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      The Epidemiology of Traumatic Brain Injury Due to Traffic Accidents in Latin America: A Narrative Review

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          Abstract

          Objective  Traumatic brain injuries (TBIs) are devastating injuries and represent a major cause of morbidity and mortality worldwide. Traffic accidents are one of the main causes, especially in low- and middle-income countries. The epidemiology of TBI due to road traffic in Latin America is not clearly documented.

          Methods  A narrative review was conducted using PubMed, SCOPUS, and Google Scholar, looking for TBI studies in Latin America published between 2000 and 2018. Seventeen studies were found that met the inclusion and exclusion criteria.

          Results   It was found that TBI due to road traffic accidents (RTAs) is more frequent in males between the ages of 15 and 35 years, and patients in motor vehicles accounted for most cases, followed by pedestrians, motorcyclists, and cyclists.

          Conclusion  Road traffic accidents is a common cause of TBI in Latin America. More studies and registries are needed to properly document the epidemiological profiles of TBI related to RTAs.

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          Most cited references14

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          Risk factors for maxillofacial injuries in a Brazilian emergency hospital sample

          Background Maxillofacial injuries occur in a significant number of trauma patients. Epidemiological assessments are essential to reaffirm patterns, identify new trends and develop clinical and research priorities for effective treatment and prevention of these injuries. Objective The aim of this study was to identify the epidemiological profile and risk factors associated with maxillofacial trauma treated at a referral emergency hospital for the Public Health System in the State Capital of Goiás, Brazil. Material and Methods A cross-sectional study was designed including 530 patients with maxillofacial trauma, 76% male, with a mean age of 25.5±15.0 years. Data were collected between May 2003 and August 2004 over weekly shift-working periods. Results: The main causes of trauma were traffic accidents (45.7%) and physical assaults (24.3%), and differences in etiological factors were identified according to gender (p<0.001). The distribution of patients according to age and etiology showed significant differences for traffic accidents (p<0.01), physical assaults (p<0.001), falls (p<0.001) and sport injuries (p<0.01). In the multinomial logistic regression analysis (R 2 = 0.233; p<0.05), age was associated with injury in traffic accidents and falls (p<0.01), sports-related accidents were associated with males (p<0.05), and alcohol consumption with assaults and traffic accidents (p<0.001). Facial soft tissue lesions were found in 98% of patients and facial fractures in 51%. Conclusions The significant association of maxillofacial trauma with young males and alcohol consumption reinforces the need for educational strategies and the development of policies for the prevention and reduction of associated damage in this specific risk group.
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            Early prognosis of severe traumatic brain injury in an urban argentinian trauma center.

            : Previous studies indicate that age, Glasgow Coma Scale score (GCS), arterial hypotension, computed tomography (CT) findings, and pupillary reactivity are strong predictors of outcome for patients with severe traumatic brain injury (TBI). However, the predictive validity of these variables has never been rigorously tested in patients from the developing world. The objective of this study was to evaluate the prognostic value of these variables in a resource-limited setting and to test their predictive power by using them to create an outcome model. : The study was conducted at Hospital Emergencias "Dr. Clemente Alvarez" in Rosario, Argentina. All patients with severe TBI meeting criteria between August 2000 and February 2003 were included. Outcome at 6 months postinjury was measured by mortality and by the Extended Glasgow Outcome Scale score. Two logistic regression models were created for predicting mortality and outcome. : Outcome measures were acquired for 100% of the sample (N = 148). There was 58% mortality; 30% had moderate to good recovery, and 12% were severely disabled. The model accurately predicted 83.9% of mortality, and 81.1% of outcome. Because of variation in timing of CT scans, the models were recalculated without the CT variable. The accuracy of prediction was 79.7% and 79% for mortality and Extended Glasgow Outcome Scale, respectively. : This study provides rigorous, prospective data that (1) validates the generalizability of the five World Health Organization/Organization Mondiale de la Santé TBI prognostic predictors outside of the developed world, and (2) provides outcome benchmarks for mortality and morbidity from severe TBI in developing countries.
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              Impact of a program for the prevention of traffic accidents in a Southern Brazilian city: a model for implementation in a developing country.

              Traffic accidents constitute the main cause of death in the first decades of life. Traumatic brain injury is the event most responsible for the severity of these accidents. The SBN started an educational program for the prevention of traffic accidents, adapted from the American model "Think First" to the Brazilian environment, since 1995, with special effort devoted to the prevention of TBI by using seat belts and motorcycle helmets. The objective of the present study was to set up a traffic accident prevention program based on the adapted Think First and to evaluate its impact by comparing epidemiological variables before and after the beginning of the program. The program was executed in Maringá city, from September 2004 to August 2005, with educational actions targeting the entire population, especially teenagers and young adults. The program was implemented by building a network of information facilitators and multipliers inside the organized civil society, with widespread population dissemination. To measure the impact of the program, a specific software was developed for the storage and processing of the epidemiological variables. The results showed a reduction of trauma severity due to traffic accidents after the execution of the program, mainly TBI. The adapted Think First was systematically implemented and its impact measured for the first time in Brazil, revealing the usefulness of the program for reducing trauma and TBI severity in traffic accidents through public education and representing a standardized model of implementation in a developing country.
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                Author and article information

                Journal
                J Neurosci Rural Pract
                J Neurosci Rural Pract
                10.1055/s-00043281
                Journal of Neurosciences in Rural Practice
                Thieme Medical and Scientific Publishers Private Ltd. (A-12, Second Floor, Sector -2, NOIDA -201301, India )
                0976-3147
                0976-3155
                April 2020
                02 May 2020
                : 11
                : 2
                : 287-290
                Affiliations
                [1 ]Ireland National University, Medical School, Galway, Ireland
                [2 ]INUB–MEDITECH, Research Group, Universidad El Bosque, Bogotá, Colombia
                [3 ]Hull York Medical School, Medicine Program, Heslington, England
                [4 ]Universidad Surcolombiana, Facultad de Salud, Neiva, Colombia
                [5 ]Maracay Central Hospital, Neurosurgery Service, Aragua, Venezuela
                [6 ]Meditech Foundation, Clinical Research Division, Cali. Colombia
                [7 ]ValleSalud Clinic, Neurosurgery Service, Cali, Colombia
                Author notes
                Address for correspondence Andrés M. Rubiano, MD Instituto de Neurociencias, Universidad El Bosque Av. Cra 9 No 131 A-02, Bogotá 110121Colombia andresrubiano@ 123456aol.com
                Author information
                http://orcid.org/0000-0003-1495-4633
                http://orcid.org/0000-0001-8931-3254
                Article
                JNRP1900333
                10.1055/s-0040-1709363
                7195969
                32367985
                58fe27ff-e612-4ad0-9a0a-da686afac04f

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.

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                Categories
                Original Article

                Neurosciences
                brain injuries,epidemiology,latin america,trauma,road traffic accidents
                Neurosciences
                brain injuries, epidemiology, latin america, trauma, road traffic accidents

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