Trauma dental y lesiones faciales por armas de aire comprimido: reporte de un caso / Dental trauma and facial injuries by airguns: a case report

Las armas de aire comprimido son utilizadas desde hace muchos años con distintos usos que van desde el tiro recreativo hasta el control de plagas. Las más comunes son aquellas que disparan ''balines" o esferas metálicas que pueden llegar a tener capacidad de penetrar tejidos dependiendo del tipo de carga y de la longitud del cañón. Se presenta un caso clínico de un masculino que fue agredido con un arma tipo pistola con carga de CO2 que recibió un impacto a nivel facial y sufrió laceración en piel de labio y fractura dental complicada.

Air guns have been used for many years for a variety of purposes ranging from recreational shooting to pest control. The most common are those that shoot "pellets" or metallic spheres that can penetrate tissues depending on the type of load and the length of the barrel. A clinical case is presented of a male who was assaulted with a CO2-loaded pistol-type weapon, hit at facial level, and suffered laceration of the lip's skin and complicated dental fracture.

Doble mecanismo de estrangulación. A propósito de un caso / Double mechanism of strangulation. Apropos of a case

RESUMEN Las asfixias mecánicas son aquellas que resultan del impedimento mecánico a la penetración del aire en las vías respiratorias, suelen clasificarse atendiendo a la naturaleza del medio mecánico que las origina y a su modo de actuar. La estrangulación puede definirse como la constricción del cuello mediante la aplicación de una fuerza activa, ajena al peso del cuerpo, que actúa por intermedio de un lazo, las manos, el antebrazo o cualquier otra estructura rígida. En la estrangulación antebraquial, la constricción del cuello se lleva a cabo normalmente rodeando al individuo con el brazo y el antebrazo. Cuando el mecanismo de la compresión del cuello es lateral, no se afectan las vías aéreas, la compresión de las arterias carótidas hace que se produzca una isquemia cerebral y pérdida de conocimiento en 10-15 segundos. El mecanismo de muerte en estos casos será la anoxia cefálica. Si la compresión del cuello es anterior, actúa ocluyendo las vías aéreas, la presión sobre los cartílagos tiroides y cricoides puede producir fracturas y el mecanismo de muerte será la obstrucción respiratoria. El presente trabajo constituyó un caso poco común de estrangulación, donde se utilizó un mecanismo combinado que llevó al occiso al deceso final. Para la realización de la discusión del caso se tuvo en cuenta los elementos del lugar del hecho, el examen del exterior y el interior del cadáver (AU).

ABSTRACT Mechanical asphyxias are those resulting from the mechanical obstruction of the air penetration in the airways. They are usually classified according to the nature of the mechanical mean producing it and the way it performs. Strangulation may be defined as neck constriction through the application of an active force not proper to the body weight, acting by means of a knot, hands, forearm or any stiff structure. In ante brachial strangulation, neck constriction is normally performed surrounding the individual with the arm and forearm. When the neck constriction mechanism is lateral, the airways are not affected: carotid arteries constriction produces a brain stroke and loss of consciousness in 10-15 s. The death mechanism in these cases will be cephalic anoxia. If the neck compression is anterior, it occludes the airways; the pressure on thyroidal and cricoid cartilages may produce fractures and death mechanism will be respiratory obstruction. The current work deals with an uncommon strangulation case, where a combined mechanism led the person to the final decease. For the case discussion the authors took into account the elements of the place, and the examination of the exterior and the inside of the corpse (AU).

Traumatismo espinhal por projéteis de armas de ar comprimido em cinco gatos / Spinal cord trauma by air gun projectiles in five cats / Traumatismo espinal por proyectiles por armas de aire comprimido en cinco felinos

O trauma medular induzido por projéteis de armas de ar comprimido é considerado incomum em animais domésticos, particularmente em gatos. Desses, os que apresentam comportamento de fuga do domicílio e os que vagueiam livremente sem supervisão correm maior risco de receber ferimentos por disparo de armas. Apesar de seu tamanho pequeno, velocidade moderada e mau design aerodinâmico, os projéteis lançados por armas de ar comprimido (chumbinho) podem causar ferimentos graves. O tratamento e o prognóstico de animais que apresentam lesões por disparo de armas podem variar consideravelmente, dependendo da localização segmentar das lesões e da extensão dos danos. Objetivou-se descrever os achados neurológicos, radiográficos e cirúrgicos de cinco felinos acometidos por trauma vertebromedular provocado por projétil balístico em virtude da incomum ocorrência desse acometimento nessa espécie.

Spinal cord trauma induced by bailistic projectiles is considered uncommon in domestic animais, particularly cats. Outdoor, and indoor-outdoor cats are at greater risk of receiving gunshot wounds. Despite their small size, moderate speed and poor aerodynamic design, projectiles from compressed air guns (pellet guns) can cause severe injury. Treatment and prognosis of animals presented with gun-related injuries can vary considerably, depending on the affected spinal segment location of the lesions, and extent of tissue damage. Due to the unusual occurrence of this type of trauma in feline patients, the goal of this report is to describe the neurologic, radiographic, and surgical findings in five cats with spinal injury secondary to air gun projectiles.

El trauma medular por balas de aire comprimido es poco frecuente en animales domésticos, especialmente en gatos. Estos animales, en especial aquellos que se escapan de su domicilio y los que deambulan libremente sin supervisión de su dueño, corren más riesgos de sufrir heridas por el disparo de armas. A pesar de que los balines de aire comprimido tienen un tamaño pequeño, una velocidad media y malo diseño aerodinámico, este tipo de proyectil puede provocar heridas graves. El tratamiento y el pronóstico de los animales que presentan lesiones provocadas por este tipo de proyectiles puede variar de forma considerable, dependiendo de la localización de las lesión y de la extensión de los daños provocados. El objetivo del presente trabajo fue describir los síntomas neurológicos, las alteraciones radiográficas y las resultados de la cirugía de cinco felinos que fueron diagnosticados con trauma vertebro-medular provocado por balines de aire comprimido, dada la baja prevalencia de este tipo de eventos en gatos.

Traumatismo espinhal por projéteis de armas de ar comprimido em cinco gatos / Spinal cord trauma by air gun projectiles in five cats / Traumatismo espinal por proyectiles por armas de aire comprimido en cinco felinos

O trauma medular induzido por projéteis de armas de ar comprimido é considerado incomum em animais domésticos, particularmente em gatos. Desses, os que apresentam comportamento de fuga do domicílio e os que vagueiam livremente sem supervisão correm maior risco de receber ferimentos por disparo de armas. Apesar de seu tamanho pequeno, velocidade moderada e mau design aerodinâmico, os projéteis lançados por armas de ar comprimido (chumbinho) podem causar ferimentos graves. O tratamento e o prognóstico de animais que apresentam lesões por disparo de armas podem variar consideravelmente, dependendo da localização segmentar das lesões e da extensão dos danos. Objetivou-se descrever os achados neurológicos, radiográficos e cirúrgicos de cinco felinos acometidos por trauma vertebromedular provocado por projétil balístico em virtude da incomum ocorrência desse acometimento nessa espécie.(AU)

Spinal cord trauma induced by bailistic projectiles is considered uncommon in domestic animais, particularly cats. Outdoor, and indoor-outdoor cats are at greater risk of receiving gunshot wounds. Despite their small size, moderate speed and poor aerodynamic design, projectiles from compressed air guns (pellet guns) can cause severe injury. Treatment and prognosis of animals presented with gun-related injuries can vary considerably, depending on the affected spinal segment location of the lesions, and extent of tissue damage. Due to the unusual occurrence of this type of trauma in feline patients, the goal of this report is to describe the neurologic, radiographic, and surgical findings in five cats with spinal injury secondary to air gun projectiles.(AU)

El trauma medular por balas de aire comprimido es poco frecuente en animales domésticos, especialmente en gatos. Estos animales, en especial aquellos que se escapan de su domicilio y los que deambulan libremente sin supervisión de su dueño, corren más riesgos de sufrir heridas por el disparo de armas. A pesar de que los balines de aire comprimido tienen un tamaño pequeño, una velocidad media y malo diseño aerodinámico, este tipo de proyectil puede provocar heridas graves. El tratamiento y el pronóstico de los animales que presentan lesiones provocadas por este tipo de proyectiles puede variar de forma considerable, dependiendo de la localización de las lesión y de la extensión de los daños provocados. El objetivo del presente trabajo fue describir los síntomas neurológicos, las alteraciones radiográficas y las resultados de la cirugía de cinco felinos que fueron diagnosticados con trauma vertebro-medular provocado por balines de aire comprimido, dada la baja prevalencia de este tipo de eventos en gatos.(AU)

Colorectal injury by compressed air: the rule of conservative therapy / Lesão colorretal por ar comprimido: a regra da terapia conservadora

ABSTRACT We are reporting a case of colorectal injury caused by a jet of compressed air directed from a distance towards the anus. The patient mentioned that it happened accidentally while his colleague was cleaning his clothes using compressed air. The patient presented with acute abdominal pain and distension. A contrast CT study did not show any free air or leakage. The patient was treated conservatively, progressed well and was discharged from the hospital on the fourth day.

RESUMO Descrevemos um caso de lesão colorretal causada por um jato de ar comprimido direcionado para o ânus, a certa distância. O paciente mencionou que o ocorrido foi acidental, enquanto um colega estava limpando suas roupas com ar comprimido. O paciente se apresentou com dores abdominais agudas e distensão. Um estudo de TC contrastado não demonstrou ar livre, nem vazamento. O paciente foi tratado conservadoramente, teve boa evolução e recebeu alta hospitalar no quarto dia.

Decreasing carbon monoxide in the diving air of artisanal fishermen in the Yucatán peninsula by separation of engine exhaust from compressor intake.

Artisanal fishermen in the Yucatán Peninsula utilize hookah dive systems (HDS). The air compressors in these HDS are not filtered, and the intake is near the engine exhaust. This proximity allows carbon monoxide (CO) from the exhaust to directly enter the HDS volume tank and contaminate the fishermen diver's air supply. Conservative safety standards permit a diver's air supply to contain 10 parts per million (ppm) of CO. This study quantified the levels of CO in the diver's air supply both before and after physical separation of the engine exhaust from the compressor intake. CO levels in seven volume tanks were analyzed before and after a 1-inch hose was attached to the compressor intake and elevated 5 feet above the engine exhaust. The tanks were drained and refilled before collecting each set of pre- and post-intervention gas samples. Four CO measurements were collected before and after the intervention from each volume tank. A C-Squared© CO Analyzer (± 1 ppm), calibrated with a Praxair 70 ppm CON2 gas (± 5%), was used to analyze the gas samples. A paired samples t-test shows a statistically significant difference in average CO values before and after the intervention (t = 6.8674, df: 27; p⟨0.0001). The physical separation of the engine exhaust from the compressor intake reduced the CO contamination of the diver air supply by 72%. This intervention could be applied to the hookah systems in the rest of the fishing cooperative to reduce the divers' risk of CO poisoning.

Subcutaneous emphysema after treatment through airabrasivedevice: case report / Enfisema subcutâneo gerado após tratamento com equipamento de ar comprimido: relato de caso

Subcutaneous emphysema is an event often generated by iatrogenic reason, caused by improper dissection of air into soft tissues and/ or anatomical structures, causing edema and visually noticeable volumetric change in the area of the incident. The main etiological factor for this is the use of equipment such as air syringe or high-speed handpieces in surgical procedures of greater magnitude; however, subcutaneous emphysema may also occur in simple procedures, such that presented in this case report, through using air-abrasive device usually proper for dental prophylaxis. This case report aimed to describe the care measurements to avoid such event, describing proper procedures for the correct solution of the case, as well as to alert the professionals about the risks and necessary precautions.

O enfisema subcutâneo é um evento muitas vezes de origem iatrogênica, causado pela infusão indevida de ar nos tecidos e/ou estruturas anatômicas, causando edemaciamento e alteração volumétrica visualmente perceptível na área do ocorrido. O principal fator etiológico para tal é o uso de equipamentos como seringa tríplice ou caneta de alta rotação durante procedimentos cirúrgicos de maior magnitude; no entanto, o enfisema subcutâneo também pode ocorrer diante de procedimentos mais simples, tal como o ocorrido no presente relato de caso, em que houve sua ocorrência pelo uso de equipamento de ar comprimido usualmente utilizado para execução de profilaxia. O objetivo do presente artigo foi relatar o caso, assim como descrever os cuidados para se evitar tal evento, e descrever procedimentos adequados para o correto prosseguimento e resolução adequada do caso.

CO and CO2 analysis in the diving gas of the fishermen of the Yucatan Peninsula.

It is reported that more than 75% of 400 artisanal fisherman divers working off the Yucatan Peninsula experience decompression sickness (DCS) each year, making DCS an epidemic in this region. These divers use primitive hookah diving support systems (HDSS). Breathing air is supplied from inadequately filtered and poorly maintained gasoline-powered air compressors. We hypothesized that air supplies could be contaminated. Air contamination could produce symptoms consistent with some presentations of DCS. This could confound and falsely elevate the true incidence of DCS. A cross-sectional study was undertaken in a fishing community. Ten fishermen from a single cohort participated. Fishermen were instructed not to drain volume tanks following their last dive of the day before their diving air was sampled. Dräger carbon monoxide (CO) 5/a-P and carbon dioxide (CO2) 100/a Short-term Tubes were used to measure 1.0 liters (L) of gas through a Visi-Float flow meter at 0.2 L/minute. Average CO value was 42 ppm (8-150 ppm). Average CO2 was 663 ppm (600-800). Measurements exceeded recommended diving norms for CO of 20 ppm. CO2 exceeded one diving organization recommendation of 500 ppm. Separation of engine exhaust from compressor intake could decrease CO values in HDSS to acceptable standards thus eliminating one possible confounder from this DCS epidemic.

Development of an auxiliary resource for diagnosis of dental caries in epidemiological surveys.

OBJECTIVE: Early dental caries diagnosis within the changing global pattern of dental caries development requires the use of auxiliary resources and adjuncts to diagnosis. The aim of this study was to introduce an alternative resource for drying teeth to enable early diagnosis of dental caries in epidemiological surveys. METHODS: Polyurethane tips and three-in-one syringes were fitted to nebulizers and non-professional portable compressors for dental surface drying. The output air pressure of these sets was compared with the output pressure from the three-in-one syringe in a dental office. RESULTS: Although the output pressure from the alternative resources was lower than the output pressure from the dental office equipment, the dental surfaces were dried satisfactorily, allowing the early diagnosis of the dental caries. CONCLUSION: When a dental setting is not available, these alternative resources for drying teeth can be used satisfactorily.

Comparison of 20-, 23-, and 25-gauge air infusion forces.

PURPOSE: To determine and compare 20-, 23-, and 25-gauge retinal infusion air jet impact pressure (force per unit area) in an experimental setting. METHODS: Experimental laboratory investigation. Infusion cannulas were connected to a compressed air system. A controlled valve mechanism was used to obtain increasing levels of infusion pressure. Each infusion tube was positioned in front of a manual transducer to measure force. Impact pressure was calculated using known formulas in fluid dynamics. RESULTS: The 20-gauge infusion jet showed similar impact pressure values compared with the 23-gauge infusion jet. Both showed higher levels than the 25-gauge infusion jet. This was because of the smaller jet force for the 25-gauge system. CONCLUSION: In this experimental study, both the 23- and the 20-gauge air infusion jet showed higher impact pressure values compared with the 25-gauge air infusion jet. This could be of concern regarding air infusion during 23-gauge vitrectomy since retinal damage has been shown in standard-gauge surgeries.