Skin Color Changes Research Articles

Patient Outcomes with a Transparent Film Dressing for Reducing Acute Dermatitis from Post-Mastectomy Radiotherapy

Dermatitis remains a source of morbidity for post-mastectomy radiotherapy (PMRT) patients. We retrospectively report our experience, including patient-reported outcomes (PROs), with a transparent film dressing (Mepitel film) for reducing acute dermatitis from PMRT. Patients who underwent prophylactic application of Mepitel film over the irradiated chest wall during PMRT for breast cancer at our institution between September 2015 and August 2019 were included. Mepitel films were regularly checked every 1-2 weeks during treatment and changed or patched as needed. Adverse events were graded according to the Common Terminology Criteria for Adverse Events (CTCAE) Version 5. Selected PROs at baseline, PMRT completion, and 3-month follow-up were obtained from the PRO-CTCAE and the Breast Cancer Treatment Outcomes Scale. Descriptive and univariate analyses (e.g., Wilcoxon signed-rank test) were performed using SPSS Statistics Version 25. 139 patients with a mean (standard deviation) age of 52 (12) years at the time of treatment met the eligibility criteria. PMRT was administered with protons in 102 (73.4%) and photons in 37 (26.6%). Approximately half (50.4%) of patients had breast reconstruction at the time of PMRT. The median (range) number of total fractions given was 25 (15-33) with a median (range) total dose of 5000 (4005-6625) cGy. Chest wall boost was administered in 21 (15.1%), and lymph node boost in 26 (18.7%). Skin boluses were used in 35 (95%) of the 37 patients treated with photons. One (1.4%) patient developed an allergic reaction to Mepitel before treatment during a sampling trial. 24 (17.5%) discontinued Mepitel before PMRT completion, most commonly due to a skin reaction (allergic or irritation) (16 (11.7%)), or difficulty with its use (poor adherence, intolerance, or discomfort) (8 (5.8%)). The median (range) number of Mepitel patching and re-applications during PMRT was 3 (0-10). 71 (51.1%) patients developed grade 1 dermatitis, 60 (43.2%) developed grade 2 dermatitis, and eight (5.8%) developed grade 3 dermatitis. On a 5-point Likert scale (0 meaning not at all and 5 meaning very severe), the median self-rated severity at PMRT completion and 3-months were 2 (mild; range 1-5; n = 86) and 1 (none; range 1-4; n = 82), respectively. Self-reported ratings of other PROs (bleeding or leaking fluid, blistering, tenderness/discomfort, tightness, telangiectasia, flaking/peeling, changes in skin color, and itchiness) on a 10-point Likert scale were as expected. The use of Mepitel films in patients undergoing PMRT with photon- and proton-based radiotherapy is feasible. Rates of acute skin toxicity compare favorably with historical controls. Based on this preliminary experience, a phase 3 randomized controlled trial (A221803) comparing Mepitel versus best supportive care for patients undergoing PMRT is pending.

Hydroxyurea-induced superinfected ulcerations: Two case reports and review of the literature.

The chronic use of hydroxyurea (HU) in some oncologic and non-oncologic diseases (psoriasis, sickle cell anemia) can be accompanied by side effects, both systemic and mucocutaneous. The most severe adverse events known in HU therapy are leg ulcers and cutaneous carcinomas. At skin level may also appear: xerosis, persistent pruritus, skin color changes (erythema, hyperpigmentation), cutaneous atrophy. Likewise, oral ulcerations and stomatitis may occur at mucosal level. Hair damage can be expressed through alopecia and nail damage through melanonychia and oncycholysis. First case, a 63-year-old woman with severe psoriasis vulgaris and chronic granulocytic leukemia, with 5 years of HU therapy, was admitted to hospital for submammary and palmoplantar ulcers, superinfected with methicillin-resistant Staphylococcus aureus and Proteus mirabilis. Clinical exam showed that the patient had also cutaneous atrophy, marked palmoplantar xerosis and melanonychia. The second case, a 72-year-old woman with primary thrombocytemia, treated with HU for 3 years, presented with necrotic leg ulcers that were superinfected with Pseudomonas aeruginosa, Enterobacter and E. Coli. The patient associates cellulitis, microbial eczema and xeroderma. In both cases, after HU discontinuation, systemic antibiotics, topical epithelizing agents and emollients, the ulcers had a slow favorable evolution. In our cases, the ulcers appeared after 5, respectively 3 years of HU therapy. It is stressed that in the first case, which had associated psoriasis, after 1 year of 1 g of HU/day, the psoriatic lesions completely disappeared. The severe progression of the ulcers was also favored by the superinfection of the ulcers with 2, respectively, 3 identified germs for which appropriate systemic antibiotics was required.

Hass avocado ripeness classification by mobile devices using digital image processing and ANN methods

Abstract Proper farming, transportation, and storage processes of Hass avocado are important owing to its recent increase in production, export, and economic activity in Colombia. Since Hass avocado pricing and utility depend on its consumption ripeness, related to changes in skin color, sensory properties, texture, and nutritional value, developing an Android mobile application, namely iHass for smartphones and tablets, which estimates the number of days in which the Hass avocado reaches its optimal ripening level during post-harvest storage, contributes toward improving the fruit quality and decreasing the export costs and losses. This study aims to monitor the ripening processes of Hass avocados in complex backgrounds and indoor environments using various digital image processing techniques. The proposed study uses the red, green, and blue color model based on the physical and chemical changes that are observed during the ripening process. Herein, the color, shape, and texture characteristics of the fruits are obtained, and the fruits are classified using an artificial neural network, which features three layers, four input parameters, six hidden neurons, and four output parameters. Furthermore, ripeness was monitored in two crops, which provided 65 samples each. The results provided a ripeness estimate accuracy of 88% and a regression value of 0.819 during the post-harvest period.

Arsenic Methyltransferase and Methylation of Inorganic Arsenic.

Arsenic occurs naturally in the environment, and exists predominantly as inorganic arsenite (As (III) and arsenate As (V)). Arsenic contamination of drinking water has long been recognized as a major global health concern. Arsenic exposure causes changes in skin color and lesions, and more severe health conditions such as black foot disease as well as various cancers originating in the lungs, skin, and bladder. In order to efficiently metabolize and excrete arsenic, it is methylated to monomethylarsonic and dimethylarsinic acid. One single enzyme, arsenic methyltransferase (AS3MT) is responsible for generating both metabolites. AS3MT has been purified from several mammalian and nonmammalian species, and its mRNA sequences were determined from amino acid sequences. With the advent of genome technology, mRNA sequences of AS3MT have been predicted from many species throughout the animal kingdom. Horizontal gene transfer had been postulated for this gene through phylogenetic studies, which suggests the importance of this gene in appropriately handling arsenic exposures in various organisms. An altered ability to methylate arsenic is dependent on specific single nucleotide polymorphisms (SNPs) in AS3MT. Reduced AS3MT activity resulting in poor metabolism of iAs has been shown to reduce expression of the tumor suppressor gene, p16, which is a potential pathway in arsenic carcinogenesis. Arsenic is also known to induce oxidative stress in cells. However, the presence of antioxidant response elements (AREs) in the promoter sequences of AS3MT in several species does not correlate with the ability to methylate arsenic. ARE elements are known to bind NRF2 and induce antioxidant enzymes to combat oxidative stress. NRF2 may be partly responsible for the biotransformation of iAs and the generation of methylated arsenic species via AS3MT. In this article, arsenic metabolism, excretion, and toxicity, a discussion of the AS3MT gene and its evolutionary history, and DNA methylation resulting from arsenic exposure have been reviewed.

Detecting Pulse Rates From Facial Videos Recorded in Unstable Lighting Conditions: An Adaptive Spatiotemporal Homomorphic Filtering Algorithm

Recent studies have shown that changes in human facial skin color due to varying blood flows can be recorded on videos by consumer-level cameras and, interestingly, can be used to measure pulse rates in a noncontact manner. However, it remains unclear whether the video-based pulse rate detection is feasible when videos are recorded in unstable lighting conditions. To address unstable illumination, a novel algorithm named adaptive spatiotemporal homomorphic filtering (ASTHF) is proposed in this article, with a focus on the separation of pulse signals and illumination-induced noise. This method first employs the homomorphic filtering framework to make illumination-induced noise in a video linearly separable. Subsequently, it incorporates a spatiotemporal filter into the framework, aiming to remove illumination-induced noise from both the time domain and the space domain of the video. To adapt to diverse illumination in the real world, the filter parameters are determined adaptively according to the sparsity in frequency spectrum of pulse signals. ASTHF is tested on two data sets, including 406 video samples. The test results show that ASTHF has stronger robustness to unstable illumination than state-of-the-art methods, improving the Pearson’s correlation coefficient by 5% in a challenging scenario compared with the best contrasting method. The proposed method demonstrates promise to achieve noncontact pulse rate detection from facial videos involving unsteady illumination.

Physiological changes in newborn skin after natural oil massage in rural Nepal

# Background Natural oils are applied daily to newborn infant skin during massage in certain cultures. In hospitalized premature infants, topical oils reduced infection and improved skin condition. A community study among neonates in rural Nepal compared sunflower and mustard oils for effects on skin integrity. Particularly notable was the rapid increase in skin rash that peaked at day 14 and lessened by day 28 for both oils, a finding not previously reported. # Methods To investigate the rash physiology, high-resolution digital images were collected for a subset of 216 premature and full-term infants. Image features were characterized for type and severity, quantified for color and surface texture and compared to measures of skin barrier integrity. # Results Skin features were observed in 403 of 811 images, including localized erythema, discrete papules and an occasional pustule. Miliaria crystallina was noted in 32.2%. A second texture, with raised, “pebble” features, characterized 26%. Of 216 subjects, 61% had “pebble” on at least one visit. Miliaria severity increased and day 14 was higher than 1 and 7 (P<0.05). Pebble texture severity increased. Day 28 was higher than 1, 3 and 7 (P<0.05). Skin pH was lower and erythema, rash and massage numbers were higher for miliaria than without it (P<0.05). Subjects with and without pebble texture did not differ for skin integrity measures. # Conclusions An understanding of the maturational changes in qualitative and quantitative skin color and texture with routine neonatal oil massage provides the basis for leveraging this commonly practiced ritual to optimize skin care.

Dynamic Courtship Signals and Mate Preferences in Sepia plangon.

Communication in cuttlefish includes rapid changes in skin coloration and texture, body posture and movements, and potentially polarized signals. The dynamic displays are fundamental for mate choice and agonistic behavior. We analyzed the reproductive behavior of the mourning cuttlefish Sepia plangon in the laboratory. Mate preference was analyzed via choice assays (n = 33) under three sex ratios, 1 male (M): 1 female (F), 2M:1F, and 1M:2F. We evaluated the effect of modifying polarized light from the arms stripes and ambient light with polarized and unpolarized barriers between the cuttlefish. Additionally, to assess whether a particular trait was a determinant for mating, we used 3D printed cuttlefish dummies. The dummies had different sets of visual signals: two sizes (60 or 90 mm mantle length), raised or dropped arms, high or low contrast body coloration, and polarized or unpolarized filters to simulate the arms stripes. Frequency and duration (s) of courtship displays, mating, and agonistic behaviors were analyzed with GLM and ANOVAs. The behaviors, body patterns, and their components were integrated into an ethogram to describe the reproductive behavior of S. plangon. We identified 18 body patterns, 57 body patterns components, and three reproductive behaviors (mating, courtship, and mate guarding). Only sex ratio had a significant effect on courtship frequency, and the male courtship success rate was 80%. Five small (ML < 80 mm) males showed the dual-lateral display to access mates while avoiding fights with large males; this behavior is characteristic of male “sneaker” cuttlefish. Winner males showed up to 17 body patterns and 33 components, whereas loser males only showed 12 patterns and 24 components. We identified 32 combinations of body patterns and components that tended to occur in a specific order and were relevant for mating success in males. Cuttlefish were visually aware of the 3D-printed dummies; however, they did not start mating or agonistic behavior toward the dummies. Our findings suggest that in S. plangon, the dynamic courtship displays with specific sequences of visual signals, and the sex ratio are critical for mate choice and mating success.

Marine Science: Cephalopods

Fascinating, alien, complex, and intelligent, cephalopods are among the most interesting creatures on Earth. Written by an international team of cephalopod experts, Octopus, Squid & Cuttlefish presents an informative and visually stunning overview of this amazing group of creatures. Each chapter contains two main sections. The first half of each presents aspects of cephalopod biology covering five overarching topics: “Cephalopod Anatomy,” “Phylogeny & Evolution,” “Peculiar Lifestyles” (reproduction, development, locomotion, migration, and other topics), “Behavior, Cognition & Intelligence,” and “Cephalopods & Humans.” The discussion of each subject is brief, as is appropriate for a general overview text such as this. The remainder of each chapter is devoted to several double-page spreads of representative species. Beautiful, richly colored full-page photographs provide portraits of each species presented. The text is informative and readable, and generously illustrated with clear and useful diagrams.Cephalopod biology is so unusual that almost every page of the overview section reveals interesting biology. A discussion of the biochemistry and anatomy of cephalopod skin gives readers an understanding of how squids and octopus can display a vast array of colors and skin textures for communication and camouflage.A section on “Dwarfs & Giants” presents the vast adult size range, which is greater than that of any other animal on Earth; included in this section are the mysterious and mythic giant and colossal squids. A section on locomotion presents the anatomical adaptations that allow for the many different methods by which cephalopods move through their aquatic environments: walking, swimming, jetting, and even flying. The section on behavior and intelligence is particularly fascinating, highlighting some of the characteristics that make this group of animals particularly unusual and unique. Within this section, readers will learn the details of communication by rapid changes in skin coloration; decision making processes (in mollusks!); the use of mimicry in some octopus species; and mating behaviors, including fights between males and sneaky cheating techniques for mating opportunities in both males and females.The individual species profiles provide basic information for each group: a world map showing the species' range and a brief description of its classification, typical habitat, feeding habits, and other key behaviors. A full page of photographs gives the reader a look at each animal, often showing details of behavior and habitat as well. Finally, a two-paragraph discussion of each provides some more details about habitat, behavior, ecological niche, conservation status, and more. Here we find the magnificent giant Australian cuttlefish, the charming striped pyjama squid, the breathtaking blanket octopus, the “living fossil” vampire squid, and the rare shelled fuzzy nautilus, among many others.Octopus, Squid & Cuttlefish provides an excellent overview of the world's cephalopods, detailed enough to be interesting and informative to a reader with a good biology background. Experts will probably want a more in-depth text. Students in biology, ecology, marine science, and animal behavior classes will all find value in this book. Furthermore, anyone interested in biology, evolution, and adaptation will find perusing the pages of Octopus, Squid & Cuttlefish fascinating and rewarding.

Prevalence of foot disorders according to chronic kidney disease stage.

Chronic kidney disease (CKD) is a public health disease that affects 15.1% of the adult population. Although a high prevalence (94.1%) of skin disorders has been detected in people on haemodialysis or with advanced CKD, few studies have analysed foot disorders at initial CKD stages. To analyse the prevalence of foot disorders according to CKD stage. A total of 209 people with a mean age of 73.2 ± 13.8 years (52.0% women) in the nephrology department of Virgen del Puerto Hospital, Plasencia (Spain) were examined from January 2018 to April 2019. CKD stages were determined by nephrologists according to the Kidney DiseaseImproving Global OutcomesGuideline. An expert podiatrist identified foot disorders. Data were statistically treated with the IBM SPSS Statistics. Comparisons between variables were analysed by the χ2 test or Fisher's exact test, with a significance level of less than 5%. The prevalence of foot disorders was high for skin disorders (97.6% dermatopathies and 66.0% keratopathies), nail disorders (98.5% onychopathies) and toe deformities (97.1%). People at initial and intermediate stages presented more keratopathies (hyperkeratosis at G1 and G3a and pinch callus at G3a). Stage G1 showed fewer changes in nail colour and half and half nails. Stage G4 showed more claw toes and hematomaand stage G5 more Beau's lines, changes in skin colour, hematomasand thin shiny skin. The high prevalence of foot disorders detected in people with CKD requires specific and personalised professional care to relieve symptoms and avoid complications, helping to improve the quality of life of people with this condition.

Tracking skin colour and wrinkle changes during cosmetic product trials using smartphone images.

To explore how the efficacy of product trials for skin cosmetics can be improved through the use of consumer-level images taken by volunteers using a conventional smartphone. 12 women aged 30-60years participated in a product trial and had close-up images of the cheek and temple regions of their faces taken with a high-resolution Antera 3D CS camera at the start and end of a 4-week period. Additionally, they each had "selfies" of the same regions of their faces taken regularly throughout the trial period. Automatic image analysis to identify changes in skin colour used three kinds of colour normalisation and analysis for wrinkle composition identified edges and calculated their magnitude. Images taken at the start and end of the trial acted as baseline ground truth for normalisation of smartphone images and showed large changes in both colour and wrinkle magnitude during the trial for many volunteers. Results demonstrate that regular use of selfie smartphone images within trial periods can add value to interpretation of the efficacy of the trial.

Advances in the research of clinical treatment of hyperpigmentation and hypopigmentation after burns

Hyperpigmentation and hypopigmentation are complications commonly seen in burn patients after wound healing, which may have seriously adverse impact on the appearances of the patients. The change of skin color in the exposed areas such as the face and hands may cause great psychological burden on the patients. While the occurrence and development mechanisms of hyperpigmentation and hypopigmentation post burns are unclear, it is generally believed to be associated with excess or deficiency of melanin content in the epidermis. Therefore, the therapeutic strategies of hyperpigmentation or hypopigmentation are as follows: the former focuses on inhibiting the synthesis of melanin and reducing the content of melanin in the skin, while the latter can restore the normal skin color by improving the function of melanocytes to promote the synthesis of melanin. In recent years, the therapeutic technologies for abnormal melanin metabolism after burns have developed rapidly. In this paper, treatment strategies commonly used in clinical practice are summarized in terms of photoelectric therapies, drugs, and operations, aiming to provide references for the treatment of patients who suffer abnormal pigmentation after burns.

Pigmentation effects of blue light irradiation on skin and how to protect against them.

BackgroundVisible light, in particular blue light, has been identified as an additional contributor to cutaneous photoageing. However, clinical studies demonstrating the clear effect of blue light on photoageing are still scarce, and so far, most studies have focused on broad‐spectrum visible light. Although there is evidence for increased skin pigmentation, the underlying mechanisms of photoageing in vivo are still unclear. Furthermore, there is still a need for active ingredients to significantly protect against blue light‐induced hyperpigmentation in vivo.Our study had two aims: to detect visible changes in skin pigmentation following repeated irradiation of the skin with LED‐based blue light and to reduce pigmentation using suitable active ingredients.MethodWe conducted a randomized, double‐blind and placebo‐controlled clinical study on 33 female volunteers with skin phototypes III and IV. We used a repetitive blue light (4 × 60 J cm−2, 450 nm) irradiation protocol on the volunteers’ inner forearms. Using hyperspectral imaging, we assessed chromophore status. In addition, we took chromameter measurements and photographs to assess visible hyperpigmentation.ResultsWe measured significant changes in chromophore status (P < 0.001 vs baseline), that is of melanin, haemoglobin and oxygen saturation, immediately after blue light irradiation. In addition, we found visible skin colour changes which were expressed by a significant decrease in ITA° values (delta ITA° = −16.89, P < 0.001 vs baseline for the placebo group) and an increase in a* (delta a* = +3.37, P < 0.001 vs baseline for the placebo group) 24 h post‐irradiation. Hyperpigmentation and skin reddening were mitigated by both a formulation containing 3% of a microalgal product and a formulation containing 3% niacinamide.ConclusionOur study sets out an efficient and robust protocol for investigating both blue light‐induced cutaneous alterations, such as changes in skin chromophores, and signs of photoageing, such as hyperpigmentation. Moreover, we have shown evidence that both an extract of the microalga Scenedesmus rubescens and niacinamide (vitamin B3) have the potential to protect against blue light‐induced hyperpigmentation.

Detection of human fatigue level based on changes in skin color using RGB sensor

Decreased work capacity could be caused by fatigue, which is a state of decreased efficiency and endurance. Fatigue can be measured using various methods, one of them is based on heart rate. Measurement of fatigue levels based on heart rate has been widely carried out, one of them is the use of contactless measurement. The objective of this research was to detect human fatigue levels using an RGB sensor based on changes in skin color with image processing technology. This research started from testing of the data intake system, followed by image data retrieval in the form of images before and after physical activity and fatigue levels data using the step test method. Image data capture is performed using an RGB sensor in the form of a Kinect 360 and mirrorless camera, while fatigue levels data used a pulse monitor. The next step was processing data using a simple linear regression method to see the level of correlation between the results of image processing in the form of changes in the RGB color of the skin with changes in fatigue levels based on changes in heart rate. The results of simple linear regression showed significant RGB color changes toward changes in fatigue levels with a correlation value reaching 0.8 when using mirrorless camera then Kinect 360. This result showed that the use of mirrorless camera is better. The average correlation value of 20 subjects at all points above 0.6 on the two sensors used. Each of the RGB color components had a significant change. This showed that there was a relationship between changes in RGB with fatigue level changes so that the method of detecting fatigue levels based on changes in skin color can be done.

Calf And Foot Injury- Crossfit

HISTORY: A 51-year-old female presented with three-year worsening left lower leg and foot pain. No injury at time of onset but was active with CrossFit five times weekly. Pain began on bottom of forefoot with radiation through the sole of foot to posterior calf and popliteal fossa. Pain described as 7-8/10 in intensity, constant, sharp/stabbing in nature, with burning sensation on the bottom of foot. Associated with weakness of the left ankle, foot drop requiring patient to wear an ankle-foot orthotic, swelling, and color changes with her foot turning blue/red intermittently. Pain was unrelieved with oral NSAIDS, steroids, and only temporary relief with topical anti-inflammatory gel, heat/ice, deep tissue massage, and dry-needling with physical therapy. PHYSICAL EXAMINATION: Examination revealed skin color changes with blue discoloration of left foot that was cool to touch. Tender to palpation maximally over left gastrocnemius muscle, Achilles tendon, sole and ball of foot; 0/5 strength with left ankle dorsiflexion/plantar flexion, ankle inversion/eversion or great toe extension. Sensation intact to light touch in L2-S2 dermatomes. Reflexes normal and symmetric bilaterally. DIFFERENTIAL DIAGNOSIS: 1.Peripheral nerve damage secondary to entrapment/compression 2.Vascular insufficiency 3.Complex regional pain syndrome TEST AND RESULTS: MRI without IV contrast of left tibia/fibula, foot, ankle: - Mild intramuscular edema within gastrocnemius and soleus, focal fatty atrophy adjacent to medial soleus muscle. Generalized subcutaneous edema throughout ankle. EMG: -No evidence of left lumbosacral radiculopathy, left lower limb mononeuropathy, or large fiber peripheral neuropathy US lower extremity Veins: - No DVT in left lower extremity Ankle brachial index: - Normal arterial Doppler study on the left leg during rest with normal PVR waveforms. NM bone scan: - No abnormal blood flow or blood pool uptake involving the left foot or ankle. Mild radiotracer uptake in left midfoot. FINAL/WORKING DIAGNOSIS: Complex regional pain syndrome TREATMENT/OUTCOMES: 1. Physical Therapy focused on strengthening exercises and desensitization techniques 2. Diclofenac topical gel applied up to four times daily 3. Gabapentin 600mg BID 4. Referral to Pain Medicine for lumbar sympathetic nerve block

Digital surface scanning in flap perfusion

Monitoring vascular perfusion of transferred tissue is essential in reconstructive surgery to recognize early flap failure. The aim of this study was to evaluate the ability of a digital surface scanner to detect vascular perfusion disorders through the monitoring of skin colour changes. A total of 160 surface scans of the forearm skin were performed with a TRIOS 3D scanner. Vascular compromise was simulated at different time-points by intermittent occlusion of the blood supply to the forearm skin (first the arterial blood supply and then the venous blood supply). Skin colour changes were examined according to the hue, saturation, and value colour scale. Colour differences were analysed with a paired t-test. Significant differences were observed between the colour of the normal skin and that of the vascular compromised skin (P<0.01). The surface scanner could distinguish between arterial occlusion and venous congestion (P<0.01). A digital surface scan is an objective, non-invasive tool to detect early vascular perfusion disorders of the skin.

Monitoramento da taxa de saturação de oxigênio no sangue e frequência cardíaca via método de magnificação Euleriana sem contato físico

O monitoramento da frequência cardíaca (FC) e da taxa de saturação de oxigênio no sangue (SpO2) é fundamental em cirurgias e unidades de terapia intensiva. Nas últimas décadas surgiram vários estudos sobre monitoramento de sinais vitais sem contato físico, mas poucos são focados na SpO2. Este artigo apresenta uma solução para o monitoramento da taxa de saturação de oxigênio no sangue e frequência cardíaca sem contato físico com o paciente através da técnica de fotopletismografia por imagens. A magnificação de vídeo Euleriana (EVM) foi empregada na solução proposta para ampliar as variações de cores que ocorrem na pele devido ao ciclo circadiano. O software desenvolvido foi executado em uma plataforma de hardware livre e de baixo custo.Foram realizados experimentos com nove indivíduos saudáveis. Ao comparar os resultados experimentais com os obtidos com um oxímetro de pulso de referência, a solução proposta mostrou boa acurácia nas medidas de SpO2, com diferença menor que 2%, atendendo os requisitos da norma que regulamenta os equipamentos de oximetria de pulso.

Cutaneous manifestations in patients with chronic renal failure on hemodialysis

Chronic renal failure (CRF) associated with many cutaneous manifestations starts from xerosis, dark pigmentation, to life threatening severe uncontrolled itching. Cutaneous problems with CRF having different and newer manifestations after hemodialysis interventions. To assess the prevalence of cutaneous manifestations including hair and nails in chronic renal failure (CRF) patients on hemodialysis . One hundred patients of CRF undertaking hemodialysis were examined for various cutaneous presentations. cutaneous manifestations seen in eighty six patients. The commonest finding was xerosis (81%),had wide range of clinical presentation with pruritus (56%) produced distress symptoms skin color changes presented commonly as pallor (65%), and cutaneous hyperpigmentation (53%) manifesting physical and psycological disturbance s respectively. Othera skin problem found peculiar to chronic renal failure are acquired perforating dermatoses of kyrles diease (20%); prevalence of cutaneous infections especially dermatophytosis and other superficial fungal infections (28%), pyoderma(10%) and viral (13%) infections; other important cutaneous manifestation are purpura (10%); and eczema(2%). The nail changes sharing significant presentations in majority of renal failure patients which included half and half nail (20%),as important clinical marker followed by koilonychia (16%), onychomycosis (16%), onycholysis (11%), Mees’ lines (7) Hair changes also contributing significant clinical finding as sparse body hair (27. Wide array of oral mucosal changes presented mainly as macroglossia (36%), xerostomia (28%), ulcerative stomatitis (27%), and uremic odour(7%). CRF had a significant cutaneous changes mainly as xerosis, pruritus acquired perforating dermatoses, uraemic odour and hyperpigmentation. These changes served as clinical clue in diagnosis and therapeutic management. These changes were attributed by disease (CRF) as well as hemodialysis. Management aimed as alleviation of sufferings and improve life quality.

Primary adrenal insufficiency secondary to bilateral adrenal lymphoma

Involvement of adrenal glands in lymphoma is rare; the patient may have variable presentations. We report a case of a 62-year-old Saudi female who presented to our center with a few-week history of fatigue, weight loss, subjective fever, and a recent change in skin color. On examination, she looked dehydrated and had a drop in blood pressure with postural change and hyperpigmentation of the skin of the face and hands. Morning cortisol levels were low, and adrenocorticotropic hormone levels were high, which indicated primary adrenal insufficiency (PAI). An adrenal computed tomography (CT) scan revealed bilateral adrenal enlargement. After excluding pheochromocytoma, a CT scan-guided trucut biopsy of the adrenals confirmed non-Hodgkin lymphoma. The patient was started on steroid replacement therapy, and after stabilization, a plan was made to initiate chemotherapy for the treatment of lymphoma; unfortunately, the patient died shortly after diagnosis because of rapid progression of the disease. Adrenal lymphoma can present with PAI and should be considered in the presence of bilateral adrenal enlargement; it is an aggressive tumor and carries poor prognosis if the treatment is delayed.

The expression of opsins in the human skin and its implications for photobiomodulation: A Systematic Review.

Skin is the organ most extensively exposed to light of a broad range of wavelengths. Several studies have reported that skin expresses photoreceptive molecules called opsins. However, the identity and functional role of opsins in the human skin remain elusive. We aim to summarize current scientific evidence on the types of opsins expressed in the skin and their biological functions. A primary literature search was conducted using PubMed to identify articles on dermal opsins found in nonhuman animals and humans. Twenty-two articles, representing, however, a non-exhaustive selection of the scientific papers published in this specific field, met the inclusion criteria. In nonhuman animals, opsins and opsin-like structures have been detected in the skin of fruit fly, zebrafish, frog, octopus, sea urchin, hogfish, and mouse, and they mediate skin color change, light avoidance, shadow reflex, and circadian photoentrainment. In humans, opsins are present in various skin cell types, including keratinocytes, melanocytes, dermal fibroblasts, and hair follicle cells. They have been shown to mediate wound healing, melanogenesis, hair growth, and skin photoaging. Dermal opsins have been identified across many nonhuman animals and humans. Current evidence suggests that opsins have biological significance beyond light reception. In nonhuman animals, opsins are involved in behaviors that are critical for survival. In humans, opsins are involved in various functions of the skin although the underlying molecular mechanisms remain unclear. Future investigation on elucidating the mechanism of dermal opsins will be crucial to expand the therapeutic benefits of photobiomodulation for various skin disorders.

FUNCTIONAL STATE CHANGES OF THE VEGETATIVE NERVOUS SYSTEM IN PATIENTS WITH ACALCULOUS CHOLECYSTITIS DEPENDING ON THE TYPE OF SOMATOFORM VEGETATIVE DYSFUNCTION AND ESSENTIAL HYPERTENSION

Objective: to establish the features of the functional state changes of the autonomicnervous system in patients with chronic noncalculous cholecystitis, depending on the typeof concomitant somatoform autonomic dysfunction and hypertension stage II.Material and methods. 138 patients were examined: 98 of them with chronic acalculouscholecystitis in the exacerbation phase and concomitant somatoform autonomicdysfunction, 40 patients with chronic noncalculous cholecystitis in the phase ofexacerbation with accompanying essential hypertension stage II and 30 practicallyhealthy persons who made up the control group. To characterize the state of theautonomic nervous system we used A.M. Vein vegetative symptoms scale, Ashner-Danyini,Danielopulu (orthoclinostatic) tests.Results. Indices’ analysis of the carried out investigation of the general vegetativesymptoms have shown that the skin color changes during excitement, physical activity inpatients with somatoform autonomic dysfunction according to hypertensive type, cardiacneurosis and hypertension had a negative tendency, that is, the skin was pale, whatreflects an increase of the sympathetic nervous system tone and forms a decrease fromthe state of eutonia in scores by 1.7 times, 1.6 times and 2.0 times respectively (p<0.05).Pulse rate veritably increased (51.6%, 41.9% and 54.8% (p<0.05)) in patients of the 1st,3rd and 4th groups, in patients of the 2nd group it veritably decreased (29.0% (p <0.05))when conducting orthostatic test. During clino-orthostatic test, the pulse rate changed inthe diametrically opposite direction: in patients of the 1st, 3rd and 4th groups it sloweddown (21.9%, 28.1% and 31.3%, respectively (p< 0.05)), in patients of the 2nd groupit probably accelerated (21.9% (p <0.05)). During Ashner’s test in patients of the 1stand 3rd groups the pulse rate paradoxically tended to accelerate (20.0% and 26.7% (p<0.05)); in patients of the 4th group it veritably increased 30.0% (p <0.05), in patients ofthe 2nd group it veritably decreased (52.8%, p <0.05).Conclusions. Thus, an increase in the tone of the sympathetic part of the autonomicnervous system with frequent sympathoadrenal crises is observed in patients withchronic acalculous cholecystitis and concomitant somatoform vegetative dysfunction byhypertension type and cardiac neurosis as well as hypertension type II, and vagotonia witha predominance of the vago-insular crises is peculiar for the patients with concomitantsomatoform vegetative dysfunction according to hypotonic type.