A retrospective study of Traumatic Dental Injuries in a Brazilian dental urgency service

Epidemiologic aspects of traumatic dental injuries (TDI) were evaluated in the permanent dentition in a sample of 847 patients treated at the Dental Urgency Service of the Dental School of the Federal University of Goiás, Brazil, between May 2000 and May 2008. The statistical treatment analyzed data from frequency distribution and chi-square test. The level of significance was set at 5% for all analyses. The results showed a higher incident among males (610; 72.01%) with mean age of 6-10 year-old. Uncomplicated crown fracture (without pulp exposure) (502; 26.95%), avulsion (341; 18.30%) and complicated crown fracture (with pulp exposure) (330; 17.71%) were the most prevalent TDI. The prevalence of trauma throughout the years showed proportionality, being observed a larger number of cases between July and September (249; 29.39%). The most affected teeth were the maxillary central incisors (65.65%), followed by the maxillary left lateral incisors (19.67%). In 311 participants (18.25%), only one tooth was involved, while in most patients (536; 81.75%), TDI occurred in more than one tooth. Significant proportion (82.27%) of traumatized teeth presented completely formed root apex. The main etiologic factors involved in TDI were falls (51.71%), traffic accidents (22.90%) and violence (5.67%). Based on the obtained data, it may be concluded that accurate policies of TDI prevention must be established, capable of stimulating the exposure of appropriate protocols for management of these lesions. The prevalence of TDI in Goiânia subpopulation is compared to the prevalence reported in epidemiological studies in others populations.

Epidemiology of leisure, transportation, occupational, and household physical activity: prevalence and associated factors

Background: To estimate the prevalence of and identify factors associated with physical activity in leisure, transportation, occupational, and household settings. Methods: This was a cross-sectional study aimed at investigating living and health conditions among the population of São Paulo, Brazil. Data on 1318 adults aged 18 to 65 years were used. To assess physical activity, the long version of the International Physical Activity Questionnaire was applied. Multivariate analysis was conducted using a hierarchical model. Results: The greatest prevalence of insufficient activity related to transportation (91.7%), followed by leisure (77.5%), occupational (68.9%), and household settings (56.7%). The variables associated with insufficient levels of physical activity in leisure were female sex, older age, low education level, nonwhite skin color, smoking, and self-reported poor health; in occupational settings were female sex, white skin color, high education level, self-reported poor health, nonsmoking, and obesity; in transportation settings were female sex; and in household settings, with male sex, separated, or widowed status and high education level. Conclusion: Physical activity in transportation and leisure settings should be encouraged. This study will serve as a reference point in monitoring different types of physical activities and implementing public physical activity policies in developing countries

Acidentes e doenças do trabalho notificadas, de motoristas profissionais do Estado de São Paulo

São descritos os acidentes do trabalho para motoristas profissionais residentes no Estado de São Paulo. Os dados tiveram origem em base específica elaborada nas CATs e processos notificados na Previdência Social do Estado de São Paulo, entre 1997 e 1999. Apresentam-se as características dos motoristas acidentados e dos acidentes do trabalho. São analisadas taxas de incidência, mortalidade e letalidade dos motoristas para o Estado, Região Metropolitana de São Paulo e Município de São Paulo

Epidemiology of Leisure, Transportation, Occupational, and Household Physical Activity: Prevalence and Associated Factors

Background: To estimate the prevalence of and identify factors associated with physical activity in leisure, transportation, occupational, and household settings. Methods: This was a cross-sectional study aimed at investigating living and health conditions among the population of So Paulo, Brazil. Data on 1318 adults aged 18 to 65 years were used. To assess physical activity, the long version of the International Physical Activity Questionnaire was applied. Multivariate analysis was conducted using a hierarchical model. Results: The greatest prevalence of insufficient activity related to transportation (91.7%), followed by leisure (77.5%), occupational (68.9%), and household settings (56.7%). The variables associated with insufficient levels of physical activity in leisure were female sex, older age, low education level, nonwhite skin color, smoking, and self-reported poor health; in occupational settings were female sex, white skin color, high education level, self-reported poor health, nonsmoking, and obesity; in transportation settings were female sex; and in household settings, with male sex, separated, or widowed status and high education level. Conclusion: Physical activity in transportation and leisure settings should be encouraged. This study will serve as a reference point in monitoring different types of physical activities and implementing public physical activity policies in developing countries.

Evaluation of biologic occupational risk control practices: Quality indicators development and validation

Background: There is growing demand for the adoption of qualification systems for health care practices. This study is aimed at describing the development and validation of indicators for evaluation of biologic occupational risk control programs. Methods: The study involved 3 stages: (1) setting up a research team, (2) development of indicators, and (3) validation of the indicators by a team of specialists recruited to validate each attribute of the developed indicators. The content validation method was used for the validation, and a psychometric scale was developed for the specialists` assessment. A consensus technique was used, and every attribute that obtained a Content Validity Index of at least 0.75 was approved. Results: Eight indicators were developed for the evaluation of the biologic occupational risk prevention program, with emphasis on accidents caused by sharp instruments and occupational tuberculosis prevention. The indicators included evaluation of the structure, process, and results at the prevention and biologic risk control levels. The majority of indicators achieved a favorable consensus regarding all validated attributes. Conclusion: The developed indicators were considered validated, and the method used for construction and validation proved to be effective.

Incidence of injuries to the lower limbs joints in kung fu athletes

Background and Study Aim: This study evaluated the influence of competitive practice and training aspects on incidence of injuries to the lower limbs joints in formalized (taolu) and combat (sanshou) kung fu athletes. Material/Methods: One hundred and twenty-seven kung fu athletes (taolu, n=82; sanshou, n=45) were interviewed about kung fu practice (practice time, competition time and competition level), training volume (days of training per week and hours per training session) and injury profiles (incidence and type). Continuous variables were compared by non-parametric Kolmogorov-Smirnov test (disciplines and competition levels as grouping variables). The effects of categorical variables (kung fu practice) on injury profiles were analyzed using the Pearson`s chi-square test. The level of significance was set at p<0.05. Results: Our data exhibited large frequency of injury reports (70.1%) and significantly differences on injury profiles between disciplines and competition levels. Taolu athletes, despite the lower practice/competition time (-51.5 and -41.8%, respectively), presented frequency of injury reports twofold greater, longer daily training volume (23.3%) and higher incidence of lower limbs joints injuries than sanshou athletes (35.4% and 11.8%, respectively). Conclusions: Our results suggest a link between injury profiles (incidence and type) and specific characteristics of kung fu disciplines.

Effects of quadriceps and anterior tibial muscles electrical stimulation on the feet and ankles of patients with spinal cord injuries

Study design: Controlled clinical test. Objectives: The purpose of this study was to assess the effects of quadriceps and anterior tibial muscles electrical stimulation on the feet and ankles of patients with spinal cord injuries and to compare them with able-bodied individuals and a group of patients who did not undergo neuromuscular electrical stimulation (NMES). Setting: This study was conducted at the Hospital das Clinicas of Unicamp, Campinas, Sao Paulo, Brazil. Methods: Between January and April 2008, 30 patients at the spinal cord injury ambulatory clinic who underwent NMES (group A) were submitted to a clinical and radiographic assessment of their feet and ankles and compared with a spinal cord injury group (group B) who did not undergo NMES and a group of able-bodied individuals (group C). The Kruskal-Wallis test was used to compare all the three groups, and between-group differences (P < 0.05) were investigated with the Mann-Whitney test. Results: The mean mobility of the midfoot and ankle subtalar joint was significantly higher in group C than in groups A and B. Differences in the mean measurements of the profiles of the talocalcaneal and the talus-first metatarsal angles were statistically significant for group A vs the other groups (P = 0.0020, 0.0024, respectively). Foot deformities were found in groups including claw toes and flat feet (group A) and grade I ulcers on the lateral malleolus and calcaneus (group B). Conclusion: Partial-load NMES maintains the feet and ankles in a planted and adequate walking position in patients with spinal cord injuries, a favorable result of new technologies that allows these patients to reacquire independent walking capacity. Spinal Cord (2010) 48, 881-885; doi:10.1038/sc.2010.50; published online 18 May 2010

Identification and control of occupational risks in a Sao Paulo metropolitan region quarry

Crushed stone mining is the third largest mining economy in Brazil, where almost half is produced in the Sao Paulo metropolitan region. The segment registers the highest number of accidents among the extractive industries, which justifies the concern with workers` health and safety, and the importance of controlling occupational hazards. Since 2002, the NR-22 Standard (NR-22: Occupational Health and Safety in Mining) makes compulsory the elaboration of a Risk Management Program that identifies risks and establishes control measures. Considering the crushed stone mining industry importance to the state, this paper evaluates and discusses the risks identified in unit operations during the production process of crushed stone in an open pit mine in order to propose control measures for the development of the Risk Management Program. Although this study refers to a specific quarry, it can be applied to other mines from the same sector since some considerations are made regarding differences in manufacturing processes. The research was based on the identification of the main risks associated with drilling, blasting, load & haulage, crushing and screening through field measurements of some hazardous agents, together with company reports. The results contributed to the choice of the appropriate control measures for the improvement Of workers` health and safety conditions.

Stone fruit injuries and damage at the wholesale market of Sao Paulo, Brazil

Mechanical injuries and diseases in stone fruit are important causes for market rejection. The objectives of this research were to quantify and characterize the mechanical injuries and diseases in peaches, nectarines and plums at Sao Paulo`s wholesale market, the largest in Brazil. Incidence of injuries was assessed weekly in 1 % of the marketed fruit (2973 fruit/week), from September to December in 2003 and 2004. Mechanical injuries were the most frequent injuries in both years, ranging from 8.73% (plum) to 44.5% (nectarine) of injured fruit. There was a significant positive correlation between the incidence of postharvest mechanical injuries and postharvest diseases. Incidence of postharvest diseases varied from 2.5% to 6.6%. Cladosporium rot (Cladosporium sp.) and brown rot (Monilinia fructicola) were the most frequent diseases, and were mostly detected in the apexes of nectarines and peaches. Aurora (peach), Sunraycer (nectarine) and Gulfblaze (plum) varieties were the most susceptible to injuries and diseases. (c) 2007 Elsevier B.V. All rights reserved.

PHRENIC NERVE TRANSFER IN THE RESTORATION OF ELBOW FLEXION IN BRACHIAL PLEXUS AVULSION INJURIES: HOW EFFECTIVE AND SAFE IS IT?

OBJECTIVE: Phrenic nerve transfer has been used for treating lesions of the brachial plexus since 1970. Although, today, surgeons are more experienced with the technique, there are still widespread concerns about its effects on pulmonary function. This study was undertaken to evaluate the effectiveness and safety of this procedure. METHODS: Fourteen patients with complete palsy of the upper limb were submitted to phrenic nerve transfer as part of a strategy for surgical reconstruction of their plexuses. Two patients were lost to follow-up, and 2 patients were followed for less than 2 years. Of the remaining 10 patients, 9 (90%) were male. The lesions affected both sides equally. The mean age of the patients was 24.8 years (range, 14-43 years), and the mean interval from injury to surgery was 6 months (range, 3-9 months). The phrenic nerve was always transferred to the musculocutaneous nerve, and a nerve graft (mean length, 8 cm; range, 4.5-12 cm) was necessary in all cases. RESULTS: There was no major complication related to the surgery. Seven patients (70%) recovered functional level biceps strength (Medical Research Council grade >= 3). All of the patients exhibited a transient decrease in pulmonary function tests, but without clinical respiratory problems. CONCLUSION: On the basis of our small series and data from the literature, we conclude that phrenic nerve transfer in well-selected patients is a safe and effective procedure for recovering biceps function.

Enabling International Communication among Brazilian Occupational Therapists: Seeking Consensus on Occupational Terminology

The purpose of this study was to examine how key occupational therapy terminologies are used by Brazilian occupational therapists. A nominal group approach combined with a Delphi technique involving 31 Brazilian occupational therapists was applied. A sociolinguistic approach was adopted since it broadens our understanding of the social and cultural determinants of terminology consolidation. Brazilian occupational therapists were found to adopt the term activity more often than human action or doing. Even less often were praxis and occupation applied. No consensus was reached regarding which of the terms is most preferred. While Brazilian occupational therapists have been developing their profession from international standards, it is still embedded in local demands and policies. Additionally, the political context must be considered when building an international dialogue between members of a professional body. Such a dialogue could engage professionals from different countries in meaningful exchanges about their practices. These exchanges may lead to the development of solid professional communities that can contribute meaningfully to social change. Copyright (C) 2010 John Wiley & Sons, Ltd.

What needs to be done? Occupational therapy responsibilities and challenges regarding human rights

Background: Addressing human rights issues brings forth ethical and political responsibilities for occupational therapists and requires new epistemological and educational approaches. The way occupational therapists have faced these challenges has depended upon historical, cultural and social contexts. Aim and method: By means of literature review and historical analysis, this paper reflects on how occupational therapists have dealt with human matters issues and on the contemporary changes within the profession. Results and discussion: The paper portrays how Latin American occupational therapists have engaged in social transformation by choosing not to transform ethical and political problems into technical matters. Taking into account experiences and views from South Africa, Brazil and Chile, the paper outlines the importance of developing political literacy and interdisciplinary professional/postprofessional education to prepare the new generation of occupational therapists to engage in social transformation. Addressing issues of invisibility and lack of access to human rights, the paper reflects on the need of developing conceptual tools and strategies for change, and discusses the transformations being produced in contemporary occupational therapy. Conclusion: Occupational therapists and scientists need to be attentive to human rights issues. They also need to answer the call for interconnectedness in the present-day complex societies, and engage in networking and a cross-bordering dialogue. Nevertheless, although necessary and welcome, international cooperation requires a permanent exercise of cultural sensitivity, political awareness and self-awareness.

Assessment of Occupational Genotoxic Risk among Brazilian Hairdressers

Objectives: To evaluate the genotoxic risk to hairdressers exposed daily to chemical substances such as hair dyes, waving and straightening preparations and manicurists` products by the Comet assay test (single-cell gel electrophoresis). Methods: The Comet assay was performed on blood samples from 69 female hairdressers (36.4 +/- 10.7 years old) currently employed in 21 different beauty institutes in Sao Paulo, Brazil, and on 55 female control blood donors (32.6 +/- 10.0 years old) from the Sao Paulo University Clinical Hospital blood bank. All the control subjects had occupations other than hairdresser. Comet assays were performed by evaluating 100 blood lymphocytes per individual and graded by visual score according to comet tail length. Results: The hairdressers showed a higher frequency of DNA damage revealed by Comet Score (159.8 +/- 71) when compared to the control group (125.4 +/- 64.1), and the difference was statistically significant by the Student`s t-test (P = 0.005). Multiple regression analysis showed that in addition to the hairdressers` profession, tobacco use contributed to the higher frequency of cells with comets (P < 0.05). Conclusions: The observed DNA damage could be associated with the hairdressers` occupational environment, where different chemicals are chronically manipulated and inhaled. Considering that this profession in many countries, including Brazil, is not officially regulated, more attention should focus on these professionals not only by legislative bodies but also by multidisciplinary teams able to develop and implement risk prevention and control strategies for chemical, physical and biological agents to which hairdressers are exposed.

Genitoperineal Injuries Associated With the Use of an Orthopedic Table With a Perineal Posttraction

Background: Surgical treatment of lower extremity fractures commonly involves the use of orthopedic table with perineal post for countertraction. However, prolonged application of the perineal post has been associated with significant complications. We describe our experience in the management of genitoperineal cutaneous injuries associated with the use of a traction table. Methods: Six patients with genitoperineal complications attributed to the use of a traction table were treated at our institution over a period of 2 years. The patient`s median age was 25 (range, 2028) years and all had fractures caused by motor vehicle collision. We evaluated the clinical presentation of these perineal injuries, operative time, therapeutic approach, clinical outcomes, and hospitalization time. Results. The mean operative time of the orthopedic surgery was 318 minutes 128 minutes (range, 185-540). All patients developed a partial-thickness necrotic area involving the perineum and scrotum in 2 days to 15 days (mean, 7 +/- 5.4) after the surgery. Three patients developed infection of the necrotic tissue. All patients underwent surgical debridement 16.5 days +/- 6.5 days (range, 13-29) after the orthopedic surgery and only one debridement procedure was nec-sure was possible in one case, and in the other cases the wound healed completely by second intention. The mean hospitalization time was 26.3 days +/- 9.7 days (range, 19-44). conclusion: Genitoperineal skin necrosis induced by perineal traction posttable is a morbid complication that demands surgical debridement and prolonged hospitalization for your treatment. There are many procedures available to reduce the risk of this complication that should be used more liberally by the orthopedic surgeons.

Low-Intensity Pulsed Ultrasound Accelerates Healing in Rat Calcaneus Tendon Injuries

STUDY DESIGN: Controlled laboratory study. OBJECTIVE: To evaluate the effect of low-intensity therapeutic ultrasound on the murine calcaneus tendon healing process. BACKGROUND: Therapeutic ultrasound promotes formation and maturation of scar tissue. METHODS: Calcaneus tendon tenotomy and tenorrhaphy was performed on 28 Wistar rats. After the procedure, the animals were randomly divided into 2 groups. The animals in the experimental group received a 5-minute ultrasound application, once a day, at a frequency of 1 MHz, a spatial average temporal average intensity of 0.1 W/cm(2), and a spatial average intensity of 0.52 W/cm(2) at a 16-Hz frequency pulse mode (duty cycle, 20%). Data for the injured side were normalized in relation to the data from the contralateral healthy calcaneus tendon (relative values). The animals in the control group received sham treatment. After a 28-day treatment period, the animals were sacrificed and their tendons surgically removed and subjected to mechanical stress testing. The parameters analyzed were cross-sectional area (mm(2)), ultimate load (N), tensile strength (MPa), and energy absorption (mJ). RESULTS: A significant difference between groups was found for the relative values of ultimate load and tensile strength. The mean +/- SD ultimate load of the control group was -3.5% +/- 32.2% compared to 33.3% +/- 26.8% for the experimental group (P = .005). The mean tensile strength of the control group was -47.7% +/- 19.5% compared to -28.1% +/- 24.1% for the experimental group (P = .019). No significant difference was found in cross-sectional area and energy absorption. CONCLUSION: Low-intensity pulsed ultrasound produced by a conventional therapeutic ultrasound unit can positively influence the calcaneus tendon healing process in rats. J Ort hop Sports Phys Ther 2011;41(7):526-531, Epub 2 February 2011. doi:10.2519/jospt.2011.3468