169,728 research outputs found
Are local and systemic conditions important for the development of onychomycosis?
Available epidemiological data indicate that the prevalence of onychomycosis due to dermatophytes increases with ageing. The aim of this study was to investigate the epidemiology of dermatophyte nail infections in 2 populations selected only on an age basis and to verify whether the presence of onychomycosis was associated with increased exposure to possible predisposing factors. From January to June 1995, the nails of 1,800 military recruits and 253 elderly individuals living in a nursing home were examined. Mycological studies were performed in all cases of suspected onychomycosis. The presence of systemic or local diseases that may favor fungal nail infection as well as exposure to environmental factors were assessed in the 2 populations. Onychomycosis was diagnosed in 8 recruits (0.44%) and 38 of the elderly people (15%). The presence of onychomycosis was not related to the degree of exposure to environmental factors or to systemic or local diseases
Proximal subungual onychomycosis due to Microsporum canis
: A case of proximal subungual onychomycosis due to Microsporum canis in a 36-year-old woman is presented. The onychomycosis involved the left thumb and the little fingernails, with thinning of the nail plate and crumbling of the nail plate surface. A milky-white discoloration of the proximal portion of the left thumbnail was also evident. A 2-mm longitudinal nail biopsy showed a large number of fungal elements in the whole length of the nail plate. Fungal hyphae were more numerous in the ventral nail plate and produced detachment of the superficial nail plate. The nail bed was not invaded by fungal elements and was devoid of inflammatory changes. Proximal subungual onychomycosis is uncommon in immunocompetent individuals but has frequently been described in patients with AIDS. In our patient, in whom the proximal subungual onychomycosis was due to M. canis, there were no clinical or biochemical signs of immunodeficiency. Oral treatment with terbinafine, 250 mg/daily for 2 months, produced clinical and mycological cure
Onychomycosis due to Scopulariopsis brevicaulis: Clinical features and response to systemic antifungals
Six cases of Scopulariopsis onychomycosis, including four patients with onychomycosis exclusively caused by Scopulariopsis brevicaulis and two patients with a mixed nail infection (S. brevicaulis + Tricophyton rubrum and S. brevicaulis + T. interdigitale), are reported. Four patients presented with a typical distal subungual onychomycosis characterized by subungual hyperkeratosis and onychomycosis of the distal nail plate. In two patients, Scopulariopsis infection produced a total dystrophic onychomycosis associated with painful periungual inflammation. Three patients were treated with four pulses of itraconazole, 400 mg daily for 1 week a month, and three patients with terbinafine, 250 mg daily for 4 months. The mycological examination 8 months after discontinuation of treatment showed that one patient was mycologically cured whereas the remaining five patients still carried S. brevicaulis in their nails. The clinical examination at the end of the follow-up period showed a complete cure of the nail abnormalities in only one patient
Terbinafine vs griseofulvin in the treatment of onychomycosis due to dermatophytes
Griseofulvin has been for a long time the only available antifungal agent for the systemic therapy of onychomycosis. However, this drug requires long treatment yielding low success rates and frequent relapses combined with a relatively high incidence of side effects. recently terbinafine, a new antifungal agent which has been shown to be an effective treatment with short-term regimen for onychomycosis, has been introduced in Italy. In a comparative double-blind study the efficacy of terbinafine and griseofulvin in the treatment of onychomycosis bas been evaluated. Out of 9 patients affected by fingernail onychomycosis, 4 were treated with terbinafine at the dosage of 250 mg/day for 2 months and 5 with griseofulvin at the dosage of 1 g/day for 4 months. Of 29 patients affected by toenail onychomycosis, 14 were treated with terbinafine 250 mg/day for 4 months and 15 with griseofulvin 1 g/day for 9 months. In all cases follow-up was 6 months. All four patients with fingernail onychomycosis (100%) and 11 of the 14 patients with toenail onychomycosis (78.5%) treated with terbinafine were completely cured. Two patients with fingernail onychomycosis (40%) and 4 patients with toenail onychomycosis (26.5%) treated with griseofulvin were cured. The successful results obtained with terbinafine, with the absence of concomitant relapses or side effects, suggest this drug as an agent of choice in the treatment of onychomycosis
Terbinafine in the treatment of onychomycosis in patients with hepatic disease or in organ transplant recipients [2]
Not presen
Treatment of dermatophyte nail infections: An open randomized study comparing intermittent terbinafine therapy with continuous terbinafine treatment and intermittent itraconazole therapy
Background: Terbinafine persists in the nail at effective concentrations for several weeks after discontinuation of treatment. Objective: Our purpose was to verify whether intermittent terbinafine therapy is effective in dermatophytic onychomycosis and to compare the results of intermittent terbinafine with those of intermittent itraconazole and continuous terbinafine treatment. Methods: An open, randomized study of 63 patients was performed with three treatment regimens: terbinafine, 250 mg daily (21 patients); terbinafine, 500 mg daily for 1 week every month (21 patients); or itraconazole, 400 mg daily for 1 week every month (21 patients). Treatment was continued for 4 months in toenail infections (60 patients) and 2 months in fingernail infections (3 patients). Results: At the end of the follow-up period (6 months after discontinuation of treatment) 16 of 17 patients (94.1%) with toenail onychomycosis were mycologically cured in the terbinafine 250 mg group, 16 of 20 (80%) in the terbinafine 500 mg group, and 15 of 20 (75%) in the itraconazole group. Conclusion: The percentage of patients who were mycologically cured was higher in the continuous terbinafine group than in the intermittent terbinafine and itraconazole groups, but statistical analysis did not reveal any significant difference between these cure rates
Toenail onychomycosis due to Trichophyton soudanense in two white Italian patients
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Going Beyond Counting First Authors in Author Co-citation Analysis
The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Multiple nodular lesions of the chin and oral mucosa in a patient with Sjogren's syndrome
Sjogren's syndrome is an autoimmune disease characterised by generalised lymphoproliferation. Patients have an increased risk of developing lymphomas which are usually derived from mucosa-associated lymphoid tissue (MALT). We report a low grade, non-Hodgkin's lymphoma of the skin and oral mucosa in a patient with Sjogren's syndrome
Mitomycin C in highly myopic eyes - Author reply
Ophthalmology. 2005 Feb;112(2):208-18; discussion 219.
Mitomycin C modulation of corneal wound healing after photorefractive keratectomy in highly myopic eyes.
Gambato C, Ghirlando A, Moretto E, Busato F, Midena E.
SourceRefractive Surgery Service and Antimetabolite Therapy Research Unit, Department of Ophthalmology, University of Padova, Padova, Italy.
Abstract
PURPOSE: To evaluate the role of topical mitomycin C in corneal wound healing (CWH) after photorefractive keratectomy (PRK) in highly myopic eyes.
DESIGN: Prospective, double-masked, randomized clinical trial.
PARTICIPANTS: Seventy-two eyes of 36 patients affected by high (>7 diopters) myopia.
METHODS: In each patient, one eye was randomly assigned to PRK with intraoperative topical 0.02% mitomycin C application, and the fellow eye was treated with a placebo. Postoperatively, mitomycin C-treated eyes received artificial tears (3 times daily, tapered in 3 months), whereas the fellow eye was treated with fluorometholone sodium 2% and artificial tears (3 times daily, tapered in 3 months).
MAIN OUTCOME MEASURES: Uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), contrast sensitivity, manifest refraction, and biomicroscopy. Contrast sensitivity was determined using the Pelli-Robson chart. Corneal confocal microscopy documented CWH.
RESULTS: Mean follow-up was 18 months (range, 12-36). No side effects or toxic effects were documented. At 12-month follow-up examination, UCVAs (logarithm of the minimum angle of resolution) were 0.4+/-0.48 and 0.5+/-0.53 (P = .03) in mitomycin C-treated eyes and corticosteroid-treated eyes, respectively. At 1 year, corneal haze developed in 20% of corticosteroid-treated eyes, versus 0% of mitomycin C-treated eyes. At 12, 24, and 36 months, corneal confocal microscopy showed activated keratocytes and extracellular matrix significantly more evident in untreated eyes (Ps = 0.004, 0.024, and 0.046, respectively).
CONCLUSION: Topical intraoperative application of 0.02% mitomycin C can reduce haze formation in highly myopic eyes undergoing PRK.
Comment in
Ophthalmology. 2006 Feb;113(2):357; author reply 357-8
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