Estimated potential death and disability averted with vehicle safety interventions, Association of Southeast Asian Nations.

Objective: To evaluate road safety in member countries of the Association of Southeast Asian Nations and estimate the benefits that vehicle safety interventions would have in this group of countries. Methods: We used a counterfactual analysis to assess the reduction in traffic deaths and disability-adjusted life years (DALYs) lost if eight proven vehicle safety technologies and motorcycle helmets were entirely in use in countries of the Association of Southeast Asian Nations. We modelled each technology using country-level incidence estimations of traffic injuries, and the prevalence and effectiveness of the technology to calculate the reduction in deaths and DALYs if the technology was fitted in the entire vehicle fleet. Findings: The availability of electronic stability control, including the antilock braking systems, would provide the most benefits for all road users with estimates of 23.2% (sensitivity analysis range: 9.7-27.8) fewer deaths and 21.1% (9.5-28.1) fewer DALYs. Increased use of seatbelts was estimated to prevent 11.3% (8.11-4.9) of deaths and 10.3% (8.2-14.4) of DALYs. Appropriate and correct use of motorcycle helmets could result in 8.0% (3.3-12.9) fewer deaths and 8.9% (4.2-12.5) fewer DALYs. Conclusion: Our findings show the potential of improved vehicle safety design and personal protective devices (seatbelts and helmets) to reduce traffic deaths and disabilities in the Association of Southeast Asian Nations. These improvements can be achieved by vehicle design regulations and creating consumer demand for safer vehicles and motorcycle helmets through mechanisms such as new car assessment programmes and other initiatives.

Isokinetic assessment of the hip muscles in patients with osteoarthritis of the knee.

OBJECTIVES: To evaluate the difference in isokinetic strength of hip muscles between patients with knee osteoarthritis (OA) and matched healthy controls, and to establish the correlation between this isokinetic strength and pain and function in patients with knee OA. METHODS: 25 patients with a diagnosis of unilateral knee OA, 25 patients with bilateral knee OA, and 50 matched controls were evaluated using the visual analog scale for pain, knee Lequesne index, Western Ontario and McMaster Universities questionnaire and an isokinetic test. RESULTS: The groups were matched for age, gender and body mass index. The results of the isokinetic test revealed lower peak torque of the hip in patients with OA of the knee than in the control group for all movements studied. Strong correlations were found between the peak torque, visual analog scale and function. CONCLUSIONS: Patients with OA of the knee exhibit lower isokinetic strength in the hip muscles than healthy control subjects. Strengthening the muscles surrounding the hip joint may help to decrease pain in people with knee OA. Some correlations between pain/function and peak torque were found.

Isokinetic assessment of the hip muscles in patients with osteoarthritis of the knee

OBJECTIVES: To evaluate the difference in isokinetic strength of hip muscles between patients with knee osteoarthritis (OA) and matched healthy controls, and to establish the correlation between this isokinetic strength and pain and function in patients with knee OA. METHODS: 25 patients with a diagnosis of unilateral knee OA, 25 patients with bilateral knee OA, and 50 matched controls were evaluated using the visual analog scale for pain, knee Lequesne index, Western Ontario and McMaster Universities questionnaire and an isokinetic test. RESULTS: The groups were matched for age, gender and body mass index. The results of the isokinetic test revealed lower peak torque of the hip in patients with OA of the knee than in the control group for all movements studied. Strong correlations were found between the peak torque, visual analog scale and function. CONCLUSIONS: Patients with OA of the knee exhibit lower isokinetic strength in the hip muscles than healthy control subjects. Strengthening the muscles surrounding the hip joint may help to decrease pain in people with knee OA. Some correlations between pain/function and peak torque were found.

Grau de satisfação do paciente e complicações pós-operatórias da cirurgia de septoplastia com e sem o uso de tampão nasal / Degree of the patient satisfaction and post-operative complications for septoplasty surgery with and without the use of nasal buffer

Objetivo: Avaliar o grau de satisfação dos pacientes a realização de septoplastia com e sem o emprego de tampões nasais e avaliar as complicações mais freqüentes em relação ao uso ou não de tampões nasais após a realização de septoplastia. Método: Clínico prospectivo randomizado comparativo entre pacientes com tampão nasal e sem tamponamento. Os autores observaram 152 pacientes, operados de septoplastia no Hospital Angelina Caron. Foram avaliados quanto ao grau de satisfação nas primeiras 72 horas e após 7 dias; e as principais complicações em intervalos seriados de 72 horas e após 7 dias. Resultados: Grupo sem tamponamento avaliou como de boa qualidade o pós-operatório, apenas 2 pacientes avaliaram como péssima a recuperação. O grupo que usou tampão nasal a recuperação não foi bem tolerada por mais da metade dos pacientes e o motivo por não submeter-se a nova cirurgia foi o tampão nasal, seguido pelo medo de realizar anestesia. Os pacientes que não usaram tampão também tiveram menor número de casos de complicações como hemorragia, abscesso, infecção, dor/queixas respiratórias e sinéquia/crostas no pós-operatório imediato, após 72 horas e após 7 dias. Conclusão: Tamponamento nasal embora bastante difundido no meio cirúrgico, não propicia contentamento do paciente. Assim como a maioria dos cirurgiões já propõe realização de cirurgia com anestesia geral ou local, também deveria avaliar a técnica a ser empregada e informar ao paciente sobre a possibilidade de realizar a cirurgia com e sem tamponamento nasal.

Objective: To assess the degree of satisfaction of pacients submitted the septoplasty with and without the use of nasal buffer and assess the most common complications pursuant to the use of tampons or not after nasal septoplasty. Method: Randomized prospective clinical method compared between patients with and without nasal buffer. The authors observed 152 patients operated on septoplasty in Hospital Angelina Caron. They were assessed for degree of satisfaction in the first 72 hours and after 7 days; and the major complications in intervals of 72 hours and after 7 days. Results: The group without nasal buffer assessed the post-operative as offering good quality, only 2 patients evaluated it as a bad recovery. For the group using nasal buffer the recovery was not well tolerated by more than a half of the patients and the reason for not undergoing a new surgery was the nose buffer, followed by the fear of undergoing anesthesia. Patients who did not use buffer also had fewer cases of complications such as bleeding, abscesses, infection, pain/respiratory complaints and synechia/crusts in the immediate postoperative period, after 72 hours and after 7 days. Conclusion: Although septoplasty with nasal buffer is very widespread in the surgical middle, It does not provide the patient satisfaction. As most surgeons now propose holding of surgery with general or local anesthesia, they should also assess the technique to be employed and inform the patient about the possibility of conducting the surgery with and without nasal buffer.

Measurement of upper limb ulcers in patients with systemic sclerosis: reproducibility and correlation with pain, function, and quality of life.

BACKGROUND: There are a large number of studies addressing the treatment and assessment of chronic ulcers. Despite the fact that ischemic ulcers are frequent and difficult to manage in cases of systemic sclerosis, there is minimal literature on assessment measures regarding these wounds or on their reproducibility. OBJECTIVES: The aim of this study was to investigate intraobserver and interobserver reproducibility regarding ulcer dimension measurements in patients with systemic sclerosis. Correlations between pain, upper limb function, pinch strength, and quality of life were also determined. METHODS: A prospective 11-week follow-up study was carried out to assess active upper limb ulcers. Ulcer diameter, ulcer area, and interobserver reproducibility were performed weekly. Quality of life (Medical Outcomes Study 36-Item Short-Form Health Survey), upper limb function (disabilities of the arm, shoulder, and hand), pinch strength, pain, visual analog scale, and intraobserver reproducibility were assessed at baseline, 3, 7, and 11 weeks. RESULTS: Fifty-one active ulcers were recorded. Larger ulcer diameter, smaller ulcer diameter, and ulcer area demonstrated excellent intraobserver (r > .81, p < .001) and interobserver reproducibility (r > .76, p < .001). There was significant correlation between ulcer dimension and visual analog scale scores for pain (r = .42; p < .001) and some Medical Outcomes Study 36-Item Short-Form Health Survey; pinch strength; and disabilities of the arm, shoulder, and hand domains (r >or= .40; p < .01). DISCUSSION: Simple measurement instruments for the assessment of ischemic ulcers were reproducible in patients with SSc and correlated to other variables of interest for these wounds.

Estudo experimental de corticóide injetável em microcirurgia laríngea / Experimental study of injetable corticoid in laringeal microsurgery

Avaliação macroscópica da presença de sinéquias e quantificação comparativa da deposição de fibras de colágeno total em pregas vocais após exérese de fragmento de mucosa a frio, com ou sem, o uso de corticóide injetável local...

Evaluate the presence of synechiae and comparatively quantify collagen fibers deposition in vocal folds that underwent excision of the mucosa fragments with cold instrument, with or without using local injected corticoid controlled experimental...