Carlos Gorios

Transport accidents among children and adolescents at the emergency service of a teaching hospital in the southern zone of the city of São Paulo

Objective to describe the victim profile and circumstances of transport accidents involving children and adolescents who were attended at a teaching hospital in the southern zone of the city of São Paulo. Methods this was an individual observational case series study among patients up to the age of 19 years who were attended at a hospital in the southern zone of the city of São Paulo, state of São Paulo, Brazil, due to traffic accidents. The files notifying suspected or confirmed cases of violence and accidents (SIVVA files) covering January to December 2012 were analyzed. Results among the 149 cases notified, 64.4% related to males and 35.6% to females. The transport accidents were predominantly among males, irrespective of age. The main injury diagnoses were superficial head trauma (24.8%) followed by multiple non-specified trauma (36.4%), in both sexes. Conclusion transport accidents among children and adolescents occurred more often among males. The main transport accidents among the children and adolescents attended as emergency cases were caused by motor vehicles and motorcycles. Among the accident victims, the largest proportion was attended because of being run over.

Analysis of hospitalization occurred due to motorcycles accidents in São Paulo city

OBJECTIVE: To characterize the motorcycle accidents occurred in the city of São Paulo, SP, Brazil in the year 2013, with emphasis on information about hospital admissions from SIH/SUS. METHODS: This is a retrospective cross-sectional study. The study covered 5,597 motorcyclists traumatized in traffic accident during the year 2013 occurred in the city of São Paulo. A survey was conducted using secondary data from the Information System of Hospitalization Health System (SIH/SUS). RESULTS: In 2013, in the city of São Paulo there were 5,597 admissions of motorcyclists traumatized in traffic accidents, of which 89.8% were male. The admission diagnosis were: leg fracture, femur fracture, and intracranial injury. CONCLUSION: This study confirms other preliminary studies on several points, among which stands out the highest prevalence of male young adults. Level of Evidence II, Retrospective Study.

Accidents involving motorcyclists and cyclists in the municipality of São Paulo: characterization and trends.

Objective To describe the characteristics of motorcycle and bicycle accident victims, according to notifications of suspected and confirmed accidents that have occurred in the municipality of São Paulo. Method This was a descriptive epidemiological study. It covered all accidents (12,924) that occurred involving motorcycles (11,366) and bicycles (1558) between January 2011 and October 2013. Data in the Health Departments information system for surveillance of violence and accidents (SIVVA) was surveyed. Results Motorcycle accidents accounted for 52.1% of the cases notified and bicycles, 7.1%. Males predominated in both types of accidents: 81.6% and 80.6%, respectively. In the motorcycle accidents, the predominant age group among the victims was from 20 to 24 years. Both types of accidents occurred during the daytime (7:00–18:00 h): 37.4% and 27.0% respectively. Among the motorcycle accidents, the driver had been using alcohol in 3% and it was not possible to identify whether this had occurred in 67%. Conclusions Public policies prioritizing financial and human resources applied toward reducing these types of accidents need to be brought in.

MAGNETIC RESONANCE IMAGING FOR DIAGNOSING THE PRE-SLIP STAGE OF THE CONTRALATERAL PROXIMAL FEMORAL EPIPHYSIS IN PATIENTS WITH UNILATERAL EPIPHYSIOLYSIS

To assess the importance of using conventional magnetic resonance imaging and T2 mapping to determine the pre-slip stage of the contralateral epiphysis in patients with a clinical and radiographic diagnosis of unilateral proximal femoral epiphysiolysis who were initially treated with in-situ fixation. Methods: This prospective clinical study on 11 patients with unilateral epiphysiolysis was conducted between February 2009 and August 2010, using magnetic resonance imaging on the contralateral hip. Results: We observed abnormalities in the proximal femoral capital physis of the contralateral unaffected hip, with edema under the growth plate in 27% of the patients assessed. Conclusion: Magnetic resonance imaging is an early and sensitive method for detecting the pre-slip stage of the proximal femoral epiphysis.

Ressonância magnética no diagnóstico do pré-escorregamento da epífise femoral proximal contralateral em pacientes com epifisiólise unilateral

OBJETIVO: Avaliar a importância da ressonância magnetica convencional e com mapa T2 na determinacao do pre-escorregamento da epifise contralateral em pacientes com diagnostico clinico e radiografico de epifisiolise femoral proximal unilateral, tratadas inicialmente com fixacao in situ. METODOS: Estudo clinico prospectivo de 11 pacientes com epifisiolise unilateral entre fevereiro de 2009 e agosto de 2010, com ressonância magnetica do quadril contralateral. RESULTADOS: Verificamos alteracoes na regiao fisaria capital femoral proximal no lado contralateral a doenca, com edema sob a placa de crescimento em 27% dos pacientes analisados. CONCLUSAO: A ressonância magnetica e um metodo sensivel e precoce para deteccao do pre-escorregamento epifisario femoral proximal.

Estudo da rigidez do ligamento cruzado anterior do joelho e dos enxertos para sua reconstrução com o ligamento patelar e com os tendões dos músculos semitendíneo e grácil

Com o objetivo de avaliar a rigidez do ligamento cruzado anterior e dos enxertos preparados para sua reconstrucao a partir da porcao central do ligamento patelar e dos tendoes dos musculos semitendineo e gracil duplos, oriundos dos mesmos joelhos, o autor utiliza 20 joelhos de cadaveres humanos, frescos, todos masculinos, com idade media de 32,2 ± 8,9 anos, variando de 17 a 47 anos. As estruturas analisadas foram submetidas a tres ensaios mecânicos de tracao, com intervalos de 10 minutos para recuperacao, em maquina Kratos K-5002 (eletromecânica), com velocidade de 20 mm/min ate atingir 147,15 N (15 kgf), mantendo-as alongadas por um periodo de 15 minutos. Todas as estruturas observadas apresentam um aumento da rigidez aos sucessivos testes realizados, exceto entre o 2o e o 3o teste do ligamento cruzado anterior onde nao apresentou diferenca estatistica. A analise estatistica permite concluir que os ciclos sucessivos dos ensaios mecânicos determinam um aumento da rigidez dos enxertos analisados.

Femoral Fracture in Elderly: An Avoidable Cause?

Introduction: The frequency of femoral fractures has increased significantly in recent decades. It is known that this is closely related to geriatric population increase in our society, becoming a relevant public health problem. Objective: To identify the epidemiological profile of femoral fractures after an accidental fall among elderly people living in the city of Sao Paulo. Methods: This is a cross-sectional, quantitative, descriptive and retrospective study. We analyzed a total of 188 cases of fall among elderly (60 years old or more) diagnosed with femoral fractures, notified in The Information System for Violence and Accidents Surveillance (SIVVA), between January and October of 2017. Results: The main injury diagnoses among elderly who suffered from fall accidents were femoral neck fracture (28.7%) and pertrochanteric fracture (24.5%). In relation to age and gender, femoral fractures due to accidental fall were predominantly among elderly with 80 years old or more (51.1%) and females (62.8%). Femoral fractures due to falls were more frequent in white individuals (62.2%), main place of occurrence were in the elder residence and during daytime. Conclusion: Femoral fractures among elderly occurred predominantly in female, white individuals, playing a major role due to their high morbimortality, making public health policies for elderly direct a greater attention to this population.

Physical and sexual aggression against elderly persons reported in the city of São Paulo

Objectives : To characterize the population of elderly people who have suffered physical and sexual violence, and describe the features of this aggression based on the Information System for Violence and Injury Surveillance (ISVIS) of the Municipal Health Department of the city of Sao Paulo. Method : A cross-sectional, retrospective study was performed of all cases of elderly victims of physical and sexual violence reported in Sao Paulo in 2013. Results : A total of 602 cases of elderly victims of physical abuse were reported, of which 52.3% were male. In the same period there were ten reported cases of elderly victims of sexual assault, 90% of whom were female. The main diagnosis of injury was head trauma (33.2%) and 65.0% of victims were discharged from hospital immediately. Conclusion : Physical abuse with the use of physical force was higher among male elderly persons, and sexual assault was higher among women. Most of the attacks took place at the residence of the elderly person, and were committed by family members.

Fatores associados à queda em idosos atendidos em hospital da região sul da cidade de São Paulo

Introducao: Atualmente, o aumento da expectativa de vida da populacao, este fenomeno necessita de uma reorganizacao do Sistema de Saude, devido a fragilidade dos idosos pelo seu declinio fisiologico poderem apresentar o risco de sofrer queda. Objetivo: Analisar por meio do prontuario hospitalar, mulheres e homens com idade de 60 anos ou mais, que tenham sido atendidos por queda, no ano 2010, no hospital situado na regiao sul de Sao Paulo. Metodo: Trata-se de um estudo individuado-observacional de serie de casos, com pacientes com 60 anos e mais de idade, que foram atendidos por queda em hospital situado na regiao sul da cidade de Sao Paulo. Resultados: A queda do mesmo nivel foi mais frequente entre os idosos do sexo feminino. Entre os idosos que foram atendidos por queda, a idade foi predominante entre os 75 anos e mais de idade. Conclusao: O tipo de trauma, tanto na queda do mesmo nivel quanto de um nivel ao outro, houve uma frequencia maior trauma superficial da cabeca.