Efficient sequestration of cesium ions using phosphoric acid-modified activated carbon fibers from aqueous solutions.

In this study, acid-modified activated carbon fibers (ACF-Ps) were synthesized by phosphorylation. Three different types of ACF-based adsorbents functionalized with PO43-, P2O74-, or P3O105- ions, namely, ACF-P1, ACF-P2, and ACF-P3, were prepared by phosphorylating ACF with trisodium phosphate (Na3PO4), sodium dihydrogen pyrophosphate (Na2H2P2O5), and sodium tripolyphosphate (Na5P3O10), respectively, and utilized as adsorbents to remove cesium ions (Cs+) from aqueous solutions. Among the tested adsorbents, ACF-P3 exhibited the highest Cs+ adsorption capacity of 37.59 mg g-1 at 25 °C and pH 7 which is higher than that of ACF (5.634 mg g-1), ACF-P1 (19.38 mg g-1), and ACF-P2 (30.12 mg g-1) under the same experimental conditions. More importantly, the Cs+ removal efficiencies of ACF-P3 (82.90%), ACF-P2 (66.2%), ACF-P1 (34.2%) were 29.3-, 23.4-, and 12.11-fold higher than that of un-treated ACF (2.83%). The results suggested that the phosphorylation with Na5P3O10 is highly suitable for Cs+ adsorption which effectively functionalizes ACF with a greater number of phosphate functional groups. Adsorption and kinetic data well-fitted the Langmuir isotherm and pseudo-second-order model, respectively, which indicated the monolayer adsorption of Cs+ onto ACF-P1, ACF-P2, and ACF-P3 which were largely controlled by chemisorption. Overall, phosphoric acids containing different phosphate-based polyanions (PO43-, P2O74-, or P3O105-) enriched -OH and/or -COOH surface functional groups of ACF in addition to P-containing surface groups (PO, C-P-O, C-O-P, and P-O) and facilitated the Cs+ adsorption through surface complexation and electrostatic interactions.

Ultrasonic treatment of endocrine disrupting compounds, pharmaceuticals, and personal care products in water: An updated review.

Pharmaceuticals, personal care products (PPCPs), and endocrine-disrupting compounds (EDCs) have seen a recent sustained increase in usage, leading to increasing discharge and accumulation in wastewater. Conventional water treatment and disinfection processes are somewhat limited in effectively addressing this micropollutant issue. Ultrasonication (US), which serves as an advanced oxidation process, is based on the principle of ultrasound irradiation, exposing water to high-frequency waves, inducing thermal decomposition of H2O while using the produced radicals to oxidize and break down dissolved contaminants. This review evaluates research over the past five years on US-based technologies for the effective degradation of EDCs and PPCPs in water and assesses various factors that can influence the removal rate: solution pH, temperature of water, presence of background common ions, natural organic matter, species that serve as promoters and scavengers, and variations in US conditions (e.g., frequency, power density, and reaction type). This review also discusses various types of carbon/non-carbon catalysts, O3 and ultraviolet processes that can further enhance the degradation efficiency of EDCs and PPCPs in combination with US processes. Furthermore, numerous types of EDCs and PPCPs and recent research trends for these organic contaminants are considered.

Removal of endocrine disruptors and pharmaceuticals by graphene oxide-based membranes in water: A review.

Membrane-based water treatment has emerged as a promising solution to address global water challenges. Graphene oxide (GO) has been successfully employed in membrane filtration processes owing to its reversible properties, large-scale production potential, layer-to-layer stacking, great oxygen-based functional groups, and unique physicochemical characteristics, including the creation of nano-channels. This review evaluates the separation performance of various GO-based membranes, manufactured by coating or interfacial polymerization with different support layers such as polymer, metal, and ceramic, for endocrine-disrupting compounds (EDCs) and pharmaceutically active compounds (PhACs). In most studies, the addition of GO significantly improved the removal efficiency, flux, porosity, hydrophilicity, stability, mechanical strength, and antifouling performance compared to pristine membranes. The key mechanisms involved in contaminant removal included size exclusion, electrostatic exclusion, and adsorption. These mechanisms could be ascribed to the physicochemical properties of compounds, such as molecular size and shape, hydrophilicity, and charge state. Therefore, understanding the removal mechanisms based on compound characteristics and appropriately adjusting the operational conditions are crucial keys to membrane separation. Future research directions should explore the characteristics of the combination of GO derivatives with various support layers, by tailoring diverse operating conditions and compounds for effective removal of EDCs and PhACs. This is expected to accelerate the development of surface modification strategies for enhanced contaminant removal.

Photocatalytic and electrocatalytic degradation of bisphenol A in the presence of graphene/graphene oxide-based nanocatalysts: A review.

Bisphenol A (BPA), a widely recognized endocrine disrupting compound, has been discovered in drinking water sources/finished water and domestic wastewater influent/effluent. Numerous studies have shown photocatalytic and electrocatalytic oxidation to be very effective for the removal of BPA, particularly in the addition of graphene/graphene oxide (GO)-based nanocatalysts. Nevertheless, the photocatalytic and electrocatalytic degradation of BPA in aqueous solutions has not been reviewed. Therefore, this review gives a comprehensive understanding of BPA degradation during photo-/electro-catalytic activity in the presence of graphene/GO-based nanocatalysts. Herein, this review evaluated the main photo-/electro-catalytic degradation mechanisms and pathways for BPA removal under various water quality/chemistry conditions (pH, background ions, natural organic matter, promotors, and scavengers), the physicochemical characteristics of various graphene/GO-based nanocatalysts, and various operating conditions (voltage and current). Additionally, the reusability/stability of graphene/GO-based nanocatalysts, hybrid systems combined with ozone/ultrasonic/Fenton oxidation, and prospective research areas are briefly described.

Ultrasonic treatment of dye chemicals in wastewater: A review.

The existence of pollutants, such as toxic organic dye chemicals, in water and wastewater raises concerns as they are inadequately eliminated through conventional water and wastewater treatment methods, including physicochemical and biological processes. Ultrasonic treatment has emerged as an advanced treatment process that has been widely applied to the decomposition of recalcitrant organic contaminants. Ultrasonic treatment has several advantages, including easy operation, sustainability, non-secondary pollutant production, and saving energy. This review examines the elimination of dye chemicals and categorizes them into cationic and anionic dyes based on the existing literature. The objectives include (i) analyzing the primary factors (water quality and ultrasonic conditions) that influence the sonodegradation of dye chemicals and their byproducts during ultrasonication, (ii) assessing the impact of the different sonocatalysts and combined systems (with ozone and ultraviolet) on sonodegradation, and (iii) exploring the characteristics-based removal mechanisms of dyes. In addition, this review proposes areas for future research on ultrasonic treatment of dye chemicals in water and wastewater.

Methotrexate-Induced Accelerated Nodulosis in a Patient with Systemic Lupus Erythematosus.

Methotrexate (MTX)-induced accelerated nodulosis (MIAN) reportedly occurs in patients with rheumatic arthritis receiving MTX therapy. However, it has also been reported in patients with other autoinflammatory conditions, such as systemic lupus erythematosus (SLE). A 38-year-old woman diagnosed with SLE presented with multiple movable, firm, flesh-colored nodules on both hands that had developed 3 years ago. She was taking oral medications, specifically hydroxychloroquine, azathioprine, and MTX. Histopathological examination revealed palisaded granulomatous inflammation, surrounded by histiocytes and lymphocytes, along the dermis to the subcutaneous fat layer. Fibrinoid degeneration was observed at the center of the granulomatous inflammation, and dermal mucin deposition was not observed. The patient was diagnosed with MIAN, and therefore discontinuation of MTX was recommended. Subsequently, the lesions almost completely disappeared with no signs of recurrence. MIAN exhibits clinicopathological features similar to those of rheumatoid nodules; therefore, it can be easily misdiagnosed. Herein, we report a case of MIAN in a patient with SLE to contribute to the accurate diagnosis and appropriate management.

Effect of knowledgebase transition of a clinical decision support system on medication order and alert patterns in an emergency department.

A knowledgebase (KB) transition of a clinical decision support (CDS) system occurred at the study site. The transition was made from one commercial database to another, provided by a different vendor. The change was applied to all medications in the institute. The aim of this study was to analyze the effect of KB transition on medication-related orders and alert patterns in an emergency department (ED). Data of patients, medication-related orders and alerts, and physicians in the ED from January 2018 to December 2020 were analyzed in this study. A set of definitions was set to define orders, alerts, and alert overrides. Changes in order and alert patterns before and after the conversion, which took place in May 2019, were assessed. Overall, 101,450 patients visited the ED, and 1325 physicians made 829,474 prescription orders to patients during visit and at discharge. Alert rates (alert count divided by order count) for periods A and B were 12.6% and 14.1%, and override rates (alert override count divided by alert count) were 60.8% and 67.4%, respectively. Of the 296 drugs that were used more than 100 times during each period, 64.5% of the drugs had an increase in alert rate after the transition. Changes in alert rates were tested using chi-squared test and Fisher's exact test. We found that the CDS system knowledgebase transition was associated with a significant change in alert patterns at the medication level in the ED. Careful consideration is advised when such a transition is performed.

Intradermal Low-Fat Spindle Cell Lipoma: A Case Report.

Spindle cell lipoma is a rare benign neoplasm that features a mixture of evenly aligned spindle cells, mature adipocytes, and ropey collagen. Most cases of spindle cell lipoma are found in the subcutaneous tissue, and intradermal spindle cell lipoma is rarely reported. We present a case of intradermal spindle cell lipoma in a 46-year-old female who presented with a 0.7-cm flesh-colored and dome-shaped nodule on the right temple that had developed 6 years ago. This mass was excised, and upon histopathologic examination, an unencapsulated lesion was located in the dermis, which consisted of bland spindle cells, scanty mature adipocytes, rare lipoblasts, and ropey collagen bundles with prominent basophilic myxoid stroma. Immunohistochemical staining showed diffuse positivity for CD34, negativity for the S-100 protein, and loss of retinoblastoma protein expression. Based on these features, intradermal low-fat spindle cell lipoma was diagnosed. No evidence of local recurrence was observed 4 months after excision. Intradermal low-fat spindle cell lipomas are extremely rare and can easily be mistaken for tumors that have similar clinical and histopathological findings. Herein, we report a globally rare case of an intradermal low-fat spindle cell lipoma.

Superficial CD34-Positive Fibroblastic Tumor: Two Case Reports.

Superficial CD34-positive fibroblastic tumor (SCPFT) is a recently described disease entity characterized by marked nuclear pleomorphism, low mitotic count, and diffuse CD34 positivity. It is a rare, distinctive, low-grade fibroblastic neoplasm. To date, only 44 cases have been reported in the English-language literature. Herein, we report two cases of SCPFT involving a 48-year-old male and a 22-year-old male with superficial tumors on the right and left thighs, respectively. Excision was performed in both cases. Histologically, both tumors showed spindle-to-epithelioid cells arranged in fascicular or sheet-like patterns. Most cells displayed granular or eosinophilic glassy cytoplasm, marked nuclear pleomorphism, and a low mitotic rate. On immunohistochemical staining, tumor cells were diffusely positive for CD34 and negative for S100 protein, smooth muscle actin, and desmin. After wide excision, neither patient experienced recurrence or metastasis after 16 months and 11 months of clinical follow-up, respectively. To the best of our knowledge, these are the first two cases of SCPFT reported in Korea. We believe these case reports would contribute to the clinicopathological understanding of SCPFT and assist clinicians in differentiating this tumor from other superficial soft tissue neoplasms.

Development of ultra-high surface area polyaniline-based activated carbon for the removal of volatile organic compounds from industrial effluents.

Removing volatile organic compounds (VOCs) from aqueous solutions is critical for reducing VOC emissions in the environment. Activated carbons are widely used for removal of VOCs from water. However, they show less application feasibility and low removal due to less surface area. Here, a cost-effective and high surface area activated carbonized polyaniline (ACP) was synthesized to sustainable removal of VOCs from water. The ACP microstructure, surface properties, and pore structure were investigated using Brunauer-Emmett-Teller (BET) theory, Scanning Electron Microscopy (SEM), and Transmission Electron Microscopy (TEM). The specific surface area of ACP6:1 (2988.13 m2/g) was greater than that of commercial activated carbon (PAC) (1094.49 m2/g), indicating that it has excellent VOC adsorption capacity. The effects of pH, initial VOC concentration, time, temperature, and ionic strength were studied. According to kinetic and thermodynamic studies on VOCs adsorption, it is an exothermic and spontaneous process involving rate-limiting kinetics. Adsorption isotherms follow the Freundlich isotherm model, suggesting that the adsorbent surface is heterogeneous with multilayer adsorption and maximum ACP adsorption capacities of 1913.9, 2453.3, 1635.8, and 3327.0 mg/g at 293 K for benzene, toluene, ethylbenzene, and perchloroethylene, respectively, representing a 3- to 5-fold improvement over PAC. ACP is a promising adsorbent with a high adsorption efficiency for VOC removal.

Efficiency of Ppy-PA-pani and Ppy-PA composite adsorbents in Chromium(VI) removal from aqueous solution.

In this study, first time the combination of composites with Phytic acid (PA) as the organic binder cross-linker is reported. The novel use of PA with single and double conducting polymers (polypyrrole (Ppy) and polyaniline (Pani)) were tested against removal of Cr(VI) from wastewater. Characterizations (FE-SEM, EDX, FTIR, XRD, XPS) were performed to study the morphology and removal mechanism. The adsorption removal capability of Polypyrrole - Phytic Acid - Polyaniline (Ppy-PA-Pani) was deemed to be higher than Polypyrrole - Phytic Acid (Ppy-PA) due to the mere existence of Polyaniline as the extra polymer. The kinetics followed 2nd order with equilibration at 480 min, but Elovich model confirmed that chemisorption is followed. Langmuir isotherm model exhibited maximum adsorption capacity of 222.7-321.49 mg/g for Ppy-PA-Pani and 207.66-271.96 mg/g for Ppy-PA at 298K-318K with R2 values of 0.9934 and 0.9938 respectively. The adsorbents were reusable for 5 cycles of adsorption-desorption. The thermodynamic parameter, ΔH shows positive values confirmed the adsorption process was endothermic. From overall results, the removal mechanism is believed to be chemisorption through Cr(VI) reduction to Cr(III). The use of phytic acid (PA) as organic binder with combination of dual conducting polymer (Ppy-PA-Pani) was invigorating the adsorption efficiency than just single conducting polymer (Ppy-PA).

Stable and recyclable lanthanum hydroxide-doped graphene oxide biopolymer foam for superior aqueous arsenate removal: Insight mechanisms, batch, and column studies.

In this study, a graphene oxide-based lanthanum hydroxide/chitosan foam (CSGOL foam) was synthesized for arsenate (As(V)) remediation in surface water. The synthesized CSGOL foam texture and purity was assessed using scanning electron microscopy (SEM), Brunauer-Emmett-Teller (BET) surface area, X-ray diffraction (XRD), thermogravimetric analysis (TGA), Fourier transform infrared spectroscopy (FT-IR), and X-ray photoelectron spectroscopy (XPS) studies. The results proved that the foam was highly porous, stable, and had high surface functionality that facilitated adsorption for water pollutant removal. The sorption results proved that the As(V) removal was high (146.20 mg/g at pH 6 with 0.5 g/L CSGOL foam) when compared to the similar type of materials, endothermic chemisorption due to the production of monodentate and bidentate inner-sphere complexes. Furthermore, continuous column results indicated that the As(V) concentration in real surface waters was reduced to WHO standards (less than 10 µg As/L of water) of As(V) in drinking water for up to 10,000 bed volume. Further it can be used up to four cycles without loss of efficacy less than 93%. Because of its excellent removal capabilities and simple synthesis technique, CSGOL foam shows significant promise for treating As(V)-containing water. Further, the XPS analysis and batch studies results suggests that As(V) removal mechanism was involved electrostatic and surface complexation through chemical interaction predominately.

Correction: Frequent Mobile Electronic Medical Records Users Respond More Quickly to Emergency Department Consultation Requests: Retrospective Quantitative Study.

[This corrects the article DOI: 10.2196/14487.].

Experimentally and spectroscopically evidenced mechanistic study of butyl peroxyacid oxidative degradation of benzo[a]pyrene in soil.

Benzo[a]pyrene (BaP) is a major indicator of soil contamination and categorized as a highly persistent, carcinogenic, and mutagenic polycyclic aromatic hydrocarbon. An advanced peroxyacid oxidation process was developed to reduce soil pollution caused by BaP originating from creosote spills from railroad sleepers. The pH, organic matter, particle size distribution of soil, and concentrations of BaP and heavy metals (Cd, Cu, Zn, Pb, and As) in the BaP-contaminated soils were estimated. A batch experiment was conducted to determine the effects of organic acid type, soil particle size, stirring speed, and reaction time on the peroxyacid oxidation of BaP in the soil samples. Additionally, the effect of the organic acid concentration on the peroxyacid degradation of BaP was investigated using an oxidizing agent in spiked soil with and without hydrogen peroxide. The results of the oxidation process indicated that BaP and heavy metal residuals were below acceptable Korean standards. A significant difference in the oxidative degradation of BaP was observed between the spiked and natural soil samples. The formation of a peroxyacid intermediate was primarily responsible for the enhanced BaP oxidation. Further, butyric acid could be reused thrice without losing the efficacy (<90%). The systematic peroxyacid oxidative degradation mechanism of BaP was also discussed. A qualitative analysis of the by-products of the BaP reaction was conducted, and their corresponding toxicities were determined for possible field applications. The findings conclude that the developed peroxyacid oxidation method has potential applications in the treatment of BaP-contaminated soils.

Circulating miRNAs in extracellular vesicles related to treatment response in patients with idiopathic membranous nephropathy.

BACKGROUND: Extracellular vesicle (EV)-microRNAs (miRNAs) are potential biomarkers for various renal diseases. This study attempted to identify the circulating EV-miRNA signature not only for discriminating idiopathic membranous nephropathy (IMN) from idiopathic nephrotic syndrome (INS), but also to predict the treatment response of patients with IMN. METHODS: We prospectively enrolled 60 participants, including those with IMN (n = 19) and INS (n = 21) and healthy volunteers (HVs; n = 20) in this study. Using RNA sequencing, we assessed the serum EV-miRNA profiles of all participants. To identify the EV-miRNAs predictive of treatment response in IMN, we also analyzed EV-miRNAs among patients with IMN with and without clinical remission. RESULTS: The expression levels of 3 miRNAs differed between IMN patients, INS patients and HVs. In addition, compared to HVs, RNA sequencing revealed differential expression of 77 and 44 EV-miRNAs in patients with IMN without and with remission, respectively. We also identified statistically significant (|fold change ≥ 2, p < 0.05) differences in the expression levels of 23 miRNAs in IMN without remission. Biological pathway analysis of miRNAs in IMN without remission indicated that they are likely involved in various pathways, including renal fibrosis. CONCLUSION: Our study identified EV-miRNAs associated with IMN as well as those associations with therapeutic response. Therefore, these circulating EV-miRNAs may be used as potential markers for the diagnosis and prediction of treatment response in patients with IMN.

Weight Change Alters the Small RNA Profile of Urinary Extracellular Vesicles in Obesity.

INTRODUCTION: Various kidney diseases reportedly show different urinary extracellular vesicle (EV) RNA profiles. Although obesity is one of the main causes of chronic kidney disease, the expression pattern of urinary EV RNA in obesity is uncertain. Our aim was to sequence the small RNA profiles of urinary EVs in obese patients before and after weight reduction and compare them to those of healthy volunteers (HVs). METHODS: We recruited age-sex-matched obese patients and HVs. The small RNA profiles of urinary EVs were analyzed using RNA sequencing. To evaluate the effect of weight reduction, small RNA profiles of urinary EVs 6 months after bariatric surgery were also analyzed. RESULTS: The proportion of urinary EVs transfer RNA and microRNA of obese patients differed from that of HVs. Obese patients showed differential expression of 1,343 small RNAs in urinary EVs compared to HVs (fold change ≥2 and p value <0.05). Among those, 61 small RNAs were upregulated in obese patients and downregulated after weight reduction, whereas 167 small RNAs were downregulated in obese patients and upregulated after weight reduction. RNA sequencing revealed the correlation between the specific urinary EV small RNAs and clinical parameters including body weight, low-density lipoprotein cholesterol, triglyceride, high-density lipoprotein cholesterol, serum glucose, estimated glomerular filtration rate, and albuminuria. CONCLUSION: Obese patients showed distinct urinary EV small RNA profiles compared to HVs. Weight reduction altered urinary EV small-RNA profiles in obese patients.

Magnetic-watermelon rinds biochar for uranium-contaminated water treatment using an electromagnetic semi-batch column with removal mechanistic investigations.

Biosorption using modified biochar has been increasingly adopted for the sustainable removal of uranium-contaminated from an aqueous solution. In this research study, the facile preparation and surface characteristics of magnetized biochar derived from waste watermelon rind to treat U(VI) contaminated water were investigated. The porosity, specific surface area, adsorption capacity, reusability, and stability were effectively improved after the magnetization of biochar. The kinetics and isotherm studies found that the U(VI) adsorption was rate-limiting monolayer sorption on the homogeneous surface of magnetized watermelon rind biochar (MWBC). The maximum adsorption capacity was found to be 323.56 mg of U(VI) per g of MWBC at pH 4.0 and 293 K that was higher than that of watermelon rind biochar (WBC) (135.86 mg g-1) and other sourced biochars. The surface interaction mechanism, environmental feasibility, applicability for real-filed water treatment studied in the electromagnetic semi-batch column, and reusability of MWBC were also explored. Furthermore, salient raised the ion exchange and complexation action capacity of MWBC due to the presence of Fe oxide. The overall results indicated that MWBC was not only inexpensive and had a high removal capacity for U(VI), but it also easily enabled phase separation from an aqueous solution, with more than three times reusability at a minimum removal capacity of 99%.

Prediction Algorithms for Blood Pressure Based on Pulse Wave Velocity Using Health Checkup Data in Healthy Korean Men: Algorithm Development and Validation.

BACKGROUND: Pulse transit time and pulse wave velocity (PWV) are related to blood pressure (BP), and there were continuous attempts to use these to predict BP through wearable devices. However, previous studies were conducted on a small scale and could not confirm the relative importance of each variable in predicting BP. OBJECTIVE: This study aims to predict systolic blood pressure and diastolic blood pressure based on PWV and to evaluate the relative importance of each clinical variable used in BP prediction models. METHODS: This study was conducted on 1362 healthy men older than 18 years who visited the Samsung Medical Center. The systolic blood pressure and diastolic blood pressure were estimated using the multiple linear regression method. Models were divided into two groups based on age: younger than 60 years and 60 years or older; 200 seeds were repeated in consideration of partition bias. Mean of error, absolute error, and root mean square error were used as performance metrics. RESULTS: The model divided into two age groups (younger than 60 years and 60 years and older) performed better than the model without division. The performance difference between the model using only three variables (PWV, BMI, age) and the model using 17 variables was not significant. Our final model using PWV, BMI, and age met the criteria presented by the American Association for the Advancement of Medical Instrumentation. The prediction errors were within the range of about 9 to 12 mmHg that can occur with a gold standard mercury sphygmomanometer. CONCLUSIONS: Dividing age based on the age of 60 years showed better BP prediction performance, and it could show good performance even if only PWV, BMI, and age variables were included. Our final model with the minimal number of variables (PWB, BMI, age) would be efficient and feasible for predicting BP.

The Relationship Between Breast Density Change During Menopause and the Risk of Breast Cancer in Korean Women.

BACKGROUND: The aim of this study was to investigate the relationship between changes in breast density during menopause and breast cancer risk. METHODS: This study was a retrospective, longitudinal cohort study for women over 30 years of age who had undergone breast mammography serially at baseline and postmenopause during regular health checkups at Samsung Medical Center. None of the participants had been diagnosed with breast cancer at baseline. Mammographic breast density was measured using the American College of Radiology Breast Imaging Reporting and Data System. RESULTS: During 18,615 person-years of follow-up (median follow-up 4.8 years; interquartile range 2.8-7.5 years), 45 participants were diagnosed with breast cancer. The prevalence of dense breasts was higher in those who were younger, underweight, had low parity or using contraceptives. The cumulative incidence of breast cancer increased 4 years after menopause in participants, and the consistently extremely dense group had a significantly higher cumulative incidence (CI) of breast cancer compared with other groups [CI of extremely dense vs. others (incidence rate per 100,000 person-years): 375 vs. 203, P < 0.01]. CONCLUSION: Korean women whose breast density was extremely dense before menopause and who maintained this density after menopause were at two-fold greater risk of breast cancer. PREVENTION RELEVANCE: Extremely dense breast density that is maintained persistently from premenopause to postmenopause increases risk of breast cancer two fold in Korean women. Therefore, women having risk factors should receive mammography frequently and if persistently extremely dense breast had been detected, additional modalities of BC screening could be considered.

Prevalence and Characteristics of Onychomycosis in Patients with Knee Osteoarthritis: A Single-centre Prospective Cross-sectional Study.

Knee disorders that compromise patients' lower leg movements and self-care may put these patients at greater risk of onychomycosis. However, little is known about the prevalence of onychomycosis in patients with knee diseases. This study evaluated the prevalence and characteristics of onychomycosis in patients with knee osteoarthritis. A total of 520 consecutive patients with symptomatic knee osteoarthritis who visited the Department of Orthopedics for a potential knee surgery were evaluated for onychomycosis by PCR-based reverse blot hybridization assay. Of the 520 patients, 308 (59.2%) were diagnosed with onychomycosis. Age (p = 0.004), male sex (p = 0.015), and being barefooted (p = 0.031) were statistically significant risk factors for onychomycosis. Knee disease severity, based on Kellgren-Lawrence grade, was associated with severity of onychomycosis. The impairment of physical function and self-care caused by knee disorders may increase the prevalence of onychomycosis in these patients.