Variation in Leg Tissue Dielectric Constant Values of Healthy Young Adult Females With and Without Compression Bandaging.

Background The clinical efficacy of a compression application has been often limited to the assessment of the change in limb volume, change in clinical symptoms (i.e., wound size, pain, range of motion, incidence of cellulitis), or vascular hemodynamics of the whole limb. Assessing compression-related biophysical changes of a localized area, such as around a wound, or in an area outside of an extremity cannot be objectively assessed by these measurements. Tissue dielectric constant (TDC) values, which provide a measure of the local tissue water (LTW) content, offer an alternative method to document variation in the LTW content of the skin in a specific location. The goals of the present research were (1) to characterize TDC values, expressed as percentage tissue water, from multiple areas along the medial aspect of the lower leg of healthy volunteers and (2) to explore the potential utilization of the TDC values to assess change in tissue water content in a localized area following compression applications. Methods TDC was measured at 10, 20, 30, and 40 cm proximal to the medial malleolus on the medial aspect of the right leg of 18 young adult healthy women with an age range of 18-23 years and a body mass index of 18.7 to 30.7kg/

Venous, Arterial, and Neuropathic Leg Ulcers With Emphasis on the Geriatric Population.

Leg ulcers are a common and often serious problem in older adults. Underlying conditions that increase risk include age-related increases in chronic venous insufficiency, peripheral artery disease, connective tissue and autoimmune conditions, reduced mobility, and diabetes mellitus (DM). Geriatric patients have a higher risk of multiple wound-related complications including infection, cellulitis, ischemia, and gangrene, any of which may lead to further complications including amputation. The very presence of these lower extremity ulcers in the elderly negatively impacts their quality of life and ability to function. Understanding and early identification of the underlying conditions and wound features are important for effective ulcer healing and complication mitigation. This targeted review focuses on the three most common types of lower extremity ulcers: venous, arterial, and neuropathic. The goal of this paper is to characterize and discuss the general and specific aspects of these lower extremity ulcers and their relevancy and impact on the geriatric population. The top five main results of this study can be summarized as follows. (1) Venous ulcers, caused by inflammatory processes secondary to venous reflux and hypertension, are the most common chronic leg ulcer in the geriatric population. (2) Arterial-ischemic ulcers are mainly due to lower extremity vascular disease, which itself tends to increase with increasing age setting the stage for an age-related increase in leg ulcers. (3) Persons with DM are at increased risk of developing foot ulcers mainly due to neuropathy and localized ischemia, both of which tend to increase with advancing age. (4) In geriatric patients with leg ulcers, it is important to rule out vasculitis or malignancy as causes. (5) Treatment is best made on a case-by-case basis, considering the patient\u27s underlying condition, comorbidities, overall health status, and life expectancy

Longitudinal Effects of a Novel Advanced Pneumatic Compression Device on Patient-Reported Outcomes in the Management of Cancer-Related Head and Neck Lymphedema: A Preliminary Report

BACKGROUND: Head and neck cancer (HNC) survivors experience head and neck lymphedema (HNL), which requires treatment to prevent morbidity. We explore the self-reported outcomes and satisfaction of patients with HNC receiving treatment for HNL with an advanced pneumatic compression device (APCD). METHODS: HNC survivors (n = 205) prescribed with an at-home Flexitouch head and neck APCD completed pretreatment and posttreatment self-reported assessments addressing efficacy, function, and symptoms. Participant average age was 60 years with 74% male. Pre-post responses for ≥25 days of use were assessed via the non-parametric Wilcoxon Signed Rank test. RESULTS: Analysis revealed statistically significant improvement in all symptoms and all function items (P \u3c 0.00001). Compliance with prescribed therapy (at least 30 minutes daily) was high with 71% of participants reporting daily use and 87% reporting overall satisfaction. CONCLUSIONS: The reported improvements in function and symptoms, and high compliance rate, provide a rationale for a subsequent randomized controlled trial

Programmable intermittent pneumatic compression as a component of therapy for breast cancer treatment-related truncal and arm lymphedema

Abstract Lymphedema is a chronic condition often requiring lifelong treatment to avoid worsening of extremity and trunk swelling with concomitant complications. The physiological basis for truncal treatment, although clinically recognized, until recently, was not well documented. Herein, we expand on earlier work by reporting on clinical outcomes, therapist observations, and subjective impressions of five patients with truncal lymphedema whose in-home self-treatment includes the Flexitouch ® system (FT) pneumatic device. Patients received in-clinic complete decongestive therapy and in-home self-care including FT. Results, determined after 2 months of treatment, showed reductions in trunk and arm swelling, fibrotic tissue softening, pain reduction, and improved range of motion and flexibility. Patients reported that FT was easy and comfortable to use and enhanced in-home compliance. Results suggest that limb and trunk lymphedema can be effectively treated in the home with an advanced programmable pneumatic device with truncal coverage, such as the FT system

Gender differences in facial skin dielectric constant measured at 300 MHz

measurements at 300 MHz provide non-invasive data on free and bound tissue water. TDC-data is available for some body sites, but most is for female forearm. Contrastingly, there are no data on face-skin or comparative data between genders. Our goals were to obtain facial-TDC reference values and determine if TDC-values differ between genders. Methods: TDC was measured at forehead, cheek, and fore-arm in 60 young adults (30 men) to a 1.5-mm depth. Measured TDC-values were compared with TDC-values calculated using skin-thickness data. Results: Measured TDC-values ranged from 39.6 ± 2.9 at male-forehead to 28.2 ± 2.4 at female forearm and were signif-icantly different (P < 0.001) among each site in the order fore-head> cheek>forearm. Male TDC-values were greater than female TDC-values (P < 0.01) with differences from 5.6 % at forehead to 11.3 % at forearm. Calculated TDC-values incorpo-rating site and gender skin-thickness differences yielded TDC-values at the most 3 % different from measured values. Conclusion: Gender differences should be considered in clini-cal studies in which men and women are included in a com-mon study population with respect to experimental design and data interpretation. This is especially true if absolute TDC-values are of interest rather than changes in TDC-values on the same subject subsequent secondary to an intervention. Key words: face skin – dielectric constant – skin water – skin thickness – skin hydration – skin moisturizatio

Advances in intravesical drug delivery systems to treat bladder cancer

Chemotherapeutic agents administered intravesically to treat bladder cancer have limited efficacy due to periodic dilution and wash-out during urine formation and elimination. This review describes the pathophysiology, prevalence and staging of bladder cancer, and discusses several formulation strategies used to improve drug residence within the bladder. These include the use of amphiphilic copolymers, mucoadhesive formulations, hydrogels, floating systems, and liposomes. Various in vitro and in vivo models recently employed for intravesical drug delivery studies are discussed. Some of the challenges that have prevented the clinical use of some promising formulations are identified

Pneumatic compression devices for in-home management of lymphedema: two case reports

The two patients in this case series had experienced long-term difficulty controlling lymphedema at home. Both patients had used numerous home therapies, including older-generation intermittent pneumatic compression devices, without success. The Flexitouch® system, an advanced pneumatic device, was prescribed to assist them with in-home efforts by providing therapy to their affected limbs in addition to the lower trunk area for the patient with lymphedema of the lower extremity; and the trunk, chest wall, and shoulder areas for the patient with lymphedema of the upper extremity. Both patients achieved successful home maintenance of lymphedema, as judged by limb volume, clinical observations, and subjective patient impressions, after incorporating the Flexitouch® system. Neither patient experienced the deleterious effects (worsening genital edema; fibrotic cuff development) that they had experienced with the older-generation intermittent pneumatic compression devices they had previously used. Incorporating the Flexitouch® system as part of maintenance may improve success for lymphedema patients who have previously struggled with in-home management

Bioreactors as engineering support to treat cardiac muscle and vascular disease

Cardiovascular disease is the leading cause of morbidity and mortality in the Western World. The inability of fully differentiated, load-bearing cardiovascular tissues to in vivo regenerate and the limitations of the current treatment therapies greatly motivate the efforts of cardiovascular tissue engineering to become an effective clinical strategy for injured heart and vessels. For the effective production of organized and functional cardiovascular engineered constructs in vitro, a suitable dynamic environment is essential, and can be achieved and maintained within bioreactors. Bioreactors are technological devices that, while monitoring and controlling the culture environment and stimulating the construct, attempt to mimic the physiological milieu. In this study, a review of the current state of the art of bioreactor solutions for cardiovascular tissue engineering is presented, with emphasis on bioreactors and biophysical stimuli adopted for investigating the mechanisms influencing cardiovascular tissue development, and for eventually generating suitable cardiovascular tissue replacements