Escape To Guantanamo Bay Bottomless Party

Our schools work

seems we have entered a positive dynamic and fruitful for podiatry.

In my short time as a practitioner, I am limited to the time to say whether the schools worked well before, but what if you can see is that every time they are doing more and better.

The new website of the General Council of Official Colleges of Chiropodists has remodeled its website and now have a private area for schools.

will receive information as it exits.

also

College of Galicia is catching up with the collection of data for each college to keep them updated as current legislation.

Little by little they are taking steps, moving forward, this is the way forward.

Storing Leather In A Cold Room

patella femoral syndrome

began with the announcement of the web of 41 National Congress of Podiatry

"At today's date (15 February) we disclose to the blogs of podiatry, the official website of the National Congress of Podiatry 41
onwards and in the news section will be published promptly all realcionados.
with the event. " José Luis Fernández

Lake Secretary General

With the great work you are doing this school, I have no doubt that Congress will do a fine.

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Otherway:

As I have emphasized on many other occasions, and we continue to do so, plantar orthoses not only treat the foot.

Let's get a case of a patient with subtalar pronation (heel is between 6 and 10 ° of eversion) and collapse of the midtarsal joint with no sign of structures responsible resupinación takeoff.

When you try to step foot in pronation and the AMT collapsed, the take will be through a less efficient and more abrupt for the foot known as Low Gear that is oblique and occurs in the antero-lateral ft 3 º to 5 º MTT.

This is because the tension that structures will not be performed with greater efficiency because in Low Gear resistance offered by the metatarsal heads is not perpendicular but oblique.

If the traction of the flexor muscles occurs longitudinally in the sagittal plane, it is possible to maintain the distal epiphysis of the MTT to the ground and promote the FD of MTPJ, however, if there is traction obliquely by ASA with ABD forefoot pronation, the tension in a transverse plane will be less effective, hence the appearance of the 5 th and 4 th adductus, varus and in some cases infraductus, and are affected in all three planes.

(But do not get to speak today on the High and Low gear, since it is more complex)

Get consistent unlock all joints from head to foot, is so destructive that can occur for a general reaction in the body.

An extreme example would be the cancer that can lead to destabilization of the body structures that alter the position of the head, shoulders, back, pelvis, hips, knees and feet.

This could alter the dynamic stability producing a domino effect that is dislodged a piece to the next. Therefore, an overload in the neck will tilt the shoulders, they turn the spine, pelvis, hips, knees, feet.

(In one recent case, a young girl with a subtalar pronation important due to a pathological joint morphology in the AMT allow excessive motion and instability that left foot as dead, the muscle was fine but later responded This caused the MI rotation, internal rotation to turn a anteriorization iliac wing and internal rotation, giving a false and misleading impression Dissymmetry turn the pelvis, caused a misalignment of the spine and shoulder, so had lateralized neck.

taping was with that foot to have the Plantar Orthoses and had no back pain but a lot of pain in the neck which was now almost straight.)

pain and discomfort in various parts of body often occur almost simultaneously.

The destabilization can be anywhere in the body from head to foot, so it is important to find the cause and treat it, if it's a mechanical reason or refer if for other reasons such as lack of sight, hearing loss, etc.

postural control is affected at times when we make a well-off, a job in the same position. For. eg. A skilled player will have more developed right leg than the left. A clerk will tend to be muscular contractions by subjecting the body to a position held and atrophy of muscles, biomechanics will not be the same and these people will go to consultation by saying that he has left a helomas, who never had that before to sport but now, using good shoes, etc etc.

inappropriate

Some stability mechanisms subtalar pronation as benign, nowadays, with smooth, hard surfaces of roads, walks, etc make the walk does not behave as it has been designed to act as our stand is made for irregularities, the mechanisms that enjoys, are not made for the modern world.

The intrinsic muscles of the foot that appears paralyzed and inactive in many patients as a result of disorientation and loss of proprioception, if it fails, we lose the prevention of collapse of the joint capsule and ligaments stretching causing great tension in the plantar fascia.

flexors Plantar overloaded soleus and posterior tibial when overloaded, it causes the calcaneus everts.

Shin splint (shin splints), stress fractures of both the tarsi and metatarsal injury talo-navicular ligament, Achilles tendonitis, heel spur syndrome des, medial calcaneal nerve irritation or entrapment, HAV, etc;

There relations diseases as a forefoot valgus or a radio 1, plantarflexion with the external rotators of the hip. External rotators, as part of the powerful gluteal region, in its superficial part, the member rotates "backwards" to rotate, in a desperate attempt to resupinate the foot.

Synergy resupinación normal foot in preparation for starting the propulsion phase of gait, the piriformis (pyramid) is the most important.

The problem begins when the foot's bone structure is abnormal.

Pronation produces internal rotation of the tibia and an eccentric external rotator downloads.

When the collapse of the ASA and AMT is large and prolonged, the muscle produces external rotation of the hip and surges due to the increase in origin-insertion distance, so it will be less effectively its eccentric and concentric contractions and will suffer damages and injuries.

With this picture, there are hip bursitis, piriformis syndrome, local muscle pain upper quadrant of the buttock syndrome, iliotibial band friction and retro-patellar pain.

is very common that the dysfunction is a key factor in the poor traction of the patella and displayed an inhibition of the vastus medialis oblique (seen in previous publication).

not only the lateral posterior compartment of the hip affects the knee and hip also a common cause of groin pain is excessive lateral rotation of the leg.

Suddenly the adductor

is positioned as the first manager to perform hip flexion. This is achieved in a very aggressive and some consequences such as the mismatch that occurs in the pelvic muscles can cause tears.

A similar tension occurs in the plantar fascia is strained to its limits.

This stress can cause nerve entrapment and Achilles enthesitis and Sever in young people. (10-15 years).

When the problem is in the bottom of the lower limb dysfunction occurs with internal rotation and pelvic anteriorization or increase of lordosis and kyphosis causing the neck forward.

abdominal strength and endurance, it will be taken into account when presented with a pathological foot muscles as this will oppose movements that develop the pathological hip, pelvis, spine.

lumbar lordosis in the muscle appear contractures due to muscle shortening.

A plantar orthotic treatment by corrective and / or functional, aided by a muscular rehabilitation of the area it gives good results if it were only the muscular and postural re-education as the muscles tend to quickly return to initial state accommodating the disease. Often surgery in structures proximal to the foot, do not give good results because treating the biomechanical forces acting on such return destructuras modified structures that were already wealthy, again causing a continuous "around the room" and tissue damage.

is an open discussion, with much room to investigate, but the studies are there, the results also. Who wants to devote himself to biomechanics, I believe it is necessary to understand, treat and study the positive and negative effects that occur throughout the body.

I apologize for the poor coherence of some sentences, the reason is that in these articles, I have been more complicated than normal English translation on other occasions. -------------------------------------------------
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------------ Who makes or prescribing plantar orthoses daily and want to correct, have you ever wondered if there is evidence that plantar orthoses correct? "Plantar orthotics align the body?
Studies about it is, contradict these questions, although it is true that there is evidence that some do, because they solve problems, but what do they do?.
Through clinical practice I have been doing (available soon) has made me rethink many things I had learned much theory and not in many cases corresponds to reality.
The forefoot varus and valgus say there, I've been taught twice in this theory and my personal opinion (without any scientific value nor demonstrated empirically) is that it is too subjective, depending on how we align the foot, depending on how neutralize the ASA, as in some cases is supinated or pronated as tibial torsion, we will give the forefoot is everted, inverted, or neutral.
If I agree to the supinated forefoot that is caused by muscle dysfunction capsuloligamentous accommodations due to a continued subtalar pronation and excessive.
If I agree to post and forefoot wedges to restructure, retrain a cause forefoot and midfoot and hindfoot effects.
But what most agree, is more modern theories of Root, as are those of Dannamberg, the foot works harder in the sagittal plane in the transverse plane, I also agree with Kirby, we assess the strengths and the center of pressure if they are more medialized or lateralized. That is subject to physical concepts, to vectors, magnitudes, force, pressure, kinematic and kinetic mostly, which is more objective, more measurable, "more demonstrably" more scientific.

There are different views on these issues, that is, opinions, worthless, and it is difficult to arrive at a common point because the studies do not give anyone reason removed. We further investigate
.........

Sean Cody I Could Not Resist

I have not addressed specific diseases or biomechanics, so today Versare about it, with little personal nuances and great content collected existing literature.

In clinical practice, we can find people who attend our clinics suffering from various problems, but rarely come for problems unrelated to their feet. One issue to be addressed today is patellofemoral syndrome or syndrome of the corridor.

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patellofemoral syndrome is a multifactorial problem, which as its name suggests it occurs in the joint between the back of the patella and anterior femur.

in the literature are many causes as the etiology of this syndrome among which we can find the increased Q angle, tension and shortening in the posterior chain of the lower limb in both hamstrings as gastrocnemius tension in the anterior structures of the hip, where we have the iliac psoas and the rectus femoris, pronated, high or low patella, medial obliculo failure of the vast, poor activation of the posterior fibers of gluteus medius. These factors produce a change in pressure between the patella and femur.

This condition is well treated by physical treatment. The treatment will be aimed at two objectives: 1 º Download

pathological stress that occurs in the soft tissues around the patellofemoral joint, to optimize the position of the patella and reduce overhead.

2 º Improving the mechanics of the lower limb, because if it works well, there will be improvement in the patient's symptoms.

Performing stretching tight lateral structures and changing the activation pattern of vastus medialis oblique, should decline the tendency of the patella to move laterally and should improve this position.

To stretch the side structures, can be done passively by massaging the lateral retinaculum and iliotibial band.

The most effective way to stretch an adaptive shortening of the tissues of the retinaculum is using tape to cause permanent elongation of tissues. This is based on the phenomenon of creep (creep phenomenom). This phenomenon occurs in viscoelastic materials when a small but constant load is applied. It has been widely documented that the length of the soft tissues may be increased with a prolonged stretch.

(which, this could be of interest when dealing with such common diseases as the gastrocnemius equinus through night splints or bandages simply functional)

The magnitude of the increase of displacement depends on the duration of application of stretch, so if applied for long periods, the increase in the elongation is higher.

Sobre el efecto que el tape produce sobre la patela hay diversas opiniones en la literatura:

- Algunos investigadores creen que el tape cambia el ángulo de la articulación patelo-femoral y el desplazamiento lateral de la patela, pero que el ángulo de congruencia no cambia.(Roberts.1989).

- Otros han coincidido en no encontrar cambios en el ángulo de congruencia cuando la patela está con el tape, pero el ángulo de congruencia es medido con 45º de flexión de rodilla, y pequeños cambios en la posición de la patela deberían haber ocurrido antes (Bockrath,1992)

Un estudio más reciente medido sobre pacientes asintomáticos, ha demostrado a medial displacement tape was effective in the medial movement of the patella (p = 0.003) but not effective in maintaining the position with intense exercise (p <0,001).

But with the tape were preventing change which side of the patella occurs with exercise (p = 0.016).

The patellar tapping is unique for each person, as well as the corrective to this cause, placement and voltage is measured individually for each person, based on evaluation patellar position.

Each strip of tape that we place should be reassessed periodically based on the symptoms that appear with the activity. By placing the tape, the patient should experience an improvement right away, otherwise you will have to re-examine what we have done well.

This treatment is very useful for soft tissue release tension and improve the symptomatology of the patellofemoral joint but not for injuries inside the knee. A

guidelines to follow depending on where you locate the trouble, and how to evaluate where to place the tape. Be placed in both the medial and lower than average and sometimes in both positions.

To reduce download the stress of the plantar fat area as well as irritation of the pes ananserinus enthesitis, irritation of the iliotibial band, can make a bandage with tape in the form of V, where the summit will go on the tibial tubercle and both bands will tour the lateral side of the head to be inserted into the femoral condyles. The knee should be minimal bending.

In a study (Cushnage, 1994) with persons 70 years with osteoarthritis, they put 3 bands of tape, one medial, one lateral and one central and 4 days to appreciate the symptoms.

The most positive result was taken with the bands that conseguiron medials symptoms improve by 25%.

The tape lasts throughout the day every day until the patient has learned to activate the VMO (vastus medialis oblique) at the right time. May be suspended at any time.

Once the skill, the tape carefully removed p or night, allowing the skin to recover. The tape can cause destruction of the skin through touch or as
a consequence of an allergic reaction. The p skin repair and care is essential.

The patient should be trained never to have pain or swelling as it is shown that under these conditions produces an inhibitory effect of muscle activity.

If the patient returns to experience pain, you must set the tape.

has been shown that cuadripces is a major etiological entity in this disease causing lateral displacement of the patella (in contrast to the VMO) and should have good elasticity and work it with isometric exercises to strengthen it.

The foot and its importance in this syndrome.

In patients with prolonged pronation (pronation not, that's another debate, time vs. quantity) in the midstance phase, they should "teach" how to work the muscles of your feet supinating. This should improve the stability of the foot to push off (off) and reduce the increased valgus vector force created in the knee as a result of the pronated foot.

training position is to support medium, which is sent to raise the bow while keeping the hallux against the ground and then raise on 1 MTT and hallux soil.

The mission of this exercise is to enhance the anterior tibial muscle, posterior and peroneus longus. If you are unable to perform the exercise correctly will require a brace to treat plantar muscle imbalance and / or causes that produce pathomechanics hiperopronación pronation or maintained.

In short, patellofemoral syndrome may be due to various etiologies in which the state will be as important muscle of all lower limb as mechanical causes.

muscle gain importance in the vastus medialis oblique and cuadripces, but can not be ruled that a tight hamstring and gastrocnemius may cause mechanical disturbance and subsequent patellofemoral symptoms.

tape treatments are usually effective, and in cases produced by pathomechanics will be useful training, physiotherapy and orthotics plantar.

Replace Vaseline For Masterbation

The podiatry, compilation and why is not the same theory to practice after the course

Today I wanted to make a compilation of cases, an individual could not present because of the time would require. I would like to make this compilation an overview, criticism and humility.

things in medicine are not always what they seem, make mistakes is part of learning, as in the photo shown, to the facts most unusual as snow at sea level can occur, for it is rare.

Many times we get to query patients with clinical symptoms of lumbar level, knee, or foot, and after a biomechanical examination, just to diagnose an ankle equinus, gastrocnemius either equine gastrosoleo horses, equine ankle bone block or capsuloligamentous. In women is more common due to lack of stretching, the use of high heels, to have a shorter Achilles tendon than men and that, combined with inactivity, systemic diseases like cholesterol, there is a muscle atrophy, loss of elasticity and systematic contractures over the years.

Unlike the case of this picture, the horse is absolute, do not get to play with the heel on the floor at any time, always walking on tiptoe on one foot, and the other almost touching the heel but also not get it. The years have led to what you have now is a bone block which gets no more than 5 of total joint movement.

This is an interesting case in which I missed in diagnosis. Had been diagnosed with Dyshidrotic eczema (did not have before the HQT) has been treated in accordance to it but was not improved. Was complicated by an infection, the culture was positive for Staphylococcus aureus and Gemella. Luckily for him, in the antibiogram out sensitive to all drugs, although referral to a dermatologist, have given amoxi-clav, when I was using amoxicillin and cloxacillin would change (long live the wise use of antibacterials).

been referred to a dermatologist for psoriatic pustular suspect, since in that case will be with PUVA treatment.
This is the finger of a lady who dropped an object on top, after 3 days, since the day after the injury came ER and prescribed ibuprofen.

is true, that when he went to the emergency, no hematoma was present as exaggerated as the treatment has been correct. When she went because the pain would not let him or walk or sleep, I did a drain and the pain improved significantly. After making a debridement of the area which hurt him, it showed a dislocation of the nail plate in the peroneal canal.

In this case, a recent arrival, after 5 months of healing in the medical center, and ordered him to continue performing the dry cures at home. , Presented with pain.
The patient is not diabetic, but had been operated for years claw toes and metatarsals are not HQT and helomas causing movement in the area, which together with xeroderma eventually cause ulceration.
Without a discharge, the ulcer is impossible to close.

In only 3-4 weeks, the appearance of the ulcer has improved greatly.
now is what is costing close to everything and that you have a plantar orthosis that takes 10 days to download them and not enough and that closes false ulcer covering the area of \u200b\u200bHQT. As I said before, the treatment involves downloading the area, if the plant does not discharge brace enough or it will be tweaked again.
This patient has pain in the hallux for 10 years. By removing the nail plate considerable relief to abolish symptoms. This is what I found. I have asked for a Rx for differential diagnosis between subungual exostosis, vascular tumor or just a wound. The Rx
no noticeable exostosis, and protection of the area, the wound has sent so it was a long-standing injury resulting from repetitive microtrauma caused by the blow of the hallux against the shoe. The patient does not have a hallux pronation hiperextensus but the ASA supine on 1 radio.

This is the sample fibrokeratoma the first patient I operated. I had years with him in the back of the nail plate of 5 th finger, giving now, we deformed the nail plate causing a longitudinal depression. Was removed and 9 months later still has not come out again.
This patient had this injury, but was not the reason for consultation. This was in my early days when dermatology was a big gap for me. Can be categorized as nummular eczema and the onset is due by the patient's underlying disease and its treatments.
This is a case in which the patient had 3 months with a podiatrist and a doctor to treat the helomas it had in the back of the finger. The problem is that they had not done a thorough debridement, and it was closed in vain, and after we debride debrided and the bone, the final cure was at 2 weeks after debridement everything.
See the medial aspect of the distal phalanx of 5 th finger. That helomas is both painful and in some cases, even removing it still bothering you, or returns to bother a few days.
We often blame ourselves that we remove evil, is what it is ignorance, but the blame should be aware that it is theirs. Years of evolution, helomas chronic abuse based on corn remedies and natural remedies to remove infections with non-sterile equipment, etc.

Patient young football player. Not only has a temporary bone, the trine, but has suffered the avulsion fracture. This Rx is made one year after the trauma of a kick. A maximum plantarflexion still bothering him.


View this exposure or until additional tests can be simple, but nothing is further from reality, often come with chronic pain patients for many years of evolution have gone through all the specialists, I have done everything and still not being diagnosed or cured.
In such cases come to us with all faith in the world to see what we can tell.
These cases are more complicated, but the ones I like, look for a diagnosis of any cause in which various causes often coexist.
not easy when diagnosing a disease and everything that we have been taught to treat anything that does not improve the picture.

When we have doubts and we lost, it is helpful to make a differential diagnosis in which we pointed the signs, symptoms, history and other important information. Will also aim symptoms varying over time and how it evolves with different treatments. Then we do several categories. Neuropathic pain, inflammatory pain, mechanical pain. Effect of soft tissue, nerves, vascular, bone, systemic.
The problem is that in more than one occasion we have to label the box in several tables eg: a clinical case update:

elderly patient with tingling in the 1 st finger, also pain on lateral side of the leg to below the peroneal malleolus, it crackles foot in all the movements without knowing where it came from and that passive manipulation is not nothing. Go
After investigating and discarding (leg pain due to dysfunction of the posterior tibial overloading the PLL), has found a point of maximum pain tibial malleolus area supports a well tenosynovitis of the tibialis posterior or long flexor of the hallux, which in turn causes inflammation of the posterior tibial nerve neuritis which gives the symptoms of hypoesthesia, tingling.
A taping, anti-inflammatories and the problem is resolved in 14 days. Need a plant support to treat posterior tibial dysfunction, but the patient refuses.

In another case, a child with Sever, and treated with insoles, NSAIDs, rest, etc, again due to relapse and see what you can do. Presents a plantar wart on the heel, pain on palpation of Sever, Achilles tendonitis and tendinosis of the peroneus longus (as NMR), magnetic resonance imaging performed in other post the radiologist may see a bone cyst in the area. On the radiograph is not seen nothing, and on MRI a few months earlier.

As we see, there are cases that are very complicated, both for ourselves and for any other professional. To err is human and what we do and continuously over the years. Medicine is not 1 +1 = 2, but it is a constant struggle for knowledge, for knowledge. Not bad
professional malpractice or being bad at your job that mistake, that we fail, that does not solve some cases. What if it would be good is to have several patients tell us, "it hurts here," and we let fall those words in a drawer from which he never will.
We have several differential diagnoses for each disease, search for questions, question, test treatments, good or bad result, but after all, alternatives.
Certainly there who is more specialized in one field, so that others can not cope, cover correctly, but is normal, time is finite and if you dedicate yourself to something you will not have time for another.

Almost everyone has started the way in which wrong will fail and the agenda, but it will not stop trying to find the solution.

Recipes Using Betty Crocker Mix

Day of Pharmacology. Conclusions






After I go to university course theoretical and practical limitation in podiatry, I can say I've seen the best course of all those I have.

When I say better, because it was the course that I was more able to assimilate in one day, to have kept almost all concentration during 10 hours without lowering our guard for a second, where we have absorbed every second and every word that the two wonderful speakers have commented.

Dr. Carlos Rodriguez, MD and specialist in Clinical Pharmacology, Professor of the University of La Coruna, who already knew of us taught at the Diploma in Podiatry.
Their presentations are very clear, focused directly on clinical practice (this had a lot to the organizers at the time of preparing the program) that has given us new knowledge and strengthen those who already had.

Dr. Carmen Durán, Doctor of Pharmacy and Clinical Pharmacology Specialist, Primary Care Pharmacy.
We were surprised at all since their papers on topics such as antiplatelet, anticoagulant and diabetes, in which everyone assumed that we would be overwhelmed by names of many prescription medications that rarely, but has not been well, thanks to its exposure we have learned much about these drugs.

All this information has explained both doctors, have been broken up, analyzed thoroughly, and we have squeezed all questions, solve all our doubts and problems that came up and giving us confidence in other medicines less commonly used in podiatry but have encouraged us to give them as would be the major and minor opiates and oral corticosteroids.

clinical cases have been very useful, we discussed first in groups and then between all the various cases we have some trapping, and addressed various pathologies from the well-known diabetes to gout.

We have encouraged at all times to prescribe, to that because we do from scratch, do it well, such is the rational use of antibacterial spectrum first using shorter and go up, something that almost everyone knew but few they made.
also scales acute and chronic pain according to WHO, since non-steroidal painkillers such as acetaminophen to opioids, when and how to prescribe them.

have also been issues with room for controversy as the use of Bleomycin. We are told that if it is not indicated in the prospectus, which can not be used because you risk "As you lose hair, and although many studies have been talking about its effectiveness is useless when a complaint. The only thing that could serve as a mitigating factor in a case of complaint is that the information set that is used for tumors and may consider a wart a benign tumor. We recommend that if you do use an informed consent.

For colchicine, advised us not to use it, but appears in many clinical guidelines as an effective treatment for gout, adverse effects are very important as it is an antimitotic. Full-dose NSAIDs are equally effective and better tolerated.

disproportionate use gastroprotective, gastric protectors have some indications and include a history of gastric ulcer patients over 65 years as the most important indications for what can not be used systematically.

Patients taking NSAIDs such as ibuprofen for months, after 2 to 3 months reduces the risk of injury
gi
We have different types of prescription are: prescription complacent, which is what we use for the patient wear something because it is required, the prescription defense, which is used too, especially antibiotics, in which broad-spectrum because we doubt our opinion diagnosis and we cover everything to be safer, when what we are doing is to create more resistance to more types of bacteria.

neuropathic pain, the use of antiepileptic drugs.
treatments in patients anticoagulation and antiplatelet agents.
The malpractice being committed systematically at national level all kinds of professionals, from us to doctors.

also advised us not to withdraw antiplatelet drugs to patients before minor surgery with little risk of bleeding, since in the most prestigious journals is absolutely forbidden, but if surgery is higher, you can do what has already been done, suspender el tratamiento durante el tiempo necesario para cada uno, y mientras administrar heparinas de bajo peso molecular.

Un punto importante de las prescripciones, es el seguimiento del paciente, no podemos dar un medicamento y mandarlo venir al cabo de 2 semanas, ya que todos los medicamentos tienen sus efectos adversos y reacciones medicamentosas, por lo que es preciso realizar un seguimiento a corto plazo de la evolución tanto de la patología como del fármaco para poder valorar problemas o que no está mejorando la sintomatología que presenta el paciente.

Hemos visto antibiogramas y análiticas, interpretarlas y en casos de pacientes con dislipemias recomendarles indicaciones para mejorar your health, because as our speakers have said, we are professionals and that is also part of our work.


Finally, we have provided contact with them to perform at any moment all questions that we come up. We have supported
new prescribers as encouraging us to do so without fear, but with consistency, with great power comes great responsibility.

As always, the relationship between all partners has been exemplary, going back to see old friends and meeting new ones in a very cordial and pleasant climate.

In conclusion, it has been a most useful course, all have come up with a good taste, so we as the speakers because they have seen that our level was not as low as previously thought.