Novel system configuration with activated sludge like-geometry to develop aerobic granular biomass under continuous flow.

A novel continuous flow system with "flat geometry" composed by two completely mixed aerobic tanks in series and a settler was used to promote the formation of aerobic granular sludge. Making similarities of this system with a typical sequencing batch reactor (SBR), for aerobic granules cultivation, the value of the tank 1/tank 2 vol ratio and the biomass recirculation rate would correspond with the feast/famine length ratio and the length of the operational cycle, respectively, while the settler upflow liquid velocity imposed would be related to the settling time. From the three experiments performed the best results were obtained when the tank 1/tank 2 vol ratio was of 0.28, the sludge recycling ratio of 0.25 and the settler upflow velocity of 2.5 m/h. At these conditions the aggregates had settling velocities between 29 and 113 m/h, sludge volume index at 10 min (SVI10) of 70 mL/g TSS and diameters between 1.0 and 5.0 mm.

Epididymal mitochondrial status of hypothyroid rats examined by transmission electron microscopy.

Hypothyroid rats show alterations in the mobility of sperm recovered from their epididymides. The AgNOR technique, immunohistochemistry and transmission electron microscopy were used to investigate changes in epithelial cells from epididymides of rats treated with (131)I. Counting of NORs did not permit detection of changes in the proliferative capacity of epididymides of hypothyroid animals. Transmission electron microscopy revealed changes in the mitochondria of hypothyroid rats that probably are associated with incipient apoptosis.

Tratamiento quirúrgico de fracturas transversas más pared posterior de acetábulo / Surgical treatment of transverse and posterior acetabular wall fractures

Objective: Describe our experience in the surgical treatment of transverse with posterior wall fractures of the acetabulum, the elements that help in the choice of the approach and functional and radiological results of this type of injury. Methods: We retrospectively evaluated 9 patients (9 fractures) with transverse and posterior wall fractures operated between August 2008 and September 2010. Six patients were men and 3 women with an average age of 40.4 years. We reviewed the surgical protocols, the perioperative data and the pre and post operative radiological images. We registered the complications and the functional results with the Merle D’Aubigne and Postel score. Results: All cases were considered secondary to high energy mechanisms. Five patients had posterior dislocation of the hip and 4 had central dislocation. Eight patients had associated injuries. In the early postoperative period there were no complications. One patient had posttraumatic osteoarthritis and required total hip arthroplasty. The average of Merle d’Aubigne score was 16.1 points. Conclusion: Surgical treatment for this type of injury had good results in this group of patients.

Objetivo: Describir nuestra experiencia en el tratamiento quirúrgico de las fracturas transversas más pared posterior de acetábulo, los elementos que ayudan en la elección del abordaje y los resultados funcionales y radiológicos de este tipo de lesiones. Material y Métodos: Estudio retrospectivo y descriptivo de una serie consecutiva de 9 pacientes (9 fracturas) operados de una fractura transversa más pared posterior de acetábulo entre agosto de 2008 y septiembre de 2010. Seis hombres y 3 mujeres con una mediana de edad de 40,4 años se operaron en este período. Se revisaron los protocolos operatorios, las fi chas clínicas y las imágenes pre y postoperatorias. Se evaluaron las complicaciones tempranas y tardías y los resultados funcionales de acuerdo a la escala de Merle D’Aubigne y Postel a un seguimiento promedio de 17 meses. Resultados: Todos los casos se consideraron secundarios a mecanismos de alta energía. Cinco pacientes presentaron luxación posterior de cadera y 4 presentaron luxación central. Ocho pacientes presentaron lesiones asociadas. En el postoperatorio temprano no se presentaron complicaciones. Un paciente presentó artrosis post traumática y requirió artroplastía total de cadera. El puntaje promedio de Merle d’Aubigne fue de 16,1 puntos. Conclusión: El tratamiento quirúrgico para este tipo de lesiones tiene buenos resultados en el corto plazo en este grupo de pacientes.

Técnica quirúrgica para facilitar lacolocación de tornillos sacroilíacospercutáneos / Percutaneous iliosacral screw fixation

Percutaneous iliosacral screw fixation is a useful technique for fixation of posterior pelvis ring injuries but it has potential complications. We describe a surgical technique modification of the original technique described by Routt etal. Using the surface of the C-arm as a guide in the inlet and outlet views, exact positioning of the guide wire is easier and surgical time as radiation exposure are decreased. We hope that this modification, in addition to a better understanding of sacral anatomical variations and risk factors for misplacement of iliosacral screws would reduce complications related to this procedure.

La fijación percutánea con tornillos sacroilíacos es una técnica de utilidad demostrada para la fijación de las fracturas de la pelvis posterior, sin embargo, no está exenta de riesgos. Describimos una modificación de la técnica quirúrgica original descrita por Routt et al. Utilizando las superficies del fluoroscopio como referencia en las vistas inlet y outlet, se facilita la orientación de la aguja guía disminuyendo el tiempo operatorio y el tiempo de radiación necesaria para la colocación de este tipo de osteosíntesis. Esperamos que esta modificación, asociado a un mejor conocimiento de la anatomía del sacro y los factores asociados a mal posición de los tornillos sacroilíacos permita disminuir los riesgos asociados a este procedimiento.

Sternal and vertebral fractures, a well-known association, usually overlooked: review of six clinical cases / Fraturas vertebrais e fraturas concomitantes do esterno: revisão de seis casos / Fracturas vertebrales y fracturas concomitantes del esternón: revisión de seis casos

OBJECTIVE: the association of sternal and vertebral fractures has previously been described in the literature. These lesions are frequently overlooked at the initial evaluation. The purpose of this study was to review and discuss the diagnostic methods used to diagnose these lesions and to highlight the importance of early recognition of these fractures. METHODS: we performed a retrospective analysis of six patients who suffered sternal and concomitant vertebral fractures. Clinical charts and imaging studies were reviewed. RESULTS: all patients were diagnosed with sternal fractures at the initial evaluation, but only two were diagnosed with vertebral fractures. CONCLUSION: failure to recognize these fractures at initial evaluation may be associated with the fact that the upper thoracic region is difficult to explore. In the presence of sternal fractures, a vertebral fracture must be ruled out even though major injuries are not present. A computer tomography (CT) scan and magnetic resonance imaging (MRI) should be obtained despite negative X-rays if clinical suspicion is present.

OBJETIVO: a associação de fraturas do esterno e vertebral tem sido previamente descrita na literatura. Essas lesões são frequentemente negligenciadas na avaliação inicial. O objetivo deste estudo foi analisar e discutir os métodos diagnósticos utilizados para essas lesões e salientar a importância do reconhecimento precoce dessas fraturas. MÉTODOS: foi realizada uma análise retrospectiva de seis pacientes que sofreram, concomitantemente, fraturas do esterno e vertebrais, por meio da análise de prontuários e exames de imagem. RESULTADOS: todos os pacientes foram diagnosticados com fraturas do esterno na avaliação inicial, mas somente dois foram diagnosticados com fraturas vertebrais. CONCLUSÃO: o não-reconhecimento dessas fraturas na avaliação inicial pode ser associado à dificuldade de explorar a região torácica superior. Na presença de fraturas do esterno, uma fratura vertebral deve ser descartada, embora lesões maiores não sejam presentes. A tomografia computadorizada (TC) e a ressonância magnética (RM) devem ser obtidas se houver suspeita clínica, apesar de os raios-X serem negativos.

OBJETIVO: la asociación de las fracturas del esternón y vertebrales ha sido descrita previamente en la literatura. Estas lesiones son frecuentemente descuidadas en la evaluación inicial. El objetivo de este estudio fue analizar y discutir los métodos diagnósticos utilizados para estas lesiones y resaltar la importancia del reconocimiento precoz de estas fracturas. MÉTODOS: fue realizado un análisis retrospectivo de seis pacientes que sufrieron concomitantemente fracturas del esternón y vertebrales, por medio del análisis de las historias clínicas y exámenes de imagen. RESULTADOS: todos los pacientes fueron diagnosticados con fracturas del esternón en la evaluación inicial, pero solamente dos fueron diagnosticados con fracturas vertebrales. CONCLUSIONES: el hecho de no reconocer estas fracturas en la evaluación inicial puede estar asociado a la dificultad de explorar la región torácica superior. En la presencia de fracturas del esternón, una fractura vertebral debe ser descartada, así no estén presentes lesiones mayores. La tomografía computarizada y la resonancia magnética deben ser obtenidas en el momento de sospecha clínica, aunque el rayo-X sea negativo.

Fijación externa supra-acetabular de pelvis: nota técnica / Supra acetabular pelvic external fixation: technical note

Introduction: External fixation is a useful technique for the treatment of instable pelvic fractures. There are several configuration alternatives regarding to Schanz pin placement. In order to assure safe placement of the Shanz pins, it is useful to obtain an intraoperative fluoroscopic image of the supra-acetabular teardrop, wich indicates the linear osseous path between the anterior inferior iliac spine (AIIS) and the posterior superior iliac spine (PSIS). Material and Method: The surgical technique for safe supra-acetabular pin placement is described using an anatomic piece corresponding to the pelvis of a middle-aged male. A combination of outlet and obturador projections is sued to show an adequate fluoroscopic vision of the supra-acetabular teardrop. The result of this technique is demonstrated with a case report. Results: Having achieved a proper intraoperative vision of the supra-acetabular teardrop, the Schanz pins can be safely placed from the anterior inferior iliac spine (AIIS) through the osseous corridor in order to reach the posterior superior iliac spine (PSIS). Conclusions: Placing both Schanz pins in the supra-acetabular area and guided under fluoroscopic vision as described in this technique, allows reaching the posterior pelvis, achieving better control of bone fragments and compression of the posterior pelvic ring through an anterior approach. Therefore, this technique is an excellent alternative for external fixation of an unstable pelvic fracture.

Introducción: La fijación externa es de gran utilidad para el tratamiento de fracturas inestables de pelvis. Existen diversas opciones de configuración y alternativas para la colocación de los fijadores externos. Para la colocación segura de estas agujas de Schanz, la imagen fluoroscópica intra operatoria de la “lágrima” supra-acetabular, que indica el trayecto lineal entre la espina ilíaca antero inferior (EIAI) y la espina ilíaca postero superior (EIPS), resulta de gran utilidad. Material y Método: Se describe la técnica para la colocación de estas agujas en una pieza anatómica bajo visión fluoroscópica y cómo obtener una adecuada visión de la “lágrima” supra-acetabular al colocar el aparato de rayos en outlet-obsturatriz. Además se muestra el resultado de esta técnica en un caso clínico. Resultados: Obteniendo una adecuada visión intra-operatoria de la “lágrima” supra-acetabular se pueden colocar agujas de Schanz o cualquier material de osteosíntesis desde la espina ilíaca antero inferior hasta la espina ilíaca postero superior a través de un corredor óseo supra-acetabular. Conclusiones: Las agujas de Schanz colocadas en la zona supra-acetabular bajo control de rayos con la técnica aquí descrita permiten alcanzar la zona posterior de la pelvis (EIPS), logrando un mejor control de los fragmentos óseos y permitiendo la compresión desde anterior de la pelvis posterior. Son por lo tanto una excelente alternativa al momento de decidir una fijación externa de fracturas inestables de pelvis.

Osteotomía del trocánter mayor tipo flip en el tratamiento quirúrgico de fracturas de acetábulo / Trochanteric flip osteotomy in the treatment of acetabular fractures

Objective: Analyze a series of patients that underwent surgery for an acetabular fracture in which a trochanteric flip osteotomy was used and discuss the advantages of this surgical procedure. Materials and Method: The clinical files of 8 patients treated of acetabular fractures with this approach is reported. Functional results are evaluated with the Merle d´Aubigne scale. Also, postoperative complications were age of patients was 41 years (range: 28-60 years). Mean follow-up was 13.8 months (range: 4-41 months). Functional results were excellent in 2 patients, good in 4 patients, regular in one patient and poor in one patient. Postoperative complications include two cases of heterotopic ossifications. No loosening of the osteotomy or avascular necrosis of the femoral head was observed. Conclusions: This technique facilitates in selected acetabular fractures, to obtain better visualization and more accurate reduction, by allowing safely dislocation of the femoral head and assessment of the intraarticular reduction.

Objetivo: Revisar los resultados radiológicos y funcionales de una serie de pacientes operados por fractura de acetábulo en que se utilizó un abordaje posterior con osteotomía del trocánter mayor tipo "flip", discutir ventajas y complicaciones potenciales de esta técnica. Material y Método: Se revisaron las fichas clínicas de 8 pacientes operados por fractura de cotilo en que se utilizó la osteotomía del trocánter mayor tipo "flip". Se evaluaron las complicaciones observadas y los resultados clínicos con la escala de Merle d`Aubigne. Resultados: La edad promedio de los pacientes fue de 41 años (rango: 28-60 años). El seguimiento promedio fue de 13,8 meses (rango: 4-41 meses). En cuanto a los resultados funcionales, en 2 pacientes fueron excelentes, en 4 pacientes buenos, en 1 paciente regular y en 1 paciente malo. Las complicaciones fueron 2 casos de osificaciones heterotópicas grado I y II de Broker. No hubo casos de aflojamiento de trocánter mayor o necrosis avascular. Conclusiones: Esta técnica quirúrgica facilita el tratamiento en casos seleccionados de fracturas acetabulares, al permitir luxar la cadera y mejorar la visualización de la reducción intraarticular, sin agregar mayores complicaciones.

Hemodinamia inestable en fracturas de pelvis estables / Results in the surgical treatment of the unstable shoulder

We report two cases of hemodynamic instability secondary to stable pelvic fractures. Both patients had isolated arterial lesions with large pelvic hematomas. In the two cases embolization of the injured vessel was performed. Knowing the existence of this kind of traumatic lesion is crucial for early diagnosis improving the results in the treatment of this life-threatening condition. Patients with pelvic fractures should be under observation for long periods of time, because delayed hemorrhage can occur.

Presentamos dos casos de inestabilidad hemodinámica en pacientes con fracturas de pelvis que fueron consideradas estables. Los pacientes presentaban lesión arterial traumática aislada y hematoma para-vesical de gran tamaño. Ambos fueron tratados de manera exitosa mediante embolización de su lesión arterial. Conocer este tipo de lesiones y diagnosticarlas de manera oportuna son claves en el buen resultado clínico de una lesión potencialmente mortal pero frecuentemente subvalorada. Es aconsejable observar por períodos prolongados de tiempo a pacientes con fracturas de pelvis ya que pueden producirse sangrados tardíos.

La necesidad de contextualización de la teoría psicoanalítica / The need of contextualization of the psychoanalytic theory

En este trabajo se describe la brecha que hay en Chile entre la formación psicoanalítica tanto teórica como técnica que se recibe en la Asociación Psicoanalítica dependiente de la IPA, y lo que posteriormente se enseña en el mundo académico tanto de instituciones como universitario. La autora propone poner atención a esta divergencia y plantea cambios en la formación que permitan estar más acordes a las necesidades clínicas y teóricas actuales.

This paper describes the gap existing in Chile between psychoanalytic formation, both theoretical and technical received in the Psychoanalytic Association belonging to IPA, and what is taught in the academic circles, institutions and universities. The author suggests focusing greater attention on these divergences and proposes the necessary changes to the training in order to align it with actual clinical and theoretical needs.

Artroscopía de cadera y trauma articular: revisión bibliográfica a propósito de dos casos clínicos / Hip arthroscopy in articular trauma: bibliographic review of two cases

Although intra-articular lesions after hip trauma are frequent, reports of patients treated with hip arthroscopy are limited. The most common indications for this procedure are loose bodies, labral lesions and chondral lesions. Some of these patients may have preexisting femoroacetabular impingement. We present in this article two case reports of intra-articular lesions after traumatic hip dislocation. The first is a case of a man with an anterior labral lesion and loose bodies after closed hip reduction. The second case is a man with a large anterior labral lesion with a previous femoroacetabular impingement. Both of them were treated by debridement of unstable labrum. Additionally loose bodies removal was performed in the first patient and femoral head-neck osteochondroplasty in the second one with excellent clinical results. Hip arthroscopy has proven to be a safe and effective surgical technique for treating specific posttraumatic lesions and previous femoroacetabular impingement.

Son frecuentes las lesiones intraarticulares post-fractura o luxación de cadera siendo escasos los reportes de tratamiento artroscópico de estas lesiones. Las principales indicaciones son cuerpos libres intraarticulares, lesiones del labrum o lesiones condrales. Puede coexistir además una deformidad preexistente como el pellizcamiento femoroacetabular. Se presentan 2 casos clínicos de pacientes con lesiones intraarticulares después de una luxación de cadera. El primer caso con una lesión del labrum anterior y cuerpos libres intraarticulares después de la reducción cerrada. El segundo caso con una extensa lesión del labrum anterior además de un pellizcamiento femoroacetabular. Ambos fueron tratados mediante artroscopía de cadera realizándose la estabilización del labrum. Además, se realizó la extracción de los fragmentos libres y una osteocondroplastía femoral respectivamente, con una excelente evolución clínica. La artroscopía de cadera es una técnica efectiva y segura para el tratamiento de estas lesiones traumáticas y corrección de la deformidad preexistente en casos de pellizcamiento femoroacetabular.

La influencia del constructivismo en el psicoanálisis / The influence of constructivism in psychoanalysis

El artículo es una discusión sobre el cambio de paradigma epistemológico en la teoría psicoanalítica. Se desarrollan las ideas de cambio del marco positivista al marco constructivista, de este último se toma la visión del constructivismo dialéctico desarrollado por Irwin Z. Hoffman, discutiéndose sus implicancias en la práctica clínica. Se ilustra a través de dos ejemplos.

The article is about the epistemological paradigm shift in psychoanalytical theory. It develops ideas about a change from the positivistic to the constructivist frame. In the latter, the concepts by Irwin Z. Hoffman about dialectic constructivism are specially highlighted. The discussion centers on what this change of frame means in clinical work and is ilustrated with two examples.

Perceptions of nurses with regard to doctor-patient communication.

The objective of this study was to evaluate nurses' perceptions of communication between doctors and patients with cancer, AIDS and rheumatoid arthritis. A cross-sectional study was conducted with 741 nurses in 12 hospitals. Nurses received a self-questionnaire that included questions on personal value and attitudes. The answers were used in constructing affective variables (religious beliefs, attitude towards death, paternalism). The prevalence of explicit communication in 'nurse perception of doctor-patient communication' in the case of cancer was 4.5%, with AIDS 30%, and with rheumatoid arthritis 41.8%. When the value of communication was evaluated, it became evident that the likelihood of a nurse perceiving explicit communication in reference to a diagnosis of cancer was 6.5 time greater when communication was considered to be of greater value (CI 95% 2.6-6.6). For nurses who accept the possibility of death, the likelihood of perceiving explicit communication in the case of AIDs was 7.4 times greater than for nurses who deny this possibility (CI 95% 3.7-14.7), and when nurses displayed a deeply religious attitude, the likelihood of perceiving explicit communication was 80% greater than for nurses without this attitude (CI 95% 1.1-2.9). Nurses participate actively in the process of attending to patients with cancer and other disabling illnesses. Thus, there is a need for health professionals who provide compassionate attention, which will improve the various interrelationships between nurses and patients.

Epididymal cytology changes in hypothyroid rats.

The purpose of this research was to investigate, using light, transmission, and scanning electron microscope, the effect of hypothyroidism on the ultrastructure of the rat epididymis. Thyroidectomy was obtained by ip injection of 270 microCi of (131)I per rat. One month later, several portions of cauda epididymis were examined. Morphological differences were detected in the epididymis of the hypothyroid animals when compared to the control normal rats. The hypothyroid conditions were associated with important changes in the epididymis. The light observations showed cells with clearing of the chromatin and increased density and thickness of the chromatic rim, chromatinic net, and disappearance of the segment of the chromatin rim. In the scanning electron microscope broken, oblique, denuded epithelial cells with loss of stereocilia were observed, as well as flattening of the tubule. The hypothyroid condition under transmission electron microscope was associated with a decrease in the height of the cells, diminution of the internal lumen and number of mitoses, and decreased chromatin decondensation. Results obtained confirmed that hypothyroidism causes marked structural changes in the ductus epididymis and could adversely affect the maturation and motility of sperm.

Epididymal scanning electron microscopy study in hypothyroid rats.

The purpose of this research was to investigate, using scanning electron microscopy, the effect of hypothyroidism on the ultrastructure of the rat cauda epididymis. Thyroidectomy was obtained by ip injection of 270 muCi of 131I per rat. One month later, several portions of cauda epididymis were examined. Morphological and physiological differences were detected in the cauda epididymis of the hypothyroid animals when compared to the control normal rats. The hypothyroid condition was associated with important changes in the luminal surface of the cauda epididymis epithelium. Broken, oblique, and loss of stereocilia, denuded epithelial cells, and flattening of the tubule were observed. The results confirm that hypothyroidism causes marked structural changes in the cauda ductus epididymis and could be adversely affect sperm maturation motility.

High-affinity binding of T3 to epididymis nuclei.

Thyroid hormones play an important role in epididymal function. Hypothyroid animals experience a significant decrease in the number and forward motility of sperm and a remarkable impairment of epididymal morphology. However, it is yet unknown if such activity is due to direct actions of iodothyronines on the target epididymis. The eventual identification of T3 receptors in the nucleous of epididymal cells becomes relevant. For this reason, the authors searched for specific high-affinity binding of T3 to these nuclei. Twenty prepuberal male Wistar rats were used. The testes and epididymis were approached as one unit through a scrotal incision. The fat-free epididymides were subjected to standard techniques to prepare the nuclei for incubations with 125I-T3 concentrations, ranging from 0.5 x 10(-9) to 2.0 x 10(-11) M. Calculations of association constants and binding capacities were performed according to Scatchard. A single binding site with a Ka of 3.06 +/- 0.6 x 10(9) M(-1) or Kd of 3.26 +/- 0.6 x 10(10) M and a maximal binding capacity of 0.11 +/- 0.02 pmol T3/microg DNA were observed. It is concluded that these nuclei contain a specific T3 receptor. This finding strongly suggests that thyroid hormones have direct effects on the epididymis.

Changes in the epididymal ultrastructure in hypothyroid rats.

The purpose of this research was to investigate the effect of hypothyroidism on the ultrastructure of the rat cauda epididymis. Thyroidectomy was obtained by i.p. injection of 270 microCi of 131I per rat. One month later, several portions of cauda epididymis were examined in an electron microscope. Morphological and physiological differences were detected in the cauda epididymis of the hypothyroid animals when compared to the control normal rats. The hypothyroid condition was associated with a decrease in the height of the cells and diminution of the internal lumen, number of mitoses, and chromatin decondensation. Hypothyroidism produces a remarkable impairment of epididymal morphology that could be mainly responsible for the functional alterations that lead to the dramatic slowing of spermatozoa motility, commonly seen in severe thyroid insufficiency.

Thyroid gland and epididymal sperm motility in rats.

The purpose of this research was to investigate the effect of hypofunction of the thyroid gland, caused by radioactive suppression of the gland, on the pattern of spermatozoa motility in different segments of the rat epididymis. Thyroidectomy was obtained by i.p. infection of 270 microCi of I-131. After about 30 days, the animal reached hypothyroidism as determined by serum level of T4. When the motility pattern of the sperm obtained from the epididymis of normal rats was compared to that of hypothyroid animals, a drop in the parameter of path velocity (VAP), progressive velocity (VSL), and track speed (VCL) were detected. Hypofunction was associated with decreasing sperm motility in the epididymis. In thyroidectomized rats injected with T4, no sperm motility changes were observed.

Cholesterol-lowering effect of policosanol on rabbits with hypercholesterolaemia induced by a wheat starch-casein diet.

The effect of policosanol, a mixture of high-molecular-weight aliphatic alcohols isolated from sugarcane wax, on casein-induced hypercholesterolaemia in rabbits was studied. When policosanol was administered by the oral route once daily for 30 d (50 mg/kg) the increases in plasma total cholesterol and LDL-cholesterol (LDC-C) were significantly reduced when compared with the control group. The incorporation of 3H2O into sterols in the liver was significantly depressed, suggesting inhibition of hepatic cholesterol biosynthesis. The oral administration of policosanol raised the rate of removal of 125I-labelled LDL from serum. Kinetic parameters calculated following injection of [125I]LDL showed than in casein-fed rabbits, the terminal half-life (t1/2) was significantly decreased after policosanol treatment. The hepatic LDL-binding activity was increased after policosanol administration which suggested that the enhanced clearance was due, at least in part, to increased receptor-mediated uptake of LDL by the liver. Considered together, these results suggest that policosanol can significantly reduce the increase of plasma LDL-C in rabbits fed on a wheat starch-casein diet by reducing cholesterol biosynthesis in the liver. Such an effect could account for the enhancement of LDL catabolism through the receptor-mediated pathway.

A survey of parental knowledge about car seats in children

Motor vehicle accidents are the main cause of death and disability between 1 and 4 years of age. Since 1980 the Academy of Pediatrics has been promoting the correct use of car seats. The major reason that car seats are not fulfilling their full potential is their incorrect or lack of use. In order to evaluate parental knowledge about car seat use for children and their actual use in the population visiting HURRA, a survey was performed which demonstrated that only 57.6 of the parents interviewed had infant car seats and that only 83.3 of owners actually use it. As many as 94.4 had correct knowledge about car seat use, but the majority of correct information was not provided by the medical staff. The majority of parents use seat belts for their own protection but a significantly smaller percentage use car seats for their own children

A survey of parental knowledge about car seats in children.

Motor vehicle accidents are the main cause of death and disability between 1 and 4 years of age. Since 1980 the Academy of Pediatrics has been promoting the correct use of car seats. The major reason that car seats are not fulfilling their full potential is their incorrect or lack of use. In order to evaluate parental knowledge about car seat use for children and their actual use in the population visiting HURRA, a survey was performed which demonstrated that only 57.6% of the parents interviewed had infant car seats and that only 83.3% of owners actually use it. As many as 94.4% had correct knowledge about car seat use, but the majority of correct information was not provided by the medical staff. The majority of parents use seat belts for their own protection but a significantly smaller percentage use car seats for their own children.