Multiphoton FLIM Analyses of Native and UVA-Modified Synthetic Melanins.

To better understand the impact of solar light exposure on human skin, the chemical characterization of native melanins and their structural photo-modifications is of central interest. As the methods used today are invasive, we investigated the possibility of using multiphoton fluorescence lifetime (FLIM) imaging, along with phasor and bi-exponential fitting analyses, as a non-invasive alternative method for the chemical analysis of native and UVA-exposed melanins. We demonstrated that multiphoton FLIM allows the discrimination between native DHI, DHICA, Dopa eumelanins, pheomelanin, and mixed eu-/pheo-melanin polymers. We exposed melanin samples to high UVA doses to maximize their structural modifications. The UVA-induced oxidative, photo-degradation, and crosslinking changes were evidenced via an increase in fluorescence lifetimes along with a decrease in their relative contributions. Moreover, we introduced a new phasor parameter of a relative fraction of a UVA-modified species and provided evidence for its sensitivity in assessing the UVA effects. Globally, the fluorescence lifetime properties were modulated in a melanin-dependent and UVA dose-dependent manner, with the strongest modifications being observed for DHICA eumelanin and the weakest for pheomelanin. Multiphoton FLIM phasor and bi-exponential analyses hold promising perspectives for in vivo human skin mixed melanins characterization under UVA or other sunlight exposure conditions.

In vivo multiphoton multiparametric 3D quantification of human skin aging on forearm and face.

Quantifying skin aging changes and characterizing its 3D structure and function in a non-invasive way is still a challenging area of research, constantly evolving with the development of imaging methods and image analysis tools. In vivo multiphoton imaging offers means to assess skin constituents in 3D, however prior skin aging studies mostly focused on 2D analyses of dermal fibers through their signals' intensities or densities. In this work, we designed and implemented multiphoton multiparametric 3D quantification tools for in vivo human skin pigmentation and aging characterization. We first demonstrated that despite the limited field of view of the technic, investigation of 2 regions of interest (ROIs) per zone per volunteer is a good compromise in assessing 3D skin constituents in both epidermis and superficial dermis. We then characterized skin aging on different UV exposed areas-ventral and dorsal forearms, face. The three major facts of aging that are epidermal atrophy, the dermal-epidermal junction (DEJ) flattening and dermal elastosis can be non-invasively quantified and compared. Epidermal morphological changes occur late and were only objectified between extreme age groups. Melanin accumulation in suprabasal layers with age and chronic exposure on ventral and dorsal forearms is less known and appears earlier. Superficial dermal aging changes are mainly elastin density increase, with no obvious change in collagen density, reflected by SHGto2PEF ratio and SAAID index decrease and ImbrN index increase on all skin areas. Analysis of the z-dermal distribution of these parameters highlighted the 2nd 20 µm thickness normalized dermal sub-layer, that follows the DEJ shape, as exhibiting the highest aging differences. Moreover, the 3D ImbrN index allows refining the share of photoaging in global aging on face and the 3D SAAID index on forearm, which elastin or fibrillar collagens densities alone do not allow. Photoaging of the temple area evolves as a function of chronic exposure with a more pronounced increase in elastin density, also structurally modified from thin and straight elastic fibers in young volunteers to dense and compact pattern in older ones. More generally, multiphoton multiparametric 3D skin quantification offers rich spatial information of interest in assessing normal human skin condition and its pathological, external environment or product induced changes.

Ozone in Patients with Periodontitis: A Clinical and Microbiological Study.

The purpose of this article was to assess the effectiveness of ozone therapy as an adjunct to mechanical therapy in periodontitis patients. Thirty-two patients diagnosed with generalized periodontitis were selected, with a total of 655 teeth examined. Each patient's mouth was divided into four quadrants (the split-mouth model) to be randomly treated with four sessions of gaseous ozone or air. The following clinical variables were recorded: the gingival index, the periodontal clinical attachment loss, the Miller's mobility index and the clinical improvements, as assessed through the visual analog scale (VAS). In addition, the microorganisms were qualitatively compared. After four weeks of treatment, the teeth of the ozone-treated quadrants showed statistically significant reductions in the gingival index and an improvement in the clinical attachment (p < 0.0001). The same treatment also significantly improved mobility by between 70% and 86% compared to the control group (p < 0.0001). Statistically significant differences were also recorded for the VAS (p < 0.0001). In the qualitative study of the subgingival flora, significant differences were observed (p < 0.0001). The overall results of this trial support the view that ozone treatment is effective and well tolerated in cases of generalized chronic periodontitis.

In vivo melanin 3D quantification and z-epidermal distribution by multiphoton FLIM, phasor and Pseudo-FLIM analyses.

Characterizing melanins in situ and determining their 3D z-epidermal distribution is paramount for understanding physiological/pathological processes of melanin neosynthesis, transfer, degradation or modulation with external UV exposure or cosmetic/pharmaceutical products. Multiphoton fluorescence intensity- and lifetime-based approaches have been shown to afford melanin detection, but how can one quantify melanin in vivo in 3D from multiphoton fluorescence lifetime (FLIM) data, especially since FLIM imaging requires long image acquisition times not compatible with 3D imaging in a clinical setup? We propose an approach combining (i) multiphoton FLIM, (ii) fast image acquisition times, and (iii) a melanin detection method called Pseudo-FLIM, based on slope analysis of autofluorescence intensity decays from temporally binned data. We compare Pseudo-FLIM to FLIM bi-exponential and phasor analyses of synthetic melanin, melanocytes/keratinocytes coculture and in vivo human skin. Using parameters of global 3D epidermal melanin density and z-epidermal distribution profile, we provide first insights into the in vivo knowledge of 3D melanin modulations with constitutive pigmentation versus ethnicity, with seasonality over 1 year and with topical application of retinoic acid or retinol on human skin. Applications of Pseudo-FLIM based melanin detection encompass physiological, pathological, or environmental factors-induced pigmentation modulations up to whitening, anti-photoaging, or photoprotection products evaluation.

Simultaneous NAD(P)H and FAD fluorescence lifetime microscopy of long UVA-induced metabolic stress in reconstructed human skin.

Solar ultraviolet longwave UVA1 exposure of human skin has short-term consequences at cellular and molecular level, leading at long-term to photoaging. Following exposure, reactive oxygen species (ROS) are generated, inducing oxidative stress that might impair cellular metabolic activity. However, the dynamic of UVA1 impact on cellular metabolism remains unknown because of lacking adequate live imaging techniques. Here we assess the UVA1-induced metabolic stress response in reconstructed human skin with multicolor two-photon fluorescence lifetime microscopy (FLIM). Simultaneous imaging of nicotinamide adenine dinucleotide (NAD(P)H) and flavin adenine dinucleotide (FAD) by wavelength mixing allows quantifying cellular metabolism in function of NAD(P)+/NAD(P)H and FAD/FADH2 redox ratios. After UVA1 exposure, we observe an increase of fraction of bound NAD(P)H and decrease of fraction of bound FAD indicating a metabolic switch from glycolysis to oxidative phosphorylation or oxidative stress possibly correlated to ROS generation. NAD(P)H and FAD biomarkers have unique temporal dynamic and sensitivity to skin cell types and UVA1 dose. While the FAD biomarker is UVA1 dose-dependent in keratinocytes, the NAD(P)H biomarker shows no dose dependence in keratinocytes, but is directly affected after exposure in fibroblasts, thus reflecting different skin cells sensitivities to oxidative stress. Finally, we show that a sunscreen including a UVA1 filter prevents UVA1 metabolic stress response from occurring.

Assessing the impact of COVID-19 on liver cancer management (CERO-19).

BACKGROUND & AIMS: The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems and it may have heavily impacted patients with liver cancer (LC). Herein, we evaluated whether the schedule of LC screening or procedures has been interrupted or delayed because of the COVID-19 pandemic. METHODS: An international survey evaluated the impact of the COVID-19 pandemic on clinical practice and clinical trials from March 2020 to June 2020, as the first phase of a multicentre, international, and observational project. The focus was on patients with hepatocellular carcinoma or intrahepatic cholangiocarcinoma, cared for around the world during the first COVID-19 pandemic wave. RESULTS: Ninety-one centres expressed interest to participate and 76 were included in the analysis, from Europe, South America, North America, Asia, and Africa (73.7%, 17.1%, 5.3%, 2.6%, and 1.3% per continent, respectively). Eighty-seven percent of the centres modified their clinical practice: 40.8% the diagnostic procedures, 80.9% the screening programme, 50% cancelled curative and/or palliative treatments for LC, and 41.7% modified the liver transplantation programme. Forty-five out of 69 (65.2%) centres in which clinical trials were running modified their treatments in that setting, but 58.1% were able to recruit new patients. The phone call service was modified in 51.4% of centres which had this service before the COVID-19 pandemic (n = 19/37). CONCLUSIONS: The first wave of the COVID-19 pandemic had a tremendous impact on the routine care of patients with liver cancer. Modifications in screening, diagnostic, and treatment algorithms may have significantly impaired the outcome of patients. Ongoing data collection and future analyses will report the benefits and disadvantages of the strategies implemented, aiding future decision-making. LAY SUMMARY: The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems globally. Herein, we assessed the impact of the first wave pandemic on patients with liver cancer and found that routine care for these patients has been majorly disrupted, which could have a significant impact on outcomes.

In vivo multiphoton imaging for non-invasive time course assessment of retinoids effects on human skin.

BACKGROUND: In vivo multiphoton imaging and automatic 3D image processing tools provide quantitative information on human skin constituents. These multiphoton-based tools allowed evidencing retinoids epidermal effects in the occlusive patch test protocol developed for antiaging products screening. This study aimed at investigating their relevance for non-invasive, time course assessment of retinoids cutaneous effects under real-life conditions for one year. MATERIALS AND METHODS: Thirty women, 55-65 y, applied either retinol (RO 0.3%) or retinoic acid (RA 0.025%) on one forearm dorsal side versus a control product on the other forearm once a day for 1 year. In vivo multiphoton imaging was performed every three months, and biopsies were taken after 1 year. Epidermal thickness and dermal-epidermal junction undulation were estimated in 3D with multiphoton and in 2D with histology, whereas global melanin density and its z-epidermal distribution were estimated using 3D multiphoton image processing tools. RESULTS: Main results after one year were as follows: a) epidermal thickening with RO (+30%); b) slight increase in dermal-epidermal junction undulation with RO; c) slight decrease in 3D melanin density with RA; d) limitation of the melanin ascent observed with seasonality and time within supra-basal layers with both retinoids, using multiphoton 3D-melanin z-epidermal profile. CONCLUSIONS: With a novel 3D descriptor of melanin z-epidermal distribution, in vivo multiphoton imaging allows demonstrating that daily usage of retinoids counteracts aging by acting not only on epidermal morphology, but also on melanin that is shown to accumulate in the supra-basal layers with time.

Imaging and quantifying drug delivery in skin - Part 2: Fluorescence andvibrational spectroscopic imaging methods.

Understanding the delivery and diffusion of topically-applied drugs on human skin is of paramount importance in both pharmaceutical and cosmetics research. This information is critical in early stages of drug development and allows the identification of the most promising ingredients delivered at optimal concentrations to their target skin compartments. Different skin imaging methods, invasive and non-invasive, are available to characterize and quantify the spatiotemporal distribution of a drug within ex vivo and in vivo human skin. The first part of this review detailed invasive imaging methods (autoradiography, MALDI and SIMS). This second part reviews non-invasive imaging methods that can be applied in vivo: i) fluorescence (conventional, confocal, and multiphoton) and second harmonic generation microscopies and ii) vibrational spectroscopic imaging methods (infrared, confocal Raman, and coherent Raman scattering microscopies). Finally, a flow chart for the selection of imaging methods is presented to guide human skin ex vivo and in vivo drug delivery studies.

Imaging and quantifying drug delivery in skin - Part 1: Autoradiography and mass spectrometry imaging.

In this two-part review we present an up-to-date description of different imaging methods available to map the localization of drugs on skin as a complement of established ex-vivo absorption studies. This first part deals with invasive methods which are grouped in two classes according to their underlying principles: i) methods using radioactivity such as autoradiography and ii) mass spectrometry methods such as MALDI and SIMS. For each method, a description of the principle is given along with example applications of imaging and quantifying drug delivery in human skin. Thanks to these techniques a better assessment of the fate of drugs is obtained: its localization on a particular skin structure, its potential accumulation, etc. A critical comparison in terms of capabilities, sensitivity and practical applicability is included that will help the reader to select the most appropriate technique depending on the particular problem to be solved.

Ethanol-induced symptoms in patients receiving gemcitabine diluted from a concentrate for solution for infusion containing ethanol.

Purpose Ethanol as an excipient is used to enhance the solubility of gemcitabine, but, sometimes, the dose of ethanol a patient may be given is much higher than the dose considered to be toxic. We aimed to assess ethanol-related symptoms and signs in patients receiving two formulations of gemcitabine, with and without ethanol. Methods A randomized double blind cross-over study was conducted. All patients being treated with gemcitabine received two consecutive doses of the drug, one diluted from a concentrate for solution for infusion (CSI) containing ethanol and the other from a lyophilized powder, without ethanol, which was used as control group. After each administration, patients were surveyed in order to assess the appearance of any alcohol consumption symptoms (dizziness, difficulty speaking, unsteady walking, impaired balance, mood swings and slower reactions). Widmark formula and the amount of alcohol measured on the breath (breathalyzer) were used to estimate blood alcohol concentration. Results Twenty-four patients received both formulations and were included in the analysis. Mean administered ethanol dose when prepared from CSI was 15.81 ± 2.25 g (mean ± SD). When using CSI gemcitabine, estimated blood ethanol concentration was 0.033 g/dl according to Widmark formula and 0.02 g/dl according to breathalyzer results. Although overall incidence of symptoms was higher in the study group, the difference was not statistically significant (33% vs. 25%; p = 0.53). Conclusions These findings prove there is no difference in the onset of ethanol related symptoms when using CSI instead of lyophilized powder on the reconstitution of gemcitabine.

Multicolor two-photon imaging of endogenous fluorophores in living tissues by wavelength mixing.

Two-photon imaging of endogenous fluorescence can provide physiological and metabolic information from intact tissues. However, simultaneous imaging of multiple intrinsic fluorophores, such as nicotinamide adenine dinucleotide(phosphate) (NAD(P)H), flavin adenine dinucleotide (FAD) and retinoids in living systems is generally hampered by sequential multi-wavelength excitation resulting in motion artifacts. Here, we report on efficient and simultaneous multicolor two-photon excitation of endogenous fluorophores with absorption spectra spanning the 750-1040 nm range, using wavelength mixing. By using two synchronized pulse trains at 760 and 1041 nm, an additional equivalent two-photon excitation wavelength at 879 nm is generated, and achieves simultaneous excitation of blue, green and red intrinsic fluorophores. This method permits an efficient simultaneous imaging of the metabolic coenzymes NADH and FAD to be implemented with perfect image co-registration, overcoming the difficulties associated with differences in absorption spectra and disparity in concentration. We demonstrate ratiometric redox imaging free of motion artifacts and simultaneous two-photon fluorescence lifetime imaging (FLIM) of NADH and FAD in living tissues. The lifetime gradients of NADH and FAD associated with different cellular metabolic and differentiation states in reconstructed human skin and in the germline of live C. Elegans are thus simultaneously measured. Finally, we present multicolor imaging of endogenous fluorophores and second harmonic generation (SHG) signals during the early stages of Zebrafish embryo development, evidencing fluorescence spectral changes associated with development.

Actividad antiagregante plaquetaria pero no anticoagulante de extractos de Morinda citrifolia L / Antiplatelet but not anticoagulant activity of Morinda citrifolia L. leaf extracts

Introduction: morinda citrifolia L (Noni) is a medicinal plant species that has gained popularity among Cuban population, suggesting the need to characterize the pharmacological activities of noni preparations developed in Cuba. Objective: assessing the effects of Noni leaf and fruit extracts on platelet aggregation and blood coagulation, as well as the possible influence of plant age, leaf maturity and extract total phenol and flavonoid contents on it. Methods: green and yellow leaves and light yellow fruits were collected from three- and six- year old Noni trees. Leaf (30 g/100 mL w/v) and fruit (100 g/100 mL w/v) extracts were prepared by maceration in 50 percent alcohol and water respectively. The concentrations of total soluble solids (TSS), phenolic compounds (PHEN) and flavonoids expressed as quercetin (FLV) in the extracts were determined. The in vitro effects of leaf (0,4 and 0,8 mg TSS/mL) and fruit (0,6 and 1,2 mg TSS/mL) extracts on ADP-induced platelet aggregation (PA), prothrombin time (PT) and partial activated thromboplastine time (PATT) in human plasma was determined. Furthermore, the ex vivo effects of a leaf extract (42 and 378 mg TSS / kg i.p. and 630 mg/kg p.o.) on these variables of rat plasma were assessed. Results: fruit extracts showed higher TSS, but lower PHE and FLV values than leaf extracts. Leaf but not fruit extracts inhibited ADP-induced PA that was independent on plant age and leaf maturity. A significant reduction of PA was ex vivo induced by a leaf extract in rats. TP and PATT were not modified during in vivo or ex vivo experiments. Conclusion: noni leaf hydro-alcohol extracts developed in Cuba have antiplatelet but not anticoagulant effect(AU)

Introducción: morinda citrifolia L (Noni) ha ganado popularidad entre la población cubana, lo que sugiere la necesidad de caracterizar farmacológicamente las preparaciones de noni desarrolladas en Cuba. Objetivo: evaluar los efectos de extractos de hojas y frutos de Noni sobre la agregación plaquetaria y la coagulación sanguínea, así como la influencia de la edad de la planta, la madurez de la hoja y los contenidos de fenoles totales y flavonoides. Métodos: hojas verdes y amarillas y frutos ligeros amarillos fueron recolectados de plantas de noni de tres y seis años de edad. Extractos de hojas (30 g/100 mL w/v) y frutos (100 g/100 mL w/v) estuvieron preparados por maceración en alcohol al 50 por ciento y agua, al respecto. Las concentraciones de sólidos totales (TSS), compuestos fenólicos (PHEN) y flavonoides expresados como quercetina (FLV) fueron determinadas. Los efectos de los extractos de hojas (0,4 y 0,8 mg TSS/mL) y de frutos (0,6 y 1,2 mg TSS/mL) sobre la agregación plaquetaria (PA) inducida por ADP, el tiempo de protrombina (PT) y el tiempo parcial de tromboplastina parcial activado (PATT) fueron determinados en plasma humano in vitro y los efectos de un extracto de hojas (42 y 378 mg TSS/kg i.p. y 630 mg/kg p.o.) sobre estas variables de plasmas de ratas fueron evaluados ex vivo. Resultados: los extractos de frutos tuvieron mayor contenido de TSS pero menores de PHEN y FLV que los de hojas. Estos últimos inhibieron la PA in vitro en plasma humano independiente de la edad de la planta y la madurez de las hojas. Un extracto de hojas indujo significativa reducción de PA ex vivo en ratas. TP y PATT no fueron modificados en ninguna situación experimental. Conclusión: extractos hidroalcohólicos de hojas de Noni desarrollados en Cuba tienen efecto antiagregante plaquetario pero no anticoagulante(AU)

Antiplatelet but not anticoagulant activity of Morinda citrifolia L. leaf extracts / Actividad antiagregante plaquetaria pero no anticoagulante de extractos de Morinda citrifolia L

INTRODUCCIÓN: morinda citrifolia L (Noni) ha ganado popularidad entre la población cubana, lo que sugiere la necesidad de caracterizar farmacológicamente las preparaciones de noni desarrolladas en Cuba. OBJETIVO: evaluar los efectos de extractos de hojas y frutos de Noni sobre la agregación plaquetaria y la coagulación sanguínea, así como la influencia de la edad de la planta, la madurez de la hoja y los contenidos de fenoles totales y flavonoides. MÉTODOS: hojas verdes y amarillas y frutos ligeros amarillos fueron recolectados de plantas de noni de tres y seis años de edad. Extractos de hojas (30 g/100 mL w/v) y frutos (100 g/100 mL w/v) estuvieron preparados por maceración en alcohol al 50 % y agua, al respecto. Las concentraciones de sólidos totales (TSS), compuestos fenólicos (PHEN) y flavonoides expresados como quercetina (FLV) fueron determinadas. Los efectos de los extractos de hojas (0,4 y 0,8 mg TSS/mL) y de frutos (0,6 y 1,2 mg TSS/mL) sobre la agregación plaquetaria (PA) inducida por ADP, el tiempo de protrombina (PT) y el tiempo parcial de tromboplastina parcial activado (PATT) fueron determinados en plasma humano in vitro y los efectos de un extracto de hojas (42 y 378 mg TSS/kg i.p. y 630 mg/kg p.o.) sobre estas variables de plasmas de ratas fueron evaluados ex vivo. RESULTADOS: los extractos de frutos tuvieron mayor contenido de TSS pero menores de PHEN y FLV que los de hojas. Estos últimos inhibieron la PA in vitro en plasma humano independiente de la edad de la planta y la madurez de las hojas. Un extracto de hojas indujo significativa reducción de PA ex vivo en ratas. TP y PATT no fueron modificados en ninguna situación experimental. CONCLUSIÓN: extractos hidroalcohólicos de hojas de Noni desarrollados en Cuba tienen efecto antiagregante plaquetario pero no anticoagulante.

INTRODUCTION: morinda citrifolia L (Noni) is a medicinal plant species that has gained popularity among Cuban population, suggesting the need to characterize the pharmacological activities of noni preparations developed in Cuba. OBJECTIVE: assessing the effects of Noni leaf and fruit extracts on platelet aggregation and blood coagulation, as well as the possible influence of plant age, leaf maturity and extract total phenol and flavonoid contents on it. METHODS: green and yellow leaves and light yellow fruits were collected from three- and six- year old Noni trees. Leaf (30 g/100 mL w/v) and fruit (100 g/100 mL w/v) extracts were prepared by maceration in 50 % alcohol and water respectively. The concentrations of total soluble solids (TSS), phenolic compounds (PHEN) and flavonoids expressed as quercetin (FLV) in the extracts were determined. The in vitro effects of leaf (0,4 and 0,8 mg TSS/mL) and fruit (0,6 and 1,2 mg TSS/mL) extracts on ADP-induced platelet aggregation (PA), prothrombin time (PT) and partial activated thromboplastine time (PATT) in human plasma was determined. Furthermore, the ex vivo effects of a leaf extract (42 and 378 mg TSS / kg i.p. and 630 mg/kg p.o.) on these variables of rat plasma were assessed. RESULTS: fruit extracts showed higher TSS, but lower PHE and FLV values than leaf extracts. Leaf but not fruit extracts inhibited ADP-induced PA that was independent on plant age and leaf maturity. A significant reduction of PA was ex vivo induced by a leaf extract in rats. TP and PATT were not modified during in vivo or ex vivoexperiments. CONCLUSION: noni leaf hydro-alcohol extracts developed in Cuba have antiplatelet but not anticoagulant effect.

Importancia del intercambio científico entre colegas / Significance of the scientific exchange among colleagues

La presentación de los nuevos estudios en eventos nacionales e internacionales y su ulterior publicación en revistas de impacto, cierra el ciclo de toda investigación científica, pero el debate entre los investigadores, es lo que aporta una mayor relevancia a los resultados alcanzados y permite una mayor claridad de los mismos...

Automatic 3D segmentation of multiphoton images: a key step for the quantification of human skin.

BACKGROUND/PURPOSE: Multiphoton microscopy has emerged in the past decade as a useful noninvasive imaging technique for in vivo human skin characterization. However, it has not been used until now in evaluation clinical trials, mainly because of the lack of specific image processing tools that would allow the investigator to extract pertinent quantitative three-dimensional (3D) information from the different skin components. METHODS: We propose a 3D automatic segmentation method of multiphoton images which is a key step for epidermis and dermis quantification. This method, based on the morphological watershed and graph cuts algorithms, takes into account the real shape of the skin surface and of the dermal-epidermal junction, and allows separating in 3D the epidermis and the superficial dermis. RESULTS: The automatic segmentation method and the associated quantitative measurements have been developed and validated on a clinical database designed for aging characterization. The segmentation achieves its goals for epidermis-dermis separation and allows quantitative measurements inside the different skin compartments with sufficient relevance. CONCLUSIONS: This study shows that multiphoton microscopy associated with specific image processing tools provides access to new quantitative measurements on the various skin components. The proposed 3D automatic segmentation method will contribute to build a powerful tool for characterizing human skin condition. To our knowledge, this is the first 3D approach to the segmentation and quantification of these original images.

Determinación de algunos indicadores bioquímicos en personas con linfedema secundario de miembros inferiores / Determination of some biochemical parameters in patients with secondary lymphedema of lowers limbs

Introducción: el linfedema es una enfermedad crónica, con tasas de incidencia y prevalencia que van en aumento y con efectos negativos sobre la calidad de vida de los enfermos.Objetivo: describir el comportamiento de algunos parámetros bioquímicos en personas con linfedema secundario de miembros inferiores. Métodos: estudio descriptivo de corte transversal en las 16 personas con linfedema secundario de miembros inferiores detectadas en el municipio Cerro, con un rango de edad que osciló entre 18 y 72 años, 10 eran mujeres (62,5 por ciento) y seis eran hombres (37,5 por ciento). Se cuantificaron los siguientes parámetros bioquímicos: glucosa, colesterol total, triglicéridos, fibrinógeno, y Factor VII. Se analizó el comportamiento de las variables de forma global e individualizada.Resultados: al analizar de forma individual el comportamiento de las variables, de acuerdo a los límites de normalidad publicados por los fabricantes de los diagnosticadores, se halló que más del 50 por ciento de los pacientes tuvieron cifras normales; por debajo de los límites inferiores se encontraron el colesterol total en 7 (43,75 por ciento) pacientes, los triglicéridos en 2 (12,5 por ciento) y la glucosa en 5 (31,25 por ciento), sin constatar ninguno con cifras elevadas; sin embargo, esto último si fue apreciado, con igual frecuencia, en el caso del FVII y el fibrinógeno, en 4 (25 por ciento) enfermos, respectivamente.Conclusión: los resultados obtenidos no permitieron seleccionar ningún parámetro como marcador propio del linfedema, pero sí contribuirán a elevar el nivel de conocimiento de esta enfermedad poco estudiada(AU)

Introduction: lymphedema is a chronic illness, with rates of incidence and prevalence that are on the rise and with negative effects on the patients' quality of life.Objective: To describe the behaviour of some biochemical parameters in patients with secondary lymphedema of the lower limbs. Methods: a descriptive cross-sectional study conducted in 16 persons with secondary lymphedema of the lower limbs, who were detected in Cerro municipality; 10 were women (62.5 percent) and six were men (37.5 percent) aged 18 to 72 years. The following biochemical parameters were quantitated: glucose, total cholesterol, triglycerides, fibrinogen, and Factor VII. The behaviour of the variables were globally and individually analyzed. Results: according to the normal limits set by the manufacturers of diagnostics, the analysis of the individual behaviour found that more than 50 percent of the patients presented normal figures; values lower than the limit figures were found in total cholesterol (n=7, 43.75 percent), triglycerides (n=2, 12.50 percent,) and glucose (n=5, 31.25 percent); however, high figures were equally observed in the case of Factor VII and fibrinogen (n=4, 25 percent) respectively.Conclusions: It may be stated that the obtained results did not allow selecting any parameter as the right marker of lymphedema, but did help to raise the level of knowledge on this poorly studied disease(AU)