Laser method can also be used for endothelial function assessment in clinical practice

International audienc

Linguistic analysis of laser speckle contrast images recorded at rest and during biological zero: comparison with laser Doppler flowmetry data

Laser speckle contrast imaging (LSCI) is a newly commercialized imaging modality to monitor microvascular blood flow. Contrary to the well-known laser Doppler flowmetry (LDF), LSCI has the advantage of giving a full-field image of surface blood flow using simple instrumentation. However, laser speckle contrast images are not fully understood yet and their link with LDF signals still has to be studied. To quantify the similarity between LSCI and LDF symbolic sequences, we propose to use, for the first time, the index adapted from linguistic analysis and information theory proposed by Yang For this purpose, LSCI and LDF data were recorded simultaneously on the forearm of healthy subjects, at rest and during a vascular occlusion (biological zero). We show that there are different dynamical patterns for LSCI and LDF data, and the distances between these patterns differ through the space scales explored. Moreover, our results suggest that these different dynamical patterns could be linked to blood flow. The quantitative metric used herein therefore provides new information on LSCI and brings knowledge on links between LSCI and LDF

Excellent inter- and intra-observer reproducibility of microvascular tests using laser speckle contrast imaging.

Post-occlusive reactive hyperaemia (PORH) and vasodilation induced by acetylcholine (ACh) iontophoresis are tests of endothelial function that can be studied with laser speckle contrast imaging (LSCI). LSCI has the advantage of having good temporal and spatial resolutions but can lead to a high amount of data when several minutes of recordings are needed. Parameters of PORH and ACh iontophoresis vasodilation are therefore often determined by several observers or by the same observer on different days. Nevertheless, inter- and intra-observer reproducibility for the determination of such parameters has not been studied yet. We analyzed inter-observer and intra-observer reproducibility of baseline, peak and plateau determination for the two microvascular tests. Ten recordings of both PORH and ACh iontophoresis have been analyzed by two blinded trained observers. For peak determination, inter-observer coefficient of variation (CV) was 4.7% and 3.0% for PORH and ACh respectively. Intra-observer reproducibility expressed in CV ranges from 2.4% to 5.4% for PORH-peak and ACh-peak. CVs for peak determination are better than for baseline or plateau determination for both microvascular tests. This suggests that when microvascular vasodilations are reported, the data segments measured have to be noted. Finally microvascular tests using LSCI have an excellent intra- and inter-observer reproducibility

Multiscale Entropy Study of Medical Laser Speckle Contrast Images

Laser speckle contrast imaging (LSCI) is a noninvasive full-field optical imaging technique that gives a 2-D microcirculatory blood flow map of tissue. Due to novelty of commercial laser speckle contrast imagers, image processing of LSCI data is new. By opposition, the numerous signal processing works of laser Doppler flowmetry (LDF) data-that give a 1-D view of microvascular blood flow-have led to interesting physiological information. Recently, analysis of multiscale entropy (MSE) of LDF signals has been proposed. A nonmonotonic evolution of MSE with two distinctive scales-probably dominated by the cardiac activity-has been reported. We herein analyze MSE of LSCI data. We compare LSCI results with the ones of LDF signals obtained during the same experiment. We show that when time evolution of LSCI single pixels is studied, MSE presents a monotonic decreasing pattern, similar to the one of Gaussian white noises. By opposition, when the mean of LSCI pixel values is computed in a region of interest (ROI) and followed with time, MSE pattern becomes close to the one of LDF data, for ROI large enough. LSCI is gaining increased interest for blood flow monitoring. The physiological implications of our results require future study

Axon-reflex cutaneous vasodilatation is impaired in type 2 diabetic patients receiving chronic low-dose aspirin

Low-dose aspirin is largely but non-homogeneously used in primary prevention of cardiovascular complication in type-2 diabetic patients. We hypothesised that low-dose aspirin could interfere with the cutaneous neurovascular responses in type-2 diabetic patients. Galvanic current-induced vasodilatation (CIV) is an original non-noxious integrative model of neurovascular interaction and is impaired under low-dose aspirin in healthy subjects. Twenty type-2 diabetic patients (ten not receiving aspirin: D-NA and ten regularly receiving ≤ 150 mg/day aspirin: D-A), and ten age-, BMI-, and gender-matched non-diabetic control volunteers (MC), underwent macro- and microvascular investigations, including: CIV, acetylcholine (ACh) and sodium nitroprusside (SNP) iontophoresis, post-occlusive hyperemia (POH), neuropathy symptom (NSS) and disability (NDS) scores, and thermal and vibration sensory thresholds. Results are presented as median [25–75 centile] and microvascular results are expressed in multiple from baseline conductance (%Cb). CIV was 554 [349–769] %Cb in MC, 251 [190–355] %Cb in D-NA and 159 [136–202] %Cb in D-A (p < 0.05). No differences were observed between the three groups except for CIV, which is impaired in diabetic patients and further impaired in those regularly receiving low-dose aspirin, while other macrovascular, microvascular and clinical-sensitivity investigations show no significant difference. Potential clinical markers for the impairment of the neurovascular interaction are still required in diabetes. Correlation of the CIV response with the risk of cutaneous complications in diabetic patients remains to be tested

Clostridium difficile infection among veterans health administration patients

OBJECTIVETo report on the prevalence and incidence of Clostridium difficile infection (CDI) from 2009 to 2013 among Veterans Healthcare Administration patientsDESIGNA retrospective descriptive analysis of data extracted from a large electronic medical record (EMR) databaseSETTINGData were acquired from VHA healthcare records from 2009 to 2013 that included outpatient clinical visits, long-term care, and hospitalized care as well as pharmacy and laboratory information.RESULTSIn 2009, there were 10,207 CDI episodes, and in 2013, there were 12,143 CDI episodes, an increase of 19.0%. The overall CDI rate increased by 8.4% from 193 episodes per 100,000 patient years in 2009 to 209 episodes per 100,000 patient years in 2013. Of the CDI episodes identified in 2009, 58% were identified during a hospitalization, and 42% were identified in an outpatient setting. In 2013, 44% of the CDI episodes were identified in an outpatient setting.CONCLUSIONThis is one of the largest studies that has utilized timely EMR data to describe the current CDI epidemiology at the VHA. Despite an aging population with greater burden of comorbidity than the general US population, our data show that VHA CDI rates stabilized between 2011 and 2013 following increases likely attributable to the introduction of the more sensitive nucleic acid amplification tests (NAATs). The findings in this report will help establish an accurate benchmark against which both current and future VA CDI prevention initiatives can be measured.Infect. Control Hosp. Epidemiol. 2015;36(9):1038–1045</jats:sec