scholarly journals The Review of Most Current Therapy for Large Area of Hypertrophic Scar and Keloid

2015 ◽  
Vol 1 (1) ◽  
pp. 29-33
Author(s):  
Wang Xi-Qiao ◽  
Keyword(s):  
Hypertrophic Scar ◽  
Optimal Choice ◽  
Current Therapy ◽  
Large Area ◽  
Pressure Therapy ◽  
Invasive Therapy ◽  
Non Invasive ◽  
Scar Treatment ◽  
Increased Risk ◽  
Unbearable Pain

For the large area scar or keloid, the treatment is still posing a great challenge. Because the invasive therapy has an unbearable pain and increased risk of side effect, like the steroid injection and cryotherapy, so the non-invasive therapy is actually the optimal choice for large area scar and children patients. Here we introduce the major modalities for the treatment of large area scar, like pressure therapy, Silicone, Onion extract, and scar massage. In addition, three aspects are recommended for the scar therapy: early use, combination use and persistent use, which is essential for a successful scar treatment. Keywords: Hypertrophic scar, Keloid, Scar treatment, Large area scar.

Semi-Quantitative Ultrasonographic Evaluation of NAFLD

2020 ◽  
Vol 26 (32) ◽  
pp. 3915-3927 ◽  
Author(s):  
Stefano Ballestri ◽  
Claudio Tana ◽  
Maria Di Girolamo ◽  
Maria Cristina Fontana ◽  
Mariano Capitelli ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Imaging Techniques ◽  
Metabolic Complications ◽  
Nonalcoholic Fatty Liver ◽  
Non Invasive ◽  
Increased Risk ◽  
Risk Of Progression ◽  
Progressive Liver Disease

: Nonalcoholic fatty liver disease (NAFLD) embraces histopathological entities ranging from the relatively benign simple steatosis to the progressive form nonalcoholic steatohepatitis (NASH), which is associated with fibrosis and an increased risk of progression to cirrhosis and hepatocellular carcinoma. NAFLD is the most common liver disease and is associated with extrahepatic comorbidities including a major cardiovascular disease burden. : The non-invasive diagnosis of NAFLD and the identification of subjects at risk of progressive liver disease and cardio-metabolic complications are key in implementing personalized treatment schedules and follow-up strategies. : In this review, we highlight the potential role of ultrasound semiquantitative scores for detecting and assessing steatosis severity, progression of NAFLD, and cardio-metabolic risk. : Ultrasonographic scores of fatty liver severity act as sensors of cardio-metabolic health and may assist in selecting patients to submit to second-line non-invasive imaging techniques and/or liver biopsy.

scholarly journals Microwave thermometry with potential application in non-invasive monitoring of hyperthermia

2020 ◽  
Vol 28 (5) ◽  
pp. 739-750
Author(s):  
Morteza Ghaderi Aram ◽  
Larisa Beilina ◽  
Hana Dobsicek Trefna
Keyword(s):  
Least Squares Method ◽  
Regularization Parameter ◽  
Region Of Interest ◽  
Optimal Choice ◽  
Adaptive Finite Element Method ◽  
Adaptive Finite Element ◽  
Non Invasive ◽  
Full Wave ◽  
Reconstruction Quality ◽  
Regularization Techniques

AbstractIntegration of an adaptive finite element method (AFEM) with a conventional least squares method has been presented. As a 3D full-wave forward solver, CST Microwave Studio has been used to model and extract both electric field distribution in the region of interest (ROI) and S-parameters of a circular array consisting of 16 monopole antennas. The data has then been fed into a differential inversion scheme to get a qualitative indicator of how the temperature distribution evolves over a course of the cooling process of a heated object. Different regularization techniques within the Tikhonov framework are also discussed, and a balancing principle for optimal choice of the regularization parameter was used to improve the image reconstruction quality of every 2D slice of the final image. Targets are successfully imaged via proposed numerical methods.

scholarly journals Echocardiographic diagnosis of atrial cardiomyopathy allows outcome prediction following pulmonary vein isolation

2021 ◽  
Author(s):  
Martin Eichenlaub ◽  
Bjoern Mueller-Edenborn ◽  
Jan Minners ◽  
Martin Allgeier ◽  
Heiko Lehrmann ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Validation Cohort ◽  
Low Voltage ◽  
Predictive Values ◽  
Contact Mapping ◽  
Non Invasive ◽  
Increased Risk ◽  
Echocardiographic Parameters

Abstract Background Relevant atrial cardiomyopathy (ACM), defined as a left atrial (LA) low-voltage area ≥ 2 cm2 at 0.5 mV threshold on endocardial contact mapping, is associated with new-onset atrial fibrillation (AF), higher arrhythmia recurrence rates after pulmonary vein isolation (PVI), and an increased risk of stroke. The current study aimed to assess two non-invasive echocardiographic parameters, LA emptying fraction (EF) and LA longitudinal strain (LAS, during reservoir (LASr), conduit (LAScd) and contraction phase (LASct)) for the diagnosis of ACM and prediction of arrhythmia outcome after PVI. Methods We prospectively enrolled 60 consecutive, ablation-naive patients (age 66 ± 9 years, 80% males) with persistent AF. In 30 patients (derivation cohort), LA-EF and LAS cut-off values for the presence of relevant ACM (high-density endocardial contact mapping in sinus rhythm prior to PVI at 3000 ± 1249 sites) were established in sinus rhythm and tested in a validation cohort (n = 30). Arrhythmia recurrence within 12 months was documented using 72-h Holter electrocardiograms. Results An LA-EF of < 34% predicted ACM with an area under the curve (AUC) of 0.846 (sensitivity 69.2%, specificity 76.5%) similar to a LASr < 23.5% (AUC 0.878, sensitivity 92.3%, specificity 82.4%). In the validation cohort, these cut-offs established the correct diagnosis of ACM in 76% of patients (positive predictive values 87%/93% and negative predictive values 73%/75%, respectively). Arrhythmia recurrence in the entire cohort was significantly more frequent in patients with LA-EF < 34% and LASr < 23.5% (56% vs. 29% and 55% vs. 26%, both p < 0.05). Conclusion The echocardiographic parameters LA-EF and LAS allow accurate, non-invasive diagnosis of ACM and prediction of arrhythmia recurrence after PVI. Graphic abstract

scholarly journals Non-Invasive Ventilatory Strategies to Decrease Bronchopulmonary Dysplasia—Where Are We in 2021?

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 132
Author(s):  
Vikramaditya Dumpa ◽  
Vineet Bhandari
Keyword(s):  
Lung Injury ◽  
Bronchopulmonary Dysplasia ◽  
Premature Infants ◽  
Extremely Low Birth Weight ◽  
Positive Pressure ◽  
Invasive Ventilation ◽  
Clinical Practices ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Increased Risk

Recent advances in neonatology have led to the increased survival of extremely low-birth weight infants. However, the incidence of bronchopulmonary dysplasia (BPD) has not improved proportionally, partly due to increased survival of extremely premature infants born at the late-canalicular stage of lung development. Due to minimal surfactant production at this stage, these infants are at risk for severe respiratory distress syndrome, needing prolonged ventilation. While the etiology of BPD is multifactorial with antenatal, postnatal, and genetic factors playing a role, ventilator-induced lung injury is a major, potentially modifiable, risk factor implicated in its causation. Infants with BPD are at a higher risk of developing complications including sepsis, pulmonary arterial hypertension, respiratory failure, and death. Long-term problems include increased risk of hospital readmissions, respiratory infections, and asthma-like symptoms during infancy and childhood. Survivors who have BPD are also at increased risk of poor neurodevelopmental outcomes. While the ultimate solution for avoiding BPD lies in the prevention of preterm births, strategies to decrease its incidence are the need of the hour. It is time to focus on gentler modes of ventilation and the use of less invasive surfactant administration techniques to mitigate lung injury, thereby potentially decreasing the burden of BPD. In this article, we discuss the use of non-invasive ventilation in premature infants, with an emphasis on studies showing an effect on BPD with different modes of non-invasive ventilation. Practical considerations in the use of nasal intermittent positive pressure ventilation are also discussed, considering the significant heterogeneity in clinical practices and management strategies in its use.

scholarly journals Non-invasive mid-term ECG monitoring for the detection of atrial fibrillation in an outpatient population

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Cai ◽  
K.K Yeo ◽  
P Wong ◽  
C.K Ching
Keyword(s):  
Atrial Fibrillation ◽  
Public Institution ◽  
First Episode ◽  
Prior History ◽  
Funding Source ◽  
Monitoring Device ◽  
Ecg Monitoring ◽  
Non Invasive ◽  
Increased Risk ◽  
The Mean

Abstract Background Atrial fibrillation (AF) is a common arrhythmia with significant morbidity due to an increased risk of ischemic stroke. Outpatient electrocardiogram (ECG) monitoring is an integral part of the diagnosis of AF. Conventional 24 hour Holter monitoring can be cumbersome and often fails to diagnose patients with paroxysmal AF. Spyder ECG is a non-invasive ECG monitoring device that allows wireless transmission of ECG information for analysis. It is small and comfortable, allowing for easy application for the screening and detection of AF over a mid-term duration. Purpose This study aims to evaluate the incidence of AF in patients with no prior AF and CHADsVASC score of at least 1 with the use of the Spyder ECG mid-term ECG monitoring device. Methods Patients aged 21 to 85 years old with no prior history of AF and CHADsVASC score of at least 1 were recruited from outpatient clinics of 3 large tertiary hospitals in Singapore from December 2016 to April 2019. Patients wore the Spyder ECG device for up to 2 weeks, during which continuous ECG information was uploaded onto a central cloud database and analysed. Results There were 363 patients recruited. The mean age was 61±10.0 years and 65.1% were male. There were 80.3% Chinese, 11.6% Malay, 7.5% Indian and 20.6% of other races. 68.3% of the patients were non-smokers and 74.0% of them were non-alcohol drinkers. The mean BMI of 25.5±4.7 kg/m2. The patient population had significant co-morbidities. 76.3% of the patients had hypertension, 69.4% of them had hyperlipidemia and 40.5% of them had diabetes mellitus. 10.0% of them had congestive cardiac failure and 56.7% had ischaemic heart disease. 11.3% of patients had a previous stroke and 20.4% had a prior myocardial infarction. 7.8% of the patients had asthma, 5.8% of them had thyroid disease and 9.9% of them had chronic kidney disease. They were monitored for a mean of 5.4±2.9 days each. There were 15 (4.1%) patients in whom AF was detected. The patients with AF wore the device for a mean of 5.7±2.0 SD days. The mean burden of AF was 9.0% of monitored time. 46.7% of the patients with AF had detection of AF on the first day, 26.7% on the second day, 13.3% on the third day and 13.3% on the seventh day. The mean duration of the first episode of AF was 251±325 minutes. 7 out of 15 (46.7%) of patients had first episodes of AF lasting less than 10 minutes. Conclusion Continuous mid-term ECG monitoring was able to detect AF in 15 (4.1%) of a population of 363 patients with no prior AF and CHADsVASC score of at least one, monitored for a mean of 5.4 days. Most episodes (53.3%) of AF were detected after the first day of ECG monitoring. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Duke-NUS Medical School Singapore

scholarly journals Non-Invasive Therapy for Device Infection Might Increase Device Related Infections Endocarditis

2011 ◽  
Vol 27 (Supplement) ◽  
pp. OP53_4
Author(s):  
Takashi Yamada ◽  
Masao Ooshima ◽  
Kohtaro Okamoto ◽  
Yasue Tashima ◽  
Takaomi Shiroshita ◽  
...  
Keyword(s):  
Invasive Therapy ◽  
Non Invasive ◽  
Device Infection

MO736ELECTROCHEMICAL SKIN CONDUCTANCE BY SUDOSCAN: A NEW TOOL TO PREDICT INTRA-DIALYTIC HYPOTENSION

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Pauline Reach ◽  
Maxime Touzot ◽  
Yannis Lombardi ◽  
Catherine Maheas ◽  
Emmanuelle Sacco ◽  
...  
Keyword(s):  
Skin Conductance ◽  
Cumulative Risk ◽  
Intradialytic Hypotension ◽  
Multiple Risk Factors ◽  
Non Invasive ◽  
Invasive Test ◽  
Arterial Blood ◽  
A Value ◽  
Increased Risk ◽  
Before And After

Abstract Background and Aims Intradialytic hypotension (IDH) is a common complication in hemodialysis (HD) patients. It is associated with multiple risk factors including cardiac dysfunction and alterations of the peripheral autonomic nervous system. To which extent, dysautonomia may contributed to the occurrence of IHD remains elusive. We sought to investigate the clinical utility of Sudocan®, a device that quantify dysautonomia, in the prediction of IDH. Method We conducted a prospective monocentric study in adult HD patients from July 2019 to February 2020. Dysautonomia was assessed by the measurements of hand and foot Electrochemical Skin Conductance (ESC) by Sudocan®, before and after the end of HD. A pathological hand ESC was defined by an ESC value &lt; 40 μs in Caucasian or &lt; 30 μs in afro-American and Caribbean patients, and a pathological foot ESC by a value &lt; 50 μs in Caucasian or &lt; 30 μs in afro-American and Caribbean patients. Arterial blood pressure (BP) was monitored before, every thirty minutes and after the end of the HD session. The primary end point was the incidence of IDH, according to the NKD/K-DOQI definition, during the 3 month-period study. Results A total of 176 HD patients (64 ±14 years old) were enrolled. Mean pre-dialysis hand and foot ESC were 45±20 μS and 54±22 μS, respectively. Thirty-five and 40% of patients had a pathological ESC at the hand and foot, respectively. Forty-Six IDH occurred during the study period. Logistic regression showed that a pathological hand ESC was associated with an increased risk of IDH [OR=0.39, IC95% (0.15-0.97), p= 0.04]. The cumulative risk incidence of IHD during the study was 2.17 [IC95% (1.21-3.89), p= 0.01] and 1.89 [IC95% (1.06-2.38), p= 0.03], with a pathological hand and foot ESC, respectively. Conclusion A pathological hand ESC, as assessed by a simple, non-invasive test, such as Sudoscan®, is associated with an increased risk of IDH.

Non-invasive predictors for infranodal conduction delay in patients with left bundle branch block after TAVR

2021 ◽  
Author(s):  
Chloé Auberson ◽  
Patrick Badertscher ◽  
Antonio Madaffari ◽  
Meriton Malushi ◽  
Luc Bourquin ◽  
...  
Keyword(s):  
Left Bundle Branch Block ◽  
Predictive Value ◽  
Conduction Delay ◽  
Bundle Branch Block ◽  
Non Invasive ◽  
Transcatheter Aortic Valve ◽  
Increased Risk ◽  
Surface Ecg ◽  
Pr Interval ◽  
Electrocardiographic Parameters

Abstract Aims Left bundle branch block (LBBB) is the most common conduction disorder after transcatheter aortic valve replacement (TAVR) with an increased risk of atrioventricular (AV) block. The aim of the current study was to identify non-invasive predictors for infranodal conduction delay in patients with LBBB. Methods We analyzed consecutive patients undergoing TAVR with pre-existing or new-onset LBBB between August 2014 and August 2020. His ventricular (HV) interval measurement was performed on day 1 after TAVR. Baseline, procedural, as well as surface and intracardiac electrocardiographic parameters were included. Infranodal conduction delay was defined as HV interval > 55 ms. Results Of 825 patients screened after TAVR, 151 patients (82 ± 6 years, 39% male) with LBBB were included. Among these, infranodal conduction delay was observed in 25%. ΔPR (difference in PR interval after and before TAVR), PR and QRS duration after TAVR were significantly longer in the group with HV prolongation. In a multivariate analysis in patients with sinus rhythm (n = 123), ΔPR (OR per 10 ms increase: 1.52; 95%CI: 1.19–2.01; p = 0.002) was the only independent factor associated with infranodal conduction delay. A change in PR interval by 20 ms yielded a specificity of 83% and a sensitivity of 46%, with a negative predictive value of 84% and a positive predictive value of 45% to predict HV prolongation. Conclusions Simple analysis of surface ECG and a calculated ΔPR < 20 ms can be used as predictor for the absence of infranodal conduction delay in post-TAVR patients with LBBB. Graphical abstract

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