Features of the ultrasound image of the nail plate and surrounding tissues in patients with onychomycosis of the feet

2020 ◽  
Vol 18 (4) ◽  
pp. 169-176
Author(s):  
M.M. Tlish ◽  
◽  
M.E. Shavilova ◽  
A.A. Matishev ◽  
◽  
...  
Keyword(s):  
Ultrasonic Transducer ◽  
Nail Plate ◽  
Ultrasound Image ◽  
Pathological Process ◽  
Acoustic Properties ◽  
Control Group ◽  
Nail Bed ◽  
The Matrix ◽  
Clinical Variants ◽  
Scanning Frequency

Objective. To study echographic and hemodynamic features of the nail plate and surrounding tissues in patients with different clinical variants of onychomycosis of the feet using an ultrasonic transducer with a scanning frequency of 15–22 MHz and on this basis to define the most significant ultrasound signs of this pathology. Patients and methods. 52 patients with onychomycosis of the feet (the main group) and 20 volunteers (the control group) without a fungal nail infection were examined. Ultrasonic scanning was performed using a transducer with a frequency of 15–22 MHz. The sonographic structure and sizes of nail components were registered. Features of blood supply were studied in the area of the nail bed and root using duplex scanning. Results. In patients with onychomycosis in the nail plate, the change in lateral dimensions of its layers was revealed. Structural imperfection and uneven increase in the thickness of intermediate layer of the nail plate, misalignment of ventral and dorsal layers were detected. Discontinuity and blurring of the structure of the ventral layer were observed in this context. In patients with subungual onychomycosis, a thickening of the nail bed and change in its acoustic properties were revealed. When the nail root was involved in the pathological process, an increase in echogenicity and blurring of boundaries in the matrix area were recorded. Decreased value of hemodynamic indices and smoothing of the dopplerographic curve, in comparison with the control group, were observed. Conclusion. Detected ultrasound signs broaden the understanding of changes in the nail echostructure and hemodynamics indices under the influence of a fungal infection, and can be useful in comprehensive diagnostics of onychomycosis of the feet. Key words: sonographic and hemodynamic signs of onychomycosis, nail ultrasonography

scholarly journals Ultrasound Assessment of Changes in Nails in Psoriasis and Psoriatic Arthritis

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Magdalena Krajewska-Włodarczyk ◽  
Agnieszka Owczarczyk-Saczonek ◽  
Waldemar Placek ◽  
Maja Wojtkiewicz ◽  
Andrzej Wiktorowicz ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Ultrasound Examination ◽  
Morphological Changes ◽  
Nail Plate ◽  
Control Group ◽  
Dorsal Plate ◽  
Nail Bed ◽  
The Matrix ◽  
Group A ◽  
Ultrasound Assessment

Aim of the Study. The aim of the study was to conduct an ultrasound (US) assessment of changes in fingernails in psoriatic patients with nail involvement. Material. A total of 69 patients with psoriatic changes in nails participated in the study, including 38 patients with psoriasis (Ps) and 31 with psoriatic arthritis (PsA) and 30 people in the control group. A total of 988 nails were examined. Results. The thickness of the nail plate, nail bed, and matrix as shown in an ultrasound examination increased with the mNAPSI index (r=0.328, p=0.021; r=0.219, p=0.036; and r=0.422, p=0.011, respectively). The thickness of nail plate, bed, and matrix in patients with onycholysis and hyperkeratosis-type changes (concomitant or present separately) was significantly greater than when only pitting-type changes occurred (p=0.007, p=0.035, and p=0.023, respectively). An examination of nails with only pitting-type changes showed an increase in the matrix thickness compared to the control group (p=0.018). The focal hyperechoic involvement of the dorsal plate (80%) was the change most often observed in an US examination in Ps patients, whereas loosening of the borders of the ventral plate was most often observed in PsA patients. The thickness of nail bed in PsA patients increased with the duration of arthritis (r=0.399, p=0.022) and was correlated with the number of swollen digits (r=0.278, p=0.041). Conclusions. The findings of this study may indicate an association of an inflammation in the nail bed with PsA development. Apart from a direct assessment of the described morphological changes of nails, a US examination could prove useful in an assessment of intensity of a local inflammation as a prognostic factor for PsA development.

scholarly journals Ultrasound Evaluation of the Effectiveness of the Use of Acitretin in the Treatment of Nail Psoriasis

2021 ◽  
Vol 10 (10) ◽  
pp. 2122
Author(s):  
Magdalena Krajewska-Włodarczyk ◽  
Zbigniew Żuber ◽  
Agnieszka Owczarczyk-Saczonek
Keyword(s):  
Morphological Changes ◽  
Nail Plate ◽  
Clinical Signs ◽  
Extensor Tendon ◽  
Control Group ◽  
Nail Bed ◽  
Nail Psoriasis ◽  
Ultrasound Evaluation ◽  
Tendon Thickness ◽  
Retinoid Treatment

The study aimed to evaluate the effect of retinoid treatment on the morphological changes in the nail apparatus in patients with nail psoriasis. Material and methods: 41 patients aged 32 to 64 with nail psoriasis, without clinical signs of psoriatic arthritis, started on acitretin 0.6 to 0.8 mg kg b.w./d, for six months and 28 people in the control group were included in the study. Both groups had ultrasound examination of fingernails and digital extensor tendon in the distal interphalangeal joints. In psoriatic patients, US examination was conducted before starting the treatment and after six months. A total of 685 nails were examined. Results: After six months of treatment, there was a reduction in the thickness of the nail bed and nail matrix (p = 0.046 and p = 0.031, respectively). The thickness of the nail plates decreased, although it was statistically insignificant (p = 0.059) and it was higher than in the control group (p = 0.034). The reduced severity of clinical nail changes after six months of retinoid treatment did not correlate with the reduction in extensor tendon thickness in any group of patients. Conclusions: In patients with nail psoriasis, acitretin treatment resulted in a rapid decrease in the thickness of the nail bed and matrix, but it did not affect the thickness of the nail plate after six months. There was no effect of acitretin on the digital extensor tendon thickness or the increased blood supply to the tendon area. The results of the study may indicate the usefulness of ultrasound nail examinations in patients with nail psoriasis not only to assess the advancement of morphological changes and response to treatment, but also to choose the potential treatment.

scholarly journals Subungual Glomus Tumor: A Review of 15 Cases Treated with Partial Nail Plate Excision Technique

2021 ◽  
Author(s):  
Mahmoud Farzan ◽  
Mahdi Neshan ◽  
Amir Reza Farhoud ◽  
Abbas Abdoli
Keyword(s):  
Glomus Tumor ◽  
Nail Plate ◽  
Tumor Location ◽  
Tumor Treatment ◽  
Nail Bed ◽  
Nail Deformity ◽  
Surgical Methods ◽  
The Matrix ◽  
The Mean

Background: Although there are various surgical methods for subungual glomus tumor treatment, there is no consensus on the optimal surgical approach. Methods: We analyzed the outcomes of 15 patients treated with partial nail plate excision technique. The medial or lateral section of the nail plate was excised longitudinally based on the tumor location. After incision of the nail bed and tumor removal, the matrix was repaired carefully. Results: In this study, 15 people, including 11 men and four women, were studied. The mean onset of symptoms until diagnosis was 88 months. In the postoperative evaluation, the mean follow-up was 20 months. Two patients had recurrent tumors, and one had postoperative nail deformity. Conclusion: Meticulous nail bed repair and complete tumor excision are key treatment points needed to prevent nail deformity and recurrence.  

scholarly journals AB0440 CLINICAL AND IMMUNOLOGICAL FEATURES OF THE SYSTEMIC SCLEROSIS-OVERLAP SYNDROMES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1248.2-1248
Author(s):  
O. Desinova ◽  
M. Starovoytova ◽  
L. P. Ananyeva ◽  
O. Koneva ◽  
L. Garzanova ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Pathological Process ◽  
Point Of View ◽  
Joint Involvement ◽  
Laboratory Findings ◽  
Overlap Syndromes ◽  
Digital Ischemia ◽  
Immune Alterations ◽  
Clinical Variants

Background:Systemic Sclerosis (SSc) overlap syndromes (SSc with polymyositis / dermatomyositis (PM/DM), rheumatoid arthritis (RA), etc.) still remain a group of very heterogenous and not very well studied clinical variants of SSc that are characterized by certain clinical and immunological features.Objectives:Identify clinical and immunological features of the SSc-overlap syndromesMethods:80 pts with SSc-PM/DM and 35 pts with SSc-RA undergoing standard clinical examination and laboratory immunological evaluation.Results:ANA Hep2 was positive in 98% of SSc-PM/DM pts; a-Scl-70 was in 34%, a - PM-Scl and RF were in 20%. ACA (6%), a-RNP (9%), and a - Jo-1 (5%) were significantly less common. Correlation analysis showed significant prevalence of conduction abnormalities in pts with a-Scl-70- (p<0.03); PM-Scl was rarely associated with cardiac arrhythmia (p<0.02) and pericarditis (p<0.03), but there was an association between ACA and presence of digital ischemia (p<0.04). Three pts with limited skin had Scl-70 and PM-Scl antibodies, two of them manifested clinical features of DM. A-Jo-1 was found in 3 pts with a longstanding disease (14,10 and 7 years), and one of these pts was also positive for a-Scl-70. All pts had limited skin and two had interstitial lung disease with FVC values of 79% and 74.8%.ANA Hep2 was positive in 96% of SSc-RA pts; a-Scl-70 – in 28%, and a-RNP - in 30%. RF-positivity was in 72% of pts, and Anti-CCP - in 27%. Simultaneous Anti-CCP and a-Scl-70 was found in one case, and Anti-CCP - anti-RNP – in another, both were associated with low RF titers. All pts had early joint involvement which became prevailing in subsequent years, and onset of the disease between 30 and 36 years. There was a correlation between laboratory signs of inflammatory activity and immunological disorders: ESR and a-Scl-70 (p<0.03). Anti-CCP and a-Scl-70 co-positivity was a significantly less frequent phenomenon (p<0.04). There was a remarkable 28% proportion of a-Scl-70 cases in SSc-RA with limited cutaneous which is usually characterized by ACA-positivity.Conclusion:SSc-PM/DM and SSc-RA appear to be an active disease from the immunological point of view, confirming therefore an important role of immune alterations in disease progression. Laboratory findings display specific pathogenetic features of SSc-overlap syndromes; laboratory abnormalities can be used to measure the activity and specify characteristics of the pathological process.Disclosure of Interests:None declared

An Analysis of the Matrix (Progressive Matrices) Test Results on 700 Neurotic (Military) Subjects, and a Comparison with the Shipley Vocabulary Test

1943 ◽  
Vol 89 (375) ◽  
pp. 202-215 ◽  
Author(s):  
H. Halstead
Keyword(s):  
Control Group ◽  
Vocabulary Test ◽  
Test Results ◽  
Emergency Hospital ◽  
The Matrix ◽  
Military Patients ◽  
Group 1

Seven hundred Progressive Matrices records of male neurotic military patients admitted to Sutton Emergency Hospital between April and November, 1942, were compared with a control group (1). The distribution of the patients' scores shows a negatively skewed curve with a clustering of scores below the control median (Fig. 1).

scholarly journals Effect of Methotrexate in the Treatment of Distal Interphalangeal Joint Extensor Tendon Enthesopathy in Patients with Nail Psoriasis

2018 ◽  
Vol 7 (12) ◽  
pp. 546 ◽  
Author(s):  
Magdalena Krajewska-Włodarczyk ◽  
Agnieszka Owczarczyk-Saczonek ◽  
Waldemar Placek ◽  
Maja Wojtkiewicz ◽  
Joanna Wojtkiewicz
Keyword(s):  
Nail Plate ◽  
Extensor Tendon ◽  
Interphalangeal Joint ◽  
Response To Treatment ◽  
Distal Interphalangeal Joint ◽  
Nail Psoriasis ◽  
The Matrix ◽  
Tendon Thickness ◽  
Distal Interphalangeal ◽  
Methotrexate Treatment

To assess the effect of methotrexate on the development of distal interphalangeal joint extensor tendon enthesopathy in psoriasis, thirty-two people aged 34 to 57 years with nail psoriasis and distal interphalangeal joint extensor tendon enthesopathy (19 patients with Ps (psoriasis) and 13 with PsA (psoriatic arthritis) were started on methotrexate at 15 to 25 mg/week and the treatment was continued for 6 months). A total of 319 nails were examined. After six months of treatment, the thicknesses of the nail plate, nail bed and nail matrix were found to decrease in both groups of patients. Methotrexate treatment resulted in a decrease in the joint extensor tendon thickness only in patients with Ps (0.94 ± 0.05 vs. 0.96 ± 0.04, p < 0.001), where the tendon thickness after treatment correlated with the matrix thickness (r = 0.337, p = 0.018) and with the bed thickness (r = 0.299, p = 0.039). Methotrexate treatment resulted in a decrease in the extensor tendon thickness only in patients with Ps but not in PsA. The findings of this study may suggest the effectiveness of systemic treatment of nail psoriasis in patients without arthritis and the use of US nail examinations in Ps and PsA patients in morphological change assessment and response to treatment.

scholarly journals Translational studies of electrophoretic mobility and phase picture of erythrocytes with consideration of development of stress response during a pathological process

2018 ◽  
Vol 46 (8) ◽  
pp. 765-771
Author(s):  
A. V. Deryugina ◽  
M. N. Ivashchenko ◽  
P. S. Ignat'ev ◽  
A. G. Samodelkin
Keyword(s):  
Stress Response ◽  
Electrophoretic Mobility ◽  
Pathological Process ◽  
Diagnostic Methods ◽  
Interference Microscopy ◽  
Control Group ◽  
Cell Counts ◽  
Leukocyte Counts ◽  
The Impact

Rationale:Modern cell diagnostic methods are in high demand during the development of new approaches in personalized medicine. Coherent phase interferometry and cell microelectrophoresis are among such methods that are being actively introduced into the diagnostic process in medical institutions.Aim:To substantiate the potential use of biophysical and morphodensitometrical erythrocytes parameters as criteria of treatment efcacy and course of adaptation process in patients with gastrointestinal tract disorders.Materials and methods:The study included 25 patients aged from 40 to 54 years (11 males and 14 females), among them 9 (36%) with gastric peptic ulcer, 3 (12%) with duodenal ulcer, 8 (32%) with acute gastritis, and 5 (20%) with acute pancreatitis. Biophysical and morphological particulars of peripheral blood erythrocytes were assessed before and after treatment using cell diagnostic techniques, such as microelectrophoresis and laser modulation interference microscopy. Also, we evaluated changes over time in routine clinical laboratory tests, such as red and white blood cell counts, hemoglobin levels, and erythrocyte sedimentation rate (ESR), and differential leukocyte counts. The control group included 10 healthy donors aged from 36 to 52 years.In vitroexperiments were performed to assess the erythrocyte electrophoretic mobility (EEPM) and morphology of erythrocytes treated with epinephrine or cortisol.Results:After the treatment, the patients demonstrated a decrease in their leukocyte counts (by 27%), a 2-fold increase in monocyte counts and an ESR decrease (by 10%), compared to the corresponding baseline values before treatment (p < 0.05 for all comparisons). EEPM increased by 12% (1.37 vs. 1.22 mcm × cm/V × s, p < 0.05). The erythrocyte pool of the patients before treatment, had a decreased proportion of discocytes, compared to that in the control group (85.2 vs. 95.4%, р < 0.05), increased proportions of echinocytes, stomatocytes and degenerative forms (11, 2.8 and 1%, respectively, р < 0.05). After the treatment, the discocytes counts increased virtually up to their physiological normal range (91.3%). However, the surface of the discoid cells remained heterogeneous with multiple microspicules; this resulted in changes of electrokinetic and morphological properties of erythrocyte response to stress reaction occurring in the body. The impact of the stress effectors was confrmed inin vitroexperiments assessing the effects of epinephrine (1 × 10-9 g/mL) and cortisol (5 × 10-7 g/mL) on erythrocytes. At 120 minutes of the experiment, epinephrine decreased EEPM (1.14 vs. 1.24 mcm × cm/V × s at baseline, р < 0.05) and increased cell sphericity. On the contrary, cortisol increased EEPM (1.72 vs. 1.36 mcm × cm/V × s, р < 0.05), with non-signifcant echinocytic transformation.Conclusion:Biophysical and morphodensitometric parameters of red blood cells obtained with the use of current express methods of cell microelectrophoresis and coherent interference microscopy help to objectivize the intensity of stress response during a pathological process and activation of adaptation mechanisms during the treatment.

scholarly journals PLASMA CONCENTRATION OF ENDOTHELIN-1 IN PATIENTS WITH HYPERTENSION ASSOCIATED WITH OBESITY, DEPENDING ON THE LYS198ASN POLYMORPHISM OF THE ENDOTHELIN-1 GENE

2021 ◽  
Vol 9 (1) ◽  
pp. 87-94
Author(s):  
Yu.O. Smiianova
Keyword(s):  
Body Weight ◽  
Heart Rhythm ◽  
Pathological Process ◽  
Main Group ◽  
Overweight And Obesity ◽  
Control Group ◽  
Endothelin 1 ◽  
Normal Body ◽  
Heart Rhythm Disorders ◽  
Normal Body Weight

Endothelial dysfunction is considered one of the main mechanisms for the further development of arterial hypertension (AH) and its complications, and endothelin-1 (ЕТ-1) plays one of the key roles in this process. Endothelium is drawn into the pathological process at the earliest stages of AH development. ЕТ-1 is currently considered as a marker and predictor of the stage and consequences of AH, chronic heart failure (CHF), coronary heart disease (CHD), in particularly, acute myocardial infarction (MI), heart rhythm disorders, pulmonary hypertension, atherosclerotic vascular injury, target vascular disorders. One factor that may influence the level of ЕТ-1 is the endothelin-1 gene Lys198Asn polymorphism, which is considered by many researchers as a possible genetic marker of AH. However, the effect of this polymorphism on the level of plasma ЕТ-1 level in patients with AH of varying severity in Ukraine is understudied. The basis of this work were the materials of a complete examination of 160 patients with a verified diagnosis of AH I, stage II of 1, 2, 3 degrees (main group) and 110 apparently healthy persons (control group). Patients of the main group were divided into three subgroups: 1st group ­– 75 patients with normal body weight; 2nd group – 48 overweight patients; 3rd group – 37 patients with alimentary obesity. In obese patients, the waist circumference in women was around 103 (96–115) cm, and in men – 108 (105–116) cm, which indicates an abdominal type of obesity in these patients. As a result of the study, it was found that the level of ЕТ-1 is higher in patients with AH who suffer with overweight and obesity as compared with patients with AH and normal body weight. Also, the peptide level depends on the genotype of patients and is higher in AH patients with the genotype Asn198Asn and Lys198Asn as compared to carriers of the genotype Lys198Lys.

scholarly journals MORPHOLOGY AND MORPHOMETRIC INDICATORS OF THE MUCOUS MEMBRANE OF VARIOUS PARTS OF THE INTESTINE OF PATIENTS WITH POSTCHOLECYSTECTOMY SYNDROME

2020 ◽  
Vol 28 (3) ◽  
pp. 58-64
Author(s):  
Ivan T. Shcherbakov ◽  
Nina I. Leontieva ◽  
Nina M. Grachiova ◽  
Alina I. Soloviova ◽  
Nikolay A. Vinogradov ◽  
...  
Keyword(s):  
Sigmoid Colon ◽  
Mucous Membrane ◽  
Recurrent Abdominal Pain ◽  
Pathological Process ◽  
Morphometric Study ◽  
Control Group ◽  
Epithelial Layer ◽  
Intestinal Villi ◽  
Postcholecystectomy Syndrome ◽  
Number Of Patients

The actuality of the problem is associated with an increase in the number of patients with cholelithiasis of working age and a significant increase in cholecystectomies not only in Russia, but throughout the world. It is known that more than 2,5 million are performed annually. Moreover, 5-40% of operated patients develop postcholecystectomy syndrome, which is manifested by recurrent abdominal pain and cholegenic diarrhea. The aim of the study is to assess morphofunctional changes in the mucous membrane of various parts of the intestine in patients with postcholecystectomy syndrome. Histological, histochemical, morphometric and bacterioscopic, parasitological methods were used to study 42 biopsy specimens of the mucous membrane of various parts of the intestines of patients who underwent cholecystectomy. The control group consisted of 18 biopsies of practically healthy individuals. To objectify the study, a morphometric study of the mucous membrane of the duodenum according to 34 parameters, of the cecum and sigmoid colon according to 22 parameters was carried out. In the mucous membrane of the duodenum, chronic duodenitis of varying degrees of activity of the pathological process and atrophy of the intestinal villi were revealed, the intestinal glands were shortened, the intestinal villi are less wide. The epithelial layer of intestinal villi and intestinal glands was abundantly infiltrated with neutrophilic granulocytes. The density of the inflammatory cellular infiltrate in the stroma of the intestinal villi and intestinal glands increased. On the surface of the epithelial layer of the intestinal villi and between the intestinal glands, campylobacters were often found, less often - cryptosporidia. In the mucous membrane of the cecum and sigmoid colon, chronic colitis of varying degrees of activity of the pathological process and atrophy of the intestinal glands were revealed. The thickness of the mucous membrane and the depth of the intestinal glands were lower than normal. Thus, in patients with postcholecystectomy syndrome, pronounced morphometric and histological changes were revealed in the mucous membrane of various parts of the intestine, while the depth and degree of its damage were more significant in its proximal parts.

scholarly journals GOUT AND NONALCOHOLIC FATTY LIVER DISEASE: EFFECT OF ENTEROSORPTION’S ADDITION TO COMMON TREATMENT

2020 ◽  
Vol 5 (2) ◽  
pp. 40-46
Author(s):  
U. O. Mudra
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Pathological Process ◽  
Control Group ◽  
Nonalcoholic Fatty Liver ◽  
Group 2 ◽  
Disease Effect ◽  
Basic Treatment

Background. Gout is still one of the major health problems despite significant advances in treatment in recent years. It has been proved that pathogenetic mechanisms of development and progression of gout are associated with nonalcoholic fatty liver disease. Complex pathogenic treatment of patients aimed at different parts of the pathological process has recently been supplemented with the enterosorbents. Objective. The aim of the research is to study the clinical features of gout with concomitant nonalcoholic fatty liver disease (NAFLD) and to evaluate the effect of carbon enterosorbent on its course. Methods. 123 patients were involved in the study. They were divided into 2 groups: group 1 included patients with gout without liver damage, and group 2 included patients with concomitant NAFLD. Each of these groups was divided into subgroups, in which the patients received carbon enterosorbent carboline plus basic treatment. The control group consisted of 30 healthy persons. Anamnesis, physical examination, uric acid (UA), C-reactive protein (CRP) content, erythrocyte sedimentation rate (ESR) in serum were determined. Gout activity was evaluated using the Gout Activity Score (GAS). Results. Basic treatment in combination with carbon enterosorbent contributed to faster cure of intoxication, pain and joint syndromes, as well as decrease of the inflammatory process activity. Conclusions. The course of gout in the patients with concomitant NAFLD is more severe. Adding of carbon granular enterosorbent carboline in the complex treatment of patients with gout with or without concomitant NAFLD in the exacerbation phase contributes to a faster cureing dynamics of clinical and laboratory manifestations of the disease.

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