Evaluation of changes in laser Doppler flowmetry indices in patients with a combined subtype of rosacea under the influence of a course of complex phototherapy

BACKGROUND: The development of new methods for the treatment of rosacea, as well as a combination of various methods of physiotherapy, is of scientific and practical interest. In this work, the assessment of changes in microcirculation indices under complex phototherapy has been carried out. AIMS: Тo assess changes in microcirculation indices in patients with a combination of rosacea subtypes according to laser Doppler flowmetry under a course of complex phototherapy. MATERIAL AND METHODS: In 20172020 a randomized controlled study of 130 patients with a combination of rosacea subtypes. All patients were divided into 4 groups. In each separate group, laser therapy and 1% metronidazole cream were used (group I); phototherapy and 1% metronidazole cream (group II); complex photolaser therapy and 1% metronidazole cream (group III); in the comparison group (group IV), patients show only 1% metronidazole cream. The treatment, the duration of which was 3 months, included 6 sessions with an interval of 2 weeks. The effectiveness of therapy was assessed according to the data of laser Doppler flowmetry, reflecting changes in the hemodynamics of the microvasculature in the affected skin areas. RESULTS: The developed complex method, including exposure to intense pulsed light (intense pulsed light, IPL) 5201100 nm in combination with submillisecond neodymium laser radiation 1064 nm (submilisecond Nd: YAG laser 1064 nm) and daily application of 1% metronidazole cream showed the most pronounced improvement in the state of microcirculation according to laser Doppler flowmetry in comparison with the rest groups. Against the background of the course of complex phototherapy for all patients with the combined subtype of rosacea, statistically significant changes were in the volume of blood flow, modulation coefficients, coefficient of variation. On the contrary, no statistically significant changes were found in the ranges corresponding to active regulatory factors endothelial, neurogenic, myogenic, and passive respiratory and cardiac, as well as in the T index. CONCLUSION: After the course of complex phototherapy in the group of patients with a combination of rosacea subtypes, there was a decrease in the severity of clinical manifestations of diseases, as well as an improvement in the main indicators of microcirculation according to laser Doppler flowmetry.

Assessment of the dynamics of indicators of morphological and functional characteristics of the skin in patients with the combined subtype of rosacea under the influence of complex phototherapy

Rosacea is a common chronic inflammatory dermatosis of vascular origin, characterized by a lesion of the face skin in the form of erythema and papulopustular elements. Taking into account the new research devoted to the treatment of rosacea, it is of scientific and practical interest to develop new methods for the treatment of this dermatosis using complex physiotherapy approaches and their synergy, for example, IPL radiation (without the use of photo filters) and submilisecond neodymium 1,064nm laser radiation. Material and methods. The study included 130patients with the combined subtype of rosacea (CSR) with varying degrees of severity of ETR and PPR. In order to study the effectiveness of complex photo- and laser therapy of CSR, all patients were divided into 4groups by simple randomization (envelope method). The treatment of the patients in each separate group included: group I — laser therapy and 1% metronidazole cream; group II — phototherapy and 1% metronidazole cream; group III — complex photo-laser therapy and 1% metronidazole cream; group IV — comparison group, patients received only 1% metronidazole cream. This work takes into account the synergism of both physiotherapeutic effects provided by non-truncated (without the use of photo filters) IPL radiation and submilisecond neodymium 1,064 nm laser radiation, as well as the increased destruction of pathologically altered vessels observed during the sequential use of both procedures, and the developed original method of treating patients with CSR. Conclusion. Based on the obtained results, it was concluded that the maximum improvement in the morphofunctional parameters of the skin was in the third group of patients with CSR. The increase in the hydration index of the skin exceeded the indicators of the other groups of patients with CSR. Also, the intensity of sebum production decreased most significantly. There was a maximum narrowing of the excretory ducts of the sebaceous glands, while in the other groups, the narrowing of the excretory ducts of the sebaceous glands occurred to a lesser and equal extent. Such changes reflect the pronounced effect of complex phototherapy on the tone of the sphincter of the excretory duct, the intensity of sebum production, as well as on the synthesis of collagen and elastin, which is reflected in the maximum approximation to the indicators of the group of healthy volunteers of such characteristics as «hydration» and «smoothness».

Assessment of the dynamics of indicators of morphological and functional characteristics of the skin in patients with the combined subtype of rosacea under the influence of complex phototherapy

Rosacea is a common chronic inflammatory dermatosis of vascular origin, characterized by a lesion of the face skin in the form of erythema and papulopustular elements. Taking into account the new research devoted to the treatment of rosacea, it is of scientific and practical interest to develop new methods for the treatment of this dermatosis using complex physiotherapy approaches and their synergy, for example, IPL radiation (without the use of photo filters) and submilisecond neodymium 1,064 nm laser radiation. Material and methods: The study included 130 patients with the combined subtype of rosacea (CSR) with varying degrees of severity of ETR and PPR. In order to study the effectiveness of complex photo- and laser therapy of CSR, all patients were divided into 4 groups by simple randomization (envelope method). The treatment of the patients in each separate group included: group I — laser therapy and 1% metronidazole cream; group II — phototherapy and 1% metronidazole cream; group III — complex photo-laser therapy and 1% metronidazole cream; group IV — comparison group, patients received only 1% metronidazole cream. This work takes into account the synergism of both physiotherapeutic effects provided by non-truncated (without the use of photo filters) IPL radiation and submilisecond neodymium 1,064 nm laser radiation, as well as the increased destruction of pathologically altered vessels observed during the sequential use of both procedures, and the developed original method of treating patients with CSR. Conclusion: Based on the obtained results, it was concluded that the maximum improvement in the morphofunctional parameters of the skin was in the third group of patients with CSR. The increase in the hydration index of the skin exceeded the indicators of the other groups of patients with CSR. Also, the intensity of sebum production decreased most significantly. There was a maximum narrowing of the excretory ducts of the sebaceous glands, while in the other groups, the narrowing of the excretory ducts of the sebaceous glands occurred to a lesser and equal extent. Such changes reflect the pronounced effect of complex phototherapy on the tone of the sphincter of the excretory duct, the intensity of sebum production, as well as on the synthesis of collagen and elastin, which is reflected in the maximum approximation to the indicators of the group of healthy volunteers of such characteristics as «hydration» and «smoothness».

Specific cognitive–neurophysiological processes predict impulsivity in the childhood attention-deficit/hyperactivity disorder combined subtype

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent neuropsychiatric disorders in childhood. Besides inattention and hyperactivity, impulsivity is the third core symptom leading to diverse and serious problems. However, the neuronal mechanisms underlying impulsivity in ADHD are still not fully understood. This is all the more the case when patients with the ADHD combined subtype (ADHD-C) are considered who are characterized by both symptoms of inattention and hyperactivity/impulsivity.MethodCombining high-density electroencephalography (EEG) recordings with source localization analyses, we examined what information processing stages are dysfunctional in ADHD-C (n = 20) compared with controls (n = 18).ResultsPatients with ADHD-C made more impulsive errors in a Go/No-go task than healthy controls. Neurophysiologically, different subprocesses from perceptual gating to attentional selection, resource allocation and response selection processes are altered in this patient group. Perceptual gating, stimulus-driven attention selection and resource allocation processes were more pronounced in ADHD-C, are related to activation differences in parieto-occipital networks and suggest attentional filtering deficits. However, only response selection processes, associated with medial prefrontal networks, predicted impulsive errors in ADHD-C.ConclusionsAlthough the clinical picture of ADHD-C is complex and a multitude of processing steps are altered, only a subset of processes seems to directly modulate impulsive behaviour. The present findings improve the understanding of mechanisms underlying impulsivity in patients with ADHD-C and might help to refine treatment algorithms focusing on impulsivity.

Planning Skills of Adolescents With ADHD

Objective: This study assesses planning skills of adolescents with ADHD using a multi-method assessment and explores subtype differences between inattentive and combined subtypes. Method: One hundred fifteen adolescents with ADHD and 34 typically developing controls completed subtests of the Delis–Kaplan Executive Function System (D-KEFS), Behavioral Assessment of the Dysexecutive Syndrome (BADS), and Behavior Rating Inventory of Executive Function (BRIEF). Results: No group differences were found on the D-KEFS. The BADS Zoo Map test showed longer completion times in the inattentive than in the combined subtype and controls. The BRIEF showed more planning problems in adolescents with ADHD (both subtypes) than in controls, with the combined subtype showing most problems on overall executive functioning. Conclusion: Only a proportion of adolescents with ADHD shows planning deficits. To capture these planning problems in adolescents with ADHD, it seems important to use multiple measures of planning, both ratings and “less structured” neurocognitive measures of planning.