Objective
This study aimed to examine the relationship between cognitive factors (cognitive fusion and catastrophizing) and functional limitation experienced by fibromyalgia patients across different levels of pain severity (i.e. moderation).
Methods
The sample comprised 226 women with fibromyalgia. Their mean age was 56.91 years (SD = 8.94; range = 30 to 78 years).
Results
Pain severity, cognitive fusion, and all components of catastrophizing (i.e., rumination, magnification, and helplessness) contributed to greater fibromyalgia impact on functioning in the multivariate analyses (all p <.001). A moderation effect was also found in the relationship between cognitive fusion and fibromyalgia impact on functioning (B = -0.12, t = -2.42, p = .016, [-0.22, -0.02]) and between magnification and fibromyalgia impact (B = -0.37, t = -2.21, p = .028, [-0.70, -0.04]). This moderation was not observed for rumination and helplessness.
Conclusions
The results suggest that some maladaptive forms of thought management (i.e., cognitive fusion and magnification) should be preferably challenged at milder levels of pain severity when attempting to improve functioning in people with fibromyalgia. According to our findings, cognitive fusion and magnification might have less room to impact functioning at higher levels of pain severity, therefore, rumination and helplessness, which had comparable associations with functioning irrespective of pain levels, would be preferable targets in psychological interventions with fibromyalgia patients experiencing more severe pain levels.
Onychomycosis is a common chronic fungal infection of the nail that causes discoloration and/or thickening of the nail plate. Oral agents are generally preferred, except in the case of mild toenail infection limited to the distal nail plate. Terbinafine and itraconazole are the only approved oral therapies, and fluconazole is commonly utilized off-label. Cure rates with these therapies are limited, and resistance to terbinafine is starting to develop worldwide. In this review, we aim to review current oral treatment options for onychomycosis, as well as novel oral drugs that may have promising results in the treatment of onychomycosis.
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