Changes In Peripheral Blood Flow Research Articles

Doppler ultrasonographic measurements of the lateral digital palmar artery in pregnant mares.

Cardiovascular changes have been reported in late pregnancy in mares. However, there are no data on changes in peripheral blood flow. Doppler ultrasound represents a sensitive method for assessing the blood flow directed to the hoof. The aims of this study were to evaluate the blood flow parameters of the lateral palmar digital artery (LPDA) in pregnant mares and to assess intra- and interrater agreement between two observers with different levels of experience. The LPDAs of pregnant Italian Standardbred mares were examined. The vessels were located with B-mode ultrasound and analyzed with color and pulsed wave Doppler. The following parameters were recorded by the operators: heart rate (HR), peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI). Measurements were performed between 2 and 3 months of gestation (T1), in the last month of pregnancy (T2) and a week after delivery (T3). Seventeen mares aged 3-18 years met the inclusion criteria. Ultrasound examinations of the LPDA were subjectively easy to perform and well tolerated by the mares. Interrater and intrarater agreement were good and moderate, respectively. The HR was higher at T2 than at T1 and T3. The PSV and RI changed significantly during pregnancy, with higher values at T2 and T3, whereas the EDV remained unchanged throughout the examination. Doppler examination showed that peripheral flow changes were present in mares in late pregnancy. However, the persistence of higher values after delivery invites further investigation to assess the correlation between metabolic/endocrine changes related to pregnancy and Doppler parameters.

PERFUSION INDEX FROM UPPER LIMB AS A TOOL IN THE PREDICTION OF SPINAL ANAESTHESIA INDUCED HYPOTENSION DURING CAESAREAN DELIVERY

Background: Hypotension following spinal anaesthesia during elective caesarean commonly seen either due to decreased in vascular tone or decreased cardiac output because of blood pooling. Peripheral perfusion index (PI) being a non-invasive measure of real time change in peripheral blood flow can be a dynamic measure in prediction of hypotension. This is a prospective study done in Assam Medical college and hospital recruiting 100 Methodology: parturient based on inclusion and exclusion criteria. They were divided into two groups with 50 parturient in each group with baseline PI>3.5 and <3.5 respectively. The statistical analysis was done using SPSS. Statistical significance was fixed at 5% level (p value <0.05). Majority of parturient were less than 25years of age, less than 160cms Results: in height and weight less than 65kgs in both groups. No statistical significance observed between the study groups in terms of duration of surgery. The incidences of Hypotension in Group I (PI > 3.5) was 54% compared to Group II (PI ≤ 3.5) which was 13% and was highly statistically significant (p=0.001). Parturient with a baseline PI >3.5 were Conclusion: at higher risk of developing hypotension compared to those with a baseline PI ≤ 3.5 following spinal anaesthesia. Thus, preoperative baseline PI can be used as a predictive tool for hypotension.

Do Sports Compression Garments Alter Measures of Peripheral Blood Flow? A Systematic Review with Meta-Analysis.

One of the proposed mechanisms underlying the benefits of sports compression garments may be alterations in peripheral blood flow. We aimed to determine if sports compression garments alter measures of peripheral blood flow at rest, as well as during, immediately after and in recovery from a physiological challenge (i.e. exercise or an orthostatic challenge). We conducted a systematic literature search of databases including Scopus, SPORTDiscus and PubMed/MEDLINE. The criteria for inclusion of studies were: (1) original papers in English and a peer-reviewed journal; (2) assessed effect of compression garments on a measure of peripheral blood flow at rest and/or before, during or after a physiological challenge; (3) participants were healthy and without cardiovascular or metabolic disorders; and (4) a study population including athletes and physically active or healthy participants. The PEDro scale was used to assess the methodological quality of the included studies. A random-effects meta-analysis model was used. Changes in blood flow were quantified by standardised mean difference (SMD) [± 95% confidence interval (CI)]. Of the 899 articles identified, 22 studies were included for the meta-analysis. The results indicated sports compression garments improve overall peripheral blood flow (SMD = 0.32, 95% CI 0.13, 0.51, p =0.001), venous blood flow (SMD = 0.37, 95% CI 0.14, 0.60, p = 0.002) and arterial blood flow (SMD = 0.30, 95% CI 0.01, 0.59, p = 0.04). At rest, sports compression garments did notimprove peripheral blood flow (SMD = 0.18, 95% CI -0.02, 0.39, p = 0.08). However,subgroup analyses revealed sports compression garmentsenhance venous (SMD = 0.31 95% CI 0.02, 0.60, p = 0.03), but not arterial (SMD = 0.12, 95% CI -0.16, 0.40, p = 0.16), blood flow. During a physiological challenge, peripheral blood flow was improved (SMD = 0.44, 95% CI 0.19, 0.69, p = 0.0007), with subgroup analyses revealing sports compression garments enhance venous (SMD = 0.48, 95% CI 0.11, 0.85, p = 0.01) and arterial blood flow (SMD = 0.44, 95% CI 0.03, 0.86, p = 0.04). At immediately after a physiological challenge, there were no changes in peripheral blood flow (SMD = - 0.04, 95% CI - 0.43, 0.34, p = 0.82) or subgroup analyses of venous (SMD = - 0.41, 95% CI - 1.32, 0.47, p = 0.35) and arterial (SMD = 0.12, 95% CI - 0.26, 0.51, p = 0.53) blood flow. In recovery, sports compression garmentsdid not improve peripheral blood flow (SMD = 0.25, 95% CI -0.45, 0.95, p = 0.49). The subgroup analyses showed enhanced venous (SMD = 0.67, 95% CI 0.17, 1.17, p = 0.009), but not arterial blood flow (SMD = 0.02, 95% CI -1.06, 1.09, p = 0.98). Use of sports compression garments enhances venousblood flow at rest, during and in recovery from, but not immediately after, a physiological challenge.Compression-induced changes in arterial blood flow were only evident during a physiological challenge.

Indicators Of Pulmonary Blood Flow in Assessing the Degree of Maturity of Fetal Lungs

Morpho structural change of lung tissue due to the degree of its maturation should be accompanied by a change in peripheral blood flow, and therefore we set the goal of determining the characteristics of peripheral blood flow of lung tissue in fetuses with different degrees of lung maturity.

The effectiveness of the inclusion of ozone therapy in comprehensive rehabilitation programs for post-COVID syndrome

BACKGROUND: The global scale of the pandemic of a new coronavirus infection is determined by the involvement of the entire world population in the problem. Recently, the scientific and medical community has been paying increased attention to the consequences of COVID-19, including aspects of the rehabilitation of patients who have had this infection.
 AIM: to evaluate the effectiveness and safety of including ozone therapy in the rehabilitation of patients with long COVID.
 MATERIALS AND METHODS: This randomized controlled clinical trial included 51 patients aged 29 to 78 years with a confirmed diagnosis of pneumonia associated with SARS-CoV-2 (J12.8). Patients were divided into three statistically comparable groups depending on the complex of rehabilitation treatment, which they received. In the first (control) group (n=17), a 10-day course included daily breathing exercises and physiotherapy for the lungs. In the second (main) group (n=18), in addition to the complex of basic measures, daily intravenous infusions of ozonized saline with an ozone concentration of 2.0 mg/l were performed daily. Patients in the third group (comparison, n=16) received ozone therapy every other day. In order to determine the effectiveness and safety of the inclusion of systemic ozone therapy in a comprehensive program for the rehabilitation of patients after COVID-19, an analysis of blood oxygen saturation in air, laboratory parameters (D-dimer and C-reactive protein), changes in peripheral blood flow, a decrease in patients' oxygen demand to and after a 10-day course of rehabilitation treatment. The dynamics of patients' complaints and changes in the patient's quality of life during rehabilitation were assessed using the EQ5D questionnaire.
 RESULTS: All patients during rehabilitation had positive dynamics in all parameters, there were no adverse reactions during the course and 2 months after rehabilitation. An analysis of various indicators revealed a greater effectiveness in prescribing systemic ozone therapy for rehabilitation. When comparing different methods, it turned out that daily ozone therapy had a better effect on laboratory parameters than daily ozone therapy.
 CONCLUSIONS: The use of ozone therapy in the complex rehabilitation of patients after COVID-19 is safe and effective. Further study in more patients is needed to determine indications and criteria for use.

Use of Thermography in Clinical and Sports Evaluations of Equine Animals: A review

Thermography in equine medicine is applied in the prevention, diagnosis and prognosis of diseases, as it can detect changes in peripheral blood flow. It can also act in the treatment by monitoring the instituted therapy. Skin infrared imaging thermometry is a method that detects, records, and produces images reflecting the microcirculatory dynamics of the skin surface in real time. The technique emerged from the studies of Hippocrates and has since gone through several advances, reaching significant milestones in the period of World War II, when it was effectively used in the tank's night vision system. In the 1970s, there was a big leap when it was possible to generate an image in five minutes. Several scientific studies point out its functionality both in human medicine and veterinary medicine with precision and practicality. It has been applied in equine sports medicine to clinical practice to assess musculoskeletal injuries as an indicator of physiological stress, assess resistance, be part of the anti-doping program of the International Equestrian Federation. It is an easy to apply, safe, and affordable method It proves to be an excellent non-invasive diagnostic method for athlete horses.

Effect of cycle ergometry on peripheral blood flow, vascular conductance, and vascular resistance in young people

IntroductionThe study aimed to evaluate haemodynamic changes in peripheral blood flow, vascular conductance (VC), and peripheral vascular resistance (PVR) in healthy individuals undergoing passive and active lower limb cycle ergometry.MethodsThis was a prospective, controlled, randomized study with a crossover design, in which 14 normotensive volunteers were allocated to receive: (1) assessment without intervention (control group); (2) passive lower limb cycle ergometry; and (3) active cycle ergometry of lower limbs. In the physical exercise session of the active and passive lower limb cycle ergometry protocol, the volunteers were placed in the supine position and then performed aerobic exercise for 20 minutes. Forearm blood flow was measured with a venous occlusion plethysmograph, blood pressure was evaluated with oscillometric and automatic equipment, and heart rate was monitored continuously through lead II of electrocardiogram.ResultsActive cycle ergometry was able to promote hypotension after physical exercise owing to a reduction in mean blood pressure (<i>p</i> = 0.000), with an improvement in vascular function as reflected by a reduction in PVR (<i>p</i> = 0.000) and an increase in VC (<i>p</i> = 0.000). Although the reduction in mean blood pressure in the passive cycle ergometry group was not significant, it was sufficient to promote an increase in VC (<i>p</i> = 0.049) and a reduction in PVR (<i>p</i> = 0.008).ConclusionsA single session of 20 minutes of physical exercise with passive or active cycle ergometry of the lower limbs was sufficient to promote haemodynamic changes in normotensive individuals.

Cortical Anoxic Spreading Depolarization During Cardiac Arrest is Associated with Remote Effects on Peripheral Blood Pressure and Postresuscitation Neurological Outcome

BackgroundSpreading depolarizations (SDs) are self-propagating waves of neuronal and glial depolarizations often seen in neurological conditions in both humans and animal models. Because SD is thought to worsen neurological injury, the role of SD in a variety of cerebral insults has garnered significant investigation. Anoxic SD is a type of SD that occurs because of anoxia or asphyxia. Although asphyxia leading to a severe drop in blood pressure may affect cerebral hemodynamics and is widely known to cause anoxic SD, the effect of anoxic SD on peripheral blood pressure in the extremities has not been investigated. This relationship is especially important to understand for conditions such as circulatory shock and cardiac arrest that directly affect both peripheral and cerebral perfusion in addition to producing anoxic SD in the brain.MethodsIn this study, we used a rat model of asphyxial cardiac arrest to investigate the role of anoxic SD on cerebral hemodynamics and metabolism, peripheral blood pressure, and the relationship between these variables in 8- to 12-week-old male rats. We incorporated a multimodal monitoring platform measuring cortical direct current simultaneously with optical imaging.ResultsWe found that during anoxic SD, there is decoupling of peripheral blood pressure from cerebral blood flow and metabolism. We also observed that anoxic SD may modify cerebrovascular resistance. Furthermore, shorter time difference between anoxic SDs measured at different locations in the same rat was associated with better neurological outcome on the basis of the recovery of electrocorticography activity (bursting) immediately post resuscitation and the neurological deficit scale score 24 h post resuscitation.ConclusionsTo our knowledge, this is the first study to quantify the relationship between peripheral blood pressure, cerebral hemodynamics and metabolism, and neurological outcome in anoxic SD. These results indicate that the characteristics of SD may not be limited to cerebral hemodynamics and metabolism but rather may also encompass changes in peripheral blood flow, possibly through a brain–heart connection, providing new insights into the role of anoxic SD in global ischemia and recovery.

Acute changes in forearm vascular compliance during transient sympatho-excitation.

The study of vascular regulation often omits important information about the elastic properties of arteries under conditions of pulsatile flow. The purpose of this study was to examine the relationship between muscle sympathetic nerve activity (MSNA), vascular bed compliance, and peripheral blood flow responses in humans. We hypothesized that increases in MSNA would correlate with reductions in vascular compliance, and that changes in compliance would correspond with changes in peripheral blood flow during sympatho‐excitation. MSNA (microneurography), blood pressure (Finopres), and brachial artery blood flow (Doppler ultrasound), were monitored in six healthy males at baseline and during the last 15 s of voluntary end‐inspiratory, expiratory apneas and 5 min of static handgrip exercise (SHG; 20% maximum voluntary contraction) and 3 min of post‐exercise circulatory occlusion (SHG + PECO; measured in the non‐exercising arm). A lumped Windkessel model was employed to examine vascular bed compliance. During apnea, indices of MSNA were inversely related with vascular compliance, and reductions in compliance correlated with decreased brachial blood flow rate. During SHG, despite increased MSNA, compliance also increased, but was unrelated to increases in blood flow. Neither during SHG nor PECO did indices of MSNA correlate with forearm vascular compliance nor did vascular compliance correlate with brachial flow. However, during PECO, a linear combination of blood pressure and total MSNA was correlated with vascular compliance. These data indicate the elastic components of the forearm vasculature are regulated by adrenergic and myogenic mechanisms during sympatho‐excitation, but in a reflex‐dependent manner.

Microcirculation and tissue oxygenation in the head and limbs during hyperbaric oxygen treatment.

Hyperbaric oxygen (HBO) exposure for 10-15 min has been shown to reduce peripheral blood flow due to vasoconstriction. However, the relationship between decreased peripheral blood flow and the therapeutic effects of HBO treatment on peripheral circulatory disorders remain unknown. Longer exposures have been reported to have vasodilatory effects and increase peripheral blood flow. This study investigated the effect of HBO treatment on blood flow and transcutaneous oxygen pressure (TcPO2). Twenty healthy volunteers aged 20-65 years (nine males) participated in this study. All participants breathed oxygen for 60 min at 253.3 kPa. Peripheral blood flow using laser Doppler flowmetry and TcPO2 on the ear, hand, and foot were continuously measured from pre-HBO exposure to 10 min post-exposure. Peripheral blood flow in each body part decreased by 7-23% at the beginning of the HBO exposure, followed by a slow increase. Post-exposure, peripheral blood flow increased 4-76% in each body part. TcPO2 increased by 840-1,513% during the exposure period, and remained elevated for at least 10 min after the exposure. The findings of the current study suggest vasoconstriction during HBO treatment is transient, and even when present does not inhibit the development of increased tissue oxygen partial pressure. These findings are relevant to studies investigating changes in peripheral blood flow during HBO treatment in patients with circulatory disorders.

Effect of Carbon Dioxide (CO2)-Rich Water Immersion on Changes of Peripheral Blood Flow in Patients with Kidney Disease

Endothelial dysfunction is experienced in hemodialysis patients, characterized by stiffness in the blood vessel walls resulting in decreased peripheral blood flow. The research objective was to determine the effect of immersion in CO2 water on peripheral blood flow changes. Experimental design with 30 patients divided into two groups; 18 patients immersed their feet in CO2 water (1,300 ppm) at 37-38°C and 12 patients were immersed in fresh water at 36-37°C performed 2-3 times per week for four weeks, measurement of peripheral blood flow using Laser Doppler Flowmetry on day 1 and 28. Peripheral blood flow from the CO2 water immersion group decreased from 12,443 mL/minute to 11,677 mL/minute (decreased by 0.766 mL/minute), while the freshwater immersion group decreased from 8,471 mL/minute to 6,776 mL/minute (decreased by 1,695 mL/min). Immersion in CO2 water tends to reduce peripheral blood flow inhibition more than immersion in fresh water in hemodialysis patients.

The role of behavioral, autonomous, and adaptive processes in rodent thermoregulation

Meteorological variables are the main abiotic factors that directly influence reactions in rodent metabolism, activating the action of thermoregulatory mechanisms aimed at homeostasis and can involve several factors that work together to dissipate or conserve body heat. In this scenario, we aimed to address, synthetically, the main means that rodents have to adapt and survive faced with the thermoregulatory challenges posed by the environment in which they live. Among these processes, behavioral changes can occur in water and food intake, as well as voluntary displacement to environments offering greater thermal comfort. The autonomic processes involve innate mechanisms that act quickly to facilitate thermal exchange, such as sweating, respiratory evaporation, and changes in peripheral blood flow. Adaptation involves evolutionary processes that, in the long run, alter the morphophysiological characteristics of the epidermis and coat, in order to conserve or dissipate heat. Knowledge of the role of these processes in adaptive physiology is essential to understand how the thermal environment affects rodents and how deleterious effects are mitigated.

Peripheral Blood Flow Changes to Cutaneous and Muscular Beds in Response to Acute Hookah Smoking

Hookah (waterpipe) smoking is a growing tobacco epidemic. Though perceived as a safer tobacco alternative, hookah smoke contains, in addition to tobacco combustion products, large amounts of charcoal combustion products-implicated in cardiovascular disease-from the burning charcoal used to heat the flavored tobacco. To date, little is known on the vascular effects of hookah smoking. The aim of this study was to characterize the peripheral circulatory response to acute hookah smoking in cutaneous and muscular beds. In 21 healthy young adult habitual hookah smokers who did not smoke cigarettes (age 24 ± 1 years, mean ± SE), we measured plasma nicotine, exhaled carbon monoxide, skin blood flow (laser Doppler velocimetry) and calf muscle blood flow (strain-gauge plethysmography) before and for up to 60 minutes after ad lib hookah smoking. In nine subjects, nonsmoking time-control studies were performed. Hookah smoking, which increased plasma nicotine by 5.8 ng/ml (from 0.6 ± 0.1 to 6.4 ± 1.3, p <0.001) and exhaled carbon monoxide by 27 ppm (from 2.7 ± 0.2 to 29.5 ± 2.2, p <0.001), decreased skin blood flow by 23% (20.1 ± 2.8 to 14.8 ± 1.9 units, p <0.001) and increased skeletal muscle blood flow by 34% (2.3 ± 0.1 to 2.9 ± 0.2 units, p = 0.010). These responses required more than one hour to recover after smoking cessation. All cardiovascular parameters were unchanged in the nonsmoking time-control studies. Although perceived to be innocuous, hookah smoking produces acute cutaneous vasoconstriction with skeletal muscle vasodilation, a dissociated pattern of peripheral blood flow responses that is characteristic of nicotine and carbon monoxide. In conclusion, these findings provide objective evidence to challenge the perception that hookah smoking is a safer tobacco alternative.

Cardiovascular reactivity to acute stress associated with sickness absence among Japanese men and women: A prospective study.

ObjectiveWe aimed to investigate associations between cardiovascular reactivity to acute stress and sickness absence among Japanese male and female workers, in a prospective study.MethodsAmong healthy employed Japanese workers who underwent mental health checks between 2006 and 2009, data of 111 participants were analyzed. Changes in blood pressure, pulse rate, peripheral blood flow (PBF), and heart rate variability (HRV) (high frequency [HF] and low frequency [LF]) were calculated using differences between the two tasks, mirror drawing stress [MDS] and a maze task, and the postperiod value. Sickness absence through March 2010 was followed up by mail survey (average follow‐up 2.3 years). Logistic regression analysis was used, adjusting for lifestyle factors.ResultsAmong 12 participants who took sickness absences, eight were owing to mental problems. Changes in the LF during the MDS and maze tasks and LF‐to‐HF ratio during the MDS task were positively associated with all sickness absences (odds ratio [OR], 95% confidence interval [CI]: 2.09, 1.03–4.22; 2.04, 1.09–3.82; and 3.10, 1.46–6.58, respectively). Changes in PBF during the MDS task were also associated with increased risk of sickness absence (OR, 95% CI: 2.53, 1.10–5.81).ConclusionCardiovascular reactivity to acute stress should be considered at workers' health checks.

Perfusion index and Plethysmographic variability index values in spontaneously breathing clinically stable term neonates in room air in the first 10 days of life

Background: Perfusion index (PI) and Pleth Variability Index (PVI) are newer pulseoximeter derived numerical non-invasive measures of Peripheral perfusion. PI gives real time changes in peripheral blood flow and PVI the dynamic changes in the PI that occur during the respiratory cycle. Reference values for neonatal population are very few and not yet published for Indian neonates. We undertook this study to establish the reference values for the first 10 days of life in term neonates. Methods: Prospective analytical study conducted at Division of Neonatology, Government Rajaji Hospital, Madurai Medical College. Inborn term neonates, spontaneously breathing in room air and clinically stable, without respiratory distress, on direct breast feeds or oral feeds are eligible for the study. PI, PVI values are recorded on the foot of neonates using Masimo Pulse oximeter for 15 minutes and data transferred to a computer and analyzed. Results: The Primary outcome median value of perfusion index is 1.4 IQR (1.0, 2.0) and Pleth variability index is 19.0 IQR (15.0, 25.0). Conclusions: The reference ranges for perfusion index and pleth variability index in healthy term Indian neonates are presented.

Monitoring of peripheral blood flow in patients with systemic lupus erythematosus by using laser speckle contrast analysis

Objective To noninvasively assess peripheral blood flow changes in patients with systemic lupus erythematosus (SLE) before and after treatments by using laser speckle contrast analysis (LSCA), to compare eripheral blood flow between SLE patients and healthy controls, and to evaluate effects of air temperature, age and gender on peripheral blood flow changes. Methods Clinical data on air temperature at the first visit (groups of ≥ 20 ℃ and < 20 ℃ ), age (groups of < 20, 20-< 40 and ≥ 40 years), gender, blood and urine routine test results, complement levels and immunologic test findings were collected from 47 patients with SLE. The patients' condition was evaluated by systemic lupus erythematosus disease activity index (SLEDAI), and Spearman's correlation analysis was carried out to assess its correlation with peripheral blood flow changes (expressed as changes in speckle flow index [△SFI]values) measured by LSCA. Peripheral blood flow was compared between the 47 patients and 30 healthy human controls. Results Compared with healthy controls, SLE patients showed significantly lower subungual SFI values (7.017 ± 0.356 vs. 9.765 ± 0.337, t = 5.182, P 0.05) compared with those at the baseline. Air temperature affected subungual blood flow significantly (t = 2.415, P 0.05). In addition, neither gender nor age had obvious effects on subungual or periungual blood flow. Conclusions Compared with healthy controls, peripheral blood flow significantly changed in patients with SLE, and was improved to a certain extent after treatment. Air temperature markedly affects subungual blood flow. LSCA may be a supplementary approach to more convenient and quantitative assessment of the severity of SLE. Key words: Lupus erythematosus, systemic; Blood flow velocity; Laser speckle contrast analysis

Peripheral Blood Flow Responses to Pain Following a Hypnosis Intervention in Sickle Cell Disease

Introduction: Vaso-occlusive pain crises are considered the "hallmark" of sickle cell disease (SCD). Persistent occurrence is thought to lead to changes in the peripheral and central nervous system, which can then in turn lead to changes in pain sensitivity. Imaging studies have shown that hypnotic analgesia can reduce activity in supraspinal areas of the "pain matrix." To date there are no published studies looking at the effectiveness of hypnosis in altering pain perception in patients with SCD. The purpose of this study was to investigate changes in peripheral blood flow in response to a 30-minute hypnosis intervention and its relationship to pain sensitivity.Methods: To assess the effectiveness of increasing vasodilation, a laboratory based, single session hypnosis protocol was administered to a sample of 14 SCD patients and 14 healthy controls. Continuous readings for SpO2, pulse rate and pulse waveform was monitored using a pulse oximetry transducer placed on the left thumb. Bio-behavioral pain measures were collected during a standardized pain protocol before and after a hypnosis session, performed by a trained therapist. The protocol consisted of assessing pain tolerance and threshold via a heat probe (˚C) for "pain task 1", preceded by an anticipation period. "Pain task 2" consisted of assessing pain intensity via the same heat probe (˚C) on a 1-100 visual analog scale (VAS), preceded by another anticipation period.Results: To investigate blood-flow responses to their respective baseline (baseline vs. hypnosis), all recorded signal following these two periods was normalized respectively. Independent sample t-tests between both normalized anticipation and pain responses periods revealed controls showed no response to hypnosis for anticipation period 1(t(23.42) = .184, p = .855, d = .072), but SCD patients showed a large increase in blood flow (t(16.99) = 4.189, p = .0006, d = 1.79). Neither controls (t(21.05) = .00, p = .994, d = .003) or SCD patients (t(19.99) =.718, p = .481, d = .305) showed an effect of hypnosis in response to pain task 1. Neither controls (t(23.96) = -.139, p = .890, d = -.05) or SCD patients (t(18.82) = 1.035, p = .313, d = .441) showed a response to anticipation period 2, but the effect size reveals that this may be due to a lack of power. Neither controls (t(16.52) = .258, p = .799, d = .101) or SCD patients (t(19.63) = p = .5375, d = .268) showed no changes in response to hypnosis for pain task 2. Independent sample t-tests revealed no significant difference in pain threshold (t(13) = 0.941, p = .364, d = .251) or tolerance (t(13) = 0.937, p = 0.366, d = 0.250) in SCD patients before and after hypnosis. Differences in pain ratings were marginal but showed a decrease with medium effect (t(13) = -1.5315, p = 0.150, d = 0.409). The same tests revealed significant decreases in controls for pain threshold (t(13) = 2.825, p = 0.01, d = .755), pain tolerance (t(13) = 2.482, p = 0.02, d = 0.664), and pain rating (t(13) = 2.950, p = 0.01, d = .789).Conclusion: Results revealed that hypnosis may be an effective treatment in helping manage vasoconstriction in SCD as a response to cognitive appraisals about pain, as well as reducing pain sensitivity. The data presented provide preliminary clinical evidence of the use of hypnosis as a treatment method to improve vasodilation in SCD patients and decreasing pain crises, thus increasing overall quality of life. DisclosuresNo relevant conflicts of interest to declare.

A New Proposal for Management of Severe Frostbite in the Austere Environment

Despite advances in outdoor clothing and medical management of frostbite, individuals still experience catastrophic amputations. This is a particular risk for those in austere environments, due to resource limitations and delayed definitive treatment. The emerging best therapies for severe frostbite are thrombolytics and iloprost. However, they must be started within 24 hours after rewarming for recombinant tissue plasminogen activator (rt-PA) and within 48 hours for iloprost. Evacuation of individuals experiencing frostbite from remote environments within 24 to 48 hours is often impossible. To date, use of these agents has been confined to hospitals, thus depriving most individuals in the austere environment of the best treatment. We propose that thrombolytics and iloprost be considered for field treatment to maximize chances for recovery and reduce amputations. Given the small but potentially serious risk of complications, rt-PA should only be used for grade 4 frostbite where amputation is inevitable, and within 24 hours of rewarming. Prostacyclin has less risk and can be used for grades 2 to 4 frostbite within 48 hours of rewarming. Until more field experience is reported with these agents, their use should probably be restricted to experienced physicians. Other modalities, such as local nerve blocks and improving oxygenation at high altitude may also be considered. We submit that it remains possible to improve frostbite outcomes despite delayed evacuation using resource-limited treatment strategies. We present 2 cases of frostbite treated with rt-PA at K2 basecamp to illustrate feasibility and important considerations.

Evaluation of cardiorespiratory changes during various phases of menstrual cycle in young women before and soon after exercise

Background: Menstruation involves a cyclic expulsion of sanguinous fluid and a sloughing of uterine wall in a female and is a typical feature of the reproductive cycle in humans and subhuman primates. The variations in radial artery distensibility are typical in the natural menstrual cycle. Respiratory function is influenced by female sexual hormones, especially progesterone, which could increase ventilator at rest and soon after exercise. Objective: To study the cardiorespiratory changes during mid-follicular phase and early luteal phases of menstrual cycle before and soon after exercise. Materials and Methods: The samples were collected from young unmarried and nonpregnant women of age group 17 and 25 years from Government General Hospital, Madras Medical College. Blood was drawn during the mid-follicular phase and early luteal phase of menstrual cycle; the serum was separated and stored at 20C. The separated serum was used for quantitative determination of estradiol (E2) concentration by SMAR Test diagnostics and for progesterone determination using hormone kit. Cardiac output, peripheral blood flow, expiratory blast test, performance of isotonic exercise, and cardiac output measurement were performed, and the comparison was made between the different phases of parameters. Result: Cardiac output, peripheral blood flow, and expiratory blast test were performed, and the comparison was made between the parameters. Female subjects show higher ventilatory responses in the luteal phases than in the follicular phase without a change in VO2. Progesterone stimulates respiration and the alveolar PCO2 in women during the luteal phase of menstrual cycle, which is lower than that in men. During exercise, the muscle blood flow can increase a maximum of about 25-fold, the value being 90 mL/100g muscle/min from resting blood flow of 3.6 mL/100 g. In expiratory blast test, a normal subject can increase the mercury column to 55–100 mm or more during a single forceful expiration. Conclusion: The result suggests that cardiovascular parameters were more affected in follicular phase after exercise. Respiratory parameters were more affected in luteal phase after exercise. Change in peripheral blood flow was found to show marked effect than in cardiac output.

Infrared Thermal Image for Assessing Animal Health and Welfare

Infrared thermal imaging is a non-destructive testing technology that can be used to determine the superficial temperature of objects. This technology has an increasing use in detecting diseases and distress in animal husbandry within the poultry, pig and dairy production. The process can identify changes in peripheral blood flow from the resulting changes in heat loss and; therefore, have been a useful tool for evaluating the presence of disease, edema, and stress in animals. This paper reviews the current literature related to the use of infrared technology and discusses their results and implications in animal welfare issues, poultry, pig and bovine industry.