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1

Nail Care Products  

MedlinePLUS

... basis to consumers also must bear an ingredient declaration, with the names of the ingredients listed in ... order of predominance. The requirement for an ingredient declaration does not apply, for example, to products used ...

2

Artificial Nails Require Care to Keep Nails Healthy  

MedlinePLUS

... beauty Nail care Artificial nails Artificial nails require care to keep nails healthy Acrylic nails, gel nails, ... nails look flawless. With a little bit of care, you can keep these artificial nails looking healthy ...

3

[Nails semiology].  

PubMed

For those interested in nails, a fairly good knowledge of the anatomy of the nail unit is indispensable. But nothing will replace a careful, clinical examination of the nail apparatus. The shape of the nail, surface abnormalities and coloration, with or without a magnifying glass, may well provide a medical diagnosis not only in dermatology but also for medicine in general. Pits on the surface of the nail plate may be enough to diagnose psoriasis on a limited area of scalp dandruff. Even partial detachment of the nail apparatus might lead to the suspicion of psoriatic arthritis. A triangular lunula is associated with the absence of patellas. Finally, no pulmonary examination of a smoker is complete without looking for clubbing. It is high time to pay tribute to the nail. PMID:25443634

Baran, Robert

2014-11-01

4

Nail Hygiene  

MedlinePLUS

... a number of people, as is common in commercial nail salons. Infections of the fingernails or toenails ... Clean any nail grooming tools before use. In commercial settings such as nail salons , sterilize nail grooming ...

5

Psoriatic Nails  

MedlinePLUS

... plate is becoming detached from the nail bed (onycholysis). There may be reddened skin around the nail. ... in nails: Psoriasis of fingernails. Psoriasis of fingernails. Onycholysis in psoriatic fingernails. Pustular psoriasis on toenails and ...

6

Final report of the safety assessment of methacrylate ester monomers used in nail enhancement products.  

PubMed

Methacrylate ester monomers are used in as artificial nail builders in nail enhancement products. They undergo rapid polymerization to form a hard material on the nail that is then shaped. While Ethyl Methacrylate is the primary monomer used in nail enhancement products, other methacrylate esters are also used. This safety assessment addresses 22 other methacrylate esters reported by industry to be present in small percentages as artificial nail builders in cosmetic products. They function to speed up polymerization and/or form cross-links. Only Tetrahydrofurfuryl Methacrylate was reported to the FDA to be in current use. The polymerization rates of these methacrylate esters are within the same range as Ethyl Methacrylate. While data are not available on all of these methacrylate esters, the available data demonstrated little acute oral, dermal, or i.p. toxicity. In a 28-day inhalation study on rats, Butyl Methacrylate caused upper airway irritation; the NOAEL was 1801 mg/m3. In a 28-day oral toxicity study on rats, t-Butyl Methacrylate had a NOAEL of 20 mg/kg/day. Beagle dogs dosed with 0.2 to 2.0 g/kg/day of C12 to C18 methacrylate monomers for 13 weeks exhibited effects only in the highest dose group: weight loss, emesis, diarrhea, mucoid feces, or salivation were observed. Butyl Methacrylate (0.1 M) and Isobutyl Methacrylate (0.1 M) are mildly irritating to the rabbit eye. HEMA is corrosive when instilled in the rabbit eye, while PEG-4 Dimethacrylate and Trimethylolpropane Trimethacrylate are minimally irritating to the eye. Dermal irritation caused by methacrylates is documented in guinea pigs and rabbits. In guinea pigs, HEMA, Isopropylidenediphenyl Bisglycidyl Methacrylate, Lauryl Methacrylate, and Trimethylolpropane Trimethacrylate are strong sensitizers; Butyl Methacrylate, Cyclohexyl Methacrylate, Hexyl Methacrylate, and Urethane Methacrylate are moderate sensitizers; Hydroxypropyl Methacrylate is a weak sensitizer; and PEG-4 Dimethacrylate and Triethylene Glycol Dimethacrylate are not sensitizers. Ethylene Glycol Dimethacrylate was not a sensitizer in one guinea pig study, but was a strong sensitizer in another. There is cross-reactivity between various methacrylate esters in some sensitization tests. Inhaled Butyl Methacrylate, HEMA, Hydroxypropyl Methacrylate, and Trimethylolpropane Trimethacrylate can be developmental toxicants at high exposure levels (1000 mg/kg/day). None of the methacrylate ester monomers that were tested were shown to have any endocrine disrupting activity. These methacrylate esters are mostly non-mutagenic in bacterial test systems, but weak mutagenic responses were seen in mammalian cell test systems. Chronic dermal exposure of mice to PEG-4 Dimethacrylate (25 mg, 2 x weekly for 80 weeks) or Trimethylolpropane Trimethacrylate (25 mg, 2 x weekly for 80 weeks) did not result in increased incidence of skin or visceral tumors. The carcinogenicity of Triethylene Glycol Dimethacrylate (5, 25, or 50%) was assessed in a mouse skin painting study (50 microl for 5 days/week for 78 weeks), but was not carcinogenic at any dose level tested. The Expert Panel was concerned about the strong sensitization and crossor co-reactivity potential of the methacrylate esters reviewed in this report. However, data demonstrated the rates of polymerization of these Methacrylates were similar to that of Ethyl Methacrylate and there would be little monomer available exposure to the skin. In consideration of the animal toxicity data, the CIR Expert Panel decided that these methacrylate esters should be restricted to the nail and must not be in contact with the skin. Accordingly, these methacrylate esters are safe as used in nail enhancement products when skin contact is avoided. PMID:16596769

2005-01-01

7

Nail Detachment  

Microsoft Academic Search

\\u000a Onycholysis describes detachment of the nail plate from the nail bed. It may be caused by traumatic, inflammatory, infective\\u000a or neoplastic nail disorders. Linking onycholysis to a specific cause is impossible in some cases (idiopathic onycholysis).\\u000a Onycholysis may affect the fi ngernails or the toenails. It generally starts distally due to disruption of the onychocorneal\\u000a band and moves proximally. Proximal

Antonella Tosti; Ralph Daniel; Bianca Maria Piraccini; Matilde Iorizzo

8

Green Nail Syndrome  

MedlinePLUS

... the nail bed; this is also known as onycholysis. When the nail is detached from the nail ... to the area under the nail contributes to onycholysis. People at risk for separated nails are gardeners, ...

9

Worn down nails after acrylic nail removal.  

PubMed

Worn-down nail syndrome is a nail disorder characterized by thinning of the distal nail plate caused by repetitive chemical or mechanical trauma. We present a previously undescribed source of worn-down nail syndrome caused by trauma from nail filing after acrylic nail removal. PMID:25612131

Wu, Timothy P; Morrison, Brian W; Tosti, Antonella

2015-01-01

10

Common nail disorders.  

PubMed

Brittle nail, simple chronic paronychia, and onycholysis represent three of the most prevalent nail disorders. Brittle nails are characterized by increased fragility of the nail plate due to damage to the nail matrix or changes to nail plate cohesion, caused by internal and/or external factors. Simple chronic paronychia represents an inflammatory process of the lateral and/or proximal nail folds of the fingernails or toenails often preceded by damage to the cuticle. Onycholysis describes the detachment of the nail plate from its nail bed, often attributable to dermatologic conditions, infections, drug therapy, or trauma. PMID:24079587

Shemer, Avner; Daniel, C Ralph

2013-01-01

11

Pin care  

MedlinePLUS

... bone - rod care; Broken bone - nail care; Broken bone - screw care ... Broken bones can be fixed in surgery with metal pins, screws, nails, rods, or plates. These metal pieces hold the bones in place while they heal. Sometimes, the ...

12

Keloid formation on the great toe after chronic paronychia secondary to ingrown nail.  

PubMed

Keloid is a clinically intractable fibro-proliferative disease that spreads beyond the original scar or lesion. Although several theories have attempted to explain the mechanism of keloid formation, the phenomenon still remains obscure. Our present study examines a rare case of keloid formation that occurred on the great toe after a repeated paronychia secondary to an ingrown nail. The 22-year-old female patient had a large keloid with chronic paronychia and a history of ingrown nails on her left great toe on both the lateral nail folds. We excised the keloids and made new lateral nail grooves without extracting the nail. The open wounds were conservatively managed with the help of moisturized dressings until the wounds were completely epithelialised. Adjuvant therapies with oral medication, intermittent intralesional injection and toe care were performed during the follow-up period. Histopathological analysis of the specimen revealed the presence of irregular, thick, glassy and dense collagen of keloid and inflammation of paronychia. During the 14-month follow-up period, adjuvant combination therapies successfully inhibited recurrence of keloid as well as paronychia and the normal appearance of the great toe was maintained. This study addresses a case of keloid formation on the great toe due to repeated recurrence of ingrown nails and consequent chronic paronychia. It is implied that if an ingrown nail is not controlled, it will result in the production of chronic inflammation and tension stress, which might trigger the formation of a secondary keloid. PMID:23506345

Lee, Kang Woo; Burm, Jin Sik; Yang, Won Yong

2013-04-01

13

-- Evaluating County-Based Healthy Nail Salon Recognition Program --  

EPA Science Inventory

Objectives: The City of San Francisco, California established a recognition program for nail salons that use safer nail products and receive worker safety training. This pilot study examined whether participating salons had reduced levels of toluene, methyl methacrylate (MMA), a...

14

Investigation of Human Nail Microstructure with Ultrasound  

NASA Astrophysics Data System (ADS)

Investigation of a human fingernail and the extraction of the data on its microstructure and elastic properties is important in three main aspects. First of all, various diseases of the nail can be differentiated more precisely; second of all, it is possible to non-invasively track during time the effects of a cosmetic product upon the nail; third of all, because various processes in the organism have a strong influence upon the nail plate growth, the monitoring of the nail morphology and its mechanical properties may be used as additional information for the diagnosis of a number of medical disorders, such as systemic sclerosis, psoriasis, chronic hand eczema, anemia etc. The aim of the present study was to carry out a detailed ultrasound investigation in the high-frequency range (25-50 MHz) of a human nail including micro-anatomical structure imaging and ultrasound velocity evaluation, using B-scans obtained with a scanning acoustic microscope. On the images, exact topology of the nail, nail matrix and the underlying bone have been revealed. Additionally, a certain type of inclined internal layering along the nails of some individuals has been found, which was not reported in previous ultrasonic studies of the nail.

Maeva, A. R.; Bakulin, E. Y.; Denisova, L. A.; Maev, R. Gr.

15

Home care: products and techniques.  

PubMed

Periodontal disease is common in dogs and cats. Prevention and treatment is important for general health and well-being of our pets. Both prevention and treatment of periodontal disease have two components, namely maintenance of oral hygiene and professional periodontal therapy. Maintenance of oral hygiene is performed by the owner and is, therefore, also called home care. The preventions and long-term control of periodontal disease requires adequate home care. This chapter details home care techniques and available products. PMID:11269998

Gorrel, C

2000-11-01

16

[Anatomy, biology, physiology and basic pathology of the nail organ].  

PubMed

The nail is the largest skin appendage. It grows continuously through life in a non-cyclical manner; its growth is not hormone-dependent. The nail of the middle finger of the dominant hand grows fastest with approximately 0.1 mm/day, whereas the big toe nail grows only 0.03-0.05 mm/d. The nails' size and shape vary characteristically from finger to finger and from toe to toe, for which the size and shape of the bone of the terminal phalanx is responsible. The nail apparatus consists of both epithelial and connective tissue components. The matrix epithelium is responsible for the production of the nail plate whereas the nail bed epithelium mediates firm attachment. The hyponychium is a specialized structure sealing the subungual space and allowing the nail plate to physiologically detach from the nail bed. The proximal nail fold covers most of the matrix. Its free end forms the cuticle which seals the nail pocket or cul-de-sac. The dermis of the matrix and nail bed is specialized with a morphogenetic potency. The proximal and lateral nail folds form a frame on three sides giving the nail stability and allowing it to grow out. The nail protects the distal phalanx, is an extremely versatile tool for defense and dexterity and increases the sensitivity of the tip of the finger. Nail apparatus, finger tip, tendons and ligaments of the distal interphalangeal joint form a functional unit and cannot be seen independently. The nail organ has only a certain number of reaction patterns that differ in many respects from hairy and palmoplantar skin. PMID:24718505

Haneke, E

2014-04-01

17

Nail psoriasis: a review.  

PubMed

Nail psoriasis is common, occurring in up to half of patients with psoriasis and in 90% of patients with psoriatic arthritis. Left untreated, it may progress to debilitating nail disease, which leads to significant functional impairment. The most common clinical signs of nail psoriasis are nail plate pitting and onycholysis. Other classical signs include oil drop discoloration, subungual hyperkeratosis, and splinter hemorrhages. The modified Nail Psoriasis Severity Index (mNAPSI) can be used to grade the severity of nail psoriasis, while the Nail Psoriasis Quality of Life Scale (NPQ10) is a questionnaire that evaluates the impact of nail psoriasis on the patient's functional status and quality of life. Treatment of nail psoriasis should be individualized according to the patient's preferences, severity of nail changes, and presence of skin and/or joint involvement. Both topical and intralesional therapies are safe and effective treatment modalities for nail disease, but are limited by poor adherence and pain, respectively. Systemic therapy such as oral retinoids may be considered for widespread nail disease causing significant morbidity. Among biologic agents, tumor necrosis factor-? inhibitors and T-cell-targeted therapies such as ustekinumab may be useful for refractory severe nail psoriasis. PMID:22784035

Tan, Eugene S T; Chong, Wei-Sheng; Tey, Hong Liang

2012-12-01

18

Fungal nail infection  

MedlinePLUS

... hair, nails, and outer skin layers. Common fungal infections include: Athlete's foot Jock itch Ringworm on the skin of the body or head Fungal nail infections are most often seen in adults. They often ...

19

Nail Lifting (Onycholysis)  

MedlinePLUS

... rise up like a hood. Nail lifting creates space under the nail that gathers dirt and debris ... 2006-2013 Logical Images, Inc. All rights reserved. Advertising Notice This Site and third parties who place ...

20

[Ingrown nails or onychocryptosis.  

PubMed

Ingrown nails come down to a conflict between the nail plate and the periungual tissue, causing pain, morbidity and impairment. The feet are mainly affected. The treatments are numerous: medical, podiatric, or surgical. Surgical management has two approaches: the techniques focused on the periungual skin and those on the nail plate. Among the latter, partial nail avulsion followed by matrix phenolization, known as "Boll's technique", is still highly regarded. PMID:25448121

Blatière, Véronique

2014-10-23

21

[Malignant nail tumors].  

PubMed

Because of the large number of different tissues making up the distal phalanx of fingers and toes, a large variety of malignant tumors can be found in and around the nail apparatus. Bowen disease is probably the most frequent nail malignancy. It is usually seen as a verrucous plaque of the nail fold and nail bed in persons above the age of 40 years. It slowly grows over a period of years or even decades before degenerating to an invasive squamous cell carcinoma. The latter may also occur primarily often as a weeping onycholysis. The next most frequent nail malignancy is ungual melanoma. Those arising from the matrix are usually pigmented and often start with a longitudinal melanonychia whereas those originating from the nail bed remain amelanotic, are often nodular and mistaken for an ingrown nail in an elderly person. The treatment of choice for in situ and early invasive subungual melanomas is generous extirpation of the nail apparatus whereas distal amputation is only indicated for advanced melanomas. In addition to these frequent nail malignancies, nail-specific carcinomas, malignant vascular and osseous tumors, other sarcomas, nail involvement in malignant systemic disorders and metastases may occur. In most cases, they cannot be diagnosed accurately on clinical grounds. Therefore, a high degree of suspicion is necessary in all isolated or single-digit proliferations that do not respond to conservative treatment. PMID:24718507

Haneke, E

2014-04-01

22

Incarcerated tibial nail.  

PubMed

Removal of intramedullary nails is considered a routine procedure but may prove to be challenging. Bone ongrowth or overgrowth, damage to the proximal threads of the nail, and broken nails or locking screws may complicate intramedullary nail removal. This article presents a case of a 28-year-old patient with an incarcerated tibial nail and describes a salvage procedure for tibia nail extraction after all previously described methods have failed. The authors recommend that no excessive force be used to extract an incarcerated nail but to approach the problem in a step-wise fashion. If the nail is still incarcerated and will not move, the tibia needs to be completely open by removing a one-third of circumference longitudinal bone window. It is important to discuss all the possible options with the patient during the consent. The patient may not be aware of the difficulties that can be encountered during nail removal and the fact that it may necessitate a major procedure followed by a prolonged recovery time. It is important to ascertain the reason for nail removal and whether it is necessary to implement even drastic measures to do so. Infection, nonunion, deformity or refracture requiring fixation are indications for nail removal. PMID:19301793

Lindeque, Bennie Gp; Agudelo, Juan

2009-02-01

23

[Psoriasis of the nails].  

PubMed

Psoriasis is an inherited chronic hyper proliferative autoimmune disease. Nail involvement is common and is found in 61% of cases of cutaneous psoriasis, with lifetime incidence of 90%; 80 to 90% in patients with psoriatic arthritis. Classical manifestations on the nail apparatus are correlated with the origin site of the disease. The proximal matrix produces pitting, trachyonychia and Beau's lines, transverse grooves. The distal matrix (lunula) may appear spotted or erythematous in color. Inflammation of the mid or distal matrix causes leuconychia due to nail incorporation of parakeratotic cells. Nail bed and hyponychium can show onycholysis, oil drops (salmon patches) subungual hyperkeratosis and at the distal nail bed splinter hemorrhages. Induction or severe exacerbation of psoriasis may be due to drugs, such as ?-blockers, lithium, antimalarial agents, anti-TNF and interferon. PMID:25443636

Baran, Robert

2014-11-01

24

Insights into drug delivery across the nail plate barrier.  

PubMed

Topical therapy is at the forefront in treating nail ailments (especially onychomycosis and nail psoriasis) due to its local effects, which circumvents systemic adverse events, improves patient compliance and reduces treatment cost. However, the success of topical therapy has been hindered due to poor penetration of topical therapeutics across densely keratinized nail plate barrier. For effective topical therapy across nail plate, ungual drug permeation must be enhanced. Present review is designed to provide an insight into prime aspects of transungual drug delivery viz. nail structure and physiology, various onychopathies, techniques of nail permeation enhancement and in vitro models for trans-nail drug permeation studies. Updated list of drug molecules studied across the nail plate and key commercial products have been furnished with sufficient depth. Patents pertinent to, and current clinical status of transungual drug delivery have also been comprehensively reviewed. This is the first systematic critique encompassing the detailed aspects of transungual drug delivery. In our opinion, transungual drug delivery is a promising avenue for researchers to develop novel formulations, augmenting pharmaceutical industries to commercialize the products for nail disorders. PMID:24964054

Saner, Manish V; Kulkarni, Abhijeet D; Pardeshi, Chandrakantsing V

2014-11-01

25

Bacterial Nail Infection (Paronychia)  

MedlinePLUS

... the skin. People with chronic paronychia may have periodic, painful flare-ups. This type of nail infection ... Dec 2008 Information for other ages: Child Infant Table of Contents: Overview Who's At Risk Signs and ...

26

[Nail involvement in leprosy].  

PubMed

Leprosy, a disease caused by Mycobacterium leprae, primarily affects the skin and nerves, but the nails are also involved in as many as 3 out of 4 patients .The factors that trigger nail changes in leprosy are numerous and include repeated trauma, neuropathy, vascular impairment, infections, lepra reactions, and the drugs used to manage the disease. The changes most often reported include subungual hematomas, onycholysis, onychauxis, onychogryphosis, pterygium unguis, and onychoheterotopia, most of which can be attributed to nerve damage and trauma. Furthermore, the acro-osteolysis that occurs in the advanced stages of the disease may present with brachyonychia, racquet nails, or even anonychia. Infections of the nail bed leading to paronychia and onychomycosis should also be taken into account in leprosy. Other typical changes include longitudinal striae, pitting, macrolunula, Terry nails, leukonychia, hapalonychia, and Beau lines. In this review, we describe the principal nail changes associated with leprosy. These changes, which are highly varied and diverse in origin, are in fact a reflection of the significant morbidity caused by M. leprae infection. PMID:22056258

Belinchón Romero, I; Ramos Rincón, J M; Reyes Rabell, F

2012-05-01

27

Treatment of Nail Psoriasis with a Two-Compound Formulation of Calcipotriol plus Betamethasone Dipropionate Ointment  

Microsoft Academic Search

Background: Treatment of nail psoriasis remains a challenge. Objective: To evaluate the efficacy of a two-compound product of calcipotriol plus betamethasone dipropionate ointment on nail psoriasis in an open-label study. Methods: Twenty-five psoriatic patients with nail involvement and mild cutaneous psoriasis were instructed to apply a calcipotriol-betamethasone valerate ointment formulation once daily for 12 weeks on affected nails. Outcome measures

D. Rigopoulos; S. Gregoriou; C. R. Daniel; III; H. Belyayeva; G. Larios; P. Verra; C. Stamou; G. Kontochristopoulos; G. Avgerinou; A. Katsambas

2009-01-01

28

Curvature Index of Pincer Nail  

PubMed Central

Summary: Pincer nails are a common problem, and various treatments have been reported. However, there is no simple assessment of severity. We designed a curvature index for the nail plate to assess the severity of pincer nail. Measurement of the curvature index was as follows. The apparent width of the nail tip was defined as A, and the traced length of the nail tip was defined as B. The curvature index was defined as B divided by A (B/A). With this curvature index, it is easy to describe the severity of the pincer nail and to compare the improvement before and after treatment. PMID:25289244

2013-01-01

29

Drug-induced nail disorders.  

PubMed

Nail disorders are defined according to their appearance and the part of the nail affected: the nail plate, the tissues that support or hold the nail plate in place, or the lunula. The consequences of most nail disorders are purely cosmetic. Other disorders, such as ingrown nails, inflammation, erythema, abscesses or tumours, cause functional impairment or pain. The appearance of the lesions is rarely indicative of their cause. Possible causes include physiological changes, local disorders or trauma, systemic conditions, toxic substances and drugs. Most drug-induced nail disorders resolve after discontinuation of the drug, although complete resolution sometimes takes several years. Drugs appear to induce nail disorders through a variety of mechanisms. Some drugs affect the nail matrix epithelium, the nail bed or the nail folds. Some alter nail colour. Other drugs induce photosensitivity. Yet others affect the blood supply to the nail unit. Nail abnormalities are common during treatment with certain cytotoxic drugs: taxanes, anthracyclines, fluorouracil, EGFR, tyrosine kinase inhibitors, etc. Some drugs are associated with a risk of serious and painful lesions, such as abscesses. When these disorders affect quality of life, the benefits of withdrawing the drug must be weighed against the severity of the condition being treated and the drug's efficacy, taking into account the harm-benefit balance of other options. Various anti-infective drugs, including tetracyclines, quinolones, clofazimine and zidovudine, cause the nail plate to detach from the nail bed after exposure to light, or cause nail discoloration. Psoralens and retinoids can also have the same effects. PMID:25162091

2014-07-01

30

Dressings and Products in Pediatric Wound Care  

PubMed Central

Significance: The increasing complexity of medical and surgical care provided to pediatric patients has resulted in a population at significant risk for complications such as pressure ulcers, nonhealing surgical wounds, and moisture-associated skin damage. Wound care practices for neonatal and pediatric patients, including the choice of specific dressings or other wound care products, are currently based on a combination of provider experience and preference and a small number of published clinical guidelines based on expert opinion; rigorous evidence-based clinical guidelines for wound management in these populations is lacking. Recent Advances: Advances in the understanding of the pathophysiology of wound healing have contributed to an ever-increasing number of specialized wound care products, most of which are predominantly marketed to adult patients and that have not been evaluated for safety and efficacy in the neonatal and pediatric populations. This review aims to discuss the available data on the use of both more traditional wound care products and newer wound care technologies in these populations, including medical-grade honey, nanocrystalline silver, and soft silicone-based adhesive technology. Critical Issues: Evidence-based wound care practices and demonstration of the safety, efficacy, and appropriate utilization of available wound care dressings and products in the neonatal and pediatric populations should be established to address specific concerns regarding wound management in these populations. Future Directions: The creation and implementation of evidence-based guidelines for the treatment of common wounds in the neonatal and pediatric populations is essential. In addition to an evaluation of currently marketed wound care dressings and products used in the adult population, newer wound care technologies should also be evaluated for use in neonates and children. In addition, further investigation of the specific pathophysiology of wound healing in neonates and children is indicated to promote the development of wound care dressings and products with specific applications in these populations. PMID:24761363

King, Alice; Stellar, Judith J.; Blevins, Anne; Shah, Kara Noelle

2014-01-01

31

Household Products Database: Personal Care  

MedlinePLUS

... Names Types of Products Manufacturers Ingredients About the Database FAQ Product Recalls Help Glossary Contact Us More ... holders. Information is extracted from Consumer Product Information Database ©2001-2014 by DeLima Associates. All rights reserved. ...

32

The nail in the elderly.  

PubMed

Treating elderly patients has become common in daily clinical practice. Consequently, it is important to focus our interest on a neglected region: the nail area. Anatomy and physiology are indispensable for a good comprehension of some phenomenons. Histopathology of senile changes may explain some pathologic situations and is indispensable for diagnosing uncommon tumors. Chemical composition shows that a normal nail contains 18% water. The rate of linear nail decreases as age advances. Ridging is a normal finding on fingernails, with color varying from shades of yellow to grey. The most common disorders, however, are linked to repeated trauma, with sometimes ingrowing toenails with different appearances. Tumors in the nail area are relatively frequent. Nail fungal infection may be isolated or associated with conditions such as psoriasis and diabetes. The management of the main nail disorders observed in the elderly are presented. PMID:21146733

Baran, Robert

2011-01-01

33

Titanium, Sinusitis, and the Yellow Nail Syndrome  

Microsoft Academic Search

Yellow nail syndrome is characterized by nail changes, respiratory disorders, and lymphedema. In a yellow nail patient with\\u000a a skeletal titanium implant and with gold in her teeth, we found high levels of titanium in nail clippings. This study aims\\u000a to examine the possible role of titanium in the genesis of the yellow nail syndrome. Nail clippings from patients with

Fredrik Berglund; Björn Carlmark

34

Ciclopirox vs amorolfine: in vitro penetration into and permeation through human healthy nails of commercial nail lacquers.  

PubMed

One of the pre-requisite for a successful topical antifungal drug indicated for onychomycosis is its bioavailability into the nail unit for achieving fungal eradication and clinical benefit. The aim of this study was to compare in vitro permeation/penetration through and into human nails of amorolfine (MRF) from a 5% anhydrous commercial formulation (Loceryl®) and ciclopirox (CPX) from the 8% aqueous formulation in hydroxypropyl chitosan (HPCH) technology (Onytec®). The ability of the active ingredient to reach efficacious concentrations to inhibit nail pathogens was also evaluated. The amounts of drug permeated and retained in human healthy nails were determined using a suitably modified diffusion apparatus. HPLC analysis of the samples was performed. The HPCH-based CPX formulation demonstrated an efficient penetration into and permeation through the nail plates. Conversely, Loceryl® produced an amount of MRF permeated through and penetrated into the human toenails significantly lower than CPX. The evaluation of the efficacy index showed a higher potential efficacy of Onytec® with respect to Loceryl® on nail pathogens. The present work not only reinforced the previous results on different experimental substrates, but pointed out the superiority of HPCH-based Onytec® formulation containing CPX with respect to Loceryl® commercial product with MRF, both in terms of higher permeation through and penetration into the human nail, and for the efficacy towards the most common ungual pathogens. PMID:24509963

Monti, Daniela; Tampucci, Silvia; Chetoni, Patrizia; Burgalassi, Susi; Mailland, Federico

2014-02-01

35

Cosmetics and Skin Care Products  

Microsoft Academic Search

\\u000a Contact allergy to ingredients of cosmetics is one of the most frequent causes of contact allergy. While patients may report\\u000a reactions to fragrance items, preservative allergy may not be suspected. The reaction typically resembles eczema on the face\\u000a or hands, although any body site may be affected. Products left on the skin are much more likely to cause allergic reactions

Jonathan M. L. White; Anton C. Groot; Ian R. White

36

Defining care products to finance health care in the Netherlands.  

PubMed

A case-mix project started in the Netherlands with the primary goal to define a complete set of health care products for hospitals. The definition of the product structure was completed 4 years later. The results are currently being used for billing purposes. This paper focuses on the methodology and techniques that were developed and applied in order to define the casemix product structure. The central research question was how to develop a manageable product structure, i.e., a limited set of hospital products, with acceptable cost homogeneity. For this purpose, a data warehouse with approximately 1.5 million patient records from 27 hospitals was build up over a period of 3 years. The data associated with each patient consist of a large number of a priori independent parameters describing the resource utilization in different stages of the treatment process, e.g., activities in the operating theatre, the lab and the radiology department. Because of the complexity of the database, it was necessary to apply advanced data analysis techniques. The full analyses process that starts from the database and ends up with a product definition consists of four basic analyses steps. Each of these steps has revealed interesting insights. This paper describes each step in some detail and presents the major results of each step. The result consists of 687 product groups for 24 medical specialties used for billing purposes. PMID:21350859

Westerdijk, Machiel; Zuurbier, Joost; Ludwig, Martijn; Prins, Sarah

2012-04-01

37

Urinary and air phthalate concentrations and self-reported use of personal care products among minority pregnant women in New York City  

PubMed Central

Diethyl phthalate (DEP) and di-n-butyl phthalate (DnBP) are used extensively in personal care products, including fragrances (DEP) and nail polish (DnBP). Between May 2003 and July 2006, we gathered questionnaire data on use of 7 product categories (deodorant, perfume, hair spray, hair gel, nail polish/polish remover, liquid soap/body wash, lotion/mist) over 48 hours during the 3rd trimester of pregnancy from 186 inner-city women. A 48-hour personal air sample was collected and analyzed for DEP and DnBP; a maternal spot urine sample was collected and analyzed for their monoester metabolites, monoethyl phthalate (MEP) and mono-n-butyl phthalate (MnBP), respectively. Ninety-seven percent of air samples and 84% of urine samples were collected within ±2 days of the questionnaire. During the 48 hours, 41% of women reported perfume use and 10% reported nail polish/polish remover use. In adjusted analyses, no association was seen between nail product use and air DnBP or urine MnBP concentrations. Women reporting perfume use had 2.3 times higher (95% CI 1.6, 3.3) urinary MEP concentrations. Personal air DEP increased 7% for each 25% increase in a composite indicator of the 6 other product categories (p<0.05) but was not associated with perfume use. Air DEP was correlated with urine MEP concentrations only among non-perfume users (r=0.51, p<0.001). Results suggest that perfume use is a significant source of DEP exposure. PMID:20354564

Just, Allan C.; Adibi, Jennifer J.; Rundle, Andrew G.; Calafat, Antonia M.; Camann, David E.; Hauser, Russ; Silva, Manori J.; Whyatt, Robin M.

2011-01-01

38

Cleanser, Detergent, Personal Care Product Pretreatment Evaluation  

NASA Technical Reports Server (NTRS)

The purpose of the Cleanser, Detergent, Personal Care Product, and Pretreatment Evaluation & Selection task is to identify the optimal combination of personal hygiene products, crew activities, and pretreatment strategies to provide the crew with sustainable life support practices and a comfortable habitat. Minimal energy, mass, and crew time inputs are desired to recycle wastewater during long duration missions. This document will provide a brief background on the work this past year supporting the ELS Distillation Comparison Test, issues regarding use of the hygiene products originally chosen for the test, methods and results used to select alternative products, and lessons learned from testing.

Adam, Niklas

2010-01-01

39

7 CFR 3201.97 - Sun care products.  

Code of Federal Regulations, 2014 CFR

...2014-01-01 2014-01-01 false Sun care products. 3201.97 Section 3201...PROCUREMENT Designated Items § 3201.97 Sun care products. (a) Definition. Products including sunscreens, sun blocks, and suntan lotions that are...

2014-01-01

40

7 CFR 3201.97 - Sun care products.  

Code of Federal Regulations, 2013 CFR

...2013-01-01 2013-01-01 false Sun care products. 3201.97 Section 3201...PROCUREMENT Designated Items § 3201.97 Sun care products. (a) Definition. Products including sunscreens, sun blocks, and suntan lotions that are...

2013-01-01

41

7 CFR 3201.70 - Hair care products.  

Code of Federal Regulations, 2013 CFR

...2013-01-01 2013-01-01 false Hair care products. 3201.70 Section 3201...PROCUREMENT Designated Items § 3201.70 Hair care products. (a) Definitions...hygiene products specifically formulated for hair cleaning and treating applications,...

2013-01-01

42

7 CFR 3201.70 - Hair care products.  

Code of Federal Regulations, 2012 CFR

...2012-01-01 2012-01-01 false Hair care products. 3201.70 Section 3201...PROCUREMENT Designated Items § 3201.70 Hair care products. (a) Definitions...hygiene products specifically formulated for hair cleaning and treating applications,...

2012-01-01

43

7 CFR 3201.70 - Hair care products.  

Code of Federal Regulations, 2014 CFR

...2014-01-01 2014-01-01 false Hair care products. 3201.70 Section 3201...PROCUREMENT Designated Items § 3201.70 Hair care products. (a) Definitions...hygiene products specifically formulated for hair cleaning and treating applications,...

2014-01-01

44

[Knowledge production on family health care].  

PubMed

In this article we present an overview of the publication about the health care in the family context. We developed a bibliographical research taking as source the following databases: SciELO, MEDLINE and Lilacs using the keywords: health care and family caregivers considering the period from 1995 through 2007. We realized that there are few studies on the subject and some of them are quite superficial in their approach. Our focus was directed to the understanding of: types of methodologies applied; theoretical approach; "care" concepts; analysis of culture and social class; references to networking; gender considerations and finally consensus and gaps in the studies. The results show that most of the studies assume a qualitative methodology compatible with the high complexity level of the studied subject and theoretical approaches of comprehensive character exploring meanings and conceptions. The discussion of the role of culture, social class distinctions and gender relations in the production and sourcing of health care arise once in a while but without the proper depth. The importance of the role of woman-mother in producing and providing health care is generally disregarded of criticism. We noticed a trend to use broader health care concepts that synthesize material, affective and social aspects, although without a discussion in a concrete way. PMID:20640312

Gutierrez, Denise Machado Duran; Minayo, Maria Cecília de Souza

2010-06-01

45

Heavy metal exposure from personal care products.  

PubMed

Numerous studies have described human exposure to heavy metals from diverse sources in Nigeria, but little is known about the exposure from personal care products, and few or no report is available on the personal care product concentrations of cadmium, chromium, copper and zinc, which have biotic effects. The levels of these elements were determined in 74 samples of 5 different classes of personal care products commonly used in Nigeria using atomic absorption spectrophotometry. Significant levels of Cd, Cr, Cu and Zn were found in all the products. The highest values of Cd (0.553 ppm) and Cu (0.783 ppm) were observed in hair cream, while medicated cream was mostly implicated for Cr (0.383 ppm) and Zn (0.793 ppm). Since no limit relating to cosmetic products is available, it is difficult to ascertain if the values of metals obtained in this study are too high or low; but Cd and Cr are prohibited in any amount in cosmetics. Prolonged use of soaps and creams containing these elements may pose threat to human health and the environment. PMID:19789830

Ayenimo, J G; Yusuf, A M; Adekunle, A S; Makinde, O W

2010-01-01

46

Drug-related nail disease.  

PubMed

Drug-induced nail abnormalities can present with a wide variety of clinical manifestations that are often dose-related and that disappear after drug withdrawal. Some nail changes are asymptomatic and only cause cosmetic problems, whereas others cause pain and discomfort and impair manual activities or deambulation. New side effects have been recently observed with different groups of anticancer agents. These include painful onycholysis and subungual abscesses caused by taxanes and anthracyclines (eg, doxorubicin) in addition to ingrown nails, paronychia, and pyogenic granuloma associated with the use of tyrosine kinase inhibitors of the epidermal growth factor receptor (eg, erlotinib, gefitinib). PMID:24079591

Piraccini, Bianca Maria; Alessandrini, Aurora

2013-01-01

47

Randomized controlled trial of a water-soluble nail lacquer based on hydroxypropyl-chitosan (HPCH), in the management of nail psoriasis  

PubMed Central

Background Nail psoriasis occurs in up to 50% of patients affected by psoriasis, with a significant impact on quality of life that leads to a real clinical need for new therapeutic options. Aim To confirm whether the strengthening and hardening properties of the hydroxypropyl-chitosan (HPCH) nail lacquer could improve the structure of the nail plates on psoriatic nails. Materials and methods A randomized, double-blind, placebo controlled, parallel-group trial was carried out to evaluate the efficacy and tolerability of a hydrosoluble nail lacquer containing HPCH, Equisetum arvense, and methylsulfonylmethane on nail psoriasis. The test product or a placebo was applied once daily for 24 weeks to all fingernails. Efficacy assessments were performed on the target fingernail by means of the modified Nail Psoriasis Severity Index score. A cut-off score of 4 was considered to define the clinical cure rate (ie, Cure ?4, Failure >4). Results After 24 weeks, the clinical cure rate showed the statistically significant superiority of the HPCH nail lacquer compared to placebo in both the intention-to-treat (Fisher’s exact test, P=0.0445) and the per protocol population (Fisher’s exact test, P=0.0437). This superiority was already present after 16 weeks of treatment. Moreover, the analysis of the modified Nail Psoriasis Severity Index-50 showed a statistically significant clinical improvement after 12 weeks of treatment in comparison to the results obtained after 8 weeks (Fisher’s exact test, P<0.05). Conclusion The trial showed that HPCH nail lacquer could be a new, valid, effective, and safe option for decreasing the signs of nail dystrophy in psoriatic patients. PMID:24904219

Cantoresi, Franca; Caserini, Maurizio; Bidoli, Antonella; Maggio, Francesca; Marino, Raffaella; Carnevale, Claudia; Sorgi, Paola; Palmieri, Renata

2014-01-01

48

Nail lengthening and fingertip amputations.  

PubMed

Fingertip injuries can be treated in different ways, including shortening with primary closure, skin grafts, and local or distant flaps. Nail bed involvement complicates fingertip reconstruction and may influence the choice of treatment. Local flaps can usually replace the pulp and provide a satisfactory functional and aesthetic result, whereas reconstruction of the fingernail apparatus is more difficult. In the period between 1998 and 2001, 12 fingertip injuries with nail bed involvement were treated with a combination of local flaps (Tranquilli-Leali and Venkataswami flaps) and the eponychial flap. The eponychial flap described by Bakhach is a backward cutaneous translation flap that lengthens the nail plate and restores a good appearance of the nail apparatus. This technique is simple to use and can be used with different flaps for pulp reconstruction. PMID:14504512

Adani, Roberto; Marcoccio, Ignazio; Tarallo, Luigi

2003-10-01

49

Micronutrients for Hair and Nails  

Microsoft Academic Search

\\u000a As the appearance of hair and nails is a major concern for woman worldwide, we have tried to collect the most reliable therapeutic\\u000a sources with a particular interest for micronutrients. The latter is a term used to include trace elements found in minerals,\\u000a vitamins, amino acids, and herbs. Some of them may be used in both hair and nails, for

E. Haneke; Robert Baran

50

The productivity of primary care research networks.  

PubMed Central

Primary care research networks are being publicly funded in the United Kingdom to promote a culture of research and development in primary care. This paper discusses the organisational form of these networks and how their productivity can be evaluated, drawing on evidence from management science. An evaluation of a research network has to take account of the complexity of the organisation, the influence of its local context, and its stage of development. Output measures, such as number of research papers, and process measures, such as number of research meetings, may contribute to an evaluation. However, as networking relies on the development of informal, trust-based relationships, the quality of interactions within a network is of paramount importance for its success. Networks can audit and reflect on their success in promoting such relationships and a more formal qualitative evaluation by an independent observer can document their success to those responsible for funding. PMID:11141879

Griffiths, F; Wild, A; Harvey, J; Fenton, E

2000-01-01

51

A method to modify angle-stable intramedullary nail construct compliance.  

PubMed

Traditional interlocked intramedullary (IM) nails have recently been modified to provide enhanced angular stability. These so-called 'angle-stable' IM nails are designed to eliminate construct toggle and also provide increased axial, bending, and torsional stiffness. While this added stability is needed for small fracture gaps to heal, angle-stable nails may be too stiff for large fracture gaps to unite. Even though relative stability is recommended for large fracture gaps, recent in vivo data indicates that traditional nails may allow for too much motion for healing to occur. The current study evaluated a modified technique for implanting an angle-stable nail which allows for an intermediate amount of stability. The compliance of the nail construct was adjusted by over-drilling the near cortex interlocking hole. This led to increased construct motion in torsion, but less so in axial compression and bending. This modification creates stability which is partway between angle-stable and traditional IM nail designs. These findings were unchanged after 50,000 fatigue loading cycles. By carefully selecting the magnitude of over-drilling, the compliance of the construct can easily be modified as it is being implanted. This design modification may lead to more reliable fracture union since the surgeon can tailor the nail compliance to the injury and bone quality. PMID:25328462

Flanagan, B P; LeCronier, D; Kubacki, M R; Telehowski, P; Atkinson, P

2014-01-01

52

Physics of nail conditions: why do ingrown nails always happen in the big toes?  

PubMed

Although surgical treatment of nail conditions can be traced back centuries to the writings of Paul Aegineta (625-690 AC), little is known about the physical laws governing nail growth. Such a poor understanding together with the increasing number of nail salons in the high street should raise legitimate concerns regarding the different procedures applied to nails. An understanding of the physics of nail growth is therefore essential to engage with human medicine and to understand the aetiology of nail conditions. In this context, a theory of nail plate adhesion, including a physical description of nail growth can be used to determine the transverse and longitudinal curvatures of the nail plate that are so important in the physical diagnosis of some nail conditions. As a result physics sheds light on: (a) why/how nails/hooves adhere strongly, yet grow smoothly; (b) why hoof/claw/nail growth rates are similar across species; (c) potential nail damage incurred by poor trimming; (d) the connection between three previously unrelated nail conditions, i.e. spoon-shaped, pincer and ingrown nails and; last but not least, (e) why ingrown nails occur preferentially in the big toes. PMID:25322083

Rauch, Cyril; Cherkaoui-Rbati, Mohammed

2014-12-01

53

Nail psoriasis: a review of the literature.  

PubMed

Nails are considered epidermal appendages, and as such, are commonly affected in patients with psoriasis, 80% of whom are likely to develop nail psoriasis as a result of their condition. Two patterns of nail disorders have been shown to be caused by psoriasis. Nail matrix involvement can result in features such as leukonychia, pitting (punctures or cupuliform depressions), red spots in the lunula and crumbling. Nail bed involvement, on the other hand, can cause onycholysis, salmon or oil-drop patches, subungual hyperkeratosis and splinter hemorrhages. Nail disease causes aesthetic and functional impairment, and is indicative of more severe forms of psoriasis as well as of joint involvement. The treatment for nail psoriasis involves behavioral interventions, topical medications, or systemic therapy in case of extensive skin or joint involvement. This article presents a review of the main features of nail psoriasis, its clinical presentation, diagnostic and assessment methods, clinical repercussions, and of its available treatment options. PMID:24770509

Schons, Karen Regina Rosso; Knob, Cristiane Faccin; Murussi, Nádia; Beber, André Avelino Costa; Neumaier, Walter; Monticielo, Odirlei André

2014-01-01

54

Nail psoriasis: a review of the literature*  

PubMed Central

Nails are considered epidermal appendages, and as such, are commonly affected in patients with psoriasis, 80% of whom are likely to develop nail psoriasis as a result of their condition. Two patterns of nail disorders have been shown to be caused by psoriasis. Nail matrix involvement can result in features such as leukonychia, pitting (punctures or cupuliform depressions), red spots in the lunula and crumbling. Nail bed involvement, on the other hand, can cause onycholysis, salmon or oil-drop patches, subungual hyperkeratosis and splinter hemorrhages. Nail disease causes aesthetic and functional impairment, and is indicative of more severe forms of psoriasis as well as of joint involvement. The treatment for nail psoriasis involves behavioral interventions, topical medications, or systemic therapy in case of extensive skin or joint involvement. This article presents a review of the main features of nail psoriasis, its clinical presentation, diagnostic and assessment methods, clinical repercussions, and of its available treatment options. PMID:24770509

Schons, Karen Regina Rosso; Knob, Cristiane Faccin; Murussi, Nádia; Beber, André Avelino Costa; Neumaier, Walter; Monticielo, Odirlei André

2014-01-01

55

Congenital malalignment of the big toe nail.  

PubMed

Congenital malalignment of the big toe nail is based on a lateral deviation of the nail plate. This longitudinal axis shift is due to a deviation of the nail matrix, possibly caused by increased traction of the hypertrophic extensor tendon of the hallux. Congenital malalignment of the big toe nail is typically present at birth. Ingrown toenails and onychogryphosis are among the most common complications. Depending on the degree of deviation, conservative or surgical treatment may be recommended. PMID:22117849

Wagner, Gunnar; Sachse, Michael Max

2012-05-01

56

The nail dystrophy of psoriatic arthritis  

Microsoft Academic Search

Nail abnormalities occur frequently in patients with psoriatic arthritis. This study of the finger nails of 46 patients with psoriatic arthritis, 100 nonpsoriatic rheumatism patients, and 100 nonpsoriatic general medical patients was designed to characterise these abnormalities with particular reference to the severity of nail pitting. The results of the study suggest: (1) Onycholysis alone in the absence of previous

C J Eastmond; V Wright

1979-01-01

57

Nail Changes Secondary to Docetaxel (Taxotere)  

Microsoft Academic Search

Docetaxel is a new taxoid antineoplastic drug widely used for advanced breast cancer. Skin and nail toxicity are one of the more frequent nonhematologic adverse reactions. Besides dark pigmentations and Beau’s lines, subungual hemorrhage, orange discoloration, acute painful paronychia, onycholysis, subungual hyperkeratosis and transverse loss of the nail plate are described. The type of nail alteration is related with the

O. Correia; C. Azevedo; E. Pinto Ferreira; F. Braga Cruz; J. Polónia

1999-01-01

58

[Diagnosis and management of nail psoriasis].  

PubMed

Nail psoriasis has traditionally been considered as one of the most difficult forms of psoriasis to treat. The most recent studies have found a higher prevalence of fungal infections in psoriatic nails and therefore cultures before and during treatment are necessary. Over the last few years, novel psoriatic therapies have been developed, some of which are effective for both skin and nail lesions (cyclosporine and biologic agents). Of the topical agents, vitamin D and A derivatives as well as nail lacquer containing 8 % clobetasol propionate can help improve lesions of both the nail bed and matrix. PMID:18206085

Sánchez-Regaña, M; Umbert, P

2008-01-01

59

Nail abnormalities associated with systemic pathologies.  

PubMed

Nail abnormalities can arise in conjunction with or as a result of systematic pathologies. These pathologies include single-organ diseases, multisystemic diseases, and drug-induced insults. Clinical signs associated with these conditions include dyschromias, vascular alterations, periungual tissue changes, textural dystrophies, contour alterations, and growth-rate alterations. The associated systemic pathologies may affect any part of the nail apparatus, including the nail matrix, the nail plate, the nail bed, the underlying vasculature, and the periungual tissues. The anatomical location and extent of damage determine the clinically manifested anomaly. PMID:24079592

Zaiac, Martin N; Walker, Ashley

2013-01-01

60

Nail Psoriasis: The Journey So Far  

PubMed Central

Nail involvement is an extremely common feature of psoriasis and affects approximately 10-78% of psoriasis patients with 5-10% of patients having isolated nail psoriasis. However, it is often an overlooked feature in the management of nail psoriasis, despite the significant burden it places on the patients as a result of functional impairment of manual dexterity, pain, and psychological stress. Affected nail plates often thicken and crumble, and because they are very visible, patients tend to avoid normal day-to-day activities and social interactions. Importantly, 70-80% of patients with psoriatic arthritis have nail psoriasis. In this overview, we review the clinical manifestations of psoriasis affecting the nails, the common differential diagnosis of nail psoriasis, Nail Psoriasis Severity Index and the various diagnostic aids for diagnosing nail psoriasis especially, the cases with isolated nail involvement. We have also discussed the available treatment options, including the topical, physical, systemic, and biological modalities, in great detail in order to equip the present day dermatologist in dealing with a big clinical challenge, that is, management of nail psoriasis. PMID:25071247

Dogra, Alka; Arora, Amanjot Kaur

2014-01-01

61

[A boy with nail abnormalities].  

PubMed

A 12-year-old boy consulted the dermatologist for nail abnormalities. Three weeks earlier, he was treated with doxycycline 100 mg BID for 10 days because of erythema chronicum migrans. Following sun exposure, the patient had developed distal onycholysis surrounded by a hyperpigmented zone. He was diagnosed with doxycycline-induced photo-onycholysis. PMID:23838405

Atiq, Nasirah; van Meurs, Tim

2013-01-01

62

Medicare Payment: Surgical Dressings and Topical Wound Care Products  

PubMed Central

Medicare patients' access to surgical dressings and topical wound care products is greatly influenced by the Medicare payment system that exists in each site of care. Qualified healthcare professionals should consider these payment systems, as well as the medical necessity for surgical dressings and topical wound care products. Scientists and manufacturers should also consider these payment systems, in addition to the Food and Drug Administration requirements for clearance or approval, when they are developing new surgical dressings and topical wound care products. Due to the importance of the Medicare payment systems, this article reviews the Medicare payment systems in acute care hospitals, long-term acute care hospitals, skilled nursing facilities, home health agencies, durable medical equipment suppliers, hospital-based outpatient wound care departments, and qualified healthcare professional offices. PMID:25126477

Schaum, Kathleen D.

2014-01-01

63

Medicare Payment: Surgical Dressings and Topical Wound Care Products.  

PubMed

Medicare patients' access to surgical dressings and topical wound care products is greatly influenced by the Medicare payment system that exists in each site of care. Qualified healthcare professionals should consider these payment systems, as well as the medical necessity for surgical dressings and topical wound care products. Scientists and manufacturers should also consider these payment systems, in addition to the Food and Drug Administration requirements for clearance or approval, when they are developing new surgical dressings and topical wound care products. Due to the importance of the Medicare payment systems, this article reviews the Medicare payment systems in acute care hospitals, long-term acute care hospitals, skilled nursing facilities, home health agencies, durable medical equipment suppliers, hospital-based outpatient wound care departments, and qualified healthcare professional offices. PMID:25126477

Schaum, Kathleen D

2014-08-01

64

Comparative anatomy of mouse and human nail units.  

PubMed

Recent studies of mice with hair defects have resulted in major contributions to the understanding of hair disorders. To use mouse models as a tool to study nail diseases, a basic understanding of the similarities and differences between the human and mouse nail unit is required. In this study we compare the human and mouse nail unit at the macroscopic and microscopic level and use immunohistochemistry to determine the keratin expression patterns in the mouse nail unit. Both species have a proximal nail fold, cuticle, nail matrix, nail bed, nail plate, and hyponychium. Distinguishing features are the shape of the nail and the presence of an extended hyponychium in the mouse. Expression patterns of most keratins are similar. These findings indicate that the mouse nail unit shares major characteristics with the human nail unit and overall represents a very similar structure, useful for the investigation of nail diseases and nail biology. PMID:23408541

Fleckman, Philip; Jaeger, Karin; Silva, Kathleen A; Sundberg, John P

2013-03-01

65

Comparative Anatomy of Mouse and Human Nail Units  

PubMed Central

Recent studies of mice with hair defects have resulted in major contributions to the understanding of hair disorders. To use mouse models as a tool to study nail diseases, a basic understanding of the similarities and differences between the human and mouse nail unit is required. In this study we compare the human and mouse nail unit at the macroscopic and microscopic level and use immunohistochemistry to determine the keratin expression patterns in the mouse nail unit. Both species have a proximal nail fold, cuticle, nail matrix, nail bed, nail plate, and hyponychium. Distinguishing features are the shape of the nail and the presence of an extended hyponychium in the mouse. Expression patterns of most keratins are similar. These findings indicate that the mouse nail unit shares major characteristics with the human nail unit and overall represents a very similar structure, useful for the investigation of nail diseases and nail biology. PMID:23408541

Fleckman, Philip; Jaeger, Karin; Silva, Kathleen A.; Sundberg, John P.

2013-01-01

66

How to Select Anti-Aging Skin Care Products  

MedlinePLUS

... Adult skin Anti-aging products: Selecting How to select anti-aging skin care products Dermatologists share their ... make a noticeable difference. When shopping for sunscreen, select one that offers all of the following: Broad ...

67

Fungal nail infections: diagnosis and management.  

PubMed

1) Fungal nail infection, or onychomycosis, mainly affects toenails. Infections are generally asymptomatic. Spontaneous regressions, but also complications, appear to be rare. Discomfort and cosmetic complaint are occasionally reported; 2) After a review of the literature based on the standard Prescrire procedure, we examined the diagnosis and management of fungal nail infections; 3) Clinical signs of fungal nail infections are non-specific. Alternative diagnoses include psoriasis and nail microtrauma. Nail hyperkeratosis and leukonychia are useful diagnostic pointers. Matrix involvement has important implications in the choice of treatment; 4) Detection of fungal structures by direct examination of a nail sample is strongly suggestive of fungal nail infection. In contrast, cases of negative direct examination with positive culture must be interpreted with caution, as contamination is frequent; 5) Antifungal lacquers (5% amorolfine and 8% ciclopirox) applied to the nails cure about 30% of fungal infections and sometimes cause mild irritation. There is no firm evidence that these solutions are any more effective than other topical antifungals applied daily to the affected nail. Trimming, filing or grinding the nail, in addition to these drug treatments, is likely to be beneficial, but these measures have not been evaluated; 6) Chemical nail destruction with a combination of urea and bifonazole, followed by treatment with an antifungal ointment, can be used when the nail is markedly thickened. Non-comparative trials have shown cure rates close to 70% at three months when the matrix is not involved, and 40% with matrix involvement. Drug application is inconvenient and local reactions are frequent. Surgical nail avulsion carries a risk of local infection and permanent nail dystrophy; 7) Oral terbinafine is effective in more than 50% of cases but its cutaneous, hepatic and haematological adverse effects are severe in about 1 in 2000 patients and can be life-threatening; 8) It is better to treat Candida nail infections with oral azoles (ketonazole, itraconazole) than with terbinafine. These treatments carry a risk of serious adverse effects and numerous drug interactions; 9) Fungal nail infections are usually mild. Treatments with potentially severe adverse effects must therefore be used with caution. It is better not to treat fungal nail infections if the risks outweigh the expected benefits. PMID:19391293

2009-02-01

68

Randomized Trial of Reamed and Unreamed Intramedullary Nailing of Tibial Shaft Fractures  

PubMed Central

Background: There remains a compelling biological rationale for both reamed and unreamed intramedullary nailing for the treatment of tibial shaft fractures. Previous small trials have left the evidence for either approach inconclusive. We compared reamed and unreamed intramedullary nailing with regard to the rates of reoperations and complications in patients with tibial shaft fractures. Methods: We conducted a multicenter, blinded randomized trial of 1319 adults in whom a tibial shaft fracture was treated with either reamed or unreamed intramedullary nailing. Perioperative care was standardized, and reoperations for nonunion before six months were disallowed. The primary composite outcome measured at twelve months postoperatively included bone-grafting, implant exchange, and dynamization in patients with a fracture gap of <1 cm. Infection and fasciotomy were considered as part of the composite outcome, irrespective of the postoperative gap. Results: One thousand two hundred and twenty-six participants (93%) completed one year of follow-up. Of these, 622 patients were randomized to reamed nailing and 604 patients were randomized to unreamed nailing. Among all patients, fifty-seven (4.6%) required implant exchange or bone-grafting because of nonunion. Among all patients, 105 in the reamed nailing group and 114 in the unreamed nailing group experienced a primary outcome event (relative risk, 0.90; 95% confidence interval, 0.71 to 1.15). In patients with closed fractures, forty-five (11%) of 416 in the reamed nailing group and sixty-eight (17%) of 410 in the unreamed nailing group experienced a primary event (relative risk, 0.67; 95% confidence interval, 0.47 to 0.96; p = 0.03). This difference was largely due to differences in dynamization. In patients with open fractures, sixty of 206 in the reamed nailing group and forty-six of 194 in the unreamed nailing group experienced a primary event (relative risk, 1.27; 95% confidence interval, 0.91 to 1.78; p = 0.16). Conclusions: The present study demonstrates a possible benefit for reamed intramedullary nailing in patients with closed fractures. We found no difference between approaches in patients with open fractures. Delaying reoperation for nonunion for at least six months may substantially decrease the need for reoperation. Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence. PMID:19047701

2008-01-01

69

IMAGE IN ENDOCRINOLOGY: Dirty Nails  

Microsoft Academic Search

42-YR-OLD MAN presented with symptoms and signs of hyperthyroidism, including a large symmetrical goi- ter with a bruit, tachycardia, brisk reflexes, and fingernail changes consistent with onycholysis (Plummer's nails), shown in Fig. 1. After thyroidectomy, he has remained well with nor- mal thyroid function tests. A photograph of his fingernails after 18 months of follow-up is shown in Fig. 2.

Hans K. Ghayee; John Q. A. Mattern; David S. Cooper

2005-01-01

70

Persistent Toenail Onycholysis Associated With Beta-Papillomavirus Infection of the Nail Bed.  

PubMed

: Onycholysis, separation of the nail plate from the nail bed, is etiologically classified as primary (idiopathic) or secondary (eg, caused by psoriasis, squamous cell carcinoma). Repetitive microtrauma plays a role in idiopathic onycholysis and also facilitates human papillomavirus (HPV) infection. Herein, we report a case of persistent primary onycholysis associated with repetitive trauma and infection by a multiplicity of Beta-papillomavirus (Beta-PV) genotypes. An otherwise healthy 27-year-old woman presented with a 6-year history of onycholysis of the halluces and right second toe. Her occupation required wearing steel-toed boots. Fungal cultures were negative and antifungal therapy was ineffective. Punch biopsy of the hallux nail bed revealed epidermal hyperplasia, acanthosis, hypergranulosis, hyperkeratosis, and regions of koilocytosis without significant inflammation. This histopathology implicated chronic irritation and HPV infection. Immunohistochemistry demonstrated productive HPV infection. Nested PCR using degenerate consensus primers revealed infection with 5 known and 1 novel Beta-PV genotypes (HPV 5, HPV 8, HPV 20, HPV 23, HPV 37, and FA25). The histopathology of primary onycholysis is unknown. Based on the aforementioned, we propose that repetitive microtrauma caused by wearing steel-toed boots promoted onycholysis and HPV infection, the latter of which, altered the differentiation of nail bed epithelium, preventing adhesion of nail plate to the nail bed. Lastly, the presence of oncogenic Beta-PV genotypes (ie, HPV 5, 8, and 20) implicates a risk for subungual squamous cell carcinoma, particularly if the nail remains symptomatic and persistently irritated. PMID:24999548

Umanoff, Nicole; Werner, Betina; Rady, Peter L; Tyring, Stephen; Carlson, J Andrew

2014-07-01

71

Nail Abnormalities: Clues to Systemic Disease  

Microsoft Academic Search

The visual appearance of the fingernails and toenails may suggest an underlying systemic disease. Clubbing of the nails often suggests pulmonary disease or inflammatory bowel disease. Koilonychia, or \\

ROBERT S. FAWCETT; Thomas M. Hart; SEAN LINFORD; DANIEL L. STULBERG

72

Methylisothiazolinone: An Emergent Allergen in Common Pediatric Skin Care Products  

PubMed Central

Recalcitrant dermatitis, such as that of the hands, face, or genitals, may be due to allergic contact dermatitis (ACD) from ingredients in seemingly innocuous personal care products. Rising rates of allergy have been noted due to the preservative methylisothiazolinone (MI). This preservative is commonly found in skin and hair care products, especially wipes. This study evaluated the use of MI in products specifically marketed for babies and children and examined the associated marketing terms of such products. Ingredients of skin care products specifically marketed for babies and children were surveyed at two major retailers. Of 152 products surveyed, 30 products contained MI. Categories of products surveyed included facial or body wipes, antibacterial hand wipes, hair products, soaps, bubble baths, moisturizers, and sunscreens. Facial or body wipes and hair products were the categories with the greatest number of MI-containing products. MI-containing products were manufactured by a number of popular brands. Of note, products marketed as “gentle,” “sensitive,” “organic,” or “hypoallergenic” often contained MI, thus emphasizing the importance of consumer scrutiny of product choices. These findings reinforce the importance of educating parents and providing consumer decision-making advice regarding common skin care products, in order to help prevent ACD in children. PMID:25342949

Schlichte, Megan J.

2014-01-01

73

Industry-Sponsored Child Care: A Question of Productivity.  

ERIC Educational Resources Information Center

This booklet discusses labor productivity in Texas industry as related to the increasing number of women and their need for child care. Information (in narrative and tabular form) is presented on: production costs and labor productivity, the recent influx of women into the Texas labor force, the social and economic characteristics of women in the…

Purnell, Mimi

74

PHARMACEUTICALS AND PERSONAL CARE PRODUCTS (PPCPS) AS ENVIRONMENTAL POLLUTANTS  

EPA Science Inventory

The occurrence of pharmaceuticals and personal care products (PPCPs) as trace environmental pollutants is a multifaceted issue whose scope of concerns continues to expand. PPCPs comprise thousands of distinct chemicals from numerous therapeutic and consumer classes. They typical...

75

PHARMACEUTICALS AND PERSONAL CARE PRODUCTS: DIVERSE GALAXY OF ENVIRONMENTAL POLLUTANTS  

EPA Science Inventory

The occurrence of pharmaceuticals and personal care products (PPCPs) as trace environmental pollutants is a multifaceted issue whose scope of concerns continues to expand. PPCPs comprise thousands of distinct chemicals from numerous therapeutic and consumer classes. They typical...

76

21 CFR 886.5928 - Soft (hydrophilic) contact lens care products.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Soft (hydrophilic) contact lens care products. 886... § 886.5928 Soft (hydrophilic) contact lens care products. (a) Identification. A soft (hydrophilic) contact lens care product is a...

2010-04-01

77

78 FR 49528 - Consolidation of Wound Care Products Containing Live Cells  

Federal Register 2010, 2011, 2012, 2013, 2014

...of Wound Care Products Containing Live Cells AGENCY: Food and Drug Administration...certain wound care products containing live cells from the Center for Devices and Radiological...more wound care products containing live cells are developed such consolidation is...

2013-08-14

78

The AO unreamed nail: friend or foe  

Microsoft Academic Search

Twenty-nine tibial shaft fractures were stabilized with the AO unreamed tibial nail. These included 13 type A fractures, 11 type B fractures and five type C injuries. Fourteen of the fractures were open. The AO unreamed tibial nail was the primary device used in all cases. Our series suggests that this is an easy device to insert and that its

F. S. Haddad; K. Desai; J. S. Sarkar; J. H. Dorrell

1996-01-01

79

The nail and hair in forensic science  

Microsoft Academic Search

Drugs, chemicals, and biological substances accumulate and are stored in hair and nails where they can be detected and measured. Advantages of analyzing hair and nail samples also include their easy and non-invasive collection, the small sample size required for analysis, and their easy storage at room temperature. We report 3 examples of heavy metal poisoning diagnosed because of the

C Ralph Daniel; Bianca Maria Piraccini; Antonella Tosti

2004-01-01

80

Functional Analysis and Treatment of Nail Biting  

ERIC Educational Resources Information Center

This study applied functional analysis methodology to nail biting exhibited by a 24-year-old female graduate student. Results from the brief functional analysis indicated variability in nail biting across assessment conditions. Functional analysis data were then used to guide treatment development and implementation. Treatment included a…

Dufrene, Brad A.; Watson, T. Steuart; Kazmerski, Jennifer S.

2008-01-01

81

Microstructure of Horseshoe Nails Using Neutron Diffraction  

NASA Astrophysics Data System (ADS)

Neutron diffraction allows nondestructive testing of the bulk microstructure of mechanical components. The microstructures of horseshoe nails made through three different processes have been explored as a function of position along the nail. Despite all nails being made of similar plain low-carbon steel and being process annealed after manufacture, the microstructures are far from the same. Nails made from strip, using a cold forging stamping process, show narrower diffraction peaks indicating a narrower distribution of lattice parameters and also show diffraction peak intensity ratios closer to those expected for unstrained steel. Thus, the distribution of the orientation of grains in these nails is closer to that of undistorted steel compared to nails made through the other two processes considered—one a drawing from wire and the other a combination of rolling and cold forging. The blades of the drawn nails showed little preferred orientation but the converse was true in the heads. Differing patterns of preferred orientation suggest that the various manufacturing approaches result in substantially different mechanical advantages for the three types of nails, a result in accord with mechanical testing.

Goossens, D. J.; Studer, A. J.; Stachurski, Z. H.

2010-04-01

82

Association of hypermobility and ingrown nails.  

PubMed

Ingrown nail (onychocryptosis) is a common condition with severe pain and various associated morbidities. Although some underlying factors are identified, its etiology remains largely unknown. Generalized joint hypermobility (GJH) is a common entity with clinical features that might prone affected individuals to ingrown nails. Herein, we investigated the incidence of GJH in patients with ingrown nails to determine possible association between hypermobility and ingrown nail formation. Patients 16-50 years of age who were undergoing treatment for ingrown nails at the dermatology clinic were consecutively enrolled into the study. Patients with known rheumatic diseases or orthopedic foot disorders were excluded. All patients were in a pain-free period at the time of examination. The control group was comprised of age- and sex-matched healthy subjects without a history of ingrown nail. Assessment of GJH was made according to Beighton criteria. Local hypermobility was evaluated by measurement of range of motion using a goniometer. Thirty-nine patients (male/female, 17/22, mean age 31.9?±?11.3 years) and 32 healthy subjects (male/female 12/20, mean age 31.7?±?10.4 years) were included. Patients with ingrown toe nails were more likely to have GJH compared to healthy subjects (35.9 vs. 9.4 %, p?=?0.009). Toes with ingrown nails had significantly smaller maximum dorsiflexion angles (p?nail formation may be associated with GJH. However, when examined locally, there is a limited range of motion in the affected toe rather than hypermobility, which could be due to the degenerative process facilitated by the hypermobility. PMID:22661053

Erdogan, Fatma Gulru; Tufan, Abdurrahman; Guven, Munevver; Goker, Berna; Gurler, Aysel

2012-09-01

83

"Nailing" the management of the ingrown great toenail.  

PubMed

"Nailing" the management of the severely ingrown great toenail, commonly encountered in the adolescent population, is an important tool in the pediatrician's armamentarium. I have found great toenail removal to be worthwhile, with straightforward indications; and quite rewarding for my patients in terms of time, convenience, and costs. The key to the procedure is to keep it simple. Four basic vital steps are involved: (1) operative permit and explanation; (2) performing a careful complete digital nerve block; (3) removing the entire toenail; and, importantly, (4) performing a partial chemical matricectomy--with readily available silver nitrate sticks--to prevent frequent recurrences. PMID:25369572

Block, Stan L

2014-11-01

84

Nails  

MedlinePLUS

... Media contacts Public service advertisements Stats and facts Gold Triangle Awards Stories and news News releases Press ... Teenage skin Tropical travel Vitamin D Cosmetic treatments Gold Triangle Awards Home Media resources Stats and facts ...

85

Phthalates in cosmetic and personal care products: Concentrations and possible dermal exposure  

Microsoft Academic Search

Phthalates are multifunctional chemicals that are used in a variety of consumer products including cosmetic and personal care products. This study aims at determining phthalate levels in cosmetic and personal care products obtained from the Canadian market. Overall 252 products including 98 baby care products were collected at retail stores in several provinces across Canada in year 2007. These products

Diane Koniecki; Rong Wang; Richard P. Moody; Jiping Zhu

2011-01-01

86

Hereditary onycho-osteodysplasia (nail-patella syndrome). A three-generation familial study.  

PubMed

Hereditary onycho-osteodysplasia or nail-patella syndrome is an uncommon familial musculoskeletal condition that is primarily seen initially in orthopaedic clinics. This three-generation familial review identifies three affected family members, one of whom demonstrated spondylolisthesis, a condition not previously associated with nail-patella syndrome. All affected family members demonstrated the typical radial nail dysplasias, hypoplastic patellae, iliac horns, and posterior dislocation of the radial heads. Overgrowth of the medial femoral condyles caused valgus deformities of the knees that necessitated orthotic treatment in the youngest affected family member. Although this syndrome has classic common musculoskeletal anomalies, the lumbar spine should also be carefully examined for the presence of spondylolysis and for signs of potential spondylolisthetic development. PMID:2023790

Letts, M

1991-03-01

87

[Nail psoriasis--an ignored disorder. Pathogenesis, diagnosis and therapy].  

PubMed

Approximately 50% of all patients with psoriasis develop characteristic nail changes as a clinical correlate of psoriatic inflammation of the nail matrix and/or nail bed. The most frequent signs of nail psoriasis are pitting and distal onycholysis. The most commonly used score to assess the severity of nail involvement at present is the Nail Psoriasis Severity Index (NAPSI). Although more than half of affected patients experience a significant physical and mental impairment, this index does not include patient-reported symptoms. There is a striking association between nail psoriasis and a higher risk of psoriatic arthritis with a prevalence of nail involvement among patients with psoriatic arthritis as high as 70%. A possible explanation is the close anatomical link between the nail apparatus and the distal interphalangeal joint; enthesitis of the latter is carried by fibers to the nail and becomes clinically visible as nail psoriasis. Nail involvement is not adequately reflected in current concepts of disease management. There is limited evidence for the efficacy of topical therapies in nail psoriasis. A number of large studies document an improvement of nail psoriasis in response to biologics and, more recently, also to methotrexate. PMID:22382303

Kahl, C; Hansen, B; Reich, K

2012-03-01

88

Heat profiles of laser-irradiated nails  

NASA Astrophysics Data System (ADS)

Onychomycosis is a worldwide problem with no tendency for self-healing, and existing systemic treatments achieve disease-free nails in only 35 to 76% of cases. Recently, treatment of nail fungus with a near-infrared laser has been introduced. It is assumed that fungal eradication is mediated by local heat. To investigate if laser treatment has the potential to eradicate fungal hyphae and arthrospores, laser heat application and propagation needs to be studied in detail. This study aimed to measure nail temperatures using real-time videothermography during laser irradiation. Treatment was performed using 808- and 980-nm linear scanning diode lasers developed for hair removal, enabling contact-free homogeneous irradiation of a human nail plate in one pass. Average and peak temperatures increased pass by pass, while the laser beam moved along the nail plates. The achieved mean peak temperatures (808 nm: 74.1 to 112.4°C, 980 nm: 45.8 to 53.5°C), as well as the elevation of average temperatures (808 nm: 29.5 to 38.2°C, 980 nm: 27.1 to 32.6°C) were associated with pain that was equivalent to that of hair removal procedures and was not significantly different for various wavelengths. The linear scanning laser devices provide the benefits of contact-free homogeneous heating of the human nail while ensuring adequate temperature rises.

Paasch, Uwe; Nenoff, Pietro; Seitz, Anna-Theresa; Wagner, Justinus A.; Kendler, Michael; Simon, Jan C.; Grunewald, Sonja

2014-01-01

89

Sarcoid and the nail: review of the literature.  

PubMed

Nail involvement in sarcoidosis is rare, but its presence is often associated with chronic systemic disease. We have reviewed all 33 reported cases of nail involvement with sarcoidosis, including our own case. Nail changes in sarcoidosis, while rare, can include dystrophy (n=10, 30%), onycholysis (n=7, 21%), subungual hyperkeratosis (n=7, 21%), nail hyperkeratosis (n=2, 6%) and longitudinal ridging (n=8, 24%). All reported cases of nail sarcoidosis occurred in the setting of systemic involvement. In almost half of the cases, bony cysts were noted on radiological examination. The presence of nail dystrophy in a patient with sarcoidosis should therefore prompt radiological examination and investigation for systemic involvement. PMID:23368092

Momen, S E; Al-Niaimi, F

2013-03-01

90

Treatment of ingrown nail: comparison of recurrence rates between the nail matrix phenolization classical technique and phenolization associated with nail matrix curettage - is the association necessary?  

PubMed

Some services in Brazil combine curettage of the nail matrix with phenolization in the treatment of ingrown nails, with the objective of further increasing efficacy. The objective of this research was to compare the cure rates between the phenolization technique and phenolization associated with nail matrix curettage. A retrospective study was done which included 271 cases. There was only a 5% recurrence rate for the phenolization procedure, compared with 7.7% for combined phenolization/nail matrix curettage. There was no statistically significant difference between the two techniques, which indicated that there is no need for curettage of the nail matrix. Phenolization worked even for level III disease. PMID:22147058

Tassara, Glaysson; Machado, Mônica Alberto; Gouthier, Mabely Araújo Duarte

2011-01-01

91

Ultrasonography reveals nail thickening in patients with chronic plaque psoriasis.  

PubMed

Nail psoriasis is usually investigated and diagnosed by clinical examination. Ultrasonography is a non-invasive imaging technique for studying soft tissue involvement. The objective of this study was to estimate nail involvement in patients with chronic plaque psoriasis by ultrasonography. Prevalence, clinical type and severity of nail involvement according to nail psoriasis and severity index (NAPSI) were investigated in 138 patients with psoriasis. The thickness of the plate and bed of the fingernails was measured in 54 patients with psoriasis, 46 healthy controls and 37 patients with chronic eczema, using an ultrasonographic system equipped with a frequency transducer of 18 MHz. The prevalence of nail psoriasis was 73 % (102 out of 138). Onycholysis and thickening of the nail plate were the most common clinical type affecting 56 and 50 % of patients, respectively; splinter haemorrhages was the less common involving 10 % of patients. The mean NAPSI score was 18.4 ± 17.5 (SD; range 0-107). The thickness of fingernail plate and bed was significantly higher in patients with psoriasis with nail disease compared to healthy controls and patients with chronic eczema (p < 0.001). There was a linear correlation between NAPSI and plate and bed nail thickness (r = 0.52 and r = 0.38, p = 0.001). Increased nail plate and bed thickness was observed also in patients with psoriasis without clinically apparent nail involvement. In conclusion, thickening of the nail is a common feature of nail psoriasis also in patients without clinically apparent nail involvement. PMID:23011659

Gisondi, P; Idolazzi, L; Girolomoni, G

2012-11-01

92

A modified intramedullary nail interlocking design yields improved stability for fatigue cycling in a canine femur fracture model.  

PubMed

Intramedullary nailing has evolved to become the standard of care for most diaphyseal femoral and tibial fractures, as well as an expanding number of metaphyseal fractures. Owing to the unstable nature of some fractures, the intramedullary device may be subjected to significant stresses owing to a lack of solid cortical contact after nailing. In such cases, excessive interfragmentary motion (due to construct toggle) has been shown to occur. Such motion increases the likelihood of a non- or delayed-union. In the current study, two versions of a modified, angle stable interlocking design were subjected to fatigue testing in a segmental defect fracture model representing a canine femur. As a control, a third group of constructs were stabilized with a traditional nail that allowed a small amount of toggle. All constructs were subjected to 50,000 fatigue cycles representing 12 weeks of cage activity at physiologic levels of combined axial-torsional loading. Torsional testing pre- and post-fatigue revealed 4.6 +/- 1.3 degrees of toggle in the traditional nail and no toggle with the angle stable nail designs. The stable nails were also significantly stiffer in axial compression and torsion before and after cycling. These data indicate that the enhanced stability of the modified interlocking designs can be maintained throughout fatigue cycling in a challenging fracture model. PMID:22783763

Garlock, Adam N; Donovan, Jim; LeCronier, David J; Houghtaling, John; Burton, Stephen; Atkinson, Patrick J

2012-06-01

93

Soft-tissue nail-fold excision: a definitive treatment for ingrown toenails  

PubMed Central

Background Ingrown toenail, or onychocryptosis, is a common source of morbidity worldwide. The current standard of care focuses on the nail as the causative agent, and, in cases that are resistant to medical management, surgical correction via nail avulsion and phenol matrix ablation is used. Unfortunately, this treatment leads to poor cosmetic results, high rates of recurrence and low patient satisfaction. Methods We retrospectively reviewed a case series of 124 consecutive patients who underwent surgical correction of ingrown toenails from 1988 to 2004. We recorded the operative technique and postoperative wound healing via photographs. We assessed outcomes and patient satisfaction using self-reports and 7-point Likert scale questionnaires. Results Our surgical approach involved the excision of excessive nail-fold granulation tissue with preservation of the nail and its matrix. In total, 72.5% of patients were under the age of 29 (69.4% men). Before surgical intervention, 78.8% of patients scored their pain as severe, 69.9% had difficulty wearing normal footwear and 64.3% had difficulty with normal activities because of their ingrown toenails. A total of 212 surgical sites were analyzed, with a median follow-up of 8 years. No recurrences were identified in any patients (100%, n = 124). Overall, 94.3% (n = 116) stated that they were highly satisfied with the procedure. Only 1.6% (n = 2) reported a loss of sensation at the surgical site. Conclusion Surgical correction of ingrown toenails via soft-tissue excision of the nail folds, coupled with preservation of the nail and its matrix, had excellent cosmetic results, no recurrences and high rates of patient satisfaction. PMID:20646404

Chapeskie, Henry; Kovac, Jason R.

2010-01-01

94

Allergic contact dermatitis from sculptured acrylic nails: special presentation with an airborne pattern.  

PubMed

Methylmethacrylate was first reported in 1941 as a cause of contact dermatitis. Since then, occupational contact allergies to acrylates in dentistry, orthopedic surgery, printing industry and industry have been reported, but few reports are found in the literature as a consequence of the contact with sculptured artificial acrylic nails which are increasingly popular. We describe here 3 patients with contact allergy to acrylates in artificial sculptured nails. Patch tests were performed with the Portuguese baseline series of contact allergens and an extended series of acrylates were applied. In particular, we tested three female patients with allergic contact dermatitis from sculptured acrylic nails. Two of these patients were both customers and also technical nail beauticians. Two patients developed periungual eczema; one presented only with face and eyelid dermatitis had no other lesions. The tests showed positive reaction to 2-hydroxyethylmethacrylate (2-HEMA) and 2-hydroxypropylmethacrylate (2-HPMA) in all the three patients. Our cases demonstrate the variety of clinical presentations of allergic contact dermatitis from acrylic sculptured nails. They show the need to warn patients of persistent and sometimes permanent side effects of these products. They also emphasize the importance of cosmetic ingredient labeling. PMID:25386316

Maio, Paula; Carvalho, Rodrigo; Amaro, Cristina; Santos, Raquel; Cardoso, Jorge

2012-01-01

95

A Clinical Trial to Investigate the Effect of Cynatine HNS on Hair and Nail Parameters  

PubMed Central

Objective. A new, novel product, Cynatine HNS, was evaluated for its effects as a supplement for improving various aspects of hair and nails in a randomized, double-blind, placebo-controlled clinical trial. Methods. A total of 50 females were included and randomized into two groups. The active group (n = 25) received 2 capsules containing Cynatine HNS, comprised of Cynatine brand keratin (500?mg) plus vitamins and minerals, per day, and the placebo group (n = 25) received 2 identical capsules of maltodextrin per day for 90 days. End points for hair loss, hair growth, hair strength, amino acid composition, and hair luster were measured. End points were also measured for nail strength and the appearance of nails. Results. The results show that subjects taking Cynatine HNS showed statistically significant improvements in their hair and nails when compared to placebo. Conclusion. Cynatine HNS is an effective supplement for improving hair and nails in 90 days or less. EudraCT number is 2014-002645-22. PMID:25386609

Veghte, Robert H.

2014-01-01

96

Human dermal exposure to galaxolide from personal care products.  

PubMed

Musks are synthetic fragrances applied on personal care and household products as fixatives, by retarding the release of other fragrances with higher volatility. Galaxolide is the most used polycyclic musk since the 90th decade, and it has been detected in several environmental and biological matrices, particularly in human tissues and fluids. For exposure assessment purposes, large-monitoring data need to be obtained and rapid but reliable analytical techniques are requested. The main objective of this study is to develop and validate a new and fast analytical methodology to quantify galaxolide in personal care products and to apply this method to real matrices like skin care products (creams and lotions), shower products (soap bar), hair care products (shampoo and hair conditioner) and oral care products (toothpaste), to evaluate the human dermal exposure risk. A dispersive solid-phase extraction is proposed, using QuEChERS methodology, followed by HPLC with fluorescence detection. Some extraction parameters were studied, like the ratio of sample/solvent amounts, the homogenization time, the salt addition effect and the used sorbents. The validation parameters of the developed method were the following: a linearity range of 0.005-1.002 mg kg?¹ sample, a limit of detection of 0.001 mg kg?¹ sample, repeatability between 0.7% and 11.3% (variation coefficient of six standard injections), an intermediate precision of 2.5% (variation coefficient of six independent analysis of the same sample), mean recoveries ranging from 65% (soap bar) to 95% (body cream) and 3% of global uncertainty in most of the working range. The time of analysis, including the extraction steps, is 60 min, allowing a throughput of 4 samples h?¹ . Galaxolide was detected in all of the seven analysed products in concentrations ranging from 0.04 ± 0.01 mg kg?¹ sample (toothpaste) to 280.78 ± 8.19 mg kg?¹ sample (perfumed body cream), which may correspond to a significant estimated daily human dermal exposure of 904 ?g day?¹. PMID:23406205

Correia, P; Cruz, A; Santos, L; Alves, A

2013-06-01

97

Contact Allergen Avoidance Program: a topical skin care product database.  

PubMed

Management of allergic contact dermatitis can be challenging for patients because of difficulties they encounter while attempting to avoid antigens identified by patch tests. The disorder is commonly caused by fragrances, preservatives, or other ingredients found in skin care products. After patch testing, the clinician routinely educates the patient on the sources of the antigens to which he or she is sensitive. Because typical allergen names are long, are difficult to spell, commonly have numerous complex synonyms, and are often frankly intimidating for patients, compliance with allergen avoidance is frequently problematic. We have developed a Contact Allergen Avoidance Program database tool that generates an extensive list of skin care products that are free of the given patient's allergens. It has been used clinically for 2 years to facilitate successful antigen avoidance and has been positively received by both patients and clinicians. PMID:11123418

Yiannias, J A; el-Azhary, R A

2000-12-01

98

Fatigue strength of common tibial intramedullary nail distal locking screws  

Microsoft Academic Search

BACKGROUND: Premature failure of either the nail and\\/or locking screws with unstable fracture patterns may lead to angulation, shortening, malunion, and IM nail migration. Up to thirty percent of all unreamed nail locking screws can break after initial weight bearing is allowed at 8–10 weeks if union has not occurred. The primary problem this presents is hardware removal during revision

Lanny V. Griffin; Robert M Harris; Joseph J Zubak

2009-01-01

99

Unusual manifestation of the yellow nail syndrome - Case report*  

PubMed Central

The yellow nail syndrome is a rare disorder characterized by the classic triad of yellow and dystrophic nails, lymphedema and pleural effusion. We report in this paper a case of yellow nail syndrome, presenting the classic triad of the disease, associated with an unusual lymph accumulation in the abdomen region. PMID:24937826

Papaiordanou, Francine; Epstein, Marina Gabrielle; Miyaoka, Mariana Yumi; Yang, Jeane Jeong Hoon; Pires, Mario Cezar

2014-01-01

100

Thumbnail Sketches: EDTA-Type Chelating Agents in Everyday Consumer Products: Some Medicinal and Personal Care Products.  

ERIC Educational Resources Information Center

Discusses various ethylenediaminetetraacetate (EDTA)-type chelating agents found in ophthalmic products, personal care products, and disinfectants. Also discusses the properties and action of these EDTA agents. (JN)

Hart, J. Roger

1984-01-01

101

Usage pattern of personal care products in California households Xiangmei (May) Wu a  

E-print Network

the potential for health risks associated with certain ingredients (e.g., phthalates) in personal care products care products, e.g., phthalates, oxybenzone, triclosan, heavy metals (e.g., lead and arsenic

Leistikow, Bruce N.

102

Controversies in the Treatment of Ingrown Nails  

PubMed Central

Ingrown toenails are one of the most frequent nail disorders of young persons. They may negatively influence daily activities, cause discomfort and pain. Since more than 1000 years, many different treatments have been proposed. Today, conservative and surgical methods are available, which, when carried out with expertise, are able to cure the disease. Packing, taping, gutter treatment, and nail braces are options for relatively mild cases whereas surgery is exclusively done by physicians. Phenolisation of the lateral matrix horn is now the safest, simplest, and most commonly performed method with the lowest recurrence rate. Wedge excisions can no longer be recommended PMID:22675345

Haneke, Eckart

2012-01-01

103

Controversies in the treatment of ingrown nails.  

PubMed

Ingrown toenails are one of the most frequent nail disorders of young persons. They may negatively influence daily activities, cause discomfort and pain. Since more than 1000 years, many different treatments have been proposed. Today, conservative and surgical methods are available, which, when carried out with expertise, are able to cure the disease. Packing, taping, gutter treatment, and nail braces are options for relatively mild cases whereas surgery is exclusively done by physicians. Phenolisation of the lateral matrix horn is now the safest, simplest, and most commonly performed method with the lowest recurrence rate. Wedge excisions can no longer be recommended. PMID:22675345

Haneke, Eckart

2012-01-01

104

Gauze Strip Tourniquet for Nail Surgery  

PubMed Central

All nail surgical procedures require the use of a tourniquet. The nail bed, being a very vascular structure, needs to be exsanguinated at the start and then a tourniquet needs to be tied at the base. A number of tourniquets have been described, including a Foley's catheter, a Penrose drain, a rubber strip or a rubber band. The present article explains the use of the easily available, improvised, gauze strip tourniquet. This does not require much special preparation, is easily autoclavable, perfect for single use and can achieve exsanguination as well as tightening as a single step. This technique does not require much learning and is easily reproducible in almost all surgical setups.

Grover, Chander; Nanda, Soni; Nagi Reddy, Belum Siva

2014-01-01

105

Frequency and longitudinal trends of household care product use  

NASA Astrophysics Data System (ADS)

The use of household cleaning products and air fresheners exposes people to a variety of chemicals, including some that have been shown to be irritants, potential carcinogens and endocrine disrupting compounds. In addition, some react with ambient ozone infiltrating to the indoor environment to form potentially toxic secondary pollutants. Although realistic estimates of usage patterns are necessary for modeling potential exposures in risk assessments, few studies have documented cleaning habits and product usage to characterize how they vary between households and over time. In addition, understanding within-household temporal variability of use is important to assess the reliability of exposure questionnaires used in epidemiological surveys and improve the cost-efficiency of data collection. In the SUPERB (Study of Use of Products and Exposure-Related Behavior) study, frequencies of use of eight types of household cleaning products and air fresheners and the performance of different types of cleaning tasks are collected in three annual telephone and six quarterly web-based surveys. All-purpose and glass cleaners were the products most frequently used among all products surveyed. Use frequencies differed by demographic and other household characteristics for some products. Product usage was internally consistent, with over 75% of pairwise cross-sectional correlations between product types statistically significantly different from zero. In addition, each product type was correlated with at least one cleaning habit. Frequency of cleaning product use and performing cleaning tasks did not vary by season. An examination of intra-household variability showed moderately to highly consistent usage patterns over time, with lower temporal consistency observed among products used more frequently, such as all-purpose cleaners. Frequency of household care product usage was consistent enough that in epidemiologic studies, participants can be classified, for example, into three categories on the basis of a single assessment, with only minimal misclassification.

Moran, Rebecca E.; Bennett, Deborah H.; Tancredi, Daniel J.; Wu, Xiangmei (May); Ritz, Beate; Hertz-Picciotto, Irva

2012-08-01

106

Assignment of the Gene for a New Hereditary Nail Disorder, Isolated Congenital Nail Dysplasia, to Chromosome 17p13  

Microsoft Academic Search

Isolated congenital nail dysplasia is an autosomal dominant disorder recently observed in a large family from southern Germany. The disorder is characterized by longitudinal streaks, thinning, and impaired formation of the nail plates leading to increased vulnerability of the free nail margins. In most cases, all fingernails and toenails are similarly involved with some accentuation of the thumb and great

Alice Krebsová; Henning Hamm; Susanne Karl; André Reis; Hans Christian Hennies

2000-01-01

107

Titanium Dioxide Nanoparticles in Food and Personal Care Products  

PubMed Central

Titanium dioxide is a common additive in many food, personal care, and other consumer products used by people, which after use can enter the sewage system, and subsequently enter the environment as treated effluent discharged to surface waters or biosolids applied to agricultural land, incinerated wastes, or landfill solids. This study quantifies the amount of titanium in common food products, derives estimates of human exposure to dietary (nano-) TiO2, and discusses the impact of the nanoscale fraction of TiO2 entering the environment. The foods with the highest content of TiO2 included candies, sweets and chewing gums. Among personal care products, toothpastes and select sunscreens contained 1% to >10% titanium by weight. While some other crèmes contained titanium, despite being colored white, most shampoos, deodorants, and shaving creams contained the lowest levels of titanium (<0.01 ?g/mg). For several high-consumption pharmaceuticals, the titanium content ranged from below the instrument detection limit (0.0001 ?g Ti/mg) to a high of 0.014 ?g Ti/mg. Electron microscopy and stability testing of food-grade TiO2 (E171) suggests that approximately 36% of the particles are less than 100 nm in at least one dimension and that it readily disperses in water as fairly stable colloids. However, filtration of water solubilized consumer products and personal care products indicated that less than 5% of the titanium was able to pass through 0.45 or 0.7 ?m pores. Two white paints contained 110 ?g Ti/mg while three sealants (i.e., prime coat paint) contained less titanium (25 to 40 ?g Ti/mg). This research showed that while many white-colored products contained titanium, it was not a prerequisite. Although several of these product classes contained low amounts of titanium, their widespread use and disposal down the drain and eventually to WWTPs deserves attention. A Monte Carlo human exposure analysis to TiO2 through foods identified children as having the highest exposures because TiO2 content of sweets is higher than other food products, and that a typical exposure for a US adult may be on the order of 1 mg Ti per kilogram body weight per day. Thus, because of the millions of tons of titanium based white pigment used annually, testing should focus on food-grade TiO2 (E171) rather than that adopted in many environmental health and safety tests (i.e., P25), which is used in much lower amounts in products less likely to enter the environment (e.g., catalyst supports, photocatalytic coatings). PMID:22260395

Weir, Alex; Westerhoff, Paul; Fabricius, Lars

2012-01-01

108

Pincer Nail Deformity in a Patient with Amyotrophic Lateral Sclerosis  

PubMed Central

Although several manifestations of skin involvement in cases of amyotrophic lateral sclerosis (ALS) have been reported, the pincer nail deformity has not been previously reported in a patient with ALS. The pincer nail deformity is characterized by distortion of the shape of the nail with transverse over curvature and may be associated with systemic diseases and certain medications. We herein describe the case of a patient presenting with a pincer nail deformity associated with rapidly advancing ALS. This case suggests a potential link between quickly advancing disease and the pincer nail deformity. PMID:25568742

Fujita, Youshi; Fujita, Takehisa

2014-01-01

109

Cost of external fixation vs external fixation then nailing in bone infection  

PubMed Central

AIM: To study the cost benefit of external fixation vs external fixation then nailing in treatment of bone infection by segment transfer. METHODS: Out of 71 patients with infected nonunion tibia treated between 2003 and 2006, 50 patients fitted the inclusion criteria (26 patients were treated by external fixation only, and 24 patients were treated by external fixation early removal after segment transfer and replacement by internal fixation). Cost of inpatient treatment, total cost of inpatient and outpatient treatment till full healing, and the weeks of absence from school or work were calculated and compared between both groups. RESULTS: The cost of hospital stay and surgery in the group of external fixation only was 22.6 ± 3.3 while the cost of hospital stay and surgery in the group of early external fixation removal and replacement by intramedullary nail was 26.0 ± 3.2. The difference was statistically significant regarding the cost of hospital stay and surgery in favor of the group of external fixation only. The total cost of medical care (surgery, hospital stay, treatment outside the hospital including medications, dressing, physical therapy, outpatient laboratory work, etc.) in group of external fixation only was 63.3 ± 15.1, and total absence from work was 38.6 ± 6.6 wk. While the group of early removal of external fixation and replacement by IM nail, total cost of medical care was 38.3 ± 6.4 and total absence from work or school was 22.7 ± 4.1. The difference was statistically significant regarding the total cost and absence from work in favor of the group of early removal and replacement by IM nail. CONCLUSION: Early removal of external fixation and replacement by intramedullary nail in treatment of infected nonunion showed more cost effectiveness. Orthopaedic society needs to show the cost effectiveness of different procedures to the community, insurance, and health authorities.

Emara, Khaled Mohamed; Diab, Ramy Ahmed; Ghafar, Khaled Abd EL

2015-01-01

110

Correction of Pincer Nail Deformity Using Dermal Grafting  

PubMed Central

Pincer nail deformity is characterized by excessive curvature and distortion of the nail in the transverse dimension, and particularly at the distal part of the nail plate. This deformity leads to pinching off and loss of soft tissue in the affected digit, causing severe pain. Many treatment methods have been proposed; however, an effective long-term method preserving the nail matrix has not yet been established. We present here a case of pincer nail in the left thumb in a 49-year-old woman who was treated successfully with dermal grafting under the nail bed. We describe the surgical method and the treatment results. To the best of our knowledge, this is the first report in the Korean medical literature on the use of dermal grafting for the treatment of pincer nail deformity. PMID:22346262

Nam, Hyun Min; Kim, Ui Kyung; Park, Seok Don; Kim, Jeong Hee

2011-01-01

111

Treatment of Nail Psoriasis: Common Concepts and New Trends  

PubMed Central

The lifetime incidence of nail involvement in psoriatic patients is estimated to be 80–90%, and the nails can be affected in 10% to 55% of psoriatic patients. Psoriasis may also solely involve the nails, without any other skin findings, in which the treatment can be more challenging. Nail psoriasis may lead to considerable impairment in quality of life due to aesthetic concerns and more importantly limitations in daily activities resulting from the associated pain, which may be overlooked by the physicians. Several topical and systemic treatment modalities, as well as radiation and light systems, have been used in the treatment of nail psoriasis. In the last decade, the introduction of biologic agents and the utilization of laser systems have brought a new insight into the treatment of nail psoriasis. This paper focuses on the recent advances, as well as the conventional methods, in treating nail psoriasis in adults and children, in reference to an extensive literature search. PMID:23762032

Oram, Yasemin; Akkaya, A. Deniz

2013-01-01

112

Tibiotalocalcaneal arthrodesis with retrograde intramedullary nailing  

Microsoft Academic Search

Nineteen patients (20 feet) with severe hindfoot and ankle deformity underwent tibiotalocalcaneal fusion with a retrograde locked intramedullary nail as a limb-salvage procedure. The purpose of this study was to compare the complication rates of this procedure in diabetic versus nondiabetic patients. There were 8 men and 11 women with preoperative diagnoses including Charcot neuroarthropathy, primary osteoarthritis, rheumatoid arthritis, equinocavovarus,

Robert W Mendicino; Alan R Catanzariti; Karl R Saltrick; Michael F Dombek; Brandon L Tullis; Trenton K Statler; Brandi M Johnson

2004-01-01

113

[Bundle nailing of forearm fractures. Indications and results].  

PubMed

Hackethal developed the nailing procedure named after him in 1959. The rationale of Hackethal nailing is an elastic jamming, which can only be achieved by obeying four rules: jamming of the nails in the cortical window, jamming then in the waist of the medullary cavity, spreading the bunch of nails in the metaphysis and filling up the conus of the medullary cavity with short nails. We confined Hackethal nailing to closed and first-degree open fractures of the 2nd-5th sixth of the shaft of the forearm. If closed reduction and nailing were impossible, we performed a plate fixation (AO), in second- or third-degree open fractures we treated with fixators (Orthofix). In a 13-year period we performed Hackethal bundle nailing in 65 patients with 115 fractures. In 54% patients surgery was performed within the first 8 hours following admission. We used two or three nails passing the fracture and one short nail. Except for 1 case, in which we needed a plaster of Paris, we achieved rational stability. On average, the nails were removed after 11.5 months. The healing and complication rates were assessed by follow-up examination of 49 patients. The results were excellent and good in 71.5% patients, satisfactory 11.4% and poor in 17.1%. Complications consisted of a 2.1% infection rate (osteitis), 3.1% non-union, 2.1% with a synostosis, 1% refracture (during removal of the nails) and 3.1% migration of nails, combined with tendon rupture. We have seen 1 case with metallosis. In conclusion with our confined spectrum of indications Hackethal nailing is a low-risk method, which leads to a rational stability and early bone healing. PMID:1925606

Winckler, S; Brug, E; Baranowski, D

1991-07-01

114

A Clinical Study of 35 Cases of Pincer Nails  

PubMed Central

Background Pincer nail is a nail deformity characterized by transverse overcurvature of the nail plate. Pincer nail can affect a patient's quality of life due to its chronic, recurrent course; however, there have been no clinical studies on the pincer nail condition in Korean patients. Objective The purpose of this study was to characterize the clinical findings and treatment of pincer nail. In addition, possible etiological factors were considered, and treatment efficacy was evaluated. Methods The medical records and clinical photographs of 35 patients (12 males, 23 females) who were diagnosed with pincer nail between August 1, 2005 and July 31, 2009 were studied. Results Patient age ranged from 10 to 77 (52.09±17.26) years, and there was a predominance of female (23 out of 35 patients, F:M=2:1). The mean duration of the disorder was 7.45 years (range 0.25~40); 85% had pincer nail for at least 1 year. In addition, 40% had a history of previous treatment and recurrence. There were 82.8% patients with the common type of pincer nails. The most commonly involved nails were both great toenails. Among 35 patients, nail grinding was started in 30 patients, and 25 patients showed clinical improvement with nail grinding. The width index increased and the height index decreased after treatment. The mean follow up period was 8.42 months (range 1~27), and 7 patients showed recurrence after 8.8 months (range 2~20). Among 35 patients, 5 patients were treated with nail extraction with matricectomy, and the symptoms resolved immediately. The mean follow up period was 7.6 months (range 0~19), and recurrence was not observed. Onychomycosis was also present in 37.1% of patients, and itraconazole pulse therapy for 3 months was added. Conclusion The results of this study demonstrate the clinical features of pincer nail in Korean patients. The findings show that the common type of pincer nail was most common, and nail grinding as a conservative treatment greatly improved pincer nails despite a risk of recurrence. When onychomycosis was also present, oral antifungal therapy added to nail grinding resulted in a more rapid change in nail thickness and clinical improvement. PMID:22148007

Lee, Jae In; Lee, Young Bok; Oh, Shin Tack; Cho, Baik Kee

2011-01-01

115

Intrapelvic Migration of the Lag Screw in Intramedullary Nailing  

PubMed Central

Internal fixation with intramedullary devices has gained popularity for the treatment of intertrochanteric femoral fractures, which are common injuries in the elderly. The most common complications are lag screw cut out from the femoral head and femoral fracture at the distal tip of the nail. We report here a rare complication of postoperative lag screw migration into the pelvis with no trauma. The patient was subsequently treated with lag screw removal and revision surgery with total hip arthroplasty. This case demonstrated that optimal fracture reduction and positioning of the lag screw are the most important surgical steps for decreasing the risk of medial migration of the lag screw. Furthermore, to prevent complications, careful attention should be paid to subsequent steps such as precise insertion of the set screw. PMID:25610680

Toki, Shunichi; Hamada, Daisuke; Yoshioka, Shinji; Tsutsui, Takahiko; Tamaki, Yasuaki; Sairyo, Koichi

2014-01-01

116

Accounting for intended use application in characterizing the contributions of cyclopentasiloxane (D5) to aquatic loadings following personal care product use: antiperspirants, skin care products and hair care products.  

PubMed

Decamethylcyclopentasiloxane, commonly known as D5 (cyclopentasiloxane) has a wide application of use across a multitude of personal care product categories. The relative volatility of D5 is one of the key properties attributed to this substance that provide for the derived performance benefits from the use of this raw material in personal care formulations. On this basis, rapid evaporative loss following use of many products comprising D5 is expected following typical use application and corresponding wear time. Studies were conducted on three key product categories containing D5 (antiperspirants, skin care products and hair care products) to characterize the amount of D5 that may be destined to 'go down the drain' following simulated typical personal care use scenarios. Marketed antiperspirants and skin care products were applied to human subjects and hair care products were applied to human hair tressesand subsequently rinsed off at designated time points representative of typical consumer cleansing and personal hygiene habits. Wash water was collected at 0, 8 and 24h (antiperspirant and hair care analysis) and additionally at 4h (skin care analysis) post product application and samples were analyzed by isotope dilution headspace gas chromatography/mass spectrometry (GC/MS) to quantify the concentration of D5 destined to be available to go down the drain in captured wash water. It is demonstrated that significant amounts of D5 in 'leave-on' application products evaporate during typical use and that the concentration of D5 available to go down the drain under such conditions of use is only a very small (negligible) fraction of that delivered immediately upon product application. PMID:23186890

Montemayor, Beta P; Price, Bradford B; van Egmond, Roger A

2013-10-01

117

Assessment of Occupational Symptoms and Chemical Exposures for Nail Salon Technicians in Daegu City, Korea  

PubMed Central

Objectives This study aimed to evaluate occupational symptoms and chemical exposures of nail salon technicians. Methods Work-related symptoms of nail salon technicians in Daegu City were surveyed using a researcher-administered questionnaire, and responses were compared to those of non-exposed office workers as controls. Personal exposure level of airborne volatile organic compounds was also monitored using passive samplers. Results A total of 159 subjects in 120 salons were interviewed. Average work-shift concentrations of 13 chemicals were measured for 50 workers from 30 salons using personal passive samplers. The most frequently reported respiratory or neurologic symptoms by nail shop technicians compared to controls were nose irritation (odds ratio [OR], 54.0; confidence interval [CI], 21.6 to 134.8), followed by headache (OR, 9.3; CI, 4.7 to 18), and throat irritation (OR, 4.3; CI, 2.2 to 8.5). For eyes and skin, 92% of respondents complained eye irritation (OR, 13.1; CI, 5.7 to 30.1). In musculoskeletal symptoms, workers reported pain or discomfort in shoulders (OR, 20.3; CI, 7.7 to 54) and neck (OR, 19.7; CI, 8.9 to 43.6). From personal measurements, the proportion of exceeding the Korean Occupational Exposure Limit was the highest for acetone with 64%, followed by toluene (50%), butyl acetate (46%), and methyl methacrylate (12%). However, the service was being provided without a proper ventilation system in most surveyed shops. Conclusions Based on these findings, it is warranted to have appropriate local exhaust ventilation place to ensure adequate health protection of nail shop technicians as well as customers. At the same time, greater policy interests are warranted in nail care business to protect health of both workers and customers. PMID:24921020

Park, Sung-Ae; Gwak, Sugyeong

2014-01-01

118

Titanium dioxide nanoparticles in food and personal care products.  

PubMed

Titanium dioxide is a common additive in many food, personal care, and other consumer products used by people, which after use can enter the sewage system and, subsequently, enter the environment as treated effluent discharged to surface waters or biosolids applied to agricultural land, incinerated wastes, or landfill solids. This study quantifies the amount of titanium in common food products, derives estimates of human exposure to dietary (nano-) TiO(2), and discusses the impact of the nanoscale fraction of TiO(2) entering the environment. The foods with the highest content of TiO(2) included candies, sweets, and chewing gums. Among personal care products, toothpastes and select sunscreens contained 1% to >10% titanium by weight. While some other crèmes contained titanium, despite being colored white, most shampoos, deodorants, and shaving creams contained the lowest levels of titanium (<0.01 ?g/mg). For several high-consumption pharmaceuticals, the titanium content ranged from below the instrument detection limit (0.0001 ?g Ti/mg) to a high of 0.014 ?g Ti/mg. Electron microscopy and stability testing of food-grade TiO(2) (E171) suggests that approximately 36% of the particles are less than 100 nm in at least one dimension and that it readily disperses in water as fairly stable colloids. However, filtration of water solubilized consumer products and personal care products indicated that less than 5% of the titanium was able to pass through 0.45 or 0.7 ?m pores. Two white paints contained 110 ?g Ti/mg while three sealants (i.e., prime coat paint) contained less titanium (25 to 40 ?g Ti/mg). This research showed that, while many white-colored products contained titanium, it was not a prerequisite. Although several of these product classes contained low amounts of titanium, their widespread use and disposal down the drain and eventually to wastewater treatment plants (WWTPs) deserves attention. A Monte Carlo human exposure analysis to TiO(2) through foods identified children as having the highest exposures because TiO(2) content of sweets is higher than other food products and that a typical exposure for a US adult may be on the order of 1 mg Ti per kilogram body weight per day. Thus, because of the millions of tons of titanium-based white pigment used annually, testing should focus on food-grade TiO(2) (E171) rather than that adopted in many environmental health and safety tests (i.e., P25), which is used in much lower amounts in products less likely to enter the environment (e.g., catalyst supports, photocatalytic coatings). PMID:22260395

Weir, Alex; Westerhoff, Paul; Fabricius, Lars; Hristovski, Kiril; von Goetz, Natalie

2012-02-21

119

[Removal of a massive broken tibial intramedullary nail].  

PubMed

A problem arose when the reamed tibia nail was replaced by a massive unreamed tibia nail. Of the nail fractures, it is difficult to remove the distal fragment from the medullary cavity. It may also happen that the connecting screw between the insertion handle and the nail breaks off at the edge of the implant, which complicates removal of the nail. The authors have developed a technique for removing the implant without having to saw a fissure in the marrow. A concave instrument is slid over the part of the nail left behind after which the two are connected by means of a K wire. This method has been successfully applied in two patients. PMID:9577222

Frima, A J; Karthaus, A J

1998-03-01

120

[Removal of a broken massive tibial intramedullary nail].  

PubMed

A problem has arisen when replacing the reamed tibia nail by the massive unreamed tibia nail. In case of nail fracture it is difficult to remove the distal fragment from the medullary cavity. It may also occur that the connecting screw between the insertion handle and the nail breaks off at the edge of the implant, which much complicates removal of the nail. The authors have developed a technique to remove the implant without having to saw a fissure in the marrow. A concave instrument is slid over the part of the nail left behind after which the two are connected by means of a K wire. This method has been successfully applied in 2 patients. PMID:10025247

Frima, A J; Karthaus, A J

1998-12-01

121

Cessation of nail growth following Bajiaolian intoxication.  

PubMed

Bajiaolian (Dysosma pleianthum), a species in the Mayapple family (Podophyllum pelatum), has been widely used as a traditional Chinese herbal medication for the remedies of snake bite, tumor growth, post-partum recovery, and acne. It has also been used in western medicine, especially topically for various skin lesions. Both oral ingestion and dermal application may result in severe toxicity. The clinical presentations reported after Bajiaolian poisoning include nausea, vomiting, diarrhea, abdominal cramps, tachycardia, orthostatic hypotension, paralytic ileus, urinary retention, hepatorenal dysfunction, leukocytosis followed by leukopenia, thrombocytopenia, prolonged areflexia, prolonged paraethesia and sensory ataxia, dizziness, fever, memory impairment, hallucinations, paranoia, convulsion, fainting, and coma. There are no previous reports in the literature about the cessation of nail growth as a clinical presentation following Bajiaolian poisoning. We present a case of nail growth that was halted for more than seven years after a single case of Bajiaolian poisoning. PMID:17852156

Chou, Shang-Lin; Chou, Ming-Yueh; Kao, Wei-Fong; Yen, David H T; Huang, Chun-I; Lee, Chen-Hsen

2008-02-01

122

Follow-up study of patients treated for ingrown nails with the nail matrix phenolization method.  

PubMed

In the past 7 years, a total of 537 ingrown nail lesions were treated with the nail matrix phenolization method (NMP). A study was performed based on follow-up examinations and a questionnaire survey regarding recurrence rate, degree severity, duration of postoperative pain, and other relevant factors. The major advantages of the NMP revealed by our study were: (1) The surgical procedure is easy to perform and does not require specialized equipment; (2) total time requirement for surgery is minimal; (3) the operation can be performed in the presence of a concomitant infection; (4) the recurrence rate is low (1.1%); and (5) postoperative pain and postoperative bed rest is minimized. These results indicate that NMP is an extremely effective method for treatment of ingrown nails. PMID:7892317

Kimata, Y; Uetake, M; Tsukada, S; Harii, K

1995-04-01

123

Candida parapsilosis of the nail-bed without onychomycosis.  

PubMed

Candida parapsilosis is an emerging fungal pathogen that was once thought to be solely a colonizing organism. C. parapsilosis is increasingly becoming reported as the most common Candida species that causes onychomycosis. Clinical findings include typically severe dystrophy of the nail fold and plate as well as thickening and fragmentation of the plate, particularly in the distal plate. We present a unique case of C. parapsilosis infection of the nail bed without infection of the nail plate and with twenty-nail melanonychia. PMID:25526338

Rieder, Evan; Hu, Stephanie W; Meehan, Shane A; Adigun, Chris

2014-01-01

124

Marked improvement in nail psoriasis during treatment with etanercept.  

PubMed

Psoriasis is a chronic inflammatory skin condition that affects approximately 3% of the population. Up to 50% of patients with psoriasis have concurrent nail psoriasis, up to 30% of patients with skin psoriasis also have psoriatic arthritis and of these, approximately 80% have nail disease. The treatment of nail psoriasis is often challenging, and there is a need for new therapeutic options. Effective biological agents used in the treatment of moderate to severe chronic plaque psoriasis may represent a new therapeutic modality for this disease. A case of rapid improvement is reported in nail psoriasis under etanercept monotherapy with maintained efficacy following the withdrawal of continued therapy. PMID:22353156

Gómez Vázquez, Mercedes; Navarra Amayuelas, Ramón

2011-01-01

125

Market trends in baby skin care products and implications for clinical practice.  

PubMed

Although the U.S. pediatric skin care market is a $1.7 billion industry, little is known regarding the usage pattern of skin care products in very young children. We have begun to recognize that common over-the-counter skin care products may have positive or negative effects on skin barrier function. Thus, knowing what and how skin care products are used early in life is important. The goal of the current study was to better understand skin care product use in the United States using market research data. We found that the prevalence of use was greater than 50% for all skin care product categories and age groups. Premoistened cleansing wipes and cloths were the most frequently used product, followed by baby oil and lotion and body and baby powder. Baby bath and shampoo products were used at least five times per week per household, and caregivers generally preferred products that were fragrance-free and made for sensitive skin. Lower-income households reported a higher frequency of product use and were less likely to purchase fragrance-free products or ones that were made for sensitive skin. Our findings suggest that the prevalence of pediatric skin care product use is high and conflicts with current recommended skin care guidelines. Product use and preferences may also vary according to race and ethnicity and household income level. PMID:25236850

Gao, Xiang; Simpson, Eric L

2014-11-01

126

Management of unusual case of self-inflicted penetrating craniocerebral injury by a nail  

PubMed Central

During war, sharp high-speed missiles have been driven inside the brain; however, in civilian practice it is rare to see such episodes. An approximately 10-cm long nail was driven inside the brain in an attempt to commit suicide by a schizophrenic patient. The case is being reported for its rarity in civilian practice and as a case of clinical interest. After investigating the patient by plain X-rays and a CT scan, he was operated by a neurosurgical team and the nail was successfully removed. In post-operative phase, patient was given medical and psychiatric care along with psychological counseling. The patient made good uneventful recovery in the post-operative phase. PMID:20606802

Kishore, Kamal; Sahu, Sandeep; Bharti, Pradeep; Dahiya, Subhash; Kumar, Ajay; Agarwal, Anurag

2010-01-01

127

Iontophoretically enhanced ciclopirox delivery into and across human nail plate.  

PubMed

Transungual delivery of antifungal drugs is hindered by the low permeability of human nail plates, and as such, repeated dosing over a long period of time is necessary for effective treatment. The objectives of this study were to explore the possibilities of (a) enhancing the delivery of ciclopirox (CIC) across human nail plates and (b) sustaining CIC delivery from the larger resultant drug depot in the nail plates with constant voltage iontophoresis. In vitro passive and 9 V cathodal iontophoretic transport experiments of CIC across human nails were performed. Transungual CIC delivery with Penlac was the control. The amounts of CIC released from and deposited in the nails were determined in drug release and extraction experiments, respectively. Iontophoresis increased the flux of CIC permeated across the nail approximately 10 times compared to passive delivery from the same formulation or from Penlac. A significant amount of CIC was loaded into and released from the nails; the CIC concentrations were estimated to be above the minimum inhibitory concentrations of CIC for dermatophytic molds. The apparent transport lag time decreased in iontophoretic transport. The results demonstrate that iontophoresis was able to deliver an effective amount of CIC into and across the nails, and this suggests the feasibility of a constant voltage battery-powered transungual iontophoretic device. PMID:19117048

Hao, Jinsong; Smith, Kelly A; Li, S Kevin

2009-10-01

128

Tractor nail as impacted foreign body: rare case scenario.  

PubMed

A patient presented with a metallic nail impacted in the right orbital floor after being hit by a projectile. The nail was disimpacted and removed as guided by the radiograph image. Radiography proved helpful in forming a coherent scheme for case management. PMID:23329332

Khanduja, Sumeet; Khurana, Aruj; Sachdeva, Sumit; Rathi, Ashok; Khurana, A K

2013-06-01

129

Researchers Find Stem Cells That Help Nails Regenerate  

MedlinePLUS

... on this page, please enable JavaScript. Researchers Find Stem Cells That Help Nails Regenerate Normal function helps with ... November 24, 2014 Related MedlinePlus Pages Nail Diseases Stem Cells MONDAY, Nov. 24, 2014 (HealthDay News) -- Researchers have ...

130

SmartNails: display- and image-dependent thumbnails  

Microsoft Academic Search

In order to overcome poor readability of text and recognizability of image features in low resolution thumbnails, a novel image representation of compound document images - a SmartNail representation - is presented. SmartNails are replacements or supplements to traditional thumbnails for compound documents and contain cropped and scaled image and text segments. Image- and text-based analysis are merged to generate

Kathrin Berkner; Edward L. Schwartz; Christophe Marle

2003-01-01

131

[Assessment of psoriatic nail lesions therapy by means of nail psoriasis severity index].  

PubMed

The problem of psoriatic nail lesions is known for a long time. According to various authors, psoriatic onychodystrophy has been diagnosed in 15-78% of patients with psoriasis. At the same time, we know that the treatment of psoriatic nail lesions is not always successful. The aim of the study was to evaluate the therapeutic efficacy of the drug onypso in the complex treatment of patients with psoriasis by means of NAPSI index. We observed 39 patients with psoriasis (20 men and 19 women at the age of 19 to 65 years with disease duration of 1 year to 25 years). The distribution of clinical manifestations of psoriatic onychodystrophy was as follow: thimble symptom -150 plates, subungual hyperkeratosis lesion type - 90 plates, onycholysis lesion type was observed in 50 plates. As a systemic treatment we used the cytostatic agent methotrexate - parenteral administration of 25 mg (once a week). In duration of total treatment course the patient received 90 -120 mg. Local treatment was provided by means of varnish onypso (once a day for 6 months). The survey revealed that at 7 weeks of treatment there was a 25 % reduction of initial value of NAPSI index, at the end of 14 weeks of therapy the above mentioned index was reduced for 50 % and at the 24 weeks for 75% respectively. It should be noted, that resolution of the cutaneous pathology was much faster than improvement of the structure of affected nail plates. Thus, drug onypso proposed for the specific treatment of nail lesions used in the complex therapy of patients with psoriasis is simple in use, accessible, compliant and highly effective. As a conclusion, we can say that NAPSI method, used to determine the extent of lesions and the effectiveness of the therapy, can objectively evaluate the dynamics of clinical pathology of the nails and adequacy of used treatment. PMID:22155805

Tsiskarishvili, N V; Katsitadze, A G; Tsiskarishvili, N I

2011-10-01

132

Nail injury and diquat exposure: forgotten but not gone.  

PubMed

Primary fingernail changes that result from chemical exposures are seldom encountered in clinical practice. A cluster investigation was conducted on employees at a pesticide packaging company. Six employees reported simultaneous onset of defects occurring in their fingernails, including nail discoloration, nail dimpling, and nail shedding. Multiple pesticides and herbicides including diquat were used in the facility at the time of the cluster onset. A literature review noted 6 articles published before 1975 documenting similar nail changes associated with paraquat, diquat, or other herbicide use. Only one such case report published after 1985 could be located. Diquat was the only material that was previously reported in the medical literature as causing nail defects and also in use at this facility. Diquat exposure is the most plausible explanation for the observed changes in these workers' fingernails. PMID:22828259

Kibby, Thomas; Ring, Daniel S

2012-01-01

133

Safety of botanical ingredients in personal care products/cosmetics.  

PubMed

The key issue of the safety assessment of botanical ingredients in personal care products (PCP) is the phytochemical characterisation of the plant source, data on contamination, adulteration and hazardous residues. The comparative approach used in the safety assessment of GM-plants may be applied to novel botanical PCP ingredients. Comparator(s) are the parent plant or varieties of the same species. Chemical grouping includes definition of chemical groups suitable for a read-across approach; it allows the estimation of toxicological endpoints on the basis of data from related substances (congeneric groups) with physical/chemical properties producing similar toxicities. The Threshold of Toxicological Concern (TTC) and Dermal Sensitisation Threshold (DST) are tools for the assessment of trace substances or minor ingredients. The evaluation of skin penetration of substances present in human food is unnecessary, whereas mixtures may be assessed on the basis of physical/chemical properties of individual substances. Adverse dermal effects of botanicals include irritation, sensitisation, phototoxicity and immediate-type allergy. The experience from dietary supplements or herbal medicines showed that being natural is not equivalent to being safe. Pragmatic approaches for quality and safety standards of botanical ingredients are needed; consumer safety should be the first objective of conventional and botanical PCP ingredients. PMID:21111022

Antignac, Eric; Nohynek, Gerhard J; Re, Thomas; Clouzeau, Jacques; Toutain, Hervé

2011-02-01

134

Study to prospectively evaluate reamed intramedually nails in patients with tibial fractures (S.P.R.I.N.T.): Study rationale and design  

PubMed Central

Background Surgeons agree on the benefits of operative treatment of tibial fractures – the most common of long bone fractures – with an intramedullary rod or nail. Rates of re-operation remain high – between 23% and 60% in prior trials – and the two alternative nailing approaches, reamed or non-reamed, each have a compelling biological rationale and strong proponents, resulting in ongoing controversy regarding which is better. Methods/Design The objective of this trial was to assess the impact of reamed versus non-reamed intramedullary nailing on rates of re-operation in patients with open and closed fractures of the tibial shaft. The study to prospectively evaluate reamed intramedullary nails in tibial fractures (S.P.R.I.N.T) was a multi-center, randomized trial including 29 clinical sites in Canada, the United States and the Netherlands which enrolled 1200 skeletally mature patients with open (Gustilo Types I-IIIB) or closed (Tscherne Types 0–3) fractures of the tibial shaft amenable to surgical treatment with an intramedullary nail. Patients received a statically locked intramedullary nail with either reamed or non-reamed insertion. The first strategy involved fixation of the fracture with an intramedullary nail following reaming to enlarge the intramedullary canal (Reamed Group). The second treatment strategy involved fixation of the fracture with an intramedullary nail without prior reaming of the intramedullary canal (Non-Reamed Group). Patients, outcome assessors, and data analysts were blinded to treatment allocation. Peri-operative care was standardized, and re-operations before 6 months were proscribed. Patients were followed at discharge, 2 weeks post-discharge, and at 6 weeks, 3, 6, 9, and 12 months post surgery. A committee, blinded to allocation, adjudicated all outcomes. Discussion The primary outcome was re-operation to promote healing, treat infection, or preserve the limb (fasciotomy for compartment syndrome after nailing). The primary outcome was a composite comprising the following re-operations: bone grafts, implant exchanges, and dynamizations, in patients with fracture gaps less than 1 cm post intramedullary nail insertion. Infections and fasciotomies were considered events irrespective of the fracture gap. We planned a priori to conduct a subgroup analysis of outcomes in patients with open and closed fractures. S.P.R.I.N.T is the largest collaborative trial evaluating alternative orthopaedic surgical interventions in patients with tibial shaft fractures. The methodological rigor will set new benchmarks for future trials in the field and its results will have important impact on patient care. The S.P.R.I.N.T trial was registered [ID NCT00038129] and received research ethics approval (REB#99-077). PMID:18573205

2008-01-01

135

Impact of a Healthy Nails Program on Nail-Biting in Turkish Schoolchildren: A Controlled Pretest-Posttest Study  

ERIC Educational Resources Information Center

This study was conducted to examine the effect of a healthy nails program on nail-biting in Turkish schoolchildren. This quasi-experimental study was of pretest-posttest control group design. A total of 50 students of a primary school formed the intervention group, while 53 students from the same school formed the control group. Data were…

Ergun, Ayse; Toprak, Rumeysa; Sisman, Fatma Nevin

2013-01-01

136

Green Nail Syndrome (Pseudomonas aeruginosa Nail Infection): Two Cases Successfully Treated with Topical Nadifloxacin, an Acne Medication  

PubMed Central

Green nail syndrome (GNS) caused by Pseudomonas aeruginosa is the most common bacterial nail infection. The treatment of GNS is challenging in many cases and recommendations based on clinical trials are lacking. We report two cases with GNS successfully treated with off-label use of topical nadifloxacin, a fluoroquinolone approved for acne and bacterial skin infections in some countries. PMID:25202260

Müller, Simon; Ebnöther, Myriam; Itin, Peter

2014-01-01

137

Yellow Nail Syndrome and Nail Lichen Planus may be Induced by a Common Culprit. Focus on Dental Restorative Substances  

PubMed Central

Different clinical appearances such as Yellow nail syndrome and Lichen planus or lichenoid reactions can originate from close or identical etiologies. They may result from dental restorative materials or metal allergy. Interestingly, the nail sometimes returns to its normal condition, months after the withdrawal of the offending agents.

Baran, Léon-Robert

2014-01-01

138

Fungal infections of the skin and nail: new treatment options.  

PubMed

Knowledge of the currently available antifungal agents, along with clinical, microbiologic and histopathologic methods, can help the medical professional optimally manage skin and nail fungal infections. With regards to treatment of fungal disease of the skin or nail, there are a variety of systemic antifungal agents, including several newer agents that have different formulations, tolerability, adverse effect profiles and spectrum of activity. This review will highlight the clinically important fungal infections of the skin and nail and describe the activity and role of antifungal treatment. PMID:25241767

Eldridge, Matthew L; Chambers, Cindy J; Sharon, Victoria R; Thompson, George R

2014-11-01

139

Nail lichen planus in a patient with alopecia totalis.  

PubMed

A 67-year-old man with a three-year history of non-scarring alopecia that progressed to alopecia totalis despite intralesional glucocorticoid injections is presented. He developed 20-nail dystrophy that was recalcitrant to antifungal and anti-inflammatory treatments. Biopsy of the nail matrix showed histopathologic features of lichen planus. Alopecia totalis and isolated lichen planus of the nails are uncommon subtypes of common dermatologic disorders. Rarely reported concurrently, we provide a review of the literature of their association, which is most likely attributed to their autoimmune pathogeneses. PMID:25526340

Ginsberg, Brian A; Yost, John Montgomery; Lewin, Jesse; Hale, Christopher S; Meehan, Shane A; Carucci, John A; Ramachandran, Sarika

2014-12-01

140

Conservative treatment of a femoral neck fracture following nail removal  

PubMed Central

With increased longevity, the management of fragility fractures in the elderly is becoming more frequent. In particular, hip fractures have considerable importance due to the significant morbidity and mortality. A 67-year-old woman underwent intramedullary nail (IMN) removal inserted for a pertrochanteric fracture that had occurred 20 months earlier. This was indicated due to continuous discomfort related to the protruding apex of the implant over the great trochanter. Due to pain persistence two days after surgery, a computed tomography (CT) scan was performed, documenting a minimally displaced impacted subcapital femoral neck fracture. Conservative management with close radiographic follow-up was conducted. After six months, the patient had returned to previous daily activities and a satisfactory range of motion was achieved without pain on walking. The purpose of our paper is to discuss the decision of removing hardware in the elderly osteoporotic patient and to analyze the possibility to conservatively treat an impacted minimally displaced subcapital fracture occurring after the removal of an IMN inserted previously for the treatment of a trochanteric fracture. In the elderly population with decreased bone quality, the removal of intramedullary implants of the proximal femur should be carefully evaluated, and osteoporotic patients undergoing reduction and fixation of femoral fractures should be encouraged to start antiosteoporotic therapy (bisphosphonate, teriparatide) to reduce the risk of further bone loss. Conservative treatment should be considered for the management of lesser symptomatic minimally displaced impacted fractures, where the inherent stability of the fracture allows rapid healing without further surgical attempts. PMID:24672194

Legnani, Claudio; Dondi, Alessandra; Pietrogrande, Luca

2013-01-01

141

23. INTERIOR VIEW, SIDE FLOOR, SHOWING THE BANK OF NAIL ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

23. INTERIOR VIEW, SIDE FLOOR, SHOWING THE BANK OF NAIL CUTTING MACHINES WITH FOUR IN OPERATION (NOTE WALL OF OLD SECTION, BLACKSMITH'S SHOP, IN BACKGROUND) - LaBelle Iron Works, Thirtieth & Wood Streets, Wheeling, Ohio County, WV

142

6. REMAINS OF PLANK WALL NAILED TO POSTS WITHIN CANAL ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. REMAINS OF PLANK WALL NAILED TO POSTS WITHIN CANAL CONSTRUCTED TO PROTECT OUTSIDE CANAL BANK. VIEW IS TO THE WEST. - Snake River Ditch, Headgate on north bank of Snake River, Dillon, Summit County, CO

143

21 CFR 886.5918 - Rigid gas permeable contact lens care products.  

Code of Federal Regulations, 2010 CFR

...rigid gas permeable contact lens care product is a device...storing of a rigid gas permeable contact lens. This includes all solutions and tablets used together with rigid gas permeable contact lenses. (b)...

2010-04-01

144

POLLUTION FROM PERSONAL ACTIONS, ACTIVITIES, AND BEHAVIORS: PHARMACEUTICALS AND PERSONAL CARE PRODUCTS IN THE ENVIRONMENT  

EPA Science Inventory

Perhaps more so than with any other class of pollutants, the occurrence of pharmaceuticals and personal care products (PPCPS) in the environment highlights the immediate, intimate, and inseparable connection between the personal activities of individual citizens and their environ...

145

ORIGINS AND RAMIFICATIONS OF PHARMACEUTICALS AND PERSONAL CARE PRODUCTS IN THE ENVIRONMENT  

EPA Science Inventory

Perhaps more so than with any other class of pollutants, the occurrence of pharmaceuticals and personal care products (PPCPS) in the environment highlights the immediate, intimate, and inseparable connection between the personal activities of individual citizens and their environ...

146

POLLUTION FROM PERSONAL ACTIONS, ACTIVITIES, AND BEHAVIORS: PHARMACEUTICALS AND PERSONAL CARE PRODUCTS IN THE ENVIRONMENT  

EPA Science Inventory

Perhaps more so than with any other class of pollutants, the occurrence of pharmaceuticals and personal care products (PPCPs) in the environment highlights the immediate, intimate, and inseparable connection between the personal activities of individual citizens and their environ...

147

International scientists’ priorities for research on pharmaceutical and personal care products in the environment  

EPA Science Inventory

Pharmaceuticals and personal care products (PPCPs) are widely discharged into the environment via diverse pathways. The effects of PPCPs in the environment have potentially important human and ecosystem health implications, so credible, salient, and legitimate scientific evidence...

148

PHARMACEUTICALS AND PERSONAL CARE PRODUCTS IN THE ENVIRONMENT: POLLUTION FROM PERSONAL ACTIONS, ACTIVITIES, AND BEHAVIORS  

EPA Science Inventory

Perhaps more so than with any other class of pollutants, the occurrence of pharmaceuticals and personal care products (PPCPS) in the environment highlights the immediate, intimate, and inseparable connection between the individual activities of consumers and their environ...

149

PHARMACEUTICALS AND PERSONAL CARE PRODUCTS AS UBIQUITOUS POLLUTANTS FROM PERSONAL USE AND ACTIVITIES  

EPA Science Inventory

Perhaps more so than with any other class of pollutants, the occurrence of pharmaceuticals and personal care products (PPCPS) in the environment highlights the immediate, intimate, and inseparable connection between the individual activities of consumers and their environment. In...

150

PHARMACEUTICALS AND PERSONAL CARE PRODUCTS (PPCP'S) AS ENVIRONMENTAL POLLUTANTS: POLLUTION FROM PERSONAL ACTIONS  

EPA Science Inventory

The occurrence of pharmaceuticals and personal care products (PPCPs) as trace environmental pollutants is a multifaceted issue whose scope of concerns continues to expand. PPCPs comprise thousands of distinct chemicals from numerous therapeutic and consumer classes. They typical...

151

PHARMACEUTICALS AND PERSONAL CARE PRODUCTS (PPCPS) AS ENVIRONMENTAL POLLUTANTS: POLLUTION FROM PERSONAL ACTIONS  

EPA Science Inventory

The occurrence of pharmaceuticals and personal care products (PPCPs) as trace environmental pollutants is a multifaceted issue whose scope of concerns continues to expand. PPCPs comprise thousands of distinct chemicals from numerous therapeutic and consumer classes. They typicall...

152

POLLUTION FROM PERSONAL ACTIONS AND ACTIVITIES - PHARMACEUTICALS AND PERSONAL CARE PRODUCTS (PPCPS)  

EPA Science Inventory

The occurrence of pharmaceuticals and personal care products (PPCPs) as trace environmental pollutants is a multifaceted issue whose scope of concerns continues to expand. PPCPs comprise thousands of distinct chemicals from numerous therapeutic and consumer classes. They typical...

153

COMPLICATIONS ENCOUNTERED DURING LENGTHENING OVER AN INTRAMEDULLARY NAIL  

Microsoft Academic Search

Background: In limb-lengthening, the quest for increased patient comfort and a reduced period of external fixation has led to techniques such as lengthening over an intramedullary nail. The goals of this study were to investigate the rate and types of complications encountered during lengthening over an intramedullary nail and to identify solutions to these complications. Methods : Forty-two segments (thirty-five

MEHMET KOCAOGLU; LEVENT ERALP; ONDER KILICOGLU; HALIL BURC; MEHMET CAKMAK

154

Chloronychia: green nail syndrome caused by Pseudomonas aeruginosa in elderly persons  

PubMed Central

Green nails, also known as chloronychia or green nail syndrome, are characterized by green discoloration of the nail plate (greenish-yellow, greenish-brown, greenish-black), proximal chronic non-tender paronychia, and distolateral onycholysis. The cause is Pseudomonas aeruginosa infection of the nail plate in persons whose hands are constantly exposed to water, soaps, and detergents or are subject to mechanical trauma, especially in the elderly. Green or black coloration of the nails should raise suspicion for Pseudomonas infection and be treated with an oral quinolone (ciprofloxacin), particularly in aged patients. We present three cases of green nails in elderly persons. PMID:25609938

Chiriac, Anca; Brzezinski, Piotr; Foia, Liliana; Marincu, Iosif

2015-01-01

155

Chloronychia: green nail syndrome caused by Pseudomonas aeruginosa in elderly persons.  

PubMed

Green nails, also known as chloronychia or green nail syndrome, are characterized by green discoloration of the nail plate (greenish-yellow, greenish-brown, greenish-black), proximal chronic non-tender paronychia, and distolateral onycholysis. The cause is Pseudomonas aeruginosa infection of the nail plate in persons whose hands are constantly exposed to water, soaps, and detergents or are subject to mechanical trauma, especially in the elderly. Green or black coloration of the nails should raise suspicion for Pseudomonas infection and be treated with an oral quinolone (ciprofloxacin), particularly in aged patients. We present three cases of green nails in elderly persons. PMID:25609938

Chiriac, Anca; Brzezinski, Piotr; Foia, Liliana; Marincu, Iosif

2015-01-01

156

Dystrophic Psoriatic Fingernails Treated with 1% 5Fluorouracil in a Nail Penetration-Enhancing Vehicle: A Double-Blind Study  

Microsoft Academic Search

Background: Topically applied nail therapeutics need to permeate the nail plate to reach the nail bed or nail matrix and exert their potential beneficial effect at these locations to obtain a therapeutic benefit. So far only topically applied 5-fluorouracil on affected nails of psoriatic patients has been shown to produce a notable clearance. Vehicle formulations enhancing nail permeation processes are

E. M. G. J. de Jong; H. E. Menke; M. C. G. van Praag

1999-01-01

157

Photobiological safety evaluation of UV nail lamps.  

PubMed

We evaluated six UV nail lamps representative of major US manufacturers to evaluate radiant hazards as defined in ANSI/IESNA RP-27 Recommended Practice for Photobiological Safety. Lamps were evaluated at three positions, 1 cm above the inner surface approximating exposure to the hand and the 20 cm RP-27 non-general light source distance, oriented normal and 45° to the opening. Hazard to skin at intended use distance classified these devices into Risk Group 1 or 2 (Low to Moderate) with S(?) weighted Actinic UV ranging 1.2-1.7 ?W cm(-2) and 29.8-276.25 min permissible daily exposure. At 20 cm on center and 45° UV risk to skin and eyes were all within Exempt classification. Actinic UV ranged 0.001-0.078 ?W cm(-2) and unweighted near UV (320-400 nm) ranged 0.001-0.483 mW cm(-2). Likewise the retinal photochemical blue light hazard and retinal thermal and cornea/lens IR were also Exempt. One device had aphakic eye hazard slightly rising into Risk Group 1 (Low). There were no other photobiological risks to normal individuals. Total exposure following programmed times and steps accumulate to only a small fraction of RP-27 permissible daily occupational exposure. These risks are further mitigated in realistic nonoccupational use scenarios as it is unlikely to be a daily occurrence. PMID:23550905

Dowdy, John C; Sayre, Robert M

2013-01-01

158

Intramedullary leg lengthening with a motorized nail  

PubMed Central

Background and purpose In the last decade, intramedullary limb lengthening has become a viable alternative to traditional external systems. We retrospectively analyzed the use of an intramedullary motorized nail (Fitbone) in a consecutive series of 32 patients. Patients and methods During the period September 2006 to December 2008, 32 consecutive patients with a median age of 17 (IQR: 15–19) years were treated with a fully implantable, motorized intramedullary lengthening device (Fitbone). The median leg length discrepancy was 35 (IQR: 30–44) mm at the femur (n = 21) and 28 (IQR: 25–30) mm at the tibia (n = 11). Results Leg lengthening was successful in 30 of 32 cases, with no residual relevant discrepancy (± 5 mm). No intraoperative complications were observed. The consolidation index was significantly different (p = 0.04) between femoral lengthening (mean 35 days/cm) and tibial lengthening (mean 48 days/cm) but did not depend on age older/younger than 16 or previous operations at the affected site. 3 problems, 3 obstacles, and 4 complications (3 minor, 1 major) were encountered in 8 patients, 5 of which were implant-associated. Interpretation This technique even allows correction in patients with multiplanar deformities. Compared to external devices, intramedullary systems provide comfort and reduce complication rates, give improved cosmetic results, and lead to fast rehabilitation since percutaneous, transmuscular fixation is prevented. This results in reasonable overall treatment costs despite the relatively high costs of implants. PMID:21561309

2011-01-01

159

Tibiotalocalcaneal arthrodesis with retrograde intramedullary nailing.  

PubMed

Nineteen patients (20 feet) with severe hindfoot and ankle deformity underwent tibiotalocalcaneal fusion with a retrograde locked intramedullary nail as a limb-salvage procedure. The purpose of this study was to compare the complication rates of this procedure in diabetic versus nondiabetic patients. There were 8 men and 11 women with preoperative diagnoses including Charcot neuroarthropathy, primary osteoarthritis, rheumatoid arthritis, equinocavovarus, posttraumatic osteoarthritis, gouty arthritis, and ankle malunion. Ten of 20 procedures were performed in patients with diabetes. The average patient age was 56 years, and the average postoperative follow-up was 19.8 months. Nineteen of 20 ankles (95%) achieved successful fusion with an average time of 4.1 months. Four patients (21%) required either a fracture brace or an ankle foot orthosis at final follow-up. Five patients (25%) had major complications and 11 patients had minor complications. Major complications included osteomyelitis (n = 2), Charcot arthropathy (n = 2), failure of fixation (n =1), soft-tissue necrosis (n = 1), cardiac arrest (n = 1), cerebral vascular accident (n = 1), and fatal pulmonary embolus (n = 1). All patients with major complications were diabetic, and 14 of 20 combined major and minor complications occurred in patients with diabetes. The complication rate was found to be high in diabetic patients with end-stage deformity undergoing a limb salvage PMID:15057853

Mendicino, Robert W; Catanzariti, Alan R; Saltrick, Karl R; Dombek, Michael F; Tullis, Brandon L; Statler, Trenton K; Johnson, Brandi M

2004-01-01

160

The Aesthetic Turn in Green Marketing: Environmental Consumer Ethics of Natural Personal Care Products  

Microsoft Academic Search

Green consumerism is on the rise in America, but its environmental effects are contested. Does green marketing contribute to the greening of American consciousness, or does it encourage corporate greenwashing? This tenuous ethical position means that eco-marketers must carefully frame their environmental products in a way that appeals to consumers with environmental ethics and buyers who consider natural products as

Anne Marie Todd

2004-01-01

161

76 FR 51038 - Draft Guidance for Industry: Cell Selection Devices for Point of Care Production of Minimally...  

Federal Register 2010, 2011, 2012, 2013, 2014

...2007D-0290] Draft Guidance for Industry: Cell Selection Devices for Point of Care Production...Manipulated Autologous Peripheral Blood Stem Cells; Withdrawal of Draft Guidance AGENCY...entitled ``Draft Guidance for Industry: Cell Selection Devices for Point of Care...

2011-08-17

162

Basic Fibroblast Growth Factor for Treatment of Onychomadesis with Delayed Regrowth of the Nail  

PubMed Central

Onychomadesis usually arises from an inflammation of the paronychium or as a result of blisters and hemorrhaging under a nail that has been struck or compressed. No documented interactions between basic fibroblast growth factor (bFGF) and onychomadesis have hitherto been reported. This case report describes a 25-year-old woman with onychomadesis following infection of the ingrown nail of her left thumb. After ten months of observation with no treatment showed no regrowth of her left thumbnail, the external use of bFGF and antibiotic ointment was started. One month later, nail regrowth was observed up to the halfway point of the nail bed, and after treatment for three months, the regrown nail reached the top of the nail bed. Both thumbnails now looked identical. This case suggests that external use of bFGF can promote nail regrowth in cases of onychomadesis with delayed regrowth of the nail. PMID:23864965

Oji, Tomito; Yazawa, Masaki; Kishi, Kazuo

2013-01-01

163

Genetics Home Reference: T-cell immunodeficiency, congenital alopecia, and nail dystrophy  

MedlinePLUS

... Recent literature OMIM Genetic disorder catalog Conditions > T-cell immunodeficiency, congenital alopecia, and nail dystrophy On this ... Glossary definitions Reviewed August 2014 What is T-cell immunodeficiency, congenital alopecia, and nail dystrophy? T-cell ...

164

Green nail syndrome treated with the application of tobramycin eye drop.  

PubMed

Green nail syndrome (chromonychia) is a nail disorder characterized by onycholysis and green-black discoloration of the nail bed. This condition is often associated with chronic paronychia. Pseudomonas aeruginosa is the most commonly identified organism in cultures from the affected area. Despite the various treatment options available, removal of the nail is still necessary in many cases. A 35-year-old man presented with dark-greenish discoloration of the nail plate and onycholysis on the left thumbnail. He had been treated with oral antifungal and antibiotic agents for several months; however, the lesion showed no improvement. The diagnosis of green nail syndrome was established after a positive bacterial culture, and on the basis of the antibiotic sensitivity test result, tobramycin eye drop (Tobrex®) was then prescribed. Three weeks later, the nail discoloration almost vanished but the onycholysis remained. Herein, we recommend the application of tobramycin eye drop as an easy and safe treatment option for green nail syndrome. PMID:25143684

Bae, Youin; Lee, Gang Mo; Sim, Ji Hoon; Lee, Sanghoon; Lee, Sung Yul; Park, Young Lip

2014-08-01

165

Green Nail Syndrome Treated with the Application of Tobramycin Eye Drop  

PubMed Central

Green nail syndrome (chromonychia) is a nail disorder characterized by onycholysis and green-black discoloration of the nail bed. This condition is often associated with chronic paronychia. Pseudomonas aeruginosa is the most commonly identified organism in cultures from the affected area. Despite the various treatment options available, removal of the nail is still necessary in many cases. A 35-year-old man presented with dark-greenish discoloration of the nail plate and onycholysis on the left thumbnail. He had been treated with oral antifungal and antibiotic agents for several months; however, the lesion showed no improvement. The diagnosis of green nail syndrome was established after a positive bacterial culture, and on the basis of the antibiotic sensitivity test result, tobramycin eye drop (Tobrex®) was then prescribed. Three weeks later, the nail discoloration almost vanished but the onycholysis remained. Herein, we recommend the application of tobramycin eye drop as an easy and safe treatment option for green nail syndrome. PMID:25143684

Bae, Youin; Lee, Gang Mo; Sim, Ji Hoon; Lee, Sanghoon; Lee, Sung Yul

2014-01-01

166

Frizzled6 deficiency disrupts the differentiation process of nail development  

PubMed Central

Nails protect the soft tissue of the tips of digits. The molecular mechanism of nail (and claw) development is largely unknown, but we have recently identified a Wnt receptor gene, Frizzled6 (Fzd6) that is mutated in a human autosomal-recessive nail dysplasia. To investigate the action of Fzd6 in claw development at the molecular level, we compared gene expression profiles of digit tips of wild-type and Fzd6?/? mice, and show that Fzd6 regulates the transcription of a striking number of epidermal differentiation-related genes. Sixty-three genes encoding keratins, keratin associated proteins, and transglutaminases and their substrates were significantly down-regulated in the knockout mice. Among them, four hard keratins, Krt86, Krt81, Krt34 and Krt31; two epithelial keratins, Krt6a and Krt6b; and transglutaminase1 were already known to be involved in nail abnormalities when dysregulated. Immunohistochemical studies revealed decreased expression of Krt86, Krt6b and involucrin in the epidermal portion of the claw field in the knockout embryos. We further showed that Dkk4, a Wnt antagonist, was significantly down-regulated in Fzd6?/? mice along with Wnt, Bmp and Hh family genes; and Dkk4 transgenic mice showed a subtly but appreciably modified claw phenotype. Thus, Fzd6-mediated Wnt signaling likely regulates the overall differentiation process of nail/claw formation. PMID:23439395

Cui, Chang-Yi; Klar, Joakim; Georgii-Heming, Patrik; Fröjmark, Anne-Sophie; Baig, Shahid M.; Schlessinger, David; Dahl’, Niklas

2013-01-01

167

Complications after titanium elastic nailing of pediatric tibial fractures.  

PubMed

A retrospective review of 60 diaphyseal tibia fractures (31 closed and 29 open fractures) treated with flexible intramedullary fixation was conducted. All charts and radiographs were reviewed. Children ranged in age from 5.1 to 17 years. Fifty patients with 51 fractures were followed up until union and comprised the study group. The mean follow-up period for these 50 patients was 79 weeks. Forty-five fractures achieved bony union within 18 weeks (mean, 8 weeks). Five patients (11%) had delayed healing (3 had delayed unions that ultimately healed with casting or observation, and 2 had nonunions that required secondary procedures to achieve union [1 patient underwent a fibular osteotomy, and 1 underwent exchange nailing with a reamed tibial nail]). These 5 fractures ultimately healed, with a mean time to union of 41 weeks. Patients with delayed healing tended to be older (mean age, 14.1 years) versus the study population as a whole (mean age, 11.7 years). In addition to delayed union, other complications were observed in the study population. One patient healed with malunion (13-degree valgus), requiring corrective osteotomy. One patient with a grade II open fracture was diagnosed with osteomyelitis at the fracture site after attaining bony union. Two patients developed nail migration through the skin, requiring modification or nail removal. The fixation of pediatric diaphyseal tibia fractures with titanium elastic nails is effective but has a substantial rate of delayed healing, particularly in older patients. PMID:17513967

Gordon, J Eric; Gregush, Ronald V; Schoenecker, Perry L; Dobbs, Matthew B; Luhmann, Scott J

2007-06-01

168

The Huckstep intramedullary compression nail. Indications, technique, and results.  

PubMed

A four-sided, intramedullary compression nail of solid titanium alloy has been developed since 1967. This nail is 12.5 mm in diameter with 4.5-mm transverse holes at 15-mm intervals, for 4-mm fine threaded screws. It has four oblique holes in the proximal end to allow 4.5-mm lag screws to be inserted up the femoral neck. A compressor over the trochanter can be used for compression in transverse fractures. Advantages include inert titanium alloy, which is stronger than the average femoral shaft, a recessed end of the nail, reaming to only 13 mm, and a quadrilateral shape. No operative roentgenograms are usually required. Comminuted, oblique, and infected fractures of the entire length of the femoral shaft down to the supracondylar region can be held rigidly, usually allowing for immediate weight-bearing. The femur can be lengthened or shortened with compression and the knee can be arthrodesed with a 60-cm nail. One hundred twenty-two nails inserted since 1974 included 32 comminuted or oblique acute femoral fractures. Forty-two patients had had failure of other implants. Among these, 34 had nonunion for one year and 17 nonunion for more than three years. Fifty-one bones in 47 patients were stabilized for pathologic fractures and other conditions. Complications were minimal. PMID:3769297

Huckstep, R L

1986-11-01

169

Humeral shaft fracture management, a prospective study; nailing or plating  

PubMed Central

Introduction In this fast moving & advancing era no body want to remain handicapped in immobilization by cast with limited movement. As our knowledge is growing, orthopedic implants and appliances also advancing, and creating a very potential options to manage fracture shaft of humerus by internal fixation either by plate osteosynthesis or interlocking nailing. We are here to evaluate the options of internal fixation; nailing and plating. Material and method We prospectively evaluated the results of 30 patients having humeral Shaft fracture. Who were internally fixed by antegrade interlocking nailing (15) and DCP plate (15). Patients are followed up on average of 16–19 months and results were evaluated with standard protocol. Results All fractures united uneventfully with usual complication. However we need 2 reoperation in nailing and 1 case of plating for bone grafting. Conclusion Internal fixation have immense use in providing better results in form of less deformity, early mobilization and good union. Plating is better option for fixation in terms of less union time, better joint function and lesser reoperation However Nailing is good alternative as minimal invasive approach, less infection, less nerve injury, less chance of implant failure.

Kumar, Rupesh; Singh, Pankaj; Chaudhary, Lal Jee; Singh, Shailendra

2012-01-01

170

Nail: A practical interface generator for data formats Julian Bangert and Nickolai Zeldovich  

E-print Network

Nail: A practical interface generator for data formats Julian Bangert and Nickolai Zeldovich MIT CSAIL ABSTRACT We present Nail, an interface generator that allows pro- grammers to safely parse and generate protocols defined by a Parser-Expression based grammar. Nail uses a richer set of parser

Sabatini, David M.

171

76 FR 23559 - Certain Steel Nails From the United Arab Emirates: Initiation of Antidumping Duty Investigation  

Federal Register 2010, 2011, 2012, 2013, 2014

...Administration [A-520-804] Certain Steel Nails From the United Arab Emirates...typical of sales of certain steel nails produced in the UAE and...Exhibit AD-6. Through market research, the petitioner obtained a quoted transaction price for certain steel nails produced by DWE and...

2011-04-27

172

Comparison of dynamic hip screw and gamma nail: a prospective, randomized, controlled trial  

Microsoft Academic Search

We report a prospective, randomized, controlled trial, comparing the results of treatment with a dynamic hip screw (DHS) and a gamma nail in 95 consecutive patients with peri-trochanteric fractures of the femur. The DHS was used in 48 patients, the gamma nail in 47. Clinical and radiological outcomes were similar, but the gamma nail was associated with a higher incidence

M. S. Butt; S. J. Krikler; S. Nafie; M. S. Ali

1995-01-01

173

Airborne contact dermatitis and asthma in a nail art operator.  

PubMed

Nail art (creation and decoration of artificial nails) is a growing fashion trend. Proportionally to its popularity, the number of allergic reactions to the materials used has recently increased. We report the case of a nail art operator who developed occupational allergy to acrylates, manifested with the unusual simultaneous presence of asthma and dermatitis. Cutaneous lesions only affected areas not covered by individual protection devices or clothes, even if such areas were not in direct contact with acrylates, suggesting airborne allergic contact dermatitis. While respiratory problems were solved with the correct use of a mask at the workplace, facial dermatitis proved impossible to avoid or control and, for this reason, the patient had to change her work. PMID:24488773

Vaccaro, Mario; Guarneri, Fabrizio; Barbuzza, Olga; Cannavò, Serafinella Patrizia

2014-01-01

174

Solitary eccrine syringofibroadenoma with nail involvement: A rare entity  

PubMed Central

Eccrine syringofibroadenoma (ESFA) is a rare, benign tumor of eccrine sweat gland origin that usually presents as a nodule on the extremities of an elderly person. It can also present as an ulcerative plaque, verrucous lesion, papular or nodular lesion or as palmoplantar keratoderma. Although the clinical features are variable, histology is characteristic in the form of anastomosing strands, cords and columns of epithelial cells embedded in a fibrovascular stroma. We report the case of a 62-year-old male with a nodular lesion on the extremity that caused secondary involvement of the nail in the form of complete nail dystrophy. The histology showed features consistent with ESFA. Nail involvement by ESFA is a rare presentation and is rarely described in the literature.

Arora, Pooja; Bansal, Shuchi; Garg, Vijay Kumar; Khurana, Nita; Lal, Brahmanand

2015-01-01

175

Arachnomyces kanei (anamorph Onychocola kanei) sp. nov., from human nails.  

PubMed

Five isolates of a slow-growing cycloheximide resistant hyphomycetous fungus were obtained from nail specimens and investigated for their relationship to Onychocola canadensis (teleomorph Arachnomyces nodosetosus), a known agent of onychomycosis. In one patient diagnosed with superficial white onychomycosis, etiology was confirmed by a nail sample showing atypical filaments in direct microscopy, and by a follow-up specimen yielding cultures of the same fungus. A case of mixed infection with Aspergillus sydowii was also confirmed after examination of cultures grown from three successive microscopic-positive hallux nail specimens. For other isolates, etiological significance could not be confirmed by repeat sampling or results of direct microscopy were negative or unknown. Mating experiments yielded setose ascomata containing smooth oblate ascospores typical of Arachnomyces species. Phylogenetic analysis of ITS 2 region sequences support the conspecificity of the isolates and their placement within the genus. A. kanei sp. nov. (anamorph O. kanei sp. nov.) is described. PMID:12521121

Gibas, C F C; Sigler, L; Summerbell, R C; Hofstader, S L R; Gupta, A K

2002-12-01

176

Road Nail: Experimental Solar Powered Intelligent Road Marking System  

NASA Astrophysics Data System (ADS)

Driving in low visibility conditions (night time, fog or heavy precipitation) is particularly challenging task with an increased probability of traffic accidents and possible injuries. Road Nail is a solar powered intelligent road marking system of wirelessly networked signaling devices that improve driver safety in low visibility conditions along hazardous roadways. Nails or signaling devices are autonomous nodes with capability to accumulate energy, exchange wireless messages, detect approaching vehicles and emit signalization light. We have built an experimental test-bed that consists of 20 nodes and a cellular gateway. Implementation details of the above system, including extensive measurements and performance evaluations in realistic field deployments are presented. A novel distributed network topology discovery scheme is proposed which integrates both sensor and wireless communication aspects, where nodes act autonomously. Finally, integration of the Road Nail system with the cellular network and the Internet is described.

Samardžija, Dragan; Tesli?, Nikola; Todorovi?, Branislav M.; Kova?, Erne; Isailovi?, ?or?e; Miladinovi?, Bojan

2012-03-01

177

Exposure data for personal care products: Hairspray, spray perfume, liquid foundation, shampoo, body wash, and solid antiperspirant  

Microsoft Academic Search

Reliable exposure information for cosmetic and other personal care products and ingredients is needed in order to conduct safety assessments. Essential information includes both the amount of product applied, and the frequency of use. To obtain current data, studies to assess consumer use practices were undertaken. Six widely used personal care product types were included in the studies. Five of

Linda Loretz; Anne Marie Api; Leila Barraj; Joel Burdick; De Ann Davis; William Dressler; Enrico Gilberti; Gwendolyn Jarrett; Steve Mann; Y. H. Laurie Pan; Thomas Re; Kevin Renskers; Carolyn Scrafford; Sally Vater

2006-01-01

178

Fate of pharmaceuticals and personal care products in wastewater treatment plants -Conception of a database and first results  

E-print Network

1 Fate of pharmaceuticals and personal care products in wastewater treatment plants - Conception of detection and removals of pharmaceutical products in wastewater treatment plants. Abstract: We created and personal care products (PPCPs) in wastewater treatment plants (WWTPs). From 117 scientific publications, we

Paris-Sud XI, Université de

179

Mechanical strength of McLaughlin hip nail-plates manufactured from 316 LVM stainless steel. A biomechanical study of unstable trochanteric fractures. V.  

PubMed

Mechanical testing of McLaughlin hip nail-plates manufactured from 316 LVM stainless steel was performed. The mode of failure is described and the results are compared with previous tests of McLaughlin implants manufactured from Cobalt-Chromium-Molybdenum alloy. As there was no significant difference between these two products as regards the basic mechanical problem of failure of the nail-plate junction, it is recommended that the design be changed to make the implant suitable for internal fixation of unstable trochanteric fractures. PMID:7446023

Jensen, J S

1980-06-01

180

Serious Penetrating Craniocerebral Injury Caused by a Nail Gun  

PubMed Central

Penetrating cerebral injuries caused by foreign bodies occur rarely due to the substantial mechanical protection offered by the skull. Throughout most of history, the brain, residing in a "closed box" of bone, has not been vulnerable to external aggression. Recently, we encountered a serious penetrating craniocerebral injury caused by a nail gun. Total excision of the offending nail via emergency craniotomy was performed, but the patient's neurologic status was not improved in spite of aggressive rehabilitative treatment. Here, we report on this troublesome case in light of a review of the relevant literature. PMID:25628820

Jeon, Yong Hyun; Kim, Dong Min; Kim, Sung Hoon

2014-01-01

181

FDA's Report on New Health Care Products Approved in 1999  

NSDL National Science Digital Library

Released on January 18 by the US Food and Drug Administration (FDA), this report highlights some of the approximately 140 medications and medical devices approved by the FDA last year. The highlighted products are listed by the groups of patients or diseases they are designed to help. The report also discusses FDA approval and application procedures. While neither extensive nor particularly easy to read, the report still contains a useful overview of the most important new drugs and treatments to enter the market in 1999.

182

Demand and Supply–Based Operating Modes—A Framework for Analyzing Health Care Service Production  

PubMed Central

Context: The structure of organizations that provide services should reflect the possibilities of and constraints on production that arise from the market segments they serve. Organizational segmentation in health care is based on urgency and severity as well as disease type, bodily function, principal method, or population subgroup. The result is conflicting priorities, goals, and performance metrics. A managerial perspective is needed to identify activities with similar requirements for integration, coordination, and control. Methods: The arguments in this article apply new reasoning to the previous literature. Findings: The method used in this article to classify health care provision distinguishes different types of health problems that share generic constraints of production. Conclusions: The analysis leads to seven different demand-supply combinations, each with its own operational logic. These are labeled demand and supply–based operating modes (DSO modes), and constitute the managerial building blocks of health care organizations. The modes are Prevention, Emergency, One visit, Project, Elective, Cure, and Care. As analytical categories the DSO modes can be used to understand current problems. Several operating modes in one unit create managerial problems of conflicting priorities, goals, and performance metrics. The DSO modes are constructed as managerially homogeneous categories or care platforms responding to general types of demand, and supply constraints. The DSO modes bring methods of industrial management to bear on efforts to improve health care. PMID:21166870

Lillrank, Paul; Groop, P Johan; Malmström, Tomi J

2010-01-01

183

Irradiation of advanced health care products - Tissues and biologics  

NASA Astrophysics Data System (ADS)

Radiation sterilization of tissues and biologics has become more common in recent years. As a result it has become critical to understand how to adapt the typical test methods and validation approaches to a tissue or biological product scenario. Also data evaluation sometimes becomes more critical than with traditional medical devices because for many tissues and biologics a low radiation dose is required. It is the intent behind this paper to provide information on adapting bioburden tests used in radiation validations such that the data can be most effectively used on tissues and biologics. In addition challenges with data evaluation are discussed, particularly the use of less-than values for bioburden results in radiation validation studies.

Winters, Martell

2014-12-01

184

Selenium Toxicity from a Misformulated Dietary Supplement, Adverse Health Effects, and the Temporal Response in the Nail Biologic Monitor  

PubMed Central

Use of dietary supplements in the U.S. has increased steadily over the last 25 years. While misformulation is uncommon, the consequences can be serious. A March 2008 voluntary market recall removed supplement products responsible for the most serious selenium toxicity outbreak that has occurred in the U.S. We quantified selenium concentrations in the misformulated supplement products, measured the temporal response in the nail biologic monitor, and associated exposure to self-reported selenosis symptoms. Subjects recruited through state health departments and referrals provided samples of the misformulated supplement products, exposure information, monthly toenail and or fingernail clippings or onycholysitic nail fragments, and listed their newly onset adverse health effects attributed to selenium toxicity. Ninety-seven subjects enrolled and submitted at least one test sample. Peak selenium concentrations (up to 18.3 and 44.1 ?g/g for toenails and fingernails, respectively) were measured. Multiple samples (52 total) of all six recalled supplement lots were analyzed ranging from 22,300 to 32,200 ?g selenium per daily dose. Average consumption was 30.9 ± 13.9 doses; 73 subjects provided follow-up data on selenosis symptoms at 2.50 ± 0.14 years. Nail samples accurately reflect exposure in this selenium toxicity outbreak, which resulted in long-term/permanent adverse health effects. PMID:23538937

Morris, John Steven; Crane, Stacy B.

2013-01-01

185

Personal care product use and urinary levels of phthalate metabolites in Mexican women.  

PubMed

Sources of phthalates other than Polyvinyl chloride (PVC) related products are scarcely documented in Mexico. The objective of our study was to explore the association between urinary levels of nine phthalate metabolites and the use of personal care products. Subjects included 108 women who participated as controls in an ongoing population-based case-control study of environmental factors and genetic susceptibility to breast cancer in northern Mexico. Direct interviews were performed to inquire about sociodemographic characteristics, reproductive history, use of personal care products, and diet. Phthalate metabolites measured in urine by high performance liquid chromatography-isotope dilution tandem mass spectrometry were monoethyl phthalate (MEP), monobenzyl phthalate (MBzP), mono-n-butyl phthalate (MBP), mono-isobutyl phthalate (MiBP), mono-3-carboxypropyl phthalate (MCPP) as well as mono-2-ethylhexyl phthalate (MEHP), mono-2-ethyl-5-oxohexyl phthalate (MEOHP), mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP), mono-2-ethyl-5-carboxypentyl phthalate (MECPP) that are metabolites of di-ethylhexyl phthalate (DEHP). Detectable urinary concentrations of phthalate metabolites varied from 75% (MEHP) to 100% (MEP, MBP, MEOHP, MEHHP and MECPP). Medians of urinary concentrations of some phthalate metabolites were significantly higher among users of the following personal care products compared to nonusers: body lotion (MEHHP, MECPP and sum of DEHP metabolites (?DEHP)), deodorant (MEHP and ?DEHP), perfume (MiBP), anti-aging facial cream (MEP, MBP and MCPP) and bottled water (MCPP, MEHHP and MEOHP). Urinary concentrations of MEP showed a positive relationship with the number of personal care products used. Our results suggest that the use of some personal care products contributes to phthalate body burden that deserves attention due to its potential health impact. PMID:21429583

Romero-Franco, Michelle; Hernández-Ramírez, Raúl U; Calafat, Antonia M; Cebrián, Mariano E; Needham, Larry L; Teitelbaum, Susan; Wolff, Mary S; López-Carrillo, Lizbeth

2011-07-01

186

Pharmaceuticals, Personal Care Products, and Endocrine Disruptors in Water: Implications for the Water Industry  

Microsoft Academic Search

For over 70 years, scientists have reported that certain synthetic and natural compounds could mimic nat- ural hormones in the endocrine systems of animals. These substances are now collectively known as en- docrine-disrupting compounds (EDCs), and have been linked to a variety of adverse effects in both humans and wildlife. More recently, pharmaceuticals and personal care products (PPCPs) have been

Shane A. Snyder; Paul Westerhoff; Yeomin Yoon; David L. Sedlak

2003-01-01

187

ENVIRONMENTAL ANALYTICAL CHEMISTRY OF PHARMACEUTICAL AND PERSONAL CARE PRODUCTS: THE SEPARATIONS FOCUS TURNS TO POLAR ANALYTES  

EPA Science Inventory

Within the scope of a number of emerging contaminant issues in environmental analysis, one area that has received a great deal of public interest has been the assessment of the role of pharmaceuticals and personal care products (PPCPs) as stressors and agents of change in ecosyst...

188

Pharmaceuticals and Personal Care Products in the Environment: What are the Big Questions?  

EPA Science Inventory

Over the past 10-15 years, a significant amount of work has been done by the scientific, regulatory and business communities into effects and risks of pharmaceuticals and personal care products (PPCPs) in the environment. It is now timely to review the current knowledge and to...

189

Treatment of ingrown nail with a special device composed of shape-memory alloy.  

PubMed

Ingrown nail is a common nail problem resulting in pain and disability in daily life. Recently, a new treatment modality for an ingrown nail was reported that used a device composed of shape-memory alloy, K-D. The aim of the present study was to determine the efficacy, recurrence rate and complications of K-D. Between June 2010 and September 2012, 24 patients (31 nails) underwent treatment of symptomatic incurved nails with a K-D. Patients were evaluated at pretreatment and during every visit. The mean age of the patients involved was 43.4 years. The mean period of follow up was 161 days. The mean maintenance period was 41 days. The right first toenail was the most common site. Almost ingrown nails healed and the nail deformity was corrected after the procedure. Among the 31 nails, seven of the ingrown nails recurred during follow up (22.6% recurrence rate). The recurrence rate of the patients with stage 1, 2 and 3 ingrown nails was 22.2%, 33.3% and 14.2%, respectively. The majority of patients were very satisfied. There were no side-effects in most patients except loss of nail in one patient. K-D has some advantages such as simple application steps, no deformity after the procedure, high patient satisfaction and obvious effect compared to other non-invasive and invasive methods. PMID:24612270

Park, Se-Won; Park, Ji-Ho; Lee, Jong-Hee; Lee, Dong-Youn; Lee, Joo-Heung; Yang, Jun-Mo

2014-04-01

190

Nail apparatus melanoma: is trauma a coincidence? Is this peculiar tumor a real acral melanoma?  

PubMed

Nail Apparatus Melanoma (NAM) is rare, particularly in Caucasians. Understanding its pathogenesis and collecting epidemiologic data may be difficult due to its location and the exiguity of the case series of this cancer. Cutaneous melanoma has been thought related to UV radiation, and NAM is considered an acral variant of melanoma, even if the nail presents a specific anatomy. Little is reported about pathogenesis, except reports suggesting traumatic injuries as a causal factor. UV exposure is debated in nail melanoma because of its structure. The nail is, in fact, a unique structure with sun-exposed and non exposed melanocytes. NAM arises from the nail melanocytes, located in the nail matrix, which is the germinative part of the nail and composed of a proximal and distal portion. The proximal nail matrix lays under the proximal nail fold that covers it and is non-sun exposed, while the distant nail matrix, clinically visible as the lunula, is sun-exposed, though lying underneath the nail plate. According to these anatomical data, NAM is a distinct melanoma type, and studies need to classify it as acral melanoma or as a particular type of melanoma with its own pathogenesis and prognostic criteria. This study investigates potential risk factors of NAM, emphasizing (i) trauma and (ii) UV exposure among our NAM patients. PMID:23153047

Fanti, P A; Dika, E; Misciali, C; Vaccari, S; Barisani, A; Piraccini, B M; Cavrin, G; Maibach, H I; Patrizi, A

2013-06-01

191

Mucocutaneous manifestations and nail changes in patients with end-stage renal disease on hemodialysis.  

PubMed

Mucocutaneous manifestations are common among patients on hemodialysis (HD). This study was undertaken to determine the prevalence of mucocutaneous manifestations in patients with end-stage renal disease (ESRD) who are on HD. In this cross-sectional, descriptive and analytic study conducted in 2009, 100 patients on HD at the Five Azar Hospital in Gorgan city were randomly selected. All the patients underwent detailed examination by a dermatologist to look for lesions in the skin, hair, nail and mucous membranes; if felt necessary, biopsy was obtained from the lesions. The findings were statistically analyzed using SPSS-13 software. For evaluation of normality of distribution, Kolmogorov-Smirnov was used, for quantitative variables Mann-Whitney and T-test (abnormal distribution) were used and for qualitative variables, Chi-2 and Fisher were used. In this study, P-value less than 0.05 was considered significant. Fifty-one males and 49 females were enrolled. The mean age was 49 ± 12 years. Diabetes was the most common cause of ESRD. In 95% of the patients, at least one mucocutaneous manifestation was present. Xerosis (78.3%) was the most common lesion, followed by pruritus (39.1%), lentigo (34.8%), skin discoloration (32.6%), leukonychia (32%) and thinning of the nail bed (24%). Xerosis, scaling, lentigo, folliculitis, idiopathic guttate hypopigmentation, leukonychia and half and half nail were associated with age. A significant relationship was seen between duration on dialysis and skin discoloration and leukonychia. Clubbing had a significant association with calcium-phosphorus product (Ca × P). There was a significant association between serum ferritin level and pruritus and tinea versicolor lesions. Our study shows that mucocutaneous manifestations are common among patients with ESRD. Identification of these manifestations and their association with causative factors are useful for preventing the lesions. PMID:23354189

Tajbakhsh, Ramin; Dehghan, Mohammad; Azarhoosh, Ramin; Haghighi, Ali Nobakht; Sadani, Somayeh; Zadeh, Soheila Samad; Kabootari, Maryam; Qorbani, Mostafa

2013-01-01

192

Lichen Nitidus Presenting with Nail Changes-Case Report and Review of the Literature.  

PubMed

Lichen nitidus of the nail is rare and can precede the onset of skin lesions. Delayed diagnosis is common. We present an unusual case of lichen nitidus-associated nail changes that preceded the onset of skin lesions in a 4-year-old Indian girl. We also conduct a review of six other cases of lichen nitidus with nail involvement from the English-language literature. Clues to the diagnosis of lichen nitidus include violaceous or pigmentary changes of the nail fold and subtle lichenoid papules on the affected digits. Lichen nitidus of the nails appears to be less severe than nail changes of lichen planus and is generally self-limiting. Understanding the natural history of lichen nitidus of the nails will help physicians better counsel patients and their families. PMID:25440319

Tay, Evelyn Yuxin; Ho, Madeline Sheun Ling; Chandran, Nisha Suyien; Lee, Joyce Siong-See; Heng, Yee Kiat

2014-12-01

193

Ingrown toenails (unguis incarnatus): Nail braces/bracing treatment  

PubMed Central

Nail bracing is a safe, simple, and inexpensive treatment option that avoids surgery, requires no anesthetic, requires no recovery period, allows wearing the existing shoes, offers immediate relief from pain, and allows the practice of daily activities. Braces can be used for prolonged periods of times. If recurrence occurs, reapplication of bracing is usually required. PMID:24688206

Chiriac, Anca; Solovan, Caius

2014-01-01

194

Treatment of Midshaft Clavicular Fractures With Elastic Titanium Nails  

PubMed Central

Background: One of the modern techniques for the treatment of clavicle fracture (Fx) is elastic titanium intramedullary nailing. But, there are different opinions about this technique. We studied this technique in 12 patients with clavicle Fx and assessed its outcome. Objectives: We aimed to study the prognosis of midshaft clavicular Fx treated via minimally invasive stable elastic intramedullary nailing. Patients and Methods: We operated on 13 clavicle Fx in 12 patients from 2008 through 2012. We used a new technique called minimally invasive titanium elastic intramedullary nailing for operating patients with midshaft clavicular Fx. Results: Clinical union was achieved 3-5 weeks after the operation with no pain over Fx sites upon physical examination. Radiologic union appeared at 6 to 12 weeks .We did not encounter nonunion or infection, but one of the comminuted Fx united 1 cm shorter; however, it had a solid union with a good score. All but two patients had good scores. Conclusions: Although controversy exist regarding intramedullary nailing of clavicle Fx, our results using this technique for minimally comminuted midshaft clavicular Fx were very good. PMID:25337513

Keihan Shokouh, Hassan; Naderi, Mohammad Nasir; Keihan Shokouh, Mahsa

2014-01-01

195

Midshaft Clavicular Fracture and Titanium Elastic Intra-medullary Nail  

PubMed Central

Introduction: Clavicular injury is common in active and younger age group with male preponderance (male-female ratio is 2:1). Purpose of this study was to analyze the outcome of surgically treated displaced fracture midshaft clavicular fracture using Intra-medullary fixation by titanium elastic nail. Materials and Methods: We present a series of cases of midshaft clavicular fracture who were subjected to Intra medullary fixation with the average nail diameter of 2.5 to 3 mm titanium elastic nail system by the closed/open reduction method under Image intensifier control. Results: Average time taken for full clinical and radiological union was nine weeks (with minimum six weeks to maximum eleven weeks). Time taken for fully functional recovery (time of functional disability) was 35±7 days in all patients except in two cases of floating shoulder and one case of poly-traumatic patient in which it was 50 days. Follow-up period ranged between 9 months and 24 months with an average of 18 months. Average Constant-Murley-Score after assessment of shoulder function was 96.8. Conclusion: Titanium elastic intra-medullary nailing is a promising surgery with excellent functional outcome, safer percutaneous method with less invasive nature and rapid healing tendency with fewer complications in contrast to plate osteosynthesis. PMID:24596743

Mishra, Pankaj Kumar; Gupta, Anuj; Gaur, Suresh Chandra

2014-01-01

196

Managing Chemotherapy Side Effects: Skin and Nail Changes  

MedlinePLUS

... and Nail Changes Protect your skin from the sun. l Try to stay out of the sun. l When you are outside, always wear sunscreen ... me to use? 3. What should the SPF (sun protection factor) be in the sunscreen and lip ...

197

Study and Reduction of Noise from a Pneumatic Nail Gun  

Microsoft Academic Search

This paper describes the reduction of noise from a pneumatic 18 gauge nail gun. The objectives were to identify the major sources of noise, implement possible noise reduction measures, and evaluate the effectiveness of the modifications. Sound measurements were taken according to a procedure that was developed based on the ANSI S12.15-1992 standard for power tools. Results show that the

Daniel A. Hicks; Kha Vu; Mohan D. Rao

198

A few aspects of transonychial water loss (TOWL): inter-individual, and intra-individual inter-finger, inter-hand and inter-day variabilities, and the influence of nail plate hydration, filing and varnish.  

PubMed

The aim of the study was to measure transonychial water loss (TOWL) in order to identify the extent of inter-individual, intra-individual inter-finger, inter-hand, and inter-day variabilities, and the influence of nail wetting, filing and varnishing on TOWL, with a view to determine parameters for the measurement of TOWL and its possible applications. Fingernail and toenail TOWL was measured using the condenser-chamber AquaFlux (Biox) and a specially designed Nail Adaptor supplied by Biox. A wide range of TOWL values (28-75g/m(2)h for fingernails and 26-48g/m(2)h for toenails) were found, with significant inter-individual variability. Intra-individual variability was lower; however, in the same individual, inter-finger, inter-hand/foot and inter-day variabilities were found, as well as a strong correlation between nail plate thickness and TOWL. Wetting the nails, even briefly, resulted in a significant rise in TOWL, which subsequently took much longer to return to control values. Filing the nail plate surface with a pharmaceutical file caused large increases in TOWL, whose profile (with number of filing strokes) was fairly different among individuals. As expected, nail varnish application reduced TOWL; the different extent of TOWL reduction by different varnishes suggests a potential use of TOWL measurements for product comparisons. PMID:18582566

Murdan, Sudaxshina; Hinsu, Dhrumit; Guimier, Marie

2008-10-01

199

In vitro biomechanical comparison of solid and tubular interlocking nails in neonatal bovine femurs.  

PubMed

This study biomechanically evaluates solid and tubular interlocking nails in bovine neonatal femurs. Paired femurs from 40 neonatal dairy calves were obtained for mechanical testing. Intact femurs and four combinations of experimentally manipulated femurs (intact or ostectomized femurs with either a solid or tubular interlocking nail) were tested in craniocaudal and lateromedial bending, eccentric axial compression, and external torsion to evaluate composite rigidity, local/gap stiffness, and load to failure (compression and torsion only). In torsional composite rigidity, femurs with tubular interlocking nails were more complaint than intact femurs or intact femurs with solid interlocking nails (P < .001). Ostectomized femurs with solid interlocking nails were similar to intact femurs with tubular interlocking nails. Within femurs with tubular interlocking nails, ostectomized femurs were more compliant than intact femurs (P < .0001). In craniocaudal and lateromedial bending rigidity, ostectomized femurs were more complaint than intact femurs, regardless of interlocking nail type (P < .001). Within ostectomized femurs, tubular interlocking nails were more complaint than solid interlocking nails in craniocaudal bending (P < .05) and there was a similar trend in lateromedial bending (P = .06). In eccentric axial compression, local/gap stiffness was significantly greater in intact femurs compared with intact femurs with solid (48% of intact bone) or tubular (45% of intact bone) interlocking nails and ostectomized femurs with solid (18% of intact bone) or tubular (11% of intact bone) interlocking nails (P < .0001). In torsional testing, local/gap stiffness was not significantly different between intact femurs and intact femurs with interlocking nails, but was significantly lower in ostectomized femurs with solid (2% of intact bone) and tubular (0.2% of intact bone) interlocking nails (P < .0001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7653038

Trostle, S S; Wilson, D G; Dueland, R T; Markel, M D

1995-01-01

200

Organic UV filters in personal care products in Switzerland: a survey of occurrence and concentrations.  

PubMed

Organic ultraviolet (UV) filters are a group of compounds designed to absorb UV radiation and hence protect our skin against UV-induced damage. Apart from traditional sunscreens, they can be found in many other categories of personal care products (PCPs). These include skin care, facial makeup and lip care products, which are often used simultaneously, and on a regular basis. The frequency of occurrence as well as concentrations of organic UV filters contained in PCPs change over time. Furthermore, in Switzerland the exact UV filter concentrations are confidential. To date, only limited data are available for the levels of organic UV filters in PCPs, and these data refer mainly to sunscreens. In this paper, we provide an up-to-date frequency of occurrence and concentrations of organic UV filters in PCPs, including for the first time PCPs used in everyday life. A total of 116 PCPs was selected on the basis of a product-use questionnaire and distributed among seven PCP categories: lip care products, lipsticks, face creams, liquid makeup foundations, aftershaves, hand creams, and sunscreens. Concentrations of 22 organic UV filters were measured in the selected PCPs. The most frequently occurring UV filters were butyl methoxydibenzoylmethane (BMBM) detected in 82 products (71%), ethylhexyl methoxycinnamate (EHMC) in 59 products (51%) and octocrylene (OCT) in 50 products (43%). BMBM, EHMC and OCT concentrations averaged 2.6%, 4.0%, and 6.0%, respectively. Overall, UV filter concentrations in PCPs applied regularly throughout the year can be as high as those in sunscreens that are primarily used for sun protection and hence applied only on selected days. PCPs that are used on a regular basis, and often simultaneously, thus represent an important and, as yet, unquantified source of UV filter exposure. This study provides essential information for aggregate exposure assessments that combine data on concentrations of individual UV filters widely used in a variety of PCP categories. PMID:23026542

Manová, Eva; von Goetz, Natalie; Hauri, Urs; Bogdal, Christian; Hungerbühler, Konrad

2013-07-01

201

Getting the product right: how competition policy can improve health care markets.  

PubMed

As hospital, physician, and health insurance markets consolidate and change in response to health care reform, some commentators have called for vigorous enforcement of the federal antitrust laws to prevent the acquisition and exercise of market power. In health care, however, stricter antitrust enforcement will benefit consumers only if it accounts for the competitive distortions caused by the sector's long history of government regulation. This article directs policy makers to a neglected dimension of health care competition that has been altered by regulation: the product. Competition may have failed to significantly lower costs, increase access, or improve quality in health care because we have been buying and selling the wrong things. Competition policy makers-meaning both antitrust enforcers and regulators-should force the health care industry to define and market products that can be assembled and warranted to consumers while keeping emerging sectors such as mHealth free from overregulation, wasteful subsidy, and appropriation by established insurer and provider interests. PMID:24841884

Sage, William M

2014-06-01

202

Nails of newborns in monitoring drug exposure during pregnancy.  

PubMed

This project was developed to investigate the usefulness of newborn nails for monitoring in utero drug exposure. Cocaine, benzoylecgonine, morphine, methadone, caffeine, nicotine, and cotinine were determined in nail samples from the first 3 months of life of 25 newborns abandoned immediately after birth (group 1) and of 33 babies born at the local maternity hospital whose families were recruited on a voluntary basis (group 2). All substances were measured by gas chromatography-mass spectrometry (detection limit: 0.025 ng/mg). Moreover, analytical results were compared with mothers' self-reported habits when the information was available. In group 1, 12 nails were found positive for caffeine and 13 for both nicotine and cotinine. Six samples tested cocaine- (range, median: 0.14-0.25, 0.175 ng/mg) and benzoylecgonine-positive (range, median: 0.12-0.20, 0.165 ng/mg). Both nicotine and cocaine were always retrieved together with their main metabolite. Morphine was found in four samples (range, median: 0.10-0.15, 0.125 ng/mg), methadone in five samples (range, median: 0.12-0.26, 0.170 ng/mg) that were found negative for all other compounds. In group 2, two samples tested positive for methadone (0.16, 0.17 ng/mg). The mothers self-report of the use of coffee always corresponded to caffeine positivity in the newborn nails (n=6), whereas six samples tested positive for nicotine and/or cotinine with a non-smoking mother. Sixteen out of the 33 samples of group 2 tested negative for all compounds. In conclusion, for the first time, results showed that, once that sample collection problems are solved, nails of the first period of life can be a very interesting indicator of in utero drug exposure. PMID:18620824

Mari, Francesco; Politi, Lucia; Bertol, Elisabetta

2008-08-01

203

Partial Removal of Nail Matrix in the Treatment of Ingrown Nails: Prospective Randomized Control Study Between Curettage and Electrocauterization.  

PubMed

The aim of this study was to compare the result of electrocauterization and curettage, which can be done with basic instruments. Patients with ingrown nail were randomized to 2 groups. In the first group, nail matrix was removed by curettage, and the second group, nail matrix was removed by electrocautery. A total of 61 patients were enrolled; 32 patients were operated by curettage, and 29 patients were operated by electrocautery. Wound infections, as early complication, were found in 15.6% (5/32) of the curettage group, 10.3% (3/29) of the electrocautery group patients each (P = .710). Nonrecurrence was observed in 93.8% (30/32) and 86.2% (25/29) of the curettage and electrocautery groups, respectively, (lower limit of 1-sided 90% confidence interval = -2.3% > -15% [noninferiority margin]). To remove nail matrix, the curettage is effective as well as the electrocauterization. Further study is required to determine the differences between the procedures. PMID:25256283

Kim, Maru; Song, In-Guk; Kim, Hyung Jin

2014-09-25

204

Retrograde nailing for supracondylar fracture around total knee replacement: A compatibility study using the Trigen supracondylar nail  

Microsoft Academic Search

The incidence of periprosthetic supracondylar femoral fractures around total knee arthroplasties (TKRs) is increasing. An acceptable treatment is to insert a supracondylar nail, but not all TKRs will permit this. An unofficial table of compatibilities is available from Smith and Nephew, but this has not been peer reviewed. We ascertained the ten most common TKR prostheses currently used in the

V. A. Currall; M. Kulkarni; W. J. Harries

2007-01-01

205

Clinical Evidence for the Relationship between Nail Configuration and Mechanical Forces  

PubMed Central

Summary: Mechanobiology is an emerging field of science that focuses on the way physical forces and changes in cell or tissue mechanics contribute to development, physiology, and disease. As nails are always exposed to physical stimulation, mechanical forces may have a particularly pronounced effect on nail configuration and could be involved in the development of nail deformities. However, the role of mechanobiology in nail configuration and deformities has rarely been assessed. This review describes what is currently understood regarding the effect of mechanical force on nail configuration and deformities. On the basis of these observations, we hypothesize that nails have an automatic curvature function that allows them to adapt to the daily upward mechanical forces. Under normal conditions, the upward daily mechanical force and the automatic curvature force are well balanced. However, an imbalance between these 2 forces may cause nail deformation. For example, pincer nails may be caused by the absence of upward mechanical forces or a genetic propensity increase in the automatic curvature force, whereas koilonychias may occur when the upward mechanical force exceeds the automatic curvature force, thereby causing the nail to curve outward. This hypothesis is a new concept that could aid the development of innovative methods to prevent and treat nail deformities. PMID:25289309

Ogawa, Rei

2014-01-01

206

Automated fit quantification of tibial nail designs during the insertion using computer three-dimensional modelling.  

PubMed

Intramedullary nailing is the standard fixation method for displaced diaphyseal fractures of the tibia. An optimal nail design should both facilitate insertion and anatomically fit the bone geometry at its final position in order to reduce the risk of stress fractures and malalignments. Due to the nonexistence of suitable commercial software, we developed a software tool for the automated fit assessment of nail designs. Furthermore, we demonstrated that an optimised nail, which fits better at the final position, is also easier to insert. Three-dimensional models of two nail designs and 20 tibiae were used. The fitting was quantified in terms of surface area, maximum distance, sum of surface areas and sum of maximum distances by which the nail was protruding into the cortex. The software was programmed to insert the nail into the bone model and to quantify the fit at defined increment levels. On average, the misfit during the insertion in terms of the four fitting parameters was smaller for the Expert Tibial Nail Proximal bend (476.3?mm(2), 1.5?mm, 2029.8?mm(2), 6.5?mm) than the Expert Tibial Nail (736.7?mm(2), 2.2?mm, 2491.4?mm(2), 8.0?mm). The differences were statistically significant (p???0.05). The software could be used by nail implant manufacturers for the purpose of implant design validation. PMID:25515223

Amarathunga, Jayani P; Schuetz, Michael A; Yarlagadda, Prasad Kvd; Schmutz, Beat

2014-12-01

207

346 BULLETIN OF THE UNlTEb STATES FISR COMVISSION. or ''nail bed ''is lost the nail does not again grow out, so in the case  

E-print Network

, as much depends or1 its right preparation for the table, we took some pains to inquire how it is cooked346 BULLETIN OF THE UNlTEb STATES FISR COMVISSION. or ''nail bed ''is lost the nail does not again, they are frozen solid as they lie in boxes. This process is SO perfected in the works at Salem, N. J., that 128

208

Fatigue strength of common tibial intramedullary nail distal locking screws  

PubMed Central

Background Premature failure of either the nail and/or locking screws with unstable fracture patterns may lead to angulation, shortening, malunion, and IM nail migration. Up to thirty percent of all unreamed nail locking screws can break after initial weight bearing is allowed at 8–10 weeks if union has not occurred. The primary problem this presents is hardware removal during revision surgery. The purposes of our study was to evaluate the relative fatigue resistance of distal locking screws and bolts from representative manufacturers of tibial IM nail systems, and develop a relative risk assessment of screws and materials used. Evaluations included quantitative and qualitative measures of the relative performance of these screws. Methods Fatigue tests were conducted to simulate a comminuted fracture that was treated by IM nailing assuming that all load was carried by the screws. Each screw type was tested ten times in a single screw configuration. One screw type was tested an additional ten times in a two-screw parallel configuration. Fatigue tests were performed using a servohydraulic materials testing system and custom fixturing that simulated screws placed in the distal region of an appropriately sized tibial IM nail. Fatigue loads were estimated based on a seventy-five kilogram individual at full weight bearing. The test duration was one million cycles (roughly one year), or screw fracture, whichever occurred first. Failure analysis of a representative sample of titanium alloy and stainless steel screws included scanning electron microscopy (SEM) and quantitative metallography. Results The average fatigue life of a single screw with a diameter of 4.0 mm was 1200 cycles, which would correspond roughly to half a day of full weight bearing. Single screws with a diameter of 4.5 mm or larger have approximately a 50 percent probability of withstanding a week of weight bearing, whereas a single 5.0 mm diameter screw has greater than 90 percent probability of withstanding more than a week of weight bearing. If two small diameter screws are used, our tests showed that the probability of withstanding a week of weight bearing increases from zero to about 20 percent, which is similar to having a single 4.5 mm diameter screw providing fixation. Conclusion Our results show that selecting the system that uses the largest distal locking screws would offer the best fatigue resistance for an unstable fracture pattern subjected to full weight bearing. Furthermore, using multiple screws will substantially reduce the risk of premature hardware failure. PMID:19371438

Griffin, Lanny V; Harris, Robert M; Zubak, Joseph J

2009-01-01

209

Successful Treatment of Nail Lichen Planus with Alitretinoin: Report of 2 Cases and Review of the Literature.  

PubMed

Background: Treatment of nail lichen planus (LP) is difficult and an optimal therapy is lacking. Objective: To report additional cases to the scant existing literature to learn more about therapeutic options for nail LP. Methods: A regimen of 30 mg alitretinoin daily in 2 cases of nail LP over a period of 9 and 8 months, respectively. Results: In either case, nail changes showed marked improvement under oral alitretinoin therapy within 2 and 4 months, respectively. In both patients, affected nails with end-stage destructive pterygium were resistant to any previously applied therapy. Conclusion: Alitretinoin is an effective treatment option for nail LP. We recommend early diagnosis of nail LP and early initiation of systemic therapy with alitretinoin to prevent the development of pterygium and permanent nail damage. However, further clinical studies are needed to establish reliable guidelines for nail LP therapy. © 2014 S. Karger AG, Basel. PMID:25322730

Alsenaid, Adel; Eder, Irina; Ruzicka, Thomas; Braun-Falco, Markus; Wolf, Ronald

2014-10-11

210

Biodegradation and removal of pharmaceuticals and personal care products in treatment systems: a review  

Microsoft Academic Search

Pharmaceuticals and personal care products (PPCPs) have been the focus of much recent research as concerns rise about their\\u000a occurrence in bodies of water worldwide. In an effort to characterize the risk and determine the prevalence of these micropollutants\\u000a in lakes and rivers, many researchers are examining PPCP removal from impaired water during wastewater treatment and water\\u000a recycling (soil passage)

Kathryn M. Onesios; Jim T. Yu; Edward J. Bouwer

2009-01-01

211

How are pharmaceutical and personal care products (PPCPs) removed from urban wastewaters?  

Microsoft Academic Search

The presence of bioactive trace pollutants such as pharmaceuticals and ingredients of personal care products (PPCPs) in different\\u000a environmental compartments (rivers, lakes, groundwaters, sediments, etc.) is an emerging issue due to the lack of existing\\u000a information about the potential impact associated with their occurrence, fate and ecotoxicological effects. Due to the low\\u000a PPCP concentrations reported in wastewaters (ppb or ppt)

Sonia Suárez; Marta Carballa; Francisco Omil; Juan M. Lema

2008-01-01

212

Building a “smart nail” for penetration tests on Li-ion cells  

NASA Astrophysics Data System (ADS)

Nail penetration is one safety test that Li-ion cells experience in order to simulate some aspects of an internal short circuit event. To our knowledge, nail penetration is usually performed with an ordinary steel nail. Normally, the only data gathered has been a simple pass/fail result depending on whether or not the cell emitted smoke or flame, along with a thermocouple on the surface of the cell. A “smart nail” has been developed to allow the collection of temperature versus time data at the point of nail penetration. This nail, in conjunction with a thermocouple on the cell surface and tabs on the ends to measure voltage, should provide some new insights into the behavior of cells during this type of abuse testing as well as aid in the developing of safer Li-ion cell chemistries.

Hatchard, T. D.; Trussler, S.; Dahn, J. R.

2014-02-01

213

Corrective Tibial Osteotomy in Young Adults Using an Intramedullary Nail  

PubMed Central

Purpose The purpose of this study was to document results of a less invasive technique of open wedge proximal tibial osteotomy (PTO) for the varus knee in young adults using an intramedullary tibial nail. Materials and Methods We prospectively studied 24 knees in 16 young patients with varus knee deformity. The mean follow-up was 54 months (range, 36 to 107 months) and the mean age of patients at the time of operation was 25.8 years (range, 18 to 40 years). The open wedge PTO was performed below tibial tuberosity using a percutaneous multiple drill-hole technique. Conventional intramedullary tibial nail was used for fixation without bone graft. Radiographic evaluations were made using mechanical alignment (MA), posterior tibial slope angle, and Insall-Salvati ratio. Union time, loss of correction, implant failure, and associated complications were also investigated. Results The mean MA was significantly changed from -9.7° preoperatively to 1.1° at the final follow-up (p<0.001). There was no significant change in the proximal tibial anatomy and patellar height. All patients achieved radiographic bony union at an average of 3.1 months without loss of correction. The only complication was knee pain due to nail prominence in 3 patients. Conclusions Radiographic evaluation indicated that PTO using an intramedullary tibial nail leads to significant improvement in radiographic parameters without changes in posterior tibial slope or patellar height. We found that this technique could be a less invasive and effective alternative for correction of the varus knee in young adults. PMID:24944974

Kim, Kang-Il; Thaller, Peter H.; Ramteke, Alankar; Lee, Seung-Hyuk

2014-01-01

214

Arthrodesis of the knee with a modular titanium intramedullary nail.  

PubMed

We retrospectively studied the results of arthrodesis of the knee with a modular titanium intramedullary nail that couples at the knee. The study group consisted of thirteen patients who had a malignant tumor around the knee, five who had failure of a total knee arthroplasty, and three who had a locally destructive benign tumor about the knee. All of the patients were followed for a minimum of two years. Through a single incision at the knee, one nail was inserted retrograde into the femur and the other, antegrade into the tibia; the two nails were joined at the level of the knee by a conical couple and were secured with locking screws. The diameters of the nails were different, to accommodate the dissimilar sizes of the tibial and femoral intramedullary canals. A solid osseous fusion was achieved in nineteen (90 per cent) of the twenty-one patients (sixteen who had had resection of a tumor and three who had had a failed arthroplasty), at an average of 8.4 months (range, three to nineteen months) after the operation. One patient had a delayed union, but fusion was achieved after additional bone-grafting. Of the sixteen patients who were available for clinical and radiographic evaluation at the time of the study, fifteen were satisfied with the over-all outcome and thirteen had either less pain or the same amount of pain as they had had preoperatively. There were no mechanical failures of the implant and no recurrences of tumor. Complications occurred in eight (38 per cent) of the twenty-one patients: three patients had a stress fracture, three had a peroneal nerve palsy (one of which was transient), one had a superficial wound infection, and one had reflex sympathetic dystrophy. PMID:9010183

Arroyo, J S; Garvin, K L; Neff, J R

1997-01-01

215

Two synchronous periungual BCC treated with Mohs surgery. Nail polish related?  

PubMed

Basal cell carcinoma (BCC), the most frequent malignant skin tumor observed in Caucasian adults, especially males, occurs mainly in sun-exposed areas of the body. BCC in the periungual tissues, such as proximal nail fold, nail matrix, nail bed and hyponychium, is rarely reported. We report a patient with two synchronous BCC of the periungual tissue localized in the IV and V fingernail, effectively treated with Mohs micrographic surgery. PMID:22849570

Dika, Emi; Patrizi, Annalisa; Fanti, Pier Alessandro; Alessandrini, Aurora; Sorci, Rita; Piraccini, Bianca Maria; Vaccari, Sabina; Misciali, Cosimo; Maibach, Howard I

2013-06-01

216

When all you have is a dermatoscope— start looking at the nails  

PubMed Central

Pigmented and non-pigmented nail alterations are a frequent challenge for dermatologists. A profound knowledge of clinical and dermatoscopic features of nail disorders is crucial because a range of differential diagnoses and even potentially life-threatening diseases are possible underlying causes. Nail matrix melanocytes of unaffected individuals are in a dormant state, and, therefore, fingernails and toenails physiologically are non-pigmented. The formation of continuous, longitudinal pigmented streaks (longitudinal melanonychia) may either be caused by a benign activation of matrix melanocytes (e.g., as a result of trauma, inflammation, or adverse drug reactions) or by a true melanocytic proliferation (e.g., in a nevus or melanoma). In general, non-continuous nail alterations, affecting only limited parts of the nail apparatus, are most frequently of non-melanocytic origin. Important and common differential diagnoses in these cases are subungual hemorrhage or onychomycosis. In addition, foreign bodies, bacterial infections, traumatic injuries, or artificial discolorations of the nail unit may less frequently cause non-continuous nail alterations. Many systemic diseases that may also show involvement of the nails (e.g., psoriasis, atopic dermatitis, lichen planus, alopecia areata) tend to induce alterations in numerous if not all nails of the hands and feet. A similar extensive and generalized alteration of nails has been reported after treatment with a number of systemic drugs, especially antibiotics and cytostatics. Benign or malignant neoplasms that may also affect the nail unit include glomus tumor, Bowen’s disease, squamous cell carcinoma, and rare collision tumors. This review aims to assist clinicians in correctly evaluating and diagnosing nail disorders with the help of dermatoscopy. PMID:25396079

Haenssle, Holger A.; Blum, Andreas; Hofmann-Wellenhof, Rainer; Kreusch, Juergen; Stolz, Wilhelm; Argenziano, Giuseppe; Zalaudek, Iris; Brehmer, Franziska

2014-01-01

217

A case of ingrown toenail accompanied by extreme soft tissue hypertrophy to the extent of invisible nail.  

PubMed

Ingrown nails occur when the nail fold grows inwards into the nail bed. This condition affects daily life and causes a loss of labor, and therefore, should be meticulously tackled and immediately treated. Ingrown nail is categorized in three stages based on pain, erythema, infection, drainage, and the presence of granulation tissue. We present hypertrophic tissue excision and bilateral partial matrix excision in an unclassified case of ingrown toenail in which the bilateral side wall hypertrophy covered the entire nail; normal tissue of the nail was invisible, along with first year follow-up results. PMID:23268828

Seyfettino?lu, F?rat; Sünneli, Özgür; Dülgero?lu, Ali; Bora, Osman Arslan

2012-01-01

218

Radiation exposure to the surgeon during closed interlocking intramedullary nailing  

SciTech Connect

During interlocking intramedullary nailing of twenty-five femoral and five tibial fractures, the primary surgeon wore both a universal film badge on the collar of the lead apron and a thermoluminescent dosimeter ring on the dominant hand to quantify the radiation that he or she received. When distal interlocking was performed, the first ring was removed and a second ring was used so that a separate recording could be made for this portion of the procedure. At the conclusion of the study, all of the recorded doses of radiation were averaged. The average amount of radiation to the head and neck during the entire procedure was 7.0 millirems of deep exposure and 8.0 millirems of shallow exposure. The average dose of radiation to the dominant hand during insertion of the intramedullary nail and the proximal interlocking screw was 13.0 millirems, while the average amount during insertion of the distal interlocking nail was 12.0 millirems. Both of these averages are well within the government guidelines for allowable exposure to radiation during one-quarter (three months) of a year. Precautions that are to be observed during this procedure are recommended.

Levin, P.E.; Schoen, R.W. Jr.; Browner, B.D.

1987-06-01

219

Tolerance of natural baby skin-care products on healthy, full-term infants and toddlers  

PubMed Central

Purpose To evaluate the tolerance of baby skin-care products with at least 95% naturally derived ingredients on infants and toddlers. Materials and methods Healthy, full-term infants and toddlers aged 1–36 months were enrolled. In study 1, a lightly fragranced natural baby hair and body wash (n=30), a lightly fragranced natural baby shampoo (n=30), or a lightly fragranced natural baby lotion (n=32) were assessed over 2 weeks. In study 2, a lightly fragranced natural baby hair and body wash and a lightly fragranced natural baby lotion (n=33) were assessed as a regimen over 4 weeks. The wash and shampoo were used three or more times per week, but not more than once daily. Lotions were applied in the morning or after a bath. Clinicians assessed the arms, legs, torso, or scalp for erythema, dryness, peeling/flakiness (study 1 only), tactile roughness, edema (study 1 only), rash/irritation (study 2 only), and overall skin condition (study 2 only) at baseline, week 1, and weeks 2 or 4. Parents completed skin assessment questionnaires. In study 2, stratum corneum hydration was measured. Subjects were monitored for adverse events. Results No significant changes in clinical grading scores were observed, indicating that all products were well tolerated. By the end of each study, >90% of parents/caregivers believed each product was mild and gentle. In study 2, improvement in stratum corneum hydration was observed (+37% at week 1 and +48% at week 4, P<0.05 for both). In study 1, one baby experienced mild erythema on the neck and scalp after using the shampoo (possibly related to treatment). In study 2, there were no product-related adverse events. Conclusion The natural baby skin-care products were well tolerated by infants and toddlers when used alone or as part of a skin-care regimen. PMID:24523593

Coret, Catherine D; Suero, Michael B; Tierney, Neena K

2014-01-01

220

Effects of Organic Solvents on the Barrier Properties of Human Nail  

PubMed Central

The effects of organic solvent systems on nail hydration and permeability have not been well studied. The objectives of the present study were to investigate the effects of binary aqueous organic solvent systems of ethanol (EtOH), propylene glycol (PPG), and polyethylene glycol 400 (PEG) on the barrier properties of nail plates. 3H–water, 14C–urea, and 14C–tetraethylammonium ions were the probes in the nail uptake and transport experiments to study the effect(s) of organic solvents on nail hydration and permeability. Gravimetric studies were also performed as a secondary method to study nail hydration and the reversibility of the nail after organic solvent treatments. Both ungual uptake and transport were directly related to the concentration of the organic solvent in the binary systems. Partitioning of the probes into and transport across the nail decreased with an increase in the organic solvent concentration. These changes corresponded to the changes in solution viscosity and the barrier properties of the nail. In general, the effects for PPG and PEG were more pronounced than those for EtOH. Practically, these results suggest that organic solvents in formulations can increase nail barrier resistivity. PMID:21607952

Smith, Kelly A.; Hao, Jinsong; Li, S. Kevin

2012-01-01

221

PHARMACEUTICALS AND PERSONAL CARE PRODUCTS IN THE ENVIRONMENT: AN OVERVIEW - POLLUTION FROM PERSONAL ACTIONS, ACTIVITIES, AND BEHAVIORS  

EPA Science Inventory

Perhaps more so than with any other class of pollutants, the occurrence of pharmaceuticals and personal care products (PPCPS) in the environment highlights the immediate, intimate, and inseparable connection between the individual activities of consumers and their environment. I...

222

PHARMACEUTICALS AND PERSONAL CARE PRODUCTS IN THE ENVIRONMENT: AN OVERVIEW - POLLUTION FROM PERSONAL ACTIONS, ACTIVITIES, AND BEHAVIORS  

EPA Science Inventory

Perhaps more so than with any other class of pollutants, the occurrence of pharmaceuticals and personal care products (PPCPS) in the environment highlights the immediate, intimate, and inseparable connection between the personal activities of individual citizens and their...

223

PHARMACEUTICALS AND PERSONAL CARE PRODUCTS IN THE ENVIRONMENT: AN OVERVIEW - POLLUTION FROM PERSONAL ACTIONS, ACTIVITES, AND BEHAVIORS  

EPA Science Inventory

Perhaps more so than with any other class of pollutants, the occurrence of pharmaceuticals and personal care products (PPCPs) in the environment highlights the immediate, intimate, and inseparable connection between the personal activities of individual citizens and their environ...

224

Baby care product development: artificial urine in vitro assay is useful for cosmetic product assessment.  

PubMed

As a result of infants' inability to control urination, the skin of the diaper area has special needs for protection from irritating effects of urine and prevention of diaper dermatitis such as products for cleansing and protection of the skin. Several in vitro models are currently available to assess tolerance. In vitro testing using artificial urine allows the protective effects of diaper-region cosmetics to be ascertained. Thus, a new model defined as "artificial urine in vitro assay" has been added to our traditional pre-clinical in vitro testing program. IL1-? is a highly active and pleiotropic pro-inflammatory cytokine. It plays a key role in inflammation and is the biological mirror of irritation induced by diaper dermatitis. This study determines, on human skin explants, if a cosmetic formula is (1) tolerated equally as well in the presence of artificial urine as in its absence and (2) is able to decrease IL1-? production induced by artificial urine or Sodium Dodecyl Sulfate. 31 tests including 17 in-house formulas, 10 bench-markers and 4 combinations of products were performed and data obtained are represented on a simple four-point scale (from practically non protective to very protective). It allows determination of formula-type groups that will have predictable protective properties in subsequent clinical trials and comparison with competitors' products. It is a useful aid in the formulation stage and provides readily-useable data for the cosmetic risk assessment. PMID:23850986

Degouy, Arnaud; Gomez-Berrada, Marie-Pierre; Ferret, Pierre-Jacques

2014-02-01

225

Penetration of (14C)-Efinaconazole Topical Solution, 10%, Does Not Appear to be Influenced by Nail Polish  

PubMed Central

Onychomycosis is a common nail disorder with significant medical impacts and aesthetic consequences. Patients seek treatment for several reasons, including the unsightliness of the nail(s). Even with successful management, it takes months for the diseased nail to appear cosmetically normal. Patients commonly apply nail polish to mask the appearance of the dystrophic nail, though it is contraindicated with the currently available topical lacquers for onychomycosis. The authors’ nonclinical study using a cadaver nail model showed that penetration of efinaconazole topical solution, 10%, a new antifungal being developed for the treatment of mild-to-moderate toenail onychomycosis, was not influenced by application of nail polish. Polishes showed an increase in surface tackiness with repeated efinaconazole topical solution, 10% application. The medical and aesthetic significance of the authors’ findings have yet to be assessed clinically. PMID:25276275

Gold, Linda Stein; Korotzer, Andrew

2014-01-01

226

Ocular irritation reversibility assessment for personal care products using a porcine corneal culture assay.  

PubMed

Personal care product manufacturers have used a broad spectrum of alternative ocular irritation assays during the past two decades because these tests do not require the use of live animals, they provide reliable predictive data, and they are relatively inexpensive to conduct. To complement these assays, the ex vivo Porcine Corneal Opacity Reversibility Assay (PorCORA) was recently developed using a corneal culture model to predict reversibility of ocular irritants. Three commercially available consumer products (a shampoo, a hair color glaze, and a hair colorant system containing 12% hydrogen peroxide) were each tested in two PorCORA study replicates in order to assess potential ocular damage reversibility for surfactant-, propylene carbonate-, and peroxide-based formulations, respectively. Under the exaggerated, in vitro study conditions, the surfactant-based shampoo may cause irreversible porcine corneal damage (histological changes in the epithelial squamous cell and/or basal cell layers), whereas the hair color glaze and 12% hydrogen peroxide product caused fully reversible ocular irritation (microscopic changes only in the superficial squamous cell layer). The hair color glaze and peroxide product results correlate with established in vivo data for similar compounds, but the shampoo results contradicted previous BCOP results (expected to be only a mild irritant). Therefore, although the PorCORA protocol shows promise in predicting the extent and reversibility of potential ocular damage caused by accidental consumer eye exposure to personal care products, the contradictory results for the surfactant-based shampoo indicate that more extensive validation testing of the PorCORA is necessary to definitively establish the protocol's reliability as a Draize test replacement. PMID:21172418

Donahue, Douglas A; Avalos, Javier; Kaufman, Lewis E; Simion, F Anthony; Cerven, Daniel R

2011-04-01

227

[Management of onychocryptosis in primary care: A clinical case].  

PubMed

Onychocryptosis (ingrown toenail) is a condition commonly seen in Primary Care clinics. It is uncomfortable and restrictive for patients and has a high incidence in males between second and third decades of life. It is of unknown origin, with a number of predisposing triggering factors being involved. Treatment depends on the stage of the ingrown nail and the procedures may range from conservative to minor surgery that can be performed by the Primary Care physician in the health centre. We report the case of a 25-year onychocryptosis that did not respond to conservative management, and was extracted with partial matricectomy of the nail. PMID:24034767

Zavala Aguilar, K; Gutiérrez Pineda, F; Bozalongo de Aragón, E

2013-09-01

228

Contraceptive pill-induced porphyria cutanea tarda presenting with onycholysis of the finger nails  

Microsoft Academic Search

A case of porphyria cutanea tarda induced by oral contraceptive pill therapy is reported, and its unusual presenting sign of onycholysis of the finger nails is noted. Reference is made to the rarity of nail changes in porphyria and the regression of the onycholysis in the patient following therapy is outlined.

J. P. Byrne; J. M. Boss; R. P. Dawber

1976-01-01

229

Fatigue behavior of Ilizarov frame versus tibial interlocking nail in a comminuted tibial fracture model: a biomechanical study  

Microsoft Academic Search

BACKGROUND: Treatment options for comminuted tibial shaft fractures include plating, intramedullary nailing, and external fixation. No biomechanical comparison between an interlocking tibia nail with external fixation by an Ilizarov frame has been reported to date. In the present study, we compared the fatigue behaviour of Ilizarov frames to interlocking intramedullary nails in a comminuted tibial fracture model under a combined

Erik Hasenboehler; Wade R Smith; Laurence Laudicina; Giby C Philips; Philip F Stahel; Steven J Morgan

2006-01-01

230

Impact of expanded-duty assistants on cost and productivity in dental care delivery.  

PubMed Central

Data from an experimental dental program are used to develop a linear programming model of dental care delivery that the authors use to examine the economic implications of introducing expanded-duty dental assistants (EDDA's) in three types of dental practices. The authors examine the changes in productivity and profitability that result from hiring one or more EDDAs and conclude that a dentist in solo practice can more than double his net revenue by hiring one EDDA but will not increase his productivity further by hiring additional EDDAs. Two- and three-dentist groups also can increase revenue by hiring EDDAs, but, beyond a certain point, an inverse relationship exists between the number of auxiliaries hired and net revenue generated. PMID:812848

Lipscomb, J; Scheffler, R M

1975-01-01

231

Caryocar brasiliense supercritical CO2 extract possesses antimicrobial and antioxidant properties useful for personal care products  

PubMed Central

Background The cosmetic and pharmaceutical industries have an increasing interest in replacing synthetic antimicrobials in dermatological products due to increased microbial resistance to conventional antimicrobial agents. Pequi (Caryocar brasiliense) is a native fruit tree of the Brazilian Cerrado, specifically used in cosmetics, in the food industry, and for medicinal purposes. Leishmanicidal and antifungal activities have been reported previously. This study was designed to evaluate the antimicrobial and antioxidant activities of a C. brasiliense extract obtained by supercritical CO2 extraction. Methods The minimum inhibitory concentrations (MICs) against Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus were determined by the classical microdilution method. Antiseptic activity against these organisms was evaluated by the plate diffusion method. The antioxidant potential of the extract was evaluated using a method based on the oxidation of 2,2?-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS). The extract’s chemical profile was analyzed for the presence of alkaloids, saponins, anthraquinones, steroids, tannins, flavonoids, and phenolic compounds according to standard colorimetric methods. Results The C. brasiliense supercritical CO2 extract exhibits antimicrobial activity against all bacteria tested. It also possesses antioxidant activity, when compared to a vitamin E standard. Conclusions The C. brasiliense supercritical CO2 extract may be useful for the development of personal care products, primarily for antiseptic skin products that inactivate, reduce, prevent, or arrest the growth of microorganisms with the inherent intent to mitigate or prevent disease as well as products that minimize damage caused by free radicals. PMID:24565304

2014-01-01

232

Linkage analysis of the Nail-patella syndrome  

SciTech Connect

Nail-patella syndrome (NPS) is an autosomal dominant disorder characterized by dysplasia of nails and patella, decreased mobility of the elbow, iliac horns, and, in some cases, nephropathy. The disorder has been mapped to the long arm of chromosome 9, but the precise localization and identity of the NPS gene are unknown. Linkage analysis in three NPS families, using highly informative dinucleotide repeat polymorphisms on 9q33-q34, confirmed linkage of NPS to this chromosome. Recombinations were detected, by two-point linkage analysis, between NPS and the centromeric markers D9S60 and the gelsolin gene and the telomeric markers D9S64 and D9S66, in one of the families. Haplotype analysis suggested an additional recombination between NPS and the argininosuccinate synthetase (ASS) gene. These results localize the NPS gene to an interval on 9q34.1, distal to D9S60 an proximal to ASS, comprising a genetic distance of {approximately}9 cM. This represents a significant refinement in the localization of the NPS gene. 25 refs., 2 figs., 1 tab.

Campeau, E.; Watkins, D.; Rouleau, G.A. [Montreal General Hospital, Quebec (Canada); Babul, R.; Der Kaloustian, V.M. [McGill Univ., Montreal (Canada); Buchanan, J.A.; Meschino, W. [North York General Hospital (Canada)

1995-01-01

233

An evaluation of flexible intramedullary nail fixation in femoral shaft fractures in paediatric age group.  

PubMed

Sixty-two femoral shaft fractures in 60 patients treated by elastic intramedullary nailing with mean age of the patients being 9.2 years (range 5 years to 12 years) and average follow-up of 15 months (range 7 months to 60 months) are evaluated. Twenty-eight fractures were fixed with titanium elastic nail while 34 fractures were fixed with Enders nail. There were 40 midshaft fractures, 18 proximal femoral and 4 were fractures of distal third. Fracture patterns were transverse in 35, short oblique in 14 cases and 13 were spiral fractures. Mean age of union in this series was 17 weeks (range 12 weeks to 28 weeks). Ten cases had complications, 5 had nail tip irritation, 3 varus or valgus malalignment and 2 had delayed union. In this series, we did not have any non-union, refracture, limb length discrepancy or any major infection. The result demonstrates 100% union rate irrespective of the age, weight and height of the patient. Regardless of the site of fracture and their pattern, it united every time with elastic nail fixation. We did not find and mismatch in the results of fractures stabilised with titanium elastic nail with that of elastic stainless steel nail. PMID:22315772

Kumar, Sanjay; Roy, Sandip Kumar; Jha, Amrish Kumar; Chatterjee, Debdutta; Banerjee, Debabrata; Garg, Anant Kumar

2011-06-01

234

Nail changes in connective tissue diseases: a study of 39 cases.  

PubMed

The objective is to identify nail unit changes associated with connective tissue diseases (CTD) and evaluate their frequency. We carried a prospective study between March 2012 and March2013 in our department. All patients with CTD were included. A clinical examination of the fingernails was done by the same dermatologist. Nail features were noted and classified and photos taken. Thirty nine patients were enrolled including: 16 systemic sclerosis, 14 lupus erythematosus (SLE), 8 dermatomyositis (DM), 1 primary Sjorgen's syndrome. The mean age was 40 years old. The mean duration of the disease was 6 years. Nail unit changes were present in 27 patients (69%). The abnormalities observed were Longitidunal ridging in 11 patients, Peri ungueal erythema in 10 patients, Peri-ungual telangiectasia in 11 patients, Ragged cuticle in 10 patients fingertips scars in 9 patients, Increase of longitudinal curvature and beaking of the nail in 4 patients, Increase in transverse curvature in 4 patients, dyschromia of the proximal nail fold in 3 patients, Subungual hyperkeratosis in 3 patients, onycholysis in 2 patients, splinter haemorrhages in 3 patients, nail plate pigmentation in 2 patients, pseudoclubbing in 1 patient, macrolunula in 1 patients, Red lunulae in one patient, bluish-black discoloration of the nail plate in one patient. The proximal nailfold was found to be most sites affected. PMID:25419288

Elmansour, Imane; Chiheb, Soumia; Benchikhi, Hakima

2014-01-01

235

Nail alterations as a surrogate marker for the efficacy of low-dose metronomic chemotherapy.  

PubMed

Docetaxel is a well-known causative agent of nail alterations. The aim of this study was to reveal the impact of nail alterations associated with low-dose metronomic (LDM) docetaxel chemotherapy on the survival of non-small cell lung cancer (NSCLC) patients. Clinical information, survival data and nail alterations in patients treated with LDM docetaxel chemotherapy (docetaxel 15 mg/m(2) per week) were retrospectively reviewed. Forty-nine patients were included in this study. Various nail alterations were observed in 17 of the 49 patients (34.7%). Onycholysis and subungual hyperkeratosis were observed in 22.4% and 10.2% of patients, respectively. The number of docetaxel administration cycles was correlated with the incidence and severity of nail alterations. Univariate and multivariate analysis clearly demonstrated that the occurrence of nail alterations was an independent favorable prognostic factor for overall survival. Nail alterations associated with treatment may act as a surrogate marker for the efficacy of low-dose metronomic docetaxel chemotherapy. PMID:23599750

Kibata, Kayoko; Tamaki, Takeshi; Inagaki, Noriko; Ogata, Makoto; Shimizu, Toshiki; Nomura, Shosaku

2013-04-01

236

Nail alterations as a surrogate marker for the efficacy of low-dose metronomic chemotherapy  

PubMed Central

Docetaxel is a well-known causative agent of nail alterations. The aim of this study was to reveal the impact of nail alterations associated with low-dose metronomic (LDM) docetaxel chemotherapy on the survival of non-small cell lung cancer (NSCLC) patients. Clinical information, survival data and nail alterations in patients treated with LDM docetaxel chemotherapy (docetaxel 15 mg/m2 per week) were retrospectively reviewed. Forty-nine patients were included in this study. Various nail alterations were observed in 17 of the 49 patients (34.7%). Onycholysis and subungual hyperkeratosis were observed in 22.4% and 10.2% of patients, respectively. The number of docetaxel administration cycles was correlated with the incidence and severity of nail alterations. Univariate and multivariate analysis clearly demonstrated that the occurrence of nail alterations was an independent favorable prognostic factor for overall survival. Nail alterations associated with treatment may act as a surrogate marker for the efficacy of low-dose metronomic docetaxel chemotherapy. PMID:23599750

KIBATA, KAYOKO; TAMAKI, TAKESHI; INAGAKI, NORIKO; OGATA, MAKOTO; SHIMIZU, TOSHIKI; NOMURA, SHOSAKU

2013-01-01

237

Nail changes in connective tissue diseases: a study of 39 cases  

PubMed Central

The objective is to identify nail unit changes associated with connective tissue diseases (CTD) and evaluate their frequency. We carried a prospective study between March 2012 and March2013 in our department. All patients with CTD were included. A clinical examination of the fingernails was done by the same dermatologist. Nail features were noted and classified and photos taken. Thirty nine patients were enrolled including: 16 systemic sclerosis, 14 lupus erythematosus (SLE), 8 dermatomyositis (DM), 1 primary Sjorgen's syndrome. The mean age was 40 years old. The mean duration of the disease was 6 years. Nail unit changes were present in 27 patients (69%). The abnormalities observed were Longitidunal ridging in 11 patients, Peri ungueal erythema in 10 patients, Peri-ungual telangiectasia in 11 patients, Ragged cuticle in 10 patients fingertips scars in 9 patients, Increase of longitudinal curvature and beaking of the nail in 4 patients, Increase in transverse curvature in 4 patients, dyschromia of the proximal nail fold in 3 patients, Subungual hyperkeratosis in 3 patients, onycholysis in 2 patients, splinter haemorrhages in 3 patients, nail plate pigmentation in 2 patients, pseudoclubbing in 1 patient, macrolunula in 1 patients, Red lunulae in one patient, bluish- black discoloration of the nail plate in one patient. The proximal nailfold was found to be most sites affected. PMID:25419288

Elmansour, Imane; Chiheb, Soumia; Benchikhi, Hakima

2014-01-01

238

Hydration of nail plate: a novel screening model for transungual drug permeation enhancers.  

PubMed

Drug delivery by topical route for the treatment of onychomycosis, a nail fungal infection, is challenging due to the unique barrier properties of the nail plate which imparts high resistance to the passage of antifungal drugs. Permeation enhancers are used in transungual formulations to improve the drug flux across the nail plate. Selection of the effective permeation enhancer among the available large pool of permeation enhancers is a difficult task. Screening the large number of permeation enhancers using conventional Franz diffusion cells is laborious and expensive. The objective of present study was to evolve a simple, accurate and rapid method for screening of transungual drug permeation enhancers based on the principle of hydration of nail plate. The permeation enhancer which affects the structural or physicochemical properties of nail plate would also affect their hydration capacity. Two screening procedures namely primary and secondary screenings were evolved wherein hydration and uptake of ciclopirox olamine by nail plates were measured. Hydration enhancement factor, HEF(24) and drug uptake enhancement factor, UEF(24) were determined for screening of 23 typical permeation enhancers. The Pearson's correlation coefficient between HEF(24) and UEF(24) was determined. A good agreement between the HEF(24) and UEF(24) data proved the validity of the proposed nail plate hydration model as a screening technique for permeation enhancers. PMID:22705091

Chouhan, P; Saini, T R

2012-10-15

239

Anaerobic-aerobic sequencing bioreactors improve energy efficiency for treatment of personal care product industry wastes.  

PubMed

Personal care product (PCP) industry liquid wastes contain shampoo residues, which are usually treated by aerobic activated sludge (AS). Unfortunately, AS is expensive for PCP wastes because of high aeration and energy demands, whereas potentially energy-positive anaerobic designs cannot meet effluent targets. Therefore, combined anaerobic-aerobic systems may be the best solution. Seven treatment systems were assessed in terms of energy and treatment performance for shampoo wastes, including one aerobic, three anaerobic (HUASB, AHR and AnCSTR) and three anaerobic-aerobic reactor designs. COD removals were highest in the HUASB-aerobic (87.9 ± 0.4%) and AHR-aerobic (86.8±0.5%) systems, which used 69.2% and 62.5% less energy than aerobic AS. However, actual methane production rates were low relative to theoretical in the UASB and AHR units (?10% methane/COD removed) compared with the AnCSTR unit (?70%). Anaerobic-aerobic sequence reactors show promise for treating shampoo wastes, but optimal designs depend upon whether methane production or COD removal is most important to operations. PMID:23639409

Ahammad, S Z; Bereslawski, J L; Dolfing, J; Mota, C; Graham, D W

2013-07-01

240

Microbial decontamination of cosmetic raw materials and personal care products by irradiation  

NASA Astrophysics Data System (ADS)

Typical levels of sporadically occurring (dynamic) microbial contamination of cosmetic raw materials: pigments, abrasives and liposomes, as well as of final products for personal care: toothpaste, crayons, shampoos, cleansers and creams, were evaluated. In most cases the contamination was dominated by a single population of microorganisms, either Gram-negative bacteria or molds. The feasibility of microbial decontamination by irradiation was studied by determining the resistance to gamma radiation of contaminating microflora in situ. It was expressed as a dose required for the first 90% reduction, D first 90% red . The values in the range 1-2 kGy for molds and 0.1-0.6 kGy for Gram-negative bacteria were obtained. This relatively high susceptibility to irradiation allowed inactivation factors close to 6 to be achieved with doses generally not exceeding 3 kGy, and yielding endpoint contamination less than 10/g.

Katušin-Ražem, Branka; Mihaljevi?, Branka; Ražem, Dušan

2003-03-01

241

Nail gun injuries in residential carpentry: lessons from active injury surveillance  

PubMed Central

Objective: To describe circumstances surrounding injuries involving nail guns among carpenters, calculate injury rates, identify high risk groups and preventive measures. Methods and setting: Active injury surveillance was used to identify causes of injury among a large cohort of union residential and drywall carpenters. Injured carpenters were interviewed by experienced journeymen; enumeration of workers and hourworked were provided by the union. The combined data allowed definition of a cohort of carpenters, their hours worked, detailed information on the circumstances surrounding injuries, and identification of preventive measures from the perspectives of the injured worker and an experienced investigator. Results: Nail guns were involved in 14% of injuries investigated. Ninety percent of these injuries were the result of the carpenter being struck, most commonly by a nail puncturing a hand or fingers. The injury rate among apprentices was 3.7 per 200 000 hours worked (95% confidence interval (CI) 2.7 to 4.9) compared with a rate of 1.2 among journeymen (95% CI 0.80 to 1.7). While not always the sole contributing factor, a sequential trigger would have likely prevented 65% of the injuries from tools with contact trip triggers. Conclusions: Training, engineering, and policy changes in the workplace and manufacturing arena are all appropriate targets for prevention of these injuries. Use of sequential triggers would likely decrease acute injury rates markedly. Over 70% of injuries among residential carpenters were associated with through nailing tasks (such as nailing studs or blocks, trusses or joists) or toe nailing (angled, corner nailing) as opposed to flat nailing used for sheathing activities; this provides some indication that contact trip tools could be used solely for flat nailing. PMID:12642553

Lipscomb, H; Dement, J; Nolan, J; Patterson, D; Li, L

2003-01-01

242

[Detection of bone marrow embolism in femoral intramedullary nailing using transesophageal echocardiography].  

PubMed

Cardiopulmonary complications are known in intramedullary nailing, especially of the femur. Transesophageal echocardiography now allow intraoperative detection of embolized bone-marrow, recognizable as reflecting particles in the right atrium. In intramedullary nailing of a femoral fracture with a closed distal fragment bone-marrow embolism was detectable in the right atrium during reaming of the medullary canal. This technique should permit further research on the pathophysiology of pulmonary alterations during intramedullary nailing and also testing the effectiveness of pressure-relief in the medullary canal as proposed by drilling a bone-hole. PMID:2734960

Wenda, K; Henrichs, K J; Biegler, M; Erbel, R

1989-04-01

243

Characteristics of patients with yellow nail syndrome and pleural effusion.  

PubMed

Yellow nail syndrome (YNS) can be associated with a pleural effusion (PE) but the characteristics of these patients are not well defined. We performed a systematic review across four electronic databases for studies reporting clinical findings, PE characteristics, and most effective treatment of YNS. Case descriptions and retrospective studies were included, unrestricted by year of publication. We reviewed 112 studies (150 patients), spanning a period of nearly 50 years. The male/female ratio was 1.2/1. The median age was 60 years (range: 0-88). Seventy-eight percent were between 41-80 years old. All cases had lymphoedema and 85.6% had yellow nails. PEs were bilateral in 68.3%. The appearance of the fluid was serous in 75.3%, milky in 22.3% and purulent in 3.5%. The PE was an exudate in 94.7% with lymphocytic predominance in 96% with a low count of nucleated cells. In 61 of 66 (92.4%) of patients, pleural fluid protein values were >3?g/dL, and typically higher than pleural fluid LDH. Pleurodesis and decortication/pleurectomy were effective in 81.8% and 88.9% of cases, respectively, in the treatment of symptomatic PEs. The development of YNS and PE occurs between the fifth to eighth decade of life and is associated with lymphoedema. The PE is usually bilateral and behaves as a lymphocyte-predominant exudate. The most effective treatments appear to be pleurodesis and decortication/pleurectomy. PMID:25123563

Valdés, Luis; Huggins, John T; Gude, Francisco; Ferreiro, Lucía; Alvarez-Dobaño, José M; Golpe, Antonio; Toubes, María E; González-Barcala, Francisco J; José, Esther San; Sahn, Steven A

2014-10-01

244

The biological fate of silver ions following the use of silver-containing wound care products - a review.  

PubMed

Ionic silver has a long history as an antimicrobial in human health care. This article is a review of the published literature on how ionic silver may enter the body from exposure to silver-containing wound care products and its eventual metabolic fates, in an assessment of the safety during normal use of these products in wound care. Following the application to breached skin, there appears to be little evidence of localised or systemic toxicity, and this is borne out by the continuous use of silver sulfadiazine formulations for more than 50 years. Consequently, following normal use, the risk of silver ion toxicity locally and systemically is considered to be low or negligible. PMID:23173975

Walker, Michael; Parsons, David

2014-10-01

245

Study of the transformation of two salicylates used in personal care products in chlorinated water.  

PubMed

Disinfection of swimming pool water is essential to inactivate pathogenic microorganisms. However chlorine based disinfectants, the most commonly used, are known to lead to the formation of disinfection by-products (DBPs), some of which have been associated with adverse health effects. Precursors of DBPs include the organic matter present in the water used to fill the swimming pool, human body fluids and personal care products (PCPs) used by swimmers and bathers. The increased use, in the last years, of PCPs lead to an increased concern about the fate of PCPs in swimming pool waters and potential health risks of formed DBPs. In this study, the chemical transformations of two salicylates, benzyl salicylate (BzS) and phenyl salicylate (PS), incorporated in several PCPs, in chlorinated water were investigated. High-performance liquid chromatography (HPLC) with UV-diode-array detection (HPLC-UV-DAD) was used to follow the reaction kinetics and HPLC with mass spectrometry (HPLC-MS) was used to tentatively identify the major transformation by-products. Under the experimental conditions used in this work both salicylates reacted with chlorine following pseudo-first order kinetics: rate constant k = (0.0038 ± 0.0002) min(-1) and half-life t1/2 = (182 ± 10) min for BzS and rate constant k = (0.0088 ± 0.0005) min(-1) and half-life t1/2 = (79 ± 4) min for PS (mean ± standard deviation). The reactions of the two salicylates in chlorinated water led to the formation of DBPs that were tentatively identified as mono- and dichloro- substituted compounds. Most probably they result from an electrophilic substitution of one or two hydrogen atoms in the phenolic ring of both salicylates by one or two chlorine atoms. PMID:25086797

de Oliveira e Sá, Mariana M; Miranda, Margarida S; da Silva, Joaquim C G Esteves

2014-11-15

246

Anatomic structures at risk: curved hindfoot arthrodesis nail--a cadaveric approach.  

PubMed

Retrograde intramedullary nailing of the hindfoot and ankle is an established procedure for salvage of severe foot and ankle deformity, arthritis, tumor, and instability. In the present study, retrograde hindfoot (tibiotalocalcaneal) arthrodesis nailing was performed using a standardized technique on 7 cadaver specimens by trained senior surgeons. The specimens were then dissected to determine the distance of the subcalcaneal structures at risk from the insertion point of the nail. The findings showed that the distance of the lateral neurovascular bundle from the edge of the nail was 6.5 (range 3.5 to 8, 95% confidence interval 5.9 to 7.1) mm. No neurovascular bundle was compromised, and all were within a previously described "safe window." PMID:25176005

Knight, Timothy; Rosenfeld, Peter; Jones, Ioan Tudur; Clark, Callum; Savva, Nick

2014-01-01

247

[Nail-patella syndrome associated with monoclonal gammopathy. Review regarding a case].  

PubMed

A 54 years old female with significant impairment of renal function is presented. On physical examination, the presence of dystrophic nails, elbow dysplasia and prominent iliac horns. Familial study showed similar nail and bone deformities in 3 of six sons. The nail patella syndrome diagnosis was based on these findings. This is a rare autosomal dominant hereditary disease, probably related to congenital alterations in collagen metabolism. Clinical characteristics include bone abnormalities that principally involve knees and elbows, nail alterations and the presence of iliac horns, that are considered pathognomonic of the syndrome. Renal involvement is observed in 30 to 55% of cases. This patient had also an IgA-lambda paraprotein, whose relationship to the above mentioned syndrome is uncertain, since no evidences of malignant plasma cell dyscrasia were demonstrated. PMID:8235167

Panace, R; Mocarquer, A; Anguita, T; Cortés, H

1993-01-01

248

The new production theory for health care through clinical reengineering: a study of clinical guidelines--Part I.  

PubMed

Drucker writes that the emerging theory of manufacturing includes four principles and practices: statistical quality control, manufacturing accounting, modular organization, and systems approach. SQC is a rigorous, scientific method of identifying variation in the quality and productivity of a given production process, with an emphasis on improvement. The new manufacturing economics intends to integrate the production strategy with the business strategy in order to account for the biggest portions of costs that the old methods did not assess: time and automation. Production operations that are both standardized and flexible will allow the organization to keep up with changes in design, technology, and the market. The return on innovation in this environment is predicated on a modular arrangement of flexible steps in the process. Finally, the systems approach sees the entire process as being integrated in converting goods or services into economic satisfaction. There is now a major restructuring of the U.S. health care industry, and the incorporation of these four theories into health care reform would appear to be essential. This two-part article will address two problems: Will Drucker's theories relate to health care (Part I)? Will the "new manufacturing" in health care (practice guidelines) demonstrate cost, quality, and access changes that reform demands (Part II)? PMID:10139368

Sharp, J R

1994-12-01

249

Pharmaceuticals and personal care products (PPCPs) in surface and treated waters of Louisiana, USA and Ontario, Canada  

Microsoft Academic Search

A newly developed analytical method was used to measure concentrations of nine pharmaceuticals and personal care products (PPCPs) in samples from two surface water bodies, a sewage treatment plant effluent and various stages of a drinking water treatment plant in Louisiana, USA, and from one surface water body, a drinking water treatment plant and a pilot plant in Ontario, Canada.

Glen R. Boyd; Helge Reemtsma; Deborah A. Grimm; Siddhartha Mitra

2003-01-01

250

ANALYTICAL CHEMISTRY RESEARCH NEEDS FOR MAPPING TRENDS OF PHARMACEUTICAL AND PERSONAL CARE PRODUCT POLLUTION FROM PERSONAL USE  

EPA Science Inventory

The consensus among environmental scientists and risk assessors is that the fate and effects of pharmaceutical and personal care products (PPCPS) in the environment are poorly understood. Many classes of PPCPs have yet to be investigated. Acquisition of trends data for a suite of...

251

Supply-Side Effect of Health Care Facilities on Productivity Amongst the Female Workers in the Readymade Garment Sector  

Microsoft Academic Search

This study was conducted in 4 selected garment factories within Dhaka city. The objectives of this study were to find out health care access (Supply-side effect) in the garments factory for the women workers and their relation to the productivity. A total of 300 women garment workers were included in this study. Most (60.0%) of the respondents were adolescents, unmarried

Housne Ara Begum; Homayra Fahmida

2009-01-01

252

Synovial metallosis resulting from intraarticular intramedullary nailing of a distal femoral nonunion.  

PubMed

An 80-year-old man sustained a T-shaped supracondylar fracture of the femur associated with distal one-third shaft comminution. Initial failure of a 95 degrees angle blade plate was followed by insertion of an intraarticular intramedullary nail stabilized with static locking-screw fixation. A second failure of the implant was treated by extraarticular tension band condylar buttress plate osteosynthesis. Severe knee synovial metallosis was found at the time of removal of the intraarticular nail device. PMID:8377040

Johnson, E E; Marroquin, C E; Kossovsky, N

1993-01-01

253

Docetaxel-induced palmoplantar erythrodysesthesia syndrome and long-lasting multiple nail changes  

PubMed Central

Palmoplantar erythrodysesthesia syndrome (PPES) and nail changes are common presentations of cutaneous toxicity of docetaxel chemotherapy, which deteriorate the quality of life of patients. Herein, we describe a female patient who developed PPES and multiple nail changes due to docetaxel treatment for infiltrative ductal carcinoma. Cold application and elevation of extremities during docetaxel infusion, potent topical steroids and oral pyridoxine increased the tolerance to chemotherapy and provided regression of painful cutaneous lesions without cessation of the treatment. PMID:24741199

Akoglu, Gulsen

2014-01-01

254

Docetaxel-induced nail toxicity: a case of severe onycholysis and topic review.  

PubMed

Docetaxel is a commonly-used anti-cancer chemotherapeutic agent given its efficacy in a large variety of solid tumors. It is associated with various adverse effects one of which is nail toxicity. We report a case of severe onycholysis as a result of treatment with docetaxel in a patient who suffered from metastatic nasopharyngeal carcinoma. The case report will be followed by a discussion on the possible mechanism and preventive strategies for taxane-induced nail toxicity. PMID:21933605

Lau, Chi-Pan; Hui, Pun; Chan, Tak-Cheung

2011-08-01

255

Docetaxel-induced palmoplantar erythrodysesthesia syndrome and long-lasting multiple nail changes.  

PubMed

Palmoplantar erythrodysesthesia syndrome (PPES) and nail changes are common presentations of cutaneous toxicity of docetaxel chemotherapy, which deteriorate the quality of life of patients. Herein, we describe a female patient who developed PPES and multiple nail changes due to docetaxel treatment for infiltrative ductal carcinoma. Cold application and elevation of extremities during docetaxel infusion, potent topical steroids and oral pyridoxine increased the tolerance to chemotherapy and provided regression of painful cutaneous lesions without cessation of the treatment. PMID:24741199

Akoglu, Gulsen

2014-01-01

256

Aggregate consumer exposure to UV filter ethylhexyl methoxycinnamate via personal care products.  

PubMed

Ultraviolet (UV) filters are substances designed to protect our skin from UV-induced damage and can be found in many categories of personal care products (PCPs). The potential endocrine-disrupting effects attributed to UV filter ethylhexyl methoxycinnamate (EHMC) are being debated. We evaluated the aggregate exposure of the Swiss-German population (N=1196; ages ?1-97years) to EHMC via the use of PCPs; thus we provide the first comprehensive information about the current EHMC exposure sources and aggregate exposure levels. In our probabilistic modeling method performed at an individual level, PCP use data obtained by a postal questionnaire were linked to concentration data on EHMC gained from chemical analyses of PCPs used by the questionnaire respondents. The modeled median and 99.9th percentile of the internal aggregate exposure for the general population were 0.012 and 0.873mgday(-1)kg(-1) and 0.008 and 0.122mgday(-1)kg(-1) for the summer/autumn and winter/spring period, respectively. The major contributors to internal aggregate exposure were sunscreen products in summer/autumn (females: 64%; males: 85%; children aged ?12years 93%). In winter/spring, lip care dominated for females (30%) and sunscreen for males (38%) and children aged ?12years (50%). Overall, the internal aggregate exposure estimates for the studied population are shown to be below the Derived No Effect Level (DNEL) for EHMC i.e., the level of exposure above which humans should not be exposed; however, when an intense short-term exposure via sunscreen is accounted for during a sunbathing day, at the high-end percentiles (99.9th) the predicted aggregate exposure exceeds the DNEL for thyroid-disrupting effects such as for children aged ?4years, who might be particularly susceptible to endocrine disrupting events. It is nevertheless critical to acknowledge that quantitative data on transdermal penetration of EHMC from PCPs are currently insufficient. Since long-term effects of endocrine disruptors are not known, future studies are warranted to provide accurate quantitative data on transdermal penetration of EHMC and to determine its metabolic fate in humans. PMID:25454242

Manová, Eva; von Goetz, Natalie; Hungerbuehler, Konrad

2015-01-01

257

Clinical application of a pedicle nail system with polymethylmethacrylate for osteoporotic vertebral fracture  

PubMed Central

The instrumentation of the osteoporotic spine may sometimes result in failure due to the loosening or pullout of the conventional pedicle screw. Moreover, augmentation of screws with polymethylmethacrylate (PMMA) has risks of complications. We developed a new and original pedicle nail system with PMMA for osteoporotic vertebral fractures. A clinical evaluation of this novel pedicle nail system utilized in patients with an osteoporotic vertebral collapse was performed to determine the effectiveness and safety of this technique. Thirty-four elderly patients who suffered from osteoporotic compression fractures were treated by posterolateral fusion using the pedicle nail system. The mean follow-up period was 37 months. Of the 25 patients with neurological symptoms, two patients improved two stages at the Frankel level. Fifteen patients improved one stage at the Frankel level, and eight other patients improved, however, their improvement did not exceed a Frankel level. Nine cases with neuralgia symptoms improved from 4.4 to 2.2 points on average on the Denis pain scale (p < 0.01). The fusion rate was 94% as determined by X-rays of flexion and extension, and the correction of the compression fracture site was maintained well. A pedicle nail system stabilizes the spinal column with osteoporosis and reduces the instrumentation failure. The technique for the insertion of the pedicle nail reduces complication from cement augmentation. The authors speculate that the strategy using the pedicle nail system for osteoporotic spine may be effective and safe when the surgery is performed through a posterior approach. PMID:20414689

Tanaka, Masato; Sugimoto, Yoshihisa; Takigawa, Tomoyuki; Ozaki, Toshifumi; Konishi, Hitoshi

2010-01-01

258

Field dissipation of four personal care products in biosolids-amended soils in North China.  

PubMed

The present study investigated the dissipation behaviors of 4 typical personal care products (PCPs)-triclocarban (TCC), triclosan (TCS), tonalide (AHTN), and galaxolide (HHCB)- in soils amended with biosolids under field conditions in North China. The results showed that the 4 target compounds were detected in all biosolids-amended soils at levels of a few nanograms per gram to thousands of nanograms per gram (dry wt). The residual concentrations of the 4 PCPs were found in the following order: TCC?>?TCS?>?AHTN?>?HHCB. Significant dissipation of the 4 PCPs was observed in the biosolids-amended soils, with half-lives ranging from 26 d to 133 d. Furthermore, repeated biosolids applications and a higher biosolids application rate could lead to higher accumulation of the 4 PCPs in the agricultural soils. Based on the detected concentrations in the field trial and limited ecotoxicity data, high risks to soil organisms are expected for TCC, whereas low to medium risks are expected in most cases for AHTN, HHCB, and TCS. PMID:25044513

Chen, Feng; Ying, Guang-Guo; Ma, Yi-Bing; Chen, Zhi-Feng; Lai, Hua-Jie

2014-11-01

259

Removal of pharmaceuticals and personal care products in a membrane bioreactor wastewater treatment plant.  

PubMed

Ninety-nine pharmaceuticals and personal care products (PPCPs) were analyzed in influent, final effluent, and biosolids samples from a wastewater treatment plant employing a membrane bioreactor (MBR). High concentrations in influent were found for acetaminophen, caffeine, metformin, 2-hydroxy-ibuprofen, paraxanthine, ibuprofen, and naproxen (10(4)-10(5) ng/L). Final effluents contained clarithromycin, metformin, atenolol, carbamazepine, and trimethoprim (>500 ng/L) at the highest concentrations, while triclosan, ciprofloxacin, norfloxacin, triclocarban, metformin, caffeine, ofloxacin, and paraxanthine were found at high concentrations in biosolids (>10(3) ng/g dry weight). PPCP removals varied from -34% to >99% and 23 PPCPs had ?90% removal. Of the studied PPCPs, 26 compounds have been rarely or never studied in previous membrane bioreactor (MBR) investigations. The removal pathway showed that acetaminophen, 2-hydroxy-ibuprofen, naproxen, ibuprofen, codeine, metformin, enalapril, atorvastatin, caffeine, paraxanthine, and cotinine exhibited high degradation/transformation. PPCPs showing strong sorption to solids included triclocarban, triclosan, miconazole, tetracycline, 4-epitetracycline, norfloxacin, ciprofloxacin, doxycycline, paroxetine, and ofloxacin. Trimethoprim, oxycodone, clarithromycin, thiabendazole, hydrochlorothiazide, erythromycin-H2O, carbamazepine, meprobamate, and propranolol were not removed during treatment, and clarithromycin was even formed during treatment. This investigation extended our understanding of the occurrence and fate of PPCPs in an MBR process through the analysis of the largest number of compounds in an MBR study to date. PMID:24901615

Kim, M; Guerra, P; Shah, A; Parsa, M; Alaee, M; Smyth, S A

2014-01-01

260

Assessment of cadmium, lead, and nickel levels in hair care products marketed in Turkey.  

PubMed

This study evaluated the content of cadmium (Cd), lead (Pb), and nickel (Ni) in 105 hair care products commercially available in Turkey. Cd, Pb, and Ni were detected in 40%, 21.91%, and 94.29% of the samples, respectively. Maximum Cd concentrations were detected in two shampoo samples, and the highest Pb level was found in a hair conditioner, all of them were herbal-based formulations. The highest mean levels of Ni were detected in hairstyling agents. The overall results were lower than the Canadian and German regulatory limits; however, according to the European Council Directive and Turkish Cosmetic Legislation, Cd, Pb, and Ni are listed as the substances that are prohibited in any amounts in cosmetics. Moreover, Ni content of 17.14% of the samples was above the limit of allergic contact dermatitis. It is known that these toxic metals tend to accumulate in body and prolonged use of them may potentially pose threat to human health. Thus, regular market monitoring and safer limits should be seriously considered especially for susceptible groups of the population like the pediatric group. PMID:25507466

Sipahi, Hande; Charehsaz, Mohammad; Sonmez, Ipek; Soykut, Bu?ra; Erdem, Onur; Aydin, Ahmet

2014-01-01

261

Assessment of cadmium, lead, and nickel levels in hair care products marketed in Turkey.  

PubMed

This study evaluated the content of cadmium (Cd), lead (Pb), and nickel (Ni) in 105 hair care products commercially available in Turkey. Cd, Pb, and Ni were detected in 40%, 21.91%, and 94.29% of the samples, respectively. Maximum Cd concentrations were detected in two shampoo samples, and the highest Pb level was found in a hair conditioner, all of them were herbal-based formulations. The highest mean levels of Ni were detected in hairstyling agents. The overall results were lower than the Canadian and German regulatory limits; however, according to the European Council Directive and Turkish Cosmetic Legislation, Cd, Pb, and Ni are listed as the substances that are prohibited in any amounts in cosmetics. Moreover, Ni content of 17.14% of the samples was above the limit of allergic contact dermatitis. It is known that these toxic metals tend to accumulate in body and prolonged use of them may potentially pose threat to human health. Thus, regular market monitoring and safer limits should be seriously considered especially for susceptible groups of the population like the pediatric group. PMID:25423743

Sipahi, Hande; Charehsaz, Mohammad; Sonmez, Ipek; Soykut, Bu?ra; Erdem, Onur; Aydin, Ahmet

2014-01-01

262

Pharmaceuticals and Personal Care Products in the Environment: What Are the Big Questions?  

PubMed Central

Background: Over the past 10–15 years, a substantial amount of work has been done by the scientific, regulatory, and business communities to elucidate the effects and risks of pharmaceuticals and personal care products (PPCPs) in the environment. Objective: This review was undertaken to identify key outstanding issues regarding the effects of PPCPs on human and ecological health in order to ensure that future resources will be focused on the most important areas. Data sources: To better understand and manage the risks of PPCPs in the environment, we used the “key question” approach to identify the principle issues that need to be addressed. Initially, questions were solicited from academic, government, and business communities around the world. A list of 101 questions was then discussed at an international expert workshop, and a top-20 list was developed. Following the workshop, workshop attendees ranked the 20 questions by importance. Data synthesis: The top 20 priority questions fell into seven categories: a) prioritization of substances for assessment, b) pathways of exposure, c) bioavailability and uptake, d) effects characterization, e) risk and relative risk, f?) antibiotic resistance, and g) risk management. Conclusions: A large body of information is now available on PPCPs in the environment. This exercise prioritized the most critical questions to aid in development of future research programs on the topic. PMID:22647657

Rudd, Murray A.; Brooks, Bryan W.; Caldwell, Daniel J.; Choi, Kyungho; Hickmann, Silke; Innes, Elizabeth; Ostapyk, Kim; Staveley, Jane P.; Verslycke, Tim; Ankley, Gerald T.; Beazley, Karen F.; Belanger, Scott E.; Berninger, Jason P.; Carriquiriborde, Pedro; Coors, Anja; DeLeo, Paul C.; Dyer, Scott D.; Ericson, Jon F.; Gagné, François; Giesy, John P.; Gouin, Todd; Hallstrom, Lars; Karlsson, Maja V.; Larsson, D. G. Joakim; Lazorchak, James M.; Mastrocco, Frank; McLaughlin, Alison; McMaster, Mark E.; Meyerhoff, Roger D.; Moore, Roberta; Parrott, Joanne L.; Snape, Jason R.; Murray-Smith, Richard; Servos, Mark R.; Sibley, Paul K.; Straub, Jürg Oliver; Szabo, Nora D.; Topp, Edward; Tetreault, Gerald R.; Trudeau, Vance L.; Van Der Kraak, Glen

2012-01-01

263

Treated wastewater irrigation: uptake of pharmaceutical and personal care products by common vegetables under field conditions.  

PubMed

Global water shortage is placing an unprecedented pressure on water supplies. Treated wastewater is a valuable water resource, but its reuse for agricultural irrigation faces a roadblock: the public concern over the potential accumulation of contaminants of emerging concern (CECs) into human diet. In the present study, we measured the levels of 19 commonly occurring pharmaceutical and personal care products (PPCPs) in 8 vegetables irrigated with treated wastewater under field conditions. Tertiary treated wastewater without or with a fortification of each PPCP at 250 ng/L, was used to irrigate crops until harvest. Plant samples at premature and mature stages were collected. Analysis of edible tissues showed a detection frequency of 64% and 91% in all vegetables from the treated wastewater and fortified water treatments, respectively. The edible samples from the two treatments contained the same PPCPs, including caffeine, meprobamate, primidone, DEET, carbamazepine, dilantin, naproxen, and triclosan. The total concentrations of PPCPs detected in edible tissues from the treated wastewater and fortified irrigation treatments were in the range of 0.01-3.87 and 0.15-7.3 ng/g (dry weight), respectively. Annual exposure of PPCPs from the consumption of mature vegetables irrigated with the fortified water was estimated to be only 3.69 ?g per capita. Results from the present study showed that the accumulation of PPCPs in vegetables irrigated with treated wastewater was likely limited under field conditions. PMID:25211705

Wu, Xiaoqin; Conkle, Jeremy L; Ernst, Frederick; Gan, Jay

2014-10-01

264

Analytical methods for the determination of personal care products in human samples: an overview.  

PubMed

Personal care products (PCPs) are organic chemicals widely used in everyday human life. Nowadays, preservatives, UV-filters, antimicrobials and musk fragrances are widely used PCPs. Different studies have shown that some of these compounds can cause adverse health effects, such as genotoxicity, which could even lead to mutagenic or carcinogenic effects, or estrogenicity because of their endocrine disruption activity. Due to the absence of official monitoring protocols, there is an increasing demand of analytical methods that allow the determination of those compounds in human samples in order to obtain more information regarding their behavior and fate in the human body. The complexity of the biological matrices and the low concentration levels of these compounds make necessary the use of advanced sample treatment procedures that afford both, sample clean-up, to remove potentially interfering matrix components, as well as the concentration of analytes. In the present work, a review of the more recent analytical methods published in the scientific literature for the determination of PCPs in human fluids and tissue samples, is presented. The work focused on sample preparation and the analytical techniques employed. PMID:25127618

Jiménez-Díaz, I; Zafra-Gómez, A; Ballesteros, O; Navalón, A

2014-11-01

265

Personal care product use and urinary phthalate metabolite and paraben concentrations during pregnancy among women from a fertility clinic  

PubMed Central

Parabens and phthalates are potential endocrine disruptors frequently used in personal care/beauty products, and the developing fetus may be sensitive to these chemicals. We measured urinary butyl-paraben (BP), methyl-paraben (MP), propyl-paraben (PP), mono-n-butyl phthalate (MBP), and monoethyl phthalate (MEP) concentrations up to three times in 177 pregnant women from a fertility clinic in Boston MA. Using linear mixed models, we examined the relationship between self-reported personal care product use in the previous 24 hours and urinary paraben and phthalate metabolite concentrations. Lotion, cosmetic, and cologne/perfume use were associated with the greatest increases in the molar sum of phthalate metabolite and paraben concentrations, although the magnitude of individual biomarker increases varied by product used. For example, women who used lotion had BP concentrations 111% higher (95% confidence interval [CI]:41%, 216%) than non-users, while their MBP concentrations were only 28% higher (CI:2%, 62%). Women using/cologne/perfume had MEP concentrations 167% (CI:98%, 261%) higher than non-users, but BP concentrations were similar. We observed a monotonic dose-response relationship between the total number of products used and urinary paraben and phthalate metabolite concentrations. These results suggest that questionnaire data may be useful for assessing exposure to a mixture of chemicals from personal care products during pregnancy. PMID:24149971

Braun, Joe M.; Just, Allan C.; Williams, Paige L.; Smith, Kristen W.; Calafat, Antonia M.; Hauser, Russ

2014-01-01

266

Personal care product use and urinary phthalate metabolite and paraben concentrations during pregnancy among women from a fertility clinic.  

PubMed

Parabens and phthalates are potential endocrine disruptors frequently used in personal care/beauty products, and the developing fetus may be sensitive to these chemicals. We measured urinary butyl-paraben (BP), methyl-paraben, propyl-paraben, mono-n-butyl phthalate (MBP), and monoethyl phthalate (MEP) concentrations up to three times in 177 pregnant women from a fertility clinic in Boston, MA. Using linear mixed models, we examined the relationship between self-reported personal care product use in the previous 24?h and urinary paraben and phthalate metabolite concentrations. Lotion, cosmetic, and cologne/perfume use were associated with the greatest increases in the molar sum of phthalate metabolite and paraben concentrations, although the magnitude of individual biomarker increases varied by product used. For example, women who used lotion had BP concentrations 111% higher (95% confidence interval (CI): 41%, 216%) than non-users, whereas their MBP concentrations were only 28% higher (CI: 2%, 62%). Women using cologne/perfume had MEP concentrations 167% (CI: 98%, 261%) higher than non-users, but BP concentrations were similar. We observed a monotonic dose-response relationship between the total number of products used and urinary paraben and phthalate metabolite concentrations. These results suggest that questionnaire data may be useful for assessing exposure to a mixture of chemicals from personal care products during pregnancy. PMID:24149971

Braun, Joe M; Just, Allan C; Williams, Paige L; Smith, Kristen W; Calafat, Antonia M; Hauser, Russ

2014-01-01

267

Retrograde Intramedullary Nailing with a Blocking Pin Technique for Reduction of Periprosthetic Supracondylar Femoral Fracture after Total Knee Arthroplasty: Technical Note with a Compatibility Chart of the Nail to Femoral Component  

PubMed Central

Periprosthetic fractures after total knee arthroplasty (TKA) present a clear management challenge, and retrograde intramedullary nails have recently gained widespread acceptance in treatment of these fractures. In two cases, we found a blocking screw technique, first reported by Krettek et al., was useful in the reduction of the fractures. Both patients attained preinjury mobility after intramedullary nailing. Moreover, we present a chart summarizing the notch designs of various femoral components because some prosthetic knee designs are not amenable to retrograde nailing. We hope this will be helpful in determining indications for retrograde nailing in periprosthetic fractures after TKA.

Hamada, Daisuke; Takasago, Tomoya; Tsutsui, Takahiko; Suzue, Naoto; Sairyo, Koichi

2014-01-01

268

Rescheduling of combination hydrocodone products: problems for long-term care practitioners.  

PubMed

The Drug Enforcement Administration recently announced the final rule to reschedule hydrocodone combinations from schedule III of the Controlled Substances Act to the more restrictive schedule II category. This regulatory change will have broad operational implications for practitioners serving the health care needs of long-term care residents. Stakeholders will need to work collectively to identify possible efficiencies to counter some of the anticipated costs as well as its effect on patient care. PMID:25591027

Mattingly Ii, T Joseph

2015-01-01

269

Safety assessment of personal care products/cosmetics and their ingredients  

SciTech Connect

We attempt to review the safety assessment of personal care products (PCP) and ingredients that are representative and pose complex safety issues. PCP are generally applied to human skin and mainly produce local exposure, although skin penetration or use in the oral cavity, on the face, lips, eyes and mucosa may also produce human systemic exposure. In the EU, US and Japan, the safety of PCP is regulated under cosmetic and/or drug regulations. Oxidative hair dyes contain arylamines, the most chemically reactive ingredients of PCP. Although arylamines have an allergic potential, taking into account the high number of consumers exposed, the incidence and prevalence of hair dye allergy appears to be low and stable. A recent (2001) epidemiology study suggested an association of oxidative hair dye use and increased bladder cancer risk in consumers, although this was not confirmed by subsequent or previous epidemiologic investigations. The results of genetic toxicity, carcinogenicity and reproductive toxicity studies suggest that modern hair dyes and their ingredients pose no genotoxic, carcinogenic or reproductive risk. Recent reports suggest that arylamines contained in oxidative hair dyes are N-acetylated in human or mammalian skin resulting in systemic exposure to traces of detoxified, i.e. non-genotoxic, metabolites, whereas human hepatocytes were unable to transform hair dye arylamines to potentially carcinogenic metabolites. An expert panel of the International Agency on Research of Cancer (IARC) concluded that there is no evidence for a causal association of hair dye exposure with an elevated cancer risk in consumers. Ultraviolet filters have important benefits by protecting the consumer against adverse effects of UV radiation; these substances undergo a stringent safety evaluation under current international regulations prior to their marketing. Concerns were also raised about the safety of solid nanoparticles in PCP, mainly TiO{sub 2} and ZnO in sunscreens. However, current evidence suggests that these particles are non-toxic, do not penetrate into or through normal or compromised human skin and, therefore, pose no risk to human health. The increasing use of natural plant ingredients in personal care products raised new safety issues that require novel approaches to their safety evaluation similar to those of plant-derived food ingredients. For example, the Threshold of Toxicological Concern (TTC) is a promising tool to assess the safety of substances present at trace levels as well as minor ingredients of plant-derived substances. The potential human systemic exposure to PCP ingredients is increasingly estimated on the basis of in vitro skin penetration data. However, new evidence suggests that the in vitro test may overestimate human systemic exposure to PCP ingredients due to the absence of metabolism in cadaver skin or misclassification of skin residues that, in vivo, remain in the stratum corneum or hair follicle openings, i.e. outside the living skin. Overall, today's safety assessment of PCP and their ingredients is not only based on science, but also on their respective regulatory status as well as other issues, such as the ethics of animal testing. Nevertheless, the record shows that today's PCP are safe and offer multiple benefits to quality of life and health of the consumer. In the interest of all stakeholders, consumers, regulatory bodies and producers, there is an urgent need for an international harmonization on the status and safety requirements of these products and their ingredients.

Nohynek, Gerhard J., E-mail: gnohynec@rd.loreal.co [L'OREAL R and D, Global Safety Evaluation, 92600 Asnieres (France); Antignac, Eric [L'OREAL R and D, Global Safety Evaluation, 92600 Asnieres (France); Re, Thomas [L'Oreal USA, Research and Development, Clark, NJ 07066 (United States); Toutain, Herve [L'OREAL R and D, Global Safety Evaluation, 92600 Asnieres (France)

2010-03-01

270

Safety assessment of personal care products/cosmetics and their ingredients.  

PubMed

We attempt to review the safety assessment of personal care products (PCP) and ingredients that are representative and pose complex safety issues. PCP are generally applied to human skin and mainly produce local exposure, although skin penetration or use in the oral cavity, on the face, lips, eyes and mucosa may also produce human systemic exposure. In the EU, US and Japan, the safety of PCP is regulated under cosmetic and/or drug regulations. Oxidative hair dyes contain arylamines, the most chemically reactive ingredients of PCP. Although arylamines have an allergic potential, taking into account the high number of consumers exposed, the incidence and prevalence of hair dye allergy appears to be low and stable. A recent (2001) epidemiology study suggested an association of oxidative hair dye use and increased bladder cancer risk in consumers, although this was not confirmed by subsequent or previous epidemiologic investigations. The results of genetic toxicity, carcinogenicity and reproductive toxicity studies suggest that modern hair dyes and their ingredients pose no genotoxic, carcinogenic or reproductive risk. Recent reports suggest that arylamines contained in oxidative hair dyes are N-acetylated in human or mammalian skin resulting in systemic exposure to traces of detoxified, i.e. non-genotoxic, metabolites, whereas human hepatocytes were unable to transform hair dye arylamines to potentially carcinogenic metabolites. An expert panel of the International Agency on Research of Cancer (IARC) concluded that there is no evidence for a causal association of hair dye exposure with an elevated cancer risk in consumers. Ultraviolet filters have important benefits by protecting the consumer against adverse effects of UV radiation; these substances undergo a stringent safety evaluation under current international regulations prior to their marketing. Concerns were also raised about the safety of solid nanoparticles in PCP, mainly TiO(2) and ZnO in sunscreens. However, current evidence suggests that these particles are non-toxic, do not penetrate into or through normal or compromised human skin and, therefore, pose no risk to human health. The increasing use of natural plant ingredients in personal care products raised new safety issues that require novel approaches to their safety evaluation similar to those of plant-derived food ingredients. For example, the Threshold of Toxicological Concern (TTC) is a promising tool to assess the safety of substances present at trace levels as well as minor ingredients of plant-derived substances. The potential human systemic exposure to PCP ingredients is increasingly estimated on the basis of in vitro skin penetration data. However, new evidence suggests that the in vitro test may overestimate human systemic exposure to PCP ingredients due to the absence of metabolism in cadaver skin or misclassification of skin residues that, in vivo, remain in the stratum corneum or hair follicle openings, i.e. outside the living skin. Overall, today's safety assessment of PCP and their ingredients is not only based on science, but also on their respective regulatory status as well as other issues, such as the ethics of animal testing. Nevertheless, the record shows that today's PCP are safe and offer multiple benefits to quality of life and health of the consumer. In the interest of all stakeholders, consumers, regulatory bodies and producers, there is an urgent need for an international harmonization on the status and safety requirements of these products and their ingredients. PMID:20005888

Nohynek, Gerhard J; Antignac, Eric; Re, Thomas; Toutain, Herve

2010-03-01

271

Treatment of the femoral shaft fracture with a curved heat-treated COP clover-leaf nail.  

PubMed

The commonly used straight intramedullary nail has certain limitations and disadvantages. Following radiographic and metallurgical studies we have developed a curved heat-treated clover-leaf nail using a newly developed precipitation hardening stainless steel (COP). The nail is bent with a slot on the convex side and the radius of curvature is 115 cm which corresponds to the anatomical antero-lateral convexity of the human femur. The nail has been satisfactory in clinical use since 1971 and has provided not only more stable internal fixation but also allowed fixation of fractures beyond the middle third of the shaft. PMID:528087

Onoue, Y; Sunami, Y; Fujiwara, H; Sadakane, T; Yasuda, S

1979-01-01

272

Comparative Study Using Intramedullary K-wire Fixation Over Titanium Elastic Nail in Paediatric Shaft Femur Fractures  

PubMed Central

Background: Fracture shaft femur is common paediatric trauma leading to significant morbidity. Conservative treatments available are associated with prolonged periods of immobilization. Use of flexible intramedullary implant allows early rehabilitation in diaphyseal fractures of femur in children. Aim: The aim of the present study is to compare fixation of diaphyseal femur fracture by titanium elastic nail and intramedullary K-wires in children. Setting and Design: Prospective randomized study in a tertiary care hospital. Material and Methods: Fifty-two children between 6 years and 14 years of age with femoral shaft fracture were assigned either in Group I or Group II based on computer generated random numbers. In Group I closed percutaneous intramedullary K- wire fixation and in Group II closed percutaneous intramedullary titanium elastic nail was used to fix the fractures. Partial weight bearing was allowed after 6 weeks of surgery and full weight bearing at clinico-radiological union. Results: Average time of radiological union was 6 to 10 weeks in both groups. In both the groups two cases had entry site irritation which resolved with early implant removal. One case in both the groups had unacceptable mal-alignment. Both the groups had few cases of limb-length discrepancy, which was in acceptable limit, except two cases of TENS. There was no statistically significant difference between the results of both the groups. But, using K-wires significantly reduced the cost of treatment. Conclusion: Most of such fractures in our society are neglected because of high cost of treatment. Providing a cheaper alternative in form of K-wires may be beneficial for the patients from low socio-economic status.

Anand, Tushar; Singh, Sudhir

2014-01-01

273

The use of immunohistochemistry in the evaluation of the nail matrix in biopsies of ingrown toenails.  

PubMed

The success of surgical approaches to ingrown toenails depends on the extraction (either partial or total) of the nail matrix. The identification of the nail matrix in specimens taken from ingrown toenails is not always easy because of the fragmentation of the biopsies, difficulties in matrix orientations and the heavy inflammatory infiltrate. In biopsies taken from polydactyly surgeries, the matrix shows a peculiar pattern of expression of the CD10 and CD34 markers that differs from the one shown by the lateral nail fold. We investigated whether such a pattern was also found in biopsies from ingrown toenails, which can be greatly distorted through inflammation and fibrosis. We examined 15 biopsies from cases of ingrown toenails at different clinical stages. We performed routine Hematoxylin-Eosin studies, as well as immunohistochemical studies with CD10, CD34, HMB-45 and Melan-A. The morphologic changes in all cases were typical of those found in ingrown toenails and their intensities correlated with the clinical stages. Matrical keratinization was identified in all of the biopsies. Morphologic features that are compatible with the lateral nail fold were also seen in seven of the 15 biopsies. In five cases, an intermediate area of transition between matrix and lateral nail folds was heavily distorted by inflammatory changes. Melanocytic markers showed scattered intra-epidermal cells in all but one case. HMB-45 and Melan-A were equally good in demonstrating the melanocytic population. We concluded that the expression of CD10 and CD34 in cases of ingrown toenails is preserved and it follows the pattern described in nails from polydactyly. Therefore, both markers can be useful in fragmented specimens taken from surgeries for ingrown toenails, in order to confirm the removal of the nail matrix. PMID:23771067

Fernandez-Flores, A; Martínez-Nova, A

2013-01-01

274

Development of an interlocked nail for segmental defects in the rabbit tibia.  

PubMed

Previous animal models have been developed to study intramedullary nailing for challenging segmental defects in the tibia. In large animals, interlocked nail fixation created a stable environment suitable to study new bone growth technologies placed in the defect. To our knowledge, there are no comparable interlocked tibial defect models for the rabbit in which new technologies could be evaluated. Such a model would be helpful since the rabbit is a popular initial model for orthopedic research studies owing to its wide availability and low cost. While numerous studies have nailed the rabbit tibia, all were non-locked implants that allowed some degree of instability between the fracture fragments. In addition, the non-locked nails were constructed of stainless steel, whereas human nails are increasingly made from titanium alloy. In the current study, an interlocked titanium nail was developed for the rabbit tibia. It was implanted in cadaver tibiae and subjected to fatigue cycling in combined compression and bending at physiologic levels to 21,061 cycles. This duration is estimated to represent 12 weeks of gait by the animal. Before and after fatigue cycling, monotonic testing was performed in compression and bending at physiologic levels. The intact contralateral limbs served as controls. All limbs completed the cycling; the instrumented limbs exhibited interfragmentary cyclic strain amplitudes during fatigue (616 +/- 139 micro-strain), which was significantly greater than the control limbs (136 +/- 35 microstrain). Monotonic strain amplitudes for the test limbs in bending and compression were 4839 +/- 1028 and 542 +/- 122 microstrain, respectively; corresponding values for the control bones were 407 +/- 118 and 95 +/- 38 microstrain, respectively. These data are similar to those presented in prior studies in larger bone models. The current study presents one method for interlocked nail fixation for this complex tibial shaft fracture in a small animal. PMID:22611873

LeCronier, David J; Papakonstantinou, John S; Gheevarughese, Vineetha; Beran, Casey D; Walter, Norman E; Atkinson, Patrick J

2012-04-01

275

Drug delivery to the nail: therapeutic options and challenges for onychomycosis.  

PubMed

Onychomycosis is one of the most common nail disorders. It affects 10-30% of the world population and is caused by dermatophytes, non-dermatophytes, molds, and yeasts. Present treatment methods of onychomycosis include oral therapy, topical therapy, and a combination of both; they have mild-to-moderate efficacy, with a relapse and reinfection rate of 20-25%. For oral therapy, newer antifungal compounds (azole class and allylamine class) are being investigated to increase efficacy and minimize side effects. Oral therapy with antifungal agents have severe side effects, with lesser bioavailability and longer duration of treatment. By contrast, topical therapy of onychomycosis is associated with greater patient compliance and fewer systemic side effects and drug interactions. Current topical treatment options of onychomycosis are nail lacquers, ointments, lotions, solutions, and gels, but these formulations have been unsuccessful due to poor penetration and distribution of drugs at the infected site. Therefore, novel therapeutic options are constantly being researched to improve the efficacy of onychomycosis treatment by enhancing the permeation of the drug across the nail to reach the infected site. Various physical and chemical enhancement methods have been studied to increase the permeation of drugs across the nail plate to the nail bed. Device-based therapeutic options have also been investigated to increase the antifungal drug concentration and its effects in the onychomycotic nail. Randomized clinical trials of these novel therapies have demonstrated better efficacy. The present review discusses the anatomy of the human nail, onychomycosis and its types, onycholysis, and conventional and novel therapies. We also review patents granted as well as design challenges facing optimal drug formulation for onychomycosis treatment. PMID:25271773

Barot, Bhavesh S; Parejiya, Punit B; Patel, Hetal K; Mehta, Dharmik M; Shelat, Pragna K

2014-01-01

276

Removal of selected pharmaceuticals, personal care products and artificial sweetener in an aerated sewage lagoon.  

PubMed

A sewage lagoon serving the small municipality of Lakefield in Ontario, Canada was monitored in the summer, fall and winter to determine removals of carbamazepine, trimethoprim, sulfamethoxazole, ibuprofen, gemfibrozil, triclosan, sucralose, HHCB and AHTN. Concentrations of these compounds in untreated and treated wastewater were estimated by deploying POCIS and SPMD passive samplers in the sewage lagoon. Passive samplers were also deployed at several points upstream and downstream of the point of discharge from the lagoon into the Otonabee River. LC-MS/MS and GC-MS were utilized to determine the concentrations of pharmaceuticals and personal care products (PPCPs) and sucralose, an artificial sweetener. Among PPCPs sampled by POCIS, the highest estimated concentration in untreated wastewater was ibuprofen sampled during the fall, at an estimated concentration of 60.3 ng/L. The estimated average concentration of sucralose was 13.6 ng/L in the untreated wastewaters. Triclosan, HHCB and AHTN in SPMDs were highest during fall season, at 30, 1677 and 109 ng/L, respectively. For all compounds except gemfibrozil, carbamazepine and sucralose, removals were highest in the summer (83.0 to 98.8%) relative to removals in the fall (48.4 to 91.4%) and winter (14.0 to 78.3%). Finally, the estimated concentrations of carbamazepine, sulfamethoxazole, triclosan and HHCB were compared with predicted values obtained through application of the WEST® modeling tool, with a new model based on the River Water Quality Model No. 1 and extended with dynamic mass balances describing the fate of chemicals of emerging concern subject to a variety of removal pathways. The model was able to adequately predict the fate of these four compounds in the lagoon in summer and winter, but the model overestimated removals of three of the four test compounds in the fall sampling period. This lagoon was as effective at removing PPCPs as many conventional WWTPs, but removals were better during the summer. PMID:24393598

Hoque, M Ehsanul; Cloutier, Frédéric; Arcieri, Carlo; McInnes, Mark; Sultana, Tamanna; Murray, Craig; Vanrolleghem, Peter A; Metcalfe, Chris D

2014-07-15

277

Comparative uptake and translocation of pharmaceutical and personal care products (PPCPs) by common vegetables.  

PubMed

Reuse of treated wastewater to irrigate agricultural crops is increasing in many arid and semi-arid areas around the world. The presence of numerous pharmaceutical and personal care products (PPCPs) in treated wastewater and their potential transfer into food produce such as vegetables poses an unknown human health risk. The goal of this study was to identify PPCPs that have a comparatively high potential for plant uptake and translocation. A total of 20 frequently-occurring PPCPs were compared for their accumulation into four staple vegetables (lettuce, spinach, cucumber, and pepper) grown in nutrient solutions containing PPCPs at 0.5 or 5?gL(-1). Triclocarban, fluoxetine, triclosan, and diazepam were found at high levels in roots, while meprobamate, primidone, carbamazepine, dilantin, and diuron exhibited more active translocation from roots to leaves. Root uptake of neutral PPCPs was positively correlated with the pH adjusted log Kow(i.e., log Dow), and was likely driven by chemical adsorption onto the root surfaces. In contrast, translocation from roots to leaves was negatively related to log Dow, suggesting hydrophilicity-regulated transport via xylems. Compounds preferentially sorbed to roots should be further evaluated for their uptake in tuber vegetables (e.g., carrot, radish) under field conditions, while those easily translocated into leaves (e.g., carbamazepine, dilantin) merit focused consideration for leafy and other vegetables (e.g., lettuce, cucumber). However, estimation of dietary intake by humans suggested the implied risks from exposure to PPCPs via wastewater irrigation to be negligible. PMID:23973619

Wu, Xiaoqin; Ernst, Frederick; Conkle, Jeremy L; Gan, Jay

2013-10-01

278

Evaluation of pharmaceuticals and personal care products as water-soluble molecular markers of sewage.  

PubMed

We examined the utility of 13 pharmaceuticals and personal care products (PPCPs) as molecular markers of sewage contamination in riverine, groundwater, and coastal environments. The PPCPs were crotamiton, ibuprofen, naproxen, ketoprofen, fenoprofen, mefenamic acid, thymol, triclosan, propyphenazone, carbamazepine, diethyltoluamide, ethenzamide, and caffeine. Measurements in 37 Japanese rivers showed positive correlations of riverine flux of crotamiton (r2 = 0.85), carbamazepine (r2 = 0.84), ibuprofen (r2 = 0.73), and mefenamic acid (r2 = 0.67) with the population in the catchments. In three surveys in the Tamagawa estuary, crotamiton, carbamazepine, and mefenamic acid behaved conservatively across seasons within a salinity range of 0.4-29 per thousand, suggesting their utility as molecular markers in coastal environments. Removal of ketoprofen and naproxen in the estuary was ascribed to photodegradation. Ibuprofen and thymol were removed from estuarine waters in summer by microbial degradation. Triclosan was removed by a combination of microbial degradation, photodegradation, and adsorption. These results were consistent with those of river water incubated for 8 d at 25 degrees C in the dark in order to examine the effects of biodegradation and photodegradation. Crotamiton was detected in groundwater from the Tokyo metropolitan area (12 out of 14 samples), suggesting wastewater leakage from decrepit sewers. Carbamazepine, ketoprofen, and ibuprofen (5/14), caffeine (4/14), and diethyltoluamide (3/14) were also detected in the groundwater, whereas the other carboxylic and phenolic PPCPs were not detected and were thought to be removed during their passage through soil. All the data demonstrated the utility of crotamiton and carbamazepine as conservative markers in freshwater and coastal environments. We recommend combining these conservative markers with labile PPCPs to detect inputs of poorly treated sewage. PMID:18800500

Nakada, Norihide; Kiri, Kentaro; Shinohara, Hiroyuki; Harada, Arata; Kuroda, Keisuke; Takizawa, Satoshi; Takada, Hideshige

2008-09-01

279

Multi-residue determination of pharmaceutical and personal care products in vegetables.  

PubMed

Treated wastewater irrigation and biosolid amendment are increasingly practiced worldwide and contamination of plants, especially produces that may be consumed raw by humans, by pharmaceutical and personal care products (PPCPs), is an emerging concern. A sensitive method was developed for the simultaneous measurement of 19 frequently-occurring PPCPs in vegetables using high-performance liquid chromatography-electrospray ionization tandem mass spectrometry (HPLC-ESI-MS/MS) for detection, combined with ultrasonic extraction and solid phase extraction (SPE) cleanup for sample preparation. Deuterated standards were used as surrogates to quantify corresponding analytes. The corrected recoveries ranged between 87.1 and 123.5% for iceberg lettuce, with intra- and inter-day variations less than 20%, and the method detection limits (MDLs) in the range of 0.04-3.0 ng g?¹ dry weight (dw). The corrected recoveries were equally good when the method was used on celery, tomato, carrot, broccoli, bell pepper and spinach. The method was further applied to examine uptake of PPCPs by iceberg lettuce and spinach grown in hydroponic solutions containing each PPCP at 500 ng L?¹. Twelve PPCPs were detected in lettuce leaves with concentrations from 0.2 to 28.7 ng g?¹ dw, while 11 PPCPs were detected in spinach leaves at 0.04-34.0 ng g?¹ dw. Given the diverse chemical structures of PPCPs considered in this study, this method may be used for screening PPCP residues in vegetables and other plants impacted by treated wastewater or biosolids, and to estimate potential human exposure via dietary uptake. PMID:22867843

Wu, Xiaoqin; Conkle, Jeremy Landon; Gan, Jay

2012-09-01

280

Pharmaceuticals and personal care products in the environment: agents of subtle change?  

PubMed Central

During the last three decades, the impact of chemical pollution has focused almost exclusively on the conventional "priority" pollutants, especially those acutely toxic/carcinogenic pesticides and industrial intermediates displaying persistence in the environment. This spectrum of chemicals, however, is only one piece of the larger puzzle in "holistic" risk assessment. Another diverse group of bioactive chemicals receiving comparatively little attention as potential environmental pollutants includes the pharmaceuticals and active ingredients in personal care products (in this review collectively termed PPCPs), both human and veterinary, including not just prescription drugs and biologics, but also diagnostic agents, "nutraceuticals," fragrances, sun-screen agents, and numerous others. These compounds and their bioactive metabolites can be continually introduced to the aquatic environment as complex mixtures via a number of routes but primarily by both untreated and treated sewage. Aquatic pollution is particularly troublesome because aquatic organisms are captive to continual life-cycle, multigenerational exposure. The possibility for continual but undetectable or unnoticed effects on aquatic organisms is particularly worrisome because effects could accumulate so slowly that major change goes undetected until the cumulative level of these effects finally cascades to irreversible change--change that would otherwise be attributed to natural adaptation or ecologic succession. As opposed to the conventional, persistent priority pollutants, PPCPs need not be persistent if they are continually introduced to surface waters, even at low parts-per-trillion/parts-per-billion concentrations (ng-microg/L). Even though some PPCPs are extremely persistent and introduced to the environment in very high quantities and perhaps have already gained ubiquity worldwide, others could act as if they were persistent, simply because their continual infusion into the aquatic environment serves to sustain perpetual life-cycle exposures for aquatic organisms. This review attempts to synthesize the literature on environmental origin, distribution/occurrence, and effects and to catalyze a more focused discussion in the environmental science community. PMID:10592150

Daughton, C G; Ternes, T A

1999-01-01

281

In vitro studies to show sequestration of matrix metalloproteinases by silver-containing wound care products.  

PubMed

Excess or "uncontrolled" proteinase activity in the wound bed has been implicated as one factor that may delay or compromise wound healing. One proteinase group--matrix metalloproteinases--includes collagenases, elastase, and gelatinases and can be endogenous (cell) or exogenous (bacterial) in origin. A study was conducted to assess the ability of five silver-containing wound care products to reduce a known matrix metalloproteinase supernatant concentration in vitro. Four silver-containing wound dressings (a carboxy-methyl cellulose, a nanocrystalline, a hydro-alginate, and a collagen/oxidized regenerated cellulose composite dressing), along with a 0.5% aqueous silver nitrate [w/v] solution and controls for matrix metalloproteinase-2 and matrix metalloproteinase-9 sourced from ex vivo dermal tissue and blood monocytes, respectively, were used. Extracts were separated and purified using gelatine-Sepharose column chromatography and dialysis and polyacrylamide gel electrophoretic zymography was used to analyze specific matrix metalloproteinase activity. All dressings and the solution were shown to sequester both matrix metalloproteinases. The silver-containing carboxy-methyl cellulose dressing showed significantly greater sequestration for matrix metalloproteinase-2 at 6 and 24 hours (P< 0.001) compared to the other treatments. For matrix metalloproteinase-9, both the carboxy-methyl cellulose dressing and the oxidized regenerated cellulose dressing achieved significant sequestration when compared to the other treatments at 24 hours (P <0.001), which was maintained to 48 hours (P < 0.001). Results from this study show that silver-containing dressings are effective in sequestering matrix metalloproteinase-2 and -9 and that this can be achieved without a sacrificial protein (eg, collagen). Although the varying ability of wound dressings to sequester matrix metalloproteinases has been shown in vitro, further in vivo evidence is required to confirm these findings. PMID:17893426

Walker, Michael; Bowler, Philip G; Cochrane, Christine A

2007-09-01

282

Trichophyton onychocola sp. nov. isolated from human nail.  

PubMed

A previously undescribed Trichophyton species was isolated from the nail of a 33-year-old man with a history of probable distal lateral subungual onychomycosis (without confirmation by mycological examination). The infection occurred for the first time five years earlier (in 2006) and affected the right great toenail, with complete clinical remission after treatment with ciclopirox olamine. This undescribed species was isolated during probable relapse in 2011, but its etiological significance was not confirmed, that is, direct microscopy was negative and additional clinical samples were not collected. The species is probably geophilic based on phylogenetic analysis (internal transcribed spacer [ITS] rDNA) and is most closely related to the anamorphic T. thuringiense, homothallic Arthroderma ciferrii (anamorph T. georgiae), and heterothallic A. melis. The new species is characterized by yellowish colonies, red reverse on several media, positive urease test, negative hair-perforation test, absence of growth at 34°C, absence of macroconidia, formation of one-celled clavate microconidia, and spiral hyphae. The species grows well on sterilized human hairs placed on agar medium without any additional nutrients and forms gymnothecium-like structures covered by peridial hyphae. The combination of unique micro- and macromorphological features and physiological and sequence data from four unlinked loci (ITS, benA, RPB2, and act1 gene) justified the proposal of a new species T. onychocola sp. nov. PMID:24577005

Hubka, Vit; Cmokova, Adela; Skorepova, Magdalena; Mikula, Peter; Kolarik, Miroslav

2014-04-01

283

Improving Care for Children With Complex Needs  

ClinicalTrials.gov

Medically Complex Children; Care Coordination; Case Manager; Care Manager; Collaborative Care; Disease Management; Patient Care Team or Organization; Managed Care; Children With Chronic Conditions; Children With Special Health Care Needs; Shared Care Plan; Patient Care Plan; Health Care and Resource Utilization; Adherence to Care; Functional Status and Productivity; Health Related Quality of Life; Satisfaction With Care; Care Coordinator; Family Experience of Care; Quality Health Care

2014-11-18

284

Biofiltration of wastewater treatment plant effluent: Effective removal of pharmaceuticals and personal care products and reduction of toxicity  

Microsoft Academic Search

This study investigates biofiltration for the removal of dissolved organic carbon (DOC), pharmaceuticals and personal care products (PPCPs), and for the reduction of non-specific toxicity expressed as baseline toxicity equivalent concentration (baseline-TEQ). Two filtering media, sand and granular activated carbon, were tested. The influence of pre-ozonation and empty-bed contact time (EBCT, from 30 to 120 min) was determined. The experiments were

J. Reungoat; B. I. Escher; M. Macova; J. Keller

2011-01-01

285

Individual and Mixture Effects of Selected Pharmaceuticals and Personal Care Products on the Marine Phytoplankton Species Dunaliella tertiolecta  

Microsoft Academic Search

Pharmaceuticals and personal care products (PPCPs) entering the environment may have detrimental effects on aquatic organisms.\\u000a Simvastatin, clofibric acid, diclofenac, carbamazepine, fluoxetine, and triclosan represent some of the most commonly used\\u000a and\\/or detected PPCPs in aquatic environments. This study analyzed the individual and mixture toxicity of these six PPCPs\\u000a to the marine phytoplankton species Dunaliella tertiolecta using a standard 96-hour

Marie E. DeLorenzo; Jessica Fleming

2008-01-01

286

Outcome of one-stage correction of deformities of the ankle and hindfoot and fusion in Charcot neuroarthropathy using a retrograde intramedullary hindfoot arthrodesis nail.  

PubMed

We report the outcomes of 20 patients (12 men, 8 women, 21 feet) with Charcot neuro-arthropathy who underwent correction of deformities of the ankle and hindfoot using retrograde intramedullary nail arthrodesis. The mean age of the patients was 62.6 years (46 to 83); their mean BMI was 32.7 (15 to 47) and their median American Society of Anaesthetists score was 3 (2 to 4). All presented with severe deformities and 15 had chronic ulceration. All were treated with reconstructive surgery and seven underwent simultaneous midfoot fusion using a bolt, locking plate or a combination of both. At a mean follow-up of 26 months (8 to 54), limb salvage was achieved in all patients and 12 patients (80%) with ulceration achieved healing and all but one patient regained independent mobilisation. There was failure of fixation with a broken nail requiring revision surgery in one patient. Migration of distal locking screws occurred only when standard screws had been used but not with hydroxyapatite-coated screws. The mean American Academy of Orthopaedic Surgeons Foot and Ankle (AAOS-FAO) score improved from 50.7 (17 to 88) to 65.2 (22 to 88), (p = 0.015). The mean Short Form (SF)-36 Health Survey Physical Component Score improved from 25.2 (16.4 to 42.8) to 29.8 (17.7 to 44.2), (p = 0.003) and the mean Euroqol EQ?5D?5L score improved from 0.63 (0.51 to 0.78) to 0.67 (0.57 to 0.84), (p = 0.012). Single-stage correction of deformity using an intramedullary hindfoot arthrodesis nail is a good form of treatment for patients with severe Charcot hindfoot deformity, ulceration and instability provided a multidisciplinary care plan is delivered. Cite this article: Bone Joint J 2015;97-B:76-82. PMID:25568417

Siebachmeyer, M; Boddu, K; Bilal, A; Hester, T W; Hardwick, T; Fox, T P; Edmonds, M; Kavarthapu, V

2015-01-01

287

Meta-analysis of reamed versus unreamed intramedullary nailing for open tibial fractures  

PubMed Central

Background Open fractures of the tibial diaphysis are usually caused by high-energy trauma and associated with severe bone and soft tissue injury. Reamed and unreamed intramedullary nailing are often used for treatment of tibial injury. The purpose of this study was to investigate the clinical efficacy of reamed versus unreamed intramedullary nailing for open tibial fractures (OTF). Methods A meta-analysis was conducted according to the guidelines of the Cochrane Collaboration using databases containing the Cochrane Library, PubMed, EMbase, Chinese Biomedical Database, Chinese VIP information, and WanFang Database. Randomized and semi-randomized controlled clinical trials of both reamed and unreamed intramedullary nailing for OTF treatment were analyzed using Reviewer Manager (RevMan5.0) software. Results A total of 695 references were initially identified from the selected databases. However, only four studies were assessed, matching all the eligibility criteria conducted by two independent reviewers. The result showed that there was no statistical difference in healing rate, secondary surgery rate, implant failure rate, osteofascial compartment syndrome, and infection during the postoperative period between reamed and unreamed nails in OTF. Conclusions Findings of this study suggest that there was no statistical difference between reamed and unreamed intramedullary nailing in clinical treatment of OTF. However, the result of this meta-analysis should be cautiously accepted due to some limitations, and further studies are still needed. PMID:25149501

2014-01-01

288

[Flexible metallic intramedullary nail, an ideal osteosynthesis material for femoral fractions].  

PubMed

The authors have used modified Ender nails for the treatment of femural fractures. Nails of different sizes are used in different arrangements, depending on the site of the lesion. Thus, for fractures of the femural neck 3 metallic nails, with a diameter of 4 mm are used, introduced through the internal supra-condylian aspect in paralel arcs; two nails, 5 mm in diameter, are introduced in the same way for the correction of the fractures involving the trochanterian massif; for fractures sited under the trochanterian massif (diaphysis, supracondylian, and supra- and inter-condylian), 5 mm diameter nails are used, placed on the internal and external aspects of the condyl in metalic arcs. This type of intervention was demonstrated to be stable, rapid, non-haemorrhagic and with low risk of shock. Supported walking is started in the first week after surgery--in cases with fractures of the trochanterian massif and of the diaphysis--provided these are stable fractures, in the first month when unstable fractures occur at the same level, and after 3--4 months in cases of fractures of the cervical neck. The authors' experience in the treatment of 250 cases is presented. PMID:147494

Firic?, A; Mucichescu, D; Troianescu, O; R?zu?, M

1977-01-01

289

Anatomy of the Greater Trochanteric ‘Bald Spot’: A Potential Portal for Abductor Sparing Femoral Nailing?  

PubMed Central

Soft tissue injury occurs when using a piriformis portal for femoral nailing. Standard trochanteric portals also can injure the gluteus medius and external rotator tendons, which may be a source of hip pain after nailing. On the lateral facet of the greater trochanter, a “bald spot” may exist that is devoid of tendon insertion. This may be a potential portal for intramedullary nail insertion. We defined the dimensions and location of this region. Cadaveric specimens were dissected to expose the tendon insertions on the greater trochanter. A computer navigation system was used with a stylus and bone morphing to determine the tendon insertions and bald spot anatomy. The greater trochanteric bald spot is covered by the subgluteus medius bursa and has no tendon insertions. Its center lies 11 mm distal to the tip of the greater trochanter and 5 mm anterior to the midline. The shape is ellipsoid with a diameter of 21 mm. This region is large enough to accommodate the size of most nailing system reamers without tendon footprint infringement. Use of this modified entry site may reduce soft tissue injury with nailing procedures and minimize subsequent hip pain. PMID:18347886

Robertson, William J.; Boraiah, Sreevathsa; Barker, Joseph U.; Lorich, Dean G.

2008-01-01

290

Stress relaxation of grouted entirely large diameter B-GFRP soil nail  

NASA Astrophysics Data System (ADS)

One of the potential solutions to steel-corrosion-related problems is the usage of fiber reinforced polymer (FRP) as a replacement of steel bars. In the past few decades, researchers have conducted a large number of experimental and theoretical studies on the behavior of small size glass fiber reinforce polymer (GFRP) bars (diameter smaller than 20 mm). However, the behavior of large size GFRP bar is still not well understood. Particularly, few studies were conducted on the stress relaxation of grouted entirely large diameter GFRP soil nail. This paper investigates the effect of stress levels on the relaxation behavior of GFRP soil nail under sustained deformation ranging from 30% to 60% of its ultimate strain. In order to study the behavior of stress relaxation, two B-GFRP soil nail element specimens were developed and instrumented with fiber Bragg grating (FBG) strain sensors which were used to measure strains along the B-GFRP bars. The test results reveal that the behavior of stress relaxation of B-GFRP soil nail element subjected to pre-stress is significantly related to the elapsed time and the initial stress of relaxation procedure. The newly proposed model for evaluating stress relaxation ratio can substantially reflect the influences of the nature of B-GFRP bar and the property of grip body. The strain on the nail body can be redistributed automatically. Modulus reduction is not the single reason for the stress degradation.

Li, Guo-wei; Ni, Chun; Pei, Hua-fu; Ge, Wan-ming; Ng, Charles Wang Wai

2013-08-01

291

Prebending of a titanium elastic intramedullary nail in the treatment of distal radius fractures in children.  

PubMed

Abstract The aims of this study were to introduce a method to treat distal radius diaphyseal metaphyseal junction fractures by prebending an elastic intramedullary nail and to evaluate the factors influencing fracture apposition. Fifty-two consecutive patients (4 to 15 years old) with a distal radius diaphyseal metaphyseal junction fracture were included. The nail was inserted and advanced into the proximal radial fragment as normal. After bending the nail distally about 90° at the site predetermined to lie at the distal segment, the elastic intramedullary nail was advanced until the prebent part completely entered the marrow cavity. The fracture angular deformity was fully corrected in anterior-posterior and lateral views. The apposition rate was 90% to 100% in lateral view, >50% in anterior-posterior view. The operation time was 16.73 ± 6.253 minutes. The average time of fracture healing was 5 months (range, 4-7 months). During 12 to 19 months of follow-up, firm fracture healing and good remodeling were observed, and there was no impaired forearm rotation function or secondary fracture. Our study showed the treatment of distal radius diaphyseal metaphyseal junction fractures by prebent intramedullary nail could make up for the deficiency of Kirschner wires and steel plates and keep the fracture stable. Fracture type and the anatomical features of the distal radius were associated with fracture apposition. PMID:24833151

Cai, Haoqi; Wang, Zhigang; Cai, Haiqing

2014-01-01

292

Utilization of human nails as a trace-element monitor in epidemiologic studies  

SciTech Connect

The utilization of human nails as a monitor for dietary intake of minerals, and especially trace elements, has been under investigation in the authors laboratories using neutron activation analysis. Rationale for the choice of the toenail is two-fold. First, experience has demonstrated that a high percentage of subjects will cooperate by furnishing nail samples when requested. These samples are easily transferred and can be conveniently catalogued and stored. Second, the elemental content of a nail sample was deposited prior to its being sampled. In the case of the nail sample from the great toe, this time differential can be approximately one year. This allows case control studies of human disease to be designed where there is less chance that the disease has caused substantial changes in diet or metabolism. Even so, epidemiologists prefer to design and conduct prospective case control studies if possible. Due to their ease of collection, transfer, and storage, nails can potentially make a greater number of such studies feasible. Toenails are currently being analyzed in their laboratory via instrumental neutron activation analysis in two case-control, cancer studies. Results for selenium, magnesium, calcium, and sulfur will be discussed with respect to the evaluation of the toenail as a dietary monitor for these elements.

Morris, J.S.; Sullivan, T.; Wetter, L.

1986-01-01

293

Skin care and incontinence  

MedlinePLUS

Incontinence - skin care ... in a wheelchair, regular chair, or bed TAKING CARE OF THE SKIN Using diapers and other products ... skin. Over time, the skin breaks down. Special care must be taken to keep the skin clean ...

294

Mycobacterium cosmeticum sp. nov., a novel rapidly growing species isolated from a cosmetic infection and from a nail salon.  

PubMed

Four isolates of a rapidly growing Mycobacterium species had a mycolic acid pattern similar to that of Mycobacterium smegmatis, as determined by HPLC analyses. Three of the isolates were from footbath drains and a sink at a nail salon located in Atlanta, GA, USA; the fourth was obtained from a granulomatous subdermal lesion of a female patient in Venezuela who was undergoing mesotherapy. By random amplified polymorphic DNA electrophoresis and PFGE of large restriction fragments, the three isolates from the nail salon were shown to be the same strain but different from the strain from the patient in Venezuela. Polymorphisms in regions of the rpoB, hsp65 and 16S rRNA genes that were shown to be useful for species identification matched for the two strains but were different from those of other Mycobacterium species. The 16S rRNA gene sequence placed the strains in a taxonomic group along with Mycobacterium frederiksbergense, Mycobacterium hodleri, Mycobacterium diernhoferi and Mycobacterium neoaurum. The strains produced a pale-yellow pigment when grown in the dark at the optimal temperature of 35 degrees C. Biochemical testing showed that the strains were positive for iron uptake, nitrate reduction and utilization of d-mannitol, d-xylose, iso-myo-inositol, l-arabinose, citrate and d-trehalose. The strains were negative for d-sorbitol utilization and production of niacin and 3-day arylsulfatase, although arylsulfatase activity was observed after 14 days. The isolates grew on MacConkey agar without crystal violet but not on media containing 5 % (w/v) NaCl or at 45 degrees C. They were susceptible to ciprofloxacin, amikacin, tobramycin, cefoxitin, clarithromycin, doxycycline, sulfamethoxazole and imipenem. The name Mycobacterium cosmeticum sp. nov. is proposed for this novel species; two strains, LTA-388(T) (=ATCC BAA-878(T)=CIP 108170(T)) (the type strain) and 2003-11-06 (=ATCC BAA-879=CIP 108169) have been designated, respectively, for the strains of the patient in Venezuela and from the nail salon in Atlanta, GA, USA. PMID:15545488

Cooksey, Robert C; de Waard, Jacobus H; Yakrus, Mitchell A; Rivera, Ismar; Chopite, Marina; Toney, Sean R; Morlock, Glenn P; Butler, W Ray

2004-11-01

295

Comparative endurance testing of the Biomet Matthews Nail and the Dynamic Compression Screw, in simulated condylar and supracondylar femoral fractures  

Microsoft Academic Search

BACKGROUND: The dynamic compression screw is a plate and screws implant used to treat fractures of the distal femur. The Biomet Matthews Nail is a new retrograde intramedullary nail designed as an alternative surgical option to treat these fractures. The objective of this study was to assess the comparative endurance of both devices. METHOD: The dynamic compression screw (DCS) and

Laurence M O'Connor-Read; Jerome A Davidson; Benjamin M Davies; Michael G Matthews; Paul Smirthwaite

2008-01-01

296

Comparison of a New Braid Fixation System to an Interlocking Intramedullary Nail for Tibial Osteotomy Repair in an Ovine Model  

E-print Network

by placing 1or 2 lock- ing screws at either end of the nail. These screws engage the bone cortices, HIROHITO KOBAYASHI, MS, and MARK D. MARKEL, DVM, PhD, Diplomate ACVS Objectives--To compare bone healing) and polymethylmethacrylate bone cement with an interlocking intramedullary (IM) nail fixation in an ovine model. Study Design

Scharer, John E.

297

Optimization and Validation of RP-HPLC-UV/Vis Method for Determination Phenolic Compounds in Several Personal Care Products  

PubMed Central

An HPLC method with ultraviolet-visible spectrophotometry detection has been optimized and validated for the simultaneous determination of phenolic compounds, such as butylated hydroxyanisole (BHA) and butylated hydroxytoluene (BHT) as antioxidants, and octyl methyl cinnamate (OMC) as UVB-filter in several personal care products. The dynamic range was between 1 to 250?mg/L with relative standard deviation less than 0.25% (n = 4). Limits of detection for BHA, BHT, and OMC were 0.196, 0.170, and 0.478?mg/L, respectively. While limits of quantification for BHA, BHT, and OMC were 0.593, 0.515, and 1.448?mg/L, respectively. The recovery for BHA, BHT, and OMC was ranged from 92.1–105.9%, 83.2–108.9%, and 87.3–103.7%, respectively. The concentration ranges of BHA, BHT, and OMC in 12 commercial personal care samples were 0.13–4.85, 0.16–2.30, and 0.12–65.5?mg/g, respectively. The concentrations of phenolic compounds in these personal care samples were below than maximum allowable concentration in personal care formulation, that is, 0.0004–10?mg/g, 0.002–5?mg/g, and up to 100?mg/g for BHA, BHT, and OMC, respectively. PMID:21760792

Akkbik, Mohammed; Assim, Zaini Bin; Ahmad, Fasihuddin Badruddin

2011-01-01

298

Vulvar Care  

MedlinePLUS

... care professionals to share with clients. Any other reproduction is sub- ject to the Journal of Midwifery & ... jelly keeps the area moist and soft . For Sexual Activity • Some birth control products you can get ...

299

International scientists' priorities for research on pharmaceutical and personal care products in the environment.  

PubMed

Pharmaceuticals and personal care products (PPCPs) are widely discharged into the environment via diverse pathways. The effects of PPCPs in the environment have potentially important human and ecosystem health implications, so credible, salient, and legitimate scientific evidence is needed to inform regulatory and policy responses that address potential risks. A recent "big questions" exercise with participants largely from North America identified 22 important research questions around the risks of PPCP in the environment that would help address the most pressing knowledge gaps over the next decade. To expand that analysis, we developed a survey that was completed by 535 environmental scientists from 57 countries, of whom 49% identified environmental or analytical chemistry as their primary disciplinary background. They ranked the 22 original research questions and submitted 171 additional candidate research questions they felt were also of high priority. Of the original questions, the 3 perceived to be of highest importance related to: 1) the effects of long-term exposure to low concentrations of PPCP mixtures on nontarget organisms, 2) effluent treatment methods that can reduce the effects of PPCPs in the environment while not increasing the toxicity of whole effluents, and 3) the assessment of the environmental risks of metabolites and environmental transformation products of PPCPs. A question regarding the role of cultural perspectives in PPCP risk assessment was ranked as the lowest priority. There were significant differences in research orientation between scientists who completed English and Chinese language versions of the survey. We found that the Chinese respondents were strongly orientated to issues of managing risk profiles, effluent treatment, residue bioavailability, and regional assessment. Among English language respondents, further differences in research orientation were associated with respondents' level of consistency when ranking the survey's 15 comparisons. There was increasing emphasis on the role of various other stressors relative to PPCPs and on risk prioritization as internal decision making consistency increased. Respondents' consistency in their ranking choices was significantly and positively correlated with SETAC membership, authors' number of publications, and longer survey completion times. Our research highlighted international scientists' research priorities and should help inform decisions about the type of hazard and risk-based research needed to best inform decisions regarding PPCPs in the environment. Disciplinary training of a scientist or engineer appears to strongly influence preferences for research priorities to understand PPCPs in the environment. Selection of participants and the depth and breadth of research prioritization efforts thus have potential effects on the outcomes of research prioritization exercises. Further elucidation of how patterns of research priority vary between academic and government scientists and between scientists and other government and stakeholders would be useful in the future and provide information that helps focus scientific effort on socially relevant challenges relating to PPCPs in the environment. It also suggests the potential for future collaborative research between industry, government, and academia on environmental contaminants beyond PPCPs. PMID:24954797

Rudd, Murray A; Ankley, Gerald T; Boxall, Alistair B A; Brooks, Bryan W

2014-10-01

300

Nail projectiles propelled by a mason's lacing cord: an experimental approach.  

PubMed

The recent clinical observation of two unintentional penetrating ocular and cerebral injuries due to 90-mm construction nails gave occasion to an experimental study to check the alleged trauma mechanism for plausibility. Both casualties reported that they had attached a mason's lacing cord to the masonry using a nail as anchoring when suddenly the nail was yanked from its moorings and propelled like a missile by the overstretched lacing cord. As to the best of the authors' knowledge, this mechanism of injury has not yet been reported in any of the literature; it was the aim to find an experimental approach to review the plausibility of the alleged sequence of events leading to the accidents. The tensile strength at break and strain at break of different mason's lacing cords (diameter of 1 and 2 mm) were measured according to DIN EN ISO 2062 by using a tensile testing machine. Based on the maximum spring energy of the lacing cords, which was determined 174.9 J for the 1-mm cord (length 10 m) and 747.4 J for the 2-mm cord (length 10 m), the maximum possible velocity of the nails as projectiles was calculated to be 243.5 m/s for the 1-mm cord and 503.4 m/s for the 2-mm cord. The critical elongation a cord of a certain length has to be stretched to deliver enough kinetic energy to a 90-mm nail to surpass the threshold velocity for skin penetration, which was investigated by Sellier (1977) to be approximately 18 m/s, was also calculated. To conclude, the energy delivered by the cords is high enough to surpass the rather low threshold velocity of nails. The details of how these accidents occurred, which seemed questionable at first, can be reasonably explained by trauma biomechanics. PMID:22562442

Frank, Matthias; Grossjohann, Rico; Schikorr, Wolfgang; Tesch, Ralf; Lange, Jörn; Ekkernkamp, Axel; Langner, Sönke; Bockholdt, Britta; Tost, Frank

2013-01-01

301

Overall Well-Being as a Predictor of Health Care, Productivity, and Retention Outcomes in a Large Employer  

PubMed Central

Abstract Employers struggle with the high cost of health care, lost productivity, and turnover in their workforce. The present study aims to understand the association between overall well-being and these employer outcomes. In a sample of 11,700 employees who took the Well-being Assessment, the authors used multivariate linear and logistic regression to investigate overall well-being as a predictor of health care outcomes (total health care expenditure, emergency room visits, hospitalizations), productivity outcomes (unscheduled absence, short-term disability leave, presenteeism, job performance ratings), and retention outcomes (intention to stay, voluntary turnover, involuntary turnover). Testing this hypothesis both cross-sectionally and longitudinally, the authors investigated the association between baseline well-being and these outcomes in the following year, and the relationship between change in overall well-being and change in these outcomes over 1 year. The results demonstrated that baseline overall well-being was a significant predictor of all outcomes in the following year when holding baseline employee characteristics constant. Change in overall well-being over 1 year also was significantly associated with the change in employer outcomes, with the exception that the relationship to change in manager-rated job performance was marginally significant. The relationships between overall well-being and outcomes suggest that implementing a well-being improvement solution could have a significant bottom and top line impact on business performance. (Population Health Management 2013;16:397–405) PMID:23480368

Shi, Yuyan; Coberley, Carter R.; Pope, James E.

2013-01-01

302

Characterization and quantitation of polyolefin microplastics in personal-care products using high-temperature gel-permeation chromatography.  

PubMed

In recent years, the development of reliable methods for the quantitation of microplastics in different samples, including evaluating the particles' adverse effects in the marine environment, has become a great concern. Because polyolefins are the most prevalent type of polymer in personal-care products containing microplastics, this study presents a novel approach for their quantitation. The method is suitable for aqueous and hydrocarbon-based products, and includes a rapid sample clean-up involving twofold density separation and a subsequent quantitation with high-temperature gel-permeation chromatography. In contrast with previous procedures, both errors caused by weighing after insufficient separation of plastics and matrix and time-consuming visual sorting are avoided. In addition to reliable quantitative results, in this investigation a comprehensive characterization of the polymer particles isolated from the product matrix, covering size, shape, molecular weight distribution and stabilization, is provided. Results for seven different personal-care products are presented. Recoveries of this method were in the range of 92-96 %. PMID:25410643

Hintersteiner, Ingrid; Himmelsbach, Markus; Buchberger, Wolfgang W

2015-02-01

303

The Effects of Simultaneous Use of Careful Online Planning and Task Repetition on Accuracy, Complexity, and Fluency in EFL Learners' Oral Production  

ERIC Educational Resources Information Center

This article reports on a study that was primarily aimed at investigating the effects of simultaneous use of careful online planning and task repetition on accuracy, complexity, and fluency in the oral production of learners of English as a foreign language (EFL). The effects of four planning and task repetition conditions (i.e. careful online…

Ahmadian, Mohammad Javad; Tavakoli, Mansoor

2011-01-01

304

The Effects of Guided Careful Online Planning on Complexity, Accuracy and Fluency in Intermediate EFL Learners' Oral Production: The Case of English Articles  

ERIC Educational Resources Information Center

The purpose of the study reported in this article was twofold: First, to see whether guided careful online planning assists intermediate learners of English as a foreign language (EFL) in accurate oral production of English articles ("an/a" and "the"); and, second, to see whether guided careful online planning has any effects on global complexity…

Ahmadian, Mohammad Javad

2012-01-01

305

Speckle-correlation analysis of the microcapillary blood circulation in nail bed  

SciTech Connect

We present the results of the experimental studies of the possibility of monitoring the blood microcirculation in human finger nail bed with application of speckle-correlation analysis, based on estimating the contrast of time-averaged dynamic speckles. The hemodynamics at normal blood circulation and under conditions of partially suppressed blood circulation is analysed. A microscopic analysis is performed to visualise the structural changes in capillaries that are caused by suppressing blood circulation. The problems and prospects of speckle-correlation monitoring of the nail bed microhemodynamics under laboratory and clinical conditions are discussed. (optical technologies in biophysics and medicine)

Vilenskii, M A; Agafonov, D N; Zimnyakov, D A; Tuchin, Valerii V; Zdrazhevskii, R A

2011-04-30

306

Effective medium theory for the finite conductivity bed-of-nails structure  

NASA Astrophysics Data System (ADS)

We present and illustrate an effective medium theory of the finite conductivity periodic finite wire medium (the bed-of-nails structure). It is constructed using a renormalization approach to obtain the system of equations satisfied by the electromagnetic field and the electric current in the limit of large wavelength-to-period ratio. The model is tested numerically and its domain of validity is characterized using full vector three dimensional finite element calculations. Bed-of-nails structures exhibit large absorption with small reflection while their low fill factor allows considerable freedom to control other characteristics of the metamaterial such as its mechanical, thermal or chemical robustness.

C?buz, A. I.; Nicolet, A.; Zolla, F.; Felbacq, D.

2009-10-01

307

A longitudinal study to identify the influence of quality of chronic care delivery on productive interactions between patients and (teams of) healthcare professionals within disease management programmes  

PubMed Central

Objective The chronic care model is an increasingly used approach to improve the quality of care through system changes in care delivery. While theoretically these system changes are expected to increase productive patient–professional interaction empirical evidence is lacking. This study aims to identify the influence of quality of care on productive patient–professional interaction. Setting Longitudinal study in 18 Dutch regions. Participants Questionnaires were sent to all 5076 patients participating in 18 Disease Management Programmes (DMPs) in 2010 (2676 (53%) respondents). One year later (T1), 4693 patients still participating in the DMPs received a questionnaire (2191 (47%) respondents) and 2?years later (in 2012; T2) 1722 patients responded (out of 4350; 40% response). Interventions DMPs Primary outcome measure Patients’ perceptions of the productivity of interactions (measured as relational coordination/coproduction of care) with professionals. Patients were asked about communication dimensions (frequent, accurate, and problem-solving communication) and relationship dimensions (shared goals and mutual respect). Findings After controlling for background characteristics these results clearly show that quality of chronic care (T0), first-year changes in quality of chronic care (T1—T0) and second-year changes in quality of chronic care (T2—T1) predicted productive interactions between patients and professionals at T2 (all at p?0.001). Furthermore, we found a negative relationship between lower educational level and productive interactions between patients and professionals 2?years later. Conclusions We can conclude that successfully dealing with the consequences of chronic illnesses requires proactive patients who are able to make productive decisions together with their healthcare providers. Since patients and professionals share responsibility for management of the chronic illness, they must also share control of interactions and decisions. The importance of patient-centeredness is growing and this study reports a first example of how quality of chronic care stimulates productive interactions between patients and professionals. PMID:25239294

Cramm, Jane Murray; Nieboer, Anna Petra

2014-01-01

308

Mom and Baby Skin Care  

MedlinePLUS

... and baby skin care Mom and baby skin care Skin care concerns during and after pregnancy Melasma Also known ... chilled product can help alleviate the itch. Hair care concerns during and after pregnancy Excessive hair growth ...

309

Constructing Men Who Teach: Research into Care and Gender as Productive of the Male Primary Teacher  

ERIC Educational Resources Information Center

This paper argues that in order to begin loosening the ties that bind care and gender in primary education, we need to re-examine the knowledge sought and found by educational research about teachers. The focus is primarily on how we understand men who teach. Through an examination of two scholarly texts -- Ashley, M., and J. Lee [2003.…

Pulsford, Mark

2014-01-01

310

The psychological contract: enhancing productivity and its implicatona for long-term care  

Microsoft Academic Search

When hired, a new employee is usually given a job description and an explanation of benefits. In addition, the employee will also have a psychological contract with the organization. This contract, often unstated, reflects the main source of the employee's motivation to work hard. This is true of all groups of employees, including long-term care staff. Common examples of psychological

Raymond B. Flannery

2002-01-01

311

Comparison of our self-designed rotary self-locking intramedullary nail and interlocking intramedullary nail in the treatment of long bone fractures  

PubMed Central

Objective The purpose of this study is to compare the clinical effects of our self-designed rotary self-locking intramedullary nail (RSIN) and interlocking intramedullary nail (IIN) for long bone fractures. Methods A retrospective study was performed in 1,704 patients who suffered bone fractures and underwent RSIN or IIN operation in our hospital between March 1999 and March 2013, including 494 with femoral fractures, 572 with humeral fractures, and 638 with tibial fractures. Among them, 634 patients were followed up for more than 1 year. The operative time, intraoperative blood loss, postoperative complications, healing rate, and the excellent and good rate of functional recovery were compared between two groups. Results Compared with IIN group, RSIN group exhibited significantly shorter operative time and less intraoperative blood loss no matter for humeral, femoral, or tibial fractures (all p?nail breakage or loosening occurred, but radial nerve injury and incision infection were respectively observed in one patient with humeral fracture. In IIN group, nail breakage or loosening occurred in 7 patients with femoral fractures and 16 patients with tibial fractures, radial nerve injury was observed in 8 patients with humeral fractures, and incision infection was present in 2 patients with humeral fractures and 1 patient with femoral fracture. The complication rate of IIN group was significantly higher than that of RSIN group (p?

2014-01-01

312

Care of the Nails (Course Outline) Cosmetology 2: 9207.01.  

ERIC Educational Resources Information Center

An outline of the materials, equipment, and implements used for manicuring and pedicuring is presented in this course program. A guide to the services in the cosmetology field is laid out in a number of time blocks which cover: the Fingernails (3 hours), Manicure Supplies (2 hours), Manicure Techniques (20 hours), Pedicuring (5 hours), Basic…

Dade County Public Schools, Miami, FL.

313

Lateral fold and partial nail bed excision for the treatment of recurrent ingrown toenails  

PubMed Central

Background Ingrown toenail is one of the most common nail complaints. Although some surgical treatments have been described for relapse cases, frequent recurrence of pain, infection, and poor cosmetic results prompted us to search for an appropriate treatment. Objective This study was aimed at evaluation of our surgical technique of lateral fold and partial nail bed excision for the treatment of recurrent ingrown toenails. Materials and methods We retrospectively reviewed the charts of 138 patients who underwent surgery by lateral fold and partial nail bed excision from 2009 to 2011. The operative technique, results, and long-term outcomes were recorded. Results 131 patients were followed up. 121 patients (92.37%) were cured. 10 patients (7.63%) had recurrent problems in 12 digits (7.06%). Of these, only 6 patients underwent surgery again. Conclusions Lateral fold and partial nail bed excision is a simple, safe, and effective technique for treatment of recurrent ingrown toenails with a low risk of relapse. PMID:22837801

Zhu, Xiaoqiang; Shi, Hengming; Zhang, Lu; Gu, Yan

2012-01-01

314

Electrothermic damage to the nail due to arcing in high-voltage discharge.  

PubMed

The burn effects in high-voltage electrocutions are manifold ranging from inconspicuous marks to deep charring. Apart from lesions caused by direct contact with a live conductor, the victim's body may suffer flash burns from arcing resulting in extensive scattered or confluent heat damage of the skin. In such cases, the nail plates of fingers and toes may undergo thermal changes which up to now have not been mentioned in the pertinent literature. Macroscopically, the nail shows a yellowish discoloration with tiny and closely arranged verruciform elevations. Histologically, the uppermost layer of the nail plate is interspersed with small vacuoles resembling micro-blisters as seen in the corneal layer of common electric marks. The surface of the nail is coated with a thin film of carbonaceous material. Based on an accidental high-voltage electrocution recently observed by the authors, attention is also drawn to the possible occurrence of contact burns from metal objects heated by the current as this finding is usually described only in victims of lightning strikes and not in the context of high-voltage discharges of technical electricity. PMID:24314514

Bielefeld, Lena; Mierdel, Katrin; Pollak, Stefan; Perdekamp, Markus Große

2013-12-10

315

Missing Creases of Distal Finger Joints as a Diagnostic Clue of Nail-Patella Syndrome  

Microsoft Academic Search

Nail-patella syndrome (NPS, OMIM 161200) is an autosomal dominant disorder with a clinical characteristic tetrad consisting of fingernail dysplasia, hypoplastic or absent patellae, bony protuberances of the ilia (iliac horns) and dislocation of the radial head. Kidney involvement may lead to renal failure, and there is an increased risk for glaucoma. Clinical diagnostic skin clues are triangular lunulae especially on

Peter H. Itin; Georg Eich; Susanna K. Fistarol

2006-01-01

316

Quantitative Analysis of Nail Polish Remover Using Nuclear Magnetic Resonance Spectroscopy Revisited  

ERIC Educational Resources Information Center

Substantial modifications are presented for a previously described experiment using nuclear magnetic resonance (NMR) spectroscopy to quantitatively determine analytes in commercial nail polish remover. The revised experiment is intended for a second- or third-year laboratory course in analytical chemistry and can be conducted for larger laboratory…

Hoffmann, Markus M.; Caccamis, Joshua T.; Heitz, Mark P.; Schlecht, Kenneth D.

2008-01-01

317

A meta-analysis of the Gamma nail and dynamic hip screw in treating peritrochanteric fractures  

PubMed Central

The objective of this meta-analysis was to compare the fixation outcome of the Gamma nail and dynamic hip screw (DHS) in treating peritrochanteric fractures. Relevant randomised controlled studies were included, and the search strategy followed the requirements of the Cochrane Library Handbook. Methodological quality was assessed and data were extracted independently. Seven studies involving 1,257 fractures were included which compared the effect of the Gamma nail and DHS. The results showed a higher rate of postoperative femoral shaft fracture with the Gamma nail compared to the DHS [relative risk (RR): 7.27, 95% confidence interval (CI): 2.83–18.70, P?nail over the DHS in treating peritrochanteric fractures. PMID:19401825

Liu, Ming; Yang, Zhiming; Pei, Fuxing; Huang, Fuguo; Chen, Shiqiang

2009-01-01

318

Intramedullary nails vs osteosynthesis plates for femoral fracture stabilization: A finite element analysis.  

PubMed

In diaphyseal femoral fractures, an accurate quantification of the biomechanical differences between implants can help the surgeon make his choice. This study uses the finite element (FE) method to characterize the differences between intramedullary nails and osteosynthesis plates at different stages of femoral fracture healing, and assesses how these differences are affected by the size and consolidation of the fracture. Simulations were performed using a femur model with a 1 and 3 mm diaphyseal fracture at two stages of consolidation. The fracture was stabilized with an osteosynthesis plate or an intramedullary nail made of stainless steel (SS), titanium (Ti) or a composite material. The Ti implants bore lower von Mises stresses ( ó vM ) than the SS implants, and ó vM in the implants decreased with fracture consolidation. Nails tended to bear higher stresses than plates, though these differences were reduced in unstable fractures. This change in trend proves that fixation choice is critical for weak fractures. Both the dilatational stress ó dil and the octahedral shear strain å oct of the fractures varied significantly with the type of fracture and fixation device. In accordance with the literature, our results suggest that plates induce fracture healing through intramembranous ossification without fracture callus formation. Nails, on the other hand, induce endochondral ossification with fibrous tissue formation. The composite implants have mechanical limitations, but increasing their yield stress could overcome these drawbacks. PMID:20799221

Charles-Harris, M; Lacroix, D; Proubasta, I; Planell, J A

2005-01-01

319

[Follow-up results of complications in tibial intramedullary and interlocking nailing].  

PubMed

Faults in the technique of tibial nail locking and possibilities of complications thereafter are numerous, showing that this procedure is also not foolproof. On the basis of the results of follow-up examinations carried out in 42 cases with perioperative and postoperative complications out of a total of 229 patients on whom tibia nail locking was performed in the period from 1987 through 1992, we were able to state that in the learning curve for the initial period the overall rate of complications amounted to as much as 25.5%. After we-like other authors--made routine use of the method of static nail locking the overall rate of complications dropped to 5.6%. Although we cannot confirm an increase in the occurrence of the compartment syndrome on account of static nail locking, we deem it advisable to point to the possibility of this postoperative complications, as well as to the chance of avoiding incomplete healing by early decompression. PMID:7992499

Wallenböck, E; Hasenhüttl, K

1994-01-01

320

Intramedullary nailing of the tibia without a fracture table: the transfixion pin distractor technique.  

PubMed

A series of 44 fractures of the tibia requiring operative stabilization were treated using an intraoperative external transfixion pin frame to correct angular deformity and maintain length in preparation for intramedullary (IM) nailing, eliminating the need for a fracture table. The technique requires a radiolucent operating room table; the injured extremity is draped free. A transfixion pin is inserted in the os calcis. Rotational deformity is manually corrected. Using fluoroscopic control, a second transfixion pin is inserted at a location just distal and parallel to the proximal tibial articular surface, paralleling the horizontal plane of the first pin. The transfixion pins are connected with carbon fiber rods, creating a rectangular frame. Manual fracture reduction is followed by "fine tuning" with compressor/distractor clamps as needed. Alternatively, for added reduction force, the carbon fiber rod on the concave side of the angular deformity may be replaced with the AO/ASIF universal distractor. IM nailing is then performed in the usual fashion. In this series, an acceptable reduction was obtained in all cases. This technique shortens setup time, provides complete access to the distal part of the tibia, and allows free manipulation of the limb, thereby facilitating nail insertion and placement of distal locking screws. Use of medial and lateral bars prevents the angular deformity often created or exacerbated with the use of the universal distractor alone. This technique is recommended for IM nailing of all fractures of the tibia that would otherwise require use of the fracture table or universal distractor. PMID:8027887

Moed, B R; Watson, J T

1994-01-01

321

Forensic DNA typing of human nails at various stages of decomposition  

Microsoft Academic Search

Forensic scientists often face the problem of extracting and typing human DNA from degraded materials such as muscle and bones from decomposed bodies. Bone samples are particularly difficult and time consuming to be analyzed and other body tissues suffer from rapid deterioration. Nails are a well-known source of DNA and their composition makes them less predisposed to decomposition compared to

A. Piccinini; N. Cucurachi; F. Betti; M. Capra; S. Coco; F. D'Avila; R. Lorenzoni; A. Lovisolo

2006-01-01

322

Element profiles in hair and nails of children reflect the uptake from food and the environment.  

PubMed

The present study evaluated if the element profiles in hair and nails of children from the Lake Victoria region in Kenya reflect uptake from food and the environment. To this purpose, the element concentrations in hair and nails were related to element concentrations measured in food items, water, and soil. The highest intake of most elements occurred via ingestion of the fish Rastrineobola argentea, which is consumed in higher quantities than other fish and food items. Element concentrations in hair and nails were correlated to food and soil in element-specific patterns. Multivariate analysis combining principal component analysis and multidimensional scaling enabled us to cluster individuals from specific sites and to relate differences between sites to food-consumption patterns and environmental exposures. Site-specific differences in macroelement concentrations among the children were attributed to patterns of food consumption, while those in microelement concentrations reflected differences in geochemical background. It is concluded that the simultaneous analysis of elements in human hair and nails allows separation of populations based on food consumption and geochemical background. PMID:22553000

Oyoo-Okoth, Elijah; Admiraal, Wim; Osano, Odipo; Kraak, Michiel H S

2012-07-01

323

Osteosynthesis of fractures of the femur with flexible metallic intramedullary nails.  

PubMed

The authors discuss their use of Ender's method in the treatment of fractures of the femur. The diameter and length of the nails depends on the type of fracture. 1) Three nails of 4 mm diameter are introduced in parallel from the medial condyle in fractures of the femoral neck; 2) 5 mm nails are used, in similar fashion, for the fixation of intertrochanteric and subtrochanteric fractures; 3) 5 mm nails are used for diaphyseal, supracondylar and intercondylar fractures, introduced in crossed fashion ("Eiffel Tower" technique) from both medial and lateral condyles. This method of fixation has proved to be extremely stable. The operation itself is quick, with no blood loss or shock. The patient can resume partial weight bearing after a week in stabilised intertrochanteric and shaft fractures, after a month in less stable types, and after three to four months in fractures of the neck of the femur. This report is based on the first 250 cases treated by this method. PMID:753805

Firica, A; Troianescu, O; Petre, M

1978-04-01

324

Genetic and environmental influences on finger-sucking and nail-biting in Japanese twin children.  

PubMed

The purpose of this study was to clarify the genetic contribution to finger-sucking and nail-biting in childhood using the largest databases available on Japanese twins. The subjects were 1131 pairs of 12-year-old twin children, consisting of 1057 males and 1205 females. All data were gathered by maternal questionnaire, and responses to the questionnaire were checked in the medical interview. The prevalence of finger-sucking between 0 to 2 years was 40% in males and 43% in females (p = .0053). The prevalence of nail-biting up until the age of 12 years was 28% in males and 26% in females (nonsignificant). Concordance rates and polychoric correlations were all higher in monozygotic pairs than in dizygotic pairs, irrespective of the sex combination. Univariate and bivariate genetic analyses using structural equation modeling was performed. The results showed that the proportion of total phenotypic variance attributable to genetic influences was 66% in males and 50% in females for finger-sucking, and 50% in both males and females for nail-biting. A co-occurrence of finger-sucking and nail-biting was observed in 17.7% of males (tetrachoric correlation: r = .40) and 15.7% of females (r = .32), which was attributed partly to common genetic or environmental factors. The proportion of total shared variance explained by genetic factors was 67%. PMID:16176716

Ooki, Syuichi

2005-08-01

325

Elastic intramedullary nailing and DBM-Bone marrow injection for the treatment of simple bone cysts  

Microsoft Academic Search

BACKGROUND: Simple or unicameral bone cysts are common benign fluid-filled lesions usually located at the long bones of children before skeletal maturity. METHODS: We performed demineralized bone matrix and iliac crest bone marrow injection combined with elastic intramedullary nailing for the treatment of simple bone cysts in long bones of 9 children with a mean age of 12.6 years (range,

Anastasios D Kanellopoulos; Andreas F Mavrogenis; Panayiotis J Papagelopoulos; Panayotis N Soucacos

2007-01-01

326

Development of a technique for cement augmentation of nailed tibiotalocalcaneal arthrodesis constructs  

Microsoft Academic Search

BackgroundTibiotalocalcaneal arthrodesis with a retrograde nail is an established procedure. Many patients considered for this arthrodesis have poor bone stock, which may make it difficult to obtain construct stability. This study was undertaken to determine whether stability could be enhanced by the cement augmentation of the calcaneal locking screws.

Kajetan Klos; Dirk Wähnert; Boyko Gueorguiev; Karsten Schwieger; Gunther O. Hofmann; Markus Windolf; Thomas Mückley

2010-01-01

327

Docetaxel-induced Nail Changes – A Neurogenic Mechanism: A Case Report  

Microsoft Academic Search

Docetaxel is a new taxoid widely used in chemotherapy for advanced breast cancer and other solid malignancies. Painful nail changes with onycholysis occur in about 40% of docetaxel-treated patients as a prominent adverse effect. We report a patient with a complete peripheral palsy of the right arm due to advanced breast cancer with diffuse tumor infiltration of the brachial plexus.

Gunnar Wasner; Felix Hilpert; Jörn Schattschneider; Andreas Binder; Jacobus Pfisterer; Ralf Baron

2002-01-01

328

Planar fuel cell utilizing nail current collectors for increased active surface area  

DOEpatents

A plurality of nail current collector members are useful in the gas flow passages of an electrochemical device to optimize the active surfaces of the device and to provide structural support. In addition, the thicknesses of cathode and anode layers within the electrochemical device are varied according to current flow through the device to reduce resistance and increase operating efficiency.

George, Thomas J. (Star City, WV); Meacham, G. B. Kirby (Shaker Heights, OH)

2002-03-26

329

3066 consecutive Gamma Nails. 12 years experience at a single centre  

PubMed Central

Background Fixation of trochanteric hip fractures using the Gamma Nail has been performed since 1988 and is today well established and wide-spread. However, a number of reports have raised serious concerns about the implant's complication rate. The main focus has been the increased risk of a subsequent femoral shaft fracture and some authors have argued against its use despite other obvious advantages, when this implant is employed. Through access to a uniquely large patient data base available, which is available for analysis of trochanteric fractures; we have been able to evaluate the performance of the Gamma Nail over a twelve year period. Methods 3066 consecutive patients were treated for trochanteric fractures using Gamma Nails between 1990 and 2002 at the Centre de Traumatologie et de l'Orthopedie (CTO), Strasbourg, France. These patients were retrospectively analysed. Information on epidemiological data, intra- and postoperative complications and patients' outcome was retrieved from patient notes. All available radiographs were assessed by a single reviewer (AJB). Results The results showed a low complication rate with the use of the Gamma Nail. There were 137 (4.5%) intraoperative fracture-related complications. Moreover 189 (6.2%) complications were detected postoperatively and during follow-up. Cut-out of the lag screw from the femoral head was the most frequent mechanical complication (57 patients, 1.85%), whereas a postoperative femoral shaft fracture occurred in 19 patients (0.6%). Other complications, such as infection, delayed healing/non-union, avascular femoral head necrosis and distal locking problems occurred in 113 patients (3.7%). Conclusions The use of the Gamma Nail in trochanteric hip fractures is a safe method with a low complication rate. In particular, a low rate of femoral shaft fractures was reported. The low complication rate reported in this series can probably be explained by strict adherence to a proper surgical technique. PMID:20579384

2010-01-01

330

Abnormal nail fold capillaroscopic findings in patients with coronary slow flow phenomenon  

PubMed Central

The coronary slow flow phenomenon (CSFP) is the delayed opacification of coronary arteries in the absence of significant stenosis. The pathogenesis of CSFP has not been completely understood yet. There are several proposed mechanisms such as the structural and functional abnormalities in coronary microcirculation. Nail fold capillaroscopy is a simple, noninvasive examination of the microvasculature and suggested to be a useful technique for analysis in various inflammatory and autoimmune diseases. In this study; we hypothesized that; CSFP is a part of systemic vascular entity rather than a problem confined to coronary vasculature and our aim was to investigate the nail fold capillaries of the patients with CSFP and compare to those with normal coronary flow (NCF). The study was designed as a case-control study and total 25 patients (10 male, mean age 55 ± 9 years) with documented CSFP, and 24 patients (15 male, mean age 55 ± 11 years) with NCF were recruited. Nail fold capillaroscopy examinations were performed by video dermatoscopy in all patients and results were compared between two groups. The demographic and clinical characteristics were similar between patients of CSFP and NCF groups. Nail fold capillary abnormalities including dilatation, tortuosity and microhemorrhage were present in 15 (60%) patients in CSFP group and 5 (21%) patients in NCF group (p < 0.05 OR: 5.7 95% C.I 1.602-20.279). In this study, we found that the abnormalities in nail fold capillaries suggesting the presence of inflammation and anatomical changes were significantly higher in patients with CSFP. PMID:24955181

Yuksel, Serkan; Pancar Yuksel, Esra; Yenercag, Mustafa; Soylu, Korhan; Zengin, Halit; Gulel, Okan; Meriç, Murat; Aydin, Fatma; Senturk, Nilgun; Sahin, Mahmut

2014-01-01

331

TITANIUM ELASTIC NAIL - COMPLICATIONS IN THE TREATMENT OF PAEDIATRIC DIAPHYSEAL FRACTURE OF FEMUR§  

PubMed Central

Background: Femoral shaft fracture is the most common major paediatric orthopaedic. For generations traction and casting was the standard treatment for all femoral shaft fractures in children. Over the past two decades the advantages of fixation and rapid mobilisation have been increasingly recognised. Methods: A prospective study was conducted in five private hospitals in the district of Bankura, West Bengal over a period of two years (April 2010 to March 2012) on 70 patients with closed shaft femur fractures between 6- 14 years age of either sex. The aim was to find out the short term complications of titanium elastic nailing in diaphyseal fracture of femur in children and compare the findings of this study with pre- existing studies in this field. Results: In our study the most common complication was pain at nail entry site (60%). 5.71% had local inflammatory reaction due to nails. Superficial infection occurred in 2.85%. At the end of 1 year, 2.85% had limb length discripancies. Proximal migration occurred in 2.85%. 2.85% encountered acute reactive synovitis, 5.71% developed angulation of fracture site and 2.85% developed per operative breakage of nail. Conclusion: The treatment of paediatric shaft femur fracture has been drastically changed over the last two decades to internal fixation by elastically stable intra- medullary nail (ESIN). In our study, we encountered only a few complications most of them being minor. Most of the complications were surgical technique related and were seen at the initial phase of the learning curve. PMID:23359222

Sarkar, Saikat; Bandyopadhyay, Ranadeb; Mukherjee, Arindam

2013-01-01

332

Longitudinal erythronychia: individual or multiple linear red bands of the nail plate: a review of clinical features and associated conditions.  

PubMed

Longitudinal erythronychia is a linear red band on the nail plate that originates at the proximal nail fold, traverses the lunula, and extends to the free edge of the nail plate. Longitudinal erythronychia is classified based upon the number of nails affected and the number of red streaks present on each nail as follows: type Ia (monodactylous - single band), type Ib (monodactylous - bifid bands), type IIa (polydactylous - single band), and type IIb (polydactylous - multiple bands). Associated morphologic findings that can be present at the distal tip of the nail with longitudinal erythronychia include fragility, onycholysis, splinter hemorrhage, splitting, subungual keratosis, thinning, and V-shaped nick. Some patients with longitudinal erythronychia seek medical evaluation because of pain in the associated distal digit; however, the linear red nail plate dyschromia is often asymptomatic and the individual is concerned about the cosmetic appearance or distal nail fragility. Longitudinal erythronychia can be a clinical manifestation of an underlying local or systemic condition. Benign tumors (glomus tumor, onychopapilloma, and warty dyskeratoma), malignant neoplasms (malignant melanoma and squamous cell carcinoma), and other conditions (hemiplegia and postsurgical scar) can be associated with monodactylous longitudinal erythronychia or it may be idiopathic or the initial stage of polydactylous longitudinal erythronychia-associated systemic conditions. Polydactylous longitudinal erythronychia is most commonly reported in patients with Darier disease (keratosis follicularis); other associated conditions include acantholytic dyskeratotic epidermal nevus, acantholytic epidermolysis bullosa, acrokeratosis verruciformis of Hopf, amyloidosis, graft-versus-host disease, lichen planus, and pseudobulbar syndrome. Polydactylous longitudinal erythronychia has also been observed as an idiopathic finding. Biopsy of the nail matrix and nail bed may be necessary to establish the diagnosis of a longitudinal erythronychia-associated condition. Indeed, a biopsy should be seriously considered in patients aged more than 50 years who present with a monodactylous longitudinal red band to exclude squamous cell carcinoma. Treatment of longitudinal erythronychia depends on the etiology. For patients with longitudinal erythronychia-associated discomfort or severe nail splitting, a surgical excision may provide not only the underlying diagnosis of the nail dyschromia, but also relief of related symptoms. PMID:21668031

Cohen, Philip R

2011-08-01

333

[An analysis of user satisfaction and of productivity in a primary care model with the participation of physicians and technicians].  

PubMed

To attend health requirements of a poor community nearby Mexico City, the Ministry of Health, implemented an innovative health services model, compounded by allied health personnel (AHP) and general practitioners. The main feature of this model is that the AHP had been involved to provide clinical services in five causes of consultation: upper acute respiratory infections, diarrheal disease, prenatal care, family planning and well-child program. In this paper, the authors analyze the patient's satisfaction and the productivity of this model compared with the conventional one. In order to evaluate patient's satisfaction, 500 patients were interviewed, 300 who were attended by innovative model and 200 who were attended by the traditional one. In both health services models a high percentage (98%) of the patients were satisfied with the attention they received. The productivity analysis showed that the number of consultations given for the five causes mentioned above and for other causes, was higher in the innovative model than in the traditional one. The relevance of the allied health personnel to provide primary care services is discussed. PMID:7892624

Pérez-Cuevas, R; Libreros, V; Reyes, S; Santacruz, J; Alanís, V; Gutiérrez, G

1994-01-01

334

Field dissipation and risk assessment of typical personal care products TCC, TCS, AHTN and HHCB in biosolid-amended soils.  

PubMed

The antimicrobial agents triclocarban (TCC) and triclosan (TCS) and synthetic musks AHTN (Tonalide) and HHCB (Galaxolide) are widely used in many personal care products. These compounds may release into the soil environment through biosolid application to agricultural land and potentially affect soil organisms. This paper aimed to investigate accumulation, dissipation and potential risks of TCC, TCS, AHTN and HHCB in biosolid-amended soils of the three field trial sites (Zhejiang, Hunan and Shandong) with three treatments (CK: control without biosolid application, T1: single biosolid application, T2: repeated biosolid application every year). The one-year monitoring results showed that biosolids application could lead to accumulation of these four chemicals in the biosolid-amended soils, with the residual concentrations in the following order: TCC>TCS>AHTN>HHCB. Dissipation of TCC, TCS, AHTN and HHCB in the biosolid-amended soils followed the first-order kinetics model. Half-lives for TCC, TCS, AHTN and HHCB under the field conditions of Shandong site were 191, 258, 336 and 900 days for T1, and 51, 106, 159 and 83 days for T2, respectively. Repeated applications of biosolid led to accumulation of these personal care products and result in higher ecological risks. Based on the residual levels in the trial sites and limited toxicity data, high risks to soil organisms are expected for TCC and TCS, while low-medium risks for AHTN and HHCB. PMID:24239829

Chen, Feng; Ying, Guang-Guo; Ma, Yi-Bing; Chen, Zhi-Feng; Lai, Hua-Jie; Peng, Feng-Jiao

2014-02-01

335

Part 3 of a 4-part series Lip and Common Dental Care Products: Trends and Alternatives  

PubMed Central

Objective: To provide updated data on the use of ingredients that are common potential contact allergens in several categories of lip and oral products. To identify useful alternative products with few or no common contact allergens. Design: In November 2009, the full ingredient lists of 5,416 skin, hair, and cosmetic products marketed by the CVS pharmacy chain was copied from CVS.com into Microsoft Word format for analysis. Computer searches were made in Microsoft Word using search/replace and sorting functions to accurately identify the presence of specific allergens in each website product. Measurements: Percentages of American Contact Dermatitis Society core series allergens (and other common preservatives) were calculated. Results: The use of American Contact Dermatitis Society core series allergens (and other preservatives) in various categories of lip and oral products are reported. Conclusion: Data on allergens and alternatives for lip and oral products is not widely published. This article reviews some of the common potential allergens in lip liners, lipsticks, lip moisturizers, mouthwashes, and toothpastes. Suitable available alternative products for patients with contact allergy are listed. PMID:21938270

Jacob, Sharon; Katta, Rajani; Nedorost, Susan; Warshaw, Erin; Zirwas, Matt; Kruk, Ann

2011-01-01

336

7 CFR 3201.93 - Leather, vinyl, and rubber care products.  

Code of Federal Regulations, 2013 CFR

...nourish, protect, and restore leather, vinyl, and rubber surfaces, including cleaners, conditioners, protectants, polishes, waxes, etc. (b) Minimum biobased content. The Federal preferred procurement product must have a minimum biobased...

2013-01-01

337

Rapid LC-MS method for the detection of common fragrances in personal care products without sample preparation.  

PubMed

An LC-MS method for the analysis of personal care and household products without sample preparation is presented. The method takes advantage of the Direct-electron ionization (EI) LC-MS interface for the quantitation of principal components, as well as for the identification of unknown or undeclared ingredients. The technique has proven its inertness toward matrix effects and the electron ionization allows quantitation and library identification. Commercially available products (shower gel, perfume, and hand cream) were diluted with methanol and injected directly into a nano-LC column. Limonene, linalool, and citral were selected as target compounds because of their use as fragrances in toiletry and detergent products. These and all other fragrances are commonly determined with GC-MS analysis, prior to sample cleanup, a procedure that can lead to analytes loss. The selected compounds are not detected with ESI because of their poor or very low response. Figures of merit and validation studies were executed and special attention was devoted to matrix-effects evaluation, because a sample preparation procedure is not involved. No matrix effects were observed, and the repeatability was excellent even after several weeks of operation. Products composition was investigated in full scan mode to determine the presence of unknown or not listed ingredients. PMID:24273185

Famiglini, Giorgio; Termopoli, Veronica; Palma, Pierangela; Capriotti, Fabiana; Cappiello, Achille

2014-05-01

338

Influence of Urbanization Level and Gross Domestic Product of Counties in Croatia on Access to Health Care  

PubMed Central

Aim To examine the association of counties’ urbanization level and gross domestic product (GDP) per capita on the access to health care. Methods Counties were divided in two groups according to the urbanization level and GDP per capita in purchasing power standards. The number of physicians per 100?000 inhabitants, the number of physicians in hospitals in four basic specialties, physicians’ workload, average duration of working week, the average number of insurants per general practice (GP) team, and the number of inhabitants covered by one internal medicine outpatient clinic were compared between predominantly urban and predominantly rural counties, and between richer and poorer counties. Our study included only GP teams and outpatients’ clinics under the contract with the Croatian Institute for Health Insurance. Data on physicians were collected from the Ministry of Health and Social Welfare, the Croatian Institute for Health Insurance, the Croatian Institute for Public Health, and the Croatian Medical Chamber. Data on the contracts with the Croatian Institute for Health Insurance and health care services provided under these contracts were obtained from the database of the Institute, while population and gross domestic product data were obtained from the Database of the Croatian Institute for Statistics. World Health Organization Health for All Database was used for the international comparison of physician’s data. Results There was no significant difference in the total number of physicians per 100?000 inhabitants between predominantly urban and predominantly rural counties (206.9?±?41.0 vs 175.4?±?30.3; P?=?0.067, t test) nor between richer and poorer counties (194.5?±?49.8 vs 187.7?±?25.3; P?=?0.703, t test). However, there were significantly fewer GPs per 100?000 inhabitants in rural than urban counties (49.0?±?5.5 vs 56.7?±?4.6; P?=?0.003, t test). GPs in rural counties had more insurants than those working in urban counties (1.749.8?±?172.8 vs 1.540.7?±?106.3; P?=?0.004, t test). The working week of specialists in the four observed specialties in hospitals was longer than the recommended 48 hours a week. Conclusion The lack of physicians, especially in primary health care can lead to a reduced access to health care and increased workload of physicians, predominantly in rural counties, regardless of the counties’ GDP. PMID:18581617

Bagat, Mario; Drakuli?, Velibor; Sekelj Kauzlari?, Katarina; Vlahuši?, Andro; Bili?, Ivica; Matani?, Dubravka

2008-01-01

339

Determining the exposure factors of personal and home care products for exposure assessment.  

PubMed

An accurate understanding of the usage patterns of consumer products is important for realistic exposure assessment. Since such patterns differ by country, a Korean national database for exposure factors is needed. We determined the exposure factors of 10 consumer products (face cleanser, toothpaste, shampoo, hair conditioner, body wash, dish and laundry detergents, fabric deodorizer, antistatic spray, and shoe polish. Field survey staff visited homes and collected product use information by questionnaire. In total, 816 men and 2517 women aged 15 years and older from 2500 households completed the questionnaire. Field technicians also re-visited 85 households to investigate the circumstances of use and the reliability of the questionnaire data. Greater than 97% of the sampled population reported use of toothpaste and shampoo. Hair conditioner, body wash, and face cleanser were used by ~60% of the population and by specific age groups and genders. The amount of consumer products used was comparable between that reported in the questionnaire and that measured directly during house visits, and the ratios of usage amounts ranged from 0.75 to 1.69. The exposure factor data obtained from this study could be useful for regulatory agencies when setting safety guidelines for product use. PMID:25582860

Park, Ji Young; Lee, Kiyoung; Hwang, Yunhyung; Kim, Jin Hee

2015-03-01

340

75 FR 61132 - Certain Steel Nails from the People's Republic of China: Initiation of Antidumping Duty New...  

Federal Register 2010, 2011, 2012, 2013, 2014

...and 19 CFR 351.214(c), the Department received a NSR request from Shanghai Colour Nail Co., Ltd. (``Shanghai Colour''). Shanghai Colour's request was properly made during August 2010, which is the annual anniversary...

2010-10-04

341

Intramedullary nailing for treatment of pathologic femoral fractures due to metastases.  

PubMed

Pathologic fractures of the femur because of bone metastases seriously affect the quality of life of cancer patients. Different surgical options are indicated to achieve a durable and solid fixation, depending on several clinical, prognostic and mechanical factors. Locked intramedullary nailing is currently used to treat pathologic femoral fractures in patients with multiple metastases when the trochanteric region or shaft is mainly involved. This study evaluates intramedullary nailing for treatment of patients with pathologic femoral fractures, focussing on complications, clinical and functional outcomes and survival rates. The series included 80 pathologic fractures treated with a titanium alloy Proximal Nail (Standard or Antirotation) or Lateral Anterograde Femoral Nail (PFN, PFNA or LAFN, Synthes) inserted in a locked static mode. Acrylic cement was used to fill the bone cavity after nail insertion in eight patients; percutaneous cementoplasty was simultaneously performed in 11 cases of severe ipsilateral acetabular osteolysis. Postoperative outcomes focussed on pain relief, postoperative mobility and quality of life and they were analysed retrospectively using QOL-ACD and ECOG. Eleven patients (13.75%) suffered from non-fatal DVT post-surgery, with no pulmonary embolism. Six patients (7.5%) developed superficial wound infections and two patients (2.5%) developed pnaeumonia. There was no loss of reduction, breakage, screw pull out, or hardware or implant failure that required component substitution or revision. Lung histotype and the contemporary presence of cerebral and visceral metastases appeared to be predisposing factors in reducing survival time. All patients attained satisfactory pain relief, early deambulation and a marked clinical improvement during the first 6-10 postoperative months, with gradual worsening thereafter from deterioration of their general condition due to cancer progression. The patients' survival rate was 40% at 1 year, 25% at 2 years and 15% at 3 years. Results confirm that multiple factors related to patients and primary cancer may affect survival rate after femoral fracture. Intramedullary nailing should be indicated for pathologic fractures at femoral diaphysis and metaphysis when cancer is in an advanced stage. This procedure offers good and durable stability, and enables pain relief, early postoperative mobilisation and weight-bearing, thus improving the quality of life of cancer patients. PMID:24119652

Piccioli, Andrea; Rossi, Barbara; Scaramuzzo, Laura; Spinelli, Maria Silvia; Yang, Zuozhang; Maccauro, Giulio

2014-02-01

342

Dynamic osteosynthesis by modified Kuntscher nail for the treatment of tibial diaphyseal fractures  

PubMed Central

Background: We evaluated a series of diaphyseal fractures of the tibia using low-cost, Indian-made modified Kuntscher nail (Daga nail) with the provision of distal locking screw for the management of the tibial diaphyseal fractures. Materials and Methods: One hundred and fifty one consecutive patients with diaphyseal fractures of tibia with 151 fractures who were treated by Daga nail were enrolled. One of the patients who had died because of cancer, and the two patients who were lost to follow-up at 3 months were excluded from the study.Therefore data of 148 patients with one hundred and fortyeight fractures is described. One hundred twenty closed fractures, 20 open Grade I fractures, and eight open Grade II fractures as per Gustilo and Anderson classification were included in this study. One hundred fourteen men and 34 women, with a mean age of 38.4 years, were studied. The result were analysed for Surgical time, duration of hospitalisation, union time, union rate, complication rate, functional recovery and crutch walking time. The fractures were followed at least until the time of solid union. Results: The follow-up period averaged 15 months (range, 6–26 months). Union occurred in 140 cases (94.6%). The mean time to union was 13 weeks for closed fractures,17.8 weeks for Grade I open fractures, and 21.6 weeks for Grade II open fractures. Compartment syndrome occurred in two patients. Superficial infection occurred in five cases of Grade I and II compound fractures. Three closed fractures and one case of Grade I compound fracture required bone grafting for delayed union. Two cases of Grade II compound fracture with nonunion required revision surgery and bone grafting. Twelve cases resulted in acceptable malalignment due to operative technical error. In four cases, the distal screw breakage was seen, but none of these complications interfered with fracture healing. Recovery of joint motion was essentially normal in those patients without knee or ankle injury. Conclusion: Unreamed distally locked dynamic tibial nailing (modified Kuntscher nail/Daga nail) can produce excellent clinical results for diaphyseal tibial fractures. It has the advantages of technical simplicity, minimal cost, user-friendly instrumentation, and a short learning curve. PMID:19838368

Gadegone, Wasudeo M; Salphale, Yogesh S

2009-01-01

343

Causes and treatments of lag screw's cut out after intramedullary nailing osteosinthesis for trochanteric fractures.  

PubMed

Background. Superior cut-out of a lag screw remains a serious complication in the treatment of trochanteric or subtrochanteric fractures and it is related to many factors: the type of fracture, osteoporosis and the stability of fracture reduction. Little is known about the outcome after revision surgery for complications of the gamma nail. We assessed the outcome in patients who had revision surgery because of lag screw's cut out after gamma nailing for a trochanteric fracture.Material and Method. We present a study of 20 consecutive patients who underwent treatment after 20 cut-out of the lag screw ?xation of a trochanteric fracture with Gamma Locking Nail from September 2004 to November 2010. In 16 patients hip prothesis was performed, in 1 the removal of the implant and in 3 the reosteosynthesis. We reviewed 13 patients: 10 total hip arthroplasty, 2 endoprothesis and 1 reosteosynthesis of nail and lag screw (mean follow up: 26 months, mean age: 73 years old), 7 patients died. Patients were reviewed retrospectively by an independent observer. Clinical evaluation was performed, Oxford score and Harris Hip score were measured. X-Ray examination was performed after a minimum of 12 months of follow up.Results. Mean Harris Hip Score mean was 67 and mean Oxford score was 32 in hip prothesis group (12 patients). We had several complications, Implant-related complications were: 2 ipometria > 2cm, 2 recurrent hip arthroplasty dislocations (1 reoperated), 4 persistent thigh pain. In only 4 patients none complications were observed. Another patient,  who had been subjected to reosteosinthesis, obtained better results (HHS:95, Oxford score:45) but with a 2 cm ipometria and occasional pain in the thigh.Conclusion. Cut out after gamma nail is consequent to biological or mechanical causes. Treatment of this complication is hip prosthesis (parzial or total hip arthroplasty), reosteosynthesis of the lag screw and/or the nail and the removal of the implant. Conversion to total/parzial hip arthroplasty may be a demanding operation with a higher complication rate respect to the standard, while reosteosynthesis is possible in selected patients and early cutting out. PMID:25245649

Gazzotti, Gabriele; Matino, Giovanni; Tsatsis, Christos; Sacchetti, GianLuigi; Baudi, Paolo; Catani, Fabio

2014-01-01

344

Prenatal Care  

MedlinePLUS

... Our ePublications > Prenatal care fact sheet ePublications Prenatal care fact sheet Print this fact sheet Prenatal care ... More information on prenatal care What is prenatal care? Prenatal care is the health care you get ...

345

The Low Keratin Affinity of Efinaconazole Contributes to Its Nail Penetration and Fungicidal Activity in Topical Onychomycosis Treatment  

PubMed Central

Onychomycosis is a common fungal nail disease that is difficult to treat topically due to the deep location of the infection under the densely keratinized nail plate. Keratin affinity of topical drugs is an important physicochemical property impacting therapeutic efficacy. To be effective, topical drugs must penetrate the nail bed and retain their antifungal activity within the nail matrix, both of which are adversely affected by keratin binding. We investigated these properties for efinaconazole, a new topical antifungal for onychomycosis, compared with those of the existing topical drugs ciclopirox and amorolfine. The efinaconazole free-drug concentration in keratin suspensions was 14.3%, significantly higher than the concentrations of ciclopirox and amorolfine, which were 0.7% and 1.9%, respectively (P < 0.001). Efinaconazole was released from keratin at a higher proportion than in the reference drugs, with about half of the remaining keratin-bound efinaconazole removed after washing. In single-dose in vitro studies, efinaconazole penetrated full-thickness human nails into the receptor phase and also inhibited the growth of Trichophyton rubrum under the nail. In the presence of keratin, efinaconazole exhibited fungicidal activity against Trichophyton mentagrophytes comparable to that of amorolfine and superior to that of ciclopirox. In a guinea pig onychomycosis model with T. mentagrophytes infection, an efinaconazole solution significantly decreased nail fungal burden compared to that of ciclopirox and amorolfine lacquers (P < 0.01). These results suggest that the high nail permeability of efinaconazole and its potent fungicidal activity in the presence of keratin are related to its low keratin affinity, which may contribute to its efficacy in onychomycosis. PMID:24752277

Sugimoto, Noriaki; Hosaka, Shinya; Katafuchi-Nagashima, Maria; Arakawa, Yoshio; Tatsumi, Yoshiyuki; Jo Siu, William; Pillai, Radhakrishnan

2014-01-01

346

The use of a retrograde fixed-angle intramedullary nail for tibiocalcaneal arthrodesis after severe loss of the talus  

Microsoft Academic Search

Tibiocalcaneal arthrodesis may be the only means of obtaining a painless and stable limb when there is loss of the talus.\\u000a We present the early results of a prospective study on tibiocalcaneal arthrodesis using a latest-generation retrograde intramedullary\\u000a nail. In the period 2006–2007, nine patients underwent tibiocalcaneal arthrodesis with retrograde intramedullary nailing.\\u000a Five of these patients had infection-related loss of

Kajetan Klos; Thomas Drechsel; Florian Gras; Claudia Beimel; Andreas Tiemann; Gunther O. Hofmann; Thomas Mückley

2009-01-01

347

The low keratin affinity of efinaconazole contributes to its nail penetration and fungicidal activity in topical onychomycosis treatment.  

PubMed

Onychomycosis is a common fungal nail disease that is difficult to treat topically due to the deep location of the infection under the densely keratinized nail plate. Keratin affinity of topical drugs is an important physicochemical property impacting therapeutic efficacy. To be effective, topical drugs must penetrate the nail bed and retain their antifungal activity within the nail matrix, both of which are adversely affected by keratin binding. We investigated these properties for efinaconazole, a new topical antifungal for onychomycosis, compared with those of the existing topical drugs ciclopirox and amorolfine. The efinaconazole free-drug concentration in keratin suspensions was 14.3%, significantly higher than the concentrations of ciclopirox and amorolfine, which were 0.7% and 1.9%, respectively (P < 0.001). Efinaconazole was released from keratin at a higher proportion than in the reference drugs, with about half of the remaining keratin-bound efinaconazole removed after washing. In single-dose in vitro studies, efinaconazole penetrated full-thickness human nails into the receptor phase and also inhibited the growth of Trichophyton rubrum under the nail. In the presence of keratin, efinaconazole exhibited fungicidal activity against Trichophyton mentagrophytes comparable to that of amorolfine and superior to that of ciclopirox. In a guinea pig onychomycosis model with T. mentagrophytes infection, an efinaconazole solution significantly decreased nail fungal burden compared to that of ciclopirox and amorolfine lacquers (P < 0.01). These results suggest that the high nail permeability of efinaconazole and its potent fungicidal activity in the presence of keratin are related to its low keratin affinity, which may contribute to its efficacy in onychomycosis. PMID:24752277

Sugiura, Keita; Sugimoto, Noriaki; Hosaka, Shinya; Katafuchi-Nagashima, Maria; Arakawa, Yoshio; Tatsumi, Yoshiyuki; Jo Siu, William; Pillai, Radhakrishnan

2014-07-01

348

X-ray fluorescence measurements of arsenic micro-distribution in human nail clippings using synchrotron radiation.  

PubMed

Arsenic (As) distribution in nail clippings from three healthy human subjects was investigated using the microbeam experimental setup of the hard x-ray micro-analysis (HXMA) beamline from the Canadian Light Source (CLS) synchrotron. A pair of toenail and fingernail clippings was collected from each of three subjects (one contributed two fingernail clippings). The fingernail and toenail clippings were embedded in polyester resin and cut in cross-sectional slices with an average thickness of 270 µm. Nine nail clipping cross sections were analyzed from the three subjects. The same method was used to produce five cross sections of nail phantom clippings with concentrations of As ranging from 0 to 20 µg g?1, in increments of 5 µg g?1. These samples were used to produce a calibration line for the As K? peak. The energy of the x-ray beam was set at 13 keV for optimal excitation of As and the beam size was 28 × 10 µm2. Each sample was analyzed using a point-by-point scanning technique in a 45° beam-sample and 90° beam-detector geometry. The dwelling time was set at 30 s for the human nail clippings and 20 s for the nail phantom clippings, using a step size of 50 µm in both the horizontal and vertical directions for all samples. As concentration for each point was calculated based on the calibration line parameters and the fitted amplitude of the observed As K? peak. As concentration maps were produced for each nail clipping cross section. The maps show that small regions (<0.1 mm2) with higher As concentrations (>1 µg g?1) are located predominantly in the ventral and dorsal layers of the nail. The results are in agreement with findings reported in a recent study and can be linked to nail histology and keratin structure. PMID:24137704

Gherase, Mihai R; Desouza, Elstan D; Farquharson, Michael J; McNeill, Fiona E; Kim, Chang-Yong; Fleming, David E B

2013-09-01

349

Caring Teachers and Symbolic Violence: Engaging the Productive Struggle in Practice and Research  

ERIC Educational Resources Information Center

Symbolic violence may not be a desirable theory to apply to public schooling--its structuralist limitations render it deterministic, lacking in human agency, and unpalatable to researchers and educators who see schools as viable and productive sites of social transformation. Perhaps for these reasons, it seems little has been written about…

Scott, Brigitte C.

2012-01-01

350

Frequency and longitudinal trends of household care product use Rebecca E. Moran a  

E-print Network

SUPERB Indoor environment d-limonene a b s t r a c t The use of household cleaning products and air infiltrating to the indoor environment to form potentially toxic secondary pollutants. Although realistic, pesticides and other semi-volatile compounds that partition into dust in homes (Bennett and Furtaw, 2004

Leistikow, Bruce N.

351

Simultaneous assessment of arsenic and selenium in human nail phantoms using a portable x-ray tube and a detector.  

PubMed

A novel approach to the measurement of arsenic and selenium in nail phantoms is demonstrated. Two-component nail phantoms of 0.7 mm and 1.5 mm thickness were made from a polyester resin-salt mixture and dosed with equal arsenic and selenium concentrations ranging from 0 to 30 microg g(-1). A backing was made to simulate the soft tissue and bone of the great toe. Characteristic x-rays for arsenic and selenium were recorded using a portable x-ray tube and a silicon PiN diode detector. The minimum instrumental detection limits for arsenic and selenium in 0.7 mm solitary nail samples were as follows: 0.510 +/- 0.018 microg g(-1) and 0.519 +/- 0.026 microg g(-1) respectively; for 1.5 mm solitary nail: 0.465 +/- 0.035 microg g(-1) and 0.561 +/- 0.062 microg g(-1); for 0.7 mm nail with backing: 1.522 +/- 0.038 microg g(-1) and 1.401 +/- 0.049 microg g(-1); for 1.5 mm nail with backing: 1.354 +/- 0.054 microg g(-1) and 1.367 +/- 0.068 microg g(-1). PMID:20182007

Roy, Christopher W; Gherase, Mihai Raul; Fleming, David E B

2010-03-21

352

Prioritising chemicals used in personal care products in China for environmental risk assessment: application of the RAIDAR model.  

PubMed

China represents a significant market for the sale of personal care products (PCPs). Given the continuous emission of hundreds of chemicals used in PCPs to waste water and the aquatic environment after regular use, methods for prioritising the environmental risk assessment for China are needed. In an effort to assess the prioritisation of chemicals used in PCPs in China, we have identified the chemical ingredients used in 2500 PCPs released to the Chinese market in 2009, and estimated the annual emission of these chemicals. The physical-chemical property data for these substances have been estimated and used as model inputs in the RAIDAR model. In general, the RAIDAR model provides an overall assessment of the multimedia fate of chemicals, and provides a holistic approach for prioritising chemical ingredients. The prioritisation exercise conducted in this study is shown to be strongly influenced by loss processes, such as the removal efficiencies of WWT plants and biotransformation. PMID:22265345

Gouin, Todd; van Egmond, Roger; Price, Oliver R; Hodges, Juliet E N

2012-06-01

353

Sources, distribution and potential risks of pharmaceuticals and personal care products in Qingshan Lake basin, Eastern China.  

PubMed

In this study, we examined the occurrence and distribution of 12 selected pharmaceutical and personal care products (PPCPs) in Qingshan Lake basin and evaluated their potential ecological risks. Caffeine was the dominant compound among all selected PPCPs in the aqueous phase (23.8-344.7ng/L). Sediment release contributed minimally to caffeine levels found in the aqueous phase of Qingshan Lake. Concentrations of selected PPCPs in dry season water samples were generally higher than those in the water samples obtained during the wet or median water seasons. The risks of residual caffeine in water on aqueous organisms was minimal (risk quotient values below 0.01). Sulfamethoxazole and triclocarban posed the highest environmental risks despite their low concentrations (below 25ng/L in water and 10?g/kg in sediment) in Qingshan Lake basin. The risks produced by selected PPCPs in sediments were generally higher than in the aqueous phase. PMID:23871206

Zhu, Saichang; Chen, Hong; Li, Jianan

2013-10-01

354

Trends in monitoring pharmaceuticals and personal-care products in the aquatic environment by use of passive sampling devices  

USGS Publications Warehouse

The use of passive sampling in monitoring pharmaceuticals and personal-care products (PPCPs) in the aquatic environment is discussed. The utility of passive sampling methods for monitoring the fraction of heavy metals and the biologically available fraction of non-polar organic priority pollutants is recognized and these technologies are being used in surveys of water quality. These devices are used to measure the dissolved fraction and they can yield information that can be used in the development of risk assessments models. These devices can also be used to locate illegal damping and to monitor specific sources of input of PPCPs into the environment, or to monitor the effectiveness of water treatment processes in the removal of these compounds from wastewater. These devices can provide representative information at low cost which necessitate a combination of laboratory calibration and field studies for emerging pollutants.

Mills, G.A.; Vrana, B.; Allan, I.; Alvarez, D.A.; Huckins, J.N.; Greenwood, R.

2007-01-01

355

Occurrence and source apportionment of pharmaceuticals and personal care products in the Beiyun River of Beijing, China.  

PubMed

This work investigates, for the first time, the occurrence and sources of 15 pharmaceuticals and personal care products (PPCPs) in surface water of Beijing, one of most densely populated cities in the world, in three sampling events representing different seasonal flow conditions. The detection frequencies of most PPCPs were in the range of 50-100%. The median concentrations of the selected PPCPs ranged from not detected to 4200ngL(-1) (caffeine). Generally, higher PPCP levels were observed in early spring, indicating both low flow condition and cold-water temperature might enhance their persistence. Source apportionment showed freshly discharged untreated sewage (67%) significantly contributed to the PPCP burden in the Beiyun River, which provides important information for environmental management. PMID:25303665

Dai, Guohua; Wang, Bin; Huang, Jun; Dong, Rui; Deng, Shubo; Yu, Gang

2015-01-01

356

Characterisation and comparison of the uptake of ionizable and polar pesticides, pharmaceuticals and personal care products by POCIS and Chemcatchers.  

PubMed

Growing concern about the environmental impact of ionizable and polar organic chemicals such as pesticides, pharmaceuticals and personal care products has lead to the inclusion of some in legislative and regulatory frameworks. It is expected that future monitoring requirements for these chemicals in aquatic environments will increase, along with the need for low cost monitoring and risk assessment strategies. In this study the uptake of 13 neutral and 6 ionizable pesticides, pharmaceuticals and personal care products by modified POCIS (with Strata™-X sorbent) and Chemcatchers™ (SDB-RPS or SDB-XC) was investigated under controlled conditions at pH = 6.5 for 26 days. The modified POCIS and Chemcatcher™ (SDB-RPS) samplers exhibited similar performance with the uptake of the majority of the 19 chemicals of interest categorised as linear over the 26 day deployment. Only a few ionized herbicides (picloram and dicamba) and triclosan showed negligible accumulation. Chemcatcher™ with SDB-XC sorbent performed relatively poorly with only carbamazepine having a linear accumulation profile, and 8 compounds showing no measurable accumulation. Differences in the uptake behavior of chemicals were not easily explained by their physico-chemical properties, strengthening the requirement for detailed calibration data. PES membranes accumulated significant amount of some compounds (i.e. triclosan and diuron), even after extended deployment (i.e. 26 days). At present there is no way to predict which compounds will demonstrate this behavior. Increasing membrane pore size from 0.2 to 0.45 ?m for Chemcatcher™ (SBD-RPS) caused an average increase in Rs of 24%. PMID:25208684

Kaserzon, S L; Hawker, D W; Kennedy, K; Bartkow, M; Carter, S; Booij, K; Mueller, J F

2014-11-01

357

Advancement in shampoo (a dermal care product): preparation methods, patents and commercial utility.  

PubMed

Shampoo is a cleaning aid for hair and is the most evolving beauty products in the present scenario. Today's shampoo products are of great importance as they provide cleaning of hair with the benefits of conditioning, smoothing and good health of hair i.e. dandruff, dirt, grease and lice free hair. Various types of shampoos depending upon function, nature of ingredient, and their special effects are elaborated in this study. Generally shampoos are evaluated in terms of physical appearance, detergency, surface tension, foam quality, pH, viscosity, and percent of solid content, flow property, dirt dispersion, cleaning action, stability and wetting time. The attention should be paid at its patent portion which attracts towards itself as it provides wide knowledge related to shampoo. This article reviews the various aspects of shampoo in terms of preparation methods, various patents and commercial value. PMID:24433548

Deeksha; Malviya, Rishabha; Sharma, Pramod K

2014-01-01

358

Business oriented EU human cell and tissue product legislation will adversely impact Member States' health care systems.  

PubMed

The transplantation of conventional human cell and tissue grafts, such as heart valve replacements and skin for severely burnt patients, has saved many lives over the last decades. The late eighties saw the emergence of tissue engineering with the focus on the development of biological substitutes that restore or improve tissue function. In the nineties, at the height of the tissue engineering hype, industry incited policymakers to create a European regulatory environment, which would facilitate the emergence of a strong single market for tissue engineered products and their starting materials (human cells and tissues). In this paper we analyze the elaboration process of this new European Union (EU) human cell and tissue product regulatory regime-i.e. the EU Cell and Tissue Directives (EUCTDs) and the Advanced Therapy Medicinal Product (ATMP) Regulation and evaluate its impact on Member States' health care systems. We demonstrate that the successful lobbying on key areas of regulatory and policy processes by industry, in congruence with Europe's risk aversion and urge to promote growth and jobs, led to excessively business oriented legislation. Expensive industry oriented requirements were introduced and contentious social and ethical issues were excluded. We found indications that this new EU safety and health legislation will adversely impact Member States' health care systems; since 30 December 2012 (the end of the ATMP transitional period) there is a clear threat to the sustainability of some lifesaving and established ATMPs that were provided by public health institutions and small and medium-sized enterprises under the frame of the EUCTDs. In the light of the current economic crisis it is not clear how social security systems will cope with the inflation of costs associated with this new regulatory regime and how priorities will be set with regard to reimbursement decisions. We argue that the ATMP Regulation should urgently be revised to focus on delivering affordable therapies to all who are in need of them and this without necessarily going to the market. The most rapid and elegant way to achieve this would be for the European Commission to publish an interpretative document on "placing on the market of ATMPs," which keeps tailor-made and niche ATMPs outside of the scope of the medicinal product regulation. PMID:24052113

Pirnay, Jean-Paul; Vanderkelen, Alain; De Vos, Daniel; Draye, Jean-Pierre; Rose, Thomas; Ceulemans, Carl; Ectors, Nadine; Huys, Isabelle; Jennes, Serge; Verbeken, Gilbert

2013-12-01

359

Outcome of compartment syndrome following intramedullary nailing of tibial diaphyseal fractures.  

PubMed

Seventeen cases of compartment syndrome were treated in a group of 626 consecutive patients with tibial diaphyseal fractures. Clinical and radiological follow-up was performed at an average of 24 months (range 8-54 months). Functional outcome was assessed using Edward's classification. All patients who developed compartment syndrome had fracture stabilisation with a reamed intramedullary nail using skeletal traction. The average interval between the nailing procedure and fasciotomy was 11 h. Results were good in 10 cases, fair in four cases and poor in the remaining three cases. Patients who had decompression within 12 h had a good functional outcome. Patients with poor results were all treated at an interval greater than 24 h. PMID:11382428

Mullett, H; Al-Abed, K; Prasad, C V; O'Sullivan, M

2001-06-01

360

Radiation exposure to the surgeon during femoral interlocking nailing under fluoroscopic imaging.  

PubMed

Femoral interlocking nailing requires fluoroscopic assistance for insertion of the nail and distal screws. In this study, scattered radiation to the eye and hand of the operating surgeon was measured during the procedure. Thermo-luminescent dosimeter (TLD) was used to quantify the dose received by the surgeon. The mean radiation exposure time during the procedure was 3.89 minutes. The mean scattered radiation doses to the hand and eye were 0.27 mSv and 0.09 mSv per procedure respectively. These very low doses have made a surgeon very unlikely to receive more than the recommended annual dose limit set by the National Council on Radiological Protection. PMID:16381279

Muzaffar, T S Tengku; Imran, Y; Iskandar, M A; Zakaria, A

2005-07-01

361

Titanium elastic nails for pediatric femur fractures: lessons from the learning curve.  

PubMed

Traditionally, the treatment of choice in managing pediatric femur fractures has been traction and casting. Newer methods have focused on earlier mobility and shorter hospitalization. Use of retrograde titanium elastic nails (TENs) can quicken stabilization while allowing enough motion at the fracture site to generate excellent callus. Since TENs were first introduced in North America, our Level 1 Pediatric Trauma Center has prospectively followed all of its TEN patients. In this article, we present lessons from the learning curve of our first 50 cases--focusing on complications and their prevention. In the course of obtaining predominately excellent results, we have learned several important principles regarding TEN preoperative planning, operative technique, and aftercare. The most common problem encountered has been irritation at the nail insertion site (18% of cases). Very proximal fractures may be more challenging; unstable fractures and fractures in larger, older children are best managed with a short period of adjunctive immobilization. PMID:11876280

Flynn, John M; Luedtke, Lael; Ganley, Theodore J; Pill, Stephan G

2002-02-01

362

Sclerosing osteomyelitis of Garré: management of femoral pain by intramedullary nailing.  

PubMed

We describe a case of chronic sclerosing osteomyelitis of Garré in a 50-year-old woman occurring in her right femur and presenting with uncontrolled pain. The patient was initially treated with intramedullary reaming of the femur, but 3?years later re-presented with similar symptoms. This required further reaming and intramedullary nailing, achieving good clinical outcomes and lasting pain relief at 8-year follow-up. PMID:25538212

Vannet, Nicola Bader; Williams, Huw L M; Healy, Brendan; Morgan-Jones, Rhidian

2014-01-01

363

Compression nailing for posttraumatic rotational femoral deformities: open versus minimally invasive technique  

Microsoft Academic Search

Between January 1996 and December 1999, we performed 30 derotational osteotomies with compression nailing in 29 patients. In 18 cases (group 1), we used an intramedullary saw (minimally invasive technique), and in 12 cases (group 2), we used a conventional open technique. Follow-up included clinical, conventional radiological, and computer tomographical assessment. The mean angle of derotation was 28.6±12.3° in group

Thomas Mückley; Christian Lerch; Oliver Gonschorek; Ivan Marintschev; Volker Bühren; Gunther O. Hofmann

2005-01-01

364

Mutations in Frizzled 6 cause isolated autosomal-recessive nail dysplasia.  

PubMed

Inherited and isolated nail malformations are rare and heterogeneous conditions. We identified two consanguineous pedigrees in which some family members were affected by isolated nail dysplasia that suggested an autosomal-recessive inheritance pattern and was characterized by claw-shaped nails, onychauxis, and onycholysis. Genome-wide SNP array analysis of affected individuals from both families showed an overlapping and homozygous region of 800 kb on the long arm of chromosome 8. The candidate region spans eight genes, and DNA sequence analysis revealed homozygous nonsense and missense mutations in FZD(6), the gene encoding Frizzled 6. FZD(6) belongs to a family of highly conserved membrane-bound WNT receptors involved in developmental processes and differentiation through several signaling pathways. We expressed the FZD(6) missense mutation and observed a quantitative shift in subcellular distribution from the plasma membrane to the lysosomes, where the receptor is inaccessible for signaling and presumably degraded. Analysis of human fibroblasts homozygous for the nonsense mutation showed an aberrant response to both WNT-3A and WNT-5A stimulation; this response was consistent with an effect on both canonical and noncanonical WNT-FZD signaling. A detailed analysis of the Fzd(6)(-/-) mice, previously shown to have an altered hair pattern, showed malformed claws predominantly of the hind limbs. Furthermore, a transient Fdz6 mRNA expression was observed in the epidermis of the digital tips at embryonic day 16.5 during early claw morphogenesis. Thus, our combined results show that FZD6 mutations can result in severe defects in nail and claw formation through reduced or abolished membranous FZD(6) levels and several nonfunctional WNT-FZD pathways. PMID:21665003

Fröjmark, Anne-Sophie; Schuster, Jens; Sobol, Maria; Entesarian, Miriam; Kilander, Michaela B C; Gabrikova, Dana; Nawaz, Sadia; Baig, Shahid M; Schulte, Gunnar; Klar, Joakim; Dahl, Niklas

2011-06-10

365

Complications and Functional Recovery in Treatment of Femoral Shaft Fractures with Unreamed Intramedullary Nailing  

PubMed Central

ABSTRACT Introduction: Fracture of the femoral shaft is a common fracture encountered in orthopedic practice. In the 1939, Küntscher introduced the concept of intramedullary nailing for stabilization of long bone fractures. Intramedullary nailing has revolutionized the treatment of fractures. Material and methods: The study included 37 male patients and 13 female patients, averaged 39±20,5 years (range, 16 to 76 years). Results and discussion: There were 31 left femurs and 21 right femurs fractured. 46 fractures were the result of blunt trauma. Low energy trauma was the cause of fractures in six patients, of which five in elderly females. 49 fractures were closed. Healing time given in weeks was 19,36 ± 6,1. The overall healing rate was 93,6%. There were three (6,25%) major complications nonunion. There were one (2%) delayed union, one (2%) rotational malunion and no infection. The shortening of 1 cm were in two patients. Antercurvatum of 10 degrees was found in one patient. There was no statistically significant reduction of a motion in the hip and knee (p<0.05). There was statistically significant in the thigh (knee extensors) muscle weakness (p<0.001). Conclusion: Intramedullary nailing is the treatment of choice for femoral shaft fractures. PMID:24783908

Sadic, Sahmir; Custovic, Svemir; Smajic, Nedim; Fazlic, Mirsad; Vujadinovic, Aleksandar; Hrustic, Asmir; Jasarevic, Mahir

2014-01-01

366

Hindfoot Valgus following Interlocking Nail Treatment for Tibial Diaphysis Fractures: Can the Fibula Be Neglected?  

PubMed Central

Purpose. We evaluated whether intramedullary nail fixation for tibial diaphysis fractures with concomitant fibula fractures (except at the distal one-third level) managed conservatively with an associated fibula fracture resulted in ankle deformity and assessed the impact of the ankle deformity on lower extremity function. Methods. Sixty middle one-third tibial shaft fractures with associated fibular fractures, except the distal one-third level, were included in this study. All tibial shaft fractures were anatomically reduced and fixed with interlocking intramedullary nails. Fibular fractures were managed conservatively. Hindfoot alignment was assessed clinically. Tibia and fibular lengths were compared to contralateral measurements using radiographs. Functional results were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Foot and Ankle Disability Index Score (FADI). Results. Anatomic union, defined as equal length in operative and contralateral tibias, was achieved in 60 fractures (100%). Fibular shortening was identified in 42 fractures (68%). Mean fibular shortening was 1.2?cm (range, 0.5–2?cm). Clinical exams showed increased hindfoot valgus in 42 fractures (68%). The mean KOOS was 88.4, and the mean FADI score was 90. Conclusion. Fibular fractures in the middle or proximal one-third may need to be stabilized at the time of tibial intramedullary nail fixation to prevent development of hindfoot valgus due to fibular shortening. PMID:25544899

Uzun, Metin; Kara, Adnan; Ada?, Müjdat; Karslio?lu, Bülent; Bülbül, Murat; Beksaç, Burak

2014-01-01

367

Outcomes of Geriatric Hip Fractures Treated with AFFIXUS Hip Fracture Nail  

PubMed Central

Geriatric hip fractures are one of the commonest fractures worldwide. The purpose of this study was to report the outcomes of a series of unstable geriatric hip fractures treated with AFFIXUS hip fracture nail. A retrospective study of 100 unstable geriatric hip fractures treated with AFFIXUS hip fracture nail is presented. The mean follow-up duration was 8 months (range 3–32). Of the patients 83% were female. The average age was 85 years. The fracture was treated by closed reduction and intramedullary fixation. The mean acute hospital stay was 17.6 days. Systemic complications occurred in 29 patients (29%) and local complications in 3 patients (3%) including lag screw cutout in one patient (1%), lag screw backout in one patient (1%), and deep infection in one patient (1%). Mechanical failures and periprosthetic fractures were not observed in our series. Fractures united in all patients. Preinjury activity level was recovered in 78% of the patients. The results of AFFIXUS hip fracture nail were satisfactory in most elderly patients. The unique design of the lag screw and its thread spacing had effectively reduced cut-out rate. PMID:25580303

Mabrouk, Ahmed; Madhusudan, Mysore; Waseem, Mohammed; Kershaw, Steven

2014-01-01

368

Multi-modal intra-operative navigation during distal locking of intramedullary nails.  

PubMed

The interlocking of intramedullary nails is a technically demanding procedure which involves a considerable amount of X-ray acquisitions; one study lists as many as 48 to successfully complete the procedure and fix screws into 4-6mm distal holes of the nail. We propose to design an augmented radiolucent drill to assist surgeons in completing the distal locking procedure without any additional X-ray acquisitions. Using an augmented reality fluoroscope that coregisters optical and X-ray images, we exploit solely the optical images to detect the augmented radiolucent drill and estimate its tip position in real-time. Consequently, the surgeons will be able to maintain the down the beam positioning required to drill the screws into the nail holes successfully. To evaluate the accuracy of the proposed augmented drill, we perform a preclinical study involving 6 surgeons and ask them to perform distal locking on dry bone phantoms. Surgeons completed distal locking 98.3% of the time using only a single X-ray image with an average navigation time of 1.4 0.9 min per hole. PMID:25296403

Diotte, Benoit; Fallavollita, Pascal; Wang, Lejing; Weidert, Simon; Euler, Ekkehard; Thaller, Peter; Navab, Nassir

2014-10-01

369

The Retrograde Tibial Nail: presentation and biomechanical evaluation of a new concept in the treatment of distal tibia fractures.  

PubMed

Displaced distal tibia fractures require stable fixation while minimizing secondary damage to the soft tissues by the surgical approach and implants. Antegrade intramedullary nailing has become an alternative to plate osteosynthesis for the treatment of distal metaphyseal fractures over the past two decades. While retrograde intramedullary nailing is a standard procedure in other long bone fractures, only few attempts have been made on retrograde nailing of tibial fractures. The main reasons are difficulties of finding an ideal entry portal and the lack of an ideal implant for retrograde insertion. The Retrograde Tibial Nail (RTN) is a prototype intramedullary implant developed by our group. The implant offers double proximal and triple distal interlocking with an end cap leading to an angle-stable screw-nail construct of the most distal interlocking screw. Its design meets the requirements of a minimally invasive surgical approach, with a stable fracture fixation by multiple locking options. The 8mm diameter curved nail, with a length of 120 mm, is introduced through an entry portal at the medial malleolus. We see possible indications for the RTN in far distal tibial shaft fractures, distal extraarticular metaphyseal tibial fractures and in distal tibia fractures with simple extension into the ankle joint when the nail is combined lag screw fixation. A biomechanical comparison of the current RTN prototype against antegrade nailing (Expert Tibial Nail, Synthes(®), ETN) was performed. Both implants were fixed with double proximal and triple distal interlocking. Seven biomechanical composite tibiae were treated with either osteosynthesis techniques. A 10mm defect osteotomy 40 mm proximal to the joint line served as an AO 43-A3 type distal tibial fracture model. The stiffness of the implant-bone constructs was measured under low and high extra-axial compression (350 and 600 N) and under torsional load (8 Nm). Results show a comparable stability during axial loading for the two implant types with slightly higher stability in the RTN group. Rotational stability was superior for the RTN. Statistical analysis proved a significant difference (p<0.05) between the ETN and RTN for rotational stability. This study suggests that retrograde tibia nailing with the RTN is a promising new concept for the treatment of distal tibia fractures. PMID:24225228

Kuhn, Sebastian; Appelmann, Philipp; Pairon, Philip; Mehler, Dorothea; Rommens, Pol M

2014-01-01

370

Occurrence of herbicides and pharmaceutical and personal care products in surface water and groundwater around Liberty Bay, Puget Sound, Washington  

USGS Publications Warehouse

Organic contaminants, such as pharmaceuticals and personal care products (PPCPs), pose a risk to water quality and the health of ecosystems. This study was designed to determine if a coastal community lacking point sources, such as waste water treatment plant effluent, could release PPCPs, herbicides, and plasticizers at detectable levels to their surface water and groundwater. Research was conducted in Liberty Bay, an embayment within Puget Sound, where 70% of the population (?10,000) uses septic systems. Sampling included collection of groundwater and surface water with grab samples and the use of polar organic chemical integrative samplers (POCIS). We analyzed for a broad spectrum of 25 commonly used compounds, including PPCPs, herbicides, and a flame retardant. Twelve contaminants were detected at least once; only N,N-diethyl-meta-toluamide, caffeine, and mecoprop, a herbicide not attributed to septic systems, were detected in more than one grab sample. The use of POCIS was essential because contaminants were present at very low levels (nanograms), which is common for PPCPs in general, but particularly so in such a small community. The use of POCIS allowed the detection of five compounds that were not present in grab samples. Data suggest that the community is contaminating local water with PPCPs; this effect is likely to increase as the population and product usage increase. The results presented here are a first step toward assessing the transport of herbicides and PPCPs into this coastal system.

Dougherty, Jennifer A.; Swarzenski, Peter W.; Dinicola, Richard S.; Reinhard, Martin

2010-01-01

371

Ecotoxicity and environmental risk assessment of pharmaceuticals and personal care products in aquatic environments and wastewater treatment plants.  

PubMed

A wide range of pharmaceuticals and personal care products (PPCPs) are present in the environment, and many of their adverse effects are unknown. The environmental risk assessment of 26 PPCPs of relevant consumption and occurrence in the aquatic environment in Spain was accomplished in this research. Based on the ecotoxicity values obtained by bioluminescence and respirometry assays and by predictions using the US EPA ecological structure-activity relationship (ECOSAR™), the compounds were classified following the Globally Harmonized System of Classification and Labelling of Chemicals. According to the criteria of the European Medicines Agency, the real risk of impact of these compounds in wastewater treatment plants (WWTPs) and in the aquatic environment was predicted. In at least two ecotoxicity tests, 65.4 % of the PPCPs under study showed high toxicity or were harmful to aquatic organisms. The global order of the species' sensitivity to the PPCPs considered was as follows: Vibrio fischeri (5 min) > Vibrio fischeri (15 min) > algae > crustaceans > fish > biomass of WWTP. Acetaminophen, ciprofloxacin, clarithromycin, clofibrate, ibuprofen, omeprazole, triclosan, parabens and 1,4-benzoquinone showed some type of risk for the aquatic environments and/or for the activated sludge of WWTPs. Development of acute and chronic ecotoxicity data, the determination of predicted and measured environmental concentrations of PPCPs, the inclusion of metabolites and transformation products and the evaluation of mixtures of these compounds will allow further improvements of the results of the ERAs and, finally, to efficiently identify the compounds that could affect the environment. PMID:25064485

Ortiz de García, Sheyla Andrea; Pinto Pinto, Gilberto; García-Encina, Pedro A; Irusta-Mata, Rubén

2014-10-01

372

[Dependence of a recurrence rate of a growing in nail from the choice of the operative intervention method and preoperative preparation].  

PubMed

The investigation results on dependence of the growing in nail recurrence rate from the choice of the operative intervention method and preoperative preparation are adduced. There were operated on 73 patients. The 1/3 nail plate resection, excision of pathologic granulations and the nail bed, the nail bed plasty were performed in 51 patients. In preoperative preparation there were used the baths, containing a decoction of a Wormwood bitter and antiseptic preparation--1% spirituous solution of chlorophyllypte--locally in a form of bandages. PMID:22702124

Biliaeva, O O; Korzhik, N P; Myronov, O M

2012-03-01

373

Controlled nail delivery of a novel lipophilic antifungal agent using various modern drug carrier systems as well as in vitro and ex vivo model systems.  

PubMed

The penetration behavior into human nails and animal hoof membranes of a novel antifungal agent (EV-086K) for the treatment of onychomycosis was investigated in this study. The new drug provides a high lipophilicity which is adverse for penetration into nails. Therefore, four different formulations were developed, with particular focus on a colloidal carrier system (CCS) due to its penetration enhancing properties. On the one hand, ex vivo penetration experiments on human nails were performed. Afterwards the human nail plates were cut by cryomicrotome in order to quantify the drug concentration in the dorsal, intermediate and ventral nail layer using high-performance liquid chromatography (HPLC) with UV detection. On the other hand, equine and bovine hoof membranes were used to determine the in vitro penetration of the drug into the acceptor compartment of an online diffusion cell coupled with Fourier transform infrared attenuated total reflectance (FTIR-ATR) spectroscopy. In combination, both results should exhibit a correlation between the EV-086K penetration behavior in human nail plates and animal hoof membranes. The investigations showed that the developed CCS could increase drug delivery through the human nail most compared to other formulations (nail lacquer, solution and hydrogel). Using animal hooves in the online diffusion cell, we were able to calculate pharmacokinetic data of the penetration process, especially diffusion and permeability coefficients. Finally, a qualitative correlation between the penetration results of human nails and equine hooves was established. PMID:24560884

Naumann, Sandy; Meyer, Jean-Philippe; Kiesow, Andreas; Mrestani, Yahya; Wohlrab, Johannes; Neubert, Reinhard H H

2014-04-28

374

Development and mechanical testing of a short intramedullary nail for fixation of femoral rotational osteotomy in cerebral palsy patients  

PubMed Central

Background Rotational osteotomy is frequently indicated to correct excessive femoral anteversion in cerebral palsy patients. Angled blade plate is the standard fixation device used when performed in the proximal femur, but extensile exposure is required for plate accommodation. The authors developed a short locked intramedullary nail to be applied percutaneously in the fixation of femoral rotational osteotomies in children with cerebral palsy and evaluated its mechanical properties. Methods The study was divided into three stages. In the first part, a prototype was designed and made based on radiographic measurements of the femoral medullary canal of ten-year-old patients. In the second, synthetic femoral models based on rapid-prototyping of 3D reconstructed images of patients with cerebral palsy were obtained and were employed to adjust the nail prototype to the morphological changes observed in this disease. In the third, rotational osteotomies were simulated using synthetic femoral models stabilized by the nail and by the AO-ASIF fixed-angle blade plate. Mechanical testing was done comparing both devices in bending-compression and torsion. Results The authors observed proper adaptation of the nail to normal and morphologically altered femoral models, and during the simulated osteotomies. Stiffness in bending-compression was significantly higher in the group fixed by the plate (388.97 ± 57.25 N/mm) than in that fixed by the nail (268.26 ± 38.51 N/mm) as torsional relative stiffness was significantly higher in the group fixed by the plate (1.07 ± 0.36 Nm/°) than by the nail (0.35 ± 0.13 Nm/°). Conclusions Although the device presented adequate design and dimension to fit into the pediatric femur, mechanical tests indicated that the nail was less stable than the blade plate in bending-compression and torsion. This may be a beneficial property, and it can be attributed to the more flexible fixation found in intramedullary devices. PMID:21711560

2011-01-01

375

Microstructure and thermal shock resistance of the peg-nail structured TBCs treated by selective laser modification  

NASA Astrophysics Data System (ADS)

In this study, a peg-nail structured laser modification was implemented on thermal barrier coatings (TBCs) by a pulsed Nd:YAG laser. The effects of the peg-nail structured laser modified units on microstructure and thermal shock resistance of the TBCs were investigated. The results indicated that the surface roughness of the peg-nail structured laser modified units was less than that of the as-sprayed coating. The laser modified region, which penetrated the whole YSZ top coating and the partial NiCoCrAlYTa bond coating, consisted of a network of segmented cracks perpendicular to surface and a dense dendritic columnar structure associating with a thin discontinuous equiaxed grains on its surface. The interface between the top coating and the bond coating exhibited a metallurgical bond to some degree after the peg-nail structured laser modification. XRD analysis revealed that the as-sprayed coating was composed of nonequilibrium tetragonal (T?) phase, cubic (C) phase and a small amount of monoclinic (M) phase, however, the last phase disappeared after laser modification. The thermal shock tests indicated that the cyclical lifetime of the as-sprayed TBCs were enhanced around 3-5 times by the peg-nail structured laser modification after 130 thermal shock cycles. The TBCs' failure was due to the oxide scale growth of bond coating and the thermal expansion mismatch stress during thermal shock cycles. Furthermore, both improvement on strain accommodation and delay of cracks propagation resulting from network segmented cracks perpendicular to the surface and dendritic columnar structure in the peg-nail structured units, formation of metallurgical bonding which enhances bonding strength, creating the lamellar and columnar alternate microstructure with toughness and rigidity hybrid characteristics for providing more compliance to the coating, were all considered as the main reasons of improving thermal shock lifetime of peg-nail structured laser modified TBCs.

Chang, Fa; Zhou, Kesong; Tong, Xin; Xu, Liping; Zhang, Xiaofeng; Liu, Min

2014-10-01

376

Aggregate exposure approaches for parabens in personal care products: a case assessment for children between 0 and 3 years old  

PubMed Central

In the risk assessment of chemical substances, aggregation of exposure to a substance from different sources via different pathways is not common practice. Focusing the exposure assessment on a substance from a single source can lead to a significant underestimation of the risk. To gain more insight on how to perform an aggregate exposure assessment, we applied a deterministic (tier 1) and a person-oriented probabilistic approach (tier 2) for exposure to the four most common parabens through personal care products in children between 0 and 3 years old. Following a deterministic approach, a worst-case exposure estimate is calculated for methyl-, ethyl-, propyl- and butylparaben. As an illustration for risk assessment, Margins of Exposure (MoE) are calculated. These are 991 and 4966 for methyl- and ethylparaben, and 8 and 10 for propyl- and butylparaben, respectively. In tier 2, more detailed information on product use has been obtained from a small survey on product use of consumers. A probabilistic exposure assessment is performed to estimate the variability and uncertainty of exposure in a population. Results show that the internal exposure for each paraben is below the level determined in tier 1. However, for propyl- and butylparaben, the percentile of the population with an exposure probability above the assumed “safe” MoE of 100, is 13% and 7%, respectively. In conclusion, a tier 1 approach can be performed using simple equations and default point estimates, and serves as a starting point for exposure and risk assessment. If refinement is warranted, the more data demanding person-oriented probabilistic approach should be used. This probabilistic approach results in a more realistic exposure estimate, including the uncertainty, and allows determining the main drivers of exposure. Furthermore, it allows to estimate the percentage of the population for which the exposure is likely to be above a specific value. PMID:23801276

Gosens, Ilse; Delmaar, Christiaan J E; ter Burg, Wouter; de Heer, Cees; Schuur, A Gerlienke

2014-01-01

377

The Effects of Graduated Exposure, Modeling, and Contingent Social Attention on Tolerance to Skin Care Products with Two Children with Autism  

ERIC Educational Resources Information Center

Children with autism may display unusual or fearful responses to common stimuli, such as skin care products. Parents of children with autism have often reported that their children will not allow the application of these types of substances to their skin and if the parent persists, the children become extremely upset and anxious. Such responding…

Ellis, Ellyn M.; Ala'i-Rosales, Shahla S.; Glenn, Sigrid S.; Rosales-Ruiz, Jesus; Greenspoon, Joel

2006-01-01

378

APPLICATION OF US EPA METHODS TO THE ANALYSIS OF PHARMACEUTICALS AND PERSONAL CARE PRODUCTS IN THE ENVIRONMENT: DETERMINATION OF CLOFRIBIC ACID IN SEWAGE EFFLUENT BY GCMS  

EPA Science Inventory

An emerging area of research concerns pharmaceuticals and personal care products in the environment and their possible impact on biota and ecosystems. The long term effects of constant perfusion of PPCPs into the aquatic environment are presently unknown. Some compounds are known...

379

Simultaneous quantification of polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and pharmaceuticals and personal care products (PPCPs) in Mississippi river water, in New Orleans, Louisiana, USA  

Microsoft Academic Search

An effective analytical method for simultaneously determining 16 polycyclic aromatic hydrocarbons (PAHs), 28 polychlorinated biphenyl (PCBs), and 12 pharmaceuticals and personal care products (PPCPs) has been developed to measure their concentrations in the Mississippi river waters in New Orleans, Louisiana, USA. The method involves the simultaneous extraction of the selected PAHs, PCBs, and PPCPs, from the aqueous phase by solid

Shaoyuan Zhang; Qiang Zhang; Shameka Darisaw; Odi Ehie; Guangdi Wang

2007-01-01

380

Pharmaceuticals and personal care products (PPCPs) and endocrine disrupting chemicals (EDCs) in stormwater canals and Bayou St. John in New Orleans, Louisiana, USA  

Microsoft Academic Search

Samples were collected from two stormwater canals and a recreational urban waterway known as Bayou St. John in New Orleans, Louisiana, USA and analyzed for a range of pharmaceuticals and personal care products (PPCPs) and endocrine disrupting chemicals (EDCs). Concentrations of 7 PPCPs and EDCs were measured by a method that provides for simultaneous extraction and quantification of the following

Glen R. Boyd; Jordan M. Palmeri; Shaoyuan Zhang; Deborah A. Grimm

2004-01-01

381

Emission of artificial sweeteners, select pharmaceuticals, and personal care products through sewage sludge from wastewater treatment plants in Korea.  

PubMed

Concern over the occurrence of artificial sweeteners (ASWs) as well as pharmaceuticals and personal care products (PPCPs) in the environment is growing, due to their high use and potential adverse effects on non-target organisms. The data for this study are drawn from a nationwide survey of ASWs in sewage sludge from 40 representative wastewater treatment plants (WWTPs) that receive domestic (WWTPD), industrial (WWTPI), or mixed (domestic plus industrial; WWTPM) wastewaters in Korea. Five ASWs (concentrations ranged from 7.08 to 5220 ng/g dry weight [dw]) and ten PPCPs (4.95-6930 ng/g dw) were determined in sludge. Aspartame (concentrations ranged from 28.4 to 5220 ng/g dw) was determined for the first time in sewage sludge. The median concentrations of ASWs and PPCPs in sludge from domestic WWTPs were 0.8-2.5 and 1.0-3.4 times, respectively, the concentrations found in WWTPs that receive combined domestic and industrial wastewaters. Among the five ASWs analyzed, the median environmental emission rates of aspartame through domestic WWTPs (both sludge and effluent discharges combined) were calculated to be 417 ?g/capita/day, followed by sucralose (117 ?g/capita/day), acesulfame (90 ?g/capita/day), and saccharin (66?g/capita/day). The per-capita emission rates of select PPCPs, such as antimicrobials (triclocarban: 158 ?g/capita/day) and analgesics (acetaminophen: 59 ?g/capita/day), were an order of magnitude higher than those calculated for antimycotic (miconazole) and anthelmintic (thiabendazole) drugs analyzed in this study. Multiple linear regression analysis of measured concentrations of ASWs and PPCPs in sludge revealed that several WWTP parameters, such as treatment capacity, population-served, sludge production rate, and hydraulic retention time could influence the concentrations found in sludge. PMID:24695211

Subedi, Bikram; Lee, Sunggyu; Moon, Hyo-Bang; Kannan, Kurunthachalam

2014-07-01

382

Safety evaluations under the proposed US Safe Cosmetics and Personal Care Products Act of 2013: animal use and cost estimates.  

PubMed

The proposed Safe Cosmetics and Personal Care Products Act of 2013 calls for a new evaluation program for cosmetic ingredients in the US, with the new assessments initially dependent on expanded animal testing. This paper considers possible testing scenarios under the proposed Act and estimates the number of test animals and cost under each scenario. It focuses on the impact for the first 10 years of testing, the period of greatest impact on animals and costs. The analysis suggests the first 10 years of testing under the Act could evaluate, at most, about 50% of ingredients used in cosmetics. Testing during this period would cost about $ 1.7-$ 9 billion and 1-11.5 million animals. By test year 10, alternative, high-throughput test methods under development are expected to be available, replacing animal testing and allowing rapid evaluation of all ingredients. Given the high cost in dollars and animal lives of the first 10 years for only about half of ingredients, a better choice may be to accelerate development of high-throughput methods. This would allow evaluation of 100% of cosmetic ingredients before year 10 at lower cost and without animal testing. PMID:24468774

Knight, Jean; Rovida, Costanca

2014-01-01

383

Biofiltration of wastewater treatment plant effluent: effective removal of pharmaceuticals and personal care products and reduction of toxicity.  

PubMed

This study investigates biofiltration for the removal of dissolved organic carbon (DOC), pharmaceuticals and personal care products (PPCPs), and for the reduction of non-specific toxicity expressed as baseline toxicity equivalent concentration (baseline-TEQ). Two filtering media, sand and granular activated carbon, were tested. The influence of pre-ozonation and empty-bed contact time (EBCT, from 30 to 120 min) was determined. The experiments were performed at a pilot-scale with real WWTP effluent. A previous study showed that biological activity had developed on the filtering media and dissolved organic removal had reached a steady state before sampling commenced. The results show that biological activated carbon (BAC) has a good potential for the removal of DOC (35-60%), PPCPs (>90%) and baseline-TEQ (28-68%) even without pre-ozonation. On the contrary, the sand shows limited improvement of effluent quality. Varying the EBCT does not influence the performance of the BAC filters; however, dissolved oxygen concentration could be a limiting factor. The performances of the BAC filters were stable for over two years suggesting that the main mechanism of organic matter and PPCPs removal is biodegradation. It is concluded that BAC filtration without pre-ozonation could be implemented as a low cost advanced treatment option to improve WWTP effluent chemical quality. PMID:21450327

Reungoat, J; Escher, B I; Macova, M; Keller, J

2011-04-01

384

Modeling uptake of selected pharmaceuticals and personal care products into food crops from biosolids-amended soil.  

PubMed

Biosolids contain a variety of pharmaceuticals and personal care products (PPCPs). Studies have observed the uptake of PPCPs into plants grown in biosolids-amended soils. This study examined the ability of Dynamic Plant Uptake (DPU) model and Biosolids-amended Soil Level IV (BASL4) model to predict the concentration of eight PPCPs in the tissue of plants grown in biosolids-amended soil under a number of exposure scenarios. Concentrations in edible tissue predicted by the models were compared to concentrations reported in the literature by calculating estimated human daily intake values for both sets of data and comparing them to an acceptable daily intake value. The equilibrium partitioning (EqP) portion of BASL4 overpredicted the concentrations of triclosan, triclocarban, and miconazole in root and shoot tissue by two to three orders of magnitude, while the dynamic carrot root (DCR) portion overpredicted by a single order of magnitude. DPU predicted concentrations of triclosan, triclocarban, miconazole, carbamazepine, and diphenhydramine in plant tissues that were within an order of magnitude of concentrations reported in the literature. The study also found that more empirical data are needed on the uptake of cimetidine, fluoxetine, and gemfibrozil, and other ionizable PPCPs, to confirm the utility of both models. All hazard quotient values calculated from literature data were below 1, with 95.7% of hazard quotient values being below 0.1, indicating that consumption of the chosen PPCPs in plant tissue poses de minimus risk to human health. PMID:25207852

Prosser, Ryan S; Trapp, Stefan; Sibley, Paul K

2014-10-01

385

Individual and mixture effects of selected pharmaceuticals and personal care products on the marine phytoplankton species Dunaliella tertiolecta.  

PubMed

Pharmaceuticals and personal care products (PPCPs) entering the environment may have detrimental effects on aquatic organisms. Simvastatin, clofibric acid, diclofenac, carbamazepine, fluoxetine, and triclosan represent some of the most commonly used and/or detected PPCPs in aquatic environments. This study analyzed the individual and mixture toxicity of these six PPCPs to the marine phytoplankton species Dunaliella tertiolecta using a standard 96-hour static algal bioassay protocol. All PPCPs tested had a significant effect on D. tertiolecta population cell density. However, of the six PPCPs tested, only triclosan yielded toxicity at typical environmental concentrations. The 96-hour EC(50) values for triclosan, fluoxetine, simvastatin, diclofenac, and clofibric acid were 3.55 microg/L, 169.81 microg/L, 22,800 microg/L, 185,690 microg/L, and 224,180 microg/L, respectively. An EC(50) value could not be determined for carbamazepine; however, the highest concentration tested (80,000 microg/L) reduced cell density by 42%. Both mixtures tested-simvastatin-clofibric acid and fluoxetine-triclosan-demonstrated additive toxicity. The presence of PPCP mixtures may decrease the toxicity threshold for phytoplankton populations. Detrimental effects on phytoplankton populations could ultimately impact nutrient cycling and food availability to higher trophic levels. The results of this study are a first step toward identifying the risk of PPCPs to estuarine organisms and may benefit environmental resource managers. PMID:17846821

DeLorenzo, Marie E; Fleming, Jessica

2008-02-01

386

Determination of pharmaceuticals, personal care products, and pesticides in surface and treated waters: method development and survey.  

PubMed

Water is fundamental to the existence of life since it is essential to a series of activities, such as agriculture, power generation, and public and industrial supplies. The residual water generated by these activities is released into the environment, reaches the water systems, and becomes a potential risk to nontarget organisms. This paper reports the development and validation of a quantitative method, based on solid-phase extraction and liquid chromatography tandem mass spectrometry, for the simultaneous analysis of 18 pharmaceuticals and personal care products (PPCPs) and 33 pesticides in surface and drinking waters. The accuracy of the method was determined by calculating the recoveries, which ranged from 70 to 120 % for most pesticides and PPCPs, whereas limits of quantification ranged from 0.8 to 40 ng/L. After the validation step, the method was applied to drinking and surface waters. Pesticides and PPCPs were found in concentrations lower than 135.5 ng/L. The evaluation of different water sources with regard to contamination by pesticides and PPCPs has been quite poor in southern Brazil. PMID:23539208

Caldas, Sergiane Souza; Bolzan, Cátia Marian; Guilherme, Juliana Rocha; Silveira, Maria Angelis Kisner; Escarrone, Ana Laura Venquiaruti; Primel, Ednei Gilberto

2013-08-01

387

Microbial community structure and pharmaceuticals and personal care products removal in a membrane bioreactor seeded with aerobic granular sludge.  

PubMed

A process involving the use of membrane bioreactor seeded with aerobic granular sludge (GMBR) was applied to the treatment of sewage containing pharmaceuticals and personal care products (PPCPs). The removal effects of five kinds of medicines in the reactor were investigated, and the microbial communities were constructed by polymerase chain reaction and denaturing gradient gel electrophoresis. We also determined the effects of different sludge retention and hydraulic retention times (SRT and HRT, respectively) and influent organic loading on GMBR's efficiency in processing sewage containing PPCPs. The removal effects of the GMBR on five PPCPs varied. Using the GMBR, the removal rates of prednisolone, naproxen and norfloxacin were 98.56, 84.02 and 87.85 %, respectively. The removal rates of sulfamethoxazole and ibuprofen were 77.83 and 63.32 %, respectively. In the system, PPCP drugs had relatively less effect on microbial diversity. A certain succession was observed in the structural variation of microbial species in the GMBR. Microorganisms that can degrade PPCPs gradually accumulated, and antibiotic-resistant microorganisms, such as Firmicutes sp., Aeromonas sp. and Nitrospira sp., served a key function in the treatment of sewage containing antibiotics. Long SRT and HRT during the GMBR process can facilitate the removal of most PPCPs. The system efficiently removed PPCPs at high influent organic loading. PMID:25099174

Xia, Zhao; Xiao-Chun, Wang; Zhong-Lin, Chen; Hao, Xu; Qing-Fang, Zhang

2015-01-01

388

Occurrence of organic wastewater contaminants, pharmaceuticals, and personal care products in selected water supplies, Cape Cod, Massachusetts, June 2004  

USGS Publications Warehouse

In June 2004, the U.S. Geological Survey, in cooperation with the Barnstable County Department of Health and Environment, sampled water from 14 wastewater sources and drinking-water supplies on Cape Cod, Massachusetts, for the presence of organic wastewater contaminants, pharmaceuticals, and personal care products. The geographic distribution of sampling locations does not represent the distribution of drinking-water supplies on Cape Cod. The environmental presence of the analyte compounds is mostly unregulated; many of the compounds are suspected of having adverse ecological and human health effects. Of the 85 different organic analyte compounds, 43 were detected, with 13 detected in low concentrations (less than 1 microgram per liter) from drinking-water supplies thought to be affected by wastewater because of previously detected high nitrate concentrations. (Phenol and d-limonene, detected in equipment blanks at unacceptably high concentrations, are not included in counts of detections in this report.) Compounds detected in the drinking-water supplies included the solvent, tetrachloroethylene; the analgesic, acetaminophen; the antibiotic, sulfamethoxazole; and the antidepressant, carbamazapine. Nitrate nitrogen, an indicator of wastewater, was detected in water supplies in concentrations ranging from 0.2 to 8.8 milligrams per liter.

Zimmerman, Marc J.

2005-01-01

389

Use Patterns of Leave-on Personal Care Products among Swiss-German Children, Adolescents, and Adults  

PubMed Central

In order to model exposure to ingredients contained in personal care products (PCPs) and assess their potential risks to human health, access to reliable PCP use data, including co-use patterns, is essential. A postal questionnaire survey was conducted to determine the use patterns of eight leave-on PCP categories among the German-speaking population of Switzerland (N = 1,196; ages 0–97 years), providing for the first time in Europe PCP use data for children <12 years of age. The majority of respondents (99%) reported having used at least one of the investigated PCP categories in the past year. Co-use of two or more PCP categories at the same time was common and more complex amongst adults. Regular use of face cream and body lotion was very high in the youngest group of children aged 0–4 years (more than 79% respondents) who may be more vulnerable to certain adverse effects of some PCP ingredients. A comparison with previously collected information on PCP use patterns in Germany and the Netherlands indicates differences in PCP use patterns among European consumers and suggests that surrogate PCP use data from other countries must be used with caution. This work extends the existing knowledge of PCP use patterns and will be useful for new exposure assessments for ingredients contained in PCPs used by the young consumers. PMID:23823714

Manová, Eva; von Goetz, Natalie; Keller, Carmen; Siegrist, Michael; Hungerbühler, Konrad

2013-01-01

390

Occurrence of halogenated transformation products of selected pharmaceuticals and personal care products in secondary and tertiary treated wastewaters from southern california.  

PubMed

Final effluent samples from 10 southern California (United States) wastewater treatment facilities, employing four distinct treatment schemes, were surveyed for selected pharmaceuticals, personal care products (PPCPs), alkylphenols, and 21 of their halogenated disinfection byproducts. Chlorinated and brominated standards and isotopically labeled internal standards were synthesized and purified to confirm and more accurately quantify selected disinfection byproducts of salicylic acid, bisphenol A, gemfibrozil, naproxen, diclofenac, technical 4-nonylphenol, and 4-tert-octylphenol using high-performance liquid chromatography and tandem mass spectrometry. Concentrations of parent compounds ranged from <10 to 3830 ng/L (gemfibrozil), and those of chloro/bromo byproducts ranged from <4 to 370 ng/L (dibromo nonylphenol). The highest concentrations of parent compounds were measured in effluent that was not subjected to tertiary treatment. The chlorinated and brominated byproduct concentration may be affected by the influent concentration of parent compounds, hydraulic retention times, and chlorine contact times. Salicylic acid was readily halogenated, which is evident from the ratio of halogenated to nonhalogenated species. There were no measured chlorinated byproducts of bisphenol A despite occasionally high concentrations of the parent compound. Not surprisingly, higher concentrations of most brominated species were measured in the treatment plant with the highest bromide concentrations. These results demonstrate the occurrence of novel halogenated byproducts of PPCPs that have limited toxicological data and significant uncertainty with regard to their risk to ecological systems. PMID:25611547

Bulloch, Daryl N; Nelson, Eric D; Carr, Steve A; Wissman, Chris R; Armstrong, Jeffrey L; Schlenk, Daniel; Larive, Cynthia K

2015-02-17

391

The PFNA proximal femur nail in treatment of unstable proximal femur fractures--3 cases of postoperative perforation of the helical blade into the hip joint.  

PubMed

The proximal femur nail antirotation represents a new generation of intramedullary nailing devices for fixation of stable and unstable trochanteric fractures of the proximal femur. We report 3 cases of postoperative perforation of the helical blade through the femoral head into the hip joint without any signs of rotational or varus displacement of the fracture. PMID:18978550

Brunner, Alexander; Jöckel, Jens Arne; Babst, Reto

2008-01-01

392

A Randomized Controlled Trial of a Novel Self-Help Technique for Impulse Control Disorders: A Study on Nail-Biting  

ERIC Educational Resources Information Center

Nail-biting is currently classified as an impulse control disorder not otherwise specified. Although seldom targeted as a primary symptom, nail-biting is often associated with somatic complications and decreased quality of life. The present study assessed the effectiveness of an innovative self-help technique, titled decoupling (DC). DC aims at…

Moritz, Steffen; Treszl, Andras; Rufer, Michael

2011-01-01

393

Stochastic modeling of the variation of velocity and permeability as a function of effective pressure using the Bed-of-Nails asperity-deformation model  

E-print Network

. The dependence of permeability and velocity on effective pressure has previously been modeled using the Bed-of-Nails asperity-deformation model. The main objective of this research was to explore the sensitivity of the Bed-of-Nails and effective-pressure models...

Genova Barazarte, Ezequiel

2009-05-15

394

Home Care  

MedlinePLUS

Home Care Basic Facts & Information Role of Health Care Professionals in Home Care Your physician is the leader of an interdisciplinary ... travel to see the healthcare team. Is Home Care Right for You? Home care is especially useful ...

395

Coffin Nails: The Tobacco Controversy in the 19th Century  

NSDL National Science Digital Library

Culled from the archives of Harper's Weekly, this online trove of visual material and articles deals with the controversy over the alleged health benefits and potential hazards of smoking. The site begins with an orienting essay by John Adler, the publisher of HarpWeek. The compilation itself is quite revealing, pointing out that, as early as 1862, tobacco addiction was a recognized problem, and that the tobacco industry responded to public health concerns by marketing tobacco products that supposedly contained "no nicotine." The site is divided into five major sections, including ones dealing with smoking habits of the young, the "bad behavior" personified by those who smoked excessively, and "healthful" smoking products. All of these sections contain ample selections of news articles from Harper's (usually available as a scanned image and with transcripted text) and the wonderful cartoons of Thomas Nast. Overall, this site will be of great interest to those looking to see how Americans felt about this "noxious weed" in the last-half of the nineteenth century.

396

Complications after intramedullary nailing of femoral fractures in a low-income country  

PubMed Central

Background Some surgeons believe that internal fixation of fractures carries too high a risk of infection in low-income countries (LICs) to merit its use there. However, there have been too few studies from LICs with sufficient follow-up to support this belief. We first wanted to determine whether complete follow-up could be achieved in an LIC, and secondly, we wanted to find the true microbial infection rate at our hospital and to examine the influence of HIV infection and lack of follow-up on outcomes. Patients and methods 137 patients with 141 femoral fractures that were treated with intramedullary (IM) nailing were included. We compared outcomes in patients who returned for scheduled follow-up and patients who did not return but who could be contacted by phone or visited in their home village. Results 79 patients returned for follow-up as scheduled; 29 of the remaining patients were reached by phone or outreach visits, giving a total follow-up rate of 79%. 7 patients (5%) had a deep postoperative infection. All of them returned for scheduled follow-up. There were no infections in patients who did not return for follow-up, as compared to 8 of 83 nails in the group that did return as scheduled (p = 0.1). 2 deaths occurred in HIV-positive patients (2/23), while no HIV-negative patients (0/105) died less than 30 days after surgery (p = 0.03). Interpretation We found an acceptable infection rate. The risk of infection should not be used as an argument against IM nailing of femoral fractures in LICs. Many patients in Malawi did not return for follow-up because they had no complaints concerning the fracture. There was an increased postoperative mortality rate in HIV-positive patients. PMID:24171678

2013-01-01

397

Mutation analysis of LMX1B gene in nail-patella syndrome patients.  

PubMed Central

Nail-patella syndrome (NPS), a pleiotropic disorder exhibiting autosomal dominant inheritance, has been studied for >100 years. Recent evidence shows that NPS is the result of mutations in the LIM-homeodomain gene LMX1B. To determine whether specific LMX1B mutations are associated with different aspects of the NPS phenotype, we screened a cohort of 41 NPS families for LMX1B mutations. A total of 25 mutations were identified in 37 families. The nature of the mutations supports the hypothesis that NPS is the result of haploinsufficiency for LMX1B. There was no evidence of correlation between aspects of the NPS phenotype and specific mutations. PMID:9837817

McIntosh, I; Dreyer, S D; Clough, M V; Dunston, J A; Eyaid, W; Roig, C M; Montgomery, T; Ala-Mello, S; Kaitila, I; Winterpacht, A; Zabel, B; Frydman, M; Cole, W G; Francomano, C A; Lee, B

1998-01-01

398

Simultaneous Nailing of Skeletal Metastases: Is the Mortality Really that High?  

Microsoft Academic Search

Introduction  The risk of death during simultaneous nailing of pathologic and impending fractures in patients with metastatic disease is\\u000a believed to be so high that some authors have advocated a staged approach, especially for impending fractures. However, there\\u000a are limited data to either support or refute the appropriateness of staging of multiple impending or pathologic fractures.\\u000a \\u000a \\u000a \\u000a \\u000a Questions\\/purposes  We therefore determined the rate

Bryan Moon; Patrick Lin; Robert Satcher; Valerae Lewis

399

Radiation exposure to the hands and the thyroid of the surgeon during intramedullary nailing.  

PubMed

During 41 procedures of intramedullary nailing of femoral and tibial fractures, the primary surgeon and the first assistant wore ring dosimeters on their dominant index fingers. While the average fluoroscopy time per procedure was 4.6 min, the average dose of radiation to the dominant hand of the primary surgeon was 1.27 mSv and 1.19 mSv to the first assistant. The dose limit for the extremities is 500 mSv per year, as recommended by the International Commission on Radiological Protection. Extrapolation of the mean dose of the primary surgeon and first assistant per procedure of 1.23 mSv leads to the result that the recommended dose limit of 500 mSv would only be exceeded if more than 407 intramedullary nailing procedures are carried out per year. The duration of fluoroscopy time correlated with the radiation dose to the hands of the surgeons, though it was determined by phantom measurements that the majority of radiation exposure occurred during brief exposures of the hands in the direct X-ray beam on the X-ray tube near side of the patient. In order to assess the surface doses of the thyroid gland to the primary surgeon with and without a lead shield, we performed in vitro measurements during operative procedures of the lower leg simulating different intraoperative situations under fluoroscopic control. The average registered ionizing dosage without a thyroid shield was approximately 70 times higher than with thyroid lead protection. In a previous study we found average fluoroscopy times during intramedullary nailing of the tibia and femur of 4.6 min per procedure. Extrapolation of this value leads to the result, that even when 1000 intramedullary nailings were carried out without wearing lead protection, only 13 per cent of the dose limit recommended by the International Commission on Radiological Protection for the thyroid of 300 mSv per year would be reached; by wearing the lead protection only 0.2 per cent of the recommended dose would be reached. PMID:9813705

Müller, L P; Suffner, J; Wenda, K; Mohr, W; Rommens, P M

1998-07-01

400

Superficial Acral Fibromyxoma involving the nail's apparatus. Case report and literature review*  

PubMed Central

Superficial Acral Fibromyxoma is a rare tumor of soft tissues. It is a relatively new entity described in 2001 by Fetsch et al. It probably represents a fibrohistiocytic tumor with less than 170 described cases. We bring a new case of SAF on the 5th toe of the right foot, in a 43-year-old woman. After surgical excision with safety margins which included the nail apparatus, it has not recurred (22 months of follow up). We carried out a review of the location of all SAF published up to the present day. PMID:24626661

García, Ana Márquez; Mendonça, Francisco Manuel Ildefonso; Cejudo, Manuel Perea; Martínez, Francisco M. Camacho; Martín, Juan José Ríos

2014-01-01

401

Comparison of Wedge Resection (Winograd Procedure) and Wedge Resection Plus Complete Nail Plate Avulsion in the Treatment of Ingrown Toenails.  

PubMed

The present retrospective study compared the efficacy of wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion for the treatment of ingrown toenails (onychocryptosis). Two surgical methods were performed in 95 patients with a stage 2 or 3 ingrown toenail. Each patient was examined weekly until healing and then at 1, 6, and 12 months of follow-up. The outcomes measured were surgical duration, healing time, recurrence rate, the incidence of postoperative infection, and cosmetic appearance after surgery. Of the 95 patients (115 ingrown toenails) included in the present study, 39 (41.1%) underwent wedge resection (Winograd procedure) and 56 (59%), wedge resection plus complete nail plate avulsion. The mean surgical duration for wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion was 14.9 ± 2.4 minutes and 15.1 ± 3.2 minutes, respectively (p = .73). The corresponding healing times were 2.8 ± 1.2 weeks and 2.7 ± 1.3 weeks (p = .70). Recurrence developed in 3 (3.2%) patients after wedge resection (Winograd procedure) and in 4 (4.2%) after wedge resection plus complete nail plate avulsion. In addition, postoperative infection occurred in 3 (3.2%) patients after wedge resection (Winograd procedure) and 2 (2.1%) after wedge resection plus complete nail plate avulsion. Both of the surgical procedures were practical and appropriate for the treatment of ingrown toenails, being simple and associated with low morbidity and a high success rate. However, cosmetically, wedge resection (Winograd procedure) would be the better choice because the nail plate remains intact. PMID:25441276

Huang, Jia-Zhang; Zhang, Yi-Jun; Ma, Xin; Wang, Xu; Zhang, Chao; Chen, Li

2014-11-22

402

Arsenic in hair and nails of individuals exposed to arsenic-rich groundwaters in Kandal province, Cambodia.  

PubMed

The health implications of the consumption of high arsenic groundwater in Bangladesh and West Bengal are well-documented, however, little is known about the level of arsenic exposure elsewhere in Southeast Asia, where widespread exploitation of groundwater resources is less well established. We measured the arsenic concentrations of nail and hair samples collected from residents of Kandal province, Cambodia, an area recently identified to host arsenic-rich groundwaters, in order to evaluate the extent of arsenic exposure. Nail and hair arsenic concentrations ranged from 0.20 to 6.50 microg g(-1) (n=70) and 0.10 to 7.95 microg g(-1) (n=40), respectively, in many cases exceeding typical baseline levels. The arsenic content of the groundwater used for drinking water purposes (0.21-943 microg L(-1) (n=31)) was positively correlated with both nail (r=0.74, p<0.0001) and hair (r=0.86, p<0.0001) arsenic concentrations. In addition, the nail and hair samples collected from inhabitants using groundwater that exceeded the Cambodian drinking water legal limit of 50 microg L(-1) arsenic contained significantly more arsenic than those of individuals using groundwater containing <50 microg L(-1) arsenic. X-ray absorption near edge structure (XANES) spectroscopy suggested that sulfur-coordinated arsenic was the dominant species in the bulk of the samples analysed, with additional varying degrees of As(III)-O character. Tentative linear least squares fitting of the XANES data pointed towards differences in the pattern of arsenic speciation between the nail and hair samples analysed, however, mismatches in sample and standard absorption peak intensity prevented us from unambiguously determining the arsenic species distribution. The good correlation with the groundwater arsenic concentration, allied with the relative ease of sampling such tissues, indicate that the arsenic content of hair and nail samples may be used as an effective biomarker of arsenic intake in this relatively recently exposed population. PMID:18234288

Gault, Andrew G; Rowland, Helen A L; Charnock, John M; Wogelius, Roy A; Gomez-Morilla, Inma; Vong, Sovathana; Leng, Moniphea; Samreth, Sopheap; Sampson, Mickey L; Polya, David A

2008-04-01

403

Application of response function methodology for the simultaneous determination of potential fragrance allergens and preservatives in personal care products using micellar electrokinetic chromatography.  

PubMed

A micellar electrokinetic chromatography method was developed for determination of 15 suspected fragrance allergens and preservatives. The target compounds are widely used as ingredients in many personal care products, and all of them are included in the European Regulation concerning cosmetic products. The method was optimized by using a central composite experimental design and response surface methodology. A modified chromatographic response function was defined to weigh the terms in the response function adequately. After optimization of experimental conditions, a background electrolyte of 100 mM sodium dodecyl sulphate and 24 mM sodium tetraborate and pH 9.0 was selected for the separation of the analytes. The developed methodology was evaluated in terms of linearity, limits of detection and quantification, precision and accuracy, showing appropriate values (i.e., R (2)?=??0.99 and accuracy of 89-115 %). Finally, applicability of the micellar electrokinetic chromatography method was assessed by successfully quantifying fragrance allergens and preservatives in commercial personal care products. The most commonly found analyte was linalool (48.3 % of samples) followed by benzoic acid (37.6 %). All samples contained at least one of the target compounds, thus confirming the ubiquity of fragrance allergens and preservatives in personal care products. PMID:24306329

Lopez-Gazpio, J; Garcia-Arrona, R; Millán, E

2014-01-01

404

Preconception Care and Prenatal Care  

MedlinePLUS

... Clinical Trials Resources and Publications En Español Preconception Care and Prenatal Care: Condition Information Skip sharing on social media links Share this: Page Content What is preconception care? Preconception care is the care a woman receives ...

405

Fatigue behavior of Ilizarov frame versus tibial interlocking nail in a comminuted tibial fracture model: a biomechanical study  

PubMed Central

Background Treatment options for comminuted tibial shaft fractures include plating, intramedullary nailing, and external fixation. No biomechanical comparison between an interlocking tibia nail with external fixation by an Ilizarov frame has been reported to date. In the present study, we compared the fatigue behaviour of Ilizarov frames to interlocking intramedullary nails in a comminuted tibial fracture model under a combined loading of axial compression, bending and torsion. Our goal was to determine the biomechanical characteristics, stability and durability for each device over a clinically relevant three month testing period. The study hypothesis was that differences in the mechanical properties may account for differing clinical results and provide information applicable to clinical decision making for comminuted tibia shaft fractures. Methods In this biomechanical study, 12 composite tibial bone models with a comminuted fracture and a 25 mm diaphyseal gap were investigated. Of these, six models were stabilized with a 180-mm four-ring Ilizarov frame, and six models were minimally reamed and stabilized with a 10 mm statically locked Russell-Taylor Delta™ tibial nail. After measuring the pre-fatigue axial compression bending and torsion stiffness, each model was loaded under a sinusoidal cyclic combined loading of axial compression (2.8/28 lbf; 12.46/124.6 N) and torque (1.7/17 lbf-in; 0.19/1.92 Nm) at a frequency of 3 Hz. The test was performed until failure (implant breakage or ? 5° angulations and/or 2 cm shortening) occurred or until 252,000 cycles were completed, which corresponds to approximately three months testing period. Results In all 12 models, both the Ilizarov frame and the interlocking tibia nail were able to maintain fracture stability of the tibial defect and to complete the full 252,000 cycles during the entire study period of three months. A significantly higher stiffness to axial compression and torsion was demonstrated by the tibial interlocking nail model, while the Ilizarov frame provided a significantly increased range of axial micromotion. Conclusion This is the first study, to our knowledge, which compares the biomechanical properties of an intramedullary nail to an external Ilizarov frame to cyclic axial loading and torsion in a comminuted tibia shaft fracture model. Prospective, randomized trials comparing Ilizarov frames and interlocked tibial nails are needed to clarify the clinical impact of these biomechanical findings. PMID:17156471

Hasenboehler, Erik; Smith, Wade R; Laudicina, Laurence; Philips, Giby C; Stahel, Philip F; Morgan, Steven J

2006-01-01

406

The occurrence of pharmaceuticals, personal care products, endocrine disruptors and illicit drugs in surface water in South Wales, UK.  

PubMed

The presence and fate of 56 pharmaceuticals, personal care products, endocrine disruptors and illicit drugs (PPCPs) were investigated in the South Wales region of the UK. Two contrasting rivers: River Taff and River Ely were chosen for this investigation and were monitored for a period of 10 months. The impact of the factors affecting the levels of concentration of PPCPs and illicit drugs in surface water such as surrounding area, proximity to wastewater effluent and weather conditions, mainly rainfall was also investigated. Most PPCPs were frequently found in river water at concentrations reaching single microgL(-1) and their levels depended mainly on the extent of water dilution resulting from rainfall. Discharge of treated wastewater effluent into the river course was found to be the main cause of water contamination with PPCPs. The most frequently detected PPCPs represent the group of pharmaceuticals dispensed at the highest levels in the Welsh community. These were antibacterial drugs (trimethoprim, erythromycin-H(2)O and amoxicillin), anti-inflammatories/analgesics (paracetamol, tramadol, codeine, naproxen, ibuprofen and diclofenac) and antiepileptic drugs (carbamazepine and gabapentin). Only four PPCPs out of 56 (simvastatin, pravastatin, digoxin and digoxigenin) were not quantified over the course of the study. Several PPCPs were found to be both ubiquitous and persistent in the aqueous environment (e.g. erythromycin-H(2)O, codeine, carbamazepine, gabapentin and valsartan). The calculated average daily loads of PPCPs indicated that in total almost 6 kg of studied PPCPs are discharged daily into the studied rivers. The illicit drugs studied were found in rivers at low levels of ng L(-1). Average daily loads of amphetamine, cocaine and its main metabolite benzoylecgonine were as follows: 8, 1.2 and 39 gday(-1), respectively. Their frequent occurrence in surface water is primarily associated with their high illegal usage and is strongly associated with the discharge of insufficiently treated wastewater effluent. PMID:18514758

Kasprzyk-Hordern, Barbara; Dinsdale, Richard M; Guwy, Alan J

2008-07-01

407

Simulation of the fate of selected pharmaceuticals and personal care products in a highly impacted reach of a Canadian watershed.  

PubMed

Municipal wastewater treatment plants (WWTPs) dispose of numerous trace organic contaminants in the receiving waters that can impact biological function in aquatic organisms. However, the complex nature of WWTP effluent mixtures and a wide variety of potential mechanisms that can alter physiological and reproductive development of aquatic organisms make it difficult to assess the linkages and severity of the effects associated with trace organic contaminants. This paper describes a surface water quality modeling exercise that was performed to understand the relevant contaminant fate and transport processes necessary to accurately predict the concentrations of trace organic compounds present in the aquatic environment. The target compounds modeled include a known antiandrogenic personal care product (triclosan) and selected pharmaceuticals (venlafaxine, naproxen, and carbamazepine). The WASP 7.5 model was adapted and calibrated to reflect approximately ten kilometers of reach of the Grand River watershed that is highly influenced by a major urban WWTP. Simulation of the fate and transport of the target compounds revealed that flow-driven transport processes (advection and dispersion) greatly influenced the behavior of the target contaminants in the aquatic environment. However, fate mechanisms such as photolysis and biodegradation can play an important role in the attenuation of some compounds. The exception was carbamazepine where it was shown to act as a conservative tracer compound for wastewater specific contaminants in the water phase. The calibrated water quality model can now be employed in a number of future applications. Prediction of fate and transport of other trace organic contaminants across the watershed and assessment of the performance of WWTP infrastructure upgrades in the removal of these compounds are just a few examples. PMID:24727037

Arlos, M J; Bragg, L M; Servos, M R; Parker, W J

2014-07-01

408

Combined effects of pharmaceuticals, personal care products, biocides and organic contaminants on the growth of Skeletonema pseudocostatum.  

PubMed

Organisms in the environment are exposed to a number of pollutants from different compound groups. In addition to the classic pollutants like the polychlorinated biphenyls, polyaromatic hydrocarbons (PAHs), alkylphenols, biocides, etc. other compound groups of concern are constantly emerging. Pharmaceuticals and personal care products (PPCPs) can be expected to co-occur with other organic contaminants like biocides, PAHs and alkylphenols in areas affected by wastewater, industrial effluents and intensive recreational activity. In this study, representatives from these four different compound groups were tested individually and in mixtures in a growth inhibition assay with the marine algae Skeletonema pseudocostatum (formerly Skeletonema costatum) to determine whether the combined effects could be predicted by models for additive effects; the concentration addition (CA) and independent action (IA) prediction model. The eleven tested compounds reduced the growth of S. pseudocostatum in the microplate test in a concentration-dependent manner. The order of toxicity of these chemicals were irgarol>fluoxetine>diuron>benzo(a)pyrene>thioguanine>triclosan>propranolol>benzophenone 3>cetrimonium bromide>4-tert-octylphenol>endosulfan. Several binary mixtures and a mixture of eight compounds from the four different compound groups were tested. All tested mixtures were additive as model deviation ratios, the deviation between experimental and predicted effect concentrations, were within a factor of 2 from one or both prediction models (e.g. CA and IA). Interestingly, a concentration dependent shift from IA to CA, potentially due to activation of similar toxicity pathways at higher concentrations, was observed for the mixture of eight compounds. The combined effects of the multi-compound mixture were clearly additive and it should therefore be expected that PPCPs, biocides, PAHs and alkylphenols will collectively contribute to the risk in areas contaminated by such complex mixtures. PMID:24632557

Petersen, Karina; Heiaas, Harald Hasle; Tollefsen, Knut Erik

2014-05-01

409

Effects of solution chemistry on adsorption of selected pharmaceuticals and personal care products (PPCPs) by graphenes and carbon nanotubes.  

PubMed

Adsorption of three selected pharmaceuticals and personal care products (PPCPs) (ketoprofen (KEP), carbamazepine (CBZ), and bisphenol A (BPA)) by two reduced graphene oxides (rGO1 and rGO2) and one commercial graphene was examined under different solution conditions. Single-walled carbon nanotubes (SWCNTs), multiwalled carbon nanotubes (MWCNTs), and powdered graphite were also investigated for comparison. All adsorption isotherms followed the order of SWCNTs > rGO1 > rGO2 > MWCNTs > graphene > graphite, consistent with the orders of their surface areas and micropore volumes. After surface area normalization, adsorption affinities of the three PPCPs onto graphenes were lower than onto graphite, suggesting incomplete occupation for adsorption sites because of the aggregation of graphene sheets and the presence of oxygen-containing functional groups. The observed pH effects on adsorption correlated well with the pH-regulated distribution of the protonated neutral species of the three PPCPs. Increasing ionic strength from 0 to 20 mM increased KEP adsorption due to the electrostatic screening by Na(+) and Ca(2+). Both humic acid (HA) and sodium dodecylbenzenesulfonate (SDBS) suppressed PPCPs adsorption to all adsorbents, but their impacts onto graphenes were lower than those onto CNTs because of their lower adsorption by graphenes. More severe HA (or SDBS) effect was found on negatively charged KEP at the tested solution pH 6.50 due to the electrostatic repulsion between the same charged KEP and HA (or SDBS). The findings of the present study may have significant implications for the environmental fate assessment of PPCPs and graphene. PMID:25353977

Liu, Fei-fei; Zhao, Jian; Wang, Shuguang; Du, Peng; Xing, Baoshan

2014-11-18

410

Rapid analysis of pharmaceuticals and personal care products in fish plasma micro-aliquots using liquid chromatography tandem mass spectrometry.  

PubMed

A sensitive analytical method based on liquid-liquid extraction (LLE) and liquid chromatography tandem mass spectrometry (LC-MS/MS) was developed for rapid analysis of 11 pharmaceuticals and personal care products (PPCPs) in fish plasma micro-aliquots (?20?L). Target PPCPs included, bisphenol A, carbamazepine, diclofenac, fluoxetine, gemfibrozil, ibuprofen, naproxen, risperidone, sertraline, simvastatin and triclosan. A relatively quicker and cheaper LLE procedure exhibited comparable analyte recoveries with solid-phase extraction. Rapid separation and analysis of target compounds in fish plasma extracts was achieved by employing a high efficiency C-18 HPLC column (Agilent Poroshell 120 SB-C18, 2.1mm×50mm, 2.7?m) and fast polarity switching, enabling effective monitoring of positive and negative ions in a single 9min run. With the exception of bisphenol A, which exhibited relatively high background contamination, method detection limits of individual PPCPs ranged between 0.15 and 0.69pg/?L, while method quantification limits were between 0.05 and 2.3pg/?L. Mean matrix effect (ME) values ranged between 65 and 156% for the various target analytes. Isotope dilution quantification using isotopically labelled internal surrogates was utilized to correct for signal suppression or enhancement and analyte losses during sample preparation. The method was evaluated by analysis of 20?L plasma micro-aliquots collected from zebrafish (Danio rerio) from a laboratory bioaccumulation study, which included control group fish (no exposure), as well as fish exposed to environmentally relevant concentrations of PPCPs. Using the developed LC-MS/MS based method, concentrations of the studied PPCPs were consistently detected in the low pg/?L (ppb) range. The method may be useful for investigations requiring fast, reliable concentration measurements of PPCPs in fish plasma. In particular, the method may be applicable for in situ contaminant biomonitoring, as well as bioaccumulation and toxicology studies employing small fishes with low blood compartment volumes. PMID:25640994

Chen, Fangfang; Gong, Zhiyuan; Kelly, Barry C

2015-02-27

411

Removal of Pharmaceuticals and Personal Care Products during Water Recycling: Microbial Community Structure and Effects of Substrate Concentration  

PubMed Central

Many pharmaceuticals and personal care products (PPCPs) have been shown to be biotransformed in water treatment systems. However, little research exists on the effect of initial PPCP concentration on PPCP biotransformation or on the microbial communities treating impacted water. In this study, biological PPCP removal at various concentrations was assessed using laboratory columns inoculated with wastewater treatment plant effluent. Pyrosequencing was used to examine microbial communities in the columns and in soil from a soil aquifer treatment (SAT; a method of water treatment prior to reuse) site. Laboratory columns were supplied with different concentrations (0.25, 10, 100, or 1,000 ?g liter?1) of each of 15 PPCPs. Five PPCPs (4-isopropyl-3-methylphenol [biosol], p-chloro-m-xylenol, gemfibrozil, ketoprofen, and phenytoin) were not removed at any tested concentrations. Two PPCPs (naproxen and triclosan) exhibited removals independent of PPCP concentration. PPCP removal efficiencies were dependent on initial concentrations for biphenylol, p-chloro-m-cresol, chlorophene, diclofenac, 5-fluorouracil, ibuprofen, and valproic acid, showing that PPCP concentration can affect biotransformation. Biofilms from sand samples collected from the 0.25- and 10-?g liter?1 PPCP columns were pyrosequenced along with SAT soil samples collected on three consecutive days of a wetting and drying cycle to enable comparison of these two communities exposed to PPCPs. SAT communities were similar to column communities in taxonomy and phylotype composition, and both were found to contain close relatives of known PPCP degraders. The efficiency of biological removal of PPCPs was found to be dependent on the concentration at which the contamination occurs for some, but not all, PPCPs. PMID:24509919

Onesios-Barry, Kathryn M.; Berry, David; Proescher, Jody B.; Sivakumar, I. K. Ashok

2014-01-01

412

Pharmaceuticals and Personal Care Products in Archived U.S. Biosolids from the 2001 EPA National Sewage Sludge Survey  

PubMed Central

In response to the U.S. National Academies’ call for a better assessment of chemical pollutants contained in the approximately 6.9 million dry tons of digested municipal sludge produced annually in the United States, the mean concentration of 72 pharmaceuticals and personal care products (PPCP) were determined in 110 biosolids samples collected by the U.S. Environmental Protection Agency (EPA) in its 2001 National Sewage Sludge Survey. Composite samples of archived biosolids, collected at 94 U.S. wastewater treatment plants from 32 states and the District of Columbia, were analyzed by liquid chromatography tandem mass spectrometry using EPA Method 1694. Thirty-eight (54%) of the 72 analytes were detected in at least one composite sample at concentrations ranging from 0.002 to 48 mg kg?1 dry weight. Triclocarban and triclosan were the most abundant analytes with mean concentrations of 36 ± 8 and 12.6 ± 3.8 mg kg?1 (n = 5), respectively, accounting for 65% of the total PPCP mass found. The loading to U.S. soils from nationwide biosolids recycling was estimated at 210–250 metric tons per year for the sum of the 72 PPCPs investigated. The results of this nationwide reconnaissance of PPCPs in archived U.S. biosolids mirror in contaminant occurrences, frequencies and concentrations, those reported by the U.S. EPA for samples collected in 2006/07. This demonstrates that PPCP releases in U.S. biosolids have been ongoing for many years and the most abundant PPCPs appear to show limited fluctuations in mass over time when assessed on a nationwide basis. The here demonstrated use of five mega composite samples holds promise for conducting cost-effective, routine monitoring on a regional basis. PMID:20106500

McClellan, Kristin; Halden, Rolf U.

2010-01-01

413

Removal of pharmaceuticals and personal care products during water recycling: microbial community structure and effects of substrate concentration.  

PubMed

Many pharmaceuticals and personal care products (PPCPs) have been shown to be biotransformed in water treatment systems. However, little research exists on the effect of initial PPCP concentration on PPCP biotransformation or on the microbial communities treating impacted water. In this study, biological PPCP removal at various concentrations was assessed using laboratory columns inoculated with wastewater treatment plant effluent. Pyrosequencing was used to examine microbial communities in the columns and in soil from a soil aquifer treatment (SAT; a method of water treatment prior to reuse) site. Laboratory columns were supplied with different concentrations (0.25, 10, 100, or 1,000 ?g liter(-1)) of each of 15 PPCPs. Five PPCPs (4-isopropyl-3-methylphenol [biosol], p-chloro-m-xylenol, gemfibrozil, ketoprofen, and phenytoin) were not removed at any tested concentrations. Two PPCPs (naproxen and triclosan) exhibited removals independent of PPCP concentration. PPCP removal efficiencies were dependent on initial concentrations for biphenylol, p-chloro-m-cresol, chlorophene, diclofenac, 5-fluorouracil, ibuprofen, and valproic acid, showing that PPCP concentration can affect biotransformation. Biofilms from sand samples collected from the 0.25- and 10-?g liter(-1) PPCP columns were pyrosequenced along with SAT soil samples collected on three consecutive days of a wetting and drying cycle to enable comparison of these two communities exposed to PPCPs. SAT communities were similar to column communities in taxonomy and phylotype composition, and both were found to contain close relatives of known PPCP degraders. The efficiency of biological removal of PPCPs was found to be dependent on the concentration at which the contamination occurs for some, but not all, PPCPs. PMID:24509919

Onesios-Barry, Kathryn M; Berry, David; Proescher, Jody B; Sivakumar, I K Ashok; Bouwer, Edward J

2014-04-01

414

Occurrence of acidic pharmaceuticals and personal care products in Turia River Basin: from waste to drinking water.  

PubMed

The occurrence of 21 acidic pharmaceuticals, including illicit drugs, and personal care products (PPCPs) in waste, surface and drinking water and in sediments of the Turia River Basin (Valencia, Spain) was studied. A liquid chromatography tandem mass spectrometry (LC-MS/MS) method was developed for the determination of these PPCPs with electrospray (ESI) in negative ionization (NI) mode. Ammonium fluoride in the mobile phase improved ionization efficiency by an average increase in peak area of 5 compared to ammonium formate or formic acid. All studied compounds were detected and their concentration was waste water>surface water>drinking water. PPCPs were in waste water treatment plants (WWTPs) influents up to 7.26?gL(-1), dominated by ibuprofen, naproxen and 11-nor-9-carboxy-?9-tetrahydrocannabinol (THCOOH). WWTPs were highly effective in removing most of them, with an average removal rate of >90%. PPCPs were still detected in effluents in the 6.72-940ngL(-1) range, with the THCOOH, triclocarban, gemfibrozil and diclofenac as most prevalent. Similarly, diclofenac, gemfibrozil, ibuprofen, naproxen and propylparaben were detected quite frequently from the low ngL(-1) range to 7?gL(-1) in the surface waters of Turia River. Ibuprofen, methylparaben, salicylic acid and tetrahydrocannabinol (THC) were at concentrations up to 0.85ngg(-1) d.w. in sediments. The discharge of WWTP as well as of non-treated waters to this river is a likely explanation for the significant amount of PPCPs detected in surface waters and sediments. Mineral and tap waters also presented significant amounts (approx. 100ngL(-1)) of ibuprofen, naproxen, propylparaben and butylparaben. The occurrence at trace levels of several PPCPs in drinking water raises concerns about possible implications for human health. PMID:24686145

Carmona, Eric; Andreu, Vicente; Picó, Yolanda

2014-06-15

415

Detection of pharmaceuticals and personal care products (PPCPs) in near-shore habitats of southern Lake Michigan.  

PubMed

Pharmaceuticals and personal care products (PPCPs) have been documented throughout the United States freshwaters but research has focused largely on lotic systems. Because PPCPs are designed to have a physiological effect, it is likely that they may also influence aquatic organisms. Thus, PPCPs may negatively impact aquatic ecosystems. The objectives of this research were to quantify PPCP abundance in near-shore habitats of southern Lake Michigan and identify factors related to PPCP abundance. Stratified sampling was conducted seasonally at four southern Lake Michigan sites. All sites and depths had measurable PPCP concentrations, with mean individual compound concentrations of acetaminophen (5.36 ng/L), caffeine (31.0 ng/L), carbamazepine (2.23 ng/L), cotinine (4.03 ng/L), gemfibrozil (7.03 ng/L), ibuprofen (7.88 ng/L), lincomycin (4.28 ng/L), naproxen (6.32 ng/L), paraxanthine (1,7-dimethylxanthine; 46.2 ng/L), sulfadimethoxine (0.94 ng/L), sulfamerazine (0.92 ng/L), sulfamethazine (0.92 ng/L), sulfamethoxazole (26.0 ng/L), sulfathiazole (0.92 ng/L), triclocarban (5.72 ng/L), trimethoprim (5.15 ng/L), and tylosin (3.75 ng/L). Concentrations of PPCPs varied significantly among sampling times and locations (river mouth vs offshore), with statistical interactions between the main effects of site and time as well as time and location. Concentrations of PPCPs did not differ with site or depth. Temperature, total carbon, total dissolved solids, dissolved oxygen, and ammonium concentrations were related to total pharmaceutical concentrations. These data indicate that PPCPs are ubiquitous and persistent in southern Lake Michigan, potentially posing harmful effects to aquatic organisms. PMID:23648448

Ferguson, Patrick J; Bernot, Melody J; Doll, Jason C; Lauer, Thomas E

2013-08-01

416

Monitoring of emerging contaminants (pharmaceuticals, Personal Care Products, surfactants and heavy metals) in a quaternary detritic aquifer  

NASA Astrophysics Data System (ADS)

The presence of 209 emerging compounds, surfactants, priority substances according to the 2008/105/EC Directive, 10 heavy metals and microbiological organisms in blended water and aquifer samples was investigated in a quaternary aquifer. The effects of these compounds over the environment are not clear in many cases, but many of them have been classified as endocrine disruptor compounds, EDC. Their presence in the media is controlled in one hand by their transformation and/or removal rates and, on the other hand, by their continuous release into the media, due to the broad use of these in many human activities (pharmaceuticals, personal care products, pesticides, heavy metals, LAS and others). The attention of this work focusses on the presence and fate of these substances in the vadose zone and the aquifer. The aquifer catchment (81km2) located in SE Spain presents a high natural salinity (with EC values of ~7,500 ?S cm-1, and high concentrations of chloride, sulphate and sodium), making it unsuitable to be used as drinking water or irrigation. Two sampling campaigns (February and June 2011) in wells and springs have been carried out top characterize physic-chemical, microbiological and emerging contaminants presence in the aquifer. A total of 209 emerging pollutants grouped into the following classes were analysed: 125 pharmaceutical compounds (Phs), 20 polyaromatic hydrocarbons (PAHs) and Dioxins, 46 pesticides, 3 volatile priority pollutants as well as the most commonly used anionic surfactants were identified for further analysis. Heavy metals included: Cu, Cd, Pb, Hg, Ni, Zn, Sn, Pt, Pd and Tl. Results showed that 39 out of all compounds were detected: 11 pharmaceuticals, 9 PAHs, 19 pesticides, 4 surfactants and 4 heavy metals. Two of the compounds, endosulfan-? and Ni, were detected in concentrations above the allowed regulation. Although results are limited to 2 sampling campaigns, it is important to note that surfactants (LAS), pesticides PAHs and Dioxins were detected in most of the water samples, this indicates the presence of wastewater effluents of urban origin and agricultural impacts. The ubiquitous presence of LAS is related to the low-sorption capacity and its wide variety of applications, ranging from cleaning products to pesticide formulation (among others).

Candela, L.; Valdes-Abellan, J.; Jiménez-Martínez, J.

2012-04-01

417

The new production theory for health care through clinical reengineering: a study of clinical guidelines--Part II.  

PubMed

In Part I of this two-part article, in the December 1994 issue of the journal, the author discussed the manufacturing theories of Peter Drucker in terms of their applicability for the health care field. He concluded that Drucker's four principles and practices of manufacturing--statistical quality control, manufacturing accounting, modular organization, and systems approach--do have application to the health care system. Clinical guidelines, a variation on the Drucker theory, are a specific example of the manufacturing process in health. The performance to date of some guidelines and their implications for the health care reform debate are discussed in Part II of the article. PMID:10139603

Sharp, J R

1995-01-01

418

Ultra-high-performance liquid chromatography–tandem mass spectrometry for determining the presence of eleven personal care products in surface and wastewaters  

Microsoft Academic Search

Personal care products (PCPs) are widely used emerging contaminants which can cause adverse environmental effects. This paper reports the development and validation of a method based on solid-phase extraction (SPE) and ultra-high-performance liquid chromatography–electrospray ionisation–tandem mass spectrometry (UHPLC–(ESI)MS–MS) for simultaneously determining eleven PCPs: 4 preservatives (methylparaben; ethylparaben; benzylparaben; propylparaben); 2 antimicrobial agents (triclocarban and triclosan) and 5 UV filters (2,4-dihydroxybenzophenone;

Marta Pedrouzo; Francesc Borrull; Rosa Maria Marcé; Eva Pocurull

2009-01-01

419

Percutaneous reduction and flexible intramedullary nailing for monteggia fracture in a skeletally mature patient  

PubMed Central

INTRODUCTION Monteggia lesions are defined as a fracture of the proximal ulna with an associated radial head dislocation. Management of these injuries varies depending upon the patient population, ranging from non-operative treatment with closed reduction and immobilization to surgical fixation. Percutaneous techniques of radial head reduction are often reserved for skeletally immature patients. PRESENTATION OF CASE In this case report, a 14-year-old female presented with left elbow pain three days after a fall. Radiographs and CT images from an outside hospital revealed a displaced left radial head fracture and a non-displaced proximal olecranon fracture, consistent with a Monteggia equivalent fracture. The patient underwent percutaneous reduction and internal fixation of the radial head with a flexible intramedullary nail (Metaizeau technique), and open reduction and internal fixation of the olecranon. She developed a 25 degree left elbow flexion contracture and, five months after her index procedure, underwent arthroscopic release and removal of hardware. The radial head reduction was near anatomic and she regained full extension. DISCUSSION This report demonstrates that percutaneous reduction with intramedullary nailing and fixation techniques can be performed successfully in skeletally mature patients. CONCLUSION Given their less invasive nature, we recommend attempting percutaneous interventions in some skeletally mature individuals for fracture reduction and fixation. PMID:25460489

Beutel, Bryan G.; Klifto, Christopher S.; Chu, Alice

2014-01-01

420

Propionibacterium acnes and Staphylococcus lugdunensis Cause Pyogenic Osteomyelitis in an Intramedullary Nail Model in Rabbits  

PubMed Central

Propionibacterium acnes and coagulase-negative staphylococci (CoNS) are opportunistic pathogens implicated in prosthetic joint and fracture fixation device-related infections. The purpose of this study was to determine whether P. acnes and the CoNS species Staphylococcus lugdunensis, isolated from an “aseptically failed” prosthetic hip joint and a united intramedullary nail-fixed tibial fracture, respectively, could cause osteomyelitis in an established implant-related osteomyelitis model in rabbits in the absence of wear debris from the implant material. The histological features of P. acnes infection in the in vivo rabbit model were consistent with localized pyogenic osteomyelitis, and a biofilm was present on all explanted intramedullary (IM) nails. The animals displayed no outward signs of infection, such as swelling, lameness, weight loss, or elevated white blood cell count. In contrast, infection with S. lugdunensis resulted in histological features consistent with both pyogenic osteomyelitis and septic arthritis, and all S. lugdunensis-infected animals displayed weight loss and an elevated white blood cell count despite biofilm detection in only two out of six rabbits. The differences in the histological and bacteriological profiles of the two species in this rabbit model of infection are reflective of their different clinical presentations: low-grade infection in the case of P. acnes and acute infection for S. lugdunensis. These results are especially important in light of the growing recognition of chronic P. acnes biofilm infections in prosthetic joint failure and nonunion of fracture fixations, which may be currently reported as “aseptic” failure. PMID:24599975

Gahukamble, Abhay Deodas; McDowell, Andrew; Post, Virginia; Salavarrieta Varela, Julian; Rochford, Edward Thomas James; Richards, Robert Geoff; Patrick, Sheila

2014-01-01