Unexpected Barium Aspiration.

A barium esophagram is a diagnostic test used for the evaluation of dysphagia. However, this test has the potential risk for aspiration of the barium contrast. Barium aspiration typically localizes to the right lower lobe or left lingular lobe. We present a case of barium aspiration localized to the right middle lobe that persisted on chest X-ray. A 62-year-old male with a past medical history of hypertension, long-term back pain, gastritis, and anxiety presented with the complaints of hoarseness of voice, dysphagia, and weight loss for several months. During the esophagram, the patient aspirated the barium contrast. Chest X-ray confirmed the aspiration in the right middle lobe with a tree in bud appearance suggesting involvement of bronchioles. Three months later, a repeat chest X-ray revealed residual contrast. Pulmonary complications are directly related to the amount of aspirated barium and can include hypoxia, respiratory failure, secondary aspiration pneumonia, shock, and acute respiration distress syndrome. The prognosis of a barium aspiration is dependent on the amount of barium aspirated.

Barium-induced toxic anterior segment syndrome.

Toxic anterior segment syndrome (TASS) is a rapid-onset inflammation of the eye following uneventful ocular surgery. We report a case of TASS following Baerveldt glaucoma implant (BGI) surgery. Inductively coupled plasma-mass spectrometry (ICP-MS) identified barium in the eye and in the eluate from the bleb of the BGI. We attribute TASS in our patient to the dissolution of barium from the BGI and its entry into the eye, where it causes severe inflammation.

The Effects of Gunshot Residue Components (Pb, Ba, and Sb) on the Life History Traits of Lucilia sericata (Diptera: Calliphoridae).

The present study aimed to investigate the impact of gunshot residue (GSR) components (Pb, Sb, and Ba) on the life history parameters of Lucilia sericata (Meigen, 1826) (Diptera: Calliphoridae). This experiment was carried out at the Zoology Department, the Ondokuz Mayis University in 2020. About 50 larvae, respectively were exposed to the chicken liver with four different concentrations of GSR particles and life history parameters recorded. A two-way analysis of variance (Two way ANOVA) was used on the larval weight, and length, development time, percentage of pupal and larval survival. Pearson's correlation coefficient was used to assess the association between life-history parameters and the concentration of GSR. The total development times decreased with increasing Sb, Ba, and Pb concentrations in the diets 1-3 d when compared to the control The results showed that Ba and Sb significantly decreased larval and pupal survival and GSR decreased the pupa and adult weight as compared to the control. We concluded that life-history parameters of L. sericata are sensitive to GSR residue and heavy metal changes in the environment. The presence of gunshot residue in the corpse should be kept in mind in a criminal investigation.

A Need for a Diagnostic Management Protocol in Barium Aspiration.

We experienced a patient who presented with lung abscess one month after aspirating barium during a gastric cancer screening examination. The patient had no subjective symptoms suggesting a swallowing disorder. Rigorous history taking under suspicion of aspiration and a further assessment of the cause of aspiration revealed hypopharyngeal cancer. Lung abscess and hypopharyngeal cancer, both treatable but potentially fatal conditions, were not diagnosed until one month after the aspiration. This highlights the need for guidance for patients and physicians to follow in the event of barium aspiration, as it is the most common complication of a barium examination. A health checkup for one condition (gastric cancer) may also be an opportunity to diagnose another underlying condition.

An unwitnessed case of foreign body aspiration of barium from an unknown source.

Foreign body (FB) aspiration is potentially life-threatening in children. A variety of sources and objects have been noted in aspiration events with possible complications ranging from mild to life-threatening. While rare, barium aspiration can cause severe complications, and removal is particularly challenging. Complications of retained barium include acute respiratory distress syndrome, pneumonitis, sepsis, even death. Regardless of the foreign body's identity, substance removal is critical in management. Resourcefulness of removal techniques and an interdisciplinary approach may allow for maximally effective management. We present a case of a pediatric barium aspiration from an unknown source and review evaluation and management strategies.

Neumonitis por aspiración de contraste de bario / Barium contrast aspiration pneumonitis

No disponible

Forensic tracers of exposure to produced water in freshwater mussels: a preliminary assessment of Ba, Sr, and cyclic hydrocarbons.

Hydraulic fracturing is often criticized due in part to the potential degradation of ground and surface water quality by high-salinity produced water generated during well stimulation and production. This preliminary study evaluated the response of the freshwater mussel, Elliptio complanata, after exposure to produced water. A limited number of adult mussels were grown over an 8-week period in tanks dosed with produced water collected from a hydraulically fractured well. The fatty tissue and carbonate shells were assessed for accumulation of both inorganic and organic pollutants. Ba, Sr, and cyclic hydrocarbons indicated the potential to accumulate in the soft tissue of freshwater mussels following exposure to diluted oil and gas produced water. Exposed mussels showed accumulation of Ba in the soft tissue several hundred times above background water concentrations and increased concentrations of Sr. Cyclic hydrocarbons were detected in dosed mussels and principle component analysis of gas chromatograph time-of-flight mass spectrometer results could be a novel tool to help identify areas where aquatic organisms are impacted by oil and gas produced water, but larger studies with greater replication are necessary to confirm these results.

Unusual focal opacities in the lungs.

[No Abstract Available].

Low-keV and Low-kVp CT for Positive Oral Contrast Media in Patients with Cancer: A Randomized Clinical Trial.

Background Substantial gain in the attenuation of iodine on low-kVp and dual-energy CT processed low-keV virtual monochromatic images provides an opportunity for customization of positive oral contrast media administration. Purpose To perform an intrapatient comparison of bowel labeling, opacification, and taste preference with iodinated oral contrast medium (ICM) in standard (sICM) and 25%-reduced (rICM) concentrations at low tube voltage (100 kVp) or on low-energy (50-70 keV) virtual monochromatic images compared with barium-based oral contrast medium (BCM) at 120 kVp. Materials and Methods In this prospective clinical trial, 200 adults (97 men, 103 women; mean age, 63 years ± 13 [standard deviation]) who weighed less than 113 kg and who were undergoing oncologic surveillance (from April 2017 to July 2018) and who had previously undergone 120-kVp abdominopelvic CT with BCM randomly received sICM (7.2 g iodine) or rICM (5.4 g iodine) and underwent 100-kVp CT or dual-energy CT (80/140 kVp) scans to be in one of four groups (n = 50 each): sICM/100 kVp, rICM/100 kVp, sICM/dual-energy CT, and rICM/dual-energy CT. Qualitative analysis was performed for image quality (with a five-point scale), extent of bowel labeling, and homogeneity of opacification (with a four-point scale). Intraluminal attenuation of opacified small bowel was measured. A post-CT patient survey was performed to indicate contrast medium preference, taste of ICM (with a five-point scale), and adverse effects. Data were analyzed with analogs of analysis of variance. Results All CT studies were of diagnostic image quality (3.4 ± 0.3), with no difference in the degree of bowel opacification between sICM and rICM (P > .05). Compared with BCM/120 kVp (282 HU ± 73), mean attenuation was 78% higher with sICM/100 kVp (459 HU ± 282) and 26%-121% higher at sICM/50-65 keV (50 keV = 626 HU ± 285; 65 keV = 356 HU ± 171). With rICM, attenuation was 46% higher for 100 kVp (385 HU ± 215) and 19%-108% higher for 50-65 keV (50 keV = 567 HU ± 270; 65 keV = 325 HU ± 156) compared with BCM (P < .05). A total of 171 of 200 study participants preferred ICM to BCM, with no taste differences between sICM and rICM (3.9 ± 0.6). Fifteen participants had diarrhea with BCM, but none had diarrhea with ICM. Conclusion A 25%-reduced concentration of iodinated oral contrast medium resulted in acceptable bowel labeling while yielding substantially higher luminal attenuation at low-kVp and low-keV CT examinations with improved preference in patients undergoing treatment for cancer. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Laghi in this issue.

Phytoremediation of barium-affected flooded soils using single and intercropping cultivation of aquatic macrophytes.

Aquatic macrophytes are potentially useful for phytoremediation on flooded areas. A field study in Brazil was conducted to evaluate Eleocharis acutangula (E), Cyperus papyrus (C) and Typha domingensis (T) in monocropping and intercropping, aiming to phytoremediate barium-polluted flooded soils. The treatments were: monocroppings (E, C and T); double intercroppings (EC, ET and CT); and triple intercropping (ECT). The 180-d field trial was performed in a flooded area with high barium content, with a randomized complete block design and three replicates. Plant stand size, biomass yield, and Ba concentration aboveground/Ba concentration in roots (translocation factor - TF) as well as Ba mass aboveground/Ba mass in roots (mass translocation factor - mTF) were determined. Most of the treatments did not differ on dry biomass, except for EC, which showed the lowest yield. Consistently with its biology, E. acutangula in monocropping showed the largest plant stand. Otherwise, intercroppings with T. domingensis achieved the highest amounts of barium absorbed from the soil and transferred most of the barium content from belowground to aboveground (mTF > 1.0), especially ET, which showed the highest mTF among the intercroppings (2.03). Remarkably, TF values did not reflect such phytoextraction ability for CT and ECT. Thus, mTF was more appropriate than TF to assess phytoextraction capacity. Furthermore, it was demonstrated that intercropping can increase barium uptake from flooded soils. Particularly, the intercropping ET constituted the most cost-effective treatment, with the cyperaceous species providing high plant coverage while T. domingensis facilitated barium removal by translocating it to the aboveground biomass.

Zinc and selenium modulate barium-induced oxidative stress, cellular injury and membrane-bound ATPase in the cerebellum of adult rats and their offspring during late pregnancy and early postnatal periods.

CONTEXT: Barium (Ba) may induce oxidative stress leading to tissues injury. OBJECTIVE: Our study investigated the therapeutic efficiency of zinc (Zn) and selenium (Se) against neurotoxicity induced by Ba in adult rats and their progeny. MATERIAL AND METHODS: Pregnant rats are exposed either to Ba (67 ppm), Ba + Zn, Ba + S or to only Zn and Se. RESULTS: In Ba-treated rats, there was an increase of MDA, H2O2, AOPP levels and SOD activity in the cerebellum of dams and their pups, a decrease in GPx, CAT, AChE, Na+K+-ATPase and Mg2+-ATPase activities, GSH and NPSH levels. These changes were confirmed by histological damages. Co-administration of Zn or Se to Ba-treated rats ameliorated the biochemical and histological aspects. CONCLUSION: Our results revealed that Zn and Se have shown promising effects against Ba toxicity in the cerebellum of adult rats and their suckling pups.

Liver Abscess and Portal Vein Thrombosis Due to Ileal Diverticulitis Mediated by Barium Fluoroscopy.

We report a case of liver abscess and portal vein thrombosis, which occurred due to diverticulitis at the terminal ileum in a 59-year-old man. The patient underwent a barium fluoroscopic examination 1 month before presenting to our hospital. He also showed liver dysfunction due to thrombosis at the superior mesenteric and portal veins. His inflammation gradually subsided after the initiation of treatment, but the recovery was not sufficient. Thus, surgery was performed. The patient condition improved after surgery and he was discharged. Barium examinations are relatively safe, but can sometimes cause severe adverse effects in patients with certain risk factors, and an appropriate diagnosis and treatment are necessary when symptoms appear.

Research on Hygiene Based on Fieldwork and Experimental Studies.

Several experimental studies on hygiene have recently been performed and fieldwork studies are also important and essential tools. However, the implementation of experimental studies is insufficient compared with that of fieldwork studies on hygiene. Here, we show our well-balanced implementation of both fieldwork and experimental studies of toxic-element-mediated diseases including skin cancer and hearing loss. Since the pollution of drinking well water by toxic elements induces various diseases including skin cancer, we performed both fieldwork and experimental studies to determine the levels of toxic elements and the mechanisms behind the development of toxic-element-related diseases and to develop a novel remediation system. Our fieldwork studies in several countries including Bangladesh, Vietnam and Malaysia demonstrated that drinking well water was polluted with high concentrations of several toxic elements including arsenic, barium, iron and manganese. Our experimental studies using the data from our fieldwork studies demonstrated that these toxic elements caused skin cancer and hearing loss. Further experimental studies resulted in the development of a novel remediation system that adsorbs toxic elements from polluted drinking water. A well-balanced implementation of both fieldwork and experimental studies is important for the prediction, prevention and therapy of toxic-element-mediated diseases.

[A Case of Small Intestinal Metastasis with Intussusception Due to Barium].

A 48-year-old man noticed nausea and took health examination. After chest X-ray and gastrointestinal barium study was underwent, he was referred to our hospital because of abnormal shadow in the chest X-ray. CT scan revealed about 4 cm tumor in the hilum of left lung and target sign in the small intestine. He was diagnosed with intussusception and emergency operation was performed. During the laparotomy, we found 2 intussusceptions in the small intestine and we performed manual reduction using Hutchinson's maneuver. We confirmed the mass in oral side of the intussusception site but we did not confirmed any tumor in anal of the intussusception. This suggests the intussusception was caused by barium. Finally 3 small intestine tumor was observed and we resected and reconstructed each of the tumor. Histopathological examination showed small intestinal metastasis from pleomorphic carcinoma of the lung.

The Association Between Barium Examination and Subsequent Appendicitis: A Nationwide Population-Based Study.

OBJECTIVE: The incidence and association between appendicitis and barium examination (BE) remain unclear. Such potential risk may be omitted. We conducted a longitudinal, nationwide, population-based cohort study to investigate the association between BE and appendicitis risk. METHODS: From the Taiwan National Health Insurance Research Database, a total of 24,885 patients who underwent BE between January 1, 2000 and December 31, 2010 were enrolled in a BE cohort; an additional 98,384 subjects without BE exposure were selected as a non-BE cohort, matched by age, sex, and index date. The cumulative incidences of subsequent appendicitis in the BE and non-BE cohorts were assessed using the Kaplan-Meier curves and log-rank test. Cox proportional hazards regression analyses were employed to calculate the appendicitis risk between the groups. RESULTS: The cumulative incidence of appendicitis was higher in the BE cohort than in the non-BE cohort (P = .001). The overall incidence rates of appendicitis for the BE and non-BE cohorts were 1.19 and 0.80 per 1000 person-years, respectively. After adjustment for sex, age, and comorbidities, the risk of appendicitis was higher in the BE cohort (adjusted hazard ratio = 1.46, 95% confidence interval = 1.23-1.73) compared with the non-BE cohort, especially in the first 2 months (adjusted hazard ratio = 9.72, 95% confidence interval = 4.65-20.3). CONCLUSIONS: BE was associated with an increased, time-dependent appendicitis risk. Clinicians should be aware of this potential risk to avoid delayed diagnoses.