Factors influencing cure rates of non-dermatophyte mold and Candida onychomycosis: analysis of outcomes in 81 patients who completed treatment.

OBJECTIVES: Onychomycosis shows a poor response to current topical, oral, or device-related antifungal therapies. The aim of this study was to identify factors influencing the cure rates of non-dermatophyte mold and Candida onychomycosis. METHODS: Eighty-one patients who completed treatments were divided into "cured" and "non-cured" groups. The statistical significance of differences between the two groups was studied. RESULTS: Male gender (P < 0.01), long duration of disease before the initiation of treatment (P < 0.02), three or more infected nails (P < 0.0002), continuous exposure to water and detergents (P < 0.05), frequent exposure to mud and soil (P < 0.01), barefoot walking (P < 0.025), concomitant diabetes and hypertension (P < 0.04), eczema (P < 0.03), and associated paronychia (P < 0.01) had negative effects on cure rates of onychomycosis. Patient age, occupation, site of illness (hand, foot or big toe), type of disease (distal and lateral subungual onychomycosis, proximal subungual onychomycosis or total dystrophic onychomycosis), pathogenic fungi, and treatment modality had no statistically significant impact on cure rate. CONCLUSIONS: To minimize the failure rate of antifungal therapies in the treatment of onychomycosis, patients are advised to start treatment as soon as possible, and to avoid predisposing factors such as exposure to water, detergents, mud and soil, and barefoot walking.

Enraizamento de estacas de genótipos de Camellia sinensis L. em meio ácido, presença de alumínio e ácido indolbutírico / Rooting of Camellia sinensis L. in acid medium, the presence of aluminum and indolebutyric acid

RESUMO Experimentos foram conduzidos para avaliar o efeito do meio ácido e do alumínio, assim como para determinar a concentração mais apropriada de ácido indolbutírico (AIB) para o enraizamento de estacas de diferentes genótipos de Camellia sinensis L (planta de chá). Para tal, foram coletados ramos de plantas-matrizes em Pariquera-Açu-SP, Brasil, no inverno de 2012 e preparadas estacas semi-lenhosas, contendo uma gema e uma folha, que foram mantidas em viveiro com 70% de sombreamento. A irrigação do substrato foi feita com água e soluções contendo ácido fosfórico e sulfato de alumínio a pH 5,5, 4,5; 3,5. No primeiro experimento, o delineamento experimental foi o inteiramente casualizado em esquema fatorial 3 x 7, três genótipos (F 15, IAC 259 e Comum) e sete condições diferentes de enraizamento (vermiculita a pH 6,5, vermiculita acidificada com ácido fosfórico a pH 3,5; 4,5 e 5,5 ou vermiculita acidificada com sulfato de alumínio a pH 3,5; 4,5 e 5,5). No segundo experimento, o tratamento que promoveu o maior enraizamento no primeiro experimento (vermiculita acidificada com sulfato de alumínio a pH 3,5) foi combinado ao tratamento com AIB. O delineamento experimental utilizado foi o inteiramente casualizado em esquema fatorial 3 x 6, sendo três genótipos e seis concentrações de AIB (0, 2000, 4000, 6000, 8000 e 1000 mg L-1). A vermiculita acidificada com sulfato de alumínio a pH 3,5, combinada a aplicação de 10000 mg L-1 de AIB por 30 segundos, foi o tratamento mais adequado para o enraizamento de estacas semi-lenhosas dos genótipos F15, IAC 259 e Comum.

ABSTRACT The experiments were carried out to evaluate the effect of medium acidic and aluminum, as well as determine the most suitable concentration of indolebutyric acid (IBA) for rooting cuttings of different genotypes of Camellia sinensis L (tea plant). Such, stems were collected from mother plants in Pariquera-Açu, São Paulo state, Brazil, in winter 2012 and prepared semi-hardwood cuttings, with one bud and one leaf, which were kept in a nursery with 70% of shading. Irrigation substrate was taken with water and solutions containing phosphoric acid and aluminum sulfate at pH 5.5, 4.5; 3,5. In the first experiment, the experimental design was completely randomized in a factorial scheme 3x7, three genotypes (F 15, IAC 259 and Comum) and seven different conditions of rooting (vermiculite at pH 6.5, acidified with phosphoric acid or aluminum sulfate vermiculite at pH 3.5, 4.5 and 5.5). In the second experiment, the treatment that promoted the highest rooting in the first experiment (vermiculite acidified with aluminum sulfate at pH 3.5) was combined with treatment with IBA The experimental design was completely randomized in a factorial scheme 3x6, three genotypes and six concentrations of IBA (0, 2.000, 4.000, 6.000, 8.000 and 10.000 mg L-1). Vermiculite acidified with aluminum sulphate to pH 3.5, combined application of 10.000 mg L-1 IBA for 30 seconds was the most appropriate treatment for cutting propagation of genotypes F15, IAC 259 and Comum. Vermiculite acidified with aluminum sulfate at pH 3.5, combined treatment with 10,000 mg L-1 IBA for 30 seconds, was the most suitable conditions for the rooting of cuttings Camellia sinensis L.

Influence of narrow-band UVB phototherapy on cutaneous microbiota of children with atopic dermatitis.

OBJECTIVE: In the present work, the effect of narrow-band ultraviolet B (UVB) phototherapy on a cutaneous microbial population was evaluated in patients with atopic dermatitis (AD) and compared with control patients (vitiligo). METHODS: Count, isolation and identification of cutaneous microbiota from anticubital fossa were performed in 10 controls and 10 AD patients, both submitted to similar levels (P > 0.05) of UVB phototherapy (4.3 +/- 0.9 and 4.3 +/- 0.8 accumulated joules, respectively). Additionally, Staphylococcus aureus isolates were screened for the production of exotoxins. RESULTS: The total and staphylococcal cutaneous microbial population levels were higher (P < 0.05) in AD patients than in the controls. All these population levels decreased (P < 0.05) for both AD and control patients after UVB phototherapy, which also decreased the SCORAD for AD patients. All patients with AD and 50% of controls were carriers of S. aureus, and harboured the bacteria simultaneously on skin and anterior nares. All of the S. aureus strains recovered from AD patient skin produced toxin and the B type was the most frequently detected (70%), followed by C (20%) and A (10%) toxins. Only 40% of the S. aureus isolates from control patients produced toxin. After UVB treatment, microbial population levels of AD patients were similar (P > 0.05) to the ones found in control patients before phototherapy, and toxin production ability of S. aureus isolates decreased drastically. CONCLUSION: The results of the present study show the beneficial effect of UVB phototherapy on AD and suggest that this may be attributable not only to reduction of skin surface bacteria but also to the suppression of superantigen production from S. aureus.