Science.gov

Sample records for nail care products

  1. Nail Care Products

    MedlinePLUS

    ... premarket approval authority, with the exception of most color additives. However, FDA may pursue enforcement action against violative products, or against firms or individuals who violate the law (See FDA Authority Over Cosmetics ). While FDA regulates the ...

  2. Artificial Nails Require Care to Keep Nails Healthy

    MedlinePLUS

    ... Z Health and beauty Nail care Artificial nails Artificial nails require care to keep nails healthy Acrylic ... people can safely wear artificial nails. Before applying artificial nails Apply artificial nails only to healthy nails. ...

  3. Artificial Nails Require Care to Keep Nails Healthy

    MedlinePLUS

    ... Bumps and growths Color problems Contagious skin diseases Cosmetic treatments Dry / sweaty skin Eczema / dermatitis Hair and ... MJ, Scher RK. “Nail diseases related to nail cosmetics.” Dermatol Clin. 2006 Apr;24(2):233-9. - ...

  4. Teaching Your Child Healthy Nail Care

    MedlinePLUS

    ... the hands well. Teaching children to dry their hands well is important. If nails stay wet for a while, a nail infection can develop. 3. Rub lotion on the fingernails. Nails need moisturizing to ...

  5. Nail Disease for the Primary Care Provider.

    PubMed

    Biesbroeck, Lauren K; Fleckman, Philip

    2015-11-01

    Nail disorders are commonly seen by both primary practitioners and dermatologists. Nail disease spans a broad variety of diagnoses, including infectious, inflammatory, and neoplastic disorders. Dermatophyte onychomycosis can have clinical findings that overlap with other disorders, mandating adequate diagnosis before treatment is initiated. Periungual verrucae typically respond to keratolytics or cryotherapy, but may require topical immunotherapy or intralesional injections. Any verruca recalcitrant to treatment should undergo biopsy to rule out squamous cell carcinoma. Patients with longitudinal melanonychia or erythronychia involving a single digit should be evaluated by a dermatologist, with biopsy of nail matrix considered to rule out underlying malignancy. PMID:26476249

  6. Teaching Your Child Healthy Nail Care

    MedlinePLUS

    ... nails. 5. Eat foods that contain plenty of protein and vitamin B7 (also called biotin). Meat, fish, milk, walnuts, almonds, and eggs are rich in protein and vitamin B7. These foods help to keep ...

  7. Nails

    MedlinePLUS

    ... hand. On average, fingernails grow 3.5 millimeters (mm) per month, while toenails grow an average of 1.6 mm per month. 1 Nail growth rates depend on ... see a dermatologist. 1. Yaemsiri S, Hou N, Slining MM, He K. Growth rate of human fingernails and ...

  8. What's Wrong with Biting My Nails?

    MedlinePLUS

    ... Puberty Video: Am I Normal? (Girls and Puberty) Movie: Digestive System How the Body Works Main Page ... For Kids For Parents MORE ON THIS TOPIC Movie: Nails Your Nails Activity: The Nails Taking Care ...

  9. Nail abnormalities

    MedlinePLUS

    Nail abnormalities are problems with the color, shape, texture, or thickness of the fingernails or toenails. ... Fungus or yeast cause changes in the color, texture, and shape of the nails. Bacterial infection may ...

  10. Your Nails

    MedlinePLUS

    ... Puberty Video: Am I Normal? (Girls and Puberty) Movie: Digestive System How the Body Works Main Page ... THIS TOPIC Blisters, Calluses, and Corns Athlete's Foot Movie: Nails Word Find: Nails What's Wrong With Biting ...

  11. Fungal nail infection

    MedlinePLUS

    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 ...

  12. Fungal Nail Infection (Onychomycosis)

    MedlinePLUS

    ... disorders. In the most common form of fungal nail infections, fungus grows under the growing portion of the nail ... doctor may perform testing, such as scraping a nail to examine for fungi or clipping a nail to look for bacterial ...

  13. Yellow nails, lymphedema and chronic cough: Yellow nail syndrome in an eight-year-old girl

    PubMed Central

    Siddiq, Ishita; Hughes, Daniel

    2012-01-01

    Yellow nail syndrome is a rare disease and reported mainly in adults. A case of yellow nail syndrome involving an eight-year-old girl with associated discoloured yellowish nails on the fingers and toes, lymphedema and chronic cough, and sputum production is reported. PMID:22332131

  14. Nutrition and nail disease.

    PubMed

    Cashman, Michael W; Sloan, Steven Brett

    2010-01-01

    The nail is a specialized keratinous skin appendage that grows approximately 2 to 3 mm per month, with complete replacement achieved in 6 to 9 months. Although this structure can be easily overlooked, nail disorders comprise approximately 10% of all dermatologic conditions. This contribution first provides an overview on the basic anatomy of the nail that will delineate between the nail unit (eg, hyponychium, nail bed, proximal nail fold, and matrix) and anatomic components not part of the nail unit (eg, lateral nail folds, nail plate, and eponychium). The function of each nail structure will also be presented. The chemical profile of the normal nail plate is reviewed with a discussion of its keratin content (hair type keratin vs epithelial type keratin), sulfur content, and mineral composition, including magnesium, calcium, iron, zinc, sodium, and copper. The remainder will focus on nail manifestations seen in states of malnutrition. Virtually every nutritional deficiency can affect the growth of the nail in some manner. Finally, the discussion will include anecdotal use of nutritional and dietary supplements in the setting of brittle nail syndrome as well as a brief overview of biotin and its promising utility in the treatment of nail disorders. PMID:20620759

  15. Nailing Pompeii

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    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.”

  16. Investigation of Human Nail Microstructure with Ultrasound

    NASA Astrophysics Data System (ADS)

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

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

  17. Utility of Gel Nails in Improving the Appearance of Cosmetically Disfigured Nails: Experience with 25 Cases

    PubMed Central

    Nanda, Soni; Grover, Chander

    2014-01-01

    Background: Gel nails are a commonly used cosmetic procedure, though their use by dermatologists has not been evaluated. These can be used to improve the appearance of cosmetically disfigured nails where other treatment options have failed; the condition is self-limiting or irreversible; or to camouflage the dystrophy until healing. Materials and Methods: A prospective, uncontrolled, open-label study on 25 participants presenting with cosmetically disfigured nails was undertaken. Mycologically negative, consenting patients with various nail plate surface abnormalities like trachyonychia (n =8); superficial pitting (n =6); onychorrhexis (n =4); superficial pitting with onychoschizia (n =3); Beau's lines (n =3) and pterygium (n =1) were included. The patients received gel nail application using Ranara gel nail kit®. Extra care was taken to avoid any damage to cuticle. Standard pre- and post-treatment photographs were taken to assess improvement. Patient satisfaction score (1-10); Global assessment score of improvement (no improvement to excellent improvement) and any side effects reported were recorded. Results: The average age of treated patients was 30.44±11.39 years (range 18-60 years). A total of 69 nails were treated (average of 2.76 per patient). Post-procedure, the average patient satisfaction score was 9.08 ± 0.86 (range 7-10). The Global assessment showed excellent improvement (40% cases); good improvement (56% cases) and mild improvement in the single case of pterygium treated. Conclusions: The use of Gel nails in patients with cosmetically disfiguring nail plate surface abnormalities (like trachyonychia, onychoschizia, pitting, etc.) was found to produce good to excellent improvement in most of the cases. The patient satisfaction with the procedure was rated as high. This, coupled with absence of side effects, make gel nails a valuable tool in improving cosmesis and satisfaction among patients presenting with nail plate surface abnormalities. Further studies with larger number of patients are required to assess the impact these prostheses can have. PMID:24761096

  18. Common nail changes and disorders in older people

    PubMed Central

    Abdullah, Lina; Abbas, Ossama

    2011-01-01

    Abstract Objective To present family physicians with common nail alterations and disorders occurring in the elderly population and their management options. Quality of evidence The evidence relating to different nail conditions is mostly derived from randomized controlled trials, meta-analyses, and review articles. However, given the scarcity of evidence on some conditions, articles with weaker levels of evidence were also included in our review. Main message Given the growing elderly population and the associated demographic changes and longer lifespans, geriatric care is becoming more of a complicated and multidisciplinary effort in which the role of the family physician is increasingly important. Although common among the elderly, nail changes are often not brought to the attention of primary caregivers and are thus overlooked. These nail changes can affect various components of the nail unit and might represent normal age-related nail alterations or nail abnormalities that require immediate intervention. Knowledge and familiarity with these common nail abnormalities and their underlying causes is important for the family practitioner in order to effectively reach an accurate diagnosis and provide better care of this large and growing elderly population. Conclusion Nail changes are common in the elderly, and family physicians are best placed to diagnose and treat these common problems. It is important that family physicians also recognize less common but more serious nail problems that require immediate treatment. PMID:21321168

  19. Nail Fungal Infections

    MedlinePLUS

    ... know where or how you got a fungal nail infection. A warm, wet place is a good place for a fungus to grow. If you often wear heavy work ... in locker rooms, you can pick up a fungus from the warm, wet floors. ... fungal infections in their nails at the same time. This can happen because ...

  20. Skin, Hair, and Nails

    MedlinePLUS

    ... a fungus infection that can affect the skin, nails, or scalp. Fungi called dermatophytes can infect the skin and related ... is called tinea corporis; and ringworm of the nails is called tinea unguium. With tinea corporis, the fungi can cause scaly, ring-like lesions anywhere on ...

  1. Advanced Nail Surgery

    PubMed Central

    Haneke, Eckart

    2011-01-01

    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. PMID:22279381

  2. Interlocked Intramedullary Nail Without Fluoroscopy.

    PubMed

    Zirkle, Lewis G; Shahab, Faseeh; Shahabuddin

    2016-01-01

    Surgical Implant Generation Network (SIGN) was founded 15 years ago to create equality of fracture care throughout the world. This is done by education and supply of the appropriate implants and instruments to implement the education. SIGN implants have been used in 150,000 long bone fractures in developing countries. The same implants and instruments are used to provide intramedullary nail interlocking screw fixation in the tibia, femur, and humerus. The design of SIGN implants and the surgical technique are described. PMID:26614921

  3. Insights into drug delivery across the nail plate barrier.

    PubMed

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

    2014-11-01

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

  4. Unreamed femoral nailing.

    PubMed

    Abbas, D; Faisal, M; Butt, M S

    2000-11-01

    Sixty one femoral fractures treated with ACE unreamed titanium nail (AIM femoral nail, ACE Medical, Los Angeles, CA) were studied. Ten patients died before bony union and three were lost to follow up. Forty eight fractures were followed up for an average of 11.2 months (4-31 months). All fractures united except one in which plating and bone grafting was performed at 6 months due to failure of progression of union. The mean time to bony union was 6.2 months. There was no implant failure but one distal interlocking bolt broke at 6 weeks. No incidence of adult respiratory distress syndrome (ARDS) was observed. Malunion was seen in one patient whereas three cases had shortening of more than 2 cm. Our results show that unreamed femoral nailing using titanium nail is a safe and effective procedure for the treatment of femoral shaft fractures. PMID:11084159

  5. Women's exposure to phthalates in relation to use of personal care products.

    PubMed

    Parlett, Lauren E; Calafat, Antonia M; Swan, Shanna H

    2013-03-01

    Several phthalates, particularly diethyl phthalate (DEP) and di-n-butyl phthalate, can be used in personal care products (PCPs) to fix fragrance and hold color. We investigated associations between women's reported use of PCPs within the 24 h before urine collection and concentrations of several urinary phthalate metabolites. Between 2002 and 2005, 337 women provided spot urine samples and answered questions regarding their use of 13 PCPs at a follow-up visit 3-36 months after pregnancy. We examined associations between urinary concentrations of several phthalate metabolites and use of PCPs using linear regression. Use of individual PCPs ranged from 7% (nail polish) to 91% (deodorant). After adjusting for age, education, and urinary creatinine, women reporting use of perfume had 2.92 times higher (95% CI: 2.20-3.89) concentration of monoethyl phthalate (MEP; the primary metabolite of DEP) than other women. Other PCPs that were significantly associated with MEP concentrations included: hair spray, nail polish, and deodorant. MEP concentrations increased with the number of PCPs used. PCP use was widespread in this group of recently pregnant women. Women's use of PCPs, particularly of perfumes and fragranced products, was positively associated with urinary concentration of multiple phthalate metabolites. PMID:23168567

  6. Titanium exposure and yellow nail syndrome

    PubMed Central

    Ataya, Ali; Kline, Kristopher P.; Cope, Jessica; Alnuaimat, Hassan

    2015-01-01

    Yellow nail syndrome is a rare disease of unclear etiology. We describe a patient who develops yellow nail syndrome, with primary nail and sinus manifestations, shortly after amalgam dental implants. A study of the patient's nail shedding showed elevated nail titanium levels. The patient had her dental implants removed and had complete resolution of her sinus symptoms with no change in her nail findings. Since the patient's nail findings did not resolve we do not believe titanium exposure is a cause of her yellow nail syndrome but perhaps a possible relationship exists between titanium exposure and yellow nail syndrome that requires further studies.

  7. Dressings and Products in Pediatric Wound Care

    PubMed Central

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

    2014-01-01

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

  8. Household Products Database: Personal Care

    MedlinePLUS

    ... bubble bath care giving cleaner clipper lubricant cologne/fragrance concealer conditioner conditioner, dandruff contact lens cleaner cuticle ... foundation/liquid makeup foundation/liquid makeup w/SPF fragrance hair color hair conditioner hair lightener hair relaxer ...

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

    PubMed

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

    2014-02-01

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

  10. Nail as a window of systemic diseases

    PubMed Central

    Singal, Archana; Arora, Rahul

    2015-01-01

    Certain nail changes are specific for various dermatological disorders. In addition, examination of nails may also provide an insight into more sinister systemic manifestations in the form of both subtle as well as specific changes. These findings may present as a defect of various anatomical components of the nail unit; nail matrix, nail plate and/or nail bed or vasculature. This article is an attempt to equip the dermatologists with a foresight to suspect and diagnose the unapparent systemic connotations that may be possible by a simple but detailed nail examination. PMID:25821724

  11. Cleanser, Detergent, Personal Care Product Pretreatment Evaluation

    NASA Technical Reports Server (NTRS)

    Adam, Niklas

    2010-01-01

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

  12. 7 CFR 3201.97 - Sun care products.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  13. 7 CFR 3201.97 - Sun care products.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...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...

  14. Magnesium alloy wires as reinforcement in composite intramedullary nails.

    PubMed

    Morawska-Chochó?, Anna; Ch?opek, Jan; Domalik-Pyzik, Patrycja; Szaraniec, Barbara; Grzy?ka, Ewa

    2014-01-01

    A promising group of biomaterials assigned for the production of intramedullary nails are composites with a polylactide (PLA) matrix, reinforced with wires made of magnesium alloys and carbon fibres. The paper describes the effect of the composition of magnesium alloy wires, their number and orientation in the composite, as well as their connection with differently directed long carbon fibres, on the mechanical properties and the degradation rate of the obtained intramedullary nails. Among the tested implant prototypes, the best mechanical characteristics and a gradual and uniform course of magnesium alloy wires were exhibited by the PLA+CF1D+MgI composite nails (with a unidirectional orientation of carbon fibres and an axially oriented single Mg alloy wire). The strength of these nails became gradually decreased with the incubation time, which should allow for a gradual loading of the bone. In the case of the PLA with only magnesium alloy wires (without carbon fibres), the increase of the number of wires, on the one hand, stimulates the improvement of the nails' strength, yet on the other hand, a higher content of magnesium alloys in the PLA matrix affects the nails' faster resorption. PMID:24642977

  15. Scopulariopsis brevicaulis in nails.

    PubMed

    Onsberg, P

    1980-01-01

    Scopulariopsis brevicaulis was demonstrated in 226 out of 5,600 patients examined for abnormal toe-nails. Among 3,700 patients without onychomycosis S. brevicaulis was demonstrated as a contaminant in 2%. Onychomycosis, present in 1,925 patients, was caused by S. brevicaulis in 6%, but 10% of these cases were mixed infections with dermatophytes. In the approximately 1,800 cases of onychomycosis due to other reasons, S. brevicaulis was a contaminant in 2%. A specific finding of S. brevicaulis on direct microscopy is diagnostic, and a number of colonies greater than or equal to 10 supports the diagnosis, while in the presence of less than or equal to 3 colonies and no S. brevicaulis on direct microscopy the diagnosis is unlikely. Onychomycosis due to S. brevicaulis was most often diagnosed in elderly persons, with equal frequency in men and women. PMID:6447633

  16. Nail lengthening and fingertip amputations.

    PubMed

    Adani, Roberto; Marcoccio, Ignazio; Tarallo, Luigi

    2003-10-01

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

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

    PubMed Central

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

    2014-01-01

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

  18. Through-the-nail technique.

    PubMed

    Tsiridis, Eleftherios; Narvani, Amir Ali; Schizas, Constantin

    2005-04-01

    Ipsilateral fractures of the neck of the femur and the femoral shaft are uncommon injuries and they present considerable challenge as the concurrent survival of the femoral head and union of the femoral shaft fracture is of paramount importance. We present a young male patient who sustained a Garden IV fracture of the neck of his right femur following a road traffic accident, with the fracture being adjacent to an ipsilateral intramedullary nail inserted 10 years previously for a midshaft femoral fracture; the nail was broken, with its proximal fragment lying behind the greater trochanter. The patient was operated on within 6 hours from the injury. An attempt was made to remove the nail but this was abandoned as warring iatrogenic bone loss was encountered, due to the proximity of the fracture to the nail entry point. Instead, three cancellous lag-screws were inserted to fix the fracture in a triangular fashion. Two screws placed posteriorly behind the nail, and one anterior screw through the nail. PMID:16152859

  19. Nail damage from gel polish manicure.

    PubMed

    Chen, Andrea F; Chimento, Stacy M; Hu, Shasa; Sanchez, Margaret; Zaiac, Martin; Tosti, Antonella

    2012-03-01

    Manicures can result in nail damage via instrumentation, nail polish, nail polish removers, and artificial nails. We report nail weakness, brittleness, and thinning in five subjects after the application of a new manicure system called gel polish and removal with acetone and manual peeling. All subjects complained that the polish was very difficult to remove and that their nails became much thinner after the procedure. Pseudoleukonychia and onychoschizia lamellina were noted on examination. One subject underwent ultrasound and reflectance confocal microscopy (RCM) measurements of nail plate before and after the gel polish application, which showed thinned nail plate (0.063 vs. 0.050 cm and 0.059 vs. 0.030 cm, respectively). Overall, we call attention to the adverse effects of gel polish manicures in five subjects. In addition, our case illustrates potential utility of ultrasound and RCM in measuring nail plate thickness. PMID:22360331

  20. 7 CFR 3201.101 - Automotive care products.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... compounds, polishes, degreasers, soaps, wheel and tire cleaners, leather care products, interior cleaners... percent of the weight (mass) of the total organic carbon in the finished product. (c)...

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

    NASA Astrophysics Data System (ADS)

    Rauch, Cyril; Cherkaoui-Rbati, Mohammed

    2014-12-01

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

  2. The productivity of primary care research networks.

    PubMed Central

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

    2000-01-01

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

  3. 7 CFR 3201.82 - Foot care products.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 15 2014-01-01 2014-01-01 false Foot care products. 3201.82 Section 3201.82... Designated Items § 3201.82 Foot care products. (a) Definition. Products formulated to be used in the soothing or cleaning of feet. (b) Minimum biobased content. The Federal preferred procurement product...

  4. 7 CFR 3201.82 - Foot care products.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 15 2013-01-01 2013-01-01 false Foot care products. 3201.82 Section 3201.82... Designated Items § 3201.82 Foot care products. (a) Definition. Products formulated to be used in the soothing or cleaning of feet. (b) Minimum biobased content. The Federal preferred procurement product...

  5. 7 CFR 3201.97 - Sun care products.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 15 2014-01-01 2014-01-01 false Sun care products. 3201.97 Section 3201.97... Designated Items § 3201.97 Sun care products. (a) Definition. Products including sunscreens, sun blocks, and suntan lotions that are topical products that absorb or reflect the sun's ultraviolet radiation...

  6. Nail Splitting (Onychoschizia)

    MedlinePLUS

    ... and occupational exposure to various chemicals (alkalis, acids, cement, solvents, thioglycolates, salt, sugar solutions). Injury (trauma) may ... also effective, but they may cause an allergic reaction in the skin. When to Seek Medical Care ...

  7. [Nail plate susceptibility to Scopulariopsis brevicaulis infection].

    PubMed

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

    2002-01-01

    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

  8. Nail Psoriasis: The Journey So Far

    PubMed Central

    Dogra, Alka; Arora, Amanjot Kaur

    2014-01-01

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

  9. 7 CFR 735.105 - Care of agricultural products.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 7 2014-01-01 2014-01-01 false Care of agricultural products. 735.105 Section 735.105... § 735.105 Care of agricultural products. Each warehouse operator must at all times, including during any... agricultural products in their custody as required in the applicable licensing agreement....

  10. 7 CFR 3201.70 - Hair care products.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 15 2013-01-01 2013-01-01 false Hair care products. 3201.70 Section 3201.70... Designated Items § 3201.70 Hair care products. (a) Definitions. (1) Personal hygiene products specifically formulated for hair cleaning and treating applications, including shampoos and conditioners. (2) Hair...

  11. 7 CFR 3201.70 - Hair care products.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 15 2014-01-01 2014-01-01 false Hair care products. 3201.70 Section 3201.70... Designated Items § 3201.70 Hair care products. (a) Definitions. (1) Personal hygiene products specifically formulated for hair cleaning and treating applications, including shampoos and conditioners. (2) Hair...

  12. 7 CFR 3201.70 - Hair care products.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 15 2012-01-01 2012-01-01 false Hair care products. 3201.70 Section 3201.70... Designated Items § 3201.70 Hair care products. (a) Definitions. (1) Personal hygiene products specifically formulated for hair cleaning and treating applications, including shampoos and conditioners. (2) Hair...

  13. Wnt activation in nail epithelium couples nail growth to digit regeneration.

    PubMed

    Takeo, Makoto; Chou, Wei Chin; Sun, Qi; Lee, Wendy; Rabbani, Piul; Loomis, Cynthia; Taketo, M Mark; Ito, Mayumi

    2013-07-11

    The tips of mammalian digits can regenerate after amputation, like those of amphibians. It is unknown why this capacity is limited to the area associated with the nail. Here we show that nail stem cells (NSCs) reside in the proximal nail matrix and that the mechanisms governing NSC differentiation are coupled directly with their ability to orchestrate digit regeneration. Early nail progenitors undergo Wnt-dependent differentiation into the nail. After amputation, this Wnt activation is required for nail regeneration and also for attracting nerves that promote mesenchymal blastema growth, leading to the regeneration of the digit. Amputations proximal to the Wnt-active nail progenitors result in failure to regenerate the nail or digit. Nevertheless, ?-catenin stabilization in the NSC region induced their regeneration. These results establish a link between NSC differentiation and digit regeneration, and suggest that NSCs may have the potential to contribute to the development of novel treatments for amputees. PMID:23760480

  14. 7 CFR 3201.70 - Hair care products.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...OF AGRICULTURE GUIDELINES FOR DESIGNATING BIOBASED PRODUCTS FOR FEDERAL PROCUREMENT Designated...overall condition of hair. (b) Minimum biobased content. The minimum biobased content for all hair care products shall...

  15. 7 CFR 3201.70 - Hair care products.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...OF AGRICULTURE GUIDELINES FOR DESIGNATING BIOBASED PRODUCTS FOR FEDERAL PROCUREMENT Designated...overall condition of hair. (b) Minimum biobased content. The minimum biobased content for all hair care products shall...

  16. 7 CFR 3201.70 - Hair care products.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...OF AGRICULTURE GUIDELINES FOR DESIGNATING BIOBASED PRODUCTS FOR FEDERAL PROCUREMENT Designated...overall condition of hair. (b) Minimum biobased content. The minimum biobased content for all hair care products shall...

  17. How to Select Anti-Aging Skin Care Products

    MedlinePLUS

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

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

    PubMed Central

    2008-01-01

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

  19. Methylisothiazolinone: An Emergent Allergen in Common Pediatric Skin Care Products

    PubMed Central

    Schlichte, Megan J.

    2014-01-01

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

  20. Microstructure of Horseshoe Nails Using Neutron Diffraction

    NASA Astrophysics Data System (ADS)

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

    2010-04-01

    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.

  1. Urinary incontinence products - self-care

    MedlinePLUS

    ... have problems with urinary incontinence (leakage), wearing special products will keep you dry and help you avoid ... you can buy many types of urinary incontinence products. These products help keep your skin dry and ...

  2. 21 CFR 886.5928 - Soft (hydrophilic) contact lens care products.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...2010-04-01 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...

  3. 21 CFR 886.5918 - Rigid gas permeable contact lens care products.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...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...

  4. How to Select Anti-Aging Skin Care Products

    MedlinePLUS

    ... zone Video library Find a dermatologist How to select anti-aging skin care products Dermatologists share their ... make a noticeable difference. When shopping for sunscreen, select one that offers all of the following: Broad ...

  5. PHARMACEUTICALS AND PERSONAL CARE PRODUCTS (PPCPS) AS ENVIRONMENTAL POLLUTANTS

    EPA Science Inventory

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

  6. 7 CFR 735.105 - Care of agricultural products.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AGRICULTURE REGULATIONS FOR WAREHOUSES REGULATIONS FOR THE UNITED STATES WAREHOUSE ACT Warehouse Licensing § 735.105 Care of agricultural products. Each warehouse operator must at all times, including during...

  7. 7 CFR 735.105 - Care of agricultural products.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AGRICULTURE REGULATIONS FOR WAREHOUSES REGULATIONS FOR THE UNITED STATES WAREHOUSE ACT Warehouse Licensing § 735.105 Care of agricultural products. Each warehouse operator must at all times, including during...

  8. PHARMACEUTICALS AND PERSONAL CARE PRODUCTS: DIVERSE GALAXY OF ENVIRONMENTAL POLLUTANTS

    EPA Science Inventory

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

  9. NailO: Fingernails as an Input Surface

    E-print Network

    Kao, Cindy Hsin-Liu

    We present NailO, a nail-mounted gestural input surface. Using capacitive sensing on printed electrodes, the interface can distinguish on-nail finger swipe gestures with high accuracy (>92%). NailO works in real-time: we ...

  10. Ultrasound-mediated nail drug delivery system.

    PubMed

    Abadi, Danielle; Zderic, Vesna

    2011-12-01

    A novel ultrasound-mediated drug delivery system has been developed for treatment of a nail fungal disorder (onychomycosis) by improving delivery to the nail bed using ultrasound to increase the permeability of the nail. The slip-in device consists of ultrasound transducers and drug delivery compartments above each toenail. The device is connected to a computer, where a software interface allows users to select their preferred course of treatment. In in vitro testing, canine nails were exposed to 3 energy levels (acoustic power of 1.2 W and exposure durations of 30, 60, and 120 seconds). A stereo -microscope was used to determine how much of a drug-mimicking compound was delivered through the nail layers by measuring brightness on the cross section of each nail tested at each condition, where brightness level decreases coincide with increases in permeability. Each of the 3 energy levels tested showed statistical significance when compared to the control (P < .05) with a permeability factor of 1.3 after 30 seconds of exposure, 1.3 after 60 seconds, and 1.5 after 120 seconds, where a permeability factor of 1 shows no increase in permeability. Current treatments for onychomycosis include systemic, topical, and surgical. Even when used all together, these treatments typically take a long time to result in nail healing, thus making this ultrasound-mediated device a promising alternative. PMID:22124008

  11. Clinical outcomes of patients with isolated femoral shaft fractures treated with S.I.G.N interlock nails versus Cannulated Interlock Intramedullary nails

    PubMed Central

    Panti, Juan Paulo L.; Geronilla, Mario; Arada, Ernesto Carlo

    2013-01-01

    Objective The S.I.G.N (Surgical Implant Generation Network Inc.) solid intramedullary nail is originally designed for tibial shaft fractures and is currently being used for femoral shaft fractures as an extended use. The nail is used in developing nations such as the Philippines, as an alternative for those who could not afford the commercially available nails. The main objective of the study is to determine whether there is a difference in clinical outcomes of patients with isolated femoral shaft fractures in Philippine General Hospital, treated with S.I.G.N intramedullary nails versus Cannulated intramedullary nails, from year 2007 to 2012. Population A total of 175 patients fulfilled the inclusion criteria based from reviews of censuses, in-patient and OPD charts of the trauma section of the Department of Orthopedics, Philippine General Hospital. The Surgical Implant Generation Network (S.I.G.N) Fracture Care On-line Database was also screened for patients to be included in the study. A total of 68 patients were able to follow-up, with 48 patients in the S.I.G.N group and 20 patients for the Cannulated group. Main outcome measures The dependent variables of the study are radiographic and clinical union, knee range of motion, weight bearing status, and complications. Results The subjects were divided into patients operated with S.I.G.N nails and with Cannulated Interlock Intramedullary nails. For the S.I.G.N group, the mean age is 32.1 years and mean follow-up is 40.75 weeks post-op. The Cannulated group has a mean age of 27.9 years and mean follow-up of 35.85 weeks post-op. Radiographic union rate for the S.I.G.N group is 68.8% while for the Cannulated group is 80%. Clinical union and full weight bearing status of patients are 100% in both groups. There is no significant difference with the number of patients with full range of motion in both groups: (S.I.G.N: 85%; Cannulated: 90%). Complication rates are also non-significant (S.I.G.N: 12.5%; Cannulated: 5%). Conclusions There is no significant difference between patients with isolated femoral shaft fractures treated with S.I.G.N. Interlock Intramedullary nail versus Cannulated Interlock Intramedullary nail in terms of Clinical and radiographic union, weight bearing, knee range of motion and complication rate. PMID:24396239

  12. Nails

    MedlinePLUS

    ... Resource Center Join the AAD Boards study tools Online Learning Center Meetings and events AAD publications Make a difference Career planning Residents & Fellows Community Media Relations Toolkit Dermatology issues in the news Background materials Customized press ...

  13. [Pleuritis in yellow nail syndrome].

    PubMed

    Kossakowski, C A; Schmiegelow, P; Müller, K-M

    2012-03-01

    A 76-year-old man presented clinically with coughing and shortness of breath and was diagnosed radiologically to have massive pleural effusion as a combined feature of yellow nail syndrome. A lung biopsy was taken and revealed histologically: chronic non-specific inflammation in the pleuropulmonary border, intrapleural edema with eightfold pleural thickening in comparison to normal, angiogenesis in both the nutritive and functional intrapleural blood vessels, no abnormalities of lymphatic vessels with normal topographical distribution as detected by immunohistochemistry for antibody D2-40, granulomatous chronic foreign body reaction as a consequence of pleural effusion therapy by talcum pleurodesis.The histopathological findings of chronic non-specific pleuritis with angiogenesis and increased permeability of blood vessels led to massive intrapleural edema with pleural effusion. Abnormalities of lymphatic vessels could not be confirmed. Considering the features of this disease, they are probably secondary to chronic r infectious or immunological inflammation or paraneoplastic complications with angiogenesis (in about 19%). PMID:22048329

  14. How to Stop Biting Your Nails

    MedlinePLUS Videos and Cool Tools

    ... like biting your nails, try playing with a stress ball or silly putty instead. This will help ... of hangnails, or other triggers, such as boredom, stress, or anxiety. By figuring out what causes you ...

  15. How to Stop Biting Your Nails

    MedlinePLUS Videos and Cool Tools

    ... Bumps and growths Color problems Contagious skin diseases Cosmetic treatments Dry / sweaty skin Eczema / dermatitis Hair and ... and the side effects can be more than cosmetic. Repeated nail biting can make the skin around ...

  16. Heat profiles of laser-irradiated nails.

    PubMed

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

    2014-01-01

    Onychomycosis is a worldwide problem with no tendency for self-healing, and existing systemic treatments achieve disease-free nails in only 35 to 76% of cases. Recently, treatment of nail fungus with a near-infrared laser has been introduced. It is assumed that fungal eradication is mediated by local heat. To investigate if laser treatment has the potential to eradicate fungal hyphae and arthrospores, laser heat application and propagation needs to be studied in detail. This study aimed to measure nail temperatures using real-time videothermography during laser irradiation. Treatment was performed using 808- and 980-nm linear scanning diode lasers developed for hair removal, enabling contact-free homogeneous irradiation of a human nail plate in one pass. Average and peak temperatures increased pass by pass, while the laser beam moved along the nail plates. The achieved mean peak temperatures (808 nm: 74.1 to 112.4°C, 980 nm: 45.8 to 53.5°C), as well as the elevation of average temperatures (808 nm: 29.5 to 38.2°C, 980 nm: 27.1 to 32.6°C) were associated with pain that was equivalent to that of hair removal procedures and was not significantly different for various wavelengths. The linear scanning laser devices provide the benefits of contact-free homogeneous heating of the human nail while ensuring adequate temperature rises. PMID:24407504

  17. Heat profiles of laser-irradiated nails

    NASA Astrophysics Data System (ADS)

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

    2014-01-01

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

  18. Lateral drug diffusion in human nails.

    PubMed

    Palliyil, Biji B; Li, Cong; Owaisat, Suzan; Lebo, David B

    2014-12-01

    The main objective of the current work is to demonstrate the process of passive lateral diffusion in the human nail plate and its effect on the passive transungual permeation of antifungal drug ciclopirox olamine (CPO). A water soluble dye, methyl red sodium salt (MR) was used to visualize the process of lateral diffusion using a novel suspended nail experiment. The decline in concentration of CPO correlates with that of concentration of MR from the proximal to the distal end of the nail in suspended nail study. Three toenails each were trimmed to 5 mm × 5 mm (25 mm(2)), 7 mm × 7 mm (49 mm(2)), and 9 mm × 9 mm (81 mm(2)) to study the extent and effect of lateral diffusion of the CPO on its in vitro transungual permeation. The permeation flux of CPO decreased as the surface area of the toenail increased. There was a positive correlation between the concentrations of CPO and MR in the area of application and in the peripheral area of the toenails of the three surface areas, confirming the findings in the suspended nail experiment. Profound lateral diffusion of CPO was demonstrated and shown to reduce the in vitro passive transungual drug permeation and prolong the lag-time in human toenails. The study data implies that during passive in vitro transungual permeation experiments, the peripheral nail around the area of drug application has to be kept to a minimum, in order to get reliable data which mimics the in vivo situation. PMID:24970585

  19. Safety of skin care products during pregnancy

    PubMed Central

    Bozzo, Pina; Chua-Gocheco, Angela; Einarson, Adrienne

    2011-01-01

    Abstract Question Many of my female patients complain about acne, unwanted hair growth, and other skin problems that have only developed since they became pregnant. Are products used for these types of benign skin conditions safe to use in pregnancy, as it is understandable that women want to look their best at this important time in their lives? Answer With the exception of hydroquinone, which has a relatively high systemic absorption rate, and tretinoin, for which the evidence is controversial, these products act locally and therefore produce minimal systemic levels. Consequently, in most cases women can deal with these cosmetically unappealing skin conditions without compromising the safety of their unborn children. PMID:21673209

  20. Transungual delivery of terbinafine by iontophoresis in onychomycotic nails.

    PubMed

    Nair, Anroop B; Vaka, Siva Ram Kiran; Murthy, S Narasimha

    2011-10-01

    Trans-nail permeability is limited due to the innate nature of the nail plate and the recent investigations indicated the potential of iontophoresis in enhancing the transungual drug delivery in normal nails. However, the onychomycotic nails differ from the normal nails with respect to the anatomical and biological features. The current study investigated the effect of iontophoresis (0.5 mA/cm(2) for 1 h) on the transungual delivery of terbinafine in onychomycotic finger and toe nails. The presence of fungi in the onychomycotic nails was diagnosed by potassium hydroxide (KOH) microscopy. Passive and iontophoretic delivery of terbinafine across the infected nail was studied in Franz diffusion cell. Further, the release profile of terbinafine from the drug-loaded nails was investigated by agar diffusion method. KOH microscopy confirmed the presence of fungi in all the nails used. The amount of drug permeated across the nail plate was enhanced significantly during iontophoresis over passive delivery, that is, by 21-fold in case of finger and 37-fold in case of toe nails. Further, the total drug load in the onychomycotic nail was enhanced by ~12-fold (in both finger and toe nails) due to iontophoresis. Release of terbinafine from the iontophoresis-loaded nails into agar plates exhibited two phases, a rapid phase followed by a steady release, which extended >2 months. This study concluded that the drug delivery in onychomycotic nails did not differ significantly when compared with normal nails, although the extent of drug permeation and drug load differs between finger and toe nails. PMID:21457120

  1. Iontophoresis across the proximal nail fold to target drugs to the nail matrix.

    PubMed

    Manda, Prashanth; Sammeta, Srinivasa M; Repka, Michael A; Murthy, S Narasimha

    2012-07-01

    The main objective of the present study was to investigate the plausibility of iontophoretic delivery of drugs to the nail matrix via proximal nail fold. The in vitro drug transport studies were performed in Franz diffusion cells across folded epidermis, which is used as a model for the proximal nail fold. The amount of drug transported into the receiver compartment following iontophoresis for 3 h at 0.5 mA/cm(2) was 150-fold higher than the control (0.008 ± 0.002 ?g/cm(2)). The amount of drug present in the skin after iontophoresis (0.45 ± 0.12 ?g/mg) was approximately fivefold higher as compared with that of the control (0.08 ± 0.01 ?g/mg). Iontophoresis of terbinafine across the proximal nail fold was assessed using excised cadaver toe model as well. A custom-designed foam-pad-type patch system was used for iontophoresis in cadaver toes. The amount of the drug delivered into the nail matrix following iontophoresis for 3 h was significantly higher than the minimum inhibition concentration of terbinafine. However, on the contrary, passive delivery for about 24 h did not result in any detectable drug levels in the nail matrix. Iontophoresis across the proximal nail fold could be developed as a potential method to target drugs to nail matrix. PMID:22487899

  2. Flexible intramedullary nail removal using a broken screw removal set.

    PubMed

    Ferry, Scott T; Dahners, Laurence E

    2006-05-01

    The use of flexible titanium intramedullary nails for management of pediatric long bone fractures and some adult fractures has become common. Nail removal after union can be challenging and often requires a larger exposure than nail placement to allow the insertion of grasping devices, such as pliers. A percutaneous technique for the removal of flexible intramedullary nails using extraction bolts from a broken screw removal set is presented. The technique is especially useful when the end of the nail is not prominent and where a hollow reamer from the same set can expose the nail end for the extraction bolt to be used. PMID:16766939

  3. Cleanser, Detergent, Personal Care Product, and Pretreatment Evaluation

    NASA Technical Reports Server (NTRS)

    Adam, Niklas; Carrier, Chris; Vega, Leticia; Casteel, Michael; Verostko, chuck; Pickering, Karen

    2011-01-01

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

  4. Managing Chemotherapy Side Effects: Skin and Nail Changes

    MedlinePLUS

    ... anD human services national institutes of health Managing Chemotherapy Side Effects Skin and Nail Changes “I was ... brands you should use on your skin. Managing Chemotherapy Side Effects: Skin and Nail Changes Protect your ...

  5. 42. INTERIOR VIEW OF THE NAIL HARDENER USED TO HARDEN ...

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

    42. INTERIOR VIEW OF THE NAIL HARDENER USED TO HARDEN AND TEMPER THE NAILS; WEST TUBES IN FOREGRPUND AND DRAWBACK TUBE IN THE CENTER - LaBelle Iron Works, Thirtieth & Wood Streets, Wheeling, Ohio County, WV

  6. Case report of nail bed injury after blunt trauma; what lies beneath the nail?

    PubMed Central

    Nanninga, Geraldine L.; de Leur, Kevin; van den Boom, Anne Loes; de Vries, Mark R.; van Ginhoven, Tessa M.

    2015-01-01

    Introduction A stable, mobile and sensate fingertip is of paramount importance to perform daily tasks and sense dangerous situations. Unfortunately, fingertips are easily injured with various extents of soft tissue damage. Delayed and inadequate treatment of nail bed injuries may cause substantial clinical problems. The aim is to increase awareness about nail bed injuries among physicians who often treat these patients. Presentation of case We present a 26-year-old male with blunt trauma to a distal phalanx. Conventional radiographs showed an intra-articular, multi-fragmentary fracture of the distal phalanx. At the outpatient department the nail was removed and revealed a lacerated nail bed, more than was anticipated upon during the first encounter at the emergency department. Discussion Blunt trauma to the fingertip occurs frequently and nail bed injuries are easy to underestimate. An adequate emergency treatment of nail bed injuries is needed to prevent secondary deformities and thereby reduce the risk of secondary reconstruction of the nail bed, which often gives unpredictable results. Conclusion However, adequate initial assessment and treatment are important to achieve the functional and cosmetic outcomes. Therefore awareness of physicians at the emergency department is essential. PMID:26348396

  7. Spectrophotometric determination of triclosan in personal care products

    NASA Astrophysics Data System (ADS)

    Lu, Huihui; Ma, Hongbing; Tao, Guanhong

    2009-09-01

    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.

  8. Unusual manifestation of the yellow nail syndrome - Case report*

    PubMed Central

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

    2014-01-01

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

  9. Skin and nail mycoses in patients with diabetic foot.

    PubMed

    Papini, M; Cicoletti, M; Fabrizi, V; Landucci, P

    2013-12-01

    Diabetes mellitus affects all socioeconomic and age groups and its incidence is rapidly increasing worldwide. The diabetic foot complication represents one of the most complex and serious complications in these patients. Fungal infections can also contribute to the severity of the diabetic foot. The aim of the present study was to evaluate the prevalence of foot skin and toenail mycosis in a group of 75 patients with diabetic foot complication and in a matched control group. Diabetic patients showed onychomycosis in 53.3% and foot skin mycosis in 46.7% of the cases, with a prevalence of both fungal infections significantly higher than that observed in the control group. At least one type of these fungal infections was present in 69.3% of diabetic subjects with a highly significant difference compared to control group (P<0.001). Trichophyton rubrum and Trichophyton interdigitale were the most common species responsible of both nail and skin infections. Candida spp, Fusarium spp, Aspergillus spp and other moulds. were found in about 1/3 onychomycosis. Previous toe amputation was significantly associated with both skin and nail mycosis. The present study confirms that both tinea pedis and onychomycosis have a high prevalence in subjects suffering from diabetic foot complication, and that the problem of fungal infections of the foot in diabetic subjects is still highly underestimated. Consequently, there is an important clinical rationale for careful mycological examination of diabetic foot and an adequate treatment tailored for each individual patient according to the fungal species involved. PMID:24442040

  10. Screening-level human health risk assessment of toluene and dibutyl phthalate in nail lacquers.

    PubMed

    Kopelovich, Luda; Perez, Angela L; Jacobs, Neva; Mendelsohn, Emma; Keenan, James J

    2015-07-01

    Toluene and dibutyl phthalate (DBP) are found in many consumer products, including cosmetics, synthetic fragrances, and nail polish. In 2012, the California Environmental Protection Agency evaluated 25 nail products and found that 83% of the products that claimed to be toluene-free contained toluene at concentrations ranging up to 190,000?ppm, and 14% of the products that claimed to be DBP-free contained DBP at concentrations ranging up to 88,000?ppm. We conducted a preliminary, screening-level analysis of the potential toluene and DBP-related health risks to consumers and professionals based on the medium and maximum concentrations of toluene and DBP presented in the 2012 report and evaluated dermal and inhalation exposure to a salon patron, nail technician, and home user. We concluded that the maximum toluene concentration for the technician and home user scenarios exceeded the California MADL, but the estimated air concentrations did not exceed the Federal or Cal OSHA PEL. The MADL for DBP was exceeded for all user scenarios at both the median and maximum concentrations. Using these highly conservative assumptions, exposures above regulatory limits could possibly occur during routine use of nail products; further research is needed in order to evaluate potential human health risks. PMID:25865937

  11. New Concepts in Median Nail Dystrophy, Onychomycosis, and Hand, Foot, and Mouth Disease Nail Pathology

    PubMed Central

    Hoy, Nathan Y.; Leung, Alexander K. C.; Metelitsa, Andrei I.; Adams, Stewart

    2012-01-01

    Nails are underutilized as diagnostic tools, despite being involved in many dermatologic conditions. This paper explores new concepts in the treatment of median nail dystrophy (MND), onychomycosis, and the nail pathology of hand, foot, and mouth disease (HFMD). A Pubmed database literature search was conducted for MND treatment, onychomycosis treatment, and HFMD nail pathology. Only papers published after January 2008 were reviewed. The results showed that 0.1% tacrolimus ointment can be an effective treatment for MND. Early studies on laser therapy indicate that it is a safe and efficacious treatment option for onychomycosis, compared to conventional oral antifungal agents. Vicks VapoRub (The Proctor & Gamble Company, Cincinnati, OH) is effective against onychomycosis and is a reasonable option in patients who choose to forgo conventional treatments. Lastly, there is evidence to support a correlation between HFMD and onychomadesis. PMID:22462009

  12. Fungal infections of the nails in Western Australia.

    PubMed

    McAleer, R

    1981-02-13

    Between 1963 and 1972, 986 fungi were isolated from the nails of patients in Western Australia. Three clinical types of infections in both finger and toe nails were studied. All 3 types occurred more commonly in adults over the age of 20. Multiple infections were relatively frequent. Two hundred and fourteen of the nail infections were caused by dermatophyte fungi. Trichophyton rubrum was the predominant aetiologic agent isolated from both finger and toe nails, T. mentagrophytes and other dermatophytes were involved to a lesser degree. Paronychia of the finger nails was common and mainly caused by C. albicans. Aspergillus species were the most frequent fungi grown from superficial white onychomycosis. PMID:7219514

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

    ERIC Educational Resources Information Center

    Hart, J. Roger

    1984-01-01

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

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

    PubMed Central

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

    2015-01-01

    AIM: To study the cost benefit of external fixation vs external fixation then nailing in treatment of bone infection by segment transfer. METHODS: Out of 71 patients with infected nonunion tibia treated between 2003 and 2006, 50 patients fitted the inclusion criteria (26 patients were treated by external fixation only, and 24 patients were treated by external fixation early removal after segment transfer and replacement by internal fixation). Cost of inpatient treatment, total cost of inpatient and outpatient treatment till full healing, and the weeks of absence from school or work were calculated and compared between both groups. RESULTS: The cost of hospital stay and surgery in the group of external fixation only was 22.6 ± 3.3 while the cost of hospital stay and surgery in the group of early external fixation removal and replacement by intramedullary nail was 26.0 ± 3.2. The difference was statistically significant regarding the cost of hospital stay and surgery in favor of the group of external fixation only. The total cost of medical care (surgery, hospital stay, treatment outside the hospital including medications, dressing, physical therapy, outpatient laboratory work, etc.) in group of external fixation only was 63.3 ± 15.1, and total absence from work was 38.6 ± 6.6 wk. While the group of early removal of external fixation and replacement by IM nail, total cost of medical care was 38.3 ± 6.4 and total absence from work or school was 22.7 ± 4.1. The difference was statistically significant regarding the total cost and absence from work in favor of the group of early removal and replacement by IM nail. CONCLUSION: Early removal of external fixation and replacement by intramedullary nail in treatment of infected nonunion showed more cost effectiveness. Orthopaedic society needs to show the cost effectiveness of different procedures to the community, insurance, and health authorities. PMID:25621219

  15. 1st meeting on topical drug delivery to the nail.

    PubMed

    Murdan, Sudaxshina

    2007-07-01

    The first ever symposium dedicated solely to drug delivery to the nail following topical application was held on the 2nd April 2007, in London, UK, organised by Dr Clive Roper (Charles River Laboratories, Scotland) and Dr Sudaxshina Murdan (School of Pharmacy, University of London, UK), under the auspices of Skin Forum. The 1-day meeting was attended by approximately 35 delegates from industry, academia and hospitals, and provided a much-needed forum for the presentation and discussion of research and problems in this emerging field. Topical drug delivery is especially suitable for onychomycosis (fungal infections of the nail plate and/or nail bed) and nail psoriasis, which affect 2 - 13 and 1 - 3% of the general population, respectively, and make up the bulk of nail disorders. Topical therapy would avoid the adverse events and drug interactions of systemic antifungal agents and the pain of injection when antipsoriatic agents are injected into affected nail folds. However, successful topical therapy is extremely challenging due to the very low permeability of the nail plate. Five speakers spoke about various aspects of topical drug delivery to the nail, including review of the nail plate structure, function, diseases, their existing therapies (systemic and topical), limitations and global sales. The need for effective topical drug delivery to the nail to overcome the problems associated with present treatment, and the fact that there are few topical formulations available for the treatment of nail fungal infections and psoriasis, and the even fewer effective formulations, was highlighted. PMID:17683257

  16. Influence of the intramedullary nail preparation method on nail's mechanical properties and degradation rate.

    PubMed

    Morawska-Chochó?, Anna; Ch?opek, Jan; Szaraniec, Barbara; Domalik-Pyzik, Patrycja; Balacha, Ewa; Bogu?, Maciej; Kucharski, Rafael

    2015-06-01

    When it comes to the treatment of long bone fractures, scientists are still investigating new materials for intramedullary nails and different manufacturing methods. Some of the most promising materials used in the field are resorbable polymers and their composites, especially since there is a wide range of potential manufacturing and processing methods. The aim of this work was to select the best manufacturing method and technological parameters to obtain multiphase, and multifunctional, biodegradable intramedullary nails. All composites were based on a poly(l-lactide) matrix. Either magnesium alloy wires or carbon and alginate fibres were introduced in order to reinforce the nails. The polylactide matrix was also modified with tricalcium phosphate and gentamicin sulfate. The composite nails were manufactured using three different methods: forming from solution, injection moulding and hot pressing. The effect of each method of manufacturing on mechanical properties and degradation rate of the nails was evaluated. The study showed that injection moulding provides higher uniformity and homogeneity of the particle-modified polylactide matrix, whereas hot pressing favours applying higher volume fractions of fibres and their better impregnation with the polymer matrix. Thus, it was concluded that the fabrication method should be individually selected dependently on the nail's desired phase composition. PMID:25842113

  17. Student productivity in a comprehensive care program without numeric requirements.

    PubMed

    Holmes, D C; Trombly, R M; Garcia, L T; Kluender, R L; Keith, C R

    2000-11-01

    As the dental students of the Class of 2000 entered the Comprehensive Care Clinic at the University of Colorado School of Dentistry in the spring of their second year (spring of 1998), a different, competency-based set of clinical expectations was communicated to them. These students were presented a list of "Recommended Core Experiences" and told that the "requirements" for completion of the Comprehensive Care Program were 1) successful performance on all departmental competency examinations, and 2) timely completion of the comprehensive dental treatment appropriate to each assigned patient. This study examined the number of procedures completed during the six semesters in the Comprehensive Care Clinic for the Class of 2000, as compared to the clinical activity for the Class of 1999 during the same stage of their career. The overall mean number of clinical procedures performed per student was 7 percent greater for the students in the Class of 2000 than for those in the Class of 1999. These results suggest that numerical requirements are not necessary to ensure dental student productivity and that, in fact, students can complete more clinical procedures in a comprehensive care clinical environment without numerical requirements. PMID:11191876

  18. Titanium Dioxide Nanoparticles in Food and Personal Care Products

    PubMed Central

    Weir, Alex; Westerhoff, Paul; Fabricius, Lars

    2012-01-01

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

  19. Clinical guidelines for the recognition of melanoma of the foot and nail unit

    PubMed Central

    2010-01-01

    Malignant melanoma is a life threatening skin tumour which may arise on the foot. The prognosis for the condition is good when lesions are diagnosed and treated early. However, lesions arising on the soles and within the nail unit can be difficult to recognise leading to delays in diagnosis. These guidelines have been drafted to alert health care practitioners to the early signs of the disease so an early diagnosis can be sought. PMID:21040565

  20. Ability of hydroxypropyl chitosan nail lacquer to protect against dermatophyte nail infection.

    PubMed

    Ghannoum, M A; Long, L; Isham, N; Bulgheroni, A; Setaro, M; Caserini, M; Palmieri, R; Mailland, F

    2015-04-01

    The development of a topical agent that would strengthen the nail, improve the natural barrier, and provide better drug penetration to the nail bed is needed. In this study, we examined the effects of a hydroxypropyl chitosan (HPCH)-based nail solution using a bovine hoof model. Following application of the nail solution, changes in the hardness of the hoof samples were measured using the Vickers method. Tensile and flexural strengths were tested by stretching or punching the samples, respectively. The ultrastructure was examined using scanning electron microscopy (SEM), and samples stained with periodic acid-Schiff (PAS) stain were used to determine the fungal penetration depth. The comparators included 40% urea and 70% isopropyl alcohol solutions. The HPCH nail solution increased hoof sample hardness in comparison to the untreated control sample (mean, 22.3 versus 19.4 Vickers pyramid number [HV]). Similarly, the HPCH solution increased the tensile strength (mean, 33.07 versus 28.42 MPa) and flexural strength (mean, 183.79 versus 181.20 MPa) compared to the untreated control. In contrast, the comparators had adverse effects on hardness and strength. SEM showed that the HPCH solution reduced the area of sample crumbling following abrasion compared to the untreated control (7,418 versus 17,843 pixels), and the PAS-stained images showed that the HPCH solution reduced penetration of the dermatophyte hyphae (e.g., penetration by Trichophyton mentagrophytes was <25 ?m at day 9 versus 275 ?m in the untreated control). Unlike chemicals normally used in cosmetic treatments, repeated application of the HPCH nail solution may help prevent the establishment of new or recurring fungal nail infection. PMID:25547349

  1. Ability of Hydroxypropyl Chitosan Nail Lacquer To Protect against Dermatophyte Nail Infection

    PubMed Central

    Long, L.; Isham, N.; Bulgheroni, A.; Setaro, M.; Caserini, M.; Palmieri, R.; Mailland, F.

    2014-01-01

    The development of a topical agent that would strengthen the nail, improve the natural barrier, and provide better drug penetration to the nail bed is needed. In this study, we examined the effects of a hydroxypropyl chitosan (HPCH)-based nail solution using a bovine hoof model. Following application of the nail solution, changes in the hardness of the hoof samples were measured using the Vickers method. Tensile and flexural strengths were tested by stretching or punching the samples, respectively. The ultrastructure was examined using scanning electron microscopy (SEM), and samples stained with periodic acid-Schiff (PAS) stain were used to determine the fungal penetration depth. The comparators included 40% urea and 70% isopropyl alcohol solutions. The HPCH nail solution increased hoof sample hardness in comparison to the untreated control sample (mean, 22.3 versus 19.4 Vickers pyramid number [HV]). Similarly, the HPCH solution increased the tensile strength (mean, 33.07 versus 28.42 MPa) and flexural strength (mean, 183.79 versus 181.20 MPa) compared to the untreated control. In contrast, the comparators had adverse effects on hardness and strength. SEM showed that the HPCH solution reduced the area of sample crumbling following abrasion compared to the untreated control (7,418 versus 17,843 pixels), and the PAS-stained images showed that the HPCH solution reduced penetration of the dermatophyte hyphae (e.g., penetration by Trichophyton mentagrophytes was <25 ?m at day 9 versus 275 ?m in the untreated control). Unlike chemicals normally used in cosmetic treatments, repeated application of the HPCH nail solution may help prevent the establishment of new or recurring fungal nail infection. PMID:25547349

  2. Indoor air quality survey of nail salons in Boston.

    PubMed

    Goldin, Laura J; Ansher, Liza; Berlin, Ariana; Cheng, Jenny; Kanopkin, Deena; Khazan, Anna; Kisivuli, Meda; Lortie, Molly; Bunker Peterson, Emily; Pohl, Laura; Porter, Sam; Zeng, Vivian; Skogstrom, Tiffany; Fragala, Matt A; Myatt, Theodore A; Stewart, James H; Allen, Joseph G

    2014-06-01

    Employees in nail salons, largely Vietnamese immigrant women in Boston, are exposed to a range of volatile organic chemicals from the products used in salons, including solvents, glues and polishes. Some of these chemicals have the potential to cause short and long-term adverse health effects. Only limited research has been performed on assessing occupational exposures. This project aimed to characterize total volatile organic compound (TVOC) and PM2.5 concentrations in nail salons as a function of ventilation, building characteristics, customer and employee occupancy, and type of services being performed. Students conducted sampling in 21 salons in Boston, MA from September to December, 2011. Study visits included: indoor environmental quality measurements (TVOCs, PM2.5 and carbon dioxide), site observations, and an interview. CO2 levels in 15 of 21 salons exceeded 800 ppm, suggesting that these salons may have insufficient ventilation. Higher TVOC and PM2.5 levels were found in salons with less ventilation (as estimated using CO2 concentrations). Contrary to our a priori hypothesis, average levels of TVOCs, CO2 and PM2.5 were consistent throughout salons, indicating that exposures may not be restricted to areas in the salon where work is being performed (e.g., at the manicure table). Higher TVOC concentrations were observed when tasks were being performed, yet were not dependent upon the number of tasks being performed. Improving ventilation conditions in salons to meet minimum outdoor air delivery requirements can reduce exposures to TVOCs. PMID:23765035

  3. Gauze strip tourniquet for nail surgery.

    PubMed

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

    2014-07-01

    All nail surgical procedures require the use of a tourniquet. The nail bed, being a very vascular structure, needs to be exsanguinated at the start and then a tourniquet needs to be tied at the base. A number of tourniquets have been described, including a Foley's catheter, a Penrose drain, a rubber strip or a rubber band. The present article explains the use of the easily available, improvised, gauze strip tourniquet. This does not require much special preparation, is easily autoclavable, perfect for single use and can achieve exsanguination as well as tightening as a single step. This technique does not require much learning and is easily reproducible in almost all surgical setups. PMID:25538439

  4. Cessation of nail growth following Bajiaolian intoxication.

    PubMed

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

    2008-02-01

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

  5. [Nail-fold capillaroscopy in dermatology].

    PubMed

    Senet, P; Fichel, F; Baudot, N; Gaitz, J-P; Tribout, L; Frances, C

    2014-01-01

    Nail-fold capillaroscopy is a non-invasive tool to study the microcirculation and is increasingly being used in dermatology, angiology and rheumatology. More recently, the use of video-capillaroscopy has allowed computer storage of capillaroscopic images (video-capillaroscopy), enabling evaluation of changes in capillaroscopic abnormalities during the follow-up of patients with systemic sclerosis or mixed connective tissue disease. Qualitative and quantitative assessment of the nail-fold dermal capillaries and of their organization can readily distinguish between a normal capillaroscopic pattern in primary Raynaud phenomenon and a specific sclerodermic pattern in secondary Raynaud phenomenon carrying a very high risk of systemic sclerosis. Apart from its important role as a diagnostic tool for distinguishing between primary and secondary Raynaud phenomenon, capillaroscopy is now used to predict the risk of development of digital ulcers and of future visceral complications in patients with systemic sclerosis. Moreover, nail-fold capillaroscopy is essential for differential diagnosis between connective tissue diseases, for the etiologic diagnosis of digital necrosis and diffuse interstitial lung disease, and in sclerodermiform syndromes. PMID:24951141

  6. Radiographic findings in the nail-patella syndrome

    PubMed Central

    Louis, Thomas H.

    2015-01-01

    Nail-patella syndrome is a rare disorder characterized classically by the tetrad of nail hypoplasia or aplasia, aplastic or hypoplastic patellae, elbow dysplasia, and the presence of iliac horns. Iliac horns are considered pathognomonic, and the presence of hypoplastic or aplastic patellae in conjunction with nail abnormalities is a cardinal feature of diagnosis. Elbow dysplasia is present in most cases and can exhibit features typical of the syndrome. Herein we present the radiographic findings of the elbows, knees, and pelvis of a woman with nail-patella syndrome. PMID:26130880

  7. Titanium dioxide nanoparticles in food and personal care products.

    PubMed

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

    2012-02-21

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

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

    PubMed Central

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

    2010-01-01

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

  9. 7 CFR 3201.93 - Leather, vinyl, and rubber care products.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 15 2014-01-01 2014-01-01 false Leather, vinyl, and rubber care products. 3201.93... FEDERAL PROCUREMENT Designated Items § 3201.93 Leather, vinyl, and rubber care products. (a) Definition. Products that help clean, nourish, protect, and restore leather, vinyl, and rubber surfaces,...

  10. 7 CFR 3201.93 - Leather, vinyl, and rubber care products.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 15 2013-01-01 2013-01-01 false Leather, vinyl, and rubber care products. 3201.93... FEDERAL PROCUREMENT Designated Items § 3201.93 Leather, vinyl, and rubber care products. (a) Definition. Products that help clean, nourish, protect, and restore leather, vinyl, and rubber surfaces,...

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

    PubMed

    Gao, Xiang; Simpson, Eric L

    2014-01-01

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

  12. Driving NailsDriving Nails Developing an Approach forDeveloping an Approach for

    E-print Network

    better, while dampening shock waves to your hand and wrist. And, it's built to withstand a beatingEvolution of the Hammer Rock tied to a wood handleRock tied to a wood handle Copper, bronze, and iron replace stone's virtually no shock transferred back to your arm; titanium handle transfers swing energy to the nail head

  13. Outcome of intertrochanteric fractures treated by intramedullary nail with two integrated lag screws: A study in Asian population

    PubMed Central

    Kim, Jong-Won; Kim, Tae-Young; Ha, Yong-Chan; Lee, Young-Kyun; Koo, Kyung-Hoi

    2015-01-01

    Background: The incidence of intertrochanteric fracture has increased during recent years as life expectancy has also increased. Currently, orthopedic surgeons use various fixation methods for intertrochanteric fractures like, intramedullary (IM) nailing or dynamic hip screws and plates. The intramedullary (IM) nail with two integrated lag screws has been used recently in intertrochanteric fractures to overcome Z-affect phenomenon. However, no study is available in an Asian population. This prospective study was undertaken to document the clinical and radiologic outcomes of the IM nail with two integrated lag screws and its limitations in Asian patients. Materials and Methods: Osteosynthesis was performed using InterTAN nail in 100 patients with an intertrochanteric fractures followed up for at least 1 year after surgery. We evaluated the recovery rates to prefracture status, time to bony union and the incidence of complications. Results: Seventy four patients were available for at least 1 year followup examinations. Forty-five patients (60.8%) recovered prefracture status. Mean time to bony union was 18.3 ± 8.6 weeks. Intraoperative technical problems related to an unavoidable superior positioning of the lag screw occurred in five cases. Postoperative complications requiring reoperation occurred in three patients; two cases of varus collapse with cut out and one case of periprosthetic fracture. Conclusions: The IM nail with two integrated lag screws showed favorable outcomes in Asian patients with an intertrochanteric fracture even though several complications that were not previously reported with this nail were found. The proper selection of patients and careful insertion of two lag screws should be mandatory in Asian patients. PMID:26229165

  14. Evaluating a county-based Healthy nail Salon Recognition Program

    EPA Science Inventory

    To determine whether nail solons that participate in the SF recognition program have reduced measured levels of toluene, methyl methacrylate (MMA), and total volatile organic compounds (TVOC)as compared to nail salons that do not participate. We also evaluated changes in worker ...

  15. Iontophoretically enhanced ciclopirox delivery into and across human nail plate.

    PubMed

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

    2009-10-01

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

  16. Iontophoretically Enhanced Ciclopirox Delivery into and Across Human Nail Plate

    PubMed Central

    HAO, JINSONG; SMITH, KELLY A.; LI, S. KEVIN

    2009-01-01

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

  17. TOXIC TRACE METALS IN MAMMALIAN HAIR AND NAILS

    EPA Science Inventory

    Data have been compiled from the available world literature on the accumulation and bioconcentration of selected toxic trace metals in human hair and nails and other mammalian hair, fur, nails, claws, and hoofs. The toxic trace metals and metalloids include antimony, arsenic, bor...

  18. Prognostic Factors for Predicting Outcomes After Intramedullary Nailing of the Tibia

    PubMed Central

    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.

    2012-01-01

    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. PMID:23032589

  19. A chemical mixer with dark-green nails.

    PubMed

    Leung, Lawrence K; Harding, John

    2015-01-01

    Nails are integral extensions of the skin and they together form the largest organ of the human body. Changes in nail appearance can be due to external insults or internal pathologies, and nail signs have to be interpreted in light of a good history. We present an interesting case of a man who developed dark-green discolouration of his nails over a short period of time. His work as a chemical mixer rendered him susceptible to hazardous chemical exposure. A notification was filed and the local Occupational Health Department discovered insufficient protective gear and lack of protocols regarding hazards of isocyanate-based resin. The patient also reported washing utensils with bare hands. Based on the meniscal demarcation borders between the discoloured and normal areas, plus a positive bacterial culture from nail clippings, the final diagnosis of isocyanate-resin-induced onycholysis with secondary Pseudomonas infection remained as the most likely clinical diagnosis. PMID:26040827

  20. Drug delivery into microneedle-porated nails from nanoparticle reservoirs.

    PubMed

    Chiu, Wing Sin; Belsey, Natalie A; Garrett, Natalie L; Moger, Julian; Price, Gareth J; Delgado-Charro, M Begoña; Guy, Richard H

    2015-12-28

    This study demonstrates the potential of polymeric nanoparticles as drug reservoirs for sustained topical drug delivery into microneedle-treated human nail. Laser scanning confocal microscopy was used to image the delivery of a fluorescent model compound from nanoparticles into the nail. A label-free imaging technique, stimulated Raman scattering microscopy, was applied, in conjunction with two-photon fluorescence imaging, to probe the disposition of nanoparticles and an associated lipophilic 'active' in a microneedle-porated nail. The results provide clear evidence that the nanoparticles function as immobile reservoirs, sequestered on the nail surface and in the microneedle-generated pores, from which the active payload can be released and diffuse laterally into the nail over an extended period of time. PMID:26478016

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

    PubMed Central

    Müller, Simon; Ebnöther, Myriam; Itin, Peter

    2014-01-01

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

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

    PubMed Central

    2008-01-01

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

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

    PubMed

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

    2011-08-01

    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

  4. Skeletal metastatic disease of the femur: results by management with intramedullary nailing.

    PubMed

    Märdian, S; Schaser, K-D; Ruppert, M; Melcher, I; Haas, N P; Schwabe, P

    2015-01-01

    PURPOSE OF THE STUDY This study aimed to analyse the outcome following intramedullary nailing for metastases of the femur in a large cohort with special regard to mechanical, implant associated complications and patient survival. Furthermore, we aimed to identify factors influencing the overall survival. MATERIAL AND METHODS All patients (n = 74) that underwent intramedullary nailing for metastatic disease of the femur between 2004 and 2008 and were retrospectively reviewed. Data were recorded from the patients' medical record and the outpatients' clinics files. Details about the tumour biology, the surgery performed as well as the postoperative care were documented. Survival data were extracted from patient records or obtained via communication with outpatient oncologists or the community registration office. RESULTS 74 (28 (37.8%) male, 46 (62.2%) female; p = 0.048) patients with a mean age of 64.4 ± 11.7 years were included. Breast (25, 33.8%), lung (18, 24.3%), bone marrow (7, 9.5%) and kidney (6, 8.1%) were the primary tumours in more than 75% of all patients. The mean overall survival was 17.5 (95% CI: 9.6 - 25.5) months. Patients with osseous metastases had a significant longer survival than patients with visceral and/or cerebral metastases (p = 0.025 and p = 0.032). CONCLUSION Intramedullary nailing represents a valuable fixation method for pathologic fractures or impending fractures of the femur in patients with an advanced stage of metastatic disease. It provides adequate stability to outlast the patient s remaining life-span. However, the balance must be found between therapeutic resignation and surgical overtreatment since operative treatment may be accompanied with serious complications. Key words: bone metastases, intramedullary nailing, metastatic disease, cement augmentation, osteolytic defect. PMID:26317289

  5. 78 FR 69644 - Certain Steel Nails From the People's Republic of China: Final Results of Expedited First Sunset...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-20

    ...'') Review, 78 FR 39256 (July 1, 2013). DATES: Effective Date: November 20, 2013. FOR FURTHER INFORMATION... the Tariff Act of 1930, As Amended, 70 FR 24533 (May 10, 2005). Scope of the Order The merchandise... Hardware & Mesh Products Co, Ltd 21.24 Nanjing Dayu Pneumatic Gun Nails Co., Ltd 21.24 Qidong Liang...

  6. 21 CFR 886.5928 - Soft (hydrophilic) contact lens care products.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... SERVICES (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5928 Soft (hydrophilic) contact lens care products. (a) Identification. A soft (hydrophilic) contact lens care product is a device... means of heat. (b) Classification. Class II (Special Controls) Guidance Document: “Guidance for...

  7. Nail incorporation kinetics of terbinafine in onychomycosis patients.

    PubMed

    Schatz, F; Bräutigam, M; Dobrowolski, E; Effendy, I; Haberl, H; Mensing, H; Weidinger, G; Stütz, A

    1995-09-01

    Patients with toe-nail onychomycosis were treated with terbinafine (250 mg daily, n = 20) for either 6 or 12 weeks in a randomized double-blind study. Plasma and distal nail clippings were taken before initiation of therapy and 1, 6, 12, 18, 24, 36 and 48 weeks thereafter. Analytical data of terbinafine extracted from nail clippings or plasma were obtained by high-performance liquid chromatography (HPLC). Nail extracts and isolated HPLC terbinafine peaks were analysed using a combined gas chromatography-mass spectroscopy system (GC-MS) for unequivocal identification of the drug. Terbinafine could be detected in the distal nail in the majority of the patients within 1 week of starting therapy. Maximum terbinafine levels of 0.52 and 1.01 micrograms/g were measured after 18 weeks in the 6- and 12-week treatment groups, respectively. While plasma levels decreased rapidly after termination of therapy terbinafine was detected in the nails as long as 30 weeks (6 weeks treatment) and 36 weeks (12 weeks treatment) after termination of therapy at a range of 0.28-0.19 microgram/g. The drug concentrations measured at all time points are well above the minimum inhibitory concentration (MIC) for dermatophytes and other fungi. These data suggest that the drug reaches the nail plate rapidly and persists there for several months after cessation of active treatment. PMID:8593713

  8. Enhancing the nail permeability of topically applied drugs.

    PubMed

    Murdan, Sudaxshina

    2008-11-01

    The topical therapy of nail diseases, especially of onychomycosis, and to a smaller extent, of nail psoriasis, is desirable to avoid the side effects associated with their systemic therapy, to increase patient compliance and reduce the cost of treatment. Systemic therapy is however the mainstay of treatment due to the poor permeability of the nail plate to topically applied drugs. For effective topical therapy, ungual drug permeation must be enhanced. This can be achieved by disrupting the nail plate using physical techniques or chemical agents. Alternatively, drug permeation into the intact nail plate may be encouraged, for example, by iontophoresis or by formulating the drug within a vehicle which enables high drug partition out of the vehicle and into the nail plate. The physical techniques (manual and electrical nail abrasion, acid etching, ablation by lasers, microporation, application of low-frequency ultrasound and electric currents) and chemicals (thiols, sulphites, hydrogen peroxide, urea, water, enzymes) that have shown ungual enhancer activity are discussed in this review. Optimal drug formulation, while crucial to ungual drug delivery, is only briefly reviewed due to the limited literature. PMID:18976136

  9. Antifungal activity, experimental infections and nail permeation of an innovative ciclopirox nail lacquer based on a water-soluble biopolymer.

    PubMed

    Togni, Giuseppe; Mailland, Federico

    2010-05-01

    P-3051 is an innovative 8% ciclopirox nail lacquer, based on hydroxypropyl chitosan (HPCH) as a film-forming agent. The authors' aim was to investigate P-3051's in vitro antifungal activity, as well as its in vitro and in vivo nail permeation. The dilution susceptibility tests performed for Trichophyton rubrum (T. rubrum) and Candida parapsilosis (C. parapsilosis) showed that the minimum inhibitory concentrations (MICs) of P-3051, as percent of ciclopirox, was for both fungi < or = 0.0015% (equivalent to a concentration of 15.6 mg/ ml). In the biological assay of in vitro nail permeation and fungal inhibition, the authors observed that P-3051 permeated well through bovine hoof membranes and produced dose-dependent inhibitory effects on dermatophyte, yeast and mold strains. Moreover, the inhibition effects were higher than those obtained by equal amounts of the ciclopirox reference nail lacquer. P-3051 and the reference showed the same protective activity in experimental infections with strains of dermatophytes isolated from clinical samples. The amount of ciclopirox remained in cut fingernails washed six hours after in vivo application of P-3051 ranged between 18 and 35% of the applied dose. After in vitro application to cut human nails, 40-50% of the applied ciclopirox penetrated during the first six hours, independent of nails being infected or uninfected, intact or filed. In both experiments, the concentration of ciclopirox is largely higher (three to four orders of magnitude) than the MICs for nail pathogens. PMID:20480796

  10. 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

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

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

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

  12. Dermoscopy and Onychomycosis: guided nail abrasion for mycological samples*

    PubMed Central

    Bet, Diego Leonardo; dos Reis, Ana Lucia; Chiacchio, Nilton Di; Belda Junior, Walter

    2015-01-01

    Mycological examination is still the cornerstone for the diagnosis of onychomycosis for many dermatologists, but sampling technique interferes on its sensitivity and specificity. Nail abrasion may be used to reach the most proximal part of the lesion and can be easily accomplished with an electric abrasor. We suggest nail plate dermoscopy to identify the best location for localized abrasion to obtain adequate samples for mycological examination.

  13. Nail polish as a source of exposure to triphenyl phosphate.

    PubMed

    Mendelsohn, Emma; Hagopian, Audrey; Hoffman, Kate; Butt, Craig M; Lorenzo, Amelia; Congleton, Johanna; Webster, Thomas F; Stapleton, Heather M

    2016-01-01

    Triphenyl phosphate (TPHP) is primarily used as either a flame retardant or plasticizer, and is listed as an ingredient in nail polishes. However, the concentration of TPHP in nail polish and the extent of human exposure following applications have not been previously studied. We measured TPHP in ten different nail polish samples purchased from department stores and pharmacies in 2013-2014. Concentrations up to 1.68% TPHP by weight were detected in eight samples, including two that did not list TPHP as an ingredient. Two cohorts (n=26 participants) were recruited to assess fingernail painting as a pathway of TPHP exposure. Participants provided urine samples before and after applying one brand of polish containing 0.97% TPHP by weight. Diphenyl phosphate (DPHP), a TPHP metabolite, was then measured in urine samples (n=411) and found to increase nearly seven-fold 10-14h after fingernail painting (p<0.001). To determine relative contributions of inhalation and dermal exposure, ten participants also painted their nails and painted synthetic nails adhered to gloves on two separate occasions, and collected urine for 24h following applications. Urinary DPHP was significantly diminished when wearing gloves, suggesting that the primary exposure route is dermal. Our results indicate that nail polish may be a significant source of short-term TPHP exposure and a source of chronic exposure for frequent users or those occupationally exposed. PMID:26485058

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

    EPA Science Inventory

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

  15. PHARMACEUTICAL AND PERSONAL CARE PRODUCTS AS UBIQUITOUS POLLUTANTS FROM PERSONAL USE AND ACTIVITIES

    EPA Science Inventory

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

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

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

    E-print Network

    Leistikow, Bruce N.

    , usage patterns of $30 types of personal care products (e.g., shampoo, sun- screen, fragrance, etc.) were Euro- pean Toiletries and Cosmetics Database (http://www.tns-global. com/uk/etcdneeds) contain

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

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

    PubMed Central

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

    2015-01-01

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

  4. 7 CFR 3201.82 - Foot care products.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...AGRICULTURE GUIDELINES FOR DESIGNATING BIOBASED PRODUCTS FOR FEDERAL PROCUREMENT...cleaning of feet. (b) Minimum biobased content. The Federal preferred procurement product must have a minimum biobased content of at least 83...

  5. 7 CFR 2902.26 - Lip care products.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...AGRICULTURE GUIDELINES FOR DESIGNATING BIOBASED PRODUCTS FOR FEDERAL PROCUREMENT Designated...drying of the lips. (b) Minimum biobased content. The preferred procurement product must have a biobased content of at least 82 percent,...

  6. 7 CFR 3201.26 - Lip care products.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...AGRICULTURE GUIDELINES FOR DESIGNATING BIOBASED PRODUCTS FOR FEDERAL PROCUREMENT Designated...drying of the lips. (b) Minimum biobased content. The preferred procurement product must have a biobased content of at least 82 percent,...

  7. 7 CFR 3201.26 - Lip care products.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...AGRICULTURE GUIDELINES FOR DESIGNATING BIOBASED PRODUCTS FOR FEDERAL PROCUREMENT Designated...drying of the lips. (b) Minimum biobased content. The preferred procurement product must have a biobased content of at least 82 percent,...

  8. 7 CFR 3201.82 - Foot care products.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...AGRICULTURE GUIDELINES FOR DESIGNATING BIOBASED PRODUCTS FOR FEDERAL PROCUREMENT...cleaning of feet. (b) Minimum biobased content. The Federal preferred procurement product must have a minimum biobased content of at least 83...

  9. 7 CFR 2902.26 - Lip care products.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...AGRICULTURE GUIDELINES FOR DESIGNATING BIOBASED PRODUCTS FOR FEDERAL PROCUREMENT Designated...drying of the lips. (b) Minimum biobased content. The preferred procurement product must have a biobased content of at least 82 percent,...

  10. Exploring the biology of the nail: An intriguing but less-investigated skin appendage.

    PubMed

    Saito, Masataka; Ohyama, Manabu; Amagai, Masayuki

    2015-09-01

    The nail is a highly keratinized structure covering the tip of the digit, and considered to have several important functions in our daily life. In recent years, as biological aspects of the nail organ have been characterized, we realize that the nail unit and the hair follicle share various biological and immunological features. In particular, development and homeostasis of the nail unit also requires intimate epithelial-mesenchymal interactions that involve signaling pathways such as Wnt. There is also a striking immunological resemblance between both appendages, since the nail matrix, like the anagen hair bulb and the bulge, was shown to present unique characteristics of an immune privileged site. On the other hand, considerable progress in identifying nail stem cells has succeeded in locating putative stem cell niches in the nail unit. In this context, it is intriguing that nail stem cells residing in the nail matrix were recently shown to possess the ability to organize the process leading to digit regeneration. Further elucidation of signaling pathways governing epithelial-mesenchymal interactions in the nail unit seems to be a key to develop a novel therapeutic tool to treat amputees using nail epithelium. However, it is at least certain that the nail unit has a promising potential for the future of regenerative medicine. This review explores the biology of the nail organ by focusing on intriguing knowledge gained from recent studies. PMID:25999148

  11. Optimizing the use of blood products in trauma care.

    PubMed

    Hess, John R; Hiippala, Seppo

    2005-01-01

    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. PMID:16221314

  12. Frizzled6 deficiency disrupts the differentiation process of nail development.

    PubMed

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

    2013-08-01

    Nails protect the soft tissue of the tips of digits. The molecular mechanism of nail (and claw) development is largely unknown, but we have recently identified a Wnt receptor gene, Frizzled6 (Fzd6), that is mutated in a human autosomal-recessive nail dysplasia. To investigate the action of Fzd6 in claw development at the molecular level, we compared gene expression profiles of digit tips of wild-type and Fzd6(-/-) mice, and showed that Fzd6 regulates the transcription of a striking number of epidermal differentiation-related genes. Sixty-three genes encoding keratins (Krts), keratin-associated proteins, and transglutaminases (Tgms) and their substrates were significantly downregulated in the knockout mice. Among them, four hard Krts, Krt86, Krt81, Krt34, and Krt31; two epithelial Krts, Krt6a and Krt6b; and Tgm 1 were already known to be involved in nail abnormalities when dysregulated. Immunohistochemical studies revealed decreased expression of Krt86, Krt6b, and involucrin in the epidermal portion of the claw field in the knockout embryos. We further showed that Dkk4, a Wnt antagonist, was significantly downregulated in Fzd6(-/-) mice along with Wnt, Bmp, and Hh family genes; and Dkk4 transgenic mice showed a subtly but appreciably modified claw phenotype. Thus, Fzd6-mediated Wnt signaling likely regulates the overall differentiation process of nail/claw formation. PMID:23439395

  13. In vitro antimycotic activity and nail permeation models of a piroctone olamine (octopirox) containing transungual water soluble technology.

    PubMed

    Dubini, Francesco; Bellotti, Maria Grazia; Frangi, Alessandra; Monti, Daniela; Saccomani, Luigi

    2005-01-01

    Several in vitro studies with a new medical device (Myfungar) containing 0.5% of piroctone olamine (CAS 68890-66-4, octopirox) in a hydroxypropyl chitosan hydroalcoholic solution were performed. The chemical name of the active ingredient is 1-hydroxy-4-methyl-6 (2,4,4-trimethylpentyl)-2(1H)-pyridone; combination with 2-amino-ethanol (1:1). The antimycotic activity was determined in the most common fungi responsible of nail infections such as Candida parapsilosis, Scopulariopsis brevicaulis or Trichophyton rubrum. The minimum inhibitory concentration (MIC), found by means of the broth dilution susceptibility method, ranged between 0.0003% and 0.006% for all pathogens considered. The in vitro permeation study was performed by using bovine hoof membranes inserted in a modified Gummer vertical permeation cell. The experiment showed, at 30 h, a retention of the product in the nail membranes by 11.1% of the applied dose. No piroctone permeation through bovine hoof membranes could be detected by HPLC due to the limit of quantitation of this method. On the other hand, permeation of nail membranes has been demonstrated by a biological assay: the study of in vitro permeation through bovine hoof membranes, performed by biological assay, showed dose-dependent inhibition rings of T. rubrum growth by the tested device, placed either on disks for antibiogram or on nail fragments. The placebo did not show any inhibition. In vitro experimental infection by T. rubrum showed a preventive activity of the tested device on fungal growth as well as a curative activity, as the pathogen was eradicated by the tested solution in previously infected nails. PMID:16149717

  14. Early events in the invasion of the human nail plate by Trichophyton mentagrophytes.

    PubMed

    Rashid, A; Scott, E; Richardson, M D

    1995-12-01

    A new in vitro model for the study of nail invasion by dermatophyte fungi was developed. The dermatophyte Trichophyton mentagrophytes, and fragments of finger-nails and toe-nails were used. Arthroconidia were inoculated on the ventral surface of the nails. After 6 h, adherence and germination of arthroconidia was observed. By 16 h, small germ tubes with side branches were evident. At about 24 h, micro-colonies had become established. At 48 h, a mycelium had formed, and at about 72 h most of the nail fragment was covered with fungal growth. Nail penetration occurred from the ventral surface through the intercellular spaces, and with longer incubation all three layers were invaded by arthroconidia growing through channels. Nail invasion occurred in the absence of added nutrients. Dermatophyte fungi appeared to invade the nail by a combination of mechanical and chemical factors. The model provides a substrate to study the pharmacokinetics and bioavailability of new antifungal agents in situ. PMID:8547048

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

    MedlinePLUS

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

  16. Enhancing transungual delivery and spreading of efinaconazole under the nail plate through a unique formulation approach.

    PubMed

    Kircik, Leon H

    2014-12-01

    Onychomycosis is a very common nail disorder seen in dermatological practice. It is difficult to treat successfully for a multitude of reasons, and although topical antifungal therapy might be considered ideal for mild to moderate onychomycosis, efficacy has been limited by poor nail penetration of active ingredient through the nail plate into the nail bed and nail matrix to the site of infection. The intrinsic properties of an antifungal and its vehicle formulation are both considered important contributors to effective treatment. Here we review the formulation approach to efinaconazole topical solution, 10% an effective and well-tolerated treatment for onychomycosis. We demonstrate that the low surface tension formulation affords better penetration of efinaconazole through the nail plate, and also to the site of infection by spreading into the space between the nail and nail bed. PMID:25607788

  17. Withdrawal resistance of ring-shank nails embedded in Southern pine lumber 

    E-print Network

    Skulteti, Matthew John

    1996-01-01

    resistances of ring-shank nails embedded in Southern pine lumber, 2) identifying candidate probability distributions for the withdrawal data, 3) critically evaluating currently published design values for withdrawal resistance of ring-shank nails, and 4...

  18. Novel database for exposure to fragrance ingredients in cosmetics and personal care products.

    PubMed

    Comiskey, D; Api, A M; Barratt, C; Daly, E J; Ellis, G; McNamara, C; O'Mahony, C; Robison, S H; Safford, B; Smith, B; Tozer, S

    2015-08-01

    Exposure of fragrance ingredients in cosmetics and personal care products to the population can be determined by way of a detailed and robust survey. The frequency and combinations of products used at specific times during the day will allow the estimation of aggregate exposure for an individual consumer, and to the sample population. In the present study, habits and practices of personal care and cosmetic products have been obtained from market research data for 36,446 subjects across European countries and the United States in order to determine the exposure to fragrance ingredients. Each subject logged their product uses, time of day and body application sites in an online diary for seven consecutive days. The survey data did not contain information on the amount of product used per occasion or body measurements, such as weight and skin surface area. Nevertheless, this was found from the literature where the likely amount of product used per occasion or body measurement could be probabilistically chosen from distributions of data based on subject demographics. The daily aggregate applied consumer product exposure was estimated based on each subject's frequency of product use, and Monte Carlo simulations of their likely product amount per use and body measurements. Statistical analyses of the habits and practices and consumer product exposure are presented, which show the robustness of the data and the ability to estimate aggregate consumer product exposure. Consequently, the data and modelling methods presented show potential as a means of performing ingredient safety assessments for personal care and cosmetics products. PMID:26003515

  19. Trace Elements in Nails as Biomarkers in Clinical Research

    PubMed Central

    He, Ka

    2010-01-01

    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. PMID:20813017

  20. The Chinese Nail Murders: forensic medicine in Imperial China.

    PubMed Central

    Summers, W. C.

    1999-01-01

    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. PMID:11138936

  1. Infection of the finger-nail by Pyrenochaeta unguis-hominis.

    PubMed

    English, M P

    1980-07-01

    Infection of the finger-nail of an elderly woman by Pyrenochaeta unguis-hominis is reported. The small lesion was extending slowly into the healthy nail plate. The fungus has been isolated from diseased toe-nails on two previous occasions but its extra-human habitat is unknown. PMID:7426409

  2. Effects of nail polish on microbial growth of fingernails. Dispelling sacred cows.

    PubMed

    Baumgardner, C A; Maragos, C S; Walz, J; Larson, E

    1993-07-01

    Nail polish worn on short, healthy nails does not appear to be associated with increased microbial counts on the fingernails. Additional studies to examine the effect of wearing nail polish on other aspects of hand hygiene may be warranted, however. PMID:8338363

  3. Lateral resistance of ring-shank nail connections in Southern Pine lumber 

    E-print Network

    Theilen, Ross Dean

    1996-01-01

    significant reduction in dowel bearing strength was observed for 4.50 compared to 3.76 mm diameter nails. While ring-shank nail connection maximum loads were roughly twice that of common nails for the same diameter, no significant differences were observed...

  4. Outcome of Distal Both Bone Leg Fractures Fixed by Intramedulary Nail for Fibula & MIPPO in Tibia

    PubMed Central

    Gupta, Anil; Anjum, Rashid; Singh, Navdeep; Hackla, Shafiq

    2015-01-01

    Background: Fractures of the distal third of the tibia are mostly associated with a fibular fracture that often requires fixation. The preferred treatment of distal tibial fracture is the minimally invasive percutaneous plate osteosynthesis (MIPPO) procedure. However, there are no clear cut guidelines on fixation of the fibular fracture and currently most orthopedic surgeons use a plate osteosynthesis for the fibula as well. A common complication associated with dual plating is an increased chance of soft tissue necrosis, infection, and in some cases resulting in an exposed implant. We conducted a prospective study to analyze the results of fractures of the distal in both leg bones managed by the MIPPO procedure for tibial fractures and a rush nail for fibular fractures. Methods: The study was conducted in a tertiary care hospital from November 2012 to May 2014, a total of 30 fractures in 30 patients (18 males, 12 females) with a mean age of 42.4 years (26-60 years) were treated in our institution in the aforesaid time period with MIPPO for tibia and rush nail for fibular fractures. All the cases were operated on by a single surgeon in emergency within 24 hours. The patients with skin blistering and compound fractures were excluded from this study. Rehabilitative measures were proceeded as per patient’s pain profile, isometric and isotonic exercises were started on the first post-operative day, with full weight bearing at 10-12 weeks after assessing clinical and radiological union. Regular follow up of patients was done, radiographs were taken at the immediate post-operative period and at 3, 6, 12 and 24 weeks. Results: All the patients were available for regular follow up. Radiological and clinical union proceeded normally in all the patients, no patients had signs of any deep infection, delayed union or nonunion, three patients had a superficial infection of the tibial incision that healed with a change in antibiotic. Conclusions: The use of dual plating for fixation of the lower tibia and fibula fractures is often associated with soft tissue complications, exposed implant, and increased risk of infection. We conclude that in fractures of the distal tibia and fibula it is better to use a rush nail for the fibula with a concurrent MIPPO for the tibia for the reasons cited above. Moreover, with the use of rush nail the cost of implant is also reduced, which is a very important factor in developing countries. PMID:26110179

  5. The human nail--barrier characterisation and permeation enhancement.

    PubMed

    Walters, Kenneth A; Abdalghafor, Haydar M; Lane, Majella E

    2012-10-01

    The human nail remains one of the most challenging membranes for formulation scientists to target and for clinicians to heal. Its formidable barrier properties are the primary reason that oral therapy remains the primary approach to manage ungual infections. This article considers the major structural properties underlying the excellent barrier function of the nail, with particular emphasis on the role of biophysical methods in advancing our knowledge of this appendage. Formulations currently available for management of ungual disease are discussed and their therapeutic efficacy is assessed. Finally, experimental strategies to enhance ungual permeation are reviewed and prospects for future developments in the field are considered. PMID:22521879

  6. Serious Penetrating Craniocerebral Injury Caused by a Nail Gun

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

    Morris, John Steven; Crane, Stacy B.

    2013-01-01

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

  8. The isolation of Botryodiplodia theobromae from a nail lesion.

    PubMed

    Restrepo, A; Arango, M; Velez, H; Uribe, L

    1976-03-01

    Botryodiplodia theobromae not known to produce onychomycosis was repeatedly recovered from a healthy woman with evident lesions in a toe nail. Mycelial fragments were observed in the scales and the fungus was isolated in cycloheximide-free culture media. The report indicates that many fungi, hitherto considered non-pathogens, may still be able to colonize a vaiety of human tissues. PMID:1265567

  9. Your Supplies: 1 Plinko Board board tacked with nails

    E-print Network

    Smith-Konter, Bridget

    Your Supplies: 1 Plinko Board ­ board tacked with nails 9 marbles grid marked from 0-9 on both sides calculator marker ruler Background: You are going to try and determine the size of a marble by rolling a "bombarding marble" into a grid of "target marbles." The marble diameter will be calculated from

  10. 11. INTERIOR, NAILING MACHINE IN EAST CENTRAL PORTION OF SHOP ...

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

    11. INTERIOR, NAILING MACHINE IN EAST CENTRAL PORTION OF SHOP AREA, FROM APPROXIMATELY 50 FEET SOUTH OF SOUTHWEST CORNER OF 'WING', LOOKING NORTH. - Oakland Naval Supply Center, Lumber Storage & Box Factory, East of Fifth Street, between H & I Streets, Oakland, Alameda County, CA

  11. 78 FR 78382 - Steel Nails From China; Determination

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-26

    ... The Commission instituted this review on July 1, 2013 (78 FR 40172) and determined on October 21, 2013 that it would conduct an expedited review (78 FR 68472, November 14, 2013). The Commission completed... COMMISSION Steel Nails From China; Determination On the basis of the record \\1\\ developed in the subject...

  12. Malrotation following reamed intramedullary nailing of closed tibial fractures

    PubMed Central

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

    2012-01-01

    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. PMID:22719118

  13. Detection of Drugs in Nails: Three Year Experience.

    PubMed

    Shu, Irene; Jones, Joseph; Jones, Mary; Lewis, Douglas; Negrusz, Adam

    2015-10-01

    Nails (fingernails and toenails) are made of keratin. As the nail grows, substances incorporate into the keratin fibers where they can be detected 3-6 months after use. Samples are collected by clipping of 2-3 mm of nail from all fingers (100 mg). We present drug testing results from 10,349 nail samples collected from high-risk cases during a 3-year period of time. Samples were analyzed by validated analytical methods. The initial testing was performed mostly using enzyme-linked immunosorbent assay, but by liquid chromatography-tandem mass spectrometry (LC-MS-MS) as well. Presumptive positive samples were subjected to confirmatory testing with sample preparation procedures including washing, pulverizing, digestion and extraction optimized for each drug class. The total of 7,799 samples was analyzed for amphetamines. The concentrations ranged from 40 to 572,865 pg/mg (median, 100-3,687) for all amphetamine analytes. Amphetamine and methamphetamine were present in 14% of the samples, 22 samples were positive for 3,4-methylenedioxymethamphetamine (0.3%), 7 for methylenedioxyamphetamine (0.09%) and 4 for 3,4-methylenedioxy-N-ethylamphetamine (0.05%). Cocaine and related analytes were found in 5% samples (7,787 total), and the concentration range was 20-265,063 pg/mg (median 84-1,768). Opioids overall ranged from 40 to 118,229 pg/mg (median 123-830). The most prevalent opioid was oxycodone (15.1%) and hydrocodone (11.4%) compared with 1.0-3.6% for the others, including morphine, codeine, hydromorphone, methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine and oxymorphone. Carboxy-?-9-tetrahydrocannabinol positivity rate was 18.1% (0.04-262 pg/mg, median 6.41). Out of 3,039 samples, 756 were positive (24.9%) for ethyl glucuronide (20-3,754 pg/mg, median 88). Other drugs found in nails included barbiturates, benzodiazepines, ketamine, meperidine, tramadol, zolpidem, propoxyphene, naltrexone and buprenorphine. Nail analyses have become a reliable way of determining the long-term use and abuse of drugs. Extraction techniques are simple and produce accurate and precise results. Sensitive analytical instrumentation, mainly LC-MS-MS, allows for detection of femtogram (10(-15) g) quantities of substances in nails. Samples were from a high-risk population, therefore the extraordinary positivity rate was observed. PMID:26378136

  14. Estrogenic and anti-estrogenic activity of off-the-shelf hair and skin care products.

    PubMed

    Myers, Sharon L; Yang, Chun Z; Bittner, George D; Witt, Kristine L; Tice, Raymond R; Baird, Donna D

    2015-05-01

    Use of personal care products is widespread in the United States but tends to be greater among African Americans than whites. Of special concern is the possible hazard of absorption of chemicals with estrogenic activity (EA) or anti-EA (AEA) in these products. Such exposure may have adverse health effects, especially when it occurs during developmental windows (e.g., prepubertally) when estrogen levels are low. We assessed the ethanol extracts of eight commonly used hair and skin products popular among African Americans for EA and AEA using a cell proliferation assay with the estrogen sensitive MCF-7:WS8 cell line derived from a human breast cancer. Four of the eight personal care products tested (Oil Hair Lotion, Extra-dry Skin Lotion, Intensive Skin Lotion, Petroleum Jelly) demonstrated detectable EA, whereas three (Placenta Hair Conditioner, Tea-Tree Hair Conditioner, Cocoa Butter Skin Cream) exhibited AEA. Our data indicate that hair and skin care products can have EA or AEA, and suggest that laboratory studies are warranted to investigate the in vivo activity of such products under chronic exposure conditions as well as epidemiologic studies to investigate potential adverse health effects that might be associated with use of such products. PMID:24849798

  15. Static or Dynamic Intramedullary Nailing of Femur and Tibia

    PubMed Central

    Omerovic, Djemil; Lazovic, Faruk; Hadzimehmedagic, Amel

    2015-01-01

    Introduction: The basic principle of non-surgical fracture treatment is to restore the original anatomical position of fractured fragments by different techniques, without direct access to the bone and without further traumatizing of tissues. Intramedullary nailing is synthesis and consolidation of fracture fragments with the main goal to gain strength and permanent placement of the implants. Two techniques of intramedullary osteosynthesis are used: with dynamic or with static intramedullary nail. Dynamization include conversion of static nail by removing screws from the longest fragment. Aim: The aim of this study is to determine whether there is a difference in the speed and quality of healing of the type A and B fractures of the femur and tibia treated by static or dynamic intramedullary nails and to compare the results. Material and methods: The study was conducted at the Clinic for Orthopaedics and Traumatology, Clinical Center University Sarajevo from January 2004 to June 2009. The study was retrospective-prospective, manipulative, controlled and it was conducted on a total of 129 patients with closed fractures of the diaphysis of the femur and tibia type A and type B, with different segments of bone, regardless of sex and age structure, with the exception of children under 14 years of age. Results: Precisely there were 47 patients with femoral fractures and 82 patients with tibial fractures. The average number of weeks of healing femoral and tibial fractures was slightly in advantage of static intramedullary osteosynthesis, it was 17.08 weeks (SD=3.382). The average number of weeks of healing in 23 patients with fractures of the femur, treated by dynamic intramedullary osteosynthesis was 17.83 (SD=2.978). We can conclude that static intramedullary nailing osteosynthesis unable movements between fragments which directly stimulates bone formation and formation of minimal callus. Conclusion: Static intramedullary osteosynthesis resolve the problem of stabilizing the fracture, limb shortening and rotation of fragments. PMID:26005261

  16. Irradiation of advanced health care products - Tissues and biologics

    NASA Astrophysics Data System (ADS)

    Winters, Martell

    2014-12-01

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

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

    EPA Science Inventory



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

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

    EPA Science Inventory

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

  19. WEBPAGE ON ENDOCRINE DISRUPTOR CHEMICALS, PHARMACEUTICALS, AND PERSONAL CARE PRODUCTS - UPDATE 6/28/02

    EPA Science Inventory

    The presence of endocrine disruptors, pharmaceuticals, and personal care products in the environment and in drinking waters is a growing concern in the US. The definition of endocrine disruptors is a matter of debate, however, a simple definition is that endocrine disruptors are ...

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

    EPA Science Inventory

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

  1. Antiandrogenic properties of parabens and other phenolic containing small molecules in personal care products

    E-print Network

    Hammock, Bruce D.

    care products Jiangang Chen a , Ki Chang Ahn b , Nancy A. Gee a,c , Shirley J. Gee b , Bruce D. Hammock b,d , Bill L. Lasley a,c, a Center for Health and the Environment, University of California, Davis impact on human reproductive health. © 2007 Elsevier Inc. All rights reserved. Keywords: Androgen

  2. 21 CFR 886.5918 - Rigid gas permeable contact lens care products.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... SERVICES (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5918 Rigid gas permeable... device intended for use in the cleaning, conditioning, rinsing, lubricating/rewetting, or storing of a... Industry Premarket Notification (510(k)) Guidance Document for Contact Lens Care Products.”...

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

    PubMed

    Sage, William M

    2014-06-01

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

  4. Time-Dependent Electrical Properties of Human Nail Upon Hydration In Vivo

    PubMed Central

    HAO, JINSONG; SMITH, KELLY A.; LI, S. KEVIN

    2009-01-01

    The objectives of this study were to investigate the effects of hydration and solution ion concentration on the electrical properties of human nail in vivo and compare these in vivo results with those in vitro. In vivo electrical resistance measurements on the nail were conducted with a three-electrode system in phosphate buffered saline of 0.01–0.6 M. The effect of electric current on nail resistance and possible adverse effects were studied under 1.5- and 9-V iontophoresis in vivo. The electrical resistance of the nail plate was measured in vitro in side-by-side diffusion cells under the same conditions and compared with those in vivo. The in vivo electrical resistance decreased significantly upon 2-h nail hydration and then slowly decreased to a constant value, showing the same pattern as that in vitro. No significant effect of the applied voltage upon the nail electrical resistance was observed. Higher current densities caused moderate sensation and slight changes in nail appearance after iontophoresis. The observed decrease in nail resistance demonstrates the significance of nail hydration in transungual iontophoresis. The in vitro and in vivo correlation suggests that the in vitro nail plate can be a model in the research and development of transungual iontophoretic delivery. PMID:19462425

  5. The psychological contract: enhancing productivity and its implications for long-term care.

    PubMed

    Flannery, Raymond B

    2002-01-01

    When hired, a new employee is usually given a job description and an explanation of benefits. In addition, the employee will also have a psychological contract with the organization. This contract, often unstated, reflects the main source of the employee's motivation to work hard. This is true of all groups of employees, including long-term care staff. Common examples of psychological contracts for long-term care administrative staff include autonomy, social acceptance, and being in the forefront of cutting-edge research. An awareness of these psychological contracts can result in better "fits" between employee aspirations and relevant long-term care organization tasks so that productivity is enhanced. This article outlines the steps necessary to create these good fits in ways that benefit both the organization and its employees. These recommendations are of particular relevance to administrators and supervisors in long-term carefacilities. PMID:12083346

  6. Propagation of Bisphosphonate-Related Femoral Stress Fractures Despite Femoral Nailing

    PubMed Central

    Fang, Christian; Chau, Jackie Yee-Man; Woo, Siu-Bon; Lau, Tak-Wing; Kwan, Kenny; Leung, Frankie

    2014-01-01

    We report 2 cases of atypical femoral fracture displacement despite treatment with intramedullary (IM) nailing. Both patients had received more than 3 years of bisphosphonates. One patient had prophylactic fixation of an atypical femur fracture due to intractable pain. The other had undergone nailing previously for a traumatic shaft fracture. The patient then received bisphosphonate later and sustained an atypical fracture with the nail in place. Both femoral nails were slotted, cannulated stainless steel piriformis entry designs. These 2 cases are among the first reported failures of IM fixation in preventing displacement of a bisphosphonate stress fracture. We advice caution when using slotted nails in prophylaxis of atypical femur fractures because of its significantly reduced torsional stiffness compared to modern nonopen sectioned nails. PMID:24660094

  7. Allografting in Locked Nailing and Interfragmentary Wiring for Humeral Nonunions

    PubMed Central

    Lin, Wei-Peng

    2009-01-01

    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. PMID:19701671

  8. Flexible intramedullary nailing in paediatric femoral shaft fractures.

    PubMed

    Anastasopoulos, John; Petratos, Dimitrios; Konstantoulakis, Charalampos; Plakogiannis, Christos; Matsinos, George

    2010-06-01

    This retrospective study aims to evaluate the efficacy of flexible intramedullary (IM) nails as a fixation device of paediatric femoral shaft fractures. A total of 36 children with 37 closed fractures were treated by this method. The patients ranged in age from 7.2 to 13.5 years and the mean follow-up was 25.5 months. All patients had open femoral growth plates at the time of surgery. All fractures united and none of the patients needed re-operation. Complications included pain/irritation at the insertion site, superficial wound breakdown and one case of delayed union. No major complications were recorded. After nail removal, all children had full range of hip and knee motion. At final follow-up, although radiographs revealed that 44% of the children had malalignment at the fracture site in one or both planes, none of the children presented with clinical malalignment of the fractured limb. Maximum angulation that was calculated on the coronal plane was 5 degrees into varus and on the sagittal plane 7 degrees of anterior angulation (apex posteriorly). Leg-length discrepancy was assessed clinically and radiographically when needed. A total of 50% of the children had a leg-length inequality but none of them complained of a functional problem. Flexible nailing of diaphyseal fractures of the femur is a reliable method with a small learning curve and allows early mobilisation. Most of our minor complications were technique related and could be avoided. PMID:19906371

  9. The use of natural health products by paediatric patients in respite care

    PubMed Central

    Beringer, Audrey; Vaillancourt, Régis; Villarreal, Gilda; Vadeboncoeur, Christina

    2015-01-01

    OBJECTIVES: To determine the use and potential interactions of natural health products (NHPs) with conventional medications in children with life-limiting illnesses. METHODS: The present study was a retrospective medical record review of palliative care patients <18 years of age who were admitted for respite care to a Canadian paediatric hospice between January 1, 2008 and December 31, 2013. The NHPs were identified according to Health Canada’s inclusion criteria. RESULTS: A total of 106 children were included in the present study. Eighty-two (77.4%) had used one or more NHPs: 60 (56%) used vitamins and minerals; 45 (42.5%) used other products including probiotics, omega-3, organic acids and essential fatty acids; 34 (32.1%) used everyday consumer products; 12 (11.3%) used herb or plant-based remedies; and one (0.9%) used homeopathic remedies. Thirty-nine potential NHP-medication and 10 potential NHP-NHP interactions were identified. A considerable number of patients (n=54) used at least one medication and NHP, or two NHPs with potential interactions. The most common type of interaction was pharmacokinetic: decreasing blood concentrations of the medication, NHP or both (43.9% of NHP users); and enhancing the blood concentration of an NHP for NHP-NHP interactions (22% of NHP users). CONCLUSION: A high proportion of patients in respite care use NHPs. Most used NHPs and medications that have potential interactions, although there were no adverse clinical manifestations in the present study. It is important to educate health care professionals about NHPs, the evidence available and lack thereof. This could reduce the most serious interactions and improve the alliance between parents and health care providers to balance the potential risks and benefits of NHPs. PMID:25722640

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

    PubMed Central

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

    2014-01-01

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

  11. [Penetrating injury of the left ventricle caused by a nail gun; report of a case].

    PubMed

    Suda, Hisao; Nakayama, Takuya; Sunada, Masatoshi; Miyata, Yosuke; Yamada, Toshiyuki

    2014-05-01

    Penetrating cardiac injuries are life-threatening emergencies. We present a case of a 24-year-old construction worker who accidentally shot himself with a nail gun. Chest X-ray showed a 6 cm-long nail overlapping the cardiac shadow. A computed tomography (CT) scan revealed the nail penetrating the left ventricle and a large amount of pericardial effusion. Median sternotomy was performed and cardiopulmomary bypass was established. Then, the nail was removed and the left ventricular wound was repaired by 4-0 Prolene mattress sutures buttressed with felt-strips. He had an uncomplicated postoperative course and was discharged 7 days postoperatively. PMID:24917290

  12. [The present study situation and application prospect of nail analysis for abused drugs].

    PubMed

    Chen, Hang; Xiang, Ping; Shen, Min

    2010-10-01

    In forensic toxicology analysis, various types of biological samples have their own special characteristics and scope of applications. In this article, the physiological structure of nails, methods for collecting and pre-processing samples, and for analyzing some poisons and drugs in the nails are reviewed with details. This paper introduces the influence factors of drug abuse of the nails. The prospects of its further applications are concluded based on the research results. Nails, as an unconventional bio-sample without general application, show great potential and advantages in forensic toxicology. PMID:21287743

  13. Effects of organic solvents on the barrier properties of human nail.

    PubMed

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

    2011-10-01

    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. (3) H-water, (14) C-urea, and (14) C-tetraethylammonium ions were the probes in the nail uptake and transport experiments to study the effect(s) of organic solvents on nail hydration and permeability. Gravimetric studies were also performed as a secondary method to study nail hydration and the reversibility of the nail after organic solvent treatments. Both ungual uptake and transport were directly related to the concentration of the organic solvent in the binary systems. Partitioning of the probes into and transport across the nail decreased with an increase in the organic solvent concentration. These changes corresponded to the changes in solution viscosity and the barrier properties of the nail. In general, the effects for PPG and PEG were more pronounced than those for EtOH. Practically, these results suggest that organic solvents in formulations can increase nail barrier resistivity. PMID:21607952

  14. Reduction of nutrients, microbes, and personal care products in domestic wastewater by a benchtop electrocoagulation unit

    NASA Astrophysics Data System (ADS)

    Symonds, E. M.; Cook, M. M.; McQuaig, S. M.; Ulrich, R. M.; Schenck, R. O.; Lukasik, J. O.; van Vleet, E. S.; Breitbart, M.

    2015-03-01

    To preserve environmental and human health, improved treatment processes are needed to reduce nutrients, microbes, and emerging chemical contaminants from domestic wastewater prior to discharge into the environment. Electrocoagulation (EC) treatment is increasingly used to treat industrial wastewater; however, this technology has not yet been thoroughly assessed for its potential to reduce concentrations of nutrients, a variety of microbial surrogates, and personal care products found in domestic wastewater. This investigation's objective was to determine the efficiency of a benchtop EC unit with aluminum sacrificial electrodes to reduce concentrations of the aforementioned biological and chemical pollutants from raw and tertiary-treated domestic wastewater. EC treatment resulted in significant reductions (p < 0.05, ? = 0.05) in phosphate, all microbial surrogates, and several personal care products from raw and tertiary-treated domestic wastewater. When wastewater was augmented with microbial surrogates representing bacterial, viral, and protozoan pathogens to measure the extent of reduction, EC treatment resulted in up to 7-log10 reduction of microbial surrogates. Future pilot and full-scale investigations are needed to optimize EC treatment for the following: reducing nitrogen species, personal care products, and energy consumption; elucidating the mechanisms behind microbial reductions; and performing life cycle analyses to determine the appropriateness of implementation.

  15. Reduction of nutrients, microbes, and personal care products in domestic wastewater by a benchtop electrocoagulation unit

    PubMed Central

    Symonds, E. M.; Cook, M. M.; McQuaig, S. M.; Ulrich, R. M.; Schenck, R. O.; Lukasik, J. O.; Van Vleet, E. S.; Breitbart, M.

    2015-01-01

    To preserve environmental and human health, improved treatment processes are needed to reduce nutrients, microbes, and emerging chemical contaminants from domestic wastewater prior to discharge into the environment. Electrocoagulation (EC) treatment is increasingly used to treat industrial wastewater; however, this technology has not yet been thoroughly assessed for its potential to reduce concentrations of nutrients, a variety of microbial surrogates, and personal care products found in domestic wastewater. This investigation's objective was to determine the efficiency of a benchtop EC unit with aluminum sacrificial electrodes to reduce concentrations of the aforementioned biological and chemical pollutants from raw and tertiary-treated domestic wastewater. EC treatment resulted in significant reductions (p < 0.05, ? = 0.05) in phosphate, all microbial surrogates, and several personal care products from raw and tertiary-treated domestic wastewater. When wastewater was augmented with microbial surrogates representing bacterial, viral, and protozoan pathogens to measure the extent of reduction, EC treatment resulted in up to 7-log10 reduction of microbial surrogates. Future pilot and full-scale investigations are needed to optimize EC treatment for the following: reducing nitrogen species, personal care products, and energy consumption; elucidating the mechanisms behind microbial reductions; and performing life cycle analyses to determine the appropriateness of implementation. PMID:25797885

  16. Perspectives and strategies of alternative methods used in the risk assessment of personal care products.

    PubMed

    Quantin, P; Thélu, A; Catoire, S; Ficheux, H

    2015-11-01

    Risk assessment for personal care products requires the use of alternative methods since animal testing is now totally banned. Some of these methods are effective and have been validated by the "European Union Reference Laboratory for alternatives to animal testing"; but there is still a need for development and implementation of methods for specific endpoints. In this review, we have focused on dermal risk assessment because it is the prime route of absorption and main target organ for personal care products. Within this field, various areas must be assessed: irritation, sensitisation and toxicokinetic. Personal care product behaviour after use by the consumer and potential effects on the environment are also discussed. The purpose of this review is to show evolution and the prospects of alternative methods for safety dermal assessment. Assessment strategies must be adapted to the different chemical classes of substances studied but also to the way in which they are used. Finally, experimental and theoretical technical parameters that may impact on measured effects have been identified and discussed. PMID:26184446

  17. Alteration of the diffusional barrier property of the nail leads to greater terbinafine drug loading and permeation.

    PubMed

    Nair, Anroop B; Sammeta, Srinivasa M; Kim, Hyun D; Chakraborty, Bireswar; Friden, Phillip M; Murthy, S Narasimha

    2009-06-22

    The diffusional barrier property of biological systems varies with ultrastructural organization of the tissues and/or cells, and often plays an important role in drug delivery. The nail plate is a thick, hard and impermeable membrane which makes topical nail drug delivery challenging. The current study investigated the effect of physical and chemical alteration of the nail on the trans-ungual drug delivery of terbinafine hydrochloride (TH) under both passive and iontophoretic conditions. Physical alterations were carried out by dorsal or ventral nail layer abrasion, while chemical alterations were performed by defatting or keratolysis or ionto-keratolysis of the nails. Terbinafine permeation into and across the nail plate following various nail treatments showed similar trends in both passive and iontophoretic delivery, although the extent of drug delivery varied with treatment. Application of iontophoresis to the abraded nails significantly improved (P<0.05) TH permeation and loading compared to abraded nails without iontophoresis or normal nails with iontophoresis. Drug permeation was not enhanced when the nail plate was defatted. Keratolysis moderately enhanced the permeation but not the drug load. Ionto-keratolysis enhanced TH permeation and drug load significantly (P<0.05) during passive and iontophoretic delivery as compared to untreated nails. Ionto-keratolysis may be more efficient in permeabilization of nail plates than long term exposure to keratolysing agents. PMID:19481686

  18. Impact of IT on health care professionals: changes in work and the productivity paradox.

    PubMed

    Hebert, M A

    1998-05-01

    Health care organizations are under increasing pressure to become more efficient while at the same time maintaining or improving the quality of care. Information technology (IT), with its potential to increase efficiency, accuracy and accessibility of information, has been expected to play an important role in supporting these changes. We report the impact of patient care information systems on health care professionals in five community hospitals. The study framework incorporated both quality of care in Donabedian's elements of structure-process-outcome and Grusec's three levels of IT impact: direct substitution, proceduralization and new capabilities. The study results suggest that, for specific tasks, IT increased efficiency and productivity--a single employee was able to complete more tasks. However, this produced other consequences not predicted. Participants noted this change did not 'free up time' to spend with patients, but meant there were potentially more opportunities to provide services and more tasks to complete. Other effects included: reduced job satisfaction as more time was spent on the computer; less frequent interactions with patients and for shorter duration; and an increasingly 'visible' accountability as performance was easily monitored. There were also changes in roles and responsibilities as the computer enabled tasks to be carried out from a number of locations and by a variety of personnel. When innovations are introduced into organizations there are both expected and unexpected consequences. Increased awareness of the interactive relationship between computer users and the technology helps organizations better understand why results do, or do not, occur. One must look beyond just simply increasing productivity by replacing manual tasks with automated ones, to examining how the changes influence the nature of work and relationships within the organization. PMID:10181380

  19. Sun-care product advertising in parenting magazines: what information does it provide about sun protection?

    PubMed

    Kang, Hannah; Walsh-Childers, Kim

    2014-01-01

    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

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

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

    PubMed

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

    2013-06-01

    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

  3. 76 FR 29266 - Certain Steel Nails From the United Arab Emirates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-20

    ..., and by publishing the notice in the Federal Register of April 6, 2011 (76 FR 19124). The conference... Certain Steel Nails From the United Arab Emirates Determination On the basis of the record \\1\\ developed... imports from the United Arab Emirates of certain steel nails, provided for in subheadings 7317.00.55,...

  4. 77 FR 27080 - Certain Steel Nails From the United Arab Emirates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-08

    ..., Washington, DC, and by publishing the notice in the Federal Register of November 23, 2011 (76 FR 72438). The... Certain Steel Nails From the United Arab Emirates Determination On the basis of the record \\1\\ developed... certain steel nails, provided for in subheadings 7317.00.55, 7317.00.65, and 7317.00.75 of the...

  5. Bifunctional ectodermal stem cells around the nail display dual fate homeostasis and adaptive wounding

    E-print Network

    Chuong, Cheng-Ming

    Bifunctional ectodermal stem cells around the nail display dual fate homeostasis and adaptive of regeneration and the dynamics of their SC homeostasis remain to be unraveled. A slow cycling characteristic has cell population is bifunctional. Upon nail plucking injury, the homeostasis is tilted with these SCs

  6. 76 FR 52313 - Certain Steel Nails From the United Arab Emirates: Postponement of Preliminary Determination of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-22

    ... Arab Emirates. See Certain Steel Nails From the United Arab Emirates: Initiation of Antidumping Duty Investigation, 76 FR 23559 (April 27, 2011). The notice of initiation stated that the Department would issue its... International Trade Administration Certain Steel Nails From the United Arab Emirates: Postponement...

  7. Penetrating intracranial nail-gun injury to the middle cerebral artery: A successful primary repair

    PubMed Central

    Isaacs, Albert M.; Yuh, Sung-Joo; Hurlbert, R. John; Mitha, Alim P.

    2015-01-01

    Background: Penetrating nail-gun injuries to the head are rare, however, the incidence has been gradually rising over the last decade. While there is a large volume of case reports in the literature, there are only a few incidences of cerebrovascular injury. We present a case of a patient with a nail-gun injury to the brain, which compromised the cerebral vasculature. In this article, we present the case, incidence, pathology, and a brief literature review of penetrating nail-gun injuries to highlight the principles of management pertaining to penetration of cerebrovascular structures. Case Description: A 26-year-old male presented with a penetrating nail-gun injury to his head. There were no neurological deficits. Initial imaging revealed that the nail had penetrated the cranium and suggested the vasculature to be intact. However, due to the proximity of the nail to the circle of Willis the operative approach was tailored in anticipation of a vascular injury. Intraoperatively removal of the foreign body demonstrated a laceration to the M1 branch of the middle cerebral artery (MCA), which was successfully repaired. Conclusion: To our knowledge, this is the first reported case of a vascular arterial injury to the MCA from a nail-gun injury. It is imperative to have a high clinical suspicion for cerebrovascular compromise in penetrating nail-gun injuries even when conventional imaging suggests otherwise. PMID:26500798

  8. Contaminants in human nail dust: an occupational hazard in podiatry?

    PubMed Central

    2014-01-01

    Background There has been limited literature indicating that podiatrists’ health may be at risk from exposure to human nail dust. Previous studies carried out in the UK have shown that large amounts of dust become airborne during the human nail drilling procedure and are present in the air up to 10 hours after a clinical session. This increases the risk of Respiratory Tract (RT) infection for the practitioner. Methods This study used a nasal swabbing technique and fungal culture to determine whether podiatrists (n = 50) had the same microbes present in their nasal cavities as non-podiatry health professional control group (n = 45). All swabs were cultured, counted and identified for each subject. Survey data of use and type of nail drill, type of mask used and frequency of change over a two week period. Results The results showed podiatrists had a greater range of microbes in their nasal cavities although the controls had greater overall numbers of organisms. The known pathogen and common mould, Aspergillus fumigatus was ost commonly found fungus within the podiatric group with 44% of the group having the fungus present. All nail drills used by the podiatrists had some form of dust extraction (except one). Of concern was 17% (n = 8) of the podiatrists did not use a mask at all whilst drilling and seemed unaware of any infection control issues. Simple disposable masks were the most frequently worn with only half being changed after each patient further increasing the cross infection risk Conclusion The high levels of Aspergilus contamination is a significant finding in the podiatry group as this fungus is small enough to enter the tissue of the nasal cavity and as a small particle will stay airborne in the room for up to 16 hours. Aspergilus has been shown to cause brain and soft tissue tumours in extreme cases. The high levels of upper respiratory track problems reported in the literature may well be caused by this fungal agent. The non use and use of inappropriate masks by podiatrists is clearly an occupational hazard to their health and well being. PMID:24552311

  9. Nail-like targets for laser plasma interaction experiments

    SciTech Connect

    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

    2007-12-18

    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.

  10. Pharmaceuticals and personal care products in chicken meat and other food animal products: a market-basket pilot study.

    PubMed

    Baron, Patrick A; Love, David C; Nachman, Keeve E

    2014-08-15

    Pharmaceutical drugs are extensively used in industrial food animal production. We examined whether residues of veterinary antibiotics and other pharmaceuticals and personal care products (PPCPs) were detectable in a small market-basket sample of retail chicken (n=39), ground beef (n=3) and milk (n=3) samples. High-performance liquid chromatography and tandem mass spectrometry were used to assess the concentration of 59 PPCPs and their residues in animal products. All samples of ground beef, milk, and 14 chickens were analyzed individually, while an additional 25 chicken samples were pooled and analyzed in groups of five. The majority of PPCPs were not detected in meat and milk samples. Caffeine was detected in two of three milk samples (0.4 ng/mL, 2.0 ng/mL) and in 10 of 19 individual and pooled chicken samples (median: 18.6 ng/g, range: 6.1-28.8 ng/g). Acetaminophen was detected in three of three milk samples (median: 1.5 ng/mL, range: 1.4-2.1 ng/mL). Antibiotics in the tetracycline class were detected in two of three milk samples (median: 1.0 ng/mL, range: 0.1-2.0 ng/mL) and did not exceed regulatory residue tolerances of 300 ng/mL. There are no regulatory residue tolerances for caffeine or acetaminophen in animal products. The acetaminophen detections in milk, however, raise questions about extra-label and unapproved use of pharmaceutical drugs in food animal production, as this drug is not approved for use in lactating dairy cattle or any other type of food animal production. Additional studies are needed to confirm our finding of PPCPs in meat and dairy products. PMID:24858227

  11. Analysis of human nails by laser-induced breakdown spectroscopy

    NASA Astrophysics Data System (ADS)

    Hosseinimakarem, Zahra; Tavassoli, Seyed Hassan

    2011-05-01

    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.

  12. Linkage analysis of the Nail-patella syndrome

    SciTech Connect

    Campeau, E.; Watkins, D.; Rouleau, G.A.; Babul, R.; Der Kaloustian, V.M.; Buchanan, J.A.; Meschino, W.

    1995-01-01

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

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

    PubMed Central

    Lipscomb, J; Scheffler, R M

    1975-01-01

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

  14. Instrument to assess the nursing care product: development and content validation 1

    PubMed Central

    Cucolo, Danielle Fabiana; Perroca, Márcia Galan

    2015-01-01

    Abstract Objectives: develop and validate the content of a tool about nursing care production. Method: the data were collected between 2011 and 2013, based on focus groups, the application of semistructured questionnaires (prototype test) and the Delphi technique. The focus groups were used to produce the instrument items and held at three hospitals in the interior of the State of São Paulo, involving 20 nurses. A panel of 10 experts evaluated the instrument. Results: after two phases of the Delphi technique, the tool consisted of eight items. The content validity index of the scale corresponded to ?0.9 and the content validity of the items ranged between 0.8 and 1.0, indicating the maintenance of the structure and content. The assertion on the applicability in daily nursing practice showed a content validity index of the scale equal to 0.8. Conclusion: this study permitted the development and content validation of scale on nursing care production, equipping the nurses in their management practice. PMID:26444166

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

    PubMed

    Blackman, Tim

    2013-07-01

    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

  16. Functional Knee Outcomes in Infrapatellar and Suprapatellar Tibial Nailing: Does Approach Matter?

    PubMed

    Courtney, P Maxwell; Boniello, Anthony; Donegan, Derek; Ahn, Jaimo; Mehta, Samir

    2015-12-01

    We conducted a study to determine differences in knee pain in patients who underwent either traditional infrapatellar nailing or suprapatellar nailing. From a single institution, we identified patients who had an isolated tibial shaft fracture (Orthopaedic Trauma Association type 42 A-C) surgically fixed with an intramedullary nail between 2009 and 2012. Each patient was contacted by telephone by an investigator blinded to surgical exposure, and the Oxford Knee Score (OKS) questionnaire was administered. Operative time and quality of reduction on postoperative radiographs were compared between the 2 approaches. Twenty-four patients underwent infrapatellar nailing, and 21 patients had a suprapatellar nail placed with approach-specific instrumentation. Mean OKS (maximum, 48 points) was 40.1 for the infrapatellar group and 36.7 for the suprapatellar group (P = .293). Compared with the infrapatellar approach, suprapatellar nailing improved radiographic reduction in the sagittal plane (2.90° vs 4.58°; P = .044) and required less operative fluoroscopy time (81 vs 122 s; P = .003). We found no difference in OKS between the infrapatellar and suprapatellar approaches. Although further study is needed, the suprapatellar entry portal appears to be a safe alternative for tibial nailing with use of appropriate instrumentation. PMID:26665254

  17. In Vitro penetration of a novel oxaborole antifungal (AN2690) into the human nail plate.

    PubMed

    Hui, Xiaoying; Baker, Stephen J; Wester, Ronald C; Barbadillo, Sherry; Cashmore, Anne K; Sanders, Virginia; Hold, Karin M; Akama, Tsutomu; Zhang, Yong-Kang; Plattner, Jacob J; Maibach, Howard I

    2007-10-01

    Onychomycosis is a challenging fungal infection to treat topically, likely due to the unique properties of the nail plate. This seemingly impenetrable barrier has high resistance to the passage of antifungal drugs in sufficient concentrations to kill the causative fungi deep in the nail bed. Recently, a new class of antifungal agent was described, termed oxaboroles, which have broad-spectrum activity. These oxaboroles were designed with properties believed to be required to allow for easier transit through the nail plate. Herein, we report (i) the nail penetration results of four oxaboroles that led to the selection of AN2690, (ii) the results of the nail penetration of AN2690 from four vehicles, and (iii) the nail penetration of AN2690 in its chosen vehicle compared to a commercial control, ciclopirox. AN2690 has superior penetration compared to ciclopirox, and achieves levels within and under the nail plate that suggest it has the potential to be an effective topical treatment for onychomycosis. PMID:17621679

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

    PubMed

    Chouhan, P; Saini, T R

    2012-10-15

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

  19. Onychopharmacokinetics of terbinafine hydrochloride penetration from a novel topical formulation into the human nail in vitro.

    PubMed

    Hui, Xiaoying; Lindahl, Åke; Lamel, Sonia; Maibach, Howard I

    2013-09-01

    This study determined the onychopharmacokinetics, nail absorption, distribution, and penetration of [¹?C]-terbinafine HCl in a new topical formulation into/through the human finger nail using the in vitro finite dose model. This study determined the penetration rate of terbinafine HCl from multiple doses of topical formulation applied daily for 14 days. Results showed that the total dose recovery (mass balance) was almost 100%. The concentration of terbinafine HCl in the deeper nail plate (ventral/intermediate layers) and the cotton-pad nail bed samples after the 14-day treatment were 613?±?145 and (±S.D.) and 27?±?1.2 µg/cm³ (or 1.9?±?0.6 µg/cm³ daily) on average, respectively. In comparison with nail concentration data from the literature for other topical terbinatine formulations, our results show that higher amounts of terbinafine HCl reached the deep nail plate and/or the nail bed after a 14-day topical treatment with this topical formulation in vitro. PMID:22873754

  20. Nailing versus plating in thoracic trauma: an experimental study in sheep.

    PubMed

    Neudeck, F; Wozasek, G E; Obertacke, U; Thurnher, M; Schlag, G

    1996-06-01

    In this study, femoral intramedullary pressure, fat embolization, and pulmonary response were measured during reamed and unreamed nailing and plating of femoral fractures after blunt thoracic trauma. Intramedullary peak pressures of 425 mm Hg (mean 205 mm Hg) occurred in the reamed nail group (group I) during reaming with the 9-mm reamer, while in the unreamed nail group (group II) peak values were seen during nail insertion (330 mm Hg) with a mean of 203 mm Hg. Plating never led to a pressure rise over 67 mm Hg (mean 37 mm Hg). In reamed nailing, the most intense embolism was identified under ultrasound imaging with the large awl and with the 9.0-mm reamer (mean 2.2) and in the unreamed nail group during nail insertion (mean 2.8). Minimal echoes appeared during plating. The pulmonary arterial pressure did not vary significantly postoperatively between the three groups (p < 0.08). Our findings indicate that intramedullary fracture fixation causes a higher increase of intramedullary pressure and more fat and bone marrow embolization than extramedullary ones. Nevertheless, only minimal differences in the pulmonary hemodynamic response (pulmonary arterial pressure) were noted even in the presence of thoracic trauma. PMID:8656488

  1. Lgr6 marks nail stem cells and is required for digit tip regeneration.

    PubMed

    Lehoczky, Jessica A; Tabin, Clifford J

    2015-10-27

    The tips of the digits of some mammals, including human infants and mice, are capable of complete regeneration after injury. This process is reliant on the presence of the overlaying nail organ and is mediated by a proliferative blastema. Epithelial Wnt/?-catenin signaling has been shown to be necessary for mouse digit tip regeneration. Here, we report on Lgr5 and Lgr6 (leucine-rich repeat-containing G protein-coupled receptor 5 and 6), two important agonists of the Wnt pathway that are known to be markers of several epithelial stem cell populations. We find that Lgr5 is expressed in a dermal population of cells adjacent to the specialized epithelia surrounding the keratinized nail plate. Moreover, Lgr5-expressing cells contribute to this dermis, but not the blastema, during digit tip regeneration. In contrast, we find that Lgr6 is expressed within cells of the nail matrix portion of the nail epithelium, as well as in a subset of cells in the bone and eccrine sweat glands. Genetic lineage analysis reveals that Lgr6-expressing cells give rise to the nail during homeostatic growth, demonstrating that Lgr6 is a marker of nail stem cells. Moreover, Lgr6-expressing cells contribute to the blastema, suggesting a potential direct role for Lgr6-expressing cells during digit tip regeneration. This role is confirmed by analysis of Lgr6-deficient mice, which have both a nail and bone regeneration defect. PMID:26460010

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

    PubMed Central

    2014-01-01

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

  3. [Infections of finger and toe nails due to fungi and bacteria].

    PubMed

    Nenoff, P; Paasch, U; Handrick, W

    2014-04-01

    Infections of the finger and the toe nails are most frequently caused by fungi, primarily dermatophytes. Causative agents of tinea unguium are mostly anthropophilic dermatophytes. Both in Germany, and worldwide, Trichophyton rubrum represents the main important causative agent of onychomycoses. Yeasts are isolated from fungal nail infections, both paronychia and onychomycosis far more often than generally expected. This can represent either saprophytic colonization as well as acute or chronic infection of the nail organ. The main yeasts causing nail infections are Candida parapsilosis, and Candida guilliermondii; Candida albicans is only in third place. Onychomycosis due to molds, or so called non-dermatophyte molds (NDM), are being increasingly detected. Molds as cause of an onychomycosis are considered as emerging pathogens. Fusarium species are the most common cause of NDM onychomycosis; however, rare molds like Onychocola canadensis may be found. Bacterial infections of the nails are caused by gram negative bacteria, usually Pseudomonas aeruginosa (recognizable because of green or black coloration of the nails) but also Klebsiella spp. and gram positive bacteria like Staphylococcus aureus. Treatment of onychomycosis includes application of topical antifungal agents (amorolfine, ciclopirox). If more than 50?% of the nail plate is affected or if more than three out of ten nails are affected by the fungal infection, oral treatment using terbinafine (in case of dermatophyte infection), fluconazole (for yeast infections), or alternatively itraconazole are recommended. Bacterial infections are treated topically with antiseptic agents (octenidine), and in some cases with topical antibiotics (nadifloxacin, gentamicin). Pseudomonas infections of the nail organ are treated by ciprofloxacin; other bacteria are treated according to the results of culture and sensitivity testing. PMID:24718510

  4. Molecular diffusion in the human nail measured by stimulated Raman scattering microscopy

    PubMed Central

    Chiu, Wing Sin; Belsey, Natalie A.; Garrett, Natalie L.; Moger, Julian; Delgado-Charro, M. Begoña; Guy, Richard H.

    2015-01-01

    The effective treatment of diseases of the nail remains an important unmet medical need, primarily because of poor drug delivery. To address this challenge, the diffusion, in real time, of topically applied chemicals into the human nail has been visualized and characterized using stimulated Raman scattering (SRS) microscopy. Deuterated water (D2O), propylene glycol (PG-d8), and dimethyl sulphoxide (DMSO-d6) were separately applied to the dorsal surface of human nail samples. SRS microscopy was used to image D2O, PG-d8/DMSO-d6, and the nail through the O-D, -CD2, and -CH2 bond stretching Raman signals, respectively. Signal intensities obtained were measured as functions of time and of depth into the nail. It was observed that the diffusion of D2O was more than an order of magnitude faster than that of PG-d8 and DMSO-d6. Normalization of the Raman signals, to correct in part for scattering and absorption, permitted semiquantitative analysis of the permeation profiles and strongly suggested that solvent diffusion diverged from classical behavior and that derived diffusivities may be concentration dependent. It appeared that the uptake of solvent progressively undermined the integrity of the nail. This previously unreported application of SRS has permitted, therefore, direct visualization and semiquantitation of solvent penetration into the human nail. The kinetics of uptake of the three chemicals studied demonstrated that each altered its own diffusion in the nail in an apparently concentration-dependent fashion. The scale of the unexpected behavior observed may prove beneficial in the design and optimization of drug formulations to treat recalcitrant nail disease. PMID:26056283

  5. Permeation studies of novel terbinafine formulations containing hydrophobins through human nails in vitro.

    PubMed

    Vejnovic, Ivana; Huonder, Cornelia; Betz, Gabriele

    2010-09-15

    Existing treatments of onychomycosis are not satisfactory. Oral therapies have many side effects and topical formulations are not able to penetrate into the human nail plate and deliver therapeutical concentrations of active agent in situ. The purpose of the present study was to determine the amount of terbinafine, which permeates through the human nail plate, from liquid formulations containing enhancers, namely hydrophobins A-C in the concentration of 0.1% (w/v). The used reference solution contained 10% (w/v) of terbinafine in 60% (v/v) ethanol/water without enhancer. Permeability studies have been performed on cadaver nails using Franz diffusion cells modified to mount nail plates and filled with 60% (v/v) ethanol/water in the acceptor chamber. Terbinafine was quantitatively determined by HPLC. The amount of terbinafine remaining in the nail was extracted by 96% ethanol from pulverized nail material after permeation experiment and presented as percentage of the dry nail weight before the milling test. Permeability coefficient (PC) of terbinafine from reference solution was determined to be 1.52E-10 cm/s. Addition of hydrophobins improved PC in the range of 3E-10 to 2E-9 cm/s. Remaining terbinafine reservoir in the nail from reference solution was 0.83% (n=2). An increase of remaining terbinafine reservoir in the nail was observed in two out of three tested formulations containing hydrophobins compared to the reference. In all cases, known minimum inhibitory concentration of terbinafine for dermatophytes (0.003 microg/ml) has been exceeded in the acceptor chamber of the diffusion cells. All tested proteins (hydrophobins) facilitated terbinafine permeation after 10 days of permeation experiment, however one of them achieved an outstanding enhancement factor of 13.05 compared to the reference. Therefore, hydrophobins can be included in the list of potential enhancers for treatment of onychomycosis. PMID:20620203

  6. Glycated nail proteins as a new biomarker in management of the South Kivu Congolese diabetics

    PubMed Central

    Katchunga, Philippe B.; Mirindi, Patrick N.; Kishabongo, Antoine S.; Cikomola, Justin C.; Bwanamdogo, Socrate; Philippé, Jan; Speeckaert, Marijn M.

    2015-01-01

    Introduction Diagnosis and monitoring of diabetes mellitus in sub-Saharan Africa, based on blood analyses, are hampered by infrastructural and cultural reasons. The first aim of this study was to evaluate the diagnostic accuracy of glycated nail proteins for diabetes mellitus. The second aim was to compare the course of short- and long-term glycemic biomarkers after 6 months of antidiabetic treatment. These objectives should support our hypothesis that glycated nail proteins could be used as an alternative glycemic biomarker. Materials and methods This case-control study consisted of 163 black diabetics and 67 non-diabetics of the South Kivu (Democratic Republic of Congo). Diagnostic accuracy of glycated nail proteins was evaluated using ROC curve analysis. At the start of the study, glycated nail protein concentrations were compared between diabetics and non-diabetics, using a nitro blue tetrazolium (NBT) colorimetric method. In a subgroup of 30 diabetics, concentrations of glycated nail proteins, fasting glucose (Accu-Chek® Aviva), serum fructosamine (NBT) and HbA1c (DCA-2000+®) were measured at start and after 6 months. Results ROC analysis yielded an AUC of 0.71 (95% confidence interval (CI): 0.65-0.76) and a cut-off point of 3.83 ?mol/g nail. Concentration of glycated nail proteins was significantly higher (P < 0.001) in diabetics in comparison with non-diabetics. After 6 months of antidiabetic treatment, a significant drop in the fasting glucose concentration (P = 0.017) and concentration of glycated nail proteins (P = 0.008) was observed in contrast to serum fructosamine and HbA1c. Conclusions Measurement of glycated nail proteins could be used to diagnose and monitor diabetes mellitus in sub-Saharan Africa. PMID:26526975

  7. Küntscher nailing in the treatment of femoral fractures in children. Is it completely contraindicated?

    PubMed

    Valdiserri, L; Marchiodi, L; Rubbini, L

    1983-09-01

    Seventeen children between the ages of 6 and 12 years with fractured femoral shafts were treated by Küntscher nailing. They were followed up clinically and radiographically to ascertain if nailing had any long term adverse effects. The following radiographic parameters were considered: --valgus, varus angle; --distance between lesser trochanter and acetabulum; --width of the neck of the femur; --distance between greater trochanter and acetabulum; --intertrochanteric distance. On analysing the results it was found that Küntscher nailing did not give rise to any adverse effects provided it is carried out after 8-9 years of age. PMID:6662707

  8. Keratinophilic and saprophytic fungi isolated from students' nails in Egypt.

    PubMed

    Abdel-Hafez, A I; el-Sharouny, H M

    1990-01-01

    In order to determine the presence of dermatophytes and saprophytes in healthy toe and finger nails, 120 students (60 male and 60 female) from preparatory schools at Sohag Governorate (Upper Egypt) were studied. 54 species in addition to 3 varieties belonging to 17 genera were isolated. Six species of true dermatophytes were collected: Microsporum audouinii var. rivalieri, M. cookei, Trichophyton mentagrophytes, T. simii, T. terrestre and T. verrucosum. Chrysosporium, a well-known keratinophilic genus, was prevalent and represented by 7 species (C. asperatum, C. indicum, C. keratinophilum, C. luteum, C. pannorum, C. tropicum and Chrysosporium state of Thielavia sepedonium). The commonest saprophytes in order of frequency were members of the genera Aspergillus, Penicillium, Alternaria, Scopulariopsis, Fusarium, Paecilomyces, Chaetomium, Syncephalastrum, Mucor, Rhizopus and Acremonium. PMID:2338622

  9. Fusarium Solani: A Causative Agent of Skin and Nail Infections

    PubMed Central

    Kuruvilla, Thomas S; Dias, Meena

    2012-01-01

    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. PMID:22837572

  10. Caregiver burden, productivity loss, and indirect costs associated with caring for patients with poststroke spasticity

    PubMed Central

    Ganapathy, Vaidyanathan; Graham, Glenn D; DiBonaventura, Marco D; Gillard, Patrick J; Goren, Amir; Zorowitz, Richard D

    2015-01-01

    Objective Many stroke survivors experience poststroke spasticity and the related inability to perform basic activities, which necessitates patient management and treatment, and exerts a considerable burden on the informal caregiver. The current study aims to estimate burden, productivity loss, and indirect costs for caregivers of stroke survivors with spasticity. Methods Internet survey data were collected from 153 caregivers of stroke survivors with spasticity including caregiving time and difficulty (Oberst Caregiver Burden Scale), Work Productivity and Activity Impairment measures, and caregiver and patient characteristics. Fractional logit models examined predictors of work-related restriction, and work losses were monetized (2012 median US wages). Results Mean Oberst Caregiver Burden Scale time and difficulty scores were 46.1 and 32.4, respectively. Employed caregivers (n=71) had overall work restriction (32%), absenteeism (9%), and presenteeism (27%). Caregiver characteristics, lack of nursing home coverage, and stroke survivors’ disability predicted all work restriction outcomes. The mean total lost-productivity cost per employed caregiver was US$835 per month (>$10,000 per year; 72% attributable to presenteeism). Conclusion These findings demonstrate the substantial burden of caring for stroke survivors with spasticity illustrating the societal and economic impact of stroke that extends beyond the stroke survivor. PMID:26609225

  11. Trends in Exposure to Chemicals in Personal Care and Consumer Products.

    PubMed

    Calafat, Antonia M; Valentin-Blasini, Liza; Ye, Xiaoyun

    2015-12-01

    Synthetic organic chemicals can be used in personal care and consumer products. Data on potential human health effects of these chemicals are limited-sometimes even contradictory-but because several of these chemicals are toxic in experimental animals, alternative compounds are entering consumer markets. Nevertheless, limited information exists on consequent exposure trends to both the original chemicals and their replacements. Biomonitoring (measuring concentrations of chemicals or their metabolites in people) provides invaluable information for exposure assessment. We use phthalates and bisphenol A-known industrial chemicals-and organophosphate insecticides as case studies to show exposure trends to these chemicals and their replacements (e.g., other phthalates, non-phthalate plasticizers, various bisphenols, pyrethroid insecticides) among the US general population. We compare US trends to national trends from Canada and Germany. Exposure to the original compounds is still prevalent among these general populations, but exposures to alternative chemicals may be increasing. PMID:26342608

  12. Pharmaceuticals and personal care products alter the holobiome and development of a medically important mosquito.

    PubMed

    Pennington, Marcus J; Rivas, Nicholas G; Prager, Sean M; Walton, William E; Trumble, John T

    2015-08-01

    The increasing demand for fresh water has forced many countries to use reclaimed wastewater for agricultural purposes. This water contains pharmaceuticals and personal care products (PPCPs) that remain biologically active following passage through wastewater treatment plants. Run-off from farms and contaminated water from treatment facilities exposes aquatic ecosystems to PPCPs. This study examined the effects of PPCPs on a lower trophic organism. Culex quinquefasciatus larvae were reared in water contaminated with environmentally relevant concentrations of common PPCPs. Acetaminophen alone and a mixture of contaminants were found to increase developmental time of larvae. Susceptibility to Bti increased in larvae exposed to antibiotics, acetaminophen, or a mixture of PPCPs. Antibiotics, hormones, and the mixture altered the mosquito bacterial microbiome. Overall, the results indicate that at environmentally relevant concentrations, PPCPs in reclaimed water can have biologically important effects on an ecologically and medically important lower trophic level insect. PMID:25913146

  13. Applications of molecularly imprinted polymers to the analysis and removal of personal care products: A review.

    PubMed

    Figueiredo, L; Erny, G L; Santos, L; Alves, A

    2016-01-01

    Personal-care products (PCPs) involve a variety of chemicals whose persistency along with their constant release into the environment raised concern to their potential impact on wildlife and humans health. Regarded as emergent contaminants, PCPs demonstrated estrogenic activity leading to the need of new methodologies to detect and remove those compounds from the environment. Molecular imprinting starts with a complex between a template molecule and a functional monomer, which is then polymerized in the presence of a cross-linker. After template removal, the polymer will contain specific cavities. Based on a good selectivity towards the template, molecularly imprinted polymers (MIPs) have been investigated as efficient materials for the analysis and extraction of the so called emergent pollutants contaminants. Rather than lowering the limit of detections, the key theoretical advantage of MIP over existing methodologies is the potential to target specific chemicals. This unique feature, sometime named specificity (as synonym to very high selectivity) allows to use cheap, simple and/or rapid quantitative techniques such as fast separation with ultra-violet (UV) detection, sensors or even spectrometric techniques. When a high degree of selectivity is achieved, samples extracted with MIPs can be directly analyzed without the need of a separation step. However, while some papers clearly demonstrated the specificity of their MIP toward the targeted PCP, such prove is often lacking, especially with real matrices, making it difficult to assess the success of the different approaches. This review paper focusses on the latest development of MIPs for the analysis of personal care products in the environment, with particular emphasis on design, preparation and practical applications of MIPs. PMID:26695327

  14. Capacity in Thai Public Hospitals and the Production of Care for Poor and Nonpoor Patients

    PubMed Central

    Valdmanis, Vivian; Kumanarayake, Lilani; Lertiendumrong, Jongkol

    2004-01-01

    Objective To assess the capacity of Thai public hospitals to proportionately expand services to both the poor and the nonpoor. This is accomplished by measuring the production of services provided to poor, relative to nonpoor, patients and the plant capacity of individual public hospitals to care for the patient load. Study Setting Thai public hospitals operating in 1999, following the economic crisis when public hospitals were required to treat all patients irrespective of ability to pay. Study Design and Data Collection Input and output data for 68 hospitals were collected using databases and questionnaire surveys. A distinction was made between inpatient and outpatient services to both poor and nonpoor patients and the data were assessed statistically. Data Analysis Congestion and capacity indices to measure poor/nonpoor service trade-offs and capacity utilization were estimated. The analysis was undertaken by data envelopment analysis (DEA), a nonparametric linear programming approach used to derive efficiency and productivity estimates. Principal Findings Increases in the amount of services provided to poor patients did not reduce the amount of services to nonpoor patients. Overall, hospitals are producing services relatively close to their capacity given fixed inputs. Possible increases in capacity utilization amounted to 5 percent of capacity. Conclusions Results suggest that some increased public hospital care can be accomplished by reallocation of resources to less highly utilized hospitals, given the budgetary constraints. However, further expansion and increase in access to health services will require plant investments. The study illustrates how DEA methodologies can be used in planning health services in data constrained settings. PMID:15544647

  15. Marchetti Vicenzi elastic retrograde nail in the treatment of humeral shaft fractures: review of the current literature.

    PubMed

    Ruffilli, A; Traina, F; Pilla, F; Fenga, D; Faldini, C

    2015-12-01

    Shoulder impairment following anterograde intramedullary nailing for humeral shaft fractures represents a challenging problem for the orthopedic surgeon. Traditional retrograde nailing lowers the rates of shoulder impairment although exposing the surgeons to severe technical issues related to the proximal interlocking. The Marchetti Vicenzi nail (MVN) permits a retrograde insertion along with a self-locking mechanism that lowers the risk of iatrogenic damage during proximal interlocking. Aim of this literature review was to evaluate all the case series dealing with MVN and the obtained results in terms of union rates, complications, and functional outcomes in order to evaluate evidence that would substantiate the adoption of MVN in the treatment of humeral shaft fractures. A search was performed using the keywords "humeral shaft fracture nail," "humeral retrograde nail," "humeral elastic nail," "Marchetti Vicenzi nail," "Marchetti nail," "Vicenzi nail." After accurate revision 13 articles found to be relevant with a total of 532 humeral fractures (traumatic and pathologic) and non-unions treated with MVN. The cumulative healing rate reported is 93.7 % with 6.3 % of non-unions. Despite the fact that obtained results compare favorably to the published data on the outcome of anterograde nailing, the evaluated studies presented a huge number of methodological flaws, thus making it difficult to recommend the adoption of MVN in preference of other better-validated forms of treatment. PMID:26559733

  16. Transient Biometrics using Finger Nails Igor Barros Barbosa Theoharis Theoharis Christian Schellewald

    E-print Network

    Schellewald, Christian

    Transient Biometrics using Finger Nails Igor Barros Barbosa Theoharis Theoharis Christian Athwal School of Digital Media Technology Birmingham City University Abstract Transient biometrics, a new concept for biometric recog- nition, is introduced in this paper. A traditional perspective of biometric

  17. Different physicochemical properties of antimycotic agents are relevant for penetration into and through human nails.

    PubMed

    Neubert, R H H; Gensbügel, C; Jäckel, A; Wartewig, S

    2006-07-01

    This article reports the characterization of the physicochemical properties of two important antifungal topical drugs, amorolfine and ciclopirox. Furthermore, the release of the drugs from commercial lacquer formulations for treatment of onychomycosis was studied using the online FTIR-ATR technique. Based on the physicochemical background of these two drugs and their release from commercial lacquer formulations for treatment of onychomycosis, the suitability of these drugs for optimized local antifungal therapy to human nails is discussed. Amorolfine appears to be more suitable for drug delivery to human nails because it penetrates into the nails via the hydrophilic pathway. Furthermore amorolfine penetrates very well into fungal cells, due to the pH value of the nail, as well as the pKa value of this antimycotic agent and the lipophilic properties of its base form. PMID:16889067

  18. Hidrotic ectodermal dysplasia of hair, teeth, and nails: case reports and review.

    PubMed Central

    Chitty, L S; Dennis, N; Baraitser, M

    1996-01-01

    We report two families with the Witkop "tooth and nail syndrome". This term is a misnomer, as the hair was mildly involved in the original case reports and in the families reported here. Images PMID:8863167

  19. Ram's Horn Nail - Giant Onychomatricoma Treated by Complete Surgical Excision- A Rare Case Report.

    PubMed

    Saranya, M; Saritha, M; Karthikeyan, K

    2015-01-01

    Giant onychomatricoma is a rare fibroepithelial nail matrix tumor with only two previous reports in literature, from Mexico. An 80-year-old female patient presented with a progressively painless mass in the left great toe nail, following trauma, of 2 years duration. On examination there was a single, hard, immobile mass of size 4 × 3 × 2 cm with proximal hyperpigmentation of the left great toe nail. The mass was totally excised and a punch biopsy of nail matrix was taken. Histopathology revealed hyperkeratosis, acanthosis, multiple channels lined by flattened epithelium and fibrocollagenous tissue in horizontal orientation in deeper layers. The patient had no recurrence after 1 month. We report this case for its rare and distinct clinical presentation, characteristic histopathology and easy surgical treatment. PMID:26538734

  20. Ram’s Horn Nail - Giant Onychomatricoma Treated by Complete Surgical Excision- A Rare Case Report

    PubMed Central

    Saranya, M; Saritha, M; Karthikeyan, K

    2015-01-01

    Giant onychomatricoma is a rare fibroepithelial nail matrix tumor with only two previous reports in literature, from Mexico. An 80-year-old female patient presented with a progressively painless mass in the left great toe nail, following trauma, of 2 years duration. On examination there was a single, hard, immobile mass of size 4 × 3 × 2 cm with proximal hyperpigmentation of the left great toe nail. The mass was totally excised and a punch biopsy of nail matrix was taken. Histopathology revealed hyperkeratosis, acanthosis, multiple channels lined by flattened epithelium and fibrocollagenous tissue in horizontal orientation in deeper layers. The patient had no recurrence after 1 month. We report this case for its rare and distinct clinical presentation, characteristic histopathology and easy surgical treatment. PMID:26538734

  1. A Pilot Study: Nailing Indian Elections with the Indelible Ink Mark

    PubMed Central

    Abraham, Anil; Roga, Gillian; Thomas, Naveen

    2015-01-01

    Context: The indelible ink that's used in our elections was developed by National Physical Laboratories (NPL), Delhi in 1962, and has been used ever since. Though formulated by NPL, it is manufactured by Mysore Paints and Varnish Ltd. owned by the Karnataka Government. Earlier, the ink mark was applied on the cuticle but with effect from February 01, 2006 the ink is applied on the voter's left index fingernail from the distal end proximally until the cuticle using an applicator. This idea of the ink mark applied during elections was used as a simple tool to measure the rate of nail growth in a busy outpatient department of a Tertiary Hospital in South India. Aims: To assess the feasibility of using the ink mark during elections as a method of obtaining data of nail growth across the spectrum of the entire country. Subjects and Methods: In 74 patients presenting to a hospital, the rate of nail growth was measured. The voter's mark on the left index fingernail of patients during the recent elections was used as a marker for measuring the length of the nail. Results: The average rate of nail growth was 0.113 mm/day. The rate of nail growth was found to be more in females, younger individuals, pregnancy, patients on nutritional supplementation, psoriasis. Conclusion: This study which was conducted on 74 patients using the election ink mark successfully confirmed the possibility of using it as an efficient tool in measuring the rate of nail growth. The findings revealed the slightly higher rate of nail growth as compared to a study done by Rani et al. However, the limited sample size in this study was the major limitation. PMID:26677268

  2. Half-and-half nails in a pediatric patient after chemotherapy.

    PubMed

    Afsar, Fatma Sule; Ozek, Gulcihan; Vergin, Canan

    2015-12-01

    Half-and-half nail, characterized by a reddish brown distal band with a sharply demarcated white proximal band, is a specific manifestation of chronic kidney disease, but it is unusual to occur after chemotherapy. We report a seven-year-old girl who developed half-and-half nails in her fingers one month after treatment with modified Berlin-Frankfurt-Munster protocol followed by maintenance therapy with oral methotrexate and 6-mercaptopurine for pre-B acute lymphoblastic leukemia. PMID:25597374

  3. Investigation of different formulations for drug delivery through the nail plate.

    PubMed

    Vejnovic, Ivana; Simmler, Linda; Betz, Gabriele

    2010-02-15

    Topical therapies for nail diseases are limited by keratinized cells in the human nail plate. An optimal permeation enhancer would not only improve drug delivery through the nail plate, but would also open new possibilities for treating neighboring target sites if systemic circulation is reached. The aim of the present work was to identify permeation enhancers and to improve the understanding of physicochemical parameters that influence drug permeation. Caffeine served as the model drug, and formulations were prepared in water and 20% (v/v) ethanol/water solutions. Tested enhancers were urea, dimethyl sulfoxide (DMSO), methanol, N-acetyl-L-cysteine (NAC), docusate sodium salt (DSS), boric acid, and fungal proteins, such as hydrophobins. Permeability studies employed cadaver nails in modified Franz-type diffusion cells. The permeability coefficient of caffeine in ethanol/water was determined to be 1.56 E-08 cm/s and was improved to 2.27 E-08 cm/s by the addition of NAC. Formulations containing either methanol or DMSO showed the highest permeability coefficients in the range of 5-7.5 E-08 cm/s. Enhancers could be classified according to their permeation enhancement: methanol>class II hydrophobins>DMSO>followed by class I hydrophobins and urea. Ethanol at a concentration of 20% (v/v) in water did not influence swelling of nail samples. Hydrophobins are suggested to be efficient in drug delivery through the nail plate. PMID:19941943

  4. Incidentally Discovered a Self-Inflicted a Nail in the Brain of Schizophrenia Patient

    PubMed Central

    Son, Seungnam; Kang, Dong-Ho; Kim, Byung-Hyo

    2011-01-01

    The self-infliction of foreign bodies into the brain represents rare a clinical phenomenon that has been reported primarily in cases involving accidents and suicide attempts. However, various motivations for self-injurious behaviors as well as suicide attempts have been reported, especially in patients with psychotic illnesses. A 47-year-old man with a history of schizophrenia presented to our hospital due to the presence of a nail on his plain skull X-ray. He diagnosed paranoid type of schizophrenia about 17 years earlier, and his psychiatric symptoms were well controlled by medication. Interestingly, he was not aware of the presence of the nail in his brain and showed no neurological deficits. In the course of detailed history taking, we discovered that the nail was driven into his brain during a hallucinatory experience that had occurred more than 10 years earlier. Because we believed that removing the nail from his brain would be more dangerous than maintaining the status quo, the nail was not removed. This is a very rare case of a self-inflicted injury involving inserting a nail into the brain under the influence of hallucinations. The absence of adverse effects or neurological symptoms/signs related to the presence of a foreign metallic body in the brain for over 10 years is exceptional. PMID:21994517

  5. Concentrations and assessment of exposure to siloxanes and synthetic musks in personal care products from China.

    PubMed

    Lu, Yan; Yuan, Tao; Wang, Wenhua; Kannan, Kurunthachalam

    2011-12-01

    We investigated the concentrations and profiles of 15 siloxanes (four cyclic siloxanes, D(4)-D(7); 11 linear siloxanes, L(4)-L(14)), four synthetic musks (two polycyclic musks, HHCB and AHTN; two nitro musks, MX and MK), and HHCB-lactone, in 158 personal care products marketed in China. Siloxanes were detected in 88% of the samples analyzed, at concentrations as high as 52.6 mg g(-1); Linear siloxanes were the predominant compounds. Among synthetic musks, more than 80% of the samples contained at least one of these compounds, and their total concentrations were as high as 1.02 mg g(-1). HHCB was the predominant musk in all of the samples analyzed, on average, accounting for 52% of the total musk concentrations. Based on the median concentrations of siloxanes and musks and the average daily usage amounts of consumer products, dermal exposure rates in adults were calculated to be 3.69 and 3.38 mg d(-1) for siloxanes and musks, respectively. PMID:21899935

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

    PubMed

    Walker, Michael; Parsons, David

    2014-10-01

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

  7. Low-Velocity Nail-Gun Injuries to the Interventricular Septum: Report of Two Cases, One in a Child

    PubMed Central

    Michalsen, Kara L.; Iguidbashian, John P.; Kyser, James P.

    2015-01-01

    Nail-gun injury to the heart is rare. Nail-gun injury to the interventricular septum is rarer: we could find only 5 reported cases, and none involving a child. We report 2 additional cases, in which nails penetrated the interventricular septum without causing acute pericardial tamponade, heart block, or shunt across the septum. Transesophageal echocardiography provides a dynamic way to evaluate the patient preoperatively, intraoperatively, and postoperatively. In the cases reported here, both the adult with multiple interventricular nails and the child with a single nail underwent foreign-object removal via median sternotomy. The child needed cardiopulmonary bypass for removal of the nail. There were no short-term or long-term sequelae from these interventricular septal injuries. PMID:26413027

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

    EPA Science Inventory

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

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

    EPA Science Inventory



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

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

    PubMed

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

    2015-01-01

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

  11. Pharmaceutical and personal care products in tile drainage following land application of municipal biosolids.

    PubMed

    Lapen, D R; Topp, E; Metcalfe, C D; Li, H; Edwards, M; Gottschall, N; Bolton, P; Curnoe, W; Payne, M; Beck, A

    2008-07-25

    Land application of municipal biosolids (sewage) is a common farming practice in many parts of the world. There is potential for transport of pharmaceuticals and personal care products (PPCPs) from agricultural fields to adjacent surface waters via tile drainage systems. In this study, liquid municipal biosolids (LMB) (total solids=11,933 mg L(-1)), supplemented with selected PPCPs and the fluorescent dye tracer rhodamine WT (RWT), were applied to tile drained fields using two land application approaches. Objectives included evaluating the relative benefits of land application practices with respect to reducing PPCP loadings to tile drains, evaluating PPCP persistence in tile water, and determining whether rhodamine WT can be used to estimate PPCP mass loads in tile. The PPCPs examined included an antibacterial agent used in personal care products (triclosan), a metabolite of nicotine (cotinine), and a variety of drugs including two sulfonamide antimicrobials (sulfapyridine, sulfamethoxazole), a beta-blocker (atenolol), an anti-epileptic (carbamazepine), an antidepressant (fluoxetine), analgesic/anti-inflammatories (acetaminophen, naproxen, ibuprofen), and a lipid-regulator (gemfibrozil). Maximum observed PPCP concentrations in the spiked LMB were about 10(3) ng g(-1) dry weight. PPCPs were shown to move rapidly via soil macropores to tile drains within minutes of the land application. Maximum observed PPCP concentrations in tile effluent associated with the LMB application-induced tile flow event were approximately 10(1) to 10(3) ng L(-1). PPCP mass loads, for the application-induced tile-hydrograph event, were significantly (p<0.1) higher for surface spreading over non-tilled soil (incorporation tillage occurring 20 h post-application), relative to aerating soil immediately prior to surface spreading using an AerWay slurry deposition system. PPCP concentrations that were detected above the limit of quantitation (LOQ) in tile water during several precipitation-induced tile flow events that occurred post-application, included: triclosan (max. approximately 1.5 x 10(2) ng L(-1)), carbamazepine (max. approximately 7 x 10(1) ng L(-1)), atenolol (max approximately 4 x 10(1) ng L(-1)), and cotinine (max approximately 2 x 10(1) ng L(-1)). In spite of their presence in biosolids, the other PPCPs were not observed above LOQ concentrations during these events. PPCP concentrations were predicted from RWT concentrations over a 40 day study period. Tile mass loads as a percent of PPCP mass applied to soil ranged from 4.2%+/-SD of 9.2% to 7.1%+/-10.9% for the AerWay system and surface spreading plus incorporation treatments, respectively. PMID:18455753

  12. Effect of angular stability and other locking parameters on the mechanical performance of intramedullary nails.

    PubMed

    Hoffmann, Stefanie; Gerber, Claus; von Oldenburg, Geert; Kessler, Manuel; Stephan, Daniel; Augat, Peter

    2015-04-01

    To extend the indications of intramedullary nails for distal or proximal fractures, nails with angle stable locking options have been developed. Studies on the mechanical efficacy of these systems have been inconsistent likely due to confounding variables such as number, geometry, or orientation of the screws, as well as differences in the loading mode. Therefore, the aim of this study was to quantify the effect of angular stability on the mechanical performance of intramedullary nails. The results could then be compared with the effects of various locking screw parameters and loading modes. A generic model was developed consisting of artificial bone material and titanium intramedullary nail that provided the option to systematically modify the locking screw configuration. Using a base configuration, the following parameters were varied: number of screws, distance and orientation between screws, blocking of screws, and simulation of freehand locking. Tension/compression, torsional, and bending loads were applied. Stiffness and clearance around the zero loading point were determined. Angular stability had no effect on stiffness but completely blocked axial clearance (p=0.003). Simulation of freehand locking reduced clearance for all loading modes by at least 70% (p<0.003). The greatest increases in torsional and bending stiffness were obtained by increasing the number of locking screws (up to 80%, p<0.001) and by increasing the distance between them (up to 70%, p<0.001). In conclusion, our results demonstrate that the mechanical performance of IM nailing can be affected by various locking parameters of which angular stability is only one. While angular stability clearly reduces clearance of the screw within the nail, mechanical stiffness depends more on the number of screws and their relative distance. Thus, optimal mechanical performance in IM nailing could potentially be obtained by combining angular stability with optimal arrangement of locking screws. PMID:25581739

  13. An Effective Approach for Optimization of a Composite Intramedullary Nail for Treating Femoral Shaft Fractures.

    PubMed

    Samiezadeh, Saeid; Tavakkoli Avval, Pouria; Fawaz, Zouheir; Bougherara, Habiba

    2015-12-01

    The high stiffness of conventional intramedullary (IM) nails may result in stress shielding and subsequent bone loss following healing in long bone fractures. It can also delay union by reducing compressive loads at the fracture site, thereby inhibiting secondary bone healing. This paper introduces a new approach for the optimization of a fiber-reinforced composite nail made of carbon fiber (CF)/epoxy based on a combination of the classical laminate theory, beam theory, finite-element (FE) method, and bone remodeling model using irreversible thermodynamics. The optimization began by altering the composite stacking sequence and thickness to minimize axial stiffness, while maximizing torsional stiffness for a given range of bending stiffnesses. The selected candidates for the seven intervals of bending stiffness were then examined in an experimentally validated FE model to evaluate their mechanical performance in transverse and oblique femoral shaft fractures. It was found that the composite nail having an axial stiffness of 3.70 MN and bending and torsional stiffnesses of 70.3 and 70.9 N?m2, respectively, showed an overall superiority compared to the other configurations. It increased compression at the fracture site by 344.9 N (31%) on average, while maintaining fracture stability through an average increase of only 0.6?mm (49%) in fracture shear movement in transverse and oblique fractures when compared to a conventional titanium-alloy nail. The long-term results obtained from the bone remodeling model suggest that the proposed composite IM nail reduces bone loss in the femoral shaft from 7.9% to 3.5% when compared to a conventional titanium-alloy nail. This study proposes a number of practical guidelines for the design of composite IM nails. PMID:26458035

  14. Effects of three pharmaceutical and personal care products on natural freshwater algal assemblages.

    PubMed

    Wilson, Brittan A; Smith, Val H; deNoyelles, Frank; Larive, Cynthia K

    2003-05-01

    Treated wastewaters in the United States contain detectable quantities of surfactants, antibiotics, and other types of antimicrobial chemicals contained in pharmaceutical and personal-care products (PPCPs) that are released into stream ecosystems. The degradation characteristics of many of these chemicals are not yet known, nor are the chemical properties of their byproducts. They also are not currently mandated for removal under the U.S. Clean Water Act. Three representative PPCPs were individually tested in this study using a series of laboratory dilution bioassays: Ciprofloxacin (an antibiotic), Triclosan (an antimicrobial agent), and Tergitol NP 10 (a surfactant), to determine their effects on natural algal communities sampled both upstream and downstream of the Olathe, KS wastewater treatment plant (WWTP). There were no significant treatment effects on algal community growth rates during the exponential phase of growth, but significant differences were observed in the final biomass yields (p < 0.001). All three compounds caused marked shifts in the community structure of suspended and attached algae at both the upstream and downstream sites (p < 0.05). Increasing the concentrations of all three compounds over a 3 orders of magnitude range also caused a consistent decline in final algal genus richness in the bioassays. Our results suggest that these three PPCPs may potentially influence both the structure and the function of algal communities in stream ecosystems receiving WWTP effluents. These changes could result in shifts in both the nutrient processing capacity and the natural food web structure of these streams. PMID:12775039

  15. Nanotechnologies for Removal of Pharmaceuticals and Personal Care Products from Water and Wastewater. A Review.

    PubMed

    Cincinelli, Alessandra; Martellini, Tania; Coppini, Ester; Fibbi, Donatella; Katsoyiannis, Athanasios

    2015-05-01

    The occurrence of pharmaceuticals and other hazardous substances in surface waters and drinking water and the long-term exposure may represent a potential risk for both the environment and human health. Many studies have evidenced that conventional technologies used for wastewater treatment do not completely remove pharmaceuticals and personal care products (PPCPs) residues, which can be detected in receiving waters at concentrations ranging from few ng L(-1) until more than ?g L(-1). Nanomaterials are of fundamental importance in the current research efforts to develop more efficient water treatment and remediation systems in place of conventional technologies. This review provides a comprehensive overview of the most relevant works available in literature reporting the use of nanosorbents (nanotubes and zeolites), nanofiltration (NF) and advanced oxidation processes (AOPs) for the removal of PPCPs compounds from water and wastewater. The literature review of laboratory- and pilot-scale studies have shown that nanomaterials are promising tools in environmental cleaning processes and water purification, even if more researches are necessary. PMID:26504950

  16. Pharmaceuticals and personal care products in the aquatic environment in China: a review.

    PubMed

    Bu, Qingwei; Wang, Bin; Huang, Jun; Deng, Shubo; Yu, Gang

    2013-11-15

    Pharmaceuticals and personal care products (PPCPs) have been detected as contaminants of emerging concern ubiquitously in the aquatic environment in China and worldwide. A clear picture of PPCP contamination in the Chinese aquatic environment is needed to gain insight for both research and regulatory needs (e.g. monitoring, control and management). The occurrence data of 112 PPCPs in waters and sediments in China has been reviewed. In most cases, the detected concentration of these PPCPs in waters and sediments were at ng/L and ng/g levels, which were lower than or comparable to those reported worldwide. A screening level risk assessment (SLERA) identified six priority PPCPs in surface waters, namely erythromycin, roxithromycin, diclofenac, ibuprofen, salicylic acid and sulfamethoxazole. The results of SLERA also revealed that the hot spots for PPCP pollution were those river waters affected by the megacities with high density of population, such as Beijing, Tianjin, Guangzhou and Shanghai. Limitations of current researches and implications for future research in China were discussed. Some regulatory issues were also addressed. PMID:24036145

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed

    Strübmann, A; Weißen, H J; Wirtz, A

    1993-12-01

    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

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

    PubMed

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

    2014-11-01

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

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

    PubMed

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

    2014-11-01

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

  1. Plant uptake of pharmaceutical and personal care products from recycled water and biosolids: a review.

    PubMed

    Wu, Xiaoqin; Dodgen, Laurel K; Conkle, Jeremy L; Gan, Jay

    2015-12-01

    Reuse of treated wastewater for agricultural irrigation is growing in arid and semi-arid regions, while increasing amounts of biosolids are being applied to fields to improve agricultural outputs. These historically under-utilized resources contain "emerging contaminants", such as pharmaceutical and personal care products (PPCPs), which may enter agricultural soils and potentially contaminate food crops. In this review, we summarize recent research and provide a detailed overview of PPCPs in the soil-plant systems, including analytical methods for determination of PPCPs in plant tissues, fate of PPCPs in agricultural soils receiving treated wastewater irrigation or biosolids amendment, and plant uptake of PPCPs under laboratory and field conditions. Mechanisms of uptake and translocation of PPCPs and their metabolisms in plants are also reviewed. Field studies showed that the concentration levels of PPCPs in crops that were irrigated with treated wastewater or applied with biosolids were very low. Potential human exposure to PPCPs through dietary intake was discussed. Information gaps and questions for future research have been identified in this review. PMID:26254067

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-01-01

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

  4. Foot Care

    MedlinePLUS

    ... warm, dark, and moist—the perfect place for fungus to grow. A fungus can cause dry skin, redness, blisters, itching, and ... toenails are caused by a piece of the nail piercing the skin. This can happen if you ...

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

    SciTech Connect

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

    2010-03-01

    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.

  6. Employer-incurred health care costs and productivity losses associated with influenza

    PubMed Central

    Karve, Sudeep; Misurski, Derek A.; Meier, Genevieve; Davis, Keith L.

    2013-01-01

    The primary objective of this study was to assess trends in employer expenditures for both direct medical costs and indirect productivity losses associated with influenza. A retrospective analysis was performed using two of the MarketScan family of databases for 2005–2009. Patients with at least one diagnosis claim for influenza during an influenza season were selected. We estimated seasonal incidence of influenza in the employed population from the MarketScan Commercial Claims and Encounters database. Health care utilization and costs and productivity losses were assessed during the 21-d period following the influenza diagnosis date. Compared with the 2005–2006 season (493 per 100,000 plan members), influenza incidence increased during the 2006–2007 (598 per 100,000 plan members) and 2007–2008 (1,142 per 100,000 plan members) seasons and had a dramatic increase during the pandemic season of 2008–2009 (1,715 per 100,000 plan members) . The total influenza-related employer spending per 100,000 plan members also increased by over 400% during the 2008–2009 influenza season [$623,248; confidence interval (CI]):$601,518-$644,991], compared with 2005–2006 ($145,834; 95% CI: $135,067-$156,603). The primary drivers of the increased costs were emergency room, outpatient and inpatient visits. Total costs associated with influenza-related missed work time per 100,000 plan members increased over 4-fold from $26,479 in the 2005–2006 influenza season to $122,811 in 2008–2009. Overall, as expected, considerably higher direct and indirect costs were observed during the 2008–2009 influenza pandemic season than during other influenza seasons. In recent years, the influenza-related employer burden has increased considerably. In future, employers may need efficient resource allocation in order to address the productivity losses and increasing direct medical costs associated with increased influenza incidence. One of the strategies that employers may consider is increasing influenza vaccination rates among employees, which likely will help lower the influenza incidence and the associated downstream direct and indirect costs. PMID:23321849

  7. The potential application of functionally graded material for proximal femoral nail antirotation device.

    PubMed

    Gong, He; Wang, Lizhen; Zheng, Dong; Fan, Yubo

    2012-09-01

    Proximal femoral nail antirotation (PFNA) device is an intramedullary nail system designing for the treatment of trochanteric fractures. It is composed of a helical neck blade, a nail and a distal locking bolt. There were some reports of femoral shaft fractures even after the fractures were healed. The stress shielding effects of the PFNA device made of stiff titanium alloy on the bone-remodeling behavior of the host femur and the uneven distribution of interface shear stress may contribute to this complication. Recently, a new class of composite called functionally graded material (FGM) was developed, that consisted a gradual pattern of material composition and/or microstructures, and was introduced in dental implant and cementless hip stem. Accordingly, in this paper, we hypothesized that FGM might be used as the material of the nail in PFNA device with the material composition of the nail gradually shifting from more stiff at the proximal side of the femur to more flexible 'iso-elastic' towards the distal side. This hypothesis can be evaluated from the long-term remodeling behavior of host femur and the stress distributions in the PFNA device and bone. PMID:22781926

  8. Expert tibia nail for subtrochanteric femoral fracture to prevent thermal injury

    PubMed Central

    Lee, Kyung-Jae; Min, Byung-Woo; Jung, Jae-Hoon; Kang, Mi-Kyung; Kim, Min-Ji

    2015-01-01

    Introduction Subtrochanteric femoral fractures are relatively uncommon, accounting for 7–15% of all hip fractures and treatment of these fractures are considered challenge for orthopaedic surgeons. Although several treatment options are reported with up to 90% of satisfactory results, the choice of the appropriate implant is still a matter of debate. Some authors reported thermal injury after reaming for intramedullary nail fixation in patients with narrow medullary canal. Presentation of case A 21-year-old female patient was admitted to our hospital because of right subtrochanteric femoral fracture. The narrowest diameter of medullary canal of her femur was about 7 mm but she refused open reduction and internal fixation with plate due to large scar formation. We used expert tibia nail instead of femoral intramedullary nail to prevent thermal injury. Discussion Subtrochanteric femoral fractures are difficult to treat because of their biomechanical and anatomical characteristics. Although several implants are reported for the surgical treatment of these fractures, intramedullary nails have been advocated due to their biological and biomechanical advantages. However, under certain circumstances with associated injury or anatomic difference we might consider another treatment options. Conclusion Expert tibia nail may be considered one of the treatment options for subtrochanteric femoral fracture with narrow medullary canal. We also emphasize the importance of preoperative evaluation of the medullary canal size for these risky fractures. PMID:25839435

  9. Overcoming the nail barrier: A systematic investigation of ungual chemical penetration enhancement.

    PubMed

    Brown, M B; Khengar, R H; Turner, R B; Forbes, B; Traynor, M J; Evans, C R G; Jones, S A

    2009-03-31

    This study investigated the in vitro nail permeability of penetrants of varying lipophilicity-caffeine (CF, logP -0.07), methylparaben (MP, logP 1.96) and terbinafine (TBF, logP 3.3) and the effect of 2 novel penetration enhancers (PEs), thioglycolic acid (TA) and urea hydrogen peroxide (urea H(2)O(2)) on their permeation. Studies were conducted using full thickness human nail clippings and ChubTur((R)) diffusion cells and penetrants were applied as saturated solutions. The rank order of steady-state penetrant flux through nails without PE application (MP>CF>TBF) suggested a greater sensitivity to penetrant molecular weight rather than logP. TA increased the flux of CF and MP approximately 4- and approximately 2-fold, respectively, whilst urea H(2)O(2) proved ineffective at enhancing permeability. The sequential application of TA followed by urea H(2)O(2) increased TBF and CF flux ( approximately 19- and approximately 4-fold, respectively) but reversing the application order of the PEs was only mildly effective at increasing just MP flux ( approximately 2-fold). Both nail PEs are likely to function via disruption of keratin disulphide bonds and the associated formation of pores that provide more 'open' drug transport channels. Effects of the PEs were penetrant specific, but the use of a reducing agent (TA) followed by an oxidising agent (urea H(2)O(2)) dramatically improved human nail penetration. PMID:19071202

  10. Gentamicin release from biodegradable poly-l-lactide based composites for novel intramedullary nails.

    PubMed

    Morawska-Chochó?, Anna; Domalik-Pyzik, Patrycja; Ch?opek, Jan; Szaraniec, Barbara; Sterna, Jacek; Rzewuska, Magdalena; Bogu?, Maciej; Kucharski, Rafael; Mielczarek, Przemys?aw

    2014-12-01

    One of the major problems in orthopedic surgery is infection associated with implantation. The treatment is a very difficult and long-term process. A solution to this issue can be the use of implants which additionally constitute an antibiotic carrier preventing the development of an infection. Prototypes of biodegradable intramedullary nails made of three different composites with a poly(L-lactide) matrix were designed. The nails served as gentamicin sulfate (GS) carrier - an antibiotic commonly used in the treatment of osteomyelitis. The matrix was reinforced with carbon fibers (CF), alginate fibers (Alg) and magnesium alloy wires (Mg), as well as modified with bioactive particles of tricalcium phosphate (TCP) in various systems. In this way, novel, multi-phase and multifunctional degradable intramedullary nails were obtained. The tests demonstrated strong dependence between the type of the modifying phase introduced into the composite, and the rate of drug release. Introduction of gentamicin into the nail structure strengthened and prolonged antibacterial activity of the nails. PMID:25491796

  11. High Plasticizer Levels In Males Linked to Delayed Pregnancy for Female Partners

    MedlinePLUS

    ... in hundreds of products (PDF - 176KB) , such as fragrances, shampoos, nail polish, plastic film and sheets. For ... personal care products such as nail products and cosmetics, and in printing inks, pharmaceutical coatings, and insecticides. ...

  12. Improving Care for Children With Complex Needs

    ClinicalTrials.gov

    2014-11-18

    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

  13. Characterizing the passage of personal care products through wastewater treatment processes.

    PubMed

    Oppenheimer, Joan; Stephenson, Roger; Burbano, Arturo; Liu, Li

    2007-12-01

    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 pharmaceuticals and personal care products (PPCPs). Nevertheless, European studies performed at bench-scale or at small facilities have demonstrated that a critical minimum solids retention time (SRT) can achieve good reduction of many EDCs and pharmaceuticals. The objective of this study was to expand these findings to the removal performance for 20 PPCPs commonly found in the influent to full-scale facilities operating in the United States. The participating plants use SRT conditions ranging from 0.5 to 30 days and include facility capacities ranging from 19 000 m3/d (5 mgd) to greater than 1 136 000 m3/d (300 mgd). Two pilot membrane bioreactors were also included in the study. The 20 PPCPs were categorized into nine bin combinations of occurrence frequency and treatment reduction performance. While most compounds were well removed, galaxolide (a musk fragrance) occurred frequently and was resistant to removal. A minimum critical SRT, defined as the minimum SRT, needed to consistently demonstrate greater than 80% removal (SRT80), was compound-dependent, with most compounds removed at 5 to 15 days and a small group requiring longer SRTs. From limited data, no additional removal could be attributed to the use of membrane bioreactors, media filters, or longer hydraulic retention times. Reverse osmosis was effective in removing any remaining compounds. PMID:18198702

  14. Personal care product preservatives: risk assessment and mixture toxicities with an industrial wastewater.

    PubMed

    Carbajo, Jose B; Perdigón-Melón, Jose A; Petre, Alice L; Rosal, Roberto; Letón, Pedro; García-Calvo, Eloy

    2015-04-01

    The aquatic toxicity of eight preservatives frequently used in personal care products (PCPs) (iodopropynyl butylcarbamate, bronopol, diazolidinyl urea, benzalkonium chloride, zinc pyrithione, propylparaben, triclosan and a mixture of methylchloroisothiazolinone and methylisothiazolinone) was assessed by means of two different approaches: a battery of bioassays composed of single species tests of bacteria (Vibrio fischeri and Pseudomonas putida) and protozoa (Tetrahymena thermophila), and a whole biological community resazurin-based assay using activated sludge. The tested preservatives showed considerable toxicity in the studied bioassays, but with a marked difference in potency. In fact, all biocides except propylparaben and diazolidinyl urea had EC50 values lower than 1 mg L(-1) in at least one assay. Risk quotients for zinc pyrithione, benzalkonium chloride, iodopropynyl butylcarbamate and triclosan as well as the mixture of the studied preservatives exceeded 1, indicating a potential risk for the process performance and efficiency of municipal sewage treatment plants (STPs). These four single biocides explained more than 95% of the preservative mixture risk in all bioassays. Each individual preservative was also tested in combination with an industrial wastewater (IWW) from a cosmetics manufacturing facility. The toxicity assessment was performed on binary mixtures (preservative + IWW) and carried out using the median-effect principle, which is a special case of the concept of Concentration Addition (CA). Almost 70% of all experiments resulted in EC50 values within a factor of 2 of the values predicted by the median-effect principle (CI values between 0.5 and 2). The rest of the mixtures whose toxicity was mispredicted by CA were assessed with the alternative concept of Independent Action (IA), which showed higher predictive power for the biological community assay. Therefore, the concept used to accurately predict the toxicity of mixtures of a preservative with a complex industrial wastewater depends on degree of biological complexity. PMID:25585550

  15. Cotton honeydew (Gossypium hirsutum L.) extract offers very interesting properties for hair cosmetics and care products.

    PubMed

    Oberto, G; Bauza, E; Berghi, A; Portolan, F; Botto, J M; Peyronel, D; Dal Farra, C; Domloge, N

    2005-01-01

    Cotton honeydew extract is composed of a unique combination of oligosaccharides, including fructose, glucose, inositol, melezitose, saccharose, trehalose and trehalulose. Studies have shown that these oligosaccharides exhibit a protective effect. Therefore, we were interested in studying the effect of these oligosaccharides on normal and damaged human hair. Both clinical and scanning electron microscopy (SEM) studies were performed. Standardized human hair samples were used to determine the effect of a rinse-off mask with 1% cotton honeydew extract on the ultrastructure of hair. In addition, hair samples were submitted to different aggressions, following various experimental protocols. SEM showed that, without extra aggression, the cuticle scales appeared to lie more smoothly in the hair in cotton honeydew extract-treated samples than in untreated samples. The extract-treated hair samples were also less prone to chipping. In contrast, the control, untreated hair samples retained a dry and damaged appearance and were prone to chipping and progressive splitting. In a clinical study, 15 volunteers had half of their hair treated with a formula with 1% honeydew extract and the other half was left untreated as a control. Pictures and visual evaluation of the hair showed that the honeydew extract formula left the hair with a smoothness that was far superior to the control side and this result was confirmed by SEM. In addition, mRNA studies on epidermal cells were performed and confirmed the stimulating effect of honeydew extract on keratin synthesis. These results demonstrate that cotton honeydew extract can be of great use in hair care products and cosmetics. PMID:16223202

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

    PubMed Central

    Daughton, C G; Ternes, T A

    1999-01-01

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

  17. Presence and effects of pharmaceutical and personal care products on the Baca National Wildlife Refuge, Colorado.

    PubMed

    Zenobio, Jenny E; Sanchez, Brian C; Leet, Jessica K; Archuleta, Laura C; Sepúlveda, Maria S

    2015-02-01

    Pharmaceuticals and personal care products (PPCPs) have raised concerns due to their potential effects to aquatic organisms. These chemicals appear in mixtures at very low concentrations thus making their detection and quantification difficult. Polar organic chemical integrative samplers (POCIS) concentrate trace levels of chemicals over time increasing method sensitivity and thus represent a cost-effective screening tool for biomonitoring studies. The Baca National Wildlife Refuge (BNWR), Colorado, is home for several endemic fish species, including Rio Grande chub (Gila pandora). The objectives of this study were to (1) determine the types and concentrations of PPCPs in the Refuge, (2) compare and contrast two methods (grab and POCIS) for the quantification of PPCPs from surface water, and (3) determine effects due to PPCP exposure in fish. Between 2011 and 2013, 141 PPCPs were quantified using a combination of grab samples and POCIS. Although no PPCPs were detected from the grab samples, high concentrations of N,N-Diethyl-meta-toluamide (DEET) and triclosan were detected in all fish sampling sites with POCIS. Fathead minnows (Pimephales promelas) and Rio Grande chubs of both sexes were collected in 2011 and 2012. Several biological responses were observed in both species from creeks contaminated with PPCPs; however the presence of PPCPs in the reference site did not allow for valid data comparison and interpretation. We conclude that POCIS is a sensitive method for the detection and quantification of PPCPs and for identification of reference sites and that appropriate "reference" sites need to be identified at the BNWR for follow-up studies with native fish. PMID:25465958

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

    PubMed

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

    2014-07-15

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

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

    PubMed

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

    2012-09-01

    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

  20. Direct UV photolysis of selected pharmaceuticals, personal care products and endocrine disruptors in aqueous solution.

    PubMed

    Carlson, Jules C; Stefan, Mihaela I; Parnis, J Mark; Metcalfe, Chris D

    2015-11-01

    Pharmaceuticals and personal care products (PPCPs), and endocrine disrupting compounds (EDCs) are micropollutants of emerging concern that have been detected in the aquatic environment and in some cases, in drinking water at nanogram per liter levels. The goal of this study was to evaluate the removal of 15 model PPCPs and EDCs from water by direct UV photolysis, using either low (LP)-or medium (MP) -pressure mercury vapor arc lamps. Some of the model compounds are either weak bases or weak acids, and therefore, the pKa values were determined or confirmed for those compounds using spectrophotometric titrations. The molar absorption coefficients of ionized and non-ionized forms were also determined. The quantum yields at 253.7 nm in phosphate buffer solutions of pH 7.2 were determined to be 0.033 ± 0.004 for sulfamethoxazole, 0.0035 ± 0.0008 for sulfachloropyridazine, 0.006 ± 0.002 for acetaminophen, 0.34 ± 0.07 for triclosan, 0.35 ± 0.14 for estrone, 0.08 ± 0.05 for 17?-ethinylestradiol, 0.086 ± 0.012 for ibuprofen. The quantum yield for 4-n-nonylphenol photolysis at 253.7 nm varied with the initial concentration from 0.32 ± 0.08 at 23 ?g/L to 0.092 ± 0.006 at 230 ?g/L. The pseudo-first order rate constants determined for direct photolysis at 253.7 nm of the studied micropollutants followed the order: triclosan ? sulfamethoxazole > 4-n-nonylphenol ? sulfachloropyridazine ? estrone > acetaminophen ? 17?-ethinylestradiol ? ibuprofen. In contrast to the results observed for the monochromatic radiation (LP lamp), all 15 model compounds photolyzed under exposure to the broadband radiation emitted by the MP lamp. PMID:26282501

  1. 78 FR 16651 - Certain Steel Nails From the People's Republic of China; Final Results of Third Antidumping Duty...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-18

    ... International Trade Administration Certain Steel Nails From the People's Republic of China; Final Results of... Review'' section of this notice. \\1\\ See Certain Steel Nails from the People's Republic of China..., International Trade Administration, U.S. Department of Commerce, 14th Street and Constitution Avenue...

  2. 78 FR 56861 - Certain Steel Nails From the People's Republic of China: Preliminary Results of the Fourth...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-16

    ...The Department of Commerce (``Department'') is conducting the fourth administrative review of the antidumping duty order on certain steel nails (``nails'') from the People's Republic of China (``PRC'').\\1\\ The Department has preliminarily determined that sales have been made below normal value (``NV'') by the respondents examined during the period of review (``POR''), August 1, 2011, through......

  3. The SIGN Nail: Factors in a Successful Device for Low-Resource Settings.

    PubMed

    Haonga, Billy Thomson; Zirkle, Lewis G

    2015-10-01

    Surgeons in low-resource settings manage an increasing number of patients presenting with high-energy fractures. The number of surgeons and the operating time available are frequently not adequate to treat these fractures in a timely manner. A common cause of delay in treating fractures is waiting for the patient to accumulate sufficient funding to pay for the surgery, including the surgical implant. The donation of the SIGN intramedullary nail interlocking screw system obviates a major delay in timing of surgery. The SIGN intramedullary nail has been designed to be used in low-resource settings as it can be placed without fluoroscopy or electricity. The SIGN-trained surgeons are very skillful in hand reaming the canal, placing the nail, and interlocking screws without fluoroscopy. As more is learned about fracture healing, the SIGN system continues to evolve. The SIGN system is expanding to include deformity correction and soft tissue coverage. PMID:26356214

  4. A unique nail gun injury to the heart with a delayed presentation.

    PubMed

    Jodati, Ahmadreza; Safaei, Naser; Toufan, Mehrnoush; Kazemi, Babak

    2011-09-01

    We describe a 24-year-old construction worker who was unaware that he had been shot by a pneumatic nail gun in the chest during work. After returning home, he felt some palpitations and mild shortness of breath, and in the mirror discovered a non-bleeding pinpoint skin wound in his upper chest. He admitted himself to the emergency department of a local hospital and, after a detailed history and a chest X-ray had been taken, he was surprisingly diagnosed with a penetrating nail injury to the heart and was referred to our center. Transthoracic echocardiography and chest computed tomography were done, and the patient was transported to the operating room. After the nail had been removed and the mitral valve repaired, the patient was discharged on the fifth postoperative day without any complications. PMID:21636580

  5. Manicure and Pedicure Safety

    MedlinePLUS

    ... beauty General skin care Hair care Nail care Artificial nails Manicure, pedicure safety Nail biting Tips for ... make nails break more frequently. Do not wear artificial nails to cover up nail problems as they ...

  6. Skin care and incontinence

    MedlinePLUS

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

  7. Diagnosing intensive care units and hyperplane cutting for design of optimal production systems

    E-print Network

    Traina, J. Adam (Jeffrey Adam)

    2015-01-01

    This thesis provides a new framework for understanding how conditions, people, and environments of the Intensive Care Unit (ICU) effect the likelihood the preventable harm will happen to a patient in the ICU. Two years of ...

  8. Fixator-augmented flexible intramedullary nailing for osteopenic femoral shaft fractures in children.

    PubMed

    Kong, Heather; Sabharwal, Sanjeev

    2016-01-01

    Children with underlying metabolic bone diseases, such as osteogenesis imperfecta and spastic cerebral palsy, pose a challenge in the treatment of femoral shaft fractures. We performed flexible intramedullary nailing with supplemental monolateral external fixation in a subgroup of such patients. The external fixator assists in controlling angulation and rotation at the fracture site, and avoids the need for supplemental casting with its associated problems such as skin breakdown and difficulty with personal hygiene. We describe the surgical technique, pitfalls, and outcomes in a series of four patients with underlying osteopenia treated with external fixator-augmented flexible nailing for femoral shaft fractures. PMID:26426508

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

    SciTech Connect

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

    2011-04-30

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

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

    PubMed Central

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

    2011-01-01

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

  11. Use of an aggregate exposure model to estimate consumer exposure to fragrance ingredients in personal care and cosmetic products.

    PubMed

    Safford, B; Api, A M; Barratt, C; Comiskey, D; Daly, E J; Ellis, G; McNamara, C; O'Mahony, C; Robison, S; Smith, B; Thomas, R; Tozer, S

    2015-08-01

    Ensuring the toxicological safety of fragrance ingredients used in personal care and cosmetic products is essential in product development and design, as well as in the regulatory compliance of the products. This requires an accurate estimation of consumer exposure which, in turn, requires an understanding of consumer habits and use of products. Where ingredients are used in multiple product types, it is important to take account of aggregate exposure in consumers using these products. This publication investigates the use of a newly developed probabilistic model, the Creme RIFM model, to estimate aggregate exposure to fragrance ingredients using the example of 2-phenylethanol (PEA). The output shown demonstrates the utility of the model in determining systemic and dermal exposure to fragrances from individual products, and aggregate exposure. The model provides valuable information not only for risk assessment, but also for risk management. It should be noted that data on the concentrations of PEA in products used in this article were obtained from limited sources and not the standard, industry wide surveys typically employed by the fragrance industry and are thus presented here to illustrate the output and utility of the newly developed model. They should not be considered an accurate representation of actual exposure to PEA. PMID:26071898

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

    PubMed

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

    2014-10-01

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

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

    ERIC Educational Resources Information Center

    Ahmadian, Mohammad Javad; Tavakoli, Mansoor

    2011-01-01

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

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

    ERIC Educational Resources Information Center

    Ahmadian, Mohammad Javad

    2012-01-01

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

  15. Overall well-being as a predictor of health care, productivity, and retention outcomes in a large employer.

    PubMed

    Sears, Lindsay E; Shi, Yuyan; Coberley, Carter R; Pope, James E

    2013-12-01

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

  16. POLLUTION FROM PERSONAL ACTIONS, ACTIVITIES, AND BEHAVIORS: PHARMACEUTICALS AND PERSONAL CARE PRODUCTS IN THE ENVIRONMENT MULTIDIMENSIONAL SCIENCE ISSUES RELEVANT TO REGULATORY CONSIDERATIONS

    EPA Science Inventory

    Perhaps more so than with any other class of anthropogenic chemicals, 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 ...

  17. Intermittent therapy with terbinafine and nail abrasion for dermatophyte toe onychomycosis: a pilot study.

    PubMed

    Succi, Isabella B; Bernardes-Engemann, Andréa R; Orofino-Costa, Rosane

    2013-05-01

    Onychomycosis constitutes up to 50% of all nail disorders. Toenails are generally affected, mostly due to dermatophytes. Terbinafine is the most potent antifungal agent in vitro against dermatophytes. There are few randomised controlled trials using a non-continuous dose of terbinafine. The aim of this open-label pilot study was to reduce the total drug amount, the collateral effects and, specially, the costs; albeit maintaining the same efficacy of the standard regimens. Compare the outcomes of two different intermittent regimens with the same total amount of the medication (42 tablets in 6?months). Forty-one patients were divided into the following groups: terbinafine 250?mg?day(-1) , for 7?days, monthly or terbinafine 500?mg?day(-1) , once daily, for 7?days, every 2?months, both plus nail abrasion during 6?months. The efficacy was evaluated at months 6, 12 and 18 using the disease free nail criteria. Total cure?=?group I: eight patients (44.4%) and group II: eight patients (44.4%). Partial cure?=?group I: five patients (27.8%) and group II: four patients (22.2%). Treatment failure?=?group I: five patients (27.8%) and group II: three patients (16.7%). Recurrence?=?group I: zero patients (0.0%) and group II: three patients (16.7%). Two intermittent dosing regimens of terbinafine plus nail abrasion proved to be an alternative statistically effective, safe and with reduced drug costs for dermatophytes toenail onychomycosis. PMID:23294342

  18. On the Value of Nonremovable Reminders for Behavior Modification: An Application to Nail-Biting (Onychophagia)

    ERIC Educational Resources Information Center

    Koritzky, Gilly; Yechiam, Eldad

    2011-01-01

    The authors examined the effectiveness of a novel behavior modification method for dysfunctional and impulsive habits, based on nonremovable reminders (NrRs). NrRs were implemented by having participants wear nonremovable wristbands designated to constantly remind them of their resolution to quit the targeted habit (nail-biting). Participants were…

  19. [The treatment of upper femoral unicameral bone cysts in children by Ender's nailing technique].

    PubMed

    Catier, P; Bracq, H; Canciani, J P; Allouis, M; Babut, J M

    1981-01-01

    The authors have operated on 2 children aged 7 and 8 years who had developed a large unicameral bone cyst in the trochanteric and upper femoral diaphysial region. Ender's nails were inserted into the bone above the lower femoral epiphysial plate. Healing occurred rapidly. PMID:6453404

  20. Proc. Nail. Acad. Sci. USA Vol. 89, pp. 89-93, January 1992

    E-print Network

    Kay, Mark A.

    Proc. Nail. Acad. Sci. USA Vol. 89, pp. 89-93, January 1992 Genetics Expression of human al-antitrypsin in dogs after autologous transplantation of retroviral transduced hepatocytes (gene therapy and Departments of *Cell Biology, tMolecular Genetics, tSurgery, lComparative Medicine, and ttPathology, Baylor

  1. 78 FR 40172 - Steel Nails From China; Institution of a Five-Year Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-03

    ... employment statute for Federal employees, and Commission rule 201.15(b) (19 CFR 201.15(b)), 73 FR 24609 (May... duty order on imports of steel nails from China (73 FR 44961). The Commission is conducting a review to... Management and Budget (OMB) number is not displayed; the OMB number is 3117-0016/USITC No....

  2. Effect of hydration on the permeation of ketoconazole through human nail plate in vitro.

    PubMed

    Gunt, Hemali B; Kasting, Gerald B

    2007-12-01

    The impact of hydration on the permeation of the antifungal drug, ketoconazole, through excised human nails in vitro was evaluated in diffusion cell studies. Nails treated with [(3)H]ketoconazole solvent-deposited onto the dorsal surface were maintained in incubators at 32 degrees C and exposed sequentially to relative humidities (dorsal side) of 15, 40, 80 and 100% over a period of 40 days. The ventral side was bathed in a pH 7.4 phosphate buffer. Ascending and descending humidity regimens were tested. Increasing the ambient RH from 15 to 100% enhanced permeation of radiolabel associated with [(3)H]ketoconazole by a factor of three. Diffusivities estimated from these data and the associated nail water contents (estimated in a separate study) can be described by a free volume theory. Therefore, formulations or treatments, which increase nail hydration, have potential to improve topical therapy for onychomycosis, if a favorable balance between drug delivery and growth conditions for the dermatophytes can be achieved. PMID:17928205

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  4. 76 FR 19124 - Certain Steel Nails From the United Arab Emirates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-06

    ..., except to the extent permitted by section 201.8 of the Commission's rules, as amended, 67 FR 68036..., 67 FR 68168, 68173 (November 8, 2002). In accordance with sections 201.16(c) and 207.3 of the rules... Certain Steel Nails From the United Arab Emirates AGENCY: United States International Trade...

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

    DOEpatents

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

    2002-03-26

    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.

  6. EVALUATION OF METHODS FOR ANALYSIS OF HUMAN FAT, SKIN, NAILS, HAIR, BLOOD AND URINE

    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 ...

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

    ERIC Educational Resources Information Center

    Pulsford, Mark

    2014-01-01

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

  8. 7 CFR 3201.93 - Leather, vinyl, and rubber care products.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...AGRICULTURE GUIDELINES FOR DESIGNATING BIOBASED PRODUCTS FOR FEDERAL PROCUREMENT...polishes, waxes, etc. (b) Minimum biobased content. The Federal preferred procurement product must have a minimum biobased content of at least 55...

  9. 7 CFR 3201.93 - Leather, vinyl, and rubber care products.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...AGRICULTURE GUIDELINES FOR DESIGNATING BIOBASED PRODUCTS FOR FEDERAL PROCUREMENT...polishes, waxes, etc. (b) Minimum biobased content. The Federal preferred procurement product must have a minimum biobased content of at least 55...

  10. Miltefosine is effective against Candida albicans and Fusarium oxysporum nail biofilms in vitro.

    PubMed

    Machado Vila, Taissa Vieira; Sousa Quintanilha, Natália; Rozental, Sonia

    2015-11-01

    Onychomycosis is a fungal nail infection that represents ?50?% of all nail disease cases worldwide. Clinical treatment with standard antifungals frequently requires long-term systemic therapy to avoid chronic disease. Onychomycosis caused by non-dermatophyte moulds, such as Fusarium spp., and yeasts, such as Candida spp., is particularly difficult to treat, possibly due to the formation of drug-resistant fungal biofilms on affected areas. Here, we show that the alkylphospholipid miltefosine, used clinically against leishmaniasis and cutaneous breast metastases, has potent activity against biofilms of Fusarium oxysporum and Candida albicans formed on human nail fragments in vitro. Miltefosine activity was compared with that of commercially available antifungals in the treatment of biofilms at two distinct developmental phases: formation and maturation (pre-formed biofilms). Drug activity towards biofilms formed on nail fragments and on microplate surfaces (microdilution assays) was evaluated using XTT [2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide] assays, and drug effects on fingernail biofilms were analysed by scanning electron microscopy (SEM). For F. oxysporum, miltefosine at 8??g ml-?1 inhibited biofilm formation by 93?%, whilst 256??g ml-?1 reduced the metabolic activity of pre-formed nail biofilms by 93?%. Treatment with miltefosine at 1000??g ml-?1 inhibited biofilm formation by 89?% and reduced the metabolic activity of pre-formed C. albicans biofilms by 99?%. SEM analyses of biofilms formed on fingernail fragments showed a clear reduction in biofilm biomass after miltefosine treatment, in agreement with XTT results. Our results show that miltefosine has potential as a therapeutic agent against onychomycosis and should be considered for in vivo efficacy studies, especially in topical formulations for refractory disease treatment. PMID:26404553

  11. A Biomechanical Comparison of Locked and Unlocked Long Cephalomedullary Nails in a Stable Intertrochanteric Fracture Model

    PubMed Central

    Kane, P; Vopat, B; Paller, D; Koruprolu, S; Daniels, AH; Born, C

    2015-01-01

    Objectives This study compared the torsional properties of stable intertrochanteric femur fractures in a cadaveric bone model utilizing two different distal fixation strategies: unlocked long cephalomedullary nailing versus dynamically locked nailing. Methods 14 matched pairs of cadaveric femora were randomly assigned to one of two distal fixation treatment groups; a single distal interlock screw placed in the dynamic orientation or no distal screw fixation. A stable two part intertrochanteric fracture was produced. Specimens were potted and mounted in a double gimbal fixture facilitating unconstrained motion in the sagittal and coronal planes. Specimens were cyclically loaded dynamically in both internal and external rotation. Range of motion, internal and external rotation stiffness, torsion stiffness, torsion yield and ultimate torsion magnitude were calculated. Results The samples instrumented with a distal locking screw reported statistically significantly greater internal (1.54 ± 0.81Nm/° versus 1.08 ± 0.35Nm/°, p = 0.026) and external rotational stiffness (1.42 ± 0.72Nm/° versus 0.86 ± 0.36Nm/°, p = 0.009). Samples with locked distal fixation were statistically stiffer and displayed statistically less displacement at the yield and peak torque. The yield torque was statistically significantly higher in the samples without distal fixation (14.2 ± 3.3Nm versus 10.6 ± 3.8Nm, p = 0.037). The peak torque was comparable between locked an unlocked samples (15.0 ± 4.6Nm versus 16.2 ± 4.2Nm, p = 0.492). Conclusion Distal locking of femoral intramedullary nails increases the stiffness of the nail-femur construct. Unlocked samples displayed statistically significant higher yield torque while maintaining comparable peak torque as the locked samples. This study indicates that treating stable intertrochanteric fractures with unlocked, long intramedullary nails may be an acceptable option, although further clinical study will be needed to test this assertion. PMID:24978941

  12. Preliminary results of the treatment of proximal femoral fractures with the AFFIXUS nail.

    PubMed

    Kanakaris, Nikolaos K; Noviello, Chiara; Saeed, Zumbair; Mitrogiannis, Leonidas; Tosounidis, Theodoros H; Tartaglia, Nicola

    2015-11-01

    Contemporary fixation of the proximal femur is performed utilising a number of implants adopting different concepts and techniques. Cephalomedullary nails in particular represent one of two main options, the other being dynamic hip screw (DHS). The aim of this cohort study is to present the early experience of two large units from different countries of the use of the AFFIXUS™ nail for stabilisation of proximal femoral fractures. Over a period of almost three years, data from 476 proximal femoral fractures were collected and analysed using a specific research protocol, assessing data relevant to basic demographic details, in-hospital stay, surgical technique and post discharge outcomes with a minimum follow up of 6 months. Both the short and long versions of the nail were used in both centres, however, with some statistically significant differences as far as the type of fractures stabilised with the nail, which also translated to differences in the combination or not of 2 lag screws, and the static or dynamic mode of the proximal fixation construct. Other areas of difference amongst the 2 units, were the length of hospital stay and return of patients to their pre-injury residence, most likely reflecting the different social circumstances between the 2 countries. Overall mortality at a median follow up period of 17 months (range 6 to 35) was limited to 6.3%, nonunion and cut out rates 2.7%, whilst revision surgery occurred in just 2.5%. Over the first 6 months of follow up 63.6% returned to their pre-injury ambulatory status and 90.5% to their pre-injury residence. Further studies and higher level of scientific evidence is needed to verify the findings of this retrospective cohort study as to the effectiveness and safety of this new cephalomedullary nail. PMID:26384659

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

    NASA Astrophysics Data System (ADS)

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

    2011-12-01

    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.

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

    PubMed Central

    2013-01-01

    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. PMID:23281775

  15. Ethnic hair care products may increase false positives in hair drug testing.

    PubMed

    Kidwell, David A; Smith, Frederick P; Shepherd, Arica R

    2015-12-01

    The question of why different races appear more susceptible to hair contamination by external drugs remains controversial. This research studied susceptibility of head hair to external cocaine and methamphetamine when hair products have been applied. Three different chemical classes of ethnic hair products were applied to Caucasian, Asian, and African hair. Some products increased the methamphetamine and cocaine concentrations in all hair types. A unique finding of this research is that certain ethnic hair products can replace moisture as a diffusion medium, thereby increasing the susceptibility to contamination over 100-fold compared to petroleum-based products. PMID:26338354

  16. Validation of an aggregate exposure model for substances in consumer products: a case study of diethyl phthalate in personal care products

    PubMed Central

    Delmaar, Christiaan; Bokkers, Bas; ter Burg, Wouter; Schuur, Gerlienke

    2015-01-01

    As personal care products (PCPs) are used in close contact with a person, they are a major source of consumer exposure to chemical substances contained in these products. The estimation of realistic consumer exposure to substances in PCPs is currently hampered by the lack of appropriate data and methods. To estimate aggregate exposure of consumers to substances contained in PCPs, a person-oriented consumer exposure model has been developed (the Probabilistic Aggregate Consumer Exposure Model, PACEM). The model simulates daily exposure in a population based on product use data collected from a survey among the Dutch population. The model is validated by comparing diethyl phthalate (DEP) dose estimates to dose estimates based on biomonitoring data. It was found that the model's estimates compared well with the estimates based on biomonitoring data. This suggests that the person-oriented PACEM model is a practical tool for assessing realistic aggregate exposures to substances in PCPs. In the future, PACEM will be extended with use pattern data on other product groups. This will allow for assessing aggregate exposure to substances in consumer products across different product groups. PMID:25352161

  17. Practice paper of the academy of nutrition and dietetics: principles of productivity in food and nutrition services: applications in the 21st century health care reform era.

    PubMed

    Gregoire, Mary B; Theis, Monica L

    2015-07-01

    Food and nutrition services, along with the health care organizations they serve, are becoming increasingly complex. These complexities are driven by sometimes conflicting (if not polarizing) human, department, organization, and environment factors and will require that managers shift how they think about and approach productivity in the context of the greater good of the organization and, perhaps, even society. Traditional, single-factor approaches to productivity measurements, while still valuable in the context of departmental trend analysis, are of limited value when assessing departmental performance in the context of an organization's goals and values. As health care continues to change and new models of care are introduced, food and nutrition services managers will need to consider innovative approaches to improve productivity that are consistent with their individual health care organization's vision and mission. Use of process improvement tools such as Lean and Six Sigma as strategies for evaluating and improving food and nutrition services efficiency should be considered. PMID:26115561

  18. Scented traces--Dermal exposure of synthetic musk fragrances in personal care products and environmental input assessment.

    PubMed

    Homem, Vera; Silva, Eduardo; Alves, Arminda; Santos, Lúcia

    2015-11-01

    Synthetic musks are organic compounds used as fragrance and fixative additives in several personal care products. Until now, little is known about their occurrence and distribution in these household commodities. However, this information is essential to perform a human dermal exposure assessment. Therefore, this study gives an overview on the levels of 12 synthetic musks in 140 personal care products from 7 different categories (body and hair wash, toilet soaps, shaving products, dentifrice products, deodorants/antiperspirants, moisturizers and perfumes). They were analysed by QuEChERS extraction followed by gas chromatography-mass spectrometry. Detection limits were found between 0.01ngg(-1) (galaxolide) and 5.00ngg(-1) (musk xylene). Higher average concentrations of total synthetic musks were detected in perfumes (5245.05?gg(-1)) and shampoos (487.67?gg(-1)) for adults. Galaxolide, exaltolide and cashmeran were the most detected compounds. Combining these results with the daily usage amounts, an average daily dermal exposure of 75.69?gkgbw(-1)day(-1) for adults and 15.54?gkgbw(-1)day(-1) for babies/children was achieved. The main contributors for adult and babies/children dermal exposure were perfumes and lotions, respectively. About 40% of the adult daily dermal exposure is related to exaltolide, 30% galaxolide, and 15% tonalide, while for babies/children 96% occurs due to exaltolide. An estimate of the amount of musks discharged "down-the-drain" into the wastewater treatment systems through the use of toiletries was also performed. An average emission per capita of 6.7mgday(-1) was determined and galaxolide and exaltolide were the predominant musks in the effluents. PMID:26150197

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

    PubMed

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

    2014-02-01

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

  20. Single-substance and mixture toxicity of five pharmaceuticals and personal care products to marine periphyton communities.

    PubMed

    Backhaus, Thomas; Porsbring, Tobias; Arrhenius, Asa; Brosche, Sara; Johansson, Per; Blanck, Hans

    2011-09-01

    The single-substance and mixture toxicity of five pharmaceuticals and personal care products (fluoxetine, propranolol, triclosan, zinc-pyrithione, and clotrimazole) to marine microalgal communities (periphyton) was investigated. All compounds proved to be toxic, with median effective concentration values (EC50s) between 1,800 nmol/L (triclosan) and 7.2 nmol/L (Zn-pyrithione). With an EC50 of 356 nmol/L, the toxicity of the mixture falls into this span, indicating the absence of strong synergisms or antagonisms. In fact, a comparison with mixture toxicity predictions by the classical mixture concepts of concentration addition and independent action showed a good predictability in the upper effect range. However, the mixture provoked stimulating effects (hormesis) in the lower effect range, hampering the application of either concept. An independent repetition of the mixture experiment resulted in a principally similar concentration-response curve, again with clear hormesis effects in the lower range of test concentrations. However, the curve was shifted toward higher effect concentrations (EC50 1,070 nmol/L), which likely is due to changes in the initial species composition. Clear mixture effects were observed even when all five components were present only at their individual no-observed-effect concentrations (NOECs). These results show that, even with respect to mixtures of chemically and functionally dissimilar compounds, such as the five pharmaceuticals and personal care products investigated, environmental quality standards must take possible mixture effects from low-effect concentrations of individual compounds into consideration. PMID:21647943

  1. Perishable Product Supply Chains in Health Care: Models, Analysis, and Computations

    E-print Network

    Nagurney, Anna

    Chains #12;The Pharmaceutical Industry Pharmaceutical, that is, medicinal drug, manufacturing On In This Talk The Pharmaceutical Industry and Issues A Generalized Network Oligopoly Model for Pharmaceutical Product Supply Chains #12;The Pharmaceutical Industry and Issues Anna Nagurney Perishable Product Supply

  2. Tapping into social resources to address occupational health : a network analysis of Vietnamese-owned nail salons

    E-print Network

    Doan, Tam Minh-Thi, 1976-

    2004-01-01

    Social networks in the Vietnamese nail salon industry were studied for their utility in addressing occupational health risks. Major findings include heavy reliance on family networks for fundamental needs, an extensive ...

  3. 77 FR 46686 - Steel Nails From the People's Republic of China: Notice of Court Decision Not in Harmony With...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-06

    ...Final Scope Ruling: Certain Steel Nails from the People's Republic of China, Request by Target Corporation, Memorandum from James C. Doyle, Director Office 9, to Edward C. Yang, Acting Deputy Assistant Secretary for Antidumping and Countervailing...

  4. 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, 2014

    2012-04-24

    ...: Final Results and Final Rescission of the Second Antidumping Duty Administrative Review, 77 FR 12556....; (13) Kyung Dong Corp.; (14) Nanjing Dayu Pneumatic Gun Nails Co., Ltd.; (15) Rizhao Handuck...

  5. Firearm suicide committed using an unusual combination of tandem missiles: a bullet, a nail, and a screw.

    PubMed

    Mihailovic, Zoran; Savic, Slobodan; Atanasijevic, Tatjana

    2007-09-01

    An interesting case of firearm suicide carried out using an unusual type of handmade weapon and a peculiar combination of tandem missiles is presented. A nail and a screw were placed in the rifle barrel ahead of a bullet, and all 3 were simultaneously discharged. The inflicted injury began with 1 common channel, which later split in 2 separate channels, both directed backwards and upwards; one was caused by the screw, ending in the epistropheal body, and the other, caused by the bullet and the nail, penetrated into the cranial cavity, where it bifurcated in 2 branches, one from the bullet, ending in the cerebellar tissue, and the other from the nail, penetrated through the brain stem. The established site of the entrance suicidal wound, the appearance of the weapon, and the unusual missiles are discussed with regard to the available references dealing with different types of nail injuries to the head. PMID:17721170

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

    PubMed

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

    2014-07-01

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

  7. Five millennia of wound care products--what is new? A literature review.

    PubMed

    Mouës, Chantal M; Heule, Freerk; Legerstee, Ron; Hovius, Steven E R

    2009-03-01

    The first wound an wound treatments were described five millennia ago. Since then, various principles of wound care have been passed on from generation to generation. In contrast to large numbers of general technological inventions over the last 100 years, progress beyond ancient wound care practices is a recent phenomenon. It is essential to know the historical aspects of wound treatment (both successes and failures) in order to continue this progress and provide future direction. A survey of the literature shows that concepts such as "laudable pus" persisted for hundreds of years and that lasting discoveries and meaningful progress did not occur until grand-scale manufacturing and marketing started. Landmarks such as understanding the principles of asepsis/antisepsis, fundamental cellular research findings, knowledge about antibiotics/antimicrobials, moist wound healing, and the chemical and physical processes of wound healing have provided the foundation to guide major developments in wound management, including available evidence-based guidelines. Although research regarding interaction of basic wound management principles remains limited, the combined efforts of global research and clinical groups predict a bright future for improved wound management. PMID:19359707

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

    PubMed

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

    2012-01-01

    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

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

    PubMed

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

    2014-05-01

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

  10. 78 FR 49528 - Consolidation of Wound Care Products Containing Live Cells

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-14

    ...Evaluation, CDRH, to the Office of Cellular, Tissue and Gene Therapies, CBER. The jurisdictional assignment of these products...Patrick Riggins, Office of Cellular, Tissue and Gene Therapy, Center for Biologics Evaluation and Research,...

  11. [Optimizing the effect of a cosmetic care product on the human skin].

    PubMed

    Schrader, K

    1989-12-15

    After explaining the idea and purpose of cosmetic products, we report on the course of development these products usually take: marketing briefing, selection of the raw materials, serial experiments and stability tests, and finally, dermatophysiological efficacy tests. In particular, we deal with the application of adenosine triphosphate (ATP) and its moisturing and smoothing effect on human skin. Our results are discussed in detail. PMID:2633510

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

    PubMed

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

    2012-04-01

    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

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

    PubMed Central

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

    2008-01-01

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

  14. [The biomechanical study of rotating-arm self-locking intramedullary nails in comminuted femoral shaft fractures].

    PubMed

    Fang, Yue; Fu, Xiuxin; Chi, Leiting; Wang, Guanglin; Yang, Tianfu

    2006-10-01

    This study was sought to compare and evaluate the biomechanical properities of rotating-arm self-locking intramedullary nails (RSIN) with domestic femoral intramedullary nail (DFIN) in communited femoral shaft fractures. A 2 cm midshaft defect was created on seven pairs of cadaver femur, and fixed with two kinds of intramedullary nails. Then the torsion, four-point bending and axial loading to failure were tested on these models. The load versus deformation curve was generated from the load recorded by the load cell and the deformation simultaneously recorded by the linear variable displacement transducer. The mean torsional stiffness of the femora fixed with RSIN was 0.98 Nm/degree, which was significantly less than that fixed with the similar nails reported in documents, and the mean value of bending stiffness of the femur fixed with DFIN was larger than that of the femur fixed with RBIN, but there was no significant statistic difference. For use in fracture models under compression load beyond 1200 N, the RBIN was more rigid than DFIN, which provided the biggest load. All the parameters of the test with nails were greater than that for femur fixed with nails. In conclusion, FBIN probably provides enough strength and rigidity for use in communited femoral shaft fractures. PMID:17121350

  15. Effect of oral terbinafine treatment on cyclosporin pharmacokinetics in organ transplant recipients with dermatophyte nail infection.

    PubMed

    Jensen, P; Lehne, G; Fauchald, P; Simonsen, S

    1996-07-01

    Eleven patients with either kidney, heart or lung transplants, immunosuppressed with cyclosporin A, and with culture-proven dermatophyte toe nail infection, were given 250 mg terbinafine orally daily for 12 weeks. No changes in cyclosporin A dosage were made. A statistically significant decrease in mean specific cyclosporin A blood trough levels was found at 4, 8 and 12 weeks. No other statistically significant changes in the pharmacokinetic profile of cyclosporin A were seen. Terbinafine possibly induces a cyclosporin A metabolic degradation, which, however, is of little clinical significance. Terbinafine treatment is a safe therapeutical option in cyclosporin A-treated patients with dermatophyte nail infection. Cyclosporin A levels should be controlled during treatment. PMID:8869684

  16. Residential building stakeholders' attitudes and beliefs regarding nail gun injury risks and prevention.

    PubMed

    Albers, James T; Hudock, Stephen D; Lowe, Brian D

    2013-01-01

    Pneumatic nail guns are ubiquitous at residential construction sites across the United States. These tools are noted for the traumatic injuries that can occur from their operation. Different trigger mechanisms on these tools are associated with different levels of risk. Residential building subcontractors and workers, both native-born and immigrant, were brought together in focus groups to discuss their attitudes and beliefs regarding risk factors for nail gun injury as well as barriers to the adoption of safer technology. Participants' comments are organized first by influences on traumatic injury occurrence or prevention and later by sociotechnical system category. Participants attributed influences on injury risk to personal and external causation factors in all sociotechnical system categories; however, participants more frequently described influences on injury prevention as related to workers' behaviors, rather than to external factors. A discussion of these influences with respect to attribution theory and sociotechnical models of injury causation is presented. PMID:24704813

  17. Opto-Thermal Transient Emission Radiometry (OTTER) to image diffusion in nails in vivo.

    PubMed

    Xiao, P; Zheng, X; Imhof, R E; Hirata, K; McAuley, W J; Mateus, R; Hadgraft, J; Lane, M E

    2011-03-15

    This work describes the first application of Opto-Thermal Transient Emission Radiometry (OTTER), an infrared remote sensing technique, to probe the extent to which solvents permeate the human nail in vivo. Decanol, glycerol and butyl acetate were selected as model solvents. After application of the solvents, individually, to human volunteers, OTTER was used to depth profile the solvents. The permeation rate of the solvents was ranked as glycerol>decanol>butyl acetate. It is possible that some of the butyl acetate may have evaporated during the experiment. The ability of decanol to extract lipids from biological tissue is also considered. These preliminary results demonstrate the potential of OTTER as a tool to identify optimal excipients with which to target drugs to the nail. PMID:21251961

  18. Spontaneous coronary artery dissection in a parturient with Nail-Patella syndrome.

    PubMed

    Nizamuddin, S L; Broderick, D K; Minehart, R D; Kamdar, B B

    2015-02-01

    Spontaneous coronary artery dissection is an uncommon cause of acute coronary syndrome, occurring predominantly in women during and immediately after pregnancy; it carries a mortality rate of greater than 50%. While the exact etiology is unknown, possible contributing factors include pregnancy-related hormonal, connective tissue and hemodynamic changes. We present a case of a 35-year-old multigravid woman with Nail-Patella syndrome who developed an acute myocardial infarction secondary to spontaneous coronary artery dissection during labor which was not diagnosed until after delivery. We hypothesize that abnormal collagen fiber formation found in Nail-Patella syndrome may have put her at an increased risk of coronary dissection and myocardial infarction. Regardless of etiology, a delay in diagnosis of myocardial ischemia can lead to significant morbidity and mortality. In light of the increasing burden of cardiac disease in the obstetric population, clinicians should remain vigilant for signs of myocardial infarction and prepare for definitive diagnosis and treatment. PMID:25433575

  19. UV-curable gel formulations: Potential drug carriers for the topical treatment of nail diseases.

    PubMed

    Kerai, Laxmi Valji; Hilton, Stephen; Murdan, Sudaxshina

    2015-08-15

    Nail diseases are common, cause significant distress and treatments are far from successful. Our aim was to investigate the potential of UV-curable gels - currently used as cosmetics - as topical drug carriers for their treatment. These formulations have a long residence on the nail, which is expected to increase patient compliance and the success of topical therapy. The gels are composed of the diurethane dimethacrylate, ethyl methacrylate, 2-hydroxy-2-methylpropiophenone, an antifungal drug (amorolfine HCl or terbinafine HCl) and an organic liquid (ethanol or NMP) as drug solvent. Following its application to a substrate and exposure to a UVA lamp for 2 min, the gel polymerises and forms a smooth, glossy and amorphous film, with negligible levels of residual monomers. No drug-polymer interactions were found and drug loading did not affect the film's properties, such as thickness, crystallinity and transition temperatures. In contrast, the organic solvent did influence the film's properties; NMP-containing films had lower glass transition temperatures, adhesion and water resistance than ethanol-based ones. Water-resistance being a desired property, ethanol-based formulations were investigated further for stability, drug release and ungual permeation. The films were stable under accelerated stability testing conditions. Compared to terbinafine, amorolfine was released to a greater extent, had a higher ungual flux, but a lower concentration in the nailplate. However, both drugs were present at considerably high levels in the nail when their MICs are taken into account. We thus conclude that UV-curable gels are promising candidates as topical nail medicines. PMID:26187167

  20. [Pyoderma gangrenosum after intramedullary nailing of tibial shaft fracture : A differential diagnosis to necrotizing fasciitis].

    PubMed

    Hackl, S; Merkel, P; Hungerer, S; Friederichs, J; Müller, N; Militz, M; Bühren, V

    2015-12-01

    Pyoderma gangrenosum is a rare non-infectious neutrophilic dermatitis, whereas necrotizing fasciitis is a life-threatening bacterial soft tissue infection of the fascia and adjacent skin. As in the case described here after intramedullary nailing, the clinical appearance of both diseases can be similar. Because of the completely different therapeutic approach and a worse outcome in the case of false diagnosis, pyoderma gangrenosum should always be taken into consideration before treating necrotizing fasciitis. PMID:25672810

  1. Spooning of the nails and webbing of the esophagus: koilonychia and Plummer-Vinson Syndrome.

    PubMed

    Mangla, Ankit; Agarwal, Nikki; Yu, Jie; Telfer, Margaret

    2015-12-01

    Chronic iron deficiency can be associated with nail deformities like Koilonychia and Platynychia. It can also be associated with esophageal webs (Plummer-Vinson syndrome or Patterson-Brown-Kelly syndrome) causing dysphagia in the patient. Though the pathogenesis of this association remains anecdotal and presence of these physical findings should prompt the clinician towards considering chronic iron deficiency as the cause of anemia. PMID:26734146

  2. Robust identification and localization of intramedullary nail holes for distal locking using CBCT: a simulation study.

    PubMed

    Kamarianakis, Z; Buliev, I; Pallikarakis, N

    2011-05-01

    Closed intramedullary nailing is a common technique for treatment of femur and tibia fractures. The most challenging step in this procedure is the precise placement of the lateral screws that stabilize the fragmented bone. The present work concerns the development and the evaluation of a method to accurately identify in the 3D space the axes of the nail hole canals. A limited number of projection images are acquired around the leg with the help of a C-arm. On two of them, the locking hole entries are interactively selected and a rough localization of the hole axes is performed. Perpendicularly to one of them, cone-beam computed tomography (CBCT) reconstructions are produced. The accurate identification and localization of the hole axes are done by an identification of the centers of the nail holes on the tomograms and a further 3D linear regression through principal component analysis (PCA). Various feature-based approaches (RANSAC, least-square fitting, Hough transform) have been compared for best matching the contours and the centers of the holes on the tomograms. The robustness of the suggested method was investigated using simulations. Programming is done in Matlab and C++. Results obtained on synthetic data confirm very good localization accuracy - mean translational error of 0.14 mm (std=0.08 mm) and mean angular error of 0.84° (std=0.35°) at no radiation excess. Successful localization can be further used to guide a surgeon or a robot for correct drilling the bone along the nail openings. PMID:21183392

  3. Prenatal Care

    MedlinePLUS

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

  4. Influence of human nail etching for the assessment of topical onychomycosis therapies.

    PubMed

    Repka, Michael A; Mididoddi, Praveen K; Stodghill, Steven P

    2004-09-10

    The purpose of this investigation was to study the physico-chemical properties of hot-melt extruded films containing ketoconazole and to determine the influence of 'nail etching' on film bioadhesion and drug permeability for the assessment of topical onychomycosis therapies. Hot-melt extrusion (HME) was used to prepare films containing 20% w/w ketoconazole. Ketoconazole 0.125% gel was also prepared using Carbopol 974P NF. Films were processed at a temperature range of 115-120 degrees C utilizing a Killion extruder (KLB-100), and were evaluated for post-extrusion drug content, content uniformity, bioadhesion, thermal behavior and nail drug permeation. The extruded films demonstrated excellent content uniformity and post-processing drug content. Tensile and peel tests were recorded to determine the bioadhesive profiles. In this study, work of adhesion and peak adhesive force determinations using the peel tests provided more sensitive results for evaluating the bioadhesivity of the HME films than the tensile tests. The in vitro permeability profiles have demonstrated, that nail samples treated with an 'etchant' demonstrated a significant increase in drug permeability compared to control. Differential scanning calorimetry (DSC) thermograms indicated that ketoconazole was in solid solution within the HME films. These findings are encouraging for the future design and formulation of novel drug delivery systems for the topical treatment of onychomycosis. PMID:15336385

  5. Corrosion behavior, biocompatibility and biomechanical stability of a prototype magnesium-based biodegradable intramedullary nailing system.

    PubMed

    Krämer, Manuel; Schilling, Markus; Eifler, Rainer; Hering, Britta; Reifenrath, Janin; Besdo, Silke; Windhagen, Henning; Willbold, Elmar; Weizbauer, Andreas

    2016-02-01

    Implants made of degradable magnesium alloys are a potential alternative to conventional orthopaedic implant materials, e.g. stainless steel or titanium. Intramedullary nails made of the magnesium alloy LAE442 were subjected to cyclic fatigue tests in both distilled water and Hank's Balanced Salt Solution (HBSS) at 37.5°C until implant failure or a limit of 500,000cycles was reached. In distilled water, four of the five nails were still intact after the end of the biomechanical test. In HBSS, a breakage within the first 70,000 bending cycles was observed. Additionally, the degradation rate of this alloy was determined in HBSS according to the weight loss method (0.24±0.12mmyear(-1)) and based on gas release (0.21±0.03mmyear(-1)) with a standard eudiometer. A cytotoxicity test with L929 cells was carried out in accordance with EN ISO 10993-5/12. This test demonstrated sufficient cell viability of the diluted extracts (50%, 25% and 12.5%). The relative metabolic activity of the 100% extract was reduced slightly below 70%, which is classified as a threshold value for cytotoxicity. In conclusion, this in vitro study indicates that intramedullary nails made of LAE442 may not have the required fatigue resistance for load-bearing applications and the development of a corrosion-protective coating may be necessary to prevent early failure of the implant. PMID:26652357

  6. Complex proximal femoral fractures in the elderly managed by reconstruction nailing – complications & outcomes: a retrospective analysis

    PubMed Central

    Rethnam, Ulfin; Cordell-Smith, James; Kumar, Thirumoolanathan M; Sinha, Amit

    2007-01-01

    Background Unstable proximal femoral fractures and pathological lesions involving the trochanteric region in the elderly comprise an increasing workload for the trauma surgeon as the ageing population increases. This study aims to evaluate use of the Russell-Taylor reconstruction nail (RTRN) in this group with regard to mortality risk, complication rates and final outcome. Methods Retrospective evaluation of 42 patients aged over 60 years who were treated by reconstruction nailing for proximal femoral fractures over a 4 year period. Results Over two-thirds of patients were high anaesthetic risk (ASA > 3) with ischemic heart disease the most common co-morbidity. 4 patients died within 30 days of surgery and 4 patients required further surgery for implant related failure. Majority of patients failed to regain their pre-injury mobility status and fewer than half the patients returned to their original domestic residence. Conclusion Favourable fixation of unstable complex femoral fractures in the elderly population can be achieved with the Russell-Taylor reconstruction nail. However, use of this device in this frail population was associated with a high implant complication and mortality rate that undoubtedly reflected the severity of the injury sustained, co-morbidity within the group and the stress of a major surgical procedure. PMID:18271998

  7. Analysis of gene expression profiles in healing rat fractures treated with nail and plate fixation.

    PubMed

    Wang, S D; Li, X L; Liu, H P

    2014-01-01

    To compare fracture healing therapies, the gene expression profiles of rat fracture samples treated with nail and plate fixation were analyzed at 1 day, 3 days, 1 week, 2 weeks, 4 weeks, and 6 weeks after surgery. The gene expression profiles GSE1685, which include 19 samples, were downloaded from the Gene Expression Omnibus database. After preprocessing, the gene expression profiles were subjected to time series analysis using the Short Time-series Expression Miner software, and the significantly differentially expressed gene (DEG) sets were selected. Further, the distributions of those DEG sets on the corresponding chromosomes were identified using the functional classification tool. Finally, the DEGs were subjected to function and pathway enrichment analysis. DEG analysis indicated that the number of DEGs (854 genes) from nail fixation was significantly lower than that of DEGs (1029 genes) from plate fixation. The DEGs were mainly enriched in cell proliferation, cellular localization, and response to wounding functions. Several critical DEGs expressed during the fracture healing process were screened, and 2 common pathways were enriched for the DEGs in the nail fixation and plate fixation. These DEGs and pathways may be potential targets or predictive markers during fracture healing. PMID:25366739

  8. Outcomes of Geriatric Hip Fractures Treated with AFFIXUS Hip Fracture Nail

    PubMed Central

    Mabrouk, Ahmed; Madhusudan, Mysore; Waseem, Mohammed; Kershaw, Steven

    2014-01-01

    Geriatric hip fractures are one of the commonest fractures worldwide. The purpose of this study was to report the outcomes of a series of unstable geriatric hip fractures treated with AFFIXUS hip fracture nail. A retrospective study of 100 unstable geriatric hip fractures treated with AFFIXUS hip fracture nail is presented. The mean follow-up duration was 8 months (range 3–32). Of the patients 83% were female. The average age was 85 years. The fracture was treated by closed reduction and intramedullary fixation. The mean acute hospital stay was 17.6 days. Systemic complications occurred in 29 patients (29%) and local complications in 3 patients (3%) including lag screw cutout in one patient (1%), lag screw backout in one patient (1%), and deep infection in one patient (1%). Mechanical failures and periprosthetic fractures were not observed in our series. Fractures united in all patients. Preinjury activity level was recovered in 78% of the patients. The results of AFFIXUS hip fracture nail were satisfactory in most elderly patients. The unique design of the lag screw and its thread spacing had effectively reduced cut-out rate. PMID:25580303

  9. Outcomes of Geriatric Hip Fractures Treated with AFFIXUS Hip Fracture Nail.

    PubMed

    Mabrouk, Ahmed; Madhusudan, Mysore; Waseem, Mohammed; Kershaw, Steven; Fischer, Jochen

    2014-01-01

    Geriatric hip fractures are one of the commonest fractures worldwide. The purpose of this study was to report the outcomes of a series of unstable geriatric hip fractures treated with AFFIXUS hip fracture nail. A retrospective study of 100 unstable geriatric hip fractures treated with AFFIXUS hip fracture nail is presented. The mean follow-up duration was 8 months (range 3-32). Of the patients 83% were female. The average age was 85 years. The fracture was treated by closed reduction and intramedullary fixation. The mean acute hospital stay was 17.6 days. Systemic complications occurred in 29 patients (29%) and local complications in 3 patients (3%) including lag screw cutout in one patient (1%), lag screw backout in one patient (1%), and deep infection in one patient (1%). Mechanical failures and periprosthetic fractures were not observed in our series. Fractures united in all patients. Preinjury activity level was recovered in 78% of the patients. The results of AFFIXUS hip fracture nail were satisfactory in most elderly patients. The unique design of the lag screw and its thread spacing had effectively reduced cut-out rate. PMID:25580303

  10. Multi-modal intra-operative navigation during distal locking of intramedullary nails.

    PubMed

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

    2015-02-01

    The interlocking of intramedullary nails is a technically demanding procedure which involves a considerable amount of X-ray acquisitions; one study lists as many as 48 to successfully complete the procedure and fix screws into 4-6 mm distal holes of the nail. We propose to design an augmented radiolucent drill to assist surgeons in completing the distal locking procedure without any additional X-ray acquisitions. Using an augmented reality fluoroscope that coregisters optical and X-ray images, we exploit solely the optical images to detect the augmented radiolucent drill and estimate its tip position in real-time. Consequently, the surgeons will be able to maintain the down the beam positioning required to drill the screws into the nail holes successfully. To evaluate the accuracy of the proposed augmented drill, we perform a preclinical study involving six surgeons and ask them to perform distal locking on dry bone phantoms. Surgeons completed distal locking 98.3% of the time using only a single X-ray image with an average navigation time of 1.4 ± 0.9 min per hole. PMID:25296403

  11. 78 FR 68027 - Notification of Proposed Production Activity, Revlon Consumer Products Corporation, Subzone 93G...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-13

    ...production. On its domestic sales, Revlon would be able to choose the duty rates during customs entry procedures that apply to perfume and bath splash, lip make-up products, eye make-up products, nail polish, face make-up powder, foundation and...

  12. 78 FR 49528 - Consolidation of Wound Care Products Containing Live Cells

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-14

    ... information. The Web page address is: http://www.fda.gov/BiologicsBloodVaccines/CellularGeneTherapyProducts... Cellular, Tissue and Gene Therapy, Center for Biologics Evaluation and Research, WOC1, Rm. 234N (HFM-705... transferred from the Office of Device Evaluation, CDRH, to the Office of Cellular, Tissue and Gene...

  13. Wound Care.

    PubMed

    Balsa, Ingrid M; Culp, William T N

    2015-09-01

    Wound care requires an understanding of normal wound healing, causes of delays of wound healing, and the management of wounds. Every wound must be treated as an individual with regard to cause, chronicity, location, and level of microbial contamination, as well as patient factors that affect wound healing. Knowledge of wound care products available and when negative pressure wound therapy and drain placement is appropriate can improve outcomes with wound healing. Inappropriate product use can cause delays in healing. As a wound healing progresses, management of a wound and the bandage material used must evolve. PMID:26022525

  14. Estimating fatty alcohol contributions to the environment from laundry and personal care products using a market forensics approach.

    PubMed

    Mudge, Stephen M; DeLeo, Paul C

    2014-01-01

    Fatty alcohol-based surfactants are widely used in detergents and personal care products; they are typically disposed of down-the-drain and are degraded or removed during wastewater treatment. Analytical data had shown concentration and profile differences between regions of the United States. Market sales data were purchased relevant to the sampling dates. In combination with analysis of the fatty alcohol profiles in the top selling products, the influent profiles were reconstructed and compared to the whole U.S. sales data. The per capita usage rate for fatty alcohols through these 4000+ top selling products was 4.9 g per day, with 88% arising from liquid laundry detergents and hand dish detergents. This extrapolates to a national usage of 185,000 tonnes per year. There were significant differences in the purchasing habits of the inhabitants across the four regions sampled, although this had minimal impact on the fatty alcohol profile which was dominated by the C12 moiety. The U.S. market was also dominated by petrochemically-sourced chemicals. This market forensics approach using purchased sales data was able to extend our knowledge of the fate of these chemicals without a major (expensive) sampling and analytical campaign. PMID:24220601

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

    USGS Publications Warehouse

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

    2007-01-01

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

  16. I Can’t Believe It’s Not Toothpaste! Poison Control Center Calls Regarding Dental and Oral-Care Products

    PubMed Central

    Suchard, Jeffrey R.

    2003-01-01

    Background: A cluster of incidents in which non-tooth-paste products were used to brush teeth prompted a review of all calls to one Poison Control Center (PCC) regarding exposures to dental and oral-care products to determine if any resulted in significant toxicity. Methods: Retrospective review of 65,849 calls to one PCC during one calendar year. All inquiries about exposures to substances used as dental or oral-care products were analyzed by a single reviewer for reported adverse effects; including hospital admission or PCC referral for emergent medical evaluation. Results: 798 calls involved exposure to dental or oral-care products, comprising 1.21 % of all calls received. Toothbrushing incidents with non-toothpaste products (122 cases) did not result in any significant recognized toxicity. Twenty-four patients were either referred for emergent medical evaluation (14) or were admitted to the hospital (10). In 23 of these patients (96%), the toxic agent was either an over-the-counter analgesic or a local anesthetic used to treat dental pain. Conclusions: Among PCC calls received regarding dental and oral-care products, over-the-counter analgesics and local anesthetics used for dental pain resulted in the most frequent need for emergent medical evaluation or for hospital admission. PMID:20852712

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

    PubMed

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

    2014-11-01

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

  18. Controlled nail delivery of a novel lipophilic antifungal agent using various modern drug carrier systems as well as in vitro and ex vivo model systems.

    PubMed

    Naumann, Sandy; Meyer, Jean-Philippe; Kiesow, Andreas; Mrestani, Yahya; Wohlrab, Johannes; Neubert, Reinhard H H

    2014-04-28

    The penetration behavior into human nails and animal hoof membranes of a novel antifungal agent (EV-086K) for the treatment of onychomycosis was investigated in this study. The new drug provides a high lipophilicity which is adverse for penetration into nails. Therefore, four different formulations were developed, with particular focus on a colloidal carrier system (CCS) due to its penetration enhancing properties. On the one hand, ex vivo penetration experiments on human nails were performed. Afterwards the human nail plates were cut by cryomicrotome in order to quantify the drug concentration in the dorsal, intermediate and ventral nail layer using high-performance liquid chromatography (HPLC) with UV detection. On the other hand, equine and bovine hoof membranes were used to determine the in vitro penetration of the drug into the acceptor compartment of an online diffusion cell coupled with Fourier transform infrared attenuated total reflectance (FTIR-ATR) spectroscopy. In combination, both results should exhibit a correlation between the EV-086K penetration behavior in human nail plates and animal hoof membranes. The investigations showed that the developed CCS could increase drug delivery through the human nail most compared to other formulations (nail lacquer, solution and hydrogel). Using animal hooves in the online diffusion cell, we were able to calculate pharmacokinetic data of the penetration process, especially diffusion and permeability coefficients. Finally, a qualitative correlation between the penetration results of human nails and equine hooves was established. PMID:24560884

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

    PubMed

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

    2013-12-01

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

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

    PubMed

    Preker, A S; Harding, A; Travis, P

    2000-01-01

    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. PMID:10916915

  1. Occurrence of herbicides and pharmaceutical and personal care products in surface water and groundwater around Liberty Bay, Puget Sound, Washington

    USGS Publications Warehouse

    Dougherty, Jennifer A.; Swarzenski, Peter W.; Dinicola, Richard S.; Reinhard, Martin

    2010-01-01

    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.

  2. Occurrence of Scopulariopsis and Scedosporium in nails and keratinous skin. A 5-year retrospective multi-center study.

    PubMed

    Issakainen, Jouni; Heikkilä, Hannele; Vainio, Eeva; Koukila-Kähkölä, Pirkko; Castren, Mirja; Liimatainen, Oili; Ojanen, Tarja; Koskela, Markku; Meurman, Olli

    2007-05-01

    A 5-year retrospective multicenter study was performed for microascaceous moulds (Microascaceae, Ascomycetes) in Finnish clinical specimens. The files from 1993-1997 of six clinical mycology laboratories in Finland were searched for reports of these fungi, mainly Scopulariopsis and Scedosporium anamorphs in keratinous specimens. From the 521 primary findings, 165 cases were selected for further study based on direct microscopy, colony numbers and accompanying fungi. The clinical records of 148 cases (141 Scopulariopsis, 7 Scedosporium) were studied. Of the nail infections from which Scopulariopsis was recovered, 39 cases were further separated which showed clinical or laboratory-based evidence of dermatophytosis. In the remaining 90 'non-dermatophyte' nail cases, Scopulariopsis spp. were the only documented fungal agents (c. 6 cases/million/year). The patients were mainly elderly, 66% of whom had problems involving their big toe nails. For 74% of them, the nail problem was mentioned as their reason for visiting the physician. However, only 18% had documented benefit from treatment. The Scopulariopsis nail infections seem to be treatment-resistant and the pathogenesis and etiological role of Scopulariopsis remain poorly understood. PMID:17464841

  3. Wettability behavior of special microscale ZnO nail-coated mesh films for oil-water separation.

    PubMed

    Du, Xin; Huang, Xing; Li, Xiaoyu; Meng, Xiangmin; Yao, Lin; He, Junhui; Huang, Hongwei; Zhang, Xueji

    2015-11-15

    The surface free energy and geometrical structure are two important factors to govern the surface wettability. However, the design and simple synthesis of materials with specific surface free energy and geometrical structure, and their elaborate regulations are still a key challenge. Herein, through one-step thermal evaporation method, we successfully synthesized aligned arrays of highly crystallized ZnO with modulated nail structures on the stainless steel meshes for the first time. Owing to the decoration of [0001] oriented nail structures, the wire surface of meshes were indeed enclosed by the ZnO (0002) facets, which had the lowest surface energy in wurtzite structure. Under no any further modifications, just by regulating the nail structure and density as well as the mesh pore sizes, we not only obtained ZnO nail-coated mesh with hydrophobic, oleophilic (oil penetration), and underwater oleophilic properties, but also fabricated one with hydrophilic (water penetration), oleophilic (oil penetration), and underwater superoleophobic properties. Furthermore, interestingly, the separation of oil and water mixture was realized by utilizing two ZnO-nail coated meshes with different wettability. The underlying mechanism was investigated and discussed in the work. Therefore, our study provides interesting insight into the design of novel functional films with desired surface wettability for the separation of oil-water mixture. PMID:26207588

  4. The Effects of Graduated Exposure, Modeling, and Contingent Social Attention on Tolerance to Skin Care Products with Two Children with Autism

    ERIC Educational Resources Information Center

    Ellis, Ellyn M.; Ala'i-Rosales, Shahla S.; Glenn, Sigrid S.; Rosales-Ruiz, Jesus; Greenspoon, Joel

    2006-01-01

    Children with autism may display unusual or fearful responses to common stimuli, such as skin care products. Parents of children with autism have often reported that their children will not allow the application of these types of substances to their skin and if the parent persists, the children become extremely upset and anxious. Such responding…

  5. APPLICATION OF US EPA METHODS TO THE ANALYSIS OF PHARMACEUTICALS AND PERSONAL CARE PRODUCTS IN THE ENVIRONMENT: DETERMINATION OF CLOFRIBIC ACID IN SEWAGE EFFLUENT BY GCMS

    EPA Science Inventory

    An emerging area of research concerns pharmaceuticals and personal care products in the environment and their possible impact on biota and ecosystems. The long term effects of constant perfusion of PPCPs into the aquatic environment are presently unknown. Some compounds are known...

  6. Stochastic modeling of the variation of velocity and permeability as a function of effective pressure using the Bed-of-Nails asperity-deformation model 

    E-print Network

    Genova Barazarte, Ezequiel

    2009-05-15

    . The dependence of permeability and velocity on effective pressure has previously been modeled using the Bed-of-Nails asperity-deformation model. The main objective of this research was to explore the sensitivity of the Bed-of-Nails and effective-pressure models...

  7. ISET Journal of Earthquake Technology, Paper No. 496, Vol. 45, No. 1-2, March-June 2008, pp. 3140 NUMERICALANALYSIS OF PERFORMANCE OF SOIL NAIL WALLS IN

    E-print Network

    Gupta, Vinay Kumar

    a vertical cut of 8 m height under seismic conditions. The wall is designed in conventional manner by using: Soil Nailing, Conventional Design, Seismic Performance, Numerical Analysis INTRODUCTION In areas­40 NUMERICALANALYSIS OF PERFORMANCE OF SOIL NAIL WALLS IN SEISMIC CONDITIONS G.L. Sivakumar Babu and Vikas Pratap Singh

  8. Complications after intramedullary nailing of femoral fractures in a low-income country

    PubMed Central

    2013-01-01

    Background Some surgeons believe that internal fixation of fractures carries too high a risk of infection in low-income countries (LICs) to merit its use there. However, there have been too few studies from LICs with sufficient follow-up to support this belief. We first wanted to determine whether complete follow-up could be achieved in an LIC, and secondly, we wanted to find the true microbial infection rate at our hospital and to examine the influence of HIV infection and lack of follow-up on outcomes. Patients and methods 137 patients with 141 femoral fractures that were treated with intramedullary (IM) nailing were included. We compared outcomes in patients who returned for scheduled follow-up and patients who did not return but who could be contacted by phone or visited in their home village. Results 79 patients returned for follow-up as scheduled; 29 of the remaining patients were reached by phone or outreach visits, giving a total follow-up rate of 79%. 7 patients (5%) had a deep postoperative infection. All of them returned for scheduled follow-up. There were no infections in patients who did not return for follow-up, as compared to 8 of 83 nails in the group that did return as scheduled (p = 0.1). 2 deaths occurred in HIV-positive patients (2/23), while no HIV-negative patients (0/105) died less than 30 days after surgery (p = 0.03). Interpretation We found an acceptable infection rate. The risk of infection should not be used as an argument against IM nailing of femoral fractures in LICs. Many patients in Malawi did not return for follow-up because they had no complaints concerning the fracture. There was an increased postoperative mortality rate in HIV-positive patients. PMID:24171678

  9. Investigation on internal short circuits of lithium polymer batteries with a ceramic-coated separator during nail penetration

    NASA Astrophysics Data System (ADS)

    Kim, Cheon-Soo; Yoo, Jin-Seong; Jeong, Kyung-Min; Kim, Keon; Yi, Cheol-Woo

    2015-09-01

    Internal short circuit of a lithium polymer battery (4.6 Ah capacity and 4.30 V charging voltage) with a ceramic-coated separator has been investigated by infrared measurement during nail penetration. The surface temperatures at nail penetration area and battery body were simultaneously measured by infrared camera and, as a result, three different failure modes have been proposed. The battery with 100% of SOC experiences thermal runaway phenomenon by means of the second internal short circuit. The batteries with low SOC (0% and 50% of SOC) were also investigated to identify the phenomena occurred in SOC 100% battery (the second internal short circuit), but neither fire nor explosion in the battery with low SOC was observed. The analysis of burr status after nail penetration demonstrates that it is quite important factor related to the failure modes. The results of this study can be applied to the design of safe battery.

  10. Scytalidium hyalinum isolated from the toe nail of an Australian patient.

    PubMed

    Maslen, M M; Hogg, G G

    1992-01-01

    The isolation of Scytalidium hyalinum from the toe nail of a patient from Melbourne is reported. This is the first record of the isolation of this fungus from a clinical site in Australia. A brief history is given of the occurrence of Scytalidium hyalinum and the related fungus, Hendersonula toruloidea, in tinea pedis and tinea unguium in immigrants to the United Kingdom from tropical countries. Attention is drawn to the possible presence of these dermatophyte-like infections in patients in Australia. PMID:1303078

  11. Custom-Made Antibiotic Cement Nails in Orthopaedic Trauma: Review of Outcomes, New Approaches, and Perspectives

    PubMed Central

    Wasko, Marcin K.; Kaminski, Rafal

    2015-01-01

    Since the first description in 2002 by Paley and Herzenberg, antibiotic bone cement nails (ACNs) have become an effective tool in the orthopaedic trauma surgeons' hands. They simultaneously elute high amounts of antibiotics into medullary canal dead space and provide limited stability to the debrided long bone. In this paper, we perform a systematic review of current evidence on ACNs in orthopaedic trauma and provide an up-to-date review of the indications, operative technique, failure mechanisms, complications, outcomes, and outlooks for the ACNs use in long bone infection. PMID:26509153

  12. Arsenic in hair and nails of individuals exposed to arsenic-rich groundwaters in Kandal province, Cambodia.

    PubMed

    Gault, Andrew G; Rowland, Helen A L; Charnock, John M; Wogelius, Roy A; Gomez-Morilla, Inma; Vong, Sovathana; Leng, Moniphea; Samreth, Sopheap; Sampson, Mickey L; Polya, David A

    2008-04-01

    The health implications of the consumption of high arsenic groundwater in Bangladesh and West Bengal are well-documented, however, little is known about the level of arsenic exposure elsewhere in Southeast Asia, where widespread exploitation of groundwater resources is less well established. We measured the arsenic concentrations of nail and hair samples collected from residents of Kandal province, Cambodia, an area recently identified to host arsenic-rich groundwaters, in order to evaluate the extent of arsenic exposure. Nail and hair arsenic concentrations ranged from 0.20 to 6.50 microg g(-1) (n=70) and 0.10 to 7.95 microg g(-1) (n=40), respectively, in many cases exceeding typical baseline levels. The arsenic content of the groundwater used for drinking water purposes (0.21-943 microg L(-1) (n=31)) was positively correlated with both nail (r=0.74, p<0.0001) and hair (r=0.86, p<0.0001) arsenic concentrations. In addition, the nail and hair samples collected from inhabitants using groundwater that exceeded the Cambodian drinking water legal limit of 50 microg L(-1) arsenic contained significantly more arsenic than those of individuals using groundwater containing <50 microg L(-1) arsenic. X-ray absorption near edge structure (XANES) spectroscopy suggested that sulfur-coordinated arsenic was the dominant species in the bulk of the samples analysed, with additional varying degrees of As(III)-O character. Tentative linear least squares fitting of the XANES data pointed towards differences in the pattern of arsenic speciation between the nail and hair samples analysed, however, mismatches in sample and standard absorption peak intensity prevented us from unambiguously determining the arsenic species distribution. The good correlation with the groundwater arsenic concentration, allied with the relative ease of sampling such tissues, indicate that the arsenic content of hair and nail samples may be used as an effective biomarker of arsenic intake in this relatively recently exposed population. PMID:18234288

  13. Emission of artificial sweeteners, select pharmaceuticals, and personal care products through sewage sludge from wastewater treatment plants in Korea.

    PubMed

    Subedi, Bikram; Lee, Sunggyu; Moon, Hyo-Bang; Kannan, Kurunthachalam

    2014-07-01

    Concern over the occurrence of artificial sweeteners (ASWs) as well as pharmaceuticals and personal care products (PPCPs) in the environment is growing, due to their high use and potential adverse effects on non-target organisms. The data for this study are drawn from a nationwide survey of ASWs in sewage sludge from 40 representative wastewater treatment plants (WWTPs) that receive domestic (WWTPD), industrial (WWTPI), or mixed (domestic plus industrial; WWTPM) wastewaters in Korea. Five ASWs (concentrations ranged from 7.08 to 5220 ng/g dry weight [dw]) and ten PPCPs (4.95-6930 ng/g dw) were determined in sludge. Aspartame (concentrations ranged from 28.4 to 5220 ng/g dw) was determined for the first time in sewage sludge. The median concentrations of ASWs and PPCPs in sludge from domestic WWTPs were 0.8-2.5 and 1.0-3.4 times, respectively, the concentrations found in WWTPs that receive combined domestic and industrial wastewaters. Among the five ASWs analyzed, the median environmental emission rates of aspartame through domestic WWTPs (both sludge and effluent discharges combined) were calculated to be 417 ?g/capita/day, followed by sucralose (117 ?g/capita/day), acesulfame (90 ?g/capita/day), and saccharin (66?g/capita/day). The per-capita emission rates of select PPCPs, such as antimicrobials (triclocarban: 158 ?g/capita/day) and analgesics (acetaminophen: 59 ?g/capita/day), were an order of magnitude higher than those calculated for antimycotic (miconazole) and anthelmintic (thiabendazole) drugs analyzed in this study. Multiple linear regression analysis of measured concentrations of ASWs and PPCPs in sludge revealed that several WWTP parameters, such as treatment capacity, population-served, sludge production rate, and hydraulic retention time could influence the concentrations found in sludge. PMID:24695211

  14. Seasonal variation in the occurrence and removal of pharmaceuticals and personal care products in different biological wastewater treatment processes.

    PubMed

    Sui, Qian; Huang, Jun; Deng, Shubo; Chen, Weiwei; Yu, Gang

    2011-04-15

    The occurrence of 12 pharmaceuticals and personal care products (PPCPs) in two wastewater treatment plants in Beijing was studied monthly over the course of one year. The removal of PPCPs by three biological treatment processes including conventional activated sludge (CAS), biological nutrient removal (BNR), and membrane bioreactor (MBR) was compared during different seasons. Seasonal variations of PPCPs in the wastewater influent were discrepant, while in the wastewater effluent, most PPCPs had lower concentrations in the summer than in the winter. For the easily biodegradable PPCPs, the performance of MBR was demonstrated to be more stable than CAS or BNR especially during winter months. Diclofenac, trimethoprim, metoprolol, and gemfibrozil could be moderately removed by MBR, while their removal by CAS and BNR was much lower or even negligible. Nevertheless, no removal was achieved regardless of the season or the treatment processes for the recalcitrant PPCPs. Studies on the contribution of each tank of the MBR process to the total removal of four biodegradable PPCPs indicated the oxic tank was the most important unit, whereas membrane filtration made a negligible contribution to their elimination. PMID:21428396

  15. Occurrence of organic wastewater contaminants, pharmaceuticals, and personal care products in selected water supplies, Cape Cod, Massachusetts, June 2004

    USGS Publications Warehouse

    Zimmerman, Marc J.

    2005-01-01

    In June 2004, the U.S. Geological Survey, in cooperation with the Barnstable County Department of Health and Environment, sampled water from 14 wastewater sources and drinking-water supplies on Cape Cod, Massachusetts, for the presence of organic wastewater contaminants, pharmaceuticals, and personal care products. The geographic distribution of sampling locations does not represent the distribution of drinking-water supplies on Cape Cod. The environmental presence of the analyte compounds is mostly unregulated; many of the compounds are suspected of having adverse ecological and human health effects. Of the 85 different organic analyte compounds, 43 were detected, with 13 detected in low concentrations (less than 1 microgram per liter) from drinking-water supplies thought to be affected by wastewater because of previously detected high nitrate concentrations. (Phenol and d-limonene, detected in equipment blanks at unacceptably high concentrations, are not included in counts of detections in this report.) Compounds detected in the drinking-water supplies included the solvent, tetrachloroethylene; the analgesic, acetaminophen; the antibiotic, sulfamethoxazole; and the antidepressant, carbamazapine. Nitrate nitrogen, an indicator of wastewater, was detected in water supplies in concentrations ranging from 0.2 to 8.8 milligrams per liter.

  16. Uptake and Tissue Distribution of Pharmaceuticals and Personal Care Products in Wild Fish from Treated-Wastewater-Impacted Streams.

    PubMed

    Tanoue, Rumi; Nomiyama, Kei; Nakamura, Haruna; Kim, Joon-Woo; Isobe, Tomohiko; Shinohara, Ryota; Kunisue, Tatsuya; Tanabe, Shinsuke

    2015-10-01

    A fish plasma model (FPM) has been proposed as a screening technique to prioritize potential hazardous pharmaceuticals to wild fish. However, this approach does not account for inter- or intraspecies variability of pharmacokinetic and pharmacodynamic parameters. The present study elucidated the uptake potency (from ambient water), tissue distribution, and biological risk of 20 pharmaceutical and personal care product (PPCP) residues in wild cyprinoid fish inhabiting treated-wastewater-impacted streams. In order to clarify the uncertainty of the FPM for PPCPs, we compared the plasma bioaccumulation factor in the field (BAFplasma = measured fish plasma/ambient water concentration ratio) with the predicted plasma bioconcentration factor (BCFplasma = fish plasma predicted by use of theoretical partition coefficients/ambient water concentration ratio) in the actual environment. As a result, the measured maximum BAFplasma of inflammatory agents was up to 17 times higher than theoretical BCFplasma values, leading to possible underestimation of toxicological risk on wild fish. When the tissue-blood partition coefficients (tissue/blood concentration ratios) of PPCPs were estimated, higher transportability into tissues, especially the brain, was found for psychotropic agents, but brain/plasma ratios widely varied among individual fish (up to 28-fold). In the present study, we provide a valuable data set on the intraspecies variability of PPCP pharmacokinetics, and our results emphasize the importance of determining PPCP concentrations in possible target organs as well as in the blood to assess the risk of PPCPs on wild fish. PMID:26348835

  17. Safety evaluations under the proposed US Safe Cosmetics and Personal Care Products Act of 2013: animal use and cost estimates.

    PubMed

    Knight, Jean; Rovida, Costanca

    2014-01-01

    The proposed Safe Cosmetics and Personal Care Products Act of 2013 calls for a new evaluation program for cosmetic ingredients in the US, with the new assessments initially dependent on expanded animal testing. This paper considers possible testing scenarios under the proposed Act and estimates the number of test animals and cost under each scenario. It focuses on the impact for the first 10 years of testing, the period of greatest impact on animals and costs. The analysis suggests the first 10 years of testing under the Act could evaluate, at most, about 50% of ingredients used in cosmetics. Testing during this period would cost about $ 1.7-$ 9 billion and 1-11.5 million animals. By test year 10, alternative, high-throughput test methods under development are expected to be available, replacing animal testing and allowing rapid evaluation of all ingredients. Given the high cost in dollars and animal lives of the first 10 years for only about half of ingredients, a better choice may be to accelerate development of high-throughput methods. This would allow evaluation of 100% of cosmetic ingredients before year 10 at lower cost and without animal testing. PMID:24468774

  18. Use Patterns of Leave-on Personal Care Products among Swiss-German Children, Adolescents, and Adults

    PubMed Central

    Manová, Eva; von Goetz, Natalie; Keller, Carmen; Siegrist, Michael; Hungerbühler, Konrad

    2013-01-01

    In order to model exposure to ingredients contained in personal care products (PCPs) and assess their potential risks to human health, access to reliable PCP use data, including co-use patterns, is essential. A postal questionnaire survey was conducted to determine the use patterns of eight leave-on PCP categories among the German-speaking population of Switzerland (N = 1,196; ages 0–97 years), providing for the first time in Europe PCP use data for children <12 years of age. The majority of respondents (99%) reported having used at least one of the investigated PCP categories in the past year. Co-use of two or more PCP categories at the same time was common and more complex amongst adults. Regular use of face cream and body lotion was very high in the youngest group of children aged 0–4 years (more than 79% respondents) who may be more vulnerable to certain adverse effects of some PCP ingredients. A comparison with previously collected information on PCP use patterns in Germany and the Netherlands indicates differences in PCP use patterns among European consumers and suggests that surrogate PCP use data from other countries must be used with caution. This work extends the existing knowledge of PCP use patterns and will be useful for new exposure assessments for ingredients contained in PCPs used by the young consumers. PMID:23823714

  19. Seasonal variations in concentrations of pharmaceuticals and personal care products in drinking water and reclaimed wastewater in southern California.

    PubMed

    Loraine, Gregory A; Pettigrove, Mark E

    2006-02-01

    Southern California imports nearly all of its potable water from two sources: the Colorado River and the California State Water Project (Sacramento-San Joaquin River Basin). Sewage treatment plant effluent (STPE) heavily impacts both of these sources. A survey of raw and treated drinking water from four water filtration plants in San Diego County showed the occurrence of several polar organic "pharmaceuticals and personal care products" (PPCP). These included phthalate esters, sunscreens, clofibrate, clofribric acid, ibuprofen, triclosan, and DEET. Several of these were also found in the finished water, such as di(ethylhexyl) phthalate, benzophenone, ibuprofen, and triclosan. Occurrence and concentrations of these compounds were highly seasonally dependent, and reached maximums when the flow of the San Joaquin River was low and the quantity of imported water was high. The maximum concentrations of the PPCPs measured in the raw water were correlated with low flow conditions in the Sacramento-San Joaquin Delta that feeds the State Water Project. The PPCP concentrations in raw imported water in the summer months approached that of reclaimed nonpotable wastewater. PMID:16509304

  20. Occurrence of pharmaceuticals and personal care products and associated environmental risks in the central and lower Yangtze river, China.

    PubMed

    Wu, Chenxi; Huang, Xiaolong; Witter, Jason D; Spongberg, Alison L; Wang, Kexiong; Wang, Ding; Liu, Jiantong

    2014-08-01

    Pharmaceutical and personal care products (PPCPs) residues are being highlighted around the world as of emerging concern in surface waters. Here the occurrence of PPCPs in the central and lower Yangtze River, along with four large freshwater lakes within the river basin (Dongting, Poyang, Tai, and Chao) was reported. Fifteen out of twenty selected PPCPs were detected in the collected surface water samples. Caffeine, paraxanthine, sulfamethazine, and clindamycin were detected with 100 percent frequency in the Yangtze River. In the river, the highest average concentration was observed for erythromycin (296 ng L(-1)), followed by caffeine (142 ng L(-1)) and paraxanthine (41 ng L(-1)). In the four lakes, total PPCP concentrations were much higher in the Chao (1547 ng L(-1)) and Tai (1087 ng L(-1)) lakes compared to the Poyang (108 ng L(-1)) and Dongting (137 ng L(-1)) lakes. Lincomycin and clindamycin were most abundant in the lakes, especially in the Tai Lake. Environmental risk assessment for the worst case scenario was assessed using calculated risk quotients, and indicates a high environmental risk of erythromycin and clarithromycin in the Yangtze River, clarithromycin in the Chao Lake, and clindamycin in the Tai Lake. PMID:24836873

  1. Emerging contaminants (pharmaceuticals, personal care products, a food additive and pesticides) in waters of Sydney estuary, Australia.

    PubMed

    Birch, G F; Drage, D S; Thompson, K; Eaglesham, G; Mueller, J F

    2015-08-15

    The current investigation of marine water from 30 sites adjacent to stormwater outlets across the entire Sydney estuary is the first such research in Australia. The number of analytes detected were: 8/59 pharmaceutical compounds (codeine, paracetamol, tramadol, venlafaxine, propranolol, fluoxetine, iopromide and carbamazepine), 7/38 of the pesticides (2,4-dichlorophenoxyacetic acid (2,4-D), 3,4-dichloroaniline, carbaryl, diuron, 2-methyl-4-chlorophenoxyacetic acid (MCPA), mecoprop and simazine) and 0/3 of the personal care products (PCPs) analysed. An artificial sweetener (acesulfame) was detected, however none of the nine antibiotics analysed were identified. Sewage water is not discharged to this estuary, except infrequently as overflow during high-precipitation events. The presence of acesulfame (a recognised marker of domestic wastewater) and pharmaceuticals in water from all parts of the estuary after a dry period, suggests sewage water is leaking into the stormwater system in this catchment. The pesticides are applied to the environment and were discharged via stormwater to the estuary. PMID:26130525

  2. Quantification of pharmaceuticals, personal care products, and perfluoroalkyl substances in the marine sediments of Puget Sound, Washington, USA.

    PubMed

    Long, Edward R; Dutch, Margaret; Weakland, Sandra; Chandramouli, Bharat; Benskin, Jonathan P

    2013-08-01

    Concentrations of 119 pharmaceuticals and personal care products (PPCPs) and 13 perfluoroalkyl substances (PFASs) in marine sediments measured throughout Puget Sound (n?=?10) and Bellingham Bay (n?=?30), Washington, USA, are reported. These data are among the first measurements of PPCPs and PFASs in marine sediments from the Pacific Northwest and provide a comparison to previous measurements of these chemicals in influent, effluent, and biosolids from municipal wastewater treatment plants throughout the region. The concentrations of both PPCPs and PFASs in sediments from Puget Sound and Bellingham Bay ranged from very low to non-detectable for most compounds. Only 14 of the 119 PPCPs and 3 of 13 PFASs were quantifiable in sediments. Diphenhydramine (an antihistamine) was most frequently detected (87.5% of samples), with a maximum concentration of 4.81?ng/g dry weight and an estimated mean detected concentration of 1.68?ng/g. Triclocarban (an antibacterial) was detected in 35.0% of the samples, with a maximum concentration of 16.6?ng/g dry weight. Perfluoroalkyl substances were detected in 2.5% of analyses. Perfluorobutanoate, perfluorooctane sulfonate, and perfluorooctane sulfonamide were detected in 7, 5, and 1 sample(s) each, respectively, with the highest concentrations observed for perfluorooctane sulfonate (1.5?ng/g). Detected concentrations were often highest within the industrial harbor in Bellingham Bay and near the cities of Seattle and Bremerton. Environ Toxicol Chem 2013;32:1701-1710. © 2013 SETAC. PMID:23843318

  3. Occurrence of halogenated transformation products of selected pharmaceuticals and personal care products in secondary and tertiary treated wastewaters from southern California.

    PubMed

    Bulloch, Daryl N; Nelson, Eric D; Carr, Steve A; Wissman, Chris R; Armstrong, Jeffrey L; Schlenk, Daniel; Larive, Cynthia K

    2015-02-17

    Final effluent samples from 10 southern California (United States) wastewater treatment facilities, employing four distinct treatment schemes, were surveyed for selected pharmaceuticals, personal care products (PPCPs), alkylphenols, and 21 of their halogenated disinfection byproducts. Chlorinated and brominated standards and isotopically labeled internal standards were synthesized and purified to confirm and more accurately quantify selected disinfection byproducts of salicylic acid, bisphenol A, gemfibrozil, naproxen, diclofenac, technical 4-nonylphenol, and 4-tert-octylphenol using high-performance liquid chromatography and tandem mass spectrometry. Concentrations of parent compounds ranged from <10 to 3830 ng/L (gemfibrozil), and those of chloro/bromo byproducts ranged from <4 to 370 ng/L (dibromo nonylphenol). The highest concentrations of parent compounds were measured in effluent that was not subjected to tertiary treatment. The chlorinated and brominated byproduct concentration may be affected by the influent concentration of parent compounds, hydraulic retention times, and chlorine contact times. Salicylic acid was readily halogenated, which is evident from the ratio of halogenated to nonhalogenated species. There were no measured chlorinated byproducts of bisphenol A despite occasionally high concentrations of the parent compound. Not surprisingly, higher concentrations of most brominated species were measured in the treatment plant with the highest bromide concentrations. These results demonstrate the occurrence of novel halogenated byproducts of PPCPs that have limited toxicological data and significant uncertainty with regard to their risk to ecological systems. PMID:25611547

  4. In Vivo Caprine Model for Osteomyelitis and Evaluation of Biofilm-Resistant Intramedullary Nails

    PubMed Central

    Tran, Nhiem; Tran, Phong A.; Jarrell, John D.; Engiles, Julie B.; Thomas, Nathan P.; Young, Matthew D.; Hayda, Roman A.; Born, Christopher T.

    2013-01-01

    Bone infection remains a formidable challenge to the medical field. The goal of the current study is to evaluate antibacterial coatings in vitro and to develop a large animal model to assess coated bone implants. A novel coating consisting of titanium oxide and siloxane polymer doped with silver was created by metal-organic methods. The coating was tested in vitro using rapid screening techniques to determine compositions which inhibited Staphylococcus aureus growth, while not affecting osteoblast viability. The coating was then applied to intramedullary nails and evaluated in vivo in a caprine model. In this pilot study, a fracture was created in the tibia of the goat, and Staphylococcus aureus was inoculated directly into the bone canal. The fractures were fixed by either coated (treated) or non-coated intramedullary nails (control) for 5 weeks. Clinical observations as well as microbiology, mechanical, radiology, and histology testing were used to compare the animals. The treated goat was able to walk using all four limbs after 5 weeks, while the control was unwilling to bear weight on the fixed leg. These results suggest the antimicrobial potential of the hybrid coating and the feasibility of the goat model for antimicrobial coated intramedullary implant evaluation. PMID:23841085

  5. Oral terbinafine (Lamisil) in the treatment of fungal infections of the skin and nails.

    PubMed

    Roberts, D T

    1997-01-01

    The efficacy and safety of antifungal drugs depend upon their mode of action, the minimal inhibitory concentration (MIC) and its relationship to the minimal fungicidal concentration (MFC), the spectrum of activity and drug kinetics at the involved site. Terbinafine acts at the fungal cell wall. Its MIC against dermatophytes is the lowest of all currently available systemic antifungal agents. It is the only one with an MIC:MFC ratio of 1:1 so that terbinafine should be effective over very short treatment durations in dermatophyte infections of the scalp, palms and soles, and nail, providing that drug penetration is adequate, as it appears to be. Therapeutic levels persist for a considerable period after the cessation of treatment, also favouring short-duration therapy. Terbinafine is effective against all varieties of dermatophyte. Terbinafine given over 4 weeks or less is effective against Trichophyton of the scalp in children and adults. Its efficacy in zoophilic ectrothrix infection is anecdotal, but it is likely on theoretical grounds. Terbinafine is also effective against pityriasis versicolor and vaginal candidosis, but only topically. As of March 1996, around 3,000,000 patients have been treated worldwide with terbinafine, mostly for 12 weeks for toe-nail onychomycosis. Gastro-intestinal disturbance and minor skin rashes are seen in 5 and 2% of patients, respectively. PMID:9154400

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

    PubMed Central

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

    2007-01-01

    Background Simple or unicameral bone cysts are common benign fluid-filled lesions usually located at the long bones of children before skeletal maturity. Methods We performed demineralized bone matrix and iliac crest bone marrow injection combined with elastic intramedullary nailing for the treatment of simple bone cysts in long bones of 9 children with a mean age of 12.6 years (range, 4 to 15 years). Results Two of the 9 patients presented with a pathological fracture. Three patients had been referred after the failure of previous treatments. Four patients had large lesions with impending pathological fractures that interfered with daily living activities. We employed a ratio to ascertain the severity of the lesion. The extent of the lesion on the longitudinal axis was divided with the normal expected diameter of the long bone at the site of the lesion. The mean follow-up was 77 months (range, 5 to 8 years). All patients were pain free and had full range of motion of the adjacent joints at 6 weeks postoperatively. Review radiographs showed that all 7 cysts had consolidated completely (Neer stage I) and 2 cysts had consolidated partially (Neer stage II). Until the latest examination there was no evidence of fracture or re-fracture. Conclusion Elastic intramedullary nailing has the twofold benefits of continuous cyst decompression, and early immediate stability to the involved bone segment, which permits early mobilization and return to the normal activities of the pre-teen patients. PMID:17916249

  7. Propionibacterium acnes and Staphylococcus lugdunensis cause pyogenic osteomyelitis in an intramedullary nail model in rabbits.

    PubMed

    Gahukamble, Abhay Deodas; McDowell, Andrew; Post, Virginia; Salavarrieta Varela, Julian; Rochford, Edward Thomas James; Richards, Robert Geoff; Patrick, Sheila; Moriarty, Thomas Fintan

    2014-05-01

    Propionibacterium acnes and coagulase-negative staphylococci (CoNS) are opportunistic pathogens implicated in prosthetic joint and fracture fixation device-related infections. The purpose of this study was to determine whether P. acnes and the CoNS species Staphylococcus lugdunensis, isolated from an "aseptically failed" prosthetic hip joint and a united intramedullary nail-fixed tibial fracture, respectively, could cause osteomyelitis in an established implant-related osteomyelitis model in rabbits in the absence of wear debris from the implant material. The histological features of P. acnes infection in the in vivo rabbit model were consistent with localized pyogenic osteomyelitis, and a biofilm was present on all explanted intramedullary (IM) nails. The animals displayed no outward signs of infection, such as swelling, lameness, weight loss, or elevated white blood cell count. In contrast, infection with S. lugdunensis resulted in histological features consistent with both pyogenic osteomyelitis and septic arthritis, and all S. lugdunensis-infected animals displayed weight loss and an elevated white blood cell count despite biofilm detection in only two out of six rabbits. The differences in the histological and bacteriological profiles of the two species in this rabbit model of infection are reflective of their different clinical presentations: low-grade infection in the case of P. acnes and acute infection for S. lugdunensis. These results are especially important in light of the growing recognition of chronic P. acnes biofilm infections in prosthetic joint failure and nonunion of fracture fixations, which may be currently reported as "aseptic" failure. PMID:24599975

  8. Propionibacterium acnes and Staphylococcus lugdunensis Cause Pyogenic Osteomyelitis in an Intramedullary Nail Model in Rabbits

    PubMed Central

    Gahukamble, Abhay Deodas; McDowell, Andrew; Post, Virginia; Salavarrieta Varela, Julian; Rochford, Edward Thomas James; Richards, Robert Geoff; Patrick, Sheila

    2014-01-01

    Propionibacterium acnes and coagulase-negative staphylococci (CoNS) are opportunistic pathogens implicated in prosthetic joint and fracture fixation device-related infections. The purpose of this study was to determine whether P. acnes and the CoNS species Staphylococcus lugdunensis, isolated from an “aseptically failed” prosthetic hip joint and a united intramedullary nail-fixed tibial fracture, respectively, could cause osteomyelitis in an established implant-related osteomyelitis model in rabbits in the absence of wear debris from the implant material. The histological features of P. acnes infection in the in vivo rabbit model were consistent with localized pyogenic osteomyelitis, and a biofilm was present on all explanted intramedullary (IM) nails. The animals displayed no outward signs of infection, such as swelling, lameness, weight loss, or elevated white blood cell count. In contrast, infection with S. lugdunensis resulted in histological features consistent with both pyogenic osteomyelitis and septic arthritis, and all S. lugdunensis-infected animals displayed weight loss and an elevated white blood cell count despite biofilm detection in only two out of six rabbits. The differences in the histological and bacteriological profiles of the two species in this rabbit model of infection are reflective of their different clinical presentations: low-grade infection in the case of P. acnes and acute infection for S. lugdunensis. These results are especially important in light of the growing recognition of chronic P. acnes biofilm infections in prosthetic joint failure and nonunion of fracture fixations, which may be currently reported as “aseptic” failure. PMID:24599975

  9. Preconception Care and Prenatal Care

    MedlinePLUS

    ... NICHD Research Information Clinical Trials Resources and Publications Preconception Care and Prenatal Care: Condition Information Skip sharing on ... media links Share this: Page Content What is preconception care? Preconception care is the care a woman receives ...

  10. Biological removal of pharmaceuticals and personal care products during laboratory soil aquifer treatment simulation with different primary substrate concentrations.

    PubMed

    Onesios, Kathryn M; Bouwer, Edward J

    2012-05-01

    Pharmaceuticals and personal care products (PPCPs) have been detected in bodies of water worldwide, yet their effects on the environment are not fully understood. Recent toxicity studies suggest that mixtures of PPCPs at low concentrations may be detrimental to exposed organisms, highlighting the need to remove PPCPs from wastewater treatment plant effluent before it is discharged to the environment. In this study, the utility of biofilm-based PPCP removal as a means to prevent environmental PPCP contamination was investigated. The removal of 14 PPCPs, each at an initial concentration of 10 ?g/L, was studied in laboratory sand columns inoculated with wastewater treatment plant effluent. The examined PPCPs included biosol, biphenylol, p-chloro-m-cresol, p-chloro-m-xylenol, chlorophene, sodium diclofenac, gabapentin, gemfibrozil, 5-fluorouracil, ibuprofen, ketoprofen, naproxen, triclosan, and valproic acid. Ten of the PPCPs were removed by greater than 95% during column passage, while the four other compounds proved more recalcitrant. The effect of the concentration (either 50 or 1000 ?g/L) of an easily degradable primary substrate (acetate) supplied along with the mixture of PPCPs was examined. Most of the tested PPCPs were removed consistently by the biofilms regardless of the concentration of acetate, although the extent of removal for three compounds showed dependence on acetate concentration, and two behaved with no reproducible pattern over time. Biofilm protein measurements indicated that the mixture of PPCPs supplied to columns suppressed biofilm growth, suggesting toxicity of the PPCPs to the biofilm communities. This laboratory-scale experiment suggests that biofilm-based water treatment strategies, such as soil aquifer treatment and slow sand filtration, may be well-suited for the removal of many PPCPs from impacted water. PMID:22374299

  11. Biomarkers of human exposure to personal care products: results from the Flemish Environment and Health Study (FLEHS 2007-2011).

    PubMed

    Den Hond, Elly; Paulussen, Melissa; Geens, Tinne; Bruckers, Liesbeth; Baeyens, Willy; David, Frank; Dumont, Emmie; Loots, Ilse; Morrens, Bert; de Bellevaux, Benoit Nemery; Nelen, Vera; Schoeters, Greet; Van Larebeke, Nicolas; Covaci, Adrian

    2013-10-01

    Personal care products (PCPs), such as soaps, perfumes, cosmetics, lotions, etc., contain a variety of chemicals that have been described as potentially hormone disrupting chemicals. Therefore, it is important to assess the internal exposure of these chemicals in humans. Within the 2nd Flemish Environment and Health Study (FLEHS II, 2007-2011), the human exposure to three classes of pollutants that are present in a wide variety of PCPs--i.e. polycyclic musks (galaxolide, HHCB and tonalide, AHTN in blood), parabens (urinary para-hydroxybenzoic acid, HBA) and triclosan (urinary TCS)--was assessed in 210 Flemish adolescents (14-15 years) and in 204 adults (20-40 years) randomly selected from the general population according to a stratified two stage clustered study design. The aim of this study was to define average levels of exposure in the general Flemish population and to identify determinants of exposure. Average levels (GM (95% CI)) in the Flemish adolescents were 0.717 (0.682-0.753) ?g/L for blood HHCB; 0.118 (0.108-0.128) ?g/L for blood AHTN; 1022 (723-1436) ?g/L for urinary HBA and 2.19 (1.64-2.92) ?g/L for urinary TCS. In the adults, levels of HBA were on average 634 (471-970) ?g/L. Inter-individual variability was small for HHCB and AHTN, intermediate for HBA, and large for TCS. All biomarkers were positively associated with the use of PCPs. Additionally, levels of HHCB and AHTN increased with higher educational level of the adolescents. Both in adults and adolescents, urinary HBA levels were negatively correlated with BMI. We define here Flemish exposure values for biomarkers of PCPs, which can serve as baseline exposure levels to identify exposure trends in future biomonitoring campaigns. PMID:23792252

  12. Pharmaceuticals and Personal Care Products in Archived U.S. Biosolids from the 2001 EPA National Sewage Sludge Survey

    PubMed Central

    McClellan, Kristin; Halden, Rolf U.

    2010-01-01

    In response to the U.S. National Academies’ call for a better assessment of chemical pollutants contained in the approximately 6.9 million dry tons of digested municipal sludge produced annually in the United States, the mean concentration of 72 pharmaceuticals and personal care products (PPCP) were determined in 110 biosolids samples collected by the U.S. Environmental Protection Agency (EPA) in its 2001 National Sewage Sludge Survey. Composite samples of archived biosolids, collected at 94 U.S. wastewater treatment plants from 32 states and the District of Columbia, were analyzed by liquid chromatography tandem mass spectrometry using EPA Method 1694. Thirty-eight (54%) of the 72 analytes were detected in at least one composite sample at concentrations ranging from 0.002 to 48 mg kg?1 dry weight. Triclocarban and triclosan were the most abundant analytes with mean concentrations of 36 ± 8 and 12.6 ± 3.8 mg kg?1 (n = 5), respectively, accounting for 65% of the total PPCP mass found. The loading to U.S. soils from nationwide biosolids recycling was estimated at 210–250 metric tons per year for the sum of the 72 PPCPs investigated. The results of this nationwide reconnaissance of PPCPs in archived U.S. biosolids mirror in contaminant occurrences, frequencies and concentrations, those reported by the U.S. EPA for samples collected in 2006/07. This demonstrates that PPCP releases in U.S. biosolids have been ongoing for many years and the most abundant PPCPs appear to show limited fluctuations in mass over time when assessed on a nationwide basis. The here demonstrated use of five mega composite samples holds promise for conducting cost-effective, routine monitoring on a regional basis. PMID:20106500

  13. Effect of silica fouling on the removal of pharmaceuticals and personal care products by nanofiltration and reverse osmosis membranes.

    PubMed

    Lin, Yi-Li; Chiou, Jheng-Hong; Lee, Chung-Hsiang

    2014-07-30

    In this study, one reverse osmosis (XLE) and two nanofiltration (NF90 and NF270) membranes were fouled by silica to evaluate its effect on the flux decline as well as the removal of six pharmaceuticals and personal care products (PPCPs) including carbamazapine (CBZ), triclosan (TRI), ibuprofen (IBU), sulfadiazine (DIA), sulfamethoxazole (SMX) and sulfamethazine (SMZ) from pH 3 to 10. The membranes were characterized by physicochemical properties including hydrophobicity, surface morphology and PPCPs adsorption with or without the presence of silica fouling to validate the rejection mechanisms of PPCPs. The fouling mechanisms were investigated using the modified Hermia model. It was found that all membranes with silica fouling showed more severe permeate flux decline at low pHs (3 and 5) than at high pHs (8 and 10) by the decomposition of nonionized silica particles to form a dense gel layer on membrane surfaces, which was hard to be removed by backwash. Silica fouling rendered the membrane surface considerably more hydrophilic, and only IBU, TRI and SMZ were adsorbed on membranes. Silica fouling on tight membranes (NF90 and XLE) can promote rejection of most PPCPs because the dense fouling layer could supply membrane with synergistic steric hindrance to reduce the transportation of PPCPs across membrane surface, implying that size exclusion is the dominating mechanism. While for loose NF270, electrostatic repulsion dominates by enhanced rejection of PPCPs as pH increased. Although fouling layer could provide extra steric hindrance for NF270, its effect was overwhelmed by the accompanied cake-enhanced concentration polarization phenomenon (CEOP). CEOP impeded back diffusion of PPCPs into the feed solution, trapped and accumulated PPCPs on membrane surface so as to increase their diffusion across membrane. At all pH levels, intermediate blocking and gel layer formation was the major fouling mechanism for tight and loose membrane, respectively. PMID:24560524

  14. Development of a thermal desorption-gas chromatography-mass spectrometry method for determining personal care products in air.

    PubMed

    Ramírez, Noelia; Marcé, Rosa Maria; Borrull, Francesc

    2010-06-25

    This study describes the development of a new analytical method for determining 14 personal care products (PCPs) - nine synthetic musks, four parabens and one insect repellent - in air samples. The method is based on active sampling on sorbent tubes and thermal desorption-gas chromatography-mass spectrometry analysis, and is rapid, sensitive and drastically reduces the risk of sample contamination. Three kinds of tubes and traps were tested, those filled with Tenax TA being the most suitable for this study. Method validation showed good repeatability and reproducibility, low detection limits (between 0.03 ng m(-3) for DPMI and 12.5 ng m(-3) for propyl paraben) and good linearity for all compounds. Stability during storage indicated that samples must be kept refrigerated at 4 degrees C and analysed within 1 week of collection. The applicability of the technique to real samples was tested in different indoor and outdoor atmospheres. The total PCP values for indoor air ranged from 135 ng m(-3) in a pharmacy to 2838 ng m(-3) in a hairdresser's, whereas the values for outdoor air ranged from 14 ng m(-3) for a suburban environment to 26 ng m(-3) for an urban environment. In general, the most abundant synthetic musks were galaxolide (5.9-1256 ng m(-3)), musk xylene (1.6-766 ng m(-3)) and tonalide (1.1-138 ng m(-3)). Methyl and ethyl paraben (2.4-313 ng m(-3) and 1.8-117 ng m(-3), respectively) were the most abundant parabens. Although thermal desorption methods have been widely used for determining volatile organic compounds, they are rarely used with semi-volatile compounds. This study thus demonstrates that the thermal desorption method performs well with semi-volatile compounds and, for the first time, that it can be used for determining PCPs. PMID:20483421

  15. Removal of Pharmaceuticals and Personal Care Products during Water Recycling: Microbial Community Structure and Effects of Substrate Concentration

    PubMed Central

    Onesios-Barry, Kathryn M.; Berry, David; Proescher, Jody B.; Sivakumar, I. K. Ashok

    2014-01-01

    Many pharmaceuticals and personal care products (PPCPs) have been shown to be biotransformed in water treatment systems. However, little research exists on the effect of initial PPCP concentration on PPCP biotransformation or on the microbial communities treating impacted water. In this study, biological PPCP removal at various concentrations was assessed using laboratory columns inoculated with wastewater treatment plant effluent. Pyrosequencing was used to examine microbial communities in the columns and in soil from a soil aquifer treatment (SAT; a method of water treatment prior to reuse) site. Laboratory columns were supplied with different concentrations (0.25, 10, 100, or 1,000 ?g liter?1) of each of 15 PPCPs. Five PPCPs (4-isopropyl-3-methylphenol [biosol], p-chloro-m-xylenol, gemfibrozil, ketoprofen, and phenytoin) were not removed at any tested concentrations. Two PPCPs (naproxen and triclosan) exhibited removals independent of PPCP concentration. PPCP removal efficiencies were dependent on initial concentrations for biphenylol, p-chloro-m-cresol, chlorophene, diclofenac, 5-fluorouracil, ibuprofen, and valproic acid, showing that PPCP concentration can affect biotransformation. Biofilms from sand samples collected from the 0.25- and 10-?g liter?1 PPCP columns were pyrosequenced along with SAT soil samples collected on three consecutive days of a wetting and drying cycle to enable comparison of these two communities exposed to PPCPs. SAT communities were similar to column communities in taxonomy and phylotype composition, and both were found to contain close relatives of known PPCP degraders. The efficiency of biological removal of PPCPs was found to be dependent on the concentration at which the contamination occurs for some, but not all, PPCPs. PMID:24509919

  16. Rapid analysis of pharmaceuticals and personal care products in fish plasma micro-aliquots using liquid chromatography tandem mass spectrometry.

    PubMed

    Chen, Fangfang; Gong, Zhiyuan; Kelly, Barry C

    2015-02-27

    A sensitive analytical method based on liquid-liquid extraction (LLE) and liquid chromatography tandem mass spectrometry (LC-MS/MS) was developed for rapid analysis of 11 pharmaceuticals and personal care products (PPCPs) in fish plasma micro-aliquots (?20?L). Target PPCPs included, bisphenol A, carbamazepine, diclofenac, fluoxetine, gemfibrozil, ibuprofen, naproxen, risperidone, sertraline, simvastatin and triclosan. A relatively quicker and cheaper LLE procedure exhibited comparable analyte recoveries with solid-phase extraction. Rapid separation and analysis of target compounds in fish plasma extracts was achieved by employing a high efficiency C-18 HPLC column (Agilent Poroshell 120 SB-C18, 2.1mm×50mm, 2.7?m) and fast polarity switching, enabling effective monitoring of positive and negative ions in a single 9min run. With the exception of bisphenol A, which exhibited relatively high background contamination, method detection limits of individual PPCPs ranged between 0.15 and 0.69pg/?L, while method quantification limits were between 0.05 and 2.3pg/?L. Mean matrix effect (ME) values ranged between 65 and 156% for the various target analytes. Isotope dilution quantification using isotopically labelled internal surrogates was utilized to correct for signal suppression or enhancement and analyte losses during sample preparation. The method was evaluated by analysis of 20?L plasma micro-aliquots collected from zebrafish (Danio rerio) from a laboratory bioaccumulation study, which included control group fish (no exposure), as well as fish exposed to environmentally relevant concentrations of PPCPs. Using the developed LC-MS/MS based method, concentrations of the studied PPCPs were consistently detected in the low pg/?L (ppb) range. The method may be useful for investigations requiring fast, reliable concentration measurements of PPCPs in fish plasma. In particular, the method may be applicable for in situ contaminant biomonitoring, as well as bioaccumulation and toxicology studies employing small fishes with low blood compartment volumes. PMID:25640994

  17. Monitoring of emerging contaminants (pharmaceuticals, Personal Care Products, surfactants and heavy metals) in a quaternary detritic aquifer

    NASA Astrophysics Data System (ADS)

    Candela, L.; Valdes-Abellan, J.; Jiménez-Martínez, J.

    2012-04-01

    The presence of 209 emerging compounds, surfactants, priority substances according to the 2008/105/EC Directive, 10 heavy metals and microbiological organisms in blended water and aquifer samples was investigated in a quaternary aquifer. The effects of these compounds over the environment are not clear in many cases, but many of them have been classified as endocrine disruptor compounds, EDC. Their presence in the media is controlled in one hand by their transformation and/or removal rates and, on the other hand, by their continuous release into the media, due to the broad use of these in many human activities (pharmaceuticals, personal care products, pesticides, heavy metals, LAS and others). The attention of this work focusses on the presence and fate of these substances in the vadose zone and the aquifer. The aquifer catchment (81km2) located in SE Spain presents a high natural salinity (with EC values of ~7,500 ?S cm-1, and high concentrations of chloride, sulphate and sodium), making it unsuitable to be used as drinking water or irrigation. Two sampling campaigns (February and June 2011) in wells and springs have been carried out top characterize physic-chemical, microbiological and emerging contaminants presence in the aquifer. A total of 209 emerging pollutants grouped into the following classes were analysed: 125 pharmaceutical compounds (Phs), 20 polyaromatic hydrocarbons (PAHs) and Dioxins, 46 pesticides, 3 volatile priority pollutants as well as the most commonly used anionic surfactants were identified for further analysis. Heavy metals included: Cu, Cd, Pb, Hg, Ni, Zn, Sn, Pt, Pd and Tl. Results showed that 39 out of all compounds were detected: 11 pharmaceuticals, 9 PAHs, 19 pesticides, 4 surfactants and 4 heavy metals. Two of the compounds, endosulfan-? and Ni, were detected in concentrations above the allowed regulation. Although results are limited to 2 sampling campaigns, it is important to note that surfactants (LAS), pesticides PAHs and Dioxins were detected in most of the water samples, this indicates the presence of wastewater effluents of urban origin and agricultural impacts. The ubiquitous presence of LAS is related to the low-sorption capacity and its wide variety of applications, ranging from cleaning products to pesticide formulation (among others).

  18. 78 FR 68472 - Steel Nails From China; Scheduling of an Expedited Five-Year Review Concerning the Antidumping...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-14

    ... Commission determined that the domestic interested party group response to its notice of institution (78 FR... took effect on November 7, 2011. See 76 FR 61937 (October 6, 2011) and the newly revised Commission's... Steel Nails From China; Scheduling of an Expedited Five-Year Review Concerning the Antidumping...

  19. 76 FR 30101 - Certain Steel Nails From the People's Republic of China: Final Results of Antidumping Duty...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-24

    ... Antidumping Duty Order: Certain Steel Nails From the People's Republic of China, 73 FR 44961 (August 1, 2008... Results of Antidumping Duty Changed Circumstances Review, 76 FR 22369 (April 21, 2011) (``Initiation and... FR 24122 (May 3, 2004) and Notice of Final Results of Changed Circumstances Review and Revocation...

  20. 76 FR 22369 - Certain Steel Nails From the People's Republic of China: Initiation and Preliminary Results of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-21

    ...: Certain Steel Nails From the People's Republic of China, 73 FR 44961 (August 1, 2008) (``Order''). On...: Coumarin from the People's Republic of China, 69 FR 24122 (May 3, 2004) (``Coumarin from the PRC''). \\5... Order: Bulk Aspirin from the People's Republic of China, 69 FR 77726 (December 28, 2004) (``Aspirin...

  1. 75 FR 34425 - Certain Steel Nails from the People's Republic of China: Final Results of the First New Shipper...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-17

    ...Limit for the Final Results of the First New Shipper Review, 75 FR 14423...coils using materials such as plastic, paper, or wire. Certain steel nails subject...Analysis of the Final Results of the First New Shipper Review of Certain...

  2. 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, 2014

    2011-04-26

    ...published the final results of the first administrative review of the...China: Final Results of the First Antidumping Duty Administrative...materials such as plastic, paper, or wire. Certain steel nails...calculations for the Final Results. First, we agree with Stanley...

  3. 77 FR 27421 - Certain Steel Nails From the United Arab Emirates: Amended Final Determination of Sales at Less...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-10

    ... of Sales at Less Than Fair Value, 77 FR 17029 (March 23, 2012) (Final Determination). On May 2, 2012... of Final Determination, 76 FR 68129 (November 3, 2011) (Preliminary Determination). Continuation of... International Trade Administration Certain Steel Nails From the United Arab Emirates: Amended...

  4. 75 FR 34425 - Certain Steel Nails from the People's Republic of China: Final Results of the First New Shipper...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-17

    ...''). See Notice of Antidumping Duty Order: Certain Steel Nails From the People's Republic of China, 73 FR... from the People's Republic of China: Notice of Preliminary Results of the New Shipper Review, 75 FR... Final Results of the First New Shipper Review, 75 FR 14423 (March 25, 2010). On January 13, 2010,...

  5. Thermogelling hydrogels of cyclodextrin/poloxamer polypseudorotaxanes as aqueous-based nail lacquers: application to the delivery of triamcinolone acetonide and ciclopirox olamine.

    PubMed

    Nogueiras-Nieto, Luis; Begoña Delgado-Charro, M; Otero-Espinar, Francisco J

    2013-04-01

    This work investigated the use of in situ gelling hydrogels based on polypseudorotaxanes of Pluronic F-127 and partially methylated ?-cyclodextrin as aqueous nail lacquers. N-acetylcysteine and urea were incorporated as penetration enhancers. The formulations were tested for their ability to deliver ciclopirox and triamcinolone across human nail plate and bovine hoof. Simple aqueous solutions of the drugs with N-acetylcysteine provided measurable fluxes across hoof membranes but became quickly depleted of drug. Further, these solutions would have a short residence time upon nail application. Addition of Pluronic F-127 facilitated drug solubilization and provided the formulations with in situ gelling properties but drug entrapment into the micelles slowed down the delivery process. This was solved by addition of methylated ?-cyclodextrin; the formulations retained the thermogelling properties, drug solubilization was further increased, and drug delivery was accelerated. The polymer chains compete with the drugs for the cyclodextrin cavity forming polypseudorotaxanes, which facilitated drug release. The permeability of both drugs was higher across bovine hoof than human nail. The new polypseudorotaxanes formulation delivered more ciclopirox across human nail than a marketed organic lacquer which supports the growing hypothesis that aqueous-based nail lacquers represent a superior formulation strategy in nail topical delivery. PMID:23201053

  6. Analysis of polybrominated diphenyl ethers and emerging halogenated and organophosphate flame retardants in human hair and nails.

    PubMed

    Liu, Liang-Ying; Salamova, Amina; He, Ka; Hites, Ronald A

    2015-08-01

    A method for the digestion, extraction, fractionation, and analysis of three classes of flame retardants, including 36 polybrominated diphenyl ethers (PBDEs), 9 halogenated alternative flame retardants (AFRs), and 12 organophosphate esters (OPEs) in human hair and nail samples was developed. The method employed HNO3/H2O2 digestion, liquid-liquid extraction with (4:1 vol) hexane:dichloromethane, fractionation on a 6g column of 2.5% water deactivated Florisil, and analysis by gas chromatographic mass spectrometry. The accuracy and precision of the method was validated using spiked samples of 6 replicates for both hair and nail samples. The method validation results showed good accuracy and precision for all PBDEs except BDE-209, all AFRs except hexabromobenzene (HBB), and all of the 12 OPEs, with average recovery efficiencies>90% and relative standard deviations (RSDs)<10%. The average recovery efficiencies for HBB were between 60% and 86%, with RSDs<10%. BDE-209 had recovery efficiencies of 64% (RSD, 13%) for hair and 71% (RSD, 10%) for nail. This method was applied to analyze 5 human hair and 5 fingernail samples from the general student population at Indiana University Bloomington campus. BDE-47 and BDE-99 were the predominant PBDEs detected in both hair and nail samples, with a concentration range of 11-620 and 4.6-780ng/g (dry weight) in hair and 7.3-43 and 2.1-11ng/g in nails, respectively. Di-(2-ethylhexyl)-tetrabromophthalate (TBPH) and 2-ethylhexyl-2,3,4,5-tetrabromobenzoate (TBB) were detected in all the samples, with concentrations of 20-240 and 11-350ng/g in hair and <17-80 and <9.2-71ng/g in nails, respectively. Among the 12 OPEs analyzed, tris(2-chloroethyl)phosphate (TCEP), tris(1-chloro-2-propyl)phosphate (TCIPP), tris(1,3-dichloro-2-propyl) phosphate (TDCIPP), and triphenyl phosphate (TPHP) were most often detected. The concentrations of these OPEs (summed together) were 1100-3900 and 380-18,000ng/g in hair and nails, respectively. These levels exceed those of both the PBDEs and the AFRs. PMID:26122855

  7. Nail Hygiene

    MedlinePLUS

    ... Water Fluoridation Leadership Policy & Recommendations Fast Facts Healthy Water Sites Healthy Water Home Drinking Water Healthy Swimming / ... Handwashing: A Corporate Activity [PDF - 1 page] Healthy Water Sites Healthy Water Home Drinking Water Healthy Swimming / ...

  8. Indwelling catheter care

    MedlinePLUS

    ... clean washcloths 2 clean hand towels Mild soap Warm water A clean container or sink Follow these skin ... your nails. Wet one of the washcloths with warm water and soap it up. Gently wash all around ...

  9. Respite Care

    MedlinePLUS

    ... traditional home-based care, as well as adult day care, skilled nursing, home health, and short term institutional ... take any one of the following forms: Adult Day Care: These programs are designed to provide care and ...

  10. Hospice Care

    MedlinePLUS

    ... Page Resize Text Printer Friendly Online Chat Hospice Care What is Hospice Care? When is Hospice Care ... Family Counseling and Support Services What is Hospice Care? Hospice programs are available to help terminally ill ...

  11. Preconception Care

    MedlinePLUS

    ... should speak with your healthcare provider about preconception care. Preconception care is care you receive before you get pregnant. It involves finding and taking care of any problems that might affect you and ...

  12. The effects of corrosive substances on human bone, teeth, hair, nails, and soft tissue.

    PubMed

    Hartnett, Kristen M; Fulginiti, Laura C; Di Modica, Frank

    2011-07-01

    This research investigates the effects of household chemicals on human tissues. Five different human tissues (bone, tooth, hair, fingernails, and skin/muscle/fat) were immersed into six different corrosive agents. These agents consisted of hydrochloric acid, sulfuric acid, lye, bleach, organic septic cleaner, and Coca-Cola(®) soda. Tap water was used as a control. Tissue samples were cut to consistent sizes and submerged in the corrosive liquids. Over time, the appearance, consistency, and weight were documented. Hydrochloric acid was the most destructive agent in this study, consuming most tissues within 24 h. Sulfuric acid was the second most destructive agent in this study. Bleach, lye, and cola had no structural effects on the hard tissues of the body, but did alter the appearance or integrity of the hair, nails, or flesh in some way. The organic septic cleaner and tap water had no effect on any of the human tissue tested during the timeframe of the study. PMID:21447075

  13. Stabilisation of a loosened femoral gamma nail by percutaneous cement injection (cementoplasty): a new technique.

    PubMed

    Gallo, Giacomo; Caudal, Amandine; Bronsard, Nicolas; Hauger, Olivier; Amoretti, Nicolas

    2015-10-01

    Surgical repair of pertrochanteric and subtrochanteric fractures in the elderly is usually achieved using an endomedullary nail. Unfortunately, even today, some of the patients who undergo this intervention develop periprosthetic bone absorption over time that can lead to loosening of the prosthesis, resulting in pain, joint instability and the need for revision surgery. Surgical revision is hindered by potential complications related to patients' existing underlying medical conditions. It is often the case that these patients are weak and present comorbidities, which can lead to an absolute contraindication to surgery. An interesting alternative could be the stabilisation by percutaneous injection of cement (cementoplasty) in the periprosthetic space under CT and fluoroscopic guidance. In patients with absolute contraindication we performed percutaneous cementoplasty as treatment for femoral prosthesis loosening. Our procedure was technically a success following the end of the intervention period (follow-up: 6 months). The patient no longer experienced significant pain and showed stability of the prosthesis, as demonstrated by CT. PMID:26138339

  14. The history and evolution of surgical instruments. VI. The surgical blade: from finger nail to ultrasound.

    PubMed Central

    Kirkup, J.

    1995-01-01

    Elective surgery requires planned incisions and incisions require appropriate blades. In the prehistoric era, division of the umbilical cord and other minor procedures were probably undertaken with human teeth and nails, and later with plant, animal and mineral substitutes, as witnessed by studies of primitive societies still surviving or recently extinct. More efficient metallic blades appeared in historic times and ultimately generated five specific shapes which are analysed in detail. Today, as minimally invasive techniques, endoscopes, laser and ultrasound sources evolve, many hallowed incisions of surgical access diminish in length or disappear entirely. In historical terms, elective surgery of the twentieth century will be recalled as an interlude characterised by maximally invasive incisions. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 PMID:7486768

  15. Successful Removal of a Screw Nail in the Jejunum Using Double-Balloon Enteroscopy

    PubMed Central

    Kim, Dong Ju; Sim, Myoung Ki; Lee, Sang Wook

    2015-01-01

    The vast majority of foreign bodies (FBs) that enter the stomach pass through the gastrointestinal tract spontaneously. When the FB enters the small bowel-beyond the reach of conventional endoscopy-daily radiographs are needed to ensure its safe passage. However, endoscopic intervention is an appropriate management strategy for a sharp-pointed FB, because sharp FBs have a higher risk of intestinal perforation. We describe here a case in which a 1.5-cm, sharp-pointed screw nail in the proximal jejunum was removed successfully by double-balloon enteroscopy from a 19-year-old-male with autism. This case adds to the growing body of evidence demonstrating the value of therapeutic double-balloon enteroscopy in the field of FB ingestion PMID:26473131

  16. Low-threshold photonic-band-edge laser using iron-nail-shaped rod array

    SciTech Connect

    Choi, Jae-Hyuck; No, You-Shin; Hwang, Min-Soo; Jeong, Kwang-Yong; Park, Hong-Gyu E-mail: hgpark@korea.ac.kr; Kwon, Soon-Yong; Yang, Jin-Kyu E-mail: hgpark@korea.ac.kr; Kwon, Soon-Hong

    2014-03-03

    We report the experimental demonstration of an optically pumped rod-type photonic-crystal band-edge laser. The structure consists of a 20?×?20 square lattice array of InGaAsP iron-nail-shaped rods. A single-mode lasing action is observed with a low threshold of ?90??W and a peak wavelength of 1451.5?nm at room temperature. Measurements of the polarization-resolved mode images and lasing wavelengths agree well with numerical simulations, which confirm that the observed lasing mode originates from the first ?-point transverse-electric-like band-edge mode. We believe that this low-threshold band-edge laser will be useful for the practical implementation of nanolasers.

  17. A rabbit humerus model of plating and nailing osteosynthesis with and without Staphylococcus aureus osteomyelitis.

    PubMed

    Arens, D; Wilke, M; Calabro, L; Hackl, S; Zeiter, S; Zderic, I; Richards, R G; Moriarty, T F

    2015-01-01

    The local mechanical environment at a fracture is known to influence biological factors such as callus formation, immune cell recruitment and susceptibility to infection. Infection models incorporating a fracture are therefore required to evaluate prevention and treatment of infection after osteosynthesis. The aim of this study was to create humane, standardised and repeatable preclinical models of implant-related bone infection after osteosynthesis in the rabbit humerus. Custom-designed interlocked intramedullary nails and commercially available locking plates were subjected to biomechanical evaluation in cadaveric rabbit humeri; a 10-week in vivo healing study; a dose response study with Staphylococcus aureus over 4 weeks; and finally, a long-term infection of 10 weeks in the plate model.Outcome measures included biomechanical testing, radiography, histology, haematology and quantitative bacteriology. Both implants offered similar biomechanical stability in cadaveric bones, and when applied in the in vivo study, resulted in complete radiographic and histological healing and osteotomy closure within 10-weeks. As expected in the infection study, higher bacterial doses led to an increasing infection rate. In both infected groups, there was a complete lack of osteotomy closure at 4 weeks. C-reactive protein (CRP), lymphocyte: granulocyte ratio and weight loss were increased in infected animals receiving IM nails in comparison with non-inoculated equivalents, although this was less evident in the plate group. In the 10-week infection group, healing does not occur in the plated rabbits. We have successfully developed a rabbit model that is suitable for further studies, particularly those looking into preventative strategies for post-traumatic implant-related osteomyelitis. PMID:26388617

  18. Possible effects of metallosis on spermatozoal apoptotic genes expression in individuals with intramedullary nailing prosthesis.

    PubMed

    Elsamanoudy, Ayman Z; Shaalan, Dalia; Gaballah, Mohammad A; El-Atta, Hend M Abo; Helaly, Ahmed M N

    2014-06-01

    Seminal quality could be affected by metallosis caused by intramedullary nailing (IMN). Our objectives were to estimate metal ion levels in the seminal plasma of subjects with IMN, to determine their effects on semen parameters and on spermatozoal apoptotic gene expression, and to determine whether these expressed genes could be used as candidate biomarkers of seminal deterioration in individuals with IMN or not. Semen samples were collected from 60 subjects with IMN and 30 age-matched healthy controls. Seminal plasma contents of cobalt (Co), chromium (Cr), and molybdenum (Mo) were assayed. Spermatozoal Bcl-2 and Bax gene expressions were determined. Studied semen parameters were significantly lower in subjects with IMN for ?5 years in relation to controls while the concentrations of Co, Cr, and Mo in the seminal plasma samples were significantly higher. There were significantly lower spermatozoal Bcl-2 expression, higher Bax expression, and lower Bcl-2/Bax ratio in subjects with IMN for ?5 years than in controls. In subjects with IMN for ?5 years, receiver operating characteristic (ROC) curve analysis of studied gene expressions and Bcl-2/Bax ratio were done showing priority of the ratio with 86.7 % sensitivity, 100 % specificity, 100 % positive predictive value, and 93.8 % negative predictive value at cutoff values ?0.777. Co, Cr, and Mo metals are found at high concentrations in the seminal plasma of individuals with IMN leading to increased spermatozoal apoptotic activity. Spermatozoal Bcl-2/Bax ratio could be used as a candidate biomarker of reproductive disorders in individuals with intramedullary nailing. PMID:24723216

  19. IEEE TRANSACTIONS ON ROBOTICS AND AUTOMATION, VOL. 13, NO. 2, APRIL 1997 301 Fig. 8. Experimental results of driving nails. (a) The proposed hitting using

    E-print Network

    Saha, Subir Kumar

    . Experimental results of driving nails. (a) The proposed hitting using t = t1d and = tan01 k: (b) A conventional hitting with t = t1 and = 0: be driven slantwise by the friction force on the face of the nail, and the hammer is swung by s1d of (33) so that the hitting time can be t1d: When the hammer hits the head

  20. Consumer product exposures associated with urinary phthalate levels in pregnant women

    PubMed Central

    Buckley, Jessie P.; Palmieri, Rachel T.; Matuszewski, Jeanine M.; Herring, Amy H.; Baird, Donna D.; Hartmann, Katherine E.; Hoppin, Jane A.

    2012-01-01

    Human phthalate exposure is ubiquitous, but little is known regarding predictors of urinary phthalate levels. To explore this, 50 pregnant women aged 18–38 years completed two questionnaires on potential phthalate exposures and provided a first morning void. Urine samples were analyzed for 12 phthalate metabolites. Associations with questionnaire items were evaluated via Wilcoxon tests and t-tests, and r-squared values were calculated in multiple linear regression models. Few measured factors were statistically significantly associated with phthalate levels. Individuals who used nail polish had higher levels of mono-butyl phthalate (p=0.048) than non-users. Mono-benzyl phthalate levels were higher among women who used eye makeup (p=0.034) or used makeup on a regular basis (p=0.004). Women who used cologne or perfume had higher levels of di-(2-ethylhexyl) phthalate metabolites. Household products, home flooring or paneling, and other personal care products were also associated with urinary phthalates. The proportion of variance in metabolite concentrations explained by questionnaire items ranged between 0.31 for mono-ethyl phthalate and 0.42 for mono-n-methyl phthalate. Although personal care product use may be an important predictor of urinary phthalate levels, most of the variability in phthalate exposure was not captured by our relatively comprehensive set of questionnaire items. PMID:22760436

  1. Uptake of human pharmaceuticals and personal care products by cabbage (Brassica campestris) from fortified and biosolids-amended soils.

    PubMed

    Holling, Cheryl S; Bailey, Jonathon L; Vanden Heuvel, Brian; Kinney, Chad A

    2012-11-01

    Human pharmaceuticals and personal care products (PPCPs) are routinely found in biosolids from wastewater treatment plants (WWTPs). Once land applied, the PPCPs in biosolids are potentially available for plant uptake and bioaccumulation. This study used a greenhouse model to investigate uptake of PPCPs commonly detected in biosolids by the agricultural plant Chinese cabbage (Brassica campestris). Two series of greenhouse experiments were conducted as part of this project. In the first set of experiments, four pharmaceuticals were added to an organic matter-rich soil in environmentally relevant concentrations based on typical biosolids application rates, resulting in final soil concentrations of 2.6 ng g(-1) carbamazepine, 3.1 ng g(-1) sulfamethoxazole, 5.4 ng g(-1) salbutamol, and 0.5 ng g(-1) trimethoprim. In the second set of experiments, the cabbage was grown in soil amended with an agronomic rate of biosolids from a local WWTP. The ambient concentration of PPCPs in the biosolids resulted in final soil concentrations of 93.1 ng g(-1) carbamazepine, 67.4 ng g(-1) sulfamethoxazole, 30.3 ng g(-1) salbutamol, 433.7 ng g(-1) triclosan, and 24.7 ng g(-1) trimethoprim. After growing to maturity, the aerials of the plants were separated from roots and the two tissue types were analyzed separately. All four human pharmaceuticals were detected in both tissues in the cabbage grown in the soil fortified with the four pharmaceuticals with median concentrations of 255.4 ng g(-1) aerials and 272.9 ng g(-1) roots carbamazepine; 222.8 ng g(-1) aerials and 260.3 ng g(-1) roots sulfamethoxazole; 108.3 ng g(-1) aerials and 140.6 ng g(-1) roots salbutamol; and 20.6 ng g(-1) aerials and 53.7 ng g(-1) roots trimethoprim. Although all study compounds were present in the biosolids-amended planting soil, only carbamazepine (317.6 ng g(-1) aerials and 416.2 ng g(-1) roots), salbutamol (21.2 ng g(-1) aerials and 187.6 ng g(-1) roots), and triclosan (22.9 ng g(-1) aerials and 1220.1 ng g(-1) roots) were detected in the aerials of the cabbage. In addition to the study compounds detected in the aerials, sulfamethoxazole was detected in the roots of one of the plants in the biosolid-amended soil. In comparison to many previous studies that have utilized PPCP concentration that exceed environmentally relevant concentrations, plants in this study were exposed to environmentally relevant concentrations of the PPCPs, yet resulted in uptake concentrations similar to or greater than those reported in comparable studies. We suggest that rhizosphere conditions, particularly the presence of dissolved organic matter in the planting matrix, might be one of the critical factors determining mobilization and bioavailability of xenobiotic compounds such as PPCPs. PMID:23051741

  2. Three-dimensional finite element analysis and comparison of a new intramedullary fixation with interlocking intramedullary nail.

    PubMed

    Liu, Chang-cheng; Xing, Wen-zhao; Zhang, Ya-xing; Pan, Zheng-hua; Feng, Wen-ling

    2015-03-01

    This study was set to introduce a new intramedullary fixation, explore its biomechanical properties, and provide guidance for further biomechanical experiments. With the help of CT scans and finite element modeling software, finite element model was established for a new intramedullary fixation and intramedullary nailing of femoral shaft fractures in a volunteer adult. By finite element analysis software ANSYS 10.0, we conducted 235-2,100 N axial load, 200-1,000 N bending loads and 2-15 Nm torsional loading, respectively, and analyzed maximum stress distribution, size, and displacement of the fracture fragments of the femur and intramedullary nail. During the loading process, the maximum stress of our new intramedullary fixation were within the normal range, and the displacement of the fracture fragments was less than 1 mm. Our new intramedullary fixation exhibited mechanical reliability and unique advantages of anti-rotation, which provides effective supports during fracture recovery. PMID:25280782

  3. Nail-Patella Syndrome: clinical and molecular data in 55 families raising the hypothesis of a genetic heterogeneity.

    PubMed

    Ghoumid, Jamal; Petit, Florence; Holder-Espinasse, Muriel; Jourdain, Anne-Sophie; Guerra, José; Dieux-Coeslier, Anne; Figeac, Martin; Porchet, Nicole; Manouvrier-Hanu, Sylvie; Escande, Fabienne

    2016-01-01

    Nail-Patella Syndrome (NPS) is a rare autosomal dominant condition comprising nail and skeletal anomalies. Skeletal features include dysplastic patellae and iliac horns, as well as scapula and elbow dysplasia. Nephropathy and glaucoma or intra-ocular hypertension can sometimes be present. NPS is due to variants affecting function in LMX1B, which encodes a LIM-homeodomain protein critical for limb, kidney and eye development. We describe the phenotype and the molecular data of 55 index patients and their 39 relatives presenting with typical NPS. We identified 38 different LMX1B anomalies, 19 of which were not reported before. In our series, 9% of families are not carriers of a LMX1B genomic alteration after extensive study of the coding and non-coding regions of the gene. One of the families showed no linkage to the LMX1B locus, raising the hypothesis of a genetic heterogeneity. PMID:25898926

  4. Beyond Care?

    ERIC Educational Resources Information Center

    Hedge, Nicki; Mackenzie, Alison

    2012-01-01

    Care is a feature of all of our lives, all of the time. An analysis of Scotland's Curriculum for Excellence reveals that care and caring permeate complex dimensions of life in and after school and we ask here, if, on some accounts, care can do the work required of it. Acknowledging the significance of her contribution to care, we focus on the work…

  5. Systematic review of economic evaluations of human cell-derived wound care products for the treatment of venous leg and diabetic foot ulcers

    PubMed Central

    Langer, Astrid; Rogowski, Wolf

    2009-01-01

    Background Tissue engineering is an emerging field. Novel bioengineered skin substitutes and genetically derived growth factors offer innovative approaches to reduce the burden of diabetic foot and venous leg ulcers for both patients and health care systems. However, they frequently are very costly. Based on a systematic review of the literature, this study assesses the cost-effectiveness of these growth factors and tissue-engineered artificial skin for treating chronic wounds. Methods On the basis of an extensive explorative search, an appropriate algorithm for a systematic database search was developed. The following databases were searched: BIOSIS Previews, CRD databases, Cochrane Library, EconLit, Embase, Medline, and Web of Science. Only completed and published trial- or model-based studies which contained a full economic evaluation of growth factors and bioengineered skin substitutes for the treatment of chronic wounds were included. Two reviewers independently undertook the assessment of study quality. The relevant studies were assessed by a modified version of the Consensus on Health Economic Criteria (CHEC) list and a published checklist for evaluating model-based economic evaluations. Results Eleven health economic evaluations were included. Three biotechnology products were identified for which topical growth factors or bioengineered skin substitutes for the treatment of chronic leg ulceration were economically assessed: (1) Apligraf®, a bilayered living human skin equivalent indicated for the treatment of diabetic foot and venous leg ulcers (five studies); (2) Dermagraft®, a human fibroblast-derived dermal substitute, which is indicated only for use in the treatment of full-thickness diabetic foot ulcers (one study); (3) REGRANEX® Gel, a human platelet-derived growth factor for the treatment of deep neuropathic diabetic foot ulcers (five studies). The studies considered in this review were of varying and partly low methodological quality. They calculated that due to shorter treatment periods, fewer complications and fewer inpatient episodes the initial cost of the novel biotechnology products may be offset, making the treatment cost-effective or even cost-saving. The results of most studies were sensitive to initial costs of the products and the evidence of effectiveness. Conclusion The study results suggest that some growth factors and tissue-engineered artificial skin products feature favourable cost-effectiveness ratios in selected patient groups with chronic wounds. Despite the limitations of the studies considered, it is evident that health care providers and coverage decision makers should take not only the high cost of the biotechnology product but the total cost of care into account when deciding about the appropriate allocation of their financial resources. However, not only the cost-effectiveness but first of all the effectiveness of these novel biotechnology products deserve further research. PMID:19591680

  6. Preliminary results from osteosynthesis using Ender nails by means of a percutaneous technique, in humeral diaphysis fractures in adults?

    PubMed Central

    Godinho, Glaydson Gomes; França, Flávio de Oliveira; Freitas, José Márcio Alves; Santos, Flávio Márcio Lago; Correa, Guilherme de Almeida Sellos; Maia, Lucas Russo

    2015-01-01

    Objective To demonstrate the clinical and functional results from treatment of humeral diaphysis fractures using Ender nails. Methods Eighteen patients who underwent osteosynthesis of humeral diaphysis fractures using Ender nails were evaluated. In addition to the clinical and radiographic evaluations, patients with a minimum of one year of follow-up were assessed by means of the Constant, American Shoulder and Elbow Surgeons (ASES), Mayo Clinic and Simple Shoulder Value (SSV) functional scores, and in relation to the degree of satisfaction with the final result. The fixation technique used was by means of an anterograde percutaneous route. Results All the patients achieved fracture consolidation, after a mean of 2.9 months (ranging from 2 to 4 months). The mean Constant score was 85.7 (ranging from 54 to 100) and the mean ASES score was 95.9 (ranging from 76 to 100). All the patients achieved the maximum score on the Mayo Clinic scale. Conclusion Fixation of humeral diaphysis fractures using Ender nails by means of a percutaneous technique was shown to be a method with promising preliminary results. PMID:26417566

  7. Hydration and N-acetyl-l-cysteine alter the microstructure of human nail and bovine hoof: implications for drug delivery.

    PubMed

    Nogueiras-Nieto, L; Gómez-Amoza, J L; Delgado-Charro, M B; Otero-Espinar, F J

    2011-12-20

    This work aimed to (a) characterize the microstructure and porosity of human nail and bovine hoof by mercury intrusion porosimetry and SEM image analysis, (b) study the effects of hydration and of N-acetyl-l-cysteine treatment on the microstructure of both membranes, and (c) determine whether the microstructural modifications were associated with changes in drug penetration measured by standard diffusion studies. Bovine hoof surface is more porous than nail surface although there were no differences between the mean surface pore sizes. Hydration and N-acetyl-l-cysteine increased the roughness and apparent surface porosity, and the porosity determined by mercury intrusion porosimetry of both membranes. Pore-Cor™ was used to generate tridimensional structures having percolation characteristics comparable to nail and hooves. The modeled structures were horizontally banded having an inner less-porous area which disappeared upon treatment. Treatment increased the predicted permeability of the simulated structures. Triamcinolone permeation increased significantly for hooves treated N-acetyl-l-cysteine, i.e., the membranes for which microstructural and permeability changes were the largest. Thus, microstructural changes determined via mercury intrusion porosimetry and subsequently modeled by Pore-Cor™ were related to drug diffusion. Further refinement of the technique will allow fast screening of penetration enhancers to be used in ungual drug delivery. PMID:21906642

  8. Histopathological examination of nail clippings using PAS staining (HPE-PAS): gold standard in diagnosis of Onychomycosis.

    PubMed

    Jeelani, Shazia; Ahmed, Qazi Masood; Lanker, Audil Mohmad; Hassan, Iffat; Jeelani, Nasir; Fazili, Tawheeda

    2015-01-01

    Onychomycosis is fungal infection of one or more of the nail units. However, because fungi cause only about half of all nail dystrophies, the use of appropriate diagnostic techniques is important to ensure correct diagnosis and treatment. Aim of the present study was to compare direct microscopy, culture and HPE-PAS for diagnosis of onychomycosis by evaluating their sensitivity and various other relevant statistical parameters. A prospective, hospital-based, cross-sectional study was conducted on 216 patients with a high degree of clinical suspicion of onychomycosis. Nail specimens were evaluated using three diagnostic methods, i.e. direct microscopy using 20% Potassium hydroxide (KOH) & 40% Di-methyl-suphoxide (DMSO), culture and histopathological examination using PAS stain (HPE-PAS). Of 216 patients direct microscopy was positive in 138 (63.9%), culture in 147 (68%) and HPE-PAS in 164 patients (76%). One hundred and seventy-nine patients fitted into the criteria set for confirmed diagnosis of onychomycosis. Using this as a denominator; direct microscopy, culture and HPE-PAS had sensitivities of 77.1%, 70% and 91.6% respectively. Also, HPE-PAS showed the highest sensitivity of 94.7% in 19 cases with prediagnostic antimycotic treatment compared to direct microscopy (42.1%) or culture (57.9%). HPE-PAS shows high sensitivity for diagnosis of onychomycosis and can be considered as a gold standard in the diagnosis of onychomycosis. PMID:25346218

  9. Allergic contact dermatitis caused by cosmetic products.

    PubMed

    González-Muñoz, P; Conde-Salazar, L; Vañó-Galván, S

    2014-11-01

    Contact dermatitis due to cosmetic products is a common dermatologic complaint that considerably affects the patient's quality of life. Diagnosis, treatment, and preventive strategies represent a substantial cost. This condition accounts for 2% to 4% of all visits to the dermatologist, and approximately 60% of cases are allergic in origin. Most cases are caused by skin hygiene and moisturizing products, followed by cosmetic hair and nail products. Fragrances are the most common cause of allergy to cosmetics, followed by preservatives and hair dyes; however, all components, including natural ingredients, should be considered potential sensitizers. We provide relevant information on the most frequent allergens in cosmetic products, namely, fragrances, preservatives, antioxidants, excipients, surfactants, humectants, emulsifiers, natural ingredients, hair dyes, sunscreens, and nail cosmetics. PMID:24656778

  10. Pregnancy care

    MedlinePLUS

    ... gets a head start on a healthy life. PRENATAL CARE Good prenatal care includes good nutrition and health habits before and ... your pregnancy and childbirth . This provider will provide prenatal care, delivery, and postpartum services. Take folic acid. If ...

  11. Critical Care

    MedlinePLUS

    Critical care helps people with life-threatening injuries and illnesses. It might treat problems such as complications from surgery, ... attention by a team of specially-trained health care providers. Critical care usually takes place in an ...

  12. Palliative Care

    MedlinePLUS

    Palliative care is treatment of the discomfort, symptoms, and stress of serious illness. It provides relief from distressing symptoms ... of the medical treatments you're receiving. Hospice care, care at the end of life, always includes ...

  13. Hospice Care

    MedlinePLUS

    Hospice care is end-of-life care. A team of health care professionals and volunteers provides it. ... can remain as alert and comfortable as possible. Hospice programs also provide services to support a patient's ...

  14. Hospice Care

    MedlinePLUS

    HOSPICE CARE Hospice offers a special type of care that focuses on providing you and your family with comfort, pain relief, ... or those we choose to call family. About Hospice Care. Provides pain and symptom relief tailored to ...

  15. Managed Care

    MedlinePLUS

    Managed care plans are a type of health insurance. They have contracts with health care providers and medical facilities to ... cost more. There are three types of managed care plans: Health Maintenance Organizations (HMO) usually only pay for ...

  16. [Orthopaedic implants. Application outside of patient care?].

    PubMed

    Manhart, J; Dietze, A; Büttner, A

    2015-01-01

    Internal fracture fixation represents a widespread concept for the treatment of fractures. As the number of implants increases, person tracking may be possible. In spring 2010 near Rostock (Germany), human remains including a stainless steel nail were found. Forensic analysis considered the parts of skeleton to belong to a man of medium height, exposed to outdoor conditions for several years to a few decades. The tibial nail was analysed and according to the product identification number possible hospitals of implant placement and transportation paths were determined and screened. Furthermore a match analysis of the database of missing individuals of the last 15 years was undertaken and a DNA match analysis identified a local individual who had been missing since winter 2003. Equipped with the actual patient's identity, out of academic interest a survey of clinical documents such as discharge letters and operative reports was performed, but was inconclusive. Although technically feasible, tracking the patient in this case based on the implant product number itself was unsuccessful. In this case report, the feasibility, validity and efficiency of this option are presented and discussed. PMID:24458026

  17. Cleaning up Floor Care.

    ERIC Educational Resources Information Center

    Carr, Richard; McLean, Doug

    1995-01-01

    Discusses how educational-facility maintenance departments can cut costs in floor cleaning through careful evaluation of floor equipment and products. Tips for choosing carpet detergents are highlighted. (GR)

  18. Development of a multianalyte method based on micro-matrix-solid-phase dispersion for the analysis of fragrance allergens and preservatives in personal care products.

    PubMed

    Celeiro, Maria; Guerra, Eugenia; Lamas, J Pablo; Lores, Marta; Garcia-Jares, Carmen; Llompart, Maria

    2014-05-30

    An effective, simple and low cost sample preparation method based on matrix solid-phase dispersion (MSPD) followed by gas chromatography-mass spectrometry (GC-MS) or gas chromatography-triple quadrupole-mass spectrometry (GC-MS/MS) has been developed for the rapid simultaneous determination of 38 cosmetic ingredients, 25 fragrance allergens and 13 preservatives. All target substances are frequently used in cosmetics and personal care products and they are subjected to use restrictions or labeling requirements according to the EU Cosmetic Directive. The extraction procedure was optimized on real non-spiked rinse-off and leave-on cosmetic products by means of experimental designs. The final miniaturized process required the use of only 0.1g of sample and 1 mL of organic solvent, obtaining a final extract ready for analysis. The micro-MSPD method was validated showing satisfactory performance by GC-MS and GC-MS/MS analysis. The use of GC coupled to triple quadrupole mass detection allowed to reach very low detection limits (low ng g(-1)) improving, at the same time, method selectivity. In an attempt to improve the chromatographic analysis of preservatives, the inclusion of a derivatization step was also assessed. The proposed method was applied to a broad range of cosmetics and personal care products (shampoos, body milk, moisturizing milk, toothpaste, hand creams, gloss lipstick, sunblock, deodorants and liquid soaps among others), demonstrating the extended use of these substances. The concentration levels were ranging from the sub parts per million to the parts per mill. The number of target fragrance allergens per samples was quite high (up to 16). Several fragrances (linalool, farnesol, hexylcinnamal, and benzyl benzoate) have been detected at levels >0.1% (1,000 ?g g(-1)). As regards preservatives, phenoxyethanol was the most frequently found additive reaching quite high concentration (>1,500 ?g g(-1)) in five cosmetic products. BHT was detected in eight samples, in two of them (a baby care product and a lipstick) at high concentrations (>1,000 ?g g(-1)). Methyl paraben was also found at high levels (>1,700 ?g g(-1)) in three leave-on samples. Finally, triclosan was found at the maximum concentration limit (0.3%) laid down by the European regulation in two deodorant samples, and the total paraben concentration was close to the maximum concentration permitted (0.8%) in one leave-on sample (body milk). PMID:24767833

  19. COMPOSITES AND MANUFACTURED PRODUCTS SCREW-HOLDING CAPACITY OF

    E-print Network

    , and ness, bending stiffness and strength), wood species (pine vs. sweetgum) had an millworkmarkets/32 between its components. For maximum joints or constructions at complete water- inch (18 ram). The product nificantly alter the screw-holding capac- els were cut for bending modulus of elas- (screw or nail

  20. Productivity loss and resource utilization, and associated indirect and direct costs in individuals providing care for adults with schizophrenia in the EU5

    PubMed Central

    Gupta, Shaloo; Isherwood, Gina; Jones, Kevin; Van Impe, Kristel

    2015-01-01

    Objective This study aimed to understand the impact of providing care for adults with schizophrenia on productivity, resource utilization, and costs in the EU5 (France, Germany, Italy, Spain, and UK). Methods Data from the 2010, 2011, and 2013 EU5 National Health and Wellness Survey, an online questionnaire of a nationwide sample of adults, were analyzed. Schizophrenia caregivers (n=398) were matched to noncaregivers (n=158,989) and other caregivers (n=14,341) via propensity scores. Outcome measures included health care utilization, Work Productivity and Activity Impairment questionnaire-based scores, and associated direct and indirect costs (estimated from the literature). Significant differences between schizophrenia caregivers vs noncaregivers and other caregivers (eg, cancer and Alzheimer’s disease) were examined. Results After matching, schizophrenia caregivers reported greater activity impairment (38.4% vs 26.1%), provider visits (8.0 vs 5.7), emergency room visits (0.9 vs 0.2), hospitalizations (0.8 vs 0.1), and direct costs (€2,258 vs €617) than noncaregivers, all P<0.001. Employed schizophrenia caregivers reported greater absenteeism, presenteeism, overall work impairment (35.0% vs 20.7%), and indirect costs (€6,667 vs €3,795) than noncaregivers, all P<0.001. Schizophrenia caregivers (vs other caregivers) reported greater activity impairment (38.4% vs 32.3%) and provider visits (8.0 vs 6.6), P<0.05. A greater proportion of schizophrenia caregivers (vs other caregivers) reported at least one emergency room visit (26.1% vs 20.2%) and hospitalization (20.4% vs 14.3%), P<0.05. Employed schizophrenia caregivers incurred greater indirect costs than other caregivers (€6,667 vs €5,104). Discussion Schizophrenia caregivers reported greater activity impairment, resource utilization, and costs than noncaregivers and other caregivers. Better support systems for schizophrenia caregivers may help reduce the burden on the health care system and caregivers. PMID:26648745

  1. Determination of pharmaceuticals, steroid hormones, and endocrine-disrupting personal care products in sewage sludge by ultra-high-performance liquid chromatography-tandem mass spectrometry.

    PubMed

    Yu, Yiyi; Huang, Qiuxin; Cui, Jianlan; Zhang, Kun; Tang, Caiming; Peng, Xianzhi

    2011-01-01

    A sensitive method has been developed and validated for the determination of diverse groups of pharmaceuticals, steroid hormones, and hormone-like personal care products in sewage sludge. Samples were extracted by ultrasonic-assisted extraction followed by solid-phase extraction cleanup. For determination of estrogens and hormone-like phenolic compounds, sample extracts were further derivatized with dansyl chloride and purified with silica gel column chromatography to improve the analytical sensitivity. The chemicals were determined by ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) in multiple-reaction monitoring mode. Recoveries ranged mostly from 63% to 119% with relative standard deviations within 15%. Method quantification limits were 0.1-3 ng?g(-1) dry weight (dw) for sewage sludge. The method was applied to a preliminary investigation of pharmaceuticals and personal care products (PPCPs) in sewage sludge and sediment in the Pearl River Delta, South China. Triclosan, triclocarban, 2-phenylphenol, bisphenol A, and parabens were ubiquitously detected at 3.6-5088.2 ng?g(-1) dw in sludge and 0.29-113.1 ng?g(-1) dw in sediment samples, respectively. Estrone, carbamazepine, metoprolol, and propranolol were also frequently quantified in the sludge and sediment samples. The dewatering process caused no significant losses of these PPCPs in sewage sludge. PMID:21046090

  2. [Treatment of fungus infection with diabetic foot--importance of the foot care].

    PubMed

    Shinjo, Takamichi

    2008-12-01

    Fungus infection is high frequently complicated of the diabetic foot. Especially onychomycosis make a injury neighbor toe skin or paronychia. This tiny lesion make a bacterial infection, and progress to foot gangrene unfortunately if patient delayed treatment. So it is important to do daily check of the foot and regularly foot care included nail care. Toenail onychomycosis need medicational treatment just after microscopically diagnosis. It is important to check the interaction between the antifungal medicine and other medicine, and side effect after started treatment. PMID:19069095

  3. A Fast, Accurate and Easy to Implement Method for Pose Recognition of an Intramedullary Nail using a Tracked C-arm

    NASA Astrophysics Data System (ADS)

    Esfandiari, H.; Amiri, S.; Lichti, D. D.; Anglin, C.

    2014-06-01

    A C-arm is a mobile X-ray device that is frequently used during orthopaedic surgeries. It consists of a semi-circular, arc-shaped arm that holds an X-ray transmitter at one end and an X-ray detector at the other. Intramedullary nail (IM nail) fixation is a popular orthopaedic surgery in which a metallic rod is placed into the patient's fractured bone (femur or tibia) and fixed using metal screws. The main challenge of IM-nail fixation surgery is to achieve the X-ray shot in which the distal holes of the IM nail appear as circles (desired view) so that the surgeon can easily insert the screws. Although C-arm X-ray devices are routinely used in IM-nail fixation surgeries, the surgeons or radiation technologists (rad-techs) usually use it in a trial-and-error manner. This method raises both radiation exposure and surgery time. In this study, we have designed and developed an IM-nail distal locking navigation technique that leads to more accurate and faster screw placement with a lower radiation dose and a minimum number of added steps to the operation to make it more accepted within the orthopaedic community. The specific purpose of this study was to develop and validate an automated technique for identifying the current pose of the IM nail relative to the C-arm. An accuracy assessment was performed to test the reliability of the navigation results. Translational accuracy was demonstrated to be better than 1 mm, roll and pitch rotations better than 2° and yaw rotational accuracy better than 2-5° depending on the separate angle. Computation time was less than 3.5 seconds.

  4. [Benign subcutaneous emphysema after nail penetration. Case report and important differential diagnoses].

    PubMed

    Kantelberg, C; Meyer, C; Harland, U

    2014-02-01

    Crepitus under the skin after penetrating injuries: harmless benign subcutaneous emphysema or life-threatening infection with gas-producing bacteria (gas gangrene because of Clostridium perfringens, crepitating cellulitis because of anaerobic Streptococcus or other coliforme bacteria)? We report a case of a 74-year-old male who developed massive crepitation of the left upper extremity and the lateral thoracic wall and mediastinal emphysema after sustaining a laceration of the left thumb and forefinger from a nail. Because there was the suspicion of gas gangrene we performed generous skin incisions of the ventral and dorsal part of the hand, the forearm and upper arm and open wound treatment. A triple antibiotic therapy was initiated. Due to fast regression of the subcutaneous emphysema and the mediastinal emphysema, continuing lack of symptoms, negative smear test results from the beginning and low infection parameters in the blood all wounds could be closed 9 days after primary surgery. The suspicion of gas gangrene was not confirmed so the diagnosis of benign subcutaneous emphysema was made. PMID:23703620

  5. Prevalence of pathogenic fungi in the toe-webs and toe-nails of diabetic patients.

    PubMed

    Alteras, I; Saryt, E

    1979-07-16

    100 diabetic and 100 diabetes-free patients were mycologically examined for the presence of pathogenic fungi in their toe-webs and toe-nails. While there were clinical signs of presumed mycotic infection in 73 of the diabetic and in 66 of the non-diabetic subjects, the examination of the KOH-treated specimens revealed fungal elements in only 70 of the former and in 53 of the latter group. Isolation of the causative agent was possible in 57 of the diabetic patients (T. rubrum in 46%, C. albicans in 31%, T. mentagrophytes in 21% and E. floccosum in 3%) and in 40 of the control group (T. rubrum 57,5%, T. mentagrophytes 35%, C. albicans 5%, E. floccosum 2,5%). An interesting correlation was observed between the level of blood sugar and the percentage of positive fungal findings, the patients with more than 3000 mg/ml being 100% afected. C. albicans was found in a lower percentage in non-diabetic patients. The in vitro test of the sensitivity of the isolated organisms to the antidiabetic drugs, received by the patients, showed no significant anti-fungal activity. PMID:384255

  6. Sporicidal effect of amorolfine and other antimycotics used in the therapy of fungal nail infections.

    PubMed

    Seidl, Hans P; Jäckel, Andreas; Müller, Julia; Schaller, Martin; Borelli, Claudia; Polak, Annemarie

    2015-10-01

    Although topical antifungal therapies for treating onychomycosis are available, the cure rate is unsatisfactorily low with a simultaneously high risk of recurrence. One reason might be the formation of dormant fungal cells by the pathogen, known as spores, which can survive in the affected nail keratin, thereby evading the effect of antifungal drugs. In this in vitro study, the ability of amorolfine and four other antimycotics (ciclopirox, bifonazole, terbinafine and fluconazole) to kill microconidia of the dermatophyte Trichophyton rubrum, chlamydospores of the dermatophyte Epidermophyton floccosum and blastospores of the yeast Candida albicans was extensively studied as these fungi occur predominantly in onychomycosis. The effectiveness of all five antimycotics depended on the drug concentration and the incubation time: a concentration of 10-1000 times the minimum inhibitory concentration against growing hyphae cells is needed to exert a sporicidal action. Amorolfine and ciclopirox showed the same sporicidal efficacy and kinetics for all three varieties of spores. Both were more effective than fluconazole and bifonazole against microconidia and chlamydospores as well as slightly more potent against chlamydospores and blastospores than terbinafine after 4 days of incubation and at concentrations of ?10 ?g ml(-1). Finally, sporicidal activity on the tested strains was demonstrated for all five different antimycotics used for onychomycosis treatment. PMID:26334024

  7. The Efficacy of Ultraviolet Irradiation on Trichophyton Species Isolated From Nails

    PubMed Central

    Nematollahi, Ahmad Reza; Badiee, Parisa; Nournia, Ensieh

    2015-01-01

    Background: The treatment of onychomycosis is a challenge and infections are typically more severe and difficult to treat in toenails than in fingernails. Objectives: The current study aimed to investigate the fungicidal effect of ultraviolet radiation on the growth of dermatophytes isolated from nails. Patients and Methods: Samples from patients with clinical manifestations of onychomycosis were inoculated onto Sabouraud dextrose agar and incubated at 30°C for 14 days. Isolated species were identified by specific laboratory examinations; UV-A, UV-B, and UV-C light were used to irradiate two strains of Trichophyton mentagrophytes and T. rubrum. Colony count, size and growth rate of the isolated fungi were evaluated under laboratory conditions. Results: Trichophyton rubrum type 1 was less sensitive to UV-A and UV-C, and more sensitive to UV-B than type 2. T. mentagrophytes type 2 was slightly responsive to UV-A therapy, although no decrease in colony count was observed. Increased doses of UV-B and UV-C irradiation decreased the counts. The effect of radiation on colony size was dependent on the dose and type of irradiation. Conclusions: UV-A, UV-B, and UV-C light seem to be effective in decreasing colony growth of the most prevalent fungi, which caused onychomycosis in the current study samples. Further studies are needed to determine the efficacy of ultraviolet light therapy, identify possible side effects, and establish appropriate dosages for the antifungal effect of this therapy. PMID:26322201

  8. Chronic Expanding Hematoma in the Popliteal Fossa after Pseudoaneurysm Surgery because of Nail Puncture

    PubMed Central

    Deveci, Alper; Ozkurt, Bulent; Simsek, Mehmet Emin; Tabak, Abdullah Yalcin; Bozkurt, Murat

    2014-01-01

    Hematomas caused by surgery or trauma that persist and expand slowly for more than a month are defined as chronic expanding hematomas (CEH). Magnetic resonance imaging (MRI) is useful for the diagnosis. Total excision with the pseudocapsule is the treatment method. Pseudoaneurysms result from arterial wall disruptions and can be mistaken for CEH. We present a rare case report of a 45-year-old man with a large, painful swelling in his left popliteal fossa. He had a puncture wound by a nail 11 years ago and a gradually expanding mass occurred in his popliteal fossa. A pseudoaneurysm was detected and operated a year later. After surgery, a gradually expanding mass recurred in his popliteal fossa. On the arteriography, the popliteal artery was occluded and the blood flow was maintained with collateral vessels. On MRI, an enormous swelling of 115?×?107?×?196?cm in diameter was seen. It was diagnosed as CEH and was excised completely protecting the collateral vessels and there was no recurrence after a year from the surgery. PMID:25610684

  9. Treatment of Unstable Intertrochanteric Fractureswith Proximal Femoral Nail Antirotation II: Our Experience in Indian Patients§

    PubMed Central

    Kumar, G.N. Kiran; Sharma, Gaurav; Khatri, Kavin; Farooque, Kamran; Lakhotia, Devendra; Sharma, Vijay; Meena, Sanjay

    2015-01-01

    Introduction: Unstable intertrochanteric fractures are difficult to manage and the choice of implant is critical for fracture fixation. The purpose of this study was to evaluate the functional and radiological outcome of proximal femoral nail antirotationII (PFNA II) in the treatment of unstable intertrochanteric fractures. Materials and Methods: We reviewed 45 patients of unstable intertrochanteric fractures, who were treated with the PFNA II between 2011 and 2013. Of which, 3 patients were died within 6 months of follow up. Hence, 42 patients were available for the study including 26 men and 16 women. The mean age was 61 years (range, 35 -90). Clinical evaluation was done using Harris hip score. The position of the blade in the femoral head was evaluated using Cleveland zones and tip apex distance. The fracture reduction was assessed using the Garden Alignment Index and postoperative fracture gap (mm) measurement. Results: The mean follow up period was 15.3 months (range, 9-27). Excellent to good results were accounted for 78% of cases according to Harris hip score. No cases of cut out or breakage of the implant noted. Implant removal was done in 2 patients due to persistent anterior thigh pain. Conclusion: We recommend PFNA II for fixation of unstable intertrochanteric fractures with less operative time and low complication rate. However, proper operative technique is important for achieving fracture stability and to avoid major complications.

  10. Asymmetric gait nail unit syndrome: the most common worldwide toenail abnormality and onychomycosis.

    PubMed

    Zaias, Nardo; Rebell, Gerbert; Escovar, Sandra

    2014-01-01

    Asymmetric gait nail unit syndrome (AGNUS) is the result of asymmetric shoe pressure on the toes and foot caused by ubiquitous uneven flat feet that affect the gait. The pressure produces clinical changes in the toenails, which are identical to all clinical types of dermatophyte and opportunistic onychomycosis, yet they are dermatophytes-free. AGNUS produces additional signs that make it easy to identify. Its coexistence with fungal disease has resulted in reports describing new clinical types of onychomycosis, identifying signs of drug resistance, assessing severity index, and defining complete clinical cure when taking a systemic or topical antifungal, as well as "retronychia." These signs are typically seen in the toenails of patients with AGNUS. AGNUS has a mechanical etiology and can coexist with dermatophytosis, which is a hereditary disease. AGNUS can coexist with any other disease affecting the toenails and results in greater clinical severity than each condition individually. AGNUS is and has been the most common worldwide toenail abnormality in shoe-wearing societies. PMID:25335350

  11. Prenatal Care

    MedlinePLUS

    Prenatal care is the health care you get while you are pregnant. It includes your checkups and prenatal testing. Prenatal care can help keep you and your baby healthy. It lets your health care provider spot health problems early. Early treatment ...

  12. Infected nail plate model made of human hair keratin for evaluating the efficacy of different topical antifungal formulations against Trichophyton rubrum in vitro.

    PubMed

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

    2013-08-01

    A novel model of infected nail plate for testing the efficacy of topical antifungal formulations has been developed. This model utilized keratin film made of human hair keratin as a nail plate model. Subsequent to infection by Trichophyton rubrum, the common causative agent of onychomycosis, keratin films as infected nail plate models were treated with selected topical formulations, that is cream, gel, and nail lacquer. Bovine hoof was compared to keratin film. In contrast to the common antifungal susceptibility test, the antifungal drugs tested were applied as ready-to-use formulations because the vehicle may modify and control the drug action both in vitro and in vivo. Extrapolating the potency of an antifungal drug from an in vitro susceptibility test only would not be representative of the in vivo situation since these drugs are applied as ready-to-use formulations, for example as a nail lacquer. Although terbinafine has been acknowledged to be the most effective antifungal agent against T. rubrum, its antifungal efficacy was improved by its incorporation into an optimal formulation. Different gels proved superior to cream. Therefore, this study is able to discriminate between efficacies of different topical antifungal formulations based on their activities against T. rubrum. PMID:23419812

  13. 76 FR 51038 - Draft Guidance for Industry: Cell Selection Devices for Point of Care Production of Minimally...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-17

    ... published in the Federal Register of July 26, 2007 (72 FR 41080), FDA announced the availability of a draft... Production of Minimally Manipulated Autologous Peripheral Blood Stem Cells; Withdrawal of Draft Guidance... Blood Stem Cells (PBSCs)'' dated July 2007. DATES: August 17, 2011. FOR FURTHER INFORMATION...

  14. Glossary of Managed Care Definitions

    MedlinePLUS

    ... managed care plan who review new drugs and biotechnology products to decide which ones the plan will ... to evaluate new tests, treatments, drugs, medical devices, biotechnology products, and surgical procedures, to decide what the ...

  15. Simultaneous determination of free carnitine and total choline by liquid chromatography/mass spectrometry in infant formula and health-care products: single-laboratory validation.

    PubMed

    Andrieux, Pierre; Kilinc, Tamara; Perrin, Christian; Campos-Giménez, Esther

    2008-01-01

    A single-laboratory validation study was conducted for a liquid chromatographic/mass spectrometric (LCIMS) method for the simultaneous determination of the free carnitine and total choline in milk-based infant formula and health-care products. The sample preparation used for both carnitine and choline was adapted from AOAC Official Method 999.14, with an acidic and enzymatic hydrolysis of esterified forms of choline. Carnitine and choline were quantified by ion-pair chromatography with single-quadrupole MS detection, using their respective deuterated internal standards. The repeatability relative standard deviation was < or =2.5 and 2.1%, respectively, for carnitine and choline. The intermediate reproducibility relative standard deviation was <4.7 and 2.4%, respectively, for carnitine and choline. The ranges of the average product-specific recoveries were 92-98 and 94-103%, respectively, for carnitine and choline. Choline concentration determined in infant formula reference material SRM 1846 was in agreement with the reference value. The proposed method was compared with the enzymatic methods for a range of products; good correlation (r = 0.99) was obtained, although a significant bias was observed for both analytes. The method, with a short chromatographic run time (7 min), is convenient for routine analysis to enhance analytical throughput and is a good alternative to enzymatic assays. PMID:18727537

  16. Remediation of pharmaceuticals and personal care products using an aerobic granular sludge sequencing bioreactor and microbial community profiling using Solexa sequencing technology analysis.

    PubMed

    Zhao, Xia; Chen, Zhonglin; Wang, Xiaochun; Li, Jinchunzi; Shen, Jimin; Xu, Hao

    2015-03-01

    Recently, a new type of organic pollution derived from pharmaceuticals and personal care products (PPCPs) is gradually on the rise. Wastewater treatment to remove PPCPs was investigated using an aerobic granular sludge sequencing bioreactor (GSBR). After optimization of influent organic load, hydraulic shear stress, sludge settling time, etc., aerobic granular sludge was analyzed for its physiological and biochemical characteristics and tested for its efficacy to remove PPCPs wastewater. The granular sludge effectively removed some but not all of the PPCPs tested; removal correlated with the microbial profiles in the granules, as assessed using Solexa sequencing technology. Sequencing revealed the presence of five phylogenetic groups: Proteobacteria, Bacteroidetes, Betaproteobacteria, an unclassified genus, and Zoogloea. The results demonstrated changes in the microbial profiles with time in response to the presence of PPCPs. The effects of PPCPs on microbial communities in granular sludge process are discussed. PMID:25531682

  17. Occurrence and risk assessment of pharmaceuticals and personal care products and endocrine disrupting chemicals in reclaimed water and receiving groundwater in China.

    PubMed

    Li, Zhen; Xiang, Xi; Li, Miao; Ma, Yeping; Wang, Jihua; Liu, Xiang

    2015-09-01

    Groundwater recharge using reclaimed water is considered a promising method to alleviate groundwater depletion. However, pollutants in reclaimed water could be recharged into groundwater during this process, thereby posing a risk to groundwater and human health. In this study, 12 cities in northern China were selected for reclaimed water and groundwater sampling. Analysis of the samples revealed the presence of nine pharmaceutical and personal care products (PPCPs) and five endocrine disrupting compounds (EDCs). In reclaimed water, all the PPCPs and EDCs were found, with sulpiride (SP) and estriol (E3) being most frequently detected. In groundwater samples, only ketoprofen (KP), mefenamic acid (MA), nalidixic acid (NA) and SP were detected among PPCPs, while bisphenol-A (BPA) was dominant among the target EDCs. The risk quotients (RQs) of all target PPCPs and EDCs except 17?-ethinyl estradiol (EE2) and E3 were below 1 in groundwater samples, indicating that EE2 and E3 deserve priority preferential treatment before recharging. PMID:25982733

  18. Major pharmaceuticals and personal care products (PPCPs) in wastewater treatment plant and receiving water in Beijing, China, and associated ecological risks.

    PubMed

    Dai, Guohua; Huang, Jun; Chen, Weiwei; Wang, Bin; Yu, Gang; Deng, Shubo

    2014-06-01

    The occurrence of 15 pharmaceuticals and personal care products in the influent and effluent from the wastewater treatment plant (WWTP) and its receiving water in Beijing, China were determined. Results from the present study confirmed that caffeine, N,N-diethyl-m-toluamide and chloramphenicol were removed at a high rate (>70 % efficiency). In contrast, removal efficiency of the other 12 compounds was quite poor (ranged from -40 % to 58 %). Some compounds in the receiving river were present at higher concentrations compared to those in the WWTP effluent, indicating that sources other than treated effluents are present. The risk to the aquatic environment was estimated by a ratio of measured environmental concentration and predicted no-effect concentration. For those compounds found in the effluent and surface water, mefenamic acid, trimethoprim and gemfibrozil may pose a medium risk to aquatic environment. PMID:24619361

  19. Oxygen partial pressure in outer layers of skin of human finger nail folds

    PubMed Central

    Wang, W; Winlove, C P; Michel, C C

    2003-01-01

    To gain insight into oxygen transport by the cutaneous microcirculation, we have developed oxygen-sensitive microelectrodes (tip diameter ?5 ?m) to measure the distribution of PO2 in dermal papillae of the finger nail folds of healthy human subjects. Oxygen entry into the tissue was minimised by covering the skin with a layer of paraffin oil. The finger was held under a dissecting microscope and microelectrodes were guided into position. PO2 varied from 5–25 % of its atmospheric value, Pair (?160 mmHg), depending on the location within the papilla. Along the axis of a papillary loop, PO2 decreased from 40.0 ± 4.8 mmHg (mean ± s.e.m., n = 6) at the base to 30.4 ± 5.2 mmHg (n = 6) at the tip. The lowest values of PO2, in the range of 5 % of Pair, were measured in the epidermis where the metabolism of cells was highest and the steepest PO2 gradients were recorded in the vicinity of the epidermal–dermal boundary. When the local circulation was abruptly reduced or stopped, PO2 fell exponentially with time, with a time constant of 8.4 ± 1.5 s (n = 7). When flow was reinstated, PO2 rose exponentially to a new value with a time constant of 4.8 ± 0.8 s (n = 6). The steady state PO2 following reperfusion was ?23 % higher than the pre-occlusion value (P < 0.05, ANOVA and two-tailed Student's t test) indicating localised reactive hyperaemia. PMID:12702744

  20. Critical analysis of endocrine disruptive activity of triclosan and its relevance to human exposure through the use of personal care products.

    PubMed

    Witorsch, Raphael J

    2014-07-01

    This review examines the mammalian and human literature pertaining to the potential endocrine disruptive effects of triclosan (TCS). Dietary exposure to TCS consistently produces a dose-dependent decrease in serum thyroxine (T4) in rats without any consistent change in TSH or triiodothyronine (T3). Human studies reveal no evidence that the TCS exposure through personal care product use affects the thyroid system. TCS binds to both androgen and estrogen receptors in vitro with low affinity and evokes diverse responses (e.g., agonist, antagonist, or none) in steroid receptor transfected cell-based reporter assays. Two of three studies in rats have failed to show that TCS exposure suppresses male reproductive function in vivo. Three of four studies have failed to show that TCS possesses estrogenic (or uterotrophic) activity in rats. However, two studies reported that, while TCS lacks estrogenic activity, it can amplify the action of estrogen in vivo. The in vitro, in vivo, and epidemiologic studies reviewed herein show little evidence that TCS adversely affects gestation or postpartum development of offspring. Furthermore, previously reported toxicity testing in a variety of mammalian species shows little evidence that TCS adversely affects thyroid function, male and female reproductive function, gestation, or postpartum development of offspring. Finally, doses of TCS reported to produce hypothyroxinemia, and occasional effects on male and female reproduction, gestation, and offspring in animal studies are several orders of magnitude greater than the estimated exposure levels of TCS in humans. Overall, little evidence exists that TCS exposure through personal care product use presents a risk of endocrine disruptive adverse health effects in humans. PMID:24897554

  1. Occurrence of Selected Pharmaceuticals, Personal-Care Products, Organic Wastewater Compounds, and Pesticides in the Lower Tallapoosa River Watershed near Montgomery, Alabama, 2005

    USGS Publications Warehouse

    Oblinger, Carolyn J.; Gill, Amy C.; McPherson, Ann K.; Meyer, Michael T.; Furlong, Edward T.

    2007-01-01

    Synthetic and natural organic compounds derived from agricultural operations, residential development, and treated and untreated sanitary and industrial wastewater discharges can contribute contaminants to surface and ground waters. To determine the occurrence of these compounds in the lower Tallapoosa River watershed, Alabama, new laboratory methods were used that can detect human and veterinary antibiotics; pharmaceuticals; and compounds found in personal-care products, food additives, detergents and their metabolites, plasticizers, and other industrial and household products in the environment. Well-established methods for detecting 47 pesticides and 19 pesticide degradates also were used. In all, 186 different compounds were analyzed by using four analytical methods. The lower Tallapoosa River serves as the water-supply source for more than 100,000 customers of the Montgomery Water Works and Sanitary Sewer Board. Source-water protection is a high priority for the Board, which is responsible for providing safe drinking water. The U.S. Geological Survey, in cooperation with the Montgomery Water Works and Sanitary Sewer Board, conducted this study to provide baseline data that could be used to assess the effects of agriculture and residential development on the occurrence of selected organic compounds in the lower Tallapoosa River watershed. Twenty samples were collected at 10 sites on the Tallapoosa River and its tributaries. Ten samples were collected in April 2005 during high base streamflow, and 10 samples were collected in October 2005 when base streamflow was low. Thirty-two of 186 compounds were detected in the lower Tallapoosa River watershed. Thirteen compounds, including atrazine, 2-chloro-4-isopropylamino-6-amino-s-triazine (CIAT), hexazinone, metalaxyl, metolachlor, prometryn, prometon, simazine, azithromycin, oxytetracycline, sulfamethoxazole, trimethoprim, and tylosin, had measurable concentrations above their laboratory reporting levels. Concentrations were estimated for an additional 19 compounds that were detected below their laboratory reporting levels. The two most frequently detected compounds were the pesticides atrazine (19 of 20 samples) and simazine (13 of 20 samples). Tylosin, a veterinary antibiotic, was detected in 8 of 20 samples. Other compounds frequently detected at very low concentrations included CIAT and hexazinone (a degradate of atrazine and a pesticide, respectively); camphor (derived from personal-care products or flavorants), para-cresol (various uses including solvent, wood preservative, and in household cleaning products), and N,N-diethyl-m-toluamide (DEET, an insect repellent).

  2. Painful pathologic fracture of the humerus: percutaneous osteoplasty with bone marrow nails under hybrid computed tomography and fluoroscopic guidance.

    PubMed

    Anselmetti, Giovanni Carlo; Manca, Antonio; Chiara, Gabriele; Tutton, Sean; Iussich, Gabriella; Gino, Giancarlo; Grignani, Giovanni; Ortega, Cinzia; Moselli, Nora; Regge, Daniele

    2011-07-01

    A case of a 75-year-old patient with a painful pathologic humeral shaft fracture, with unacceptably high surgical risk and unsatisfactory analgesia is reported. In this case, impaired arm function and persistent pain with conservative management resulted in a poor quality of life. Palliation with image-guided percutaneous osteoplasty was considered. Because of potential cement leakage, inadequate fracture reduction, the site of the fracture, and the mobility of the joints in that area, image-guided percutaneous delivery of metallic bone marrow nails implanted together with polymethyl methacrylate (PMMA) osteoplasty was performed. This procedure achieved humeral shaft stabilization, bone fragment alignment, fracture reduction, and pain relief. PMID:21708321

  3. Self Care

    MedlinePLUS

    ... Chronic Disease Self Assessment Self Care Connections Experiences Research Learning Evaluation Print Email Self Care If you are living with a chronic health condition, having a new set of skills to help you cope can make a real ...

  4. CARES Foundation

    MedlinePLUS

    ... a walk in your area. For more information, contact Dina@CaresFoundation.org Support Our Mission Research, education ... Meeting. Beaver County, PA, 2:00pm More events>>> Contact Us CARES Foundation is a nonprofit organization committed ...

  5. Hospice care

    MedlinePLUS

    Hospice care helps people with illnesses that cannot be cured and who are nearing death. The goal ... give comfort and peace instead of a cure. Hospice care provides: Support for the patient and the ...

  6. Hospice Care

    MedlinePLUS

    ... Caregiver Questions to Ask about Advanced Cancer Research Hospice Care On This Page What is hospice, and ... organizations can provide more information about hospice. National Hospice and Palliative Care Organization 1–800–658–8898 ( ...

  7. Hair Care

    MedlinePLUS

    ... Body Looking and feeling your best Hair care Hair care Short, long, curly, straight, up, down. Hair options can seem endless! Not all of what makes your hair look good comes from the outside, though. Good ...

  8. Hospice Care

    MedlinePLUS

    ... Pressure High Blood Pressure Tools & Resources Stroke More Hospice Care Updated:Aug 9,2013 Hospice – or “comfort” – care helps patients and their families ... including medical care, financial concerns and living arrangements. Hospice can be offered in a patient’s home or ...

  9. Are cosmetics used in developing countries safe? Use and dermal irritation of body care products in jimma town, southwestern ethiopia.

    PubMed

    Amasa, Wayessa; Santiago, Dante; Mekonen, Seblework; Ambelu, Argaw

    2012-01-01

    Background. Rabbit skin model was used to test skin irritation of the most commonly used cosmetic products in Jimma town, southwestern Ethiopia. The most commonly used cosmetics were Dove, Glysolid, College, Top Society, Fair and Lovely, Nivea, Lux, Magic fruit world, Solea, Body talk, Kris, Holly, Victoria, and Sweet Heart. Methods. Intact and abraded rabbit skins were tested for erythema and edema under shade and under sun exposure. Draize Primary Irritation Index (PII) was used to calculate skin irritation of each cosmetic. Cosmetic ingredients were analyzed from the labels. Results and Discussion. Only Dove cream caused no skin irritation except for an abraded skin under sun exposure for five consecutive days. It has been identified that application of cosmetics on abraded skin under sunny condition worsens the irritation. Cosmetic labels revealed that most ingredients used in all products were those restricted chemicals due to their adverse health effects. Conclusion. This study has concluded that use of cosmetics under sunshine and also on abraded skin increases skin irritation. Hence, those users who have abraded skin are advised not to apply those cosmetics on continuous basis specifically under sun exposure. PMID:23209460

  10. Are Cosmetics Used in Developing Countries Safe? Use and Dermal Irritation of Body Care Products in Jimma Town, Southwestern Ethiopia

    PubMed Central

    Amasa, Wayessa; Santiago, Dante; Mekonen, Seblework; Ambelu, Argaw

    2012-01-01

    Background. Rabbit skin model was used to test skin irritation of the most commonly used cosmetic products in Jimma town, southwestern Ethiopia. The most commonly used cosmetics were Dove, Glysolid, College, Top Society, Fair and Lovely, Nivea, Lux, Magic fruit world, Solea, Body talk, Kris, Holly, Victoria, and Sweet Heart. Methods. Intact and abraded rabbit skins were tested for erythema and edema under shade and under sun exposure. Draize Primary Irritation Index (PII) was used to calculate skin irritation of each cosmetic. Cosmetic ingredients were analyzed from the labels. Results and Discussion. Only Dove cream caused no skin irritation except for an abraded skin under sun exposure for five consecutive days. It has been identified that application of cosmetics on abraded skin under sunny condition worsens the irritation. Cosmetic labels revealed that most ingredients used in all products were those restricted chemicals due to their adverse health effects. Conclusion. This study has concluded that use of cosmetics under sunshine and also on abraded skin increases skin irritation. Hence, those users who have abraded skin are advised not to apply those cosmetics on continuous basis specifically under sun exposure. PMID:23209460

  11. Fusarium spp. is able to grow and invade healthy human nails as a single source of nutrients.

    PubMed

    Galletti, J; Negri, M; Grassi, F L; Kioshima-Cotica, É S; Svidzinski, T I E

    2015-09-01

    Onychomycosis caused by Fusarium spp. is emerging, but some factors associated with its development remain unclear, such as whether this genus is keratinolytic. The main aim of the present study was to evaluate the ability of Fusarium to use the human nail as a single source of nutrients. We also performed an epidemiological study and antifungal susceptibility testing of Fusarium spp. that were isolated from patients with onychomycosis. The epidemiological study showed that Fusarium species accounted for 12.4 % of onychomycosis cases, and it was the most common among nondermatophyte molds. The most frequent species identified were F. oxysporum (36.5 %), F. solani (31.8 %), and F. subglutinans (8.3 %). Fluconazole was not active against Fusarium spp., and the response to terbinafine varied according to species. Fusarium was able to grow in vitro without the addition of nutrients and invade healthy nails. Thus, we found that Fusarium uses keratin as a single source of nutrients, and the model proposed herein may be useful for future studies on the pathogenesis of onychomycosis. PMID:26007318

  12. Implementation of boundary conditions in modeling the femur is critical for the evaluation of distal intramedullary nailing.

    PubMed

    Bayoglu, Riza; Okyar, A Fethi

    2015-11-01

    In previous numerical and experimental studies of the intramedullary nail-implanted human femur several simplifications to model the boundary and loading conditions during pre-clinical testing have been proposed. The distal end of the femur was fixed in the majority of studies dealing with the biomechanics of the lower extremity, be it numerical or experimental, which resulted in obviously non-physiological deflections. Per contra, Speirs et al. (2007) proclaimed physiological deflections as a result of constraining the femur in a novel statically determinate fashion in combination with using a complex set of muscle forces. In tandem with this, we have shown that not only the deflections but also the stress and strain predictions turn out to be much lower in magnitude, as a result of using the latter approach. To illustrate the dramatic change in results, we compared these results with those of two other models employing commonly used boundary and loading conditions in retrograde stabilization of a distal diaphyseal fracture. The model used herewith resulted in more realistic femoral cortical strains, lower stresses on both the nail and the screws, as well as such deflections in the overall structure. PMID:26341599

  13. High refractive index immersion liquid for super-resolution 3D imaging using sapphire-based aNAIL optics

    E-print Network

    Laskar, Junaid M; Herminghaus, Stephan; Daniels, Karen E; Schröter, Matthias

    2015-01-01

    Optically-transparent immersion liquids with refractive index (n ~ 1.77) to match sapphire-based aplanatic numerical aperture increasing lens (aNAIL) are necessary for achieving deep 3D imaging with high spatial resolution. We report that antimony tribromide (SbBr$_{3}$) salt dissolved in liquid diiodomethane (CH$_{2}$I$_{2}$) provides a new high refractive index immersion liquid for optics applications. The refractive index is tunable from n = 1.74 (pure) to n = 1.873 (saturated), by adjusting either salt concentration or temperature; this allows it to match (or even exceed) the refractive index of sapphire. Importantly, the solution gives excellent light transmittance in the ultraviolet to near-infrared range, an improvement over commercially-available immersion liquids. This refractive index matched immersion liquid formulation has enabled us to develop a sapphire-based aNAIL objective that has both high numerical aperture (NA = 1.17) and long working distance (WD = 12 mm). This opens up new possibilities ...

  14. Mechanical failures after fixation with proximal femoral nail and risk factors

    PubMed Central

    Koyuncu, ?emmi; Altay, Ta?k?n; Kayal?, Cemil; Ozan, F?rat; Yamak, Kamil

    2015-01-01

    Background This study aims at assessing the clinical results, radiographic findings, and associated complications after osteosynthesis of trochanteric hip fractures with proximal femoral nail (PFN). Methods A total of 152 patients with hip fractures who underwent osteosynthesis with PFN were included. The hip fracture types in the patients included in the study were classified according to the American Orthopedic/Orthopedic Trauma Association (AO/OTA). AO/OTA A1, A2, and A3 type fractures were found in 24 (15.8%), 107 (70.4%), and 21 (13.8%) patients, respectively. The Baumgaertner scale was used to assess the degree of postoperative reduction. The Salvati–Wilson hip function (SWS) scoring system was used to evaluate functional results. After a follow-up period, clinical and radiographic results were evaluated and complications were assessed. The relationship between the complications and SWS score, age, sex, fracture type, reduction quality, and time from the fracture to surgery was evaluated. Results Eighty-five (55.9%) female patients and 67 (44.1%) male patients were enrolled in the study. Seventy-nine (51.9%) patients had left hip fractures, and 73 (48.1%) had right hip fractures. The mean age was 76 (range 21–93) years, and the mean follow-up duration was 23.6 (range 7–49) months. Postoperatively, one patient (0.6%) had a poor reduction, 16 patients (10.5%) had an acceptable reduction, and 135 patients (88.9%) had a good reduction according to the above criteria. The SWS scores were excellent, good, moderate, and poor in 91 (59.8%), 45 (29.6%), 15 (9.8%), and one (0.6%) patients, respectively. Late postoperative complications were seen in 27 patients (17.7%). A total of 14 patients (9.2%) underwent a revision procedure for mechanical complications. Conclusion The study results suggest that the quality of fracture reduction is an important factor that affects the revision rate and SWS score in patients with mechanical complications after osteosynthesis with PFN for trochanteric fractures. PMID:26719682

  15. APPLICATION OF U.S. EPA METHODS TO THE ANALYSIS OF PHARMACEUTICALS AND PERSONAL CARE PRODUCTS IN THE ENVIRONMENT: DETERMINATION OF CLOFIBRIC ACID IN SEWAGE EFFLUENT BY GC-MS

    EPA Science Inventory

    An emerging area of research concerns pharmaceuticals and personal care products in the
    environment and their possible impact on biota and ecosystems. The long term effects of
    constant perfusion of PPCPs into the aquatic environment are presently unknown. Some
    compoun...

  16. What is palliative care?

    MedlinePLUS

    Comfort care; End of life - palliative care; Hospice - palliative care ... Both palliative care and hospice care provide comfort. But palliative care can begin at diagnosis, and at the same time as treatment. Hospice care begins ...

  17. HUMAN NAILS AS A BIOMARKER OF ARSENIC EXPOSURE FROM WELL WATER IN AN INNER MONGOLIAN POPULATION: COMPARING ATOMIC FLUORESCENSE SPECTROMETRY AND NEUTRON ACTIVATION ANALYSIS

    EPA Science Inventory

    Arsenic (As) is found naturally in the geological strata within the Ba Men Region of West Central Inner Mongolia, China. Residents here have been chronically exposed to a wide range of drinking water As levels for more than 20 years. Nails and drinking water samples were collec...

  18. Comparison of the antifungal efficacy of terbinafine hydrochloride and ciclopirox olamine containing formulations against the dermatophyte Trichophyton rubrum in an infected nail plate model.

    PubMed

    Täuber, Anja; Müller-Goymann, Christel C

    2014-07-01

    Onychomycosis is a fungal infection mostly induced by dermatophytes such as Trichophyton rubrum. Due to slow nail growth, the treatment takes 3-9 months depending on the nail size and infected area. Hence, high efficacy of the active ingredient without systemic side effects is of major interest. To test the efficacy of an antifungal formulation, an appropriate in vitro model reflecting the in vivo situation as close as possible is required. In this study, a variety of antifungal formulations, i.e., commercial ones (Ciclopoli and Lamisil cream), those used in compounding pharmacies (Pentravan) as well as poloxamer 407-based systems, have been evaluated in an infected nail plate model. The active pharmaceutical ingredients (APIs) were ciclopirox olamine and terbinafine hydrochloride. The poloxamer 407-based formulations consisted of poloxamer 407, double distilled water, propylene glycol, isopropyl alcohol, medium chain triglycerides and either 1% ciclopirox olamine or 1% terbinafine hydrochloride as API, respectively. Former studies have shown high permeation rates of terbinafine hydrochloride from similar poloxamer 407-based formulations with dimethyl isosorbide instead of propylene glycol. The present contribution shows superior inhibition of T. rubrum growth from poloxamer 407-based formulations in comparison to the commercial Lamisil cream. Moreover, poloxamer 407-based formulations were equally effective as the nail lacquer Ciclopoli even though the poloxamer formulations contained only 1% of the drug instead of 8% in the marketed lacquer. Poloxamer 407-based systems containing ciclopirox olamine proved to be about as effective as similar terbinafine hydrochloride systems. PMID:24490976

  19. Will disruptive innovations cure health care?

    PubMed

    Christensen, C M; Bohmer, R; Kenagy, J

    2000-01-01

    It's no secret that health care delivery is convoluted, expensive, and often deeply dissatisfying to consumers. But what is less obvious is that a way out of this crisis exists. Simpler alternatives to expensive care are already here--everything from $5 eyeglasses that people can use to correct their own vision to angioplasty instead of open-heart surgery. Just as the PC replaced the mainframe and the telephone replaced the telegraph operator, disruptive innovations are changing the landscape of health care. Nurse practitioners, general practitioners, and even patients can do things in less-expensive, decentralized settings that could once be performed only by expensive specialists in centralized, inconvenient locations. But established institutions--teaching hospitals, medical schools, insurance companies, and managed care facilities--are fighting these innovations tooth and nail. Instead of embracing change, they're turning the thumbscrews on their old processes--laying off workers, delaying payments, merging, and adding layers of overhead workers. Not only is this at the root of consumer dissatisfaction with the present system, it sows the seeds of its own destruction. The history of disruptive innovations tells us that incumbent institutions will be replaced with ones whose business models are appropriate to the new technologies and markets. Instead of working to preserve the existing systems, regulators, physicians, and pharmaceutical companies need to ask how they can enable more disruptive innovations to emerge. If the natural process of disruption is allowed to proceed, the result will be higher quality, lower cost, more convenient health care for everyone. PMID:11143147

  20. Occurrence and behavior of pharmaceuticals, steroid hormones, and endocrine-disrupting personal care products in wastewater and the recipient river water of the Pearl River Delta, South China.

    PubMed

    Yu, Yiyi; Huang, Qiuxin; Wang, Zhifang; Zhang, Kun; Tang, Caiming; Cui, Jianlan; Feng, Jialiang; Peng, Xianzhi

    2011-04-01

    The occurrence and behavior of ?-blockers, antiepileptic drug carbamazepine and its metabolites, X-ray contrast agent iopromide, natural and synthetic hormones, and several groups of hormone-like personal care products (PCPs), including antiseptics (triclocarban, triclosan, and 2-phenylphenol), parabens and bisphenol A, were investigated in municipal wastewater, sewage sludge, and urban river water of the Pearl River Delta, South China. The pharmaceuticals, natural hormones and PCPs were ubiquitously detected in the raw wastewater from a sewage treatment plant (STP). Only triclocarban and triclosan were detected at significant amounts in the dewatered sludge. Iopromide and the PCPs were greatly removed/transformed from the aqueous phase of the wastewater. The ?-blockers were only moderately removed/transformed. Carbamazepine passed through the STP almost unchanged. Biodegradation was the dominant process for elimination/transformation of the pharmaceuticals, hormones, and most PCPs in the STP. However, sorption also played an important role in the fate of triclocarban with nearly 50% of the mass load entering the STP ended up and persisted in the dewatered sludge. The pharmaceuticals, estrone, and PCPs were also widely detected in the Pearl River at Guangzhou. Bisphenol A had the highest concentration. The pharmaceutical concentrations in the Pearl River were higher in March than in May, most likely due to less dilution by lower precipitation. The omnipresence and high levels of the pharmaceuticals and PCPs in the Pearl River may be associated with direct discharge of untreated wastewater and pose potential risks to the ecological system. PMID:21424011

  1. Determination of endocrine-disrupting phenols, acidic pharmaceuticals, and personal-care products in sewage by solid-phase extraction and gas chromatography-mass spectrometry.

    PubMed

    Lee, Hing-Biu; Peart, Thomas E; Svoboda, M Lewina

    2005-11-11

    The occurrence, fate, and effects of phenols with endocrine-disrupting properties as well as some pharmaceuticals and personal-care products in the environment have frequently been discussed in recent literature. In many cases, these compounds were determined by using individual methods which can be time-consuming if results for multiple parameters are required. Using a solid-phase extraction procedure with an anion exchanger in this work, we have developed and optimized a multi-residue method for the extraction of 21 phenols and acids in sewage influent and effluent. The phenols and acids were then selectively eluted in separate fractions and were converted into pentafluoropropionyl (PFP) and tert-butyldimethylsilyl (TBDMS) derivatives, respectively, for gas chromatography-mass spectrometric (GC/MS) determination. When applied to the sewage samples under study, the results for nonylphenol, bisphenol A (BPA), triclosan (TCS), 17ss-estradiol (E2), estrone (E1), salicylic acid, ibuprofen, naproxen, diclofenac, and a few other acidic drugs were consistent with those determined previously by individual methods. Using the same procedure, we also report, for the first time, the occurrence of 2-phenylphenol and parabens in those sewage samples. PMID:16257298

  2. Increased Interleukin-4 production by CD8 and gammadelta T cells in health-care workers is associated with the subsequent development of active tuberculosis.

    PubMed

    Ordway, Diane J; Costa, Leonor; Martins, Marta; Silveira, Henrique; Amaral, Leonard; Arroz, Maria J; Ventura, Fernando A; Dockrell, Hazel M

    2004-08-15

    We evaluated immune responses to Mycobacterium tuberculosis in 10 health-care workers (HCWs) and 10 non-HCWs and correlated their immune status with the development of active tuberculosis (TB). Twenty individuals were randomly recruited, tested, and monitored longitudinally for TB presentation. Peripheral blood mononuclear cells (PBMCs) from donors were stimulated with M. tuberculosis and tested for cell proliferation and the production of interferon (IFN)- gamma, interleukin (IL)-5, and IL-4, by use of enzyme-linked immunosorbent or flow-cytometric assays. HCWs had higher levels of cell proliferation (24,258 cpm) and IFN- gamma (6373 pg/mL) to M. tuberculosis than did non-HCWs (cell proliferation, 11,462 cpm; IFN- gamma, 3228 pg/mL). Six of 10 HCWs showed increased median percentages of CD8+IL-4+ (4.7%) and gammadelta +IL-4+ (2.3%) T cells and progressed to active TB. HCWs who remained healthy showed increased median percentages of CD8+IFN- gamma+ (25.0%) and gammadelta +IFN- gamma+ (8.0%) and lower percentages of CD8+IL-4+ (0.05%) and gammadelta +IL-4+ (0.03%) T cells. PMID:15272404

  3. Fibular fixation as an adjuvant to tibial intramedullary nailing in the treatment of combined distal third tibia and fibula fractures: a biomechanical investigation

    PubMed Central

    Morin, Paul M.; Reindl, Rudolf; Harvey, Edward J.; Beckman, Lorne; Steffen, Thomas

    2008-01-01

    Objective Distal third tibia fractures have classically been treated with standard plating, but intramedullary (IM) nailing has gained popularity. Owing to the lack of interference fit of the nail in the metaphyseal bone of the distal tibia, it may be beneficial to add rigid plating of the fibula to augment the overall stability of fracture fixation in this area. This study sought to assess the biomechanical effect of adding a fibular plate to standard IM nailing in the treatment of distal third tibia and fibula fractures. Methods Eight cadaveric tibia specimens were used. Tibial fixation consisted of a solid titanium nail locked with 3 screws distally and 2 proximally, and fibular fixation consisted of a 3.5 mm low-contact dynamic compression plate. A section of tibia and fibula was removed. Testing was accomplished with an MTS machine. Each leg was tested 3 times; with and without a fibular plate and with a repetition of the initial test condition. Vertical displacements were tested with an axial load up to 500 N, and angular rotation was tested with torques up to 5 N•m. Results The difference in axial rotation was the only statistically significant finding (p = 0.003), with fibular fixation resulting in 1.1° less rotation through the osteotomy site (17.96° v. 19.10°). Over 35% of this rotational displacement occurred at the nail–locking bolt interface with the application of small torsional forces. Conclusion Fibular plating in addition to tibial IM fixation of distal third tibia and fibula fractures leads to slightly increased resistance to torsional forces. This small improvement may not be clinically relevant. PMID:18248705

  4. Elastic Stable Intramedullary Nailing (ESIN), Orthoss® and Gravitational Platelet Separation - System (GPS®): An effective method of treatment for pathologic fractures of bone cysts in children

    PubMed Central

    2011-01-01

    Background The different treatment strategies for bone cysts in children are often associated with persistence and high recurrence rates of the lesions. The safety and clinical outcomes of a combined mechanical and biological treatment with elastic intramedullary nailing, artificial bone substitute and autologous platelet rich plasma are evaluated. Methods From 02/07 to 01/09 we offered all children with bone cysts the treatment combination of elastic intramedullary nailing (ESIN), artificial bone substitute (Orthoss®) and autologous platelet rich plasma, concentrated by the Gravitational Platelet Separation (GPS®) - System. All patients were reviewed radiologically for one year following the removal of the intramedullary nailing, which was possible because of cyst obliteration. Results A cohort of 12 children (4 girls, 8 boys) was recruited. The mean patient age was 11.4 years (range 7-15 years). The bone defects (ten humeral, two femoral) included eight juvenile and four aneurysmal bone cysts. Five patients suffered from persistent cysts following earlier unsuccessful treatment of humeral bone cyst after pathologic fracture; the other seven presented with acute pathologic fractures. No peri- or postoperative complications occurred. The radiographic findings showed a total resolution of the cysts in ten cases (Capanna Grade 1); in two cases a small residual cyst remained (Capanna Grade 2). The intramedullary nails were removed six to twelve months (mean 7.7) after the operation; in one case, a fourteen year old boy (Capanna Grade 2), required a further application of GPS® and Orthoss® to reach a total resolution of the cyst. At follow-up (20-41 months, mean 31.8 months) all patients showed very good functional results and had returned to sporting activity. No refracture occurred, no further procedure was necessary. Conclusions The combination of elastic intramedullary nailing, artificial bone substitute and autologous platelet rich plasma (GPS®) enhances the treatment of bone cysts in children, with no resulting complications. PMID:21314981

  5. Day Care.

    ERIC Educational Resources Information Center

    Merro, John; And Others

    Interviews on the quality of day care in the United States are presented in this transcript of a program broadcast in the National Public Radio weekly series, "Options in Education." Writers, day care center personnel and others describe and evaluate the current situation. Federal legislation concerning children is examined, and researchers…

  6. Multiple self-inserted pins and nails in pericardium in a patient of schizophrenia: Case report and review

    PubMed Central

    Soren, S.; Surjit; Chaudhury, S.; Bakhla, A. K.

    2015-01-01

    This report is the case of multiple self-inserted pins and nails in chest and pericardial cavity in a young male suffering from schizophrenia. This act of self-mutilation was done to get relief from burning sensation in chest and palpitations. Review of the relevant literature revealed that self-inflicted intra-cardiac needle injuries occur mainly in young and middle-aged adults suffering from psychiatric disorders, commonly depression, schizophrenia, and substance use disorders. In one-fourth of the patients, it is due to deliberate self-harm. About 70% use a single needle but 30% may use multiple needles. Second attempts are rare. Majority of the patients (85%) are managed by surgery and recover from the injury. The condition has a low mortality rate of 5%. PMID:26257490

  7. Promoting and maintaining or restoring healthy nails: practical recommendations for clinicians and patients.

    PubMed

    Pariser, David; Scher, Richard K; Elewski, Boni; Rich, Phoebe

    2013-06-01

    The American Academy of Dermatology guidelines for managing patients with onychomycosis, published almost 2 decades ago, provide sound, basic recommendations for clinicians. This article provides a quick reference for clinicians and includes a handout for patients to support the health care provider's educational efforts. PMID:24156163

  8. Big data in health care.

    PubMed

    Schouten, Pieter

    2013-02-01

    By identifying and applying advanced revenue cycle analytics, healthcare providers can: Free up cash. Find new revenues without harming core services. Improve productivity, profitability, and patient care. PMID:23413667

  9. Monitoring Outpatient Care

    NASA Technical Reports Server (NTRS)

    2003-01-01

    Each year, health care costs for managing chronically ill patients increase as the life expectancy of Americans continues to grow. To handle this situation, many hospitals, doctors practices, and home care providers are turning to disease management, a system of coordinated health care interventions and communications, to improve outpatient care. By participating in daily monitoring programs, patients with congestive heart failure, chronic obstructive pulmonary disease, diabetes, and other chronic conditions requiring significant self-care are facing fewer emergency situations and hospitalizations. Cybernet Medical, a division of Ann Arbor, Michigan-based Cybernet Systems Corporation, is using the latest communications technology to augment the ways health care professionals monitor and assess patients with chronic diseases, while at the same time simplifying the patients interaction with technology. Cybernet s newest commercial product for this purpose evolved from research funded by NASA, the National Institute of Mental Health, and the Advanced Research Projects Agency. The research focused on the physiological assessment of astronauts and soldiers, human performance evaluation, and human-computer interaction. Cybernet Medical's MedStar Disease Management Data Collection System is an affordable, widely deployable solution for improving in-home-patient chronic disease management. The system's battery-powered and portable interface device collects physiological data from off-the-shelf instruments.

  10. [Simultaneous determination of 18 pharmaceuticals and personal care products in surface water by ultra-high performance liquid chromatography-tandem mass spectrometry].

    PubMed

    Zhu, Saichang; Wang, Jing; Shao, Weiwei; Chen, Hong

    2013-01-01

    An analytical method has been developed and validated for the simultaneous determination of 18 pharmaceuticals and personal care products (PPCPs), including antibiotics (trimethoprim, erythromycin x 2H2O, norfloxacin, ofloxacin, pencilline G, penicillin V potassium salt, cephalexin and sulfamethoxazole), beta-bloker (atenolol), anophelifuge (N, N-diethyl-3-methylbenzoylamide, DEET), antiepileptics (carbamazepine), central nervous system stimulant (caffeine), lipid modifying agent (clofibric acid), non-steroidal anti-inflammatory drugs (ibuprofen, naproxen and diclofenac sodium salt) and antimicrobial agents (triclosan and triclocarban). The detection and qualification of the target compounds were performed by ultra-high performance liquid chromatography-tandem mass spectrometry. The optimized mobile phases were methanol as organic phase, 0. 3% (v/v) formic acid-5 mmol/L ammonium acetate for positive electrospray ionization (ESI+) and 5 mmol/L ammonium acetate for ESI- as inorganic phase. Water samples were concentrated by solid phase extraction at 2 mL/min, and all the target PPCPs were efficiently extracted at pH 7. The extracted PPCPs were eluted by the mixture of methanol and acetonitrile (1 : 1, v/v). The average recoveries of the target compounds in the spiked pure water samples ranged from 53.9% - 112%. The average recoveries of the target compounds ranged from 45.1% - 156.6% with the relative standard deviations ranged from 2.4% - 15.7%, in the surface water samples spiked at 100 ng/L. The surface water samples collected from Yu Hangtang River in Hangzhou were detected. The results showed that nine PPCPs were detected including caffeine that reached a maximum concentration of 550.7 ng/L. It proved that this analytical method is reliable and acceptable. PMID:23667984

  11. Pharmaceuticals and personal care products in untreated and treated sewage sludge: Occurrence and environmental risk in the case of application on soil - A critical review.

    PubMed

    Verlicchi, P; Zambello, E

    2015-12-15

    This review is based on 59 papers published between 2002 and 2015, referring to about 450 treatment trains providing data regarding sludge concentrations for 169 compounds, specifically 152 pharmaceuticals and 17 personal care products, grouped into 28 different classes. The rationale of the study is to provide data to evaluate the environmental risk posed by the spreading of treated sludge in agriculture. Following discussion of the legislative scenario governing the final disposal of treated sludge in European countries and the USA, the study provides a snapshot of the occurrence of selected compounds in primary, secondary, mixed, digested, conditioned, composted and dried sludge originating in municipal wastewater treatment plants fed mainly with urban wastewater as well as in sludge-amended soil. Not only are measured values reported, but also predicted concentrations based on Kd values are reported. It emerges that in secondary sludge, the highest concentrations were found for fragrances, antiseptics and antibiotics and an attenuation in their concentrations occurs during treatment, in particular anaerobic digestion and composting. An in-depth literature survey of the (measured and predicted) Kd values for the different compounds and treated sludge are reported and an analysis of the influence of pH, redox conditions, sludge type was carried out. The data regarding measured and predicted concentrations of selected compounds in sludge-amended soil is then analyzed. Finally an environmental risk assessment posed by their occurrence in soil in the case of land application of sludge is examined, and the results obtained by different authors are compared. The most critical compounds found in the sludge-amended soil are estradiol, ciprofloxacin, ofloxacin, tetracycline, caffeine, triclosan and triclocarban. The study concludes with a focus on the main issues that should be further investigated in order to refine the environmental risk assessment. PMID:26327643

  12. Pharmaceuticals and personal care products in effluent matrices: A survey of transformation and removal during wastewater treatment and implications for wastewater management.

    PubMed

    Oulton, Rebekah L; Kohn, Tamar; Cwiertny, David M

    2010-11-01

    Pharmaceuticals and personal care products (PPCPs) represent pollutants of emerging concern, originating in surface and drinking waters largely from their persistence in wastewater effluent. Accordingly, a wealth of recent investigations has examined PPCP fate during wastewater treatment, focusing on their removal during conventional (e.g., activated sludge) and advanced (e.g., ozonation and membrane filtration) treatment processes. Here, we compile nearly 1500 data points from over 40 published sources pertaining to influent and effluent PPCP concentrations measured at pilot- and full-scale wastewater treatment facilities to identify the most effective series of technologies for minimizing effluent PPCP levels. Available data suggest that at best a 1-log(10) concentration unit (90%) of PPCP removal can be achieved at plants employing only primary and secondary treatment, a performance trend that is maintained over the range of reported PPCP influent concentrations (ca. 0.1-10(5) ng L(-1)). Relatively few compounds (15 of 140 PPCPs considered) are consistently removed beyond this threshold at facilities using solids removal and conventional activated sludge (CAS), and most PPCPs are removed to a far lesser extent. Further, increases in CAS hydraulic retention time or sludge retention time do not appreciably increase removal beyond this limit. In contrast, plants employing advanced treatment methodologies, particularly ozonation and/or membranes, remove the vast majority of PPCPs beyond 1-log(10) concentration unit and oftentimes to levels below analytical detection limits in effluent. Data also indicate that passive approaches for tertiary treatment (e.g., wetlands and lagoons) represent promising options for PPCP removal. We conclude by addressing future challenges and frontiers in wastewater management posed by PPCPs including analytical needs for their real-time measurement, energy demands associated with advanced treatment technologies, and byproducts arising from transformation of PPCPs during treatment. PMID:20938541

  13. Evaluating the treatment of a synthetic wastewater containing a pharmaceutical and personal care product chemical cocktail: compound removal efficiency and effects on juvenile rainbow trout.

    PubMed

    Osachoff, Heather L; Mohammadali, Mehrnoush; Skirrow, Rachel C; Hall, Eric R; Brown, Lorraine L Y; van Aggelen, Graham C; Kennedy, Christopher J; Helbing, Caren C

    2014-10-01

    Pharmaceutical and personal care products (PPCPs) can evade degradation in sewage treatment plants (STPs) and can be chronically discharged into the environment, causing concern for aquatic organisms, wildlife, and humans that may be exposed to these bioactive chemicals. The ability of a common STP process, conventional activated sludge (CAS), to remove PPCPs (caffeine, di(2-ethylhexyl)phthalate, estrone, 17?-ethinylestradiol, ibuprofen, naproxen, 4-nonylphenol, tonalide, triclocarban and triclosan) from a synthetic wastewater was evaluated in the present study. The removal of individual PPCPs by the laboratory-scale CAS treatment plant ranged from 40 to 99.6%. While the efficiency of removal for some compounds was high, remaining quantities have the potential to affect aquatic organisms even at low concentrations. Juvenile rainbow trout (Oncorhynchus mykiss) were exposed to influent recreated model wastewater with methanol (IM, solvent control) or with PPCP cocktail (IC), or CAS-treated effluent wastewater with methanol (EM, treated control) or with PPCP cocktail (EC). Alterations in hepatic gene expression (evaluated using a quantitative nuclease protection plex assay) and plasma vitellogenin (VTG) protein concentrations occurred in exposed fish. Although there was partial PPCP removal by CAS treatment, the 20% lower VTG transcript levels and 83% lower plasma VTG protein concentration found in EC-exposed fish compared to IC-exposed fish were not statistically significant. Thus, estrogenic activity found in the influent was retained in the effluent even though typical percent removal levels were achieved raising the issue that greater reduction in contaminant load is required to address hormone active agents. PMID:24963889

  14. Investigation of pharmaceuticals, personal care products and endocrine disrupting chemicals in a tropical urban catchment and the influence of environmental factors.

    PubMed

    You, Luhua; Nguyen, Viet Tung; Pal, Amrita; Chen, Huiting; He, Yiliang; Reinhard, Martin; Gin, Karina Yew-Hoong

    2015-12-01

    Previous studies showed the presence of multiple emerging organic contaminants (EOCs) in urban surface waters of Singapore even though there are no obvious direct wastewater discharges. In this study, we investigated the occurrence and distribution of 17 pharmaceuticals and personal care products (PPCPs) and endocrine disruptive compounds (EDCs) in a tropical urban catchment of Singapore. Monthly samples were collected from a reservoir and its 5 upstream tributaries during a 16-month period. Analysis of samples showed all sites had measurable PPCP and EDC concentrations, with caffeine (33.9-2980 ng/L), salicylic acid (5-838 ng/L), acetaminophen (<4-485.5 ng/L), BPA (<2-919.5 ng/L) and DEET (13-270 ng/L) being the most abundant. Marked differences in concentrations of target analytes between the reservoir and upstream tributaries were observed, and were tentatively attributed to the spatial differences in source inputs, water dilution capacity as well as natural attenuation of EOCs. Significant correlations between EOCs and conductivity, dissolved oxygen, chlorophyll a, turbidity, nutrients and cumulative precipitation were observed. These factors appeared to affect the distribution and attenuation of EOCs, depending on their physicochemical properties. Rainfall also influenced the temporal distribution of caffeine, BPA, triclosan, fipronil and DEET in the reservoir. Ecological risk assessment showed that caffeine, acetaminophen, estrone, BPA, triclosan and fipronil may warrant further survey. In particular, BPA levels exceeded the literature-based Predicted No-Effect Concentration (PNEC) value, highlighting the need for source control and/or water remediation in this urban catchment. PMID:26138904

  15. Occurrence and loss over three years of 72 pharmaceuticals and personal care products from biosolids-soil mixtures in outdoor mesocosms

    PubMed Central

    Walters, Evelyn; McClellan, Kristin; Halden, Rolf U.

    2010-01-01

    Municipal biosolids are in widespread use as additives to agricultural soils in the United States. Although it is well known that digested sewage sludge is laden with organic wastewater contaminants, the fate and behavior of micropollutants in biosolids-amended agricultural soils remain unclear. An outdoor mesocosm study was conducted in Baltimore, Maryland, to explore the fate of 72 pharmaceuticals and personal care products (PPCPs) over the course of three years in biosolids/soil mixtures (1:2) that were placed in plastic containers made from polyvinylchloride and kept exposed to ambient outdoor conditions. Of the 72 PPCPs tested for using EPA Method 1694, 15 were initially detected in the soil/biosolids mixtures at concentrations ranging from low parts-per-billion to parts-per-million levels. The antimicrobials triclocarban and triclosan showed the highest initial concentrations at 2715 and 1265 ?g kg?1, respectively. Compounds showing no discernable loss over three years of monitoring included diphenhydramine, fluoxetine, thiabendazole and triclocarban. The following half-life estimates were obtained for compounds showing first-order loss rates: azithromycin (408 – 990 d) carbamazepine (462 – 533 d), ciprofloxacin (1155 – 3466 d), doxycycline (533 – 578 d), 4-epitetracycline (630 d), gemfibrozil (224 – 231 d), norfloxacin (990 – 1386 d), tetracycline (578 d), and triclosan (182 – 193 d). Consistent with other outdoor degradation studies, chemical half-lives determined empirically exceeded those reported from laboratory studies or predicted from fate models. Study results suggest that PPCPs shown in the laboratory to be readily biotransformable can persist in soils for extended periods of time when applied in biosolids. This study provides the first experimental data on the persistence in biosolids-amended soils for ciprofloxacin, diphenhydramine, doxycycline, 4-epitetracycline, gemfibrozil, miconazole, norfloxacin, ofloxacin, and thiabendazole. PMID:20728197

  16. Single and combined toxicity of pharmaceuticals and personal care products (PPCPs) on the rainbow trout liver cell line RTL-W1.

    PubMed

    Schnell, Sabine; Bols, Niels C; Barata, Carlos; Porte, Cinta

    2009-07-26

    The toxicological implications of the presence of pharmaceuticals and personal care products (PPCPs) in the aquatic environment remain largely unknown. Acute toxicity tests have generally failed to detect the subtle action elicited by those compounds at environmentally relevant concentrations and they have often overlooked the fact that toxicity can be influenced by additive and synergistic effects. The aim of this study was to further assess the cytotoxicity of different pharmaceuticals and synthetic musks as well as their mixtures on the rainbow trout liver cell line RTL-W1. Eleven pharmaceuticals from different therapeutic classes (anti-inflammatory drugs, serotonin re-uptake inhibitors and lipid regulators) and five synthetic musks from the two major groups (nitro- and polycyclic musks) were selected for the study. Two fluorescent dyes were used to monitor cell viability. Among the tested compounds, estimated EC50s (effective concentration causing 50% decline of cell viability) denoted that polycyclic musks (7-25 microM) followed by anti-depressives (7-50 microM) showed the highest potential to induce cytotoxicity, whereas lipid regulators (20-380 microM), anti-inflammatory drugs (160-260 microM) and nitromusks (100-240 microM) had the lowest toxicity. Within a given therapeutic class, combined toxicity of mixtures was additive, following in most cases the concentration addition concept. However, the combined toxicity was higher than additive for those mixtures that included one compound from each class (i.e. dissimilar mixtures). Overall, this study shows that in the aquatic environment, toxicity of PPCPs on non-target organisms may occur at concentrations lower than expected due to synergistic effects between the different toxicants. PMID:19500862

  17. Seasonal occurrence, removal, mass loading and environmental risk assessment of 55 pharmaceuticals and personal care products in a municipal wastewater treatment plant in Central Greece.

    PubMed

    Papageorgiou, Myrsini; Kosma, Christina; Lambropoulou, Dimitra

    2016-02-01

    A comprehensive study, which contains the seasonal occurrence, removal, mass loading and environmental risk assessment of 55 multi-class pharmaceuticals and personal care products (PPCPs), took place in the wastewater treatment plant (WWTP) of Volos, Greece. A one year monitoring study was performed and the samples were collected from the influent and the effluent of the WWTP. Solid phase extraction was used for the pre-concentration of the samples followed by an LC-DAD-ESI/MS analysis. Positive samples were further confirmed by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). The maximum concentrations of the PPCPs varied between 21ng/L and 15,320ng/L in the influents and between 18ng/L and 9965ng/L in the effluents. The most commonly detected PPCPs were the diuretic furosemide, the beta-blockers atenolol and metoprolol, the analgesics paracetamol, nimesulide, salicylic acid and diclofenac and the psychomotor stimulant caffeine. The removal efficiencies ranged between negative and high removal rates, demonstrating that the WWTP is not able to efficiently remove the complex mixture of PPCPs. The estimated mass loads ranged between 5.1 and 3513mg/day/1000 inhabitants for WWTP influent and between 4.1 to 2141mg/day/1000 inhabitants for WWTP effluent. Finally, environmental risk assessment has been regarded a necessary part of the general research. According to the results produced from the calculation of the risk quotient on three trophic levels, the anti-inflammatory drug diclofenac and the antibiotics, trimethoprim and ciprofloxacin, identified to be of high potential environmental risk for acute toxicity, while diclofenac also for chronic toxicity. PMID:26613513

  18. Treatment of Trochanteric Fractures with the Gamma3 Nail - Methodology and Early Results of a Prospective Consecutive Monitored Clinical Case Series

    PubMed Central

    A.C, Unger; E, Wilde; B, Kienast; C, Jürgens; A. P, Schulz

    2014-01-01

    Objectives: There is only sparse data on clinical results and complications of the third-generation Gamma nailing system (Gamma3, Stryker). Therefore, we started a large multi-centre case series in 2008. The aim of this paper is to present the study design and early results of a single arm of a prospective, consecutive, monitored, post-market follow-up evaluation of Gamma3 nails. Methods: From September 2009 to January 2012, 154 consecutive patients with an average age of 80 ± 1.43 years (50-99 years) and a trochanteric femoral fracture were included in the local arm of the trial. All patients that fulfilled the inclusion criteria were treated with a Gamma3 nail. Preoperative variables included age, gender, fracture classification, walking ability (Merle d’Aubigné score), daily activity level (retrospective Zuckerman score), ASA rating of operative risk, waiting time for operation, use of walker or crutches and body mass index (BMI). Skin-to-skin time, fluoroscopy time, blood loss, intraoperative complications and device information were recorded for each patient. Follow-up postoperative assessment was undertaken at 4, 12 and 24 months. Hip range of motion, pain around the hip and the tight, walking ability (Merle d’Aubigné score, Sahlgrenska mobility score) and management of daily life (Zuckerman score) were used to evaluate the outcome. Results: The descriptive data of age, gender, BMI, ASA classification, fracture type and skin-to-skin time is similar to other studies. Median fluoroscopy time was 62 seconds (range: 4-225 seconds) and significantly shorter in closed reductions. No intraoperative implant-related complication was recorded. A cut-out of the leg-screw during assessment period occurred in 2.6% patients (n = 4). At the 12-month assessment two (1.8%) non-unions were identified and two patients (1.8%) had broken the femoral shaft below the 180 mm nail after a fall. Analysis of the scores showed significantly declined mobility and activity in daily life four months after operation which increased significantly from four to 12 months and increased slightly between 12 and 24 months after fracture. Conclusion: A low implant-associated complication rate was achieved in geriatric patients with trochanteric femoral fractures using the Gamma3 nail. A better outcome concerning mobility, activity in daily life and complications compared to the Gamma2 nail could not be found in comparison to historic data. PMID:25621082

  19. Treatment of subtrochanteric fractures. A comparison of the Gamma nail and the dynamic hip screw: short-term outcome in 58 patients

    PubMed Central

    Saarenpää, I.; Heikkinen, T.

    2006-01-01

    The aim of this non-randomised prospective study was to evaluate the short-term outcome of Gamma nail and dynamic hip screw (DHS) fixation in the treatment of subtrochanteric hip fractures due to low-energy trauma in the elderly. All of the 1,624 femoral hip fractures in 1,511 patients of the Oulu Hospital, aged over 49 years, were prospectively registered from 1991?1999 using special forms. Seventy-three (4.5%) of the fractures were subtrochanteric. After exclusions, 58 patients constituted the final study group. Of these, 43 were treated with Gamma nails and 15 with DHS. Background factors before the fracture, complications, reoperations and functional parameters at 4 months were recorded using standardised forms. Intraoperative and hospital data were collected from patient records. The Seinsheimer fracture types IIIA, IIC and V were the most common fracture patterns when the Seinsheimer classification system was used, and Fielding II and AO 31A3.3, respectively, were the most common types in the Fielding and AO classification system. There were four (9%) intraoperative complications in the Gamma nail group as compared to none in the DHS group. On the other hand, postoperative complications were more common in the DHS group (27%) than in the Gamma nail group (7%). We recognised a correlation between certain fracture types and the likelihood of typical intra- or postoperative complications or difficulties with both devices: In Gamma nailing, difficulty in closed reduction as well as the rate of open reduction and the use of supplementary fixation were most frequent in the Seinsheimer IIC fractures. It is also noticeable that all of the postoperative device failures and fracture displacements of the DHS group occurred in the Seinsheimer type IIIA category. Detailed fracture classification is essential for the choice of the fixation device, and the present study confirms the presumption that, despite the perioperative problems associated with Gamma nailing, this technique may be preferable to plate fixation for specific fracture types with medial cortical comminution, such as Seinsheimer type IIIA. PMID:16633810

  20. Hospice Care

    MedlinePLUS

    ... a special program of care for terminally ill (dying) patients and their families. Rather than trying to ... to provide the best quality of life for dying patients by providing a holistic approach. That means ...