The Commerson's dolphin as Subantarctic sentinel of POPs: Insights into the pollutant status in one of the southernmost coastal areas of the globe.

Persistent organic pollutants (POPs) are halogenated contaminants found globally. Cetaceans are impacted by these pollutants, and nowadays, it is essential to understand their presence to mitigate their impacts. This study aimed to establish baseline levels of POPs in the blubber of Commerson's dolphins (Cephalorhynchus commersonii) within the Subantarctic ecosystem. A wide range of POPs concentrations were measured among individuals: ΣPCBs from 289.5 to 15264 ng g-1 lw and ΣDDTs from 540.4 to 17657 ng g-1 lw. Levels of HCB and mirex ranged from 48 to 1703.7 ng g-1 lw and 5.1-1917.4 ng g-1 lw, respectively. The predominant POPs were mid-to high molecular weight PCBs (hexa-PCBs), consistent with other findings in cetaceans of the southern hemisphere. The mean ratio of ΣDDT/ΣPCB was 0.44, with p,p'-DDE/ΣDDT at 0.56, indicating p,p'-DDE as the dominant DDT isomer. Furthermore, differences in POP concentrations were observed based on sexual maturity, with mature males exhibiting higher levels of Æ©PCBs, HCB, Æ©DDT, and mirex. Age and total body length of animals were strongly correlated with POP concentrations. Our study provides valuable insights into the pollutant status of POPs in the Subantarctic population of Commerson's dolphins inhabiting the southernmost coastal regions of South America.

Reptile responses to fire across the western Mediterranean Basin.

Effects of anthropogenic activities, including climate change, are modifying fire regimes, and the dynamic nature of these modifications requires identification of general patterns of organisms' responses to fire. This is a challenging task because of the high complexity of factors involved (including climate, geography, land use, and species-specific ecology). We aimed to describe the responses of the reptile community to fire across a range of environmental and fire-history conditions in the western Mediterranean Basin. We sampled 8 sites that spanned 4 Mediterranean countries. We recorded 6064 reptile sightings of 36 species in 1620 transects and modeled 3 community metrics (total number of individuals, species richness, and Shannon diversity) as responses to environmental and fire-history variables. Reptile community composition was also analyzed. Habitat type (natural vs. afforestation), fire age class (time since the last fire), rainfall, and temperature were important factors in explaining these metrics. The total number of individuals varied according to fire age class, reaching a peak at 15-40 years after the last fire. Species richness and Shannon diversity were more stable during postfire years. The 3 community metrics were higher under postfire conditions than in unburned forest plots. This pattern was particularly prevalent in afforested plots, indicating that the negative effect of fire on reptiles was lower than the negative effect of afforestation. Community composition varied by fire age class, indicating the existence of early- and late-successional species (xeric and saxicolous vs. mesic reptiles, respectively). Species richness was 46% higher in areas with a single fire age class relative to those with a mixture of fire age classes, which indicates pyrodiverse landscapes promoted reptile diversity. An expected shift to more frequent fires will bias fire age distribution toward a predominance of early stages, and this will be harmful to reptile communities.

Respuestas de reptiles al fuego en la Cuenca Mediterránea occidental Resumen Los efectos de actividades antropogénicas, incluyendo el cambio climático, están modificando los regímenes de fuego, y la naturaleza dinámica de estas modificaciones requiere la identificación de patrones generales de las respuestas de los organismos al fuego. Esta es una tarea desafiante debido a la gran complejidad de los factores involucrados (incluyendo clima, geografía, uso de suelo y la ecología de cada especie). Nuestro objetivo fue describir las respuestas de la comunidad de reptiles al fuego bajo diversas condiciones ambientales e historias de fuego en la Cuenca Mediterránea occidental. Muestreamos ocho sitios en cuatro países mediterráneos. Registramos 6064 avistamientos de reptiles de 36 especies en 1620 transectos y modelamos tres métricas comunitarias (número total de individuos, riqueza de especies y diversidad de Shannon) como respuestas a las variables ambientales y de historia de fuego. También analizamos la composición de la comunidad de reptiles. El tipo de hábitat (natural versus forestación), la clase de edad del fuego (tiempo transcurrido desde el último incendio), la precipitación pluvial y la temperatura fueron factores importantes en la explicación de estas métricas. El número total de individuos varió de acuerdo con la clase de edad del fuego, alcanzando un pico a los 15­40 años después del último incendio. La riqueza de especies y la diversidad de Shannon fueron más estables durante los años posteriores a incendios. Las tres métricas de la comunidad fueron más altas bajo condiciones post incendio que en las parcelas sin historial de fuego. Este patrón fue particularmente prevalente en parcelas forestadas, lo cual indica que el efecto negativo del fuego sobre los reptiles fue menor que el efecto negativo de la forestación. La composición de la comunidad varió por clase de edad del fuego, indicando la existencia de especies sucesionales tempranas y tardías (reptiles xéricos y saxícolas, respectivamente). La riqueza de especie fue 46% mas alta en áreas con una sola clase de edad del fuego que en aquellas con una mezcla de clases de edad del fuego, lo cual indica que los paisajes pirodiversos promovieron la diversidad de reptiles. Un cambio esperado hacia incendios más frecuentes sesgará la distribución de la edad del fuego hacia una predominancia de etapas tempranas, y esto será perjudicial para las comunidades de reptiles.

Temporal activity and detection rates of chilla (Lycalopex griseus) in Tierra del Fuego, Argentina.

Designing mitigation strategies for invasive species requires a clear understanding of their ecology and behaviour. Chilla (or grey fox; Lycalopex griseus) were introduced to Isla Grande de Tierra del Fuego (Tierra del Fuego Island) in 1951 to control European rabbit (Oryctolagus cuniculus) populations. Although this management strategy was unsuccessful, the chilla spread across the island and are now considered invasive. Despite this, there is a lack of research concerning their ecology and behavioural patterns, particularly on the Argentinian side of the island. We assessed the detection rates and temporal activity patterns of chillas using camera traps in the Argentinian region of Tierra del Fuego Island. Chilla had average detection rates of 61.7 (SD ± 33.3, range = 13.5-105.7) per 100 trap nights. Although analysis by clock time suggested cathemeral activity patterns, when analysed by sun time the chillas exhibited distinct nocturnal activity patterns. These findings offer the first information on the detection rates of chilla on the Argentinian side of Tierra del Fuego Island and reveal new insights into their temporal activity patterns, providing an important basis for future research that may aid the development of more effective management and conservation strategies.

La dinámica del comercio ilegal de armas de fuego en Lima, Perú / The dynamics of the illegal firearms trade in Lima, Peru / A dinâmica do comércio ilegal de armas de fogo em Lima, Peru

El comercio ilegal de armas de fuego representa un problema significativo para mantener el orden y la seguridad del país, pues conlleva la adquisición de armas y municiones sin cumplir la normatividad y las regulaciones proporcionadas por el Estado, desviando la utilización de dichos equipos hacia la delincuencia. La investigación tiene como propósito analizar la dinámica del comercio ilegal de armas de fuego en Lima, Perú, mediante una metodología cualitativa y de diseño fenomenológico hermenéutico. La muestra incluye veinte funcionarios de la Policía Nacional del Perú (PNP) y la Superintendencia Nacional de Control de Servicios de Seguridad, Armas, Municiones y Explosivos de Uso Civil (Sucamec). La información se recolectó por medio de entrevistas semiestructuradas. El estudio concluye que el comercio ilegal de armas de fuego se estructura en tres fases clave: la primera fase determinada por la filtración o desvío de armas del mercado legal al ilegal, debido a la falta de control y fiscalización por las autoridades pertinentes. La segunda fase implica la creación de un mercado ilegal en espacios itinerantes, donde participan diversos actores, como intermediarios y compradores. La tercera y última fase comprende la consumación del delito, incluye la entrega del arma y el pago bajo estrictas medidas de seguridad para asegurar la impunidad de los involucrados.

The illegal trade in firearms represents a significant problem for the maintenance of order and security in the country, as it leads to the acquisition of arms and ammunition without complying with the norms and regulations provided by the State, diverting the use of such equipment towards crime. The purpose of this research is to analyse the dynamics of the illegal firearms trade in Lima, Peru, using a qualitative methodology and a hermeneutic phenomenological design. The sample includes twenty officers from the Peruvian National Police (PNP) and the National Superintendence for the Control of Security Services, firearms, Ammunition and Explosives for Civilian Use (Sucamec). The information was collected through semi-structured interviews. The study concludes that the illegal firearms trade is structured in three key phases: the first phase determined by the leakage or diversion of arms from the legal to the illegal market, due to the lack of control and oversight by the relevant authorities. The second phase involves the creation of an illegal market in itinerant spaces, where various actors, such as intermediaries and buyers, participate. The third and final phase involves the consummation of the crime, including the delivery of the weapon and payment under strict security measures to ensure the impunity of those involved.

O comércio ilegal de armas de fogo representa um problema significativo para a manutenção da ordem e da segurança no país, pois leva à aquisição de armas e munições sem o cumprimento das normas e regulamentos fornecidos pelo Estado, desviando o uso desses equipamentos para o crime. O objetivo desta pesquisa é analisar a dinâmica do comércio ilegal de armas de fogo em Lima, Peru, usando uma metodologia qualitativa e um desenho fenomenológico hermenêutico. A amostra inclui vinte policiais da Polícia Nacional do Peru (PNP) e da Superintendência Nacional de Controle de Serviços de Segurança, Armas, Munições e Explosivos para Uso Civil (Sucamec). As informações foram coletadas por meio de entrevistas semiestruturadas. O estudo conclui que o comércio ilegal de armas de fogo está estruturado em três fases principais: a primeira fase é determinada pelo vazamento ou desvio de armas do mercado legal para o ilegal, devido à falta de controle e fiscalização por parte das autoridades competentes. A segunda fase envolve a criação de um mercado ilegal em espaços itinerantes, onde vários atores, como intermediários e compradores, participam. A terceira e última fase envolve a consumação do crime, incluindo a entrega da arma e o pagamento sob rigorosas medidas de segurança para garantir a impunidade dos envolvidos.

Spinal gunshot wounds: A retrospective, multicenter, cohort study. / [Artículo traducido] Lesiones vertebrales por proyectil de arma de fuego: estudio de cohorte retrospectivo, multicéntrico.

INTRODUCTION AND OBJECTIVE: To describe the demographic and clinical characteristics and treatment of patients with spinal gunshot wounds across Latin America. MATERIAL AND METHODS: Retrospective, multicenter cohort study of patients treated for gunshot wounds to the spine spanning 12 institutions across Latin America between January 2015 and January 2022. Demographic and clinical data were recorded, including the time of injury, initial assessment, characteristics of the vertebral gunshot injury, and treatment. RESULTS: Data on 423 patients with spinal gunshot injuries were extracted from institutions in Mexico (82%), Argentina, Brazil, Colombia, and Venezuela. Patients were predominantly male civilians in low-risk-of-violence professions, and of lower/middle social status, and a sizeable majority of gunshots were from low-energy firearms. Vertebral injuries mainly affected the thoracic and lumbar spine. Neurological injury was documented in 320 (76%) patients, with spinal cord injuries in 269 (63%). Treatment was largely conservative, with just 90 (21%) patients treated surgically, principally using posterior open midline approach to the spine (79; 87%). Injury features distinguishing surgical from non-surgical cases were neurological compromise (P = 0.004), canal compromise (P < 0.001), dirty wounds (P < 0.001), bullet or bone fragment remains in the spinal canal (P < 0.001) and injury pattern (P < 0.001). After a multivariate analysis through a binary logistic regression model, the aforementioned variables remained statistically significant except neurological compromise. CONCLUSIONS: In this multicenter study of spinal gunshot victims, most were treated non-surgically, despite neurological injury in 76% and spinal injury in 63% of patients.

Heridas de guerra en el Perú del siglo XIX: la lesión ocular de Andrés Avelino Cáceres / War wounds in nineteenth century Peru: the eye injury of Andrés Avelino Cáceres

RESUMEN Andrés Avelino Cáceres (1836-1923) fue un destacado político y militar peruano que ocupó la presidencia en dos periodos y lideró al ejército peruano durante la Guerra del Pacífico, por lo que es considerado un héroe nacional. Al inicio de su carrera militar, durante el sitio a la ciudad de Arequipa en 1858, sufrió una lesión ocular cuya cicatriz se observa en las fotografías que se le tomaron posteriormente a lo largo de su vida, lo que hizo que fuera apodado "El Tuerto" aunque al parecer su agudeza visual estuvo indemne. En este trabajo describiremos las circunstancias en las que se produjo la lesión oftálmica de Andrés Avelino Cáceres, las secuelas que pudo tener este traumatismo oftálmico y el tratamiento médico que pudo haber recibido, en base al propio relato del héroe y a las imágenes suyas que se conservan.

ABSTRACT Andrés Avelino Cáceres (1836-1923) was a prominent Peruvian politician and military man who held the presidency for two terms and led the Peruvian army during the Pacific War, for which he is considered a national hero. At the beginning of his military career, during the siege of the city of Arequipa in 1856, he suffered an eye injury whose scar can be seen in the photographs that were taken of him later throughout his life, which led to him being nicknamed "El Tuerto". We will describe the circumstances in which the ophthalmic injury of Andrés Avelino Cáceres occurred, the consequences that this ophthalmic trauma could have had and the treatment he could have received, based on the hero's own story and the images of him that are preserved.

Presence of Echinococcus granulosussensulato in the endoparasitic fauna of feral dogs in Tierra del Fuego, Argentina.

The feral dog population from Tierra del Fuego (Argentina) has affected provincial sheep production, and is responsible for the decrease of 43% of the sheep stock. In addition, feral dogs preys on the native fauna, especially the guanaco (Lama guanicoe), a species protected by law. Except for some data on the aforementioned impact, very little is known about feral dogs features in this region, such as distribution, abundance, diet, reproduction, health status, among others. Therefore, a descriptive observational study was carried out in the period 2018-2021 in Tierra del Fuego, with the aim to recognize the endoparasitic fauna of these dogs, with emphasis on Echinococcus granulosus sensu lato (s.l.). Feces samples were collected from 83 feral dogs captured in 15 farms, which were evaluated using flotation and sedimentation coproparasitological techniques, and optical microscope observation. These qualitative methods showed that 66.3% of the samples were positive. Nine parasitic forms were found, including eggs of taenids, Toxocara canis and Toxascaris leonina, and Sarcocystis spp. oocysts and Giardia spp. cysts. Samples with more than one parasitic form were also observed, among which the Taenia/Sarcocystis spp. association was the most frequent. For the diagnosis of canine echinococcosis, the detection of Echinococcus spp. antigens by Copro-ELISA and the molecular confirmation by Copro-PCR were performed. The Copro-ELISA test was positive in 10/80 (12.5%) of the samples processed, while 11 samples (13.8%) were positive by Copro-PCR. Their distribution showed that 9 (81.8%) corresponded to farms with sheep farming, and 2 (18.2%) with cattle farming. The presence of E. granulosus s.l. in feral dogs from Tierra del Fuego is the most relevant finding in this study. These results confirm that feral dogs have access to viscera infected with hydatid cysts. However, the intermediate hosts involved (sheep, cattle or guanacos) should be investigated. Its impact on the transmission of cystic echinococcosis in this region should be evaluated, as well as the adequacy of the disease prevention and control actions implemented in Tierra del Fuego should be considered. Finally, the existence of a wild cycle of the disease should be evaluated, in which feral dogs would act as a source of infection for other animals and humans.

Spinal gunshot wounds: A retrospective, multicenter, cohort study.

INTRODUCTION AND OBJECTIVE: To describe the demographic and clinical characteristics and treatment of patients with spinal gunshot wounds across Latin America. MATERIAL AND METHODS: Retrospective, multicenter cohort study of patients treated for gunshot wounds to the spine spanning 12 institutions across Latin America between January 2015 and January 2022. Demographic and clinical data were recorded, including the time of injury, initial assessment, characteristics of the vertebral gunshot injury, and treatment. RESULTS: Data on 423 patients with spinal gunshot injuries were extracted from institutions in Mexico (82%), Argentina, Brazil, Colombia, and Venezuela. Patients were predominantly male civilians in low-risk-of-violence professions, and of lower/middle social status, and a sizeable majority of gunshots were from low-energy firearms. Vertebral injuries mainly affected the thoracic and lumbar spine. Neurological injury was documented in n=320 (76%) patients, with spinal cord injuries in 269 (63%). Treatment was largely conservative, with just 90 (21%) patients treated surgically, principally using posterior open midline approach to the spine (n=79; 87%). Injury features distinguishing surgical from non-surgical cases were neurological compromise (p=0.004), canal compromise (p<0.001), dirty wounds (p<0.001), bullet or bone fragment remains in the spinal canal (p<0.001) and injury pattern (p<0.001). After a multivariate analysis through a binary logistic regression model, the aforementioned variables remained statistically significant except neurological compromise. CONCLUSIONS: In this multicenter study of spinal gunshot victims, most were treated non-surgically, despite neurological injury in 76% and spinal injury in 63% of patients.

Biotopes of the intertidal zone in Clarence Island (south of the Strait of Magellan).

Background: The characteristics of the Strait of Magellan promote the formation of unique environments, with diverse habitats and marine organisms. This fragmentation of the landscape generates diverse little-explored ecological associations, especially in the zone of sub-Antarctic islands of the Tierra del Fuego archipelago. One way to address this lack of knowledge is through the biotope characterization methodology, with ecological units composed of the habitat and the communities associated with these environments, obtaining data and information on the dominant and incidental taxonomic groups. This is a good research model to conduct baseline studies in coastal benthic marine environments. New information: A data set in Darwin Core standard is presented of the species that make up the intertidal biotopes of Clarence Island (Tierra del Fuego Archipelago, south of the Strait of Magellan). This includes 50 identified species and the specific coordinates for each sampled location, with a total of 1400 georeferenced records. Mollusks were the most diverse taxon with 21 species, followed by algae (14 species). Sessile organisms such as the barnacles Elminiuskingii and Austromegabalanuspsittacus predominate in these ecosystems, followed by bivalve mollusks such as Choromytiluschorus and Mytiluschilensis, which together with Nacellamagellanica and the alga Hildenbrandia sp. make up more than 50% of the total records. The inclusion of biotope patterns in this study complements the information on benthic marine flora and fauna in the intertidal zone, including new records for the coast in the Clarence Island area, which is within the boundary of the Kawésqar National Park.

Detection and analysis of Shiga toxin producing and enteropathogenic Escherichia coli in cattle from Tierra del Fuego, Argentina.

Shiga toxin producing Escherichia coli (STEC) and enteropathogenic E. coli (EPEC) are pathovars that affect mainly infants' health. Cattle are the main reservoir of STEC. Uremic hemolytic syndrome and diarrheas can be found at high rates in Tierra del Fuego (TDF). This study aimed to establish the prevalence of STEC and EPEC in cattle at slaughterhouses in TDF and to analyze the isolated strains. Out of 194 samples from two slaughterhouses, STEC prevalence was 15%, and EPEC prevalence was 5%. Twenty-seven STEC strains and one EPEC were isolated. The most prevalent STEC serotypes were O185:H19 (7), O185:H7 (6), and O178:H19 (5). There were no STEC eae + strains (AE-STEC) or serogroup O157 detected in this study. The prevalent genotype was stx2c (10/27) followed by stx1a/stx2hb (4/27). Fourteen percent of the strains presented at least one stx non-typeable subtype (4/27). Shiga toxin production was detected in 25/27 STEC strains. The prevalent module for the Locus of Adhesion and Autoaggregation (LAA) island was module III (7/27). EPEC strain was categorized as atypical and with the ability to cause A/E lesion. The ehxA gene was present in 16/28 strains, 12 of which were capable of producing hemolysis. No hybrid strains were detected in this work. Antimicrobial susceptibility tests showed that all strains were resistant to ampicillin and 20/28 were resistant to aminoglycosides. No statistical differences could be seen in the detection of STEC or EPEC either by slaughterhouse location or by production system (extensive grass or feedlot). The rate of STEC detection was lower than the one reported for the rest of Argentina. STEC/EPEC relation was 3 to 1. This is the first study on cattle from TDF as reservoir for strains that are potentially pathogenic to humans.

Calculating the risk of fire in community pharmacies. Gustav-Purt method

Introduction: Fire is a chemical reaction of combustion, based on the strongly exothermic "oxidation-reduction" phenomena that produce a big detachment of light and heat.Its effects are, generally, harmful, producing personal injuries due to smoke, toxic gasses, and extremely hot temperatures; and damaged materials and buildings. Fire is produced when the three following factors simultaneously coexist in time and space: Fuel; a comburent agent, usually the oxygen in the air; and heat, which contributes the necessary energy to actuate the reaction. Besides, it is necessary, for the production of the flame, the existence of a chain reaction. Method: The Gustav-Purt Method, which aim is to calculate the potential risk in a determinate building and of the means to fight fires should be implemented. Results: After the calculation of the distinct factors, the conclusion that the risk of fire in a pharmacy is high is reached. Discussion: Therefore, strict inspection by sanitary authorities to avert the danger of the fire is necessary.

Introducción: El fuego es una reacción química de combustión, basado en los fenómenos de oxidación-reducción fuertemente exotérmica que se manifiesta por desprender gran cantidad de luz y calor. Sus efectos son generalmente perjudiciales, produciendo daños personales por el humo, gases tóxicos y temperaturas extremas, causando grandes daños a instalaciones y bienes. El fuego se produce cuándo existen simultáneamente en el tiempo y en un mismo lugar los tres factores siguientes: Combustible, Agente Comburente, normalmente el oxígeno del aire y Calor, que contribuye con la energía necesaria para activar la reacción. Además, es necesario, para la producción de la llama, la existencia de reacciones de cadena. Método: El método de Gustav Purt, tiene por objetivo calcular el riesgo potencial existente en un edificio determinado y qué medios de lucha contra incendios son necesarios implementar. Resultados: Tras el cálculo de los distintos factores, se llega a la conclusión que el riesgo de incendio en una farmacia es elevado. Discusión: Por consiguiente, es necesario la estricta inspección de las autoridades sanitarias de la Administración para evitar el peligro del fuego.

Lesiones mortales por armas traumáticas: reporte de caso / Fatal injuries due to traumatic weapons: Case report

Introducción. Las armas de energía cinética son diseñadas para generar lesiones dolorosas y superficiales. Sin embargo, las lesiones asociadas causan confusión al ser abordadas como heridas por proyectil de arma de fuego, convirtiendo el enfoque y el manejo correcto en un desafío. El caso presentado describe un paciente herido en el cuello por arma traumática con el objetivo de analizar factores que permitan identificar este tipo de heridas y sus implicaciones en el manejo. Caso clínico. Paciente masculino de 31 años que ingresó con intubación orotraqueal, remitido de una institución de nivel 2, con herida por aparente proyectil de arma de fuego con trayectoria transcervical. Se encontró hemodinámicamente estable, pero con dificultad para la valoración clínica, por lo que se realizaron exámenes complementarios que descartaron lesión aerodigestiva. La tomografía de cuello reportó proyectil alojado en musculatura paravertebral izquierda, descartando trayectoria transcervical. Discusión. El comportamiento de las lesiones asociadas a los proyectiles de armas depende de varios factores, como el tipo de material del proyectil, su velocidad y las propiedades del tejido impactado. Se presentó un caso en que inicialmente se sospechaba una lesión transcervical, pero con la evaluación se identificó el proyectil cinético en la musculatura paravertebral. Conclusión. En el abordaje de un paciente con sospecha de herida por proyectil de arma de fuego se debe considerar ante todo la respuesta clínica y la correlación del supuesto vector del proyectil con las lesiones sospechadas. La evaluación imagenológica permite identificar oportunamente los proyectiles y evitar procedimientos o terapias innecesarias que forman parte del manejo convencional del paciente con trauma penetrante

Introduction. Kinetic energy weapons are designed to produce superficial and painful injuries. Nevertheless, the approach of these patients in the emergency department can be confusing as they can be managed as gunshot wounds. This case describes a patient with an injury in the neck caused by kinetic energy gun. In addition, we analyzed factors that might identify these wounds and their implications in the management. Clinical case. A 31-year-old male patient who presented to the emergency department referred from a second level hospital with gunshot wound with suspected trans-cervical trajectory. They performed orotracheal intubation and transferred to our institution. Due to the patient ́s hemodynamic stability and impossibility for clinical evaluation, test and radiology tests were performed. These ruled out any aero-digestive injuries. The CT-scan reported a bullet hosted in the left paravertebral muscles, ruling out a trans-cervical trajectory. Discussion. Several factors contribute to the injuries produced by kinetic energy weapons. The injury patterns may vary according to the bullet material, muzzle velocity and impacted tissue characteristics. In this case, an initial trans-cervical injury was suspected and due to clinical evaluation we identified the bullet hosted in the paravertebral muscles. Conclusion. In the approach of a patient with suspicion of gunshot wound, as surgical team we must consider clinical manifestations and the correlation of the vector with suspected injuries. Evaluation of diagnostic imaging allows the identification of traumatic bullets, avoiding unnecessary procedures in the conventional management of patients with penetrating trauma

Evaluating population histories in Patagonia and Tierra del Fuego, Chile, using ancient mitochondrial and Y-chromosomal DNA.

OBJECTIVES: This study aims to characterize the genetic histories of ancient hunter-gatherer groups in Fuego-Patagonia (Chile) with distinct Marine, Terrestrial, and Mixed Economy subsistence strategies. Mitochondrial (mtDNA) and Y-chromosome data were generated to test three hypotheses. H0: All individuals were drawn from the same panmictic population; H1: Terrestrial groups first populated the region and gave rise to highly specialized Marine groups by ~7,500 cal BP; or H2: Marine and Terrestrial groups represent distinct ancestral lineages who migrated independently into the region. METHODS: Ancient DNA was extracted from the teeth of 50 Fuegian-Patagonian individuals dating from 6,895 cal BP to after European arrival, and analyzed alongside other individuals from previous studies. Individuals were assigned to Marine, Terrestrial, and Mixed Economy groups based on archeological context and stable isotope diet inferences, and mtDNA (HVR1/2) and Y-chromosome variation was analyzed. RESULTS: Endogenous aDNA was obtained from 49/50 (98%) individuals. Haplotype diversities, FST comparisons, and exact tests of population differentiation showed that Marine groups were significantly different from Terrestrial groups based on mtDNA (p < 0.05). No statistically significant differences were found between Terrestrial and Mixed Economy groups. Demographic simulations support models in which Marine groups diverged from the others by ~14,000 cal BP. Y-chromosome results showed similar patterns but were not statistically significant due to small sample sizes and allelic dropout. DISCUSSION: These results support the hypothesis that Marine and Terrestrial economic groups represent distinct ancestral lineages who diverged during the time populations were expanding in the Americas, and may represent independent migrations into Fuego-Patagonia.

O efeito provocado pela sirene na saúde dos profissionais de batalhões do corpo de bombeiros / The effect of the siren on the health of professionals in fire battalions / El efecto de la sirene en la salud de los profesionales de batalla en el cuerpo de la bomba

Introdução: O ruído é um som que provoca efeitos nocivos ao ser humano, sendo uma sensação auditiva desagradável que interfere na percepção do som desejado. Indivíduos expostos a níveis elevados de ruídos por um longo período de tempo podem sofrer danos mentais, socias e físicos. Os bombeiros são uma classe profissional que está frequentemente exposta a ruídos, dentre eles, de sirenes, veículos, ferramentas e alarmes. Objetivo: Investigar o efeito provocado pela sirene na saúde dos profissionais dos batalhões do Corpo de Bombeiros do Distrito Federal. Método: Foi aplicado questionário para avaliar o desconforto gerado pelo ruído e feita medição dos níveis de pressão sonora dos veículos e equipamentos utilizados em resgate. Foram aplicados os testes estatísticos pertinentes, adotando o nível de significância menor que 0,05. Resultados: O ambiente de trabalho foi classificado, na presente pesquisa, como ruidoso por 80,5 % dos participantes, sendo que 72% destes o classificaram como moderado e 15% como excessivo. As queixas mais citadas após a entrada na incorporação foram alteração no sono, o desconforto com sons altos, a intolerância e a irritabilidade. O tempo de serviço, como profissional do Corpo de Bombeiros, interferiu nas questões emocionais relacionadas a aspectos de estresse e distúrbios do sono. Conclusão: O ruído excessivo pode desencadear queixas auditivas e extra-auditivas nos bombeiros. Isso pode causar irritabilidade, distúrbios do sono e desconforto com sons altos. Dessa forma, é imprescindível a implementação de medidas de proteção, visando prevenir efeitos deletérios à saúde dos profissionais.

Introduction: Noise is a sound that causes harmful effects to the human being, being an unpleasant hearing sensation that interferes with the perception of the desired sound. Individuals exposed to high levels of noise over a long period of time may suffer mental, social, and physical harm. Firefighters are a professional class that is often exposed to noises, among them sirens, vehicles, tools and alarms. Objective: To investigate the effect of the siren on the health of the professionals of the Federal District Fire Department battalions. Method: A questionnaire was applied to evaluate the discomfort generated by noise and measurement of the sound pressure levels of vehicles and equipment used in rescue. Relevant statistical tests were applied, adopting the level of significance below 0.05. Results: The working environment was classified, in the present study, as noisy by 80.5% of the participants, 72% of them classified it as moderate and 15% as excessive. The most cited complaints after entry into incorporation were alteration in sleep, discomfort with loud sounds, intolerance and irritability. The length of service, as a Fire Department professional, interfered with the emotional issues related to aspects of stress and sleep disorders. Conclusion: Excessive noise can trigger hearing and extra-hearing complaints in firefighters. This can cause irritability, sleep disturbances, and discomfort with loud sounds. In this way, it is essential to implement protective measures, with a view to preventing harmful effects on the health of professionals.

Introducción: el ruido es un sonido que causa efectos nocivos en los seres humanos, y es una sensación de oído desagradable que interfiere con la percepción del sonido deseado. Las personas expuestas a altos niveles de ruido durante un largo período de tiempo pueden sufrir daños mentales, sociales y físicos. Los bomberos son una clase profesional que a menudo está expuesta al ruido, entre ellos sirenas, vehículos, herramientas y alarmas. Objetivo: Investigar el efecto de la sirena en la salud de los trabajadores del batallón en el Departamento de Bomberos del Distrito Federal. Método: Se aplicó un cuestionario para evaluar la incomodidad generada por el ruido y para medir los niveles de presión acústica de los vehículos y equipos utilizados con fines de rescate. Se aplicaron las pruebas estadísticas pertinentes, con un nivel significativo inferior a 0,05. Resultados: El entorno de trabajo fue clasificado en esta encuesta como ruidoso por el 80,5 % de los participantes, de los cuales el 72 % lo clasificó como moderado y el 15 % como excesivo. Las quejas más citadas después de la incorporación fueron malestar del sueño, intolerancia e irritabilidad. La duración del servicio, como profesional en el Departamento de Bomberos, interfirió con problemas emocionales relacionados con aspectos de estrés y trastornos del sueño. Conclusión: El ruido excesivo puede desencadenar quejas auditivas y no auditivas en los bomberos. Esto puede causar irritabilidad, trastornos del sueño y molestias con sonidos fuertes. De este modo, es esencial aplicar medidas de protección para prevenir los efectos nocivos en la salud de los profesionales.

Spinal fractures and thoracoabdominal injuries in polytraumatized patients: epidemiological evaluation / Fraturas da coluna vertebral e lesões toracoabdominais em pacientes politraumatizados: avaliação epidemiológica / Fracturas vertebrales y lesiones toracoabdominales en pacientes politraumatizados: evaluación epidemiológica

ABSTRACT Objective: Establish the frequency of incidences, management, and description of the relationship between thoracic and abdominal trauma and spinal injury. Methods: Observational, retrospective study of quantitative analysis carried out through the analysis of medical records of patients who presented spinal fractures and associated thoracoabdominal injuries. The participants were treated at a reference hospital in trauma care in Curitiba-PR from 2019 to 2021. The data were from patients with spine fractures referring to gender, age, trauma mechanism, fracture classification, associated injuries, Frankel neurological scale, and proposed treatment. Results: There was a predominance of male patients (84.5%) and young, with a mean age of 37.3 years, victims of car accidents. The main vertebrae affected were the lumbar spine (36.8%) and thoracic spine (36.2%). The most prevalent associated injuries were extra vertebral and cervical spine fractures. The most observed thoracic injuries were hemothorax, chest contusion, and fracture of multiple costal arches, while the most observed abdominal injuries were kidney injury, hemoperitoneum/abdominal hematoma, and liver injury. Of the total patients analyzed, 68% had fractures with associated thoracoabdominal injuries. Conclusion: Abdominal and thoracic injuries are frequently associated with spine fractures, with an association of 14.6% and 53.4%, respectively. The production of knowledge on the subject contributes to creating action plans to optimize the management and reduce the morbidity and mortality of these cases. Levels of evidence III; Systematic Review.

Resumo: Objetivos: Estabelecer a frequência de incidências, manejo e descrição da relação entre traumas torácicos e abdominais com a lesão da coluna vertebral. Métodos: Estudo observacional, retrospectivo de análise quantitativa realizado através da análise de prontuários de pacientes que apresentaram fraturas da coluna vertebral e lesões toracoabdominais associadas. Os participantes incluídos foram atendidos em um hospital referência no atendimento ao trauma em Curitiba-PR no período de 2019 a 2021. Os dados foram de pacientes com fratura de coluna referente a sexo, idade, mecanismo de trauma, classificação da fratura, lesões associadas, escala neurológica de Frankel e tratamento proposto. Resultados: Houve predomínio de pacientes masculinos (84,5%) e jovens, sendo a média de idade de 37,3 anos, vítimas de acidentes automobilísticos. As principais vértebras acometidas foram de coluna lombar (36,8%) e torácica (36,2%). As lesões associadas mais prevalentes foram as fraturas extravertebrais e de coluna cervical. As lesões torácicas mais observadas foram o hemotórax, contusão torácica e fratura de múltiplos arcos costais, enquanto as lesões abdominais mais observadas foram lesão renal, hemoperitônio/ hematoma abdominal e lesão hepática. Sendo do total de pacientes analisados 68% apresentavam fraturas com lesões toracoabdominais associadas. Conclusão: Lesões abdominais e torácicas frequentemente estão associadas a fraturas de coluna, com associação de 14,6% e de 53,4% respectivamente. A produção de conhecimento sobre o assunto, contribui para criação de planos de ação para a otimização do manejo e redução da morbimortalidade desses casos. Nível de evidência III; Revisão sistemática.

Resumen: Objetivos: Establecer la frecuencia de incidencias, manejo y descripción de la relación entre trauma torácico y abdominal y lesión medular. Métodos: Estudio observacional, retrospectivo de análisis cuantitativo realizado a través del análisis de historias clínicas de pacientes que presentaron fracturas de columna y lesiones toracoabdominales asociadas. Los participantes incluidos fueron atendidos en un hospital de referencia en atención de trauma en Curitiba-PR de 2019 a 2021. Los datos fueron de pacientes con fracturas de columna con referencia a sexo, edad, mecanismo de trauma, clasificación de fractura, lesiones asociadas, escala neurológica de Frankel y tratamiento propuesto. Resultados: Predominaron los pacientes del sexo masculino (84,5%) y jóvenes, con una edad media de 37,3 años, víctimas de accidentes automovilísticos. Las principales vértebras afectadas fueron la columna lumbar (36,8%) y la columna torácica (36,2%). Las lesiones asociadas más prevalentes fueron las fracturas extra vertebrales y de columna cervical. Las lesiones torácicas más observadas fueron hemotórax, contusión torácica y fractura de múltiples arcos costales, mientras que las lesiones abdominales más observadas fueron lesión renal, hemoperitoneo/ hematoma abdominal y lesión hepática. Del total de pacientes analizados, el 68% presentaba fracturas con lesiones toracoabdominales asociadas. Conclusión: Las lesiones abdominales y torácicas se asocian con frecuencia a las fracturas de columna, con una asociación del 14,6% y 53,4% respectivamente. La producción de conocimiento sobre el tema contribuye a la creación de planes de acción para optimizar el manejo y disminuir la morbimortalidad de estos casos. Nivel de evidencia; Revisión sistemática.

Risk Predictors Associated with Firearm Use: A Scope Review / Preditores de Riscos Associados ao Uso da Arma de Fogo: Uma Revisão de Escopo / Predictores de Riesgo Asociados con el Uso de Armas de Fuego: Una Revisión del Alcance

Abstract The use of firearms is a complex issue which involves issues related to mental health and public policies. This scoping review aimed to analyze individual and social risk predictors for the use of firearms. Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews - PRISMA-ScR, six databases were consulted and 605 studies, retrieved. After screening, 16 empirical studies were selected for this review. Individual predictors included psychiatric diagnosis, abusive use of alcohol, high anxiety, and use of psychiatric medication; whereas social ones, access to firearms, absence of laws restricting the possession of weapons, and war experiences. We find the need for further research on the subject, especially by Brazilian science, since 87.5% of the studies this review screened came from the United States.

Resumo O uso da arma de fogo pela população é um tema complexo que envolve questões relacionadas à saúde mental e políticas públicas. O objetivo dessa revisão de escopo foi analisar os preditores de riscos, individuais e sociais, para o uso da arma de fogo. Com base nas diretrizes do Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews - PRISMA-ScR, seis bases de dados foram consultadas com a identificação de 605 artigos. Após processo de triagem, 16 estudos empíricos foram selecionados para a revisão. Os preditores individuais identificados foram: diagnóstico de transtornos mentais, uso abusivo de álcool, ansiedade elevada, uso de medicação psiquiátrica. Os classificados como sociais compreenderam: acesso a armas de fogo, ausência de leis restritivas à posse de armas, experiência de guerra. Verificou-se a necessidade de mais pesquisas sobre o tema principalmente pela ciência brasileira, visto que 87,5% dos estudos triados nesta revisão foram provenientes dos Estados Unidos.

Resumen El uso de armas de fuego por parte de la población es un tema complejo que involucra cuestiones relacionadas con la salud mental y las políticas públicas. El objetivo de esta revisión de alcance fue analizar los predictores de riesgo individual y social para el uso de armas de fuego. Con base en los lineamientos de Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), se consultaron seis bases de datos, lo que generó la identificación de 605 artículos. Después de un proceso de selección, se seleccionaron 16 estudios empíricos para su revisión. Los predictores individuales identificados fueron: diagnóstico de trastornos mentales, abuso de alcohol, ansiedad elevada y uso de medicación psiquiátrica. Los predictores sociales: acceso a armas de fuego, ausencia de leyes que restrinjan la tenencia de armas y experiencia de guerra. Se observó una necesidad de más investigación sobre el tema, principalmente por parte de la ciencia brasileña, ya que el 87,5% de los estudios seleccionados en esta revisión provenían de los Estados Unidos.

Tratamiento de las fracturas por herida de arma de fuego: revisión bibliográfica sistematizada / Treatment of gunshot wound fractures: systematic review of the literature / Tratamento de fraturas por arma de fogo: revisão bibliográfica sistematizada

Introducción: Las fracturas por heridas de arma de fuego son un motivo de consulta habitual en nuestro país. Existe gran variabilidad de conductas respecto a su tratamiento. El objetivo principal de este trabajo es analizar los distintos tratamientos y sus indicaciones. Materiales: Se realizó una revisión sistematizada de la literatura en las bases de datos Pubmed y Scielo. Se incluyeron artículos con fracturas por herida de arma de fuego en miembros superiores e inferiores, excluyendo la mano. Se analizó: tratamiento (ortopédico o quirúrgico), debridamiento, antibioticoterapia y complicaciones. Resultados: Se obtuvieron 19 artículos que cumplían los criterios de inclusión y exclusión. Los artículos tuvieron un Nivel de Evidencia tipo 2b, 3 y 4. Conclusiones: Los artículos analizados tienen un bajo nivel de evidencia. La fijación quirúrgica es variable y depende de la topografía ósea, la lesión de partes blandas y las lesiones asociadas. El debridamiento profundo está relacionado con mayores índices de infección. Las fracturas estables de tratamiento ortopédico no deberían debridarse ya que aumenta los índices de infección. Debería realizarse antibioticoterapia intravenosa inicial en todos los pacientes, la terapia posterior es discutida.

Introduction: Fractures due to gunshot wounds are a common reason for consultation in our country. There is great variability of conduct regarding its treatment. The main objective of this work is to analyze the different treatments and their indications. Materials: A systematic review of the literature was carried out in the Pubmed and Scielo databases. Articles with fractures due to gunshot wounds in the upper and lower limbs (excluding the hand) were included. We analyzed: treatment (orthopedic or surgical), debridement, antibiotic therapy and complications. Results: 19 articles were obtained that met the inclusion and exclusion criteria. The articles had a Level of Evidence type 2b, 3 and 4. Conclusions: The articles analyzed have a low level of evidence. Surgical fixation is variable and depends on bone topography, soft tissue injury, and associated injuries. Deep debridement is associated with higher rates of infection. Stable orthopedically treated fractures should not be debrided as this increases infection rates. Initial intravenous antibiotic therapy should be performed in all patients, subsequent therapy is discussed.

Introdução: As fraturas por ferimentos por arma de fogo são motivo comum de consulta em nosso país. Há grande variabilidade de conduta quanto ao seu tratamento. O objetivo principal deste trabalho é analisar os diferentes tratamentos e suas indicações. Materiais: Foi realizada revisão sistemática da literatura nas bases de dados Pubmed e Scielo. Foram incluídos artigos com fraturas por arma de fogo em membros superiores e inferiores, excluindo a mão. Foram analisados: tratamento (ortopédico ou cirúrgico), desbridamento, antibioticoterapia e complicações. Resultados: foram obtidos 19 artigos que atenderam aos critérios de inclusão e exclusão. Os artigos tinham Nível de Evidência tipo 2b, 3 e 4. Conclusões: Os artigos analisados ​​apresentam baixo nível de evidência. A fixação cirúrgica é variável e depende da topografia óssea, lesão de tecidos moles e lesões associadas. O desbridamento profundo está associado a maiores taxas de infecção. Fraturas estáveis ​​tratadas ortopedicamente não devem ser desbridadas, pois isso aumenta as taxas de infecção. A antibioticoterapia intravenosa inicial deve ser realizada em todos os pacientes, a terapia subsequente é discutida.

Presença de risco de transtorno do estresse pós-traumático em policiais militares feridos por arma de fogo / Presence of risk of posttraumatic stress disorder in military police officers wounded by firearms / Presencia de riesgo de trastorno de estrés postraumático en policías militares heridos por armamiento de fuego

Este estudo teve como objetivo identificar o risco de desenvolvimento de transtorno de estresse pós-traumático (TEPT), bem como sua associação com pensamentos ou tentativas suicidas e a saúde mental de policiais militares feridos por arma de fogo, na Região Metropolitana de Belém (RMB), nos anos de 2017 a 2019. A pesquisa contou com a participação de 30 entrevistados, que responderam o Inventário Demográfico e a Lista de verificação de TEPT para o DSM-5 (PCL-5). Para análise dos dados, utilizou-se a técnica estatística Análise Exploratória de Dados e a técnica multivariada Análise de Correspondência. Os resultados revelaram a existência de risco de desenvolvimento do transtorno de forma parcial ou total em uma expressiva parcela da população entrevistada, tendo homens como maioria dos sintomáticos, com média de 38 anos, exercendo atividades operacionais e vitimados em via pública quando estavam de folga do serviço. O ferimento deixou a maioria com sequelas, com destaque para dores crônicas, limitações de locomoção e/ou mobilidade e perda parcial de um membro. E, ainda, policiais sintomáticos apresentaram comportamentos suicidas, relatando já terem pensado ou tentado tirar a própria vida. Desta forma, conclui-se que policiais militares são expostos constantemente a traumas inerentes a sua profissão. Quando há ameaça de vida, como nos casos de ferimentos por arma de fogo, são suscetíveis a sequelas físicas decorrente do ferimento, somadas a sequelas mentais tardias, como o surgimento de sintomatologias de TEPT e ideação suicida.(AU)

This study aimed to identify the risk of developing post-traumatic stress disorder (PTSD) and its associations around suicidal thoughts or attempts and mental health in military police officers injured by firearms, in the Metropolitan Region of Belem (RMB), from 2017 to 2019. The research had the participation of 30 respondents who answered the Demographic Inventory and the PTSD checklist for DSM-5 (PCL-5). For data analysis, we used the statistical technique Exploratory Data Analysis and the multivariate technique Correspondence Analysis. The results revealed the existence of risk of developing partial or total disorder in a significant portion of the interviewed population, with men as most of the symptomatic individuals, with mean age of 38 years, developing operational activities and victimized on public roads when they were off duty. The injuries left most of them with sequelae, especially chronic pain, limited locomotion and/or mobility, and partial loss of a limb. In addition, symptomatic officers showed suicidal behavior, such as reporting they had thought about or tried to take their own lives. Thus, we conclude that military policemen are constantly exposed to traumas inherent to their profession. When their lives are threatened, as in the case of firearm wounds, they are susceptible to physical sequelae resulting from the injury, in addition to late mental sequelae, such as the appearance of PTSD symptoms and suicidal ideation.(AU)

Este estudio tuvo como objetivo identificar el riesgo de desarrollo de trastorno de estrés postraumático (TEPT) y sus asociaciones con pensamientos o tentativas suicidas y la salud mental en policías militares heridos por armamiento de fuego, en la Región Metropolitana de Belém (Brasil), en el período entre 2017 y 2019. En el estudio participaron 30 entrevistados que respondieron el Inventario Demográfico y la Lista de verificación de TEPT para el DSM-5 (PCL-5). Para el análisis de datos se utilizaron la técnica estadística Análisis Exploratoria de Datos y la técnica multivariada Análisis de Correspondencia. Los resultados revelaron que existen riesgos de desarrollo de trastorno de estrés postraumático de forma parcial o total en una expresiva parcela de la población de policías entrevistados, cuya mayoría de sintomáticos eran hombres, de 38 años en media, que ejercen actividades operacionales y fueron victimados en vía pública cuándo estaban de día libre del servicio. La lesión dejó la mayoría con secuelas, especialmente con dolores crónicos, limitaciones de locomoción y/o movilidad y la pierda parcial de un miembro. Aún los policías sintomáticos presentaran comportamiento suicida, tales como relataran qué ya pensaron o tentaron quitar la propia vida. Se concluye que los policías militaran se exponen constantemente a los traumas inherentes a su profesión. Cuando existe amenaza de vida, como en los casos de heridas por armamiento de fuego, son expuestos a secuelas físicas transcurridas de la herida, sumado a secuelas mentales tardías, como el surgimiento de sintomatologías de TEPT y la ideación suicida.(AU)

Doble lesión de la médula espinal por proyectil de arma de fuego con migración en el canal medular: reporte de un caso / Dual spinal cord injury caused by a firearm projectile migrated into the spinal canal: A case report

Introducción. El tratamiento quirúrgico de las lesiones por proyectil de arma de fuego en la columna es controversial; sin embargo, el déficit neurológico es uno de los criterios para su indicación. Presentación del caso. Hombre de 21 años que ingresó al servicio de urgencias de un hospital de tercer nivel en Bogotá, Colombia, por múltiples heridas de arma de fuego, paraplejía, hipoestesia en miembros inferiores y silla de montar, e incapacidad para moverse, por lo que se realizó toracotomía y laparotomía. Ante la ausencia de fuerza muscular y reflejos, se diagnosticó lesión de la médula espinal de grado A según la American Spinal Injury Association Impairment Scale (ASIA). A las 12 horas del ingreso, se llevó al paciente a extracción quirúrgica de un proyectil (laminectomía y durotomía longitudinal) sin lograr la extracción, por lo que se utilizó fluoroscopia, en la que se observó que la bala había migrado cefálicamente al espacio intervertebral L4-L5. Se realizó laminectomía de L4-L5, exposición del saco dural y durotomía longitudinal, logrando la extracción del proyectil. A los 20 días se observó mejoría de la función motora y la fuerza muscular, contracción voluntaria de cuádriceps y grado C en ASIA.Conclusión. La extracción del proyectil en lesiones de la médula espinal se recomienda cuando hay migración de este en el canal medular. Se sugiere usar fluoroscopia antes y después de la cirugía

Introduction: Surgical treatment of spinal gunshot wounds is controversial, however, neurological deficit is one of the criteria for its indication. Case presentation: A 21-year-old man was admitted to the emergency department of a tertiary care hospital in Bogotá, Colombia, due to multiple gunshot wounds, paraplegia, hypoesthesia in the lower limbs and saddle area, and inability to move, for which thoracotomy and laparotomy were performed. Given the absence of muscle strength and reflexes, a grade A spinal cord injury was diagnosed according to the American Spinal Injury Association Impairment Scale (ASIA). Twelve hours after admission, the patient was taken to surgery for the removal of a firearm projectile (laminectomy and longitudinal durotomy) without achieving the extraction, so a fluoroscopy was carried out, in which it was observed that the bullet had migrated cephalad to the L4-L5 intervertebral space. L4-L5 laminectomy, dural sac exposure, and longitudinal durotomy were performed, leading to the removal of the projectile. After 20 days, improvement of motor function and muscle strength, voluntary contraction of quadriceps, and grade C in ASIA were reported.Conclusion: Projectile removal in spinal cord injuries is recommended when the projectile migrates into the spinal canal. Fluoroscopy is recommended before and after surgery

Embolización de cuerpo extraño por la raíz aórtica por lesión por arma de fuego: caso clínico de una paciente asintomática de diez años.

Foreign body embolies that origin arterial system have mostly seen symptomatic and that's why they require emergency surgery. However, asymptomatic cases are followed conservatively, they can cause vascular-related end-organ pathologies as time passes. Foreign body migration from the ascending aorta to the end-organ artery is a very rare in literature after a fire gun injury. In symptomatic cases, emergency surgery should be planned immediately. In asymptomatic cases, the risks and benefits should first be considered before any surgical approach.

Las embolias de cuerpo extraño que tienen origen en el sistema arterial se han presentado en su mayoría sintomáticas y por eso requieren cirugía de emergencia. Sin embargo, los casos asintomáticos se siguen de manera conservadora, pueden causar patologías vasculares relacionadas con los órganos diana a medida que pasa el tiempo. La migración de cuerpos extraños desde la aorta ascendente hasta la arteria del órgano blanco es muy rara en la literatura después de una lesión por arma de fuego. Casos sintomáticos, la cirugía de emergencia debe planificarse de inmediato. En casos asintomáticos, primero se deben considerar los riesgos y beneficios antes de cualquier abordaje quirúrgico.