Vasomotion Changes After Hyperbaric Oxygen Therapy In Diabetic Patients

Backround: Aim of this study was to assess changes in vasomotion during post–occlusive reactive hyperaemia in patients after hyperbaric oxygen therapy (HBOT). Methods: 38 patients with type 2 diabetes mellitus underwent 15 sessions of HBOT consisting of 90 minutes of eathing 100 % oxygen at 2.5 atm. We used laser Doppler flowmetry (LDF) to assess vasomotion during post–occlusive reactive hyperaemia. Results: We observed significant increase in endothelial (3.22 [2.07 – 5.31] vs. 4.91 [2.9 – 6.57], p < 0.05), neurogenic (0.64 [0.44 – 1.01] vs. 0.85 [0.53 – 1.63], p < 0.05), cardiac (9.22 [7.21 – 13.79] vs. 12.74 [8.66 – 16.83], p < 0.05) and total spectral activity (20.93 [15.97 – 27.88] vs. 27.96 [17.45 – 37.99], p < 0.05) after HBOT. No significant changes were observed in myogenic and respiratory spectral activity Conclusion: Our study demonstrated vasomotion changes measured by LDF after HBOT.

The prognosis of ocular inflammation index after pterygium surgery based on Oculus Keratograph(R) 5M and Visual analogue scale / 中华实验眼科杂志

Objective To investigate the characteristics of ocular surface inflammation index after pterygium excision by using Oculus Keratograph(R) 5M and Visual analogue scale and evaluated the effectiveness of antiinflammatory treatment.Methods A prospective case control study was performed.Eighteen patients (6 males and 12 females) who suffered from primary pterygium were recruited in Zhongshan Ophthalmic Center from June to September 2016.All patients were treated with monocular pterygium excision combined with amniotic membrane transplantation.Anti-inflammatory treatment was given after surgery,and the ocular inflammation index was evaluated at preoperative and 1st,3rd,7th,10th,30th and 60th day postoperative.The temporal conjunctival hyperemia index (TCHI) was assessed by Oculus Keratograph(R) 5M with a red eye index analysis software.Ocular symptom scores (OSS) and visual analogue scale (VAS) were used to analyze the subjective symptoms of the patients.Fluorescein staining was used to detect the epithelization of corneal and scleral wound.The best corrected visual acuity (BCVA),intraocular pressure and complications were evaluated in this study.This study was approved by the Medical Ethics Committee of Zhongshan Ophthalmic Center of Sun Yat-sen University (2016KYPJ024).All patients signed informed consent for clinical research.Results No drug-related ocular and systemic adverse events were found during the follow-up.Corneal epithelial defect was recovered on 10th day,and conjunctival epithelization was observed in sclera exposed area on 30th day.The BCVA on the 60th day was 0.12±0.17,which was significantly lower than 0.34±0.36 preoperatively (t =3.401,P =0.003).Compared with those before surgery,OSS and VAS were significantly increased on 1 st day (OSS:Z =-4.255,P =0.000;VAS:Z =-5.256,P =0.000).The OSS on 7th day was not significantly different from that before surgery (Z=-0.958,P=0.372).VAS decreased to baseline on 30th day.The OSS on 60th day after surgery was significantly lower than that before surgery (Z =-2.397,P =0.037).TCHI was higher than 1.2 preoperatively,and increased to the highest on 1 st day after surgery,with significant difference between them (t=-6.620,P=0.000).The TCHI decreased to baseline on 7th day,no significant difference were obtained when compared with preoperative TCHI (t =-1.050,P =0.310),and TCHI on 60th day after surgery was lower than that before surgery,with significant difference between them (t =2.758,P =0.020).Conclusions The subjective symptoms combined with conjunctival hyperemia can be more accurate assessment of ocular surface inflammation in the perioperative period of pterygium surgery,which can be used as an evaluation index to assess the effectiveness of anti-inflammatory treatment.

Abnormal Microvascular Reactivity with Hypercholesterolaemia in Pregnancy

Background: Post-occlusive skin reactive hyperaemia (PORH) is a model used to assess microvascular reactivity. This study aims to compare PORH response among pregnant hypercholesterolaemic patients with age and gestational age-matched controls. Methods: This cross sectional study involved 17 hypercholesterolaemic, pregnant women and 20 pregnant controls entering their early third trimester. Laser Doppler fluximetry (LDF) was used to measure skin perfusion. The process of PORH was performed by occluding the upper arm with an occlusion cuff at 200 mmHg for 3 minutes. Skin perfusion was recorded before, during, and after occlusion release. Baseline perfusion, time to achieve peak perfusion (Tp), peak perfusion after occlusion release (PORHpeak), and maximum change in perfusion due to occlusion (PORHmax) were recorded. Results: Serum total cholesterol (TC) was significantly different (P < 0.001) between the 2 groups: 7.25 (SEM 0.18) mmol/L for hypercholesterolaemic women and 5.54 (SEM 0.15) mmol/L for the control group. There were no significant differences in their baseline, PORHpeak, and PORHmax. However, Tp in the hypercholesterolaemic group was significantly increased (P = 0.024) compared with the controls at 14.9 (SEM 0.6) seconds and 13.1 (SEM 0.5) seconds, respectively. Conclusion: Pregnant hypercholesterolaemic patients showed an abnormal microvascular reactivity response. Tp with ischemia was significantly increased compared with normocholesterolaemic controls.

Fenómenos autónomos referidos por punto gatillo miofacial en el músculo temporal como una respuesta neuropática / Autonomus referred phenomena by myofacial trigger point in temporalis muscle as a neuropathic response

Los puntos gatillo miofaciales (Pgs) son puntos hiperirritables en un músculo esquelético asociado a un nódulo palpable causado por una banda muscular tensa. Los Pgs miofaciales presentan dentro de sus signos y síntomas alteraciones motoras, sensoriales y autonómicas. En este artículo reportamos un caso en el que se presenta un fenómeno autónomo referido a partir de un punto gatillo miofacial y se plantean las vías neuroanatómicas involucradas en esta respuesta, analizando la hipótesis que las respuestas autónomas referidas asociadas al dolor pueden considerarse eventos neuropáticos del sistema nervioso autónomo.

Myofascial trigger points (MTP) are hyperirritable points in skeletal muscle associated with a palpable lump caused by a strained muscle band. MTP presented within signs and symptoms of motor, sensory and autonomic impairment. In this article we report a case in which an autonomous referred phenomena from a myofascial trigger point and raises the neuroanatomical pathways involved in this response, considering the hypothesis that self-related responses associated with neuropathic pain can be regarded as events of the autonomic nervous system. Clinical and experimental evidence discussed in this article indicates that myofascial trigger point pain is an autonomic phenomena associated, that can be systemic and localized, and must be considered in evaluating patients with these diagnosis.