Столы +на Вавада Минеры

خار پاشنه چیست؟

خار پاشنه یک منبع شایع درد پاشنه پا است. خار پاشنه رشد استخوانی است که به استخوان پاشنه شما (پالکانئوس) متصل شده و در قوس پای شما رشد می کند.

دلایل ایجاد خار پاشنه

فاسیای پلانتار  یک نوار فیبری ضخیم از بافت همبند است که از سطح پایین استخوان پاشنه منشا می گیرد و در امتداد کف پا به سمت انگشتان پا امتداد می یابد. فاسیای کف پا به عنوان یک محدودیت غیرفعال برای صاف شدن بیش از حد قوس پا عمل می کند. هنگامی که فاسیای کف پا دچار پارگی های کوچک یا ملتهب می شود، به فاسیای کف پا معروف است. به طور خلاصه، فاشیای کف پا مزمن باعث خار پاشنه می شود.

هنگامی که بهبودی فاشیای کف پا را به تعویق می اندازید و آسیب ادامه می یابد، بدن شما بافت نرم ضعیف و آسیب دیده را با استخوان ترمیم می کند. معمولاً فاسیای آسیب دیده شما از طریق فعالیت فیبروبلاست بهبود می یابد. فیبروبلاست ها به طور طبیعی حداقل به مدت شش هفته عمل می کنند. اگر آسیب شما بیش از این زمان ادامه داشته باشد، استئوبلاست ها به آن ناحیه جذب می شوند. استئوبلاست ها استخوان را تشکیل می دهند و نتیجه آن استخوان (یا کلسیفیکاسیون) در داخل فاسیای کف پا یا در محل قرارگیری استخوان پاشنه است. این تشکیلات استخوانی به عنوان خار پاشنه شناخته می شوند.

علائم خار پاشنه چیست؟

• معمولاً ابتدا صبح یا بعد از استراحت متوجه درد زودرس خار پاشنه در زیر پاشنه پا خواهید شد.
• درد پاشنه پا با اولین قدم ها بدتر می شود و با گرم شدن آن با فعالیت بهبود می یابد.
• هنگامی که ناحیه حساس را لمس می کنید، ممکن است یک توده استخوانی دردناک را احساس کنید.

خار پاشنه چگونه تشخیص داده می شود؟

بهترین فیزیوتراپ یا پزشک ورزشی شما خار مارماهی و فاشیای کف پا را بر اساس علائم، شرح حال و معاینه بالینی شما تشخیص می دهد.

پس از تأیید خار پاشنه یا فاشیای کف پا، آنها بررسی خواهند کرد که چرا شما احتمالا مستعد ابتلا به خار پاشنه هستید و یک برنامه درمانی برای کاهش احتمال حملات بعدی شما ایجاد می کنند.

اشعه ایکس کلسیفیکاسیون یا استخوان را در فاسیای کف پا یا در زمان ورود آن به استخوان پاشنه نشان می دهد. این استخوان اضافی به عنوان خار پاشنه یا پاشنه شناخته می شود.

اسکن اولتراسوند و MRI هرگونه پارگی، التهاب یا کلسیفیکاسیون کف پا را شناسایی می کند.

آزمایشات پاتولوژی (از جمله غربالگری آنتی ژن HLA B27) ممکن است اسپوندیلوآرتریت را شناسایی کند، که می تواند علائمی شبیه به فاسیای کف پا ایجاد کند.

عوامل خطر برای خار پاشنه

در موارد زیر احتمال ابتلا به فاسیای کف پا و خار پاشنه در شما بیشتر است:

درمان خار پاشنه 

درد خار پاشنه به ندرت دائمی است. فاشیای کف پا، علت اصلی خار پاشنه، برگشت پذیر است و با موفقیت درمان می شود. بیش از 90 درصد از افراد مبتلا به فاشیای کف پا یا خار پاشنه با درمان فیزیوتراپی در بهترین مرکز فیزیوتراپی به طور قابل توجهی بهبود می یابند.

اگر درد کف پا یا درد خار پاشنه شما پس از چند ماه درمان محافظه کارانه ادامه یابد، پزشک ممکن است داروهای ضد التهابی استروئیدی (کورتیکواستروئید) را به پاشنه پا تزریق کند. نشان داده است که تزریق کورتیزون فواید کوتاه مدتی دارد، اما ممکن است پیشرفت شما را در میان مدت و بلندمدت به تاخیر بیاندازد، که می تواند به این معنی باشد که برای مدت طولانی تری از حملات مکرر رنج خواهید برد.

در سال اول درمان، از گزینه های غیر جراحی برای درد خار پاشنه استفاده می شود. استراحت نسبی از تمام فعالیت هایی که باعث درد پاشنه پا می شوند در ابتدا توصیه می شود.

فیزیوتراپی خار پاشنه

فیزیوتراپی به افزایش دامنه حرکتی مفصل از طریق کاهش تنش در عضلات اطراف و در نتیجه رباط فاشیای پلانتار کمک می کند تا استرس در منشاء آن بر روی پاشنه کاهش یابد. فیزیوتراپیست به افراد تمریناتی را برای کشش عضلات ساق پا و پا برای تسکین درد همراه ارائه می دهند. این تمرینات را می توان به تنهایی و قبل از فعالیت انجام داد. 

یک معیار اضافی برای افراد فعالی که درد همراه با ورزش دارند، کفش مناسب است. به افرادی که دردشان با یک جفت کفش خاص همراه است توصیه می شود استفاده از آنها را متوقف کنند. ممکن است به آنها دستور داده شود که یک ارتز را در کفش قرار دهند تا پاشنه پا را برای کاهش درد پا بالا بیاورند.  

سرما درمانی

درمان سرد و گرم نیز ممکن است برای درمان درد همراه با خار پاشنه استفاده شود. سرما درمانی برای التهاب رباط فاشیای کف پا مفید است. گرما به شل شدن ماهیچه های سفت کمک می کند و جریان خون را برای بهبودی به بافت های آسیب دیده کمک می کند.  

پس از 12 ماه درمان محافظه کارانه، در صورتی که پیشرفت قابل توجهی حاصل نشده باشد، احتمالاً برداشتن خار پاشنه با جراحی لازم است. این مداخله بیشترین خطر را در بین تمام درمان ها دارد. 

درمان خار پاشنه در یک نگاه

1. ورزش درمانی
2. پرداختن به علل زمینه‌ای درد پاشنه پا، مانند سفت شدن ساق پا، فاسیای کف پا، سفت شدن فلکسورهای لگن و غیره.
3. اصلاح  بیومکانیک پا  با تجویز کفی یا  ارتز  در صورت نیاز.
4. ارائه یک برنامه مدیریت طولانی مدت برای کمک به جلوگیری از عود.
5. خار پاشنه ممکن است در نهایت نیاز به تزریق داشته باشد، اما به طور کلی با درمان فیزیوتراپی برطرف می شود.
6. شاک ویو تراپی برای درمان خار پاشنه و درد فاشیای کف پا توصیه شده است. در حالی که ما این درمان را ارائه نمی دهیم، هر بیماری که در گذشته آن را دریافت کرده باشد، می گوید که احساس می کند از درمان ما که شامل همه موارد فوق است، سود بیشتری می برد.

What Is Mitral Valve Prolapse?

In mitral valve prolapse (MVP), also called Barlow’s syndrome, the flaps of the mitral valve do not close correctly. Instead, the valve bulges into the atrium. This can lead to mitral valve regurgitation, which means that blood leaks back into the left atrium through the prolapsed valve.

Only about three percent of Americans have mitral valve prolapse, according to the National Heart, Lung, and Blood Institute, and among these cases, serious complications are uncommon. (NHLBI) Most of the time, people with MVP do not have any symptoms, and it does not affect their daily lives.

What Are Risk Factors for Mitral Valve Prolapse?

Experts do not know exactly what causes MVP. Most people are born with abnormalities that cause the condition. These may include mitral valve flaps that are too big, thick, or stretchy. (NHLBI)

The Mayo Clinic reports that MVP is most commonly found in men over age (Mayo) It is also found more often in people born with disorders of the connective tissue (collagen, ligaments, tendons, etc.).

MVP often runs in families, so you may be more likely to have it if your parents or other relatives do.

Certain conditions may lead to mitral valve prolapse. These include:

• scoliosis–curvature of the spine
• adult polycystic kidney disease–a genetic condition in which large cysts interfere with kidney function
• Connective tissue problems such as Marfan’s syndrome–a genetic condition that affects the connective tissue of the skeletal and cardiovascular systems, eyes, and skin

How Is Mitral Valve Prolapse Treated?

In most cases, you won’t need any treatment for mitral valve prolapse. However, if you have noticeable symptoms, your doctor might choose to treat your condition.

Treatment often involves taking medications to help relieve any symptoms you’re experiencing. Possible medications your doctor might prescribe include:

• aspirin–to reduce the risk of blood clots
• beta blockers–to prevent your heart from beating irregularly and to improve blood flow
• blood thinners–to prevent blood clots
• diuretics–to remove excess fluid from the lungs
• vasodilators–to widen the blood vessels and improve blood flow

If your condition is more serious, such as if you have severe regurgitation or impaired heart function, you may need surgery. There are two basic types of surgery for this issue: valve replacement and valve repair. Your doctor will generally opt to repair the valve if possible.

If repairing the valve isn’t possible, it may be replaced with either a man-made mechanical valve or a biological valve harvested from a cow or pig or created from human tissue. There are pros and cons to both kinds of valves, so your doctor will discuss your options with you before the procedure.

RAE Systems Inc. announces the grand opening of a new larger facility to manage its European operations. “The new facility located at Kirstinehøj in Copenhagen will be our European gateway to Scandinavia, Western Europe, Eastern Europe, Russia, the Middle East, Africa, India, Australia and New Zealand in order to serve the industrial safety, petrochemical and public safety markets,” said Chris Hameister, vice

president, Europe, Middle East, and Asian operations. “This latest investment demonstrates RAE Systems Europe’s long-term service commitment to its customers, distribution partners and subsidiaries.”

“RAE Systems Europe ApS opened its doors in with three people. This new larger facility demonstrates our commitment, confidence, and success in the European market. Europe, the Middle East, India and the

surrounding countries continue to fuel our growth in industrial gas detection products,” said Robert Chen, president and CEO for

RAE Systems.

“Our European operations now include 30 people to manage sales, training, customer service, and distribution beyond the European

Union. It is a great pleasure to be in Copenhagen today to dedicate this new facility and to deliver best in class safety and security solutions for our European customers and distribution partners.”

Monitoring networks for energy production and refining, industrial and

environmental safety, and public and government first responder security sectors.

RAE Systems’ products are used in over 65 countries by many of the world’s leading corporations and by many international government agencies.

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• The bear market was a multi-year market-wide downturn
• Forward to and fundamentals are strong with some undervalued asset groups 
• Investors should expect short market-wide bear-phases and brutal group-wide downturns 
• The crypto market is no longer one cohesive entity. Invest accordingly

Context: the bear market

Those who have been in crypto for a few years still shudder when they think about the aftermath of the ICO craze. After an incredible run in the second half of November , bitcoin’s price lost 80% within a year. The flash flood of retail money that went in on a get-rich-quick-spree dried up almost as fast as it had arrived. 

Many ICO projects with lofty claims, promising to “Disrupt the X trillion $ ABC industry” lost 90% in the first month and then another 90%. More than a few never made it back from the abyss, as investors pulled the plug and called it quits.

Builders with genuine intentions and good projects faced difficulty with lining up funding rounds. Community-operated cryptocurrencies like Ethereum or bitcoin saw miners leave in droves and network security tank.

The gold-digger mentality of the past year left a disgusting aftertaste and made investors and developers give a wide berth around anything labelled crypto. 

The market stayed depressed for more than a year and only started to pick up again at the end of March It would take until November until bitcoin’s price would surpass the peaks of its bull run.

Bitcoin price during the bull market and its aftermath. Source: goalma.org

Why the sad faces?

The main reason for the crypto market depression is that most projects were vaporware. ICOs raised hundreds of millions with a whitepaper or just a website full of ludicrous claims.

Retail investors were happy to keep pumping bags as long as the number went up but got cold feet as they realised that many teams consisted of a web developer, five marketers, and little else. Distrust and disappointment fed upon each other as cryptocurrencies became notorious for being scams. A look at the total market capitalisation of the crypto market excluding bitcoin shows how severe the downturn was.

Total crypto market capitalisation excluding bitcoin. Source: goalma.org

$75m in October turned into $50m by mid The market cap before the ICO boom was reached again only in September Retail investors had bought heavily into an already frothy, overpriced market and got slaughtered as rational expectations returned and market participants saw that the king was without clothes.

Without a crystal ball to predict the future, it is best to look at fundamentals to gauge the stage of the market cycle. While no one can predict the movement of a market, there are clear indicators for caution that investors need to heed.

Fundamental difference

A fundamental approach to valuing the crypto market is complex because cryptocurrencies are more like emerging currencies than growth stocks. Numbrs research has an excellent piece on this.

On-chain analysts like Willy Woo or David Puell use a combination of indicators to get a clearer outlook. 

Bitcoin’s MVRV z-score, developed by Nic Carter et al., was a very accurate indicator for market tops in the past. Currently, at , this metric is far from market bottoms and nowhere near tops of 6 or above, last seen before the Mai sell-off, where bitcoin lost 50% of its value. It is also a far cry from the pre crash peaks of 9.

Bitcoin market value to realised value per standard deviation of market capitalisation. Source: goalma.org

Another intriguing piece of data is the amount of funding for blockchain projects. CBInsights reports a % increase when comparing the first nine months of to Not retail investors, but VCs and other professionals with a longer time horizon fund most projects.

Blockchain funding at record highs in Source: Twitter

Compared to ICOs, today’s crypto projects deliver. Decentralised finance now has more than $bn under management, and projects like SushiSwap or goalma.org have price-to-sales ratios of ten or lower.

Meanwhile, play-to-earn games like Axie Infinity open up whole new economies for thousands of gamers through secondary markets for in-game items and characters.

The fundamental difference between and is:

1. Bitcoin’s price is high but not frothy
2. Decentralised finance is still vacuuming up assets.
3. Play to earn seems just to get started
4. VC interest in funding blockchain companies is growing

Total market capitalisation has increased from $bn at the peak of to $tn in November The size of the market points to a different scenario for the “next crypto winter”.

Every man for himself

A closer look at the dynamics of the last year reveals that the “crypto market” doesn’t behave like a singular entity anymore. Compared to the price of ETH, DeFi tokens got pummeled with $SUSHI down % while play to earn token $AXS skyrocketed +% since the beginning of

The crypto market has started to differentiate. While tail risks like a Tether implosion or a regulatory crackdown would affect the market as a whole, investors should begin to approach crypto investments like macro or stock. Careful research and evaluation of individual projects is likely to yield better results than blanket purchases of the whole market. 

Bundling assets into groups and purchasing top projects is a good way to diversify. If exposure to play to earn games is desired, investors could buy $AXS, $YGG and $GALA. A conviction that DeFi tokens are undervalued could lead to purchasing $SUSHI, $SPELL and $OHM. Specific category indexes like the DeFi Pulse Index or the Metaverse index by IndexCoop allow purchasing of managed groups.

Or take the recent rise of Metaverse coins after Facebook rebranded itself as Meta. Tokens like $SAND outperformed the entire market measured in YTD gains within weeks.

Metaverse Index 3M performance. Source: goalma.org

Conclusion &#; This time it’s different

A style wipeout of all crypto assets across the board is highly unlikely this time. “History doesn’t repeat itself, but it rhymes”, Mark Twain famously said.

Instead of multi-year downtrends, we will see some group-agnostic bear phases of the whole crypto market with quick recoveries, as investors see that the grass isn’t greener anywhere else. And we’re almost destined to see brutal downdrafts of asset groups as crypto investors take profit and move elsewhere. 

Dips are opportunities to enter into overvalued assets or sectors, as this beautiful research by Galaxy Digital shows.

6M and 12M returns following bitcoin downturns. Source: Galaxy Digital

Buying the dip is not just a slogan in crypto; it makes good investing sense, primarily for drawdowns of % to %. To conclude: Onwards, to more dips!