Management of incontinence-associated dermatitis with topical antibiotics and antifungal medication.

OBJECTIVE: The primary goals of managing incontinence-associated dermatitis (IAD) are to control the incontinence and to stop the progress of dermatitis. This study evaluated the effectiveness of using a combination of topical antibiotic and topical antifungal medication to manage IAD. METHOD: Patients with grade 2 IAD treated with a combination of topical antibiotic Biomycin (CBC Biotechnological and Pharmaceutical, Taiwan) and antifungal clotrimazole (Sinphar Group, Taiwan) between January 2017 and January 2019 were included in this retrospective study. Data collected included patients' age, sex, diagnosis, body mass index, comorbidities and surface area involved. Patients were reviewed fortnightly until the wounds had healed, the patient was discharged or had died. RESULTS: A total of 76 patients were included. There were 39 men and 37 women with a mean age of 74 years. In 58 (76%) patients, the surface area involved was >50cm2, in 13 (17%) patients the involved area was 20-50cm2 and in five (7%) patients the area involved was <20cm2. The mean number of days treated was 10.3 (range: 1-53). A total of 46 (61%) patients showed total healing of their IAD, 17 (22%) patients showed improvement of >50% of the involved area, seven (9%) patients showed improvement of 0-50%, five (7%) patients showed no improvement and one (1%) patient showed an increase in the area involved. CONCLUSION: This combination of treatment was effective in the management of IAD. It was cheap, easy to apply, easy to remove and easily accessible. It could be used efficiently by the hospital staff and the patient's family.

Photoinduced single- versus double-bond torsion in donor-acceptor-substituted trans-stilbenes.

The electronic absorption and fluorescence spectra, quantum yields for fluorescence (Phi(f)) and trans --> cis photoisomerization (Phi(tc)), and fluorescence lifetimes of trans-4-(N-arylamino)-4'-cyanostilbenes (2H, 2Me, 2OM, 2CN, and 2Xy with aryl = phenyl, 4-methylphenyl, 4-methoxyphenyl, 4-cyanophenyl, and 2,5-dimethylphenyl, respectively), trans-4-(N-methyl-N-phenylamino)-4'-cyanostilbene (2MP), trans-4-(N,N-diphenylamino)-4'-cyanostilbene (2PP), trans-4-(N-methyl-N-phenylamino)-4'-nitrostilbene (3MP), and three ring-bridged analogues 2OMB, 2MPB, and 3MPB are reported. Whereas fluorescence and torsion of the central double bond account for the excited decay of the majority of these donor-acceptor substituted stilbenes in both nonpolar and polar solvents (i.e., Phi(f) + 2Phi(tc) approximately 1), exceptions are observed for 2OM, 3MP, and 3MPB in solvents more polar than THF and for 2Me and 2MP in acetonitrile as a result of the formation of a weakly fluorescent and isomerization-free twisted intramolecular charge transfer (TICT) state (i.e., Phi(f) + 2Phi(tc) << 1). The TICT state for 2OM, 2Me, and 2MP results from the torsion of the stilbenyl-anilino C-N single bond, but the torsion of the styryl-anilino C-C bond is more likely to be responsible for the TICT state formation of 3MP and 3MPB. In conjunction with the behavior of aminostilbenes 1, a guideline based on the values of Phi(f) and Phi(tc) for judging the importance of a TICT state for trans-stilbenes is provided. Accordingly, the TICT state formation is unimportant for the excited decay of trans-4-(N,N-dimethylamino)-4'-cyanostilbene (DCS). In contrast, our results support the previously proposed TICT state for trans-4-(N,N-dimethylamino)-4'-nitrostilbene (DNS).

Substituent-dependent photoinduced intramolecular charge transfer in N-aryl-substituted trans-4-aminostilbenes.

The photochemical behavior of trans-4-(N-arylamino)stilbene (1, aryl = 4-substituted phenyl) in solvents more polar than THF is strongly dependent on the substituent in the N-aryl group. This is attributed to the formation of a twisted intramolecular charge transfer (TICT) state for those with a methoxy (1OM), methoxycarbonyl (1CO), or cyano (1CN) substituent but not for those with a methyl (1Me), hydrogen (1H), chloro (1Cl), or trifluoromethyl (1CF) substituent. On the basis of the ring-bridged model compounds 3-6, the TICT states for 1CN and 1CO result from the twisting of the anilino-benzonitrilo C-N bond, but for 1OM it is from the twisting of the stilbenyl-anilino C-N bond, both of which are distinct from the TICT states previously proposed for N,N-dimethylaminostilbenes.

Origin of the N-methyl and N-phenyl substituent effects on the fluorescence vibronic structures of trans-4-aminostilbene and its derivatives in hexane.

The origin of the N-substituent effect on the room temperature fluorescence vibronic structures of trans-4-aminostilbene (1), its disubstituted derivatives (2 and 3), and the fused-ring analogs (4) in hexane has been investigated. The fluorescence spectra of aminostilbenes 1-4 in hexane are structured and the intensity ratio of the 0,1 vs. the 0,0 band decreases upon N-methyl or N-phenyl substitution, indicating that the N-substituents reduce the displacement in the equilibrium configuration (deltaQe) between the ground and the excited states. Our data are consistent with a planar fluorescing state for 1-4 in hexane. The N-substituents affect the planarity of the ground state structures as well as the conjugation length allowed for exciton resonance, both of which are in accord with the observed progression in fluorescence vibronic structures. According to our analysis, the conformation effect that is associated with the geometry of the amino group appears to play a major role. The corresponding studies on the solvent effect suggest that the fluorescing state of 1-4 in more polar solvents is also a planar charge-transfer state.