[Epidemiology of maxillofacial fractures due to traffic accidents in Medellin (Colombia)]. / Epidemiología de las fracturas maxilofaciales por accidente de tráfico en Medellín (Colombia).

OBJECTIVE: To characterize maxillofacial fractures due to traffic accidents in patients attending the Hospital Universitario San Vicente Fundación (Medellin-Colombia) from 1998 to 2010. METHODS: A descriptive study (n =1609) was carried out with information from the medical records of patients meeting the inclusion criteria established by the general objective of the study. The variables consisted of sex, age, year, type and number of fractures, and type of vehicle. A descriptive analysis of the variables was performed and the frequency of fractures due to traffic accidents was calculated according to year and sex. Crude and adjusted odds ratios (aOR) were estimated to establish associations among age, type of vehicle, and the presence of two or more fractures with stratification by sex. RESULTS: The frequency of maxillofacial fractures due to traffic accidents increased in 2007 (men: n=198, women: n=35) and decreased from 2008 to 2010 in both sexes. Fractures were more frequent in persons aged <35 years (80%) and in men (82%). The highest frequency of fractures was observed in motorists. Male users of motorcycles (aOR=1.41; confidence interval 95% [95%CI]: 1.02- 1.94) and bicycles (aOR=1.61; 95%CI: 1.01- 2.56) were more likely to report two or more fractures compared with pedestrians, after adjustment for other variables. CONCLUSIONS: Most maxillofacial fractures occurred in men and in motorists. Future studies should analyze other determinants affecting the epidemiology of maxillofacial fractures. Strategies should be designed to improve the use of protective elements and drivers' knowledge and practices.

Epidemiología de las fracturas maxilofaciales por accidente de tráfico en Medellín (Colombia) / Epidemiology of maxillofacial fractures due to traffic accidents in Medellin (Colombia)

Objetivo: Caracterizar las fracturas maxilofaciales por accidente de tráfico en pacientes del Hospital Universitario San Vicente Fundación (Medellín-Colombia, 1998-2010). Métodos: Estudio descriptivo (n=1609) con la información de las historias clínicas de los pacientes que cumplieron los criterios de inclusión según el objetivo general. Variables: sexo, edad, año, número de fracturas, tipo de fractura, tipo de vehículo. Análisis descriptivo de las variables y de la frecuencia de las fracturas por accidente de tráfico según año de estudio y sexo. Se calcularon odds ratios crudas y ajustadas (ORa) mediante regresión logística con el fin de establecer asociaciones entre la edad y el tipo de vehículo con la presencia de dos o más fracturas estratificando por sexo. Resultados: Se observa un aumento en la frecuencia de fracturas maxilofaciales por accidente de tráfico en el año 2007 (hombres, n=198; mujeres, n=35), y un descenso en el periodo 2008-2010 para ambos sexos. Las fracturas ocurrieron con más frecuencia en menores de 35 años (80%) y en hombres (82%). La mayor frecuencia de fracturas ocurre en motoristas. Los hombres usuarios de motocicleta (ORa=1,41; intervalo de confianza del 95% [IC95%]: 1,02-1,94) y bicicleta (ORa=1,61; IC95%: 1,01-2,56) tuvieron una mayor probabilidad de presentar dos o más fracturas, en comparación con los peatones, tras ajustar por otras variables. Conclusiones: La mayoría de las fracturas ocurrieron en hombres y en motocicleta. Es necesario explorar otros determinantes que afectan su epidemiología y promover estrategias que permitan mejorar el uso de elementos de protección, así como los conocimientos y las prácticas de los conductores (AU)

Objective: To characterize maxillofacial fractures due to traffic accidents in patients attending the Hospital Universitario San Vicente Fundación (Medellin-Colombia) from 1998 to 2010. Methods: A descriptive study (n =1609) was carried out with information from the medical records of patients meeting the inclusion criteria established by the general objective of the study. The variables consisted of sex, age, year, type and number of fractures, and type of vehicle. A descriptive analysis of the variables was performed and the frequency of fractures due to traffic accidents was calculated according to year and sex. Crude and adjusted odds ratios (aOR) were estimated to establish associations among age, type of vehicle, and the presence of two or more fractures with stratification by sex. Results: The frequency of maxillofacial fractures due to traffic accidents increased in 2007 (men: n=198, women: n=35) and decreased from 2008 to 2010 in both sexes. Fractures were more frequent in persons aged <35 years (80%) and in men (82%). The highest frequency of fractures was observed in motorists. Male users of motorcycles (aOR=1.41; confidence interval 95% [95%CI]: 1.02- 1.94) and bicycles (aOR=1.61; 95%CI: 1.01- 2.56) were more likely to report two or more fractures compared with pedestrians, after adjustment for other variables. Conclusions: Most maxillofacial fractures occurred in men and in motorists. Future studies should analyze other determinants affecting the epidemiology of maxillofacial fractures. Strategies should be designed to improve the use of protective elements and drivers’ knowledge and practices (AU)

[The social vulnerability index regarding Medellín's disabled population]. / Índice de vulnerabilidad de la población en situación de discapacidad en Medellín.

OBJECTIVE: Constructing a social vulnerability index (SVI) for Medellín's disabled population during 2008 aimed at determining areas which were reducing opportunities for this population to use their tangible and intangible assets, thus impairing their quality of life. METHODS: This descriptive cross-sectional study drew on a source of secondary information regarding people having some kind of limitation recorded in the Quality of Life Survey, 2008. Physical, human and social variables were grouped when constructing the SVI; the models were run in principal component analysis to determine their degree of vulnerability, defined by the number of negative factors identified (high category=4 or 5, medium=2 or 3 and low=1 or none). Such classification led to identifying non-causal relationships with demographic variables through Mann-Whitney, Chi-square and Kruskal-Wallis tests (5.0 % statistical significance level); multinomial logistic regression was used for calculating adjusted measures for epidemiological measurement, such as opportunity ratios and confidence intervals. RESULTS: A degree of medium vulnerability predominated in disabled people living in Medellín (60.3 %) followed by low vulnerability (28.7 %) and high vulnerability populations (11.0 %). CONCLUSIONS: The proposed ISV classified the city's communes according to high, medium or low vulnerability, supported by the use of statistical and spatial location techniques.

Índice de vulnerabilidad de la población en situación de discapacidad en Medellín / The social vulnerability index regarding Medellín's disabled population

Objetivo Construir un índice de vulnerabilidad para la población de Medellín en situación de discapacidad en el 2008, con el fin de determinar los aspectos que disminuyen las oportunidades de hacer uso de sus activos materiales e inmateriales, deteriorando por ende la calidad de vida de esta población. Métodos Estudio descriptivo transversal, con fuente de información secundaria de personas con algún tipo de limitación registrada en la Encuesta de Calidad de Vida 2008. En la construcción del índice se agruparon las variables en los componentes físico, humano, social, se corrieron modelos de análisis de componentes principales para determinar los grados de vulnerabilidad, los cuales se definieron según número de factores negativos identificados, quedando la categoría alta (4 ó 5), mediana (2 ó 3), y baja (1 o ninguno). Con esta clasificación, se identificaron relaciones no causales con las variables demográficas, a través de las pruebas de Mann-Whitney, Chi-cuadrado y Kruskal-Wallis, con nivel de significación estadística del 5,0 %;y medidas epidemiológicas, como razón de oportunidad e intervalo de confianza, se calcularon medidas ajustadas a través de regresión logística multinomial. Resultados El grado de vulnerabilidad media predominó en las personas en situación de discapacidad de Medellín con el 60,3 %, seguido de la población con baja vulnerabilidad (28,7 %) y con alta vulnerabilidad se encontró el 11,0 %. Conclusiones El índice de vulnerabilidad que se propone, clasifica las comunas de la ciudad según vulnerabilidad alta, media o baja, apoyado en el uso de técnicas estadísticas y de ubicación espacial.

Objective Constructing a social vulnerability index (SVI) for Medellín's disabled population during 2008 aimed at determining areas which were reducing opportunities for this population to use their tangible and intangible assets, thus impairing their quality of life. Methods This descriptive cross-sectional study drew on a source of secondary information regarding people having some kind of limitation recorded in the Quality of Life Survey, 2008. Physical, human and social variables were grouped when constructing the SVI; the models were run in principal component analysis to determine their degree of vulnerability, defined by the number of negative factors identified (high category=4 or 5, medium=2 or 3 and low=1 or none). Such classification led to identifying non-causal relationships with demographic variables through Mann-Whitney, Chi-square and Kruskal-Wallis tests (5.0 % statistical significance level); multinomial logistic regression was used for calculating adjusted measures for epidemiological measurement, such as opportunity ratios and confidence intervals. Results A degree of medium vulnerability predominated in disabled people living in Medellín (60.3 %) followed by low vulnerability (28.7 %) and high vulnerability populations (11.0 %). Conclusions The proposed ISV classified the city's communes according to high, medium or low vulnerability, supported by the use of statistical and spatial location techniques.

Educación, salud y empleo de la población con algún tipo de limitación. Medellín, 2008 / Education, health and employment of people with some sort of limitation. Medellin, 2008 / Educação, saúde e emprego da povoação com algum tipo de limitação. Medellin, 2008

Objetivo: describir las características sociales, demográficas y los componentes de educación, salud y empleo de la población con algún tipo de limitación de la ciudad de Medellín, 2008. Materiales y Métodos: estudio descriptivo transversal, con fuente de información secundaria de 4283 personas con algún tipo de limitación (sensorial, física, mental o del habla) registradas en la Encuesta de Calidad de Vida 2008. El análisis fue univariado y bivariado según sexo y comuna, se acompañó con pruebas estadísticas. Resultados: de las personas con algún tipo de limitación, el 53,2% eran mujeres, con 46 años en promedio, el 84,5% están afiliados a salud, el 26,2% están incapacitados permanentemente para trabajar y el 78% de las personas con algún tipo de limitación no recibió ingresos de ningún tipo en el año 2008. La limitación más prevalente fue la sensorial (48,6%), seguida de la física (39,3%), mental (26,3%) y del habla (14,4%). Estas últimas presentaron un 38,4% de analfabetismo y el 35% de los limitados físicos presentó deserción escolar. Conclusiones: se evidenció una relación directamente proporcional entre la edad y la presencia de algún tipo de discapacidad; adicional a esto, existen factores económicos, educativos y de salud que deterioran su calidad de vida y aumentan su vulnerabilidad.

Objective: To describe the social, demographic characteristics and the education, health, and employment components of people with some kind of limitation in the city of Medellin, 2008. Materials and Methods: descriptive transversal study with secondary data source of 4,283 people with some type of limitation (sensory, physical, mental or speech) recorded in the 2008 Quality of Life Survey. The univariate and bivariate analysis was carried out by sex and district, and it was accompanied by statistical tests. Results: of those people with some kind of limitation, 53.2% were women, 46 years old average, 84.5% are part of the health system, 26.2% are permanently disabled to work and 78% of these people with some kind of limitation did not receive any income in 2008. The most prevalent limitation was the sensory limitation (48.6%), followed by physical limitation (39.3%), mental limitation (26.3%) and speech limitation (14.4%). These last ones showed a 38.4% illiteracy and 35% of the physically limited presented school dropout. Conclusions: A direct relationship between age and the presence of a disability was evident. In addition to this there is economical, educational and health factors deteriorate their quality of life and increase their vulnerability.

Objetivo: descrever as características sociais demográficas e os componentes de educação, saúde e emprego da povoação com algum tipo de limitação da cidade de Medellín, 2008. Materiais e Métodos: pesquisa descritiva transversal, com fonte de informação secundaria de 4283 pessoas com algum tipo de limitação (Sensorial, física, mental o de falar) registrado na Enquete de Qualidade de Vida 2008. O analise foi uni- variado e bivariado segundo sexo e comuna, acompanhou se testes estadísticos. Resultados: das pessoas com algum tipo de limitação, o 53,2% foram mulheres, com 46 anos em meia, o 84,5% estão afiliados a saúde, o 26,2% são deficientes físicos permanentes para trabalhar e o 78% das pessoas com algum tipo de deficiência física não recebeu ingressos de nenhum tipo no ano 2008. A deficiência física mais prevalente foi a sensorial (48,6%), seguida da física (39,3%), mental (26,3%) e do fala (14,4%). Esta ultima apresentou um 38,4% de analfabetismo e o 35% dos limitados físicos apresentou deserção escolar. Conclusões: evidenciou se uma relação diretamente proporcional entre idade e a presença de algum de tipo de deficiência; adicional a isto, existem fatores econômicos, educativos e de saúde que deterioraram sua qualidade de vida e aumentam sua vulnerabilidade.