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1.
J Foot Ankle Surg ; 60(6): 1207-1211, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34158227

RESUMO

Plantar callosities under lesser metatarsals are often accompanied by the hallux valgus, and the cause of callosity is thought to be associated with the foot deformity, such as the metatarsal length discrepancy, the abnormal metatarsal head height, cavus, flat foot, and rheumatoid conditions. However, it is unclear which variable is most involved in the cause of callosity in hallux valgus deformity. To clarify the factors associated with the callosity with hallux valgus deformity, we conducted multiple image assessments based on weightbearing radiography and computed tomography. A retrospective review was performed based on the collection of clinical records from all patients with hallux valgus treated from 2010 to 2019 in our institution. We measured the hallux valgus angle, intermetatarsal angles, calcaneal pitch angles, talo-first metatarsal angles, metatarsal length, metatarsal head height, first metatarsal pronation angles, and sesamoid position with weightbearing radiography and computed tomography. We analyzed the relation between callosity formation and imaging assessments using univariate and multivariate logistic regression models. Fifty feet were retrospectively evaluated, and multiple logistic analyses by the stepwise method revealed that the first metatarsal-lateral-sesamoid distance was the only radiographical variable associated with callosity formation among all the tested variables (p < .001). As the grade of the callosity became more severe, the lateral shift of the lateral sesamoid increased. The position of the sesamoid bone appears to have a critical role in the assessment and choice of treatment protocols and further research needs to be conducted on the relationship with the position of sesamoid bone to elucidate the mechanism of callus formation.


Assuntos
Calosidades , Hallux Valgus , Ossos do Metatarso , Hallux Valgus/diagnóstico por imagem , Humanos , Ossos do Metatarso/diagnóstico por imagem , Osteotomia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Suporte de Carga
2.
Br J Community Nurs ; 26(Sup6): S26-S33, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34106004

RESUMO

This article discusses the effects of ageing on the skin, particularly the main structural and functional changes that occur in the epidermis and dermis that make the skin more vulnerable to damage. Specific alterations that occur with ageing include slower epidermal turnover, flattening of the epidermal-dermal junction, loss of moisture and hydration as well as reduced immunity placing the skin at increased risk of damage. The discussion will also examine common periwound complications associated with ageing including; maceration, excoriation, dry skin, hyperkeratosis, callus, contact dermatitis and eczema. Strategies to manage these problems and interventions to reduce the risk of these complications include moisturising the skin to make it more resilient, debriding keratinised and callus tissue in the periwound area, appropriate choice of dressings to manage excessive exudate, careful removal of dressings as well as treating inflammatory conditions of the periwound skin.


Assuntos
Envelhecimento/fisiologia , Bandagens , Higiene da Pele , Pele/fisiopatologia , Cicatrização , Idoso , Calosidades , Eczema , Exsudatos e Transudatos , Serviços de Saúde para Idosos , Humanos , Qualidade de Vida , Higiene da Pele/enfermagem , Resultado do Tratamento
3.
J Foot Ankle Res ; 14(1): 30, 2021 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-33849632

RESUMO

BACKGROUND: An intractable plantar keratoma (IPK) is a conical thickening of the epidermis' stratum corneum and a common cause of foot pain which can have a significant, detrimental impact on the mobility, quality of life and independence of individuals. Conservative treatments are currently offered to patients with IPK, but they are unsatisfactory since they do not offer a sufficient or permanent reduction of symptoms. The purpose of this study was the evaluation of the feasibility, safety and effectiveness of innovative treatments for intractable plantar keratoma (IPK). METHODS: A randomized single blind trial with 40 patients divided with block randomization in four parallel groups was conducted to compare treatment combinations: conservative sharp debridement only or sharp debridement with needle insertion, physiological water injection or lidocaine injection. All patients obtained the same treatment four times at a four-week interval. At each visit, visual analog scale (VAS), Foot Function Index (FFI) and IPK size were evaluated. VAS and FFI were also completed at a six and twelve-month follow-up. RESULTS: Our findings in regards to feasibility demonstrated recruitment challenges because of the anticipated pain that would be provoked by needle insertion may not be worth the potential pain relief compared to debridement alone from the patient's perspective. This was also the principal cause of drop out. Our preliminary results show no main effect of group for any of the clinical outcomes: pain felt on VAS, FFI score, IPK's size (p > 0.05). However, the analysis revealed a statistically significant effect of time on VAS (p < 0.001), FFI score (p < 0.001) and IPK's size (width and depth (p < 0.001); length (p = 0.001)), but no group x time interaction was found (p > 0.05). CONCLUSIONS: This study demonstrates that IPK treatment consisting of sharp debridement with needle insertion, physiological saline water injection or lidocaine injection is feasible and safe. There was a non-statistically significant trend toward diminishing pain intensity compared to scalpel debridement alone. The pain provoked by needle insertion and injection treatments must be addressed with a scientifically proven protocol to make it more comfortable for patients before these treatments could be considered in further studies. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04777227 . 2 March, 2021 - Retrospectively registered (All participants were recruited prior to registration).


Assuntos
Anestésicos Locais/administração & dosagem , Calosidades/terapia , Desbridamento/métodos , Ceratose/terapia , Lidocaína/administração & dosagem , Águas Salinas/administração & dosagem , Idoso , Desbridamento/instrumentação , Estudos de Viabilidade , Feminino , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Medição da Dor , Dor Processual/etiologia , Dor Processual/prevenção & controle , Método Simples-Cego , Resultado do Tratamento
4.
J Foot Ankle Res ; 14(1): 20, 2021 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-33743792

RESUMO

BACKGROUND: Minimally invasive surgery (MIS) procedures cause less trauma to the patient and might improve recovery. This study aimed to determine the efficacy and safety of condylectomy with MIS to treat interdigital corns of the lesser toes. METHODS: This prospective cohort study was conducted in seven podiatry centers. Patients with interdigital corns of the lesser toes, progressing for more than a year, with one or more recurrences in the last year following conservative treatments were eligible. The recruited patients were classified according to their treatment: conservative or surgical (condylectomy with MIS) and were compared. Patient satisfaction, pain, the clinical and functional status of the foot and the appearance of sequelae were assessed at 3 and 6 months after treatment. RESULTS: At 6 months, patients in the surgical treatment group showed no pain on pressure, which significantly differed from the conservative treatment group (p <  0.001). They also improved clinical and functional status of the foot, reaching values comparable to those of the standard population. No paresthesia, joint stiffness or instability, toe malalignment, or corn transfer to a contiguous site resulted from the surgical treatment. CONCLUSIONS: Condylectomy with MIS is effective and safe to treat interdigital corns of the lesser toes.


Assuntos
Calosidades/terapia , Tratamento Conservador/métodos , Doenças do Pé/terapia , Osteotomia/métodos , Podiatria/estatística & dados numéricos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Podiatria/métodos , Estudos Prospectivos , Dedos do Pé/patologia , Dedos do Pé/cirurgia , Resultado do Tratamento
6.
J Am Podiatr Med Assoc ; 110(4)2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32997761

RESUMO

BACKGROUND: Plantar hyperkeratotic lesions are prevalent foot problems in the older population, affecting 30% to 65% of people older than 65 years. Their onset is a common cause of foot pain due to the release of inflammatory mediators. Because of its simplicity, scalpel debridement is the most common treatment. We assessed how the degree of plantar hyperkeratosis debridement affects self-perception of pain in older people. METHODS: Three hundred older participants (mean ± SD age, 76.3 ± 7.4 years) were randomly allocated to receive full debridement (FD) of plantar hyperkeratoses, partial debridement (PD) of plantar hyperkeratoses, or debridement simulation (control group). Plantar hyperkeratotic pain was measured on a visual analog scale before treatment, just after treatment, 24 hours after treatment, and 7 days after treatment. RESULTS: Both FD and PD of plantar hyperkeratoses of the forefoot generate similar levels of self-perception of pain just after treatment (P = .32), 24 hours after treatment (P = .15), and 7 days after treatment (P = .22). Significant differences were found between the groups treated using a scalpel (FD and PD) and the control group just after treatment (P = .04 for FD; P = .05 for PD), 24 hours after treatment (P = .03 for FD; P = .04 for PD), and 7 days after treatment (P = .04 for FD and PD). CONCLUSIONS: The results of this trial suggest that there are no significant differences in pain reduction between PD and FD of forefoot plantar hyperkeratoses in older people.


Assuntos
Calosidades , Ceratodermia Palmar e Plantar , Idoso , Idoso de 80 Anos ou mais , Calosidades/cirurgia , Desbridamento , Humanos , Dor , Medição da Dor
8.
Diabetes Metab Syndr ; 14(3): 221-223, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32200305

RESUMO

Many types of skin lesions have been described in patients with diabetes, but prolonged prayer-induced hyperkeratosis and callous formation are rare. We describe such lesions in a 62-year-old Muslim patient with uncontrolled glycemia who practiced prolonged, repeated religious prayers in sitting position causing significant pressure over dorsum of both ankles. He developed prayer-induced callous formation on dorsum of both ankles, with more thickening and a healed ulcer on left. Prayer-induced skin lesions should be carefully managed in patients with diabetes, who are more vulnerable for infections and gangrene due to as venous/arterial insufficiency and peripheral neuropathy.


Assuntos
Calosidades/etiologia , Diabetes Mellitus Tipo 2/patologia , Pé Diabético/patologia , Pé/patologia , Hiperpigmentação/etiologia , Islamismo , Pele/patologia , Tornozelo/patologia , Calosidades/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Postura
9.
Genes (Basel) ; 11(2)2020 02 21.
Artigo em Inglês | MEDLINE | ID: mdl-32098197

RESUMO

Edelweiss (Leontopodium Alpinum) in the family Asteraceae is a wildflower that grows in rocky limestone places. Here, we investigated the efficacy of edelweiss callus culture extract (Leontopodium Alpinum callus culture extract; LACCE) using multiple assays from in vitro to in vivo as well as transcriptome profiling. Several in vitro assay results showed the strong antioxidant activity of LACCE in response to UVB treatment. Moreover, LACCE suppressed inflammation and wrinkling; however, moisturizing activity was increased by LACCE. The clinical test in vivo demonstrated that constant application of LACCE on the face and skin tissues improved anti-periorbital wrinkles, skin elasticity, dermal density, and skin thickness compared with the placebo. The RNA-Sequencing results showed at least 16.56% of human genes were expressed in keratinocyte cells. LACCE up-regulated genes encoding several KRT proteins; DDIT4, BNIP3, and IGFBP3 were involved in the positive regulation of the developmental process, programmed cell death, keratinization, and cornification forming skin barriers, which provide many advantages in the human skin. By contrast, down-regulated genes were stress-responsive genes, including metal, oxidation, wounding, hypoxia, and virus infection, suggesting LACCE did not cause any harmful stress on the skin. Our comprehensive study demonstrated LACCE is a promising agent for anti-aging cosmetics.


Assuntos
Envelhecimento/efeitos dos fármacos , Asteraceae/genética , Extratos Vegetais/farmacologia , Antioxidantes/farmacologia , Asteraceae/metabolismo , Calosidades/genética , Técnicas de Cultura de Células , Perfilação da Expressão Gênica/métodos , Humanos , Queratinócitos , Pele/efeitos dos fármacos , Transcriptoma/genética
11.
Mod Rheumatol ; 30(2): 287-292, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30836028

RESUMO

Objectives: We aimed to investigate the relationship of callosities of the forefoot with foot deformity, the Health Assessment Questionnaire Disability Index (HAQ-DI) and modified total Sharp score (TSS) in patients with rheumatoid arthritis (RA).Methods: A total of 202 patients and 404 feet were enrolled. We examined the prevalence of callosities. Clinical data included the HAQ-DI, TSS, hallux valgus angle (HVA), and calcaneal pitch angle (CPA). The analysis of factors associated with callosities of the forefoot was performed by comparing patients with and without callosities of the forefoot.Results: The prevalence of callosities was 31.2% of all patients and 24.0% of all feet. The patients with callosities of the forefoot had significantly higher TSS of the foot. The presence of callosities affected the HAQ-DI walking score. HVA and CPA were identified as being associated with callosities of the forefoot. Analyzing from the cutoff values, the odds ratios of HVA, CPA, and HVA and (combined) CPA were 4.64, 1.73, and 2.99, respectively.Conclusion: Hallux valgus and flatfoot were related to callosities of the forefoot in RA. This study suggested that to prevent callosities of the forefoot, early diagnosis and foot care for hallux valgus and flatfoot are needed in daily practice.


Assuntos
Artrite Reumatoide/epidemiologia , Calosidades/epidemiologia , Deformidades Adquiridas do Pé/epidemiologia , Adulto , Idoso , Artrite Reumatoide/patologia , Feminino , Articulações do Pé/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
12.
J Dairy Sci ; 103(2): 1843-1855, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31759610

RESUMO

A systematic review was conducted to elucidate the role of teat-end hyperkeratosis (THK) as a risk factor for clinical mastitis (CM) or subclinical mastitis (SCM). Scientific papers on the subject were identified by means of a database search. All types of peer-reviewed analytical studies, observational or experimental and published in English, could be included in the review, regardless of publication year. Of 152 identified records, 18 articles were selected, of which 8 were prospective cohort studies, 9 were cross-sectional, and 1 was a hybrid case-control study. Internal validity of studies was assessed using a score system ranging from 0 to 6, based on design, risk of bias, and statistical methods. The most frequent study limitation was improper use of statistical methods to avoid confounding of associations between THK and CM or SCM. The 3 studies that used CM as outcome (all with high validity scores) showed positive associations with THK (especially severe), although the magnitude and statistical significance of the estimates differed among them. Most studies that used SCM as the primary outcome (based on microbiological examination of milk) reported that only severe THK was associated with SCM. Two studies with high validity scores reported moderate to strong associations between severe THK and incidence or prevalence of Staphylococcus aureus intramammary infection. Two studies with high validity scores reported that only severe THK was associated with the risk of somatic cell count (SCC) ≥200,000 cells/mL and increased mean SCC, respectively. Although 4 cross-sectional studies reported positive associations between THK and SCC, these associations were possibly spurious because confounding factors, such as parity, were not considered in the analyses. Results of the reviewed studies suggest that severe THK is a risk factor for both CM and SCM, as defined by microbiological examination of milk, SCC thresholds, or mean SCC. The effect of severe THK on both contagious (especially Staphylococcus aureus) and environmental CM or SCM emphasizes the importance of teat health for mastitis control. Four studies demonstrated that quarters with mild THK had lower prevalence of intramammary infection or lower mean SCC than quarters with no THK, suggesting that development of mild THK, as a physiological response to milking, can have a protective effect. Dairy consultants should focus on monitoring and minimizing occurrence of severe THK to prevent CM and SCM.


Assuntos
Ceratose/veterinária , Mastite Bovina/epidemiologia , Leite/microbiologia , Infecções Estafilocócicas/veterinária , Staphylococcus aureus/isolamento & purificação , Animais , Calosidades/epidemiologia , Calosidades/veterinária , Estudos de Casos e Controles , Bovinos , Contagem de Células/veterinária , Estudos Transversais , Indústria de Laticínios , Feminino , Ceratose/epidemiologia , Glândulas Mamárias Animais/microbiologia , Mastite Bovina/microbiologia , Gravidez , Prevalência , Estudos Prospectivos , Fatores de Risco , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia
13.
Sci Rep ; 9(1): 17364, 2019 11 22.
Artigo em Inglês | MEDLINE | ID: mdl-31757982

RESUMO

Hallux valgus (HV) is a foot deformity that can be treated with Chevron osteotomy, and a modified plantarward oblique osteotomy has been proposed in recent years. However, no research has focused on the correctional power of the osteotomy. The aim of this study was to examine the character of this plantarward oblique Chevron osteotomy (POCO) and to determine the rationale of this method.Radiographs and clinical data from 65 HV patients (77 feet) with painful callosities were evaluated. The intermetatarsal angle, hallux valgus angle, and relative height of the second metatarsal were measured, and a valid width of the first metatarsal was proposed. A visual analogue scale (VAS) and the American Orthopaedic Foot and Ankle Society hallux-metatarsophalangeal interphalangeal scale (AOFAS) were used to evaluate the patients' clinical results.There were significant differences in the HVA and IMA. The decline in the height of the second metatarsal was positively related to the decline in the height of the first metatarsal, but the changes were smaller for the first metatarsal. Painful callosities disappeared in 77 feet, 4 (5.1%) patients had no pain but a remaining plantar callosity, and 2 (2.6%) patient had relieved pain with a plantar callosity after follow-up. The VAS scores improved from 8.58 ± 0.50 to 1.96 ± 0.75 points after the operation (p < 0.001). Significant differences were demonstrated in the AOFAS scores (65.81 ± 4.05 vs 87.88 ± 3.41, p < 0.001). The modified POCO prevents the dorsal migration of the metatarsal head, preserves other lesser metatarsals and provides an opportunity for patients who may possibly need additional future deformity correction. Therefore, POCO is a safe and effective method to treat hallux valgus and offers the superior potential benefits of correction and transfer metatarsalgia.


Assuntos
Calosidades/cirurgia , Hallux Valgus/cirurgia , Osteotomia/métodos , Dor/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Adulto , Idoso , Artralgia/diagnóstico por imagem , Artralgia/cirurgia , Calosidades/complicações , Calosidades/diagnóstico por imagem , Feminino , Seguimentos , Hallux Valgus/complicações , Hallux Valgus/diagnóstico por imagem , Humanos , Masculino , Ossos do Metatarso/diagnóstico por imagem , Ossos do Metatarso/cirurgia , Metatarso Valgo/diagnóstico por imagem , Metatarso Valgo/cirurgia , Articulação Metatarsofalângica/diagnóstico por imagem , Articulação Metatarsofalângica/cirurgia , Pessoa de Meia-Idade , Procedimentos Ortopédicos/efeitos adversos , Procedimentos Ortopédicos/métodos , Osteotomia/efeitos adversos , Dor/diagnóstico por imagem , Dor/etiologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Resultado do Tratamento
14.
Nature ; 571(7764): 261-264, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31243365

RESUMO

Until relatively recently, humans, similar to other animals, were habitually barefoot. Therefore, the soles of our feet were the only direct contact between the body and the ground when walking. There is indirect evidence that footwear such as sandals and moccasins were first invented within the past 40 thousand years1, the oldest recovered footwear dates to eight thousand years ago2 and inexpensive shoes with cushioned heels were not developed until the Industrial Revolution3. Because calluses-thickened and hardened areas of the epidermal layer of the skin-are the evolutionary solution to protecting the foot, we wondered whether they differ from shoes in maintaining tactile sensitivity during walking, especially at initial foot contact, to improve safety on surfaces that can be slippery, abrasive or otherwise injurious or uncomfortable. Here we show that, as expected, people from Kenya and the United States who frequently walk barefoot have thicker and harder calluses than those who typically use footwear. However, in contrast to shoes, callus thickness does not trade-off protection, measured as hardness and stiffness, for the ability to perceive tactile stimuli at frequencies experienced during walking. Additionally, unlike cushioned footwear, callus thickness does not affect how hard the feet strike the ground during walking, as indicated by impact forces. Along with providing protection and comfort at the cost of tactile sensitivity, cushioned footwear also lowers rates of loading at impact but increases force impulses, with unknown effects on the skeleton that merit future study.


Assuntos
Calosidades/fisiopatologia , Pé/patologia , Pé/fisiologia , Dor/fisiopatologia , Tato/fisiologia , Caminhada/fisiologia , Adulto , Boston , Calosidades/patologia , Feminino , Fricção/fisiologia , Dureza/fisiologia , Humanos , Quênia , Masculino , Pessoa de Meia-Idade , Estimulação Física , Pressão , Sapatos , Fenômenos Fisiológicos da Pele , Suporte de Carga/fisiologia , Adulto Jovem
15.
J Foot Ankle Res ; 12: 13, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30815036

RESUMO

Background: Descriptions of the techniques for condylectomies via minimally invasive surgery (MIS) to treat interdigital helomas of the lesser toes are scarce in the literature. This study aimed to define and describe this surgical technique. Methods: This observational study was performed using the Delphi method. We collected the anonymous opinions of a multidisciplinary international panel of ten experts by answering a 43-items questionnaire via e-mail. Statements with an average score ≥ 3 were included in the next round, as were those in which none of the three statements reached the minimum score of 3 within the same item. Results: Response rate: 90%. Three rounds were needed to reach consensus on proposed items. A new statement that combined two statements was proposed in round 3. Eleven recommendations regarding the incision and instruments used to perform this surgical technique were obtained based on the expert consensus. Conclusions: A longitudinal incision to the distal pulp of the toe or an incision to the centre of the plantar aspect of the head of the proximal phalanx should be performed according to the affectation, and a Beaver 64 scalpel blade, a blunt elevator and a Shannon-Isham burr are the most acceptable tools for this kind of surgery.


Assuntos
Calosidades/cirurgia , Osteotomia/métodos , Dedos do Pé/cirurgia , Anestesia Local/métodos , Técnica Delfos , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos
16.
Sensors (Basel) ; 18(10)2018 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-30274209

RESUMO

Excessive pressure and shear stress while walking cause a risk of callus formation, which eventually causes foot ulcers in patients with diabetes mellitus. Callus under the second metatarsal head (MTH) has been associated with increased shear stress/pressure ratios (SPR). Callus under the fifth MTH has been associated with increased peak shear stress (PSS). The purpose of this study is to examine whether the effect of the suitable size and width of shoes prevents diabetic foot ulcers under the second and fifth MTH. We measured the pressure and shear stress by testing three kinds of sizes and two types of width of shoes. Significant difference was not observed in the SPR under the second MTH among different sizes of shoes. However, the pressure and shear stress were significantly lower when putting on shoes of fit size compared with larger sizes. The PSS under the fifth MTH was significantly smaller when putting on shoes of fit width compared with those of narrow width. Wearing shoes of fit size and width has the potential to prevent callus formation by reducing the pressure and shear stress constituting SPR under the second MTH and PSS under the fifth MTH.


Assuntos
Calosidades/prevenção & controle , Pé/anatomia & histologia , Ossos do Metatarso/anatomia & histologia , Sapatos/estatística & dados numéricos , Adulto , Pé Diabético/prevenção & controle , Feminino , Voluntários Saudáveis , Humanos , Pressão , Caminhada
18.
Acta Vet Scand ; 60(1): 2, 2018 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-29325588

RESUMO

BACKGROUND: Having a poor teat-end condition is associated with increased mastitis risk, hence avoiding milking machine settings that have a negative effect on teat-end condition is important for successful dairy production. Milking-time testing (MTT) can be used in the evaluation of vacuum conditions during milking, but the method is less suited for herds using automatic milking systems (AMS) and relationships with teat end condition is poorly described. This study aimed to increase knowledge on interpretation of MTT in AMS and to assess whether milk-flow data obtained routinely by an AMS can be useful for the management of teat-end health. A cross-sectional study, including 251 teats of 79 Norwegian Red cows milked by AMS was performed in the research herd of the Norwegian University of Life Sciences. The following MTT variables were obtained at teat level: Average vacuum level in the short milk tube during main milking (MTVAC), average vacuum in the mouthpiece chamber during main milking and overmilking, teat compression intensity (COMPR) and overmilking time. Average and peak milk flow rates were obtained at quarter level from the AMS software. Teat-end callosity thickness and roughness was registered, and teat dimensions; length, and width at apex and base, were measured. Interrelationships among variables obtained by MTT, quarter milk flow variables, and teat dimensions were described. Associations between these variables and teat-end callosity thickness and roughness, were investigated. RESULTS: Principal component analysis showed clusters of strongly related variables. There was a strong negative relationship between MTVAC and average milk flow rate. The variables MTVAC, COMPR and average and peak milk flow rate were associated with both thickness and roughness of the callosity ring. CONCLUSIONS: Quarter milk flow rate obtained directly from the AMS software was useful in assessing associations between milking machine function and teat-end condition; low average milk flow rates were associated with a higher likelihood of the teat having a thickened or roughened teat-end callosity ring. Since information on milk flow rate is readily available from the herd management system, this information might be used when evaluating causes for impaired teat-end condition in AMS.


Assuntos
Calosidades/prevenção & controle , Indústria de Laticínios/métodos , Lactação/fisiologia , Glândulas Mamárias Animais/patologia , Animais , Calosidades/etiologia , Calosidades/patologia , Bovinos , Estudos Transversais , Indústria de Laticínios/instrumentação , Feminino , Análise de Componente Principal , Fatores de Tempo
19.
Ann Plast Surg ; 80(2S Suppl 1): S55-S58, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29369100

RESUMO

INTRODUCTION: Plantar hyperkeratosis, such as corns and calluses, is common in older people and associated with pain, mobility impairment, and functional limitations. It usually develops on the palms, knees, or soles of feet, especially under the heels or balls. There are several treatment methods for plantar hyperkeratosis, such as salicylic acid plaster and scalpel debridement, and conservative modalities, such as using a shoe insert and properly fitting shoes. METHODS: We present an effective method of reconstructing the wound after corn excision using a split-thickness sole skin graft (STSSG). We harvested the skin graft from the arch of the sole using the dermatome with a skin thickness of 14/1000th inches. RESULTS: Because the split-thickness skin graft, harvested from the sole arch near the distal sole, is much thicker than the split-thickness skin graft from the thigh, it is more resistant to weight and friction. The healed wound with STSSG coverage over the distal sole was intact, and the donor site over the sole arch had healed without complication during the outpatient follow-up, 3 months after surgery. CONCLUSIONS: The recovery time of STSSG for corn excision is shorter than that with traditional treatment. Therefore, STSSG can be a reliable alternative treatment for recurrent palmoplantar hyperkeratosis.


Assuntos
Calosidades/cirurgia , Doenças do Pé/cirurgia , Placa Plantar/cirurgia , Transplante de Pele/métodos , Cicatrização/fisiologia , Idoso , Calosidades/diagnóstico , Estudos de Coortes , Desbridamento/métodos , Feminino , Doenças do Pé/diagnóstico , Sobrevivência de Enxerto , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Placa Plantar/fisiopatologia , Prognóstico , Recidiva , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Coleta de Tecidos e Órgãos/métodos , Resultado do Tratamento
20.
Dis Mon ; 64(3): 64-91, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28826743

RESUMO

Ageing process is associated with changes to the aspect, biomechanics, structure and function of the foot, it may be related with a marked presence of foot conditions, pain, disability and other overall health problems that constitute a major public health concern. Also, the prevalence of epidemiologic research found an incidence of foot problems which is even higher as a consequence of increasing life expectation. Several studies have also suggested that such foot disorders currently affect between 71 and 87% of older patients and are a frequent cause of medical and foot care. Thus, these kind problems are extremely common conditions in the general population, especially in the elderly who are associated with poor quality of life, balance impairment, increase the risk of falls, dificulty on putting shoes, fractures, restrict mobility and performance of activities of daily living that turn can produce serious physical, mental and social consequences in the older people. The role of the physician in the assessment, evaluation, and examination of foot problems is very important, yet it is often an overlooked and undervalued component of geriatric health care. The purpose of this article is to review and to provide an overview of the most common foot deformities precipitating factors, clinical presentation, evidence-based diagnostic evaluation, and treatment recommendations with a view to preventing medical conditions or deformities affecting the feet that may alter foot condition and general health amongst the elderly.


Assuntos
Doenças do Pé/fisiopatologia , Dor/psicologia , Qualidade de Vida , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Calosidades/fisiopatologia , Feminino , Deformidades Adquiridas do Pé/fisiopatologia , Doenças do Pé/complicações , Doenças do Pé/psicologia , Avaliação Geriátrica , Humanos , Masculino , Osteoartrite/fisiopatologia , Dor/etiologia , Fatores de Risco
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