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Nail Care Products  


... Acrylics") Artificial nails are composed primarily of acrylic polymers and are made by reacting together acrylic monomers, such as ethyl methacrylate monomer, with acrylic polymers, such as polymethylmethacrylate. When the reaction is completed, ...


Artificial Nails Require Care to Keep Nails Healthy  


... treatment for any nail problems. If you have questions or concerns about caring for your nails, see a dermatologist. Search Find a Dermatologist ZIP code: Radius: Search Advanced search » Home Advertising, marketing and sponsorships Legal notice Site map Copyright © 2013 ...


Nail care for newborns  


Newborn fingernails and toenails are usually soft and flexible. However, if they are ragged or too long, ... to keep your baby's nails clean and trimmed. Newborns do not yet have control of their movements. ...


Nail cosmetics.  


The nail as an anatomic structure protects the terminal phalanx of the digit from injury. Historically, it has served as a tool for protection and for survival. As civilizations developed, it attained the additional function of adornment. Nail beautification is a big industry today, with various nail cosmetics available, ranging from nail hardeners, polishes, extensions, artificial/sculpted nails, and nail decorations. Adverse events may occur either during the nail-grooming procedure or as a reaction to the individual components of the nail cosmetics. This holds true for both the client and the nail technician. Typically, any of the procedures involves several steps and a series of products. Separate "nail-bars" have been set up dedicated to serve women and men interested in nail beautification. This article attempts to comprehensively inform and educate the dermatologist on the services offered, the products used, and the possible/potential adverse effects related to nail-grooming and nail cosmetics. PMID:22565430

Madnani, Nina A; Khan, Kaleem J


Tips for Healthy Nails  


... treatment for any nail problems. If you have questions or concerns about caring for your nails, see a dermatologist. Search Find a Dermatologist ZIP code: Radius: Search Advanced search » Home Advertising, marketing and sponsorships Legal notice Site map Copyright © 2013 ...


Nail surgery.  


Nail surgery is a special branch of hand and dermatologic surgery. It is not widely performed, and many physicians do not feel at ease to perform it. The objective of this contribution is to give a short overview of the most important surgical procedures in clinical practice. References from the literature and the author's own experiences are condensed to describe what a dermatologic practitioner with knowledge of the nail and some surgical skills can perform. Nail surgery is a precise technique that requires careful administration and attention to details. Proper patient preparation starts with a patient history to identify potential contraindications and to prevent unnecessary complications. The author recommends isopropyl alcohol scrub and chlorhexidine for disinfection and ropivacaine 1% for anesthesia. The technique used for anesthesia depends on the type of surgery. Surgical procedures are described for diagnostic biopsies, nail avulsion in general, onychogryposis, paronychia treatment, hematomas and bone fracture due to trauma, removal of subungual foreign bodies, ingrowing nails, pincer nails, warts, ungual fibrokeratomas, digital myxoid pseudocyst, subungual exostoses, and various tumors. If performed correctly with adequate skills, nail surgery will lead to functionally and aesthetically satisfying results in the majority of instances. PMID:24079580

Haneke, Eckart


Nail-Gun Injuries to the Hand  

PubMed Central

Background: The nail gun is a commonly utilized tool in carpentry and construction. When used properly with appropriate safety precautions, it can facilitate production and boost efficiency; however, this powerful tool also has the potential to cause serious injury. The most common site of nail-gun injuries in both industrial and nonoccupational settings is the hand. Materials and Methods: We report on two patients with nail-gun injuries to the hand. A review of the literature and discussion of clinical evaluation and treatment of nail-gun injuries to the hand are presented. Results: Two patients present with soft tissue injuries to the hand with the nail embedded and intact at the injury site. Operative removal of the nail and wound care resulted in successful treatment in both cases. Nail-gun injuries to the hand vary in severity on the basis of the extent of structural damage. Treatment is based on the severity of injury and the presence and location of barbs on the penetrating nail. Conclusion: Healthcare providers must understand and educate patients on the prevention mechanics of nail-gun injuries. Nail-gun injuries to the hand necessitate appropriate evaluation techniques, understanding of surgical management versus nonsurgical management, and awareness of potential pitfalls in treatment.

Pierpont, Yvonne N.; Pappas-Politis, Effie; Naidu, Deepak K.; Salas, R. Emerick; Johnson, Erika L.; Payne, Wyatt G.



Household Products Database: Personal Care  


... mascara Men's Products Mens Products moisturizing mouthwash nail polish/enamel nappies night cream/lotion pain relief/first aid permanent Personal Cleanliness polish remover pre-lightener preshave protective hand cream semi- ...


Evaluation of nail abnormalities.  


Knowledge of the anatomy and function of the nail apparatus is essential when performing the physical examination. Inspection may reveal localized nail abnormalities that should be treated, or may provide clues to an underlying systemic disease that requires further workup. Excessive keratinaceous material under the nail bed in a distal and lateral distribution should prompt an evaluation for onychomycosis. Onychomycosis may be diagnosed through potassium hydroxide examination of scrapings. If potassium hydroxide testing is negative for the condition, a nail culture or nail plate biopsy should be performed. A proliferating, erythematous, disruptive mass in the nail bed should be carefully evaluated for underlying squamous cell carcinoma. Longitudinal melanonychia (vertical nail bands) must be differentiated from subungual melanomas, which account for 50 percent of melanomas in persons with dark skin. Dystrophic longitudinal ridges and subungual hematomas are local conditions caused by trauma. Edema and erythema of the proximal and lateral nail folds are hallmark features of acute and chronic paronychia. Clubbing may suggest an underlying disease such as cirrhosis, chronic obstructive pulmonary disease, or celiac sprue. Koilonychia (spoon nail) is commonly associated with iron deficiency anemia. Splinter hemorrhages may herald endocarditis, although other causes should be considered. Beau lines can mark the onset of a severe underlying illness, whereas Muehrcke lines are associated with hypoalbuminemia. A pincer nail deformity is inherited or acquired and can be associated with beta-blocker use, psoriasis, onychomycosis, tumors of the nail apparatus, systemic lupus erythematosus, Kawasaki disease, and malignancy. PMID:22534387

Tully, Amber S; Trayes, Kathryn P; Studdiford, James S



Nail Trauma  


... the trauma to the nail injures the nail matrix (the tissue inside the cuticle at the base ... a ridge or split can develop. If the matrix heals normally, this deformity eventually will disappear as ...


Current topics in nail surgery  


BACKGROUND: Nail surgery can be performed in an office-based dermatology practice with a limited amount of specialized equipment and training. Several excellent reviews have been published in recent years that detail the techniques of nail surgery for both the novice and the experienced practitioner. OBJECTIVE: In this article recent developments in nail surgery are discussed. Topics that are treated include the general principles of nail surgery, including epidemiologic issues, studies of nail anatomy, instrumentation, and anesthesia. The reconstruction of injuries and congenital defects involving the nail is explained, and the role of the hand surgeon clarified. Appropriate removal of tumours and cysts is considered, with special attention to the management of malignant lesions. The controversy regarding more or less conservative management of melanonychia striata is addressed, and the need for early diagnosis of subungual melanoma is emphasized. Other topics are surgical management of ingrown nails and onychomycosis. Newer areas of nail surgery, such as laser surgery of the nail, psychodermatology of the nail, and the role of primary care physicians in simple nail surgery are also examined. PMID:10575165

Alam; Scher



Psoriatic Nails  


PsoriasisNet Article Psoriatic Nails About 50 percent of persons with active psoriasis have psoriatic changes in fingernails and/or toenails. In some instances psoriasis may occur only in the nails and nowhere else on the body. Psoriatic changes ...


Nail histopathology.  


The structure of the nail unit is complex and many dermatologists and dermatopathologists have an incomplete understanding of it. Familiarity with the anatomy and histology of this unit, however, is a key factor in improving the diagnostic yield of nail biopsy. Inflammatory or infectious conditions that affect the nail can have a marked impact on a patient's quality of life. A wide-ranging variety of tumors can also develop in this region and they may be life-threatening or require surgery that will result in functional defects. The author reviews the anatomy and histology of the nail unit as well as the basic histopathologic findings in the most common conditions affecting the nails. PMID:23871460

Martin, B



Fungal nail infection  


Nails - fungal infection; Onychomycosis; Infection - fungal - nails; Tinea unguium ... hair, nails, and outer skin layers. Common fungal infections include: Athlete's foot Jock itch Ringworm on the ...


Nail Fungus  


... a fungus that belongs to a group of fungi called dermatophytes. But yeasts and molds also can be responsible for nail fungal infections. What are fungi? Fungi are microscopic organisms that don't need ...


Common nail disorders.  


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


Controlling Chemical Hazards in the Nail Salon Industry.  

National Technical Information Service (NTIS)

Artificial nail products are composed of various chemicals. The main ingredient for most artificial nail products is ethyl methacrylate (EMA). In 1974 the U.S. Food and Drug Administration (FDA) banned a similar chemical, methyl methacrylate (MMA), for us...

A. B. Spencer C. F. Estill J. B. McCammon O. E. Johnston



Yellow nail syndrome (image)  


Yellow nail syndrome is characterized by yellow nails that lack a cuticle, grow slowly, and are loose or detached (onycholysis). Yellow nail syndrome is most commonly associated with lung disorders, and ...


Yellow nails (image)  


Yellow nails are seen in the 'yellow nail syndrome' in which there is thickening and yellow to yellow-green discoloration of all nails. Lymphedema, especially of the ankles, and compromised respiration ...


Mycology of nail disorders.  


Cases of onychomycosis represent up to 30% of diagnosed superficial fungal infections and are caused by three groups of fungi: dermatophytes, yeasts, and nondermatophytic molds. The majority of toenail infections are caused by dermatophytes; Trichophyton rubrum is isolated with the greatest frequency. In infections of fingernails, Candida species can be isolated as frequently as the dermatophytes. Of the molds, Scytalidium species can infect both fingernails and toenails, as well as adjacent skin, and represent 3% of the nail infections in a temperate country such as the United Kingdom but a much higher proportion in tropical countries. Other molds such as Scopulariopsis, Acremonium, and Aspergillus species can infect damaged nails. The isolation of a dermatophyte is always considered indicative of infection, but the presence of other molds, which may be aerial contaminants, must be interpreted with care. PMID:8077512

Midgley, G; Moore, M K; Cook, J C; Phan, Q G



Nail Gun Injuries Among Construction Workers  

Microsoft Academic Search

Pneumatic nail guns greatly increase worker productivity and are extensively used in wood frame building construction, with especially high use in residential construction. One surveillance report of nail gun injuries in Washington State has been published; however, other literature consists largely of case reports and case series in trauma journals. The major objective of the current study was to investigate

John M. Dement; Hester Lipscomb; Leiming Li; Carol Epling; Tejas Desai



Nailing Pompeii  

NASA Astrophysics Data System (ADS)

Roman hihstorian Pliny the Younger noted that Mount Vesuvius blew its top and destroyed Pompeii in the early afternoon of August 24, 1,918 years ago. Now, a team of scientists, tempted by the certainty of that record, has confirmed the eruption to within 7 years. The team developed and used an improved radioactive argon-argon dating technique, which they say can reliably establish the age of rocks as old as the solar system or as recent as 1,000 years old.“We nailed the date to 5% on our first attempt, so we could probably get the error down to 1% or less,” says Paul Renne, adjunct associate professor of geology and geophysics at the University of California at Berkeley and director of the private Berkeley Geochronology Center. “Dating things that are really young has always been the Holy Grail of potassium-argon [an earlier method] and argonargon dating.”

Showstack, Randy


Nail-Plate-Reinforced Bolt Joints of Kerto-LVL Structures. Production Specification.  

National Technical Information Service (NTIS)

The publication is the final report of the product development research project on developing Kerto-LVL structure joints which can be assembled on the construction site. Included are the product specifications and design, and the production and quality co...

A. Kevarinmaeki J. Kangas T. Nokelainen P. Kanerva



Dosimetry during intramedullary nailing of the tibia  

PubMed Central

Background Intramedullary nailing under fluoroscopic guidance is a common operation. We studied the intraoperative radiation dose received by both the patient and the personnel. Patients and methods 25 intramedullary nailing procedures of the tibia were studied. All patients suffered from tibial fractures and were treated using the Grosse-Kempf intramedullary nail, with free-hand technique for fixation of the distal screws, under fluoroscopic guidance. The exposure, at selected positions, was recorded using an ion chamber, while the dose area product (DAP) was measured with a DAP meter, attached to the tube head. Thermoluminescent dosimeters (TLDs) were used to derive the occupational dose to the personnel, and also to monitor the surface dose on the gonads of some of the patients. Results The mean operation time was 101 (48–240) min, with a mean fluoroscopic time of 72 seconds and a mean DAP value of 75 cGy·cm2. The surface dose to the gonads of the patients was less than 8.8 mGy during any procedure, and thus cannot be considered to be a contraindication for the use of this technique. Occupational dose differed substantially between members of the operating personnel, the maximum dose recorded being to the operator of the fluoroscopic equipment (0.11 mSv). Interpretation Our findings underscore the care required by the primary operator not to exceed the dose constraint of 10 mSv per year. The rest of the operating personnel, although they do not receive very high doses, should focus on the dose optimization of the technique.



A preliminary survey of Vietnamese nail salon workers in Alameda County, California.  


In recent decades, the nail salon industry has been one of the fastest growing in the U.S. California has over 300,000 workers licensed to perform nail care services. Though little is known about their health, these workers routinely handle cosmetic products containing carcinogens and endocrine disruptors that may increase a woman's breast cancer risk. Additionally, an estimated 59-80% of California nail salons are run by Vietnamese women who face socio-cultural barriers that may compromise their workplace safety and health care access. In a pilot project designed to characterize Vietnamese nail salon workers in Alameda County, California in order to inform future health interventions and reduce occupational exposures, we conducted face-to-face surveys with a convenience sample of 201 Vietnamese nail salon workers at 74 salons. Of the workers surveyed, a majority reported that they are concerned about their health from exposure to workplace chemicals. Additionally, a sizeable proportion reported having experienced some health problem after they began working in the industry, particularly acute health problems that may be associated with solvent exposure (e.g. skin and eye irritation, breathing difficulties and headaches). Our findings highlight a critical need for further investigation into the breast cancer risk of nail salon workers, underscored by the workers' routine use of carcinogenic and endocrine-disrupting chemicals, their prevalent health concerns about such chemicals, and their high level of acute health problems. Moreover, the predominance of Vietnamese immigrant women in this workforce makes it an important target group for further research and health interventions. PMID:18478317

Quach, Thu; Nguyen, Kim-Dung; Doan-Billings, Phuong-An; Okahara, Linda; Fan, Cathyn; Reynolds, Peggy



Uncoiling of reamer during intramedullary nailing for fracture shaft of femur  

PubMed Central

Intramedullary nailing is considered the standard of care for closed femoral shaft fractures. Several studies have shown that reamed intramedullary nailing is a safe procedure in fracture shaft femur with lower nonunion rates than unreamed nailing. Reamed intramedullary nailing provides better stability because of increased contact between the nail and medullary canal. However, careful attention to reaming techniques as well good instrumentation is necessary while undertaking such a procedure. We report what is, to the best of our knowledge, the first case of uncoiling of reamer while reaming the medullary canal. Possible causes and measures to avoid such a complication are discussed.

Meena, Sanjay; Trikha, Vivek; Singh, Vivek; Mittal, Samarth; Kishanpuria, Tanmay S.



Application of Ground Anchors and Soil Nails in Roadway Construction (on CD-ROM).  

National Technical Information Service (NTIS)

This product, 'Application of Ground Anchors and Soil Nails in Roadway Construction' includes five multimedia presentations that describe and explain the principles of science and engineering related to the construction of ground anchors and soil nail wal...



Advanced Nail Surgery  

PubMed Central

Six techniques not yet widely known or used in the dermatologic surgery of the nails are briefly described. Small-to-medium-sized tumours of the proximal nail fold (PNF) can be excised and the defect repaired with advancement or rotation flaps. A superficial biopsy technique of the matrix for the diagnosis of longitudinal brown streaks in the nail, which allows rapid histological diagnosis of the melanocyte focus to be performed, is described here. Because the excision is very shallow and leaves the morphogenetic connective tissue of the matrix intact, the defect heals without scarring. Laterally positioned nail tumours can be excised in the manner of a wide lateral longitudinal nail biopsy. The defect repair is performed with a bipedicled flap from the lateral aspect of the distal phalanx. Malignant tumours of the nail organ often require its complete ablation. These defects can be covered by a full-thickness skin graft, reversed dermal graft, or cross-finger flap. The surgical correction of a split nail is often difficult. The cicatricial tissue of the matrix and PNF have to be excised and the re-attachment of these wounds prevented. The matrix defect has to be excised and sutured or covered with a free matrix graft taken either from the neighbouring area or from the big toe nail.

Haneke, Eckart



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



Nail Gun Safety: A Guide for Construction Contractors.  

National Technical Information Service (NTIS)

Nail guns are used every day on many construction jobs - especially in residential construction. They boost productivity but also cause tens of thousands of painful injuries each year. Nail gun injuries are common - one study found that 2 out of 5 residen...



Nail Bed Injuries  


... grafted from the same finger or from other digits. Tendon injury may require splinting or pinning. Local ... bed can be reconstructed with grafts from other digits. Grafts may be taken from the nail bed ...


Bacterial Nail Infection (Paronychia)  


... 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 ...


Nail Lifting (Onycholysis)  


... or fungal infection is present, you may require antibacterial or antifungal treatment. Trusted Links MedlinePlus: Nail Diseases ... Skinsight's terms of service and privacy policy. The material on this site is for informational purposes only, ...


The Lefevre ulnar nail.  


The Lefevre nail applies the principles of locked intramedullary nailing in the treatment of fractures of the ulna. It is made up of two segments which slide telescopically, so that assembly may be in compression, distraction or neutral. Fixation at the two ends of the ulna is guaranteed by two transverse screws. It may be used in pseudarthrosis and osteotomies for lengthening and shortening, as well as in simple or complex fractures. The cases presented provide an overview of the use of the nail at the Brest Center, where the nail was invented and developed, and at the Rizzoli Institute. The study includes 22 fractures, 1 pseudarthrosis and 1 osteotomy. Consolidation was obtained in all of the cases after an average of 2.5 months. Immobilization in plaster was required only in cases with associated lesion of radius. The functional results obtained were satisfactory. PMID:1756675

Boriani, S; Lefevre, C; Malingue, E; Bettelli, G


Nail gun injuries among construction workers.  


Pneumatic nail guns greatly increase worker productivity and are extensively used in wood frame building construction, with especially high use in residential construction. One surveillance report of nail gun injuries in Washington State has been published; however, other literature consists largely of case reports and case series in trauma journals. The major objective of the current study was to investigate the occurrence of nail gun-associated injuries among construction workers and to identify preventable work-related factors associated with these injuries. Nail gun-related injuries occurring among a cohort of 13,347 carpenters in Ohio who worked union hours during the time period January 1, 1994, until September 30, 1997, were identified by matching the cohort with workers' compensation claims made to the Ohio Bureau of Workers' Compensation. We also analyzed workers' compensation claims for North Carolina Home Builders Association members for the period July 1996-November 1999 to identify nail gun-related injuries. Analyses included stratified analyses of claims by nature and body part injured, calculation of nail gun injury rates, and analyses of free text descriptions of injuries. Overall, nail gun injuries were responsible for 3.9 percent of workers' compensation claims with 8.3 percent to 25.5 percent of claims involving paid lost work time. The overall rate of nail gun injuries (cases per 200,000 work hours) was 0.33 in North Carolina and 0.26 in Ohio, reflecting the greater concentration of wood frame construction workers in the North Carolina population studied. Higher rates of injury were observed for carpenters in North Carolina and among residential carpenters in Ohio. The predominant body part injured was the hands/fingers, with 80 to 89 percent of injuries being nail punctures. Analyses of free text information for puncture injuries found approximately 70 percent of injuries to occur during the framing/sheathing stage of construction. Our data suggest that approximately 69 percent of puncture injuries may be due to an inadvertent gun discharge or misfire, preventable in large part by the use of sequential triggers. Worker training and education also are important components of nail gun injury prevention. PMID:12746081

Dement, John M; Lipscomb, Hester; Li, Leiming; Epling, Carol; Desai, Tejas



Production of nursing care in primary health care services.  


This descriptive and quantitative study aimed to characterize the production of nursing care in primary health care services in a region of the city of Ribeirão Preto, state of São Paulo, Brazil. The study sample comprised care actions delivered by nurses and registered in the HygiaWeb Information System, from 2006 to 2009. Statistical analysis was performed. Results showed that nursing care delivered by nurses accounted for 9.5 to 14.6% of total professional care provided by professionals. Eventual care actions were the most frequent. The concentration of programmatic care was higher for children, women, pregnant and postpartum women. In conclusion, the predominance of eventual care demonstrated that the health system has been focused on acute conditions. Little of nursing work has been directed at the achievement of comprehensiveness, considering the inexpressive share of longitudinal follow up in total care delivery. The expansion of nursing staff represents potential for care delivery to the population, but further qualification of nursing actions is needed. PMID:22990156

Matumoto, Silvia; Vieira, Kátia Cristina dos Santos; Pereira, Maria José Bistafa; dos Santos, Claudia Benedita; Fortuna, Cinira Magali; Mishima, Silvana Martins


Aging changes in nails (image)  


The nails change with aging, growing more slowly, and becoming dull and brittle. The color may change from translucent to yellowed and opaque. Nails, especially toenails, may become hard and thick and ...


Nails: diagnostic clue to genodermatoses.  


Nails are cutaneous appendages mostly involved in mechanical functions. However, nails may reflect presence of various systemic disorders evidenced by alteration of their shape, size, color or texture. Genodermatoses are multisystem disorders with cutaneous involvement. Many of the genodermatoses present with nail changes and some of these may be the clinical pointers to the diagnosis. Diagnostic clues to various genodermatoses derived from nail findings have been discussed. PMID:22565426

Inamadar, Arun C; Palit, Aparna


Biomechanics of the interlocking nail  

Microsoft Academic Search

Conventional interlocking nails for the femur use an inclined proximal interlocking screw; the AO\\/ASIF universal interlocking nail utilizes a transverse interlocking screw which is anchored in cortical bone. The transverse position of the screw allows one to employ the nail for either the right or left side. The yield strength of the thinner diameter transverse screw, (thread 4.5 mm, core

C. Kinast; R. Frigg; S. M. Perren



Anatomic aspects of tibiotalocalcaneal nail arthrodesis.  


During the past 15 years, tibiotalocalcaneal nail arthrodesis has become an established procedure for the treatment of specific disorders of the hindfoot and ankle. However, controversy exists regarding the proper starting point for obtaining and maintaining the correct hindfoot position to allow successful fusion. One of the challenges with this procedure is aligning the tibial canal with the central talus and calcaneus for placement of the intramedullary nail. We performed a cadaver study to evaluate the radiographic and anatomic position of the tibial canal and the central talus as it relates to placement of a retrograde tibiotalocalcaneal nail. In our subjects, guide wires directed in an antegrade fashion down the tibial canal were more likely to enter lateral to the midline of the talus and miss the calcaneal body medially. These data have revealed a mismatch among the central axis of the tibia, talus, and calcaneus. Surgeons must pay careful attention to wire placement across these 3 bone segments during retrograde tibiotalocalcaneal nailing. PMID:24021265

Hyer, Christopher F; Cheney, Nick



New tools in nail disorders.  


Tumors of the nail unit may be difficult to diagnose because of the screening effect of the nail plate. In longitudinal melanonychia, several new promising techniques assist with early diagnosis of melanoma (in vivo matrix dermoscopy and immunohistochemistry) as well as sparing as much of the healthy tissues as is possible (shave biopsy technique). Diagnosing nail disorders is in some instances difficult both for the clinician and the pathologist. New tools such as polymerase chain reaction have been proposed for onychomycosis, which accounts for more than half of nail conditions, will allow quick and accurate diagnosis. However, polymerase chain reaction analysis remains expensive and is not routinely used by clinicians. Scoring nail dystrophy by clinical observation remains very subjective; therefore, severity indexes have been proposed. Another emerging noninvasive technique is forensic analysis of nail clippings for detection of drug intake and abuse, as well as exposure to environmental pollution. PMID:19341942

Richert, Bertrand; Lateur, Nadine; Theunis, Anne; Andre, Josette



Efficacy Testing for Hair Care Products  

Microsoft Academic Search

For the efficacy testing of hair care products, a number of methods are available. Scanning electron microscopy and atomic force microscopy are most suitable for surface evaluation; the swelling properties in the course of a treatment are determined using a fiber-swelling analyzer, and the luster may be reliably determined by means of a multiangle goniophotometer. Further, surface tension is a

Hartwig Höcker



Nail psoriasis - a treatment challenge.  


Nail involvement in psoriasis is common and mostly occurs with other lesions but can also occur alone. Besides psychosocial and aesthetic impairments, patients often complain about functional impairment. Nail psoriasis is a predictor for more severe psoriasis, decreased quality of life, and a higher risk for the development of psoriatic arthritis. Onychomycosis and other differential diagnoses should be excluded prior to treatment. This article presents an overview of different clinical appearances of nail psoriasis, the essential diagnostic assessment before treatment, important differential diagnoses, and published data on treatment options for nail psoriasis. PMID:23425398

Radtke, Marc A; Beikert, Florian C; Augustin, Matthias



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,...



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...



Erosive potential of oral care products.  


Seven oral care products and orange juice as a positive control were tested for the erosive potential by immersing each enamel specimen (10 per group) into solutions of the various products for 10 and 20 min. Before and after the experiment Knoop surface hardness (SMH) was measured. The enamel microstructure before and after immersion was assessed by scanning electron microscopy and confocal laser scanning microscopy. Orange juice produced the most marked losses of hardness after 10 and 20 min. Among the dental hygiene products only the fluoride-free toothpaste produced a significant reduction of hardness after 10 as well as after 20 min. With the exception of Elmex gel, all tested oral care products led to a significant (p < 0.05) increase of enamel hardness. The results of the hardness measurements corresponded with the microstructure findings. It may, therefore, be concluded that the tested fluoride-containing oral care products do not exhibit any erosive potential, which could be picked up with the methodologies under study. PMID:11359059

Lussi, A; Hellwig, E



Fungal infections of the nail.  


Onychomycoses represent the most frequently seen nail diseases and are the most difficult to treat of all skin mycoses. They are rare in children and increase in incidence with age. Most cases are caused by dermatophytes, in particular by Trichophyton rubrum, less frequently by T mentagrophytes and Epidermophyton floccosum. Molds may secondarily infect nails already diseased; however, some are probably capable of primary invasion of nail tissues. Yeasts, particularly Candida albicans, are mainly isolated from fingernails in chronic paronychia and onycholysis, and from nails in chronic mucocutaneous candidosis. Mixed infections by dermatophytes, molds, and/or yeasts are not uncommon. Probably, most fungi cannot infect a healthy nail organ, and only predisposing factors such as impaired blood circulation, peripheral neuropathy, diabetes mellitus, damage from repeated minor trauma, and limited immune defects as well as AIDS make the nail susceptible to fungal infection. Most onychomycoses are secondary to a mycosis of the adjacent skin. Distallateral subungual onychomycosis starts at the hyponychium spreading proximally to the nail bed and matrix. In proximal subungual onychomycosis, the fungus infects the cuticle and eponychium to reach the matrix where it becomes enclosed into the nail plate substance. Total dystrophic onychomycosis may result from either form or develop in chronic mucocutaneous candidosis. Superficial white onychomycosis is commonly a culture of T mentagrophytes on the surface of a toenail. Mycotic paronychia and onycholysis are usually due to C albicans. Clinically, onychomycoses have to be differentiated from noninfectious onychodystrophy, nail psoriasis, lichen planus unguium, and chronic nail eczema. Despite a considerable number of effective antifungal drugs, treatment has remained difficult because the predisposing factors are usually not amendable to therapy. PMID:2018719

Haneke, E



Nail technician's ventilator  

US Patent & Trademark Office Database

A portable apparatus for removing fumes and vapors from the work area of a nail technician comprises a transparent hood having two semicircular end walls attached at opposite ends of a semicylindrical side wall so as to create a generally semicylindrical enclosure defining an interior chamber when placed on a flat surface. The side wall has an inner layer and an outer layer which is separated from the inner layer by a preselected distance so as to define a plenum therebetween. Both the inner layer and the outer layer have four portions defining hand openings for the insertion of hands of a nail technician and a customer. The inner layer has a plurality of apertures extending from the interior chamber to the plenum. The hood has at least one suction port in communication with the plenum, the suction port also being in communication with a source of reduced pressure by means of any convenient air passageway such as a hose. The invention optionally includes an in-line filter means connected between said at least one suction port and said source of reduced pressure as well as an air freshener means connected to an exhaust port of the source of reduced pressure, preferable a vacuum cleaner.



Drug-related nail disease.  


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


Nail psoriasis as a severity indicator: results from the PsoReal study  

PubMed Central

Background: Although nail psoriasis affects a substantial proportion of psoriasis patients and causes significant psychologic distress, few epidemiologic data characterizing patients with nail involvement are available. The aim of this research was to elucidate differences between patients with nail psoriasis and those without any nail involvement, taking quality indicators of health care from the patient’s perspective into account. Methods: In total, 2449 patient members of the Deutscher Psoriasis Bund, the largest patient organization for psoriasis in Germany, were interviewed in this nationwide, noninterventional, cross-sectional study. Patients with nail psoriasis were compared with patients without any nail involvement with regard to gender, age, disease duration, affected body surface area, health-related quality of life (Dermatology Life Quality Index [DLQI] ED-5D), patient-defined treatment benefit, amount of inpatient treatments, disease duration, and numbers of work days lost. Results: Data from 2449 patients with psoriasis were analyzed. Overall, 44.8% (1078) of patients were female, mean age was 57.0 ± 11.7 years, and 72.8% had nail involvement and showed higher values for affected body surface area than those without nail involvement (8.3% versus 5.6%, respectively; P < 0.004). Health-related quality of life was significantly lower in patients with nail psoriasis (DLQI 7.2 versus 5.3; ED-5D 60.1 versus 67.3), who had more days off work (9.8 versus 3.3). Conclusion: Nail involvement is an important symptom of psoriasis and is associated with greater disease severity and quality of life impairment. Accordingly, management of psoriasis should include a special focus on nail involvement.

Radtke, Marc A; Langenbruch, Anna K; Schafer, Ines; Herberger, Katharina; Reich, Kristian; Augustin, Matthias



The fixion proximal femur nailing system: biomechanical properties of the nail and a cadaveric study  

Microsoft Academic Search

The treatment of choice for early mobilization of hip fracture is surgery, which traditionally employs side plates and screws or intramedullary nails. We examined the biomechanical properties of a new proximal femoral nail system. The new expandable Fixion proximal femur nailing (PFN) system, made of stainless-steel alloy, consists of a nail, a peg and an anti-rotation pin. Upon positioning, the

Ely L Steinberg; Nehemia Blumberg; Shmuel Dekel


Nail dystrophy in psoriatic arthritis presenting as nail onychomycosis: a case report.  


Dystrophic nail changes without a skin lesion is a rare form of psoriasis. We describe a patient that presented with a chronic nail onychomycosis and a destructive thumb interphalangeal joint which was initially considered as onychomycotic joint infection, and was later diagnosed as having dystrophic nail changes in psoriatic arthritis and coexistent onychomycosis. The nail changes were completely normalized after methotrexate treatment. PMID:22351553

Kim, Joon Yub; Baek, Goo Hyun; Gong, Hyun Sik



Stabilized body care products, household products, textiles and fabrics  

US Patent & Trademark Office Database

Disclosed are stabilized body care products, household products, textiles and fabrics comprising an effective stabilizing amount of at least one compound selected from the group consisting of formula (I)-(III) ##STR00001## where G.sub.1 and G.sub.2 are independently alkyl of 1 to 4 carbon atoms or are together pentamethylene, Z.sub.1 and Z.sub.2 are each methyl, or Z.sub.1 and Z.sub.2 together form a linking moiety which may additionally be substituted by an ester, ether, hydroxy, oxo, cyanohydrin, amide, amino, carboxy or urethane group, X is an inorganic or organic anion, and where the total charge of cations h is equal to the total charge of anions j; and an organic UV filter selected from (c.sub.1) dibenzoylmethane derivatives; (c.sub.2) cinnamic acid esters; (c.sub.3) camphor derivatives; and (c.sub.4) trianilino-s-triazine derivatives.



Congenital malalignment of the big toe nail.  


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



Retrieval of a broken intramedullary femoral nail.  


A method of retrieval of the distal fragment of a broken intramedullary femoral nail is described. The procedure is simple and requires a steel drill, a standard nail extraction hook and a slotted hammer. The method was successfully used in two patients with ununited fractures of the femoral shaft in which the broken intramedullary nail had jammed in the distal fragment. PMID:1572710

Khan, F A



[Nail plate susceptibility to Scopulariopsis brevicaulis infection].  


Nail plate susceptibility to Scopulariopsis brevicaulis infection. Experimental Scopulariopsis brevicaulis infection of toe and finger nails collected from 79 persons of both sexes and at various age is presented. Crumbled nail fragments were incubated with a S. brevicaulis strain isolated from toenail acauliosis. The culture was inspected and evaluated under light microscope after seven days of incubation. Hyphe intensively penetrating nail fragments were found in 67.1% of toenails and 38% of fingernails. The infection was most intensive in the nails collected from males and elderly persons. PMID:16894717

Macura, Anna B; Pawlik, Boles?aw; Perun, Magdalena; Król, Monika



Consensus on melanonychia nail plate dermoscopy*  

PubMed Central

This statement, focused on melanonychia and nail plate dermoscopy, is intended to guide medical professionals working with melanonychia and to assist choosing appropriate management for melanonychia patients. The International Study Group on Melanonychia was founded in 2007 and currently has 30 members, including nail experts and dermatopathologists with special expertise in nails. The need for common definitions of nail plate dermoscopy was addressed during the Second Meeting of this Group held in February 2008. Prior to this meeting and to date (2010) there have been no evidence-based guidelines on the use of dermoscopy in the management of nail pigmentation.

Chiacchio, Nilton Di; de Farias, Debora Cadore; Piraccini, Bianca Maria; Hirata, Sergio Henrique; Richert, Bertrand; Zaiac, Martin; Daniel, Ralph; Fanti, Pier Alessandro; Andre, Josette; Ruben, Beth S; Fleckman, Philip; Rich, Phoebe; Haneke, Eckart; Chang, Patricia; Cherit, Judith Dominguez; Scher, Richard; Tosti, Antonella



Primary care productivity and the health care safety net in New York City.  


Urban safety net providers are under pressure to improve primary care productivity. In a survey of ambulatory care facilities in New York City, productivity (measured as the number of primary care visits per provider hour) increases with exam rooms per physician but has no association with computerized information systems or tightly controlled reimbursement. Also, sample facilities rely heavily on residents, which makes these facilities sensitive to medical education policies and raises questions about quality of care for the poor. We conclude that urban safety net providers will have difficulty making the productivity improvements demanded by a more competitive health system. PMID:11189792

Duck, E; DeLia, D; Cantor, J C



Onycholysis induced by nail hardener.  


Nail hardeners appeared in the market during the 1960s. They were basically solutions of formaldehyde. The first adverse effects were published in 1966 (1). Reactions were onycholysis, chromonychia, subungual haemorrhage, and hyperkeratosis. Onycholysis may be non-inflammatory or inflammatory, and is accompanied by throbbing pain. Inflammatory reactions are followed by paronychia and occasional dermatitis on the digital pulpa. PMID:17868227

Helsing, Per; Austad, Joar; Talberg, Hans Jørgen



Comparative anatomy of mouse and human nail units.  


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



Dermatologic photography of nail pathologies.  


Professional-quality photography of nail pathologies can easily be a routine in a dermatologist's office with the use of modern equipment for a camera system. The camera body component should be a single-lens reflex. The optics should be a true "macro" lens focusing to half life-size for multiple nails and, with an accessory tube, to life-size (X 1 or 1:1) for individual nails. If a choice of focal length macro lenses is available, the longer-length lens is preferable, somewhere between 90 and 120 mm, depending on the manufacturer. A portable electronic flash unit with both thyristor circuitry plus macro focusing sensor calibration is recommended. A flash bracket enabling off-camera flash positioning will provide shadow-producing "pointlight" illumination for delineating pictorial texture and anatomic architecture. One film should be standardized: a daylight-rated color film producing slides not prints, preferably Kodachrome 64 or Ektachrome 64 or 100, manufactured by Eastman Kodak Co. The ASA rating of the film should be matched with the power of the flash unit so that exposure should be a minimum of f.11 or f.16 to provide adequate depth of field at the close-up and ultra close-up magnifications required for nail pathologies. Patient and camera should be positioned so that the major axis of the anatomic site parallels that of camera back (plane of film). The image should fill up as much of the film frame as possible by moving the camera system into close-ups while retaining anatomic landmarks and some portion of uninvolved nail or skin in the immediate area. Film inventories should be stored in either a refrigerator or freezer to avoid heat- and humidity-induced degradation of imaging. When exposed, the film should always be developed by the same processing laboratory, preferably one of Eastman Kodak's regional laboratories throughout the United States. PMID:3830513

Weiss, C H



Titanium, sinusitis, and the yellow nail syndrome.  


Yellow nail syndrome is characterized by nail changes, respiratory disorders, and lymphedema. In a yellow nail patient with a skeletal titanium implant and with gold in her teeth, we found high levels of titanium in nail clippings. This study aims to examine the possible role of titanium in the genesis of the yellow nail syndrome. Nail clippings from patients with one or more features of the yellow nail syndrome were analyzed by energy dispersive X-ray fluorescence. Titanium was regularly found in finger nails in patients but not in control subjects. Visible nail changes were present in only half of the patients. Sinusitis with postnasal drip and cough was the most common complaint. The dominant source of titanium ions was titanium implants in the teeth or elsewhere. The titanium ions were released through the galvanic action of dental gold or amalgam or through the oxidative action of fluorides. In other patients the titanium was derived from titanium dioxide in drugs and confectionary. Stopping galvanic release of titanium ions or canceling exposure to titanium dioxide led to recovery. In one patient with a titanium implant, the symptoms recurred after renewed exposure to titanium. Yellow nail syndrome is caused by titanium. PMID:20809268

Berglund, Fredrik; Carlmark, Björn



YAWN (Yet Another Window on NAIL (exclamation mark)).  

National Technical Information Service (NTIS)

We present the important features of the NAIL knowledge-base system. These include the 'capture-rule' architecture for integrating different logic-evaluation strategies, the NAIL strategy-selection algorithm, and the NAIL intermediate code for coupling wi...

A. Van Gelder J. D. Ullman J. F. Naughton K. Morris Y. Saraiya



Hospital Design's Influence on Productivity and Quality of Care.  

National Technical Information Service (NTIS)

The differences between two hospitals' level of productivity and quality of care were investigated to determine if efficiency in hospital design, and modern technology provide increases in either of these factors. The study consisted of a study of a singl...

B. A. Schwenk



Prevalence of nail involvement in nodal osteoarthritis  

Microsoft Academic Search

The presence of nail changes was investigated in 102 patients with nodal osteoarthritis of the hand. Nail lesions were seen in 14\\/102 patients (13.7%), a prevalence higher than that observed in 96 controls (4\\/96, 4.2%; chi square 4.37, p=0.036). An increased risk of nail changes was associated with osteoarthritis of the hand (odds ratio=3.7, 95% CI 1.13 to 11.8). Longitudinal

M. A. Cimmino; B. Seriolo; S. Accardo



[Familial nail patella-syndrome].  


Nail patella-syndrome is a rare hereditary (autosomal dominant) disorder resulting from a heterogenous loss of function in the LMXB1 gene on chromosome 9q34. It is associated with multiple deformities. Patients have a characteristic tetrad of pathologic symptoms including fingernail dysplasia, hypoplastic or absence patella, radial head dislocation, iliac horns and in some cases nephropathy and ophtalmo-logical findings (glaucoma). In this study four affected members in one family are presented. All of the familly members presented absence or hypoplastic patella and fingernails dysplasia. There were not indications for surgical treatment dislocated radial heads or subluxated dysplastic patella. Genetic counseling is recomended because nail patella syndrome is an autosomal dominant disease. PMID:16521531

Or?owski, Jan



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

Code of Federal Regulations, 2010 CFR

...2009-04-01 false Rigid gas permeable contact lens care products. 886.5918 ...886.5918 Rigid gas permeable contact lens care products. (a) Identification. A rigid gas permeable contact lens care product is a device...



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

Code of Federal Regulations, 2010 CFR

... false Soft (hydrophilic) contact lens care products. 886.5928 ...886.5928 Soft (hydrophilic) contact lens care products. (a) Identification. A soft (hydrophilic) contact lens care product is a device...



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

Code of Federal Regulations, 2010 CFR

... false Soft (hydrophilic) contact lens care products. 886.5928 ...886.5928 Soft (hydrophilic) contact lens care products. (a) Identification. A soft (hydrophilic) contact lens care product is a device...



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

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Rigid gas permeable contact lens care products. 886.5918 ...886.5918 Rigid gas permeable contact lens care products. (a) Identification. A rigid gas permeable contact lens care product is a device...




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



Congenital onychoheterotopia involving multiple toe nails.  


Onychoheterotopia is an uncommon condition in which nail tissue is found beyond the common nail unit of the digits of the hands and feet, most often on the fifth digit of the hand. It represents an extra and independent nail that can be present either congenitally, or more commonly, acquired following trauma. The exact pathogenesis of the congenital type is undetermined. We report a 25-year-old male with multiple congenital ectopic nails of the toes since birth, which has not been reported before. PMID:24072377

Yadav, Savita; Khullar, Geeti; Dogra, Sunil


Approach to managing patients with nail psoriasis.  


Psoriasis is a chronic inflammatory skin condition that affects approximately 2% of the population. Up to 50% of patients with psoriasis have concurrent nail psoriasis, with a lifetime incidence of 80% to 90%. Up to 30% of patients with skin psoriasis also have psoriatic arthritis (PsA) and of these, approximately 80% have nail disease. However, nail involvement is often overlooked by physicians, despite the significant burden it places on 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 are usually concerned about the appearance of their nails, often causing them to avoid normal day-to-day activities (including work). In the longer-term, nail involvement may be a signal of a more severe form of psoriasis or a precursor of PsA. Conventional treatment of nail psoriasis is generally considered inconvenient by patients, and it is limited by adverse effects and often a reduction in efficacy over time. There is also a lack of controlled clinical trials' data and no consistent treatment approach has been advocated. Recently, the effects of biologic agents targeted against tumour necrosis factor alpha (TNFalpha) on nail psoriasis have been investigated. The multicentre, double-blind EXPRESS [European Infliximab for Psoriasis (Remicade) Efficacy and Safety Study] trial revealed that infliximab 5 mg/kg at weeks 0, 2, 6, and then every 8 weeks significantly improved nail psoriasis, evaluated using the Nail Psoriasis Severity Index (NAPSI) in 378 patients with moderate to severe psoriasis. Significant improvement was reported as early as week 10, and at week 50 full nail clearance was evident in 45% of patients receiving infliximab. There is also evidence from small studies that infliximab significantly improves nail lesions and quality of life in patients with nail psoriasis. There is a need for improving the awareness of nail psoriasis and its impact on patients' quality of life. Moreover, the potential role for nail involvement as a link between psoriasis and PsA underlines its importance and the need for effective management. Infliximab has been shown to improve psoriatic nail lesions and quality of life, and it should be considered as one of the most appropriate available treatment options for the many patients with this distressing condition. PMID:19686381

Reich, K



Intracranial nail. A case report.  


Penetrating cranio-cerebral trauma caused by fire-arm constitute the most frequent penetrating wounds in civilian ambit; in these cases the great extention of cerebral damage is the result of distructive forces generated by high velocity which moves this bodies. In civilian ambit cranio-cerebral wounds caused by penetrating bodies, but moved by low cinetic energy are increasing constantly, due to the development of industrial activities. The cases reported in literature are few; in the present paper we present the case of a cranio-cerebral wound caused by a nail, which is the longest nail ever reported in literature (9 cm). Cranio-cerebral penetrating wounds caused by nail are reported only as curious experience; none authors tried to standard the medical-surgical approach as for what concern the clinic valutation, as for treatment. We think that for these traumatic event, we can adapt the same valutations criteria used for wounds caused by fire-arms. For what concerns surgery of such injuries, we consider the emergency operation the best solution; generally in these cases the purpose of surgery is not the removal of devitalized tissues, evacuation of hematomas or removal of bone fragments or of penetrating bodies as happen in cases of penetrating bodies moved by high cinetic energy, but for the possible complications which can result immediately or after the trauma. PMID:7562030

Tancioni, F; Gaetani, P; Pugliese, R; Rodriguez y Baena, R



Productivity and effectiveness in health care.  


In a series of studies, the Swedish Expert Group on Public Finance (ESO) has examined productivity trends in the public sector. Covering some 70% of the public sector, the group found an aggregate productivity loss of 1.5% a year from 1970 to 1980. In the medical services, there was a 3% decline in productivity from 1960 to 1980. One implication of the findings is that the growth rate of Swedish GNP has probably been overestimated. Determinants of productivity trends in the public sector and criticisms levelled at the studies are discussed in the paper. PMID:1983250

Tarschys, D



Safety and efficacy of personal care products containing colloidal oatmeal  

PubMed Central

Background Colloidal oatmeal is a natural ingredient used in the formulation of a range of personal care products for relief of skin dryness and itchiness. It is also used as an adjunctive product in atopic dermatitis. The safety of personal care products used on vulnerable skin is of particular importance and the risk of developing further skin irritations and/or allergies should be minimized. Methods In a series of studies, we tested the safety of personal care products containing oatmeal (creams, cleansers, lotions) by assessing their irritant/allergenic potential on repeat insult patch testing, in safety-in-use and ocular studies using subjects with nonsensitive and sensitive skin. We also tested the skin moisturizing and repair properties of an oatmeal-containing skin care product for dry skin. Results We found that oatmeal-containing personal care products had very low irritant potential as well as a very low allergenic sensitization potential. Low-level reactions were documented in 1.0% of subjects during the induction phase of repeat insult patch testing; one of 2291 subjects developed a persistent but doubtful low-level reaction involving edema during the challenge phase in repeat insult patch testing. No allergies were reported by 80 subjects after patch testing after in-use application. Sustained skin moisturizing was documented in subjects with dry skin that lasted up to 2 weeks after product discontinuation. Conclusion Our results demonstrate that colloidal oatmeal is a safe and effective ingredient in personal care products. No allergies were reported by consumers of 445,820 products sold during a 3-year period.

Criquet, Maryline; Roure, Romain; Dayan, Liliane; Nollent, Virginie; Bertin, Christiane



Opto-thermal radiometry for in-vivo nail measurements  

NASA Astrophysics Data System (ADS)

We have developed a new method for in-vivo human nail characterization by using opto-thermal transient emission radiometry (OTTER) and condenser-chamber TEWL (trans-dermal water loss) method - AquaFlux. With OTTER, we can measure nail water content, nail water concentration depth profiles, as well as topically applied solvent penetration through nail. With AquaFlux, we can measure nail transonychial water loss (TOWL). Combining the water content results with TOWL results, we can get the water diffusion coefficient of nail. Measuring the water diffusion coefficients of nail at different nail water concentration levels can also yield information on how nail diffusion coefficients change with water content. We will present the theoretical background, and experimental results on water concentration depth profile in nail, as well as topically applied solvent penetration through nail.

Xiao, P.; Ciortea, L. I.; Singh, H.; Berg, E. P.; Imhof, R. E.



Industry Sector Analysis, Hong Kong: Skin Care Products, June 1994.  

National Technical Information Service (NTIS)

The market survey covers the skin care products market in Hong Kong. The analysis contains statistical and narrative information on projected market demand, end-users, receptivity of Hong Kong consumers to U.S. products, the competitive situation, and mar...



Nail-gun injuries treated in emergency departments--United States, 2001-2005.  


Speed, ease of use, and ready availability have made pneumatic nail guns a common tool used in work settings such as residential construction and wood-product fabrication. In addition, the tools are now readily available to consumers, extending to the public what had been primarily a potential work-related hazard. To characterize nail-gun injuries in work and nonwork settings, patients with nail-gun injuries treated in U.S. hospital emergency departments (EDs) were studied by using the U.S. Consumer Product Safety Commission's (CPSC's) National Electronic Injury Surveillance System (NEISS) and the NEISS occupational injury supplement (NEISS-Work) maintained by CDC's National Institute for Occupational Safety and Health (NIOSH). This report describes the results of that analysis, which indicated that during the 5-year period 2001-2005, an average of approximately 37,000 patients with injuries related to nail-gun use were treated annually in EDs, with 40% of injuries (14,800) occurring among consumers. In addition, data on ED-treated injuries indicated that, in 2005, nail-gun injuries among consumers were approximately three times higher than in 1991 (4,200). Additional measures are needed to prevent nail-gun injuries among both workers and consumers. PMID:17431377



Mycobacteria in Nail Salon Whirlpool Footbaths, California  

PubMed Central

In 2000, an outbreak of Mycobacterium fortuitum furunculosis affected customers using whirlpool footbaths at a nail salon. We swabbed 30 footbaths in 18 nail salons from 5 California counties and found mycobacteria in 29 (97%); M. fortuitum was the most common. Mycobacteria may pose an infectious risk for pedicure customers.

Jang, Yvonne; Zizek, Candi; Ely, Janet; Winthrop, Kevin L.; Desmond, Edward



Straight Talk About Nail-Gun Safety.  

National Technical Information Service (NTIS)

This publication provides the following nail gun safety tips in a comic book format. Nail Gun Trigger Safety: (1) Removing the safety tip spring or disabling any safety device increases the risk of injury. OSHA prohibits doing these things. (2) Use the 's...



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.



Mycobacteria in nail salon whirlpool footbaths, California.  


In 2000, an outbreak of Mycobacterium fortuitum furunculosis affected customers using whirlpool footbaths at a nail salon. We swabbed 30 footbaths in 18 nail salons from 5 California counties and found mycobacteria in 29 (97%); M. fortuitum was the most common. Mycobacteria may pose an infectious risk for pedicure customers. PMID:15829204

Vugia, Duc J; Jang, Yvonne; Zizek, Candi; Ely, Janet; Winthrop, Kevin L; Desmond, Edward



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.



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



Prevalence of nail involvement in nodal osteoarthritis.  


The presence of nail changes was investigated in 102 patients with nodal osteoarthritis of the hand. Nail lesions were seen in 14/102 patients (13.7%), a prevalence higher than that observed in 96 controls (4/96, 4.2%; chi square 4.37, p = 0.036). An increased risk of nail changes was associated with osteoarthritis of the hand (odds ratio = 3.7, 95% CI 1.13 to 11.8). Longitudinal lines were the most frequent nail alteration and accounted for 10/14 of the observed lesions. Nail involvement was associated with long-lasting symptoms related to osteoarthritis and high serum iron concentration. This complication of osteoarthritis is not as rare as might appear from the literature, and its pathogenesis remains to be investigated. PMID:8088060

Cimmino, M A; Seriolo, B; Accardo, S



Optimal alignment of the distal screws in the tibial nailing  

Microsoft Academic Search

Serious stress concentration around the regions near the distal nail?holes and the distal screws in conventional tibial interlocking nails has been reported in previous studies. A three?dimensional finite element model was used to study the interlocking nail, the fractured tibia and the locking screws. The distal screws were inserted into the tibial nail in different configurations. We found that the



Longitudinal, transverse, and diffuse nail hyperpigmentation induced by hydroxyurea  

Microsoft Academic Search

Hydroxyurea is a cytostatic agent used in patients with myeloproliferative disorders that may produce nail hyperpigmentation, most frequently longitudinal melanonychia. We present a patient treated with hydroxyurea whose nails showed several patterns of nail hyperpigmentation, including longitudinal and transverse bands, and a diffuse darkening of the nail matrix. (J Am Acad Dermtol 1999;40:333-4.)

Angela Hernández-Martín; Santiago Ros-Forteza; Pablo de Unamuno



Penetrating craniocerebral injuries from nail-gun use  

Microsoft Academic Search

Three patients with penetrating craniocerebral nail-gun injuries are described. In the first patient the nail was impinging on the internal carotid artery (ICA) in the carotid canal. On removal of the nail, the patient developed a false aneurysm at the site. To our knowledge, this is the first reported case of nail-gun injury affecting the ICA and also the first

S. Selvanathan; T. Goldschlager; J. McMillen; S. Campbell



The London nail bombings: the St. Thomas' Hospital experience.  


At 18:00 h on 17 April 1999 a nail bomb exploded outside a supermarket in Brixton, London. This was the first of a series of three identical nail bombs. The injuries were due to penetrating nails, most were relatively minor, with only three patients requiring general anaesthesia for removal of nails and debridement. One 6-year-old child subsequently underwent onward referral for neurosurgical treatment. At 18:40 h on 30 April 1999, the third bomb exploded (there were no casualties at our hospital from the second bomb, that in Brick Lane on 24 April 1999) in the confined environment of the Admiral Duncan public house in Soho. The injuries were much more severe than those seen from the Brixton bomb. Two persons died on the scene and 81 were injured; 27 were transferred to our hospital. Three primary lower limb amputations were performed. Within the first 24h, four patients required ITU care and two onward referral to the regional burns unit. Injuries such as those seen in these two bombings are common in war situations. In peacetime it is rare to see this spectrum of injury and hence surgeons can be unaware of optimal management protocols. Our approach in these patients, based on thorough initial debridement and delayed closure/split skin grafting is similar to that advocated by the International Committee of the Red Cross based on their war surgery experience. We emphasise debridement without any initial reconstructive procedures. We also discuss some logistic problems of major incidents. PMID:14580815

Hart, A J; Mannion, S; Earnshaw, P; Ward, A



Health hazard evaluation report HETA 90-048-2253, Haute Nails, Norman, Oklahoma  

SciTech Connect

In response to a request from the owner/operator of the Haute Nails Salon, Norman, Oklahoma, an evaluation was undertaken of possible chemical exposures from the use of nail sculpturing products. Haute Nails was an artificial nail sculpturing and tanning salon employing two full time nail sculpturers and four part time receptionists. The company was located on the first floor of a two story brick building. Long term general area air sampling was conducted for volatile organic chemicals, formaldehyde, and methacrylates; personal breathing zone air sampling was conducted for methacrylates. Ethyl-methacrylate concentrations in long term samples ranged from 10.3 to 14.1 mg/cu m. Breathing zone concentrations of ethyl-methacrylate were 128 mg/cu m for a 7 minute sample and 78.9 mg/cu m for a 14 minute sample during nail sculpturing. Carbon-dioxide measurements exceeded the recommended level of 1000 parts per million. The authors conclude that there were no overexposures to ethyl-methylacrylate during the evaluation. The heating and air conditioning system did not provide for the mechanical exchange of outside air and no exhaust fans were located in the area served by the system. The authors recommend that an outside air supply duct be added to the present system.

Almaguer, D.; Blade, L.M.



Amyloid peptide enhances nail rusting: novel insight into mechanisms of aging and Alzheimer's disease.  


Oxidative stress is believed to play a major role in the dysfunction and degeneration of neurons that occurs in Alzheimer's disease (AD). Amyloid beta-peptide forms insoluble aggregates in the brains of AD patients and it has been shown that the neurotoxic actions of amyloid beta-peptide involve membrane lipid peroxidation. However, it is not known how amyloid beta-peptide induces oxidative stress. Here we describe a simple experiment that we performed 6 years ago that demonstrates that amyloid beta-peptide is itself a source of oxyradicals. The weights of iron nails were recorded and the nails were then incubated in one of three different solutions: water (control), 1mM amyloid beta-peptide (1-40) in water, and 1mM bovine serum albumin in water. After 1 month of incubation the nails were then removed, allowed to dry, and then their weights determined. The weights of all the nails decreased, but the amount of weight decrease in the nails that had been incubated in the presence of amyloid beta-peptide was approximately twice that of the nails incubated in the control solutions. These data provide direct evidence that amyloid beta-peptide generates, or facilitates the production of, oxyradicals thereby enhancing metal oxidation. PMID:12067589

Mattson, Mark P; Mattson, Elliot P



Long-range, nonautonomous effects of activated Notch1 on tissue homeostasis in the nail.  


Using an antibody directed against gamma-secretase-generated antigen unique to activated Notch1, we mapped Notch1 activation strictly to suprabasal cells in epidermis, nail matrix, and other skin appendages during normal development. The consequences of Notch1 activation in keratinizing nail cells were investigated in a transgenic mouse model. Ectopic activation of Notch1 in postmitotic cells within the nail keratogenous zone resulted in longer nails. BrdU labeling revealed an increased number of mitotic cells in transgenic nails. The matrix and keratogenous zone expanded distally due to the increase in cell numbers. The mitosis-promoting effects by a gene product expressed exclusively in postmitotic cells indicates a long-range effect of transgenic Notch1 on regulation of nail homeostasis. We demonstrate that activation of Notch1 in the keratogenous zone resulted in ectopic activation of Wnt signaling, the first such evidence in vertebrates. However, we detected little or no beta-catenin activation in proliferating matrix cells, indicating that Wnt is at most an indirect mediator of Notch-induced proliferation. These data support the existence of a novel, cell-nonautonomous role for Notch in maintaining homeostasis of stratified squamous epithelia by indirectly promoting mitosis in basally located cells. PMID:14597207

Lin, Meei-Hua; Kopan, Raphael



Microscopic examination of normal nail clippings  

PubMed Central

Background: Nail clipping analysis for diagnosing causes of onychodystrophy other than onychomycosis is investigated to a very small extent. In order to achieve acceptance as a diagnostic method for any kind of nail abnormalities, normal microscopic parameters have to be established first. In most reported cases, nail plates were fixed in formalin with processing of the specimens with routine automated histotechnique. Methodology: Fifteen pairs of normal nails were studied. One nail fragment was placed in a container with formalin, and the other was kept dry in a proper receptacle. Fixed specimens were submitted to standard automated tissue processing (formalin group) and dry specimens were directly embedded in paraffin (dry group). Several microscopic parameters were analyzed. Results: Nail plate thickness ranged from 0.25 to 0.50 mm (mean 0.36 mm) and subungual region from 0 to 0.31 mm (mean 0.11 mm). Forty-one percent of cases presented onychokaryosis, and hypereosinophilic nuclear shadows were detected in 63%, statistically more frequent in the dry group (p=0.002). Parakeratosis was present in 86% of nails varying from 1 to 13 layers (mean 5.6). None of the nails presented fungi, neutrophils, and blood or serum collections. Bacteria were seen in 60% of specimens. Both groups yielded adequate microscopic preparations for analysis with no statistical difference in the dryness or hardness of specimens or difficulty in cutting the paraffin blocks (p=1). Conclusion: These microscopic findings of a normal population can be used as parameters for evaluating any cause of onychodystrophy. The dry method is faster and cheaper and yields adequate slide preparations for microscopic analysis of nail clippings.

Werner, Betina; Antunes, Andre



The rational use of oral care products in the elderly  

Microsoft Academic Search

This review examines the evidence of the effectiveness of oral care products in preventing and controlling dental caries and periodontal disease in the ageing population. The strength of evidence is indicated using the following hierarchy: Type 1 (systematic reviews), Type 2 (randomised controlled trials), Type 3 (observational studies) and Type 4 (traditional reviews). Most of the evidence to support the

R. M. Davies



Consumer purchase intention for organic personal care products  

Microsoft Academic Search

Purpose – Using the theory of planned behavior (TPB) to examine the effects of consumer values and past experiences on consumer purchase intention of organic personal care products, this study aims to consider further the moderating effect of perceived behavioral control on the attitude-intention relationship. Design\\/methodology\\/approach – An online survey was conducted with 207 online panel members, and multiple regression

Hee Yeon Kim; Jae-Eun Chung



Innovative Scanning Electron Microscopic Techniques for Evaluating Hair Care Products  

Microsoft Academic Search

Synopsis-The utilization of microscopy in studying human hair is briefly reviewed. Reasons for selecting the SCANNING ELECTRON MICROSCOPE (SEM) over the transmission electron microscope and the optical microscope are discussed. The use of the SEM in evaluating HAIR CARE PRODUCTS is then described. A new technique employing a ROTATING HAIR STAGE, specially designed and fabricated for this study, is presented.



Pharmaceutical and personal care products (PPCPs) in urban receiving waters  

Microsoft Academic Search

The transport pathways of pharmaceutical and personal care products (PPCP) discharges within the urban water cycle include both combined and separate sewer systems with only the former receiving treatment. The dry-weather flow dilution patterns for selected PPCPs following discharge from a sewage treatment works (STW) to a North London stream indicate a persistent downstream increase in concentration. The dilution ratio

J. B. Ellis



The 'PDA nail': traumatic nail dystrophy in habitual users of personal digital assistants.  


All-in-one devices with mobile phone, web browser, and organizer are now owned by over 6 million people and their popularity is increasing. These devices are often called personal digital assistants (PDAs) or 'BlackBerry(R)' devices, after a popular brand name of these appliances. The use of PDAs is associated with exposure of distal thumbs and nails to repeated pressure with a frequency of up to a few thousand times per hour and several tens of thousands of times per day. We describe two cases of traumatic thumb nail dystrophy associated with using a PDA keyboard for several hours per day. Both patients developed median nail plate dystrophy after 4-8 months of habitual PDA use. One patient also developed thumb nail psoriasis and paronychia. All symptoms resolved a few months after discontinuing PDA use. Analysis of nail biomechanics, performed by using a finite element fingertip model, showed that maximal stress reaches approximately 3 MPa and appears near the root on the internal surface of the nail, while it reaches approximately 2 MPa and appears around one-third from the root on the outside surface. In conclusion, biomechanical stress resulting from overuse of PDAs may result in various types of nail dystrophy. We suggest the general term 'PDA nails' for these nail abnormalities. PMID:19354334

Olszewska, Malgorzata; Wu, John Z; Slowinska, Monika; Rudnicka, Lidia



Spectrophotometric determination of triclosan in personal care products  

NASA Astrophysics Data System (ADS)

A spectrophotometric method for the determination of triclosan in personal care products was proposed. It was based on the reaction of sodium nitrite with p-sulfanilic acid in an acidic medium to form diazonium ion, with which triclosan further formed an azo compound in an alkaline medium. The resulting yellow colored product has a maximum absorption at 452 nm. A good linear relationship ( r = 0.9999) was obtained in the range of 0-30 mg L -1 triclosan. A detection limit of 0.079 g L -1 was achieved and the relative standard deviation was 0.24% ( n = 11) at 14 mg L -1 triclosan. The proposed method has been applied to the analyses of triclosan in several personal care products and the results were in good agreement with those obtained by high-performance liquid chromatography.

Lu, Huihui; Ma, Hongbing; Tao, Guanhong



Nail apparatus melanoma: a diagnostic opportunity*  

PubMed Central

Malignant Melanoma is a high mortality neoplasm. The involvement of the nail apparatus is rare, with only 2 out of 3 patients seeking medical attention as the result of recent nail melanocytic lesions. This results in late diagnosis and a prognosis worse than cutaneous melanoma. We report a female, presenting with ulcerative lesions with clinical and laboratory features compatible with leishmaniasis. On return after treatment initiation a longitudinal melanonychia was observed on her first right finger. Biopsy of the nail matrix was performed. Histopathology was compatible with melanoma in situ. Longitudinal melanonychia is not a specific sign for melanoma and it is important that the dermatologist should identify the suspect lesions correctly. The incidental diagnosis of nail melanoma in situ in our case significantly impacted the patient's survival.

Carreno, Ana Maria; Nakajima, Silvia Rocha; Pennini, Silmara N.; Candido, Renato; Schettini, Antonio Pedro Mendes



Isolated nail fold vasculitis in rheumatoid arthritis.  

PubMed Central

OBJECTIVES--To establish the clinical significance of isolated nail fold vasculitis in patients with rheumatoid arthritis (RA). METHODS--Patients attending hospital with established RA were assessed by a single observer using unaided vision. Isolated nail fold vasculitis (NFV) was diagnosed as small nail edge or nail fold lesions without any evidence of other extra-articular or systemic vasculitis. Patients were followed prospectively. RESULTS--Thirty patients with isolated NFV were identified and followed for a median interval of 22 months. Three patients died within three months of diagnosis and six developed complications possibly indicative of extra-articular disease: xerostomia (three), pericarditis (one), pleural effusion and empyaema (one), pulmonary fibrosis (one). No patient developed systemic vasculitis. CONCLUSION--Isolated NFV has a favourable prognosis compared with systemic vasculitis. There is a low risk of developing systemic or extra-articular disease.

Watts, R A; Carruthers, D M; Scott, D G



The red nail--always benign?  


Red nail is a common disorder. However, a thorough examination of the patient's nails allows one to distinguish different diseases. For example, longitudinal erythronychia may be monodactylous or polydactylous. Only the former type can show histologically Bowen's disease or an amelanotic melanoma. Among the polydactylous type, the nosologic position of the acantholytic and dyskeratotic naevus versus Darier's disease is still controversial. Acantholytic epidermolysis bullosa looks like bullous Darier's disease, and acrokeratosis of Hopf may present also red longitudinal streaks. Subungual warty dyskeratoma is rare, but other dermatoses such as lichen planus, psoriasis, mail melanoma and various tumours have to be ruled out. Finally nail involvement in amyloidosis may precede the other signs of this systemic disease. The purpose of this paper will be focused on red nails that can present principally with red lunulae, solitary longitudinal erythronychia and multiple longitudinal erythronychia. Other aspects of this feature will also be raised. PMID:20096204

Baran, R



Retrograde bridging nailing of periprosthetic femoral fractures.  


A retrograde femoral nail was designed to slide over the tip of the femoral stem. Eighteen patients (4 male symbol, 14 female symbol) were treated with this retrograde nail between 1995 and 2003. The mean age was 81.4 years (range 61-96) with a mean follow-up of 21 months (range 4-61 months). Eight patients suffered from severe comorbidity. Mean surgical time was 91 min. Fourteen patients regained their preoperative functional level. Six patients died within the first post-operative year of natural causes. Their knee- and hip-function were reasonable considering the age group and co-morbidity. One revision was required and one patient had a protruding nail. In all patients radiological union of the fracture was seen between 4 and 12 months after surgery. Retrograde bridging nailing of the periprosthetic fractured femur is a therapeutic option in geriatric or impaired patients and can serve as a definitive implant. PMID:17306269

Zuurmond, R G; Pilot, P; Verburg, A D



Severe 20-nail psoriasis successfully treated by low dose methotrexate.  


Severe involvement of the nail matrix can lead to extensive dystrophic changes of the nail plate. Topical or intralesional corticosteroids, photochemotherapy, oral retinoids, and methotrexate (MTX) are among the therapies used. Treatment of severe psoriatic nail disease is often unsatisfactory. We report a case of severe psoriatic nail dystrophy involving all 20 nails successfully treated by low dose MTX. A previously healthy 11-year-old girl presented with painful deformity involving all 20 nails that developed over a one-month period. Examination revealed geographic and fissured tongue, as well as severe nail dystrophy of all 20 nails characterized by erythematous swelling of the nail folds, yellowish discoloration of nail plates with pitting, severe crumbling and destruction, transverse depressions, prominent oil spots, and swelling of proximal nail. Topical clobetasol propionate and calcipotriol were tried first but the nail dystrophy continued to progress. Low dose of MTX (5 mg per week) was initiated. The response was fairly satisfactory with emergence of normal plate proximally as early as 4 weeks; complete resolution of the severe nail dystrophy was achieved after 9 and 13 months of MTX therapy for fingers and toes, respectively. The present case illustrates that weekly low dose oral MTX may be a good treatment option for severe psoriatic nail dystrophy in patients without other contraindications for MTX therapy. PMID:19951644

Lee, Julia Yu-Yun



Special locations dermoscopy: facial, acral, and nail.  


Although dermoscopy reflects the anatomy, skin anatomy is different on facial and acral skin as well as in the nail unit. Malignant patterns on acral sites include the parallel ridge pattern and irregular diffuse pigmentation, whose presence should lead to a biopsy. Malignant patterns on the face include features of follicular invasion (signet-ring images, annular granular images, and rhomboidal structures) and atypical vessels. Malignant patterns on the nail unit include the micro-Hutchinson sign and irregular longitudinal lines. PMID:24075549

Thomas, Luc; Phan, Alice; Pralong, Pauline; Poulalhon, Nicolas; Debarbieux, Sébastien; Dalle, Stéphane



Biomechanical investigation of a novel ratcheting arthrodesis nail  

PubMed Central

Background Knee or tibiotalocalcaneal arthrodesis is a salvage procedure, often with unacceptable rates of nonunion. Basic science of fracture healing suggests that compression across a fusion site may decrease nonunion. A novel ratcheting arthrodesis nail designed to improve dynamic compression is mechanically tested in comparison to existing nails. Methods A novel ratcheting nail was designed and mechanically tested in comparison to a solid nail and a threaded nail using sawbones models (Pacific Research Laboratories, Inc.). Intramedullary nails (IM) were implanted with a load cell (Futek LTH 500) between fusion surfaces. Constructs were then placed into a servo-hydraulic test frame (Model 858 Mini-bionix, MTS Systems) for application of 3 mm and 6 mm dynamic axial displacement (n = 3/group). Load to failure was also measured. Results Mean percent of initial load after 3-mm and 6-mm displacement was 190.4% and 186.0% for the solid nail, 80.7% and 63.0% for the threaded nail, and 286.4% and 829.0% for the ratcheting nail, respectively. Stress-shielding (as percentage of maximum load per test) after 3-mm and 6-mm displacement averaged 34.8% and 28.7% (solid nail), 40.3% and 40.9% (threaded nail), and 18.5% and 11.5% (ratcheting nail), respectively. In the 6-mm trials, statistically significant increase in initial load and decrease in stress-shielding for the ratcheting vs. solid nail (p = 0.029, p = 0.001) and vs. threaded nail (p = 0.012, p = 0.002) was observed. Load to failure for the ratcheting nail; 599.0 lbs, threaded nail; 508.8 lbs, and solid nail; 688.1 lbs. Conclusion With significantly increase of compressive load while decreasing stress-shielding at 6-mm of dynamic displacement, the ratcheting mechanism in IM nails may clinically improve rates of fusion.



Human dermal exposure to galaxolide from personal care products.  


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



Sarcoid and the nail: review of the literature.  


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



The fixion proximal femur nailing system: biomechanical properties of the nail and a cadaveric study.  


The treatment of choice for early mobilization of hip fracture is surgery, which traditionally employs side plates and screws or intramedullary nails. We examined the biomechanical properties of a new proximal femoral nail system. The new expandable Fixion proximal femur nailing (PFN) system, made of stainless-steel alloy, consists of a nail, a peg and an anti-rotation pin. Upon positioning, the nail and peg are expanded to their maximal diameter. The current biomechanical study investigated: nail bending strength and stiffness, fatigue properties and hip peg strength. A cadaveric study that determined the effect of the expandable peg on the femoral head included subsidence testing, pull and torsion testing and intra-osseous pressure (IOP) measurements before and after expansion. Biomechanical properties of the new nail met ASTM F384 guideline requirements. The cadaver study yielded equivalent results for the pullout test between the peg and the hip screw, but found the peg superior in the torsion strength test. IOP during peg insertion and expansion was substantially lower than the threshold pressure that causes avascular necrosis. The biomechanical tests found the new system to be safe and able to provide good abutment of the nail to the bone. We conclude that the Fixion PFN system proved to be an effective proximal femur fracture fixation device. PMID:15519340

Steinberg, Ely L; Blumberg, Nehemia; Dekel, Shmuel



Pharmaceuticals and Personal Care Products in the Environment  

Microsoft Academic Search

Various problems concerning the pharmaceutical and personal care products (PPCPs) in the environment of the Eastern European\\u000a countries are described. The main classes of PPCPs in the environment, as well as major occurrence pathways and PPCPs fate,\\u000a are depicted. The influence of specifics of the regional pharmaceutical market, medication consumption culture and pharmaceutical\\u000a waste disposal techniques on environmental pollution with

Gheorghe Duca; Veaceslav Boldescu


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


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



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).

Weir, Alex; Westerhoff, Paul; Fabricius, Lars




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



Managing Chemotherapy Side Effects: Skin and Nail Changes  


... anD human services national institutes of health Managing Chemotherapy Side Effects Skin and Nail Changes Call your ... lotion to help my skin feel better.” Managing Chemotherapy Side Effects: Skin and Nail Changes Protect your ...


Küntscher nailing of the tibia--a new tibial jig.  


This paper illustrates the use of a new tibial jig which facilitates closed Küntscher nailing of the tibia. A brief history of medullary nailing is given, followed by a description of the jig. PMID:7364476

King, R



Dietary treatment of chylous ascites in yellow nail syndrome.  

PubMed Central

Chylous ascites has rarely been reported in yellow nail syndrome. A case of chylous ascites in yellow nail syndrome is described which was treated successfully with dietary restriction of fat and supplements of medium chained triglycerides.

Tan, W C



A Nailed Plate Connector for Glued-Laminated Timbers.  

National Technical Information Service (NTIS)

The performance of a metal-to-wood fastener employing specially designed and hardened steel nails was determined for compressive and tensile loading. Variables such as nail length, nail spacing, fixity of nailhead in plate, form of shank, and end- and edg...

W. M. McCowan



Mechanical Behavior of Joints Combining Adhesives and Nails.  

National Technical Information Service (NTIS)

The report gives methods of analysis for joints bonded with deformable adhesives, nails, or combined adhesive and nails when the joints are subjected to either shear or moment in the plane of the joint. The analysis shows that nails carry a very small por...

T. L. Wilkinson



Retained portion of latex glove during femoral nailing. Case report.  


A case of retained glove during Kuntscher intramedullary nailing is described. An abscess around the glove could have lead to osteomyelitis. One need to be cautious feeling the top end of the nail while femoral nailing to avoid such a complication. PMID:9141352

Sadat-Ali, M; Marwah, S; al-Habdan, I



Practical Uses of Botanicals in Skin Care  

PubMed Central

Cosmeceuticals are the fastest growing sector of the cosmetic industry, and the future of antiaging cosmeceuticals in particular is very promising. Botanical extracts that support the health, texture, and integrity of the skin, hair, and nails are widely used in cosmetic formulations. They form the largest category of cosmeceutical additives found in the marketplace today due to the rising consumer interest and demand for natural products. Various plant extracts that formed the basis of medical treatments in ancient civilizations and many traditional cultures are still used today in cleansers, moisturizers, astringents, and many other skin care products. New botanical skin care treatments are emerging, presenting dermatologists and their patients the challenge of understanding the science behind these cosmeceuticals. Thus, dermatologists must have a working knowledge of these botanicals and keep up with how they evolve to provide optimal medical care and answer patient questions. The most popular botanicals commonly incorporated into skin care protocols are discussed.

Stallings, Alison F.



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.  


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



Acquired Pincer Nail Deformity Associated with Renal Failure  

PubMed Central

Pincer nail deformity represents a loss in the normal convex shape of the nail and has been reported in association with various diseases and medications. The authors report a man with end-stage renal disease due to bladder carcinoma who developed pincer nail deformity while on hemodialysis. Previous case reports cite diabetes as a suspected cause of pincer nail development in patients with renal failure. However, the patient described in this case was not diabetic and his nail dystrophy is likely related to arteriovenous fistula placement.

Deleon, Dianne



In vitro human nail penetration and kinetics of panthenol.  


The in vitro absorption of panthenol into and through the human nail was examined in this study. Panthenol, the alcohol form of pantothenic acid (vitamin B5), is believed to act as a humectant and improve the flexibility and strength of nails. A liquid nail treatment formulated with panthenol (2%) was compared to a solution of panthenol (2%) in water. Fingernail specimens were dosed daily for 7 days with either the nail treatment (non-lacquer film forming) formulation or aqueous solution with sampling performed every 24 h. Panthenol concentrations were determined in the dorsal surface, interior (by drilling and removal) and in the supporting bed under the human nail. Panthenol levels in the dorsal nail (R(2) = 0.87; P < 0.001), nail interior (R(2) = 0.94; P < 0.001) and nail supporting bed (R(2) = 0.79; P < 0.003) showed a significant linear increase with each day of dosing. Significantly more panthenol was delivered into the interior nail and supporting bed by a nail treatment formulation than from an aqueous solution. The film acts not only as a reservoir of panthenol, but also acts to increase the hydration of the nail and the thermodynamic activity of panthenol as well, thereby enhancing diffusion. PMID:18489355

Hui, X; Hornby, S B; Wester, R C; Barbadillo, S; Appa, Y; Maibach, H



[Modified Ender nail in the treatment of unstable peritrochanteric fractures].  


The distal migration of the nails has been described as the most common complication in the treatment of the unstable peritrochanteric fractures with Ender nailing. Because of his design and site of insertion Ender nails are backing out secondary to collapse and impaction of the fractures. Author presented a new modified Ender nails with special notches on its surface, which was used in 19 males and 3 females aged 37-86 (mean 56.9) with unstable peritrochanteric fractures. Three patient died before solid union was achieved. Among 19 patient with healed fractures, distal backing of the new nails was observed in one. In six patients distal migration of the nails was less than 1 cm. Roughening of the nail's surface reduce the risk of distal migration in the treatment of unstable peritrochanteric fractures by Ender method. PMID:10423913

Semenowicz, J



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.

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



Tests of stationarity and cointegration of health care expenditure and gross domestic product  

Microsoft Academic Search

This study examines the long-run relationship among the per capita private, public, and total health care expenditure and per capita gross domestic product and population growth of Turkey. We find some evidence of multivariate cointegrating relationships among the health care expenditure and gross domestic product, and population growth. We further find a bivariate cointegrating relationship between private health care expenditure

Halil Kiymaz; Yasemin Akbulut; Ahmet Demir




Microsoft Academic Search

Analytical electron microscopy was performed in order to elucidate the importance of calcium and sulfur to the hardness of nails. The free surfaces adsorb a considerable quantity of calcium from the environment. It is suggested that such adsorption occurs due to ion exchange. This concept is supported by the fact that the distribution of sulfur does not vary over the

B. Forslind; R. Wroblewski; B. A. Afzelius



The supracondylar femoral nail in tibia.  


We have found the intramedullary supracondylar femoral nail to be useful in special situations involving the tibia: proximal tibial fractures and nonunions, intercalary resections for tumors in the proximal or distal tibial diaphysis, and tibio-talo-calcaneal arthrodeses. We report on ten such cases. PMID:14504824

Pant, R; Ilyas, I; Younge, D A



Young Children's Full-Day Patterns of Cortisol Production on Child Care Days  

PubMed Central

Objective To examine toddlers’ full-day patterns of cortisol production on child care days and non–child care days, with a particular focus on whether the mid-afternoon elevations at child care persist into the evening or decrease to typical levels observed on non–child care days. Design A prospective observational study. Setting Four child care centers in a suburban, mid-Atlantic area. Participants Forty-two children aged 16 to 24 months attending full-day child care. Main Exposure Full-day child care. Outcome Measure Salivary cortisol samples obtained at wake-up, mid-morning, mid-afternoon, and bedtime for children on 2 child care days and 2 non–child care days. Results Children showed different patterns of cortisol production on child care days compared with non–child care days (?42=18.21, P=.001). Child care days were characterized by an afternoon increase in cortisol levels (unlike non–child care days) and decreases to bedtime values that were comparable with levels on non–child care days. Conclusion Results suggest that the effects of child care on children’s cortisol production are time limited across the day.

Sumner, Melissa Manni; Bernard, Kristin; Dozier, Mary



Proximal Femoral Nail Antirotation versus Gamma3 nail for intramedullary nailing of unstable trochanteric fractures. A randomised comparative study.  


The purpose of this study was to compare the clinical results and the complication rates of a new generation of two intramedullary fixation devices: Proximal Femoral Nail Antirotation® (PFNA) and Gamma3®. We conducted a prospective randomised multicentre trial of 61 patients who underwent a PFNA fixation treatment (31 patients) or a Gamma3 nail (30 patients). We documented the fixation failure complications as well as data of the surgical procedure, the clinical and functional outcomes (the EuroQoL5 questionnaire, the Katz index score, the Short Form 36 (SF-36), and the Harris Hip Score) and the plain radiographic parameters at 3,6 and 12 months follow up. The PFNA and Gamma3 fixation devices were similar in terms of complication rates. The risk for experiencing a postoperative complication after Gamma3 nailing was 40% versus 45% after PFNA fixation. At the 6-month and 1-year follow-up evaluations, there were no significant differences in terms of range of motion, clinical scores and radiological outcomes. PMID:23622992

Vaquero, J; Munoz, J; Prat, S; Ramirez, C; Aguado, H J; Moreno, E; Perez, M D



New developments in magnetic resonance imaging of the nail unit.  


The evolution of dedicated magnetic resonance imaging (MRI) musculoskeletal equipment allows new sequences and better images of the nail unit. The use of MRI has modified the imaging strategies used in treating inflammatory arthritis. In the case of psoriatic arthritis (PsA), the MRI study of the nail unit identifies nail involvement, which appears as an initial lesion for the induction of distal phalanx damage and consequently of distal interphalangeal joint arthritis. All patients with psoriasis, even in the absence of a clinically evident onychopathy, show characteristic MRI changes in the nail. This evidence could have a practical diagnostic value, because MRI study of the nail could document diagnosis in patients with undifferentiated spondyloarthropathies who have a barely evident psoriasis. We discuss the advantages and problems related to the use of low-field and high-field MRI in the study of the nail unit of patients with PsA. PMID:22751592

Soscia, Ernesto; Sirignano, Cesare; Catalano, Onofrio; Atteno, Mariangela; Costa, Luisa; Caso, Francesco; Peluso, Rosario; Bruner, Vincenzo; Aquino, Maria Maddalena; Del Puente, Antonio; Salvatore, Marco; Scarpa, Raffaele



Tumors of the Nail Unit. A Review. Part II: Acquired Localized Longitudinal Pachyonychia and Masked Nail Tumors.  


: This second part of the review categorizes the site-specific nail tumors, as proposed in the first part, according to their clinical presentations. Acquired localized longitudinal pachyonychia allows for the specific recognition of onychogenic nail tumor, which can be classified into 2 groups according to the predominant compartment of origin within the nail unit as follows: epithelial tumors encompassing onychocytic matricoma and onychocytic carcinoma, and fibroepithelial tumors: the so-called onychomatricoma. As onychomatricoma is neither an epithelial matrical tumor nor a tumor with a limited differentiation toward the matrix, the author proposes instead the descriptive term of panonychoma fibropapilliferum (POP). The designation of POP does convey to the surgical pathologist or the dermatopathologist the key morphological pattern of this tumor. It should be noted that the proposed term of panonychoma is analogous to the nomenclature that is well established for follicular neoplasms with differentiation toward all elements of the normal hair follicle, that is panfolliculoma. The second term fibropapilliferum is used to highlight the mixed fibroepithelial nature of this neoplasm, which forms multiple rudimentary nail units. These nail units construct multiple nail plates that join together and form a single thick nail plate. According to nail anatomy, 2 types of POP are described: POP of the apical matrix/eponychium, with a pseudo-condylomatous pattern, and POP of the ventral matrix with a foliated pattern in transverse sections and a fibrokeratoma-like pattern in the longitudinal sections. Suggestions for the evaluation and clinical management of localized longitudinal pachyonychia are proposed. On histology of a nail clipping, 2 patterns with clinical significance can be individualized. A horizontal alignment of large cavities indicates POP of the ventral matrix. A haphazard arrangement of smaller cavities in the nail plate, including an arrangement in the inferior two-thirds of the nail clipping, should prompt a biopsy of the distal ventral matrix to rule out a malignant lesion. In the setting of the "masked "nail tumor, a clinical subtype with some significance can be individualized, the subungual keratotic nodule growing rapidly. Three nail bed tumors are discussed within this latter group. Two new clinicopathological variants of subungual keratoacanthoma are described, and a new nail bed tumor is discussed: the infundibulocystic nail bed squamous cell carcinoma. The absence of striking nuclear atypia and the giant cystic to multicystic pattern distinguishes infundibulocystic nail bed squamous cell carcinoma from follicular infundibulocystic squamous cell carcinoma. The last section proposes a classification of folliculogenic nail bed tumors. The follicular microcysts of the nail bed have previously been called subungual epidermoid inclusions or onycholemmal cysts, but the term follicular microcysts of the nail bed is more pertinent, because of the multiple lines of follicular differentiation (infundibular, tricholemmal, apocrine, and sebaceous) seen in their benign and malignant counterparts. Absent in a large portion of the normal nail bed, the follicular microcysts seem to have a peculiar propensity for the formation of tumors that vary in maturity from simple follicular microcystic hyperplasia associated with acquired longitudinal melanonychia to microcystic nail bed hamartoma and microcystic nail bed carcinoma (the so-called onycholemmal carcinoma). The concluding tables emphasize the key and essential histological features required to make the diagnosis of site-specific nail tumors and guide appropriate therapy. The author proposes to categorize subungual tumors into 2 types: subungual skin tumors (including subungual skin metastasis from internal malignancies) and nail tumors. Nail tumors can be accurately classified using a combined clinical and histogenetic approach. This new and expanding group of appendageal tumors is important for both dermatologists and dermatopathologists for the potentia

Perrin, Christophe



Supracondylar nailing of distal periprosthetic femoral fractures  

Microsoft Academic Search

Seven patients who sustained complex distal femoral fractures above total knee arthroplasties all treated by supracondylar\\u000a (retrograde) femoral nailing were retrospectively evaluated. All the patients demonstrated uncomplicated postoperative follow-ups\\u000a and returned to weight bearing between 2 and 3 months after surgery. No delayed healing occurred and alignment of the femur\\u000a was satisfactory.

D. Weber; D. L. Pomeroy; L. A. Schaper; W. E. Badenhausen Jr; J. I. Curry; M. W. Smith; K. E. Suthers



Intramedullary nails: some design features of the distal end.  


Intramedullary nails are used to stabilise fractures of the proximal femur. The nail acts by transferring loads from the proximal fraction to the rest of the femoral shaft. The way in which this occurs depends to a large extent on the design of the distal end of the nail. This is not dissimilar to the situation with regard to load shedding (or load transfer) from the femoral component of a total hip replacement. A finite element model of a fractured femur with either a neck or a subtrochanteric fracture is set up to investigate the effects of nail length, nail distal stiffness and material stiffness on the structural behaviour of the system. Specifically what is considered is the influence of these parameters on the stress across the fracture and the normal pressure that the nail exerts on the endosteum of the femoral diaphysis. It is found that a longer nail could produce higher contact stress between the tip of the nail and the endosteum. Also, this contact stress is reduced when the distal region of the nail is made more flexible either by incorporating longitudinal slots or by using a material with a lower modulus of elasticity. PMID:14519352

Wang, C J; Brown, C J; Yettram, A L; Procter, P



Unusual nail pigmentation following cyclophosphamide-containing chemotherapy regimen  

PubMed Central

Cyclophosphamide therapy may rarely cause pigmentation of the nails which is of different patterns. We report a patient who developed pigmentation of nails after six cycles of cyclophosphamide, methotrexate, and 5-flourouracil chemotherapy, each repeated after 28 days for breast cancer. The patient developed nail pigmentation that started proximally and spread distally and involved all the nails of both hands and feet except the second and third toenails of right foot. Using Naranjo ADR Probability Scale, the case revealed a “probable” association with cyclophosphamide.

Kumar, Santosh; Dixit, Rakesh; Karmakar, Saurabh; Paul, Sayan



Drugs in nails: physiology, pharmacokinetics and forensic toxicology.  


In recent years, drug analysis in keratinised matrices, such as hair and nails, has received considerable attention because of several advantages over drug testing methodologies employing body fluids, such as urine or serum. For example, keratinic matrices, such as finger- and toenails, can accumulate drugs during long term exposure. Drugs are incorporated into nails by a double mechanism: (i) deposition into the root of the growing nail via the blood flow in the nail matrix; and (ii) incorporation via the nail bed during growth from the lunula to the beginning of the free margin. Together, these account for a wide retrospective window of drug detection. Nails can provide a good forensic matrix for the detection of drugs of abuse. Indeed, the international literature has reported the use of nail analysis in postmortem detection of drugs of abuse, drug testing in the workplace and drug screening to detect prenatal exposure, even though further studies are needed for correct interpretation of the data obtained. Another application of drug analysis in nails consists of the possibility of detecting the presence of an antimycotic at the site of action during antifungal therapy for patients with onychomycosis. When available, this evidence has permitted drug treatment of a shorter duration and reduced toxicity. However, so far the potential of drug monitoring in nails still lacks harmonisation and validation of analytical methodologies and a better comprehension of the possible correlation between drug concentrations in the matrix and period of exposure. PMID:10709775

Palmeri, A; Pichini, S; Pacifici, R; Zuccaro, P; Lopez, A



Palliative care is not yet a well-defined product within the Dutch healthcare insurance system.  


In the Netherlands, the quality and availability of palliative care has improved markedly within the last decade. However, many open questions remain concerning the position of palliative care as an insurable product on the Dutch healthcare market. Therefore, we analysed the policies of all private Dutch healthcare insurance companies as well as the public insurance policy for extraordinary medical costs. We studied how and which parts of palliative care were reimbursed in 2007. We observed a huge variability in costs and reimbursement regulations reflecting a rapid turnover of products for palliative care due to various new developments on this specific field of medical care. We conclude that a better definition of the product 'palliative care' is necessary for patients, health care providers and insurance companies. PMID:19150578

Jansen, Wim J J; Vissers, Kris C P; Zuurmond, Wouter W A; van Montfort, Guus P W P; Rhebergen, Andre; Loer, Stephan A



Cephalomedullary nailing for proximal femoral fractures.  


From May 1999 to April 2002, we treated 14 patients with subtrochanteric femoral fractures and seven patients with ipsilateral fractures of the femoral neck and shaft using a second-generation cephalomedullary interlocked nail. Patients mean age was 36 (20-60) years, and 19 fractures were caused by high-energy trauma. Four patients had associated injuries. The average follow-up was 23 (16-30) months. Per-operatively, we had problems in locating the entry portal in four patients, and one nail was driven through the inter-condylar notch. All fractures except two united. One patient had non-union of the femoral neck and one of both neck and shaft. One patient united with shortening of more than 1.5 cm and varus angulation at the fracture site. Two patients had loosening and backing out of the proximal screw. The second-generation cephalomedullary nail is a suitable treatment option for proximal femoral fractures, but it requires a high degree of accuracy and technical expertise. PMID:15647914

Kakkar, Rahul; Kumar, S; Singh, A K



Fe distribution and speciation in human nails  

NASA Astrophysics Data System (ADS)

Micro-X-ray Fluorescence (?-XRF) and Fe-K edge micro-X-ray Absorption Near Edge Structure (?-XANES) spectroscopies are applied for the study of the distribution and the spatially-resolved bonding environment of Fe in human nails. The ?-XRF maps reveal that Fe forms islands where its concentration is up to six times higher than in the rest of the sample. Comparison of the map characteristics of two nails that belong to healthy and ill donors (affected by lung cancer), reveals that there is no significant variation in the size distribution of the Fe-rich inclusions contrary to their spatial density which is found higher in the nail of the ill donor. However, a relation between the variations of the spatial density and the illness can not be established due to the small number of the studied samples. The analysis of the Fe-K ?-XANES spectra reveals that the bonding environment of Fe varies between the samples and between different spots of the same sample with different Fe concentration. The characteristics of the pre-edge peak in the Fe-K XANES spectra indicate the presence of both Fe+3 and Fe+2 that participate in the formation of distorted octahedra. Finally, the area under the pre-edge peak depends linearly on the position of the absorption edge indicating variation of the Fe ligation between the samples and/or between different spots in the same sample.

Katsikini, M.; Pinakidou, F.; Mavromati, E.; Paloura, E. C.; Gioulekas, D.; Grolimund, D.



Retrograde Versus Antegrade Intramedullary Nailing of Gunshot Diaphyseal Femur Fractures.  


BACKGROUND: The use of retrograde nailing for gunshot wound femur fractures is controversial due to concerns of knee sepsis after this procedure since the knee is entered to introduce the nail into the canal. QUESTIONS/PURPOSES: We compared retrograde and antegrade nailing for gunshot femur fractures to determine whether (1) knee sepsis or other adverse events were more likely to complicate procedures using retrograde nails, (2) there were differences in surgical time or blood loss, and (3) there were differences in radiographic union. METHODS: We retrospectively reviewed our prospective trauma database from 1999 to 2012 for patients with a diagnosis of gunshot and femur fracture. We performed a detailed review of medical records and radiographs for those patients with OTA Classification Type 32 femur fractures secondary to gunshot injury treated with either retrograde or antegrade femoral nailing. Eighty-one patients were treated with intramedullary nailing (53 retrograde and 28 antegrade). We reviewed elements of the operative treatment (procedure, anesthesia time, operative time, and estimated blood loss) for all 81 patients. For clinical and radiographic review, followup was adequate for 43 and 25 patients with retrograde and antegrade nailing, respectively. Minimum followup was 3 months for both groups (retrograde: mean, 41 months; range, 3-148 months; antegrade: 26 months: range, 3-112 months). RESULTS: No patients in either group developed knee sepsis. No significant differences were found between groups with regard to operative time, blood loss, or radiographic union. CONCLUSIONS: With the numbers available, immediate retrograde nailing appears as safe and effective as antegrade nailing for gunshot femur fractures. Immediate retrograde nailing is as safe as antegrade nailing for gunshot femur fractures. LEVEL OF EVIDENCE: Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence. PMID:23690149

Dougherty, Paul J; Gherebeh, Petra; Zekaj, Mark; Sethi, Sajiv; Oliphant, Bryant; Vaidya, Rahul



Characterization of indoor air contaminants in a randomly selected set of commercial nail salons in Salt Lake County, Utah, USA.  


Air samples were collected in 12 randomly selected commercial nail salons in Salt Lake County, Utah. Measurements of salon physical/chemical parameters (room volume, CO(2) levels) were obtained. Volatile organic compound (VOC) concentrations were collected using summa air canisters and sorbent media tubes for an 8-h period. Multivariate analyses were used to identify relationships between salon physical/chemical characteristics and the VOCs found in the air samples. The ACGIH(®) additive mixing formula was also applied to determine if there were potential overexposures to the combined airborne concentrations of chemicals monitored. Methyl methacrylate was detected in 58% of the establishments despite having been banned for use in nail products by the state of Utah. Formaldehyde was found above the NIOSH REL(®) (0.016?ppm) in 58% of the establishments. Given the assortment of VOCs to which nail salon workers are potentially exposed, a combination of engineering as well as personal protective equipment is recommended. PMID:23286453

Alaves, Victor M; Sleeth, Darrah K; Thiese, Matthew S; Larson, Rodney R



Prognostic Factors for Predicting Outcomes After Intramedullary Nailing of the Tibia  

PubMed Central

Background: Prediction of negative postoperative outcomes after long-bone fracture treatment may help to optimize patient care. We recently completed the Study to Prospectively Evaluate Reamed Intramedullary Nails in Patients with Tibial Fractures (SPRINT), a large, multicenter trial of reamed and unreamed intramedullary nailing of tibial shaft fractures in 1226 patients. Using the SPRINT data, we conducted an investigation of baseline and surgical factors to determine any associations with an increased risk of adverse events within one year of intramedullary nailing. Methods: Using multivariable logistic regression analysis, we investigated fifteen baseline and surgical factors for any associations with an increased risk of negative outcomes. Results: There was an increased risk of negative events in patients with a high-energy mechanism of injury (odds ratio [OR] = 1.57; 95% confidence interval [CI], 1.05 to 2.35), a stainless steel compared with a titanium nail (OR = 1.52; 95% CI, 1.10 to 2.13), a fracture gap (OR = 2.40; 95% CI, 1.47 to 3.94), and full weight-bearing status after surgery (OR = 1.63; 95% CI, 1.00 to 2.64). There was no increased risk with the use of nonsteroidal anti-inflammatory agents, late or early time to surgery, or smoking status. Open fractures had a higher risk of events among patients treated with reamed nailing (OR = 3.26; 95% CI, 2.01 to 5.28) but not in patients treated with unreamed nailing (OR = 1.50; 95% CI, 0.92 to 2.47). Patients with open fractures who had wound management either without any additional procedures or with delayed primary closure had a decreased risk of events compared with patients who required subsequent, more complex reconstruction (OR = 0.18 [95% CI, 0.09 to 0.35] and 0.29 [95% CI, 0.14 to 0.62], respectively). Conclusions: We identified several baseline fracture and surgical characteristics that may increase the risk of adverse events in patients with tibial shaft fractures. Surgeons should consider the predictors identified in our analysis to inform patients treated for tibial shaft fractures. Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Schemitsch, Emil H.; Bhandari, Mohit; Guyatt, Gordon; Sanders, David W.; Swiontkowski, Marc; Tornetta, Paul; Walter, Stephen D.; Zdero, Rad; Goslings, J.C.; Teague, David; Jeray, Kyle; McKee, Michael D.; Schemitsch, Emil H.; Bhandari, Mohit; Guyatt, Gordon; Sanders, David W.; Swiontkowski, Marc; Tornetta, Paul; Walter, Stephen D.; Zdero, Rad; Goslings, J.C.; Teague, David; Jeray, Kyle; McKee, Michael D.



Taxane-induced nail changes: incidence, clinical presentation and outcome.  


The clinical characteristics of nail changes in seven patients receiving taxane-containing chemotherapy are described. They include nail pigmentation, subungual hematoma, Beau's lines and onycholysis and subungual suppuration. The incidence of such changes (ranging from 0% to 44%) is reviewed from a Medline search of the literature. PMID:12562663

Minisini, A M; Tosti, A; Sobrero, A F; Mansutti, M; Piraccini, B M; Sacco, C; Puglisi, F



Nail damage in spray operators exposed to paraquat  

PubMed Central

Hearn, C. E. D., and Keir, W. (1971).Brit. J. industr. Med.,28, 399-403. Nail damage in spray operators exposed to paraquat. Nail damage in 55 persons due to contamination by diluted paraquat in a group of 296 spray operators employed on a sugar estate in Trinidad is described. The commonest lesion seen was transverse white bands of discoloration, but loss of nail surface, transverse ridging, gross deformity of the nail plate, and loss of nails occurred. The index, middle, and ring fingers of the right hand were predominantly affected and this could be ascribed to leakage from the knapsack sprayer. It is emphasized that, although the degree of contamination was unusually gross, it is nonetheless important to recognize that the diluted material can cause nail damage. Simple hygienic precautions and proper maintenance of spraying equipment can prevent its occurrence. Periodic medical examinations are recommended even for workers exposed only to diluted paraquat. The distribution of the nail lesions confirms that they are the result of a local action. Following cessation of further exposure subsequent nail growth is normal. Images

Hearn, C. E. D.; Keir, W.



Tractor nail as impacted foreign body: rare case scenario.  


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



Rotational malalignment after intramedullary nailing of femoral fractures  

Microsoft Academic Search

OBJECTIVES: Intramedullary nailing has been accepted as the treatment of choice for femoral shaft fractures. The aim of our study was to determine the incidence and implications of rotational malalignment after intramedullary nailing using computed tomography measurements. DESIGN: Cohort study. SETTING: Patients who postoperatively visited the orthopaedic outpatient and radiology clinics. PATIENTS: Seventy-six patients, 59 men and 17 women, with

R. L. Jaarsma; D. F. M. Pakvis; N. J. J. Verdonschot; J. Biert; A. van Kampen



Preparation of Hair and Nail Samples for Trace Element Analysis  

Microsoft Academic Search

The method of washing of human hair and nail samples is examined by neutron activation and ?-ray analysis. The amounts of Na, K, Br, Au, Zn and La that are removed by successive washings determine the optimum number of washing for removing these trace elements as surface contaminants. A total solution contact time with the nails is 5 minutes, and

Hubert A. Scoble; Robert Litman



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).



Expandable intramedullary nails for fixation of tibial shaft fractures.  


Interlocking intramedullary nailing is currently the preferred treatment for most tibial fractures requiring operative treatment, with good results and a relatively low complication rate as reported in large clinical series. However, vascular and neurological complications caused by interlocking screws have been reported. In addition, insertion of distal interlocking screws can be technically demanding and may entail substantial exposure. We present the results with an expandable self-locking nail in the management of 52 AO type A and B tibial shaft fractures. The mean time to union was 15.8 weeks and the rate of union was 98%. The average surgical time was 60 minutes. Complications were those usually seen in diaphysis nailing and no complication was noted during nail expansion. Interlocking screws are not necessary, which reduces the risk of iatrogenic lesions. The expandable nail allows effective management of AO type A and B diaphyseal fractures of the tibia, a lower radiation exposure and shorter operative time. PMID:23409575

Ghafil, Dior; Ackerman, Pieter; Baillon, Renaud; Verdonk, Rene; Delince, Philippe



Productivity and selected indicators of care in maternity and infant care and children and youth projects according to sponsorship.  


Bureau Common Reporting Requirements (BCRR) data tapes for Fiscal Year 1980 were analyzed to determine whether the type of sponsoring agency influenced the productivity or indicators of care of Maternity and Infant Care and Children and Youth Projects. Sponsors were classified as either health department or non-health department, health department or major medical center, or public or private in three separate sets of analyses. Some of these analyses indicated that special projects that were either health department or public agency sponsored were more likely to have more non-medical patient encounters and more health education and social work staff for a given level of expenditures. Although publicly sponsored projects employed fewer physician equivalents than did the non-public projects, those physicians were more productive. Despite these differences in encounters, staffing, and utilization of physicians, there were no differences in available measures of the process of care between categories of projects in any of the analyses. PMID:3230374

Kotch, J B; Coulter, M L; Porter, C Q; Miller, C A



Keratin film made of human hair as a nail plate model for studying drug permeation.  


The limited source of human nail plate for studying drug permeation inspired us to develop a nail plate model made of human hair keratin. The manufacturing process consisted of keratin extraction, dialysis, molding, solvent evaporation, and curing, producing a water-resistant film. The permeability of the film was examined using three markers: sodium fluorescein, rhodamine B, and fluorescein isothiocyanate-dextran as water-soluble, lipid-soluble, and large molecule models, respectively. Bovine hoof was used for comparison. First investigation showed that keratin films (thickness 120 ?m) resembled hooves (thickness 100 ?m) except that these films were more permeable to rhodamine B compared with hooves (1.8-fold, p<0.01). Subsequent investigations using ungual penetration enhancers (urea, thioglycolic acid, and papain) showed that keratin films were generally more susceptible than hooves. This study revealed that the produced keratin film offers a possibility as a human nail plate substitute. However, inclusion of the penetration enhancer must be carefully interpreted. PMID:21791369

Lusiana; Reichl, Stephan; Müller-Goymann, Christel C



[Free me from this nail! Please!].  


Ingrowing toenails are a very frequent pathology in children and adolescents. There is an anatomic component, but also other factors, such as inadequate shoes and incorrect nail-trimming. We treated 47 patients with 69 ingrowing toenails, between one and 15 years of age. The evolution time was one month to 10 years and 11 patients had precedent surgeries. Lateral electrosurgical matricectomy was the choice technique. With a follow up of at least eight months, there is only one case of recurrence. PMID:9859515

Leal, M J; Lucas, A P; Duarte, R



Pharmaceutical and personal care products in sewage treatment works.  


In this study a number of analytical procedures are described to determine pharmaceuticals and personal care products (PPCPs) and their metabolites during sewage treatment. The work shows that PPCPs occur in sewage influent and are removed by various wastewater treatment processes. PPCPs include a wide range of chemicals such as prescription drugs as well as diagnostic agents, fragrances, sun-screen agents, and various other compounds commonly present in household items (e.g. detergents, cleaners, toothpastes etc.). During this study a number of PPCPs including painkillers (aspirin, ibuprofen), cholesterol control medication (clofibric acid), antibacterial agents (triclosan), musks (including galaxolide and tonalide), X-ray contrast media (diatrizoate), cancer treatment drugs (cyclophosphamide) and anti-depressant drugs (fluvoxamine) were investigated. Analysis was carried out using a number of techniques. Samples were extracted using solid phase extraction or liquid-liquid extraction and the extracts analysed using capillary gas chromatography-mass spectrometry (GC-MS) with selected ion monitoring or liquid chromatography mass spectrometry (LC-MS) or LC-MS-MS. The results obtained show that aspirin, clolibric acid, diatrozate, fluvoxamine and cyclophosphamide were not detected in any of the crude sewage or sewage effluent samples above the limit of detection of the applied methods. Ibuprofen was detected in all crude sewage samples as well as in all effluent samples with one exception. Removal of ibuprofen by the different STWs was generally between 80-100%, with the exception of one STW where removal was poor (14.4 to 44%). Triclosan was also detected in all crude sewage samples and in all sewage effluent samples. The highest concentration of triclosan detected was 3100 ng l(-1). A high removal efficiency was observed in effluent samples taken on two occasions (average removal 95.6%). The concentrations of musks detected in the crude sewage were generally low except for galaxolide and tonalide. The results from STW effluent samples showed significant removal of galaxolide (70-83% removal) except at one STW (STW 1) where removal was low (57% and 39%). Similar removal efficiencies for tonalide were achieved at these STWs (73-96%) except at STW 1 where removal was poor (53%). PMID:14587856

Kanda, Rakesh; Griffin, Paul; James, Huw A; Fothergill, James



Effects of environmental conditions to which nails are exposed on DNA analysis of them  

Microsoft Academic Search

To investigate the feasibility of DNA analysis of nails taken from human remains after environmental exposure, we tested the quantity and quality of DNA that could be recovered from nails exposed to various conditions. We first investigated whether there is an inter- or intra-subject difference in the DNA content of nails using nails obtained from 333 volunteers. DNA content did

Akinori Nakanishi; Fumio Moriya; Yoshiaki Hashimoto



Three dimensional finite difference analysis of soil-nailed walls under static conditions  

Microsoft Academic Search

Soil nailing has been extensively used as an efficient method for improving stability of slopes. There are many different approaches including limit equilibrium methods to understand soil-nailed wall behaviour under static loading conditions. Having three construction stages involved in soil nailing construction (excavation, nail installation and face stabilization), in the framework of a numerical approach, the present study aimed to

A. M. Halabian; A. M. Sheikhbahaei; S. H. Hashemolhosseini



Failure of knee arthroplasty secondary to inadequate technique in cephalomedullary nailing of a subtrochanteric hip fracture.  


A case of total knee replacement loosening caused by a failed cephalomedullary nail is presented. The nail was inserted for the treatment of an unstable subtrochanteric femoral fracture. The distal locking screw of the nail subsequently fractured allowing the leg to shorten and causing the nail to displace the femoral component of the knee replacement leading to a valgus alignment and deformity of the knee. In order to revise the knee the long ? nail had to be replaced by a shorter nail to allow a femoral component with a long stem to be used. This case illustrates the importance of using shorter nails in patients with prosthetic knees. PMID:22602840

Clement, Rhys Gareth Ellis; Burnett, Richard



The production of authoritative knowledge in American prenatal care.  


Using Jordan's concept of authoritative knowledge, this article describes some of the ways that the prenatal care practices of a group of U.S. women help to consolidate biomedical hegemony. We analyze the considerations that the women took into account when deciding whether or not to accept specific prenatal care recommendations as authoritative, focusing on when and how they used their own "embodied" knowledge and experience as a standard against which to assess the validity of clinical recommendations. The data provide insight into medicalization processes and the role patients themselves play in furthering biomedical hegemony. PMID:8744081

Browner, C H; Press, N



Nail Biting; Etiology, Consequences and Management  

PubMed Central

Nail biting (NB) is a common, but unresolved, problem in psychiatry, psychology, medicine and dentistry. While it seems that NB is a simple behavior that can be stopped easily, many of the children with NB have already tried to stop it, but they have not been successful. The frustrations due to failed attempt involve others such as parents and siblings. The present review aims at providing an overview of prevalence, co-morbidities, education and counseling, and management for NB. Overall, the reviewed literatures suggest that co-morbidities of psychiatric disorders and other stereotypic behaviors in clinical sample of children with NB is more than 80%, and more than half of the parents suffer from psychiatric disorders mainly depression. Treatment of NB, however, is not as easy as it seems. The management of NB is much more complicated than just focusing on stopping it. Nail biting cannot be managed without considering its co-morbidities, antecedents and consequences. It might be concluded form the reviewed literature that children with NB, parents, siblings, and teachers should be educated about what to do and what not to do about NB. Punishment is not effective. Moreover, clinical randomized controlled trials are required to make available evidence-based behavioral and pharmacologic treatment protocols.

Ghanizadeh, Ahmad



Visualisation of human characteristics in vehicle and health care product development  

Microsoft Academic Search

The purpose of the research project described in this paper is to improve the efficiency of product development processes by exchanging knowledge and experiences about user centred design methods and technologies between the two branches: vehicle and health care industries. The health care industry can benefit from visualisation and simulation tools that include computer manikins, a physical representation of the

Mikael Blomé; Maria Jönsson; Daniel Lundström; CARAN AB; Dan Högberg



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...



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...



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...



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...



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...



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...


Transnational family networks and ethnic minority business development : The case of Vietnamese nail-shops in the UK  

Microsoft Academic Search

Purpose – This paper seeks to understand the role played by transnational family networks in ethnic minority business development. Design\\/methodology\\/approach – The Vietnamese nail-care sector is taken as a case study. The research involved interviews with ten owner-managers and four key informants involved in this industry in London. The analysis draws on concepts of “strong” and “weak” network ties and

Susan Bagwell



Recovery from depression, work productivity, and health care costs among primary care patients  

Microsoft Academic Search

We describe a secondary analysis of data from a randomized trial conducted at seven primary care clinics of a Seattle area HMO. Adults with major depression (n=290) beginning antidepressant treatment completed structured interviews at baseline, 1, 3, 6, 9, 12, 18, and 24 months. Interviews examined clinical outcomes (Hamilton Depression Rating Scale and depression module of the Structured Clinical Interview

Gregory E Simon; Dennis Revicki; John Heiligenstein; Louis Grothaus; Michael VonKorff; Wayne J Katon; Timothy R Hylan



Optimizing the use of blood products in trauma care  

PubMed Central

Blood transfusion has been used to treat the injured since the US Civil War. Now, it saves the lives of tens of thousands of injured patients each year. However, not everyone who receives blood benefits, and some recipients are injured by the transfusion itself. Effective blood therapy in trauma management requires an integration of information from diverse sources, including data relating to trauma and blood use epidemiology, medical systems management, and clinical care. Issues of current clinical concern in highly developed trauma systems include how to manage massive transfusion events, how to limit blood use and so minimize exposure to transfusion risks, how to integrate new hemorrhage control modalities, and how to deal with blood shortages. Less developed trauma systems are primarily concerned with speeding transport to specialized facilities and assembling trauma center resources. This article reviews the factors that effect blood use in urgent trauma care.



Production cost structure in US outpatient physical therapy health care.  


This paper investigates the technology cost structure in US physical therapy care. We exploit formal economic theories and a rich national data of providers to tease out implications for operational cost efficiencies. The 2008-2009 dataset comprising over 19?000 bi-weekly, site-specific physical therapy center observations across 28 US states and Occupational Employment Statistics data (Bureau of Labor Statistics) includes measures of output, three labor types (clinical, support, and administrative), and facilities (capital). We discuss findings from the iterative seemingly unrelated regression estimation system model. The generalized translog cost estimates indicate a well-behaved underlying technology structure. We also find the following: (i) factor demands are downwardly sloped; (ii) pair-wise factor relationships largely reflect substitutions; (iii) factor demand for physical therapists is more inelastic compared with that for administrative staff; and (iv) diminishing scale economies exist at the 25%, 50%, and 75% output (patient visits) levels. Our findings advance the timely economic understanding of operations in an increasingly important segment of the medical care sector that has, up-to-now (because of data paucity), been missing from healthcare efficiency analysis. Our work further provides baseline estimates for comparing operational efficiencies in physical therapy care after implementations of the 2010 US healthcare reforms. PMID:22431432

Lubiani, Gregory G; Okunade, Albert A



Drug-induced skin, nail and hair disorders.  


Drug eruptions are among the most common adverse drug reactions, affecting approximately 3% of hospitalised patients. Although the rate of severe cutaneous adverse reactions to medications is low, these reactions can affect anyone who takes medication, and can result in death or disability. Two general patterns can be distinguished, depending on the type of onset of these cutaneous adverse drug reactions: acute or chronic. Acute-onset events are usually rather specific cutaneous 'syndromes' that constitute emergencies and should therefore be promptly recognised and treated, while chronic-onset events often present as dermatological diseases. The challenge is therefore to recognise the drug aetiology in front of a 'classical' dermatosis such as acne, lichen or pemphigus. Therefore, clinicians should carefully evaluate the signs or symptoms of all adverse reactions thought to be drug related, and discontinue the offending agent when feasible. Erythematous drug eruptions are the most frequent and less severe acute immune drug-induced rashes, and are sometimes difficult to differentiate from viral eruptions. On the other hand, acute urticaria and angioedema are sometimes life-threatening eruptions for which a drug aetiology must be investigated. Photosensitivity, vasculitis and skin necrosis belong to the acute onset reactions, which are not always drug-induced, in contrast to fixed drug eruptions. The early recognition of acute generalised exanthematous pustulosis, DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome, Stevens-Johnson syndrome and toxic epidermal necrolysis are of high importance because of the specific mechanisms involved and the different prognosis of each of these diseases. Chronic onset drug-induced disorders include pigmentary changes, drug-induced autoimmune bullous diseases, lupus, pseudo lymphoma and acneiform eruptions; these are discussed, along with specific data on drug-induced hair and nail disorders. As the disorders are numerous, the mechanisms and the drugs involved in the development of these various reactions are multiple. The list of drugs discussed in relation to the different disorders are as accurate as possible at the time of preparation of this review, but will need updating as new drugs emerge onto the market. We emphasize the clinical recognition, pathophysiology and treatment of skin, hair and nail adverse drug reactions, and the role of each doctor involved in the management of these patients in the notification of the adverse drug reaction to health authorities, using the minimal requirement for notification proposed. PMID:17973540

Valeyrie-Allanore, Laurence; Sassolas, Bruno; Roujeau, Jean-Claude



Some considerations in clinical evaluation of mental health care products  

Microsoft Academic Search

Mental health professionals in clinical settings have a responsibility to ensure that product evaluations are carried out safely and produce results useful to patients, clinicians and administrators. Little information regarding this issue has appeared in mental health literature. Increasing concern in this area has led to new Food and Drug Administration regulations which require more stringent product evaluations. A case

Linda M. Caley; Diane M. Pinchoff



Geotechnical Engineering Circular No. 7: Soil Nail Walls.  

National Technical Information Service (NTIS)

This document provides state-of-the-practice information for the selection, analysis, design, and construction of soil nail walls in highway applications using the Allowable Stress Design (ASD) procedure. The intended audience for this document includes g...

C. A. Lazarte D. Espinoza P. J. Sabatini V. Elias



Effect of Moisture Content on Nail Bearing Strength.  

National Technical Information Service (NTIS)

Current philosophy of lateral connection design strength is based on the yield theory that relates connection performance to fastener bending strength and wood dowel bearing strength. This study investigated the nail bearing properties of four species gro...

D. R. Rammer




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



14. Detail view of the old rotating nail case and ...  

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

14. Detail view of the old rotating nail case and glass display cases now located in the second floor meeting room; looking southeast. - Horsepasture Store, U.S. Route 58 & State Route 687, Horse Pasture, Henry County, VA


Yellow nail syndrome as a cause of unexplained edema.  


Yellow nail syndrome is a rare cause of edema due to a disordered lymphatic drainage. We recently observed two cases of long-standing, chronic edema, whose nature could not be understood despite innumerable diagnostic procedures. The diagnosis was suspected based on an attentive clinical exam and confirmed by radionuclide lymph scan. Yellow nail syndrome has to be considered in the differential diagnosis in cases of systemic edema, as well as long standing pleural effusions, particularly in patients with bronchiectasis or sinusitis. Clues to diagnosis are the presence of dystrophic, yellowish nails, peripheral lymphedema and relapsing pleural effusions and/or ascites. Long-term control of symptoms is difficult to achieve and may benefit from the judicious use of diuretics and intravenous albumin and by topical alpha-tocopherol. Pleurodesis may be needed. Other pathologic conditions are often associated to yellow nail syndrome and should be ruled out. PMID:20440922

Cimini, C; Giunta, R; Utili, R; Durante-Mangoni, E



FDA Alerts Health Care Professionals about Sterile Products ...  

Center for Drug Evaluation (CDER)

... is working closely with the Centers for Disease Control and Prevention ... of human and veterinary drugs, vaccines and other biological products for ... More results from


2D Numerical Simulations of Soil Nail Walls  

Microsoft Academic Search

In practice, numerical simulations of soil nail walls are often carried out to assess the performance and stability. In the\\u000a present study, implications of the use of advanced soil models, such as hardening soil model and hardening soil with small-strain\\u000a stiffness model to simulate the behavior of in situ soil on the overall response of simulated soil nail wall have

Vikas Pratap Singh; G. L. Sivakumar Babu



The Fixion nail in the lower limb. Preliminary results.  


The Fixion nail is an intramedullary nail made of stainless steel, that may be used to treat fractures of the humerus and in the lower limb. This nail is made up of a cylinder that has 4 longitudinal bars which, once inserted in the bone segment, expands via a pressure hydraulic system using physiological solution. The nail may be introduced without reaming and after its expansion it adheres to the bone walls producing stabilization of the fracture. In order to guarantee good stability, the apex of the nail must exceed the fracture line by 5 cm. Indications were initially limited to type 32 and 42 A1-2-3 fractures of the mid third of the lower limb, to then be expanded to type B1 fractures in the AO system. A total of 20 nails were used in 19 patients, with an average time of 7 days for partial weight-bearing and 40 days for total weight-bearing, achieving consolidation on day 18 after an average of 5 months in the femur and 4 months in the tibia. Reaming of the intramedullary canal was carried out in all of the cases. PMID:12701469

Pascarella, R; Nasta, G; Nicolini, M; Bertoldi, E; Maresca, A; Boriani, S


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

Federal Register 2010, 2011, 2012, 2013

...Trade Administration [A-570-909] Certain Steel Nails from the People's Republic of China: Initiation...of the antidumping duty order on certain steel nails (``steel nails'') from the People's Republic of China...



77 FR 19190 - Certain Steel Nails From the People's Republic of China: Extension of Time Limit for the...  

Federal Register 2010, 2011, 2012, 2013

...Administration [A-570-909] Certain Steel Nails From the People's Republic of China...the antidumping order on certain steel nails from the People's Republic of China...administrative review on certain steel nails from the PRC, covering 383...



76 FR 9752 - Certain Steel Nails From the People's Republic of China: Extension of Time Limit for the...  

Federal Register 2010, 2011, 2012, 2013

...Administration [A-570-909] Certain Steel Nails From the People's Republic of China...antidumping duty order on certain steel nails from the People's Republic of China...Antidumping Duty Order: Certain Steel Nails From the People's Republic of...



76 FR 77205 - Certain Steel Nails From the People's Republic of China: Extension of Time Limit for the Final...  

Federal Register 2010, 2011, 2012, 2013

...Trade Administration [A-570-909] Certain Steel Nails From the People's Republic of China: Extension of...Results of the antidumping duty order on certain steel nails (``steel nails'') from the People's Republic of China...



75 FR 77828 - Certain Steel Nails From the People's Republic of China: Extension of Time Limit for the Final...  

Federal Register 2010, 2011, 2012, 2013

...Trade Administration [A-570-909] Certain Steel Nails From the People's Republic of China: Extension of...Results of the antidumping duty order on certain steel nails (``steel nails'') from the People's Republic of China...



77 FR 8808 - Certain Steel Nails From the People's Republic of China: Extension of Time Limit for the Final...  

Federal Register 2010, 2011, 2012, 2013

...Trade Administration [A-570-909] Certain Steel Nails From the People's Republic of China: Extension of...antidumping duty administrative review on certain steel nails (``steel nails'') from the People's Republic of China...



[Retrograde tibial intramedullary nailing with the Flex Nail--treatment of tibial fracture in an unusual case].  


We report a case by a 75 year old female patient suffering a third-degree open fracture of the shinbone with a severe damage of the soft tissue. Primary operation was a temporary fixation with a fixateur externe and a radical debridement of the soft tissue with vacuum-sealing. Ten days later we did the definitive surgery. Osteosynthesis was done by a retrograd nailing with the flexible unreamed humerus nail (Flex-Nail) through the medial ankle. The defect of the soft tissue was treated by a muscle flap and meshgraft transplantation. Healing of the soft tissue and beginning consolidation of the fracture comes after 4 months. In our opinion the retrograd inserted Flex-Nail is a good option for treatment of compound fractures of the lower leg in special cases. PMID:12243019

Wagner, F; Schaudig, W; Bauer, R



Nonclassical yellow nail syndrome in six-year-old girl: a case report  

PubMed Central

Introduction The yellow nail syndrome is usually described as the combination of yellow nails with lymphoedema and often with respiratory manifestations such as pleural effusions, chronic sinusitis and bronchiectasis. The syndrome is most often seen in the middle-aged individuals. Case presentation We present a 6-year-old girl with yellow nail syndrome having pansinusitis and bronchiectasis. Conclusion The components comprising the classical triad of yellow nail syndrome in children may not necessarily be present altogether. Therefore, yellow nail syndrome should be suspected in children having only typical nail changes.



Minimally invasive exchange tibial nailing for a broken solid nail: case report and description of a new technique.  


We present a minimally invasive technique for the removal of a broken solid tibial nail. A special device was invented that minimizes the extraction difficulties. After minimal over-reaming, the device is slid in an antegrade fashion over the nail and locked. Retraction is safe and easy. This article is an illustrative case-presentation describing the device and the surgical technique. PMID:16314724

Gosling, Thomas; Allami, Mohamad; Koenemann, Bernd; Hankemeier, Stefan; Krettek, Christian


Survey of Organosilicone Compounds, Including Cyclic and Linear Siloxanes, in Personal-Care and Household Products  

Microsoft Academic Search

The determination of organosiloxanes in consumer products is important for the evaluation and characterization of sources\\u000a of human and environmental exposures. In this study, we determined concentrations of cyclic siloxanes [octamethylcyclotetrasiloxane\\u000a (D4), decamethylcyclopentasiloxane (D5), dodecamethylcyclohexasiloxane (D6)], tetradecamethylcycloheptasiloxane (D7)] and linear siloxanes (L4 to L14) in a variety of consumer products (n = 76), including hair-care products, skin lotions, body washes, cosmetics, nursing

Yuichi Horii; Kurunthachalam Kannan



Fixator-assisted nailing and consecutive lengthening over an intramedullary nail for the correction of tibial deformity.  


We report the results of using a combination of fixator-assisted nailing with lengthening over an intramedullary nail in patients with tibial deformity and shortening. Between 1997 and 2007, 13 tibiae in nine patients with a mean age of 25.4 years (17 to 34) were treated with a unilateral external fixator for acute correction of deformity, followed by lengthening over an intramedullary nail with a circular external fixator applied at the same operating session. At the end of the distraction period locking screws were inserted through the intramedullary nail and the external fixator was removed. The mean amount of lengthening was 5.9 cm (2 to 8). The mean time of external fixation was 90 days (38 to 265). The mean external fixation index was 15.8 days/cm (8.9 to 33.1) and the mean bone healing index was 38 days/cm (30 to 60). One patient developed an equinus deformity which responded to stretching and bracing. Another developed a drop foot due to a compartment syndrome, which was treated by fasciotomy. It recovered in three months. Two patients required bone grafting for poor callus formation. We conclude that the combination of fixator-assisted nailing with lengthening over an intramedullary nail can reduce the overall external fixation time and prevent fractures and deformity of the regenerated bone. PMID:20044694

Bilen, F E; Kocaoglu, M; Eralp, L; Balci, H I



Product–service systems in health care: case study of a drug–device combination  

Microsoft Academic Search

Although often mentioned as an area in which product–service systems (PSS) possess great potential, the health care sector\\u000a has not been in the focus of research in the past. This paper briefly reviews the challenges and benefits of implementing\\u000a PSS and analyses the special characteristics of the health care market. A case study is then reported in which a PSS

S. A. Mittermeyer; J. A. Njuguna; J. R. Alcock



Estrogenic personal care products in a greywater reuse system.  


The occurrence and fate of parabens in a greywater system was assessed. The potential for removal of residual paraben concentrations in effluent greywater with chlorine dioxide was also investigated. The influent to the greywater plant was characterised by considerable variation, with concentrations from below the detection limit to 40 microg/L and the five commonly used parabens in consumer products were frequently detected. After the biological treatment only two paraben were detected with concentration from 65-120 ng/L. Chlorine dioxide treatment of the biologically treated effluent with dosages down to 0.75 mg/L resulted in more than 97% reduction of all parabens. Formation of the by-product chloroform was insignificant from the chlorine dioxide treatment. PMID:18075177

Andersen, H R; Lundsbye, M; Wedel, H V; Eriksson, E; Ledin, A



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.


Intramedullary nailing: evolutions of femoral intramedullary nailing: first to fourth generations.  


Intramedullary femoral nailing is the gold standard for femoral shaft fixation but only in the past 27 years. This rapid replacement of closed traction and cast techniques in North America was a controversial and contentious evolution in surgery. As we enter the fourth generation of implant design, capabilities, and surgical technique, it is important to understand the driving forces for this technology. These forces included changes in radiographic imaging capabilities, biomaterial design and computer-assisted manufacturing, and the recognition of the importance of mobilization of the trauma patient to avoid systemic complications and optimize functional recovery. PMID:22089849

Russell, Thomas A



Treatment strategies for intramedullary nailing of femoral shaft fractures.  


Intramedullary nailing has become the gold standard to treat femoral shaft fractures. It is unknown which nailing technique orthopedic surgeons prefer. The goal of this study was to determine current techniques and perioperative complications of intramedullary nailing of diaphyseal femoral fractures. Fifty-one institutions in 26 countries participated in an international survey to assess detailed descriptions of preferred operative strategies and perioperative complications. Altogether, 517 cases of diaphyseal femoral fractures were collected. The Internet-based survey incorporated information about fracture classification, time to operation, Injury Severity Score, type of nail, and operative technique, as well as perioperative complications such as infection, femoral neck fracture, and hardware failure. The preferred position for implantation was supine (91.1%). Most surgeons used a traction table (57.1%) and an antegrade implantation technique (84.5%). Intraoperative fractures of the femoral neck occurred in 1.2% of cases when a traction table was used and in 0.2% if no traction table was used, but without statistical significance (P>.16). In 59.2% of the cases, an isolated femur fracture was present, while the rest sustained multiple injuries. In polytrauma patients and patients with severe thorax injuries, most surgeons chose a delayed treatment with intramedullary femoral nails. Interestingly, 38.0% of the patients with severe thorax injuries were treated on the first day with intramedullary femoral nails. The total rate of complications for intramedullary femoral nailing was low (4.9%), but a high rate of intraoperative femoral neck fractures was observed (1.4%). PMID:20954660

Wild, Michael; Gehrmann, Sebastian; Jungbluth, Pascal; Hakimi, Mohssen; Thelen, Simon; Betsch, Marcel; Windolf, Joachim; Wenda, Klaus



A cost and production analysis of hospital dental care programs.  

PubMed Central

To provide hospital dental programs with useful information about the expansion of dental services and the identification of pertinent financial information, a production function and cost function analysis was performed. Results showed that hospital ownership (public or private) and size of the dental clinics were associated with the cost of providing dental services and the volume of services provided. Among 23 hospitals studied, private hospitals had a much lower cost per visit, had more paid attending dentist staff, paid their resident dentists less, and had significantly more billings paid by Medicaid and by patients than public hospitals. When stratified by ownership and size, these basic differences were accentuated for the small clinics. Except for primarily the Medicaid and self-pay billings, the characteristics of large public and private hospital dental clinics were extremely similar. Multiple regression analysis found that a decrease in cost per visit was associated with more visits to dentists and more to hygienists. Production of dental services could be increased by increasing the number of attending dentists, hygienists, and residents. Preliminary econometric analysis reveals that the optimal mix of attending dentists to resident dentists should be approximately 1.8 full-time equivalent (FTE) resident for every 1 attending FTE dentist to produce the most dental services at the lowest cost.

Wan, T T; Vanostenberg, P R; Salley, J J; Singley, D W; West, J L



A cost and production analysis of hospital dental care programs.  


To provide hospital dental programs with useful information about the expansion of dental services and the identification of pertinent financial information, a production function and cost function analysis was performed. Results showed that hospital ownership (public or private) and size of the dental clinics were associated with the cost of providing dental services and the volume of services provided. Among 23 hospitals studied, private hospitals had a much lower cost per visit, had more paid attending dentist staff, paid their resident dentists less, and had significantly more billings paid by Medicaid and by patients than public hospitals. When stratified by ownership and size, these basic differences were accentuated for the small clinics. Except for primarily the Medicaid and self-pay billings, the characteristics of large public and private hospital dental clinics were extremely similar. Multiple regression analysis found that a decrease in cost per visit was associated with more visits to dentists and more to hygienists. Production of dental services could be increased by increasing the number of attending dentists, hygienists, and residents. Preliminary econometric analysis reveals that the optimal mix of attending dentists to resident dentists should be approximately 1.8 full-time equivalent (FTE) resident for every 1 attending FTE dentist to produce the most dental services at the lowest cost. PMID:3116582

Wan, T T; Vanostenberg, P R; Salley, J J; Singley, D W; West, J L


Telecommuting and health care: a potential for cost reductions and productivity gains.  


Health care administrators are striving to maintain positive operating margins while remaining responsive to community needs. As they look for ways to reduce costs and improve productivity, they may consider the benefits associated with telecommuting. Telecommuting refers to the work performed by organizational employees who use computers and telecommunication equipment to work at home or at remote sites one or more days a week. Benefits to the health care industry include release of valuable hospital space, reduced employee turnover, and increased productivity. The time away from the institution may provide administrators with valuable planning time, free from interruptions. PMID:10153620

Jacobs, S M; Pelfrey, S; Van Sell, M



Photobiological safety evaluation of UV nail lamps.  


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



The history and global market of oral home-care products.  


This literature review reports the history and the current market of oral home-care products. It provides information extending from the products used by our ancestors to those currently available, as well as on the changes in the supply and consumption of these products. Although the scientific knowledge about oral diseases has improved greatly in recent years, our ancestors had already been concerned with cleaning their teeth. A variety of rudimentary products and devices were used since before recorded history, like chewing sticks, tree twigs, bird feathers, animal bones, tooth powder and home-made mouth rinses. Today, due to technological improvements of the cosmetic industry and market competition, home-use oral care products available in the marketplace offer a great variety of options. An increase in the consumption of oral care products has been observed in the last decades. Estimates show that Latin America observed a 12% increase in hygiene and beauty products sales between 2002 and 2003, whereas the observed global rate was approximately 2%. A significant increase in the per capita consumption of toothpaste, toothbrush, mouthrinse and dental floss has been estimated from 1992 to 2002, respectively at rates of 38.3%, 138.3%, 618.8% and 177.2%. Pertaining to this increased supply and consumption of oral care products, some related questions remain unanswered, like the occurrence of changes in disease behavior due to the use of new compounds, their actual efficacy and correct indications, and the extent of the benefits to oral health derived from consuming more products. PMID:19838554

Jardim, Juliana Jobim; Alves, Luana Severo; Maltz, Marisa



Interacting with consumers to inform, educate, consult, and assist with the purchase and use of personal care products  

US Patent & Trademark Office Database

Educating a consumer about a personal care product. A request for information regarding a personal care product is received from a consumer. A description of one or more physical characteristics associated with the consumer and related to the personal care product is also received from the consumer. In response to the received request and description, a visual representation of a three-dimensional model is provided to the consumer. The three-dimensional model is a function of the received physical characteristics and the personal care product.



[Analysis of nursing scientific production about family care at home (2000-2005)].  


This study aimed to analyze the nursing's scientific production about the thematic family care at home, through bibliographic research in electronic data bases in which nursing journals with QUALIS " C" international evaluation are indexed, and in the bibliographical collection of two universities of Ceará, relative to the period of 2000 to 2005. 33 articles were analyzed. The results permitted the verification that postgraduation students were more interested in the thematic; 85% of the studies were arising from of the Southeast of the Country and of the predominance of qualitative studies (26). We establish also 29 participations of family members in activities of care. In conclusion, the nursing has inserted the family care at home in its researches, however still of incipient way, what shows its inhibited contribution for the preparation of those families for the practical care. PMID:18604434

Gomes Rocha, Edilma; Gomes Machado, Ana Larissa; Fialho, Ana Virgínia de Melo; Moreira, Thereza Magalhães


Elastoplasticity analysis of the nails used in long bone fractures  

NASA Astrophysics Data System (ADS)

Elastoplastic endomedullary nail-insertion system in long bone fractures is a method which allows generating forces, moments, frictions and stress states in parts of the bone previously selected. Adding previous knowledge on the distribution of forces and acting moments over the bone fragments to be threaded, as well as on the elastoplastic and mechanical properties of the nails to be inserted (designing a special, specific structure for each case), the results, coming from 26 years of applying this technique, have been promising. It is from this perspective that we call this threading and anchoring procedure "Selective Tension System" (STS). Physicochemical analyses and mechanical trials on elastoplastic nails used in the osteosynthesis in long bone fractures are presented. The magnitude of the forces produced by flattening the nails and the reacting forces at both ends are measured. It is expected that the evidence provided on the elastic variability of these nails will be useful as guidance on the availability and choice of the elastoplastic combinations that best fit each patient.

Paterson, R.; Del Sel, G.; Paterson, A.; Miralles, M. T.; Del Sel, N.



[Intramedullary interlocking of humeral fractures and nonunions with Seidel nail].  


The advantages and disadvantages of interlocking Seidel's nails determined by their construction and the way of insertion were presented on the basis of own experience and literature. The advantages are strength and shape of the nails which are conductive to fragments stability and make insertion into humerus medullar canal easier. The tools set for insertion and locking of distal part. It doesn't truly protect from torsion displacements. Locking takes place by draw for a few weeks by external immobilization. The Seidel's nail has also disadvantages associated with proximal insertion. Unavoidable injury of supraspinatus tendon insertion can be the reason of loss of shoulder function. The antegrade fixation can cause pushing distal fragment downward by tip of the nail. It is necessary to control it's insertion under image intensifier. Presented disadvantages of Seidel's nail fixation didn't result in any problems in humerus fractures or pseudoarthroses healing. In one case it was necessary to perform additional decortication and space of fracture fulfillment with bone grafts. PMID:16158873

Modrzewski, Krzysztof; Urban, Tadeusz; Gaweda, Krzysztof



First experience and complications with the long Gamma nail.  


Treatment of proximal femoral fractures is difficult. A retrospective analysis of 92 patients treated with a custom-made extended gamma nail with a mean follow up of 4 months is presented. The early results of this new method are promising. The indications for the use of the long gamma nail were intertrochanteric fractures with extension to the subtrochanteric region, imminent and pathologic fractures of the intertrochanteric and subtrochanteric region, mostly in elderly patients, proximal femoral fractures, and combination injuries in multiple trauma patients and delayed unions. In 67 cases the patients were primarily treated with a long Gamma nail. In 25 cases the nail was used after the failure of initial treatment. Complications occurred in 32 patients; however, 88 patients were able to walk at the end of the study. The advantage of this new method is that with a closed surgical technique full weight bearing directly after the operation is achieved. The long Gamma nail provides a procedure by which most complex fractures in the proximal femur can be managed. PMID:8483181

Stapert, J W; Geesing, C L; Jacobs, P B; de Wit, R J; Vierhout, P A



Comparative study of nail sampling techniques in onychomycosis.  


Onychomycosis is a common problem. Obtaining accurate laboratory test results before treatment is important in clinical practice. The purpose of this study was to compare results of curettage and drilling techniques of nail sampling in the diagnosis of onychomycosis, and to establish the best technique and location of sampling. We evaluated 60 patients suffering from distal and lateral subungual onychomycosis and lateral subungual onychomycosis using curettage and vertical and horizontal drilling sampling techniques from three different sites of the infected nail. KOH examination and fungal culture were used for detection and identification of fungal infection. At each sample site, the horizontal drilling technique has a better culture sensitivity than curettage. Trichophyton rubrum was by far the most common pathogen detected by both techniques from all sampling sites. The drilling technique was found to be statistically better than curettage at each site of sampling, furthermore vertical drilling from the proximal part of the affected nail was found to be the best procedure for nail sampling. With each technique we found that the culture sensitivity improved as the location of the sample was more proximal. More types of pathogens were detected in samples taken by both methods from proximal parts of the affected nails. PMID:19583689

Shemer, Avner; Davidovici, Batya; Grunwald, Marcelo H; Trau, Henri; Amichai, Boaz



Extended Neviaser portal approach to antegrade humeral nailing.  


Certain arthropathies can distort the normal acromiohumeral relationship and make traditional anterolateral access to the proximal humerus for nailing difficult or impossible. This article presents a case of bilateral antegrade humeral nailing in which the Neviaser portal approach was used for humeral shaft fractures in a patient with distorted shoulder anatomy secondary to severe cuff tear arthropathy and rheumatoid arthritis. Based on a literature review, extending the traditional superomedial (Neviaser) portal to the shoulder to perform humeral nailing has never been described clinically. An 85-year-old woman with rheumatoid arthritis and bilateral cuff tear arthropathy presented after a mechanical fall from standing height with bilateral acute humeral shaft fractures. Preoperative fluoroscopy confirmed the inability to access the traditional starting point with an anterolateral approach due to a shield acromion resulting from cuff tear arthropathy and rheumatoid arthritis. Bilateral locked antegrade humeral nails were successfully placed through a 3-cm incision just off the medial border of the acromion and directly posterior to the acromioclavicular joint (the extended Neviaser portal approach). Postoperatively, the patient demonstrated early evidence of clinical and radiographic union. She was able to return to her preinjury function level, with an active range of motion comparable with her baseline. The Neviaser portal approach to antegrade humeral nailing is an effective solution to diaphyseal humeral fractures when access to the traditional anterolateral proximal humeral starting port is not possible due to distorted shoulder anatomy. PMID:23383679

Dilisio, Matthew F; Fitzgerald, Ryan E; Miller, Eric T



[Chronic inflammation 30 years after tibial intramedullary nailing--foreign body reaction or bacterial infection?].  


30 years after two-fold marrow nailing of the tibia due to the formation of a pseudarthrosis and timely removal of the implants in a miner who was 17 years of age at that time, we found a chronic irritation that required surgical therapy. After excision of a two inch long sequester and escape of a small and cheesy core without identification of germs the patient is symptom-free since one and a half year. A foreign-body reaction to corrosion products of the implant or a late infection with low-virulent germs of the bradytrophic medullary callus appears to be the underlying cause. PMID:8098575

Grauhan, O; Hierholzer, J; Speitling, A; Schauwecker, H H; Neuhaus, P



Tests of stationarity and cointegration of health care expenditure and gross domestic product: an application to Turkey.  


This study examines the long-run relationship among the per capita private, public, and total health care expenditure and per capita gross domestic product and population growth of Turkey. We find some evidence of multivariate cointegrating relationships among the health care expenditure and gross domestic product, and population growth. We further find a bivariate cointegrating relationship between private health care expenditure and per capita gross domestic product. Accordingly, a 10% increase in gross domestic product would translate into a 21.9% increase in total health care expenditure while controlling population growth. The income elasticity of health expenditure is found to be greater than 1, implying that health care is a luxury good in Turkey. Finally we note that there exists one-way causality running from per capita gross domestic product to various definitions of health care expenses. PMID:17109146

Kiymaz, Halil; Akbulut, Yasemin; Demir, Ahmet



Stress analysis of the distal locking screws for femoral interlocking nailing  

Microsoft Academic Search

In femoral locked nailing, the distal locking screws are vulnerable to mechanical failure. Biomechanical studies have shown that the stress on these screws is substantially affected by the fit of the nail in the medullary canal. In this study, a “closed form” mathematical model based on elastic beam-column theory was developed to investigate how the nail–cortical contact, which was simulated

Jinn Lin; Son-Jyh Lin; Po-Quang Chen; Shu-Hua Yang



Potential exposure of German consumers to engineered nanoparticles in cosmetics and personal care products.  


The rapid increase in the number of consumer products containing engineered nanoparticles (ENP) raises concerns about an appropriate risk assessment of these products. Along with toxicological data, exposure estimates are essential for assessing risk. Currently, cosmetics and personal care products (C&PCP) represent the largest ENP-containing consumer product class on the market. We analyzed factors influencing the likelihood that ENP-containing products are available to consumers. We modelled potential external exposure of German consumers, assuming a maximum possible case where only ENP-containing products are used. The distribution of exposure levels within the population due to different behavior patterns was included by using data from an extensive database on consumer behavior. Exposure levels were found to vary significantly between products and between consumers showing different behavior patterns. The assessment scheme developed here represents a basis for refined exposure modelling as soon as more specific information about ENPs in C&PCP becomes available. PMID:21417685

Lorenz, Christiane; Von Goetz, Natalie; Scheringer, Martin; Wormuth, Matthias; Hungerbühler, Konrad



Occurrences of pharmaceutical and personal care products as micropollutants in rivers from Romania  

Microsoft Academic Search

The occurrence of pharmaceutical and personal care products (PPCPs) was investigated in the Somes River. The aim of this study was to obtain a first overview about the contamination of Somes River (Transylvania) with PPCPs. The samples were preconcentrated by Solid Phase Extraction (SPE) procedures and analysed by GC\\/MS. A number of 15 compounds including pharmaceutics, metabolites, intermediates and musk

Zaharie Moldovan



Health Care Expenditures in the National Health Expenditures Accounts and in Gross Domestic Product: A Reconciliation  

Microsoft Academic Search

This paper provides a most detailed reconciliation to date of the National Health Expenditure Accounts (NHEA), the official estimates of health care spending in the United States from the Centers for Medicare and Medicaid Services (CMS), and the estimates of health expenditures that are part of gross domestic product (GDP) produced by the Bureau of Economic Analysis (BEA) as part

Micah Hartman; Robert Kornfeld; Aaron Catlin



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

Microsoft Academic Search

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

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



Characterizing the Passage of Personal Care Products Through Wastewater Treatment Processes  

Microsoft Academic Search

Wastewater treatment facilities use secondary treatment to stabilize the effect of discharged effluent on receiving waters by oxidizing biodegradable organic matter and reducing suspended solids and nutrients. The process was never specifically intended to remove trace quantities of xenobiotics, such as endocrine-disrupting compounds (EDCs) and pharmaceu- ticals and personal care products (PPCPs). Nevertheless, European studies performed at bench-scale or at

Joan Oppenheimer; Roger Stephenson; Arturo Burbano; Li Liu


Steps Toward Effective Production of Speech (STEPS): No. 5--How to Take Care of a Hearing Aid.  

ERIC Educational Resources Information Center

|The booklet, one of a series of guides for parents of deaf-blind children developed by Project STEPS (Steps Toward Effective Production of Speech), gives parents practical suggestions for caring for their deaf-blind child's hearing aid. An initial section provides basic information on hearing aid function and care. Specific care ideas are…

Sheeley, Eugene C.; McQuiddy, Doris


Primary Nailing in the Open Fractures of the Tibia-Is it worth?  


Context (Background): The tibial shaft is one of the most common sites of open fractures. The specific methods of skeletal stabilization and soft tissue treatment of open fractures continue to be topics of debate in the orthopaedic traumatology. Aims: To evaluate the results of the intramedullary nailing in the open fractures of the tibia, especially in the Indian scenario. Settings and Design: An observational, descriptive study which was done at a tertiary care hospital from 2006 to 2010. Material and Methods: A prospective study was done on thirty cases which had sustained open fractures of t/hable Gustilo and Anderson grades I, II and III, who were operated for primary intramedullary interlocking nail fixation after thorough debridement and closure of their wounds with suturing, lateral skin release, split thickness skin grafting and muscle pedicle flap, where ever necessary. All the patients were followed up for a minimum of two years. Statistical Analysis: Descriptive statistics and Fisher's Exact test were used. Results: Of the total thirty cases, ten were of grade I, seven were of grade II, three were of grade IIIA, seven were of grade IIIB and three were of grade IIIC. Dynamization was done in nine cases. The average time to union was 16.0 weeks in the grade I cases, it was 18.3 weeks in the grade II cases, it was 23.6 weeks in the grade III A cases, it was 28.4 weeks in the grade III B cases and it was 32 weeks in the grade III C cases. The mean time to union was 20.7 weeks. Infection occurred in 3 cases. Delayed unions were observed in 4 cases. A non union occurred in 1 case of type IIIC. A mal union was observed in 1 case of type IIIB. 1 case of grade IIIC had the compartmental syndrome. No case had any implant failure (nail / screw breakage), or deep vein thrombosis. Conclusion: We conclude that the unreamed intramedullary nailing in cases of open fractures of the tibia, with an early soft tissue coverage, results in a faster soft tissue and bony healing, an easier soft tissue coverage, a better biomechanical stability and early rehabilitation and infection rates as comparable to those which are seen with other methods. PMID:23905118

Agrawal, Atul; Chauhan, Vijendra Devisingh; Maheshwari, Rajesh K; Juyal, Anil Kumar



Avoiding varus malreduction during cephalomedullary nailing of intertrochanteric hip fractures.  


We describe a technique for preventing varus malreduction of intertrochanteric hip fractures during fixation with a cephalomedullary nail. When the entry reamer guidewire is positioned in the fracture line, passage of the entry reamer may simply push the proximal fragment medially and the distal fragment laterally rather than ream the accurate entry path. Subsequent nail insertion will result in a varus deformity of the proximal femur. The simple technique described in this report uses a brief period of over-distraction to wedge the entry reamer guidewire against the lateral edge of the proximal fragment, permitting the reamer to cut a correct path in the lateral edge of the proximal fragment. Creation of a proper entry path is essential to maintain anatomic reduction during cephalomedullary nailing of intertrochanteric hip fractures. PMID:20734198

Hak, David J; Bilat, Christian



Ipsilateral hip and femoral shaft fractures treated with intramedullary nails  

PubMed Central

This study retrospectively analysed 34 patients with ipsilateral hip and femoral shaft fractures treated over a period of 10 years between January 1995 and January 2005. They had an average age of 35 years. Twenty-six (76.47%) of these cases suffered high-velocity trauma (RTA); six others had fallen from a height (17.65%), and two had suffered only minimal trauma (5.88%). Twenty were extracapsular (58.82%) and 14 were intracapsular. They were evaluated with an average follow-up of 28 months, both clinically and radiologically; 26 patients (76.47%) had a good result (Friedman and Wyman score). When the intracapsular fracture was detected postperatively, there was one delayed union and one non-union. When the fracture is diagnosed preoperatively, we recommend reconstruction nail fixation. If the hip fracture is diagnosed intra- or postoperatively following nailing of the shaft, we propose the miss-a-nail technique as an option.

Kumar, M. Ajith; Ireshanavar, Sandeep S.; Sudhakar, Dr



The Chinese Nail Murders: forensic medicine in Imperial China.  

PubMed Central

Robert van Gulik was a respected Dutch sinologist and author who first translated a collection of traditional Chinese detective stories into English and then created additional fictional stories based on the same characters and setting in the Tang dynasty. One of these stories, The Chinese Nail Murders, draws on van Gulik's professional interest in law and his knowledge of early Chinese works on forensic medicine. This novel develops a common theme in Chinese detective fiction, murder by a nail wound to the head. The difficulty in detection of this mode of violence posed a particular problem for the examining magistrate because postmortem examination was mostly limited to external observations. This essay compares the development of Chinese and Western forensic medicine in the context of the nail murder motif.

Summers, W. C.



Trace Elements in Nails as Biomarkers in Clinical Research  

PubMed Central

Background The importance of trace elements in relation to human health has been increasingly recognized. Accurate and adequate quantification of trace elements are crucial in clinical research. Design This review was to discuss the rationale of using nail trace elements as biomarkers in clinical studies. Results For most trace elements, dietary instruments can not appropriately capture the intakes because of the minimal amounts and wide variations in the same foods grown in different area as well as the non-dietary exposures. Therefore, biomarkers may be essential in studying trace elements. Although there are notable differences among trace elements in the availability of biomarkers, increasing evidence supports that nail particularly toenail concentrations of most trace elements are useful biomarkers of exposure in which a single sample is assumed to represent long-term exposure. Conclusions As compared to other potential biomarkers of trace elements, nail measurement has certain advantages in clinical research.

He, Ka



Survey of trace elements in human nails: an international comparison  

SciTech Connect

Evaluation of trace metals in human tissues such as hair and nails has proven useful in the studies pertaining to chronic body exposure. These have also been suggested as indexes to evaluate environmental exposure by toxic trace metals. Though hair have been more extensively studied than finger nails, yet it remains that the latter tissue is equally promising in the characterization of certain diseases and abnormalities. These studies reveal continued interest in trace elements in the devitalized human tissues. The authors conducted earlier a survey of trace elements in human hair and in continuation of this study the present communication reports the data on trace elements in human nails in populations of diverse regions. Over 500 specimens drawn from Japan, India, Poland, Canada and U.S.A. were analyzed for 21 trace elements. An attempt has also been made to differentiate trace elements distributed according to age, sex and living habits of the donors.

Takagi, Y.; Matsuda, S.; Imai, S.; Ohmori, Y.; Masuda, T.; Vinson, J.A.; Mehra, M.C.; Puri, B.K.; Kaniewski, A.



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



Perspectives of residential contractors on nail gun safety.  


Perspectives on nail gun safety were sought from residential contractors as part of an injury surveillance and prevention effort (2005-2008). Anonymous surveys inquired about tool use, training, injury risk, and awareness of the 2003 American National Standards Institute (ANSI) standard calling for shipment of pneumatic nail guns used in wood framing with sequential actuation. Despite some awareness of inexperience, lack of training, speed and tool design in injury causation, 55 percent consistently reported injuries resulted from worker carelessness. Contractors reported safety experiences of their employees were considerably better than those of other residential contractors. After five years, only 16 percent reported any awareness of the voluntary standard. These findings raise questions as to what gains can realistically be expected from passage of voluntary standards such as the one described here. Given that the epidemiology of acute injuries from pneumatic nail guns is now well-described, the safer sequential trigger should be required to protect workers. PMID:20943476

Lipscomb, H J; Nolan, J; Patterson, D



A case of nail-patella syndrome associated with thyrotoxicosis  

PubMed Central

Nail-patella syndrome, also known as hereditary onycho-osteodystrophy, is a rare autosomal dominant disorder with pleiotropic phenotypic expression. The present report is of a nail-patella syndrome patient, a 26-year-old female, admitted to our NeuroMuscular Rehabilitation Clinic Division for neurological symptoms, secondary to a severe spondylolysthesis with bilateral L5 pedicle fracture. During hospitalization, she was also diagnosed with mild thyrotoxicosis, but interestingly enough, the bone mineral density, assessed at multiple sites, was quasi-normal. Abbreviations BMD – bone mineral density, BMI – body mass index, DXA – dual-energy X-ray absorptiometry, FT4 – serum free thyroxin, HOOD – Hereditary onycho-osteodystrophy, NPS – Nail-patella syndrome, TSH – thyroid-stimulating hormone

Haras, B; Vulpoi, F; Onose, Gh



Impact of hair-care products on FAEE hair concentrations in substance abuse monitoring.  


Previous studies have indicated that the use of high-ethanol-content (>65%) hair-care products may elevate fatty acid ethyl ester (FAEE) concentrations in hair. In this case series, nine individuals were identified by FAEE analysis to be chronic alcohol abusers in the context of child-welfare substance abuse monitoring. Based on patient claims of moderate or no alcohol consumption, the presence of ethanol in the patients' hair-care regimens was investigated. Samples were additionally tested for the presence of ethyl glucuronide (EtG). From a total of nine patients, 12 hair samples were submitted for analysis. Patient histories were obtained as well as Material Safety Data Sheets (MSDS) listing hair-care product ethanol content. Hair samples were pre-washed to remove external contamination and analyzed for FAEE and EtG by GC-MS. According to the Society of Hair Testing consensus guidelines, FAEE levels exceeding 0.50 ng/mg and/or EtG levels exceeding 30 pg/mg indicate chronic excessive alcohol consumption. Upon initial analysis, the nine samples exhibited positive FAEE findings ranging from 0.496 to 4.984 ng/mg. MSDS review revealed the presence of ethanol from 10% to 95% by volume in at least one hair-care product used by each individual. Results of the EtG analysis ranged from 1.9 to 23.5 pg/mg. These findings indicate that regular use of products with ethanol content as low as 10% can impact FAEE results. EtG analysis should be used to confirm FAEE findings and appears to be unaffected by hair-care products, likely due to alternative mechanisms of incorporation. PMID:21301822

Gareri, Joey; Appenzeller, Brice; Walasek, Paula; Koren, Gideon



A review on the use of non-timber forest products in beauty-care in Bangladesh  

Microsoft Academic Search

This review describes the non-timber forest products (NTFPs) used for different aspects of beauty-care in Bangladesh on the\\u000a basis of extensive literature survey. The diverse plant species, including used parts and using patterns for hair care, facial\\u000a treatments and body care, were summarized in 13 tables. This paper accumulate the scattered knowledge regarding the use of\\u000a plants in beauty-care in

Sayma Akhter; Abdul Halim; Shawkat Islam Sohel; Swapan Kumar Sarker; Mohammad Shaheed Hossain Chowdhury; Sanjay Saha Sonet



Fluoride in the urine, hair, and nails of phosphate fertiliser workers.  

PubMed Central

The fluoride content in the urine, hair, and nails of 106 workers employed in a phosphate fertiliser plant was significantly raised above the control level. Positive correlations were found between the group means for concentrations of fluorides in urine and hair (r = 0.77), urine and nails (r = 0.99), and hair and nails (r = 0.70). Individual values in the whole population gave significant correlations between concentrations in urine and nails (r = 0.73). The obtained results indicate that the fluoride content in hair and nails may be used as an indicator of occupational exposure to fluorides.

Czarnowski, W; Krechniak, J



Influence of antioxidants on the sun protection properties of hair care products.  


Aim of this study was to determine the influence of commercially available antioxidants on sun protection properties of hair care products. To evaluate changes of human hair L*a*b-color measurements, tensile strength measurements and high pressure dynamic scanning calorimetry (HPDSC) measurements were carried out. To have a measure for the concentration of the activity of the reactive species, causing hair or color damage, chemiluminescence measurements were carried out. Before the test with the antioxidants experiments were carried out to evaluate effects of varied artificial weathering conditions on physical properties of hair. Here high relative humidity (85%) and low radiant flux (600W/m2) exhibited the biggest changes in natural hair color but the lowest changes in the in tensile strength and HPDSC measurements. All of the tested antioxidants reduced the chemiluminescence level when used in a pre-sun or after-sun formulation. According to the HPDSC measurements the antioxidants showed a slight increase of the peak temperature and therewith a hint towards a protection effect when used in a pre-sun or after-sun product. In contrast thereto some of the antioxidants reduced the tensile strength of sun care products for hair when added. A slight reduction in the lightening of natural hair color could be observed when antioxidants were present in the sun care formulations. The effect of antioxidants in sun care formulations used on dyed hair was strongly dependent on the shade of hair. The addition of some antioxidants yielded significant improvements of the protection properties of the used sun care product in some measurement methods. PMID:15645086

Meinert, Knut; Springob, Christian; Schmidt, Carl U; Kripp, Thomas C



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


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



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


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



Effects of topical alkane vapocoolant spray on pain intensity prior to digital nerve block for ingrown nail surgery.  


Needle penetration and local anesthetic infiltration are 2 painful steps that cause considerable stress and anxiety during digital nerve block, which is the most frequently used regional anesthesia for ingrown nail surgery. The purpose of this study was to evaluate the effectiveness of topical alkane vapocoolant spray in decreasing pain during digital nerve block for ingrown nail surgery. The authors conducted a prospective, randomized clinical trial with 62 patients who underwent big toenail surgery. Prior to the digital block, alkane vapocoolant spray was applied to patients who were selected by flipping a coin. A visual analog scale (VAS) was used for assessment of pain during the skin needle penetration and during the infiltration of the anesthetic product. VAS scores during needle penetration were significantly lower in the intervention group. However, VAS scores during infiltration were similar statistically. Alkane vapocoolant spray has no noticeable clinical benefit in decreasing pain intensity during digital nerve block in patients undergoing toenail surgery. PMID:20400416

Kose, Ozkan; Saylan, Sedat; Ediz, Naim; Yigit, Seyhmus



An in vivo evaluation of surface polishing of TAN intermedullary nails for ease of removal.  


Fractures of the tibia and femoral diaphysis are commonly repaired by intra-medullary (IM) nailing. Currently IM nails are available in either electropolished stainless steel (SS) or in Titanium-Aluminium-Niobium (TAN). After healing, removal of the nails still is common but removal of TAN IM nails often has complications whereas SS IM nails of the same design are less often associated with problems. We believe the differences in removal are due to the ability of TAN to promote strong bone on-growth. We have previously shown in vivo that polishing cortical screws reduces removal torque and the percentage of bone-implant contact. Therefore, we postulate that bony on-growth onto IM nails can be reduced by means of surface polishing, for ease of removal. Here we aim to compare the pull-out forces for removal of standard TAN (TAN-S) compared to experimental paste polished TAN (TAN-PP) IM nails from a bilateral non-fracture sheep tibia model after 12 months implantation. Histological analysis was also performed to assess tissue on-growth to the nails. We show that polishing significantly reduces (p=0.05) the extraction force required for TAN IM nail removal. This effect in part is attributable to the distinct tissue-material reaction produced. For TAN-S nails direct bone contact was observed while for TAN-PP nails a fibrous tissue interface was noted. Since TAN is preferred over SS for IM nailing due to superior biocompatibility and mechanical properties, we believe these findings could be used to recommend changes to current surface technologies of intramedullary nails to reduce complications seen with nail removal especially in rapidly growing bone in children. PMID:19771539

Hayes, J S; Vos, D I; Hahn, J; Pearce, S G; Richards, R G



Malrotation following reamed intramedullary nailing of closed tibial fractures  

PubMed Central

Background: Rotational malalignment after intramedullary tibial nailing is rarely addressed in clinical studies. Malrotation (especially >10°)of the lower extremity can lead to development and progression of degenerative changes in knee and ankle joints. The purpose of this study is to determine the incidence and severity of tibial malrotation after reamed intramedullary nailing for closed diaphyseal tibial fractures. Materials and Methods: Sixty patients (53 males and 7 females) with tibial diaphyseal fracture were included in this study. The mean age of the patients was 33.4±13.3 years. All fractures were manually reduced and fixed using reamed intramedullary nailing. A standard method using bilateral limited computerized tomography was used to measure the tibial torsion. A difference greater than 10° between two tibiae was defined as malrotation. Results: Eighteen (30%) patients had malrotation of more than 10°. Malrotation was greater than 15° in seven cases. Good or excellent rotational reduction was achieved in 70% of the patients. There was no statistically significant relation between AO tibial fracture classification and fibular fixation and malrotation of greater than 10°. Conclusions: Considering the high incidence rate of tibial malrotation following intramedullary nailing, we need a precise method to evaluate the torsion intraoperatively to prevent the problem.

Jafarinejad, Adel Ebrahimpour; Bakhshi, Hooman; Haghnegahdar, Maryam; Ghomeishi, Nima



A freeze-fracture study of the human nail plate  

Microsoft Academic Search

This study of freeze-fracture replicas of human nail plate fragments demonstrates that keratin filaments have a width of about 100 Å. The ‘marginal band’ is probably formed by a row of particles, 50 Å in diameter, arranged along the inner surface of the plasma membrane. These particles are often masked by keratin filaments. In nonjunctional areas, the plasma membranes are

Ruggero Caputo; Giovanni Gasparini; Donata Contini



Early Complications Associated With Cephalomedullary Nail for Intertrochanteric Hip Fractures.  


BACKGROUND:: Use of cephalomedullary devices for pertrochanteric fractures has been associated with complications of cutout, fracture distal to the tip of the implant, infection, and hardware failure. The goal of recent design changes (a trapezoidal shape of the proximal device, with interdigitation of the cephalocervical screws) in cephalomedullary nails was to improve fracture fixation and stability of pertrochanteric fractures. This is a retrospective review of the first 127 surgeries using this new cephalomedullary nail to review early complications seen with this device. METHODS:: A review of early complications (cutout, infection, fracture distal to the tip, fracture collapse, and hardware failure) for 100 patients who met inclusion criteria was performed. RESULTS:: Postoperative mechanical complications included six (6%) patients with significant collapse of the femoral neck, six (6%) fractures distal to the implant (short nail only, n = 75), one (1%) cutout, four (4%) infections, and one (1%) implant breakage. The implant breakage occurred at the screw-nail interface. CONCLUSION:: In our study population, we found this newer cephalomedullary device had complications similar to those reported with devices in previous studies. PMID:21768898

Erez, Orry; Dougherty, Paul J



Intramedullary nailing for fibrous dysplasia of lower limbs  

PubMed Central

Fibrous dysplasia (FD) of the bone is rare and self-limiting. However, lesion expansion may occur, causing pain, deformity and pathological fracture, in which case surgery is occasionally required. Indicators of FD have not been previously described, although there are several surgical procedures reported (curettage, curettage and graft, and internal fixation). In this study we discuss whether intramedullary nailing of these lesions could result in more favorable outcomes in correcting deformities, including the prevention of secondary fractures and maintenance of the bone, compared to other internal fixation methods. A total of 39 patients with FD of the bone treated with intramedullary nailing were retrospectively analyzed. The surgical procedures involved curettage, grafting and intramedullary nailing. No infection, thromboembolism or other notable complications occurred. The patients resumed full activities of daily living. At the last follow-up, 33 patients presented no pain and seven patients had occasional mild pain. The clinical score according to the modified criteria of Guille improved from an average of 4.4 points prior to surgery to an average of 8 points following surgery. The neck shaft angle of the femur improved from an average of 90? prior to surgery to 125? following surgery. Intramedullary nailing may be used to correct deformity and prevent pain and refracture in FD of the bone of the lower limbs with large lesions, pathological fracture or deformities. All patients were allowed full athletic recovery following surgery.




Immediate intramedullary nailing of femoral shaft fractures due to gunshots  

Microsoft Academic Search

With increasing violence in our society, the number of gunshot fractures is likely to increase. Fourteen femoral fractures caused by gunshot injuries were treated with statically locked intramedullary nailing within 8 h of injury. Three patients had concomitant femoral arterial injuries. At follow-up (average 22 months) the results were assessed using a standardized grading system. Thirteen fractures had progressed to

R. M. Nicholas; G. F. McCoy



Locked intramedullary femoral nailing without fracture table or image intensifier.  


The present retrospective study aims to evaluate the outcome in 41 patients of femoral shaft fractures, who had closed intramedullary nailing in lateral decubitus position without fracture table or image intensifier. Mean age was 33.2 (range, 18-70) years. The cannulated reamer in proximal fragment (as intramedullary joystick) and Schanz screw in the distal fragment (as percutaneous joystick) were simultaneously used to assist closed reduction of the fracture without the use of image intensifier. Closed reduction was successful in 38 patients. Open reduction was required in 3 patients. Schanz screw was used for closed reduction in 12 patients. Average number of intra-operative radiographic exposures was 4.4. Two patients had exchange nailing using large diameter nails. One patient had nonunion. Angular and rotatory malalignments were observed in seven patients. We are of the opinion that the present technique is a safe and reliable alternative to achieve closed locked intramedullary nailing and is best suited to stable, less comminuted (Winquist-Hansen types I and II) diaphyseal fractures of the femur. PMID:22081272

Rohilla, Rajesh; Singh, Roop; Rohilla, Seema; Magu, Narender K; Devgan, Ashish; Siwach, Ramchander



The Soho nail bomb: the UCH experience. University College Hospital.  

PubMed Central

This paper documents the clinical course of the casualties treated at University College Hospital, following the detonation of a terrorist nail bomb in a public house in Soho, London. The need for adequate primary debridement is paramount, including consideration of definitive primary limb amputation. Images Figure 1 Figure 2 Figure 3

Ng, R. L.; James, S. E.; Philp, B.; Floyd, D.; Ross, D. A.; Butler, P. E.; Brough, M. D.; McGrouther, D. A.



Fundamental study on formulation design of skin care products by modeling of tactile sensation.  


The objective of this study is to construct a method to quantify and formulate the human tactile sensation. We have tried to indicate the sensory scores of tactile sensation as a combination of the physical values of skin care products. Consequently, the extracted principle factors of the sensory properties could be related to the physical values by multiple regression analysis. For the next step, we investigated the physical mechanism of tactile sensation, and proposed a method to formulate the sensory properties. A method to formulate the sensory properties of skin care products was constructed based on the relation between sensory values, principal factors, physical values and composition. The method was verified by sensory evaluation. PMID:24110753

Akiyama, Yoko; Mishima, Fumihito; Nishijima, Shigehiro



GC-MS analytical methods for the determination of personal-care products in water matrices  

Microsoft Academic Search

This article discusses the more recent methods combining gas chromatography and mass spectrometry (GC-MS) for analysis of personal-care products (PCPs) in water matrices. We describe different procedures for sample extraction and preparation as well as different instrumental methods commonly used for these compounds. GC-MS and GC-tandem MS (GC-MS2), which are complementary to liquid chromatography combined with MS (LC-MS), allow identification

Giulia Basaglia



Separation and determination of basic dyes formulated in hair care products by capillary electrophoresis  

Microsoft Academic Search

A capillary electrophoretic (CE) method for analyzing five basic dyes (Basic Red 76, Basic Brown 16, Basic Yellow 57, Basic Brown 17 and Basic Blue 99) sold under the trade name Arianor, which are commonly used in hair care products, has been established. A buffer of 100mM acetic acid–ammonium acetate (50:50) containing 90% (v\\/v) methanol was employed in a fused-silica

Yoshinori Masukawa



Biological Degradation of Common Pharmaceuticals and Personal Care Products in Soils with High Water Content  

Microsoft Academic Search

Biological degradation rates of six pharmaceuticals and personal care products were examined in soil from a land application\\u000a site and in adjacent soil with no prior history of effluent exposure. Microbial degradation rates were compared over 2 weeks\\u000a under standing water or saturated conditions and draining conditions after having been saturated for 3 days. Biological degradation\\u000a of 17?-estradiol exhibited rapid rates of

Deborah L. Carr; Audra N. Morse; John C. Zak; Todd A. Anderson



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



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



Impact of hair-care products on FAEE hair concentrations in substance abuse monitoring  

Microsoft Academic Search

Previous studies have indicated that the use of high-ethanol-content (>65%) hair-care products may elevate fatty acid ethyl\\u000a ester (FAEE) concentrations in hair. In this case series, nine individuals were identified by FAEE analysis to be chronic\\u000a alcohol abusers in the context of child-welfare substance abuse monitoring. Based on patient claims of moderate or no alcohol\\u000a consumption, the presence of ethanol

Joey Gareri; Brice Appenzeller; Paula Walasek; Gideon Koren



Product qualification: a barrier to point-of-care microfluidic-based diagnostics?  


One of the most exciting applications of microfluidics-based diagnostics is its potential use in next generation point-of-care (POC) devices. Many prototypes are already in existence, but, as of yet, few have achieved commercialisation. In this article, we consider the issue surrounding product qualification as a potential barrier to market success. The study discusses, in the context of POC microfluidics-based diagnostics, what the generic issues are and potential solutions. Our findings underline the need for a community-based effort that is necessary to speed up the product qualification process. PMID:23652789

Tantra, Ratna; van Heeren, Henne



Vascular injury involving proximal medial-to-lateral oblique locking screw insertion in tibial intramedullary nailing.  


Orthopaedic surgeons have reported increased neurologic complications with the employment of next-generation tibial nail fixation with variable proximal and distal locking options. However, vascular injury due to oblique screw placement has not been documented. We describe a case in which a medial-to-lateral oblique locking screw led to significant vascular injury. The judicious use of these screws and their relative contribution to fracture stability should be carefully considered for individual cases. Additionally, drill penetration through the far tibial cortex may not be obvious and utilizing oscillation or reverse drilling techniques may be of benefit. Lastly, the forward thrust of the popliteal artery with the use of a positioning bump in the popliteal fossa may place the vascular structure at increased risk of injury. Employing means to avoid these injuries and minimize risks in pertinent patients is of utmost importance. PMID:21846016

Hussain, Waqas; Balach, Tessa; Leland, J Martin



New method for determination of efficacy of health care personnel hand wash products.  

PubMed Central

A method of studying the effects of health care personnel hand wash products is described. The fingernail regions of the hands of volunteers are inoculated with a mixture of Escherichia coli and Serratia marcescens, and the areas are dried for a standard time. After routine hand washing, each fingernail region is individually scrubbed with an electric toothbrush which moves longitudinally to the handle into collection fluid contained in a petri dish. The test bacteria in the fluid are then enumerated. (Bacillus subtilis spores may be included as tracers to show degree of physical removal of the procedure.) This method has several advantages over the frequently used glove juice technique. Experimental designs with large numbers of volunteers, multiple sampling sites, and many hand wash products may be performed. Ten sampling sites (fingers) are available, versus the two gloved hands for testing products. (Efficiency is almost 100% in the recovery of spore tracers placed on the fingernails.) Many commercial health care personnel hand wash products containing antimicrobial agents substantive to the skin do not rapidly reduce numbers of inoculated bacteria in the fingernail regions to any greater extent than nonantimicrobial hand washes. Products containing isopropanol or ethanol are very effective in decreasing bacteria in areas around and under the fingernails.

Mahl, M C



Creating an environment for caring using lean principles of the Virginia Mason Production System.  


As healthcare leaders search for viable options to cut costs, increase efficiencies, and improve the product that they offer to customers, many are looking at different business models to adopt. At the same time, an aging workforce of nurses feel the pressure of being overworked and understaffed, resulting in both decreased job and patient satisfaction. Virginia Mason Medical Center in Seattle, Wash, has implemented the Virginia Mason Production System, using proven concepts adapted from the Toyota Production System that effectively eliminate "muda" or waste, in workplace processes. The authors discuss the application of the Virginia Mason Production System and how it has resulted in increased time for nurses to care for their patients. PMID:17563521

Nelson-Peterson, Dana L; Leppa, Carol J



Sun-Care Product Advertising in Parenting Magazines: What Information Does It Provide About Sun Protection?  


This study analyzed the content of sun-care product advertisements in five major U.S. parenting magazines with high circulation: Family Circle, Parents, Family Fun, Parenting (Early Years), and Parenting (School Years). The study examined what information sun-care product advertisements tell parents about skin cancer prevention and about sunscreen use for themselves or for their children based on the Health Belief Model concepts of perceived benefits and perceived barriers. Results showed that the most commonly mentioned benefit of the product was that it blocks ultraviolet A (UVA) and ultraviolet B (UVB) rays. One-third of the ads promoted the product's effectiveness in overcoming four of the barriers that prevent people from using sunscreens: eye irritation, skin irritation, an unpleasant smell, and the need to reapply sunscreen too often or after physical activity. However, only a few of the ads provided information about the consequences of unprotected sun exposure or mentioned methods of sun protection or skin cancer prevention other than sunscreen use. We discuss the implications of these messages for parents' ability to understand correctly how to protect their children from damaging sun exposure. PMID:23066971

Kang, Hannah; Walsh-Childers, Kim



A computational evaluation of the effect of intramedullary nail material properties on the stabilization of simulated femoral shaft fractures.  


Titanium flexible intramedullary nails have become far more prevalent for stabilization of pediatric femur fractures in recent years. While steel may be expected to have superior fracture stability due to its higher elastic modulus; titanium alloy has experimentally demonstrated improved biomechanical stability, as measured by gap closure and nail slippage. The purpose of this study was to verify these observations computationally, and thus, explain why titanium alloy may be better suited for surgical fixation of fractured femurs. A finite element model of a femur with complete mid-diaphyseal fracture and having two 3.5 mm nails in a retrograde "C" pattern was created. Static analyses were run in which the nail material properties were titanium alloy or stainless steel, respectively. Gap closure for the stainless steel nails was 1.03 mm; while the titanium alloy nails had 0.69 mm of closure. Titanium alloy nails slipped slightly less at each loading increment than stainless steel nails. The titanium alloy nails distributed stress more evenly along the nail axis, resulting in lower peak magnitudes. These results agree with previously published clinical and biomechanical studies that reported increased gap closure and nail slippage with stainless steel nails. The increased deformation of the titanium alloy nail likely increases the contact area with the intramedullary canal wall, thus, increasing stability. Additionally, stainless steel nails had higher curve apex von Mises stresses, potentially inducing a stress-shielding effect which could hamper remodeling and consequently increase risk of re-fracture. PMID:17905637

Perez, Angel; Mahar, Andrew; Negus, Charles; Newton, Peter; Impelluso, Tom



[Nurses' subjectivity production and the decision-making in the process of care].  


This study aimed to understand the relationship between Nurse's production of subjectivity and the decision-making in the process of Nursing care. A qualitative design of research was conducted. The investigation was carried out with twelve nurses who work at the Associação de Caridade Santa Casa do Rio Grande, a hospital located in Rio Grande, RS, Brazil. For data collection, focus group technique was used three meetings were conducted in december 2011. The results were presented in semantic categories: Capitalist System: maintenance of employment bond; Submission System: institutionalized culture and vision of society; Nursing Hierarchical System; and Values System: feeling of guilt and lack of professional recognition. The capitalist system mediates, mainly, the behavior that prevails in the decision-making process in Nursing care. PMID:24015473

Busanello, Josefine; Lunardi Filho, Wilson Danilo; Kerber, Nalú Pereira da Costa




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...



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...



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...


The new diagnosing method basing on the frequency analysis of human's nails in T-RAY  

NASA Astrophysics Data System (ADS)

It has been reported that many kinds of sickness can be reflected in one's nails. And because of the special composition and structure of nails, they are very suitable for T-ray detecting. Therefore we want to see whether we can diagnose some sickness by only analyzing the transmission of the nails. The experiments consist of three parts. In the first part, we took 200 samples which came from about 20 years old people. By that way, we got that the peak transmission wavelengths of human's nail is about 1.7THz and we almost acknowledged the characteristics of nails. Then we changed our samples coming from different ages, and some interesting phenomenon were coming out. Lastly, by detecting the nails which are taken from special patients, we discovered some sickness can be detected using T-ray.

Ma, Pengcheng; Xiao, Long



The Overlooked Role of Deficit or NonProductive Behaviors in Traditional Assessment of Long-Term Care Residents  

Microsoft Academic Search

Most instruments that examine long-term care residents' problem behavior assess only productive behaviors that require immediate behavioral management (e.g., kicking, wandering, screaming). However, it was hypothesized that the deficit or non-productive problem behaviors of older adults in long-term care (e.g., social withdrawal, excessive sleeping, and not eating) may be as problematic as their more salient counterparts. A factor analysis of

Jennifer L. Hillman



Nail Swelling as a Preformulation Screen for the Selection and Optimisation of Ungual Penetration Enhancers  

Microsoft Academic Search

Introduction  Targeting drug treatment to fungal infections that reside within or below the nail plate is problematic due to the highly\\u000a restrictive barrier of the human nail. To optimise topical formulations for ungual drug delivery, inclusion of an effective\\u000a penetration enhancer (PE) is imperative. At present, in vitro nail permeation studies can take weeks or months in order to obtain any

R. H. Khengar; S. A. Jones; R. B. Turner; B. Forbes; M. B. Brown



Technique for intraoperative determination of femoral rotation with a lateral femur nail (LFN, Synthes, Oberdorf, Switzerland)  

Microsoft Academic Search

Endomedullary femur nails with a head–neck implant offer an up to now unused point of reference for the determination of rotation\\u000a during osteosynthesis. The lateral femur nail (LFN) or the long Proximal Femur Nail (long PFNA), for example, have recon screws\\u000a or a blade placed at a 10° angle to the distal locking screw in the transversal plane. \\u000a If the

Dominik Hoigné; Robert Hauck; Reto Babst


Nail changes due to docetaxel—a neglected side effect and nuisance for the patient  

Microsoft Academic Search

Goals of work  The objective of this study is to estimate the frequency and severity of nail changes due to treatment with the cytotoxic\\u000a drug docetaxel and, secondly, to estimate how the nail changes effects the patients cosmetically and functionally in their\\u000a daily activities. Finally, we want to clarify whether fungal infection could contribute in causing the nail changes.\\u000a \\u000a \\u000a \\u000a Materials and

Dorte Winther; Ditte Marie Saunte; Marianne Knap; Vera Haahr; Anders Bonde Jensen



Long-range, nonautonomous effects of activated Notch1 on tissue homeostasis in the nail  

Microsoft Academic Search

Using an antibody directed against ?-secretase-generated antigen unique to activated Notch1, we mapped Notch1 activation strictly to suprabasal cells in epidermis, nail matrix, and other skin appendages during normal development. The consequences of Notch1 activation in keratinizing nail cells were investigated in a transgenic mouse model. Ectopic activation of Notch1 in postmitotic cells within the nail keratogenous zone resulted in

Meei-Hua Lin; Raphael Kopan



Generalized Lichen nitidus with Oral and Nail Involvement in a Child  

Microsoft Academic Search

The generalized form of lichen nitidus (LN) with oral and nail changes is extremely rare in childhood. We report a 10-year-old boy with generalized LN associated with oral involvement and onychodystrophy. Oral lesions showed yellowish papules on the gums. The nails had longitudinal striations and pits on the finger-nails, and transversal ridging of the big toes was found. Cutaneous and

V. Bettoli; M. P. De Padova; M. Corazza; A. Virgili



Case Report: Patella Baja After Retrograde Femoral Nail Insertion  

PubMed Central

Patella baja is a rare condition that can result from conditions involving trauma around the knee. Risk factors are believed to include scar tissue formation in the retropatellar fat pad, extensor mechanism dysfunction, and immobilization in extension. Early recognition and aggressive treatment are critical components in minimizing long-term disability. We present a case report of a woman with a fracture of the femoral diaphysis who underwent retrograde placement of an intramedullary nail. Subsequent followup revealed development of patella baja with resultant disability. The diagnosis was made late and the treatment was ineffective. Although patella baja has been reported in trauma around the knee, causative factors include retrograde femoral nailing. We believe early recognition and institution of treatment are important.

Mirza, Amer



Consumption and occurrence of pharmaceutical and personal care products in the aquatic environment in Spain.  


The occurrence of sixty pharmaceutically active compounds (PhACs), twenty metabolites and eight personal care products (PCPs) in the aquatic environment in Spain and their predicted environmental concentrations (PECs) were calculated and compared with measured environmental concentrations (MECs) obtained from relevant published research. The occurrence in the aquatic environment was calculated through a mass balance approach considering the following: the number of pharmaceutical prescriptions issued, the amount of pharmaceutical discharged without consumption, consumption, self-medication, pharmacokinetics, treatment in wastewater facilities and discharged to aquatic environment. The estimation of consumption of active compounds of pharmaceuticals was conducted by at least one of the following methodologies: number of commercial packages sold, data for the number of defined daily dose per 1000 inhabitants per day (DHD), and pattern of treatment. Comparison of these methodologies for some compounds showed similar estimated consumption ranges. The highest pharmaceutical occurrence in the aquatic environment was for acetaminophen glucuronide, Galaxolide®, Iso-E-super®, acetaminophen, valsartan, amoxicillin, 2-hydroxy-ibuprofen, iopromide, omeprazole, carbamazepine 10, 11-epoxide, iopamidol, salicylic ?-d-O-glucuronide acid, Tonalide®, acetylsalicylic acid (ASA), clarithromycin and iohexol, with releases between 5 and 600 ty(-1). The relation of PEC/MEC was calculated for 58% of the compounds under study, and 64.7% of them had PEC/MEC ratios between 0.5 and 2. PEC values were mostly overestimated (57.4%). The predicted concentrations for pharmaceutical and personal care products (PPCPs) that had a high occurrence in the aquatic environment were very close to the measured concentrations. This research provides information that had not been calculated and analyzed previously, at least for Spain. Estimation of the PECs for pharmaceutical, personal care products and metabolites is a useful tool for identifying compounds that should be considered for environmental concern, and such estimations could be used to improve environmental risk assessment studies. PMID:23287535

Ortiz de García, Sheyla; Pinto Pinto, Gilberto; García Encina, Pedro; Irusta Mata, Rubén



Classical lissencephaly associated with dolichocephaly, hair and nail defect.  


We report on an 1-day-old boy with classical lissencephaly (grade 1, according to Kato and Dobyns, 2003) associated with an extended phenotype, including dolichocephaly, and hair and nail defects. The diagnosis of lissencephaly was made in utero, allowing the rapid characterization of the phenotype at birth. Because previously reported cases were not associated with the features described in our proband, they might represent a newly identified condition. PMID:16376045

Celentano, Claudio; Zannolli, Raffaella; Buoni, Sabrina; Domizio, Sergio; Sabatino, Giuseppe; Colosimo, Cesare; Saponari, Anita; Pallotta, Rosanna; Swift, James A; Rotmensch, Sigi; Liberati, Marco



Callus patterns in femoral lengthening over an intramedullary nail.  


Our objectives were to evaluate callus patterns seen in femoral lengthening over an intramedullary nail by Li classification regarding shape and type and to predict the result while using the nail to reduce the external fixation period and its complications. Eight hundred digital radiographs of 15 patients with 15 segments of femur shortening who underwent femoral lengthening with a monolateral external fixator over an intramedullary nail were analyzed retrospectively by four observers. Each radiograph was studied for callus shape, feature type, and callus density using pixel values. The classification was tested for concurrence and reproducibility by interobserver studies and callus patterns were compared with treatment indices to evaluate how they correlated with the outcome. Mean length gained was 4.5?cm (range: 2-8?cm). External fixator index (EFI) was 21.68?days/cm. Average distraction consolidation index (DCI) was 48.49?days/cm. Fusiform callus was seen in three cases, cylindrical in seven, and lateral in five. The homogenous pathway had higher DCI (43.7) than the heterogeneous pathway (32.9), and mixed pathways making up the rest had a DCI of 50.1. Pixel value of callus showed gradual increase in density until 20-24 weeks, then density gradually fell for 8 weeks, again increased after 32 weeks, again gradually fell, and was comparable to adjacent normal bone by 44-48 weeks. Our results suggest that the Li classification can be satisfactorily applied to lengthening procedures over intramedullary nails. The radiologic pattern and pixel value of regenerate can be correlated with the clinical outcome and can be an aid of prognostic value for the surgeon. PMID:21284034

Muzaffar, Nasir; Hafeez, Arifa; Modi, Hitesh; Song, Hae-Ryong



Treatment of proximal humerus fracture using multiple intramedullary flexible nails  

Microsoft Academic Search

A total of 61 patients with a proximal humeral fracture was treated between January 1996 and March 1998 by closed reduction\\u000a and fracture fixation with intramedullary Prvot (or Nancy) nails. Of these, 28 female and 25 male patients with a mean age\\u000a of 52 years (range 3–91 years) were reviewed clinically and radiologically with a mean follow-up of 17 months

S. W. Wachtl; C. B. Marti; H. M. Hoogewoud; R. P. Jakob; E. Gautier



Supracondylar nailing of periprosthetic fractures above total knee arthroplasties  

Microsoft Academic Search

Supracondylar nailing was performed in 10 patients who sustained periprosthetic fractures above total knee arthroplasties.\\u000a The fractures occurred in women with an average age of 67.4 years (range, 42–92 years). All fractures healed in a satisfactory\\u000a alignment in an average duration of 13.2 weeks (range, 12–18 weeks). None of the fractures needed bone grafting. There were\\u000a no cases of wound

A. Kumar; M. Catre; P. Weiler; S. Butt



PIXE analysis of elemental concentrations in human hair and nails  

NASA Astrophysics Data System (ADS)

The PIXE technique was applied to examine the elemental concentrations in scalp hair and nails collected over several months from three subjects living in Rio de Janeiro, Brazil. The results were then compared with data taken from the literature, and with the range and average elemental concentrations obtained by analyzing, using the same technique and laboratory conditions, samples of scalp hair taken from 51 men and 50 women living in another region of Latin America.

Paschoa, A. S.; Baptista, G. B.; Mauricio, G. M.; Leite, C. V. Barros; Lerner, Y. B.; Issler, P. F.



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.

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



Allografting in Locked Nailing and Interfragmentary Wiring for Humeral Nonunions  

PubMed Central

In this prospective study, we compared outcomes after repair of humeral nonunions when morsellized fresh-frozen allograft or autograft was used to augment repair by intramedullary nailing. Sixty-five patients with humeral shaft nonunions of greater than 6 months’ duration and gross instability at the nonunion site were included and treated by locked nailing, interfragmentary wiring, and bone grafting. Graft type was determined by patient preference. Outcomes assessed included union rate and functional recovery of the arm. Secondary end points included operative blood loss, operation time, hospital stay, time to fracture healing, and complications. Twenty-eight patients with autografts and 36 with allografts were followed up more than 2 years. The baseline conditions of the two groups were similar. The autograft group had greater blood loss and longer operative time than the allograft group. The autograft group also had a longer hospital stay. The healing rate, time to healing, and functional scores did not differ between these two groups. In the autograft group, 43% reported pain and limited mobility as a result of the donor site. We concluded that when used in association with locked nailing for humeral nonunions, allografts can achieve treatment results similar to autografts but without donor site complications. Level of Evidence: Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence. Electronic supplementary material The online version of this article (doi:10.1007/s11999-009-1055-8) contains supplementary material, which is available to authorized users.

Lin, Wei-Peng



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.



Intramedullary nailing of clavicular midshaft fractures in adults using titanium elastic nail.  


Objective: Studies showed elastic stable intramedullary nailing (ESIN) of displaced midclavicular fractures has excellent outcomes, as well as high complication rates and specific problems. The aim was to discuss ESIN of midshaft clavicular fractures. Methods: Totally 60 eligible patients (aged 18-63 years) were randomized to either ESIN group or non-operative group between January 2007 and May 2008. Clavicular shortening was measured after trauma and osseous consolidation. Radiographic union and complications were assessed. Function analysis including Constant shoulder scores and disabilities of the arm, shoulder and hand (DASH) scores were performed after a 15-month follow-up. Results: ESIN led to a signifcantly shorter time to union, especially for simple fractures. In ESIN group, all patients got fracture union, of which 5 cases had medial skin irritation and 1 patient needed revision surgery because of implant failure. In the nonoperative group, there were 3 nonunion cases and 2 symptomatic malunions developed requiring corrective osteotomy. At 15 months after intramedullary stabilization, patients in the ESIN group were more satisfied with the appearance of the shoulder and overall outcome, and they benefited a lot from the great improvement of post-traumatic clavicular shortening. Furthermore, DASH scores were lower and Constant scores were significantly higher in contrast to the non-operative group. Conclusion: ESIN is a safe minimally invasive surgical technique with lower complication rate, faster return to daily activities, excellent cosmetic and better functional results, restoration of clavicular length for treating mid-shaft clavicular fractures, resulting in high overall satisfaction, which can be regard as an alternative to plate fixation or nonoperative treatment of mid-shaft clavicular fractures. PMID:22118480

Chen, Qing-Yu; Kou, Dong-Quan; Cheng, Xiao-Jie; Zhang, Wei; Wang, Wei; Lin, Zhang-Qin; Cheng, Shao-Wen; Shen, Yue; Ying, Xiao-Zhou; Peng, Lei; Lv, Chuan-Zhu



Care robots for the supermarket shelf: a product gap in assistive technologies.  


The literature on the development of assistive robots is dominated by technological papers with little consideration of how such devices might be commercialised for a mass market at a price that is affordable for older people and their families as well as public services and care insurers. This article argues that the focus of technical development in this field is too ambitious, neglecting the potential market for an affordable device that is aleady in the realm of the 'adjacent possible' given current technology capabilities. It also questions on both ethical and marketing grounds the current effort to develop assistive robots with pet-like or human-like features. The marketing literature on 'really new products' has so far not appeared to inform the development of assistive robots but has some important lessons. These include using analogies with existing products and giving particular attention to the role of early adopters. Relevant analogies for care robots are not animals or humans but useful domestic appliances and personal technologies with attractive designs, engaging functionality and intuitive usability. This points to a strategy for enabling mass adoption - which has so far eluded even conventional telecare - of emphasising how such an appliance is part of older people's contemporary lifestyles rather than a sign of age-related decline and loss of independence. PMID:23729915

Blackman, Tim



Type of Evidence Behind Point-of-Care Clinical Information Products: A Bibliometric Analysis  

PubMed Central

Background Point-of-care (POC) products are widely used as information reference tools in the clinical setting. Although usability, scope of coverage, ability to answer clinical questions, and impact on health outcomes have been studied, no comparative analysis of the characteristics of the references, the evidence for the content, in POC products is available. Objective The objective of this study was to compare the type of evidence behind five POC clinical information products. Methods This study is a comparative bibliometric analysis of references cited in monographs in POC products. Five commonly used products served as subjects for the study: ACP PIER, Clinical Evidence, DynaMed, FirstCONSULT, and UpToDate. The four clinical topics examined to identify content in the products were asthma, hypertension, hyperlipidemia, and carbon monoxide poisoning. Four indicators were measured: distribution of citations, type of evidence, product currency, and citation overlap. The type of evidence was determined based primarily on the publication type found in the MEDLINE bibliographic record, as well as the Medical Subject Headings (MeSH), both assigned by the US National Library of Medicine. MeSH is the controlled vocabulary used for indexing articles in MEDLINE/PubMed. Results FirstCONSULT had the greatest proportion of references with higher levels of evidence publication types such as systematic review and randomized controlled trial (137/153, 89.5%), although it contained the lowest total number of references (153/2330, 6.6%). DynaMed had the largest total number of references (1131/2330, 48.5%) and the largest proportion of current (2007-2009) references (170/1131, 15%). The distribution of references cited for each topic varied between products. For example, asthma had the most references listed in DynaMed, Clinical Evidence, and FirstCONSULT, while hypertension had the most references in UpToDate and ACP PIER. An unexpected finding was that the rate of citation overlap was less than 1% for each topic across all five products. Conclusions Differences between POC products are revealed by examining the references cited in the monographs themselves. Citation analysis extended to include key content indicators can be used to compare the evidence levels of the literature supporting the content found in POC products.



75 FR 14423 - Certain Steel Nails From the People's Republic of China: Extension of Time Limit for the Final...  

Federal Register 2010, 2011, 2012, 2013

...International Trade Administration [A-570-909] Certain Steel Nails From the People's Republic of China: Extension of Time Limit...January 23, 2008, through January 31, 2009. See Certain Steel Nails from the People's Republic of China: Notice of...



Ciclopirox delivery into the human nail plate using novel lipid diffusion enhancers.  


Abstract Context: Onychomycosis is a common fungal infection of the nail plate and bed that affects up to 14% of the population and can have a substantial impact on the quality of life of those affected. Objective: This study compared the onychopharmacokinetics, nail absorption, nail distribution, and nail penetration of [(14)C]-ciclopirox dissolved in novel lipid diffusion enhancers with that of a commercial ciclopirox nail lacquer using the in vitro finite dose model. Materials and methods: The penetration rate of ciclopirox was determined by applying doses of topical formulation twice daily to human nail plates for 11?d. Drug absorption was then measured by monitoring its rate of appearance in each nail layer and in the cotton pad/nail supporting bed. Results: After a multiple day treatment, cumulative concentrations of ciclopirox formulated with lipid enhancers in the deep nail layer and the nail bed were significantly greater than cumulative concentrations of the commercial ciclopirox lacquer (p?nail can be utilized as a means of effective transungual delivery. PMID:23600655

Hafeez, Farhaan; Hui, Xiaoying; Selner, Marc; Rosenthal, Bert; Maibach, Howard



Knowledge, skills, and productivity in primary eye care among health workers in Tanzania: need for reassessment of expectations?  

Microsoft Academic Search

The aim of this study was to assess the primary eye care knowledge, skills, and productivity of primary health workers at dispensaries in a district in Tanzania. Factors likely to contribute to knowledge, skills, and productivity were also assessed. A descriptive cross-sectional study design was used. All health workers employed at government dispensaries in Mwanga District, Kilimanjaro Region, Tanzania were

Emmanuel Byamukama; Paul Courtright



75 FR 38080 - Certain Steel Nails From the People's Republic of China: Rescission of New Shipper Review  

Federal Register 2010, 2011, 2012, 2013

...Administration [A-570-909] Certain Steel Nails From the People's Republic of China...antidumping duty order on certain steel nails from the People's Republic of shipper review. See Certain Steel Nails From the People's Republic of...



Selected problems in the bone union of complicated diaphyseal fractures treated with interlocking nail.  


Background. This article discusses the effectiveness and technical problems encountered in the union of complications of diaphyseal fractures treated with interlocking nail. Material and methods. Between 2000-2003 we operated 35 patients for pseudoarthrosis (humerus - 6, femur - 13, tibia - 16). In a one-step procedure a plate was removed from the humerus (3 patients) or femur (4 patients), a retrograde interlocking nail was introduced, and spongy grafts were applied. In the remaining patients an external stabilizer or ZESPOL outer plate were first removed; then, after soft tissue healing, an anterograde nail was introduced sequentially using a closed technique. This method of nailing was also used in patients with plates that had previously been removed. The Dencker classification was used to evaluate outcome. Results. We achieved bone union in all cases. We observed intra- and post operative complications in 5 cases: breakage of distal locking screws in 4 patients, and breakage of 1 tibial nail. In closed nailing we encountered major difficulties in passing through the sclerotic edges of pseudoarthrosis, and it also proved extremely difficult to maintain the right direction of the reamer without a guiding wire, which was crucial for a successful operation. Conclusions. Interlocking nailing is an efficacious method of treatment of complications in fracture healing, but in some cases closed nailing of pseudoarthrosis is difficult. PMID:17597691

Kusz, Damian; Dudko, S?awomir; Wojciechowski, Piotr; Guzik, Henryk



Platica Directa Sobre Securidad Con Pistolas De Clavos (Straight Talk About Nail-Gun Safety).  

National Technical Information Service (NTIS)

This publication provides the following nail gun safety tips in a comic book format. Nail Gun Trigger Safety: (1) Removing the safety tip spring or disabling any safety device increases the risk of injury. OSHA prohibits doing these things. (2) Use the 's...



[Removal of broken interlocking nails and reosteosynthesis--related clinical problems].  


Nine patients with six fractures of the intramedullary cannulated nails and four Gamma nails are presented. In five patients broken implants had been removed by simple and safe method by use of tape extractor and than four patients has had intramedullary reosteosynthesis by closed method. The main causes in most cases were technical errors and early full weighbearing. PMID:16021825

Or?owski, Jan; Rylski, Waldemar; Kowalski, Daniel



Hereditary leukonychia, or porcelain nails, resulting from mutations in PLCD1.  


Hereditary leukonychia (porcelain nails or white nails) is a rare nail disorder with an unknown genetic basis. To identify variants in a gene underlying this phenotype, we identified four families of Pakistani origin showing features of hereditary leukonychia. All 20 nails of each affected individual were chalky and white in appearance, consistent with total leukonychia, with no other cutaneous, appendageal, or systemic findings. By using Affymetrix 10K chip, we established linkage to chromosome 3p21.3-p22 with a LOD score (Z) of 5.1. We identified pathogenic mutations in PLCD1 in all four families, which encodes phosphoinositide-specific phospholipase C delta 1 subunit, a key enzyme in phosphoinositide metabolism. We then identified localization of PLCD1 in the nail matrix. It was recently shown that PLCD1 is a component of the human nail plate by proteomic analysis and is localized in the matrix of human nails. Furthermore, mutations detected in PLCD1 resulted in reduced enzymatic activity in vitro. Our data show that mutations in PLCD1 underlie hereditary leukonychia, revealing a gene involved in molecular control of nail growth. PMID:21665001

Kiuru, Maija; Kurban, Mazen; Itoh, Munenari; Petukhova, Lynn; Shimomura, Yutaka; Wajid, Muhammad; Christiano, Angela M



Pitfalls and complications in the use of the proximal femoral nail  

Microsoft Academic Search

Background and aims Osteosynthesis with the proximal femoral nail (PFN) features the advantages of high rotational stability of the head–neck fragment, an unreamed implantation technique and the possibility of static or dynamic distal locking. However, the use of the nail is technically ambitious and is accompanied by some risks of error, which can lead to failure of the osteosynthesis. In

Joachim Windolf; Dirk A. Hollander; Mohssen Hakimi; Wolfgang Linhart



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


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



Locked intramedullary nailing of humeral shaft fractures. Implant design, surgical technique, and clinical results.  


We report our experience with a modified implant and a new technique for locked intramedullary nailing of the humerus in 41 patients. Locking was by cross-screws placed from lateral to medial in the proximal humerus, and anteroposteriorly in the distal humerus. Early in the series, 11 nails were inserted at the shoulder, but we found that rehabilitation was faster after retrograde nailing through the olecranon fossa, which was used for the other 30. We used a closed technique for 29 of the nailings. Of the 41 patients treated, 21 had acute fractures, five had nonunion, and 15 had pathological fractures. Secure fixation was obtained for comminuted and osteoporotic fractures in any part of the humeral shaft, which allowed the early use of crutches and walking frames. Two nails were locked at only one end, and one of these became the only failure of union after an acute fracture. PMID:8300675

Ingman, A M; Waters, D A



[Nail susceptibility to fungal infections in patients with hypothyroidism and hyperthyroidism].  


Onychomycosis is a frequent disorder in adults. The objective of the study was evaluation of finger and toe nails susceptibility to Candida albicans and a dermatophyte Trichophyton mentagrophytes infection in patients with symptomatic hypothyroidism and hyperthyroidism as compared with healthy persons. The materials comprised finger and toe nails from 23 patients with hypothyroidism (in 8 cases postoperative, and in 15 cases caused by Hashimoto type thyroiditis), and from 27 patients with hyperthyroidism (including 17 cases of Graves-Basedow disease, and 10 with nodular goitre). Nails from 22 healthy persons of similar sex and age distribution served as controls. A significantly more frequent and more intensive than in control group toe nail infection with C. albicans was found in the patients with both hypothyroidism and hyperthyroidism. The enhanced toe nail susceptibility to C. albicans infection did not depend on autoimmunological aetiology of both hypothyroidism and hyperthyroidism. PMID:16229238

Macura, Anna B; Gasi?ska, Teresa; Pawlik, Boles?aw



Radiological evidence of a modern 'martyr's crown': suicide by multiple self-inflicted nail gun shots.  


A man attempted suicide by shooting seven nails into his head with a nail gun; five in the right temporal region and two in the left. He subsequently presented at the emergency department with complaints of headache. He was found to be oriented in space and time, with no focal neurological deficits. The patient handed the nail gun to the doctors and informed them that he had earlier attempted suicide. Radiological studies showed the presence of nails arranged like a 'martyr's crown'. The man died six days after the surgical removal of the nails. Autopsy was refused by Italian authorities. We conclude that imaging techniques are an adjuvant to forensic medical diagnosis and forensic autopsies. PMID:22941146

Pomara, Cristoforo; D'Errico, Stefano; Fineschi, Vittorio; Guglielmi, Giuseppe



Closed intramedullary nailing of femoral shaft fractures in an echelon III facility.  


This study was performed to assess the safety of performing intramedullary (IM) nailing in an established echelon III theater hospital. Twenty-two patients (23 fractures) sustained subtrochanteric or diaphyseal femur fractures and presented to the Air Force theater hospital (AFTH) at Balad Air Base, Iraq, for definitive treatment. Sixteen grade IIIA open fractures underwent staged intramedullary nailing. Seven closed fractures were treated with either immediate or staged intramedullary nailing as facility operations tempo dictated. Definitive follow-up was only available for 8 fractures at 2 months and for 5 fractures at 6 months, but no patient was readmitted to any U.S. military hospital in Iraq for treatment of infection or intramedullary nail removal. Although the results are not conclusive, the authors suggest that intramedullary nailing may be performed with acceptable infection risk in an established echelon III facility. Further study will help to establish the efficacy of this treatment approach. PMID:19317191

Keeney, James A; Ingari, John V; Mentzer, Kurt D; Powell, Elisha T



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, Dfirst90%red. The values in the range 1-2kGy for molds and 0.1-0.6kGy 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 3kGy, and yielding endpoint contamination less than 10/g.

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



Nanotribological effects of hair care products and environment on human hair using atomic force microscopy  

NASA Astrophysics Data System (ADS)

Tribological properties are useful in the study of human hair and other biological materials. Major sources of investigation for conditioner treated hair includes localization of conditioner, mechanisms related to changes in surface roughness, friction, and adhesion on the nanoscale due to conditioner agents, and how the products change the microstructure of the cuticle. The paper presents nanotribological studies investigating surface roughness, friction, and adhesion using atomic force/friction force microscopy (AFM/FFM). Test samples include virgin and chemically damaged hair, both with and without commercial conditioner treatment, as well as chemically damaged hair with experimental conditioner treatments. Friction force mapping provides insight into the localized change in friction caused by the application of hair care materials. Adhesive force maps to study adhesion on the cuticle surface provide information about localization and distribution of conditioner as well. A discussion is presented on these properties of hair as a function of relative humidity, temperature, durability, and conditioning treatments.

Latorre, Carmen; Bhushan, Bharat



Low-energy treatment of colourant wastes using sponge biofilters for the personal care product industry.  


Four trickling biofilter designs were assessed as low-energy alternatives to aerobic activated sludge (AS) for the treatment of personal care product industry wastes. The designs included partially submerged packed-media and sponge reactors with and without active aeration. Partial submergence was used to reduce active aeration needs. Simulated colourant wastes (up to COD=12,480 mg/L, TN=128 mg/L) were treated for 201 days, including wastes with elevated oxidant levels. COD and TN removal efficiencies were always >79% and >30% (even without aeration). However, aerated sponge reactors consistently had the highest removal efficiencies, especially for TN (?60%), and were most tolerant of elevated oxidants. This study shows sponge biofilters have great potential for treating colourant wastes because they achieve high treatment efficiencies and reduce energy use by >40% relative to AS systems. PMID:23294645

Ahammad, S Z; Zealand, A; Dolfing, J; Mota, C; Armstrong, D V; Graham, D W



Phase distribution and removal of pharmaceuticals and personal care products during anaerobic sludge digestion.  


The fate and removal of 48 pharmaceuticals and personal care products (PPCPs) during anaerobic digestion of sewage sludge were investigated in four full-scale sewage treatment plants (STPs). We measured concentrations in both the liquid and solid phases of the sludge to compare the distribution ratios (Kd) between phases before and after digestion. The results showed changes in Kd values of PPCPs with carboxyl or amino functional groups, probably due to a shift of dissociation equilibrium with the increase in pH. Sulfamethoxazole and trimethoprim were almost completely degraded (>90%); triclosan, triclocarban, and ofloxacin were moderately degraded (around 30-50%); but carbamazepine was not eliminated. To our knowledge, this is the first report that shows (i) the occurrence and removal of several tens of PPCPs by anaerobic sludge digestion in full-scale municipal STPs and (ii) the change of distribution between the liquid and solid phases during digestion. PMID:23774781

Narumiya, Masanori; Nakada, Norihide; Yamashita, Naoyuki; Tanaka, Hiroaki



Retrograde femoral nailing in elderly patients: outcome and functional results.  


Functional outcome after retrograde femoral intramedullary nailing was investigated in 35 patients older than 60 years (mean, 86 years) with 36 fractures, comprising 15 (41.7%) shaft and 21 (58.3%) distal fractures; overall, 7 (19.4%) periprosthetic fractures occured. Twenty-two (62.9%) of 35 patients were evaluated at a mean 16.5-month follow-up with the Lyshom-Gillquist score and the SF-8 questionaire. Primary union rate was 97.8%, with no significant differences in duration of surgery, bone healing, mobilization, and weight bearing among different fracture types; periprosthetic fractures revealed a significantly delayed mobilization (P=.03). Complications occured significantly more often among distal femoral fractures (P=.009), including all revision surgeries. The most frequently encountered complication was loosening of distal locking bolts (n=3). Lysholm score results were mainly influenced by age-related entities and revealed fair results in all fractures (mean in the femoral shaft fracture group, 78.1 vs mean in the distal femoral fracture group, 74.9; P=.69), except in the periprosthetic subgroup, which had good results (mean, 84.8; P=.23). This group also had increased physical parameters according to SF-8 score (P=.026). No correlation existed between SF-8 physical parameters and patient age or surgery delay, whereas a negative correlation existed between patient age and SF-8 mental parameters (P=.012). Retrograde femoral intramedullary nailing is commonly used in elderly patients due to reliable bone healing, minimal soft tissue damage, and immediate full weight bearing. It also offers a valid alternative to antegrade nailing in femoral shaft fractures. PMID:22691657

Neubauer, Thomas; Krawany, Manfred; Leitner, Lukas; Karlbauer, Alois; Wagner, Michael; Plecko, Michael



Fatigue load of current tibial intramedullary nail designs: a simulated study.  


Comminuted tibial shaft fractures are traditionally treated with statically locked intramedullary nailing and protected weight bearing until fracture callous is evident. The purpose of this study was to demonstrate that a simulation of immediate full weight bearing following intramedullary nailing of these fractures does not result in implant failure.A comminuted fracture model was created using 2 pieces of polyvinyl chloride (PVC) pipe. Ten-millimeter-diameter tibial nails (Synthes, Paoli, Pennsylvania; Styker, Mahwah, New Jersey; Zimmer, Warsaw, Indiana; Smith & Nephew, Memphis, Tennessee) were inserted within the PVC pipe and secured proximally and distally with 2 or 3 locking bolts. The constructs were cycled in axial compression for 500,000 cycles or until implant failure. The tests were conducted using a modified staircase method (200 N per step), and the fatigue strength was identified for each of the tibial nail designs. When 2 interlocking bolts were placed proximally and distally, the fatigue strength was between 900 and 1100 N for the Stryker nail, 1100 and 1300 N for the Zimmer nail, 1200 and 1400 N for the Synthes nail, and 1400 and 1600 N for the Smith & Nephew nail. Adding a third interlocking bolt proximally and distally to the Smith & Nephew nail increased the fatigue strength by 13% to between 1700 and 1900 N. In all cases, implant failures occurred through the proximal or distal interlocking bolts.Biomechanical tests suggest that current tibial nail designs may permit immediate full weight bearing of comminuted tibial shaft fractures with minimal risk of implant failure. This may facilitate mobilization in the early postoperative period, especially in the multiply injured patient. PMID:21667907

Wagner, Mark; Liu, Qi; Ellis, Thomas J



Minimally invasive plate osteosynthesis (MIPO) in the treatment of the femoral shaft fracture where intramedullary nailing is not indicated  

PubMed Central

The aim of this study was to examine the results of minimally invasive plate osteosynthesis (MIPO) of the femoral shaft fracture in patients where intramedullary nailing is contraindicated and evaluate the proper number of the screws for stable fixation. This was a retrospective study of 36 closed femoral shaft fractures which underwent MIPO using a conventional 4.5 broad dynamic compression plate (DCP) with 14–18 holes fixed with three or four screws in the proximal and distal fragments. Thirty-three fractures had bony union in 21.0 weeks (range, 12–28 weeks), two had delayed union that required bone graft and union at 28 and 32 weeks. Malalignment occurred in five cases. Sixty-two fragments were fixed with three screws—40 in cluster and 22 in separated positions. Ten fragments were fixed with four screws—eight in cluster and two separated. Broken screws were found in three cases; all were in the group with three screws fixed in cluster group. MIPO of the femoral shaft fracture is an alternative treatment in the patient where intramedullary nailing is contraindicated. Malalignment is the common complication that must be carefully evaluated intraoperatively. We recommend using at least three separated screws in each fragment to reduce the risk of screw breakage.

Chiewcharntanakit, S.



Nail-like targets for laser plasma interaction experiments  

SciTech Connect

The interaction of ultra-high power picosecond laser pulses with solid targets is of interest both for benchmarking the results of hybrid particle in cell (PIC) codes and also for applications to re-entrant cone guided fast ignition. We describe the construction of novel targets in which copper/titanium wires are formed into 'nail-like' objects by a process of melting and micromachining, so that energy can be reliably coupled to a 24 {micro}m diameter wire. An extreme-ultraviolet image of the interaction of the Titan laser with such a target is shown.

Pasley, J; Wei, M; Shipton, E; Chen, S; Ma, T; Beg, F N; Alexander, N; Stephens, R B; MacPhee, A G; Hey, D; Pape, S L; Patel, P; Mackinnon, A J; Key, M H; Offermann, D; Link, A; Chowdhury, E; Van-Woerkom, L D; Freeman, R R



Locked intramedullary nailing for difficult nonunions of the humeral diaphysis.  


Antegrade intramedullary nailing and bone grafting was carried out for 27 patients with resistant atrophic nonunion of the humeral diaphysis. The initial fracture was open in 12 cases and closed in 15. There were ten proximal humeral fractures, 13 mid-shaft fractures and four distal humeral shaft fractures. Most had previous attempts at internal fixation with bone grafting. Fifteen cases united, but 12 remained ununited necessitating further surgical treatment. The failures were all in the more complex cases. Lack of rigidity and compression may be the problem. PMID:12761651

Ilyas, I; Younge, D A



The Stability Score of the Intramedullary Nailed Intertrochanteric Fractures: Stability of Nailed Fracture and Postoperative Patient Mobilization  

PubMed Central

Background Intertrochanteric fractures of the femur are the most common type of fracture, and are an increasing occurrence due to the aging of the population. The objectives of our study are to predict the fate of intertrochanteric fractures treated with intramedullary hip nails by assessing the postoperative fracture stability utilizing the newly developed scoring system, and to help rehabilitate these patients. Methods Eighty-two patients with intertrochanteric fractures that were treated with intramedullary hip nails between December, 2004 and January, 2011 were subjected to this study. The patients who could be followed for a minimum of one year postoperatively were enrolled. The immediate postoperative conditions were determined by radiograms: reduction status (3 parameters/4 points: contact accuracy of posteromedial cortex, severity of angulation, and distraction), fixation status (3 parameters/3 points: tip-apex distance, location of tip of the lag screw, entry point of the intramedullary nail), and fracture type (1 parameter/1 point: stable or unstable type by the Kyle's classification). Postoperative reduction loss and fixation failure were checked by radiograms taken at a minimum 3 months postoperative. Results Reduction loss and fixation failure were observed in 14 consecutive patients (17%). The fixation failure rate was 100% (2 patients) in score 1, 60% (3 out of the 5 patients) in score 2, 39% (3 out of the 8 patients) in score 3, and 50% (4 out of the 8 patients) in score 4 groups. There were fixation failures only in 1 out of 13 patients with score 5, and in 1 out of 18 patients with score 6. There was no fixation failure in 17 patients with score 7 and 11 patients with score 8. Conclusions Maintenance of the fracture reduction by the stable fixation in the patient scores over 5 could be predicted by the postoperative radiograms.

Lee, Sung-Rak; Yoon, Min Geun; Moon, Myung-Sang; Heo, Jee-Hyun



New technique for humerus shaft fracture retrograde intramedullary nailing.  


Humeral shaft fracture intramedullary nailing is less invasive than plates and screws. Antegrade technique has postoperative shoulder pain, increased rehab time, and frequent reoperation for rod removal. Published retrograde technique is not collinear with the shaft, has insertion site fractures (5% to 15%), and radial nerve palsies (5%). Our retrograde technique is collinear with the humerus shaft, simpler, and decreases operative fracture risk. The supine patient's elbow is fully flexed. A guide pin is inserted through the triceps tendon to the olecranon fossa roof, aligned with the humerus shaft, and drilled thought the cortex followed by the 6.5 mm cannulated drill through a small triceps splitting incision. The guide pin is passed along the humerus shaft and across the fracture. A small incision is made to identify and protect the radial nerve during reduction, reaming, and rod insertion. Flexible reamers are used and the nail placed and locked at least distally to prevent distal migration. An institutional review broad approved retrospective review of Louisiana State University Health Sciences Center adult humeral shaft fractures with retrograde technique from 1999 to January of 2009 was carried out. Sixteen patients were treated without perioperative fracture or nerve palsy. PMID:21869643

Hollister, Anne M; Saulsbery, Carla; Odom, Jennifer L; Anissian, Lucas; Garon, Mark Tyson; Jordan, Jenee'



Reconstruction nailing for ipsilateral femoral neck and shaft fractures.  


The surgical management of ipsilateral fractures of the femoral neck and shaft presents a difficult and challenging problem for the orthopaedic surgeon. The purpose of the present study was to report the mid-term results and complications in a series of patients who sustained ipsilateral femoral neck and shaft fractures and treated in our trauma department with a single reconstruction nail for both fractures. Eleven patients were included in the study with an average age of 46.4 years. The mean follow-up was 47 months (range, 15-75 months). There were no cases of a missed diagnosis at initial presentation. The mean time to union was 4.5 months for the neck fracture and 8.2 months for the shaft. There were no cases of avascular necrosis of the femoral head or non-union of the neck fracture. The mean Harris Hip Score was (85 ± 4.3). Complications included two cases of shaft fracture non-union and one case of peroneal nerve palsy. Heterotopic ossification at the tip of the greater trochanter was evident in two cases without causing any functional deficit. The current study suggests that reconstruction nailing produces satisfactory clinical and functional results in the mid-term. The complications involved only the femoral shaft fracture and were successfully treated with a single operative procedure. PMID:21779894

Tsarouhas, Alexandros; Hantes, Michael E; Karachalios, Theohilos; Bargiotas, Konstantinos; Malizos, Konstantinos N



Analysis of human nails by laser-induced breakdown spectroscopy  

NASA Astrophysics Data System (ADS)

Laser-induced breakdown spectroscopy (LIBS) is applied to analyze human fingernails using nanosecond laser pulses. Measurements on 45 nail samples are carried out and 14 key species are identified. The elements detected with the present system are: Al, C, Ca, Fe, H, K, Mg, N, Na, O, Si, Sr, Ti as well as CN molecule. Sixty three emission lines have been identified in the spectrum that are dominated by calcium lines. A discriminant function analysis is used to discriminate among different genders and age groups. This analysis demonstrates efficient discrimination among these groups. The mean concentration of each element is compared between different groups. Correlation between concentrations of elements in fingernails is calculated. A strong correlation is found between sodium and potassium while calcium and magnesium levels are inversely correlated. A case report on high levels of sodium and potassium in patients with hyperthyroidism is presented. It is shown that LIBS could be a promising technique for the analysis of nails and therefore identification of health problems.

Hosseinimakarem, Zahra; Tavassoli, Seyed Hassan



Evaluating the Role of Support Group Structures as Vehicles of Palliative Care: Giving Productivity in the Kanye Care Program in Botswana  

PubMed Central

Aims: The article aims to explore, evaluate, and discuss the role associated with the presence or absence of caregivers’ support groups in the Kanye care program in Botswana. Objective: The objective of the study was to solicit the views, attitudes, and thinking of palliative caregivers on the role, and implication of the presence and absence of support groups as vehicles influencing care-giving productivity. Materials and Methods: The study was explorative and descriptive in nature and used a qualitative design, involving 82 primary caregivers in focus group discussions and five community home-based care nurses in one- to-one interviews. Results: The support groups were found to play the following pivotal roles: (1) facilitate forums of strengthening caregivers; (2) facilitate sharing and exchange of information among caregivers; (3) facilitate counselling, debriefings, and education among caregivers; (4) foster the spirit and feelings of togetherness among caregivers; and (5) act as advocacy fronts and an opportunity of pooling and mobilizing the resources. Conclusion: The article recommends to the Government and the nongovernmental organizations to assist all care programs to institute and facilitate the formation of caregivers’ support groups.

Kang'ethe, Simon



Breakage of a Third Generation Gamma Nail: A Case Report and Review of the Literature  

PubMed Central

The use of intramedullary nails to treat trochanteric fractures of the femur has increased with the increasing size of the elderly population. The third generation Gamma nail is currently one of the most popular devices for the treatment of trochanteric fractures. Nail breakage is a rare complication, possibly resulting from fatigue fracture of the implant. We present the first reported case of breakage of a third generation Gamma nail that was not used to treat a pathological fracture. An 83-year-old woman with an unstable trochanteric fracture of the femur was treated using a third generation Gamma nail. She was referred to our hospital 14 months postoperatively with nail breakage at the opening for the lag screw. The breakage was secondary to nonunion, which was thought to be mainly due to insufficient reduction of the fracture. The broken nail was removed, and the patient underwent cemented bipolar hemiarthroplasty. At followup 18 months later, she was mobile with a walker and asymptomatic with no complications. This case shows that inadequate operation such as insufficient reduction of the trochanteric fracture may result in nonunion and implant breakage, even when using a high-strength, well-designed implant.

Iwakura, Takashi; Lee, Sang Yang; Nishida, Kotaro; Kuroda, Ryosuke; Kurosaka, Masahiro



Breakage of a third generation gamma nail: a case report and review of the literature.  


The use of intramedullary nails to treat trochanteric fractures of the femur has increased with the increasing size of the elderly population. The third generation Gamma nail is currently one of the most popular devices for the treatment of trochanteric fractures. Nail breakage is a rare complication, possibly resulting from fatigue fracture of the implant. We present the first reported case of breakage of a third generation Gamma nail that was not used to treat a pathological fracture. An 83-year-old woman with an unstable trochanteric fracture of the femur was treated using a third generation Gamma nail. She was referred to our hospital 14 months postoperatively with nail breakage at the opening for the lag screw. The breakage was secondary to nonunion, which was thought to be mainly due to insufficient reduction of the fracture. The broken nail was removed, and the patient underwent cemented bipolar hemiarthroplasty. At followup 18 months later, she was mobile with a walker and asymptomatic with no complications. This case shows that inadequate operation such as insufficient reduction of the trochanteric fracture may result in nonunion and implant breakage, even when using a high-strength, well-designed implant. PMID:23762698

Iwakura, Takashi; Niikura, Takahiro; Lee, Sang Yang; Sakai, Yoshitada; Nishida, Kotaro; Kuroda, Ryosuke; Kurosaka, Masahiro



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.




Full-thickness skin graft after nail complex resection for malignant tumors.  


Melanoma in situ and early squamous cell carcinoma can be treated successfully with excision with narrow margins. However, as the extent of disease is known only after pathologic examination of the entire lesion, the appropriate initial surgical margin is a dilemma. Lesions that involve the nail complex present an additional challenge for surgeons-whether to excise the nail complex partially or completely. The ideal form of reconstruction is also in question. We elect to completely excise the nail complex with immediate reconstruction using a full-thickness skin graft, allowing complete tumor clearance and preserving the distal phalanx. We retrospectively reviewed records of patients who had undergone complete nail complex excision and immediate skin grafting. We assessed the need for additional procedures for positive resection margins, full-thickness skin graft take on the bare bone of the distal phalanx, and final aesthetic appearance. Our study included 9 patients who had surgery on a total of 10 digits. One patient underwent repeat resection with distal phalanx disarticulation after pathologic assessment revealed a positive margin for an invasive tumor No patients had a local recurrence. Two patients required a second procedure-one for excision of a nail remnant and another for excision of an epidermal inclusion cyst. All patients were satisfied with the results, with none wanting further nail reconstruction, and all returned to presurgery use of the hand. This technique is effective for managing melanoma in situ and early squamous cell carcinoma that affect the nail complex. PMID:21606778

Puhaindran, Mark Edward; Cordeiro, Peter G; Disa, Joseph J; Mehrara, Babak J; Athanasian, Edward A



Loceryl nail lacquer--realization of a new galenical approach to onychomycosis therapy.  


Loceryl nail lacquer was developed to provide the effective antifungal drug, amorolfine, in a once-weekly dosage regimen combined with a convenient mode of application. Traditional formulations such as creams and nail solutions do not fulfil these requirements because they are wiped or washed off very rapidly. Amorolfine nail lacquer builds a non-water-soluble film on the nail plate, and this film remains in place for 1 week. The film contains a high concentration of amorolfine and forms a depot from which the drug is delivered and which allows the drug to permeate the nail plate. The film-forming polymer and the solvent were optimized for drug release, stability, and convenience of application (drying time, no gloss, transparency). In preclinical development, porcine hoof horn was used as a screening model to differentiate between formulations and dosage strengths with respect to the penetration rate. A high drug concentration of 11.72 micrograms/specimen (10 mm in diameter) was reached in the hoof horn after 6 h, increasing to 39.5 micrograms/specimen within 7 days, the maximum duration of the investigation. The drug concentration achieved was far above its minimum inhibitory concentration. Furthermore, the penetration model clearly indicated that amorolfine crossed the horn barrier and was found in the moistened gauze which simulated the nail bed. After a 7-day penetration period, 1.8% of the applied dose (500 micrograms) was available under the nail. PMID:1458660

Pittrof, F; Gerhards, J; Erni, W; Klecak, G



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.

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



Flexible intramedullary nailing in paediatric femoral fractures. A report of 73 cases  

PubMed Central

Background Flexible intramedullary nailing has emerged as an accepted procedure for paediatric femoral fractures. Present indications include all patients with femoral shaft fractures and open physis. Despite its excellent reported results, orthopaedic surgeons remain divided in opinion regarding its usefulness and the best material used for nails. We thus undertook a retrospective study of paediatric femoral fractures treated with titanium or stainless steel flexible nails at our institute with a minimum of 5 years follow up. Material and methods We included 73 femoral shaft fractures in 69 patients treated with retrograde flexible intramedullary nailing with a minimum follow up of 5 years. Final limb length discrepancy and any angular or rotational deformities were determined. Results Mean age at final follow up was 15.5 years (10-21 years). Mean follow up was 7.16 years (5.0-8.6 years). Titanium and stainless steel nails were used in 43 and 30 cases respectively. There were 51 midshaft, 17 proximal, and 5 distal fractures. All fractures united at an average of 11 weeks but asymptomatic malalignment and LLD were seen in 19% and 58% fractures respectively. LLD ranged from -3 cm to 1.5 cm. Other complications included superficial infection(2), proximal migration of nail(3), irritation at nail insertion site(5) and penetration of femoral neck with nail tip(1). There were 59 excellent, 10 satisfactory and 4 poor results. Conclusion Flexible intramedullary nailing is reliable and safe for treating paediatric femoral shaft fractures. It is relatively free of serious complications despite asymptomatic malalignment and LLD in significant percentage of fractures.




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...


Rejection of pharmaceuticals and personal care products (PPCPs) and endocrine disrupting chemicals (EDCs) by low pressure reverse osmosis membranes  

Microsoft Academic Search

This paper aims to elucidate retention characteristics of some pharmaceuticals and personal care products (PPCPs), and endocrine disrupting chemicals (EDCs), by two polyamide low pressure reverse osmosis (LPRO) membranes. Feed solution pH did not have an influence on rejections of undissociated solutes, which was most likely governed by adsorption, size exclusion and diffusion simultaneously. Size exclusion was presumably dominant, especially

H. Ozaki; K. Fukami; N. Ikejima; S. Matsui; Y. Shimizu; R. R. Giri; S. Taniguchi; R. Takanami



Ecotoxicological effects of typical personal care products on seed germination and seedling development of wheat ( Triticum aestivum L.)  

Microsoft Academic Search

Biochemical responses of wheat (Triticum aestivum L.) seedlings stressed by two typical personal care products (PCPs) – triclosan (TCS) and galaxolide (HHCB) were experimentally investigated to assess their ecological risks. The results showed that wheat shoot and root elongation was significantly inhibited by 50–250mg L?1 TCS and HHCB. Wheat roots were sensitive to TCS, while shoots were sensitive to HHCB.

Jing An; Qixing Zhou; Yuebing Sun; Zhiqiang Xu



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



[Dilatation technique with the TNS (transcutaneous nail insertion system) for minimally invasive implantation of intramedullary nails at the proximal femur].  


A new technique of a minimally invasive approach to the proximal femur was developed for the management of per- and subtrochanteric fractures using intramedullary nail blade systems. For creating the entry portal at the proximal femur a transcutaneously applied Kirschner-wire is used. Subsequently, a new developed trocar system (TNS) for the protection of the soft tissue during reaming procedures is placed via a small cutaneous incision. The reaming of the femoral shaft can be performed through this trocar system. A new targeting jig especially adapted to the gliding nail was used in this first series. From December 1998 to June 1999 12 patients were treated with this new technique in the Department of Trauma Surgery of the Philipps-University in Marburg. The mean age of the 8 female and 4 male patients was 78 (+/- 12) years. The majority of the total group were old patients with a mean ASA score of 3-4. Relevant intraoperative complications using the new dilatation approach were not observed. All patients were mobilised after few days. Postoperative complications or infections were not found. In the clinical practice of the management of per- and subtrochanteric femoral fractures the new dilatation approach has proved to be more comfortable and minimally invasive than the standard technique existing to date. PMID:10883603

Stiletto, R; Schädel-Höpfner, M; Schnabel, M



Undetected iatrogenic lesions of the anterior femoral shaft during intramedullary nailing: a cadaveric study  

PubMed Central

Background The incidence of undetected radiographically iatrogenic longitudinal splitting in the anterior cortex during intramedullary nailing of the femur has not been well documented. Methods Cadaveric study using nine pairs of fresh-frozen femora from adult cadavers. The nine pairs of femora underwent a standardized antegrade intramedullary nailing and the detection of iatrogenic lesions, if any, was performed macroscopically and by radiographic control. Results Longitudinal splitting in the anterior cortex was revealed in 5 of 18 cadaver femora macroscopically. Anterior splitting was not detectable in radiographic control. Conclusion Longitudinal splitting in the anterior cortex during intramedullary nailing of the femur cannot be detected radiographically.

Papadakis, Stamatios A; Zalavras, Charalampos; Mirzayan, Raffy; Shepherd, Lane



Intramedullary tibial nailing in distal third tibial fractures: distal locking screws and fracture non-union.  


Distal third tibial fractures are prone to non-union following tibial nail insertion. The purpose of this study was to assess the union of distal third tibial fractures in patients who have undergone intra-medullary (IM) tibial nailing with one versus two distal locking screws. Sixty-five patients who had intramedullary tibial nail fixation were retrospectively analysed. Our results showed that 80% of non-unions in distal third fractures had only one distal locking screw compared to 20% who had two distal locking screws. This is statistically significant (p<0.01). We therefore conclude that two distal locking screws are essential for distal third fractures. PMID:17410364

Mohammed, Aso; Saravanan, Ramaswamy; Zammit, Jason; King, Richard



Formation of nanostructure on hair surface: its characteristic optical properties and application to hair care products.  


Uneven structures on hair fiber surface, such as lift up of cuticle or build up of hair spray ingredients, generally cause a diffuse reflection which results in a dull and unhealthy appearance. However, in the case of finer structure than wavelength of visible light, the optical properties change significantly. An application of the phenomenon to hair care products is reported in this paper. Formation of the fine structure on hair surface was achieved by only a shampoo and rinse-off conditioner system including amino-silicone. Chroma enhancement of hair and light introduction into hair fibers were observed simultaneously with formation of the fine structure on the hair surface. The light introduction phenomenon is understood in terms of "Effective Medium Approximation" (EMA). The simulation study based on EMA indicates that a very low refractive index surface is expected to be realized, which well explains the optical experimental results. When the shampoo and conditioner system developed to form the structure on fiber surface was applied to dyed hair, enhancement and long-lasting of vivid appearance was confirmed in spite of dye elution. PMID:17728928

Watanabe, Shunsuke; Sato, Hirayuki; Shibuichi, Satoshi; Okamoto, Masayuki; Inoue, Shigeto; Satoh, Naoki


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.

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.; Gagne, Francois; 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, Jurg Oliver; Szabo, Nora D.; Topp, Edward; Tetreault, Gerald R.; Trudeau, Vance L.; Van Der Kraak, Glen



Seasonal variation of endocrine disrupting compounds, pharmaceuticals and personal care products in wastewater treatment plants.  


The occurrence of 14 endocrine disrupting compounds (EDCs), pharmaceuticals and personal care products (PPCPs) in influents, effluents and sludge from five wastewater treatment plants (WWTPs) in southern California was studied in winter and summer. All 14 compounds were detected in influent samples from the five WWTPs except for estrone. Paracetamol, naproxen and ibuprofen were the dominant compounds, with mean concentrations of 41.7, 35.7 and 22.3 ?g/L, respectively. The treatment removal efficiency for most compounds was more than 90% and concentrations in the effluents were relatively low. Seasonal variation of the compounds' concentration in the wastewater was significant: the total concentration of each compound in the wastewater was higher in winter than in summer, which is attributed to more human consumption of pharmaceuticals during winter and faster degradation of the compounds in summer. The highest concentrations of triclosan and octylphenol were detected in sewage sludge, with mean concentrations of 1505 and 1179 ng/g, respectively. Risk quotients (RQs), expressed as the ratios of environmental concentrations and the predicted no-effect concentrations (PNEC), were less than unity for all the compounds except for estrone in the effluents, indicating no immediate ecological risk is expected. However, RQs were higher than unity for 2 EDCs (estrone and octylphenol) and carbamazepine in sludge samples, indicating a significant ecotoxicological risk to human health. Therefore, appropriate treatment of sewage sludge is required before its application. PMID:23178835

Yu, Yong; Wu, Laosheng; Chang, Andrew C



Triclosan, an environmental pollutant from health care products, evokes charybdotoxin-sensitive hyperpolarization in rat thymocytes.  


The effects of triclosan, an environmental pollutant from household items and health care products, on membrane potential and intracellular Ca(2+) concentrations of rat thymocytes were examined by a flow cytometry with fluorescent probes, di-BA-C(4) and fluo-3-AM, because triclosan is often found in humans and wild animals. Triclosan at a concentration of 3 ?M decreased the intensity of di-BA-C(4) fluorescence, indicating the triclosan-induced hyperpolarization. The application of charybdotoxin, a specific inhibitor of Ca(2+)-dependent K(+) channels, and the removal of external Ca(2+) eliminated the triclosan-attenuation of di-BA-C(4) fluorescence. Furthermore, triclosan augmented the fluo-3 fluorescence under normal Ca(2+) condition, indicating that triclosan increased intracellular Ca(2+) concentration. These results suggest that triclosan induces membrane hyperpolarization by increasing intracellular Ca(2+) concentration that activates Ca(2+)-dependent K(+) channels. Since the change in membrane potential of lymphocytes influence cellular immune functions, triclosan may exert adverse actions on immune system in human and wild animals. PMID:22004961

Kawanai, Takuya



Access to dental care: a historical review of medicaid eligibility growth and dental productivity decline.  


The present dilemma in providing dental services to the indigent and Medicaid recipients throughout this nation has generated considerable controversy as to the evolution of the problem. Most states recognize that there are deficiencies in the provision of dental services to these populations and are seeking resolutions. While state licensing board practices and dental professional society politics have been the object of criticism as contributing to if not causing of this problem, other rational and statistically valid explanations for the current difficulty exist. As an explanation for access to care issues, this paper explores the decline in the national numbers of dental practitioners and concomitant dental productivity. Furthermore, it relates those parameters to the dramatic rise in the utilization and demand for dental services resulting from a robust economy, population growth trends, and changes in state and federal Medicaid legislation that increase numbers of Medicaid-eligible recipients. While these general trends are national in scope and application, the state of North Carolina and its experience will be used to fully explore the impact of these trends at the state and local level. PMID:11569600

Kinlaw, D H



Water vapour permeability of skin care products in relation to molecular and environmental influences.  


Synopsis An in vitro method for characterization of water retention behaviour of emollients was developed. The human skin is imitated with the aid of a polytetrafluoro ethylene membrane and the degree of water vapour evaporation after impregnation with different emollients is determined. Results obtained from different studies under changing conditions indicate that this is a precise and efficient method which is easy to perform with very simple equipment. It allows the generation of data for the characterization of emollients as an aid for skin care product formulation. Additionally, basic studies on emollient water retention due to exogenous influences are possible. Résumé Une méthode in vitro pour caractéroen l'aptitude a'la rétention d'eau d'un émolliant a été mise au point. La peau humaine est simulée avec l'aide d'une membrane en polytetrafluoro éthylène (PTFE), et l'evaporation de la voyeur d'eau après impregnation avec divers émolliants est mesurée. Après différentes études dans diverses conditions expérimentales, les résultats obtenus montrent qu'une méthode précise et efficaee a été développée, facile à methe en ocuore avec un équipement simple. Elle permet d'obtenin les donnécs caractéristiques d'émolliants, facilitant le formulation de produits de soin pour la peau. Des études supplémentaires concernant l'évolution de la capacitéà la rétention d'eau d'un émolliant en fonction de facteurs exterieurs sont envisageables. PMID:19281613

Strübmann, A; Weißen, H J; Wirtz, A



ICLAS Working Group on Harmonization: international guidance concerning the production care and use of genetically-altered animals.  


Replacement, Reduction and Refinement, the ‘Three Rs’ of Russell & Burch, are accepted worldwide as fundamental to the ethics of animal experimentation. The production, care and use of genetically-altered animals can pose particular challenges to the implementation of the Three Rs,1 necessitating additional considerations by those responsible for overseeing the ethical use and appropriate care of animals involved in science. The International Council for Laboratory Animal Science brings representatives of the international laboratory animal science community together to recommend acceptance of guidance documents.The harmonization of guidance concerning genetically-altered animals was seen as a priority because of the increasing globalization of research involving these animals. PMID:23563121

Rose, M; Everitt, J; Hedrich, H; Schofield, J; Dennis, M; Scott, E; Griffin, G



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: [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)



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


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



Finite element study of trochanteric gamma nail for trochanteric fracture.  


A three-dimensional finite element study of trochanteric fracture fixation by a trochanteric gamma nail (TGN) was investigated in this study. The analyses were performed under one-legged stance load boundary conditions to study the stress distribution and displacements. The influence of material properties (E-modulus) of the implant, the bone and contact condition in the fracture zone was determined. The results show that the stresses in the implant were lower in case of titanium alloy implant material but at the same time higher displacements occurred. The results also indicate that the stresses in the TGN gradually reduced throughout the healing process of the bone in the fracture zone. PMID:12538064

Sitthiseripratip, K; Van Oosterwyck, H; Vander Sloten, J; Mahaisavariya, B; Bohez, E L J; Suwanprateeb, J; Van Audekercke, R; Oris, P



A Tabletop Interface Using Nail Images and Real Object Recognition  

NASA Astrophysics Data System (ADS)

Many researches and developments of table-top interface have been proposed in the last decade. In a table-top system, the difference of operations between the digital media and the physical media like a paper gives us unsatisfactory experience and disturbs a comfortable simultaneous using of them. It is required for user satisfaction that the user can operate the digital and physical media seamlessly. In this paper, we propose a table-top interface system that allows users to operate digital media intuitively by using gesture recognition. The proposed table can capture an image of the object on the table by press gesture recognition from users' nail images based on SVM, and can acquire a digital content from a digital paper reader by shake gesture of the device. The evaluation experiments show that the proposed system recognizes users' finger state with higher accuracy and the users can intuitively operate the table without awareness of the data transmission.

Hara, Kenta; Takemura, Noriko; Iwai, Yoshio; Sato, Kosuke


[Treatment of tibial shaft fractures by intramedullary locking nailing].  


Authors analyzed consecutive series of 56 tibial shaft fractures (43 men and 13 women) treated by intramedullary locking nails in years 1993-2004. Age of patients ranged from 17 to 83 years (mean 38 years). The final result was analyzed in 51 patients (91%). The bone union was observed in 50 patients. Fractures united within 6 months in 45 patients (88%), between 8 and 15 months in 5 patients. Operative treatment of non-union was necessary in one patient. The fractures united in anatomical axis in 45 cases, small (less than 10 degrees) valgus deviation was noticed in four patients, whereas five patients with fractures localized in distal part of the tibia had 11-30 degrees valgus deviation. The limb length inequality more than 1 cm was noticed in one case. There was neither infection nor compartment syndrome. One patient died because of fatal pulmonary embolism. PMID:16875183

Ko?odziej, Robert; Blacha, Jan; Blicharski, Tomasz; Gagala, Jacek



Fusarium Solani: A Causative Agent of Skin and Nail Infections  

PubMed Central

Fusarium spp are non-dermatophytic hyaline moulds found as saprophytes and plant pathogens. Human infections are probably a result of various precipitating predisposing factors of impaired immune status. Immunocompetent individuals of late are also vulnerable to various unassuming saprophytic and plant pathogens. To stress the need to identify correctly and institute appropriate antifungal therapy in newly emerging human fungal infectious agents. Repeated mycological sampling of the skin and nails of the suspected fungal infection were processed as per the standard format including direct microscopy and fungal culture on Sabouraud's dextrose agar. The fungus was isolated as Fusarium solani. Fusarium is an important plant pathogen and soil saprophyte. Infection is acquired by direct inoculation or inhalation of spores. It is associated with a variety of diseases like keratitis, onychomycosis, eumycetoma, skin lesions and disseminated diseases.

Kuruvilla, Thomas S; Dias, Meena



Refractures of the paediatric forearm with the intramedullary nail in situ.  


Forearm fractures in children are common. When conservative treatment fails, internal fixation with Elastic Stable Intramedullary Nailing (ESIN) become the first choice in the operative treatment of diaphyseal forearm shaft fractures. Refractures with the intramedullary nail in situ are known to occur but formal guidelines to guide management in such fractures are lacking. We present a well-documented case of a radius midshaft refracture in a 12-year-old boy with the intramedullary nail in situ, managed by closed reduction. Literature is reviewed for this type of complication, the treatment of 30 similar cases is discussed and a treatment strategy is defined. The refracture of the paediatric forearm fracture with the intramedullary nail in situ is a rare, but probably under recognised complication which is observed in approximately 2.3% of the study population. Closed reduction may be considered in these cases. PMID:24068378

van Egmond, Pim W; van der Sluijs, Hans A; van Royen, Barend J; Saouti, Rachid



Intramedullary nailing in fracture treatment: history, science and Küntscher's revolutionary influence in Vienna, Austria.  


Although the first intermedullary fixation technique was already reported in 1886, successfully inter-medullary nailing did not start until November 1939 when Küntscher's revolutionary technique was applied for the first time. Whereas Küntscher initially stated that his "marrow nail" was suitable for almost every fracture type as well as for other procedures including fixation of osteotomies, joint arthrodesis and pseudarthro-sis treatment he tried to develop an own nail for every possible fracture type through the years. Undoubtedly, Küntscher has to be considered one of the most influential surgeons. Nevertheless, he was never offered a university position and a lot of people did not acknowledge his brilliancy until his death in 1972. Only in Vienna the willingness to seize Küntscher's ideas was high. Therefore, in addition to a historic overview and to fundamental knowledge referring to reamed and unreamed respectively to static and dynamic nailing Küntscher's influence on Viennese researchers is presented in our paper. PMID:21939796

Vécsei, Vilmos; Hajdu, Stefan; Negrin, Lukas L



Southern Pine Pallets Assembled with Stiff-Stock and Hardened-Steel Pallet Nails.  

National Technical Information Service (NTIS)

The report describes the performance of two types (stiff stock and hardened) nails and two methods of installation (hand and machine) and the comparative value of each in the assembly of wooden pallets.

E. G. Stern



Charcot ankle fusion with a retrograde locked intramedullary nail.  


Twenty patients with severe neuropathic (Charcot) ankle deformities underwent 21 attempted ankle fusions with a retrograde locked intramedullary nail as an alternative to amputation. All had insensate heel pads and had failed at nonoperative methods of accommodative ambulatory bracing. In 11, the talus was either absent, or the deformity was of sufficient magnitude to require talectomy to align the calcaneus under the tibia for plantigrade weightbearing. Ages ranged from 28 to -68 (average 56.3) years. Nineteen were diabetic, 12 being insulin-dependent. Their average body weight was 102 kg, with 11 greater than 90 kg at the time of surgery. Eight had chronic large full thickness ulcers overlying, but not involving bone of the medial malleolus, medial midfoot, or proximal fifth metatarsal, at the time of surgery. At a follow-up of 12 to 31 months, 19 achieved bony fusion. In the 10 patients where talectomy was not required, fusion was achieved at an average of 5.3 months without complications. In the patients who required talectomy, six of the patients required eight additional operations to achieve fusion. Three achieved fusion following removal of the nail and prolonged bracing. One opted for ankle disarticulation for chronic persistent infection, rather than attempt reoperation. One died of unrelated causes during the early postoperative period. Retrograde locked intramedullary ankle fusion is a reasonable alternative to amputation in the neuropathic (Charcot) ankle that cannot be controlled with standard bracing techniques. The potential for morbidity requiring reoperation is greatly increased when the deformity is of sufficient magnitude to require talectomy to achieve alignment of the calcaneus in a plantigrade weight-bearing position under the tibia or when there are large open ulcers. PMID:9391814

Pinzur, M S; Kelikian, A



[Analysis of the results of peri-trochanteric fracture treated by the Ender nails].  


Results of Ender nailing in 140 patients aged between 49 and 99 (mean 81 years) with peritrochanteric fracture have been analyzed. Pros and cons of the method are discussed and potential complications pointed out. The method proved useful; results were good despite advanced age of the patients. In fractures grade I and II Kayle scale Ender nailing resulted in least complications. The risk of death was doubled by delaying surgical intervention. PMID:10575790

Go?da, W; Krzywo?, J; Swiech, M; Cnota, H



Intertrochanteric fractures in elderly high risk patients treated with Ender nails and compression screw  

PubMed Central

Background: Ender and Simon Weidner popularized the concept of closed condylocephlic nailing for intertrochanteric fractures in 1970. The clinical experience of authors revealed that Ender nailing alone cannot provide secure fixation in elderly patients with osteoporosis. Hence we conducted a study to evaluate the efficacy of a combined fixation procedure using Ender nails and a cannulated compression screw for intertrochanteric fractures. Materials and Methods: 76 patients with intertrochanteric fractures were treated using intramedullary Ender nails and cannulated compression screw from January 2004 to December 2007. The mean age of the patients was 80 years (range 70-105 years).Using the Evan’s system of classification 49 were stable and 27 unstable fractures. Inclusion criteria was high risk elderly patients (age > 70 years) with intertrochanteric fracture. The exclusion criteria included patients with pressure sores over the trochanteric region. Many patients had pre-existing co-morbidities like diabetes mellitus, hypertension, COPD, ischemic heart disease, CVA and coronary artery bypass surgery. The two Ender nails of 4.5mm each were passed across the fracture site into the proximal neck. This was reinforced with a 6.5 mm cannulated compression screw passed from the sub trochanteric region, across the fracture into the head. Results: The mean follow-up was 14 months (range 9-19 months) Average time to fracture union was 10 weeks (range 6-16 weeks). The mean knee ROM was 130° (± 5°). There was no case of nail penetration into hip joint. In five cases with advanced osteoporosis there was minimal migration of Ender nails distally. Conclusions: The Ender nailing combined with compression screw fixation in cases of intertrochanteric fractures in high risk elderly patients could achieve reliable fracture stability with minimal complications.

Gangadharan, Sidhartha; Nambiar, MR



Screw elastic intramedullary nail for the management of adult forearm fractures  

PubMed Central

Background: The failure of the conventional nailing of both forearm bones or isolated fractures of radius and ulna pose a potential problem of nail migration and rotational instability, despite the best reduction. The purpose of this paper is to evaluate the results of screw elastic intramedullary nail for the treatment of adult diaphyseal fractures of both forearm bones, which effectively addresses the problems associated with the conventional nailing systems for the forearm fractures. Materials and Methods: Seventy-six adults with forearm fractures (radius and ulna or isolated fracture of the single bone) were retrospectively evaluated. Fifty males and 26 females with the mean age of 38 years (range, 18-70 years) underwent closed reduction and screw intramedullary nail fixation. Ten patients required limited open reduction. The fractures were classified according to the AO/OTA system. The average followup was 12 months (range, 6 to 18 months). Results: The mean surgical time was 45 minutes (35 to 65 minutes). The meantime to union was 14 weeks (10-21 weeks). The results were graded as excellent in 50, good in 18 patients, and acceptable in eight patients, using the criteria of Grace and Eversman. We had superficial infection in three cases, one case of delayed infection, painful bursa in two cases, delayed union in two cases, malunion with dislocation of the DRUJ in two cases, injury to the extensor tendon of the thumb in one case, and one case of incomplete radioulnar synostosis. Conclusion: Closed reduction and internal fixation of forearm fractures by screw intramedullary nails reestablishes the near normal relationship of the fractured fragments. Screw intramedullary nail effectively controls both rotatory forces and the migration of the nail. It produces excellent clinical results in isolated fractures of either bones, as well as both bones of the forearm in adults.

Gadegone, Wasudeo; Salphale, Yogesh S; Lokhande, Vijayanand



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

Microsoft Academic Search

The instrumentation of the osteoporotic spine may sometimes result in failure due to the loosening or pullout of the conventional\\u000a pedicle screw. Moreover, augmentation of screws with polymethylmethacrylate (PMMA) has risks of complications. We developed\\u000a a new and original pedicle nail system with PMMA for osteoporotic vertebral fractures. A clinical evaluation of this novel\\u000a pedicle nail system utilized in patients

Keiya Yamana; Masato Tanaka; Yoshihisa Sugimoto; Tomoyuki Takigawa; Toshifumi Ozaki; Hitoshi Konishi



Treatment of Psoriatic Nails with Topical Cyclosporin: A Prospective, Randomized Placebo-Controlled Study  

Microsoft Academic Search

Background: Nail involvement is a frequent event in the course of psoriasis causing severe distress. While systemic cyclosporin (CsA) represents a well-established therapy of psoriasis, its topical use is limited by the difficult penetration of the molecule through the skin and the nail because of its highly lipophilic nature. Objectives: We carried out a prospective randomized placebo-controlled study in order

S. P. Cannavò; F. Guarneri; M. Vaccaro; F. Borgia; B. Guarneri



TEM characterization of the fine scale microstructure of a Roman ferrous nail  

NASA Astrophysics Data System (ADS)

This paper describes the microstructure of a Roman ferrous nail through its observation by transmission electron microscopy. The morphologies of pearlitic colonies and ferritic grains are detailed and the relationship between pearlitic colonies and ferrite in Roman nails is explicitly demonstrated for the first time. Observations also confirm the presence of dislocations in ferritic grains and attest to the existence of very small carbide precipitates that have not been pointed out previously in standard archaeometric studies.

Douin, J.; Henry, O.; Dabosi, F.; Sciau, P.



Water sorption of nails treated with wool keratin proteins and peptides  

Microsoft Academic Search

Water has a considerable effect on human keratin fibres, such as nails, and is therefore crucial for their cosmetic performance.\\u000a Wool proteins are mild, natural, biodegradable and are sustainably produced with multiple functionalities. They have a potential\\u000a for use in the cosmetic and detergent markets. The effectiveness of two wool keratin ingredients in restoring the water sorption\\u000a characteristics of nails

C. Barba; M. Martí; A. Roddick-Lanzilotta; A. Manich; J. Carilla; J. L. Parra; L. Coderch



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.

Daughton, C G; Ternes, T A



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


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



Occurrence and removal of pharmaceuticals and personal care products (PPCPs) in an advanced wastewater reclamation plant.  


The occurrence of nineteen pharmaceutically active compounds and personal care products was followed monthly for 12 months after various stages of treatment in an advanced wastewater reclamation plant in Gwinnett County, GA, U.S.A. Twenty-four hour composite samples were collected after primary clarification, activated sludge biological treatment, membrane filtration, granular media filtration, granular activated carbon (GAC) adsorption, and ozonation in the wastewater reclamation plant. Compounds were identified and quantified using high performance liquid chromatography/tandem mass spectrometry (LC-MS/MS) and gas chromatography/mass spectrometry (GC-MS) after solid-phase extraction. Standard addition methods were employed to compensate for matrix effects. Sixteen of the targeted compounds were detected in the primary effluent; sulfadimethoxine, doxycycline, and iopromide were not found. Caffeine and acetaminophen were found at the highest concentrations (?10(5) ng/L), followed by ibuprofen (?10(4) ng/L), sulfamethoxazole and DEET (?10(3) ng/L). Most of the other compounds were found at concentrations on the order of hundreds of ng/L. After activated sludge treatment and membrane filtration, the concentrations of caffeine, acetaminophen, ibuprofen, DEET, tetracycline, and 17?-ethynylestradiol (EE2) had decreased by more than 90%. Erythromycin and carbamazepine, which were resistant to biological treatment, were eliminated by 74 and 88%, on average, by GAC. Primidone, DEET, and caffeine were not amenable to adsorption by GAC. Ozonation oxidized most of the remaining compounds by >60%, except for primidone and DEET. Of the initial 16 compounds identified in the primary effluent, only sulfamethoxazole, primidone, caffeine and DEET were frequently detected in the final effluent, but at concentrations on the order of 10-100 ng/L. Removal of the different agents by the various treatment processes was related to the physical-chemical properties of the compounds. PMID:21864879

Yang, Xin; Flowers, Riley C; Weinberg, Howard S; Singer, Philip C



Pharmaceuticals and personal care products found in the Great Lakes above concentrations of environmental concern.  


The monitoring of pharmaceuticals and personal care products (PPCPs) has focused on the distribution in rivers and small lakes, but data regarding their occurrence and effects in large lake systems, such as the Great Lakes, are sparse. Wastewater treatment processes have not been optimized to remove influent PPCPs and are a major source of PPCPs in the environment. Furthermore, PPCPs are not currently regulated in wastewater effluent. In this experiment we evaluated the concentration, and corresponding risk, of PPCPs from a wastewater effluent source at varying distances in Lake Michigan. Fifty-four PPCPs and hormones were assessed on six different dates over a two-year period from surface water and sediment samples up to 3.2km from a wastewater treatment plant and at two sites within a harbor. Thirty-two PPCPs were detected in Lake Michigan and 30 were detected in the sediment, with numerous PPCPs being detected up to 3.2km away from the shoreline. The most frequently detected PPCPs in Lake Michigan were metformin, caffeine, sulfamethoxazole, and triclosan. To determine the ecological risk, the maximum measured environmental concentrations were compared to the predicted no-effect concentration and 14 PPCPs were found to be of medium or high ecological risk. The environmental risk of PPCPs in large lake systems, such as the Great Lakes, has been questioned due to high dilution; however, the concentrations found in this study, and their corresponding risk quotient, indicate a significant threat by PPCPs to the health of the Great Lakes, particularly near shore organisms. PMID:23973285

Blair, Benjamin D; Crago, Jordan P; Hedman, Curtis J; Klaper, Rebecca D



Consumer inhalation exposure to formaldehyde from the use of personal care products/cosmetics.  


We measured consumer exposure to formaldehyde (FA) from personal care products (PCP) containing FA-releasing preservatives. Six study subjects applied facial moisturiser, foundation, shower gel, shampoo, deodorant, hair conditioner, hair styling gel or body lotion at the 90th percentile amount of EU PCP consumer use. FA air concentrations were measured in the empty room, in the presence of study subjects prior to PCP use, and for one hour (breathing zone, area monitoring) after PCP use. The mean FA air concentration in the empty bathroom was 1.32 ± 0.67 ?g/m³, in the presence of subjects it was 2.33 ± 0.86 ?g/m³). Except for body lotion and hair conditioner (6.2 ± 0.1.9 or 4.5 ± 0.1.5 ?g/m³, respectively), mean 1-h FA air concentrations after PCP use were similar to background. Peak FA air concentrations, ranging from baseline values (2.2 ?g/m³; shower gel) to 11.5 ?g/m³ (body lotion), occurred during 0-5 to 5-10 min after PCP use. Despite of exaggerated exposure conditions, FA air levels were a fraction of those considered to be safe (120 ?g/m³), occurring in indoor air (22-124 ?g/m³) or expired human breath (1.4-87 ?g/m³). Overall, our data yielded evidence that inhalation of FA from the use of PCP containing FA-releasers poses no risk to human health. PMID:22406137

Lefebvre, Marc-André; Meuling, Wim J A; Engel, Roel; Coroama, Manuela C; Renner, Gerald; Pape, Wolfgang; Nohynek, Gerhard J



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


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



A calibration method for proposed XRF measurements of arsenic and selenium in nail clippings  

NASA Astrophysics Data System (ADS)

A calibration method for proposed x-ray fluorescence (XRF) measurements of arsenic and selenium in nail clippings is demonstrated. Phantom nail clippings were produced from a whole nail phantom (0.7 mm thickness, 25 × 25 mm2 area) and contained equal concentrations of arsenic and selenium ranging from 0 to 20 µg g-1 in increments of 5 µg g-1. The phantom nail clippings were then grouped in samples of five different masses: 20, 40, 60, 80 and 100 mg for each concentration. Experimental x-ray spectra were acquired for each of the sample masses using a portable x-ray tube and a detector unit. Calibration lines (XRF signal in a number of counts versus stoichiometric elemental concentration) were produced for each of the two elements. A semi-empirical relationship between the mass of the nail phantoms (m) and the slope of the calibration line (s) was determined separately for arsenic and selenium. Using this calibration method, one can estimate elemental concentrations and their uncertainties from the XRF spectra of human nail clippings.

Gherase, Mihai R.; Fleming, David E. B.



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.

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



Removal of a femoral nail with osseous overgrowth at the end-cap: A navigated and cannulated minimally invasive technique.  


Intramedullary nail removal can be demanding, especially in cases of implant breakage or bony overgrowth at the end-cap, if the exact insertion depth of the nail is neglected in the index surgery. In the presented case, two challenging nail removals were necessary. The first was performed in a re-nailing procedure due to a pseudarthrosis with implant breakage, and the second was performed during hardware removal after fracture healing in a situation where there was deep intramedullary placement of the exchange nail. For the second implant removal a minimally invasive approach based on instrument placements over a navigated guide-wire was used to reduce the iatrogenic morbidity associated with an extensive open approach to the nail and to decrease the radiation exposure for the patient and the operating team. PMID:23176131

Marintschev, Ivan; Rausch, Sascha; Fujak, Albert; Klos, Kajetan; Hofmann, Gunther O; Gras, Florian



A search for longitudinal variations in trace element levels in nails of Alzheimer’s disease patients  

Microsoft Academic Search

Levels of Br, Hg, K, and Zn were determined by INAA in the nails of Alzheimer’s disease (AD) patients at 6-mo intervals for\\u000a up to 3 yr. These elements have been shown to be imbalanced in AD nail. Bromine showed no trends. Mercury tended to decrease\\u000a in nail with increasing age of patient, and with the duration and severity of

D. E. Vance; W. D. Ehmann; W. R. Markesbery



Determination of organic micro-pollutants such as personal care products, plasticizers and flame retardants in sludge  

Microsoft Academic Search

In this study, a method for the determination of organic micro-pollutants, i.e. personal care products such as synthetic musk\\u000a fragrances, household bactericides, organophosphate flame retardants and plasticizers, as well as phthalates in sludge, has\\u000a been developed. This method is based on lyophilisation and accelerated solvent extraction followed by clean-up steps, i.e.\\u000a solid phase extraction and size exclusion chromatography. The determination

Xijuan Chen; Kai Bester



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



Qualification of an automated device to objectively assess the effect of hair care products on hair shine.  


The authors developed and qualified an automated routine screening tool to quantify hair shine. This tool is able to separately record individual properties of hair shine such as specular reflection and multiple reflection, as well as additional features such as sparkle, parallelism of hair fibers, and hair color, which strongly affect the subjective ranking by individual readers. A side-by-side comparison of different hair care and styling products with regard to hair shine using the automated screening tool in parallel with standard panel assessment showed that the automated system provides an almost identical ranking and the same statistical significances as the panel assessment. Provided stringent stratification of hair fibers for color and parallelism, the automated tool competes favorably with panel assessments of hair shine. In this case, data generated with the opsira Shine-Box are clearly superior over data generated by panel assessment in terms of reliability and repeatability, workload and time consumption, and sensitivity and specificity to detect differences after shampoo, conditioner, and leave-in treatment. The automated tool is therefore well suited to replace standard panel assessments in claim support, at least as a screening tool. A further advantage of the automated system over panel assessments is the fact that absolute numeric values are generated for a given hair care product, whereas panel assessments can only give rankings of a series of hair care products included in the same study. Thus, the absolute numeric data generated with the automated system allow comparison of hair care products between studies or at different time points after treatment. PMID:22152491

Hagens, Ralf; Wiersbinski, Tim; Becker, Michael E; Weisshaar, Jürgen; Schreiner, Volker; Wenck, Horst


Microbially Mediated Degradation of Common Pharmaceuticals and Personal Care Products in Soil Under Aerobic and Reduced Oxygen Conditions  

Microsoft Academic Search

Biological degradation rates of estrogen compounds and common pharmaceutical and personal care products (PPCPs) were examined\\u000a in soils with a long history of exposure to these compounds through wastewater effluent and in soil not previously exposed.\\u000a Biological degradation rates over 14 days were compared under aerobic and anaerobic conditions. Estrogen compounds including\\u000a estrone, 17?-estradiol, estriol, and 17?-ethinylestradiol exhibited rapid degradation by

Deborah L. Carr; Audra N. Morse; John C. Zak; Todd A. Anderson



Rapid determination of parabens in personal care products by stable isotope GC-MS/MS with dynamic selected reaction monitoring.  


In this study, a rapid and sensitive analytical method for the determination of methyl-, ethyl-, propyl-, and butyl esters of para-hydroxy benzoic acid (parabens) in personal care products was developed and fully validated. Test portions were extracted with methanol followed by vortexing, sonication, centrifugation, and filtration without derivatization. The four parabens were quantified by GC-MS/MS in the electron ionization mode. Four corresponding isotopically labeled parabens were selected as internal standards, which were added at the beginning of the sample preparation and used to correct for recovery and matrix effects. Sensitivity, extraction efficiency, and recovery of the respective analytes were evaluated. The coefficients of determination (r(2)) were all greater than 0.995 for the four parabens investigated. The recoveries ranged from 97 to 107% at three spiked levels and a one-time (single) extraction efficiency greater than 97% was obtained. This method has been applied to screen 26 personal care products. This is the first time that a unique GC-MS/MS method with dynamic selected reaction monitoring and confirmation of analytes has been used to determine these parabens in cosmetic personal care products. PMID:23494853

Wang, Perry G; Zhou, Wanlong



Use of the F-Tool for the removal of a bent intramedullary femoral nail with a sagittal plane deformity.  


Locked intramedullary nailing is the current standard of treatment for femoral shaft fractures and has low complication rates. Bent femoral intramedullary nails resulting from secondary trauma are rare and technically challenging. This article describes a case of a 36-year-old man who presented with a bent femoral intramedullary nail following a motorcross accident. The patient had a previous femoral shaft fracture treated with an intramedullary nail. Previous reports outlined methods to remove bent femoral nails through the fracture site and proximally; however, this article describes a novel technique combining the use of a Midas Rex MR7 high-speed burr (Medtronic, Minneapolis, Minnesota) and the F-Tool (Synthes, West Chester, Pennsylvania) to facilitate nail extraction.The patient was placed in the lateral decubitus position. After limited exposure at the fracture site, the intramedullary nail was weakened at the apex of the deformity with a Midas Rex MR7 high-speed burr. We then used the F-Tool to straighten the nail to facilitate removal through the original proximal insertion site. The F-Tool allows forces to be concentrated at the apex of the deformity and minimizes soft tissue damage. Additional advantages of our technique include limited exposure and the ability to remove the nail in 1 piece. PMID:22385460

Heffernan, Michael J; Leclair, Walter; Li, Xinning



Forces required to initiate sliding in second-generation intramedullary nails.  


Second-generation intramedullary nails, which allow the fixation screw that is placed in the femoral head to slide distally and thus allow compression of the fracture of the femoral neck, have become a popular option for the treatment of ipsilateral fractures of the femoral neck and shaft. However, the sliding characteristics of the screw within the barrel of the nail or the side-plate have not been assessed biomechanically, to our knowledge. The goal of the current study was to investigate the forces required to initiate sliding of the proximal screw in intramedullary devices and to compare these forces with those required to initiate sliding of hip screws. The loading configuration simulated the typical angle of 135 degrees between the intramedullary nail and the proximal screw. The forces required to initiate sliding of the proximal screw, with the screw extended fifty-one, seventy-six, eighty-six, and 102 millimeters beyond the proximal end of the barrel, were measured for three different types of second-generation intramedullary nails (Recon, ZMS, and Gamma), a sliding compression hip screw, and an intramedullary hip screw, and these forces were then compared. With each amount of extension of the screw, the hip screws required lower forces to initiate sliding than did the second-generation intramedullary devices. Of the second-generation devices, the Gamma nail required the highest forces to initiate sliding; the Recon and ZMS nails required 20 to 40 percent lower forces compared with the Gamma nail. None of the devices jammed in any of the loading configurations that were tested. When the extension of the screw was increased, higher forces were required to initiate sliding. PMID:9840631

Loch, D A; Kyle, R F; Bechtold, J E; Kane, M; Anderson, K; Sherman, R E



75 FR 29601 - In the Matter of the Designation of Taleb Nail; Also Known as Djaafar Abou Mohamed; Also Known as...  

Federal Register 2010, 2011, 2012, 2013

...Taleb Nail; Also Known as Djaafar Abou Mohamed; Also Known as Abou Mouhadji; Also Known as Mohamed Ould Ahmed Ould Ali; Also Known as Tayeb...Taleb Nail, also known as Djaafar Abou Mohamed, also known as Abou Mouhadji, also...



Radiation-free drill guidance in interlocking of intramedullary nails.  


Intramedullary nailing is a technically demanding procedure which involves an excessive amount of x-ray acquisitions; one study lists as many as 48 to successfully complete the procedure. In this work, a novel low cost radiation-free drilling guide is designed to assist surgeons in completing the distal locking procedure without any x-ray acquisitions. Using an augmented reality fluoroscope that coregisters optical and x-ray images, we exploit solely the optical images to detect the drilling guide in order to estimate the tip position in real-time in x-ray. We tested over 200 random drill guide poses showing a mean tip-estimation error of 1.72 +/- 0.7mm which is significantly robust and accurate for the interlocking. In a preclinical study on dry bone phantom, three expert surgeons successfully completed the interlocking 56 out of 60 trials with no x-ray acquisition for guidance and an average time of 2 min. PMID:23285530

Diotte, Benoit; Fallavollita, Pascal; Wang, Lejing; Weidert, Simon; Thaller, Peter-Helmut; Euler, Ekkehard; Navab, Nassir



Development of a one-handed nail clipper for stroke survivors.  


Due to the physical effects of stroke, many stroke survivors experience difficulty clipping their nails. Much of this difficulty is due to weakness in the upper extremities, loss of dexterity, spasticity, and vision problems. Our goal was to design a device that would help stroke survivors shorten their finger nails, providing increased independence, convenience, comfort, and safety compared to their current method of cutting nails. From user interviews and observations, we developed several prototypes to solve this problem. The final design, the Step 'n Snip, consists of a finger nail clipper mounted on an inclined, rotatable metal rod. The clipper is attached to a foot pedal with a long steel bike brake cable, which the pedal then uses to actuate the clipper. The pedal is mounted on a base that is shaped such that it provides a nesting space for the clipper frame during storage; the two parts are kept together by a swiveling clip. The clipper itself is at a convenient height for users and is fitted with a nail clippings collection system. PMID:18430684

Carhart, Christopher; Ciechowski, Rafal; Groat, Doug; Stevans, Alyson


More intramedullary nails and arthroplasties for treatment of hip fractures in Sweden  

PubMed Central

Background and purpose The surgical methods for treatment of femoral neck fractures and trochanteric hip fractures vary. We describe the changes in Sweden over the period 1998–2007 and the regional differences in treatment. Patients and methods Data on 144,607 patients were drawn from the National Patient Register. Results The proportion of femoral neck fractures treated with arthroplasty increased from 10% in 1998 to 52% in 2007. The use of intramedullary (IM) nails for pertrochanteric fractures increased from 5% to 20%, at the expense of the use of different sliding hip screws. In subtrochanteric fractures, the use of IM nails increased from 32% to 72%. Re-admissions within 180 days due to hip complications were more common after internal fixation for femoral neck fractures than after arthroplasty, and more common after intramedullary nailing of pertrochanteric fractures than after use of sliding hip screws. Treatment varied substantially within Sweden, particularly regarding the use of IM nails. Interpretation An increase in arthroplasties reflects an evidence-based treatment rationale for femoral neck fractures, whereas the increase in use of IM nails in pertrochanteric fractures lacks scientific support. The geographic variations call for national treatment guidelines. Further clinical trials are needed to solve the treatment issues regarding per- and subtrochanteric fractures.



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.

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



Numerical investigation of mechanical effects caused by various fixation positions on a new radius intramedullary nail.  


Fracture of the radius diaphysis is an unusual injury in adults. Open reduction and plate osteosynthesis has been recommended by most of the authors. However, this trend has started to change with the recent introduction of newly designed interlocking intramedullary (IM) nails. New generation of IM nails are developed in order to utilise the advantages of IM nails against plates. Because of its anatomical structure, the radius bone has a complex geometry. Therefore, the callus structure, which forms during the healing period, should not be affected from external effects, such as excessive loads or motion. In this study, effects of radial styloid process (RSP), dorsal side and ulnar notch edge fixations of a new design radius IM nail on the healing period were numerically investigated. A three-dimensional solid model of radius was obtained from computed tomography images of a volunteer and callus structure model, was placed accordingly and different fixations of implants were performed. The models were analysed under axial loads transferring from the wrist to the radius bone using finite element method. As a result of the analysis, fixation of IM nail from RSP was found to be beneficial on healing period in terms of both callus motion and emerging stresses. PMID:23682815

Celik, A; Kovac?, H; Saka, G; Kaymaz, I



Precise robot-assisted guide positioning for distal locking of intramedullary nails.  


This paper presents a novel image-guided robot-based system to assist orthopedic surgeons in performing distal locking of long bone intramedullary nails. The system consists of a bone-mounted miniature robot fitted with a drill guide that provides rigid mechanical guidance for hand-held drilling of the distal screws' pilot holes. The robot is automatically positioned so that the drill guide and nail distal locking axes coincide, using a single fluoroscopic X-ray image. Since the robot is rigidly attached to the intramedullary nail or bone, no leg immobilization or real-time tracking is required. We describe the system and protocol and present a method for accurate and robust drill guide and nail hole localization and registration. The in vitro system accuracy experiments for fronto-parallel viewing show a mean angular error of 1.3 degrees (std = 0.4 degrees ) between the computed drill guide axes and the actual locking holes axes, and a mean 3.0 mm error (std = 1.1 mm) in the entry and exit drill point, which is adequate for successfully locking the nail. PMID:15889550

Yaniv, Ziv; Joskowicz, Leo



Analysis of the error in using insurance mortality to price long term care products  

Microsoft Academic Search

Long term care (LTC) pricing requires the use of underlying experience data of mortality and lapse rates of healthy insureds, LTC inci- dence rates, LTC utilization rates, and LTC termination rates from recovery or death. It is important that the pricing process uses the most up-to-date industry tables, modified for a company's own experience and anticipated changes due to improvements

Guy Rolland Rasoanaivo; Jeyaraj Vadiveloo; Charles Vinsonhaler; Nalini Ravishanker


Sharps injury recordkeeping activities and safety product use in California health care facilities  

Microsoft Academic Search

Background: In 1999, licensed health care facilities in California (N = 2532) were invited to participate in a survey about occupational bloodborne pathogens exposure surveillance activities, recordkeeping methods, and use of safety-enhanced sharps devices. Results: A total of 1274 facilities responded to the survey from January 1999 through August 1999 (response rate = 50%). Sharps-related injuries were recorded for multiple

Marion Gillen; Martha Davis; Jennifer McNary; Alisa Boyd; Julieann Lewis; Chris Curran; Carol A. Young; Mary Schuller; James Cone



Normative models of health technology assessment and the social production of evidence about telehealth care  

Microsoft Academic Search

Telehealthcare is a rapidly growing field of clinical activity and technical development. These new technologies have caught the attention of clinicians and policy makers because they seem to offer more rapid access to specialist care, and the potential to solve structural problems around inequalities of service provision and distribution. However, as a field of clinical practice, telehealthcare has consistently been

Tracy Williams; Carl May; Frances Mair; Maggie Mort; Linda Gask



Pharmaceutical product safety recalls: A retrospective pattern analysis in a tertiary care public hospital (2003 – 2009)  

Microsoft Academic Search

Pharmaceutical product recalls (PRs) have become rampant and increased dramatically in recent years. Decision for PR is made if there is or may be risk to the user of the product due to faulty production or medical reasons. This retrospective study was to evaluate the pattern and trend of PR incidence and to identify the major manufacturing and clinical root

Nahlah Elkudssiah Ismail; Muhammad Anwar Nawab Khan



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


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



Performance Oriented Packaging (POP) Testing of 60mm SMOKE WP M302A1 Mortar Cartridge, Packed Nine (9) in a Nailed Wood Box.  

National Technical Information Service (NTIS)

This report covers the POP tests performed on nailed wood box fabricated per MIL-B-2427. This nailed wood box is being used as shipping and storage container of various 60mm Mortar Cartridges. The nailed wood box tested (P/N 9215577) contained nine spiral...

O. L. Bogdan



76 FR 72438 - Certain Steel Nails From the United Arab Emirates; Scheduling of the Final Phase of Antidumping...  

Federal Register 2010, 2011, 2012, 2013

...that are cut. Certain steel nails may be of one piece...more pieces. Certain steel nails may be produced from any type of steel, and have a variety...are not limited to, coating in vinyl, zinc (galvanized, whether by...



76 FR 75871 - Certain Steel Nails From the People's Republic of China: Final Rescission of Antidumping Duty New...  

Federal Register 2010, 2011, 2012, 2013

...that are cut. Certain steel nails may be of one piece...more pieces. Certain steel nails may be produced from any type of steel, and have a variety...are not limited to, coating in vinyl, zinc (galvanized, whether by...



76 FR 22369 - Certain Steel Nails From the People's Republic of China: Initiation and Preliminary Results of...  

Federal Register 2010, 2011, 2012, 2013

...that are cut. Certain steel nails may be of one piece...more pieces. Certain steel nails may be produced from any type of steel, and have a variety...are not limited to, coating in vinyl, zinc (galvanized, whether by...



76 FR 30101 - Certain Steel Nails From the People's Republic of China: Final Results of Antidumping Duty...  

Federal Register 2010, 2011, 2012, 2013

...that are cut. Certain steel nails may be of one piece...more pieces. Certain steel nails may be produced from any type of steel, and have a variety...are not limited to, coating in vinyl, zinc (galvanized, whether by...



76 FR 23279 - Certain Steel Nails From the People's Republic of China: Amended Final Results of the First...  

Federal Register 2010, 2011, 2012, 2013

...that are cut. Certain steel nails may be of one piece...more pieces. Certain steel nails may be produced from any type of steel, and have a variety...are not limited to, coating in vinyl, zinc (galvanized, whether by...



77 FR 24462 - Certain Steel Nails From the People's Republic of China: Amended Final Results of the Second...  

Federal Register 2010, 2011, 2012, 2013

...that are cut. Certain steel nails may be of one piece...more pieces. Certain steel nails may be produced from any type of steel, and have a variety...are not limited to, coating in vinyl, zinc (galvanized, whether by...



Improving Care for Children With Complex Needs

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



Simulation of realistic EarthCARE spaceborne Doppler products from ARM ground-based, SPIDER airborne and CRM data  

NASA Astrophysics Data System (ADS)

The Cloud-profiling radar on ESA and JAXA's future EarthCARE mission will be the first spaceborne Doppler radar to ever fly [1]. This W-band CPR, which operates at 94.05 GHz, should provide an unprecedented global coverage of vertical-velocity field distribution of the Earth's atmosphere, and therewith a better characterization of dynamic energy transfers in the atmosphere. Prior to EarthCARE's launch, one needs to simulate the Doppler products to be expected from such a CPR, viz. the radar reflectivity and the mean velocity. Our work addresses this need by using existing ground-based and airborne Doppler measurements to generate realistic EarthCARElike spaceborne data. The input to our algorithm consists of actual atmospheric Doppler measurements obtained either from ground-based ARM [2], or from an airborne platform such as SPIDER [3], the Japanese CPR from the National institute od Information and Communications Technologies (NICT). Several corrections are then applied to account for the spacecraft motion as well as the spaceborneantenna characteristics. The realism of the simulated products is also achieved in terms of spatial and temporal resolution. Further, the effects of random fluctuations, noise and finite temporal sampling are included. In addition to highlighting the peculiarities of the generation of Doppler products according to the source of the original input data, our paper will show the corrections that are applied to recover the mean-Doppler velocity, particularly in the presence of aliasing and non-uniform beam-filling contaminations. Several scenarii will be discussed to explore the added value of EarthCARE data at a finer spatial resolution.

Sy, O. O.; Tanelli, S.; Takahashi, N.; Ohno, Y.; Horie, H.; Kollias, P.



Intramedullary fibular allograft and nail for treatment of femoral shaft nonunion.  


We present a difficult case of hypertrophic nonunion associated with a large cavity in the lower third of the femur. The cavity had been created by a windshield-wiper effect after failure of fixation with a Schneider intramedullary rod in a patient weighing 450 pounds. Treatment consisted of exchanging the Schneider nail with a larger-diame-ter interlocking nail and using the intramedullary fibular allograft to fill the cavity. The fracture healed 4 months after the procedure. At 5-year follow-up, the patient had no complaint, and plain radiographs showed obliteration of the large cavity in the distal femur. Intramedullary fibular graft technique can be used as an adjunct to use of an intramedullary nail when the distal femur contains a large cavity or when the intramedullary rod does not provide adequate fixation stability. PMID:12041519

Ebraheim, Nabil A; Sabry, Fady F; Elgafy, Hossein



New surgical treatment using a docking nail for postoperative periprosthetic femoral fracture after total hip arthroplasty.  


We report 2 cases of patients (75 and 81 years old) who had a femoral shaft fracture around the femoral prosthesis after total hip arthroplasty. Using information on the implanted stem and the preoperative radiographs, we cut and trimmed an ordinary supracondylar type intramedullary nail, after which we have termed a "docking nail." We then performed osteosynthesis using the docking nail, which is connected to the tip of the implanted stem to ensure proper alignment. Within 3 months, bony union with good alignment was observed in both patients without malunion or infection. Clinical and radiographic examination during the follow-up period showed good results. The advantages of this method are that it is less invasive and simpler compared with the conventional methods. PMID:22749660

Nakano, Shunji; Yoshioka, Shinji; Tezuka, Fumitake; Nakamura, Masaru; Chikawa, Takashi; Shimakawa, Tateaki



[Locked intramedullary nailing in treatment of femur and tibia delayed union and pseudoarthrosis].  


Five patients treated operatively on account of tibia and femur shaft delayed union and pseudoarthrosis were re-operated by locked intramedullary nailing. The method permits stable bone fixation. Intramedullary canal reaming stimulates bone union, as it refreshes fracture site and is a source of bone graft. Intramedullary nail covers anatomical axis of bone and, in the case of femur, is close to its mechanical axis. It diminishes the risk of implant breakage. The method permits active and efficient rehabilitation. Some fractures stabilised with external fixator or operated by Zespol or Polfix method can be re-operated by close technic. It shortens time of operation and diminishes its aggressiveness. In our opinion locked intramedullary nailing is an efficient method in treatment of tibia and femur shaft delayed union and pseudoarthrosis. PMID:15307378

Wójcik, Krzysztof; Ga?dzik, Tadeusz Szymon; Jaworski, Jerzy Miros?aw; Gajda, Tomasz



[The nail-patella syndrome: rare genetically determined cause of proteinuria].  


Nail-patella syndrome (NPS) is rare genetic disorder with autosomal mode of inheritance resulting from mutations in the LMX1B gene mapped on the long arm of chromosome 9 (9q34), encoding transcription factor, also named LMX1B. This syndrome is characterized by a skeletal malformations, such as dysplasia of the knees (with typical patellar hypoplasia or aplasia), elbows and nails as well as characteristic protuberaces of ilium named ,,iliac homes". Chronic nephropathy and nails dysplasia are most common extraosseal signs of NPS. Familial, genetic proved (missense mutation -G599A (R200Q) case of NPS in the mother and her son was presented. Clinical features characteristic for this syndrome and observed in both our patients were compared to the data published previously. PMID:18634531

Zarzecki, Mi?osz; Nieszporek, Teresa; Chudek, Jerzy; Wiecek, Andrzej



Linkage analysis in two large Italian pedigrees affected with nail patella syndrome.  


Nail patella syndrome (NPS) or osteo-onychodysplasia, is an autosomal dominant disorder characterised by nail dysplasia, absent or hypoplastic patellae, iliac horns and nephropathy. Previous studies have demonstrated linkage of the nail patella locus to the ABO and adenylate kinase loci on human chromosome 9q34. Recently, informative recombination events placed the NPS locus within a 1-2 cM interval within D9S60 and the AK1 gene. We describe here linkage analysis performed in two large Italian pedigrees with 10 and 11 members affected, respectively. A set of highly informative markers have been analysed and the allele segregation in the two families confirmed the linkage to chromosome 9. The presence of three recombination events allows definition of the critical region with a centrometric boundary between markers D9S1881 and D9S1840 and a telomeric boundary between markers D9S315 and D9S290. PMID:9781042

Melchionda, S; Seri, M; Carella, M; Piemontese, M R; Zhang, X X; Zelante, L; Romeo, G; Gasparini, P


Femoral shaft fractures in children: elastic stable intramedullary nailing in 31 cases.  


We report our experience with elastic stable intramedullary titanium nailing (ESIN) of femoral shaft fractures in children. From 1998 to 2001, we treated 31 children (20 boys), median age 6 (4-11) years, with ESIN for 29 closed and 2 grade I open femoral shaft fractures. We reviewed 30 children clinically after median 1.5 (1-3) years. Their median hospital stay was 6 (2-20) days. All fractures were radiographically united at a median of 7 (5-9) weeks. The nails were removed in 29 children after a median of 22 (6-38) weeks postoperatively. At follow-up, we found a leg-length discrepancy up to 1 cm in 6 children and 10 degrees of internal rotational deformity in 1 child. No angular deformity had occurred. Elastic stable intramedullary nailing seems to be a safe method for the treatment of femoral shaft fractures in children between 4 and 11 years of age. PMID:15260414

Houshian, Shirzad; Gøthgen, Charlotte Buch; Pedersen, Niels Wisbech; Harving, Søren



Zidovudine-induced nail pigmentation in a 12-year-old boy.  


Zidovudine is an important component of first-line antiretroviral treatment (ART) regimens used to manage pediatric HIV. Nail pigmentation with zidovudine is a well-documented occurrence in adults, especially dark-skinned individuals. But it has so far not been reported in children. Here, we report a pediatric case of zidovudine-induced nail pigmentation. A 12-year-old boy receiving ART with zidovudine, lamivudine, and nevirapine presented to dermatology OPD with complaint of diffuse bluish-brown discoloration of all fingernails. The pigmentation was noticed by the patient after 3 months of initiating zidovudine-based regimen. It first appeared in thumb nails, gradually involved all fingernails, and increased in intensity over time. Though harmless and reversible, psychological aspects of this noticeable side effect may hamper adherence to therapy and may lead to unnecessary investigations and treatment for misdiagnosis such as cyanosis or melanoma. PMID:23248416

Chawre, Sanjeevani M; Pore, Shraddha M; Nandeshwar, Manish B; Masood, Nausheen M


Zidovudine-induced nail pigmentation in a 12-year-old boy  

PubMed Central

Zidovudine is an important component of first-line antiretroviral treatment (ART) regimens used to manage pediatric HIV. Nail pigmentation with zidovudine is a well-documented occurrence in adults, especially dark-skinned individuals. But it has so far not been reported in children. Here, we report a pediatric case of zidovudine-induced nail pigmentation. A 12-year-old boy receiving ART with zidovudine, lamivudine, and nevirapine presented to dermatology OPD with complaint of diffuse bluish-brown discoloration of all fingernails. The pigmentation was noticed by the patient after 3 months of initiating zidovudine-based regimen. It first appeared in thumb nails, gradually involved all fingernails, and increased in intensity over time. Though harmless and reversible, psychological aspects of this noticeable side effect may hamper adherence to therapy and may lead to unnecessary investigations and treatment for misdiagnosis such as cyanosis or melanoma.

Chawre, Sanjeevani M.; Pore, Shraddha M.; Nandeshwar, Manish B.; Masood, Nausheen M.



Amino acid composition of human nail, as measured by gas-liquid chromatography.  


We describe a quantitative method for determination of histidine and 16 other amino acids in a nail hydrolysate. This is based on the formation of trifluoroacetyl amino acid methyl esters and gas-liquid chromatographic analysis with use of two columns of mixed stationary phases. Histidine is determined as a triple derivative Nalpha-trifluroacetyl-Nim-carbethoxy methyl histidinate. The specificity and reproducibility of the method are illustrated. As little as 1 mg of amino acid per gram of nail can be determined, and 15 hydrolysates can be completely analyzed in 10 working days. Data obtained from multiple analyses of 10 nail hydrolysates by the method described closely parallel those obtained in another laboratory, in which an amino acid analyzer was used. PMID:975504

Greaves, M; Moll, J M



Photoacoustic spectroscopy to evaluate the penetration of two antifungal agents through the human nail  

NASA Astrophysics Data System (ADS)

The aim of the present study was to evaluate the penetration of two antifungal agents through human nail by using Photoacoustic Spectroscopy. The experiments were performed using ciclopirox in two different vehicles, resulting in formulations coded as G0291L and G0291C. The propagation rate of the two formulations through the nails was evaluated in different samples from 15 healthy volunteers. The statistical test One Way ANOVA was used to discriminate the formulation with higher penetration rate. The results showed that G0291L has the higher penetration rate. In conclusion, our results showed that Photoacoustic Spectroscopy is a useful tool to evaluate the propagation of topically applied substances through the human nail.

Nuglisch, L. E. R.; Dias, D. T.; Sehn, E.; Bento, A. C.; Baesso, M. L.; Santos, S. T. S.; Fushimi, M. Y.



Alcohol ethoxycarboxylates—Mild, high-foaming surfactants for personal-care products  

Microsoft Academic Search

Alcohol ethoxycarboxylates (AEC) may be derived from alcohol ethoxylates (AEO) either by reaction of the nonionic surfactant\\u000a with monochloroacetic acid (MCAA) or by oxidation. If MCAA is used, a -CH2COOH unit is added to the AEO. When an AEO is oxidized, the terminal -CH2OH group is selectively converted to -COOH. By use of proprietary carefully controlled oxidation technology, a variety

W. W. Schmidt; D. R. Durante; R. Gingell; J. W. Harbell



[In defense of society: the invention of palliative care and the production of subjectivities].  


This article is a theoretical reflection that is part of a study named Em Defesa da Sociedade: a invenção dos Cuidados Paliativos (In Defense of Society: the invention of Palliative Care). In order to articulate this discussion, we used the 2007edition of the Palliative Care Manual published by the World Health Organization (WHO), as we understand it is part of a body of work capable of producing subjectivities and ruling conduct. In this sense, we intend to understand how the discourses on palliative care are associated and promote the invention of a new subject that would work as a bio-political strategy in order to defend society. Based on the textual analysis of the discourse presented in the manual, with the help of the Cultural Studies framework and inspired by the works of Michel Foucault, we present one of the possible meanings derived from the readings of the WHO Guide. Thus, we observe the (re)organization and (re)invention of a subject that invests in the subjectivity of individuals and constitutes an actual framework that regulates and rules the population. PMID:22576552

da Silva, Karen Schein; Kruse, Maria Henriqueta Luce



Skin care and incontinence  


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


Chairman's choice: "slip sliding away"--the importance of quality performance in wound care products.  


We outline how a change in the manufacturing of an impregnated gauze dressing product impacts upon wound healing and describe the steps taken by the manufacturer and by the University of Alabama at Birmingham (UAB) in the identification and resolution of the problem. After a change in name and manufacturing vendors, the Burn Dressing Team at the UAB Burn Center noted that the newly named product was stretching, rolling, appeared to have more ointment on it, and created sloughing of skin grafts. Using the Seven-Step Method, the manufacturer and the Burn Dressing Team identified the problem and facilitated a process improvement activity. The UAB validated the redesigned product, and the new product was standardized for production and distribution. This experience at UAB demonstrates businesses working together to achieve a common goal. Such process improvement activities are invaluable to healthcare providers for maintaining standards of healthcare and achieving desired patient outcomes. PMID:18997560

Coles, Karen M


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.



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

NASA Astrophysics Data System (ADS)

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.

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



[Ender nails in the stabilization of trochanteric fractures of the femur in the elderly].  


Results of treatment for trochanteric fracture of the femur in 50 patients aged 25-91 (mean 71 years) are presented. In all cases reviewed the fracture has been stabilized with 3 or 4 Ender nails. In majority of cases bony union has been achieved. Short operating time, small incision remote from fracture site, early weight bearing constitute unquestionable advantages of the method. Most frequent complications as shortening of the extremity involved, excessive external rotation, pain related to migration of the nails, varus deformity at the fracture site were usually found in patients with marked osteoporotic changes. PMID:10495551

Wójcik, B; Tokarowski, A; Swieboda, A; Kaleta, M; Nowak, R



[The place of bundle nailing in the surgical treatment of fractures of the shin bones].  


Authors report about their good experiences with the tibia bundle-nailing during 23 years' patient-material on the Traumatological Department of the Hospital in Eger/Hungary comparing to other osteosynthesis methods. They report about their operative technic, the indications, post-operative treatment and analyse their results. In connection with operative treatment of 251 patients with this method they emphasize that the bundle-nailing of Hackethal is by correct indication a method of tried integrity in these days, too. PMID:1877099

Kovalkovits, I; Habis, G



[Multimorbid patients with poor soft tissue conditions: treatment of distal tibia fractures with retrograde intramedullary nailing].  


The appropriate treatment of a distal tibia fracture in multimorbid patients with poor soft tissue and skin conditions, poor peripheral blood supply and osteopenic bone is challenging. In this case report we present two patients with these characteristics. Given these exceptional conditions none of the conventional therapies (e.g. cast, internal plate fixation, external fixation, anterograde intramedullary nailing) appeared feasible. To achieve sufficient fracture healing, we chose an unconventional treatment approach of retrograde tibial nailing with inclusion of the ankle and subtalar joint. PMID:23052700

Loosen, S; Preuss, S; Zelle, B A; Pape, H-C; Tarkin, I S



Variations in mature market consumer behavior within a health care product: implications for marketing strategy.  


America is undergoing a profound age shift in its demographic make-up with people 55 and over comprising an increasing proportion of the population. Marketers may need to increase their response rate to this shift, especially in refining the application of marketing theory and practice to older age consumers. To this end, a survey of older couple buying behavior for health insurance coverage is reported here. Results clarify evaluative criteria and the viability of multiple market segmentation for health care coverage among older consumers as couples. Commentary on the efficacy of present health coverage marketing programs is provided. PMID:10143892

Hopper, J A; Busbin, J W



[From the production to the use of research results in care practice: a consolidating experience].  


Although it is desirable that professionals use research results, often they are not prepared for that. This article aims to present the process of development and establishment of innovations, based on Rogers' model, through strategies to train nurses to use the best evidences for a quality clinical practice. It is a partnership between a educational institution and a hospital care institution. Following identification of problems from nurses' own practice in a health institution research proposals were developed to search for evidences and to test interventions. Results of this experience evidenced the viability of use of a model presented as a methodological framework what contributed to reach the institutions' goal. PMID:21103785

de Carvalho, Emília Campos; Laus, Ana Maria; Caliri, Maria Helena Larcher; Rossi, Luci Grupioni


Foaming and emulsifying properties of soy protein isolate and hydrolysates in skin and hair care products  

Microsoft Academic Search

There is a growing market for formulating proteins into a wide variety of products including laundry detergents, bath products,\\u000a shampoos, and skin cleansers. Soy protein isolate (SPI), soy protein hydrolysate A (SPHA) from papainmodified SPI, and hydrolysate\\u000a B from papain- and proteasemodified SPI were used in blends with three major detergents, sodium dodecyl sulfate (SDS), sodium\\u000a laureth sulfate (SLS), and

Wu Wu; N. S. Hettiarachchy



Spurious claims for health-care products: an experimental approach to evaluating current UK legislation and its implementation.  


The lay media, and especially the Internet, contain many misleading claims for health products which have previously been inadequately regulated by consumer law. This was an experimental interventional survey within a consumer health-care setting. Three health products were chosen on the basis of being widely available on the UK market and having no available evidence of effectiveness. Twelve volunteers submitted 39 complaints to Consumer Direct (UK portal for the regulator Trading Standards) regarding false health claims, and 36 complaints were followed up for a maximum of 4.8 months. The mean time from submission of complaints to Consumer Direct to acknowledgement by the relevant Trading Standards office was 13 days. There were no responses from Trading Standards for 22% of complaints. At the end of the study one supplier had amended their website following Trading Standards advice, but did not stop all health claims. Another stopped advertising their product on the Internet and the third continued the health claims unchanged. EU directive 2005/29/EC is largely ineffective in preventing misleading health claims for consumer products in the UK. PMID:22403120

Rose, Leslie B; Posadzki, Paul; Ernst, Edzard



Mom and Baby Skin Care  


... 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 ...


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.

Bagat, Mario; Drakulic, Velibor; Sekelj Kauzlaric, Katarina; Vlahusic, Andro; Bilic, Ivica; Matanic, Dubravka



[The effectiveness of hand hygiene products on MRSA colonization of health care workers by using CHROMagar MRSA].  


The aims of this study were; to investigate the hand hygiene compliance of the health care workers (HCWs) during their routine patient care, to determine the methicillin-resistant Staphylococcus aureus (MRSA) hand colonization of the HCWs, to investigate the effect of different hand hygiene products on MRSA colonization and to evaluate the effectiveness of chromogenic agar for detecting MRSA. HCWs were investigated during their routine patient care and hand cultures were taken before and after hand wash/hygiene. Two different techniques were used to obtain the hand cultures: fingertip method (CHROMagar MRSA containing HygiSlide); and direct swab method and then inoculation to CHROMagar MRSA media. MRSA strains grown on those cultures were confirmed with conventional methods. A total of 100 HCWs (of them 61 were female; mean age: 32.7 ± 5.2 years; age range: 25-51 years) involving physicians (n= 33), nurses (n= 38) and health care assistants (n= 29), were included in the study. MRSA was detected in 39% and 11% before hand hygiene and in 13% and 6% after hand hygiene, with HygiSlide CHROMagar media and with CHROMagar in plate media, respectively. No difference were found regarding clinics, occupations, or the type of patient handling in those HCWs who were positive (n= 13) for MRSA colonization following hand hygiene, and those who were negative (n= 26). However, the type of the hand hygiene product used exhibited a statistical difference. None of the seven HCWs who used alcohol based hand rub revealed growth in the second culture while 10 of 19 (53%) HCWs who used soap and three of 13 (23%) HCWs who used chlorhexidine were still colonized with MRSA. In terms of reduction in the MRSA counts, the most effective one was the alcohol based hand rub while the soap was the least, since seven of 19 (37%) HCWs who used soap showed no reduction at all in the MRSA counts. A high ratio of hand colonization with MRSA was detected in our hospital staff (39%). It was shown that the colonization could be reduced significantly (with a rate of 66%) with hand hygiene. Alcohol based hand rub was found to be the most effective method in hand hygiene. The fingertip technique was found to be superior to inoculation to plate media for obtaining hand cultures and CHROMagar MRSA media was found to be rapid, effective and practical for detecting the MRSA hand colonization. PMID:22639312

Koçak Tufan, Zeliha; Irmak, Hasan; Bulut, Cemal; Cesur, Salih; K?n?kl?, Sami; Demiröz, Ali Pekcan



Comparative efficacy and safety of amorolfine nail lacquer 5% in onychomycosis, once-weekly versus twice-weekly.  


Amorolfine is a new topical antifungal of the phenylpropyl morpholine class which is highly active both in vitro and in vivo against yeasts, dermatophytes and moulds responsible for superficial fungal infections. Human pharmacological studies have established that amorolfine has a persistent antifungal effect in the nail bed and in the skin without being systemically absorbed. This has been confirmed by clinical work showing that amorolfine is effective in treating dermatomycoses and onychomycoses when administered as cream or nail lacquer. It is ineffective when given orally for systemic mycoses or bacterial infections in animals. In earlier studies a 5% concentration of amorolfine nail lacquer was found to produce a better cure rate in onychomycosis than a lower concentration of 2%. From data available on the penetration of amorolfine and on the persistence of mycologically relevant tissue concentrations, it appeared likely that once- or twice-weekly application of nail lacquer should suffice to produce a satisfactory therapeutic effect in onychomycosis. The aim of this investigation was to assess the efficacy and tolerability of 5% amorolfine nail lacquer given once versus twice weekly to patients with onychomycosis of finger nails and toe nails. PMID:1458665

Reinel, D; Clarke, C



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…

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



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



Survey of the Positioning Accuracy of Nail Plates for Trussed Rafter Manufacture.  

National Technical Information Service (NTIS)

A general survey of trussed rafter manufacture was carried out by TRADA in 1979 which highlighted a problem concerning the accuracy of the positioning of nail plates in trussed rafter manufacture. The aims of this survey were to find out whether a propose...



[Knee arthrodesis performed with intramedullary nailing technique in failed total knee replacement--a preliminary report].  


Knee arthrodesis is the method of choice in treatment of failed total knee replacement. It is recommended when revisory total knee replacement is impossible. The authors present 2 cases of knee fusions using intramedullary nails after prosthesis loosening (1 aseptic, 1 septic). In both cases good results were achieved, with no complications observed during convalescence. PMID:15307386

Ga?dzik, Tadeusz Szymon; Kotas-Strzoda, Justyna; Bozek, Marek



Role of gamma nail in management of pertrochanteric fractures of femur  

PubMed Central

Background: Pertrochanteric fractures which involve trochanteric fractures with varying fracture geometry pose a significant challenge to the treating orthopedic surgeon. The aim of this study is to evaluate the management of pertrochanteric fractures of the femur using gamma nail [Asia pacific (AP)]. Materials and Methods: Sixty patients of pertrochanteric fractures were treated by closed reduction internal fixation by gamma nail from 1 January 1993 to 31 December 2000. Four patients were lost to follow-up. The remaining 56 patients were followed for a mean period of 3.2 years (range 2-4 years).The results were evaluated by assessing the patients regarding their clinical and functional outcome at follow-up as per Kyle's criteria. Results: Peroperative jamming of nail (n = 1), failed distal locking (n = 1), superior cut out of lag screw (n = 1) and postoperative varus malreduction (n = 1) were the complications observed. End results were excellent in 46.34%, good in 36.58%, fair in 14.64%, poor in 2.43%. Conclusion: Gamma nail in expert hands is a suitable implant for management of pertrochanteric fractures of the femur.

Sharma, Vipin; Babhulkar, Sushrut; Babhulkar, Sudhir



Expandable intramedullary nailing and platelet rich plasma to treat long bone non-unions  

PubMed Central

Background Roentgenographic and functional outcomes of expandable self locking intramedullary nailing and platelet rich plasma (PRP) gel in the treatment of long bone non-unions are reported. Materials and methods Twenty-two patients suffering from atrophic diaphyseal long bone non-unions were enrolled in the study. Patients were treated with removal of pre-existing hardware, decortication of non-union fragments, and fixation of pseudoarthrosis with expandable intramedullary nailing (Fixion™, Disc’O Tech, Tel Aviv, Israel). At surgery, PRP was placed in the pseudoarthrosis rim. Results The thirteen-month follow-up showed 91% (20/22 patients) of patients attaining bony union. The average time to union was 21.5 weeks. No infection, neurovascular complication, rotational malalignment, or limb shortening >4 mm were observed. The healing rate of non-unions was comparable to that observed in previous studies but with a lower complication frequency. Conclusions The combined use of self locking intramedullary nailing and PRP in the management of atrophic diaphyseal long bone non-unions seems to produce comparable results with less complications than previously reported. Further data are warranted to investigate the single contribution of PRP gel and Fixion nail.

Mariconda, Massimo; Romano, Gaetano; Capuano, Nicola; Romano, Luigi; Ianno, Bruno; Milano, Carlo




EPA Science Inventory

The research program surveyed and evaluated the methods and procedures to identify and quantitate chemical constituents in human tissues and fluids including fat, skin, nails, hair, blood, and urine. These methods have been evaluated to determine their ease and rapidity, as well ...


Structure of Water, Proteins, and Lipids in Intact Human Skin, Hair, and Nail  

Microsoft Academic Search

Raman spectroscopy is a nondestructive analytical method for determining the structure and conformation of molecular compounds. It does not require sample preparation or pretreatment. Recently, near-infrared Fourier transform Raman spectroscopy has emerged as being specially suited for investigations of biologic material. In this study, we obtained near-infrared Fourier transform Raman spectra of intact human skin, hair, nail, and stratum corneum.

Monika Gniadecka; Ole Faurskov Nielsen; Daniel Højgaard Christensen; Hans Christian Wulf



Early results of retrograde expandable nail fixation of 29 distal femoral fractures.  


The authors retrospectively reviewed 27 consecutive patients with 29 fractures of the distal femur treated with the new retrograde expandable nail. One 10-mm diameter nail that expands to 16 mm was used with the possibility of locking in the condylar area only. Retrieved data included single versus multiple injuries, fracture type, operation time, reaming or nonreaming, hospitalization and healing times, and intra- and postoperative complications. The overall average operation time was 96 (range 40-320) minutes, but only 65 (range 40-120) minutes for isolated fractures. The overall mean hospitalization time was 16 (range 3-40) days, but only 7 (range 4-10) days for isolated fractures. Follow-up continued until fracture healing or for a minimum of 1 year (average 14 months, range 12-24 months). The average clinical union time was 83 (range 43-179) days, and the mean radiographic healing was 87 (range 43-179) days. One patient developed a nonunion that required exchange of the nail to the same device. Another patient underwent hardware removal during a procedure for a torn meniscus. These preliminary results demonstrate satisfactory healing and alignment for the treatment of distal femoral shaft fractures by means of this new device without jeopardizing the knee joint by nail protrusion. PMID:21502204

Steinberg, Ely Liviu; Elis, Yacov; Shasha, Nadav; Luger, Elchanan



Ciclopirox nail lacquer topical solution 8% in the treatment of toenail onychomycosis  

Microsoft Academic Search

Background: Onychomycosis is a relatively common condition affecting toenails more than fingernails. It is caused predominantly by dermatophytes. Onychomycosis can cause pain and discomfort and has the potential to be a source of morbidity. Objective: We evaluated the efficacy and safety of ciclopirox nail lacquer solution 8% used to treat onychomycosis of the toe in the United States and in

Aditya K. Gupta; Philip Fleckman; Robert Baran



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


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)



Nanotribological effects of hair care products and environment on human hair using atomic force microscopy  

Microsoft Academic Search

Tribological properties are useful in the study of human hair and other biological materials. Major sources of investigation for conditioner treated hair includes localization of conditioner, mechanisms related to changes in surface roughness, friction, and adhesion on the nanoscale due to conditioner agents, and how the products change the microstructure of the cuticle. The paper presents nanotribological studies investigating surface

Carmen Latorre; Bharat Bhushan



Runoff of pharmaceuticals and personal care products following application of biosolids to an agricultural field  

Microsoft Academic Search

Municipal biosolids are a source of nutrients for crop production. Beneficial Management Practices (BMPs) can be used to minimize the risk of contamination of adjacent water resources with chemical or microbial agents that are of public or environmental health concern. In this field study, we applied biosolids slurry at a commercial rate using either subsurface injection or broadcast application followed

Edward Topp; Sara C. Monteiro; Andrew Beck; Bonnie Ball Coelho; Alistair B. A. Boxall; Peter W. Duenk; Sonya Kleywegt; David R. Lapen; Michael Payne; Lyne Sabourin; Hongxia Li; Chris D. Metcalfe



An adaptive approach to facilitating research productivity in a primary care clinical department.  


Efforts to foster the growth of a department's or school's research mission can be informed by known correlates of research productivity, but the specific strategies to be adopted will be highly context-dependent, influenced by local, national, and discipline-specific needs and resources. The authors describe a multifaceted approach-informed by a working model of organizational research productivity-by which the University of Minnesota Department of Family Medicine and Community Health (Twin Cities campus) successfully increased its collective research productivity during a 10-year period (1997-2007) and maintained these increases over time.Facing barriers to recruitment of faculty investigators, the department focused instead on nurturing high-potential investigators among their current faculty via a new, centrally coordinated research program, with provision of training, protected time, technical resources, mentoring, and a scholarly culture to support faculty research productivity. Success of these initiatives is documented by the following: substantial increases in the department's external research funding, rise to a sustained top-five ranking based on National Institutes of Health funding to U.S. family medicine departments, later-stage growth in the faculty's publishing record, increased research capacity among the faculty, and a definitive maturation of the department's research mission. The authors offer their perspectives on three apparent drivers of success with broad applicability-namely, effective leadership, systemic culture change, and the self-awareness to adapt to changes in the local, institutional, and national research environment. PMID:23702527

Weber-Main, Anne Marie; Finstad, Deborah A; Center, Bruce A; Bland, Carole J



High-level aminoglycoside resistance and beta-lactamase production in enterococci at a tertiary care hospital in India.  


Enterococci, a family of important opportunistic pathogens, exhibits intrinsic resistance to a number of antimicrobial agents in addition to acquired multidrug resistance. The present study was conducted to determine whether enterococci at a tertiary care hospital in India exhibit high-level aminoglycoside resistance and beta-lactamase production. Enterococci were isolated from various clinical specimens and identified phenotypically. High-level resistance (HLR) to gentamicin, kanamycin, and streptomycin was determined by disc diffusion tests. Beta-lactamase production was detected using three methods: iodometric, acidometric, and chromogenic beta-lactamase assays. Among the 86 enterococci isolated, 34 were found to have HLR to one or more aminoglycosides; HLR to kanamycin was most common. Vancomycin resistance was present in four of the isolates. Only one enterococcus produced beta-lactamase, and it was sensitive to ampicillin on routine disc diffusion testing. Beta-lactamase production among enterococci, though not very common, may be missed on routine susceptibility testing. Frequent occurrence of HLR to kanamycin makes amikacin a poor choice for inclusion in combination therapy with cell wall-active agents. PMID:19305061

Agarwal, Jyotsna; Kalyan, Rajkumar; Singh, Mastan



Simultaneous Use of Cannulated Reamer and Schanz Screw for Closed Intramedullary Femoral Nailing  

PubMed Central

Introduction. Closed reduction is a critical component of the intramedullary nailing and at times can be difficult and technically challenging resulting in increased operative time. Fluoroscopy is used extensively to achieve closed reduction which increases the intra-operative radiation exposure. Materials and Methods. Sixty patients with femoral diaphyseal fractures treated by locked intramedullary nailing were randomized in two groups. In group I, fracture reduction was performed under fluoroscopy with a cannulated reamer in the proximal fragment or with simultaneous use of a cannulated reamer in the proximal fragment and a Schanz screw in the distal fragment. Patients in group II had fracture reduction under fluoroscopy alone. Results. Closed reduction was achieved in 29 patients in group I and 25 patients in group II. The guide wire insertion time, time for nail insertion and its distal locking, total operative time, and total fluoroscopic time were 26.57, 27.93, 68.03, and 0.19 minutes in group I, compared with 30.87, 27.83, 69.93, and 0.24 minutes in group II, respectively. The average number of images taken to achieve guide wire insertion, for nail insertion and its locking and for the complete procedure in group I, respectively, was 12.33, 25.27, and 37.6 compared with 22.1, 26.17, and 48.27, respectively, in group II. Conclusion. The use of cannulated reamer in proximal fragment as intramedullary joystick and Schanz screw and in the distal fragment as percutaneous joystick facilitates closed reduction of the fracture during closed intramedullary femoral nailing with statistically significant reduction in guide wire insertion time and radiation exposure.

Rohilla, Rajesh; Singh, Roop; Magu, Narender K.; Devgan, Ashish; Siwach, Ramchander; Sangwan, Sukhbir Singh



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.


Direct Detection of Pharmaceuticals and Personal Care Products from Aqueous Samples with Thermally-Assisted Desorption Electrospray Ionization Mass Spectrometry  

NASA Astrophysics Data System (ADS)

An ambient mass spectrometric method based on desorption electrospray ionization (DESI) has been developed to allow rapid, direct analysis of contaminated water samples, and the technique was evaluated through analysis of a wide array of pharmaceutical and personal care product (PPCP) contaminants. Incorporating direct infusion of aqueous sample and thermal assistance into the source design has allowed low ppt detection limits for the target analytes in drinking water matrices. With this methodology, mass spectral information can be collected in less than 1 min, consuming ~100 ?L of total sample. Quantitative ability was also demonstrated without the use of an internal standard, yielding decent linearity and reproducibility. Initial results suggest that this source configuration is resistant to carryover effects and robust towards multi-component samples. The rapid, continuous analysis afforded by this method offers advantages in terms of sample analysis time and throughput over traditional hyphenated mass spectrometric techniques.

Campbell, Ian S.; Ton, Alain T.; Mulligan, Christopher C.



Diurnal variability of pharmaceutical, personal care product, estrogen and alkylphenol concentrations in effluent from a tertiary wastewater treatment facility.  


Hourly samples of tertiary wastewater effluent were analyzed for 30 pharmaceuticals, personal care products, estrogenic steroids, and alkylphenols in order to better understand the rate at which these compounds enter the environment. Several distinct patterns of daily cycling were observed, and were characterized as three separate categories. The concentrations of compounds such as trimethoprim, sulfamethoxazole, naproxen, estrone, and triclosan varied greatly during a daily cycle, with relative standard deviations exceeding 100% of their daily mean. Less extreme daily cycles were seen for other compounds such as azithromycin, atenolol, tert-octylphenol, iopromide and gemfibrozil. Peak concentrations for most compounds occurred in the early evening (5-8 pm). However, some compounds including carbamazepine, primidone, fluoxetine, and triclocarban exhibited little or no variability. PMID:21189012

Nelson, Eric D; Do, Huy; Lewis, Roger S; Carr, Steve A



Determination of organic micro-pollutants such as personal care products, plasticizers and flame retardants in sludge.  


In this study, a method for the determination of organic micro-pollutants, i.e. personal care products such as synthetic musk fragrances, household bactericides, organophosphate flame retardants and plasticizers, as well as phthalates in sludge, has been developed. This method is based on lyophilisation and accelerated solvent extraction followed by clean-up steps, i.e. solid phase extraction and size exclusion chromatography. The determination is performed by gas chromatography coupled to mass spectrometry. Stable isotope-labelled compounds such as musk xylene (MX D15), tri-n-butylphosphate (TnBP D27) and triphenylphosphate (TPP D15) were used as internal standards. Recovery rates were determined to be 36-114% (with typical relative standard deviation of 5% to 23%) for the target compounds. The limit of detection was 3-30 ng g(-1), and the limit of quantification was 10-100 ng g(-1) dry matter. PMID:19779701

Chen, Xijuan; Bester, Kai



Reproduction-induced neuroplasticity: natural behavioural and neuronal alterations associated with the production and care of offspring.  


As a female transitions into motherhood, many neurobiological adaptations are required to meet the demands presented by her offspring. In addition to the traditional maternal responses (e.g. crouching, nursing, retrieving, grooming), our laboratories have observed several behavioural modifications accompanying parity, especially in the areas of foraging and emotional resilience. Additionally, brain modifications have been observed in the hippocampus and amygdala, providing support for neural plasticity extending beyond the expected hypothalamic alterations. Interestingly, we have observed parenting-induced neuroplasticity to persist into late adulthood, even providing protection against age-related brain and memory deficits. Although the majority of work on the parental brain has been conducted on females, preliminary research suggests similar changes in the biparental male California deer mouse. Taken together, research suggests that the parental brain is dynamic and changeable as it undergoes diverse and, in some cases, long-lasting, modifications to facilitate the production and care of offspring. PMID:18266940

Kinsley, Craig H; Lambert, Kelly G



Ranking of concern, based on environmental indexes, for pharmaceutical and personal care products: An application to the Spanish case.  


A wide range of Pharmaceuticals and Personal Care Products (PPCPs) are present in the environment, and many of their adverse effects are unknown. The emergence of new compounds or changes in regulations have led to dynamical studies of occurrence, impact and treatment, which consider geographical areas and trends in consumption and innovation in the pharmaceutical industry. A Quantitative study of Structure-Activity Relationship ((Q)SAR) was performed to assess the possible adverse effects of ninety six PPCPs and metabolites with negligible experimental data and establish a ranking of concern, which was supported by the EPA EPI Suite™ interface. The environmental and toxicological indexes, the persistence (P), the bioaccumulation (B), the toxicity (T) (extensive) and the occurrence in Spanish aquatic environments (O) (intensive) were evaluated. The most hazardous characteristics in the largest number of compounds were generated by the P index, followed by the T and B indexes. A high number of metabolites has a concern score equal to or greater than their parent compounds. Three PBT and OPBT rankings of concern were proposed using the total and partial ranking method (supported by a Hasse diagram) by the Decision Analysis by Ranking Techniques (DART) tool, which was recently recommended by the European Commission. An analysis of the sensibility of the relative weights of these indexes has been conducted. Hormones, antidepressants (and their metabolites), blood lipid regulators and all of the personal care products considered in this study were at the highest levels of risk according to the PBT and OPBT total rankings. Furthermore, when the OPBT partial ranking was performed, X-ray contrast media, H2 blockers and some antibiotics were included at the highest level of concern. It is important to improve and incorporate useful indexes for the predicted environmental impact of PPCPs and metabolites and thus focus experimental analysis on the compounds that require urgent attention. PMID:23995140

Ortiz de García, Sheyla; Pinto, Gilberto Pinto; García-Encina, Pedro A; Mata, Rubén Irusta



Critical factors in cut-out complication after gamma nail treatment of proximal femoral fractures  

PubMed Central

Background The most common mechanical failure in the internal fixation of trochanteric hip fractures is the cut-out of the sliding screw through the femoral head. Several factors that influence this complication have been suggested, but there is no consensus as to the relative importance of each factor. The purpose of this study was to analyse the cut-out complication with respect to the following variables: patients’ age, fracture type, fracture reduction, implant positioning and implant design. Methods 3066 consecutive patients were treated for trochanteric fractures with Gamma Nails between 1990 and 2002 at the Centre de Traumatologie et de l`Orthopedie (CTO), Strasbourg, France. Cut-out complications were identified by reviewing all available case notes and radiographs. Subsequently, the data were analysed by a single reviewer (AJB) with focus on the studied factors. Results Seventy-one cut-out complications were found (2.3%) of the 3066 trochanteric fractures. Cut-out failure associated with avascular head necrosis, pathologic fracture, deep infection or secondary to prior failure of other implants were excluded from the study (14 cases). The remaining 57 cases (1.85 %, median age 82.6, 79% females) were believed to have a biomechanical explanation for the cut-out failure. 41 patients had a basicervical or complex fracture type. A majority of cut-outs (43 hips, 75%) had a combination of the critical factors studied; non-anatomical reduction, non-optimal lag screw position and the characteristic fracture pattern found. Conclusions The primary cut-out rate of 1.85% was low compared with the literature. A typical cut-out complication in our study is represented by an unstable fracture involving the trochanteric and cervical regions or the combination of both, non-anatomical reduction and non-optimal screw position. Surgeons confronted with proximal femoral fractures should carefully scrutinize preoperative radiographs to assess the primary fracture geometry and fracture classification. To reduce the risk of a cut-out it is important to achieve both anatomical reduction and optimal lag screw position as these are the only two factors that can be controlled by the surgeon.



Impact of health care information technology on hospital productivity growth: a survey in 17 acute university hospitals.  


The quantification of the added value of information technologies (IT) in the health sector is a major issue for decision-makers and health care professionals. This paper relates the application of an economic production function in hospitals with different integration levels of their clinical information systems (CIS). The study concerns 17 university hospitals within the Assistance Publique Hôpitaux de Paris group that were followed from 1998 to 2005. Using an extended Cobb-Douglas production function, yearly incomes (Y) were correlated with three inputs: capital (K), labor (L) and IT expenses (T). The results indicate that incomes are significantly and positively associated with the three input variables with elasticity coefficients: alpha, beta and gamma of 0.81, 0.17, and 0.09 that appear to be in the range of values found in secondary and tertiary sectors. The IT elasticity coefficient (gamma) is higher in the subgroup of 6 hospitals that integrate, or started to integrate, a complete CIS within the study period than in the 11 reference hospitals. In a general production function, hospital costs appear to be positively connected to the level of IT expenses, capital and labor. Calculations in two subgroups of AP-HP hospitals divided according to the importance of the IT integration level seem to indicate that the more the clinical information system is integrated, the more its influence is positive in hospital production. The results of this first survey are sufficiently encouraging to try to refine them (better granularity) and to spread them in time (over a longer period) and space (to other hospital structures). PMID:17911707

Meyer, Rodolphe; Degoulet, Patrice; Omnes, Louis



77 FR 12556 - Certain Steel Nails From the People's Republic of China: Final Results and Final Partial...  

Federal Register 2010, 2011, 2012, 2013

...companies within the country are subject to government control and, thus, should...merchandise in an NME country this single rate of government control, the Department determined...Nanjing Dayu Pneumatic Gun Nails Co.,...



76 FR 16379 - Certain Steel Nails From the People's Republic of China: Final Results of the First Antidumping...  

Federal Register 2010, 2011, 2012, 2013

...companies within the country are subject to government control and, thus, should...merchandise in an NME country this single rate facto and de jure control could not be verified...Nanjing Dayu Pneumatic Gun Nails Co.,...



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



"Make or buy" decisions in the production of health care goods and services: new insights from institutional economics and organizational theory.  

PubMed Central

A central theme of recent health care reforms has been a redefinition of the roles of the state and private providers. With a view to helping governments to arrive at more rational "make or buy" decisions on health care goods and services, we propose a conceptual framework in which a combination of institutional economics and organizational theory is used to examine the core production activities in the health sector. Empirical evidence from actual production modalities is also taken into consideration. We conclude that most inputs for the health sector, with the exception of human resources and knowledge, can be efficiently produced by and bought from the private sector. In the health services of low-income countries most dispersed production forms, e.g. ambulatory care, are already provided by the private sector (non-profit and for-profit). These valuable resources are often ignored by the public sector. The problems of measurability and contestability associated with expensive, complex and concentrated production forms such as hospital care require a stronger regulatory environment and skilled contracting mechanisms before governments can rely on obtaining these services from the private sector. Subsidiary activities within the production process can often be unbundled and outsourced.

Preker, A. S.; Harding, A.; Travis, P.



Comparing the environmental footprints of home-care and personal-hygiene products: the relevance of different life-cycle phases.  


An in-depth life-cycle assessment of nine home-care and personal-hygiene products was conducted to determine the ecological relevance of different life-cycle phases and compare the environmental profiles of products serving equal applications. Using detailed data from industry and consumer-behavior studies a broad range of environmental impacts were analyzed to identify the main drivers in each life-cycle stage and potentials for improving the environmental footprints. Although chemical production significantly adds to environmental burdens, substantial impacts are caused in the consumer-use phase. As such, this research provides recommendations for product development, supply chain management, product policies, and consumer use. To reduce environmental burdens products should, for instance, be produced in concentrated form, while consumers should apply correct product dosages and low water temperatures during product application. PMID:20028065

Koehler, Annette; Wildbolz, Caroline



N-acetylcysteine versus placebo for treating nail biting, a double blind randomized placebo controlled clinical trial.  


Nail biting is a common behavioral problem. While there are established behavioral interventions for management, they are of modest efficacy, and there is minimal evidence for effective pharmacotherapy. This study investigated the role of N-acetylcysteine (NAC) a potent glutathione and glutamate modulator for the treatment of pathological nail biting in children and adolescents. This pilot randomized, double-blind, placebo-controlled clinical trial of NAC (800 mg/day) or placebo enrolled 42 children and adolescents with chronic nail biting. Nail length was the objective outcome. Evaluations were carried out three times; before treatment, one month after enrollment in the study, and two months after enrollment. The duration (chronicity) of nail biting in the NAC and placebo groups was 3.63(2.45) and 5.09(3.74) years (P=0.14). The mean nail length gradually increased in both the NAC and placebo groups during this trial. There was a statistically significant difference between the two groups regarding increased nail length after the first month of trial [(5.21(5.75) and 1.18(3.02) millimeters], however no difference after two months was observed. Two patients in the NAC group discontinued medication due to adverse events. One patient experienced headache, agitation, and social withdrawal, and another patient expressed severe aggression after taking medication and was withdrawn from the study. This study supports the hypothesis that NAC decreases nail biting behavior in children and adolescents over the short term. NAC is relatively well tolerated and severe adverse effects are rare. However, there was a high rate of dropout. Further studies with longer durations that build on these preliminary data are recommended. This study is registered at the Iranian Registry of Clinical Trials (Irct registration number: IRCT201103023930N3). PMID:23651231

Ghanizadeh, Ahmad; Derakhshan, Nima; Berk, Michael



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


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 µm(2). 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 mm(2)) 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:23969703

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



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


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). T