Psoriatic arthritis - Tofacitinib as a new treatment

Introduction: JAK inhibitors are used in the treatment of psoriatic arthritis when there is a lack of effective response or intolerance to first-line drugs or their use must be discontinued due to the presence of side effects. JAK inhibitors inhibit the JAK-STAT signaling pathway which plays a significant role in the pathogenesis of many inflammatory and autoimmune diseases. This mechanism leads to a reduction in the level of pro-inflammatory cytokines which causes rapid improvement in the patient's clinical condition. Tofacitinib is the best-known drug in this group; its use carries an increased risk of cardiovascular events and reactivation of the varicella-zoster virus. Regular monitoring of patients results in faster detection of the first signs of undesirable effects and the cessation of their progression. The drug's safety profile is acceptable and the benefits outweigh possible complications.   Aim of  the study:   The aim of the study is to summarize the available knowledge about tofacitinib treatment in psoriatic arthritis. The way of work, effectiveness of treatment and potential side effects were summarized and described.   Materials and methods:   The literature available in PubMed database was reviewed using the following keywords: “Psoriatic arthritis”, “Tofacitinib”, “JAK inhibitors”, “JAK-STAT”   Conclusion:   Tofacitinib treatment in rheumatology is used in psoriatic arthritis. The rapid improvement in the clinical condition of patients treated with JAK inhibitors is due to their direct impact on the modulation of the pathogenesis of the disease. The predictable benefits of therapy outweigh the side effects which can be detected at an early stage with regular monitoring of the patient

Finger Injury Related to Climbing: Anatomy, Function, Mechanism of Injury, Diagnosis, Treatment

Introduction  Rock climbing has surged in popularity over the past few decades, attracting a diverse range of participants from recreational enthusiasts to professional athletes. While climbing offers numerous physical and mental benefits, it also presents significant injury risks. Rock climbing is a sport that imposes extreme stress on the fingers, particularly on the flexor pulley system. Injuries to these structures can severely impact a climber's ability to perform and progress in the sport. Understanding the anatomy, injury mechanisms, and treatment modalities is essential for effective management and prevention.  Aim of the study  The purpose of this narrative review is to comprehensively describe information on the anatomy, function, mechanism of injury, diagnosis, and treatment modalities of the finger flexor pulley system (FFPS).  Materials and methods   The methodology for the literature search involved using the keyword "pulley" and adding terms such as "treatment", "mechanism", "function", "anatomy", "diagnosis", and "symptoms". The search terms were entered into the PubMed and Google Scholar databases. The review works and clinical trials were taken into account.  Conclusion   Finger flexor pulley system (FFPS) strain is a common overuse injury in climbers, often caused by the crimp grip used in rock climbing. Pulleys A2 and A4 are particularly vulnerable. Diagnosis involves physical examination and imaging tests, such as ultrasonography and, if necessary, magnetic resonance imaging. Grade I to III injuries are typically treated conservatively, while surgical treatment may be necessary for grade IVb injuries. Using a splint or H-taping the fingers after an injury can help prevent further damage and provide support for the affected pulleys.&nbsp

Factors influencing a child's development in the early years of life and their impact on adulthood

Introduction:   This article reviews a number of studies that have sought to determine how factors that occur in prenatal life and early childhood may lead to psychiatric disorders in adulthood. It focuses on the relationships between the physiology and pathophysiology of the autonomic nervous system and their impact on the child's development, on previously experienced traumas, on living in unfavorable conditions, on factors that have a negative impact on the fetus during pregnancy, and on the existence of two psychopathological dimensions and their connections with specific psychiatric disorders.   Aim of study:   The aim of the study is to present a comprehensive review of some of the most common forms of childhood maltreatment and show how powerful the impact they have on children’s development and their later adult life.     Materials and methods:   Materials used in this study were found in the PubMed database, using the following keywords: childhood maltreatment, sexual abuse, physical abuse, mental abuse, alcohol and drug abuse, and psychiatric disorders.   Conclusion:   The work clearly shows that neglect, abuse, and abnormal behavior have a direct impact on psychiatric disorders occurring in children and on the consequences that children have to bear as a result of their adult lives.

Finger Injury Related to Climbing: Anatomy, Function, Mechanism of Injury, Diagnosis, Treatment

Introduction  Rock climbing has surged in popularity over the past few decades, attracting a diverse range of participants from recreational enthusiasts to professional athletes. While climbing offers numerous physical and mental benefits, it also presents significant injury risks. Rock climbing is a sport that imposes extreme stress on the fingers, particularly on the flexor pulley system. Injuries to these structures can severely impact a climber's ability to perform and progress in the sport. Understanding the anatomy, injury mechanisms, and treatment modalities is essential for effective management and prevention.  Aim of the study  The purpose of this narrative review is to comprehensively describe information on the anatomy, function, mechanism of injury, diagnosis, and treatment modalities of the finger flexor pulley system (FFPS).  Materials and methods   The methodology for the literature search involved using the keyword "pulley" and adding terms such as "treatment", "mechanism", "function", "anatomy", "diagnosis", and "symptoms". The search terms were entered into the PubMed and Google Scholar databases. The review works and clinical trials were taken into account.  Conclusion   Finger flexor pulley system (FFPS) strain is a common overuse injury in climbers, often caused by the crimp grip used in rock climbing. Pulleys A2 and A4 are particularly vulnerable. Diagnosis involves physical examination and imaging tests, such as ultrasonography and, if necessary, magnetic resonance imaging. Grade I to III injuries are typically treated conservatively, while surgical treatment may be necessary for grade IVb injuries. Using a splint or H-taping the fingers after an injury can help prevent further damage and provide support for the affected pulleys.

The Role of Sport in Human Health: Prevention and Treatment of Osteoporosis

Introduction and purpose  Osteoporosis is the most prevalent metabolic bone disease, characterized by diminished bone mineral density, compromised bone microarchitecture, and geometry, culminating in diminished bone strength and susceptibility to fractures. Physical activity posits potential as a preventive measure and therapeutic approach for osteoporosis. The aim of this study was to assess the impact of physical activity on the prevention and treatment of osteoporosis. Materials and method In order to curate appropriate sources for this article, a comprehensive search was conducted within the PubMed and Google Scholar databases.  A brief description of the state of knowledge One of the risk factors for osteoporosis is a lack of physical activity. For this reason, many scientists have decided to conduct some research to determine whether physical activity will have a beneficial impact on both the prevention and treatment of osteoporosis. These studies show that physical activity can benefit people with osteoporosis by improving bone density, balance, strength, and overall physical function. Regular and long-term exercise is essential to maximize these benefits. Summary The studies conducted so far provide promising results and confirm the beneficial impact of physical exercises on people with osteoporosis as well as on the prevention of this disease. Exercises should be performed regularly and persistently

Achilles tendon rupture: etiology, diagnosis, prevention, repair, complications and their relation to future sports performance in the athletic population

The Achilles tendon is the most powerful and longest in our body. 20% of all serious tendon ruptures involve the Achilles tendon (AT). An AT rupture can be a career-ending injury. Proven risk factors predisposing and preventing tendon rupture are presented, as well as epidemiological data on the incidence of this disease in the population. In addition, it illustrates currently used diagnostic methods and presents the benefits they bring. Achilles tendon ruptures have a detrimental impact on athletic performance, and the most appropriate treatment method and return-to-play recommendations remain controversial. Recent studies show that operative intervention improves strength and functional results and is more effective compared to non-operative treatment combined with rehabilitation. Currently, according to the latest research, surgical intervention should be used, especially in athletes and very physically active people, because it shortens the time to return to full fitness and allows for better sports achievements in the future. However, you should remember about the complications that may result from such treatment. Nevertheless, the benefits of surgery outweigh the possible losses, especially to the athletic population. The purpose of this study is to comprehensively review the relationship between surgical repair of a ruptured AT and future athletic performance in an athlete population. The available research shows the effectiveness, side effects, complications, and benefits of surgical correction of a ruptured tendon in the athlete population, as well as the quality of performance they are able to achieve after recovery. Materials and methods: Materials used in this study were found in the PubMed database, using the following keywords: Achilles tendon”, Achilles tendon rupture”, Return to play’’, Athletes injury”, Athletic population”

Effectiveness and Safety of Antifibrotic Treatment in Pulmonary Fibrosis Associated with Rheumatoid Arthritis

Introduction and Objective. Rheumatoid arthritis (RA) stands as a chronic, systemic autoimmune inflammatory ailment. Lung involvement is one of the most common extra-articular manifestations of RA. Rheumatoid Arthritis-Associated Interstitial Lung Disease (RA-ILD) is a severe, progressive disease leading to pulmonary fibrosis, characterized by deterioration of lung function, exacerbation of symptoms and typical radiological features, and early mortality. Review methods and materials This review utilized PubMed, Mendeley by using search terms such as pulmonary fibrosis in rheumatoid arthritis nintedanib treatment, and pulmonary fibrosis in rheumatoid arthritis pirfenidone treatment. All searches were verified by humans, duplicated results and unreliable have been rejected. In addition, case reports and previously established literature reviews were excluded from the review. We used all available original studies evaluating and comparing the efficacy and safety of anti-fibrotic drugs to create this review. Brief description of the state of knowledge In this review, we discuss therapeutic strategies for antifibrotic treatment involving nintedanib and pirfenidone. Furthermore, we compare the efficacy of both drugs, their influence on the extension of life, their safety profiles, and associated side effects based on research findings, and discuss the molecular mechanisms of their action.  Summary Clinical trials concerning RA-ILD showed that nintedanib and pirfenidone slow the rate of FVC decline in patients with RA-ILD. The safety profile observed in both drugs was similar simultaneously occurring mainly gastrointestinal symptoms. Both drugs have been approved for the RA-ILD treatment program, nevertheless in the current body of knowledge, it is not feasible to definitively determine which drug therapy should be initiated first, as their characteristics are notably similar