Is It Back Pain or Pott's Disease?

Tuberculosis is a public health problem in Portugal. It can have extrapulmonary manifestations, with the spine being the most frequent and significant location affected within the bone area. We present the case of a 65-year-old man with left lumbar sciatic pain, 11% body weight loss, and anorexia. Later, he developed left crural hemiparesis and hypoesthesia, failing to respond to analgesia. A computerized tomography scan of the lumbar spine showed L5-S1 spondylodiscitis. The patient was admitted for study and started empirical antibiotic therapy. Due to lack of clinical and analytical response and inconclusive bone biopsy, surgical decompression of the lumbar abscess was performed, with isolation of multi-sensitive Mycobacterium tuberculosis. He took anti-tuberculostatic drugs for a year and did physiotherapy, fully recovering from neurological deficits due to his illness. On account of tuberculosis's prolonged and non-specific clinical presentation, a high index of clinical suspicion is needed for a well-timed diagnosis and treatment to prevent serious complications.

A Novel Approach to Training Monotony and Acute-Chronic Workload Index: A Comparative Study in Soccer.

Load is a multifactorial construct, but usually reduced to parameters of volume and intensity. In the last decades, other constructs have been proposed for assessing load, but also relying on relationships between volume and intensity. For example, Foster's Training Monotony has been used in athletes' load management simply by computing mean weekly load divided by its standard deviation, often multiplied by session rate of perceived exertion. Meanwhile, the Acute to Chronic Workload Ratio (ACWR) has been debated by the sport scientists as a useful monitoring metric and related to so-called injury prevention. None of these models includes parameters that are representative of training specificity, namely load orientation. The aim of this study is to present broader conceptual approaches translated by new indices for assessing Intraweek Training Monotony (ITM) and Acute to Chronic Workload Index (ACWI) while incorporating load orientation, session duration and weekly density (frequency normalized) in addition to parameters related to proxies of external and/or internal load. Our ITM and Foster's Training Monotony were similar in terms of average values, but very different for individualized analysis, illustrating how average values may be deceiving. While Foster's model provided clusters of values, ITM provided more scattered, individualized data. ACWI and ACWR provided very distinct qualitative information, and the two models were uncorrelated. Therefore, the models incorporating training load orientation presented in this study provide distinct and not redundant information when compared to previous models. More importantly, ITM and ACWI are metrics that are compatible to each other and might fit to coaches' monitoring targets in the short and medium terms, respectively. Because our models include several parameters, including load orientation, we contend that might provide a more complete monitoring tool. However, we suggest they are used for intraindividual comparisons and not so strongly for interindividual comparisons.

Doença renal infantil: qualidade de vida / Childhood kidney disease: quality of life

Introdução: A crescente incidência de doenças crónicas, nomeadamente a patologia renal, dificulta o desfrutar de uma vida normal, dadas as modificações ocorridas no quotidiano. Objetivos: Caracterizar a qualidade de vida percebida pelas crianças com patologia renal que frequentam campos de férias e analisar a relação entre as variáveis sociodemográficas e clínicas. Metodologia: Estudo Ibérico descritivo-correlacional e transversal, misto: quantitativo e qualitativo. A amostra é composta por 29 crianças espanholas e 13 portuguesas, com patologia renal crónica, que frequentaram campos de férias com idades entre 7 e 17 anos. Utilizou-se a escala KINDL (Bullinger & Ravens-Sieberer, 1998a, 1998b), que contempla 7 dimensões: Bem-estar Físico, Bem-Estar Emocional, Autoestima, Família, Amigos, Escola e Situação Clínica. Agregaram-se 6 questões sociodemográficas e um bloco de notas. Resultados: Os participantes revelaram uma perceção positiva da qualidade de vida. A dimensão "Autoestima" foi a melhor percecionada e o "Bem-estar Emocional" a pior. As crianças de nacionalidade espanhola percecionaram melhor qualidade de vida. Relativamente às restantes variáveis, as diferenças não foram estatisticamente significativas. Pela análise de conteúdo efetuada aos testemunhos, emergiram sentimentos positivos, o que nos permite inferir que o campo de férias foi uma atividade que contribuiu para a socialização e melhoria da qualidade de vida das crianças. Conclusão: Estes dados revelam que seria benéfico um acompanhamento individualizado, mais direcionado às necessidades específicas de cada criança, por uma equipa multidisciplinar. Os campos de férias enquanto formativos e lúdicos são essenciais.

Introduction: The increasing incidence of chronic diseases such as kidney disease, makes it difficult to appreciate a normal life due to the changes in lifestyle. Objectives: To characterize the quality of life perceived by children with kidney disease who attend summer camps as well as to analyze the relationship between the sociodemographic and clinical variables. Methodology: Iberian descriptive, correlational and cross-sectional study, mixed nature: quantitative and qualitative. The sample is composed of 29 Spanish children and 13 Portuguese with chronic kidney disease who are on summer camps with aged between 7 and 17 years. We used the KINDL scale (Bullinger & Ravens-Sieberer, 1998a, 1998b), which includes 7 dimensions: Wellness Physical, Emotional Wellness, Self-Esteem, Family, Friends, School and Location Clinic. They added up 6 questions of sociodemographic and a notepad. Results: The patients showed a positive perception of quality of life. "Self-esteem" dimension was the best perceived and "Emotional Well-being" the worst. Children with Spanish nationality percceived better quality of life. For the remaining variables, the differences were not statistically significant. The content analysis to the testimonies, emerged positive feelings, which allows us to infer that the summer camp was an activity that contributed to the socialization and improving the quality of life of children. Conclusion: These data show that an individual monitoring would be beneficial, targeted to the specific needs of each child, by a multidisciplinary team. The holiday camps as formative and ludic are essential.