Diagnóstico prenatal, síndrome Freeman-Sheldon mediante ultrasonido y estudio genético. Reporte de caso / Prenatal diagnosis of Freeman-Sheldon syndrome using ultrasound and genetic testing. Case report

Objetivos: Describir un caso de diagnóstico prenatal de síndrome de Freeman-Sheldon mediante hallazgos ecográficos y secuenciación completa del exoma fetal. Materiales y métodos: Mujer de 33 años, con antecedentes de hipotiroidismo en tratamiento, a quien en semana 19 se realizó ecografía de detalle anatómico, en la cual se observaron deformidades en el feto en más de dos áreas corporales (extremidades superiores e inferiores), sugiriendo el diagnóstico de artrogriposis. Posteriormente, se brindó asesoría genética y se realizó amniocentesis en semana 20 de gestación, con análisis de la hibridación in situ por fluorescencia, seguido de secuenciación completa del exoma fetal. Este último examen permitió identificar una variante patogénica heterocigota en el gen MYH3, la cual se asocia con la artrogriposis distal tipo 2A. Conclusiones: La realización de la secuenciación completa de exoma fetal es un factor clave para identificar la mutación del gen MYH3, y confirma que las deformidades evidenciadas por ultrasonido estaban relacionadas con la artrogriposis distal tipo 2A. Es importante hacer la secuenciación de exoma fetal en fetos que muestren hallazgos de malformaciones articulares en el ultrasonido prenatal.

Objectives: To describe a case of prenatal diagnosis of Freeman-Sheldon syndrome based on ultrasound findings and complete fetal exome sequencing. Materials and methods: A 33-year-old woman currently on treatment for hypothyroidism in whom a 19-week detailed anatomical ultrasound scan showed fetal deformities in more than two body areas (upper and lower limbs), suggesting a diagnosis of arthrogryposis. Genetic counseling was provided and amniocentesis was performed at 20 weeks for fluorescence in situ hybridization (FISH) analysis and complete fetal exome sequencing, with the latter allowing the identification of a heterozygous pathogenic variant of the MYH3 gene which is associated with type 2A distal arthrogryposis. Conclusions: Complete fetal exome sequencing was a key factor in identifying the MYH3 gene mutation and confirmed that the deformities seen on ultrasound were associated with type 2A distal arthrogryposis. It is important to perform complete fetal exome sequencing in cases of joint malformations seen on prenatal ultrasound.

O clube de leitura "por uma prescrição segura" como ensino e aprendizagem de estudantes de medicina: um relato de experiência / The journal club "for a sefety prescription" as teaching and learning for medical students: an experience report / Club de lectura "por prescripción segura" como enseñanza y aprendizaje de estudiantes de medicina: informe de experiencia

Objetivo: O presente estudo busca descrever o relato de experiência do clube de leitura "Por uma Prescrição Segura" de estudantes de medicina como estratégia para desenvolver habilidades de pesquisa na literatura científica e estudo crítico de evidências, focando em uma prescrição segura. Método: Desenvolveu-se o clube de leitura com nove estudantes de medicina, os quais participaram de reuniões dirigidas por líder estudantil e uma professora. As reuniões ocorreram quinzenalmente, ao vivo, via Google Meet. Os estudantes desenvolveram questões sobre diferentes temas, pesquisaram a literatura, localizaram e estudaram criticamente os artigos. Resultados: os dados revelaram a participação dos estudantes no Clube de Leitura nas reuniões planejadas coletivamente e com os temas: "Medicina Baseada em Evidências"; "Revisão Integrativa"; "Segurança da prescrição, paciente e medicamento"; "Polifarmácia"; "Resistência aos antimicrobianos"; "Prescrição de psicofármacos"; "Incorporação de tecnologias"; "Práticas integrativas e complementares, Cuidados paliativos". Conclusão: O clube de leitura proporcionou o desenvolvimento do trabalho acadêmico de pesquisa e estudo da literatura científica sobre prescrição segura. Além disso, trouxe compreensão dos conceitos e modelos de práticas de medicina baseada em evidência no estágio pré-clínico. Foi uma estratégia-modelo liderada por estudante e orientada pela professora com resultado favorável para integrar as atividades curriculares.

Objective: The present study seeks to describe the experience report of the medical students' jornal club "For a Sefety Prescription" as strategy to develop skills on searching in cientific literature and critically study of the evidences, focusing on safe prescription. Method: The journal club was developed with nine medical students, who participated in meetings led by a student leader and a teacher. The meetings ocorred biweekly, live, via Google Meet. The students developed questions on different topics, searched the literature, located and critically studied the articles. Results: the data revealed the participation of students in the jornal club in meetings planned collectively and with the themes: "Evidence-Based Medicine"; "Integrative Review"; "Prescription, patient and medication safety"; "Polypharmacy"; "Antimicrobial resistance"; "Prescription of psychotropic drugs"; "Incorporation of technologies"; "Integrative and complementary practices, Palliative care". Conclusion: The article-centered journal club provided the development of academic work on research and study of the scientific literature on safe prescribing. In addition, broght understanding of the concepts and models of evidence-based medicine practices in the preclinical stage. It is a student-led and teacher-led model strategy with favorable outcome for integrating curricular activities.

Objetivo: El presente estudio describe el relato de experiencia del club de lectura de estudiantes de medicina como una estrategia para desarrollar habilidades de investigacion en la literatura cientifica y estudio critico de la evidencia, con enfoque en la prescripción segura. Método: se desarrolló un club de lectura con nueve estudiantes de medicina que participaron en reuniones dirigidas por un líder estudiantil y un maestro. Las reuniones se realizaron quincenalmente, en vivo, a través de Google Meet. Los estudiantes desarrollaron preguntas sobre diferentes temas, investigaron la literatura, localizaron y estudiaron críticamente los artículos. Resultados: los datos revelaron la participación de los estudiantes del club de lectura en encuentros planificados colectivamente y con los temas: "Medicina Basada en la Evidencia"; "Revisión Integrativa"; "Seguridad de la prescripción, del paciente y de los medicamentos"; "Polifarmacia"; "Resistencia antimicrobiana"; "Prescripción de psicofármacos"; "Incorporación de tecnologías"; "Prácticas integradoras y complementarias, cuidados paliativos". Conclusión: El club de lectura centrado en el artículo proporcionó el trabajo académico de investigar y estudiar la literatura científica sobre la prescripción segura. Además, comprensión de los conceptos y modelos de las prácticas de la medicina basada en la evidencia en la etapa preclínica. Es una estrategia modelo dirigida por el estudiante y el docente con resultados favorables para la integración de actividades curriculares.

The practice and exploration of the new teacher training mode of MOOC and micro-course club / 中华医学教育探索杂志

This study summarizes the construction background, rules and regulations and institutional settings of the MOOC and Micro-course Club in the Second Hospital of Jilin University, discusses the means of teacher training for clinical teachers, and shows the application effect of the club. At the same time, the related problems encountered in the process of club construction are summarized and reflected. The construction of MOOC and micro-course clubs is conducive to improving the information-based teaching level of clinical teachers, and also provides new inspiration and ideas for the construction of medical clubs.

Factors affecting medication adherence of hypertension and diabetes club members in the District Health Centers in the City of Baguio

Background@#Medication adherence is important to mitigate complications of NCDs. Hypertension and diabetes clubs were intended to make essential medications accessible to club members. Despite these efforts, patients avail treatment and management in acute care with noted complications. To address this problem, it is important to identify factors that affect patients’ adherence medication.@*Objectives@#This study aimed to determine the factors affecting adherence to medications of members enrolled in the Hypertension and Diabetes Club in the district health centers in the city of Baguio.@*Methods@#This is a cross-sectional study with a total of 374 respondents from the 16 different district health centers in the City of Baguio, obtained through random sampling. A validated questionnaire was utilized for the collection of data and was presented using percentage and frequency tables. A chi-square test was used to find the association of clinic-demographic data with respondents’ medication adherence.@*Results@#Hypertension and Diabetic Club members overall reported good adherence to medication. Majority of the respondents are female and are older than 61 years old while comorbidities show significant association with level of adherence. On the other hand, lack of finances, feeling that the drug is not effective, multiple medications, taking medications for many years, interference with meal plan, feeling the dose is too high, and complexity of drug regimen are noted to be associated factors for non-adherence.@*Conclusion@#Hypertension and Diabetes Club a community-based management in the City of Baguio shows a good impact on patients’ medication adherence. Comorbidities, chronicity, good family support as well as good physician-patient relationship can positively affect adherence to medications. On the other hand, factors affecting medications non-adherence are: complexity of medications, subjective report that medication is too high, interference to meal, having medications for many years and having multiple medications. Identifying factors affecting adherence and nonadherence are important to decrease further complications of the common NCDs.

De torcida organizada a movimento independente: análise temática sobre a trajetória de um agrupamento de torcedores no sul do Brasil / From supporters' group to independent movement: thematic analysis on the path of a group of fans in southern Brazil

Diante da polimorfia do torcer e das sociabilidades em torno do futebol, o texto propõe: a) conhecer como surgiu um agrupamento de torcedores na cidade de Rio Grande/RS enquanto núcleo de uma Torcida Organizada (TO) do Sport Club Internacional; b) identificar os motivos que fizeram com que a TO se transformasse em um Movimento Independente de torcedores colorados; e c) descrever e analisar os desdobramentos que essa transição provocou nos processos organizativos do agrupamento. Foram realizadas seis entrevistas semiestruturadas, sendo três diretores e três membros mais antigos, as quais foram examinadas através da análise temática. Identificou-se que conflitos geracionais, busca de reconhecimento político e um processo de semiprofissionalização organizativa foram fatores que interviram na emergência e transição de núcleo para Movimento Independente e, por efeito, subjetivaram os modos de torcer dos integrantes.

Facing the polymorphism of supporting and sociability around football, the text proposes: a) to understand how a group of fans in the city of Rio Grande/RS emerged as kernel of a Sport Club Internacional's Supporter's Group; b) identify the reasons that turned the Supporter's Group into an Independent Movement of Colorado fans; and c) to describe and analyze the consequences that this transition generated in the organizational processes of the group. Six semi-structured interviews were carried out, being three of them with directors and three with senior members, which were then scanned through thematic analysis. It was identified that generational conflicts, the pursuit for political recognition and an organizational semi-professionalization process were factors that intervened in the emergence and transition of the kernel to Independent Movement and, in effect, subjectivized the ways of cheering by the members.

O Cotinguiba esporte clube como espaço de lazer e sociabilidade em aracaju ­ se: décadas de 1980 e 1990 / Cotinguiba sport club as a space for leisure and sociability in aracaju ­ se: 1980's and 1990's

O texto apresentado tem como objetivo analisar o Cotinguiba Esporte Clube como espaço de lazer e sociabilidade na cidade de Aracaju (SE) entre o início da década de 1980 e final da década de 1990, e identificar as atividades utilizadas como lazer no período em questão. O Cotinguiba é o primeiro e um dos clubes, esportivo e social, mais importantes da cidade de Aracaju. Logo, o estudo tem característica de uma pesquisa qualitativa, combinando elementos de cunho bibliográfico e documental. Para acessar aos dados foram realizadas entrevistas, assim como também foram acessados documentos referentes ao clube. Como resultado foi possível perceber o quanto o Cotinguiba foi importante para a população de Aracaju nas décadas estudadas, pois, através das atividades físico esportivas, bem como das suas festividades realizadas houve uma interferência relevante quanto às mudanças nos costumes e hábitos de lazer e nos aspectos socioculturais da população da cidade de Aracaju.

The present text aims to analyze the Cotinguiba Esporte Clube as a space for leisure and sociability in the city of Aracaju (SE) between the beginning of the 1980s and the end of the 1990s, and to identify the activities used as leisure in the period in question. Cotinguiba is the first and one of the most important sports and social clubs in the city of Aracaju. Therefore, the study has the characteristic of a qualitative research, combining bibliographic and documentary elements. To access the data, interviews were carried out, as well as documents referring to the club. As a result, it was possible to perceive how important Cotinguiba was for the population of Aracaju in the decades studied, because, through physical sports activities, as well as their festivities, there was a relevant interference regarding changes in customs and leisure habits and in the aspects sociocultural aspects of the population of the city of Aracaju.

Uso de club drugs entre estudantes de graduação: prevalência, características associadas e a influência dos pares / Club drugs use among undergraduate students: prevalence, associated characteristics and peer influence

OBJETIVO: Medir a prevalência do uso na vida, no último ano e no último mês de duas club drugs ­ o ecstasy e o LSD ­, bem como as características associadas ao uso dessas substâncias, no último mês, entre estudantes de graduação de uma universidade no Sul do Brasil. MÉTODOS: Trata-se de um estudo transversal conduzido no ano de 2015 com amostragem aleatória sistemática por conglomerados. Participaram 1.423 estudantes de graduação. Foi utilizado um modelo de análise multivariável em três níveis hierárquicos por meio da regressão de Poisson com ajuste robusto da variância. RESULTADOS: As prevalências de uso na vida, no último ano e no último mês de club drugs foram de 12,7%, 7,8% e 3,8%, respectivamente. Indivíduos do sexo masculino, com orientação sexual homossexual ou bissexual, mais jovens, que moravam com seus pares, solteiros, e que relataram uso no último mês de tabaco e maconha apresentaram maior probabilidade de ter feito uso no último mês de alguma club drug. Entretanto, a variável mais fortemente associada a esse desfecho foi ter algum amigo que já fez uso de alguma droga ilícita na vida (RP = 19,54). CONCLUSÕES: O ambiente universitário parece ser um terreno fértil para a difusão do uso de club drugs. O fortalecimento de uma rede de apoio institucional da universidade, capaz de propor atividades de prevenção, bem como de identificar, acolher e encaminhar casos em que haja abuso e dependência dessas substâncias, pode ser uma estratégia importante para lidar com essa problemática.

OBJECTIVE: To measure the prevalence of lifetime, last-year, and last-month use of two club drugs ­ ecstasy and LSD ­, as well as the characteristics associated with the last-month use of these substances among undergraduate students at a university in southern Brazil. METHODS: This was a cross-sectional study conducted in 2015 with a clustered systematic sampling strategy. Overall, 1,423 undergraduate students participated. A three-level hierarchical multivariate analysis model was used through Poisson regression with robust adjustment of variance. RESULTS: Prevalence of lifetime, last-year, and lastmonth use of club drugs were 12.7%, 7.8% and 3.8%, respectively. Male participants, with homosexual or bisexual sexual orientation, younger, who lived with their peers, who were single, and who reported last-month use of tobacco and marijuana had higher probability of last-month use club drugs. However, the variable most strongly associated with this outcome was having a friend with lifetime use of illicit drugs (PR = 19.54). CONCLUSIONS: University environment seems to be a fertile ground for the spread of the use of club drugs. The strengthening of the university's institutional assistance network, capable of proposing prevention activities, as well as identifying, supporting and referring cases where there is abuse and dependence on these substances can be an important strategy to deal with this problem.

Torceres: pensando diferentes possibilidades de pertencimento clubístico / Multiple ways to be a soccer fan: thinking of the different possibilities of club membership

Partindo do conceito de pertencimento clubístico, traçamos reflexões sobre fidelidade, exclusividade e imutabilidade, comumente acionadas para legitimar a relação torcedor-clube. No diálogo com quatro pesquisas, identificamos elementos que, de diferentes modos, tensionam tais aspectos. Na experiência de mulheres casadas com jogadores de futebol, encontramos uma polifiliação com diferentes nuances entre torcer para o "time de coração" e para clubes nos quais jogam ou jogaram os cônjuges: formas de torcer marcadas por diferentes intensidades e modos de engajamento. Para torcedoras organizadas, a construção do torcer próprio é permeada por relações desiguais de gênero, concessões e, até mesmo violências, que sustentam os padrões de um "torcer genuíno". E, por fim, no caso de uma torcedora travesti, a cisheteromasculinidade atua a excluindo do universo futebolístico, e o acolhimento acontece no clube rival.

Based on a concept of club membership, we trace reflections about fidelity, exclusivity, and immutability, frequently triggered to legitimize the relation between supporters and soccer teams. In dialogue with four researches, we identify elements which, in different ways, question these aspects. In the experiences of women who are married to soccer players, we found a polyphiliation with different nuances between support "the team of your heart" and the teams in which the husbands had played or still playing: forms of supporting the teams marked by different levels of intensities and engagements. In the case of women supporters who are members in organized associations of supporters, the construction of being a supporter by themselves is crossed by asymmetrical relations of gender, concessions and even violence, that sustain a supposed genuine form of being soccer fans. And, at last, in the case of a transgender soccer supporter, the cisheteromasculinity operate in her exclusion of the soccer universe, and the reception (that is part of being a supporter for her), happens in the rival team.

Psychosocial development and mental health in youth Brazilian club athletes: examining the effects of age, sport type, and training experience / Desenvolvimento psicossocial e saúde mental em jovens atletas: examinando os efeitos da idade, tipo de esporte e nível de experiência

Abstract Physical activity occurring through organized sport has been positioned as an engaging manner not only to prevent chronic-degenerative diseases but also to promote healthier societies. However, there is a lack of evidence linking competitive sport participation in the club environment in promoting youth athletes' psychosocial development and mental health. Thus, this study aimed to analyze the effects of age, sport type, and training experience on the psychosocial development and mental health of youth Brazilian club athletes. Participants were 220 male adolescent athletes (Mean =14.09 years; SD = 2.21) from individual and team sports. Instruments included the Portuguese Youth Experience Survey for Sport (P-YES-S) and the Portuguese Mental Health Continuum - Short Form (P-MHC-SF). Correlation and multilevel linear regression analyses were performed. The results indicated a moderated correlation between both questionnaires. For the P-YES-S, model effect estimations showed variation for age in the Personal and Social Skills dimension and variations for training experience in the Cognitive Skills and Negative Experiences dimensions. For the P-MHC-SF, model effect estimations showed variation for age in the Emotional Well Being dimension and variation for sport type in Social Well Being and Psychological Well Being dimensions. More research is needed to continue examining how characteristics of sport participation are related to psychosocial development and mental health.

Resumo A atividade física por meio do esporte organizado tem sido posicionada como uma ferramenta potencial não apenas para prevenir o acometimento de doenças crônico degenerativas, mas também para promover uma sociedade mais saudável. Contudo, ainda existe uma lacuna científica acerca da relação entre a participação no esporte competitivo no contexto de clubes e a promoção do desenvolvimento psicossocial e a saúde mental de jovens atletas. Assim, este estudo buscou analisar os efeitos da idade, tipo de esporte e nível de experiência no desenvolvimento psicossocial e na saúde mental de jovens atletas de um clube brasileiro. Os participantes foram 220 atletas adolescentes do sexo masculino (Média = 14,09 anos; DP = 2,21) de esportes individuais e coletivos. Os instrumentos incluíram o Questionário de Experiência Esportiva em Jovens - Português (P-YES-S) e o Contínuo de Saúde Mental - Short Form - Português (P-MHC-SF). Análises de correlação e regressão linear multinível foram realizadas. Os resultados indicaram uma correlação moderada entre os dois questionários. Para o P-YES-S, as estimativas do efeito do modelo mostraram variação para a idade na dimensão Habilidades Pessoais e Sociais e variações para o nível de experiência nas dimensões Habilidades Cognitivas e Experiências Negativas. Para o P-MHC-SF, as estimativas do efeito do modelo mostraram variação para a idade na dimensão Bem-estar Emocional e variação para o tipo de esporte nas dimensões Bem-Estar Social e Bem-Estar Psicológico. Mais pesquisas são necessárias para continuar examinando como as características da participação no esporte estão relacionadas ao desenvolvimento psicossocial e à saúde mental.

Engagement in different sport disciplines during university years and risk of locomotive syndrome in older age: J-Fit

BACKGROUND@#Among former Olympic-level athletes, engagement in different sport disciplines has been associated with mortality risk in subsequent years. However, limited evidence is available on whether engagement in different sport disciplines at a young age is associated with locomotive syndrome (LS) risk later in life. This study examined the relationship between engagement in different sport disciplines during university years and LS risk in older age among former university athletes.@*METHODS@#Participants were 274 middle-aged and 294 older men alumni who graduated from a school of physical education in Japan. LS risk was defined as answering "yes" to any of the Loco-check questions. Data on university sports club membership were collected using questionnaires. University clubs were classified into three groups of cardiovascular intensity (low, moderate, high), following the classification system of sport disciplines by the American College of Cardiology. This classification considers the static and dynamic components of an activity, which correspond to the estimated percent of maximal voluntary contraction reached and maximal oxygen uptake achieved, respectively. University clubs were grouped based on the risk of bodily collision (no, yes) and extent of physical contact (low, moderate, high). Relationships between engagement in different sport disciplines and LS risk were analyzed using Cox proportional hazards models, and adjusted for age, height, weight, joint disease, habitual exercise, and smoking and drinking status.@*RESULTS@#Adjusted hazard ratios and 95% confidence intervals associated with the low, moderate, and high cardiovascular intensity sports were 1.00 (reference), 0.48 (0.22-1.06, P = 0.070), and 0.44 (0.20-0.97, P = 0.042) in older men, respectively; however, there was no significant association between these parameters among middle-aged men. Engagement in sports associated with physical contact and collision did not affect LS risk in either group.@*CONCLUSIONS@#Engagement in sports associated with high cardiovascular intensity during university years may reduce the risk of LS in later life. Encouraging young people to participate in such activities might help reduce LS prevalence among older populations.

A Rare Case of VACTERL Association

Klippel-Feil syndrome (KFS) is a rare skeletal disorder primarily characterized by abnormal union or fusion of two or more cervicalvertebrae. It also includes multiple system anomalies. Herewith, we report a case of 22 years old male who presented withmultiple skeletal anomalies. On subsequent radiological investigations, patient was diagnosed to have Klippel-Feil syndromewith type IV club hand.

La Asociación Médica Argentina y el Rotary Club de Buenos Aires. La misión rotaria y su relación con la medicina / The Argentine Medical Association and the Rotary Club of Buenos Aires. The rotary mission and its relationship with medicine

Con motivo del centenario del Rotary Club de Buenos Aires (RCBA), se describe su relación con la también centenaria Asociación Médica Argentina (AMA), a través de personalidades que pertenecieron a ambas entidades. Reseñamos la misión rotaria y su relación con la medicina. (AU)

On the occasion of the centenary of the Rotary Club of Buenos Aires (RCBA), its relationship with the also centennial Argentine Medical Association (AMA) is described, through personalities that belonged to both entities. A review of the Rotary mission and its relationship with medicine is made. (AU)

Sociabilidade e lazer entre mulheres camponesas: vivências no clube de mães / Sociability and leisure among peasant women: experiences in the mothers club

O estudo realiza uma análise de uma organização denominada clube de mães. A partir de um estudo de caso, na comunidade São Caetano, município de São Lourenço do Oeste, em Santa Catarina/Brasil, nosso objetivo foi compreender o papel que o clube de mães ocupa nas práticas de sociabilidade e nas formas de organização de mulheres camponesas. O clube de mães transpõe as dicotomias dos espaços sociais, abrindo a possibilidade de ação das mulheres no espaço público, já que elas passam a frequentar outras comunidades, e deslocam-se a outros municípios, para os quais viajam coletivamente. Ao observar o significado do clube de mães, compreende-se o aumento do reconhecimento e da visibilidade das mulheres camponesas, além da constituição deafeto entre elas.

The study conducts an analysis of an organization called the Mothers Club from a case study in the São Caetano community, municipality of São Lourenço do Oeste, in Santa Catarina / Brazil, our The objective was to understand what role the mother club plays in sociability practices and forms of women's organization peasants. The mothers club bridges the space dichotomies opening up women's action in the space as they come to attend other communities, and they travel to other municipalities, to which they travel collectively. Observing the meaning of the mothers club means increasing the recognition and visibility of peasant women, as well as the constitution of affection between them.

Comparison of risk for HIV, syphilis and HCV infection between club drug users and traditional drug users in TaizhouCity / 上海预防医学

Objective To compare the risk for HIV, syphilis and HCV infection between club drug users and traditional drug users in Taizhou City of Zhejiang Province, in order to provide evidence for further behavioral intervention. Methods Drug users in Taizhou were surveyed with the questionnaires for national HIV sentinel surveillance during 2016-2019.Blood samples were collected for detection of HIV, syphilis and HCV antibodies. Results A total of 1 612 drug users were surveyed, in which club drug users accounted for 78.7% and traditional drug users 21.3%.Significant differences were observed in gender, age, educational level, ethnic background, and household registration between these two groups (P < 0.05).Among club drug users, injecting drug users accounted for 7.1%, lower than traditional drug users (P < 0.001).Among the injecting drug users, those who shared needles with others accounted for 8.9%, similar to the traditional drug users (P>0.05).In the past year, the proportion of having sex after drug abuse among club drug users was 77.9%, higher than traditional drug users (P=0.002).The proportion of condom use during sex were nearly 30.0% for both club drug users and traditional drug users.Of the club drug users, 0.2% were infected with HIV, which was not significantly different from that in traditional drug users (P>0.05).The prevalence of syphilis among club drug users was 12.6%, higher than traditional drug users (P < 0.05);whereas the HCV prevalence (10.4%) was lower among club drug users (P < 0.001). Conclusion The threats of blood-borne transmission and sexual transmission of diseases are common among club drug users, suggesting the need of targeted intervention measures.

Opportunities and Challenges of Blood Donation and Blood Therapy in Ethiopia

Blood is our body fluid that delivers essential substances (nutrients and oxygen) to the cells and exports metabolic waste products away from cells. Blood donation is a procedure in which a voluntary and healthy individual has his blood drawn for transfusion to the one who needs it. Securing safe blood components, based on voluntary, unpaid blood donation, are an important nationwide aim to prevent scarcity of blood. The donated blood has a huge role in surgery, injury, delivery of a baby and other bleeding cases. However, in a lot of low and middle-income countries like Ethiopia, blood provision is significantly inadequate. There is more reliance on family replacement and paid donors which are expected to have transfusion transmissible infections. This is because of many factors including lack of awareness and motivation, lack of knowledge, poor attitude, misconception, and so on. Without humane gifts of noble donors, that also from the heart, many lives might have lost for want of blood. Blood donation is the most generous and may be considered as the leading ever contribution to mankind. Hence, the young generation should be motivated to carry out this charitable activity. All the smiths and misconceptions should be removed in order that adequate extent of blood is made available at national and regional blood banks of Ethiopia for saving the life of patients. Thus, increasing knowledge, hastening the development of good attitude towards blood donation and establishing more donor clubs in the society particularly among students within high schools/preparatory schools and Universities of Ethiopia should be the target.

Prevalencia de mano zamba radial en Hospital Shriners-México y revisión de la literatura / Radial club hand prevalence at Shriners Hospital-Mexico and literature review

Resumen: Introducción: La mano zamba radial congénita se caracteriza por la desviación radial de la mano como resultado de hipoplasia o ausencia del radio. Material y métodos: Se realizó un estudio descriptivo, retrospectivo, transversal y observacional de los pacientes activos con diagnóstico de mano zamba radial. Resultados: Se estudiaron 71 pacientes y 92 extremidades, la prevalencia en nuestro hospital fue de 0.08%, 64.7% fueron hombres y 35.3% mujeres. Se observaron 22 pacientes con afectación de la extremidad torácica derecha, 28 de la izquierda y 21 pacientes bilateral. Se encontró que 93% de los pacientes presentaban un síndrome asociado. El tipo de displasia longitudinal radial más común fue la tipo I. Cincuenta y ocho extremidades no contaban con pulgar. El Estado de México es el más afectado y 91.6% contaban con un responsable tutelar con escolaridad máxima de preparatoria.

Abstract: Introduction: Radial club hand is characterized by radial deviation of the hand, as a result of hypoplasia or absence of the radius. Material and methods: A descriptive, retrospective, cross-sectional and observational study of active patients diagnosed with radial club hand at the Shriners-Mexico Hospital was carried out. Results: We studied 71 patients and 92 limbs, the prevalence was 0.08%, 64.7% were men and 35.3% women. We observed 22 patients with involvement of the right thoracic extremity, 28 left and 21 bilateral. It was found that 93% of the patients had an associated syndrome. The most common type of radial longitudinal dysplasia was type 1. 58 limbs did not have a thumb. The State of Mexico is the most affected and 91.6% had a guardian with maximum high school education.

Are scoring systems useful for predicting results of treatment for clubfoot using the ponseti method? / Os sistemas de pontuação são úteis para prever os resultados do tratamento de pé torto equinovaro pelo método de ponseti?

ABSTRACT Objective: The aim of this study was to verify whether the Pirani and Dimeglio clinical scoring systems could predict results of Ponseti therapy. Methods: Forty-seven patients with clubfoot deformities treated with the Ponseti method were enrolled in the study. Clinical evaluation with the Pirani and Dimeglio scoring systems was performed before the treatment and after the second cast fixation. The number of fixations, necessity for achillotomy, and recurrence of the deformity were determined as parameters of the therapy results. The patients were divided into three groups according to the severity of their deformities, and the groups were compared with one another. Results: Clubfoot correction required an average of 6.8 casts. Five patients developed a recurrence. Comparing the therapy outcomes among the groups, we found statistically significant differences in the Pirani classification after the second fixation (the number of casts [p =.003] and necessity to perform an achillotomy [p =.014]) and in the Dimeglio scores before therapy (number of casts [p =.034]) and after the second fixation (number of relapses [p =.032]). Conclusion: Although clinical scoring systems showed some dependence on the parameters of treatment outcomes, their predictive function can be used in only a limited way. Level of evidence II, Prospective comparative study.

RESUMO Objetivo: O objetivo deste estudo foi verificar se os sistemas de pontuação clínica de Pirani e Dimeglio poderiam servir para prever os resultados do tratamento com o método de Ponseti. Métodos: Quarenta e sete pacientes com diagnóstico de pé torto equinovaro tratados pelo método de Ponseti foram incluídos no estudo. A avaliação clínica com os sistemas de pontuação de Pirani e Dimeglio foi realizada antes do tratamento e depois da segunda fixação de gesso. O número de fixações com gesso, a necessidade de realização de aquilotomia e a recorrência da deformidade foram determinadas como parâmetros dos resultados do tratamento. Os pacientes foram divididos em três grupos, de acordo com a gravidade das deformidades, e esses grupos foram comparados entre si. Resultados: A correção do pé torto exigiu uma média de 6,8 gessos e cinco pacientes apresentaram recidiva. Ao comparar os resultados do tratamento entre os grupos, verificou-se diferença estatisticamente significante na classificação de Pirani após a segunda fixação (número de gessos [p = 0,003], necessidade de realizar aquilotomia [p = 0,014]) e pontuação de Dimeglio antes do tratamento (número de gessos [p = 0,034]) e depois da segunda fixação (número de recidivas [p = 0,032]). Conclusão: Embora os sistemas de pontuação clínica tenham mostrado alguma dependência dos parâmetros dos resultados do tratamento, sua função preditiva pode ser usada de maneira limitada. Nível de evidência II, Estudo comparativo prospectivo.

Strategies for coaches' development in a football club: a learning organization

Abstract Aim: The aim of this study was to identify the strategies adopted in a football club to support coaches' development. Methods: Eight coaches and four technical coordinators from a Brazilian elite club participated. After transcribing data from semi-structured interviews with coaches and technical coordinators, they were analyzed using the QSR Nvivo 9.2 software. Results: Three support schemes and their respective pillars of action were identified: a) Mentoring and meeting - Assistance among coaches, discussions with coaching staff, and free theme meetings; b) Incentive for continuing education; c) Club Pillars - Club goals, continuity of coaches, evaluation of coaches. Conclusion: Data allowed us to identify the important contributions of this Club in continued ongoing coach development. Moreover, we may characterize the Club as an authentic learning organization due to the promotion of a safe work environment that stimulates coaches' engagement in the Club's organizational culture and enables adequate communication and the constant update through courses and meetings.

Luto em Santa Maria: estudo da tragédia sob um olhar sistêmico / Mourning in Santa Maria: a study of the tragedy under a systemic vision

O resultado do trabalho de luto da perda de um filho depende muito de como a família está encarando essa perda e de qual o ciclo de vida pelo qual o sistema familiar está passando. A presente pesquisa aborda alguns aspectos teóricos importantes relacionados às observações feitas em dois dias de acompanhamento das atividades da Associação dos Familiares de Vítimas e Sobreviventes da Tragédia de Santa Maria (AVTSM), no município de Santa Maria, estado do Rio Grande do Sul, nos dias 11 e 12 de abril de 2017, bem como procede à análise de conteúdo de seis entrevistas realizadas com mães e pai de vítimas. O trabalho realizado pela AVTSM é de fundamental importância aos pais e às mães que participam, pois, além de proporcionar atividades psicossociais para os membros e fortalece o vínculo coletivo entre eles. Além disso, tais atividades têm caráter terapêutico e incentivam os envolvidos a melhorar e a resgatar a vontade de viver e de se adaptar à realidade cruel que é viver sem seus filhos.(AU)

The outcome from the elaboration of mourning of the loss of a son largely depends on how the family is facing this loss and what life cycle the family system is going through. The present research addresses some important theoretical aspects related to observations made in two days of monitoring from the activities of the Association of Families of Victims and Survivors of the Santa Maria's Tragedy (AVTSM), in the city of Santa Maria, in the Rio Grande do Sul State, on 11 and 12 of April in 2017. Together with the analysis of the content of six interviews made with parents of the victims. The work made by AVTSM is of fundamental importance to mothers and fathers that participate in it, because it not only proportionate psychosocial activities to the members, it also strengthens the collective bond between them. Moreover, these activities have a therapeutic character and encourages the involved to get better and recover the will to live and adapt to the cruel reality that is living without their children.(AU)

Bem-estar em equinos do Jockey Club do Paraná: indicadores clínicos, etológicos e ritmo circadiano do cortisol / Welfare in horses of the Jockey Club Paraná: clinic ethologic indicators and circadian rhythm of cortisol

Com o objetivo de estudar parâmetros indicativos de bem-estar, 30 equinos de corrida foram avaliados quanto ao temperamento, comportamento, parâmetros clínicos (condição geral, escoriações, escore corporal, cólicas no último ano, frequências cardíaca e respiratória) e níveis de cortisol plasmático (matutino, vespertino e ritmo circadiano). Todos os animais apresentaram boas condições físicas gerais, parâmetros clínicos normais para a espécie e não tiveram cólica no ano anterior ao estudo, demonstrando a preocupação dos tratadores com a saúde física dos animais. Contudo, 36,7% dos animais estudados apresentavam estereotipias. Apesar da alta incidência de indivíduos com ritmo circadiano do cortisol (RCC) alterado dentro do grupo de animais com comportamentos anormais (63,64%), não foi encontrada diferença estatística (P>0,05) quando comparado com a incidência do grupo de animais sem estereotipia (31,58%). Quatro animais com estereotipia portavam dispositivos para restringir a expressão de anomalias. Desses, todos apresentaram RCC alterado, permitindo demonstrar que equinos restringidos fisicamente de realizar sua estereotipia apresentam 18 vezes mais chances de ter alteração no RCC do que um animal de comportamento normal. Conclui-se que os equinos do Jockey Club do Paraná, apesar de apresentarem condições físicas satisfatórias comparados a estudos nacionais anteriores, possuíam alterações comportamentais e de função adrenocortical compatíveis com estresse crônico. Os achados também corroboram noções prévias de que a estereotipia é uma forma de tentar aliviar o estresse crônico em equinos, e que o uso de meios físicos para restringir sua manifestação aumenta a chance de distúrbios no metabolismo do cortisol.(AU)

The objective was to study indicative parameters of welfare in 30 race horses evaluated for temperament, behavior, clinical parameters (general condition, abrasions, body score, colic in the last year, heart and respiratory rates) and plasma cortisol levels (morning, afternoon and circadian rhythm). All animals presented good general physical condition, normal clinical parameters for the species and no colic episodes in the year preceding the study. However, 36.7% of animals had stereotypies. Despite the high incidence of altered circadian cortisol rhythmicity (CCR) within the group of animals with abnormal behavior (63.64%), there was no statistical difference (P>0.05) when compared with the incidence in the group animals without stereotyping (31.58%). Four animals with stereotypic behavior carried devices to restrict the expression of anomalies. All these four individuals had altered CCR, showing that restricting the stereotypic behavior of a horse increases 18 times the chances of altered CCR when compared to an individual with normal behavior. The horses of the Jockey Club of Paraná, despite having good physical condition compared to previous national studies, had behavioral and adrenocortical function consonant with chronic stress changes. The results also corroborate previous concepts of stereotyping as stress relieving in horses, and that the use of its physical restriction increases the chances of disturbances in cortisol metabolism.(AU)