Dissertationen zum Thema „Foot diseases“

Within East African countries many of the known infectious diseases of animals occur commonly and are poorly controlled. Foot-and-mouth disease (FMD) is one of the contagious viral diseases that has great impact on economic development both in terms of direct and indirect losses. The epidemiology of the disease is complex due to the presence of six of the seven serotypes and the presence of large numbers of both wild and domestic susceptible animals in the region. Decision-making to determine the importance of FMD control relative to the economic consequences and what FMD control strategies should be applied based on the epidemiological information is required. In this regard the first step is to investigate the genetic relationships/variability of East African isolates and their phylogeographic distribution. These can provide base-line information for designing control strategies by vaccination as well as the determination of the sources of infection. Sufficient genetic information on the FMO serotypes O, SAT-1 and SAT-2 are lacking and therefore the number of viral Iineages and genotypes or topotypes from East African countries could not be determined. Published studies on the relative occurrence and genotype distribution of FMO are largely confined to the southern and western part of the continent. In this study, the genetic profile of the 3 most prevalent serotypes (0, SAT-2 and SAT-1) recovered from outbreaks in East Africa between 1957 and 2003 was addressed. Phylogenetic analysis of partial and complete sequences of the 10 gene revealed the presence of distinct lineages and genotypes for East Africa as well as historical relationships of some of the genotypes with isolates from other regions. A great variation in the occurrence and distribution of these serotypes were found. All the African and the Middle East/South East Asian isolates of serotype O included in this study clustered into one lineage having 8 distinct topotypes. These results indicated that between countries as well as inter-regional (east and west Africa) spread of viruses occurred in the past. Inter-regional spread of the virus between eastern Africa and western Africa was also confirmed for SAT-1 viruses. The fact that phylogenetic links are found with both serotypes implies that the spread of viruses was possibly associated with unrestricted animal movement due to nomadic movement in Africa. The phylogenetic relationships of SAT-1 viruses are more diversified in Africa. Eight lineages and 11 genotypes were identified when the optimal nucleotide sequence differences of ≥ 23% for lineages and ≥ 6% for genotypes were used as a cut-off values. It was observed that viruses from Uganda are evolving independently from viruses elsewhere on the continent and clustered into 3 discrete lineages. In contrast, viruses from countries neighbouring Uganda, Kenya and Tanzania, clustered into one lineage. Uganda also harboured 3 topotypes of SAT-2 virus isolates, one is distinct for Uganda and the other are shared with Kenya and Zaire (DRC). This study highlighted distinct lineages found in Uganda and needs further investigation. Within SAT-2, 67 isolates from 22 African countries and Saudi Arabia clustered into 5 lineages which consisted of 15 genotypes. Clustering of viruses into distinct genotypes (topotypes) according to year of isolation and geographical origin was observed showing countries with common boundaries shared common epizootics in the past. These results also showed a link between eastern and southern African countries. Attempts were also made to investigate the incidence of FMD in Ethiopia using sera collected from cattle, small ruminants and wildlife. The results obtained from the liquid phase blocking ELISA and the 3ABC ELISA indicated the presence of SAT-1 and SAT-2 in buffalo populations in the southern part of Ethiopia while results from small ruminants and other wildlife were not indicative of any significant role in the epidemiology of FMD. Serological results also indicated that SAT-1 is present in cattle, although this serotype has not been previously identified. The cumulative molecular epidemiological results from this and previous studies indicated that genetic variability of FMD viruses can be independently maintained within country/countries or regions as well as inter-regions of Africa. The serological results from buffaloes in East Africa are also suggestive of a possible reservoir of the SAT types FMD in the region which has a great impact on the control of the disease. Furthermore, the numerous lineages and genotypes of FMD virus isolates in Africa having distinct or overlapping distributions as well as the genetic linkage between regions will complicate the epidemiology of the disease. Therefore, it is strategically important to consider a regional approach and the use of a vaccine which contains a cocktails of antigens of FMD virus strains.
Thesis (PhD)--University of Pretoria, 2004.
Veterinary Tropical Diseases
unrestricted

Dissertation (PhD (Agric))--University of Stellenbosch, 2005.
ENGLISH ABSTRACT: During the past few years a drastic reduction has been noted in the survival rate of grafted grapevines in nurseries, as well as in young vineyards in the Western Cape Province of South Africa. Circumstantial evidence suggested that Cylindrocarpon spp., which cause black foot disease of grapevine, were associated with this decline. Black foot disease of grapevine is a relatively new, and as yet poorly known disease affecting vines in various countries where grapevines are cultivated. Primary aims of this research have been (1) to conduct nursery surveys in order to determine which fungi are involved in the decline phenomenon, with special reference to the involvement of Cylindrocarpon spp., (2) to identify and characterise the organisms believed to be the causal organisms of black foot disease, and (3) the development of control and/or management strategies to prevent or eradicate Cylindrocarpon infections. Nursery grapevines were sampled at different stages from three commercial nurseries in the Wellington area of the Western Cape Province and were investigated during the 19992000 season by means of destructive sampling. The first samples were taken in September from callused cuttings prior to planting in nurseries. After planting, asymptomatic rooted cuttings were selected from nurseries after 3, 6 and 9 months. Isolation studies clearly demonstrated that different “Cylindrocarpon spp.” infected cuttings from nursery soils. These species rarely occurred in rootstock propagation material prior to planting. At the time of planting, the susceptible basal ends (especially the pith area) of most of the nursery cuttings are partly or even fully exposed. Callus roots also break during the planting process, resulting in small wounds susceptible to infection by soilborne pathogens. The isolation studies revealed that the first infections occurred in the roots, followed by infections of the rootstocks. These infections increased progressively during the course of the growing season. Substantial variation in cultural and morphological characters was observed among the Cylindrocarpon isolates obtained from the nursery survey, as well as from isolations that were made from diseased grapevines. Morphological and phylogenetic studies were conducted to identify these “Cylindrocarpon spp.” and to establish their association with black foot disease. Sequences of the partial nuclear large subunit ribosomal DNA (LSU rDNA), internal transcribed spacers 1 and 2 of the rDNA including the 5.8S rDNA gene (ITS), and partial β-tubulin gene introns and exons were used for phylogenetic inference. Phylogenetic analyses confirmed the diversity observed among the isolates and four Cylindrocarpon-like species were identified. One of these species was initially identified as Cylindrocarpon destructans. However, further research revealed C. destructans to represent a species complex. Grapevine isolates of “C. destructans” proved to be identical to the ex-type strain of Cylindrocarpon liriodendri, which also produced a teleomorph, Neonectria liriodendri in culture. A second species was newly described in this study as Cylindrocarpon macrodidymum (Neonectria macrodidyma). The two remaining Cylindrocarpon-like species were placed in a new genus, Campylocarpon. The two species were named Campylocarpon fasciculare and Campylocarpon pseudofasciculare. Pathogenicity studies confirmed that all four species were able to reduce root and shoot mass significantly. Knowledge obtained pertaining to the disease cycle of black foot disease suggest that suitable management strategies should focus on prevention of primary infection in nurseries. However, at present, no fungicides are registered for control of this disease in South African vineyards or nurseries. Thirteen fungicides were screened in vitro for mycelial inhibition of these pathogens. Prochloraz manganese chloride, benomyl, flusilazole and imazalil were the most effective fungicides tested, and were subsequently included in semi-commercial field trials. Basal ends of grafted cuttings were dipped (1 min) in various chemical and biological treatments prior to planting in open-rooted nurseries. Black foot pathogens were not isolated from grafted cuttings prior to planting in nurseries. Additional treatments involved soil amendments with Trichoderma formulations and hot water treatment (50°C for 30 min) of dormant nursery grapevines. Field trials were evaluated after a growing season of eight months. The incidence of black foot pathogens was not significantly and/or consistently reduced by the majority of chemical or biological treatments. However, these pathogens were not isolated from uprooted plants that were subjected to hot water treatment. It is therefore recommended that hot water treatment of dormant nursery plants be included in an integrated strategy for the proactive management of black foot disease in grapevine nurseries.
AFRIKAANSE OPSOMMING: Gedurende die afgelope paar jaar is ‘n drastiese afname waargeneem in die sukses van geënte wingerdplante in kwekerye, sowel as jong wingerde van die Wes-Kaap. Omstandigheidsgetuienis dui daarop dat Cylindrocarpon spp., wat die wingerdsiekte swartvoet veroorsaak, geassosieer word met hierdie agteruitgang. Swartvoet is ‘n relatiewe nuwe siekte waarvan daar baie min inligting bekend is, alhoewel dit voorkom in verskeie lande waar wingerd verbou word. Die primêre doel van navorsing was (1) om opnames in wingerdkwekerye uit voer om te bepaal watter swamme betrokke is by die verskynsel van agteruitgang, met spesiale verwysing na die betrokkenheid van Cylindrocarpon spp., (2) om die organismes te identifiseer en te karakteriseer wat daarvan verdink word dat hulle die siekte swartvoet veroorsaak, en (3) om beheer en/of bestuurspraktyke te ontwikkel om Cylindrocarpon infeksies te voorkom of uit te wis. Kwekeryplantjies in drie kommersiële kwekerye in die Wellington omgewing van die Wes-Kaap is gedurende verskillende tye gedurende die groeiseisoen gemonitor. Die opnames het plaasgevind gedurende die 19992000 seisoen deur middel van destruktiewe monsterneming. Die eerste monsters is geneem in September nadat die stokkies geënt en gekallus is en voordat dit in die kwekery geplant is. Na plant is asimptomatiese, gewortelde plante vanuit die kwekerye na 3, 6 en 9 maande uitgehaal. Isolasiestudies dui duidelik daarop dat verskillende “Cylindrocarpon spp.” plante vanuit die kwekerygrond geïnfekteer het. Hierdie spesies het selde voorgekom in onderstok-voortplantingsmateriaal voor plant. Tydens plant is die vatbare basale gedeelte, veral die pit, van die meeste geënte stokkies gedeeltelik of selfs volledig blootgestel. Kalluswortels breek ook tydens plant wat wonde laat vir infeksie deur grondgedraagde siektes. Die isolasiestudies dui ook daarop dat die eerste infeksies in die wortels plaasgevind het, gevolg deur infeksies van die onderstokke. Hierdie infeksies het toenemend voorgekom gedurende die verloop van die groeiseisoen. Substansiële variasie in kultuur- en morfologiese eienskappe is waargeneem in die Cylindrocarpon isolate wat tydens die kwekeryopnames versamel is, sowel as van isolasies wat gemaak is uit siek plante. Morfologiese en filogenetiese studies is uitgevoer om hierdie “Cylindrocarpon spp.” te identifiseer en hul betrokkenheid by die siekte swartvoet uit te klaar. Gedeeltelike DNS volgordes van die groot ribosomale subeenheid (“LSU rDNA”), interne getranskribeerde spasiëerderarea (“ITS1, “ITS2”), insluitend die 5.8S rRNS geen, en gedeeltelike β-tubilien geen introns and eksons is gebruik vir filogenetiese analise. Filogenetiese analises het die diversiteit wat waargeneem is tussen die verskillende isolate bevestig deurdat vier Cylindrocarpon-agtige spesies geïdentifiseer is. Een van hierdie spesies is aanvanklik geïdentifiseer as Cylindrocarpon destructans. Verdere navorsing het egter daarop gedui dat C. destructans ‘n spesie-kompleks verteenwoordig. “C. destructans” afkomstig van wingerd blyk identies te wees aan die ex-tipe isolaat van Cylindrocarpon liriodendri, wat ook ’n teleomorf, Neonectria liriodendri in kultuur vorm. ’n Tweede spesie is nuut beskryf in hierdie studie as Cylindrocarpon macrodidymum (Neonectria macrodidyma). Die twee oorblywende Cylindrocarpon-agtige spesies is geplaas in ‘n nuwe genus, Campylocarpon. Die twee spesies staan bekend as Campylocarpon fasciculare en Campylocarpon pseudofasciculare. Patogenisiteitstudies het bevestig dat al vier spesies die vermoë het om wortel- en lootmassa van wingerdplant drasties te verlaag. Kennis wat opgedoen is rakende die lewensiklus van swartvoet dui daarop dat bestuurspraktyke daarop moet fokus om primêre infeksies in wingerdkwekerye te voorkom. Op die oomblik is daar egter geen fungisiedes geregistreer vir die beheer van die siekte in Suid- Afrikaanse wingerde of kwekerye nie. Dertien fungisiedes is in vitro geëvalueer om te bepaal of dit miseliumgroei van hierdie swamme kan inhibeer. Prochloraz mangaan chloried, benomyl, flusilasool en imazalil was die effektiefste fungisiedes wat ondersoek is, en is gevolglik ingesluit in semi-kommersiële veldproewe. Die basale gedeelte van geënte stokkies is gedoop (1 min) in verskeie chemies en biologiese behandelings voordat dit geplant is in die kwekerye. Patogene wat geassosieer word met swartvoet is nie vanuit geënte stokkies geïsoleer voordat dit in die kwekerye geplant is nie. Addisionele behandelings het bestaan uit grondtoevoegings met Trichoderma formulasies, sowel as warmwaterbehandeling (50°C vir 30 min) van dormante kwekeryplante. Die veldproewe is geëvalueer na ‘n groeiseisoen van 8 maande. Die voorkoms van swartvoet patogene is nie betekenisvol/konstant verlaag deur die meeste chemies en biologiese behandelings nie. Hierdie patogene is egter nie vanuit plante geïsoleer wat na uithaal aan warmwaterbehandeling blootgestel is nie. Dit word dus aanbeveel dat warmwaterbehandeling van dormante kwekeryplante deel word van ‘n geïntegreerde strategie vir die pro-aktiewe beheer van swartvoet in wingerdkwekerye.

The aim of this thesis is to evaluate the short and long term effectiveness of foot orthoses in the treatment of plantar fasciitis.Three studies were undertaken, the first two informing the third. The aim of the first study was to establish prescription habits of Australian and New Zealand podiatrists in order to ascertain the most commonly prescribed foot orthoses. The second study was conducted to establish the most appropriate outcome measure to assess the effectiveness of foot orthoses in the treatment of plantar faciitis. The main study, a pragmatic single-blind randomised control trial, was conducted to evaluate the effectiveness of three types of foot orthoses in the treatment of plantar fasciitis. The research concluded that provision of appropriate foot orthoses produces small short-term benefits in function for people with plantar fasciitis, but no effect is apparent at twelve months.
Doctor of Philosophy (PhD)

Foot-and-mouth disease virus (FMDV) is an economically devastating and highly contagious livestock pathogen. It exists as seven serotypes, comprising numerous antigenically distinct subtypes. The large amount of antigenic heterogeneity has confounded attempts at developing broadly reactive vaccines. In order to overcome this issue the fundamentals of the interactions between the virus and the host humoral immune response must first be understood. Previous work in this area using monoclonal antibody (mAb) escape mutants has identified five antigenic sites for the O serotype and efforts have been made to quantify their relative importance. However, this does not represent a complete picture of serotype O antigenicity. The work conducted in this thesis demonstrates the role of a limited number of dominant substitutions in mediating the antigenic diversity of serotype O Foot-and-Mouth disease virus. Two alternative but complementary methods for identifying epitopes were developed. The first used a mathematical model to analyse newly generated serological and sequence data from 105 viruses, cultured for this purpose (and cross-reacted to 5 reference antisera), in the context of an existing crystallographic structure to identify and quantify the antigenic importance of sites on the surface of the virus. The second approach was purely structural, using existing B cell epitope prediction tools to develop a method for predicting FMDV epitopes using existing crystallographic structures of FMDV. These techniques were validated by the use of reverse genetics, which confirmed the impact on cross reactivity of two predicted novel serotype O antigenic residues, with a further four novel residues identified by looking in depth at the interactions between two genetically close, but antigenically distant viruses. This increased knowledge of the antigenic composition of serotype O FMDV contributes to our understanding of the nature of vaccine efficacy and the breadth of protection, which, in the longer term, will aid in the goal of developing vaccines to better protect livestock from such a highly antigenically variable disease.

Foot-and-mouth disease (FMD) is an economically devastating picornaviral disease affecting over 40 species of cloven-hoofed animals. The virus occurs as seven immunologically distinct serotypes which are characterized by high levels of intra- and intertypic variation. The three South African Territories (SAT) serotypes 1-3 are endemic to sub-Saharan Africa, a region where the epidemiology of the disease is particularly complex due to the presence of six of the seven serotypes, the role of wildlife in virus maintenance and the apparently higher levels of variation in the endemic serotypes. These factors make it imperative to establish methods suited to elucidating the regional epidemiology. One of the integral parts of this process is the genetic characterization of regionally representative viruses in order to assess the variation in the field and to clarify the role of wildlife. Nucleotide sequence data and methods suited to studying the SAT-types are however limited. A first priority was therefore to establish a PCR-based nucleotide sequencing technique targeting the highly immunogenic and phylogenetically informative 1D genome region encoding the VP1 protein. The screening of multiple serotypes and subtypes prevalent on the African continent confirmed that this method was robust and well-suited to molecular epidemiological studies in the southern Africa region. The method was first applied in the characterization of FMD virus recovered from the reproductive tract of free-living African buffalo in the Kruger National Park. Nucleotide sequencing assisted in authentication of the results and indicated that carrier status was likely, but it was not possible to unequivocally demonstrate persistent infection of FMDV. In a separate study, the role of impala antelope (Aepyceros melampus) in the epidemiology of the disease in South Africa was assessed. Genetic characterization of impala and African buffalo (Syncerus caffer) viruses collected over an eleven year period confirmed that inter-species transmission occurred on several occasions and that virus can persist in impala populations for more than 12 months. Inter-species transmission and investigation of the possible mechanisms facilitating virus transmission from persistently infected buffalo focussed on the Kruger National Park in South Africa. In order to ensure regional relevance the study was broadened to incorporate buffalo populations throughout southern Africa. Viruses of the three SAT-types recovered from diverse African buffalo populations were therefore characterized. The results reveal that independently evolving viral lineages occur in distinct geographical regions for each of the SAT-types examined and that the levels of intratypic variation are in the order of 52 - 55 % on nucleotide level across the genome region characterized. Given the strict locality-specific grouping of buffalo viruses the likely usefulness of this database for tracing the origin and course of contemporary and historical SAT-type outbreaks was investigated. Molecular epidemiological studies conclusively show that buffalo are indeed the ultimate source of infection for susceptible cloven-hoofed animals occurring in close proximity, that interspecies transmission occurs between cattle and antelope and that trans-boundary transmission of virus remains a threat to disease security in southern African countries.
Thesis (PhD (Microbiology))--University of Pretoria, 2007.
Microbiology and Plant Pathology
unrestricted

Las enfermedades de la madera se encuentran entre las patologías más dañinas que afectan al cultivo de la vid. El pie negro es una de las más destacadas, afectando a las plantas en vivero y en plantaciones jóvenes. Los agentes causales están incluidos dentro de los géneros Campylocarpon, ¿Cylindrocarpon¿, Cylindrocladiella e Ilyonectria. Éstos se caracterizan por ser habitantes del suelo y, se ha demostrado que permanecen en él, infectando al material de propagación cultivado en campos de vivero. La presencia de hongos asociados al pie negro en vivero, así como sus fuentes potenciales de inóculo en suelos de vivero y de viñedos comerciales, no han sido nunca estudiados en España. En este sentido, el objetivo de esta Tesis ha sido estudiar la epidemiología de hongos que causan el pie negro de la vid en España. En primer lugar, las distintas fases del proceso viverístico se evaluaron como fuentes potenciales de inóculo de estos patógenos. Se tomaron muestras en cuatro fases del proceso de propagación de las que se extrajo el ADN, detectándose las especies causantes del pie negro de la vid mediante multiplex, nested PCR. En las fases estudiadas se detectaron I. liriodendri y el complejo I. macrodidyma. También se estudió la detección de especies de Ilyonectria en material de propagación de vid, antes y después de la fase de enraizamiento en campos de vivero, mediante técnicas de aislamiento y multiplex, nested PCR. Este estudio confirmó que el número de plantas infectadas con estos patógenos aumenta durante el proceso de enraizamiento en campos de vivero. Ilyonectria torresensis fue la única especie aislada de las plantas tras la inducción del callo. Sin embargo, las especies I. liriodendri, I. novozelandica e I. torresensis se aislaron frecuentemente tras el período de cultivo en campos de vivero. Respecto a la detección molecular, se detectaron un número elevado de muestras positivas en planta tras la inducción del callo y después del proceso de enraizamiento. Mediante el uso de cuatro técnicas diferentes, aislamiento fúngico a partir de raíces de plántulas de vid utilizadas como plantas trampa, aislamiento a partir de raíces de malas hierbas, multiplex, nested PCR y qPCR, se estudió el suelo de campos de plantas madre como fuente de inóculo de estos patógenos. De las raíces de plantas trampa se aislaron las especies I. alcacerensis, I. macrodidyma, I. novozelandica e I. torresensis. ¿Cylindrocarpon¿ macrodidymum fue la única especie aislada de las raíces de malas hierbas. En los análisis de suelos realizados mediante multiplex, nested PCR así como mediante qPCR se observó un elevado porcentaje de detección del complejo I. macrodidyma en muestras de ADN de suelo, mientras que el porcentaje de detección de I. liriodendri fue menor. Las mismas técnicas descritas para campos de plantas madre se utilizaron para estudiar los suelos de campos de vivero y de viñedos comerciales. Los resultados obtenidos en estos dos tipos de campos fueron similares a los obtenidos en campos de plantas madre. Finalmente, se estudió el efecto de la temperatura, pH y potencial osmótico (¿s) sobre el crecimiento miceliar, la esporulación y la producción de clamidosporas de ¿C.¿ liriodendri, ¿C.¿ macrodidymum y ¿C.¿ pauciseptatum, con el objetivo de mejorar el conocimiento de los factores que afectan al crecimiento, reproducción y supervivencia de estos patógenos. Todos los aislados estudiados crecieron en un rango de temperaturas comprendido entre 5 y 30ºC. Se observó crecimiento miceliar en un rango de pH comprendido entre 4 y 8. Respecto al efecto del ¿s, el crecimiento miceliar fue mejor en medio de cultivo PDA ajustado a -0,5, -1,0 y/o -2,0 MPa en comparación con el crecimiento miceliar observado en PDA sin ajustar a ningún ¿s (-0,3 MPA). La mayoría de los aislados de ¿Cylindrocarpon¿ esporularon a todas las temperaturas, pHs y valores de ¿s estudiados. En general, la producción de clamidosporas no se vio afectada por la temperatura, el pH y el ¿s.
Agustí Brisach, C. (2013). Studies on the epidemiology of black-foot disease of grapevine in Spain [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/27598
TESIS

The aim of this thesis is to evaluate the short and long term effectiveness of foot orthoses in the treatment of plantar fasciitis.Three studies were undertaken, the first two informing the third. The aim of the first study was to establish prescription habits of Australian and New Zealand podiatrists in order to ascertain the most commonly prescribed foot orthoses. The second study was conducted to establish the most appropriate outcome measure to assess the effectiveness of foot orthoses in the treatment of plantar faciitis. The main study, a pragmatic single-blind randomised control trial, was conducted to evaluate the effectiveness of three types of foot orthoses in the treatment of plantar fasciitis. The research concluded that provision of appropriate foot orthoses produces small short-term benefits in function for people with plantar fasciitis, but no effect is apparent at twelve months.

Orientador: Ana Maria Minarelli Gaspar
Coorientador: Sidney Jose Lima Ribeiro
Coorientador: Helena Megumi Sonobe
Banca: Marlus Chorilli
Banca: Rondinelli Donizetti Herculano
Banca: Carlos Alberto Fortulan
Banca: Eliana Cristina da Silva Rigo
Resumo: Feridas crônicas são multifatoriais e resultantes do processo de cicatrização inadequada, no qual não ocorre reparação tecidual ordenada e temporal, ou ainda, há ausência de restauração anatômica e funcional completa, comprometendo a vida cotidiana dos indivíduos. Para a melhoria da assistência à saúde destas pessoas, buscou-se uma alternativa de cobertura com a utilização de membrana de celulose bacteriana (CB), por esta ser biodegradável, biocompatível, não tóxica e não alergênica, na aplicação na pele com área queimada ou lesada e para alívio da dor; foi associada à membrana um medicamento anti-inflamatório, aprovado pela Agência Nacional de Vigilância Sanitária (ANVISA) e já comercializado. Assim, o objetivo deste estudo foi desenvolver cobertura de CB incorporado com antiinflamatório Ibuprofeno (CB/Ibu) e avaliar a utilização em pacientes com feridas crônicas vasculogênicas de membros inferiores. Foram utilizadas membranas de celulose, obtidas com o cultivo de bactérias Gluconacetobacter xylinus com incorporação do anti-inflamatório Ibuprofeno e avaliadas por diferentes técnicas físico-químicas como MEV (Microscopia Eletrônica de Varredura), Difração de Raios X, TG (Análise Termogravimétrica), DSC (Calorimetria Exploratória Diferencial), Infravermelho, UV-vis (Espectroscopia Eletrônica na região do UV-Visível); ensaios de proliferação celular com fibroblastos cultivados testes de liberação do Ibuprofeno e da membrana de CB/Ibu e os testes de permeação e retenção de Ibupr... (Resumo completo, clicar acesso eletrônico abaixo)
Doutor

Diabetes mellitus is a complex metabolic disorder that lasts a life time and can damage a person's feet. Poorly controlled diabetes can lead to the chronic complications of macrovascular disease and peripheral neuropathy in the feet. Neglect of feet that have these complications can result in the serious consequences of ulceration, infection, gangrene and amputation. The medical, rehabilitation and direct hospital costs due to diabetes are considered to be high. Current literature documents evidence that a significant number of lower limb amputations caused by diabetes can be prevented. Foot problems that are the result of minor trauma have been found to be one of the major causes of lower limb amputations in people with diabetes. Minor trauma can be avoided if people with diabetes practise appropriate footcare procedures. The high costs and the preventable nature of lower limb amputations are good reasons to educate people to practice appropriate footcare. In recent years there has been a strong move to implement diabetes education programs that actively encourage people with diabetes to manage their condition and their footcare. The type of education modes used have ranged from individual counselling to group education programs. Evaluation of diabetes education programs have focused mainly on improvement in knowledge about diabetes with some attention on changes in behaviour as shown by improved blood sugar levels and weight loss. There has been minimal evaluation based on changes in behaviour concerning footcare. Furthermore, the use of learning techniques that advance the impact of learning and induce behaviour change towards improved self-care have not been considered. This research study examined one diabetic footcare progran1 that targeted adult people with diabetes. The education format incorporated adult learning techniques that were aimed at facilitating changes in behaviour towards compliance with the prescribed regime of footcare for people with diabetes. The objective of the study was to evaluate the footcare education component of the diabetes education program by identifying the number of subjects who changed their footcare practices after the education program. The footcare practices studied were (a) daily checking of feet, (b) drying the skin between the toes and ( c) daily checking of shoes. Adult learning techniques were assessed to decide if they were influential in facilitating behaviour change. Reasons for, and obstacles that prevented, behaviour change were sought to give more indepth information regarding the effectiveness of the footcare education. The results showed that a minimum of 68% of subjects showed an improvement in compliance with all three behaviours after the footcare education program. The compliance rate for the behaviour of drying the skin between the toes was particularly high (almost 93%). The easy access to relevant information, recognition that footcare is part of normal hygiene and the knowledge that lower limb amputations are preventable with appropriate care were all reasons cited for the increased compliance with the prescribed behaviours. The support found in group education, the fun atmosphere and the use of educational tools were all found to facilitate compliance. Individual foot assessments were also identified as an effective learning tool. Diabetic footcare education programs that follow a similar format are recommended.

Research objective and experimental tasks. The study was designed to explore the incidence and severity of root and foot rots and ascochyta blight in field pea crops and to identify the measures and practices for the prevention and control of the diseases caused by the pathogens of Ascochyta complex. Experimental tasks: - To identify the susceptibility of various field pea varieties to root and foot rots and ascochyta blight under different agro-ecological conditions. - To establish the effect of meteorological factors on the severity of root and foot rots and ascochyta blight in field pea crops. - To determine the frequency of detection of pathogens of Ascochyta complex on various pea varieties. - To estimate the feasibility of control of the diseases caused by the pathogens of Ascochyta complex using seed treatment and fungicide application. - To assess the impact of seed treatment and fungicide application on field pea productivity and yield components. - To study the possible side-effect of the chemical seed treatment on the microflora of pea rhizosphere and soil.
Tyrimų tikslas ir uždaviniai. Tyrimais siekta ištirti šaknų, pašaknio puvinių ir askochitozės išplitimą bei žalingumą sėjamojo žirnio pasėliuose, nustatyti Ascochyta komplekso patogenų sukeliamų ligų prevencijos ir kontrolės priemones. Tyrimų uždaviniai: - Nustatyti įvairių sėjamojo žirnio veislių jautrumą šaknų, pašaknio puviniams ir askochitozei skirtingomis agroekologinėmis sąlygomis. - Nustatyti meteorologinių faktorių įtaką šaknų, pašaknio puvinių ir askochitozės intensyvumui žirniuose. - Nustatyti Ascochyta komplekso patogenų aptikimo dažnį ant įvairių veislių žirnių. - Įvertinti Ascochyta komplekso patogenų sukeliamų ligų kontrolės galimybę naudojant beicus ir fungicidus. - Įvertinti beicų ir fungicidų įtaką žirnių derlingumui ir derliaus komponentams. - Ištirti galimą cheminių beicų šalutinį poveikį žirnių rizosferos bei dirvožemio mikroflorai.

Merino sheep are the most numerous domestic livestock in Australia and feral goats are wide-spread and locally abundant in many of the regions where sheep are grazed. Foot and mouth disease (FMD) is a disease of ungulates that causes severe economic hardship to countries where outbreaks occur or where it has become endemic. In India, Africa, Greece and recently the United Kingdom and Eire, sheep and goats have been implicated in the spread and maintenance of FMD. In Australia, there are contingency plans (AUSVETPLANS) for dealing with an outbreak of FMD. Included in those plans are strategies for control of the disease in feral ungulates including feral pigs and feral goats. Modelling has provided assistance in developing strategies to combat outbreaks in feral pigs and for controlling outbreaks in domestic livestock. No models have been constructed to aid decisions about controlling FMD in feral goats where they co-occur with merino sheep. In Australia, the greatest densities of free-ranging feral goats and domestic livestock occur in the high rainfall zone (> 500 mm mean annual rainfall) along the eastern tablelands and adjacent slopes of the Great Dividing Range. Previous studies of feral goat biology, population dynamics and behaviour in Australia have concentrated on arid and semi-arid zones or on islands. Interactions between free ranging feral goats and merino sheep have not previously been studied in the high rainfall zone. My study investigated the ecological and behavioural characteristics of feral goats and their interactions with sympatric merino sheep at a high rainfall site in central eastern New South Wales. The population dynamics, biological and behavioural parameters of feral goats and sheep were then used to model FMD in such an environment. Deterministic temporal models and a new spatial stochastic model were used. Of particular interest were the rates of contact within and between subgroups of feral goats (termed herds and mobs), within and between subgroups of merino sheep (termed flocks and mobs), and between subgroups of the two species. Feral goats at the study site were found to be numerous (mean density = 34.94 goats km-2, from aerial surveys), in good condition, fecund and had high adult survival and low annual adult mortality (survival= 0.81�1.00) in the absence of harvesting and hunting. They had an observed instantaneous rate of increase of 0.112 per year. Annual rate of increase was similar to other sites in Australia without sustained harvesting pressure. Home ranges were small for both males (3.754 km², s.e. = 0.232, n = 116 goats) and females (2.369 km², s.e. = 0.088, n = 241 goats). From this and other Australasian studies, an inverse power function was found to be an excellent descriptor of the relationship between mean annual rainfall and female home range size. A resource selection function was fitted in a geographic information system to observational data of feral goats. The habitat selection of feral goats included a preference for wooded vegetation on eastern and north eastern aspects at higher elevations. The resource selection function was also used to set the probabilities of occurrence of feral goats in 1 ha areas of the landscape and these probabilities were used to generate heterogeneity in a spatial model of foot and mouth disease virus (FMDV) transmission. Daily per capita contact rates were estimated from observed contacts in the field where a contact between individuals was recognised when one approached within 1 body length ([approx] 1m) of another. The contacts between feral goats within herds were frequent and occurred at a rate of 6.96 (s.e. = 1.27) goat�goat contacts day-1. Sheep to sheep contacts were slightly less frequent (4.22 sheep�sheep contacts day-1, s.e. = 0.65) but both estimates were most likely negatively biased because of observer errors in estimating the number of individual animals coming in contact with observation subject (focal) animals. Contacts between herds of feral goats were not common and those between adjacent populations were fewer than 1 per year. In sheep, flock to flock contact was largely governed by husbandry practices and occurred at a mean daily rate of 0.0014 flock�flock contacts. Contacts between sheep and feral goats were less frequent but nonetheless common (2.82 goat�sheep contacts day-1, s.e. = 0.40). In feral goats the size of the mob in which focal goats were observed was found to be the most important factor in determining contact rates between individuals and a counter-intuitive inverse relationship was identified. Contacts were heterogeneous and density was not an important determinant of contact rates implying that, because of the uniformly high densities at the site, saturation had occurred. The temporal models of FMDV transmission showed that the rate of contact within and between species was such that FMD was predicted to spread rapidly throughout an infected herd or flock. Control strategies of intense culling of feral goats at the population level were predicted to allow the disease to persist at low prevalence, with a small peak corresponding to the annual lambing pulse in sheep. However, the same level of control (>90% reduction) at the herd level was predicted to eliminate FMD and allow the safe reintroduction of sheep. Extreme control that left very small groups (<3 individuals) may be counter productive because such small groups are likely to join the reintroduced sheep in an effort by the goats to meet gregarious urges. The spatial model was more reassuring. It predicted that FMD would die out in a mixed sheep and feral goat population in less than 90 days because of the low rate of herd to herd contact and herd to flock contact. For similar environments, the contingency planning consequences are that an outbreak of FMD introduced into feral goats from sympatric sheep is likely to be containable by removing all the sheep, determining the extent and likely range of the feral goats, then removing a substantial proportion of or eradicating each herd. Feral goats, being relatively sedentary, are unlikely to spread to adjacent populations and the disease will die out through lack of contact between herds and populations. Because feral goat home ranges overlap and are centred on one or two small catchments, a containment ring of feral goat control, set to encompass the home range of a target herd and that of adjacent herds, should be adequate to limit spread of FMD.

Climate-sensitive infectious diseases such as hand-foot-mouth disease (HFMD) are expected to increase with the changing climate, leading to a greater burden on population health. The extent to which the changes in climate can or will affect population health varies across regions, depending on specific climate characteristics and variability, and on the specific socio-economic and health infrastructure of each region. Hence, local regional-specific climate change adaptation measures needed to be based on an understanding of the health impacts at the regional level. This is particularly relevant when dealing with the hand-foot-mouth disease (HFMD). HFMD, caused by a group of enteroviruses, mainly EV71 and CVA16, is an emerging and increasingly wide spread climate-sensitive infectious disease. It has become endemic over recent decades in many countries, especially in the Western Pacific Region including China, Japan, Singapore and Vietnam. Millions of children suffer from this disease every year, and in severe cases, it is fatal. Research has focused on clinical diagnosis, testing, and treatment in order to reduce mortality. Few studies have investigated prevention and control of HFMD. Recent studies have begun to examine the relationship between HFMD and climate factors such as temperature, humidity, and rainfall. These studies also report that there are regional variations associated with differences in socio-economic characteristics, geographic and climate zones. Thus, regional research is needed to better understand the specific climate-HFMD associations, especially in the “high-risk” regions vulnerable to climate change such as the Mekong Delta Region (MDR) in southern Vietnam. The MDR has been a focus of climate change research over the past decade. While studies have identified many climate change related issues such as increases in temperature and number of hot days, sea level rises and floods. However, only a few have examined the impacts of climate change on human health and none on prevention and control measures or climate change adaptation. In fact, health is not even included by Vietnam’s national climate change adaptation plan. Thus, research into climate change-sensitive infectious diseases such as the HFMD to demonstrate its increasing spread and adverse impacts and provide evidence-based recommendations for prevention and control is urgently needed. This study aimed to examine the influence of climate, socio-economic, and health-related factors on the distribution of HFMD, and to suggest strategies to improve HFMD prevention and control with a focus on the MDR. It used mixed methods to explore the status of HFMD in the MDR, investigated the multiple factors influencing it, its high-risk locations, and current methods to prevent and control it. It used quantitative methods, consisting of temporal analysis (time-series analysis) and spatial and space-time analysis, to examine the climate factors influencing HFMD, and to detect high-risk clusters of it in time and space. This was followed by the use of spatial autoregressive models to determine the potential influences of ten socio-economic and health-related factors on its distributions across all provinces of the MDR. Qualitative methods, including extensive literature and document reviews and in-depth interviews with 17 health staff at both provincial and national level, were used to understand their perspectives on the current situation of HFMD, existing prevention and control measures, and the support required by health staff in order to improve prevention and control, especially in the context of climate change. The study examined the associations between three climate factors, temperature, humidity, and rainfall, and the incidence of HFMD in the MDR for both daily and weekly analyses. The finding demonstrated statistically significant associations, especially for temperature and humidity. Specifically, a one-degree increase in temperature was associated with a 1.7% (95%CI, 0.1-3.3%) increase of HFMD at lag 0 day, and a one-percent increase in humidity was associated with a 0.3% (95%CI, 0.1-0.5%) increase in HFMD at lag 3 day. Furthermore, the strength of temperature-HFMD associations and humidity-HFMD associations both increase with week lags. Consequently, following increases in temperature projected for the MDR as a result of the changing climate, the number of HFMD cases is expected to increase in the region. Regarding spatial distribution of HFMD, this study identified four provinces with relatively higher risks: Long An, Dong Thap, Vinh Long, and Ben Tre provinces. They all share borders in the north of the MDR. Quantitative analysis also revealed high-risk time-space clusters, implying that for the high-risk time of year in the high-risk provinces, more attention should be paid to HFMD prevention and control. This study also found that two out of the ten socio-economic and health-related factors examined had strong modifying effects on the distribution of HFMD across the 13 provinces: the percentage of children under one year old having full vaccination (-7.13%; 95%CI, -12.9 - -1.33%) and the percentage of houses with access to safe water (-3.69%; 95%CI, -7.11- -0.27%). Further analysis of the modification effects of these two factors on climate-HFMD associations found different levels of association between the groups with higher/lower immunisation or higher/lower access to safe water. These findings provide evidence that socio-economic and health-related factors influence the incidence of HFMD. This suggests that future studies should focus on a comprehensive analysis of such factors in order to develop predictive models of HFMD. Through qualitative methods, this research has gained a better understanding of the current situation of HFMD and its prevention and control from the perspective of health staff at both the provincial and national levels, including their existing difficulties in implementing and sustaining prevention and control measures in their communities. The key challenges that health staff face include issues related to health risk communication with community members, the frequent overloading in hospitals in particular times and locations, the change in seasonal patterns of common infectious diseases, the lack of knowledge and awareness of climate change and its potential impacts on health in the region, and the weak collaboration between the health sector and the environmental sector in general. The key recommendation of this study are (1) the national climate change adaptation plan should include health sectors and strategies to reduce adverse climate change impacts on health, (2) the prevention and control plan of HFMD should focus more strongly on the identified high-risk areas and set up surveillance and information sharing across provinces (3) health authority should establish inter-provinces collaboration and health notification system to promptly notify other provinces of outbreak in order to prevent potential spread of HFMD , and (4) health staff should be provided with more information about how climate change affects health to enable them to develop more effective communication with community members and develop better plan for HFMD prevention and control. This study contributes to the scientific evidence base of the associations between HFMD and climate, and socio-economic factors with a focus on the MDR. It also presents the perspectives of health staff dealing with HFMD and their support needs in order to improve prevention and control. The study itself has already helped to raise health staff awareness of the potential impacts of climate change on health, in particular, infectious disease. The methods used in this study can be applied by other regions dealing with infectious diseases to provide convincing evidence of the relationship between climate change and health. Future studies should focus on translating research evidence into policies and practices to prevent and control HFMD tailored to address local/regional conditions, and to integrate health into climate change adaptation activities in Vietnam.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Medicine
Griffith Health
Full Text

Diabetes can affect the structure and function of the foot, resulting in severe limitation of mobility and reduction of life expectancy. Early warning signs include limited joint mobility (LJM), soft tissue changes, high plantar pressure (HPP), high pressure time integrals (P/TI) and plantar callus. These abnormalities were examined in 216 young people with diabetes and 57 controls. The fingers, toes, ankle subtalar and first metatarsophalangeal joints shows reduced motion and the plantar aponeurosis was thicker in diabetic subjects. Skin thickness was the same for diabetic and control subjects. LJM in the feet was more common in males and older subjects. Subtalar and finger LJM was associated with early sensory nerve changes and finger LJM was associated with retinopathy and higher HbAtc. Thicker plantar aponeurosis was associated with male gander and larger feet. High peak pressure, high P/TI and callus were no more common in diabetic subjects than controls. However, high P/TI and callus were associated with early sensory nerve changes in young people with diabetes. Diabetic subjects with callus were significantly older than those without callus. Those with HPP had higher body mass index and less motion at the first MTP joints than those without HPP. Although plantar callus, HPP and high P/TI were no more common in young people with diabetes these abnormailities may be complicated by diabetes. Cushioning, custom orthoses or both in combination significantly reduced peak pressure and P/TI in diabetic subjects.
Doctor of Philosophy (PhD)

Im Zuge systematisch durchgeführter thermografischer Untersuchungen an 95 Asiatischen Elefanten in europäischen Zoos konnten physiologische Wärmeprofile aller nicht von Fußkrankheiten betroffener Elefanten erstellt werden. Um eine objektivere Befundung zu ermöglichen, wurden dafür definierte Messbereiche an den Füßen festgelegt und deren Temperaturdaten als Wärmekurven für jeden Zeh dargestellt. Es zeigte sich, dass die Bandbreite von Temperaturen gleicher Messbereiche starken individuellen Schwankungen unterliegt, weshalb eine Befundung nicht anhand absoluter Temperaturwerte erfolgen sollte. So wurden über gleichen Messbereichen unterschiedlicher Elefanten Temperaturunterschiede von bis zu 8 °C festgestellt. Auch die Umgebungsfaktoren während der Untersuchung tragen zu dieser Varianz bei. Bei Umgebungstemperaturen zwischen 17,5 °C und 23 °C stellt sich durch Erhöhung der Außentemperatur um 1 °C eine um 0,5 °C erhöhte Wärmeabstrahlung über der Haut dar. Eine Erhöhung der Luftfeuchte um 1 % verursacht eine um 0,03 °C vermehrte Wärmeabstrahlung. Die Wärmeprofile stellten sich für die Kronsaum- und Hufwandbereiche der Zehen eines Fußes von medial nach lateral in einem parabelförmigen Verlauf dar, wobei die höchsten Temperaturen an den kranialen Zehen gemessen wurden. Die Differenz zwischen Kronsaum- und Hufwandbereichen blieb dabei konstant. Die Temperaturen der Zehenregion oberhalb des Kronsaums folgten nicht dieser Parabelform, lagen aber, außer an der jeweils medialen Seite, konstant unterhalb der Kronsaumtemperaturen. Bei Vergleich mit thermografischen Befunden erkrankter Zehen zeigte sich meist ein starker Anstieg der Zehenregiontemperatur weit über die Kronsaumtemperaturen hinaus, weshalb sich dieses Verhältnis als Indiz für ein akutes Enzündungsgeschehen nutzen lässt. Ein gleichmäßiges Wärmeprofil, welches möglichst dicht dem in dieser Arbeit entwickelten Profil gleicht und konstante Temperaturdifferenzen zwischen den einzelnen Messbereichen aufweist, ist ein gutes Indiz für einen gesunden Fuß. Thermografische Befundungen sollten immer mit Hilfe herkömmlicher visueller Auswertung und zusätzlich der Erstellung eines Wärmeprofils vorgenommen werden, um die Subjektivität zu minimieren. Erstmalig wurden in dieser Arbeit drei Elefanten mittels Pedografie untersucht, um Aufschlüsse über die Druckverteilung unter dem Elefantenfuß zu erhalten. Wie bei Menschen und pedografisch vermessenen Rindern fanden sich auch beim Elefanten charakteristische Druckprofile. Druckspitzenwerte tauchten hierbei vor allem im kranialen Bereich der Füße als Druckleiste, aber auch im kaudalen Bereich in Form zweier Druckpfeiler auf. Experimente mit einer Methode zur Simulierung weicheren Untergrundes schienen die Druckspitzenwerte etwas abzuschwächen und das allgemeine Druckprofil einzuebnen, waren aber nur schwer auszuwerten. Die Methode eignet sich ebenso zur Erfassung der tatsächlich belasteten Fläche der Füße, welche sich bei stärkerer Belastung, beispielsweise dreibeinigem Stehen, vergrößerte. Trotz noch einiger methodischer und technischer Probleme, eröffnet sich mit der Pedografie ein sicherlich lohnenswertes Forschungsfeld für weitere Studien, die einen besseren Einblick in die Druckphysiologie des Elefantenfußes gewähren könnten. Weiterhin wurden in dieser Arbeit Daten der Elefantenhaltungssysteme von 17 besuchten europäischen Zoos, sowie Daten über Häufigkeit und Art der Gliedmaßenkrankheiten und anderer gesundheitlicher Parameter aller 95 untersuchter Elefanten ausgewertet. Hierbei zeigte sich immer noch starker Verbesserungsbedarf im Hinblick auf Innengehegegrößen und die verwendeten Bodenmaterialien. Auch Bewegungsprogramme für den Aufenthalt im Außengehege wurden nur in weniger als der Hälfte der Zoos eingesetzt. Positiv fiel auf, dass die Elefanten in den besuchten Zoos kaum noch angekettet werden und falls doch, nur kurzzeitig zu Untersuchungszwecken. Den Daten der Haltungsanalysen entsprechend, fielen die Auswertungen zur Fußgesundheit aus: Nur 36 % der untersuchten Elefanten litten bisher noch niemals unter Fußerkrankungen. Allein zum Zeitpunkt der Untersuchung wurden bei 27 % der Tiere akute Erkrankungen festgestellt, die unter Behandlung standen. Hierbei handelte es sich hauptsächlich um Abszesse oder andere entzündliche Veränderungen im Bereich des Nagelbetts. Weiterhin wurden 30 % der Elefanten als übergewichtig eingeschätzt und 36 % der Tiere zeigten stereotype Bewegungsmuster
A total of 95 Asiatic Elephants in 17 European zoos were systematically examined using a high resolution thermographic camera and physiologic heat profiles of elephant’s feet without known foot diseases were established. To allow a more objective evaluation of thermographic findings, the feet and toes were divided schematically into defined areas for measurement purposes, based on anatomical features for which the temperature data was then plotted to produce heat curves for each area. Measurements of temperatures pertaining to similar areas of different elephants showed strong individual fluctuation. Temperature variation was as high as 8 °C in similar areas between elephants. Thus, evaluation of thermographic findings should never be based on absolute temperature readings alone. This strong variation is partly caused by environmental factors during the examination. With environmental temperatures between 17,5 °C and 23 °C, a one degree increase of this temperature will cause a 0,5 °C increase of the heat radiation of the feet. An increase of air humidity by 1 % will cause an increase of 0,03 °C of the measured thermographical heat radiation. The physiological heat profiles for coronary and hoof wall areas of the toes showed an arched, parable-like shape when plotted from the medial over the cranial to the lateral toes. The highest temperature readings were found on the cranial toes. The difference between coronary and hoof wall temperatures of similar toes were constant all over the foot. The physiological heat profiles of the toe areas above the coronary region did not show this arched shape but stayed below the coronary temperature readings except on the medial toe. On comparison with thermographic findings of inflammated toes, a strong increase of this area above the coronary band was found which exceeded the temperature of the coronary region. This characteristic can be used as an indicator for acute inflammations. A regular heat profile, which resembles closely the physiological heat profile created in this study and which shows constant temperature differences between the defined areas of the single toes, is a good indicator of healthy foot. It is recommended that thermographic examinations always are evaluated using conventional observation of the heat patterns in conjunction with the additional creation of a heat profile to minimize subjectivity by the clinician. For the first time three elephants were examined in this study using a new pedographic method to gain information on the pressure distribution below the elephant’s foot. As found in humans as well as in pedographically examined cows, the pressure distribution in elephant’s feet showed a characteristic profile. Pressure peaks showed up especially in the cranial area of the foot, possibly the border between sole and pad, as well as in the caudal region in the shape of two pressure pillars. Experiments with a method to simulate softer ground seemed to lower the pressure peaks slightly in favor of a broader distribution, but were very difficult to evaluate, especially considering the small sample size. This method is also suited to register the actual area size put under pressure by the elephant, which was shown to rise under increased pressure, e. g. three legged standing. Despite some encountered methodical and technical problems, pedography of elephants is going to be a very promising field for further scientific studies in order to acquire more information on the physiology of pressure distribution. Data on husbandry conditions of the 17 visited zoos and as well as data on frequency and type of foot diseases and other health parameters of all 95 examined elephants were also collected and evaluated. A strong need for improvement was observed in terms of enclosure sizes and the surface materials used in indoor enclosures. Also, daily routines to increase activity of the elephants in the outdoor enclosures were found to be carried out only in half of the visited zoos. On a positive note, elephants in the evaluated zoos were hardly ever chained and if so, only for examination purposes. According to the data of the husbandry evaluation the information on the current status of foot health showed the need for improvement: Only in 36 % of the examined elephants foot problems were so far not encountered. On the time of examination 27 % of the animals were found to be under ongoing treatment for foot diseases. Mostly these were abscesses or other inflammation processes in the area of the nail’s laminar tissue. Out of the study sample, 30 % of the elephants were estimated to be overweight and 36 % showed stereotypic movement patterns

INTRODUÇÃO: As alterações do comprimento relativo dos metatarsais no plano axial são consideradas por muitos autores uma causa de distribuição inadequada da carga durante a marcha, sobrecarregando as estruturas plantares do antepé, culminando com a metatarsalgia. A meta do tratamento cirúrgico dessa síndrome é estabelecer o alinhamento da fórmula metatarsal. Porém, muitos estudos evidenciam uma taxa de 15% de recidiva da metatarsalgia após a reconstrução do formato preconizado no plano axial, conduzindo a um questionamento sobre a importância do alinhamento das cabeças dos metatarsais no plano coronal. OBJETIVO: Esse estudo tem como objetivo avaliar o padrão de alinhamento das cabeças dos metatarsais no plano coronal com carga, em indivíduos sem e com metatarsalgia. MÉTODO: Estudo transversal, avaliou 106 indivíduos entre 30 a 65 anos, dividindo-os em dois grupos de 106 pés cada, um sem dor, deformidades e calosidades nos pés e outro grupo com metatarsalgia entre os 2º, 3º e 4º metatarsais. O recrutamento dos indivíduaos foi realizado no Pronto Socorro do IOT e no ambulatório do IOT HC FMUSP, respeitando os critérios de inclusão, exclusão e aplicando o Termo de Consentimento Livre e Esclarecido. Indivíduos com deformidades no mediopé, retropé e tornozelo, pacientes com cirurgias ou fraturas prévias no pé, doenças reumatológicas e síndromes osteoneuromusculares, não foram incluídos. Após a seleção, os indivíduos foram submetidos a duas radiografias, uma axial do antepé com carga, avaliando o plano coronal de modo a aferir as alturas das cabeças dos metatarsais, e uma anteroposterior dos pés com carga, determinando o comprimento de cada raio. A análise estatística foi realizada, comparando as medidas entre os grupos. RESULTADOS: Foram avaliados 106 indivíduos, divididos em dois grupos com 106 pés cada. No grupo com metatarsalgia, 34 pés (32%) eram de pacientes do sexo masculino, apresentando uma média de idade de 49,5 anos. Foram identificados 33 pés com hálux valgo no grupo com metatarsalgia. No grupo sem patologia 54 pés (51%) eram de pacientes do sexo masculino, apresentando uma média de idade de 44,6 anos. As variáveis antropométricas como tamanho do pé, peso, altura e IMC, entre os grupos, não apresentaram diferença estatística. As cabeças dos metatarsais em ambos grupos se distribuíram em formato não retilíneo no plano coronal, seguindo a fórmula M1 M3 > M4=M5. O apoio distal do 1º raio apresentou uma posição mais plantar no grupo com metatarsalgia (p=0,000). CONCLUSÃO: As cabeças dos metatarsais em indivíduos com metatarsalgia e sem deformidade em valgo do 1º dedo, se alinharam no plano coronal de modo que M1 M3 > M4=M5, sendo M1 < M3, M1 < M4 e o M1 < M5. As cabeças dos metatarsais em indivíduos sem dor, calosidades e deformidades no antepé, se alinharam no plano coronal de modo que M1 M3 > M4=M5, sendo M1 < M3 e M1=M4=M5. No plano coronal o ponto de apoio do M1 se posicionou mais plantar nos pés de indivíduos com metatarsalgia
INTRODUCTION: Many authors consider the differences in the relative length of metatarsals in the axial plane, the cause of inadequate load distribution during the gait, overloading the forefoot plantar structures, culminating with metatarsalgia. The realignment of the metatarsal formula is the goal of surgical treatment of this syndrome. However, many studies have shown a 15% rate of metatarsalgia recurrence after the reconstruction in the axial plane, questioning the importance of the metatarsal heads alignment in the coronal plane. OBJECTIVE: This study aims to evaluate the alignment pattern of metatarsal heads in the coronal plane in individuals with and without metatarsalgia. METHODS: A cross-sectional study evaluated 106 individuals between 30 and 65 years old. They were divided in two groups of 106 feet each, one without foot pathologies and another group with metatarsalgia between the 2nd, 3rd and 4th metatarsals. The recruitment was performed at the IOT HC FMUSP for both groups, respecting the criteria of inclusion, exclusion and applying the Informed Consent Term. Individuals with midfoot, hindfoot and ankle deformities, patients with previous surgeries or fractures in the foot, rheumatologic diseases and osteoneuromuscular syndromes were not included. After the selection, the subjects were submitted to one weightbearing forefoot axial radiograph, evaluating the coronal plane in order to verify the heights of the metatarsals heads, and other weightbearing anteroposterior foot radiograph, determining the length of each ray. Statistical analysis was performed comparing the measurements between groups. RESULTS: A hundred six individuals were evaluated, forming two groups with 106 feet each. The group with metatarsalgia presented 34 male patients feet (32%), with a mean age of 49.5 years. Thirty-three feet with hallux valgus were identified in the metatarsalgia group. In the non-pathological group were found 54 male patients feet (51%), with a mean age of 44.6 years. Anthropometric variables such as foot size, body weight, height and BMI between the groups did not present statistical difference. The metatarsal heads in both groups were distributed in curved line in the coronal plane, following the formula M1 M3 > M4 = M5. The distal support of the 1st ray was positioned more plantar in the metatarsalgia group (p = 0.000). CONCLUSION: The metatarsal heads in individuals with metatarsalgia and no hallux valgus, were aligned in the coronal plane following this formula M1 M3 > M4 = M5, with M1 < M3, M1 < M4 and M1 < M5. The metatarsal heads in individuals without pain, callosities and forefoot deformities, were aligned in the coronal plane following the position M1 M3 > M4 = M5, with M1 < M3 and M1 = M4 = M5. In the coronal plane, the M1 weightbearing point was more plantar in the feet of individuals with metatarsalgia

During a surveillance programme all the known diabetics (1150) were identified from a general population of 97,034 representing all patients registered with 10 general practices. A control group of 751 non-diabetic subjects were also drawn from the same general population. A single observer reviewed 1077 (93.6%) of the diabetics and 480 (69%) of the controls. Peripheral vascular disease was detected using doppler ankle/brachial pressure index in 20.6% (95% CI 18.2-23.0) of diabetics and 9.6% (95% CI 7.0-11.2) of controls. There was no significant difference between the prevalence in non-insulin dependent and insulin dependent diabetics after adjusting for age. The prevalence in either type of diabetes was however significantly greater than in controls. Multiple logistic regression analysis revealed that age, cerebrovascular disease, coronary artery disease, mean systolic blood pressure, blood glucose, proteinuria and serum cholesterol were significantly and independently associated with the presence of peripheral vascular disease in diabetics. Body mass index was inversely associated. For controls only age and smoking were found to be significant variables. Neuropathy determined by clinical evaluation and sensory vibration thresholds was found in 16.8% (95% CI 14.6-19.0) of diabetics and 2.9% (95% CI 1.4-4.3) of controls (p