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1.
Sensors (Basel) ; 21(18)2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34577238

RESUMO

In this paper, we describe the possibility of using the energy of a compressed air flow, where cryogenic temperatures are achieved within the flow behind the nozzle, when reaching a critical flow in order to maximize the energy gained. Compared to the energy of compressed air, the energy obtained thermoelectrically is negligible, but not zero. We are therefore primarily aiming to maximize the use of available energy sources. Behind the aperture separating regions with a pressure difference of several atmospheres, a supersonic flow with a large temperature drop develops. Based on the Seebeck effect, a thermocouple is placed in these low temperatures to create a thermoelectric voltage. This paper contains a mathematical-physical analysis for proper nozzle design, controlled gas expansion and ideal placement of a thermocouple within the flow for best utilization of the low temperature before a shockwave formation. If the gas flow passes through a perpendicular shockwave, the velocity drops sharply and the gas pressure rises, thereby increasing the temperature. In contrast, with a conical shockwave, such dramatic changes do not occur and the cooling effect is not impaired. This article also contains analyses for proper forming of the head shape of the thermocouple to avoid the formation of a detached shockwave, which causes temperature stagnation resulting in lower thermocouple cooling efficiency.


Assuntos
Ar Comprimido , Atmosfera , Temperatura Baixa , Pressão , Temperatura
2.
PLoS One ; 16(7): e0254524, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34270580

RESUMO

Pneumatically-actuated soft robots have advantages over traditional rigid robots in many applications. In particular, their flexible bodies and gentle air-powered movements make them more suitable for use around humans and other objects that could be injured or damaged by traditional robots. However, existing systems for controlling soft robots currently require dedicated electromechanical hardware (usually solenoid valves) to maintain the actuation state (expanded or contracted) of each independent actuator. When combined with power, computation, and sensing components, this control hardware adds considerable cost, size, and power demands to the robot, thereby limiting the feasibility of soft robots in many important application areas. In this work, we introduce a pneumatic memory that uses air (not electricity) to set and maintain the states of large numbers of soft robotic actuators without dedicated electromechanical hardware. These pneumatic logic circuits use normally-closed microfluidic valves as transistor-like elements; this enables our circuits to support more complex computational functions than those built from normally-open valves. We demonstrate an eight-bit nonvolatile random-access pneumatic memory (RAM) that can maintain the states of multiple actuators, control both individual actuators and multiple actuators simultaneously using a pneumatic version of time division multiplexing (TDM), and set actuators to any intermediate position using a pneumatic version of analog-to-digital conversion. We perform proof-of-concept experimental testing of our pneumatic RAM by using it to control soft robotic hands playing individual notes, chords, and songs on a piano keyboard. By dramatically reducing the amount of hardware required to control multiple independent actuators in pneumatic soft robots, our pneumatic RAM can accelerate the spread of soft robotic technologies to a wide range of important application areas.


Assuntos
Robótica/métodos , Conversão Análogo-Digital , Inteligência Artificial , Ar Comprimido , Mãos/fisiologia , Humanos , Robótica/instrumentação , Transistores Eletrônicos
3.
Am J Case Rep ; 22: e929671, 2021 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-33611333

RESUMO

BACKGROUND In this observational case report, we describe a case of orbital cellulitis caused by blunt trauma from an orbital compressed air and diesel explosion injury. CASE REPORT A 44-year-old man presented to our emergency department with a marked clinical worsening of right upper eyelid swelling, accompanied by pain, fever, and redness. Four days prior, the patient's right eye was struck by a pressurized diesel engine explosion. He sought treatment at another hospital, where an initial examination was conducted and a small laceration was found and immediately treated with irrigation and medication. The wound became progressively worse, and on examination at our hospital, we diagnosed orbital cellulitis, multiple abscesses, and pneumo-orbital formations. There was no indication of infection from the ears, nose, throat, and oral cavity, which usually causes orbital cellulitis. Drainage, debridement, incision, and necrotomy with orbital decompression (canthotomy and cantholysis procedure) was then performed on the patient. CONCLUSIONS Diesel explosion injury can cause orbital cellulitis which can appear to be a simple case at first but has a poor prognosis. Therefore, evaluating the patient's trauma history, computed tomography scan, and histopathological examination are essential in establishing the diagnosis. As early as possible, a diagnosis should be made to prevent tissue damage due to inflammation. Surgical debridement and the administration of a corticosteroid and antibiotic were key to managing the presented case.


Assuntos
Ar Comprimido , Celulite Orbitária , Abscesso , Adulto , Explosões , Humanos , Masculino , Celulite Orbitária/diagnóstico , Celulite Orbitária/etiologia , Tomografia Computadorizada por Raios X
4.
Molecules ; 25(23)2020 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-33266146

RESUMO

We report a novel compressed air-driven continuous-flow digital PCR (dPCR) system based on a 3D microfluidic chip and self-developed software system to realize real-time monitoring. The system can ensure the steady transmission of droplets in long tubing without an external power source and generate stable droplets of suitable size for dPCR by two needles and a narrowed Teflon tube. The stable thermal cycle required by dPCR can be achieved by using only one constant temperature heater. In addition, our system has realized the real-time detection of droplet fluorescence in each thermal cycle, which makes up for the drawbacks of the end-point detection method used in traditional continuous-flow dPCR. This continuous-flow digital PCR by the compressed air-driven method can meet the requirements of droplet thermal cycle and diagnosis in a clinical-level serum sample. Comparing the detection results of clinical samples (hepatitis B virus serum) with commercial instruments (CFX Connect; Bio Rad, Hercules, CA, USA), the linear correlation reached 0.9995. Because the system greatly simplified the traditional dPCR process, this system is stable and user-friendly.


Assuntos
Técnicas Biossensoriais/métodos , Ar Comprimido , DNA Viral/genética , Vírus da Hepatite B/genética , Hepatite B/diagnóstico , Reação em Cadeia da Polimerase/métodos , DNA Viral/sangue , Fluorescência , Hepatite B/sangue , Hepatite B/virologia , Vírus da Hepatite B/isolamento & purificação , Humanos , Temperatura
5.
Diving Hyperb Med ; 50(4): 363-369, 2020 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-33325017

RESUMO

INTRODUCTION: The presence of a persistent (patent) foramen ovale (PFO) increases the risk of decompression sickness (DCS) whilst diving with pressurised air. After the diagnosis of a PFO, divers will be offered a number of options for risk mitigation. The aim of this study was to review the management choices and modifications to diving practices following PFO diagnosis in the era preceding the 2015 joint position statement (JPS) on PFO and diving. METHODS: A retrospective study was conducted of divers sourced from both the Alfred Hospital, Melbourne and the Divers Alert Network Asia-Pacific during the period 2005-2015. Divers were contacted via a combination of phone, text, mail and email. Data collected included: diving habits (years, style and depths); DCS symptoms, signs and treatment; return to diving and modifications of dive practices; history of migraine and echocardiography (ECHO) pre- and post-intervention; ECHO technique(s) used, and success or failure of PFO closure (PFOC). Analyses were performed to compare the incidence of DCS pre- and post-PFO diagnosis. RESULTS: Seventy-three divers were interviewed. Sixty-eight of these returned to diving following the diagnosis of PFO. Thirty-eight underwent PFOC and chose to adopt conservative diving practices (CDPs); 15 chose PFOC with no modification to practices; 15 adopted CDPs alone; and five have discontinued diving. The incidence of DCS decreased significantly following PFOC and/or adoption of conservative diving practices. Of interest, migraine with aura resolved in almost all those who underwent PFOC. CONCLUSIONS: Many divers had already adopted practices consistent with the 2015 JPS permitting the resumption of scuba diving with a lowering of the incidence of DCS to that of the general diving population. These results support the recommendations of the JPS.


Assuntos
Ar Comprimido , Doença da Descompressão , Mergulho , Forame Oval Patente , Forame Oval , Doença da Descompressão/diagnóstico por imagem , Doença da Descompressão/epidemiologia , Doença da Descompressão/etiologia , Mergulho/efeitos adversos , Forame Oval Patente/complicações , Forame Oval Patente/diagnóstico por imagem , Forame Oval Patente/epidemiologia , Humanos , Estudos Retrospectivos
6.
Ann Emerg Med ; 76(6): 801-803, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32950279

RESUMO

Orbital compartment syndrome is a critical ophthalmic emergency that needs urgent diagnosis and treatment to prevent permanent vision loss caused by optic nerve compression or retinal ischemia. In this article, we present a child with orbital compartment syndrome caused by orbital emphysema as a result of a rare type of ocular trauma and introduce a simple technique to decompress the pressure. The patient was a 4-year-old boy who experienced a compressed air blast to his left eye. He presented to the emergency department with a frozen globe, tight orbit, and chemosis, without any evidence of globe rupture, conjunctival laceration, and orbital bone fracture. Computed tomographic scan demonstrated extensive subcutaneous, intraorbital, and intracranial emphysema. The pressure was immediately relieved under intravenous sedation by inserting a 27-gauge needle into the chemotic subconjunctival space at the lower lid fornix, followed by gentle manipulation of the globe to help the air escape through the needle. Compressed air injury is a rare type of orbital trauma, and this patient constituted the youngest case ever reported in the English literature, to our knowledge. Air decompression through the conjunctiva as described in this article is a useful technique that can be applied by emergency medicine specialists with special caution for patients with orbital compartment syndrome and orbital emphysema caused by compressed air injury.


Assuntos
Ar Comprimido/efeitos adversos , Descompressão/métodos , Órbita/lesões , Enfisema Subcutâneo/terapia , Pré-Escolar , Túnica Conjuntiva/cirurgia , Medicina de Emergência/métodos , Serviço Hospitalar de Emergência , Traumatismos Oculares/complicações , Humanos , Masculino , Agulhas/efeitos adversos , Doenças Orbitárias/complicações , Enfisema Subcutâneo/diagnóstico por imagem , Enfisema Subcutâneo/etiologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
7.
Diving Hyperb Med ; 50(3): 292-294, 2020 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-32957133

RESUMO

Arterial gas embolism (AGE) may result when diving while breathing compressed gas and ascending rapidly or with a closed glottis. Pulmonary over-pressurisation can result in lung stretch injury with entry of bubbles into the pulmonary venous circulation and subsequently the systemic arterial circulation. We present the case of an individual who suffered AGE while breathing compressed air at 1.2 metres' fresh water (mfw) in a swimming pool and discuss the factors determining the depth at which this form of injury may occur. This case serves to underscore the fact that risk of AGE exists at shallow depths.


Assuntos
Ar Comprimido , Mergulho , Embolia Aérea , Lesão Pulmonar , Mergulho/efeitos adversos , Embolia Aérea/diagnóstico por imagem , Embolia Aérea/etiologia , Humanos , Água
8.
Rev. medica electron ; 42(2): 1724-1731, mar.-abr. 2020.
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1127029

RESUMO

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).


Assuntos
Humanos , Masculino , Idoso , Asfixia/classificação , Lesões do Pescoço/mortalidade , Asfixia/mortalidade , Mecânica Respiratória , Causas de Morte , Ar Comprimido , Medicina Legal
11.
Eur J Surg Oncol ; 46(1): 155-159, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31493986

RESUMO

INTRODUCTION: Electrostatic precipitation Pressurized IntraPeritoneal Aerosol Chemotherapy (ePIPAC) has shown superior penetration depth and tissue uptake compared to standard PIPAC. We investigated the feasibility and objective tumor response to ePIPAC with 1 min of precipitation in patients with peritoneal metastasis (PM). MATERIALS AND METHODS: Patients with PM from various abdominal cancers were included in an amendment to the ongoing prospective PIPAC-OPC2 trial. Colorectal and appendiceal PM were treated with oxaliplatin, patients with PM from other primaries were treated with a combination of cisplatin and doxorubicin. Three ePIPAC procedures were planned in each patient including repeated peritoneal biopsies for response evaluation. After emission to the peritoneal cavity, the aerosolized chemotherapeutics were precipitated for 1 min followed by immediate exsufflation and abdominal closure. Histological regression from the first to the third ePIPAC was evaluated according to the Peritoneal Regression Grading Score (PRGS) and compared to data from the PIPAC-OPC1 trial. Complications and toxicities were recorded according to Dindo-Clavien and CTCAE. RESULTS: Sixty-five ePIPAC procedures were performed in 33 patients (median 2, range 1-6). Ten patients were eligible for response evaluation based on biopsies from the first and third ePIPAC procedure. Four patients had disease progression, four patients had regressive disease, and two patients had stable disease according to PRGS. No life threatening adverse reactions and no mortality was observed following ePIPAC. CONCLUSION: One minute ePIPAC was feasible and safe, but the histological tumor response was insufficient compared to standard PIPAC directed therapy with 30 min passive diffusion time.


Assuntos
Aerossóis/administração & dosagem , Antineoplásicos/administração & dosagem , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/secundário , Adulto , Idoso , Biópsia , Cisplatino/administração & dosagem , Ar Comprimido , Dinamarca , Progressão da Doença , Doxorrubicina/administração & dosagem , Estudos de Viabilidade , Humanos , Pessoa de Meia-Idade , Gradação de Tumores , Oxaliplatina/administração & dosagem , Fatores de Tempo
12.
J Forensic Sci ; 65(1): 200-208, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31335988

RESUMO

Structured light scanning is a noninvasive, accurate, and cost-effective 3D imaging technique, but due to reflection issues is yet to be utilized for tool mark analysis on fresh bone. During imaging, reflection from shiny surfaces, such as greasy bone, disrupts image formation. This study tested the David SLS-1 scanner's ability to image saw marks and explored six strategies to reduce reflection by [1] dulling the surface or [2] altering the projected light. The surface was dulled by freezing, talcum powder, dulling spray, or compressed air. The projected light was altered with a diffuser or limited to single pattern-coded. Results demonstrated that the resolution was insufficient for capturing minute details of striae. All six tests failed to reduce reflection sufficiently to produce complete images, but projecting vertical pattern-coded light showed the most promise. Future research is required concentrating on enhancing resolution and exploring the role of pattern-coded light in reducing reflection.


Assuntos
Fêmur/diagnóstico por imagem , Imageamento Tridimensional , Lasers , Animais , Ar Comprimido , Fêmur/patologia , Antropologia Forense , Modelos Animais , Suínos , Talco
13.
Undersea Hyperb Med ; 46(4): 409-419, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31509897

RESUMO

The descent is a critical part of a dive, both physically and mentally. Pulmonary ventilation, expressed as respiratory minute volume (RMV) and heart rate (HR) were recorded during fast and slow descents to 35 meters (m) in open water while breathing compressed air, and during swimming horizontally at moderate velocity at an 11-m depth. Values of both types of descents were compared with reference values recorded at 11 m, the "plateau" phase, halfway through the 35-m dives. It is hypothesized that the "slow-descent" and "plateau-phase" values will be less than 'fast-descent values. Depth, cylinder pressure, water temperature and HR were recorded with a dive computer yielding time-averaged means (mRMV and mHR) for the descent and for plateau. Of the 18 divers included, 16 performed the fast descents and 11 made the slow descents. The fast descents (23 m·min-1 vertically), performed with 0-8 fin kicks, yielded mRMVDescent=28 ambient L (aL)·min-1, which is 82% higher (P⟨0.001) than mRMVPlateau of 15 aL·min-1. Further, mHRDescent was121 beats·min-1 23% higher (P⟨0.001), than mHRPlateau of 100 bpm. Slow descents (2.4 m·min-1 vertically) yielded 17 aL·min-1 with mHR=101 beats·min-1, values only slightly higher than at Plateau. The 11-m dive (swimming horizontally) yielded 24 m·min-1 with 32 fin kicks·min-1, mRMV=35 aL·min-1 and mHR=115 beats·min-1. Fast descents cause a higher RMV and HR that cannot be explained by physiology alone. Presumably mental stress is a main contributor. For dives deeper than 20 m, a descent velocity of 10 m·min-1 is recommended to reduce cardiac stress, in particular for older divers.


Assuntos
Mergulho/fisiologia , Mergulho/psicologia , Frequência Cardíaca , Ventilação Pulmonar , Estresse Psicológico/complicações , Aceleração , Adulto , Idoso , Ar Comprimido , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Respiração , Água do Mar , Estresse Fisiológico , Natação/fisiologia , Piscinas , Temperatura
14.
Undersea Hyperb Med ; 46(4): 447-459, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31509901

RESUMO

Introduction: The mining and tunneling industries are historically associated with hazardous exposures that result in significant occupational health concerns. Occupational respiratory exposures causing pneumoconiosis and silicosis are of great concern, silicosis being non-curable. This work demonstrates that compressed-air workers (CAWs) performing tunnel hyperbaric interventions (HIs) may be at risk for hazards related to bentonite exposure, increasing the likelihood of developing harmful illnesses including cancer. Bentonite dust inhalation may result in respiratory levels of silica exceeding acceptable industrial hygiene standards. Methods: A qualitative observational exposure assessment was conducted on CAWs while they were performing their HI duties. This was followed by quantitative data collection using personal and area air sample techniques. The results were analyzed and interpreted using standard industrial hygiene principles and guidelines from NIOSH and OSHA. Results: Our work suggests bentonite dust exposure may be an emerging particulate matter concern among CAWs in the tunneling industry. Aerosolized bentonite particles may have potential deleterious effects that include pneumoconiosis and silicosis. Silicosis can result in the development of pulmonary carcinoma. Conclusions: The modern tunneling industry and required hyperbaric interventional tasks represent a potential public health and occupational concern for CAWs. This paper introduces the modern tunneling industry and the duties of CAWs, the hazardous environment in which they perform their duties, and describes the risks and potential harmful health effects associated with these hazardous exposures.


Assuntos
Bentonita/toxicidade , Ar Comprimido , Materiais de Construção/toxicidade , Poeira , Arquitetura de Instituições de Saúde , Exposição Ocupacional/efeitos adversos , Poluentes Ocupacionais do Ar/química , Poluentes Ocupacionais do Ar/toxicidade , Bentonita/química , Indústria da Construção , Materiais de Construção/análise , Segurança de Equipamentos , Filtração/instrumentação , Humanos , Pressão , Pesquisa Qualitativa , Dispositivos de Proteção Respiratória , Estados Unidos , United States Occupational Safety and Health Administration/normas
15.
Sci Rep ; 9(1): 13320, 2019 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-31527725

RESUMO

Production of blood-borne microparticles (MPs), 0.1-1 µm diameter vesicles, and interleukin (IL)-1ß in response to high pressure is reported in lab animals and associated with pathological changes. It is unknown whether the responses occur in humans, and whether they are due to exposure to high pressure or to the process of decompression. Blood from research subjects exposed in hyperbaric chambers to air pressure equal to 18 meters of sea water (msw) for 60 minutes or 30 msw for 35 minutes were obtained prior to and during compression and 2 hours post-decompression. MPs and intra-particle IL-1ß elevations occurred while at pressure in both groups. At 18 msw (n = 15) MPs increased by 1.8-fold, and IL-1ß by 7.0-fold (p < 0.05, repeated measures ANOVA on ranks). At 30 msw (n = 16) MPs increased by 2.5-fold, and IL-1ß by 4.6-fold (p < 0.05), and elevations persisted after decompression with MPs elevated by 2.0-fold, and IL-1ß by 6.0-fold (p < 0.05). Whereas neutrophils incubated in ambient air pressure for up to 3 hours ex vivo did not generate MPs, those exposed to air pressure at 180 kPa for 1 hour generated 1.4 ± 0.1 MPs/cell (n = 8, p < 0.05 versus ambient air), and 1.7 ± 0.1 MPs/cell (p < 0.05 versus ambient air) when exposed to 300 kPa for 35 minutes. At both pressures IL-1ß concentration tripled (p < 0.05 versus ambient air) during pressure exposure and increased 6-fold (p < 0.05 versus ambient air) over 2 hours post-decompression. Platelets also generated MPs but at a rate about 1/100 that seen with neutrophils. We conclude that production of MPs containing elevated concentrations of IL-1ß occur in humans during exposure to high gas pressures, more so than as a response to decompression. While these events may pose adverse health threats, their contribution to decompression sickness development requires further study.


Assuntos
Micropartículas Derivadas de Células/patologia , Mergulho/efeitos adversos , Interleucina-1beta/metabolismo , Adulto , Pressão do Ar , Micropartículas Derivadas de Células/metabolismo , Ar Comprimido/efeitos adversos , Descompressão/métodos , Doença da Descompressão/patologia , Mergulho/fisiologia , Feminino , Humanos , Interleucina-1beta/fisiologia , Masculino , Ativação de Neutrófilo/fisiologia , Neutrófilos/patologia , Oxigênio
16.
Hand Surg Rehabil ; 38(5): 312-316, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31400497

RESUMO

High-pressure injection injuries to the fingers resulting from the introduction of a foreign substance, such as oil or paint, through a minor puncture wound are rare but can have serious clinical consequences. The objective of this article was to examine the long-term outcomes after surgical debridement of these injuries. We present a retrospective case series of 8 adults who had a high-pressure injection injury to their hand and underwent surgical debridement in our facility. Data were extracted from our outpatient registry. Assessment included a full physical examination, grip strength, range of motion, two-point discrimination and Quick Disability of the Arm, Shoulder, and Hand (QuickDASH) questionnaire. We followed 8 male patients for an average of 12.7 years. Their average age was 37 at time of injury and all had injured their right dominant hand. Seventy-five percent of the injuries were to the index finger. Seven out of the 8 patients returned to their pre-injury occupation, 4 out of 8 patients had reduced range of motion of the affected digit. Injury sequelae adversely affected activities of daily living (ADL) with an average QuickDASH score of 26. Grip strength in the injured hand was reduced by an average of 35% in 6 out of 8 patients compared with the uninjured hand. Sensation was also reduced in the affected digit in 7 out of 8 patients. All patients suffered from some level of neuropathic pain and/or cold intolerance. High pressure injection injury to the fingers is a serious event found amongst industrial laborers. In most patients, this injury will lead to long-term disability along with a negative impact on ADL. However, most patients eventually return to their pre-injury occupation. Extensive, single or repeat debridement of high-pressure injection injuries remains a valid treatment option with good long-term results.


Assuntos
Ar Comprimido/efeitos adversos , Desbridamento , Traumatismos dos Dedos/cirurgia , Corpos Estranhos/cirurgia , Traumatismos Ocupacionais/cirurgia , Ferimentos Penetrantes/cirurgia , Atividades Cotidianas , Adulto , Avaliação da Deficiência , Seguimentos , Força da Mão , Humanos , Masculino , Pessoa de Meia-Idade , Óleos , Pintura , Amplitude de Movimento Articular , Estudos Retrospectivos , Retorno ao Trabalho , Solventes
17.
Am J Forensic Med Pathol ; 40(4): 376-380, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31306168

RESUMO

Barotrauma-associated perforation of the colon is not common and usually occurs due to the passage of compressed air through the anus. Most of the cases are accidental and done for fun often at the victim's workplace. Therefore, it is necessary that the workers should be made aware of the dangers of the equipment they regularly use at their workplace. Here, we describe one such case where a rice mill worker died when compressed air through an air pump pipe entered his rectum. His chief complaint was abdominal pain and breathing difficulty. Computed tomography scan of the abdomen and thorax showed pneumoperitoneum, pneumomediastinum, and soft tissue emphysema. There was a complete tear in the rectosigmoid junction of the colon. The mucosa was deeply hemorrhagic and congested. Histopathology of this segment showed hemorrhagic necrosis of the mucosa.


Assuntos
Colo/lesões , Ar Comprimido/efeitos adversos , Perfuração Intestinal/etiologia , Exposição Ocupacional/efeitos adversos , Colo/diagnóstico por imagem , Colo/patologia , Evolução Fatal , Hemorragia Gastrointestinal/diagnóstico por imagem , Hemorragia Gastrointestinal/patologia , Humanos , Mucosa Intestinal/patologia , Perfuração Intestinal/diagnóstico por imagem , Perfuração Intestinal/patologia , Masculino , Enfisema Mediastínico/diagnóstico por imagem , Necrose , Peritonite/etiologia , Pneumoperitônio/diagnóstico por imagem , Tomografia Computadorizada por Raios X
18.
J Med Case Rep ; 13(1): 133, 2019 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-31060601

RESUMO

BACKGROUND: Rectal perforation by foreign bodies is known; however, high-pressure injury leading to rectal blowout has been confined to battlefields and is less often encountered in general medical practice. Apart from iatrogenic injuries during colonoscopy, barotrauma from compressed air is encountered very less frequently. Owing to the infrequent nature of these injuries, the mechanism is still not well understood. We present our experience with treating high-pressure transanal barotrauma to the rectum and colon in three similar cases. CASE PRESENTATION: The mode of injury was accidental or a cruel, perverted joke played by acquaintances. The high-pressure air jet column overcomes the anal sphincter barrier, pushing enormous amounts of air through the anus into the bowel, which ruptures when the burst pressure is reached. A huge amount of free gas was noted in the peritoneal cavity on x-rays, and a big gush was noted during surgery. All these cases had rectosigmoid junction blowout with multiple colonic injuries. The patients underwent exploratory laparotomy with resection of severely injured segments and proximal ileostomy. They underwent restoration of bowel continuity after 2-3 months and were doing well in follow-up. CONCLUSIONS: Colorectal injuries by pneumatic insufflation through the anus depends on the air pressure, air flow velocity, anal resting pressure, and the distance between the source and anus. The relative fixity of the rectum and the bends of the sigmoid make the rectosigmoid junction more prone to rupture by high-pressure air jet. Education regarding such machines and their safe use must be encouraged because most of these cases are accidental and due to ignorance.


Assuntos
Canal Anal/lesões , Barotrauma/etiologia , Colo Sigmoide/lesões , Ar Comprimido/efeitos adversos , Perfuração Intestinal/etiologia , Adulto , Humanos , Perfuração Intestinal/cirurgia , Masculino , Peritonite/etiologia , Pneumoperitônio/etiologia , Adulto Jovem
19.
Ann Biol Clin (Paris) ; 77(3): 281-286, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31115339

RESUMO

Extreme leukocytosis may lead to false hyperkalemia when blood samples are conveyed by pneumatic tube system (PTS). The aim of this study was to define whether even moderate leukocytosis and also non malignancy cells like neutrophils may influence potassium values after PTS transportation. MATERIALS AND METHODS: Uncentrifuged blood samples are sent to the local laboratory through PTS. Data were retrospectively collected from routine testing carried out on all specimens arrived in the laboratory between September 2017 and March 2018. Clinical chemistry testing is routinely performed using lithium-heparin tubes. When false hyperkalemia induced by leukocytosis is suspected, potassium measurement is then performed in serum (clotting activator tubes) or whole blood samples. The analysis was focused on samples with both leukocytosis (i.e., >15×109/L) and plasma potassium >5.0 mmol/L, before any corrective therapeutic measure to lower potassium levels was established. RESULTS: A total number of 18 samples were included in our analysis, 9 drawn from patients with hematologic malignancies and 9 without. In the 9 patients without hematologic malignancies (median leukocyte count, 20.4×109/L), the median potassium value was 5.4 mmol/L in plasma and 4.5 mmol/L in serum or whole blood. In the 9 patients with hematologic malignancies (median leukocyte count, 151.9×109/L; p <0.001), the median potassium value was 7.7 mmol/L in plasma and 4.3 mmol/L in serum or whole blood (median difference, 2.9 mmol/L; p <0.001). CONCLUSION: The results of our study suggest that even modest leukocytosis (i.e., around 15x109/L), which can be frequently encountered in clinical practice, may be associated with a significant variation of plasma potassium. This would lead us to conclude that plasma samples transportation by PTS should be avoided in patients with even mild leukocytosis.


Assuntos
Coleta de Amostras Sanguíneas/efeitos adversos , Ar Comprimido/efeitos adversos , Hiperpotassemia/diagnóstico , Leucocitose/diagnóstico , Fase Pré-Analítica/métodos , Transportes/métodos , Artefatos , Coleta de Amostras Sanguíneas/métodos , Estudos de Casos e Controles , Diagnóstico Diferencial , Reações Falso-Positivas , Neoplasias Hematológicas/sangue , Humanos , Hiperpotassemia/sangue , Hiperpotassemia/etiologia , Inflamação/sangue , Leucocitose/sangue , Leucocitose/etiologia , Potássio/análise , Potássio/sangue , Fase Pré-Analítica/normas , Estudos Retrospectivos , Transportes/normas
20.
Urol Clin North Am ; 46(2): 207-213, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30961854

RESUMO

Percutaneous nephrolithotomy is the treatment of choice for large renal stones. Larger, straight access tracts allow for use of rigid pneumatic and ultrasonic lithotripsy devices. Through advanced technologies, more efficient fragmentation has become possible, allowing for a variety of treatment options depending on stone location, size, and composition. As novel methods of lithotripsy enter the clinical sphere, it is a requirement that the operating urologist understand the available surgical options and the associated mechanisms used to best treat their patients. This article discusses the mechanisms of basic pneumatic and ultrasonic devices, and examines the data regarding current and novel combination lithotrites.


Assuntos
Litotripsia/instrumentação , Litotripsia/tendências , Terapia por Ultrassom/instrumentação , Ar Comprimido/uso terapêutico , Gases/uso terapêutico , Humanos , Invenções/tendências , Litotripsia/métodos , Nefrolitotomia Percutânea/instrumentação , Nefrolitotomia Percutânea/métodos , Nefrolitotomia Percutânea/tendências , Terapia por Ultrassom/métodos , Terapia por Ultrassom/tendências
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