Оптимизация диагностики и лечения посттравматического онихолизиса

Onycholysis is a peculiar and prevalent nail affection conditioned by the detachment of the distal part of the nail from the nail bed. The absence of any reliable diagnostics criteria often results in diagnostics errors, inadequate treatment and reduced patient’s life quality. Goal of the research. To find out whether it is possible to use OCT for diagnosing onycholysis and Merz Spezial Dragees for the treatment of posttraumatic onycholysis, and to reasonably confirm the drug efficacy using OCT. Materials and methods. The study involved 15 volunteers with posttraumatic onycholysis aged 20-35 (mean age: 28) including 12 female and 3 male subjects. One nail was affected in 7 cases, and two nails were affected in 8 cases. The area of the onycholysis zone was less than one third of the nail area (mean NAPSI value: 2.9 points). For the purposes of clinical control over the efficacy of Merz Spezial Dragees and nail monitoring, the OCT method was applied. Tests were performed 5 and 7 weeks after the observation and treatment onset. Results. Merz Spezial Dragees contribute to faster regression of clinical manifestations of posttraumatic onycholysis and recovery of the normal state of the nail.Онихолизис - своеобразное и часто встречающееся поражение ногтевого аппарата, обусловленное отслоением дистальной части ногтевой пластины от ногтевого ложа. Отсутствие надежных диагностических критериев на практике нередко приводит к диагностическим ошибкам, неадекватной терапии, снижению качества жизни пациента. Цель работы. Изучить возможность использования оптической когерентной томографии (ОКТ) для диагностики онихолизиса, применения Специального Драже Мерц для лечения посттравматического онихолизиса и получить объективное подтверждение эффективности препарата с использованием ОКТ. Материал и методы. В исследовании приняли участие 15 добровольцев (12 женщин и 3 мужчины) в возрасте от 20 до 35 лет (средний возраст 28 лет) с посттравматическим онихолизисом. В 7 случаях была повреждена одна ногтевая пластина, в 8 случаях - две. Площадь зоны онихолизиса составляла не более 1/3 от площади ногтевой пластины (среднее значение индекса NAPSI - 2,9 балла). Осуществляли клинический контроль эффективности Специального Драже Мерц и мониторинг состояния ногтевого аппарата методом ОКТ. Исследование повторяли через 5 и 7 нед. от начала наблюдения и начала терапии. Результаты. Применение Специального Драже Мерц способствует более быстрому регрессу клинических проявлений посттравматического онихолизиса и восстановлению нормальной структуры ногтевого аппарата

Evaluation of the effectiveness of underwater running machine in complex rehabilitation of patients with lumbar dorsalgia to improve local microcirculation

The authors describe the method of application of underwater running machine in the treatment of patients with lumbar dorsalgia. Aim: To evaluate the effectiveness of the inclusion of underwater running machine comprehensive rehabilitation program in patients with lumbar dorsalgia to improve the local microcirculation. Material and Methods: The study included 20 patients with lumbar dorsalgia. Results: Application of course of study on an underwater running machine provides patients with lumbosacral dorsopathy pronounced effect on a vascular component. Conclusion: The study demonstrated that the use of an underwater treadmill in the complex treatment of patients with lumbosacral dorsopathy is highly effective and pathogenetically substantiated method factor in the local microcirculation and normalizes physiological static position of the spine

Влияние локальной кортикостероидной терапии и такролимуса на морфофункциональные показатели кожи различных фототипов

Objective. To assess the effect of local corticosteroid therapy and Tacrolimus on the morphological and functional skin indices of different phototypes. Materials and methods. The authors conducted a complex assessment of the morphological and functional skin condition of different phototypes among healthy volunteers under the impact of corticosteroids and Tacrolimus. The study involved 20 healthy volunteers (10 people of the 1st and 2nd skin phototypes and 10 people of the 5th and 6th skin phototypes; 14 males and 6 females; mean age: 2з years). The morphological condition of the skin was assessed with the use of optical coherent tomography (Applied Physics Institute, Russian Academy of Sciences, Nizhny Novgorod) while the functional condition was assessed with the use of Multi Skin Test Center MC 750 (Courage+Khazaka Cologne, Germany). Results. The authors revealed that the application of local corticosteroids is accompanied with a reliable reduction in the epidermis thickness developing earlier in the subjects belonging to the 5th and 6th phototypes and, at the same time, increased transepidermal water loss and reduced corneous layer humidity. An increase in the corneous layer thickness accompanied by an increase in the humidity factor was registered in all phototypes in the areas where Tacrolimus was applied. It is possible to select the correct tactics of the anti-inflammatory therapy on the basis of monitoring the morphological and functional skin condition in the process of applying local corticosteroids: to determine the optimum duration of the corticosteroid therapy and switch to calcineurin inhibitors on a timely basis when there is a need to perform an antiinflammatory therapy to achieve the maximum efficacy with the minimum risk of complication development.Цель. Оценить влияние локальной кортикостероидной терапии и такролимуса на морфофункциональные показатели кожи различных фототипов. Материал и методы. Проведена комплексная оценка морфофункционального состояния кожи здоровых добровольцев различных фототипов под влиянием кортикостероидных средств и такролимуса. В исследовании приняли участие 20 здоровых добровольцев (10 человек I, II фототипов кожи и 10 человек V, VI фототипов; 14 мужчин и 6 женщин, средний возраст 23 года). Морфологическое состояние кожи изучали с помощью оптического когерентного томографа (ИПФ РАН, Нижний Новгород), функциональные — с помощью многофункционального комбайна Multi Skin Test Center MC 750 (“Courage + Khazaka Cologne”, Германия). Результаты. Установлено, что нанесение локальных кортикостероидов сопровождается достоверным уменьшением толщины эпидермиса, развивающимся в более ранние сроки у представителей V, VI фототипов, и параллельно наблюдающимся увеличением показателя трансэпидермальной потери воды и уменьшением показателя влажности рогового слоя. В зоне нанесения такролимуса зарегистрировано увеличение толщины рогового слоя у представителей всех фототипов, сопровождающееся увеличением показателя влажности. Мониторинг морфофункционального состояния кожи в процессе использования локальных кортикостероидов позволяет правильно выбрать тактику противовоспалительной терапии: определить оптимальную продолжительность кортикостероидной терапии и при необходимости продолжения противовоспалительной терапии осуществить своевременный переход на ингибиторы кальциневрина и таким образом добиться максимальной эффективности с минимальным риском развития осложнений

Body appreciation around the world: Measurement invariance of the Body Appreciation Scale-2 (BAS-2) across 65 nations, 40 languages, gender identities, and age.

The Body Appreciation Scale-2 (BAS-2) is a widely used measure of a core facet of the positive body image construct. However, extant research concerning measurement invariance of the BAS-2 across a large number of nations remains limited. Here, we utilised the Body Image in Nature (BINS) dataset - with data collected between 2020 and 2022 - to assess measurement invariance of the BAS-2 across 65 nations, 40 languages, gender identities, and age groups. Multi-group confirmatory factor analysis indicated that full scalar invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional BAS-2 model has widespread applicability. There were large differences across nations and languages in latent body appreciation, while differences across gender identities and age groups were negligible-to-small. Additionally, greater body appreciation was significantly associated with higher life satisfaction, being single (versus being married or in a committed relationship), and greater rurality (versus urbanicity). Across a subset of nations where nation-level data were available, greater body appreciation was also significantly associated with greater cultural distance from the United States and greater relative income inequality. These findings suggest that the BAS-2 likely captures a near-universal conceptualisation of the body appreciation construct, which should facilitate further cross-cultural research. [Abstract copyright: Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362