Nail Surface Research Articles

Effects of natural environments on drug contents in nails: comparison of drug residual rates between nails and hair to determine the drug-use history of corpses in unnatural death cases using micro-segmental analysis.

We previously developed evaluation methods using micro-segmental analysis (MSA) to examine the effects of external environments on drug content in hair and nails. In this study, the effects of the natural environmental factors (water, temperature, humidity, light, and soil) on drug contents in nails were examined and compared with our previous experimental data on hair. Four hay-fever medicines were used as model drugs (fexofenadine, epinastine, cetirizine, and desloratadine) to evaluate drug stability in the nails. Reference nails containing the four medicines were collected from patients with hay fever who ingested the medicines daily for four months. The nails were exposed to various natural environments for up to four months. The effects of temperature, humidity, and light on drug contents in the nails were comparatively small. Soil significantly decomposed the nail surfaces and decreased the drug content of the nails (up to 17%). Water also decreased the drug content (up to 12%), although no apparent changes in nail surfaces were observed. In comparison with hair data obtained under the same environmental conditions, light affected drugs in the hair rather than in nails, whereas water and soil greatly affected drugs in the nails rather than in hair. Although the disposition of drugs incorporated in the tissues differed between nails and hair, the analytes were detected in nails and hair strands left in severe natural environments. MSA could be useful for estimating drug-use histories and personal profiles using the nails and hair of a corpse.

Nail Alterations From Musical Instruments: Insights for Dermatologists Treating Musicians.

Long-term practice and performance with a musical instrument predispose musicians to several skin conditions and nail disorders. We conducted a comprehensive literature search of the PubMed, Scopus, and Google Scholar databases for articles on nail alterations in musicians. Complications were divided into modifications of the nail surface and nail plate, soft-tissue abnormalities, and periungual tissue and distal pulp disorders. Health care professionals should be aware of these various modifications related to the use of musical instruments and provide preventive measures.

Surface material analysis for human papillomavirus detection in nail Bowen's disease caused by HPV type 58.

Over the past few years, cases of human papillomavirus (HPV) infection in nail Bowen's disease have been reported. This disease presents diagnostic challenges due to its similarity to nail malignant melanoma, particularly with respect to the clinical manifestation of black nail streaks. While skin biopsy is usually employed for diagnosis, it is an invasive procedure. We report the case of a 52-year-old healthy Japanese male with a pigmented streak on the nail of the fourth finger of his right hand, which had extended from the central to the lateral nail fold within 4 months. Dermoscopic examination revealed a dark-brown pigmented band with splinter microhemorrhage. Clinically, nail Bowen's disease was suspected. The lesion was excised in strips under local anesthesia. Histopathological examination revealed hyperkeratosis, parakeratosis, papillomatosis, and dyskeratotic cells with atypical nuclei irregularly arranged. Immunohistochemistry using anti-HPV L1 antibody detected HPV-positive cells in the upper epidermis and stratum corneum of the nail matrix. Mucosal high-risk HPV type 58 DNA was detected from brush cytology of the keratotic surface prior to surgery, which was confirmed in formalin-fixed, paraffin-embedded excised samples using polymerase chain reaction (PCR) and subsequent direct DNA sequencing. Our case highlights HPV type 58 as a potential causative agent of nail Bowen's disease and shows that brush cytology of the surface material prior to excision may be a useful and less invasive way for mucosal high-risk HPV detection. PCR analysis of the nail surface could serve as a supplementary diagnostic tool for nail Bowen's disease.

Effects of two types of surface treatments on the structural elasticity of human fingernails.

The human nail has a three-layered structure. Although it would be useful to quantitatively evaluate the changes in deformability of the nail due to various surface treatments, few studies have been conducted. The effects of two types of surface treatment-a chemically acting nail softener and a physically acting nail strengthener-on the deformability of human fingernails were investigated. The Young's modulus of each plate of the nail samples before and after softening treatment was determined by nanoindentation. The Young's modulus of the strengthener was determined by conducting a three-point bending test on a polyethylene sheet coated with the strengthener. Young's modulus decreased in order from the top plate against the softening treatment time, and the structural elasticity for bending deformation (SEB) of the nail sample, which expresses the deformability against bending deformation independent of its external dimensions, decreased to 60% after 6h of treatment. The Young's modulus of the nail strengthener was 244.5MPa, which is less than 10% of the SEB of the nail. When the nail strengthener was applied to the nail surface, the SEB decreased to 73%, whereas the flexural rigidity increased to 117%. Changes in nail deformability caused by various surface treatments for softening and hardening were quantitatively evaluated successfully.

Influence of repeated wetting and drying on withdrawal capacity of wooden nails and metal nails

Metal nails pose inherent safety risks to wood structures due to their susceptibility to moisture-induced rusting. Currently, densified wooden nails create an opportunity to replace metal fasteners with renewable materials, so the durability of wooden nail joints is crucial for the stability of wood structures. This study investigated the withdrawal resistance and corrosion resistance of densified wooden nails (gun-driven and manual-driven) and low-carbon steel nails (smooth shank and helical shank) when inserted on Chinese fir(Cunninghamia lanceolata (Lamb.) Hook.) specimens following repeated wet-dry cycles, aiming to provide scientific evidence for the engineering application of densified wooden nails. The results demonstrated that among the untreated samples, gun-driven wooden nails exhibited the highest withdrawal strength, surpassing manual-driven nails by factors of 4.16 (wooden nails), 3.19 (smooth nails), and 1.24 (helical nails). However, following the wet-dry cycles, the withdrawal strength and withdrawal energy of gun-driven wooden nails experienced significant reductions, but no obvious corrosion traces were found on the nail surfaces. Although the mechanical properties of smooth nails were obviously increased, the degree of corrosion was the most serious. In contrast, the mechanical properties of manual-driven wooden nails and helical nails remained relatively stable. Except for cycle-0, all types of nails displayed small stiffness fluctuations throughout the wet-dry cycles.

41113 The use of chemical peels for nail surface rejuvenation

41113 The use of chemical peels for nail surface rejuvenation

Evaluation of Thermography as a Diagnostic Technique in Asymptomatic or Incipient Onychomycosis.

Onychomycosis is usually diagnosed symptomatically due to the very clear signs caused by the fungus on the nail surface and structure, although the growth of the infecting agent must also be verified by culture in an enriched medium. This procedure is normally lengthy (four weeks), and samples can be contaminated, delaying the prescription of appropriate and effective treatment. Only one previous study has addressed the possibility of using thermography as a diagnostic method for onychomycosis in older people (31-70 years). The present study confirms this use but in individuals aged 18-31 years with incipient mycosis and no pathological signs. Using an FLIR E60 BX camera in a study with 214 samples, we found that men had more onychomycosis than women. We observed a relation between the presence of infection and nail temperature, with a higher temperature in yeast infections (+1 °C) and a lower temperature in dermatophyte infections (-2 °C). A higher temperature by almost 1 °C was also observed in older participants. Thermography can be viewed as a new diagnostic method in asymptomatic or incipient onychomycosis, providing the thermographic camera is sufficiently sensitive and the appropriate procedure is followed, although fungal culture is always necessary to confirm recovery after treatment.

Development and Evaluation of Luliconazole Nail Lacquer Containing Potential Permeation Enhancers for an Enhanced Transungual Drug Delivery

Background: Topical therapy for nail infection has a serious drawback of drug permea-tion via keratinized human nail plate. Onychomycosis, or tinea unguium, is a human nail fungal infection affecting nearly 19% of the world’s population. Aim: Purposely, we aimed to develop and evaluate nail lacquer formulations incorporated with lu-liconazole utilizing different permeation enhancers for targeted transungual drug delivery. Nail clippings were treated with luliconazole solution (5% w/v) with or without permeation enhancers and screened by determining the hydration enhancement factor and retention of the drug in the nail clippings. Different batches of nail lacquer formulations were prepared to employ Eudragit, poly-ethylene glycol 400, Tween 80, and permeation enhancer with the highest hydration enhancement factor value. Methods: Successively, the formulations were evaluated for studies like compatibility, application, gloss, blush, smoothness of flow, adhesion, non-volatile content, etc. Based on the results of physi-cal characterization and in vitro release study, formulations based on Eudragit RLPO and RSPO containing N-acetylcysteine and urea and the Eudragit RL100 containing urea as penetration en-hancer were found to be potentially useful. Furthermore, a comparative ex vivo evaluation of the formulations for permeation across the nail clippings revealed that the luliconazole-loaded Eudragit RLPO formulations containing N-acetylcysteine and urea provided the highest flux (5.12 μg/cm2/min) and shortest lag time (17.4 min). Results: Morphological analysis showed an increase in the number of pores on the nail surface, leading to the enhancement of drug diffusion across the nail matrix and nail bed. Conclusion: Furthermore, the luliconazole nail lacquer formulation exhibited higher antifungal ac-tivity, viscosity, and stability properties. Hence, the results suggest that the developed luliconazole nail lacquer formulation is an efficient topical transungual drug delivery system.

Material properties of Japanese and western wooden nails

The corrosion characteristics of Japanese (J) and Western (W) nails with and without coating the Fe3O4 layer on the nail surface were examined experimentally to understand their mechanical properties and corrodibility. In this study, (i) one of the historical J-nails made by the forging process and (ii) commonly employed commercial W-nails created by extruding were used. Although the grain size and strain value differed depending on the nail and its location(sharpened tip, body, and flattened head), the microstructure of both nails consisted of ferrite and cementite structures. A high internal strain was created in the W-nail due to the nail creation by the extruding process. In particular, a high strain was obtained in the sharpened tip and flattened head areas of the W-nail compared to its body area, caused by severe plastic deformation. A high strain was also obtained in the sharpened tip area of the J-nail owing to the severe forging process. Such a high strain was related to the high hardness. The high hardness of the sharpened tip area of the J-nail (220 HV) was slightly lower than that of the W-nail's tip area. The hardness of the J-nail decreased non-linearly to its head area, which was affected by a low strain and largely grown grains. The corrosion occurred on the J- and W-nail surfaces, where lepidocrocite (γ-FeOOH) was detected due to the weak-acidity oxidation, i.e., acid rain. The corrosion extent was different depending on the nail. Although the corrosion was detected for the J-nail after exposure for 3 months, the corrosion occurred on W-nail after exposure to the atmosphere for a week. Different corrosion extents between J- and W-nails were affected by their microstructural characteristics and strain levels, i.e., different surface energy. The corrosion resistance of both nails was improved by coating the Fe3O4 layer on the nail surface, where the corrosion extent for both J- and W-nails was similar due to the corrosion protection by the Fe3O4 layer. The corrosion characteristics directly affected their mechanical properties: tensile strength and ductility. This work systematically analyzed details of the mechanical properties of the nails after corrosion.

Rapid-killing efficacy substantiates the antiseptic property of the synergistic combination of carvacrol and nerol against nosocomial pathogens.

Globally, new classes of synthetic and natural antibiotics and antivirulents have continuously been validated for their potential broad-spectrum antagonistic activity with the aim of identifying an effective active molecule to prevent the spread of infectious agents in both food industry and medical field. In view of this, present study is aimed at evaluating the rapid killing efficacy of bioactive molecules Carvacrol (C) and Nerol (N) through British Standard European Norm 1276: phase2/step1 (EN1276) protocol. Active molecules C and N showed broad-spectrum antimicrobial activity against the test strains Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli and Enterococcus hirae at concentration range of 78.125, 625, 156.25 and 312.5 μg/mL, respectively, for C, and 625 μg/mL for N. Whereas, combinatorial approach showed efficient activity with four times reduced concentration of C and N at 78.125 and 156.25 µg/mL, respectively, against test strains. Further, EN1276 results proved the rapid killing efficacy of test strains in 1 min of contact time with significant (> 5 log) growth reduction at 100X concentration of actives. SEM analysis and reduced concentration of protease, lipids and carbohydrate contents of treated group biofilm components ascertained preformed biofilm disruption potential of C + N on polystyrene and nail surfaces. C + N at synergistic concentration exhibited no adverse effect on HaCaT cells at 78.125 µg/mL (C) + 156.25 µg/mL (N). Taken together, based on the observed experimental results, present study evidence the antiseptic/disinfectant ability of C + N and suggest that the combination can preferentially be used in foam-based hand wash formulations.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00203-022-03197-x.

Analysis of risk factor for nail breakage in patients with mechanical failures after proximal femoral nail antirotation in intertrochanteric fractures.

Breakage of the intramedullary nail is a rare complication after proximal femoral nail antirotation (PFNA) in intertrochanteric fracture treatment. The purpose of this study was (1) to investigate the frequency of nail breakage among the patients who were treated for mechanical failure after PFNA for intertrochanteric/pertrochanteric fracture, and (2) to determine the risk factors for nail breakage in PFNA treatment of intertrochanteric fracture.To identify mechanical failure after internal fixation using PFNA, we retrospectively reviewed the data of 35 patients (35 hips) who required reoperation after PFNA with a helical blade for intertrochanteric/pertrochanteric fracture between June 2005 and June 2018.We evaluated the frequency of breakage of PFNA and compared the demographic and radiologic parameters between the breakage and control (non-breakage) groups. We also compared the lever arm for the load of stress from the fulcrum according to the centrum-collum-diaphyseal (CCD) angle of blade by using reverse design technique.Among the 25 patients with mechanical failure after PFNA except 10 patients with peri-implant infection and osteonecrosis, 7 (28.0%) showed breakage of PFNA at average of 8 months (range, 5–13 months) after index surgery. A larger horizontal offset (the horizontal distance from the lateral surface of the IM nail and the medial tip of helical blade) was associated with an increased risk of nail breakage. A CCD angle of 130° has a shorter lever arm for the load of stress from the fulcrum, meaning a higher stress for nail breakage, although there was no association between CCD angle and breakage of the nail.Our study suggested that higher horizontal offset and a higher CCD angle can increase the risk of breakage of the PFNA nail at the aperture for the helical blade.

Relevant insights into onychomycosis’ pathogenesis related to the effectiveness topical treatment

Onychomycosis (OM) is a fungal infection, responsible for about 50% of nail diseases. OM has been attributed to the ability of fungi to naturally organize themselves into biofilms on nail surfaces. However, little is known about the exact role of the biofilm in the etiopathogenesis of OM, as well as its influence in the permeation of a topical treatment. The objectives of this study were to review the literature for topical OM treatments in clinical trials, assess the efficiency of these treatments, and discuss factors that could affect the success of these treatments. First, a systematic search of articles published in the MEDLINE database (PubMed) between January 2010 and December 2019 was conducted, focusing on drugs under clinical trials for the topical treatment of OM. Of the publications selected, it was clear that none of them had considered the fungi organized in biofilm. Therefore, we reflected on some important variables involved in OM, such as the nail structure and the mechanism of fungal invasion. Some methods, such as histopathologic analysis and spectroscopy techniques, were found to be effective in the detection of nail biofilm, and could be used in future drug permeation studies. This review allowed us to conclude that novel antifungals for the topical treatment of OM must consider the drug to permeate through biofilm. Natural products, such as propolis, seem strong candidates in this respect.

Application of a three-dimensional scanner to the quantitative assessment of the nail plate condition after a hybrid manicure procedure-Preliminary study.

About 90% of women worldwide use nail care products, including manicure ones. A manicure procedure results in nail damage, therefore it is necessary to search for new, objective methods of assessing the impact of the procedures and products applied within the nail plate. In this study, an attempt was made to quantify the impact of manicure procedures on the nail plate condition. Twenty thumb nail plates were examined. Before the manicure procedures, alginate casts were prepared for each of the subjects. The analysis of the three-dimensional (3D) nail surface structure included the assessment of the nail sections and the assessment of differences in the nail structure after superposition of 3D images of the nail plates before and after the manicure procedures. The obtained results show that the nail plate structure changed to a similar extent in each measured section after the manicure procedure. A change in the height of the nails is not a desirable phenomenon as it suggests damage to the nail caused by the substances included in the preparations applied to the nails, acetone, or filing the nail plate. This proves the great influence of the technique of removing artificial nails on the structure of the natural plate. The use of a 3D scanner allows for precise, biometric, quantitative, and repeatable measurements of changes in the nail structure after a manicure procedure. The use of the hybrid and gel manicure procedure causes significant damage to the nail plate, especially in its distal portion.

You Can Handle It: Pediatric Hand Injuries from Toddlers to Teens

As so many of children’s interactions with the world are through their hands, it is no surprise that hand injuries are a common pediatric complaint. Fractures of the hand and wrist account for 2.3% of pediatric emergency department visits, with a peak incidence in the teenage years, coinciding with participation in sports or fights. Hand injuries may be subtle, and appropriate recognition, treatment, and referral are vital for preventing long-term morbidity.After a focused history, providers should inspect for edema, ecchymosis, laceration, or deformity and assess all joints for motor function in addition to active and passive range of motion. The examiner should evaluate sensation and capillary refill, particularly distal to the injury. Any sensorimotor abnormality should raise concern for tendon or nerve involvement. Bony anatomy should be meticulously palpated, with any point tenderness or crepitus evaluated for fracture.The distal phalanx is frequently fractured in toddlers, with peak incidence at 2 years of age. The mechanism is often a crush injury, such as in a doorframe, resulting in a nail bed hematoma, laceration, or amputation. A subungual hematoma with an intact nail plate may be managed with supportive care when it involves less than 50% of the nail surface, or with trephination when it involves greater than 50%. Nail bed lacerations may be anesthetized with a digital block. After nail plate removal and copious irrigation, the laceration should be repaired with absorbable sutures. Glue may be an acceptable alternative but is not appropriate in all situations, particularly a contaminated wound. After repair, the nail fold may be stented open with the native nail, aluminum suture packaging, or nonadherent gauze; however, whether this maneuver improves outcomes awaits ongoing research. Antibiotic drug therapy should be considered for a nail bed laceration with an associated fracture that is contaminated or has significant bone exposure. Tetanus prophylaxis should be administered when indicated.When a nail bed laceration is suspected, radiographs should be obtained: a fracture is present in approximately half of cases, frequently a “tuft fracture” of the distal phalanx. Most fractures can be managed with a finger splint; however, fractures with significant displacement may require future operative management. Seymour fractures are Salter-Harris type I or II fractures of the distal phalanx in which the nail bed becomes entrapped between fracture fragments. These are best visualized on lateral radiographs and should be treated as an open fracture with antibiotics and evaluation by a hand specialist. Complications of Seymour fractures include malunion, nail bed deformity, and osteomyelitis. Treatment within 24 hours is associated with improved outcomes.Amputated fingertips should be wrapped in saline-soaked gauze, placed in a plastic bag, and stored in an ice water slurry, with reimplantation attempted as soon as possible. Amputations that are grossly contaminated, require significant debridement, have exposed bone, or have significant tissue loss warrant evaluation by a hand specialist.Injuries to the middle and proximal phalanxes are associated with athletics and peak between ages 10 and 14 years. Nondisplaced or minimally displaced fractures may be managed with a finger splint or buddy taping. Patients undergoing buddy taping should be counseled on the importance of compliance to avoid skin breakdown and loss of fixation or joint mobility. Painful or unstable proximal phalanx fractures should be placed in an ulnar or radial gutter splint with intrinsic plus positioning (wrist in 20°–30° extension, metacarpophalangeal joints in 70°–90° of flexion, and interphalangeal joints in full extension). A hand specialist should evaluate fractures that are displaced, malrotated, angulated, or involve the physis or joint. A Salter-Harris type II fracture of the proximal phalanx is common, occurring most often in the fifth finger, usually resulting from an abduction injury. Called an “extra-octave fracture,

Effect of Intramedullary Nailing Patterns on Interfragmentary Strain in a Mouse Femur Fracture: A Parametric Finite Element Analysis.

Delayed long bone fracture healing and nonunion continue to be a significant socioeconomic burden. While mechanical stimulation is known to be an important determinant of the bone repair process, understanding how the magnitude, mode, and commencement of interfragmentary strain (IFS) affect fracture healing can guide new therapeutic strategies to prevent delayed healing or nonunion. Mouse models provide a means to investigate the molecular and cellular aspects of fracture repair, yet there is only one commercially available, clinically-relevant, locking intramedullary nail (IMN) currently available for studying long bone fractures in rodents. Having access to alternative IMNs would allow a variety of mechanical environments at the fracture site to be evaluated, and the purpose of this proof-of-concept finite element analysis study is to identify which IMN design parameters have the largest impact on IFS in a murine transverse femoral osteotomy model. Using the dimensions of the clinically relevant IMN as a guide, the nail material, distance between interlocking screws, and clearance between the nail and endosteal surface were varied between simulations. Of these parameters, changing the nail material from stainless steel (SS) to polyetheretherketone (PEEK) had the largest impact on IFS. Reducing the distance between the proximal and distal interlocking screws substantially affected IFS only when nail modulus was low. Therefore, IMNs with low modulus (e.g., PEEK) can be used alongside commercially available SS nails to investigate the effect of initial IFS or stability on fracture healing with respect to different biological conditions of repair in rodents.

Biodegradation behaviors of magnesium(Mg)-based alloy nails in autologous bone grafts: In vivo study in rabbit skulls.

In this study, autologous bone grafts using bone-fixing nails made of magnesium-zinc-calcium ternary alloys were performed using rabbit skulls. Two types of nails for bone fixation were prepared: 2.5 mm width, 3 mm length and 2.5 mm width, 2 mm length. A disk-shaped bone with a diameter of 5 mm was resected from the parietal bone and fixed with a 3 mm long nail. As a control group, a 2 mm long nail was driven into the existing bone. The rabbits were sacrificed at 1, 4, 12, and 24 weeks after surgery. The resected samples were observed with micro X-ray CT, and embedded in methyl methacrylate to prepare non-decalcified specimens. The in vivo localization of elements was examined using energy-dispersive X-ray spectroscopy (EDS). Micro X-ray CT images of samples showed volume reduction due to degradation in both the bone graft and control groups. No significant difference in the amount of degradation between the two groups was observed, however characteristic degradation processes were observed in each group. The samples stained with alizarin red S showed amorphous areas around the nails, which were considered as corrosion products and contacted directly with the newly formed bones. EDS analysis showed that corrosion products were mainly composed of magnesium and oxygen at an early stage, while calcium and phosphorus were detected on the surface layer during the long-term observation. The degradation speed of the magnesium alloy nails varied depending on the shapes of the nails and surrounding tissue conditions. A calcium phosphate layer was formed on the surface of magnesium alloy nails, suggesting that the degradation rate of the nail was slow.

Evaluation and detection of early nail damage caused by nail enamel.

Many nail cosmetics have components that are considered irritants or allergens. Due to the current clinical assessment limitations, it is often too late to identify nail enamel hazards until they cause disease. Thus, it is essential to investigate effective methods of detecting minor changes and early lesions in nails before they worsen. To provide a reliable method to investigate and evaluate nail enamel hazards on nails earlier using ultrasonic equipment. Eighty-three volunteers with smooth, lustrous nails were enrolled after being clinically examined. The thumbnails and middle nails were evaluated before and after using nail enamel for 2weeks. Nail health was then assessed using three methods: clinical evaluation, nail surface image analysis, and an ultrasonic device. Using clinical diagnostic and imaging methods for analyzing the nail surface showed no visible differences before and after using nail enamel for 2weeks. However, there was a significant difference in the nails' depth and density (p<0.001). The depth had increased 10% for thumbnails (about 20μm), and the density had decreased by 3.0%. As for middle nails, the depth had increased by 9.4% (about 19μm), and the density had decreased by 3.0%. The present study provided evidence that nail enamel can significantly irritate hyperplasia and decrease the density of the nails, but detecting that slow process of pathological changes cannot currently be assessed by conventional clinical evaluation and image analysis. Thus, our study provided a practical novel approach for evaluating these visually imperceptible nail changes.

Evaluation of nail surface topography using a three-dimensional in vivo optical skin imaging system.

The analysis of nail surface topography is a subject of ever-increasing interest in dermatology, especially in cosmetic studies. However, there is no accurate and scientifically sound instrumental method that can identify and provide quantitative data on nail surface topography. The right index fingers of 78 healthy individuals were examined. The severity of nail roughness was rated by two independent dermatologists on a scale of 1 to 3. Using the phaseshift rapid in vivo measurement of the skin (PRIMOS) system, three-dimensional microtopography was performed, and the roughness parameter values were calculated and evaluated. The relationship between clinical nail roughness grade and nail roughness parameter values obtained utilizing PRIMOS was evaluated. A moderate correlation was found between the roughness parameter values and the clinical roughness grade. Our study showed that an overall relationship exists between the nail roughness parameter values obtained using PRIMOS and clinically observed nail surface changes. With further studies, PRIMOS could be a valuable tool for clinicians and researchers for conducting an accurate and objective patient assessment in daily practice and demonstrating effectiveness of different therapies for nail dystrophy or evaluating cosmetic effects of various topical treatments in future clinical trials.

A simple ZVI-Fenton pre-oxidation using steel-nails for NOM degradation in water treatment

The feasibility of a heterogeneous Fenton Process (ZVI/H2O2) using commercial low-carbon-steel nails as the Zero-Valent Iron (ZVI) source was evaluated for the first time for the removal of natural organic matter (NOM) from natural surface waters with distinct physico-chemical characteristics. The synergistic effect of ZVI nails and H2O2 on the process was confirmed. Results showed similar removal efficiencies of NOM in water samples from Thames river and Regent's Park lake (both in London, UK) (under initial pH 3.5 and 100% excess of H2O2 dosage), reaching dissolved organic carbon (DOC) removals of 61.6% ± 3.0 and 59.6% ± 4.7, and UV254 removals of 79.9% ± 0.6 and 77.3 ± 6.2, respectively with 60 min of batch reaction time. ZVI nail surface characterization by scanning electron microscopy (SEM), X-ray energy-dispersive spectroscopy (EDS), and X-ray photoemission spectroscopy (XPS) revealed the formation of a passivating oxide-hydroxide layer on the nail during the reaction, which reduces its surface activity with 20% in continuous use. Results indicate that ZVI/H2O2 process using commercial iron nails is a promising pre-oxidation step for drinking water treatment. The low cost of commercial nails together with the facility of separating them from the water are the main advantages for the application of this process in remote regions with limitations in infrastructure and/or finance.

The Success of Topical Treatment of Onychomycosis Seems to Be Influenced by Fungal Features.

Aim To evaluate the topical treatment of onychomycosis using a 10% hydroalcoholic propolis extract (PE) in two aleatorily chosen patients and analyze possible risk factors from hosts including some particularities of the isolated fungi that may justify the outcomes achieved. Materials and Methods A topical treatment, with PE, was started in two cases of toe onychomycosis due to T. rubrum. The in vitro PE antifungal activity against these isolates was confirmed. Moreover, the ability of the fungi to infect the human nail was evaluated also in an ex vivo study, analyzed by histopathology. Results Within four months, both patients showed evident improvement, but with different outcomes. The possible host-related risk factors justifying the poorer outcome in patient 1 include a longer duration time of onychomycosis (50 years). Some particularities in the T. rubrum strain isolated from this patient in relation to that found in patient 2 were observed: (1) the hypha morphology suggesting a major adaptation of the fungus to the host; (2) a 16 times greater propolis concentration was required in vitro; and (3) a faster ability to start a growth using the nail as the only nutritional source. Additionally, this isolate was more efficient in producing a biofilm on the nail surface. Conclusions A partial clinical and complete mycological cure for the two patients was achieved after four months of PE daily use. Despite a complete recovery, a different outcome was observed between both cases. A more persistent onychomycosis, added to greater fungal potential to produce biofilm on the nail, seems to influence greatly the success of a topical treatment with PE.