Epidemiological profile of patients with traumatic spinal fracture / Perfil epidemiológico dos pacientes com fratura traumática de coluna vertebral / Perfil epidemiológico de los pacientes con fractura traumática de la columna vertebral

ABSTRACT Objective: To analyze the epidemiological profile of patients with spinal fractures and the characteristics of the population at risk attended at a university hospital. Methods: The study population is composed of 202 patients diagnosed and treated for vertebral fracture due to trauma. The variables were correlated with each other and the correlations with p<0.05 were considered statistically significant. Results: The ratio of incidence of trauma between the sexes was 3:1 for males. The mean age was 37 years and the age group with the highest incidence was between 20 and 39 years. Traffic accidents were the most frequent mechanism (51.2%) and secondly, falls (33.2%). There was a statistical correlation between trauma mechanisms to age group and region of the spine. The first lumbar vertebra (L1) fracture alone accounted for 21.5% of all cases studied associated with the fall mechanism. Spinal cord injury was recorded in 33.7% of the individuals in the sample. A total of 57.3% of the patients were submitted to surgical treatment and 41.7% to the conservative treatment. The mean hospitalization time was 15 days. Conclusions: Spinal fractures are important determinants of morbidity and mortality in the population with a major impact on economically active individuals, especially males. They are directly associated to traffic accidents in the young population and to falls in the higher age brackets. Primary prevention of trauma is the main mechanism for change in this scenario.

RESUMO Objetivo: Analisar o perfil epidemiológico dos pacientes com fratura da coluna vertebral e as características da população de risco atendida em um hospital universitário. Métodos: A população do estudo é composta de 202 pacientes diagnosticados e tratados por fratura de vértebras devido a trauma. As variáveis foram correlacionadas entre si e consideradas estatisticamente significantes as correlações com p < 0,05. Resultados: A relação da incidência do trauma entre os sexos foi 3:1 para o sexo masculino. A média de idade foi 37 anos e a faixa etária de maior incidência entre 20 e 39 anos. Os acidentes de trânsito foram o mecanismo de mais frequente (51,2%) e em segundo lugar, as quedas (33,2%). Houve correlação estatística dos mecanismos de trauma conforme faixa etária e região da coluna vertebral. A fratura de primeira vértebra lombar (L1) representou sozinha 21,5% de todos os casos estudados associados ao mecanismo queda. A lesão raquimedular foi registrada em 33,7% dos indivíduos da amostra. Um total de 57,3% dos pacientes foi submetido a tratamento cirúrgico e 41,7% ao conservador. O tempo de internação médio foi de 15 dias. Conclusões: As fraturas de coluna são importantes determinantes de morbidade e mortalidade da população, com impacto principal nos indivíduos economicamente ativos, sobretudo do sexo masculino. Estão diretamente associadas a acidentes de trânsito na população jovem e a quedas nas faixas etárias maiores. A prevenção primária do trauma é o principal mecanismo para mudança desse cenário.

RESUMEN Objetivo: Analizar el perfil epidemiológico de los pacientes con fractura de la columna vertebral y las características de la población de riesgo tratada en un hospital universitario. Métodos: La población del estudio está compuesta de 202 pacientes diagnosticados y tratados por fractura de vértebras debido a trauma. Las variables se correlacionaron entre sí y se consideraron estadísticamente significativas las correlaciones comp < 0,05. Resultados: La proporción de incidencia del trauma entre los sexos fue 3:1 para el sexo masculino. La edad media fue de 37 años y el rango de edad de mayor incidencia fue entre 20 y 39 años. Los accidentes de tránsito fueron el mecanismo más frecuente (51,2%) y en segundo lugar, las caídas (33,2%). Se observó correlación estadística entre los mecanismos de trauma según el grupo de edad y la región de la columna vertebral. La fractura de la primera vértebra lumbar (L1) sola representó el 21,5% de todos los casos estudiados asociados al mecanismo de caída. La lesión de la médula espinal se registró en el 33,7% de los individuos de la muestra. Un total de 57,3% de los pacientes fueron sometidos a tratamiento quirúrgico y el 41,7% al conservador. La duración promedio de la estancia hospitalaria fue de 15 días. Conclusiones: Las fracturas de columna son determinantes importantes de morbilidad y mortalidad con impacto principal en los individuos económicamente activos, sobre todo del sexo masculino. Se asocian directamente con los accidentes de tránsito en la población joven y a las caídas en los rangos de edad mayores. La prevención primaria del trauma es el principal mecanismo para cambiar este escenario.

Influence of Plasmodium vivax malaria on the relations between the osmotic stability of human erythrocyte membrane and hematological and biochemical variables.

This study evaluated the influence of infection by Plasmodium vivax on the relations between hematological and biochemical variables and the osmotic stability of the erythrocyte membrane in a Brazilian Amazon population. A total of 72 patients with P. vivax malaria were included in the study and invited to return after 14 days, post-treatment with chloroquine and primaquine, for clinical and laboratorial reevaluations. The osmotic stability of the erythrocyte membrane was analyzed by nonlinear regression of the dependency of the absorbance of hemoglobin, released with hemolysis, as a function of the salt concentration, and it was represented by the inverse of the salt concentration at the midpoint of the curve (1/H 50) and by the variation of salt concentration, which promotes lysis (dX). Bivariate and multivariate methods were used in the analysis of the results. Prior to treatment of the disease, the erythrocytes showed greater stability, probably due to the natural selection of young and also more stable erythrocytes. The bivariate analysis showed that 1/H 50 was positively correlated with red cell distribution width (RDW), urea, triglycerides, and very low-density lipoprotein (VLDL)-cholesterol, but negatively associated with albumin, HDL-cholesterol, and indirect bilirubin, while dX was negatively associated with the mean corpuscular hemoglobin concentration. These associations were confirmed by canonical correlation analysis. Stepwise multiple linear regression showed that albumin, urea, triglycerides, and VLDL-cholesterol are the variables with the highest abilities of predicting erythrocyte stability. The bivariate analysis also showed that the hematological index RDW was related to elevated levels of bilirubin and decreased levels of albumin and urea, associated with liver damage resulting from malaria.