Epidemiological Pattern of Traumatic Brain Injury in Brazil between 2008 and 2019

Introduction Traumatic brain injuries (TBIs) are a public health problem with high economic impact, as well as an important cause of death and sequela in polytrauma patients, affecting mainly young adults. Objective To analyze the temporal trend of TBI incidence in Brazil between 2008 and 2019, according to age group and gender. Methods An ecological study, based on secondary data from hospital admissions for TBI in all Brazilian states between 2008 and 2019. The numbers were collected using the hospital information systemof the Unified Health System in Brazil.We performed a descriptive analysis using the data obtained. Linear regression models were used to measure the incidence trend of TBI in the period adopted. Results The state of Piauí had the highest increase in the incidence of TBI in the country in the last 10 years (coefficient ß»63.43 e p»0.002). The main concern, though, is the increase in the incidence of TBI amongst children (0­4 years old) in the states of Ceará (ß»31.22 and p<0.001 for boys; ß»42.20 and p<0.001 for girls), Paraná (ß»37.26 and p»0.011 for boys; ß»25.90 and p»0.015 for girls), Pernambuco (ß»20.08 and p»0.016 for girls), Mato Grosso (ß»18.76 and p»0.005 for boys; ß»16.11 and p»0.035 for girls), and Distrito Federal (ß»48.87 and p»0.004 for girls; ß»48.28 and p»0.006 for boys). Conclusion The analysis of the results is able to point out improvements that can be made. Besides that, it is remarkably important to redirect public polices to preventive medicine sincemany of the TBI causes are avoidable through awareness and education of the population.

Perineal Rectosigmoidectomy Associated with Low Colorectal Anastomosis for Complete Rectal Prolapse Correction – Altemeier’s Procedure

Introduction: Rectal prolapse constitutes in rectal protrusion through anal orifice. It’s more frequent in elderly women and the correction is exclusively surgical and fundamental, given the condition’s social relevance. We intend to describe a perineal rectosigmoidectomy (Altemeier) for correction of prolapse in multi-morbidity elder patient. Case Report: Female patient, 78 years old, evaluated by proctology ward of CHSBC. She Came in with complaint of anal region bulge for past 2 years. Proctological examination showed 15 cm rectal procidentia Rectal prolapse’s diagnosis came from colonoscopy. A perineal rectosigmoidectomy associated with colorectal anastomosis was done (Altemeier’s Procedure). There was appropriate postoperative evolution, discharge with good wound healing and ambulatorial follow up with good general healing.Discussion: Rectal prolapse is a result of anatomical alterations due to factors such as age and multiparity. Clinical presentation: abdominal discomfort, constipation, feces and gases release. Itleads to life quality loss, thus surgical interventions become essential. Corrective surgeries seek to give back fecal continence. Currently, procedures branch out into abdominal and perineal. Altemeier consists in complete rectal removal via perineum. It’s appropriate for high surgical risk elders, since it has the lowest complications rate