The effect of flexor tenotomy on healing and prevention of neuropathic diabetic foot ulcers on the distal end of the toe

Background Flexor tenotomy is a minimally invasive surgical alternative for the treatment of neuropathic diabetic foot ulcers on the distal end of the toe. The influence of infection on healing and time to heal after flexor tenotomy is unknown. Flexor tenotomy can also be used as a prophylactic treatment. The effectiveness as a prophylactic treatment has not been described before. Methods A retrospective study was performed with the inclusion of all consecutive flexor tenotomies from one hospital between January 2005 and December 2011. Results From 38 ulcers, 35 healed (92%), with a mean time to heal of 22 ± 26 days. The longest duration for healing was found for infected ulcers that were penetrating to bone (35 days; p = .042). Cases of prophylactic flexor tenotomies (n=9) did not result in any ulcer or other complications during follow-up. Conclusions The results of this study suggest that flexor tenotomy may be beneficial for neuropathic diabetic foot ulcers on the distal end of the toe, with a high healing percentage and a short mean time to heal. Infected ulcers that penetrated to bone took a significantly longer time to heal. Prospective research, to confirm the results of this retrospective study, should be performed.

Functionally different pads on the same foot allow control of attachment: stick insects have load-sensitive "heel" pads for friction and shear-sensitive "toe" pads for adhesion.

Stick insects (Carausius morosus) have two distinct types of attachment pad per leg, tarsal "heel" pads (euplantulae) and a pre-tarsal "toe" pad (arolium). Here we show that these two pad types are specialised for fundamentally different functions. When standing upright, stick insects rested on their proximal euplantulae, while arolia were the only pads in surface contact when hanging upside down. Single-pad force measurements showed that the adhesion of euplantulae was extremely small, but friction forces strongly increased with normal load and coefficients of friction were [Formula: see text] 1. The pre-tarsal arolium, in contrast, generated adhesion that strongly increased with pulling forces, allowing adhesion to be activated and deactivated by shear forces, which can be produced actively, or passively as a result of the insects' sprawled posture. The shear-sensitivity of the arolium was present even when corrected for contact area, and was independent of normal preloads covering nearly an order of magnitude. Attachment of both heel and toe pads is thus activated partly by the forces that arise passively in the situations in which they are used by the insects, ensuring safe attachment. Our results suggest that stick insect euplantulae are specialised "friction pads" that produce traction when pressed against the substrate, while arolia are "true" adhesive pads that stick to the substrate when activated by pulling forces.

Cannibal Animal Games: A new variant of Tic-Tac-Toe

This paper presents a new partial two-player game, called the cannibal animal game, which is a variant of Tic-Tac-Toe. The game is played on the infinite grid, where in each round a player chooses and occupies free cells. The first player Alice can occupy a cell in each turn and wins if she occupies a set of cells, the union of a subset of which is a translated, reflected and/or rotated copy of a previously agreed upon polyomino P (called an animal). The objective of the second player Bob is to prevent Alice from creating her animal by occupying in each round a translated, reflected and/or rotated copy of P. An animal is a cannibal if Bob has a winning strategy, and a non-cannibal otherwise. This paper presents some new tools, such as the bounding strategy and the punching lemma, to classify animals into cannibals or non-cannibals. We also show that the pairing strategy works for this problem.

From head to toe.'De la cabeza al dedo del pie'.

Unidad didáctica del área de lengua inglesa. Se presentan una serie de secuencias de actividades que posibilitan la utilización integrada de las diferentes dimensiones de la competencia en comunicación lingüística: hablar, escuchar, preguntar y contestar oralmente, leer y escribir. Se propone una progresión real de las tareas, situaciones de comunicación y tipologías textuales que van respondiendo a la evolución tanto de los intereses del alumnado como de sus necesidades de comunicación. La unidad se estructura en dos bloques: uno, referente al material del profesor con orientaciones para el desarrollo; y el otro, al del alumno, con actividades.

From head to toe.

Los niños realizan movimientos con sus cuerpos a imitación de los que realizan los animales, que les preguntan si ellos también pueden hacerlos. Mover los brazos como un mono, aplaudir con las manos al igual que una foca, girar el cuello como una jirafa, son algunos ejemplos de los ejercicios para realizar individualmente o en grupo.

Estudo do processo de combustão in-situ usando poços horizontais como produtores de óleo (Toe-to-Hell Air Injection)

The method "toe-to-heel air injection" (THAITM) is a process of enhanced oil recovery, which is the integration of in-situ combustion with technological advances in drilling horizontal wells. This method uses horizontal wells as producers of oil, keeping vertical injection wells to inject air. This process has not yet been applied in Brazil, making it necessary, evaluation of these new technologies applied to local realities, therefore, this study aimed to perform a parametric study of the combustion process with in-situ oil production in horizontal wells, using a semi synthetic reservoir, with characteristics of the Brazilian Northeast basin. The simulations were performed in a commercial software "STARS" (Steam, Thermal, and Advanced Processes Reservoir Simulator), from CMG (Computer Modelling Group). The following operating parameters were analyzed: air rate, configuration of producer wells and oxygen concentration. A sensitivity study on cumulative oil (Np) was performed with the technique of experimental design, with a mixed model of two and three levels (32x22), a total of 36 runs. Also, it was done a technical economic estimative for each model of fluid. The results showed that injection rate was the most influence parameter on oil recovery, for both studied models, well arrangement depends on fluid model, and oxygen concentration favors recovery oil. The process can be profitable depends on air rate

Broiler walking ability and toe asymmetry under harsh rearing conditions

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

One step forward: contrasting the effects of Toe clipping and PIT tagging on frog survival and recapture probability

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Predicting the pathogen of diabetic toe osteomyelitis by two consecutive ulcer cultures with bone contact

In this study, we investigate the accuracy of two consecutive ulcer cultures with bone contact compared to bone biopsy for the diagnosis of diabetic toe osteomyelitis. The same nurse and orthopaedic surgeon obtained all samples: sample A-1: bone contact swabbing through the ulcer; sample A-2: a second culture swabbing from the bone surface within 24 h; sample B: surgical bone biopsy in the operating theatre. The kappa statistic measure between samples A-1 and A-2 (bone contact swabs) indicated 82.35% agreement. The sensitivity, specificity, positive and negative predictive values of the two samples A compared to B were 96%, 79%, 92% and 88%, respectively, for the causative pathogen. These results were similar with prior antibiotic treatment, discordant bone surface swabs or with monomicrobial infections. As a conclusion, two consecutive diabetic toe cultures with bone contact accurately predict the pathogen of diabetic toe osteomyelitis in 90% of cases.

Excision arthroplasty as a therapy for recurring osteoarthritis of the toe joint of dogs

Chronic osteoarthritis of the metacarpophalangeal joint is predominantly observed in working dogs. Surgical intervention is often required to maintain a functional limb. Excision arthroplasty represents a simple, relatively quick and cosmetically esthetic alternative to arthrodesis, endoprosthesis or amputation. In the present study, the technique of excision arthroplasty is described and discussed as a treatment method for chronic osteoarthritis of the metacarpophalangeal joint.