Tomáš Navrátil

Do Corticosteroids Prevent Oesophageal Stricture After Corrosive Ingestion

The most serious complication of corrosive damage to the oesophagus besides perforation is stricture formation. The role of corticosteroids in preventing corrosive-induced strictures is controversial. This review evaluates the usefulness of corticosteroid treatment by critically assessing clinical reports published between 1991 and 2004 in the English, German, French and Spanish literature. Inclusion criteria were the presence of second- or third-degree oesophageal injuries documented by endoscopy and management involving either at least an 8-day course of corticosteroids or no steroid therapy. Ten studies with a total of 572 patients fulfilled the inclusion criteria: six studies employed corticosteroids, two studies did not use corticosteroids, and two studies compared the outcome with and without corticosteroid treatment. In those patients with second-degree burns, the incidence of stricture in the corticosteroid-treated patients was 13.8% and in the non-corticosteroid-treated patients was 6.3%. In those patients with third-degree burns, significantly worse results were found in the corticosteroid-treated group (71.0%) than in the non-corticosteroid-treated group (23.1%). As all studies did not separate second- and third-degree burns, re-analysis of the outcome was undertaken. In the 305 patients treated with corticosteroids, 35.1% developed strictures, whereas 33.3% of the 267 non-corticosteroid-treated patients developed strictures. These data suggest that systemic corticosteroids are not beneficial for second- and third-degree corrosive oesophageal burns. Therefore, the use of corticosteroids in the management of corrosive ingestions should be abandoned as they do not prevent the development of strictures and may lead to the development of serious adverse effects.

Twenty-year inter-annual trends and seasonal variations in precipitation and stream water chemistry at the Bear Brook Watershed in Maine, USA.

Mean annual concentration of

Distribution and Pools of Mercury in Czech Forest Soils

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2,3,7,8-TCDD exposure, endothelial dysfunction and impaired microvascular reactivity

in wet-only deposition has decreased between 1988 and 2006 at the paired watershed study at Bear Brook Watershed in Maine, USA (BBWM) due to substantially decreased emissions of SO2. Emissions of NOx have not changed substantially, but deposition has declined slightly at BBWM. Base cations,

Acute Methanol Poisoning: Prevalence and Predisposing Factors of Haemorrhagic and Non‐Haemorrhagic Brain Lesions

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Effect of fire on pools of mercury in forest soil, Central Europe.

, and Clu2009−u2009 concentrations were largely unchanged, with small irregular changes of <1xa0μeq Lu2009−u20091 per year from 1988 to 2006. Precipitation chemistry, hydrology, vegetation, and temperature drive seasonal stream chemistry. Low flow periods were typical in June–October, with relatively greater contributions of deeper flow solutions with higher pH; higher concentrations of acid-neutralizing capacity, Si, and non-marine Na; and low concentrations of inorganic Al. High flow periods during November–May were typically dominated by solutions following shallow flow paths, which were characterized by lower pH and higher Al and DOC concentrations. Biological activity strongly controlled

Erratum to: Positive serum ethanol concentration on admission to hospital as the factor predictive of treatment outcome in acute methanol poisoning

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Successful Use of Hydroxocobalamin and Sodium Thiosulfate in Acute Cyanide Poisoning: A Case Report with Follow-up.

and Ku2009+u2009. They were depressed during the growing season and elevated in the fall. Since 1987, East Bear Brook (EB), the reference stream, has been slowly responding to reduced but still elevated acid deposition. Calcium and Mg have declined fairly steadily and faster than

DEPOSITION AND FATE OF LEAD IN A FORESTED CATCHMENT, LESNI POTOK, CENTRAL CZECH REPUBLIC

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Beryllium Geochemistry in the Lesni Potok Catchment (Czech Republic), 7 Years of Systematic Study

, with consequent acidification (lower pH and higher inorganic Al). Eighteen years of experimental treatment with (NH4)2SO4 enhanced acidification of West Bear Brook’s (WB) watershed. Despite the manipulation,