scholarly journals Infrared Thermography as a Method of Verification in Raynaud’s Phenomenon

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 981
Author(s):  
Lotte Lindberg ◽  
Bent Kristensen ◽  
Ebbe Eldrup ◽  
Jane Frølund Thomsen ◽  
Lars Thorbjørn Jensen
Keyword(s):  
Diagnostic Test ◽  
Sensitivity And Specificity ◽  
Raynaud’S Phenomenon ◽  
Systolic Pressure ◽  
Target Population ◽  
Raynaud's Phenomenon ◽  
Local Cooling ◽  
Thermographic Imaging ◽  
Alternative Algorithm ◽  
Finger Systolic Pressure

Raynaud’s phenomenon (RP) is characterized by the episodic whitening of the fingers upon exposure to cold. A recently described thermographic algorithm was proposed as a diagnostic replacement of the currently applied finger systolic pressure (FSP) test. The aim of the study was to evaluate the performance of the thermographic algorithm when applied in patients suspected of having RP. Forty-three patients were examined using thermographic imaging after local cooling of the hands in water of 10 °C for 1 min. The thermographic algorithm was applied to predict the probability of RP. The performance of the algorithm was evaluated with different cut-off levels. A new algorithm was proposed based on patients from the target population. The performance of the tested algorithm was noninferior to the FSP test, when a cut-off level of 0.05 was applied, yielding a sensitivity and specificity of 69% and 58%, respectively. The accuracy was 66%. The FSP test had a sensitivity and specificity of 77% and 37%, respectively, and the accuracy was 59%. The thermographic method proved useful for detecting RP and was able to replace the FSP test as a diagnostic test. The alternative algorithm revealed that other thermographic variables were more predictive of the target population, but this should be verified in future patients.

scholarly journals Characteristic Features of Infrared Thermographic Imaging in Primary Raynaud’s Phenomenon

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 558
Author(s):  
Lotte Lindberg ◽  
Bent Kristensen ◽  
Jane F. Thomsen ◽  
Ebbe Eldrup ◽  
Lars T. Jensen
Keyword(s):  
Raynaud’S Phenomenon ◽  
Area Under The Curve ◽  
Raynaud's Phenomenon ◽  
Great Promise ◽  
Healthy Controls ◽  
Local Cooling ◽  
Predictive Values ◽  
Verification Method ◽  
Thermographic Imaging ◽  
Characteristic Features

Raynaud’s phenomenon (RP) is characterized by the episodic whitening of the fingers upon exposure to cold. Verification of the condition is crucial in vibration-exposed patients. The current verification method is outdated, but thermographic imaging seems promising as a diagnostic replacement. By investigating patients diagnosed with RP, the study aimed at developing a simple thermographic procedure that could be applied to future patients where verification of the diagnosis is needed. Twenty-two patients with primary RP and 58 healthy controls were examined using thermographic imaging after local cooling of the hands for 1 min in water of 10°C. A logistic regression model was fitted with the temperature curve characteristics to convey a predicted probability of having RP. The characteristics time to end temperature and baseline temperature were the most appropriate predictors of RP among those examined (p = 0.004 and p = 0.04, respectively). The area under the curve was 0.91. The cut-off level 0.46 yielded a sensitivity and specificity of 82% and 86%, respectively. The positive and negative predictive values were 69% and 93%, respectively. This newly developed thermographic method was able to distinguish between patients with RP and healthy controls and was easy to operate. Thus, the method showed great promise as a method for verification of RP in future patients. Trial registration: ClinicalTrials.gov NCT03094910.

scholarly journals The Application of Fluorescence Optical Imaging in Systemic Sclerosis

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Alexander Pfeil ◽  
Karl F. Drummer ◽  
Joachim Böttcher ◽  
Christian Jung ◽  
Peter Oelzner ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Soft Tissue ◽  
Sensitivity And Specificity ◽  
Raynaud’S Phenomenon ◽  
High Sensitivity ◽  
Raynaud's Phenomenon ◽  
Response To Treatment ◽  
Therapeutic Effects ◽  
Tissue Inflammation ◽  
Soft Tissue Inflammation

Objective. The aim of this study was to visualize soft tissue inflammation using FOI on patients with Systemic Sclerosis (SSc) characterized by SSc-related Raynaud’s phenomenon and to detect the therapeutic response to treatment with iloprost or alprostadil.Methods. Twenty-one patients with SSc and Raynaud’s phenomenon and twenty-six healthy controls were prospectively included. The SSc patients were intravenously treated with iloprost or alprostadil over seven days. FOI was performed at baseline and after seven days using an intravenous application of indocyanine green (ICG). The hands were divided into nineteen segments per hand. All segments were quantitatively evaluated to determine changes in ICG.Results. The sensitivity and specificity of FOI in the detection of ICG enhancement in patients with SSc were 95% versus 96%. At baseline, 31.5% hand segments showed ICG enhancement. After seven days of either iloprost or alprostadil therapy a significant reduction in the ICG was observed which ranged from 40.9% to 24.7%.Conclusion. The study demonstrates that the FOI technique is able to visualize soft-tissue inflammation with both high sensitivity and specificity. The anti-inflammatory therapeutic effects of iloprost were slightly stronger than alprostadil. FOI offers promising benefits in the diagnosis and therapy of patients with SSc-associated Raynaud’s phenomenon.

Impaired transient vasodilation and increased vasoconstriction to digital local cooling in primary Raynaud's phenomenon

2011 ◽  
Vol 301 (2) ◽  
pp. H324-H330 ◽  
Author(s):  
Matthieu Roustit ◽  
Sophie Blaise ◽  
Claire Millet ◽  
Jean-Luc Cracowski
Keyword(s):  
Blood Flow ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Topical Anesthesia ◽  
Sensory Nerves ◽  
Local Cooling ◽  
Doppler Flowmetry ◽  
Percentage Decrease ◽  
Significant Difference ◽  
And Gender

Raynaud's phenomenon (RP) is defined as episodic ischemia of the extremities in response to cold. Although the structure of skin capillaries is normal in primary RP, some data suggest impairment of microvascular function. We aimed at testing whether digital skin blood flow was lower in RP than in controls while cooling locally. We further evaluated the contribution of sensory nerves in the response. We recruited 21 patients with primary RP and 20 healthy volunteers matched on age and gender. After a 10-min baseline at 33°C, skin temperature was cooled at 15 or 24°C during 30 min on the forearm and the finger while monitoring perfusion with a custom-design laser Doppler flowmetry probe. Perfusion was also assessed after topical anesthesia. Blood flow was expressed as cutaneous vascular conductance (CVC). Data were subsequently expressed as area above the curve (AAC0–30) of the percentage decrease from baseline CVC (%BL). CVC on the dorsum of the finger was lower in RP patients compared with controls at 15°C (AAC0–30 were 106,237.2 and 69,544.3%BL·s, respectively; P = 0.02) and at 24°C (AAC0–30 were 86,915 and 57,598%BL·s, respectively; P = 0.04) whereas we observed no significant difference on the finger pad and the forearm. Topical anesthesia increased CVC in patients with RP ( P = 0.05), whereas it did not affect reactivity in controls ( P = 0.86). Our study shows exaggerated skin microvascular vasoconstriction to local cooling on the dorsum of the finger in primary RP compared with controls. Part of this abnormal response in primary RP depends on sensitive nerves.

scholarly journals “Beet” the cold: beetroot juice supplementation improves peripheral blood flow, endothelial function, and anti-inflammatory status in individuals with Raynaud’s phenomenon

2019 ◽  
Vol 127 (5) ◽  
pp. 1478-1490 ◽  
Author(s):  
Anthony I. Shepherd ◽  
Joseph T. Costello ◽  
Stephen J. Bailey ◽  
Nicolette Bishop ◽  
Alex J. Wadley ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Endothelial Function ◽  
Diastolic Blood Pressure ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Beetroot Juice ◽  
Local Cooling ◽  
Inflammatory Status ◽  
Anti Inflammatory

Raynaud’s phenomenon (RP) is characterized by recurrent transient peripheral vasospasm and lower nitric oxide (NO) bioavailability in the cold. We investigated the effect of nitrate-rich beetroot juice (BJ) supplementation on 1) NO-mediated vasodilation, 2) cutaneous vascular conductance (CVC) and skin temperature (Tsk) following local cooling, and 3) systemic anti-inflammatory status. Following baseline testing, 23 individuals with RP attended four times, in a double-blind, randomized crossover design, following acute and chronic (14 days) BJ and nitrate-depleted beetroot juice (NDBJ) supplementation. Peripheral Tsk and CVC were measured during and after mild hand and foot cooling, and during transdermal delivery of acetylcholine and sodium nitroprusside. Markers of anti-inflammatory status were also measured. Plasma nitrite concentration ([nitrite]) was increased in the BJ conditions ( P < 0.001). Compared with the baseline visit, thumb CVC was greater following chronic-BJ (Δ2.0 flux/mmHg, P = 0.02) and chronic-NDBJ (Δ1.45 flux/mmHg, P = 0.01) supplementation; however, no changes in Tsk were observed ( P > 0.05). Plasma [interleukin-10] was greater, pan endothelin and systolic and diastolic blood pressure (BP) were reduced, and forearm endothelial function was improved, by both BJ and NDBJ supplementation ( P < 0.05). Acute and chronic BJ and NDBJ supplementation improved anti-inflammatory status, endothelial function and blood pressure (BP). CVC following cooling increased post chronic-BJ and chronic-NDBJ supplementation, but no effect on Tsk was observed. The key findings are that beetroot supplementation improves thumb blood flow, improves endothelial function and anti-inflammatory status, and reduces BP in people with Raynaud’s. NEW & NOTEWORTHY This is the first study to examine the effect of dietary nitrate supplementation in individuals with Raynaud’s phenomenon. The principal novel findings from this study were that both beetroot juice and nitrate-depleted beetroot juice 1) increased blood flow in the thumb following a cold challenge; 2) enhanced endothelium-dependent and -independent vasodilation in the forearm; 3) reduced systolic and diastolic blood pressure, and pan-endothelin concentration; and 4) improved inflammatory status in comparison to baseline.

Raynaud's phenomenon in patients treated with cisplatin, vinblastine, and bleomycin for germ cell cancer: measurement of vasoconstrictor response to cold.

1989 ◽  
Vol 7 (7) ◽  
pp. 940-942 ◽  
Author(s):  
S W Hansen ◽  
N Olsen
Keyword(s):  
Germ Cell ◽  
Raynaud’S Phenomenon ◽  
Serum Magnesium ◽  
Cell Cancer ◽  
Systolic Pressure ◽  
Raynaud's Phenomenon ◽  
Germ Cell Cancer ◽  
Control Group ◽  
Cold Response ◽  
Vasoconstrictor Response

The prevalence of Raynaud's phenomenon (RP) was studied in patients treated with cisplatin, vinblastine, and bleomycin. Thirty-two patients with germ cell cancer were followed for a median of 78 months (range, 49 to 106 months). All had obtained complete remission during treatment; none had relapsed at last follow-up examination. All blood samples, including serum magnesium, were normal. The arterial vasoconstrictor response to cold in the finger was measured by cuff- and strain-gauge techniques at 30, 15, and 10 degrees C. Blood pressure (BP) was measured auscultatorily, using a 12-cm broad cuff on the ipsilateral upper arm. Fourteen patients (44%) had developed anamnestic RP, and all showed an exaggerated response to cold; arterial closure was provoked in nine patients. Eighteen patients (56%) were without finger symptoms. These patients had an exaggerated response to cold in comparison with controls, and in two patients, RP was provoked. None of the patients had an increased systolic pressure gradient from arm to finger when compared with a control group. Thus, an exaggerated cold response was found to be a prolonged vasospastic side effect not only in patients with RP, but also in patients without finger symptoms.

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