RESUMO
OBJECTIVE: Limited information has been published about opioid prescribing practices in Puerto Rico. The objective of this study was to create baseline trends of opioids distributed over a period of fourteen years in Puerto Rico. METHODS: We examined data from the U.S. Drug Enforcement Administration's Automation of Reports and Consolidated Orders System (ARCOS) for the period 1999-2013. ARCOS data reflects the amount of controlled substances legally dispensed. Analyses include the distribution of opioids (in morphine milligram equivalent kg per 10,000 persons) by year and entity (pharmacy, hospital, practitioner). RESULTS: The distribution of four drugs (fentanyl, hydromorphone, methadone, oxycodone) increased over 100% between 1999 and 2013. The distribution of two drugs (hydrocodone and meperidine) declined between 1999 and 2013. Oxycodone distribution grew from 0.13 MME kg grams per 10,000 persons in 1999 to 0.29 MME kg in 2013. CONCLUSION: ARCOS data showed that the overall amount of opioid pain relievers distributed in Puerto Rico increased by 68% between 1999 and 2013. Currently, prescription opioid pain reliever overdose deaths in Puerto Rico do not appear to be skyrocketing as they are in the mainland U.S. However, the ongoing problem with prescription opioid pain reliever overdoses in certain areas should serve as a warning to monitor consumption of opioid pain relievers, as well as changes in prescription drug abuse, overdoses, and deaths.
Assuntos
Analgésicos Opioides/provisão & distribuição , Prescrições de Medicamentos/estatística & dados numéricos , Tratamento Farmacológico/tendências , Humanos , Porto Rico , Fatores de TempoRESUMO
OBJECTIVE: To describe the circumstances of fall-related injuries among youth 0-19 years treated in emergency departments in Nicaragua; to estimate the incidence rates (IR) of falls; and, to identify areas for prevention efforts. MATERIAL AND METHODS: All patients <20 years who were residents of Managua, León, Jinotepe, and Ciudad Sandino (6593) were selected for analysis. Data were collected with the 2004 Injury Surveillance System. RESULTS: In 2004, the IR of falls for youth <20 years old was 104.2 incidents per 10000 persons. The IR for male youth was twice that of female youth. Overall, trees (23.3%) and beds (15.2%) were the main objects involved in falls. Fractures were the leading injuries sustained. CONCLUSIONS: This study identifies three areas that can be addressed: furniture, recreation, and physical environment. Interventions that may be most useful for caregivers and adolescents include changes in the home environment and recreation play areas, as well as educational programs.
Assuntos
Acidentes por Quedas/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/etiologia , Acidentes por Quedas/prevenção & controle , Adolescente , Criança , Pré-Escolar , Serviço Hospitalar de Emergência , Feminino , Humanos , Incidência , Lactente , Masculino , Nicarágua , Ferimentos e Lesões/prevenção & controle , Ferimentos e Lesões/terapia , Adulto JovemRESUMO
OBJECTIVE: To describe the circumstances of fall-related injuries among youth 0-19 years treated in emergency departments in Nicaragua; to estimate the incidence rates (IR) of falls; and, to identify areas for prevention efforts. MATERIAL AND METHODS: All patients <20 years who were residents of Managua, León, Jinotepe, and Ciudad Sandino (6593) were selected for analysis. Data were collected with the 2004 Injury Surveillance System. RESULTS: In 2004, the IR of falls for youth <20 years old was 104.2 incidents per 10000 persons. The IR for male youth was twice that of female youth. Overall, trees (23.3 percent) and beds (15.2 percent) were the main objects involved in falls. Fractures were the leading injuries sustained. CONCLUSIONS: This study identifies three areas that can be addressed: furniture, recreation, and physical environment. Interventions that may be most useful for caregivers and adolescents include changes in the home environment and recreation play areas, as well as educational programs.
OBJETIVO: Describir las lesiones relacionadas con caídas entre los niños y adolescentes menores de 20 años de edad que fueron tratados en departamentos de emergencia de Nicaragua, 2004. Describir las circunstancias y estimar la tasa de incidencia (TI) de las caídas entre niños y adolescentes de 0-19 años atendidos en las salas de emergencia en Nicaragua. Además, identificar áreas dónde dirigir los esfuerzos de prevención. MATERIALES Y MÉTODOS: Se seleccionaron todos los pacientes (6593) de 0-19 años lesionados por caídas atendidos en emergencia por el Sistema de Vigilancia de Lesiones en 2004 en las ciudades de Managua, León, Jinotepe y Ciudad Sandino. RESULTADOS: En 2004, la TI para caídas en niños y adolescentes 0-19 años fue 104.2 por 10000 habitantes. La TI en varones fue dos veces más alta que en mujeres. Los principales objetos involucrados fueron árboles (23.3 por ciento) y camas (15.2 por ciento). La principal naturaleza de lesión fue fractura (35.7 por ciento). CONCLUSIONES: Mobiliario, lugares de recreación y ambiente físico fueron las áreas identificadas. Desarrollar intervenciones incluyendo cambios en el ambiente del hogar y áreas recreacionales, así como programas educacionales, resulta muy útil para adolescentes y cuidadores.
Assuntos
Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Adulto Jovem , Acidentes por Quedas/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/etiologia , Acidentes por Quedas/prevenção & controle , Serviço Hospitalar de Emergência , Incidência , Nicarágua , Ferimentos e Lesões/prevenção & controle , Ferimentos e Lesões/terapiaRESUMO
The objective of this study was to describe the nonfatal unintentional injuries among children aged <15 years treated in four emergency departments (EDs) in Nicaragua. The 2004 Injury Surveillance System included all cases of injuries that attended the four hospital EDs (n = 37,577). We analysed the records of 13,426 children aged <15 years who sustained nonfatal unintentional injuries. The leading causes of injuries were falls (50.5%), blunt force trauma (13.2%) and transport-related incidents (11.5%). Transport-related injuries primarily involved cyclists (42.3%) and motor-vehicle passengers (32.5%). Ten per cent of the injured children were hospitalised. This is the first study to present the epidemiology of nonfatal unintentional injuries among children treated in EDs in Nicaragua. Unintentional injuries are an important cause of morbidity, but the burden remains largely unaddressed. The implementation of the already well-established transportation-related prevention strategies should be a priority. Prevention of falls (falls being the leading cause of injury among children) demands further study.