Physical violence in children and adolescents: a retrospective study of injuries to the head and neck region

Aim: This study aimed to investigate the prevalence of physical violence and head and neck injuries among children and adolescents who suffered physical aggression, firearm aggression, and white gun aggression referred to the Legal Medical Department in a southern city in Brazil. Methods: This study was performed at Legal Medical Department in the city of Pelotas, RS, Brazil, from January 2011 to December of 2015. Data were collected from medical reports of children and adolescents (0-19 years old). Demographic information such as sex, age, and skin color was collected. Data were submitted to Chi-square test and multivariate Poisson regression analysis. Results: In this study, 2,716 physical examination reports were analyzed, with a total of 2,171 exams resulting from violence; lesions that had physical aggression as their etiology (1,951) had a higher prevalence. The analysis of the exams revealed that the majority were adolescents (90,05%), white (84.09%), and female (50.21%). The head and neck regions were affected in most cases of violence (57.90%). In the adjusted model, the occurrence of injuries in the head and neck region was higher in males (PR 1.16, CI 95% 1.08 - 1.25), among adolescents (PR 1.28, CI 95% 1.10 - 1.48) and in victims of physical aggression compared to victims of the firearm (2.81, CI 95% 1.79 - 4.40). Conclusion: The results revealed a high prevalence of head and face injuries in victims of violence and that there was a greater prevalence of physical violence among adolescents compared to children and males

Traumatismo torácico por arma blanca / Thoracic trauma by a bladed weapon

Resumen Objetivos Describir las características, índices de gravedad de traumatismo (IGT), morbilidad, mortalidad y factores asociados a mortalidad en pacientes hospitalizados por traumatismo torácico por arma blanca (TTAB). Materiales y Método Estudio analítico transversal. Período enero de 1981 a diciembre de 2017. Revisión base de datos prospectiva, protocolos quirúrgicos, fichas clínicas. Se describe y compara las características de los TTAB. Se calculó IGT: Injury Severity Score (ISS), Revised Trauma Score ( RTS-T) y Trauma Injury Severity Score (TRISS). Resultados Total 4.163 pacientes hospitalizados por TT, 2.286 hospitalizados por TTAB. Hombres: 2.131 (93,2%), edad promedio 27,8 ± 10,7 años, TTAB aislado 2.035 (89,0%), asociado a lesiones extratorácicas 251 (11,0%) y de éstos 124 (5,5%) se consideraron politraumatismos. Mecanismos principales del traumatismo: agresión 2.246 (98,3%) y autoagresión 22 (1,0%). Lesiones y hallazgos torácicos más frecuentes: neumotórax 1.473 (64,4%), hemotórax 1.408 (61,6%), enfisema subcutáneo 485 (21,2%). Tratamiento definitivo: pleurotomía 1.378 (60,3%), cirugía torácica 537 (23,5%) y tratamiento médico 370 (16,2%). Hospitalización promedio 6,2 ± 6,5 días, IGT: ISS promedio 10,9 ± 7,2, RTS-T promedio 11,6 ± 1,4 y TRISS promedio 3,6. Morbilidad: 318 (13,9%). Mortalidad: 32 (1,4%). Conclusión Los TTAB ocurren frecuentemente en hombres jóvenes por agresión. La mayoría se puede tratar con pleurotomía exclusiva.

Aim Our objectives are to describe and correlate the clinical characteristics, trauma severity indexes (TSI) and morbidity and mortality in patients hospitalized for thoracic trauma by a bladed weapon (TTBW). Materials and Method Transversal analytic study. Period January-1981 to December-2017. Prospective database review, surgical protocols, clinical files. The characteristics of the TTBW are described and compared. Injury Severity Score (ISS), Revised Trauma Score (RTS-T) and Trauma Injury Severity Score (TRISS) were calculated. Results Total of 4,163 patients hospitalized for TT, 2,286 hospitalized for TTBW. Men: 2,131 (93.2%), average age 27.8 ± 10.7 years, isolated TTBW 2,035 (89.0%), associated with extra thoracic injuries 251 (11.0%) and of these 124 (5.5%) were considered polytrauma. Main mechanisms of trauma: Aggression 2,246 (98.3%) and self-aggression 22 (1.0%). Most frequent injuries and thoracic findings: pneumothorax 1,473 (64.4%), hemothorax 1,408 (61.6%), subcutaneous emphysema 485 (21.2%). Definitive treatment: Pleurotomy 1,378 (60.3%), thoracic surgery 537 (23.5%) and medical treatment 370 (16.2%). Average hospital stay: 6.2 ± 6.5 days. ISS average 10.9 ± 7.2, RTS-T average 11.6 ± 1.4 and TRISS average 3.6. Morbidity: 318 (13.9%). Mortality: 32 (1.4%). Discussion TTBW are frequent in our environment, unlike on an international level. Conclusions TTBW frequently occur in young male patients due to aggression. The majority can be treated with exclusive pleurotomy.

Analysis of homicidal deaths in and around Bastar region of Chhattisgarh.

FREEDOM FROM VIOLENCE, not necessarily proportional with development in some basic capabilities like nutrition, longevity and literacy which positively related to economic growth. So, dealing with violence in society is intrinsically a matter of public interest. In present study 79 cases of homicidal deaths due to different mechanical injuries was studied in two year period from 1/1/2009 to 31/12/2010. The incidence of homicidal death was 9.13% during this period. Males affected more in comparison to females. Majority of cases were fall in 21-40 yrs. of age comprising 50 cases (63.28%).Injuries by blunt weapons commonly observed in 30 cases (37.97%) which followed by injuries by sharp weapons 19 cases (24.05%). Totally 329 sharp injuries observed in comparison to 152 blunt injuries. Incidences were prevalent at dense forest area 26 cases (32.91%), in married persons 55 cases (69.62%), in between 6 pm to 12 midnight 24 cases (30.37%) and revenge was main motive 23 cases (29.11%).

Acidente com material perfurocortante entre profissionais de enfermagem de um hospital universitário / Accidente con material corto-punzante entre profesionales de enfermería de un hospital universitario / Accidents with cutting and piercing materials among nursing professionals at a university hospital

Os riscos ocupacionais a que os profissionais da equipe de enfermagem estão sujeitos no desempenho de suas funções são consideráveis. Assim estabeleceu-se como objetivo deste estudo analisar os acidentes perfurocortantes no período de 2002 a 2006, envolvendo a equipe de enfermagem de um hospital universitário, para compreender o contexto em que ocorrem. A utilização destas informações pode ser ferramenta de prevenção. Estudo descritivo, retrospectivo quantitativo e qualitativo. Na análise quantitativa foi utilizada estatística descritiva e na qualitativa o discurso do sujeito coletivo. Por meio das fichas de notificação do Núcleo de Vigilância Epidemiológica do Hospital, foi possível identificar acidentes do gênero no período pesquisado. Entrevistas foram direcionadas às vítimas de acidentes que tiveram como paciente-fonte portador de Síndrome da Imunodeficiência Adquirida/ Vírus da Imunodeficiência Humana, hepatite B e C. Os achados demonstraram que ainda persiste um grau significativo do desconhecimento ou banalização dos acidentes entre profissionais da saúde.

Los riesgos ocupacionales a que los profesionales del equipo de enfermería están sujetos en el desempeño de sus funciones son considerables. Así, se estableció como objetivo de este estudio analizar los accidentes con perforación y corte en el período de 2002 a 2006 que involucraron al equipo de enfermería de un hospital universitario, para comprender el contexto en que ocurren. Usar esta información puede ser una herramienta de prevención. Este es un estudio descriptivo, retrospectivo cuantitativo y cualitativo. En el análisis cuantitativo se usó la estadística descriptiva y en la cualitativa el discurso del sujeto colectivo. Por medio de las fichas de notificación del Núcleo de Vigilancia Epidemiológica del Hospital, fue posible identificar accidentes del género en el período investigado. Se hicieron entrevistas con las víctimas de accidentes que tuvieron como paciente-fuente a portadores de Síndrome de la Inmunodeficiencia Adquirida/ Virus de la Inmunodeficiencia Humana, hepatitis B y C. Lo hallazgos demostraron que todavía persiste un grado significativo de desconocimiento o banalización de los accidentes entre profesionales de la salud.

The occupational hazards to which nursing professionals are subject while performing their duties are considerable. Hence, this study aimed at analyzing accidents with cutting and piercing instruments involving the nursing team of a university hospital from 2002 to 2006 in order to understand the context in which they occurred. The use of such information can be a prevention tool. This is a descriptive, retrospective, quantitative and qualitative study. Descriptive statistics was used for quantitative analysis and the collective subject discourse was utilized for qualitative observation. By using report forms from the hospital's Epidemiological Surveillance Center, it was possible to identify that type of accident in the studied period. Interviews were targeted at accident victims who had patients with the Acquired Immunodeficiency Syndrome/ the Human Immunodeficiency Virus, Hepatitis B and C as source patients. The findings showed that a significant lack of knowledge and the banalization of accidents still persist among health care professionals.

Acidentes de trabalho com material perfurocortante envolvendo profissionais de enfermagem de unidade de emergência hospitalar / Labour accidents with piercing and cutting materials involving nursing staff in a hospital emergency department / Accidentes de trabajo con material perforocortante abarcando profesionales de enfermería de unidad de emergencia hospitalaria

O objetivo do presente estudo foi identificar e analisar a ocorrência de acidentes de trabalho com material perfurocortante entre a equipe de enfermagem. Estudo descritivo e exploratório, com abordagem quantitativa, realizado em 2008. A população do estudo foi composta por 101 trabalhadores da unidade de emergência de um hospital público no município de Niterói – RJ. Verificou-se 44 (43,6%) profissionais envolvidos nesse tipo de acidente, sendo a agulha oca o objeto mais frequentemente associado (68,2%) e o reencape de agulhas o responsável por 38,6% dos acidentes ocorridos. Em conclusão, os resultados fornecem dados importantes que poderão subsidiar programas de prevenção de riscos ocupacionais.

The aim of this study was to identify and analyse the occurrence of labour accidents with sharp material among nursing staff. Conducted in 2008, it was descriptive, quantitative and exploratory. The study population consisted of 101 employees of a public hospital in Niteroi (Rio de Janeiro State). This type of accident involved 44 (43.6%) nurses and most frequently hollow needles (68.2%); needle recapping was responsible for 38.6% of accidents. In conclusion, the results provide important data that could support programs to prevent occupational hazards.

El objetivo de este estudio fue identificar y analizar la ocurrencia de accidentes de trabajo con material perforocortante entre el personal de enfermería. Estudio descriptivo y exploratorio, con abordaje cuantitativo, cumplido en 2008. La población del estudio consistió de 101 trabajadores de la unidad de emergencia de un hospital público en Niterói – RJ – Brasil. Hubo 44 (43,6%) profesionales involucrados en ese tipo de accidente, siendo la aguja hueca el objeto más frecuentemente asociado (68,2%) y el reencapar de agujas lo responsable por 38,6% de los accidentes acaecidos. En conclusión, los resultados proporcionan datos importantes que podrán apoyar los programas de prevención de riesgos laborales.

Acidente ocupacional por material perfurocortante entre profissionais de saúde de um Centro Cirúrgico / Accidente laboral por exposición a material corto-punzante entre los profesionales de un centro quirúrgico / Occupational accident with sharpe edge material among workers of an operating center

O acidente ocupacional por material perfurocortante constitui uma preocupação para instituições e trabalhadores de saúde, devido à elevada frequência de procedimentos invasivos, e a dinâmica do trabalho. Objetivou-se identificar a incidência dos acidentes, dos materiais envolvidos, dos fatores contribuintes e das condutas tomadas pós-acidente. Participaram de um estudo transversal 127 funcionários do centro cirúrgico. Registraram-se 23,6 por cento (30/127) acidentes com envolvimento de agulha (73,3 por cento), lâmina de bisturi (6,7 por cento) e eletrocautério (6,7 por cento). Os fatores contribuintes para o acidente foram: falta de atenção (36,7 por cento), más condições de trabalho (20,0 por cento), descuido (13,3 por cento), pressa (10 por cento) e acaso/azar (6,7 por cento). Somente 15,4 por cento dos acidentes foram registrados. A subnotificação deveu-se à irrelevância do acidente, desconhecimento do protocolo de rotina, displicência e sobrecarga de trabalho. Os resultados alertam para a importância de se implementar estratégias para adoção/revisão de protocolos pós-acidentes, visando a redução dos acidentes e de sua subnotificação.

Occupational accidents involving piercing-cutting material are a concern for institutions and health workers due to the high frequency of invasive procedures and the dynamics involved in their practice. The objective of the present study was to identify the incidence of accidents, devices involved, contributing factors and post-accident behaviors. A cross-sectional study was conducted among 127 healthcare workers from the operating center. Of the total number of accidents reported, 23.6 percent (30/127) involved piercing-cutting materials, including needles (73.3 percent), scalpels (6.7 percent) and electrocautery (6.7 percent). The factors contributing to the accident were: lack of attention (36.7 percent), poor working conditions (20.0 percent), neglect (13.3 percent), rushing (10 percent) and accident/chance (6.7 percent). Only 15.4 percent of the accidents were recorded. Underreporting was due to: irrelevance of the accident, unaware of the protocol of routine, negligence and work overload. Results show the importance of implementing strategies for adopting/reviewing post-accident protocols aiming at reducing accidents and their underreporting.

El accidente laboral por elementos corto-punzantes constituye una preocupación para instituciones y trabajadores de la salud, debido a la elevada frecuencia con la que se realizan procedimientos invasivos y por la dinámica del trabajo. Se objetivó identificar la incidencia de los accidentes, los materiales involucrados, los factores contribuyentes y las conductas tomadas con posterioridad al accidente. Participaron de un estudio transversal 127 trabajadores de un centro quirúrgico. Sobre un porcentaje de accidentados del 23,6 por ciento (30/127), el 73,3 por ciento sufrió accidentes involucrando agujas, 6,7 por ciento se accidentó con hojas de bisturí y 6,7 por ciento se accidentó con electrocauterizador. Los factores que contribuyeron a los accidentes fueron: falta de atención (36,7 por ciento), malas condiciones de trabajo (20,0 por ciento), descuido (13,3 por ciento), prisa (10,0 por ciento) y casualidad / azar (6,7 por ciento). Sólo el 15,4 por ciento de los accidentes fueron registrados. La falta de notificación se debió a la irrelevancia del accidente, desconocimiento del protocolo de rutina, displicencia y sobrecarga de trabajo. Los resultados alertan sobre la importancia de implementar estrategias para adopción / revisión de protocolos post accidentes, apuntando a la reducción de la cantidad de accidentes y a evitar la ausencia de registro de los mismos.

A study of homicidal deaths by mechanical injuries in Surat, Gujarat.

Violence has been always an integral part of the human civilization since its inception. Human beings have been progressively become expert in producing various type of weapons both for offensive and defensive purposes. This study was aimed to evaluate the mechanical injuries in homicidal cases of different motives and also to find out the most vulnerable portion of the body so as to minimize the loss of human life and common weapon used in such cases. The present study was carried out on 166 cases of homicidal deaths due to mechanical injuries during the year 2004 -05. Incidence of homicidal death due to mechanical injuries was averagely 83 cases per year. Mechanical injuries were quite common in homicidal deaths involving 130 males and 36 female victims. Majority of victims were in the age group of 21-40 years include 104 cases (62.65%). Stab injuries were commonly seen on the abdomen and chest due to sharp cutting weapons. Blunt force was the most commonly employed method in 80 cases (48.19%). Incidence of firearm was quite rare. Lungs were commonly involved internal organ. Male group was dominant over female group in defensive mechanism.

Reparación primaria versus colostomía en lesiones del colon / Primary repair vs. colostomy in colon injuries

Introducción: El colon es el segundo órgano más frecuentemente lesionado en las heridas por trauma penetrante de abdomen. En México, las lesiones por arma blanca o de fuego van en aumento. Nuestro objetivo fue evaluar el principal manejo para las lesiones traumáticas de colon. Material y métodos: Estudio retrospectivo y aleatorizado de 178 pacientes con trauma abdominal y lesiones de colon, en un lapso de cinco años (enero de 2003 a junio de 2008) en el Hospital General de Balbuena. Se comparó el uso del cierre primario y cirugía derivativa con colostomía. Se analizó sexo, grupo de edad, tipo de herida, grado de lesión y mortalidad. Resultados: De 178 pacientes, 156 fueron hombres (87.6 %) y 22 mujeres (12.4 %). El grupo de edad con mayor afección fue el de 21 a 30 años; 74 pacientes (41.6 %) presentaron heridas por instrumento punzocortante y 104 pacientes (58.4 %) heridas por arma de fuego. El principal manejo fue mediante cierre primario: 92 casos (51.7 %) versus 86 (48.3 %) para cirugía derivativa; sin embargo, en las heridas por arma de fuego el principal manejo fue la colostomía (67 casos). La mortalidad fue de 17 casos (9.55 %) debido a causas diversas como lesiones a múltiples órganos de manera asociada. Conclusiones: En las lesiones colónicas debe individualizarse el tratamiento, según la etiopatogenia, grado de lesión y lesiones asociadas.

BACKGROUND: Colon trauma is frequent and its prevalence is difficult to establish because of the different factors that intervene in its origin. In Mexico, traumatic colon injuries, albeit stab wounds or gunshot wounds, are on the rise. Our objective was to evaluate the most appropriate management for traumatic colon injuries. METHODS: We conducted a retrospective study of 178 case files of patients with abdominal trauma and colon lesions during a 5-year period from January 2003 to June 2008 from the General Hospital of Balbuena, Mexico City. The study compared the use of primary closure vs. colostomy, analyzing variables such as sex, age, type of wound, severity of lesion and mortality. RESULTS: There were a total of 178 patients; 156 were male (87.6%) and 22 were female (12.4%). The most affected age group was between 21 and 30 years; 74 patients (41.6%) had stab wounds and 104 patients (58.4%) had gunshot wounds. Management consisted mainly of primary closure in 92 cases (51.7%) vs. colostomy in 86 patients (48.3%). However, 64% of gunshot wounds were treated with colostomy. Reported mortality was 9.55% and this was due to different factors such as multiple organ injury. CONCLUSIONS: Treatment of traumatic colon injury should be case specific, taking into account the mechanism of the lesion, its severity and associated injuries.

Prevalencia de lesiones por objetos cortopunzantes en el personal de enfermería de unidades de terapia y quirúrgicas / Prevalence of sharp device lesions in the nursing staff of intensive care and surgical service units

Con el objetivo de determinar la prevalencia de lesiones cortopunzantes en el personal de enfermería de unidades de terapia y quirúrgica de un hospital clinico-quirúrgico de La Habana, se realizó un estudio de corte transversal en diciembre del 2005. Mediante un cuestionario se obtuvo la información relativa al antecedente de lesiones en la semana anterior, características del accidente, reporte de la lesión, inmunización contra hepatitis B y conocimientos sobre prácticas de prevención. Para el análisis se utilizó la técnica estadística de análisis de distribución de frecuencias. Se realizó comparación de medias (prueba t) para el análisis de las variables cuantitativas continuas. Se encuestaron a 62 enfermeros(as), 14 (22,6 por ciento) tuvieron una lesión cortopunzante, más frecuente en las unidades quirúrgicas (33,3 por ciento) que en las terapias (15,8 por ciento). En general no reportan el accidente 64,3 por ciento, 72,6 por ciento reenfundan las agujas; 87,1 por ciento está inmunizado contra la hepatitis B 53,2 por ciento refieren dominar la técnica de una mano; 30,6 por ciento no domina el procedimiento correcto posterior a una lesión, el personal más joven e inexperto se expone más frecuentemente al riesgo de lesiones, y los de más experiencia en el servicio tienen mayor riesgo de tener un accidente. Se demostró una elevada prevalencia de lesiones cortopunzantes, observándose un deficiente funcionamiento de la vigilancia de lesiones y desconocimiento de las prácticas de prevención de lesiones.

With the objective of determining the prevalence of sharp device injures in the nursing staff of intensive care and surgical service units from a clinical-surgical hospital located in La Habana province, a cross-sectional study was performed in december, 2005. Questionnaire provided information about antecedents to injures in the previous week, characteristics of the accident, injure report, hepatitis B immunization, and preventive practice knowledge. To this end, the statistical technique of frequency distribution analysis was used. Mean comparison (t test) served to analyze continuous quantitative variables. Sixty two male and female nurses were surveyed to find out that 14 (22,6 percent) had some sharp device injures that occurred more often in surgical units (33,3 percent) than in intensive care units (15,8).Generally, 64,3 percent of the staff did not report the injures; 72,6 percent put away the needles; 87,1 percent was hepatitis B –immunized, 53,2 percent states they mastered one-hand technique, 30,6 percent did not perform the correct procedure after an injure; the youngest and unexperienced staff was more exposed to the risk of being injured and the more experienced at service had higher risk of accident. A high prevalence of sharp device lesions was demonstrated, thus observing poor surveillance of lesions and lack of knowledge about injure-preventing practices.

Homicides by sharp weapons.

In the present society, which is gradually becoming over democratic it is natural that old values of sanctity of life changes and personality problems develop due to consequent stress of life. This ultimately results in violence. Killing of a human being is one of the most serious or major crimes. Since very long time, different judicial authority to prevent crime and its further occurrence framed laws. The laws were made according to the religious make up of the society but later the laws were according to the emperor’s own convenience. In spite of all these, there has been a phenomenal rise in the incidence of homicide all over the world and also in India. The study was conducted on 200 alleged cases of homicides. The incidence of homicidal deaths was observed as 13.03% with male preponderance and the commonest age affected was 21 to 40 yrs. Out of different weapons used to inflict the injuries on dead bodies of homicides, 31(10.88%) sharp cutting weapons were used. Incised wounds were present maximum 38(29.69%) on head and face. Defence wounds were present in 72(36%) of homicide deaths.

The incidence of drug abuse in unnatural deaths in northern Thailand.

OBJECTIVE: Study the incidence of drug abuse in persons with unnatural deaths such as traffic accidents, homicide with gunshot wounds, etc. MATERIAL AND METHOD: One hundred and fifty three cases with a mean age of 34 years (range 10 to 76) were studied. The decedents were mostly male (92%), with a variety of occupations including laborers (76.9%), traders (15.4%), and student (7.7%). The causes of death were mainly traffic injuries (33%), gunshot wounds (26%) and others (stab wound, poisoning, asphyxia etc 41%). The manner of death was accidents in 40% and homicides in 28%. RESULTS: Nine percent were positive for methamphetamine or amphetamine derivatives. Tests for Heroin, 6-MAM, morphine, or cocaine were also performed but not detected. The drug positive cases were mostly males (85%) with the most common age range of 21-30 years (35.4%) and 61% with only primary education. Homicide by gunshot wounds was the most common cause of death at 69.2%, followed by hanging (15.4%), electrocution (7.7%), and poisoning (7.7%). The concentration of methamphetamine in urine was between 501-61,147 ng/ml, which cannot be correlated with intoxication. There were no deaths from overdose. Three Benzodiazepine, one toluene, and one meperidine cases were also found in cases of methamphetamine abuse. Alcohol was found mostly in the persons with unnatural deaths (53.6%) from traffic accidents. CONCLUSION: This information helps us understand the marketing strategies, and the trading routes. All data will be used for planning to eradicate these drugs from Thailand in line with government strategies.

Accidentes por objetos punzocortantes en estudiantes de una escuela de odontología / Accidents produced by punching cutting objects in students of an odontology school

Objetivo: Determinar la frecuencia de accidentes por objetos punzocortantes en estudiantes de una Escuela de Odontología, durante un ciclo escolar (diez meses) y su posible asociación con el grado cursado. Metodología: Estudio transversal con información retrospectiva en 103 alumnos de 21 a 24 años de edad, cursando 3º, 4º y 5º año de la carrera de Cirujano Dentista. Se aplicó cuestionario con doce ítemes (relativos al accidente y lesión, perfil de vacunación y seguimiento del accidente). Se calcularon las medidas epidemiológicas de frecuencia y asociación. Resultados: El 46,6 por ciento de la población estudiada reportó por lo menos un accidente; causado principalmente por explorador y agujas. Los momentos en que se presentó el accidente fueron: mientras se atendía al paciente, durante la manipulación (traslado) y lavado de instrumental, en orden de importancia. La tasa de incidencia fue de 5,4 accidentes por cada 10.000 horas-persona de práctica. No hubo diferencia estadísticamente significativa en la frecuencia de accidentes de acuerdo al grado escolar cursado. Conclusión: Existe una alta ocurrencia de accidentes por punzocortantes en la práctica odontológica de los estudiantes, independientemente del grado escolar cursado, lo cual refleja la necesidad de implementar medidas para la vigilancia y prevención de dichos eventos por las enormes consecuencias potenciales que éstos suelen tener.

Cómo actuar frente a un accidente punzo-cortante / How to act when a piercing-cutting accident occurs

Es necesario implementar estrictas normas de bioseguridad y agudizar nuestros sentidos frente a la atención odontológica de nuestros pacientes, con el fin de prevenir pinchazos y cortes accidentales. Pero si a pesar de ello esto se produjera, debemos conservar la calma y cumplir una serie de pautas que enumeramos a continuación para minimizar el riesgo de infección

Trauma renal: revisión de la experiencia del Hospital San Juan de Dios / Renal trauma: review of the experience in the Hospital San Juan de Dios

Revisar la experiencia en trauma renal en el Hospital San Juan de Dios, Servicio de Salud Metropolitano Occidente. Se revisan todos los registros de alta con diagnóstico de trauma renal entre los años 1994 y 2000. Se estudian retrospectivamente todos los registros caracterizando pacientes por edad, sexo, tipo trauma, estudio imagenológico y necesidad de cirugía. Durante el período se hospitalizaron 20 pacientes con diagnóstico de trauma renal. Sus edades oscilan entre los 17 y 64 años (mediana 33), 17 (85 por ciento) corresponden a sexo masculino. 4 (20 por ciento) sufren trauma penetrante, todos ellos por arma blanca, 16 (80 por ciento) presentan trauma contuso, principalmente por accidente automovilístico y caída de altura (66 por ciento). Dieciséis pacientes fueron manejados conservadoramente. De los pacientes que fueron a cirugía, en 2 de ellos se realizó nefrectomía por trauma contuso en riñón patológico. Los otros 2 presentaban trauma penetrante y se realizó nefrorrafia. En 3 pacientes del estudio no se realizó TAC. De los 20 pacientes, 9 fueron GI, 8 GII, 1 GIII, 2 GIV. La experiencia de nuestro servicio reproduce lo publicado. El trauma renal es más frecuente en hombres 4:1, el trauma cerrado es responsable del 80 por ciento de los mecanismos, siendo su génesis los accidentes automovilísticos y caídas. Las lesiones penetrantes se asocian a traumas de mayor grado. El manejo conservador es una alternativa en pacientes con trauma renal penetrante bien etapificado.

Ocorrência de acidentes com instrumentos pérfuro-cortantes em alunos de graduaçäo do curso de odontologia da Universidade Paranaense / Ocurrence of accidents with cutting instruments in graduation students of dentristy course of the Paraná University

Realizou-se um levantamento para detectar as características da ocorrência de acidentes com instrumentos pérfuro-cortantes na clínica odontológica da Universidade Paranaense, para posterior aconselhamento aos acadêmicos. Utilizou-se para o levantamento, um questionário composto por 9 itens, sendo o mesmo aplicado em 122 estudantes do curso de Odontologia, que exerciam atividades de atendimento clínico. Tais acidentes se relacionaram principalmente à lavagem de instrumental, raspagem periodontal e anestesia. Pode-se salientarque em relaçäo ao momento do atendimento, a maioria dos acidentes ocorreu na fase final. Os instrumentos mais envolvidos em ordem decrescente foram a sonda exploradora, a agulha anestésica e a cureta periodontal. O item relacionado ao motivo que favoreceu o acidente demonstrou que a grande maioria decorreu por desatençäo e presa, seguidos de itens com menores proporçöes. Conclui-se que a ocorrência de acidentes com instrumentos pérfuro-cortantes constitui sério problema em nível de controle de infecçäo cruzada, e que medidas preventivas devem ser reforçadas para a reduçäo dos mesmos.

Ferimento perfurante ocular: 400 casos admitidos na clínica oftalmológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de Säo Paulo / Penetrating ocular injury: 400 cases admitted in the ophthalmologic clinic of the Hospital das Clínicas da Faculdade de Medicina da Universidade de Säo Paulo

Foi realizado um estudo retrospectivo de 400 casos de ferimento perfurante ocular admitidos na Clínica Oftalmológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, no período de janeiro de 1991 a dezembro de 1992. Houve maior incidência de ferimento perfurante no sexo masculino (79,5 por cento) e o grupo etário de 21 a 30 anos foi o mais exposto ao trauma. Os acidentes de trânsito representaram 30,8 por cento, seguidos pelos acidentes domésticos (27,8 por cento), ocupacionais (22,8 por cento), lazer e esporte (10,2 por cento) e violência (8,5 por cento). O atendimento inicial ocorreu no primeiro dia para 82,6 por cento dos casos e após o terceiro dia para 8,2 por cento dos pacientes. Os ferimentos perfurantes oculares constituíram causa importante de incapacidade visual funcional: apenas 61 de 283 olhos alcançaram acuidade visual de 20/40 ou melhor. Medidas preventivas necessitam ser tomadas para reduzir a indicência de perfurações oculares.

Morbilidad al egreso en un servicio de oftalmologia / Morbidity at discharge in an Ophthalmology Service

Se revisaron las tarjetas de codificacion del Departamento de Estadisticas del Hospital Provincial Docente "Antonio Luaces Iraola" de Ciego de Avila, y se tomo el diagnostico principal en el egreso de las correspondientes al servicio de oftalmologia en un periodo de 11 anos (enero 1982 a diciembre de 1992). La catarata senil (24,7 por ciento), las conjuntivitis (24,0 por ciento), los glaucomas (5,6 por ciento), las heridas perforantes oculares (5,2 por ciento), las ulceras corneales (4,7 por ciento) y las hetecroforias (4,26 por ciento) fueron los diagnosticos, al egreso mas frecuentes

Aspectos epidemiológicos das vítimas de atropelamento, colisão, ferimento por arma de fogo e branca relacionados ao atendimento pré-hospitalar / Epidemiological data related to run over victims, collision, gunshot and stab wounds as reported by the pre-hospitalar attendance

Este estudo apresenta dados epidemiológicos de vítimas de atropelamento, colisão, ferimento por arma de fogo e arma branca relacionados ao atendimento pré-hospitalar na Região Sul do Município de São Paulo nos meses de dezembro/90 e janeiro/91. Das 1192 vítimas, 75 por cento eram do sexo masculino, entre 15 e 29 anos (48,07 por cento) e foram transportadas na maioria das vezes por diferentes meios de transportes particulares (77,53 por cento) num prazo máximo de 30 minutos (68,62 por cento). Os atropelamentos, colisões, ferimentos por arma de fogo e arma branca ocorreram mais frequentemente entre 18 e 24 horas; sábado foi o dia da semana com maior número de vítimas (19,63 por cento). As vítimas por ferimento por arma de fogo apresentaram o maior percentual de óbito (17,57 por cento).