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Bol. micol. (Valparaiso En linea) ; 36(2): 5-11, dic. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1352529


El síndrome de la uña verde o cloroniquia corresponde a la infección por Pseudomonas aeruginosa de una lámina ungueal dañada en pacientes con algún factor de riesgo identificable, siendo los más frecuentes la inmunosupresión, el ambiente húmedo constante y la patología ungueal preexistente. Su diagnóstico es relativamente sencillo si se logra observar la tríada característica de coloración verdosa de la lámina ungueal, paroniquia proximal crónica y onicolisis distal; en casos de duda diagnóstica se puede enviar una muestra de la uña afectada para cultivos o estudio histopatológico. El pilar de su tratamiento corresponde al uso de antibióticos tópicos o sistémicos en conjunto con medidas generales que protejan de la humedad. Es muy importante enfatizar la prevención de esta patología en el personal de salud, especialmente en el contexto del lavado de manos frecuente y riguroso implementado durante la pandemia COVID-19, ya que existen reportes de transmisión nosocomial de P. aeruginosa por profesionales de la salud con infección ungueal.(AU)

Green nail syndrome or chloronychia is the infection of a damaged nail plate by Pseudomonas aeruginosa in a patient with an identifiable risk factor; the most frequently described are immunosuppression, a persistent moist environment and preexisting nail disease. Its diagnosis is relatively simple if the characteristic triad of green discoloration of the nail plate, chronic proximal paronychia and distal onycholysis can be observed, in cases of doubt a sample of the affected nail can be sent for cultures or histopathology. The cornerstone of treatment is the use of topical or systemic antibiotics along with measures to protect the nail from moisture. Prevention of this disease must be emphasized in health care personnel, especially in the context of frequent and rigorous handwashing practices implemented during the COVID-19 pandemic, since there are reports of nosocomial transmission of P. aeruginosaby health care professionals with nail infection.(AU)

Pseudomonas aeruginosa/pathogenicity , Pseudomonas Infections , Nails/microbiology , Pseudomonas Infections/diagnosis , Pseudomonas Infections/drug therapy , Syndrome , Health Personnel , Onychomycosis , Onycholysis , COVID-19
An. bras. dermatol ; 96(1): 47-50, Jan.-Feb. 2021. graf
Article in English | LILACS | ID: biblio-1152797


Abstract Background: Dermatologists don't have a good knowledge of the surgical treatment for ingrown toenails and there is no consensus on which is the best approach. Objective: To develop an easy and effective surgical approach to solve the problem of ingrown toenails. Methods: We identified 67 patients with ingrown toenails in varying degrees of severity which were treated with the standardized approach. Results: All the patients had a completely recovery from the disease and none complained about the cosmetic result. Study limitations: The number of cases is limited. Conclusion: The standardized surgical approach is easily learned and very effective. The recurrence rate is lower than with other treatments.

Humans , Nails , Nails, Ingrown/surgery , Recurrence , Treatment Outcome
An. bras. dermatol ; 95(2): 217-220, Mar.-Apr. 2020. graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-1130854


Abstract Melanonychia is the change in the coloration of the nail plate resulting from the deposition of melanin. Among its causes are melanocytic hyperplasia, melanocytic activation and nail melanoma. Subungual follicular inclusions are histological findings of unknown etiology, possibly related to trauma. We present three cases of melanonychia of different etiologies with subungual follicular inclusions, an association that has not been well described and with an indefinite pathogenesis.

Humans , Male , Adult , Hair Follicle/pathology , Melanosis/pathology , Nail Diseases/pathology , Ultrasonography , Hair Follicle/diagnostic imaging , Dermoscopy , Melanosis/diagnostic imaging , Middle Aged , Nail Diseases/diagnostic imaging , Nails/pathology
Article in English | WPRIM | ID: wpr-881506


@#BACKGROUND: Quality systematic reviews (SRs) are essential in the practice of evidence-based dermatology. We assessed the methodologic quality of SRs in dermatology from the Philippines. METHODS: We searched databases (MEDLINE, CDSR, PROSPERO, HERDIN; from inception until June 30, 2019), and secondary sources. We included SRs, authored by Filipino primary authors, which included clinical trials on any intervention for the treatment or prevention of a dermatologic disease or for maintenance of healthy skin, hair or nails. Two reviewers independently extracted data and appraised the methodological quality of each included SR using the AMSTAR 2. The 16-item AMSTAR 2 has 7 critical items and 9 non-critical items. The number of critical items mainly determine the overall confidence in the results of the review. Descriptive analysis using means and standard deviation for continuous data, and frequency and percentage distribution for categorical data were employed. RESULTS: Twenty SRs were included in this review, and were mostly published in the 2010s. Majority of SRs had three authors, who belonged to a single institution, with at least one dermatologist. The most common topic was infections and both oral and topical interventions were used. Majority had 5 included studies in the SRs, with a median number of 425 participants. The median number of critical flaws in the included SRs was 4.5, and non-critical flaws, 5. Overall confidence was critically low in majority (19/20 ) of included reviews, with only one review rated as low. CONCLUSION: The methodologic quality of the dermatology SRs from the Philippines based on the AMSTAR 2 tool was poor with a rating of critically low in majority. There is a need to improve quality of conduct and reporting through dissemination of the reporting guidelines such as the PRISMA

Humans , Nails , Philippines , Dermatologists , Dermatology , Data Management , Data Collection , Publications , Maintenance , Reference Standards
Rev. Soc. Bras. Med. Trop ; 53: e20190214, 2020. tab, graf
Article in English | LILACS | ID: biblio-1057290


Abstract INTRODUCTION: The aim of this study was to evaluate some virulence factors in Candida albicans isolates from patients with onychomycosis and determine the correlation between these factors and the antifungal resistance profile. METHODS: Seventy species of C. albicans were confirmed using polymerase chain reaction amplification of the HWP1 gene. According to the Clinical & Laboratory Standards Institute guidelines, the susceptibility profile of four antifungal agents was investigated, and the production of aspartyl protease, phospholipase, haemolysin, and biofilm was determined. The correlation between these profiles was also investigated. RESULTS: The isolates indicated different levels of resistance and production of virulence factors. Significant correlations were observed between the minimum inhibitory concentration (MIC) of fluconazole/itraconazole and biofilm production, between phospholipase production and fluconazole/itraconazole MIC, and between fluconazole MIC and hemolytic activity in C. albicans isolates. The results also showed significant correlations between phospholipase activity and biofilm production. CONCLUSIONS: Our findings will contribute to a better understanding of the pathogenesis of C. albicans and characterize the relationship between virulence factors and antifungal resistance, which may suggest new therapeutic strategies considering the possible involvement of the virulence mechanism in the effectiveness of treatment.

Humans , Candida albicans/pathogenicity , Onychomycosis/microbiology , Virulence Factors , Antifungal Agents/pharmacology , Nails/microbiology , Phospholipases/biosynthesis , Candida albicans/drug effects , Candida albicans/ultrastructure , Microscopy, Electron, Scanning , Microbial Sensitivity Tests , Polymerase Chain Reaction , Biofilms/growth & development , Drug Resistance, Fungal , Aspartic Acid Proteases/biosynthesis , Hemolysis
Gac. méd. Méx ; 155(5): 453-457, Sep.-Oct. 2019. tab
Article in English | LILACS | ID: biblio-1286542


Introduction: The low-density lipoprotein (LDL)/high-density lipoprotein (HDL) index is a predictive factor for atherosclerosis, which is associated with oxidative modifications. Objective: To assess the association of the index with oxidative stress markers. Methods: 444 subjects were included and were clinically, anthropometrically and biochemically characterized; superoxide dismutase, glutathione peroxidase 3 (GPx3), magnesium and oxidized LDL (oxLDL) index (oxLDL/HDL) were quantified. Results: A decrease of 1.014 units in the LDL/HDL index was associated with a superoxide dismutase increase of 1 unit/mL (p = 0.030), while a decrease of 0.023 units was associated with a GPx3 increase of 1 nmol/min/mL (p < 0.0005). An increase of one unit in the index was associated with an increase of 0.831 in the oxLDL/HDL index (p < 0.05). After controlling for the effect of gender, age, smoking, obesity and insulin resistance, a reduction of 0.001 per index unit was associated with an increase of 1 µg/g of magnesium in the nails (p = 0.020). Conclusions: The LDL/HDL index shows an inverse relationship with the antioxidant status and a direct relationship with oxidation status, regardless of other cardiovascular and oxidative stress risk factors.

Humans , Male , Female , Adult , Superoxide Dismutase/blood , Oxidative Stress , Glutathione Peroxidase/blood , Lipoproteins, HDL/blood , Lipoproteins, LDL/blood , Insulin Resistance , Smoking , Sex Factors , Cross-Sectional Studies , Age Factors , Magnesium/analysis , Nails/chemistry , Obesity
An. bras. dermatol ; 94(3): 344-347, May-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1011119


Abstract: Background: Of all nail disorders seen in dermatology offices, half of them are due to onychomycosis. The main differential diagnosis is nail psoriasis. The objective of this study was to compare the microscopic findings, other than the presence of fungi, in the clipping of onychomycosis versus normal nails and nail psoriasis. Methods: Cross-sectional study of onychomycosis cases, analyzed by clipping and compared with data on normal nails and those with nail psoriasis. Results: Sixty-two onychomycosis samples were compared with 30 normal nails and 50 nails with psoriasis. In onychomycosis, measurement of subungual region, serous lakes, neutrophils and number of layers of parakeratosis are more intense than in psoriasis. Onychocariosis is less common in psoriasis, while bacteria are more frequent. The nail transition zone is more commonly blurred and irregular in onychomycosis. Conclusion: Clipping helps in the differential diagnosis of onychomycosis and nail psoriasis and may be useful even when fungi are not found.

Humans , Onychomycosis/pathology , Nail Diseases/pathology , Nails/pathology , Parakeratosis , Psoriasis/microbiology , Psoriasis/pathology , Cross-Sectional Studies , Onychomycosis/microbiology , Diagnosis, Differential , Nail Diseases/microbiology , Nails/microbiology , Neutrophils
An. bras. dermatol ; 94(3): 293-297, May-June 2019. tab
Article in English | LILACS | ID: biblio-1011097


Abstract: Background: Dermatophytosis is a cutaneous disease caused by filamentous keratinophilic fungi belonging to the genera Trichophyton, Microsporum and Epidermophyton, which present a high prevalence in the general population, being among the most common mycoses affecting about 20% of the world's population. Objective: To carry out the epidemiological survey of cases of dermatophytosis in patients from the Sistema Único de Saúde in a regional Laboratory in the period of 5 years (2009 to 2013). Methods: A retrospective study (January 2009 to December 2013) was carried out with a qualitative and quantitative design, through the registry book of the laboratory, Mycology Sector, where cases of patients with suspected dermatomycosis were analyzed. Results: In a 5-year period, a total of 4467 cases were suspected of having a fungal infection. Of these, 68.74% (3071) cases were of dermatomycosis. In relation to cultures with fungal growth, 12.54% (385 cases) were dermatophyte fungi and 7.97% (245 cases) non-dermatophyte fungi were isolated. Among the species identified, there was a higher prevalence of T. rubrum complex (75%), T. mentagrophytes complex (11.68%) and M. canis (7.01%). Regarding the sites analyzed, nail involvement was the most frequent in 75% of the cases. Study Limitations: This work is representative in the studied region. Conclusions: Dermatomycosis samples are the most frequent among all samples of fungal infections from these patients, with the nail being the most affected area and the fungi T. rubrum complex and T. mentagrophytes complex the most frequent.

Humans , Male , Female , Adult , Middle Aged , Young Adult , Tinea/epidemiology , Tinea/microbiology , Trichophyton/isolation & purification , Brazil/epidemiology , Sex Factors , Prevalence , Retrospective Studies , Epidermophyton/isolation & purification , Microsporum/isolation & purification , Nails/microbiology , National Health Programs
Article in English | WPRIM | ID: wpr-776952


INTRODUCTION@#Ingrowing toenail (IGTN) or onychocryptosis is not uncommon in children and adolescents. However, there is a dearth of evidence in the literature on the management of IGTN in this age group. This study aimed to compare the results of nonoperative treatment for IGTN with that of operative treatment among children and adolescents.@*METHODS@#All children and adolescents who were treated for IGTN at our institution between 2010 and 2014 were included for this retrospective study. Demographic data, treatment prescribed and outcome at six months after presentation were analysed.@*RESULTS@#Overall, 199 patients were recruited. There were 123 (61.8%) boys and 76 (38.2%) girls. Median age was 14 years. Among 199 toes, 162 (81.4%) were treated nonoperatively, with nail care advice, topical antibiotics and daily cleansing. Only 37 (18.6%) toes were treated operatively. In the operative group, 23 (62.2%) patients underwent wedge resections, while the remaining 14 (37.8%) had total nail avulsions; for all patients, germinal matrices were preserved. At the six-month follow-up, there were 5 (3.1%) cases of recurrence in the nonoperative group when compared to 3 (8.1%) recurrences in the operative group.@*CONCLUSION@#We recommend that IGTN in children and adolescents be treated in the first instance by nonoperative methods. Operative options can be considered for resistant cases or in case of recurrence of IGTN.

Adolescent , Anti-Bacterial Agents , Therapeutic Uses , Child , Female , Hospitals, Pediatric , Humans , Male , Nails , Nails, Ingrown , Drug Therapy , General Surgery , Recurrence , Retrospective Studies , Singapore , Toes
Article in Korean | WPRIM | ID: wpr-766580


Skin diseases associated with athletic activities can be classified as skin infections, inflammatory reactions, trauma, and abnormal proliferation, depending on the cause of the condition. Athlete's nodule is a generic term for reactive nodules that occur in athletes. It is particularly common in the foot due to tight sneakers, repetitive pressure or friction, and inappropriate choice of shoes or other sports equipment. The diagnosis of black heel (calcaneal petechiae) should be considered when numerous black spots occur on the soles in patients who frequently engage in abrupt movements, such as starts, stops, or leaps. Palmoplantar eccrine hidradenitis may occur in athletes who play baseball, dance, and climb, activities in which repetitive and strong stimuli are applied to the floor of the hands and feet. Painful fat herniation should be suspected in cases of painful skin-colored firm nodules on the feet of athletes who place a large amount of weight on their feet when moving. Itching, urticaria, angioedema, chest tightness, and syncope occurring within 5 minutes after starting exercise should be suspected to be exercise-induced angioedema/anaphylaxis. Excessive force can cause deformation of nails, as in tennis toe and jogger's toenail. For the diagnosis and treatment of sports-related skin diseases, it is essential to pay attention to patients' hobbies and exercise habits, including sports, and to consider the relationship of those habits with the presumed mechanisms of the skin disease. In addition, thorough pre-exercise warm-ups, increasing strength gradually, and wearing proper equipment will help prevent the occurrence of sports-related skin diseases.

Angioedema , Athletes , Baseball , Dancing , Diagnosis , Foot , Friction , Hand , Heel , Hidradenitis , Hobbies , Humans , Nails , Pruritus , Shoes , Skin Diseases , Skin , Sports , Sports Equipment , Syncope , Tennis , Thorax , Toes , Urticaria
Article in Korean | WPRIM | ID: wpr-759790


BACKGROUND: Onychomycosis is a chronic fungal nail disease that may have a profound effect on quality of life (QOL). OBJECTIVE: The purpose of this study was to evaluate the QOL in patients with toenail onychomycosis using the onychomycosis quality of life questionnaire (ONYCHO) and to determine the factors influencing the QOL of toenail onychomycosis patients. METHODS: A total of 102 adults (mean age, 59.54 years) with toenail onychomycosis who visited our department between July 2017 and June 2018 completed the ONYCHO, which consists of statements pertaining to social, emotional, and symptom problems. All patients with toenail onychomycosis had been diagnosed by positive direct microscopic examination. RESULTS: Most of the patients demonstrated significantly reduced QOL. The degree of QOL impairment differed between subgroups. Both social (p<0.01) and emotional (p<0.05) impairments were more conspicuous in the female than in the male patients, although there were no differences according to symptoms. Patients with more extent of toenail involvement were more affected by onychomycosis in all three ONYCHO scales (p for trend<0.05). In terms of the type of toenail onychomycosis, the degrees of social (p for trend<0.05), emotional (p for trend<0.05), and symptom (p for trend<0.01) impairment were more prominent in patients with total dystrophic onychomycosis than in those with superficial white onychomycosis and distal and lateral subungual onychomycosis. A tendency toward better QOL in terms of social problems, but not emotional or symptom problems, was associated with a longer duration of the disease (B, 8.95, 95%CI, 0.99–16.91). CONCLUSION: Although toenail onychomycosis is not a life-threatening disease, it has a significantly negative impact on the overall QOL of patients, which should be a focus of concern.

Adult , Female , Humans , Male , Nail Diseases , Nails , Onychomycosis , Quality of Life , Social Problems , Weights and Measures
São Paulo; s.n; 2019. 107 p.
Thesis in Portuguese | LILACS | ID: biblio-1049761


Introdução - Crianças estão expostas diariamente a diversos fatores de risco que podem afetar sua saúde, desde condições socioculturais e fisiológicas, até exposições endógenas e exógenas. Elementos Potencialmente Tóxicos (EPT) podem ser mais absorvidos por crianças em comparação a adultos. Os efeitos crônicos surgem mesmo com exposição a baixas doses, pois as crianças estão em fase de desenvolvimento e, portanto, são mais vulneráveis. Níveis desses EPTs em matrizes biológicas são comumente usados como biomarcadores de exposição ambiental. Objetivo - Explorar o uso de biomarcadores de exposição subcrônica a chumbo e cádmio em unhas das mãos. Métodos - Foram analisadas e comparadas amostras de sangue e unha de 592 indivíduos, as quais foram coletadas em estudo prévio. A população de estudo foi composta por pré-escolares entre 1 e 4 anos de idade que frequentavam 50 Centros de Educação Infantil (CEI) da cidade de São Paulo na época da coleta. As análises de ambas as amostras foram realizadas por espectrometria de massa com plasma indutivamente acoplado (ICP-MS). Para avaliar se a intensidade da exposição a chumbo e ao cádmio impacta nos níveis dos elementos analisados em unhas, os resultados dos metais no sangue foram estratificados por níveis de exposição ao chumbo e ao cádmio. Para baixa exposição foram consideradas as amostras com níveis sanguíneos menores do que os valores de referência do Centers for Diseases Control and Prevention (CDC) (< 5 µg.dL POT. -1 para chumbo e < 0,24 µg.L POT.-1 para cádmio). No grupo de alta exposição, foram incluídas as amostras com níveis sanguíneos acima dos percentis 97,5 para o chumbo e 95 para o cádmio, encontrados nas crianças anteriormente estudadas (> 13,9 µg.L POT.-1 e 2,97 µg.L POT.-1, respectivamente). O intervalo entre os valores de referência e os percentis ficou estabelecido como faixa de exposição intermediária. Testes de correlação de Spearman foram aplicados entre as concentrações de ambos os metais no sangue e na unha (p < 0,05), considerando fatores de risco potenciais (localização do CEI por densidade de tráfego veicular e zona geográfica, e existência de fumante no domicílio). Resultados - A média geométrica dos níveis de chumbo nas unhas foi de 0,02 µg.g POT. -1 (IC 95%: 0,02-0,03 µg.g POT. -1). Para o cádmio, a média não foi calculada devido ao alto percentual de valores abaixo do limite de detecção (LD). Correlações positivas foram encontradas entre os níveis de chumbo nas unhas e no sangue (r = 0,08; p = 0,04), entre os níveis do elemento nas unhas e CEI localizado em rua com alta densidade de tráfego de veículos (r= 0,23; p <0,0001). Houve correlação positiva entre os níveis de chumbo e cádmio nas unhas (r = 0,31; p <0,0001) e no sangue (r = 0,35; p <0,0001), sendo mais expressiva nas unhas do grupo de pré-escolares de escolas localizadas na zona leste (r = 0,44; p <0,0001). Conclusão - Chumbo na unha pode ser eleito como biomarcador de exposição, quando se pretende iniciar um screening de exposição ambiental, sobretudo em áreas de alta densidade de tráfego de veículos. Os pré-escolares sofreram coexposição entre chumbo e cádmio. O uso da unha na biomonitorização de pré-escolares pode auxiliar no delineamento de estudos posteriores de exposições ambientais aos EPTs, redirecionando recursos com maior precisão.

Introduction - Children are daily exposed to several risk factors that can affect their health, from sociocultural and physiological conditions to endogenous and exogenous substances exposure. Potentially toxic elements (PTE) can be more absorbed by children than adults. Chronic effects can appear even at low exposures, because children are in development phase and, therefore, are more vulnerable. PTE levels in biological matrices are commonly used as environmental exposure biomarkers. Objective - To explore the use of lead and cadmium sub chronic exposure biomarkers in fingernails. Methods - blood and nail samples of 592 individuals will be analyzed and compared, which were collected in previous study. The study population was composed of preschool children aged between 1 and 4 years old who attended 50 day care centers (DCC) in the city of São Paulo at the sampling time. Both sample analysis were performed by inductively coupled plasma mass spectrometry (ICP-MS). To assess if lead and cadmium exposure intensity impacts in analyzed nail element levels, the results of blood metals were stratified by lead and cadmium exposure levels. As low exposure was considered samples with blood levels lower than the Centers for Diseases Control and Prevention (CDC) reference values (<5 µg.L POT.-1 for lead and <0.24 µg.L POT.-1 for cadmium). High exposure group included samples with blood levels above the 97.5th percentile for lead and 95th for cadmium found in the previously studied children (> 13.9 µg.L POT.-1 and 2.97 µg.L POT.-1, respectively). The interval between the reference values and the percentiles was established as the intermediate exposure range. Spearman's correlation tests were applied between the concentration of both metals in the blood and the nail (p <0.05), considering PTE exposure risk factors (DCC location by vehicle traffic density and geographic region, and smoker in the home. Results - The geometric mean of nail lead levels was 0.02 µg.g POT. -1 (95% CI: 0.02- 0.03 µg.g POT. -1). Cadmium means are not calculated because high percentage of values below limit of detection (LD). Positive correlations were found between nail and blood lead levels (r = 0.08; p = 0.04), between nail lead level and DCC located in high vehicle traffic density street (r = 0.23; p <0.0001). Positive correlation also found between nail and lead and cadmium levels (r = 0.31; p <0.0001) and between blood (r = 0.35; p <0.0001), being more expressive in nails of DCC east region preschool children group (r = 0.44; p <0.0001). Conclusions - Nail lead can be elected as biomarker of exposure, when are intend to start a screening of environmental exposure, especially in high traffic vehicle areas. Preschool children suffered co-exposure between lead and cadmium. Nail use in preschool children biomonitoring can assist in later PTE environmental exposure studies design, redirecting resources more accurately.

Child, Preschool , Cadmium , Biomarkers , Public Health , Environmental Exposure , Lead , Metals , Nails
Araçatuba; s.n; 2019. 62 p. ilus, tab, graf.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1051432


Objetivo: Avaliar a ingestão de fluoreto (F) por crianças de 1 a 3 anos de idade pela dieta e a concentração de F nas unhas. Método: Crianças (n=202) de 12 meses de idade, participantes de um programa preventivo para bebês, tiveram a ingestão de F monitorada por meio da aplicação de um Questionário de Frequência Alimentar semiquantitativo (QFA), composto por 70 itens, divididos em 9 grupos de alimentos frequentemente encontrados na dieta de crianças nesta faixa etária. O QFA foi aplicado durante 2 anos, a cada 3 meses, juntamente com a coleta das unhas e de água usada para beber ou preparar comida. A concentração de F da dieta, nas unhas e na água foi determinada com eletrodo íon-específico, após microdifusão facilitada por hexametildisiloxano ou pelo método direto. Os dados obtidos foram submetidos à análise de variância a dois critérios, seguida pelo teste de comparação múltipla de StudentNewman-Keuls , bem como coeficiente de correlação de Sperman (p<0,05). Resultados: A média da ingestão de F pela dieta e água aumentou significativamente dos 12 aos 24 meses (0,015 mg F/Kg/dia e 0,09 mg F/Kg/dia) (p<0,05) declinando após 27 meses (0,011 mg F/Kg/dia e 0,05 mg F/Kg/dia) (p<0,05). Aos 36 meses um pico foi observado na ingestão de F pela dieta (0,013mg F /Kg/dia) (p<0,05). Houve crescente aumento nos níveis de F nas unhas dos pés e mãos, com diferença significativa em alguns períodos de estudo (18 à 27 meses, p<0,05), sendo que maiores concentrações de F foram vistas nas unhas das mãos em relação aos pés (3,7 µg F/g; 3,4 µg F/g, respectivamente p<0,05). Entre a estimativa de ingestão de fluoreto em função do peso da criança (mg F/kg/dia) e o fluoreto nas unhas da mão (Sperman?s r = -0,024; p=0,396) ou unhas do pé (Sperman?s r = -0,002; p=0,957), nenhuma correlação foi observada. Conclusão: A ingestão de fluoreto por meio da dieta em crianças de 1 a 3 anos de idade ficou dentro de limites considerados como seguros e o QFA parece ser uma boa ferramenta para estimar a ingestão de fluoreto de crianças.. Pequenas variações na ingestão diária de F pela dieta foram detectadas nas unhas ao longo dos períodos de estudo (após 30 a 60 dias)(AU)

Objective: To evaluate fluoride (F) intake by 1-3 year-old children from the diet, as well as F concentrations in fingernails and toenails. Methods: Children (n=202) 12 months old, participants in a preventive program for infants, had their F ingestion monitored by means of the application of a semi-quantitative food frequency questionnaire (FFQ), composed of 70 items, divided into 9 groups of foodstuff. The FFQ was applied during 2 years, every 3 months, along with the collection of nails and water samples used for drinking and food preparation. The concentration of F in the diet, nails, and water was determined with an ion-specific electrode, after hexamethyldisiloxane-facilitated microdiffusion or by the direct method. The data obtained were submitted to the 2-way analysis of variance criteria followed by the Student-Newman-Keuls, and by Spearman correlation coeficiente (p<0.05). Results: The average ingestion of F by diet and water was significantly higher from 12 to 24 months (0.015 mg F/Kg/day and 0.09 mg F/Kg/day) (p<0.05), decreasing after 27 months (0.011 mg F/Kg/day and 0.05 mg F/Kg/day) (p<0.05). At 36 months, a peak of F ingestion from the diet (0.013mg F /Kg/day) (p<0.05) was observed. There was a continuous increase in F levels in finger- and toenails, with a significant difference in some periods of the study (18 to 27 months, p<0.05); higher F concentrations were observed for fingernails over toenails (3.7 µg F/g; 3.4 µg F/g, respectively, p<0.05). No significant correlation was observed between the estimate of ingestion of fluoride related to the weight of the child (mg F/kg/day) and the fluoride in fingernails (Spearman?s r = -0.024; p=0.396) or toenails (Spearman?s r = -0.002; p=0.957). Conclusion: The ingestion of fluoride from the diet in 1-3 year-old children was shown to fall within safe limits, and the FFQ appears to be a satisfactory tool to estimate the ingestion of fluoride. Small variations of daily ingestion of F by diet were detected in the nails through the periods in the study (after 30 to 60 days)(AU)

Humans , Male , Female , Infant , Child, Preschool , Diet , Fluorides , Nails
Braz. dent. j ; 29(5): 475-482, Sept.-Oct. 2018. tab
Article in English | LILACS | ID: biblio-974182


Abstract This research aimed to determine the influence of fluoridated groundwater and 1,100 ppm fluoride dentifrice on biomarkers of exposure to fluoride in preschoolers. A cross-sectional study was performed on thirty preschoolers recruited from naturally fluoridated and non-fluoridated areas (n=15). Total Daily Fluoride Intake (TDFI) from diet and dentifrice, and Daily Urinary Fluoride Excretion (DUFE) was measured over 24 h. Nails samples were collected twice during 30 days. Fluoride analyses were performed using a fluoride-ion-specific electrode. Data were evaluated using the Student and paired t-test, Pearson correlation analysis, multiple linear regression analysis (α≤0.05). Fluoridated groundwater and dentifrice were the dominant sources (r2 > 0.83) of TDFI in children from a naturally fluoridated and a non-fluoridated area, respectively. A positive correlation between TDFI and DUFE (r=0.50), and between [F] in fingernails and toenails (r=0.60) were found in children from a naturally fluoridated area. The [F] in nails of finger and toe were not correlated to TDFI. The consumption of fluoridated groundwater influenced the fluoride concentration in urine. In addition, the use of 1,100 ppm fluoride dentifrice did not influence the fluoride concentration in urine and fingernails.

Resumo Esta pesquisa teve como objetivo determinar a influência de águas fluoretadas subterrâneas e do dentifrício com 1.100 ppm de fluoreto nos biomarcadores de exposição ao flúor em pré-escolares. Foi realizado um estudo transversal em trinta pré-escolares recrutados em áreas naturalmente fluoretadas e não fluoretadas (n = 15). A ingestão diária total de flúor (TDFI) a partir da dieta e do dentifrício, assim como a excreção urinária diária de flúor (DUFE), foram medidas ao longo de 24 horas. Amostras de unhas foram coletadas duas vezes durante 30 dias. As análises de flúor foram realizadas usando um eletrodo específico para íon flúor. Os dados foram analisados utilizando o teste t de Student e pareado, a análise de correlação de Pearson, e a análise de regressão linear múltipla (a≤0,05). As águas subterrâneas e dentifrícios fluoretados foram as fontes dominantes (r2>0,83) do TDFI em crianças da área naturalmente fluoretada e não fluoretada, respectivamente. Uma correlação positiva entre TDFI e DUFE (r=0,50) e entre [F] nas unhas das mãos e dos pés (r=0,60) foi encontrada em crianças da área naturalmente fluoretada. A [F] nas unhas das mãos e dos pés não foi correlacionada com TDFI. O consumo de águas subterrâneas fluoretadas influenciou a concentração de flúor na urina. Além disso, o uso de dentifrício com 1.100 ppm de fluoreto não influenciou a concentração de fluoreto na urina e nas unhas.

Humans , Female , Child, Preschool , Biomarkers/analysis , Fluoridation , Dentifrices/chemistry , Fluorides/analysis , Groundwater , Brazil/epidemiology , Cross-Sectional Studies , Urinalysis , Fluorosis, Dental/epidemiology , Nails/chemistry
Infectio ; 22(2): 105-109, abr.-jun. 2018. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-892761


Abstract Introduction: Onychomycosis are fungal nail infections that can be caused by dermatophytes, non-dermatophytic molds and yeasts, which are capable of breaking down keratin. Mixed onychomycosis are a controversial subject and they are the outcome of the combination of two dermatophytes, dermatophytes/nondermatophytic molds or dermatophytes/yeast. Objetives: To determine the frequency of total dystrophic onychomycosis caused by more than one etiological agent (mixed onychomycosis) in outpatients from a Dermatologic Center in Guatemala and to establish the characteristics associated with this fungal infection. Methods: Prospective observational study from August to December of 2012. Nail samples were obtained from patients with total dystrophic onychomycosis to identify the causal agents by culture in Sabouraud dextrose and Mycosel® agar. Results: 32 of 130 patients had mixed onychomycosis. 68.5% were associated to tinea pedis. The most common association was between T. rubrum + Candida, T. rubrum + M. canis and T. rubrum + opportunist fungi. Conclusions: Mixed onychomycosis represent 25% of the total dystrophic onychomycosis in Guatemala. We observed an important relationship between diabetes and the main association was T. rubrum with Candida spp.

Resumen Introducción: Las onicomicosis son infecciones fúngicas de las uñas que pueden ser causadas por dermatofitos, mohos no dermatofitos y levaduras, que son capaces de degradar la queratina. Las onicomicosis mixtas son un tema polémico y es el resultado de la combinación de dos dermatofitos, dermatofitos / mohos no dermatofitos o dermatofitos / levadura. Objetivos: Determinar la frecuencia de la onicomicosis distrófica total causada por más de un agente etiológico (onicomicosis mixta) en pacientes ambulatorios de un Centro Dermatológico en Guatemala y establecer las características asociadas a esta infección fúngica. Métodos: Estudio observacional prospectivo de agosto a diciembre de 2012. Se obtuvieron muestras de uñas de pacientes con onicomicosis distrófica total para identificar los agentes causales en cultivo de agar dextrosa Sabouraud y Mycosel®. Resultados: 32 de 130 pacientes tenían onicomicosis mixta. 68.5% se asociaron a tinea pedis. La asociación más común fue entre T. rubrum + Candida, T. rubrum + M. canis y T. rubrum + hongos oportunistas. Conclusiones: La onicomicosis mixta representa el 25% de la onicomicosis distrófica total en Guatemala. Observamos una relación importante entre la diabetes y la asociación principal fue T. rubrum con Candida spp.

Humans , Male , Female , Adult , Middle Aged , Aged , Onychomycosis , Dermatology , Tinea Pedis , Candida , Agar , Arthrodermataceae , Fungi , Guatemala , Infections , Nails
Article in English | WPRIM | ID: wpr-739173


Epidermolysis bullosa (EB) is a very rare inherited disease featured with skin blistering resulting from minor trauma. Sometimes the esophageal mucosa could also be involved, which leads to esophageal strictures. Here we report two cases of EB-related esophageal strictures who were successfully treated with esophageal balloon dilations. The two cases with EB had severe dysphagia. Clinical examination showed signs of malnutrition, skin blisters and loss of toenails due to EB. They underwent careful fluoroscopic balloon dilation with 10- and 16-mm-sized balloon catheters, respectively. They could ingest soft and some solid foods after the procedure and maintained during the 20 months and 16 months follow-up periods.

Blister , Catheters , Constriction, Pathologic , Deglutition Disorders , Epidermolysis Bullosa , Esophageal Stenosis , Follow-Up Studies , Malnutrition , Mucous Membrane , Nails , Skin
Article in English | WPRIM | ID: wpr-762495


BACKGROUND: Intestinal parasitic infections are major public health problems worldwide, with high prevalence in low income countries where substandard food hygiene practices are common. Asymptomatic food handlers with poor personal hygiene could be potential sources of parasitic infections. This study was aimed to assess the prevalence of intestinal parasitic infections and associated factors among asymptomatic food handlers working at Haramaya University cafeterias, eastern Ethiopia. METHODS: A cross-sectional study was conducted among asymptomatic food handlers working at Haramaya University cafeterias from August 2015 to January 2016. Population proportion to size allocation and systematic random sampling techniques were used to identify the study participants. Stool samples were collected and examined simultaneouly using direct and modified formol ether concentration wet smear techniques. Data were entered and analyzed using SPSS version 20.0 software. Logistic regressions were applied to assess association between independent variable and intestinal parasitic infections. Statistical significance was declared at a p-value less than 0.05. RESULTS: A total of 417 asymptomatic food handlers were enrolled in this study. Of these, females comprised 79.4%. Large proportion (39.3%) of food handlers were in the age group of 31–40 years. The overall prevalence of intestinal parasitic infections was 25.2% (95% CI: 18.3, 29.6). Entamoeba histolytica/ dispar (46.7%) and A. lumbricoides (14.3%) were the most frequent isolates. Having no formal education [AOR: 2.13, 95% CI: 1.24, 3.67], monthly income of less than 45.7 USD [AOR: 3.86, 95% CI: 1.62, 9.20], lack of hand washing after the use of the toilet with soap [AOR: 2.43, 95% CI: 1.22, 4.86] and untrimmed fingernails [AOR: 3.31, 95% CI: 1.99, 5.49] have significant association with intestinal parasitic infections. CONCLUSIONS: The high prevalence of intestinal parasitic infections in this study highlights the importance of food handlers as probable sources of parasitic infections. Public health measures and sanitation programs should be strengthened to control the spread of intestinal parasitic infections.

Cross-Sectional Studies , Education , Entamoeba , Ether , Ethiopia , Female , Formaldehyde , Hand Disinfection , Helminths , Humans , Hygiene , Logistic Models , Nails , Prevalence , Public Health , Sanitation , Soaps
Article in Korean | WPRIM | ID: wpr-740541


PURPOSE: The number of patients with dyslipidemia have been increasing steadily over the past few decades in South Korea. The association between the chromium level and chronic disease has attracted considerable interest, but few studies have been conducted on the Korean population. The aim of this study was to identify the dietary and non-dietary correlates of the toenail chromium level, and evaluate the association between the toenail chromium level and dyslipidemia. METHODS: The baseline data of an ongoing prospective cohort study in Yeungnam area in South Korea were analyzed. A total of 500 participants aged 35 years or older who completed questionnaires on their demographics, lifestyle characteristics, and medical information were included. The toenail chromium level was analyzed by neutron activation analysis. The dietary intake was assessed using a validated 146-item semi-quantitative food frequency questionnaire. The blood lipid profiles were obtained from medical examinations conducted by the Korean National Health Insurance Service or medical institutions. RESULTS: Higher chromium levels were associated with the residential area (urban), higher education level, higher intakes of noodles and vegetables, and lower intake of fruits. Multiple logistic regression analysis showed that the toenail chromium levels were not associated significantly with the prevalence of dyslipidemia (odds ratio: 0.99, 95% confidence interval: 0.61 ~ 1.60). CONCLUSION: This study is the first study in Korea to determine the independent correlates of the toenail chromium levels and the association between chromium exposure and dyslipidemia. These findings provide useful scientific evidence for the development of chromium intake guidelines for the Korean population.

Chromium , Chronic Disease , Cohort Studies , Demography , Dyslipidemias , Education , Fruit , Humans , Korea , Life Style , Logistic Models , Nails , National Health Programs , Neutron Activation Analysis , Prevalence , Prospective Studies , Vegetables