VIDEOFLUOROSCOPIC EVALUATION OF THE IMPACT OF CAPSULE SIZE AND SUBJECT'S AGE AND GENDER ON CAPSULE SWALLOWING.

BACKGROUND: People recurrently have difficulties swallowing solid medications, which can be associated with the size of the medication and the age and gender of individuals. OBJECTIVE: To evaluate the impact of capsule size and adults' age and gender on oral and pharyngeal capsule transit during capsule swallows. METHODS: Videofluoroscopy was used to measure capsule oral and pharyngeal transit during swallows in 49 healthy individuals (17 men and 32 women), with a mean age of 46 years (ranging from 23 to 88 years). Smaller capsules were filled with 0.50 mL of barium sulfate, and larger capsules were filled with 0.95 mL of barium sulfate; the volume of liquid ingested with the capsules was also quantified in each ingestion. The measurements included the oral preparation time, oral transit time, swallowing reaction time, time to laryngeal vestibule closure, laryngeal vestibule closure duration, pharyngeal transit time, and upper esophageal sphincter opening duration. RESULTS: The capsule size did not influence either the oral or pharyngeal transit time. Increased liquid volume was ingested with larger capsules and by people older than 40 years. The oral transit time was shorter in older adults (60-88 years), and the time to laryngeal vestibule closure was longer in women. CONCLUSION: The size of large capsules did not make a difference in oral or pharyngeal transit when compared with smaller capsules. The capsule size and the participant's age influenced the volume of liquid ingested - larger capsules and older individuals required a larger volume. The capsule oral transit was faster in individuals older than 60 years. BACKGROUND: •Swallowing is influenced by the characteristics of what is being swallowed. BACKGROUND: •There was no difference in swallowing capsules containing 0.50 mL or 0.95 mL. BACKGROUND: •Larger capsules need more liquid ingestion to make swallowing easier. BACKGROUND: •Individuals older than 40 years need a greater volume of liquid to swallow capsules than younger adults.

Sulfate supply decreases barium availability, uptake, and toxicity in lettuce plants grown in a tropical Ba-contaminated soil.

Barium (Ba) is a non-essential element that can cause toxicity in living organisms and environmental contamination. Plants absorb barium predominantly in its divalent cationic form Ba2+. Sulfur (S) can decrease the availability of Ba2+ in the soil by causing its precipitation as barium sulfate, a compound known for its very low solubility. The objective of this study was to evaluate the effect of soil sulfate supply in soil Ba fractions, as well as on plant growth, and Ba and S uptake by lettuce plants grown in artificially Ba-contaminated soil under greenhouse conditions. The treatments consisted of five Ba doses (0, 150, 300, 450, and 600 mg kg-1 Ba, as barium chloride) combined with three S doses (0, 40, and 80 mg kg-1 S, as potassium sulfate). The treatments were applied to soil samples (2.5 kg) and placed in plastic pots for plant cultivation. The Ba fractions analyzed were extractable-Ba, organic matter-Ba, oxides associated-Ba, and residual-Ba. The results indicate that the extractable-Ba fraction was the main one responsible for Ba bioavailability and phytotoxicity, probably corresponding to the exchangeable Ba in the soil. The dose of 80 mg kg-1 of S reduced extractable-Ba by 30% at higher Ba doses while it increased the other fractions. Furthermore, S supply attenuated the growth inhibition in plants under Ba exposure. Thus, S supply protected the lettuce plants from Ba toxicity by reduction of Ba availability in soil and plant growth enhancement. The results suggest that sulfate supply is a suitable strategy for managing Ba-contaminated areas.

Determination of the Gastrointestinal Passage Rate Using Dexa Technology and Barium Sulfate As a Marker in Japanese Quails

The objective of this study was to characterize the dynamics of food passage in the gastrointestinal tract (GIT) of Japanese quail. A randomized design was used with four treatments and four experimental units with one bird each, nine of which were measured in time. The ingredients used were albumin, starch, cellulose, and soybean oil. Suspensions containing barium sulfate and saline were prepared, except for soybean oil. For each bird, 2.5 mL of the suspension was administered directly to the crop. Dual-energy absorptiometry (DEXA) was used to quantify the passage of food. The birds were sedated and maintained under inhalation anesthesia during the scan. Measurements were taken at intervals of 0.5, 1, 2, 4, 6, 8, 10, 12, and 24 h. The variables identified were passage time, first quality, and the average time of each variable. Based on these results, the ingredients may show differences in dynamic passing on the Japanese quail GIT. The duration of the first attempt was 32 min, ranging from 21 to 44 min. The average time value of food choice was close to 10.8 h and varied according to the ingredient from 8.45-12.16 h. Among the variables, soybean oil presented values ​​that denote a fast passage in the GIT, while albumin presented values ​​that denote a slower passage. The dynamics of food passage in the GIT of Japanese quails varies according to the chemical composition of the ingredients.(AU)

Effect of planting density of the macrophyte consortium of Typha domingensis and Eleocharis acutangula on phytoremediation of barium from a flooded contaminated soil.

Barite (BaSO4) is a component of drilling fluids used in the oil and gas industry and may cause barium (Ba) contamination if it is spilled onto flooded soils. Under anoxic soil conditions and low redox potential, sulfate can be reduced to a more soluble form (sulfide), and Ba can be made available. To design a solution for such environmental issues, a field study was conducted in a Ba-contaminated flooded area in Brazil, in which we induced Ba phytoextraction from the management of the planting density of two intercropped macrophytes. Typha domingensis and Eleocharis acutangula were grown in four initial planting densities: "Ld" (low density: 4 and 32 plants m-2); "Md" (medium density: 8 and 64 plants m-2); "Hd" (high density: 12 and 128 plants m-2); "Vhd" (very high density: 16 and 256 plants m-2). Vhd produced the largest number of plants after 300 days. However, the treatments did not differ in terms of the amount of biomass. The increments in the initial planting density did not increase the Ba concentration in the aerial part. The greatest Ba phytoextraction (aerial part + root) was achieved by Ld treatment, which removed approximately 3 kg of Ba ha-1. Md and Vhd treatments had the highest Ba translocation factors. Because more plants per area did not result in greater Ba phytoextraction, a lower planting density was recommended for the intercropping of T. domingensis and E. acutangula to promote the phytoextraction of barium, due to possible lower implementation costs in contaminated flooded environments.

Tissue response to white mineral aggregate-based cement containing barium sulfate as alternative radiopacifier: A randomized controlled animal study.

The purpose of this study was to investigate the tissue reaction stimulated by BaSO4 - and Bi2 O3 -containing White MTA Angelus, in comparison with Bi2 O3 -containing white Portland cement, and white ProRoot MTA. Thirty-six adult male Wistar rats (Rattus norvegicus), weighing between 250 and 300 g, were distributed into three groups (n = 12) in accordance with the period of sacrifice (15, 30, and 60 days). Four polyethylene tubes filled with the tested cements were implanted into the dorsum of each rat. Lateral wall of the tubes served as the negative control. After the experimental periods, the animals were euthanized by overdose of pentobarbital anesthetic solution, and the specimens were prepared for microscopic analysis under ×50, ×100, and ×400 magnifications. Inflammatory scores (0-3) were used to grade the tissue reaction. Data were analyzed by the Kruskal-Wallis test and Dunn's test for individual comparisons (p < .05). A mild to moderate inflammatory tissue reaction was observed at the 15-day period, which decreased over the course of the periods for all cements, except for Portland cement. There was no significant difference among the tissue responses for ProRoot MTA, BaSO4 - and Bi2 O3 -containing White MTA Angelus at the 60-day period (p > .05). The Portland group had moderate inflammatory reaction at the final period of analysis, which was statistically different when compared to the other groups (p < .05). The microscopic findings of this animal study suggest that the addition of BaSO4 to White MTA Angelus does not hampers the biocompatibility of the cement.

Massive extrusion of calcium hydroxide paste containing barium sulphate during endodontic treatment.

A 31-year-old woman was referred for the evaluation of persistent lower lip numbness following endodontic treatment of tooth #36. Imaging examinations showed a large amount of radiopaque/hyperdense material spread in an angiographic distribution in the left mandibular body region. Laboratory analyses of tooth #36 and adjacent periapical tissue, surgically extracted in an external Service due to acute pain following endodontic treatment, identified chronic inflammatory reaction and birefringent crystalloid foreign bodies rich in barium and sulphur, leading to the diagnosis of alveolar nerve injury due to accidental extrusion of intracanal dressing material composed of calcium hydroxide [Ca(OH)2 ] paste incorporated with barium sulphate. Clinicians should be aware that Ca(OH)2 when in contact with periapical tissues may lead to persistent toxicities, such as necrosis, pain and paraesthesia. Therefore, injectable Ca(OH)2 systems should be used with caution because they can cause paste extrusion and damage to the lower alveolar nerve.

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.

Robot-assisted surgery and endoscopic management of gastrocolic fistula: A rare complication of acute pancreatitis in a patient who had undergone sleeve gastrectomy.

Ten years after undergoing sleeve gastrectomy, a 39-year-old man developed pancreatitis and, after recovery, presented with severe diarrhea. An image study showed barium contrast passing from the stomach to the colon. Before surgery, initial treatment consisted of parenteral nutrition and antibiotics. The patient then underwent robot-assisted resection of a gastrocolic fistula and omentoplasty. However, 72 h after surgery, the amount of suction drainage suggested that the fistulous track repair was leaking. Therefore, we decided to perform endoscopy to place a self-expanding covered stent at the gastroesophageal junction as well as a nasojejunal tube to continue nutritional supplementation. After the patient had fasted for 2 weeks, there was no evidence of leakage in the image studies. The patient was discharged after he had clinically improved, and the stent was removed at the end of 8 weeks. The combination of robot-assisted surgery and endoscopic management is effective for treating gastrocolic fistula.

Study on the Correlation between Barium Radiography and Pulmonary Infection rate in the Evaluation of Swallowing Function.

OBJECTIVES: To compare the results respectively obtained from the utilization of 60% barium sulfate suspension and Iohexol as contrast agents for videofluoroscopic swallowing studies and the relationship between the clinical application of the two kinds of contrast agents and the incidence of pneumonia. METHODS: Sixty cases of stroke patients with dysphagia were selected in rehabilitation department of our hospital, and the gender, age, position of the disease, and stroke nature between groups had no significant difference. Among which, 30 patients who were administered 350 mgI/ml Iohexol, and the other 30 patients with 60% barium sulfate suspension as contrast agent. We performed videofluoroscopic swallowing studies with barium 60% versus Iohexol within 1 week after admission and 2 weeks after admission. RESULTS: After 2 weeks in hospital, the aspiration pneumonia incidence of two groups was statistically significant (p<0.05), the pneumonia incidence of Iohexol group was lower than barium sulfate group which might have a impossble relevance with barium aspiration. CONCLUSIONS: During the videofluoroscopic swallowing study of dysphagia after stroke, barium sulfate can enhance the pneumonia incidence, and Iohexol can be widely applied in videofluoroscopic swallowing study.

Detection of coffee adulteration with soybean and corn by capillary electrophoresis-tandem mass spectrometry.

The detection of coffee adulteration with soybean and corn by capillary electrophoresis-tandem mass spectrometry was accomplished by evaluating the monosaccharides profile obtained after acid hydrolysis of the samples. The acid hydrolysis, using H2SO4 as a catalyst, increases the ionic strength of the sample impairing the electrophoretic separation. Therefore, Ba(OH)2 was used to both neutralize the medium and reduce the content of sulfate by precipitation of BaSO4. The best separation of nine determined monosaccharides (fucose, galactose, arabinose, glucose, rhamnose, xylose, mannose, fructose and ribose) plus inositol as internal standard was obtained in 500 mmol·L-1 triethylamine, pH 12.3. The monosaccharides are separated as anionic species at this pH. The proposed method is simple, fast (<12.0 min), present linear calibration curves (r2 = 0.995), and relative standard deviation for replicate injections lower than 5%. The LOQ for all monosaccharides was lower than 0.01 mmol·L-1, which is in accordance with the tolerable limits for coffee. Principal component analysis (PCA) was used to evaluate interrelationships between the monosaccharide profile and the coffee adulteration with different proportions of soybean and corn. Fucose, galactose, arabinose, glucose, sucrose, rhamnose, xylose, mannose, fructose, and ribose were quantified in packed roast-and-ground commercial coffee samples, and differences between adulterated and unadulterated coffees could be detected.

Study on the Correlation between Barium Radiography and Pulmonary Infection rate in the Evaluation of Swallowing Function

OBJECTIVES: To compare the results respectively obtained from the utilization of 60% barium sulfate suspension and Iohexol as contrast agents for videofluoroscopic swallowing studies and the relationship between the clinical application of the two kinds of contrast agents and the incidence of pneumonia. METHODS: Sixty cases of stroke patients with dysphagia were selected in rehabilitation department of our hospital, and the gender, age, position of the disease, and stroke nature between groups had no significant difference. Among which, 30 patients who were administered 350 mgI/ml Iohexol, and the other 30 patients with 60% barium sulfate suspension as contrast agent. We performed videofluoroscopic swallowing studies with barium 60% versus Iohexol within 1 week after admission and 2 weeks after admission. RESULTS: After 2 weeks in hospital, the aspiration pneumonia incidence of two groups was statistically significant (p<0.05), the pneumonia incidence of Iohexol group was lower than barium sulfate group which might have a impossble relevance with barium aspiration. CONCLUSIONS: During the videofluoroscopic swallowing study of dysphagia after stroke, barium sulfate can enhance the pneumonia incidence, and Iohexol can be widely applied in videofluoroscopic swallowing study.

Barium sulphate aspiration pneumonia in a cat with megaesophagus and dextroposition of the aortic arch: case report / Pneumonia aspirativa por sulfato de barrio em gato com megaesôfago e destroposição de arco da aorta: relato de caso

A six-month-old female cat suffered aspiration of an abundant amount of barium sulfate during a radiographic procedure for the diagnosis of megaesophagus. Latero-lateral contrast radiography revealed severe dilation of the thoracic esophagus cranial to the base of the heart. Persistence of the right aortic arch was suspected and later confirmed during corrective surgery. Accumulation of barium sulfate, used as a contrast agent, was clearly observed in the lumen of the bronchi, bronchioles, and alveoli in the radiographic image. Days after the surgery, the animal developed severe respiratory distress, which resulted in death. Cytology results and histology analysis using polarized light demonstrated that the lumen of bronchi, bronchioles, and alveoli exhibited evident histiocytic infiltration with cytoplasm filled by abundant amorphous refractive granular material consistent with barium sulfate. In this report, we describe the anatomical, cytological, histopathological (using polarized light), and x-ray findings of a case of barium sulfate aspiration pneumonia in a cat resulting from the use of this contrast medium for the diagnosis of megaesophagus secondary to persistent right aortic arch.(AU)

Uma gata de seis meses aspirou grande quantidade de sulfato de bário durante procedimento radiográfico para diagnóstico de megaesôfago. Contraste radiográfico látero-lateral revelou dilatação de esôfago torácico até a base do coração. Persistência do arco aórtico direito foi confirmada durante cirurgia corretiva. Acúmulo de sulfato de bário, utilizado como agente de contraste, foi observado no lúmen de brônquios, bronquíolos e alvéolos à imagem radiográfica. Dias após a cirurgia o animal desenvolveu insuficiência respiratória grave e evoluiu para óbito. Resultado de citologia e histologia utilizado luz polarizada demonstrou que lúmen de brônquios, bronquíolos e alvéolos mostraram infiltração histológica com citoplasma cheio de material refratário granular amorfo compatível com sulfato de bário. Nesse relatório, descrevemos achados anatômicos, citológicos, histopatológicos e radiográficos de um caso de pneumonia aspirativa em gata resultante do uso desse meio de contraste para diagnóstico de megaesôfago secundário a persistência do arco aórtico direito.(AU)

Barium sulphate aspiration pneumonia in a cat with megaesophagus and dextroposition of the aortic arch: case report / Pneumonia aspirativa por sulfato de barrio em gato com megaesôfago e destroposição de arco da aorta: relato de caso

A six-month-old female cat suffered aspiration of an abundant amount of barium sulfate during a radiographic procedure for the diagnosis of megaesophagus. Latero-lateral contrast radiography revealed severe dilation of the thoracic esophagus cranial to the base of the heart. Persistence of the right aortic arch was suspected and later confirmed during corrective surgery. Accumulation of barium sulfate, used as a contrast agent, was clearly observed in the lumen of the bronchi, bronchioles, and alveoli in the radiographic image. Days after the surgery, the animal developed severe respiratory distress, which resulted in death. Cytology results and histology analysis using polarized light demonstrated that the lumen of bronchi, bronchioles, and alveoli exhibited evident histiocytic infiltration with cytoplasm filled by abundant amorphous refractive granular material consistent with barium sulfate. In this report, we describe the anatomical, cytological, histopathological (using polarized light), and x-ray findings of a case of barium sulfate aspiration pneumonia in a cat resulting from the use of this contrast medium for the diagnosis of megaesophagus secondary to persistent right aortic arch.(AU)

Uma gata de seis meses aspirou grande quantidade de sulfato de bário durante procedimento radiográfico para diagnóstico de megaesôfago. Contraste radiográfico látero-lateral revelou dilatação de esôfago torácico até a base do coração. Persistência do arco aórtico direito foi confirmada durante cirurgia corretiva. Acúmulo de sulfato de bário, utilizado como agente de contraste, foi observado no lúmen de brônquios, bronquíolos e alvéolos à imagem radiográfica. Dias após a cirurgia o animal desenvolveu insuficiência respiratória grave e evoluiu para óbito. Resultado de citologia e histologia utilizado luz polarizada demonstrou que lúmen de brônquios, bronquíolos e alvéolos mostraram infiltração histológica com citoplasma cheio de material refratário granular amorfo compatível com sulfato de bário. Nesse relatório, descrevemos achados anatômicos, citológicos, histopatológicos e radiográficos de um caso de pneumonia aspirativa em gata resultante do uso desse meio de contraste para diagnóstico de megaesôfago secundário a persistência do arco aórtico direito.(AU)

Long-term quality of life after peroral endoscopic myotomy remains compromised in patients with achalasia type III.

Background and study aims Peroral endoscopic myotomy (POEM) is an excellent endoscopic treatment for achalasia. Clinical and manometric parameters are used for evaluation and follow-up. However, clinical success does not guarantee high quality of life (QoL) scores, generating doubts about their direct relationship. We aimed to evaluate QoL scores before and after POEM at medium and long term, to evaluate differences between achalasia subtypes and find which factors related to low QoL scores. Patients and methods Achalasia-confirmed patients undergoing POEM between February 2012 and November 2016. and completing at least 1 year of follow-up, were included. Assessment before and at 1, 6, 12, 24, 36 and 48 months after POEM employed manometry, barium series, Eckardt score, and the AE-18 health-related QoL scale. Demographic, clinical, and procedure characteristics were documented, with comparisons between subgroups. Multiple logistic regression analysis was done. Results 65 of 88 patients were included (38 women, 27 men; median age 47 years, interquartile range [IQR] 20 - 81), and 50 (76.9 %) completed 4 years of follow-up. Eckardt score improved (median, preprocedure 10 vs. post-procedure 2; P = 0.002) and this persisted. There was initial improvement in median integrated relaxation pressure (IRP) (29.4 mmHg [16 - 55] vs. 10.3 mmHg [3 - 18]; P = 0.000) and median QoL scores (40 vs. 68 at 1 month; P = 0.002); however IRP increased and QoL scores decreased. Men with confirmed type III achalasia had low QoL scores. Conclusions All patients had significant clinical improvement after POEM, with medium- to long-term persistence. Though quality of life and IRP initially improved, they deteriorated in the long term. Male sex and type III achalasia seem to be associated with low QoL scores.

Monte Carlo Simulation Used to Calculate Energy Correction Factor for Thermoluminescent Dosimeters Used by Occupational Workers on Pediatric Exams.

The main objective of this work is to simulate the X-ray scattered spectra by different pediatric phantoms (simulation of children subjected to barium meal procedures) to calculate an energy correction factor (ECF) to the reading of thermoluminescent dosimeters (TLDs). To perform this evaluation, the TLDs were positioned over three areas in two occupational workers: eyes, thyroid and hands. The Geant4 toolkit was used to define the spectra collected by TLDs, making possible to calculate the ECF. This work was developed in two stages: (1) evaluation of scattered spectra by different standard phantoms (newborn, 1, 5 and 10 years old); (2) definition of the ECF to the absorbed energy by each TLD. Geant4 shows to be a good toolkit to calculate the ECF and among the different characteristics evaluated, in this work, the TLD position and acceleration voltages are the most significant parameters that may influence the ECF calculated.

Corkscrew esophagus.

Corkscrew esophagus (also referred as rosary bead esophagus) is a classic finding of diffuse esophageal spasm (DES) in barium studies reflecting abnormal contractions, leading to compartmentalization and curling of the esophagus, ultimately giving an appearance similar to a corkscrew or rosary beads. We review the pathophysiology of this finding, correlating it to corkscrew and rosary images that originated this classic description.

[Elective laparoscopic right colectomy for caecal volvulus: case report and literature review]. / Colectomía derecha laparoscópica electiva por vólvulo cecal: reporte de un caso y revisión de la literatura.

BACKGROUND: Caecal volvulus is an uncommon cause of intestinal obstruction. Its clinical presentation is non-specific, with the diagnosis usually confirmed by barium enema and abdominal computed tomography. Treatment depends on many factors, and minimally invasive approaches are becoming the treatment of choice. CLINIC CASE: A 54 years old female, admitted to the Emergency Department with clinical symptoms of intestinal obstruction. On physical examination she had a palpable, firm, and tympanitic mass in the right abdomen, with peritoneal irritation. The radiographs of the abdomen, barium enema and abdominal computed tomography showed caecal volvulus. As she showed a full remission after the barium enema, with no clinical or biochemical data of systemic inflammatory response syndrome or peritoneal irritation, she was discharged to her home. Two weeks later, a laparoscopic right hemicolectomy was performed with an ileo-transverse extracorporeal anastomosis. Her progress was satisfactory, and she was discharged 4 days after surgery due to improvement. CONCLUSION: Caecal volvulus is a rare cause of intestinal obstruction, with high mortality rates, and is caused by excessive mobility of the caecum. Its incidence is increasing. Treatment depends on many factors. Early non-surgical untwisting, followed by an elective laparoscopic surgical procedure offers several advantages and reduces mortality.