Health Updates-July 2010

Pediatrics:

Accidental Battery-Ingestions on the Rise in Children and Can be Fatal

Pediatrics, 6 June 2010

Recent cases suggest that severe and fatal button battery ingestions are increasing and current treatment may be inadequate.There has been a 6.7-fold increase in the percentage of button battery ingestions with major or fatal outcomes from 1985 to 2009 (National Poison Data System-U.S.). Ingestions of 20- to 25-mm-diameter cells increased from 1% to 18% of ingested button batteries (1990–2008), paralleling the rise in lithium-cell ingestions (1.3% to 24%). Outcomes were significantly worse for large-diameter lithium cells (20 mm) and children who were younger than 4 years. The 20-mm lithium cell was implicated in most severe outcomes. Severe burns with sequelae occurred in just 2 to 2.5 hours. Most fatal (92%) or major outcome (56%) ingestions were not witnessed. At least 27% of major outcome and 54% of fatal cases were misdiagnosed, usually because of nonspecific presentations. Injuries extended after removal, with unanticipated and delayed esophageal perforations, tracheoesophageal fistulas, fistulization into major vessels, and massive hemorrhage.

Bottom Line: Have a very low threshold to call your doctor if there is any potential that you child has swallowed a battery.

Adult Medicine

Writing down your thoughts and emotions might help relieve the
symptoms of irritable bowel syndrome (IBS), researchers say. This
early researchis the first to test so-called “expressive writing” in
people with IBS, and the results are still very preliminary. Studies
looking at this type of writing, in which the writer is encouraged to
“really let go” and get to the bottom of their feelings, has shown
that it can be beneficial for some.

The exercise has helped people with depression, rheumatoid arthritis,
chronic pain, high blood pressure and AIDS, the authors of the new
study noted online in the June 15th issue of the American Journal of
Gastroenterology. According to Dr. Albena Halpert of Boston Medical
Center, the 82 patients in the IBS study reported improvements in
disease severity, coping and thinking at 1 and 3 months after they
started writing and also described their quality of life improving.

http://www.medscape.com/viewarticle/724078

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