RESUMO
Chlorine concentrations (pH 6 to 7 and 22 to 27°C) that killed arthrospores (spores) of Geotrichum candidum or sporangioles (spores) of Rhizopus stolonifer, causal agents of sour rot and Rhizopus rot, respectively, in moving water within 30 to 45 s did not prevent these pathogens from inoculating wounded tomatoes (Lycopersicon esculentum) in a water flume containing chlorine and spores. Free chlorine concentrations of 20 or 25 mg/liter were lethal to spores of G. candidum within 30 s in most in vitro tests, whereas spores of R. stolonifer were slightly less sensitive. Wounded tomatoes placed in a flume with free chlorine at 30 mg/liter and then exposed to spores for 1 min developed about 50% less decay incidence during storage at 24°C for 6 days than did fruit exposed to spores and water alone. In the absence of chlorine, incidence averaged 57% (range, 15 to 95%) for R. stolonifer and 38% (range, 17 to 58%) for G. candidum. Sporadic sour rot lesions were observed among fruit that had been treated with free chlorine at 75 mg/liter, whereas chlorine at up to 180 mg/liter failed to completely protect fruit from Rhizopus rot. A water-soluble dye rapidly penetrated wounds on tomato fruit. The dye framed the outlines of cells at the wound surface and appeared to penetrate into a few intercel-lular spaces. Application of 1% sodium hypochlorite decolorized the dye on the wound surface, whereas deposits located below the wound surface remained blue. Thus, spores suspended in moving water can escape the action of chlorine if carried into intercellular spaces by diffusion or by capillary movement of cell sap and water.
RESUMO
Gluten-free diets have been used in the treatment of patients with dermatitis herpetiformis in our department since 1967. Of the 212 patients with dermatitis herpetiformis attending between 1967 and 1992, 133 managed to take the diet, and 78 of these achieved complete control of their rash by diet alone. Of the remaining 55 patients taking a gluten-free diet, all but three were taking partial diets; over half of these patients managed to substantially reduce the dose of medication required. Of the 77 patients taking a normal diet, eight entered spontaneous remission, giving a remission rate of 10%; a further two patients who had been taking gluten-free diets were found to have remitted when they resumed normal diets. Loss of IgA from the skin was observed in 10 of 41 (24%) patients taking strict gluten-free diets. These patients had been taking their diets for an average of 13 years (range 5-24 years), and their rash had been controlled by diet alone for an average of 10 years (range 3-16 years). The advantages of a gluten-free diet in the management of patients with dermatitis herpetiformis are: (i) the need for medication is reduced or abolished; (ii) there is resolution of the enteropathy, and (iii) patients experience a feeling of well-being after commencing the diet. Thus, we propose that a gluten-free diet is the most appropriate treatment for patients with dermatitis herpetiformis.
