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1.
J Endod ; 46(3): 358-363, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32035639

RESUMO

INTRODUCTION: Age-related changes of dental pulp tissue and atherosclerosis of carotid arteries as its feeding arteries could influence the functionality of pulpal circulation. The objective of our study was to evaluate the effect of aging (physiological process) and carotid bifurcation atherosclerosis (pathologic process) on the pulpal microcirculatory system using multifractal analysis of the laser Doppler flowmetry signal. METHODS: Three groups of 10 subjects were enrolled in the study: the young group (healthy subjects, 20-25 years), the middle-aged group (healthy subjects, 50-60 years), and the clinical group (subjects with carotid bifurcation atherosclerosis, 50-60 years). Pulpal blood flow (PBF) signals recorded by laser Doppler flowmetry were assessed by multifractal analysis that estimates Hölder exponents of the signal. PBF levels, the average mean values, and the range of Hölder exponents were obtained. RESULTS: PBF levels were significantly higher in the young group compared with the middle-aged and clinical groups, and the difference between the middle-aged and clinical groups was not statistically significant. The range of the Hölder exponents was narrower in the middle-aged and clinical groups than in the young group and narrower in the clinical group than in the middle-aged group. The average mean value of Hölder exponents was significantly higher in the young group than in the middle-aged and clinical groups, whereas there was no significant difference between the middle-aged and clinical groups. CONCLUSIONS: Our study investigating the multifractality of the PBF signal showed that the aging process and carotid atherosclerosis could affect the complex structure of PBF oscillations and contribute to a better understanding of pulpal hemodynamics.


Assuntos
Doenças das Artérias Carótidas , Polpa Dentária , Polpa Dentária/irrigação sanguínea , Hemodinâmica , Humanos , Fluxometria por Laser-Doppler , Microcirculação , Pessoa de Meia-Idade , Fluxo Sanguíneo Regional
2.
Acta Cir Bras ; 34(12): e201901203, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32049184

RESUMO

PURPOSE: Composite flaps used in reconstructive surgery may intra- and postoperatively suffer from hypoperfusion and/or ischemia-reperfusion influencing wound healing. We aimed to follow-up the effect of ischemia on adipocutaneous flaps' wound healing and microcirculation. METHODS: In anesthetized rats groin flaps were formed bilaterally. In Control group the flaps were repositioned and sutured back. In Ischemia-Reperfusion (I/R) group before repositioning and suturing the flap pedicles were clamped for 60 minutes. Laser Doppler (LD) fluxmetry and temperature probes were applied on the cranial, central and caudal flap regions before/after preparation and ischemia, re-suturing, and on the 1st-3rd-5th-7th-14th postoperative days, before the final examinations and biopsies for histology. RESULTS: Flaps' skin temperature quickly recovered after repositioning. LD values were lower in the I/R group, reaching a significant level by the 3rd postoperative day, and remained lowered till the 14th day. The magnitude of alterations differed in the flap regions. Histologically normal wound healing process was seen, except for some I/R flaps, where hypertrophized mammary glands were found. CONCLUSIONS: Short-term ischemia could influence flap microcirculation and wound healing, and may result in hypertrophized mammary glands. Laser Doppler could be used to evaluate intra- and postoperative microcirculatory changes and may have significance in predicting complications.


Assuntos
Procedimentos Cirúrgicos Dermatológicos/efeitos adversos , Microcirculação/fisiologia , Retalho Miocutâneo/irrigação sanguínea , Traumatismo por Reperfusão/complicações , Pele/irrigação sanguínea , Cicatrização/fisiologia , Animais , Biópsia , Temperatura Corporal , Modelos Animais de Doenças , Fluxometria por Laser-Doppler , Masculino , Retalho Miocutâneo/patologia , Período Pós-Operatório , Ratos , Valores de Referência , Traumatismo por Reperfusão/patologia , Reprodutibilidade dos Testes , Pele/patologia , Fatores de Tempo , Resultado do Tratamento
3.
Artigo em Inglês | MEDLINE | ID: mdl-32032408

RESUMO

This study aimed to evaluate with laser Doppler flowmetry (LDF) the effect of topical hyaluronic acid (HA) application on the vascularization of free gingival graft (FGG) donor and recipient sites during the early wound healing period and to investigate the effect of HA application on the dimensional change of the FGG. Forty systemically healthy, nonsmoking patients who required FGG due to insufficient amount of attached gingiva in a partial edentulism were randomly assigned to a study group: test (FGG+HA) or control (FGG alone). The LDF values of the donor and recipient sites were measured in both groups before the operation and at 4, 7, 10, 14, and 30 postoperative days. LDF measurement of the graft was performed as soon as the graft was taken from the palatal site. FGG dimensions (width, height, and thickness) were assessed and recorded at baseline and on day 30, as well as the percentage of the changes in these values. LDF values of the recipient site in the FGG+HA group were found to be statistically higher than those in the control group on days 4 and 7 (P = .013 and P = .020, respectively); however, no differences were found for days 10, 14, and 30. Additionally, no differences were found for the LDF values of the palatal site between the FGG+HA and control groups (P > .05) at all examined time points. The height of the graft measured on day 30 was statistically higher in the FGG+HA than the control group (P < .001). The percentage change in thickness and height of the FGG was statistically lower in the FGG+HA than control group (P = .028 and P < .001, respectively). Application of HA on the recipient bed under the FGG at the first week of healing allows the formation of a well-vascularized layer, which acts as a barrier against tissue tensions by functioning as a scaffold between the recipient bed and FGG, thus reducing the shrinkage of the graft, especially in the vertical direction. This study further showed that the graft taken from the donor site had a remaining blood perfusion value of its own.


Assuntos
Ácido Hialurônico , Procedimentos Cirúrgicos Bucais , Gengiva , Humanos , Fluxometria por Laser-Doppler , Cicatrização
4.
J Appl Oral Sci ; 28: e20190145, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32049132

RESUMO

OBJECTIVE: Ultrasonic wave technology is widely used during dental treatments. We previously demonstrated that this method protects the gingival tissue. However, the physiological change on the gingival microvasculature caused by this method remains unclear. The aim of this study was to investigate the relationship between the morphological and physiological effects on gingival microcirculation when preparing teeth, using the conventional dental turbine or ultrasonic method. METHODOLOGY: The lower premolar teeth of beagle dogs were prepared along the gingival margin by using a dental turbine or ultrasonic wave instrument. Gingival vasculature changes were investigated using scanning electron microscopy for corrosion resin casts. Gingival blood flow at the preparation site was determined simultaneously by laser Doppler flowmetry. These assessments were performed immediately (Day 0), at 7 days and 30 days after tooth preparation. RESULTS: At day 0, in the turbine group, blood vessels were destroyed and some resin leaked. Furthermore, gingival blood flow at the site was significantly increased. In contrast, the ultrasonic group demonstrated nearly normal vasculature and gingival blood flow similar to the non-prepared group for 30 days after preparation. No significant alterations occurred in gingival circulation 30 days after either preparation; however, the turbine group revealed obvious morphological changes. CONCLUSIONS: Based on multiple approach analyses, this study demonstrated that ultrasonic waves are useful for microvascular protection in tooth preparation. Compared with a dental turbine, ultrasonic wave instruments caused minimal damage to gingival microcirculation. Tooth preparation using ultrasonic wave instruments could be valuable for protecting periodontal tissue.


Assuntos
Gengiva/irrigação sanguínea , Microcirculação/fisiologia , Preparo do Dente/instrumentação , Ondas Ultrassônicas , Animais , Protocolos Clínicos , Instrumentos Odontológicos , Cães , Feminino , Humanos , Fluxometria por Laser-Doppler/métodos , Microscopia Eletrônica de Varredura , Reprodutibilidade dos Testes , Fatores de Tempo , Preparo do Dente/métodos
5.
Acta Odontol Scand ; 78(1): 31-37, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31349769

RESUMO

Objectives: To determine the baseline perfusion parameters of the alveolar mucosa using laser Doppler flowmetry and tissue spectrophotometry (LDF-TS) in healthy adults.Material and methods: Forty-two healthy adult subjects of either sex were tested. The perfusion of the alveolar mucosa was evaluated using a laser Doppler flowmetry and tissue spectrophotometry using O2C 'oxygen to see' device. The measurements encompassed the maxillary and mandibular mucosa at 20 different points.Results: The O2C device is a reliable method for noninvasive measurement of different perfusion parameters of the oral mucosa. The hemoglobin saturation values (So2 in %), as well as relative amount of hemoglobin in arbitrary units (AU) of the maxillary mucosa demonstrated lower values of that in the mandible. The flow value (AU) exhibited a significant difference in the posterior molar region only, while the velocity value (AU) showed a significant difference across all points except for the anterior region.Conclusion: the present study provides a set of brand-new perfusion parameters of the microcirculation of the alveolar mucosa using LDF-TS. The study suggests a variation of the perfusion parameters between the maxilla and the mandible. Differences in the anatomy of the blood supply, the thickness of the mucosa and the cortical bone, may be attributed to this variation. Further studies using different probes and a combination of ultrasonic measurements and SDF imaging will aid in giving a better overview of the perfusion in the oral mucosa.


Assuntos
Fluxometria por Laser-Doppler/métodos , Mandíbula/irrigação sanguínea , Maxila/irrigação sanguínea , Microcirculação/fisiologia , Mucosa Bucal/irrigação sanguínea , Oxigênio/fisiologia , Espectrofotometria/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Perfusão
6.
J Craniomaxillofac Surg ; 47(12): 1973-1979, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31810844

RESUMO

The Cook-Swartz-Doppler probe is an easy to handle and reliable tool for free flap monitoring. In the head and neck region different confounders can affect the read out. We therefore analyzed the use of the Doppler probe regarding these potential difficulties and to compare the diagnostic accuracy in arterial or venous monitoring of free flaps in the head and neck region. A retrospective study was performed in which all patients were included who underwent free flap surgery in the head and neck region in the Department of Plastic Surgery and the Department of Maxillofacial Surgery of our institution between 2010 and 2018 and were monitored with an implanted Doppler probe. 147 free tissue transfers were included. No significance was found for arterial and venous placement of the Doppler probe for sensitivity (artery 83.3%; vein 84.6%; p = 0.87), specificity (artery 89.2%; vein 96.1%; p = 0.17) and negative predictive value (artery 96.7%; vein 94.2%; p = 0.55). A better positive predictive value for placing the Doppler probe around the artery (82.7%) than the vein (61.1%) was found in our study (p = 0.056). The better positive predictive value in arterial monitoring suggests that this is the more reliable measuring method to assess flap perfusion in the head and neck region.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Retalhos de Tecido Biológico , Neoplasias de Cabeça e Pescoço/cirurgia , Monitorização Ambulatorial/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Retalhos Cirúrgicos/irrigação sanguínea , Adulto , Idoso , Idoso de 80 Anos ou mais , Retalhos de Tecido Biológico/irrigação sanguínea , Retalhos de Tecido Biológico/fisiologia , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Fluxometria por Laser-Doppler/instrumentação , Microcirurgia/métodos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/cirurgia , Estudos Retrospectivos
7.
Am J Orthod Dentofacial Orthop ; 156(5): 603-610, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31677668

RESUMO

INTRODUCTION: The objective of this study is to evaluate and compare the initial changes of pulpal blood flow (PBF) using clear aligner and fixed orthodontic treatment. METHODS: A total of 45 subjects were subdivided into 2 groups: group 1; 25 subjects treated with preadjusted edgewise fixed appliance with 0.014″ nickel titanium as the alignment archwire and group 2; 20 subjects treated using clear aligner. In both groups, PBF was measured for the maxillary right and mandibular left teeth using Laser Doppler flowmetry at different time intervals (20 minutes, 48 hours, 72 hours, and 1 month) after the fitting of the nickel titanium archwire in group 1 and after the delivery of the second aligner in group 2. A repeated-measures analysis of variance and a Bonferroni post-hoc comparison test were applied to determine differences at the various time intervals. RESULTS: The PBF decreased in both types of appliances after force application. The maximum reduction in PBF was reached after 72 hours. It returned to its normal values within 1 month. The differences in PBF between the 2 groups did not reach any statistical significance. CONCLUSIONS: PBF in orthodontically treated teeth decreased 20 minutes after orthodontic force application in both fixed and clear aligner appliances. In both treatment groups, most changes occurred within 48 hours of force application. PBF returned to its normal values within 1 month. Changes in PBF in both treatment groups were comparable.


Assuntos
Polpa Dentária , Aparelhos Ortodônticos Fixos , Aparelhos Ortodônticos Removíveis , Humanos , Fluxometria por Laser-Doppler , Maxila
8.
Georgian Med News ; (294): 46-50, 2019 Sep.
Artigo em Russo | MEDLINE | ID: mdl-31687948

RESUMO

In the era of modern technology is becoming increasingly popular implantation. This method is one of the leading methods in prosthetics of dental patients. Implantation solves a number of problems both aesthetic and functional. However, the percentage of complications, such as peri-implantitis and mucositis, leading to a violation of the chewing function of the dentition, is steadily increasing. To date, the etiology and pathogenesis of post-implantation complications have not been definitively clarified. One of the leading predictors is psychoemotional stress. On the basis of the literature analysis method to study stress, its impact on the development of periimplantitis, is laser Doppler flowmetry, allows you to quickly assess the state of microcirculation of the oral cavity at the stage of diagnosis, prior to the commencement of pharmacotherapy and in the dynamics of treatment and to adjust treatment regimen to prevent postoperative complications. The obtained LDF-grams allow to reflect the state of the regulatory systems of the body, and therefore it is possible to use LDF for the diagnosis of psychological stress.


Assuntos
Implantes Dentários/efeitos adversos , Implantes Dentários/microbiologia , Mucosite/microbiologia , Peri-Implantite/microbiologia , Infecções Relacionadas à Prótese/microbiologia , Humanos , Fluxometria por Laser-Doppler , Microcirculação , Mucosa Bucal/microbiologia , Mucosite/complicações , Peri-Implantite/complicações , Complicações Pós-Operatórias , Infecções Relacionadas à Prótese/etiologia
9.
J Endod ; 45(11): 1403-1404, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31570174
11.
J Cosmet Sci ; 70(5): 259-270, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31596228

RESUMO

The aim of the study was to investigate skin microcirculation, flux, and temperature changes induced by the application of Dead Sea mud (DSM) formulas with different mud salts and mineral contents using laser Doppler flowmetry. Instrumental analysis of eight over-the-shelf DSM products and four different samples of nonformulated Dead Sea mud were carried out to determine their contents of various salts and elements, including K, Na, Cl, Mg, Mn, Ca, SO3, SiO2, Al, Br, Fe, Hg, Cr, Co, Ni, Cu, Zn, As, Cd, Pb, and Sr. Three DSM samples with different levels of salts were then used to study the influence of salt content on skin irritation potential using laser Doppler flowmetry. Fifteen healthy nonsmoking females aged 18-45 years participated in the study. Subjects were randomly assigned to either "Salted" mud group (n = 5), "As is" mud group (n = 5), or "Over-the-Shelf" mud group (n = 5). Five circular areas were marked on the ventral aspect of each forearm. One forearm was assigned randomly for mud treatment and the other forearm was untreated. Ten milliliters of mud was applied on the assigned forearm and left for 30 minutes. Two reading protocols were designed and used to study the effects of tested type of mud on skin blood flux and temperature during mud application (protocol 2) as well as before and after mud removal (protocol 1). All types of tested mud were not associated with a significant measurable elevation in skin temperature and skin blood flow. All types of Dead Sea mud did not cause detectable microcirculatory and skin temperature changes regardless of their different mineral and salts contents.


Assuntos
Fluxometria por Laser-Doppler , Adolescente , Adulto , Feminino , Humanos , Microcirculação , Pessoa de Meia-Idade , Minerais , Dióxido de Silício , Pele , Adulto Jovem
12.
J Cardiovasc Surg (Torino) ; 60(6): 742-748, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31599142

RESUMO

BACKGROUND: Our aim was to investigate the impact of the non-skeletonized (pedicled) versus the skeletonized left internal mammary (LIMA) harvesting technique on the postoperative sternal and parasternal skin perfusion in patients undergoing coronary artery bypass grafting (CABG), as compared to patients undergoing non-CABG heart surgery. METHODS: We included 142 patients who underwent non-bypass (N.=39) or CABG surgery (N.=103). CABG cases were differentiated according to the LIMA harvesting technique: skeletonized (N.=74) or non-skeletonized (N.=29). Parasternal and sternal skin perfusion measurements via a Laser Doppler Imaging tool were performed on the preoperative day and 5-7 days postoperatively, using a grid of 15 spatially segregated measurement points across the chest and normalization to a distinct reference point. Data were analyzed retrospectively. RESULTS: In the CABG group, the non-skeletonized LIMA harvesting resulted in a near-significant (P=0.057, two-sided Student t-test, 95% CI -[0.111, 0.002]), and the skeletonized LIMA harvesting in a significant (P< 0.001, 95% CI [-0.096, -0.032]) post-surgical decrease of left-sided parasternal skin perfusion in arbitrary perfusion units (APU), as compared to right-sided parasternal skin perfusion. No corresponding differences were found for the non-bypass group (P=0.5, 95% CI [-0.065, 0.033]). The harvesting techniques did not yield significantly different post-surgical parasternal skin perfusion measures in the CABG group (P=0.6). CONCLUSIONS: Measurement of parasternal skin perfusion using Laser Doppler Imaging is feasible. Both harvesting techniques resulted in a reduced parasternal/sternal skin perfusion upon removal of the internal mammary artery.


Assuntos
Ponte de Artéria Coronária/efeitos adversos , Fluxometria por Laser-Doppler , Artéria Torácica Interna/transplante , Imagem de Perfusão/métodos , Pele/irrigação sanguínea , Coleta de Tecidos e Órgãos/efeitos adversos , Idoso , Velocidade do Fluxo Sanguíneo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Fluxo Sanguíneo Regional , Estudos Retrospectivos , Fatores de Risco , Esterno , Resultado do Tratamento
13.
Handchir Mikrochir Plast Chir ; 51(5): 362-366, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31574550

RESUMO

The depth assessment of thermal wounds is subject to many variables. Therefore, technical systems are increasingly being used to determine severity. Particularly hand burns can have clinically relevant consequences in terms of function and aesthetic appearance. Hence, a secure assessment for an adequate treatment is necessary.Technical analyzes such as Hyperspectral Imaging, Laser-Doppler-Imaging or Laser-Speckle-Imaging are intended to simplify and objectify the examination by helping to determine the necessary depth of necrectomy and thus to define the skin transplantation area. Furthermore, the diverse technical devices are to improve the functional result, reduce the severity of scarring and cosmetic complaints, and facilitate the evaluation of inexperienced personnel in the field of burn medicine.Therefore, various technical approaches have been pursued, which are largely based on optical principles. The respective devices are not yet used in the standard diagnosis of burn wounds.In future studies it will be necessary to determine an algorithm for the measurement intervals based on the wound dynamics and to evaluate which methodology is superior to the specificity and sensitivity.


Assuntos
Queimaduras , Queimaduras/diagnóstico por imagem , Queimaduras/patologia , Queimaduras/cirurgia , Cicatriz , Humanos , Fluxometria por Laser-Doppler , Pele/diagnóstico por imagem , Transplante de Pele
14.
Lupus ; 28(11): 1320-1328, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31522626

RESUMO

OBJECTIVES: The objectives of this study were to assess the reliability of a novel objective outcome measure, laser Doppler imaging (LDI), its validity against skin biopsy histology and other clinical instruments, including localized cutaneous lupus disease area and severity index (L-CLASI) and visual analogue scale (VAS) score of photographs, and its responsiveness to clinical change with therapy. METHODS: A prospective observational cohort study was conducted in 30 patients with active cutaneous lupus erythematosus (CLE). At baseline and 3 months, disease activity was assessed using L-CLASI and a high resolution LDI system by two assessors. Skin biopsy was scored as 0 = non-active, 1 = mild activity and 2 = active. Photographs were assessed by two clinicians using 100 mm VAS. Inter-rater reliability was analyzed using Bland-Altman limits of agreement. Correlation between histology and LDI, L-CLASI and VAS and sensitivity to change of LDI with physician subjective assessment of change (PSAC) at 3 months were analyzed using Kendall's tau-a. RESULTS: Of 30 patients with CLE, 28 (93%) were female, mean (SD) age 48.4 (11.5) y, 25 (83%) were Caucasians, 25 (83%) had concurrent systemic lupus erythematosus and 16 (53%) were smokers. CLE subtypes were acute = 9, subacute = 8 and chronic = 13. Inter-rater agreement for LDI was fair but for VAS score of photographs was poor. In 20 patients with biopsy, correlation with histology was better for LDI (tau-a = 0.53) than L-CLASI (tau-a = 0.26) (difference = 0.27; 90% CI 0.05-0.49) or VAS score of photographs (tau-a = 0.17) (difference = 0.36; 90% CI 0.04-0.68). There was a moderate correlation between PSAC score and change in LDI (tau-a = 0.56; 90% CI 0.38-0.74; p < 0.001, n = 15). CONCLUSION: LDI provides a reliable, valid and responsive quantitative measure of inflammation in CLE. It has a better correlation with histology compared to clinical instruments. LDI provides an objective outcome measure for clinical trials.


Assuntos
Fluxometria por Laser-Doppler , Lúpus Eritematoso Cutâneo/diagnóstico por imagem , Lúpus Eritematoso Sistêmico/diagnóstico por imagem , Adulto , Biópsia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Estudos Prospectivos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
15.
Graefes Arch Clin Exp Ophthalmol ; 257(11): 2391-2399, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31378831

RESUMO

PURPOSE: To determine whether water drinking test (WDT) alters choroidal structure using binarization of enhanced depth imaging optical coherence tomographic (EDI-OCT) images. METHODS: We performed a prospective study of 57 eyes of 57 normal subjects. The intraocular pressure (IOP), EDI-OCT images, and laser speckle flowgraphic images were recorded at baseline, and at 15, 30, 45, and 120 min after the WDT. The EDI-OCT images were converted to binary images using ImageJ software, and we examined luminal area, interstitial area, whole choroidal area, the ratio of luminal area to whole choroidal area (L/W ratio), subfoveal choroidal thickness (SCT), and central retinal thickness (CRT). RESULTS: The luminal area, L/W ratio, whole choroidal area, and IOP were significantly increased 30 min after water drinking; levels returned to the baseline at 120 min. No significant changes were found in the CRT and interstitial area. The fluctuations in the SCT after water intake were significantly correlated with those in the L/W ratio and luminal area but not with those of the interstitial area. The choroidal blood flow velocity was significantly decreased at 30 min. Fluctuations in the luminal area, L/W ratio, and whole choroidal area were significantly correlated with IOP fluctuations. CONCLUSIONS: The changes in the SCT after water drinking were mainly due to the changes in the choroidal vascular space. Dilatations of the choroidal vessels after water drinking may lead to choroidal thickening and subsequent IOP elevation. These findings should be considered in the evaluation of choroidal structure in patients with retinal disease.


Assuntos
Velocidade do Fluxo Sanguíneo/fisiologia , Corioide/diagnóstico por imagem , Ingestão de Líquidos/fisiologia , Vasos Retinianos/fisiologia , Tomografia de Coerência Óptica/métodos , Adulto , Corioide/irrigação sanguínea , Estudos Transversais , Feminino , Seguimentos , Humanos , Pressão Intraocular/fisiologia , Fluxometria por Laser-Doppler , Masculino , Estudos Prospectivos , Valores de Referência , Vasos Retinianos/diagnóstico por imagem , Adulto Jovem
17.
Muscle Nerve ; 60(6): 673-678, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31465118

RESUMO

INTRODUCTION: Large-fiber neuropathy is rare in neurofibromatosis type 1, but small-fiber neuropathy has not been studied. METHODS: Patients with neurofibromatosis type 1 underwent nerve conduction studies for large-fiber assessment. Small-fiber tests included quantitative thermal thresholds, laser Doppler flare imaging, intraepidermal nerve fiber density, and corneal nerve fiber length. RESULTS: Of the 52 patients enrolled, 31 (60%) were female and the mean age was 33.0 ± 12.3 years. Four (8%) patients had abnormal nerve conduction studies. Small-fiber tests were frequently abnormal: thermal thresholds in 7 (13%); laser Doppler flare imaging in 10 (19%); intraepidermal nerve fiber density in 11 (22%); and corneal nerve fiber length in 27 (52%). The mean corneal nerve fiber length was below normative level (10.1 ± 2.7 mm/mm3 ). DISCUSSION: Small-fiber neuropathy may be common in neurofibromatosis type 1, and should be investigated in symptomatic patients.


Assuntos
Condução Nervosa/fisiologia , Neurofibromatose 1/fisiopatologia , Neuropatia de Pequenas Fibras/fisiopatologia , Adulto , Córnea/inervação , Eletrodiagnóstico , Feminino , Humanos , Microscopia Intravital , Fluxometria por Laser-Doppler , Masculino , Microscopia Confocal , Pessoa de Meia-Idade , Neurofibromatose 1/complicações , Limiar Sensorial , Pele/irrigação sanguínea , Pele/patologia , Neuropatia de Pequenas Fibras/etiologia , Sensação Térmica , Vasodilatação , Adulto Jovem
18.
Invest Ophthalmol Vis Sci ; 60(8): 3110-3118, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31323681

RESUMO

Purpose: Blood flow in the optic nerve head (ONH) is known to be reduced in eyes with advanced glaucoma. However, experimental results from non-human primates suggest an initial increase in ONH blood flow at the earliest stages of damage. This study assesses flow and pulsatile hemodynamics across a range of severities to test the hypothesis that this also occurs in human glaucoma. Methods: Laser speckle flowgraphy was used to measure average mean blur rate (MBRave) within ONH tissue (a correlate of capillary blood flow) and the pulsatile waveform in 93 eyes with functional loss and 74 glaucoma suspect/fellow eyes without functional loss. These were compared against results from 92 healthy control eyes. Parameters produced by the instrument's software were age-corrected, then compared between groups using generalized estimating equation models. Results: The mean MBRave in the control eyes was 12.5 units. In glaucoma suspect/fellow eyes, the mean was 16.4 units, higher with P < 0.0001. In eyes with functional loss, the mean was 13.8 units, lower than eyes without functional loss with P < 0.0001, although still higher than control eyes with P = 0.0096. Analysis of the pulsatile waveform suggested that the deceleration in flow as it approaches its maximum across the cardiac cycle was delayed in glaucoma. Conclusions: Blood flow within ONH capillaries was higher in glaucoma suspect eyes than in healthy controls. It was less elevated in eyes that had developed functional loss. The mechanisms causing these changes and their relation to concurrent changes in pulsatile hemodynamics remain under investigation.


Assuntos
Velocidade do Fluxo Sanguíneo/fisiologia , Capilares/fisiopatologia , Glaucoma de Ângulo Aberto/fisiopatologia , Microcirculação/fisiologia , Disco Óptico/irrigação sanguínea , Fluxo Sanguíneo Regional/fisiologia , Adulto , Idoso , Capilares/diagnóstico por imagem , Feminino , Angiofluoresceinografia , Fundo de Olho , Glaucoma de Ângulo Aberto/diagnóstico , Humanos , Pressão Intraocular , Fluxometria por Laser-Doppler/métodos , Masculino , Pessoa de Meia-Idade , Prognóstico , Tomografia de Coerência Óptica/métodos
19.
Artigo em Russo | MEDLINE | ID: mdl-31329184

RESUMO

AIM: To study the impact of comprehensive anti-edematous therapy (CAET) on the microcirculatory indicators of patients with lower limb lymphedema. MATERIAL AND METHODS: The investigation enrolled 60 patients with stages I-III lower limb lymphedema (according to its classification (T.V. Savchenko and A.V. Pokrovsky, 2004). All the patients were randomly divided into two groups: 1) 30 patients received CAET; 2) 30 patients had basic therapy with a conventional lymphovenous tonic and elastic compression. The time course of microcirculatory changes were evaluated in all the patients, by using laser Doppler flowmetry. RESULTS: Analysis of the findings revealed that all the patients had spastic and stagnant microcirculation prior to treatment. After a treatment cycle, group 1 showed positive changes in the clinical manifestations of the disease and in the microcirculation, while group 2 displayed slight reductions in sensation of heaviness, leg swelling, as well as positive changes at the level of the venules of the microcirculatory bed. CONCLUSION: This investigation of microcirculatory indicators in patients with lower limb lymphedema revealed a considerable improvement at the level of all microcirculatory components (arterioles, precapillaries, and venules) after CAET.


Assuntos
Extremidade Inferior/irrigação sanguínea , Linfedema/terapia , Microcirculação/fisiologia , Humanos , Fluxometria por Laser-Doppler , Resultado do Tratamento
20.
J Thorac Cardiovasc Surg ; 158(5): 1481-1488, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31358338

RESUMO

OBJECTIVE: The main therapeutic method of treatment for local hyperhidrosis is endoscopic thoracic sympathectomy. Generally, resections of the sympathetic trunk or ganglia are performed between the second rib and sixth rib. However, this procedure can result in compensatory sweating, in which excess sweating occurs on the back, chest, and abdomen. Compensatory sweating has been regarded as a thermoregulatory response and thought to be untreatable. This study suggests that compensatory sweating is not a physiologic reaction and is indeed treatable. METHODS: Eight patients with severe compensatory sweating were treated by observing blood perfusion of the skin with laser speckle flowgraphy, which determines the sympathetic nerves related to the area of skin with compensatory sweating. When intraoperative monitoring with laser speckle flowgraphy indicated the position of compensatory sweating by electrical stimulation of the sympathetic ganglion, ganglionectomy was performed. RESULTS: The skin domain that each sympathetic nerve controls was able to be detected by laser speckle flowgraphy. In all patients, compensatory sweating was resolved after interruption of the ganglia or sympathetic nerves related to compensatory sweating. CONCLUSIONS: Our results demonstrate that compensatory sweating is caused by denatured sympathetic nerves influenced by endoscopic thoracic sympathectomy and is not the result of a physiological response. With laser speckle flowgraphy, the sympathetic nerve related to the sweating of various parts of the body could be identified. The treatment of compensatory sweating on the back, chest, and stomach was previously considered to be difficult; however, compensatory sweating is demonstrated to be treatable with this technique.


Assuntos
Estimulação Elétrica/métodos , Hiperidrose , Monitorização Intraoperatória , Simpatectomia , Procedimentos Cirúrgicos Torácicos , Adulto , Endoscopia/efeitos adversos , Endoscopia/métodos , Feminino , Ganglionectomia/métodos , Humanos , Hiperidrose/diagnóstico , Hiperidrose/etiologia , Hiperidrose/fisiopatologia , Hiperidrose/terapia , Fluxometria por Laser-Doppler/métodos , Masculino , Pessoa de Meia-Idade , Monitorização Intraoperatória/instrumentação , Monitorização Intraoperatória/métodos , Imagem de Perfusão/métodos , Glândulas Sudoríparas/inervação , Sudorese/fisiologia , Simpatectomia/efeitos adversos , Simpatectomia/métodos , Sistema Nervoso Simpático/cirurgia , Procedimentos Cirúrgicos Torácicos/efeitos adversos , Procedimentos Cirúrgicos Torácicos/métodos , Resultado do Tratamento
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