scholarly journals Preliminary Evidence of the Efficacy of Nitric Acid Treatment in Onychomycosis

2021 ◽  
Vol 18 (24) ◽  
pp. 13371
Author(s):  
Félix Marcos-Tejedor ◽  
Natividad Santos-Carnicero ◽  
Raquel Mayordomo
Keyword(s):  
Nitric Acid ◽  
Severity Index ◽  
Preliminary Evidence ◽  
Nail Dystrophy ◽  
Limited Efficacy ◽  
Pharmacological Interactions ◽  
Before And After ◽  
Active Substances ◽  
Antifungal Efficacy ◽  
Rapid Treatment

Onychomycosis is the main cause of toenail disorders and is produced by a fungal infection. It is becoming more prevalent because of new lifestyles and immunosuppression statuses. The therapeutic approach to onychomycosis is under considerable study because of the lengthy treatments that require strong patient commitment, the limited efficacy of treatments, the inclusion of active substances that can be hepatotoxic and cause pharmacological interactions, and/or the questionable efficacy of treatments due to a lack of clinical trials. This study responds to the demand for rapid treatment with minimal pharmacological interactions. Methods: The efficacy of nitric acid 60% treatment in patients with onychomycosis was monitored and studied. The antifungal efficacy of nitric acid was measured by microbiological culture before and after treatment and the clinical evolution of nail dystrophy was quantitatively measured by monitoring with the Onychomycosis Severity Index (OSI). Results: The results show that, with the protocol used, nitric acid 60% painlessly cured 40% (microbiologic cure) of the cases treated, and in all cases, clinical improvement was observed (p = 0.011). Conclusions: The treatment with nitric acid 60% is as efficient as conventional treatments, requires less patient compliance of the treatment and produces no pharmacological interactions, providing alternative treatment in the case of hepatotoxicity.

Preliminary Validation of the Severity of Nail Psoriasis Score (SNAPS) for the Assessment of Nail Psoriasis in Patients With Psoriatic Arthritis

2021 ◽  
pp. 247553032110114
Author(s):  
Anna Antony ◽  
Sadaf Saeed ◽  
Darren Hart ◽  
Preeti Nair ◽  
Charlotte Cavill ◽  
...  
Keyword(s):  
Severity Index ◽  
Routine Care ◽  
Measurement Properties ◽  
Strong Correlations ◽  
Nail Dystrophy ◽  
Psoriasis Area Severity Index ◽  
Nail Psoriasis ◽  
Outcome Instrument ◽  
Preliminary Validation

Background: Psoriatic nail dystrophy is infrequently assessed in routine care and observational cohorts due to the lack of a feasible validated outcome measure. Objective: To assess the measurement properties of the “Severity of NAil Psoriasis Score” (SNAPS) in PsA. Methods: Nail photography was performed on prospectively recruited patients at baseline and 6 months. The modified Nail Psoriasis Severity Index (mNAPSI) and Physician Nail Visual Acuity Scale (PhNVAS) were comparator instruments for construct validity. Reliability and feasibility were assessed using intra-class correlations (ICCs) and timed scoring. Responsiveness was assessed by correlating the changes in SNAPS, mNAPSI and PhNVAS. Retrospective data from the Bath PsA database was further utilized to assess responsiveness. Results: 21 patients participated in the prospective validation at baseline. Inter- and intra-rater reliability of SNAPS were 0.94 and 0.93-0.96 (p ≤ 0.005). Mean times required to score SNAPS and mNAPSI were 59 and 136 seconds. There were strong correlations between SNAPS and mNAPSI (r = 0.95, p < 0.001) and PhNVAS (r = 0.77, p < 0.001) at baseline. There was a significant reduction in the mNAPSI and SNAPS (p < 0.005) at 6 months and a strong correlation between the change in SNAPS and mNAPSI (rho = 0.838, p < 0.001). Historical data from 57 patients commenced on Etanercept were evaluated. Mean SNAPS reduced from 3.6 to 2.0 at 3 months and 1.2 at 6 months (p < 0.05). Change in SNAPS correlated with changes in Psoriasis Area Severity Index and Dermatology Quality of Life at 3 and 6 months (r≥0.510; p ≤ 0.003). Conclusion: SNAPS is a feasible, reliable and responsive outcome instrument for psoriatic nail dystrophy.

The behavior of managers handling digital business transformations: theoretical issues and preliminary evidence from firms in the manufacturing industry

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Diego Matricano ◽  
Laura Castaldi ◽  
Mario Sorrentino ◽  
Elena Candelo
Keyword(s):  
Organizational Culture ◽  
Case Studies ◽  
Manufacturing Industry ◽  
Qualitative Content Analysis ◽  
Preliminary Evidence ◽  
Digital Innovation ◽  
Content Type ◽  
Textual Data ◽  
Before And After ◽  
Theoretical Issues

PurposeOrganizational culture plays a central role when dealing with the issue of digital business transformation (DBT). Managers handling a DBT and involved in digital strateging are expected to modify the organizational culture of firms to make it more fitting with the paradigm of digital economy and having more chance of success. Thus, it is noteworthy to inspect the role they can have over DBTs. Accordingly, the purpose of this paper is to investigate the behavior that managers assume when they approach DBTs by investigating whether they act as mentors/facilitators or entrepreneurs/innovators, as coordinators or decision makers.Design/methodology/approachTo achieve the above purpose, ten case studies about manufacturing firms have been selected. Case studies, retrieved by the Digital Innovation Observatories of the School of Management of the Politecnico di Milano, are studied and analyzed by means of a qualitative content analysis on textual data. This allows getting specific insights into organizational culture before and after DBT and about the role played by managers.FindingsAchieved results disclose that managers need to modify the organizational culture of their firms to handle a successful DBT. However, firms can assume different organizational culture and thus the role assumed by managers handling a DBT can change as well.Originality/valueTo the authors knowledge, this paper is among the first that aim to investigate the role that mangers assume when handling DBTs. In particular, originality lies in the fact that assumed roles are rebuilt in reference to their ability to modify organizational culture.

The Flash Technique in a Low-Intensity Group Trauma Intervention for Healthcare Providers Impacted by COVID-19 Patients

2021 ◽  
pp. EMDR-D-20-00053
Author(s):  
Philip E. Manfield ◽  
Lewis Engel ◽  
Ricky Greenwald ◽  
David G. Bullard
Keyword(s):  
Group Intervention ◽  
Healthcare Providers ◽  
Preliminary Evidence ◽  
Effect Sizes ◽  
Traumatic Memories ◽  
Low Intensity ◽  
Before And After ◽  
Flash Technique ◽  
Rapid Relief

The flash technique (FT) is a low-intensity individual or group intervention that appears to rapidly lessen the distress of disturbing and traumatic memories. This paper reports on the safety and effectiveness of group FT with 77 healthcare providers and 98 psychotherapists impacted by working with COVID-19 patients. One-hour webinars included 30 minutes of psychoeducation and two guided 15-minute FT interventions, focused on participants’ most distressing pandemic-related memory. Before and after each 15-minute FT intervention, they rated that memory using the 11-point zero-to-ten subjective units of disturbance (SUD) scale. Results from both interventions were highly significant with large effect sizes (p < .001, Hedges’ g = 2.01, Hedges’ g = 2.39). No adverse reactions were reported. For 35 participants who processed the same memory in both interventions, the pre–post SUD scores from the beginning of intervention #1 to the end of intervention #2 showed a significant reduction with a large effect size (p < .001, Hedges’ g = 3.80). For this group, both intervention #1 and intervention #2 showed significant reductions with large effect sizes (p < .001, Hedges’ g = 2.00) (p < .001, Hedges’ g = 1.18). Follow-up SUD scores were obtained from 58 participants, with the mean disturbance level showing a significant further decrease. These findings provide preliminary evidence that group FT appears to safely provide rapid relief from disturbing memories. FT merits further research.

Eco-Friendly Dye-free Coloration Technology for Wool Based on Fenton Reagent Pretreatment

2011 ◽  
Vol 239-242 ◽  
pp. 3327-3330 ◽  
Author(s):  
Yan Ling Sui ◽  
Yong Zhu Cui
Keyword(s):  
Nitric Acid ◽  
Emission Reduction ◽  
Optimal Conditions ◽  
Fenton Reagent ◽  
Saving Energy ◽  
Before And After ◽  
Series Of Experiments

The wool was pretreated with Fenton reagent in this paper, on this basis, 4-hydroxy benzaldehyde and concentrated nitric acid were used to discuss the dye-free coloration deeply. It was analyzed comparatively through a series of experiments on the wool before and after Fenton reagent pretreatment, and the effects of concentrations, temperature and time on the coloration were further discussed. The experiment indicated that, compared with untreated wool, the color of wool with Fenton reagent pretreatment was deeper and the coloration rate was quicker. It realized good coloration at lower temperatures, which achieved the goal of saving energy and emission reduction. The optimal conditions were that concentrations of 4-hydroxy benzaldehyde and concentrated nitric acid were 2.5% and 3% respectively, reacting time was 90min, and reacting temperature was 70°C.

scholarly journals The Safety and Efficacy of Pregabalin Add-on Therapy in Restless Legs Syndrome Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Hyoeun Bae ◽  
Yong Won Cho ◽  
Keun Tae Kim ◽  
Richard P. Allen ◽  
Christopher J. Earley
Keyword(s):  
Side Effects ◽  
Restless Legs Syndrome ◽  
Severity Index ◽  
Efficacy And Safety ◽  
Restless Legs ◽  
Persistent Symptoms ◽  
Before And After ◽  
Severity Index Score ◽  
Irls Score ◽  
Symptomatic Control

Pregabalin is increasingly being used as a first-line treatment for symptomatic control of restless legs syndrome (RLS). This study aimed to evaluate the efficacy and safety of pregabalin as add-on therapy in RLS patients already taking dopamine agonists (DA) but still in need of further management. Patients with idiopathic RLS were enrolled, and all had already been prescribed DA for at least 3 months but still had either persistent symptoms, side effects, or comorbid insomnia. An initial dose of 75 mg pregabalin was begun, adjusted as needed, and maintained at a stable dose for 4 weeks, followed by observation for a total of 8 weeks. RLS symptoms and insomnia scores were evaluated before and after add-on pregabalin treatment. Patients were monitored for side effects that could be attributed to pregabalin. A total of 32 RLS patients were enrolled, and 20 subjects remained until the endpoint. After the pregabalin add-on, the mean IRLS score showed significant improvement compared to the baseline (p &lt; 0.001). The insomnia severity index score also improved (p = 0.036), and no serious adverse effects were observed. Our preliminary data suggests the potential for pregabalin as an add-on therapy to DA with regards to both efficacy and safety in patients who have inadequate RLS improvement.

scholarly journals Average molecular weight of surfactants in aerosols

2007 ◽  
Vol 7 (5) ◽  
pp. 13805-13838 ◽  
Author(s):  
M. T. Latif ◽  
P. Brimblecombe
Keyword(s):  
Molecular Weight ◽  
Surface Tension ◽  
Atmospheric Aerosols ◽  
Average Molecular Weight ◽  
Molecular Size ◽  
Weight Fraction ◽  
Ozone Exposure ◽  
Before And After ◽  
Fine Mode ◽  
Active Substances

Abstract. Surfactants in atmospheric aerosols determined as methylene blue active substances (MBAS) and ethyl violet active substances (EVAS). The MBAS and EVAS concentrations can be correlated with surface tension as determined by pendant drop analysis. The effect of surface tension was more clearly indicated in fine mode aerosol extracts. The concentration of MBAS and EVAS was determined before and after ultrafiltration analysis using AMICON centrifuge tubes that define a 5000 Da (5 K Da) nominal molecular weight fraction. Overall, MBAS and to a greater extent EVAS predominates in fraction with molecular weight below 5 K Da. In case of aerosols collected in Malaysia the higher molecular fractions tended to be a more predominant. The MBAS and EVAS are correlated with yellow to brown colours in aerosol extracts. Further experiments showed possible sources of surfactants (e.g. petrol soot, diesel soot) in atmospheric aerosols to yield material having molecular size below 5 K Da except for humic acid. The concentration of surfactants from these sources increased after ozone exposure and for humic acids it also general included smaller molecular weight surfactants.

scholarly journals Evaluation of Efficacy and Safety Profile of Intense Pulsed Light Treatment in Melasma in Darker Skin Type

2020 ◽  
Vol 12 (1) ◽  
pp. 3-8
Author(s):  
Nishant Choudhary ◽  
Abhishek De ◽  
Amrita Sil ◽  
Gobinda Chatterjee
Keyword(s):  
Safety Profile ◽  
Severity Index ◽  
Skin Type ◽  
Intense Pulsed Light ◽  
P Value ◽  
Efficacy And Safety ◽  
Pulsed Light ◽  
First Line Therapy ◽  
Type Iv ◽  
Before And After

AbstractIntroduction. We undertook a prospective, interventional study to evaluate the efficacy and safety profile of Intense Pulsed light (IPL) treatment of melasma in dark skin phenotypes.Material and Methods. The study was conducted in 32 patients of skin type IV and V. IPL with 640 nm and 690 nm filters was used. The patients were called once a month to undergo 6 sessions. Melasma area and severity index (MASI) and Clinician Global Impression Scores were used for evaluation. We followed “per protocol” analysis.Results. Out of 26 patients who completed the treatment, 12 patients showed improvement, MASI remained unchanged in 10 patients and 4 patients showed deterioration. MASI scores before and after treatment were 6.70 ± 3.53 and 6.32 ± 3.90 (p value=0.6891). Erythema and pain were the common side effects noted. Seventeen out of 32 patients had thyroid disorders.Conclusion. IPL should be avoided as a first line therapy in darker skin type. However, it can be used as an adjuvant therapy in some cases after careful deliberations.

Assessment and documentation of incontinence-associated dermatitis after implementation of a standardised instrument: a comparative study

2019 ◽  
Vol 28 (Sup9) ◽  
pp. S4-S11 ◽  
Author(s):  
Mary Montague ◽  
Matthew Karafa ◽  
Nancy M. Albert
Keyword(s):  
Standard Deviation ◽  
Weighted Kappa ◽  
Severity Index ◽  
Skin Condition ◽  
Assessment Instrument ◽  
Clinical Nurses ◽  
Before And After ◽  
Implementation Period ◽  
Improved Accuracy ◽  
Good Agreement

Objective: In this study, clinical nurses' documentation of incontinence-associated dermatitis (IAD) were compared with wound expert documentation before and after implementing a valid, reliable severity index (SI) instrument. Methods: A prospective, non-equivalent, two group comparative design within three hospital medical units. Pre- and post-implementation skin condition documentation were compared by clinician type, and post-implementation IADSI scores were assessed for agreement using standard and weighted Kappa. Results: Of 89 patients (pre-, n=48 and post-, n=38), mean (standard deviation) age was 72.4±13.7 years and 57.3% had IAD. Mean IADSI score was 13.2 (standard deviation: 10.5; range: 0–52), reflecting pink intact skin. Post-implementation, skin documentation between clinicians was more likely to match, from 35.4 to 84.2%, p<0.001. Post-implementation, after controlling for age, gender and race, the odds ration (OR) of matched documentation between clinicians was 5.80 ([95% confidence interval: 1.8, 18.6], p=0.003) compared with pre-implementation. In the post-implementation period, standard Kappas for agreement in clinical nurse-wound expert documentation in the lower back/buttocks/upper thigh areas ranged from 0.82 to 1.0, reflecting very good agreement. Weighted kappas ranged from 0.76 to 1.0, also reflecting good to very good agreement. Conclusion: Implementation of an IADSI assessment instrument improved accuracy of IAD documentation.

The Affordable Care Act and emergency department use by low acuity patients in a US hospital

2020 ◽  
pp. 095148482094359
Author(s):  
Daniel Keyes ◽  
Hisham Valiuddin ◽  
Hassan Mouzaihem ◽  
Patrick Stone ◽  
Jaqueline Vidosh
Keyword(s):  
Emergency Department ◽  
Affordable Care Act ◽  
Cohort Analysis ◽  
Severity Index ◽  
Chi Square ◽  
Before And After ◽  
Primary Care Patients ◽  
Ed Visits ◽  
The Affordable Care Act ◽  
Status Data

Background The Affordable Care Act (ACA) is one of the biggest healthcare reforms in US history. A key issue is the ACAs effect on low acuity, potentially primary care patients. This study evaluates the effect of the ACA on low acuity patients seen in the emergency department (ED). Methods This is an age-period-cohort analysis for a community hospital ED in Michigan, from 2009 to 2015. Patients were stratified by age, year seen, emergency severity index (ESI) and insurance status. Data were compared between before and after ACA along with descriptive statistics, Chi-square and Student t-tests. The primary outcome was the change in ED usage by low acuity. Patients > 65 were used as a temporal control. Results 305,350 ED visits were analyzed. ED visits with ESI 4/5 increased from 11.9% to 14.8%. Patients < 19 years increased from 25.5% to 34.3% (p = .0026). Ages 19–25 increased from 16.3% to 19.7% (p = 0.0515). Ages 26–64 increased from 11% to 14.9% (p = 0.0129). Ages > 65 increased from 5.1% to 6.5%. Patients < 65 showed a decreased uninsured rate from 12.30% to 6.28% (p < 0.0001). Comparatively, for age > 65: uninsured rate remained the same 0.46% to 0.49%. Conclusion Low acuity ED visits increased with the ACA reform in conjunction with a more insured population.

scholarly journals 0514 Efficacy of a Forehead-Cooling Device for Treating Insomnia in Veterans

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A197-A197
Author(s):  
E Nofzinger
Keyword(s):  
Prospective Study ◽  
Large Scale ◽  
Prospective Trial ◽  
Sleep Onset ◽  
Severity Index ◽  
Post Treatment ◽  
Cooling Device ◽  
Insomnia Severity Index ◽  
Before And After ◽  
Insomnia Severity

Abstract Introduction In 2 independent studies, we explored whether a forehead-cooling device was effective in improving insomnia in veterans. Methods Both studies were uncontrolled and exploratory in nature. The first study involved 20 veterans who expressed interest in using the forehead-cooling device and received 4 weeks treatment. The second study involved 19 veterans who were recruited via media to participate in a 4-week study and were compensated for their participation. All participants completed questionnaires before and after treatment. Results In the retrospective analysis, veterans had improvements over baseline in insomnia severity index (M ± SD =17.6 ± 4.7 pre- vs 6.9 ± 3.5 post-treatment, t(19) = -9.4, p&lt;0.00001), in sleep latency (M ± SD = 61.7 ± 49.1 minutes pre- vs 25.0 ± 20.8 minutes post-treatment, t(19) = -4.6, p&lt;0.001) and in minutes awake after sleep onset (M ± SD =78.7 ± 57.8 minutes pre- vs 29.9 ± 18.3 minutes post-treatment, t(19) = -4.0, p&lt;0.001). In the prospective study, veterans had improvements in insomnia severity index over baseline (M ± SD = 20.7 +3.8 pre- vs 9.5 ± 7.5 post-treatment, t(18) = 5.8, p&lt;0.00001), depression severity on the PHQ-9 (M ± SD = 21.5 ±6.1 pre- vs 14.2 ± 5.1 post-treatment, t(18) =4.1, p&lt;0.001) and anxiety severity on the GAD 7 (M ± SD = 9.8 ±7.1 pre- vs. 6.2 ± 5.4 post-treatment, t(18) = -3.1, p&lt;0.01). Conclusion Use of a forehead-cooling device improved insomnia in veterans. These findings were replicated in an independent prospective trial. Reductions in depressive and anxiety symptoms from baseline were also noted in the prospective study. These promising preliminary data suggest the need for further large scale randomized controlled trials to establish the efficacy of forehead-cooling on insomnia in veterans. Support Ebb Pharmaceuticals, Pittsburgh, PA 15222

Sign in / Sign up

Export Citation Format

Share Document