scholarly journals The Efficacy of Phototherapy for the Treatment of Onychomycosis: An Observational Study

Photonics ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 350
Author(s):  
Nadia Dembskey ◽  
Heidi Abrahamse

(1) Background: Onychomycosis accounts for 50% of nail pathologies and is a therapeutic challenge due to an increase in resistance to antifungal agents. This study aimed to explore the effectiveness of 1064 nm diode laser irradiation for the treatment of Onychomycosis and establish a new set of laser parameters for effective and safe treatment; (2) Methods: An exploratory, single-blinded study was conducted on forty-five patients with toenail Onychomycosis. Digital images and nail clippings were taken for Periodic Acid-Schiff (PAS) staining and fungal microscopy and culture (MC&S). Group 1 received 5% topical Amorolfine lacquer to apply to affected nails. Group 2 received 1064 nm diode laser treatment at 10 mW/s, hallux 790 J/cm2 and lesser digits 390 J/cm2 (standard treatment). Group 3 received 1064 nm diode laser treatment at 10 mW/s, hallux 1 100 J/cm2 and lesser digits 500 J/cm2 (new treatment parameters). After laser treatment, nail temperatures were taken with a surface thermometer; (3) Results: PAS staining was more sensitive in identifying Onychomycosis (91.1%), compared to Fungal Microscopy (44.4%). Comparing treatment requirements over a period of 24 weeks, there was a statistical significance, p ≤ 0.01 (**), for standard laser treatment and, p ≤ 0.001 (***), for new laser parameter treatment, indicating treatment needed over time decreased. No adverse effects were noted with new laser therapy. An 86.7% visual improvement was noted in Group 3 after 24 weeks; (4) Conclusions: Phototherapy, or photo thermolysis, was the best treatment option for Onychomycosis. A new protocol for the standardization of laser irradiation with the possible inclusion into the Scoring Clinical Index for Onychomycosis treatment plan, was proposed.

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 700.1-700
Author(s):  
E. Trallero-Araguás ◽  
F. Romero ◽  
I. Castellví ◽  
V. Ortiz-Santamaria ◽  
S. Castañeda ◽  
...  

Background:Idiopathic inflammatory myopathies are a heterogenous group of systemic autoimmune diseases. Several phenotypes have been linked to specific autoantibodies. Clinically amyopathic dermatomyositis with rapidly progressive interstitial lung disease, the most severe form of ILD, is associated with the anti-MDA5 antibodies. However not all the patients with dermatomyositis and anti-MDA5 positive antibodies develop this severe condition.Objectives:We aim to define different phenotypes from a large cohort of patients diagnosed with dermatomyositis who were positive to anti-MDA5 antibodies.Methods:We retrospective analyzed the clinical and immunological data of 90 anti-MDA5 patients [50 female, 55.6%, mean (SD) age at diagnosis 47 (15.4) yrs.] with dermatomyositis recruited from a multicenter register in Spain (MEDRA5) including 30 hospitals. All the patients fulfill de International Myositis Classification Criteria (EULAR/ACR) for dermatomyositis (score >90%). Anti-MDA5 were detected by means of commercial immunoblot (EUROIMMUN©). The chi-square test was used to assess the relationships between qualitative variables. The Kruskal-Wallis test was used to compared medians between groups.Results:Sixty-six patients (73.3%) were diagnosed with clinically amyopathic dermatomyositis. Three different phenotypes linked with the anti-MDA5 antibody were identified. Group 1: patients with rapidly-ILD phenotype (28 patients, 31.1%), group 2: antisynthetase-like phenotype (23 patients, 25.5%), and group 3: non-ILD phenotype (39 patients, 43.3%). Clinical and immunological comparison between the groups disclosed that age at disease onset was higher (median, IQR) in patients from group 1 [53 (43-60)] vs. group 2 [46 (40-56)] or group 3 [42(41-51)] (p=0.01); disease onset was more frequent in spring in patients from group 1 (46.5%) than in the rest of the groups (21.7% and 28.9%) (p<0.01). Cancer was detected in 7 patients, only associated with myositis in 3 cases (3 years interval between cancer and dermatomyositis) without significant differences between phenotypes. Vasculitis (one case ANCA positive) was detected in 9 cases (6 limited to skin, 1 renal and 1 intestinal), 6 of them in the group 3 (statistical significance, in comparison with group 1 and 2, p<0.01). Mortality rate was higher in group 1 (51.9%, 16 out of 17 due to refractory respiratory failure) vs group 2 (12.5%) or 3 (0%) (p<0.001). Anti Ro52 positivity was more frequent in group 1 (65.4%) vs. group 2 (25%) or 3 (35.5%) (p<0.017), although it did not reach statistical significance in terms of mortality (p=0.173) or patients admitted in the intensive care unit (p=0.173). Mechanic hands were more frequent in group 2 (40.6%) than in groups 1 (25%) and 3 (34.4%) (p=0.05). Fever was significantly most frequent in group 1(52.6%) than in group 2 (21.1%) and 3 (26.3%) (p=0.001). Other clinical or immunological features such as arthritis, myositis, or the number of characteristic skin lesions among others were not more frequent in one group or another.Conclusion:Three different phenotypes of patients positive to anti-MDA5 were identified. The presence or not of ILD, or the different type (rapidly progressive or not) of ILD were the main feature that allow to differentiate these phenotypes, which are relevant in clinical practice.References:[1]Allenbach Y, Uzunhan Y, Toquet S, et al; French Myositis Network. Different phenotypes in dermatomyositis associated with anti-MDA5 antibody: Study of 121 cases. Neurology. 2020;95: e70-e78.Acknowledgements:List of contributors of MEDRA5 group: Aguilar-García J (Internal Medicine, Hospital Costa del Sol, Marbella), Carrión-Barberá I (Rheumatology, Hospital del Mar, Barcelona), Cobo-Ibañez T (Rheumatology, Hospital Infanta Sofía, San Sebastián de los Reyes), de Escalante-Yangüela B (Internal Medicine, Hospital Clínico Lozano Blesa, Zaragoza), Fonseca-Aizpuru EM (Internal Medicine, Hospital de Cabueñes, Gijón), González-Cubillo L (Intensive Medicine, Hospital Universitario de Cruces, Barakaldo), González-Gay MA (Rheumatology, Hospital Marqués de Valdecilla, Santander), Prieto-González S (Internal Medicine, Hospital Clinic, Barcelona), Ruiz-Román A (Rheumatology, Hospital Universitario Virgen del Rocío, Sevilla), Calero-Paniagua I (Internal Medicine, Hospital Virgen de la Luz, Cuenca), Callejas-Rubio JL (Internal Medicine, Hospital Clínico San Cecilio, Granada), Gil-Vila A (Internal Medicine, Hospital Vall d’Hebron, Barcelona), de Miguel-Campo B (Internal Medicine, Hospital Doce de Octubre, Madrid), García-Sevilla R (Pneumology, Hospital General Universitario de Alicante, Alicante), Iriarte-Fuster A (Internal Medicine, Hospital de Bellvitge, Hospitalet de Llobregat), Jovani-Casano V (Rheumatology, Hospital General Universitario de Alicante, Alicante), Lozano-Rivas N (Rheumatology, Hospital Virgen de la Arritxaca, Murcia), Martín-Gascón M (Internal Medicine, Hospital Morales Meseguer, Murcia), Martinez-González O (Rheumatology, Hospital Universitario de Salamanca, Salamanca), Monteagudo-Jiménez M (Internal Medicine, Hospital Parc Taulí, Sabadell), Mora-Ortega GM (Pneumology, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes), Moral-Moral Pedro (Internal Medicine, Hospital Universitari i Politecnic La Fe, Valencia), Pérez-De Pedro I (Interna Medicine, Hospital Regional Universitario de Málaga, Málaga), Picazo-Talavera MR (Rheumatology, Hospital del Sureste, Madrid), Rubio-Rivas M (Internal Medicine, Hospital de Bellvitge, Hospitalet de Llobregat)Disclosure of Interests:None declared


2019 ◽  
Vol 20 (20) ◽  
pp. 5078 ◽  
Author(s):  
Hiroyuki Yazu ◽  
Naoyuki Kozuki ◽  
Murat Dogru ◽  
Ayako Shibasaki ◽  
Hiroshi Fujishima

The use of eyewash solutions in Japan, especially in patients with allergic conjunctivitis and contact lens wearers, has been increasing. Our aim was to investigate how the use of preservative-free eyewash solution in healthy eyes for one month affects corneal safety and ocular surface mucin. We analyzed 42 eyes of 21 individuals (17 males, four females; mean age: 36.1 ± 7.4 years) without ocular allergies, dry eyes, or other ocular diseases through a prospective study. Eyes were randomized to a wash group (group one) and a nonwash follow up group (group two). We evaluated the dry eye-related quality-of-life score (DEQS), tear film breakup time (TBUT), fluorescein staining score, mRNA expression of MUC5AC and MUC16, MUC16 immunohistochemistry, and MUC5AC periodic acid Schiff (PAS) staining. There was a significant decrease in DEQS scores after one month of eyewash use (p < 0.05). There were no significant differences in other evaluation items that were analyzed (all p > 0.05). Furthermore, no significant differences were observed between group one and group two in all endpoints (all p > 0.05). The results suggest that one month use of a nonpreserved eyewash solution has no detrimental effects on the tear film and the ocular surface mucins.


2012 ◽  
Vol 30 (27) ◽  
pp. 3389-3395 ◽  
Author(s):  
Joseph A. Roscoe ◽  
Charles E. Heckler ◽  
Gary R. Morrow ◽  
Supriya G. Mohile ◽  
Shaker R. Dakhil ◽  
...  

Purpose We conducted a double-blind randomized clinical trial of the following four regimens for controlling delayed nausea (DN): group 1: palonosetron + dexamethasone on day 1 with prochlorperazine on days 2 and 3; group 2: granisetron + dexamethasone on day 1 with prochlorperazine on days 2 and 3; group 3: aprepitant + palonosetron + dexamethasone on day 1 with aprepitant + dexamethasone on days 2 and 3; and group 4: palonosetron + dexamethasone on day 1 with prochlorperazine + dexamethasone on days 2 and 3. Patients and Methods Chemotherapy-naive patients received doxorubicin, epirubicin, cisplatin, carboplatin, or oxaliplatin. The primary end point was average nausea assessed four times daily on days 2 and 3. Primary analyses were whether nausea control would be improved by using palonosetron versus granisetron on day 1 (group 1 v group 2); by adding dexamethasone on days 2 and 3 (group 1 v group 4); and by using aprepitant versus prochlorperazine (group 3 v group 4). Statistical significance was set at P = .017. Results Two hundred thirty-four, 234, 241, and 235 evaluable patients were accrued to groups 1, 2, 3, and 4, respectively. Adjusted mean differences for the three planned analyses were as follows: palonosetron versus granisetron: −0.01 (95% CI, −0.23 to 0.20; P = .72); adding dexamethasone on days 2 and 3: 0.20 (95% CI, −0.02 to 0.41; P = .01); and using aprepitant versus prochlorperazine: −0.03 (95% CI, −0.24 to 0.19; P = .56). Conclusion The addition of dexamethasone on days 2 and 3 reduced DN. Palonosetron and granisetron have similar effects on DN. The beneficial effect of adding aprepitant for control of DN was the same as adding prochlorperazine.


Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3761-3761 ◽  
Author(s):  
Denis Soulieres ◽  
Sylvain Marchand ◽  
Xiaoduan Weng ◽  
Julie Bergeron ◽  
Louise Robin ◽  
...  

Abstract Introduction: β-thalassemia (thal) minor is caused by multiple β-globin (gb) gene mutations, most being located in the promotor and IVS-1. Large variations in erythrocyte indices between β-thal minor patients have been reported and are thought to be caused by the type of β-gb gene mutation. α-thal minor is caused by partial or total α-gb gene deletions. α-gb gene deletions have been reported in all racial origins. It is therefore likely that α-gb gene deletions occur in β-thal minor patients.This combination of gb genes mutations could also have an impact on erythrocyte indices. Objectives: The trial objectives were to determine the prevalence of α-gb gene deletions in β-thal minor patients and to compare erythrocyte indices between 3 groups. Group 1: no α-gb gene deletion, Group 2: deletion of 1 α-gb gene, Group 3: deletion of 2 α-gb genes. Methods: Diagnosis of β-thal minor was established using hemoglobin HPLC analysis (Variant II, Bio-Rad) with increased HbA2 +/− increased HbF without mutant Hb. The DNA of consecutive cases with newly diagnosed β-thal minor was extracted from leucocytes. A multiplex PCR assay was used to detect the presence of 7 α-globin gene deletions: −α3.7,− α4.2, −− SEA, −− FIL, −− MED, −− THAI, − α20.5. Data on age, sex and erythrocyte indices (Hb, MCV, RBC and RDW) was recorded. An ANOVA was used to compare groups. P significance was established at 0.01 to adjust for multiple analysis. Results: 300 specimen were collected in 9 months. 34 were excluded because of poor DNA quality or presence of a mutant Hb. 25 patients (9.4%) had at least 1 α-globin gene deletion. Group1 included 241 patients, Group 2: 20 patients and Group 3: 5 patients. No differences for age or sex were present between the groups. Differences in erythrocyte indices are reported in Table 1. LogMCV was used to adjust for variance heterogeneity. Conclusions: 9.4% of β-thal minor have α-gb gene deletions. The only parameter that is significantly different between groups is MCV (Hb not reaching the pre-specified level of 0.01). It is therefore possible that differences in MCV between patients with β-thal minor can be explained by α-gb gene deletions. The concommittant presence of β-gb and α-gb mutations might improve the β-gb/α-gb imbalance implicated in ineffective erythropoiesis and a significant increase in MCV (and Hb but not reaching statistical significance in this study due to the sample size). However, this parameter does not have sufficient power to differenciate or identify β-thal minor patients with α-globin gene deletions. Other factors certainly influence MVC variability in β-thal minor patients and the independant influence of this variable (α-gb gene deletions) will require further investigation. Erythrocyte indices between groups Parameter Group Mean Std Deviation 95% CI P MCV 1 65.8657 3.9845 65.3580–66.3734 <.0001 2 70.0600 7.5579 66.5228–73.5972 3 73.2600 3.6011 68.7886–77.7314 Log MCV 1 1.8176 .02637 1.8142–1.8209 <.0001 2 1.8432 .04504 1.8221–1.8643 3 1.8644 .02152 1.8377–1.8912 RDW 1 16.0004 1.2800 15.8380–16.1628 .068 2 15.4500 1.8958 14.5627–16.3373 3 15.0200 2.0909 12.4238–17.6162 RBC 1 5.7081 .7369 5.6144–5.8018 .885 2 5.6835 .6729 5.3686–5.9984 3 5.5500 .6181 4.7826–6.3174 Hemoglobin 1 119.7759 14.9010 117.8851–121.6668 .038 2 127.3000 13.6501 120.9115–133.6885 3 129.4000 12.3410 114.0766–144.7234


Reproduction ◽  
2003 ◽  
pp. 855-863 ◽  
Author(s):  
A Albihn ◽  
RO Waelchli ◽  
J Samper ◽  
JG Oriol ◽  
BA Croy ◽  
...  

A novel xenogeneic transplantation approach was used to determine whether it is embryonic or maternal tissue that produces the material that gives rise to the mucin-like glycoprotein of the equine embryonic capsule. Endometrial biopsy samples and conceptuses from six mares at days 13-15 after ovulation were prepared as 1 mm(3) grafts of endometrium, trophoblast and capsule for transplantation, alone or in combination, into various sites in 88 immunodeficient (severe combined immunodeficient or RAG2/gamma(c) double mutant) mice. The overall recovery rate of grafts was over 50%, reaching 100% with experience and use of the renal subcapsular space exclusively. Periodic acid-Schiff (PAS) staining demonstrated capsule-like extracellular glycoprotein secretions at the graft site in 11 of 22 sites examined. Strong PAS-positive reactions (5-7 microm thick) were found in four of six sites containing trophoblast alone, five of six endometrium plus trophoblast sites, and zero of eight grafts of endometrium alone. Two recovered grafts of capsule were also PAS-positive. The secreted glycoprotein was identified as equine embryonic capsule material by using a monoclonal antibody (mAb) specific to equine capsule (mAb OC-1) in two experiments. In the first, in cryosections, this antibody bound to 19 of 19 recovered trophoblast graft secretions (including those in 12 from mice that had not received endometrium at any site), ten of ten recovered endometrium plus trophoblast grafts, and zero of 12 recovered endometrial grafts from mice in which trophoblast had been grafted to the same site or another site in the same mouse. In the second experiment, in paraformaldehyde-fixed sections of grafts from 11 mice, specific staining, identical to that shown by grafted capsule, was obtained with grafts of trophoblast (both alone and in combination with endometrium) but not with grafts of endometrium. These results support the contention that trophoblast is the principal source of equine embryonic capsule. In addition, they demonstrate that xenogeneic grafting is a useful means of culturing endometrium and conceptus tissues outside the mare when in vitro techniques do not suffice.


2006 ◽  
Vol 3 (3) ◽  
pp. 183-188 ◽  
Author(s):  
Tang Xin-Yan ◽  
Zeng Wei-Dong ◽  
Mi Yu-Ling ◽  
Liu Hong-Yun ◽  
Zhang Cai-Qiao

AbstractPrimordial germ cells (PGCs) were isolated from the genital ridges of chicken (Gallus domesticus) embryos at the 19th stage and purified by Ficoll density-gradient centrifugation. PGCs were co-cultured with somatic cells in preliminary culture and subcultured. Identification of PGCs was carried out by histochemical methods, including alkaline phosphatase (AKP) and periodic acid–Schiff (PAS). The proliferating activity of PGCs in subculture was demonstrated by immunocytochemistry of proliferating cell nuclear antigen (PCNA). Meanwhile, proliferating PGCs were compared under different culture conditions of 5–20% fetal cattle serum (FCS), insulin–transferrin–selenite (ITS) medium, conditioned medium (CM), 15% FCS+ITS, 15% FCS+40% CM. The results showed that the cultured PGCs were positive for AKP and PAS staining and displayed intensive proliferating activity by PCNA. The PGCs without centrifugation grew better than those with centrifugation. The PGCs formed larger colonies in media with 5% FCS or ITS than other media, indicating that 5% FCS or ITS supplemented media could be an ideal culture system for PGC proliferation in the PGC-somatic cell co-culture, in addition to the embryonic fibroblast feeder layer.


2010 ◽  
Vol 2 (2) ◽  
pp. 45-53 ◽  
Author(s):  
Đorđi Gocev ◽  
Katerina Damevska

Abstract Histopathological analysis is not a routine procedure for diagnosing fungal skin infections. In the histopathological specimens, fungi are visible only when using special stain such as periodic acid-Schiff (PAS). However, histopathological analysis may not be performed in small laboratories. Histopathological characteristics of fungal skin infections are not specific. In all skin biopsy cases, obtained without clinical suspicion of fungal infection, the knowledge of certain, most frequent histopathological reaction patterns, as well as specific histopathological indicators (a diagnostic histopathological “clue”), of certain superficial mycoses e.g., dermatophytoses, may raise a suspicion of fungal infection and warrant a fungal-specific staining. A retrospective analysis of all PAS-stained sections was carried out. All PAS-positive biopsy specimens were assessed for clinical features, histopathological patterns of skin reactions, and presence of histopathological indicators. Our results have shown that out of the total of 361 PAS-stained sections, fungal hyphae were identified in 12 (3.3%) specimens. In 5 (1.4%) cases, the diagnosis of fungal infection was suspected on clinical grounds, while in 7 (1.9%) cases detection of fungi was an unexpected finding. The most frequent type of histopathological pattern was spongiotic, and the most frequent histopathological indicator was the presence of neutrophils within the epidermis. Our results confirm that dermatophytoses may present with clinical and histological non-specific findings. PAS staining represents a relatively cheap and simple fungal-specific staining. It has been suggested that it not only confirms that the selected material is actually invaded, but also reduces the number of false-negative direct reports, where fungi are cultured from a microscopically negative specimen. Apart from a small percentage of positive findings, our results justify the need for routine PAS staining of all clinically and histologically non-specific inflammatory skin conditions.


2006 ◽  
Vol 14 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Mara Cristina Santos Felippe ◽  
Wilson Tadeu Felippe ◽  
Catherine Schmitz Espezim ◽  
Sérgio Fernando Torres de Freitas

AIM: To evaluate the effect of different irrigant solutions employed during removal and replacement of calcium hydroxide paste on the diffusion of hydroxyl ions through root canal dentine in vitro. METHODOLOGY: Thirty-five maxillary and mandibular human canines with straight and fully developed roots were used. After mechanical preparation up to 1mm short of tooth length, 30 canals were filled with calcium hydroxide paste and 5 canals were left empty; all teeth had their coronal accesses properly sealed. Teeth were placed in plastic containers with distilled water, and pH was read after 30 days when the paste from 20 teeth was renewed. After removal of the paste by endodontic instrumentation and irrigation with distilled water, canals were replenished with newly mixed paste in Group 1 and 2. In these groups, final irrigation was conducted with 5 mL of EDTA followed by 5 mL of NaOCl in specimens in Group 1, and 5 mL of NaOCl only in specimens in Group 2. In 10 teeth the paste was not replenished at 30 days (Group 3). All specimens were returned to the containers with fresh distilled water, and the pH was recorded after another 30 days. The differences between the first (30d) and second (60d) pH readings were calculated and submitted to analysis of variance and individual comparisons using the Scheffeé's test. RESULTS: Results of mean analysis on differences of pH readings showed that greater diffusion had occurred on specimens in Group 3. Individual comparisons using Scheffeé's test showed statistical significance between Groups 2 and 3, and equivalence between all other groups. CONCLUSION: It was concluded that the use of EDTA did not enhance diffusion of hydroxyl ions through root canal dentine.


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