[Trauma Injuries Associated with Rope Bullfights in the Azores: A Cross-Sectional Study]. / Trauma Associado às Touradas à Corda nos Açores: Um Estudo Transversal.

INTRODUCTION: The aim of the study was to describe trauma injuries associated with rope bullfights in the Azores, Portugal, regarding the cause of the incident, trauma mechanism, most affected anatomical areas, and injury severity. METHODS: Two-year cross-sectional study in the local hospital with prospective data collection. Patients who were consecutively admitted to the local hospital's emergency department with trauma injuries from the bull's direct impact or from falls either during the bull's escape or when handling the rope, were included. Data on general demographics, lesion characteristics, treatments, need for hospitalization and mortality were collected. RESULTS: Fifty-six incidents and 80 trauma injuries were identified. The main cause of trauma was the bull's direct impact (37; 66.07%) and the mechanism of injury was blunt trauma in all patients (100%; 56). Head and neck injuries (27; 33.75%) were the most common. The median Injury Severity Score at the emergency department admission was 4. Major trauma was noted in five patients (8.92%). Ten patients (17.85%) needed hospitalization with a median hospital stay of seven days. Three of the 10 hospitalized patients (30%) were previously admitted to the intensive care unit. Surgery was performed in six patients (10.71%). CONCLUSION: The main cause of trauma was the bull's direct impact, and the mechanism of injury was blunt trauma. The most affected anatomical areas were the head and neck. These findings are a wake-up call to the impact of these events regarding the economic costs they entail, the costs for the health of the local population, the safety measures currently implemented and the availability of the necessary means to treat these patients.

Introdução: O objetivo deste estudo foi caracterizar as lesões traumáticas tauromáquicas ocorridas nas touradas à corda nos Açores no que diz respeito à causa do incidente, mecanismo de trauma, área anatómica mais afetada e gravidade das lesões. Métodos: Estudo unicêntrico, transversal, com a colheita prospetiva de dados realizada durante dois anos. Foram incluídos os doentes que consecutivamente recorreram ao serviço de urgência do hospital local por lesões traumáticas ocorridas por trauma direto com o animal ou quedas aquando da fuga ou manuseio da corda. Foram colhidos dados demográficos gerais, características da lesão, tratamentos efetuados, necessidade de internamento hospitalar e mortalidade. Foi realizada uma análise estatística descritiva com recurso ao software estatístico SPSS. Resultados: Registaram-se 56 admissões hospitalares e 80 lesões traumáticas. A principal causa de traumatismo foi o trauma direto com o animal (37; 66,07%) e o mecanismo de lesão foi o trauma fechado (56; 100%). As áreas anatómicas mais afetadas foram a cabeça e pescoço (27; 33,75%). A mediana de Injury Severity Score foi de 4 à admissão hospitalar. Cinco doentes (8,92%) apresentaram trauma major. Dez doentes (17,85%) necessitaram de internamento hospitalar com uma mediana de dias de internamento de sete (IIQ 4,5 dias). Três (30%) dos doentes internados necessitaram de internamento em unidade de cuidados intensivos. Seis doentes (10,71%) foram submetidos a cirurgia. Conclusão: A principal causa de traumatismo foi o trauma direto com o animal e o mecanismo de lesão foi o trauma fechado. As áreas anatómicas mais afetadas foram a cabeça e pescoço. Estes dados constituem um alerta para o impacto destes eventos no que diz respeito aos custos económicos que acarretam, aos custos para a saúde da população local, às medidas de segurança atualmente implementadas e à disponibilidade dos meios necessários para tratar estes doentes.

Paraneoplastic opsoclonus-myoclonus syndrome as a rare presentation of breast cancer.

Opsoclonus-myoclonus paraneoplastic syndrome is a medical condition that includes opsoclonus along with diffuse or focal body myoclonus and truncal titubation with or without ataxia and other cerebellar signs. This rare neurological syndrome is poorly understood and can result in long-term cognitive, behavioral and motor sequelae. We report a case of a 49-year-old woman with anti-Ri antibody opsoclonus-myoclonus syndrome and an invasive ductal carcinoma with axillary nodes involvement. Following the diagnosis of opsoclonus-myoclonus syndrome, a multimodal immunotherapy treatment, with partial remission of the neurological symptoms. The patient underwent lumpectomy and axillary node dissection and the surgical pathology confirmed the diagnosis of breast cancer stage IIA. This was followed by chemotherapy, radiotherapy and hormone therapy with tamoxifen. At the 6 months follow-up there was a partial improvement, anti-Ri antibody was subsequently reported as negative and there was no evidence of disease recurrence.

Pacientes com doenças renais atendidos na emergência de um hospital escola / Patients with kidney diseases assisted in the emergency unit of a teaching hospital / Pacientes con enfermedades renales atendidos en la emergencia de un hospital escuela

Objetivo: caracterizar os pacientes atendidos no Pronto Atendimento (PA) do Hospital de Base (HB). Método: estudo transversal. A amostra foi constituída de 1716 prontuários de pacientes atendidos no PA no período de janeiro de 2009 a maio de 2010. As variáveis quantitativas foram analisadas no Programa Excel (Microsoft), teste qui-quadrado e teste de Kruskal-Wallis, sendo considerado o nível de significância quando P < que 5%. Resultados: houve predominância do sexo feminino, brancos, de oito a 11 anos de escolaridade, que trabalham em outras profissões, casados, tendo como patologia renal a cólica nefrética não especificada e alta médica após consulta e/ou internação. Conclusão: pacientes com doenças renais agudas tiveram alta e pacientes com doenças renais crônicas ficaram internados, com associação significativa.(AU)

Objective: to characterize the patients that receive care in the Emergency Department (ED) of the Base Hospital (BH). Method: cross-sectional study. The sample consisted of 1716 records of patients assisted in the ED from January 2009 to May 2010. Quantitative variables were analyzed in Excel program (Microsoft), using chi-square test and Kruskal-Wallis test, and considering a level of significance when P <5%. Results: there was a predominance of females, white skinned, with eight to 11 years of schooling, working in other professions, married, with unspecified renal colic as the kidney pathology and discharged after medical consultation and/or hospitalization. Conclusion: patients with acute kidney disease were discharged and patients with chronic kidney disease were hospitalized, with a significant association.(AU)

Objetivo: caracterizar los pacientes atendidos en el Pronto Atendimiento (PA) del Hospital de Base (HB). Método: estudio transversal. La muestra fue constituida de 1716 prontuarios de pacientes atendidos en el PA en el período de enero de 2009 a mayo de 2010. Las variables cuantitativas fueron analizadas en el Programa Excel (Microsoft), test Qui-cuadrado y test de Kruskal-Wallis, siendo considerado el nivel de significancia cuando P < que 5%. Resultados: hubo predominancia del sexo femenino, blancos, de ocho a 11 años de escolaridad, que trabajan en otras profesiones, casados, con patología renal la cólica nefrítica no especificada y alta médica después de la consulta y/o internación. Conclusión: pacientes con enfermedades renales agudas tuvieron alta y pacientes con enfermedades renales crónicas se quedaron internados, con asociación significativa.(AU)