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INTRODUCTION: Current microvascular assessments may not be practical or accessible requiring experienced personnel and/or ongoing equipment costs. Piezoelectric transducers can reliably obtain finger blood pressure waves, similar to peripheral arterial tonometry devices; thus, they could be used to estimate microvascular function. We aimed to validate piezoelectric transducers as an alternative measure of microvascular function compared to EndoPAT. METHODS: Twenty-five adults (aged 20-64 years) completed reactive hyperemia (5 min forearm circulatory occlusion and 3 min recovery) with piezoelectric transducers on the middle fingers and EndoPAT probes on the index fingers. Average area under the curve (AUC) of the pulse wave signal for the occluded and control arms was determined at baseline, every 30 s post-occlusion, and 10 s around the peak response. Microvascular function index (MFI) was calculated as the ratio of AUC post-occlusion to AUC baseline in the test arm, then normalized to the same ratio in the control arm. MFI at each time point was correlated with the reactive hyperemia index (RHI) from the EndoPAT. RESULTS: The greatest significance was found between RHI and MFI at 10 s around the peak response (Spearman's r = 0.67, p = 0.0002; Pearson's r = 0.76, p = 0.00001). CONCLUSION: MFI is a reusable and user-friendly microvascular function assessment that could provide better access to vascular health screening.
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Análise Custo-Benefício , Desenho de Equipamento , Dedos , Hiperemia , Microcirculação , Valor Preditivo dos Testes , Fluxo Sanguíneo Regional , Humanos , Adulto , Pessoa de Meia-Idade , Masculino , Feminino , Hiperemia/fisiopatologia , Adulto Jovem , Dedos/irrigação sanguínea , Projetos Piloto , Transdutores , Reprodutibilidade dos Testes , Fatores de Tempo , Análise de Onda de Pulso/instrumentação , Velocidade do Fluxo SanguíneoRESUMO
BACKGROUND: Systemic sclerosis (SSc) is a complex autoimmune connective-tissue disease, characterised by vasculopathy and fibrosis of the skin and internal organs. Activation of microvascular endothelial cells (ECs) causes the intimal hyperplasia that characterises the vascular remodelling in SSc. The most frequent complication of SSc is the development of digital ulcers (DUs). Thymic stromal lymphopoietin (TSLP) may trigger fibrosis and sustain vascular damage. Aim of this study was to evaluate the correlation between serum level of TSLP and DUs. METHODS: 75 consecutive SSc patients were enrolled and serum TSLP levels were measured. The presence of history of DUs (HDU) was evaluated. Recurrent new DUs were defined as the presence of at least 3 episodes of DUs in a 12-months follow up period. The risk of developing new DUs was calculated by applying the capillaroscopic skin ulcer risk index (CSURI). RESULTS: The median value of TSLP was higher in patients with HDU than patients without HDU [181.67 pg/ml (IQR 144.67; 265.66) vs 154.67 pg/ml (IQR 110.67; 171.33), p < 0.01]. The median value of TSLP was higher in patients with an increased CSURI index than patients without an increased CSURI [188 pg/ml (IQR 171.33; 246.33) vs 159.33 pg/ml (IQR 128.67; 218), p < 0.01]. Kaplan-Meier curves demonstrated that free survival from new DUs was significantly (p < 0.01) lower in SSc patients with increased TSLP serum levels. CONCLUSION: TSLP might have a key role in digital microvascular damage of SSc patients.
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Biomarcadores , Citocinas , Dedos , Angioscopia Microscópica , Escleroderma Sistêmico , Úlcera Cutânea , Linfopoietina do Estroma do Timo , Humanos , Escleroderma Sistêmico/sangue , Escleroderma Sistêmico/patologia , Feminino , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Citocinas/sangue , Úlcera Cutânea/patologia , Úlcera Cutânea/etiologia , Úlcera Cutânea/sangue , Adulto , Fatores de Risco , Biomarcadores/sangue , Dedos/irrigação sanguínea , Idoso , Microvasos/patologia , Microvasos/metabolismo , Fatores de Tempo , Regulação para Cima , Recidiva , Fibrose , Medição de RiscoRESUMO
OBJECTIVE: Raynaud phenomenon (RP) and digital ulcers (DUs) are the main signs of digital vasculopathy in systemic sclerosis (SSc). Selexipag is an oral prostacyclin agonist approved for SSc-related pulmonary arterial hypertension. Following our previous preliminary short-course report, we herein present long-term data on selexipag safety and efficacy in the treatment of SSc digital vasculopathy. METHODS: Selexipag was administered to patients with SSc with severe digital vasculopathy refractory or with contraindication to all other vasoactive therapies. Each subject was assessed at baseline and after 3, 6, and 12 months. Clinical outcomes related to RP and DUs were evaluated along with modified Rodnan skin score of the fingers. Digital perfusion was assessed by laser speckle contrast analysis (LASCA). Nailfold videocapillaroscopy (NVC) was also performed. RESULTS: Eight patients with SSc (63% female, mean age 50.1 years) received selexipag. After 12 months of treatment, RP was reported to significantly decrease in the number of daily episodes and mean duration (P < 0.001 and P = 0.01, respectively). All patients achieved a complete healing of their DUs (P = 0.03) within 6 months. A progressive reduction of fingers skin score was observed (P = 0.03). No structural changes of capillaries were noted on NVC. Conversely, LASCA revealed an important increase in total digital perfusion (P = 0.004) despite seasonal variability. The safety profile was consistent with that reported in the literature. CONCLUSION: We observed a sustained efficacy of selexipag on SSc digital vasculopathy during 1 year of administration. Our promising results encourage the design of a new randomized controlled trial to evaluate the effect of selexipag on SSc digital vasculopathy.
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Acetamidas , Dedos , Pirazinas , Doença de Raynaud , Escleroderma Sistêmico , Humanos , Feminino , Escleroderma Sistêmico/tratamento farmacológico , Escleroderma Sistêmico/complicações , Masculino , Pessoa de Meia-Idade , Doença de Raynaud/tratamento farmacológico , Doença de Raynaud/etiologia , Dedos/irrigação sanguínea , Resultado do Tratamento , Acetamidas/uso terapêutico , Acetamidas/efeitos adversos , Adulto , Pirazinas/uso terapêutico , Pirazinas/efeitos adversos , Idoso , Úlcera Cutânea/etiologia , Úlcera Cutânea/tratamento farmacológico , Angioscopia Microscópica/métodosRESUMO
INTRODUCTION: There is limited literature on digital ischemia in systemic Lupus erythematosus (SLE). We report the prevalence, associations and outcome of digital infarcts and gangrene from the Indian SLE inception cohort (INSPIRE). METHODS: From the web-based database of INSPIRE, we extracted information for patients with 'Digital Infarct' and 'Digital gangrene' at enrolment into cohort, together considered as critical peripheral ischemia (CPI); all others were controls. We describe the associations of CPI with SLE clinical phenotype, autoantibodies, and disease activity at enrolment. We also report short term outcomes viz. Digital tissue loss and early mortality up to 6 months and recurrence of digital ischemic events in cases till date. RESULTS: Of 2503 SLE patients enrolled into the INSPIRE cohort, we identified 75 (2.9%) patients with CPI, 72 (96%) women and 6 (8%) children. Of them, 55 (73.3%) had digital gangrene and 21 (28%) patients had digital infarcts. Majority of digital gangrene resulted in amputation distal to terminal phalanx (63.6%). Multivariable analysis showed that pulmonary hypertension AOR [6.34 (1.99, 20.2)], coexistent thrombosis AOR [27.8 (15.7, 48.7)], triple antiphospholipid antibody positivity AOR [5.36 (1.67, 16.9)] and the presence of anti-Scl-70-antibody AOR [5.59 (1.86, 16.7)] were more likely while patients with class 3 or 4 lupus nephritis AOR [0.37 (0.15, 0.95)] and anti-nucleosome antibodies AOR [0.47 (0.23, 0.99)] were less likely to be associated with CPI. SLEDAI and short-term mortality were similar between cases and controls. CONCLUSIONS: CPI occurred in a higher proportion (2.9%) of SLE patients in the INSPIRE cohort as compared to earlier reports. Both prothrombotic state and vasculopathy contribute to its occurrence.
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Dedos , Gangrena , Isquemia , Lúpus Eritematoso Sistêmico , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/epidemiologia , Feminino , Masculino , Isquemia/epidemiologia , Adulto , Índia/epidemiologia , Prevalência , Gangrena/epidemiologia , Gangrena/etiologia , Dedos/irrigação sanguínea , Dedos/patologia , Pessoa de Meia-Idade , Adulto Jovem , Criança , Amputação Cirúrgica/estatística & dados numéricos , Estudos de Coortes , Adolescente , Análise Multivariada , Fatores de RiscoRESUMO
PURPOSE: Exposure to cold temperatures decreases finger temperature (Tfing) and dexterity. Decreased manual function and dexterity can be serious safety risks, especially in tasks that require fine motor movements that must be performed outdoors. The aim of this study was to determine whether hand heating with a minimal power requirement (14.8 W) results in a smaller reduction in Tfing and manual dexterity performance during mild cold exposure compared to a non-heated control condition. METHODS: In a randomized crossover design, twenty-two healthy participants were exposed to a moderately cold environment (5 ºC) for 90 min. One condition had no intervention (CON), while the other had the palmar and dorsal hands heated (HEAT) by using electric heating films. Tfing and cutaneous vascular conductance (CVC) were continuously monitored using laser Doppler flowmetry. Manual dexterity performance and cognitive function were assessed by the Grooved Pegboard Test (GPT) and Stroop Color-Word (SCW) test, respectively, during the baseline period and every 30 min during the cold exposure. RESULTS: After the cold exposure, Tfing was higher in HEAT relative to CON (CON 9.8 vs. HEAT 13.7 ºC, p < 0.0001). GPT placing time, as an index of dexterity performance, was also shorter in HEAT by 14.5% (CON 69.10 ± 13.08 vs. HEAT 59.06 ± 7.99 s, p < 0.0001). There was no difference in CVC between the two conditions during the cold exposure (p > 0.05 for all). Cognitive function was similar between two conditions (p > 0.05 for all). CONCLUSION: The proposed hand heating method offers a practical means of heating fingers to maintain dexterity throughout prolonged cold exposure.
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Temperatura Baixa , Mãos , Humanos , Masculino , Feminino , Adulto , Mãos/fisiologia , Dedos/fisiologia , Dedos/irrigação sanguínea , Temperatura Cutânea/fisiologia , Destreza Motora/fisiologia , Adulto Jovem , Calefação/instrumentação , Calefação/métodos , Estudos Cross-Over , Desempenho Psicomotor/fisiologia , Temperatura AltaRESUMO
INTRODUCTION: A common consideration for replantation success is the ischemia time following injury and the preservation temperature. A classic principle within the hand surgery community describes 12 hours of warm ischemia and 24 hours of cold ischemia as the upper limits for digit replantation; however, these limits are largely anecdotal and based on older studies. We aimed to compare survival data from the large body of literature to aid surgeons and all those involved in the replantation process in hopes of optimizing success rates. METHODS: The PubMed database was queried on April 4th, 2023, for articles that included data on digit replantation survival in terms of temperature of preservation and ischemia time. All primary outcomes were analyzed with the Mantel-Haenszel method within a random effects model. Secondary outcomes were pooled and analyzed using the chi-square statistic. Statistical analysis and forest plot generation were completed with RevMan 5.4 software with odds ratios calculated within a 95% confidence interval. RESULTS: Our meta-analysis identified that digits preserved in cold ischemia for over 12 hours had significantly higher odds of replantation success than the amputated digits replanted with 0-12 hours of warm ischemia time ( P ≤ 0.05). The odds of survival in the early (0-6 hours) replantation group were around 40% greater than the later (6-12 hours) replantation group ( P ≤ 0.05). Secondary outcomes that were associated with higher survival rates included a clean-cut amputation, increased venous and arterial anastomosis, a repair that did not require a vein graft, and replants performed in nonsmokers ( P ≤ 0.05). DISCUSSION: Overall, these findings suggest that when predicting digit replantation success, time is of the essence when the digit has yet to be preserved in a cold environment. This benefit, however, is almost completely diminished when the amputated digit is appropriately maintained in a cold environment soon after injury. In conclusion, our results suggest that there is potential for broadening the ischemia time limits for digit replant survival outlined in the literature, particularly for digits that have been stored correctly in cold ischemia.
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Amputação Traumática , Traumatismos dos Dedos , Reimplante , Humanos , Reimplante/métodos , Amputação Traumática/cirurgia , Traumatismos dos Dedos/cirurgia , Fatores de Tempo , Dedos/irrigação sanguínea , Dedos/cirurgia , Isquemia Quente , Isquemia Fria , Isquemia/cirurgia , TemperaturaRESUMO
OBJECTIVE: The purpose of this study is to compare the results of the innervated digital artery perforator (IDAP) flap and the direct-flow homodigital flap as reconstruction methods for fingertip soft tissue amputations. This issue is important in hand surgery, and we aim to identify the method that provides the best functional and cosmetic outcomes. METHODS: Between 2020 and 2022, 32 patients with fingertip amputations were reconstructed by the same surgeon using two different methods. The patients were retrospectively divided into two groups: those who underwent IDAP (n = 14) and those who had a direct-flow homodigital flap (n = 18). We compared the groups in terms of defect size, cold intolerance, venous congestion, Sollerman hand function test scores, Seddon sensory test scores, and follow-up periods, as well as flap viability, flexion contracture, and static two-point discrimination (s2PD). RESULTS: Of the 32 patients (26 men, 6 females; age: mean 28.72 ± 11.5 years), the injuries were caused by different mechanisms, including sharp (57.1% IDAP), crush (75% IDAP) and entanglement (66.7% homodigital). The average area of tissue loss was approximately 2.70 ± 1.37 cm², while the average s2PD measurement was approximately 4.94 ± 1.04 mm. Postoperatively, the Seddon sensory test results for the homodigital flap group were S4 (61.5%), S3 (23.1%), S3+ (7.7%), and S2 (7.7%), compared to the IDAP group, which showed S4 (57.9%), S3+ (21.1%), and S3 (21.1%). Complications occurred in five patients, though no flap loss or revision was required. The postoperative mean Sollerman hand function scores were higher for the homodigital group than for the IDAP group, with values of 75 ± 2.64 and 73 ± 3.34, respectively. Although not statistically significant, the results numerically suggest that the IDAP flap is better in terms of sensory recovery and hand function compared to the homodigital flap (p > 0.05). CONCLUSIONS: This is the first investigation to compare direct-flow flaps with IDAP. The average follow-up period for patients who underwent homodigital surgery was also shorter than that of the IDAP group. Furthermore, the mean postoperative two-point discrimination and postoperative Sollerman function score were higher in patients who had homodigital surgery.
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Traumatismos dos Dedos , Retalho Perfurante , Procedimentos de Cirurgia Plástica , Humanos , Masculino , Feminino , Adulto , Retalho Perfurante/irrigação sanguínea , Retalho Perfurante/inervação , Traumatismos dos Dedos/cirurgia , Estudos Retrospectivos , Procedimentos de Cirurgia Plástica/métodos , Amputação Traumática/cirurgia , Adulto Jovem , Pessoa de Meia-Idade , Retalhos Cirúrgicos/irrigação sanguínea , Retalhos Cirúrgicos/inervação , Lesões dos Tecidos Moles/cirurgia , Adolescente , Resultado do Tratamento , Dedos/inervação , Dedos/irrigação sanguínea , Dedos/cirurgiaRESUMO
OBJECTIVES: Early shock reversal is crucial to improve patient outcomes. Capillary refill time (CRT) is clinically important to identify and monitor shock in children but has issues with inconsistency. To minimize inconsistency, we evaluated a CRT monitoring system using an automated compression device. Our objective was to determine proper compression pressure in children. METHODS: Clinician force for CRT was collected during manual CRT measurement as a reference for automated compression in a previous study (12.9 N, 95% confidence interval, 12.5-13.4; n = 454). An automated compression device with a soft inflation bladder was fitted with a force sensor. We evaluated the effectiveness of the automated pressure to eliminate pulsatile blood flow from the distal phalange. Median and variance of CRT analysis at each pressure was compared. RESULTS: A comparison of pressures at 300 to 500 mm Hg on a simulated finger yielded a force of 5 to 10 N, and these pressures were subsequently used for automated compression for CRT. Automated compression was tested in 44 subjects (median age, 33 months; interquartile range [IQR], 14-56 months). At interim analysis of 17 subjects, there was significant difference in the waveform with residual pulsatile blood flow (9/50: 18% at 300 mm Hg, 5/50:10% at 400 mm Hg, 0/51: 0% at 500 mm Hg, P = 0.008). With subsequent enrollment of 27 subjects at 400 and 500 mm Hg, none had residual pulsatile blood flow. There was no difference in the CRT: median 1.8 (IQR, 1.06-2.875) in 400 mm Hg vs median 1.87 (IQR, 1.25-2.8325) in 500 mm Hg, P = 0.81. The variance of CRT was significantly larger in 400 mm Hg: 2.99 in 400 mm Hg vs. 1.35 in 500 mm Hg, P = 0.02, Levene's test. Intraclass correlation coefficient for automated CRT was 0.56 at 400 mm Hg and 0.78 at 500 mm Hg. CONCLUSIONS: Using clinician CRT measurement data, we determined either 400 or 500 mm Hg is an appropriate pressure for automated CRT, although 500 mm Hg demonstrates superior consistency.
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Capilares , Dedos , Humanos , Dedos/irrigação sanguínea , Masculino , Feminino , Pré-Escolar , Lactente , Capilares/fisiologia , Fluxo Pulsátil/fisiologia , Choque/fisiopatologia , Choque/diagnóstico , Choque/terapia , Criança , Pressão , Monitorização Fisiológica/métodos , Monitorização Fisiológica/instrumentação , AutomaçãoRESUMO
Finger vein recognition methods, as emerging biometric technologies, have attracted increasing attention in identity verification due to their high accuracy and live detection capabilities. However, as privacy protection awareness increases, traditional centralized finger vein recognition algorithms face privacy and security issues. Federated learning, a distributed training method that protects data privacy without sharing data across endpoints, is gradually being promoted and applied. Nevertheless, its performance is severely limited by heterogeneity among datasets. To address these issues, this paper proposes a dual-decoupling personalized federated learning framework for finger vein recognition (DDP-FedFV). The DDP-FedFV method combines generalization and personalization. In the first stage, the DDP-FedFV method implements a dual-decoupling mechanism involving model and feature decoupling to optimize feature representations and enhance the generalizability of the global model. In the second stage, the DDP-FedFV method implements a personalized weight aggregation method, federated personalization weight ratio reduction (FedPWRR), to optimize the parameter aggregation process based on data distribution information, thereby enhancing the personalization of the client models. To evaluate the performance of the DDP-FedFV method, theoretical analyses and experiments were conducted based on six public finger vein datasets. The experimental results indicate that the proposed algorithm outperforms centralized training models without increasing communication costs or privacy leakage risks.
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Algoritmos , Dedos , Veias , Humanos , Dedos/irrigação sanguínea , Dedos/fisiologia , Veias/fisiologia , Aprendizado de Máquina , Identificação Biométrica/métodosRESUMO
Finger vein (FV) biometrics have garnered considerable attention due to their inherent non-contact nature and high security, exhibiting tremendous potential in identity authentication and beyond. Nevertheless, challenges pertaining to the scarcity of training data and inconsistent image quality continue to impede the effectiveness of finger vein recognition (FVR) systems. To tackle these challenges, we introduce the visual feature-guided diamond convolutional network (dubbed 'VF-DCN'), a uniquely configured multi-scale and multi-orientation convolutional neural network. The VF-DCN showcases three pivotal innovations: Firstly, it meticulously tunes the convolutional kernels through multi-scale Log-Gabor filters. Secondly, it implements a distinctive diamond-shaped convolutional kernel architecture inspired by human visual perception. This design intelligently allocates more orientational filters to medium scales, which inherently carry richer information. In contrast, at extreme scales, the use of orientational filters is minimized to simulate the natural blurring of objects at extreme focal lengths. Thirdly, the network boasts a deliberate three-layer configuration and fully unsupervised training process, prioritizing simplicity and optimal performance. Extensive experiments are conducted on four FV databases, including MMCBNU_6000, FV_USM, HKPU, and ZSC_FV. The experimental results reveal that VF-DCN achieves remarkable improvement with equal error rates (EERs) of 0.17%, 0.19%, 2.11%, and 0.65%, respectively, and Accuracy Rates (ACC) of 100%, 99.97%, 98.92%, and 99.36%, respectively. These results indicate that, compared with some existing FVR approaches, the proposed VF-DCN not only achieves notable recognition accuracy but also shows fewer number of parameters and lower model complexity. Moreover, VF-DCN exhibits superior robustness across diverse FV databases.
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Dedos , Redes Neurais de Computação , Humanos , Dedos/fisiologia , Dedos/irrigação sanguínea , Veias/diagnóstico por imagem , Veias/fisiologia , Processamento de Imagem Assistida por Computador/métodos , Algoritmos , Bases de Dados Factuais , Identificação Biométrica/métodosRESUMO
With the development of biometric identification technology, finger vein identification has received more and more widespread attention for its security, efficiency, and stability. However, because of the performance of the current standard finger vein image acquisition device and the complex internal organization of the finger, the acquired images are often heavily degraded and have lost their texture characteristics. This makes the topology of the finger veins inconspicuous or even difficult to distinguish, greatly affecting the identification accuracy. Therefore, this paper proposes a finger vein image recovery and enhancement algorithm using atmospheric scattering theory. Firstly, to normalize the local over-bright and over-dark regions of finger vein images within a certain threshold, the Gamma transform method is improved in this paper to correct and measure the gray value of a given image. Then, we reconstruct the image based on atmospheric scattering theory and design a pixel mutation filter to segment the venous and non-venous contact zones. Finally, the degraded finger vein images are recovered and enhanced by global image gray value normalization. Experiments on SDUMLA-HMT and ZJ-UVM datasets show that our proposed method effectively achieves the recovery and enhancement of degraded finger vein images. The image restoration and enhancement algorithm proposed in this paper performs well in finger vein recognition using traditional methods, machine learning, and deep learning. The recognition accuracy of the processed image is improved by more than 10% compared to the original image.
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Algoritmos , Dedos , Processamento de Imagem Assistida por Computador , Veias , Humanos , Dedos/irrigação sanguínea , Dedos/diagnóstico por imagem , Veias/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Identificação Biométrica/métodos , AtmosferaRESUMO
Pulse oximeters are widely used in hospitals and homes for measurement of blood oxygen saturation level (SpO2) and heart rate (HR). Concern has been raised regarding a possible bias in obtaining pulse oximeter measurements from different fingertips and the potential effect of skin pigmentation (white, brown, and dark). In this study, we obtained 600 SpO2 measurements from 20 volunteers using three UK NHS-approved commercial pulse oximeters alongside our custom-developed sensor, and used the Munsell colour system (5YR and 7.5YR cards) to classify the participants' skin pigmentation into three distinct categories (white, brown, and dark). The statistical analysis using ANOVA post hoc tests (Bonferroni correction), a Bland-Altman plot, and a correlation test were then carried out to determine if there was clinical significance in measuring the SpO2 from different fingertips and to highlight if skin pigmentation affects the accuracy of SpO2 measurement. The results indicate that although the three commercial pulse oximeters had different means and standard deviations, these differences had no clinical significance.
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Dedos , Oximetria , Saturação de Oxigênio , Pigmentação da Pele , Humanos , Oximetria/métodos , Oximetria/instrumentação , Pigmentação da Pele/fisiologia , Dedos/irrigação sanguínea , Dedos/fisiologia , Saturação de Oxigênio/fisiologia , Masculino , Adulto , Feminino , Oxigênio/sangue , Oxigênio/metabolismo , Frequência Cardíaca/fisiologia , Adulto JovemRESUMO
PURPOSE: Though the finger is generally recommended for pulse oxygen saturation (SpO2) monitoring site, its reliability may be compromised in conditions of poor peripheral perfusion. Therefore, we compared the performance of nasal septum SpO2 monitoring with finger SpO2 monitoring relative to simultaneous arterial oxygen saturation (SaO2) monitoring in generally anesthetized patients. METHODS: In 23 adult patients, comparisons of SpO2 measured at the nasal septum and finger with simultaneous SaO2 were made at four time points during the 90 min study period. A pulse oximetry monitoring failure was defined as a > 10 s continuous failure of in an adequate SpO2 data acquisition. Core temperature as well as finger-tip and nasal septum temperatures were simultaneously measured at 10 min intervals. RESULTS: A total of 92 sets of SpO2 and SaO2 measurements were obtained in 23 patients. The bias and precision for SpO2 measured at the nasal septum were - 0.8 ± 1.3 (95% confidence interval: - 1.1 to - 0.6), which was similar to those for SpO2 measured at the finger (- 0.6 ± 1.4; 95% confidence interval: - 0.9 to - 0.4) (p = 0.154). Finger-tip temperatures were consistently lower than other two temperatures at all time points (p < 0.05), reaching 33.5 ± 2.3 °C at 90 min after induction of anesthesia. While pulse oximetry monitoring failure did not occur for nasal septum probe, two cases of failure occurred for finger probe. CONCLUSIONS: Considering the higher stability to hypothermia with a similar accuracy, nasal septum pulse oximetry may be an attractive alternative to finger pulse oximetry. Trail registration This study was registered with Clinical Research Information Service (CRIS: https://cris.nih.go.kr/cris/en/ ; ref: KCT0008352).
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Anestesia Geral , Dedos , Septo Nasal , Oximetria , Saturação de Oxigênio , Humanos , Oximetria/métodos , Oximetria/instrumentação , Dedos/irrigação sanguínea , Masculino , Feminino , Anestesia Geral/métodos , Pessoa de Meia-Idade , Septo Nasal/cirurgia , Adulto , Saturação de Oxigênio/fisiologia , Temperatura Corporal/fisiologia , Monitorização Intraoperatória/métodos , Monitorização Intraoperatória/instrumentação , Idoso , Reprodutibilidade dos Testes , Oxigênio/sangueRESUMO
OBJECTIVE: To assess the changes in blood vessel stiffness and digital pulse wave amplitude because of flowmediated dilatation, and to explore how these two variables change when endothelial dysfunction is experimentally induced. METHODS: The experimental study was conducted at the departments of physiology at the College of Medicine, Mustansiriyah University, and the College of Medicine, Al-Iraqia University, Baghdad, Iraq, from October 14, 2021, to May 31, 2022, and comprised healthy young males who were subjected to the flow-mediated dilatation technique on the left brachial artery. Pulse transit time and the amplitude of the digital pulse wave were measured during reactive hyperaemia for 2.5 minutes from the left middle finger using a piezoelectric pressure sensor and a simultaneous Lead I electrocardiogram. Endothelial dysfunction (ED) was induced by oscillatory and retrograde shear rates. The correlation between variables was calculated in Excel running on the Windows operating system. RESULTS: There were 10 second-year medical students with mean age 22±0 years and mean body mass index 25.7±4.8kg/m2. During reactive hyperaemia, pulse transit time was significantly increased by 3-5% in both normal endothelium and experimentally induced endothelial dysfunction relative to the pre-occluded artery, and the difference was not significant (p>0.05). Digital pulse wave amplitude increased significantly in normal endothelium relative to the pre-occluded artery (p<0.05), but not in experimentally-induced endothelial dysfunction (p>0.05). CONCLUSIONS: The pulse transit time and digital pulse wave amplitudes of the photo plethysmography signal may be used to detect changes in vessel wall diameter and tone throughout the reactive hyperaemia process. Digital pulse wave amplitude was better able to detect experimentally-induced endothelial dysfunction, as assessed by the flowmediated dilatation protocol, than pulse transit time.
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Artéria Braquial , Dedos , Pletismografia , Análise de Onda de Pulso , Humanos , Masculino , Análise de Onda de Pulso/métodos , Adulto Jovem , Dedos/irrigação sanguínea , Artéria Braquial/fisiologia , Artéria Braquial/fisiopatologia , Pletismografia/métodos , Endotélio Vascular/fisiopatologia , Endotélio Vascular/fisiologia , Vasodilatação/fisiologia , Hiperemia/fisiopatologia , Rigidez Vascular/fisiologia , AdultoRESUMO
OBJECTIVE: Cold sensitivity of the fingers is common in several conditions. It has been linked to digital vasospasm, microvascular dysfunction, and neural mechanisms. This study aimed to investigate the normal digital microvascular response to a cold stress test in healthy individuals using Laser Speckle Contrast Imaging (LSCI). METHODS: Twenty-six healthy individuals, mean age 31 (SD 9) years were included. Skin perfusion of digits II-V was measured using Laser Speckle Contrast Imaging before and after a standardized cold stress test. Changes in skin perfusion from baseline were analyzed between hands, digits, and sexes. RESULTS: Skin perfusion was significantly (p < 0.0001) affected by cold provocation in both the cold exposed and the contralateral hands in all participants of the study. This effect was significantly different between the radial (digit II and III) and the ulnar (digit V) side of the hands (p < 0.001). There was a trend towards a larger decrease in perfusion in men (ns), and a faster recovery to baseline values in women (ns). A larger inter subject variability was seen in perfusion values in women. CONCLUSIONS: The normal microvascular response to cold provocation may involve both centrally and regionally mediated processes. When exposing one hand to a cold stress test, the contralateral hand responds with simultaneous but smaller decreases in perfusion.
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Resposta ao Choque Frio , Mãos , Masculino , Humanos , Feminino , Adulto , Microcirculação , Dedos/irrigação sanguínea , Pele/irrigação sanguínea , Temperatura Baixa , Fluxometria por Laser-Doppler/métodosRESUMO
Vibration exposure from handheld tools can affect the hands with neurological symptoms and vibration-induced Raynaud's phenomenon (VRP). The underlying pathophysiological mechanisms are not fully known, however, changes in the composition of blood parameters may contribute to VRP with an increase in blood viscosity and inflammatory response. The aim of this study was to examine the effect on blood parameters in capillary blood from fingers that had been exposed to a vibrating hand-held tool. This study involved nine healthy participants who had been exposed to vibration and an unexposed control group of six participants. Capillary blood samples were collected before and after vibration exposure for the exposed group, and repeated samples also from the control group. The exposed groups were exposed to vibration for a 15-min period or until they reached a 5.0 m/s2 vibration dose. Analysis of blood status and differential counting of leucocytes was performed on the capillary blood samples. The results of the blood samples showed an increase in mean value for erythrocyte volume fraction (EVF), hemoglobin, red blood cell count, white blood cell count and neutrophils, as well as a decrease of mean cell volume, mean cell hemoglobin, and mean cell hemoglobin concentration. The increase of EVF and neutrophils was statistically significant for samples taken from the index finger but not the little finger. Even though the study was small it showed that an acute vibration exposure to the hands might increase EVF and neutrophilic granulocytes levels in the capillary blood taken from index fingers.
Assuntos
Doenças Profissionais , Doença de Raynaud , Humanos , Vibração , Dedos/irrigação sanguínea , Eritrócitos , Doença de Raynaud/diagnóstico , LeucócitosRESUMO
Raynaud's phenomenon (RP) is characterized by episodic vasospasm in peripheral vessels and ischemia of the fingers. Venous arterialization is thought to induce neovascularization and increased oxygen tension. In this report, we describe a patient with RP in the fingers of both hands in whom venous arterialization achieved an acceptable result in both hands. The patient was a 62-year-old woman with a 10-year history of worsening pain and cold sensation in the tips of the index, middle, ring, and little fingers on both sides. The venous arterialization procedure was performed on both hands simultaneously at the level of the anatomical snuff box between radial artery and cephalic vein in dorsal hand. There was no need for valvectomy in the level of hands. To prevent development of the steal phenomenon in the arterialized veins, the superficial basilic and median veins of the forearm were ligated via 1 cm skin incisions. The pain and cold sensation in the fingertips of both hands remained decreased, and the nonhealing ulcers on the fingertips healed without the need for amputation. The observation period was 14 months, and the surface temperature of the fingers was increased after venous arterialization, as was the temperature of the palm and forearm. There was no problem when administering intravenous infusion into the forearm on either side postoperatively. The case showed venous arterialization was effective for RP without increasing intravenous pressure in the affected limb, and further investigation is necessary.
Assuntos
Mãos , Doença de Raynaud , Feminino , Humanos , Pessoa de Meia-Idade , Mãos/cirurgia , Veias/cirurgia , Dedos/irrigação sanguínea , Dor/etiologia , Artéria Radial/cirurgia , Doença de Raynaud/etiologia , Doença de Raynaud/cirurgiaRESUMO
Prosthetic attack is a problem that must be prevented in current finger vein recognition applications. To solve this problem, a finger vein liveness detection system was established in this study. The system begins by capturing short-term static finger vein videos using uniform near-infrared lighting. Subsequently, it employs Gabor filters without a direct-current (DC) component for vein area segmentation. The vein area is then divided into blocks to compute a multi-scale spatial-temporal map (MSTmap), which facilitates the extraction of coarse liveness features. Finally, these features are trained for refinement and used to predict liveness detection results with the proposed Light Vision Transformer (Light-ViT) model, which is equipped with an enhanced Light-ViT backbone, meticulously designed by interleaving multiple MN blocks and Light-ViT blocks, ensuring improved performance in the task. This architecture effectively balances the learning of local image features, controls network parameter complexity, and substantially improves the accuracy of liveness detection. The accuracy of the Light-ViT model was verified to be 99.63% on a self-made living/prosthetic finger vein video dataset. This proposed system can also be directly applied to the finger vein recognition terminal after the model is made lightweight.
Assuntos
Dedos , Veias , Dedos/irrigação sanguínea , Veias/diagnóstico por imagemRESUMO
The need for contactless vascular biometric systems has significantly increased. In recent years, deep learning has proven to be efficient for vein segmentation and matching. Palm and finger vein biometrics are well researched; however, research on wrist vein biometrics is limited. Wrist vein biometrics is promising due to it not having finger or palm patterns on the skin surface making the image acquisition process easier. This paper presents a deep learning-based novel low-cost end-to-end contactless wrist vein biometric recognition system. FYO wrist vein dataset was used to train a novel U-Net CNN structure to extract and segment wrist vein patterns effectively. The extracted images were evaluated to have a Dice Coefficient of 0.723. A CNN and Siamese Neural Network were implemented to match wrist vein images obtaining the highest F1-score of 84.7%. The average matching time is less than 3 s on a Raspberry Pi. All the subsystems were integrated with the help of a designed GUI to form a functional end-to-end deep learning-based wrist biometric recognition system.
Assuntos
Aprendizado Profundo , Punho , Punho/diagnóstico por imagem , Punho/irrigação sanguínea , Mãos/irrigação sanguínea , Biometria , Dedos/irrigação sanguíneaRESUMO
This research work focuses on a Near-Infra-Red (NIR) finger-images-based multimodal biometric system based on Finger Texture and Finger Vein biometrics. The individual results of the biometric characteristics are fused using a fuzzy system, and the final identification result is achieved. Experiments are performed for three different databases, i.e., the Near-Infra-Red Hand Images (NIRHI), Hong Kong Polytechnic University (HKPU) and University of Twente Finger Vein Pattern (UTFVP) databases. First, the Finger Texture biometric employs an efficient texture feature extracting algorithm, i.e., Linear Binary Pattern. Then, the classification is performed using Support Vector Machine, a proven machine learning classification algorithm. Second, the transfer learning of pre-trained convolutional neural networks (CNNs) is performed for the Finger Vein biometric, employing two approaches. The three selected CNNs are AlexNet, VGG16 and VGG19. In Approach 1, before feeding the images for the training of the CNN, the necessary preprocessing of NIR images is performed. In Approach 2, before the pre-processing step, image intensity optimization is also employed to regularize the image intensity. NIRHI outperforms HKPU and UTFVP for both of the modalities of focus, in a unimodal setup as well as in a multimodal one. The proposed multimodal biometric system demonstrates a better overall identification accuracy of 99.62% in comparison with 99.51% and 99.50% reported in the recent state-of-the-art systems.