Acidentes de trânsito no Brasil de 1998 a 2010: muitas mudanças e poucos resultados

The paper describes the situation of road traffic accidents in Brazil since 1998, when a new Brazilian traffic law was approved, up to the year 2010. A review of both academic and non-academic literature was carried out, including journals (both indexed and non-indexed), technical reports, author searches, searches in paper reference lists and direct contact with researchers. The main problems related to road traffic accidents in Brazil identified were the increase in the absolute number of deaths and in the mortality rates, a rapid increase in the number of motorcycles, and drink & driving. Influent authors in the field and centers of expertise were identified. Some potential solutions are presented by the authors, who suggest that the public offices related to traffic regulation and control are not taking suitable measures for control and reduction of road traffic accidents.O artigo descreve a situação dos acidentes de trânsito no Brasil, desde a implementação do Código de Trânsito Brasileiro de 1998 até o ano de 2010. Foi realizada análise dos principais trabalhos científicos e publicações não acadêmicas nacionais. A revisão de literatura incluiu periódicos indexados, não indexados, relatórios técnicos, busca específica por autores, referências bibliográficas de artigos e contato com pesquisadores. Os principais problemas do trânsito brasileiro identificados foram aumento do número absoluto de mortos e das taxas de mortalidade, ampliação da frota de motocicletas e o uso de álcool. Foram identificados autores influentes e ilhas de produção de conhecimento nas áreas pesquisadas. Os autores apresentam algumas possíveis soluções e sugerem que o poder público não tem assumido a responsabilidade que lhe cabe no controle e redução dos acidentes de trânsito.El articulo describe la situación de los accidentes de tránsito en Brasil, desde la implementación del Código de Transito Brasileño de 1998 hasta el año de 2010. Se realizó análisis de los principales trabajos científicos y publicaciones no académicas nacionales. La revisión de literatura incluyó periódicos indexados, no indexados, informes técnicos, búsqueda especifica por autores, referencias bibliográficas de artículos y contacto con investigadores. Los principales problemas de tránsito brasileño identificados fueron aumento del número absoluto de muertos y de las tasas de mortalidad, ampliación de la flota de motocicletas y el uso de alcohol. Se identificaron autores influyentes e islas de producción de conocimiento en las áreas investigadas. Los autores presentaban algunas posibles soluciones y sugieren que el poder público no ha asumido la responsabilidad que le cabe en el control y reducción de los accidentes de tránsito

Emergency room retrograde transbrachial arteriography for the management of axillosubclavian vascular injuries

Background: our purpose was to determine the accuracy of single-injection, retrograde transbrachial arteriography (RTBA), performed in the emergency room, for suspected axillosubclavian injuries.Methods: Thirty-three patients were prospectively assigned for RTBA. Clinical indications for RTBA included high-risk mechanism of injury, decreased (n = 19) or absent (n = 5) brachial pulse, neurologic deficits (n = 11), external or intrathoracic bleeding (n = 4), and bruit (n = 2). Brachial artery was cannulated with an 18-gauge catheter. A sphygmomanometer cuff was placed at the forearm and inflated to 250 mm Hg. Twenty milliliters of nonionic contrast media was injected countercurrent and a single anteroposterior chest radiograph was obtained. Small intimal flaps were followed by serial ultrasound. Surgical findings were used to establish RTBA accuracy.Results. RTBA was successfully performed in all cases. Arterial lesions were detected in 28 (84.8%) patients, including thrombosis (n = 8), arteriovenous fistula (n = 8), and false aneurysm (n = 7) as the most frequent lesions. A sensitivity of 96.5%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 80% were observed with RTBA.Conclusion. We conclude that RTBA is a safe and accurate technique to be used in the emergency room for the rapid detection of axillosubclavian arterial injuries.Universidade Federal de São Paulo, Dept Surg, UNIFESP, EPM, São Paulo, BrazilPronto Socorro Hosp, FFFCMPA, Porto Alegre, RS, BrazilUniversidade Federal de São Paulo, Dept Surg, UNIFESP, EPM, São Paulo, BrazilWeb of Scienc