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Objective: To evaluate the epidemiology and prognostic factors associated with traumatic brain injury by a firearm projectile (FAP)., Methods: We reviewed the medical records of 181 patients in the Department of Neurosurgery of Santa Casa de São Paulo (São Paulo Holy House) diagnosed with traumatic brain injury (TBI) resulting from FAP from January 1991 to December 2005. Were evaluated: age, sex, Glasgow Coma Scale (GCS) on admission, brain region affected by the FAP, type of injury (penetrating or tangential), type of treatment and outcome, based on GCS. The relationship between therapeutic strategy and outcome was analyzed using the Chi-square test with Yates correction. The Fisher test was used to verify the same correlation individually for each group stratified by GCS on admission., Results: Of the 181 patients, 85% were male (n = 154) and 15% female (n = 27). Mean age was 31.04 years (± 10.98). The mostly affected brain region was the frontal lobe (27.6%), followed by temporal (24.86%) and occipital (16.57%) ones. Of the TBIs evaluated, 16% were tangential and 84%, penetrating., Conclusion: Patients undergoing surgical treatment had better outcome than those submitted to conservative treatment, and patients who were more severe at admission (GCS 3-8) have better results with the neurosurgical procedure.

This research study was carried out in a public tertiary emergency hospital in the city of São Paulo, Brazil, with 20 professionals of nursing (2 nurses, 11 technicians, and 7 auxiliaries). It aimed at analyzing the role of communication in the interaction of professionals with patients, and at identifying its importance for nurse professionals. Data were collected using individual interviews. Content analyses revealed three main categories: difficulties imposed by the emergency ward environment on proper communication, dichotomy between doing and executing, and communication as care--revealing a mechanization of communication and its need by the patient.

The aim of our investigation was to evaluate, with a prevalence study, the modes of transmission of Hepatitis B virus (HBV), within infected subjects and their household contacts in the State of Amazon, western Brazilian Amazon. We studied 97 index cases and 258 household contacts. Out of the 258 household contacts of HBV, 51.6% had serological markers of a past infection, 12.0% signs of active infection, suggesting that the virus circulates within household members. The high prevalence among siblings (23.6%) demonstrates the importance of personal contact in the transmission of this virus. Another indirect indicator of intra-familial transmission was the high prevalence of HBV markers within contacts of a fulminant hepatitis. The vertical transmission of HBV in our region may or may not occur, but if it does it as a rare event. Our results demonstrate the importance of the presence of HBV, and demand other investigations to clarify the inter-familial transmission of these viruses in our region.