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Purpose: Aims of this study are to evaluate the current terminology and assess the influence of the latest proposals on the terminology used for Achilles tendon-related disorders in both daily practice and literature. Methods: (1) All orthopedic surgeons experienced in the field of foot and ankle surgery of the Ankleplatform Study Group were invited to participate in this survey by email. They were requested to fill out a survey on terminology in six typical cases with Achilles tendon-related disorders. (2) A systematic literature search of Achilles tendon-related disorders was performed in eight foot and ankle journals in Medline, Embase (Classic) from 2000 to 2016. All extracted terms were counted and compared to the terminology proposals, based on anatomic location, symptoms, clinical findings and histopathology. Results: (1) In total, 141 of the 283 (50%) orthopedic surgeons responded to the survey. In five out of six cases with Achilles tendon-related disorders, the majority gave an answer according to latest proposals. (2) An overview of terminology used for Achilles tendon-related disorders from 2000 to 2016 shows an increase in use of terminology according to the latest proposals based on anatomic location, symptoms, clinical findings and histopathology. Conclusion: The revised terminology for Achilles tendon-related disorders based on anatomic location, symptoms, clinical findings and histopathology is used by the majority of orthopedic surgeons and is increasingly used in the literature. However, the indistinct Haglund eponyms are still frequently used in Achilles tendon-related terminology. Level of evidence: Level IV. [ABSTRACT FROM AUTHOR]

La presente investigación tiene el objetivo de Aplicar las herramientas web para establecer la difusión de las potencialidades turísticas en la comunidad El Churo con el propósito de materializar la difusión turística para incentivar la promoción a través de acciones online y offline. La metodología usada en esta investigación es bajo el paradigma positivista con el enfoque cuantitativo con el uso del método inductivo y es una investigación de tipo descriptiva, que se apoya en la observación. Este procedimiento dado que facilita el uso de técnicas como la encuesta y entrevista. La población de estudio corresponde a la Asociación de Producción Pesquera Artesanal El Churo (ASOPROPECHU) con 64 socios, los cuales son participes en el proyecto de investigación Turismo Natural y Cultural en el Cantón Pedernales de la ULEAM-Ext. Pedernales, por lo que se implementó el muestreo no Probabilístico, de tipo ocasional u opinático, siendo realizada a 30 socios. Como resultado la comunidad presenta potencial turístico como consecuencia de los recursos físico-natural, como lo es la posición estratégica y su cercanía al mar, lo que lo beneficia por el estuario del río Cojimíes, donde se desarrolla la pesca y se puede transformar hacia la pesca deportiva, la observación de aves, el recorrido por el manglar, así como, desde las actividades terrestres, el ciclo paseo, la ejecución de juegos tradicionales y otras actividades para sostener la cultura. En conclusión, El Churo se presenta como una oportunidad de ampliar la oferta en el Cantón por sus recursos turísticos.

Seagrass meadows are prominent in many coastal zones worldwide and significant contributors to global primary production. The large bottom roughness (or canopy) created by seagrass meadows substantially alters near-bed hydrodynamics and sediment transport. In this study, we investigate how a seagrass meadow in a low-energy environment (forced by local winds) modifies near-bed mean and wave-driven flows and assess how this relates to suspended sediment concentration (SSC). A two-week field study was conducted at Garden Island in southwestern Australia, a shallow and sheltered coastal region subjected to large diurnal sea-breeze cycles, typical of many low-energy environments where seagrasses are found. The mean and turbulent flow structure, along with optical estimates of SSC, were measured within both a seagrass canopy and over an adjacent bare bed. Near-bed mean current velocities within the seagrass canopy were on average 35% of the velocity above the canopy. Oscillatory wave velocities were less attenuated than mean current velocities, with near-bed values on average being 83% of those above the canopy. Mean and maximum shear velocities inferred from currents and waves above the canopy frequently exceeded the threshold for sediment resuspension, but no significant variation was observed in the SSC. However, a significant correlation was observed between SSC and bed shear stress estimated using near-bed velocities inside the canopy. When sediment was resuspended, there were substantial differences between the SSCs within and above the canopy layer, with higher levels confined within the canopy. This study demonstrates the importance of measuring near-bed hydrodynamic processes directly within seagrass canopies for predicting the role seagrass meadows play in regulating local rates of sediment resuspension.

Introduction: Some parameters used to diagnose sarcopenia and functional autonomy disorders can lead to interpretation and classification errors. Objective: To analyze sarcopenia markers and their relationship with the strength and gait of physically active older women aged between 55 and 76 years. Materials and Methods: Analytical observational study conducted in 178 physically active Colombian women who were distributed in two age groups (group 1: 55-66 years, n=98, and group 2: 67-76 years, n=80). A multiple linear regression model was used to establish possible correlations between strength and gait indicators (dependent variables) and body composition (independent variables). Results: Fat mass and appendicular mass (appendicular lean/height2(kg/m2)) explained power variance in the lower limbs in group 1 (G1) (SJ: p=0.001, R2=0.56; CMJ: p=0.001, R2=0.51; CMJAS: R2=0.60, p=0.001). Similar results were observed in group 2 (G2) (SJ: R2=0.32, DW1=2.14; CMJ: R2=0.51, DW2=2.38; CMJAS: R2=0.41, DW3=2.56). Furthermore, fat mass explained variance in gait pattern in G1 and G2 differently (G1: p=-0.006; R2=20%; G2: p=-0.001; R2=29%). Conclusion: Recording fat and appendicular mass allow studying negative changes in lower limb strength and their effect on gait pattern, as well as identifying the type of sarcopenia and functional autonomy disorders in physically active Colombian women aged 55 to 76 years.

Tem-se por objetivo, com o presente artigo, apontar uma visão crítica sobre a desumanização na educação, a partir de Rogers e Morin, considerando o panorama atual no ensino. Utilizou-se da metodologia bibliográfica e exploratória. Uma vez detectada uma situação de fragilidade e necessidade de revisão da conjuntura atual no campo educacional, apresentou-se a visão de cada autor, com um acento especial para o resgate do humano e a valorização da pessoa do aluno, enquanto protagonista do processo de educação. A postura do ‘aprender a aprender’ torna-se fundamental nesta discussão e funciona aqui como uma dobradiça, pois encontra-se presente tanto à reflexão de Morin (2011, 2014) como de Rogers (1973, 1987), o que vai justamente colaborando para o encontro de pontos de intersecção entre os dois pensadores. Ao final, apresenta-se algumas chaves de leitura que articulam a análise anterior sobre via de possibilitar saídas frente ao atual momento vivido pela educação.

Background: When nonsurgical treatment of a Morton neuroma is unsuccessful, neurectomy is indicated. The purpose of the present retrospective study was to evaluate the long-term outcomes, complications, and adverse events following a distal plantar transverse incision for the excision of an intermetatarsal neuroma.Methods: We conducted a retrospective review of 168 consecutive patients who underwent surgical excision of a Morton neuroma that had been unresponsive to nonsurgical treatment. The clinical diagnosis was confirmed by means of magnetic resonance imaging and histological analysis. All patients underwent excision of the neuroma through a distal transverse plantar approach; concomitant foot and ankle disorders were also treated. Postoperatively, a three-grade patient satisfaction scale was administered to assess the results of the procedure and a clinical examination was performed for all patients.Results: One hundred and sixty patients (204 feet, 227 neuromas) were assessed at a median of 7.1 ± 3.9 years (range, one to twenty-one years) postoperatively. A good result was reported for 143 patients (89.4%); a fair result, for eleven (6.9%); and a poor result, for six (3.8%). The eleven patients with a fair result reported scar-related symptoms such as skin hardening, loss of sensation at the incision site, discomfort wearing shoes with high heels, and local paresthesias with no recurrence of the neuroma. The six patients with a poor result reported pain and paresthesias, and the recurrence of a neuroma was confirmed at the time of reoperation.Conclusions: Producing a marked reduction in pain and high overall patient satisfaction, a distal transverse plantar incision is comparable with other surgical approaches for the surgical treatment of a Morton neuroma. [ABSTRACT FROM AUTHOR]

BACKGROUND: Plantar forefoot ulcers in individuals with diabetes often lead to deep infection and lower extremity amputation. Increasing evidence suggests that the process is initiated by increased passive stiffness within the gastrocnemius-soleus musculotendinous unit. The goal of this investigation was to perform ultrasound examination of the Achilles tendon in a consecutive group of asymptomatic diabetic individuals to identify any inherent structural pathology that might be associated with the increased stiffness that appears to be associated with the development of diabetic forefoot ulcers. MATERIALS AND METHODS: Seventy consecutive diabetic individuals with no past history of diabetic foot morbidity underwent ultrasonography of their Achilles tendons. Each patient was also tested for fasting glucose and glycosylated hemoglobin as a measure of diabetes control. Ten similarly aged non-diabetics with no history of Achilles tendinopathy served as controls. RESULTS: The ultrasonography revealed disorganized tendon fibers in 62 of 70 (89%) patients, and calcification within the Achilles tendon in 53 (76%) patients. The Achilles tendon thickness averaged 5.0 (range, 4 to 8) mm. There was no correlation between patient age and Achilles tendon thickness (r = 0.292, p = 0.014); however, there was a trend for duration of disease and Achilles tendon disorganization (p = 0.073). The oldest patients also appeared to demonstrate a trend for more ultrasound-measured Achilles tendinopathy. There was no correlation between fasting glucose or glycosylated hemoglobin and Achilles tendon alterations. CONCLUSION: This investigation confirms structural abnormalities within the Achilles tendon of diabetic individuals that might represent biologic changes affecting the inherent stiffness that leads to increased forefoot pressure and the development of plantar forefoot ulcers. This process appears to worsen with advanced age and does not appear to be related to diabetes control. [ABSTRACT FROM AUTHOR]

Históricamente, Costa Rica se ha caracteriza por realmente no poseer una política de defensa definida dentro de sus estamentos estatales. Esto se debe a que se ha convivido dentro de la narrativa militar del país centroamericano en una disyuntiva que radica entre la paz y la seguridad del Estado. Lo anterior se puede explicar, en gran medida, porque tradicionalmente el gobierno costarricense no ha podido consolidar amenazas verdaderamente considerables en la región que comprometan su seguridad y defensa nacionales. Entren los factores que ayudan a entender esta condición se encuentran el carácter de excepcionalidad de sus fuerzas armadas, la preeminencia del derecho internacional como instrumento de defensa nacional y el principio de neutralidad en conflictos armados, además de la presencia y el acompañamiento que desempeñan los Estados Unidos. Las amenazas transnacionales tradicionales han sufrido una transformación que, en la actualidad, pueden verse relativamente reducidas a la lucha contra el narcotráfico y el crimen interno en la nación tica.

O artigo reflete sobre os processos construtores de novas tecnologias advindas da dinâmica da produção de novos conhecimentos científicos, que envolvem demandas de mercado, associadas aos interesses industriais, ao consumo e às expectativas sociais diante das inovações tecnológicas, o que impõe à comunidade científica e acadêmica, novos desafios na elaboração de saberes, principalmente, naqueles apoiados na perspectiva da complexidade com a concorrência de múltiplas áreas e campos de conhecimento, incluindo enfaticamente o da biossegurança. Através dessa dinâmica analítica discute-se a essencialidade da biossegurança e sua interface com as inovações tecnológicas e a bioética que se estabelecem pelas vertentes da política em beneficio das ações preventivas, voltadas para promoção da qualidade de processos tecnológicos inovadores direcionados para a saúde.

BACKGROUND: Injury to the metatarsophalangeal or interphalangeal joints of the hallux is an unusual clinical problem. MATERIALS AND METHODS: This investigation represents a retrospective case series accumulated over a twenty year period of ninety-three beach soccer players who were treated for an osteochondral injury of the hallux metatarsophalangeal or interphalangeal joints of their dominant (kicking) foot. RESULTS: Eighty-one patients underwent surgical excision of an avascular osteochondral fragment that had been identified by both plain radiography and magnetic resonance imaging. All but two patients were able to return to participation with either minimal or no pain. Two patients progressed to hallux rigidus and metatarsophalangeal joint arthritis. CONCLUSION: This retrospective case series describes a sports-related injury of the hallux metatarsophalangeal or interphalangeal joints that is likely produced by hyper-flexion or hyperextersion. This descriptive case series might well characterize heretofore unexplained post-traumatic pain and swelling involving the hallux. [ABSTRACT FROM AUTHOR]

O artigo busca apresentar a formação do laboratório de vigilância sanitária no Brasil, a partir da criação do Laboratório Central de Controle de Drogas e Medicamentos (LCCDM), em 1954, e as mudanças ocorridas com a transformação do mesmo no Instituto Nacional de Controle de Qualidade em Saúde (INCQS), em 1981, e posteriormente, com a criação da Agência Nacional de Vigilância Sanitária (Anvisa), em 1999. Discute também as mudanças organizacionais e o seu impacto no controle analítico do risco sanitário dos produtos ofertados à população.

O artigo busca apresentar a formação do laboratório de vigilância sanitária no Brasil, a partir da criação do Laboratório Central de Controle de Drogas e Medicamentos (LCCDM), em 1954, e as mudanças ocorridas com a transformação do mesmo no Instituto Nacional de Controle de Qualidade em Saúde (INCQS), em 1981, e posteriormente, com a criação da Agência Nacional de Vigilância Sanitária (Anvisa), em 1999. Discute também as mudanças organizacionais e o seu impacto no controle analítico do risco sanitário dos produtos ofertados à população.

Kikuchi Fujimoto disease (KFD) was first described in Japan in 1972 almost simultaneously by Kikuchi and Fujimoto. It is a rare, self-limiting, benign form of histiocytic necrotizing lymphadenitis, which can be mistaken for tuberculosis, lymphoma or systemic lupus erythematosus. Although the pathogenesis of KFD is not fully understood, infectious and autoimmune etiologies have been proposed. It generally presents as cervical lymphadenopathy with associated systemic signs and symptoms. Definitive diagnosis requires histopathological examination of the affected lymph nodes. There are only few cases described in the literature, as far as we are aware we report the first case of KFD in the Dominican Republic.