A pilot study of intralesional methotrexate injections versus triamcinolone acetonide in patients affected by nail matrix psoriasis

Nail disorders in general are difficult to treat and often frustrating, and this is also the case with nail psoriasis, especially when it is limited to the nails, and not affecting joints. The quality of life of patients with nail psoriasis is negatively affected, owing to the chronic course of the disease and frequent relapses. The purpose of this study was to compare treatment response and maintenance of response during follow-up of 12 patients with nail matrix psoriasis limited to a few nails, who were treated with intralesional injections of either methotrexate (MTX) 25 mg/mL or triamcinolone acetonide 10 mg/mL. Patients were treated every 6 weeks for 24 weeks and followed up for 6 months. Photographic documentation and assessment by Nail Psoriasis Severity Index were performed during each treatment session and at each follow-up visit. At the end of the four treatment sessions, all patients had improvement of their disease, which continued during follow-up, especially for the MTX-treated group

Socio economic disparities in the appropriateness of disease management of diabetes: results of AEQUITAS study

n/

A Practical Algorithm for the Management of Superficial Folliculitis of the Scalp: 10 Years of Clinical and Dermoscopy Experience

Introduction: Superficial folliculitis of the scalp (SFS) is a common complaint in clinical practice, and initial presentation may be difficult to differentiate as they may appear very similar to each other. Objectives: The aim of this thesis is to describe the pathologies that occur clinically as folliculitis of the scalp, identify their causes and characteristics and create a standardized classification. Methods: This is a retrospective clinical, dermoscopic and histopathological study over 10 years of dermatologic consultations. Only individuals with a confirmed diagnosis of SFS (updated diagnostic criteria or biopsy) were included. Results: In this review, we describe the various clinical features of different causes of SFS in ninety-nine cases and divided into infectious due to fungus, bacteria, or virus and inflammatory conditions such as rosacea, acneiform eruption and Ofuji syndrome. Conclusions: The clinician must differentiate SFS from other underlying scarring disorders to prevent poorer outcomes. We created an algorithm to help the clinician reach a proper diagnosis

Tinea capitis in children: a systematic review of management

Background Tinea capitis is the most common cutaneous fungal infection in children. Objectives This review aims to evaluate the differences that exist between medications for the treatment of tinea capitis, to determine whether there are any significant adverse effects associated and to define the usefulness of sample collection methods. Methods We conducted a systematic literature search of available papers using the databases PubMed, OVID, Cochrane Libraries and ClinicalTrials.gov. Twenty‐one RCTs and 17 CTs were found. Results Among the different antifungal therapies (oral and combination thereof), continuous itraconazole and terbinafine had the highest mycological cure rates (79% and 81%, respectively), griseofulvin and terbinafine had the highest clinical cure rates (46% and 58%, respectively) and griseofulvin and terbinafine had the highest complete cure rate (72% and 92%, respectively). Griseofulvin more effectively treated Microsporum infections; terbinafine and itraconazole more effectively cured Trichophyton infections. Only 1.0% of children had to discontinue medication based on adverse events. T. tonsurans was the most common organism found in North America, and hairbrush collection method is the most efficient method of sample collection. Additionally, using a hairbrush, toothbrush or cotton swab to identify the infecting organism(s) is the least invasive and most efficient method of tinea capitis sample collection in children. Conclusions Current dosing regimens of reported drugs are effective and safe for use in tinea capitis in children

Non-linear Dynamics of Steam Turbine Blades with Shroud: Numerical Analysis and Experiments.

The prediction of the aeromechanical behavior of low-pressure blades represents one of the main challenges in the Steam Turbine Industry. The evaluation of forced response and damping is critical for the reliability of new designs and usually requires expensive validation campaigns such as Wheel Box Tests (WBT). A WBT consists of one or more blade rows assembled on a rotor and spun at the desired rotating speed in a vacuum cell, with synchronous excitation provided by various sources. The WBT provides accurate information about the blade modes frequency, the alternating response level, and allows the evaluation of the mechanical damping. Given the large effort in terms of costs and time associated to the experimental activity, the possibility to rely on the output of a numerical code either during the first steps of a new design or to investigate the effect of minor changes to a current design would be extremely beneficial to the development of future products. In order to compute the non-linear forced response of shrouded blades of steam turbines, custom numerical solvers must be developed, since commercial finite element (FE) solvers do not perform this kind of analysis in the frequency domain. In this paper, the forced response of a blade with shrouds of a low pressure steam turbine is computed and numerical results are compared with the experimental Wheel Box Tests performed at GE Oil & Gas. The calculations require a three-step procedure: in the first step, a non-linear static analysis is performed in ANSYS® in order to compute the actual contact area on the shroud surface and the distribution of static normal loads, then a reduced order model of the blade is generated in ANSYS® taking into account the stiffening effect on the blade of the pre-stress due to the centrifugal force, finally the reduced model is imported in a numerical code and the non-linear forced response of the blade is computed. The numerical code solves the balance equations of the system in the frequency domain, by means of the Harmonic Balance Method, imposing cyclic symmetry boundary conditions of the system. An interpolation procedure is implemented in order to manage the non-perfectly matching meshes of the shroud contact surfaces, while the tangential and normal contact stiffness is computed with a numerical model based on the contact mechanics principles. The numerical and the experimental results around some of the critical resonances of the system are compared in order to assess the reliability and accuracy of the numerical tool for its future implementation in the mechanical design practice of the blade

Dermoscopy of non-skin cancer nail disorders.

Nail dermoscopy is becoming more and more frequently utilized for the diagnosis of nail disorders. It can be performed with handy dermoscope or with a video dermoscope, which allows magnifications of up to 200. Nail dermoscopy requires a good knowledge of nail anatomy and physiology and the pathogenesis of nail diseases: we have to know which part of the nail we have to look at! The nail is in fact not visible as a whole at one time, but its different parts should be observed, moving the lens back and forth and transversally. All nail disorders can be observed by dermoscopy. However, except for some diseases in which the technique really adds a lot to clinical examination, in most of the cases, nail dermoscopy only permits a better visualization of symptoms already evident to the naked eye. Dermoscopic features of nail signs are always very interesting and surprising, and may help in our understanding of nails

Non-linear Dynamics of Steam Turbine Blades with Shroud: Numerical Analysis and Experiments

The prediction of the aeromechanical behavior of low-pressure blades represents one of the main challenges in the Steam Turbine Industry. The evaluation of forced response and damping is critical for the reliability of new designs and usually requires expensive validation campaigns such as Wheel Box Tests (WBT). A WBT consists of one or more blade rows assembled on a rotor and spun at the desired rotating speed in a vacuum cell, with synchronous excitation provided by various sources. The WBT provides accurate information about the blade modes frequency, the alternating response level, and allows the evaluation of the mechanical damping. Given the large effort in terms of costs and time associated to the experimental activity, the possibility to rely on the output of a numerical code either during the first steps of a new design or to investigate the effect of minor changes to a current design would be extremely beneficial to the development of future products. In order to compute the non-linear forced response of shrouded blades of steam turbines, custom numerical solvers must be developed, since commercial finite element (FE) solvers do not perform this kind of analysis in the frequency domain. In this paper, the forced response of a blade with shrouds of a low pressure steam turbine is computed and numerical results are compared with the experimental Wheel Box Tests performed at GE Oil & Gas. The calculations require a three-step procedure: in the first step, a non-linear static analysis is performed in ANSYS® in order to compute the actual contact area on the shroud surface and the distribution of static normal loads, then a reduced order model of the blade is generated in ANSYS® taking into account the stiffening effect on the blade of the pre-stress due to the centrifugal force, finally the reduced model is imported in a numerical code and the non-linear forced response of the blade is computed. The numerical code solves the balance equations of the system in the frequency domain, by means of the Harmonic Balance Method, imposing cyclic symmetry boundary conditions of the system. An interpolation procedure is implemented in order to manage the non-perfectly matching meshes of the shroud contact surfaces, while the tangential and normal contact stiffness is computed with a numerical model based on the contact mechanics principles. The numerical and the experimental results around some of the critical resonances of the system are compared in order to assess the reliability and accuracy of the numerical tool for its future implementation in the mechanical design practice of the blade