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microcirculation test

microcirculation test Excludes Scleroderma in Raynaud’s

microcirculation test Excludes Scleroderma in Raynaud’s

he absence of a systemic sclerosis (SSc) nailfold pattern in patients with Raynaud’s phenomenon or suspected connective tissue disease is of high clinical value as a biomarker to rule out SSc, according to a large cohort study from the U.K.

For identifying patients who met the 2013 American College of Rheumatology/European League Against Rheumatism or the Very Early Diagnosis of Systemic Sclerosis (VEDOSS) criteria for SSc, the study found that a nailfold capillaroscopy pattern had a negative predictive value of 90% (95% CI 86 to 93), according to Maya H. Buch, MBChB, PhD, and colleagues from the University of Leeds, writing in BMC Musculoskeletal Disorders.

That pattern also had a sensitivity of 71% (95% CI 61 to 80), a specificity of 95% (95% CI 91 to 97), and a positive predictive value of 84% (95% CI 74 to 91).

“We were very impressed with nailfold capillaroscopy’s utility in negative prediction,” Buch said in an interview with MedPage Today. “The most valuable result here is the low likelihood of scleroderma in patients with Raynaud’s phenomenon who do not have any scleroderma-specific features on nailfold capillaroscopy. In practice, this means we can more confidently reassure such a patient and discharge care back to the patient’s general practitioner.”

The researchers noted that to the best of their knowledge, this is the first study to demonstrate that the absence of any SSc pattern on nailfold capillaroscopy maintains its known negative predictive value, including for patients with secondary Raynaud’s phenomenon, who are considered at increased risk of SSc. “This study is only one of two to include a large unselected cohort of patients with Raynaud’s phenomenon — mirroring clinical practice in which rheumatology departments frequently receive referrals of patients with Raynaud’s from GPs,” Buch said.

Primary Raynaud’s phenomenon is associated with normal microcirculation architecture, whereas microangiopathies are associated with secondary Raynaud’s, she explained. The SSc nailfold capillaroscopy pattern correlates with disease duration and severity, and also predicts future vascular and visceral organ damage. Nailfold capillaroscopy also detects vascular problems in glaucoma.

Although an SSc nailfold capillaroscopy pattern is sometimes present in other connective tissue diseases, “nailfold capillaroscopy could be performed to provide reassurance to the rheumatologist in the assessment of both [primary and secondary] Raynaud’s phenomenon,” the researchers wrote.

Buch and colleagues studied 347 patients referred for nailfold capillaroscopy to a tertiary-care center from January 2009 to October 2013. The mean age of the cohort was 47 years and 83% were female. Clinical review showed that 54 patients (16%) did not have true Raynaud’s phenomenon, 69 (20%) had primary Raynaud’s, 172 (50%) had secondary Raynaud’s, and 52 (15%) had SSc.

At referral, 46 patients (89%) met either VEDOSS or the 2013 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria for SSc. Of the patients with secondary Raynaud’s, 71 (41%) were being managed for connective tissue disease or inflammatory arthritis, while 101 (59%) had an antibody and/or a red-flag feature for SSc.

A nailfold capillaroscopy pattern for SSc was detected in 80 patients (23%) — 43 with early, 31 with active, and six with late-pattern vasculopathy. This pattern was observed in 37 patients (71%) diagnosed with SSc, 30 (17%) with secondary Raynaud’s, nine (13%) with primary Raynaud’s, and four (7%) without Raynaud’s.

Considering only those patients with non-SSc connective tissue disease or inflammatory arthritis, 16 of 71 patients (23%) had an SSc pattern. This was detected in two of five patients with SLE, eight of 42 with undifferentiated connective tissue disease, four of six with mixed connective tissue disease, one of three with Sjogren’s syndrome, and one of 14 with inflammatory arthritis.

Interestingly, the team said, participants meeting ACR/EULAR criteria were more likely to have an SSc nailfold capillaroscopy pattern than those meeting the VEDOSS criteria were: 84% versus 42%, respectively. “This may be related to the earlier stage of disease in those meeting VEDOSS with less time for detectable vasculopathic changes at the nailfold to develop,” the researchers wrote. “These findings are important as the earlier detection and management of SSc may lead to reduced morbidity and earlier detection of its complications.”

Among the study limitations were the lack of formal measurements to determine enlarged capillaries and the use of two different nailfold capillaroscopy methods, which might have introduced bias. As in clinical practice, the examiners were not blinded to the clinical diagnosis, possibly introducing investigator bias. In addition, the retrospective analysis may have missed important data, particularly the presence of telangiectasia.

The authors cited the need for larger, more defined prospective studies of a heterogeneous group of Raynaud’s patients. Buch noted that the current study is part of a larger Leeds program to identify biomarkers for accurately identifying patients at risk for scleroderma or those with scleroderma at risk for poorer outcomes.

microcirculation test

microcirculation test Findings in Diabetic Patients (A Pilot Cross-Sectional Study)

microcirculation test Findings in Diabetic Patients (A Pilot Cross-Sectional Study)

Background: Microcirculation is affected in diabetes mellitus and Microvascular abnormalities cause persistent diabetic complications. The aim of this study was nailfold capillaroscopic assessment to describe the pathological changes (morphological and structural) in capillary of a large series of patients with type 1 and 2 diabetes. Methods: A cross-sectional study was carried out in a microcirculation test Center (Tehran-Iran) between 2011 and 2014. The study included 235 types 1, 2 diabetic patients. All patients underwent 10 nailfolds capillaroscopy examinations. Microvascular architecture, disturbances capillary distribution, capillary morphology, capillary density, efferent/afferent limb ratio, subpapillary venular plexus, and morphological abnormalities were evaluated. Conclusions were stated as normalor scleroderma pattern. Results of patients’ capillaroscopic images were recorded and analyzed quantitatively and qualitatively. P value < 0.05 was considered as statistical significance. Results: of all participants with mean age 59.91 ± 12.39, 183 cases (77.9%) were female and 52 (22.1%) were male. Tortuosity of capillaries was more often observed in our subjects (235 cases) followed by angiogenesis (171 cases). Normal and early scleroderma patterns were observed in 195 (83.0%) and 40 cases (17.0%). Based on P values, altered micro vascular architecture, capillary distribution and capillary morphology were more frequent in patients with scleroderma pattern in comparison to patients with normal pattern (P value < 0.05). Morphological abnormalities except from neo formation capillary and mega capillary were also significantly more common in patients with scleroderma pattern than patients in counterpart group (P value < 0.05). Conclusion: Nailfold capillaroscopy as a non-invasive, diagnostic and prognostic method may potentially affect on diabetes outcome and control.

microcirculation test

What is microcirculation test?

What is microcirculation test?

Light design, View clear, Easy operation
DMX-980-1 Microcirculation Microscope Set (with aluminum case and accessories) • Total weight: 2.6 kg.
Shipping Carton Size: 360x140x300mm • Total: 2.9 kgs
DMX-980-1 Microcirculation Microscope (one year warranty)
• Magnification: 320 times (about 5-7 lines left to right of the screen)
• Power: 12VDC ± 1V / 250mA Input
• Operating temperature: -20 ° C to 50 ° C
Video output: composite video signal output
• TV system: NTSC
Focusing system: with micro-focus button, image analysis
• Light source: LED group light source, long service life (LED light source group lifetime warranty)
Coaxial power cable and signal cable with 12VDC Input and Output
• Video output: TFT LCD screen, TV screen output
• Body weight: 600g (body size: 109x100x163mm)

8 “LCD color high resolution screen
Resolution: 800 * 600 RGB
• left and right degrees of view: 70-70 degrees
• Up-down viewing: 65-65 degrees
• Voltage: 9-15VDC
Working temperature: -20 ~ +70
• Weight: 640g
• Size: 220x175x70mm
International voltage transformers
• Enter: 100-240VAC
Output: 12VDC 1.5A
• DC plug size: diameter 5.5mm, diameter 2.1mm
• Weight: 120g
Baby bottle
• Capacity: 50cc
Aluminum case
• Weight: 1200g
• Size: 335x270x125mm

DMX Microcirculator standard accessories are as follows:
1.100 ~ 240V Transformer (International Transformer)
2. Baby bottle
3. Carrying aluminum case (portable or shoulder-type)
4. Microscope mainframe
5.8-inch screen
6. Signal transmission line
7. Microcirculation map interpretation page
8. Chinese and English operating instructions
9. Microcirculation Knowledge Profile

microcirculation test

microcirculation test for Diagnosis of Secondary Raynaud

microcirculation test for Diagnosis of Secondary Raynaud

Nailfold capillaroscopy can determine whether or not Raynaud’s is secondary to an illness such as scleroderma. Raynaud’s is often the first symptom of scleroderma, and may precede the onset of Scleroderma and other scleroderma symptoms by years or by months.

Only 5% to 20% of people with Raynaud’s phenomenon subsequently develop scleroderma, but about 90% of scleroderma patients experience this extreme cold sensitivity with red/blue flashes in their hands and feet as a primary manifestation of their disease. What Causes Raynaud’s? National Heart Lung and Blood Institute. NIH.
Low Risk for Developing Systemic Sclerosis

Some people with positive ANA and Raynaud’s never go on to develop a defined connective tissue disease (CTD).

A 2006 study presented at the American College of Rheumatology meeting showed that there is a subset of patients with positive ANA and Raynaud’s who never go on to develop systemic scleroderma.
High Risk Factors for Systemic Sclerosis

Raynaud’s + SSc Antibodies + Abnormal Nailfold = 60x Higher Risk of Systemic Sclerosis

Difficulties in diagnosis of systemic sclerosis-related interstitial lung disease (SSc-ILD). The diagnosis of SSc-ILD could maybe be made sooner if a capillaroscopy was performed earlier, according to the current criteria of early SSc. PMC, Respirol Case Rep, 2015 Sep; 3(3): 99–101.
microcirculation test and Other Diseases

microcirculation test and Other Diseases. Capillaroscopy can also be useful for the diagnosis of secondary Raynaud’s due to diseases other than scleroderma, including glaucoma, graft vs. host disease, rheumatoid arthritis, and vascular diseases.
Research on Nailfold Patterns in Systemic Sclerosis

Nailfold capillary abnormalities in erectile dysfunction (ED) of systemic sclerosis (SSc). Neither the presence or absence of abnormal capillaroscopy findings nor the subdivision into early, active and late patterns is associated with coexistent ED in SSc. PubMed,Rheumatology. (Also see Erectile Dysfunction and Scleroderma)

Nailfold capillaroscopy (NFC) abnormalities as predictors of mortality in patients with systemic sclerosis (SSc). Avascular scores higher than 1.5 at NFC was an independent predictor of death in SSc, suggesting that NFC can be useful for predicting SSc outcome. PubMed, Clin Exp Rheumatol.

microcirculation test

What is microcirculation test?

What is microcirculation test?

Technical parameters

1.magnification over 400 times

2. built-in camera380 000 pixels

3. light source LED

4.brightness of the light source over 600cd/m2

5. Stage X-Y double layer compound mechanical stage

6. Color LCD monitor 8.5inch (4:3) Color LCD monitor 7 inch (16:9)

7.AC input 100-240V50/60Hz DC output DC12V,2A

8. Package aluminum box (Size 40x29x36cm)

9. Gross weight 6.8kg

Testing conditions

1) Check the room temperature and humidity. Room temperature and humidity

should be kept relatively constant. room temperature should be maintained in the 22-24 degree , relative humidity about 70%

2) the patient generally take seats, keep the height of the hand the same with heart

3) Preparation of paraffin oil or cedar oil.Drop 2 drops in the nailfold skin. (Purpose prove light

transmission, and reduce skin scattering)

4)Testing generally be in the morning or afternoon, and review should at the same time every day .

5) the patient should

a.Avoiding intense activity or manual labor within one hour before testing

b. Take a rest about 15-30 minutes before testing

c.Can not take any drug which will affect the cardiovascular vessels before testing

d. Does not smoke , wash hands or eat within an hour before testing

e.Pay attention to the influence of the Female menstrual

microcirculation test

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