The burden of suicide across different altitudes: 11-year geodemographic analysis conducted in 221 cantons in Ecuador ranging from 0 to 4300 m of elevation.

BACKGROUND: The World Health Organization and the Global Burden of Disease study estimate that almost 800 000 people die from suicide yearly. The role of non-traditional risk factors such as climate and high-altitude exposure are poorly understood. AIMS: This study aims to determine a potential relationship between altitude exposure and suicide rates among 221 cantons located at different altitudes ranging from 0 to 4300 m. METHOD: We conducted an 11-year, country-wide, population-based analysis on age- and gender-standardised suicide rates in Ecuador, based on the official data from the National Institute of Statistics, using all available self-harm death codes (ICD-10 codes X60-X84). RESULTS: A total of 11 280 cases of suicide were reported during 2011-2021. Suicide rates were higher among men (11.48/100 000). In terms of elevation, suicide rates were significantly higher among people from high-altitude cantons (3.7/100 000) versus those from low-altitude cantons. When applying the International Society Mountain Medicine categorisation, suicide rates were significantly higher at moderate- (4.3/100 000), high- (3.6/100 000) and very-high-altitude cantons (4.4/100 000) when compared with low-altitude locations (2.5/100 000). CONCLUSIONS: Ecuador is one of the few countries that has a vast range of cantons located at different altitudes. We found that living at higher elevations is positively associated with greater suicide rates. Although the rates are significantly greater as elevation increases, a clear linear relationship is not apparent, likely because of the interplay of socioeconomic factors, including urbanicity. The effect of chronic hypobaric hypoxia on mood cannot be ruled out, although the existence of causal mechanisms remains to be elucidated.

The impact of an integrative healthcare system on longevity in a nonagenarian population in Northern Mexico: an observational study.

BACKGROUND: Despite the growth in the older population, there is a noticeable research gap regarding integrative health systems for older people and their impact on longevity in nonagenarians. This study aimed to evaluate the effect of an integrative health system consisting of medical services, recreational facilities, and housing on longevity in a population of nonagenarians in Northern Mexico. METHODS: This was a cross-sectional, retrospective, descriptive-analytical study in which we measured and analyzed medical history such as number of hospitalizations, visits to geriatric consultation, hypertension, history of chronic pain, polypharmacy, dementia, rheumatic disease, diabetes mellitus, insomnia, depression, ischemic cardiomyopathy, among others. We also measured social engagement and number of caregivers. A logistic regression was performed to evaluate the predictors of mortality in this population. RESULTS: We included one hundred and ninety-five nonagenarians with a mean (SD) age of 94 (4.2) years and of which 112 (55.7%) were female. The findings from logistic regression analysis indicated that a higher frequency of hospitalizations was associated with an elevated mortality risk (OR = 1.272, p = 0.049). Conversely, increased visits to geriatric consultation services as primary care were linked to a reduced mortality risk (OR = 0.953, p = 0.002). Additionally, social engagement displayed a protective effect (OR = 0.336, p = 0.05). CONCLUSIONS: This study highlighted the role of systemic health approaches in extending life through insights into nonagenarian patients' involvement in primary care, as measured by consultation frequency, and participation in social activities, mitigating mortality risks. Meanwhile, it emphasized the potential consequences of higher hospitalization rates on increased mortality risk.

Cardiorespiratory arrest during and after nuss procedure: case report.

BACKGROUND: Pectum excavatum is a congenital thoracic alteration that can present important physiological alterations depending on the severity of the case. The Nuss procedure is a minimally invasive technique for managing chest wall deformity, in which there is a risk of perioperative complications. CASE PRESENTATION: This article presents the case of a 16-year-old patient who underwent placement of a Nuss bar and suffered intraoperative and postoperative cardiorespiratory arrest. CONCLUSIONS: it is important to consider the possible early and late complications scenarios as well as their treatment in patients with pectum excavatum scheduled for a Nuss procedure.

Postoperative Outcomes of Analgesic Management with Erector Spine Plane Block at T5 Level in Pediatric Patients Undergoing Cardiac Surgery with Sternotomy: A Cohort Study.

Introduction: There is limited evidence on the impact of erector spinae plane block (ESPB) as part of multimodal analgesia in pediatric population undergoing cardiac surgery. Methods: A retrospective cohort study was conducted in patients under 18 years of age, who underwent cardiac surgery Risk Adjusted classification for Congenital Heart Surgery (RACHS-1) ≤3 by sternotomy. The study aims to evaluate the effect of ESPB as part of multimodal analgesia in pediatric patients undergoing cardiac surgery compared to conventional analgesia (CA) on relevant clinical outcomes: length of hospital stay, length of ICU stay, opioid consumption, time to extubation, mortality, and postoperative complications. The participants included were treated in a reference hospital in Colombia from July 2019 to June 2022. Results: Eighty participants were included, 40 in the ESPB group and 40 in the CA group. There was a significant decrease (Log rank test p = 0.007) in days to length of hospital stay in ESPB group (median 6.5 days (IQR: 4-11)) compared to the CA group (median 10.5 days (IQR: 6-25)). Likewise, there was a higher probability of discharge from the ICU in the ESPB group (HR 1.71 (95% CI: 1.05-2.79)). The ESPB group had lower opioid consumption (p < 0.05). There were no differences in time to extubation, mortality, and postoperative complications. Conclusion: ESPB as part of multimodal analgesia in pediatric patients undergoing cardiac surgery is feasible and associated with shorter hospital length of stay, faster ICU discharge and lower opioid consumption.

Ethnic Differences in the Prevalence of Hypertension in Colombia: Association With Education Level.

BACKGROUND: A higher prevalence of hypertension is reported among Afro-descendants compared with other ethnic groups in high-income countries; however, there is a paucity of information in low- and medium-income countries. METHODS: We evaluated 3,745 adults from 3 ethnic groups (552 White, 2,746 Mestizos, 447 Afro-descendants) enrolled in the prospective population-based cohort study (PURE)-Colombia. We assessed associations between anthropometric, socioeconomic, behavioral factors, and hypertension. RESULTS: The overall prevalence of hypertension was 39.2% and was higher in Afro-descendants (46.3%) than in Mestizos (37.6%) and Whites (41.5%), differences that were due to the higher prevalence in Afro-descendant women. Hypertension was associated with older age, increased body mass index, waist circumference and waist-to-hip ratio, independent of ethnicity. Low education was associated with hypertension in all ethnic groups, and particularly in Afro-descendants, for whom it was the factor with the strongest association with prevalence. Notably, 70% of Afro-descendants had a low level of education, compared with 52% of Whites-26% of Whites were university graduates while only 7% of Afro-descendants were. We did not find that education level alone had a mediator effect, suggesting that it is not a causal risk factor for hypertension but is an indicator of socioeconomic status, itself an important determinant of hypertension prevalence. CONCLUSIONS: We found that a higher prevalence of hypertension in Colombian Afro-descendants than other ethnic groups. This was principally associated with their lower mean educational level, an indicator of lower socioeconomic status.

The prediction of Metabolic Syndrome alterations is improved by combining waist circumference and handgrip strength measurements compared to either alone.

BACKGROUND: Adiposity is a major component of the metabolic syndrome (MetS), low muscle strength has also been identified as a risk factor for MetS and for cardiovascular disease. We describe the prevalence of MetS and evaluate the relationship between muscle strength, anthropometric measures of adiposity, and associations with the cluster of the components of MetS, in a middle-income country. METHODS: MetS was defined by the International Diabetes Federation criteria. To assess the association between anthropometric variables (waist circumference (WC), waist-to-hip ratio (W/H), body mass index (BMI)), strength (handgrip/kg bodyweight (HGS/BW)) and the cluster of MetS, we created a MetS score. For each alteration (high triglycerides, low HDLc, dysglycemia, or high blood pressure) one point was conferred. To evaluate the association an index of fat:muscle and MetS score, participants were divided into 9 groups based on combinations of sex-specific tertiles of WC and HGS/BW. RESULTS: The overall prevalence of MetS in the 5,026 participants (64% women; mean age 51.2 years) was 42%. Lower HGS/BW, and higher WC, BMI, and W/H were associated with a higher MetS score. Amongst the 9 HGS/BW:WC groups, participants in the lowest tertile of HGS/BW and the highest tertile of WC had a higher MetS score (OR = 4.69 in women and OR = 8.25 in men;p < 0.01) compared to those in the highest tertile of HGS/BW and in the lowest tertile of WC. CONCLUSION: WC was the principal risk factor for a high MetS score and an inverse association between HGS/BW and MetS score was found. Combining these anthropometric measures improved the prediction of metabolic alterations over either alone.

Rotura aguda de prótesis valvular aórtica biológica Biocor® seis años después de su implante: reporte de un caso / Acute rupture a a Biocor® aortic valve prosthesis six years after implantation

Resumen: Un hombre de 66 años portador de una prótesis valvular aórtica SJM Biocor® (Saint Jude Medical, St Paul, Minn), instalada 6 años antes, se presentó con disnea severa de rápida instalación. Mediante ecocardiografía de superficie y transesofágica se demostró insuficiencia aórtica masiva y el paciente fue reintervenido con éxito. En la operación se observó un desprendimiento parcial de la inserción del velo coronario izquierdo al anillo protésico. No había endocarditis. Se implantó una nueva prótesis biológica Trifecta® (Saint Jude Inc, St Paul, Minn) N°27. La evolución precoz y a 2 años de la intervención es muy satisfactoria.

Abstract A 66 year-old man with a SJM Biocor® (Saint Jude Medical, St Paul, Minn) implanted 6 years before developed unexpected severe dyspnea. Surface and transesophageal echocardiograms confirmed severe aortic regurgitation. The patient was rapidly re operated on. There was a partial detachment of the left coronary leaflet form the valve annulus. There was no evidence of endocarditis. A new valve (Trifecta® (Saint Jude Inc, St Paul, Minn) N°27). was inserted. Clinical course has been uneventful up to two years post surgery.

May Measurement Month 2018: an analysis of blood pressure screening results from Colombia.

High blood pressure (BP) is the leading global preventable cause of death and the most common risk factor for cardiovascular disease (CVD). However, due to its asymptomatic nature, the lack of awareness of this condition causes underdiagnosis and low rates of adherence to pharmacological treatment. Looking for practical approaches to increase awareness worldwide, the International Society of Hypertension (ISH) implemented the 2nd May Measurement Month campaign in 2018 (MMM18). In order to contribute to this initiative, Colombia participated as one of the 89 countries involved in this hypertension screening programme. Blood pressure was measured in subjects from 11 departments in Colombia. Under the leadership of the Fundación Oftalmológica de Santander (FOSCAL), 400 volunteers across the country collected the data following the MMM protocol. Measurements from 35 548 participants with a mean age of 41.9 years were obtained. In total, 9475 (26.7%) of the total population studied had hypertension. Of those with hypertension, 69.9% of these subjects were aware of their condition, 65.0% were on antihypertensive medication, and 43.1% had controlled BP. Of those on medication, 66.3% had controlled BP. Hypertension screening, awareness, treatment, and control should be a priority in public health objectives due to its elevated burden of disease and direct association with increased CVD. The MMM campaign provided a positive impact in the diagnosis of hypertension across Colombia. Although efforts are being made to expand treatment capability and adherence, still more are needed to insure a broader coverage of antihypertensive medication in Colombia.

Psychometric Properties and Measurement Invariance Across Gender and Age-Group of the Perseverative Thinking Questionnaire-Children (PTQ-C) in Colombia.

Recent research has found that repetitive negative thinking (RNT) is an important transdiagnostic process both in adult and child psychopathology. This finding has led some authors to design content-independent measures of RNT that can be administered across disorders. One of these instruments is the Perseverative Thinking Questionnaire (PTQ) and its version for children (PTQ-C). This study presents the Spanish translation of the PTQ-C and its psychometric analysis in a sample of 1,127 Colombian children and adolescents (8-18 years old). All items obtained good discrimination indexes, and internal consistency was excellent (.93). A cross-validation study was conducted to analyze the factor structure of the PTQ-C, which strongly supported the one-factor structure. Measurement invariances across gender and age-group (8-12 and 13-18 years old) were also found. The PTQ-C scores for older boys were lower than for younger boys, whereas the inverse pattern was found for girls. The PTQ-C showed strong correlations with measures of pathological worry, emotional symptoms, and psychological inflexibility. In conclusion, the Spanish translation of the PTQ-C appears to be a valid and reliable measure of RNT.

The hidden costs of living in a transformed habitat: Ecological and evolutionary consequences in a tripartite mutualistic system with a keystone mistletoe.

Land use change is one of the most important anthropogenic drivers of biodiversity loss. Nevertheless, the ecological and evolutionary consequences of habitat transformation remain less understood than those from habitat fragmentation. Transformed habitats are structurally simpler, altering species composition and their ecological interactions, potentially compromising gene flow and genetic diversity. We focused on a tripartite mutualistic system composed of a mistletoe (Tristerix corymbosus), its pollinator (Sephanoides sephaniodes) and its seed disperser (Dromiciops gliroides) to assess changes in their ecological and evolutionary dynamics as a result of habitat transformation. We used eight microsatellite markers to compare genetic diversity, relatedness and gene flow among five mistletoe groups inhabiting native and transformed habitats (abandoned Eucalyptus globulus plantations). We found that these groups were genetically structured, with greater allelic richness and genetic diversity in their native habitat. Also, we found higher relatedness among mistletoe individuals in transformed habitats, which varied as a function of the geographic distance among plants, probably as a result of larger resource availability, which influenced mutualist visitation rates. We did not find differences in the current migration patterns, which suggests that Tristerix corymbosus may be resilient to habitat transformation. Yet, its highly specialized interactions along with changes in its spatial configuration depict a more complex scenario, which probably impose a cost in terms of lower genetic diversity and increased relatedness that might compromise its long-term viability.

The most effective pollinator principle applies to new invasive pollinators.

G. L. Stebbins' most effective pollinator principle states that when pollinators are not limiting, plants are expected to specialize and adapt to the most abundant and effective pollinator species available. In this study, we quantify the effectiveness of bees, hummingbirds and hawkmoths in a Chilean population of Erythranthe lutea (Phrymaceae), and examine whether flower traits are subject to pollinator-mediated selection by the most effective pollinator species during two consecutive years. Unlike most species in the pollinator community, the visitation rate of the recently arrived Bombus terrestris did not change substantially between years, which together with its high and stable pollen delivery to flower stigmas made this species the most important in the pollinator assemblage, followed by the solitary bee Centris nigerrima Flower traits were under significant selection in the direction expected for short-tongue bees, suggesting that E. lutea is in the initial steps of adaptation to the highly effective exotic bumblebee. Our results illustrate the applicability of Stebbins' principle for new invasive pollinators, and stress their importance in driving flower adaptation of native plant species, a critical issue in the face of biotic exchange and homogenization.

Beyond habitat structure: Landscape heterogeneity explains the monito del monte (Dromiciops gliroides) occurrence and behavior at habitats dominated by exotic trees.

Habitat structure determines species occurrence and behavior. However, human activities are altering natural habitat structure, potentially hampering native species due to the loss of nesting cavities, shelter or movement pathways. The South American temperate rainforest is experiencing an accelerated loss and degradation, compromising the persistence of many native species, and particularly of the monito del monte (Dromiciops gliroides Thomas, 1894), an arboreal marsupial that plays a key role as seed disperser. Aiming to compare 2 contrasting habitats (a native forest and a transformed habitat composed of abandoned Eucalyptus plantations and native understory vegetation), we assessed D. gliroides' occurrence using camera traps and measured several structural features (e.g. shrub and bamboo cover, deadwood presence, moss abundance) at 100 camera locations. Complementarily, we used radio telemetry to assess its spatial ecology, aiming to depict a more complete scenario. Moss abundance was the only significant variable explaining D. gliroides occurrence between habitats, and no structural variable explained its occurrence at the transformed habitat. There were no differences in home range, core area or inter-individual overlapping. In the transformed habitats, tracked individuals used native and Eucalyptus-associated vegetation types according to their abundance. Diurnal locations (and, hence, nesting sites) were located exclusively in native vegetation. The landscape heterogeneity resulting from the vicinity of native and Eucalyptus-associated vegetation likely explains D. gliroides occurrence better than the habitat structure itself, as it may be use Eucalyptus-associated vegetation for feeding purposes but depend on native vegetation for nesting.

Meta-analysis of anthropogenic habitat disturbance effects on animal-mediated seed dispersal.

Anthropogenic habitat disturbance is a strong biodiversity change driver that compromises not only the species persistence but also the ecological interactions in which they are involved. Even though seed dispersal is a key interaction involved in the recruitment of many tree species and in consequence critical for biodiversity maintenance, studies assessing the effect of different anthropogenic disturbance drivers on this interaction have not been performed under a meta-analytical framework. We assessed the way habitat fragmentation and degradation processes affect species diversity (abundance and species richness) and interaction rates (i.e., fruit removal and visitation rates) of different groups of seed-disperser species at a global scale. We obtained 163 case studies from 37 articles. Results indicate that habitat degradation had a negative effect on seed-disperser animal diversity, whereas habitat fragmentation had a negative effect on interaction rates. Birds and insects were more sensitive in terms of their diversity, whereas mammals showed a negative effect on interaction rates. Regarding habitat, both fragmentation and degradation had a negative effect on seed-disperser animal diversity only in temperate habitats, and negative effects on interaction rates in tropical and temperate habitats. Our results indicate that the impact of human disturbance on seed-disperser species and interactions is not homogeneous. On the contrary, the magnitude of effects seems to be dependent on the type of disturbance, taxonomic group under assessment, and geographical region where the human impact occurs.

How forest marsupials are affected by habitat degradation and fragmentation? A meta-analysis.

Habitat fragmentation and degradation are important biodiversity change drivers worldwide. Their effects have been described for many animal groups, but little is known about marsupials. We conducted a meta-analysis aiming to evaluate the actual effects of habitat fragmentation and degradation on forest marsupials. From a literature survey, we obtained 85 case studies reporting disturbance comparisons. We found a negative overall effect, as well as a negative effect for habitat fragmentation, but not for habitat degradation. Marsupials from Oceania were negatively affected by habitat disturbance, whereas there was no effect for those from South America. Arboreal marsupials were negatively affected, whereas terrestrial marsupials did not. Species from the families Dasyuridae (Antechinus spp.) and Microbiotheriidae (Dromiciops gliroides) showed to be sensitive to habitat disturbance.

Grado de transportación del canal radicular de tres sistemas de instrumentación rotatoria: estudio a través de tomografía computarizada Cone beam / Degree of root canal transportation of three rotary instrumentation systems: a cone-beam computed tomography study

Introducción: en la preparación del sistema de canales radiculares se debe lograr una conformación progresivamente cónica desde apical hacia coronal, sin generar accidentes de procedimiento. Se define como transportación al cambio de ubicación espacial del canal radicular con respecto a su ubicación original, produciéndose así el desgaste no proporcional de alguna de las paredes dentinarias en relación con la anatomía original de este. Durante la última década, se han fabricado nuevos instrumentos endodónticos rotatorioscon base en níquel-titanio (NiTi), lo que provee mayor flexibilidad y resistencia a la fractura, disminuye el tiempo de trabajo y la fatiga del operador, facilitando así la conformación adecuada del canal y reduciendo accidentes durante los procedimientos.Método: estudio in vitro, de 45 canales radiculares humanos superiores e inferiores con curvaturas severas seleccionados a través de radiografías convencionales. Se formaron 3 grupos de 15 conductos que fueron preparados con los sistemas de instrumentación rotatoria antes mencionados. Se utilizótecnología Cone beam para registro de imágenes previas y posteriores a la instrumentación, las que se tomaron a través de rodetes de siliconaconformando una arcada dentaria con la idea de ser un montaje reproducible posinstrumentación. Se hicieron mediciones en los cortes tomados a los 2, 4, 6, y 8 mm desde el ápice por canal instrumentado, en cada corte se hicieron 4 mediciones, pared vestibular, lingual, furca y cara libre. Los datos obtenidos fueron analizados mediante test Wilcoxon para muestras pareadas y el test ANOVA. Resultados yconclusiones: los resultados indican que el sistema ProTaper Universal (Dentsplay-Maillefer, Switzerland) produce mayor transportación delcanal radicular a nivel del tercio medio en comparación con los sistemas RaCe (FKG-Dentaire, Switzerland) y K3 (SybrondEndo, USA).

Introduction: the preparation of root canals should provide a progressively tapered shape from apical towards coronal, without producing procedural errors. Transportation is defined as the change in location of the root canal with respect to its original position, producing unbalanced wear in any of the dentine walls in relation to their original anatomy. New rotary endodontic instruments have been developed during the latest decade with nickel-titanium (NiTi), a material that provides increased flexibility and fracture strength, reduces working time and operator fatigue, and facilitates proper canal preparation while reducing procedural errors. Method: this wasan in vitro study on 45 upper and lower human root canals with moderate to severe curvatures, selected through conventional radiograph They were sorted out in 3 groups of 15 canals that were prepared with the aforementioned rotary instrumentation systems. The cone beam technology was used to record images before and after instrumentation; these images were obtained by means of a silicon rim that formed a dental arch intended to serve as a post-instrumentation reproducible assembly. Measurements were made in sections taken at 2, 4, 6, and 8 mm from the apex via instrumented canal; four measurements were made in each section: the buccal, lingual, furcation and free side walls. The obtained data were analyzed with the Wilcoxon test for paired samples and the ANOVA test.Results and conclusions: the results suggest that the ProTaper Universal system (Dentsply-Maillefer, Switzerland) produces the most root canal transportation at the middle third compared with the RaCe (FKG-Dentaire, Switzerland) and K3 (SybronEndo, USA) systems. Also, the K3 system showed more conservative wear at 2, 4 and 6 mm of root canal instrumentation, which makes it suitable for instrumenting thin and curved canals.

Evaluation of the diagnostic utility of fiberoptic bronchoscopy for smear-negative pulmonary tuberculosis in routine clinical practice.

We evaluated the diagnostic yield of fiberoptic bronchoscopy for the diagnosis of smear-negative pulmonary tuberculosis in patients treated at a referral hospital in Lima, Peru. Of the 611 patients who underwent the procedure, 140 (23%) were diagnosed with tuberculosis based on the analysis of BAL samples. Being young and being male were significantly associated with positive cultures. In addition, 287 patients underwent post-bronchoscopic sputum smear testing for AFB, the results of which increased the diagnostic yield by 22% over that obtained through the analysis of BAL samples alone. We conclude that the analysis of BAL samples and post-bronchoscopic sputum samples provides a high diagnostic yield in smear-negative patients suspected of having pulmonary tuberculosis.

Disseminated toxoplasmosis in an immunocompetent patient from Peruvian Amazon.

We report a case of severe toxoplasmosis in an immunocompetent patient, characterized by pneumonia, retinochoroiditis, hepatitis and myositis. Diagnosis was confirmed by serology, T. gondii in thick blood smear and presence of bradyzoites in muscle biopsy. Treatment with pyrimethamine plus sulfadoxine was successful but visual acuity and hip extension were partially recovered. This is the first case report of severe toxoplasmosis in an immunocompetent patient from Peru.

Disseminated toxoplasmosis in an immunocompetent patient from Peruvian Amazon / Toxoplasmosis diseminada en un paciente inmunocompetente procedente de la Amazonía peruana

We report a case of severe toxoplasmosis in an immunocompetent patient, characterized by pneumonia, retinochoroiditis, hepatitis and myositis. Diagnosis was confirmed by serology, T. gondii in thick blood smear and presence of bradyzoites in muscle biopsy. Treatment with pyrimethamine plus sulfadoxine was successful but visual acuity and hip extension were partially recovered. This is the first case report of severe toxoplasmosis in an immunocompetent patient from Peru.

Reportamos un caso de toxoplasmosis severa en un paciente inmunocompetente caracterizado por neumonía, retinocoroiditis, hepatitis y miositis. El diagnóstico fue confirmado por serología, el hallazgo de T. gondii en gota gruesa y la presencia de bradizoitos en biopsia muscular. El tratamiento con pirimetamina mas sulfadoxina fue exitoso pero solo hubo una parcial recuperación de la agudeza visual y de la capacidad de extensión de la cadera. Este es el primer reporte de un caso de toxoplasmosis severa en el Perú.

Caracterización de los accidentes de tránsito en la región Callao-Perú, 1996-2004 / Characterization of traffic accidents in Callao-Perú, 1996-2004

Objetivo: Describir las características de los accidentes de tránsito en el Callao (de 1996 a 2004). Material y métodos: Estudio ecológico descriptivo de fuentes secundarias. Se tomó en cuenta la información registrada por las instituciones que participan en la cobertura de un accidente de tránsito en el Callao (policía, hospitales y morgue) y que forman parte del Comité Multisectorial para la Vigilancia y Prevención de los Accidentes de Tránsito. Los resultados se presentan en gráficos y tablas. Resultados: En el Callao se registraron 25 426 accidentes de tránsito entre 1996 y 2004. El tipo de accidente más común fue el choque. El exceso de velocidad fue la condición que más accidentes ha causado (29.9%). El 61% de los accidentes de tránsito se produjeron en fin de semana. La Av. Gambetta presentó la mayor cantidad de accidentes (4 414). De los 23 315 accidentes registrados entre 1996 y 2003, 48% concluyeron en daño material, la mayoría de éstos por choques (86.8%), mientras que 667 accidentes (3% del total) fueron fatales. Los atropellos tuvieron consecuencia fatal en 11.9%. Los años con mayor número de muertes fueron 1996 y 1998. Los atendidos son 66% hombres y 64.8% del total de atendidos correspondió al grupo etario de 20 a 64 años. La lesión medular fue el diagnóstico más frecuente (24%) en el Instituto Nacional de Rehabilitación con sede en el Callao. Los traumatismos múltiples y encéfalo-craneanos fueron la causa de muerte más común (70.7%). Conclusiones: Los accidentes de tránsito son un grave problema de salud pública en el Callao. Existe una leve disminución en frecuencia después del año 2000.

Objective: To describe the characteristics of traffic accidents in Callao from 1996 to 2004. Methods: Ecological, descriptive study of secondary sources. We took into account data collected by institutions involved in responding to traffic accidents in Callao (police, hospitals and morgue) and data from the ôMultisectorial Committee for the Surveillance and Prevention of Traffic Accidentsõ. The results are presented in graphs and tables. Results: Between 1996 and 2004 there were 25 426 registered traffic accidents in Callao. Collissions with other vehicles cars were the most common type of traffic accident. Speeding is the most common cause of accidents (29.9%). 61% of traffic accidents occur during the weekend. Gambetta Avenue had the highest number of accidents (4 414). Of the 23 315 accidents that occurred between 1996 and 2003, 48% resulted in vehicular damage, mostly from collissions with other vehicles (86.8%), and 667 accidents (3% of total) were fatal. 11.9% of run overs were fatal. 1996 and 1998 were the years with the highest number of fatalities. 66% of the persons treated for injuries due to traffic accidents were male and 64.8% were between teh ages of 20 to 64. Spinal cord injury was the most frequent diagnosis (24%) in the Callao center of the National Rehabilitation Institute. Multiple traumas and encephalo-cranial trauma were the most common cause of death (70.7%). Conclusions: Traffic accidents are a serious public health problem in Callao. There is a slight decrease in frequency after 2000.