Effectiveness of Text Message Reminders on Adherence to Inhaled Therapy in Patients With Asthma: Prospective Multicenter Randomized Clinical Trial.

BACKGROUND: Poor adherence to inhaled medication in asthma patients is of great concern. It is one of the main reasons for inadequate asthma control. OBJECTIVE: The goal of the research was to determine if motivational messages using short message service (SMS, or text) improved adherence to inhaled medication in patients with asthma. METHODS: A prospective multicenter randomized parallel-group clinical trial was conducted in 10 asthma clinics in Spain. Adherence was assessed with electronic monitors (Smartinhaler, Adherium Ltd) connected to inhalers. Patients in the SMS group received psychologist-developed motivational messages every 3 days for 6 months. RESULTS: There were 53 patients in the SMS group and 88 patients in the control group. After 6 months, mean electronic adherence was 70% (SD 17%) in the intervention group and 69% (SD 17%) in the control group (P=.82). Significant differences between the study groups in morning and evening adherence to inhaled therapy, asthma control, exhaled nitric oxide levels, or improvement of lung functions were not observed. CONCLUSIONS: Motivational messages were not useful to improve adherence to inhaled asthma medication compared with usual care.

A Simple Score for Future Risk Prediction in Patients with Controlled Asthma Who Undergo a Guidelines-Based Step-Down Strategy.

BACKGROUND: The minimum controlling dose of treatment must be established in patients with asthma, but the outcome of step-down is unpredictable. OBJECTIVE: To identify factors associated with risk of control loss when stepping down asthma treatment and to develop a score to predict this risk. METHODS: A prospective, multicenter study including adults with well-controlled asthma was performed. Treatment was stepped up or stepped down over a 12-month period to maintain asthma control. We determined associations between clinical and functional variables and step-down failure. Finally, we derived a score to predict loss of control in 1 cohort and validated it in an independent cohort. RESULTS: The derivation cohort consisted of 228 patients; 218 completed at least 1 step-down episode and a total of 495 step-down episodes were evaluated. A medical-record documented postbronchodilator spirometry result of <70% forced expiratory volume in 1 second (FEV1)/forced vital capacity (odds ratio [OR] = 2.08; 95% confidence interval [CI]: 1.26-3.43), current FEV1 < 80% (OR = 1.80; 95% CI: 1.03-3.14), ≥1 severe exacerbation in the previous 12 months (OR = 2.43; 95% CI: 1.48-4.01), and Asthma Control Test score < 25 (OR = 2.30; 95% CI: 1.35-3.92) were independently associated with failure. The score showed an area under the curve of 0.690 (95% CI: 0.633-0.747; P < .05) in the derivation cohort and 0.76 (95% CI: 0.643-0.882; P < .001) in a validation cohort of 114 patients. A score <4.5 implies a low risk of failure (<20%), whereas a score >8 implies a high risk (>40%). CONCLUSION: This score can facilitate the prediction of step-down failure before medication taper in patients with well-controlled asthma.

Effect of implementing the European guidelines for functional evaluation before lung resection on cardiorespiratory morbidity and 30-day mortality in lung cancer patients: a case-control study on a matched series of patients.

OBJECTIVES: We hypothesized that postoperative cardiorespiratory morbidity and/or 30-day death rates decreased after implementing the new European ERS/ESTS guidelines for functional evaluation before lung resection and tested the hypothesis by means of a case-control study. METHODS: The analysis included a series of 916 consecutive patients who underwent an anatomical pulmonary resection for non-small-cell lung cancer in our centre. Patients were divided into cases (September 2009-August 2012) and controls (December 2002-August 2009). We reviewed the records from a prospective computerized database; the final dataset included no missing data. The primary studied outcomes were the occurrence of cardiorespiratory morbidity or 30-day death after surgery. The patients were 1:1 propensity score matched according to the following variables age, ppoFEV1% and the need of pneumonectomy. RESULTS: After the matching process, 670 cases (335 cases and 335 controls) entered into the study. The rates of pneumonectomy in cases and controls were 5.7 and 13.2%, respectively, (P < 0.0001) in the whole series and 5.7 and 6.9% after matching (P = 0.52). Cardiorespiratory morbidity was 8.1% (27 of 308) in cases and 9.8% (33 of 335) in controls [odds ratio (OR): 0.8; 95% confidence interval (CI): 0.4-1.4]. Thirty-day mortality was 0.90% (3/335) in cases and 1, 2% (4 of 335) in controls (OR: 0.7; 95% CI: 0.1-4.4). CONCLUSIONS: Although we have observed a trend towards lower cardiorespiratory morbidity and 30-day mortality after implementing ERS/ESTS guidelines, the benefit of the guidelines remains unclear. Multicentric analysis including a very large number of cases is needed to demonstrate statistically the effectiveness of the guidelines to reduce operative mortality and cardiorespiratory morbidity. Maybe the effect could be easier demonstrated in series with higher operative mortality or morbidity.

Primera fase de validación del algoritmo europeo de evaluación funcional previa a la resección pulmonar: cuantificación del cumplimiento de las recomendaciones en la práctica clínica real / The initial phase for validating the European algorithm for functional assessment prior to lung resection: Quantifying compliance with the recommendations in actual clinical practice

Objetivo: Cuantificar el grado de cumplimiento de las recomendaciones contenidas en la guía en la práctica clínica publicada en 2009 por la ERS y la ESTS sobre evaluación preoperatoria del riesgo de la resección pulmonar en la actividad asistencial diaria de un hospital terciario. Método: Estudio prospectivo observacional. Registro de datos en tiempo real de los pacientes consecutivos remitidos para evaluación desde septiembre de 2009 a diciembre de 2010. Se ha registrado la presencia o ausencia de los estudios incluidos en el algoritmo, sus resultados y, en caso de ausencia de alguna prueba, por qué no se realizó. Se aportan las tasas de mortalidad hospitalaria y de morbilidad cardiorrespiratoria postoperatoria. Resultados: De 173 pacientes evaluados, 171 casos fueron resecados, con una mortalidad del 1,2% y una morbilidad cardiorrespiratoria del 11,7%. La tasa de fallos del primer nivel del algoritmo fue del 4,6%, y del segundo nivel (prueba de esfuerzo) del 26%. La ausencia de prueba de esfuerzo se debió a problemas estructurales hospitalarios y a la incapacidad del paciente para realizarla. De los pacientes que se sometieron a esta prueba, 31 alcanzaron un VO2max de 20ml/kg-min o más y fueron intervenidos sin cálculo de los valores de FEV1ppo y DCLOppo; 35 precisaron de dicho cálculo para decidir su operabilidad, y en 2 casos no se recomendó la intervención por inoperabilidad funcional del paciente. Conclusiones: En el 18,5% de los casos se han encontrado fallos en la aplicación del algoritmo, fundamentalmente por ausencia de la prueba de esfuerzo. La tasa de adecuación al algoritmo debe ser mejorada antes de poder realizar otros estudios de validación(AU)

Objective: To quantify the degree of compliance with the recommendations of the clinical practice guidelines published in 2009 by the ERS and the ESTS regarding the preoperative assessment of risk of lung resection in daily clinical practice at a tertiary hospital. Method: A prospective, observational study of real-time data collected from consecutive patients who had been referred for evaluation from September 2009 to December 2010. We recorded the presence or absence of the recommended studies included in the algorithm, their results and, when a test was missing, the reasons why it was not performed. Hospital mortality and cardio-respiratory morbidity rates are also presented.Results173 patients were evaluated. In 171 cases, lung resection was performed, with a mortality of 1.2% and a cardio-respiratory morbidity of 11.7%. The failure rate of the first level of the algorithm was 4.6% and for the second level (VO2max test) it was 26%. The absence of exercise tests was mainly due to hospital structural problems and the patients’ inability to perform it. Out of the patients who performed the exercise testing, 31 reached a VO2max of 20ml/kg-min or more and underwent surgery without calculation of FEV1ppo and DCLOppo; 35 patients required the calculation to determine their operability and in 2 cases the intervention was not recommended due to functional inoperability of the patient. Conclusions: The validation process found lack of compliance with the proposed algorithm in 18.5% of the cases basically due to the absence of the exercise tests. The rate of adherence to the algorithm recommendations should be improved before performing any other validation studies(AU)

The initial phase for validating the European algorithm for functional assessment prior to lung resection: quantifying compliance with the recommendations in actual clinical practice.

OBJECTIVE: To quantify the degree of compliance with the recommendations of the clinical practice guidelines published in 2009 by the ERS and the ESTS regarding the preoperative assessment of risk of lung resection in daily clinical practice at a tertiary hospital. METHOD: A prospective, observational study of real-time data collected from consecutive patients who had been referred for evaluation from September 2009 to December 2010. We recorded the presence or absence of the recommended studies included in the algorithm, their results and, when a test was missing, the reasons why it was not performed. Hospital mortality and cardio-respiratory morbidity rates are also presented. RESULTS: 173 patients were evaluated. In 171 cases, lung resection was performed, with a mortality of 1.2% and a cardio-respiratory morbidity of 11.7%. The failure rate of the first level of the algorithm was 4.6% and for the second level (VO(2max) test) it was 26%. The absence of exercise tests was mainly due to hospital structural problems and the patients' inability to perform it. Out of the patients who performed the exercise testing, 31 reached a VO(2max) of 20 ml/kg-min or more and underwent surgery without calculation of FEV(1)ppo and DCLOppo; 35 patients required the calculation to determine their operability and in 2 cases the intervention was not recommended due to functional inoperability of the patient. CONCLUSIONS: The validation process found lack of compliance with the proposed algorithm in 18.5% of the cases basically due to the absence of the exercise tests. The rate of adherence to the algorithm recommendations should be improved before performing any other validation studies.

Value of the average basal daily walked distance measured using a pedometer to predict maximum oxygen consumption per minute in patients undergoing lung resection.

OBJECTIVES: Maximum oxygen consumption per min (VO(2max)) is currently considered the most accurate test for the preoperative risk assessment in patients scheduled for pulmonary resection. Due to its high-technology requirements and cost, VO(2max) is performed less frequently than is desired. The objective of this investigation is to determine if the measurement of the basal daily ambulatory activity of the patients, with a pedometer, can be used to predict VO(2max) values. METHODS: This is a prospective study on 38 patients referred for scheduled lobectomy or pneumonectomy. Daily basal preoperative activity of the patients was measured 3 weeks before surgery by means of an OMROM HJ-72OIT-E2 pedometer. Before surgery, VO(2max) (dependent variable) was calculated using a Master Screen CPX module of Jaeger-Vyasis-Healthcare. The following independent variables were studied: age, sex, preoperative forced expiratory volume in 1s percentage (FEV1%) and carbon monoxide diffusing capacity percentage (DLCO%), mean number of steps per day (aerobic and non-aerobic), mean daily time of aerobic activity (in min) and mean daily walked distance (in km). Two linear regression models with bootstrap robust estimation of the standard error of the coefficients were adjusted and the estimated values of VO(2max) were kept as a new variable for comparison. To avoid collinearity problems, only one of the pedometer records entered the regression model. RESULTS: Data of the series (mean ± SD): age 62.8 ± 10.14 years; FEV1% 90.1 ± 21.8; DLCO% 82.8 ± 20.1. After collinearity analysis, mean daily walked distance was chosen as the most representative variable. In the first regression model, 'Distance' (p = 0.000) was highly correlated to the dependent variable (adjusted R²: 0.812). The second model improved the predictive value of the first one adding DLCO% to the model. In this model, DLCO% (p = 0.000) and 'Distance' (p = 0.002) were correlated to the dependent variable. The adjusted R² of the second lineal model was 0.935. CONCLUSION: These preliminary data show that a combination of the measured daily ambulatory activity using a pedometer, especially the mean daily walked distance in km, and the DLCO% of the patient could predict the VO(2max) value. Larger data series are needed for conclusive results.

[Hemodynamic and inflammatory markers of sleep apnea-hypopnea syndrome and nocturnal hypoxemia: effects of treatment with nasal continuous positive airway pressure]. / Marcadores hemodinámicos e inflamatorios del síndrome de apneas-hipopneas durante el sueño e hipoxemia nocturna. Efectos del tratamiento nasal con presión positiva continua de la vía aérea nasal.

OBJECTIVE: In this study, we assessed factors associated with cardiovascular risk in patients with sleep apnea-hypopnea syndrome (SAHS) through analysis of plasma concentrations of N-terminal prohormone brain natriuretic peptide (NTproBNP) and high-sensitivity C-reactive protein (hsCRP). In addition, we analyzed the effect of nasal continuous positive airway pressure (nCPAP) on these markers. PATIENTS AND METHODS: Forty-two patients with SAHS (mild to moderate in 15 cases and severe in 27) were compared with 14 individuals without SAHS. The participants were not receiving drug treatment and they did not have diabetes, hypertension, marked dyslipidemia, or cardiovascular disease, which was ruled out both clinically and by echocardiography and (99m)Tc-tetrofosmin scintigraphy at rest and during exercise. The effects of nCPAP in patients with severe SAHS were analyzed after 6 months of treatment. RESULTS: Following adjustment for age, body mass index, and smoking habit, the mean concentrations of markers were not significantly higher in patients with severe SAHS than in those with mild-to-moderate SAHS or in control subjects. Nevertheless, in patients with SAHS the main factor influencing NTproBNP concentrations was the percentage of time with a nocturnal arterial oxygen saturation of less then 90% (r=0.37, P=.017). No variables predictive of hsCRP concentration were identified. The concentrations of the markers were reduced by nCPAP, but the differences were not statistically significant. CONCLUSIONS: While nocturnal hypoxemia in SAHS is responsible for variations in the plasma concentration of NTproBNP (as a result of cardiovascular changes), SAHS appears not to be associated with the inflammatory marker hsCRP when patients with heart disease, cardiovascular risk factors, or those receiving pharmacologic treatment are excluded.

Marcadores hemodinámicos e inflamatorios del síndrome de apneas-hipopneas durante el sueño e hipoxemia nocturna. Efectos del tratamiento nasal con presión positiva continua de la vía aérea nasal / Hemodynamic and inflammatory markers of sleep apnea-hypopnea syndrome and nocturnal hypoxemia: effects of treatment with nasal continuous positive airway pressure

OBJETIVO: Investigamos los factores del síndrome de apneas-hipopneas durante el sueño (SAHS) que activan losmecanismos de riesgo cardiovascular, a través del estudio delas concentraciones plasmáticas del fragmento N-terminaldel precursor del péptido natriurético cerebral (NTproBNP)y de la proteína C reactiva de alta sensibilidad (PCRas), asícomo el efecto que sobre ellos tiene el tratamiento con presiónpositiva continua de la vía aérea nasal (CPAPn).PACIENTES Y MÉTODOS: Se estudió a 42 pacientes conSAHS (leve-moderado en 15 casos y grave en 27), comparadoscon 14 personas sin SAHS. No tomaban fármacos nipresentaban diabetes, hipertensión, dislipemia importante oenfermedad cardiovascular, que se descartó tanto clínicamentecomo por ecocardiografía y tomografía computarizadapor emisión de fotón cínico-esfuerzo con 99mTc-tetrofosmina.En los pacientes con SAHS grave se estudiaron losefectos de 6 meses con CPAPn.RESULTADOS: Ajustando por edad, índice de masa corporaly tabaquismo, las medias de los biomarcadores no fueronsignificativamente más altas en los pacientes con SAHS graveque en aquéllos con SAHS leve-moderado o en los controles.Sin embargo, en los pacientes con SAHS el principal factorque influyó en las concentraciones de NTproBNP fue elporcentaje de tiempo con saturación arterial de oxígeno nocturnamenor del 90% (r = 0,37; p = 0,017), sin que se encontraraningún predictor de los valores séricos de la PCRas. Laaplicación de CPAPn hizo descender, pero no significativamente,las concentraciones de los biomarcadores.CONCLUSIONES: Mientras que la hipoxemia nocturna en elSAHS es la responsable de las variaciones en los valores delNTproBNP, derivado de la afectación cardíaca, el SAHS noparece estar asociado con el biomarcador inflamatorioPCRas, cuando se excluye a los pacientes con alteracionescardíacas, factores de riesgo cardiovascular o en tratamiento farmacológico

OBJECTIVE: In this study, we assessed factors associated withcardiovascular risk in patients with sleep apnea-hypopneasyndrome (SAHS) through analysis of plasma concentrationsof N-terminal prohormone brain natriuretic peptide(NTproBNP) and high-sensitivity C-reactive protein (hsCRP).In addition, we analyzed the effect of nasal continuous positiveairway pressure (nCPAP) on these markers.PATIENTS AND METHODS: Forty-two patients with SAHS(mild to moderate in 15 cases and severe in 27) were comparedwith 14 individuals without SAHS. The participants were notreceiving drug treatment and they did not have diabetes,hypertension, marked dyslipidemia, or cardiovascular disease,which was ruled out both clinically and by echocardiographyand 99mTc-tetrofosmin scintigraphy at rest and duringexercise. The effects of nCPAP in patients with severe SAHSwere analyzed after 6 months of treatment.RESULTS: Following adjustment for age, body mass index,and smoking habit, the mean concentrations of markerswere not significantly higher in patients with severe SAHSthan in those with mild-to-moderate SAHS or in controlsubjects. Nevertheless, in patients with SAHS the mainfactor influencing NTproBNP concentrations was thepercentage of time with a nocturnal arterial oxygensaturation of less then 90% (r=0.37, P=.017). No variablespredictive of hsCRP concentration were identified. Theconcentrations of the markers were reduced by nCPAP, butthe differences were not statistically significant.CONCLUSIONS: While nocturnal hypoxemia in SAHS isresponsible for variations in the plasma concentration ofNTproBNP (as a result of cardiovascular changes), SAHSappears not to be associated with the inflammatory markerhsCRP when patients with heart disease, cardiovascularrisk factors, or those receiving pharmacologic treatment are excluded

Estudio diagnóstico-terapéutico de las lesiones bucofaciales por accidente ciclístico / Diagnostic and therapeutic diagnosis of the buccofacial injuries resulting from bicycle accident

Se realizó un estudio descriptivo y transversal sobre aspectos diagnóstico-terapéuticos del trauma maxilofacial por accidente ciclístico en 194 pacientes con lesiones bucofaciales, atendidos en el Servicio de Cirugía Maxilofacial de Urgencia del Hospital Clinicoquirúrgico "Saturnino Lora" de Santiago de Cuba, durante el período comprendido del 1 de octubre de 1998 al 31 de diciembre de 1999. Se encontró que la caída fue el accidente causante del mayor número de lesionados, fundamentalmente no graves, mientras que la colisión produjo el mayor porcentaje de lesiones graves y defunciones. Las lesiones de tejido blando predominaron en este tipo de accidente, sobre todo en las contusiones y laceraciones, generalmente provocadas por las caídas, que originaron la mayor parte y diversidad de las lesiones óseas, con primacía en las fracturas cigomáticas, palatoalveolares y de mandíbula. La colisión sobresalió como causante de las fracturas nasales, nasoetmoidales y de Le Fort combinadas. El cráneo preponderó como región anatómica más afectada, así como también por la diversidad y gravedad de las lesiones asociadas con traumatismos faciales. Prevalecieron las lesiones maxilofaciales de carácter no grave, compatibles con procedimientos no quirúrgicos y atendidas preferentemente de forma ambulatoria(AU)

Estudio diagnóstico-terapéutico de las lesiones bucofaciales por accidente ciclístico / Diagnostic and therapeutic diagnosis of the buccofacial injuries resulting from bicycle accident

Se realizó un estudio descriptivo y transversal sobre aspectos diagnóstico-terapéuticos del trauma maxilofacial por accidente ciclístico en 194 pacientes con lesiones bucofaciales, atendidos en el Servicio de Cirugía Maxilofacial de Urgencia del Hospital Clinicoquirúrgico "Saturnino Lora" de Santiago de Cuba, durante el período comprendido del 1 de octubre de 1998 al 31 de diciembre de 1999. Se encontró que la caída fue el accidente causante del mayor número de lesionados, fundamentalmente no graves, mientras que la colisión produjo el mayor porcentaje de lesiones graves y defunciones. Las lesiones de tejido blando predominaron en este tipo de accidente, sobre todo en las contusiones y laceraciones, generalmente provocadas por las caídas, que originaron la mayor parte y diversidad de las lesiones óseas, con primacía en las fracturas cigomáticas, palatoalveolares y de mandíbula. La colisión sobresalió como causante de las fracturas nasales, nasoetmoidales y de Le Fort combinadas. El cráneo preponderó como región anatómica más afectada, así como también por la diversidad y gravedad de las lesiones asociadas con traumatismos faciales. Prevalecieron las lesiones maxilofaciales de carácter no grave, compatibles con procedimientos no quirúrgicos y atendidas preferentemente de forma ambulatoria(AU)

A descriptive and cross-sectional study on the diagnostic and therapeutic aspects of the maxillofacial trauma due to bicycle accident was undertaken in 194 patients with buccofacial injuries that received attention at the Emergency Maxillofacial Surgery Service of "Saturnino Lora" Clinical and Surgical Hospital in Santiago de Cuba from October 1, 1998 to December 31, 1999. It was observed that fall was the accident that caused the highest number of injured persons, mainly non-severe, whereas collision produced the greatest percentage of severe injuries and deaths. The injuries of the soft tissue prevailed in this type of accident, above all in the contusions and lacerations, generally caused by the fall, which was the mechanism that originated the largest number and diversity of the osteal injuries, with predominance of the zygomatic, palatoalveolar and mandibular fractures. The collision stood out in the production of combined nasal, nasoethmoidal and Le Fort fractures. The most affected region was the cranium. It also showed the highest diversity and severity of the injuries associated with facial traumatisms. It was observed a predominance of the non-severe maxillofacial injuries, which were compatible with the non-surgical procedures and received ambulatory care(AU)

Repercusión oftalmológica de los traumatismos maxilofaciales / Ophthalmological repercussion of maxillofacial traumatisms

Se presenta un estudio prospectivo de 40 pacientes afectados por traumatismos maxilofaciales con lesiones oftalmológicas asociadas, asistidos en el Hospital Clinico quirúrgico Docente "Saturnino Lora" de Santiago de Cuba, durante el año 1995. La lesión oftalmológica más frecuente fue el hematoma palpebral, asociado con un porcentaje significativo de lesiones graves, las cuales estaban en relación con el área afectada durante el traumatismo. Se comportó con incidencia elevada la agudeza visual dentro de los límites normales. La secuela que más se presentó fue la cicatriz deformante de anejos. Se reportan casos de secuelas graves como la pérdida del globo ocular. Los estudios electrofisiológicos demostraron su importancia para la evaluación funcional de las lesiones oftalmológicas(AU)

Epidemiología del trauma maxilofacial por accidente ciclístico / Epidemiology of the maxillofacial trauma caused by bicycle accident

Se realizó un estudio descriptivo y transversal sobre aspectos epidemiológicos del trauma maxilofacial por accidentes ciclísticos en 194 pacientes con diagnóstico clínico, radiográfico o ambos, de lesiones en esta región, que fueron recibidos y atendidos en el Servicio de Urgencia de Cirugía Maxilofacial del Hospital Clinicoquirúrgico "Saturnino Lora" de Santiago de Cuba, durante el período comprendido desde el 1 de octubre de 1998 hasta el 31 de diciembre de 1999. Entre los resultados más sobresalientes figuraron el predominio de los adultos jóvenes de 20 a 39 años de edad, sobre todo de los varones, la caída como modalidad de accidente, la colisión como la causante del mayor número de lesionados graves y defunciones. La imprudencia e ingestión de alcohol en conductores laboralmente activos resultaron ser las causas y víctimas que prevalecieron en este tipo de accidente, particularmente en el horario de 4 p.m. a 12 a.m. y en la calle, esta última la vía donde más accidentes y lesionados se produjeron. Las contusiones y laceraciones dentro de los tejidos blandos y las fracturas zigomáticas, nasales y palatoalveolares dentro del tejido duro, resultaron los patrones de lesiones predominantes(AU)

Repercusión oftalmológica de los traumatismos maxilofaciales / Ophthalmological repercussion of maxillofacial traumatisms

Se presenta un estudio prospectivo de 40 pacientes afectados por traumatismos maxilofaciales con lesiones oftalmológicas asociadas, asistidos en el Hospital Clinico quirúrgico Docente "Saturnino Lora" de Santiago de Cuba, durante el año 1995. La lesión oftalmológica más frecuente fue el hematoma palpebral, asociado con un porcentaje significativo de lesiones graves, las cuales estaban en relación con el área afectada durante el traumatismo. Se comportó con incidencia elevada la agudeza visual dentro de los límites normales. La secuela que más se presentó fue la cicatriz deformante de anejos. Se reportan casos de secuelas graves como la pérdida del globo ocular. Los estudios electrofisiológicos demostraron su importancia para la evaluación funcional de las lesiones oftalmológicas(AU)

A prospective study of 40 patients suffering from maxillofacial traumatisms with associated ophthalmological injuries that recieved attention at "Saturnino Lora" Clinical and Surgical Teaching Hospital, in Santiago de Cuba, in 1995, was presented. The most frequent ophthalmological injury was the palpebral hematoma associated with a significant percentage of severe injuries, which were related to the area affected during traumatism. Visual acuity had an elevated incidence within the normal limits. The adnexa deforming scar was the most common sequela. Cases of severe sequelae, such as the loss of the eyeball, were reported(AU)

Epidemiología del trauma maxilofacial por accidente ciclístico / Epidemiology of the maxillofacial trauma caused by bicycle accident

Se realizó un estudio descriptivo y transversal sobre aspectos epidemiológicos del trauma maxilofacial por accidentes ciclísticos en 194 pacientes con diagnóstico clínico, radiográfico o ambos, de lesiones en esta región, que fueron recibidos y atendidos en el Servicio de Urgencia de Cirugía Maxilofacial del Hospital Clinicoquirúrgico "Saturnino Lora" de Santiago de Cuba, durante el período comprendido desde el 1 de octubre de 1998 hasta el 31 de diciembre de 1999. Entre los resultados más sobresalientes figuraron el predominio de los adultos jóvenes de 20 a 39 años de edad, sobre todo de los varones, la caída como modalidad de accidente, la colisión como la causante del mayor número de lesionados graves y defunciones. La imprudencia e ingestión de alcohol en conductores laboralmente activos resultaron ser las causas y víctimas que prevalecieron en este tipo de accidente, particularmente en el horario de 4 p.m. a 12 a.m. y en la calle, esta última la vía donde más accidentes y lesionados se produjeron. Las contusiones y laceraciones dentro de los tejidos blandos y las fracturas zigomáticas, nasales y palatoalveolares dentro del tejido duro, resultaron los patrones de lesiones predominantes(AU)

A descriptive cross-sectional study on epidemiological aspects of the maxillofacial trauma caused by bicycle accidents was conducted among 194 patients with clinical or radiographic diagnosis, or both, of injuries in this region. They received attention at the Emergency Service of Maxillofacial Surgery of "Saturnino Lora" Clinical and Surgical Hospital, in Santiago de Cuba, from October 1st, 1998 to December 31st, 1999. Some of the most significant results were: the predominance of young adults aged 20-39, mainly males, among the victims, the fall as an accident modality, the collision as the cause of the highest number of severe injures and deaths, and imprudence and alcohol ingestion in working drivers. These were some of the prevailing causes in this type of accident, ocurring particularly from 4 pm to 12 am, in the street, where most of the accidents and injuries are reported. The contusions and lacerations within the soft tissues and the zygomatic, nasal and palatoalveolar fractures in the hard tissue were the predominating injury patterns(AU)