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Choking is a relevant public health problem. Data in medical literature are scarce and fatal events are dramatically under-reported.The aim of this manuscript is to give a real estimation of this problem and to raise awareness about this topic.Materials and methods. All deaths caused by choking reported by Italian Mass Media over a two years period were collected. Suspected sudden infant death syndrome was an exclusion criteria.Results. 76 deaths due to foreign body airway obstruction were identified, 51% during 2018 and 49% in 2019, without identifiable time clusters. Choking affected every age, including pre-scholar children (25%), children 6 to 18 years old (3%), adults (38%), and elderly patients (34%). Witnessed cases were 61 (80%) but in almost half 26 cases (42%) the fatal event occurred before or without first aid maneuvers being performed.Conclusion. On the Italian territory, during a 2 years period, three cases per month of fatal choking due to foreign-body airway obstruction occurred, many of them in adult patients (38%). Italian people seem not to be educated to provide first aid in these settings.

Penetrating wounds from sea urchin spines are marine injuries that may cause morbidity in humans. Seasonal fishing for abalone in Dhofar is associated with an increase in the number of these injuries, as divers may strike their extremities, especially the dorsum of hands and fingers, on the rocks where Echinoderms and juvenile abalone (Haliotis mariae) are anchored. The immediate effect of injuries includes pain, edema, bleeding, erythema, and rarely systemic complications. There can be a delayed effect in the form of chronic granulomatous skin disease, which is a slow developing reaction to retained spine fragments in the wound that may take several months to develop. We report a case of sea urchin granulomas in a 45-year-old male who injured his hands by the spines of sea urchin while harvesting Haliotis mariae. Clinical manifestations, histological patterns, and treatment modalities are discussed here, to enhance the knowledge about these injuries and the available therapies.

An eleven month old male, juvenile lion brought for rehabilitation at the Olusegun Obasanjo Presidential Library (OOPL) Wildlife Park was diagnosed with gastrointestinal foreign body and intussusception based on the history of persistent vomiting following ingestion of a cotton towel, and radiographic findings of a radiopaque gastric foreign body extending from the fundus to the pylorus and a cylindrical soft tissue mid-abdominal mass. The lion was premedicated with an intramuscular injections of ketamine (5 mg.kg−1) and midazolam (0.25 mg.kg−1), while anaesthesia was induced with an intravenous injection of propofol (2 mg.kg−1). A celiotomy followed by gastrotomy and subsequent intestinal resection and anastomosis was performed to remove the gastrointestinal foreign bodies and correct the intussus ception. The lion recovered well without any complication and was gradually introduced back into the group housing three weeks later following successful alimentation process. This report is probably the first case of intussusception in a lion that was associated with a gastrointestinal foreign body.

Purpose: To report the clinicopathologic features of a case of conjunctival synthetic fiber granuloma. Case Report: A 6-year-old girl presented with a slow-growing red nodule in the right inferior conjunctival sac with no history of surgery or trauma. Histopathological examination revealed foreign body type granulomatous inflammation around birefringent fibers of variable colors consistent with synthetic fiber granuloma. Conclusion: This is the first case report of synthetic fiber (teddy bear) conjunctival granuloma from Iran. Despite its scarcity, ophthalmologists should consider this type of granuloma in the differential diagnoses of childhood conjunctival lesions especially when the lesion is unilateral and inferior.

Introduction and Aim: Retained intracorporeal textile products (gossypiboma-textiloma) are undesired and accidental surgical results for both patients and surgeons, which are underreported because of medicolegal remifications. Fourteen textiloma cases, who had been treated or whose treatment procedures had been followed-up personally by two general surgeons in a period of 27 years almost during their whole professional lives were presented to describe and define the clinical and pathological characteristics. Material and Methods: Patient characteristics including gender and age, areas of location within the body, time intervals until diagnosis, clinical presentations and complaints, treatment modalities, complications, causative surgical interventions, and diagnostic approaches were retrospectively evaluated. Results: Nine female and five male patients with a mean age of 43.07 ± 15.23 (median: 45) years at diagnosis were enrolled in the study. Cesarean section in three, inguinal hernioraphy in four, explorative laparotomy because of acute abdomen in one, sigmoid colon resection in one, appendectomy and right salpingoophorectomy in one, etrangulated incisional hernia after a previous surgical intervention because of an ovarian mass in one, thyroidectomy in one, epigastric hernioraphy in one, and bilateral segmental mastectomy with bilateral axillary sentinal lymph node dissection in one were the causative surgical interventions. Locations of textilomas were the abdominal cavity in seven, inguinal surgical wound in four, epigastric surgical wound in one, thyroidectomy lodge in one, and bilateral axillary cavities in one patient. The mean time interval until diagnosis was 14.48 (median: 5.5) months. Dıscussıon: Earlier recognition of foreign bodies can provide a better outcome. Conclusion: Gossypibomas are preventable iatrogenic faults which create severe problems. Strict adherence to the rules of the operation room is a must to keep the tip of the iceberg shut in the Pandora’s box.

Intracranial foreign body granulomas are rarely reported. Clinical symptoms caused by foreign body granulomas can be noticed from months to many years after surgical procedure. The most common reported etiology is suture material. A 45-year-old woman was presented with grand mal epilepsy. She was operated for brain tumor 19 years ago. In CT scan, a round radio-dense mass resembling a tumor at anterior fossa was seen. She underwent craniotomy and resected a granuloma with cotton fibers surrounded by yellow capsule without residual or recurrent tumor. Granuloma can mimic intracranial meningioma and special attention should be paid not to leave cotton pledgets during operations.

Paciente do sexo masculino, branco, 43 anos, apresentava há dois anos lesão única, localizada no joelho direito, além de descamação nas regiões plantares. O exame micológico direto das lesões plantares mostrava filamentos de dermatófitos, mas foi negativo na lesão do joelho. Porém o exame histopatológico dessa área demonstrou presença de granuloma de corpo estranho com hifas de dermatófitos, confirmando o diagnóstico de granuloma de Majocchi.Caucasian male patient, 43 years old, presented two years ago with one single lesion in the right knee, in addition to desquamation in the plantar region. Direct mycological exam of the plantar damage showed filaments of dermatophytes, but it was negative for the knee injury. However, histopathology of the area showed presence of foreign body granuloma with hyphae of dermatophytes, confirming the diagnosis of Majocchi's granuloma.

Los tricobezoares son poco comunes, pueden presentarse en estómagos normales, pero la mayoría ocurre como complicación de una cirugía gástrica en casos con alteración de la función del píloro e hipoperistalsis. Se debe sospechar el tricobezoar en un paciente joven, generalmente mujer, con una masa móvil o firme en el epigastrio. Algunos pacientes permanecen asintomáticos por meses o años y otros presentan síntomas que pueden ser insidiosos o dramáticamente agudos. Aunque la entidad es diagnosticada por imágenes, la endoscopia permite su identificación de una forma más eficaz. Algunos bezoares pueden ser tratados endoscópicamente, pero se recomienda el tratamiento quirúrgico para los de mayor tamaño o con complicaciones. Una vez tratado, se debe hacer énfasis en la prevención de la recurrencia. Se presenta el caso de una paciente con un tricobezoar gástrico complicado, con antecedentes de cirugía gástrica por la misma causa en la edad pediátrica, que requiere nueva cirugía por recurrencia y sin mostrar trastornos psiquiátricos.