Diseases Of Subcutaneous Tissue Research Articles

Therapeutic possibilities of topical corticosteroids in modern clinical practice

Over the past decade, dermatological practice has seen an increase in the number of patients suffering from skin and subcutaneous tissue diseases. Annually, 6.4-6.9 million new cases of this group of diseases are registered, which encourages the constant search for new drugs and the continuous improvement of methods and schemes of application of proven drugs. Topical corticosteroids, despite more than 65 years of history of use in the treatment of patients with steroid-sensitive dermatoses, have not lost their relevance. At present, they have no therapeutic alternative in terms of speed of onset and anti-inflammatory activity, so they are essential in the treatment of many skin pathologies. One of the trends in modern pharmacology is not so much the production of new active molecules of TCS or their modifications, as the creation of new pharmacological forms of known molecules - micronized, nanonized, which give the drug the most important property -increased bioavailability. This advanced technology is actively used in the production of domestic topical drugs of Akriderm lines, which make a major contribution to the program of import substitution and drug availability for the population. The optimal combination of ingredients of the foundation of these drugs complements and potentiates the therapeutic effect of steroid. For more than 30 years in clinical practice, a combination of 0.05% betamethasone dipropionate, 0.1% gentamicin sulfate and 1% clotrimazole (Triderm, Akriderm GK) is used. Many years of positive clinical experience of dermatologists using this fixed combination proves the validity of its use in many clinical situations when bacterial and fungal infection is involved. An open randomized comparative study conducted by Russian dermatologists on the efficacy and safety of Akriderm GK (cream) and Triderm (cream) in the complex treatment of eczema showed similar profiles of high clinical efficacy and safety of both drugs.

Systemic autoimmune disease as a cause of death: mortality burden and comorbidities.

ObjectivesSystemic autoimmune diseases (SAIDs) have chronic trajectories and share characteristics of self-directed inflammation, as well as aspects of clinical expression. Nonetheless, burden-of-disease studies rarely investigate them as a distinct category. This study aims to assess the mortality rate of SAIDs as a group and to evaluate co-occurring causes of death.MethodsWe used death certificate data in the Netherlands, 2013–2017 (N = 711 247), and constructed a SAIDs list at the fourth-position ICD-10 level. The mortality rate of SAIDs as underlying cause of death (CoD), non-underlying CoD, and any-mention CoD was calculated. We estimated age-sex-standardized observed/expected (O/E) ratios to assess comorbidities in deaths with SAID relative to the general deceased population.ResultsWe observed 3335 deaths with SAID on their death certificate (0.47% of all deaths). The mortality rate of SAID was 14.6 per million population as underlying CoD, 28.0 as non-underlying CoD, and 39.7 as any-mention CoD. The mortality rate was higher for females and increased exponentially with age. SAID-related deaths were positively associated with all comorbidities except for solid neoplasms and mental conditions. Particularly strong was the association with diseases of the musculoskeletal system (O/E = 3.38; 95% CI: 2.98, 3.82), other diseases of the genitourinary system (O/E = 2.73; 95% CI: 2.18, 3.38), influenza (O/E = 2.71; 95% CI: 1.74, 4.03), blood diseases (O/E = 2.02; 95% CI: 1.70, 2.39), skin and subcutaneous tissue diseases (O/E = 1.95; 95% CI: 1.54, 2.45), and infectious diseases (O/E = 1.85; 95% CI: 1.70, 2.01).ConclusionSystemic autoimmune diseases constitute a rare group of causes of death, but contribute to mortality through multiple comorbidities. Classification systems could be adapted to better encompass these diseases as a category.

Приоритетные факторы риска питьевой воды систем централизованного питьевого водоснабжения, формирующие негативные тенденции в состоянии здоровья населения

Our research object was long-term dynamics of parameters describing drinking water from centralized water supply systems and additional cases of health disorders among population in Russia directly caused by low-quality drinking water. Our research goal was to perform hygienic assessment of priority risk factors related to drinking water and potential health disorders that could be caused by them. Our research technique was hygienic analysis of drinking water parameters as per data taken from the federal statistical form No. 18 entitled «Data on sanitary situation in a RF region» over 2000–2019, the federal information fund of social and hygienic monitoring over 2012–2019, and calculation of associated health disorders as per MG 5.1.0095–14. Specific weight of centralized water supply sources that didn’t conform to sanitary-epidemiologic requirements decreased by 4.7 % over 2000–2019 and amounted to 14.9 %. Over the last 20 years there has been a descending trend in specific weight of water samples taken from centralized water supply sources that don’t conform to sanitary requirements as per sanitary-chemical parameters (by 2.7 %) and microbiological parameters (by 4.8%). Over 2000–2019, specific weight of water distribution networks not conforming to sanitary-epidemiologic requirements decreased by 10.7 % and amounted to 15.9 % in 2019. Over the last 20 years there has been an increase in quality of drinking water taken from centralized distribution networks. Specific weight of water samples from centralized distribution networks not conforming to sanitary requirements as per microbiological and sanitary-chemical parameters fell by 6.7 % and 7.9 % respectively. In 2012–2019 in the RF hygienic parameters of drinking water quality were the most violated as per contents of bromine, silicon, chlorine, iron, sodium, lithium, magnesium, manganese, chloroform, boron, strontium, sulfides, and hydrogen sulphide. Overall, in the RF in 2019 more than 1.66 million cases of digestive diseases, cardiovascular diseases, diseases of skin and subcutaneous tissue, and other health disorders were directly related to drinking water being contaminated with chemicals and microbiological agents; it was by 13.3 % lower than in 2012 regarding morbidity associated with drinking water quality. Priority risk factors were chlorine, chlorine organic compounds (COC), ammonia, iron, manganese, arsenic, nickel, copper, boron, magnesium, and other compounds.

Priority risk factors related to drinking water from centralized water supply system that create negative trends in population health

Our research object was long-term dynamics of parameters describing drinking water from centralized water supply systems and additional cases of health disorders among population in Russia directly caused by low-quality drinking water. Our research goal was to perform hygienic assessment of priority risk factors related to drinking water and potential health disorders that could be caused by them. Our research technique was hygienic analysis of drinking water parameters as per data taken from the federal statistical form No. 18 entitled «Data on sanitary situation in a RF region» over 2000–2019, the federal information fund of social and hygienic monitoring over 2012–2019, and calculation of associated health disorders as per MG 5.1.0095–14. Specific weight of centralized water supply sources that didn’t conform to sanitary-epidemiologic requirements decreased by 4.7 % over 2000–2019 and amounted to 14.9 %. Over the last 20 years there has been a descending trend in specific weight of water samples taken from centralized water supply sources that don’t conform to sanitary requirements as per sanitary-chemical parameters (by 2.7 %) and microbiological parameters (by 4.8%). Over 2000–2019, specific weight of water distribution networks not conforming to sanitary-epidemiologic requirements decreased by 10.7 % and amounted to 15.9 % in 2019. Over the last 20 years there has been an increase in quality of drinking water taken from centralized distribution networks. Specific weight of water samples from centralized distribution networks not conforming to sanitary requirements as per microbiological and sanitary-chemical parameters fell by 6.7 % and 7.9 % respectively. In 2012–2019 in the RF hygienic parameters of drinking water quality were the most violated as per contents of bromine, silicon, chlorine, iron, sodium, lithium, magnesium, manganese, chloroform, boron, strontium, sulfides, and hydrogen sulphide. Overall, in the RF in 2019 more than 1.66 million cases of digestive diseases, cardiovascular diseases, diseases of skin and subcutaneous tissue, and other health disorders were directly related to drinking water being contaminated with chemicals and microbiological agents; it was by 13.3 % lower than in 2012 regarding morbidity associated with drinking water quality. Priority risk factors were chlorine, chlorine organic compounds (COC), ammonia, iron, manganese, arsenic, nickel, copper, boron, magnesium, and other compounds.

Comparison between Conventional Decalcification and a Microwave-Assisted Method in Bone Tissue Affected with Mycetoma.

Mycetoma is a lifelong granulomatous disease of subcutaneous tissues and bones. Histopathology is a substantiated indicative method based on the assumption of a definitive diagnosis of mycetoma. It requires efficient processing of tissues including bone decalcification. The decalcification process must ensure complete removal of calcium and also a proper preservation of tissue and microorganisms' staining ability. Objectives. To compare the conventional method used in decalcification with the microwave method using different decalcification solutions. Different characteristics were tested, including the speed of decalcification and morphological and fungal preservation in bone tissue affected with mycetoma. Materials and Methods. Three decalcification solutions were employed to remove calcium from 50 bone tissue samples affected with mycetoma, including 10% neutral buffered EDTA (pH 7.4), 5% nitric acid, and 5% hydrochloric acid. Conventional and microwave methods were used. Haematoxylin-eosin (HE) stain, Gridley's stain, and Grocott hexamine-silver stain were employed to evaluate the bone and fungi morphologies. Results. The decalcification time of the conventional method compared with the microwave method with 10% EDTA (pH 7.4) took 120 hours and 29 hours, while 5% hydrochloric acid and 5% nitric acid took 8 hours and 3 hours, separately. Also, 10% EDTA is the best decalcifying agent for HE staining and fungal stains. 5% hydrochloric acid and 5% nitric acid can be used for fungal staining. Conclusion. The current study investigated the effects of different decalcifying agents as well as two decalcification procedures on the preservation of the bone structure and fungal staining, which will help to develop suitable protocols for the analyses of the bone tissue affected with mycetoma infection.

Diseases of the skin and subcutaneous tissue in railway transport workers: hygienic aspects

Introduction. Extending professional longevity, preventing diseases and improving the quality of life of railway transport workers are the priority areas of activity of RZhD-Meditcina medical institutions. However, the infl uence of production factors on the prevalence and course of skin and subcutaneous tissue diseases in employees of this important branch of the national economy has not yet been suffi ciently studied. The aim of the study is to study the hygienic features of working conditions in railway transport workers that aff ect the course of skin and subcutaneous tissue diseases.Materials and methods. Materials for hygienic and statistical research were sanitary and hygienic characteristics of working conditions of railway transport workers and statistical reports of the private healthcare institution «Clinical hospital» RZhD-Meditcina « of Barnaul for 2014-2018. A retrospective analysis of the incidence of temporary disability, the number of days of disability, and the number of exacerbations in employees of harmful professions in the Altai region of the West Siberian railway with chronic skin and subcutaneous tissue diseases was conducted.Results. According to the sanitary and hygienic characteristics of working conditions, the most unfavorable working conditions of all railway specialties are employees of locomotive crews and track fi tt ers. Combined eff ects of chemical, meteorological, and physical factors of the production environment and the severity of the labor process belong to class 3 (with a high risk of occupational diseases). Th is leads to a signifi cantly higher (p=0.010944) number of days of disability (27.8±0.83) and the number of exacerbations of chronic skin diseases in railway transport workers than in the rest of the adult population not in contact with occupational hazards (25.32±1.2).Conclusions. Th e combined impact of factors of the production environment and the severity of the labor process, despite the systematic comprehensive prevention, leads to a more severe course of chronic dermatoses in railway transport workers.

Iron Metabolism in the Human Body and Setting its Hygienic Limits for Drinking Water. Review. Part 2

Iron is an assential element for the growth, division, differentiation and functioning of any cell in the body. Iron is virtually important for human and danger at the same time, because with excessive accumulation it causes oxidative stress with formation of highly active oxygen radicals and reactive form of nitrogen that can destroy cell membranes, proteins, nucleic acids, reduce cell viability, with, according to modern concepts, can contribute to the development of many diseases (cardiovascular, rheumatic, gastrointestinal, neurodegenerative, oncological, metabolic and others), and also accelerate the aging process. Part 1 of this review discussed the issues of iron metabolism in human, including its regulation at the cellular and systemic levels, the intake, transport, use, accumulation and export of iron in cells, the role of the labile iron pool in the cytoplasm of cells and plasma non-transferrin bound iron. Data are provided on the causes, frequency and significance of iron overload in the formation of free radicals and the development of oxidative stress. Part 2 of the review provides information on diseases associated with iron overload as well as information on ferroptosis - a new type of iron-dependent regulated cell death. Attention is paid to the works of domestic authors, where it was found that prolonged use of drinking water with a high iron content is unfavorable for the population and leads to an increase in the overall incidence, the development of the diseases of the blood, skin and subcutaneous tissue, musculoskeletal system, digestive system, urogenital system, and allergic diseases. Separate publications are cited on the possibility of a negative effect of iron at concentrations in water of 0.3 mg/l and lower. The material of the review emphasizes the preventive significance of caution attitude to regulating iron in the water in the Russian Federation, where 1/3 of the population uses iron-containing water for drinking, and substantiate the feasibility of establishing a hygienic limit for iron in water not higher than 0.3 mg/l.

Iron Metabolism in the Human Body and Setting its Hygienic Limits for Drinking Water. Review. Part 2

Iron is an assential element for the growth, division, differentiation and functioning of any cell in the body. Iron is virtually important for human and danger at the same time, because with excessive accumulation it causes oxidative stress with formation of highly active oxygen radicals and reactive form of nitrogen that can destroy cell membranes, proteins, nucleic acids, reduce cell viability, with, according to modern concepts, can contribute to the development of many diseases (cardiovascular, rheumatic, gastrointestinal, neurodegenerative, oncological, metabolic and others), and also accelerate the aging process. Part 1 of this review discussed the issues of iron metabolism in human, including its regulation at the cellular and systemic levels, the intake, transport, use, accumulation and export of iron in cells, the role of the labile iron pool in the cytoplasm of cells and plasma non-transferrin bound iron. Data are provided on the causes, frequency and significance of iron overload in the formation of free radicals and the development of oxidative stress. Part 2 of the review provides information on diseases associated with iron overload as well as information on ferroptosis - a new type of iron-dependent regulated cell death. Attention is paid to the works of domestic authors, where it was found that prolonged use of drinking water with a high iron content is unfavorable for the population and leads to an increase in the overall incidence, the development of the diseases of the blood, skin and subcutaneous tissue, musculoskeletal system, digestive system, urogenital system, and allergic diseases. Separate publications are cited on the possibility of a negative effect of iron at concentrations in water of 0.3 mg/l and lower. The material of the review emphasizes the preventive significance of caution attitude to regulating iron in the water in the Russian Federation, where 1/3 of the population uses iron-containing water for drinking, and substantiate the feasibility of establishing a hygienic limit for iron in water not higher than 0.3 mg/l.

The Burden of Skin and Subcutaneous Diseases in the United States From 1990 to 2017

Skin and subcutaneous diseases affect the health of millions of individuals in the US. Data are needed that highlight the geographic trends and variations of skin disease burden across the country to guide health care decision-making. To characterize trends and variations in the burden of skin and subcutaneous tissue diseases across the US from 1990 to 2017. For this cohort study, data were obtained from the Global Burden of Disease (GBD), a study with an online database that incorporates current and previous epidemiological studies of disease burden, and from GBD 2017, which includes more than 90 000 data sources such as systematic reviews, surveys, population-based disease registries, hospital inpatient and outpatient data, cohort studies, and autopsy data. The GBD separated skin conditions into 15 subcategories according to incidence, prevalence, adequacy of data, and standardized disease definitions. GBD 2017 also estimated the burden from melanoma of the skin and keratinocyte carcinoma. Data analysis for the present study was conducted from September 9, 2019, to March 31, 2020. Primary study outcomes included age-standardized disability-adjusted life-years (DALYs), incidence, and prevalence. The data were stratified by US states with the highest and lowest age-standardized DALY rate per 100 000 people, incidence, and prevalence of each skin condition. The percentage change in DALY rates in each state was calculated from 1990 to 2017. Overall, age-standardized DALY rates for skin and subcutaneous diseases increased from 1990 (821.6; 95% uncertainty interval [UI], 570.3-1124.9) to 2017 (884.2; 95% UI, 614.0-1207.9) in all 50 states and the District of Columbia. The degree of increase varied according to geographic location, with the largest percentage change of 0.12% (95% UI, 0.09%-0.15%) in New York and the smallest percentage change of 0.04% (95% UI, 0.02%-0.07%) in Colorado, 0.04% (95% UI, 0.01%-0.06%) in Nevada, 0.04% (95% UI, 0.02%-0.07%) in New Mexico, and 0.04% (95% UI, 0.02%-0.07%) in Utah. The age-standardized DALY rate, incidence, and prevalence of specific skin conditions differed among the states. New York had the highest age-standardized DALY rate for skin and subcutaneous disease in 2017 (1097.0 [95% UI, 764.9-1496.1]), whereas Wyoming had the lowest age-standardized DALY rate (672.9 [95% UI, 465.6-922.3]). In all 50 states and the District of Columbia, women had higher age-standardized DALY rates for overall skin and subcutaneous diseases than men (women: 971.20 [95% UI, 676.76-1334.59] vs men: 799.23 [95% UI, 559.62-1091.50]). However, men had higher DALY rates than women for malignant melanoma (men: 80.82 [95% UI, 51.68-123.18] vs women: 42.74 [95% UI, 34.05-70.66]) and keratinocyte carcinomas (men: 37.56 [95% UI, 29.35-49.52] vs women: 14.42 [95% UI, 10.01-20.66]). Data from the GBD suggest that the burden of skin and subcutaneous disease was large and that DALY rate trends varied across the US; the age-standardized DALY rate for keratinocyte carcinoma appeared greater in men. These findings can be used by states to target interventions and meet the needs of their population.

Iron Metabolism in the Human Body and its Hygienic Limits for Drinking Water. Review. Part 1

Iron is an essential element indispensable for the growth, division, differentiation and functioning of any living cell in the body. for humans iron is vitally important and dangerous at the same time, because with excessive accumulation it causes oxidative stress with the formation of highly active oxygen radicals and reactive forms of nitrogen that can destroy cell membranes, proteins, nucleic acids, reduce cell viability, which, according to modern concepts, can contribute to the development of many diseases (cardiovascular, rheumatic, gastrointestinal, neurodegenerative, oncological, metabolic and others), and also accelerate the aging process. This review discusses the issues of iron metabolism in humans, including its regulation at the cellular and systemic levels, the intake, transport, use, accumulation and export of iron in cells, the role of the labile iron pool in the cytoplasm of cells and plasma non-transferrin bound iron. There are provided data on the causes, prevalence iron overload in the formation of free radicals, the development of oxidative stress and related common diseases, as well as information on ferroptosis, a new type of iron-dependent regulated cell death. Attention is paid to the works of domestic authors, where it was found that prolonged use of drinking water with a high iron content is unfavorable for the population and leads to an increase in the overall incidence, the development of diseases of the blood, skin and subcutaneous tissue, musculoskeletal system, digestive system, urogenital system, and allergic diseases. There are cited separate publications on the possibility of a negative effect of iron at concentrations in water at a level of 0.3 mg/l and lower. The materials of the review emphasize the preventive value of a cautious attitude to regulating iron in the water of the Russian Federation, where 1/3 of the population uses iron-containing water for drinking, and substantiate the feasibility of establishing a hygienic standard for iron in water not higher than 0.3 mg/l, without inclusion in regulatory documents level of 1 mg/l as permissible.

Iron Metabolism in the Human Body and its Hygienic Limits for Drinking Water. Review. Part 1

Iron is an essential element indispensable for the growth, division, differentiation and functioning of any living cell in the body. for humans iron is vitally important and dangerous at the same time, because with excessive accumulation it causes oxidative stress with the formation of highly active oxygen radicals and reactive forms of nitrogen that can destroy cell membranes, proteins, nucleic acids, reduce cell viability, which, according to modern concepts, can contribute to the development of many diseases (cardiovascular, rheumatic, gastrointestinal, neurodegenerative, oncological, metabolic and others), and also accelerate the aging process. This review discusses the issues of iron metabolism in humans, including its regulation at the cellular and systemic levels, the intake, transport, use, accumulation and export of iron in cells, the role of the labile iron pool in the cytoplasm of cells and plasma non-transferrin bound iron. There are provided data on the causes, prevalence iron overload in the formation of free radicals, the development of oxidative stress and related common diseases, as well as information on ferroptosis, a new type of iron-dependent regulated cell death. Attention is paid to the works of domestic authors, where it was found that prolonged use of drinking water with a high iron content is unfavorable for the population and leads to an increase in the overall incidence, the development of diseases of the blood, skin and subcutaneous tissue, musculoskeletal system, digestive system, urogenital system, and allergic diseases. There are cited separate publications on the possibility of a negative effect of iron at concentrations in water at a level of 0.3 mg/l and lower. The materials of the review emphasize the preventive value of a cautious attitude to regulating iron in the water of the Russian Federation, where 1/3 of the population uses iron-containing water for drinking, and substantiate the feasibility of establishing a hygienic standard for iron in water not higher than 0.3 mg/l, without inclusion in regulatory documents level of 1 mg/l as permissible.

The development of organization and provision of medical preventive care of patients with chronic dermatitis

The diseases of skin and subcutaneous tissue, despite the constantly improving methods of their diagnosis and treatment, continue to widespread in the population of the Russian Federation. Consequently, it is relevant to develop evidence-based measures of improving dermatological medical care for the population. The purpose of study is to develop and substantiate proposals for improving specialized medical care of patients with chronic dermatitis in megalopolis. The questionnaire survey of 412 patients with chronic dermatitis, residing in Moscow, and 197 dermatovenerologists from Moscow state medical institutions was carried out. The measures of improving dermatological medical care were proposed. The study identified lacking of adequate provision of therapeutic and preventive medical care of patients with chronic dermatitis and their relatively low medical activity. The article substantiates proposals for improving of organization and provision of dermatological medical care, provided by medical and organizational activities for patients and doctors. To select the optimal strategy for patients with chronic dermatitis, the appropriate algorithm was developed that included four consecutive stages: initial examination of patient; patient records filling in with data of additional laboratory diagnosis; prescription of drug and non-drug therapy; conducting of preventive courses of drug therapy and prescription of SPA-treatment. The results of study inputted into identification of risks associated with provision of specialized medical care in area of Dermatovenerology and medical activity of patients including subsequent development of proposals for their elimination.

Health Status of Primary School Children Studying in Dynamic Postures

Background: The innovative form of organizing schooling in the mode of dynamic postures providing for alternation of standing and sitting postures at each lesson is implemented in order to prevent detrimental health effects of the long-term stationary sitting posture, reduce static and educational fatigue, preserve and strengthen health in educational institutions. Our objective was to assess the health status of primary school children studying in dynamic postures. Materials and methods: We assessed the health status of 174 pupils aged 7–10 in the first to third grades of primary school studying in the mode of dynamic postures. The health data was obtained from their personal medical records. The assessment was carried out in accordance with the comprehensive methodology for assessing health of children and adolescents based on the 10th revision of the International Statistical Classification of Diseases and Related Health Problems. Physical development was measured using regression scales. Results: We established that visual impairment (137.9‰) and musculoskeletal disorders (109.2‰) ranked highest in the structure of functional disorders (FD) among the first to third graders. The prevalence of functional disorders of the circulatory and respiratory system was 86.2‰ and 80.5‰, respectively. Musculoskeletal conditions dominated in the structure of chronic diseases (63.0%), the prevalence being 293.1‰. These were followed by diseases of the skin and subcutaneous tissue and gastrointestinal diseases with the prevalence rate of 46.0‰ each. The total prevalence of functional abnormalities among the primary school first to third graders was 500.0‰ while the prevalence rate of chronic diseases was 465.5‰. Normal physical development was observed in 82.9% of the subjects. Overweight and obesity were detected in 11% and 0.6% of the children, respectively, while underweight, small and big height were measured in 3.1%, 1.8%, and 0.6% of the children, respectively. Conclusions: The comparative data analysis helped establish lower disease prevalence rates among the children studying in dynamic postures compared to those studying in the seated position. Our findings may serve as a scientific substantiation of efficiency of using the dynamic posture regime in order to maintain and improve health of schoolchildren.

Prevalence of skin and subcutaneous tissue diseases in manual and semi-automatic welding workers

During the medical examination of welders of shipbuilding enterprises, a wide prevalence of professional and professionally caused diseases of the skin and subcutaneous tissue was revealed, including combined forms of pathology in the form of epidermis of the skin with pyodermitis - in 16.8%, burn dermatitis and pyodermitis in 12.6% of workers.

Data mining on varieties, therapeutic uses and medicinal characteristics of Traditional Chinese Medicine preparations for treating hair loss

Purpose: To review the varieties, therapeutic uses, and medicinal characteristics of traditional Chinese medicine (TCM) preparations for treating hair loss, and to provide a reference for research and development of new drugs.Methods: For this review, literature from the last 50 years pertaining to the treatment of hair loss via TCM were collected mainly from China National Knowledge Infrastructure database and Wanfang Data Resource System database. Information on Chinese traditional patent medicines and ethnomedicines for treating hair loss was drawn from books.Results: A total of 322 preparations were identified, including 135 preparations made by medical institutions, 108 Chinese traditional patent medicines, 60 preparations produced by doctors themselves, and 19 ethnomedicines. The forms of dosage included decoctions, pills, capsules, tablets, granules, tinctures, liniments, and powders. These preparations are traditionally used in the treatment of skin and subcutaneous tissue diseases. A total of 400 medicinal materials were used in preparations, including 339 from plants, 40 from animals, 14 from minerals. The most commonly used Chinese medicinal materials in order of frequency were Rehmannia glutinosa (Gaertn.) DC., Fallopia multiflora (Thunb.) Haraldson, Angelica sinensis (Oliv.) Diels, Ligustrum lucidum W.T. Aiton and Ligusticum chuanxiong Hort.Conclusion: TCM preparations for treating hair loss are abundant in variety. They are mainly decoctions, and primarily botanical medicinal materials. Most of the preparations are composed of Chinese medicinal materials for ‘toning the kidneys’ and ‘nourishing the liver’. They are used mainly in the treatment of seborrheic alopecia and alopecia areata

ACTUAL PROBLEMS OF DERMATOVENEROLOGICAL SERVICE DEVELOPMENT: OPINION OF SERVICE PROVIDERS

The aim: To determine the features and trends of dermatovenerological health of population; to identify conditions and problems of providing dermatovenerological care. Materials and methods: Bibliographic, epidemiological, medico-statistical, sociological methods were used. Scientific literature, data from the Center of Medical Statistics of the Ministry of Health of Ukraine concerning population health and dermatovenerological establishments activity on 2000-2019, data of authors` own sociological researches on opinion of dermatovenerological profile experts about available problems and ways of their decision were analyzed. Results: A long-term tendency towards a decrease in the incidence of skin and subcutaneous tissue diseases by 8,6% during 2000-2017 and the incidence of venereal diseases during 2000-2019 was revealed (for syphilis - by 15,5 times, gonorrhea - by 6,8 times). At the same time, during 2014-2019 there was an increase in the incidence of atopic dermatitis by 3,6%, of contact dermatitis - by 5,2%, of trichophytia and microsporia by 22,6%, as well as increase in the prevalence of psoriasis - by 6,0%. The incidence of sexually transmitted diseases remains significant. Trends in recent years indicate a deterioration in dermatological health and an increasing need for medical services. During healthcare reforming over the course of nineteen years there was a reduction in the amount of dermatovenerologists and their number per population by 31,5%, the amount of dermatological institutions - by 2,6 times and beds - by 3,9 times. According to 18,6±3,1 per 100 surveyed respondents, the availability of dermatovenerological care to the population is low, and its deterioration in the COVID-19 pandemic was confirmed by 80,1±4,0. Some factors that negatively affect the quality of medical services have been identified: insufficient amount and quality of medical equipment (57,1±4,0 per 100 respondents), insufficient opportunity for continuous professional development (34,0±3,8); lack of computers (30,8±3,7); lack of motivation to improve the quality of work (28,8±3,6). The priority measures that need to be taken to improve dermatovenerological medical services have been identified. Conclusions: The study of dermatovenerological profile experts` opinion regarding the current state of the dermatovenerological service, human resources, the availability and quality of the services made it possible to identify a number of organizational and administrative problems as well as to prioritize activities on providing dermatovenerological care to the population in the context of healthcare reform and COVID-19 pandemic.

Incidence of skin and subcutaneous tissue diseases in children at age of 15—17 years in the Udmurt Republic

Incidence of skin and subcutaneous tissue diseases in children at age of 15—17 years in the Udmurt Republic

Demography and the Context of Health in Paliative Care

The aim of our work was to analyse the tendencies of hospitalization in the palliative care wards and trends in the consumption of analgesics prescribed by geriatrics. Analysed was the consumption of 21,302 most common diagnoses in the hospitalized patients at palliative care wards in the period from 1/2016 to 12/2017. The data were based on the request provided by Všeobecnázdravotnápoisťovňa, a.s. (health insurance company). In the trend analysis was used APC (annual percentage change indicator), and for statistic analysis was used IBM SPSS Statistics. Further was analysed the consumption of 12,888 of the most commonly prescribed analgesics by geriatrics in the period from 1/2016 to 12/2017. In 2017 was found the significant decrease in hospitalized patients in palliative care wards with the diagnoses as follows: tumours (APC -22.9 %), mental and behavioural disorders (APC -4.6 %), disorders of nervous system (APC -26.3 %), skin and subcutaneous tissue diseases (APC -35.1 %), respiratory disorders (APC -35.4 %), shoulder and arm fractures (APC -25.6 %), multiple area injuries (APC -54, 5 %) and later consequences of lower limb injuries (APC -58.3 %). The aging of the population brings a great challenge to ensure the adequate financial, human and other material resources to ensure the sufficient economic productivity and promote the status of active aging in the context of human dignity and fundamental principles of humanism that should not disappear from our society. Key words: demography; noncommunicable diseases; palliative care; population ageing; public health.

Successful outcome of kleibsella necrotising fasciitis in an immunocompromised child with conservative measures

Necrotizing soft tissue infections (NSTIs), are rare, very rapidly progressing disease of superficial fascia and subcutaneous cellular tissue. They are considered as secondary infections as they develop from an initial break down of skin integrity due to trauma or surgery. There is significant local tissue destruction causing grave morbidity and long-term sequelae. NSTIs are rare in children and the predisposing factors are skin damage due to trauma, diabetes, malnutrition and immunosuppression. Broad spectrum antibiotics, wide surgical debridement and supportive care are the standard treatment options. Diagnostic delays are common as the initial signs and symptoms mimics cellulitis or abscess. The diagnostic challenges in immunocompromised host are due to the facts that : i) infections are caused by diverse organisms that are usually not considered pathogens in healthy hosts; ii) infections of soft tissue might be a part of a bigger systemic infection; iii) immune deficiency masks the clinical signs. We report a case of successful outcome with nonsurgical management of necrotizing fasciitis in a boy with newly diagnosed Acute lymphoblastic anemia. He developed Klebsiella Necrotizing Fasciitis (NF) in the first week of induction therapy and his wound healed without surgical debridement or reconstructive measures, due to the high index of suspicion, early diagnosis and adequate intervention.

Неоднородность региональной заболеваемости в России – принципы оценки и прогноза

The aim of the study is to develop the assessment technology and forecasting heterogeneity of regional incidence for differentiated healthcare management. Material and methods. The incidence of skin and subcutaneous tissue diseases in children aged 0–14 years in 2009–2017 in Russia was used as a material. The sources of information were the data of state statistics. Generally accepted statistical methods were used for the analysis. Results. The expressed heterogeneity of regions of the Russian Federation on children’s dermatological morbidity with a coefficient of variation of 28% is revealed. The marked size of heterogeneity steadily persisted in the 8-year follow-up. The stable predisposition of subjects to a certain rank place is proved. The territories were ranked according to the total 9-year rank. The classification of territories into types of low, medium and high risk of morbidity is carried out. Long-term stability of regional trajectories allows extrapolating them for prediction. Conclusion. The complex of statistical calculations forming the standard “forecast of regional heterogeneity technology assessment” is carried out. Used methods is universal and it could be used in assessment of any sign heterogeneity: morbidity, mortality, fertility, crime, unemployment, etc.