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PubMed1997

Rock-shells (Thais clavigera) as an indicator of As, Cu, and Zn contamination on the Putai Coast of the black-foot disease area in Taiwan.

This study presents the distribution of arsenic (As), copper (Cu), and zinc (Zn) in various seafoods-oysters (Crassostrea gigas), false fusus (Hemifuscus tuba), venus clams (Cyclina sineasis), green mussels (Perna viridis), blood clams (Arca granosa), flounders (Psettodes erumei), and rock-shells (Thais clavigera) collected from the Putai coast of the black-foot disease (BFD) area in Taiwan. Special attention is paid to evaluate the relationships among As, Cu, and Zn and effect of body size on metal concentration in Thais clavigera. Maximum Zn and Cu geometric mean (GM) concentrations (GM = 615 and 376 microg/g, dry wt, respectively) are found in oysters (Crassostrea gigas), and the values are much higher than those of the other organisms by about 1.7-208 and 1.8-375 times, respectively. Similarly, Thais clavigera has a high capacity for accumulating Cu and Zn collected from the same location. One interesting point is that relatively high As concentrations (GM = 65.7 microg/g, dry wt) in Thais clavigera are found as compared with those in other organisms (range from GM = 2.37 to 40.2 microg/g, dry wt). The As concentrations are significantly higher in Thais clavigera (1.62-27.7 times) than those in other organisms (p < 0.05), except for the false fusus (Hamifuscus tuba). A linear regression analysis shows a significant increase in Zn concentration with increasing Cu concentration in Thais clavigera. On the other hand, the As concentration is correlated with Cu and Zn concentrations (r = 0.77 and 0.77, respectively; p < 0.05) in Thais clavigera. Double logarithmic plots of metal content and concentration against dry-body weight and shell length show linear relationships. The result indicates that large individuals have higher contents of Cu, Zn and As, and have slopes of 1.58, 1.38, and 1.34, respectively. In addition, metal concentrations against shell length for all animal sizes also indicate that Cu, Zn and As have slopes of 1.92, 1.18, and 1.11, respectively. In conclusion, Thais clavigera has a high capactiy for accumulating As, Cu, and Zn and is a potential bioindicator for monitoring As, Cu and Zn.

Animals↗
PubMed2005

Interventions for foot disease in rheumatoid arthritis: a systematic review.

OBJECTIVE: To systematically review medical and surgical foot intervention studies in rheumatoid arthritis (RA), focusing on clinical efficacy, study quality, and risk of harm. METHODS: We searched appropriate databases using a combination of the terms "rheumatoid arthritis" and "foot" against terms indicating treatment; we also hand-searched references. We selected articles in English (1968-2003) comprising randomized controlled trials (RCTs), controlled clinical trials (CCTs), prospective observational studies, and large retrospective observational surgical studies (> 50 cases). RCT quality was examined using Jadad scoring; other designs were assessed qualitatively. RESULTS: Inclusion criteria were met by 33 of 894 identified studies, comprising 5 RCTs and 1 CCT (all nonsurgical), 15 prospective observational studies (8 nonsurgical, 7 surgical), and 12 large retrospective studies (all surgical). Functional, custom-designed and semirigid orthoses and extra-depth shoes were effective in single RCTs of variable quality; no comparative studies have been conducted. This finding was supported by a CCT and prospective observational studies. There was no evidence of harm. There were no controlled trials of surgery. Prospective observational studies suggest that forefoot arthroplasty and first metatarsophalangeal joint implants, but not plantar callous debridement, are effective. Comparative retrospective analyses suggest that some procedure variants may be better, and surgery may relieve pain better than orthoses. Infection was the main risk. CONCLUSION: RCT evidence shows that orthoses and special shoes are likely to be beneficial in patients with RA. The only evidence of benefit from surgery comes from observational studies, because no RCTs have been conducted. Further RCT evidence is needed, although well-designed observational studies may be helpful.

Arthritis, Rheumatoid↗
PubMed2004

Wound dressings in diabetic foot disease.

Wound dressings represent a part of the management of diabetic foot ulceration. Ideally, dressings should alleviate symptoms, provide wound protection, and encourage healing. No single dressing fulfills all the requirements of a diabetic patient with an infected foot ulcer. Dressings research in this area is generally poor. However, each category of dressings has particular characteristics that aid selection. Nonadhesive dressings are simple, inexpensive, and well tolerated. Foam and alginate dressings are highly absorbent and effective for heavily exuding wounds. Hydrogels facilitate autolysis and may be beneficial in managing ulcers containing necrotic tissue. Dressings containing inidine and silver may aid in managing wound infection. Occlusive dressings should be avoided for infected wounds. All dressings require frequent change for wound inspection. Heavily exudating ulcers require frequent change to reduce maceration of surrounding skin. Dressing choice should be guided by the characteristics of the ulcer, the requirements of the patient, and costs.

Bandages↗