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Ingestion of foreign objects
... There are a few case reports describing such injuries or accidents involving the ingestion or impalement of a toothbrush [7,8]. ...
... Of these cases, 10 were associated with patients who had been diagnosed with bulimia [17][18][19][20][21], five occurred while brushing the teeth [22][23][24][25][26] and four occurred while brushing the back part of the tongue or pharynx [16,[27][28][29]. There was one case report [30] in which the toothbrush was swallowed as an effort to remove a foreign body, one case in which the subject ingested the toothbrush in an attempt to commit suicide [31] and another case of ingestion that led to death [7]. In most of the cases, the toothbrush did not pass the stomach, but there were cases in which the observed toothbrush location was the esophagus, duodenum, colon, liver and oropharynx. ...
Aim:
To systemically collect and summarize the literature on case reports concerning adverse events associated with the oral use of a toothbrush.
Materials and methods:
Two electronic databases were searched for articles published up to October 2013 to identify appropriate studies using focused search terms and 'case reports' as a filter. Results. A comprehensive search identified 419 unique titles and abstracts. Ninety-four studies met the eligibility criteria. In total, 118 subjects (age range = 1-60 years) presented adverse events related to the oral use of a toothbrush. Events could be summarized in five categories, of which ingestion was the most reported problem among the individuals (50 cases). This was followed by impaction of a toothbrush (27 cases). Reports more frequently involved females and children were more likely to have injuries compared to males and adults. Most of the cases that presented with adverse events of the oral use of a toothbrush were referred for treatment to a physician.
Conclusions:
The combined evidence related to serious adverse events as presented in case reports showed that the oral use of a toothbrush can be associated with ingestion, impaction, instant trauma, gingival traumatic injury and seizures. Given the incidence of reporting, important recommendations are that a toothbrush should not be used to induce vomiting, nor should people walk or run with this device in their mouths, especially children.
... sen, & Shah, 2001;Soong, Harvey, & Doherty, 1990;Weiner, 2001)-is a relatively rare but potentially dangerous behavior that is associated with multiple costs to the patient, their family, and the general public. When surgery is required, the cost per patient averages $45,000 per unique patient (Huang et al., 2010), and in the most extreme cases, death is a potential consequence (Klein, 2012;Weiner, 2001).Psychiatric outcomes for individuals with SII are typically poor (Gitlin et al., 2007;James & Allen-Mersh, 1982;Soong et al., 1990), suggesting the importance of better understanding the factors underlying this condition to guide the selection and implementation of the most appropriate treatment approaches. ...
... )-is a relatively rare but potentially dangerous behavior that is associated with multiple costs to the patient, their family, and the general public. When surgery is required, the cost per patient averages $45,000 per unique patient (Huang et al., 2010), and in the most extreme cases, death is a potential consequence (Klein, 2012;Weiner, 2001). ...
The focus of this practice review is to understand the precursors, correlates, and treatment of self-injury by ingestion of foreign objects among patients in inpatient mental health facilities. These cases exhibited pervasive psychopathology of early onset, histories of severe personality disorder, and trauma. The cases seemingly presented a higher incidence of medical complications than is reported in the literature, and treatment outcomes varied from modest-to-good success. Considering these difficulties, the goal of this practice review is to shed light on the motivation and treatment of self-injury by ingestion and to consider directions where existing theory and research could inform treatment strategies in future cases. We conclude the practice review with a summary of questions that remain to be answered with future research studies and make recommendations regarding treatment of these difficult cases. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
... For example, we have been informed that they place tape over razor blades, as others have reported. 6 Despite what we know, it is very difficult to trust them because they usually insist that the object is not protected or that the batteries have not been emptied. Whether this is true is always an enigma that involves risks. ...
The management of foreign bodies in the gastrointestinal tract is not standardized. Foreign body ingestions in prisoners are always intentional and inmates can be manipulative, which makes medical decision even more difficult. Our objective is to propose a decisional algorithm for management of foreign body ingestion in prisoners. We reviewed the records of 198 admissions for foreign body ingestion for a 10-year period. Type and number of ingested foreign bodies, radiographic findings, outcome as well as the management method including conservative, endoscopic removal, or surgical treatment were analyzed. Most cases were managed conservatively (87.6%). Endoscopy of the upper gastrointestinal tract was performed in 37 cases with a success rate of 46 per cent. In 9.3 per cent of cases, the final treatment was endoscopic. Only five patients required surgical treatment, being emergent just in one case. We advocate conservative treatment for asymptomatic patients with foreign body ingestion. Endoscopic removal is proposed for pointed objects or objects bigger than 2.5 cm located in the stomach. Objects longer than 6 to 8 cm located in the stomach should be removed by endoscopy or laparoscopy. Patients with objects in the small bowel or colon should be treated conservatively unless there are complications or they fail to progress.
... . But for prison inmates in foreign countries, the common foreign objects are razor blades, metallic stars, toothbrushes, radio antennae and so on [6][7][8][9][10][13][14][15] . ...
Foreign objects in the gastrointestinal tract are usually the result of accidental swallowing. Yet foreign object ingestion is often seen in prisoners who mainly desire to leave prison. We report here on a series of 33 Korean prisoners with foreign object ingestion and they were treated endoscopically or surgically.
We reviewed the medical records of 33 Korean prisoners (52 episodes) who were admitted due to ingestion of foreign objects between January 1998 and June 2004 to Konyang University Hospital and Gyeongsang National University Hospital.
All the patients were male with a mean age of 35 years. The most common duration from ingestion to the visit to the ER was within 24 hours (25/52 episodes). Most of the foreign objects were located in the esophagus (42.3%) and stomach (42.3%). The number of foreign objects was one in 28 episodes, two in 12 episodes and three or more in twelve episodes. The most common foreign objects were metal wires (26/52 episodes). The mean size of the foreign objects was 11.9 centimeters long. Successful endoscopic treatment was performed in most patients (46/52 episodes, 88.5%). The remaining six cases were treated surgically.
The foreign objects in prisoners were a variety of unusual things because of the prison environment, and endoscopy is a mainstay of treatment for foreign object removal in Korean prisoners.
Probiotics are "bacteria that are good for you' evolving out of the food industry, without quality data or a framework in which to function. This review asks three questions, the answers to which dictate the level of success that probiotics have had in moving into the medical model. How do they work? Evidence is summarised to show that (at least) certain bacteria activate Peyer's patch T cells to drive the common mucosal system via toll-like receptors on antigen presenting cells. They influence distant mucosal sites, promoting Th1 cytokine responses while downregulating Th2 responses. New data is included. Are all probiotics the same? They clearly are not - variation occurs between different isolates and importantly within isolates due to variable production/storage and poor quality control. These latter issues, together with poor clinical trials lacking surrogate markers of activation, have made clinical assessment very difficult. Do they have a role in man? Yes they do, but whether that is now or in the future largely depends on the quality of studies done. There is clear evidence in man that mucosal INF-gamma secretion is stimulated, indicating promotion of immune protection, downregulation of hypersensitivity disease and (yet to be demonstrated) enhanced apoptosis to reduce cancer risk. Preliminary evidence suggests that certain probiotics may regulate cytokine secretion around a mean, ensuring optimal protection without non-specific damage. Thus probiotics appear to restore defective immunity rather than stimulate, an observation relevant to restoration of Th1 immunity in infants.