickness liquefactive necrosis directly under the paste contact area. The necrosis spread laterally in the dermis beyond the area of paste contact and was bordered by a neutrophilic infiltrate. At T14, the cauterized horn buds had epidermal to superficial dermal ulceration and crusting, dermal neutrophilic infiltration and granulation tissue formation. In contrast, most of the caustic paste-treated horn buds consisted of a superficial dermal crust or predominantly necrotic tissue fragments. The remaining viable areas had histiocytic inflammation with peripheral neutrophils and early granulation tissue formation. Caustic paste disbudding caused poorly demarcated lesions that were more severe and extensive and took longer to heal than those due to cautery. Cauterization induced a more intense acute reaction adjacent to the primary lesion compared with caustic paste.
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Affiliation(s)
- Jere Lindén
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine and Finnish Centre for Laboratory Animal Pathology, HiLIFE Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Suvi Taponen
- Department of Production Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
| | - Vera Talvitie
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine and Finnish Centre for Laboratory Animal Pathology, HiLIFE Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Eveliina Leppävuori
- Department of Production Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Laura Hänninen
- Department of Production Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland; Research Centre for Animal Welfare, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
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Sutherland J, Bowen L. Ingestion of foreign bodies and caustic substances in children. BJA Educ 2023; 23:2-7. [PMID: 36601025 PMCID: PMC9805929 DOI: 10.1016/j.bjae.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
| | - L. Bowen
- Children's Hospital for Wales, Cardiff, Wales, UK
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Abstract
PURPOSE To investigate the safety and efficacy of topical erythropoietin for the treatment of scleral necrosis. METHODS This study enrolled eight consecutive patients with scleral necrosis due to previous ocular surgery, rheumatoid arthritis-associated necrotizing anterior scleritis, and thermal and chemical burns. Conventional treatments failed to heal avascular scleral lesions in all eyes. Patients were treated with topical erythropoietin (3000 IU/mL) four times a day. RESULTS The mean patient age was 37.6 ± 15.5 years. The interval between the development of scleral necrosis and initiation of topical erythropoietin was 25.6 ± 12.0 days. The necrotic sclera completely healed within 31.9 ± 16.9 days in all patients. The avascular lesions did not recur, and there was no evidence of side effects during the study. CONCLUSION Our results showed that topical erythropoietin could be safely used to manage scleral necrosis. Randomized clinical trials are needed to further explore the efficacy of this intervention in patients with avascular scleral lesions.
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Affiliation(s)
- Sepehr Feizi
- Ophthalmic Research Center, Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Alireza Baradaran-Rafii
- Ophthalmic Research Center, Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Esfandiari
- Department of Ophthalmology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ahmad Kheirkhah
- Department of Ophthalmology, Long School of Medicine, University of Texas Health at San Antonio, San Antonio, Texas, USA
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8
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Galo A, Farid M, Almasharqah R. The conservative management of self-inflicted chemical burns: Case report and literature review. Scars Burn Heal 2022; 8:20595131221080545. [PMID: 35355687 PMCID: PMC8958678 DOI: 10.1177/20595131221080545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Chemical burns, particularly injuries related to psychiatric illnesses, are underreported in the literature. We present two cases of self-inflicted alkali chemical burns managed conservatively. Frequent clinical review of the burn was aimed to ensure appropriate healing and compliance with the treatment plan based on regular dressing changes. Case 1 A 24-year-old woman presented during the first day of the initial injury with a minor self-inflicted chemical burn to the right forearm. The causative agent was an oven cleaner containing sodium hydroxide triggering an alkali-based burn. The surface area of the injury was 0.5% total body surface area (TBSA) full-thickness burn. The patient had a complex psychiatric history diagnosed with personality disorder, anxiety and depression. Case 2 A 55-year-old woman presented with a self-inflicted left forearm full-thickness burn (0.5% TBSA). This was five days after the initial injury from an oven cleaner containing sodium hydroxide. The patient had a psychiatric history of anxiety and depressive disorder. The mainstay of burn management was conservative with regular dressing changes and a topical agent. Telemedicine via a designated email address was given to the patient for virtual clinical burn review and any urgent issues. Photograph of the initial burn was taken, and clinic visits were scheduled to determine healing progress. Conclusion Self-inflicted chemical burns are to be managed within a multidisciplinary setting including early psychiatric involvement. We advocate a holistic approach to determine conservative or operative management, taking into account patient factors, burn complexity and clinician's judgement to streamline the treatment plan. Lay Summary Chemical burns due to self-harm are rare to see in clinical practice. A review of two cases secondary to intentional burns sustained using an oven cleaning material. Patients had psychiatric issues and were on medications to control symptoms. Close observation with regular dressings and topical cream would allow burns to heal without the need for an operation. Our recommendation would be to treat these burns with dressings and regular follow up in the clinic or virtually till healed.
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Affiliation(s)
- Amenah Galo
- Queen Elizabeth Hospital Birmingham, Burns Unit, Mindelsohn Way, Birmingham, B15 2TH, UK
| | - Mohammed Farid
- Queen Elizabeth Hospital Birmingham, Burns Unit, Mindelsohn Way, Birmingham, B15 2TH, UK
| | - Riyadh Almasharqah
- Queen Elizabeth Hospital Birmingham, Burns Unit, Mindelsohn Way, Birmingham, B15 2TH, UK
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Keilani C, De Faria A, Baus A, Delbarre M, Schaal J, Froussart-Maille F, Bey E, Duhamel P. Eyelid Chemical Burns: A Multidisciplinary And Challenging Approach. Ann Burns Fire Disasters 2021; 34:312-318. [PMID: 35035323 PMCID: PMC8717906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/14/2021] [Indexed: 06/14/2023]
Abstract
During second- and third-degree eyelid sulfuric acid burns, many surgeons prefer to wait until primary wound separation occurs before grafting. However, this approach may miss the chance to recover the eyelids and can cause ectropion, resulting in delayed eyeball healing with exposure keratitis. We propose that early eyelid release and grafting makes a significant difference in long-term outcomes and improves eyeball healing. Here, we present the case of a woman who presented second- and third-degree burns of the eyelids secondary to physical domestic assault with acid, who had an early surgical management with a full-thickness skin graft. Ten days after surgery, we found that the graft had survived totally, and the donor site of the right arm had already healed. Eyelids were successfully grafted and the functions of both eyelids were well recovered, allowing complete cover of the eyeball. Two months after surgery, functional and cosmetic results were satisfying, with no postoperative lagophthalmos or difficulties with exposure-related problems. Case reports of eyelid chemical burns are very few. No specific and codified management of eyelid chemical burns was found in the literature search. This case report demonstrated that a multidisciplinary approach led by both ophthalmologists and plastic surgeons must be decided early (<6h) in order to achieve synergistic and coordinated management between the eye and the eyelid. There is a significant improvement in ocular healing with early excision and grafting of eyelids after sulfuric acid burn.
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Affiliation(s)
- C. Keilani
- Department of Plastic Surgery and Burn Treatment, Percy Military Hospital, Clamart, France
- Department of Ophthalmology, Percy Military Hospital, Clamart, France
- acial and Oculoplastic Surgery Unit, Quinze-Vingts National Center, Paris, France
- Faculty of Medicine Pierre et Marie Curie, Sorbonne University Paris VI, France
- Assistance Publique des Hôpitaux de Paris, France
| | - A. De Faria
- Department of Ophthalmology, Percy Military Hospital, Clamart, France
| | - A. Baus
- Department of Plastic Surgery and Burn Treatment, Percy Military Hospital, Clamart, France
| | - M. Delbarre
- Department of Ophthalmology, Percy Military Hospital, Clamart, France
| | - J.V. Schaal
- Burn Center, Percy Military Hospital, Clamart, France
| | | | - E. Bey
- Department of Plastic Surgery and Burn Treatment, Percy Military Hospital, Clamart, France
| | - P. Duhamel
- Department of Plastic Surgery and Burn Treatment, Percy Military Hospital, Clamart, France
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Abstract
Common skin warts frequently appear on the fingers of children, a patient population in whom finger-sucking is a prevalent habit. Despite overlap between these two pediatric conditions, there are no well-reported specific precautions against the use of topical blistering wart treatments, such as trichloroacetic acid and cantharidin, in finger-sucking children with warts. We report the case of oral ulcers in a pediatric patient secondary to thumb-sucking after receiving treatment for multiple finger warts with combination cryotherapy, trichloroacetic acid, and cantharidin.
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Affiliation(s)
- Jennifer McConnell
- Division of Pediatric Emergency Medicine, Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Lindsey Claire Epperson
- Division of Medical Toxicology, Department of Emergency Medicine, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Faye Eifert
- Division of Pediatric Dermatology, Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kim Aldy
- Division of Medical Toxicology, Department of Emergency Medicine, The University of Texas Southwestern Medical Center, Dallas, TX, USA
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Al-Turck KMA, Aldosary S, Alrabiah R, Albusayes R, Alnamlah S. Cultural and Personal Practices with Unusual Oral Findings: Three Case Reports and a Literature Review. Clin Cosmet Investig Dent 2021; 13:361-370. [PMID: 34466036 PMCID: PMC8402952 DOI: 10.2147/ccide.s322302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/27/2021] [Indexed: 11/23/2022] Open
Abstract
Due to increased migration, dentists are encountering patients with varied cultural practices. The main aim of this study was to report three cases in which cultural/individual oral practices appeared to be suggestive of disease, leading to initial misdiagnoses. We describe the case findings of three individuals treated at the Oral Diagnosis Clinic at the College of Dentistry at King Saud University in Riyadh, Saudi Arabia. In two cases, the patients presented with a missing uvula and dark maxillary gingiva. The initial diagnoses in both cases were incorrect. Further questioning revealed that the individuals had gingival tattoos and uvulectomies performed for traditional reasons. The patient in the third case presented with a diffuse red and white bilateral lesion on the buccal mucosa. The initial diagnosis was possible speckled leukoplakia. Upon further questioning, a definitive diagnosis of a chemical burn from a coarse salt mouth rinse due to personal oral practices was made. A literature review of these cultural practices is included. Our case report findings and the literature review highlight the need to consider cultural practices that can affect oral health and cause unusual oral findings when recording medical histories. Increasing awareness regarding these practices may help dentists provide appropriate treatment plans and reduce misdiagnoses. Furthermore, by understanding cultural practices, dentists may educate their patients about the harmful effects of some of these traditions.
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Affiliation(s)
- Kawkab M A Al-Turck
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Sara Aldosary
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Reem Alrabiah
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Riham Albusayes
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Sarah Alnamlah
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Varma S, Shanbhag SS, Donthineni PR, Mishra DK, Singh V, Basu S. High-Resolution Optical Coherence Tomography Angiography Characteristics of Limbal Stem Cell Deficiency. Diagnostics (Basel) 2021; 11:1130. [PMID: 34205702 DOI: 10.3390/diagnostics11061130] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/02/2021] [Accepted: 06/17/2021] [Indexed: 12/15/2022] Open
Abstract
This study aimed to identify the anterior segment high-resolution optical coherence tomography (HR-OCT) and HR-OCT angiography (HR-OCTA) features suggestive of limbal stem cell deficiency (LSCD) as confirmed by both impression cytology (IC) and in vivo confocal microscopy (IVCM). This was a single-centre prospective cross-sectional study including 24 eyes of 22 patients with clinical suspicion of LSCD based on peripheral superficial corneal vascularisation and scarring. On IC and IVCM, performed and interpreted by blinded observers, 12 eyes each were diagnosed with and without LSCD. Additionally, 10 eyes of 5 healthy volunteers with no ocular pathology were also imaged. The 136 HR-OCT/A images of these 34 eyes were analysed with respect to 12 imaging parameters; the parameters most suggestive of LSCD were identified and the sensitivity and specificity were calculated. In the LSCD group, the most common aetiology was ocular chemical burns (83%), whereas in the non-LSCD group, the most common aetiology was viral keratitis (67%). Multiple logistic regression analysis revealed that mean epithelial reflectivity, mean stromal reflectivity, and mean superficial vascular density were the parameters that were diagnostic of LSCD on HR-OCT/A (p < 0.0001). A ratio of the mean epithelial reflectivity to stromal reflectivity of >1.29 corresponded with a high sensitivity (91.7%) and specificity (98.75%); while a mean superficial vascular density score of >0.38 corresponded with a sensitivity of 97.9% and specificity of 73.8%. In conclusion, HR-OCT/A as a non-invasive imaging modality could prove to be a useful tool for confirming the diagnosis of LSCD, with potential clinical and research applications.
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Hao D, Nourbakhsh M. Recent Advances in Experimental Burn Models. Biology (Basel) 2021; 10:526. [PMID: 34204763 DOI: 10.3390/biology10060526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 12/13/2022]
Abstract
Simple Summary Human burns are diverse and the most difficult injuries to study in clinical settings. Numerous experimental burn models designed to study and compare different aspects of burns and their consequences and treatment are steadily progressing. This review summarizes the latest advances in experimental burn research as a guide to aid in the future design of studies. Abstract Experimental burn models are essential tools for simulating human burn injuries and exploring the consequences of burns or new treatment strategies. Unlike clinical studies, experimental models allow a direct comparison of different aspects of burns under controlled conditions and thereby provide relevant information on the molecular mechanisms of tissue damage and wound healing, as well as potential therapeutic targets. While most comparative burn studies are performed in animal models, a few human or humanized models have been successfully employed to study local events at the injury site. However, the consensus between animal and human studies regarding the cellular and molecular nature of systemic inflammatory response syndrome (SIRS), scarring, and neovascularization is limited. The many interspecies differences prohibit the outcomes of animal model studies from being fully translated into the human system. Thus, the development of more targeted, individualized treatments for burn injuries remains a major challenge in this field. This review focuses on the latest progress in experimental burn models achieved since 2016, and summarizes the outcomes regarding potential methodological improvements, assessments of molecular responses to injury, and therapeutic advances.
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Chauhan N, Prasad RS. Methylene Chloride Burns: A Case Report and Review of Literature. Indian J Plast Surg 2021; 54:94-96. [PMID: 33814750 PMCID: PMC8012789 DOI: 10.1055/s-0041-1725224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Chemical burns account for a small percentage of burns but contribute to significant number of burn-related mortalities. The major challenge posed by chemical burns is difficulty in correct depth estimation, as the damage continues to progress until they are effectively neutralized. Besides the most common etiology of chemical burns by alkalis and acids, there are many other unique causes of chemical burns. The author describes a case of chemical burns by heavy duty paint remover, the main composition of which is methylene chloride. Although several studies about methylene chloride poisoning are available in literature, only one case report of burns due to methylene chloride exists in literature. These burns are unique in their presentation. The author describes the presentation and challenges in management of this burn. Clinical trial registration
Not applicable.
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Affiliation(s)
- Neha Chauhan
- Department of Plastic Surgery, St. Philomena's Hospital, Viveknagar, Bangalore, Karnataka, India
| | - R Shankar Prasad
- Department of Medicine, St. Philomena's Hospital, Viveknagar, Bangalore, Karnataka, India
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15
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Brambilla E, Crevani M, Petrolini VM, Scaravaggi G, Di Primo M, Roda E, Locatelli CA. Exposure to Nail and False Eyelash Glue: A Case Series Study. Int J Environ Res Public Health 2020; 17:E4283. [PMID: 32549349 DOI: 10.3390/ijerph17124283] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 01/13/2023]
Abstract
The use of artificial nail tips in professional manicure services and the application of false eyelashes are a growing trend among young women. Often, this “beauty routine” is performed at home without the supervision of an expert beautician, raising health problems due to either the spillage of these products or to accidental exposure to children. The aim of this study is to review the Pavia Poison Control Centre clinical records to identify the frequency, the most common route of exposure, and the possible risks associated to these events to support the decision-making process in emergency departments. The Pavia Poison Control Centre database was retrospectively searched for records reporting nail or false eyelash glue exposure from January 2007 to April 2020, and 42 patients were identified. Among the patients, 76% presented symptoms from mild to severe, while 24% were asymptomatic. The most common route of exposure was dermal, through cutaneous contact, as determined for 19 patients involved. Among these, seven patients presented with second-degree chemical burns, cutaneous erythema, and ocular symptoms. The most dangerous glue component was cyanoacrylate, leading to symptoms in 16 out of 22 patients, while three cases remained asymptomatic. Even if this exposure is relatively rare, nail and false eyelash glue can be seriously harmful, especially when exposure occurs via dermal or ocular routes. In the case of emergency, it is important to treat the patient as fast as possible to limit the damage caused by a burn. Moreover, even though these products are often perceived as harmless, safety precautions should be taken to prevent children from accidental contact.
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16
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Dewar ZE, Christiansen G. Contact chemical burn of the hand caused by xylene: A case report. J Am Coll Emerg Physicians Open 2020; 1:289-291. [PMID: 33000046 PMCID: PMC7493561 DOI: 10.1002/emp2.12079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 02/22/2020] [Accepted: 02/25/2020] [Indexed: 11/11/2022] Open
Abstract
The use of household cleaners during non-commercial cleaning applications is a very common task, and the chemical makeup of the cleaning solutions vary as much as their applications do. Although most users of these products follow the written safety directions and are generally careful with their use, it is not uncommon for users to suffer toxicologic effects of these cleaners without proper protective equipment. In this case report, we describe an unusual chemical burn pattern to the hand of a young female patient after prolonged exposure to a xylene-containing product without proper chemical-resistant gloves. Fortunately, with prompt recognition, and urgent referral for burn treatment, the patient underwent a successful debridement of the burn and suffered minimal functional impairment.
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Affiliation(s)
- Zachary Ewan Dewar
- Department of Emergency MedicineEmergency Medicine Residency Guthrie/Robert Packer HospitalSayrePennsylvania
| | - Gregory Christiansen
- Department of Emergency MedicineEmergency Medicine Residency Guthrie/Robert Packer HospitalSayrePennsylvania
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17
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Abstract
A retrospective analysis was conducted by using data from the National Electronic Injury Surveillance System for children <5 years who were treated in US emergency departments (EDs) from 2002-2016) for a cosmetic-related injury. An estimated 64 686 (95% confidence interval = 53 037-76 335) children were treated in EDs for cosmetic-related injuries during the 15-year study period. There was no significant change in the rate (slope = 1.1 per 10 000 children per year, P = .95) of injuries over the study period. Injuries were most commonly associated with nail care (28.3%), hair care (27.0%), skin care (25.0%), and fragrance (12.7%) products. Children aged <2 years were most frequently injured (59.3%), and poisoning was the most common diagnosis (86.2%). To our knowledge, this is the first study to use a nationally representative sample to describe the epidemiology of cosmetic-related injuries among children aged <5 years. Unintentional exposure to cosmetics is an important source of injury for young children.
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Affiliation(s)
- Jordan Vajda
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Rebecca J McAdams
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Kristin J Roberts
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Motao Zhu
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,The Ohio State University College of Medicine, Columbus, OH, USA
| | - Lara B McKenzie
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,The Ohio State University College of Medicine, Columbus, OH, USA
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18
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Majeed S, Rahman MU, Majeed H, Rahman SU, Hayat A, Smith SD. Chemical mismanagement and skin burns among hospitalized and outpatient department patients. Int J Occup Saf Ergon 2019; 27:817-830. [PMID: 31251122 DOI: 10.1080/10803548.2019.1638142] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Purpose. This article attempts to elucidate the nature of chemicals causing major and minor skin burns, and their associated characterization across different industries, using Fujian provincial hospitals' admission and outpatient department records. Materials and methods. Data were collected from the provincial hospitals of Fujian through a questionnaire, sent via email, from June 1, 2017 to November 30, 2017. The collected responses were statistically analyzed using SPSS version 19 through the interquartile range, median, Mann-Whitney U test and Fisher's exact test with two-tailed significance. Results and conclusions. The results of 306 collected responses reveal that the majority of skin burn cases are due to a lack of technical education and professional training among workers handling chemicals. This study suggests that management's effective supervision and governmental regulations may help to prevent chemical skin burns at work, and can further be controlled by hiring professional workers alongside providing training to them in chemical handling as well as using protective equipment and developing appropriate management policies to improve victims' well-being and quality of life. Findings will help workers, doctors, hospitals, industries, government and other stakeholders to understand and control chemical hazards on site to minimize the risks of chemical skin burn incidents.
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Affiliation(s)
| | | | - Hammad Majeed
- Department of Chemistry, University of Agriculture, Pakistan
| | - Sami Ur Rahman
- Urban Policy Unit Planning and Development Department, Government of Khyber Pakhtunkhwa (UPU, P&DD GoKP) Civil Secretariat, Pakistan
| | - Asif Hayat
- College of Chemistry, Fuzhou University, China
| | - Sandra D Smith
- University of Auckland Business School, University of Auckland, New Zealand
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19
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Hughes CD, Dabek RJ, Riesel JN, Baletic N, Chodosh J, Bojovic B. Short Runs for a Long Slide: Principalization in Complex Facial Restoration after Acid Attack Burn Injury. Craniomaxillofac Trauma Reconstr 2019; 12:75-80. [PMID: 30815220 DOI: 10.1055/s-0038-1668511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 07/03/2018] [Indexed: 10/28/2022] Open
Abstract
Burn injuries are responsible for a significant portion of surgically treatable morbidity throughout the world and particularly in underdeveloped and developing countries. Intentional flame, chemical, and contact burns are unfortunately a common mechanism of injury. It is estimated that intentional chemical burns are responsible for between 2 and 20% of burn injuries seen at burn centers in lower income countries. Women are commonly targeted and the perpetrators are often known to the victims. The combination of a high disease prevalence, limited surgical and anesthetic resources, a vulnerable patient population, and largely disfiguring, nonlethal injuries present unique challenges for the reconstructive surgeon who may not encounter such cases regularly. In this article, we present a case of a 16-year-old female who sustained severe, full-thickness burns to the face including eyelids, neck, abdomen, and upper extremities after an intentional acid attack. She began her treatment course with us approximately 1 year after the injury. The deformities of her oral and periorbital regions presented particularly difficult reconstructive problems, including impending visual loss. Using plastic surgical principalization, we provided our patient adequate restoration of facial form and function through numbers of interventions using fundamental and state-of-the-art techniques.
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Affiliation(s)
- Christopher D Hughes
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts.,Division of Plastic, Reconstructive and Laser Surgery, Shriners Hospitals for Children Boston, Boston, Massachusetts
| | - Robert Jaroslaw Dabek
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Johanna N Riesel
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Nemanja Baletic
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - James Chodosh
- Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
| | - Branko Bojovic
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts.,Division of Plastic, Reconstructive and Laser Surgery, Shriners Hospitals for Children Boston, Boston, Massachusetts
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20
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Abstract
The objective was to perform a thorough review of published and other available data to elucidate the extent of chemical skin injuries in the US. Chemical skin injuries differ significantly from skin lesions produced by other injury mechanisms, so this review was restricted to the former. Retrieval of relevant published data was performed in PubMed and Google. Other data were retrieved from the American College of Surgeons National Trauma Databank, American Burn Association National Burn Repository, US Department of Labor Bureau of Labor Statistics, websites of all 50 US States Departments of Health, and the National Poison Data System of the American Association of Poison Control Centers. Two areas of significance in disfiguring skin burn injuries and particularly of chemical skin injuries, psychosocial issues and the associated financial burden, have been briefly reviewed. Because of the paucity of published data, international as well as US data have been included. A brief description of an active flushing fluid as an alternative to potable water, Diphoterine® solution, has also been included. Chemical skin injuries generally comprise approximately 2-5% of all skin burns, but sometimes higher percentages have been reported. Data analysis shows that while there are various sources regarding the epidemiology of chemical skin injuries, the total annual number cannot be determined because there is no centralized US national reporting mechanism. Literature and clinical experience demonstrate the importance of chemical skin injuries in USA. Dermal exposures to chemicals can result in mortality and morbidity. Chemical skin injuries can be avoided or ameliorated and preventive advanced measures should be taken to reduce or ameliorate them.
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Affiliation(s)
- Alan H Hall
- Toxicology Consulting and Medical Translating Services, Springtown and Azle, TX, USA.,Colorado School of Public Health, University of Colorado-Denver, Denver, CO, USA
| | | | - Howard I Maibach
- Department of Dermatology, University of California School of Medicine-San Francisco, San Francisco, CA, USA
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21
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Dikhit PS, Srivastava A, Boyena KK. Injury to the oral mucosa by organophosphates without systemic toxicity: a rare case. Br J Oral Maxillofac Surg 2018; 56:755-757. [PMID: 30093185 DOI: 10.1016/j.bjoms.2018.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 07/23/2018] [Indexed: 11/16/2022]
Abstract
We describe a case of multiple Zargar grade IIA ulcerations of the oral mucosa with no systemic toxicity in a patient after ingestion of an organophosphate. Serial debridement, control of superadded infections, and active physiotherapy were the mainstay of the treatment plan. We know of no other reported cases of poisoning by organophosphates that caused burns of the oral mucosa and no systemic toxicity.
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Affiliation(s)
- P S Dikhit
- SDM Dental College, Dharwad, India; Department of Dental Surgery, AIIMS, Bhubaneshwar, India.
| | - A Srivastava
- Department of Dental Surgery, AIIMS, Bhubaneshwar, India; Hitkarni Dental College, Jabalpur, India.
| | - K K Boyena
- Department of Trauma and Emergency, AIIMS, Bhubaneshwar, India.
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22
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Dohlman CH, Cade F, Regatieri CV, Zhou C, Lei F, Crnej A, Harissi-Dagher M, Robert MC, Papaliodis GN, Chen D, Aquavella JV, Akpek EK, Aldave AJ, Sippel KC, DʼAmico DJ, Dohlman JG, Fagerholm P, Wang L, Shen LQ, González-Andrades M, Chodosh J, Kenyon KR, Foster CS, Pineda R, Melki S, Colby KA, Ciolino JB, Vavvas DG, Kinoshita S, Dana R, Paschalis EI. Chemical Burns of the Eye: The Role of Retinal Injury and New Therapeutic Possibilities. Cornea 2018; 37:248-251. [PMID: 29135604 PMCID: PMC8728745 DOI: 10.1097/ico.0000000000001438] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To propose a new treatment paradigm for chemical burns to the eye - in the acute and chronic phases. METHODS Recent laboratory and clinical data on the biology and treatment of chemical burns are analyzed. RESULTS Corneal blindness from chemical burns can now be successfully treated with a keratoprosthesis, on immediate and intermediate bases. Long term outcomes, however, are hampered by early retinal damage causing glaucoma. New data suggest that rapid diffusion of inflammatory cytokines posteriorly (TNF-α, etc) can severely damage the ganglion cells. Prompt anti-TNF-α treatment is markedly neuroprotective. Long term profound reduction of the intraocular pressure is also vital. CONCLUSION A new regimen, in addition to standard treatment, for severe chemical burns is proposed. This involves tumor necrosis factor alpha (TNF-α) inhibition promptly after the accident (primarily for retinal neuroprotection), prophylactic maximal lowering of the intraocular pressure (starting immediately), and keratoprosthesis implantation in a later quiet state.
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Affiliation(s)
- Claes H Dohlman
- Cornea Service and Boston Keratoprosthesis Laboratory, Massachusetts Eye and Ear Infirmary and Schepens Eye Research Institute, Harvard Medical School, Boston, MA
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23
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Abstract
PURPOSE: The brown marmorated stink bug is native to Asia (China, Taiwan, Japan, and the Korean peninsula). Its bodily fluids are toxic and irritating to the human skin and eyes. Human case reports are rare. Only one report of irritant contact dermatitis has been published. We report a case of irritant contact keratitis resulting from the chemical components of the bodily fluids of the bug. MATERIALS AND METHODS: A case report. RESULTS: A 74-year-old male presented to our emergency department with pain and redness in his right eye, which had been exposed to the bodily fluids of a brown marmorated stink bug. A patch of central corneal epithelial defect with conjunctival congestion and chemosis was found in his right eye. His best-corrected visual acuity (BCVA) (OD) was 6/20. We prescribed topical antibiotic and lubricant medications. The corneal epithelial defect recovered gradually over the course of several days. BCVA worsened to 2/60 but recovered gradually to 6/8.6 after the epithelial defect healed and after use of topical steroid for suppression of the local inflammation. DISCUSSION: The adult brown marmorated stink bug is characterized by its shield shape and its dark, mottled, brown color. The stink bug ranges in length from 14 to 17 mm. A startled stink bug will react by biting or spraying a foul-smelling liquid from its thorax. When disturbed or crushed, the stink bug excretes a highly potent, odorous smell. The major component of the bodily fluids is trans-2-decenal and trans-2-octenal, chemicals that belong to the aldehyde group. Hydrogen ions (H+) produced by reduction and oxidation of aldehyde can induce chemical burn injuries to the ocular surface. Irritant contact keratitis may occur through this mechanism. CONCLUSION: Stink bugs excrete odorous bodily fluids as a defensive mechanism when threatened. If the toxic fluid gets into the human eye, it can cause unexpected chemical burns or injury. Patients whose eyes come into contact with these bodily fluids should rinse their eyes thoroughly and immediately seek medical attention.
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Affiliation(s)
- Yi-Syun Shen
- Department of Ophthalmology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Chao-Chien Hu
- Department of Ophthalmology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.,School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
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24
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Neri I, Ravaioli GM, Faldella G, Capretti MG, Arcuri S, Patrizi A. Chlorhexidine-Induced Chemical Burns in Very Low Birth Weight Infants. J Pediatr 2017; 191:262-265.e2. [PMID: 29173315 DOI: 10.1016/j.jpeds.2017.08.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 07/20/2017] [Accepted: 08/02/2017] [Indexed: 12/16/2022]
Abstract
Skin disinfection with chlorhexidine gluconate has not been standardized in preterm infants. We present 5 cases of chemical burns that occurred within the first 2 days of life in very low birth weight neonates after skin disinfection with aqueous and alcohol-based chlorhexidine solutions.
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Affiliation(s)
- Iria Neri
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Giulia Maria Ravaioli
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
| | - Giacomo Faldella
- Department of Obstetric, Gynecological and Pediatric Sciences, Operative Unit of Neonatology, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Maria Grazia Capretti
- Department of Obstetric, Gynecological and Pediatric Sciences, Operative Unit of Neonatology, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Santo Arcuri
- Department of Obstetric, Gynecological and Pediatric Sciences, Operative Unit of Neonatology, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
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25
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Zhang Y, Wang X, Liu Y, Jiang X, Ye C, Ni L, Zhang L, Zhang J, Xu B, Han C. Management of a Rare Case With Severe Hydrofluoric Acid Burns: Important Roles of Neutralizers and Continuous Renal Replacement Therapy. INT J LOW EXTR WOUND 2017; 16:289-295. [PMID: 29132247 DOI: 10.1177/1534734617736198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Hydrofluoric acid (HF), a dangerous inorganic acid, is widely used in various industries and in daily life. Chemical burns caused by HF exposure occur more frequently in some regions worldwide. It has been reported that some cases with HF burns can be lethal due to the hypertoxicity of HF. In this article, we present a case of a 24-year-old worker who suffered HF burns by 53% HF solution to his face, neck, and nasal cavity. This patient quickly developed electrolyte disturbance, that is, hypocalcemia, and hypopotassemia, and myocardial injury after exposure. Multiple measures had been taken to treat this patient, including fluid resuscitation, electrolyte replacement, timely wound treatment with neutralizers, and respiratory tract care. Moreover, continuous renal replacement therapy was also employed to remove fluoride in the circulatory system and rectify the electrolyte disturbance and acid-base imbalance. The patient smoothly pulled though and survived. High fluoride levels in the dialysate solution were confirmed, indicating that continuous renal replacement therapy is an effective and potentially lifesaving treatment for acute HF poisoning.
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Affiliation(s)
| | - Xingang Wang
- 2 Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | | | | | | | | | - Liping Zhang
- 2 Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | | | - Bin Xu
- 3 Zhejiang Academy of Medical Sciences, Hangzhou, China
| | - Chunmao Han
- 2 Second Affiliated Hospital of Zhejiang University, Hangzhou, China
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26
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Abstract
Objective: To present the successful outcome of regenerating agent (RGTA) treatment in a patient with severe ocular surface chemical injury. Methods: Case report Results: A 14-year-old female patient was admitted to our clinic following chemical burn in the left eye. Her best corrected visual acuity (BCVA) was 20/40; and she had total corneal and 75% conjunctival epithelial loss, corneal haze, and limbal ischemia for nine clock hours in the left eye. The patient had already received standard therapy consisting of patching, preservative-free artificial tears, topical netilmicin, topical dexamethasone, oral doxycycline, and vitamin C for two weeks. We initially cleaned the conjunctival necrotic tissues, applied the silicon hydrogel bandage contact lens, exchanged the topical netilmicin with preservative-free moxifloxacin and supplemented this therapy with RGTA (Cacicol20, Paris, France) once in two days. The BCVA of the patient improved to 20/20 and the ocular surface re-epithelization was completed on day 20. Conclusion: RGTAs are effective biological agents for the treatment of corneal epithelial defects following severe ocular surface chemical injuries.
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Affiliation(s)
- Melih Ustaoglu
- Sisli Hamidiye Etfal Training and Research Hospital, Ophthalmology Clinic, Istanbul, Turkey
| | - Nilgun Solmaz
- Haseki Training and Research Hospital, Ophthalmology Clinic, Istanbul, Turkey
| | - Feyza Onder
- Haseki Training and Research Hospital, Ophthalmology Clinic, Istanbul, Turkey
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27
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Zamatto F, Argenziano S, Arsenijevic J, Ponthieu A, Bertotto M, Di Donna F, Harries AD, Zachariah R. Migrants caught between tides and politics in the Mediterranean: an imperative for search and rescue at sea? BMJ Glob Health 2017; 2:e000450. [PMID: 29225947 PMCID: PMC5717924 DOI: 10.1136/bmjgh-2017-000450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 08/23/2017] [Accepted: 08/24/2017] [Indexed: 11/04/2022] Open
Affiliation(s)
- Federica Zamatto
- Operations and Medical Department, Médecins Sans Frontières, Brussels Operational Centre, Rome, Italy
| | - Stefano Argenziano
- Operations and Medical Department, Médecins Sans Frontières, Brussels Operational Centre, Rome, Italy
| | - Jovana Arsenijevic
- Operational Research Unit (LuxOR), Médecins Sans Frontières, Brussels Operational Centre, Luxembourg City, Luxembourg
| | - Aurelie Ponthieu
- Analysis and Advocacy Unit, Médecins Sans Frontières, Brussels Operational Centre, Brussels, Belgium
| | - Marco Bertotto
- Operations and Medical Department, Médecins Sans Frontières, Brussels Operational Centre, Rome, Italy
| | - Francesco Di Donna
- Operations and Medical Department, Médecins Sans Frontières, Brussels Operational Centre, Rome, Italy
| | - Anthony D Harries
- Center for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France
- London School of Hygiene and Tropical Medicine, London, UK
| | - Rony Zachariah
- Operational Research Unit (LuxOR), Médecins Sans Frontières, Brussels Operational Centre, Luxembourg City, Luxembourg
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28
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Hosseini S, Rashtchi V, Kamali K, Moghimi M. Epidemiology and outcome of 2,590 burned patients in Northwest Iran. Ann Burns Fire Disasters 2017; 30:85-90. [PMID: 29021718 PMCID: PMC5627557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 06/25/2017] [Indexed: 06/07/2023]
Abstract
Burns are calamities with considerable morbidity and mortality rates. We attempted to examine the epidemiology of burns in Zanjan city, in northwest Iran, by a systematic study of existing information. The medical files of 2,590 thermal burn patients treated in our hospital in Zanjan city, Iran, from December 2010 to November 2016 were studied. Patient information, including age, sex, burn degree, season, cause of burn, hospital stay and treatment results were analyzed. About 65% of the patients were male (n=1691). Most burns (92.8%) were less than 30% total body surface area. Mean age and hospital stay were 25.4 years old and 9.1 days, respectively. The most common causes of burn were hot liquids, gas explosion and fire, respectively. Except for self-immolation, which was more common among men, there was no significant relationship between cause of burn and the studied variables. The six-year mortality rate was 2.9%, and was more common in the years 2011 to 2013. In addition, distribution of causes of burn had a significant trend (variation). Fire burn had a decreasing trend and gas and chemical burn had increasing trends in this period. In northwest Iran the causes of burn changed over the six years. Chemical burns, gas explosion burns and burn mortality increased. Some of these results were due to economic and pharmaceutical sanctions in Iran. Because of Iran's industrial development, it is recommended that preventive measures for chemical, gas and electrical burns be conducted.
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Affiliation(s)
- S.N. Hosseini
- Department of Surgery, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - V. Rashtchi
- Department of Anesthesiology, Faculty of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
| | - K. Kamali
- Department of Public Health, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - M.H. Moghimi
- Department of Surgery, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
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29
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Abstract
Over the past several years, a number of articles and online posts have circulated on the Internet associating use of disposable and cloth diapers with chemical burns on babies' skin. Because both mild chemical burns and diaper dermatitis (diaper rash) can cause skin redness and peeling, it is not surprising that some confusion has arisen regarding the association between these two conditions. However, diapers cannot cause chemical burns because they are made of inert materials. Diaper rash and chemical burns are distinct conditions that require different evaluation and treatment, which is why it is important for pediatricians to help parents understand the difference.
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Affiliation(s)
- Kara Shah
- 1 Kenwood Dermatology, Cincinnati, OH, USA
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30
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Abstract
Burns are a common cause of preventable morbidity and mortality in children. Thermal and chemical burns are the most common types of burns. Their clinical appearance can be similar and the treatment is largely similar. Thermal burns in children occur primarily after exposure to a hot surface or liquid, or contact with fire. Burns are typically classified based on the depth and total body surface area, and the severity and onset of the burn can also depend on the temperature and duration of contact. Chemical burns are caused by chemicals-most commonly acids and alkalis-that can damage the skin on contact. In children, the most common cause of chemical burns is from household products such as toilet bowl cleaners, drain cleaners, detergents, and bleaches. Mild chemical burns generally cause redness and pain and can look similar to other common rashes or skin infections, whereas severe chemical burns are more extreme and may cause redness, blistering, skin peeling, and swelling.
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Affiliation(s)
- Shan Yin
- 1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,2 University of Cincinnati, Cincinnati, OH, USA
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Shin HJ, Chang JS, Ahn S, Kim TO, Park CK, Lim JH, Oh IJ, Kim YI, Lim SC, Kim YC, Kwon YS. Acute respiratory distress syndrome and chemical burns after exposure to chlorine-containing bleach: a case report. J Thorac Dis 2017; 9:E17-E20. [PMID: 28203432 DOI: 10.21037/jtd.2017.01.45] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Chlorine-containing bleach can cause acute respiratory distress syndrome (ARDS) and chemical burns. However, simultaneous occurrence of the two conditions caused by this agent is very rare. We describe the case of a 74-year-old female who presented with shortness of breath and hemoptysis following accidental exposure to chlorine-containing bleach. She had second- to third-degree chemical burns on both buttocks and thighs, and received mechanical ventilation because of the development of ARDS. Mechanical ventilation was discontinued on day 6 of hospitalization because of the rapid improvement of hypoxemia, and the patient was transferred to another hospital for further management of the chemical burns on day 18.
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Affiliation(s)
- Hong-Joon Shin
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Jin-Sun Chang
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Seong Ahn
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Tae-Ok Kim
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Cheol-Kyu Park
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Jung-Hwan Lim
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - In-Jae Oh
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Yu-Il Kim
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Sung-Chul Lim
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Young-Chul Kim
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Yong-Soo Kwon
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
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Zhang Y, Wang X, Ni L, Ye C, Zhang J, Han C, Yu C. Early and Thorough Wound Debridement Is Crucial for Treatment of Patients With Thermal Burns and para-Chloronitrobenzene Poisoning. INT J LOW EXTR WOUND 2016; 15:255-9. [PMID: 27230896 DOI: 10.1177/1534734616650113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
para-Chloronitrobenzene (p-CNB) is one of the important chemicals with high liposolubility and oxidizing properties. Heated p-CNB liquid can cause thermal injury by absorption over skin and wound and even methemoglobinemia by conversion of hemoglobin into methemoglobin. Severe methemoglobinemia is a life-threatening condition that demands immediate treatment. It is very rare for individuals to be injured by heated p-CNB, but they should be carefully attended to because of the peculiarities of this kind of injury. In the past 10 years, we received 5 patients who were injured by heated p-CNB. In addition to the intravenous administration of methylene blue, prompt and thorough wound management played a crucial role in the treatment of these critically ill patients, indicating the potential value of sufficient information for the clinical practitioners. The purpose of this article is to report our experience in the management of patients with thermal burns and p-CNB poisoning.
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Affiliation(s)
| | - Xingang Wang
- Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | | | | | | | - Chunmao Han
- Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Chaoheng Yu
- Second Affiliated Hospital of Zhejiang University, Hangzhou, China
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Li ZN, Yuan ZF, Mu GY, Hu M, Cao LJ, Zhang YL, Liu L, Ge MX. Inhibitory effect of polysulfated heparin endostatin on alkali burn induced corneal neovascularization in rabbits. Int J Ophthalmol 2015; 8:234-8. [PMID: 25938033 DOI: 10.3980/j.issn.2222-3959.2015.02.04] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 09/06/2014] [Indexed: 12/11/2022] Open
Abstract
AIM To investigate anti-angiogenic effects of polysulfated heparin endostatin (PSH-ES) on alkali burn induced corneal neovascularization (NV) in rabbits. METHODS An alkali burn was made on rabbit corneas to induce corneal NV in the right eye of 24 rabbits. One day after burn creation, a 0.2 mL subconjunctival injection of 50 µg/mL PSH-ES, 50 µg/mL recombinant endostatin (ES), or normal saline was administered every other day for a total of 14d (7 injections). Histology and immunohistochemisty were used to examine corneas. Corneal NV growth was evaluated as microvessel quantity and corneal vascular endothelial growth factor (VEGF) expression was measured by immunohistochemical assay. RESULTS Subconjunctival injection of ES and PSH-ES resulted in significant corneal NV suppression, but PSH-ES had a more powerful anti-angiogenic effect than ES. Mean VEGF concentration in PSH-ES treated corneas was significantly lower than in ES treated and saline treated corneas. Histological examination showed that corneas treated with either PSH-ES or ES had significantly fewer microvessels than eyes treated with saline. Additionally corneas treated with PSH-ES had significantly fewer microvessels than corneas treated with ES. CONCLUSION Both PSH-ES and recombinant ES effectively inhibit corneal NV induced by alkali burn. However, PSH-ES is a more powerful anti-angiogenic agent than ES. This research has the potential to provide a new treatment option for preventing and treating corneal NV.
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Affiliation(s)
- Zhao-Na Li
- Department of Ophthalmology, The Second People's Hospital of Jinan, Jinan 250001, Shandong Province, China
| | - Zhong-Fang Yuan
- Department of Ophthalmology, Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, Shandong Province, China
| | - Guo-Ying Mu
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China
| | - Ming Hu
- Department of Ophthalmology, The Second People's Hospital of Jinan, Jinan 250001, Shandong Province, China
| | - Li-Jun Cao
- Department of Ophthalmology, The Second People's Hospital of Jinan, Jinan 250001, Shandong Province, China
| | - Ya-Li Zhang
- Department of Ophthalmology, The Second People's Hospital of Jinan, Jinan 250001, Shandong Province, China
| | - Lei Liu
- Department of Ophthalmology, The Second People's Hospital of Jinan, Jinan 250001, Shandong Province, China
| | - Ming-Xu Ge
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China
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Abstract
The ingestion of corrosive substances may produce severe burns to the upper aerodigestive tract and stomach, particularly if the pH is greater than 12 or less than two. There is a biphasic age grouping with adult cases most often involving self-harm and pediatric cases accidental ingestion. Three cases are reported to demonstrate characteristic features following the ingestion of potassium hydroxide, glacial acetic acid and Lysol(®) , respectively. All deaths were due to the effects of caustic burns to the upper aerodigestive tract, esophagus and stomach with perforation and/or hemorrhage. The extent of injuries in these cases depends on the nature, amount, and concentration of the agent and on the exposure time. A point to note at autopsy is that tissue damage may also occur from postmortem exposure. Typical injuries involve perioral, limb, and trunk burns, with extensive aerodigestive liquefactive/coagulative necrosis causing hemorrhage and perforation.
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Affiliation(s)
- Roger W Byard
- School of Medical Sciences, The University of Adelaide, and Forensic Science SA, Adelaide, SA, Australia
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35
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Alper N, Desai K, Rabinowitz S. Management of hydrofluoric Acid burns. Eplasty 2014; 14:ic42. [PMID: 25525489 PMCID: PMC4215592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Netanel Alper
- aDivision of Plastic Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ
| | - Kunj Desai
- aDivision of Plastic Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ,Correspondence:
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Abstract
Chemical burns represent potentially blinding ocular injuries and constitute a true ocular emergency requiring immediate assessment and initiation of treatment. The majority of victims are young and exposure occurs at home, work place and in association with criminal assaults. Alkali injuries occur more frequently than acid injuries. Chemical injuries of the eye produce extensive damage to the ocular surface epithelium, cornea, anterior segment and limbal stem cells resulting in permanent unilateral or bilateral visual impairment. Emergency management if appropriate may be single most important factor in determining visual outcome. This article reviews the emergency management and newer techniques to improve the prognosis of patients with chemical injuries.
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Affiliation(s)
- Parul Singh
- Department of Ophthalmology, V. C. S. G. Government Medical Sciences and Research Institute, Srinagar, Garhwal, Uttarakhand, India
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Svider PF, Johnson AP, Folbe AJ, Carron MA, Eloy JA, Zuliani G. Assault by battery: battery-related injury in the head and neck. Laryngoscope 2014; 124:2257-61. [PMID: 24659384 DOI: 10.1002/lary.24686] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 03/11/2014] [Accepted: 03/21/2014] [Indexed: 11/12/2022]
Abstract
OBJECTIVES/HYPOTHESIS To estimate nationwide incidence of emergency department (ED) visits for battery-related injury (BRI) occurring in the head and neck, and analyze demographic and anatomic-specific trends. METHODS The National Electronic Injury Surveillance System (NEISS) was searched for BRI in the head and neck, with analysis for incidence, anatomic site, age and gender, and specific diagnoses. RESULTS There were an estimated 18,803 head and neck BRI ED visits from 2003 to 2012. A total of 65.8% of patients were male. A total of 92.8% of patients were treated/examined and then released, and 4.7% of patients were admitted. A plurality (34.2%) of patients had BRI related to nose injures, and this represented the youngest cohort (median: 3 years old). The vast majority of ear and nose diagnoses were "foreign bodies"; two-thirds of mouth injuries were related to burns, whereas lacerations predominated in the face and head. Nearly half of ED visits involved patients between 2 and 5 years of age. A total of 45.2% of cases involving patients ≥ 65 years of age were related to hearing aid batteries as foreign bodies. CONCLUSION BRI in the head and neck results in a significant amount of ED visits. Mechanisms of injury vary by age and anatomic location, but a considerable male predilection exists. Whereas pediatric patients are primarily affected, particularly patients between 2 to 5 years of age, injuries do occur among adults. Importantly, the prevalence of dislodged hearing-aid batteries in the elderly necessitates comprehensive patient education to increase awareness and counseling regarding this complication. Awareness of demographic and anatomic-specific trends reported in this analysis may be an invaluable adjunct for history-taking and clinical examination.
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Affiliation(s)
- Peter F Svider
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan
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Ramakrishnan K, Mathivanan T, Jayaraman V, Babu M, Shankar J. Current scenario in chemical burns in a developing country: Chennai, India. Ann Burns Fire Disasters 2012; 25:8-12. [PMID: 23012609 PMCID: PMC3431731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Indexed: 06/01/2023]
Abstract
Chemical burns are not uncommon in India. Both accidental and non-accidental chemical burns are encountered in our setting. In the paediatric age group, chemical burns are mainly accidental. Analysis of chemical burn admissions to the Burn Units of a medical college hospital, and to an exclusively tertiary care children's hospital in Chennai, India, from 2001 to 2010 is described. A total number of 75 adults and 38 children are included in the study. Detailed analysis of age, sex, percentage of burn total body surface area (TBSA %), causative agents, aetiology (accidental or non-accidental), treatment instituted, mortality, and outcome are reported.
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Affiliation(s)
- K.M. Ramakrishnan
- Corresponding author: Prof. Dr K. Mathangi Ramkrishnan,
Department of Plastic Surgery & Burns, Kanchi Kamakoti CHILDS Trust Hospital12A, Nageswara RoadNungambakkam, Chennai 600034India.044 42001800 Ext 604044 28259633
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Touzopoulos P, Zarogoulidis P, Mitrakas A, Karanikas M, Milothridis P, Matthaios D, Kouroumichakis I, Proikaki S, Pavlioglou P, Katsikogiannis N, Constantinidis TC. Occupational chemical burns: a 2-year experience in the emergency department. J Multidiscip Healthc 2011; 4:349-52. [PMID: 22096339 PMCID: PMC3210074 DOI: 10.2147/jmdh.s25141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Indexed: 11/23/2022] Open
Abstract
Chemical burn injuries are a result of exposure to acid, alkali, or organic compounds. In this retrospective study, a total of 21 patients suffering occupational chemical burns, came to the emergency room at the University General Hospital of Alexandroupolis, from 2008 to 2010; 76.2% were workers, 19% were farmers, and 4.8% were desk officers. The majority of burns were due to exposure to acid (61.9%). Upper extremities were the most frequently injured area followed by the lower extremities and thorax. None of the patients needed further hospital care, but in the follow-up, four of the patients suffered keloid. Proper surgical treatment at the emergency room decreases the length of hospital stay for patients who suffer chemically induced burns.
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Affiliation(s)
- Panagiotis Touzopoulos
- 1st University Surgical Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis
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Mitra S. Combined autologous and allograft limbal cell transplantation with penetrating keratoplasty in a case of chemical corneal burn patient. Oman J Ophthalmol 2011; 2:126-9. [PMID: 20927209 PMCID: PMC2903917 DOI: 10.4103/0974-620x.57312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A patient with chemical corneal burn presented two months after the acute episode of chemical injury to his right eye (OD) and was diagnosed with severe limbal stem cell deficiency and with vascularized corneal opacity OD. Limbal cell transplantation and penetrating keratoplasty (PKP) was performed. The autologous and allograft limbal tissue included peripheral cornea, limbus and conjunctiva obtained from contralateral eye and cadaveric eye bank cornea. Central corneal button was used for a PKP with 32 intermittent sutures. One year after the procedure, the corneal surface remains clear with a best corrected visual acuity of 6/12 (-2.00 DS / -2.75 DC-/ 150°. Eighteen sutures are still in place; no vascularization has extended beyond the host graft junction. Ocular surface is wetting well with no filamentary keratitis. Combined autologous and allograft limbal cell transplant can be performed for severe deficiency of corneal stem cells in a patient with chemical corneal burn.
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Affiliation(s)
- Sandip Mitra
- Department of Ophthalmology, Al-Zahra Private Hospital, Sharjah, UAE
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Abstract
A case of chemical burns due to cetrimide applied to the nappy area of an infant is recorded.
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