Recurrent Onychomadesis of the Toenails in Children and Adults: A Case Series

2021 ◽  
pp. 1-3
Author(s):  
Dana Sous ◽  
Michela V.R. Starace ◽  
Lu Chen ◽  
Elizabeth L. Nieman ◽  
Milan J. Anadkat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Side Effects ◽  
Treatment Strategy ◽  
Viral Infections ◽  
Nail Plate ◽  
Case Series ◽  
Drug Side Effects ◽  
Case Presentation ◽  
Nail Bed ◽  
Physical Trauma

<b><i>Introduction:</i></b> Onychomadesis occurs when the nail plate separates from the nail matrix and nail bed, eventually leading to shedding of the nail. This condition has been attributed to viral infections, autoimmune disorders, drug side effects, and physical trauma. A subset of patients has a recurrent form of onychomadesis without a clear trigger; this phenomenon is not well characterized in the literature. <b><i>Case Presentation:</i></b> We present a case series of pediatric and adult patients with recurrent toenail onychomadesis in order to better characterize the disorder and explore possible etiologies, risk factors, and treatments. <b><i>Discussion/Conclusion:</i></b> For the cases herein, we propose microtrauma associated with footwear as the underlying etiology given the periodicity of nail shedding, exclusion of other etiological factors, and presence of predisposing risk factors in certain patients. Many patients saw improvement with application of urea 40% cream, suggesting this can be a valuable part of a treatment strategy, in addition to minimizing injury to involved digits.

Operative Treatment of the Ingrown Toenail With a Less-Invasive Technique: Flashback to the Original Winograd Technique

2017 ◽  
Vol 11 (2) ◽  
pp. 138-141 ◽  
Author(s):  
Yalkin Camurcu ◽  
Hakan Sofu ◽  
Ahmet Issin ◽  
Nizamettin Kockara ◽  
Hakan Saygili
Keyword(s):  
Nail Plate ◽  
Case Series ◽  
Operation Time ◽  
Invasive Technique ◽  
Nail Bed ◽  
Less Invasive ◽  
Ingrown Toenail ◽  
Case Series Study ◽  
Stage 1

Objective: The aim of this study was to evaluate the results of the partial nail plate excision and curettage of nail bed and matrix (the original Winograd technique) in patients with ingrown toenail. Materials and methods:Patients with ingrown toenail who were treated surgically from May 2014 to June 2015, with a minimum follow-up of 1 year were included in this study. Those who had previous ingrown toenail surgery were excluded. Partial nail plate excision with curettage of nail bed and nail matrix was performed for all patients. Rifampicin soaked sterile gauze was placed onto the wounds after the procedure. Results:The study population included 100 males and 89 females with a mean age of 30 years. Eight patients (4.2%) had stage 1, 71 patients (37.6%) had stage 2, and 110 patients (58.2%) had stage 3 ingrown toenails. The mean operation time was 4.8 minutes. No complication occurred during the procedure. It was found that 15 patients (7.9%) had recurrence during the follow-up. Conclusion:The original Winograd technique is an efficient and less-invasive technique for the treatment of ingrown toenail, with lower rates of recurrence and complications. Levels of Evidence: Therapeutic Case Series Study, Level IV

scholarly journals A Multimodal Hair-Loss Treatment Strategy Using a New Topical Phytoactive Formulation: A Report of Five Cases

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Sanusi Umar ◽  
Marissa J. Carter
Keyword(s):  
Side Effects ◽  
Hair Loss ◽  
Hair Growth ◽  
Case Series ◽  
Previous Treatment ◽  
Case Presentation ◽  
Topical Minoxidil ◽  
Continued Use ◽  
New Formulation ◽  
Infant Stage

Introduction. Current approved medications for hair loss, such as topical minoxidil and oral finasteride, may have suboptimal efficacy or side effects precluding continued use in some patients. Thus, we report an evaluation of the efficacy, safety, and tolerability of a new topical botanical formulation -GASHEE containing over 12 phytoactive ingredients that affect multiple targets in the cascade of pathophysiologic events that cause hair loss. Five patients with various hair-loss conditions, including cases of previous treatment failures, are presented. Case Presentation. This is a case series of four women and one man with hair loss due to various causes, four of whom had failed minoxidil treatment for over a year. All patients used the topical treatment as a sole therapy for at least 3 months before the documentation of outcomes, which involved interval changes noted through each patient’s account, direct observation, and photography. Discussion. In all patients, we observed significant improvements in hair regrowth in the nape, crown, vertex, and temple areas after 3–15 months of treatment. All patients were highly satisfied with their results and reported no adverse events. Although the use of botanicals in the treatment of hair loss is in an infant stage, the new formulation used in this study demonstrated a good efficacy related to hair growth, warranting further evaluation.

scholarly journals Amantadine withdrawal syndrome masquerading as COVID-19 encephalopathy: a case report and review of the literature

2021 ◽  
Vol 2021 (2) ◽  
Author(s):  
John P Murray ◽  
Angela Kerins
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Side Effects ◽  
Withdrawal Syndrome ◽  
Clinical Manifestations ◽  
Case Series ◽  
Altered Mental Status ◽  
Review Of The Literature ◽  
Medication Discontinuation ◽  
Hypoactive Delirium

ABSTRACT Amantadine withdrawal syndrome (AWS) is a rare but recognized cause of severe and persistent altered mental status sometimes with co-occurring extrapyramidal symptoms. First described in a case series from 1987, its clinical manifestations have been characterized along a spectrum ranging from profound hypoactive delirium to hyperactive delirium with hallucinations. Risk factors for withdrawal include abrupt medication discontinuation, prolonged use, older age and underlying dementia. Herein we describe a case of a 52-year-old woman who presented with confusion, hallucinations, and coronavirus disease-2019 infection. She subsequently developed a prolonged hypoactive delirium after her amantadine was tapered and held. Her hypoactive delirium entirely resolved with resumption of amantadine confirming the diagnosis of AWS. This case illustrates the importance of slowly tapering dopaminergic medications and being aware of rare pharmacologic side effects.

Study and Development of an Anthroposophical Formula Based on Phosphorus and Formica rufa for Onychomycosis´s Treatment

2020 ◽  
Vol 14 (2) ◽  
pp. 98-107
Author(s):  
Ana Maria Rodrigues ◽  
Sônia Maria de Figueiredo ◽  
Emanoelle Fernandes Rutren La Santrer ◽  
Claudia Barbosa Assunção ◽  
Amanda Gabrielle Soares de Abreu ◽  
...  
Keyword(s):  
Side Effects ◽  
Fungal Infection ◽  
Research Group ◽  
Nail Plate ◽  
Normal Growth ◽  
Extensive Review ◽  
Nail Bed ◽  
Formica Rufa ◽  
Common Diseases ◽  
Therapeutic Alternatives

: Onychomycosis is a fungal infection of the nail plate or nail bed that leads to the gradual destruction of the nail. The main difficulties in the treatment of onychomycosis refer to the duration of treatments and their side effects. Thus, it becomes relevant to look for new therapeutic alternatives in the treatment of such common diseases that are efficient without causing the undesirable side effects on the patient's body. In this way, the objective of this study was to develop an anthroposophical formula for the treatment of onychomycosis, based on Phosphorus and Formica rufa, from an extensive bibliographic survey on the functions of these components, evaluating within the principles of Anthroposophy. Considering the set of knowledge and practices on the use of these components, it was possible to arrive at a proposal therapy that can be effective for the treatment of onychomycosis. After an extensive review of several existing patents, it was observed that formulations containing Phosphorus and Formica rufa together have not been described in other studies. Subsequently, our research group published a patent of the anthroposophical formula using these two components, with the number BR1020180750755, which will be efficient to help the recovery of nails, and facilitate normal growth.

scholarly journals Clinical Analysis of Micafungin Treatment in Children with Candida Infection: A Single Center Experiment

2020 ◽  
Vol 54 (4) ◽  
pp. 181-187
Author(s):  
Ayşe Şahin ◽  
Nazan Dalgıç ◽  
Ayşe Barış ◽  
Banu Özata Abanoz
Keyword(s):  
Risk Factors ◽  
Side Effects ◽  
Clinical Characteristics ◽  
Pediatric Patients ◽  
Laboratory Data ◽  
Case Series ◽  
Venous Catheter ◽  
Clinical Analysis ◽  
Candida Infection ◽  
Candida Infections

Objective: For the treatment of invasive candidiasis (IC) which is confirmed or suspected in adults, echinocandins are usually recommended. In children; however, very little is known about using echinocandins for IC management. Micafungin (MCFG) is approved for both treatment and prevention (prophylaxis) of invasive Candida infections. In this study, pediatric patients diagnosed with Candida infection and treated with MCFG were evaluated retrospectively. Clinical characteristics of the patients and the results of MCFG treatment were discussed in light of the literature. Material and Methods: The study included 10 pediatric patients aged between 28 days and 16 years. They were diagnosed with Candida infection between January 01, 2017 and January 01, 2019, and were treated with MCFG. The patients’ microbiological and laboratory data, demographic and clinical characteristics, risk factors for IC, MCFG treatment characteristics and the side effects were recorded retrospectively from electronic records. Results: The median age of the patients in the study was 22 months (range 1.5 to 178 mo). Candida species isolated from the patients were C. parapsilosis, C. orthopsilosis, C. tropicalis, C. albicans, C. kefyr and C. guilliermondii. The most common underlying disease was gastrointestinal anomaly and related problems. The most common risk factors included the use of broad-spectrum antibiotics, total parenteral nutrition, mechanical ventilation, and central venous catheter. The median dose of MCFG was 2 mg/kg per day (d) and was applied to the patients for a minimum of 3 days and a maximum of 23 days. There were no side effects observed. Conclusion: In our limited case series of pediatric patients, MCFG was found effective in treating both proven and suspected invasive Candida infections and no adverse side effects were observed.

scholarly journals Clinical Analysis of Micafungin Treatment in Children with Candida Infection: A Single Center Experiment

2020 ◽  
Vol 54 (4) ◽  
pp. 201-207
Author(s):  
Ayşe Şahin ◽  
Nazan Dalgıç ◽  
Ayşe Barış ◽  
Banu Özata Abanoz
Keyword(s):  
Risk Factors ◽  
Side Effects ◽  
Clinical Characteristics ◽  
Pediatric Patients ◽  
Laboratory Data ◽  
Case Series ◽  
Venous Catheter ◽  
Clinical Analysis ◽  
Candida Infection ◽  
Candida Infections

Objective: For the treatment of invasive candidiasis (IC) which is confirmed or suspected in adults, echinocandins are usually recommended. In children; however, very little is known about using echinocandins for IC management. Micafungin (MCFG) is approved for both treatment and prevention (prophylaxis) of invasive Candida infections. In this study, pediatric patients diagnosed with Candida infection and treated with MCFG were evaluated retrospectively. Clinical characteristics of the patients and the results of MCFG treatment were discussed in light of the literature. Material and Methods: The study included 10 pediatric patients aged between 28 days and 16 years. They were diagnosed with Candida infection between January 01, 2017 and January 01, 2019, and were treated with MCFG. The patients’ microbiological and laboratory data, demographic and clinical characteristics, risk factors for IC, MCFG treatment characteristics and the side effects were recorded retrospectively from electronic records. Results: The median age of the patients in the study was 22 months (range 1.5 to 178 mo). Candida species isolated from the patients were C. parapsilosis, C. orthopsilosis, C. tropicalis, C. albicans, C. kefyr and C. guilliermondii. The most common underlying disease was gastrointestinal anomaly and related problems. The most common risk factors included the use of broad-spectrum antibiotics, total parenteral nutrition, mechanical ventilation, and central venous catheter. The median dose of MCFG was 2 mg/ kg per day (d) and was applied to the patients for a minimum of 3 days and a maximum of 23 days. There were no side effects observed. Conclusion: In our limited case series of pediatric patients, MCFG was found effective in treating both proven and suspected invasive Candida infections and no adverse side effects were observed.

scholarly journals High Rates of Blood Transfusion Associated with Parkinson’s Disease

2021 ◽  
Author(s):  
Shane Shahrestani ◽  
Ali R. Tafreshi ◽  
Nolan Brown ◽  
Khashayar Dashtipour
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Side Effects ◽  
Blood Transfusion ◽  
Demographic Data ◽  
Cohort Analysis ◽  
High Rate ◽  
Drug Side Effects ◽  
Linear Modeling

Abstract ImportanceAs evidence continues to accumulate regarding the multi-organ dysfunction associated with Parkinson’s Disease (PD), it is still unclear as to whether PD increases the risk of hematological pathology. ObjectiveTo investigate the association between PD and hematological pathology and relevant risk factors.Design, Setting, and ParticipantsThis retrospective cohort analysis was conducted using 8-years of the National Readmission Database. All individuals diagnosed with PD were queried at the time of primary admission, and all relevant demographic data was collected. Readmissions, complications, and risk factors were analyzed at 30, 90, 180, and 300-day intervals. Statistical analysis included multivariate gaussian-fitted modelling, with age, sex, comorbidities, and discharge weights as covariates. Coefficients of model variables were exponentiated and interpreted as odds ratios. Predictive models were developed using generalized linear modeling. Complications were queried using International Classification of Disease codes.Main Outcomes and MeasuresReadmission for blood transfusion within readmission intervals and potential risk factors for blood transfusion. ResultsAnalysis was with 1,765,800 PD patients (mean age: 76.3±10.4; 44.1% female). Rates of percutaneous blood transfusion in readmitted patients at 30, 90, 180, and 300 days was found to be 8.7%, 8.6%, 8.3%, and 8.3% respectively. At all timepoints, modelling revealed that those with anti-parkinsonism medication side effects at the primary admission had increased rates of gastrointestinal (GI) hemorrhage (average OR: 1.02; 95%CI: 1.01-1.03, p<0.0001) and blood transfusion (average OR: 1.06; 95%CI: 1.05-1.08, p<0.0001) at readmission. PD patients who experienced GI hemorrhage of any etiology, including as a side effect of anti-parkinsonism medication, were found to have significantly higher rates of blood transfusion at all timepoints (average OR: 1.14; 95%CI: 1.13-1.16, p<0.0001). Kaplan-Meier survival analysis and predictive modelling confirmed these findings, with significantly higher rates of blood transfusion seen in PD patients with drug side effects and GI hemorrhage compared to those without.Conclusions and RelevanceOur findings suggest that PD patients may be readmitted at a high rate for blood transfusion procedures. These readmissions were found to be significantly associated with anti-parkinsonism drug side effects and GI hemorrhage of any etiology. Long-term management of PD patients should focus on both neurological and non-neurological complications.

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