Management Of Severe Thoracic Impalement Trauma Against Two-wheeled Horse Carriage: A Case Report And Literature Review.

Thoracic injuries in general are of great importance due to their high incidence and high mortality. Thoracic impalement injuries are rare but severe due to the combination of cause, effect and result. This study's primary objective is to report the case of a young man who was impaled by a two-wheeled horse carriage shaft while crashing his motorcycle in a rural zone. An EMT-B ferry was called at the crash scene and a conscious patient was found, sustaining a severe impalement injury to the left hemithorax, suspended over the floor by the axial skeleton with the carriage shaft coming across his left chest. As a secondary objective, a literature review of thoracic impalement injuries is performed. Cases of thoracic impalement injury require unique and individualized care based on injury severity and affected organs. Reported protocols for managing impalement injuries are entirely anecdotal, with no uniformity on impaled patient's approach and management. In penetrating trauma, it is essential not to remove the impaled object, so that possible vascular lesions remain buffered by the object, avoiding major bleeding and exsanguination haemorrhage. Severed impaled thoracic patients should be transferred to a specialist centre for trauma care, as these lesions typically require complex multidisciplinary treatment. High-energy thoracic impalement injuries are rare and hold a high mortality rate, due to the complexity of trauma and associated injuries such as thoracic wall and lung lesions. Modern medicine still seems limited in cases of such seriousness, not always with satisfactory results.

Filtros de areia aplicados à irrigação localizada: teoria e prática

The application of sand filters in localized irrigation systems is recommended in the presence of organic and algae contamination. The proper design and maintenance of these equipments are essential to assure an effective water quality control, in order to reduce the emitters clogging, to keep its water application uniformity, and to prevent increasing in the system operation costs. Despite the existence of some references about design, operation and maintenance of these filters, they are dispersed, with not enough details to guarantee the optimization of its hydraulics structure design and the proper selection of porous media to be used. Therefore, the objective of this work was to report a current literature review, relating practical information with scientific knowledge. The content of this review would help to induce and intensify the research on this subject and to contribute so the operational functions for the equipment are reached. It is also expected to assist the improvement of the filtration and flushing processes in the agricultural irrigation and the development of original design procedures and the rational use of these devices.

Caracterização sensorial de amêndoas de castanha-de-caju fritas e salgadas

Shelled, roasted and salted cashew nut kernels were packaged in three different flexible materials (PP/PE= polypropylene / polyethylene; PETmet/PE= metallized polyethylene terephthalate / polyethylene; PET/Al/LDPE= polyethylene terephthalate / aluminum foil / low density polyethylene ), with different barrier properties. Kernels were stored for one year at 30° C and 80% relative humidity. Quantitative descriptive sensory analysis (QDA) were performed at the end of storage time. Descriptive terms obtained for kernels characterization were brown color, color uniformity and rugosity for appearance; toasted kernel, sweet, old and rancidity for odor; toasted kernel, sweet, old rancidity, salt and bitter for taste, crispness for texture. QDA showed that factors responsible for sensory quality decrease, after one year storage, were increase in old aroma and taste, increase in rancidity aroma and taste, decrease in roasted kernel aroma and taste, and decrease of crispness. Sensory quality decrease was higher in kernels packaged in PP/PE.