Left Atrial Appendage Rupture due to Blunt Chest Trauma during a Motor Vehicle Accident / 日本心臓血管外科学会雑誌

Blunt traumatic rupture of the heart carries a high mortality rate. Anatomical injuries have included the atrium, appendage and ventricle but injury to the left appendage has been reported very rarely. We present the case of a 71-year-old female who was a driver in a motor collision with major front-end damage where air bags were deployed. After being intubated and receiving pericardiocentesis for cardiac tamponade at an advanced critical care and emergency medical center, the patient was taken to our hospital and emergently to the operating room for exploration. There was brisk bleeding coming from a 2 cm laceration on the left atrial appendage. The injury was repaired using 4-0 polypropylene felt pledget-supported horizontal mattress sutures on the beating heart with the assistance of cardiopulmonary bypass. The present report describes this patient and our findings from a literature review.

The unreasonable use of high beam at nighttime among motor vehicle drivers / 预防医学

Objective@#To observe the incidence of unreasonable use of high beam at nighttime among motor vehicle drivers, so as to provide the evidence for the prevention and control of road traffic injury. @*Methods@#Four roads into city and five urban roads were selected in Yongkang of Zhejiang Province. An automatic recording system was used to collect the unreasonable use of high beam among motor vehicle drivers on the selected roads from 19:00 to 5:00 on Monday, Wednesday, Friday and Sunday during a week in July 2020. The regression tree model was used to analyze the relationship of the unreasonable use of high beam with road, time and traffic flow. @*Results@# A total of 89 989 motor vehicles were observed, and 2 419 motor vehicle drivers had unreasonable use of high beam, with an incidence rate of 2.69%. The incidence rate of the unreasonable use of high beam was 3.14% in the roads into city, which was higher than 2.30% in the urban roads ( P<0.05 ). The incidence rates of the unreasonable use of high beam in the roads into city and in the urban roads were 5.15% and 2.90% on Wednesday, which were higher than those on Monday ( 2.89% and 2.34% ), Friday ( 2.90% and 1.92% ) and Sunday (2.06% and 2.12%). The highest incidence rate of the unreasonable use of high beam in the roads into city was 6.07% between 4:00 and 5:00, and in the urban roads was 4.50% between 2:00 and 3:00. The results of regression tree classification analysis showed that the highest incidence rate was 8.13% on the roads into city in the east, west and south directions, and on the urban roads in the east and north directions with less than 317 vehicles per hour on Wednesday. @*Conclusion@#It is more likely for motor vehicle drivers to use high beams unreasonably at nighttime on the roads into city with less traffic flow.

Effectiveness of seatbelts in mitigating traumatic brain injury severity / 世界急诊医学杂志（英文）

@#Over the past few decades, traumatic brain injuries (TBIs) have become one of the leading causes of death and the leading cause of injury-related death in the USA.[1,2] It is estimated that 1.70 million people are subject to TBIs each year.[2] Males are more likely to sustain TBIs (59%); the most common age groups are 0-5 years, 15-19 years, and >65 years.[2] Approximately 1.36 million people present to the emergency department (ED), 275,000 are admitted to the hospital, and 52,000 people die from TBIs.[2] The leading causes of TBIs are falling (35.2%), motor vehicle collisions (MVCs, 17.3%), struck by/against an object (16.5%), and assault (10.0%).[2] These statistics combine to make TBIs the leading cause of injury-related death in the USA at 30.5%.[2] It has been estimated that, with specific guidelines from the Brain Trauma Foundation, up to 50.0% of the 52,000 TBI-related deaths may be prevented.[3]

A retrospective study of blunt trauma abdomen in a tertiary center in central India: evaluation, management and outcome

Background: Blunt abdominal trauma is fairly common emergency and it is one of the important components of polytrauma. It requires high degree of suspicion, investigation and management. Inspite of improved imaging techniques leading to early recognition it is still associated with high morbidity and mortality. Trauma is the leading cause of blunt abdominal injury. This aim of the study was to find etiology, early diagnosis and management of patients with blunt abdominal trauma.Methods: This a retrospective study conducted in Gandhi medical college, Bhopal in which 90 cases of blunt abdominal trauma presented to emergency and outpatient department were included in the study duration of January 2019 to December 2019.Results: Motor vehicle accident was the most common mode of injury. Liver being the most common visceral organ injured while the most common surgery performed was the repair or resection and anastomosis of hollow viscous perforation. Rib fracture was the most common extra abdominal injury seen in 17.7% cases. Mortality rate was 5.5%. Most of the liver, spleen and renal injuries can be managed non-operatively whereas hollow viscous injury needs laparotomy.Conclusions: The result of present study is similar to other studies. Rapid diagnosis, early and timely referral, adequate and trained staff, close and careful monitoring, early wise and skilled decision to go for operative or non-operative management can help save many lives.

Epidemiology of Adult Trauma at a Tertiary Hospital in Riyadh, Saudi Arabia

Objective: To identify the type and mechanism of trauma-based on patients’ characteristics at a tertiary hospital in Riyadh, Saudi Arabia. Methods: The study was a retrospective cohort observational study using the Trauma Registry of King Abdulaziz Medical City, Riyadh, Saudi Arabia. The study period was from January 2015 to December 2018. The data gathered were demographic information, mortality, type and mechanism of injury, Glasgow Coma Scale (GCS), Injury Severity Score (ISS) and the Triage Revised Trauma Scale (T-RTS). Categorical data are described with percentage and frequency, and numerical data with mean and standard deviation. A Chi-square was used to assess the relationship between the type of trauma and patient characteristics. A Fisher exact test was used to compare the type of injury with the other variables. A p-value of less than 0.05 was considered statistically significant. Results: A total of 4083 participants. The majority were male (79.9%, n=3263). Blunt trauma was the most prevalent type of injury (87.4%, n=3570, p<0.001). A motor vehicle accident was the most prevalent mechanism of injury (42.1%, n=1717). The highest proportion of trauma per age group was in the 21-30 year age group (32.6%, n=1331). The lowest GCS and RTS mean scores were observed in blunt trauma (p<0.001 and 0.001 respectively). In addition, the highest ISS mean score was observed in the blunt trauma subgroup (p<0.001). Conclusion: The study highlights the type and mechanism of trauma at KAMC in Riyadh, Saudi Arabia, based on gender, age groups, types of trauma and mechanisms of injury. This data will be a valuable resource for the local healthcare system.

Assessing driving risk in patients with glaucoma / Avaliação do risco de dirigir em pacientes com glaucoma

ABSTRACT Glaucoma is the leading cause of irreversible blindness worldwide and can affect a broad array of daily activities, including driving. Recently, studies investigating the relationship between driving performance and glaucoma have received a great deal of interest. Assessment of driving behavior is not straightforward because driving is a complex skill involving significant multi-tasking ability. In this review, we summarize recent work from clinical studies investigating how glaucoma can affect driving performance. Patients with glaucoma are more likely to be involved in motor vehicle collisions when compared to healthy subjects. Here we describe how conventional functional tests performed in glaucoma patients, such as visual field measurements via standard automatic perimetry, are associated with driving performance. However, the risk of motor vehicle collisions is not entirely attributable to visual field impairment in glaucoma, suggesting that other factors also account for both driving safety and performance. Finally, we show different studies suggesting that parameters from driving simulators can be helpful because they can identify the impact of visual loss on complex situations.

RESUMO O glaucoma é a principal causa de cegueira irreversível em todo o mundo e pode afetar uma ampla gama de atividades diárias, incluindo a direção veicular. Recentemente, estudos que investigam a relação entre o desempenho na condução veicular e o glaucoma têm recebido grande interesse. A avaliação do comportamento de dirigir não é direta porque dirigir é uma habilidade complexa que envolve habilidade multitarefa significativa. Nesta revisão, resumimos trabalhos recentes de estudos clínicos que investigam como o glaucoma pode afetar o desempenho na direção. Pacientes com glaucoma têm maior probabilidade de se envolverem em colisões de veículos motorizados quando comparados a indivíduos saudáveis. Descrevemos aqui como os testes funcionais convencionais realizados em pacientes com glaucoma, como as medições de campo visual por meio de perimetria automática padrão, estão associados ao desempenho na direção. No entanto, o risco de colisão de veículo motorizado não é totalmente atribuível ao comprometimento do campo visual no glaucoma, sugerindo que outros fatores também são responsáveis pela segurança e pelo desempenho. Finalmente, mostramos diferentes estudos sugerindo que os parâmetros dos simuladores de direção podem ser úteis porque eles podem identificar o impacto da perda visual em situações de complexas.

Epidemiological profile of pedestrian-motor vehicle trauma in the metropolitan area of Guadalajara

Background: According to ENSANUT, 60% of deaths are caused by road traffic injuries and affect the most vulnerable road users such as pedestrians, cyclists, and motorcyclists. Of this percentage, 45% were pedestrians. Objective: The objective of this study was to define the epidemiological profile of pedestrian-motor vehicle trauma in the Metropolitan Area of Guadalajara. Materials and Methods: A cross-sectional study was conducted on pedestrians injured in car collisions who were referred to a third-level public hospital from 2014 to 2015. The variables comprised the municipality where the event occurred, demographic characteristics, substance abuse, medication, the use of devices while crossing the street, and severity of injury. The information was analyzed using percentages, standard deviation, and χ2 for comparison-related factors according to the injury severity, considering p < 0.05 as statistically significant. Results: The total number of injured pedestrians was 397. The municipalities with the highest number of injured pedestrians were Guadalajara (41.3%) and Zapopan (29.7%). Males were the most affected (80.4%), with most incidents affecting those in the age group of 18–39 years old (34.5%). Roughly 65% of cases occurred at night and on Fridays, Saturdays, and Sundays. The most common injuries were fractures and injuries to the extremities and head, with 27% of injured pedestrians showing severe injuries. Conclusion: Although we did not find any statistical significance, the information gathered from this study indicates a need to implement preventive strategies about vial education and the improvement of signals and protective elements on the streets to aid vehicle and pedestrian flow and control or reduce the number of injured pedestrians.

Prevalência e fatores associados à hipertensão em trabalhadores do transporte coletivo urbano no Brasil / Prevalence and factors associated with hypertension in urban public transport workers in Brazil

Contexto: Os trabalhadores do transporte coletivo urbano têm grande importância social nas cidades. Estão expostos a condições de trabalho que causam adoecimento, ganhando destaque as doenças cardiovasculares. Objetivo: Caracterizar a produção científica sobre prevalência e fatores associados à hipertensão em trabalhadores do transporte coletivo urbano no Brasil. Métodos: Revisão integrativa realizada em abril e maio de 2016, nas bases de dados Scientific Eletronic Library Online e Literatura Latino-Americana e do Caribe em Ciências da Saúde, cujo acesso se deu por meio da Biblioteca Virtual em Saúde, com a utilização dos descritores: hipertensão; pressão arterial alta; doenças cardiovasculares; saúde do trabalhador; epidemiologia; fatores de risco; e da palavra-chave "motoristas de ônibus". Foram selecionados artigos publicados entre 2002 e 2016, em português, totalizando 13 trabalhos. Resultados: A maioria dos estudos era do tipo transversal, publicada em 2006, conduzida na Região Sudeste do Brasil. As prevalências da hiper-tensão variaram entre 5,7 e 49,2%. Os fatores associados encontrados foram: obesidade; problemas psiquiátricos menores; baixo consumo de sal; consumo de gordura animal; idade acima de 46 anos; e vibração no ônibus. Conclusão: A produção científica acerca do tema é restrita, reforçando a necessidade de aprofundamento no assunto. As prevalências encontradas, por vezes, foram alarmantes. Destacaram-se fatores associados relativos ao estilo de vida e trabalho, características do indivíduo e aqueles ligados diretamente ao posto de trabalho. Considerar a hipertensão como um fator ligado ao trabalho nessa classe ocupacional é importante, evidenciando a necessidade de instituir um programa permanente de melhoria da organização do trabalho para promover saúde.

Background: Urban public transport workers have major social relevance in cities. These workers are exposed to work conditions that cause illness, cardiovascular diseases in particular. Aim: To characterize the scientific literature on the prevalence of and factors associated with hypertension in urban public transport workers in Brazil. Methods: Integrative review conducted in April and May 2016 in databases Scientific Electronic Library Online and Latin American and Caribbean Health Sciences Literature, accessed via Virtual Health Library, using the following keywords: hypertension; high blood pressure; cardiovascular diseases; occupational health; epidemiology; risk factors; and "bus drivers" in Portuguese. Studies published in Portuguese from 2002 to 2016 were selected, resulting 13 articles. Results: Most of the studies had cross-sectional design, had been published in 2006 and conducted in the Southeastern region of Brazil. The prevalence of hypertension ranged from 5.7 to 49.2%. The associated factors found included: obesity; minor psychiatric disorders; low salt consumption; consumption of animal fat; age over 46 years old; and bus vibration. Conclusion: The scientific literature on the analyzed subject is scant, which reinforces the need for more thorough studies. The prevalence rates found were sometimes alarming. Lifestyle and individual work characteristics, as well as factors directly related to work stood out. Considering hypertension as a work-related factor is relevant for this class of workers, emphasizing the need to develop a permanent program for work organization improvement to promote their health.

Exploration of the Causes of Musculoskeletal Injuries of Different Age Groups in Local Society.

Aims: To study the types of all possible injuries in different age groups and its prevalence in the Saudi society, especially in the city of Jeddah and its causes. Study Design: A prospective study with a special questionnaire to collect data. Place and Duration of Study: Department of Radiology (X-ray Unit), King Abdulaziz University Hospital, Jeddah, Saudi Arabia, for 6 months. Methodology: A questionnaire developed by the authors was used to collect data. The questionnaire had two parts. The first part was used to collect demographic data, and the second part was used to determine the type of injuries (trauma, motor vehicle accident, sudden and chronic). The subjects of the survey were chosen randomly from the radiology department at King Abdulaziz University Hospital (KAUH). Then, SPSS 15.0 for Windows was used for statistical analyses. Data are presented using descriptive statistics and were analyzed using the chi-squared test. Results: The participants (subjects) were male (56.5%) and female (43.5%) that had a mean age of 28.98±1.09 years, a mean height of 148.02±1.55 cm, and a mean mass of 58.71±1.63 kg. The older adults were the majority (32.2%) in this study followed by pediatric (30.6%) where the immune is lower than the other age groups’ categories and is more affected by musculoskeletal injuries. The common injuries of the different musculoskeletal system were explored and obtained. That the highest percentage is related to trauma (58.9%) in all age groups, where the dominant percentage in trauma was in the pediatric age group (27.6%). Through our study, it was found that there is a high significant relationship (p < 0.05) with a degree of freedom is (df=12) between age groups and type of injuries for all genders. Conclusion: More education needs to be provided for our community in preventing and limiting personal injury especially in younger age groups.

The Buffering analysis to identify common geographical factors within the vicinity of severe injury related to motor vehicle crash in Malaysia / 世界急诊医学杂志（英文）

@#BACKGROUND: The main objective was to identify common geographical buildup within the 100-meter buffer of severely injured based on injury severity score (ISS) among the motor vehicle crash (MVC) victims in Malaysia. METHODS: This was a prospective cohort study from July 2011 until June 2013 and involved all MVC patients attending emergency departments (ED) of two tertiary centers in a district in Malaysia. A set of digital maps was obtained from the Town Planning Unit of the district Municipal Office (local district map). Vector spaces were spanned over these maps using GIS software (ARCGIS 10.1 licensed to the study center), and data from the identified severe injured cases based on ISS of 16 or more were added. Buffer analysis was performed and included all events occurring within a 100-meter perimeter around a reference point. RESULTS: A total of 439 cases were recruited over the ten-month data collection period. Fifty two (11％) of the cases were categorized as severe cased based on ISS scoring of 16 and more. Further buffer analysis looking at the buildup areas within the vicinity of the severely injured locations showed that most of the severe injuries occurred at locations on municipal roads (15, 29％), straight roads (16, 30％) and within villages buildup (suburban) areas (18, 35％). CONCLUSION: This study has successfully achieved its objective in identifying common geographical factors and buildup areas within the vicinity of severely injured road traffic cases.

An analysis on the influencing factors for the severity of motor vehicle road traffic injures / 预防医学

Objective To know the influencing factors for the severity of motor vehicle road traffic injures ,and to provide scientific basis for making appropriate intervention measures.Methods 7 977 patients with motor vehicle road traffic injuries who were first diagnosed in injury surveillance sentinel hospital of Tongxiang City in 2012 and 2013 were selected, and the factors influencing the severity of injury were analyzed.Results The multivariate logistic regression analysis showed an increased risk of the injure severity among the people aged over 65 years old,alcohol drinking before the injury and migrant workers,the values of OR(95%CI)were 3. 231(2. 091 -4. 993),2. 796(1. 697-4. 607)and 1. 424(1. 217-1. 666)respectively.However,women,motor vehicle drivers,collision with non motor vehicle driver and using safety belt may contribute to the less serious damage,and the values of OR (95%CI)were 0. 837 (0. 753 -0. 930 ),0. 769 (0. 622-0. 952),0. 753 (0. 598-0. 948)and 0. 691 (0. 492-0. 970)respectively.Conclusion The risk factors for the severity of motor vehicle road traffic injures are elderly people,migrant workers and alcohol drinking.The safety education should be provided among the people and the targeted interventions should be developed and implemented.

Hospital-Wide Standardization of Warnings about Driving Motor Vehicles While Taking Drugs: An Example from Nagoya City East Medical Center (Part 2) / 医薬品情報学

<b>Objective: </b>When vehicular accidents occur as a result of impaired consciousness etc., because of adverse drug reactions, there is a risk that third parties may be harmed.  Till date, at Nagoya City East Medical Center (hereinafter, our hospital), the warnings about driving motor vehicles while taking drugs has varied depending on the doctor or pharmacist who provides the guidance.  Therefore, throughout our hospital, we aimed to standardize these warnings and to introduce measures to strictly enforce them.<br><b>Methods: </b>Among all the drugs used at our hospital, we identified those with warnings on the package insert about driving motor vehicles and classified them in accordance with “The Drug Administration Guidance Criteria Regarding the Driving of Vehicles,” created by our hospital on the basis of descriptions on the package insert and the level of risk of taking drugs.  We then standardized the warnings about driving motor vehicles while taking drugs, throughout our hospital.<br><b>Results: </b>Of the 1,416 drugs used at our hospital, we identified 294 (21%) with warnings about driving motor vehicles on the package insert, and more than half of these (158 drugs) had warnings about the prohibition of driving motor vehicles on the package insert.  As a result of classifying the drugs according to “The Drug Administration Guidance Criteria Regarding the Driving of Vehicles,” we identified 53 drugs with warnings about the prohibition of driving motor vehicles.  By the classification of the level of risk of taking drugs while driving motor vehicles and the hospital-wide standardization of the warnings about driving motor vehicles while taking drugs, we are now able to provide drug administration guidance in the form of warnings that are customized to the level of risk of using each drug.<br><b>Conclusion: </b>These measures have clarified the level of risk of taking each drug and warnings about driving motor vehicles while taking them.  In the future, we intend to cooperate with local pharmacies to intervene in the prescription of drugs outside well as inside hospitals.

Clinical study of indirect optic nerve injury caused by motor vehicle accident / 中华急诊医学杂志

Objective To evaluate the curative effects of intravenous methylprednisolone (IVMP) during the conservative management for patients with indirect optic nerve injury (ONI),and to analyze the benefits of visual evoked potential (VEP) monitoring in prognosis assessment.Methods Among the 253 patients with cranial-facial injury,108 sufferred from optic nerve injury including 89 cases without optic nerve decompression treatment.These 89 patients were randomly divided into:group A,in which patients were given methylprednisolone intravenously for 7 days; and group B,in which patients without methylprednisolone treatment.The extent of and time required for eyesight recovery were recorded.VEP measurement was carried out in all cases.Results No differences in gender,age and BMI (Body Mass Index,all P ＞ 0.05) were observed.The incidence of ONI was higher in patients with motorcycle accident than that in those with car accident (P ＜0.01).In the motorcycle accidents,casualties wearing a helmet had lower incidence of ONI (P ＜ 0.01).Patients treated with methylprednisolone had a shorter recovery time (P ＜ 0.01) from blindness,however there was no difference in long-term outcome between group A and B.In patients with visual improvement in the “ non-extinguished” group,the amplitude and latency of the P wave of VEP were markedly ameliorated after the treatments (P ＜ 0.01).Conclusions Most of the ONI casualties in our study were resulted from motorcycle accidents,and wearing a helmet is an effective protection measure.The intravenous methylprednisolone (IVMP) showed no effect on improving the prognosis in patients with conservative treatment.The IVMP shortened the recovery time at the expense of increase in risk of complications.VEP examination is beneficial in prognosis assessment for non-operative ONI patients.The improvement of the amplitude and latency of P wave has close correlations with patients'visual recovery.

Research progress on foot and ankle injuries of occupants in frontal motor vehicle crashes / 医用生物力学

Road traffic injuries have become a major social issue. With the development of technology, legislation and safety consciousness, the fatal rate of brain and chest injuries has been declined. However, as to prevent foot and ankle injuries of occupants still no effectual protective devices have been developed. In this paper, research progress on foot and ankle injuries of occupants was reviewed, which found out that most of such injuries in the frontal motor vehicle crashes occurred more easily to the drivers, which was possibly due to the special loading on their lower extremity during braking. Although there still exists a continuing debate about taxonomy of the frontal motor vehicle crashes, researchers have approached unified understanding that foot and ankle injuries are usually caused in the real-world narrow object frontal crashes. Until now, studies on foot and ankle injury and its protective mechanisms in various types of crashes are rarely conducted. A combination of the in-vitro experiment and computational modeling would be an ideal method to solve this issue.

Transtorno de estresse pós-traumático em vítimas de acidentes rodoviários graves: análise de fatores preditores / Posttraumatic stress disorder among serious motor vehicle accident victims: analysis of predictors

CONTEXTO: Os acidentes rodoviários são acontecimentos potencialmente traumáticos que podem originar transtornos psicológicos, designadamente transtorno de estresse pós-traumático (TEPT). Os estudos são controversos quanto ao poder preditivo da dissociação peritraumática e os sintomas de transtorno de estresse agudo (TEA) para predizer TEPT, mas referem que as mulheres reportam mais sintomas de transtorno pós-exposição traumática. OBJETIVO: Analisar o contributo da dissociação peritraumática, dos sintomas de TEA e do gênero para predizer TEPT quatro meses após o acidente. MÉTODO: Cento e vinte e quatro homens e mulheres, vítimas de acidentes graves, avaliados no hospital (t1) e reavaliados quatro meses depois (t2). RESULTADOS: Entre os participantes, 64,5% apresentam TEA (t1) e 58,9%, TEPT (t2). Os sintomas de dissociação peritraumática e TEA correlacionam-se positivamente com os sintomas de TEPT. As mulheres reportam mais dissociação peritraumática, TEA e TEPT. A dissociação peritraumática, o TEA e o gênero (feminino) explicam 26,8% da variância de TEPT, sendo o contributo do gênero marginalmente significativo. CONCLUSÕES: O número de vítimas com sintomas de TEPT após acidente grave é elevado e os sintomas peritraumáticos são preditores de TEPT, sugerindo a necessidade de considerar os sintomas iniciais na prevenção de transtorno posterior.

BACKGROUND: Motor vehicle accidents (MVA) are traumatic experiences that are related to psychological disorders as posttraumatic stress disorder (PTSD). Peritraumatic dissociation and acute stress disorder (ASD) have been studied as predictors of PTSD. Studies have also found that women report more psychological symptoms after traumatic experiences than do men. OBJECTIVE: Analyze the explanatory contribution of peritraumatic dissociative experiences, ASD symptoms and gender toward the subsequent development of PTSD. METHOD: One hundred twenty-four male and female victims of serious MVA were evaluated at the hospital (t1) and four months after the MVA (t2). Participants completed a peritraumatic dissociative experiences questionnaire (PDEQ) (t1), a questionnaire used to evaluate ASD (SASRQ) (t1) and a traumatic event scale (RTES) used to evaluate PTSD (t2). RESULTS: Of the studied population, 64.5% report ASD (t1) and 58.9% report PTSD (t2). Peritraumatic dissociation and ASD symptoms are positively correlated with PTSD symptoms. Females report more peritraumatic dissociation, ASD and PTSD than do males. Peritraumatic dissociation, ASD and gender (female) explain 26.8% of the observed variance in PTSD symptoms (t2), with gender contributing only marginally to the model. DISCUSSION: A high rate of MVA victims report PTSD, and peritraumatic responses predict the subsequent development of PTSD, suggesting the need to consider these predictors in methods for the prevention of psychopathology.

An intercept survey on the status of driving after alcohol drinking among motor vehicle drivers in 6 counties of Zhejiang, China / 中华流行病学杂志

Objective To investigate the status of driving after drinking alcohol among motor vehicle drivers and to provide evidence for the development of specific interventions.Methods A 7-day intercept survey on driving after alcohol drinking,having drinking habit or driving after getting drunk,among motor vchicle drivers,was conducted in 6 counties of Zhejiang province,2010.Results 16 467 motor vehicle drivers were included in the survey.Rates of driving after drinking alcohol [blood alcohol concentration (BAC)＞0 mg/100 ml],having habit of drinking alcohol (20 mg/100 ml≤BAC＜80 mg/100 ml) and driving after being drunk (BAC≥80 mg/100 ml),were 1.82％,1.03％ and 0.27％ respectively.Rates of driving after drinking alcohol,having habit of drink alcohol and driving and drunk-driving among the drivers from urban areas were significantly higher than those of drivers from rural areas,and those rates of male drivers were significantly higher than female drivers as well.60.20％ of drivers after drinking alcohol,were 35 to 49 year-olds,and the three above said rates all increased along with age.The highest above said three rates were observed at 23:00 PM and 1:00 AM.Compared with other motor vehicle drivers,motorcyclists possessed the highest rates of the three items,as 9.27％,5.01％ and 1.57％ respectively.Conclusion Driving after drinking alcohol among motor vehicle drivers still prevailed in Zhejiang,especially between 23:00PM and 1:00 AM.Drivers from the cities,being male or motorcyclists were among the high-risk populations that called for special attention to be paid in the future,including law enforcement and health promotion to fight against the problem.

Pilot Study on Construction of a Database for In-depth Analysis of Occupant Injury and Vehicle Damage of Domestic Motor Vehicle Crash Accidents

PURPOSE: The purpose of this study is to suggest methods for construction of a database for in-depth analysis of the relationship between occupant injury and vehicle damage in domestic motor vehicle crash accidents through analysis of real examples of real motor vehicle crash accidents. METHODS: Among patients who visited the emergency room of three domestic hospitals due to motor vehicle crash accidents from January 2011 to September 2011, we collected data on patients with an ISS (Injury Severity Score) over 16. In addition, we surveyed the cause of the accident, information on vehicles involved in the accident, the type and amount of damage inflicted on the vehicle, and the severity of injury of the patient. Damage to the vehicle was presented using the CDC (Collision Deformation Classification) code by evaluation of photo-images of the damaged vehicle, and a trauma score was used for evaluation of the severity of the patient's injury. RESULTS: Of 76 cases of motor vehicle accidents, the number of subjects was 87, with an average age of 43.2+/-17.9. Of these, 68(78.2%) subjects were males, 65(74.7%) subjects were drivers, 35(42.2%) subjects had fastened their seat belts, and, in 15(19.7%) cases, the airbag was deployed in the accident. Averages of ISS and RTS (Revised Trauma Score) were 32.3 and 6.6, respectively. Among 45 cases of frontal collision, chest injury was the most common (30,66.7%), and average AIS (Abbreviated Injury Scale) of chest injury was the highest (3.1+/-0.7). Severity of head injury (AIS 1) and mean ISS by PDoF (Principal Direction of Force) showed a significant difference (p<0.001, p=0.003, respectively), and mean ISS between seat belt users and non-users also differed (23.8 vs. 37.5, p=0.002). In addition, the occupant's mean ISS in vehicles whose airbag was deployed was lower (23.7 vs. 33.9), however, no statistically significant difference was observed (p=0.123). CONCLUSION: For analysis of the relationship between occupant injury and vehicle damage in domestic motor vehicle crash accidents, construction of an in-depth database through the national surveillance system for motor vehicle traffic accidents is necessary.

Examen oftálmico para trámite de la licencia de conducción en Santiago de Cuba / Ophthalmic test for the procedure to obtain a driving licence in Santiago de Cuba

Se evaluó la experiencia acumulada durante los años 2003-2009 por la Comisión Municipal de Chequeo Oftalmológico de Santiago de Cuba; grupo de trabajo evaluador de los aspirantes a obtener la licencia de conducción, que radica en el Policlínico Docente Frank País García. En tal sentido, el examen ocular a los presuntos futuros conductores reviste suma importancia, de modo que constituye una gran responsabilidad, tanto para el médico como para los interesados, que esa revisión de la agudeza visual se realice con la calidad requerida y periódicamente para brindar una mayor seguridad en la vía pública. En el municipio de Santiago de Cuba, donde se dispone de vastos conocimientos prácticos al respecto y capital humano capacitado, se han logrado buenos resultados hasta el 2010; éxito en esta esfera que se ha extendido a las restantes comisiones de la provincia y contribuido a alcanzar la excelencia en los servicios.

The experience gathered during the years 2003-2009 from the Municipal Committee of Ophthalmic Examination in Santiago de Cuba was assessed; this work group is settled in the Teaching General Hospital Frank País Garcia and evaluates the candidates for obtaining a driving license. In this way, the ophthalmic test to the presumptive future drivers involves great significance, so it constitutes a great responsibility for both, the doctor and the interested person, to carry out this ophthalmic examination with the required quality and periodically, to provide a major safety in the public highway. In the municipality of Santiago de Cuba, where wide practical knowledge on the topic and qualified human staff is stipulated. Good results have been achieved up to 2010 in Santiago de Cuba municipality where wide practical knowledge and qualified human staff exist; and this success was broaden to the other committees of the province, which has contributed to reach excellence on the services.

Tráfego veicular como método de avaliação da exposição à poluição atmosférica nas grandes metrópoles / Motor vehicle traffic as an air pollution exposure assessment method in big cities

A poluição atmosférica é uma das maiores preocupações para a saúde pública. Entre os estudos conduzidos para testar a associação entre poluição do ar e os mais diversos desfechos em saúde, alguns utilizaram dados viários e de tráfego veicular como avaliação da exposição. O presente trabalho pretende revisar e discutir alguns dos aspectos metodológicos dos estudos que utilizaram este método, principalmente em áreas onde a fonte veicular é uma grande geradora de poluentes. Realizou-se uma busca bibliográfica com palavras-chave relacionadas à poluição atmosférica e tráfego veicular, e foram selecionados artigos publicados entre os anos de 2000 e 2009. Foram constatadas várias abordagens para avaliar a exposição, enfatizando-se o método da Densidade de Tráfego Ponderada pela Distância, que considera as vias e a distância das mesmas em relação ao local de interesse e o tráfego. Além disso, destaca-se a importância do uso de técnicas de sistemas de informação geográfica (SIG) como instrumento na construção de modelos para mensurar a exposição.

The Jamaica Injury Surveillance System a profile of the intentional and unintentional injuries in Jamaican Hospitals / El Sistema de Vigilancia de Lesiones en Jamaica (SVLJ) u n perfil de las lesiones intencionales y no intencionales en hospitales de Jamaica

BACKGROUND: Injuries in Jamaica are a major public health problem as demonstrated by a hospital based computerized injury surveillance system established in 1999 that provides a risk profile for injuries. SUBJECTS AND METHOD: Injury data from 2004 were selected to provide an annual profile, as comprehensive injury data were available from nine public hospitals. These nine public hospitals provide care for 70% of the Jamaicans admitted to hospitals annually. RESULTS: Data are presented on unintentional injuries where falls caused 44%, lacerations 27% and accidental blunt injuries were 17% of these. For motor vehicle related injuries, 55% were sustained while commuting by motorcars, 17% while riding motorbikes/bicycles and 16% of those injured were pedestrians. Most violence related injuries were due to fights (76%) with acquaintances (47%) who used sharp objects (40%) to inflict the injury. CONCLUSION: The Jamaica Injury Surveillance System (JISS) data, augmented by data collected on injuries from the health centres and the sentinel surveillance system, give a measure of the magnitude of the impact of injuries on the health services. The JISS provides data on the profile of injuries seen and treated at health facilities in Jamaica. In collaboration with police data and community-based surveys, it can be used to complete the risk profiles for different types of injuries. The data generated at the parish, regional and national levels form the basis for the design and monitoring of prevention programmes, as well as serve to support and evaluate policy, legislative control measures and measures that impact on interventions.

ANTECEDENTES: Las lesiones constituyen un problema importante de la salud pública en Jamaica, como lo demuestra el sistema de vigilancia computarizada de las lesiones, establecido en 1999, el cual proporciona un perfil de riesgo de las lesiones. SUJETOS Y MÉTODO: Datos de lesiones ocurridas en el 2004 fueron seleccionados a fin de ofrecer un perfil anual, ya que se disponía de un conjunto amplio de datos de nueve de los hospitales públicos. Estos nueve hospitales públicos dan atención al 70% de los jamaicanos ingresados a los hospitales cada año. RESULTADOS: Se presentan datos sobre lesiones no intencionales, según los cuales las caídas representaron el 44%, las laceraciones el 27% y las contusiones accidentales el 17%. En cuanto a las lesiones relacionadas con automóviles, el 55% fueron producidas durante la transportación diaria en vehículos automotores a centros de trabajo o estudio; el 17% se produjo en viajes en motos o bicicletas; y el 16% de los heridos fueron peatones. La mayoría de las lesiones relacionadas con la violencia se debieron a peleas (76%) con conocidos (47%) que usaron objetos perforocortantes (40%) para infligir las heridas. CONCLUSIÓN: Los datos del SVLJ, aumentados con los datos sobre lesiones recopilados en los centros de salud y el sistema de vigilancia centinela, dan una medida de la magnitud del impacto de las lesiones en los servicios de salud. El SVLJ proporciona datos sobre el perfil de las lesiones vistas y tratadas en los centros de salud de Jamaica. En colaboración con datos de la policía y encuestas a nivel de la comunidad, el sistema puede ser usado para completar los perfiles de riesgo en relación con diferentes tipos de lesiones. Los datos generados a nivel provincial, regional y nacional constituyen la base para el diseño y monitoreo de los programas de prevención. Asimismo, sirven para apoyar y evaluar políticas, legislaciones, medidas de control así como medidas relativas al impacto de las intervenciones.