Fenton process effect on sludge disintegration.

This study investigated the disintegration of sewage sludge through the Fenton process. The study was conducted by both the conventional Fenton-type process (CFP) (Fe2+/H2O2) and the Fenton-type process (FTP) (nZVI/H2O2). Experiments were performed using different pH, catalyst iron (Fe2+ and nZVI), and H2O2 dosages. Different parameters such as the degree of disintegration (DD), soluble chemical oxygen demand (SCODS), and particle size distribution were studied to investigate the effects of CFP and FTP processes on the disintegration of sludge. In addition to these parameters, scanning electron microscope, Fourier-transform infrared spectroscopy, and X-ray diffraction analyses were done to determine the changes in sludge characterization before and after disintegration. In the study, the optimal catalyst iron was determined to be (Fe2+ and nZVI) 4 g/kg total solids (TS), and the H2O2 dosage was determined to be 10 g/kg TS. The experiments were performed with consideration of the 1-h oxidation time. While DD was found to be 31.8% and the SCODS was found to be 364 mg/L for FTP, DD and SCODS were found to be 14.1% and 256 mg/L for CFP, respectively.

Sacroiliitis during isotretinoin treatment: Causal association or coincidence?

Isotretinoin, a retinoid derivate used in acne treatment, has a variety of side effects involving the musculoskeletal system; however, sacroiliitis is rarely observed. Our aim was to present nine cases of sacroiliitis in patients being treated with isotretinoin. Sacroiliitis was identified and monitored using magnetic resonance imaging (MRI). Clinical symptoms were resolved with nonsteroidal anti-inflammatory drug therapy after isotretinoin treatment was ceased. Different from the other cases, follow-up MRI was done. Follow-up MRI revealed improvement in some patients. Although the association between isotretinoin therapy and sacroiliitis has been covered in literature, this association is not yet completely understood. We aimed to discuss the relationship between two.

The Overlapped Triple Circle Pulse Technique with Nd:YAG Laser for Refractory Hand Warts.

BACKGROUND AND OBJECTIVE: Inadvertent superficial treatment of hand warts causes recurrence, whereas aggressive treatment can lead to tissue defects resulting in hand dysfunction. This study aimed to determine the effectiveness of a novel laser treatment modality for recalcitrant hand warts. MATERIALS AND METHODS: The study included 51 patients who were treated for 146 recalcitrant hand warts using 1064 nm long-pulsed Nd:YAG laser between 2011 and 2014. The laser treatment method is novel because each treated wart was aligned at the intersection point of the circles of 3 laser pulses per session. RESULTS: Among the 146 hand warts, 88.35% were successfully treated with one session and 100% of those that required a second treatment session were treated successfully, based on the 12 month follow-up examination. CONCLUSIONS: Long-pulsed Nd:YAG laser treatment was observed to be a safe, rapid, and effective method for treating recalcitrant hand warts.

Psychiatric comorbidities and alexithymia in patients with seborrheic dermatitis: a questionnaire study in Turkey.

OBJECTIVE: The aim of the study was to determine the levels of anxiety, depression, and obsessive-compulsive symptoms in patients with seborrheic dermatitis (SD) compared with healthy subjects. Additionally, we aimed to investigate the presence of alexithymia among patients and its association with these psychiatric comorbidities. METHODS: A total of 117 consecutive adult patients (66 male, 51 female) with SD and 95 age- and gender-matched healthy controls selected from the community (46 male, 49 female) were enrolled in the study. The demographic characteristics of the patients were recorded. The clinical severity of the disease was assessed according to the Seborrheic Dermatitis Area and Severity Index (SDASI) scoring system. Both patients and controls were evaluated by the validated Turkish versions of the Hospital Anxiety and Depression Scale (HADS), Maudsley Obsessive Compulsive Inventory (MOCI), and Toronto Alexithymia Scale (TAS-26). RESULTS: There were no statistically significant differences between the patient and control groups regarding the mean scores of depressive or obsessive-compulsive symptoms or alexithymia (all p > 0.05). However, anxiety scores in patients with SD were higher than in controls (p = 0.001). No significant relationship was present between anxiety and disease severity nor disease duration (p > 0.05). Thirty-eight patients with high anxiety scores were found to be more alexithymic (p = 0.000). CONCLUSION: SD is one of the inflammatory skin disorders that is known to be triggered or aggravated by stress. However, little scientific evidence exists to confirm this view. In addition, very limited data are available about the presence of the personality profiles leading to emotional dysregulation such as alexithymia and concurrent psychiatric disorders in patients with SD. Our study showed that anxiety levels were significantly higher in patients with SD compared with healthy controls but there was no significant association with alexithymia, depression, or obsessive-compulsive symptom levels. Dermatologists should be particularly vigilant to the possibility of concurrent psychiatric morbidity in patients with SD in order to improve patients' well-being.

Cutaneous drug eruptions by current antiepileptics: case reports and alternative treatment options.

Serious cutaneous drug eruptions due to antiepileptics have been defined for many drugs like carbamazepine, diphenylhydantoin, phenytoin and valproate. In recent years, adverse cutaneous reactions due to the current antiepileptic drugs have also been reported. In this paper, two cases are presented: a 48-year-old female receiving gabapentin for postherpetic neuralgia who developed leukocytoclastic vasculitis after 8 weeks and a 23-year-old male receiving lamotrigine for epileptic seizures who developed toxic epidermal necrolysis (TEN) in 15 days. Alternative therapy approaches with practical suggestions are also discussed.

Efficacy of oral fluconazole in the treatment of seborrheic dermatitis: a placebo-controlled study.

BACKGROUND: Seborrheic dermatitis (SD) is a common, chronic dermatosis. Although the pathogenetic mechanisms of SD are not clear, Malassezia spp. yeasts are known to cause the disease. Previous studies have shown that topical and systemic antifungals provide clinical benefit. OBJECTIVE: To evaluate the safety and efficacy of short-term oral fluconazole in patients with SD. METHODS: Sixty-three patients with mild-to-moderate SD were randomly allocated to receive either oral fluconazole 300 mg in a single dose per week or placebo, for 2 weeks. Twenty-seven patients taking fluconazole and 23 patients taking placebo completed the study and were analyzed. The SD area severity index (SDASI) score and the patient's subjective assessment of pruritus and burning sensation were evaluated before and after treatment. Both the investigator and the patients were blinded to treatment. RESULTS: A statistically significant improvement in SDASI score after treatment compared with baseline was obtained with fluconazole (p=0.01) but not with placebo. However, the difference between the treatment groups was not statistically significant (p>0.05). Subjective improvements in symptoms, such as pruritus and burning sensation, were observed in both groups but no statistically significant differences versus baseline were seen. CONCLUSION: The results of this study indicate that fluconazole provides marginal and statistically insignificant benefit for the therapy of SD. However, larger studies using different dosages and/or durations of fluconazole therapy may provide a rationale for systemic use of fluconazole in SD.

Leg ulcers and hydroxyurea: report of three cases with essential thrombocythemia.

CASE 1: A 65-year-old woman with essential thrombocythemia (ET) had been taking oral hydroxyurea (HU), 1,000 mg daily, for 7 years. Six months ago, she developed an ulcer on the outer part of her left ankle, which healed spontaneously within 2 months. She presented with a new, tender, shallow ulcer, 2 cm x 2 cm in size, at the same site. Doppler examination revealed thrombosis of the left common femoral vein and a calcified atheroma plaque of the left common femoral artery. The dosage of HU was decreased to 500 mg daily when the platelet counts were found to be within normal levels. The ulcer completely healed within 2 months with occlusive wound dressings, and has not recurred within the follow-up period of 1 year. CASE 2: A 56-year-old women presented with multiple, painful, leg ulcers of 1 year duration. She had been diagnosed as having ET and had been on HU therapy, 1,500 mg/day, for the past 5 years. Interferon-alpha-2b was started 3 months ago, in addition to HU, which was tapered to 1,000 mg daily. She had suffered from hypertension for 20 years treated with nifedipine and enalapril, and had recently been diagnosed with diabetes mellitus which was controlled by diet. Examination revealed three ulcers located on the lateral aspects of both ankles and right distal toe. Arterial and venous Doppler examinations were within normal limits. Histopathology of the ulcer revealed nonspecific changes with a mixed inflammatory cell infiltrate around dermal vessels. The ulcers completely healed within 10 weeks with topical hydrocolloid dressings. After healing, she was lost to follow-up. A year later, it was learned that she had developed a new ulcer at her right heel, 3 months after her last visit (by phone call). This ulcer persisted for 8 months until HU was withdrawn. CASE 3: A 64-year-old woman with ET presented with a painful leg ulcer of 6 months' duration. She had been taking oral HU for 5 years. She had a 20-year history of hypertension treated with lisinopril. Examination revealed a punched-out ulcer of 2 cm x 2 cm over the right lateral malleolus. Doppler examination of the veins revealed insufficiency of the right greater saphenous and femoral veins. Angiography showed multiple stenoses of the right popliteal and femoral arteries. As her platelet count remained high, HU was continued. During the follow-up period of 13 months, the ulcer showed only partial improvement with local wound care.