Estudio de las heridas por amoladora tratadas en el Hospital de Clínicas y Hospital Pasteur, Montevideo, Uruguay / Grinder injuries treated at the Clínicas and Pasteur Hospital of Montevideo, Uruguay / Estudo das lesões por esmerilhadeira tratadas no Hospital de Clínicas e Hospital Pasteur, Montevidéu, Uruguai

Resumen: Introducción: las heridas causadas por amoladora representan una consulta frecuente al cirujano plástico en nuestro país. Los objetivos del presente trabajo fueron conocer la epidemiología de los pacientes que consultaban con estas lesiones, conocer las circunstancias del accidente y estudiar si existía relación entre las condiciones de uso de la herramienta y la gravedad de las lesiones. Material y método: se realizó un estudio descriptivo, transversal, donde se recabaron los datos de los pacientes que consultaban por heridas por amoladora en las puertas de emergencia de Hospital Pasteur y Hospital de Clínicas en un período de 6 meses. Resultados: un total de 76 pacientes fueron incluidos en el estudio, la mayoría de sexo masculino, en edad laboral activa (39 a 58 años) dedicados a la realización de trabajos temporales o tareas de construcción, con bajo nivel de instrucción. El 84% de las heridas fueron graves. El 61% de los pacientes no utilizó los elementos de seguridad de la herramienta al momento del accidente. La mayoría de las lesiones se produjeron fuera del ambiente laboral. Conclusiones: en base a nuestro trabajo pudimos establecer el perfil epidemiológico de la población más susceptible de sufrir estas lesiones. Comprobamos que las heridas producidas por amoladora son en su mayoría graves y requieren procedimientos complejos para su resolución.

Summary: Introduction: grinder injuries represent a large number of consultations for plastic surgeons in our country. This study aims to learn about the epidemiological characteristics of patients who consulted for these lesions and the circumstances of the accidents, and to analyze whether there is a relationship between the conditions for tool use and the severity of lesions. Methodology: we conducted a retrospective, descriptive, transversal study where we collected data from the patients who consulted for grinder injuries at the emergency departments of Pasteur and Clínicas Hospital during a 6-month period. Results: seventy-six patients were included in the study, most of which were male working adults (between 39 and 58 years-old) who had temporary jobs or were performing construction works and had low levels of education. 84% of lesions were severe. 61% of patients did not respect safety regulations at the time of the accident. Most lesions occurred out of working hours. Conclusions: based on our study, we could identify the epidemiological profile of the most vulnerable population for this kind of lesions. We proved that most grinder lesions are severe and their management requires complex procedures.

Resumo: Introdução: as lesões causadas por esmerilhadeira são causa frequente de consulta ao cirurgião plástico no Uruguai. Os objetivos do presente trabalho foram conhecer as características dos pacientes que consultaram com essas lesões, conhecer as circunstâncias do acidente e analisar a possível relação entre as condições de uso da ferramenta e a gravidade das lesões. Metodologia: foi realizado um estudo descritivo, transversal, onde foram coletados dados de pacientes que consultaram por lesões de esmerilhadeira no pronto-socorro do Hospital Pasteur e Hospital de Clínicas durante um período de 6 meses. Resultados: foram incluídos no estudo 76 pacientes, a maioria do sexo masculino, em idade ativa para trabalhar (39 a 58 anos) dedicados à realização de trabalhos temporários ou trabalhos na construção civil, com baixo nível de escolaridade. 84% dos ferimentos foram graves. 61% dos pacientes não utilizaram os elementos de segurança da ferramenta no momento do acidente. A maioria das lesões ocorreu fora do ambiente de trabalho. Conclusões: com base em nosso trabalho conseguimos estabelecer o perfil da população mais suscetível a esses agravos. Constatamos que a maioria das lesões causadas por esmerilhadeiras são graves, exigindo procedimentos complexos para sua resolução.

Falsas vías en pacientes atendidos en la Facultad de Estomatología de La Habana / False pathways in patients treated at the Faculty of Dentistry of Havana

RESUMEN Introducción: la falsa vía es la apertura artificial en las paredes del conducto debido a penetración de la dentina; lo que provoca comunicación entre el espacio pulpar y el periodonto. Estos accidentes suelen ocurrir durante la realización de tratamientos endodónticos o al preparar el lecho para colocación de pernos. Esto provoca daño al periodonto, pudiendo desarrollarse bolsas periodontales. Objetivo: identificar la frecuencia de estos accidentes, y determinar su asociación con la presencia de periodontitis. Materiales y métodos: se realizó un estudio descriptivo y transversal en la Facultad de Estomatología de La Habana, entre enero de 2011 y enero de 2016. El universo estuvo constituido por 50 dientes con falsa vía, correspondientes a 50 pacientes. La información se obtuvo a través de: interrogatorio, examen clínico, radiografías e historias clínicas, previo consentimiento de los pacientes. Se procedió al llenado de un formulario confeccionado al efecto. Resultados: el 52,0 % de falsas vías correspondió al grupo de 35 a 59 años, los dientes más afectados fueron los incisivos, con 40,0 %. El 60,0 % de las perforaciones fueron ocasionadas por terapia endodóntica. Se detectó periodontitis en el 30,0 % de los dientes perforados. Conclusiones: las falsas vías fueron predominantes en el grupo de edad de 35 a 59 años, los incisivos fueron los dientes más afectados, la mayoría de las lesiones se produjo durante la terapia endodóntica. Más de la cuarta parte de las lesiones estuvo asociada a periodontitis (AU).

ABSTRACT Introduction: the false way is the artificial opening in the walls of the conduit due to penetration of the dentin; which causes communication between the pulp space and the periodontium. These accidents often occur during endodontic treatments or when preparing the bed for bolt placement. This causes damage to the periodontium, and periodontal pockets may develop. Objective: to identify the frequency of these accidents, and to determine their association with the presence of periodontitis. Materials and methods: a descriptive and cross-sectional study was carried out in the Faculty of Dentistry of Havana, between January 2011 and January 2016. The universe consisted of 50 teeth with false pathway, corresponding to 50 patients. The information was obtained through: interrogation, clinical examination, radiographs and medical histories, with the consent of the patients. A completed form was filled out. Results: 52,0 % of false pathways corresponded to the group of 35 to 59 years, the teeth most affected were the incisors, with 40,0 %. 60,0 % of the perforations were caused by endodontic therapy. Periodontitis was detected in 30,0 % of the perforated teeth. Conclusions: the false pathways were predominant in the age group of 35 to 59 years, the incisors were the most affected teeth, most of the lesions occurred during endodontic therapy. More than a quarter of the lesions were associated with periodontitis (AU).

Instrumento para evaluar conocimientos en enfermeros sobre lesiones no intencionales en la infancia temprana / An Instrument for Assessing Nurses' Knowledge about Unintentional Injuries in Early Childhood

RESUMEN Introducción: Las lesiones no intencionales en la infancia temprana representan un problema de salud por su frecuencia, magnitud, severidad y trascendencia. La prevención de dichas lesiones es compleja y, en la atención primaria, el profesional de enfermería puede y debe ejercer una importante función dirigida a tal fin. Objetivo: Describir el diseño y validación de un instrumento para la evaluación del nivel de conocimientos que tienen los enfermeros sobre lesiones no intencionales en la infancia temprana. Métodos: Estudio metodológico que basó el diseño del instrumento en la literatura científica y la validación en criterio de expertos, que incluyó enfermeras nacionales e internacionales, pedagogos, médicos pediatras y epidemiólogos. El nivel de competencia fue medido por el coeficiente K. La concordancia se midió mediante el Índice Kappa de Cohen. Para medir la comprensión se realizó prueba piloto, con16 enfermeras del Policlínico Área I del municipio Cienfuegos. La confiablidad de consistencia interna se calculó con coeficiente Alfa de Cronbach mediante el programa estadístico Epidat. Resultados: Se obtuvo un instrumento fiable y válido que permite evaluar el nivel de conocimientos sobre lesiones no intencionales en la infancia temprana. Conclusiones: La utilización del instrumento diseñado y validado fue punto de referencia para la identificación nivel de conocimiento y el diseño de intervenciones educativas en la comunidad(AU)

ABSTRACT Introduction: Unintentional injuries in early childhood represent a health problem due to their frequency, magnitude, severity and transcendence. The prevention of such injuries is complex and in the primary care, the nursing professional can and should exercise an important function directed to that end. Objective: Describe the design and validation of an instrument for evaluation of the level of knowledge nurses have about unintentional injuries in early childhood. Methods: Methodological study that based the design of the instrument on the scientific literature and the validation in criterion of experts, who It included national and international nurses, pedagogues, pediatric doctors and epidemiologists. The level of competence was measured by the coefficient K. The concordance was measured by Cohen's Kappa Index. To measure comprehension, a pilot test was carried out, with 16 nurses from the Policlínico Área I of the Cienfuegos municipality. The reliability of internal consistency was calculated with the Cronbach's Alpha coefficient using the statistical program Epidat. Results: A reliable and valid instrument was obtained that allows assessing the level of knowledge about unintentional injuries in early childhood. Conclusions: The use of the designed and validated instrument was a point of reference for the identification level of knowledge and the design of educational interventions in the community(AU)

Factors related to motorcycle accidents with victims: an epidemiological survey / Fatores relacionados com os acidentes de motocicleta: estudo epidemiológico

OBJECTIVE: To evaluate the factors associated with traffic motorcycles accidents. METHODS: The sample consisted of 285 motorcycle accident victims in São Paulo. Data were collected from 24-hour emergency service shifts regarding: conditions of the victims, security equipment, road and vehicle conditions. RESULTS: Victims were mostly young men (92%); 23% used the motorcycle for work (average: 8 hours per day); 45% had owned a motorcycle for less than two years; 77% were licensed motorcycle drivers; 33% had less than four years of qualification; 31% had attended a course of defensive driving. Severe lesions were identified in 67% of the unlicensed drivers. Polytrauma occurred in 9% head trauma in 5% of the entire population. Lower limb fractures occurred more frequently than upper limb (17% vs. 12%). Most wore helmets (90%) but only 18% wore helmet, boots and jacket. Positive readings for alcohol (7%) and drugs (14%) occurred in 21% of victims. Most accidents occurred as a consequence of imprudence (88%), during the day (67%), in dry weather conditions (94%). A side impact was registered in 48% of cases; 80% of motorcycles had an engine capacity up to 250 cc. In 51% of the accidents the person responsible for the accident was the driver of the other vehicle in the accident. CONCLUSION: Most accidents involve motorcyclists who are young male adults, use the motorcycle as a means of transport and do not consider safety, defensive driving and the use of alcohol and drugs as important factors.

OBJETIVOS: Avaliar fatores associados com acidentes de trânsito com motocicletas. MÉTODOS: Foram avaliadas 285 vítimas de acidente de motocicleta em São Paulo. Os dados foram coletados em plantões nas unidades de emergência. Foram coletadas informações sobre: condições das vítimas, uso de equipamentos de segurança, condições de estrada e veículo. RESULTADOS: As vítimas eram principalmente homens jovens (92%); 23% usavam a motocicleta para o trabalho (média: 8 horas por dia); 45% possuíam a motocicleta por menos de dois anos; 77% tinham habilitação para dirigir; 33% tinham menos de quatro anos de habilitação; 31% tinham feito curso de direção defensiva. Lesões graves foram identificadas em 67% dos motoristas não habilitados. Houve politraumatismo em 9% das vítimas e traumatismo craniano em 5% da população avaliada. Fraturas de membros inferiores ocorreram mais frequentemente do em membros superiores (17% contra 12%). A maioria usava capacetes (90%), mas apenas 18% usava capacete, botas e jaqueta. Dosagens positivas de álcool (7%) e drogas (14%) foram vistas e totalizaram 21% de todas as vítimas. A maioria dos acidentes ocorreu como consequência de imprudência (88%), durante o dia (67%) e sem chuva (94%). CONCLUSÃO: A maioria dos acidentes envolve vítimas do sexo masculino, adultos, que usam a motocicleta como meio de transporte e não consideram equipamentos de segurança, condução defensiva e o consumo de álcool e drogas fatores importantes para prevenção dos acidentes.