Prevalence of musculoskeletal symptoms in obese patients candidates for bariatric surgery and its impact on health related quality of life

ABSTRACT Objective This study was designed to identify the major musculoskeletal symptoms of individuals with obesity, to assess their health-related quality of life, and to evaluate the correlation between the musculoskeletal symptoms and the individuals' health-related quality of life. Materials and methods Cross-sectional study. Instruments used "Nordic Musculoskeletal Questionnaire" and "The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36)". Results In total, 41 subjects were evaluated, of which 90.15% were female. The mean age of the subjects was 40.78 ± 9.85 years and their mean body-mass index was 46.87 ± 8.08. All subjects reported musculoskeletal pain in at least one anatomical region and 80.49% had pain in three or more regions. The activity limitations due to pain were reported by 75.61% of them. The most affected regions by pain were the ankles and/or feet, lower back, knees and wrists/hands/fingers. The most associated regions with activity limitations due to pain were the ankles and/or feet, knees and lower back. The presence of pain showed a negative correlation with the domains physical functioning (PF), role-physical (RP) and body pain (BP). The activity limitations showed a negative correlation with the domains PF, BP, social functioning (SF) and role-emotional (RE). Conclusion Our data showed a high prevalence of musculoskeletal pain and limitation in activities due to pain in obese subjects. The musculoskeletal symptoms had negative correlations with physical and mental components of the health-related quality of life, highlighting the importance of ensuring that patients with obesity have access to interdisciplinary care, for the prevention and rehabilitation of musculoskeletal disorders.

Pediatric trauma due to motor vehicle accidents on high traffic roadway / Trauma pediátrico devido a acidente veicular em via de grande tráfego

Objective: To outline a profile of pediatric trauma victims and verify the likelihood of trauma in children on a high traffic roadway. Methods: A descriptive cohort study of the records of emergency medical service activations on the Rio-Niterói Bridge, a high traffic roadway in Rio de Janeiro, Brazil. Descriptive statistics were expressed as absolute and relative frequencies. The estimated risk of trauma in children aged < 12 years was calculated by means of odds ratios, with a 95% confidence interval. Results: Trauma accounted for 514 of 1,244 activations (41.31%) of the Rio-Niterói Bridge emergency medical service between March 2002 and March 2003. Response to incidents involving children aged < 12 years accounted for 52 of these (4.18%). Half of victims were between the ages of 6 and 12 years (n = 26), and 55.76% were male (n = 29). Of the 52 victims, 37 (71.15%) were involved in motor vehicle accidents (OR: 3.70; 95%CI: 1.94-7.13; p < 0.0001). Of these, 28 were vehicle?vehicle collisions (75.67%). The most common sites of injury were the extremities (n = 12; 32.43%), face (n = 10; 27.02%), and head (n = 9; 24.32%). Pre-hospital procedures were performed on 23 of the 37 patients (62.16%), and 44.23% (n = 23/52) required hospital transportation. There were no deaths during the study period. Conclusions: In this study, children were at significantly higher odds of being treated for trauma while on a highway with heavy traffic flow. The most common sites of injury in this sample were the lower extremities and the head, face, and neck complex.

Objetivo: Caracterizar o perfil dos atendimentos pediátricos por trauma e verificar a chance de ocorrência de trauma em uma rodovia de alto fluxo de veículos. Métodos: Estudo de coorte descritivo dos dados armazenados nos boletins de atendimentos realizados por grupo de resgate pré-hospitalar da Ponte Rio-Niterói, uma via de grande tráfego, no Rio de Janeiro. Estatística descritiva foi aplicada utilizando-se a frequência simples e percentual, verificando-se o risco estimado de "trauma" em crianças < 12 anos, por meio de odds ratio, com intervalo de confiança de 95%. Resultados: Em 1.244 atendimentos, entre março de 2002 e março de 2003, trauma representou 41,31% (n = 514), 76% do sexo masculino dos casos. O atendimento a crianças de até 12 anos correspondeu a 4,18% (n = 52) e metade das vítimas tinha entre 6 e 12 anos (n = 26), sendo 29 (55,76%) do sexo masculino. Entre as 52 vítimas, 71,15% (n = 37) estavam envolvidas em acidente de trânsito (OR: 3,70; IC95%: 1,94-7,13; p < 0,0001), sendo 28 (75,67%) colisões. Os locais mais frequentes de lesões foram extremidades (n = 12; 32,43%), face (n = 10; 27,02%) e cabeça (n = 9; 24,32%). Os procedimentos pré-hospitalares foram realizados em 23 dos 37 pacientes (62,16%) e 44,23% (n = 23/52) necessitaram de remoção hospitalar. Não houve óbito pediátrico durante o período analisado. Conclusões: Neste estudo as crianças apresentaram maior probabilidade de serem tratadas para traumatismo nessa rodovia de intenso fluxo de veículos. Os locais mais frequentes de lesões foram membros inferiores e o complexo cabeça, face e pescoço.

Análisis de condicionantes físicas influyentes en el rendimiento o posibles lesiones durante partidos oficiales de cadetes en un club profesional de fútbol Chileno / Physical determiners that could generate alterations in the perfomance or a possible injury in cadets players during official football games

Propósito: El fútbol es un deporte de contacto con alto riesgo de lesión, que puede afectar al jugador, al equipo y la institución. Situación que adquiere mayor relevancia en el ámbito profesional, tanto en planteles de honor como en el área cadetes de un club. A nivel nacional, el comportamiento de las lesiones en divisiones menores ha sido escasamente descrito. El propósito del estudio fue establecer condicionantes físicas que pudieran generar alteraciones en el rendimiento o una posible lesión en jugadores cadetes durante partidos oficiales de fútbol. Además, identificar zonas anatómicas más afectadas y la relación entre éstas condicionantes con la posición de juego. Diseño y muestra: Se registraron todos los incidentes de orden físico que requirieran atención por parte de los jugadores de 4 categorías (Sub 15, Sub 16, Sub 17 y Juvenil), en 293 partidos oficiales correspondientes aproximadamente al 50 por ciento de los encuentros desde el 2003 al 2007. Resultados: Las EEII fueron las más afectadas con un 60 por ciento, los incidentes físicos relativos al sistema osteoarticular concentraron el 50 por ciento de las atenciones, las contusiones fueron la principal situación de atención con un 47 por ciento. Defensas y volantes presentaron mayor porcentaje de incidentes con 37por ciento y 32 por ciento respectivamente. Conclusiones: Las EEII son las zonas anatómicas más afectadas, las contusiones fueron la principal causal de solicitud de atención. Defensas y volantes registraron mayor porcentaje de incidentes físicos durante partidos oficiales.

Purpose: Football for being a sport of contact has an important risk of injury and could affect the team and the Institution. This situation acquires major relevancy in the professional area, both in the staffs of honor and in the cadets of a club. The purpose of the study was to establish physical determiners, that could generate alterations in the performance or a possible injury in cadets players during official football games. In addition, to identify the most affected anatomical zones well as the relation among these determiners and game position. Design and sample: We registered physical incidents that needed the attention of 4 categories (Sub 15, Sub 16, Sub 17 and young), in 293 official games ,corresponding approximately to 50 percent of the meetings from 2003 to 2007. Results: The IIEE were most affected in a 60 percent, the physical incidences relative to the osteoarticular system concentrated 50 percent of the attentions, the contusions were the principal situation of attentions with 47 percent, defenses and midfielders obtained major percentages of incidents with 37 percent and 32 percent respectively. Conclusions: The IIEE are the most affected anatomical zones, the contusions were the principal grounds of request of attention. Defenses and midfielders registered major percentages of physical incidents during official games.

Non-fatal limb injuries in motorbike accidents

To determine frequency and pattern of non-fatal limb injuries in motorbike accidents victims. Cross-sectional observational study. Study was conducted at Jinnah Postgraduate Medical Centre [JPMC], Karachi, from October 2006 to March 2007. Trained data collectors prospectively collected data from the emergency department of JPMC, Karachi using structured pre-tested questionnaires. All motorbike accident victims presented to Emergency department with single or multiple bone injury in body extremities were included. Head injury patients who had first presented to neuro-surgery department were excluded. Motorbike accident victims with soft tissue injuries were also excluded from this study. Chi-square test was applied to find out statistical significance at 95% confidence level. P-value <0.05 was considered as significant. A total of 137 [39%] patients presented with tibial injury among the study sample of 348 patients, which was significantly higher than the bone injuries of the body part [p<0.001]. Out of those, in 26% of patients, fibula was also involved along with tibia fracture. Other bone injuries included femur [16%], radius [9.2%], humerus [8.3%] and others. Radius was the commonest injured bone and in highest proportion among upper limb injuries [p<0.001]. Overall, 66% of the injuries in motorbike involved lower limb fractures. The highest proportion of motorbike accidents were observed on Saturdays [31%]. Majority of the accident victims were in the age group between 16 and 30 years [41% accident cases], 27% in age group 30 to 45 years, 15% in 45 to 60 years and 5% in >60 years. Those with less than 15 years accounted for 12% of cases. Tibial bone is at the greatest risk in motorbike accidents probably due to its superficiality and exposed position while riding motorbike. Protective measures need to be taken for the prevention of disability associated with lower limb involvement in motorbike accidents

Pig bite in Brazil: a case series from a teaching hospital

A retrospective survey done from 1987 till 1990 revealed that 23 patients bitten by pigs sought medical help at a teaching hospital in Uberl andia, in southeastern Brazil. Most cases (21) were from Uberl andia. The cases were evenly distributed by month and by year; most of them (14/16; 87.5 per cent ) occurred between 7.00 a.m. and 7.00 p.m. The male to female ratio was 6.7:1. Age ranged from 6 to 73 (mean 38.95 +/- SD 22.06, median 36). The bites were more common on the upper limbs, particularly on the forearms. In 11 (47.8 per cent ) cases the injury was described as deep. In most cases where information was available the injury was related to capture, transport or immobilisation of the pig for slaughter. The following medical procedures were performed: local cleansing in 19(82.6 per cent ) cases, rabies vaccine (12; 52.2 per cent ), antirabies serum (2; 8.7 per cent ), suturing (6; 26.1 per cent ) and tetanus vaccine (12; 52.2 per cent ). There was no case of infection at the bite site, neither of rabies or tetanus. By our data, the annual incidence of pig bite in Uberl andia can be estimated to be about 1.5/100,000