Shifting patterns of disparities in unintentional injury mortality rates in the United States, 1999-2016 / Tendencias cambiantes en las disparidades en las tasas de mortalidad por traumatismo no intencional en Estados Unidos entre 1999 y 2016 / Mudança nos padrões de disparidade nas taxas de mortalidade por lesões acidentais nos Estados Unidos, 1999-2016

ABSTRACT Objectives. To analyze changes in racial/ethnic disparities for unintentional injury mortality from 1999-2016. Methods. Mortality data are from the National Center for Health Statistics (NCHS) for all unintentional injuries, analyzed separately by injury cause (motor vehicle accidents [MVA], poisonings, other unintentional) for white,black, and Hispanic populations within four age groups: 15-19, 20-34, 35-54, 55-74 for males and for females. Results. Rates across race/ethnic groups varied by gender, age and cause of injury. Unintentional injury mortality showed a recent increase for both males and females, which was more marked among males and for poisoning in all race/ethnic groups of both genders. Whites showed highest rates of poisoning mortality and the steepest increase for both genders, except for black males aged 55-74. MVA mortality also showed an increase for all race/ethnic groups, with a sharper rise among blacks, while Hispanics had lower rates than either whites or blacks. Rates for other unintentional injury mortality were similar across groups except for white women over 55, for whom rates were elevated. Conclusions. Data suggest while mortality from unintentional injury related to MVA and poisoning is on the rise for both genders and in most age groups, blacks compared to whites and Hispanics may be suffering a disproportionate burden of mortality related to MVAs and to poisonings among those over 55, which may be related to substance use.

RESUMEN Objetivos. Analizar cambios en las disparidades por raza y grupo étnico en materia de mortalidad por traumatismos no intencionales de 1999 al 2016. Métodos. Los datos de mortalidad de todos los traumatismos no intencionales provienen del Centro Nacional de Estadísticas Sanitarias y se han analizado por separado por causa de traumatismo (colisiones automovilísticas, intoxicaciones y otras causas no intencionales) y por población blanca, negra e hispana, tanto en hombres como en mujeres, en cuatro grupos etarios: de 15 a 19, de 20 a 34, de 35 a 54 y de 55 a 74. Resultados. Las tasas en todos los grupos raciales y étnicos variaron según el sexo, la edad y la causa del traumatismo. La mortalidad por traumatismo no intencional mostró un aumento reciente tanto en hombres como en mujeres, que fue más marcado en el caso de los hombres, y por intoxicación en todos los grupos raciales y étnicos de ambos sexos. La población blanca mostró las tasas más elevadas de mortalidad por intoxicación y el incremento más acentuado en ambos sexos, con excepción de los hombres negros entre 55 y 74 años de edad. La mortalidad por colisión automovilística también registró un aumento en todos los grupos raciales y étnicos, con un incremento mayor en la población negra, mientras que la población hispana mostró tasas inferiores que la blanca o la negra. Las tasas de mortalidad por otros traumatismos no intencionales fueron similares en todos grupos salvo en el caso de las mujeres blancas de más de 55 años, cuyas tasas mostraron un incremento. Conclusiones. Los datos indican que, si bien la mortalidad por traumatismo no intencional relacionada con colisiones automovilísticas e intoxicación está en alza en ambos sexos y en la mayoría de los grupos etarios, la población negra en comparación con la blanca y la hispana puede estar presentando una carga desproporcionada de mortalidad relacionada con colisiones automovilísticas e intoxicación en personas mayores de 55, que podrían estar relacionado con el consumo de sustancias psicoactivas.

RESUMO Objetivos. Analisar as mudanças nas disparidades étnico-raciais da mortalidade por lesões acidentais no período 1999-2016. Métodos. Os dados de mortalidade foram obtidos do Centro Nacional de Estatísticas de Saúde (NCHS) dos Estados Unidos para todos os tipos de lesões acidentais e analisados em separado por causa de lesão (acidentes de trânsito de veículos a motor, envenenamento/intoxicação e outros tipos de acidentes) em grupos populacionais de brancos, negros e hispânicos de ambos os sexos divididos em quatro faixas etárias: 15-19, 20-34, 35-54 e 55-74 anos. Resultados. As taxas de mortalidade nos grupos étnico-raciais variaram segundo sexo, idade e causa de lesão. Houve um aumento recente na mortalidade por lesões acidentais nos sexos masculino e feminino, sendo mais acentuado no sexo masculino e por envenenamento/intoxicação em todos os grupos étnicos-raciais de ambos os sexos. A população branca apresentou as maiores taxas de mortalidade por envenenamento/intoxicação e o aumento mais acentuado na mortalidade em ambos os sexos, exceto por homens negros de 55-74 anos. Ocorreu também um aumento da mortalidade por acidentes de trânsito de veículos a motor em todos os grupos étnico-raciais, sendo mais acentuado em negros, e a mortalidade na população hispânica foi menor que em brancos ou negros. As taxas de mortalidade por outros tipos de acidentes foram semelhantes em todos os grupos, exceto em mulheres brancas acima de 55 anos que apresentaram taxas elevadas. Conclusões. Os dados analisados indicam que, apesar de a mortalidade por lesões acidentais por acidentes de trânsito de veículos a motor e envenenamento/intoxicação estar aumentando em ambos os sexos e na maioria das faixas etárias, em comparação a brancos e hispânicos, os negros possivelmente sofrem um ônus desproporcional de mortalidade por acidentes de trânsito e envenenamento/intoxicação no grupo acima de 55 anos que pode estar associada ao uso de substâncias químicas.

[Treatment of childhood injuries and violence in public emergency services]. / Atendimentos por acidentes e violências na infância em serviços de emergências públicas.

This study aimed to analyze the profile of treatment for accidents and violence involving children under 10 years of age in Brazil in the year 2011. This was a cross-sectional descriptive study in 71 emergency services in the Brazilian Unified National Health System (SUS), located in the national capital and 24 state capitals. Data were obtained from the Ministry of Health's system of sentinel surveillance services for Violence and Accidents (VIVA Survey). The highest proportion of injuries (67.4%) occurred inside the child's home. Among unintentional injuries, falls were the most frequent (52.4%), followed by running into objects or persons (21.8%) and traffic injuries (10.9%), especially as passengers (bicycles were an important means of transportation involved in the injuries). The vast majority of unintentional injuries are avoidable, and educational measures should be adopted, especially with parents, teachers, the community, and health workers, calling attention to the risks and the adoption of safe behaviors in the home, at school, and in leisure-time activities. Cases of violence are subject to mandatory reporting, and prompt measures should be taken to protect victims.

Atendimentos por acidentes e violências na infância em serviços de emergências públicas / Treatment of childhood injuries and violence in public emergency services / Atención por accidentes y violencia contra la infancia en servicios públicos de urgencias

O objetivo deste artigo foi analisar o perfil dos atendimentos de emergência por acidentes e violências envolvendo crianças menores de 10 anos no Brasil no ano de 2011. Foi realizado estudo transversal, descritivo, em 71 serviços de urgência e emergência no âmbito do SUS, localizados no Distrito Federal e em 24 capitais brasileiras. Os dados foram obtidos no sistema de serviços sentinelas de Vigilância de Violências e Acidentes (VIVA Inquérito), do Ministério da Saúde. A maior proporção das lesões (67,4%) ocorreu no ambiente domiciliar. Dentre as injúrias não intencionais, as quedas foram a ocorrência mais frequente (52,4%), seguidas de choque contra objetos/pessoas (21,8%) e lesões no trânsito (10,9%), destacando-se as vítimas na condição de passageiros, e dentre os meios de locomoção da vítima são destaque as bicicletas. As injúrias não intencionais na grande maioria são evitáveis e devem ser adotadas medidas educativas, em especial junto aos pais, educadores, comunidade, profissionais de saúde e educação, alertando para os riscos e adoção de comportamentos seguros em relação ao ambiente doméstico, escola e de lazer. As violências são objeto de notificação obrigatória, e as ações de proteção às vítimas devem ser instituídas prontamente.

This study aimed to analyze the profile of treatment for accidents and violence involving children under 10 years of age in Brazil in the year 2011. This was a cross-sectional descriptive study in 71 emergency services in the Brazilian Unified National Health System (SUS), located in the national capital and 24 state capitals. Data were obtained from the Ministry of Health’s system of sentinel surveillance services for Violence and Accidents (VIVA Survey). The highest proportion of injuries (67.4%) occurred inside the child’s home. Among unintentional injuries, falls were the most frequent (52.4%), followed by running into objects or persons (21.8%) and traffic injuries (10.9%), especially as passengers (bicycles were an important means of transportation involved in the injuries). The vast majority of unintentional injuries are avoidable, and educational measures should be adopted, especially with parents, teachers, the community, and health workers, calling attention to the risks and the adoption of safe behaviors in the home, at school, and in leisure-time activities. Cases of violence are subject to mandatory reporting, and prompt measures should be taken to protect victims.

El objetivo de este estudio fue analizar el perfil de las consultas de urgencia por causas externas que involucran a niños menores de 10 años en Brasil, 2011. Este estudio transversal, analizando datos de la Violencia de Vigilancia y Accidentes (VIVA), encuesta realizada en 71 servicios de urgencias y emergencias en el Sistema Único de Salud (SUS), con sede en el Distrito Federal y 24 capitales brasileñas. Como resultado de ello el 67,4 % se produjo en el entorno del hogar. Las caídas fueron las más frecuentes (52,4 %), seguidas por la colisión con objetos/personas (21,8%) y las lesiones de tráfico (10,9%). Las lesiones no intencionales en la gran mayoría son evitables y se producen en el hogar y se pueden prevenir. La violencia contra los niños más pequeños son más frecuentemente cometidas por miembros de la familia y están sujetas a notificación obligatoria, destinada a la implantación de medidas de protección a las víctimas.

Epidemiological and clinical characteristics of injuries among adolescents attended at an emergency service in the city of Ribeirão Preto, São Paulo.

CONTEXT AND OBJECTIVE: Injuries are an important cause of morbidity during adolescence, but can be avoided through learning about some of their characteristics. This study aimed to identify the most frequent injuries among adolescents attended at an emergency service. DESIGN AND SETTING: Retrospective descriptive study on adolescents attended at the emergency service of the Teaching Health Center, Faculdade de Medicina de Ribeirão Preto (FMRP), between January 1, 2009, and September 30, 2009. METHODS: Age, sex, type of injury, site, day and time of occurrence, part of body involved, care received, whether the adolescent was accompanied at the time of injury and whether any type of counseling regarding injury prevention had been given were analyzed. RESULTS: Among 180 adolescents attended, 106 (58.8%) were boys and 74 (41.1%) were girls. Their ages were: 10 to 12 (66/36.6%), 12 to 14 (60/33.3%) and 14 to 16 years (54/30%). The injuries had occurred in public places (47.7%) and at home (21.1%). The main types were bruises (45.1%) and falls (39.2%), involving upper limbs (46.1%), lower limbs (31%) and head/neck (13.1%). The injuries occurred in the afternoon (44.4%) and morning (30%), on Mondays (17.7%) and Thursdays (16.6%). Radiological examinations were performed on 53.8%. At the time of injury, 76.1% of the adolescents were accompanied. Some type of counseling about injury prevention had been received by 39.4%. CONCLUSIONS: Although the injuries were of low severity, preventive attitudes need to be incorporated in order to reduce the risks and provide greater safety for adolescents.

Epidemiological and clinical characteristics of injuries among adolescents attended at an emergency service in the city of Ribeirão Preto, São Paulo / Características clínicas e epidemiológicas de lesões entre adolescentes atendidos em um pronto-socorro na cidade de Ribeirão Preto, São Paulo

CONTEXT AND OBJECTIVE: Injuries are an important cause of morbidity during adolescence, but can be avoided through learning about some of their characteristics. This study aimed to identify the most frequent injuries among adolescents attended at an emergency service. DESIGN AND SETTING: Retrospective descriptive study on adolescents attended at the emergency service of the Teaching Health Center, Faculdade de Medicina de Ribeirão Preto (FMRP), between January 1, 2009, and September 30, 2009. METHODS: Age, sex, type of injury, site, day and time of occurrence, part of body involved, care received, whether the adolescent was accompanied at the time of injury and whether any type of counseling regarding injury prevention had been given were analyzed. RESULTS: Among 180 adolescents attended, 106 (58.8 percent) were boys and 74 (41.1 percent) were girls. Their ages were: 10 to 12 (66/36.6 percent), 12 to 14 (60/33.3 percent) and 14 to 16 years (54/30 percent). The injuries had occurred in public places (47.7 percent) and at home (21.1 percent). The main types were bruises (45.1 percent) and falls (39.2 percent), involving upper limbs (46.1 percent), lower limbs (31 percent) and head/neck (13.1 percent). The injuries occurred in the afternoon (44.4 percent) and morning (30 percent), on Mondays (17.7 percent) and Thursdays (16.6 percent). Radiological examinations were performed on 53.8 percent. At the time of injury, 76.1 percent of the adolescents were accompanied. Some type of counseling about injury prevention had been received by 39.4 percent. CONCLUSIONS: Although the injuries were of low severity, preventive attitudes need to be incorporated in order to reduce the risks and provide greater safety for adolescents.

CONTEXTO E OBJETIVO: Lesões são importante causa de morbidade na adolescência, mas podem ser evitadas mediante o conhecimento de algumas de suas características. Este estudo visa identificar as lesões mais frequentes entre adolescentes atendidos em um serviço de pronto-atendimento. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo e descritivo sobre adolescentes atendidos no Pronto-Atendimento do Centro de Saúde Escola da Faculdade de Medicina de Ribeirão Preto (FMRP), entre 01/01/2009 e 30/9/2009. MÉTODOS: Analisou-se idade, sexo, tipo de lesão, local, dia e período do ocorrido, parte do corpo acometida, cuidados recebidos, se o adolescente estava acompanhado no momento da lesão e se havia recebido alguma orientação quanto à prevenção de acidentes. RESULTADOS: Dos 180 adolescentes 106 (58,8 por cento) eram rapazes e 74 (41,1 por cento) moças, com idades entre 10 a 12 anos (66/36,6 por cento), 12 a 14 anos (60/33,3 por cento) e 14 a 16 anos (54/30 por cento). 47,7 por cento das lesões aconteceram em locais públicos e 21,1 por cento, em casa. Os principais foram contusões (45,1 por cento) e quedas (39,2 por cento), acometendo membros superiores (46,1 por cento), membros inferiores (31 por cento) e cabeça/pescoço (13,1 por cento). As lesões ocorreram nos períodos da tarde (44,4 por cento) e manhã (30 por cento) e às segundas-feiras (17,7 por cento) e quintas-feiras (16,6 por cento). Foram realizados exames radiológicos em 53,8 por cento dos pacientes. No momento da lesão 76,1 por cento dos adolescentes estavam acompanhados. 39,4 por cento haviam recebido algum tipo de orientação sobre prevenção de lesões. CONCLUSÕES: Embora as lesões tenham sido de baixa gravidade, é necessário incorporar atitudes preventivas de modo a diminuir os riscos e proporcionar maior segurança aos adolescentes.

Comparative analysis of the characteristics of traumas suffered by elderly and younger patients.

OBJECTIVE: To assess the characteristics of traumas suffered by the elderly by comparison with a group of younger trauma victims. METHODS: Trauma protocols from June 10, 2008 to March 9, 2009 were evaluated including all trauma patients above 13 years of age admitted to the emergency room. Data were collected on trauma mechanism, preexisting diseases, vital signs on admission, injuries diagnosed, trauma index scores, tests and treatment. Patients over 60 years were assigned to the elderly group (Group I). Data were compared between this group and a group of younger patients (Group II), using Student's t test, the chi square test and Fisher's exact test, considering p<0.05 as significant. RESULTS: Two thousand and seventy-five trauma victims were recruited (77.1% male), 211 (10.2%) in group I. The most frequent trauma mechanisms in the elderly were falls (from patients' own height) (41%) and being hit by automobiles (28%). Preexisting diseases were more frequent in Group I and included systemic arterial hypertension and diabetes mellitus. The most frequent injuries to Group I patients were to the extremities, affecting 106 patients (50.2%). Fractures were diagnosed in 18% of the elderly patients. In comparison with younger trauma patients, elderly patients had significantly higher head scores on the AIS (0.75 + 1.17 vs. 0.54 + 1.04) (p=0.014) and lower thoracic (0.15 + 0.62 vs. 0.26 + 0.86) (p=0.018) and abdominal scores (0.05 + 0.43 vs. 0.21 + 0.82) (p<0.001). Severe injuries (AIS > 3) to the head were more frequently observed in Group I (11.4% vs. 7%) (p=0,023). Certain types of injury were more frequent in Group I: subdural hematomas (2.8% vs. 0.8%) (p=0.008), subarachnoid hemorrhages (3.8% vs. 1.3%) (p=0.005) and cerebral contusions (5.2% vs. 2.3%) (p=0.015). CONCLUSION: In comparison to younger trauma victims, the elderly group was characterized by a higher frequency of falls from their own height, concomitant diseases and severe intracranial injuries, including subdural hematoma, cerebral contusions and subarachnoid hemorrhages.

La enfermedad trauma / Trauma disease

Reports of the World Health Organization make known that the non-intentional lesions and the violence (intentional injuries) are a threatening possibility for the world's health and they represnt a 9 per cent of the whole mortality. Around 5,804,000 subjects die yearly due to lesions (16,000 subjects each day). Eight of the 15 causes of death, of the persons between 15 through 25 years old are related to violence or non-intentional injuries, whether they are produced by vehicular collisions, suicides, homicides, suffocation, burns, wars, poisoning or fallz. In Argentina, each year 8,000 subjects die due to vehicular collisions. According with the National Ministry of health, this number represents the 25 per cent of the deaths due to trauma. We think that it is interesing to present two aspects that require a conceptualization with a scientific support: The recognition of trauma as a disease (the disease trauma), and the necessity to not use the term accident to design the lesional mechanism described for non-intentional truama. The participation of institutions in the control of the disease trauma is considered by the authors.

Caracterización clínico - epidemiológica de traumas oculares graves infantiles, Pinar del Río / Clinical-epidemiological characterization of severe ocular traumas in pediatric ages, Pinar del Rio

El objetivo fue caracterizar el comportamiento clínico - epidemiológico de los traumas oculares graves infantiles. Se realizó un estudio descriptivo, longitudinal y retrospectivo cuyo universo estuvo constituido por todos los niños con traumas oculares graves (65) ingresados durante un año (2006-2007) en el Servicio de Oftalmología del Hospital Pediátrico Provincial Pepe Portilla de Pinar del Río (Cuba). El 67,7 por ciento de los ingresados presentó un trauma contuso y el 32,3 por ciento perforante. Predominó el hifema (49,2 por ciento), seguido por la herida corneal perforante (29,2 por ciento) y la catarata (9,2 por ciento). El grupo de edad de 9-12 años (40,0 por ciento), y el sexo masculino (89,2 por ciento) fueron los más afectados. Un 33,8 por ciento de los casos recibió tratamiento quirúrgico. El agente causal más frecuente fue el palo o estaca, con un 29,2 por ciento, seguido por la piedra (18,5 por ciento) y la cerbatana (15,3 por ciento)...(AU)

The objective was to characterize clinical-epidemiological behavior of severe ocular traumas in pediatric ages. A descriptive, longitudinal and prospective study which target group was comprised of all the children suffering from severe ocular traumas (65) who were admitted during a year (2006-2007) in the Ophthalmologic Service at Pepe Portilla Provincial Teaching Pediatric Hospital, Pinar del Rio (Cuba). 67, 7 per cent of the hospitalized patients presented contusions and 32, 3 per cent perforations. Hyphema prevailed (49, 2 per cent), followed by perforating wound in cornea (29, 2 per cent) and cataracts (9, 2 per cent). Ages between 9-12 (40, 0 per cent), male sex (89, 2 per cent) were the most affected; 33, 8 per cent of the cases underwent surgical treatment. The most frequent causal agents were the wooden stick with a 29, 2 per cent, followed by stones (18, 5 per cent) and blowpipe (15, 3 per cent)...(AU)

Evaluación de factores de riesgo en accidentes oculares graves infantiles / Assessment of the risk factors for severe ocular accidents in children

El objetivo fue Evaluar factores de riesgo en accidentes oculares graves infantiles. Se realizó una investigación aplicada, epidemiológica, descriptiva, longitudinal y prospectiva sobre accidentes oculares graves en el Servicio de Oftalmología del Hospital Pediátrico Provincial de Pinar del Río (2006 2007). El universo y muestra estuvo constituido por dos grupos de niños de 1- 20 años, ambos sexos y todas las etnias. Primer Grupo: niños con accidente ocular grave. Segundo Grupo: niños sin accidente ocular; determinándose una muestra total de 130 seleccionados mediante muestreo aleatorio simple. Fueron utilizados métodos empíricos y teóricos de investigación científica. El trauma ocular representó el 87,8 por ciento de los ingresos de urgencia durante el período. Se encontró que el grupo etáreo de 9-12 años (40 por ciento), y sexo masculino (89,2 por ciento) fueron los más afectados. Un 76,9 por ciento de los accidentados residía en zona rural. El 96,9 por ciento se encontraba fuera de la casa y sin compañía de adultos en el momento del trauma. Predominaron las familias con conocimientos y actitudes evaluados de regulares en relación a los accidentes oculares con un 57,7por ciento y 60,8 por ciento respectivamente. Se constató elevada frecuencia de traumas oculares infantiles graves en Pinar del Río, precisando sus factores causales de riesgo y dificultades en la prevención de los mismos...(AU)

The objective was to assess the risk factors for severe ocular accidents in children. An applied, epidemiological, descriptive, longitudinal and prospective research of the severe ocular accidents was conducted in the Ophthalmologic Service at Pepe Portilla Provincial Children Hospital, Pinar del Rio. The target group and the sample were comprised of two groups of children from 1 to 16 years old of both sexes and all ethnics. First group: children and adolescents suffering from severe ocular accidents. Second group: children and adolescents without ocular accidents; a total sample of 130 patients were chosen by means of a simple sampling at random. Empiric and theoretical scientific research methods were used. The ocular trauma represented 87, 8 per cent of the admissions in the emergency service during the period. The group of ages between 9-12 and male sex (89, 2 per cent) were the most affected; 76, 9 per cent lived in rural zones and 96, 9 per cent of the accidents occurred out of the house without adult company; knowledge and attitudes towards ocular accidents were evaluated as fair in families (57,7 per cent and 60,8 per cent respectively). A high frequency of severe ocular traumas in children was verified in Pinar del Rio, specifying causal risk factors and difficulties to prevent these accidents...(AU)

Injury deaths in the metropolitan region of Florianópolis, Southern Brazil, 1996-2002.

The objective was to analyse injury mortality in the metropolitan region of Florianópolis, Brazil, from 1996 to 2002. The study design was an ecological model. The mortality distribution was calculated along with the mortality rate due to injury in general and also by specific causes for each year during the study period and for the region's most populous towns. Injury mortality rates decreased in the period, but the homicide mortality increased by 103% when comparing the years 1996 and 2002. Most of the victims were children, young people and old people. This study confirmed a greater vulnerability among young people and the elderly, predominantly in the male population. The significant increase in the mortality rate due to homicides in this region was particularly noticeable and followed the same trend as has been observed in other regions of the country.

Estimating the distribution of external causes in hospital data from injury diagnosis.

Hospital discharge datasets are a key source for estimating the incidence of non-fatal injuries. While hospital records usually document injury diagnosis (e.g. traumatic brain injury, femur fracture, etc.) accurately, they often contain poor quality information on external causes (e.g. road traffic crashes, falls, fires, etc.), if such data is recorded at all. However, estimating incidence by external causes is essential for designing effective prevention strategies. Thus, we developed a method for estimating the number of hospital admissions due to each external cause based on injury diagnosis. We start with a prior probability distribution of external causes for each case (based on victim age and sex) and use Bayesian inference to update the probabilities based on the victim's injury diagnoses. We validate the method on a trial dataset in which both external causes and injury diagnoses are known and demonstrate application to two problems: redistribution of cases classified to ill-defined external causes in one hospital data system; and, estimation of external causes in another hospital data system that only records nature of injuries. In comparison with age-sex proportional distribution (the method usually employed), we found the Bayesian method to be a significant improvement for generating estimates of incidence for many external causes (e.g. fires, drownings, poisonings). But the method, performed poorly in distinguishing between falls and road traffic injuries, both of which are characterized by similar injury codes in our datasets. While such stop gap methods can help derive additional information, hospitals need to incorporate accurate external cause coding in routine record keeping.

Accident risk in patients with epilepsy.

OBJECTIVE: To compare the risk of accidents in patients with uncontrolled seizures, in seizure-free patients, and in patients with chronic headache. METHOD: This was a prospective longitudinal case-controlled study with interviews. A semi-structured questionnaire was used in the epilepsy and headache outpatient clinics of the Hospital das Clínicas of UNICAMP. RESULTS: Group I was composed of 48 patients with uncontrolled seizures, group II was composed of 24 seizure-free patients and group III was composed of 32 patients with headache. Thirty-nine patients (81%) in group I, 13 (54%) in group II, and 19 (59%) in group III reported accidents in the last two years. In the first group, 649 accidents (89%) were related to epileptic seizures and the average number of accidents not related to seizures was 1.7. The average number of accidents in groups II and III were both 2.4. CONCLUSION: Epileptic seizure was the most important factor determining the occurrence of accidents in people with epilepsy.

Accident risk in patients with epilepsy / Risco de acidentes em pacientes com epilepsia

OBJECTIVE: To compare the risk of accidents in patients with uncontrolled seizures, in seizure-free patients, and in patients with chronic headache. METHOD: This was a prospective longitudinal case-controlled study with interviews. A semi-structured questionnaire was used in the epilepsy and headache outpatient clinics of the Hospital das Clínicas of UNICAMP. RESULTS: Group I was composed of 48 patients with uncontrolled seizures, group II was composed of 24 seizure-free patients and group III was composed of 32 patients with headache. Thirty-nine patients (81 percent) in group I, 13 (54 percent) in group II, and 19 (59 percent) in group III reported accidents in the last two years. In the first group, 649 accidents (89 percent) were related to epileptic seizures and the average number of accidents not related to seizures was 1.7. The average number of accidents in groups II and III were both 2.4. CONCLUSION: Epileptic seizure was the most important factor determining the occurrence of accidents in people with epilepsy.

OBJETIVO: Comparar o risco de acidentes em pacientes com crises epilépticas não-controladas, em pacientes com crises epilépticas controladas e em pacientes com cefaléia crônica. MÉTODO: Estudo prospectivo longitudinal caso-controle realizado por meio de entrevistas com pacientes dos ambulatórios de epilepsia e cefaléia crônica do HC-UNICAMP. RESULTADOS: O grupo I foi composto por 48 pacientes com crises não-controladas, o grupo II foi composto por 24 pacientes com crises controladas e o grupo III foi composto por 32 pacientes com cefaléia crônica. Trinta e nove pacientes (81 por cento) do grupo I, 13 (54 por cento) do grupo II e 19 (59 por cento) do grupo III relataram acidentes nos últimos dois anos. No primeiro grupo, 649 acidentes (89 por cento) foram relacionados a crises epilépticas. A média do número de acidentes não relacionados a crises por pessoa de cada grupo foi 1,7 para o grupo I e 2,4 para os dois outros grupos. CONCLUSÃO: As crises epilépticas foram o principal fator de risco para a ocorrência de acidentes em pacientes com epilepsia.

Report on the collision between a spinner dolphin and a boat in the Fernando de Noronha Archipelago, Western Equatorial Atlantic, Brazil / Relato de colisão entre um golfinho-rotador e uma embarcação no Arquipélago de Fernando de Noronha, Atlântico central equatorial, Brasil

This paper reports a case of collision between an individual spinner dolphin and a boat in the Fernando de Noronha Archipelago, as an example of disturbance potentially caused by tourism industry activities. Photos illustrating the inflicted injuries on the animal are presented, and preventive measures to avoid this kind of accidents are proposed. This is the first report on a collision between spinner dolphins and boats.

Neste artigo, um caso de colisão entre um golfinho-rotador e uma embarcação é registrado no arquipélago de Fernando de Noronha, como um exemplo de perturbação causada potencialmente por atividades turísticas. São apresentadas fotografias ilustrando os ferimentos causados no animal e o uso de medidas de prevenção para evitar este tipo de acidentes é proposto. Este é o primeiro registro de colisão entre golfinhos-rotadores e embarcações.

Accidentes en el hogar / House accidents

Se realiza un estudio epidemiológico transversal de 185 padres de niños que acudieron al Hospital Pediátrico Provincial Docente Mártires de Las Tunas, que presentaron un accidente en el hogar, en el período de tiempo comprendido entre enero y diciembre del 2002, con el objetivo de determinar algunos factores que influyen en la aparición de los mismos en nuestro medio. Los niños entre 1-4 años fueron los más afectados, así como los del sexo masculino. El dormitorio y la cocina fueron los lugares donde más ocurrieron. El horario en que más ocurrieron fue entre 8 y 11:59 AM. Las intoxicaciones fueron las causas más frecuentes de accidentes(AU)

A transversal epidemiological study was made in 185 parents of children who came to the emergency room of the Provincial Pediatric Hospital Mártires de Las Tunas presenting a home accident, during the period from January to December of 2002, with the objective to determine some factors that have influences in the appearance of those accidents in our enviroment. Children from 1 to 4 years old were most affected, as soon as male sex. Bedrooms and kitchens were the places in which ocurred most accidents. Horary in which happened more accidents was 8:00 AM to 11:59 AM . Intoxications were the most frequently causes of accidents(AU)

Salud comunitaria II producción prevención

Presenta investigación de campo sobre la atención primaria de salud

Perspectivas para uma análise interdisciplinar e participativa de acidentes (AIPA) no contexto da indústria de proceso

El objetivo principal de este capítulo es presentar las propuestas conceptuales y metodología sobre el análisis de los accidentes industriales y sus causas, con énfasis en industrias de procesos químicos partiendo de una propuesta que interrelaciona las ciencias sociales y la actualidad con un enfoque epidemiológico en el cual un accidente es tratado como un fenómeno colectivo y de salud pública