Evaluation of Local Skeletal Muscle Blood Flow in Manipulative Therapy by Diffuse Correlation Spectroscopy

Manipulative therapy (MT) is applied to motor organs through a therapist’s hands. Although MT has been utilized in various medical treatments based on its potential role for increasing the blood flow to the local muscle, a quantitative validation of local muscle blood flow in MT remains challenging due to the lack of appropriate bedside evaluation techniques. Therefore, we investigated changes in the local blood flow to the muscle undergoing MT by employing diffuse correlation spectroscopy, a portable and emerging optical measurement technology that non-invasively measures blood flow in deep tissues. This study investigated the changes in blood flow, heart rate, blood pressure, and autonomic nervous activity in the trapezius muscle through MT application in 30 volunteers without neck and shoulder injury. Five minutes of MT significantly increased the median local blood flow relative to that of the pre-MT period (p < 0.05). The post-MT local blood flow increase was significantly higher in the MT condition than in the control condition, where participants remained still without receiving MT for the same time (p < 0.05). However, MT did not affect the heart rate, blood pressure, or cardiac autonomic nervous activity. The post-MT increase in muscle blood flow was significantly higher in the participants with muscle stiffness in the neck and shoulder regions than in those without (p < 0.05). These results suggest that MT could increase the local blood flow to the target skeletal muscle, with minimal effects on systemic circulatory function.

Correlation of Caesarean Section Rates to Maternal and Neonatal Mortality in the Eastern Mediterranean Region; A Population-Based Ecological Study

The physiological reaction of postocclusive local reactive hyperemia is regulated by neurovascular mechanisms and it reflects the function of microcirculation. Thermoregulatory changes occur first, in the form of increased skin surface temperature, which is usually followed by an increase in local blood flow. This study investigated a correlation between tourniquet duration on the upper arm, and the appearance of reactive hyperemia in the distal parts of the upper limb. Changes were registered with infrared thermometer and infrared thermography, which provided us a highly precise view of distribution of reactive hyperemia. Changes of oxygen saturation of peripheral arterial blood and blood pressure were also recorded. Our research has shown that longer duration of tourniquet leads to more intense and longer lasting reactive hyperemia in the palmar region, followed by higher temperatures of the skin surface, without any changes in postocclusive values of SpO2. Keywords: Infrared thermography, Microcirculation, Postocclusive hyperemia, Skin temperature, Tourniquet, Thermoregulatory changes.

Imaging microvasculature network evolution and neurodegeneration with precise photothrombosis approach

In the cerebral cortex, the vasculature plays important homeostatic functions, especially at the highly connected complex capillary networks. The association of focal capillary ischemia with the neurodegenerative disease as well as the laminar vascular dynamics have prompted studies of vascular micro-occlusion via photothrombosis. However, technical challenges of this approach remain, including increased temporal precision of occlusion, increasing the depth of vascular occlusion, understanding how such micro-occlusion impacts local blood flow, and ultimately the neuronal effects of such changes. Here, we have developed a novel approach that employs ultra-fast multiphoton light to induce focal Rose Bengal-induced photothrombosis. We demonstrated induction of highly precise and fast occlusion of microvessels at various types and depths. The change of the microvascular architecture and hemodynamics after occlusion revealed the autoregulation and significant difference between upstream vs downstream in layer 2/3. Further, we found that micro-occlusion at two different layers within the same vascular arbor results in distinct effects on the acute flow redistribution mechanism. To examine neuronal effects of such micro-occlusion, we produced infarct of capillaries surrounding a labeled target neuron and found this induces dramatic and rapid lamina-specific degeneration in neuronal dendritic architecture. In sum, our technique enhanced the precision and power of the photothrombotic study of microvascular function. The current results pointed to the importance of laminar scale regulation within the microvascular network, a finding which may be relevant for models of neurovascular disease.

The Relationship Between Blood Perfusion in the Lower Extremities and Heart Rate Variability at Different Positions

Previous studies have explored the relationship between the complexity of local blood flow signals and heart rate variability (HRV) under different thermal stimulations. However, the relationship between the complexity of local blood flow signals and HRV in different positions is not clear. In this study, healthy participants were placed in different body positions. The bilateral blood flux and ECG were monitored, and refined composite multiscale entropy (RC MSE) and refined composite multiscale fuzzy entropy (RC MFE) were used to measure the complexity of the local blood flux. The sample entropy was calculated to evaluate the HRV complexity. The change of body position did not affect the time domain or frequency domain of HRV, but did reverse the blood flux laterality of the lower extremities. Furthermore, there was a negative correlation between the complexity of right-side blood flux and sample entropy of HRV when the participant was in the -10 degrees position. These results provide a new perspective of the relationship between skin blood flux signals and cardiac function.

Smart Monitoring Pad for Prediction of Pressure Ulcers with an Automatically Activated Integrated Electro-Therapy System

Pressure ulcers (PU) are deep scars on the skin that cause pain, infections and severe health complications. Most movement-impaired subjects are vulnerable to PU, leading to permanent and irreversible skin damage. The system proposed in this paper aims to prevent PU formation with the design and implementation of a wirelessly controlled device that predicts PUs before their occurrence and attempts to prevent it using therapeutic feedback. A flexible pad that consists of multiple types of sensors is used, theses sensors continuously and non-invasively monitor ulcer-related vital signs in vulnerable areas, and uses these data to predict PU with a decision-making process. When PU is detected an electrical stimulation (ES) unit is automatically activated. Stimulation prevents PU formation by increasing local blood flow to the simulated area and eliminating the main factor that leads to PU formation. The system successfully monitored and predicted PU; tests were performed on three healthy volunteers and one volunteer with sacral ulcers. Results including readings of blood oxygenation, force, humidity and temperature were recorded as graphs to monitor decay/increase in values more efficiently.

Effect of Glabridin on Microvascular Permeability of Plasma Proteins Induced by Carrageenan

In the present study, investigate the anti-inflammatory effects of glabridin (GLA) in the carrageenan-induced paw edema test of rats. Inflammation is an answer to the body's immune response to various stimuli such as physical trauma, various antigens, chemicals, microorganisms, radiation-damaged tissues. The cause of this edema is the increase of vascular permeability, an increase in local blood flow, as well as the penetration of neutrophils and macrophages into the inflamed tissue. The current study aimed to determine the mechanism of microvascular leakage on carrageenan (CAR)-induced paw edema of GLA. Therefore, 10, 20 and 40 mg / kg doses of GLA were given intraperitoneal 3 days before intraplantar administration of CAR by using Evans blue (EB) method and by measuring paw thickness with electronic digital calipers. As a result, GLA inhibited both edema and microvascular leak. The results of our study suggest that pretreat-GLA to CAR-induced paw edema of rats via anti-inflammatory potential through inhibition of parameters such as microvascular escape and anti-edematous effect. These findings may be a new treatment of inflammation by anti-protein leakage of GLA.

Influence of Inosine on Cerebral Hemodynamics in Space Motion Sickness in Experimental Animals

Background: Motion sickness occurs worldwide in healthy individuals regardless of age, ethnicity, or gender. It is an acute disorder, it can also present as a chronic disorder in some individuals. Motion sickness not only includes vomiting and nausea, besides this, it includes other features such as pallor of varying degrees, cold sweating, headache, drowsiness, increased salivation, and cranial pain which is severe. Some of the other assessment scales can interpret sickness on exposure to virtual or visual stimulation and while travelling in different types of transport. Aim: The aim our research is to study the effect of the drug on the level of blood flow and vascular reactivity of cerebral vessels when simulating changes in cerebral circulation in terrestrial conditions characteristic of hypogravity. Methods: Chronic experiments were performed on non-anesthetized rabbits with large hemispheres, thalamus and hypothalamus were implanted with the needle-platinum electrodes 150 mm in diameter in the cortex, and local blood flow and vascular reactivity were recorded accordingly. Cerebrovascular disturbances were modeled using a MSAOP (motion sickness of animals in the anti-orthostatic position) with an inclined angle of 45 ° for 2 hours. Local blood flow (BF) was measured in ml/min/100 g of tissue by the method of registration of hydrogen clearance. The vasodilator coefficient of reactivity (CrCO2) was calculated by the ratio of BF against the background of inhalation of a mixture of 7% CO2 with air to the initial BF; vasoconstrictor - in relation to BF on the background of inhalation of 100% O2 to the initial BF (CrO2). A series of experiments was carried out with different routes of drug administration: First, inosine was administered intravenously at a dose of 5 mg/kg immediately before the start of SMS modeling, Same dose per oral was administered 30 minutes before the start of exposure. As a control, we used the results of experimental animals under similar conditions without the administration of the drugs. Results: Inosine has pronounced protective properties in cerebrovascular disorders on the background of space motion sickness (SMS) modeling, which is manifested by normalization of BF and restoration of compensatory reactions of cerebral vessels. In the mechanism of cerebroprotective action of inosine, it is able to correct the metabolic processes which plays an important role and helps to increase the compensatory capabilities and functional stability of the cerebrovascular system under gravitational influences. Conclusion: When using inosine per orally, the effects are more pronounced than when administered intravenously, which should be taken into account when using it for the prevention of cerebrovascular disorders in extreme conditions.

NEUROINFLAMMATION

Inflammation is a complex process, mediated by cellular and molecular mechanisms caused by a response to a tissue damage from an aggressive agent, whether if biological, chemical or physical origin. This process occurs, ultimately, with the purpose of promoting defense, repair and tissue regeneration. The inflammatory process leads to changes in blood vessels that have their diameter and flow altered, with the objective of leading to increased vascular permeability and consequent leakage of fluids and cells into the extracellular space of the affected tissue. This sequence of events generates the cardinal signs of inflammation, which are: pain, heat, redness, edema, with loss or alteration of function. The process occurs through mechanisms induced by cytokines and that despite having local manifestation, it can lead to systemic responses involving the whole organism with fever, chills, tremors, tachycardia, leukocytosis, sweating, diuresis and blood dyscrasias. In the cascade of events related to inflammation, there is initially a local stimulus that promotes morphological and functional changes in the attacked tissue that trigger the release of signaling molecules, the defensins that have a chemotactic effect on monocytes, neutrophils and lymphocytes, and pro-inflammatory mediators. that are directly involved in the next inflammatory phases. There is, then, the recognition of aggression and the aggressor agent by the receptors of cells of the immune system and release of inflammatory mediators, of the cyclooxygenase pathway that will release prostaglandin, prostacyclins and thromboxanes and by the lipooxygenase pathway that will produce leukotrienes (Figure 1). Then, there is a modification of the local microcirculation promoting vasodilation, initially arteriolar and subsequently of the venules by the action of histamine release by mast cells, and associated with an increase in local blood flow, generate the cardinal flushing and heat signals.

Proactive Body Temperature Management Protocol and Lifestyle Interventions as Predictable Cures for COVID-19 Disease: Curative Protocols Discovered from a Century of Medical Discoveries

Based on a century of medical discoveries, we propose a methodology of using lifestyle interventions and proactive body temperature management protocol as prevention and cure for COVID-19 disease. We produce robust evidence to show that lifestyle interventions have a 100% “expected response rate”, with a curative power being one to three orders of magnitude larger than that of a single lifestyle factor determined by clinical trials and can deliver immediate benefits to long-term curative benefits. On basis of a large number of studies, we propose that the local blood flow along the inner surface of the respiratory track works like an anti-viral shield, which is capable of robustly prevent and terminate viral and other infections. Breathing cold temperature from 26 °C to a frigid temperature can dramatically reduce local temperatures along the track and thus cripples the protective shield by reducing local blood flow to as little as 3-10%. A proactive body temperature management protocol (PBTM or PRTPM), which comprises pre-exposure, during-exposure, and post-exposure measures, are capable of boosting innate immune functions, anti-viral defenses, and vital organ functions. We estimate that pre-exposure and during-exposure measures can reduce temperature drops along the tract by 5°C to 20 °C, and that a series of post-exposure measures can increase local blood flow rates along the track by 2 to 20 times. The proposed measures can completely restore the anti-viral shield. All kinds epidemiological data support our estimated curative power that the protocol can prevent 90% to 97% infection incidences and deaths. We show that the protocol is even more powerful than vaccine, and maintaining a reasonable local temperature along the respiratory track is a required condition for delivering and boosting vaccine’s protection.Current medical researches have excluded temperature and air as treatments in all on-going clinical trials. This misplaced priority is an inevitable result of the financial arrangement of all parties in medicine. Such financial arrangement provides too much incentive for medicalization, the key elements of which include finding revenue-making treatments, producing good data for promoting the treatments, and finding more patients for using treatments. Since lifestyle interventions and proactive body temperature management protocol cannot be studied by flawed research model and cannot be patented for monopoly, no entity has incentives to explore their extraordinary benefits. We also found that the reason of failure to contain the COVID-19 pandemic is same as failure to find cures for cancer and AIDS. Several studies imply that best solutions for cancer, AIDS and all chronic diseases are not revenue-generating medical treatments, but things that cannot sold for revenues and things that are born and carried in human genome. Based on a century of medical discoveries in disease causes, we propose for the federal government that the most cost-effective measures are finding and eliminating a large number of disease causes hidden in food production lines, family kitchens, cooking culture, personal cooking habits, home appliances, etc. This is the only way to root out causes for more than 90% chronic diseases incidences.