[Technical aspects of intracranial pressure monitoring by subarachnoid method in severe head injury]

[The human accidents and their implications for functional communication: opinions of teachers and students about higher education]

This study aimed to verify the opinion of speech-language pathology teachers and undergraduate students about human accidents and investigate if they are seeking for knowledge and competence in this area. Fifty-two teachers and 95 students from 3 public and 3 private universities in São Paulo took part in this study. Data were collected by means of a questionnaire. According to the participants, accidents are unexpected events that cause physical, functional, emotional and social consequences. Inattentiveness, incaution as well as mental and physical fatigue are factors that contribute to accidents. The speech-language therapist, the physical therapist, the occupational therapist and the physicians were considered the most indicated professionals for correcting the sequels caused by external aggressions. They were also considered the most indicated for carrying out educational actions for the prevention of accidents in form of orientation and lectures for the population of the educational and health units. Teachers and students recognize the importance of the subject, a fact that will help optimizing the educational actions toward accident prevention and introducing new actions and research projects in the universities for improving the competences in this field of knowledge.

Fatores que influenciaram a evolução de 206 pacientes com traumatismo craniencefálico grave

A busca de fatores prognósticos para o traumatismo craniencefálico (TCE) tem sido alvo de muitos estudos nas últimas décadas. A identificação de indicadores consistentes da evolução destes pacientes tem representado um grande desafio e sua utilidade considerada evidente tanto para orientar o tratamento, quanto para a estimativa do resultado final. Baseados numa casuística de 206 pacientes com TCE grave (8 pontos ou menos pela Escala de Coma de Glasgow - ECG), estudamos a influência de vários fatores sobre a evolução dos pacientes. A gravidade inicial medida pela ECG, a presença de hipertensão intracraniana (níveis acima de 20 mmHg), o tipo de lesão intracraniana e a presença de hipoxia, hipotensão arterial e a associação de hipóxia e hipotensão arterial tiveram influência significativa sobre a evolução dos pacientes. A presença de politraumatismo (pelo menos dois sítios de lesão além do TCE) e a idade (acima e abaixo de 40 anos) não influenciaram significativamente a evolução dos pacientes desta casuística.