Reducing local tension to repair nasal septal deviation and spur.

OBJECTIVES: To introduce our method managing nasal septal spurs during endoscopic septoplasty. METHODS: We conducted a prospective study of cases treated with endoscopic septoplasty between March 2022 and June 2023. We innovated a surgical method to reduce the local mucosal tension at the spur by cutting the spur above and below the bony connection, and reducing the chance of mucosal tear and loss during dissection. The authors performed these cases at the First Affiliated Hospital of Fujian Medical University, where 40 surgeries were performed with regular postoperative follow-ups for 6-12 months. RESULTS: All patients' clinical symptoms improved significantly after surgery. After 2-4 weeks of follow-up, the mucosa could recover to the preoperative state on both sides of the nasal septum. CONCLUSION: This surgical method is suitable for most patients with nasal septal deviation, especially those with a spur, which can effectively reduce the chance of nasal septal mucosa tear and accelerate postoperative recovery. LEVEL OF EVIDENCE: Ⅳ.

Spontaneous rupture of the extensor pollicis longus tendon after conservative treatment of a non-displaced distal radius fracture in an adolescent.

A spontaneous rupture of the extensor pollicis longus (EPL) tendon after a fracture of the distal radius is a known complication in adults. In contrast, there are a paucity of reports concerning EPL tendon ruptures in children and adolescents. The authors present a case of a spontaneous rupture of the EPL tendon in a 15-year-old girl after a non-displaced distal radius fracture. The patient had no predisposing factors including rheumatoid arthritis or steroid injection. During surgery, the EPL tendon was found to be ruptured at the extensor retinaculum (third compartment). Extensor indicis proprius (EIP) to EPL transfer was performed. At the 18-month follow-up, the patient was asymptomatic and showed satisfactory thumb function, with normal active extension.

La rotura espontánea del tendón del extensor largo del pulgar (EPL) tras una fractura distal del radio es una complicación conocida en adultos. En cambio, son escasos los informes sobre roturas del tendón del EPL en niños y adolescentes. Los autores presentan un caso de rotura espontánea del tendón del EPL en una niña de 15 años tras una fractura distal del radio no desplazada. La paciente no presentaba factores predisponentes como artritis reumatoide o inyección de esteroides. Durante la intervención quirúrgica, se descubrió que el tendón del EPL estaba roto a la altura del retináculo extensor (tercer compartimento). Se realizó una transferencia del extensor indicis proprius (EIP) al EPL. A los 18 meses de seguimiento, el paciente estaba asintomático y mostraba una función satisfactoria del pulgar, con una extensión activa normal.

Spatio-temporal expression of candidate genes for nectar spur development in Tropaeolum (Tropaeolaceae: Brassicales).

BACKGROUND AND AIMS: Tropaeolaceae (Brassicales) comprise ~100 species native to South and Central America. Tropaeolaceae flowers have a nectar spur, formed by a late expansion and evagination of the fused proximal region of the perianth (i.e. the floral tube). This spur is formed in the domain of the tube oriented towards the inflorescence axis, which corresponds to the adaxial floral region. However, little is known about the molecular mechanisms responsible for the evolution of spurs in Tropaeolaceae. METHODS: In this study, we examined the spatio-temporal expression of genes putatively responsible for differential patterns of cell division between the adaxial and abaxial floral regions in Tropaeolaceae. These genes include previously identified TCP and KNOX transcription factors and the cell division marker HISTONE H4 (HIS4). KEY RESULTS: We found a TCP4 homologue concomitantly expressed with spur initiation and elaboration. Tropaeolaceae possess two TCP4-like (TCP4L) copies, as a result of a Tropaeolaceae-specific duplication. The two copies (TCP4L1 and TCP4L2) in Tropaeolum longifolium show overlapping expression in the epidermis of reproductive apices (inflorescence meristems) and young floral buds, but only TlTCP4L2 shows differential expression in the floral tube at early stages of spur formation, restricted to the adaxial region. This adaxial expression of TlTCP4L2 overlaps with the expression of TlHIS4. Later in development, only TlTCP4L2 is expressed in the nectariferous tissue of the spur. CONCLUSIONS: Based on these results, we hypothesize that Tropaeolaceae TCP4L genes had a plesiomorphic role in epidermal development and that, after gene duplication, TCP4L2 acquired a new function in spur initiation and elaboration. To better understand spur evolution in Tropaeolaceae, it is critical to expand developmental genetic studies to their sister group, the Akaniaceae, which possess simultaneously an independent duplication of TCP4L genes and a spurless floral tube.

Spontaneous rupture of the extensor pollicis longus tendon after conservative treatment of a non-displaced distal radius fracture in an adolescent / Rotura espontánea del tendón del extensor largo del pulgar tras el tratamiento conservador de una fractura no desplazada del radio distal en un adolescente

Abstract: A spontaneous rupture of the extensor pollicis longus (EPL) tendon after a fracture of the distal radius is a known complication in adults. In contrast, there are a paucity of reports concerning EPL tendon ruptures in children and adolescents. The authors present a case of a spontaneous rupture of the EPL tendon in a 15-year-old girl after a non-displaced distal radius fracture. The patient had no predisposing factors including rheumatoid arthritis or steroid injection. During surgery, the EPL tendon was found to be ruptured at the extensor retinaculum (third compartment). Extensor indicis proprius (EIP) to EPL transfer was performed. At the 18-month follow-up, the patient was asymptomatic and showed satisfactory thumb function, with normal active extension.

Resumen: La rotura espontánea del tendón del extensor largo del pulgar (EPL) tras una fractura distal del radio es una complicación conocida en adultos. En cambio, son escasos los informes sobre roturas del tendón del EPL en niños y adolescentes. Los autores presentan un caso de rotura espontánea del tendón del EPL en una niña de 15 años tras una fractura distal del radio no desplazada. La paciente no presentaba factores predisponentes como artritis reumatoide o inyección de esteroides. Durante la intervención quirúrgica, se descubrió que el tendón del EPL estaba roto a la altura del retináculo extensor (tercer compartimento). Se realizó una transferencia del extensor indicis proprius (EIP) al EPL. A los 18 meses de seguimiento, el paciente estaba asintomático y mostraba una función satisfactoria del pulgar, con una extensión activa normal.

Investigation of the relationship between foot deformities and radiographic measurements of the talus and calcaneus / Investigación de la relación entre las deformidades del pie y las mediciones radiográficas del talo y del calcáneo

SUMMARY: The weight of the body is transmitted to the foot through the subtalar joint and talus. Considering the important location of the talus and calcaneus, the morphological structures of these bones may affect the biomechanics of the subtalar joint. At the same time, the morphological structure of these bones is important in some common foot deformities. We aimed to investigate whether the various measurements of the talus and calcaneus are associated with different foot deformities in this study. In this study, radiography images of 158 (72 male and 86 female) patients within the mean age of 44 years were retrospectively examined. Eleven different measurements of the talus and calcaneus were obtained from the lateral and antero-posterior radiographs of the patients. A total of 158 patient's routine clinic radiographs were retrospectively assessed, which have calcaneal spur (n=63), hallux valgus (n=32) and control group (n=63). We determined that the body height of the calcaneus, maximum width of the head of the talus, minimum anterior width of the calcaneus were significantly different between calcaneal spur group and control group. Maximum length fibular malleolar facet of the talus was significantly different between age groups. And we determined that the calcaneal index was significantly different between hallux valgus group and control groups. Also all measurements were significantly different between males and females. As a result, some measurements that significantly determine the morphology of the talus and calcaneus were found to be significant between deformity groups and control groups. We think that our study will contribute to the literature as it is the first study in which the measurements obtained from the radiographic images of the talus and calcaneus are associated with foot deformities.

El peso del cuerpo se transmite al pie a través de la articulación subtalar y el talo. Teniendo en cuenta la importante ubicación del talo y el calcáneo, las estructuras morfológicas de estos huesos pueden afectar la biomecánica de la articulación subtalar. Al mismo tiempo, la estructura morfológica de estos huesos es importante en algunas deformidades comunes del pie. Nuestro objetivo fue investigar si las diversas medidas del talo y el calcáneo están asociadas con diferentes deformidades del pie en este estudio. Se examinaron retrospectivamente imágenes radiográficas de 158 pacientes (72 hombres y 86 mujeres) con una edad promedio de 44 años. Se obtuvieron once medidas diferentes del talo y el calcáneo a partir de las radiografías lateral y anteroposterior de los pacientes. Se evaluaron retrospectivamente un total de 158 radiografías clínicas de rutina de los pacientes, los cuales tenían espolón de calcáneo (n=63), hallux valgus (n=32) y grupo control (n=63). Determinamos que la altura del cuerpo del calcáneo, el ancho máximo de la cabeza del talo, el ancho anterior mínimo del calcáneo fueron significativamente diferentes entre el grupo con espolón calcáneo y el grupo control. La longitud máxima de la faceta maleolar fíbular del talo era significativamente diferente entre los grupos de edad. También determinamos que el índice calcáneo fue significativamente diferente entre el grupo de hallux valgus y los grupos controles. Además, todas las medidas fueron significativamente diferentes entre hombres y mujeres. Como resultado, algunas medidas que determinan la morfología del talo y el calcáneo resultaron significativas entre los grupos de deformidad y los grupos controles. Estimamos que nuestro estudio contribuirá a la literatura debido a que es el primer reporte en el que las medidas obtenidas de las imágenes radiográficas del talo y el calcáneo se asocian con deformidades del pie.

Effectiveness of mechanical treatment with customized insole and minimalist flexible footwear for women with calcaneal spur: randomized controlled trial.

BACKROUND: Calcaneal spurs are described as bony outgrowths arising on medial calcaneal, where inappropriate footwear can promote disease progression. OBJECTIVE: Investigate the effectiveness of mechanical treatment with customized insole and minimalist flexible footwear during gait training program in women with calcaneal spur. METHODS: Design: A single-blinded, randomized and controlled trial. SETTING: Biomechanics laboratory. PARTICIPANTS: Forty-three women, 29 with calcaneal spur and 14 control. INTERVENTION: Gait training program with use of the minimalist flexible footwear (MFG n = 15, age: 48.9 ± 9.4, height: 1.61 ± 0.1, BMI: 32.1 ± 7.0) and customized insole on footwear (COIG n = 14, age: 50.3 ± 5.8, height: 1.62 ± 0.1, BMI: 32.2 ± 4.3) and control (CG n = 14, age: 47.8 ± 8.6, height: 1.63 ± 0.1, BMI: 27.5 ± 4.5), followed of the evaluations: baseline (T0) and after three (T3) and six (T6) months. Duration of the intervention was of the six months consecutive for at least 42 h per week (six hours a day, seven days a week). Outcome primary were calcaneus pain (visual analogue scale), Foot Function Index (FFI), Foot Health Status Questionnaire (FHSQ-Br) and 6-min walk test (6MWT). Secondary was plantar pressure distribution by a pressure platform system during gait and static index foot posture (FPI). STATISTICAL ANALYSIS: analysis of variance for repeated measure and between groups were used to detect treatment-time interactions (α = 5%). Effect size with D Cohen's also was used between T0 and after six (T6) months of intervention. RESULTS: The MFG and COIG were effective at reducing pain after six months (MFG: 2.5-4.5 CI, p = 0.001; COIG: 1.5-3.5 CI, p = 0.011). The FFI and FHSQ-Br showed improvements with MFG and COIG after T6 (MFG: 13.7-15.4 CI, p = 0.010; COIG: 11.3-15.0 CI, p = 0.001). The 6MWT increased with MFG (589.3-622.7 CI) and COIG (401.3-644.7 CI) and foot pronation was decreased after T3 and T6 MFG (FPI Right: 4.2-5.4 CI; Left: 3.6-5.4 CI) COIG (FPI Right: 3.4-6.8 CI; Left: 3.3-5.7 CI). The contact area reduced on forefoot and rearfoot with MFG and GOIG and midfoot and rearfoot with MFG. Maximum force was reduced on foot with MFG after T3 and T6. The peak pressure was reduced on the forefoot with MFG and COIG and on midfoot and rearfoot with MFG. CONCLUSIONS: The mechanical treatment with customized insole and minimalist flexible footwear during gait training program during six months in women with calcaneal spur reduced the calcaneus pain, increased function and health feet and reduced plantar load on the rearfoot, midfoot and forefoot. However, the footwear alone was more effective than when combined customized insole, given the greater efficacy on clinical and biomechanical aspects. TRIAL REGISTRATION: ClinicalTrials.gov NCT03040557 (date of first registration: 02/02/2017).

Efectividad de la terapia por ondas de choque en lesiones de tendones y ligamentos del sistema osteomioarticular / Effectiveness of Shock Wave Therapy in Tendon and Ligament Injuries of the Osteomioarticular System

Introducción: Por más de 20 años la litotricia extracorpórea se ha aplicado con éxito en el mundo. Objetivo: Evaluar la efectividad de la terapia por ondas de choque en el tratamiento a pacientes que presentan lesiones en los tendones y ligamentos del sistema osteomioarticular. Métodos: Se realizó un estudio descriptivo, de corte transversal, con 107 pacientes diagnosticados con lesiones en los tendones y ligamentos del sistema osteomioarticular, los cuales fueron tratados con el equipo Well Wave (ondas de choque extracorpóreas) en el Complejo Científico Ortopédico Internacional Frank País, en el período comprendido entre marzo de 2019 y abril de 2020. Se realizó el análisis de las variables edad, sexo, dolor y discapacidad. Se obtuvieron frecuencias absolutas y relativas, y con ellas se confeccionaron las tablas que resumen la información estadística de la investigación. Resultados: Predominó el sexo femenino (71,9 por ciento), de 51 - 60 años (28 por ciento). El 40,2 por ciento de los pacientes fueron atendidos por presentar una tendinitis del supraespinoso. Todos los pacientes presentaban dolor antes de la aplicación de la terapia. Luego del tratamiento el 78,5 por ciento de los enfermos dejaron de sentirlo y el 71 por ciento presentó ausencia de discapacidad según escala de DASH. Según los criterios de evaluación de la respuesta al tratamiento los resultados fueron satisfactorios en el 56 por ciento de los pacientes. Conclusiones: La terapia con las ondas de choque posibilitó una rápida recuperación de los pacientes atendidos y su incorporación a las actividades diarias(AU)

ABSTRACT Introduction: Over more than 20 years, extracorporeal lithotripsy has been successfully used worldwide. Objective: To evaluate the effectiveness of shock wave therapy in the treatment of patients with injuries to the tendons and ligaments of the osteomioarticular system. Methods: A descriptive, cross-sectional study was carried out with 107 patients diagnosed with injuries to the tendons and ligaments of the osteomioarticular system. These subjects were treated with the Well Wave equipment (extracorporeal shock waves) at Frank País International Orthopedic Scientific Center, from March 2019 to April 2020. The variables age, sex, pain and disability were analyzed. Absolute and relative frequencies were obtained, and the results of statistical information of the investigation was shown in summarizing tables. Results: The female sex prevailed (71.9percent), 51 - 60 years old (28 percent). 40.2 percent of the patients were treated for supraspinatus tendinitis. All patients had pain before the use of therapy. After treatment, 78.5 percent of the patients stopped feeling pain and 71 percent showed no disability according to DASH scale. According to the treatment response evaluation criteria, the results were satisfactory in 56percent of the patients. Conclusions: This therapy enabled rapid recovery of the patients treated and their integration into daily activities(AU)

Prevalencia y biometría del espolón calcáneo en la población chilena: estudio radiológico / Prevalence and biometry of the calcaneal spur in the Chilean population: radiological study

RESUMEN: El dolor en la región calcánea del pie afecta aproximadamente a un tercio de los adultos mayores de 65 años. Asimismo, una gran cantidad de sujetos que consultan por esta condición, revelan hallazgos radiológicos de un crecimiento anormal en el hueso calcáneo, en su cara plantar, en forma de gancho denominado espolón calcáneo (EC). El objetivo del presente estudio fue relacionar la prevalencia y biometría de los EC en individuos chilenos según sexo y edad. Se realizó un estudio radiológico de tipo descriptivo-correlacional donde se revisaron al azar 400 radiografías de pies en proyección lateral de 200 sujetos chilenos entre 15 y 90 años. El análisis de los 200 exámenes radiográficos mostró que en 135 (67,5 %) de ellos presentaban EC de manera unilateral o bilateral. La presencia de al menos un EC era mayor en las mujeres 104 (52 %) que en los hombres 31 (15,5 %). Sin embargo, esta diferencia no es estadísticamente significativa p= 0,621. La edad promedio de los sujetos que presentaron EC era de 60,4 años, ampliamente superior a quien no lo presentaba (43,5 años), siendo esta diferencia estadísticamente significativa P<0,05. Se puede concluir una prevalencia del 67,5 % de EC en la población de estudio, mayor en las mujeres y directamente relacionada con la edad. Esta información podría ser de gran valor morfológico y médico debido a la escasa literatura existente sobre esta materia en individuos chilenos.

SUMMARY: Pain in the talar region of the foot affects approximately one third of people over 65 years of age. Likewise, a large number of patients who consult for this condition reveal radiological findings of an abnormal growth of the hook-shaped calcaneus called a calcaneal spur (CS). The objective of the present study was to relate the prevalence and biometrics of CS in Chilean individuals according to sex and age. A descriptive-correlational radiological study was carried out where 400 lateral projection radiographs of the feet of 200 Chilean patients between 15 and 90 years of age were randomly reviewed. The analysis of the 200 people examined showed that 135 (67.5%) presented CS unilaterally or bilaterally. The presence of at least one CS is greater in the female sex 104 (52%) than in the male sex 31 (15.5%), however, this difference is not statistically significant p = 0.621. The average age of the people who presented CS is 60.43 years, much higher than those who do not present (43.51 years), this difference being statistically significant P = Sig. It can be concluded a prevalence of 67.5% of CS in the study population, higher in the female sex and directly related to age. This information will be of great morphological and medical value due to the little existing literature on this matter in Chilean individuals.

The relationship between age-related incidences of heel spur with sex and side / Relación entre la incidencia del espolón calcáneo con la edad, sexo y lado

SUMMARY: Heel spur is an osteophytic protrusion larger than 2 mm that lies just anterior to the tuberosity of the calcaneus. Heel spur can be of two types: plantar heel spur and dorsal heel spur. The aim of this study was to evaluate the relationship between the heel spurs incidence with age, sex and side. A total of 2000 bilateral radiographs of 1000 patients (518 men and 482 women) aged 20-93 years who applied to Terme state hospital, Samsun, Turkey due to trauma were examined. Patients were grouped into 10 year age ranges (20-29 years; 30-39 years; 40-49 years; 50-59 years; 60-69 years and over 70 years). The incidences of plantar heel spur, dorsal heel spur, and both were evaluated according to age, sex and side relations. Plantar or dorsal heel spurs were detected in 32.6 % (326 patients) of the patients. The incidences of plantar heel spur, dorsal heel spur, plantar and dorsal heel spur were 26.0 %, 16.9 %, and 10.3 % respectively. According to sex, the incidence of plantar heel spur was higher in women in all age groups. Although the incidence of dorsal heel spur was higher in men in the 6th decade, it was more common in women in other age groups. The incidence of plantar heel spur was 2.615 times higher in the right foot and 2.810 times higher in the left foot in women. As the age increased, the risk of plantar heel spur increased 1.060 times in the right foot and 1.061 times in the left foot. The incidence of dorsal heel spur was 1.510 times higher in the right foot and 1.715 times higher in the left foot in women. As the age increased, the incidence of dorsal heel spur increased in both feet and this increase was 1.055 times in both feet.

RESUMEN: El espolón calcáneo es una protuberancia osteofítica de más de 2 mm que se encuentra por delante de la tuberosidad del calcáneo. El espolón calcáneo puede ser de dos tipos: espolón calcáneo plantar y espolón calcáneo dorsal. El objetivo de este estudio fue evaluar la relación entre la incidencia de espolón calcáneo con la edad, el sexo y el lado. Se examinaron un total de 2000 radiografías bilaterales de 1000 pacientes (518 hombres y 482 mujeres) de 20 a 93 años de edad que fueron solicitadas en el hospital estatal de Terme, Samsun, Turquía debido a un traumatismo. Los pacientes se agruparon en rangos de edad de 10 años (20-29 años; 30-39 años; 40-49 años; 50-59 años; 60-69 años y mayores de 70 años). Las incidencias de espolón calcáneo plantar, espolón calcáneo dorsal y ambos se evaluaron de acuerdo con la edad, el sexo y lados. Se detectaron espolones calcáneos plantares o dorsales en el 32,6 % (326 pacientes) de los pacientes. Las incidencias de espolón calcáneo plantar, espolón calcáneo dorsal, espolón calcáneo plantar y dorsal fueron del 26 %, 16,9 % y 10,3 %, respectivamente. Según el sexo, la incidencia de espolón calcáneo plantar fue mayor en mujeres en todos los grupos de edad. Aunque la incidencia del espolón calcáneo dorsal fue mayor en hombres en la sexta década, era más común en mujeres en otros grupos de edad. La incidencia de espolón calcáneo plantar fue 2,6 veces mayor en el pie derecho y 2,8 veces mayor en el pie izquierdo en mujeres. A medida que aumentaba la edad, el riesgo de espolón calcáneo plantar aumentaba 1,06 veces en el pie derecho y 1,061 veces en el pie izquierdo. La incidencia de espolón calcáneo dorsal fue 1,510 veces mayor en el pie derecho y 1,715 veces mayor en el pie izquierdo en mujeres. A medida que aumentaba la edad, la incidencia de espolón calcáneo dorsal aumentaba en ambos pies y este aumento era de 1,055 veces en ambos pies.

Molecular framework underlying floral bilateral symmetry and nectar spur development in Tropaeolum, an atypical member of the Brassicales.

PREMISE: Floral spurs are key innovations associated with elaborate pollination mechanisms that have evolved independently several times across angiosperms. Spur formation can shift the floral symmetry from radial to bilateral, as it is the case in Tropaeolum, the only member of the Brassicales with floral nectar spurs. The genetic mechanisms underlying both spur and bilateral symmetry in the family have not yet been investigated. METHODS: We studied flower development and morphoanatomy of Tropaeolum longifolium. We also generated a reference transcriptome and isolated all candidate genes involved in adaxial-abaxial differential growth during spur formation. Finally, we evaluated the evolution of the targeted genes across Brassicales and examined their expression in dissected floral parts. RESULTS: Five sepals initiate spirally, followed by five petals alternate to the sepals, five antesepalous stamens, three antepetalous stamens, and three carpels. Intercalary growth at the common base of sepals and petals forms a floral tube. The spur is an outgrowth from the adaxial region of the tube, lined up with the medial sepal. We identified Tropaeolum specific duplications in the TCP3/4L and STM gene lineages, which are critical for spur formation in other taxa. In addition, we found that TM6 (MADS-box), RL2 (RAD-like7), and KN2/6L2 and OSH6L (KNOX1 genes), have been lost in core Brassicales but retained in Tropaeolum. CONCLUSIONS: Three genes are pivotal during the extreme adaxial-abaxial asymmetry of the floral tube, namely, TlTCP4L2 restricted to the adaxial side where the spur is formed, and TlTCP12 and TlSTM1 to the abaxial side, lacking a spur.

HR-pQCT in vivo imaging of periarticular bone changes in chronic inflammatory diseases: Data from acquisition to impact on treatment indications.

Imaging is essential for the assessment of bone and inflammatory joint diseases. There are several imaging techniques available that differ regarding resolution, radiation exposure, time expending, precision, cost, availability or ability to predict disease progression. High-resolution peripheral quantitative computed tomography (HR-pQCT) that was introduced in 2004 allows the in vivo evaluation of peripheral bone microarchitecture and demonstrated high precision in assessing bone changes in inflammatory musculoskeletal diseases. This review summarizes the use of HR-pQCT for the evaluation of the hand skeleton in inflammatory joint diseases. We conducted a review of the literature regarding the protocols that involve hand joints assessment and evaluation of bone changes as erosions and osteophytes in chronic inflammatory diseases. Apart from measuring bone density and structure of the radius and the tibia, HR-pQCT has contributed to assessment of bone erosions and osteophytes, considered the hallmark of diseases as rheumatoid arthritis and psoriatic arthritis, respectively. In this way, there are some conventions recently established by rheumatic study groups that we just summarized here in order to standardize HR-pQCT measurements.

Morphometric analysis of calcaneal (heel) spurs in ancient and modern Anatolian populations / Análisis morfométrico de los espolones calcáneos en poblaciones de Anatolia antiguas y modernas

SUMMARY: Heel spurs are the bony protrusion seen especially on the dorsal and plantar face of the calcaneus bone at the attachment site of the muscles. It was aimed herein to obtain data about the life styles, daily lives, and especially the socioeconomic structures of modern and ancient Anatolian populations by evaluating the prevalence, location, age, and gender differences of heel spurs on the calcaneus and comparing these findings between the populations. Herein, the 251 calcaneus bones of 137 skeletons, which had been previously analyzed paleodemographically and dated to the Middle Ages, and 68 calcaneus bones belonging to a modern population, whose gender was unknown but lived in Anatolia, were examined in terms of heel spurs. In the current study, the presence of dorsal, plantar, or both dorsal/plantar heel spurs on these in 251 calcaneus bones was 43.9 %, 11.1 %, and 10.3 %, respectively. The presence of dorsal, plantar, or both dorsal/plantar heel spurs was determined as 22 %, 3 %, and 1.5 %, respectively, among the 68 calcaneus bones belonging to the modern population. When a comparison was made of the current study with studies in the literature on modern and prehistoric populations, a higher prevalence of heel spurs was found in prehistoric samples than in modern populations. It is our belief that this situation may have derived from the heavy labor force, environmental, or sociocultural differences in ancient Anatolian populations, insufficiency of vital materials due to inadequate industrial conditions, and the solution of anatomical disruption. In addition, the findings determined herein will guide the development of future and industrial studies on the foot and foot structure.

RESUMEN: Los espolones del talón son la protuberancia ósea que se ve especialmente en la cara dorsal y plantar del hueso calcáneo en el sitio de inserción de los músculos. El objetivo de este trabajo consistió en obtener datos sobre los estilos de vida, la vida cotidiana y, especialmente, las características socioeconómicas de las poblaciones anatolias modernas y antiguas mediante la evaluación de la prevalencia, la ubicación, la edad y las diferencias de sexo de los espolones calcáneos y comparar estos hallazgos entre los poblaciones. La muestra consistió en 251 calcáneos correspondientes a 137 esqueletos, que habían sido previamente analizados paleodemográficamente y fechados en la Edad Media; también se incluyeron 68 calcáneos pertenecientes a una población moderna de Anatolia, sin distinción de sexo. De la muestra de 251 calcáneos, se encontraron espolones calcáneos dorsales, plantares y dorsales/plantares, en el 43,9%, 11,1 % y 10,3 %, respectivamente. La presencia de espolones calcáneos dorsales, plantares y dorsales/plantares se determinó en el 22%, 3% y 1,5%, respectivamente, entre los 68 calcáneos pertenecientes a la población moderna. Cuando se realizó una comparación del estudio actual con la literatu- ra sobre poblaciones modernas y prehistóricas, se encontró una mayor prevalencia de espolones calcáneos en muestras prehistóricas que en poblaciones modernas. Creemos que esta situación puede haberse derivado a la gran fuerza de trabajo, y las diferencias ambientales o socioculturales en las antiguas poblaciones de Anatolia, la insuficiencia de materiales vitales debido a las condiciones industriales inadecuadas produjo la alteración anatómica. Además, los hallazgos aquí determinados guiarán el desarrollo de estudios futuros e industriales sobre la estructura del pie.

Do food trichomes occur in Pinguicula (Lentibulariaceae) flowers?

BACKGROUND AND AIMS: Floral food bodies (including edible trichomes) are a form of floral reward for pollinators. This type of nutritive reward has been recorded in several angiosperm families: Annonaceae, Araceae, Calycanthaceae, Eupomatiaceae, Himantandraceae, Nymphaeaceae, Orchidaceae, Pandanaceae and Winteraceae. Although these bodies are very diverse in their structure, their cells contain food material: starch grains, protein bodies or lipid droplets. In Pinguicula flowers, there are numerous multicellular clavate trichomes. Previous authors have proposed that these trichomes in the Pinguicula flower play the role of 'futterhaare' ('feeding hairs') and are eaten by pollinators. The main aim of this study was to investigate whether the floral non-glandular trichomes of Pinguicula contain food reserves and thus are a reward for pollinators. The trichomes from the Pinguicula groups, which differ in their taxonomy (species from the subgenera: Temnoceras, Pinguicula and Isoloba) as well as the types of their pollinators (butterflies/flies and bees/hummingbirds), were examined. Thus, it was determined whether there are any connections between the occurrence of food trichomes and phylogeny position or pollination biology. Additionally, we determined the phylogenetic history of edible trichomes and pollinator evolution in the Pinguicula species. METHODS: The species that were sampled were: Pinguicula moctezumae, P. esseriana, P. moranensis, P. emarginata, P. rectifolia, P. mesophytica, P. hemiepiphytica, P. agnata, P. albida, P. ibarrae, P. martinezii, P. filifolia, P. gigantea, P. lusitanica, P. alpina and P. vulgaris. Light microscopy, histochemistry, and scanning and transmission electron microscopy were used to address our aims with a phylogenetic perspective based on matK/trnK DNA sequences. KEY RESULTS: No accumulation of protein bodies or lipid droplets was recorded in the floral non-glandular trichomes of any of the analysed species. Starch grains occurred in the cells of the trichomes of the bee-/fly-pollinated species: P. agnata, P. albida, P. ibarrae, P. martinezii, P. filifolia and P. gigantea, but not in P. alpina or P. vulgaris. Moreover, starch grains were not recorded in the cells of the trichomes of the Pinguicula species that have long spurs, which are pollinated by Lepidoptera (P. moctezumae, P. esseriana, P. moranensis, P. emarginata and P. rectifolia) or birds (P. mesophytica and P. hemiepihytica), or in species with a small and whitish corolla that self-pollinate (P. lusitanica). The results on the occurrence of edible trichomes and pollinator syndromes were mapped onto a phylogenetic reconstruction of the genus. CONCLUSION: Floral non-glandular trichomes play the role of edible trichomes in some Pinguicula species (P. agnata, P. albida, P. ibarrae, P. martinezii, P. filifolia and P. gigantea), which are mainly classified as bee-pollinated species that had originated from Central and South America. It seems that in the Pinguicula that are pollinated by other pollinator groups (Lepidoptera and hummingbirds), the non-glandular trichomes in the flowers play a role other than that of a floral reward for their pollinators. Edible trichomes are symplesiomorphic for the Pinguicula species, and thus do not support a monophyletic group such as a synapomorphy. Nevertheless, edible trichomes are derived and are possibly a specialization for fly and bee pollinators by acting as a food reward for these visitors.

Efeitos da colagem do esporão lingual no microambiente periodontal e liberação de subprodutos de materiais resinosos no tratamento de mordida aberta anterior em crianças / Effects of lingual sporing collage on the periodontal micro-environment and release of by-products of resin materials on the treatment of anterior open bite in children

Introdução: O aparelho ortodôntico passivo esporão é um método utilizado em crianças para correção de mordida aberta anterior. Para realizar a fixação desses acessórios dentes é necessário a utilização de materiais resinosos que podem liberar subprodutos tóxicos como BisGMA e TEGDMA. Além disso, a movimentação dentária ortodôntica pode aumentar a concentração de interleucinas no fluido crevicular gengival (FCG). A liberação de subprodutos resinosos no tratamento de mordida aberta e o comportamento da expressão de interleucinas ainda não estão elucidados na literatura. Objetivo: (1) avaliar a expressão de citocinas no FCG em crianças com mordida aberta que receberam fixação de esporão como tratamento e (2) quantificar o BisGMA e TEGDMA na saliva desses pacientes; e (3) avaliar a migração e viabilidade de quetarinócitos humanos expostos à resina. Métodos: Foram selecionados pacientes da clínica da FO-UFMG que apresentaram mordida aberta anterior. A colagem dos esporões foi realizada e os excessos de resina foram removidos. Foram realizados exames clínico e periodontal nos incisivos superiores e inferiores, coletas do FCG (antes da colagem ­ baseline, 24 h e 7 d após) e saliva (baseline, 30 min, 24 h e 7 d após a colagem). As citocinas do FCG foram analisadas por meio do BD™ Cytometric Bead Array e as amostras de saliva, através do método de cromatografia líquida de alta eficiência. Para as análises in vitro, células imortalizadas HaCat foram tratadas com meio de cultura condicionados com incrementos do sistema resinoso em 3 diferentes diluições e posteriormente foram realizados os testes de viabilidade e migração celular. Resultados: O estudo in vivo demonstrou que houve aumento do sangramento gengival nos incisivos inferiores após 7d quando comparados ao baseline e que este índice estava maior nos dentes inferiores do que nos superiores. Em 24h e 7d após a fixação do esporão, os níveis de IL-8 nos incisivos superiores estavam aumentados. Em 7d, a concentração de IL-1ß foi aumentada em comparação ao baseline nos dois grupos de dentes. Comparando os incisivos superiores e inferiores, os níveis de IL-8, IL-1ß e IL-6 foram maiores nos superiores às 24h. A produção de citocinas pôde ser positivamente correlacionada com o aumento do volume do FCG. Houve aumento dos níveis de BisGMA e TEGDMA na saliva em 30min, com redução dos níveis em 24h e 7d. Os resultados in vitro demonstraram aumento da migração celular nos queratinóscitos expostos aos meios condicionados mesmo em baixas concentrações .Conclusão: Foi identificado que após a colagem do esporão lingual ocorreu o aumento na expressão de interleucinas no FCG. Além disso, foi possível identificar a liberação de subprodutos resinosos na saliva das crianças. Embora os mesmos possam interferir na migração celular, não há estudos que quantifiquem a exposição mínima capaz de induzir alterações no indivíduo. Sendo assim, os benefícios da colagem do esporão sobrepõem seus efeitos adversos

Introduction: The passive spur orthodontic appliance is a method used in children to correct anterior open bite. To fix these teeth accessories, it is necessary to use resinous materials that can release toxic by-products such as BisGMA and TEGDMA. In addition, orthodontic tooth movement can increase the concentration of interleukins in the gingival crevicular fluid (FCG). The release of resinous by-products in the treatment of open bite and the behavior of interleukin expression are not yet elucidated in the literature. Objective: (1) to evaluate the expression of cytokines in the FCG in children with open bite who received spur fixation as treatment and (2) to quantify the BisGMA and TEGDMA in the saliva of these patients; and (3) evaluate the migration and viability of human ketarinocytes exposed to the resin. Methods: Patients from the FO-UFMG clinic who presented anterior open bite were selected. The spurs were bonded and the excess resin was removed. Clinical and periodontal examinations were performed on the upper and lower incisors, collections of the FCG (before bonding - baseline, 24 h and 7 d after) and saliva (baseline, 30 min, 24 h and 7 d after bonding). The FCG cytokines were analyzed using the BD ™ Cytometric Bead Array and the saliva samples, using the high performance liquid chromatography method. For in vitro analysis, immortalized HaCat cells were treated with culture medium conditioned with increments of the resin system in 3 different dilutions and then the viability and cell migration tests were performed. Results: The in vivo study showed that there was an increase in gingival bleeding in the lower incisors after 7d when compared to the baseline and that this index was higher in the lower than in the upper teeth. At 24h and 7d after spur fixation, IL-8 levels in the upper incisors were increased. At 7d, the concentration of IL-1ß was increased compared to the baseline in the two groups of teeth. Comparing the upper and lower incisors, the levels of IL-8, IL-1ß and IL-6 were higher in those above 24h. Cytokine production could be positively correlated with increased FCG volume. There was an increase in the levels of BisGMA and TEGDMA in saliva in 30 minutes, with a reduction in levels in 24h and 7d. The in vitro results demonstrated an increase in cell migration in keratinocytes exposed to conditioned media even in low concentrations. Conclusion: It was identified that after the gluing of the tongue spur there was an increase in the expression of interleukins in the FCG. In addition, it was possible to identify the release of resinous by-products in children's saliva. Although they can interfere with cell migration, there are no studies that quantify the minimum exposure capable of inducing changes in the individual. Therefore, the benefits of spur bonding override its adverse effects.

Dolor plantar calcáneo. Experiencias y opciones de tratamiento / Calcaneal plantar pain. Experiences and treatment options

La talalgia se define como la percepción de dolor localizado en el talón que anatómicamente corresponde al hueso calcáneo y a las partes blandas colaterales, constituye la causa más frecuente de consulta a los especialistas en pie y tobillo, identificando dos zonas de aparición del dolor, el dolor plantar y el dolor posterior, los que están directamente relacionados con la inervación de esa zona del pie, realizamos un análisis general para evaluar las opciones iniciales de tratamiento y las indicaciones fisioterapéuticas exponiendo nuestra opinión y experiencias(AU)

Talalgia is defined as the perception of localized pain in the heel that anatomically corresponds to the calcaneus bone and collateral soft tissue, is the most frequent cause of consultation with foot and ankle specialists, identifying two areas of pain appearance, pain plantar and subsequent pain, which are directly related to the innervation of that area of the foot, we perform a general analysis to evaluate the initial treatment options and physiotherapeutic indications exposing our opinion and experiences(AU)

Golpe del espolón calcáneo complementado con electroacupuntura / Calcaneal spur shockwave complemented with electroacupuncture

El síntoma más importante del espolón calcáneo es el dolor, que se agrava con la carga estando el paciente parado o caminando; localizado en la zona del talón y de rara irra­diación. Se hace presentación de caso: mujer de 47 años de edad, sobrepeso, larga estancia de pie laborando en una cafetería, con espolón calcáneo y la descripción técnica de un único golpe en región plantar, complementado con electroacupuntura por su efecto analgésico y antiinflamatorio. La técnica se aplica por personal calificado y especializado de salud pública(AU)

The most important symptom of the calcaneal spur is pain, which worsening with the weight charge as the patients is standing up or walking; located in the heel area and of rare irradiation. Case presentation: women of 47 years of age, overweight, long time standing up as she works in a cafeteria, with a calcaneal spur and the technical description of an only plantar region shockwave, complemented with electroacupuncture for its analgesic and anti-inflammatory effect. The technique was applied by the qualified and specialized public health personal(AU)

Golpe del espolón calcáneo complementado con electroacupuntura / Calcaneal spur shockwave complemented with electroacupuncture

El síntoma más importante del espolón calcáneo es el dolor, que se agrava con la carga estando el paciente parado o caminando; localizado en la zona del talón y de rara irra­diación. Se hace presentación de caso: mujer de 47 años de edad, sobrepeso, larga estancia de pie laborando en una cafetería, con espolón calcáneo y la descripción técnica de un único golpe en región plantar, complementado con electroacupuntura por su efecto analgésico y antiinflamatorio. La técnica se aplica por personal calificado y especializado de salud pública(AU)

The most important symptom of the calcaneal spur is pain, which worsening with the weight charge as the patients is standing up or walking; located in the heel area and of rare irradiation. Case presentation: women of 47 years of age, overweight, long time standing up as she works in a cafeteria, with a calcaneal spur and the technical description of an only plantar region shockwave, complemented with electroacupuncture for its analgesic and anti-inflammatory effect. The technique was applied by the qualified and specialized public health personal(AU)

Efectividad de la terapia Su-Jok en pacientes con dolor por espolón calcáneo / Effectiveness of the Su-Jok therapy in patients with pain due to heel spur

Se realizó una intervención terapéutica en 128 pacientes con dolor por espolón calcáneo, seleccionados aleatoriamente, quienes fueron tratados en el Departamento de Rehabilitación del Hospital General Docente "Orlando Pantoja Tamayo" en el municipio de Contramaestre, de la provincia de Santiago de Cuba, de enero del 2014 a abril del 2015, con vistas a evaluar la efectividad de la terapia Su-Jok. Se conformaron 2 grupos: uno de control, que recibió tratamiento convencional, y otro de estudio, en el cual se aplicó la terapia Su-Jok. Luego de efectuado el análisis estadístico mediante las pruebas de hipótesis de homogeneidad de la Χ² y de diferencias de medias (ambas técnicas con un error permisible de 5 %), pudo concluirse que la terapia Su Jok es efectiva para aliviar el dolor por espolón calcáneo, por lo que se recomendó promoverla para ello debido a su fácil empleo y bajo costo.

A therapeutic intervention was carried out in 128 randomly selected patients with pain due to heel spur, who were treated in the Rehabilitation Department of "Orlando Pantoja Tamayo" Teaching General Hospital in Contramaestre municipality, Santiago de Cuba province, from January, 2014 to April, 2015, with the aim of evaluating the effectiveness of the Su-Jok therapy. Two groups were formed: a control group which received conventional treatment, and a study group, in which the Su-Jok therapy was applied. After the statistical analysis was carried out by means of the homogeneity and hypothesis tests of homogeneity of Χ2 and the means differences (both techniques with a permissible error of 5%), it could be concluded that the Su-Jok therapy is effective to mitigate the pain due to heel spur, so it was recommended to promote it taking into account its easy use and low cost.

Septoplastía endoscópica / Endoscopic septoplasty

La septoplastía es uno de los procedimientos quirúrgicos más frecuentes en otorrinolaringología, cuya principal indicación es la presencia de desviación septal nasal significativa. Este enfoque quirúrgico ha evolucionado en forma considerable en las últimas décadas, siendo la septoplastía endoscópica la técnica más reciente. Esta técnica moderna, basada en la septoplastía convencional, ha mostrado beneficios en cuanto al procedimiento, resultados y complicaciones. El objetivo de este artículo es revisar las indicaciones, técnica, ventajas y principales resultados de la septoplastía endoscópica.

Septoplasty is one of the most common surgical procedures in otolaryngology, whose main indication is the presence of significant nasal septal deviation. This surgical approach has evolved considerably in recent decades, and endoscopic septoplasty is the most recent technique. This modern technique based on conventional septoplasty has shown several benefits in terms of procedure, results and complications. The aim of this article is to review the indications, techniques, advantages and main results of endoscopic septoplasty.

Estructura y daños en las comunidades de octocorales (Octocorallia: Alcyonacea) de la Reserva Ecológica Siboney-Juticí, Santiago de Cuba, Cuba

Structure and injuries of octocoral communities (Octocorallia: Alcyonacea) of Ecological Reserve Siboney-Juticí, Santiago de Cuba, Cuba. In the spur-and-groove reefs of the Ecological Reserve Siboney-Juticí (Southeast Cuba) octocorals are one of the predominant components of the sessile fauna. Main objectives of the present paper are characterizing the composition, structure and conservation status of the octocoral communities and assessing on the prevailing environmental conditions in the study area. For data collection, six sampling sites were located every 2-3km ranging from 12m to 17m depth along the spur-and-groove reefs. In each site, 22-26 1m² quadrants were zigzag arranged every 2m. The density of colonies was determined per site. The severity degree and predictability of environmental conditions were inferred by using the Heterogeneity and Equitability indexes, respectively. Hydrodynamic stress and the Comparative Pollution Index were also assessed. Current affectations of the octocoral communities were also determined and classified into four main categories: mechanical damage, diseases, predation and invertebrate and macroalgae overgrowth. As a result, 25 species represented by 752 colonies were recorded and Eunicea flexuosa and Gorgonia ventalina were the most abundant. The occurrence of Eunicea succinea forma succinea constituted the first report for Eastern Cuba. Site densities ranged from 3.58±1.84 to 7.58±2.16 colonies/m² and considered from moderate to low. The biggest densities were reported at both sides of the San Juan River mouth. Despite of the composition and structure of the octocoral communities, low to high hydrodynamic stress and low and moderate levels of contamination were inferred, it is likely that these indexes could have been overestimated due to the sensitivity of the indicator species to other factors such as sedimentation. The environmental conditions were mostly favorable and stable. In general, the number of dead colonies was low and mostly caused by the detachment of the substrate and overgrowth of Millepora alcicornis. Injuries were mainly brought about by mechanical damage, followed by coenenchyme loss, predation by Cyphoma gibbosum and macroalgae overgrowth. On the other hand, negative effects by Hermodice carunculata predation, bleaching, Red Band and Black Band Disease were not observed. Among sampled species, G. ventalina colonies were the most severely damaged within the community. As a whole, octocoral communities of spur-and-groove reefs in the Ecological Reserve Siboney-Juticí showed a good conservation status. Rev. Biol. Trop. 58 (4): 1211-1221. Epub 2010 December 01.

Se estudió la comunidad de octocorales del arrecife de macizos y canales de la Reserva Ecológica Siboney- Juticí (sur oriente de Cuba) con el objetivo de caracterizar su composición, estructura y estado de conservación, así como inferir a partir de estas las condiciones ambientales imperantes en el área. La investigación se realizó entre enero y junio de 2009, en seis localidades ubicadas entre 12m y 17m de profundidad. Como unidad de muestreo se empleó un marco de 1m², el cual fue puesto en zigzag cada 2m sobre la superficie del arrecife de macizos. Se determinó, por localidad, la densidad de colonias y se infirieron los grados de severidad, constancia ambiental, tensión hidrodinámica y el Índice Comparativo de Contaminación. Se determinaron, además, los daños en la comunidad de octocorales. Se analizaron 752 colonias e identificaron 25 especies de octocorales. Eunicea flexuosa y Gorgonia ventalina fueron las especies más abundantes. La densidad fluctuó entre 3.58±1.84 colonias/m² y 7.58±2.16 colonias/ m² (densidad de baja a moderada tendiendo a baja). En la zona se infirió una tensión hidrodinámica entre baja y alta, con niveles de contaminación bajos y moderados, y un ambiente generalmente favorable y constante. Los daños de tipo mecánico fueron los más frecuentes, siendo G. ventalina la especie con más colonias dañadas. La comunidad de octocorales del hábitat de macizos y canales de la Reserva Ecológica Siboney-Juticí presentó un buen estado de conservación.