Lawrence Gibson's Online Review Report Card

Dr. Gibson - Since Mayo Clinic's excellent article on nail fungus (onychomycosis) was published, better treatments have been developed that soak infected nails in a warm water soluble antimycotic solution that improves cure rates and decreases treatment times. More details are below.Chemistry and Physics of Onychomycosis Treatments1. Water Solubility. Nail keratin is hydrophilic and Kobayashi et al 1999 found that the permeation through nail keratin of a water soluble drug was much greater than a non water soluble drug of similar molecular weight by a ratio of 90 to 1. Of the 125 or so treatments available for onychomycosis, three are at least partially water soluble (Kerydin, Loceryl and ToeMate Nail Soak).2. Energy. Gupchup-Malhotra et al 2000 determined the energy of activation to drive the permeation of water through a normal nail is 7.2 kcal/mole. All but one of the currently available therapies (ToeMate Nail Soak - 7.7 kcal/mol) are applied at room temperature (about 0.5 kcal/mol).3. Antifungal Potency. Research from Baran et al 2005 suggests that combination therapies that use two or more antimycotics with complimentary modes of action lowers overall MIC values (disabling many cellular functions simultaneously) compared to values for the antimycotics applied individually. Infections with combinations of dermatophytes, yeasts and molds are thought to be common but difficult to diagnose (Elewski et al 2015). Ciclopirox and Tomate Nail Soak demonstrate more than one mode of action and ToeMate exhibits activity against spore outgrowth that prevents reinfection.4. Nail Thickness. As keratin debris accumulates, the nail becomes thicker and increases the barrier to treatment. Kobayashi 2004 found that nail penetration decreases linearly with increasing nail thickness. Quintanar 1998 found that the application of a topical keratolytic reduces nail thickness and the energy required for penetration. Keratolytics such as salicylic acid, papain and urea are available OTC under brand names Zanaquick and Gold Cosmetics. Salicylic acid 30% is included in ToeMate Kits.5. Electrostatic Repulsion. Also known as the Donnan effect, Kobayashi 2004 found that electrostatic repulsion further inhibits nail permeability between the keratin membrane and the diffusing molecule. QAC, a cationic antimicrobial surfactant used in ToeMate Kits reduces or eliminates the repulsion and allows the diffusing molecules to enter more readily (Unhoch 1997).

I’ve been coming to the clinic in Rochester MN since 1980 and have only had 2 doctors since then. First doctor had a nasty bedside manner but was a very good doctor then when he moved out of MN. I started seeing Dr Gibson and have been very satisfied that he is my doctor. If i don’t get all my results when I’m there I get a phone call when I get home and that means a lot to an older patient! He’s a doctor that listens to what you have to say and if he doesn’t have answer he will get back to you. He has gotten me through a lot of hard times (in my mind anyways) and with a blood disease I very happy to have him as my doctor.

Hola Saludo le hablo de republica dominicanaquiero saber exactamente los problema despuey el proceso de comerse la uñas de la MANOS

Let me put it this way: If I have another ailment, I want it to be one that Dr. Gibson can treat.