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Grimes, Ian C., Bret J. Spier, Lisa R. Swize, Mary J. Lindstrom, and Patrick R. Pfau. "Predictors of Recurrent Ingestion of Gastrointestinal Foreign Bodies." Canadian Journal of Gastroenterology 27, no. 1 (2013): e1-e4. http://dx.doi.org/10.1155/2013/671273.
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BACKGROUND: Gastrointestinal foreign bodies are commonly encountered; however, little knowledge exists as to the causes of foreign body ingestions and why they occur repeatedly in some patients.OBJECTIVE: To identify and define patients at high risk for recurrent foreign body ingestion.METHODS: A retrospective chart review of foreign body ingestion was conducted at a tertiary care medical centre over an 11-year period. Variables analyzed included age, sex, incarceration status,Diagnostic and Statistical Manual of Mental Disorders-IVdiagnosis, success of endoscopy, type of sedation used, method of extraction, complications, presence of gastrointestinal pathology, and incidence of recurrent food impaction or foreign body.RESULTS: A total of 159 patients with a foreign body ingestion were identified. One hundred fourteen (77%) experienced a single episode of ingestion and 45 (23%) experienced multiple ingestions. Of the patients with multiple ingestions, 27 (60%) had recurrent food impactions while 18 (40%) ingested foreign objects. In the recurrent ingestor group, a psychiatric disorder had been diagnosed in 16 patients (35.6%) and there were 13 incarcerated individuals (28.9%). The average number of recurrences was 2.6 per patient (117 total recurrences). Individuals with a psychiatric disorder experienced 3.9 recurrences per patient, while prisoners averaged 4.1 recurrences per patient. The combination of a psychiatric disorder and being incarcerated was associated with the highest recurrence rate (4.33 per patient). Multivariable logistic regression revealed that male sex (OR 2.9; P=0.022), being incarcerated (OR 3.0; P=0.024) and the presence of a psychiatric disorder (OR 2.5; P=0.03) were risk factors for recurrent ingestion.CONCLUSION: Risk factors for recurrent ingestion of foreign bodies were male sex, being incarcerated and the presence of a psychiatric disorder.
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Kumar, Manish, Sanjeev Sachdeva, Ajay Kumar, Ujjwal Sonika, Manish Gupta, Siddharth Srivastava, Amol Dahale, and Ashok Dalal. "Gastric Foreign Bodies in Prison Inmates." Journal of Digestive Endoscopy 12, no. 02 (June 2021): 067–70. http://dx.doi.org/10.1055/s-0041-1731963.
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Abstract Objective Gastric foreign bodies are a common problem brought to an endoscopist. Prisoners are more prone to ingesting unusual foreign bodies for a secondary gain. The objective of this study was to study the profile of foreign body ingestion among the prisoners brought to a tertiary care center. Methods This is a retrospective case series. All the prisoners brought for endoscopic removal of foreign bodies between January 2018 to December 2019 were included in the analysis. Patients’ baseline characteristics, type of foreign body, management, and outcome were noted Results A total of eight inmates presented with ingestion of foreign body to our department. Most common foreign bodies ingested were drug packets and mobile phones. All ingestions were for secondary gain. Endoscopic removal was successful in all cases. Conclusion Endoscopic removal can be tried with all necessary precautions by an expert endoscopist.
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Lovejoy, Frederick H., and Alan D. Woolf. "Consultation with the Specialist." Pediatrics In Review 16, no. 12 (December 1, 1995): 473–74. http://dx.doi.org/10.1542/pir.16.12.473.
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Two particularly relevant questions frequently asked by pediatricians about caustic ingestions by children are: 1) What signs and symptoms are common with a caustic ingestion, and can esophageal injury occur in the absence of mouth burns? and 2) When should the patient be referred to the surgeon for endoscopy to confirm a corrosive ingestion? Signs and Symptoms Approximately 53 000 corrosive exposures occur yearly in the United States. The Federal Hazardous Substances Act and the Poison Prevention Packaging Act of 1970 requires that corrosive agents that have concentrations of active ingredients greater than 10% be sold in child-resistant containers. This has done much to reduce the frequency and severity of signs and symptoms of corrosive ingestions. The child may lick or take only several swallows of a corrosive liquid compared with an adolescent purposefully ingesting a corrosive, who may consume a larger amount. The lips, oral mucosa, tongue, pharynx, esophagus, and stomach all may be affected. Other areas, such as the eyes, larynx, and/or respiratory tract, also may be exposed to the corrosive agent. Many infants and children who have a history of ingesting a corrosive recently are without signs and symptoms. However, others have clear signs of injury, including pain on swallowing, drooling, excessive salivation, and inability or refusal to drink. Examination of the mouth shows edema, inflammation, or whitish areas.
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Dole, Michael, and Girish Hiremath. "Successful Endoscopic Removal of 42 Magnetic Balls." Journal of Digestive Endoscopy 08, no. 02 (April 2017): 081–82. http://dx.doi.org/10.4103/jde.jde_55_16.
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ABSTRACTForeign body ingestion in pediatric patients is a common emergency department presentation. Despite a ban and recall in 2014 for the magnetic toy “Buckyballs” due to posing a deadly risk if ingested, clinical cases continue to occur. The need for surgical management in the setting of multiple magnet ingestions is related to compromised blood supply when at least two magnets are attracted while separated by gastrointestinal mucosa, and previous studies have indicated that the majority of multiple magnet ingestions require surgical intervention. In the setting of a known recent ingestion, endoscopic removal can potentially safely avoid the morbidity and mortality associated with surgical procedures. We present an interesting clinical case of multiple magnetic ingestion managed with endoscopic procedure.
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Aronow, Stefanie P., Herbert D. Aronow, Thomas Blanchard, Steven Czinn, and Gisela Chelimsky. "Hair Relaxers: A Benign Caustic Ingestion?" Journal of Pediatric Gastroenterology and Nutrition 36, no. 1 (January 2003): 120–25. http://dx.doi.org/10.1002/j.1536-4801.2003.tb07968.x.
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ABSTRACTBackgroundDespite federally legislated safety regulations, caustic ingestions remain a significant problem in the pediatric population. The current standard of care for caustic ingestion includes upper gastrointestinal endoscopy in most cases. Hair relaxers are a common caustic ingestion at our institution, yet few data have been published describing the clinical or endoscopic outcome. We explored the relative frequency of hair relaxer ingestion, the incidence of associated upper gastrointestinal injury, and the adverse clinical sequelae resulting from these ingestions.MethodsConsecutive caustic ingestions admitted to our institution between January 1990 and January 2001 were identified. The data were collected through retrospective physician chart review, were analyzed, and were pooled with the existing literature to evaluate for the presence of esophageal injury.Results96 charts were reviewed, 29 (30%) of which were hair relaxer ingestions that underwent esophagogastroduodenoscopy; these ingestions served as our study cohort. The median age of the cohort was 14.0 months and patients were evenly divided in gender. The most common symptoms at presentation were drooling and emesis. At endoscopy, lip and oropharyngeal mucosa were most commonly affected. While six patients (20.7%) had Grade I esophageal mucosal injury and five patients (17.2%) had Grade I gastric mucosal injury, none had greater than Grade I mucosal damage. No adverse clinical events were identified. When our data were combined with all previously published cohort data, the findings were similar and no adverse clinical outcomes were reported.ConclusionsHair relaxer is the most common childhood caustic ingestion presenting to our large metropolitan tertiary care center. Symptoms are common at presentation. However, despite the high pH of these products, no clinically significant esophageal or gastric mucosal injuries and no long‐term sequelae were identified.
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Einhorn, Arnold, Lisa Horton, Michael Altieri, Dan Ochsenschlager, and Bruce Klein. "Serious Respiratory Consequences of Detergent Ingestions in Children." Pediatrics 84, no. 3 (September 1, 1989): 472–74. http://dx.doi.org/10.1542/peds.84.3.472.
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After ingesting or inhaling laundry detergent powder, eight children required hospital admission. The predominant symptoms were stridor, drooling, and respiratory distress. All but one patient underwent endoscopy of the airways and the esophagus, five children were admitted to the intensive care unit, and four children required endotracheal intubation. Laundry detergent ingestions are generally considered to have minor consequences, and there exists a paucity of literature on the subject. Evidence of significant morbidity incurred because of ingestion or inhalation of sodium carbonatecontaining laundry detergent powder is presented, together with a review of the existing literature.
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Neidich, Gary. "Ingestion of Caustic Alkali Farm Products." Journal of Pediatric Gastroenterology and Nutrition 16, no. 1 (January 1993): 75–77. http://dx.doi.org/10.1002/j.1536-4801.1993.tb10805.x.
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SummarySince the Poison Prevention Packaging Act took effect, the number of ingestions of caustic alkali from household products has been significantly reduced. Commercial caustic alkalis used on farms, however, were not included in this legislation. Fourteen children over a 5 year period were seen after ingestion of commercial caustic alkalis used on farms. Seven of the children had ingested liquid pipeline cleaners and seven had ingested solid agents used for a variety of reasons. Six of seven children ingesting liquid agents did so from nonoriginal containers into which the caustic had been transferred for convenience. All seven children ingesting solid agents did so from the original container. Eight of the 14 children were found to have second‐degree or worse esophageal involvement. Both solid and liquid caustic agents used commercially on farms can cause significant morbidity. Development of a child‐resistant container for daily transfer of liquid pipeline agents could be helpful in preventing injuries from liquid pipeline cleaners. Pediatric gastroen‐terologists as well as primary care physicians in rural areas should be familiar with this type of injury and should take an active role in instructing parents of children living on farms to prevent such injuries. Extension of the Poison Prevention Packaging Act to caustic alkalis used on farms needs to be considered.
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Forrester, Mathias B. "Nutmeg intoxication in Texas, 1998–2004." Human & Experimental Toxicology 24, no. 11 (November 2005): 563–66. http://dx.doi.org/10.1191/0960327105ht567oa.
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Nutmeg is a spice that contains volatile oils comprised of alkyl benzene derivatives (myristicin, elemicin, safrole, etc.), terpenes and myristic acid. Nutmeg has a long history of abuse. This study describes the nutmeg ingestion calls received by Texas poison centers from 1998 to 2004. There were 17 calls involving nutmeg ingestion, of which 64.7% involved intentional abuse. When abuse and non-abuse ingestions were compared, abuse ingestions were more likely to involve males (100 versus 66.7%) and adolescents (55.6 versus 16.7%). The majority of both abuse and non-abuse calls were managed outside of health care facilities (54.5 and 66.7%, respectively). None of the ingestions resulted in more than moderate clinical effects or death.
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Walker, Gary J., Phillipa Caudwell, Natalie Dixon, and Nicolette C. Bishop. "The Effect of Caffeine Ingestion on Neutrophil Oxidative Burst Responses Following Prolonged Cycling." International Journal of Sport Nutrition and Exercise Metabolism 16, no. 1 (February 2006): 24–35. http://dx.doi.org/10.1123/ijsnem.16.1.24.
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This study investigated the effect of caffeine ingestion on neutrophil oxidative burst responses to prolonged cycling. In a two part study, 19 endurance trained male cyclists (Part A – 11; Part B – 8) performed 90 min of exercise at 70% VO2max 1 h after ingesting 6 mg/kg body mass of caffeine (CAF) or placebo (PLA). CAF ingestion had no effect on the PMA-stimulated oxidative burst response (Part A), yet it attenuated the exercise-induced decline in f-MLP stimulated response that occurred with PLA (Part B). CAF ingestion significantly increased serum caffeine concentration and plasma adrenaline concentration following exercise. In addition, circulating lymphocyte count was increased following CAF ingestion whereas there was no effect on neutrophil number. Therefore, although CAF ingestion was associated with an increase in adrenaline, this was not associated with an expected decrease in neutrophil function. This suggests that in the present study, CAF ingestion influenced neutrophil function via alternative mechanisms.
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Bentur, Yedidia, Yael Lurie, Ada Tamir, Daniel C. Keyes, and Fuad Basis. "Reliability of history of acetaminophen ingestion in intentional drug overdose patients." Human & Experimental Toxicology 30, no. 1 (March 30, 2010): 44–50. http://dx.doi.org/10.1177/0960327110366784.
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The objective of this study was to determine the reliability of denial of acetaminophen ingestion in intentional drug overdose patients. All intentional drug overdose patients admitted to an emergency department who were able to provide a history were included. A detailed history was obtained on names, timing and number of medications ingested, and serum acetaminophen was assayed. Multidrug ingestion was defined as the reporting of ≥2 medications. Patients were considered ‘reliable’ if they reported acetaminophen ingestion and had detectable acetaminophen levels or the other way around. Validity parameters of acetaminophen history were assessed by sensitivity, specificity and positive and negative predictive values. A total of 154 patients were included. History was significantly more reliable in patients who denied ingestion of acetaminophen (n = 107) compared with patients who reported it (n = 47; 95.3% vs 65.9%, respectively; p < 0.0001, 95% CI of the difference 17.5%—41.2%). No suicidal patient who denied both acetaminophen and multidrug ingestions had a detectable acetaminophen level (negative predictive value 1, 95% CI 0.93—1.0). It is suggested that denial of both acetaminophen and multidrug ingestions by intentional drug overdose patients after a thorough history taking can be considered reliable for acetaminophen history. In facilities with limited resources, these patients may not require routine acetaminophen screening.
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Pomportes, Laura, Jeanick Brisswalter, Arnaud Hays, and Karen Davranche. "Effects of Carbohydrate, Caffeine, and Guarana on Cognitive Performance, Perceived Exertion, and Shooting Performance in High-Level Athletes." International Journal of Sports Physiology and Performance 14, no. 5 (May 1, 2019): 576–82. http://dx.doi.org/10.1123/ijspp.2017-0865.
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Purpose: To investigate the effect of ingesting carbohydrate (CHO), caffeine (CAF), and a guarana complex (GUAc) during a running exercise on cognitive performance, rating of perceived exertion (RPE), and shooting performance in high-level modern pentathlon athletes. Methods: A total of 10 athletes completed 4 counterbalanced sessions within a 2-wk period, corresponding to ingestions of CHO (30 g), GUAc (300 mg), CAF (200 mg), or placebo. The exercise involved a 40-min run on a treadmill at a steady speed, previously determined as a “somewhat hard” exercise (RPE 13). Shooting and cognitive performance (Simon task) were assessed in 3 phases: before exercise and ingestion, before exercise and after half ingestion, and after exercise and full ingestion. Drinks were consumed 40 min (250 mL) and 5 min (125 mL) prior to exercise and after 20 min of running (125 mL). RPE was assessed at 10-min intervals during exercise. Results: There was an interaction between drink and exercise on mean reaction time (P = .01, ) and a drink effect on RPE (P = .01, ). CHO, CAF, and GUAc enhanced the speed of information processing after exercise (P = .003, P = .004, and P = .04, respectively), but only CAF and GUAc decreased RPE (P = .002 and P = .02, respectively). Conclusion: The results highlight a beneficial effect of nutritional supplements on information processing and RPE. This finding is particularly interesting as decision-making processes are crucial in the performance of many sports.
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Brown, Clive M., Abdul G. Dulloo, Gayathri Yepuri, and Jean-Pierre Montani. "Fructose ingestion acutely elevates blood pressure in healthy young humans." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 294, no. 3 (March 2008): R730—R737. http://dx.doi.org/10.1152/ajpregu.00680.2007.
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Overconsumption of fructose, particularly in the form of soft drinks, is increasingly recognized as a public health concern. The acute cardiovascular responses to ingesting fructose have not, however, been well-studied in humans. In this randomized crossover study, we compared cardiovascular autonomic regulation after ingesting water and drinks containing either glucose or fructose in 15 healthy volunteers (aged 21–33 yr). The total volume of each drink was 500 ml, and the sugar content 60 g. For 30 min before and 2 h after each drink, we recorded beat-to-beat heart rate, arterial blood pressure, and cardiac output. Energy expenditure was determined on a minute-by-minute basis. Ingesting the fructose drink significantly increased blood pressure, heart rate, and cardiac output but not total peripheral resistance. Glucose ingestion resulted in a significantly greater increase in cardiac output than fructose but no change in blood pressure and a concomitant decrease in total peripheral resistance. Ingesting glucose and fructose, but not water, significantly increased blood pressure variability and decreased cardiovagal baroreflex sensitivity. Energy expenditure increased by a similar amount after glucose and fructose ingestion, but fructose elicited a significantly greater increase in respiratory quotient. These results show that ingestion of glucose and fructose drinks is characterized by specific hemodynamic responses. In particular, fructose ingestion elicits an increase in blood pressure that is probably mediated by an increase in cardiac output without compensatory peripheral vasodilatation.
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Suppes, Laura, Kacey Ernst, Leif Abrell, and Kelly Reynolds. "Validation of Questionnaire Methods to Quantify Recreational Water Ingestion." International Journal of Environmental Research and Public Health 15, no. 11 (November 1, 2018): 2435. http://dx.doi.org/10.3390/ijerph15112435.
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Swimming pool water ingestion volumes are necessary for assessing infection risk from swimming. Pool water ingestion volumes can be estimated by questionnaire or measuring a chemical tracer in swimmer urine. Questionnaires are often preferred to the chemical tracer method because surveys are less time consuming, but no research exists validating questionnaires accurately quantify pool water ingestion volumes. The objective of this study was to explore if questionnaires are a reliable tool for collecting pool water ingestion volumes. A questionnaire was issued at four pool sites in Tucson, Arizona to 46 swimmers who also submitted a urine sample for analyzing cyanuric acid, a chemical tracer. Perceived ingestion volumes reported on the questionnaire were compared with pool water ingestion volumes, quantified by analyzing cyanuric acid in swimmer urine. Swimmers were asked if they swallowed (1) no water or only a few drops, (2) one to two mouthfuls, (3) three to five mouthfuls, or (4) six to eight mouthfuls. One mouthful is the equivalent of 27 mL of water. The majority (81%) of swimmers ingested <27 mL of pool water but reported ingesting >27 mL (“one mouthful”) on the questionnaire. More than half (52%) of swimmers overestimated their ingestion volume. These findings suggest swimmers are over-estimating pool water ingestion because they perceive one mouthful is <27 mL. The questionnaire did not reliably collect pool water ingestion volumes and should be improved for future exposure assessment studies. Images of the ingestion volume categories should be included on the questionnaire to help swimmers visualize the response options.
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Forrester, Mathias B. "Characteristics of hand sanitizer ingestions by adolescents reported to poison centers." International Journal of Adolescent Medicine and Health 27, no. 1 (February 1, 2015): 69–72. http://dx.doi.org/10.1515/ijamh-2014-0014.
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Abstract Background: There had been reports of adolescents using hand sanitizers to obtain alcohol and ending up in emergency departments with alcohol poisoning. Objective: This study aimed to describe the pattern of adolescent ingestions of hand sanitizers reported to a statewide poison center system. Subjects: Our study subjects included patients aged 13–19 years who reported hand sanitizer ingestions as reported to Texas poison centers during 2000–2013. Materials and methods: The distribution of the ingestions was determined for various demographic and clinical factors. Results: Of 385 total cases, 61% of the patients were male, and the mean age was 15.3 years. The ingestion reason was unintentional (61%), intentional abuse/misuse (18%), and malicious (10%). Ingestion site was most frequently reported to be the patient’s own residence (53%), followed by school (35%). About 77% of the patients were managed on site. The medical outcome was serious (moderate effect or unable to follow-potentially toxic) in 5% of the cases. The most frequently reported adverse clinical effects were vomiting (5%), abdominal pain (4%), nausea (4%), throat irritation (4%), and drowsiness (2%). Conclusion: Adolescents who ingested hand sanitizers were more likely to be male and younger. One-third of the ingestions occurred at school, suggesting that school personnel might be made aware of the potential problem of hand sanitizer ingestions by adolescents. Nevertheless, despite the potential for serious outcomes from adolescent hand sanitizer ingestion, most of the ingestions reported to poison centers are not likely to be serious and can be successfully managed outside of a healthcare facility.
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Dawe, N., M. Puvanendran, and L. Flood. "Unwitnessed lithium ion disc battery ingestion: case report and review of best practice management of an increasing clinical concern." Journal of Laryngology & Otology 127, no. 1 (December 7, 2012): 84–87. http://dx.doi.org/10.1017/s0022215112002617.
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AbstractObjective:To describe a case of unwitnessed lithium ion disc battery ingestion, with a review of radiology findings and current best practice management.Case report:A three-year-old girl presented following ingestion of a foreign body, which her four-year-old brother claimed was a one pound coin. The patient was managed non-urgently and transferred for specialist ENT assessment 6 hours following the initial ingestion, with no evidence of airway compromise. A corroded battery was removed from the level of the cricopharyngeus after 8 hours, with an associated circumferential mucosal burn.Conclusion:There is increasing concern regarding the acknowledged rising incidence of lithium ion disc battery ingestion. The lack of a high index of suspicion and the inability to recognise subtleties on imaging may lead to suboptimal management with a higher degree of unnecessary immediate and delayed morbidity. The recently published American Academy of Pediatrics Guidelines may guide the approach to managing battery ingestions.
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Lent, C. M., and M. H. Dickinson. "On the termination of ingestive behaviour by the medicinal leech." Journal of Experimental Biology 131, no. 1 (September 1, 1987): 1–15. http://dx.doi.org/10.1242/jeb.131.1.1.
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Hungry leeches, Hirudo medicinalis, ingest blood meals averaging 890% of their mass in 29 min. Ingestion is terminated as a result of distension of the body: experimentally distending leeches as they feed causes an immediate cessation of ingestion and inhibits any subsequent biting behaviour; if distension is circumvented by various experimental procedures, leech ingestive periods are prolonged significantly. Ingestion is not terminated as a result of fatigue, chemical cues or mass change. Distension also underlies satiation, for removing blood from the crops of recently fed leeches qualitatively alters their satiated behaviour to biting. Biting is not a defensive reaction to injury. In rostral ganglia, impulses of the serotonergic Retzius (RZ) and LL neurones evoke the physiological components of ingestion. Localized warming of the prostomial lip induces impulses in these large effector neurones. Distending the body wall tonically hyperpolarizes the RZ and LL cells. This inhibitory response to distension is conducted from the mid-body to the anterior neurones via the ventral nerve cord. Distensive inhibition antagonizes the synaptic excitation evoked in RZ and LL neurones by thermal stimulation. Thus, a stimulus which evokes feeding synaptically excites 5-HT neurones and a stimulus which terminates ingestion inhibits them. The integration of these inputs controls the expression of leech feeding behaviour and these connections match precisely a model proposed to regulate the ingestive behaviour of blowflies.
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Phifer, C. B., and W. G. Hall. "Ingestive behavior in preweanling rats: emergence of postgastric controls." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 255, no. 2 (August 1, 1988): R191—R199. http://dx.doi.org/10.1152/ajpregu.1988.255.2.r191.
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Previous studies have indicated that the termination of intake in very young rat pups is controlled almost exclusively by the level of gastric fill; nutritive cues from diet have no effect on intake. In the present series of experiments, we investigated the ontogeny of postgastric nutritive controls of intake in rat pups ingesting independent of their dam. In 6-day-old pups, the level of gastric fill required to terminate ingestion was not affected by the presence or absence of post-gastric nutritive cues, but by 15 days of age a greater level of gastric fill was required to stop ingestion when postgastric cues were eliminated by a closed pyloric noose. This emergent post-gastric contribution to the inhibition of intake in 15-day-old pups does not depend on preexisting gastric fill signals, as sham-feeding pups (open gastric fistula) with nutrients in their intestines ingested less than pups without intestinal nutrients. These results provide evidence that postgastric controls of ingestive behavior mature during the postnatal period and just shortly before they are required at weaning.
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Rajpal, Bhumika, Manas Mitra, Arun Kaushik, and Kishalay Datta. "Acetaminophen Ingestion Turns Toxic." Indian Journal of Emergency Medicine 9, no. 3 (September 15, 2023): 123–26. http://dx.doi.org/10.21088/ijem.2395.311x.9323.14.
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Acetaminophen, commonly called “Paracetamol” is an over the counter medication available in all the pharmacies in the Indian subcontinent. The emergency and critical care department is commonly involved in the diagnosis and treatment of acetaminophen poisoning patients. The treatment guidelines are ages old but in recent times, the presentation for acetaminophen poisoning has been varied. In this case report, we will discuss the diagnosis and management of acetaminophen poisoning in a child, along with review of literature.
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Amoroso, Angela, Fabiana Di Stasio, Laura Locatelli, and Lorenzo D'Antiga. "Una ematemesi fatale." Medico e Bambino Pagine elettroniche 25, no. 4 (April 30, 2022): 81–85. http://dx.doi.org/10.53126/mebxxva081.
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Disk battery ingestions in children are increasing worldwide. This condition may cause severe complications, especially if the battery is lodged in the oesophagus. The most dangerous complication with the highest mortality rate is aorto-oesophageal fistula. The tissue damage may appear after 2 hours from the ingestion. The paper reports the case of a 2-year-old girl who was admitted to the Emergency Department 15 days after the ingestion of a disk battery and who presented with an aorto-oesophageal fistula complication.
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Massicotte, D., F. Peronnet, G. Brisson, K. Bakkouch, and C. Hillaire-Marcel. "Oxidation of a glucose polymer during exercise: comparison with glucose and fructose." Journal of Applied Physiology 66, no. 1 (January 1, 1989): 179–83. http://dx.doi.org/10.1152/jappl.1989.66.1.179.
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The purpose of this study was to compare the oxidation of 13C-labeled glucose, fructose, and glucose polymer ingested (1.33 g.kg-1 in 19 ml.kg-1 water) during cycle exercise (120 min, 53 +/- 2% maximal O2 uptake) in six healthy male subjects. Oxidation of exogenous glucose and glucose polymer (72 +/- 15 and 65 +/- 18%, respectively, of the 98.9 +/- 4.7 g ingested) was similar and significantly greater than exogenous fructose oxidation (54 +/- 13%). A transient rise in plasma glucose concentration was observed with glucose ingestion only. However, plasma insulin levels were similar with glucose and glucose polymer ingestions and significantly higher than with water or fructose ingestion. Plasma free fatty acid and glycerol responses to exercise were blunted with carbohydrate ingestion. However, fat utilization was not significantly different with water (82 +/- 14 g), glucose (60 +/- 3 g), fructose (59 +/- 11 g), or glucose polymer ingestion (60 +/- 8 g). Endogenous carbohydrate utilization was significantly lower with glucose (184 +/- 22 g), glucose polymer (187 +/- 31 g), and fructose (211 +/- 18 g) than with water (239 +/- 30 g) ingestion. Plasma volume slightly increased with water ingestion (7.4 +/- 4.5%), but the decrease was similar with glucose (-7.6 +/- 5.1%) and glucose polymer (-8.2 +/- 4.6%), suggesting that the rate of water delivery to plasma was similar with the two carbohydrates.(ABSTRACT TRUNCATED AT 250 WORDS)
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Massicotte, D., F. Peronnet, C. Allah, C. Hillaire-Marcel, M. Ledoux, and G. Brisson. "Metabolic response to [13C]glucose and [13C]fructose ingestion during exercise." Journal of Applied Physiology 61, no. 3 (September 1, 1986): 1180–84. http://dx.doi.org/10.1152/jappl.1986.61.3.1180.
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Seven healthy male volunteers exercised on a cycle ergometer at 50 +/- 5% VO2max for 180 min, on three occasions during which they ingested either water only (W), [13C]glucose (G), or [13C]fructose (F) (140 +/- 12 g, diluted at 7% in water, and evenly distributed over the exercise period). Blood glucose concentration (in mM) significantly decreased during exercise with W (5.1 +/- 0.4 to 4.2 +/- 0.1) but remained stable with G (5.0 +/- 0.4 to 5.3 +/- 0.6) or F ingestion (5.4 +/- 0.5 to 5.1 +/- 0.4). Decreases in plasma insulin concentration (microU/ml) were greater (P less than 0.05) with W (11 +/- 3 to 3 +/- 1) and F (12 +/- 4 to 5 +/- 1) than with G ingestion (11 +/- 2 to 9 +/- 5), and fat utilization was greater with F (103 +/- 11 g) than with G ingestion (82 +/- 9 g) and lower than with W ingestion (132 +/- 14 g). However F was less readily available for combustion than G; over the 3-h period 75% (106 +/- 11 g) of ingested G was oxidized, compared with 56% (79 +/- 8 g) of ingested fructose. As a consequence, carbohydrate store utilizations were similar in the two conditions (G, 174 +/- 20 g; F, 173 +/- 17 g; vs. W, 193 +/- 22 g). These observations suggest that, during prolonged moderate exercise, F ingestion maintains blood glucose as well as G ingestion, and increases fat utilization when compared to G ingestion. However, due to a slower rate of utilization of F, carbohydrate store sparing is similar with G and F ingestions.
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Wong, Cynthia A., Mariann Loffredi, Jeanne N. Ganchiff, Jia Zhao, Zhao Wang, and Michael J. Avram. "Gastric Emptying of Water in Term Pregnancy." Anesthesiology 96, no. 6 (June 1, 2002): 1395–400. http://dx.doi.org/10.1097/00000542-200206000-00019.
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Background Healthy nonpregnant patients may ingest clear liquids until 2 h before induction of anesthesia without adversely affecting gastric volume. The purpose of this study was to compare gastric emptying in term, nonlaboring pregnant women after ingestion of 50 ml water (control) with that after ingestion of 300 ml water. Methods Gastric emptying was assessed in healthy, nonobese, term pregnant volunteers using both serial gastric ultrasound examinations (n = 9) and acetaminophen absorption (n = 11) in a crossover study design. After an overnight fast, volunteers ingested 1.5 g acetaminophen and 50 or 300 ml water (assigned in random order) on two occasions separated by at least 2 days. Serial gastric antrum cross-sectional areas were determined using gastric ultrasound imaging, and the half-time to gastric emptying was calculated. Serial plasma acetaminophen concentrations were measured. Areas under the plasma acetaminophen concentration versus time curve, peak concentrations, and time to peak concentration for 50- and 300-ml ingestions were compared. Results Gastric emptying half-time was significantly shorter after ingestion of 300 ml water than after ingestion of 50 ml (24 +/- 6 vs. 33 +/- 8 min). There were no differences in acetaminophen areas under the curve at 60, 90, or 120 min, or in acetaminophen peak concentration. Time to peak concentration of acetaminophen was significantly shorter after ingestion of 300 ml water than after ingestion of 50 ml (25 +/- 12 vs. 41 +/- 19 min). Conclusions Gastric emptying in healthy, term, nonobese, nonlaboring pregnant women is not delayed after ingestion of 300 ml water compared with that after an overnight fast.
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Gonzalez, Javier T., Cas J. Fuchs, Fiona E. Smith, Pete E. Thelwall, Roy Taylor, Emma J. Stevenson, Michael I. Trenell, Naomi M. Cermak, and Luc J. C. van Loon. "Ingestion of glucose or sucrose prevents liver but not muscle glycogen depletion during prolonged endurance-type exercise in trained cyclists." American Journal of Physiology-Endocrinology and Metabolism 309, no. 12 (December 15, 2015): E1032—E1039. http://dx.doi.org/10.1152/ajpendo.00376.2015.
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The purpose of this study was to define the effect of glucose ingestion compared with sucrose ingestion on liver and muscle glycogen depletion during prolonged endurance-type exercise. Fourteen cyclists completed two 3-h bouts of cycling at 50% of peak power output while ingesting either glucose or sucrose at a rate of 1.7 g/min (102 g/h). Four cyclists performed an additional third test for reference in which only water was consumed. We employed 13C magnetic resonance spectroscopy to determine liver and muscle glycogen concentrations before and after exercise. Expired breath was sampled during exercise to estimate whole body substrate use. After glucose and sucrose ingestion, liver glycogen levels did not show a significant decline after exercise (from 325 ± 168 to 345 ± 205 and 321 ± 177 to 348 ± 170 mmol/l, respectively; P > 0.05), with no differences between treatments. Muscle glycogen concentrations declined (from 101 ± 49 to 60 ± 34 and 114 ± 48 to 67 ± 34 mmol/l, respectively; P < 0.05), with no differences between treatments. Whole body carbohydrate utilization was greater with sucrose (2.03 ± 0.43 g/min) vs. glucose (1.66 ± 0.36 g/min; P < 0.05) ingestion. Both liver (from 454 ± 33 to 283 ± 82 mmol/l; P < 0.05) and muscle (from 111 ± 46 to 67 ± 31 mmol/l; P < 0.01) glycogen concentrations declined during exercise when only water was ingested. Both glucose and sucrose ingestion prevent liver glycogen depletion during prolonged endurance-type exercise. Sucrose ingestion does not preserve liver glycogen concentrations more than glucose ingestion. However, sucrose ingestion does increase whole body carbohydrate utilization compared with glucose ingestion. This trial was registered at https://www.clinicaltrials.gov as NCT02110836.
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WHITE, J. DOUGLAS, and TOBY L. LITOVITZ. "Levothyroxine Poisoning." Pediatrics 75, no. 1 (January 1, 1985): 129. http://dx.doi.org/10.1542/peds.75.1.129.
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To the Editor.— We read the recent report by Lehrner and Weir1 of acute levothyroxine ingestions with concern. Advocacy of an aggressive approach disregards their own cases as well as the medical literature,2-5 Which contains at least seven cases of acute excessive ingestion of levothyroxine (five of which were overlooked by the authors). These reports repeatedly emphasize "a striking discrepancy between the high concentrations of active hormones and the minor clinical symptoms"4 and "the benign course after massive ingestion of levothyroxine."5
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Day, R., SM Bradberry, EA Sandilands, SHL Thomas, JP Thompson, and JA Vale. "Toxicity of traditional and soluble film automatic dishwashing tablets." Human & Experimental Toxicology 39, no. 4 (December 4, 2019): 433–39. http://dx.doi.org/10.1177/0960327119891767.
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Introduction: Detergents used in automatic dishwashing machines are of two main types: traditional tablets that require removal from an external wrapper and newer soluble film tablets. Objective: To determine the toxicity of automatic dishwashing tablets. Methods: Telephone enquiries to the UK National Poisons Information Service were analysed for the period January 2008 to June 2019. Results: Ingestion: Ingestion was involved in 798 traditional tablet exposures and 725 soluble film exposures. Clinical features (Poisoning Severity Score ≥ 1) developed in 22.2% of patients ingesting traditional tablets and in 28.8% ingesting soluble film tablets; moderate or severe toxicity was rare (<0.5% for both traditional and soluble film tablets). Children (≤5 years) significantly ( p < 0.0001) more often developed features following ingestion of soluble film ( n = 193, 28.2%) than traditional tablets ( n = 134, 19.1%). In contrast, adults more often developed features following ingestion of traditional than soluble film tablets, although this difference was not statistically significant. Eye exposure: The eye was involved in only 26 of 1539 exposures; 17 of 26 exposures resulted in ocular features. The most commonly reported features were conjunctivitis, eye pain and blurred vision, although one patient sustained a corneal abrasion and developed loss of vision. Skin exposure: Thirty-four of 1539 exposures involved the skin but only 3 developed dermal features which were minor. Conclusions: Children (≤5 years) significantly more often developed features following ingestion of soluble film than traditional tablets, although the likelihood of a child developing features was relatively low (<30%) and features that did develop were almost always mild. In contrast, adults more often developed features following the ingestion of traditional than soluble film tablets. Overall, the eye was involved in only 1.7% of exposures and only one patient sustained a corneal abrasion.
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Bebarta, Vikhyat S., Matthew D. Hensley, and Douglas J. Borys. "Acute Methotrexate Ingestions in Adults: A Report of Serious Clinical Effects and Treatments." Journal of Toxicology 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/214574.
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Objective.Limited reported data have reports effects after acute ingestion of methotrexate. Treatment recommendations do not differentiate between exposure routes. Our objective was to determine the frequency of significant toxicity effects and use of therapy after methotrexate ingestion in adults.Methods.We performed a retrospective study on adult cases reported to 6 poison centers over 6 years (2000–2005) which exceed 180,000 exposures/year. Variables collected included demographics, dosages ingested, coingestions, clinical effects, and therapies with outcomes.Results.Sixty-three patients examined over the 6-year period met inclusion criteria. No patient in the series received dialysis or died. The mean dose ingested for all patients was 24 mg (range 2.5–100 mg) and the mean dose for suicidal ingestions was 47.5 mg (12.5–100 mg). The most common clinical effects were abdominal pain, oral irritation, throat irritation, nausea, dizziness, and headache. Nine patients received folinic acid and 3 patients received sodium bicarbonate. No patient developed renal failure, bone marrow suppression, seizure, or coma. No patient died or received dialysis.Conclusion.In our series of patients from 6 poison centers over six years, 63 cases of acute adult methotrexate ingestions were reported. Methotrexate toxicity from ingestion in adults was uncommon and rarely toxic.
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Palmer, Matthew, George Heigenhauser, MyLinh Duong, and Lawrence Spriet. "Ingesting A Sports Drink Enhances Simulated Ice Hockey Performance While Reducing Perceived Effort." International Journal of Sports Medicine 38, no. 14 (October 18, 2017): 1061–69. http://dx.doi.org/10.1055/s-0043-119874.
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AbstractThis study determined whether ingesting a carbohydrate-electrolyte solution (CES) vs. progressive dehydration affected skeletal muscle glycogen use and performance in ice hockey players during simulated ice hockey exercise comprised of 3 active “periods”. Seven males (21.3±0.3 years, 184.7±1.2 cm, 84.2±3.9 kg, and 49.6±1.8 mL·kg−1·min−1) performed a hockey-specific protocol on two occasions and either dehydrated progressively (NF), or stayed well-hydrated by ingesting a CES. Muscle biopsies were taken at rest, before the 3rd period (P3), and after the final sprint in the protocol. Compared to dehydration in the NF trial (−1.8% BM), CES ingestion enhanced voluntary performance (151.0±8.0 vs. 144.1±8.7 kJ) and glycogen use (177.5±31.1 vs. 103.5±16.2 mmol·kg dm−1), and reduced perceived exertion (16±1 vs. 18±1) in P3. Mean core temperature was reduced by CES ingestion throughout the protocol (38.0±0.2 vs. 38.1±0.1°C). These results suggest that compared to progressive dehydration, staying hydrated by ingesting a CES helps preserve performance, while reducing thermal and perceptual strains, in P3 of cycle-based simulation of ice hockey exercise. These benefits are observed despite greater glycogen use in P3 with CES ingestion.
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Hodges, Nichole L., Sarah A. Denny, and Gary A. Smith. "Rare-Earth Magnet Ingestion–Related Injuries in the Pediatric Population: A Review." American Journal of Lifestyle Medicine 11, no. 3 (July 22, 2015): 259–63. http://dx.doi.org/10.1177/1559827615594336.
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Foreign-body ingestions are common among children and usually resolve with limited, if any, treatment. The ingestion of rare-earth magnets, however, commonly results in serious injury or death. These dangerous high-powered magnets can be found in the United States in a variety of consumer products, including magnetic toy sets designed for children and adults. The ingestion of one of such magnet is unlikely to cause significant harm. However, if multiple magnets are ingested, or if a magnet is ingested along with a metal object, the magnets are powerful enough to attract each other through the walls of the intestine, potentially resulting in significant internal damage. Rare-earth magnet ingestion cases are difficult to diagnose and the symptoms are not easy to differentiate from other causes of gastrointestinal illness or pain. However, delays in medical treatment can lead to serious injury or death. This review article describes the epidemiology of rare-earth magnet ingestion-related injuries and provides recommendations for diagnosis and treatment. Federal regulatory efforts related to rare-earth magnets and other prevention strategies are also discussed.
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Fraser, James A., Kayla B. Briggs, Wendy Jo Svetanoff, Thomas M. Attard, Tolulope A. Oyetunji, and Shawn D. St Peter. "Evaluation of a Symptom-Based Algorithm for Managing Battery Ingestions in Children." European Journal of Pediatric Surgery 32, no. 01 (December 16, 2021): 002–8. http://dx.doi.org/10.1055/s-0041-1740537.
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Abstract Objectives While complications from battery ingestion can be severe, especially with the emergence of stronger battery elements, not all ingestions require prompt removal. We aim to evaluate a symptom-focused algorithm for battery ingestion that emphasizes observation over intervention to investigate its safety. Materials and Methods Patients were identified through a query of foreign-body ingestion radiographs obtained between 2017 and 2020. A retrospective chart review was then performed of all patients who presented with button battery ingestions to identify compliance with our algorithm, overall outcomes, and complications. Results In total, 2% of all radiographs (44/2,237) demonstrated button battery ingestions. The median age of patients was 3.8 years (interquartile range, 2.6–5.3). Most batteries were found in the stomach (64%, n = 28), but were also identified in the esophagus (14%, n = 6), small bowel (14%, n = 6), and colon (9%, n = 4). All esophageal batteries were managed with immediate endoscopic retrieval. Ten gastric batteries were not managed per protocol, with seven admitted for observation despite being asymptomatic and repeat abdominal X-rays demonstrating persistent gastric location of the battery. Four patients underwent esophagogastroduodenoscopy; however, in two patients the battery had migrated past the stomach prior to intervention. All small bowel batteries and three of four asymptomatic colon batteries were managed per protocol; one patient had additional imaging that demonstrated battery passage. Conclusion Adherence to a symptom-focused protocol for conservative management of button battery ingestions beyond the gastroesophageal junction is safe and frequently does not require admission, serial imaging, or intervention.
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Treem, William R., William R. Long, David Friedman, and John B. Watkins. "Successful Management of an Acquired Gastric Outlet Obstruction with Endoscopy Guided Balloon Dilatation." Journal of Pediatric Gastroenterology and Nutrition 6, no. 6 (November 1987): 992–96. http://dx.doi.org/10.1002/j.1536-4801.1987.tb09449.x.
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SummaryAntral‐pyloric strictures and gastric outlet obstruction are known complications of caustic ingestions. These lesions can develop even in the absence of overt signs of potentially serious upper gastrointestinal tract pathology of abdominal pain at the time of ingestion. The development of radial balloon catheters, which can be endoscopically guided into narrow strictures and inflated, offers an alternative therapy to surgical resection if obstructing lesions. We report the successful management of a pyloric stricture secondary to a caustic ingestion by sequential endoscopically guided balloon dilatations and offer guidelines for the use of this procedure.
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Rashed, Yasser, and Khalid Khalfan. "Button Batteries and High-Powered Neodymium Magnet Ingestion in Children." Open Access Macedonian Journal of Medical Sciences 10, B (January 29, 2022): 357–64. http://dx.doi.org/10.3889/oamjms.2022.8292.
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BACKGROUND: Foreign body ingestions in pediatrics are present highly variably. For each case, it is important to consider the size of the child, the age of the child, the size of the object, and the inherently different risk of different objects ingested. It is important to note that regardless of the type of object, any foreign body should be removed from the esophagus. Over the past decade, the medical literature has particularly identified the potential for morbidity and mortality in cases of button battery and magnet ingestions. AIM: This study aims to describe the complications and how to avoid them in addition to studying the role of early endoscopic intervention in cases of button batteries (BB) and multiple magnets ingestion in children. METHODS: There were 151 children enrolled in the study, classified into two groups. The first group constitutes ninety children with BB, the other group sixty children with multiple magnets ingestion. In addition to one patient with both multiple magnets and battery ingestion, which are extracted endoscopically from the stomach without complication. BB detected in the upper gastrointestinal tract (GIT) in the esophagus, stomach, and duodenum in 70 patients were extracted endoscopically. Other 20 patients where the batteries were detected distal to duodenum were observed till the discharge of batteries was confirmed. In patients with multiple magnets, the magnets were in the upper GIT in 46 patients while found distal to the duodenum in 14 patients. RESULTS: There were 151 children enrolled in the study, classified into two groups. The first group constitutes ninety children with BB, the other group sixty children with multiple magnets ingestion. In addition to one patient with both multiple magnets and battery ingestion, which are extracted endoscopically from the stomach without complication. BB detected in the upper GIT in the esophagus, stomach, and duodenum in 70 patients were extracted endoscopically. Other 20 patients where the batteries were detected distal to duodenum were observed until the discharge of batteries was confirmed. In patients with multiple magnets, the magnets were in the upper GIT in 46 patients while found distal to the duodenum in 14 patients. CONCLUSION: This study put alarm that multiple magnets ingestion carries a high risk of gastrointestinal perforation compared to battery ingestion. Invitation to ban on the sale of products with high-powered neodymium magnets, such as Buckyballs and Buckycubes, and to keep BB difficult reachable by children. In addition to encouraging urgent endoscopic management of suspected BB or multiple magnets ingestion.
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Wu, Weiliang, Zhizhou Chen, Huixuan Zhou, Leiyuyang Wang, Xiang Li, Yuanyuan Lv, Tingting Sun, and Laikang Yu. "Effects of Acute Ingestion of Caffeine Capsules on Muscle Strength and Muscle Endurance: A Systematic Review and Meta-Analysis." Nutrients 16, no. 8 (April 12, 2024): 1146. http://dx.doi.org/10.3390/nu16081146.
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This study aimed to explore the effects of acute ingestion of caffeine capsules on muscle strength and muscle endurance. We searched the PubMed, Web of Science, Cochrane, Scopus, and EBSCO databases. Data were pooled using the weighted mean difference (WMD) and 95% confidence interval. Fourteen studies fulfilled the inclusion criteria. The acute ingestion of caffeine capsules significantly improved muscle strength (WMD, 7.09, p < 0.00001) and muscle endurance (WMD, 1.37; p < 0.00001), especially in males (muscle strength, WMD, 7.59, p < 0.00001; muscle endurance, WMD, 1.40, p < 0.00001). Subgroup analyses showed that ≥ 6 mg/kg body weight of caffeine (WMD, 6.35, p < 0.00001) and ingesting caffeine 45 min pre-exercise (WMD, 8.61, p < 0.00001) were more effective in improving muscle strength, with the acute ingestion of caffeine capsules having a greater effect on lower body muscle strength (WMD, 10.19, p < 0.00001). In addition, the acute ingestion of caffeine capsules had a greater effect in moderate-intensity muscle endurance tests (WMD, 1.76, p < 0.00001). An acute ingestion of caffeine capsules significantly improved muscle strength and muscle endurance in the upper body and lower body of males.
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Mao, Yan-Chiao, Dong-Zong Hung, Chen-Chang Yang, and Jiaan-Der Wang. "Full recovery from a potentially lethal dose of orphenadrine ingestion using conservative treatment: A case report." Human & Experimental Toxicology 29, no. 11 (March 3, 2010): 961–63. http://dx.doi.org/10.1177/0960327110364642.
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Intoxication by orphenadrine is uncommon. The clinical features consist of both central and peripheral anticholinergic effects. Ingestion of 2 to 3 g orphenadrine in an adult has been associated with fatality. A 46-year-old female was brought to our emergency department 1.5 hours after ingesting 40 tablets of 100 mg orphenadrine. She became stuporous 3 hours post-ingestion and developed generalized convulsions 1 hour later. Fifty-five hours post-ingestion, she had recovered and was found to have anterior shoulder dislocation. In addition, severe rhabdomyolysis and persistent nausea were observed. All of the above-noted toxic effects resolved with conservative treatment. Although orphenadrine intoxication can cause convulsions and hemodynamic instability, there is no available antidote and treatment remains supportive.
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Hagley, Michael T., Sheldon M. Traeger, and Hugh Schuckman. "Pronounced Metabolic Response to Modest Theophylline Overdose." Annals of Pharmacotherapy 28, no. 2 (February 1994): 195–96. http://dx.doi.org/10.1177/106002809402800207.
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OBJECTIVE: To describe a patient who developed significant metabolic abnormalities in response to a low-level theophylline ingestion. CASE SUMMARY: An 18-year-old man was examined after ingesting theophylline 3 g in a suicide attempt. Although his peak theophylline concentration was 157 μmol/L (28.2 μg/mL), it was associated with significant leukocytosis, hypokalemia, hypomagnesemia, hypophosphatemia, hyperglycemia, and lactic acidosis. These abnormalities have been previously associated with theophylline intoxication, but only in conjunction with much higher peak concentrations of theophylline. CONCLUSIONS: Significant metabolic abnormalities can occur with suicidal ingestion of relatively small amounts of theophylline. The presence of these abnormalities should be sought in theophylline overdoses. In the proper clinical circumstances, such abnormalities should raise suspicion of covert theophylline ingestion.
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Carr, Amelia J., Gary J. Slater, Christopher J. Gore, Brian Dawson, and Louise M. Burke. "Effect of Sodium Bicarbonate on [HCO3−], pH, and Gastrointestinal Symptoms." International Journal of Sport Nutrition and Exercise Metabolism 21, no. 3 (June 2011): 189–94. http://dx.doi.org/10.1123/ijsnem.21.3.189.
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Context:Sodium bicarbonate (NaHCO3) is often ingested at a dose of 0.3 g/kg body mass (BM), but ingestion protocols are inconsistent in terms of using solution or capsules, ingestion period, combining NaHCO3 with sodium citrate (Na3C6H5O7), and coingested food and fluid.Purpose:To quantify the effect of ingesting 0.3 g/kg NaHCO3 on blood pH, [HCO3−], and gastrointestinal (GI) symptoms over the subsequent 3 hr using a range of ingestion protocols and, thus, to determine an optimal protocol.Methods:In a crossover design, 13 physically active subjects undertook 8 NaHCO3 experimental ingestion protocols and 1 placebo protocol. Capillary blood was taken every 30 min and analyzed for pH and [HCO3−]. GI symptoms were quantified every 30 min via questionnaire. Statistics used were pairwise comparisons between protocols; differences were interpreted in relation to smallest worthwhile changes for each variable. A likelihood of >75% was a substantial change.Results:[HCO3−] and pH were substantially greater than in placebo for all other ingestion protocols at almost all time points. When NaHCO3 was coingested with food, the greatest [HCO3−] (30.9 mmol/kg) and pH (7.49) and lowest incidence of GI symptoms were observed. The greatest incidence of GI side effects was observed 90 min after ingestion of 0.3 g/kg NaHCO3 solution.Conclusions:The changes in pH and [HCO3−] for the 8 NaHCO3-ingestion protocols were similar, so an optimal protocol cannot be recommended. However, the results suggest that NaHCO3 coingested with a high-carbohydrate meal should be taken 120–150 min before exercise to induce substantial blood alkalosis and reduce GI symptoms.
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Wadhwa, Chhavi, Shibumon Madhavan, Alfred J. Augustine, Suresh Shenoy, and Abid Mirza. "The “mule” with golden eggs: Retrieval of unusual foreign body." Journal of Digestive Endoscopy 06, no. 02 (April 2015): 079–80. http://dx.doi.org/10.4103/0976-5042.159247.
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AbstractForeign body ingestions often consist of benign objects that will readily pass through the gastrointestinal (GI) tract without necessitating further intervention. There are various reports in the literature about intentional ingestion of foreign bodies in prisoners and body packers, which required intervention. We present a case of 44-year-old male with a history of intentional ingestion of 30 gold pellets as a carrier from Dubai to India. The pellets were successfully retrieved by upper GI endoscopy after 1-week of observation and unsuccessful attempts of conservative trial. There have been many foreign body extractions but gold retrieval has been a rare case.
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Lin, Anna, Lawrence Chi Ngong Chan, Kam Lun Ellis Hon, Siu Yan Bess Tsui, Kristine Kit Yi Pang, Hon Ming Cheung, and Alexander K. C. Leung. "Magnetic Foreign Body Ingestion in Children: The Attractive Hazards." Case Reports in Pediatrics 2019 (April 28, 2019): 1–4. http://dx.doi.org/10.1155/2019/3549242.
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Foreign body ingestions are frequent in the childhood population. Most foreign bodies are passed spontaneously through the gastrointestinal tract. However, on occasion, they can also be a rare cause of morbidity and even mortality, such as in the case of multiple magnetic foreign body ingestion, which can cause injury via magnetic attraction through bowel walls. We present two cases of multiple magnetic foreign body ingestion, which to our knowledge are the first ones reported in Hong Kong. One patient presented with shock and intestinal necrosis requiring extensive intestinal resection, whereas the other patient had no gastrointestinal injury but surgical removal was deemed necessary.
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Bulna, Amber, and Amanda C. Fifi. "Endoscopic Evaluation for Stricture Formation Post Button Battery Ingestion." Pediatric Reports 13, no. 3 (September 1, 2021): 511–19. http://dx.doi.org/10.3390/pediatric13030059.
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Every year, there are over 3300 ingestions of button batteries, mostly by young children. Initial presentation of button battery ingestion may be nonspecific, with a delay in diagnosis and removal resulting in increased risk of complications. We present the case of a five-year-old female who presented with vomiting following unwitnessed button battery ingestion. The battery was impacted in the middle esophagus for at least six hours. Endoscopy was performed for immediate removal and showed a Grade 2B erosion, warranting nasogastric tube placement. The patient remained asymptomatic following discharge and had a barium swallow that was read as normal. However, a repeat endoscopy one month later visualized stricture formation at the previous battery injury site. This case highlights the importance of both clinician and parent awareness of button battery ingestion and demonstrates that endoscopy provides the most accurate assessment of esophageal injury and complication development, even in asymptomatic patients.
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Raffa, Brittany J., Samantha Schilling, M. Katherine Henry, Victor Ritter, Colleen E. Bennett, Jeannie S. Huang, and Natalie Laub. "Ingestion of Illicit Substances by Young Children Before and During the COVID-19 Pandemic." JAMA Network Open 6, no. 4 (April 21, 2023): e239549. http://dx.doi.org/10.1001/jamanetworkopen.2023.9549.
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ImportanceInformation about the trend in illicit substance ingestions among young children during the pandemic is limited.ObjectivesTo assess immediate and sustained changes in overall illicit substance ingestion rates among children younger than 6 years before and during the COVID-19 pandemic and to examine changes by substance type (amphetamines, benzodiazepines, cannabis, cocaine, ethanol, and opioids) while controlling for differing statewide medicinal and recreational cannabis legalization policies.Design, Setting, and ParticipantsRetrospective cross-sectional study using an interrupted time series at 46 tertiary care children’s hospitals within the Pediatric Health Information System (PHIS). Participants were children younger than 6 years who presented to a PHIS hospital for an illicit substance(s) ingestion between January 1, 2017, and December 31, 2021. Data were analyzed in February 2023.ExposureAbsence or presence of the COVID-19 pandemic.Main Outcome(s) and Measure(s)The primary outcome was the monthly rate of encounters for illicit substance ingestions among children younger than 6 years defined by International Statistical Classification of Diseases, Tenth Revision, Clinical Modification diagnosis code(s) for poisoning by amphetamines, benzodiazepines, cannabis, cocaine, ethanol, and opioids. The secondary outcomes were the monthly rate of encounters for individual substances.ResultsAmong 7659 children presenting with ingestions, the mean (SD) age was 2.2 (1.3) years and 5825 (76.0%) were Medicaid insured/self-pay. There was a 25.6% (95% CI, 13.2%-39.4%) immediate increase in overall ingestions at the onset of the pandemic compared with the prepandemic period, which was attributed to cannabis, opioid, and ethanol ingestions. There was a 1.8% (95% CI, 1.1%-2.4%) sustained monthly relative increase compared with prepandemic trends in overall ingestions which was due to opioids. There was no association between medicinal or recreational cannabis legalization and the rate of cannabis ingestion encounters.Conclusions and RelevanceIn this study of illicit substance ingestions in young children before and during the COVID-19 pandemic, there was an immediate and sustained increase in illicit substance ingestions during the pandemic. Additional studies are needed to contextualize these findings in the setting of pandemic-related stress and to identify interventions to prevent ingestions in face of such stress, such as improved parental mental health and substance treatment services, accessible childcare, and increased substance storage education.
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Lent, C. M., K. H. Fliegner, E. Freedman, and M. H. Dickinson. "Ingestive behaviour and physiology of the medicinal leech." Journal of Experimental Biology 137, no. 1 (July 1, 1988): 513–27. http://dx.doi.org/10.1242/jeb.137.1.513.
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Ingestion lasts 25 min in Hirudo medicinalis and is characterized by pharyngeal peristalsis which fills the crop. This peristalsis has an initial rate of 2.4 Hz which decays smoothly to 1.2 Hz at termination of ingestion. During ingestion, the leech body wall undergoes peristalsis which appears to aid in filling the crop diverticula. Body peristalsis begins at a rate of 10 min-1 and decreases linearly to 2 min-1 at termination. The body also undergoes dorsoventral flexions when blood flow is occluded. Blood meal size increases slightly with leech size: 8.4 g for 1-g leeches and 9.7 g for 2-g leeches. However, relative meal size decreases markedly with increasing animal size; from 8.15 times body mass for 1-g to 4.80 times for 2-g leeches. When intact leeches were exposed to micromolar concentrations of serotonin, there was an increase in the rate of pharyngeal peristalsis and the size of the blood meals. Leeches excrete the plasma from their ingested blood meals. Excretion is activated during ingestion, which increases feeding efficiency by increasing the proportion of blood cells in the ingestate. Excretion continues for 4–6 days following ingestion, removing all the remaining plasma from the ingestate. Leech ingestion comprises stereotyped muscular movements, secretion of saliva and excretion of plasma. A strikingly similar feeding physiology is seen in the blood-sucking insect Rhodnius, and we suggest that efficient sanguivory may require the convergent evolution of similar ingestive mechanisms.
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Jeukendrup, Asker E., Luke Moseley, Gareth I. Mainwaring, Spencer Samuels, Samuel Perry, and Christopher H. Mann. "Exogenous carbohydrate oxidation during ultraendurance exercise." Journal of Applied Physiology 100, no. 4 (April 2006): 1134–41. http://dx.doi.org/10.1152/japplphysiol.00981.2004.
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The purposes of this study were: 1) to obtain a measure of exogenous carbohydrate (CHOExo) oxidation and plasma glucose kinetics during 5 h of exercise; and 2) to compare CHOExo following the ingestion of a glucose solution (Glu) or a glucose + fructose solution (2:1 ratio, Glu+Fru) during ultraendurance exercise. Eight well-trained subjects exercised three times for 5 h at 58% maximum O2 consumption while ingesting either Glu or Glu+Fru (both delivering 1.5 g/min CHO) or water. The CHO used had a naturally high 13C enrichment, and five subjects received a primed continuous intravenous [6,6-2H2]glucose infusion. CHOExo rates following the ingestion of Glu leveled off after 120 min and peaked at 1.24 ± 0.04 g/min. The ingestion of Glu+Fru resulted in a significantly higher peak rate of CHOExo (1.40 ± 0.08 g/min), a faster rate of increase in CHOExo, and an increase in the percentage of CHOExo oxidized (65–77%). However, the rate of appearance and disappearance of Glu continued to increase during exercise, with no differences between trials. These data suggest an important role for gluconeogenesis during the later stages of exercise. Following the ingestion of Glu+Fru, cadence (rpm) was maintained, and the perception of stomach fullness was reduced relative to Glu. The ingestion of Glu+Fru increases CHOExo compared with the ingestion of Glu alone, potentially through the oxidation of CHOExo in the liver or through the conversion to, and oxidation of, lactate.
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Jayakumar P, Selvakumar M, Meenakshi Sundari S, and Rock Britto D. "Foreign body ingestion in children and their follow-up in a tertiary care hospital – A prospective study." Asian Journal of Medical Sciences 14, no. 5 (May 1, 2023): 182–85. http://dx.doi.org/10.3126/ajms.v14i5.53248.
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Background: Foreign body (FB) ingestion is a common pediatric surgery emergency, with potential complications such as perforation, obstruction, and bleeding. The demographics, characteristics, and management of these cases can vary based on factors such as age, gender, and type of FB ingested. Aims and Objectives: This study aimed to analyze these factors in a prospective study of children with FB ingestion. Materials and Methods: This was a prospective observational study done under 13 years of age with FB ingestion who presented to a tertiary care hospital over a period of 15 months. Results: A total of 133 cases were included, with a mean age of 6.15 years and a higher prevalence in males (60.2%). The most common age group affected was 5–13 years (50.4%). The mean length of ingested FB was 2.77 cm, with 52.6% of cases ingesting FBs >2 cm. The majority of FBs were blunt (92.5%) and circular in shape (61.7%). The primary reason for ingestion was playing (95.5%). The most common site of FB impaction was the intestine (50.4%). Most cases were managed by observation(93.2%). Conclusion: FB ingestion is a common pediatric emergency, with a higher prevalence in males. Most cases can be managed by observation, and endoscopic removal or PR may be required in a small proportion of cases. Awareness of the risk factors and clinical presentation of FB ingestion can aid in prompt diagnosis and management of these cases.
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Wong, Helen H. L., and Bruce A. Phillips. "Opposites attract: a case of magnet ingestion." CJEM 11, no. 05 (September 2009): 493–95. http://dx.doi.org/10.1017/s1481803500011696.
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ABSTRACT Foreign-body ingestion is relatively common in the pediatric population and most objects pass through the gastrointestinal tract with minimal complications. Popular toy magnetic construction sets have resulted in numerous reports in the literature of serious complications including death following ingestion of multiple magnets. We report a case of a 5-year-old girl who presented to our emergency department with nonbilious vomiting and mild abdominal pain after accidentally ingesting 2 magnets 10 hours apart. Abdominal radiography showed the presence of 2 magnets, and a laparoscopy revealed multiple areas of bowel wall necrosis and perforation requiring subsequent laparotomy for repair of the bowel wall and retrieval of the magnets. This report aims to alert emergency care physicians of the necessity for early surgical referral with any multiple magnet ingestion to prevent severe complications.
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Abou Sawan, Sidney, Stephan van Vliet, Daniel W. D. West, Joseph W. Beals, Scott A. Paluska, Nicholas A. Burd, and Daniel R. Moore. "Whole egg, but not egg white, ingestion induces mTOR colocalization with the lysosome after resistance exercise." American Journal of Physiology-Cell Physiology 315, no. 4 (October 1, 2018): C537—C543. http://dx.doi.org/10.1152/ajpcell.00225.2018.
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We have recently demonstrated that whole egg ingestion induces a greater muscle protein synthetic (MPS) response when compared with isonitrogenous egg white ingestion after resistance exercise in young men. Our aim was to determine whether whole egg or egg white ingestion differentially influenced colocalization of key regulators of mechanistic target of rapamycin complex 1 (mTORC1) as means to explain our previously observed divergent postexercise MPS response. In crossover trials, 10 healthy resistance-trained men (21 ± 1 yr; 88 ± 3 kg; body fat: 16 ± 1%; means ± SE) completed lower body resistance exercise before ingesting whole eggs (18 g protein, 17 g fat) or egg whites (18 g protein, 0 g fat). Muscle biopsies were obtained before exercise and at 120 and 300 min after egg ingestion to assess, by immunofluorescence, protein colocalization of key anabolic signaling molecules. After resistance exercise, tuberous sclerosis 2-Ras homolog enriched in brain (Rheb) colocalization decreased ( P < 0.01) at 120 and 300 min after whole egg and egg white ingestion with concomitant increases ( P < 0.01) in mTOR-Rheb colocalization. After resistance exercise, mTOR-lysosome-associated membrane protein 2 (LAMP2) colocalization significantly increased at 120 and 300 min only after whole egg ingestion ( P < 0.01), and mTOR-LAMP2 colocalization correlated with rates of MPS at rest and after exercise ( r = 0.40, P < 0.05). We demonstrated that the greater postexercise MPS response with whole egg ingestion is related in part to an enhanced recruitment of mTORC1-Rheb complexes to the lysosome during recovery. These data suggest nonprotein dietary factors influence the postexercise regulation of mRNA translation in human skeletal muscle.
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Nakamura, Sadako, Kenichi Tanabe, Misa Yamate, Sanae Osada, and Tsuneyuki Oku. "Trial of Available Energy Evaluation of Highly Cross-linked Starch and Modified Cellulose Based on Breath H2 Excretion." Current Nutrition & Food Science 16, no. 5 (July 14, 2020): 794–801. http://dx.doi.org/10.2174/1573401315666190723145558.
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Background: The energy value of a substance is essential in nutritional labeling. However, the available energy of newly developed highly cross-linked phosphate starch (HCPS-N) and modified cellulose (MC) are unknown. Objective: To evaluate the available energy of HCPS-N and MC, an indirect and simple method which was applied as an indicator of the fermentability based on the breath hydrogen excretion, was used. Methods: HCPS-N was made from tapioca starch by polymerization in the presence of 0.5% phosphoric acid. MC was made from microcrystalline cellulose, maltodextrin, and karaya gum to attain a highly stable suspension. The present study was carried out using a within-subject, repeatedmeasures design. Blood was collected at 30 min intervals for 3 h after the ingestion of 30 g of a test substance. The end-respiratory gas was collected for 14 h after ingestion of 5 g of a test substance to evaluate the available energy. Results and Discussion: Plasma glucose and insulin levels did not elevate after the ingestion of HCPS-N, although they increased significantly after glucose ingestion. In the experiments to evaluate the available energy, breath hydrogen excretion after ingesting HCPS-N did not increase distinctly during the experiment. Breath hydrogen excretion after preceding HCPS-P (0 kcal) ingestion was also markedly smaller compared with the peak value at 4 h after FOS ingestion. For the ingestion of MC, breath hydrogen excretion increased scarcely, and the basal level remained until the end of the experiment. Conclusion: The available energies were evaluated to be 0 kcal/g for HCPS-N and 1 kcal/g for MC in healthy humans.
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Albretsen, Jay C., Safdar A. Khan, and Jill A. Richardson. "Cycad palm toxicosis in dogs: 60 cases (1987-1997)." Journal of the American Veterinary Medical Association 213, no. 1 (July 1, 1998): 99–101. http://dx.doi.org/10.2460/javma.1998.213.01.99.
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Objective To report clinical and epidemiologic information, summarize characteristic clinical signs and laboratory results, and describe the expected course of cycad toxicosis in dogs. Design Retrospective study. Animals 60 dogs with evidence of cycad ingestion. Procedure The National Animal Poison Control Center's case record database was searched for records of dogs ingesting cycad plants from January 1987 to November 1997. Data were retrieved on clinical signs, laboratory test results, exposure history, and physical examination findings. Cases were assessed as toxicosis, suspected toxicosis, or possible toxicosis. Results Records from 60 dogs were retrieved; 89.7% of the dogs were from the southern United States, 38.7% ingested seeds, 95% developed liver and gastrointestinal tract problems, and 53.3% had abnormal neurologic signs. High serum bilirubin concentration and alkaline phosphatase and alanine aminotransferase activities were the most common serum biochemical abnormalities. Although clinical signs were observed within 1 day, laboratory values did not change for 24 to 48 hours after cycad ingestion. Mortality rate was reportedly 32.1 %. Clinical Implications 68% of dogs responded well to treatment and supportive care. Dogs ingesting seeds are likely to develop more serious problems. Clinical signs can develop within 1 to 3 days and can last for several days. A tentative diagnosis should be made on the basis of history of ingestion, clinical signs, and duration of signs. Because of the nature of these toxins, cycad ingestion is serious and should be treated aggressively. (J Am Vet Med Assoc 1998;213:99-101)
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Reidy, P. T., D. K. Walker, J. M. Dickinson, D. M. Gundermann, M. J. Drummond, K. L. Timmerman, M. B. Cope, et al. "Soy-dairy protein blend and whey protein ingestion after resistance exercise increases amino acid transport and transporter expression in human skeletal muscle." Journal of Applied Physiology 116, no. 11 (June 1, 2014): 1353–64. http://dx.doi.org/10.1152/japplphysiol.01093.2013.
Full textAbstract:
Increasing amino acid availability (via infusion or ingestion) at rest or postexercise enhances amino acid transport into human skeletal muscle. It is unknown whether alterations in amino acid availability, from ingesting different dietary proteins, can enhance amino acid transport rates and amino acid transporter (AAT) mRNA expression. We hypothesized that the prolonged hyperaminoacidemia from ingesting a blend of proteins with different digestion rates postexercise would enhance amino acid transport into muscle and AAT expression compared with the ingestion of a rapidly digested protein. In a double-blind, randomized clinical trial, we studied 16 young adults at rest and after acute resistance exercise coupled with postexercise (1 h) ingestion of either a (soy-dairy) protein blend or whey protein. Phenylalanine net balance and transport rate into skeletal muscle were measured using stable isotopic methods in combination with femoral arteriovenous blood sampling and muscle biopsies obtained at rest and 3 and 5 h postexercise. Phenylalanine transport into muscle and mRNA expression of select AATs [system L amino acid transporter 1/solute-linked carrier (SLC) 7A5, CD98/SLC3A2, system A amino acid transporter 2/SLC38A2, proton-assisted amino acid transporter 1/SLC36A1, cationic amino acid transporter 1/SLC7A1] increased to a similar extent in both groups ( P < 0.05). However, the ingestion of the protein blend resulted in a prolonged and positive net phenylalanine balance during postexercise recovery compared with whey protein ( P < 0.05). Postexercise myofibrillar protein synthesis increased similarly between groups. We conclude that, while both protein sources enhanced postexercise AAT expression, transport into muscle, and myofibrillar protein synthesis, postexercise ingestion of a protein blend results in a slightly prolonged net amino acid balance across the leg compared with whey protein.
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Abraham, Benjamin, and Adekola O. Alao. "An Unusual Foreign Body Ingestion in a Schizophrenic Patient: Case Report." International Journal of Psychiatry in Medicine 35, no. 3 (September 2005): 313–18. http://dx.doi.org/10.2190/7ae8-3av0-w3ua-tkv4.
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The topic of foreign body ingestion has received extensive coverage in the areas of surgery, emergency medicine, and pediatrics. A subset of this topic, the intentional ingestion of foreign bodies, however, is much less common, and requires special evaluation and management. Here, we report a case of ingestion of a rolled, metal tuna can lid in a male prison inmate previously diagnosed with depression and paranoid schizophrenia. Following evaluation by the surgical team, the foreign body was removed by laparotomy and the patient was discharged back to the prison without complication. In many cases, ingestions of this type involve a command hallucination ordering the patient to swallow the foreign body. Interestingly, the patient in the present case reported auditory hallucinations commanding him not to swallow the can lid. On further investigation, we found that patient had a proclivity toward this swallowing behavior even prior to his incarceration. Early identification of inmates with this proclivity has important implications for treatment and prevention.
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Khan, Saleemullah. "Hair Dye (Kala-Pathar) Poisoning- A Lethal Toxin with Fatal Outcomes." ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 27, no. 03 (August 31, 2022): 71–72. http://dx.doi.org/10.58397/ashkmdc.v27i03.606.
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Seventy-three percent of suicides in the world occur in developing countries1. It is the third heavy cause of death in 15-44 years age-bracket2. In Southeast Asian countries, the practice of self-harm with poison ingestion is exceedingly common. Although pesticide poisoning being the most common, there has been an alarming increase in hair-dye ingestion in lower income countries like Pakistan, Bangladesh, Sri Lanka and India. The use of so-called Kala-Pathar aka Paraphenylenediamine (PPD) in making hair color is by and large confined to emerging nations specifically and is exceptionally rare in western world because of strict usage guidelines. On the contrary, the commonness of unintentional and self-destructive ingestion is more found in low financial regions where it is arising as a typical method for self-destruction especially Africa and Asia3. In our locale, Pakistan, reports have been received and recorded generally from Sindh and Punjab detailing the clinical signs and symptoms after (PPD) containing hair color ingestion4.
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Kashima, Hideaki, Saori Kamimura, Ayumi Honma, Masako Yamaoka Endo, Akira Miura, Toshio Kobayashi, and Yoshiyuki Fukuba. "Timing of Nutrient Ingestion after Mild to Moderate Cycling Exercise Does Not Affect Gastric Emptying Rate in Humans." Nutrients 12, no. 7 (July 17, 2020): 2118. http://dx.doi.org/10.3390/nu12072118.
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This study examined the effect of carbohydrate drink ingestion timing on gastrointestinal tract blood flow and motility after mild cycling exercise. Eight healthy participants were randomly assigned to ingest a liquid solution with 75 g glucose at either 5 min (PE-5) or 30 min (PE-30) after a single bout of leg cycling exercise according to target heart rate (approximately 120 beats/min). As the control trial (Con), participants ingested the same liquid solution without exercise. Celiac artery blood flow (BF), superior mesenteric artery BF, and gastric emptying rate were assessed by ultrasonography before and for 60 min after ingesting the glucose solution. Blood lactate, glucose, and plasma insulin were also measured at baseline and for 60 min after ingesting the glucose solution. Celiac artery BF significantly decreased from resting baseline immediately after exercise in both the PE-5 and PE-30 trials, and then returned to resting baseline just before the ingestion of glucose solution in the PE-30 trial. After ingesting the glucose solution, changes in celiac artery BF, superior mesenteric artery BF, % gastric emptying rate, blood lactate, blood glucose, and plasma insulin were not significantly different among the three trials. The timing of nutrient ingestion after mild exercise does not seem to impact the subsequent gastrointestinal motility, blood flow, and glycemic responses.