Impact of local and systemic antimicrobials on leukocyte- and platelet rich fibrin: an in vitro study

The aim of this study was to evaluate the effect of local and systemic administration of antimicrobials to leukocyte- and platelet-rich fibrin (L-PRF). For part A, 16 tubes of venous blood were collected from each of eight systemically healthy subjects. Prior to blood centrifugation, 12 of the 16 tubes were injected with 0.125 ml, 0.25 ml or 0.50 ml metronidazole solution. One set of L-PRF membranes was used to assess the release of vascular endothelial growth factor AB, platelet-derived growth factor, transforming growth factor beta 1, and bone morphogenetic protein 2 at indicated time points. The metronidazole release over time by L-PRF membranes was also evaluated. The remaining L-PRF membranes were placed on the surface of agar plates inoculated with three different periodontal pathogens to determine their antibacterial activity. For part B, another six subjects were enrolled with three subjects taking 2 g amoxicillin and three subjects 500 mg metronidazole as prophylaxis prior to a periodontal treatment. Before and 2 h after consuming one of the prescribed antimicrobials, three tubes of blood were collected for preparing L-PRF membranes. These membranes were used to measure the antibacterial activity against periodontal pathogens. No statistically significant difference could be found in the release of growth factors between L-PRF membranes with and without incorporation of metronidazole solution. The release of metronidazole could be detected up to day 3, however with the highest concentration during the first 4 h. This concentration was dose dependent. The antibacterial capacity of L-PRF membranes increased significantly for both the systemic intake, and after the addition of metronidazole solution to the blood tubes before centrifugation, the latter again dose dependent. The antibacterial capacity of L-PRF against the periodontal pathogens tested can significantly be enhanced by the addition of antimicrobials, without disadvantage for the release of growth factors.

Prospective international validation of the predisposition, infection, response and organ dysfunction (PIRO) clinical staging system among intensive care and general ward patients

Background

Stratifying patients with sepsis was the basis of the predisposition, infection, response and organ dysfunction (PIRO) concept, an attempt to resolve the heterogeneity in treatment response. The purpose of this study is to perform an independent validation of the PIRO staging system in an international cohort and explore its utility in the identification of patients in whom time to antibiotic treatment is particularly important.

Methods

Prospective international cohort study, conducted over a 6-month period in five Portuguese hospitals and one Australian institution. All consecutive adult patients admitted to selected wards or the intensive care, with infections that met the CDC criteria for lower respiratory tract, urinary, intra-abdominal and bloodstream infections were included.

Results

There were 1638 patients included in the study. Patients who died in hospital presented with a higher PIRO score (10 ± 3 vs 8 ± 4, p < 0.001). The observed mortality was 3%, 15%, 24% and 34% in stage I, II, III and IV, respectively, which was within the predicted intervals of the original model, except for stage IV patients that presented a lower mortality. The hospital survival rate was 84%. The application of the PIRO staging system to the validation cohort resulted in a positive predictive value of 97% for stage I, 91% for stage II, 85% for stage III and 66% for stage IV. The area under the receiver operating characteristics curve (AUROC) was 0.75 for the all cohort and 0.70 if only patients with bacteremia were considered. Patients in stage III and IV who did not have antibiotic therapy administered within the desired time frame had higher mortality rate than those who have timely administration of antibiotic.

Conclusions

To our knowledge, this is the first external validation of this PIRO staging system and it performed well on different patient wards within the hospital and in different types of hospitals. Future studies could apply the PIRO system to decision-making about specific therapeutic interventions and enrollment in clinical trials based on disease stage.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13613-021-00966-7.

The effect of agricultural intensification and water-locking on the world's largest coastal lagoonal system

The palaeolimnological conditions of Mirim Lagoon, a large coastal shallow lagoon under the influence of historical human impacts related to the development of the primary sector of the economy were reconstructed. The first significant human impact consisted of locking the estuarine system to induce the transition from brackish to freshwater conditions. During this transition, the sedimentation rate consistently increased from pre-disturbance values of 0.25 cm yr^-1 to >1 cm yr^-1. A concomitant increase in nitrogen and carbon values was recorded indicating a related eutrophication process. The highest nutrient levels were achieved during the 1990s after the incorporation of cutting-edge technologies for agricultural production such as high-yielding varieties of rice resistant to climate variability and pests, and the use of inorganic fertilisers, pesticides and water supply controlled by irrigation. After 2011, the soybean production boosted and the area cultivated with this oilseed equalled the area of rice paddies, i.e., 2 × 10⁵ ha. A sharp decrease in δ¹³C from -19 to -24‰ and in δ¹⁵N from 6 to 2‰ were observed in the sedimentary record, indicating a major shift in the composition of the organic matter after the agricultural intensification. Trace elements Cr, Cu, Ni and Zn showed a high positive correlation with Al and Fe, and enrichment factors near 1, indicating a natural and terrigenous source of these elements and also unpolluted conditions. However, the increase of As after 1990 and the positive correlation with Pb was associated with agricultural practices. All elemental ratios (K/Al, Ti/Al and V/Cr) showed constant pre-disturbance trends and a turning point ca. the 1990s. Microplastics were detected from the beginning of the 1990s and increased towards recent sediments, thus corroborating an anthropogenically impacted scenario. Therefore, the development of the primary sector of the economy exerted clear impacts on the environmental quality of the system.

Impact of g force and timing on the characteristics of platelet-rich fibrin matrices

Recently, new centrifugation protocols for the preparation of platelet-rich fibrin (PRF) have been introduced in an attempt to further improve the beneficial impact of these 2nd generation platelet concentrate membranes. This in-vitro study aimed to compare the biological and physical characteristics of three types of PRF membranes using two different centrifuges with adapted relative centrifugal forces (RCF): leucocyte- and platelet-rich fibrin, advanced platelet-rich fibrin, and advanced platelet-rich fibrin⁺. Release of growth factors, macroscopic dimensions, cellular content and mechanical properties of the respective membranes, prepared from blood of the same individual were explored. Furthermore, the impact of timing (blood draw-centrifugation and centrifugation-membrane preparation) was assessed morphologically as well as by electron microscopy scanning. No statistically significant differences amongst the three PRF modifications could be observed, neither in their release of growth factors or the cellular content, nor in clot/membrane dimensions. The difference between both centrifuges were negligible when the same g-force was used. A lower g-force, however, reduced membrane tensile strength. Timing in the preparation process had a significant impact. Adaptation of RCF only had a minimal impact on the final characteristics of PRF membranes.

Portuguese cultural adaptation and validation of the European Health Literacy Survey (HLS-EU) for children aged 9 to 10 (HLS-EU-PTc)

Introduction

To measure Health literacy (HL) as proposed in the context of the European Health Literacy Survey/questionnaire (HLS-EU-Q), the Health Literacy for Children and Adolescents (HLCA) Consortium (GE) adapted it for children. A trans-cultural adaptation and validation to Portuguese (HLS-EU-PTc), will supply policy makers, experts and health professionals with information that can promote healthier communities while fighting health disparities.

Methods

After permission was granted from the HLCA Consortium the TRAPD model was used (eg parallel translation, focus groups, two back translations). An assessment and pretesting of HLS-EU-PTc was done with 16 children for cognitive testing. A qualitative explanatory (n = 16) and quantitative, cross-sectional study (n = 82), age mean 13, SD 0.96, from Portugal (mainland) was implemented for proceed with the validation process. A variety of measures were obtained like internal consistency and mean scores.

Results

Preliminary results for evaluation of the psychometric properties of the HLS-EU-PTc show satisfactory internal consistency (Cronbach’s alpha coefficient 0.87). In a scale from 1 (very difficult) to 4 (very easy) for indicators of the HLS-EU-PTc, we have a mean of 3.25 and a SD of .478.

Conclusions

This is the first study to examine the feasibility of a Portuguese version (HLS-EU-PTc) of the HLS-EU-Q adapted for children and it indicates high internal consistency and level of self-reported HL. The usefulness of the HLS-EU-PTc instrument can be further discussed while planning public health policy strategies from the HL standpoint. The validated HLS-EU-PTc version of the HLS-EU-Qc survey, with the user’s manual can be accessed at www.literacia-saude.info.

Echinococcus granulosus hydatid cyst location is modified by Fasciola hepatica infection in cattle

BACKGROUND

Natural parasite infection occurs in wild and domestics animals with more than one parasite species at the same time, generating an infection called polyparasitism. Cystic echinococcosis reports are usually based only on infection with Echinoccocus granulosus leaving aside other internal parasitoses that could modulate both the immune response and pathogenesis of the natural infection. Fasciola hepatica is another cosmopolitan parasite in ruminants with a similar distribution to E. granulosus in different parts of the world, but no information of the effect of co-infection with E. granulosus has been described. The aims of this report were to establish E. granulosus prevalence and explore the association of F. hepatica co-infection and natural E. granulosus infections in cattle.

RESULTS

From 1725 animals, the prevalence of E. granulosus and F. hepatica was 21.16 and 51.3%, respectively. Considering both infections, older cattle (> 4 years) presented higher prevalence compared to younger animals. In E. granulosus-infected cattle, 5.21% had fertile cysts, 71.78% infertile cysts, and in 23.01% cysts were smaller than 1 cm in diameter. Considering cyst location, 39.72% had lungs cysts, 24.72% had liver cysts and 36.94% had cysts in both organs. Cyst location significantly differed between age groups: 44.68% of younger animals had cysts only in the lungs, while older animals presented hydatid cyst in the lungs and liver simultaneously (44.15%). With E. granulosus infection alone, 30.26% of cysts were found in the lungs, 31.79% in the liver and 37.95% in both organs. Regarding the co-infection of E. granulosus with F. hepatica, the proportion was significantly different (P < 0.05) with most animals having cysts only in the lungs (49.41%) and a lower level of liver infection (15.88%). Analyzing organ cyst distribution and F. hepatica absence/presence ratio within each cyst type, small cysts showed the highest difference in ratio.

CONCLUSIONS

To the best of our knowledge, this is the first report indicating that F. hepatica co-infection in cattle could be affecting the instate of hydatid cysts in the liver, displacing toward lung localization, suggesting an antagonistic relationship.

Background levels of trace elements in brown and red seaweeds from Trindade, a remote island in South Atlantic Ocean

Trace elements in organisms are normally higher in well-developed coastal areas than on oceanic islands. Few studies have used seaweeds as their sentinels on islands. This study established background levels of trace elements (As, Cd, Pb, Zn, Cu and Hg) for four seaweed species (Dictyopteris delicatula and Canistrocarpus cervicornis, brown algae; Ceratodictyon variabile and Palisada perforata, red algae) from Trindade, an oceanic Brazilian island, and verified potential differences associated to distinct environmental conditions. Spatial differences were not detected for As, Hg and Cd in samples, although the highest concentrations of these elements were observed in brown seaweeds. The highest Zn, Pb and Cu concentrations in seaweeds from the only inhabited beach may be a signal of the onset of human footprints on this still pristine, remote island. By comparison with background described in the literature, concentrations of trace elements in seaweeds were low, thus, allowing them to be considered reference levels.

Technical note: Influence of feed on image quality of abdominal ultrasonography in New Zealand white kits

<p class="Body">The aim of this study was to evaluate the influence of feed change on image quality of ultrasound scanning of the gallbladder, kidney and jejunum in New Zealand White kits. Thirty-nine 35-day-old rabbits were used, distributed into 4 diet groups: C, only commercial feed; CH, commercial feed and hay; C24H, only commercial feed, replaced by hay 24 h before examination; and CH24H, commercial feed and hay, with the commercial feed withdrawn 24 h before the exam. The rabbits received the diet for 42 d (from 35 to 77 d of age) and the ultrasound evaluations were performed on days 56 and 77. Ultrasonographic assessment for image quality focused on the possibility of visualisation and an image quality rating (3 scores: unacceptable, acceptable or excellent) for the gallbladder, kidneys and jejunum. The kidneys were visualised in 100% of animals of all diets and ages. There was no difference in visualisation (P&gt;0.05) of the gallbladder among the animals fed different diets on days 56 and 77. The C24H diet had a higher visualisation possibility (P&lt;0.05) of the jejunum compared to the C and CH diets on day 77. For the image quality score, there was no difference in the studied organs on day 56. However, on day 77, there was a difference for the jejunum (P&lt;0.05), and only the C24H and CH24H diets presented images classified as excellent. In conclusion, the image quality of the kidneys and gallbladder was unaffected by feed, and the jejunum had an improved image quality with the inclusion of hay and without the commercial feed 24 h before the test in New Zealand White rabbits at 77 d of age.</p>

Diazoxide enhances excitotoxicity-induced neurogenesis and attenuates neurodegeneration in the rat non-neurogenic hippocampus

Diazoxide, a well-known mitochondrial KATP channel opener with neuroprotective effects, has been proposed for the effective and safe treatment of neuroinflammation. To test whether diazoxide affects the neurogenesis associated with excitotoxicity in brain injury, we induced lesions by injecting excitotoxic N-methyl-d-aspartate (NMDA) into the rat hippocampus and analyzed the effects of a daily oral administration of diazoxide on the induced lesion. Specific glial and neuronal staining showed that NMDA elicited a strong glial reaction associated with progressive neuronal loss in the whole hippocampal formation. Doublecortin immunohistochemistry and bromo-deoxyuridine (BrdU)-NeuN double immunohistochemistry revealed that NMDA also induced cell proliferation and neurogenesis in the lesioned non-neurogenic hippocampus. Furthermore, glial fibrillary acidic protein (GFAP)-positive cells in the injured hippocampus expressed transcription factor Sp8 indicating that the excitotoxic lesion elicited the migration of progenitors from the subventricular zone and/or the reprograming of reactive astrocytes. Diazoxide treatment attenuated the NMDA-induced hippocampal injury in rats, as demonstrated by decreases in the size of the lesion, neuronal loss and microglial reaction. Diazoxide also increased the number of BrdU/NeuN double-stained cells and elevated the number of Sp8-positive cells in the lesioned hippocampus. These results indicate a role for KATP channel activation in regulating excitotoxicity-induced neurogenesis in brain injury.

El desafío de incorporar las redes institucionales y comunitarias en la intervención con adolescentes infractores: una investigación acción en tres regiones del sur de Chile

Se reportan los resultados obtenidos a partir de una investigación acción con componentes participativos, orientada a fortalecer el funcionamiento de redes institucionales y comunitarias para la intervención con adolescentes infractores de ley. El articulo da cuenta de los principales resultados obtenidos a partir de este proceso, centrando su análisis en un conjunto de dimensiones que permiten tener una panorámica acerca de los avances y desafíos que presentan los programas involucrados en el estudio. Los resultados reportan las dificultades de los equipos para incluir de modo eficiente los recursos de las redes inter institucionales dada la fragmentación de la política pública destinada a este grupo de adolescentes, así como las barreras para integrar la dimensión comunitaria en el trabajo con los jóvenes producto del formato de intervención así como las modalidades de financiamiento de los programas. Así también se evidencian mejoras en la comprensión e integración de estos componentes por parte de los equipos de los programas durante el proceso articulándose redes interinstitucionales con mejores grados de continuidad y complementariedad en su quehacer y una incorporación paulatina, aunque parcial de la dimensión comunitaria en la intervención.

Intestinal Alkaline Phosphatase: Potential Roles in Promoting Gut Health in Weanling Piglets and Its Modulation by Feed Additives - A Review

The intestinal environment plays a critical role in maintaining swine health. Many factors such as diet, microbiota, and host intestinal immune response influence the intestinal environment. Intestinal alkaline phosphatase (IAP) is an important apical brush border enzyme that is influenced by these factors. IAP dephosphorylates bacterial lipopolysaccharides (LPS), unmethylated cytosine-guanosine dinucleotides, and flagellin, reducing bacterial toxicity and consequently regulating toll-like receptors (TLRs) activation and inflammation. It also desphosphorylates extracellular nucleotides such as uridine diphosphate and adenosine triphosphate, consequently reducing inflammation, modulating, and preserving the homeostasis of the intestinal microbiota. The apical localization of IAP on the epithelial surface reveals its role on LPS (from luminal bacteria) detoxification. As the expression of IAP is reported to be downregulated in piglets at weaning, LPS from commensal and pathogenic gram-negative bacteria could increase inflammatory processes by TLR-4 activation, increasing diarrhea events during this phase. Although some studies had reported potential IAP roles to promote gut health, investigations about exogenous IAP effects or feed additives modulating IAP expression and activity yet are necessary. However, we discussed in this paper that the critical assessment reported can suggest that exogenous IAP or feed additives that could increase its expression could show beneficial effects to reduce diarrhea events during the post weaning phase. Therefore, the main goals of this review are to discuss IAP’s role in intestinal inflammatory processes and present feed additives used as growth promoters that may modulate IAP expression and activity to promote gut health in piglets.

Alveolar hemorrhage in systemic lupus erythematosus: a cohort review

Diffuse alveolar hemorrhage (DAH) is a rare but potentially catastrophic manifestation with a high mortality. Among rheumatologic diseases, it occurs most frequently in patients with systemic lupus erythematosus (SLE) and systemic vasculitis. Despite new diagnostic tools and therapies, it remains a diagnostic and therapeutic challenge. The aim of this work was to characterize the SLE patients with an episode of alveolar hemorrhage followed in our Clinical Immunology Unit (CIU). A retrospective chart review was carried out for all patients with SLE followed in CIU between 1984 and the end of 2013. We reviewed the following data: demographic characteristics, clinical and laboratory data, radiologic investigations, histologic studies, treatment, and outcome. We identified 10 episodes of DAH, corresponding to seven patients, all female. These represent 1.6% of SLE patients followed in our Unit. The age at DAH attack was 42.75 ± 18.9 years. The average time between diagnosis of SLE and the onset of DAH was 7.1 years. Three patients had the diagnosis of SLE and the DAH attack at the same time. Disease activity according to SLEDAI was high, ranging from 15 to 41. All patients were treated with methylprednisolone, 37.5% cyclophosphamide and 28.6% plasmapheresis. The overall mortality rate was 28.6%.

Natural background groundwater composition in the Azores archipelago (Portugal): a hydrogeochemical study and threshold value determination

Groundwater discharges were sampled in selected springs from São Miguel (Furnas and Fogo trachytic central volcanoes) and Santa Maria islands (Azores, Portugal), in order to characterize natural background levels (NBLs) and proceed to the determination of threshold values (TVs). Besides being a key issue in order to fully assess the anthropogenic pressures, NBLs are also instrumental to derive TVs, therefore complying with requirements from the European Union Groundwater Directive. The composition of groundwater corresponds mainly to low mineralized Na-HCO3 to Na-Cl water types, the latter dominant in Santa Maria island, with a decreasing order of Na>Ca>Mg>K and Cl>HCO3>SO4>NO3 for cations and anion respectively. The majority of the samples are slightly acid to slightly alkaline (pH range of 5.45-7.43), and the electrical conductivity range between 180 and 1458 μS/cm. Groundwater composition is controlled by two major drivers, addition of sea salts and dissolution of silicate minerals. Results shown that TVs established along the present study are in general in the lower rank when compared to the range of values proposed by the several EU member states, with the main exception of NO3, reflecting the impact of agriculture activities over water quality in the Azores, and lower than the national ones. The comparison between the estimated NBL and TV with values derived with another dataset from the Azores, usually higher, depicts the effect of a larger and diverse number of groundwater sources over calculations. On the other hand, all samples which show a contribution from volcanic/hydrothermal systems were excluded from the dataset, which explains why the derived NBLs and TVs are lower comparing to other active volcanic areas, which is also a conservative approach on a subject that has regulatory implications.

Spring geochemistry in an active volcanic environment (São Miguel, Azores): source and fluxes of inorganic solutes

Mineral waters were monthly sampled in selected springs from Furnas and Fogo trachytic central volcanoes (São Miguel, Azores, Portugal). Water temperatures between 15.1 °C and 90.2 °C, characterize poorly mineralized waters of Na-HCO₃ and Na-HCO₃-Cl types. According to the spring location, two watersheds were selected in each volcano to evaluate solute fluxes and chemical weathering rates (Fogo volcano: Ribeira Grande river - RRG; Furnas volcano: Ribeira Quente river - RRQ). Na, Mg, K and Ca fluxes in groundwater represented 43%, 60%, 46% and 57% of the total (subsurface plus surface fluxes) in RRG, and respectively 43%, 53%, 46% and 49% in RRQ. Average HCO₃ flux is ten times higher in RRQ (130.1 × 10(6) mol/yr) compared to RRG (13.8 × 10(6) mol/yr), reflecting the volcano degassing and the lower ratio between groundwater and river water fluxes. Based on these values, total CO₂-consumption by weathering ranged from 1.5 × 10(6)mol/km(2)/yr (RRG) to 4 × 10(6)mol/km(2)/yr (RRQ). TDS load varied between 3772 t/yr (RRG) and 15388 t/yr (RRQ), and the ratio between values in groundwater and in surface water is respectively equal to 0.72 and 2.04. The associated chemical weathering rates in groundwater were 206 t/km(2)/yr (RRG) and 399 t/km(2)/yr (RRQ). Coupled to river water, these values indicate that total chemical weathering rates are respectively equal to 493 t/km(2)/yr and 594 t/km(2)/yr. A similar approach developed for the entire archipelago showed that the chemical weathering rates due to groundwater are in the range from 33 to 321 t/km(2)/yr, being partially controlled by the age of the islands. Results of the present study point out to the need to consider groundwater solute fluxes due to weathering when establishing geochemical budgets.

Fluvial geochemistry in São Miguel Island (Azores, Portugal): source and fluxes of inorganic solutes in an active volcanic environment

River water chemistry in two of the major rivers in São Miguel Island (Azores archipelago, Portugal) has been characterized monthly between June 2010 and October 2011 in order to estimate the main geochemical processes that explain water composition and to estimate solute fluxes and the thermal water input to rivers. Both rivers (Ribeira Grande - RRG, and Ribeira Quente - RRQ) drain active trachytic central volcanoes. The number of sampling stations is seven in RRG and six in RRQ. Rivers are mainly slightly acid to basic in nature (pH in the range 5.41-8.70 in RRG and 5.90-8.10 in RRQ) and from the Na-HCO3 and Na-HCO3-Cl water types. In both cases water temperature increases towards the river mouth and median values are slightly higher in Ribeira Quente (15.5-22.4°C) comparing to Ribeira Grande river (15.2-19.7°C). Electrical conductivity suggests poorly mineralized waters (139-456 μS/cm in RRG and 209-402 μS/cm in RRQ, and values increase downstream. Higher solute fluxes are associated to HCO3 and Na, and the total CO2 flux is equal to 3647 t/yr in RRQ and 7546 t/yr in RRG. Mixture with thermal water discharges also influences river water chemistry and in RRQ the contribution to the annual average discharge rate was estimated in 2.96×10(6)m(3)/yr (12.8% of overall discharge rate in the watershed). In RRG thermal water discharges were estimated in 2.4×10(6)m(3)/yr (14.9% of the discharge rate). The minimum total CO2-consumption associated with low-temperature weathering is equal to 0.58×10(6)mol/km(2)/yr in Ribeira Quente river and equal to 0.78×10(6)mol/km(2)/yr in Ribeira Grande river.

Especificaciones de cálculo de la vida útil y estado límite de corrosión

RESUMENLos cálculos de vida útil de las estructuras de hormigón están pasando rápidamente de los laboratorios a las normativas y a ser especificados en la licitación de grandes infraestructuras. Así vidas útiles de 100 años o más se han requerido en puentes como Oresund o en el nuevo canal de Panamá. Sin embargo la especificación se realiza de forma resumida sin que se defina la forma de demostrar esa durabilidad y en algunos casos, sin siquiera mencionar los ensayos y sus valores limites que se deben utilizar. En la presente comunicación se describen los aspectos más importantes que se deben especificar en los modelos que deben ser además de los coeficientes de difusión, la concentración superficial, los factores de envejecimiento y el límite de cloruros así como la probabilidad de corrosión que se considera inaceptable.Palabras Clave: hormigón; cloruros; resistividad; difusión.ABSTRACTEstimates of service life of concrete structures are rapidly moving from laboratories to the standards and to be specified in the construction for large infrastructures. So service life of 100 years or more were required to Oresund bridge or the new Panama Canal. However, the specification is made without defining how to prove the specified durability and in some cases, without even mentioning the tests and limit values to be used. Present communication describes the most important aspects to be specified in the chloride prediction models in addition to the diffusion coefficients, which are the surface concentration, the aging factor, the limit of chlorides and the acceptable probability of corrosion.Keywords: concrete; chlorides; resistivity; diffusion.

Injuries in preschool children: the hypothetical protector effect of minor injuries and risk factors for minor and medically attended injuries

This study aimed to investigate the relationship between minor and medically attended injuries and to analyse the influence of child-related factors and family-related factors in injuries of preschool children. Individual interviews were conducted with 335 parents of 1- to 5-year-old children. Parents informed about the child and the family variables and reported the child's history of injuries in the last year. The frequencies of minor injuries and medically attended injuries were not correlated. The risk factors for both kinds of injuries include the number of siblings and the size of the family. Minor injuries were more frequent in older than in younger children. Medically attended injuries were more frequent in boys than in girls. The risk factors that influence minor and medically attended injuries are different, suggesting that the strategies to prevent and reduce injuries need to take that difference into consideration.