[Ingestion of caustic substances in children: 3 years of experience]. / Ingesta de cáusticos en niños, experiencia de 3 años.

INTRODUCTION: There is no clear consensus on the management of accidental ingestion of caustic substances in paediatrics. The aim of this study was to determine the profile of the paediatric population treated due to caustic ingestion in a Healthcare Centre. PATIENTS AND METHOD: A descriptive study was conducted on patients treated for the ingestion of caustic substances in our hospital during the period 2008-2011. RESULTS: A total of 12 patients were treated, with a mean age of 3.8 years (1-13 years), with the majority males (58.8%). An alkaline product was ingested by 58.3%, and an acid by 41.6%. The majority (58.3%) did not refer to symptoms and the remainder referred to vomiting (33.3%), odynophagia (16.6%), haematemesis (8.3%), hyper-salivation (8.3%) and shortness of breath (8.3%). Oral cavity lesions were observed in 75% of cases. All, except one, were accidental. An endoscopy was performed on all of them (100%) between 12 and 24hours post-ingestion, with pathological findings in 41.6%. In the group that ingested an alkali, 2 (16.6%) patients had lesions, one a grade 2B and one a grade 3 oesophagitis. In the acid ingestion group, 4 (33.3%) patients had lesions; one grade 1-2A oesophagitis, two acute non-erosive gastritis, and one acute haemorrhagic gastritis. A follow-up endoscopy was performed depending on the previous endoscopic findings. Only two patients presented with complications. CONCLUSIONS: Emphasis is placed on the endoscopic evaluation in the first 24hours of deliberate asymptomatic ingestions, as well as a strict follow-up in those that ingested acids, due to delayed associated lesions.

Ingesta de cáusticos en niños, experiencia de 3 años / Ingestion of caustic substances in children: 3 years of experience

Introdución: La ingesta accidental de cáusticos en pediatría no dispone de un consenso claro de actuación. El objetivo de este estudio fue caracterizar la población pediátrica atendida por ingesta de cáusticos en un centro asistencial. Pacientes y método: Estudio descriptivo de los pacientes atendidos en nuestro hospital por la ingesta de cáusticos durante el período 2008-2011. Resultados: Se atendieron 12 pacientes, edad media de 3,8 años (1-13 años). Predominio de varones (58,8%). Un 58,3% ingirió producto alcalino y un 41,6% ácido. El 58,3% no refería sintomatología, el resto refirió vómitos (33,3%), odinofagia (16,6%), hematemesis (8,3%), sialorrea (8,3%) y dificultad respiratoria (8,3%). El 75% presentaron lesiones en la cavidad oral. Todos, salvo un caso, fueron accidentales. Se realizó endoscopia al 100% entre las 12 y 24 h postingesta con hallazgos patológicos en un 41,6%. En el grupo ingesta de álcalis 2 pacientes presentaron lesiones (16,6%): una esofagitis grado 2B y una grado 3. En el grupo ingesta de ácidos 4 pacientes (33,3%) presentaron lesiones: una esofagitis aguda grado 1-2A, 2 gastritis agudas no erosivas y una gastritis aguda hemorrágica. Se realizó endoscopia de control según los hallazgos endoscópicos previos. Solo 2 presentaron complicaciones posteriores. Conclusiones: Destacamos la valoración endoscópica en las primeras 24 h en todas las ingestas sintomáticas y deliberadas, así como la reevaluación estrecha en las ingestas ácidas, por asociar lesiones diferidas.

Introduction: There is no clear consensus on the management of accidental ingestion of caustic substances in paediatrics. The aim of this study was to determine the profile of the paediatric population treated due to caustic ingestion in a Healthcare Centre. Patients and method: A descriptive study was conducted on patients treated for the ingestion of caustic substances in our hospital during the period 2008-2011. Results: A total of 12 patients were treated, with a mean age of 3.8 years (1-13 years), with the majority males (58.8%). An alkaline product was ingested by 58.3%, and an acid by 41.6%. The majority (58.3%) did not refer to symptoms and the remainder referred to vomiting (33.3%), odynophagia (16.6%), haematemesis (8.3%), hyper-salivation (8.3%) and shortness of breath (8.3%). Oral cavity lesions were observed in 75% of cases. All, except one, were accidental. An endoscopy was performed on all of them (100%) between 12 and 24 hours post-ingestion, with pathological findings in 41.6%. In the group that ingested an alkali, 2 (16.6%) patients had lesions, one a grade 2B and one a grade 3 oesophagitis. In the acid ingestion group, 4 (33.3%) patients had lesions; one grade 1-2A oesophagitis, two acute non-erosive gastritis, and one acute haemorrhagic gastritis. A follow-up endoscopy was performed depending on the previous endoscopic findings. Only two patients presented with complications. Conclusions: Emphasis is placed on the endoscopic evaluation in the first 24 hours of deliberate asymptomatic ingestions, as well as a strict follow-up in those that ingested acids, due to delayed associated lesions.

Effect of alkali and oxidative treatments on the physicochemical, pasting, thermal and morphological properties of corn starch.

BACKGROUND: Few studies on starch modifications using different chemical agents are available in the literature, and no reports were found on the combined effect of oxidation and alkaline treatment of corn starch. Thus this work evaluated the physicochemical, pasting, morphological, cystallinity and thermal properties of chemically modified corn starch, after either the isolated or combined action of alkaline (sodium hydroxide) and oxidative (sodium hypochlorite) treatments. RESULTS: The highest values for the sum of carbonyl and carboxyl and enzymatic hydrolysis occurred in starches submitted to oxidative treatment at high active chlorine concentrations. The alkali treatment in isolation modified the pasting properties, reduced the paste temperature and increased the peak viscosity, breakdown, final viscosity and setback of starches. Starch modified by the action of sodium hypochlorite and hydroxide in combination presented more severe damage on granule surfaces. CONCLUSION: The results show that corn starch modified by the combined action of oxidative and alkaline treatments should be studied more, especially at the concentration limit of sodium hydroxide where gelatinization occurs. Under these conditions the effect of oxidation can be more intense and thus allow the production of starches with different properties and an increase in their industrial applications.

Properties of dental resins submitted to pH catalysed hydrolysis.

OBJECTIVES: This study evaluated the surface microhardness (SM) and roughness (SR) alterations of dental resins submitted to pH catalysed degradation regimens. METHODS: Thirty discs of each TPH Spectrum (Dentsply), Z100 (3M-ESPE), or an unfilled experimental bis-GMA/TEGDMA resin were fabricated, totaling 90 specimens. Each specimen was polymerized for 40 s, finished, polished, and individually stored in deionized water at 37 °C for 7 days. Specimens were randomly assigned to the following pH solutions: 1.0, 6.9 or 13, and for SM or SR evaluations (n = 5). Baseline Knoop-hardness of each specimen was obtained by the arithmetic mean of five random micro-indentations. For SR, mean baseline values were obtained by five random surface tracings (R(a)). Specimens were then soaked in one of the following storage media at 37 °C: (1) 0.1 M, pH 1.0 HCl, (2) 0.1 N, pH 13.0 NaOCl, and (3) deionized water (pH 6.9). Solutions were replaced daily. Repeated SM and SR measurements were performed at the 3-, 7- and 14-day storage time intervals. For each test and resin, data were analysed by two-way ANOVA followed by Tukey's test (α = 0.05). RESULTS: There was significant decrease in SM and increase in SR values of composites after storage in alkaline medium. TPH and Z100 presented similar behaviour for SM and SR after immersion in the different media, whereas unfilled resin values showed no significant change. CONCLUSION: Hydrolytic degradation of resin composites seems to begin with the silanized inorganic particles and therefore depend on their composition. SIGNIFICANCE: To accelerate composite hydrolysis and produce quick in vitro microstructural damage, alkaline medium appears to be more suitable than acidic medium. Contemporary resin composite properties seem to withstand neutral and acidic oral environments tolerably well.

Intoxicación por cáusticos características clínico-epidemiológicas: hospital Padre Justo Arias. Rubio: enero 1996 a diciembre 2000 / Intoxication by casstic characteristic clinic-epidemiology: hospital Padre Justo Arias Rubio: january 1996 a december 2000

Se trata de un estudio de tipo descriptivo retrospectivo, con la finalidad de determinar la incidencia y las principales características epidemiológicas y clínicas de la Intoxicación por cáusticos en el Hospital tipo II "Padre Justo Arias" de la Ciudad de Rubio, Estado Táchira, para el período 1996 a 2000. Se revisaron 24 historias clínicas con el diagnóstico de "Intoxicación por Cáusticos" (ácidos y álcalis). Las variables estudiadas fueron: edad sexo, distribución por años, características clínicas, estancia hospitalaria, hallazgos endoscópicos y principales sustancias ingeridas. En los resultados se evidenció: el grupo etareo más afectado fueron los preescolares de 2 a 6 años; el 54 por ciento de los casos fueron del sexo masculino, la mayor incidencia se presentó durante los años 1996 a 1998; el 62,5 por ciento de los pacientes ameritó más de tres días de hospitalización; los principales síntomas fueron: odinofagia/disfagia, lesiones orales, sialorrea y taquicardia. Las sustancias principales implicadas fueron el hidróxido de sodio (38 por ciento) y el hipoclorito de sodio (28 por ciento). Al 60 por ciento de los pacientes se les realizó endoscopia digestiva superior, de los cuáles el 75 por ciento presentó lesiones de primer grado y el 25 por ciento restante lesiones de segundo grado, no se reportaron lesiones de tercer grado. Se concluye la necesidad de incrementar las medidas preventivas adecuadas tanto en los hogares como a nivel industrial para evitar este tipo de accidentes capaces de producir complicaciones severas e incluso la muerte