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Background: Physiological changes in the foot may be influenced by external factors such as shoe types or demographic parameters, leading to podiatric conditions in adulthood. The aim of this study was to assess the changes in morphological measurements of the feet of boys and girls during childhood and adolescence. Methods: A total of 1678 Ecuadorian children aged 8 to 17 years participated in the study. The length, width, and height of the foot were analyzed using a 3D scanner to obtain the arch height ratio for the diagnosis of pediatric flat foot. Results: Statistical differences were observed for lengths, widths, and perimeters of the foot in boys aged 5 to 15–16 years and girls aged 5 to 12–13 years. Differences in the height of the navicular bone were found in all age groups, with changes from 2.8 to 4.1% in boys and from 1.3 to 1.5% in girls. The greatest differences between boys and girls of the same age were found at 14 years old onwards. The highest prevalence of flat foot was found in 8-year-old girls (64.9%) and in 12-year-old boys (82.5%). Conclusions: The feet of Ecuadorian children develop progressively during childhood and adolescence. Boys presented with longer and wider feet than girls of the same age. The highest prevalence of flat foot was found in 12-year-old boys and 8-year-old girls. [ABSTRACT FROM AUTHOR]

Las fístulas carótido-yugulares son lesiones vasculares poco frecuentes pero muy sintomáticas cuyo tratamiento oportuno evita la aparición de complicaciones regionales y sistémicas. La primera línea de manejo es la oclusión a través de técnicas endovasculares, siendo el balón desprendible la técnica más comúnmente empleada. Recientemente se describió una alternativa de tratamiento a través de embolización con coils por técnica asistida por balón, con resultados prometedores. Se presenta el caso de un paciente adolescente con un año de evolución de masa pulsátil de volumen creciente en región submandibular izquierda, asociada a thrill, soplo y voz ronca. Se realizó angiografía con sustracción digital que documentó presencia de una fístula arterio-venosa de alto flujo y gran tamaño entre la arteria carótida externa y la vena yugular interna. Se llevó a embolización con coils por medio de técnica asistida por balón, con oclusión exitosa de la fístula y resolución de la sintomatología presentada, sin eventos adversos asociados. Palabras clave: Fistula arteriovenosa, arteria carótida interna, vena yugular interna, embolización endovascular, embolización con coils. Carotid-jugular fistulas are infrequent but very symptomatic vascular lesions whose opportune treatment avoids the appearance of regional and systemic complications. The first line of management is occlusion through endovascular techniques, being detachable balloon the most commonly used technique. Recently, an alternative treatment through balloon-assisted coils embolization was described with promising results. We present the case of a teenage patient with one year of evolution of pulsatile mass of increasing volume in the left submandibular region, associated with thrill, murmur and hoarse voice. A digital substraction angiography was performed showing presence of a high-flow, large size arteriovenous fistula between the external carotid artery and the internal jugular vein. Balloon-assisted coils embolization was carried out with successful occlusion of the fistula and resolution of the presented symptoms, without associated adverse events. Key words: Arteriovenous fistula, internal carotid artery, internal jugular vein, endovascular embolization, coils embolization., Introducción Las fístulas arteriovenosas carótido-yugulares congénitas constituyen lesiones vasculares poco comunes (1,2,3,4). Manifestaciones clínicas comúnmente descritas en pacientes con esta condición incluyen tinitus, vértigo, cefalea y presencia de masa pulsátil [...]

Las fístulas arteriovenosas durales (FAVDs) son conexiones vasculares anómalas entre arterias durales y senos venosos o venas corticales encefálicas. Estos cortocircuitos pueden cursar con isquemia o hemorragia intracraneanas que derivan del aumento en el drenaje de los senos venosos o de la hipertensión venosa cortical, implícitos en su fisiopatología. La técnica 'Gold standard' para su diagnóstico es la angiografía cerebral por sustracción digital, sin embargo, existen diferentes técnicas de imagen que aportan información importante para su caracterización y clasificación. Dentro de estos sistemas de clasificación tenemos el sistema Borden-Shucart y la escala de Cognard, que son los más utilizados. Las estrategias terapéuticas para su manejo incluyen métodos endovasculares y/o quirúrgicos. En términos generales el manejo endovascular ha reemplazado al manejo quirúrgico en los últimos años, dado que se asocia a menor tasa de morbimortalidad (mortalidad < 9%) y menor tiempo de estancia hospitalaria. Las fístulas arteriovenosas durales tentoriales (FAVDTs) corresponden al 4 a 8% del total de FAVDs y son el subtipo con mayor riesgo de sangrado, que se presenta en 38 a 74% de los pacientes. En el presente artículo se describe el caso de un paciente adulto con una FAVDT entre la arteria de Bernasconi-Cassinari y la vena de Galeno asociada a hemorragia mesencefálica. El paciente fue llevado a manejo microquirúrgico guiado por angiografía intraoperatoria, obteniendo una oclusión completa del defecto fistuloso sin complicaciones y con adecuada evolución postoperatoria. Palabras clave: Tentorial, fístula arteriovenosa dural, endovascular, neurovascular, microcirugía. Dural arteriovenous fistulas (DAVFs) are anomalous vascular connections between dural arteries and venous sinuses or cerebral cortical veins. These shunts can present with intracranial ischemia or hemorrhage that result from increased venous drainage or cortical venous hypertension, implicit in its pathophysiology. The 'gold standard' technique for diagnosis is cerebral digital subtraction angiography, however, there are different imaging techniques that provide important information for its characterization and classification. The Borden-Shucart system and the Cognard scale are the best known classification systems. Therapeutic strategies for its management include endovascular and/or surgical methods. In general terms, in recent years endovascular management has replaced surgical management since it is associated with a lower rate of morbidity and mortality (mortality < 9%) and shorter hospital stay. Tentorial dural arteriovenous fistulas (TDAVFs) account for4 to 8% of all DAVFs and they are the subtype with the highest risk of bleeding, which occurs in 38 to 74% of patients. In the present article we describe the case of an adult patient with a TDAVF between the Bernasconi-Cassinari artery and the Galen vein associated with mesencephalic hemorrhage. The patient underwent microsurgical management guided by intraoperative angiography, obtaining complete occlusion of the fistulous defect with no complications and with an adequate postoperative evolution. Key words: Tentorial, dural arteriovenous fistula, endovascular, microsurgery., Introducción Las fistulas arteriovenosas durales (FAVDs) son conexiones vasculares anómalas entre arterias durales y senos venosos o venas corticales encefálicas. Representan aproximadamente un 10 a 15% de las malformaciones vasculares [...]

Learning Management Systems (LMS) have become the principal resource for the distribution of educational material and collaboration among lecturers and students in Higher Education. The potential of these platforms does not limit to a simple manager of contents, but they also offer a wide range of tools that support the development of different methodologies according to the learning modality, namely on-campus, blended or online. This work analyzes the use of LMS and the interactions with their different tools from the lecturers' point of view, in order to detect possible incidents, check the tools' utility and evaluate their complexity. All these metrics represent valuable information to the Degree Coordinators, if they are presented in a suitable manner, to detect and resolve deficiencies in the methodology. For the analysis of the teaching activity two methods are employed: (1) surveys, to measure the subjective perception of lecturers when using LMS tools; and (2) visual analysis of the real lecturer's activity through OnlineData, a graphical analytic tool developed as part of our work to monitor LMS tools metrics. The results of both methods show differences among the perceived self-usage and actual usage, especially for the e-learning methodologies