Selma Maffei de Andrade

Characteristics of traffic accidents and victims treated through a pre-hospital service in a city in southern Brazil, 1997/2000

Traffic accidents and the resulting injury and trauma constitute an important social and public health problem. The objective of this study was to analyze the characteristics of such accidents and the victims treated by the only pre-hospital service -- the Integrated Trauma and Emergency Aid Service (SIATE) -- in the city of Londrina, Paraná State, southern Brazil, from 1997 to 2000. All victims (14,474) registered in the SIATE database were studied. The majority (> 70.0%) were male and aged 10 to 39 years. Motorcyclists were the most frequent victims (> 40.0%), and accidents occurred most frequently in December, on weekends (especially Saturdays), and at night. These results are consistent with those of other studies showing the need to implement preventive measures targeting young males, especially motorcyclists.Traffic accidents and the resulting injury and trauma constitute an important social and public health problem. The objective of this study was to analyze the characteristics of such accidents and the victims treated by the only pre-hospital service - the Integrated Trauma and Emergency Aid Service (SIATE) - in the city of Londrina, Parana State, southern Brazil, from 1997 to 2000. All victims (14,474) registered in the SIATE database were studied. The majority (> 70.0%) were male and aged 10 to 39 years. Motorcyclists were the most frequent victims (> 40.0%), and accidents occurred most frequently in December, on weekends (especially Saturdays), and at night. These results are consistent with those of other studies showing the need to implement preventive measures targeting young males, especially motorcyclists.

Características das vítimas por acidentes de transporte terrestre em município da Região Sul do Brasil

OBJETIVO: Avaliar a magnitude da morbimortalidade por acidentes de transporte terrestre e as caracteristicas das vitimas. METODOS: Foram estudadas 3.643 vitimas de acidentes de transporte terrestre ocorridos em Londrina, Parana, no primeiro semestre de 1996, abrangendo as registradas pela Policia Militar, as que morreram no local do evento ou no trajeto para o hospital, alem das atendidas em servicos de pronto-socorro ou internadas pelo Sistema Unico de Saude. Foi observado um prazo de 180 dias para verificar ocorrencia de obito. RESULTADOS: Os coeficientes de incidencia de agravos e de mortalidade medios por acidentes de transporte terrestre foram de 1582,2 e 29,0 por 100.000 habitantes, respectivamente. Esses coeficientes, entretanto, mostraram grande variabilidade em relacao a diversas caracteristicas (local de residencia, sexo, idade e categoria da vitima). Motociclistas representaram o principal tipo de vitima, seguidos por ciclistas e pedestres, perfazendo, juntos, 76,9% do total de vitimas e 81,5% das que morreram. CONCLUSOES: Os resultados revelam que os acidentes de transporte terrestre constituem-se importante causa de morbimortalidade e sugerem a necessidade de estrategias especificas de prevencao com vistas a reduzir esses eventos, principalmente os que envolvem os usuarios mais vulneraveis da via publica.OBJECTIVE To evaluate the magnitude of morbidity and mortality and describe some of the characteristics of road accident victims. METHODS The study population was composed of 3,643 victims of road accidents which occurred in Londrina, PR (Brazil), during the first semester of 1996. There were included victims from accidents registered by the Military Police, those who died at the accident scenario or on their way to the hospital, those who received emergency care or were hospitalized through the Unified Care System. It was observed a period of 180 days for death verification. RESULTS The mean incidence and mortality rates were 1,582.2 and 29. 0 per 100,000 inhabitants, respectively. These rates, however, have demonstrated great variability in relation to several characteristics (place of residence, gender, age and the victims mode of transport). The majority of victims were motorcyclists, followed by cyclists and pedestrians who, altogether, accounted for 76.9% of the total, and 81.5% of those who died. CONCLUSIONS These results suggest that road accidents constitute a major cause of morbidity and mortality and that specific preventive measures should be considered in order to reduce such accidents, especially those that involve the most vulnerable road passers.OBJETIVO: Avaliar a magnitude da morbimortalidade por acidentes de transporte terrestre e as caracteristicas das vitimas. METODOS: Foram estudadas 3.643 vitimas de acidentes de transporte terrestre ocorridos em Londrina, Parana, no primeiro semestre de 1996, abrangendo as registradas pela Policia Militar, as que morreram no local do evento ou no trajeto para o hospital, alem das atendidas em servicos de pronto-socorro ou internadas pelo Sistema Unico de Saude. Foi observado um prazo de 180 dias para verificar ocorrencia de obito. RESULTADOS: Os coeficientes de incidencia de agravos e de mortalidade medios por acidentes de transporte terrestre foram de 1582,2 e 29,0 por 100.000 habitantes, respectivamente. Esses coeficientes, entretanto, mostraram grande variabilidade em relacao a diversas caracteristicas (local de residencia, sexo, idade e categoria da vitima). Motociclistas representaram o principal tipo de vitima, seguidos por ciclistas e pedestres, perfazendo, juntos, 76,9% do total de vitimas e 81,5% das que morreram. CONCLUSOES: Os resultados revelam que os acidentes de transporte terrestre constituem-se importante causa de morbimortalidade e sugerem a necessidade de estrategias especificas de prevencao com vistas a reduzir esses eventos, principalmente os que envolvem os usuarios mais vulneraveis da via publica.

The new Brazilian traffic code and some characteristics of victims in southern Brazil

Objective—The aim was to study characteristics of traffic accident victims before and after the implementation of the new Brazilian traffic code, in January 1998. Subjects and methods—The study population was car and motorcycle occupants seen in a pre-hospital care service in Londrina, Paraná State (Brazil) before the introduction of the new Brazilian traffic code, from 22 January to 21 July 1997, and after its implementation during the same period in 1998. Victims were analyzed over the time periods according to helmet and seat belt use, gender, underage driving, and alcohol on the breath. Results—Use of seat belts increased from 45% to 62.6% and of helmets from 31.2% to 66.2% after the introduction of the new Brazilian code. The proportion driving under age 18 and with perceptible alcoholic breath declined significantly only among motorcycle riders. There was a 20% decline in car occupant injuries along with a 9% reduction in motorcycle related injuries after the change of the law. Conclusion—Results favor the hypothesis that rigorous legislation increases safer practices in traffic, at least during the first months of its implementation.

Causas externas entre menores de 15 anos em cidade do Sul do Brasil: atendimentos em pronto-socorro, internações e óbitos

OBJETIVO: Identificar causas de atendimento hospitalar ou de morte e lesoes entre menores de 15 anos vitimas de causas externas (acidentes ou violencias), residentes em Londrina, Parana, em 2001. METODO: Estudo transversal, com coleta retrospectiva de dados. As informacoes sobre morbidade foram coletadas em prontuarios dos cinco hospitais gerais da cidade, e as de mortalidade no Nucleo de Informacao em Mortalidade do Municipio, com classificacao dessas causas e do trauma gerado de acordo com a Classificacao Internacional de Doencas. RESULTADOS: Foram estudados 8.854 menores de 15 anos, com 95,7% de atendimento em pronto-socorro e alta. Entre os atendidos em pronto-socorro, com alta, houve predominância de quedas (33,9%), seguidas de eventos de intencao indeterminada (31,8%) e de acidentes causados por forcas inanimadas (15,5%), principalmente por penetracao de corpo estranho em orificio natural (4,6%) ou atraves da pele (3,2%). Nesse nivel de atencao predominaram traumatismos superficiais (32,9%) e ferimentos (29,3%). Quedas tambem foram as principais causas entre os internados (32,4%), seguidas de acidentes de transporte (19,5%), acidentes causados por forcas inanimadas (15,7%) e envenenamentos (13,5%). Entre os internados, as principais lesoes foram traumatismos superficiais (22,0%) e fraturas (19,5%). Acidentes de transporte (44,4%) e afogamento (16,7%) foram as principais causas externas de obito e o traumatismo crânio-encefalico a principal lesao fatal (50,0%). CONCLUSOES: As causas e os tipos de lesao diferem segundo o nivel de atencao e indicam a necessidade de reestruturacao dos servicos de saude visando descentralizar o atendimento as lesoes de menor complexidade.

Perfil do trabalho e acidentes de trânsito entre motociclistas de entregas em dois municípios de médio porte do Estado do Paraná, Brasil

This cross-sectional study focused on motorcycle couriers (work profile, work conditions, and traffic accidents) in Londrina and Maringá, Paraná State, Brazil. Data were collected from self-completed questionnaires in 2005-2006. In Londrina and Maringá, respectively, 377 and 500 motorcycle couriers completed the questionnaire, with mean ages of 28 and 29 years. Londrina showed a higher proportion of couriers that earned per delivery, worked both day and night or on night shifts only, and who worked more than 10 hours a day (p < 0.05). Despite greater exposure to hazardous work and traffic conditions in Londrina, there was no significant difference in the accident rates during the 12 months prior to the survey in Londrina and Maringá (2.89 and 2.80 per 100 person-months, respectively). The study detected precarious work conditions, high exposure to hazardous traffic conditions, and high accident rates among motorcycle couriers.

Acidentes de transporte terrestre em município da Região Sul do Brasil

The study was conducted in the municipality of Londrina, a medium-sized city of southern Brazil. Analysis was performed in the characteristics of road accidents that had occurred during the first semester of 1996, resulting in 3,643 victims. Car or small truck collisions were the most common type of accident. The rate of motorcycle-related injuries (per 1,000 registered vehicles) was seven times higher than that resulting from cars or small trucks. Fatality rates were higher for motorcyclists who collided with stationary objects (29.4%) and pedestrians who were injured by lorries or buses (22.2%), in comparison with a mean fatality rate of 1.8%. This information may provide a basis for the implementation of public policies aiming at reducing accidents.

Queimaduras em crianças e adolescentes: análise da morbidade hospitalar e mortalidade

Objective: this research analyzed the hospital incidence and mortality due to burns in children aged less than 15 who live in Londrina, and were treated in emergency services, hospitalized or who died because of this in 2001. Methods: This is a descriptive study. Morbidity data were obtained from the five geral hospitals of Londrina, and mortality data came from the Municipal Mortality Information Nucleus of the city. The Software Epi Info, version 6.04d was used for data analysis. Results: 182 Children under age 15, victims of burns have been studied, being 82.4% wounded by hot materials or heat source, 14.3% by exposition to smoke/fire/flame and 3.3% by exposition to electric current. Male victims were predominant (56.6%), with the highest coefficient for the age of one year (6.1 per 1000 children). The hospitalization rate was 12.6%; one death occurred. 56.5% of the cases stayed in hospital for one to three days. Conclusions: the findingsObjective: this research analyzed the hospital incidence and mortality due to burns in children aged less than 15 who live in Londrina, and were treated in emergency services, hospitalized or who died because of this in 2001. Methods: This is a descriptive study. Morbidity data were obtained from the five geral hospitals of Londrina, and mortality data came from the Municipal Mortality Information Nucleus of the city. The Software Epi Info, version 6.04d was used for data analysis. Results: 182 Children under age 15, victims of burns have been studied, being 82.4% wounded by hot materials or heat source, 14.3% by exposition to smoke/fire/flame and 3.3% by exposition to electric current. Male victims were predominant (56.6%), with the highest coefficient for the age of one year (6.1 per 1000 children). The hospitalization rate was 12.6%; one death occurred. 56.5% of the cases stayed in hospital for one to three days. Conclusions: the findings contribute to increasing epidemiological knowledge of such events, highlighting the need for preventive measures.

Risky behavior for traffic accidents: a survey among medical students in Southern Brazil

BACKGROUND Traffic accidents are one of the most frequent cause of mortality among Brazilian youths. Therefore, this study aimed at detecting the prevalence of risk factors for such accidents in a young population. METHODS Questionnaires containing questions about risky behavior for traffic accidents were answered by students from the first to the fourth year of the Medical course of the State University of Londrina, Paraná State, Brazil, during October and November, 2000. The chi-square test was used to detect differences between the sexes, with a 5% significance level. RESULTS Compared to women, male students reported a statistically significant higher frequency of transportation as a car driver, owning a driver license, to have learnt to drive a car under the age of 16 and to have drunk alcoholic beverages before driving a vehicle during the last 30 days. Among regular drivers, a lower proportion of desirable behavior was also noted among male students. Lack of attention (59.3%), disregarding traffic signals (33.5%) and speeding (22.5%) were the main factors cited as determinants for the occurrence of the last accident, with no gender difference. CONCLUSIONS These results point out for the need to implement measures in order to reduce factors that favors the occurrence of traffic accidents among these youths, especially among males.

Prevalência de obesidade abdominal em hipertensos cadastrados em uma Unidade de Saúde da Família

FUNDAMENTO: A obesidade abdominal e importante fator de risco cardiovascular e, juntamente com as dislipidemias, a intolerância a glicose e a hipertensao arterial, compoe a sindrome metabolica. OBJETIVO: Verificar a prevalencia de obesidade abdominal e fatores associados em hipertensos. METODOS: Estudo transversal com hipertensos de 20 a 79 anos cadastrados em uma Unidade Saude da Familia do municipio de Londrina, Parana. A obesidade abdominal foi identificada por meio da relacao cintura-quadril (RCQ) e da circunferencia abdominal (CA), conforme pontos de corte recomendados pela Organizacao Mundial de Saude (RCQ > 1,0 e CA > 102 cm para homens, e RCQ > 0,85 e CA > 88 cm para mulheres). RESULTADOS: Entre os 378 entrevistados, a prevalencia de obesidade abdominal identificada pela RCQ foi de 65,3% nos adultos e 68,1% nos idosos, sendo de 87,9% no sexo feminino e de 30,2% no masculino (p < 0,001). Nas mulheres, a RCQ elevada esteve associada ao relato de colesterol aumentado, nao realizacao de atividade fisica regular, ausencia de trabalho remunerado e baixa escolaridade. Nao houve associacao de RCQ elevada com quaisquer variaveis no sexo masculino. A circunferencia abdominal elevada esteve presente em 66,8% dos adultos e 64,3% dos idosos, tambem com diferencas entre os sexos (p < 0,001). A CA elevada mostrou-se associada, no sexo feminino, ao diabete e ao nao tabagismo, e, entre homens, ao diabete e a nao realizacao de atividade fisica regular. CONCLUSAO: Esses resultados mostram uma alta prevalencia de obesidade abdominal, especialmente no sexo feminino, reforcando a necessidade de estrategias que promovam a diminuicao da obesidade abdominal entre hipertensos.

Violência contra a mulher: análise de casos atendidos em serviço de atenção à mulher em município do Sul do Brasil

Este artigo, de carater descritivo, tem como objetivo apresentar o perfil de mulheres atendidas em um centro de atendimento a mulher em Londrina, Parana, e caracterizar os casos quanto aos tipos de violencia sofrida, queixa principal, ambiente em que ocorreu a violencia e tipo de vinculo do agressor com a mulher. Utilizando-se o Programa Epi Info 6.04 montou-se um banco de dados com as informacoes extraidas das fichas das mulheres atendidas pelo Servico, no ano de 2001. Do total de 470 fichas analisadas, verificou-se que a media de idade das mulheres e de 34 anos. A maioria, 47,2%, declarou-se casada e 54% possuem um ou dois filhos. Declararam-se chefes de familia 38,7% das mulheres. A violencia emocional prevaleceu, representando 56,4% dos casos, seguida pela violencia fisica (32,1%). Os principais agressores sao os atuais maridos ou companheiros das mulheres (73,4%) e o lar e o espaco onde a maioria das agressoes ocorre. Considerando-se a complexidade do problema, que esta associado a questao da construcao social dos papeis masculinos e femininos e da desigualdade existente nas relacoes entre os generos, conclui-se que os servicos de atendimento as mulheres em situacao de violencia sao de fundamental importância e que estes devem estar articulados com os servicos de saude no desenvolvimento de acoes preventivas e na perspectiva da atencao integral a mulher.