Opiniones, prácticas y conocimientos de pediatras sobre la prevención de lesiones no intencionales / Pediatricians' opinions, practices and knowledge about unintentional injuries prevention

El objetivo fue describir opiniones, prácticas y conocimientos de pediatras sobre prevención de lesiones no intencionales (LNI) Metodología: estudio descriptivo y analítico por encuesta anónima y auto-administrada a pediatras, en Mendoza, en 2015. Resultados: N: 210. La edad media de los pediatras fue 44, 55 años, 65, 2% mujeres. Doscientos (95, 22%) realizan prevención de lesiones, 76% lo hace en la mayoría de las consultas, usando método verbal principalmente. El 94, 29% (198) opinaron que la prevención mejora la seguridad en el hogar y 185 (88, 1%) que debiera hacerse en todas las consultas. Entre pediatras con menos de 10 años de antigüedad (N= 84), el 79, 6% respondió correctamente sobre sillitas, ahogamiento, andador y caídas; entre los de mayor antigüedad (N= 126) hubo 61, 9% de respuestas correctas (p= 0, 007) Conclusiones: Los pediatras son conscientes de su rol en prevención de LNI, refieren realizar actividades de prevención y conocen sobre el tema, sobre todo los más jóvenes.

Introduction: The objective of this study was to address the pediatrician's opinions, practices and knowledge on the prevention of unintentional injuries. Design: descriptive and analytical study by anonymous and self-administered survey to pediatricians, in Mendoza, in 2015. Results: N: 210. The mean age of pediatricians was 44.55 years old, 65.2% were women. 200 (95.22%) performed injury prevention, 76% did it in most of the visits, using verbal method mainly. 198 (94.29%) believed that prevention improves home safety and 185 (88.1%) should be done in all consultations. There were 79.6% correct answers among pediatricians less than 10 years' seniority (N= 84) about child car restraint system, drowning, baby walker use and falls; among the oldest (N= 126) there were 61.9% of correct answers (p= 0.007) Conclusions: Pediatricians are aware of their role in injury prevention, realized prevention activities and knew about the subject, especially the younger ones.

[Pediatricians' opinions, practices and knowledge about unintentional injuries prevention]. / Opiniones, prácticas y conocimientos de pediatras sobre la prevención de lesiones no intencionales.

INTRODUCTION: The objective of this study was to address the pediatrician's opinions, practices and knowledge on the prevention of unintentional injuries. DESIGN: descriptive and analytical study by anonymous and self-administered survey to pediatricians, in Mendoza, in 2015. RESULTS: N: 210. The mean age of pediatricians was 44.55 years old, 65.2% were women. 200 (95.22%) performed injury prevention, 76% did it in most of the visits, using verbal method mainly. 198 (94.29%) believed that prevention improves home safety and 185 (88.1%) should be done in all consultations. There were 79.6% correct answers among pediatricians less than 10 years` seniority (N= 84) about child car restraint system, drowning, baby walker use and falls; among the oldest (N= 126) there were 61.9% of correct answers (p= 0.007). CONCLUSIONS: Pediatricians are aware of their role in injury prevention, realized prevention activities and knew about the subject, especially the younger ones.

INTRODUCCIÓN: El objetivo fue describir opiniones, prácticas y conocimientos de pediatras sobre prevención de lesiones no intencionales (LNI). METODOLOGÍA: estudio descriptivo y analítico por encuesta anónima y auto-administrada a pediatras, en Mendoza, en 2015. RESULTADOS: N: 210. La edad media de los pediatras fue 44,55 años, 65,2% mujeres. Doscientos (95,22%) realizan prevención de lesiones, 76% lo hace en la mayoría de las consultas, usando método verbal principalmente. El 94,29% (198) opinaron que la prevención mejora la seguridad en el hogar y 185 (88,1%) que debiera hacerse en todas las consultas. Entre pediatras con menos de 10 años de antigüedad (N= 84), el 79,6% respondió correctamente sobre sillitas, ahogamiento, andador y caídas; entre los de mayor antigüedad (N= 126) hubo 61,9% de respuestas correctas (p= 0,007). CONCLUSIONES: Los pediatras son conscientes de su rol en prevención de LNI, refieren realizar actividades de prevención y conocen sobre el tema, sobre todo los más jóvenes.

Community-associated methicillin-resistant Staphylococcus aureus skin and soft tissue infections in a pediatric hospital in Argentina.

INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) emerged at the Pediatric Hospital of Misiones Province, north Argentina, in 2003 as a cause of community-acquired (CA) infections, mostly associated with skin and soft tissue infections (SSTIs). This study aimed to assess the microbiological, epidemiological, and clinical features of CA-MRSA SSTIs treated at the hospital. METHODOLOGY: From 2003 through 2006, a longitudinal study on CA-MRSA SSTIs was conducted. Clinical, bacteriological, and molecular data were collected and analyzed by multiple correspondences and cluster analysis (MCCA). RESULTS: A total of 138 children were enrolled; 55.8% of the children required hospitalization. The main clinical presentation was abscesses (51%). Antibiotic therapy in the previous six months was registered in 41% of the patients, and 72% of the patients had relatives with similar symptoms. Resistance to non-b-lactam antibiotics was found in less than 12% of patients. All 44 isolates carried staphylococcal cassette chromosomemec (SCCmec) type IV, and 30/44 had Panton-Valentine leucocidin (PVL) coding genes. Six pulsed-field gel electrophoresis (PFGE) patterns were detected from 17 isolates. MCCA hierarchic classification resulted in four distinctive patient classes (new variable). No relationship could be observed regarding the PVL detection, as PVL (+) isolates were detected in all classes; the same lack of significance was observed concerning the distribution of resistance to non-ß-lactam antibiotics. CONCLUSIONS: This study increases the understanding and knowledge about CA-MRSA skin and soft tissue infections in pediatric patients. Continuous efforts should be made to control this significant public health problem.

Internationally comparable diagnosis-specific survival probabilities for calculation of the ICD-10-based Injury Severity Score.

BACKGROUND: The International Statistical Classification of Diseases, 10th Revision (ICD-10)-based Injury Severity Score (ICISS) performs well but requires diagnosis-specific survival probabilities (DSPs), which are empirically derived, for its calculation. The objective was to examine if DSPs based on data pooled from several countries could increase accuracy, precision, utility, and international comparability of DSPs and ICISS. METHODS: Australia, Argentina, Austria, Canada, Denmark, New Zealand, and Sweden provided ICD-10-coded injury hospital discharge data, including in-hospital mortality status. Data from the seven countries were pooled using four different methods to create an international collaborative effort ICISS (ICE-ICISS). The ability of the ICISS to predict mortality using the country-specific DSPs and the pooled DSPs was estimated and compared. RESULTS: The pooled DSPs were based on a total of 3,966,550 observations of injury diagnoses from the seven countries. The proportion of injury diagnoses having at least 100 discharges to calculate the DSP varied from 12% to 48% in the country-specific data set and was 66% in the pooled data set. When compared with using a country's own DSPs for ICISS calculation, the pooled DSPs resulted in somewhat reduced discrimination in predicting mortality (difference in c statistic varied from 0.006 to 0.04). Calibration was generally good when the predicted mortality risk was less than 20%. When Danish and Swedish data were used, ICISS was combined with age and sex in a logistic regression model to predict in-hospital mortality. Including age and sex improved both discrimination and calibration substantially, and the differences from using country-specific or pooled DSPs were minor. CONCLUSION: Pooling data from seven countries generated empirically derived DSPs. These pooled DSPs facilitate international comparisons and enables the use of ICISS in all settings where ICD-10 hospital discharge diagnoses are available. The modest reduction in performance of the ICE-ICISS compared with the country-specific scores is unlikely to outweigh the benefit of internationally comparable Injury Severity Scores possible with pooled data. LEVEL OF EVIDENCE: Prognostic and epidemiological study, level III.

Lesiones por tránsito en el partido bonaerense de General Pueyrredón: Epidemiología, factores de riesgo y letalidad / Road Traffic Injuries in General Pueyrredón, Province of Buenos Aires: Epidemiology, Risk Factors and Lethality

INTRODUCCIÓN: En Argentina, los años de vida potencialmente perdidos (AVPP) atribuibles a lesiones por tránsito (LT)han mostrado un incremento del 68% en los últimos 10 años. Este trabajo plantea la importancia de construir la información sobre este tipo de lesiones a partir de múltiples fuentes de datos. OBJETIVO: Describir la epidemiología, la letalidad y los factores de riesgo presentes en los lesionados por tránsito (LT) en el Partido de General Pueyrredón (PGP), Provincia de Buenos Aires, entre junio de 2010 y mayo de 2011. MÉTODOS: Mediante un diseño transversal con análisis multivariado y espacial, se estudiaron las características epidemiológicas de LT en el PGP durante 12 meses a partir de cinco fuentes de datos. RESULTADOS: De 4.832 LT, el 66% fueron varones. Los motociclistas fueron el 51% y representaron el 36% de óbitos. En los mayores de 60 años, el 40% fueron peatones y se presentó la mayor letalidad. De cada 100 LT, 30 fueron internados y 1 falleció. Hubo mayor porcentaje de usuarios vulnerables (76%) que en otras publicaciones. Se hallaron cuatro tipologías: a) motociclistas varones jóvenes; b) ocupantes de vehículo a motor de cuatro ruedas; c) menores de 15 años; d) mujeres peatones y ciclistas. CONCLUSIONES: Los datos epidemiológicos y sobre factores de riesgo obtenidos a partir de múltiples fuentes contribuyen a diseñar estrategias eficaces de prevención. Es necesario promover el trabajo en red e intersectorial para alcanzar un abordaje complejo y multicausal.

INTRODUCTION: In Argentina, potential years of life lost due to premature death (PYLL) attributable to traffic injuries have increased over 68% the last 10 years. This paper discusses the importance of building information about this kind o injuries from multiple data sources. OBJECTIVE: To describe epidemiology, lethality and risk factors in people injured in road traffic accidents (PIRTA) at General Pueyrredón District (GPD), Province of Buenos Aires, from June 2010 to May 2011. METHODS: A cross-sectional design with multivariate and spatial analysis was used to study the epidemiological characteristics of PIRTA in GPD during 12 months. Five data sources were used. RESULTS: Out of 4832 PIRTA, 66% were males. Motorcyclists totaled 51%, with a death rate of 36%. The over 60s age group had 40% of pedestrians and showed the highest lethality. Out of 100 PIRTA, 30 were hospitalized and 1 died. The rate of vulnerable users (76%) was higher than in other publications. The analysis presented four typologies: a)young male motorcyclists; b) four-wheel motor vehicle occupants;c) people younger than 15 years old; d) women pedestrians and cyclists. CONCLUSIONS: Epidemiological and risk factor data obtained from multiple sources contribute to designing effective prevention strategies. It is necessary to promote networking and intersectoral work in order to have a complex, multicausal approach.

[Deaths from road injuries in Argentina: a spatial analysis for the 2001-2009 period]. / Muertes por lesiones de tránsito en Argentina: un análisis espacial para el período 2001-2009.

Traffic injuries in Argentina are the most frequent cause of death from external injuries and a public health problem of increasing magnitude at the global level. The objectives of this study are to establish the level of spatial autocorrelation at the department level and identify the formation of groupings by calculating local indicators of spatial association at the national level. The results reveal a significantly positive level of autocorrelation in Argentina. A negative level of spatial autocorrelation was recorded when mortality from road injuries was related to population density. It was also noted that mortality from road injuries could pose a more serious problem outside large urban areas.

Muertes por lesiones de tránsito en Argentina: un análisis espacial para el período 2001–2009 / Deaths from road injuries in Argentina: a spatial analysis for the 2001–2009 period

Traffic injuries in Argentina are the most frequent cause of death from external injuriesand a public health problem of increasing magnitude at the global level. Theobjectives of this study are to establish the level of spatial autocorrelation at the departmentlevel and identify the formation of groupings by calculating local indicatorsof spatial association at the national level. The results reveal a significantly positivelevel of autocorrelation in Argentina. A negative level of spatial autocorrelation wasrecorded when mortality from road injuries was related to population density. Itwas also noted that mortality from road injuries could pose a more serious problemoutside large urban areas.

Las lesiones de tránsito representan la causa más frecuente de muerte por causas externasen Argentina y un problema de creciente magnitud para la salud pública a nivel global. Losprincipales objetivos de este trabajo son establecer el nivel de autocorrelación espacial experimentadoa nivel de departamentos e identificar la conformación de agrupamientos medianteel cálculo de los indicadores locales de asociación espacial a nivel nacional. Los resultadosmostraron un nivel de autocorrelación significativamente positivo en Argentina. Al relacionarlas tasas de mortalidad por lesiones de tránsito con la densidad poblacional, se registró unnivel de autocorrelación espacial negativo. Se observó también que la mortalidad por lesionesde tránsito podría representar un problema más grave fuera de las grandes aglomeraciones.

National burden of road traffic injuries in Argentina.

More than 1.2 million people die and as many as 50 million people are injured or disabled due to road traffic injuries (RTIs) every year worldwide. The lack of reliable data hinders efforts to describe the characteristics of the issue and prioritise prevention activities. The objective was to provide a snapshot of fatal and non-fatal RTI in Argentina. We used the methodology proposed by the Global Burden of Disease Injury Expert group. External causes of deaths with unknown codes were proportionately redistributed over the known categories. In 2007 in Argentina, we estimated 5915 RTI deaths, compared with 3983 RTI deaths reported previously by the Ministry of Health, accounting for 1931 additional cases. The highest number of deaths occurred in young men (15-29 years old), although the highest RTI death rates were in the age group of 55 years and older. Four-wheeled vehicle occupants were the most common road user type killed (59.1%); vulnerable road users represented one third (29.5%) of deaths and 64% of non-fatal RTI. The national and regional estimates of RTI in Argentina should help policy makers and public-health researchers to understand the importance of RTI prevention and design specific interventions to further reduce these preventable deaths and injuries.

Factores y conductas de riesgo de enfermedad cardiovascular / Factors and risk behaviors of cardiovascular disease

En una población de 102 niños concurrentes a un club de verano (Mar del Plata, 1998) de ambos sexos, de 6 a 14 años, de nivel socioeconómico medio-alto evaluamos las conductas y factores de riesgo para enfermedades cardiovasculares. Se obtuvieron 102 encuestas (46 niños y 56 niñas) y 76 encuestas de padres. Los niños llenaron un cuestionario de preguntas abiertas y cerradas (modalidad: verdadero-falso, opciones e inquietudes) acerca de los factores de riesgo cardiovasculares. Se tomaron las medidas antropométricas (peso y talla) y de la T.A.. A todos los padres y madres se les entregó un cuestionario acerca de los factores de riesgo cariovascular, que fue autoadministrado y no obligatorio. La descripción de talla para la edad, por encima de la media, muestra la ausencia de desnutrición crónica. Se encontró el 16 por ciento de los niños en sobrepeso u obeso. En el cruce de datos de padres y niños: todos tienen factores de riesgo presentes, entre 1 a 6 factores por padre...