scholarly journals Abdominal Cutaneous Thermography and Perfusion Mapping after Caesarean Section: A Scoping Review

2020 ◽  
Vol 17 (22) ◽  
pp. 8693
Author(s):  
Charmaine Childs ◽  
Hora Soltani
Keyword(s):  
Blood Flow ◽  
Caesarean Section ◽  
Skin Temperature ◽  
Full Text ◽  
Thermal Imaging ◽  
Data Extraction ◽  
Wound Complications ◽  
Skin Perfusion ◽  
Cutaneous Perfusion ◽  
Cold Spots

Introduction: Caesarean section (CS) is the most prevalent surgical procedure in women. The incidence of surgical site infection (SSI) after CS remains high but recent observations of CS wounds using infrared thermography has shown promise for the technique in SSI prognosis. Although thermography is recognised as a ‘surrogate’ of skin perfusion, little is known of the relationship between skin temperature and skin perfusion in the context of wound healing. Aim: To assess the extent of literature regarding the application of infrared thermography and mapping of abdominal cutaneous perfusion after CS. Methods: Wide eligibility criteria were used to capture all relevant studies of any design, published in English, and addressing thermal imaging or skin perfusion mapping of the abdominal wall. The CINAHL and MEDLINE databases were searched, with two independent reviewers screening the title and abstracts of all identified citations, followed by full-text screening of relevant studies. Data extraction from included studies was undertaken using a pre-specified data extraction chart. Data were tabulated and synthesised in narrative format. Results: From 83 citations identified, 18 studies were considered relevant. With three additional studies identified from the reference lists, 21 studies were screened via full text. None of the studies reported thermal imaging and cutaneous perfusion patterns of the anterior abdominal wall. However, two observational studies partially met the inclusion criteria. The first explored analysis methodologies to ‘interrogate’ the abdominal thermal map. A specific thermal signature (‘cold spots’) was identified as an early ‘flag’ for SSI risk. A second study, by the same authors, focusing on obesity (a known risk factor for SSI after CS) showed that a 1 °C lower abdominal skin temperature led to a 3-fold odds of SSI. Conclusion: There is a significant gap in knowledge on how to forewarn of wound complications after CS. By utilising the known association between skin temperature and blood flow, thermographic assessment of the wound and adjacent thermal territories has potential as a non-invasive, independent, imaging option with which to identify tissue ‘at risk’. By identifying skin ‘hot’ or ‘cold’ spots, commensurate with high or low blood flow regions, there is potential to shed light on the underlying mechanisms leading to infective and non-infective wound complications.

scholarly journals Hallucal thenar index: A new index to detect peripheral arterial disease using laser speckle flowgraphy

Vascular ◽  
2020 ◽  
pp. 170853812093893
Author(s):  
Kazuhiro Tsunekawa ◽  
Fumio Nagai ◽  
Tamon Kato ◽  
Ikkei Takashimizu ◽  
Daisuke Yanagisawa ◽  
...  
Keyword(s):  
Blood Flow ◽  
Peripheral Arterial Disease ◽  
Operating Characteristic ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Laser Speckle ◽  
Laser Speckle Flowgraphy ◽  
Skin Perfusion ◽  
Peripheral Arterial ◽  
Cutaneous Blood

Objectives Laser speckle flowgraphy is a technology using reflected scattered light for visualization of blood distribution, which can be used to measure relative velocity of blood flow easily without contact with the skin within a short time. It was hypothesized that laser speckle flowgraphy may be able to identify foot ischemia. This study was performed to determine whether laser speckle flowgraphy could distinguish between subjects with and without peripheral arterial disease. Materials and methods All subjects were classified based on clinical observations using the Rutherford classification: non-peripheral arterial disease, class 0; peripheral arterial disease group, class 2–5. Rutherford class 6 was one of the exclusion criteria. Laser speckle flowgraphy measured the beat strength of skin perfusion as an indicator of average dynamic cutaneous blood flow change synchronized with the heartbeat. The beat strength of skin perfusion indicates the strength of the heartbeat on the skin, and the heartbeat strength calculator in laser speckle flowgraphy uses the blood flow data to perform a Fourier transform to convert the temporal changes in blood flow to a power spectrum. A total of 33 subjects with peripheral arterial disease and 40 subjects without peripheral arterial disease at a single center were prospectively examined. Laser speckle flowgraphy was used to measure hallucal and thenar cutaneous blood flow, and the measurements were repeated three times. The hallucal and thenar index was defined as the ratio of beat strength of skin perfusion value on hallux/beat strength of skin perfusion value on ipsilateral thenar eminence. The Mann–Whitney U-test was used to compare the median values of hallucal and thenar index and ankle brachial index between the two groups. A receiver operating characteristic curve for hallucal and thenar index of beat strength of skin perfusion was plotted, and a cutoff point was set. The correlation between hallucal and thenar index of beat strength of skin perfusion and ankle brachial index was explored in all subjects, the hemodialysis group, and the non-hemodialysis (non-hemodialysis) group. Results The median value of the hallucal and thenar index of beat strength of skin perfusion was significantly different between subjects with and without peripheral arterial disease (0.27 vs. 0.87, respectively; P <  0.001). The median value of ankle brachial index was significantly different between subjects with and without peripheral arterial disease (0.8 vs. 1.1, respectively; P <  0.001). Based on the receiver operating characteristic of hallucal and thenar index, the cutoff was 0.4416 and the sensitivity, specificity, positive predictive value, and negative predictive value were 68.7%, 95%, 91.7%, and 77.6%, respectively. The correlation coefficients of all subjects, the hemodialysis group, and the non-hemodialysis group were 0.486, 0.102, and 0.743, respectively. Conclusions Laser speckle flowgraphy is a noninvasive, rapid, and widely applicable method. Laser speckle flowgraphy using hallucal and thenar index would be helpful to determine the differences between subjects with and without peripheral arterial disease. The correlation between hallucal and thenar index of beat strength of skin perfusion and ankle brachial index indicated that this index was especially useful in the non-hemodialysis group.

scholarly journals Effectiveness of self-management interventions in inflammatory arthritis: a systematic review informing the 2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis

RMD Open ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. e001647
Author(s):  
Andréa Marques ◽  
Eduardo Santos ◽  
Elena Nikiphorou ◽  
Ailsa Bosworth ◽  
Loreto Carmona
Keyword(s):  
Systematic Review ◽  
Full Text ◽  
Inflammatory Arthritis ◽  
Data Extraction ◽  
Management Strategies ◽  
Psychosocial Interventions ◽  
Behavioural Therapy ◽  
Self Management ◽  
Cochrane Library ◽  
Management Interventions

ObjectiveTo perform a systematic review (SR) on the effectiveness of self-management interventions, in order to inform the European League Against Rheumatism Recommendations for its implementation in patients with inflammatory arthritis (IA).MethodsThe SR was conducted according to the Cochrane Handbook and included adults (≥18 years) with IA. The search strategy was run in Medline through PubMed, Embase, Cochrane Library, CINAHL Plus with Full Text, and PEDro. The assessment of risk of bias, data extraction and synthesis were performed by two reviewers independently. A narrative Summary of Findings was provided according to the Grading of Recommendations, Assessment, Development and Evaluation.ResultsFrom a total 1577 references, 57 were selected for a full-text review, and 32 studies fulfilled the inclusion criteria (19 randomised controlled trials (RCTs) and 13 SRs). The most studied self-management components were specific interactive disease education in ten RCTs, problem solving in nine RCTs, cognitive–behavioural therapy in eight RCTs, goal setting in six RCTs, patient education in five RCTs and response training in two RCTs. The most studied interventions were multicomponent or single exercise/physical activity in six SRs, psychosocial interventions in five SRs and education in two SRs. Overall, all these specific components and interventions of self-management have beneficial effects on IAs-related outcomes.ConclusionsThe findings confirm the beneficial effect of the self-management interventions in IA and the importance of their implementation. Further research should focus on the understanding that self-management is a complex intervention to allow the isolation of the effectiveness of its different components.

scholarly journals Evaluating the relationship between citation set size, team size and screening methods used in systematic reviews: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katie O’Hearn ◽  
Cameron MacDonald ◽  
Anne Tsampalieros ◽  
Leo Kadota ◽  
Ryan Sandarage ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Full Text ◽  
Gold Standard ◽  
Data Extraction ◽  
Statistical Testing ◽  
Computer Assisted ◽  
Screening Methods ◽  
Team Size ◽  
Cross Sectional ◽  
Set Size

Abstract Background Standard practice for conducting systematic reviews (SRs) is time consuming and involves the study team screening hundreds or thousands of citations. As the volume of medical literature grows, the citation set sizes and corresponding screening efforts increase. While larger team size and alternate screening methods have the potential to reduce workload and decrease SR completion times, it is unknown whether investigators adapt team size or methods in response to citation set sizes. Using a cross-sectional design, we sought to understand how citation set size impacts (1) the total number of authors or individuals contributing to screening and (2) screening methods. Methods MEDLINE was searched in April 2019 for SRs on any health topic. A total of 1880 unique publications were identified and sorted into five citation set size categories (after deduplication): < 1,000, 1,001–2,500, 2,501–5,000, 5,001–10,000, and > 10,000. A random sample of 259 SRs were selected (~ 50 per category) for data extraction and analysis. Results With the exception of the pairwise t test comparing the under 1000 and over 10,000 categories (median 5 vs. 6, p = 0.049) no statistically significant relationship was evident between author number and citation set size. While visual inspection was suggestive, statistical testing did not consistently identify a relationship between citation set size and number of screeners (title-abstract, full text) or data extractors. However, logistic regression identified investigators were significantly more likely to deviate from gold-standard screening methods (i.e. independent duplicate screening) with larger citation sets. For every doubling of citation size, the odds of using gold-standard screening decreased by 15 and 20% at title-abstract and full text review, respectively. Finally, few SRs reported using crowdsourcing (n = 2) or computer-assisted screening (n = 1). Conclusions Large citation set sizes present a challenge to SR teams, especially when faced with time-sensitive health policy questions. Our study suggests that with increasing citation set size, authors are less likely to adhere to gold-standard screening methods. It is possible that adjunct screening methods, such as crowdsourcing (large team) and computer-assisted technologies, may provide a viable solution for authors to complete their SRs in a timely manner.

scholarly journals Laser Doppler blood flowmeter as a useful instrument for the early detection of lower extremity peripheral arterial disease in hemodialysis patients: an observational study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Takeo Ishii ◽  
Shizuka Takabe ◽  
Yuki Yanagawa ◽  
Yuko Ohshima ◽  
Yasuhiro Kagawa ◽  
...  
Keyword(s):  
Blood Flow ◽  
Peripheral Arterial Disease ◽  
Early Stage ◽  
Arterial Disease ◽  
Hemodialysis Patients ◽  
Laser Doppler ◽  
Doppler Flowmetry ◽  
Skin Perfusion ◽  
Dorsal Area ◽  
Peripheral Arterial

Abstract Background A simpler method for detecting atherosclerosis obliterans is required in the clinical setting. Laser Doppler flowmetry (LDF) is easy to perform and can accurately detect deterioration in skin perfusion. We performed LDF for hemodialysis patients to determine the correlations between blood flow in the lower limbs and peripheral arterial disease (PAD). Methods This retrospective study included 128 hemodialysis patients. Patients were categorized into the non-PAD group (n = 106) and PAD group (n = 22), 14 early stage PAD patients were included in the PAD group. We conducted LDF for the plantar area and dorsal area of the foot and examined skin perfusion pressure (SPP) during dialysis. Results SPP-Dorsal Area values were 82.1 ± 22.0 mmHg in the non-PAD, and 59.1 ± 20.3 mmHg in PAD group, respectively (p < 0.05). The LDF-Plantar blood flow (Qb) values were 32.7 ± 15.5 mL/min in non-PAD group and 21.5 ± 11.3 mL/min in PAD group (p < 0.001). A total of 21 non-PAD patients underwent LDF before and during dialysis. The LDF-Plantar-Qb values were 36.5 ± 17.6 mL/min before dialysis and 29.6 ± 17.7 mL/min after dialysis (p < 0.05). We adjusted SPP and LDF for PAD using logistic regression, SPP-Dorsal-Area and LDF-P were significantly correlated with PAD (p < 0.05). The receiver-operating characteristic curve analysis indicated cut-off values of 20.0 mL/min for LDF-Plantar-Qb during dialysis. Conclusion LDF is a simple technique for sensitive detection of early-stage PAD. This assessment will help physicians identify early-stage PAD, including Fontaine stage II in clinical practice, thereby allowing prompt treatment.

Cardiovascular responses to head-stand posture

1963 ◽  
Vol 18 (5) ◽  
pp. 987-990 ◽  
Author(s):  
Shanker Rao
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
High Pressure ◽  
Blood Flow ◽  
Arterial Pressure ◽  
Skin Temperature ◽  
Cardiovascular Responses ◽  
Posterior Tibial Artery ◽  
Nervous Control ◽  
Posterior Tibial

Reports of cardiovascular responses to head-stand posture are lacking in literature. The results of the various responses, respectively, to the supine, erect, and head-stand posture, are as follows: heart rate/min 67, 84, and 69; brachial arterial pressure mm Hg 92, 90, and 108; posterior tibial arterial pressure mm Hg 98, 196, and 10; finger blood flow ml/100 ml min 4.5, 4.4, and 5.2; toe blood flow ml/100 ml min 7.1, 8.1, and 3.4; forehead skin temperature C 34.4, 34.0 and 34.3; dorsum foot skin temperature C 28.6, 28.2, and 28.2. It is inferred that the high-pressure-capacity vessels between the heart level and posterior tibial artery have little nervous control. The high-pressure baroreceptors take active part in postural adjustments of circulation. The blood pressure equating mechanism is not as efficient when vital tissues are pooled with blood as when blood supply to them is reduced. man; heart rate; blood flow; skin temperature Submitted on January 3, 1963

scholarly journals The interrelationship between air temperature and humidity as applied locally to the skin: The resultant response on skin temperature and blood flow with age differences

2012 ◽  
Vol 18 (4) ◽  
pp. CR201-CR208 ◽  
Author(s):  
Jerrold S. Petrofsky ◽  
Lee Berk ◽  
Faris Alshammari ◽  
Haneul Lee ◽  
Adel Hamdan ◽  
...  
Keyword(s):  
Blood Flow ◽  
Skin Temperature ◽  
Age Differences ◽  
Air Temperature ◽  
Temperature And Humidity

Relation of local skin temperature and local sweating to cutaneous blood flow

1963 ◽  
Vol 18 (4) ◽  
pp. 781-785 ◽  
Author(s):  
Leo C. Senay ◽  
Leon D. Prokop ◽  
Leslie Cronau ◽  
Alrick B. Hertzman
Keyword(s):  
Blood Flow ◽  
Skin Temperature ◽  
Sweat Gland ◽  
Cutaneous Blood Flow ◽  
Local Skin ◽  
Cutaneous Vasodilatation ◽  
Local Skin Temperature ◽  
Relationship Of ◽  
The Relationship ◽  
Cutaneous Blood

The relationship of local skin temperature and the onset of sweating to the local cutaneous blood flow was studied in the forearm and calf. The purpose of the investigation was to appraise the possible relation of sweat gland activity to the cutaneous vasodilatation which has been attributed to bradykinin or to intracranial temperatures. The onset of sweating was not marked by any apparently related increases in the rate of cutaneous blood flow. On the contrary, the onset of sweating was followed often by a stabilization or even a decrease in the level of cutaneous blood flow. The relations of the latter to the local skin temperature were complex, particularly in the forearm. There appeared to be additional unidentified influences, possibly vasomotor, operating on the skin vessels during transitional phases in the relation of skin temperature to blood flow. Submitted on October 15, 1962

The Effect on Uteroplacental Blood Flow of Epidural Anaesthesia Containing Adrenaline for Caesarean Section

1990 ◽  
Vol 10 (3) ◽  
pp. 160-161
Author(s):  
A. Skjöldebrand ◽  
J. Eklund ◽  
N. -O. Lundell ◽  
L. Nylund ◽  
B. Sarby ◽  
...  
Keyword(s):  
Blood Flow ◽  
Caesarean Section ◽  
Epidural Anaesthesia ◽  
Uteroplacental Blood Flow

Skin Perfusion, Arterial and Venous Blood Flow, and Soft Tissue Thickness in Relation to Pressure Ulcers

2013 ◽  
Author(s):  
Abinand Manorama ◽  
Tamara Reid Bush
Keyword(s):  
Blood Flow ◽  
Pressure Ulcers ◽  
Venous Blood ◽  
The Body ◽  
Venous Blood Flow ◽  
Tissue Necrosis ◽  
Tissue Thickness ◽  
Skin Perfusion ◽  
Healthcare Settings ◽  
Soft Tissue Thickness

Pressure ulcers have been a concern in healthcare settings, with more than 50% of bedridden or wheelchair-bound patients being affected [1]. Pressure ulcers typically occur on a region of the body that experiences forces from an external structure (e.g. bed, wheelchair). Researchers believe that such forces cause a decrease in blood flow, which results in tissue necrosis, causing pressure ulcers [2].

Reflex regulation of sweat rate by skin temperature in exercising humans

1984 ◽  
Vol 56 (5) ◽  
pp. 1283-1288 ◽  
Author(s):  
J. M. Johnson ◽  
D. S. O'Leary ◽  
W. F. Taylor ◽  
M. K. Park
Keyword(s):  
Blood Flow ◽  
Regression Analysis ◽  
Linear Regression ◽  
Skin Temperature ◽  
Sweat Rate ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Esophageal Temperature ◽  
Reflex Regulation ◽  
Forearm Skin

To find whether sweat rate (SR) and forearm skin blood flow ( SkBF ) were reflexly affected by skin temperature (Tsk) we used water-perfused suits to rapidly elevate Tsk during exercise. With this elevation in Tsk, there was a period of little net change in esophageal temperature (Tes) but marked responses in SR and SkBF . During this period a rise in Tsk of 4.2 +/- 0.3 degrees C was associated with an increase in SR of 0.44 +/- 0.09 mg X cm-2 X min-1 and an increase in SkBF of 3.27 +/- 0.42 ml X 100 ml-1 X min-1. Multiple linear regression analysis as well as comparison with control studies in which Tsk was kept cool also reveal a consistent role for Tsk in the reflex regulation of SR and SkBF . Responses in SR and FBF were much more marked at levels of Tsk below 33 degrees C. Below a Tsk of 33 degrees C, SR rose 0.30 +/- 0.06 mg X cm-2 X min-1 per degrees C rise in Tsk, whereas above 33 degrees SR rose only 0.05 +/- 0.01 mg X cm2 X min per degrees C. FBF rose 2.81 +/- 0.60 and 0.77 +/- 0.18 ml X 100 ml-1 X min-1 per degrees C rise in Tsk at the lower and upper ranges of Tsk, respectively.

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