Elusive Diagnosis of Superficial Peroneal Nerve Entrapment Case report

Isolated neuropathy of the superficial peroneal nerve (SPN) is a relatively rare type of peripheral neuropathy. It is linked to the mechanical entrapment of the SPN in predisposed locations of its anatomical pathway. Associated clinical findings are insufficient lifting of the latero-dorsal part of the foot, stepping on the lateral border of the foot, and commonly, a strong pain localized in the nerve dermatome.Case report. We describe a case of a 14-year-old female patient with right leg pain lasting 24 months. Repeated neurological examinations with negative findings on electromyography (EMG) were performed. The patient underwent a Steindler surgery for a suspected diagnosis of a heel spur, without any improvement. Despite complex pharmacotherapy, chronic pain developed. The patient was unable to walk, being bound to a wheelchair. Amputation of her lower limb under the knee was also considered. SPN entrapment was diagnosed at a physical examination at EuroPainClinics. Decompression of the SPN under local anaesthesia was performed at the clinic.Results. The symptoms improved immediately after the procedure, and following 2 months of rehabilitation, the patient was completely symptom-free. Her clinical state remains unchanged until this day.Conclusions. SPN entrapment is not a common diagnosis in the group of pain syndromes. Regarding the lower limb, it is imperative to include it on the list of differential diagnoses in cases of pain and functional disorders of the lateral muscle groups of the calf and leg. In the case of SPN entrapment, EMG findings may be negative

Physicochemical characterization of natural honeys from different regions in Slovakia

This study is intended to determine the physicochemical characteristics of Slovakian honeys, and compare them with specifications described in the Codex Alimentarius Standard, the European Honey directive, the Slovak Codex Alimentarius and Slovak standard No. 1/2006. In addition, we tried to find out correlations between individual constituents of honeys. Physicochemical characterization was carried out following the harmonized methods dictated by the International Honey Commission IHC. Honey samples (n=50) were collected from three honey types (blossom, blends, honeydew), and from the three main Slovakian geographical regions (named 'east', 'middle' and 'west'). The physicochemical evaluation included moisture, reduced sugars, proline, hydroxymethylfurfural (HMF), conductivity, diastase and invertase activity, pH and water activity, following the techniques proposed by the European Honey Commission (EHC). The moisture content in the honey varied from 15.26 to 17.65%, HMF levels ranged from 21.83 to 63.00 mg.kg-1, the diastase activity varied from 21.01 DN to 36.67, invertase activity varied from 121.73 to 164.11 U.kg-1, the proline content varied from 426.56 to 531.79mg.kg -1, the fructose content values were found from 36.33 to 40.20 g.100g-1, the glucose content values ranged from 27.67 to 31.00g.100g-1, the values of saccharose content were from 0.15 to 0.37g.100g-1, the conductivity varied from 29.48 to 97.24mS.cm -1, the pH value varied from 4.06 to 4.80 and the water activity content varied from 0.55 to 0.57. Significant differences (P ≤ 0.05) were found between HMF and fructose, glucose and saccharose and conductivity and pH, significant differences (P ≤ 0.01) between fructose and glucose and significant differences (P ≤ 0.001) were found between HMF and conductivity. Between blossom honey and honeydew honey were found statistical significant differences in HMF (P ≤ 0.05) and conductivity between honeydew honey and blossom honey (P ≤ 0.001). Among regions were determined statistical differences between HMF and invertase (P ≤ 0.05) and conductivity (P ≤ 0.01)

Microbial communities in bees, pollen and honey from Slovakia

As the honey-bee gastrointestinal tract microflora and pollen are the primary sources for the honey microbial community, the aim of this work was to study and characterize the microbial transit among them. Therefore, an exhaustive microbial analysis of honey, adult honey-bee gastrointestinal tract, and pollen from different Slovakian regions and different seasons, was conducted. Microbial screening revealed that the primary sources of microbial community present in Slovakian honey are pollen and the honey-bees’ digestive tract microflora, containing microorganisms normally present in dust, air and flowers. We found that the digestive tract of Slovakian adult honey-bees is highly populated by anaerobic, rather than aerobic bacteria, where coliforms, enterococci, staphylococci, Bacillus sp., Pseudomonas sp., microscopic fungi and yeast were found. Interestingly, statistical differences were found between the microflora of the gastrointestinal tract of summer and winter bees. Pollen revealed the presence of mesophil anaerobic and aerobic microorganisms, coliforms and microscopic fungi. Among these, the most representative genera were Alternaria, Cladosporium and Penicillium . In honey the counts of total anaerobic and total aerobic bacteria, that of coliforms, enterococci, bacilli, microscopic fungi and yeasts were monitored. Most frequently microscopic fungi belonging to genera Penicillium, Cladosporium and Alternaria were found

4.1 Web-based interactive learning programmes.

In the future, the training of competent dentists will need to take advantage of up-to-date digital technologies and learning practices. In order to accomplish this, the following goals should be considered: i) the design of 'customizable' web-based curriculum matrices that accommodate the training philosophies and resources of individual dental schools; ii) the development of digital instructional modules that can be incorporated or downloaded into specific parts of a curriculum; iii) the establishment of an e-consortium, which provides peer view and guidance in the design of teaching modules, and which is responsible for the storage, maintenance, and distribution of teaching modules within the consortium; iv) the development of central human and physical resources at each dental school to enable the seamless delivery of instructional modules in a variety of learning environments; and v) the assessment and provision of ICT training to students and faculty with respect to the use of computers and related digital technologies and educational software programmes. These goals should lead to the creation of a 'virtual dental school'. Within this project summative and formative evaluations should be performed during both the production and development of teaching material (e-learning material) and the learning process. During the learning process the following aspects should be measured and evaluated: i) students' behaviour; and ii) effectiveness, retention and the transfer of e-learned material into the clinical situation. To obtain evidence of the efficacy of e-learning material a certain amount of research has to be done in the near future. It is suggested that all parameters currently known have to be implemented during the development of a learning programme. Previous workers have evaluated the following elements with e-learning: i) planning, ii) programming and technical development, iii) learning behaviours, iv) learning outcomes of both the programme and the student, v) the acquisition of knowledge, skills and attitude and vi) the transfer of e-learned skills into clinical situations.link_to_subscribed_fulltex