Search

AIM: To report on the causes of trauma, indexes of trauma, and mortality related to thoracic trauma in one region of Brazil. MATERIALS AND METHODS: This prospective study was performed at the Regional Trauma Center in São José do Rio Preto over a 1-year period, from 1st July 2004 to 30th June 2005. We included all patients attending the center's emergency room with thoracic trauma and an anatomic injury scale (AIS) ≥ 2. We collected data using a protocol completed on arrival in hospital utilizing the AIS. We studied the types of accidents as well as the mortality and the AIS scores. Prevalence rates were calculated and the paired t-test and logistic regression were employed for the statistical analysis. RESULTS: There were a total of 373 casualties with AIS ≥ 2 and there were 45 (12%) deaths. The causes of thoracic trauma among the 373 casualties were as follows: 91 (24.4%) car crashes, 75 (20.1%) falls, 46 (12.3%) motorbike accidents, 40 (10.7%) stabbings, 22 (5.9%) accidents involving pedestrians, 21 (5.6%) bicycle accidents, 17 (4.6%) shootings, and 54 (14.5%) other types of accident. The severity of the injuries was classified according to the AIS: 224 (60%) were grade 2, 101 (27%) were grade 3, 27 (7.2%) were grade 4, 18 (4.9%) were grade 5, and 3 were (0.8%) grade 6. With respect to thoracic trauma, pedestrians involved in accidents and victims of shootings had mortality rates that were significantly higher than that of those involved in other types of accidents. CONCLUSION: Road accidents are the main cause of thoracic injury, with accidents involving pedestrians and shootings being associated with a greater death rate. [ABSTRACT FROM AUTHOR]

Background: Pulmonary thromboembolism is an important cause of death affecting thousands of people worldwide. The current study aims to evaluate the prevalence of death due to pulmonary embolism after trauma., Materials and Methods: The diagnoses of the causa mortis of all patients treated in the Accident and Emergency Department of Hospital de Base in São José do Rio Preto, in the period from July 2004 to June 2005, were identified from autopsy reports to check whether pulmonary thromboembolism was involved., Result: A total of 109 deaths due to trauma were detected in this period with pulmonary embolism occurring in 3 (2.75%) patients., Conclusion: Pulmonary thromboembolism is an important cause of mortality in trauma patients and so prophylactic measures should be taken during the treatment of these patients.

In a cross section study performed in Rauch in 1997 we found a high prevalence of hypertension and low levels of treatment and control. To evaluate the impact of the community-based intervention activities on blood pressure (BP), we made a cohort study in 1526 inhabitants aged between 15 and 75 years in 2003. The initial study, the advice to consult the family doctor when alterations were found, the free provision of antihypertensive drugs, the press diffusion of the study results and a healthy lifestyle were included among the intervention activities. BP was measured in the subjects' residence by especially trained nurses, considering systolic BP (SBP) and diastolic BP (DBP) as the average of three measurements in one occasion. A total of 1307 subjects (85.65%) were re-interviewed. SBP decreased from 137.98 +/- 0.57 to 132.49 +/- 0.53 mm Hg (p < 0.01) and DBP from 88.73 +/- 0.38 to 81.87 +/- 0.33 mm Hg (p < 0.01). Pressure decrease was observed in all the age groups, in both sexes and in the subgroup without receiving antihypertensive drugs. The percentage with antihypertensive drugs increased from 12.2 to 20.4 (p < 0.01). A significant relationship was observed between the percentiles of the BP changes and weight changes in subjects with and without antihypertensive drugs. Community-based intervention strategies were effective to BP control and, probably, to decrease the cardiovascular risk in a community with high prevalence of hypertension.

We conducted a study in a random sample of 1523 inhabitants (15-75 years old) of Rauch city to determine risk factors prevalence to development hypertension and cardiovascular diseases. We measured blood pressure, weight, height, waist circumference, cholesterol and glucose levels, sodium excretion, and alcohol and tobacco consumption. We found a high prevalence of hypertension (43.20% in men and 28.50% in women), and obesity-overweight (54.81% in men and 44.65% in women), both of them augmented with aging. Only 4% of hypertensive subjects were being controlled and only 32% of them were aware of their condition. Men showed a marked increment of prevalence of hypertension and obesity-overweight between groups of 15-24 years and 25-34 years. Women had delayed and more gradual increments. In male and female respectively, the prevalence of hypercholesterolemia was 26.86 and 13.81, the prevalence of diabetes was 3.42 and 1.53, and the prevalence of tobacco consumption was 34.61 and 20.83. Higher BMI and waist circumference identified subjects with higher blood pressure up to 54 and 65 years, in men and women, respectively. Age and waist circumference in the whole group, and alcohol consumption in men, were independently correlated with blood pressure; sodium excretion had no correlation. High prevalence of hypertension and obesity-overweight and their association suggest that the most important primary prevention measure in this community should be to prevent obesity. Low levels of awareness indicate the need of ongoing detection programs, and low grade to control of hypertension could be modified with education programs for health providers.

Blood pressure (BP) levels were measured in 450 students (mean age 20.8 +/- .11 years old) and were correlated with different parameters. Prevalence of arterial hypertension was, according to the JNC-V, 13% in males and 3% in females. The correlations between Body Mass Index (BMI) and BP levels were statistically significant either in males and females. Mean BP (MBP) increased 1.17 mmHg per unit of increase of BMI in males and 0.97 mmHg in females. According to the BP levels proposed by the JNC-V the male individuals were classified in three groups: optimal BP (OBP), high normal BP (HNBP) and hypertensives stage 1 (Hypert.). These groups had different BMI; OBP: 22.74 +/- 2; HNBP 24.4 +/- 0.48; Hypert. 25.06 +/- 0.66 kg/m2 (P < 0.05 Hypert. and HNBP as regards PAO; HNBP and Hypert. were not statistically different). Samples of each of these groups were taken in order to analyze other parameters such as: cardiac index (CI), total peripheral resistance (TPR), plasma glucose, plasma insulin, glucose/insulin ratio and intracellular pH in platelets. No significant differences were found in the three groups as regards plasma glucose, plasma insulin and glucose/insulin ratio. The different BP levels among the groups were due to an increase in CI: OBP 3.25 +/- 0.13; HNBP 3.76 +/- 0.2; Hypert. 4.76 +/- 36 ml/min/m2 (P < 0.05) but with TPR numerically "normal": OBP: 2139 +/- 106; HNBP 2170 +/- 114; Hypert. 1858 +/- 146 dynes sec. cm-5 m2 (NS). The intracellular pH in platelets was: 7.15 +/- 0.07 in the OBP, 7.21 +/- 0.05 in the HNBP and 7.33 +/- 0.04 in the Hypert. (P < 0.05 in the Hypert. as regards the PAO). The increase of the pHi in the Hypert. suggests hyperactive Na+/H+ exchanger.