INTRODUÇÃO: A distonia é caracterizada por contrações musculares sustentadas, frequentemente gerando movimentos de torção, repetitivos ou posturas anormais. A classificação de distonia é baseada em três eixos: idade de início, distribuição e etiologia. A definição criada pelo Comitê da Fundação de Pesquisa Médica em Distonia, em 1984, ainda está em uso atualmente. Questionamentos têm sido feitos para uma nova proposta de classificação de distonia. MATERIAIS E MÉTODOS: Trata-se de um estudo transversal descritivo de uma série de pacientes com diagnóstico de distonia primária e distonia-plus acompanhados em uma clínica brasileira especializada em distúrbios do movimento, no período de março de 2015 até fevereiro de 2016. Foi realizada a coleta de dados demográficos, clínicos e da gravidade da distonia. Os pacientes foram reavaliados e reclassificados segundo a nova proposta de classificação para as distonias. Utilizamos métodos descritivos para apresentarmos as características da amostra, o teste de Shapiro-Wilk para distribuição normal, o teste de Kruskal-Wallis para comparar grupos independentes e variáveis sem distribuição normal e o teste do X2 para comparar variáveis nominais. RESULTADOS: Dos 289 pacientes, foram 235 pacientes avaliados segundo a distribuição corporal, sendo blefaroespasmo 60 pacientes (26%), distonia cervical 51 pacientes (22%), distonia de membro 28 pacientes (12%), distonia laríngea 10 pacientes (4%), distonia oromandibular 3 pacientes (1%), distonia segmentar 46 pacientes (20%), distonia multifocal 23 pacientes (9%) e distonia generalizada 14 pacientes (6%). Foram 227/235 (97%) pacientes com distonia primária e 8 (3%) pacientes com distonia-plus. Houve maior prevalência no sexo feminino com 144 pacientes. Os pacientes com distonia generalizada, multifocal, distonia dopa-responsiva e distonia-parkinsonismo tiveram a idade de início da distonia inferior a todos os demais grupos (p=0,0001). Os pacientes com distonia do membro superior e distonia tarefa-específica tiveram a idade de início da distonia inferior às outras distonias focais e distonias segmentares (p=0,0001). Os pacientes com distonia tarefa-específica e distonia focal do membro superior têm escolaridade superior aos demais grupos (p=0,0001). Em média, foram 5±7,8 anos para o diagnóstico definitivo de distonia e 2±1,5 médicos até que o diagnóstico de distonia fosse confirmado. O truque sensorial foi mais frequente na distonia cervical 30/51 (59%) pacientes. Segundo a nova classificação, encontramos apenas mudança de resultados na distonia multifocal com 21/235 (9%) pacientes e na distonia generalizada com 16/235 (6%) pacientes. Foram 164/235 (70%) pacientes na faixa etária maior que 40 anos. Todos os pacientes tiveram curso da doença com padrão estático e a maioria com variabilidade persistente em 186/235 (79%) pacientes. Foram 227/235 (97%) pacientes com distonia isolada. Nenhum paciente apresentou lesão adquirida ou degenerativa. Foram 211/235 (90%) pacientes que apresentaram diagnóstico etiológico idiopático esporádico. CONCLUSÃO: A nova classificação de distonia não apresentou novos benefícios na prática clínica diária, comparada com classificações anteriores. O benefício maior foi uma reorganização e formação de novas definições e critérios para atividade de pesquisas científicas e identificação de casos mais raros. / INTRODUCTION: Dystonia is characterized by sustained muscle contractions, frequently causing twisting movements, repetitive or abnormal postures. Dystonia rating is based on three axes: age of onset, distribution and etiology. The definition established by the Committee of the Medical Research Foundation in dystonia in 1984, is still in use today. Claims have been made for a new proposal for dystonia rating. MATERIALS AND METHODS: This is a descriptive cross-sectional study of a number of patients with primary dystonia and dystonia-plus assisted in a Brazilian clinic specializing in movement disorders, from March 2015 to February 2016 data collection was performed demographic, clinical and severity of dystonia. The patients were re-evaluated and reclassified according to the new proposed classification for dystonia. We used descriptive methods to present the characteristics of the sample, the Shapiro-Wilk test for normal distribution, the Kruskal-Wallis test to compare independent groups and variables without normal distribution and the X2 test to compare nominal variables. RESULTS: Of the 289 patients, there were 235 patients evaluated according to body distribution, with blepharospasm 60 patients (26%), cervical dystonia 51 patients (22%), a member of dystonia 28 patients (12%), laryngeal dystonia 10 patients (4%), oromandibular dystonia 3 patients (1%), segmental dystonia 46 patients (20%), dystonia multifocal 23 patients (9%) and generalized dystonia 14 patients (6%). Were 227/235 (97%) patients with primary dystonia and 8 (3%) patients with dystonia-plus. There was a higher prevalence in females with 144 patients. Patients with generalized dystonia, multifocal, dopa-responsive dystonia and dystonia-parkinsonism had the age of onset of dystonia lower than all other groups (p = 0.0001). Patients with dystonia of the upper limb and task-specific dystonia had the early age of less dystonia other focal dystonias and segmental dystonia (p=0.0001). Patients with task-specific dystonia and focal upper limb dystonia have higher education to other groups (p=0.0001). On average, there were 5 ± 7.8 years for the definitive diagnosis of dystonia and 2 ± 1.5 doctors until the diagnosis of dystonia were confirmed. The sensory trick was more frequent in cervical dystonia 30/51 (59%) patients. According to the new classification, we found only change results in multifocal dystonia with 21/235 (9%) patients and generalized dystonia with 16/235 (6%) patients. Were 164/235 (70%) patients aged greater than 40 years. All patients had disease course with static standard and most with persistent variability in 186/235 (79%) patients. Were 227/235 (97%) patients with dystonia isolated. No patient had acquired or degenerative injury. Were 211/235 (90%) patients with sporadic idiopathic etiologic diagnosis. CONCLUSION: The new dystonia rating showed no new benefits in clinical practice compared with previous ratings. The greatest benefit was a reorganization and training of new definitions and criteria for scientific research activity and identification of rare cases.

INTRODUÇÃO: A distonia é caracterizada por contrações musculares sustentadas, frequentemente gerando movimentos de torção, repetitivos ou posturas anormais. A classificação de distonia é baseada em três eixos: idade de início, distribuição e etiologia. A definição criada pelo Comitê da Fundação de Pesquisa Médica em Distonia, em 1984, ainda está em uso atualmente. Questionamentos têm sido feitos para uma nova proposta de classificação de distonia. MATERIAIS E MÉTODOS: Trata-se de um estudo transversal descritivo de uma série de pacientes com diagnóstico de distonia primária e distonia-plus acompanhados em uma clínica brasileira especializada em distúrbios do movimento, no período de março de 2015 até fevereiro de 2016. Foi realizada a coleta de dados demográficos, clínicos e da gravidade da distonia. Os pacientes foram reavaliados e reclassificados segundo a nova proposta de classificação para as distonias. Utilizamos métodos descritivos para apresentarmos as características da amostra, o teste de Shapiro-Wilk para distribuição normal, o teste de Kruskal-Wallis para comparar grupos independentes e variáveis sem distribuição normal e o teste do X2 para comparar variáveis nominais. RESULTADOS: Dos 289 pacientes, foram 235 pacientes avaliados segundo a distribuição corporal, sendo blefaroespasmo 60 pacientes (26%), distonia cervical 51 pacientes (22%), distonia de membro 28 pacientes (12%), distonia laríngea 10 pacientes (4%), distonia oromandibular 3 pacientes (1%), distonia segmentar 46 pacientes (20%), distonia multifocal 23 pacientes (9%) e distonia generalizada 14 pacientes (6%). Foram 227/235 (97%) pacientes com distonia primária e 8 (3%) pacientes com distonia-plus. Houve maior prevalência no sexo feminino com 144 pacientes. Os pacientes com distonia generalizada, multifocal, distonia dopa-responsiva e distonia-parkinsonismo tiveram a idade de início da distonia inferior a todos os demais grupos (p=0,0001). Os pacientes com distonia do membro superior e distonia tarefa-específica tiveram a idade de início da distonia inferior às outras distonias focais e distonias segmentares (p=0,0001). Os pacientes com distonia tarefa-específica e distonia focal do membro superior têm escolaridade superior aos demais grupos (p=0,0001). Em média, foram 5±7,8 anos para o diagnóstico definitivo de distonia e 2±1,5 médicos até que o diagnóstico de distonia fosse confirmado. O truque sensorial foi mais frequente na distonia cervical 30/51 (59%) pacientes. Segundo a nova classificação, encontramos apenas mudança de resultados na distonia multifocal com 21/235 (9%) pacientes e na distonia generalizada com 16/235 (6%) pacientes. Foram 164/235 (70%) pacientes na faixa etária maior que 40 anos. Todos os pacientes tiveram curso da doença com padrão estático e a maioria com variabilidade persistente em 186/235 (79%) pacientes. Foram 227/235 (97%) pacientes com distonia isolada. Nenhum paciente apresentou lesão adquirida ou degenerativa. Foram 211/235 (90%) pacientes que apresentaram diagnóstico etiológico idiopático esporádico. CONCLUSÃO: A nova classificação de distonia não apresentou novos benefícios na prática clínica diária, comparada com classificações anteriores. O benefício maior foi uma reorganização e formação de novas definições e critérios para atividade de pesquisas científicas e identificação de casos mais raros. / INTRODUCTION: Dystonia is characterized by sustained muscle contractions, frequently causing twisting movements, repetitive or abnormal postures. Dystonia rating is based on three axes: age of onset, distribution and etiology. The definition established by the Committee of the Medical Research Foundation in dystonia in 1984, is still in use today. Claims have been made for a new proposal for dystonia rating. MATERIALS AND METHODS: This is a descriptive cross-sectional study of a number of patients with primary dystonia and dystonia-plus assisted in a Brazilian clinic specializing in movement disorders, from March 2015 to February 2016 data collection was performed demographic, clinical and severity of dystonia. The patients were re-evaluated and reclassified according to the new proposed classification for dystonia. We used descriptive methods to present the characteristics of the sample, the Shapiro-Wilk test for normal distribution, the Kruskal-Wallis test to compare independent groups and variables without normal distribution and the X2 test to compare nominal variables. RESULTS: Of the 289 patients, there were 235 patients evaluated according to body distribution, with blepharospasm 60 patients (26%), cervical dystonia 51 patients (22%), a member of dystonia 28 patients (12%), laryngeal dystonia 10 patients (4%), oromandibular dystonia 3 patients (1%), segmental dystonia 46 patients (20%), dystonia multifocal 23 patients (9%) and generalized dystonia 14 patients (6%). Were 227/235 (97%) patients with primary dystonia and 8 (3%) patients with dystonia-plus. There was a higher prevalence in females with 144 patients. Patients with generalized dystonia, multifocal, dopa-responsive dystonia and dystonia-parkinsonism had the age of onset of dystonia lower than all other groups (p = 0.0001). Patients with dystonia of the upper limb and task-specific dystonia had the early age of less dystonia other focal dystonias and segmental dystonia (p=0.0001). Patients with task-specific dystonia and focal upper limb dystonia have higher education to other groups (p=0.0001). On average, there were 5 ± 7.8 years for the definitive diagnosis of dystonia and 2 ± 1.5 doctors until the diagnosis of dystonia were confirmed. The sensory trick was more frequent in cervical dystonia 30/51 (59%) patients. According to the new classification, we found only change results in multifocal dystonia with 21/235 (9%) patients and generalized dystonia with 16/235 (6%) patients. Were 164/235 (70%) patients aged greater than 40 years. All patients had disease course with static standard and most with persistent variability in 186/235 (79%) patients. Were 227/235 (97%) patients with dystonia isolated. No patient had acquired or degenerative injury. Were 211/235 (90%) patients with sporadic idiopathic etiologic diagnosis. CONCLUSION: The new dystonia rating showed no new benefits in clinical practice compared with previous ratings. The greatest benefit was a reorganization and training of new definitions and criteria for scientific research activity and identification of rare cases.

BACKGROUND: Patient navigators have been shown to reduce cancer disparities among racial/ethnic minorities by improving timely diagnosis and treatment of cancer. We sought to determine if race/ethnicity and language concordance of patients and their navigator improved time to diagnostic resolution of breast and cervical cancer screening abnormalities. METHODS: Demographic data on patients and navigators from the Boston Patient Navigation Research Program were used to assess concordance by race, ethnicity, and language. Kaplan-Meier survival curves and Cox proportional hazards regression models examined the association of race/ethnicity and language concordance on time to definitive diagnosis of cancer screening abnormalities. All analyses were performed separately for breast and cervical groups. RESULTS: There were 1257 patients and 23 navigators in this study. In the breast group (n=655), 44% of patient-navigator pairs were concordant by race/ethnicity and 75% were language concordant. In the cervical group (n=602), 70% of patient-navigator pairs were race/ethnicity concordant and 87% were language concordant. There was no association with race/ethnicity concordance and time to diagnostic resolution for the breast group, aHR 1.19 (95% CI: 0.97, 1.46) or cervical group, aHR 1.23 (95% CI: 0.99, 1.53). However, in the stratified analysis, race/ethnicity concordance was associated with timelier resolution for minority women with breast and cervical cancer screening abnormalities but not for Whites. For cervical cancer screening abnormalities resolving in less than 90 days, language concordance was also associated with timelier resolution, aHR of 1.46 (95% CI: 1.18, 1.80) but there was no association in the breast group. In the subgroup analysis of Spanish concordance there was also an association of timelier resolution for those with cervical cancer screening abnormalities resolving in less than 90 days. CONCLUSION: Patient-navigator race/ethnicity concordance is associated with timelier diagnostic resolution of breast and cervical cancer screening abnormalities among minority women. Language concordance is also associated with timelier resolution in participants with cervical cancer screening abnormalities despite the availability and use of interpreters. Given poorer cancer outcomes among minority women, the use of patient navigators that are diverse by race/ethnicity and multilingual may help address barriers to care and improve health outcomes among low-income minorities.

At the beginning of the work there are described the most important anatomical structures in the observed locations of the both compared types of fractures The second part is divided in more chapters and it the traumatological introduction for the diaphyseal and angle fractures issue. This part is beginning with the basic partition to the further specialization on diagnostics, classification, therapy and healing focused on the tibial and ankle part. The single demographic data for the both types of fractures is described in the third part. In the last chapter there is the comprehension of the most important data of diaphyseal tibial and ankle fracture.

Fractures of proximal humerus and humeral shaft are two clinical problems that have many differences and different treatment. The aim was to compare these differences in a retrospective epidemiological study. At the beginning is an overview of anatomy, classification and treatment of humerus fractures. The point of the study was the evidence of patients, who were treated in Orthopedic - traumatological clinic of FNKV. In years 2000-2008 there were 1891 patients treated for proximal humerus fracture and 223 patients treated for humeral shaft fracture. The result of the work is an overview of incidence, sex and average age of the monitored patients, Neer's and AO classification overview and comparison of surgical and conservative treatment and the progression in time.

No

This paper addresses the under representation of Black and minority ethnic (BME) sex offenders in the sex offender treatment programme (SOTP) of the prisons of England and Wales. The proportional over representation of BME men in the male sex offender population of the prisons of England and Wales has been noted for at least ten years. Similarly the under representation of BME sex offenders in prison treatment programmes has been a cause for concern during the last decade. This paper presents current demographic data relating to male BME sex offenders in the prisons of England and Wales. The paper draws together a wide range of social and cultural theories to develop a tripartite model for understanding the dynamics underlying the non-participation of BME

O objetivo deste estudo foi o de investigar a relação de casos notificados de leucemias na faixa etária de 0 a 19 anos e proximidade de residência com linhas de energia elétrica na cidade de São Paulo, entre os anos de 1997 e 2004. Para este propósito, foram geocodificados os casos notificados de leucemias em crianças e adolescentes com idade entre 0 e 19 anos, registrados na cidade de São Paulo por meio de banco de dados fornecido pelo Registro de Câncer de Base Populacional (RCBP-SP); os casos da doença na faixa etária especificada foram georreferenciados em relação às linhas de energia elétrica, aos distritos administrativos da cidade e aos setores censitários. Assim pode-se calcular a incidência dos casos georreferenciados para o município de São Paulo utilizando como base os dados demográficos do censo de 2000, publicados pelo Instituto Brasileiro de Geografia e Estatística (IBGE) e calcular a incidência dos casos georreferenciados de acordo com o local de residência e a distância das linhas de energia elétrica, construindo mapas temáticos a partir de instrumentos disponíveis nos Sistemas de Informação Geográfica (SIG) da cidade. Desta forma foi demonstrado que os casos georreferenciados de leucemia em crianças e adolescentes com idade entre 0 e 19 anos, registrados no RCBP-SP, no período de 1997 a 2004, têm uma distribuição homogênea, quando observados em relação ao município como um todo, porém ao especificar-se a distribuição pelas distâncias das residências em relação às linhas de energia elétrica, denota-se que a incidência revela-se maior à distância de 200 metros (22,46/100.000 hab.), do que às distâncias de 400 (14,97/100.000 hab.), 600 (16,08/100.000 hab.), 800 (21,17/100.000 hab.) e 1000 metros (20,07/100.000 hab.) e que esta incidência também é maior quando comparada com a incidência geral do município (19,34/100.000 hab.). / The aim of this study was to investigate the relationship of reported cases of leukemia at the age from 0 to 19 years old and their residence proximity to power lines in the city of Sao Paulo, between the years 1997 and 2004. For this purpose, the leukemia childhood cases notified by Cancer Register Population Base of Sao Paulo city were geocoded and georreferenced in relation to the electric power lines, administrative districts and census sector of the city. Thus, we could calculate the incidence that cases utilizing the demographic bases from 2000 Brazilian census and the incidence according to the distances of electric power lines, producing the thematic layer maps from Geographical Information Systems - GIS. Our results demonstrated that childhood leukemia cases, notified by RCBP-SP from 1997 to 2004 in Sao Paulo city, have homogeneous distribution when observed all the territory, however, the highest value of incidence occurred in a 200 meters of distance the electric power lines (22,46/100.000 inhab.), when compared with 400 (14,97/100.000 inhab.), 600 (16,08/100.000 inhab.), 800 (21,17/100.000 inhab.) and 1000 meters (20,07/100.000 inhab.), and it is also biggest when compared with entire territory (19,34/100.000 inhab.).

This degree work dealt with the relation between the occurrence of TBC and the unemployment rate in the Czech Republic between 2000-2007. The work researched whether an increase or decrease in the unemployment rate in the Czech Republic influenced changes in the occurrence of TBC. The work was based on an analysis of data from the Authority of Medical Informatics and Statistics regarding the occurrence of TBC and analysis of the number of unemployed people as stated by the Czech Statistics Bureau. The hypothesis {--} with an increasing number of unemployed people the number of people suffering from TBC is increasing in the Czech Republic {--} was confirmed. Results of the research showed that it is necessary to deal with this issue regularly and intensely and that none of us may remain indifferent towards unemployed people (regardless of the fact whether they suffer from TBC or not) because each of use can suddenly become unemployed. Work has ranked among natural human activities for about ten thousand years. It is the most reliable and longest social support in people{\crq}s lives and its loss usually results in a serious disruption of mental and physical health.

O objetivo deste estudo foi o de investigar a relação de casos notificados de leucemias na faixa etária de 0 a 19 anos e proximidade de residência com linhas de energia elétrica na cidade de São Paulo, entre os anos de 1997 e 2004. Para este propósito, foram geocodificados os casos notificados de leucemias em crianças e adolescentes com idade entre 0 e 19 anos, registrados na cidade de São Paulo por meio de banco de dados fornecido pelo Registro de Câncer de Base Populacional (RCBP-SP); os casos da doença na faixa etária especificada foram georreferenciados em relação às linhas de energia elétrica, aos distritos administrativos da cidade e aos setores censitários. Assim pode-se calcular a incidência dos casos georreferenciados para o município de São Paulo utilizando como base os dados demográficos do censo de 2000, publicados pelo Instituto Brasileiro de Geografia e Estatística (IBGE) e calcular a incidência dos casos georreferenciados de acordo com o local de residência e a distância das linhas de energia elétrica, construindo mapas temáticos a partir de instrumentos disponíveis nos Sistemas de Informação Geográfica (SIG) da cidade. Desta forma foi demonstrado que os casos georreferenciados de leucemia em crianças e adolescentes com idade entre 0 e 19 anos, registrados no RCBP-SP, no período de 1997 a 2004, têm uma distribuição homogênea, quando observados em relação ao município como um todo, porém ao especificar-se a distribuição pelas distâncias das residências em relação às linhas de energia elétrica, denota-se que a incidência revela-se maior à distância de 200 metros (22,46/100.000 hab.), do que às distâncias de 400 (14,97/100.000 hab.), 600 (16,08/100.000 hab.), 800 (21,17/100.000 hab.) e 1000 metros (20,07/100.000 hab.) e que esta incidência também é maior quando comparada com a incidência geral do município (19,34/100.000 hab.). / The aim of this study was to investigate the relationship of reported cases of leukemia at the age from 0 to 19 years old and their residence proximity to power lines in the city of Sao Paulo, between the years 1997 and 2004. For this purpose, the leukemia childhood cases notified by Cancer Register Population Base of Sao Paulo city were geocoded and georreferenced in relation to the electric power lines, administrative districts and census sector of the city. Thus, we could calculate the incidence that cases utilizing the demographic bases from 2000 Brazilian census and the incidence according to the distances of electric power lines, producing the thematic layer maps from Geographical Information Systems - GIS. Our results demonstrated that childhood leukemia cases, notified by RCBP-SP from 1997 to 2004 in Sao Paulo city, have homogeneous distribution when observed all the territory, however, the highest value of incidence occurred in a 200 meters of distance the electric power lines (22,46/100.000 inhab.), when compared with 400 (14,97/100.000 inhab.), 600 (16,08/100.000 inhab.), 800 (21,17/100.000 inhab.) and 1000 meters (20,07/100.000 inhab.), and it is also biggest when compared with entire territory (19,34/100.000 inhab.).