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Revista Espanola de Enfermedades... Sep 2023"Bariolith" is defined as the concretion of barium sulfate in the intestine after performing a radiological study with said contrast. Complications derived from the use...
"Bariolith" is defined as the concretion of barium sulfate in the intestine after performing a radiological study with said contrast. Complications derived from the use of barium are exceptional, but appendicitis, intussusception, volvulus, ulceration, ischemia and perforation have been described. We present the case of a 62 years old woman, who underwent a EGD exploration on the 15th of January 2021 as a part of her study for suspected GERD.
Topics: Humans; Female; Middle Aged; Intestinal Obstruction; Barium Sulfate; Intussusception; Intestinal Volvulus; Appendicitis
PubMed: 36043557
DOI: 10.17235/reed.2022.9084/2022 -
Ear, Nose, & Throat Journal Sep 2023Laimer's diverticulum (LD) is a very rare clinical entity originating between the cricopharyngeus muscle (CPM) and circular muscular fibers of the esophagus. Its...
Laimer's diverticulum (LD) is a very rare clinical entity originating between the cricopharyngeus muscle (CPM) and circular muscular fibers of the esophagus. Its diagnosis and management remain to be elucidated. This article summarizes our experience in its diagnosis and open surgical management. A retrospective review of LD cases treated at our tertiary medical institution was conducted between July 2018 and May 2023. The clinical and demographic data were retrieved from case notes. Three cases were included in this review. There were 2 male patients and 1 female patient. The average and median ages were 47.3 and 54 years, respectively. Presenting symptoms included hoarseness, pharyngeal foreign body sensation, and neck mass. All 3 diverticula were on the left side, with the first 2 cases discovered accidentally on gastric endoscopic or cervical MRI examinations. After evaluating esophageal swallowing with barium sulfate or urografin contrast media, all the patients consented to undergo an open surgical procedure. During surgical exploration, the diverticula were found to be on the posterior part of the cervical esophagus, below CPM, and away from the recurrent laryngeal nerve, and only then, could the diagnosis of LD be established. Then, diverticulectomy and manual suturing of the esophagus was performed. Recovery of all 3 patients was uneventful. Nasogastric tube feeding lasted 7 to 12 days until esophageal examinations demonstrated no leak, and then, oral liquid feeding resumed. The median duration of follow-up was 50 months. No recurrence of symptoms or diverticulum was observed, and the swallowing function of all 3 patients was excellent. An open surgical approach is not only important for the diagnosis of LD, but can also be utilized as a safe and effective treatment.
PubMed: 37752849
DOI: 10.1177/01455613231202245 -
Cureus Aug 2023Obstructive sleep apnea (OSA), caused by airway narrowing, is likely to occur if the mandibular plane to hyoid distance is greater than 15.4 mm and the posterior...
INTRODUCTION
Obstructive sleep apnea (OSA), caused by airway narrowing, is likely to occur if the mandibular plane to hyoid distance is greater than 15.4 mm and the posterior airway space (PAS) is less than 11 mm. OSA may be caused by mandibular deficit, bimaxillary retrusion, increased lower facial height, extended soft palate, a large tongue base, and a posteroinferiorly positioned hyoid bone. Snoring and drowsiness during exercise are symptoms of OSA, which is a risk factor for high blood pressure, heart disease, and stroke, and these can result in car crashes. However, orthognathic surgery can improve dental occlusion and aesthetics by adjusting facial bone position, shape, and size. When bones move, the position and tension of soft tissues change. These novel soft tissue interactions, especially when anteroposterior, change the face's appearance and PAS dimensions. This study uses barium sulfate paste to enhance lateral cephalograms before and after orthognathic surgery to assess posterior pharyngeal airway changes.
MATERIALS AND METHODS
Barium sulfate was mixed with water to make a paste for the tongue's dorsum. A preoperative digital lateral cephalogram was obtained, and a postoperative evaluation was conducted six weeks after the procedure. In the cephalostat, the Frankfort horizontal and median planes were aligned parallel to the floor, and a radiograph was taken after the breathing cycle to standardize the hyoid bone location. Preoperative lateral cephalogram analysis using Burstone's hard tissue landmarks confirmed skeletal class II or III deformities. First, the narrowest part of the posterior pharyngeal airway was measured. Second, the narrowest portion between the soft palate and posterior pharyngeal wall parallel to the Frankfort horizontal plane was measured preoperatively, and the procedure was repeated six weeks postop.
RESULTS
Complexity characterizes the pharyngeal airway, which, along with the surrounding structures, facilitates the bodily functions of eating, talking, and breathing. The pharyngeal airway is located behind the nose, mouth, and larynx, and adjusting the jaws changes the size and structure of the pharyngeal airway and surrounding soft tissues, which may affect breathing. A statistically significant change is detected in the posterior palatal and posterior lingual airways after different orthognathic operations. After the mandible is moved forward, both the posterior palatal and posterior lingual airways enlarge. Furthermore, the soft palate exhibits slight decreases in length, thickness, and angle. Additionally, there is an anterosuperior displacement of the hyoid bone. Following maxillary superior impaction, mandibular autorotation is seen in a counterclockwise direction, which has the same result as that of mandibular advancement.
CONCLUSION
It is essential to consider these soft tissue changes when planning orthognathic procedures, as alterations in the pharyngeal airway may impact the patient's postoperative breathing and overall health. Patients with OSA or those at risk of developing it should be closely evaluated and managed appropriately during the surgical planning process.
PubMed: 37664273
DOI: 10.7759/cureus.42836 -
Inorganic Chemistry Jul 2023Radium-226 carbonate was synthesized from radium-barium sulfate (RaBaSO) at room temperature and characterized by X-ray powder diffraction (XRPD) and extended X-ray...
Radium-226 carbonate was synthesized from radium-barium sulfate (RaBaSO) at room temperature and characterized by X-ray powder diffraction (XRPD) and extended X-ray absorption fine structure (EXAFS) techniques. XRPD revealed that fractional crystallization occurred and that two phases were formed─the major Ra-rich phase, Ra(Ba)CO, and a minor Ba-rich phase, Ba(Ra)CO, crystallizing in the orthorhombic space group (no. 62) that is isostructural with witherite (BaCO) but with slightly larger unit cell dimensions. Direct-space modeling shows that the carbonate oxygens in the major Ra(Ba)CO phase are highly disordered. The solubility of the synthesized major Ra(Ba)CO phase was studied from under- and oversaturation at 25.1 °C as a function of ionic strength using NaCl as the supporting electrolyte. It was found that the decimal logarithm of the solubility product of Ra(Ba)CO at zero ionic strength (log ) is -7.5(1) (2σ) ( = 0.05 g·L). This is significantly higher than the log of witherite of -8.56 ( = 0.01 g·L), supporting the disordered nature of the major Ra(Ba)CO phase. The limited co-precipitation of Ra within witherite, the significantly higher solubility of pure RaCO compared to witherite, and thermodynamic modeling show that the results obtained in this work for the major Ra(Ba)CO phase are also applicable to pure RaCO. The refinement of the EXAFS data reveals that radium is coordinated by nine oxygens in a broad bond distance distribution with a mean Ra-O bond distance of 2.885(3) Å (1σ). The Ra-O bond distance gives an ionic radius of Ra in a 9-fold coordination of 1.545(6) Å (1σ).
PubMed: 37477287
DOI: 10.1021/acs.inorgchem.3c01513 -
Chemosphere Nov 2023Naturally occurring radioactive materials (NORMs) can be found in decommissioned oil and gas infrastructure (e.g. pipelines), including scales. The effects of NORM...
Naturally occurring radioactive materials (NORMs) can be found in decommissioned oil and gas infrastructure (e.g. pipelines), including scales. The effects of NORM contaminants from offshore infrastructure on benthic macroorganisms remain poorly understood. To test the potential ecological effects of NORM-contaminated scale, we exposed a marine amphipod, a clam and a polychaete to marine sediments spiked with low level concentrations of barium sulfate scale retrieved from a decommissioned subsea pipe. Only amphipods were included in further analysis due to treatment mortalities of the clam and polychaete. Barium (Ba) and copper (Cu) were elevated in the seawater overlying the spiked sediments, although no sediment metals exceeded guidelines. Po was the only NORM detected in the overlying waters while both Po and Ra were significantly elevated in the scale-contaminated sediments when compared with the control sediments. The whole-body burden of Ba and Ra were significantly higher in the scale-exposed amphipods. Using experiment- and scale-specific parameters in biota dose assessments suggested potential dose rates may elicit individual and population level effects. Future work is needed to assess the biological impacts and effects of NORM scale at elevated levels above background concentrations and the accumulation of NORM-associated contaminants by marine organisms.
Topics: Animals; Amphipoda; Barium; Barium Sulfate; Biological Products
PubMed: 37625489
DOI: 10.1016/j.chemosphere.2023.139939 -
Quantitative Imaging in Medicine and... Mar 2024Microvascular visualization is crucial in understanding the mechanisms of several pathologies. For instance, visualization of the tumor microenvironment is important in...
BACKGROUND
Microvascular visualization is crucial in understanding the mechanisms of several pathologies. For instance, visualization of the tumor microenvironment is important in understanding angiogenesis and role in cancer progression. Visualization would provide insights to cancer diagnosis, predicting metastatic growth, and evaluating therapeutic protocols. Similarly, understanding the microvascular network could be beneficial for study of degenerative diseases and tissue repair. The use of microscale computed tomography (micro-CT) and vascular casting agents provides high-resolution images of tissue vasculature in volumetric space. The purpose of this research was to compare a selection of commercially available contrast agents to determine the optimal solution for vascular visualization.
METHODS
A population of 16 female nude athymic mice (Charles Rivers Laboratories) were implanted with MDA-MB-231 breast cancer cells (ATCC) orthotopically in the lower left mammary fat pad to investigate the tumor microenvironment. Once tumors reach sufficient size, animals were equally divided into four groups based on the micro-CT agent to be administered, namely, control (no contrast agent), barium sulfate (BaSO), Vascupaint, or Microfil. Animals were anesthetized prior to transcarotid micro-cannulation to infuse 2 mL of the specific contrast agent for intravascular distribution throughout the animal. The jugular vein on the other side of the carotid artery was opened to drain blood flow. Following successful perfusion, animals and extracted organs underwent high-resolution micro-CT scanning (OI/CT, MILabs). Images were reconstructed and analyzed using analysis software to extract mean intensity signals.
RESULTS
Preliminary post-mortem micro-CT results reveal Vascupaint and BaSO are useful for microvascular visualization. Both Vascupaint and BaSO produced significant contrast-enhanced micro-CT image enhancement in the brain (3.39±0.93 and 6.27±3.78, respectively) and kidney (12.85±1.98 and 32.87±10.03, respectively) as compared to Microfil (0.22±0.07 and 0.91±0.63, respectively; P<0.05). For the various contrast agents, there were no differences in image enhancement from the liver, spleen, or tumor tissue (P>0.21). Moreover, use of Vascupaint and BaSO allowed for visualization of smaller microvascular structures with average diameters of 20.54±4.15 and 25.82±3.75 µm, which were smaller compared to the 91.66±24.91 µm measurements from Microfil-enhanced micro-CT images (P<0.004).
CONCLUSIONS
Our study suggests that the use of Vascupaint and BaSO is more than sufficient for visualization of microvascular structures with contrast-enhanced micro-CT imaging as these contrast agents more effectively perfused smaller blood vessels.
PubMed: 38545055
DOI: 10.21037/qims-23-901 -
Medicine Apr 2024Barium peritonitis is an inflammatory response that occurs when barium accidentally enters the abdominal cavity during a barium test. In extreme circumstances, it has...
RATIONALE
Barium peritonitis is an inflammatory response that occurs when barium accidentally enters the abdominal cavity during a barium test. In extreme circumstances, it has the potential to harm various organs and even result in death.
PATIENT CONCERNS
A 3-month-old infant was diagnosed with multiple organ failure after severe barium peritonitis.
DIAGNOSIS
Multiple organ dysfunction is associated with barium peritonitis.
INTERVENTIONS
The infant underwent surgical intervention and received ventilator support, anti-infection therapy, myocardial nutrition, liver and kidney protection, rehydration, circulation stabilization, and other symptomatic supportive care.
OUTCOMES
The patient experienced clinical death after treatment and resuscitation was unsuccessful.
LESSONS
Barium enema perforation complications are uncommon, but can lead to fatal injuries with a high mortality rate. This case highlights the importance of raising awareness among clinicians about the risks of gastroenterography in infants and children and actively preventing and avoiding similar serious complications. The mortality rate can be reduced by timely multidisciplinary consultation and joint management once a perforation occurs.
Topics: Humans; Infant; Intestinal Perforation; Multiple Organ Failure; Fatal Outcome; Peritonitis; Male; Barium Enema; Barium Sulfate; Contrast Media
PubMed: 38669395
DOI: 10.1097/MD.0000000000037926 -
Nature Communications Oct 2023Spatiotemporal control over crystal nucleation and growth is of fundamental interest for understanding how organisms assemble high-performance biominerals, and holds...
Spatiotemporal control over crystal nucleation and growth is of fundamental interest for understanding how organisms assemble high-performance biominerals, and holds relevance for manufacturing of functional materials. Many methods have been developed towards static or global control, however gaining simultaneously dynamic and local control over crystallization remains challenging. Here, we show spatiotemporal control over crystallization of retrograde (inverse) soluble compounds induced by locally heating water using near-infrared (NIR) laser light. We modulate the NIR light intensity to start, steer, and stop crystallization of calcium carbonate and laser-write with micrometer precision. Tailoring the crystallization conditions overcomes the inherently stochastic crystallization behavior and enables positioning single crystals of vaterite, calcite, and aragonite. We demonstrate straightforward extension of these principles toward other biorelevant compounds by patterning barium-, strontium-, and calcium carbonate, as well as strontium sulfate and calcium phosphate. Since many important compounds exhibit retrograde solubility behavior, NIR-induced heating may enable light-controlled crystallization with precise spatiotemporal control.
PubMed: 37816757
DOI: 10.1038/s41467-023-42126-4 -
Scientific Reports Mar 2024This work discusses selecting optimal brake friction composite alternatives based on an integrated MABAC (multi-attributive border approximation area comparison) and AHP...
This work discusses selecting optimal brake friction composite alternatives based on an integrated MABAC (multi-attributive border approximation area comparison) and AHP (analytic hierarchy process) approach. Therefore, non-asbestos automotive brake friction composites containing varying proportions of cement dust (50 to 0 wt%) and barium sulfate (0 to 50 wt%) were developed and tribo-evaluated on a Krauss machine following European regulations. Composite made up of 30 wt% cement dust and 20 wt% barium sulfate had the highest friction coefficient (0.361), lowest variability coefficient (0.598), and maximum recovery (123.27%). The composite with the least fading (15.36%) included 50 wt% cement dust, whereas the composite with the lowest wear (9.10 g) and the least frictional fluctuations (0.271) contained 50 wt% barium sulfate. By AHP, the friction coefficient (0.1989), fade (0.1696), recovery (0.1551), and wear (0.1412) were selected as the essential criteria in the performance assessment. Based on the MABAC ranking evaluation, the composite comprises 20 wt% barium sulfate and 30 wt% cement dust has the best tribological profile, whereas the composites of solely cement dust or barium sulfate have the poorest tribological profile. The acquired ranking results were confirmed using other decision-making models and subjected to sensitivity analysis to demonstrate their robustness.
PubMed: 38514706
DOI: 10.1038/s41598-023-46385-5 -
Canister valve and actuator deposition in metered dose inhalers formulated with low-GWP propellants.International Journal of Pharmaceutics Dec 2023A challenge in pressurised metered-dose inhaler (pMDI) formulation design is management of adhesion of the drug to the canister wall, valve and actuator internal...
A challenge in pressurised metered-dose inhaler (pMDI) formulation design is management of adhesion of the drug to the canister wall, valve and actuator internal components and surfaces. Wall-material interactions differ between transparent vials used for visual inspection and metal canister pMDI systems. This is of particular concern for low greenhouse warming potential (GWP) formulations where propellant chemistry and solubility with many drugs are not well understood. In this study, we demonstrate a novel application of X-ray fluorescence spectroscopy using synchrotron radiation to assay the contents of surrogate solution and suspension pMDI formulations of potassium iodide and barium sulphate in propellants HFA134a, HFA152a and HFO1234ze(E) using aluminium canisters and standard components. Preliminary results indicate that through unit life drug distribution in the canister valve closure region and actuator can vary significantly with new propellants. For solution formulations HFO1234ze(E) propellant shows the greatest increase in local deposition inside the canister valve closure region as compared to HFA134a and HFA152a, with correspondingly reduced actuator deposition. This is likely driven by chemistry changes. For suspension formulations HFA152a shows the greatest differences, due to its low specific gravity. These changes must be taken into consideration in the development of products utilising low-GWP propellants.
Topics: Metered Dose Inhalers; Nebulizers and Vaporizers; Administration, Inhalation; Catheters; Aluminum; Suspensions; Aerosol Propellants; Hydrocarbons, Fluorinated
PubMed: 37925043
DOI: 10.1016/j.ijpharm.2023.123569