How to use thermal imaging in venous insufficiency?

This paper is intended to provide studies performer on usefulness of thermal imaging for the insufficiency of superficial veins in the lower limbs. The results are a continuation of the previous research and show a new way of analysis and better correlation between standard methods of parameters like duplex ultrasonography and parameters derived from thermal imaging. In particular promised seems to be using the mean whole limb temperaturę of healthy volunteers at a proper age as a threshold to count the isotherm area, and in isotherm analysis should be taken for the whole lower limb—the sum of thermal images from anterior and posterior views (Method II). The study was performed by the use of a Thermovision E60 camera by Flir Systems. All studies (duplex ultrasonography as well as thermal imaging) were performed in a research room with a stabilized temperature on two groups of patients, a group of healthy people and patients suffering from chronic venous disease. During the study, the correlation parameters were obtained with ultrasound and thermal parameters. The results showed that temperaturę changes observed in the lower extremities of the thermal skin map are associated with a healthy state of blood supply which might be connected with blood stasis, inflammatory states and swelling that occurs in the soft tissues. We found the mean and higher correlations between thermal and ultrasound parameters, for example, a good positive correlation (r = 0.63) between the thermal range to the total limb length radio and the range of reflux was obtained. The correlation between thermal imaging parameters and duplex ultrasound parameters may show that thermovision is an extremely promising method, and it can be useful in the screening of diagnosis of superficial vein insufficiency

Advanced Technologies in Dermatology

Cellular therapies are an attractive area of regenerative medicine. For large partial thickness wound, keratinocytes transplant is suggested. The transplantation of cell graft is achieved by obtaining large amounts of cultured cells from a skin biopsy in 3 weeks. Stem cells can be applied before that, but are also efficient in chronic wound closure. Alternative treatment methods are transplants of allogeneic, biostatic skin and amnion. Amnion can be applied as a skin substitute on shallow facialburn wounds, hand burn wounds, on donor areas and granulating wounds. For medium depth or even deep burns, allogeneic skin is recommended. Thanks to the removing of cells from human allogeneic dermis, collagen scaffolding is obtained. It can be populated de novo by autologous skin cells. Artificial skin substitutes are especially good for hand burns and shallow burns. Even though scarring is a part of normal wound healing, it often leads to a pathological process. When scar treatment methods prove insufficient, surgical intervention becomes necessary. Surgical scar intervention involves removal of the pathological skin tissue fragment and replacing it with healthy skin or application of expanders. Improvement of the visual features can be also achieved by laser therapy

Thermal imaging and planimetry evaluation of the results of chronic wounds treatment with hyperbaric oxygen therapy

Background. One of the methods to treat chronic wounds is the use of hyperbaric oxygen (HBO). Objective measurement of the wound surface is an important element in the process of monitoring and predicting the progress of treatment. Objectives. The aim of the study was to evaluate the effect of hyperbaric oxygen therapy (HBOT) on ulcer wound healing in patients with chronic venous insufficiency ulcers and diabetic foot syndrome using thermal imaging and computerized planimetry. Material and methods. During a 3-year period, 284 digital computer planimetry measurements were gathered from 142 patients treated for leg ulcers caused by chronic venous insufficiency and ulcers from diabetic foot syndrome at HBOT Unit of the Dr Stanisław Sakiel Centre for Burns Treatment in Siemianowice Śląskie (Poland). Each patient took 30 HBOT sessions using a Haux multiplace HBO chamber at a pressure of 2.5 atmospheres absolute (ATA). The results of the treatment were monitored using thermovision and computerassisted planimetry measurements performed before and after HBOT. Results. Both groups of patients exhibited a reduction in the surface and perimeter of the wound after HBOT. The treatment effects were also confirmed with thermal imaging. The areas calculated from thermal imaging and planimetry are different but correlated. Conclusions. It seems that a combination of thermal imaging and planimetry may enhance the diagnosis as well as provide the physician with more information about therapy effects

Respiratory tract burn injuries

Oparzenia inhalacyjne są głębokimi urazami obarczonymi znaczną śmiertelnością, które w istotny sposób pogarszają rokowanie chorych z ciężkimi oparzeniami ciała. Zmiany zachodzące pod wpływem urazu inhalacyjnego obejmują: obrzęk i martwicę błony śluzowej oskrzeli, zwiększenie przepływu krwi przez naczynia płucne i wzrost ich przepuszczalności, gromadzenie się w świetle oskrzeli wałeczków zbudowanych ze śluzu, obumarłych komórek, włóknika i neutrofili oraz uogólnioną reakcję zapalną mediowaną przez cytokiny. W wyniku opisanych procesów dochodzi do zaburzeń wymiany gazowej w płucach i w konsekwencji do niedotlenienia tkanek. Wprowadzenie standaryzowanych procedur diagnostyki endoskopowej u chorych z podejrzeniem oparzenia dróg oddechowych pozwoliło na szybkie rozpoznanie tego urazu i wdrożenie specjalistycznego leczenia, skutkującego zmniejszeniem liczby zgonów z powodu oparzeń. Stosowane metody terapeutyczne nie zawsze są skuteczne, a przy tym obarczone powikłaniami wynikającymi z instrumentacji dróg oddechowych. Istnieje więc konieczność stałej modyfikacji postępowania i poszukiwania nowych metod leczenia. Obserwowane korzystne efekty wczesnych zabiegów tlenoterapii hiperbarycznej dają nadzieję na szybkie wprowadzenie tej metody do standardów leczenia oparzeń inhalacyjnych. Pneumonol. Alergol. Pol. 2011; 79, 4: 298–304Respiratory tract burns are one of the most serious injuries of human organism. They often accompany severe skin burns, increasing morbidity and mortality. Pathologic events happening in the lungs in the course of inhalation injury consist of: edema and necrosis of bronchial mucosa, increase of bronchial blood flow and vascular permeability, recruitment of inflammatory mediators, and obturation of bronchial tract with the casts composed of mucus, tissue debris, neutrophils and fibrin. The above mentioned processes lead to progressive disturbances of pulmonary gas exchange and tissue hypoxia. Introduction of standardized bronchoscopic procedures resulted in the possibility of early diagnosis and treatment of inhalation injuries. There are many treatment options, some of them combined with early and late complications, the optimal treatment protocol is still lacking. Early hyperbaric oxygen therapy is one of the most promising methods of treatment leading to decrease of mortality due to inhalation injury. Pneumonol. Alergol. Pol. 2011; 79, 4: 298–30

Zawał serca u chorych bez istotnych zmian w tętnicach wieńcowych

Wstęp: Zawał serca u chorych bez istotnych zmian w tętnicach wieńcowych to zagadnienie złożone, o nie do końca wyjaśnionej etiologii, nierzadko przysparzające wielu problemów diagnostycznych. W piśmiennictwie istnieje niewiele danych dotyczących problemu zawału serca z prawidłowym obrazem tętnic wieńcowych oraz odległego rokowania. Celami niniejszej pracy były: określenie odsetka chorych z zawałem serca bez istotnych zmian w tętnicach wieńcowych kierowanych do leczenia inwazyjnego; porównawcza ocena kurczliwości lewej komory w obserwacji wewnątrzszpitalnej i odległej, a także ocena częstości występowania niekorzystnych zdarzeń sercowo-naczyniowych w obserwacji wewnątrzszpitalnej i odległej

Differences in Perceived Occupational Stress by Demographic Characteristics, of European Emergency Medical Services Personnel during the COVID-19 Virus Pandemic-An International Study

Objectives: The outbreak of the COVID-19 pandemic has brought commercial, social, and economic consequences in every country that has experienced substantial SARS-CoV-2 infection rates. The complete change in the environment that took place due to the outbreak of the pandemic can lead to stressful situations, especially among healthcare personnel. Material and methods: The research were conducted during the COVID-19 pandemic between the 27 March 2020 and the 20 April 2020. The research included 1984 employees of emergency medical systems in seven European countries. An internet-based questionnaire format was adopted for the study (ΩMc-Donald > 0.7). Results: The highest level of stress was experienced by personnel in the United Kingdom M = 4.03, and the lowest by Norwegian employees M = 2.89. High levels of stress were also experienced by nurses from Spain and Poland. Women actively working in the healthcare system during the pandemic experienced higher stress levels than men. Conclusions: Women working in European emergency medical systems are more vulnerable to work-related stress, while carrying out emergency medical procedures during the pandemic. Differences in the level of stress experienced while carrying out duties in pre-hospital conditions were only found among Spanish emergency medical system personnel

PREPARACIÓN DE TOROS MARCADORES

Different methodologies for the preparation of marker bulls are described, such as fixing the sigmoid bend of the penis, artificial phimosis, lateral implant of the prepuce in Zebu bulls, resection of the apical dorsal ligament of the penis, fixation of the penis, epididymectomy, and overlap technique and surgical deviation with tunneling, concluding that the success or failure in the preparation of a marker bull depends more on the knowledge of the surgical technique and the postsurgery management than on the technique applied.Se describen diferentes metodologías para la preparación de toros marcadores, tales como, fijación de la flexura sigmoidea del pene, fimosis artificial, implantación lateral del prepucio en toros cebuínos, resección del ligamento apical dorsal del pene, fijación del pene, epididimectomía, técnica de traslape y desviación quirúrgica con tunelización, concluyendo que el éxito o fracaso en la preparación de un toro marcador, depende más del conocimiento de la técnica quirúrgica y del manejo posoperatorio que de la técnica aplicada

Thermal effects of topical hyperbaric oxygen therapy in hard-to-heal wounds - a pilot study

Clinical studies have been performed to evaluate the thermal response of topical hyperbaric oxygen therapy (THBOT) in patients suffering from hard-to-heal wounds diagnosed as venous leg ulcers located on their lower extremities. It was found that this therapy leads to a temperature decrease in areas around the wound. Moreover, a minor temperature differentiation between all areas was seen in the third period of topical hyperbaric oxygen therapy (THBOT) that may suggest that microcirculation and thermoregulation improvement start the healing process. On the other hand, the results of the conducted studies seem to prove that thermal imaging may provide a safe and effective method of analyzing wound healing of hard-to-heal wounds being treated with THBOT. This is the first study that tries to show the possibilities of a very new method by evaluating treatment of hard-to-heal wounds using thermal imaging, similar to the hyperbaric oxygen therapy effects evaluated by thermal imaging and described previously. However, the first clinical results showed a decrease in temperature due to the THBOT session and some qualitative similarities in the decrease in temperature differentiation between the studied areas and the temperature effects obtained due to hyperbaric oxygen therapy