Sistema de indicadores de morbilidad y mortalidad por accidentes de tráfico: una revisión sistemática / System of morbidity and mortality indicators for traffic accidents: a systematic review

RESUMEN Objetivo Elaborar un sistema de indicadores de morbilidad y mortalidad por accidentes de tráfico, con el fin de mejorar los procesos de recopilación y registro de la información de seguridad vial en el país. Materiales y Métodos Revisión sistemática cualitativa de artículos científicos publicados en revistas indexadas en las principales bases de datos (Scopus, PubMed, Lilacs, SciELO, Google Scholar), sobre accidentes de tráfico desde el año 1995 hasta el año 2015. La información recolectada pasó por 4 fases de revisión. Resultados Se seleccionaron 84 indicadores, agrupados en nueve dimensiones: accidentalidad, morbilidad, mortalidad, temporalidad, geoespacial, sociodemográfica, parque vehicular, impacto en salud pública, tipos y causas. Conclusiones Una gestión eficaz sobre seguridad vial exige que cada país cuente con un sistema de indicadores efectivo e institucionalizado que permita recolectar, analizar y gestionar la información de forma rápida y oportuna, enmarcada en el campo de la investigación científica, para difundir a la comunidad y organismos responsables de la seguridad vial, con miras a la adopción de medidas preventivas y correctivas. Por lo que, se recomienda a los organismos competentes de seguridad vial del país incorporar el sistema de indicadores elaborado en la presente investigación, lo cual permitirá contar con un sistema de registro de datos confiables.

ABSTRACT Objective Prepare a system of morbidity and mortality indicators for traffic accidents, to propose its implementation in Ecuador, in order to improve the processes for collecting and recording road safety information in the country. Materials and Methods Qualitative systematic review of scientific articles published in journals indexed in the main databases (Scopus, PubMed, Lilacs, SciELO, Google Scholer), on traffic accidents from 1995 to 2015. The information collected went through 4 phases review. Results 84 indicators were selected, grouped into nine dimensions: accident rate, morbidity, mortality, temporality, geospatial, socio-demographic, vehicle fleet, impact on public health, types and causes. Conclusions An effective management of road safety requires that each country have an effective and institutionalized system of indicators that allows the collection, analysis and management of information in a fast and timely manner, framed in the field of scientific research, to disseminate to the community and organizations. responsible for road safety, with a view to adopting preventive and corrective measures. Therefore, it is recommended that the competent road safety agencies of the country incorporate the system of indicators developed in this research, which will allow them to have a reliable data registration system.

FR - Inhibidores del factor de crecimiento epidérmico y toxicidad cutánea: en busca de un protocolo de manejo / RF - Epidermal Growth Factor Receptor Inhibitors and Skin Toxicity: The Search for a Management Protocol

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Aplicación del colgajo de keystone en dermatología. Experiencia clínica en 18 pacientes / The Keystone Flap in Dermatology: Clinical Experience with 18 Patients

INTRODUCCIÓN Y OBJETIVOS: El colgajo de keystone es un colgajo fasciocutáneo cuya vascularización proviene de las arteriolas perforantes musculares. Su aplicación en dermatología es para cubrir defectos en zonas de piel poco distensible (miembros inferiores, superiores y de la espalda). Presentamos nuestra experiencia clínica y los resultados quirúrgicos del centro. MATERIAL Y MÉTODOS: Estudio descriptivo retrospectivo de pacientes con tumores cutáneos malignos en miembros inferiores en los que se realizó el colgajo de keystone. RESULTADOS: Se operaron 18 pacientes con una edad media de 77,83 años. Se realizaron 17 mediante la técnica propuesta por Behan y uno con la técnica modificada de Moncrieff. El 38,8% de los tumores extirpados fueron carcinomas basocelulares, el 33,3% carcinomas epidermoides y el 27,7% tumores malignos pigmentados. El 72,22% presentaba algún factor de riesgo cardiovascular. Se observó un 38,8% de complicaciones menores y ningún caso de necrosis parcial o total del colgajo. CONCLUSIONES: Consideramos que el colgajo de keystone es una buena alternativa terapéutica a otros colgajos e injertos para la reconstrucción de defectos en miembros inferiores. Los resultados estéticos y funcionales son buenos, con una tasa de éxito elevada

INTRODUCTION AND OBJECTIVES: The keystone flap is a fasciocutaneous flap supplied by perforating arteries. It is used in dermatology to repair surgical defects in areas with low skin extensibility (the upper and lower limbs and the back). We review the clinical experience gained with keystone flap reconstruction at our hospital and report on the surgical outcomes. MATERIAL AND METHODS: Descriptive retrospective study of patients with malignant skin tumors on the lower limbs who underwent keystone flap reconstruction. RESULTS: Eighteen patients (mean age, 77.83 years) underwent keystone flap reconstruction using the Behan technique in 17 cases and the modified Moncrieff technique in one. Basal cell carcinomas accounted for 38.8% of the tumors excised, squamous cell carcinomas 33.3%, and malignant pigmented tumors 27.7%. Cardiovascular risk factors were observed in 72.2% of patients. Minor complications occurred in 38.8% of patients, and there were no cases of partial or total flap necrosis. CONCLUSIONS: We consider the keystone flap to be a good alternative to other flaps and grafts for the surgical reconstruction of lower limb defects. The success rate was high, and the cosmetic and functional outcomes were good

The Keystone Flap in Dermatology: Clinical Experience with 18 Patients. / Aplicación del colgajo de keystone en dermatología. Experiencia clínica en 18 pacientes.

INTRODUCTION AND OBJECTIVES: The keystone flap is a fasciocutaneous flap supplied by perforating arteries. It is used in dermatology to repair surgical defects in areas with low skin extensibility (the upper and lower limbs and the back). We review the clinical experience gained with keystone flap reconstruction at our hospital and report on the surgical outcomes. MATERIAL AND METHODS: Descriptive retrospective study of patients with malignant skin tumors on the lower limbs who underwent keystone flap reconstruction. RESULTS: Eighteen patients (mean age, 77.83 years) underwent keystone flap reconstruction using the Behan technique in 17 cases and the modified Moncrieff technique in one. Basal cell carcinomas accounted for 38.8% of the tumors excised, squamous cell carcinomas 33.3%, and malignant pigmented tumors 27.7%. Cardiovascular risk factors were observed in 72.2% of patients. Minor complications occurred in 38.8% of patients, and there were no cases of partial or total flap necrosis. CONCLUSIONS: We consider the keystone flap to be a good alternative to other flaps and grafts for the surgical reconstruction of lower limb defects. The success rate was high, and the cosmetic and functional outcomes were good.

Vacuna triple vírica como tratamiento de verruga subungueal recalcitrante / Mumps, Measles, and Rubella Vaccine for the Treatment of a Recalcitrant Subungual Wart

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