1/7. Chemical burn from alkaline batteries--a case report.A 2-year-old male was found to have a third degree (full thickness) burn on his rear right thigh. The father discovered the burn at a physician's office where the child was being treated for an ear infection. The physician notified authorities of suspected physical child abuse.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/7. Burn injuries caused by air bag deployment.Automobile air bags have gained acceptance as an effective measure to reduce the morbidity and mortality associated with motor vehicle accidents. As more cars have become equipped with them, new problems have been encountered that are directly attributable to the deployment of the bag itself. An increasing variety of associated injuries has been reported, including minor burns. We present two automobile drivers who were involved in front-impact crashes with air bag inflation. They sustained superficial and partial-thickness burns related to the deployment. The evaluation of these cases shows mechanisms involved in burn injuries caused by the air bag system. Most of the burns are chemical and usually attributed to sodium hydroxide in the aerosol created during deployment. Also direct thermal burns from high-temperature gases or indirect injuries due to the melting of clothing, as well as friction burns from physical contact are possible. However, the inherent risks of air bag-related burns are still outweighed by the benefits of preventing potentially life-threatening injuries.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/7. Artefactual skin disease in children and adolescents.As in adults, artefactual skin disease in children and adolescents has heterogenous presentations with multifactorial aetiology. We report a series of 32 young patients aged 8-16 years. There were 24 females and 8 males. In over half of the cases the lesions were on the head and neck. The types of lesions encountered included physical injury producing grazing, erosions and deep ulcers, chemical and thermal burns, hair cutting and shaving and skin painting. We discuss the approach that we believe should be taken with these patients, emphasizing the role of dermatology-psychiatry liaison in their management. Of great importance is the avoidance of confrontation of the patient but the clear exposition of the nature of the problem to the parents. The major aim should be to have the family accept the need for expert psychiatric assistance.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/7. Complex regional pain syndrome as a complication of a chemical burn to the foot.Complex regional pain syndrome (CRPS) is an unusual complication after burns; however, it is important to recognize so that appropriate treatment can be administered. A 60-year-old man suffered an alkali burn to the right foot. Subsequently, the patient developed CRPS with severe pain and vasomotor changes. Multimodal treatment included the early use of ropivacaine and fentanyl via epidural catheter. Oral extended-release morphine, gabapentin, and amitriptyline also were administered. Once pain was controlled, early aggressive physical therapy was instituted, and attention was turned toward wound coverage. One year after discharge, the patient was ambulating well and has returned to work. His pain was managed with a single morning dose of gabapentin and a nonsteroidal anti-inflammatory agent. Current examination of the foot revealed mild forefoot swelling without residual erythema. Ambiguities exist in the mainstay of treatment for CRPS, but this multimodal method of controlling CRPS after burn injury allowed for control of the patient's pain, early mobilization, and eventual return to work.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/7. Traumatic lesions of the gingiva: a case series.BACKGROUND: The most recent classification of periodontal diseases includes a new section on traumatic gingival lesions. Traumatic lesions of the gingiva are thought to be highly prevalent, yet the periodontal literature contains few references on the topic. The purpose of this article is to present a broad spectrum of traumatic gingival lesions of iatrogenic, accidental, and factitious origin. methods: Twelve clinical cases were selected to document chemical (due to aspirin, snuff, and peroxide), physical (due to malocclusion, flossing, removable partial denture, oral piercing, and self-inflicted trauma), and thermal (due to overheated ultrasonic scaler, hot food, and ice) injury to the gingiva. RESULTS: Chemical, physical, and thermal gingival injuries of iatrogenic, accidental, or factitious origin can have a variety of presentations with overlapping clinical features. Although the appearance and associated symptoms of a gingival lesion may be suggestive of a particular traumatic etiology, useful or confirmatory diagnostic information is often discovered through careful history-taking. The management of gingival injuries typically requires elimination of the insult and symptomatic therapy. If permanent gingival defects resulted from the injury, periodontal plastic surgery may be necessary. CONCLUSIONS: A variety of chemical, physical, and thermal injuries may involve the gingiva. Accidental and iatrogenic injuries are often acute and self-limiting, while factitious injuries tend to be more chronic in nature.- - - - - - - - - - ranking = 3keywords = physical (Clic here for more details about this article) |
6/7. Pediatric caustic ingestion and parental cocaine abuse.OBJECTIVE: To report two cases in which toddlers drank a caustic liquid which their parents had been using to prepare free-base and crack cocaine. DESIGN: Case series. RESULTS: Two toddlers presented with first- and second-degree burns of the oral cavity, pharynx and esophagus from caustic ingestion. The first had drunk ammonia from an unmarked clear plastic container the morning after "a party at a friend's house". The second had drunk potassium hydroxide from a clear plastic container which was labelled "pH UP" and had a small "Danger" sign. Both children were treated with intravenous hydration, steroids, antibiotics and analgesics. Fortunately, neither child suffered long-term physical sequelae. When questioned, the parents of both children admitted to using these alkalis to prepare free-base and crack cocaine. Appropriate steps were taken by social services to protect these children from further neglect. DISCUSSION: Despite federal legislation and public education, pediatric caustic ingestion remains a significant problem. These cases suggest that, in certain cases of pediatric caustic ingestion, caregivers should be questioned regarding possible drug abuse. Larger warning labels and further public education might help prevent many cases of pediatric caustic ingestion.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/7. Mass ammonia inhalation.The clinical, roentgenographic and laboratory findings, their relationship to each other and to the subsequent hospital course are reported for 14 victims of gaseous ammonia inhalation. Initial physical examination enabled differentiation of a mildly affected from a moderately affected group, but patients in both groups responded well to conservative medical management.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |