[Caustic esophagitis and gastritis due to hydrogen peroxide].
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Accidents, Home↗
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[Caustic proctitis after lavage: an African cause of rectal hemorrhage].
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Abdominal Pain↗
[Epidermoid carcinoma of the esophagus in caustic esophageal stenosis].
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Burns, Chemical↗
[Caustic ulcerations caused by cement].
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Adult↗
[Caustic dermatitis following application of Pevaryl spray].
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Administration, Topical↗
[Ocular trauma and caustic burns by air bags].
We report two cases of ocular injuries caused by airbag inflation. These cases illustrate two main types of airbag-induced eye injuries: chemical and traumatic. In the first case, chemical keratitis was caused by the aerosol spray of alkaline particles produced by the airbag deployment system. In the second case, the high-speed deployment system caused mechanical injury to the anterior and posterior segments demonstrating the effect of the sudden deceleration when the individual hits the airbag. These two cases as well as others reported in the literature suggest that ocular injury should always be suspected because of the inherent traumatic effect of the airbag protection system.
Acceleration↗
[Caustic burns of the esophagus in childhood].
Acute burns of the upper gastrointestinal tract require an immediate diagnostic and therapeutic approach. Early endoscopy has been shown to assist greatly in determining the further treatment of corrosive injury. The main task of radiology is to detect perforations. Early corticosteroid treatment seems to be effective in preventing stricture development in second degree burns.
Adrenal Cortex Hormones↗
Evaluation, modelling and optimization of the cleaning process of contaminated plastic food refillables.
In this study several types of bottle materials (glass, PET (polyethylene terephthalate), PC (polycarbonate), HDPE (high density polyethylene), PP (polypropylene) and PVC (polyvinyl chloride)) were evaluated in order to be used as food refillables, comparing the residual chemical contamination after classical caustic washing. Bottles were contaminated with model chemicals (chloroxylenol and d-limonene) and caustic washed with varied process parameters using a simulated laboratory-scale washing procedure. After washing, the chemical-contaminated bottles were filled with water and stored for 28 days at 37 degrees C. The concentrations of the model chemicals in the water after storage were taken as a measure of chemical contamination. The influence of the cleaning parameters (temperature, caustic and commercial additive concentration) was studied using response surface methodology. Washing temperature showed a significant influence on the removal of absorbed chemicals from surfaces compared with the effect of the caustic and especially the additive concentration. Optimization of caustic cleaning for the cleaning process in question led to better cleaning effectiveness, although none of the different washing conditions were able to remove all absorbed chemicals out of the polymeric resins. Commercially available plastic refillables (PET and PC) showed the best chemical rinsability. Glass bottles, however, had in every case the best rinsing characteristics.
Conservation of Natural Resources↗
Recycling of sludge with the Aqua Reci process.
Supercritical Water Oxidation (SCWO) is an innovative and effective destruction method for organics in sewage sludge. The SCWO process leaves a slurry of inorganic ash in a pure water phase free from organic contaminants, which opens possibilities for a simple process to recover components like phosphates and/or coagulants from the sewage sludge, a process marketed as the Aqua Reci. In a continuous pilot plant for the SCWO process digested sludge has been treated. The ash has been extracted in lab- and pilot scale with both caustic and acids in order to recover phosphates and coagulants. The particle size of the inorganic contaminants in the water after the SCWO process is between 1-10 microm, which means that it is very reactive. The phosphate, and partly the aluminium, can be extracted with caustic as iron and heavy metals are completely insoluble in caustic. This is a method to separate the phosphates from the rest of the contaminants. However, high calcium content will bind the phosphate as calcium phosphate insoluble in caustic. In most cases the calcium content is too high and the best solution is to dissolve phosphates and all metals with sulphuric acid. From this solution first iron phosphate can be separated and thereafter in a second step aluminium and finally heavy metals in a third step. Iron can be separated from the phosphate, either by leaching the phosphate with caustic off to sodium phosphate leaving a precipitate consisting of iron hydroxide, or the iron phosphate can be dissolved in hydrochloric acid followed by a liquid extraction process where ferric chloride can be separated leaving a phosphoric acid. By the acid dissolving process it is possible to recover phosphate, iron, aluminium, and heavy metals from the inorganic since the Aqua Reci process only leaves a silica residue representing about 10% of the DS content in the original sludge.
Aluminum↗
A novel approach for preventing esophageal stricture formation: sphingosylphosphorylcholine-enhanced tissue remodeling.
Using a new class of intracellular 2nd messengers to prevent stricture formation after caustic ingestion, sphingosylphosphorylcholine (SPC) has a wide spectrum of activity in cell growth regulation and signal transduction. Caustic esophageal burns were created with 15% NaOH in an experimental rat model. Control group animals (n = 10) had esophageal burns with no treatment, whereas the SPC group (n = 10) had esophageal burns gavaged with SPC for 7 days. Efficacy of treatment was assessed in 28 days by contrast esophagograms, histopathologic evaluation, and biochemically by tissue hydroxyproline (OHP) content. Contrast esophagograms demonstrated that SPC significantly prevented stricture formation. Obvious collagen deposition was present in submucosa, muscularis mucosa, and muscular layers in the control group compared with the SPC group. The damage to the esophageal wall on histopathologic examination was significantly lower in the SPC group (p < 0.05). Tissue OHP contents were significantly lower in the SPC-treated group (3.0 +/- 0.1 microg/mg) compared with the control group (4.3 +/- 0.2 microg/mg) (p < 0.05). We conclude that SPC improves healing following caustic esophageal burns. Furthermore, SPC is effective in preventing caustic esophageal strictures. These effects of SPC occur through its proliferative and specifically its remodeling effects on wound healing.
Animals↗
Role of caffeic acid phenethyl ester, an active component of propolis, against NAOH-induced esophageal burns in rats.
OBJECTIVES: This study was evaluated to investigate the efficacy of caffeic acid phenethyl ester (CAPE), which is a natural honeybee product exhibits a spectrum of biological activities including anti-microbial, anti-inflammatory, antioxidant and anti-tumoral actions, on the prevention of stricture development after esophageal caustic injuries in the rat. METHODS: Thirty healthy male Wistar albino rats were utilized in this study. The rats were randomly allotted into one of three experimental groups: group A (sham) animals were uninjured. Caustic esophageal burn was created by applying 1 ml 37.5% NaOH to the distal esophagus. Group B rats were injured but untreated. Group C rats were injured and received CAPE (10 micromol/kg/day i.p. for 28 days). Efficacy of the treatment was assessed by measuring the esophageal transit time, stenosis index, histopathologic damage score and biochemically by determining tissue hydroxyproline content, lipid peroxidation and antioxidant enzyme activities. RESULTS: The esophageal transit time, the stenosis index, histopathologic damage score and the hydroxyproline level were significantly increased in the untreated group compared with the sham and CAPE-treated groups. Treatment with CAPE decreased tissue hydroxyproline levels, histological damage, and the stenosis index, but except the esophageal transit time. Caustic esophageal burn also increased the lipid peroxidation and decreased the antioxidant enzyme activities in the untreated group. CAPE treatments decreased the elevated lipid peroxidation and also increased the reduced antioxidant enzyme activities. In corrosive esophageal burn group with no treatment, the most consistent findings were degenerative changes and increased in submucosal collagen content, and the luminal narrowing. CAPE treatment protected esophagus. Nevertheless, there was the slight increase in submucosal collagen. CONCLUSIONS: It is concluded that CAPE has a preventive effect on the stricture development after esophageal caustic injuries in the rat.
Animals↗
[Acute states in poisoning with corrosive substances].
Caustics are products which produces necrosis on contact place with chemical affinity to organic substance. Destroying intensity depend of types, concentration and quantity of product ingested. Poisons could be accidental and suicidal. Concentrated caustics rapidly produces necrosis, strong pain and severe general reaction on acute trauma, shock. Except the fact that acute burns with caustics products require an immediate diagnostic and therapeutic approach, this problem remains controversial. A retrospective analysis of 97 cases in last five years, including the war, in our ENT clinic done. Sex, age types and frequency of product ingested. Accidental, suicidal and the most often month it is happened analyzed. The acute diagnostic procedure in caustics ingestion are primarily directed toward the recognition of life-threatening complication such as shock, airway obstruction, perforation of inner organs and in severe acid ingestion, metabolic acidosis. esophagoscopy and endoscopy is accurate in predicting degree of esophageal injury. The aim of therapeutic procedures is to preserve homeostatic balance, to prevent shock and complication of acute hemorrhage or perforations as well as in the development of scar tissue and nepotistic strictures over time. The aim is to preserve the patients own esophagus. During long time experience treatment with diet, cortisone, antibiotics was successful in the prevention in the development of scar tissue and neoplastic strictures over time from esophageal II and III grade lesions.
Acute Disease↗
Absence of esophageal injury in pediatric patients after hair relaxer ingestion.
OBJECTIVE: To review the initial signs, symptoms, and endoscopic findings in children admitted to the hospital for ingestion of caustic hair relaxer. DESIGN: Retrospective medical chart review of all children admitted to the hospital with a diagnosis of caustic ingestion from January 1, 1992, to June 30, 1997. Demographics, admission signs and symptoms, and operative findings were recorded from the medical records. SETTING: An urban tertiary care children's hospital. PATIENTS: Fifty-nine children (<3 years old) admitted to the hospital for ingestion of hair relaxers. RESULTS: Two hundred nine patients were evaluated for possible caustic ingestion. Only 163 medical charts were available for review. Of these, 59 (36.2%) ingested hair relaxers. Initial signs and symptoms ranged from none to drooling and vomiting and second-degree oral cavity bums. Fifty-six patients (95%) underwent endoscopy, which revealed normal esophageal mucosa in 53 of them, mild erythema of the distal esophagus in 2, and mild esophagitis in 1. CONCLUSIONS: In our experience, hair relaxer ingestion makes up a significant proportion of all children admitted to the hospital for caustic ingestion. No significant esophageal injury was associated with hair relaxer ingestion, suggesting that endoscopy may not be necessary in these patients. Alternative management is suggested. We believe that patients who ingest hair relaxer should be admitted to the hospital for observation if parents are thought to be unreliable, and should undergo endoscopy if they cannot tolerate oral intake. Asymptomatic patients may be cared for as outpatients if they demonstrate adequate oral intake.
Administration, Oral↗
Intestinal bypass of the esophagus.
Esophageal replacement by a segment of isoperistaltic ileum with cecum or by transverse or left colon will allow near-normal swallowing for many years. The authors reviewed the course of 59 children who had bypass of their entire esophagus and of four whose distal esophagus was resected and replaced. The follow-up period ranges from 1 to 37 years; in 36 cases, it exceeds 5 years. Thirty children had caustic strictures and 25 had either isolated esophageal atresia or atresia with fistula. Two children with esophageal injury caused by foreign body ingestion and two with congenital strictures also required complete bypass. Four patients required resection and replacement of the distal esophagus only; two had acquired strictures from gastroesophageal reflux, one had varices, and one had a teratoma involving the esophagus. A retrosternal isoperistaltic ileocolic segment is our preference for complete esophageal replacement. Forty-eight patients underwent esophageal reconstruction with this procedure. The esophagus damaged by caustic ingestion was left in place in all patients, without any subsequent problem. The authors have not used the distal esophagus for anastomosis in patients with atresia, because this segment may be abnormal; and, in any case, an isoperistaltic cologastric anastomosis does not reflux. The right or left colon or jejunum was used in the other cases. Three children lost an interposed intestinal segment from necrosis even though the bowel appeared to be well vascularized at the end of the operation. Each patient had successful reconstruction using another type of interposition. An intrathoracic leak occurred in one infant. A cervical anastomotic leak developed in 11 children, and a stricture in 13. Strictures were more common in patients who had caustic burns. Three patients required surgery for adhesive intestinal obstruction. A redundant colon transplant with ulceration, and the herniation of an ileal segment into the pleural cavity with obstruction prompted reoperation in two other patients. There were two deaths early in the series, one of which was secondary to postoperative respiratory arrest. The other death occurred in a child who had a caustic pharyngeal burn and chronic aspiration. All patients were seen in our office recently, or they or their parents were interviewed by phone. All of them are taking all of their nutrition by mouth. Forty-three of the 61 survivors have had no difficulty with swallowing. One required reoperation to enlarge the thoracic inlet. Seventeen other have mild dysphagia that does not require treatment. The patients with esophageal atresia or atresia and fistula consistently have not grown as well as those who required replacement for an acquired condition or injury.
Burns, Chemical↗
Colored diffraction catastrophes.
On fine scales, caustics produced with white light show vividly colored diffraction fringes. For caustics described by the elementary catastrophes of singularity theory, the colors are characteristic of the type of singularity. We study the diffraction colors of the fold and cusp catastrophes. The colors can be simulated computationally as the superposition of monochromatic patterns for different wavelengths. Far from the caustic, where the luminosity contrast is negligible, the fringe colors persist; an asymptotic theory explains why. Experiments with caustics produced by refraction through irregular bathroom-window glass show good agreement with theory. Colored fringes near the cusp reveal fine lines that are not present in any of the monochromatic components; these lines are explained in terms of partial decoherence between rays with widely differing path differences.
Journal Article↗
Inhibition of the acetoclastic methanogenic activity by phenol and alkyl phenols.
Chemical and petrochemical industries are important sources of aromatic pollutants. Petrochemical processes like caustic washing of middle distillates produce the spent caustic liquors highly concentrated in phenol and alkyl phenols. The anaerobic technology is considered a feasible strategy for petrochemical wastewater pre-treatment although high concentrations of phenol could limit its efficiency. The goal of this work was to determine the toxicity of both selected alkyl phenols and a synthetic "spent-caustic phenols mixture" on the acetoclastic Specific Methanogenic Activity (SMA) of unadapted and phenol-adapted granular sludge. Alkyl phenols were responsible for 50% (IC50) and 100% (IC100) inhibition of the SMA at concentrations ranging from 1.6 to 5.0 mM and from 4.1 to 27.5 mM, respectively, for un-adapted granular sludge. In the case of phenol-adapted granular sludge, the inhibitory concentrations ranged from 1.7 to 14.9 mM and from 4.0 to 83.0 for IC50 and IC100, respectively, highlighting the impact of sludge acclimation. The inhibition produced by 2-ethylphenol was more acute compared to phenol and was not reduced by the phenol acclimation process. The IC50 and IC100 values obtained for the synthetic "spent-caustic phenols mixture" were 9.5 mM and 88.4 mM, respectively. The inhibitory concentrations of phenol compounds were closely correlated with compound apolarity (log P), indicating that the lipophilic character of the tested compounds was responsible for their methanogenic toxicity. An inhibition model is confirmed to estimate the IC50 and IC100.
Bacteria, Anaerobic↗
[Conservative treatment of benign esophageal strictures using dilation. Analysis of 500 cases].
UNLABELLED: The benign esophageal stenoses (BES) are common complications owing to many etiologies: gastroesophageal reflux, ingestion of corrosive agents, esophageal surgery, radiotherapy, postendoscopic variceal sclerotherapy, drug ingestion, prolonged nasogastric intubation, extrinsic compression and esophageal webs. Esophageal dilatations are worldwide recommended to treat this complication, employing dilators of many types and diameters and facilitating the food ingestion. PURPOSE: Evaluation of the results and advantages of the conservative treatment of the BES using esophageal dilatations, in outpatient service of upper digestive endoscopy. METHODS: During the period from 1981 to 1999, 500 patients with BES were treated and followed up at the Gastrocenter - UNICAMP, in an individually Program of Esophageal Dilatation for each case. The highest number of cases was under ages from 31 to 60 years old (52,8%), and males (59,2%). The most predominant etiologies were: peptic stenosis (30,4%), caustic ingestion (23,6%), anastomosis (23,2%), megaesophagus (8,0%) and prolonged nasogastric ingestion entubation (6,4%), totalizing 91,6% of the BES. Most of patients (94,2%) were submitted to the maximum of 25 dilations. Dilators from 10,5 to 16 mm were employed in 95,6% of the cases. The duration of the treatment was 24 months in 76,2% of the BES. Esophageal perforations occurred in 6 patients (1,2%), without mortality. RESULTS: Were considered excellent, good and bad results, respectively in 76,2%, 18,2% and 5,6% of the cases. On the other hand, excellent results were recorded in 81,0% of the peptic stenosis, 66,1% of the caustic stenosis and 82,7% of the anastomotic stenosis. The conservative treatment failed in 9,3% of the caustic stenosis, 4,3% of the anastomotic stenosis and 3,9% of the peptic stenosis. Thus, the caustic stenosis were unsuccessfull in the highest percentage of unsuccessful. CONCLUSION: The conservative treatment using guidewire dilators (Savary-Gilliard and Eder-Puestow) is the first choice in the BES, is effective for long time, with short complications and the surgical treatment is indicated only when the dilatations failed.
Adolescent↗
[Surgery for disease of the esophagus. 8. Corrosive esophagitis].
After the ingestion of caustic substances, not only the esophagus but also the gastrointestinal tract is injured. Severe caustic upper gastrointestinal tract injuries are associated with high mortality and morbidity rates when mediastinitis, chemical peritonitis, or perforation of the gastrointestinal tract occurs. Perforation may occur in the late phase, especially with the ingestion of alkaline solution, because the inflammation invades more deeply with the continuous release of OH-after coming into contact with protein. Therefore care must be taken in the estimation of the extent of inflammation after the ingestion of caustic alkaline solution. There are on established indications for surgery in acute-phase corrosive esophagitis. At present, we determine the indications for surgery based on blood gas examination, endoscopy, and computed tomography (CT). Blood gas examination is used to diagnose the systemic status. Endoscopy reveals corrosive changes with mucosal injury, while CT reveals the presence of mediastinitis, chemical peritonitis, and gastrointestinal tract perforation in the acute phase. Patients in the acute phase first undergo limited resection of the injured organs without reconstruction, with secondary esophageal reconstruction performed subsequently. This paper reports on our successful experience in the early surgical treatment of patients who had severe tissue injury after the ingestion of caustic substances. Patient prognosis was good using our surgical technique.
Adolescent↗