Acidentes com motociclistas: comparação entre os anos 1998 e 2010. Londrina, PR, Brasil

OBJETIVO: Comparar características de acidentes de motocicleta e de vítimas atendidas por serviços de atenção pré-hospitalar.MÉTODOS: Pesquisa transversal com dados de registros de atendimentos pré-hospitalares de motociclistas, vítimas de acidente de trânsito em Londrina, PR, em 2010, e dos resultados comparados com estudo similar de 1998. A fonte de dados foi o Registro de Atendimento do Socorrista (RAS). As frotas de motocicletas e as populações dos respectivos anos foram usadas para estimativas do risco de ocorrência de vítimas. O teste do Qui-quadrado foi usado para comparação dos perfis de acidentes e vítimas.RESULTADOS: Foram atendidos 1.576 e 3.968 motociclistas em 1998 e 2010, respectivamente (aumento de 151,8%). A taxa de motociclistas acidentados por mil habitantes passou de 396,4 para 783,1, e a de vítimas para cada mil motos de 53,1 para 61,1. Observaram-se mudanças (p < 0,05) nos perfis dos acidentes, com maiores proporções de quedas isoladas de moto, de acidentes entre motociclistas, no período da manhã, com diminuição dos ocorridos em final de semana. Em relação às vítimas, observaram-se maiores proporções de mulheres, condutores, com 35 anos ou mais. Foi menor a frequência relativa de percepção de hálito etílico e maior a prevalência do uso do capacete. Houve menor proporção de vítimas classificadas com escalas de coma e trauma moderado/grave e de encaminhamentos hospitalares. O coeficiente de letalidade imediato reduziu-se de 1,2% para 0,6%.CONCLUSÕES: Foram observadas mudanças nos perfis de acidentes e de vítimas no período. Apesar do aumento absoluto e relativo de vítimas de acidentes de motocicleta, observou-se menor gravidade proporcional desses acidentes

Extremes of maternal age and child mortality: analysis between 2000 and 2009

OBJECTIVE: To analyze the characteristics of infant mortality at the extremes of maternal age.METHOD: Retrospective, cross-sectional quantitative study using data from Live Birth Certificates, Death Certificates and from Child Death Investigation records in Londrina, Paraná, in the years of 2000-2009.RESULTS: During the 10-year study period,there were 176 infant deaths among mothers up to 19 years of age, and 113 deaths among mothers aged 35 years or more. The infant mortality rate among young mothers was 14.4 deaths per thousand births, compared to 12.9 deaths in the other age group. For adolescent mothers, the following conditions prevailed: lack of a stable partner (p<0.001), lack of a paid job (p<0.001), late start of prenatal care in the second trimester of pregnancy (p<0.001), fewer prenatal visits (p<0.001) and urinary tract infections (p<0.001). On the other hand, women aged 35 or more had a higher occurrence of hypertension during pregnancy (p<0.001), and of surgical delivery (p<0.001). Regarding the underlying cause of infant death, congenital anomalies prevailed in the group of older mothers (p=0.002), and external causes were predominant in the group of young mothers (p=0.019).CONCLUSION: Both age groups deserve the attention of social services for maternal and child health, especially adolescent mothers, who presented a higher combination of factors deemed hazardous to the child's health

Extremes of maternal age and child mortality: analysis between 2000 and 2009* *This study is part of the Research Project: “Child Mortality: progression from illness to death, Londrina-PR”, Pró-Reitoria de Pesquisa e Pós-Graduação (PROPPG), Universidade Estadual de Londrina, Londrina, PR, Brazil.

AbstractOBJECTIVETo analyze the characteristics of infant mortality at the extremes of maternal age.METHODRetrospective, cross-sectional quantitative study using data from Live Birth Certificates, Death Certificates and from Child Death Investigation records in Londrina, Paraná, in the years of 2000–2009.RESULTSDuring the 10-year study period, there were 176 infant deaths among mothers up to 19 years of age, and 113 deaths among mothers aged 35 years or more. The infant mortality rate among young mothers was 14.4 deaths per thousand births, compared to 12.9 deaths in the other age group. For adolescent mothers, the following conditions prevailed: lack of a stable partner (P<0.001), lack of a paid job (P<0.001), late start of prenatal care in the second trimester of pregnancy (P<0.001), fewer prenatal visits (P<0.001) and urinary tract infections (P<0.001). On the other hand, women aged 35 or more had a higher occurrence of hypertension during pregnancy (P<0.001), and of surgical delivery (P<0.001). Regarding the underlying cause of infant death, congenital anomalies prevailed in the group of older mothers (P=0.002), and external causes were predominant in the group of young mothers (P=0.019).CONCLUSIONBoth age groups deserve the attention of social services for maternal and child health, especially adolescent mothers, who presented a higher combination of factors deemed hazardous to the child's health

Anomalias congênitas: internações em unidade pediátrica

OBJETIVO: Analisar o perfil das crianças com anomalias congênitas em unidade pediátrica. MÉTODOS: Trata-se de uma pesquisa quantitativa e retrospectiva. A amostra constituiu-se dos prontuários de crianças de 0 a 12 anos que foram internadas na unidade pediátrica de um hospital escola público em Londrina, Paraná, de 2007 a 2009. Os dados foram obtidos por busca ativa aos registros processados no programa Epi-Info®, e submetidos à análise estatística descritiva. RESULTADOS: Ocorreram 282 primeiras internações de crianças com anomalias congênitas. Destas, 130 (46,0%) necessitaram de reinternações e totalizaram, portanto, 412. A média de internação foi de três dias. Houve predomínio do sexo masculino e faixa etária de três a sete anos. Entre as anomalias prevaleceram aquelas do aparelho geniturinário (19,6%), seguidas pelas fendas labiais e palatinas (17,3%) e pelo aparelho circulatório (16,2%). Foram realizados 269 procedimentos cirúrgicos para corrigir as anomalias. CONCLUSÕES: Este estudo reafirma a importância epidemiológica das anomalias congênitas, apontando para a necessidade de prevenir e controlar os fatores desencadeadores

Hospitalized child: characterization of surgical procedures in a hospital public school

This study aimed to characterize the surgical procedures performed in children hospitalized in the pediatric unit of a hospital public school. It is a quantitative, descriptive and cross-sectional study conducted in the city of Londrina, Paraná, from January 2007 to December 2009. Data were collected from the hospital's statistical department database record, assessing medical records of patients. During the three years of study, 2360 procedures were performed, of these 56.7% were in children who lived in the city itself. There were predominance of males (62.0%) and age group between 1 and 3 years old (30.0%). The larger amount of procedures was performed by the pediatric surgery clinic (54.6%), followed by orthopedics (14.8%) and hematology (12.1%). The most frequent procedures were appendectomy, liquor puncture and orthopedic fracture correction. Congenital malformations correction amounted 10.8% and procedures resulting from external causes 16%. Only one death occurred during the intraoperative period in three years of study. The results allowed to characterize the performed surgeries' profile, providing subsidies for improving specific techniques for management and pre-and postoperative preparation to ensure better care for child and family and reduction of possible traumas during hospitalizatio

Breastfeeding: guidance received in prenatal care, delivery and postpartum care

The aim of the study was to analyze the guidelines considering breastfeeding given by health professionals to women during prenatal care, delivery and postpartum care. Quantitative and descriptive work developed at Regional Pinheiros, Maringá-PR, from the registry in SisPreNatal, from May to August 2009. Data were collected through interviews conducted with parents at home, using a structured instrument. Participants were 36 mothers, most of whom received counseling for breastfeeding during prenatal (58.3%), maternity (87.6%) and in nursing visits to newborn (84.6%). The prevalence of exclusive breastfeeding was 37.5%, even with the end of maternity leave. The rate is still below the recommended by the World Health Organization for exclusive breastfeeding. The present results may contribute to the monitoring of health actions and development of new strategies in the maintenance of exclusive breastfeeding

Brazilian Consensus on Photoprotection

Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of nonmelanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection