Prevalência de atendimentos às vítimas de acidentes de trânsito durante a pandemia de COVID-19 / Prevalence of care for road traffic accident victims during the COVID-19 pandemic

Objetivo: Analisar a prevalência de acidentes de trânsito atendidos em um hospital de referência de urgência e emergência, no contexto da pandemia de COVID-19. Métodos: Estudo transversal, com amostra de 364 adultos vítimas de acidentes de trânsito, com idade entre 18 a 60 anos, de ambos os sexos. Utilizou-se um formulário de caracterização sociodemográfica e as características do acidente para coletar os dados. As variáveis foram analisadas por meio da estatística descritiva, análise bivariada e pelo teste Exato de Fisher, com nível de significância de 5% (p<0,05). Resultados: Na amostra, observou-se predomínio de pacientes do sexo masculino (77,1%), motoristas (71,1%), envolvendo motocicleta (68,6%) e sem a utilização do equipamento de proteção (73,3%). As lesões predominantes nos acidentes foram as fraturas (70,8%). Conclusão: Apesar da prevalência de atendimentos de urgências às vítimas de acidentes de trânsito durante a pandemia de COVID-19 ter diminuído de 0,77% (2019) para 0,34% em 2020, percebeu-se que as variáveis ainda permaneceram predominantes. Logo, os achados compreendem uma ferramenta importante para as políticas de prevenção e promoção à saúde, visando a redução de mortes, lesões e incapacidades. Descritores: Acidentes de trânsito. Serviços médicos de emergência. Epidemiologia. COVID-19

Objective: To analyze the prevalence of traffic accidents attended at an urgent and emergency referral hospital, in the context of the COVID-19 pandemic. Methods: Cross-sectional study with a sample of 364 adult victims of traffic accidents, aged between 18 and 60 years, of both sexes. A sociodemographic characterization form and accident characteristics were used to collect data. The variables were analyzed using descriptive statistics, bivariate analysis, and Fisher's Exact test, with a significance level of 5% (p<0.05). Results: In the sample, there was a predominance of male patients (77.1%), drivers (71.1%), involving motorcycle (68.6%) and without the use of protective equipment (73.3%). The predominant injuries in accidents were fractures (70.8%). Conclusion:Although the prevalence of emergency care for traffic accident victims during the COVID-19 pandemic decreased from 0.77% (2019) to 0.34% in 2020, it was noticed that the variables still remained predominant. Therefore, the findings comprise an important tool for prevention and health promotion policies, aiming at reducing deaths, injuries and disabilities. Descriptors: Accidents, traffic. Emergency medical services. Epidemiology. COVID-19

Mortalidad en accidentes por moto en Venezuela, y su relación con Políticas Públicas de seguridad vial y preventiva,1996-2018 / Mortality in motorcycle accidents in Venezuela and relationship with public road safety and preventive policies, 1996 - 2018

Los accidentes de tránsito son un problema de salud pública de gran magnitud y gravedad, en las Américas; Venezuela ocupa un lugar destacado por su alta incidencia. El objetivo de la investigación es establecer la relación entre las políticas públicas para la prevención de los accidentes de motocicletas, y las tasas de mortalidad. Metodología: Estudio documental retrospectivo de las políticas viales y las tasas de mortalidad específicas de lesionados por accidentes de motocicletas en Venezuela durante el período 1996-2018. Resultados: como causa de muerte en Venezuela (2000-2018), representa casi 7% del total, entre 6 a 50% del total de las muertes por accidentes de tránsito terrestre y se mantiene muy alta al final del período, con fallecidos por motocicletas sobre 25%. La elevación de la curva endémica de mortalidad ocurrió simultáneamente al aumento en la producción e importación de motocicletas, y cayó durante la crisis económica, en el año 2014. La legislación actualizada mas no acatada en esta materia, es notoria Conclusiones: Los accidentes de motocicleta son un problema de salud pública de primer orden en Venezuela asociadas al clima económico y social, las tasas de mortalidad tuvieron su máxima meseta de elevación durante la bonanza petrolera 2005-2013. Las políticas asociadas a la prevención de accidentes viales en moto están fragmentadas, son ineficientes y reactivas a situaciones complejas, deficientemente aplicadas por los organismos de tránsito responsables a escala nacional, regional y municipal.

Introduction. Traffic accidents are a public health problem of great magnitude and gravity in the Americas; Venezuela occupies a prominent place for its high incidence. The objective of the research is to establish the relationship between public policies for the prevention of motorcycle accidents, and mortality rates. Methodology: Retrospective documentary study of road policies and specific mortality rates of those injured by motorcycle accidents in Venezuela during the period 1996-2018. Descriptive statistical analysis with trend lines, frequency distributions and annual average rates. Results: cause of death in Venezuela (2000-2018), represents almost 7% of the total. The burden of motorcycle injury deaths represents between 6 to 50% of total road traffic fatalities and remains very high at the end of the period, with motorcycle fatalities over 25%. The elevation of the endemic mortality curve occurred simultaneously with the increase in the production and import of motorcycles, and fell concomitantly with the economic crisis in 2014. Conclusions: Motorcycle accidents are a public health problem of the first order in Venezuela associated with the economic and social climate, mortality rates had their maximum plateau of elevation during the oil economic boom 2005-2013. The policies associated with the prevention of road accidents by motorcycle are fragmented, inefficient and reactive to complex situations and poorly applied by the responsible traffic agencies at national, regional and municipal level.

Disección de aorta secundario a trauma, manejo clínico en Hospital General / Aortic dissection secondary to trauma, clinical management in General Hospital

INTRODUCCIÓN. La disección de aorta es una patología poco frecuente, cuando se presenta, lo hace de una manera catastrófica manifestada por dolor torácico o lumbar intenso acompañado de compromiso hemodinámico agudo, un diagnóstico y tratamiento temprano suelen ser cruciales para evitar la muerte del paciente, así mismo, una disección de aorta puede ser secundario a un trauma torácico por desaceleración y se presenta en 1,5% a 2%, lo que induce sobre todo a un desgarro localizado en la región del istmo aórtico. CASO CLÍNICO. Paciente masculino de 35 años, con antecedente de accidente en vehículo motorizado que provocó un traumatismo cráneo encefálico moderado, hematoma epidural parietal derecho, con resolución quirúrgica hace 18 meses, se descartó lesiones a nivel de tórax con radiografía de tórax normal, además se realizó ecografía FAST en ventana perihepática, suprapúbica, periesplénica y subxi-foidea sin encontrar alteración. Acudió al servicio de emergencia por un cuadro de hemiparesia derecha más disartria de 4 horas de evolución, se realiza tomografía de cráneo sin encontrarse lesión, catalogándose como evento cerebrovascular isquémico con recuperación neurológica. Durante su estancia hospitalaria presenta un cuadro de disnea de grandes esfuerzos y tras realizar exámenes complementarios de control se llega a una conclusión de una cardiomegalia, por lo que es referido a consulta de cardiología donde se realiza ecocardiograma, en la cual se observa disección de aorta ascendente más aneurisma por lo que se decide su ingreso y se instaura tratamiento mediante medidas de soporte, con derivación a hospital de especialidades para cirugía cardiotorácica. CONCLUSIONES. La disección de aorta secundario a un traumatis-mo es poco frecuente, sin embargo, el diagnostico siempre debe estar presente en caso de trauma por desaceleración, ya que es vital para la supervivencia del paciente y su manejo oportuno.

INTRODUCTION. Aortic dissection is an infrequent pathology; when it occurs, it does so in a catastrophic manner manifested by intense thoracic or lumbar pain accompanied by acute he-modynamic compromise. Early diagnosis and treatment are usually crucial to avoid the patient's death; likewise, aortic dissection can be secondary to thoracic trauma due to deceleration and occurs in 1.5% to 2%, which mainly induces a localized tear in the region of the aortic isthmus. CLINICAL CASE. 35-year-old male patient, with a history of motor vehicle accident that caused a moderate head injury, right parietal epidural hematoma, with surgical resolution 18 months ago, chest injuries were ruled out with normal chest X-ray, and FAST ultrasound was performed in perihepatic, suprapubic, perisplenic and subxiphoid window without finding any alteration. She went to the emergency department for a picture of right hemiparesis and dysarthria of 4 hours of evolution, a cranial tomography was performed without finding any lesion, being clas-sified as an ischemic cerebrovascular event with neurological recovery. During his hospital stay he presented with dyspnea of great effort and after performing complementary control tests, a cardiomegaly was found, so he is referred to a cardiology clinic where an echocardiogram is per-formed, which showed dissection of the ascending aorta plus aneurysm, admission is decided and treatment is instituted through supportive measures, with referral to a specialty hospital for cardiothoracic surgery. CONCLUSIONS. Aortic dissection secondary to trauma is rare, however, the diagnosis should always be present in case of trauma due to deceleration, as it is vital for the survival of the patient and its timely treatment.

Boletín Epidemiológico Semana 30/2023 (Periodo de Vacaciones Agostinas del 01 al 06-agosto 2023) / Epidemiological Bulletin Week 30/2023 (Agostinas Holiday Period 01 to 06-August 2023)

Resumen de eventos de notificación hasta SE 30/2023. Informe Epidemiológico de vigilancia intensificada. 2022-2023. Eventos de notificación intensificada diaria y acumulado. Atenciones, consultas médicas, referencias y emergencias acumuladas 2022-2023. Informe de atenciones, consultas médicas, emergencias y referencias

Summary of notification events up to SE 30/2023. Epidemiological report of intensified surveillance. 2022-2023. Daily and cumulative intensified notification events. Attentions, medical consultations, referrals and cumulative emergencies 2022-2023. Report of care, medical consultations, emergencies and references

Heberprot-P® en el tratamiento de trauma vascular distal / Heberprot-P® in the treatment of distal vascular trauma

Introducción: Los traumatismos constituyen causa frecuente de consulta. Entre sus localizaciones más comunes se encuentran las extremidades inferiores. El Heberprot-P® resulta un factor de crecimiento epidérmico que se ha utilizado durante más de una década para la cicatrización de las úlceras del pie diabético con excelentes resultados. Ampliar su utilización a otras patologías, incluso de etiología traumática, permitiría expandir las posibilidades terapéuticas para la cicatrización de las heridas. Objetivo: Exponer el resultado de la aplicación del Heberprot-P® en una amputación transtarsiana en un paciente portador de un trauma vascular distal. Presentación del caso: Paciente masculino de 23 años con antecedentes de salud. Luego de traumatismo por accidente de tránsito presentó fractura de huesos del metatarso y la sección total de la arteria pedia del pie izquierdo, lo cual provocó una gangrena húmeda de la extremidad. Por este motivo se realizó una amputación transtarsiana del pie. Se usó el Heberprot-P® como terapia para acortar el tiempo de cicatrización. Conclusiones: El Heberprot-P® resultó útil para la evolución de la herida como consecuencia de un trauma vascular, al evitar una amputación mayor, acelerar el proceso de cicatrización y conservar una extremidad funcional, lo que demostró que puede constituir una terapia eficaz para las heridas de difícil cicatrización, independientemente de su etiología(AU)

Introduction: Trauma is a frequent cause of consultation. Among its most common locations are the lower extremities. Heberprot-P® is an epidermal growth factor that has been used for more than a decade for the healing of diabetic foot ulcers with excellent results. Extending its use to other pathologies, including traumatic etiology ones, would expand the therapeutic possibilities for wound healing. Objective: To present the result of the application of Heberprot-P® in a Chopart´s amputation in a patient with distal vascular trauma. Case presentation: A 23-year-old male patient with a health history. After trauma from a traffic accident, he presented a fracture of the bones of the metatarsus and the whole section of the left foot´s pedis artery, which caused a wet gangrene of the extremity. For this reason, a Chopart´s amputation of the foot was performed. Heberprot-P® was used as therapy to shorten healing time. Conclusions: Heberprot-P® was useful for wound evolution as a result of vascular trauma, avoiding major amputation, accelerating the healing process and preserving a functional limb, which showed that it can be an effective therapy for wounds that are difficult to heal, regardless of their etiology(AU)

Jovens diante da morte: experiências de sobreviventes de acidentes de trânsito e tentativas de homicídios / Young people facing death: experiences of survivors of traffic accidents and attempted homicides / Jóvenes frente a la muerte: experiencias de sobrevivientes de accidentes de tránsito y tentativas de homicidio

INTRODUÇÃO: Ainda hoje, a morte é um tema tabu, fortemente associado ao envelhecimento. Contudo, é preocupante o número de jovens que se envolvem em situações inesperadas, como os acidentes de trânsito e as tentativas de homicídio, levando-os a se depararem com sua finitude. OBJETIVO: compreender e analisar a experiência de jovens sobreviventes de acidentes de trânsito e tentativas de homicídios. MÉTODO: Foram realizadas entrevistas narrativas com oito jovens, com idade entre 19 e 29 anos, que residem no estado de Mato Grosso do Sul e que se sobreviveram a acidentes de trânsito ou tentativas de homicídio. As entrevistas foram orientadas por um roteiro semiestruturado e foram analisadas na perspectiva da Análise de Conteúdo. RESULTADOS: O discurso dos jovens entrevistados aponta para as implicações existenciais das mudanças impostas pelas intercorrências, sobretudo a partir dos impactos que elas causaram, alterando tanto suas rotinas como também a forma como pensavam e viviam. Além disso, essa experiência também trouxe implicações na percepção da imagem corporal, além de mudanças em outros âmbitos da vida dos entrevistados, como o trabalho, os estudos, bem como as relações familiares e de amizade, que também foram afetadas. CONCLUSÃO: Faz-se necessária uma maior compreensão dessas experiências, com o intuito de contribuir com elaboração de estratégias em saúde para ajudar esses jovens a lidarem com as consequências das ocorrências que, muitas vezes, são graves e permanentes.

INTRODUCTION: Even today, death is a taboo topic, strongly associated with aging. However, the number of young people who become involved in unexpected situations, such as traffic accidents and attempted murders, is worrying, leading them to face their finitude. OBJECTIVE: To understand and analyze the experience of young survivors of traffic accidents and attempted homicides. METHOD: Open interviews were carried out with eight young people, aged between 19 and 29 years old, who live in the state of Mato Grosso do Sul and who survived traffic accidents or attempted homicides. The interviews were guided by a semi-structured script and were analyzed from the perspective of Content Analysis. RESULTS: The speech of the young people interviewed points to the existential implications of the changes imposed by the intercurrences, especially from the impacts they caused, changing both their routines and the way they thought and lived. In addition, this experience also had implications for the perception of body image, in addition to changes in other areas of the interviewees' lives, such as work, studies, as well as family and friendship relationships that were also affected. CONCLUSION: A better understanding of these experiences is needed, in order to contribute to the development of health strategies that help these young people to deal with the consequences of events that are often serious and permanent.

INTRODUCCIÓN: Hoy en día, la muerte es un tema tabú, fuertemente asociado al envejecimiento. Sin embargo, es preocupante la cantidad de jóvenes que se ven involucrados en situaciones inesperadas, como accidentes de tránsito e intentos de homicidio, que los llevan a enfrentar su finitud. OBJETIVO: Comprender y analizar la experiencia de jóvenes sobrevivientes de accidentes de tránsito y tentativas de homicidio. MÉTODO: Se realizaron entrevistas abiertas con ocho jóvenes, con edades entre 19 y 29 años, que viven en el estado de Mato Grosso do Sul y que han sobrevivido a accidentes de tráfico o intentos de homicidio. Las entrevistas fueron guiadas por un guión semiestructurado y fueron analizadas desde la perspectiva del Análisis de Contenido. RESULTADOS: El discurso de los jóvenes entrevistados apunta a las implicaciones existenciales de los cambios impuestos por las intercurrencias, especialmente a partir de los impactos que provocaron, modificando tanto sus rutinas como su forma de pensar y vivir. Además, esta experiencia también tuvo implicaciones en la percepción de la imagen corporal, además de cambios en otras áreas de la vida de los entrevistados, como el trabajo, los estudios, así como las relaciones familiares y de amistad que también se vieron afectadas. CONCLUSION: Se necesita una mejor comprensión de estas experiencias, para contribuir al desarrollo de estrategias de salud que ayuden a estos jóvenes a enfrentar las consecuencias de eventos que muchas veces son graves y permanentes.

Resiliência: avaliação de pacientes queimados em um hospital de urgência e emergência / Resilience: evaluation of burned patients in an urgency and emergency hospital / Resiliencia: evaluación de pacientes quemados en un hospital de urgencias y emergencias

A recuperação de vítimas de queimaduras é longa e dolorosa e afeta diversas esferas da vida do paciente. A resiliência, que se refere à capacidade humana de enfrentar e se adaptar a eventos adversos, exerce grande importância no processo de recuperação da queimadura. Logo, este trabalho objetiva avaliar a capacidade de resiliência de pacientes queimados, no momento da admissão e da alta hospitalar, em um hospital de emergência e urgência de Goiânia. Trata-se de um estudo descritivo, quantitativo e transversal que utiliza a Escala de Resiliência de Connor-Davidson (CD-RISC) como instrumento de mensuração. Na admissão hospitalar, a média da resiliência foi de 71,35, tendo sido observada uma relação significativa entre o fator Amparo da escala CD-RISC e a presença do(a) companheiro(a). O escore de resiliência encontrado nesta pesquisa é consistente com outros achados da literatura científica internacional e nacional referente à expressão da resiliência em vítimas de queimaduras e outros adoecimentos. A relação entre o fator Amparo e a presença de um(a) companheiro(a) enfatiza a importância da rede de apoio familiar na reabilitação do paciente queimado.(AU)

The recovery of burned patients is long and painful and impacts on different areas of people's lives. Resilience, which refers to the human capacity to face and adapt to adverse events, plays a major role in the process of recovery from burns. Therefore, the present study aims to assess the resilience of burned patients, on admission and hospital discharge, in an emergency and urgency hospital in Goiânia. This is a descriptive, quantitative and cross-sectional study that uses the Connor-Davidson Resilience Scale (CD RISC) as a measuring instrument. At hospital admission, the mean resilience was 71.35, with a significant association between the Support factor on the CD RISC scale and the presence of a partner. The resilience score found in the present study is consistent with other findings in the international and national scientific literature regarding the expression of resilience in victims of burns and other illnesses. The relationship between the Support factor and the presence of a partner emphasizes the importance of the family support network in the rehabilitation of the burned patient.(AU)

La recuperación de los pacientes quemados es larga y dolorosa e impacta en diferentes esferas de la vida de las personas. La resiliencia, que se refiere a la capacidad humana para enfrentar y adaptarse a eventos adversos, juega un papel importante en el proceso de recuperación de las quemaduras. Por tanto, el presente estudio tiene como objetivo evaluar la resiliencia de los pacientes quemados, en el momento del ingreso y el alta, en un hospital de emergencia y urgencia en Goiânia. Se trata de un estudio descriptivo, cuantitativo y transversal que utiliza la Escala de Resiliencia Connor-Davidson (CD RISC) como instrumento de medida. Al ingreso hospitalario, la resiliencia media fue de 71,35, con associación significativa entre el factor Amparo de la escala CD RISC y la presencia de pareja. El puntaje de resiliencia encontrado en el presente estudio es consistente con otros hallazgos en la literatura científica nacional e internacional sobre la expresión de resiliencia en víctimas de quemaduras y otras enfermedades. La relación entre el factor Amparo y la presencia de pareja enfatiza la importancia de la red de apoyo familiar en la rehabilitación del paciente quemado.(AU)

Uber use after alcohol consumption among car/motorcycle drivers in ten Brazilian capitals

ABSTRACT OBJECTIVE This study aimed to measure the proportion of Uber use instead of drinking and driving in ten Brazilian capitals, in 2019. METHODS A cross-sectional survey was developed in ten Brazilian capitals. Data were collected in agglomeration points (AP) and sobriety checkpoints (SC). Based on responses to a standardized questionnaire, the proportion of drivers who used Uber instead of drinking and driving was measured for total sample of each methodology and stratified by municipality, age group, gender, education level, and type of vehicle. Fisher's exact test was used to make comparisons between the strata. RESULTS A total of 8,864 drivers were interviewed. The most used means of transport to replace driving after drinking alcohol was the Uber system (AP: 54.6%; 95%CI: 51.2-58.0. SC: 58.6%; 95%CI: 55.2-61.9). Most of these users were aged from 18 to 29 years, women, with at least one higher education degree. According to the AP methodology, the highest magnitude of this indicator was found in Vitória (ES) (71.0%; 95%CI: 63.5-77.5), whereas the lowest was observed in Teresina (PI) (33.1%; 95%CI: 22.7-45.5). According to the SC methodology, the highest magnitude of the indicator was also found in Vitória (ES) (78.3%; 95%CI: 68.8-85.5), whereas the lowest was observed in Boa Vista (RR) (36.6%; 95%CI: 26.8-47.7). CONCLUSION In Brazilian capitals, the study showed higher proportions of Uber use instead of drinking and driving. This type of scientific evidence on factors associated with road traffic injuries presents the potential to guide public health interventions.

Avulsión de espina tibial posterior en el adulto. Resolución quirúrgica con técnica de "pull-out". Reporte de un caso / Adult poterior tibial spine avulsion. Pull-out surgical technique. Case report

Introducción: La avulsión de la espina tibial posterior en el adulto representa una forma infrecuente de compromiso del ligamento cruzado posterior (LCP), más común de ver en la población pediátrica. La posibilidad de consolidación de esta lesión, con el tratamiento adecuado en forma temprana, depende de un diagnóstico precoz. Caso: reportamos el caso de una paciente de veintisiete años con una lesión multiligamentaria de rodilla con inestabilidad medial y posterior, por trauma de alta energía tras sufrir un accidente de tránsito en moto. Fue tratada mediante una fijación abierta con técnica de "pull-out". Discusión: en países asiáticos es una lesión frecuente por la alta prevalencia de accidentes en moto, pero menos común en nuestro medio. Si bien el manejo quirúrgico temprano muestra mejores resultados, no existe consenso actual en cuanto a la técnica. Dos tipos de resolución (abierta y artroscópica) muestran resultados similares a largo plazo, con un mayor porcentaje de artrofibrosis en el último grupo. Conclusión: al existir controversia sobre su manejo quirúrgico, creemos que la combinación de las ventajas de ambas técnicas (abierta y artroscópica) constituye una opción reproducible, de bajo costo y con bajo índice de complicaciones.

Introduction: Avulsion of the posterior tibial spine in adults represents an infrequent form of compromise of the posterior cruciate ligament (PCL), more common to see in the pediatric population. The possibility of consolidation of this lesion, with adequate treatment early, depends on an early diagnosis.Case: we report the case of a 27-year-old patient with a multiligamentary knee injury with medial and posterior instability, due to high-energy trauma after suffering a motorcycle traffic accident. Which was treated with an open fixation with a "pull-out" technique. Discussion: in Asian countries it is a frequent injury due to the high prevalence of motorcycle accidents, being less common in our continent. Although early surgical management shows better results, there is no current consensus regarding the optimal technique. Both types of resolution (open and arthroscopic) show similar long-term results, with a higher risk of arthrofibrosis in the last group. Conclusion: as there is controversy over its surgical management, we believe that the combination of the advantages of both techniques (open and arthroscopic) constitutes a reproducible, low-cost option with a low rate of complications.

Emergency centre patients in the Democratic Republic of Congo: Some epidemiological and clinical aspects at Beni General Referral Hospital

Introduction: Little information is available regarding the characteristics of patients attending the emergency centre (EC) in the Democratic Republic of Congo. This study aims to provide some epidemiological and clinical aspects of patients admitted to the emergency centre at Beni General Referral Hospital. Methodology: For a year, from January to December 2021, a cross-sectional study was conducted. Data regarding patients' characteristics, admission modality, stay duration, reason for admission, and discharge modality was anonymously collected from patients' registers. A descriptive analysis was done with Epi-Info 7. Result: A total of 1404 patients were admitted to the EC, with a male-to-female ratio of 1.2 to 1. The age group below 18 years accounted for 35.4%. Most of the patients (75.7%) originated from urban areas. In 83% of cases, there was no recommendation from another medical facility for EC admission. The most common reasons for admission are non-traumatic gathering on top of neuropsychiatric and non-specific symptoms. Road traffic accidents are the most frequent causes of trauma symptoms. Few patients (14.7%) spent less than 12 hours in the EC. Globally, 7.3% of patients admitted to the EC were discharged after being managed, and 89% were transferred to different wards. The intra-emergency centre mortality rate was 11.8% among admitted patients in the ER at Beni General Referral Hospital. Conclusion: This epidemiology database underlines the need for developing globalizing and multi-sectoral interventions (diagnosis, therapeutic strategy, organization, health program, or health policies) in the perspective of bringing change and/or taking action in the Democratic Republic of Congo's emergency medical system.

Road traffic accident clinical pattern and management outcomes at JUMC Emergency Department; Ethiopia

Background: Road Traffic Accident is an incident on a way or street open to public traffic. It becomes one of the most significant public health problems in the world especially in developing countries. In Ethiopia, it represents a significant risk for morbidity and mortality. It is also the major public health problem even though studies done on this topic in the study area is limited. Objective: To assess clinical pattern, associated factors and management outcomes among road traffic accident Victims attending emergency department of Jimma University Medical Center. Methods: Hospital based cross sectional study design was employed to review patients' chart visited the hospital from March to April 2021. A systematic random sampling technique was applied. The data were collected using pretested checklist and analyzed using SPSS version 26. Descriptive statistics and multivariate logistic regression were computed. Variables with P<0.05 were considered statistically significant. Results: About 49.6%) were pedestrians injured of which motorcycle accounted 42.9%. More than half of victims never got any type of prehospital care. On arrival, 38.7% were classified as Red of which 71.4% of them were managed surgically. About 84.9% of victims were discharged with improvement whereas12.6% were died. Victims with head injury (AOR= 16.61: 95% CI; 3.85, 71.71), time elapsed to reach nearby health facility (AOR= 3.30; 95 CI (1.13, 9.60), condition of patient at Emergency Department (AOR= 7.78; 95% CI: 2.33, 26.06), GCS at admission (AOR= 20.12; 95% CI: 7.23, 55.96) and days spent in hospital (AOR= 6.85; 95% CI 5.81, 8.06) were independent predictors of unfavorable outcome. Conclusion: Road Traffic Accident represents a significant risk for morbidity and mortality in Ethiopia, of which head injury and multiple sites injury increase injury severity. Targeted approaches to improving care of the injured victims may improve outcomes. Thus, the clinician should take into consideration the clinical presentation and give due attention to the identified contributing factors in its management.

Experiences and Interventions by Botswana police officers in providing emergency care in road traffic collisions in the greater Gaborone region

Background Close to 500 people die annually from Road Traffic Collisions in Botswana. The country's Emergency Medical Service is limited in capacity and coverage and greatest in the region of the capital city, Gaborone. Botswana Police Service officers are often first responders to the incidents and provide first aid, however the extent of their interventions and their experiences has not been studied. Methods A questionnaire based cross-sectional survey was conducted in January 2016 on a sample of 99 officers on past pre-hospital care training, attitudes towards providing pre-hospital care for accident victims, the number of road traffic collision related deaths and injuries encountered in the last 6 months, their interventions to the victims and limitations encountered in providing care. Results The officers self-reported attending to a median of 10 injured victims (IQR = 5 ­ 20) and a median of 2 deaths (IQR = 0 ­ 4) in the preceding 6 months. The officers generally acknowledged their role and responsibility to provide pre-hospital care to the victims. Officers frequently secured accident scenes and transported injured victims to health facilities. They rarely performed haemorrhage control on victims, performed any airway manoeuvres or splint injured limbs. The major limitations to providing care were lack of first aid supplies and personal protective equipment, lack of knowledge and skills to provide care and interference from onlookers at accident scenes. Conclusion Botswana Police officers in the greater Gaborone area attend to a considerable number of traffic related injuries and fatalities. These results support many opportunities for educational interventions to add value to pre-hospital care.

Curso educação e prevenção aos acidentes de motocicleta: no trânsito, Pernambuco escolhe a vida! / Motorcycle accident prevention and education course: in traffic, Pernambuco chooses life!

A publicação Visa a operacionalização no território de ações que possam prevenir os acidentes de moto e consequentemente evitar as mortes e lesões no trânsito. Aborda os Conceitos Básicos sobre Trânsito e Educação; Panorama dos Acidentados de Motocicleta e as Estratégias de Enfrentamento e Educação e Prevenção aos Acidentes de Motocicleta.

Incidence and pattern of traumatic spine injury in a single level I trauma center of southern Iran / 中华创伤杂志(英文版)

PURPOSE@#Spine injury is one of the leading causes of death and mortality worldwide. The objective of this study was to determine the incidence, pattern and outcome of trauma patients with spine injury referred to the largest trauma center in southern Iran during the last 3 years.@*METHODS@#This is a cross-sectional study conducted between March 2018 and June 2021 in the largest trauma center in the southern Iran. The data collection form included the age, sex, injury location (cervical, thoracic, and lumbar), cause of injury (traffic accidents, falls, and assaults), length of hospital stay, injured segment of spine injury, severity of injury, and outcome. Statistical analyzes were performed using SPSS software version 24.@*RESULTS@#Totally 776 cases of spine injury were identified. The spine injury rate was 17.0%, and the mortality rate was 15.5%. Cervical spine injury (20.4%) more often occulted in motorcycle accident, and thoracic spine injury (20.1%) occulted in falls. The highest and lowest rates of spine injurys were related to lumbar spine injury (30.2%) and cervical spine injury (21.5%), respectively. There was a statistically significant relationship between the mechanism of injury and the location of spine injury (p < 0.001). And patients with lumbar spine injury had the highest mortality rate (16.7%). Injury severity score (OR= 1.041, p < 0.001) and length of stay (OR = 1.018, p < 0.001) were strong predictors of mortality in trauma patients with spine injury.@*CONCLUSION@#The results of the study showed that the incidence of traumatic spine injury rate was approximately 17.0% in southern of Iran. Road traffic injury and falls are the common mechanism of injury to spine. It is important to improve the safety of roads, and passengers, as well as work environment, and improve the quality of cars. Also, paying attention to the pattern of spine injury may assist to prevent the missing diagnosis of spine injury in multiple trauma patients.

Mortalidad en estudiantes universitarios según causas de muerte (2004-2018) / College student mortality by causes of death (2004-2018)

Introduction: College students represent an important subpopulation of the United States, with over 19 million college students in the U.S. enrolled yearly. Methods: Descriptive analysis of the causes of death for all deceased students reported by the UW Dean of Students Office (DSO) between 2004 and 2018. We analyzed frequencies and yearly rates. Results: Our analysis shows that contrary to published data and national statistics for the relevant age groups, intentional by self-harm deaths lead causes of death in enrolled students from 2004 to 2018. Intentional by self-harm is the main cause of death in male students, younger students, and white students. "Other" causes of death is the main cause in female students, older students, and students of color. Conclusions: These results must be shared with different stakeholders across campus as well as with other universities in order to support and evaluate campus-wide prevention strategies for means restriction and environmental safety.

Introducción: Los estudiantes universitarios representan una subpoblación importante de los Estados Unidos, con más de 19 millones de matriculados anualmente. Sin embargo, hay pocos datos publicados sobre la mortalidad y causas de muerte en la población universitaria. El propósito de este estudio fue analizar las causas de muerte, basadas en datos de certificados de defunción, de estudiantes matriculados en University of Winconsin- Madison desde 2004 hasta 2018. Métodos: Análisis descriptivo de las causas oficiales de muerte de todos los estudiantes fallecidos reportados por la Oficina del Decano de Estudiantes entre 2004 y 2018. Se analizaron frecuencias y tasas anuales. Resultados: El análisis muestra que, contrariamente a los datos publicados y las estadísticas nacionales para los grupos de edad relevantes, las muertes intencionales por autolesión lideran las causas de muerte en los estudiantes matriculados entre esos años. Las autolesiones intencionales son la principal causa de muerte en los estudiantes varones, en los estudiantes más jóvenes y en los estudiantes blancos. Las causas incluidas en la categoría indicada como Otras son las principales en las estudiantes mujeres, en estudiantes mayores y en estudiantes de color. Conclusiones: Los resultados de este estudio deben compartirse con las diferentes áreas interesadas en todo el campus universitario y con otras instituciones universitarias, para apoyar y evaluar las estrategias de prevención, la aplicación de los medios de restricción y la seguridad ambiental.

Immunochromatography screening devices for cannabinoids in oral fluid sample

Abstract Cannabis sativa L. is one of the most consumed drugs in the world and recent studies have associated its use with an increase in the number of traffic accidents in different countries. In many countries, like Brazil, simple and reliable methodologies are still needed for the detection of drugs on site, mainly cannabinoids, considering its prevalence of use and oral fluid (OF) has been proved as an appropriate biological matrix for this purpose. Considering that, this work aims to review previous studies on immunochromatographic devices for on-site detection of cannabinoids in OF, discussing their sensitivity, specificity, cut-offs values and confirmatory methods. This data shows the importance of choosing a screening device and it reinforces the need for its implementation in Brazil. The research was conducted on 5 databases and all original articles, published in the last 10 years, were selected. A total of 32 articles were found, providing data for 17 screening devices of distinct brands. Only 2 screening devices showed satisfactory sensitivity and specificity in the evaluated studies (≥80% and ≥90% respectively). However, it should be considered that the screening devices still have some limitations, such as a higher cut-off than those recommended by international guidelines (cut-off > 2 ng/mL), therefore demonstrating the need for more studies in the area and the importance of confirmatory analysis usually fulfilled by LC-MS/MS, GC-MS/MS or GC-MS. Thus, the screening analyzes should not be evaluated by itself, but in association with confirmatory results and observational traits (behavioral changes), for a better understanding of the traffic scenario

Profile of Hospitalizations of Children and Adolescents Victims of Transport Accidents: A Retrospective Study

Abstract Objective: To present the profile of hospitalizations due to transport accidents in individuals aged 0-19 years in a reference hospital for urgent and emergency traumatology care. Material and Methods: This retrospective study is grounded on analyzing medical records of children and adolescents hospitalized due to transport accidents in 2016 and 2017. The bivariate analyses included Chi-square and Fischer's exact tests and binary logistic regression, with a 5% significance level. Results: Four hundred and seventy-five (43.7%) of the 1,088 medical records investigated corresponded to transport accidents, and accidents involving motorcycles were the most frequent (68.3%), affecting adolescents (81.3%), while children were more involved in accidents as pedestrians (57.1%). Advancing age increases the likelihood of the outcome, with a significant association in the multivariate analysis (p<0.001). The mandible was most frequently affected in maxillofacial fractures. Conclusion: Transport accidents predominantly affect male adolescents, involving motorcycles, and the lower limbs are the most affected. The mandible was the most affected bone in maxillofacial fractures.