Intra- and Inter-rater Reliability of Peripheral Arterial Blood Flow Velocity by Means of Doppler Ultrasound.

OBJECTIVE: Although it is possible to find studies that analyze the velocity of blood flow in different arteries, the reliability of Doppler ultrasound on peripheral arteries has not yet been completely established. Our objective was to evaluate intra- and inter-rater reliability of the measurement of blood flow velocity by Doppler ultrasound of brachial, radial, popliteal, and posterior tibial arteries. METHODS: Fifty healthy individuals of both genders, aged between 18 and 45 years, were included in the study. For the evaluation of arterial blood flow velocity, a portable Doppler ultrasound device was used to measure the mean and maximum blood flow velocity of posterior tibial, popliteal, brachial, and radial arteries. Two examiners performed assessments of the same volunteers independently and twice, with an interval of 1 week between them. RESULTS: We found good to very good reliability for measuring the mean and maximum blood flow velocity of the arteries evaluated. The intraclass correlation coefficients ranged between 0.501 and 0.866, standard error of measurement ranged between 0.81 and 9.45 cm/s, and minimum detectable change ranged between 2.25 and 26.13 cm/s. CONCLUSION: The assessment of mean and maximum blood flow velocity of the brachial, radial, popliteal, and posterior tibial arteries by means of Doppler ultrasound presents acceptable reliability values, which supports the use of this evaluation method in research and clinical practice.

Photobiomodulation laser and pulsed electrical field increase the viability of the musculocutaneous flap in diabetic rats.

The purpose of this study is to investigate the effect of pulsed electrical field (PEF) and photobiomodulation laser (PBM) on the viability of the TRAM flap in diabetic rats. Fifty Wistar rats were divided into five homogeneous groups: Group 1-control; Group 2-diabetics; Group 3-diabetics + PEF; Group 4-diabetic + laser 660 nm, 10 J/cm2, 0.27 J; Group 5-diabetic + laser 660 nm, 140 J/cm2, 3.9 J. The percentage of necrotic area was evaluated using software Image J®. The peripheral circulation of the flap was evaluated by infrared thermography FLIR T450sc (FLIR® Systems-Oregon USA). The thickness of the epidermis (haematoxylin-eosin), mast cell (toluidine blue), leukocytes, vascular endothelial growth factor, fibroblast and newly formed blood vessels were evaluated. For the statistical analysis, the Kruskal-Wallis test was applied followed by Dunn and ANOVA test followed by Tukey with critical level of 5% (p < 0.05). The PEF reduced the area of necrosis, decreased the leukocytes, increased the mast cells, increased the thickness of epidermis and increased newly formed blood vessels when it was compared to the untreated diabetic group of animals. Laser 660 nm, fluence 140 J/cm2 (3.9 J) showed better results than the 10 J/cm2 (0.27 J) related to reduction of the area of necrosis and the number of leukocytes, increased mast cells, increased thickness of the epidermis, increased vascular endothelial growth factor, increased fibroblast growth factor and increase of newly formed blood vessels in diabetic animals. The laser and pulsed electrical field increase the viability of the musculocutaneous flap in diabetic rats.

Laser photobiomodulation (830 and 660 nm) in mast cells, VEGF, FGF, and CD34 of the musculocutaneous flap in rats submitted to nicotine.

The aim of this study was to investigate the effect of laser photobiomodulation (PBM) on the viability of the transverse rectus abdominis musculocutaneous (TRAM) flap in rats subjected to the action of nicotine. We evaluated 60 albino Wistar rats, divided into six groups of ten animals. Group 1 (saline) underwent the surgical technique to obtain a TRAM flap; group 2 (laser 830 nm) underwent the surgical technique and was irradiated with a laser 830 nm; group 3 (laser 660 nm) underwent the surgical technique and was irradiated with a laser 660 nm; group 4 was treated with nicotine subcutaneously (2 mg/kg/2×/day/4 weeks) and underwent surgery; group 5 (nicotine + laser 830 nm) was exposed to nicotine, underwent the surgical technique, and was irradiated with a laser 830 nm; group 6 (nicotine + laser 660 nm) was exposed to nicotine, underwent the surgical technique, and was irradiated with a laser 660 nm. The application of PBM occurred immediately after surgery and on the two following days. The percentage of necrosis was assessed using the AxioVision® software. The number of mast cells (toluidine blue staining) was evaluated, and immunohistochemistry was performed to detect vascular endothelial growth factor expression (anti-VEGF-A), fibroblasts (anti-basic FGF), and neoformed vessels (anti-CD34). PBM with a wavelength of 830 nm increased the viability of the TRAM flap, with a smaller area of necrosis, increased number of mast cells, and higher expression of VEGF and CD34. PBM increases the viability of musculocutaneous flaps treated with to nicotine.