A Review of the Aquatic Environmental Fate of Triclopyr and its Major Metabolites

The purpose of this paper is to provide an overview of the aquatic environmental fate of triclopyr and its major metabolites, TCP and TMP. This review is primarily based on results of laboratory and field studies conducted by various Federal Agencies and the registrant to support the US aquatic registration for triclopyr TEA

Mass Customization of Foot Orthosis for Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an inflammatory disease, which can cause pain, stiffness, and swelling in the joints of hands and feet. The foot is a major site for RA involvement and a major source of disability resulting from this disease. This paper introduces research which aims to create a mass customisation process for customised orthoses for patients with RA. 3D laser scanning, and gait analysis will be used to generate the orthosis geometry and rapid manufacturing, namely the selective laser sintering (SLS) process, will be used to produce the orthoses. The SLS process enables the incorporation of compositional functional elements, such as locally adjusted stiffness or flexibility, into the orthosis design. The process involved two central elements. The first was a literature survey to identify orthotic design rules for foot impairments in RA. This survey will form a platform for the design rule development and will be complemented by data obtained from two patient trials. The second is a virtual three-segment foot model, created in Anybody dynamics modelling software which can be motivated by data measured from patients using 3D motion capture and force plate systems. Once the measured data has been applied to the model, a virtual insole can be used to simulate the effects of various features in the orthosis. Considerable variation was noted in the literature for types of material, design and methods of orthotic construction. Pressure redistribution using cushioning materials was consistently mapped to painful deformed joints. Orthoses with contoured surfaces, either custom- or mass produced in thermoplastic materials of varying stiffness and density were mapped to joint motion control and deformity prevention. The paper will also describe applying patient gait data to the Anybody model, and then altering the gait pattern by applying the insole model. Future work will also be discussed.Mechanical Engineerin

The effectiveness of a multidisciplinary foot care program for children and adolescents with juvenile idiopathic arthritis: an exploratory trial

Objectives: To evaluate the effectiveness of multidisciplinary foot-care, and to evaluate the methodological considerations of a trial of multidisciplinary care in juvenile idiopathic arthritis. Design: Exploratory randomised controlled trial. Subjects/Patients: Children/adolescents with juvenile idiopathic arthritis and inflammatory joint disease affecting the foot/ankle. Methods: Standard medical care was compared with a 12 month program of multidisciplinary foot-care informed by musculoskeletal ultrasound. This program was centred on strict disease control through rigorous examination and interventions delivered by a team comprised of a paediatric rheumatologist, podiatrist, physiotherapist and musculoskeletal ultrasonographer. Patients were assessed on foot impairment and disability scores using the Juvenile Arthritis Foot Disability Index. Results: Forty-four participants, aged 3-17 years were randomly assigned to receive the experimental (n = 21) or usual care (n = 23) interventions. There was an overall improvement in levels of foot related impairments in both groups over 12 months. Between-group differences in change scores for the Juvenile Arthritis Foot Disability Index were not statistically significant at 6 or 12 month follow-ups. Conclusion: The integrated multidisciplinary foot care interventions described in this trial were safe, but did not improve foot impairment levels relative to usual care. This trial identified several methodological challenges including recruitment/retention, difficulties with outcome tools and potential confounders.</p

'Choosing shoes': a preliminary study into the challenges facing clinicians in assessing footwear for rheumatoid patients

Background: Footwear has been accepted as a therapeutic intervention for the foot affected by rheumatoid arthritis (RA). Evidence relating to the objective assessment of footwear in patients with RA is limited. The aims of this study were to identify current footwear styles, footwear characteristics, and factors that influence footwear choice experienced by patients with RA. Methods: Eighty patients with RA were recruited from rheumatology clinics during the summer months. Clinical characteristics, global function, and foot impairment and disability measures were recorded. Current footwear, footwear characteristics and the factors associated with choice of footwear were identified. Suitability of footwear was recorded using pre-determined criteria for assessing footwear type, based on a previous study of foot pain. Results: The patients had longstanding RA with moderate-to severe disability and impairment. The foot and ankle assessment demonstrated a low-arch profile with both forefoot and rearfoot structural deformities. Over 50% of shoes worn by patients were opentype footwear. More than 70% of patients’ footwear was defined as being poor. Poor footwear characteristics such as heel rigidity and sole hardness were observed. Patients reported comfort (17%) and fit (14%) as important factors in choosing their own footwear. Only five percent (5%) of patients wore therapeutic footwear. Conclusions: The majority of patients with RA wear footwear that has been previously described as poor. Future work needs to aim to define and justify the specific features of footwear that may be of benefit to foot health for people with RA

Evaluation of a morpholinothiolporphyrin for use in photodynamic therapy.

The photonecrotic effectiveness of a morpholinothiolporphyrin derived from haematoporphyrin was measured in an animal model of cerebral glioma. The dose administered was 20 mg kg-1 and the laser dose varied from 0 to 200 J cm-2. The tumour necrosis was at least as good as that of HpD, and this therapeutic response may be attributed to the targeting of specific 'photopotent' subcellular sites