Outcomes of Combined Posterior Tibial Tendon Tendoscopy and Medializing Calcaneal Osteotomy for Stage IA Progressive Collapsing Foot Deformity.

BACKGROUND: Posterior tibial tendon (PTT) tendoscopy and medializing calcaneal osteotomy (MCO) are among the available techniques for patients presenting with symptomatic flexible hindfoot valgus (stage IA) progressive collapsing foot deformity (PCFD). The aim of this study was to determine clinical and radiographic outcomes of combined PTT tendoscopy and MCO for patients presenting with symptomatic stage IA PCFD. METHODS: A retrospective cohort study was performed in order to determine clinical and radiographic outcomes of 30 combined PTT tendoscopies and MCO on 27 patients presenting with symptomatic stage IA PCFD, with a minimum follow-up of 24 months. Patient satisfaction was assessed at last available follow-up as very satisfied, satisfied, and unsatisfied. Clinical assessment was performed evaluating preoperative and last available follow-up visual analog scale for pain (VAS-P), Foot and Ankle Outcome Score (FAOS), and the 36-Item Short Form Health Survey (SF-36). Magnetic resonance imaging (MRI) was performed preoperatively on all patients. Standard weightbearing anteroposterior, lateral, and long axial view radiographs of the foot and ankle were taken preoperatively, immediate postoperatively, at 6 weeks, 3 months, 6 months, 1 year postoperatively, and last follow-up evaluation available for each patient. RESULTS: The mean follow-up was 38.6 (range, 26-62) months. We registered 27 very satisfied, 1 satisfied, and 2 unsatisfied patients. There was statistically significant improvement on all clinical scores (VAS-P, FAOS and SF-36), as well as on lateral talo-first metatarsal and hindfoot alignment angles. We found low-grade PTT tears in 5 patients (16.67%) in whom preoperative MRI documented PTT tenosynovitis alone. CONCLUSION: We found that combined PTT tendoscopy and MCO provide significant clinical and radiographic improvement for patients presenting with symptomatic stage IAB PCFD. PTT tendoscopy should be considered in the treatment of all surgically addressed flexible valgus feet as it detects tendon tears which are frequently missed on an MRI. LEVEL OF EVIDENCE: Level IV, retrospective case series.

Outcomes of Posterior Arthroscopic Subtalar Arthrodesis for Medial Facet Talocalcaneal Coalition.

BACKGROUND: Medial facet talocalcaneal coalition can be a painful condition. This study aimed to determine clinical and radiographic outcomes of posterior arthroscopic subtalar arthrodesis (PASTA) for adult patients presenting with symptomatic medial facet talocalcaneal coalition and normal hindfoot alignment, with a minimal follow-up of 18 months. METHODS: Between June 2017 and July 2019, this procedure was performed on 8 feet (8 patients; mean age, 55 [42-70] years; mean BMI, 29.8 [24.4-45.0] kg/m2). Clinical assessment was performed using Visual Analog Scale for Pain (VAS-P), Foot and Ankle Outcome Score (FAOS) and the 36-Item Short-Form Health Survey (SF-36). Patient satisfaction was assessed at the last available follow-up as "very satisfied", "satisfied" or "unsatisfied". Radiographic analysis was performed using plain radiography, computed tomography (CT) scan and magnetic resonance imaging (MRI). The primary outcome was to determine both clinical and radiographic outcomes. RESULTS: The mean follow-up was 25.1 (18.2-34.2) months. The authors found statistically significant improvement on all clinical scores (VASP-P, FAOS and SF-36). They registered 6 "very satisfied" patients, 2 "satisfied" patients and no "unsatisfied" patient. Fusion of the subtalar joint was observed in all patients by 12 weeks and in 5 of them as soon as 8 weeks postoperatively (mean, 9.5 [8-12] weeks). There were no cases of delayed fusion or nonunion of the subtalar joint, superficial or deep infection, neurovascular damage, thromboembolic event, screw breakage, need for hardware removal or revision surgery. CONCLUSION: This study found that PASTA is a safe and reliable technique for adult patients presenting with symptomatic medial facet talocalcaneal coalition and normal hindfoot alignment, demonstrating and maintaining clinical improvement at an average follow-up of 2 years. LEVEL OF EVIDENCE: Level IV, case series.

PRISEC: Comparison of Symmetric Key Algorithms for IoT Devices.

With the growing number of heterogeneous resource-constrained devices connected to the Internet, it becomes increasingly challenging to secure the privacy and protection of data. Strong but efficient cryptography solutions must be employed to deal with this problem, along with methods to standardize secure communications between these devices. The PRISEC module of the UbiPri middleware has this goal. In this work, we present the performance of the AES (Advanced Encryption Standard), RC6 (Rivest Cipher 6), Twofish, SPECK128, LEA, and ChaCha20-Poly1305 algorithms in Internet of Things (IoT) devices, measuring their execution times, throughput, and power consumption, with the main goal of determining which symmetric key ciphers are best to be applied in PRISEC. We verify that ChaCha20-Poly1305 is a very good option for resource constrained devices, along with the lightweight block ciphers SPECK128 and LEA.

Raiva humana transmitida por cães no Maranhão: avaliação das diretrizes básicas de eliminação da doença / Human rabies transmitted by dogs in the Maranhão State: an evaluation of basic guidelines for disposal of the disease

Objetivou-se avaliar as diretrizes básicas do programa de eliminação da raiva humana transmitida por cães (RHTC) no Maranhão. Realizou-se estudo transversal de avaliação normativa nos municípios com casos de RHTC no Estado do Maranhão por meio de consulta a dados primários e secundários de cinco municípios com casos notificados de RHTC de 2006 a 2010. As diretrizes investigadas foram: a) treinamento de profissionais de saúde; b) educação em saúde dirigida à comunidade; c) profilaxia pós-exposição (PPE); e d) vacinação em massa de cães. Muitos profissionais nunca participaram de treinamento sobre RHTC ou o fizeram havia muitos anos. Mais de 70% da população entrevistada jamais recebeu instruções sobre a doença, e quase 100% não sabiam como proceder frente a uma agressão por cão. Verificaram-se deficiências nas ações de PPE e irregularidades nas redes de frio. A cobertura de vacinação animal foi superior a 80% nos municípios, exceto um. Conclui-se que há deficiências no cumprimento das diretrizes básicas para a eliminação da RHTC no Maranhão, podendo resultar em novos casos humanos no Estado.

The aim of this study was to investigate the basic guidelines of the program for the elimination of dog-transmitted human rabies (DTHR) in Maranhão. The study was a cross-sectional one and involved a normative assessment of municipalities with DTHR cases in the State of Maranhão. The primary and secondary data related to five municipalities in which cases of DTHR were reported between 2006 and 2010. Guidelines related to the following areas were investigated: (a) training of health professionals; (b) community-oriented health education; (c) post-exposure prophylaxis (PEP); and (d) mass vaccination of dogs. Many of the professionals had never had training on DTHR or had only had training many years ago. More than 70% of the people interviewed had never received any instructions about the disease, and almost 100% did not know what to do if attacked by a dog. PEP measures were found to be deficient, and irregularities were observed in cold chains. Vaccination coverage of animals was greater than 80% in all municipalities except one. Our findings show that basic guidelines for elimination of DTHR in Maranhão are not being followed and that new human cases may occur in the state as a result.