Gutter treatment for ingrowing toenails.

The gutter treatment for ingrowing toenails consists of introducing a small guard along the side of the toenail and requires only three outpatient attendances. The gutter is left in place for eight to 12 weeks and then removed by the patient. Two studies were carried out to establish the long-term results of the method. In one, a preliminary retrospective study, 13 out of 25 patients who had received the gutter treatment were cured after one year compared with five out of 15 patients in whom the toenail had been avulsed. In a randomised prospective study 20 out of 36 patients (56%) treated by the gutter method were cured after one year compared with 27 out of 32 (84%) in whom the wedge resection procedure had been used. The gutter treatment demands little skill and may be carried out in general practice. It gives an excellent cosmetic result with immediate pain relief and does not compromise further surgery should this be required, thus fulfilling the main requirements for the primary treatment of choice.     

Dietary selenium in humans toenails as an indicator

Mounting laboratory and epidemiologic evidence suggests that selenium may be important in the etiology of both cancer and heart disease. We explored the use of hair and nails as indicators of selenium intake by measuring their selenium levels using neutron activation analysis, a highly sensitive and precise nondestructive technique. Levels in duplicate samples of nails, hair, and blood were all reasonably reproducible. However, selenium-containing shampoos severely contaminated some of the hair specimens, suggesting that use of hair in epidemiologic studies could be misleading. The mean selenium level in toenails from South Dakota (a known high selenium area) was 1.17 ppm (1SE = 0.09). This was significantly higher than mean levels from Boston and Georgia (medium selenium intake area) of 0.74 ppm (0.04) and 0.81 (0.03), respectively. The mean selenium level in toenails from New Zealand (low selenium area) was 0.26 (0.02) and these levels did not overlap those of other areas. The South Dakota specimens showed marked familial aggregation, probably reflecting dietary differences. Since toenails vary in length, clippings from different toes represent different time periods of formation; clippings from all ten toes reflect selenium levels integrated over an extended period. As toenails are easily collected, transported, and stored, and reflect longterm intake, they can be useful in epidemiologic studies of selenium and chronic disease.     

Ingrowing toenails: an evaluation of two treatments.

Most of the procedures used for treating ingrowing toenails cause considerable discomfort and have high failure rates. This study evaluated two methods of treatment: (a) a simple procedure, and (b) angular phenolisation. Patients were seen in a special toenail clinic and were assessed for severity and duration of symptoms. Those with no permanent deformity of the nail fold and with only minor infection were treated by the simple procedure. The nail was nicked and torn down to expose the infected nail fold. The patients were then taught to clean the area, spray it with povidone-iodine dry powder, and pack the nail fold with a twist of cotton-wool. Patients with recurrent or severe ingrowing toenails were treated by angular phenolisation. One hundred patients were treated by the simple procedure and 61 of these had had no recurrence after six months. A total of 280 phenolisations were carried out over 18 months and 272 were successful. The treatments described are simple, effective, and well tolerated and should be considered as alternatives to traditional treatment.     

Treatment of ingrowing toenails with liquid nitrogen spray cryotherapy.

Ingrowing toenails are a common debilitating condition and often require surgical intervention. In 44 patients liquid nitrogen spray cryotherapy produced a rate of success comparable with that of other nail sparing techniques but had the advantage of being a quick, simple, and cheap outpatient procedure that could be carried out with limited facilities and without anaesthesia.     

Profiles of trace elements in toenails of Arab-Americans in the Detroit area, Michigan

Exposure to environmental contaminants is complicated by factors related to socioeconomic status, diet, and other culturally conditioned risk behaviors. Determination of a trace element profile in toenails can be used as a tool in biomonitoring the exposure history or assessing the deficiency of a particular element in a study population, which can lead to a better understanding of environmental and disease risks. Toenail clippings from 259 Arab Americans (163 adults, 96 children) residing in a highly industrialized area were analyzed for Al, V, Cr, Mn, Co, Ni, Cu, As, Se, Mo, Cd, Ba, Tl, and Pb using an inductively coupled plasma-mass spectrometer. Mean concentrations were compared with published values, and the influence of age, gender, and other demographic factors were explored. Elevated levels of Ni in this population warrant further investigation. Significant differences in the mean concentration of Al, V, Cr, Mn, Cd, Pb, and Se exist between toenails of adults and children. Pearson correlation coefficients reveal strong significant associations among Cd, Cr, and Tl (p<0.05), in addition to other elements. These investigations provide insight into exposures and factors influencing exposures in this population while adding to the growing fund of knowledge surrounding use of toenails as a marker of exposure.     

Manganese in toenails is associated with hearing loss at high frequencies in humans

Purpose: Elevated hearing thresholds from high frequencies are known to be one of the hallmarks of age-related hearing loss. Our recent study showed accumulation of manganese (Mn) in inner ears resulting in acceleration of age-related hearing loss in mice orally exposed to Mn. However, there is no evidence showing an association between Mn in non-invasive biological samples and hearing loss in humans evaluated by pure tone audiometry (PTA). In this study, we evaluated Mn in non-invasive biological samples as a possible biomarker for hearing loss in humans.

Materials and methods: We determined hearing levels by PTA and Mn levels in toenails, hair and urine with an inductively coupled plasma mass spectrometer (ICP-MS) in 145 healthy subjects in Bangladesh.

Results: Multivariable analyses showed that Mn levels in toenails, but not in hair and urine samples, were significantly associated with hearing loss at 8?kHz and 12?kHz. Moreover, our experimental study showed a significant correlation between Mn levels in inner ears and nails, but not hair, in mice orally exposed to Mn.

Conclusions: The results provide novel evidence that Mn in toenails is a possible biomarker for hearing loss at high frequencies in humans.