Introduction Our study presents a method to generate a novel detection coefficient for the association between leprosy and pregnancy (DCLP). Methods The DCLP was calculated for women from the State of Pará (2007-2009), Brazil. Data were ordered, divided into five equal parts (corresponding to the P20, P40, P60, and P80 percentiles), and classified as low, medium, high, very high, or hyperendemic. Results Using the new index, we established the DCLP parameters for low (<0.36), medium (0.36-0.69), high (0.70-1.09), very high (1.10-1.50), and hyperendemic (>1.50). Conclusions The new DCLP is more appropriate than the overall detection coefficient (DC), which does not take into account the particularities of the interaction between a disease and a specific physiological state.

O objetivo do presente estudo foi avaliar a importância dos fatores de risco na gênese das complicações pleuropulmonares, pós-drenagem pleural fechada. Analisou-se, prospectivamente, no período de janeiro de 1998 a junho de 1999, um total de 167 pacientes submetidos à drenagem pleural fechada, sendo estratificados em dois grupos selecionados para um estudo de acompanhamento de coortes. Ao grupo controle, de 104 pacientes, não foi administrada antibioticoterapia e, no grupo experimental, de 63 pacientes, a cefalotina foi a droga utilizada. A idade no grupo-controle variou entre 13 e 53 anos (26,8±8,9) e no grupo experimental entre 15 e 57 (24,9±7,9), predominando o sexo masculino (95,2%), nos dois grupos estudados. O trauma aberto incidiu em 92,8% dos pacientes, com predominância para as feridas por arma branca em 58,7%, contra 24,6% de feridas por projétil de arma de fogo. As complicações pleuropulmonares estiveram presentes em 35 pacientes (33,78%) do grupo controle, ao passo que, no grupo experimental, apenas 18 (28,6%) evoluíram com este tipo de complicação. Não ocorreram óbitos em ambas as séries estudadas. Nas análises estatísticas, o modelo bivariado mostrou que o tipo de trauma e o tempo de drenagem pleural foram as variáveis que mais importância tiveram como fatores preditivos de complicações. Na análise de regressão logística multivariada, as variáveis tempo de internação, trauma fechado e volume de sangue drenado maior do que 500ml, quando associadas, influenciaram de maneira positiva a ocorrência de complicações.

The objective of this study was to analyse the risk factors for the development of thoracic infections after tube thoracostomy. Although technically simple, this procedure, 1 to 25 percent of the patients develop some type of intra or post-operative complications. A total of 167 patients, submitted to emergency tube thoracostomy, were admitted and stratified into two groups selected by randomic sampling to a cohorts accompanying study. One hundred and four patients, without antibiotic therapy, were considered as been the control group; and, 63 patients using cefalotin in post-operative as the experimental group. The mean age of the patients in the control group was 26.8±8.9 years (range, 13 - 53), and 24.9±7.9 years (range, 15 - 57) for experimental group, predominating the male sex (95.2%) in both studied groups. The penetrating chest trauma was present in 92.8% of the patients, with a higher incidence of stab wounds (58.7%) in contrast to gunshot wounds (24.6%). Thoracic complications were present in 35 patients (33.7%) of the control group, whereas, in the experimental group, only 18 patients (28.6%) developed this kind of complication. In the statistic significance analysis, the bivariate model indicated that the variable trauma type and the duration of pleural space drainage were the most relevant ones as predictive factors for infections complications. In the multivariate logistic regression, the variables blunt chest trauma, length of hospital stay and drainage blood volume higher than 500 ml, when associated, influenciated positively on the occurrence of these complications.

Os ferimentos penetrantes localizados na transição toracoabdominal (FTA), além da dificuldade diagnóstica, merecem especial atenção em relação à conduta adotada para o controle das complicações abdominais. Os autores analisaram 110 pacientes atendidos na Disciplina de Cirurgia do Trauma do Departamento de Cirurgia da UNICAMP, de 1988 a 1998, apresentando ferida penetrante toracoabdominal e submetidos à laparotomia exploradora com drenagem pleural fechada. As fístulas digestivas foram estudadas quanto à incidência, ao tratamento e à evolução pós-operatória. Do total de pacientes, 91 (82,7%) eram do sexo masculino e 19 (17,3%) do sexo feminino. A faixa etária situou-se entre 13 e 63 anos. Os FTA foram causados por projétil de arma de fogo (PAF) em 60 (54,5%) casos e por arma branca (FAB) em 50 (45,5%). As fístulas digestivas ocorreram em seis (5,4%) dos pacientes estudados, sendo quatro (3,6%) casos de fístula pancreática, um (0,9%) de fístula gástrica e um (0,9%) de fístula biliar, todos tratados de maneira conservadora, apresentando evolução favorável com resolução espontânea.

Penetrating trauma in the lower chest, is a diagnosis challenge and deserves special attention with respect to the treatment for abdominal complications. One hundred and ten patients admitted to the emergency unit of UNICAMP - University Hospital Trauma Center from 1988 to 1998 who presented thoracoabdominal penetrating wounds and were submitted to laparotomy and closed tube thoracostomy were analysed. Incidence, treatment and postoperative evolution. Digestive fistula was studied. Ninety-one patients (82,7%) were male and 19 (17,3%) female, with the age varying between 13 to 63 years old. Gunshot wounds ocurred in 60 (54,5%) patients, while stab wounds in 50 (45,5%). Digestive fistula occurred in six (5,4%) patients; four (3,6%) were pancreatic fistula, one (0,9%) biliar which and one (0,9%) gastric were managed nonoperative with a satisfactory evolution.