Functional outcome of gastrocnemius advancement flap augmented with short flexor hallucis longus tendon transfer in chronic Achilles tear

BackgroundThere are various techniques of Achilles tendon (TA) repair and reconstruction in chronic Achilles tear. However, there is no clear consensus on the relevance of one method over the other. The short flexor hallucis longus tendon (FHL) transfer has recently gained popularity because of its same phasic action, ease of harvesting and tensile strength.MethodologyFifteen chronic Achilles tear (>6 weeks) were treated with tendon repair using gastrocnemius advancement flap augmented with FHL transfer. The patients were followed-up at 1.5, 3, 6, 12 and 24 months. The clinical outcome at latest follow-up was evaluated using the American Orthopedic Foot and Ankle Score (AOFAS) and the Achilles Tendon Rupture Score (ATRS).ResultsThe mean age was 43.5 ± 12.4 years and the median time from injury to surgery was 17.13 ± 9.64 weeks. The mean gap between the retracted ends of the ruptured tendon was 5.67 ± 1.63 cm (range 4–10 cm). The mean follow-up was 19.07 ± 3.15 months (range, 13–24 months). The mean AOFAS and ATRS improved from 72.07 ± 8.29 (62–83) to 98.4 ± 2.03 (94–100) and 61.73 ± 8.16 (52–70) to 98 ± 1.85 (94–100) respectively (paired t-test, p-value 0.0001). All patients resumed their pre-injury daily activities, and there was no donor site morbidity. Two patients had sterile serous discharge, and one patient had a staphylococcus infection. These patients responded to debridement with prolonged antibiotic therapy. There were no nerve injuries or re-rupture.ConclusionThe functional outcome of chronic Achilles tear treated with gastrocnemius advancement flap augmented with short FHL transfer is rewarding.     

全球卫生治理视角下被忽视的热带病防治与国际合作

被忽视的热带病 （Neglected tropical diseases,NTDs） 是一组地方性传染病, 主要流行于贫穷、 湿热的热带与热带病地区。2012年1月WHO发布的2020年全球NTDs防治战略-- “加快消除被忽视的热带病对全球的影响： 行动路线图” （简称路线图） 以及由全球合作伙伴联合签署的 《对抗NTDs伦敦宣言》 标志着NTDs的控制与消除已被纳入到全球公共卫生日程。本文旨在以全球卫生治理的视角对当前的NTDs防治策略进行全面的解读, 对中国参与国际合作的途径进行探讨。     

Attachment Styles in Maltreated Children: A Comparative Study

The study compares the emotional impact of maltreatment on the attachment styles in three groups of children aged 6–12 years: children of drug-user fathers (n = 76), physically abused children (n = 41), neglected children (n = 38); non-abused/non-neglected children (n = 35)—control group. The secure style characterized 52% of the children of drug-user fathers and the insecure style characterized the other 48% (anxious/ambivalent or avoidant); physically abused children were characterized mainly by the avoidant attachment style, and neglected children by the anxious/ambivalent style. The conclusion is that physically abused children are at risk of antisocial behavior and sustained suspicion towards others; neglected children are at risk of social withdrawal, social rejection and feelings of incompetence, and children of drug-user fathers may be at risk of behavioral problems and drug use in adolescence.     

Efforts to mitigate the economic impact of the COVID-19 pandemic: potential entry points for neglected tropical diseases

Background::The damage inflicted by the coronavirus diseases 2019 (COVID-19) pandemic upon humanity is and will continue to be considerable. Unprecedented progr...     

A rare case of condiobolomycosis due to Conidiobolus coronatus presenting with dysphagia

Conidiobolomycosis is a neglected tropical fungal infection involving the head and neck region. Here we report the first case of atypical conidiobolomycosis presenting with dysphagia and significant weight loss from Odisha, India. It was diagnosed by histopathology and fungal culture and was suscessfully treated with saturated solution of potassium iodide.     

Sporotrichosis: hyperendemic by zoonotic transmission,with atypical presentations,hypersensitivity reactions and greater severity

In recent decades, an alarming increase in the number of sporotrichosis cases has been reported in southern and southeastern Brazil, especially in the state of Rio de Janeiro, has been considered a long-term hyperendemic condition associated with feline transmission. According to phenotypic classifications, the Sporothrix species recovered from cats were classified as S. brasiliensis in 96.5% of the studied cases. This finding has also been demonstrated in humans, which confirms the zoonotic transmission associated with this predominant species in Brazil. The zoonotic transmission of the fungus and its important virulence in the context of the hyperendemic situation in Rio de Janeiro have changed the approach to the disease, which in its classic form was restricted to certain professional groups and very specific regions in the Brazilian territory, into a public health challenge of scientific interest. Its atypical manifestations and hypersensitivity reactions are increasingly frequent, constituting a new sporotrichosis aspect, which deserves attention from the medical community, as well as from other health professionals.