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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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Salicylic acid — The treatment of warts by keratolysis involves the peeling away of dead surface skin cells with keratolytic chemicals such as salicylic acid or trichloroacetic acid. These are available in over-the-counter products or, in higher concentrations, may need to be prescribed by a physician. A 12-week daily treatment with salicylic acid has been shown to lead to a complete clearance of warts in 10–15% of the cases.
Formic acid — Topical formic acid is a common treatment for plantar warts, which works by being applied over a period of time causing the body to reject the wart.
Immunotherapy — Intralesional injection of antigens (mumps, "candida" or trichophytin antigens USP) is a new wart treatment which may trigger a host immune response to the wart virus, resulting in wart resolution. It is now recommended as a second-line therapy.
Liquid nitrogen — This, and similar cryosurgery methods, is a common surgical treatment which acts by freezing the external cell structure of the warts, destroying the live tissue.
Electrodesiccation and surgical excision, which may produce scarring.
Laser surgery — This is generally a last resort treatment, as it is expensive and painful, but may be necessary for large, hard-to-cure warts.
Cauterization — This may be effective as a prolonged treatment. As a short-term treatment, cauterization of the base with anesthetic can be effective, but this method risks scars or keloids. Subsequent surgical removal is unnecessary, and risks keloids and recurrence in the operative scar.
One approach involves shaving the affected areas. Another approach involves the use of antifungal medication.
There is no resistance to Citrus Black Spot and once a tree has been infected there is no known cure causing tree removal to be the best option. Both Federal and State governments have recommended the following preventative measures.
To control "Guignardia citriparpa" fungicides like copper and/or strobilurins should be applied monthly from early May to the middle of September (in the northern hemisphere). Applications of the fungicides are recommended in early April (northern hemisphere) if that month has experienced more rainfall than usual resulting in the ideal conditions for citrus black spot to form.
Table 1. Recommended Chemical Controls for Citrus Black Spot
1)Lower rates can be used on smaller trees. Do not use less than minimum label rate.
2)Mode of action class for citrus pesticides from the Fungicide Resistance Action Committee (FRAC) 20111. Refer to ENY-624, "Pesticide Resistance and Resistance Management," in the 2012 Florida Citrus Pest Management Guide for more details.
3)Do not use more than 4 applications of strobilurin fungicides/season. Do not make more than 2 sequential applications of strobilurin fungicides.
Another method of control is to accelerate the leaf litter decomposition under the trees in citrus groves. Accelerating this decomposition reduces the chance for ascospore inoculation which generally takes place in the middle of March. There are three possible methods to hasten this decomposition. One method is the increase the mircrosprinkler irrigation in the grove to half an hour for at least five days of the week. This form of control should continue for about a month and a half. The second method is to apply urea or ammonium to the leaf litter. The last and final method to accelerate leaf decomposition is to apply lime or calcium carbonate to the litter. Urea, lime, and calcium carbonate reduce the number of fungal structures and spore production. Since the fungus requires wet conditions to thrive, air flow in the citrus grove should be maximized to reduce leaf wetness.
Along with these methods it is also important to get rid of debris such as fallen fruit or twigs in a manner that reduces the chances of infecting other plants. Citrus Black Spot can colonize and reproduce on dead twigs. To dispose of citrus debris it should either be heated to a minimum of 180℉ for two hours, incinerated, buried in a landfill, or fed to livestock. Plant trash should be moved with caution if at all to avoid spreading the infectious ascospores. Any trees that are infected with citrus black spot should be removed from the grove and disposed of. These trees must be removed because those that are declining and stressed will often have off season bloom. If there is more than one age of fruit present on the tree, it is possible for the asexual spores on the fruit to be transferred to new fruit, intensifying the disease. This off season blooming is often more problematic with Valencia oranges when old and new crops overlap.
Treatment consists of topical application of dandruff shampoo, which contains selenium sulfide, over the skin. Topical antifungal imidazoles may also be used, such as ketoconazole. This is the same treatment plan for tinea or pityriasis versicolor.
Extensive treatments have been used on domestic animals more than on wild animals, probably because infected domestic animals are easier to identify and treat than infected wildlife. Treatment plans and management vary across taxa because this disease tends to affect each species differently. Antifungal drugs are the first line of defense to kill the agents causing phaeohyphomycosis, but despite the significant progress made in the last two decades and a 30% increase in available antifungal drugs since 2000, many drugs are not effective against black fungi. Diseases caused black fungi are hard to treat because the fungi are very difficult to kill. This high resilience may be contributed to the presence of melanin in their cell walls. Current antifungal agents the fungi are not resistant to are posaconazole, voriconazole, and azole isavuconazole.
In 2006, a free-living Eastern box turtle, "Terrapene carolina carolina", was found with a form of phaeohyphomycosis and was brought in the Wildlife Center of Virginia. Its symptom was swelling of the right hindfoot; it was diagnosed as having chromomycosis by histopathology. The center provided a series of antimicrobial treatments and a one-month course of 1 mg itraconazole, administered orally once a day. The eastern box turtle was euthanized due to further complications and the caretakers’ belief that the turtle would not be able to survive if placed back in the wild.
A recent case of a form of phaeohyphomycosis infection was found in a dog in 2011. The Journal of the American Veterinary Medical Association published a case study in which researchers successfully managed an intracranial phaeohyphomycotic fungal granuloma in a one-year-old male Boxer dog. Veterinarians of the Department of Veterinary Clinical Sciences at Tufts University surgically removed the granuloma in the right cerebral hemisphere. The patient was treated with fluconazole for 4 months, and was followed with voriconazole for 10 months. Both are medications used to treat fungal infections. Based on magnetic resonance imaging and cerebrospinal fluid (CSF) analysis 8 months after the surgery, the male Boxer’s outcome was considered excellent.
Emphasis has been placed on how to manage this disease through careful management practices including: proper handling, preventing crowding situation with animals, and transportation. Both the animals and the environment should be treated thoroughly to hinder the spread and control the fungal infection. This is especially important since humans can also contract this disease.
Bacterial leaf streak of wheat is not easily prevented, but can be controlled with clean seed and resistance. Some foliar products, such as pesticides and antibiotic compounds, have been tested for effectiveness, but have proven to have insignificant outcomes on the bacterial pathogen.
Using clean seed, with little infection, has yielded effective results for researchers and producers. The pathogen, being seed-borne, can be controlled with the elimination of contaminated seed, however, clean seed is not always a sure solution. Because the pathogen may still live in the soil, the use of clean seed is only effective if both the soil and seed are free of the pathogen. Currently, there are no successful seed treatments available for producers to apply to wheat seed for the pathogen.
Variety resistance is another option for control of the disease. Using cultivars such as Blade, Cromwell, Faller, Howard or Knudson, which are resistant to BLS may reduce the impact of the disease and potentially break the disease cycle. Avoiding susceptible cultivars such as Hat Trick, Kelby, and Samson may also reduce the presence of the disease and reduce the amount of bacterial residue in the soil. Using integrated pest management techniques such as tillage to turn over the soil and bury the infection as well as rotating crops may assist with disease management, but are not a definitive control methods. Depending on conditions, the bacteria may survive for up to 81 months. Because the bacteria is moisture driven, irrigation may also increase the risks of BLS infection.
An escharotic is a substance that causes tissue to die and slough off. Examples include acids, alkalis, carbon dioxide, metallic salts and sanguinarine, as well as certain medicines like imiquimod. Escharotics known as black salves, containing ingredients such as zinc chloride and sanguinarine containing bloodroot extracts, were traditionally used in herbal medicine as topical treatments for localised skin cancers, but often cause scarring and can potentially cause serious injury and disfigurement. Consequently, escharotic salves are very strictly regulated in most western countries and while some prescription medicines are available with this effect, unauthorized sales are illegal. Some prosecutions have been pursued over unlicensed sales of escharotic products such as Cansema.
Treatment is by reassurance, as the condition is benign, and then by correction of any predisposing factors. This may be cessation of smoking or cessation/substitution of implicated medications or mouthwashes. Generally direct measures to return the tongue to its normal appearance involve improving oral hygiene, especially scraping or brushing the tongue before sleep. This promotes desquamation of the hyperparakeratotic papillae. Keratolytic agents (chemicals to remove keratin) such as podophyllin are successful, but carry safety concerns. Other reported successful measures include sodium bicarbonate mouthrinses, eating pineapple, sucking on a peach stone and chewing gum.
Thousand cankers disease can be spread by moving infected black walnut wood. Trees intended for shipment should be inspected for dieback and cankers and galleries after harvest. G. morbidia or the walnut twig beetle ("Pityophthorus juglandis") are not currently known to be moved with walnut seed . There is currently no chemical therapy or prevention available for the disease making it difficult to control the spread of the disease from the west to the eastern united states. Wood from infected trees can still be used for commercial value, but safety measures such as removing the bark, phloem, and cambium to reduce the risk of spreading the disease with shipment. Quarantines have been put in place in some states to reduce the potential movement of fungus or beetle from that region. On May 17th, 2010, the Director of the Michigan Department of Agriculture issued a quarantine from affected states to protect Michigan’s black walnut ecology and production. Contacting the appropriate entities about possible infections is important to stopping or slowing the spread of thousand cankers disease.
Leukoedema is a harmless condition, and no treatment is indicated. People may be alarmed by the appearance and benefit from reassurance.
Sugarcane smut or "Ustilago scitaminea Sydow" is caused by the fungus "Sporisorium scitamineum"; smut was previously known as "Ustilago scitaminea". The smut 'whip' is a curved black structure which emerges from the leaf whorl, and which aids in the spreading of the disease. Sugarcane smut causes significant losses to the economic value of a sugarcane crop. Sugarcane smut has recently been found in the eastern seaboard areas of Australia, one of the world's highest-yielding sugar areas.
For the sugarcane crop to be infected by the disease, large spore concentrations are needed. The fungi uses its "smut-whip" to ensure that the disease is spread to other plants, which usually occurs over a time period of three months. As the inoculum is spread, the younger sugarcane buds just coming out of the soil will be the most susceptible. Because water is necessary for spore germination, irrigation has been shown to be a factor in spreading the disease. Therefore, special precautions need to be taken during irrigation to prevent spreading of the smut.
Another way to prevent the disease from occurring in the sugarcane is to use fungicide. This can be done by either pre-plant soaking or post-plant spraying with the specific fungicide. Pre-plant soaking has been proven to give the best results in preventing the disease, but post-plant spraying is a practical option for large sugarcane cultivations.
In affected orchards, new infections can be reduced by removing leaf litter and trimmings containing infected tissue from the orchard and incinerating them. This will reduce the amount of new ascospores released in the spring. Additionally, scab lesions on woody tissue can be excised from the tree if possible and similarly destroyed.
Chemical controls can include a variety of compounds. Benzimidazole fungicides, e.g., Benlate (now banned in many countries due to its containing the harmful chemical benzene) work well but resistance can arise quickly. A number of other chemical classes including sterol inhibitors such as Nova 40, and strobilurins such as Sovran are used extensively; however, some of these are slowly being phased out because of resistance problems.
Contact fungicides not prone to resistance, such as Captan, are viable choices. Potassium bicarbonate is an effective fungicide against apple scab, as well as powdery mildew, and is allowed for use in organic farming. Copper and Bordeaux mixture are traditional controls but are less effective than chemical fungicides, and can cause russeting of the fruit. Wettable sulfur also provides some control. Timing of application and concentration varies between compounds.
An apple scab prognostic model called RIMpro was developed by Marc Trapman, which numerically grades infection risk and can serve as a warning system. It allows better targeted spraying. Parameter for calculation are wetness of leaves, amount of rain fall and temperature.
Fifteen genes have been found in apple cultivars that confer resistance against apple scab. Researchers hope to use cisgenic techniques to introduce these genes into commercial cultivars and therefore create new resistant cultivars. This can be done through conventional breeding but would take over 50 years to achieve.
DPN lesions are benign and no treatment generally is indicated unless lesions are cosmetically undesirable. Surgical options including curettage, cryotherapy and laser therapy are options Scarring, postoperative skin discoloration or keloid formation are potential complication. Therefore, conservative dpn treatment is advisable.
BHT is a benign condition, but people who are affected may be distressed at the appearance and possible halitosis, and therefore treatment is indicated.
Black piedra is a form of piedra caused by "Piedraia hortae".
Terbinafine has been used in the treatment.
In order to control for the disease, the "Lymnaea" spp snails, which are the intermediate host for the liver flukes, need to be controlled. There are three ways that have proven most effective when controlling the snail populations:
- The first is by treating pastures and water channels with copper sulfate. This method is not always practical, because it is too expensive to treat in large areas. Lack of cooperation between neighbors is also a problem, snails are easily transported, and treated pastures become re-infested by neighboring fields and streams.
- Drenching the sheep with carbon tetra-chloride in paraffin oil has proven to be an alternative. However, drenching in more than recommended doses can be fatal, by causing liver damage, which could initiate the disease in sheep carrying "B. oedematiens" spores.
- Drainage is an effective option to eliminate the snails. However, draining the places where the grass grows eliminates a source of food for the sheep and creates other unwanted problems.
No treatment is required since the lesion is entirely benign. Some suggest that amalgam tattoos are best surgically excised so as to ensure the lesion does not represent a melanoma. Other say that excision should only be carried out if there is any doubt over the diagnosis, and that amalgam tattoos are managed by simple reassurance about the nature of the lesion. For example, if radio-opaque particles are demonstrated on the x-ray, biopsy is unnecessary.
People who have been bitten by a black widow spider are recommended to seek professional medical assistance for symptoms. Symptoms self-resolve in hours to days in a majority of bites without medical intervention.
Medical treatments have varied over the years. Some treatments (e.g. calcium gluconate) have been discovered to be useless. Currently, treatment usually involves symptomatic therapy with pain medication, muscle relaxants, and antivenom. When the pain becomes unbearable, antivenom is administered. Antivenom historically completely resolves pain in a short time. Antivenom is made by injecting horses with latrodectus venom over a period of time. The horse develops antibodies against the venom. The horse is bled and the antibodies purified for later use. Doctors recommend the use of anti-inflammatory medications before antivenom administration, because antivenom can induce allergic reactions to the horse proteins. The efficacy of antivenom has come under scrutiny as patients receiving placebo have also recovered quickly.
Antivenom is used widely in Australia for redback bites; however, in the United States it is less commonly used. Antivenom made from prior spider bite victims has been used since the 1920s. Opiates such as morphine relieve pain and benzodiazepines ease muscle spasm in most patients.
Piedra (also known as "Trichosporosis") is a hair disease caused by a fungus.
Types include:
- White piedra
- Black piedra
Skeletal eroding band (SEB) is a disease of corals that appears as a black or dark gray band that slowly advances over corals, leaving a spotted region of dead coral in its wake. It is the most common disease of corals in the Indian and Pacific Oceans, and is also found in the Red Sea.
So far one agent has been clearly identified, the ciliate "Halofolliculina corallasia". This makes SEB the first coral disease known to be caused by a protozoan. When "H. corallasia" divides, the daughter cells move to the leading edge of the dark band and produce a protective shell called a lorica. To do this, they drill into the coral's limestone skeleton, killing coral polyps in the process.
A disease with very similar symptoms has been found in the Caribbean Sea, but has been given a different name as it is caused by a different species in the genus "Halofolliculina" and occurs in a different type of environment.
Afro-textured hair is the natural hair texture of certain populations in Africa, the African diaspora, Australia and Asia, which has not been altered by hot combs, flat irons or chemicals (through perming, relaxation or other straightening methods). Each strand of this hair type grows in a tiny, spring-like helix shape. The overall effect is such that, compared to straight, wavy or curly hair, afro-textured hair appears denser.
Subungual hematomas are treated by either releasing the pressure conservatively when tolerable or by drilling a hole through the nail into the hematoma (trephining), or by removing the entire nail. Trephining is generally accomplished by using a heated instrument to pass through the nail into the blood clot. Removal of the nail is typically done when the nail itself is disrupted, a large laceration requiring suturing is suspected, or a fracture of the tip of the finger occurs. Although general anesthesia is generally not required, a digital nerve block is recommended to be performed if the nail is to be removed.
Subungual hematomas typically heal without incident, though infection or disruption of the nail (onycholysis) may occur.
The smuts are multicellular fungi characterized by their large numbers of teliospores. The smuts get their name from a Germanic word for dirt because of their dark, thick-walled, and dust-like teliospores. They are mostly Ustilaginomycetes (of the class Teliomycetae, subphylum Basidiomycota) and can cause plant disease. The smuts are grouped with the other basidiomycetes because of their commonalities concerning sexual reproduction.
Smuts are cereal and crop pathogens that most notably affect members of the grass family ("Poaceae"). Economically important hosts include maize, barley, wheat, oats, sugarcane, and forage grasses. They eventually hijack the plants' reproductive systems, forming galls which darken and burst, releasing fungal teliospores which infect other plants nearby. Before infection can occur, the smuts need to undergo a successful mating to form dikaryotic hyphae (two haploid cells fuse to form a dikaryon).
An eschar (; Greek: "eschara") is a slough or piece of dead tissue that is cast off from the surface of the skin, particularly after a burn injury, but also seen in gangrene, ulcer, fungal infections, necrotizing spider bite wounds, spotted fevers and exposure to cutaneous anthrax. The term "eschar" is not interchangeable with "scab". An eschar contains necrotic tissue, whereas a scab is composed of dried blood and exudate.
Black eschars are most commonly attributed to anthrax, which may be contracted through herd animal exposure, but can also be obtained from "Pasteurella multocida" exposure in cats and rabbits. A newly identified human rickettsial infection, "R. parkeri" rickettsiosis, can be differentiated from Rocky Mountain spotted fever by the presence of an eschar at the site of inoculation.
Eschar is sometimes called a "black wound" because the wound is covered with thick, dry, black necrotic tissue.
Eschar may be allowed to slough off naturally, or it may require surgical removal (debridement) to prevent infection, especially in immunocompromised patients (e.g. if a skin graft is to be conducted).
If eschar is on a limb, it is important to assess peripheral pulses of the affected limb to make sure blood and lymphatic circulation is not compromised. If circulation is compromised, an escharotomy, or surgical incision through the eschar, may be indicated.