Influence of interference of light and laser technologies on microcirculation in involutive changes of skin

2021 ◽  
pp. 89-93
Author(s):  
D. V. Demidion ◽  
E. L. Baranova ◽  
Zh. Yu. Yusova ◽  
M. A. Avagumyan ◽  
D. B. Kulchitskaya ◽  
...  
Keyword(s):  
Wavelet Transform ◽  
Patient Management ◽  
Clinical Effectiveness ◽  
Additional Treatment ◽  
Myogenic Tone ◽  
Fractional Laser ◽  
Doppler Flowmetry ◽  
Skin Changes ◽  
Laser Technologies ◽  
Starting Point

In a study of 115 patients, the effect of the interference of IPL exposure using filters of 640 nm and 560 nm and the use of an erbium fractional laser with a wavelength of 1565 nm on microcirculation in patients with involutive skin changes was studied. The basis of all reparative processes is the microcirculatory link, as a unit of the trophic system of the skin. Studying the effect of phototechnologies and laser fractional exposure on microcirculation, based on the results of these studies, it is possible to develop algorithms for patient management, including additional treatment methods, as well as an algorithm for standardizing procedures, including the multiplicity and number of procedures. These studies can be the starting point for the introduction of standards that will reduce the number of complications, as well as increase the clinical effectiveness of the treatment, which will make the method more widely available. The assessment of the state of microcirculation was carried out using the method of laser Doppler flowmetry (LDF), using the mathematical analysis of the wavelet transform. Under the influence of the interference of IPL exposure using filters of 640 nm and 560 nm and the use of an erbium fractional laser with a wavelength of 1565 nm, a positive dynamics of the parameters of all parts of the microcirculation was revealed according to the LDF data. In women with spastic type of MC, the initially increased neurogenic and myogenic tone of the arterioles decreased, and endothelial function improved. In women with hyperemic type of MC, there was an improvement in neurogenic tone, correction of endothelial dysfunction, and elimination of congestion in the venular link of MC. However, the above changes were more noticeable in patients with hyperemic type of MC.

scholarly journals Clinical Effectiveness of Cardiocytoprotective Therapy in Patients with Acute Coronar Syndrome (ACS) – Myocardial Infarction (MI), Who Were Performed Balloon Angioplasty and Coronary Artery Stenting

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Mykola Shved ◽  
Lesia Tsuglevych ◽  
Svitlana Heryak
Keyword(s):  
Medical Treatment ◽  
Clinical Effectiveness ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Additional Treatment ◽  
Functional Improvement ◽  
Control Group ◽  
Restorative Treatment ◽  
Coronary Syndrome ◽  
Standard Medical Treatment

The aim of the study was to increase the efficiency of restorative treatment of patients with Acute Coronary Syndrome (Miocardial Infarction) by incorporating the protocol therapy for the course of parenteral use of L-arginine and L-carnitine (Tivorel). It has been determined that patients with ACS (MI) after percutaneous coronary intervention often develop reperfusion syndrome with manifestations of left ventricular insufficiency and rhythm disturbances. Substantial clinical and functional improvement was noted under the influence of standard medical treatment in patients of control group. At the same time postinfarction remodeling with systolic and diastolic function of the heart, with the development of heart failure syndrome and endothelial dysfunction of blood vessels, and also remained resistant to extrasystole therapy, progressed. Patients in the experimental group under the influence of complex medical treatment with the inclusion of L-arginine and L-carnitine marked a significant decrease in the frequency of violations of rhythm and conduction for the second day of observation, as well as a decrease in the manifestations of post-infarction remodeling of LV, which ultimately manifested a significant improvement in myocardial contractility (EF increased by 13%) and decreased diastolic dysfunction. Improvement of the inotropic function of the heart and a significant reduction in the frequency and severity of reperfusion arrhythmias was achieved precisely due to cardiometabolic effects of L-carnitine. In addition, in patients undergoing additional treatment with L-arginine and L-carnitine after 10 days of treatment, the activity of ET-1 was significantly lowered and the concentration of nitrogen oxide metabolites in the blood plasma increased and reach the level of healthy subjects (p>0.05). So, they recovered the endothelial function of the vessels.

scholarly journals COVID-19 Pandemic and Telephone Triage before Attending Medical Office: Problem or Opportunity?

Medicina ◽  
2020 ◽  
Vol 56 (5) ◽  
pp. 250 ◽  
Author(s):  
Gabriele Cervino ◽  
Giacomo Oteri
Keyword(s):  
Patient Management ◽  
Virtual Patient ◽  
Smart Phones ◽  
Future Perspectives ◽  
Telephone Triage ◽  
Safe Environment ◽  
Current State ◽  
Medical Office ◽  
Starting Point ◽  
Epidemic Period

During the COVID-19 emergency, the medical operating protocols have been largely modified for reducing any type of contamination risk, for working in a safe way and for making the patient feel in a safe environment. Telemedicine, smart phones and apps could represent important devices for the community, in order to prevent virus trasmission and to perform quick diagnosis and management at medical offices. This manuscript could be useful for clinicians with regard to the current state of the effectiveness of the telephone triage in this COVID-19 epidemic period. Therefore, it could be an important starting point for future perspectives about telemedicine and virtual patient management.

scholarly journals Rehabilitation and Functional Neuroimaging Dose-Response Trajectories for Clinical Trials

2005 ◽  
Vol 19 (4) ◽  
pp. 276-282 ◽  
Author(s):  
Bruce H. Dobkin
Keyword(s):  
Clinical Trials ◽  
Functional Neuroimaging ◽  
Statistical Significance ◽  
Behavioral Outcomes ◽  
Experimental Treatment ◽  
Clinical Effectiveness ◽  
Additional Treatment ◽  
Dynamic State ◽  
Experimental Therapy ◽  
Behavioral Assessments

Background. In clinical trials, behavioral outcomes and physiological measures of activity-dependent plasticity that evolve with task-oriented therapies may fail to reach statistical significance. When significant, clinical effectiveness may not be robust enough to alter professional practices. Objective. Provide the conceptual basis for a research design to optimize the effect of an experimental treatment. Methods. Literature review. Results. Research designs usually do not take into consideration the dynamic state of each subject’s potential responsiveness to an intervention. Providing a rational, rather than convenient, intensity and duration of therapy may remedy this potential confounder for clinical trials. To determine whether a most effective dose of a therapy exists, investigators could assess subjects before the intervention, administer interim measures at planned intervals, and continue the intervention until the primary behavioral outcomes or functional imaging parameters or both reach a plateau for at least 15 h of additional treatment. Conclusion. Promising interventions ought to be continued in phase II/III trials until subjects reach an asymptote in the primary outcome for behavioral gains. For neuroimaging studies that aim to correlate brain-behavior measures during rehabilitation, the specific intervention should also continue until behavioral gains and cerebral adaptations have attained a persistent plateau. Future trials can investigate whether functional neuroimaging performed in parallel with repeated behavioral assessments can better inform researchers about the optimal duration of an experimental therapy and a subject’s maximal capacity for intervention-induced cerebral reorganization.

scholarly journals Atypical Presentation of Pseudoxanthoma Elasticum in Two Siblings from North India

2020 ◽  
Vol 63 (4) ◽  
pp. 198-201
Author(s):  
Sunayana Misra ◽  
Ravindra Kumar Saran
Keyword(s):  
Early Diagnosis ◽  
Patient Management ◽  
Arterial Wall ◽  
Pseudoxanthoma Elasticum ◽  
Phenotypic Heterogeneity ◽  
North India ◽  
Atypical Presentation ◽  
Skin Changes ◽  
Metabolic Defect

Pseudoxanthoma elasticum (PXE) is a rare hereditary disorder occurring due to metabolic defect in the liver and manifesting predominantly in the skin, eyes and arteries. It shows characteristic yellowish papules on the skin around the nape of neck along with looseness of skin over flexural surfaces. PXE shows marked phenotypic heterogeneity. Complications related to arterial wall and retinal Bruchs’ membrane calcification occur later in life; early diagnosis therefore helps keep patient on follow up for development of the same. In Indian patients, classic skin changes may be missed clinically making histopathology pivotal in diagnosis and patient management.

scholarly journals ОЦІНКА ЕФЕКТИВНОСТІ ЛІКУВАННЯ ЗАХВОРЮВАНЬ ПАРОДОНТА У ЖІНОК, ЯКІ ПРИЙМАЮТЬ ГОРМОНАЛЬНІ КОНТРАЦЕПТИВИ ЗА ДОПОМОГОЮ ЛАЗЕРНОЇ ДОППЛЕРІВСЬКОЇ ФЛОУМЕТРІЇ

World Science ◽  
2019 ◽  
Vol 2 (9(49)) ◽  
pp. 9-14
Author(s):  
Борисенко А. В. ◽  
Ватанха Т. В. ◽  
Мостовий С. Є.
Keyword(s):  
Periodontal Disease ◽  
Laser Doppler Flowmetry ◽  
Periodontal Diseases ◽  
Clinical Effectiveness ◽  
Treatment Method ◽  
Laser Doppler ◽  
Hormonal Contraceptives ◽  
Special Method ◽  
Doppler Flowmetry ◽  
Pregnancy Planning

Urgency. Periodontal disease is the most common human diseases. As etiologic factors among systemic diseases an important role is played by disorders of the sexual system, especially in women. Due to the use of hormonal contraceptives with estrogens, they have developed periodontal disease. For the treatment of these lesions a special method of treatment is proposed. Laser Doppler flowmetry was used to evaluate the effectiveness of the treatment.Aim: To determine the clinical effectiveness of the proposed method of complex treatment of periodontal diseases in women taking hormonal contraceptives for pregnancy planning, by estimating the blood flow in periodontal microvessels by laser Doppler flowmetry.Materials and methods. Clinical studies performed on a group of 130 women taking hormonal contraceptives for pregnancy planning with periodontal diseases. Patients were conducted a comprehensive examination of periodontal tissue before treatment and after treatment. To evaluate the clinical efficacy of treatment used Schiller-Pisarev test 1962), the index of PMA by C.Parma (1961), hygienic index by Green J.C., Vermillion J.R. (1964). Laser Doppler Flowmetry was used to evaluate the treatment efficacy.Results. As a result of the study it was found that the use of the proposed method of treatment with the drug "Normoven" can more effectively suppress dystrophic-inflammatory process in the tissues of the periodontium. This confirms ин the reduction of periodontal indices, improvement of oral hygiene, improvement of microcirculation in the tissues of periodontal patients.Conclusions. The application of the proposed treatment method increases the level of microcirculation in the gums of women with periodontal diseases who have taken oral contraceptives for the purpose of pregnancy planning.

scholarly journals Effectiveness of tests to detect the presence of SARS-CoV-2 virus, and antibodies to SARS-CoV-2, to inform COVID-19 diagnosis: a rapid systematic review

2020 ◽  
pp. bmjebm-2020-111511 ◽  
Author(s):  
David Jarrom ◽  
Lauren Elston ◽  
Jennifer Washington ◽  
Matthew Prettyjohns ◽  
Kimberley Cann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Patient Management ◽  
Sampling Methods ◽  
Clinical Effectiveness ◽  
Antibody Detection ◽  
Test Accuracy ◽  
Reference Standard ◽  
Published Evidence ◽  
Subsequent Patient

ObjectivesWe undertook a rapid systematic review with the aim of identifying evidence that could be used to answer the following research questions: (1) What is the clinical effectiveness of tests that detect the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to inform COVID-19 diagnosis? (2) What is the clinical effectiveness of tests that detect the presence of antibodies to the SARS-CoV-2 virus to inform COVID-19 diagnosis?Design and settingSystematic review and meta-analysis of studies of diagnostic test accuracy. We systematically searched for all published evidence on the effectiveness of tests for the presence of SARS-CoV-2 virus, or antibodies to SARS-CoV-2, up to 4 May 2020, and assessed relevant studies for risks of bias using the QUADAS-2 framework.Main outcome measuresMeasures of diagnostic accuracy (sensitivity, specificity, positive/negative predictive value) were the main outcomes of interest. We also included studies that reported influence of testing on subsequent patient management, and that reported virus/antibody detection rates where these facilitated comparisons of testing in different settings, different populations or using different sampling methods.Results38 studies on SARS-CoV-2 virus testing and 25 studies on SARS-CoV-2 antibody testing were identified. We identified high or unclear risks of bias in the majority of studies, most commonly as a result of unclear methods of patient selection and test conduct, or because of the use of a reference standard that may not definitively diagnose COVID-19. The majority were in hospital settings, in patients with confirmed or suspected COVID-19 infection. Pooled analysis of 16 studies (3818 patients) estimated a sensitivity of 87.8% (95% CI 81.5% to 92.2%) for an initial reverse-transcriptase PCR test. For antibody tests, 10 studies reported diagnostic accuracy outcomes: sensitivity ranged from 18.4% to 96.1% and specificity 88.9% to 100%. However, the lack of a true reference standard for SARS-CoV-2 diagnosis makes it challenging to assess the true diagnostic accuracy of these tests. Eighteen studies reporting different sampling methods suggest that for virus tests, the type of sample obtained/type of tissue sampled could influence test accuracy. Finally, we searched for, but did not identify, any evidence on how any test influences subsequent patient management.ConclusionsEvidence is rapidly emerging on the effectiveness of tests for COVID-19 diagnosis and management, but important uncertainties about their effectiveness and most appropriate application remain. Estimates of diagnostic accuracy should be interpreted bearing in mind the absence of a definitive reference standard to diagnose or rule out COVID-19 infection. More evidence is needed about the effectiveness of testing outside of hospital settings and in mild or asymptomatic cases. Implementation of public health strategies centred on COVID-19 testing provides opportunities to explore these important areas of research.

scholarly journals Different lasers reveal different skin microcirculatory flowmotion - data from the wavelet transform analysis of human hindlimb perfusion

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
L. Monteiro Rodrigues ◽  
Clemente Rocha ◽  
Hugo Ferreira ◽  
Henrique Silva
Keyword(s):  
Wavelet Transform ◽  
Challenge Test ◽  
Green Light ◽  
Lower Limbs ◽  
Spectral Amplitude ◽  
Discriminative Ability ◽  
Doppler Flowmetry ◽  
Group 2 ◽  
Microcirculatory Function

AbstractLaser Doppler flowmetry (LDF) and reflection photoplethysmography (PPG) are standard technologies to access microcirculatory function in vivo. However, different light frequencies mean different interaction with tissues, such that LDF and PPG flowmotion curves might have distinct meanings, particularly during adaptative (homeostatic) processes. Therefore, we analyzed LDF and PPG perfusion signals obtained in response to opposite challenges. Young healthy volunteers, both sexes, were assigned to Group 1 (n = 29), submitted to a normalized Swedish massage procedure in one lower limb, increasing perfusion, or Group 2 (n = 14), submitted to a hyperoxia challenge test, decreasing perfusion. LDF (Periflux 5000) and PPG (PLUX-Biosignals) green light sensors applied distally on both lower limbs recorded perfusion changes for each experimental protocol. Both techniques detected the perfusion increase with massage, and the perfusion decrease with hyperoxia, in both limbs. Further analysis with the wavelet transform (WT) revealed better depth-related discriminative ability for PPG (more superficial, less blood sampling) compared with LDF in both challenges. Spectral amplitude profiles consistently demonstrated better sensitivity for LDF, especially regarding the lowest frequency components. Strong correlations between components were not found. Therefore, LDF and PPG flowmotion curves are not equivalent, a relevant finding to better study microcirculatory physiology.

scholarly journals Post-concussion states: How do we improve our patients’ outcomes? An Australian perspective

2020 ◽  
Vol 4 ◽  
pp. 205970022096031
Author(s):  
Elizabeth Thomas ◽  
Melinda Fitzgerald ◽  
Gill Cowen
Keyword(s):  
Large Scale ◽  
Patient Management ◽  
Future Research ◽  
Limited Data ◽  
Starting Point ◽  
Symptoms And Signs

There is limited data surrounding incidence and prevalence of concussion and the resulting post-concussion states. This creates difficulty when investigating ways to optimise patient management. It is proposed that a registry of patients presenting with symptoms and signs after a concussion, as part of a large scale TBI registry across Australia, would provide a starting point for future research with a view to improving the outcomes of patients experiencing symptoms and signs after concussion.

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