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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Own data and analysis of previous publications show that situations where accidental ingestion of corrosive substances by children may have happened are frequent, but severe corrosive esophagitis leading to perforation or stricture formation is very rare. In case of suspected esophageal injury, esophagoscopy and glucocorticoid treatment become necessary. The evaluation of the initial symptoms in patients from our own material and from the literature indicates that all children with serious esophageal burns had one or more of the following symptoms: visible burns in the oral cavity, hypersalivation, retching, vomiting, retrosternal or epigastric pain, cardiovascular collaps, airway stenosis. Hence, children with an uncertain history of ingestion and without any of these symptoms need not be treated. After ingestion of liquid substances, but never of dry or granular products, lesions in the esophagus without accompanying burns in the oral cavity were observed. The evaluation of 1158 cases of accidental ingestions of several types of household products and a collection of data from the literature on the causticity of these substances shows that cleaners containing mainly detergents and phosphates (with pH values generally between 9 and 11), and household bleaches on sodium hypochlorite basis, are relatively harmless. Drain cleaners (NaOH), decalcifiers (formic acid) and detergents for automatic dish washing machines (metasilicates) are very caustic and are responsible for the majority of serious accidents in children.
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PMID:Local injuries by accidental ingestion of corrosive substances by children. 2 63

Two apparently novel viral gastroenteritides of dogs were recognized in 1978: one caused by a parvo-like virus (CPV) and one by a corona-like virus (CCV). A rotavirus has also been tentatively associated with neonatal pup enteritis. Canine viral enteritis is characterized by a sudden onset of vomiting and diarrhea, rapid spread and high morbidity. Treatment is only supportive but must be initiated promptly. Infected animals should be isolated immediately; the extremely contagious nature of these diseases makes them difficult to contain. Feces from infected dogs appear to be the primary means of transmission. Sodium hypochlorite solutions (eg, Clorox) are recommended for disinfection. The development of effective vaccines is an immediate and pressing problem.
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PMID:Canine viral enteritis. Recent developments. 22 4

The widespread use of household bleach (5.25% sodium hypochlorite) as a disinfectant by IV drug users may cause an increase in the number of IV injections of this substance. We report the case of a 31-year-old man who injected less than 1 mL of bleach and then experienced transient left-sided chest pain and vomiting. The patient did not have any serious complications. This report is similar to the only other reported case in the medical literature of an IV injection of a small amount of bleach. Based on these two reports, household bleach appears to be safe when used as a disinfectant by IV drug users, but more studies are needed.
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PMID:Intravenous injection of household bleach. 141 39

This paper discusses the attempt to increase coverage of health care delivery for preschool/school aged children by using their teachers as 1st contacts for primary health care (PHC) before referrals were made. 26 teachers from preschool and primary schools in Lagos, Nigeria attended a 1 week course run by the Institute of Child Health and Primary Care to teach them PHC skills before referrals. At the end of the course participants had to: 1) recognize common illnesses in children; 2) identify children needing immediate referrals to the hospital; 3) take temperature, sponge a child with a fever, sterilize an infant's feeding utensils using hypochlorite solution, assess the nutritional status of children; 4) list the various components and prepare a weaning diet; and 5) discuss the nutritional needs for preschool and school-aged children. All the participants improved their performance on the post-test. A year later participants and their employers were given short questionnaires. The employers rated the teachers' performance as very good and were willing to send them back for more training. The teachers were most useful in their establishments in dealing with: measles, fevers, convulsions, cuts and wounds, difficult breathing, diarrhea and vomiting, tepid sponging and temperature taking. This model is recommended for replication elsewhere. (Author's modified).
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PMID:School teachers as primary health care workers. 236 48

Of 758 infants' feeding-bottles and teats collected aseptically by health visitors in four areas of Great Britain and examined in public health laboratories, less than two-thirds of the bottles and just over half of the teats produced results within an arbitrary "satisfactory" level. The mothers who said they used the hypochlorite method of sterilization and of storage of bottles and teats produced significantly better results. More of the mothers with satisfactory results had attended mothercraft classes. Twenty-two per cent. of babies in the sample were said to have suffered from diarrhoea, or vomiting, or both.The standards of home sterilization of bottles and teats could be improved, and straightforward and effective health education is required, together with professional backing, so that mothers would put into practice what they had been taught.
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PMID:Hygiene of infant-feeding utensils. Practices and standards in the home. 544 May 67

Ingestion of sodium hypochlorite bleach is usually benign, leading most poison centers to advocate conservative, home management. We report a rare, fatal case of household bleach ingestion. A 66-y-old female ingested an unknown quantity of regular CLOROX bleach (5.25% sodium hypochlorite, pH = 11.4). Upon discovery, she was vomiting spontaneously, and had slurred speech and oral mucosal discoloration. On hospital arrival the patient became unresponsive with shallow respirations. Laboratory studies revealed hypernatremia (169 mEq Na/L), hyperchloremia (143 mEq Cl/L), and metabolic acidosis (5 mmol total CO2/L). Radiographic evaluation showed bilateral pneumothoraces and pneumoperitoneum. The patient was intubated and ventilated, hypotension was treated with fluid resuscitation, and metabolic acidosis corrected with sodium bicarbonate. Naloxone and flumazenil were given without effect, and thoracostomy tubes were placed. Rapid deterioration of vital signs and mental status ensued, with cardiorespiratory arrest from which she was resuscitated. A second cardiac arrest resulted in death. Autopsy revealed esophageal and gastric mucosal erosions, perforation at the gastroesophageal junction, and extensive necrosis of adjacent soft tissue. Stomach contents contained sodium hypochlorite, and pleural and peritoneal fluid had the aroma of bleach. Postmortem vitreous humor Na was 187 mEq/L and Cl was 169 mEq/L. Toxicologic analysis revealed meprobamate metabolites in the urine, and lidocaine in the blood. The literature regarding fatal bleach ingestion is reviewed.
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PMID:Fatal ingestion of sodium hypochlorite bleach with associated hypernatremia and hyperchloremic metabolic acidosis. 1019 36

In January 1999, an outbreak of viral gastroenteritis affected more than 300 people who attended a metropolitan concert hall over a 5-day period. Norwalk-like virus (NLV) was confirmed in faecal samples by reverse transcription polymerase chain reaction assay. The index case was a concert attendee who vomited in the auditorium and adjacent male toilet. Gastrointestinal illness occurred among members of 8/15 school parties who attended the following day. Children who sat on the same level of the auditorium as the index case were much more likely to be ill than those seated elsewhere (relative risk 7.1, 95% confidence interval 5.4-9.2. P < 0.001). The majority of other reported cases had not been present on the evening of the vomiting incident. Disinfection procedure was poor and the disinfectant used contained no sodium hypochlorite. Transmission most likely occurred through direct contact with contaminated fomites. The outbreak has implications for disinfection procedures following vomiting incidents at public venues.
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PMID:An outbreak of viral gastroenteritis following environmental contamination at a concert hall. 1240 11

Etiological factors in the development of dental erosion are usually listed as dietary acids, for instance in soft drinks and fruit juices, and intrinsic acid exposure due to gastro-intestinal disease or frequent vomiting. Quite often the list of causes in reviews and textbooks also includes frequent swimming. This paper evaluates the evidence behind this erosion etiology. The main disinfection techniques using gas chlorination and sodium hypochlorite are described, and their relative risk for development of low pH water is discussed. In the Netherlands only the relatively safe sodium hypochlorite method is used, and the quality of the water in public swimming pools is monitored monthly by independent test laboratories. Data for 2001 from such a test laboratory show that the percentage of low-pH results is very low (0.14%). It is concluded that the risk of dental erosion from frequent swimming in acidic pool water is probably negligible in the Netherlands.
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PMID:[Is Dutch swimming pool water erosive?]. 1476 39

Since 1993, the New York State Department of Health, funded by the Agency for Toxic Substances and Disease Registry, has collected data about non-petroleum hazardous substances releases through the Hazardous Substances Emergency Events Surveillance (NYHSEES) project. This study investigates risk factors for hazardous substances releases that may result in public health consequences such as injury or reported health effects. The 6428 qualifying events that occurred during the 10-year-period of 1993-2002 involved 8838 hazardous substances, 842 evacuations, more than 75,419 people evacuated, and more than 3120 people decontaminated. These events occurred both at fixed facilities (79%) and during transport (21%). The causative factors most frequently contributing to reported events were equipment failure (39%) and human error (33%). Five of the 10 chemicals most frequently associated with injuries were also among the 10 chemicals most frequently involved in reported events: sulfuric acid, hydrochloric acid, ammonia, sodium hypochlorite, and carbon monoxide. The chemical categories most frequently associated with events, and with events with adverse health effects were volatile organic compounds (VOCs) and solvents, and acids. Events with releases of hazardous substances were associated with injuries to 3089 people including employees (37%), responders (12%), the general public (29%) and students (22%). The most frequently reported adverse health effects were respiratory irritation, headache, and nausea or vomiting. Most of the injured were transported to the hospital, treated, and released (55%) or treated at the scene (29%). These data have been used for emergency response training, planning, and prevention activities to reduce morbidity and mortality from future events.
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PMID:New York hazardous substances emergency events surveillance: learning from hazardous substances releases to improve safety. 1551 63

A 16-year-old woman deliberately drank 4.5% sodium hypochlorite bleach. She was transferred to the emergency department after gastric lavage was performed at a local clinic. She experienced chest pain and fever after several vomiting episodes and esophagoscopy. Chest computerized tomography (CT) revealed air bubbles and abnormal soft tissue density at the right lateral aspect of the mid esophagus, a small amount of complicated pleural effusion, and pneumothorax. Barium esophagography revealed abnormal leakage of contrast media at the right wall of the mid esophagus, which indicated acute mediastinitis. The patient received intensive care and underwent delayed esophageal repair and colonic transplant. She was discharged 12 weeks after admission. Sodium hypochlorite is found in household bleaching agents used to disinfect dishes and bleach laundry. Poisoning due to ingestion of sodium hypochlorite bleach usually follows a benign clinical course. Few studies report severe complications such as esophageal stenosis or perforation.
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PMID:Esophageal perforation and mediastinitis after suicidal ingestion of 4.5% sodium hypochlorite [correction of hydrochlorite] bleach. 2185 50


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