Orientador: Juliano Vilaverde Schmitt / Resumo: Fundamentos: As unhas são anexos cutâneos queratinizados tendo um ritmo de crescimento de até 3 mm/mês nos quirodáctilos. Biotina é vitamina hidrossolúvel de fonte exógena, que provou aumentar a espessura da lâmina ungueal, sob regime de 2,5mg oral por 6-15 meses. O minoxidil tópico 5% 2x/dia, que tem ação comprovada no folículo piloso, foi pouco estudado na velocidade do crescimento ungueal. Não há estudos comparativos com biotina oral, ou de sua associação ao minoxidil tópico. Este estudo objetiva avaliar a eficácia do minoxidil tópico e biotina oral no aumento da velocidade de crescimento das unhas das mãos. Casuística e métodos: Ensaio clínico quasi-experimental com desenho fatorial, aberto e paralelo, envolvendo 37 voluntários adultos saudáveis, alocados em 4 grupos: controle, minoxidil 5% tópico 2x ao dia exclusivo, biotina 2,5mg oral exclusiva e uso combinado, que foram comparados quanto à velocidade do crescimento ungueal do 2o e 4o quirodáctilos, quanto ao status basal, após 14 e 28 dias de tratamento. Todos os indivíduos foram observados, sem intervenções, 14 dias após a inclusão, iniciando o tratamento após esse período, com duração de 28 dias, e reavaliações em 28 e 42 dias após a inclusão no estudo. A idade, sexo, dominância da mão, onicofagia dos pacientes foram levados em conta para comparação da velocidade de crescimento ungueal nos períodos de tratamento e no período sem intervenção, durante todo o estudo. Pré-tratamento, evidenciou-se crescimento basal mais ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Background: The nails are keratinized cutaneous attachments, their growth rate reaches up to 3 mm / month in the chirodactyls. Biotin is a water-soluble vitamin from an exogenous source that has been shown to increase the thickness of the nail plate under oral 2.5mg regimen for 6-15 months. Similarly to topical minoxidil 5% 2x / day, with proven action on the hair follicle, which has been poorly studied at the rate of nail growth. There are no comparative studies with oral biotin, or its association with other treatments. This study aims to evaluate the efficacy of topical minoxidil and oral biotin in increasing the growth velocity of fingernails. Methods: Quasi-experimental, factorial, open and parallel clinical trial involving 37 healthy adult volunteers, allocated into 4 groups: control, minoxidil 5% topical 2x daily exclusive, oral 2.5mg exclusive oral and combined use, which were compared for nail growth velocity of the 2nd and 4th chirodactyls, as to basal status, after 14 and 28 days of treatment. All subjects were observed without intervention for 14 days after inclusion, starting treatment after this period, lasting 28 days, and reassessments at 28 and 42 days after inclusion in the study. Patients' age, gender, hand dominance, onychophagy were taken into account when comparing nail growth velocity in the treatment and non-intervention periods throughout the study. Results: Pretreatment showed more pronounced basal growth in the dominant hands and among the onychopha... (Complete abstract click electronic access below) / Mestre

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A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / The (Surgical Implant Generation Network) SIGN Intramedullary (IM) nail is designed to fix long bone fractures without using a costly C‐arm imaging device. It is distributed for free to countries in need, allowing for elevation of care from the standard, lengthy traction treatment in those countries to clinically superior IM nailing. This paper compares the clinical outcomes of the SIGN IM nail to those of the IM nails used in developed countries with use of a C‐arm. The terms “Surgical Implant Generation Network” and “union” were searched in four databases. Primary studies of SIGN IM nails were included and their outcomes, including union rate, time to union, and complications, were recorded and compared to historical data of IM nails used in developed countries. Overall, there is a similar union rate in bones fixed with SIGN IM nails (94.6%) versus bones fixed with IM nails in developed countries (92.3%) (p = 0.009, OR = 1.67), while some bone types (tibia and femur) demonstrated a lower union rate when individually stratified (p = 0.008, OR = 0.26 and p = 0.002 and OR = 0.15, respectively). Mean time to union for all bone types combined showed no significant difference between SIGN IM nails and IM nails used in developed countries (p = 0.26). Complications rates were similar between SIGN IM nails and IM nails used in developed countries. It is possible for the SIGN IM nail to be used to fix long bone fractures in developing countries with outcomes comparable to the IM nail used in developed countries.

Basic information about nail behaviour, under passive and especially iontophoretic condition, lacks in the literature. Thus, this thesis aims to fill gaps in the nail understanding by studying the potential and feasibility of the application of iontophoresis to human nail. The iontophoretic and passive delivery of Sodium Fluorescein (SF) and Nile Blue Chloride (NBC) were studied, in vitro, in order to determine their pathways as well as their depth and uniformity of penetration into the nail. The permselective properties of the nail were investigated by characterizing the contribution of electroosmosis, using mannitol as a marker, and by studying the flux of two inorganic cations, sodium and lithium, during in vitro experiments. Finally, the feasibility of transungual iontophoresis and the extraction of sodium and chloride ions from the body through the nail plate were performed on a group of human volunteers. Iontophoresis led the fluorescent markers slightly deeper into the nail plate than passive diffusion. The delivery of the bianion and of the cation was not different. Both compounds mainly penetrated the nail via the transcellular pathway. Electroosmosis resulted only in a slight enhancement of the mannitol fluxes compared to passive diffusion and the fluxes presented high variability, especially at pH 7.4 and when the current was applied in the anode-to-cathode direction. The delivery of the two inorganic cations was significantly higher at pH 7.0 than at pH 4.0 and supported that nails hold a negative charge at physiological pH. Ions were easily extractable through the nail plate during in vivo iontophoresis and all volunteers' feedbacks supported iontophoresis as an acceptable technique. This thesis demonstrated the feasibility and potential of in vivo transungual iontophoresis.

The aim of the study was to characterise the environment in the Sydney region in respect of atmospheric corrosivity, timber decay risk factors and the corrosion of nails in timber in covered conditions. The study reviewed contemporary research in this field, particularly in Australia, developing an understanding of the durability failure mechanisms for timber and nails in timber. The study looked at the effects of climatic aspects, pollutants, corrosion on timber decay risk factors. The study found that the levels of risk in terms of timber degradation, corrosion and nail corrosion were greatest adjacent to the coast and at marine sites. / Doctor of Philosophy (PhD)

In the present thesis, studies on the response of soil nail walls subjected to static and seismic conditions using finite element based numerical simulations and the principle of reliability analysis have been performed. The basic methodology constitutes the study of various aspects of soil nail walls such as analyses of important external, internal and facing failure modes, development of axial forces, and displacement observations by considering various typical and prototype cases. For better understanding and presentation, subject matter of the thesis is organised in the following ten chapters. Chapter 1 of the thesis provides an introduction to the soil nailing technique and highlights some of its applications, advantages, and limitations. Chapter 2 provides a detailed review of existing literature on the soil nailing technique. Chapter 3 provides a detailed overview the various methodologies adopted in the thesis for the analyses and response study of the soil nail walls. Chapter 4 deals with the important aspects related to the plane strain finite element based numerical simulations of soil nail walls. In particular, addresses the implications of the use of advanced soil models and the consideration of bending stiffness of soil nails on the overall response of the soil nail walls. Chapter 5 presents finite element simulations based appraisal of the conventional design methodology of soil nail walls, and studies the response of typical soil nail walls under static and seismic conditions. Chapter 6 presents a reliability based study of the important failure modes of soil nail walls subjected to the variability in in-situ soil parameters, and highlights the importance of reliability analysis in context of soil nail walls. Chapter 7 proposes load and resistance factor design (LRFD) methodology in context of soil nail walls, and highlights the need in advancement of the existing conventional design methodology for soil nail walls. Chapter 8 illustrates the use of factorial design of experiment methodology in developing regression models for stability criteria analysis of soil nail walls. Chapter 9 proposes methods for assessing the adequacy of field pullout tests performed in accordance with the prevalent soil nailing guidelines. Further, a reliability based methodology is proposed for the evaluation and various applications of field pullout tests results have been illustrated. Chapter 10 summarises the various studies reported in the thesis and provides a few important conclusions. It is believed that the various studies reported in the thesis contribute to the enhancement of the existing knowledge on soil nailing technique, advancement in the analysis and design methods, and in general, are useful to the soil nailing practice.

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Objectives The Radiographic Union Score for Tibia (RUST) scoring system has been validated in multiple studies assessing the healing of tibial fractures. Our objective was to assess the inter and intraobserver reliability for the RUST in diaphyseal femoral fractures treated with intramedullary (IM) nailing. Patients and Methods A total of 60 sets of anteroposterior (AP) and lateral radiographs of diaphyseal femoral fractures treated by reamed IM nailing were randomly selected from a prospectively collected database. The 60 sets of radiographs were then scored by three reviewers using the RUST system. Interobserver reliability was measured at initial scoring. The 60 sets of radiographs were scored again by the three reviewers to calculate the intraobserver reliability. Results The RUST scores ranged from 4 to 12 with a mean score of 11.3 ± 1.3. The interobserver intraclass correlation coefficient (ICC) was 0.87 (95% CI, 0.81-0.92) and the intraobserver ICC was 0.91 (95% CI, 0.88-0.94), which indicated excellent agreement. Conclusion This study demonstrated that the RUST system can be used reliably in the assessment of healing in diaphyseal femur fractures treated by reamed intramedullary nailing, with excellent interobserver and intraobserver reliability.

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