Eficácia das palmilhas customizadas na melhora da distribuição da pressão plantar em pacientes com neuropatia diabética: Protocolo de um ensaio clínico randomizado e controlado / Efficacy of customized insoles in the improvement of plantar pressure in patients with diabetic neuropathy: Protocol of a randomized and controlled clinical trial

OBJETIVO: Avaliar a influência das palmilhas customizadas na pressão plantar de diabéticos com neuropatia em comparação ao grupo sham. MÉTODOS: O método do estudo, devidamente registrado no Registro Brasileiro de Ensaios Clínicos ­ REBEC (Clinical Trial Brazilian Register) (http://www.ensaiosclinicos.gov.br/) RBR-5NQK4K, incluiu um ensaio clínico randomizado, controlado, prospectivo, duplo-cego, com uma amostra de 46 voluntários que serão randomizados aleatoriamente numa razão de 1: 1 para serem direcionados aos grupos intervenção e controle. O grupo intervenção receberá palmilhas customizadas, com barra retrocapital e placa de etil vinil acetato (EVA) no mesmo formato da barra retrocapital, com a finalidade de reduzir a pressão no antepé. No grupo controle, as palmilhas planas serão confeccionadas sem nenhum objetivo terapêutico. Este projeto foi conduzido de acordo com o padrão de protocolo para ensaios clínicos randomizados (SPIRIT). Junto com a avaliação clínica, serão coletados dados demográficos da amostra para identificar e confirmar a presença de neuropatia periférica, em seguida, será avaliada a podobarografia e, por fim, os pacientes responderão ao questionário FAAM para avaliação da funcionalidade do pé. O desfecho primário será a análise dos pontos de pressão em KiloPascal (kPa) no pé dos pacientes com neuropatia diabética por meio da podobarografia nos pacientes do grupo intervenção e controle. O desfecho secundário será a funcionalidade do pé nas atividades de vida diária através do questionário FAAM (Foot and Ankle Ability Measure), considerando os voluntários na avaliação inicial, 3º e 6º meses. CONSIDERAÇÕES FINAIS: os futuros resultados deste estudo nos mostrarão principalmente se há ou não uma alteração estrutural na análise da pressão plantar decorrente do uso contínuo da palmilha, além de avaliar se o uso da palmilha terapêutica é eficaz na funcionalidade do pé nos mesmos portadores quando comparado à palmilha sham.

| OBJECTIVE: To evaluate the influence of customized insoles in the plantar pressure of diabetes patients with neuropathy in comparison to the sham group. METHODS: The work method, duly registered at the Registro Brasileiro de Ensaios Clínicos ­ REBEC (Clinical Trial Brazilian Register) (http://www.ensaiosclinicos.gov.br/) RBR-5NQK4K, includes a randomized, controlled, prospective, doubleblinded clinical trial, with a sample of 46 volunteers that will be randomly randomized in a 1: 1 ratio to be referred to intervention and control groups. The intervention group will receive customized insoles, with a retrocapital bar and an ethyl vinyl acetate plaque (EVA) in the same shape as the retrocapital bar, in order to reduce the pressure on the forefoot. In the control group, flat insoles will be prepared without any therapeutic objective. This project was developed according to the standard protocol for randomized clinical trials (SPIRIT). Along with the clinical evaluation, demographic data of the sample will be collected to identify and confirm the presence of peripheral neuropathy, next, the pedobarographic will be evaluated, and finally, the patients will answer the FAAM questionnaire to assess foot functionality. The primary outcome will be analyzing pressure points in KiloPascal (kPa) in the patients' feet through pedobarographic of the patients in the intervention and control groups. The secondary outcome will be the foot functionality in activities of daily living through the FAAM (Foot and Ankle Ability Measure), considering the volunteers in the initial evaluation, third and sixth months. FINAL CONSIDERATIONS: Mainly, results of this study will show whether there is a structural alteration in the analysis of the plantar pressure due to the continuous use of insoles and present the evaluation of whether the use of therapeutic insoles improves the foot functionality of the same users when compared to sham insoles.

Eccrine Angiomatous Hamartoma: A Review of Ten Cases

BACKGROUND: Eccrine angiomatous hamartoma (EAH) is a rare benign nodular lesion characterized by the proliferation of eccrine and vascular structures, generally capillaries, in the middle and deep dermis. It may be congenital or appear later in childhood, but rarely arises in adulthood. OBJECTIVE: To investigate the clinicopathologic features of EAH in Korean patients. METHODS: Ten cases of EAH diagnosed at Ajou University Hospital and Gangnam Severance Hospital in Korea from 2007 to 2010 were retrospectively reviewed. RESULTS: The age range of patients was between 5 and 66 years with an equal number of male and female patients. Apart from two congenital cases, the onset was late, ranging from 6 months to 65 years of age. All lesions were solitary and located on the distal extremities. Nine cases appeared as a yellow-brown nodule or plaque resembling a callus. Neither hyperhidrosis nor hypertrichosis was documented. Apart from the typical histological findings of EAH, prominent mucin deposition, fat component and nerve infiltration were observed. CONCLUSION: This is one of the largest single case series of EAH in the literature. Clinically, resemblance to callosities and the frequent occurrence in the adulthood were the unique features in our series.

BAP, 2,4-D e ácido acetilsalicílico na indução e diferenciação de calos em anteras de Coffea arabica L / BAP, 2,4-D and acetyl-salicylic acid on the callus induction and differentiation in Coffea arabica L. anthers

O melhoramento genético do cafeeiro por meio de métodos convencionais é um processo demorado para se obter uma nova cultivar. A redução desse tempo é possível através da produção de linhagens homozigóticas, oriundas de dihaplóides obtidas através da cultura de anteras. Objetivou-se aplicar a técnica da cultura de anteras em diferentes cvs. de Coffea arabica L. para induzir a formação de calos e regenerar plântulas di-haplóides, com uso de reguladores vegetais. Os experimentos foram conduzidos no laboratório de Biotecnologia Vegetal da Universidade Federal de Uberlândia (UFU). Anteras das cultivares Mundo Novo LCP-379-19 e Catuaí Vermelho H2077-2-5-44 foram inoculadas em meio MS suplementado com 2,0 mg L-1 de 2,4-D e AAS, nas concentrações de 0; 8; 16; 32 e 64 mg L-1. Calos de 'Catuaí Vermelho 44' foram subcultivados em meio MS acrescido de diferentes concentrações de BAP (0; 2; 4 e 8 mg L-1) e 2,4-D (0; 1; 2 e 4 mg L-1). Tanto para as cvs. Mundo Novo quanto para Catuaí Vermelho 44 o aumento das concentrações de AAS diminuiu a formação de próembrióides nos calos e somente o 2,4-D foi capaz de promover a formação de calos friáveis, porém o equilíbrio da auxina e da citocinina utilizadas no trabalho, favoreceram a produção de calos friáveis.

Coffee plant breeding through conventional methods demands a long time to obtain new cultivars. The reduction of this period is possible through the production of homozygous lines, from dihaploids obtained via anther culture. The aim of this study was to apply the anther culture technique on different C. arabica L. cultivars to induce calli formation and to regenerate dihaploid seedlings with the use of plant growth regulators. The experiments were accomplished in the Plant Biotechnology laboratory at Uberlândia Federal University (UFU). Anthers of the cultivars Mundo Novo LCP-379-19 and Catuaí Vermelho H2077-2-5-44 were inoculated on MS medium supplemented with 2.0 mg L-1 2,4-D and ASA at 0, 8, 16, 32 or 64 mg L-1. 'Catuaí Vermelho 44' calli were subcultured on MS supplemented with different concentrations of BAP (0, 2, 4 or 8 mg L-1) and 2,4-D (0, 1, 2 or 4 mg L-1). The increase in ASA concentrations decreased the pro-embryoid formation on calli of both cultivars and only 2,4-D promoted the formation of friable calli. However, the balance of auxin and cytokinin used in this study favored the production of friable calli.

Treatment of Bunionette Deformity with Diaphyseal Oblique Osteotomy / 대한족부족관절학회지

PURPOSE: The authors intended to evaluate the results of symptomatic bunionette treated with a diaphyseal oblique osteotomy. MATERIALS AND METHODS: Nine patients were followed for more than 1 year after diaphyseal oblique osteotomy for a bunionette deformity with plantar callosity. The mean age was 43 years (23-69 years), and the mean follow-up period was 27 months (12-70 months). As a combined disorder, 7 patients had hallux valgus, for which 3 distal metatarsal oteotomies, 3 proximal osteotomies, and 1 double osteotomy were performed. Clinically, preoperative and postoperative AOFAS MP-IP scale, patient's satisfaction, postoperative complications were analyzed. Radiologically, the 4th intermetatarsal angle and the 5th metatarso-phalangeal angle were analyzed. RESULTS: Clinically, AOFAS MP-IP scale was increased from 59 points preoperatively to 93 points postoperatively, and all patients were satisfied with the results. The plantar callosity had all disappeared at the final follow up. The 4th intermetatarsal angle was decreased from 12.6degrees preoperatively to 4.3degrees postoperatively, and the 5th metatarso- phalangeal angle was decreased from 21.9degrees preoperatively to 2.4degrees postoperatively. There were no significant postoperative complications. CONCLUSION: Diaphyseal oblique osteotomy of the 5th metatarsal appears to be safe and satisfactory procedure for the treatment of a symptomatic bunionette with plantar callosity.

Rehabilitation Management of Foot Pain

Foot problems are common in elderly patients, and the relief of foot pain can increase the rehabilitative potential for patients with chronic diseases, impairments, or disabilities. The author presents a detailed description of techniques for the clinical management of hallux valgus, plantar fascitis, callosities, and myofascial pain syndrome. The focus is clinical and practical, i.e., based upon common foot conditions seen in clinical practice.