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PubMedDate not supplied

Acute and chronic viral hepatitis.

Hepatitis A, B, C, D, E, and G are important causes of viral hepatitis. It is estimated that there are at least 32,000 new cases of hepatitis A, 300,000 new cases of hepatitis B, and 150,000 new cases of hepatitis C each year in the United States alone. Risk factors for hepatitis infection include sexual activity with multiple partners, intravenous drug use or sharing cocaine straws, tattooing or body piercing, exposure to blood and body fluids through health-care work, and having a blood transfusion or transplant. Diagnostic markers are important to determine the type of hepatitis and to differentiate acute from chronic infection. Up to 5% of adult patients infected with hepatitis B virus and up to 80% of those infected with hepatitis C virus become chronic carriers. Whereas acute hepatitis C virus infection is usually mild, chronic hepatitis C infection develops insidiously after an average of 10 years and may lead to cirrhosis and possibly hepatocellular carcinoma. Currently, interferon-alpha is the only FDA-approved agent to treat chronic hepatitis B and C and relapses are common with hepatitis C infection. There are many clinical trials using other antivirals and combination therapies to treat these chronic infections. Prevention through patient education of high-risk behaviors and immunization remain the best defense against acute and chronic viral hepatitis.

Acute Disease↗
PubMed2006

The SLAPPA (significance of lower abdominal/periumbilical piercing as a predictor of acute appendicitis) audit.

BACKGROUND: Anecdotal observations among medical staff suggest that young women with periumbilical piercing presenting with right iliac fossa pain are more likely to have pelvic inflammatory disease than acute appendicitis because of an unconventional lifestyle. This audit was performed to test the validity of this prejudice. METHODS: The clinical data of all female patients aged 16-45 years admitted to a teaching hospital with suspected acute appendicitis were collected prospectively over six months. Patients who had undergone previous appendicectomy or gynaecological surgery, those with known Crohn's disease, or those on antibiotics at the time of admission were excluded. RESULTS: 107 patients with a median age of 29.7 years (range 15-45 years) were studied. Thirty-two patients had periumbilical piercing (Group A) and 75 patients did not (Group B). Fifty-nine out of 107 (55.14%) were operated upon. Ten (31.2%) patients in Group A had histologically confirmed acute appendicitis compared with 25 (33.3%) in Group B. Other diagnoses in Group A included non-specific abdominal pain (n = 13, 40.6%), urinary tract infection (4, 12.5%), pelvic inflammatory disease (4, 12.5%) and ovarian cyst (1, 3.1%). Corresponding figures for patients in Group B were 30 (40.0%), 8 (10.7%), 7 (9.3%) and 4 (5.3%) respectively. None of the differences between the two groups were statistically significant. CONCLUSIONS: There was no difference in the frequency of a final diagnosis of acute appendicitis or pelvic inflammatory disease in female patients with and without periumbilical piercing. Health care professionals should not allow their clinical judgment to be prejudiced by the presence of body piercing.

Abdominal Pain↗
PubMed2007

Tongue piercing: case report of a local complication.

Historically, wearing adornments on pierced body parts has been associated with many cultures as manifestations of religious or cultural identities. Currently, its use has a broad acceptance among young people. The most common sites for piercings are the tongue and lower lip in the oral cavity. Several complications may be associated with this practice with the most frequently observed being halitosis, periodontitis, tooth fracture, glossitis, and the formation of abscesses. This paper is a case report of a patient who had a complication from a piercing on the tongue located under the overlying mucosa. It also suggests a local habit was a possible initiator of this complication.

Adolescent↗
PubMedDate not supplied

A missing tongue stud: an unusual appendicular foreign body.

Appendicitis caused by foreign bodies after body piercing is rare. Previous reports have described a variety of foreign bodies that were either found incidentally in the appendix or were felt to be responsible for appendicitis. We report a case where a patient known to have previously ingested a "tongue stud" after a tongue piercing presented with chronic right iliac fossa pain. The missing "tongue stud" had impacted in the appendix and was successfully removed by laparoscopic appendicectomy with resolution of patient's symptoms. We review the literature covering the clinical management of patients presenting with foreign bodies in the appendix.

Adolescent↗
PubMed2004

The mystery of the split earlobe.

The ancient art of body piercing has rejuvenated in the recent years as part of the fashion process. The ear is the most frequent body part to be pierced to wear jewelry. Split earlobes are commonly presented to plastic surgeons and the recurrence rate is high. The etiology of the acquired split earlobe was thought to be attributable to either trauma or heavy earrings. In this study, the authors explored the cause of the split earlobe and recurrence after surgical repair. Twenty-five patients who were using gold earrings presented with split earlobe and were studied, and the etiology of the condition was analyzed. A questionnaire was completed and the tissue obtained during surgical repair of the split earlobes was submitted for histopathological studies. This group of patients was compared with 17 subjects having stretched earlobe who were using heavy gold earrings. The control group consists of 50 subjects using gold earrings with normal earlobes. Clinical presentation and the histological studies suggest that allergy to metals used in the earring could lead to split earlobe. There is a difference between the split earlobe and stretched earlobe; the latter results from constant pull by heavy earrings. The authors present a new theory regarding the etiology of split earlobe and recommend that avoiding the offending metal in the earring is indispensable to prevent recurrence.

Adolescent↗
PubMed2005

Code of practice for food handler activities.

BACKGROUND: The food industry regulates various aspects of food handler activities, according to legislation and customer expectations. The purpose of this paper is to provide a code of practice which delineates a set of working standards for food handler hygiene, handwashing, use of protective equipment, wearing of jewellery and body piercing. METHODS: The code was developed by a working group of occupational physicians with expertise in both food manufacturing and retail, using a risk assessment approach. Views were also obtained from other occupational physicians working within the food industry and the relevant regulatory bodies. The final version of the code (available in full as Supplementary data in Occupational Medicine Online) therefore represents a broad consensus of opinion. CONCLUSION: The code of practice represents a set of minimum standards for food handler suitability and activities, based on a practical assessment of risk, for application in food businesses. It aims to provide useful working advice to food businesses of all sizes.

Body Piercing↗
PubMed2005

The case of the missing "Prince Albert".

BACKGROUND: Body piercing is increasing and so are its complications. We describe a case in which the female partner of an individual who had penile piercing was affected. CASE: A young female presented to the emergency department with the possibility of a lost/missing foreign body in the vagina. Her partner had had a "Prince Albert" type of penile piercing, which was found to be missing after sexual intercourse. Prince Albert penile piercing is a metallic bead, which is anchored to the urethral opening. On clinical examination, the bead was not found in the vagina but was seen on pelvic X-ray. A thorough sexual history resolved the mystery of the missing Prince Albert. CONCLUSION: Our case suggests that the gynecologist should be aware of the practice of genital piercing and stresses the importance of proper sexual history taking.

Adult↗
PubMed2006

Granulomatous reaction to titanium alloy: an unusual reaction to ear piercing.

A 68-year-old man presented with 4 firm, flesh-colored, and slightly erythematous nodules located on the superior pole and lobule of each ear. Although reluctant to provide details, it was discovered he had pierced his ears approximately 10 years earlier, and the nodules developed at the sites of the piercings. Keloids were suggested clinically and the lesions were excised. Microscopic examination demonstrated epithelialized tracts surrounded by a granulomatous infiltrate of macrophages, lymphocytes, and plasma cells. Closer examination revealed minute brown-black particles within macrophages. Dark-field microscopy confirmed the metallic nature of the particles. Environmental scanning electron microscopy with energy dispersive spectroscopy revealed the particles to be composed of titanium, aluminum, and vanadium. It would appear that in rare circumstances titanium alloy used in body piercing may engender a granulomatous dermatitis. The rarity of such a response to titanium alloy is discussed and the literature appraised.

Aged↗
PubMed2000

An unusual cause of gingival recession: oral piercing.

Wearing so-called jewelry in uncommon sites, termed as body piercing, is gaining increased popularity. There also seems to be a significant increase in oral piercing mainly in the lip and/or tongue. We report a case of multiple oral piercing sites and localized gingival recession as an adverse consequence. Furthermore, based on the medical characteristics of the case, we also emphasize the necessity and importance of professional dental/medical consultation before oral piercing.

Adult↗
PubMed2004

Mammalian sensitivity to elemental gold (Au degrees).

There is increasing documentation of allergic contact dermatitis and other effects from gold jewelry, gold dental restorations, and gold implants. These effects were especially pronounced among females wearing body-piercing gold objects. One estimate of the prevalence of gold allergy worldwide is 13%, as judged by patch tests with monovalent organogold salts. Eczema of the head and neck was the most common response of individuals hypersensitive to gold, and sensitivity can last for at least several years. Ingestion of beverages containing flake gold can result in allergic-type reactions similar to those seen in gold-allergic individuals exposed to gold through dermal contact and other routes. Studies with small laboratory mammals and injected doses of colloidal gold showed increased body temperatures, accumulations in reticular cells, and dose enhancement in tumor therapy; gold implants were associated with tissue injuries. It is proposed that Au degrees toxicity to mammals is associated, in part, with formation of the more reactive Au+ and Au3+ species.

Animals↗
PubMed2005

Adolescents' knowledge, beliefs, and behaviors regarding hepatitis B: Insights and implications for programs targeting vaccine-preventable diseases.

PURPOSE: To gain a better understanding of adolescents' knowledge, beliefs, and behaviors regarding hepatitis B. METHOD: Three types of data were collected as part of this investigation: (a) 45 in-depth individual interviews with staff from 20 adolescent health, sexually transmitted disease (STD), and family planning clinics; (b) 96 individual interviews with adolescents and young adults; and (c) questionnaires completed by 17,063 adolescents and young adults. All instruments focused on one or more of the following five topics: (a) knowledge about vaccines; (b) knowledge about hepatitis B; (c) barriers to vaccine acceptance, and ways to overcome these barriers; (d) benefits of the vaccine acceptance, and ways to enhance these benefits; and (e) eight hepatitis B risk factors. Interview data was analyzed using qualitative thematic note-based analyses. Survey data was analyzed using descriptive statistics and Chi-square tests. RESULTS: Adolescents and young adults seen in these clinics know very little about vaccinations in general, or hepatitis B, in particular. Adolescents exhibit low levels of perceived susceptibility, severity, response efficacy, and self-efficacy toward hepatitis B and the hepatitis B vaccine. On average, these adolescents engage in 2.36 high-risk behaviors (the most frequent of which include sexual activity, body piercing, and tattooing). Those who were sexually active, had a tattoo, had a STD, or worked with blood were significantly more likely to begin the vaccination series. CONCLUSIONS: There is a clear need for additional educational efforts regarding both vaccinations in general, and hepatitis B in particular. Though adolescents are engaging in a variety of high-risk behaviors, most perceive their risk to be low, and therefore many are not taking the necessary precautions to protect themselves.

Adolescent↗
PubMed2005

Assessment of the alveolar bone surrounding the mandibular anterior teeth of individuals wearing a tongue stud.

PURPOSE: One of the latest trends in ornamental body piercing focuses on the oral cavity, with the most common piercing site being the tongue. Oral health care professionals are anecdotally reporting the incidence of radiographically detectable alveolar bone abnormalities surrounding the mandibular anterior teeth in patients who wear tongue studs. This research study was conducted to assess the frequency and extent of bone abnormalities in the supporting alveolar bone adjacent to the mandibular anterior teeth in individuals wearing tongue studs. METHODS: With the use of convenience sampling, periapical radiographs were taken of the mandibular anterior teeth of individuals wearing tongue studs and compared to the radiographs of individuals who had never worn tongue studs (N = 46). Additionally, a self-report questionnaire was used to gather demographic data on participants and specific information related to their piercings. A periodontist conducted blind evaluations of the radiographs. RESULTS: With an alpha level of .05, a one-tailed t test indicated a significant difference between the two groups, t44 = 1.902, P = .032. However, the correlation coefficient comparing length of time to presence of alveolar bone abnormalities was 0.216, indicating a weak relationship between the amount of time that the tongue stud had been worn and the development of abnormalities in the alveolar bone. CONCLUSION: These findings indicate that individuals wearing a tongue stud for any length of time are at risk for developing abnormalities in the alveolar bone surrounding the mandibular anterior teeth.

Adolescent↗
PubMedDate not supplied

Adolescent trends in the late 20th century: fad or societal alienation?

Since teens are engaging in a variety of body modifications at increasingly early ages, health care providers should be aware of the extent and the possible harm of these activities. This article reviews the historical context, medical uses, and risks of tattooing and other forms of body modification. There is little historical precedent for the extent of body piercing as carried out by the youth today. Body building is also practiced in excess. There is little legislative control of body modification other than for tattooing. The need for even young adolescents to improve their appearance and self-esteem with such extreme and even risky measures is evidence of a regressive trend in our culture.

Adolescent↗
PubMed2000

[Complications following piercing in the oral and facial region].

The increasing distribution and social acceptance of body piercing induced us to investigate the nature and rate of complications brought about by this fashionable injury of the unscathed body. All dentists, maxillofacial surgeons and clinics within the region of the association of dentists of Bremen were asked to register all patients presenting between June and October 1998 in whom piercings of the head and neck area were visible. Response was good; 699 piercings in 273 persons were recorded and some exemplary photographs made. Some 47 persons showed local complications which ranged from keloid formation and temporary infections to cartilage necrosis and disturbances in sensibility. General diseases were described as well, mainly allergies and hepatitis. In accordance with the seriousness of the complication the medical treatment required varied. Nine persons had to be treated in hospital. In 14 cases patients suffered permanent damage. Piercings cause severe complications and considerable expense to the public health service.

Adolescent↗
PubMed1999

Ear-piercing techniques as a cause of auricular chondritis.

OBJECTIVE: To investigate the different methods of ear and body piercing as possible sources of infection, and to provide a brief literature review of infections resulting from high ear piercing as well as bacterial coverage of common disinfectants used as preparation agents. METHODS: Two cases of auricular chondritis caused by Pseudomonas are presented. A survey of 14 businesses that pierce ears was conducted using a scheduled interview. Information regarding the type of piercing instrument, composition of earring, training of employees, anatomic placement of earrings, and preparation and aftercare of ears was obtained. RESULTS: One hundred percent of the interviews attempted were completed. The cosmetic shops and earring kiosks both used hand-powered earring "guns" to pierce ears, while the tattoo parlors used sterile needles and forceps. All of the businesses interviewed used earrings composed of either 14K or 24K gold, stainless steel, and other piercing-grade metals. None of the businesses used earrings made of nickel. The cosmetic shops and kiosks used a combination of videos, demonstrations, and direct supervision to train employees but did not have a specified training period. The tattoo parlors required their employees to complete an apprenticeship training program of varying time lengths. All of the businesses pierced the lobe and cartilaginous portions of the ear. The cosmetic shops and kiosks used benzalkonium chloride or isopropyl alcohol as ear preparation agents, while the tattoo parlors used only iodine-based solutions. At all of the businesses, minimal aftercare instructions were given and they typically dealt with maintaining ear-hole patency. CONCLUSION: The cosmetic shops and earring kiosks used piercing methods that predisposed to auricular chondritis, such as poor training of employees and use of benzalkonium chloride as a preparation agent. Emergency physicians need to be aware of the severity of these types of infections, which often require surgical management and intravenous antibiotics covering Pseudomonas.

Abscess↗
PubMed2001

College students with tattoos and piercings: motives, family experiences, personality factors, and perception by others.

The motives, family experiences, and personality characteristics of 341 college students with and without tattoos or piercings were studied. Participants completed Lippa's 1991 measures of the Big Five personality factors, a shortened version of the Body Cathexis Scale, a series of questions about their childhood experiences, and questions about risk-taking behaviors. In addition, reasons to have or not have body modifications and the perceptions of people with body modifications were investigated. Of the 116 men and 186 women, 25% and 33%, respectively, had at least one tattoo or body piercing. There were very few differences in the childhood experiences or personality characteristics of people with or without body modifications. Although people with body modifications did not differ from people without modifications on the Big Five personality measures, people without modifications perceived people with modifications as much different from themselves on these measures. These results indicate that tattoos and piercings in college students are associated with significantly more risk-taking behavior, greater use of alcohol and marijuana, and less social conformity. However, the traditional stereotype that body modifications are indicators of social or personal pathology does not describe contemporary college students.

Adolescent↗
PubMed2003

Adhesions caused by umbilical piercing.

A 31-year-old woman experienced chronic pelvic pain, unresponsive to medical therapy. History, physical examination, and laboratory analyses were noncontributory except for multiple body piercings. Diagnostic laparoscopy revealed an umbilical adhesion from the small bowel to the anterior abdominal wall. The patient removed the umbilical piercing but declined surgery for adhesiolysis.

Adult↗
PubMed2000

Hazards of piercing and facial body art: a report of three patients and literature review.

Piercing has become a widespread fashion trend in Western industrialized nations within recent years. The invasive application of ornaments through cutaneous and mucosal surfaces enables the penetration of various pathogens into subcutaneous tissue. The authors describe the hazards of piercing and facial body art as they apply to 3 patients. Perichondrial auricular abscess, granulomatous perichondritis of the nasal ala, and embedding of a stud in the lower lip were the respective diagnoses. Literature was reviewed for the cultural origins and current practices of piercing, the legal background of piercing as a business, typical medical complications, and treatment recommendations. Numerous communications have been published on medical complications of piercing. The patients presented and the review of the literature illustrate that piercing is not a harmless fashion and that regulations of piercing as a business seem desirable to prevent further complications.

Adolescent↗