Background: Current evidence points to a state of hypercoagulability (consequence of hyperinflammation) as an important pathogenic mechanism that contributes to the increase in mortality in cases of COVID-19. The aim of the present study was to investigate the influence of deep-vein thrombosis on mortality patient’s infected with SARS-CoV-2. Method: A clinical trial was conducted involving 200 consecutive patients with COVID-19—100 patients who were positive for deep-vein thrombosis (venous Doppler ultrasound) and 100 who were negative for deep-vein thrombosis at a public hospital. Results: The mortality rate was 67% in the group positive for DVT and 31% in the group negative for DVT. Conclusion: Deep-vein thrombosis is associated with an increase in mortality in patients with COVID-19 and failures can occur with conventional prophylaxis for deep-vein thrombosis.

Background Operative management of severe trauma requires excellent communication among team members. The surgeon and anesthesiologist need to interact efficiently, exchanging vital information. The Definitive Surgical Trauma Care (DSTC) and Definitive Anesthesia Trauma Care (DATC) courses provide an excellent opportunity for teamwork training. Our goal was to study the impact of the joint DSTC–DATC courses in candidates’ self‐reported assessment in communication skills and techniques in a simulated intraoperative trauma scenario. Methods Study population consists of 93 candidates (67 surgeons and 26 anesthesiologists) participating in four consecutive joint DSTC–DATC courses in May and June 2019 in Brazil (3) and in Portugal (1). Median age was 30 years; 53 (60%) of subjects were male (46 senior residents and 47 specialists). All participants attended joint lectures, case discussions and surgical skills session, emphasizing intraoperative communication. Post‐course survey on several aspects of perioperative communication (responses on a Likert scale) was conducted with participants being asked which aspects of intraoperative communication they valued the most. Results All participants responded to the survey. Results displayed an increase in the self‐assessed importance of team briefing and intraoperative communication, particularly routine periodic communication, rather than only at critical moments. Postoperative team debriefing was also valued as highly relevant. Closed‐loop and direct, by‐name communication were highly rated. Self‐reported communication skills improved significantly during the course. Conclusions Joint training in the DSTC–DATC courses improved candidates’ perception and skills on proficient intraoperative communication. Further studies should address both the durability of these changes and the potential impact on patient care.

Introdução: Acidentes de trânsito (AT) são uma das principais causas de trauma no mundo. No Brasil, a taxa de mortalidade de motociclistas envolvidos em AT aumentou de forma significante entre 2004 e 2014: de 2,8 para 6,2 óbitos respectivamente por 100 mil habitantes. Objetivos: caracterizar o perfil sociodemográfico e clínico de motociclistas vítimas de Acidentes de Trânsito atendidos no Hospital de Base de São José do Rio Preto (2016 a 2018); identificar o perfil comportamental desses pacientes e rastrear sintomas de transtornos mentais. Métodos: pacientes envolvidos em acidentes com motocicleta (motoristas), atendidos no Pronto Atendimento da Cirurgia do Hospital de Base de São José do Rio Preto, SP, Brasil, foram convidados a participar do estudo e responderam aos seguintes instrumentos: Mini International Neuropsychiatric Interview (MINI) e Inventário de Auto-Avaliação para Adultos (ASR). O Banco de Dados da Unidade de Trauma do Hospital de Base forneceu as infomações do prontuário para a construção do perfil sociodemográfico e clínico (referentes às lesões do trauma) do paciente. Resultados: Os participantes (n = 40) eram principalmente do sexo masculino, com média de idade de 33,83 anos (± 12,95) e baixa escolaridade; 13 relataram dirigir após ingestão de bebida alcoólica. A maioria apresentou lesões leves. Foram identificados (ASR e MINI) problemas externalizantes e internalizantes, violação de regras, queixas somáticas, abuso de álcool e de crack. Conclusão: Entre os motociclistas acidentados houve predominância de jovens do sexo masculino com baixa escolaridade, maior prevalência de lesões nas extremidades e no abdomem, uso de álcool associado à direção e presença de sintomas de transtornos mentais internalizantes e externalizantes.

AIM:To report on the causes of trauma, indexes of trauma, and mortality related to thoracic trauma in one region of Brazil.MATERIALS AND METHODS:This prospective study was performed at the Regional Trauma Center in São José do Rio Preto over a 1-year period, from 1st July 2004 to 30th June 2005. We included all patients attending the center's emergency room with thoracic trauma and an anatomic injury scale (AIS) ≥ 2. We collected data using a protocol completed on arrival in hospital utilizing the AIS. We studied the types of accidents as well as the mortality and the AIS scores. Prevalence rates were calculated and the paired t-test and logistic regression were employed for the statistical analysis.RESULTS:There were a total of 373 casualties with AIS ≥ 2 and there were 45 (12%) deaths. The causes of thoracic trauma among the 373 casualties were as follows: 91 (24.4%) car crashes, 75 (20.1%) falls, 46 (12.3%) motorbike accidents, 40 (10.7%) stabbings, 22 (5.9%) accidents involving pedestrians, 21 (5.6%) bicycle accidents, 17 (4.6%) shootings, and 54 (14.5%) other types of accident. The severity of the injuries was classified according to the AIS: 224 (60%) were grade 2, 101 (27%) were grade 3, 27 (7.2%) were grade 4, 18 (4.9%) were grade 5, and 3 were (0.8%) grade 6. With respect to thoracic trauma, pedestrians involved in accidents and victims of shootings had mortality rates that were significantly higher than that of those involved in other types of accidents.CONCLUSION:Road accidents are the main cause of thoracic injury, with accidents involving pedestrians and shootings being associated with a greater death rate.

Background:Pulmonary thromboembolism is an important cause of death affecting thousands of people worldwide. The current study aims to evaluate the prevalence of death due to pulmonary embolism after trauma.Materials and Methods:The diagnoses of the causa mortis of all patients treated in the Accident and Emergency Department of Hospital de Base in São José do Rio Preto, in the period from July 2004 to June 2005, were identified from autopsy reports to check whether pulmonary thromboembolism was involved.Result:A total of 109 deaths due to trauma were detected in this period with pulmonary embolism occurring in 3 (2.75%) patients.Conclusion:Pulmonary thromboembolism is an important cause of mortality in trauma patients and so prophylactic measures should be taken during the treatment of these patients.